Sam arrived back at his home village to find he no longer knew anyone. With a wife and three young children, he found himself and his family living on the edges of society, in substandard living conditions, with no means of social or economic support. But since 2016, Sam has lived in Umudugudu W’ Ubuzima, a village built by the medical NGO Partners In Health. The village, surrounded by fruit trees, consists of 11 simple three-bedroom houses for families like Sam’s.

Helping Those in Need

Partners In Health, known in Rwanda as Inshuti Mu Buzima, believes that everyone has the right to health care, housing, food security, and education. PIH has been working in Rwanda since 2005 to help the government find and treat the most vulnerable patients.  When PIH started in Rwanda, it operated a small HIV clinic. Today, the organization supports the Rwandan Ministry of Health in providing comprehensive medical care to more than 900,000 people in three districts as a learning platform for comprehensive healthcare strengthening in the country.

In collaboration with local officials, PIH identifies people like Sam, who, due to extreme poverty, a high burden of disease, or other factors, are among the most vulnerable members of their communities.  As a resident of Umudugudu W’ Ubuzima (Village of Health), Sam and his wife benefit not only from having a secure place to live, but also from the agricultural and nutrition trainings that PIH provides, described by Sam as “lifesaving.”

The primary decorative feature of Sam’s living room, for example, is a large nutritional poster provided by PIH. He uses the poster as a teaching tool for others in his village. As for economic support, Sam and his wife are now working in a rice cooperative that PIH helped establish.

With financial training provided by PIH, Sam and his wife now save half of their daily income. That has enabled Sam to install electricity in their living room and buy a bicycle for transportation. When I visited Sam, he was home alone and proud to say that his wife was at the local school, where their three children are now enrolled, picking up their report cards.

Redefining Health

Recognizing that health involves treating not just the physical symptoms of disease, but also its social and economic determinants, PIH has developed support programs, often known as the Program in Social and Economic Rights, to meet needs outside of health services. The importance of treating patients holistically has been emphasized at PIH-supported health facilities around the world, informing every aspect of the organization’s health delivery model.

By pairing health services with the means to address social and economic inequities, PIH, in partnership with the Rwandan government, is ensuring that Sam and his family, and others like them, have the basic rights of health, education, and housing security.

To date, PIH has built more than 150 homes in the Rwandan districts it supports and provides 35,000 families with monthly food packages while patients undergo treatment to ensure the best possible health outcomes.  Micro-loans, and a variety of agricultural, nutritional, and financial training, help patients become self-sufficient once they are well.

Direct Relief has supported PIH in Rwanda since 2016 with donations of prescription drugs and medical material valued at more than $500,000.

The post Health Care for All, Including Sam appeared first on Direct Relief.

Celebrating World Health Worker Week (April 5 -11, 2015), a new story map from Esri, The Earth Institute at Columbia, and Direct Relief, aims to raise support and awareness for the life changing contributions of community health workers.

In dozens of countries, tens of thousands of women and men get up each morning to travel miles over rough roads and across rivers and streams to provide primary health care in some of the world’s most remote, vulnerable, and hard-to-reach places. At any given moment, these people, known as Community Health Workers (CHWs), are monitoring Ebola contacts, counseling an HIV-positive person, surveying basic health needs, or helping a newborn at risk of pneumonia.

On Front Lines of the Ebola Crisis

When the Ebola epidemic swept through West Africa last year, international organizations had difficulty establishing and maintaining community trust. Community Health Workers, many of whom are from the communities they serve, stepped in to bridge the gap. Not coincidentally, the organizations with the most durable results to show also relied extensively on CHWs for case tracking, diagnosis, sensitization, referral, and follow up. Such groups include Partners in Health and Last Mile Health in Liberia, UNFPA in Guinea, and Medical Research Centre (MRC) and Wellbody Alliance in Sierra Leone.

Arguably, CHWs are the key for the countries now rebuilding their health systems to be more comprehensive, effective, and resilient following the shock of the Ebola epidemic. They may also be the best defense against a repeat of these events in the future.

Beyond Ebola: One Million Community Health Workers

While the Ebola epidemic spotlighted the crucial work of CHWs, their value extends far beyond Ebola and West Africa. The One-Million Community Health Workers (1mCHW) Campaign was formed by the Sustainable Development Solutions Network (SDSN) and the Earth Institute at Columbia University to advocate for CHWs and document their far-reaching value.

Direct Relief and Esri teamed up with the Campaign last year to build the Operations Room; a suite of mapping applications that track the scope and enable a detailed comparison of CHW activities.

29 Stories. 24 Hours. 13 Countries

A Day in the Life: Snapshots from 24 Hours in the Lives of Community Health Workers is the latest map in the 1mCHW Campaign. It aims to convey not only the importance of the work that CHWs perform, but the everyday texture and genuine beauty of the lives they improve. This map is a guided tour of 29 CHWs in action during one long day across 13 countries in sub-Saharan Africa. Through the CHW story map, people can learn about and become more deeply engaged in one of the great causes of our time — ensuring that every person on Earth has access to health care.

The post A Day in the Life of Community Health Workers appeared first on Direct Relief.

On the 50th Anniversary of Health Centers, it is impossible to overstate their profound, positive role in the daily lives of millions of people, in thousands of communities, across every State and territory, and for our country generally.

Health Centers not only erode barriers of cost, insurance, distance, and language for those least able to access care; they save $24 billion each year in reduced hospitalizations and emergency room visits and offer demonstrable proof that accessible, high-quality, and low-cost care and preventive services are more than aspirations – they are essential and can be achieved concurrently.

For fifty years, Health Centers and their staff have reflected the insight that “community” is more than location – it’s the people and social fabric that binds it together – and that “health” involves not only that which can be diagnosed and treated by medical professionals, but many other factors as well. The terms “patient-centered” and “culturally competent” care now exist in the lexicon, but it’s because Health Centers were modelling such behaviors, by design, for decades.

This notion of community health also explains why Health Centers, in times of emergency, invariably serve such an essential and typically overlooked role. Emergencies disproportionately affect people who were vulnerable the day before the emergency occurred. Health Centers know this, because they care for the country’s most vulnerable residents every day. In every major event – from Hurricane Katrina to Sandy, tragic tornadoes in the Midwest and South, and wildfires in the West – Health Centers are indispensable actors as — if not first responders — first receivers of those in need of help.

In international health circles, bold experiments in community health are increasingly given the recognition, attention, and energy they deserve. Examples include the One Million Community Health Workers Campaign led by Jeffery Sachs, the extraordinary efforts of Partners in Health led by Paul Farmer, and Last Mile Health led by Raj Panjabi.

So why, in the U.S., for all of the energy and attention devoted to healthcare and healthcare reform, has the similarly crucial role that community health centers and community health workers have played for the past 50 years been largely overlooked?

Through a decade-long partnership with the National Association of Community Health Centers, Direct Relief has provided over $500 million in private philanthropic support to America’s Health Centers and their patients.  This has been a rare privilege and has only deepened the commitment to do more.

From the perspective of a privately funded humanitarian organization that supports community health worldwide, both philanthropic and public support will find no better investment than in America’s Health Centers in the years ahead.

The post A Bold Experiment: 50 Years of Community Health in the U.S. appeared first on Direct Relief.

An estimated 121,000 people have been displaced by the flooding in Malawi alone, where at least 53 people are reported dead. Concern across the affected countries is now turning to the potential for disease outbreaks, with displaced people living in poor sanitary conditions and lacking access to clean drinking water and health care.

The shipment will be sent to Partners in Health in Malawi, whose staff requested antibiotics and other supplies. They report that in the Neno district where they work, around 2,000 people – including 1,300 children – have been affected and that 300 of these people are being sheltered in a school.

Direct Relief continues to be in contact with partner organizations on the ground, ready to respond to additional requests for assistance.

To support Direct Relief’s Emergency Preparedness and Response programs, donate here.

The post Readying Emergency Supplies for Flood-Affected Malawi appeared first on Direct Relief.

This diagnosis can be a death sentence for women like Nanotte who have limited means and live in a country where access to screening is severely limited and treatment options are few.

To ensure that Nanotte did not become another national statistic for cervical cancer mortality, multiple nonprofits launched a massive collaborative effort to save her life. Told with her permission, Nanotte’s story follows below.

A Worrisome Diagnosis

Nanotte learned of her condition in August 2013, during one of the cervical cancer training delegations led by Dr. Rachel Masch of Basic Health International (BHI), when her pelvic exam revealed that she had a lesion that was suspicious for advanced cervical cancer. The biopsy subsequently confirmed the diagnosis of squamous cervical cancer.

Just eight months prior to screening Nanotte, Direct Relief, in partnership with BHI and St. Luc Fondation, launched the cervical cancer training and screening program at St. Luc’s clinic for maternal and prenatal health, Klinik Manitane, located in Haiti’s Artibonite Valley.

Through the program, Haitian health providers were trained to screen for cervical cancer using visual inspection with acetic acid (VIA), a low-cost and effective alternative in countries like Haiti where large-scale Pap screening cannot be adequately implemented due to lack of resources and infrastructure. Providers also learned to treat pre-cancerous lesions that are seen during the screening visit with a freezing technique called cryotherapy.

Although the program signaled increased access to services in a country with few options for basic preventive gynecological care, cryotherapy was no longer a treatment option for Nanotte. She was the first patient screened through the program whose condition was more advanced than the treatment the health workers were trained to provide.

Surgery Reveals Need for Radiation in a Country with None

To help Nanotte get the level of care she needed, Dr. Masch returned to Haiti in February 2014 to perform a pro bono radical hysterectomy (full removal of the uterus, cervix, and part of the vagina) with friend and colleague, Dr. Jill Whyte, a gynecologist oncologist at North Shore University Hospital in New York.

The surgery was performed at St. Luc’s sister facility, St. Damien’s Hospital, which generously donated their surgical suite and hospital services. Pathology from the surgery revealed a three centimeter tumor and radiation therapy and chemotherapy were indicated for treatment.

Providing the chemotherapy was not an issue, but the radiation therapy was problematic, as there are no radiotherapy facilities in Haiti. If Nanotte was to receive the treatment she needed, she would have to leave the country.

Search Begins for a Treatment Facility

In order to send her to a facility outside of Haiti, the Medical Director of St. Luc Fondation, Dr. Marc Edson Augustin, began the laborious administrative process of securing a passport for Nanotte.

Meanwhile, Direct Relief, BHI, and St. Luc simultaneously reached out to professional contacts to research countries where it might be possible to send Nanotte to receive treatment (at a price that Direct Relief’s programmatic budget could absorb). Various options were considered, including several hospitals in the United States, El Salvador, Cuba, and the Dominican Republic.

The logistics were complicated. Nanotte would need to stay for a prolonged period in a foreign country where she did not know the language, translation services would be needed for medical visits, and lodging, food and all the basic necessities of life would need to be arranged. Also, Nanotte’s daughter would need to be taken care of in her absence, and someone would need to accompany Nanotte to help navigate travel and care. It was a daunting endeavor.

A Match is Found

After many false starts, we connected with Partners In Health (PIH), a longtime Direct Relief nonprofit partner committed to improving the health of poor and marginalized people. With well-established operations in Haiti, PIH had recently opened a new hospital in the Haitian central plateau, Hôpital Universitaire de Mirebalais.

Moreover, PIH had also been screening women with VIA in that region of the country and had established oncology services for women at Hôpital Universitaire. Although radiotherapy is not available at the hospital, PIH had established referral services and a partnership with an oncology institute in the Dominican Republic.

Nanotte was referred by Dr. Augustin to Hôpital Universitaire’s oncology department, which in turn set up the necessary referrals to transfer Nanotte to the Instituto Oncológico Del Cibao in the Dominican Republic. Dr. Augustin went to work securing the necessary visas for Nanotte and her husband to make the journey.

Another Partner Steps Up

PIH staff on the ground would be assisting with the medical visits and the radiation therapy, but the chemotherapy, lodging, and transport still needed to be arranged. Direct Relief reached out to our long-term partner in the Dominican Republic, Fundación Solidaria del Divino Niño Jesús (FSDNJ).

Headed by Father Eduardo, FSDNJ has been helping to support a network of 175 medical facilities with essential medical supplies donated by Direct Relief. Once we explained Nanotte’s situation, Father Eduardo and his staff immediately mobilized to secure lodging, transportation, food, and all the basic necessities in preparation for her arrival.

Starting Chemotherapy in the Dominican Republic

On August 7, 2014 – a year after Nanotte was first seen at Klinik Manitane – she arrived in Santiago. At the Instituto Oncológico Regional Del Cibao she met oncology radiologist, Dr. Naly Cruz, who was to oversee her care.

Because of the length of time that had elapsed since the initial diagnosis, all scans and lab work were repeated, and a seven-week course of radiation and chemotherapy was prescribed. Coincidentally, the week that Nanotte started chemotherapy, a Direct Relief container of donated medicines arrived for FSDNJ that included one of the chemotherapy drugs prescribed by Dr. Cruz!

Nanotte started her treatment with a full network of support composed of FSDNJ staff, who provided for all her basic needs and introduced her to the Haitian community living in Santiago. Haitian PIH staff, working in conjunction with the oncology institute and Dr. Cruz, ensured that she was accompanied on all medical visits and that procedures were explained and translated into creole. All the teams kept in constant touch with Dr. Augustin in Haiti, Dr. Masch in New York, and Direct Relief in California.

Headed Home After 16 Weeks

Seven weeks turned into 16 weeks as Nanotte suffered terrible adverse events associated with the treatment.

Nanotte’s husband, who had accompanied her on the initial two weeks of her journey, had returned to Haiti to go back to work and care for their daughter, but he was called back to the Dominican Republic because Nanotte needed 24/7 care to help her manage the debilitating effects of the treatment.

Despite these challenges, during the week of Thanksgiving 2014, we received the best possible news: Nanotte was finally on her way home!

A Cancer of Poverty

The majority of you reading this likely don’t know of anyone who has been diagnosed with cervical cancer, let alone died from it. That’s because with regular screening, cervical cancer is a completely preventable disease.

Most women in the United States are familiar with Pap screening tests because we have had them regularly since young adulthood and have come to expect them as part of our standard care during routine medical visits.

Yet, more than a quarter of a million women die each year from cervical cancer, almost all of them in developing countries. Haiti is one such country, where the disease burden from cervical cancer is the highest in the Western Hemisphere and there are few places where women can access cervical cancer screening services.

Increasing Access to Screening & Treatment in Haiti

Because of the collaborative program between BHI, St. Luc, and Direct Relief, access to cervical cancer services is slowly increasing. Eight trained midwives now regularly screen 40-50 patients a week for cervical cancer at the twice-weekly screening clinics held at Klinik Manitane.

To date, over 2,600 women have been screened for cervical cancer and almost 400 cryotherapies have been performed. Although the screening clinics will undoubtedly save many Haitian women’s lives, Nanotte’s story proves that for some the screening comes too late.

Thanks to the indefatigable efforts of staff from St. Luc, PIH, BHI, FSDNJ, and the Insitituto Oncológico Del Cibao, she has a favorable prognosis of surviving her cancer. She will return to the Dominican Republic in January 2015 for a final treatment and follow-up tests.

Seeking a Solution

As of this writing, a second woman has been diagnosed with advanced cervical cancer through the screening services at Klinik Manitane. Because of Nanotte’s journey, we now have an established network where we can hopefully take her from diagnosis to treatment in a more timely and efficient manner.

However, it also highlights the fact that although we are grateful to be able to help Nanotte and patients like her, this journey does not provide a solution to the problems faced by women of Haiti.

Comprehensive and early screening for all women is needed to prevent cervical cancer, and if cancer is diagnosed, radiotherapy services in country are needed. It is my sincerest hope that one day this will become a reality for Haiti.

How You Can Help

To help women like Nanotte, consider supporting Direct Relief’s maternal and child health programs by making a donation here.

The post Nanotte’s Story: Battling Cervical Cancer in Haiti appeared first on Direct Relief.

While a new dedicated Ebola care center was constructed for foreign health care workers who may contract the Ebola virus, the facility is not available for local Sierra Leonean health workers.

With Sierra Leone experiencing roughly 100 new cases of Ebola each day, the newly arrived tents will serve as a dedicated unit for local health workers in need of care. Each tent is 500 square feet and comes with a lighting system, air conditioning, privacy screens, air filtration systems, and portable beds. The sanitation system will be set up by the Ministry of Health and Sanitation and the Medical Research Centre.

The tents and medical supplies were funded by a generous grant from The Paul G. Allen Family Foundation.

To date, 11 of the 12 Sierra Leonean doctors to contract the virus have died. The most recent, Dr. Victor Willoughby, died last week after contracting the virus from a patient. According to the World Health Organization, the Ebola outbreak has claimed the lives of 365 health care workers.

Ebola Response Update: Dec. 23, 2014

Direct Relief, in coordination with partner agencies, has sent 29 emergency shipments carrying 172 tons of medical aid to more than 1,000 hospitals and clinics since the outbreak began.

In the past two weeks, Direct Relief has delivered two shipments of medical resources to Sierra Leone. The first, sent to the Medical Research Centre, included basic antibiotics, antifungals, protective masks, and bed sheets. The second, shipped to Partners in Health in Sierra Leone, contained 3,000 coveralls, vitamins, IV solutions, soap, and face shields.

An additional delivery of requested medicines and supplies arrived this week in Liberia for Africare, Last Mile Health, and Christian Aid Ministries.

For more information on Direct Relief’s response to the outbreak, please visit Direct Relief’s Ebola information page.

The post First Ebola Treatment Unit for Local Health Workers Arrives in Sierra Leone appeared first on Direct Relief.

A Harvard physician and medical anthropologist as well as subject of the Pulitzer Prize-winning book, Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, A Man Who Would Cure the World, Farmer is the founding director of Partners in Health (PIH), an international charity that has worked with Direct Relief since 2008.

Over the last six years, Direct Relief has provided PIH with more than $12 million in medical aid, much of which has helped provide life-saving health care to people in Haiti.

“It’s easy to say ‘I’m against poverty,’ but linking that notion to engagement is more difficult. The link between sentiment and ideals and actually serving others is the difference—PIH can’t do that without “stuff” and that’s how we got connected with you [Direct Relief].”

Farmer shared with the crowd a personal story to illustrate disparities in health care around the world. While he was in residency for medical school, he was hit by a car and wasn’t able to walk for six months. Though a hardship, he recognized that unlike many others living in poverty, he didn’t have to worry about his family, livelihood, or about not being able to walk again.

The experience further solidified his view that all people deserve to have the same care that he had, regardless of the difficulty involved.

“Thank you to Direct Relief for taking so seriously this grand idea of providing the same standard of care, no matter of circumstance. This coming together in partnership is what matters and helps people most,” he said.

He told the audience that despite the challenges, he was encouraged by their involvement in global efforts to help impoverished people access quality health care.

“Effectiveness and compassion [in a program] are very difficult to measure, but it’s those difficult-to-measure things that bring people to a warehouse on a Sunday afternoon—people who care and have compassion for others.”

The post Dr. Paul Farmer of Partners in Health Visits Headquarters appeared first on Direct Relief.

The Harvard-educated medical doctor has worked with Partners in Health for 14 years and currently serves as Deputy Chief of Mission to Haiti. During a visit to the West Coast, he informed the group of the $16 million facility funded through donations and grants set to be completed at the end of July.

“This is the most ambitious project we have ever done in 25 years,” he said of the institution that will provide modern health services to underprivileged Haitians and serve as a hub to coordinate and run community health networks.

The 320-bed teaching hospital set on 14 acres of land in the town of Mirebalais, 40 miles northeast of capital Port-au-Price, will likely take Direct Relief’s work in Haiti in a new direction.

“They’re the best. We want to work with the best. We will reach out and try to find a way to support this hospital,” said Brett Williams, director of international programs at Direct Relief.

A partner with Direct Relief International prior to the devastating magnitude 7.0 earthquake that struck the island nation Jan. 12, 2010, Mr. Williams said cooperation has only grown closer since the disaster that left many of Haiti’s hospitals in ruins.

“On a regular basis, we share inventory we have with their entire network,” he said. “I view the partnership getting stronger and stronger.”

Partners in Health founders set root in Haiti in 1985 when they established a small two-room clinic in Cange, according to their website. Two years later, the organization was officially founded and though they now work in 12 different countries, Haiti remains their largest and most developed program.

Dr. Walton said Partners in Health does not specialize in disaster relief, but was forced to start work in the unfamiliar setting after the earthquake due to their long history in the country. With the epidemic outbreak of cholera last fall, their work has taken on an even larger role.

“There is such an unmet need,” he said. “We get flooded with patients.”

Dr. Walton praised Direct Relief for its hurricane pre-positioning in Haiti as well as its post-earthquake and post-cholera response. “I have always found Direct Relief to be an unbelievable partner,” he said.

He said he views the hospital, which will eventually be turned over to the Haitian Ministry of Health, as a way for the group to continue giving access to health care and medical training to rural Haiti. Their work in the country relies on community health workers and has always been focused in clinics outside of Port-au-Prince.

Dr. Walton said their trained health workers provide directly observed therapy, meaning they disburse medications to recipients and make sure it is consumed. They hope to introduce maternal health care training to their community health workers in the future.

Dr. Walton doesn’t see the hospital center as detracting from their work with community health workers, “It will only enhance our community projects,” he said, adding that it has lecture hall facilities for education and can be a referral institution for cases community health workers are not trained to handle.

The group hopes that eventually the project will be completely run by Haitians, who will be selected and then paired with trained physicians to learn the technology that has never been present in the country.

He said the hospital will be solar powered and host the country’s only publicly accessible computed tomography (CT) scan. Other advances include an oxygen generator and waste water treatment plant.

The post David Walton of Partners in Health visits Direct Relief appeared first on Direct Relief.

FedEx has provided air transport free of charge.

With food and clean water scarce, Direct Relief partners requested nutritional supplements, oral rehydration solutions, antibiotics, wound-care products, and personal care supplies. These essentials were donated by Abbott, Johnson & Johnson, and other corporate partners, or were purchased by the organization.

The delivered and staged materials, which total 26 tons, are being supplied to several partner organizations, including Visitation Hospital, Haitian Resource Development Foundation, and Partners in Health.

Visitation Hospital, a nonprofit outpatient facility in rural Petite Riviere de Nippes, serves a population of 266,000. Its staff of 25 sees about 85 patients a day and handles emergency care as needed. Comprehensive care is provided free of charge to 85 percent of its patients, whose health issues include serious malnutrition, malaria, and respiratory infections. The consignment of $635,000 (wholesale) of medicines, particularly antibiotics, is to support the clinic’s emergency treatment for flood-affected people.

Medicines and supplies valued at more than $370,000 have been furnished to the nonprofit Haitian Resource Development Foundation (HRDF), which supports three hospitals in Haiti, including the 200-bed Hôpital de la Communaute Haitienne in Petionville. The 24-hour facility treats more than 28,000 people a year for gastrointestinal and respiratory infections, hypertension, diabetes, and malnutrition. HRDF facilitates aid delivery through customs in Port-au-Prince and then on to hospitals.

HRDF President Dr. Aldy Castor reports that many roads are still impassable, and says that patients are presenting with dermatitis, cholera-like symptoms, and wound infections, all from prolonged contact with floodwaters. “The situation in Haiti is very precarious,” he reports. “The 800,000 people who were affected—10 percent of the country’s population—were already poor, and now they have lost everything, their homes, their crops, their possessions. When they get sick, they can’t take care of their children.” Antibiotics and personal care supplies are making the most difference now.

A 40-foot shipping container of medical aid is scheduled for delivery next week to Partners in Health, which provides comprehensive healthcare for half a million people living in the mountainous Central Plateau. In its 104-bed hospital and eight clinics across the region—home to the poorest people in the poorest country in the Western Hemisphere—it treats hundreds of patients a day. It has mobilized staff to work in the storm-affected areas, as well.

Collapsed bridges and flooded or damaged roads remain obstacles, and as the waters recede, pervasive mud challenges transportation. As the academic year starts in Haiti, shelters set up in schools are being moved to allow classes to begin. Diarrheal diseases and respiratory and skin infections are most common among the displaced population, as sanitation systems are disrupted. Many Haitians were stranded on their rooftops for days during the worst of the flooding.

The post Emergency Aid to Haiti Tops $2.3 Million appeared first on Direct Relief.