One of the unique aspects of the model of Lwala Community Alliance, is that while there is a clinic, the program is multi-dimensional, there is also a strong water, sanitation, and hygiene program (WASH), a education initiative that partners with schools and helps to provide secondary school scholarships based on academic merit and need, Umama Salama, an initiative to train community members on basic lifesaving skills to reduce maternal and infant mortality, and a sewing cooperative. The clinic staff goes on school outreaches at local primary schools which includes health education and free preventive care.
Georgetown Public Hospital Corporation (GPHC), is the central hospital for the country’s public health system. The A&E (Accident and Emergency) functions as the essentially Level 1 Trauma Center and the Emergency Department for the country. Referrals come in from all over the country from outlying health clinics and hospitals if more specialized care is needed. Georgetown is also the population center of the country and so most patients arrive? to be seen first here with acute complaints. There are multiple clinics ranging from diabetic foot clinic to eye clinic to pediatric and surgery clinic that see and refer patient to the A&E for admission or further treatment as well.
One of the most heart-rending patients I saw was young man with HIV/AIDS. He had initially presented to the clinic on 12/10 with advanced disease (for the medical folks his CD4 count was 3) and was started on antiretroviral therapy (HAART). He came back to clinic in January dehydrated with diarrhea, some fairly advanced skin ulcers, cough and fever. I remember the morning he arrived he was laying outside the clinic on a mat an hour before opening, I could tell from a distance that he was incredibly emaciated, I went over to make sure he was okay, and this man, despite his illness gave me the sweetest smile. He continued to have such a warm smile throughout the few days he spent on observation with us while receiving IV fluids and antibiotics, and gradually improved though he was still very weak. He was discharged on home-based care and I walked with the community health workers to his house a few days later to see how he was.
Coalition links Tennesseans to help for Haiti

The Tennessean

By Jenny Eaton Dyer, Ph.D.

One year ago today, a 7.0-magnitude earth­quake hit the poorest nation in our hemi­sphere:
Haiti. More than 300,000 people died, and more than 1 million Haitians were left without shelter or work. With the subsequent onslaught of Hurricane Tomas and cholera, thousands more have lost their lives.

Former U.S. Sen. Bill Frist, M.D., arrived in Port­au- Prince immediately fol­lowing the disaster with a medical mission team for the victims of the earth­quake. Hundreds waited for emergency surgery at Bap­tist Mission Hospital where the team worked day and night for the trauma patients. Within hours of his arrival, the doc­tor- senator sent back blog postings and pho­tos to his Nashville-based global health organization, Hope Through Healing Hands, sharing the stories or both horror and hope of so many who had survived.

One of his patients, 16-year-old schoolgirl Rouite Tisma, had been found alive under the rubble of her schoolhouse. Knowing she had been at the school, her frightened father
searched the site, calling her name for any sign of life. He finally heard a small sound from beneath the collapsed stone building indicating she was still alive. Three days later, they dug her out of the rubble. Her right leg was crushed, and her left forearm and hand swollen. But she and the family rejoiced that she was simply alive.

‘Network of mutuality’


How does the extreme poverty of Haiti affect Tennesseans? The Rev. Martin Luther King Jr. once said, “We are caught in an inescapable network of mutuality, tied in a single garment of destiny. Whatever affects one directly affects all indirectly.’’ Even in this landlocked state, there is a robust global health community addressing emergency relief, prevention of disease, education, extreme poverty and sustainable health care in developing nations.

Hope Through Healing Hands’ Tennessee Global Health Coalition boasts more than 60 in-state members, including nonprofit organ­izations, churches, universities and corpora­tions who touch lives in almost every coun­try in the world.

At the time the earthquake hit in Haiti, the coalition had been in existence for six
months. Yet, even in that short period, the partners were able to quickly and efficiently communicate with one another the needs, intentions and goals to begin the work of relief.

Mobile Medical Disaster Relief inoculated thousands of Haitian children against tetanus and diphtheria. Soles 4 Souls committed to providing more than 1 million pairs of shoes to Haitians. And Sweet Sleep shipped beds, mattresses and linens for children newly orphaned, for a clean, safe place to sleep.

On this anniversary of one of the most devastating earthquakes in history, we are reminded of King’s “inescapable network of mutuality.’’ Wonderful local groups and indi­viduals are changing lives in forgotten cor­ners of the world, albeit quietly, from right here in our own backyards. Tennessee’s vol­unteer spirit is alive and well.

We applaud the global efforts of these groups on behalf of Tennessee and the United States, using health as a currency for peace. In this increasingly globalized world, these countries are our neighbors in the world village, and addressing poverty — whether in Pulaski or Port-au-Prince — means a better, safer world for us all.


Jenny Eaton Dyer, Ph.D., is the executive director of Hope Through Healing Hands.



After a wonderful few days to spend time with my family and friends and recover from jet lag, I have arrived in Lwala, a small village in Western Kenya. My month in Lwala will be a combination of serving along side the clinical officers (similar to a nurse practicioner or physician assistant in the US) and nurses in clinic as well as a project focusing both public health and clinical services for malaria prevention and treatment. I thought I would provide a little context for my work this month.
A previously healthy 29 year old female arrived in the ED via motor taxi, accompanied by her family, early in the afternoon on a day I was working in the outpatient clinic. I stopped by the ED on my way home, and saw that Turno doctor had her hands full with the patient, so I stopped to help. The patient was hypoxic (74%), tachypneic (58 breaths per minute), and somewhat hypotensive (90/50). She complained of chest pain and shortness of breath for 3 days, and also thought she may have had a fever although she was afebrile on arrival to the ED. Her EKG showed sinus tachycardia, but was otherwise normal (we were only able to obtain limb leads). She appeared chronically ill. We were unable to get labs because of the time of day, and the patient was too unstable to transport for a chest x-ray. Pulmonary embolism was a major concern even though she had no risk factors, thus we gave Heparin for anticoagulation and started to arrange transfer to Guatemala City for diagnostic testing and treatment. After two hours of preparing for transport, collecting supplies (as there are none on the ambulance), and deciding which family member was going to accompany the patient, we were finally ready to go. Just prior to departure, the lab was able to run a rapid HIV test, which came back positive. This added more to the list of possible diagnoses. By this time the patient was on 10L O2 and a Dopamine drip. We added on several antibiotics for possible infection, and started the journey.
I have spent the last three weeks working in the Hospitalito in Santiago Atitlan, Guatemala. Santiago Atitlan is a city of 50,000 people, located on beautiful Lake Atitlan, surrounded by three towering volcanoes. The hospital consists of a four bed ED, two labor and delivery rooms with two beds in each, three inpatient rooms, and an operating room. The two upper levels are currently under construction, but will greatly increase the capacity of the hospital. The staff consists of mainly volunteer physicians and local nurses and technicians. The main language spoken by the patients is Tz'utujil, which is then translated by the nurses to Spanish for the physicians. Patients came to the hospital from towns all around the lake and surrounding area. They often arrived via Tuc-Tuc (motorcycle-taxi), but sometimes walked, were carried by family members, or arrived by Bomberos (volunteer firefighters without medical training or resources).
I have been back in the United States for a week and a half now. Coming home from Guatemala during the holiday season is a strange transition. I couldn't help but look at all of the (admittedly exciting) products and services being offered, and think "oh, that money for that completely useless thing could pay for 'x' children's medicine, or food." I have been trying to adjust to life in the US, and accept the differences between life here and the poverty in places like Xela, trying to enjoy the luxury but maintain the perspective. In the midst of all of this enjoyment, I am reminding myself periodically that too much acceptance of this sort of disparity leads to complacency, which only further harms people.

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