Save the Children's Katherine Bowles, Director of Health and Nutrition, thanks HTHH's donors and Senator Frist for our leadership and awareness of the food crisis in East Africa today.
Aug 24 2011
by David Brooks
Many Americans go to the developing world to serve others. A smaller percentage actually end up being useful. Those that do have often climbed a moral ladder. They start out with certain virtues but then develop more tenacious ones.
The first virtue they possess is courage, the willingness to go off to a strange place. For example, Blair Miller was a student at the University of Virginia who decided she wanted to teach abroad. She Googled “teach abroad” and found a woman who had been teaching English in a remote town in South Korea and was looking for a replacement.
Miller soon found herself on a plane and eventually at a small airport in southern South Korea. There was no one there to greet her. Eventually, the airport closed and no one came to pick her up. A monk was the only other person around and eventually he, too, left and Miller was alone.
Finally, a van with two men rolled in and scooped her up. After a few months of struggle, she had a fantastic year at a Korean fishing village, the only Westerner for miles and miles. Now she travels around Kenya, Pakistan and India for the Acumen Fund, a sort of venture capital fund that invests in socially productive enterprises, like affordable housing and ambulance services.
The second virtue they develop is deference, the willingness to listen and learn from the moral and intellectual storehouses of the people you are trying to help.
Rye Barcott was a student at the University of North Carolina who spent a summer sharing a 10-by-10 shack in Kibera, the largest slum in Nairobi, Kenya. One night he awoke with diarrhea and stumbled to the public outhouse. He slid onto the cement floor and vomited as his bare body hit puddles of human waste.
He left his soiled pants outside the hut, but when he went to find them later they were gone. He was directed to another hut where a stick-thin girl, with missing clumps of hair, had the pants, scrubbed and folded, in her lap. Barcott said softly, “I’m grateful,” and asked her why she had cleaned them. “Because I can,” she replied. A week later, she died of AIDS and her body was taken in a wheelbarrow to a communal grave.
Over the next several years, Barcott served as an officer in the Marines in places like Iraq and created an inspiring organization called Carolina for Kibera, which offers health services and serves as a sort of boys and girls club for children in the slum.
The greatest and most essential virtue is thanklessness, the ability to keep serving even when there are no evident rewards — no fame, no admiration, no gratitude.
Stephen Letchford is a doctor working in Kijabe, Kenya. One night, years ago, when he was working at a hospital in Zambia, a man stole a colleague’s computer. Letchford drove the police down the single road leading from town. The police found the man carrying the computer and, in the course of the arrest, shot him in the abdomen.
They put the man in the back of the car and rushed him back to the hospital to save his life. Letchford pressed his wounds to stem the bleeding, using tattered garbage bags as surgical gloves. He had scraped his hands gardening that day and was now covered by the man’s blood.
They saved the thief’s life and discovered he was infected with H.I.V. For several days, Letchford and his family were not sure whether he had been infected by the man who robbed them. Their faith was tested. (They later learned that he was not infected.) When the man recovered, he showed no remorse, no gratitude; he just folded in on himself, cold and uncommunicative.
This final virtue is what makes service in the developing world not just an adventure, a spiritual experience or a cinematic moment. It represents a noncontingent commitment to a specific place and purpose.
As you talk to people involved in the foreign aid business — on the giving and the receiving ends — you are struck by how much disillusionment there is.
Very few nongovernmental organizations or multilateral efforts do good, many Kenyans say. They come and go, spending largely on themselves, creating dependency not growth. The government-to-government aid workers spend time at summit meetings negotiating protocols with each other.
But in odd places, away from the fashionableness, one does find people willing to embrace the perspectives and do the jobs the locals define — in businesses, where Westerners are providing advice about boring things like accounting; in hospitals where doctors, among many aggravations, try to listen to the symptoms the patients describe.
Susan Albright, a nurse working with disabled children in Kijabe, says, “Everything I’ve ever learned I put to use here.” Her husband, Leland Albright, a prominent neurosurgeon, says simply, “This is where God wants us to be.”
by Bill Frist
Droughts happen. Famines ensue. Families are destroyed. You can't control Mother Nature. On a fact-finding mission to the border of Kenya and Somalia this month, I learned otherwise.
Traveling with Jill Biden, wife of Vice President Joe Biden, I knew going in that 12 million people in the Horn of Africa are at risk of starvation and death because of the worst drought in 60 years. Five regions in war-torn Somalia are experiencing famine, and 29,000 children in the region have died in the past three months. There is much Americans can do—immediately and inexpensively—to save lives and quickly reverse the current trajectory of catastrophe.
Mrs. Biden and I spent most of our time engaging refugees who emotionally recounted their painful, weeks-long treks through parched lands with little food and water, having no choice but to leave their husbands in war-torn Somalia, often losing a child or two along the way to dehydration or lung infection.
The extreme drought has destroyed crops and caused the death of 80% of the livestock. For most Somalis who live a pastoral lifestyle, these conditions amount to an American losing their home, job and all worldly possessions, with no food or water available to beg for or borrow.
At the Dadaab camp along the Kenya-Somalia border, more than 1,600 refugees arrived on the day of our visit, bringing the total past 50,000 for the past month. Designed for 90,000 people, the camp is swollen beyond capacity with 430,000. Another 45,000, typically malnourished with crippled immune systems, wait outside the camp with little water, no sanitation, minimal health care and only makeshift shelter.
The world community has increasingly responded to the crisis in the past few weeks, but the demand continues to outstrip what is provided. The central challenge is access: The famine is centered in lawless Somalia, which is dominated by the al Qaeda-affiliated terrorist group al Shabaab. Nongovernmental organizations find it dangerous to operate there, as 47 aid workers have been killed over the past two years and many others kidnapped.
Mrs. Biden and I witnessed an ongoing outbreak of measles in the Dadaab camp, including a new wave among refugees in their 20s. This observation suggests an unanticipated need to vaccinate older age groups. Few Somalis have been vaccinated before coming to the camps (al Shabaab discourages vaccinations, considering them a Western intervention to be shunned). In a crowded camp of almost half a million, a small measles outbreak can explode and lead to mass casualties. Vaccinations can stop this—and each costs only a dollar.
Then there's water. Its absence causes famine, and its unclean varieties cause diarrhea that is dehydrating and can be fatal. That and acute malnutrition are the big killers. But nutrient-supplied oral fluids can bring young, malnourished children back from the brink of death within a few hours.
All these health interventions are cheap and easy to administer. A dollar goes a long way toward saving lives in Africa.
Outside of immediate crisis relief, our past investments clearly are paying off. U.S.-supported early-warning networks identified the famine threat a year ago, allowing Kenya and Ethiopia to begin stockpiling food reserves and planning regional responses. The U.S. is working with the World Food Program and the United Nations to initiate innovative programs like food vouchers that reduce corruption and better distribute food. These programs encourage regional and private-sector solutions to shortages, with smoother flow of foodstuffs from more plentiful areas to drought-stricken ones.
In times of budget cuts, we must remember that, according to Oxfam International, emergency food relief during a famine costs seven times more than preventing a disaster to begin with. Hence U.S. efforts such as the multi-year, multi-agency Feed the Future program to stimulate research into making plants more nutritious and crops more drought-resistant.
With the chaotic economy dominating the news, it's easy to focus on ourselves rather than others so far away. But when we remember that we spend only a tiny fraction of one percent of our budget on developmental aid, that recent assistance is smarter and more targeted than in the past, and that our investments in the Horn of Africa alone have saved millions of lives, each of us can be proud of our past investments and supportive of their growth in the future.
What can we do as individuals who care? A good place to start is the list of aid organizations on the website of the U.S. Agency for International Development, www.usaid.gov.
Dr. Frist, a physician and former majority leader of the U.S. Senate, is chairman of Hope Though Healing Hands.
Aug 18 2011
by Omo Aisagbonhi
Vanderbilt School of Medicine
Today started as usual with ward rounds, visiting my patients: Stephen, baba with DM and Mr. SO whom we operated on for appendicitis. I really feel sorry for Stephen’s dad.
Then we went to the OR where we had one scheduled surgery and one emergent ex-lap. The scheduled surgery was removal of a breast mass; turned out to be a chocolate cyst (grossly). I really enjoyed having scrubbed in. I started the IV line and first-assisted; also got to close the skin. I really do enjoy surgery especially on days like this when I feel competent; when the operation went well, when I closed skin properly, when I feel I helped the team help a patient.
The second case was interesting. A man in his 60s/70s presented to the hospital after a road traffic accident in which he obtained rib fractures and perineal laceration. He also had an acute-appearing abdomen with left quadrant tenderness, hypoactive bowel sounds and free air on x-ray. We were concerned about stomach/small intestine perforation or splenic laceration. The interesting part of the story is that upon entering his abdomen, what we found was indeed a perforated viscus (small intestine) but there were surrounding adherent exudates to suggest bacterial perforation such as typhoid perforation, not due to trauma. His spleen and other internal organs were fine. We wonder if he was ill preceding his accident; I’d find out from him on rounds tomorrow
After the OR, went to physician conference where Dr. Aremu talked about the responsibilities of family physicians to their patients. There was a post-presentation announcement about ensuring patients pay their bills up-front especially in non-emergent cases. The thing is that this is a small town where many of our patients cannot afford the hospital bills; many go into debt as a result, but the hospital needs funds to run to be able to keep helping patients; there really is a need for a national/state-wide health insurance system.
Overall, I’ve had an excellent experience here in Ogbomoso. The physicians here do so much with very little. I admire the tradition of praying before every surgery and before every clinical encounter. There is obviously room for improvement, need for specialists such as pathologists, cardiologists and ICU physicians, and need for better diagnostic and monitoring equipment such as ECG monitors (there isn’t one even in the ICU) and CT scanners (especially given the volume of patients that present with head injuries). I think though that beyond the hospital and immediate control of hospital personnel, general road safety urgently needs to be addressed. Too many patients present with and die from otherwise preventable injuries secondary to road traffic accidents. Also urgent, is the need for a health insurance system as too many patients end up being turned away or under-treated due to inability to afford medical services.
Bill Frist: NPR Interview with Melissa Block
To listen, CLICK HERE.
Former Senator Bill Frist just came back from a fact finding-finding mission to the border of Kenya and Somalia. He and Jill Biden, the vice president's wife, visited the Dadaab camp, which was designed for 90,000 but its population of Somalian refugees has swollen to 430,000.
In an interview with NPR's Melissa Block, Frist threw out numbers. Lots of them that put the situation in the Horn of Africa in some perspective. He said: This is the worst drought in 60 years; 29,000 children under the age of five have died in the past 90 days; tens of thousands are dead; 12 million people are at risk of death; 42 percent of them die from starvation.
All of that is hard to visualize, but then Frist talks about the people he talked to at the camp.
"A family might be typically a woman who has four children, who has walked for 15, as many as 20 days to leave the area of famine and lawlessness and lack of aid... and walk across a desert, arriving many times missing one child, a child who died along the way," he said.
The children arrive at the camp malnourished or starving and what's amazing, he said, is that an inexpensive mix of water, sugar and nutrients will bring a child back to life.
Frist has seen human tragedy. He's been to Rwanda during the genocide and saw the 1980 famine in the horn of Africa. He's been to Chad, Darfur and Sudan but he says what strikes him about this particular crisis is that "the world is responding to the need itself but the need is increasing faster than the response."
"The simplicity with which this can be addressed... is not keeping up with increased demand," he said. "They're all human tragedies, but this one we can nip in the bud if we're more aggressive."
Melissa also asked some tough questions of Frist, the chairman of the non-profit Hope Though Healing Hands. She brought up the AP report that detailed that thousands of sacks of food aid were being stolen and asked what he would tell Americans, struggling through a bad economy.
"We spend less than half a percent of our budget on all of developmental aid. Not just responding to crisis but in all of developmental aid. So we don't spend nearly as much as people think," he said.
Frist admitted that this famine is a man-made crisis. The drought is bad but the political situation on the ground, the fact that Islamist militant group al Shabaab has not let aid flow in has made things worse.
"But it doesn't mean we give up," he said. "It means we stay on it. We do the best we can as the oneness of humanity gets translated by [non governmental organizations], by partnerships, by governments, by individuals who focus on it."
To read more, CLICK HERE.
Aug 11 2011
By Jill Biden and Bill Frist
This week, we traveled to Dagahaley refugee camp in Dadaab, Kenya, where hundreds of thousands of people have fled Somalia seeking to escape the worst famine in 60 years.
We met women and children who walked for weeks, often barefoot and with nothing but the clothes on their backs, desperate to find food and medical care. We heard the story of one mother who was too weak to carry both of her children, and made the wrenching choice to leave one behind on the road in hopes of saving the other. We learned of families who had arrived too late whose children became part of a devastating statistic: In the past three months alone, 29,000 children younger than 5 have died of starvation.
Fortunately, the international community has mobilized. Last year, the U.S. realized this potential for famine and worked with other countries to stockpile food and medical supplies in the region. We are now helping more than 4.6 million people.
Amid the devastation, we saw the impact of this aid. We saw inexpensive oral rehydration packs bring listless babies back to life. We saw children getting vitamins and vaccines that will stop the spread of deadly diseases throughout the camps.
Still, the scope of this crisis threatens to overwhelm the international response. Without lifesaving assistance, hundreds of thousands of people, most of them children, could die.
As governments and international organizations do their part, the rest of us can do ours. Just a few dollars can literally save a life. (Go to USAID.gov to see how you can help.)
Yet we must also confront the broader challenge of food insecurity that leaves so many people vulnerable to droughts like this one. That's why America has been helping nations such as Ethiopia and Kenya develop innovative and improved crops and irrigation methods, and new ways for farmers to market and transport their products. The goal of our aid is simple: to help create the conditions where such aid is no longer needed.
That, ultimately, is how we can help prevent the kind of suffering we see in Somalia today.
As we left one of the camps, a mother looked us in the eyes, surrounded by her four malnourished children, and asked us to please help save her family.
We all have the power to answer her plea.
Aug 11 2011
by Julie Shelton
Resident, Department of Surgery
Vanderbilt Medical Center
Photo: Kijabe Hospital
I have been in Kijabe for almost three weeks and today is the first day I received a hard and fast sign that I am in a developing country. No power. No explanation. On one minute then off the next. It happened in the OR – just a blink – but serves as a reminder that as much as there is available here in Kijabe, more than in many other hospitals in Kenya, it is still a tenuous resource. One that is dependent on the hard work of so many to keep things running as smoothly as possible so that the lights stay on, the available suture will be strong enough to hold a knot, and blood will be available for the patient with anemia who needs to have his spleen out.
My first night here I was summoned to “Casualty”, Kijabe’s version of an Emergency Room. There had been an “RTA” (a Road Traffic Accident) and all the victims had been brought to Kijabe. There were 11 total, easily filling the small room that is Casualty. Not quite knowing where to start – which patients had been seen, which had not, I glanced around the room quickly triaging patients. Doing so, I noticed some family members gathered around a stretcher with a young man lying on it. One man in particular looked up from the patient and met my gaze. The look on a trauma family member’s face is unmistakable and is the same no matter where you are from. Grief and sorrow mixed with disbelief and hope - there is hope in there as well. Hope that the news will be good. Hope that the injuries will be minor. Hope that if they are not minor, that their family member will recover quickly and without lasting harm. Hope that you will be able to help.
I was stopped in the hospital corridor the day following that trauma by that same family member – this family member described the trauma victims as his people. He wanted to thank me for helping his people. He was not satisfied by my simple “you are welcome” but in our mixed conversation of American English, British English, and Swahili I think I managed to convey that it really was my pleasure to be here and to be able to help.
His cousin in particular was one of the more seriously injured but went home after a few days of monitoring on the wards – grateful to be able to get back to his job and his family.
This is what Kijabe is able to provide by combining the work of so many – a resource, a place for people to come to heal. A place where it is a true pleasure to be able to help, where one can join with many others to keep the lights on.
Aug 10 2011
Editor's Note: William Frist, the former Republican majority leader of the U.S. Senate, is a physician.
To shed some light on that question, I joined Dr. Jill Biden, wife of Vice President Joe Biden, on a fact-finding mission over the past several days to a Somali refugee camp close to the Kenya-Somalia border.
We saw the answer as we listened to a grief-stricken mother of five, who had marched for 15 days across the parched Somali land to find food and security in a border camp. They arrived malnourished, sick and thirsty to a camp of 430,000 other refugees. They competed with 1,500 others who had made it to the camp that day, only to find it filled to capacity. Inside they would find adequate food and water.
They would find the vaccinations that are saving the lives of thousands. They would survive because of the generosity of Americans (the U.S. is responsible for 47% of the food being provided) and increasingly because of members of the world community who are standing up, in spite of challenging times in their own communities.
More than 29,000 children have died over the past three months in what is the most acute food security emergency on Earth. It's worsening by the minute and outstripping available supplies. Thousands never make it to the camps, and those that do might have to wait outside the confines where 50,000 others are waiting.
Drawing from my experiences as a doctor in refugee camps in southern Sudan and Darfur, the conditions Biden and I saw this week constitute among the worst, the result of a cruel nexus of war, drought and poverty. The issue is complex, but we know with certainty that a primary focus on health greatly improves the chances of preventing death and of establishing security throughout the Horn of Africa. It's a worthy investment.
Drought occurs regularly throughout the region, but a dysfunctional government in Somalia is incapable of responding. Direct access by the international aid community is difficult and dangerous. This is why our focus on assistance in Ethiopia and Kenya is essential.
The five regions of famine in Somalia lead to death locally and to an exodus of children and families to Kenya and Ethiopia for food. The arrival each day of 1,400 to 2,000 new Somali refugees to the Dadaab Camp alone places a huge food, economic and environmental stress on eastern Kenya.
The good news for the American taxpayer is that investments by our humanitarian and development organizations have worked. Through past advances in agriculture and food security led by the United States, we learned that from the more plentiful regions of Kenya, food is flowing to the areas of greatest need. Even though tens of thousands have died in recent weeks because of the famine, I am certain that the number would have been much higher if the American people had not so smartly invested over the past decade.
Drought and famine are not new to the Horn of Africa. By examining past famines, we have learned that among the most important acute interventions is taking steps to improve health. This primacy of health is not generally recognized by the public, but it is by USAID administrator Rajiv Shah, who accompanied us.
Drought leads to famine, and famine leads to deteriorating health. Therapeutic health intervention with vaccines and oral rehydration is easy and cheap. But we have to get material to the region. And that is why the increased aid of $105 million announced Monday by our government is so important. This also shows that we can make such a difference as individuals through our own contributions (see http://www.usaid.gov/ for organizations).
The region is witnessing the worst drought in 60 years with more than 12 million people in need of outside assistance. Even though contributions by government, NGOs and the international community are growing, the needs are growing faster than the world is responding.
Will the American people respond in these difficult times? I know based on my experiences in southern Sudan, Darfur, Chad, Haiti and Bangladesh that the American people will give generously and support our nation's ongoing response.
Americans are at their best when they respond unselfishly to others in need -- and they do so generously when they know that their investments, both personal gifts and government contributions, have value in saving lives in the short-term and supporting prevention in the long-term.
They know that their help will make a difference. Americans will act as they always do to help those in need.
The opinions expressed in this commentary are solely those of William Frist.
by Senator Bill Frist, MD
(Senator Frist with USAID Director Dr. Rajiv Shah, 8.7.11)
Yesterday, I visited the Dadaab Refugee Complex in eastern Kenya with Second Lady Dr. Jill Biden and USAID Administrator Rajiv Shah. While there, we heard stories from mothers with their children who had lost their husbands. Families who had journeyed for weeks to arrive at the camp malnourished and in dire need of medical assistance. And, worst of all, parents who had heartbreaking stories of losing children in the flight from famine in Somalia.
There are two main points, as a doctor and as a former senator, that I want to highlight in the midst of this terrible crisis.
First, though the United States has provided an enormous contribution of aid (we are providing 47% of the food), we need the help of other nations immediately. The other 53% of funding is being provided by 40 other countries. We need them to step up. We also need private donations to aid agencies as soon as possible.
For instance, there are over 150 cases of measles, which is huge and can rapidly lead to the death of thousands, in the over-crowded Dadaab camp. Vaccinations can halt the spread of such fatal diseases. These children’s health is already severely compromised by malnutrition. Aid agencies need public dollars to fight these diseases, like measles and polio, with vaccinations, oral rehydration, and vitamins, especially in children under the age of five.
However we do not need to rely on public dollars alone. I have seen firsthand that even the simplest form of aid can save lives and even tiny investments can make a huge impact. A measles vaccination costs under $2 and therapeutic feeding can cost as little as a dollar a day. A small donation from you can save the life of a child and I am confident that even in our own tough times, Americans will respond generously as they always have when catastrophe strikes around the globe.
Second, the good news is that we have learned that the famine is not an intractable problem for the region. Though Somalians are having to flee their country and drought is occurring throughout the Horn of Africa, Kenya and Ethiopia are much better prepared to withstand the low rainfall. Our American dollars over the past ten years have paid off. Our investments in agricultural and livestock advancements have prevented the drought from becoming a famine in these two countries.
The Dadaab camp is a humanitarian crisis and we need your support. Please consider a donation today. We will support those aid agencies who is on the ground providing medical and food assistance to those suffering from the effects of famine.