October 2012

Esther manages commodity supplies with meticulous record keeping {Photo credit: Y. Otieno/MSH.}Photo credit: Y. Otieno/MSH.

This is the advice that Esther Wahome, a registered community health nurse in a Kenyan health facility, gives to her clients when they come to the tuberculosis (TB) clinic. Within a short time, Esther dispenses the drugs to the patient, provides health care advice and updates her records.

Esther’s TB clinic clients are usually referred to Kayole II sub-district hospital from Toto Bora and other smaller health care centers. Kayole II, located on the outskirts of Nairobi, provides free health services and receives nearly 300 outpatients each day.

During a routine supervisory visit conducted by the USAID-funded, MSH-led, Health Commodities and Services Management (HCSM) Program, Esther, a mother of two, spoke about her work at the Kayole II TB Clinic, which she has been running for the last three months.

“I like serving in the TB clinic because I get to see patients who are weak regain their strength. Sometimes the patients come in when they are so weak and close to skin and bones that at times I wonder where to inject them. Seeing patients thrive fulfills me and is my joy,” says a smiling Esther.

"Makasi" after two months of TB treatment. {Photo credit: A. Massimba/MSH.}Photo credit: A. Massimba/MSH.

Seven-year-old Makasi, an HIV-positive orphan in Tanzania, was diagnosed with advanced tuberculosis (TB) and started on curative treatment. Clinicians at a local health center used standardized TB guidelines to overcome the difficulty of identifying TB in children co-infected with other diseases. In Afghanistan, sixteen-year-old Hamida provides for her family while trying to complete school. Hamida was visited by a community health worker, who identified her TB symptoms, and helped her access appropriate diagnosis and treatment.

Steady Progress Against Daunting Challenges

Tuberculosis mortality has fallen by a third since 1990. Yet TB is still the second leading cause of death from infectious disease worldwide. The vast majority of new cases (8.8 million in 2010) and deaths (1.1 million in 2010) occur in poorer countries. TB’s effects are often most devastating among people in fragile circumstances. Poverty and conflict push people into crowded, unsanitary conditions without appropriate nutrition and health care.

Even more, TB is fast spreading, easy to misdiagnose, often co-morbid with other diseases, and, increasingly, highly drug-resistant.

Devex interviews MSH President & CEO Dr. Jonathan D. Quick at the Clinton Global Initiative 2012. {Photo credit: Devex.}Photo credit: Devex.

Devex interviews MSH President & CEO Dr. Jonathan D. Quick at the 2012 Clinton Global Initiative (CGI) Annual Meeting.

"The last decade has been a stunning decade for global health. If you look at what's been achieved in AIDS, TB, malaria, --- less so in family planning, but still progress --- it's been an amazing decade," says MSH President & CEO Dr. Jonathan D. Quick in an interview with Devex.

Luke and volunteers construct a new house. {Photo credit: L. Ross/MSH.}Photo credit: L. Ross/MSH.

In January 2011, Amelia and her partner, Luke --- both HIV positive --- began accessing HIV care and support services at the Agape Network through its community home and palliative care program.

Agape Network is one of the NGOs that receives technical support from the PEPFAR-funded, USAID-implemented, Guyana HIV/AIDS Reduction and Prevention Project (GHARP II), led by MSH.

When the Agape staff first met Luke and Amelia, they were living with their two daughters at Luke’s family’s home. The situation was tense because Luke’s relatives did not approve of his relationship with Amelia.

Finally, in December 2011, the tension escalated and Luke, Amelia, and their family were thrown out of the house.

International Day of the Girl: End Child MarriageInternational Day of the Girl: End Child Marriage

My grandmother married at 8 years old; my mother married at age 15.

I often wonder what their lives --- their potential --- would have been, if they were not child brides.

Today, the same pattern is repeated in villages and cities around the world. Every year, nearly ten million girls are forced into marriage before they reach the age of 18 --- with little or no say in the matter.

That’s more than 25,000 girls a day; 19 girls each minute.

These girls are denied the opportunity to fulfill their potential for healthy and productive lives. When they enter marriage, most drop out of school and enter a world where they work from dusk to dawn to provide labor to the households. From their mothers' care they are transferred to the supervision of their husbands and mothers-in-law, who view them as an additional labor source. Pressured to demonstrate their fertility, they get pregnant when they are still children and face the risk of illness or death when they deliver.

And some child brides are as young as eight or nine.

Global Handwashing Day. {Image credit: MSH.}Image credit: MSH.

Today, October 15, children, schools, and communities around the world mark Global Handwashing Day.

Washing hands with soap is the "most effective and inexpensive way to prevent diarrheal and acute respiratory infections, which take the lives of millions of children in developing countries every year." In addition to handwashing with soap, proper sanitation and safe drinking water are key to preventing disease.

"Most of what we need to do to bring down the rate of child deaths is inexpensive & straightforward," USAID Administrator Raj Shah said today on Twitter. In addition to handwashing with soap, "add a bednet, vaccines, nutrition, rehydration, newborn care; we know how to drastically reduce child deaths."

Moen Kas, Afghanistan {Photo credit: Noorgha CLTS Supervisor.}Photo credit: Noorgha CLTS Supervisor.

Moen Kas, a hilly remote Afghan village absent of latrines or even a functioning water well, became an Open Defecation-Free (ODF) community within 24 days of arduous commitment from its leaders and people.

Moen Kas’ remarkable milestone makes it the first village in Afghanistan to reach ODF status in less than one month--inspired entirely from personal stories that are spreading across the country regarding the benefits of living in ODF communities.

The quick transformation was the direct result of a man from Moen Kas who had attended an ODF certification ceremony in the nearby, yet secluded, village of Ghalani.

As he watched the ceremony and learned of ODF’s benefits, he asked to speak on behalf of his village. During his speech, he praised Ghalani’s achievements within the past two months and publicly vowed that his own village would achieve ODF status in under a month.

Recognizing that this ambitious goal could not be achieved through him alone, he urged the other Moen Kas’ villagers who were also present at the ceremony to stand with him and work together.

So determined was the man in his vision to transform his village, that he invited the audience to visit Moen Kas in one week to verify it as an ODF community.

Seven-year-old Ladi Muhammed. Nigeria. {Photo credit: S. J. Garlora / MSH.}Photo credit: S. J. Garlora / MSH.

Seven-year-old Ladi Muhammed wants to become a teacher. The third of five children ranging 3 to 20 years old, Ladi and her family live in a poor Nigerian village.

The likelihood of Ladi attending primary school is low.

Public primary education is free in Nigeria, but Ladi’s parents can barely afford to feed their children. The children supplement their parents’ income with menial jobs, such as street trading, which leaves little time or energy for schooling.

Her father, Ahmadu Mohammed, wants to send all of his children to school, but does not have the financial means to do so. “It is my heartfelt desire to send my children to school, but I can’t support them due to the meager salary I earn from my work as a gateman. Our situation is tough; we can barely feed ourselves,” says Mohammed.

Without an education, Ladi’s desire to one day become a teacher appeared a distant dream.

A woman receiving antenatal care in South Sudan. {Photo credit: J. Warren/Save the Children.}Photo credit: J. Warren/Save the Children.

On a dark August night in rural South Sudan, Linda Kenneth felt the swift kick of labor pains begin. Having previously delivered five children, Linda recognized the pains and immediately called for the nearby skilled birth attendant, as it was too late in the evening for her to travel safely to the health facility. In her previous two pregnancies, she had experienced heavy bleeding after delivering, and worried similar complications might arise this time.

South Sudan has the world’s worst maternal mortality ratio (2,054 deaths per 100,000 live births), and roughly one third of these deaths can be attributed to postpartum hemorrhage (PPH). Administration of misoprostol or another uterotonic (a drug that reduces bleeding after childbirth) could prevent the majority of these deaths. Misoprostol does not require a cold supply chain, and is cheap and effective, making it a perfect candidate for community-based interventions.

Upon the birth attendant’s arrival, Linda presented the three misoprostol pills she had recently been given by a home health promoter. Several days prior, a home health promoter had visited Linda and discussed with her a birth preparedness plan, informing her of the benefits of taking misoprostol immediately after delivery to prevent excessive bleeding.

Dr. Jonathan D. Quick of MSH at Washington Post Live's forum on noncommunicable diseases. {Photo credit: Jeff Martin / for the Washington Post.}Photo credit: Jeff Martin / for the Washington Post.

The Washington Post Live panel on October 17 featured high-level noncommunicable diseases (NCDs) experts from around the world discussing how to tackle the global epidemic of NCDs.

We've compiled key moments from the panelists in a "Storify" story, told through tweets.

The panel featured some twenty high-level chronic diseases experts from around the world discussing how to tackle the global epidemic of noncommunicable diseases (NCDs).

http://storify.com/MSHHealthImpact/washington-post-live-high-level-panel...

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