USAID Impact Photo Credit: USAID and Partners

Archives for Asia

Living with Tuberculosis: A Personal Note

World TB Day has a special meaning for me, and it is not just because of my job as a USAID Health Officer in Kazakhstan.  It is because every morning for the past four months I have taken a daily isoniazid pill to treat my latent tuberculosis.

Tuberculosis, or TB, is a contagious chronic bacterial infection that is spread through the air and usually infects the lungs. More than 2 billion people—one-third of the world’s total population—are infected with TB bacilli, the microbes that cause TB, but do not show symptoms (latent TB). In the United States, between 10 and 15 million people are infected with latent TB. In other parts of the world, like in Central Asia, this number is much higher.

I found out that I had latent TB at the exam to get my first medical clearance as a foreign service officer. I suspect that I was exposed to TB while I was a volunteer in Indonesia years before. Although I was shocked and worried when I got the diagnosis, the nurse reassured me and explained that latent TB is widespread in many developing countries and that there are options for treatment. I was pregnant then so isoniazid treatment—what I’m taking now—was not an option.

I learned soon after I was diagnosed with latent TB that anyone—grandparents, fathers, mothers, and children—can be exposed and infected. In the three minutes that it will take you to read this blog post, nine people will have died from TB. Although my chance of becoming sick with active TB in my lifetime is only 1 in 10, I felt that it was important to mitigate this risk and undergo the six-month treatment regimen. Every year, approximately 2 million people die from TB.

Compared with the experience of a typical TB patient in Central Asia, the past four months have been incredibly easy for me. In Kazakhstan, for example, a patient with active TB is required to be hospitalized in a TB treatment facility for a minimum of two months even if she is no longer contagious after a short period of treatment. She is not allowed to go to work or see her family and often faces tremendous stigma and discrimination if people find out she has TB. Moreover, poor infection control practices in TB facilities greatly increase the risk that patients will be exposed to and contract either drug-sensitive TB  or, worse, multi-drug resistant TB (MDR TB). MDR-TB is a form of TB that does not respond to standard first-line TB treatment, making the treatment longer, more costly, and more likely to result in serious adverse effects. Since TB is contagious and someone with active TB can infect an average of 10 to 15 people a year, infection control is critical to protect both patients and health care providers.

MDR-TB can also caused by failure to complete the standard course of TB treatment. If I were a TB patient in Central Asia, after months in a TB hospital, I would be required to visit a health facility every day for at least seven months to take TB drugs as part of directly observed therapy. The health facility is sometimes located far away from the patient’s home. Given these challenges, it is no wonder that patient adherence rates to treatment can be as low as 25 percent in some places in Central Asia.

On World TB Day, I am heartened by the work that USAID has been doing in Central Asia to reduce the spread of this terrible disease. Across the region, we are working with governments, the Global Fund to Fight AIDS, TB, and Malaria, and other international partners to focus our efforts in three areas. First, we are reducing the time that patients are required to stay in TB facilities by improving outpatient TB treatment in order to prevent hospital-based transmission of MDR TB and increase treatment adherence. We also are introducing new diagnostic technologies that can diagnose MDR TB within a few hours as opposed to a few weeks, which will expedite their care plan , as well as to  help reduce the time that undiagnosed MDR TB patients are potentially exposing others, both in the community and in health care facilities. Finally, we are supporting an intensive program to build the skills of health providers, communities, and patients to understand and address the treatment and care of people with TB and MDR TB.

Read the rest of this entry »

Small, but Perfectly Formed: Coffee Drives Development in Timor-Leste

The road south out of Dili climbs steadily, winding back and forth with spectacular switchbacks on a paved but narrow road, one of the few that crosses Timor-Leste, ultimately reaching the country’s south coast.  I am told Timor-Leste is about the size of Connecticut – a state I have traversed many times in just a couple of hours.  Here, a couple of hours might get you into the middle of the country, but certainly not all the way across.  Of course, Connecticut doesn’t have Timor-Leste’s mountains; at nearly 10,000 feet above sea level, Mt. Ramelau towers over the country’s central highlands.

Despite the travel complications they create, it is these mountains that have put Timor-Leste on the map as one of the top coffee-producing nations in the world.  The high elevation, sloping terrain, and regular rainfall make it a near-perfect coffee-growing area—the Timor hybrid coffee produces a delicious brew.  As a result, coffee now accounts for 90 percent of all non-petroleum exports for this small island nation, and most of it is bought by Starbucks.

As we rose through the lush, verdant countryside, we quickly reached coffee plots right alongside the road.  My guide and teacher was Bency Issacs, the senior technical advisor for USAID’s coffee and agriculture rehabilitation project, run by the U.S.-based National Cooperative Business Association.  The project helps more than 23,000 farm families, about 15 percent of Timor-Leste’s population.

Read the rest of this entry »

Fighting TB in India, One Lab at a Time

Phil Carroll is the Senior Policy Communications Associate at USAID partner organization PATH. He spent two weeks in India last fall visiting PATH programs related to maternal and child health, tuberculosis, immunizations, and safe water and diarrheal disease. Originally posted at the Global Health Technologies Coalition Blog.

India is a country that changes dramatically from place to place, something I experienced firsthand while on a two week trip there this past fall. One day I was listening in on a mothers’ group meeting in one of the poorest villages in Uttar Pradesh state, and less than 24 hours later I was standing in one of the world’s most technologically advanced airports in Hyderabad—often referred to as the ‘Silicon Valley’ of India. It was during this leg of my journey where I was further convinced of the need for sustained investment in research and development.

Man in a lab coat with USAID Logo in the background.

Photo: PATH/Gabe Bienczycki

In a laboratory on the outskirts of the city, I met a handful of Indian doctors and researchers who are doing some pretty amazing, albeit subtle, things in health. Thanks to a small, less than $100,000, investment by the US Agency for International Development (USAID), the Blue Peter Public Health & Research Centre upgraded its tuberculosis (TB) lab to a higher level of biosafety. Improvements like better equipment and infrastructure and enhanced safety measures have enabled researchers here to diagnose a case of multi-drug resistant tuberculosis (MDR-TB) in a matter of days, a process that used to take the same team several months.

This is significant for a host of reasons. Diagnosing TB on the early side can help get patients on treatment faster, thereby reducing further deterioration of their lungs and other organs and ultimately save their lives. Catching TB early on can also curtail the spread of this incredibly contagious disease to others. India, which has the highest incidence of TB in the world, and 20 percent of the world’s burden, needs these sorts of advancements now more than ever. Currently, the government of India, as part of its National TB program, is only reaching 25 percent of MDR-TB patients with diagnosis. However, by 2013, it is aiming for 100 percent coverage, or around 2 million TB patients.

Read the rest of this entry »

Picture of the Week

This 3-day old male calf was produced through artificial insemination trainings conducted by the USAID Agriculture Technology Program in Turkmenistan. The breed is a mix between local Brown Swiss (mother) and pure bred Brown Swiss. Photo credit: Zulya Achilova

 

USAID and Peace Corps Partner for Volunteers’ Return to Nepal

USAID joined Peace Corps this month in Washington and Kathmandu to celebrate the return of its volunteers to Nepal for the first time in seven years.

USAID Assistant Administrator for Asia Nisha Biswal (left) and Peace Corps Director Aaron S. Williams (seated, right) signed an inter-agency agreement to re-establish a Peace Corps program in Nepal after a seven-year absence from the country. Nepal’s Ambassador to the United States Shankar Prasad Sharma (center) and Assistant Secretary of State Robert O. Blake Jr. (standing) both spoke at the signing ceremony about the lasting contributions volunteers have had in Nepal. Photo Credit: J. Truong, USAID

In Kathmandu, Nepal’s Prime Minister, Dr. Babarum Bhattarai, said at an event at his offices that “I am very pleased with the return of the Peace Corps to Nepal. From the early 60s, thousands of volunteers have served in districts all across this country. I remember in much of the 60s and 70s the volunteers were a big source of teachers for subjects like math and science. I am very glad that with USAID’s assistance, the volunteers are coming back one more time to help with agriculture and health. Those are areas that need help, and I welcome the decision to redeploy the Peace Corps.”

Among those volunteers who served in Nepal include William Douglass, who now works with USAID. “Serving as a Peace Corps Volunteer in Nepal 45 years ago gave me unique opportunities to meet and work with a wide range of Nepalese villagers, urban dwellers and government officials throughout the country. I came away from Nepal with a strong appreciation for the people and the culture, and together with my wife who was also a volunteer, have taken many opportunities to return. During two assignments in the USAID mission in the 1980s and the 1990s, I was able to promote and support Peace Corps and USAID collaboration on Nepal Government projects. I and the many other former volunteers, including a number working with or for USAID, welcome this renewed collaboration to support Nepal’s development efforts after many years of conflict.”

Read the rest of this entry »

Tackling Tuberculosis in Migrant Populations

On December 19, 2011, the day after International Migrants Day, I found myself on a plane from Almaty, Kazakhstan to Dushanbe, Tajikistan, for a business trip.  I was surrounded by Tajik laborers returning home to celebrate the New Year. Other than my three colleagues and I, the seats were filled with Tajiks bearing electronics, toys, and other gifts for their families.  Had it not been for my ignorance of Tajik or Farsi, I would have struck up a conversation with my neighbor to find out what life was like being separated from one’s family for work.  Instead, I reflected on my own family, descendants of immigrants not unlike my fellow passengers.

Migrants and medical officers discuss the TB situation in the region. Photo credit: Abt Associates,Tajikistan

On December 23, 1909, my 26-year-old great-grandmother, Auyoung Yee Lau, emigrated from China to Hawaii to join my great-grandfather, who had opened a successful shop in Honolulu.  Prior to his wife’s arrival, my great-grandfather sent home $45 each month to feed five adult family members.  I wonder what went through Auyoung Yee’s mind as she boarded the boat from Hong Kong to what she called “the land of the Golden Mountain.”  I would guess that her thoughts were on the unknown country she was about to make her life in and the three children that she had lost in recent years, two of whom died of preventable childhood diseases before the age of 3.

After my great-grandmother’s journey to America, her tragedy was overcome with the subsequent births of five boys, four girls, and finally, my grandfather, whose Chinese name translated into “Happiness Complete.”  Had my great-grandmother and her family been denied access to health care services in Hawaii due to their migration status, I wonder if my grandfather and his siblings would have suffered the same fate as Auyoung Yee’s first three children?  Would my great-grandmother’s happiness have been complete?

Read the rest of this entry »

A Triumph of Coordination: To the Last Case in India and Beyond

Ellyn Ogden delivers a polio vaccine in Kolkata. Photo credit: CORE Group

Ellyn Ogden has coordinated USAID’s polio eradication initiative since 1997 and is a frequent visitor to India.

Western Uttar Pradesh was once seen as the world’s largest reservoir of polio virus. Four districts, namely Moradabad, Bareilly, Rampur and Badaun, were considered the ‘Hot 4’ and for many years, people speculated that the last polio cases would be from these districts. But the skeptics were wrong. The districts pulled together, involved all ministries, not just the health sector, and held everyone accountable for performance. The District Magistrates took charge and became personally involved in solving any obstacles that would crop up. Vacant medical officer positions were filled and progress was monitored closely.

Across India messages travelled the TV and radio airways. Celebrities and sports legends lent their support. Rotarians urged everyone to participate, provided much needed financing, and rolled up their sleeves to help out during the campaigns. CORE and UNICEF Mobilizers spent countless hours answering mothers’ questions, and in some places visited every pregnant woman to sensitize her in advance of the need for immunization. When the baby was born, the mother would then receive a ‘congratulations’ card, an immunization card and education on how to protect the child from a range of diseases. These extraordinary efforts make a difference far beyond polio eradication.

The last polio case in India was in Howarah District of West Bengal. It was not in the ‘Hot 4.’ It was in a child who was never vaccinated against polio in the routine system. It was in an unexpected area, demonstrating the importance of a robust surveillance system. The rapid outbreak response by the West Bengal government has been exceptional. The health team in the area knows how fragile the situation is. Still, far too many families refuse vaccination, there are periodic shortages of the trivalent vaccine used in the routine system, there are vacant medical officer posts, and routine immunization sessions happen once a month rather than the needed once a week in many rural areas.

Read the rest of this entry »

Picture of the Week

Ms. Le Thi Het (right) received a wheelchair from a USAID-funded project in Danang, Vietnam which enables her to get around. She is able to easily access a nearby community rehabilitation center supported by USAID where she has been able to strengthen her legs to operate a sewing machine and expand her business with her sister, Le Thi Thuong. Photo Credit: Richard Nyberg, USAID

Meeting Needs and Supporting Disaster Management in the Philippines

The people of the Philippines have been hit hard by Tropical Storm Washi (known locally as Sendong.) Heavy rains, storm surges, flash flooding, and landslides have rocked communities on the island of Mindanao, with 1,249 people reported dead as of December 27, nearly 55,000 still in evacuation centers, and hundreds of thousands affected.

USAID responded immediately, providing an initial $100,000 for disaster-relief efforts and putting disaster management specialists on the ground to assess conditions. The Agency is providing an additional $800,000 in emergency assistance to continue to support ongoing emergency relief operations, including the distribution of emergency shelter kits, water purification tablets, water containers, and hygiene kits.

USAID is also supporting logistical operations to ensure the uninterrupted delivery of emergency supplies to the most affected populations, particularly in the hardest hit cities of Cagayan de Oro and Iligan.

However, our investment in addressing disaster risks and impact in the Philippines actually goes back many years, and is more than direct disaster response. Knowing the Philippine islands face continued risks from storms, typhoons, earthquakes, volcanoes and other natural hazards, the United States has been working with the Philippine Government and regional and local groups since 1998 to train and prepare emergency responders.

The Program for the Enhancement of Emergency Response, known as PEER, has been instrumental in staffing Philippine search-and-rescue and first-responder groups like the Philippines National Red Cross, the Bureau of Fire Protection, the Office of Civil Defense, and even the Armed Forces. Graduates of the program must complete standardized coursework in medical first response, collapsed structure search and rescue, and hospital preparedness for mass casualties.

USAID and the U.S. Forest Service also have trained Philippine emergency personnel in what is known as the Incident Command System or ICS, which makes sure responders are “speaking the same language,” or in other words, are working under the same response framework.

The United States continues to be a key partner of the Philippines by providing humanitarian assistance when disasters strike, as well as helping the people of the Philippines strengthen their disaster preparedness capacity and improve communities’ resilience to disasters.

Learn more about USAID’s response in the Philippines.

Partnering with Russia and Kyrgyzstan to Help Disabled Children

December 8 marked a big “wheels down” party in Bishkek. Three countries—the United States, Kyrgyzstan, and the Russian Federation—provided quality wheelchairs to dozens of disabled children, helping them to be more mobile and independent.

The wheelchair project was started by former Kyrgyz President Rosa Otunbayeva at a meeting with the Russian Envoy to the Kyrgyz Republic and the Russian and U.S. ambassadors in the summer of 2010.  The Frank Foundation Child Assistance International, an American non-governmental organization, received funding from USAID to procure 90 wheelchairs. Two Russian private companies, Polyus Gold and Russneft, provided funding for an additional 90 wheelchairs.  The Russian government covered costs for air shipment between New York, Moscow, and Bishkek, and the Kyrgyz government arranged free customs clearance and covered some transportation costs.  Special Envoy of the Russian Federation President to the Kyrgyz Republic Vladimir Rushailo played a leading role on the Russian side, leveraging private sector donations as well as organizing the shipment of the wheelchairs.

The day presented a unique opportunity to showcase U.S.-Russian cooperation in Kyrgyzstan.  Former Kyrgyz President Otunbayeva, Special Envoy Rushailo, and U.S. Ambassador Pamela Spratlen stood together to present the 180 wheelchairs to disabled children.  The Russian Ambassador, USAID/Russia Mission Director Charles North, and USAID/Kyrgyzstan representative Carey Gordon also participated.

“A lot of people think these two countries argue.  I would say that here in Kyrgyzstan a lot of things are done together by these two countries.  Look at this wheelchair project!  The two countries united and a good deed was done,” said President Otunbayeva.

Read the rest of this entry »

Page 11 of 21:« First« 8 9 10 11 12 13 14 »Last »