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Stillwater Strong

On June 17th, 2015, a man walked into a Bible study at Emanuel African Methodist Episcopal Church in downtown Charleston, South Carolina, waited for over an hour, then began shooting.  Nine people were killed, and a tenth victim survived.  In the days, weeks, and months following, the phrase “Charleston Strong” was seen on shirts, signs, business marquees, and even on NEEDTOBREATHE front man Bear Rinehart’s guitar on national television.

129 days later, on October, 24th, 2015, a woman in Stillwater, Oklahoma, got into her car, drove past police barricades, and into a street crowded with people assembled for Oklahoma State University’s annual homecoming parade.  Four people died in the crash, and another four dozen were injured, some critically.  Following the tragedy, much like Charleston, “Stillwater Strong” slogans were seen throughout town, from bracelets, to t-shirt fundraisers, to banners that hung from buildings.

On January 15th, 2016, a group of doctors, dentists, nurses, pharmacists, physical therapists, and volunteers from the Charleston and Stillwater communities joined together and traveled to Sebaco, Nicaragua, to conduct medical clinics in rural areas surrounding the city.  During the three clinic days, nearly 650 patients that would otherwise not have access to high-quality, affordable healthcare were treated.  Some of these patients had relatively minor conditions that were easily addressed.  Others came to our clinics with serious, potentially life-threatening, health conditions that not only required immediate treatment, but will need long term follow up care that is available to them through the new PMI clinic in Sebaco.

It might seem like a coincidence that volunteers from Charleston and Stillwater, who had never met before, joined together to provide medical care for people that do not have access to the help they desperately need.  Make no mistake, it is no coincidence.  Two cities, linked by tragedy, coming together in Christian community to serve our fellow man.  Not for recognition, not to feel better about ourselves, and not for any material gain.  The team was there to be God’s hands and feet in a broken world.  We were there to serve the “least of these”, because that’s what we are called to do (Matthew 25:37-40).

We were there because we are Charleston Strong…Stillwater Strong…Sebaco Strong.

Photo by Steve Broadway for PMI.

USAID Progress on Food Security and Nutrition in Uganda

By Celina Po, PMI Public Health Intern

This week, the article that I have selected comes from our partner USAID. As a Public Health major at Coastal Carolina University, I have taken a nutrition class and learned aspects of eating a healthy everyday diet. Though in our country, we struggle trying to eat a healthy diet, we forget those who struggle with under-nutrition and the idea of not having adequate food to prevent certain disease and illness. That is why this week, I chose to discuss the nutrition profile released by USAID and their progress with Uganda’s challenge against under-nutrition and food insecurity.

Uganda faces a nutrition situation in which households are experiencing food insecurities affecting women and especially children. Some of the effects of under-nutrition and food insecurities found in regions of Uganda include both anemia and vitamin A deficiencies. (1) USAID found that reasons for these deficiencies within different regions may be due to “access to food, lack of dietary diversity, cultural and social traditions, and poverty levels.” (2)

Over time, statistics has shown drops in existing cases that are caused by under-nutrition in both women and children. From data collected within the years 2005-2006 and 2011, there has been significant drops in the number of cases of anemia among women aged 15-49 years old (42% vs. 24%) and children aged 6-59 months (42% vs. 24%). Other cases that decreased in number of existing cases include: stunting among children under 5 (38% vs. 33%), underweight among children under 5 (16% vs. 14%), and wasting among children under 5 (6% vs. 5%). (3)

USAID currently leads the Feed the Future Initiative that specializes on global hunger and food security. The components mainly focused within this initiative are “nutrition, agriculture, and connecting nutrition to agriculture” I found it interesting as well that this initiative also had a strong gender focus. They gave recognition to women, who are usually the known caregivers of families, and those who are in charge of the production and processing of food. (4) One study by M. K. Kabahenda (et al.) similarly examined child growth by promoting nutrition education to caregivers in Uganda. What they found was a decrease in stunting (height for age) and wasting (weight for age) with children who had caregivers under the nutrition education program. (5)

Within the Feed the Future Initiative, there are side projects currently in progress that were made with different objectives for the overall goal of ending hunger in Uganda. The project Community Connector (CC) currently has objectives to reduce poverty levels and provide sustainable food security. Production for Improved Nutrition (PIN) plans to increase and improve food production, empower rural farmers, and provide support for households with vulnerable children. Lastly there is the Northern Uganda Health Integration for Enhanced Services (NU-HITES) which plans to ensure access and quality of primary health and provide sustainable health services. These projects are all due to end around 2017 in hopes of succeeding in their objectives. (6)

There was one thing that shocked me while reading this article. Usually, when thinking of ways to prevent under-nutrition, increasing the amount of healthy foods or the main income of households are the usual routes to take. After observing areas in Uganda, USAID found no correlation between producing mass amounts of crops and food and increasing household income with improving nutrition. For example, they found one region known to have high production of staple crops, but reflects a high rate of stunting in children. In comparison, a rise of income found in some areas had higher rates of anemia, vitamin A deficiency, and wasting in children regardless of socioeconomic level. (7)

In conclusion, USAID has made progress with their Feed the Future Initiative and its projects that follow it. Their plan can even help PMI’s Masindi-Kitara Medical Center in hopes that we can help with child development, dietary counseling, and treating nutrition based illnesses.

 

End Notes

  1. (USAID, 2014)
  2. (USAID, 2014)
  3. (USAID, 2014)
  4. (USAID, 2014)
  5. (Kabahenda et al., 2014)
  6. (USAID, 2014)
  7. (USAID, 2014)

 

References:

United States Agency for International Development (USAID). (2014). Uganda Nutrition Profile. Retrieved from https://www.usaid.gov/what-we-do/global-health/nutrition/countries/uganda-nutrition-profile

Kabahenda, M. K., Andress, E. L., Nickols, S. Y., Kabonesa, C., & Mullis, R. M. (2014). Promoting dietary diversity to improve child growth in less-resourced rural settings in Uganda. Journal Of Human Nutrition & Dietetics, 143-151 9p. doi:10.1111/jhn.12056

 

Photo by Joshua Drake Photography for PMI

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PMI + Peace Corps | Celebrating Partnerships

By, Linda Krisowaty, Peace Corps Volunteer in Masindi, Uganda

The briefest mention of Peace Corps tends to conjure up romantic images of a volunteer living in an isolated village, struggling to learn a new language, eating bizarre foods, dealing with homesickness, and playing pickup soccer with a ragtag bunch of children, all done, of course, with the saintliness and grace of Mother Theresa. While some of this may be true to a certain extent, this reductive view of Peace Corps glosses over several of the foundational components of the program including training, organizational capacity building, and sustainability.

In an effort to promote peace while displaying the United States’ goodwill towards other nations, John F. Kennedy signed Peace Corps into formation with an executive order on March 1, 1961. This program would eventually come to have three goals:

  • To help the people of interested countries and areas in meeting their needs for trained workers
  • To help promote a better understanding of Americans on the part of the peoples served
  • To help promote a better understanding of other peoples on the part of Americans

More than 50 years later, Peace Corps remains an integral part of the United States’ overseas diplomatic endeavors.

In order for a country to host a Peace Corps program, it must first invite the Peace Corps to participate. Peace Corps then begins working with the government to determine which areas it can best assist with and will also match potential volunteers’ skills. Operating in over 63 countries, Peace Corps places volunteers in a variety of sectors including education, health, agriculture, and youth development among several others. A volunteer’s placement is based on a lengthy application process which can take anywhere from six months to two years and includes: submitting an initial application and references, participating in a formal interview with a recruiter, and having extensive background and medical checks. If a potential volunteer meets these standards, they are then placed in a country based on their background and relevant experiences. Peace Corps is a 27 month commitment not to be taken lightly. Volunteers are expected to develop trust with and integrate within their community, learn a new language, and assist their organization in capacity building.

In Uganda specifically, volunteers are placed with a host organization according to an advertise and bid system. Various organizations apply for a volunteer and are then vetted by Peace Corps. Those which make the final cut are then presented to volunteers who bid on their top choices based on their skill set and the needs of the organization among other factors. This is how I came to work, quite fortunately, at MKMC.

Once placed at an organization within a host country, a volunteer’s main role is to assist in identifying areas of growth and need while helping facilitate innovative and creative ideas with the purpose of building up the capacity of the local organization to do work independently. All of this should be done with an eye towards sustainability, otherwise projects may not last beyond the time a volunteer is there. Volunteers do not do this work alone. They are assigned a supervisor from the local organization to oversee their projects and provide feedback as well as a counterpart to assist in the carrying out of the projects in the day-to-day. Peace Corps also creates ongoing professional development opportunities for counterparts and relevant community members in order to reinforce the concept of capacity building and sustainability.

Specifically, my role at MKMC is to utilize my background in public health and facilitation to develop, integrate, and sustain public health programming at the health centre and within the community. To accomplish this works entails working with various MKMC staff as well as my counterpart, Jimmy, to identify needs both at the health centre and within the community. Often this means doing a bit of research and conducting surveys to get appropriate data and feedback to work with. Using this, I try to create innovative or different ways to solve problems, ultimately letting the health centre guide the process and make recommendations. While a significant proportion of a Peace Corps volunteer’s work emphasizes capacity building and training, the other component is ensuring the groundwork and programs which are developed can be sustained. I have been particularly cognizant of this concept since beginning my service and have ensured that I am never working in isolation whether I am training my counterpart, community members, or staff at the health centre. While I am saddened that my time at MKMC is almost at an end, having had the opportunity to work with MKMC staff and the community in developing relevant public health programming assures me of sustainability of public health at MKMC in the future.

How SDGs and Climate Action Work Together to Make a Sustainable Impact

By, Elizabeth Tenney, PMI Public Health Intern

When looking to the future of public health for this brand new year, two things come to mind. The first of which being the United Nations Sustainable Development Summit held last September, where the new Sustainable Development Goals (SDGs) were created. Second, is the United Nations Climate Change Conference, which was held just last month in Paris. While the SDGs explicitly state “Good health and well-being” as a goal, many of the other goals directly affect health as well; some of the more obvious being “zero hunger” and “no poverty.” But how about “affordable energy” and “decent work and economic growth?” Do the goals of “sustainable cities and communities” and “climate action” directly affect the health of communities, too? Well, according to the authors of Indicators linking health and sustainability in the post-2015 development agenda, absolutely!

Did you know that “a reduction of key environmental risks, including exposure to air, water, and chemical pollution, can help to prevent up to a quarter of the total burden of disease, including a large proportion of childhood deaths?”[1]

Indicators linking health and sustainability in the post-2015 development agenda draws attention to health as an outcome of sustainable development and proposes that health-related indicators should be selected to measure the progress of sustainable development goals in non-health sectors.

By highlighting four thematic areas: cities, food and agriculture, energy, and water and sanitation, the authors showed that there are co-benefits of health and health equity associated with sustainable development policies. The primary focus of the article was on environmental factors, such as the reduction of greenhouse gas emissions and increased resistance to environmental change. At the time this article was published, in January of 2015, environmental factors had been “relatively neglected, despite importance.”[2]

The four thematic areas were chosen specifically because of their relevance to ongoing sustainable development discussions. Embedding these indicators can help to raise awareness of the probability of health gains from sustainable development policies. By making these policies more attractive to decision makers, they are more likely to be implemented.

Sharing this knowledge with decision and policy makers is essential because it can be used to “support better governance, improve accountability, and facilitate communication with communities, civil society, and the private sector.”[3]

You may be asking yourself, “Does this apply to me?” Well, we can choose to hold ourselves accountable. We can be accountable not only for the information, but for our environment and our own health, as well as the health of those who may be directly or indirectly affected by our actions. We can apply this knowledge when making decisions, both in the workplace and within our communities. By getting the word out and creating partnerships, we can make the choice to facilitate sustainable development.

I was really excited to find this article because the topics of climate and sustainability have become increasingly popular over the last year or so. I loved that the article incorporates the importance of health in all aspects of development. As a public health enthusiast, Indicators linking health and sustainability in the post-2015 development agenda applied my personal passion to other peoples’ areas of interest. I think that may have been what intrigued me the most. Also, the information was conveyed concisely and in a way that people of other professions could understand, which is essential to effecting decision makers outside of the health sector.

I was surprised to find that this article was written in January of 2015. The authors may not have known how extremely relevant and timely this article would be when they wrote it. I was happy to see that climate, an area the article described as “neglected,” has taken the spotlight in only one year’s time.

It was also encouraging to see the authors’ enthusiasm for sustainability and for creating partnerships throughout the article. We at Palmetto Medical Initiative share in this enthusiasm, as these are some of the core foundations of our organization! While we work with communities to meet their needs for delivering high-quality healthcare, we also strive to create long-term change and tangible improvements in the overall quality of life.

PMI is made possible by the very partnerships the article references. By uniting the resources available through globally minded churches, universities, organizations, and individuals, Palmetto Medical Initiative has achieved sustainable progress in the communities with which we work.

 

[1] (Dora, et al., 2015, p. 180)

[2] Ibid.

[3] (Dora, et al., 2015, p.388)

Photo by Steve Broadway for PMI

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Team Nicaragua :: Final Day

The final day is bittersweet. We are all sad to leave this beautiful country and these wonderful people, but we’re ready to see our families again.

The final clinic day was spent in Sébaco at a beautiful church in a secluded area of town. We were welcomed with open arms by many people ready to help us unload and get our mobile clinic set up.

In no time we were up and running. The entire team worked incredibly well together. From getting patients registered to the nurses taking their vital signs to the doctors diagnosing and prescribing treatment to the dental and therapy team taking care of people to the pharmacy efficiently filling the prescriptions it all ran seemingly flawlessly. Even a power outage for a few minutes couldn’t put a dampener on the very productive day of bringing quality healthcare to an under-served population.

The quality of care given by every member of the team was second to none. They each used their unique talents to ensure a happy, productive and successful day.

Integrating back into “normal” life may not be as smooth as the mobile clinic has run the last three days, but our volunteers are sure to make the transition look as easy as these last few days.

Photo by Steve Broadway for PMI

Team Nicaragua :: Clinic Day Two

The PMI Stillwater Team served over 200 patients in Molina Sur, Nicaragua today. After a beautiful drive into a rural mountain community, the team arrived to a welcoming community and a beautiful church to set up clinic. Amy G and Abby H organized a chaotic crowd of people quickly and efficiently. Our triage nurses, Joy and Vicki, met patients all day and continued to smile throughout the process. Our various providers treated patients with concern and great care as they worked to meet each patient’s need. Every patient enjoyed at least one of the added services–physical therapy with Joe, chiropractic care with Matt, glasses with Edy, or teeth cleaning with Stephanie and Shelley. The pharmacy team, Suzy, Evan, and Ashley, were organized and peaceful as they filled over 360 prescriptions. Led by the ever-encouraging team leader, Troy S, the pharmacy team took great care to not only fill prescriptions carefully and completely but to make sure patients understood the prescription and follow up instructions. All in all, our team considered this day a success!

There were many fun aspects of the day! Abby, Matt, and Steve tried to keep the dogs out of the clinic. Thankfully, they succeeded!  Our translators are now our friends! Maricella, Johnathon, Melvin, and Ashley are definitely just a few of the translators that make this clinic possible. They are patient with us and very kind. They might also think we are a little crazy at times! Our team was in awe of the sweet Nicaraguan boy with red hair and the gorgeous tiny 100 year old woman. We’ve met so many wonderful children and adults here! The people are kind and caring and very grateful, including one elderly lady who hugged and kissed Suzy on the cheek at the pharmacy.

Our team is exhausted, to say the least, but we are grateful to help the Nicaraguan people around Sébaco and the local clinic. Our hearts are forever changed by the people here, and we are pleased to call them brothers and sisters.

Ashley

Photo by Steve Broadway for PMI

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Team Nicaragua :: Clinic Day One

broadway 1

Today, PMI  Stillwater Team traveled to the community of Las Paloma, about 15 minutes outside of Sébaco. We were met by about 30 people waiting. After quickly setting up and planning logistics, we began seeing patients. Amy G. and Steve Carp ran registration, while Joy, Vicki, Stephanie, and Shelly triaged the patients. Once the patients started seeing the providers, things ramped up quickly. The hotspot of activity was no doubt the “Farmacia.”  Pharmacist Troy and his team were PMI warriors as they worked tirelessly throughout the day, filling literally hundreds and hundreds of prescriptions.

At the end of the day, our team was able to heal, educate, and empower over 200 patients. Our team worked hard treating patients , but we realize that one of our main jobs is to make sure patients know there is high quality, accessible, affordable health care available to them year round in Sébaco. Team Leader Edy (an newly adopted and honorable Stillwaterian) remarked over dinner that she thought that since our team already knew and trusted each other, we were able to hit the ground running and have such a successful first day.

Our shout outs for the first day included Evan for being a rock star, Suzy for her work in the glasses department, and the pharmacy team for bringing the thunder.

Also, we could not have had the terrific day we did without our translators and the incredible staff from the PMI Sébaco clinic.

Tomorrow we’ll visit a larger, more rural community. We are expecting even more people there than we saw today.

Bring it!!
Joe Ogle

Photo by Steve Broadway for PMI

Photos by Steve Broadway for PMI

Team Nicaragua :: The Team Has Arrived

The PMI Stillwater Team is on the ground and running in Nicaragua. We’ve added some new Stillwater converts to our team (who have basically already agreed to come to visit in the future).

A stop for the evening and dinner at the amazing Selva Negra, where the team is headed to their rooms for some rest and battery re-charging, ready to check out the PMI’s newest clinic in Sèbaco tomorrow.

What an opportunity it will be this week to all work together, using our love, gifts and talents with the amazing people of Nicaragua.

Photo by Steve Broadway for PMI

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Webale Muno | A Letter of Thanks to our MKMC Staff

By, Michael O’Neal, PMI’s Director of International Projects

As many of you know MKMC just celebrated 5 years of providing quality, accessible healthcare to our friends and family in Masindi, Uganda! Aaron’s post earlier this week highlighted the culture that has been created at MKMC, a culture of excellence, respect, quality, integrity, and I could go on and on. I could use this post to talk about a variety of things from PMI’s innovative model of providing quality healthcare in a sustainable way to the nearly 110,000 people that have received care in Masindi over the years. However, NONE of that or anything in between would be possible with out our amazing staff! Therefore, I want to take this opportunity to say THANK YOU to our amazing staff.

MKMC Staff,

Weebale muno!!!! PMI Uganda and MKMC is the successful hospital it is today because of each one of you. From our founding staff of 9 (of which 7 are still with MKMC) to each of our current 43 staff, you are the hands, feet, and heart of PMI Uganda. From day one we knew that if there was any chance of success we had to find the best of the best to work with us at MKMC. We believe in working with and empowering the local community and staff to guide our efforts in providing healthcare. All of you have helped shape what MKMC is today. Any and all success that we have had over the last 5 years can be directly tied to you! I tell people all the time that we have the best staff in Uganda. I say that with all sincerity. Not only are you the most talented clinical and administrative people in the country, but you have proven over and over again that you are committed to the people you serve!   Every patient that walks through the doors at MKMC is hurting in some way and you meet them all with a smile and a desire to help. Thank you for your commitment to serve the people of Masindi with compassion! Thank you for your partnership in providing quality care in Uganda! Thank you for investing in PMI and our vision! Thank you for teaching us how to be successful in a new culture! Thank you for your hard work and dedication! And thank you for your friendship and all the lessons you have taught us over the years. We are grateful for each one of you and could not be more proud of the MKMC staff! We look forward to many more years of working together as the PMI family to serve our brothers and sisters in Masindi!

With Sincere Thanks,
Michael (Atwooki)

 

Happy 5 Year Anniversary MKMC

Staff photo 2

By, Aaron Stroud-Romero, PMI’s Regional Director in East Africa

Five years ago we opened Masindi Kitara Medical Centre (MKMC). There were still many doubts at that time about our model, and many people wondered if poor Ugandans would be able to afford even the low prices we were charging. Looking back it is clear that we may have underestimated the value the community would place on our services and their willingness to pay for healthcare. We started with only 9 staff in 2011 running our outpatient clinic. In the five years since we have added an inpatient ward, maternity ward, and surgical theatre, and are about to open a diagnostic center and community health space. The physical growth has been incredible, but none of that would be possible without the amazing staff that we work with. Now numbering 43, our staff are some of the brightest, hardest-working, and caring people I know.

5th Anniversary Original Staff

Some of PMI’s values are dignity, love, and service. To me these values come together and are lived out in the way that we treat each patient with respect, care, and love. This is distinctly different from the vast majority of healthcare workers in other facilities, who treat patients more like a nuisance. In October, I suggested to our executive team that we plan a five-year anniversary party. In my mind I imagined an event focused on our staff to celebrate the work and success that they have earned over the last five years. Immediately the staff suggested that we include a patient celebration as part of the five-year anniversary. Along with cake and sodas, we celebrated with patients by offering free hepatitis B testing.

In addition, our staff invited one of our patients and her husband to our formal dinner celebration. Both our patient and her husband testified to the amazing quality of service that they received, both at the hands of Dr. Godson and the nursing team that continually checked on her throughout the night. She was shocked at the care she received, saying that she felt like the staff treated her like their own family member. When we started MKMC, we hoped that it would have an impact on the culture of medical care in Uganda. These situations shine through as examples of how well we have succeeded in accomplishing that goal.