HOPE works in more than 35 countries worldwide. Please enjoy our blog as we document the successes and challenges of our work to provide Health Opportunities for People Everywhere.
An ELNEC (End-of-Life Nursing Education Consortium) training was recently held at Wuhan University HOPE School of Nursing in China. Carma Erickson-Hurt, an ELNEC Instructor and Project HOPE volunteer, gave the two-day seminar which included information about palliative care, pain and symptom management, communication, ethics, loss, grief, bereavement and care during the final hours.
In China, palliative care and hospice care are in the very beginning stages of development. Concepts such as pain management, symptom management, bereavement, social and psychological issues that accompany serious illness are not well addressed in the plan of care. Most doctors and nurses have not received any formal education in palliative care. In a country of over a billion people there are fewer than 50 hospices and only a handful of palliative care programs. In Wuhan, a city of over 10 million, there is one small hospice staffed with one doctor and four nurses. The support and resources for palliative care and hospice is inadequate to meet the needs of an aging population facing chronic diseases and a significantly increasing cancer rate. It is imperative that holistic palliative care is incorporated in the treatment plan.
The training was very interactive and participants shared many case examples of the challenges they have faced in addressing pain and psychological care of very sick patients. We discussed the cases and various interventions and alternatives nurses could use in their daily practice caring for patients. We did several case studies and role plays, to act out appropriate conversations and responses to various scenarios. Some participants became emotional as they shared difficult situations they encountered and how they felt powerless to address the situation. After the course, I worked with several inpatient units on their sick patient rounds and as a team we discussed various cases. The post course rounding was very effective as it helped nurses to utilize their new knowledge at the bedside.
One area that really seemed to appeal to the nurses was how they could use humanistic interventions such as touch, empathy and conversation skills learned in this course to approach care. Nurses realized that there are many interventions they can provide in caring for patients and families and those interventions are not limited to medications. The nurses began to realize the concept of “quality of life” as part of the care they can provide.
One of my biggest breakthroughs was in the ICU. I discussed with the nurse and doctors the importance of talking to patients, even if they are comatose or intubated and may not be able to verbally reply. Although this is common practice in the United States, in China it is not.
There was a 15-year-old patient in the ICU for several weeks; he had developed sepsis and was intubated. I discussed with one of the ICU residents the importance of talking to the patient and the next day she told me, “I told his mother to touch him and get close to him, touch him and talk to him.” Although this may seem basic to many ICU staff in the U.S., in China this was not a typical approach to care as the focus is usually on the medications and technical interventions. The humanistic piece is not always addressed.
This ICU resident was so happy that she could tell the mother of this patient what she could do. She felt empowered that she could not only help the patient, but also help his mother. The ICU resident now wants to learn more about palliative care.
Several days later a young nursing student from the HOPE School of Nursing had this same 15-year-old patient. As a student, she felt a bit overwhelmed as to what she could do. I taught her to get up close to the patient, touch him and look into his eyes and just have a conversation; tell him what day it is, what the weather is like, what is happening in the city, or whatever she thought she could tell him about current events. The student did this and as she talked to the patient, his eyes moved toward her and he was actively listening to her. Such a seemingly small intervention, but so very important for psychological care. As important as classroom education is, the bedside mentoring piece is equally important for staff to see the knowledge put into practice.
Because of this training an interdisciplinary “palliative care work group” has been developed. This group plans to create simulation training scenarios and will initiate discussions with hospital leadership on the way forward in developing palliative care.
What an exciting year!
Labels: Africa , Americas , China, Haiti, Macedonia, United States , Global Health Expertise, Disaster-Relief, Chronic Disease, Humanitarian Aid, NEXTGen, Women’s and Children’s Health, Health Care Education, Partners, Infectious Disease, Health Systems Strengthening, Volunteers
Our programs and professionals made tangible strides in building health capacity across the globe in 2016. Our volunteers inspired health workers every day in hospitals and clinics that serve the most vulnerable patients – newborns and their mothers.In Sierra Leone, HOPE volunteers shared lifesaving skills in neo-natal and maternal care with local nurses whose determination is matched only by our drive to improve the quality of health care in a place of great need.
When Haiti plunged back into crisis after Hurricane Matthew struck, threatening to undo the country’s hard work in rebuilding after the 2010 earthquake, HOPE medical volunteers rushed to support doctors and nurses at St. Therese Hospital in Nippes.
In Central Asia our teams were at the forefront of amazing innovations in TB detection and treatment, giving Project HOPE a voice at international forums.
In Africa, we were on the frontlines, improving treatment for people living with HIV and are fiercely determined to work with partners seeking to end the AIDS epidemic by 2030.
In Europe, HOPE was there for thousands of people trapped in the migration crisis in Macedonia, in need of medicines and health care.
And closer to home, I was thrilled to see the Health Affairs journal, published by Project HOPE, expand its coverage of global health this year. I’m confident the journal will continue to be a crucial platform for the nation’s leading policy experts as a new administration takes office next month.
The global health challenges that await us in 2017 are enormous indeed. With a deeply dedicated staff at our headquarters in Virginia and offices around the world as well as the goodwill of our volunteers and continuing support of our dedicated supporters, we are poised to live up to our mission with even greater impact in 2017!
Check out more of HOPE’s lifesaving stories from 2016!
The devastating earthquake in Nepal on April 2015 damaged many facets of human life and the land itself. As the result, people who were already marginalized and vulnerable have become more fragile and left with very few health and social services.
In partnership with Government of Nepal, Ministry of Health and Population, Center for Disaster Philanthropy, as well as Nepal Public Health Foundation, Project HOPE carried out a post-disaster needs assessment in 14 severely affected districts.
As a result of the assessment, the “Better Access and Services Provision to Improve Maternal, Neonatal Child Health Nutrition and Hygiene Service in Makawanpur” was launched in five of the remotest villages where the Chepang are one of the major inhabitants. This program is named SPARSH in Nepali.
Makawanpur district is in the central development region of Nepal. Along with other ethnic groups, Chepangs are one of the most prominent tribal groups residing in the district. Chepang initially had a semi-nomadic (slash-and-burn agriculture) lifestyle, but this is now slowly shifting to a more settled way of life, relying increasingly upon the produce of permanent fields of maize, millet and bananas. Mostly uneducated and without much exposure to other regions, the health and social indicators of the tribe were found to be marginally low. The earthquake only exasperated the health challenges faced by the tribe.
SPARSH has successfully marked its presence in the Chepang community through an orientation program, direct community dialogue, awareness campaigns and community mobilization including a healthy baby competition and other school based activities. At the same time, SPARSH has joined the government effort directly and indirectly by providing communication training to front line health workers, community workers, health posts and similar entities. Technical support has been provided to establish birthing centers where there is no health facility. Mothers are encouraged to participate in informative group meetings and other community engagement activities.
The program aims to have long-lasting impact on health workers, the health system and the entire community.
While I was working as a physical therapist, I decided to take up work as a volunteer teacher of math and physical science in the north of Namibia in 1999. It is here that I was first impacted by HIV/AIDS. At the time, before antiretroviral therapy (ART) was available in Africa, a diagnosis with HIV in Namibia was a veritable death sentence. I stood by and watched as friends and colleagues wasted away emaciated, often stricken with diarrhea and then passed away from infection that their weakened immune system could not fight off. HIV was then a mysterious and highly stigmatized condition in the community where I lived. Some of the parents of my grade 9 and 10 students were dying, members of the large household where I lived were dying. In the pancake flat environment where I lived I could spot about eight homes as I scanned in each direction from the home where I lived that everyone had at least one member who died from AIDS-related illnesses. All of this happened within the first year and a half of my arrival to Namibia 17 years ago. All we had at the time were messages about the importance of people who were struck by the disease to live with a positive attitude. This did little to ease the suffering of people diagnosed with HIV which often quickly progressed to AIDS.
While I was living amongst this tremendous suffering, I decided that I wanted to join the fight against HIV/AIDS. We have come a long way and things have changed significantly. Lifesaving ART is available. HIV testing is available. Now with Project HOPE as the Africa Regional Director, I feel fortunate to lead an inspiring team who are fighting HIV/AIDS in Namibia and across the African continent. We are now at a stage in this battle where we can seriously talk about strategies to end AIDS in Namibia in the next 15 years and on the continent of Africa as well. This sense of optimism and hope was expressed again at Namibia’s first National AIDS Conference during the week leading up to World AIDS Day. Many of us come to conferences like this to feel reenergized, recommitted and inspired by the work of those around us. The conference has worked well in that regard for me and I look forward to sharing ideas and striving for real public health solutions with the Project HOPE team to save lives in the future. And Project HOPE even won a first-ever Namibia HIV/AIDS Hero Award for Civil Society!
I am extremely proud to attend Namibia’s first HIV/AIDS conference in Windhoek with many of the people who are driving the HIV/AIDS response here, including members of the Ministry of Health and Social Services, UN agencies, support groups for People Living With HIV (PLHIV), U.S. government implementing agencies for PEPFAR including USAID, the business community and civil society groups like Project HOPE’s Namibia team.
The aim of the Namibia National AIDS Conference is to reach a consensus on how to end AIDS in Namibia by 2030. The 2015 HIV/AIDS report by UNAIDS revealed that more than 210,000 people are living with the virus in Namibia and more than 149,000 are on antiretroviral therapy (ART). According to UNAIDS, 18 million people are on ART worldwide.
The conference gives us an opportunity to share information on new interventions. Specifically, we are looking at UNAIDS recommendations, reviewing epidemiologic evidence, current strategic documents from the Namibian government and critically reviewing the current response in Namibia. At least 100 scientific and programmatic presentations have been showcased here and Project HOPE’s innovative work has been well represented for its contribution to the response. HOPE’s work on economic empowerment to improve PLHIV adherence to care and treatment was presented by Wilfred Luyanga and was included in the conference recommendations on the first day.
During the second day of the conference, HOPE’s work in electronic data capture, Community Based ART (CBART) Refills to improve adherence to lifesaving therapy was presented as well as our innovative ART Client tracing of people who stopped taking their medicines.
Project HOPE’s novel approach of targeting the homes and families of PLHIV for comprehensive health, economic and social services and how this approach has improved the lives of children infected with and affected by HIV was also showcased.
The consensus among delegates here is that if we are going to stop the epidemic in Namibia we will need to increase efforts and investments because aside from the challenges of starting in the fight against HIV/AIDS in Namibia, finishing the fight is most difficult part of this massive and complex effort. Namibia is a country where ending AIDS is possible and there is political will and financial commitment from the Namibian government to pursue this. It is clear that if we remain in the status quo, we will not end AIDS, but rather, the number of people living with HIV will continue to grow. To end AIDS here we will need a more targeted approach including HIV prevention by ensuring that young women are empowered, tested, receive and adhere to treatment. It is also crucial that older men who infect younger women are circumcised, tested, and adhere to ART to ensure that the virus is not in their bloodstream.
There is much work to be done to establish consensus and common action to end HIV in Namibia by 2030 and the Project HOPE Namibia team is deeply invested in collaborating with other stakeholders to develop innovative public health approaches to save lives.
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