Priority In Haiti Now Is Saving Lives During Cholera Epidemic, Says PAHO Director

Prompt treatment, improved living conditions, and proper hygiene practices are the top priorities for PAHO (Pan American Health Organization), local health authorities, international agencies and NGOs (non-governmental organizations), said Dr. Mirta Roses, Director of PAHO. Dr. Roses stressed the urgent importance of clean drinking water, safe food, raising public awareness on how to combat the spread of cholera, and "building a solid water and sanitation infrastructure in Haiti,"


Dr. Roses met today with various government, private and faith-based groups, which are all responding to Haiti's cholera epidemic. Dr. Roses thanked them for their support and emphasized that the Haitian leadership is crucial in this crisis.


Dr. Roses said:
"The capacity of NGOs is fundamental in assistance to the country. But national and local leaders must be in the driver's seat because they will remain after the crisis."
Roses added that a significant number of agencies are "overwhelmed in this disaster." The January earthquake, which destroyed or overstretched much of the country's health, water and sanitation services, as well as making millions of people homeless, created the ideal ingredients for a serious cholera epidemic. Add to all this the recent flooding from Hurricane Tomas, and resources have been stretched beyond the limit.


Dr. Sylvain Aldighieri, who works at PAHO, said that current priorities are:

Improved surveillance
Improved risk assessment
Rapid detection of hot spots
Rapid response to new hot spots
Good case management
Logistics and supplies
Extensive and effective broadcasting to properly educate the population on care and prevention

There are several rural areas which are difficult to get to that concern authorities and agencies particularly, Dr. Aldighieri added. He believes that approximately one-third of all community deaths are not being registered centrally, in other words, not reported.


PAHO Deputy Director Dr. Jon Andrus said his organization continues supplying and mobilizing experts in several fields of medicine and public health, including risk communication, case management, epidemiology, laboratory work, sanitation, logistics and supply management to the authorities of the two nations on the island, Haiti and the Dominican Republic.


People on the ground are reporting that hospitals are rapidly running out of space. An MSF (M?©decins Sans Fronti??res - Doctors Without Borders) 70-bed hospital in the capital, Port-au-Prince, for example, says it is receiving 300 sick people each day. Caroline Seguin, MSF's emergency coordinator says people are pouring in even though the hospital is completely full.


Kate Alberti, an epidemiologist with Epicentre, MSF's epidemiological research center, said:
"While cholera and cholera-like symptoms can present very quickly and become life-threatening, unnecessary deaths can easily be averted with swift access to properly equipped and staffed facilities in close proximity to outbreak areas."
MSF reports that in many areas safe drinking water is extremely scarce. They give an example of the Cite Soleil neighborhood which MSF provides with 280,000 liters of water per day - enough for 14,000 people, but "far below the requirements of the neighborhood's inhabitants."


Charity organization, Oxfam, says it has 25 staff working non-stop in Petite Riviere. Their water, sanitation and hygiene program is supplying 100,000 desperate Haitians. The charity aims to move into Artibonite as well and provide safe drinking water, toilet facilities, and education on good hygiene practices.


Soources: MSF, PAHO, Oxfam.


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HHS Releases $490 Million In Emergency Funding To States For Energy Assistance For Low-Income Families

In response to the growing demands on states and families for much needed relief, U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius announced today the release of $490 million in contingency funding to help eligible low-income homeowners and renters meet home energy costs. These Low-Income Home Energy Assistance Program (LIHEAP) contingency funds will provide states, territories, tribes and the District of Columbia with additional assistance to pay heating and electricity costs.


"During these tight economic times, states and communities across the country have seen increased demand on key services, such as energy assistance for low-income families. And the record cold snap in places that traditionally don't see weather as cold as it has been this year has put even more pressure on families in these states," said HHS Secretary Sebelius. "The energy subsidies we are releasing today will help more families afford heat and avert difficult choices too many Americans face between paying for heat and paying for other essentials like food and medicine," Sebelius said.


LIHEAP helps eligible families pay for home heating, cooling, and other energy costs, as well as helping to weatherize eligible families' homes. In recent years, more than six million low-income households across the country receive assistance under LIHEAP.


The contingency funds released today are in addition to basic LIHEAP funding states receive automatically. HHS released $2.6 billion in October and $1.2 billion last week in regular block grant funds. Today's $490 million release is from a $590 million LIHEAP contingency fund leaving $100 million available for unanticipated events in the contingency fund.


In total, Congress appropriated $5.1 billion for LIHEAP in Fiscal Year 2010. "We have made a decision to release a substantial portion of available funding now to help children, seniors, and families struggling to make ends meet," said Carmen R. Nazario, HHS assistant secretary for children and families. "At a time when unemployment is unacceptably high, this assistance can provide a real helping hand to families hardest hit by the recession."


For a complete list of state allocations of the funds released today go here.


Individuals interested in applying for energy assistance should contact their local/state LIHEAP agency. For more information, go here.


U.S. Department of Health and Human services (HHS) Secretary Kathleen Sebelius comments on contingency funding to help eligible low-income homeowners and renters meet home energy costs. LIHEAP Announcement Video

Source
HHS

St. Jude, El Salvador Create Research Ethics Committee

The establishment of
research ethics committees (REC) in El Salvador will enhance the ability of
that country to undertake clinical trials that improve cure rates of
pediatric catastrophic diseases, according to investigators from St. Jude
Children's Research Hospital who helped to establish the committees.



The new programs not only ensure rigorous ethical oversight of research
involving human participants, but also serve as a model for other
institutions in high-income countries to create or strengthen existing RECs
in low-income countries, the investigators said. A report on the
establishment of these RECs in El Salvador appears in the December issue of
Lancet Oncology.



The establishment of the REC in El Salvador is important because
investigators in low-income countries often have little or no access to
such groups, said Miguela A. Caniza, M.D., assistant member of the St. Jude
Infectious Diseases Department and director of its Infectious Diseases
International Outreach Program. Yet research institutions in high-income
countries require that a REC be part of any such collaboration, she noted.



"The absence of a REC either restricts or prevents just the
collaboration needed to improve medical care in countries with limited
resources," Caniza explained. She is lead author of the report.



Other authors include Scott C. Howard and Raymond C. Barfield (St.
Jude); Wilfrido Clara and Gabriela Maron (Hospital Bloom); Jose Ernesto
Navarro-Marin (Ministry of Health and Social Assistance, El Salvador);
Roberto Rivera (Family Health International, Research Triangle Park, N.C.);
and Jonathan Camp (Center for the Study of Rhetoric and Applied
Communication FedEx; University of Memphis, Tenn.).



This work was supported in part by ALSAC.



St. Jude Children's Research Hospital



St. Jude Children's Research Hospital is internationally recognized for
its pioneering work in finding cures and saving children with cancer and
other catastrophic diseases. Founded by late entertainer Danny Thomas and
based in Memphis, Tenn., St. Jude freely shares its discoveries with
scientific and medical communities around the world. No family ever pays
for treatments not covered by insurance, and families without insurance are
never asked to pay. St. Jude is financially supported by ALSAC, its
fund-raising organization. For more information, please visit
stjude.


St. Jude Children's Research Hospital

stjude

USDA Awards Enhance The Nutritional Quality Of Food Aid Products

The USDA's National Institute of Food and Agriculture awarded nearly $3.8 million to develop healthier food products for humanitarian assistance programs.



"The United States is a major supplier of food aid, feeding millions of people around the world who are suffering during emergency situations," said Roger Beachy, director of USDA's National Institution of Food and Agriculture (NIFA). "These projects will improve the nutritional quality of food aid products these people depend on for survival."



NIFA's Food Aid Nutrition Enhancement Program (FANEP) supports the development and field testing of new ready-to-use foods, fortified blended foods, high-energy foods, micronutrient powders or other food products designed to improve the nutritional delivery and functional form of humanitarian food assistance. Projects funded by FANEP may also field test existing food products that have not yet been approved for use in food aid programs.



Fiscal Year 2010 awards were made to Johns Hopkins University (JHU) and international global health non-profit PATH. JHU received $2,729,000 to introduce and test three specially formulated foods for children ages 6-24 months in Bangladesh, where childhood under-nutrition is especially prevalent. PATH received $1 million to field test their Ultra Rice technology in Burundi. Ultra Rice is a proven, cost-effective and culturally appropriate rice fortification technology that can bridge micronutrient deficiencies and prevent malnutrition in rice-consuming communities.



FANEP is administered through the Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Programs Appropriation Act. This act called for a grant program to enhance the health of individuals, especially infants and young children, at risk for or suffering from malnutrition by further improving the nutritional content, product composition, packaging and other components of food products delivered through the McGovern-Dole International Food for Education and Child Nutrition program and the Food for Peace Title II humanitarian assistance programs.



Source:

Jennifer Martin

United States Department of Agriculture -- Research, Education and Economics

Post-Katrina Safety-Net Clinic Patients In New Orleans Report More Efficient And Affordable Health Care And Less Medical Debt Than Most U.S. Adults

A new Commonwealth Fund survey of safety-net clinic patients in New Orleans finds that, despite being disproportionately low-income and uninsured, these patients had fewer problems affording care and fewer instances of medical debt and inefficient care than most U.S. adults. In fact, the report, Coming Out of Crisis: Patient Experiences In Primary Care In New Orleans, Four Years Post Katrina, finds that, among the clinic patients surveyed, only 27 percent went without needed health care because of cost, compared with 41 percent of adults across the country.


According to the authors, this shows that the post-Katrina primary care pilot program-a system that relies primarily on a large network of local clinics funded by federal and local government, and given financial incentives to improve care-could serve as a national model for providing primary care to vulnerable groups.


"The health care safety net in New Orleans was devastated by Hurricane Katrina, but that also presented an opportunity to build something new from the ground up," said Commonwealth Fund President Karen Davis. "It's exciting to see the impact that a real focus on primary care can have on the health of this vulnerable population. I hope that the lessons learned in New Orleans will be considered as we seek ways to provide high quality, affordable health care for more Americans."


With New Orleans' major public hospital and adjacent ambulatory sites closed, in 2007 the U.S. Dept. of Health and Human Service gave a grant to the state of Louisiana that supported a network of independent neighborhood primary care centers in efforts to increase access to care and develop an organized system of care. The Commonwealth Fund survey was conducted 18 months after the grant was awarded to assess the impact of the project on patients' access to care and experiences, and provide lessons for national and state leaders on the value of strengthening primary care for vulnerable patients.


When the authors compared the 2009 survey of patients in 27 New Orleans health clinics to findings from The Commonwealth Fund's 2007 Biennial Survey, a nationally representative survey of the general population, they found that clinic patients were less worried about affordability overall. In fact, half of clinic patients (49%) reported they were confident they could afford needed care if they became seriously ill, compared with only 30 percent of adults in the general population. Medical debt was also less of a concern for clinic patients, with 34 percent reporting medical bills or debt problems compared to 40 percent in the U.S. overall. Unpaid medical bills were also a far greater problem among all U.S. adults than among clinic patients (28 percent vs. 18 percent).


Clinic patients also received care that was more efficient than the U.S. norm. According to the report, only 4 percent of clinic patients reported duplicate medical tests, or that medical records or test results were unavailable at their appointment, while overall, 34 percent of U.S. patients experienced such problems. Clinic patients also had more confidence in the health care system-three-quarters said they would be very confident in their ability to get high-quality and safe medical care; in contrast, only 39 percent of all U.S. adults were very confident that they could get high quality and safe care.















Additional Findings From The 2009 Commonwealth Fund Survey of Clinic Patients in New Orleans:


- 88 percent of patients found it is easy to get same or next-day appointments when sick, to access medical advice via telephone or during regular practice hours, or to get after-hours care (in the evenings, on weekends or on holidays).


- 79 percent of patients reported exceptional communication with their doctors and 85 percent said that their health needs are "very well" met in the clinics.


- Adults who reported "excellent patient experiences"-easy access to well-coordinated care and exceptional patient-doctor communication-were more likely to get recommended preventive services.


- New Orleans clinics serve a particularly vulnerable population: 72 percent of New Orleans clinic patients were uninsured at some point during the past year, compared with 28 percent of U.S. working age adults. Half of New Orleans clinic patients have incomes below 200 percent of poverty, compared with one-third of U.S. working-age adults.


"These findings reveal that strengthening primary care can be instrumental in helping to move the U.S. to a high performance health system," said Commonwealth Fund Assistant Vice President Melinda Abrams, a co-author of the report. "Provisions in the health care reform legislation currently being considered by Congress-including medical home pilots to test different payment methodologies, increased payment for primary care in Medicare, and loan forgiveness for physicians choosing careers in primary care-are steps towards the goal of improving health care for all Americans."


Methodology


Data come from the Commonwealth Fund 2009 Survey of Clinic Patients in New Orleans, an in-person survey conducted February 2, 2009, through April 2, 2009 with a sample of 1,573 clinic patients aged 18 and older or adults accompanying a child under the age of 18. The report limits the analysis to 1,231 respondents ages 18 to 64. The 20-minute, two-part, in-person surveys were conducted in 27 primary care and pediatric clinics across Orleans Parish that received funding from the Primary Care Access and Stabilization Grant. The survey was conducted by Social Science Research Solutions (SSRS), a branch of AUS and ICR/International Communications Research. The survey sample was drawn from all eligible patients present at the clinics on interviewing days, consisting of those ages 18 and older and visiting the clinic as a patient or accompanying a child under the age of 18. A total of 2,021 individuals were approached for an interview and 448 refused. The response rate for the survey was 77.8 percent. The data are weighted in accordance with patient flow reports to ensure that each clinic is proportionally represented. The margin of error was +/- 2.92%; however, the margin-of-error calculations for non-random samples should be treated carefully. The report also includes estimates from the 2007 Commonwealth Fund Biennial Health Insurance Survey, conducted among a nationally representative sample of 3,501 adults living in the continental U.S.

Source
Commonwealth Fund

The American Red Cross Increases Aid To Haiti

The American Red Cross is contributing $600,000 for relief operations in areas of Haiti affected by a series of powerful hurricanes. Of the contribution, $500,000 is a grant from the U.S. Government's Agency for International Development/Office of U.S. Foreign Disaster Assistance (USAID/OFDA) and will contribute to relief supplies including hygiene kits, buckets, mosquito nets, and five trained disaster workers. The additional $100,000 will be used for the procurement and distribution of shelter kits.


"Haitian Red Cross volunteers worked around the clock before and after these storms hit in rapid succession. They carried out evacuations, search and rescue, assisted in government-run shelters, provided first aid, assessed damages and distributed much-needed relief supplies," says Guillermo Garcia, Director of Latin America and the Caribbean for the American Red Cross. "The generosity of USAID/OFDA helps us maintain the flow of aid to the Red Cross workers already on the ground."


The American Red Cross maintains a 15-person office in the Haitian capital of Port-au-Prince. As soon as Hurricane Gustav struck the island, American Red Cross staff began working hand-in-hand with the Haitian Red Cross in the response to Gustav and then Ike.


"We're watching closely for any new storms forming in the Atlantic," cautions Matthew Marek, Head of Programs for the American Red Cross in Haiti. "If one develops and stalls over Haiti, and dumps 30 inches of rain like recently happened in Puerto Rico, the impact on the people here and our relief efforts to help them is simply unimaginable."


The American Red Cross has additional relief supplies- such as tarps, kitchen sets, blankets, buckets, and insecticide-treated mosquito nets-pre-positioned in Panama and ready to mobilize if a call for more support comes.


You can help the victims of countless crises around the world each year by making a financial gift to the American Red Cross International Response Fund, which will provide immediate relief and long-term support through supplies, technical assistance and other support to help those in need. The American Red Cross honors donor intent. If you wish to designate your donation to a specific disaster please do so at the time of your donation by either contacting 1-800-HELP NOW or 1-800-257-7575 (Spanish), or mailing your donation with the designation to the American Red Cross, P.O. Box 37243, Washington, D.C. 20013 or to your local American Red Cross chapter. Internet users can make a secure online contribution by visiting redcross.

American Red Cross

ZyDoc Offers Hurricane Katrina Disaster Transcription Support

ZyDoc, a technology leader in automated medical documentation solutions, announced free emergency transcription and medical record support for healthcare workers and organizations affected by the Katrina hurricane disaster. In view of the severity of the hurricane and widespread disruption of services, ZyDoc recognizes the need to fulfill the requirements of healthcare providers for medical transcription and documentation management.

With many hospitals in the effected area temporally closed or operating with limited services, the infrastructure for ongoing medical records will be severely limited. Coupled with the anticipated increase in medical services secondary to the disaster, and difficulties for healthcare providers and transcriptionists to travel or perform their duties, ZyDoc anticipates that there maybe an immediate need to offer transcription services and secure Internet based medical records to the medical community. The displaced victims will benefit from secure Internet based records that can be accessible from anywhere.


Jim Maisel, M.D., Chairman of ZyDoc explains, "The ZyDoc technology platform offers a number of advantages to the disaster area to overcome infrastructural limitations imposed by service outages and temporary personnel shortages and displacement of people. Physicians, hospitals, relief, legal, rescue and transcription companies can utilize ZyDoc infrastructure and transcription services starting work within minutes. ZyDoc intends to make our surplus capacity available immediately to the medical community on a first-come first-served basis at no charge until services can be restored."


Steve Koski, CEO and President of ZyDoc explains the operational aspects of the transcription and medical records service as follows: "Health-care workers will be able to dictate into handheld digital recorders or the ZyDoc TelDoc 800 toll-free servers. ZyDoc will supply fully edited transcription services, usually with overnight service as available, for these documents or provide Internet based ASP delivery of the voice files to the transcriptionists selected by the health-care users. Once transcribed, documents and voice files will be available immediately and securely via Internet access from any PC with a browser and stored for later access. The documents can also be automatically downloaded and printed to a PC, faxed or made available to share with authorized caregivers over the Internet. The ZyDoc carrier class datacenter has proven reliable without failure over the past two years and was operational even during the Northeast blackout. We intend to make our surplus capacity available immediately to the medical community on a first-come first-served basis at no charge."


Availability


Hurricane related services can be started by enrolling at the "try it free" link on the secure zydoc website and using the promo code: Katrina. Then contact the ZyDoc Operations Center at 631-273-6125 to receive your user login and password. Dictation can be started immediately using low-cost digital handheld recorders or the TelDoc 800 service. Completed documents will be available with secure confidential access by author on ZyDoc website. Documents can be faxed using the ZyDoc FaxDoc system and can be accessed or automatically downloaded and printed from any computer with Internet access.















Transcription ASP infrastructure solutions are also available to replace legacy and non-HIPAA-compliant services for transcription companies or hospitals that need infrastructure support. ZyDoc provides multimedia demonstrations, training, and support on an urgent or scheduled basis via the Internet at zydoc.webex and through an expansive nationwide network of Tech Data, Toshiba, and qualified integrators. For more information on ZyDoc Automated Medical Documentation Solutions visit zydoc or enroll at zydoc/leads.htm


About ZyDoc Corporation


ZyDoc is an award winning transcription service and software development company that provides automated electronic health-record documentation and infrastructure ASP legacy-replacement solutions. Physicians, transcriptionists, and other healthcare professionals use these services to produce, organize, and distribute multi-specialty patient electronic medical records (EMR) in Community Health Information Networks (CHIN). ZyDoc solves the PC illiteracy, data entry bottleneck, implementation, and cost issues that plague other clinical documentation and transcription companies. It uses transparent embedded technology that leverages front- and back-end speech recognition, workflow enhancements, and the Internet. ZyDoc is a development partner with SUNY Computer Sciences at Stony Brook, a ScanSoft platinum dealer, and an IBM Speech Premier Business Partner.


Jim Maisel, M.D.

Chairman, ZyDoc

ZyDoc Corporation

631-273-1963


James Maisel, M.D.

ZYDOC CORPORATION

jmaiselzydoc

631-273-1963

zydoc