In The News

by Lauren Eppinger
Vanderbilt University School of Nursing
Quetzaltenango, Guatemala

eppinger schools

The Guatemalan school year has ended, and mobile clinics and educational programs for school children from Primeros Pasos have also ended. All of these initiatives are a part of the healthy school program that Primeros Pasos runs, but only take place during the school year. Now these children are on their own for care and education until the beginning of next year, although the clinic will be open through mid December.

The mobile clinics are extremely useful, because they serve as screening programs for malnutrition, infection, and serious illnesses, and also offer a great educational opportunity for the children. We were able to identify several acute infections, as well as some chronic diseases. Several children with wheezing—and likely asthma—were sent to the clinic for asthma medications. Asthma can be very dangerous if not treated, and referral for proper treatment can save a child's life. Last week I referred a child back to the clinic because of a heart murmur, to run some tests and assess further to ensure that he was not anemic and malnourished. Although I am not sure what the outcome of his situation was, it was important to be able to identify children like this who are at risk of more serious problems, who can be treated.

All of the children are supposed to give stool samples at the schools. This leaves a huge amount of work for the lab to do, checking to see if there are any parasites or signs of bacterial infection, but it is worth it. A couple of days after the initial visit to the school, another group goes back to the school to distribute medicines to all children who were not already treated based on their symptoms. The children are given a bag with their medication (free of charge) and dosing information is written and illustrated for the parents to read. Although many children are treated for intestinal infections based on their symptoms, a significant amount of infections still go untreated until the stool samples are analyzed. Intestinal infections can cause discomfort, malnutrition, dehydration, and impaired growth. Therefore, identifying and treating these infections, even when relatively asymptomatic, is extremely important for a child's health.

Now that school is on break, the clinic will start bringing mobile clinics to the daycares, where pre-school aged children are cared for. Many of these children, like in the elementary schools, have few resources at home. Similar screening and treatment programs are done with these young children. I am excited for the opportunity to continue to work in the community, and identify children in need of treatment. As sad as it is to find a sick child who nobody managed to bring to the clinic, it is rewarding to know that we are able to help.

by Cody Bowers
Vanderbilt University School of Nursing
Quetzaltenango, Guatemala

cody bowers pp1

It has been two weeks since I touched down in Guatemala City and I haven't had a dull moment since my arrival. From the bus rides through the mountains to the hikes up mountains, Lauren and I have found profound experiences and learning wherever we go. The cultural lessons have been exceptionally enlightening as well as the medical paradigm shift. I have been treated in a Western model of medicine and become comfortable with treating the chronic diseases that ravage so many of the patients I've treated in the States. Now I find very little continuity of care, nor complete trust in Western medicine because many of the locals prefer the treatments of traditional healers first. I can look for hypertension and diabetes here, but will the patient be able to pay for the monthly prescription of hydrochlorothiazide or metformin? Would they trust me in my diagnostic abilities? How can someone trust their health in the hands of someone who struggles to speak their language? Would the diagnosis be relevant to their personal happiness? I find myself engaging in these circuitous internal debates, but I am optimistic that the rapport, communication and treatments will be culturally appropriate.

The patients here, especially the children are fairly fascinated with Lauren and me as we appear so much different than everyone else. I am over six feet tall and I oftentimes find myself more than a foot taller than grown adults. The differences can be glaring, but the patients and I share an intimate connection and similarity and that is the goal of health. Despite the language difficulties, it is easy to seek treatment with a 23 year old woman who fell walking down a hill a month ago and continues to have back pain. Verbal communication hurdles can be overcome with help from peers, careful physical exam and repetitious questions. Lauren and I have been able to help some patients significantly and routinely examine and reassure many others as we navigate our first few weeks in the clinic.

In her first week at the clinic Lauren noticed a physical sign during her exam that suggested the Guatemalan patient might have a rare, serious, but treatable form of brain/eye cancer. She noticed a ‘white reflex’ while shining the ophthalmoscope light into the child’s eyes, which looks exactly like the ‘red-eye’ effect found in a camera photo, but the circles in a child’s eyes are white rather than red. This ‘white reflex’ is often indicative of retinoblastoma, a form of cancer, and no other volunteer in the clinic had any idea what the ‘white reflex’ meant, except Lauren, who noticed it, and the medical doctor who ordered further testing. This child was referred for a CT scan of the brain for a more accurate image of what could be cancer or a benign response to an useful exam technique. If Lauren noticed cancer on small child, she may have saved a life, which is an inspiring and worthwhile lesson for any potential or current global health volunteer.

I've been in Guatemala for a week less than Lauren and she helped me adjust quickly. Together we have been going to mobile clinics which involves loading a backpack with medicines and going to a local school and seeing roughly 80-100 children. With 7 providers, we usually see 10-12 patients per provider and most of the exams are well child checks. For the most recent mobile clinic we all boarded the city bus and commuted 10 minutes down the road toward the Santa Maria volcano and unloaded at a desolate and dusty roadside stop. From here we hiked 20 minutes to the school which is up a long hill.

I usually keep myself in good physical shape, but with the medications backpack on my shoulders and only a week spent in the thin air of 7,600 feet elevation, it was an arduous hike with many breaks. We reached the school and set up the clinic in a classroom with tiny desks and chairs as our exam room and table. Out of the 10 children I assessed and treated this day, only 3 had complaints of illness. Two were abdominal which is common here because many children, especially the younger ones with poor hygiene have intestinal parasitic infections, but the third child had a serious skin infection causing exceptional discomfort. She was rather healthy and well nourished, but very uncomfortable. Her unease was clearly visible on her face. She smiled slowly, half-heartedly and only because she was being courtesy in response to my smile. This girl, for 7 days now, had a skin infection behind her ear that was becoming worse daily and it was by the far the most advanced case of impetigo I've ever seen. Impetigo can be described as a superficial shiny, pus-oozing, red and excoriated epidermal infection. I’m guessing she hadn’t slept well in over a week because when I touched her ear cartilage - not the site of infection - she cringed severely and any movement of the head on a pillow would definitely cause pain and awakening. I prescribed her systemic anti-biotics for the next week and told she’d be sleeping better shortly. More worrisome is whether or not she would have actually received treatment if the Primeros Pasos group hadn't gone to her school that day because she was coming from a very impoverished community.

Lauren has been awesome with the children and we all rely upon her pediatric knowledge. I am continuing to get acclimated and fit into the flow of the clinic and language requirements. I treat the easy and obvious and ask for support in navigating any vague chief complaint. Both Lauren and I have been effective and useful to the people we are treating as we are able to provide comfort, health and healing, which are essential to the happiness of any patient. We have stopped a few serious infections, offered advice to other volunteers in need of collaboration and most importantly we are engaged in a vibrant atmosphere of medicine, culture and language where we are both learning daily.

by Jenny Dyer

We want to give a special thanks to HTHH supporter, Rachel Flynn, who lives in Crossville, TN for hearing about our opportunity with Lamar Advertising and then offering us space on Flynn Signs Co., Inc. in Crossville, TN!

She and her husband Tom within hours were able to post our Water=Hope message up on 2 billboards in Crossville on their Flynn Signs.

water hope flynn

We're excited to partner with Flynn Signs!

October 5, 2010

Thank You, Lamar Advertising!

The Water=Hope Campaign on Billboards across the United States!

We want to thank the Lamar Advertising Company for creating and posting the billboard below in small and medium size markets across the nation beginning this week! They are helping us spread the word across the country that YOU can help bring safe, clean water to people around the world.

Poster 1

We are excited to be working with them and to be spreading the word about this very important global health issue.

From the Senate to the House...

On Monday, September 20, the Senate passed by unanimous consent the Senator Paul Simon Water for the World Act (S. 624). The Water for the World Act would enable the United States to help provide sustainable access to safe drinking water and sanitation for up to 100 million of the world's poorest people over the next six years.

After the Senate passed the bill, the bill went to the House of Representatives. The Water=Hope Campaign sent a letter to 185 Congressional Representatives in 20 states to let them know that over 14,000 people among their states support the Water for the World Act. If the Congressional Representative already was co-sponsoring the bill, we sent them a Thank You letter. If they were not, we asked them to co-sponsor and support the bill.

It appears the bill will come up for vote after the election. We would encourage you to personally contact your Member in the House of Representatives and urge that s/he support the Water for the World Act's passage in the House.

Click Here for a TEMPLATE LETTER to write your Congressional Representative to support the Water for the World Act.

Help Us Build Wells

We need your donation. We are working with charity:water to build wells in Ethiopia, Liberia, and Uganda, and we are supporting water purification systems in Appalachia through Living Waters for the World. Help us bring clean, safe water to villages in Africa and homes in Appalachia. Help us help others promote health as a currency for peace. We appreciate your support.

Sincerely,

Bill Frist, M.D.

by Lawrence Harrington

World Water Act would save countless lives

Oct. 4, 2010

Tennessee Voices

Lost in the high decibel debate of a polarized mid-term election, Tennessee Sen. Bob Corker recently teamed with Assistant Majority Leader Dick Durbin, D-Ill., to pass the World Water Act, a measure to provide clean water and sanitation to 100 million people around the globe.

If the measure is passed by the House and signed by the president, billions of dollars and millions of lives — most of them children — can be saved thanks to leadership and long-term thinking from both sides of the Senate chamber.

For those of us who have come to expect clean drinking water at the turn of a handle, the problem can be hard to grasp.

The complexity of water and sanitation challenges around the globe became apparent to me when I was running the Mexico office of the Inter-American Development Bank and attended the Fourth World Water Forum in Mexico City.

Worldwide drinking water is scarce

Over a billion people worldwide live without safe water. More than 2.5 billion lack adequate sanitation, exposing them to intestinal diseases costing lives and economic productivity.

The burden of hauling drinking water in many rural areas falls most heavily on women and girls, making it harder for them to stay in school.

Scarce health resources are spent treating waterborne diseases.
Even before the full impact of climate change, lack of decent water can cause mass emigration and will be a major source of global insecurity in the coming decades.

Last week, U.S. researchers concluded that 80 percent of the world’s population lives in areas with “insecure” fresh water.

The Water for the World Act builds on existing efforts to provide sustainable access to clean water and sanitation in less developed countries. The measure provides additional resources but ensures they will be spent effectively by encouraging donor coordination and rigorous project evaluation. It promotes global and regional cooperation on research and technology.

For foreign aid skeptics, water and sanitation is a good investment. A dollar spent in this sector can return as much as $8 by increasing productivity and reducing the health care and other expenditures that result from lack of water and sanitation. Our military can tell you that a good well may be more important to securing a village than fortifications. Integrated water management reduces infrastructure costs by billions of dollars, investments that many countries can ill afford.

Even in relatively developed countries in Latin America such as Mexico, small amounts of technical assistance improve management and leverage finance for struggling urban sanitation systems.

Closer to home at Vanderbilt University, students are taking steps to bring clean water and sanitation to underserved communities.
Recently, members of Engineers Without Borders spent valuable vacation time using their skills to bring water to a poor village in Peru.

A Vanderbilt engineering student, Leslie Labruto, a member of the group, recently turned 21. She told friends to forget a party and instead give money so a village in central Africa could get a new well.

Thanks to her selflessness, the village will have a source of clean water for years to come.

Sen. Corker points to personal involvement like this — church missions he made to Haiti years ago — as encouraging him to enter public service and offering a deeper understanding of the development challenges in poor countries.

Corker’s time as mayor of Chattanooga undoubtedly helped him understand the importance of providing basic services to a community and the imperative of cooperation to do good work.

Tennesseans should hope this bipartisan spirit moves the World Water Act through the House to the president’s desk.

Larry Harrington is an adjoint professor at the Center for Latin American Studies at Vanderbilt and a Nashville attorney.

October 4, 2010

by Lauren Eppinger
Vanderbilt School of Nursing
Quetzaltenango, Guatemala

lauren eppinger 1

I arrived in Guatemala almost two weeks ago. The experience of walking out of the airport into Guatemala City is a five-sense sensation—the colors, the voices, the rain, and the pollution that you can smell and taste. The intensity hasn't lessened at all since getting here.

I spend half of each day volunteering at a clinic called Primeros Pasos. The clinic is located in a rural area, where most of the patients are Quiche Maya. The clinic sees mostly children, but has been expanding to treat more women and men as well. The cost of care is relatively low (about 60 cents for a child's visit and medicine, or a tenth of a day's wage), but people still receive care inconsistently. Preventative visits are particularly rare, as most people only visit the clinic when they are sick, often after a problem has persisted for a while. The clinic has a unique model, where patients are seen by local and foreign medical students, which shows the strong value that the clinic places on education. Nurse practitioners (like Cody Bowers and me) are also part of the clinical staff, headed by a Guatemalan doctor. The clinic also works with schools, offering preventative care and education for children. Recent outreach efforts have brought a significant number of women into an educational program as well, covering nutrition, hygiene, health, medical care, and natural medicine.

The diseases seen at the clinic are extremely different from what is seen at home. It is surprising how much an environment can affect the body. Many factors come into play, such as hygiene, clean water, indoor cooking fires, physical labor, exposures, immunizations, and the high cost of care at most places. Immunizations here are inconsistent, and almost none of the children receive all of the recommended immunizations. In my first two weeks I have seen both varicella and hepatitis A, which are both almost entirely absent in the pediatric population at home. I have also treated several children for various GI infections from bacteria, parasites, and worms.

Interestingly, many of the children in the community are born with midwives at home, and are not examined by doctors until they are a few months old. Therefore, careful examination of infants at sick visits is extremely important, because it may be their first medical examination! Most babies have no records of their birth weights so it is impossible to monitor their growth rates. If the children were brought in regularly for well baby visits, we could monitor their growth, and provide immunizations, etc. but that is not the custom here.

Another prevalent issue is malnutrition. Fortunately, the clinic has made significant improvements in the nutritional status of the local children through several outreach programs. These days most children are only mildly or moderately malnourished, while in the past many were severely malnourished. However, despite this improvement, every day I have seen at least one child, and sometimes several with some degree of malnutrition. Over the next couple of months I would like to work on developing an effective way to treat these children, who so easily fall through the cracks because they are not seen to be "severely" ill.

The experience overall has been incredible. Each day I learn something new, see something new, and live with an intensity that feels unique to Guatemala.

September 22, 2010

Senator Paul Simon Water for the World Act Passes Through Senate

Your Advocacy Saves Lives

The Water=Hope Campaign celebrates that on Monday, September 20, 2010, the Senator Paul Simon Water for the World Act passed through the Senate unanimously.

We want to thank the leadership of Assistant Senate Majority Leader Richard Durbin (D-IL) and Senator Bob Corker (R-TN) and their cosponsors for sponsoring this bill which places water in the forefront of America’s development priorities, seeking to reach 100 million people around the world with sustainable access to clean water and sanitation over the next six years.

Over 10,000 of your signatures were mailed in this summer letting your Senators know that you cared about providing clean, safe water to the world's poorest.

They heard your voice.

Thank you for taking the time to advocate with Water=Hope. Because you cared, lives will be saved.

More about the bill...

The Water for the World Act represents a robust U.S. contribution to the Millennium Development Goal on water, which is to reduce by 50 percent the proportion of the world population without safe water and sanitation by six years. The Senate passage of the bill comes at a time when there is a redoubling of efforts tied to achieving the Millennium Development Goals (MDGs) for water and sanitation at the MDG Summit in New York City this week.

To achieve the goal of reaching 100 million people with sustainable access to clean water and sanitation, the bill:

• Targets underdeveloped countries with focused initiatives to improve access to clean water and sanitation;

• Fosters global cooperation on research and technology development, including regional partnerships among experts on clean water;

• Provides technical assistance and capacity-building to develop expertise within countries facing water and sanitation challenges;

• Provides seed money for the deployment of clean water and sanitation technologies; and

• Strengthens the human infrastructure at USAID and the State Department to implement clean water and sanitation programs effectively and to ensure that water receives priority attention in our foreign policy efforts.

For more, see the Durbin-Corker Press Release.

What Next?

A similar bill was introduced in the House of Representatives by Representatives Earl Blumenauer (D-OR) and Donald Payne (D-NJ).

Click HERE to see if your congressional representative is a co-sponsor.

We will continue advocating with the House of Representatives to hopefully see the passage of this bill through the House and then on to the President. We hope you will join us in this effort.

Thanks for your support,

Bill Frist, M.D.

September 16, 2010

Journey of Action

This August, Kassidy and Ryan Brown of Nashville, TN will be driving the Pan American Highway-from Alaska to Argentina. A six month expedition that will take them into 14 different countries, covering over 15,000 miles. They will be volunteering with and showcasing social entrepreneurs, non-profit organizations, universities, and high schools that are making a positive impact locally and abroad.

Two filmmakers will document the journey. Kassidy and Ryan will blog daily, upload their photography, and most importantly produce weekly webisodes. The webisodes will aim to entertain, educate, and inspire social activism within the Millennial Generation.

Kassidy and Ryan will aspire to be the social leaders of Generation Y, who are some of the world’s most influential, globally wired, technologically savvy and socially conscious people in the world, by bringing them the content they crave through the medium they consume.

Follow Kassidy and Ryan on their website: journeyofaction.com

September 16, 2010

Frist Global Health Leaders Touch over 5000 Lives This Summer

School has begun and autumn is here. We hope you had as wonderful a summer as we had here at Hope Through Healing Hands.

During the summer break, we had 7 Global Health Leaders travel to Peru, Honduras, Rwanda, Zambia, and Appalachia to promote health care through public health services and clinical care.

John Deason_pharmacy in zambia beth dental class

Photos: John Deason, Lipscomb College of Pharmacy, fills prescriptions in Namwianga, Zambia and Beth O'Connell, ETSU College of Public Health, teaches a dental hygiene class in Cygera, Rwanda.

In total, these students touched the lives of over 5000 people in villages around the world. They saw over 1800 patients, trained over 100 community health workers, educated over 2000 people on basic health such as dental hygiene, hand washing, and HIV/AIDS, and surveyed over 600 people to assess needs such as clean water and better family health care.

You can read all their blogs on our website:

Jennifer Hunt – Appalachia Region: Health Screenings for Migrant Workers

Beth O'Connell—Cygera, Rwanda: Over 1380 People Have Received Safe Water Education

John Deason—Namwianga, Zambia: The Mission Begins: Setting Up Clinics in Zambia

Please support our Global Health Leaders program so that we can continue to reach our goal of directly touching the lives of over 20,000 people around the world with health care in the next few years.

Regards,

Bill Frist, M.D.

P.S. Follow Vanderbilt School of Nursing students Cody Bowers and Lauren Eppinger as they report in from the Primeros Pasos clinic, focusing on maternal health and newborn care, from Quetzaltenango, Guatemala this fall.

Water = Hope goes to Washington! We just finished another fun weekend on the road with Brad Paisley and the H20 Tour, making stops in Spokane, Portland and the Gorge!

We started our weekend off in Spokane with some great volunteer help: college students, a high school student and parents involved with a local home schooling organization all came out to lend a hand, doing a great job and signing up lots of new supporters for the Water = Hope campaign!

Our next stop was in Portland, where, after a summer of blazing heat and humidity, we were shocked to find ourselves...cold! Once again we were joined by an awesome volunteer crew: Chris just moved to Portland where he is soon to be joining the Portland Fire Department (congrats Chris!), and he was joined by Danielle, who is in nursing school in San Francisco but was visiting the Portland area. Ryan and Sarah are both students - Ryan is in med school, in fact! And we also had Kate joining us, who literally just moved to Portland the week before to attend college, and was looking for volunteer opportunities to get involved in her community. All of our crew did a great job in Portland, roaming the lawn area and talking to fans about the campaign, gaining their support. Though it was a smaller show, Portland showed us lots of love and support and we are excited to continue our organizing efforts in the community.

Next up was the Gorge, located in the middle of Washington state, and quite possibly the most beautiful music venue in all of America. We were way excited to be working there, and it was a HUGE show, with more fans in attendance than almost any other show we’d been at!

We were joined that night by Randy and Kim, a husband and wife team who had tickets to the show but wanted to help out. They came in went to work, signing up well over 100 new supporters in a short amount of time, talking to lots and lots of fans before joining their son and mom (or mom-in-law!) in their seats. They also made a very generous donation to Water = Hope, helping us reach our well building goal all that much faster, for which we are most appreciative!

We were also joined by our two recent Washington State U grads (a big Washington U rival game was going on that night, and, depending on who they talked to, they either got lots of love for their hoodies, or a lot of grief!) who were eager to get involved, and three new volunteers that Laura from Spokane had recruited for us (thanks Laura!). All in all, it was a great three days, full of inspiring stories from fans, and lots of support and enthusiasm about our work.

We are nearing our final stretch of the H20 tour, with only two weekends remaining. Watch for us in San Francisco, San Diego, Phoenix and Albuquerque this weekend!

Check out more photos from our weekend in Washington here: http://www.facebook.com/album.php?aid=198319&id=23133677902&ref=mf

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Healthy School Program at Primeros Pasos: Guatemala

Oct 18 2010

Global Health Leader Cody Bowers Lands in Guatemala

Oct 11 2010

Water=Hope Campaign Billboard, Crossville, TN

Oct 06 2010