University Teaching Hospital

Lusaka, Zambia

by Analeta Peterson, Meharry Medical College

April 12, 2010

Experiences on the Maternity Ward

I was initially blown away at the number of delivery rooms when first arriving on the labor and delivery ward at University Teaching Hospital (UTH). There were no less than 20 beds for mothers who were in labor or those who were pregnant and very ill. The monitors, such as those used to assess fetal heart rates found in most U.S. hospitals, were absent. As were bedside sitting areas for patient's family and friends, likely as a result of limited space.

Five to seven midwives provide ongoing care to each patient. Their responsibilities include monitoring the progress of labor, delivering the neonate, and immediate resuscitation of any newborn in distress. Resident physicians decide who is admitted to the ward and also monitor the progress of each patient. I mostly assist with the admission process. Many of the patients are referred from clinics within the community that are unable to adequately care for severe cases. A small number come directly from home with symptoms of labor; occasionally they have given birth at home with a family member or friend providing assistance.

There is a constant flow of patients to be assessed and cared for, at times leaving staff overburdened. In a 24 hour period 60 deliveries were completed and others were either sent home with a diagnosis of false labor or admitted to a different ward for medical therapy. An average 10 operations, including cesarean sections and removal of ectopic pregnancies, are performed by the senior resident physicians in this same time period. The operating theater is continuously in use throughout the night.

A number of the women are HIV positive and receiving appropriate therapy. The primary diagnoses I've witnessed excluding normal labor include preeclampsia and cephalopelvic disproportion (the maternal pelvis is inadequate to deliver the fetus). These patients receive the standard of care and leave the hospital in good condition.

I am very impressed with the outcome of care on the maternity wards at UTH despite the lack of expensive equipment. The Zambian women are incredibly strong and very cooperative. I'm looking forward to my next few weeks here where I will be spending time in gynecology and visiting a rural clinic.


by Krista Ford, Princeton University

Dar Es Salaam, Tanzania

April 7, 2010

            In Dar es Salaam, March signifies the end of Tanzania's summer which starts somewhere around December. During the summer, the sun is already unbearable by 7 a.m. and the ridiculous humidity means you'll be drenched in sweat before you can even make it from home to the office.

            In addition to relief from the scorching heat, the end of summer also brings with it rain-buckets and buckets of rain. It rains almost every morning from about 6:00 am to 8:00- just in time for the morning commute. Heavy downpours come out of nowhere in the middle of the night with thunder loud enough to wake a person from a sound sleep and wind gusts strong enough to blast curtains open. The rain also seems to enjoy marathon sessions on Saturday afternoons, complete with menacing skies and enough water to keep all but the most determined inside.

            In the city the rain complicates morning commutes, forms huge puddles in the dips and valleys of bad roads and turns unpaved stretches of road into huge mud holes barely fit for travelling by foot. In parts of the city where the open drainage system has been blocked by haphazard construction of homes or shops or masses of trash and leaves that accumulated throughout the dry season redirected water often floods homes and business leaving citizens to grab a bucket and bail out the water as best they can.

            Upcountry things are much worse. Flashfloods carry away livestock, as well as elderly people and children. Puddles as big as lakes spring up and children must balance books atop their heads, remove their shoes, hitch up skirts and uniform pants and wade through knee-deep water to make their way to school. In places where the landscape forms fast flowing channels of water children simply stay home for days at a time until the water recedes enough to cross carefully.

            Like the weather, a lot of things have changed in the office. The last few months have been strongly geared towards proposal writing so a lot of time is spent researching, accessing the efficacy of existing systems and brainstorming ways that these systems can be improved.  Since February, I've provided support on two major proposals and we're currently in the process of writing another one. Also, we're wrapping up one of our biggest programs in June so I anticipate at least one visit to our field office in Dodoma to provide support on things such as end of project reporting and documenting best practices. Although it's tough to imagine wrapping things up here, it seems very appropriate that the end of my fellowship will coincide with the end of a major project.

March 23, 2010

by Jenny Dyer

Last night, Senator Bill Frist was honored by the T.J. Martell Foundation with the Lifetime Medical Achievement Award. Big Kenny Alphin of Nashville and Ross Perot Jr. of Dallas, TX presented the award citing Dr. Frist's contributions to medical science, the field of transplantation, and global health for the past 35 years.

The T. J. Martell Foundation , founded in 1975, raises funds for innovative cancer and AIDS research. Over $500,000 was raised at the event, with proceeds directed to the Frances Preston Center at the Vanderbilt Ingram Cancer Center. Frist was accompanied by his wife Karyn, and brother Tommy and his wife Trisha.

March 19, 2010

by Bill Frist, M.D.

Former Presidents George W. Bush and Bill Clinton will visit Haiti together on Monday, March 22, 2010.  It will be their first joint visit to the area.  They will be traveling with several of the board members of the Clinton Bush Haiti Fund, which to date has raised over $31 million from over 200,000 contributions for relief and recovery efforts.

The Chicago Tribune's Washington Bureau reported on this yesterday.  The Clinton Foundation announced, "Presidents Clinton and Bush will meet with Haitians, the Government of Haiti, and others providing assistance to earthquake survivors, with the goal of further establishing long-term recovery and rebuilding efforts."

I am very glad to work with the talented team at the Clinton Bush Haiti Fund, and I am honored to serve on the board of that organization - one that can provide so much help and healing to a country that is still suffering daily from the deadly January earthquake.

For more information about the Clinton Bush Haiti Fund, visit their website by clicking here.   For more information about the work Hope Through Healing Hands is doing in Haiti, you can visit our Beneficiaries page.

March 18, 2010

by Bill Frist, M.D.

CSIS Releases Report on Smart Global Health Policy

I have served on the Board of Trustees at the Center for Strategic and International Studies since 2007.  The work they are doing has continued to live up to its mission, which is "finding ways for America to sustain its prominence and prosperity as a force for good in the world."  Earlier today, CSIS issued a report from their Commission on Smart Global Health Policy, and I think it is well worth the read if you are interested in the issue of Global Health. 

The report, entitled "A Healthier, Safer, and More Prosperous World," is the result of nearly a year's worth of work, which looked in detail at the long-term U.S. strategic approach to global health. 

The Commission on Smart Global Health Policy included public servants,  top leaders in business and finance, and some of the leading minds in philanthropy and non-profit work. Together we worked hard to reach a consensus for a long-term plan for the United States to address global health issues and potentially save millions of lives around the world.

In short, the conclusion of the report is, "[t]he United States can better the lives of the world's citizens and advance its own interests by investing strategically in global health-even at a time of global economic recession and exceptional domestic challenges."

I encourage everyone interested in global health to take a look at this report and let me know your thoughts.  Working together, we can really have an impact on millions of lives.

To read the report, please click here.

March 5, 2010

by Bill Frist, M.D.

The Leading Child Killers No One Is Talking About

Which two diseases kill the most children worldwide? If you guessed AIDS, malaria, or measles, you're wrong.  Pneumonia and diarrhea claim the lives of more children under age 5 than those three diseases combined and account for over 30% of child deaths worldwide.

Pneumonia and diarrhea kill more children than any other disease - yet most people are unaware that this common illness has such a profound impact on the world's children.  Every day, 10,000 children die from pneumonia and diarrhea despite the fact that affordable prevention and treatment options exist. For millions of children around the world, these diseases could be prevented with vaccines and medicines that cost less than $10.

The real tragedy is that we have the tools to prevent most of these deaths but lack the political will to make their use a priority.  That's why Save the Children and GAVI have teamed up to continue raising the visibility of the biggest killers of children.

If the U.S. Government were to lead a global campaign to get pneumonia and diarrhea treatment to children living in just six countries - India, Pakistan, Afghanistan, Nigeria, Ethiopia and the Democratic Republic of Congo - we would see the single biggest reduction in child mortality of our lifetime - and we would be that much closer to achieving Millennium Development Goal 4 - to reduce child mortality by 2/3 by 2015.

You can help fight the leading killers of children and make a real difference in the lives of children around the world - here is how:

  • Vote for Save the Children and Gavi's life-saving idea:

     Fight the Leading Killers of Children - Urge U.S. to Invest in Child Health

Two-month-old Damon is one example of how basic health services can save children's lives.  Damon lives in a small impoverished village in Malawi, nine miles away from the nearest health facility. When Damon was 5 days old, he suddenly stopped breastfeeding and started crying.  He was weak, had a high fever, a fast pulse and short breaths. Fortunately, his mother Zione, did not have to carry Damon miles to get medical care, because a trained community health worker was right there in her community to evaluate the little boy's condition and provide antibiotics. Prompt attention from this health worker, who then referred the baby to a hospital, very likely saved Damon from a tragic death.

Show your support for the world's children and vote for US leadership against the leading killers of children. Vote today and help ensure this issue is presented to the Obama Administration and's one million supporters. Help children who cannot vote for themselves.


BGA Donates over $1800 to HTHH Haiti Disaster Relief Fund

by Jenny Dyer, Ph.D.

Battleground Academy's Middle School, Grades 5-8, collected over $1,800 from their students as a fundraiser for Haiti Relief efforts. The students gave a minimum donation of $5 for the privilege of wearing blue jeans to school (in exchange for their typical uniform attire).

Jonathan Reiss and Harris Jones, seventh graders at BGA Middle School seen in the photo above, presented the check this week to Senator Frist.

Sen. Frist told the young men that this money would be used for tetanus vaccines (via Mobile Medical Disaster Relief) and fuel for helicopters (via Samaritan Air), to name a couple of ways the money is being spent right now.

The BGA Haiti Fundraiser was led by Keli Kennedy the Community Service Coordinator.

February 23, 2010

by Bill Frist, M.D.

Haiti Fund Update 

            As of this week, we've been able to donate over $115,000 of your generous gifts to provide immediate assistance for the victims of the earthquake in Haiti. Most recently, beneficiaries have included Missionary Flights International, which has provided air transport during this time of crisis in Haiti, and Mobile Medical Disaster Relief, which will be purchasing tetanus, diphtheria, and pertussis vaccinations for over 6500 children in Port au Prince.

            Below are three great photos of how our monies have been spent already. Love Everybody has used our gift to purchase a water purification machine, Samaritan Air has provided transport for mothers and children to clinics to receive immediate aid, and Promise for Haiti has purchased an autoclave or sterilizer for their clinic in Pignon. We will continue to demonstrate exactly how your dollars have been used as our beneficiaries report back with photographs of how your gift has been spent. 


Annual Report 2009 

            Our Annual Report 2009 will be published this month! We are excited to showcase our programmatic efforts from last year with measureable results from your investment. Over 2200 patients were seen, 175 community health workers/medical personnel/leaders were trained, and 20 training courses were provided to clinics in Guatemala, Kenya, and Rwanda. We are proud of our first class of Global Health Leaders.


            For 2010, we will be supporting 13 Global Health Leaders. We are looking forward to working with new schools and new students including those from Lipscomb University and Belmont University. Our leaders are standing in the gap of the critical need for health workers in developing communities. They are bravely going into clinics, caring for patients, and training health workers to enhance and sustain the health care of children, women, and families.

Support these Global Health Leaders' work today.

February 16, 2009

On January 3rd, Big Kenny was awoken with a strong emotion. Thirty minutes later it was the words to "Cry With You." Big Kenny worked on "Cry With You" while planning his departure to Haiti to help search for Walt who was in the country working on several renewable energy projects at the time. It features a broad range of spirit and talent who came into The Last Dollar Studio to track and complete the song while Big Kenny was away. The song includes the First String Orchestra directed by Carl Marsh, recorded at Oceanway Studios the day prior to Big Kenny's departure to Haiti, spoken word by Senator Bill Frist just back from Haiti himself, Better Than Ezra members Kevin Griffin and Travis McNabb, Glotown Artist Damien Horne, Lo Carter as well as many others.

Because of the many Fan requests, if you wish to make a donation to the "Love Everybody Fund", all purchase amounts over the $1 "Cry With You" track price, will go directly into the Love Everybody Fund of the Community Foundation of Middle Tennessee. We hope this simplifies the giving process and your many wishes to HELP. Thank You.



February 10, 2010

Three Updates: Reflections and Reports

We continue to receive reports from friends and acquaintances and partners who are still in the field in Haiti. We want to share three of those stories today.

A Surgeon's Reflections, Written on a Plane Returning from Haiti

Dick Furman, M.D. -- Samaritan's Purse

            ...I don't know how their memories will affect me as time goes on.  But now it is difficult not to compare them with life, as we know it.  They will not sleep in their homes because of the after quakes.  At night they still cry out and moan and wail.  The stench remains in the air as you drive by building that collapsed.  And then there are the patients that survived and we operated on who are in despair with nowhere to go and loved ones dead.  We had our surgical team meeting this morning after which I made my last walk through the hospital and left patients I will remember for the rest of my life.  I am on the plane flying home as I think back over what was the most horrific time I have ever experienced in my life.  I have never seen such suffering.  I have never seen so many people go through so much sorrow. 

            It surely looked different on TV.  Watching it, you could get the feeling of what the earthquake was like.  You could get a feel of the destruction of buildings and houses and stores.  You could even get some insight into the terrible devastating feeling the people are going through.  But until you have examined a patient who was in the kitchen while her husband and four children were in the next room, who felt her third floor apartment begin to shake and sway and less than sixty seconds later; her family was dead and she had a slab of concrete roof lying on her legs and pelvis  -  until you are a part of that, you can't really understand what it was all about.  We operated on her and for the next week, every time I examined her at her bedside she would begin shaking her head and begin weeping.  Last night, my last night in Haiti, I left our quarters and slipped down to the hospital just before going to bed and prayed at her bedside, gently placing my hand on her head.  I didn't know how to pray, what to ask.  I realized we had done everything medically which could be done and only God's love for this woman could give her any comfort.  Our surgery was going to be successful.  The physical part of her problem would be healed but that part of her desperation was minimal to her over-all suffering.  So I prayed a verse, which came to mind.  I prayed that God would give her a peace that surpasses all human understanding that would guard her heart and her mind through Jesus Christ during this terrible time in her life.  I finished my prayer and stood by her bed and just looked at her hardened face and thought of what she has been through and wondered how long she would suffer before she realized the peace of God.

            I walked through the other wards.  Most of the patients were asleep.  I could not speak Creole nor understand it.  I would stop at the foot of certain beds and give a nod at a particular patient I had gotten to know in a very unusual way.  They didn't try to speak.  I would stand a few minutes looking at them and ask God to give them that same peace that only he could give.  I would just touch their foot or pat their leg and stand with them a moment just to let them know that even though I wouldn't see them again here on earth, I cared. 

            I stopped at the first ber in the second ward.  He had pulled his sheet up over his face.  I wanted him to see me but didn't want to awaken him even though he was one of my favorite patients.  He was a large man; a policeman, in his mid thirties.  We had put some metal pins through his broken bones on his right leg and then stabilized it with an external brace.  He had a wife and two young daughters.  His wife was giving the girls a bath when the quake hit.  For two days, the he was trapped, not knowing whether his wife and children were alive or not.  Even when some men found him and pounded the concrete off his body to free him, he did not know.  He didn't know for sure they had died until he looked back at the rest of the house and realized the slab of roof had completely crushed the bathroom portion of his home.  He had been with us three days in the hospital but didn't speak much to anybody.  I can only imagine what keeps going through his mind.  I can't imagine how I would react if my wife and all my children were suddenly taken away from me. 

            And a few beds down were the man with the little three-year-old boy who had lost part of his arm.  The man's wife and two children had died in the quake.  He kept telling me through the interrupter that his wife was thirty-two years old.  Thirty-two he kept saying. I remember him sitting and holding his boy all day in his lap as if he wanted to make certain he didn't loose him.  We had tried to discharge him earlier in the day but he had no money and nowhere to go.  At least at the hospital they received one meal a day.  We needed his bed for other patients but yet couldn't make him leave for some reason...

(Dick has a longer reflection of multiple patients. These were just some stories that remind you of the families torn apart in a moment's time.)

Reflections from a Clinical Research Nurse Trainer, Vanderbilt University -- at GHESKIO Clinic: Port au Prince

by Janet Nicotera, RN BSN

I want to let you know I am alive and well at GHESKIO. The main building the one built more than 20 yrs ago when our collaboration began is not safe but that has not stopped the work. Administration moved, research trial patients are seen outside under the trees and every inch is utilized. Two field hospitals are also on the university side so it sounds a lot like the TV show MASH all day. We have almost 6000 refugees, 1000 under 5 yrs old. I had not put my bags away and Dr. Pape had given me three new tasks..I love that about him. We are currently preparing for two post op sites and another research site so patients can have more access to care. Life goes on here. I am so grateful to be with these amazing people and learn from their tenacity.
Best, Jan

From Save the Children, a HTHH Beneficiary of Haiti Disaster Relief Funding (as of 2/10/2010)

Reading Material: SC produced this prior to the earthquake assessing the needs of Haiti last Fall, October 2009 -- Modernizing Foreign Assistance, Insights from the Field: Haiti

Our efforts in Haiti continue to make a big difference for families and children. The mass food distribution which we are managing with the World Food Program at 2 of the 19 locations in Port au Prince continues to go well (target 280.000 beneficiaries). The Family Tracing and Reunification (FTR) center and helpline was set up over the weekend at the UN logs base and is now operational as child separation and protection remain key concerns. Community registration workers were trained and began registering children in Port-au-Prince on Sunday in coordination with UNICEF, IRC and ICRC. Fully operational sub-offices in Leagone and Jacmel have been established to support our growing response in those areas. Further sub-offices in Petit Goave and Port au Prince are being established. With rains imminent, the distribution of shelter material and the establishment of planned settlements still remain among the main priorities for assistance, with sanitation and control of vector-borne diseases becoming a major concern at many temporary sites.

General Updates:

* The Government of Haiti reports that the death toll may be as high as 200,000 people, with an additional 300,000 people injured by the quake.

* To date, seven organized settlements have been established for 42,000 displaced people, with an additional 460,000 in spontaneous settlements throughout PAP.

* The Ministry of Education is in the process of assessing 6,000 schools and estimates that over 400,000 children are displaced.

Our most recent activities are as follows:

Total number of beneficiaries reached so far: 297,591

Total number of beneficiaries we intend to reach: 800,000

Non Food Items (NFIs)/Shelter:

* SC has reached a total of 9,611 families with NFIs to date. 500 families in Leogane and 511 families in Jacmel were provided with blankets, hygiene kits and other NFIs in the last three days.

* SC shelter activities will be scaled up in the coming weeks, with an interagency assessment to identify tent sites in Jacmel already underway.

Water, Sanitation and Hygiene (WASH):

* To date, SC WASH interventions have reached more than 60,000 people. This includes the construction of 156 emergency latrines, 90 bathing areas, and hand washing facilities at 20 latrines.

* Additionally, the first of an expected 150 WASH facilities was installed at a Child Friendly Space on Monday.

* SC is leading an inter-agency WASH assessment in 5 districts in Leogane and conducted training for mass hygiene promotion activities set to begin this week in Port-au-Prince.

Health and Nutrition:

* 14 SC mobile health teams have seen a total of 10,630 patients at 45 locations to date. This includes 2,760 people in Port-au-Prince, 1,143 people in Leogane and 6,727 people in Jacmel. Additionally, SC health agents are equipped with oral rehydration solution to treat cases of diarrhea.

* SC health teams completed MUAC screening for 125 children, of which 7 were found to have severe acute malnutrition and 13 had moderate malnutrition. Additionally, SC, in collaboration with Ministry of Health, completed a measles vaccination campaign along with MUAC screening in Jacmel.

*SC is leading the infant and child feeding program at the national level and is supplying safer breast milk substitutes (BMS) for infants who cannot be breastfed.

Child Protection:

* The Family Tracing and Reunification (FTR) center and helpline was set up over the weekend at the UN logs base. Community registration workers were trained and began registering children in Port-au-Prince on Sunday in coordination with UNICEF, IRC and ICRC.

* The sector specific in-depth assessment is being conducted this week in Port-au-Prince and Jacmel by SC trained volunteers. 10 additional staff will be trained for an upcoming assessment in Leogane.

* SC also held a two day workshop for CFS trainers, with 70 participants from 25 organizations.


* So far, SC food distributions have reached over 120,000 beneficiaries, including 72,000 children. This number will continue to increase as distributions in Port-au-Prince continue over the next week.

* SC distributed 25kg bags of rice to 1,700 families daily over the weekend in each of the two locations, Martissant and Tabarre, as part of the 14-day World Food Program collaboration.

* The cash programming learning group led by SC is being officially recognized by the Early Recovery cluster and Cash for Work programming is expected to begin this week.


*Of the 29 schools that were a part of SC's Rewrite the Future Campaign, 5 were totally destroyed, 14 were partially affected with varying levels of damage, 8 were not structurally affected and information was unavailable for 2. Only one of these schools has started to function.

* SC will conduct assessments in 4 zones in Leogane to identify sites for temporary learning spaces.


* Wellness sessions with staff members continue and a long-term strategy will be issued soon.

* Additionally, 70 tents, 300 sleeping bags and 300 sleeping mats for national staff arrived in Port-au-Prince on Friday, providing some much-needed relief.



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