“If you don’t practice family planning, you will have a child on your back, in your belly, on your shoulders and in a baby basket on your head.” Malawi nurse Mercy Chikhosi Nyirongo describing the song and dance from a women’s health meeting in Madisi, Malawi 2013.

Behavior change communications take many forms throughout a lifetime . . . from the parent who scolds a child for doing something harmful, to government warning labels about health hazards. Somewhere in between are the messages from this video that rise up from women simply wanting to build healthy families by practicing family planning. With one in 39 women on the continent of Africa dying from pregnancy complications, it is easy to understand this group putting family planning at the top of their health priorities.

The channels through which these messages travel are increasing through the use of technology. Mobile phones, now accessible in over 90% of the world, provide a means for health education by caregivers who put messages into local language and context. The Reverend Betty Kazadi Musau, United Methodist clergy in the Democratic Republic of the Congo, utilizes a system that does not require Internet to reach her community. The results for sending text message cholera alerts is witnessed immediately:

“People are changing their behavior. They start boiling water to drink instead of taking unclean water from the river. They drink clean water. I think this is a life transformation!” [Listen to full interview]

Mercy Neely HicksUnited Methodist Communications provides best practices in the use of technology for wellbeing by working with global communicators and leading technologists. You are invited to attend the upcoming Game Changers Summit in Nashville, Tennessee which will demonstrate the link between technology and health, and help participants put a plan into action for the messages that matter to them the most.

The right messages reaching people at the right time can save lives and build a world where all – from mother to infant – can thrive.

For more information, contact Rev. Neelley Hicks at [email protected].

Download a free copy of Using Technology for Social Good

First off, an update on the two abandoned babies: they were not there when I went to work after my three days off. I was told that the girl (who was very cute and term) had been adopted, while the boy (who was a premi, but seemed very healthy—though of course small—to me) had died.

Working at HIC has certainly taught me a great many things, none more so than how to multi-task. I’ve gotten used to—though certainly haven’t mastered—watching the perineum’s of two women who are pushing wondering who will give birth first and if I’ll have adequate time to change gloves to catch the second ones baby, to do the admission paperwork while making sure that a resuscitated baby is still breathing appropriately, and to triage patients while checking frequently for the presence of the baby’s head of a woman squatting and pushing on the floor. I’m forever impressed at what the nursing staff (as they are the main staff that run the maternity) do every day. As I say I’ve gotten used to this type of work environment, but it still stresses me out and makes me anxious. They however, are so used to it and so good at balancing multiple patients at once, that I don’t think they even notice it at this point. I think it’ll be a bit of a transition to go back to the U.S. and for each patient to have her own room (instead of an open room with three tables) and to have to certainly still have to multitask, but in a very different way.

This week I had the pleasure of visiting the Maison de Naissance (MN), a birthing type center about 30 minutes from Cayes. MN is located in a tiny town pretty far off the main road and provides much needed services to the women in the area (many of whom would never come all the way to Cayes to give birth and so would just give birth alone, or with a traditional birth attendant). MN had 7 post-partum beds, a two-bed birthing room, provides prenatal consultation serves, and birth control services (among other services). It was really nice to be able to visit MN and see a different type of birthing environment. Because MN is smaller than HIC, it was much calmer than the maternity ward I’m now used to—though I was told I visited on a very calm day. It was wonderful to see what good care the midwives were able to offer the laboring women and those who came for prenatal consultations.  High quality clinics like MN are invaluable—in my opinion—to Haiti as they provide skilled birth attendants and health care services to women in rural areas who wouldn’t typically make the journey to the nearest hospital, but nonetheless need/deserve such healthcare. 

 

The Hill

by Senator Bill Frist, MD

The United States has shown courageous leadership over the last decade on global health. Earlier this year, Congress once again voted to protect the budget for those critical investments that we make to save lives, prevent the transmission of diseases and end preventable child deaths.  During my time in Congress, we fought hard for life-saving global health programs.  We were able to work together with both Democrat and Republican presidents to launch and implement historic health initiatives in priority areas such as HIV/AIDS, malaria, vaccines, and clean water.  These programs have saved millions of lives, and proven that health is the best currency for peace.

But even as funding for global health soared, foundational programs promoting maternal and child nutrition were largely overlooked.  Yet the need for greater leadership and investments in nutrition could not be more clear.  Across the world today, 162 million children—1 in 4 children under 5 years of age—are physically and developmentally stunted, and 80 percent of those live in just 14 countries.  The combination of physical limitations and reduced cognitive development directly linked to poor nutrition sentences these children to lives of unfulfilled potential, and it creates a severe drain on their communities and countries.  A 2013 report from the UN Food and Agricultural Organization (FAO) estimates that the social and economic costs of malnutrition are unconscionably high, amounting to as much as $US3.5 trillion per year or $US500 per person globally.

Thanks to U.S. leadership on global health, child death rates have been cut in half over the last 20 years from 12 million to 6 million per year. With continued investments and unwavering leadership, child death rates could be cut in half again over the next decade. We must not save these children, only to abandon them in their most crucial developmental years.

Providing the right nutrients is fundamental to health, particularly during the first 1,000 days from a woman’s pregnancy to her child’s second birthday.  In the 2012 Copenhagen Consensus report, an expert panel of economists concluded that every $1 invested in nutrition generates as much as $138 in better health and increased productivity. Yet despite the severe costs associated with malnutrition and the extraordinary returns on nutrition investments, the world spends less than 1 percent of development aid on life saving, basic nutrition solutions.

The tide is turning. In the 2014 budget, Congress provided a funding boost to the global nutrition account, signaling strong bipartisan support to combat malnutrition.  President Obama has committed to developing a global nutrition strategy, and USAID Administrator Dr. Raj Shah, who has taken the lead on this initiative, just announced the completion of that strategy and the effort underway to develop a coordination plan across all agencies and programs that contribute to improved nutritional outcomes.   

Moreover, in June 2013 at the Nutrition for Growth event in London, the U.S. joined other world leaders and signed a global agreement that will boost global prosperity, prevent millions of infant deaths, and unlock greater human potential by working in partnership with developing countries to tackle malnutrition. This commitment is reflected in the Global Nutrition for Growth Compact, which has been endorsed by over 90 stakeholders.

Governments from Scaling Up Nutrition (SUN) countries and their development partners are also taking nutrition seriously. A total of 50 countries have joined the SUN movement to date, committing to driving forward their national nutrition plans at scale.

These plans and commitments are encouraging, but we must sustain and build upon the momentum that has been created over the last year on global nutrition. The president and Congress must remain resolute in their support for strong global health and nutrition funding in the FY15 budget and in prioritizing nutrition as a critical pillar in our foreign assistance investments.  They must work together to oversee the implementation of the new strategy, and to provide the increased resources that are necessary to reach the millions of children who continue to suffer needlessly from poor nutrition.

Investments in maternal and child nutrition build the foundation for the next generation to survive and thrive, and serve as a shining example of U.S. global leadership at its best.  

Frist, an acclaimed heart transplant surgeon, served Tennessee in the U.S. Senate from 1995 to 2007. He was Senate Majority Leader from 2003 to 2007. He is chairman of Hope Through Healing Hands and Tennessee SCORE, a professor of surgery and author of six books. Learn more about his work at BillFrist.com.

NATO soldier

Hope Through Healing Hand's mission is to promote health worldwide as a currency for peace. This Memorial Day, we'd like to say a huge thank you to all of our armed service men and women who have given sacrificially to protect our freedom and to promote peace around the globe. You are heroes in our eyes, and we thank you for your service.

Image from Nato.org

October 26

My name is Courtney and I’m a Certified-Nurse Midwife and Family Nurse Practitioner in Haiti. I’m working and living in a town called Les Cayes (or just Cayes for short), which is in the south of the county about a 4-hour drive from Port-au-Prince. I’m working at the Hospital of the Immaculate Conception (HIC), which is the main public hospital for Les Cayes (and for a significant portion of the surrounding areas).

I’m quickly getting settled into life in Cayes, and think that I’m really going to enjoy my work and time here.

As some of you may know however, Hurricane Sandy developed this week, and certainly made my first week here interesting.  Cayes is right on the ocean—meaning at sea level—meaning that with lots of rain (i.e. daily, hard rain for 3 days straight) much of the town floods. The hospital—tragically—is not at all elevated, so it succumbed to the same fate as much of the town (see photo’s of me walking to work and the hospital). The largest building—which currently houses the maternity and men’s and women’s surgical post-op—is the lowest of them all. “Luckily” in order to get into that building there are ~1.5 foot high concrete walls (dams of sort) build into the doors—meaning you have to step over them to get into the building and that they prevent water from entering the building even if the hospital grounds are flooded. Despite these barriers (which were working) the maternity and the birthing room still had an inch of water covering it (I was told it came from underground and seeped through the floor tiles). We (the maternity nurses and doctors) worked for a day like this, but eventually the hospital closed and moved the maternity patients to a Canadian ophthalmology hospital on higher ground. It’s finally stopped raining today, so hopefully things will dry out quickly and we’ll be able to get back to HIC soon.

Despite the rain and the craziness with moving hospitals I’ve thoroughly enjoyed meeting and working with the nurses and doctors that I have. They provide the best care they can, given the resources they have available to them (which are pretty limited by American standards).

 

October 28

One of the things that has struck me about my work thus far in the maternity (we’re still at the Canadian hospital, although the town has dried out completely) is how family friendly it is. There is one woman on the service who has been hospitalized for at least 4 days, and 3 of her female family members (including a 1 year old) have basically moved into the hospital with her. They sleep in spare beds right next to the woman (who is hospitalized because at 20 weeks she’s been having contractions) and seem to just spend there entire day hanging out with her.

When I got to my night shift last night that woman’s family were there—as always—and there must have been 15 other visitors (of both genders) who had come to see their respective friends/family members who were at the maternity.

Most of the time the visitors are women—but we’ve had a couple husbands come to support their laboring wives. Those men have dutifully walked up and down the hallway with their wives supporting them when they have contractions, and in general have just been with them. Although the women are alone in the delivery room those husbands who are present are typically waiting anxiously outside and peer in as soon as we open the door (after the birth).

I think that it’s great that the nurses and doctors don’t mind family members sleeping in the spare beds, and on the floor when there aren’t spare beds (as was the case with the number of patients/visitors we had last night). Additionally, I really like that family and friends are so involved, supportive of the woman while she’s hospitalized, and in the case of births so excited about the new baby.

 

Every Newborn Campaign

Articles and Videos You Don't Want to Miss

May 21 2014

This week has been the launch of the Bill & Melinda Gates Foundation's #EveryNewborn campaign, and we've seen great coverage on social media and around the web on this important issue. Here are some of our top links for you to see, in case you missed them:

Melinda Gates's speech to the World Health Organization on May 20, 2014.

Who Has Been Caring for the Baby? by Dr. Gary Darmstadt, senior fellow for Global Development at the Bill & Melinda Gates Foundation

Saving 3 million Babies Is Easier Than You Think, from TIME's Jeffrey Kluger

 

Courtney and I had the unique experience of helping a family in Mshenguville relocate their home. Mshenguville is an informal settlement within Munsieville, and the houses there are built on a hill. The houses at the bottom of the hill are in a flood-prone area with poor sewage facilities, and the families in these homes recently got permission from the local municipality to relocate to a different street near Mshenguville and move out of the flooded area. Mshenguville is sometimes referred to as a squatter’s camp because people come to the area to settle, claim an area of land, and build houses out of any available material. Because Mshenguville is an informal settlement, there is no government assistance in providing houses and resources for the community. The government simply gave the families permission to move and would not be providing new houses for the families, so anyone who wanted to move would have to do so on his or her own.

Sarakay Johnson MshenguvilleWe had the opportunity of helping a woman named Celine and her mom with the moving process. We knew Celine’s mom from the GardenSoxx® class, and when we heard they were relocating we volunteered to help. We started by preparing the site for the new house. We smoothed out the ground, cleared away the rocks, and leveled the dirt in order to create a solid foundation before the house could be physically moved to the new site.

A few days later, Celine, her family, and a group of men started the relocation process. They first had to disassemble the house piece by piece. Then they moved all the furniture, clothing, and pieces of corrugated metal that would be used to reconstruct the house to the new site that Courtney and I helped clear. By the time we arrived in the afternoon to help rebuild the house,  a great deal of progress was already made with the men doing the majority of the physical labor. Courtney and I helped hold a few pieces of metal in place while the men nailed it together, and we watched as the last side of the house was completed. Some of the metal pieces used to construct the house had corroded and could not be used in the reconstruction. The house had to be rebuilt smaller than originally intended because of a shortage of corrugated metal pieces to rebuild the house to its original size. Celine, however, remained positive that she could one day get more materials and expand her house, and she was glad to finally be moving away from the flooded area of Mshenguville.

This week we are compiling health education information and creating pamphlets for the community that will be kept at the Children’s Embassy. We had a meeting with the women in the Health Promotion Unit and discovered that there is a great need for the community to have general health information. Our preceptor asked us to create a series of brochures that would cover health topics such as nutrition and exercise, proper hand-washing technique, HIV/AIDS information, puberty, tuberculosis, and drug and alcohol abuse. We gladly agreed and will be creating different brochures for different age groups and making sure the information is culturally sensitive to the community. We will be writing the information in English and then people at the Children’s Embassy will translate the information to the various tribal languages spoken within Munsieville.

Also, this week we will be conducting part three of our research methods class. This will be the last part of the class, and we will be teaching Excel skills. After the last class, we asked the students to come up with their own short survey and then distribute it to people so that real data could be obtained. If all goes well, they will return with their survey results and we can input the data into Excel to be analyzed. We hope that the students in the class will leave with a better understanding of how to correctly develop and distribute a survey and use Excel to analyze the results. This way they can better understand the community in which they live.

It is hard to believe that Courtney and I have just over a week left in Munsieville. Our time is quickly coming to an end, and I want to savor this last little bit of time before we have to leave this wonderful community. Our sincere “thank you” to the Hope Through Healing Hands and Niswonger Foundations for helping make this incredible experience possible for both Courtney and me. We hope we made you proud.

May Newsletter

May 15 2014

Happy Mother's Day!

Her.meneutics article: "Family Planning Through A Global Lens," by Jenny Eaton Dyer, Ph.D.

Christianity Today's Her.meneutics features articles that are at the interface of women's issues and cultural issues. We were proud to have the opportunity to publish an article this week discussing the importance of access to contraception and information about a variety of family planning methods, including fertility awareness, in the developing world. These are life-saving, life-changing tools for women and families. 

In a season when contraception is debated and discussed in our own nation, it is important to consider how contraception is a pro-life cause worldwide.

U.S. Moms Support Healthy Mothers and Children Worldwide this Mother's Day

This week, Hope Through Healing Hands launched a press release citing notable faith leaders, influentials, and parents who have taken a stand to promote awareness and advocacy for maternal, newborn, and child health. 

Amy Grant, Grammy-winning Artist, notes: “Those of us who have experienced healthy pregnancies here in the U.S. need to remember how uniquely fortunate we are. For the most part, we get to choose when and how we give birth, and we have all the health care we need before, during, and after delivery. In other parts of the world, the reality is tragically different. It is estimated that 1 in 39 pregnant women in Africa died in childbirth in 2013.”

We are excited to share all the leaders who have generously offered their endorsements to the coalition. We invite you to take a moment to read about why they are speaking up for women in the developing world.

Speaking Engagements: Why Family Planning is Critical in the Developing World

Over the course of the past month, Executive Director Jenny Dyer, Ph.D. had the opportunity to speak at the Center for Strategic and International Studies on "Ethiopia's Investments in Family Planning: Lessons for U.S. Policy" along with other experts. Dyer spoke on the interface of faith and health pertaining to healthy timing and spacing of pregnancies in the developing world and its role in awareness and education both in Ethiopia as well as the United States.

We invite you to learn more about her trip to Ethiopia as well as the event. Please see the "Family Planning and Linkages with U.S. Health and Development Goals" policy paper as well as the video showcasing the amazing work done there in family planning.

Dyer also spoke at ETSU's College of Public Health on "Saving Mother and Child: Why Planning Families is Critical in Developing Nations." She offered a lecture to students and faculty that can be viewed here.

We wish everyone a Happy Mother's Day,

Bill Frist Signature

Bill Frist, MD

Greetings from rain-soaked Munsieville! Over the last two weeks, several storms have doused the Gauteng province, but the rain is necessary to turn the landscape green again and help usher in spring. While the intensity of the thunderstorms is unlike anything I have previously experienced, I am not letting the rain put a damper on my work in Munsieville.

Last week Courtney and I led part two of our surveying and research methods class, and we taught the class how to format and administer a survey. We included lessons on the layout and visual design of the survey, how to format questions and avoid bias, and the different methods used to administer questionnaires and interviews. There were eleven people in attendance, and everyone seemed engaged in the lessons. The best part of the class was teaching about interviewing techniques and conducting mock interviews to demonstrate the process. Courtney and I exemplified both a good and bad way to interview someone and then asked the class to name some positive and negative aspects of our demonstration. Next, Courtney and I paired up everyone in the class, gave them a mock interview scenario, and had them act out a good and bad interview based on what they had just learned. Everyone demonstrated understanding of what Courtney and I were teaching. All the groups really expressed their creativity, and I was pleased that the class was so engaged in the activity.

Courtney and I also got to conduct two Garden Soxx® training classes in Mshenguville. Because Safira had some trouble contacting some of the families, the training had to be rescheduled several times. It was exciting to finally have not one, but two Garden Soxx® classes in the community. After so much interest was shown in the project at the first class, Safira, Courtney, and I decided that a second class would be beneficial so that more people could learn about the Garden Soxx® project. Because Courtney and I had already created our own Garden Soxx® sock and knew how to assemble it, we went to the first class and demonstrated how to create the sock. Once we did the demonstration, we let the ladies there work together to assemble a new sock. At the second class, Courtney and I let the ladies from the first class teach the new members who were at the second class, and the ladies created three new socks together. We felt this was a good way to encourage the women of Mshenguville to take ownership of the project because they are now the ones instructing others on sock assembly. I am excited about the future of this project, and I think that it will be sustainable in the community of Mshenguville.

I am also happy to report that some of the ladies at the Children’s Embassy are starting to use the vegetables from the keyhole garden to made salads for the community! Our preceptor said she enjoyed a tasty salad of vegetables grown from our garden and commended Courtney and me on our work with both the keyhole garden and the Garden Soxx®. It is exciting to get to see the bountiful results of a small initiative that was started at the beginning of my internship.

To conclude this post, I want to mention that one of the highlights of this reporting period was getting to spend an afternoon with Mama Gloria, the sister of Archbishop Desmond Tutu. Desmond Tutu is the patron of The Thoughtful Path and a respected social rights activist who has earned several awards and recognitions for his work. His sister lives in Munsieville, just down the street from the Children’s Embassy.  It was a pleasure to spend the afternoon with Mama Gloria and hear her talk about her daily life and the people in Munsieville. She is truly an inspiring lady, and I am fortunate to have had the chance to meet her! 

Originally published in The Tennessean, May 3, 2014

When we married in December 2007, we knew we wanted to enjoy the adventure of marriage together for a while before having children. So, we concocted a whimsical battle cry: “Baby Free Until 2013!”

In summer 2013, after thoughtful conversations, we decided to go off birth control. And lo and behold, we quickly became pregnant. The battle cry worked.

As we watch Jena’s belly grow, we realize how fortunate we were, especially as some of our closest friends and family have not had nearly as much ease. We also recognize that for many, contraceptive access and the ability to time pregnancy are not universal.

You see, we work for two organizations that provide health care to HIV-infected and affected people in Africa, and we have been given a unique window into the lives of many girls, women and men in countries like Kenya, Uganda, Zambia, Ethiopia, Rwanda and Central African Republic. For our friends in that part of the world, the nuanced discussion of family planning is very different than the one we hear in the U.S.

In Lwala, Kenya, 16-20 percent of the adult population is HIV-positive. The Lwala Community Hospital is providing more than 1,000 HIV patients with life-saving medical care. Many of these patients come to us for contraceptive options.

Try to imagine that you are our friend Maurice. You are facing some frightful questions because you are HIV-positive, but your wife, Betty, is not. A nurse explains to you that the hospital is out of condoms, so you must abstain from sex or risk infecting Betty. The nurse says the condom shortage is nationwide and there is nothing she can do.

Imagine that you are our friend Sarah. You are just 13 and a new mother to a premature baby boy named Moses. You have had to drop out of school to care for your new child. You did not plan on getting pregnant, but an older relative forced himself on you while he was drunk. Your parents know about the rape but have decided not to confront the relative and instead blame you. Your circumstance makes you one of the 300 pregnant teens who delivered their babies at Lwala Community Hospital last year.

When you bring Moses in for immunizations, you ask the nurse for birth control pills, but she tells you they are not available to you without parental permission. “How do I avoid getting pregnant again?” you ask.

For us as Americans, these seem like unimaginable predicaments related to contraception — catch-22s with life-altering consequences. But, sadly, these stories are not unique in Africa.

We are Christians, propelled by our faith in a loving and merciful God to do the work we do. Most of the year, we make our home in Tennessee. We are not abortion-rights activists or “lefty liberals.” We understand why some people of faith are hesitant to support increased access to contraceptive choices. But our view has been broadened through our experiences and the many conversations we’ve had with families in Africa.

The nuanced circumstances of couples like Maurice and Betty, or young teenagers like Sarah, cannot be addressed with one-dimensional responses. We must take seriously the complexity and urgency of the dilemma for many around the world. International policies, politics and financing must do more to account for the real predicaments people face.

We believe that families have the right to time their child-rearing; protect themselves against HIV; and pursue healthy, productive and prosperous lives. We believe that teenage girls should be able to avoid unintended pregnancies and the difficult decisions and desperate measures that sometimes follow. And we believe that access to contraception is critical to reducing poverty and promoting health.

As we welcome our newborn baby, we invite you to join us in respectfully broadening the conversation around contraception to include the perspective and urgency of our friends in Africa.

James and Jena Lee Nardella live in Nashville. James is executive director of Lwala Community Alliance, and Jena is co-founder of the nonprofit Blood:Water Mission.

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