Africa

 {Photo credit: <a href="http://www.kwibuka.rw/">Kwibuka 20</a>}The #Kwibuka20 Flame of Remembrance burning bright at the Kigali Genocide Memorial Centre, Rwanda.Photo credit: Kwibuka 20

Twenty years ago, the genocide perpetrated against the Tutsi began in Rwanda. Nearly a million people were slaughtered from April through July, 1994.

In 2003, the UN General Assembly designated April 7 as International Day of Reflection on the 1994 Genocide in Rwanda. This year, to mark the 20th anniversary, the Republic of Rwanda launched Kwibuka20 (“Remember20”), a series of events commemorating the tragedy and honoring the nearly one million Rwandans who lost their lives.

The theme of Kwibuka20, “Remember, Unite, Renew”, also celebrates the remarkable story of resilience and hope of the Rwandan people, who are building a new, prosperous, and cohesive society. Kwibuka20 calls on the global community to stand together against genocide in three key ways:

 {Photo credit: MSH}(From left) Hiwot Emishaw (Health for All Campaign); Dr. Femi Thomas (National Health Insurance Scheme); Prof. Khama Rogo (Health in African Initiative, International Finance Corporation in Nigeria); Hon. Minister of Health, Prof. C.O. Onyebuchi; Amb. Bala Sanni (Federal Ministry of Health); Nuhu M. Zabagyi (NHIS Board Chairman); Marie Francoise Marie Nelly (World Bank Country Representative); Pieter Walhof (PharmAccess Foundation); Abuja, March 9, 2014.Photo credit: MSH

In Nigeria, the Health for All: Campaign for Universal Health Coverage in Africa is effectively collaborating with stakeholders to support the government move toward universal health coverage (UHC).  Led by MSH and funded by The Rockefeller Foundation, the Health for All Campaign co-hosted a National Stakeholders Meeting on UHC in conjunction with the National Health Insurance Scheme (NHIS), International Finance Corporation (IFC) and PharmAccess Foundation on March 9, 2014. The prior day, March 8, the campaign hosted a media forum on “Effective coverage of progress towards universal health coverage in Nigeria.”

 {Photo credit: Warren Zelman.}Health worker in the Democratic Republic of the Congo.Photo credit: Warren Zelman.

Documenting and sharing the perspectives of women leaders is an effective way of amplifying the collective voices of women to bring about change. Women often do not have a platform to tell their stories. These stories are personal and resonate with those of other women who aspire to leadership positions. The Leadership, Management & Governance (LMG) Project has captured some of these stories in our newest publication, "An Open Mind and a Hard Back: Conversations with African Women Leaders." 

This publication seeks to provide insights on ways women lead and govern, and the qualities and characteristics they have as leaders. It is a summary of interviews conducted with over a dozen women leaders working across the fields of government, health, law, and social reform in Burkina Faso, Democratic Republic of Congo, Liberia, Mauritius, Nigeria, Rwanda, Senegal, Seychelles, Sierra Leone, Swaziland, Uganda, and Zambia. The interviews took place from January to March 2013.

{Photo credit: Todd Shapera in Rwanda.}Photo credit: Todd Shapera in Rwanda.

Addressing NCDs is critical for global public health, but it will also be good for the economy; for the environment; for the global public good in the broadest sense… If we come together to tackle NCDs, we can do more than heal individuals–we can safeguard our very future.

- UN Secretary General Ban Ki-Moon in his remarks to the UN General Assembly in 2011

Management Sciences for Health (MSH) and the LIVESTRONG Foundation (LIVESTRONG) are proud to sponsor a Congressional staff study tour to Uganda and Rwanda examining the key elements of the countries' health systems with a particular focus on how the countries are addressing non-communicable diseases (NCDs), also known as chronic diseases.

Strong health systems are the most sustainable way of improving health and saving lives at large scale. For a health system to address the needs of its people it must:

 {Photo credit: MSH} (Left to right) Geoffrey Ratemo of Rutgers University; Senator Godliver Omondi, chair of United Disabled Persons of Kenya (UDPK); Dr. Abdi Dabar Maalim of the Transition Authority; Ndung’u Njoroge of the Transition Authority; and Evanson Minjire of Vision 2030 Secretariat at the first "Health for All" technical working group meeting in Kenya.Photo credit: MSH

The Health for All: Campaign for Universal Health Coverage is working to ensure that challenges that hinder access to quality health care in Kenya are addressed. The campaign aims to ensure that governments and stakeholders in health services delivery prioritize strengthening infrastructure, human resource for health, and health care financing to improve service delivery.

The campaign will official launch on April 28, 2014 with the theme, "Health systems strengthening for universal health coverage".

In preparation for this launch, the campaign team has recruited a Technical Working Group to spearhead the campaign. At the first meeting on January 21, 2014, the team identified the health systems strengthening theme and three sub themes for the campaign: strengthening infrastructure, human resource for health, and health care financing.

[Campaign partners at the messaging workshop in Kenya.] {Photo credit: MSH}Campaign partners at the messaging workshop in Kenya.Photo credit: MSH

{Photo credit: C. Urdaneta/MSH, South Africa.}Photo credit: C. Urdaneta/MSH, South Africa.

Cross-posted from Southern Africa HIV and AIDS Regional Exchange (SHARE).

As I sat through the official opening at the 6th South African AIDS Conference (SAAIDS), I found myself wondering what the focus of the first conference post 2015 will be. Will there be a national conference after the countries are supposed to have achieved the Millennium Development Goals?

"We have fought a good fight. At last the glass is half full," declared Professor Koleka Mlisana, the conference chair, the first of many plenary speakers to outline the successes achieved in the national AIDS response. The figures from South Africa certainly are encouraging:

{Photo credit: MSH staff}Photo credit: MSH staff

Cross-posted with permission from UHC Forward.

I walked into a pediatric unit of a teaching hospital in Nigeria a few years ago to review a patient. On the first bed was a lifeless child. He was brought in dead a few minutes earlier by his parents. His mother, "Bisi", wept uncontrollably. While in tears, she recounted how difficult it was for them to borrow money to get to the hospital. Although they got some money from a chief in the community, the two-year-old baby died before they got to the hospital.

Kunle’s story touched me deeply. Kunle’s case typifies the plight of many poor people in Nigeria and the rest of sub-Saharan Africa: The financial burden of illness makes many families poorer. People are afraid to go to hospitals because they may not be able to afford the cost of the health services they need. They prefer to buy drugs over the counter, or visit a local herbalist, who will charge little or nothing to provide poor health service.

{Photo credit: MSH/Johanna Theunissen}Photo credit: MSH/Johanna Theunissen

Cross-posted with permission from the Southern Africa HIV and AIDS Regional Exchange (SHARE).

I used to smile at the sentimental nickname for Lesotho, “The Mountain Kingdom.” Following a few visits to the capital Maseru, I had the opportunity to travel to the district of Mokhotlong, in the east of the country. Here I discovered that this term is more literal than symbolic, and no laughing matter. Narrow gravel roads with incredible switchback turns had me engaging in lively discussion in the car to avoid thinking about how close I was to the edge. More important than experiencing the rugged beauty of the physical landscape, it was on this trip that I began to discover and appreciate the grace and resilience of Lesotho’s people. A subsequent trip to Mohale’s Hoek, a district south of Maseru (further explained below) reinforced my growing admiration.

World Malaria Day 2013 {Photo credit: UNHCR/S. Hoibak.}Photo credit: UNHCR/S. Hoibak.

To me, malaria is a very personal disease.

I first came face to face with malaria during the war of my time: Vietnam. I was plucked out of residency after my first year, with only an internship under my belt, and sent as a Navy Medical Officer to war. Medical school and residency prepared me well for much of the trauma I encountered medically, but I was totally unprepared for the large-scale emotional trauma, and for the tropical diseases I had encountered only in books.

I was overwhelmed by the young children with malaria, some of whom literally died in my arms while treating them.  Yet, I also witnessed bona fide miracles: children at death’s door, comatose and unresponsive, who responded dramatically to treatments, and ultimately went home to their families.

To address malaria, I focused on promoting prevention (long-lasting insecticidal nets [LLINS] for families and intermittent preventive treatment [IPT] for pregnant women), early detection, and early treatment in the community—what is now called community case management.

That was 40 years ago.

 {Photo credit: Stephen Macharia/MSH.}Santo (right) and his father (left) share how Santo was finally diagnosed and treated for TB after being incorrectly treated for malaria for over two months.Photo credit: Stephen Macharia/MSH.

After South Sudan gained independence from Sudan in 2011, disagreements over oil-sharing between the two nations caused fighting and high economic inflation in certain regions. Desperate for security, over 110,000 Sudanese refugees escaped to South Sudan and now reside in camps in Maban County.

Bounj Hospital: Diagnosing and treating residents and refugees

These refugees, and the county’s 40,000 residents, are served by Bounj Hospital, the only TB diagnostic and treatment center in the district. This hospital is currently treating 75 patients for TB, 56 of whom are refugees.

The USAID-funded TB CARE I South Sudan project is helping to build the hospital staff’s capacity in TB treatment and infection control, despite the challenges the health workers face. Led by Management Sciences of Health in partnership with the National TB Program (NTP), the TB CARE I project team has trained over 200 health workers in TB diagnosis and treatment.

TB CARE I also teaches the health workers how to educate their patients about TB infection control and provides the trainees with regular supportive supervision and mentorship.

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