A health worker fills in a child’s immunization booklet during an immunization clinic at Phebe Hospital in central Bong County, Liberia. (Cindy Shiner/MSH)
After losing both her parents to Ebola, Liberian nurse Salome Karwah recovered from the virus herself. Protected by her new immunity, she returned to work to care for countless other victims. Time Magazine recognized her as a 2014 Person of the Year for her compassion and tirelessness. In February of this year, Nurse Karwah was rushed to the hospital with seizures following a cesarean delivery of her son. Her garish symptoms frightened the hospital staff that knew she had survived Ebola. They would not touch her. They let her die without treatment.
That is what stigma looks like.
Even after being declared free of Ebola, many survivors found themselves alone, as the International Federation of Red Cross and Red Crescent Societies reported. A chilling new normal replaced the terror and death in the isolation wards: rejection by family, friends, and neighbors, even by their places of worship. Employers fired them. Customers abandoned them. There was no carrying on with the lives they knew before Ebola. There was only more loss.
Pregnancy and childbirth are times of unparalleled change and hope for the future. But for many women, the arrival of a new baby is also a challenging time — one that can be overshadowed by depression.
The World Health Organization (WHO) estimates that more than 1 in 10 women suffer from postnatal depression, a devastating statistic that too often receives no attention. In African countries and contexts where women are exposed to poverty, persistent poor health, migration, conflict, gender-based violence, extreme stress, and unwanted pregnancy, the estimates are even higher, with up to 25 percent of women experiencing clinical depression after childbirth.
The effects of depression on social and economic wellbeing and on families are enormous, as the risks and consequences go well beyond an individual woman. Depression in pregnancy is linked to preterm birth and low birth weight, which increases the risk of complications such as undernutrition and heart disease. Women who suffer from postpartum depression are often stigmatized and less likely to benefit from postnatal and preventive health care for themselves and their children. Partners and families may have difficulty understanding why a new mother who should be happy at the birth of a healthy baby is depressed.
A community health volunteer explains the use of pregnancy tests to a client.
This World Health Worker Week (April 2-8), we honor the health workers around the world who work every day to improve health in their communities. This photo essay illustrates the important role that community health volunteers play in strengthening Madagascar's health system.
Community health volunteers (CHVs) play a critical role in providing primary health care services in Madagascar, especially for rural populations who live far from health facilities. In many areas of the country, CHVs often collectively offer services to more people than health centers do. CHVs are important extensions of the Malagasy health system, particularly for women and children.
As of 2016, the USAID Mikolo Project, led by MSH and funded by USAID, supported nearly 7,000 CHVs across 506 communes. They fill a critical gap in human resources for health in support of the Ministry of Public Health’s efforts to improve health care in the country.
The Global Health Security Agenda (GHSA), launched in 2014 by the U.S. and other countries, is dedicated to strengthening the capacities of countries to prevent, detect, and respond to infectious disease threats. The GHSA aims to protect the poorest countries and most neglected populations and works to ensure health security benefits. The GHSA assumes a multi-sectoral, holistic approach to health security and preventing infectious disease.
It will take time for the GHSA to completely achieve its goals. To do so, the global community must make a sustained effort to prevent, detect, and respond to future infectious disease threats and outbreaks, no matter where they occur. We, the global community, can do this in several ways.
First, it is important to maintain the international momentum and engagement around health security as a priority focus area. The GHSA was constructed to encourage leadership from membership countries. Countries such as Finland, Indonesia, Kenya, the United Kingdom, The Netherlands, and others have demonstrated strong leadership and strategic vision. This drive continues under the Chair of South Korea for the 2017 term.
Tuberculosis (TB) kills more people each year than any other infectious disease. It severely strains health systems and local, regional, and national economies. And, like many health crises, the disease disproportionately affects vulnerable populations. Many families incur catastrophic costs, aggravating poverty in communities.
This World TB Day, we reflect on the progress we've made and the challenges we still face in the fight to end TB. The key moving forward is to work together to ensure we don't leave anyone behind.
VIDEO: Working to End TB in Uganda
“We have the medicines that actually cure tuberculosis,” said Raymond Byaruhanga, project director for the USAID-funded, MSH-led TRACK TB project in Uganda. “So the question is why? Why [do we still see] TB today, and why isn’t it being treated?”
In 2015, TB caused 1.8 million deaths around the world, and another 10 million people fell ill from the disease, according to the World Health Organization (WHO). Women and children are particularly vulnerable. TB causes between 6 and 15 percent of all maternal deaths, and childhood TB is too often not detected, diagnosed, or treated.
Throughout global societies, women’s roles place them at the epicenter of risk from disease outbreaks and epidemics. This is true everywhere, but especially so in poor countries with health systems unprepared to meet the ever-surging demands of a public health emergency.
The interaction between gender roles, disease transmission, and socio-economic stability reach a perilous tipping point in epidemics; failing to address that interaction will result in deficient strategies for outbreak prevention and control, and in massive setbacks for women’s health, and development gains. Unless global health security measures help us understand the impact of emerging diseases on women, nations and the world will remain vulnerable to pandemics.
"The Lucky Specials" cast members attend the US premiere in Silver Spring, MD.Photo credit: Discovery Learning Alliance
As the global health community prepares to observe World TB Day on March 24, Discovery Learning Alliance, the nonprofit subsidiary of Discovery Communications, opened “The Lucky Specials” in the U.S., a feature-length film about a small-time band in a dusty town in southern Africa with an important message about health.
Mandla (Oros Mampofu) is a miner by day and plays lead guitar for The Lucky Specials by night. He dreams of making it big in the music industry, but when tragedy strikes, the band, Mandla, and their friend Nkanyiso (Sivenathi Mabuya) struggle to hold everything together.
Woven into the narrative are messages to help audiences understand and respond to one of the world’s biggest killers, tuberculosis, which killed almost two million people worldwide in 2015. That is more people than died from AIDS that year. With a unique fusion of live-action drama and state-of-the-art animation, “The Lucky Specials” reveals the unseen world of TB from the inside out.
MSH will host and support events in five countries this week to honor World TB Day.
Observed March 24, World TB Day raises awareness and mobilizes support for efforts around the world working to end tuberculosis (TB). The World Health Organization (WHO) has designated this year’s theme as “Unite to End TB: Leave No One Behind,” and many of the day’s activities will focus on addressing stigma, discrimination, and marginalization.
MSH has been a leader in strengthening health systems to fight against TB since 1999 and is working with partners in 22 countries to prevent the spread of the disease and improve the lives of those affected by it.
In Afghanistan, the Challenge TB project — funded by USAID — will lead 20 awareness events in five cities and will deliver messaging about TB in schools and health facilities. The project will also lead conferences in three provinces, focusing on successful interventions like Urban Directly Observed Treatment and the TB Information System.
The Challenge TB project will also lead World TB Day activities in 11 districts in Bangladesh, ranging from orientations and discussions with workers, to programs at schools, to rallies, to a “sputum collection camp” at an outreach center.
Women in Malawi are increasingly engaging in sustainable ways to grow household income and end poverty, such as village savings and loans groups. (Photo Credit: Feed the Children / Amos Gumulira)
Follow the conversation at the Commission on the Status of Women: #CSW61
As we prepare to join the Commission on the Status of Women (CSW) next week, where the focus will be on women’s economic empowerment in the changing world of work, I am reminded of my visit to Malawi last month.
Putting a child on the earth is a whole different type of work. Not everyone can guide a woman and her baby safely through pregnancy and childbirth.
I know what it means to keep women and babies alive and healthy because I am a midwife.
As a young girl in Mali, I passed the village dispensary on my way to school every day. I felt sorry for the people lined up outside waiting for treatment for their illnesses. I always told myself that one day I would wear the white coat of health workers and help those who are sick. During my health education training, I studied midwifery because I wanted to educate, advise and assist women before, during, and after pregnancy.
Although I stopped practicing midwifery in maternity wards, I apply my professional passion to my work with MSH. No matter where I am or what project I’m working on, I speak with midwives, visit community health centers, and counsel pregnant women about their health and about that of their children whenever I can. When I visit communities, I encourage women to go to their local clinics for prenatal exams and to breastfeed and vaccinate their babies.