by Danielle Dittrich

Vanderbilt School of Nursing

Quetzaltenango, Guatemala

The past two weeks have been an absolute whirlwind. After overnighting in Antigua I took a small bus for five hours up the winding mountains into the western highlands, finally arriving in Quetzaltenango. Quetzaltenango was and still is a principle center of Maya Ki'che and is often referred to by its Ki'che name Xelaju and abbreviated to Xela. Xela is a large city seemingly disconnected from the surrounding cities but by small winding dirt roads which the revamped and repainted yellow school buses ride along. Most women in the city still dress in traditional Mayan clothing, which becomes even more prevalent as you head out into the country side. Every morning we take the unmarked school bus from the bus stop at the Calvario Church into the mountains of Tierra Colorada Baja. Outside the church, venders sell flowers freshly cut from the mountains and beans and eggs out of street charts.

Now is the perfect time for me to be at the Primeros Pasos clinic, as many exciting changes are going on around me. Originally a pediatric clinic, the Healthy Schools Program is one of Primeros Pasos largest components. Health educators go out into the local community schools and teach about prevention of infection and communicable disease. By participating in this program, the children receive free healthcare at the clinic. For the schools that are too far from the clinic, Primeros Pasos has a mobile clinic which runs at the end of the school year. The end of the Guatemalan school year is now approaching so we have been hiking into the mountains with backpacks full of medications and medical equipment. As we are about to hit a lull in pediatric consults, all focus is on the new women's clinic.

The women's clinic will run in conjunction with the women's groups that have recently started up in the community. Similarly to the Healthy Schools program, women that participate in the women's group will receive free care. The objective is for patient to invest in their healthcare through commitment to health education. In the afternoons we have been hiking into the mountains to teach the women's groups and to talk about the new women's clinic. The women's education group has three phases: The first phase focuses on nutrition, hygiene and traditional medicine. The second phase focuses specifically on women's healthcare topics such as cervical, endometrial, and breast cancer, pap smears and self breast exams, pregnancy and prenatal care, menstruation and menopause. The last phase focuses on self esteem and leadership. In this phase, the women have a choice to start a community wellness project or to become a health educator. We are hoping to find the next group of women's health educators from this group. Each day of the week is a different women's group meeting in a different community, all in different phases of the program. The women at the women's group range in age from teens to grandmothers. Most women bring along their children, tied onto their back and over their shoulder with a traditional woven clothe. The first groups are entering the third phase; it will be very exciting to see these women become leaders. You can easily tell the difference between the timid participants of groups in phase one as compared to the outspoken individuals starting phase three, who eagerly ask me inquisitive health questions and willingly discuss women's issues.

On the first day of my clinic orientation I already had a patient. I had been told that many mothers had been asking for help when they brought in their children, but I had not anticipated for things to happen so quickly. Unfortunately, all the clinic supplies were still in the apartment, so I did the best I could with what I had.  I guess you can say the women's clinic unofficially opened the first day and officially opened two days later and I have had at least one patient every day since.  A new group of medical students have just started their rotation at the clinic. Two of the six medical students are females and I will be training them in the basics of obstetrics and gynecology in the primary care setting. It will be exciting to see them grow into the role of provider over the course of their eight week rotation. I can already tell that everyday will be a new adventure.

Next Big Nashville: How Can Artists Help

October 9, 2009, 11am

Country Music Hall of Fame, Ford Theatre

by Jenny Eaton Dyer


Today, Charlie Peacock moderated a panel on How Artists Can Help Charities, especially given the current economic climate -- when money is tighter than ever. Panelists included Billy Cerveny, Brite Revolution; Kenny Alphin, Love Everybody; Jenny Dyer, Hope Through Healing Hands; Andrea Howat, Hanson’s Walk/Tom’s Shoes; Derek Webb, Blood:Water Mission; and Barrett Ward, Mocha Club.

Having worked with artists for years at DATA/ONE on how to promote awareness, education, and advocacy to their fanbase, I offered a few practical steps that they can take to get started:

  1. MATERIALS: Set up lit/materials at merchandise tab or booth.
  2. SIGN UP SHEETS: Sign people up to on sheets at merch table or booth Get their emails/addresses.
  3. PSA: Before or between sets, show a 2-3 min PSA
  4. SHOUTOUT: Before or between sets, commit to doing a "Shout out" for 1-2 min about importance of global poverty, health, education, etc.
  5. TEXT MESSAGE: You can get a text message service so that you can direct fans during show to "text" in to capture their emails on the spot - but there are costs involved.
  6. PASS A BUCKET: You could "pass  buckets" and ask for $1 during a show.
  7. PRESS KITS/INTERVIEWS: Mention in your press kits and interviews that you encourage fans to lend their voice to the fight against global AIDS and poverty in Africa.
  8. Wear  t-shirt/sticker, etc. on stage during show.
  9. Promote  on website w link/logo.
  10. Email blast: send email to fans encouraging them to sign up.
  11. Put  info in your CD/DVD liner notes driving them to website.
  12. Continue to promote and connect fans to website Twitter and Facebook.

Educate, Activate, Motivate, Celebrate is a catchy phrase to remember on the method of promoting awareness, galvanizing action, and sustaining interest among your constituency.

I also encourage local artists to check out our new Global Health Coalition. Consider supporting a local group doing global efforts.

Artists hold a prophetic voice in society, standing at the margins, speaking truth and perspective. One voice can change the world.

Let us know if we can be a resource to you:

October 5, 2009

Global Health Leader Amelia Wood arrived a couple weeks back at Kijabe with her husband Jim and baby Josiah. She is serving as a neontologist there, bolstering health care delivery and training.

by Amelia Wood, M.D.

We have now been in Kijabe a full week. We arrived to homemade zucchini bread and an invitation to watch "So you think you can dance" from the wonderful Davis family (our neighbors just below in the Sitaplex guest house). Not having a TV at home, we were way less in the know than some of the long term missionaries here. Kijabe is like summer camp for doctors. And although there may be some sacrifices in being in Africa (like broccoli free of aphids) our overwhelming sentiment is, "man, don't we feel at home!" 

We have made many good friends in the short time since we arrived, including a missionary couple who are living our dream. Mark and Sue Newton have been in Kijabe for 12 years and they are so authentic and enjoyable that they make missionary life seem easy. Mark is a pediatric anesthesiologist who spends 10 weeks working at Vanderbilt every year and the rest of their time is at Kijabe. They have a welcoming home, wonderful children, and a black lab named Moshi. Their lives are busy, but they have graciously had us over twice in the first week - of course, one of those times we arrived un-invited! But they didn't seem to mind. It has been great to listen to them and realize that some of our hopes could in fact become realities.

PRAISE THE LORD, Jim and I found an angelic nanny named Helen who I will cry to leave. She makes it possible to work in peace knowing that our sweet Josiah is cheerfully smacking around our home under her watch. I am only working until lunch time (plus taking call) which is good because everything takes longer in Africa. It is a slow walk with Josiah on my hip to the dukkas (pronounced doo-kus = produce vendors); then bleaching the vegetables is another considerable speed bump once we get home! I actually really love hanging my own laundry out on the line (although it does mean you can't leave the job unfinished until tomorrow).

So as for our "test run" here at Kijabe....I'd say we love it. Where else could a country-boy practice pediatric surgery and his wife practice academic neonatology while their children run through the country-side?

The people here are smiley and energetic. The children are beautiful, just like everywhere. I work in the "nursery" which is an absurd understatement for the degree of illnesses managed in the small, overly heated room crammed with sick infants. We pile in as one big mass of white coats to begin rounds while the nurses sing praise songs in the next room for morning devotionals. Their singing sounds like a dream or the soundtrack to a Francis Ford Coppola film. In the nursery, the mothers all gather round to listen to our discussions as we move from baby to baby. There is no HIPPA so they support each other when things aren't going well and consol one another's babies when they are crying. Mostly, it is a type of sweet interdependence and community lost in the ultra-private and sterile US. Sometimes however, it is a cacophony of cultures-a yelling match in varied languages with beeping incubator alarms and empty infusion pumps filling in any moments of silence. The Somali women are particularly prone to finger wagging and loud refusals to suggested medical plans. I sometimes struggle to teach amidst all the hot commotion.

I usually round with my friend Stephany Hawk, who was my co-resident at Vanderbilt and is now doing a two-year stint as the pediatrician at Kijabe. Together we are training African residents in pediatrics during our daily discussions of patients in the nursery. I have also been asked to lecture at Grand Rounds for the missionary physicians -- pediatricians and family docs. Because I have had the privilege to train under Susan Niermeyer, an international expert in the care of newborns at high-altitude (Kijabe is 2000 feet higher than Denver), I plan to teach about the special challenges of caring for infants transitioning from fetal to post-natal circulation at high altitude. I will also be giving lectures in basic neonatology to the nurses who do much of the bedside care and are pivotal to keeping these babies alive. I am already attached to them, and I often need their hugs on the way out the door each day-neonatology in rural Kenya is sometimes very difficult.

Our biggest limitation to sick newborn care is the lack of total parenteral nutrition. We have many pre-term babies as well as several infants with inadequate intestinal length due to operations, who would all receive TPN in the States. At Kijabe we manage them by feeding at the earliest opportunity and praying for a miracle. It is the best thing available. We can sometimes get lipids (a component of TPN) to add to their IV fluids, and there are rumors of amino-acids, but I have yet to see any-I don't really believe they exist in Kenya. So we do the best we can with what we have.

We see a lot of death and pray that we are communicating Christ's love to these moms by caring for their children who would otherwise be forgotten. This morning, I barely left the bedside of a dying child, whose mother insisted that he was already dead-as evidenced by the ventilator breathing for the baby. The baby is not dead, but he probably will be soon. With all of the challenges and obstacles, it can be difficult to persevere at times.

Still, we do see some miracles. We have two former 29-week preterm infants who are thriving and have graduated into what American neonatologists call "feeder-growers". My favorite is baby James. He is almost ready to ‘hatch' from his incubator. Another baby I love is baby Joseph-a term newborn we admitted for sepsis. I told his father (‘Babba Joseph' as the Kenyans refer to a child's father) that he should expect Joseph not just to survive but to be a normal child. I told him that Joseph will play football (soccer) with his brothers one day. Babba Jospeh smiled broadly and declared "This is a good prophecy." Indeed, I agree.

Life is simple, hard, and lovely.


 Baby James

September 30, 2009

by Jenny Eaton Dyer, Ph.D.

Last night we had a really fantastic Global Health Gathering at the Frist home. Welcoming all Nonprofits who were dedicated to Global Health issues (or Millennium Development Goals) in Tennessee, we had an array of groups who attended who had traveled from as far away as Johnson City or Memphis.

These great groups, all who have joined the Tennessee Global Health Coalition, provide aid and service around the world. They provide beds, shoes, education and clean water for the world's poorest. Some offer leadership training, mental health services and a haven for child soldiers. We have groups who fight trafficking in all forms, and we have groups who train community health workers to provide better health care in forgotten corners of the world.

To be in a room with these heroes and learn from and about their great work was so encouraging for everyone.

Big Kenny ( and his beautiful wife, Christiev, came ( and shared their latest experience in the Sudan. He played his new song, "Forgiveness" with a collage of photos from the trip. His gift is storytelling, and he's out to change the world.

Lewis Lavine, president of Center for Nonprofit Management (, joined us to offer his organization as a resource for the nonprofit groups.

And, Senator Frist shared his story of getting involved in global health policy, the commitment to saving lives in medicine and politics, and the trajectory of Hope Through Healing Hands' Global Health Coalition for Tennessee.

Everyone enjoyed Moe's burritos and guacamole, and I think all left realizing that Tennessee indeed has a robust global health community of works that can and will be showcased. After a "speed-dating" for nonprofits ice-breaker (Kenny said it was louder in the Frist's hall last night than in a good bar!), we prompted small group discussion for these groups to think on ways to work together.

We are excited to see what the future holds for these amazing groups and partnerships.

 Courtesy of Jena Nardella: From left -- Senator Frist, Jenny Dyer, Sten Vermund, Big Kenny Alphin


 Frist Basement Hallway: "Nonprofit Speed-Dating"











Frist Basement: Small Group Discussion--Africa Group

A UMNS Feature
By Tim Tanton*
September 25, 2009

Dr. Bill Frist was flying low in a Cessna Caravan above the treetops in southern Sudan, an area routinely bombed by government forces during the country’s ongoing civil war.

The year was 1998. Frist, a U.S. senator, was entering Sudan surreptitiously as part of a medical mission sponsored by Samaritan’s Purse. Sudan had no diplomatic relations with the United States, which had identified the African country as a sponsor of terrorism.

In the remote Liu area, Frist flew over a site where bombing had claimed a rural hospital.

“It had been destroyed,” he recalls. “There was fighting all around.” However, his team was able to work in a makeshift clinic.

“I came back the next year, the fighting had stopped,” Frist, 57, says. “I came back the next year, and there was a little tiny village, maybe a hundred … huts there. And then I came back the next year, and all of a sudden the church, which had been bombed, was blossoming. There was a school there. There was a hospital there. Nobody was fighting.

“So then I said that, basically, there is something to this – that medicine or health is a currency for peace,” he says.

That idea became the foundation for his global health nonprofit, Hope Through Healing Hands. For the surgeon and former U.S. Senate majority leader, health care has a role to play in building communities – and building peace.

“You don’t go to war with somebody who has just saved the life of your child,” he explains.


September 24, 2009

Senator Frist was the Commitments Presenter in an Infrastructure Breakout Sessions Seminar: Infrastructure of Recover: Good Jobs and Smart Growth.

Global recession has slowed private sector investment and caused rampant job loss. In response, governments around the world are investing in economic recovery though forward-looking public works projects. This new generation of infrastructure investments -- from broadband networks to transit systems to clean energy technology -- is laying the ground word for global deployment of advanced technology and private sector innovation. The response to to the economic crisis has set the stage for a new generation of smarter infrastructure empowered by better use of information and more efficient use of resources. Outdated development patterns are being "leap-frogged." This session provides an opportunity to reflect on progress one year into the economic crisis and to examine the relationship between the public and private sectors.

Frist announcing Commitments.

September 23, 2009

P&G Dinner: The Procter & Gamble Company (NYSE:PG) honored partnerships that have helped the company achieve three life-saving commitments at their "Live, Learn and Thrive" Awards event. Held at a VIP reception in conjunction with the 2009 Clinton Global Initiative (CGI) in New York City, the Awards recognize partners CARE, PSI, UNICEF and World Vision for their help in improving the lives of more than 40 million children, by providing vaccines and safe drinking water to help those in need.

Senator Bill Frist was one of four who presented awards to the partners. While there, we took several photos featured below.

Sheraton NY Hotel and Towers, Avenue Restaurant

 Frist giving interview prior to award beginning on importance of clean water at global level.

Frist chatting with Hans Bender, P&G VP External Relations Global Household Care--Note PUR Packet and PUR Product produced by P&G













Frist chatting with Rich Stearns, President of World Vision (awardee) and his wife Renee Stearns.











Frist visiting with Fellow Awarder Actor Dania Ramirez
















President William J. Clinton and P&G Vice-Chair of Global Household Care, Dimitri Panayotopoulos wrapping up the evening, celebrating the launch of new commitments.



September 23, 2009

This morning I participated in an Action Network Workshop that focused on Health Systems. This past month, I wrote an Op-Ed for the Boston Globe, "Global Healthcare Needs More Than a Pill." In that, I argued that we need to consider a "systems-approach," looking at health systems as a whole - beyond just preventing and treating infectious disease. This would include considering the renovations of health clinics, providing good roads for transportation to those clinics, access to clean water, treating chronic disease, addressing child survival, and partnerships across governments, NGO's, and the private sector to make this work. Given this framework, a discussion followed about how to move forward horizontally and vertically with infectious disease, chronic disease, and maternal and child health.

Dr. Tedros Adhanom Ghebreyesus also delivered a framework for discussing Health Systems. He is currently the Minister of Health of the Federal Democratic Republic of Ethiopia. Focusing on Ethiopia, he addressed their top priorities (Infectious Disease and Maternal/Child Health) and the strategies to address these priorities to strengthen the health care delivery in Ethiopia. In sum, these strategies included the following: 1) Focus on Primary Care, 2) Building information system, 3) Strengthening the supply system for pharmaceutical delivery, 4) Providing health care financing, 5) Bolstering Human Resources, and 6) Addressing Governance. Their motto is "bigger, faster, and better" for speed, volume, and quality for better health promotion and prevention.

A robust discussion among top level NGO's and others commenced. We are eager to hear their results! Those results will then be presented back to CGI for suggestions for future commitments.


 Frist opening discussion--CGI, Sheraton NY Hotel and Tower--Wednesday, September 23, 2009

 Minister Tedros Adhanom Ghebreyesus


September 22, 2009

This afternoon, the 5th annual Clinton Global Initiative commenced with the Opening Plenary led by President Obama. It is such an exciting event for global issues with the world's elites--governmental, nonprofit leaders, private sector leaders, and celebrities to name a few--who are committed to health, infrastructure, women and girls, development, and the environment.

We are proud to announce that Hope Through Healing Hands has pledged a Commitment at CGI this year. We hope to grow our Global Health Leaders Program over the next few years to place health professionals in underserved clinics and to train community health workers around the world.

For the first evening we attended a few receptions. Along the way we ran into friends, new friends, and colleagues. See a few photos and names below.

We hope you'll follow our time here in NYC. It will be exciting.

Professor Mohammad Yunus, Grammen Bank, Nobel Peace Prize Winner and Bill Frist --Grameen America Reception, Le Parker Meridien Hotel


 Dr. Sanja Gupta and Bill Frist -- CGI Global Health Dinner, The Plaza Hotel



 Doug Ulman, President and CEO of Livestrong and Bill Frist -- CGI Global HEalth Dinner, The Plaza Hotel

In May, Senator Frist co-led a conference at CSIS entitled U.S.-Russian Global Health Collaboration. Given the outcome of discussion at the conference, the Senator produced this Op-Ed recently published in Foreign Policy.

What the Doctor Orders

The United States and Russia face strikingly similar health-care challenges -- providing a rare opportunity to strengthen their bilateral relationship.


On Wednesday night, U.S. President Barack Obama made a historic address to a joint session of Congress on the issue of health-care coverage and affordability. It is the banner issue of his first year in office, and Washington's top domestic priority. At the same time, nearly 5,000 miles away, in Moscow, legislators are undergoing a strikingly similar process to reform their health-care delivery system. Given the importance of the U.S.-Russia relationship and the similarity of the challenges confronting us, our two countries have a historic opportunity to expand our health collaboration and, in so doing, improve our diplomatic ties.

Thankfully, this process is already underway. At a summit in early July, Obama and Russian President Dmitry Medvedev announced a memorandum of understanding to expand cooperation on public health and medical sciences. The meeting also produced an agreement for Secretary of State Hillary Clinton and her Russian counterpart, Foreign Minister Sergei Lavrov, to co-chair a forthcoming bilateral commission on health collaborations.

But both countries can and should continue to do more. In May, Dr. Nikolai Gerasimenko -- vice chair of the Duma's Committee on Health Protection -- and I hosted a daylong discussion on the topic at the Center for Strategic and International Studies. Our objective was to generate a blueprint for a future strategic collaboration on health. The conference revealed a strong desire to build genuine partnerships around health on the basis of two key challenges.

The first is national demographics. Both Russia and the United States grapple with rapidly aging populations, with all that implies for the provision of health care and social services. Russia's problems are compounded by alarmingly high middle-aged male mortality and birthrates that are too low to sustain the current size of the population. Demographic regression, the Russian delegates emphasized, is the top health-policy priority. In each of our societies, efforts to encourage healthier lifestyles -- in diet, and alcohol and tobacco use -- will reduce chronic disorders, extend lives, and make for a healthier next generation.

The second challenge is the pressing need for health-care reform. Both of our countries struggle to balance the competing imperatives of high quality, equity in access and affordability, and containment of health-care costs. We are each in the midst of a historic effort to reform our health systems, bring about greater efficiencies in complex federal systems, and produce better health outcomes as a return on substantial investments.

Our dialogue also identified five choice opportunities that I hope will inform the next steps by the United States and Russia in building health cooperation.

First, there is much to be learned from each other with respect to lowering health risks associated with tobacco and alcohol use, especially among young people, including through public-education strategies and community engagement.

Second, in the face of the H1N1 pandemic flu threat, there is much we can do to improve surveillance and data use to bring about better global detection and response to emerging infectious disease threats. Even at the height of the Cold War, the Soviet Union and the United States worked together to create vaccines. Our countries could certainly benefit from such collaboration today.

Third, we should launch an annual U.S.-Russia forum on the reform of national health systems, with a special focus on financing, cost controls, and evaluation. Comparative effectiveness research across national boundaries is a vitally important undertaking. In particular, a U.S.-Russian initiative could include joint exploration of innovative approaches such as e-health and electronic medical records.

Fourth, we should engage in a discussion on how to best leverage our mutual efforts to support global health programs in those countries most affected by infectious diseases such as HIV, tuberculosis, and malaria. The Obama administration recently committed to billions in donations in this area, and Russia is emerging as a significant global health donor as well. Thus, the time is right for our two countries to more closely collaborate.

Lastly, substantial ongoing joint research, institutional twinning and professional exchanges could be expanded. This includes research and research training in alcohol abuse and related disorders, cardiovascular disease, cancer, and tuberculosis. These efforts could be broadened to encompass chronic-disease prevention and management and national health-care reform as well.

Health collaboration is a surprisingly powerful foreign-policy tool and one where U.S. and Russian interests converge. Expanded communication and cooperation will build on a history of collaboration that survived periods of acute strain. There is active interest in both our societies -- among universities, medical schools, research institutions, and private businesses, as well as key government agencies -- in joining such an enterprise.

I urge Secretary Clinton and Foreign Minister Lavrov to commission in the coming months a joint organizing committee charged with prioritizing issues, laying down a timetable, and agreeing upon some early concrete products. It could prove a vital platform for the health of our countries and the health of our bilateral relationship.

William H. Frist, M.D., is a former two-term U.S. senator from Tennessee and was the U.S. Senate majority leader from 2003 to 2007. He is a member of the Center for Strategic and International Studies' board of trustees.

Subscribe to our newsletter to recieve the latest updates.