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Mar 19, 2020

Using Research to Replicate Success

Dr. Adam Levine leads the research in May 2019.
Dr. Adam Levine leads the research in May 2019.

Throughout the West African Ebola outbreak from 2014 to 2015, the 2018 outbreak in Northwestern Democratic Republic of the Congo (DRC) and the current, second-largest outbreak in history in Northeastern DRC, International Medical Corps was there – gathering data to identify successes and extract lessons learned even as we provided care and technical training. As a result, the International Medical Corps’ Ebola Research Team has assembled one of the world’s largest — if not the largest — archive of published research on the Ebola virus and its treatment.

Two recent studies highlight the importance of collecting information to record lessons learned for the benefit of future responses: 1) the Pamoja Tulinde Maisha (PALM), or Together Save Lives, trial, which studied the effectiveness of four drugs to treat the Ebola virus; and 2) a study on prophylactic antibiotics, or the use of the antibiotics to prevent secondary infections.

With support from national, international, intergovernmental, such as the WHO, and other humanitarian organizations during the PALM trial, International Medical Corps helped test the effectiveness of four drugs in treating Ebola among more than 680 patients. After a string of disappointments in the quest for useful treatments, the results demonstrated that two of the four drugs dramatically increase patients’ chances of survival.

In the 2019 Science magazine, Kai Kupferschmidt writes, “the results [of the PALM study] should help combat the disease not only by improving patients’ chances of survival, but also by encouraging people to seek treatment early. With no effective drugs available, people with symptoms have often tried to evade detection and sought out traditional healers, which has fueled outbreaks.”

Misinformation can make the spread of diseases, such as the Ebola virus, more likely and also encourage people to be more resistant to treatment. However, results of studies like these, ones that demonstrate fewer lives lost and more effective treatments, may help convince people to seek care if they believe there is hope. 

The second study, using data gathered during the West African Ebola outbreak from 2014 to 2015, involved 360 patients diagnosed with the virus. The results found that the mortality rate among patients given the antibiotic fell to just more than half—54.7%, compared to a death rate of more than 73% among those who did not receive the drug. Our study constitutes the first evidence-based research to support the well-known practice. Evidence-based research is important because it helps transform subjective knowledge into objective data, informing not just our future responses, but also those of humanitarian agencies worldwide.

Today, our teams are again collecting data to identify the successes of our work in northeastern DRC and learn as many lessons as we can before the next emergency. Research and knowledge enhance the value of our work – and, most importantly, save lives.

We thank the GlobalGiving community of donors for supporting our efforts to inform and prevent future outbreaks.

Citations

 “Independent Monitoring Board Recommends Early Termination of Ebola Therapeutics Trial in DRC Because of Favorable Results with Two of Four Candidates.” National Institute of Allergy and Infectious Diseases, 12 Aug. 2019, Retrieved on 12 March 2020, from: www.niaid.nih.gov/news-events/independent-monitoring-board-recommends-early-termination-ebola-therapeutics-trial-drc

K. Kupferschmidt, Successful Ebola treatments promise to tame outbreaksScience, Vol. 365, p. 628, 16 August 2019, Retrieved on 12 March 2020, from: https://science.sciencemag.org/content/365/6454/628

Tyler Marshall, International Medical Corps Study Offers First Evidence That a Low-Cost Antibiotic Can Reduce Deaths in Ebola Patients, International Medical Corps, 10 February 2020, retrieved on 12 March 2020, from:https://internationalmedicalcorps.org/story/international-medical-corps-study-offers-first-evidence-that-a-low-cost-antibiotic-can-reduce-deaths-in-ebola-patients/

Ebola survivors leaving the treatment facility.
Ebola survivors leaving the treatment facility.
Mar 5, 2020

Lucky is Four Inches of Water in Your Home

Christine at our health facility in High Rock.
Christine at our health facility in High Rock.

When Hurricane Dorian hit her home, Christine—a nurse from Freetown, Grand Bahama, who works for the Public Hospitals Authority—says she and her two children were the luckiest in their neighborhood: they only had to endure four inches of standing water in the house. Christine remembers empty boats floating between homes, and—thinking about the storm surge that hit the shorelines—what seemed like “25, maybe 30 feet of water.”

She goes on: “The storm was not moving. At one point, authorities said it was moving at one mile per hour. The storm stayed for three days. We thought everyone further on the eastern side’’—which includes the towns of Freetown, High Rock, Pelican Point, and McLean’s Town—“was dead.”

When the storm finally moved on, she says, “it was like Freetown had become a different place.” Some neighbors had between four to five feet of water in their homes. Some—like her cousins, who moved in with Christine—lost their houses entirely.

Before the storm, Christine was a nurse at the Health Clinic based in High Rock, having joined the staff there in 2007. Hurricane Dorian completely destroyed the clinic. Today, Christine is working at health facility that International Medical Corps teams deployed and set up right across the street, days after the storm hit, to ensure that local people in need could continue to access healthcare. She also provides health services around other areas of the eastern part of the island, including Pelican Point and McLean’s Town, seeing about a dozen patients each day.

Nearly six months since Hurricane Dorian hit, power is still not fully restored in High Rock. Though many have moved away, the people who remain continue to need the healthcare services provided at the International Medical Corps’ High Rock Clinic, including medical care, mental health and psychosocial support, and water, sanitation and hygiene (WASH) services, including access to potable water. “We’re very grateful for the support from the US and other countries,” says Christine.

Thank you to the GlobalGiving community of donors for helping provide Christine, and her fellow healthcare professionals, with a place to continue providing urgently needed services in the Bahamas.

The temporary fixed health clinic in High Rock.
The temporary fixed health clinic in High Rock.
Feb 7, 2020

The Need for Suicide Prevention

Gathering information from groups and individuals.
Gathering information from groups and individuals.

After the devastation caused by Hurricanes Maria and Irma in Puerto Rico, International Medical Corps helps to improve mental health and reduce stigma by providing training opportunities and facilitating stress relief and emotion management sessions for both professionals and affected community members. We are also addressing an urgent need for suicide prevention.

The Línea Primera Ayuda Sicosocial, the only mental health support hotline available on the island, noted an 83% increase in calls to their suicide prevention hotline between January 2017 and January 2018. The Department of Health in Puerto Rico also reported that there was a 29% increase in suicides from 2016 to 2017 – compared to a global increase that was nearly negligible at 0.73%.

As a result, with generous support from the GlobalGiving Foundation and its community of donors, we will facilitate urgently needed suicide prevention programming in Puerto Rico.

Our teams in Puerto Rico plan to train health personnel and community members on suicide prevention strategies and how to cope with suicidal ideations. The trainingwill include both role play simulations and group exercises and cover topics like the normalization of mental health issues, myths, risk factors, signs that someone may be suicidal, crisis intervention strategies, stigma against mental health and referral mechanisms.

Following the training, we will support referrals for higher levels of care and professional support to help people know where and how to connect individuals in need with increased care.

Our approach to suicide prevention will include supporting arts-based activities in coordination with local facilities and organizations, like Centro Medico Hospitals and the Servicio de Tratimiento Residencial para Adolescentes.

The arts-based activities will help patients receiving psychiatric treatment learn how to manage their emotions and use positive coping skills, instead of turning to suicide. At the culmination of the program, we will host an art exhibition at a museum in San Juan to raise awareness of the needs surrounding suicide among patients, community leaders and local organizations.

International Medical Corps thanks the GlobalGiving Foundation and its community of donors for supporting our response to mental health needs in Puerto Rico.

Assessing mental health after the storms.
Assessing mental health after the storms.
 
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