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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.

Portable ‘Clinic In A Can’ Brings HOPE to Communities Fighting Ebola in Sierra Leone

Posted By Carrie Jo Cain, World Hope International (Project HOPE's Partner in Sierra Leone) on June 9, 2015

Labels: Sierra Leone , Disaster-Relief, Humanitarian Aid, Partners

Four

I’m thrilled to report that four Clinic In A Can units have safely arrived in Sierra Leone, and the crane is working overtime to place these portable medical units precisely in place to serve communities here.  People in Sierra Leone are truly excited and grateful to have these solar-paneled portable medical clinics, which were created by the Kansas-based nonprofit, Clinic In A Can.  The clinics use solar power energy as their primary energy source and can fit into shipping containers for transport to developing countries.

They have just arrived from the U.S., and we are managing a few challenges here and there to ensure they will all be permanently placed in the Bombali, Koinadugu, Tambaka Chiefdom, and Kambia districts, where some communities are still experiencing outbreaks of Ebola. The portable clinics are a great solution to support the country’s rudimentary health infrastructure, which has struggled to treat Ebola victims and to properly enforce isolation protocols for people who may be infected. More than 11,160 people have died in this health crisis in West Africa so far, and over 3,900 deaths occurred in Sierra Leone. The GE Foundation funded one of the units in collaboration with Project HOPE to support communities still at risk.

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Healthier Moms and Babies

Posted By: Kristina Gryboski, Ph.D. on June 6, 2015

Labels: Indonesia , Women’s and Children’s Health

Babies being weighed for growth monitoring at village health post.

Today we visited Serang, Indonesia, a few hours west of Jakarta, where Project HOPE is implementing a program funded by Johnson and Johnson to strengthen the local government's health system for maternal and newborn care and health promotion. Indonesia has one of the highest maternal mortality rates in southeast Asia, and the Indonesian Government has made reduction of maternal mortality one of the priorities of its national five year development plan (2014-2019).

We visited a community health post in Panyirapan Village, Baros, a sub-district of Serang. There, health volunteers provide group education on maternal and child health in villages and weigh children under five years old to monitor their growth. In collaboration with the local government, Project HOPE has helped to revitalize the government’s long-standing volunteer program with enhanced training on participatory group education and increased outreach to encourage women to choose childbirth with a midwife rather than a traditional birth attendant (TBA). 

Today we also visited Baros Health Center. Here, Project HOPE helped upgrade the Health Center to become a Basic Emergency Obstetric and Neonatal Care (BEmONC) facility by training the health center doctor, midwives and nurses on BEmONC and providing equipment, medicine and medical supplies. We also trained village midwives on quality maternal care (antenatal care, normal delivery care, postpartum care and counseling) and trained community health volunteers (Kader) to promote safe motherhood and healthy behaviors for mothers and children in the community.  

Health Centers offering safer birth options in Indonesia.

When we visited Baros Health Center this morning, we met a young mother. This young mother is 24 years old and from Panyaripan village. She was in labor, about to deliver her second child.  She told us her first child is six years old and was delivered with the assistance of a traditional birth attendant (TBA). In this area TBAs are still active, and many pregnant women prefer to deliver at home assisted by a TBA.

The HOPE program recognizes the importance of TBAs in a woman's birth experience and has been conducting joint trainings with volunteers and TBAs together, to help shift the TBA’s role to being a partner with the volunteer educator and the midwife, rather than handling the birth alone. 

The young mother stated that she was convinced to deliver her second child at the health center because Mrs. Anita, a Project HOPE’s-trained community health volunteer, persuaded her to have regular, monthly prenatal check-ups at the local community health post. During her regular care, the village midwife told her it is safer to deliver at the health center sinc it has been upgraded as BEmONC facility. She was more convinced to deliver at the health center after she attended the pregnant mothers’ class facilitated by Project HOPE. She also said that she will give her baby breast milk exclusively for six months, the importance of which she has learned during the maternal/child health classes she attended.

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Supporting Breastfeeding Moms in Workplace

Posted By: Kristina Gryboski, Ph.D. on June 5, 2015

Labels: Indonesia , Women’s and Children’s Health

Dr. Nasaruddin Sheldon, Country Director of Indonesia contributed to this blog.

We are in Subang, Indonesia where Project HOPE is working with factories to reach thousands of women with health information and services through an innovative program HealthWorks, funded by MSD Merck for Mothers. We first visited the Hansol Hyun factory featured in the previous blog. Next, we visited the Daenong factory which employs 3000 women. 

Like Hansol, this factory has many new initiatives for health education, screening and treatment in collaboration with the local health center, including anemia and TB for example. Like Hansol Hyun, they also have volunteer health educators among the workers who are trained to lead group discussions once a week for 30 minutes.

HealthWorks program supporting breastfeeding moms in workplace.

Another sign that the factory is integrating new health initiatives into their business practices is the new official policy for supporting breastfeeding, signed by the factory president. Bottle feeding with formula has become very common in Indonesia, and among factory workers it is more challenging to breastfeed since the workers are not with their children during the day.

I took the opportunity to talk with one of the mothers who has been successfully breastfeeding since returning to work about a year and a half ago. The factory provides a private space for expressing milk in the factory clinic, and a refrigerator to store the milk. She explained that although she breastfed exclusively since she came back to work, before Project HOPE's HealthWorks program, it was more difficult because she had no place to store her milk. There are currently about 28 women who use the lactation room.

We spoke with the with the clinic nurse who said that many women come to her for counseling about breastfeeding. They want to know how to produce enough breastmilk for their infants, and are worried that mother’s milk is not enough to meet all the dietary needs of their babies.

Breastfeeding is one of the keys to reducing stunting in childhood. Improving child nutrition is a national priority of the nation: over 33% of children in the nation who are stunted are at a disadvantage in terms of productivity and at higher risk for health problems such as diabetes later in life. The reduction of  stunting prevalence is a new target that the Indonesian Government included in their five-year development plan (2014-2019). Project HOPE is committed to supporting the ability of women to provide the best start for their children through breastfeeding.

 Purwadadi Health Center work together to better women's health.

After visiting the factory, we met with Tommy Hidayat, Occupational Health Section of Purwadadi health center. He stated that since the HealthWorks implementation, the health center was able to effectively work with factories to implement health programs in the factories for the first time. Ms. Sri Suniawati, the Regional Midwives Coordinator of Subang District also told us that many women and families still need to be convinced that breast milk is all that is needed for the first six months. It’s difficult to convince them that mother’s milk is enough. Clearly, since there are family members who care for the baby while the mother works, reaching both women at the factories and their families will be an important need going forward. Partnership between the health centers and factories is an important step for bridging the gap between communities and workplaces. To quote Mrs Herawati, Compliance Manager of the Hansol Hyun factory, “together we elevate the power of caring for others.”

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It Takes a Workplace

Posted By: Kristina Gryboski, Ph.D. on June 4, 2015

Labels: Indonesia , Women’s and Children’s Health

HealthWorks progam improving health in Indonesian factories.

Subang has been a farming town, but factories are quickly moving in and currently about 66,000 women are employed in factories here. Project HOPE is working with about 11, 600 women in five factories with our innovative HealthWorks program, funded by MSD Merck for Mothers.

Today we visited a factory that employs about 2,000 women and talked with the factory managers about the new HealthWorks program. The managers told us about how Project HOPE opened the door for them to partner with the local health center for health promotion and primary care access for women. Before Project HOPE came to facilitate the relationship between the factory owners and the government health centers, there was little trust or motivation to work together to improve the health of the factory workers. But Project HOPE's successful HealthWorks program has convinced the factory owners that better health for the employees means more productive employees, and that the government health staff  could provide services and needed health information without interrupting the workers’ production.

Meeting later that day with Dr. Budi the Chief of the District Health Office, he confirmed that before Project HOPE began implementing the HealthWorks program, it was difiuclt to reach the young women who needed services and information about maternal and child health because they were no longer able to participate in the monthly outreach sessions taking place in the villages, because they were now at work.

HealthWorks progam improving health in Indonesian factories.

Both sides, the factory management and government health partnership, are now experiencing a mutual benefit. The factory compliance manager, Mrs. Herawati, has initiated a volunteer worker-to-worker health education program, for peer support among workers to reinforce the health education given by government health staff and by the factory clinic nurse who has joined trainings on how to counsel workers about a range of health topics such as anemia, breastfeeding, and family planning. We attended a peer education session, which happens every Wednesday during work hours for about 30 minutes. Differing work divisions join on a rotating basis, and today there were pregnant young women in the group. One asked, what can I do to make sure I have enough breast milk? We saw that there is now a refrigerator at the clinic specifically for expressed breast milk, and a private place to express milk. But still, few women continue to breastfeed after returning to work after maternity leave contributing to the low national rates of exclusive breastfeeding in Indonesia. The factory is committed to encouraging breastfeeding and will continue to use multiple approaches such as posters, discussion sessions and counseling to get more health information to women.

The volunteer program has been incorporated in the job descriptions of workers selected by the factory management and government health staff, and the peer volunteers also meet monthly to plan education sessions. One volunteer educator created a new program to have health education discussions on the long bus ride home that many workers have daily.

The Indonesian Ministry of Health is very interested in the HealthWorks program, as it is consistent with their guidelines for workplace health, and helps to demonstrate to them ways to operationalize their policy which had not yet been carried out.

HealthWorks progam improving health in Indonesian factories.

One of the factory initiatives is to ensure women have access to clean drinking water at all times during their work, and they provide refill stations for women to get filtered water. They can also refill bottles to take home with them to encourage them to drink at home as well. 

It is clear that the factory and the government health clinic have a strong relationship, and this is their program going forward. Project HOPE and our local NGO partner are supporting the building of the relationship but it is clear the sustainability will come from their ‘ownership’ from the beginning. Yet more factories are coming into town, and we only are reaching five factories out of 100 or more factories. The government is asking for continued help to introduce programs in more factories to get them off to a good start for ongoing quality private-public partnerships for a better and healthier future for women and their children.

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Volunteers Helped Care for Hundreds of Patients in Nepal

Posted By: Jon Brack on May 28, 2015

Labels: Nepal , Disaster-Relief, Humanitarian Aid, Volunteers

Nepal Earthquake

As our group of Project HOPE disaster response volunteers wraps up several weeks in Nepal, we've been reflecting back on our wonderful patients and the Nepali medical professionals who we've been able to partner with to treat them. Most of this work has happened at the Manmohan Memorial Teaching Hospital, though volunteers have also spent several days at the Hope Heritage Senior Center and Israel's IDF Medical Corps Field Hospital.

Two of our Massachusetts General Hospital volunteers had an additional opportunity to help a Nepali area in need, but this time well outside of Kathmandu. Dr. Paul Biddinger and Nurse Practitioner Lindsey Martin joined a 25 member team in the Dolakha district near the epicenter of the April 25th earthquake, a 6-8 hour drive from the city. This mission to establish a two-day medical field clinic was coordinated by the Christian Broadcasting Network (CBN) and included staff from multiple countries. In two days the field clinic saw 436 patients, many of whom walked a long distance to see one of their doctors, nurses, or midwives.  Though most of the patients were only treated for primary care complaints and not earthquake-related injuries, Lindsey reported that just being there and displaying international support during a time of need was very important for the region's post-earthquake recovery.  “I cannot overstate that our presence was the best medicine.

Surgeries in Nepal

At the Manmohan Memorial Hospital, HOPE volunteers assisted with surgeries in the Operating Room, wound dressing changes in the Orthopedic Surgical Ward, critical care in the Intensive Care Unit, emergency care in the Emergency Room, and administrative coordination with Dr. Shrestha, the Hospital Director. Overall, during the time period that HOPE volunteers were at Manmohan, the hospital saw 851 outpatient visits, 46 operations, 152 ER visits, and 83 inpatient admissions. HOPE volunteers helped care for many of these patients and got to know several of them very well. Patients and volunteers exchanged stories about their families and homes, shared pictures of their children, and grew close despite the trauma and tragedy that drew them together. It was difficult saying goodbye, but we all knew that the Nepali are a strong and determined people who will recover and rebuild. We look forward to visiting their country again during a happier and more prosperous time.

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