H1N1 - your best defence is you

HDEO has posted regularly on the threat of H1N1 aka Swine flu (here, here, here and here). Today, the IFRC released a set of communication tools to support a global health intervention aimed at going the last mile. There are radio spots, posters, video clips, e-learning guides for health workers and interested members of the public, widgits and much more.




Posted above is a 30 second video mainly intended for roll out in national markets, rebranded with local Red Cross/Crescent logos and dubbed into local languages. It will also be carried by major international media.

Vaccines are not the only solution to limiting the spread of the virus. Simple measures at the individual level are one of the most effective (and cost-free) measures that can be taken. In any case vaccines will not cover each and every global citizen. If we take practical, logistical and production factors into account vaccines for everyone is anyway an impossibility - this is a fact. Never mind economical factors which basically dictate "if you can pay you're OK".

This campaign aims to stress the humanitarian imperative of getting the right information to everyone. H1N1 is a time for a concerted effort of global solidarity. It is about getting the information into the hands of those who need it most. Everyone has the right to access life-saving information and vaccines. Leave no one behind. And remember, the best defence is you!

The photo shows a technician working on a production line of inactivated H1N1 flu vaccine in Beijing. REUTERS/Jason Lee

/PC

War and Flood: Living with a Double Disaster

The Sri Lankan village of Sallitheevu in Vaharai, Northern Batticaloa, has been affected by a double tragedy in the past few years - devastated not only by the armed conflict but also by the tsunami that destroyed the east coast of the country on Boxing Day 2004.

Sivaskaran Shirani, 27, is one of the many affected by both disasters. She has four children - two boys aged 11 and five, and two girls aged ten and eight.

”Our house was completely destroyed in the tsunami, but we all escaped,” she says. “We received a new house under the tsunami reconstruction programme. Before the conflict came to our village, we had a good life. My husband was a fisherman and even had his own motorized boat. We made a good living.

Fighters in black masks

”Then during the battle for this area, fighters came to our house and ordered us to open the door. “They searched the house and found him. They dragged him into the house and executed him in front of me and the children. We were married for 12 years.”

Shirani wipes a tear as she continues her story. “After my husband was killed, we escaped the fighting in our boat and went to Valachchennai. I sold the boat there and we lived as internally displaced people (IDPs) for a while. When the fighting ended and we were allowed to return, I came back here, although we had nothing left.”

Restoring livelihoods

The Red Cross began to work in Sallitheevu to help widows and other vulnerable members of the community to restore their livelihoods after the tsunami and the conflict. Shirani received fishing nets and seeds for home gardening as well as a household grant that she used to buy a fiberglass paddle canoe, which is currently being used by a relative who gives her a percentage of his catch, bringing in a small income. She has also taken up British Red Cross sewing training.

Shirani explains the importance of this. “Fishing is seasonal and sometimes there is no catch at all. That is why I took up sewing. I hope it will help supplement our income. Before this project I didn’t know how to sew at all but I was interested in learning as I have four children to support.

“Now, after two months of training, I have the basic skills necessary to make most garments. This project will go on for couple of months more, so I expect to be able to make any garment well by then. I hope we will be able to make clothes we can sell on the market by the end of this project.”

Make a difference

Shirani is also a member of the local village committee. ”I joined the committee because I wanted to make a difference in the village as this is where my children will grow up,” she says.

Shirani is desperate to do whatever she can to help her children. “I want to go abroad and earn some money for my children. I want to go to Saudi Arabia and work as a housemaid. I hear the money there is good. I can’t watch my children suffer like this any more, so I have pawned all my jewellery and borrowed some money for the trip.

“I would have gone already, but I lost my birth certificate in the tsunami and am still waiting for them to issue a replacement. I plan to go as soon as I get it. I know the risks, but this is my last chance. If something happens to me, my children will be orphans and I can’t bear to think of that, but I can’t bear to listen to them cry with hunger either.

Educate our children

‘We have a lot of financial difficulties, but all four of my children are still in school. It was my husband’s dream to educate our children, and I will do anything I can to make sure that happens. But although the education is free, there are many expenses such as books, pencils, shoes and bags.”

As if on cue, her eight-year-old daughter walks into the house just back from school. The bottom of her school bag is in tatters, forcing her to wear the bag upside down so that the books will not fall out.

Shirani looks at her daughter’s bag and sighs. ”Some days I am not able to provide a meal or even some tea. We live very difficult lives. I am hopeful that things will continue to improve as they have since the Red Cross arrived in Sallitheevu.”

This story originally appeared on ifrc.org and was penned by Amanda George from the British Red Cross.

Children pay the price in Pakistan

The fighting in Pakistan’s north-west region has displaced between 2.5 million and 3.5 million people. Which amounts to one of the largest population movements in recent history. While more than 235,000 people are in camps, the remainder are living in the homes of relatives and friends away from the areas of violence – and nearly half of these are children who are among those most vulnerable to congested living conditions and poor sanitation facilities.

Support networks for those displaced are near their breaking point, with families facing huge challenges such as food shortages, health problems, and lack of clean water. Host families are struggling to maintain those who are staying with them.

Jahangir Khan, 15, fled his home with his mother and five younger brothers and sisters. His father stayed behind to protect their house in southeast Swat.

“The road was blocked due to the fighting, so we had to take a mountain trail to escape safely,” Jahangir recalled. “We walked for two days before we could get a van to reach my uncle’s house, where we stayed for a few days, but we had to leave because of overcrowding.”

Jahangir now lives in a cave with his family and is being supported by his uncle Taj Maluk.

The support being provided to Jahangir’s family is placing financial strain on his uncle, who is hosting ten other families at his home. He only earns the equivalent 50 dollars (CHF 54.33) a month as a farm worker, an amount that barely supports his own family of 10.

“It’s becoming more and more difficult for me to support these people. I have already sold a cow to get cash”, said 40-year-old Taj.

Jahangir now worries about his father. “It has been ten days since I saw my father,” he said, “I don’t know whether he is okay or not.”

Muhammad Zubair, 13, has not been as lucky as Jahangir. He and his family are living in an abandoned poultry farm that was cleaned and made available by villagers in Ichrian village in Mansehra district east of Swat, in an area free of fighting. (Photo right: Muhammad Zubair and his friends sit outside their living place in village Ichrian of Mansehra.)

Zubair, a student of Quran in a local Madrassah in Mingora, the capital of Swat, had to suspend his studies and move to a safer place along with his family when the fighting escalated.

“I miss my home and my friends. I don’t like living here. My friends and I used to play cricket and other sports. Life was fun,” Zubair said.

It is cold in this poultry farm at night, and sometimes the stench of dead chickens in the area from neighbouring poultry farms is overpowering.

There are around 500 people living at this facility and locals are doing their best to support them. But much more needs to be done to help these families live in a more hygienic environment that provides even the most basic comforts.

“Children are living in extremely unhealthy conditions. Most of them do not even have soap to wash” said Doctor Umar Riaz, a member of the Pakistan Red Crescent Society (PRCS).

Doctor Umar added that the ongoing fighting and the subsequent uprooting of children from their homes have resulted in significant psychological trauma. “They need to engage in sports and other social activities to cope with the situation,” he said.

For the PRCS, the health and welfare of these children is among the top priorities of the appeal for emergency funding that was launched in June to provide humanitarian relief for internally displaced people in Pakistan. These funds are urgently needed but have as yet met with a very poor response. It seems we have our work cut out for us if we are to convince donors and general public that the needs in Pakistan are pressing and present.

This post is based on an article written by my colleague Mubashir Fida in Pakistan which first appeared ifrc.org -- Mubashir also took the photos accompanying this post.

/PC

Swine Flu ain't over till it's over

Right, a factory worker at a mask factory in the Philippines where production has tripled in the last few weeks.

Swine flu (H1N1) is still with us despite the sharp fall off in media interest. Yesterday, I had to watch main news channels for ten minutes or so before the pandemic was mentioned, if at all. One news editor told me he instructed his journalists to ‘give up on swine flu. It’s a story that’s going nowhere’.

I have heard doubts and even criticism expressed from some quarters on ‘scare-mongering’ or ‘crying wolf’. What is it about human nature? Do we really want the ‘proof’ of a lethal pandemic before our eyes till we truly kick into action? Is it not in our DNA make-up to tackle life-threatening events before they happen if we are lucky and wise enough to act early based on clear warning signs?

Deliberately or not the media has contributed to a misperception that the threat has faded. This shows little respect or understanding for the nature of pandemics and could even undo all the good prevention and mitigation work that has taken root in many countries up to now.

A real and present scenario is that the current strain of H1N1 will go underground and reappear with a vengeance during the northern hemisphere’s winter influenza season in a few months time. There are many other equally unappealing scenarios.

It seems now that pigs are basically Petri dishes for the virus and not just direct transmitters. The case in Canada where infected humans passed the virus to pigs and back again proves this. What will be the scenario if this happens in Asia where avian influenza (H5N1) is still very much around. What mutant scenario will we get if these two hook up? 

In the hard-fought business of preventive health you have to base your reasoning on a whole range of scenarios. We do not have the luxury to wait till our scenarios play out, say “Told You So” and head home to wait it out in a bunker.

Now is the time to take action. We don’t need to sit around to see ‘what if’. We are programmed to prevent ‘what if’ and that is a good strategy (and a good investment) even if at times the highly unpredictable out-maneuvers us or evaporates into the ether.

Understandably, Mexico, which has absorbed a lot of media inquiry and its fair share of bad press, is keen to portray a return to pre-outbreak stability. But we are not there yet. All you have to do is look at the figures. The number of confirmed cases has more than doubled around the world since last week, as has the number of countries where swine flu (or H1N1) is now prevalent. In Spain there are some 80 confirmed cases and the UK is not far behind. In all probability these numbers are far higher. Why? Because confirmed cases are based on the capacity of laboratories to diagnose, not on the reality as such.

 Swine Flu about to “take off”

The renowned medics at International SOS had an interview with Professor John Oxford yesterday. He confirmed that, over the last 2 days, the influenza H1N1 virus has been behaving in the UK as predicted by previous mathematical models. That is, the virus is scattered over the country due to multiple introductions. 

In keeping with those models, he expects that the virus will suddenly "take off" in the UK in about 5 weeks. On the issue of severity, Professor Oxford believes that it is likely to get worse, not better. He does not think that it will "peter out". The Professor’s credentials are also worth noting. He is Professor of Virology at St Bartholomew's and the Royal London Hospital, Queen Mary's School  of Medicine and Dentistry, and is Scientific Director of Retroscreen Virology (pictured above, a ballet class in Hong Kong).

Meanwhile, today in Paris, far from the media glare, leaders from more than 30 Red Cross societies from all over the world met to discuss the current influenza outbreak and seek ways to better prepare and respond to the threat of a global pandemic. They were joined by representatives from partner organizations, including UN agencies.

Our Secretary General, Bekele Geleta stated clearly that “it is too early to claim victory over the H1N1 virus and we must remain vigilant, especially in case the virus comes again in a few months with renewed strength. We can never be too prepared to face such a threat.” 

Another colleague, an expert in pandemics and health emergencies said it another way: It ain't over till it's over. So, when it comes to pandemics, its Head Down Eyes Open all the way to the winning vaccine.

/PC

The One Million People Killer Disease

A child dies every thirty seconds from Malaria.

One million people die every year from Malaria.

Yet malaria is a preventable disease. And mosquitoe nets are the most cost-effective and hands-on preventive solution available.

Malaria will not be eradicated unless the distribution of mosquito nets is accompanied by extensive and prolonged community education and empowerment efforts.

Communities must own the response if malaria prevention is to be successful. Families at risk of being infected with the disease must know how to properly use nets and fully understand the risks they are taking if simple preventive steps are neglected.

A new report which we have just published today (World Malaria Day) demonstrates how the combination of distributing mosquito nets and working closely with the affected communities is a winning formula in the fight against malaria. When communities are trained in prevention of malaria and are empowered to ensure effective use of mosquito nets then the impact is significant and lasting. Specifically, independent studies now show that preventive use of mosquito nets goes up between ten to twenty three per cent each time a volunteer from the affected community visits families that have received a net.

Statistics may fluctuate from one country to another depending on the type of comnunities reached by the campaigns. However, the report makes it clear that distributions will only successfully reduce malaria if they are complemented by the forgotten component of malaria prevention: door-to-door education and support.

Eighty six per cent of malaria cases occur in Africa but it nevertheless remains a global problem also affecting countries in large parts of Asia and Latin America.

Rolling Back Malaria in Haiti

Let's take the case of Haiti. The year 2008 was not a good one for Haiti. This small country – one of the most vulnerable in the world – suffered a string of cyclones that devastated coastal areas, claiming a considerable number of victims and causing widespread destruction.

The health effects of the disaster were also considerable. The presence of stagnant water led to a resurgence of diseases caused by dirty water, and the dramatic rise in the number of mosquitoes led to an increased risk of malaria.

Right after the cyclones struck the country, volunteers from the Haitian Red Cross distributed impregnated mosquito nets. But we very quickly realized that we needed to extend immediate recovery efforts to include training for volunteers on how to prevent malaria, detect suspected cases and refer them to health facilities, so that they could disseminate relevant messages in the community, such as the importance of using mosquito nets, particularly for pregnant women and children under five.

This was how the programme, initially designed to distribute mosquito nets to 10,000 families, came to be launched in various areas in the country affected by the cyclones. Subsequently, it was extended to the area of Nippes, in the southwest of the country, which was chosen because it is an inaccessible area populated by vulnerable people, where the bad condition of roads hinders access to health care. Most inhabitants are poor. Although the effects of the disaster in this region received little media coverage, the impact was no less real or traumatic.

Around fifty volunteers from the Haitian Red Cross have been involved in the malaria prevention programme over the past few weeks. Their job is to identify the people most at risk in 45 places in the towns of Miragoane and Baradères, particularly households with pregnant women and children under five, who are most at risk from malaria. The three-month prevention and education campaign targets approximately 6,000 people out of a catchment population of around 60,000.

Thanks to the domino effect of the dissemination of messages, it is estimated that a total of around 30,000 people will be reached indirectly through their neighbours, relatives and community leaders (mayors, priests, hospital directors, etc.).

Once families have been identified, volunteers organize community meetings, discussion groups and home visits, during which they explain the dangers of malaria and how impregnated mosquito nets can provide effective protection. They then distribute the mosquito nets and visit the beneficiaries’ homes to ensure that they have been properly fitted.

Furthermore, these same volunteers are trained to detect people presenting the telltale signs of malaria and send them to health centres as quickly as possible.

All our volunteers live in the town where they work. They therefore know the area that they operate in very well, which increases their credibility in the eyes of the beneficiaries. This increases acceptance of prevention messages in the community and promotes changes in behaviour for the benefit of their health.

Many volunteers recruited for the programme to combat malaria also received first aid training, so that they are able to answer basic public health questions from beneficiaries when they visit their homes during the malaria prevention campaign promoting the proper use of mosquito nets.

In addition to the recovery assistance provided to help people get back to normal after the damage caused by the cyclones last year, the project also contributes to community health education and prevention efforts, making local communities more aware of the dangers of malaria and ensuring that they are better prepared to deal with future outbreaks of malaria when natural disasters strike Haiti again,” concludes Dr Myrtha Louissaint.

As a result of Red Cross / Red Crescent net distributions, since 2002 more than 289,000 malaria deaths have been averted, while 17.5 million people have been protected.

For more information please check out the World Malaria Day section on our website or watch this 2 min video on our youtube channel.

/PC