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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.

The Ebola Crisis: Report From the Front Lines

Posted By: Frederick Gerber on October 10, 2014

Labels: Africa , Sierra Leone , Global Health Expertise, Humanitarian Aid, Health Care Education, Infectious Disease, Health Systems Strengthening

Project HOPE sent a team of medical and disaster relief experts to the front lines in Ebola-affected Sierra Leone to work with key health and emergency response officials and survey health facilities, logistics and lines of communication. The goal is to identify key gaps in the country's ability to combat Ebola, effectively treat patients and operate its overall health system. The team leader and Director of Project HOPE’s Special Programs and Operations, Frederick Gerber, sent this report from Freetown: 

Project HOPE’s Director of Special Programs and Operations, Frederick Gerber

Everyone is stunned by the enormity of the situation here.  “We weren’t prepared” is a recurring theme among officials and health workers.  I’ve heard this many times before -- it's the common thread that runs through all disasters in the developing world – lack of preparation for the worst and a failure to prepare ahead of time.

The Ebola outbreak has taken an emotional toll on everyone.  Signs of stress are on every face. The government understands the need for technical and resourcing assistance, all beyond their capability, and there is a real need for international organizations to come into the country to implement solutions.  Some officials are frustrated at restrictions on travel by airline and shipping companies, which make it harder to scale up the relief effort.

In neighborhoods in the capital, at the airport and business district, shops and businesses are open, and people are still going about their business. But myths abound about the Ebola virus here. Hawking Sierra Leonean traditional medicine, local shamans are doing swift trade, peddling their belief in magic spells, witchcraft, and superstitions. There’s a local myth that chlorine wash solution – present at almost every store, house, hotel, restaurant entrance – causes cancer. 

I heard a story going around about a man in Freetown who was told his Ebola test came back negative, but his HIV test was positive.  He exclaimed, “Thank God.” 

There are abundant laws to stop human-to-human contact. “ABC” (“Avoid Body Contact”) is the chant going around; it is almost universal across Sierra Leone now.  Previous fines for not wearing a seat belt are now relaxed, as are laws for motorcyclists not wearing helmets, because of concern for people touching infected objects.  

After arriving at the Freetown Airport at 0200 hours one morning last week, I had to wash my hands in chlorinated water before entering the terminal. I filled out a lengthy health form, had my temperature taken with a thermal imager, and then was released to pick up my bags. I was met by a Sierra Leone army lieutenant escort officer; I naturally shook his hand. A porter came over to me and whispered, “I saw you shook that man in uniform’s hand.  We don’t shake hands now in Sierra Leone because of Ebola.” He impressed upon me the “No Touch” rule that I saw the next day across the country. The fact a porter would approach me and counsel me on not shaking hands is a sign of how serious Sierra Leone is about stopping the spread of the disease, and how effective the government’s been, at least, in spreading the “No Touch” rule. The “Ebola handshake” is now rubbing elbows instead of hands. 

Health workers in Sierra Leone and other Ebola-affected countries in West Africa have been seriously impacted and stigmatized.  Nurses and physicians have been turfed out of their houses and chiefdoms by neighbors and family because of the widespread fear that after treating Ebola victims, they’ll carry the disease home. 

Most private hospitals are closed now because people are frightened about catching Ebola from other infected patients.  Routine treatment of other killer diseases such as malaria, typhoid and cholera has practically stopped now, as everyone is focused on Ebola. No one wants to go to clinics, hospitals or holding centers, because they are scared these facilities are “incubators” for the disease. 

Some of these concerns are justified. Some hospitals seeing and treating Ebola patients were not – and still are not – using proper infection prevention and control (IPC) procedures. It’s the single biggest failure in Sierra Leone’s health system. Patients who didn’t have the disease when they first entered the facility later contract it from other non-segregated patients. Those old dictums – “hand washing and hand sanitization are the easiest and best way to prevent infections and illnesses from spreading” – continue to be true.

It’s likely that this crisis and the headline-making Ebola case in the U.S. will prompt the international community to be more invested in helping West Africa improve its health capacity. As the disease geometrically spreads, with one infected patient now infecting two others, who each infect four, who infect eight and so on, it will catch the international community’s attention. While Ebola is not easily spread, contrary to misinformed public and media hype, there are no vaccines or treatments against Ebola infection available for use in humans despite substantial research progress.

This may be the 21st century, but we’re still finding that culture, customs and religion continue to have as strong a pull in the opposite direction as science and facts. But Ebola can be halted with education, safe practices and infection control. And that is a message we must continue to underline.

Disasters management follows four basic phases: Preparedness, Response, Recovery, Mitigation. A nation’s response to a disaster is always a reflection of how well it prepared for it, and this Ebola epidemic is no exception. The job of the developed world now is to help less well-off countries transition to better health care systems that can stave off future crises.

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Health Affairs Publishes Global Health Edition

on September 8, 2014

Labels: , Global Health Expertise

Health Affairs

The September issue of Health Affairs, which was released on September 8, emphasizes lessons learned from developing and industrialized nations collectively seeking the elusive goals of higher quality care and lower costs. A number of studies analyze key global trends including patient engagement and integrated care, while others examine US-based policy changes and their applicability overseas.

For a quick summary of the issue, read Editor-In-Chief Alan Weil’s letter.  Watch our events page for videos and photos of our September issue briefing, taking place September 8 in Washington.

The September issue of Health Affairs was supported by the Qatar Foundation and World Innovation Summit for Health (WISH), Hamad Medical Corporation, Imperial College London, and The Commonwealth Fund.

Health Affairs is published by Project HOPE.

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Saving Lives at Birth

Project HOPE Among Finalists at SLAB Grand Challenge for Development 2014 in Washington D.C.

Posted By Judith Moore, Project HOPE’s Senior Director for Women’s and Children’s Health on August 1, 2014

Labels: , Women’s and Children’s Health

We Won! Check out our press release!

The Savings Lives at Birth partnership was launched in 2011 by USAID, the government of Norway, the Bill & Melinda Gates Foundation, Grand Challenges Canada, and the U.K’s Department for International Development.  The Grand Challenge is a global call for groundbreaking, scalable solutions to infant and maternal mortality around the time of birth and Project HOPE is among 52 finalists competing in the final stage of the competition at the Development XChange in Washington D.C.  HOPE’s Senior Director for Women’s and Children’s Health, Judith Moore, is there to showcase Inpsire, a portable electronic pediatric device that could make dramatic strides in assisting health workers to identify infants and children with danger signs, including signs of pneumonia, who need immediate treatment.

Judith Moore at Saving Lives at Birth

Pneumonia is the number one killer of children under five in the developing world -- in the five minutes it will take to read this blog, 15 children will have died.  To address this problem, Project HOPE teamed up with Virginia-based firm Guardit to develop a pioneering device that could make dramatic strides in diagnosing a disease that claims more young victims than AIDS, Malaria and measles combined. INSPIRE is a patented electronic device that will help health workers make swift and accurate early diagnoses of pneumonia and save lives by making an accurate reading of a neonate’s  breath count -- a key indicator of pneumonia.

Currently the standard method for counting breath rate in developing countries relies on health workers visually counting breaths and using a one minute timer or using counting beads that often result in mistakes and then either not treating children who need antibiotics, or treating those who don’t need the medicines.

Obtaining reliable respiratory rates is a key step in the successful identification and correct treatment of pneumonia. Healthcare workers in the field will be able to better serve the population and correctly diagnosis pneumonia by having a new and more accurate device available.

INSPIRE has been undergoing rigorous testing and producing accurate respiratory rates even when a child is in different positions. Its rugged design and easy-to-use interface make it ideal for developing world environments.  The device works when it is placed on the chest of a child, and uses a patent pending algorithm, developed by Guardit, to provide an accurate reading. 

Project HOPE is honored to be a finalist for the second time in this Grand Challenge.  Round four finalists were selected from almost 500 submissions and the final winners will be announced on August 1.

Watch a Video of Judith Moore Demonstrate the Inspire Device

Learn More About Inspire

Inspire Fact Sheet

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Volunteering in the Philippines on Pacific Partnership 2014

Posted By James Mayger, Project HOPE volunteer on July 17, 2014

Labels: The Philippines , Humanitarian Aid, Alumni, Volunteers

A navy psychiatric nurse gives a seminar on how to deal with a violent patient on Pacific Partnership 2014, Tacloban, the Philippines

James Mayger, a native of Australia, is an editor for Bloomberg News in Tokyo who covers the macro-economy of Japan and North Asia.  As a fluent speaker of Japanese, James is volunteering for Project HOPE as the liaison between the Japanese Navy and the Project HOPE volunteers and other English speakers during Pacific Partnership 2014, the annual humanitarian mission led by the U.S. Navy to Southeast Asia and the Pacific.

Today, the US Navy and the Japanese Self Defense Force ran a psychiatry seminar for nurses and orderlies of the Eastern Visayas Regional Medical Centre in Tacloban.

Poverty in Tacloban, the Philippines, where people still need help after Typhoon Yolanda caused massive destruction

The hospital was badly damaged by Typhoon Yolanda, and reconstruction is still ongoing.  Builders and carpenters are rebuilding wards, and the carpark is a pile of ruined equipment and bed frames.

First, a U.S. navy psychiatric nurse ran a seminar on how to calm violent or potentially violent patients, including how to de-escalate a potentially violent situation so as to ensure the safety of both the patient and staff member.  The seminar included advice on how to break the hold of a patient, if attacked, and also how to recognize the signs of a potentially dangerous situation.  The hospital plans to open an inpatient ward this month for psychiatric patients, and the lessons about how to approach distressed people, and how to stop staff from getting injured should be immediately applicable.

Project HOPE volunteers on Rotation 4 of Pacific Partnership 2014 in Tacloban, the Philippines

In addition, a Japanese army psychiatrist spoke about steps that health care and medical workers can take to avoid PTSD and other psychological distress from working in disaster zones.  Many of the staff of the hospital were double victims of the typhoons, losing houses, family, and friends, and then dealing with the injured and dead after the disaster. The seminar applied lessons from Japan's response to the 2011 earthquake and tsunami to suggest strategies and tools for health care workers to reduce the psychological impact of a disaster and its cleanup.

Staff at the hospital previously expressed the view that they wanted to look forward, and not revisit the typhoons and its effects.  However, the suggestions and tips from Japan's experience provide help not only in dealing with the effects of Yolanda, but other traumas and disasters that may occur in the future.

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The Philippines in July 2014 - How has it changed?

Posted By James Calderwood, RN, Project HOPE Volunteer on July 15, 2014

Labels: The Philippines , Humanitarian Aid, Alumni, Volunteers

James Calderwood, RN, Project HOPE volunteer in Tacloban, Philippines on Pacific Partnership 2014

James Calderwood is a registered nurse and health policy research associate from Washington D.C. He volunteered for Project HOPE in the Philippines immediately following Typhoon Haiyan (called Yolanda in the Philippines) in November 2013 and has now returned to the Philippines as a Project HOPE volunteer on Rotation 4 of Pacific Partnership 2014, the annual humanitarian mission led by the U.S. Navy to Southeast Asia and the Pacific.

On November 8, 2014 Typhoon Yolanda hit land and destroyed much of the central Philippines.  Tacloban, a town situated on the water, was dramatically affected by the winds and rain of the typhoon. And then real disaster struck when the storm surge - in some areas reaching 15 feet - rolled through town.  Everyone was affected by the powerful wall of water; it is estimated that 6,000 people perished that day.

As a Project HOPE volunteer I arrived in the Philippines about a week after the typhoon.  Though my primary assignment was in the rural Camotes Islands, I spent some time in Tacloban.  Even the short time I was here, I recognized the sense of community – of teamwork – of people working together to help each other, which was truly remarkable amidst the death and devastation.

James Calderwood, RN, Project HOPE volunteer with people affected by Typhoon Haiyan in Tacloban, the Philippines

Now, July 8, 2014 – eight months later – I am in Tacloban as a Project HOPE volunteer, working with the U.S. Department of Defense as part of Pacific Partnership 2014.   The Philippine military and the Japanese Maritime Self-defense Force are our partners.  The work varies from medical care to reconstructing a local school. 

Riding to and from our worksites, I see many changes since November.  Instead of fallen trees and debris, the streets are crowded with pedicabs (bicycles with passenger side-cars), tricycles (motor cycles with passenger sidecars), and an occasional truck or van.  People are selling food and various sundries from small carts or stalls.  The large modern mall even reopened last week. 

James Calderwood, RN, Project HOPE volunteer with members of the Philippine military on Pacific Partnership 2014

While overall, there are fewer blue tarps serving as roofs, laundry can be seen drying on sunny porches attached to structures that are missing roofs, windows, and often an outside wall or two.  Several families are managing to survive together inside each structure.  While some areas have electric power reconnected – others rely on generators for special activities; many are grateful for candlelight.

Nevertheless, the people continue to be positive and hopeful, and focused on the future.   They take pride in their resiliency.  It is mentioned in church sermons today, as it was back in November.  The vision is to move forward, not to dwell on the past.   There is an amazing thankfulness for the present.  There is an appreciation for what they have – and never a complaint about what they don’t have.  The human spirit is here.

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