I've spent my first 2 weeks at Kijabe Hospital working on the internal medicine team of the men's ward. Inpatient medicine at a tertiary care hospital is a quite a change of pace from rural primary care at Lwala. We have more diagnostic and treatment abilities, but also "sicker" patients. The variety in what I've seen has been tremendous – everything from the "bread and butter" medicine cases I see in the US like COPD, CHF, and diabetes but also lots of infectious diseases (HIV/AIDS, TB infections in every manifestation (brain, lung, abdomen), meningitis).
Late one evening about 4 months ago, Josephine, a 31 year old Kenyan female, was riding home from a long day of work on the back of a motorcycle. An oncoming vehicle swerved directly in front of her to pass another vehicle. As the motorcycle swerved to avoid a collision she was thrown to the ground, severely fracturing her right ankle. She was taken to the hospital, where she underwent surgical repair of the ankle. Following the operation, she continued to have pain and weakness, to the point that she could not bear weight and had to walk with a crutch. After a repeat evaluation, she was referred to Kijabe Hospital, in Kijabe, Kenya, for ankle fusion.
See how the Clinton Bush Haiti Fund's grant to Inveneo is empowering rural and underserved communities in Haiti with information and communications technologies.

Their grant will accelerate the development of sustainable, high-speed wireless broadband connectivity to 20 population centers in six rural regions across Haiti, which will in turn stimulate economic growth and support decentralization of the country. Inveneo works with several Haitian ISPs to deliver training programs that will prepare its partners to manage and take full responsibility for the network. Inveneo also provides training programs for Haitian Information and Communication Technology (ICT) entrepreneurs.

Visit www.ClintonBushHaitiFund.org to get involved.

See how the Clinton Bush Haiti Fund's grant to YouthBuild International, partnering with IDEJEN, will put young people back to work in Haiti and give them the skills necessary to rebuild their country.

The centers will serve at-risk youth (ages 16--28) by providing them with vocational training in construction and leadership skills for the future. The grant will also be used to provide a two-to-one match of trainees' savings contributions, support leadership training for the Build Back Better Youth Corps. The program also provides six months of follow-up support as trainees seek viable employment opportunities or pursue self-employment.

The first training center, JENKA, was built in Leogane, the epicenter of the earthquake where nearly 90 percent of the buildings were destroyed. This first of 12 centers is where the project's local implementing partner IDEJEN (Haitian Out of School Livelyhood Initiative) is now recruiting staff and students.

Clinton Bush Haiti Fund money enabled YouthBuild to get construction underway quickly while other projects in Haiti have stalled due to funding delays.

Visit www.ClintonBushHaitiFund.org to get involved.

See how money from the Clinton Bush Haiti Fund has provided sales and marketing support for local artisans.

Their funds also helped these local business people rebuild their workshops, damaged during the earthquake. Through our support, artisans were able to complete their order to Macy's for its exclusive "Heart of Haiti" collection, inspired by the courage and culture of the Haitian people.

Clinton Bush Haiti Fund's recent loan to Fairwinds Trading, will expand this support to artisans in three additional communities and increase employment opportunities for Haitians — particularly women. This could sustain the employment of 740 artisans and artisan managers and provide secondary employment for 185 additional individuals.

Follow-up orders from Macy's could provide income to support 4,544 individuals.

Visit www.ClintonBushHaitiFund.org to get involved.

February 15, 2010

Tuesday night Senator Frist was in New York at an event for Harvard Medical School, "Conversation: Exploring Global Health." Moderated by 60 Minutes' Byron Pitts, the event was a conversation about the history and direction of global health with Dr. Paul Farmer, who among other things leads the Department of Global Health and Social Medicine at HMS and co-founded Partners In Health one of the most influential, visionary and effective international humanitarian organizations, and Dr. Joia Mukherjee, who was just named the Director of Global Medical Education and Social Change at HMS. Listen to the whole thing or just the first few minutes for my introductions.

You've probably heard of the plight of people living in developing countries and the struggles they go through to get water. Often they may have to walk six to ten miles to the closest water source and then back again carrying the full containers of water – some weighing 40 – 60 lbs.

Consider, if you will then, that there are communities in the US where water may only be a couple hundred yards away from your home – clean, safe water coursing through a water main and yet, you have no access to it.

That is the dilemma for many families in Appalachia – municipal water may be located 1000 feet away from their home but they simply cannot afford to access it. "How can they afford not to," you may wonder?
One of the unique aspects of the model of Lwala Community Alliance, is that while there is a clinic, the program is multi-dimensional, there is also a strong water, sanitation, and hygiene program (WASH), a education initiative that partners with schools and helps to provide secondary school scholarships based on academic merit and need, Umama Salama, an initiative to train community members on basic lifesaving skills to reduce maternal and infant mortality, and a sewing cooperative. The clinic staff goes on school outreaches at local primary schools which includes health education and free preventive care.
Georgetown Public Hospital Corporation (GPHC), is the central hospital for the country’s public health system. The A&E (Accident and Emergency) functions as the essentially Level 1 Trauma Center and the Emergency Department for the country. Referrals come in from all over the country from outlying health clinics and hospitals if more specialized care is needed. Georgetown is also the population center of the country and so most patients arrive? to be seen first here with acute complaints. There are multiple clinics ranging from diabetic foot clinic to eye clinic to pediatric and surgery clinic that see and refer patient to the A&E for admission or further treatment as well.

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