Category: News

Prevention and control for women in Mozambique

Posted on by Redazione Cuamm

In Mozambique, the screening program for uterine and breast cancer began in 2009 and in just 10 years it has reached 23% of all women of reproductive age. A result to be very proud of, obtained from a fruitful collaboration between the Ministry of Health and international organizations such as CUAMM that support services within the Health Units. Despite the good results, it is important to be aware that 77% of Mozambican women have never had a check up and do not know the risks associated with uterine cancer. Percentage that becomes much higher in rural areas of the country.

And it is with this awareness that CUAMM is promoting the project “Prevention and Control of Non-Communicable Diseases“, funded by the Italian Agency for Development Cooperation. Among the results it aims to achieve is precisely that of increasing the availability and quality of cervical diagnosis and treatment services in 3 regions of the country.

In the Sofala Province in particular, the effort was greater because most of the health units were destroyed by the violent cyclone IDAI that hit the Province in March last year.

In addition to the training and accompaniment sessions of the health personnel, it was therefore necessary to restructure the health units to create clinics where diagnosis and treatment services were guaranteed. In the small Health Centre of Mutua, located about thirty km from the city of Beira, the works were very urgent because the outpatient visits took place in a tent and the Centre also received the women of the adjacent refugee camp which houses about 800 families who they lost their homes as a result of the cyclone.

The Health Centre was enlarged and a new equipped and functioning clinic was created; the health authorities wanted the inauguration to take place precisely in conjunction with the closure of the awareness activities on uterus and breast cancer that the region carried out during the month of October. And, despite the necessary precautions to reduce the spread of COVID, all the main authorities did not fail to give their support to this important initiative.

The wife of the Governor of the Province wanted to speak on behalf of everyone: “Having uterine cancer does not have to be a death sentence and a health centre like this can prove it – she said – We are aware that many efforts still need to be made, but the role of each of us is fundamental for raising awareness of other women ”, she concluded.

She then thanked the CUAMM nurses who, as the Minister of Health said, work tirelessly every month of the year to improve the health of other women like them.

December 1: World AIDS Day In Africa young women are the most at risk

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Young people and women are the most vulnerable to HIV in sub-Saharan Africa. On World AIDS Day, on December 1, while the pandemic strains health systems around the world, Doctors with Africa CUAMM is making an appeal not to overlook the indirect effects of Covid-19 and remember the millions of people whose lives, in Africa as in the rest of the world, are still at risk from another virus and another epidemic that continues to kill without making news.

The World Health Organization (WHO) estimates that in 2019 there were 38 million people living with HIV in the world, 1.7 million new infections, and 690,000 deaths. Two-thirds of HIV-positive people (25.7 million) live in Africa and, according to UNAIDS — the UN agency working to end AIDS — 25% of new HIV infections in sub-Saharan Africa are young women between 15 and 24 years; 80% of HIV-positive people aged 15 to 19 in Africa are girls.

As young women are the most affected, we must start from them to stem the spread of HIV in Africa. Doctors with Africa CUAMM focuses on this with many actions in the countries where it works, including by offering tests and treatment in all the hospitals where it is active, training health care personnel, as well as promoting activism among HIV-positive women, as happens in Beira, Mozambique, with the Kuplumussana group (“women who help each other”) and adolescents of Geração Saudavel (“conscious generation”).

The pandemic has also changed how these activists work, but they have not been discouraged. In Beira, Mozambique’s second largest city, the young activists, can no longer make house-to-house visits and so started working in the new call center set up by Doctors with Africa CUAMM, to offer advice and support to HIV-positive patients at least by phone. Because of the restrictions required by the health emergency, tests fell by 49% between April and July and meetings in counseling centers open to adolescents by 41%, but since the initial fear has passed, numbers have been slowly returning to pre-Covid levels with 32,000 consultations and 7,000 tests per quarter.

“Epidemics are won by involving communities,” Don Dante Carraro emphasizes, explaining the problem and risks, highlighting the important role of the individual for the health of all. HIV, coronavirus, and Ebola are all viruses and epidemics that must be addressed globally, thinking as one community, taking care of our most vulnerable members, who are most exposed and most at risk. For this reason, though in Italy in recent months our thoughts immediately go to the coronavirus, we cannot lower our guard now on AIDS and let the pandemic make us lose the important progress made in recent years.”

MOTHERS WHO HELP EACH OTHER

In Beira, Mozambique, since 2005, the group of HIV-positive mothers of Kuplumussana (“women who help each other” in the local language), have been at the forefront of awareness-raising activities for other women, helping those who discover they are HIV-positive and showing them that a life without shame is possible. Often HIV destroys more than people‘s immune systems, hurting their social network too as women are marginalized and stigmatized.

Geração Saudavel (“conscious generation”) is the sister association for that of the mother-activists, who often have their children born with HIV. It brings together adolescents involved in raising awareness among their peers, with meetings in schools, counseling centers, marches, and street theater.

Among tradition and change being born in Capo Delgado

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“The first 1,000 days” project deals with future mothers and their children, from pregnancy to the first 2 years of life, in the rural districts of Balama and Montepuez, in the Province of Cabo Delgado, Mozambique. The intervention takes place at several levels: community, health centres and at the Montepuez hospital with the aim of increasing the demand for and access to quality health services, and reducing maternal and neonatal mortality. In particular, the project supports the maternity and neonatal wards and the operating room of the Montepuez hospital through health personnel (3 nurses, 1 doctor and 1 surgical technician), clinical assistance, medical equipment and disposable material. Refresher courses and training internships were held for the maternal and child health nurses of the two districts and the “health centre-community” link was strengthened with the involvement of the health committees of 30 villages.

In rural communities, the role of the traditional midwife is essential to encourage pregnant women to go to antenatal visits, to direct and accompany them to give birth in health facilities and to encourage them to go to check-ups after birth with their new-borns.

In this context, the “The first 1,000 days” project collaborated with the local health authorities to train 30 traditional midwives from 15 villages in the Balama district and 15 villages in the Montepuez district. In particular, traditional midwives have been trained to recognize situations at risk and complications in pregnant women and new-borns, promptly transferring patients with complications to health centres with specialized health personnel. The midwives were provided with: a telephone to alert the nurse at the health centre and request an ambulance, a flashlight, boots and raincoat to be operational 24 hours a day, in any season.

In the health area of Mirate, where the project trained 7 traditional midwives, in the first 10 months of the project over 40% of the women who gave birth in the health centre had been sent by traditional midwives. A really encouraging sign.

The intervention is part of the broader project “The first 1,000 days. Ensuring quality healthcare services for mothers and children in Cabo Delgado”, financed by the Italian Agency for Development Cooperation (AICS) and implemented by Doctors with Africa Cuamm with AIFO, Wiwanana Foundation and Centro per la Salute del Bambino Onlus (CSB).

A living memory

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Today is the fifth anniversary of the death of our beloved Don Luigi Mazzucato, historical director of Doctors with Africa CUAMM. His memory always remains deeply alive in those who have had the gift of knowing him, in Italy and in Africa. His testimony in CUAMM, which he has served with love and passion for over fifty years, continues to be an extraordinary reference for the present and the future of our Organization.

We want to remember him with his own words taken from his Spiritual Testament:

“Many times I have pleaded in the Our Father, also for CUAMM”. “Give us each day our daily bread”, in need I understood more what it means to lack what is necessary and I felt more pressing and urgent the commitment of CUAMM to choose and serve the poor, the poorest, those who have nothing and no one to help them.

It seems a miracle that, after more than 60 years from the birth of CUAMM, under the pressure of the evangelical motto “euntes curate infirmos” and the moral duty to promote the right to health for everybody, there is still people who decide to leave. Young people and adults, believers and not, but all motivated and of great professional seriousness, willing to engage with CUAMM and to bear witness to the dedication and love to the poor, in line with the inspiring principles and style of our non-governmental body of Doctors with Africa CUAMM, practicing preferential love for the poor.

Faced with the tragedies of poverty seen so many times in my travels in Africa, strong inner reactions were created within me. These emotions led me to express myself in critical terms for the lack of clarity and ability to say things, without seeking compromises or paying attention to conveniences, in the name of the Gospel and with respect for those who have no word. For me the rule has always been “poor but free”, free to choose, free to raise one’s voice when it is considered right and right to do so.

South Sudan resisting floods

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In Shambe, South Sudan, the health centre has been flooded by rains in recent months, but the refrigerator was rescued and is still working. To preserve the vaccines, which our operators are able to bring to the facility with the help of the local community, unwilling to be discouraged by the adverse climate.

The problems began last summer when large areas of South Sudan were flooded due to torrential rains and 856,000 people had to flee their homes, according to OCHA data. Not even Yirol East County, where the Shambe health centre is located, was spared from the floods and even today the water shows no sign of decreasing.

For this reason, in order to bring stocks of vaccines and drugs to the health centre, it is necessary a long journey by car, transferring the load on the back of mules and then inside some canoes to get, often wading on foot, to the old health centre, where an indispensable but unmovable refrigerator was hoisted on top of a stack of pallets.

Thanks to the connection with the solar panels, in fact, the refrigerator can continue to store the doses of vaccines, which are then distributed in a new temporary health centre, set up by our staff in collaboration with the community in a nearby dry area and more easily accessible by people.

The example of the commitment of the Shambe community to not lose their health centre is one of the many stories of perseverance that come from South Sudan. Many other health centres and small villages can only be reached by canoe or on foot, wading through the flooded areas, where the water comes to life and our workers and volunteers must carry basic necessities over their heads, so as not to get them wet.

Vaccines, drugs, but also treatments against malnutrition, which is increasing among the displaced: people left with nothing, after having fled their homes and lands by fleeing the water.

From the county of Awerial, in another part of South Sudan where we are partners of the South Sudanese ministry for health and nutrition, the figures are even worse than in recent months. The number of displaced people is now 70,000 and shows no signs of decreasing. The effects are also seen on the health system, already fragile and under stress. In September and October, outpatient visits to the health centre in Minkamen rose by 67%: mostly new residents, seeking basic care for the most common diseases, such as diarrhoea, malaria and malnutrition.

To respond to this problem, we have organized mobile clinics and strengthened the capillary network of village workers, who can bring care directly among the displaced communities, relieving health centres and reaching even the most isolated families.

In these days, this intervention has been expanded: in addition to Awerial County we will also bring mobile clinics to the Rumbek East, Rumbek Center and Yirol East areas. Everyone’s help is needed to ensure basic care for displaced people, but also for host communities, put to the test by the emergency.

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Shed light on the “shadow pandemic”

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Today, November 25th, is the International Day against Gender Violence, established by the General Assembly of the United Nations in 1999.

This year, the day draws attention to how the Covid-19 pandemic is causing an exponential and alarming increase in gender-based violence around the world, particularly in developing countries and in the most fragile contexts, where Doctors with Africa CUAMM operates.

The United Nations has called it “the shadow pandemic“, recalling the duty to shed light on this terrible violation of human rights and calling governments, international organizations and NGOs to actively participate in the initiatives on this day. Therefore a 16-days relay of activism against gender-based violence kicks off today, a campaign launched by UN Women that will end on December 10th, International Day for Human Rights. Activities will be organized to raise public awareness and promote what we can do to prevent and fight against this devastating phenomenon. A commitment that involves everyone, not just women.

Doctors with Africa CUAMM also joins and actively participates in this campaign in the various contexts in which it intervenes: “On the occasion of the 16 days of activism for the fight against gender based violence, all the communities in the areas where we operate will be involved with the double aim to raise awareness among communities and authorities on this issue, but above all to ensure that some of them become bearers of the message – says Frederic, CUAMM program manager in Juba, South Sudan -. Due to Covid-19 the activities have been rethought and after the launch of the initiatives in the the villages, CUAMM community operators will raise awareness door-to-door or within small groups of people. In addition, the staff who work in health facilities will be directly involved to help sensitize the communities on this issue – continues Frederic -. In order to reach the greatest number of people, various media will be used, in particular talk shows on local radio stations, in which CUAMM operators, together with local authorities and community members, will promote awareness-raising messages ».

IN THE TOWNS OF LEDRO AND VALLARSA IMPROVED FACILITIES FOR NURSING HOMES

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Trento, 20th November 2020 – Doctors with Africa CUAMM launched today in Ledro and Vallarsa, two towns in the region of Trento, two new facilities to support local nursing homes, allowing family visits in Ledro and more comfortable dressing rooms in Vallarsa.

These new spaces, funded by the U.S. Government through the United States Agency for International Development (USAID), will contribute to mitigate the effect of the COVID-19 epidemic, ensuring the safety and the mental health of elderly patients.

The new facilities were inaugurated during two different events in Vallarsa and Ledro. Massimo Giordani, general director of the local union of organizations for people’s assistance (UPIPA), attended both the ceremonies, with Fr. Dante Carraro, director of Doctors with Africa Cuamm, and Andrea Atzori, chief of party of IRC19, the project which funded the facilities. In Vallarsa at 10 AM Luca Costa, major of the town, was present, with Giulia Stoffella and Michela Plazzer, president and director of the nursing home “don Giuseppe Cumer”, respectively. In Ledro at 1 PM Marisa Dubini and Roberto Povoli, president and director of the nursing home “Giacomo Cis”, welcomed the visitors.

The inauguration in Ledro.

Ledro: a new space to meet the family

The new space delivered to the nursing home of Ledro will allow visits from family members to the patients. It is joined with the main building of the house but accessible for external visitors from a different path, and it is provided of plexiglass panels to guarantee the safety of the guests of the health facility.

Given the vulnerability of the people admitted, visits from family members were forbidden between March and May 2020 in the majority of the nursing homes in Italy, with important consequences on the mental health of the people: both amid patients and relatives. With the new facility of Ledro the problem will be solved even during the upcoming months.

Vallarsa: a new changing room and a better meeting space for a covid-free facility

In Vallarsa, the nursing home pointed out the need for a new changing room for the staff, in order to maintain the structure Covid-free, not mixing clothes, personal protective equipment and scrubs. Over the last months, the staff has been using a tent built in the garden, but with the coming of winter the new space will guarantee a more comfortable place for nurses and health workers.

The new facility built in Vallarsa.

In the frame of the same project, in Vallarsa part of the patio of the nursing home has been arranged to serve as a meeting space for family visits, respecting physical distancing and safety standards during winter.

Fr. Dante Carraro, director of Doctors with Africa CUAMM, stated, “This pandemic shows us that we have to take care of the most vulnerable people. In Africa, we have been doing that for decades, focusing on the health of mothers and children in the first place. In Italy, it is clear that elderly people are much in need. For this reason, following suggestions from our doctors who have come back from Africa and are now working around Italy and here in Trento’s region too, we decided to do something specific also for nursing homes.”

 

Andrea Atzori, chief of party of Doctors with Africa CUAMM’s “Italian Response to Covid-19” project (IRC19) stated,” These two new facilities are part of a larger project that aims to create more resilient healthcare facilities and communities and to provide training for the future generation of healthcare professionals. We see how the knowledge gathered in many years of work in epidemics in Africa today is fundamental in Italy as well. We are glad we can bring help even here in Trento’s region, thanks to the work of our volunteers and to the U.S. Government, which is supporting a number of initiatives in Italy, aiming at reducing the impact of the COVID-19 epidemic.”

USAID, which funds IRC19, is the U.S. Government’s premiere development organization operating in more than 100 countries worldwide.

 

This press release is made possible by the generous support of the American people through the United States Agency for International Development (USAID). The contents are the responsibility of Doctors with Africa CUAMM, recipient of the Fixed Amount Award (FAA) No. 7200AA20FA00013 and do not necessarily reflect the views of USAID or the United States Government.

Open the eyes to the world

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Birth ensures the grace of sight to most of us, but not everyone enjoys this privilege. The warm colour of dawn that rises and illuminates the landscape, the shimmer of the water in contact with the sun rays, its own reflection, the nuances of the loved ones’ faces. How many have experienced these emotions thanks to the eyes? And how many instead, were allowed just to imagine these sensations through the stories of others?

It is normal that the sight weakens as we age, but it is not as obvious not being able to prevent this worsening and tackle it. In January 2020 Christian Blind Mission (CBM) in collaboration with Doctors with Africa CUAMM and with the support of the Italian Agency for Development Cooperation (AICS), launched the “ForeSeeing Inclusion” project dedicated to the healthcare of sight in the north of Uganda. The intervention, lasting three years, includes the involvement of over 76,521 beneficiaries and aims to contribute to the reduction of avoidable blindness by 2021, in particular in three districts: Arua, Kitgum and Lamwo.

According to the latest national census (2014), 32% of all individuals with visual impairments in Uganda are concentrated in the north of the country and 75% of these suffer from a blindness that could be avoidable, with proper knowledge and tools,. Among the most frequent problems, there is trachoma, a bacterial infection of the conjunctiva and cornea of the eye, transmissible by contact but easily treatable if identified promptly.

Andresiru Joyce, 41, is affected by it but was born in the “wrong” part of the world. For years she had been suffering from pain, itching and a very strong tearing that almost prevented her from opening her eyes, when she finally heard of this project. She arrived at the Omugo clinic from the village of Arawutuku, wearing a hat to protect herself from the light but above all to hide the shame for her condition from anyone around her. She could not see distant objects or turn her head freely to see things around her. She was given antibiotics for a week to be able to perform surgery. The operation at the Arua hospital was a success and after a few days she was discharged: «I am very grateful for the support these organizations give to the hospital. They saved my sight. I no longer feel any pain, no irritation, no tears and I am able to see clearly without any difficulty thanks to the operation ». Joyce said happily during the routine check-up at her home by the CUAMM team.

Buziru Felister, 54, also had a similar story with a successful ending. Breadwinner and mother of four children in the village of Ariaabo, she is one of the patients who benefited from the support of CBM and Doctors with Africa CUAMM. For two weeks Felister spent sleepless nights due to headaches and terrible pain in his left eye. On June 27, she arrived at the Omugocon health center with an eye bandage made of non-sterilized fabric, which took almost all of her head. She could not see absolutely anything from her left eye, due to a scar on her cornea that had turned black over time. In her condition, the only chance was the removal of the eye but, in order not to feel that pain again, Felister was ready to face the reality and she was looking forward to proceeding with the surgery. Just the imagination of a life without that suffering made her happy and relieved. After the operation and a few days under observation, Felister improved a lot and she was discharged.

«I have no more headaches and pain, I can sleep well, I can hoe and do other housework. I would like to thank the whole team, in particular the ophthalmologists of the facility for saving me, supporting me during the free surgery and with continuous checks – said Felister – I hope they can continue to support other vulnerable people like me, people that couldn’t live normally without this intervention but only enduring pain or even losing their sight completely».

The ophthalmologists of the facility are happy together with the patients, as emerges from the words of Lotomya Juliet, operator of the ophthalmic clinic: «I treasure everyday experiences. This project developed my skills in eye healthcare and made me even more aware of how essential sight is. It is beautiful and very rewarding to be the reason for a beautiful smile on patients’ faces when they regain sight – continues Juliet -. Many people came to the HC with complicated situations that caused them so much pain, the condition of some of them is so serious that they do not have a long life expectancy. But the patients here feel cared for and when they go out, more relieved. They ask me how long I will stay in the centre of Omugo and when I answer “for three years”, they are happy».

Many patients, as they age, have presbyopia – a condition that does not allow them to see clearly up close – and thanks to the correction of the eyes’ gradation, they are surprised how their vision improves and they can see well again.

«The scene is very funny – Juliet continues – They cry out for joy, they feel younger and see life more clearly. These experiences make me reflect on how tremendous blindness can be once one has enjoyed the extraordinary beauty of nature. All this gives me the inspiration and motivation to continue studying and developing my skills, so that I can continue to have an impact on the lives of people in my community by offering adequate eye care”.

Tha vital power of the patients, the passion of health personnel, and a targeted intervention: these are the ingredients so that more and more people may open their eyes to the world.

Taking care of the future

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Today, on the occasion of the World Prematurity Day, and in the coming days, Doctors with Africa CUAMM is organizing various trainings and awareness-raising initiatives on the topic, involving doctors and health professionals to share experiences and good practices.

Every year, 15 million children are born prematurely in the world, more than one out of ten children, 2,5 million dies during the first month of life. Preterm birth is among the leading cause of infant deaths under five. Still, premature birth is not the same all over the world: in Africa it is a double challenge that forces to deal with limited resources and hospitals often unprepared to welcome a preterm baby. Until recently, the concept of “neonatal care” did not exist in Africa and Neonatology wards are just a recent reality. The few skilled human resources available to the hospitals had no experience with young patients. Therefore, in this context, being born premature often meant not surviving. Today, however, things start to change: the attention and care towards the newborn are improving, as well as the presence of Neonatology wards in hospitals, although training and resources need to be further strengthened.

We renew our dedicated commitment to maternal and child health that we promote through our projects in the eight African countries in which we operate and in particular through the “Mothers and children first. 1,000 days” program. This day is not only an opportunity to draw attention and raise awareness on the topics of preterm birth, child survival and development, but it is also an important chance to talk about concrete solutions.

Taking care of premature babies means first and foremost taking care of and supporting their families, supporting health workers by providing them with all the resources they need to better manage their young patients, and not least being committed to strengthening health systems.

Because taking care of the children, especially premature babies, means “taking care of the future”.

When a refrigerator can save lives

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The emergency does not allow much time and an immediate response is essential. Until recently, there were no blood transfusions at the Turmi hospital in the South Omo region of Ethiopia. There was a lack of skilled personnel and patients who needed blood had to be transferred to Jinka, in the hospital of the chief town. What separates the need of communities from essential healthcare is often the distance, the travel time to reach the nearest health center and sometimes a too rapid worsening of clinical conditions. A fragile context, therefore, where we try to face complexities day by day. The project “The first 1000 days. Guaranteeing quality health services to mothers and children in the South Omo Zone” supported by the Italian Agency for Development Cooperation (AICS) and implemented by Doctors with Africa CUAMM, helps promote concrete change: a refrigerator powered by solar panels has been ensured, allowing the storage of some blood bags even at the Turmi hospital.

Thanks to this contribution and in particular to the presence of Memuna, the Emergency Surgical Officer in Turmi, in September the first blood transfusion was carried out to a pregnant girl, of Hamer ethnicity, with severe anemia and a very low level of hemoglobin in the blood. The woman arrived at the hospital because she felt very weak, with “pale conjunctivae”. A similar patient would previously have been immediately transferred to Jinka, forcing her not only to incur a huge expense but also causing her great distress, as the Hamers feel like “fish out of water” in the city and do not want to stay there too long.

«The change is finally beginning to be more evident- said Memuna -. We are able to respond to more emergencies and manage a greater number of caesarean sections; working together, we are able to guarantee a better service also for the management of those cases that would have surely been transferred to Jinka before».

Small contributions, simple equipment, often taken for granted here as a refrigerator, can really make a difference and save people’s lives in a limited resource context.