But the nation’s health centers are often on the frontlines as well, keeping an eye out for potential cases, comforting fearful patients, and sometimes even going out into the community to evaluate individuals.

On Tuesday, the CDC announced that the spread of the coronavirus, now called COVID-19, in the United States is all but inevitable.

In addition, the discovery of a coronavirus patient who had not recently traveled to China and who had no known exposure to travelers was announced on Thursday. Because the patient did not fit the CDC’s criteria for testing, the announcement stoked fears that this might be an instance of “community spread” – the transmission of the disease through unknown sources.

Dr. Ron Yee is a health center physician and the chief medical officer for the National Association of Community Health Centers, an organization representing the nation’s more than 1,400 health centers. He said that the arrival of the coronavirus – and the CDC’s recent announcement – have had a significant impact on facilities around the country.

Dr. Yee sat down with Direct Relief to talk about how COVID-19 has affected American health centers and their patients, from supply shortages to social stigma.

Direct Relief: Let’s talk about this recent CDC announcement that coronavirus is likely going to spread in the United States, and we have to be prepared for it. How will health centers respond to that news?

Dr. Yee: NACHC has been in contact directly with the CDC’s coronavirus response team, probably multiple times a week. They don’t feel…like they’re seeing a “community spread” yet, meaning that we’re not seeing a bunch of person-to-person cases popping up all over the country.

So I think we want to find the balance of educating our folks but not causing a panic.

We are doing a webinar [for health centers] next week in conjunction with the CDC. That’s what we did with Ebola back in 2014.

How do you tie in your response efforts? How do you transport patients? What do you do about testing? How do you pay for testing? We will walk through all the operational aspects of what happens when someone calls up or is possibly going to the hospital or isolation if they’re a person under investigation or suspected of having a true exposure.

Direct Relief: How well stocked are health centers around the country with personal protective equipment (PPE)? What do they have? What do they need? Are there pockets where the supply level is higher or lower?

Dr. Yee: The Emergency Management Advisory Coalition is a coalition of community health centers that monitor this. They have seen geographically where there are some shortages. [The shortages] are not nationwide, they’re very specific, and I think most of those are around where they have [significant] Asian and Pacific Islander populations.

People are on high alert and so they’re going to use up their PPE a lot faster, even the surgical masks. They’re not truly following the CDC guidelines that you don’t need [PPE] unless you have a true exposure. There’s a lot of fear in the field.

There’s also a stigma that’s been going on. People of Asian descent – people are starting to ask them questions like, “Have you gone to China?” Or “How come you’re not wearing a mask?”

Direct Relief: How is the CDC’s new announcement [about coronavirus’s likely spread] helpful? In what ways does it create new challenges?

Dr. Yee: It’s a double-edged sword. It’s helpful in that it’s being publicized and people need to be aware of it. You can’t just sit back and go, “Oh, it’s no big deal, it’s not going to go anywhere.”

On the other side, you don’t want to cause mass hysteria, and we’re seeing that in certain geographic areas where all the PPE is being used up for no reason. The CDC has put out specific recommendations on how to selectively use personal protective equipment in the right way so that you don’t wipe out supplies.

And they’re very specific about taking the right kind of history. First of all, keeping [potentially sick] people out of the healthcare facility, evaluating them even if it takes seeing them in their car so that they don’t expose other people.

If you don’t think about [the risk] objectively, then you get caught in this emotional thing and you go [to a health center] if…you haven’t been exposed. I think people are thinking, “Oh, maybe I stood next to somebody who had it. They came from China,” or something.

But if you read the CDC instructions, you have to be within six feet of the person and it has to be for a certain amount of time.

We’re trying to find the right balance of educating, but not causing a panic.

Direct Relief: So people are descending on health centers. Is that primarily a concern because they’re using up resources or because they’re making it more difficult to provide routine care? Why is it bad to have more people coming in?

Dr. Yee: I wouldn’t say it’s bad because that’s why we’re there.

Health centers are positioned perfectly because they have trusting relationships with folks already. I delivered kids that I followed for 20 years. So you have these relationships and they come to us and they trust us.

That’s when we say, “Look, you don’t have to get all panicked about this. Yes, this is happening in the U.S., but here’s how you protect yourself.”

We never want to say, “Don’t come to the center,” unless we’re telling them, “If you think you actually have it after you’ve walked through [the CDC’s screening questions] and thought about it, don’t come in because we want to take care of you outside [the facility].”

And we will arrange for that, whether that means coming to your car or whatever…if they meet the criteria of fever, cough, shortness of breath, exposure either directly from China or someone who’s been to China.

If somebody needs to be seen, and maybe they have a chronic disease and they’re older, and they’re really worried about this because those are the people that end up dying, we never want to miss a case like that.

Direct Relief: You mentioned that health centers are really well-positioned for this kind of response. What do health centers do well when it comes to dealing with this kind of thing? And what gives you concern or is less effective?

Dr. Yee: We’ve got, what, 1,400 health centers across the U.S., every territory, D.C. and Puerto Rico. And there’s a high trust level. Centers are where people go for their healthcare and the continuity of care is critical.

The other thing is that health centers are staffed by people who live in the community. A lot of times, my medical assistant might check in with her aunt or uncle to see me. There’s a relationship, we understand the community culturally and linguistically. All of those elements are [present] in the staff that works in the health center.

On the negative side, the biggest challenge is, “How do you educate?” There’s what, 230,000 employees at the health center. How do you educate 230,000 people on the best way to handle coronavirus or Ebola or whatever’s coming out?

[We also need to have] a very standardized approach to handling things, like the CDC, laying out guidelines and ways to handle [the outbreak].

How do we set up opportunities for people to hear the message, and then how do we nuance it for the health center: What does this look like specifically for you? What do you do when your patient calls up and says “Look, I don’t know if I was exposed or not. How do I handle this? Do I come into the clinic?” Those are the pieces that we’re working out right now.

This interview has been edited and condensed.

The post “Educating Our Folks, but Not Causing a Panic.” A Chief Medical Officer On Coronavirus. appeared first on Direct Relief.

But unlike the obsolete technology, the bacterial infection has made a roaring comeback in recent years, along with chlamydia and gonorrhea, reaching a record in 2017 with more than 2 million new cases, according to the U.S. Centers for Disease Control and Prevention. Syphilis accounts for 30,644 of those cases, up 76% in 2017 compared to 2013.

This staggering rise comes after a period of historic lows. In 1998, syphilis cases decreased by 86% from 1990 and were at World War II levels, according to a 2017 Lancet-published paper authored by Dr. Edward W. Hook III, professor of medicine, epidemiology and microbiology at University of Alabama at Birmingham.

The spike since 2013 has frustrated health care providers and public health officials, since syphilis is relatively easy to diagnose and cure.

“We should’ve had success in eliminating it years and years ago,” said Hook.

And the stakes are high, based on the latest guidance from the CDC, which outlines the potential outcomes of untreated syphilis.

“There are more serious consequences than previously thought: ocular symptoms, neurological symptoms, auditory symptoms, said Kyle Bernstein, PhD, CDC Division of STD branch chief for epidemiology and statistics.

A person exposed to HIV also has a higher risk of contracting the virus if they suffer from syphilis, according to the CDC.

The bacterial infection can become a congenital disease, and potentially life-threatening to the infant. Instances of congenital syphilis have more than doubled from 2013-2017 and there is an 80% chance of a mother passing syphilis to her baby if it’s left untreated. New cases in women surged 21% from 2016-2017.

“There is not one magic factor causing all this,” said Bernstein, but both he and Hook noted the erosion of public health funding across the U.S. as one contributing issue, which has made it more difficult for people with less means to access even basic healthcare.

In 2017, $750 million was cut from the CDC’s budget to fund the U.S. public health system via the Prevention and Public Health Fund, with $1.35 billion to be cut from that program over the next 10 years.

“Persons in lower socioeconomic situations have less access to healthcare, less access to culturally competent healthcare, and are not accessing screening services as much as folks who have higher socioeconomic status,” said Bernstein, who added, along with Hook, that another at-risk population is men who have sex with men.

A Battle on Two Fronts

Hook referenced the stigmas which surround sexually transmitted diseases as a reason for why people are reluctant to be tested, especially if it’s less readily accessible to them.

“Nobody wants to think they have an STI (sexually transmitted infection which can precede a sexually transmitted disease), so they don’t necessarily seek care for those problems, and the lack of access makes it harder to get care,” he said.

“Since the very beginning of the 20th century, there have been organized public health efforts to control STIs, which by and large have not succeeded very well, and I think stigma is a large part of that,” he said.

These factors have contributed to a situation where the chances of an American contracting syphilis are below 1%. But for individuals who have contracted syphilis, the risk of contracting it again jumps to approximately 25%, according to figures cited by Dr. Hook

The challenges presented are particularly acute at health centers and free clinics, which primarily serve low-income and uninsured patients. Many clinics have seen their budgets cut, which has hampered their ability to treat STDs, as do the pervasive daily challenges facing many of their patients.

Manhattan-based Ryan Health has avoided financial struggles thanks to being a Federally Qualified Health Center and receiving grants to combat STD’s.

“With the help of these financial resources, we are able to respond to the STD epidemic,” said Dr. Jeanne Carey, Medical Director of Ryan Health’s East Village, Manhattan location.

She also noted the barriers that impair access treatment.

“Patients who are not documented or who lack health insurance may be reluctant to seek medical care; they may not realize that there are federally qualified health centers and city department of health clinics where they can access confidential STD counseling, testing and treatment for very low or no cost,” she said.

Because of the difficulties in consistent treatment, Bicillin is the preferred treatment option, since it only requires a single dose and eliminates the need for repeat visits. It is also the only treatment available for pregnant women.

“It is slowly released from the muscle which leads to prolonged drug levels in the body. This is a big advantage for patients who have medication adherence barriers, since the other treatment protocols require multiple doses for multiple days and may not be as effective,” explained Direct Relief Pharmacist Alycia Clark.

Smarter Ways to Attack an Old Disease

Direct Relief has provided Pfizer-donated Bicillin throughout the United States after undertaking an initiative to better understand where syphilis rates were spiking by analyzing and mapping new cases relative to population sizes.

“With the syphilis infection rates climbing in the United States it was important that the donation of Bicillin was distributed effectively and used to help communities hardest hit,” said Rose Levy, a U.S. Program Manager at Direct Relief.

In the per capita report, counties with big cities — New York City and San Francisco — appeared alongside sparsely-populated rural counties, such as Cook County, Georgia, and Tunica, Mississippi.

The map, created using Esri ArcGIS software, displays CDC data of primary and secondary rates of syphilis by U.S. county.

Bernstein suggested several ways to help alleviate the transmission of syphilis from a public health standpoint.

“There are a number of things important to advancing the field, including better diagnostics done at point of care, rapid care, more alternative treatments,” he said.

For pregnant women, he recommended testing at the first prenatal visit, at 28 weeks, and at delivery.

“Through increased screening, we are diagnosing and treating STDs in a lot of people who had no symptoms and did not consider themselves to be at risk,” said Carey, about all populations.

With syphilis, screening is important because the symptoms in the primary (usually painless sores) and secondary (rashes and legions) stages will typically resolve on their own, even though the bacteria stays present and can cause more complications such as tertiary stage syphilis, neurosyphilis, or ocular syphilis, which attack the organs, brain and nervous system, or eyes, respectively.

Bernstein warned that the current situation is a “sentinel event, like a canary in the coal mine,” referring to larger systemic issues within the healthcare system that have allowed for syphilis cases to increase.

“We don’t want to accept this increase as the new normal,” Bernstein said.

While the broader political and societal issues may take some time to address, Bernstein pointed out a fundamental reason to remain optimistic about beating back the disease.

“[Syphilis] remains pretty simple to detect and treat,” he said.

The post Fight Continues Against Syphilis Comeback appeared first on Direct Relief.

The road from Addis Ababa to Adama is a study in the contrasts of contemporary Africa. Leaving Addis toward the southeast, we see the gleaming concrete and steel shell of the nearly completed tram line that promises to relieve some of the congestion on the city’s clogged roads. We pass block after block of empty housing developments, which, in theory, will fill with the new transit lines.

But the roads themselves remain pockmarked with potholes and bathed in dust and debris. Poorly fed horses stand in the middle of the street; gaunt and unconcerned, routing traffic around them. Older women bend down, their faces straining, carrying hefty loads of discarded plastic bottles wrapped in gauze tarps, presumably for sale or recycling. Alongside the road, drivers of makeshift horse-carts ferry food and other goods to points unknown, reminiscent of scenes out of any number of decades past.

And then, as if turning the page from one era to the next, we arrive at the on-ramp to the recently completed Addis-Adama Expressway. Built mostly with Chinese labor and funded with low-cost Chinese capital, the expressway appears almost like a mirage of an onrushing high-speed Africa. Endless fields of green tef grain speed past. Wind farms spin on hilltops, powering waves of rural electrification. Our pace is now more than double what it was minutes ago as we accelerate towards Adama and the regional public health laboratory for the Oromia region. Traffic, however, remains strikingly below the levels we have just left behind, possibly because few can afford the new thoroughfare’s toll.

In some ways, like the expressway that leads toward it, the Adama regional laboratory reads like a vibrant sign of an emerging but incomplete African future. It was built in 2013 with funding from the US Centers for Disease Control and USAID and operates at reasonable capacity. Brand new lab equipment hums with life in almost every room. Behind an alarmingly marked glass door sits an industrial negative-pressure storage chamber for samples of highly contagious MDR tuberculosis. The Adama laboratory seems like a model of clean, efficient diagnostic technology. And yet, there is still much work to be done.

In the regional lab director’s furniture-packed second-floor office, we call up samples of GIS maps, web applications and Tableau dashboards to review. The director is impressed and enthusiastic.  Although Adama regional laboratory is stocked with some of the best in medical diagnostic equipment, its lab information system lacks an analytics front-end. So their diagnostic output tends to be conceptualized in terms of individual patients or samples rather than in terms of populations or overall laboratory processes. GIS and Tableau might change that.

Returning to Addis after a long day of project evaluation, a thought occurs to me. If the laboratories can be networked into the type of integrated and visually rich information environment we’ve been envisioning, then the future of Ethiopia’s public health system might be one where the transfer of essential medical data is no longer contingent on the horses standing in our path.

The post Labs for Life: Ethiopia (Part Four) appeared first on Direct Relief.

It’s a wet and chilly Monday morning outside the Addis Ababa Regional Laboratory (AARL). The thick metal gates open wide and a motorcycle with knobby tires and a tall yellow container attached to its rear roars up to the front reception area. In large block letters the container reads, “Ethiopia Mail.” Inside the yellow container is a battered blue cooler with peeling biohazard stickers affixed to both sides. Specimens in Ethiopia move through an agreement with the postal service.

The driver dismounts, removes the blue cooler, and carries it over to the receptionist’s desk. She extracts a pair of translucent plastic packs, which in turn contain a set of thin, stoppered vials full of dark red blood. The vials each have barcode stickers, which are read by a hand scanner. The receptionist also enters several columns of information manually into a spreadsheet. This includes information on the specimen’s origin and its departure and arrival time, which is connected to the laboratory information system.

We’re witnessing the intake process for potentially HIV positive and high-viral-load blood specimens.

Notebooks and pens in hand, we pepper the staff with questions: Is there a regular schedule for the referral of testing samples from healthcare facilities to the regional lab? Yes. Can we have a copy for mapping? Of course, but it’s all on paper. How often does any particular facility send samples to the lab? Once per week. Do you know how long it takes to return the results? It should be about one week, but it could be longer.  Does part of the intake process always involve manual data entry? Yes, unfortunately, but some diagnostic machines such as CD4 and hematology are linked directly to the LIS. Is there anyone checking on this data in terms of structure and quality? The lab has a data quality team of 5 persons. Are all of your machines functioning right now? There’s one that’s been out for a little while, but it should be on the repair list.

Later, when we’re back at EPHI, I check my freshly built map. It tracks the national inventory of CD4 counters, and, sure enough, there’s a point for the AARL indicating that a machine is in need of repair.  All of this process graphing points to positive signs that our spatial data integrations could work.

One of the LIS staff from EPHI has accompanied us to AARL. We brief the lab director about the BD-PEPFAR program and our GIS project for viral load testing and equipment maintenance tracking. Meanwhile, the LIS staff downloads five years of viral load specimen data for us onto a USB stick. We’ll be able to pair this dataset with the one from EPHI.

Our assessment takes about an hour and a half. Anmol has a conference call to make, so the rest of us decide to walk the ½km back to the hotel to work. Before we’re even past the laboratory gates a man walks up beside me and spits on the ground, getting a few flecks of it on my pants. I try to explain that everything’s fine and not to worry while I walk, but he insists on wiping the side of my leg with a cloth.

Abruptly the man turns to leave. I quickly realize that my Android is no longer in my pocket. I stop him just before he darts into the street. He returns my phone with a sheepish shrug. I suppose no harm has been done, but from now on I’ll keep my phone in my zippered pocket.

Back in our hotel conference room, Adam loads the AARL data into Tableau while Jessica and Anmol take over on Excel. We grind through another marathon geocoding and data cleaning session. By late-afternoon Monday, our vision is blurry, and the team is in dire need of food and caffeine.

But there’s good news: the data model derived from our EPHI work last week turns out to work for us once again, with only minor variations. We can see age and gender distributions sprouting, along with the spatial distribution of the specimen network for Addis subdivided by scheduled day, testing frequencies and viral load results. Now that we’ve completed data cleanup and formatting on a second major lab, there’s every reason to believe that most every LIS system in Ethiopia — at least those from the same vendor — ought to allow us to back out a spatial understanding of the specimen referral network.

My long-deferred idea from four years ago is one small step closer to reality.

The post Labs for Life: Ethiopia (Part Three) appeared first on Direct Relief.

Most of the hard work in GIS has nothing to do with making maps. The heart of the matter, from a functional point of view at least, is not the pretty pictures but the quality, sourcing, content and structure of the data which feeds those images. Without quality data, there can be no quality GIS.

This lesson has been driven home with a vengeance over the past couple of days, as we’ve struggled to formulate a prototype that is capable of visualizing Ethiopia’s viral load specimen referral network. From where exactly will the data come? In what shape is it? How much work is required to clean it up? Do we even have sufficient permissions to proceed?

The team huddles on Wednesday afternoon after the initial conceptual GIS presentation and concludes that the only viable short-term strategy is to zero in on EPHI itself. We’re going to base ourselves at the prototype stage on historical data from EPHI’s laboratory information system (LIS). The LIS integrates several testing systems, including biology, chemistry, hematology, CD4 and viral load, as well as TB sequencing. Since it’s the national reference laboratory, EPHI receives at least a few specimens regularly from a landscape of clinical sites scattered throughout the country. From referral locations and key indicators such as testing totals, turnaround time, and test results, their LIS should contain enough information to illustrate at least one slice of Ethiopia’s viral load specimen referral network.

Once we’ve decided on a course of action, Adam and Anmol run over to track down Tigist, EPHI’s IT director. Explaining our plan, they’re able to secure permission from her to utilize the past five years of viral load data for our initial experiment in specimen referral mapping. We’re in business.

By the morning, it’s clear once again though that even modest projects with sufficient clearance face enormous challenges. The LIS was not designed with spatial analysis in mind, so it doesn’t yield easily to our goals. Like many datasets over which one has no authorship or control, there is a wide, muddy field to cross in terms of data cleaning and organization before it can become even moderately readable in GIS.

On Thursday, while one of our team members recovers from illness, the remaining group digs into the data with a local advisor, assigned to train with us, from Heal TB. The stark reality is that there is no standard in place for location descriptions, nor a matching set of IDs to leverage into viable data integration units. The geocoding problem, in particular, or the identification and attachment of coordinate points for mapping, beckons us to climb down deeper and deeper into the muck of tedious detail.

But the team is persistent. After several hours’ worth of careful code-matching, spreadsheet restructuring, field parsing and manual lookups our raw material starts to look like it contains the basis of cartographic form.  We have ourselves a working core dataset.  

Back at the hotel Thursday night, we rejoin our recovering colleague and manage to convince the concierge to open a quiet conference room up on the 12th floor for us to work. Up until the wee hours Friday morning we’re merging datasets, measuring indicators, and hammering out the first draft mapping applications in ArcGIS Online. Around 2 am East Africa time is the very first moment any of us sees this network on-screen. Even partially complete, it’s sort of exhilarating.

Friday morning, we’re back at EPHI to reconnect with primary stakeholders and review our progress. They’re a little bit stunned.  In just one week, we have pulled together a functioning model web application that enables spatial analysis of a laboratory network, in a way never before seen. Hotspot analytics are enabled in the desktop and the browser. Core indicators have been loaded into a geodatabase. By the light of our Powerpoint slides, feedback comes fast and furious from all corners of the CDC conference room.

As the first week comes to a close, the BD-PEPFAR group has its marching orders: widen the sphere of activity from EPHI to the regions, refine the data model and expand from the initial prototype phase towards viable and shareable GIS tools. 

Starting Monday, the team is heading from EPHI to the regional labs, beginning at the Addis Ababa Regional Lab and moving the following week to the Adama Regional Lab. Ethiopia’s laboratory landscape is taking shape.

The post Labs for Life: Ethiopia (Part 2) appeared first on Direct Relief.

Representatives from the Ministry of Health and the Clinton Health Access Initiative are here, alongside multiple branches of the Ethiopian Public Health Institute (EPHI), the CDC, and my team of invaluable professional volunteers in the BD-PEPFAR Labs for Life program. That team includes Adam Yeung, a health data and market analysis specialist from BD’s France offices, Anmol Chopra, a research and development specialist from BD’s India offices, and my new colleague at Direct Relief, Jessica White, who has just joined us from Stanford University. We’re here to teach basic skills in geographic information systems (GIS) to our local counterparts and to build a set of prototype mapping applications targeted towards strategic improvements in Ethiopia’s national system for diagnosing and treating HIV and tuberculosis.  

Every day, across Ethiopia, blood is being drawn and sputum collected from people suspected of infection with some of the world’s deadliest diseases. Without timely results their conditions will worsen, many of their lives will be threatened, and the risk of transmission to others will increase. Those specimen samples, once collected, are sent to hospitals and regional laboratories, usually in special packaging designed to be carried safely by the Ethiopian postal service. CD4 counts are run, viral loads are tested and TB samples are sequenced, then returned back to health clinics and hospitals where they inform medical judgments about treatment regimens and patient well-being. Sometimes, perhaps far more often than anyone would like, no diagnosis is possible because the specimens arrive at their destination unable to be read. In that case people who may be carrying serious viral infections, do not learn their status and cannot be treated appropriately.

The diagnostic system is literally the lifeblood of the healthcare system, constantly producing the epidemiological equivalent of actionable intelligence. It’s maybe a truism, but without accurate diagnosis there can be no effective treatment. Yet up until very recently there was no systematic overview of Ethiopia’s national laboratory system because there was no map. Questions like, “where are MDR-TB cases emerging most rapidly?” or, “which labs are having the hardest time meeting quality standards,” or  “what is the best way to scale up HIV viral load testing throughout the country?” had to be answered for the most part without detailed spatial information. As a result, analysis was delayed too long, hypotheses went untested, leads went unfollowed, and epidemiology lagged behind the events of the world, sometimes to alarming extents.

The BD-PEPFAR Labs for Life program is a public-private partnership which aims to make a systematic, long-term intervention in the laboratory systems of multiple countries in Africa and Asia through a combination of training, improvements in equipment and supplies, and targeted informatics. GIS is being used in this program to establish baseline conditions for spatial analysis of specimen referral, viral load testing and core lab systems effectiveness.  The maps that we build here, even if only in their prototype form, will hopefully allow EPHI and others in the CDC and the MOH to make more rapid, intelligent and targeted decisions based on detailed, accurate and timely spatial information.  

By the end of today’s initial training exercise the rain has subsided, my voice has recovered and I’ve somehow managed not to slip on the floor and break my neck. We have people lined up three and four deep to install software on their laptops and get logged in to ArcGIS Online to join groups we have set up as virtual collaborative workspaces. There’s a palpable sense of anticipation around the projects we’re planning to do together. Although GIS is brand new to many of the people in the room, we have an excellent mix of experience and enthusiasm.  In the hallway I debrief with Gonfa Ayana, the Director of the Regional Lab Capacity Building program. He’s eager to connect us with data and set up targeted training sessions around specific problem sets.

Our BD-PEPFAR team is in Ethiopia until the 4th of September, during which time I’ll be relaying our progress and conveying the ups and downs of geographic analysis and map development for some of the world’s most challenging problems, as our work unfolds, in near real time. Check back for updates.

The post Labs for Life: Ethiopia (Day 1) appeared first on Direct Relief.

Normally, as the flu season gets underway during the September-October time frame, the Centers for Disease Control (CDC) provide an invaluable service by keeping a close watch on the changing numbers of flu cases distributed around the country.

This year, however, the CDC flu tracking system is unavailable due to the ongoing shutdown of the federal government.

Direct Relief depends on CDC data about flu trends in order to understand how best to offer support to the national network of over 1100 safety net health centers and the patients who depend on them for essential healthcare.

Using analytic tools from software company Palantir, Direct Relief is integrating the best open source data available on flu trends, from Google and Healthmap.org along with background population data on risk factors including age and prevalence of respiratory illness, to get as clear a picture as possible of changing patterns of flu infection.

Every week throughout the 2013-14 flu season Direct Relief will be publishing an up-to-date seasonal influenza report based on open data, identifying key hotspots and frontline health centers in need of support.

The post Tracking Flu Trends to Better Support Health Centers appeared first on Direct Relief.

The associate program is a competitive two-year paid fellowship in which each PHAP associate is placed at a public health agency and works alongside public health professionals.

The Grand Haven, Michigan native told Direct Relief that his experience  as a Global Health Intern with Direct Relief’s partner, Centro Vivir Con Diabetes (CVCD) in Cochabamba, Bolivia, helped him gain valuable insight to how multiple organizations can work together for a cause and provided him a good example of what he wants to do when he works in health policy.

“Working with different stakeholders to implement solutions that are sustainable in the long term – that’s how you fight a chronic illness like diabetes,” said the ’13 University of Michigan public policy graduate.

As the only clinic in the country solely focused on diabetes, providing comprehensive treatment and education, Jacboson said he’s impressed with CVCD’s  mission to tackle a growing chronic disease.

“Without [CVCD] these people would have no where else to go; they would never even hear of diabetes until it’s too late,” he said. “Without government help, it’s all up to the private and nonprofit sectors.”

While interning with CVCD, Jacobson helped create a marketing strategy for the health center’s restaurant that serves healthy options for people with diabetes and helps raise revenue to subsidize care for its poorer patients. Together, the students – selected from a variety of academic backgrounds – act as a mini consulting team to improve services and ideas at CVCD.

“Michael, and the rest of the team, approached this project with an exemplary mix of humility and intelligence,” said Andrew Schroeder, Direct Relief’s Director of Research and Analysis. “They spent the time and effort required to understand the local nuances of CVCD’s operating model from the inside, which proved invaluable to their ability to apply their own expertise in smart and sustainable ways to the Center’s needs. Direct Relief and CVCD are very proud of the high level work the University of Michigan students accomplished in a very short time.”

Jacboson was equally impressed with Direct Relief’s work.

“[Direct Relief is] making such good investments that help the clinic directly help those in need,” he said.

His experience in Bolivia wasn’t his first time working overseas on public-health related projects. Jacobson previously traveled to Zambia to aid with HIV/AIDS research as well as to Ghana to conduct a survey on blood donation shortages at a hospital.

However, Jacobson said his time with CVCD helped him become more well-rounded and beefed up the expertise he needed to be accepted to the PHAP fellowship.  “I wanted to learn more about diabetes because its a growing field throughout the whole world, especially in the United States.”

When not doing health policy-related things, the self-proclaimed political junkie likes to hang out with friends near the shores of Michigan’s lakes and go downhill skiing. All of that will change in early August when he begins PHAP training for his placement in Jackson, Mississippi. Jacobson said he one day hopes to manage a clinic or hospital.

The Direct Relief community wishes Michael the best of luck and looks forward to hearing of his future accomplishments in public health.

The post Global Health Intern Alum Earns Prestigious Public Health Fellowship appeared first on Direct Relief.

The campaign’s success comes as the country looks back on the introduction of cholera two Octobers ago, which quickly grew to an epidemic. The rapid, tragic spread of cholera in Haiti is a sharp reminder of the importance of immunizations against communicable diseases, particularly for children who are often most vulnerable.

Direct Relief played a pivotal role in assisting Haiti’s Ministry of Health in their monumental campaign— which began in April as a certification effort— to vaccinate 2.5 million children against measles, rubella, and polio.

Launched under the theme, “Protect our world, get vaccinated,” the campaign sought to vaccinate all children under age 10 against measles, rubella, and polio—free-of-charge. Additionally, vitamin A was provided at not cost to children and pregnant women to combat malnutrition as well as albendozale to protect against parasites.

Working with the Centers for Disease Control (CDC) and the medical device company Beckton-Dickinson (BD), a long-time Direct Relief donor, Direct Relief was able to obtain and distribute over 700,000 needles and syringes to be used in the campaign.

The U.S. Department of Health and Human Services thanked Direct Relief  and BD for outstanding participation in the immunization campaign and the impact it will have on the region.

“Your assistance not only benefits Haiti’s national immunization program but also the region of the Americas in its effort to protect the achievement of its elimination of the measles and rubella to date. The success of Haiti’s upcoming rounds of immunization in increasing vaccination coverage rates will play an important role in Haiti’s documentation of the elimination of measles, rubella, and Congenital Rubella Syndrome necessary for regional verification,” wrote Dr. Kevin DeCock, the Director of the Center for Global Health at the Centers for Disease Control and Prevention and Dr. Anne Schuchat, U.S. Public Health Service Assistant Surgeon General.

Direct Relief supports more than 115 health facilities in Haiti and has been providing essential medicines and supplies to hospitals in the country since 1964. Over the last 48 years, Direct Relief has worked with local hospitals and clinics, delivering 1,500 tons of  essential medications  and supplies worth $82 million, and is the largest supplier of donated medicines to Haiti since the 2010 earthquake.

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