I was in Aspen earlier this week working on some of the challenges facing healthcare and the health industry in the US, but it’s time to switch gears.

From my 2008 trip to Rwanda with the ONE Campaign

Sunday, I leave for Rwanda to lead a one week group trip with my friend Dr. Paul Farmer to see some of the work being done byPartners in Health (PIH) in the country. I haven’t been in countrysince 2008, and I’m anxious to see the progress PIH and other groups are making in health.

Since the spring of 2005, Paul’s PIH organization has been in Rwanda working closely with the government and the Ministry of Health to reach the rural, underserved areas of the country. PIH began by focusing on HIV/AIDS work, but has now expanded to full healthcare offerings. Today, over 800,000 people are served by PIH’s 40 health facilities.

But the health challenges in Rwanda are still vast! Next week with PIH we’ll be considering many aspects of health in Rwanda, but one in particular that I’ll be looking at while I’m there is nutrition.

I firmly believe–and have seen firsthand!–that global health diplomacy works as a real and powerful currency of peace worldwide. And a healthy start to life–a mother enjoying a safe and healthy pregnancy leading to a safe birth and healthy infancy–is crucial to building a foundation that leads to stable communities and global peace.

Food insecurity and malnutrition account for more than half of the deaths of children under 5 in developing countries, and Rwanda has had its fare share of nutrition challenges. In 2005, 18% of children in the country were underweight.

But Rwanda’s government has made real progress in child nutrition since 2009. That year, a Presidential Initiative launched to address malnutrition. The country also joined forces with the US in the Feed the Future initiative.

A 2010 health survey showed that chronic malnutrition and stunting affect 44% of children under the age of 5 in Rwanda.

In September of last year, the Right Honorable Prime Minister, Dr. Pierre Damien Habumuremyi launched a 1,000 Days Campaign, focusing on food availability and a balanced diet for pregnant women through the first two years of life of their babies.

The first 1,000 days may seem like such a small window of opportunity for global change, but the data are clear that childhood undernutrition has long-lasting consequences.

WHO models estimate that over half of adults in the prime working age group–20-29 year olds in Rwanda–have been affected by childhood stunting. Many of these adults wear the visible badges of malnutrition: shorter height or lessened muscular development. And for just as many, malnutrition has exacted a mental toll as well, diminishing the cognitive function of the working age population.

Along with the rest of what we’ll see–including a bit of gorilla trekking and possibly gorilla surgery–I’m anxious to see what progress Rwanda’s 1,000 Days Campaign has made, and the returns realized on nutrition investment.

I’ll be sure to keep you updated.

Motherhood is a dangerous journey to take in most of the world. Nearly 300,000 women die each year from complications due to pregnancy, and 99 percent of those women are in the developing world. In Malawi, an estimated 510 out of 100,000 women will die giving birth. But Chief Kwataine, a former English teacher, has become well-known in the country for his work developing safe motherhood activities for nearly the last twenty years.

Watch this short, two-minute video to learn more about how women's (and children's) lives are being saved in Malawi. It's well worth your time.


“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

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

 

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

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.

FOR IMMEDIATE RELEASE Contact: Melany Ethridge (972) 267-1111 [email protected] Or: Kate Etue (615) 481-8420 (m)

NASHVILLE, Tenn. – Joining with Senator Bill Frist, MD’s Hope Through Healing Hands and the Bill & Melinda Gates Foundation, several U.S. celebrity and faith-based moms joined together to support to the Faith-Based Coalition for Healthy Mothers and Children Worldwide, a campaign to improve global maternal and child health, including through education about healthy spacing and timing of pregnancies.

Hope Through Healing Hands (HTHH), a Nashville-based global health organization, recently partnered with the Bill & Melinda Gates Foundation to create the coalition. Some of the moms and parents joining the effort include Amy Grant, Grammy-winning Christian music artist; Kimberly Williams Paisley, actress and writer; Jennifer Nettles, Grammy-winning Country music artist; Tracie and Scott Hamilton, Olympic gold-medal ice skater and philanthropist; Jena Lee and James Nardella, Leaders of Blood:Water Mission and Lwala Community Alliance; Cathy Taylor, DrPH, MSN, RN, Dean and Professor of The Gorden E. Inman College of Health Sciences and Nursing at Belmont University; and Elizabeth Styffe, RN MN PHN and Global Director of HIV&AIDS and Orphan Care Initiatives at Saddleback Church.

“Those of us who have experienced healthy pregnancies here in the U.S. need to remember how uniquely fortunate we are,” Amy Grant said. “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 believe children are a gift from the Lord, and every child deserves the opportunity to live a healthy life. If we can equip a mother with the knowledge of how better to time and space her children, she will be more likely to survive pregnancy and birth complications and the child will more likely survive the newborn stage,” says Elizabeth Styffe. “God wants us to live life in abundance, and we can take the first steps toward making this a reality for so many around the world.”

“Girls are often forced into marriage and pregnancy as young as age 12, and pregnancy and delivery are extremely hard on their bodies,” Jena Nardella explains.  “Too many die from complications, and those who survive often never recover 100 percent.  Yet many face continued pregnancies year after year, without being able to adequately care for their children. These adolescent girls are at much greater risk of HIV exposure which can affect their newborns, as well. As for the children, when pregnancies are not timed and spaced in a healthy way, many children don’t survive the newborn stage.”

“The cycle is devastating not only to families, but to entire countries and societies,” Senator Frist, M.D. noted, reflecting on his many trips overseas to provide medical care. “Women caught in this cycle often lose their opportunity to complete their education, which in turn limits their ability to do what they want most—to give their children an opportunity at a better life.”

“I believe this one issue – the healthy spacing and timing of pregnancies – could be a key to saving lives and economic empowerment in the developing world,” said HTHH Executive Director Jenny Dyer, Ph.D. “The good news is that we have the information and tools that can make this a reality. If a young woman in Africa can delay her first pregnancy until age 18 or later, she is dramatically more likely to stay in secondary school, and perhaps even attend college, providing stable financial support for her family to have a brighter future. Then, if she can space her pregnancies just three years apart, her children are twice as likely to survive infancy.”

Dyer continued. “There is great room for hope, and we are so delighted to have U.S. moms join us in this effort.  They can uniquely empathize with women around the world who struggle with their pregnancies, who face risk of complications during childbirth, and who suffer deeply at the illness or loss of a child. By raising their voices here at home, these leaders are bringing about transformation for women far away.”

While celebrating motherhood here in the U.S., faith communities around the country are giving their time and energy to ensure motherhood is a joy for women globally, rather than the high-risk event it is for far too many.

Information about those who have joined the coalition to date, as well as how others can help is available at http://www.hopethroughhealinghands.com/faith-based-coalition. Endorsements for the coalition are available at http://www.hopethroughhealinghands.com/endorsements_1.

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Hope Through Healing Hands is a Nashville-based nonprofit 501(c)(3) whose mission is to promote improved quality of life for citizens and communities around the world using health as a currency for peace. Senator Bill Frist, M.D., is the founder and chair of the organization, and Jenny Eaton Dyer, Ph.D., is the CEO/Executive Director.

 

 

 

 

 

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