New Jobs and Livelihoods Get Fistula Survivors on their Feet

New Jobs and Livelihoods Get Fistula Survivors on their Feet

[Editor’s note: While in Liberia 2 years ago, our Friends of Liberia group did service projects at the Methodist Mission Hospital in Ganta, Nimba County. One patient was suffering greatly from a fistula condition that was difficult to treat. ]

From the United Nations feature story

DRC/ LIBERIA/REPUBLIC OF CONGO — It takes more than an operation to get fistula survivors on their feet. First there’s a recovery period, two weeks on average, so that the patients can heal after surgery. But it’s often a job or a livelihood that really helps them reclaim their lives.

Because so many fistula survivors have been abandoned, excluded or shunned – often for years — a job or a business opportunity can mean renewed social connections and a sense of purpose, as well as a much needed livelihood.

That’s why UNFPA, the United Nations Population Fund, supports programmes that give former fistula patients skills to achieve real freedom from the legacy of fistula.

In the Democratic Republic of the Congo, former fistula patients are becoming skilled beauticians and dress makers.

In Liberia, fistula survivors are making and selling soap, flowers, baked goods, dresses and fabric.

In the Republic of Congo, there’s an individualized approach with a focus on business and management skills.

In all three countries, the women also receive coaching on the life skills that can help them become successful and overcome their tragic pasts.

“I lost all hope. I was abandoned by every member of my family. Now, some of them are beginning to relate to me,” says Nyamah Kollie, 39, one of the fistula survivors who benefited from the programme in Liberia after living with fistula for almost 20 years.

The difference a job makes

The change in Rebecca Mambweni’s life is striking. She was just 23 when she went through days of agonizing labour before a dead foetus was pulled from her uterus. The trauma to her birth canal left her incontinent .

“I lived for a year with fistula. I just stayed at home with my mum. Sometimes I could see her crying. No one wanted to be around me. My in-laws abandoned me,” she says. “They didn’t want to pay for an operation to fix me. All I could do was stay home. I couldn’t go outside just in case I urinated on myself. When I went outside people would laugh at me, pointing. It was like a prison. I sometimes felt it would just be better if I died and just be quiet somewhere else.”

Now, following her surgery and training as a beautician in DRC, she is employed and optimistic about her future:  “I work in this salon, the Salon of Hope. One day I’d really like to have a salon of my own. I’d really like all those people that laughed at me to see me now. I just want to live a normal life,” Ms. Mambweni says.

More than 350 fistula survivors have benefited from the social reintegration programme that has been put in place in DRC with UNFPA support, many of whom have been able to improve their living conditions with the training received.

In 2011, UNFPA will work with other UN agencies in DRC, like the International Labour Organization, to create a cooperative of women and girls that can generate more opportunities and bolster their enterprises. The efforts are part of the global Campaign to End Fistula, an initiative spearheaded by UNFA with a vast array of partners in 49 countries.

Baking up cakes and livelihoods in Liberia

Korpo Nelson, 39, a fistula survivor from Tubmanburg Bomi, Liberia, learned how to bake pastry while in the fistula training centre. She now sells her products to the patients in the same hospital where she was treated in 2009, after living with the condition for 23 years.

After her fistula was repaired, Lorpo Sumo, 40, needed a way to maintain herself and her three children. She learned how to bake and sells cakes to the local community. In the first two weeks after returning from the fistula rehabilitation centre in Monrovia, she earned $30, twice the national average monthly income.

More than 50 women have so far graduated from the social rehabilitation and reintegration programme in Liberia. Already one result is that about half of graduates are reunited with their husbands, whereas in the past the figure was closer to 25 per cent.

An individualized approach in the Republic of Congo

A fistula survivor receives a social reintegration kit. Photo: UNFPA, Republic of Congo, 2010

Fistula survivors in the Republic of Congo can become seamstresses, learn how to market smoked fish, or develop a soap-making business. Those that come into the programme with existing skills get the help they need to build on them.

One of the key elements of the programme is the individualized approach. Clients sign an agreement to work with a tutor who can help them build a business based on their existing or desired skills. The signed agreement entitles them to a bank account and training in business and financial literacy, so they know how to keep their books.

Start-up kits provide them with essentials to begin a business of their choosing. For example, a seamstress might be given a sewing machine and fabric.

Social reintegration activities also help to ensure that there is proper follow-up and development.

As part of the training options offered by the programme in Liberia, fistula survivors can learn how to make soap, flowers, dresses and fabric. They can also become beauticians or learn backing techniques.

—Etienne Franca with support from the Country Offices in DRC, Liberia and Republic of Congo

Related Links

Campaign to End Fistula (with videos and fact sheets)

MedlinePlus- Fistulas

Friends of Liberia Travellers Gallery (photos from the Service Projects trip to Liberia in 2008, including hospitals & an album by this editor)

MSU-led study identifies risks for quitting college

MSU-led study identifies risks for quitting college – Study identifies risks for quitting college

A study led by Michigan State University psychologist Tim Pleskac identifies the risk factors for quitting college

EAST LANSING, Mich. — College students who consider dropping out are particularly sensitive to a handful of critical events including depression and loss of financial aid, according to a study led by Michigan State University scholars.

Surprisingly, however, other events such as a death in the family and students’ failure to get their intended major did not have a significant influence on their intention to drop out, said Tim Pleskac, MSU assistant professor of psychology and lead researcher on the project.

By identifying which risks prompt students to consider quitting, the research could help in the effort to combat college withdrawal, Pleskac said. More than 40 percent of students in the United States fail to get a bachelor’s degree within six years at the college where they began, according to the National Center for Education Statistics.

“Prior to this work, little was known about what factors in a student’s everyday life prompt them to think about withdrawing from college,” Pleskac said. “We now have a method to measure what events are ‘shocking’ students and prompting them to think about quitting.”

“From an institutional perspective,” he added, “we are now better suited to think about what students we should target in terms of counseling or other assistance to help them work through these issues.”

The study, funded by the College Board, will appear in an upcoming issue of the research journal Organizational Behavior and Human Decision Processes.***

In the study, Pleskac and colleagues developed a mathematical model that describes how students decide to quit. They used the model to analyze surveys from 1,158 freshmen at 10 U.S. colleges and universities. The surveys listed 21 critical events (or “shocks) and asked students whether these events had happened to them during the previous semester; the students were later asked whether they planned to withdraw.

The critical event with the most influence was depression. Students also were sensitive to being recruited by an employer or another institution; losing financial aid or experiencing a large increase in tuition or living costs; unexpected bad grade; and roommate conflicts.

They were less sensitive to critical events such as death in the family; significant injury; inability to enter their intended major; becoming addicted to a substance; coming into a large sum of money; losing a job needed to pay tuition; and becoming engaged or married.

Previous research had studied the role critical events play in employee turnover decisions. However, this was the first study to examine the phenomenon with college withdrawal, the researchers said.

“Traditionally the problems of employee turnover and college student attrition have been viewed from different lenses,” said Jessica Keeney, a project researcher and doctoral student in psychology at MSU. “But we see a lot of similarities in how employees and students decide to quit. A ‘shocking’ event, such as a clash with a co-worker or roommate, could be the final factor that pushes someone to leave.”

 

*** For suggestions on how to get this article for free or at low cost, click here

 

 

 

Most New Jersey residents see global health as critical to state’s economy

Most New Jersey residents see global health as critical to state’s economy
R&D a key to creating jobs, improving health, building public-private partnerships

From the February 15, 2011 Eureka news alert

WASHINGTON—February 16, 2011—Despite the unpredictable economy, nearly three-quarters (73%) of New Jersey residents think spending money on research to improve health globally is important to jobs and incomes in the state, according to a new statewide poll commissioned by Research!America. The poll data will be released today at a meeting in Washington, DC, of prominent global health research and development (R&D) experts and New Jersey business, academia and nonprofit leaders. This is part of a six-state effort by Research!America.

According to the poll, most of the New Jersey population (94%) thinks it is important for their state to be a leader in health R&D, and in fact, the state is currently third in the country for total investment in this area. New Jersey is home to 17 of the world’s 20 largest pharmaceuticals, medical technology and diagnostic companies. These companies contributed nearly $30 billion to the state’s economy and accounted for more than 55,000 New Jersey jobs in medicine, research, public health and education in 2009 alone. They also are providing solutions for some of the world’s deadliest infectious diseases, such as HIV/AIDS, tuberculosis, malaria and dengue fever.

Former Congressman and Research!America Chair John Edward Porter said, “Global health research is one of New Jersey’s best investments, in which the state’s private sector plays a leading role. On the other hand, New Jersey is ranked 11th in population but is 18th in peer-reviewed federal research grants, which provide the basis on which private industry builds much of its applied research and its products. This is a growth opportunity for New Jersey. I urge the state’s leaders to further strengthen their commitment to global health R&D in New Jersey.”

Porter added, “Working to treat and prevent disease around the world not only fuels our economy and creates jobs here, but also allows some of the world’s best minds to come together here to enrich our science and our society and to improve health everywhere.”

One of the most successful approaches to moving global health R&D forward has been public-private partnerships—which often consist of joint endeavors between technology or pharmaceutical companies, universities and nonprofits. They can yield groundbreaking results.

Case in point: Research led By David Alland, MD, at the University of Medicine and Dentistry of New Jersey (UMDNJ)—together with the Foundation for Innovative New Diagnostics (FIND), the National Institutes of Health (NIH) and the manufacturing company Cepheid—spawned a new diagnostic test that tells whether a person has tuberculosis and whether it is a drug-resistant strain of the deadly disease in under two hours. Current tests, in use for over a century, can take up to three months. This new rapid TB test has been endorsed by the World Health Organization and is expected to revolutionize the way TB is treated around the world.

New Jersey residents (91% according to the poll) believe these types of partnerships are important for developing new treatments and cures, and 73% think it is important for New Jersey to offer incentives for companies to invest in research to improve health globally.

“These product development partnerships have paved new paths in global health research and created new jobs and new businesses, so it is gratifying to see that they have strong public support in New Jersey. This should send a clear message to local and national policy makers about the need to make further R&D investment a top priority,” said Mary Woolley, Research!America president and CEO.

The poll also finds that:

• 94% say infectious diseases like the flu, tuberculosis and SARS will pose some level of threat to the U.S. in the next few years, and 79% say Americans should worry about diseases like malaria, dengue fever and cholera that mostly affect poorer countries.
• 91% of the state’s residents are concerned about drug resistance and say it is important to conduct global health research to prevent the problem worldwide.
• 88% are concerned about U.S. troops overseas being exposed to global health diseases, and 86% say American civilians benefit from health research conducted by the U.S. military.

###

To learn more about global health R&D investment in New Jersey, visit www.researchamerica.org/uploads/NewJerseyFactSheet.pdf.

 

 

 

 

Broader psychological impact of 2010 BP oil spill

Broader psychological impact of 2010 BP oil spill
Spill caused significant psychological impact even to nearby communities not directly touched by oil

From the February 15, 2011 Eurkea news alert

Baltimore, MD – Feb. 17, 2011. The explosion and fire on a BP-licensed oil platform in the Gulf of Mexico in April 2010 had huge environmental and economic effects, with millions of gallons of oil leaking into the water for more than five months. It also had significant psychological impact on people living in coastal communities, even in those areas that did not have direct oil exposure, according to researchers at the University of Maryland School of Medicine who worked in collaboration with the University of Florida, Gainesville. Study results will be published in the February 17 online edition of Environmental Health Perspectives, a publication of the National Institutes of Health.

“We found that people living in communities with and without direct oil exposure had similar levels of psychological distress. People in both groups showed clinically significant levels of depression and anxiety. Also, where compared to people whose income was unaffected by the disaster, people with spill-related income loss in both groups had higher rates of depression, were less resilient and were more likely to cope using ‘behavioral disengagement,’ which involves just ‘giving up’ trying to deal the problem,” explains Lynn Grattan, Ph.D., associate professor of neurology at the University of Maryland School of Medicine.

The Maryland investigators, who traveled to the region soon after the spill, worked with Gulf Coast community leaders to get “real-time” assessments of the acute impacts of the spill. Their goal was to measure the acute psychological distress, coping resilience and perceived risk (concerns about the environmental impact and potential health consequences) of people living along the Gulf Coast. By doing this, they could help identify the potential mental health needs of the Northwest Gulf Coast communities. They examined the psychological impact in two fishing communities: Baldwin County, Alabama, and Franklin County, Florida. Baldwin County had direct oil exposure; Franklin County did not. The researchers defined indirect impact as a place where oil did not physically reach the coastline, but where anticipation of the oil spread significantly affected the community’s recreation, tourism and fishing industries.

“The findings of these University of Maryland researchers may have important implications for planning public health response in similar situations, suggesting that a broader approach may needed,” adds E. Albert Reece, M.D., Ph.D., M.B.A., vice president for medical affairs at the University of Maryland and dean of the University of Maryland School of Medicine.

The people in Florida, where oil had not reached shore, showed similar elevated levels of anxiety and depression as those living in Alabama who had direct oil exposure. Both groups had similar high levels of worry about the impact of the spill on the environment, health and seafood safety.

However, the levels of psychological distress were higher in both communities among people who had suffered income loss because of the spill. They had significantly more tension, anger, fatigue and overall mood disturbance than those whose income was not adversely affected. These people also had lower scores on resilience and may have fewer psychological resources to bounce back from adversity.

“From a public health standpoint, we need to understand that when there is a significant environmental crisis, we need to extend public health outreach and education, psychological monitoring and mental health services beyond the immediately affected areas, paying particular attention to people at risk for income loss. There are things that can be done to help people manage their stress and anxiety, and cope in these situations, so these interventions need to be available immediately in the communities where the impacted individuals live,” adds Dr. Grattan, who is also a neuropsychologist at the University of Maryland Medical Center.

The study on psychological impact built on a research program by University of Florida investigators who were already in the area to study the acute environmental and health impact of the spill. Through contacts with local community and religious leaders, trade associations, the University of Florida extension office and other agencies, the Maryland researchers recruited 71 residents in Florida and 23 from Alabama for the psychological assessment.

The team evaluated the participants through interviews and standardized assessments of psychological distress, resilience and coping. The team also looked at whether the participants had cognitive symptoms of neurotoxicity as a result of exposure to oil and chemical dispersants. These included assessments of attention, memory, and dexterity and speed (through a pegboard puzzle task). The researchers also asked the participants about what they were doing to cope with the situation, which could range from prayer and meditation to increased use of alcohol and other drugs.

Related news item

Psychological effects of BP oil spill go beyond residents of impacted shorelines

Blacks Readmitted to Hospital More Than Whites: Study

Blacks Readmitted to Hospital More Than Whites: Study
Return rates even higher for hospitals serving mostly minority patients, research shows

From the February 15, 2011 Health Day news item

TUESDAY, Feb. 15 (HealthDay News) — After leaving the hospital for treatment of three common conditions, older black people are more likely to be readmitted within 30 days than older white people, a new study finds.

Overall, older blacks have 13 percent greater odds of being readmitted to the hospital, recent research suggests, while patients treated at hospitals that primarily serve minority populations have 23 percent greater odds of readmission within 30 days.

“There are significant racial disparities in readmission rates in this country,” said the study’s lead author, Dr. Karen Joynt, a health policy fellow at the Harvard School of Public Health in Boston.

“We found that both race and site of care mattered. The next step is to find out why this disparity exists,” she said.

And, she noted, no matter what the race, about 20 percent of people discharged from the hospital are readmitted within 30 days, which suggests that there are gaps in care that need to be identified and addressed.

“Hospital discharge is a really vulnerable time. Going home from the hospital often requires medication changes, diet changes and lifestyle changes. Even in the best case scenario, one in five is being readmitted,” she said.

Because readmissions are so common, reducing the rate of readmission is a focus in health-care policy. Previous studies have suggested that racial disparities may play a role in readmission rates, but the evidence was inconclusive, according to background information in Joynt’s study.

Using national Medicare data that included more than 3 million hospital discharges for heart attack, congestive heart failure and pneumonia, the researchers compared the rate of readmissions for blacks and for whites. To conform with other research, the researchers considered any non-black patients as white, which means that Hispanics, Asians and Native Americans were placed in the white category for this study.

The researchers also looked at the data by hospital, and whether or not a hospital was primarily a minority-serving hospital.

Of the 3 million plus discharges, 276,681 (8.7 percent) were for black patients, and 2,886,330 (91.3 percent) were for white patients. About 40 percent of the black patients and 6 percent of white patients received care at hospitals that primarily served minorities.

The average age of the patients was mid-70s to early 80s, depending on the condition. There were slightly more women included in this study than men.

Overall, readmission rates were 24.8 percent for blacks and 22.6 percent for whites, which means black patients have 13 percent greater odds of readmission within 30 days after discharge, according to the study.

Among those who had been admitted for heart attack, black patients from minority-serving hospitals had the highest readmission rates — 26.4 percent, according to the study. That translated to 35 percent greater odds of readmission for this group.

The results of the study are published in the Feb. 16 issue of the Journal of the American Medical Association.***

Joynt said this study wasn’t able to tease out the reasons that these disparities exist, but said that less access to transitional care may play a role. She said that other research has shown that good follow-up care after a hospital discharge can make a difference in readmission rates.

“The biggest take-away from this study is that currently, hospital readmission is a major problem in the U.S., and we need better solutions to help prevent readmission,” said the co-author of an editorial in the same issue of the journal, Dr. Adrian Hernandez, an associate professor of medicine at Duke University School of Medicine in Durham, N.C.

“This was an excellent study that raises important questions. How can we get a process in place that strengthens the support received after discharge? How do we get resources that will enable hospitals to reach beyond their doors to provide services and support to vulnerable populations?” he said.

SOURCES: Karen Joynt, M.D., M.P.H., health policy fellow, Harvard School of Public Health, and cardiology fellow, Brigham and Women’s Hospital, Boston; Adrian Hernandez, M.D., M.H.S., associate professor, medicine, Duke University School of Medicine, Durham, N.C.; Feb. 16, 2011, Journal of the American Medical Association***

For suggestions on how to get this article for free or at low cost, please click here