HOPE works in more than 25 countries worldwide. Please enjoy our blog as we document the successes and challenges of our work.

Rethinking India’s Approach to Non-Communicable Diseases

Posted By Samir Shah, Pfizer Global Health Fellow on July 31, 2018

Labels: India , Chronic Disease

India NCD Consultation

Project HOPE is a recent recipient of the Pfizer Global Health Fellows Program (GHF), an international volunteer program that places Pfizer colleagues and teams on short-term assignments with leading international development organizations in key emerging markets. During assignments, Fellows use their professional, medical, and business expertise in ways that help increase access, quality, and efficiency of health services for people in greatest need.

As about 100 people settled into the Park Hotel in Delhi, India, recently, they walked into a meeting space unlike most others. Rather than a room setup where attendees would face a stage with endless PowerPoint slides, participants’ chairs formed a circle so that they could face each other, even during the opening plenary session. While there was some uncertainty and confusion about the unique setup, that feeling dissipated as the details of Project HOPE´s Non-Communicable Diseases (NCDs) consultation and the day’s agenda emerged. With this consultation, participants were in charge, not the facilitators. The thoughts, questions, and ideas of those who were in attendance drove the meeting. And it was the responsibility of the participants to capture ideas and questions, and also synthesize findings.

All of the participants were aware of the challenges India faces with NCDs like diabetes and cardiovascular disease and how debilitating the reality on the ground can be. They quickly reached an energetic consensus that the work to solve this problem is not only necessary with regards to public health and human life, but also to ensure India maintains and sustains the robust economic growth it has seen in recent years.

“We figured out how to beat HIV. We can figure out how to beat NCDs, too.”

Having worked at an organization focused on supporting individuals with HIV in the mid 1990’s, I can say that the disease seemed like an insurmountable problem, even in the United States. But seeing how the U.S. and a large part of the world overcame the biggest challenges with HIV, I know India is ready to tackle NCDs. And as the group correctly acknowledged, the diversity and complexity of Indian society requires flexible solutions rather than a ‘one size fits all’ approach.

In his keynote address, Dr. Jitender Singh, Minister of State in Prime Minister’s Office, acknowledged that India has gone from one end of the disease spectrum, malnourishment, to the other, obesity. As he said, disease used to be a “one week affair,” meaning that after a diagnosis was made, a resolution, whether good or bad, came quickly. But with NCDs, solutions must match disease development, so they must be long term and sustainable.

Dr. Singh also pointed out that economic growth will be driven by the health of the population. In India, 70% of the population is under the age of 40, so in order for those people to contribute to the economy, they must be healthy. In the afternoon’s Open Source Technology (OST) session, participants were asked to develop topics of discussion that they would then lead. Within minutes, a number of people had stepped forward to introduce topics important to them, and off the groups went. There were two separate 75-minute discussion sessions on topics like community engagement in healthcare, empowering healthcare workers, and developing sustainable systems to ensure follow up care was available. At the end of both sessions, participants were first asked to vote on the best ideas, then reflect on the experience and share their biggest takeaway from the entire session.

It was a truly inspiring event. And while there are follow up questions, like how stakeholders can continue to work together to take action and inspire action for long-term solutions, the problem is not insurmountable. We know that any action taken will have to be intelligent, sustainable, and flexible enough to adapt to a country of close to one billion people and this consultation enabled leaders in the field to find ways to move toward those solutions.

Transforming a Small Laboratory in Uzbekistan into a Diagnostic Powerhouse

on July 11, 2018

Labels: Uzbekistan , Global Health Expertise, Chronic Disease, Health Care Education, Infectious Disease, Health Systems Strengthening

Doctors reading medical chart

When a patient has suspected tuberculosis (TB), it’s vital to get quick and accurate test results from a laboratory professional because swift treatment can be crucial to eventual recovery.

Lola Sheralieva, a lab specialist at a TB clinic in Uzbekistan’s Bukhara region, has built her professional skills with the help of USAID’s TB Control Program – in which Project HOPE is a key partner.

Since childhood, Sheralieva has been passionate about microbiology. “The microscope was my favorite toy,” she reflects, “and even though I started my professional career as a nurse, when an opportunity presented itself for me to work at a laboratory, I was eager to take it.”

When Sheralieva began work at the TB clinic in 2010, the lab was dark and cramped and didn’t have the equipment necessary to diagnose TB. Specimens collected from patients had to be sent 600 km away to a central lab in the nation’s capital, Tashkent, for testing. Results took as long as three months, dangerously delaying treatment for patients who tested positive for TB. Not only did the wait jeopardize a patient’s chance of a complete recovery, it also increased the chance of the disease spreading to family and other people.

Over the past year, Sheralieva’s lab has been undergoing a dramatic transformation and is now a regional diagnostic powerhouse providing rapid and accurate TB test results in the regions of Bukhara and Navoi. The lab, in a building newly constructed by the Government of Uzbekistan, features state-of-the-art TB testing equipment that can not only provide results in just two hours, but can also precisely identify what drugs will most effectively treat a patient’s particular strain of the disease.

But equipment is only half the battle. It’s equally important that lab technicians like Sheralieva have the skills and training necessary to provide high quality and accurate testing.

Since 2015, Project HOPE, an implementing partner of USAID’s TB Control Program, has trained nearly 200 lab technicians in advanced testing technologies and has provided much needed testing supplies to TB laboratories in Uzbekistan’s Bukhara, Kashkadarya, Navoi and Khorezm regions. Through extensive training programs, master classes and study tours in Uzbekistan and abroad, lab staff have honed their skills in advanced molecular testing methods and quality management.

“It is amazing how quickly my lab has improved its testing speed and accuracy. After all, accurate and timely diagnosis of TB is critical for a patient’s recovery,” says Sheralieva.  “A perfect laboratory is a safe laboratory.”

To ensure a safe work environment for staff and to minimize the risks of specimen contamination, USAID has also provided training in infection control and biosafety. With the knowledge and skills gained through the training, lab technicians now have the confidence to implement facility-wide quality management systems and develop procedures to ensure lab operations with international biosafety and infection control requirements.

“I would not be where I am today without the skills received through USAID training. Laboratory services are the cornerstone of TB care and it feels great to deliver TB test results with guaranteed accuracy and on time,” says Sheralieva. “After all, we are dealing with human life.”

Anything is Possible…but Puerto Rico is Far from Recovered

Posted By Sue Flower, Connecting Hearts Abroad volunteer on July 9, 2018

Labels: Americas , United States , Disaster-Relief, Humanitarian Aid

Sue Flower, a registered nurse from Canada, is one of more than 20 Eli Lilly and Company volunteers to serve with Project HOPE in areas of Puerto Rico still struggling to recover from the devastation of Hurricane Maria. Project HOPE and Lilly volunteers provided much-needed diabetes care, other critical health services, and education in the municipalities of Loiza, Ponce, Adjuntas, and Humacao in May and June.

Sue Flower

As a registered nurse and health and safety consultant, I thought I knew what to expect when I signed up to volunteer with Project HOPE in Puerto Rico through Lilly’s Connecting Hearts Abroad program. I’m familiar with hectic days filled with many patients and the feeling of not having enough time. But being in Puerto Rico, even months after the hurricane hit, was something different than anything I had experienced before.

I joined a group of nutritionists, pharmacists, nurses, medics, and other health care professionals to help Project HOPE bring relief to the many Puerto Rican residents still in need. We provided outreach and care in community centers and shopping malls, under tents, in a bandstand space, and even a stadium. Together, we cared for more than 600 people around the island and did everything from providing blood pressure and blood sugar measurements, to nutrition advice, to diabetes education.

I’m proud to say that we were able to identify people at risk and help them get treatment. We uncovered a number of conditions and helped many. And because we also spent time listening, allowing time for people to talk, to share concerns, to let the tears flow, we were able to reassure even more. As volunteers, we used our compassion and willingness to help to enable change on a small scale.

But it’s not enough. The island is preparing for another hurricane season, even as they are still recovering from Maria. I left with bittersweet feelings, knowing that we had made a difference for many people on the island, but recognizing that there is still so much to do.

The people of Puerto Rico need long-term solutions, like education and understanding about diabetes, and support for behaviors that reduce the risk of the disease, and I’m proud to have played a part in that effort.

The Heartbreaking Plight, and Inspiring Heroism, of Guatemala’s Volcano Survivors

on July 3, 2018

Labels: Americas , Guatemala , Disaster-Relief, Humanitarian Aid

Guatemala team with children

Stories of horrendous suffering and human courage are emerging from Guatemala, a month after the Fuego volcano eruption.

Survivors are suffering from burns, respiratory issues and chronic illnesses.  Many are unable to travel long distances to reach medical professionals – highlighting the serious problems in health care access in some rural areas that the tragedy has revealed.

When patients can make it to the nearest hospital, they are often discharged before their treatment is complete due to overcrowding.  Sheila Cardwell, a Project HOPE medical volunteer has been treating many families in the affected communities. Here is her eyewitness testimony about the conditions in the area around the volcano and the vital care she has been providing.

“Each visit to a patient is heartbreaking because for many, we are their only hope.

In Alotenango one afternoon, we heard that a woman in the village was in need of wound care. Not knowing the extent of the injury, I grabbed my wound bag and with the rest of the volunteer team, went to visit the woman. We parked outside the local outdoor laundry facility where women were washing their clothes and walked down up a steep, narrow alley lined with tin-sided houses. Opening the rusty and broken metal slab that was their door, we were greeted by seven children and emaciated dogs, cats, chickens, and ducks.

Most of the children were shoeless and their feet were blackened. It appeared that their feet had been previously burned and crusted over. We walked into their home, a small, dark room with a dirt floor. In one corner, there was a wood burning stove filling the room with smoke, a commonplace in this village. 

The woman we were there to see was lying on a bed with a scarf over her burned back and buttock. Her third degree burns were extensive, going from her lower back to upper thigh and covering the entire width of her back. The wound prevented her from being able to sit or lie down. When we entered the room, she looked up and smiled, relieved to see us.

Teresa with patient in Guatemala

We learned that she had made it to the hospital two weeks before and was treated for a week, but was discharged because there were not enough beds available. Instead, she was forced to travel back home and wait in pain. Her husband was unable to help her because he had burns on his feet, which kept him from being able to walk. Together, the two of them fought through the daily pain to care for their seven grandchildren, one-and-a-half to 12 years old, whose mother recently died from cancer.

Because of the dirt floors, flies, crowded room, and poor nutrition, the woman’s burns had the potential to become seriously infected and could have led to sepsis or even death, so we visited the house every day for four days, treating the wounds and changing the bandages. We taught her husband how to care for the wounds, left supplies for them, and made arrangements for her to travel by ambulance to a hospital for follow up care.

We also took a look around the house and noticed that while the family was doing the best they could given the circumstances, they had little food and no help. Our team reached out to representatives of the local parish and together, we were able to get food, water, household and hygiene supplies, as well as diapers for the baby.

After the last visit, the children followed us down the road for one more hug. It was hard to leave this family, but we knew they had the supplies they needed to recover. There are so many here that need our help, so once we knew the family was taken care of, our team returned to the clinic we are operating from to continue medical care for others.”

Medical Team Brings HOPE to Survivors with Critical Health Needs from Guatemala’s Fuego Volcano

on June 27, 2018

Labels: Americas , Guatemala , Disaster-Relief, Humanitarian Aid, Volunteers

Volunteer with baby in Guatemala
HOPE volunteer Dr. Jabnely Muñoz in Guatemala.

Health needs have reached a critical point in communities devastated by the Fuego volcano eruption in Guatemala earlier this month. That’s why Project HOPE medical volunteers are treating patients at shelters, including one with more than 200 people from communities surrounding the volcano who have acute and chronic health issues such as respiratory complications, PTSD and related symptoms, burns, high blood pressure, and diabetes complications.  

“It has been absolutely heartbreaking to witness what is happening in Guatemala. The number of sick children we’ve been treating stands out. These kids are so sick with respiratory illness from the ash and they are so scared about the uncertainty of what comes next that many can’t sleep at night,” said HOPE medical volunteer Nicole Merrill.

The medical needs are compounded by the health care gaps that existed prior to the volcanic eruption, due in part to high poverty and illiteracy rates, a lack of trained specialists, limited access to health services, and malnutrition. As Merrill observed, “Guatemalans lack many basic necessities at baseline, and this disaster has contributed to a steep decline in the quality of life that they had.”

The clinic Project HOPE’s medical team is in was established prior to the volcano’s eruption to address the severe lack of health services the community had, but before HOPE, the clinic was only seeing patients two days a week. Now with HOPE responders working there the other five days a week, the clinic is able to see patients every day.

HOPE volunteer Dr. Jabnely Munoz in Guatemala

But direct patient care is only one piece of the puzzle. A lack of prior health services meant there was no system in place to deliver lifesaving medications to patients in the area. Medical volunteers from Project HOPE established a distribution system for medications at the shelter so that children and families could receive the medicines they needed to stay alive. And with high illiteracy rates, medical responders have to go above and beyond to make sure their patients receive proper instructions for the medications.

“I treated a toddler who came in with his parents. He had been sick for a few days with upper respiratory issues so I wrote prescriptions to treat the symptoms. As I was explaining the directions for the medications to his parents, I realized they are unable to read, meaning that they could easily give the wrong medication at the wrong time to their child. I had to improvise, so I used colored markers to mark the bottle and help them identify the different medications,” said Dr. Jabnely Muñoz.

The lack of critical health services prior to the eruption are leading to bigger challenges for patients and responders alike in the aftermath of the disaster, but thanks to Project HOPE, survivors are beginning to have hope again.

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