Highlight the good – This summer has been extraordinary. I have been given an opportunity to see first hand how one or two committed individuals can make a positive impact on an entire community. Over twenty years ago, one man was impacted by the needs in his community. It began with one can of food distributed by one man and has since developed into a multi-faceted grassroots organization – Of One Accord, Inc. – which provides vital services to its community members. But in addition to these services, the agency wears many hats. It’s a social network – community members from every walk of life congregate together and discuss ways to improve the living and working conditions in their communities or they simply stop by to say ‘howdy.’ It’s an advocate – men and women, young and old identify local needs, voice their concerns and develop initiatives that are sometimes provocative, sometimes cutting-edge and sometimes counter cultural. It’s hope – over 300 committed individuals volunteer with the agency each year, many year after year, and willingly give of themselves, their time and resources to lend a helping hand to someone in need.

Inspire greatness – Over the past few weeks, I have experienced every emotion possible…elation, laughter, sadness, joy, hope and inspiration. I have learned the stories of our precious seniors. I have cried with them as they tell me stories of loss and hardship. I have laughed with them as they tell me stories about the ‘good ole days’ – pickin’ berries, churnin’ butter and makin’ music out on the front porch. I have been inspired by their tenacity and strength and I have also shared in their grief when I am told stories of how they feel forgotten by family, friend and community. These seniors are a walking history, living testaments, a repository of knowledge. We have learned together one from another. And although I can sense that I have impacted their lives in meaningful ways through various health promotion activities, these men and women have also educated me. Through their life stories, I have learned how to cope during crisis, how to manage with limited resources and how to cook up some good vittles even if the cupboards are bare!

Encourage mutual responsibility – It’s just plain old simple mathematics! There is strength in numbers. When people join together for a common purpose, we can make a world of impact. My friend, Sue, is someone making a world of difference. Together, we can make change happen. We can empower our communities through citizen engagement. We can mobilize other likeminded community members and promote social responsibility for health. One by one, we can make lasting change! And although there are unique challenges facing rural communities, a little hard work, grit and determination by one or two local residents can = a thriving community of hope. A big shout out to Big Kenny Alphin and the Love Everybody Foundation for making this opportunity possible here in Appalachia!

            To fill you in on the rest of the events that have happened, my days at the clinic are all but over for this trip.  In the days leading up to the mission I was needed to much here to get things ready.  Once all the team members arrived (all 220 of them) things really got crazy, but I was very impressed to see how all the organization and planning really keeps things moving smoothly.  Meals are held in a large field of chairs behind the house and there is no where you can go without running into someone.  It’s nice be around so many people, but also a little hectic.

            The day of the first mission required us to get up an extra early (since I was on the advance setup team), grab a quick breakfast and start packing the lorries for the long haul to Simalundu.  Despite the early start and having to setup most of the camp with only a small fraction of the main group, the benefit of riding on top of all the piled up sleeping bags on the uncovered lorry was well worth it.  It made a very long, slow and bumpy ride rather relaxing.  I even got a short nap in.

            Once we arrived, we were greeted by a group of Zambian villagers singing songs of thanks for our arrival; it nice to have such a warm welcome. Thankfully, we were able to get everything ready before the main team arrived, and more importantly, before dark!  It was nice to finally be finished and have a hot meal. 

            After eating. my new found friend Britni (a doctor from South Africa) and I went to go see what all the commotion we were hearing from the village.  We arrived to see almost a parade of Zambian dancers singing to the moonlight in celebration of our arrival.  We were soon surrounded by many of them asking us questions from who are favorite football (soccer) teams were to if we were married.  They also did their best to teach us more Tonga, and had a blast laughing at us when we couldn’t pronounce the words correctly.

            I went to bed that night with a very big smile on my face.  The Zambians had decided to sing well into the night and the singing and marching carried throughout the entire campsite.  I can’t tell you what it does to a person to receive such a welcome.

            In the morning we set up all the giant canopies that would be our various departments and began the clinic.  I have never seen such lines of people in my life!  After one day of being there we saw over 3,000 patients!!!  The pharmacy dispensed medicine to almost all of them and most got at least 3 prescriptions each for a total of at least 9,000 scripts filled in an eight hour period!  I doubt I shall ever see the likes of such a well oiled and efficient pharmacy.

            We continued on for another day in the same fashion seeing another 3,000 patients and packed everything to move to Kapaulu the next morning (at 5:45 am!!!).  That night the Zambians threw such a celebration of signing and dancing the ground shook at times, granted they were right outside my tent.  If I thought the first night I spent that gave me a warm feeling, then this was red hot in comparison!  Few people back in the States have ever seen the gratitude from such a thankful people.  God be praised I could.

            My group piled into a little bus the next morning and had a long and sleepy drive over to our next destination where we were greeted with more songs and dancing.  The next village was much smaller and healthier than the previous and the day went fast.  We came back to Namwianga greeted by a meal of tacos and chips!  I couldn’t tell you how the American came out in my and I dashed around excited for the meal and the promise of a hot shower after only 4 days in the bush.  It’s funny how the simple pleasures seem so big once you haven’t seen them for a little while.  Multiply the gratitude the Zambians must have had when they are given little niceties, which we so often take for granted, that some have never had in their whole lives!

            God has truly blessed me with such an opportunity to experience all that I have.  Looking in at a country in such need makes me never want to leave it.  Certainly the desire to finish my degree burns even greater with in me now more than ever if only for the simple fact that I can bring more knowledge and skill to this country that could never have to many healing hands.

            We leave out again early tomorrow to go for another 4 days in the bush.  Please be in prayer that we can repeat the same successes we have been having and that our party continues to remain as a whole, very healthy.

Cygera, Rwanda

beth HIV class beth dental class

(Above: Beth teaching HIV class, Beth with Dental class)

Final Update from Rwanda

Hand Washing and Safe Water Education

      I have continued visiting individual homes in the village to provide hand washing and safe water education.  Since my last update, I spent three more afternoons visiting homes and have succeeded in reaching all 261 homes in Cyegera  in addition to the previously taught students at Kiruhura Christian College and church in Ruyenzi village.  I am proud to report that total of 1,387 people here have received hand washing and safe water education.  We were initially told by village leadership that there were 256 homes in the village, so I also effectively updated their census information on both number of houses and number of people in Cyegera.

Health Education at Kiruhura Christian College

      Due to holidays and exams at the end of the trimester, my teaching schedule changed several times; however, I rearranged my lesson plans and we successfully completed our public health lessons. The students learned about malnutrition, tuberculosis, sexually transmitted infections, and conjunctivitis, and then wrote a paper on one of these topics to include: definition, causes, consequences, prevention, and a story from related personal experience. They also completed quizzes for evaluation.  The papers and quizzes reflected good understanding of the topics by nearly all of the students.  I discussed mistakes with each student individually who did not receive a perfect score and they appreciated that.  On July 17th, I was honored to attend, by invitation, a meeting of the school administration and parents.

HIV/AIDS Education

On Saturday, July 17, and on Sunday, July 18, two HIV/AIDS classes were held at the church and were open to the public and a total of 110 people attended. Interestingly, many were not members of the school or church, so news had travelled well through the community.  The rapid spread of the disease in sub-Saharan Africa, need for prevention, and methods to prevent the spread were emphasized.   Participants were encouraged to ask questions and they asked many. They are so eager to learn.

Dental Health Education

      Continuing with dental health education I worked with the four employees of the Faith and Hope Children’s Home and also the local church congregation. I gave each of the employees supplies for themselves and their families which will impact twenty people. This is in addition to the students educated previously.  Eighty more participated in this dental education and received supplies at the church. 

Nutrition and Waste-Removal Professional Analysis

      You may recall that while analyzing environmental hazards at the Faith and Hope Children’s Home, I prepared a meal log along with information and pictures on the waste-removal system for analysis by professionals in those fields.   The meal log was sent to a registered dietician for nutrition analysis.  The waste-removal information was sent to a licensed plumber for analysis. I am waiting for their recommendations. I also have pursued information on building raised-bed gardens at the home to help alleviate nutritional gaps. This project is currently waiting for approval by my host organization. I intend to follow through on these unfinished projects even after my official internship experience is over. I feel a personal commitment to them and would like to see the children benefit from their potential.

Conclusion

      I am wrapping up the community and school health education programs and reflecting on my time in Cyegera, Rwanda. Every day has been busy and productive and I will depart knowing the health of the community has and will continue to benefit from my efforts.    I cannot thank Hope Through Healing Hands, the Niswonger Foundation and the ETSU College of Public Health enough for making this opportunity possible - we have definitely made a difference!

 

 

            Since my last report, so much has happened! I have completed my survey project of the employees and patients of Rural Medical Services (RMS).  This information will be extremely valuable to the management of RMS in determining the strategic direction of RMS in the future.  I also think this information will be very valuable to the patients of Rural Medical Services.  We received numerous ideas and comments from patients on what they think of RMS and how RMS can strive for improvement in the future.  Overall, the patients and the staff are extremely satisfied with the operations of Rural Medical Services and mostly had only positive comments to make.  Some comments made by both the staff and the employees are worth sharing; they show the perceptions of what a great organization RMS is. 
Comments from the patients:         

  • This place is the best.  Has always taken care of me and found me the best way for me to pay since I do not have insurance.  Thank you.
  • Wonderful staff, very attentive to my every need. Takes excellent care of my children
  • These ladies are the absolute best and most professional women I’ve ever had the honor to know and have came to respect them in everyway.  Thanks for everything ya’ll have done for my family; kids; and myself.
  • Everyone here at the clinic always treats you like family I love them everyone.  They always take the time to see how you are they are wonderful
  • The Nurse Practitioner even called me at home later that night to make sure my child was OK.

The employees, while offering numerous suggestions on the operations of the organization, are equally as satisfied with RMS.  From the employees:

Comments from the employees: 

  • Large company now, but still has values and care for its employees as if it were the small company it was years ago
  • Freedom to do my job without being over managed and being able to take advantage of opportunities for projects as I see best meet the goals of my department
  • RMS plays a vital role in the health care of the communities it serves and I enjoy being a part of that.  Also at RMS everyone is treated as an important part of the team regardless of their position.  We are told from the CEO that we are valuable to the organization.
  • To know that we are serving the most needed people.  Particularly for me this service is a ministry, in which the reward is to see the transformation in the life of the people we serve.
  • Ability to offer medical services and care without regard to patients insurance or financial status

 

I am looking forward to presenting my findings to the RMS leadership, employees, and Board of Directors and getting their thoughts and impressions on the information.

This past week, I attended and helped conduct Migrant Field Screenings.  These field screenings are held at various farms throughout the county.  I attended the screening at a large farm in Parrottsville, TN.   The screenings are held outside and the providers use card tables as their desks and migrant workers come to the screenings after work and are seen by health providers.  The workers include office personnel who answer the phones and use computers, workers who are out in the fields harvesting crops to those working in the packing warehouse.    That day at the farm, the providers saw numerous cases ranging from diverticulitis to diabetes. RMS provides all of these services and medicines free of charge to those wishing to participate.  Though I expected to be there just to observe, I was able to participate by taking blood sugar readings.

In addition to providing practitioners and nurses, Rural Medical Services also provides translators to help with the language barrier experienced between workers who speak only Spanish and providers who do not speak Spanish.  After having their vital signs and blood sugar checked, patients were seen by one of three providers at the screening that day.  Students from the East Tennessee State University’s College of Medicine and College of Nursing were on hand to help the providers.   Various medications were also available to the migrant workforce free of charge.    During their session with the migrant patient, providers also conducted patient education on how to better care for themselves during the extreme heat conditions that come from working in the field to stretching exercises for office staff to help avoid developing carpal tunnel syndrome.  It was interesting to see this process in action and how the providers and staff focused on the care of the patient in spite of language and cultural challenges.

 

by Kelsey Neff

July 19, 2010

We’re back on the road again with the Brad Paisley H2O World Tour, with last weekend’s visits to Chicago and Moline, IL!

waterbottle girl

Friday morning greeted us with hot temperatures and even hotter humidity! The severe temperatures didn’t sway the hardcore country fans, or our even more dedicated Water = Hope volunteer crew! We had a great group of volunteers, starting the day with 12 dedicated do-gooders, consisting of three sets of best friends. We had a group of high school students, and best friends, who had volunteered at other similar shows previously, and collected an awesome amount of e-mails and donations. We had Barry, Bob and Betty who went out into the Water World Plaza to talk to concert-goers about Water = Hope. Bob was an experienced campaigner who had volunteered at a U2 show a couple years back with the ONE Campaign, and he impressed us by raising a lot of money to build wells, working so hard we barely saw him! And last but not least, we had a best friend duo who worked together at a school and were on their feet moving for the majority of the night. Everyone did a great job, thanks to all of you for suffering through the heat with us!

threesome girls

We had a great response from fans in Chicago, raising almost three dollars for every e-mail address we collected! People were very interested in our goals and showed their support in many ways. We met a couple people from Texas who wanted to volunteer for us when we head that way in August, and others who grabbed t-shirts for a bunch of their friends and family. The show was fantastic and the crowd was great. Thanks for an awesome night Chicago!

 

moline crew

In Moline we met Colin and Erica and their friends who were committed to matching the success we had in Chicago, even though we only had a third as many volunteers. They were energetic and passionate about Water = Hope and impressed us with their results. Moline’s crowd was a touch smaller than Chicago’s crowd, but we still got a really good response from Brad Paisley fans. One fan even looked through her phone and signed her whole family up for our e-mail list; she said she knew that they would want to support this cause. We also had a lot of fans stop by our table and then sent their friends back to sign up as well. The support we felt in both Chicago and Moline was really great; thanks for a successful first weekend back Illinois!

We’ll be back on the road this weekend hitting up Cleveland and Saratoga.

In August, we’ll be in Texas and Florida; visit the Water = Hope website to learn more and volunteer: http://www.waterequalshope.com/

brittany cannon health fair 1brittany cannon health fair 2

For the past week I have been busy both in the community as well as in the clinic, conducting health fairs throughout various communities across the island.   As a result we been able to perform 215 blood sugar tests and blood pressure readings over a four week period.  Seven of the people screened were referred to Clinica Esperanza due to high blood sugar readings. There are a couple more communities that we are planning to go to within the next week or two.

The clinic has been very busy (as always) and for the past two weeks I have been working in triage. Triaging an adult involves taking the patient’s the weight, blood pressure, heart rate as well as documenting the chief complaint for the patients visit. Obviously triaging a child is a bit different and proves to be a little more difficult because it involves getting weight, height, heart rate, and head circumference (depending on the child’s age) as well as temperature from a typically very unhappy child. On average, we see around 35-40 patients per day  and referrals from the community health fairs conducted have been coming to the clinic. It is rewarding to see that the health fairs are beneficial in getting people to the clinic who would not otherwise come in;  I found it especially gratifying to have had the opportunity to triage one of the people I had referred to the clinic at one of the health fairs. I have really enjoyed the patient interaction and know that triage helps make the clinic flow a lot more smoothly as it helps the doctor prepare for the patient he or she is about to see.

In my last update I mentioned doing a nutrition education class at the clinic but have since changed my mind and thought it to be more beneficial to conduct classes regarding child health.  I have been in the process of planning early childhood developmental/preventative health classes in which I will discuss the importance of nutrition as well as other basic issues concerning the developmental stages of children.

A class on prenatal care is currently conducted every Wednesday at the clinic by a local nurse. However, through shadowing the pediatrician here and working in triage, I have come to realize that many women do not know what to do with their child after it is born. Many do not have basic knowledge regarding the stages of development of their children and are unaware of things a mother can do to enhance her child’s health. This will be the focus of my class and I will keep you all posted.

Again, thank you Hope through Healing Hands Foundation … together we are making a difference here in Roatan.

 

 

Rwanda

Beth Oconnell child w soap

(Above: Child with Soap and Water -- Hand Washing Training) 

Health Education Continues at School

                Kiruhura Christian College has continued to allow me to educate all 112 of the students on various health topics. The week of June 21-25, I taught each class about dental health and provided them with toothbrushes and toothpaste. I got this idea from a student who asked me at the end of class one day if I could teach him how to “wash” his teeth. I also gave these supplies to the headmaster, secretary, matron (woman who cares for the girl boarding students), and two teachers who participated and assisted in the education. The handout used is in the appendix below. We discussed both why and how to brush.   These students were also given information on tuberculosis, conjunctivitis, sexually transmitted infections, and malnutrition. Students will write papers about these topics and include how to prevent them. The students of the general paper classes have also been finishing up in-class presentations of the topics they wrote about previously and all of the students are interested in hearing about each of the topics.  This oral presentation also helps evaluate how thoroughly each student understands their topic.

                I taught the students of the biology class about malnutrition June 30 and July 1. In doing this, I stressed the importance of eating food from each category of food as described by the United States Department of Agriculture My Pyramid program. Malnutrition is a significant problem in this village and the people seem to have no understanding of eating a variety of foods, not just a large quantity. I hope that this education at the school will have a ripple effect into the community.

Continued Hand Washing and Water Treatment in Community

                I am continuing to teach hand washing, hygiene, and safe water education in the village. This includes instruction on why and how to do these things and provision of soap and a water treating liquid for each family. I have continued to do this through visiting individual homes and also one group program.  I have reached 192 families of Cyegera with this intervention, 1034 people. There are a total of 256 homes in the village of Cyegera, and I am going to try to reach each of them before I leave. In addition, I also visited a church in a neighboring town called Ruyenzi. The 58 people in attendance that day received the same education and supplies. That is a total of 1092 people educated on hand washing since the beginning of my field experience.  If the people change their hygiene habits and drink safe water in the future, it will have a huge impact of the overall health of the community.

Biosand Water Filtration

                On June 25, I worked with the Rwandese Health and Environment Initiative Project to reinstall one of the biosand filters. Water had not been flowing through it correctly. Replacement of the filtration media, including a better type of sand has fixed the problem. All five filters at the Faith and Hope Children’s Home and the school are working well with flow rates at the standard of 0.7 liters per minute. They began producing clean drinking water on July 4. Some of them which required maintenance will not produce drinkable water until later dates.

Conclusion

                In continuing these two initiatives, I have continued to draw from reliable web sites for sources of information and on assistance from my preceptor, the children’s home administrator, members of the church, and members of the village leader’s staff. Visits to homes in the village have been very productive and are directed by the village leader and church members. Without them, I would have no way of knowing which homes are within the village limits and how to get to them. The administrator of the children’s home has been my translator for all home, church, and the public education sessions. I also continue to look for opportunities to expand my efforts.

July 7, 2010

Building Wells and Writing Senators: Your Support=Lives Saved


Collaboration with charity: water and Living Waters for the World

We are proud to announce that we will be collaborating with charity:water to build three wells in three villages in three African nations: Ethiopia, Liberia, and Uganda. The wells will serve over 1,000 people. The digging of these wells will begin this fall, and we will update you with photos, blogs, and even GPS coordinates so you can follow the development and the life of the villages which will soon have an easier access to clean, safe water.

In the United States, we will be working with Living Waters for the World to install appropriate water treatment systems for families in the Appalachia region. It is estimated that several thousand families within Appalchia are without clean water, either due to lack of reliable water supplies or the fact that their water supply is contaminated. We will commit to ensuring that several of these families will soon have a safe, clean, and a reliable water source for their household needs.

Dear Senators...

Yesterday, we mailed out over 2,322 of YOUR signatures signed at the Brad Paisley H2O World Tour Concerts during May and June for our Senator Paul Simon Water for the World Act of 2009 petition to Senators in Virginia, Missouri, Ohio, Indiana, and Michigan.

We asked Senators Carl Levin (D-MI), Debbie Stabenow (D-MI), George V. Voinovich (R-OH), Mark R. Warner (D-VA), Jim Webb (D-VA), Claire McCaskill (D-MO), Evan Bayh (D-IN), and Richard G. Lugar (D-IN) to sign the Senator Paul Simon Water for the World Act of 2009 as a co-sponsor to advance clean water and sanitation development activities. The Act would provide 100,000,000 people with first-time access to safe drinking water and sanitation on a sustainable basis by 2015 by improving the capacity of the United States Government to fully implement the Senator Paul Simon Water for the Poor Act of 2005.

At the same time, we said thank you to Senators Sherrod Brown (D-OH) and Christopher S. Bond (R-MO) for already co-sponsoring this important bill.

If you would like to call or write your Senator, click HERE to find his/her contact information.

Don't Forget to TEXT H2O to 25383...

If you haven't already, please consider TEXTING H20 to 25383 to donate $10 to go toward building wells in Africa and providing water purification systems in Appalachia. We need your support today. Follow us on Facebook and Twitter, and help us spread the word to raise support and save lives!

Thanks for your action and advocacy for a better, safer world,

JED signature 

Jenny Eaton Dyer, Ph.D.

 

July 1, 2010 | www.mcc.gov

When Water Flows, Economic Growth Follows

Ashot Abrahamyan is a farmer in Armenia whose apricot orchards lie beneath picturesque purple mountains. His farm is 30 meters above the closest public canal; so in order to irrigate, he had to pump water for more than seven hours every day. For decades, less than three kilometers of the canal system were operational. Beginning late 2009, to respond to the irrigation needs of Mr. Abrahamyan and hundreds of other Armenian farmers, the Millennium Challenge Corporation (MCC) funded the reconstruction of gravity-fed irrigation systems as part of its compact with Armenia.

Mr. Abrahamyan describes his situation prior to and after the reconstruction, "The water in the old canal was limited and much of it vanished through the cracks in the concrete and the broken flumes. Thanks to the new canal, I will be able to save money and irrigate for two to three hours instead of eight. This will also increase the number of peaches I can grow and harvest."

MCC is funding $113 million in repairs to gravity-fed irrigation systems as well as the rehabilitation of canals, pumping stations, and drainage systems throughout Armenia. Major construction and rehabilitation have begun on 17 critical water pumping stations and five gravity-fed irrigation systems throughout Armenia.

  • $36 million investment in pumping stations will provide reliable water for irrigation and improve agricultural productivity for 100 Armenian communities in six regions.
  •  $7 million investment in gravity-fed irrigation systems will increase arable land and reduce electrical consumption.

A $16 million investment in the Ararat Valley Drainage System will reduce ground water levels in 35 communities of the Ararat and Armavir provinces and will increase crop productivity in the biggest agricultural zone in Armenia, while also maintaining an optimally balanced ecosystem in the wetlands.

Mr. Abrahamyan is one of the lead demonstration farmers for MCA-Armenia, which is managing the compact’s implementation. His orchards will benefit not only from improvements to the gravity system, but also from a more stable irrigation system that he developed after receiving training from MCC-funded on-farm water management experts. He learned ways to modify his system to improve its efficiency and save both water and energy. He will access water though the pipe outlet installed on the siphon of the canal, which will feed his pump. With construction completed in the areas near his farm, Mr. Abrahamyan is excited about the new irrigation season.

A year from now, more than 61,000 farmers in 23 communities in the Ararat, Armavir, Gegharkunik, Lori, and Shirak provinces of Armenia will see their own irrigation systems completed and precious water supplied to their lands without losses and at a lower price. MCC and MCA-Armenia look forward to making a difference in the lives of farmers like Mr. Abrahamyan, who are counting on the water, the technical expertise, and the hope that this program brings. After work is completed, even farmers at the farthest ends of the canals will be able to access water and farm lands that had been deserted.

MCC’s total investment in the agricultural and water sector in Armenia will be approximately $180 million when the program ends in September 2011. The Irrigated Agriculture project will benefit over 420,000 people by improving the quality of irrigation and increasing agricultural productivity. By rehabilitating and constructing main canals, gravity-fed irrigation systems and pumping stations; strengthening the capacity of local and national water supply entities; and providing technical and rural credit assistance to farmers, MCC expects farmers to shift from low-value to high-value crops and income from agriculture in rural areas to increase.

Press Release

Harvard School of Public Health

Operating Theatres and Essential Surgical Equipment Often Unavailable in Developing Regions

For immediate release: Wednesday, June 30, 2010

Boston, MA -- More than two billion people worldwide do not have adequate access to surgical treatment, according to a new study from the Harvard School of Public Health (HSPH). The researchers also found that people living in high-income regions have far greater access to operating theatres (surgery sites) than those living in low-income regions and that surgical facilities in low-income settings often lack essential equipment.

A substantial amount of the global burden of disease comes from illnesses and disorders that require surgery, such as complicated childbirth, cancer and injuries from road accidents. The burden of treating surgical conditions is especially acute in low-income countries. The wealthiest third of the global population undergoes 75% of the estimated 234 million surgical procedures done each year, the poorest third just 4%.

“Our findings suggest that high-income regions have more than 10 times the number of operating theatres per person than low-income regions,” said Luke Funk, research fellow in HSPH’s Department of Health Policy and Management and a surgical resident at Brigham and Women’s Hospital in Boston.  “Addressing this disparity will be a huge challenge, but global public health efforts have had a profound impact on other major sources of morbidity including malnutrition, infectious diseases, and maternal and child health. The same could be accomplished for surgical care.”  

The study appears online July 1, 2010, on the website of the journal Lancet and will appear in a later print issue.

The researchers, led by Funk and senior author Atul Gawande, associate professor in HSPH’s Department of Health Policy and Management and a surgeon at Brigham and Women’s Hospital, obtained profiles of 769 hospitals in 92 countries participating in the World Health Organization’s Safe Surgery Saves Lives initiative, which aims to reduce surgical deaths and is led by Gawande. Based on the profiles they calculated ratios of the number of functional operating theatres to hospital beds in seven geographical regions worldwide. The researchers used pulse oximetry, a monitor that measures the amount of oxygen in patients’ blood during surgery and an essential component of safe anesthesia and surgery, as an indicator of operating theatre resources.

The results showed that all high-income regions had at least 14 operating theatres per 100,000 people. In contrast, those in low-income regions had less than 2 operating theatres per 100,000 despite having a higher burden of surgical disease. In addition, pulse oximetry was unavailable in nearly 20% of the operating theatres worldwide and absent more than half the time in low-income regions. The researchers estimated that around 32 million surgeries are performed each year without pulse oximetry, a basic standard of care that is available in more than 99% of operations done in high-income regions.

According to Gawande, “It is not news that the poor have worse access to hospital services like surgery. But the size of this population is a shock. Our findings indicate that one third of the world’s population remains effectively without access to essential surgical services--services such as emergency cesarean section and treatment for serious road traffic injuries. Surgery has been a neglected component of public health planning and this clearly needs to change.”

The study is an important step in understanding the critical need for better access to surgical services and for safer operations in low-income settings worldwide. “It is important for the public health community to close the gaps between rich and poor regions if it wants to address the burden of surgical disease in developing countries,” said Funk. “This will become even more important in the next several decades as chronic diseases—which are often surgical conditions—increase with the aging of the global population.”

Support for this study was provided by the World Health Organization.

“Global Operating Theatre Distribution and Pulse Oximetry Supply: An Estimation from Reported Data,” Luke M. Funk, Thomas G. Weiser, William R. Berry, Stuart R. Lipsitz, Alan F. Merry, Angela C. Enright, Iain H. Wilson, Gerald Dziekan, Atul A. Gawande, Lancet, online July 1, 2010, vol. 375.

Visit the HSPH website for the latest newspress releases and multimedia offerings.

photo: iStockphoto/veronicadana

For more information:

Todd Datz
617.998.8819
[email protected]

###

Harvard School of Public Health (http://www.hsph.harvard.edu ) is dedicated to advancing the public's health through learning, discovery, and communication. More than 400 faculty members are engaged in teaching and training the 1,000-plus student body in a broad spectrum of disciplines crucial to the health and well being of individuals and populations around the world. Programs and projects range from the molecular biology of AIDS vaccines to the epidemiology of cancer; from risk analysis to violence prevention; from maternal and children's health to quality of care measurement; from health care management to international health and human rights. For more information on the school visit: http://www.hsph.harvard.edu

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