World Health Worker Week 2015: A Catalyst for Further Advocacy

By Aanjalie Collure, IntraHealth International 

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Last week, diverse organizations came together to honor the heroic and lifesaving work of frontline health workers in their communities and beyond, and advocate for health workforce strengthening to be a central priority in the global health agenda moving forward. Our common, heartfelt gratitude and respect for frontline health workers was undoubtedly the mobilizing force behind these passionate and concerted advocacy efforts, and World Health Worker Week 2015 provided the unique opportunity to collectively share our sentiments and work together towards these shared goals.

The first World Health Worker Week in 2013 was built on mobilizing a shared recognition that improving access to skilled, motivated, and supported health workers was absolutely central to achieving universal health coverage (UHC). Two years later, World Health Worker Week 2015 further built on this theme to stress how health workers were “the backbone of all global health goals” – from achieving an AIDS-free Generation, combatting maternal and child mortality, defeating Ebola and other infectious diseases, and, indeed, underpinning the resilient health systems we need to achieve universal health coverage. This year’s official poster for World Health Worker Week, designed by Karen Melton at IntraHealth International, creatively illustrated the foundational role health workers play in achieving these goals.

Numerous articles published by partners in recognition of WHWW highlighted the tenacity of health workers in accelerating progress towards achieving critical global health priorities. In Health Workers on Ebola Frontlines Serve Countries, Risk Own Lives, a feature story published by the World Bank for WHWW, we learned about the tireless efforts of local West African health workers in helping their countries reach zero Ebola cases, despite enormous risks, poor motivation, and ongoing shortages in essential protective equipment and training. To overcome these challenges and rebuild, the article emphasized the need for investment in “developing a national health workforce as part of a more resilient system.”

Similarly, in Health Workers Spotlight: Heroes in the Fight for an AIDS-Free Generation, The Elisabeth Glaser Pediatric AIDS Foundation (EGPAF) acknowledged how critical health workforce shortages have hindered efforts to prevent and treat pediatric HIV/AIDS, and highlighted how investments in bolstering the health workforce in Kenya, Malawi and Rwanda have had a huge impact on bolstering sexual reproductive health services in these regions.

Finally, in 289,000 Reasons Why Health Workers Count for Mothers, IntraHealth International’s President and CEO Pape Gaye advocated for investments in helping developing countries “to train and deploy health workers where they are needed most” – especially in rural areas where health workers are largely inaccessible to women like Lala, Gaye’s sister who tragically lost her baby when she could not reach a hospital nearly 20 miles away during an emergency pregnancy complication.

We also learned during this week that health workers are not only the underpinning backbone of global health goals, but also a fervent voice on behalf of the communities they serve. In Health Workers Speak, a Humans of New York-esque gallery featuring over 40 photos and quotes from health workers around the world, health workers themselves spoke passionately on their commitment to providing life-saving services at all odds. Beautiful stories were also shared in A Day in the Life, an interactive map produced by the One Million Health Workers Campaign, Esri, and Direct Relief, showcasing the diverse roles community health workers play in improving health outcomes across Africa.

Inspired by these stories, leaders and health workforce advocates took to social media to express their deep appreciation for frontline health workers. In a WHWW twitter chat organized by Johnson & Johnson on April 9th, over 300 organizations and individuals used the hashtag #HealthWorkersCount to express their gratitude for the indispensable role health workers play in communities they live and work in. Throughout the week, USAID and other US government agencies celebrated the contributions of health workers, and shared blogs highlighting what still needs to be done to achieve a sustainable and resilient global health workforce.

As a perfect capstone to this week, Save the Children Pakistan and partners hosted an awards ceremony honoring 36 lady health workers from different Pakistani districts for their life-saving work in improving maternal and child health outcomes in rural regions. Yasmeen Shahzad, a lady health worker from the Rawalpindi district, said that she felt incredibly motivated and “encouraged to work harder” after receiving her award.

With World Health Worker Week 2015 now come to a close, we feel inspired and energized to continue building the momentum we need to ensure health workforce remains a core priority of the global health and development agenda. We hope that organizations and individuals will use what they have learned from this week as a catalyst for the ongoing engagement and advocacy we need to ensure health workers around the world have the support they deserve.

Exploring A Day In The Life Of Community Health Workers

By Andrew Schroeder, Direct Relief

[This blog was originally appeared on the Direct Relief site.]

Celebrating World Health Worker Week (April 5 -11, 2015), a new story map from Esri, The Earth Institute at Columbia, and Direct Relief, aims to raise support and awareness for the life changing contributions of community health workers.

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In dozens of countries, tens of thousands of women and men get up each morning to travel miles over rough roads and across rivers and streams to provide primary health care in some of the world’s most remote, vulnerable, and hard-to-reach places. At any given moment, these people, known as Community Health Workers (CHWs), are monitoring Ebola contacts, counseling an HIV-positive person, surveying basic health needs, or helping a newborn at risk of pneumonia.

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When the Ebola epidemic swept through West Africa last year, international organizations had difficulty establishing and maintaining community trust. Community Health Workers, many of whom are from the communities they serve, stepped in to bridge the gap. Not coincidentally, the organizations with the most durable results to show also relied extensively on CHWs for case tracking, diagnosis, sensitization, referral, and follow up. Such groups include Partners in Health and Last Mile Health in Liberia, UNFPA in Guinea, andMedical Research Centre (MRC) and Wellbody Alliance in Sierra Leone.

Arguably, CHWs are the key for the countries now rebuilding their health systems to be more comprehensive, effective, and resilient following the shock of the Ebola epidemic. They may also be the best defense against a repeat of these events in the future.

Beyond Ebola: One Million Community Health Workers

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While the Ebola epidemic spotlighted the crucial work of CHWs, their value extends far beyond Ebola and West Africa. The One-Million Community Health Workers (1mCHW) Campaign was formed by the Sustainable Development Solutions Network (SDSN) and the Earth Institute at Columbia University to advocate for CHWs and document their far-reaching value.

Direct Relief and Esri teamed up with the Campaign last year to build the Operations Room; a suite of mapping applications that track the scope and enable a detailed comparison of CHW activities.

29 Stories. 24 Hours. 13 Countries

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A Day in the Life: Snapshots from 24 Hours in the Lives of Community Health Workers is the latest map in the 1mCHW Campaign. It aims to convey not only the importance of the work that CHWs perform, but the everyday texture and genuine beauty of the lives they improve. This map is a guided tour of 29 CHWs in action during one long day across 13 countries in sub-Saharan Africa. Through the CHW story map, people can learn about and become more deeply engaged in one of the great causes of our time — ensuring that every person on Earth has access to health care.

Using Basic Mobile Phones to Train Thousands of Healthcare Workers in Kenya

By Annie Geraghty, Accenture Development Partnerships  

George Ngamia has been selected by his clan as a Community Health Worker (CHW) in Kenya’s Samburu District. The Samburu lead a semi-nomadic lifestyle in a remote area of northern Kenya with little to no access to the formal healthcare system. Trained in the basics of preventative healthcare by the African-based health development organization, Amref Health Africa, George provides advice, education, referrals and frontline health services to his community, wherever it goes. But all this travelling means he has little opportunity to catch up with the other CHWs in his unit, or to visit the nearby health facility.

George’s situation is not uncommon. There is a critical shortage of all types of health workers in Africa. CHWs fill this gap remarkably well, and in many places provide the first line of healthcare. While many health ministries in Africa have a community health strategy, with a core curriculum, they lack the capabilities to train a qualified health workforce, especially in remote areas. And, at the moment, there is no scalable, sustainable method of CHW training. This means the recruitment and deployment of these workers is much slower than it could be. Indeed, of the CHWs that have been trained, most have only received a fraction of the training and tools they need; training is inconsistent and retraining opportunities are thin on the ground.

But here’s the good news. The ongoing mobile technology “revolution” in Africa has provided us with an opportunity to reach CHWs with tailored content specific to their needs. Of the 97 percent of CHWs who own a mobile phone, the majority have basic or feature (not smart) phones, and so our new Health Enablement and Learning Platform (HELP) has been developed to work precisely on these basic phones, to provide access for as many CHWs as possible.

In Kenya, HELP provides the Ministry of Health-approved training content to CHWs using a sophisticated mobile learning methodology through any mobile phone (both basic and smart phones), empowering health workers through learning opportunities and enablement tools.  It has been developed through a cross-sector collaboration between Amref Health AfricaAccenture, Mezzanine, Safaricom and the M-Pesa Foundation. HELP also provides ongoing, personalized training and productivity tools such as job aids and decision trees, developed in collaboration with the Ministry of Health.

HELP allows George to update his own knowledge on a regular basis and keep in touch with his fellow CHWs and his supervisor (a Community Health Extension Worker – CHEW) through a free group chat function available on his basic mobile phone.

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“I never knew a phone could be used to learn. It provides more in-depth and detailed information than face-to-face interaction, and will help me to deliver a high quality service.” George Ngamia, CHW, Samburu, Kenya. Photos courtesy of Amref Health Africa.

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Following a tailored education model, training is delivered through SMS and interactive voice response (IVR) and controlled with an advanced scheduling system. Randomized quizzes keep CHWs on their toes and automated reports keep supervisors informed of their progress.

 

May 2014 saw the successful completion of a 12-month pilot, where HELP was rolled out to 318 CHWs in three regions across Kenya – urban, rural and nomadic. A total of 215,000 SMS messages and 140,000 minutes of IVR audio were delivered to CHWs and 8,500 health-related group chat messages were sent. Seventy-eight percent of CHWs fully completed all nine training topics with an average quiz score of 80 percent and an overall satisfaction rating of 4.7 out of five possible. Furthermore, after four months we found that the knowledge retention level was 12 percent higher in the pilot groups.

We are now rolling the program out to 3,000 CHWs, reaching 300,000 people, and partnering with other NGOs to enable greater scale through collaboration. Together, as a coalition of NGOs and implementers, the private sector, Ministries of Health, donors and foundations, our ultimate goal is to train hundreds of thousands of health workers across Africa. We are also evolving the platform towards smart devices and richer content.

With sub-Saharan Africa expected to have 930 million mobile subscriptions by the end of 2019 – nearly one for every resident – you can be sure that mobile devices will play a critical role in changing and improving healthcare delivery across Africa, especially in remote areas where most people don’t have access to quality health facilities or providers.

For George, with such accessible training materials and support tools delivered through his basic mobile phone, that era has already begun.

Tracing the Money: A New Tool to Impact the Budget Process

This article originally appeared on the Family Care International Blog, available here: http://familycareintl.org/blog/2015/03/04/budget-calendar/

By Kathleen Schaffer, Family Care International 

Kenya calendar 2A dilapidated clinic, falling tiles, a never-ending leak. Barren and disorganized medicine shelves. An overcrowded maternity ward with desperate, soon-to-be mothers crying out for help. One nurse scrambling to meet the needs of the many patients who have come through the doors. When clients lament the clinic’s disrepair, or doctors request more supplies and personnel, they’re met with the same hopeless reply: “There’s no money.”

Through Family Care International’s (FCI) Mobilizing Advocates from Civil Society (MACS) project in Kenya, international, national and grassroots organizations as part of the Reproductive, Maternal, Newborn, and Child Health (RMNCH) Alliance are demanding better facilities, adequate and respectful maternity care, and especially, more health personnel. Kenya has only 11.8 health workers per 10,000 people–more than 40% fewer health workers than the World Health Organization’s minimum recommendation of 22.8 health workers per 10,000 people.

Of course any effort to increase the quantity and quality of health workers will have to be paid for, and that means dealing with the budget. For many of us, budgets seem abstract and intimidating, but it’s vital to engage with them since they reflect the government’s priorities and determine where the public’s money goes.

In order to make realistic demands, we need access to information about Kenya’s budget. However, over the last few years Kenya decentralized many decision-making processes, including budgeting, to the county-level. This recent decentralization has made it difficult for us to intervene effectively during the budget process.

But now, civil society organizations in Kenya can engage with budget decision-makers at the right moments thanks to a new Annual Budget Cycle Calendar, developed by the MACS project.

This new easy-to-read calendar shows the key dates for the Kenyan Annual Budget Cycle at both the national and county levels, enabling citizens to participate in both the setting of priorities and in accountability processes.

It is a great resource not only for maternal health advocates but also for the broader health community and county government officials, such as those from the Health and Finance Committees. The RMNCH Alliance will distribute the calendar in counties all over the country, and we hope to see it on many office walls as a constant resource for advocacy opportunities.

Ultimately, by being able to participate in and monitor the budget process more effectively, we will ensure that the government fulfills its commitments to maternal, newborn, and child health, and that the budget reflects the needs and priorities of the community and not just politicians.

 

International Women’s Day: Women #MakeItHappen on the Frontlines of Global Health

By Aanjalie Collure, IntraHealth International

Photo by Jonathan Torgovnik/Reportage by Getty Images

Photo by Jonathan Torgovnik/Reportage by Getty Images

Today, March 8, when the global community comes together for International Women’s Day to celebrate the achievements of women around the world, we recognize women’s central contribution to the global health workforce: a contribution that sadly often goes unnoticed in global health policy discussions. When we take a moment to imagine what the world would actually be like without women working on the frontlines of global health, we realize how indispensable women are to the frontline health workforce we need to achieve global health goals.

If we were to imagine a world without female health workers, we would overlook the heroic efforts of Josephine Finda Sellu, a deputy nurse matron from Sierra Leone who has risked her life on the frontlines of the Ebola epidemic in West Africa this past year. In an interview with the New York Times in August 2014, Ms. Sellu – one of the last “nurse survivors” of Ebola at her hospital – cries while describing the tragic loss of her colleagues; yet, through her tears, bravely declares her commitment to fight the deadly disease until its complete eradication.

Similarly, if we were to imagine a world without female health workers, we would ignore the life-saving work of Dr. Shamail Azimi of the International Medical Corps, the first female physician to enter Afghanistan following the demise of the Taliban regime in 2001. After being inspired and encouraged by her father to complete her medical studies, Dr. Azimi led a team of female health workers to Afghan cities with absolutely no health workers to assist mothers in the safe delivery of their children. Dr. Azimi has not only provided these critical life-saving services, but trained hundreds of local physicians, community health workers, traditional birth attendants, and obstetricians throughout Afghanistan.

Tragically, if we were to imagine a world without female health workers, we would ignore the enormous contribution of Nepal’s body of 50,000 female health volunteers, who have bridged rural communities to the country’s formal health system since the 1990s. Their efforts have been integral to achieving universal coverage of vitamin A supplementation, drastically cutting maternal mortality rates, and slashing under-5 mortality rates by approximately 64%.

In fact, if we were to imagine a world without female health workers, we would be discounting the life-saving work of over 75% of the health workforce in many countries. Female health workers are the muscle behind the strong push to achieve global health goals around the world – whether it be providing maternal and child health services to rural communities in Nepal, fighting for an AIDS-free generation in South Africa, or providing critical services during periods of armed conflict.

Despite this, the World Health Organization notes that there are enormous gender disparities in health workforce management positions and higher-skilled cadres. Women constitute a much smaller proportion of management and other decision-making positions, and are also often poorly represented in higher paying cadres, including dentists, pharmacists and skilled physicians. Additionally, female health workers struggle with having their work recognized and legitimated by colleagues, families, and wider communities in many areas.

These gender disparities have been largely unaddressed by health workforce policy planners, argues Hilary Standing of the Institute of Development Studies at the University of Sussex. Poor data on the gendered composition of health workforces in different countries, and in the educational and other personal barriers women face in health workforce recruitment processes, mean that policymakers do not fully realize the extent of how important these considerations must be in health workforce policy planning processes.

On International Women’s Day, we not only celebrate the life-saving contributions of female health workers around the world, but call for additional action to ensure these women are safe, well-equipped, well-supported, and well-recognized in their roles. Men, like Dr. Azimi’s father, also play an important part in supporting and championing the efforts of female health workers around the world. Together, we can build the health workforce we need – underpinned by strong, intelligent and compassionate women and men alike – to achieve healthy, happy livelihoods for all of us.

Health Workforce Shortage Weakens AIDS Response

This article originally appeared in the Center for Global Health Policy’s Science Speaks blog, available here.

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Photo from FHWC Congressional Briefing on “Building the Health Workforce We Need to Achieve an AIDS-Free Generation.” From left to right: Dr. Kate Tulenko (Vice President, Health Systems Innovation, IntraHealth International), Kelly Curran (Director, HIV and Infectious Diseases, Jhpiego), Dr. Address Malata (Principal, Kamuzu College of Nursing, University of Malawi), Lisa Carty (Director, US Liaison Office, UNAIDS), Ambassador Deborah Birx (US Global AIDS Cooridnator), Vince Blaser (Acting Director, Frontline Health Workers Coaliton).

By Rabita Aziz, Infectious Diseases Society of America 

While the U.S. government has helped train more than 140,000 healthcare workers through the U.S. President’s Emergency Plan for AIDS Relief since the program was re-authorized in 2008, Africa still needs more than one million healthcare workers to address a critical shortage, U.S. Global AIDS Ambassador Dr. Deborah Birx said Monday at a Capitol Hill briefing. Speakers at the briefing, which was organized by the Frontline Health Workers Coalition, IntraHealth, and the Elizabeth Glaser Pediatric AIDS Foundation, said no disease requires more healthcare workers in Africa than HIV.

“HIV requires a highly trained, skilled, competent, sensitive health workforce to achieve prevention and treatment goals,” Kelly Curran, Director of HIV and Infectious Diseases at Jhpiego, said. Curran described meeting a nurse who works at the medical circumcision program at the Iringa regional hospital in Tanzania, who had received training through PEPFAR. “She herself has conducted over 5,000 procedures, as well as doing HIV testing and counseling,” Curran said.

“She does STI screenings, provides condoms, and has been one of many people leading an example of a whole community response,” Curran said. Without the support of PEPFAR, she added, the nurse could not have done all that she did.

Sheila Bandazi, Chief Nursing Officer for the Ministry of Health in Malawi, recounted how one of her students, who had received training through PEPFAR’s Nurse Education Partnership Initiative, noticed that a patient who was receiving care for a wound was not healing. The nurse urged the patient to get tested for HIV, which turned out positive. The patient was placed on antiretroviral therapy, and the student expressed to Bandazi how grateful he was for receiving HIV counseling training through NEPI.

Ninety-five percent of the healthcare workers trained by PEPFAR are in sub-Saharan Africa, Ambassador Birx said. “Having healthcare workers at the right place at the right time is key,” she said, adding that there’s a mismatch between where trained health workers are and where the burden is. Referencing the PEPFAR program in Kenya, where 98 percent of patients are located at 28 percent of PEPFAR sites, she said, “We have been working at sites where there’s no HIV. We have created inequities between programs by overwhelming healthcare workers at areas with high burden of disease.”

“We need to align our resources to where the disease is,” Birx said. “With current flat funding, we’re looking at how to do the right things, at the right places, at the right time.” She added that PEPFAR is looking at site level data to separate high-achieving and low-achieving sites. “If we find amazing nurses at high-achieving sites, we need to examine the attributes that make them effective,” she said.

Ambassador Birx added that if healthcare workers are trained in HIV care, they can deal with any other disease, including chronic noncommunicable diseases.

Dr. Address Malata, Principal of the Kamuzu College of Nursing at the University of Malawi, said the quality of healthcare workers is as important as the quantity. Every program in the nursing school has an HIV component, she said, and students are trained in prevention of mother to child transmission, testing, counseling, adherence, and other prevention. “Malawi has been able to increase the number of nurses and midwives through NEPI,” she said.

“Healthcare workers need support, it’s not only about the money,” Dr. Malata said. With the introduction of graduate level programs, more students are receiving their training in Malawi and staying in country once they graduate instead of going to Western countries for their education, she said.

“I don’t believe we should worry about retention,” she said. “We used to have international migration, but the moment we started introducing post graduate training and built housing for nurses, they stayed.”

Not able to attend this congressional briefing? Click below to view our speaker’s PowerPoint slides from the event: 

debbirxAmbassador Deborah L. Birx, M.D., U.S Global AIDS Coordinator

 

 

 

 

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Dr. Address Malata, Principal, Kamuzu College of Nursing, University of Malawi (Part of Nursing Education Partnership Initiative)

 

 

 

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Lisa Carty, Director, US Liaison Office, UNAIDS

New Analysis Highlights Cost Effectiveness of Health Workforce Scale Up in Ebola-Affected Countries


WASHINGTON, March 2, 2015 /PRNewswire-USNewswire/
– An independent analysis released today and commissioned by the Frontline Health Workers Coalition (FHWC) finds that scaling up the local health workforce in West Africa is a cost-effective investment to help end the Ebola epidemic, restore essential health services and build the resilient workforce needed to tackle future threats.

The analysis, conducted by Eric Friedman of Georgetown University, utilizes publicly available data to estimate the cost—approximately$573 million over five years (or less than $115 million annually on average)—to double the skilled health workforce and ensure a comprehensive community health worker program in Liberia, Sierra Leone and Guinea.

“Frontline health workers’ heroic sacrifices must be honored with a fervent effort to end the epidemic and restore essential services,” saidVince Blaser, Acting Director of FHWC’s secretariat, housed at IntraHealth International. “This analysis underscores that investing in resilient and sustainable health workforces is a cost-effective and sound policy.”

Liberia, Sierra Leone and Guinea suffer from severe health workforce shortages that have hindered the Ebola response and ability to provide other lifesaving services. A lack of recent health workforce data in the region also limited the analysis.

“West African health workers have selflessly treated Ebola patients without proper equipment and worked grueling shifts, sometimes not knowing when their pay would come,” said Julia Bluestone, FHWC Chair and Senior Technical Advisor at Jhpiego. “Now that donors have committed to help end the epidemic and rebuild, meeting the needs of local frontline health workers must be front and center.”

The analysis is not officially authorized by the Liberian, Sierra Leonean or Guinean governments. Frontline health workforce investments should be made in close coordination with each country’s government. With a high-level Ebola forum on March 3 in Brussels and post-2015 discussions resuming, the analysis comes at a critical time to make such investments.

“We want to ensure world leaders turn their words on post-Ebola recovery into action,” said Erin Hohlfelder, Global Health Policy Director for ONE. “Starting tomorrow in Brussels and in the months ahead, leaders must commit the targeted investments needed to strengthen health workforces and systems to build a strong foundation for broader recovery.”

The Frontline Health Workers Coalition is an alliance of 40 United States-based organizations working together to urge greater U.S. investment in frontline health workers.

Read the published press release on PRNewswire here: http://www.prnewswire.com/news-releases/new-analysis-highlights-cost-effectiveness-of-health-workforce-scale-up-in-ebola-affected-countries-300043049.html

 

Cost of Scaling up the Health Workforce in Liberia, Sierra Leone, and Guinea Amid the Ebola Epidemic: FHWC Costing Analysis (March 2015)

costingcoverThe Frontline Health Workers Coalition recommends that the U.S. Government and its partners address the public health emergency resulting for the Ebola virus epidemic in Liberia, Sierra Leone, and Guinea by investing in the training, retention, and support of frontline health workers.

Based on the assumptions, data and calculations in this paper, the overall cost of doubling the health workforce over five years in Liberia, Sierra Leone, and Guinea, and expanded coverage via a community health worker program comes to approximately $573.4 million, or less than $115 million per year on average.

It should be noted that the estimates for this costing analysis were not asked for and are not those of the governments of Liberia, Sierra Leone, or Guinea – and any investments made to increase the capacity of the local frontline health workforce in these three countries should be made in close partnership and coordination with the governments of each country.

A strong commitment by the United States and other donors could help assist the three countries most heavily affected by the Ebola crisis to not only build resilient workforces and systems capable of ending the Ebola epidemic but also to restore essential health services and build capacity to respond to future health threats.

Read the full costing analysis here. 
Read our Ebola policy recommendations here. 

Find these resources and more from our members at frontlinehealthworkers.org/ebola/.

Bridging the Gap: Surgical Care in Low-Resource Settings

By Susan W. Hayes, ReSurge International 

Seven years ago, young Mohammed Hussein was playing with friends near his home in Bangladesh when an accident occurred that would change his life forever.

He and his friends were beside a road that was being paved, when Mohammed Hussein fell into a vat of hot tar. His right leg and both feet were severely burned, and without access to proper treatment for his injury, the skin on his leg began to scar and contract. The contracture of his skin became so severe that his calf became fused to the back of his thigh, leaving him disfigured and disabled.

Mohammed Hussein with his mom before his second surgery. Courtesy ReSurge International

Mohammed Hussein with his mom before his second surgery. Courtesy ReSurge International

When ReSurge’s Surgical Outreach Program director, Dr. Shafquat Khundkar, first met Mohammed Hussein six years later, he appeared to be an amputee. Dr. Khundkar learned that after his accident, Mohammed Hussein had stopped attending school and had resorted to begging as a source of income – one of the few and unfortunate choices left for an uneducated, disabled boy.

Fortunately, Mohammed Hussein was at last connected with health workers who could provide him with the surgical care he needed, and he will eventually walk again. He has had two operations with ReSurge to straighten his right leg and foot, and he will have another later this year to release the contracture on his other foot.

Mohammed Hussein’s burn injury should not have left him permanently on crutches. His disability was the direct result of a lack of access to the surgical care he needed at the time of his injury – and regrettably, his situation is not uncommon.

Approximately two billion people worldwide have no access to basic surgical care. This includes people of all age groups, not only with burn injuries like Mohammed Hussein, but also those with obstructed labor, birth defects, cataracts, cancer, diabetes, hernias and traumatic injuries from industrial and road accidents.

In fact, it is estimated that one in seven marginalized persons in the world is affected by a lack of basic surgical care, and that it contributes to 11-15% of the global burden of disease.

Yet of the 234 million surgical procedures performed each year, less than four percent of them are provided for the poorest third of the world’s population.

This represents a global crisis of enormous proportions, and an expanded and empowered health workforce in the fields of surgical care and anesthesia are needed more than ever in low and middle income countries.

Last Thursday, the World Health Organization’s Executive Board unanimously adopted a resolution on strengthening surgical care and anesthesia as a component of universal health coverage. The Resolution states that “inadequate investment in the infrastructure of health systems, inadequate training of the surgical care health workforce and the absence of a stable supply of surgical equipment and necessities in many countries impedes progress in improving delivery of emergency and essential surgical care and anesthesia.”

Mohammed Hussein with his dad after the second surgery. Courtesy ReSurge International

Mohammed Hussein with his dad after the second surgery. Courtesy ReSurge International

Back in Dhaka, Dr. Shafquat Khundkar is leading the way in expanding the number of qualified reconstructive surgeons in the country. He founded Bangladesh’s first plastic surgery residency program and says that of the approximately 40 plastic surgeons now in the country, at least 35 are his trainees.

“The inner self in me always wants me to train the next generation of humanitarians,” says Dr. Khundkar. “The need for reconstructive surgery [in Bangladesh] is immense… I am pleased that I have been able to build up a group of people who will be able to carry on my work.”

Dr. Khundkar’s work is an excellent example of the type of training that needs to be scaled up to develop the surgical skills of health workers—especially at the primary health care and first referral hospital levels.

With appropriate investment in health systems and in the surgical workforce at all levels, we will protect people like Mohammed Hussein and many others with neglected surgical diseases from death and disability, and from falling further into poverty.

The provision of essential surgical care represents a critical step toward ensuring universal health coverage—one that will require a coordinated global effort over the long term. The WHO Executive Board’s draft resolution represents a good stride in the right direction. We encourage the World Health Assembly to move forward with it and to support Member States in developing the strategies, policies, and funding needed to guarantee quality surgical care for all.

On Wednesday, February 4, 2015, ReSurge International and the G4 Alliance, in collaboration with the Congressional Global Health Caucus, are holding a Congressional briefing on Capitol Hill on the need for surgical care in low-resource settings. Click here to learn more.

A Bold Strategy and Clear Vision to Improve the Global Health Workforce

By Vince Blaser, Frontline Health Workers Coalition

If not well thought out or without a plan to garner support or how to implement, strategies can be boring, dry and ineffective in driving action. On the other hand, strategies with a clear vision backed by governments, civil society, the private sector and other stakeholders can be a galvanizing force that can and has driven enormous progress in relatively short time spans in global health and development.

As we noted on this blog last week, the World Health Organization has been tasked with creating a “zero draft” of a strategy that aims to drive and coordinate action to improve the global health workforce from 2016-2030. The Ebola epidemic in West Africa has tragically highlighted to the world that strong actions to bolster the health workforce, especially on the frontlines of care in developing countries, are desperately needed to secure progress on preventing needless deaths and enabling prosperity.

The Frontline Health Workers Coalition today sent feedback to the Geneva-based Global Health Workforce Alliance today to its Synthesis Paper of a year-long consultation it led that will inform WHO in the creation of the strategy. If you have a few minutes, read the Synthesis Paper and FHWC’s feedback over and let us know your thoughts by commenting below. More importantly, let the Global Health Workforce Alliance know your thoughts by e-mailing ghwa@who.int by tomorrow (January 31).

We’re hopeful that this will not be the last chance for civil society to comment as this strategy is developed, but it is very important to advocate now for a strategy that can drive significant investment and support for frontline health workers in the coming 15 years. We hope you will join us.