Categoria: News

Medicine and the senses

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“Tanzania amazed me so much: it is very welcoming; people are willing to help you with anything. Before leaving I was afraid to live in a context that I imagined unsafe. But this was not the case at all: being a country with a stable political situation for years, there has always been the chance to go out safely both in the village and in town” – says Stefania, JPO of gynaecology and obstetrics at the University of Milan Bicocca, who returned to Italy in early March after 6 months of service in Tosamaganga, in Tanzania.

During her university years, Stefania had already spent two months in Cameroon, gaining experience particularly in the delivery room. Then to India, where she worked as a nurse at a leper colony.

“This year, being at the 5th year of the specialty, I have had a more critical eye, a greater awareness and attention to the professional aspects- continues Stefania-. It was an incredible experience: a continuous stimulus, 14 hours a day. You face extreme situations, you have few resources and rediscover a more “human” medicine, more based on contact than the one we practice in Italy”.

Often here we lose ourselves behind bureaucracy and we immediately resort to instrumental examinations while in Africa the relationship with the patient, the medicine of the senses returns central. “Semeiotics is a great added value, especially for gynaecology and obstetrics – adds Stefania -. I have learned a lot in recent months: to know how to listen, how to interpret facial expressions of women, and to understand just from the clinical condition at what point the labor is, etc. I believe we should rediscover here too this dimension of the senses, which for obstetrics is fundamental“.

Among the many lessons learned in these months spent on the field, Stefania recalls the strength, dignity and courage with which people, in particular the mothers she took care of in hospital, face life. A life in which great joys and immense sorrows are intertwined every day and that is why it must be taken with “lightness”. And then the solidarity that you breathe, between mothers, but also among the staff. “There is great collaboration, we work side by side with the sole aim of working in the best way”.

That’s the same solidarity and cooperation that allowed to save the life of a young mother who had been referred rom the dispensary to the hospital of Tosamaganga for an eclamptic attack, a serious complication of pregnancy that could be lethal. “When she arrived at the hospital, the woman showed no signs of eclampsia – Stefania says – but after a few days she had a crisis and we had to do an emergency C-section. The clinical situation didn’t stabilize after the surgery and many other crises followed. It was decided to intubate her, despite the fact that there was only one oxygen fan for the operating room throughout the hospital, and then we took turns checking her condition over the next few weeks. We felt an incredible satisfaction and emotion when she was extubated and recovered completely” – concluded Stefania. A tough but really brave decision that allowed to save the life of the mother and her child who are fine now.

Today Stefania is back to major in gynaecology and obstetrics here in Italy, although with the desire to stay in Tosamaganga longer: a wish that, maybe someday, will bring her back on the field.

A REINFORCED COMMITMENT IN KARAMOJA

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“Yesterday at CUAMM office in Kampala, we had an important meeting with the presidents of the health professional associations of Uganda to share the mentorship activity plan of the“Reproductive, Maternal, and Child Health Services Improvement Project” (URMCHIP), financed by the World Bank and implemented by the Ministry of Health – tells Dr. Peter Lochoro, CUAMM Country Manager in Uganda -. We had the chance to discuss together the memorandum of understanding”.

The meeting held in Kampala aimed to introduce the URMCHIP mentorship activity that will be carried out in Karamoja in addition to the eight project CUAMM is already implementing in the region. The meeting took place in the presence of the executive director of the Association of Obstetricians and Gynecologists, the president of the Association of Surgeons, the secretary general of the Association of Anesthesiologists, the president of the Anesthetic Officers Association, and the president of Uganda Paediatric Association.

“Everyone welcomed the engagement and pledged to work together – adds Peter Lochoro -. Next week we are starting with the training needs assessment and hopefully an entry meeting with the district departments of health”.

A new and great opportunity to reinforce the commitment of Doctors with Africa CUAMM in Karamoja.

Vaccinate to cure

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Just in these days has begun the vaccination campaign against Covid at the hospital of Saint Luke of Wolisso, Ethiopia. After the start of vaccinations in Addis Ababa, the first doses arrived at the hospital in Wolisso, 120 kilometres from the capital: the goal is to vaccinate healthcare personnel in the forefront of addressing the different health emergencies for a reference population of over one million people. This is crucial given that, in the last month, there has unfortunately been a significant increase in positive cases, including some very serious, throughout the country.

“About 500 doses have arrived and they will be necessary to vaccinate all hospital staff, from doctors to cleaning staff – says Alberto Puccini, JPO in Internal Medicine in Wolisso –. The increase in cases over the last month has given a very strong boost to vaccinations of health workers here in Ethiopia. In fact, doctors and operators, witnessing the increase in cases even among colleagues, have better understood the importance of vaccination. The head nurse and the other nurses decided to get their shot at our first suggestion and they were very happy to have the chance to do it. I explained to them the possible side effects, so they didn’t get scared if they get a fever. To date 240 people have been vaccinated and we continue to visit the wards in order to remember the staff the opportunity of getting their vaccination”.

There is still much to do in Ethiopia, as well as throughout Africa: we need a concrete vaccination plan and we need more doses. The intervention of Doctors with Africa CUAMM aims to support local health services that were already fragile before the pandemic, and that are now even more at risk because of the virus. Health care workers are the heart of our intervention: they must be protected and trained, so that they continue to ensure all the communities safe deliveries, visits and all the essential health services.

Ethiopia Supporting the call of HINGOs

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As Doctors with Africa CUAMM, we strongly support the call by HINGOs for the protection of aid workers and civilians in Ethiopia, to ensure assistance to the people in need in the country. Publishing the statement by HINGOs, we condemn any action against humanitarian aid workers.

In light of two recent attacks on humanitarians in Ethiopia, the Humanitarian INGOs (HINGOs) call for the protection of all humanitarian aid workers and civilians to enable assistance to reach all people in need.

On 24 March in West Wellega, a GOAL vehicle was attacked, and the driver killed by unknown armed actors. On 23 March in Tigray, a driver with the independent medical agency Doctors Without Borders was beaten and their team witnessed extrajudicial killings of civilians by armed forces.

In both cases, the vehicles were clearly marked as belonging to humanitarian, non-governmental agencies. Both agencies provide life-saving nutrition and health care to crisis-affected men, women, and children across Ethiopia.

In the last year, seven humanitarian aid workers in Ethiopia have been killed by armed actors.

The HINGOs are principled humanitarian actors and work with the consent of the Ethiopian government and abide by the laws of the country. Our 54 members serve people in need regardless of ethnicity, politics, or religion.

In 2019, the HINGOs reached over 28 million people in need with life-saving assistance and essential services across the country. The HINGOs employ over 13,000 Ethiopian staff and fewer than 1% of HINGO staff are internationals.

The HINGOs strongly condemn the attacks and killings of humanitarian staff and civilians. We call on all armed actors to uphold Ethiopian and international humanitarian law. These attacks and killings must be fully investigated and those responsible should be held accountable in accordance with Ethiopian law.

Time to respond to COVID19 epidemic in Bangui

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According to WHO, the COVID-19 outbreak continues to evolve in Africa, since it was first detected in Algeria on 25 February 2020 and it is accelerating. As of August 29th 2020, there were 1,033,631 cases and 21,402 deaths within the WHO African Region.

In light of this situation, and of its ongoing mission, CUAMM is working every day close to the most vulnerable to respond to the pandemic in Africa, its collateral effects, and to continue to provide ongoing medical care.

On the 27th of august, in Bangui, in Central African Republic, CUAMM celebrated the delivery of medicines and medical supplies donated by the American global health and emergency response organization, Americares. This donation is part of the important efforts of CUAMM to support the pediatric complex of Bangui where it has operated since 2018, to improve clinical care for children and the hospital management quality.

The donation included almost 400 KGs of antibiotics, emergency medications, vitamins, chronic disease medicine, psychotherapeutics, painkillers, malaria test kits, and first aid supplies. Additional donations of aid from Americares are in progress, as part of a new partnership between CUAMM and Americares in Central African Republic.

Andrea Atzori, Head of International Relations for CUAMM says:

“This the result of a great work to promote partnership and engage organizations all over the world to support the work of CUAMM for women and children. Americares has again demonstrated the generosity of people with precious donations of drugs and supplies that are able to integrate CUAMM programs and provide lifesaving treatment for children.”

Haroun Habib, Director of Africa and Middle East Programs for Americares says:

“We are glad to work with CUAMM as a critical partner while focusing on health as a priority in times of crisis throughout Africa. Previously, our emergency programs team provided gift-in-kind donations to CUAMM in Mozambique after tropical cyclone Idai and we plan to ship at least one container and another air shipment of medicines and medical supplies to CUAMM in CAR in 2020-2021. Our ongoing and continuing work with CUAMM will help ensure that essential medical products are provided to patients and frontline health care workers to prevent and save lives through effective treatment of infectious diseases such as COVID-19.”

TB: A CHALLENGE TO FACE TOGETHER

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Maria Menya Nakeny is 34 years old mother of 6 children. She had to fight against tuberculosis, in three different stages: drug-susceptible tuberculosis, multi-resistant tuberculosis (MDR) and finally extensively drug-resistant tuberculosis (XDR). In 2016 Maria began to feel sick and she immediately turned to a traditional healer hoping to find a solution for her symptoms, but unfortunately the herbal treatment prescribed did not improve her health. Therefore, she chose to go to the health center in Lopeei where she was tested positive for tuberculosis.

In September 2016 Maria started a six-month treatment, but she stopped taking medication once she began to notice an improvement in her health, just three months after starting the treatment. The treatment for tuberculosis requires a long time, great consistency and continuity, and, although the improvements in health can be noticed quickly, it is essential to complete the whole treatment to avoid relapses. A few months after giving birth to her 5th child Maria started getting worse again.

“I went to the St. Kizito hospital in Matany and I was diagnosed with tuberculosis again. I was hospitalised for 3 weeks and then transferred to the nearest facility to continue the therapy – says Maria -. After a few days I was called again and admitted once more to Matany hospital for 3 months since I tested positive for MDR tuberculosis”.

Maria had to walk for more than 4 km every day to get her medicines at the Lopeei health center regardless the scorching sun or the heavy rains. This is precisely why she stopped the treatment again for over a week. The CUAMM team in charge of Maria’s case immediately went to her house to convince her to start again the treatment. Shortly after, Maria became pregnant again: “I was worried about how I would continue the treatment and the potential effects on my baby – Maria explains -. However, the health workers reassured and encouraged me to continue my treatment path”.

After further tests, Maria tested positive for extensively drug-resistant tuberculosis (XDR) and her treatment needed to be changed to respond to the variation in her disease.

“I realized that life is very important and I regret the moment when I had stubbornly decided to drop out the treatment. The CUAMM team and the health professionals have been committed to saving my life in every way, much more than I did for myself. I am grateful to them. I also managed to buy some goats and sheep that I take care of and now I live happily with my family”, concluded Maria.

After 4 years, in November 2020, Maria finally completed her treatment and won her battle against TB. Now she goes to the hospital once a month for check-ups. She survived thanks to the help of passionate and dedicated health workers and thanks to the support of Doctors with Africa CUAMM. She therefore suggests to all those who do not feel well in her community to go to the health center even just for a check-up and to receive the assistance they need. She also encourages people who have tested positive for TB to be steady with the treatment to avoid facing what she’s been through.

This is one of the many happy ending stories made possible thanks to the intervention in Karamoja to improve the quality of  services for diagnosis and treatment of Tb and multi-drug resistant Tb, particularly within the projects: “It’s Good Tb free! Project to contribute to a TB Free Uganda by 2020“, financed by the Italian Agency for Development Cooperation, as part of the expenditure for technical assistance to the Global Fund for the fight against aids, tuberculosis and malaria and implemented by Doctors with Africa CUAMM in partnership with the University of Milan and the University of Makerere, and the project ” Support to St. Kizito Hospital of Matany and to the Napak Distrcit in Karamoja”, financed by Fondation Assistance Internationale (FAI).

WORLD TUBERCULOSIS DAY COVID-19 IS SLOWING THE FIGHT, BUT UGANDA SHOWS SIGNS OF HOPE

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With 10 million sick people worldwide and 1.4 million deaths in 2019 alone, Tuberculosis remains one of the deadliest diseases. Twenty-five percent of new cases recorded each year are in Africa, and Covid-19’s arrival in the last year has put a strain on health systems here too. This risks being a major setback for the fight against tuberculosis. For World Tuberculosis Day, on March 24, Doctors with Africa CUAMM is joining the World Health Organization (WHO) in its urgent call that the “Clock is Ticking,” if we want to put an end to Tuberculosis.

In Uganda, in Karamoja, Doctors with Africa CUAMM is working on two projects to fight tuberculosis funded by Fondation Assistance Internationale (FAI) and by the Italian Agency for Development Cooperation (AICS). Even in the year of Covid-19, there are some signs of hope, which show how the fight against the “disease of poverty” can still be won with enough determination.

Simone Cadorin, project manager of Doctors with Africa CUAMM in Moroto, says:

“With Covid-19, we were afraid that years of work would be ruined. A year ago, the government stopped public transport, imposed a curfew, and banned travel. There was the fear was that people would no longer come to the hospital for monthly visits and to get their medicine. This we why we worked with local authorities to develop, in the midst of the emergency, home-based care for patients, visiting them at home and distributing medicines in rural areas with semi-nomadic populations. We have not only kept patients in treatment, but we have also greatly improved outcomes, going from 36% successfully completed treatments in 2019 to 85% in 2020 and bringing the dropout rate down from 42% to 11%. Lockdown measures have been recently relaxed in Uganda, and patients now come themselves to health centers. We still continue to maintain contact with each of them through the “village health teams,” who see the patients at home, make sure that they regularly take their medicine, and provide psychological help and social support to families and patients.”

It is often from the community that problems arise related to fighting viruses and infectious diseases, as we hear from Paul Okala, a patient that Doctors with Africa CUAMM has followed and who has suffered the consequences of the stigma and prejudices about Covid-19.

“Because of Covid-19,” he says, “in Karamoja, unfortunately, people think badly about those who wear a mask. I found out I had drug-resistant tuberculosis before the virus came. I was treated in Matany and then I was supposed to continue taking the medicine at home for a year, using a mask when I was with other people. Everything was fine until Covid-19 came. People started to treat me badly because I was wearing a mask; they thought I had the virus and that I would infect them. Nobody wanted to come near me and my landlord was about to kick me out. It was horrible. I didn’t know how to deal with it and even thought about giving it all up. Fortunately, the Doctors with Africa CUAMM team came and helped me to show everyone that I was not sick with Covid-19 and explain the differences between the two diseases and the different ways to handle them in the village too. Luckily, no one is upset with me anymore, and I was able to complete my treatment!”

Combating fake news about Covid-19 with training for health personnel and awareness raising in the villages was one of the major focuses of Doctors with Africa CUAMM in Uganda, as well as in the other seven countries where it is active. Many people stopped going to the hospital for fear of being infected, with the result that many women were risking their lives giving birth at home, and many babies were not being vaccinated against the most common diseases. The home-based approach developed in Karamoja shows that by going the extra mile, talking to the communities, and listening to their needs and fears, we can ensure continuity to our projects and provide health care to those who need it most.

March 24th, during the event for World Tuberculosis Day, the Ugandan Ministry of Health awarded Doctors with Africa CUAMM for their tireless and extraordinary support towards  TB services delivery in South Karamoja. The award was received by Peter Lochoro, CUAMM country representative in Uganda.

 

A SPECIAL MEETING FOR 70 YEARS OF LIFE

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On the 70th anniversary of Doctors with Africa CUAMM, Pope Francis welcomed the director Father Dante Carraro in a private audience due to the anti-covid restrictions. A special moment for our “big family” to motivate once more the passion and challenges of an increasingly necessary commitment “with Africa”.

“I brought our Africa to Pope Francis – is the excited comment of Father Dante – the greeting and the embrace of our Bishop Claudio, of the Church of Padua and of the many volunteers and operators who spend every day on the field close to the poorest. You were all there, with me: lives, families, and stories with their load of tears and smiles, with the joy for the successes and the fatigue for the obstacles that make the journey bumpy. I told him about some good results achieved but also about the many concerns for a continent increasingly excluded from the world that matters, or that thinks to matter, including an anti-covid vaccination plan that is struggling to take off. I share with everyone, volunteers, friends and supporters the excitement and energy of feeling Pope Francis by our side, like an old friend who takes you by the arm and helps you not to give up “.

 

Copyright © Vatican Media

12 May International nurses day

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Pillars of healthcare, even more important in Africa. Every day they work tirelessly, close to their patients, even at the risk of their health. Father Dante Carraro: «Without them our work would be impossible».

International Nurses Day is celebrated around the world on Tuesday 12 May, to mark the contribution that nurses make to society, and this year in particular the World Health Organization has decided to dedicate 2020 to the work of nurses and midwives.

Nurses have always been on the front line, around the world, curing patients, especially in these months in which the healthcare systems are increasingly put under pressure by the Coronavirus emergency. Africa is no exception and it starts from an even more uncertain situation.

Remembering the silent and essential work of nurses is important for Doctors with Africa Cuamm, that in Africa is present in 23 hospitals with 2,915 operators. Almost 1,000 nurses work in these facilities, supported by Cuamm and now threatened by Covid-19. Here Doctors with Africa Cuamm is working to provide personal protective equipment and introduce new prevention procedures, to protect healthcare staff particularly exposed to contagion.

If Coronavirus is the latest threat to the health of the African population, the previous challenges still remain pending, as Cuamm’s director, father Dante Carraro, explains:

«Like in Italy, even more so in Africa, nurses are the those who run the healthcare systems. From healthcare centres to day hospitals, to hospital wards, they work behind the scenes, often silently, but they’re essential for the few local doctors and for the expats. Their ability to communicate with patients – children and adults alike – also in the language of local communities, is essential. Without them, most of our work would be impossible: for this reason, it’s important to celebrate their role today. Without forgetting the many nurses and healthcare operators that in these last two months have worked without a pause in Italy, for the health of us all, even at the cost of their life»

 

Pamela in Central African Republic: «How wonderful the gratitude of relatives»

In the Paediatric Hospital of Bangui there are 205 nurses, who take care of the children coming from across the country for complicated operations, but many are also hospitalized for acute malnutrition, or for measles, which have hit the country between January and February. Pamela D’Ascenzo, nurse from Forlì (Italy), in Bangui has found very motivated colleagues, despite the challenges of their day-to-day work:

«Josette and Simplice are two of the best nurses I have worked with in these months. Josette is 38 years old and has five children: she has been working as a nurse for six years and every morning she comes a long way with great inconveniences to get to work. She says that the aspect she loves more of our work is the contact with people. Simplice is younger and has told me that he’s chosen this job to “save lives”, today for him the gratitude of the relatives of the children they heal is the best thing».   

 

Ana in South Sudan: «We’re preparing for covid-19, but we need training»

Twenty-six years old, nurse from Barcelona, Ana Artes de Arcos has learned Italian while in Erasmus in Pavia and since she’s in Rumbek she uses it with English every day, working with the staff of Doctors with Africa Cuamm:

«In the last month we’ve taken an isolation area of the hospital, built for Ebola, but not yet used, and we’ve adapted it for the management of covid-19 cases, with oxygen concentrators and drugs. Luckily, for now we don’t have confirmed cases, but we’re doing all we can to prepare, with little equipment. As a nurse, I’m pleased that people remember the importance of our role, that is often underestimated. Hospitals wouldn’t run without trained nurses and here in South Sudan it’s even more visible. Most staff here has been trained on the job: they’re motivated, capable people, but maybe they cannot read or write, because instability prevents the training of people. When you have to give drugs or monitor patients, these shortcomings are visible and I’m afraid they make a difference».

Africa and Covid-19: protecting staff

To date almost 64,000 coronavirus cases have been recorded in Africa: 38,000 in Sub-Saharan Africa; 53 countries have been hit. Doctors with Africa Cuamm, Italian healthcare organization established in 1950, is present in eight: Angola, Ethiopia, Mozambique, Central African Republic, Sierra Leone, South Sudan, Tanzania, Uganda.

While we’re preparing for the outbreak of Coronavirus in rural areas as well, we know that nurses and doctors are more exposed to contagion, despite still being too little in Africa. This is the reason why we must protect them and equip them as best as we can against the epidemic.

Problems don’t stop with Coronavirus, they exacerbate. People fear the epidemic and hospitals as sources of contagion. Many women could opt for giving birth at home, for example, with great risks for their life.

In order to secure the hospitals and the communities where Doctors with Africa Cuamm is present, we need to have:

  • Face masks, suits, face shields and disinfectant for healthcare staff, crucial but always too little;
  • Infra-red thermometers, oximeters to measure blood oxygenation and oxygen concentrators to give a basic therapy for those in need;
  • Curtains for triage and isolation units;
  • Training of staff and communities for the management of Covid-19 cases.

A daily commitment to increase trust

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Gambela is one of the poorest regions of Ethiopia and has one of the worst health indicators in the country in terms of maternal, child and access to basic health services. The intervention “Increased quality and equity of health services in Gambela Region” financed by the Italian Agency for Development Cooperation and private donors and implemented by Doctors with Africa CUAMM, aims to improve and strengthen the existing health system, promoting maternal and child services, nutrition, HIV/Aids prevention and control, in agreement with local institutions: in short, life-saving services.

This intervention is possible thanks above all to the role of community health workers, a truly fundamental access key for CUAMM’s work in the communities. But what does it mean to be community operators in Gambela?

“As community health workers we are mainly concerned with prevention. – say Marta and Zenebech – During the week we work two days in the clinic, where we provide basic healthcare, in particular to children and women, and three days in the communities where we do house-to-house health education, in one day we visit at least eight different homes”.

In the villages, in places where people usually gather, some stones have been painted, representing the themes learnt by community health workers during trainings. Each of these issues is dealt with during community meetings: good hygiene practices, the correct use of latrines, family planning, prenatal visits and much more.

“The most significant improvement we have recorded is the increase in assisted deliveries. Now practically all women give birth in a health facility. – continues Marta – This was possible thanks to the support received by Doctors with Africa CUAMM in the last two years. The “coffee ceremonies” have been the real turning point for the involvement of mothers and for a significant change in habits. These ceremonies are meetings organized by community health workers along with women in the community to discuss about maternal and child health and share their experience”.

Even from the testimony of Tigist, one of the mothers visited by the community workers, it emerges that a change of approach is taking place: “When the throes began, I asked for an ambulance, which was already occupied for another emergency and it couldn’t come. I took a taxi and went to Abobo health center, where I gave birth. My fifth daughter was born two weeks ago. Yes, they are all female. She is the first daughter I give birth in a health center and not at home, but the community health workers, by dint of insisting, convinced me. They came to my house practically every day to repeat the importance of care! I was happy, if I have other children I will go back”.

It is a team effort, one “with” the other, a daily commitment to increase people’s trust in health services.