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HOPE works in more than 35 countires worldwide. Please enjoy our blog as we document the successes and challenges of our work to provide Health Opportunities for People Everywhere.

World Health Day: Treating Dengue Fever in the DR

on April 7, 2014

Labels: Dominican Republic , Women’s and Children’s Health, Alumni, Volunteers

Dr. April Edwards with a patient and her mother at the Monte Plata women's and children's health clinic

Today is World Health Day.  This year the WorldHealth Organization is calling attention to the increasing threat of vector-borne diseases.  Through its campaign, “Small Bite, Big Threat,” the organization says that many vector-borne illnesses like Dengue Fever have re-emerged or spread to new parts of the world over the past 20 years.   Dengue Fever, a severe, flu-like illness caused by mosquito bites, is now found in more than 100 countries and puts more than 2.5 billion people at risk.

Our Dr. Charles A. Sanders International Residency Scholarship program gives resident physicians from the state of North Carolina the opportunity to learn and practice medicine at Project HOPE program sites in the developing world.  One of our 2013 Sanders Scholarship recipients, Dr. April Edwards, recently returned from the Dominican Republic, where she had spent one month practicing medicine at Project HOPE’s women’s and children’s health clinics in Santo Domingo and Monte Plata.  Dr. Edwards had this to say about treating Dengue in the Dominican Republic and how the Project HOPE-affiliated clinics are helping.

“As I worked with the doctors in Monte Plata, I realized that though many things are very similar across disciplines in different countries, some things are very region dependent.  The prime example of this is probably infections.  Where I come from, bugs I worry about on an almost daily basis include MRSA/ORSA (methicillin/oxacillin resistant Staphylococcus aureus) and C. Diff (Clostridium dificile). (Those two bugs largely exist as a result of widespread use of antibiotics.)  As I quickly learned from my supervisors, here in the DR, among the top concerns are Dengue and Cholera.  I became better versed in how to recognize them, particularly Dengue, a mosquito-borne illness that causes fevers, low blood counts and can be fatal if not recognized and treated appropriately.

Dr. April Edwards with a young patient at the Monte Plata clinic, Dominican Republic

After spending a good deal of time in Monte Plata, I had the opportunity to go to a general hospital in a relatively poor area called Barahona.  I accompanied Dr. Manzueta, one of the pediatricians with whom I had been working in Monte Plata.  I was able to go on rounds with Dr. Manzueta and the pediatric residents there.  The first place we went that morning was a whole wing full of pediatric patients with Dengue Fever in various stages.  As I had never previously seen anyone with Dengue, I began furiously scribbling down notes and watching closely as the other physicians examined the patients and taught at the bedside.  One afternoon, I also worked with Dr. Manzueta as we did what are referred to a “consults,” which are basically miniature clinic visits in the hospital.  The chief complaints generally were much the same as those at the Monte Plata clinic, only suddenly, they were much more pressed for time. 

The hospital visits made me realize how special the Project HOPE clinics are.  In a country where so many of the dangers to the health of children are from very preventable public health threats, it seems that strong patient advocates and education are key.  This is something that all members of the Project HOPE team do exceedingly well.  They are patient and take the time to educate patients and their families.  I will come away from this experience feeling invigorated and having learned a lot about neglected tropical diseases like Dengue and many other health threats that will make me a better physician.”

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Treating TB in Kavango and a Visit with the Wambo Tribes

Posted By Dinesh Pethiyagoda, Richard T. Clark Fellow, Merck & Co. on March 27, 2014

Labels: Namibia , Alumni, Infectious Disease, Volunteers

TB hospital in Kavango region of Namibia

Dinesh Pethiyagoda is an employee of Merck & Co. in Upper Gwynedd, PA in its Global Marketing Communications for diabetes franchise.  As a Richard T. Clark Fellow for World Health, he and Gary Zelko, Merck’s Director and Publisher of the Merck Publishing Group spent three months in the fall of 2013 visiting Project HOPE’s program sites in Africa.  The purpose of their fellowships was to develop new promotional materials for Project HOPE’s work in Africa to aid in attracting new sources of funding for our work in this region.

We left Zambezi early the next morning for the Kavango region of Namibia, which was a 600 km drive and on the border of Angola.  We visited TB wards in a hospital, and it was extremely sad to see patients piled in rooms with beds in very close proximity to one another, some even sleeping on dilapidated beds outside the building.  There were patients who had previously not adhered to treatment and had developed multi-drug-resistant TB and hence were kept in isolation.

It was very moving.  Project HOPE had conducted extensive community outreach programs to educate villagers on TB and had greatly increased rates of diagnosis and treatment.  Many patients were co-infected with HIV and TB, which made them harder to treat.  Over the next three days we visited more TB hospital wards and OVC (orphan & vulnerable children) and VSL (village savings & loan) meetings in remote villages which almost always had to be accessed after significant off-roading.

Treating TB in Namibia

We then proceeded on our next drive to the North Central region of Namibia, which is home to the Wambo tribes.  The people in the villages here were extremely welcoming, as usual, and the traditional greeting was “Wa La Lepo” (Did you sleep well?) to which we would always reply “Yes” in the native language, although this was rarely true for me!  The differences in culture and languages in each of the regions of this country is fascinating.  We visited more TB wards, and it was encouraging to see a donated pool table and some exercise equipment in one of the hospitals to help patients while away the time during their recovery.

The VSL groups which had formed were quite incredible.  The community has good project ideas and clear goals on what they want to do with their saved money, i.e. start a mini market, make and sell baked goods, buy goats, buy school uniforms for children, etc.  This economic strengthening program in areas that need it the most is very impressive and will hopefully lead to a better life for the villagers and their children.

Women of the Wambo tribe, northern Namibia

All villagers we visited were extremely well dressed and very well organized.  They had planned agendas, and those few who spoke English had very neat and impressive handwriting. They were so welcoming and happy, even though they had so little. Their generosity was heartwarming as most of them insisted on providing us with lunch, which consisted of two cooked chickens, maize mill porridge, greens, beans and amarula oil (extracted by an extremely tedious process after picking out small amarula nuts from the fruit and then squeezing them to get the oil).  When we were ready to leave, they would bring lots of gifts.  The gifts ranged from exotic fruits to amarula nuts, and in one instance we were even given a live chicken!  It was very clear how appreciative they were for the work Project HOPE was doing in their communities and were determined to share what little they had - totally selfless behavior.

After 12 days of non-stop travel covering probably close to 2,000 km in Namibia, we took a flight back to Windhoek.  Namibia is a wonderful, safe and diverse country with very interesting cultures, and the people are phenomenal. The next day we were off to Johannesburg, South Africa.

 

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Fellows Visit HOPE Program on Impalila Island, Namibia

Posted By Dinesh Pethiyagoda, Richard T. Clark Fellow, Merck & Co. on March 25, 2014

Labels: Namibia , Women’s and Children’s Health, Infectious Disease, Volunteers

Merck's Richard T. Clark Fellows Gark Zelko and Dinesh Pethiyagoda

Dinesh Pethiyagoda is an employee of Merck & Co. in Upper Gwynedd, PA in its Global Marketing Communications for diabetes franchise.  As a Richard T.Clark Fellow for World Health, he and Gary Zelko, Merck’s Director and Publisher of the Merck Publishing Group spent three months in the fall of 2013 visiting Project HOPE’s program sites in Africa.  The purpose of their fellowships was to develop new promotional materials for Project HOPE’s work in Africa to aid in attracting new sources of funding for our work in this region.  

After much anticipation, the day finally arrived for Gary and me to embark on our assignment with Project HOPE in Africa.  As the plane approached to land in Windhoek, Namibia, it was very apparent that we were in Sub-Saharan Africa, with an aerial view of extremely dry land with some mountains.  I had read that Namibia was experiencing one of the worst droughts in the history of the country.  We got off the plane and were pleasantly surprised to be met by Steve Neri, Project HOPE’s Africa Region Director.  On the way from the airport we saw lots of baboons by the side of the road, and Steve kept blowing his horn to scare them off. 

Gary Zelko travels with Project HOPE Namibia staff on a small boat to Impalila Island, Namibia

The first week was spent at the Project HOPE office in Windhoek acquainting ourselves with the goals of our assignment and meeting with stakeholders. The goal of our project was to enhance Project HOPE Africa’s visibility through developing and implementing a comprehensive communications and marketing strategy in order to secure new donor funding.

The next week we embarked on our journey to the north of the country, flying into Katima Mulilo Airport in the Zambezi province.  Namibia is an extremely large country, bigger than the state of Texas and twice the size of Germany.  It is the second least densely populated country in the world.

Women and children greet Richard T. Clark Fellows on Impalila Island, Namibia

We stayed at a hotel on the Namibia side of the Zambezi River, with Zambia across.  Hippos would emerge every now and then, which was quite spectacular.  The next day we set out in the early morning to visit Project HOPE’s program site on the remote island of Impalila, which is located close to the border with Botswana.

We finally reached our destination by the river bank and took an extremely small boat across.  We docked at Impalila Island.   The greeting was very cordial once we reached the shelter where the Village Savings and Loan (VSL) and Orphans and Vulnerable Children (OVC) groups are located. The ladies were dancing and welcoming us as we said “Musahili Twanye” with the cool African handshake, and then we would clap our hands for respect in a special way and say “Hande”.  The women in the village were all dressed in lovely traditional clothes.

Women and children benefiting from Project HOPE VSL and OVC programs on Impalila Island, Namibia

We conducted our first interviews with the group using a colleague to translate and learned a lot about VSL, OVC and health education programs that Project HOPE has been conducting in this extremely remote village.  The people of Impalila Island also performed a play in their language for us and were so appreciative of the education, support and training Project HOPE had provided for them.

While crossing the river again we saw a herd of elephants in the distance and then our extremely eventful drive back began. As we were on our way it started getting gloomy and dark. There was a tusker elephant that we passed less than 300 feet from the vehicle and in the distance we could see smoke and a huge bush fire which was thought to be manmade in anticipation of rain.    

Elephants are seen as Dinesh Pethiyagoda and Gary Zelko depart Impalila Island, Namibia

Then all of a sudden it started pouring rain with thunder and lightning.  An hour later our driver managed to skid away to a different path and we were back on the move.  Finally three hours later, we were back on a tar road heading back to the hotel.  What an experience.  That’s when I proclaimed Gary and myself as the “Rain Makers.”  As we continued on our trip we ended up being three for three, bringing rain to each of the northern regions we visited – all of which were badly in need of rain.

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Project HOPE Programs in Zambezi Region, Namibia

Posted By Dinesh Pethiyagoda, Richard T. Clark Fellow, Merck & Co. on March 25, 2014

Labels: Namibia , Women’s and Children’s Health, Alumni, Infectious Disease, Volunteers

Dinesh Pethiyagoda and Gary Zelko meet with beneficiaries of Project HOPE programs in the Zambezi region of Namibia

Dinesh Pethiyagoda is an employee of Merck & Co. in Upper Gwynedd, PA in its Global Marketing Communications for diabetes franchise.  As a Richard T. Clark Fellow for World Health, he and Gary Zelko, Merck’s Director and Publisher of the Merck Publishing Group spent three months in the fall of 2013 visiting Project HOPE’s program sites in Africa.  The purpose of their fellowships was to develop new promotional materials for Project HOPE’s work in Africa to aid in attracting new sources of funding for our work in this region.

After traveling to the north of Namibia and visiting remote Impalila Island, close to the border of Botswana, we then spent the next three days visiting more villages in the Zambezi region to observe and document Project HOPE programs.  Throughout our time in the Zambezi region, I was struck by how little most of the people had, yet they were always cheerful and seemed to be genuinely looking out for others in their community.

orphans are fed with food paid for by savings from Project HOPE's village savings and loan program

Education from Project HOPE representatives on hygiene, nutrition, TB, HIV, savings and loans and how to bring up vulnerable children had really helped them improve their lives.  It was now starting to make sense.  Although we had read all of the reports, seeing the work done by this organization in person was extremely impactful.  Project HOPE has the boots on the ground and the infrastructure to reach some of the most needy places in Namibia - some of which may have never before seen a vehicle or foreigners.

Group of beneficiaries of Project HOPE programs in Zambezi region of Namibia

We were included in the village meetings, which almost always took place under a big tree.  Although it was still extremely hot, the shade made for pretty neat conference rooms - so different from Upper Gwynedd, PA.  We captured imagery and conducted interviews from the standardized survey we had developed. It was awesome to be able to use my experience in market research at Merck in the villages to measure the beneficiaries' views.   After having a rather long explanation translated, they grasped the concept of rating.  However, most were so happy with Project HOPE that they would feel bad giving a 10 as the highest score and would instead say “100%.”

One village group had a phenomenal story.  They had used the village savings loan community program to save, and, as they gained interest on their money, they used the funds to open up a soup kitchen to feed orphans in the community. Seeing these children eating lunch and having proper nourishment was extremely touching, which again reinforced to me how lucky most of us are not to have to worry about basic necessities for our families.  Some of the kids had clothes on that had probably not been washed in weeks; the level of poverty was extremely sad.

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Patient Support Groups Instrumental in Battle Against TB

Posted By: Dr. Christine Whalen on March 24, 2014

Labels: Kazakhstan, Kyrgyzstan, Tajikistan, Uzbekistan , Infectious Disease

 World TB Day 2014

March 24 is World TB Day, and Project HOPE joins countries and organizations around the world to commemorate global efforts to fight TB. We stand together with our partners, committed to find, treat and cure the “missed” three million. 

Almost nine million people fall ill with TB each year and 1.3 million will die despite the fact that TB is a curable disease. WHO estimates that one third are “missed” by current health systems. While progress has been achieved, new challenges are emerging, particularly around drug-resistant TB which represents a serious threat to the control of the disease.  

TB affects mostly people in their economically productive years of life.  Many of the “missing” people with TB belong to very vulnerable groups, such as those living in poverty, migrants who do not have access to affordable quality assured care, women and children and those people living with HIV.  

Since 1994 Project HOPE supports national TB programs in Central Asia, Eastern Europe and Africa to improve access to diagnosis and quality assured treatment. We also engage communities and civil societies to assist TB patients in completing their treatment.  

In Kazakhstan, Uzbekistan, Kyrgyzstan and Tajikistan we work within communities to provide ongoing support to TB patients during their treatment – which could be from six months to two years in length. Based on assessments of barriers to diagnosis, initiating and completing treatment, Project HOPE works with local health authorities to establish patient support groups. These groups address three issues common to all countries:  

  • Improving communication between the TB patient and their care giver
  • Encouraging families to become actively engaged in the care of family members with TB 
  • Addressing stigma, feelings of loneliness and isolation so common among TB patients through peer support or former patients, resulting in increased number of patients completing treatment 
Kyrgyzstan TB Patient Support Groups World TB Day 2014

In many instances community leaders have become engaged in these patient support groups and continue to raise awareness of TB and their communities. We expect that this will have a positive impact on persons with TB symptoms seek care and who may otherwise be missed.  

Project HOPE works with others, such as women’s groups, to develop and implement local culturally appropriate solutions to barriers in accessing early diagnosis and care. These barriers may include out of pocket payments that patients must pay for transportation and other costs or permission from husbands and other family members to seek and remain in care.

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