On Friday October 21, Executive Director August Burns and Senior Clinical Officer Ellen Starr departed for the Kilimanjaro Region of Tanzania. They are currently in the process of meeting with the Association of Kilimanjaro Specialty Coffee Growers (Kilicafe), the Elizabeth Glaser Pediatric AIDS Foundation, and the Tanzania Ministry of Health to finalize plans [...]]]>

Dr. Annah Kichambati

On Friday October 21, Executive Director August Burns and Senior Clinical Officer Ellen Starr departed for the Kilimanjaro Region of Tanzania. They are currently in the process of meeting with the Association of Kilimanjaro Specialty Coffee Growers (Kilicafe), the Elizabeth Glaser Pediatric AIDS Foundation, and the Tanzania Ministry of Health to finalize plans for launching our new program in this region in January 2012.

Grounds for Health field staff Dr. Annah Kichambati has been in Moshi for a few weeks, making connections in advance of our arrival. Over the coming days, Ellen and August plan to spend some time with Annah, further developing her materials for use in training community health workers in the region.

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Tanzania

Green = New site in Moshi
Blue = Previous campaign site in Kigoma

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From Sep 21- Sep 30, 2011, Grounds for Health trained a new cohort of 11 doctors and nurses on cervical cancer screening using Visual Inspection with Acetic Acid (VIA) and Pap, and treatment of pre-cancer with cryotherapy. Of the 11 providers, nine received [...]]]>

Amanda, Kayla, and August with San Juan de Rio Coco coop collaborators

From Sep 21- Sep 30, 2011, Grounds for Health trained a new cohort of 11 doctors and nurses on cervical cancer screening using Visual Inspection with Acetic Acid (VIA) and Pap, and treatment of pre-cancer with cryotherapy. Of the 11 providers, nine received certification in VIA and five of those also received certification in Cryo. Two received certificates of participation only. Grounds for Health will support the trained providers as they put their new skills to use over the next several months, ensuring that they have the material and personnel resources needed to continue offering screening and treatment at their respective clinics,

During the course of the campaign, a total of 306 women were screened, 93% of whom were within the target age group of 30-55 years of age. The high percentage of women seen in the target group is one indicator of success for the promoter training conducted previously.  Of the total women screened, 24% had either a positive pap, positive VIA test or both and 14% received same day treatment with cryotherapy. All (100 %) of high-grade paps were confirmed with VIA.

Smiling faces after a talk on cervical cancer while waiting to be screened

This marks the first training / campaign at our new program site, San Juan del Rio Coco in the department of Madriz, Nicaragua, where we expect to continue working for three years. The event was carried out in close collaboration with our four co-ops partners at this site, UCA San Juan, UCPCO, PRODECOOP and CORCASAN. This collaboration with local, community groups, will ensure that thousands more women receive the information and access to life-saving health services long after Grounds for Health leaves.

Highlights:

• Launched new screen and treat training program and campaign in San Juan del Rio Coco, Madriz.
• Established the first treatment center in the region
• Co-op coordinators demonstrated impressive management and coordination skills
• Co-ops and SILAIS commitment mobilize local resources to help  women requiring further diagnosis and treatment

Next Steps:

• Follow up on biopsy results and next steps for patients who require additional treatment
• Donate cryo equipment at Hospital Primario Luis Felipe Mocado and one additional site staffed by provider trained to competency in cryotherapy
• Donate biopsy punches to SILAIS Somoto
• Establish schedule of supportive supervision for new provider cohort and conduct monitoring and supervision visits
• Complete pilot project with SOPPEXCCA/SILAIS Jinotega and document results
• Develop proposal for Master Training Program in Esteli and present proposal to PRODECOOP management during the pre-Assembly (later in 2011)
• Conduct follow-up meeting with co-op coordinators to develop work plan for next phase focused on community outreach and education, including mentoring for community health promoters
• Expand on the current Co-op Coordinator’s guide; develop a comprehensive resource for co-op coordinators focused on community mobilization
• Work with curriculum development experts to modify the Trainer’s guide and package it for use in the Master Training Program

Making good use of readily available materials to practice Pap and VIA

Amanda & Dra. Barinia

Volunteer team

GFH preceptors and trainees

Stats from 1st day of campaign: 66 women seen today. 16 positive for VIA 12 treated, 2 biopsies for invasive cancer, two will return tomorrow. We caught all three Pap [...]]]> Directly on the heels of the New York Times Article: Fighting Cervical Cancer With Vinegar and Ingenuity, Executive Director August Burns sent us a quick note:

Stats from 1st day of campaign: 66 women seen today. 16 positive for VIA 12 treated, 2 biopsies for invasive cancer, two will return tomorrow. We caught all three Pap positives with VIA confirming == as the NYT article states – it works quite well, including two Cancer in situs and 1 invasive cancer. Lives probably saved.

Pretty cool. Very tired.

love to all- A

Wonderful news! Stay tuned.

Next stop: Nicaragua

This past week has been a flurry of activity at the Waterbury office as Elisa helped me and August pack-up an absurdly large amount of supplies and training material into five enormous black suitcases destined for the northern highlands of Nicaragua. The fact that this will be my first trip since joining [...]]]>  

Next stop: Nicaragua

This past week has been a flurry of activity at the Waterbury office as Elisa helped me and August pack-up an absurdly large amount of supplies and training material into five enormous black suitcases destined for the northern highlands of Nicaragua. The fact that this will be my first trip since joining Grounds for Health as the new program manager in June heightened the usual mix of excitement and nervous anticipation leading up to Sunday’s departure.

This trip marks the official launch of a new three-year program in Madriz, Nicaragua.  The program will be largely based in the municipality of San Juan del Rio Coco, where Grounds for Health has recently entered into partnership with four co-ops: UCPCO, UCA San Juan, Prodecoop and CORCASAN. Already, the four co-op coordinators at this new site have impressed us with their incredible management and organizational skills. From navigating the murky waters of local health regulations to coordinating food, housing and transportation for staff, volunteers and patients to shopping for essential supplies—this team of co-op coordinators has set the bar high for all involved, challenging us to make this program better than ever.

Working closely with our in-country staff, Barinia and Amanda, the in-country team has trained 34 community health promoters (CHPs) and has tasked them with raising awareness about the risks of cervical cancer and the importance of screening and early detection. With the CHP’s hard at work, the co-op coordinators turned their attention to hand-selecting a group of trusted doctors and nurses to attend next week’s level 1 training, which will emphasize the Single Visit Approach.

Over the next couple of weeks, GFH staff and volunteers will come together with co-op coordinators, local providers, and community health promoters to improve access to life-saving screen-and-treat services in rural communities. Check out our Facebook page and Twitter feed for up-to-the-minute updates.

Much more to come …

El lunes, 15 de agosto, cooperativa Comon Yaj Nop Tic (Todos lo Pensamos), quien trabaja con Cultivando la Salud (CLS), celebró su reunión anual de socios y la inauguración de su nueva clínica en Chiapas, México. CLS empezó de trabajar con Comon Yaj Nop Tic en diciembre de 2010 y juntos hicieron las actividades de [...]]]>

El lunes, 15 de agosto, cooperativa Comon Yaj Nop Tic (Todos lo Pensamos), quien trabaja con Cultivando la Salud (CLS), celebró su reunión anual de socios y la inauguración de su nueva clínica en Chiapas, México. CLS empezó de trabajar con Comon Yaj Nop Tic en diciembre de 2010 y juntos hicieron las actividades de su campaña anual de capacitación y detección de cáncer cérvico-uterino allá en abril de 2011. Bajo el liderazgo de su coordinadora inspiradora Cecy, una enfermera local dedicada Tere, y su directiva y socios trabajadores, esta cooperativa convirtió su sueño de ofrecer servicios de salud accesibles y de alta calidad a sus socios en una realidad.

Durante semanas, ellos trabajaron para rehabilitar un espacio en las oficinas de la organización. Pintaron el cuarto, limpiaron y viajaron a la ciudad para asegurar que tuvieron todo lo que necesitaban para la inauguración. La clínica va a estar abierta los viernes y Comon Yaj Nop Tic ha invitado a socios de tres otras cooperativas locales para acudir a la clínica también. Van a trabajar allá dos médicos y dos enfermeras con una promotora de salud ayudando como asistenta. Van a enfocar en ofrecer servicios de detección de cáncer cérvico-uterino y tratamiento con crioterapia. Doctora Lupita, quien trabaja para CLS, y Cecy coordinaron un horario con los promotores de salud ya capacitados para invitar mujeres de alto riesgo de sus comunidades a la clínica y para seguir con sus capacitaciones de promotores. La clínica también tiene todo lo equipo necesario para ofrecer consultas generales gracias a una donación de medicamentos del hospital local, un glucómetro para moniterear niveles de azúcar, y un estetoscopio y baumo. Van a ofrecer todos los servicios sin cobrar y todos los médicos y enfermeras van a trabajar de manera voluntaria.

Durante la inauguración, la motivación y éxito increíble de esta cooperativa fue celebrada por muchos que han apoyado Comon Yaj Nop Tic y el programa de prevención del cáncer cérvico-uterino en la región. El gobierno municipal de La Concordia, bajo el liderazgo del presidenta generosa Yanet y Dr. Rafael, ofrecieron su apoyo con medicamentos y los servicios de Dr. Rafael cada mes. El día también fue exitoso para Silvia, la coordinadora de CESMACH – la primera cooperativa para trabajar con CLS en la región. Ella ha trabajado sin cansar por cinco años con CLS y fue responsable por haber invitado a las tres otras cooperativas para unirse con el proyecto. Después de visitar la clínica, la primera reacción de los presidentes, coordinadoras y asesores de CESMACH y Triunfo Verde (otra cooperativa local que trabaja con CLS) fue “cuando podemos empezar con la nuestra?” Ellos ya se pusieron de acuerdo para empezar esta semana y trabajar juntos convirtiendo un espacio en las oficinas de CESMACH en Jaltenango en una clínica. Este espacio dará acceso a muchos otros socios que viven lejos de las oficinas de Comon Yaj Nop Tic.

Todos los socios de esta cooperativa maravillosa estaban allá y hablé con algunos después de la inauguración. Un socio a quien conocí cuando fui a una de las comunidades mas lejanas para buscar una promotora me acercó con una sonrisa contagiosa. El ofreció su apoyo para el proyecto cuando nos conocimos en febrero, utilizó su camioneta para traer mujeres a la campaña en abril y ahora me dijo con orgullo, “esto es un sueño hecho en una realidad para nosotros… y en tan poco tiempo.”

Con una cierta tristeza concluyo este reportaje de mi casa en los EEUU. Mi estancia de seis meses en México llegó a su fin y estoy preparándome para empezar un programa de estudios de enfermería-partera que espero que ma va a permitir seguir trabajando con CLS en el futuro y volver a trabajar al lado de todas las personas inspiradoras que tuve el honor de conocer en México. Sin duda, llevaré conmigo algo muy valioso que aprendí en Chiapas: con amor, cariño y la capacidad de trabajar en equipo verdadero, es posible convertir los sueños en una realidad. Un agradecimiento profundo y sincero a todos que han hecho esto posible.

February 13, 2011

It’s 87 degrees according to my LL Bean travel clock. I notice the temperature as we move from place to place. It must have been 95 today as we sat in the Air [...]]]> This email from Executive Director August Burns a few weeks ago was too good not to share:

February 13, 2011

It’s 87 degrees according to my LL Bean travel clock. I notice the temperature as we move from place to place. It must have been 95 today as we sat in the Air Tanzania office in Kigoma trying to make our way back across the country—for some of us onto the next phase of this trip, for others on their way back home.

Air Tanzania, the successor to “Precision Air” has just announced that their plane needs maintenance and therefore there will be no flights out of Kigoma for a week. Yes, that’s a week. One plane apparently. So after 5 hours of trying to match flights to other places and then to Dar es Salaam, the capital of this country, we have hired a car and driver to take us the ten hour drive to Mwanza where we will catch a connection to Dar and then to Arusha. It is always a good reminder of the rationality of the speed that life proceeds here. As my good friend Emmanuel Mtiti has said through his broad smile:

“Don’t worry. If you do, you will have a heart attack and life is so very short”.

So we will give up the idea of a day off and pile into the car for our journey tomorrow. I will tell myself that I always wanted to see Lake Victoria.

The morning started out so well. We had our end of trip “debrief” bringing together our partners in this program around the table again. Our coffee partner Kanyovu was well represented, as were our community builders Malilo, head CBDA and Annah, community mobilizer extraordinaire. We also had the administrator from Matyazo Hospital, our good friend Laura from Sustainable Harvest and two representatives from our new partner ICAP. This meeting was essentially the wrap up of our project in many ways. Though our commitment was for three years, we had met all the goals we had set out and ICAP was ready to take the lead.

Our Goals:

• See at least 2000 women for services
• Train a minimum of 15 health care providers in VIA and cryotherapy
• Train at least 15 CBDAs in cervical cancer prevention out reach
• Develop at least two treatment sites that offered cryo therapy

Actual Results:

• Saw more than 3000 women in 11 sites providing VIA
• Trained 30 doctors and nurses to provide VIA and cryo
• Trained 15 CBDAs plus 22 more to be trained from 11 new coop member communities in the next two months
• Established 7 treatment sites, which are now functioning

As we realized that we had together far exceeded our goals, in a place that had never before seen and services addressing this major killer of women, the air was electric. A small group of people had come together from around the world, from completely different positions and places and had accomplished an incredible feat, and the work had only just begun.

In the last two weeks, we not only accomplished a refresher training for ten providers and a complete round of didactic and clinical training for a new group of ten, but we had seen 434 women for services.  175 tested VIA positive and almost all of whom (88%) received same day treatment and returned to their homes and families.

The most amazing news came from Matyazo where Dr. Ute Tratwain, a German doctor in the mission hospital there, sent a letter to let us know that  her clinic has finally managed the purchase of LEEP Electrodes.

Now the Kigoma region, the orphan region of Tanzania, which always get the least, will be perhaps the first region in Tanzania not only with a cervical cancer program, but with a complete program, from community-based education and mobilization to quality accessible services, to same day or local preventive treatment, to now having the referral ability to care for women with large lesions or early cancers, to a fund for women who need more intensive cancer therapy, to now a place at Matyazo which will offer pain control and palliative care for those few women who will die of cervical cancer so they could die comfortable at home with their families.

All in two years. If we can do it in Kigoma, we can do it anywhere.

Very, very happy.

August & Elisa

Here are a few highlights:

… Not once during my entire trip did I ever feel lonely or bored but rather overflowing with the joy I found in the relationships I established in each area of my Chiapan life, the work I was doing in [...]]]>

For more, check out her blog entry on the Café Imports Grinder.

Here are a few highlights:

… Not once during my entire trip did I ever feel lonely or bored but rather overflowing with the joy I found in the relationships I established in each area of my Chiapan life, the work I was doing in both cervical cancer prevention and coffee, and from the sheer fact that I was living in a mountainous paradise. …

… Spending a period of time working and living at origin has enriched the way I view working both in coffee and women’s health. It has added dimensions and purpose to all aspects of the work that Café Imports, Grounds for Health, and I do each day. …

Mexico, once again, swept me off my feet. I re-fell in love with working in and around coffee. Daily exercising my passion for empowering women through both words and actions piqued my senses, my heart, and my being. Blending Mexico, coffee, and women’s empowerment: idyllic. Thank you Café Imports, thank you Grounds for Health, and thank you CESMACH for including me in your pursuit of saving lives and ever-increasing the quality and sustainability of coffee.

In today’s socially conscious world, we’re gaining a greater and greater understanding of how to responsibly help the less privileged world—be it in health care, agriculture, economics or otherwise. We’re no longer just asking, “what needs to be done,” but we’re examining how things can be done to have a lasting and meaningful impact. However, [...]]]>

In today’s socially conscious world, we’re gaining a greater and greater understanding of how to responsibly help the less privileged world—be it in health care, agriculture, economics or otherwise. We’re no longer just asking, “what needs to be done,” but we’re examining how things can be done to have a lasting and meaningful impact. However, these days “sustainability” and “sustainable” are buzz words that seem to be thrown around haphazardly.

So we’re going to throw it out there:

• What is “sustainability?”
• How can we tell if our efforts are leading to it?
• How do we know when we’ve accomplished it?
• What are some good examples and why?
  

What do you think? What’s your experience? Are these questions even answerable?