Sudan etiketine sahip kayıtlar gösteriliyor. Tüm kayıtları göster
Sudan etiketine sahip kayıtlar gösteriliyor. Tüm kayıtları göster

12 Aralık 2016 Pazartesi

Crowdfunding medicine via Facebook is a lifesaver for sick children in Sudan

A tea stall under a tree on one of Khartoum’s busiest roads doesn’t look like much to pin your hopes on when seeking to cure a sick child. But dozens of anxious parents and unrelated strangers rush to places like this across Sudan every day – the former to press prescriptions and the latter cash into the hands of volunteers managing a crowdfunding operation that saves children’s lives.


The operation, set up in 2012, received donations of some $ 220,000 (£176,000) for medicines in 2014, and also collected $ 533,000 to open children’s intensive care units in two hospitals in the capital.


“If these guys weren’t here I’d start to sell things from my home, like my bed, chairs and cooking utensils,” says Arafa Moussa, who has come from the Jaffar Ibn Ouf children’s hospital across the road to get help to pay for her son’s medicines. Since her husband had a heart attack and lost his job last November, they have not managed to pay the monthly 2,000 Sudanese pounds (£248) to manage their eight-year-old’s rare condition of aplastic anaemia.


“If he didn’t get the medicine, he would bleed from his nose, eyes, ears and whole body,” says Moussa, wiping her tears as she talks about trying to sell the family home to pay for the bone marrow transplant he can only get abroad.


It was seeing children with cancer in pain that led around 15 young Sudanese volunteers to establish the crowdfunding initiative, called Sharia’ al-Hawadith. It was named after a street lined with medical facilities, and which roughly translates as Accident Lane. It is now home to a small army of young volunteers who sit under a tree sipping endless cups of tea between racing off to get prescriptions for parents who turn up or call from hospital.


Decades of conflict and the resulting sanctions against the regime of President Omar al-Bashir have crippled investment and development. International NGOs have struggled to operate in a climate of government suspicion and restrictions, which includes limiting the medical work of Médecins Sans Frontières‎ and the Red Cross.


“Our government doesn’t want [NGOs] here … there were so many, but they were driven out,” says Hathim Ahmed, one of many pharmacists working with Sharia’ al-Hawadith to provide medicines that most insurance won’t cover. None of the volunteers are paid.


The initiative does some preliminary means-testing by speaking to parents, and asks them to contribute between 10% and 50% for expensive medicines or to buy the cheap ones themselves. For those who can’t contribute, Sharia’ al-Hawadith bears the total cost.


“About 25% of the people I see can’t afford to pay for treatment or medicines,” says junior doctor Leben Khair, who has volunteered for Sharia’ al-Hawadith since discovering that most insurance policies only pay for up to 10% of medicines and that “even private insurance doesn’t cover the expensive ones”.


In Sudan, while NGOs have floundered, such online crowdsourcing models have prospered, allowing people to donate for medicines, books, blankets or food without going through an organisation that could be considered a political threat.


“We publish the daily needs in the Facebook page … and we write the medicines or the cheques we need to do today,” says Ibrahim Alsir Alsafi, a journalist, who – like most other volunteers – spends a day or an evening a week sitting at the tea stall the street.


Ayman Saeed, one of Sharia’ al-Hawadith founders, says not being an NGO has its advantages. “It gave us more room to move freely and expand as much as we can, and our [decentralised] management system … was a good strategy.” He says it gives people the chance to approach the concept in their own way.


More than 100,000 people follow the Facebook page where the prescription requests and the whereabouts of sick children are posted. With volunteers working in all of Sudan’s 18 states, and most children’s hospitals, people can give money personally or send it through people they know living locally. “Sudanese people – most of them from outside Sudan – help us by transferring lots of money. We don’t have a bank account but they transfer it to their relatives here and they come to give it to us by hand,” says Alsafi.


The initiative requires a level of trust between pharmacists and volunteers, who all keep accounts of what has been bought or given on credit per shift. Some people who donate, especially for chronic cases or for first-time donors and who want to see where their money’s going, meet the patients, and sometimes, like the volunteers, get to know their families quite well.


Some pharmacists in Khartoum say that per shift they can give away anything from 200 to 2,000 Sudanese pounds’ worth of medicine, but that they trust the initiative and know they will be paid.


“Sometimes people go to the pharmacy and they just pay our debts for the whole month,” he says.


The largest donation received was from a wealthy Khartoum woman who didn’t have cash so turned up with her gold jewellery. When the dealer found out the money was going to charity, he paid double for it.


People living abroad also respond to the regular calls for drugs that are not available in Sudan, or are extremely expensive imports, by sending them over. “Antibiotics, especially injectables, are very expensive, and cancer drugs per injectable dose can cost 900,000 Sudanese pounds. A course of 28 tablets can cost 1.5m,” says Ahmed.


Since running his own pharmacy in the hospital district, Ahmed, like many other pharmacists, has worked with different charitable funds and given away drugs to needy customers for years. He now extends credit to Sharia’ al-Hawadith to reach increasing numbers of poor people who have been hit by inflation and a falling currency, which puts medicines imported from Europe or the US even further out of reach.


“People are really getting poorer and poorer every day; things are getting worse, so we are trying to help,” he says.



Crowdfunding medicine via Facebook is a lifesaver for sick children in Sudan

21 Temmuz 2014 Pazartesi

Cholera vaccine: the rapid-correct to the South Sudan outbreak?

South Sudanese refugees cook on an open fire at a camp

Vaccinations could be the solution to cholera outbreaks in unsanitary conditions such as refugee camps. Photograph: Ashraf Shazly/AFP/Getty Images




With news of the worsening cholera crisis in South Sudan – reported by WHO to have killed 62 people and affected 2,400 more – and an anticipated outbreak in Syrian refugee camps in northern Iraq, the need for a robust international response grows. Such a situation reveals the tension between advocates for vaccines and those pressing for action on sanitation.


Cholera is a form of acute watery diarrhoea, which spreads from person to person through food and water contaminated with the bacterium vibrio cholerae. It is a miserable condition involving massive fluid loss and dehydration and left untreated can quickly lead to death. Cholera is common in places with poor water and sanitation – WHO estimates 3 to 5 million cases and up to 120,000 cholera deaths globally each year – but it’s when large epidemics occur that cholera grabs the world’s attention. The disease is highly contagious and rapidly acting, so outbreaks can be explosive.


The need for a multi-tool and integrated approach to prevention and control is widely acknowledged, but new evidence for the effectiveness of vaccines is pushing the debate toward their more widespread use, especially during outbreaks.


A new study about an outbreak in Guinea shows that two doses of the oral cholera vaccine Shanchol were able to protect people by 86%. In their vaccination strategy, Médicin Sans Frontières (MSF) and the Guinean ministry of health were able to administer over 300,000 doses of the vaccine in two rounds to the affected coastal districts, covering 75% of the population, reducing transmission of cholera and containing the outbreak. The authors of the study say that this vaccine provides protection quickly and should be used to control future outbreaks.


Shanchol was reported to be safe and efficacious in a larger trial in Kolkata with long-term results, and it is cheap: two doses cost about $ 3, or about one-third the price of the only other WHO-pre-qualified vaccine Dukoral, which has a shorter length of protection and is mostly geared toward travellers.


Both Dukoral and Shanchol require refrigeration, which is impossible in many settings, and with the more expensive product a large amount of clean water is needed for mixing the vaccine before consumption – again, unavailable in the impoverished environments where cholera is endemic or where outbreaks occurs.


Two weeks ago it was announced that another Indian firm is developing a cheaper powder form of the cholera vaccine that may require only one dose, no refrigeration, and just $ 1 to purchase. The non-profit biotechnology company Hilleman Laboratories, backed by Merck & Co and the Wellcome Trust, says it is starting clinical trials next year.


But issues around vaccine delivery, their feasibility and acceptability to communities, as well as cost concerns will continue to plague the vaccine approach to cholera. Critics have questioned whether the extensive resources required to develop, manufacture, purchase and deploy vaccines across affected populations would be better spent on basic water and sanitation infrastructure. Robust water and sewage systems are what prevents cholera from being an issue in developed countries. Indeed, even though WHO began last year stockpiling Shanchol for emergencies, it advises the use of simple oral rehydration solution as the first line approach to cholera, which is both cheap and widely available, or antibiotics for more severe diarrhoeal cases. The vaccine has not been regarded as a key public health tool.


During the cholera outbreak after the 2010 Haiti earthquake attempts for a vaccine campaign by the medical charity Partners in Health were spurned by the local government and public health officials concerned with costs and unconvinced by the vaccine’s effectiveness. Other NGOs working in the field feared that attention and resources directed toward a vaccine campaign that could cover just a fraction of the population would deflect from the need to provide clean water and permanent sanitation infrastructure.


After all, access to clean water and sanitation (which 2.5 billion people lack – half the developing world) is a precondition for improvements in most if not all other areas of health and development: poverty, hunger, gender-based violence and education to name a few. Any attention to water and sanitation in the cholera context, then, will bring wider and necessary benefits to populations.


Undeniably the key to controlling cholera is clean water, sanitation, and hygiene. The challenge is to press for attention to these more basic needs even as new research strengthens the case for implementing cholera vaccination programmes to prevent, treat, and eliminate this deadly disease.


Dr Jocalyn Clark is executive editor at International Centre for Diarrheal Disease Research. Follow @jocalynclark on Twitter.


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Cholera vaccine: the rapid-correct to the South Sudan outbreak?

13 Haziran 2014 Cuma

3D printed prosthetics: extended-phrase hope for amputees in South Sudan

Mick Ebling in South Sudan

Mick Ebeling brought two 3D printers to the Nuba Mountains in South Sudan to print limbs for war amputees. Photograph: Timoteo




In November 2013 Mick Ebeling left his property in Venice Seashore, California for the Nuba Mountains in South Sudan. His aim? To meet a younger double amputee named Daniel Omar and print him a prosthetic arm.


Given that then, Undertaking Daniel has been covered by significantly of the world’s media, so when we caught up with the entrepreneur, we were keen to know what affect the innovation is obtaining in Sudan Sudan and how Ebeling’s background in promoting is informing his efforts to use ‘technology for the sake of humanity’.


What motivated you to travel to South Sudan?


We come from the school of open source that believes that units like this need to be readily accessible to everybody. We taught a group of eight younger males to proceed undertaking the function and we left a massive box of filament and supplies and two 3D printers.


It took me about four days to get back from South Sudan, and when I acquired property I looked at my e mail and had images of two arms that were produced while we have been in the air. Naturally, Daniel feeding himself for the initial time in two many years was an incredible success, but seeing that this was sustainable, that was the most thrilling.


How sturdy are the limbs?


They truly are quite resilient. But since they are modular – you print out the knuckle, finger and palm individually – if one thing breaks, you just print it yet again. With an expensive prosthetic when something breaks you have to send it back to the manufacturer. And there is no post in the Nuba Mountains. That is one particular of the factors why this resolution is so fantastic, something can break and you’re not valuable about.


What is the funding model of your organisation, Not Impossible Labs? I read that you began off as a basis but now you happen to be for profit working with huge brands in an modern way


We began off Not Unattainable as a non-revenue and I joked that I was going deaf by the sound of the rattling of the tin cups. As a non-profit you are restricted by the whims and trends in providing. I did not want to be governed by trends, I wanted to be governed by what we desired to accomplish.


I transfered my experience as a commercial producer functioning with marketing companies. My belief is the much more folks that know about the stories that we have produced, the a lot more likelihood it truly is going to get implemented. We realised that if we get in touch with the most strong entities in the world – brand names and corporations – and work with what they previously do – develop messages close to their brand names – we can aid every other.


How does that operate in practice?


We spouse with manufacturers who have items and items and companies that make sense with our initiative. Intel and Precipart were two manufacturers that came in to underwrite Undertaking Daniel. In return they received content. They received a webfilm that they were in a position to consider out and market. They have been looking for stories to tell. Alternatively of an advert about the attributes of the solution, they acquired a potent message. The brand wins because they get acknowledged for supporting something excellent. We’re just fitting into a branding and messaging program that previously exists inside the corporate world, that ethically and organically fulfills what we want.


Are there any corporations you would not work with?


We’re not previous enough yet to encounter any ethical crossroads of what to do or not to do, but we want to operate with businesses who want to do excellent in the planet.

Do you believe your project provides any lessons for other improvement organisations?


A great deal of the NGOs above there are undertaking great work and a lot of them are bogged down by the bureaucracy of a enormous organisation. If you can implement something that overcomes that then you’re previously ahead of the game. Our purpose is for folks to be inspired by the open supply mentality of empowering and equipping people to help themselves. 3D printing puts the power into the hands of the folks on the ground. After you educate individuals on what a particular issue can do, they will often make it do anything much more.


What is the up coming challenge you are tackling?


We’re searching at taking 3D printers to Nicaragua, Vietnam, Cambodia, Colombia, Sierra Leone – spots that reached out to us. And we’re working on a undertaking right now in Mexico that’s going to help children with cerebral palsy, muscular dystrophy or a number of sclerosis to walk once more.


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• Marketing: still the dirty word of advancement?


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3D printed prosthetics: extended-phrase hope for amputees in South Sudan

4 Haziran 2014 Çarşamba

South Sudan capital faces worsening cholera outbreak

Sudanese are reflected in a pool of rain water in southern Sudan

Overall health officials are setting up new therapy centres in Juba, South Sudan, to deal with conditions connected to contaminated water and poor sanitation. Photograph: David Mwangi/Reuters




Overall health officials are warning that a cholera outbreak in South Sudan’s capital, Juba, which has left 23 folks dead and forced far more than 670 others to look for remedy, could be receiving worse. Laboratory exams have confirmed that at least 1 man or woman residing in a Juba displacement camp has contracted cholera and there are fears the ailment could spread quickly inside the crowded site.


Officials are setting up new treatment method centres across the city and treating the water sources they feel are accountable for spreading the illness, but said they anticipate at least one,000 much more people might need to have to be hospitalised prior to the outbreak ends – and that is only if cholera does not spread to other places of the nation.


Wellness minister Riek Gai Kok officially announced the cholera outbreak almost two weeks in the past – the initial in South Sudan given that 2009 – and pledged “as the government, as a nation [we] will assistance any efforts created to have this ailment”.


The outbreak was not unexpected. The Planet Wellness Organisation’s (WHO) Abdinasir Abubakar said the ministry and wellness partners had presently began preparing for the physical appearance of cholera and other communicable diseases “simply because of the context. Because we had a great deal of population motion and that population motion usually brings some overall health troubles.”


Displacement brings condition


5-and-a-half months of fighting in South Sudan has forced far more than a million men and women to flee their houses – and the situation continues to deteriorate. Despite a renewed cessation of hostilities agreement signed virtually three weeks in the past by President Salva Kiir and opposition leader Riek Machar, fighting has continued. The UN reports an additional 70,000 individuals have been displaced considering that then, some into areas with no clean water or ample latrines.


When the outbreak was announced, UN companies and partners began focusing on some of the most significant water, sanitation and hygiene (Wash) concerns – both in the displaced populations and amongst lengthy-term Juba residents.


Much of the water individuals use for drinking and cooking is collected from the Nile and delivered by tanker truck. Unicef’s Wash chief Lillian Ukwiri stated efforts are becoming produced to track down every truck and make sure every single shipment is chlorinated, some thing that ought to destroy cholera bacteria.


The UN has also place out radio advertisements instructing individuals to boil water for at least 10 minutes before consuming it or cooking with it, and to wash their hands regularly. The messages also inspire folks to report to a healthcentre as quickly as they demonstrate any signs and symptoms, which includes watery diarrhoea or vomiting, because the ailment can destroy swiftly.


When the outbreak was announced, Juba Teaching hospital set up an emergency isolation ward. It filled swiftly, with sufferers sleeping in open-air corridors that have been covered with tarpaulins. Trina Helderman, from Medair, a humanitarian group supplying emergency companies in the country, has been stationed at the ward given that it opened. She told IRIN that initially they were seeing a lot more than a hundred individuals a day, however the intake has slowed.


“It would seem that the cases are going down, but based on what the specialists have told us, it could be that the peak comes back up yet again,” she explained. “We’re just waiting to see how issues play out.”


Helderman explained the messaging does seem to be functioning, with many individuals arriving as soon as they exhibit any symptoms, which can make it simpler to deal with them. They get both oral rehydration salts to change fluid lost in diarrhoea or vomiting or – in severe instances – an intravenous drip.


But some individuals are nonetheless not generating it to the overall health centres in time. Samuel Moro’s family members stated they recognised the signs and symptoms of cholera right away, but very first attempted to deal with the condition with a homemade rehydration remedy of sugar and salt. His problem worsened in excess of the subsequent 48 hours. By the time he arrived at the isolation ward, it was as well late. He died a number of hours later on.


His brother, Kagwa Apolo, told IRIN Moro’s family members was mindful of the outbreak and had heard the messages encouraging them to look for remedy, but “we were hoping we could deal with him at residence. Individuals left him to stay at residence for a prolonged time”.


Surveillance and treatment centres


WHO’s Abubakar said the outbreak’s fatality fee is even now also large. To bring it down, he explained they necessary to boost the surveillance teams so they could much more quickly identify people in need to have of treatment, like Moro. They also essential a lot more cholera treatment centres (CTCs). Médecins Sans Frontières (MSF) opened a clinic final week in one particular of the hardest-hit locations of the city and Abubakar explained health officials are taking into consideration opening two extra centres in the coming weeks.


People are not the only shortages. Abubakar said simply because the outbreak has been worse than officials at first anticipated, it has forced them to revise the anticipated number of people displaying signs of cholera from 5,000 to ten,000, two% of the population. Two thousand individuals are anticipated to be hospitalised.


“We need to have to go back to our arranging and carry much more supplies. We need to carry far more personnel in. We need to have to set up more CTCs. We need to have to train more employees and we require to expand the response.” And that was just before MSF reported this week that the condition had officially entered one of Juba’s two displacement camps.


When the fighting started in mid-December, 1000′s of individuals crowded into the UN Mission in South Sudan’s two bases in the capital. More than 14,000 individuals are nevertheless living in every single of the camps, which do not have ample latrines or other basic sanitation facilities.


Sefan Liljegren, MSF’s area coordinator, advised IRIN there was a single laboratory-confirmed case at the UN property camp on the outskirts of Juba and 7 other sufferers who showed symptoms of cholera.


Because of their circumstances, health officials presently viewed the camps as substantial-danger regions for a cholera outbreak. Earlier this year they provided two doses of oral cholera vaccines to much more than 96% of the individuals residing in the camp in an work to mitigate the impact of a feasible outbreak.


But Liljegren said the vaccine offers only 65% coverage, which implies there is still the potential for 1000′s of individuals to grow to be sick. MSF has presently set up CTCs in each of the camps.


“The advantage in the camp is that the population is aware,” he explained. “They have a extremely shut entry to the CTC, so hopefully they will be in a position to entry remedy really quickly, and as a result, also be discharged very quickly.”


Abubakar explained they are also waiting for reviews from three other regions of the country exactly where prospective instances have been reported and acknowledged. “Our estimation is the cholera outbreak might spread outside Juba.” Even without any confirmation, the government has encouraged state officials to commence rolling out public awareness campaigns and getting ready folks for the possibility that the outbreak could spread.




South Sudan capital faces worsening cholera outbreak