In November 2013, International Medical Corps began to move from its emergency response strategy of delivering health care through mobile medical units, to a more long-term strategy of building the resilience of local communities through training and improving access to clean water sources.
Working with communities in the same areas ravaged by the cyclone, International Medical Corps has since been focused on restoring capacity and building self-reliance in these communities by developing solutions to mitigate destruction from future storms, such as investing in strategies to help communities access clean water and thwart the spread of disease -- which ultimately help local community members to become their own, best First Responders.
International Medical Corps has helped lay the foundation for building resilience in India through the following strategies:
International Medical Corps will continue to expand its capacity building work in Cyclone Phailin affected areas in India by further developing the resilience of local communities through activities focused on water and sanitation awareness, such as campaigns delivered in schools, during community gatherings, and at other events. International Medical Corps is using its local network of experienced health and hygiene promoters, who speak the local language, to communicate key messages to villagers and students, verbally and visually, on a range of health topics, including: women’s personal hygiene, safety processes for drinking/storing/ handling water, use of latrines, and the hazards associated with unhygienic behavior such as not washing hands. Additional schools located in the low-lying villages affected by the cyclone will be selected for awareness campaigns and will also receive first aid and hygiene kits.
True to its mission, International Medical Corps has moved on from disaster response to rebuilding self-reliance, supporting communities’ efforts to recover and remain resilient after future disasters, and providing them with the tools they need to be their own best First Responders.
Following its response to the catastrophic earthquake in Haiti in 2010, International Medical Corps’ teams responded to the equally devastating outbreak of cholera in late October 2010. International Medical Corps was one of the very first organizations to respond and had medical staff on the ground in one of the worst areas – Artibonite – days before the outbreak was confirmed to be cholera. International Medical Corps aggressively rolled out a network of cholera treatment centers (CTCs) and mobile medical units in Haiti’s most remote and affected areas to care for more than 39,700 cholera patients. International Medical Corps also trained and mentored more than 1,200 doctors, nurses, and community health workers so that our network of CTCs were established and staffed largely by local health professionals and could eventually be handed over to the MoH and be a part of the country’s long-term infrastructure to prevent and treat cholera.
Since that time, International Medical Corps’ work has focused on cholera preparedness and response to outbreaks, particularly in rural areas where access to health services and knowledge of cholera and how to prevent it is very low. During 2013, International Medical Corps’ work focused on cholera education and prevention activities in the Grand North, considered one of the country’s most under-served areas in terms of infrastructure and economy. The Grand North (including the North, Northeast and Northwest Departments) has demonstrated its vulnerability to cholera outbreaks, and since the initial outbreak in 2010, there have been over 135,374 suspected cholera cases within the three departments, with this region also seeing a higher case fatality rate than that of Haiti nationally, at 1.6%.
In response, International Medical Corps assessed the needs of several remote communities in the North and North-East Districts and focused its support on re-supply of the area’s health centers with general use and cholera medicines while also delivering education campaigns to help local residents prevent the spread of cholera. International Medical Corps, in partnership with the Council of Haitian Non-State Players (CONHANE) and the MSPP, worked with four community based organizations in the selected communities to conduct cholera prevention awareness activities through house-to-house visits and hygiene awareness sessions in churches and schools. By the end of 2013, International Medical Corps’ cholera prevention efforts in the north of Haiti indirectly benefitted more than 125,000 people.
Now, in 2014, International Medical Corps has continued its work responding to cholera outbreaks in Haiti in the Grand North through mobile medical units. International Medical Corps currently operates six mobile medical units staffed by trained Haitian health personnel who investigate suspected cases of cholera, provide treatment or referral, and sensitize and educate at-risk communities. Once a suspected case is identified through the surveillance system, International Medical Corps’ mobile medical unit team quickly deploys to the area to investigate the suspected case and provide treatment or support referral to the nearest health facility. The team educates the household and provide supplies to disinfect the home. The teams teach proper hand washing techniques; the importance of water treatment in order to avoid contracting cholera; and the proper use of latrines and waste management techniques.
After the household work is complete, the mobile medical team then focuses its prevention efforts with the surrounding community. The team trains and mobilizes community volunteers in the surrounding community to assist in awareness campaigns to remind the population that cholera is still present in their community and that they need to apply good hygiene practice to avoid the spread of cholera. As needed, the mobile medical teams also directly teach local residents how to identify all types of diarrheal related water diseases and cholera in particular, and how to properly prepare and use oral rehydration salts – critical tools in the fight against cholera.
Thanks to the generosity of Global Giving and other generous donors, International Medical Corps’ six mobile medical team (two in each targeted Department - the North, Northeast and Northwest) have achieved the following results from 2014 to-date: 19,576 individuals have been reached to-date with cholera prevention and health promotion messages, 19,127 Oral Rehydration Salt (ORS) sachets and 88,450 aqua tabs were distributed, and 771 cases of acute diarrhea have been treated by International Medical Corps’ teams. While this work has helped to save lives and has laid an important foundation of knowledge in vulnerable communities in the Grand North, each hurricane season now brings with it the potential for a large scale outbreak, which combined with difficult terrain and low access to health care, could result in a rapid increase in cases and deaths. Looking forward, International Medical Corps plans to continue these mobile medical units in the Grand North through the fall and then transition to broader Disaster Risk Reduction activities to help to further build resilience at the individual, household, and community level to dangerous threats such as cholera as well as other hazards in the region.
Since 1998, International Medical Corps has worked alongside the Ministry of Health in Kenya to implement a variety of programs in underserved communities throughout the country, including health care, nutrition, tuberculosis and HIV/AIDS prevention care and treatment, and water, sanitation and hygiene (WASH). Using a multi-pronged approach, International Medical Corps’ programs not only provide relief, but also enable self-reliance through education and training.
In 2007, International Medical Corps began work in the semi-arid regions of northern Kenya, including Samburu District, where water is very scarce and women and children walk miles to collect water on a daily basis. Samburu suffers from uneven rain across the district during the four months of rainy season. The people of Samburu are nomadic pastoralists, dependent on livestock and access to water for their livelihoods. Failure to obtain sufficient water for grazing livestock can mean the difference between life and death. The drought and famine crisis in 2011 created an emergency in Samburu, and the region has been fragile ever since. With support from generous donors, International Medical Corps is continuing its work in Samburu District and the region, aimed at improving provision of access to adequate and quality water, improving access to adequate and quality sanitation facilities to vulnerable community members, and improving the health and nutrition status of mothers and children.
In several rural primary schools in Samburu, International Medical Corps is implementing integrated activities aimed at improving the sanitation and hygiene of young children. Lolkunyian Primary School serves 247 students, drawing students from up to a three-hour walk away. Before International Medical Corps’ intervention, the male and female students had to share only three latrines, with no available hand washing stations and no access for disabled students. In response, International Medical Corps recently built two blocks of same-sex latrines, with three to four standard stalls and one stall specifically for persons with disabilities. Additionally, a hand washing station and water harvesting system has been installed to further promote hygiene-related health.
In Donyo Wasin Primary School, which serves 340 students, International Medical School has encouraged the formation of a Health Club to improve the hygiene practices of the students as well as the surrounding community. The Health Club, which is made up of 58 students (30 male and 28 female) from grades one through eight, performs songs and plays which teach sanitation and hygiene techniques for fellow students and the community. As a result of these activities, International Medical Corps has noted significant improvements in beneficiaries’ health, with fewer students visiting the school nurse with complaints of water related illnesses and a decrease in the practice of open defecation in the community.
In Nkutoto, villagers from the surrounding area travel great distances, particularly in the dry season, to reach the only viable water source that is located in the mountains. Unfortunately, this natural spring is unprotected, and is frequently contaminated by wild animal and livestock waste when they use the spring to drink. This contamination resulted in a small-scale cholera outbreak in 2013. After consulting with the community and the Ministry of Health, International Medical Corps constructed a pipeline to bring the water down the mountain, and is currently constructing a cover for the natural spring to protect it from future contamination. With the newly constructed water tap, the community no longer has to walk up the mountain, often with livestock in tow, to reach the water source.
Although the drought crisis has largely passed, International Medical Corps continues to engage the vulnerable population of Samburu District with water, sanitation, and hygiene programs designed to address both their immediate and long-term needs. International Medical Corps’ program is providing schools with improved sanitary facilities and promotion of appropriate hygiene practices, with the help of the health clubs, which will help to improve the quality of life of the children and the teachers, contribute to decreasing school dropout, and reduce communicable diseases such as diarrhea. In addition, the improved water sources, combined with training on how to protect and manage them, will help ensure a modest yet sustainable water supply for the community, improving the lives of mothers and children in this extremely water-scare environment.