USAID Impact Photo Credit: USAID and Partners

Archives for Health

Saving Mothers and Newborns in Afghanistan

Submitted by the USAID Maternal and Child Health Integrated Project (MCHIP)

Every 27 minutes, a woman in Afghanistan dies from complications due to pregnancy or birth. Across the country, midwives are the frontline health care providers working day and night to save these women. Educated with USAID support, Sadiqa Husseini, 24, is among the more than 2,000 new midwives who are helping to significantly reduce Afghanistan’s maternal mortality rate, which is among the highest in the world. Sadiqa was featured in a recent BBC audio slideshow on a day in the life of an Afghan midwife. The piece is a moving portrayal that demonstrates how USAID contributes to empowering women, rebuilding essential networks of skilled health care providers, improving health care services for women and families, reducing deaths of mothers and newborns, and strengthening communities.

Sadiqa had wanted to become a midwife ever since her sister nearly bled to death giving birth to her first child. At the time, Sadiqa and other family members relied on traditional means and home remedies to try to stop the bleeding. Ultimately, Sadiqa’s sister had to be taken to a hospital some 20 kilometers away. She and her newborn daughter survived, but Sadiqa’s sister never fully recovered and had no more children. The experience had a profound impact on Sadiqa.

“When I saw this happen in my own family, I wanted to become a midwife,” Sadiqa said. “I didn’t want other women to suffer like my sister and her family.”

Najiba Fazzay, a 35-year-old Community Health Worker (far right), gives a talk on maternal health care to expectant mothers in the village of Aquachanoy near Jawjzan, Afghanistan. USAID-funded programs have helped train 8,500 community health workers in Afghanistan. CREDIT: Jhpiego

USAID’s Health Services Support Project, in partnership with the Afghan Ministry of Health, allowed Sadiqa to realize her ambition. Through the project, accredited midwifery schools have been established in nearly every province of Afghanistan. These schools, assisted by USAID with partner organization Jhpiego, provide essential training for midwives like Sadiqa, helping increase the number of trained midwives to more than 2,000 (from about 450) since the fall of the Taliban.

Local health committees are involved in identifying and selecting candidates, a unique aspect of the program that builds support for midwives who return to their communities to work. Villages and communities have directly benefited from the increase in midwives: The number of Afghan health centers that are staffed with more than one midwife has increased from 10 percent (2002) to 61 percent (2009) since USAID began focusing on maternal and child health in Afghanistan in 2003.

The success of USAID-funded projects in Afghanistan has also led to the training of 8,500 community health workers and the formation of a professional midwife’s association, which includes 1,600 members. The impact of this expanded force of maternal health specialists is reflected in the increasing number of Afghan women who give birth with skilled care, a key intervention to reducing maternal and newborn deaths. According to the most recently available data, deliveries assisted by a skilled birth attendant in Afghanistan increased from 8 percent in 2003 to 19 percent in 2006.

USAID Strengthens Malaria Control Efforts in Africa

Submitted by Elissa Jensen

Thanks to a little teamwork, efforts toward sustainable malaria control in Africa just received a boost.  Indoor residual spraying (IRS), a mainstay of malaria eradication efforts for decades, has typically involved oversight by health specialists trained in IRS application.  But the intervention also requires input from environmental experts, who have historically been overlooked in IRS operations.

This summer, with USAID support under the President’s Malaria Initiative (PMI), environmental experts from across Africa participated in a workshop in Kisumu, Kenya, to review and refine best practices to support health teams in providing oversight and management of IRS.  The workshop was the first of its kind to introduce such an integrated approach.

In addition to discussing the development of environmental assessments and proper waste disposal, participants addressed the challenges associated with proper implementation of IRS considering real-life constraints, such as scarcity of water and lack of infrastructure.

With their training, participants will increasingly work alongside counterparts from the health sector to provide oversight of environmental components of IRS operations, thereby strengthening local and regional capacity for sustainable malaria control.  Soon after the workshop, in fact, two of the participants conducted environmental inspections and provided technical assistance in new spray areas in Zambia and Ethiopia.

USAID is proud to contribute to PMI, which has provided IRS to nearly 7 million houses and protected 27 million people through spray campaigns since 2006.

Delivering Hope: One Pill At a Time

Submitted by: Jessica DiRocco

It’s shocking what two little pills can do for someone living with HIV/AIDS. Antiretroviral (ARV) drugs have been a lifesaving advance in the treatment of HIV/AIDS because they limit the virus’ power to weaken the immune system. A stronger immune system means stronger individuals. Instead of sickness and immediate death, HIV becomes a manageable disease. Mothers can continue to take care of their children, husbands can continue to support their families, and children can continue to attend school. All because of two little pills. The USG, through PEPFAR, has already put almost 2.5 million people on treatment worldwide, with plans to support four million people by 2015.

To assist in reaching this goal, USAID focuses on activities that directly and indirectly support the provision of antiretroviral therapy. USAID’s comprehensive AntiRetroViral program includes: increasing access to ARVs and other medications, improving the physical infrastructure of laboratories and facilities, ensuring a consistent supply of quality drugs and commodities, building the personal capacity for health care workers to manage antiretroviral therapy programs, nutritional supplementation programs, and provide psychosocial support of patients before and throughout treatment.

The transformation of most of the people on ARVs is nothing short of amazing. After only a couple moths of ARV treatment, many individuals who were bedridden and facing death, became strong advocates armed with huge smiles and their powerful stories. In fact, several studies have begun to support the idea that people living with HIV may achieve near-normal life-expectancies through the simple act of taking their ARV drugs every day.

These remarkable results have been captured over the years through words, photos, and videos.

In 2007, the Global Fund teamed with Magnum Photos to create Access to Life- a series of photo essays which documented the impact of antiretroviral treatment on the lives of individuals around the world.

Just this year, (RED) worked with HBO to create The Lazarus Effect, a film which illustrates the transformative effect of ARV treatment through the stories of HIV-positive individuals in Zambia. USAID staff received a special screening of the film only a short time after it premiered on HBO, with representatives from (RED) present to show their support of USAID and PEPFAR work.

Most recently, the Topsy Foundation, which receives funding from Right to Care, a USAID and PEPFAR partner based in South Africa, created a short video on Selinah, a woman living with AIDS in South Africa, who experienced the disease effects of the disease being reversed over a three month period with the help of ARVs. The Topsy Foundation even won the Cannes Gold Lion award for the video at the 57th Cannes Lions International Advertising Festival.

USAID stays committed to the goals of PEPFAR and the Global Health Initiative to put more than four million people on treatment. USAID programs will continue to work so people like Selinah can maintain a healthy life.

This Week at USAID – August 16, 2010

Administrator Shah will officially swear-in Alex Dickie to be the Mission Director-designate to Iraq and Mike Harvey to be the Mission Director-designate to West Bank Gaza.

Secretary Clinton gives a speech on the Global Health Initiative (GHI) at the Johns Hopkins University Paul H. Nitze School of Advanced International Studies.  The GHI is building on the Bush Administration’s successful record in global health, and taking these remarkable achievements to the next level by further accelerating progress and investing in sustainable health delivery systems.

NBA and WNBA Bring Nets to Senegal but Grab Mosquitoes, not Baskets

Submitted by: Susan Telingator

On Friday, August 6, USAID/Senegal was pleased to be a part of the effort to distribute long-lasting, insecticide-treated mosquito nets with the United Nations Foundation’s Nothing But Nets Campaign and NBA Cares programs in Rufisque, a suburb of Dakar. Teams of NBA (National Basketball Association) and WNBA (Women’s National Basketball Association) players, USAID staff, US Peace Corps volunteers, government health workers and media crews ventured out into the town after a short ceremony emphasizing the importance of sleeping under a mosquito net in order to prevent malaria.

The visit was especially significant for those players who were born on the African continent. NBA Vice President for Development, Amadou Gallo Fall (originally from Senegal), talked to residents in their native Wolof language, followed by NBA legend Dikembe Mutombo (originally from Congo), who spoke in French.

USAID’s President’s Malaria Initiative, which has a nationwide bed net distribution program here, provided technical assistance and coordinated logistics among the various groups. The organizations spent the rest of the weekend running their “Basketball without Borders” program, a four-day camp, which received 65 of the top 19-and-under basketball players from across Africa. This was the first time these events were held in Senegal.

U.S., Russia Explore Opportunities to Collaborate to End Polio

A. Sabin and M. Chumakov work on Oral Poliomyelitis Vaccine (Moscow, 1950s)

Submitted by Jonathan Hale
Deputy Assistant Administrator for Europe & Eurasia

Today, I am back in Moscow.  The Russian government has already made significant contributions to stopping the polio outbreak in Central Asia. Now we are exploring opportunities for further U.S.-Russian collaboration on this issue to work toward ending polio once and for all. I met with Dr. Mikhail Mikhailov, Director of the M.P. Chumakov Institute of Poliomyelitis and Viral Encephalitis. We were joined by the Institute’s Deputy Director, Evgeniy Tkachenko, and some of our USAID Health Office staff to discuss U.S.-Russia collaboration on the response to the polio outbreak in Central Asia.

As Dr. Mikhailov asked me to sign the Institute’s 50-year old guest book, I was struck by the long history of cooperation between its Russian scientists and our own American scientists. In the late 1950s, Dr. Albert Sabin, the American scientist who would later become famous for developing the oral polio vaccine (OPV), needed more subjects for his vaccine clinical trials since earlier polio vaccines had been used so extensively in the United States.

Deputy Assistant Administrator for Europe & Eurasia signs the guest book at the M.P. Chumakov Institute of Poliomyelitis and Viral Encephalitis.

Although this period marked the height of the Cold War, Dr. Sabin was allowed to conduct massive clinical trials in the Soviet Union, working with Dr. M.P. Chumakov, founder of the Institute. In the first five months of 1959, ten million children in the Soviet Union received the Sabin oral vaccine.  Shortly after, the Institute began manufacturing OPV for internal and international use. Later, Dr. Sabin would receive a medal of gratitude from the Soviet Union – one of the only Americans to do so. I hope more Americans can learn about this longtime U.S.-Russian cooperation that has literally saved millions of lives around the world.

Today, as Americans and Russians explore new ways to once again fight polio – this time in Central Asia – I look forward to deepening our collaboration with the Polio Institute and the Ministry of Health on this in the coming months.

Advancing Maternal and Child Health in the World We Live In

When the theme of the 15th African Union Summit in Kampala, Uganda was announced, there was tremendous excitement among the public health community. “Maternal, Infant, and Child Health and Development in Africa” would be a real opportunity to bring to the fore some of the most critical issues in health and development. While specific diseases have gained the attention of world leaders and the global community in recent years, the essential challenge of improving the health status of women and children has often been neglected. This Summit would finally be an opportunity to engage in high-level discussion about how to improve the status of women and children on the African continent. As a Health Officer at the USAID/Uganda Mission, I was looking forward to participating in the conference in support of our U.S. Delegation, anticipating new opportunities to advance the agenda for moms and kids.

And then, two weeks before the opening of the Summit, everything changed. Terrorist bombings tore through Kampala on what should have been a joyful Sunday evening marking the close of the World Cup. Families and friends participating in the global celebration had their lives ended or forever altered by acts of horrendous murder.

Adjusting to our new reality of a terrorist threat in what is usually a safe and relaxed city was quickly overtaken by additional security concerns related to the AU Summit. Ugandans have had to simultaneously mourn while also preparing to welcome the continent’s leaders to their hometown. Grieving for many was cut short.

As I sat in the opening ceremony of the Summit on Sunday, hearing numerous Heads of State and our own Attorney General condemn the unspeakable acts of murder in Kampala, it became clear that the focus of the Summit would be Somalia. As I supported the U.S. delegation’s efforts through the Summit, Somalia and terrorism on the African continent was indeed the central theme of most meetings.

As a public health practitioner, there is of course disappointment that maternal and child health did not gain as much central attention at the Summit as had been hoped for. But the Summit made it clearer to me than ever to me why taking a development approach to advancing health in Africa is so essential. Taking a development approach means working in the real world with the real world problems that conflict, poverty, and even terrorism bring. We need to pay as much credence to applying health interventions to real-world settings as we do to the scientific research that helps us understand what might work in the first place. Conflict, poverty, and terrorism are a real part of women and children’s lives in Africa. While scientific research and innovations remain fundamentally important, we do not have the luxury of applying health interventions in a controlled setting. To advance health status in a sustainable way, we need to be vigilant of the harsh realities that women and children in Africa are facing. For although maternal and child health deserves a great deal of attention in its own right, we cannot separate health interventions that need scale-up from the realities that moms and kids are living in.

So, on the closing day of the AU Summit, I applaud the public health practitioners and advocates who soldiered on during the Summit to maintain some focus on maternal and child health, as it is an issue that deserves the highest levels of attention. But I also challenge us as a public health community to remember that terrorism and conflict are not simply distractions to our goals. This is, unfortunately, the world we are working and living in. These issues shape the lives of the women and children we are working to save. We need to work with local institutions to understand local issues, and transform evidence-based interventions into reality-based interventions. It is only by addressing the reality of conflict, poverty, and now even terrorism that our goals for improving health can be realized. With a development approach to improving health, women and children all over the continent, including Somalia, stand a better chance.

This Week at USAID – July 26, 2010

Senior Deputy Assistant Administrator for Management Drew Luten will testify before the Commission on Wartime Contracting on Subcontracting in Iraq and Afghanistan.

Administrator Shah and Ambassador Richard Holbrooke will appear before the House Appropriations Subcommittee on State, Foreign Operations for an oversight hearing on corruption in Afghanistan.

Chief Innovation Officer Maura O’Neill will participate in a briefing entitled: Innovation to Catalyze Development: Leveraging Research in Foreign Assistance, which is organized by the Global Health Technologies Coalition and the Modernizing Foreign Assistance Network.

Administrator Shah will testify before the House Foreign Affairs Subcommittee on the Western Hemisphere about: The Crisis in Haiti: Are We Moving Fast Enough?  He will also brief the Congressional Black Caucus about efforts in Haiti.

USAID – From the Field

In Zambia USAID has partnered with World Vision to implement The Community Based Prevention Initiative for Orphans and Vulnerable Children, Youth and other Vulnerable Populations Program to strengthen community response and leadership for HIV prevention and improve the quality of life for orphans and other vulnerable, at-risk children.  USAID and World Vision will work with the Zambian government to strengthen community response and leadership for HIV prevention; improve the quality of life for orphans and other at-risk children through educational, psychosocial, food and nutritional support and by improving their access to health care, child protection and legal services.

The American people’s response to HIV/AIDS in Zambia has contributed significantly to the scale up of HIV prevention, care, and treatment services. Notable among the successes has been a significant number of community-based care programs for orphans and vulnerable children, care and support programs for people living with HIV/AIDS, increased access of pregnant women to Prevention of Mother to Child Transmission services, establishment of a network of trained volunteer caregivers and peer educators, a significant number of Zambians accessing Anti-retrovrial Therapy and a decrease in the prevalence of HIV from 15.6 percent to 14.3 percent between 2001 and 2007.

In Indonesia a ribbon cutting ceremony for the Information Computer Technology (ICT) lab at the Al-Ahliyah religious junior secondary school (Madrasah) in Karawang, West Java.  The event highlights a public/private partnership to support quality and relevance of education through strengthening the use of ICT in education.  The school will receive a state-of-the-art computer lab, with equipment, software and educational resources from private sector partners.  USAID is providing teacher training and support, The Office of Defense Cooperation has also provided resources for construction of the lab building and donated staff time and resources.

How to describe the International AIDS Conference in Vienna?

Submitted by Robert Clay, Director of USAID’s Office of HIV/AIDS

Robert Clay briefs VOA's global broadcast community. Photo by VOA

Over 20,000 people (a small city) all focusing on one of the greatest development problems of our time. The first thing that strikes you is the diversity of those at the meeting – from the famous (Bill Clinton and Bill Gates) to academia (professors and students) to civil society and advocates to multilateral and bilateral donors to pharma. There are talks, seminars, posters, demonstrations (even in the plenary sessions), exhibits, condom demonstrations, cultural events, marches, press conferences, and lots of reports and products to take home. At times, it reminds me of a village scene in India where I lived for 5 years – crowded, colorful, loud, unpredictable, widely diverse, and even wonderful food smells.

There is definitely a buzz in the air. The results of the USAID-funded CAPRISA 004 trial results has excited everyone – standing ovations and tears from those who have waited so long for good microbicide news. But also excitement at seeing other results since the last meeting two years ago and hearing insightful analysis on how to overcome barriers. There is personal excitement of seeing old friends and colleagues and making new contacts in this diverse setting.

But concerns are also there. Will the money dry up? Will leaders change negative policies that fuel stigma? Will we be able to stop the number getting infected? These are big issues and everyone here seems consumed in trying to solve these problems.

This has been intensive and on the last day you can see the tired and sleep deprived faces. I don’t think people could do this any longer – especially since so many want to get back to implementing all the new ideas. But after a good rest, I’m sure most will have renewed energy and determination from Vienna. I know I can’t wait to get back to work!

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