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Field Reports

Stigma and lack of coordination between doctors, nurses and social workers prevent people living with HIV in Africa from accessing community resources. "Imagine you just received a diagnosis of HIV," says Global Strategies Program Director Pamela Mann. “You need people who understand what you are going through. But how do you find those people without the risk of being ostracized?"

Femme PlusGS

Global Strategies, working with Femme Plus in the city of Bukavu, Democratic Republic of Congo, is using an innovative map to help patients find the help they need. The goal is that the same day a patient receives a diagnosis of HIV, he or she can be directed to a nearby support group.

Beginning in 2014, Femme Plus has already mapped 43 sites that provide care to individuals living with HIV in the city of Bukavu alone. The Femme Plus team members, equipped with tablets and trained by Global Strategies in taking GPS coordinates, visit care programs and inquire about the services available. They then complete digital questionnaires, get a GPS tag on location and then transmit the data to Global Strategies. Back in the USA, the data is entered into an online cartography program and a link to the map is sent back to Congo. Ultimately, Global Strategies plans to train the local team in the map-making software as well.

The map is also useful to people living outside of Congo, "We have been in Congo for 10 years," says Global Strategies President Josh Bress, " But even we are seeing groups on the map we did not know existed. Some of these groups are doing incredible work with high risk populations and will help us moving forward as we work to deliver HIV care and prevention across the region."

zim newsletter picHwange National Park, located just south of Victoria Falls, is the largest reserve in Zimbabwe. There are over 100 different animal species and 400 bird species, including the world famous herd of 30,000 elephants, making Hwange one of the few great elephant sanctuaries left in Africa. It is also one of the last strongholds of the endangered painted dog (lycaon pictus).

Conservation groups have worked tirelessly to protect all of these special animals. But it’s not just animals that are in danger of disappearing in this region of Africa. In 2008, the Hwange District had an HIV prevalence as high as 40% and no healthcare.  Human life is also in a precarious situation. 

Global Strategies was given an incredible opportunity in 2011 to invest in a partnership with Wild4Life and Painted Dog Conservation, two nonprofit groups on the ground who witnessed the devastating effects HIV had on people living near and working in the national park.  Through the generous funding of Global Strategies’ supporters and by joining forces with these well-regarded local organizations, we were able to provide seed capital and technical expertise to help establish and accredit health clinics in this remote part of the world.  This included training and educating nurses and community health workers and upgrading facilities. 

This model is so attractive because of its sustainability. Once a clinic is accredited, the Zimbabwe Ministry of Health is committed to providing ongoing medicines, supplies and clinic staff salary support.  Through these partnerships, four clinics were accredited and connected to the national healthcare system. Now, the local population has access to HIV services and basic healthcare.

The goal of our efforts is always to improve the lives of individuals.  We always ask, did our efforts make a difference? Today approximately 830 individuals are receiving long-term antiretroviral treatment for their HIV infection to keep them healthy, prevent orphans and prevent infection of others.  The HIV prevalence has improved significantly and countless new infections have been prevented.  But still, the HIV burden in this region is unacceptably high.  During our recent field visit last month, local women and men greeted us with a song of gratitude and expressed their thanks to all of the Global Strategies supporters because now they have access to healthcare and HIV is no longer a death sentence.

Zim clinic photoBut our work is not yet done. There are still many people in rural areas that have to walk up to 20 miles to get care, including pregnant women so close to their delivery date that they can’t make the trek. Helping to accredit a fifth clinic, training healthcare workers who can conduct home visits for people who are too sick or too remote and providing ongoing supervision and education will save even more lives.

Here are some examples of how your continued support would help:

  • $30 provides one month of salary support for a community health worker to conduct home visits and extend clinic activities into the community
  • $150 provides one month of ongoing education, training and supervision of clinic staff at one clinic to ensure the quality of care provided
  • $1,250 provides one month of salary support for Painted Dog Conservation staff who coordinate healthcare activities in addition to their work to preserve the painted dog population
  • $10,000 provides required HIV training for healthcare workers at the new fifth clinic to achieve Ministry of Health accreditation

Our achievement together is a sustainable investment, coordinated locally, with a return on investment that can be measured by an HIV prevalence that was sharply decreased. By pooling resources, leveraging the existing wildlife conservation infrastructure and connecting rural clinics to the national healthcare system, the rural healthcare model is a sustainable and cost-effective way to bring healthcare to communities that were previously unserved and create long-lasting change.  Hwange National Park is known for its beauty and its focus on animal conservation. Now, because of you, in this region the Dete, Mabale, Makwandara and Lapote clinics are a reality and human life is being conserved with equal attention!

jan14 news1b This January, Global Strategies, alongside the nurses and midwives at Star of the Sea Health Center, began a community-based mother and newborn care program in the West Point neighborhood of Monrovia, Liberia. The project is a unique and innovative approach to reducing newborn mortality in an area suffering from one of the highest neonatal mortality rates in the world. Working with the incredible Liberian team, Global Strategies trained nurses, midwives and doctors not only what to do when a sick baby arrives, but how to proactively identify babies who may become sick. The program is a combination of old-fashioned and high-tech approaches---house calls with iPad minis.

Throughout the month, Global Strategies Field Clinicians trained 22 midwives and nurses how to resuscitate newborns, perform examinations and conduct risk assessments. The nurses then used what they had learned to not only treat babies born in the hospital, but to identify at-risk babies born at home. During the home visits, they record their findings with an offline survey tool that guides them through the evaluation of common risk factors--What is the babies' gestational age? Is the baby breastfeeding well? etc. When they return to the clinic, they synchronize the iPad minis with the help of a mobile wifi hotspot purchased by Global Strategies. Looking at all of the data, the clinic supervisor can efficiently advise the nurses in their management and follow up plans. Taking the longer view, Global Strategies helps the Liberian team analyze the data to identify community trends and gauge the project progress in real-time. This knowledge will better equip Global Strategies and our partners to implement interventions that are effective and appropriate to this densely populated and unique neighborhood.

Research has shown that home visits conducted by community healthcare workers are cost-effective interventions that reduce infant and newborn mortality. The Lancet Neonatal Survival Series emph asizes the importance of these visits, stating, “ Early success in averting neonatal deaths is possible in settings with high mortality and weak health systems th rough outreach and family-community care, including health education to improve home-care practices, to create demand for skilled care, a nd to improve care seeking.”

jan14 news2bThe nurses and midwives at Star of the Sea Health Center are crucial to the success of Global Strategies’ Liberia program because they are trusted members of the West Point community and are warmly welcomed into the homes of new mothers. Cindy McWhorter, Director of International Programs for Global Strategies, saw firsthand the effectiveness of home visits. She recalls, “When people spotted us at a neighbor’s home, they were eager for us to examine their babies as well.” She remembers a discussion with one midwife, Fatu. After a Global Strategies volunteer mentioned how much the people seemed to love the nurses and midwives, “Fatu said that if the people know they are loved, they are more apt to come to the clinic to deliver and vaccinate their babies.”

Global Strategies looks forward to continuing its work with the Star of the Sea Health Center and the members of the West Point community as we partner with Liberian healthcare workers to save newborn lives.

 

On World Physical Therapy Day 2013, we recognize SVYM and the Global Strategies Field Volunteers that have been working to establish a sustainable rehabilitation program for children and adults with disabilities in Karnataka, India. The World Health Organization estimates that between 110-119 million people live with conditions that impair their ability to function. These individuals are particularly susceptible to not only conditions related to their disability, but secondary conditions that develop because they cannot get to care. Global Strategies is working to change that by partnering with SVYM to deliver care where it is needed most--in the clinic, but also in the home.

 With shoulder-to-shoulder mentoring from Global Strategies Field Volunteers Laura, Deanna, Jane and Mitul, SVYM created a local rehab team and built a rehabilitation gym. Now, three days a week the hospital houses outpatient therapy in the new rehab gym, and once a week the rehab team performs field visits to the homes of children and adults who are too sick and/or disabled to travel to the hospital. This is strenuous work with long days traveling on unpaved dirt roads. However, the rehab team feels strongly that maintaining these field visits, where lifesaving therapy can be delivered in a meaningful manner and within the family's daily means, is essential to improving health. See photo and story of the work being done below.

 C.N. is an 8 year-old boy india pic1with cerebral palsy. With the help of his family, he is working on stretching and strengthening his legs in preparation for braces. C.N. attends school and can move around his home and school well enough by crawling, but with braces he would have the potential to walk. C.N. comes weekly to the outpatient clinic, and we were also able to go to his home on a field visit outing to give specific recommendations to him and his family in his everyday environment.

C.N., front, is pictured with (left to right) Deepika, interpreter; Poornima,
physiotherapy assistant; and Jane, Global Strategies Field Volunteer
 india pic2b

Thank you!

Global Strategies Field Volunteers
Laura Keyser, DPT
Deanna Chan, MOT
Jane Griffith, DPT
Loran Hollander, PT
Mitul Kapadia, MD
 
SVYM Rehab Team
M R Seetharam, Head-Health Activities
Manohar Prasad, Program Manager, Community Health Activities
Ramesh M P, Rehabilitation Coordinator
Poornima S, Physiotherapy Assistant
Prasanna, Hospital Coordinator, Kenchanahalli

This Father’s Day we thank you, our supporters, for providing meaningful work for our expert patients and fathers like Charles, who lives in a region with endemic poverty.  A job helps Charles support his own children while extending the clinic activities into the community. 

 

IMG 0348Here is his story:

 

My wife and I have three children.  My wife was sick and I didn’t know what the problem was.  We went for HIV testing together.  She was HIV postive and I was HIV negative. Two of our children were HIV postive and one was HIV negative. Sadly, my wife died. 

 

After my wife died I continued to love and care for my children.  I took them to the Children’s AIDS Program Clinic.  When the clinic staff saw I was taking good care of the children, they asked me to be part of the expert patient team. Now in addition to taking care of my family, I do home visits for other families. 

 

Thank you for the work. 

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