the week in african health

Nyala, Kalma camp, South Darfur - March 2007 (MSF Photo Blog)

The impact of conflict on the environment and then the subsequent, direct effect on human health cannot be overlooked. This internally displaced peoples (IDP) camp in Sudan shows the seriousness of that impact.

Your Old Cell Phone Can Make a Difference in Global Health

Everyone in the global health sector is writing about the incredible reach of SMS technologies working for health in developing countries, and rightly so. Hope Phones has partnered with FrontlineSMS to provide old cell phones to communities in need through SMSmedic partner organizations.
More:
Your Old Phone Can Change the World

TeleMed
A service that I just recently came across is one that is not being as widely talked about. TeleMed is different from FrontlineSMS: Medic because it connects local health care workers directly to patients in need via SMS technology. SMS: Medic is focused on health infrastructure. TeleMed does not have a website up yet, but is definitely one to watch:

Paul Farmer and the US Government?

The other big talk within global health is whether Paul Farmer will take a job within the US government. Some have expressed great hope for potential reform others voice their plea with him to continue his incredible community based work outside the bureaucracies. My opinion is that Partners in Health has developed into a strong organization and does not depend on Paul Farmer to further their work. If he wants to take on the inefficiencies and inadequacies of the US government and global health, then all the more power to him.

Southern Africa: Global Financial Crisis Leads to HIV Budget Cuts

Broken promises abound as the economic crisis deepens and the right to health falters, but activists are coming together to ensure that funding for health and HIV are not cut. International donors are expected to slash budgets for health due to the economic crisis and health experts fear that this will lead to, “less food security and quality of nutrition, which will in turn put more stress on already weak health systems.” Paula Akugizibwe, regional treatment literacy and advocacy coordinator of Windhoek-based AIDS and Rights Alliance for Southern Africa (ARASA) in Namibia demanded, “We need to ensure that African lives do not become a silent casualty of the global financial downturn. Our lives are not cheap or expendable. We expect health to be prioritised over weapons, sports and lavish politics.” Tanzania was the first sub-Saharan country to announce a 25 percent cut of its annual HIV/AIDS budget.
Other budget cut impacts:
Guinea: Medicines Running Out

Zambian High Court to Hear Groundbreaking HIV Case

On Wednesday, the Livingstone High Court was supposed to hear a ground breaking case about whether mandatory testing for HIV and discrimination solely on the basis of HIV status is constitutional in Zambia. Unfortunately two days later news came that the trial was postponed until mid-July. Be sure to keep watching this story.
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Trial postponed until 15 July

HIV Prevention and Behavior Change

Mara Gordon writes on Change.org’s Global Health Blog about a direct campaign in Tanzania discussing behavior change. “This campaign is partially paid for by the President’s Emergency Plan for AIDS Relief, U.S. government money to fight HIV that’s notoriously had lots of conservative strings attached. Had I seen this ad a year ago, I probably would have dismissed it as unrealistic abstinence-only propaganda. But behavior change works. Behavior change – in combination with access to condoms, comprehensive sexual education, open discussion about HIV and sexually transmitted infections in general, all that good liberal stuff.”
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Changing Human Behaviors: Sexual and Social
During a course on Africa’s environmental history I wrote about the need for changing human behavior in both the sexual and social arena to make a real impact in HIV prevalence. The major social change is the response from Western institutions and organizations in how they talk about HIV/AIDS and Africa while seeking to change sexual behavior.
Lesotho: Cultural Beliefs Threaten Prevention of Mother-Child HIV Transmission
Health workers note an encouraging response to the PMTCT program. The number of facilities providing PMTCT has risen from nine in 2004 to 166 by the end of 2008. The number of women who received PMTCT and subsequent antiretroviral (ARV) treatment increased from 421 in 2004 to about 5,000 by end of last year, according to 2009 National AIDS Council statistics. “The primary health care coordinator at St. James Mantsonyane Mission Hospital, Khanyane Mabitso, says stigma and cultural beliefs make it difficult for medical personnel to follow up on HIV-positive mothers and their babies.”

Progress on health-related MDGs mixed

Many advances have been made in health. Some argue that these advances have been dwarfed by the HIV/AIDS epidemic, the economic crisis, or the failures of African governments. The WHO report shows that the only statistic with concrete results was the number of children dying before the age of five. Is this a solid example of the failure of big plans and blanket goals for development?

Sierra Leone: ACC Recommends Reform At Health Ministry

The Anti-Corruption Committee report provides a number of recommendations for reform all focused on improving the health care delivery services in Sierra Leone and eliminating the risk of corrupt practices in the health services across the country.
More on health service scale-up:
Chad: Paving the Way for Better Obstetric Care
Government meetings with UNICEF to help scale-up of health services for better obstetric care across the country.

Ten Things You Can Do to Fight World Hunger

The Nation provides an interesting set of things you can do in your everyday life to fight world hunger. They properly focus on how food, a basic human need, has been commodified in our global capitalist structure. “Our planet produces enough food to feed its more than 960 million undernourished people. The basic cause of global hunger is not underproduction; it is a production and distribution system that treats food as a commodity rather than a human right.” When in February I wrote that agricultural experts had said the food crisis of the last year was over evidence from this past week point to the contrary.
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Tanzania: Food Shortage Unnecessary
“Tanzania has since independence sang the song of ‘Agriculture is the backbone of the economy’, but little has gone into strategizing and implementing viable actions towards surplus food production.”
Kenya: UN Agency Makes First Local Food Purchase from Small Scale Farmers
The United Nations World Food Programme (WFP) has for the first time bought food from small-scale farmers in Kenya under a new initiative aimed at boosting agriculture by connecting farmers to markets.
Zimbabwe: Another Year Without Much Food
Rwanda: Nearly Half the Country’s Children Are Malnourished
Kenya: Over Three Million Face Food Shortages

Africa: High Level Engagement with Continent Has Started

Speaking at a gala reception in Washington marking the beginning of “Africa Week,” Carson said: “Most of the Obama administration’s Africa team is in place, and we are gearing up. We will continue to build on and strengthen the strong bipartisan consensus in Congress and among the people of America that has motivated U.S. policy towards Africa. Over the next four years, we will be focusing our efforts on strengthening democracy, promoting sustainable development, resolving or mitigating conflict, and dealing with transnational issues such as climate change and agriculture,” he pledged. While Obama has built a great team, the White House has yet to announce any Africa Policy, greater control and influence for the Bureau of African Affairs, or take any serious (or effective) action for the continent.
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Tanzania: Obama, Kikwete Meet in Oval Office on Africa’s Conflicts

World Bank Resumes Zimbabwe Aid

Zimbabwe owes the World Bank and the African Development Bank more than $1bn, how much potential does renewed aid really hold for the country. If the debt is not forgiven there will be no way the country will be able to rebuild necessary infrastructures for health, water, etc. There are countless case studies to show this historical fact. It must also be noted that Western sanctions were a huge detriment to a country in need, maybe this marks a turnaround?

Originally posted on the SCOUT BANANA blog.

2010: access for all, stories of hope

HIV/AIDS – Part III:

20 million dead, 40 million infected, 4 million new infections each year, and counting. As the numbers grow, so too should your hope. At the heart of the issue is access to treatment and drugs for all those infected with HIV/AIDS – the number with access is growing, however it is not growing at a rate equivalent to the spread of the epidemic. Nevertheless, hope is on the horizon and is always dawning. Now here are some stories to strengthen your hope in regards to the AIDS pandemic and Africa.

At the Saint Leo clinic in small, dusty village in central Lesotho a small cluster of patients gather to be diagnosed. A thin woman sits waiting to hear advice about her racking cough. A mother of five, she said her husband had died two years earlier and had also coughed incessantly. She does not know what killed him. With these common symptoms of tuberculosis and sexually transmitted infections, many of these patients will today learn about HIV and will be tested. The test results will take a few days to be sent back from the city and many patients question why it will take so long. “We have no money and no manpower” says the clinic manager, “I have to manage everything, but neither do I feel comfortable referring patients elsewhere. They often do not show up because they are too sick, or don’t have money, or transport.” The Saint Leo clinic presents an ideal site to introduce a program to involve community members with training for HIV testing and counselling, leaving nurses time to focus on more complex aspects of treatment. Providing HIV testing and counselling at primary health clinics is key to enabling access to HIV prevention and treatment services. Lesotho has a very high rate, where 23% of adults were estimated to be infected in 2005.

When Rose Dossou became pregnant she did everything she could to have a healthy baby. SHe visited an antenatal clinic at the university hospital in Abidjan, Cote d’Ivoire. She had lost 2 babies before and was tested because she wondered if HIV had killed her babies. The test came back positive. Rose wondered how she was going to handle this, at six-months pregnant and how would she tell her husband. The doctors told her the baby may also be infected. She told her husband who remained supportive and found he was HIV positive as well. Rose wanted to do everything she could to stop the transmission to her baby and began volunteering for a clinical trial of AZT in pregnant women. Even with a good trial and a smooth birth, her new-born son at 12-months was HIV positive. Rose dropped out of school and turned her HIV positive status into her life passion. Her son spent the first three years in the hospital and she became an expert on HIV. Soon both Rose and her son were recieving treatment from a french charity. Rose’s son is now 10, goes to school and rides his bike. Rose is 42 and runs Chigata, an organization that supports children who need HIV treatment and AIDS orphans. Chigata, means Hope in the local language, organizes discussions, courses in theatre , distributes food kits, and provides drugs through a community-based pharmacy.

In Rwanda, Mwavita acquired HIV at birth, or as a result of breastfeeding. Once diagnosed Mwavita was urgently treated for both TB (tuberculosis) and HIV. She finished her TB treatment successfully, but had to stop the HIV treatment because the medicines had to be taken with food and after one month there was nothing to eat. Thankfully a neighboring family agreed to give Mwavita food whenever her family had none so she can continue her treatment. Most dosages of antiretrovirals (ARVs) are unavailable for children, so health workers have to cut and divide tablets designed for adults in order to treat children infected with HIV. This makes pediatric care extremely difficult and puts children at a much greater risk. After a few months of restarting treatment, Mwavita is healthier than ever, she has put on weight and has returned to school.

These are just a few of many stories (from WHO) that can offer great hope to the future of combatting HIV/AIDS and other disease in Africa. The HIV/AIDS pandemic highlights many issues and brings the inter-related issues of health under one lense. The lack of health workers and health infrastructure are made painfully clear, the lack of pediatric medicines and focus, and the greater problem of the lack of access to basic treatment and food almost screams at us as we examine the HIV/AIDS pandemic.