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Treat Patients with Life-Saving Hepatitis B Meds

by Hepatitis B Free
Treat Patients with Life-Saving Hepatitis B Meds
Hepatitis B Free Team in Popondetta, PNG
Hepatitis B Free Team in Popondetta, PNG

We would like to thank you for your continued support and update you on the latest activities of Hepatitis B Free.  As you can see below, our team of volunteers has been very active in several countries.

Myanmar

One of our team members, Carrie Lee, spent a month in Myanmar at one of our clinical sites as a rotating medical student.  Hepatitis C virus (HCV) infection is a major public health issue in Myanmar, affecting 2.65% of the population. New medications for HCV called directly acting antivirals (DAA) can cure up to 95% of people with HCV and with minimal side effects. However, in Myanmar these treatments have not been widely available to date.  Hepatitis B Free has been a partner in a treatment program for 200 people in the city of Yangon with local NGOs – Medical Action Myanmar and Myanmar Liver Foundation – since 2017 with these new DAA medications.  In December 2018 Carrie spent four weeks at Medical Action Myanmar learning about this HCV project. MAM is dedicated to providing healthcare for the most vulnerable people in Myanmar and specializes in HIV treatment and care.  Carrie says that she has been involved with the HCV project from a distance for some time, so it was rewarding for her to see how the project ran in real life as well as seeing the impact it is having on the lives of individuals. She was able to sit with the doctors and see patients at various stages of treatment, from diagnosis, the middle of treatment, and the end of treatment. One patient shared his story about how he became infected with HCV following a car accident seven years ago. It was the middle of the night and he needed an urgent blood transfusion, but with none immediately available, one of the doctors donated his own blood – unfortunately without time to screen the blood for blood borne viruses. The patient expressed his concerns about his family, and his relief that he received treatment at MAM for no cost and with no side effects. Sadly, this is a common story for people in countries with limited blood bank screening.  Carrie also worked on a report about the HCV program that was submitted to the Myanmar Ministry of Health in January 2019. Hepatitis B Free is currently working with MAM staff to explore expanding HCV treatment to other, more remote, regions of Myanmar.

North Korea (DPRK)

Due to sanctions and changes in US State Department policies, our team has been unable to travel to the DPRK for the past six months.  Fortunately, the State Department gave approval to our American partners to travel, and we plan to return to North Korea for 8 days in late March.  Currently, there are over 1200 patients on life-saving treatment for hepatitis B and many more should be added on the upcoming trip.  Additionally, we will be opening a fourth clinic and initiating plans for a fifth one.  Through a generous donation we have been able to obtain funding for a GeneXpert machine which will give us the capability to measure hepatitis B and C viral load.  This will greatly improve our diagnostic capabilities and allow us to treat hepatitis C as well as B.  It will potentially give us the ability to treat hepatitis B-infected pregnant women in order to reduce the risk of passing the virus to their babies.

Kiribati

Work continues in Kiribati despite the absence of some key local personnel due to maternity leave and illness.  We now have nearly 100 patients on treatment.  We are pleased to have a new volunteer, Dr. Aidan Foy, join Hepatitis B Free.  Aidan is an experienced gastroenterologist who has a special interest in working in Kiribati.  He will travel in late March with one of our board of directors, Sue Huntley, to provide training, see patients, and give administrative support to the local team.

Papua New Guinea (PNG)

In February three team members went to PNG to train local health professionals, identify patients to start treatment for hepatitis B, and to finalize arrangements for the delivery of hepatitis B medications.  Thirty-six patients with chronic hepatitis were seen and labs drawn.  Approximately ten of these will need to be started on treatment.  Clinics were set up at Popondetta General Hospital and Siroga Clinic, and lead physicians have been designated.  Team members met with the governor of Oro Province, members of Parliament, and the CEO of New Britain Palm Oil Company, and we are hopeful after these meetings that there will be sustained funding of the project with expansion in the future.  We also are welcoming a new Hepatitis B Free volunteer from the UK, Dr. Luke Mair, who will spend 3 months at Popondetta, working in clinics and leading efforts on a study to determine the prevalence of hepatitis B in the province.

Once again, we thank you for your contributions to our efforts.  There is much to be done, and we are anxious to expand our efforts into other countries, such as the Solomon Islands.  Please let others know about our organization and our efforts to combat this deadly disease.

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Happy holidays to our supporters, donors and friends,

 

We would like to thank you for your support and dedication to Hepatitis B Free this year.  Each one of you has played an important role in the success of our program this year.

Through your generosity we have been able to start hundreds of new patients on life-saving therapy for hepatitis, to continue training programs for health professionals, and to initiate national treatment programs in several new countries.  Our teams of volunteers have traveled every month to the countries we have served and provide education on a weekly basis through teleconferencing.

Attached is an article published in a medical journal describing our work in North Korea.

We wish you a joyous holiday season and a prosperous 2019!

Warmest regards,

The Hepatitis B Free Team

 


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September 2018, DPRK (Hepatitis B Free & CFK)
September 2018, DPRK (Hepatitis B Free & CFK)

We continue to be grateful for the efforts of those who support our cause of eradicating hepatitis. We are pleased to provide an update on our programs with some new successes to report and continued challenges in other areas.

North Korea (DPRK)

One of our team members, Sue Huntley, travelled to the DPRK in September for the scheduled quarterly visit. The treatment program continues to enrol new patients with hepatitis B, and over 1200 individuals are now receiving life-saving therapy.

A new challenge to our efforts was the US State Department’s refusal to grant exemptions to the travel ban to the DPRK for any humanitarian organization beginning in October. Thus, American members of Hepatitis B Free and our US partners were denied permission to travel to the DPRK for the scheduled November visit. We are hopeful that this ban on humanitarian aid will soon be lifted, and we ask your assistance in expressing your concern to legislators over this policy.

A scholarly paper which describes our DPRK program was published online in the journal Gut and Liver in September.

Fiji

We are pleased to announce that a national program of hepatitis B treatment is beginning. This represents the culmination of several years of hard work on the part of HBF. Two members of the team are currently in Fiji to train local providers and to support local government health officials as this program gets underway.

Kiribati

We see steady progress in the hepatitis B treatment program in Kiribati. Turnover in local medical personnel and a lack of resources always provide challenges in these remote islands. After a successful visit in August, two members of the team are travelling to Kiribati this week for training and patient care. Regular training also takes place through teleconferencing.

Papua New Guinea (PNG)

Another significant advance to report is the approval of a hepatitis B treatment program in the Oro District in PNG. Government endorsement of the project, acquisition of drugs at a discounted price, identification of supporting clinics, and laboratory support have all been achieved. As soon as an import license is approved, treatment with antivirals can begin. The first training session of local providers was accomplished by HBF last week through teleconference. We are hopeful that the drugs will arrive, and patients will start treatment during the first quarter of 2019. A team from HBF will travel to PNG to support the rollout of the program at that time.

Myanmar

Two members of the team will travel to Yangon in December to provide technical support and patient care for patients co-infected with hepatitis C and HIV. Our partners on this project Medical Action Myanmar (MAM) have done an outstanding job of providing patient care, detailed documentation, and management of medications.

FibroTouch

A welcome addition to our clinical capabilities was the provision of a FibroTouch transient elastography machine by HI SKY corporation from Beijing, China. This device is more portable and lighter than our current equipment, and, best of all, is battery operated. This will expand our capabilities to test for liver fibrosis and cirrhosis.

We are excited about the prospects for the coming year and thank each one of you for your support and encouragement!

The Hepatitis B Free Team

Photo credit: Christian Friends of Korea (2018)

Seeing patients in DPRK
Seeing patients in DPRK

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Dr Alice Lee training local physicians, DPRK
Dr Alice Lee training local physicians, DPRK

Since the last project update, we've been busy working to support hep B treatment for people in the DPRK and Kiribati.

DPRK

Robyn Laube, gastroenterology trainee & medical officer for Hepatitis B Free

Almost two years since the first patients were started on hep B antiviral medicines in the DPRK, volunteer teams have been returning four times each year. During these clinics, the international and local doctors see patients together, monitoring their response to treatment and starting new patients on treatment. Now, there are three clinic sites - Pyongyang, Kaesong, and Haeju.

Since our scheduled trip in March was unable to proceed due to the political circumstances, our June trip was the first this year. It was long awaited by both the hepatitis B patients and the local doctors. Together with Christian Friends of Korea (CFK), over seven days we saw a total of 978 patients across three different cities. Our joint team consisted of Heidi, Terry, Marcia and Stone and five doctors (Alice, David, Sissel, Christine, and myself).

Our clinics in Pyongyang and Kaesong are now well established and beginning to pick up pace, and this trip marked the first time we saw patients in Haeju. Haeju is located three hours south of Pyongyang by road, a beautiful drive through rice paddies, cornfields and breath-taking mountain ranges.

The electricity for our clinic was provided by a portable generator, and the water for the hospital was sourced from a single pump previously donated by CFK. The hospital laboratory contained only basic equipment such as test tubes and pipettes. Plans are currently underway to construct a new building for the hospital, including a well-equipped laboratory.

The patients in Pyongyang and Kaesong are now more familiar and comfortable with our program. They greeted us with warmth and smiles, remarking that they were happy to see us and had been looking forward to our arrival. It was heartwarming to see their faces light up as they saw their blood tests improving, signifying the success of their antiviral therapy.

The local doctors are eager to learn and have a fantastic sense of ownership of their patients. Despite their limited resources, they do whatever they can for their patients. They enjoyed having this opportunity to ask questions and practice their English skills as well as their hepatitis knowledge. They even took time out to play a game of basketball with us outside the hospital!

Our next visit in September will mark two years since the first patients were commenced on therapy, and already we cannot wait to return!

Kiribati

Since this year, hepatitis B treatment has been made available for people in Kiribati, a Pacific Island nation home to 114,000 people. Our team members have been supporting local physicians and health workers to deliver this program via regular teleconferences and training sessions, as well as in-country visits every few months. The remote distance of places like Kiribati makes it challenging to engage in education and training, but with growing mobile and internet connectivity, technology offers a way to make this possible. In collaboration with other organisations with training experience in the Pacific, we'll be continuing to build on a curriculum for health workers and doctors in order to upskill local health professionals to manage and care for people with hepatitis B.

Recently in August, Sue Huntley travelled to Kiribati and met with health professionals and patients, hearing stories about how this treatment has impacted their lives. In places where treatment has never before been available, hepatitis B has been known and feared as the cause of 'big belly, skinny legs' - meaning that people without access to treatment developed complications of severe liver disease. However, now that treatment is available, people have been able to get back to work, support their families, and have a sense of future.

Thank you!

We are truly grateful for your support and contributions which make these projects possible. It is incredibly rewarding to see the impact of these treatments on peoples' lives and are grateful for the opportunity to share these updates with you!

If you would like to know more or get involved, we would love for you to visit our website, Facebook page, or get in contact with us directly.

Photos by Robyn Laube (DPRK) and Sue Huntley (Kiribati)

Mountains in the korean countryside
Mountains in the korean countryside
Hep B patient in Kiribati (with permission)
Hep B patient in Kiribati (with permission)
Kiribati
Kiribati

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Assessing patients in the Kiribati clinic
Assessing patients in the Kiribati clinic

Thank you for your generous donations and continued support of our projects.  Through your generosity we have been able to expand our programs and increase the number of patients on treatment for hepatitis B (and C).  We are privileged to have you as partners as we care for patients and their families in the Pacific and in Asia affected by these deadly diseases.  Your support has changed lives!

Treatment begins in Kiribati

In our last report we told you about our initial trip to the island nation of Kiribati in which we trained health care professionals and identified patients to start treatment for hep B.

Since then, we are happy to report that antiviral medications have arrived in country, and the first cohort of patients have been started on therapy. Two members of Hepatitis B Free (Dr Thao Lam and Co-Director Sue Huntley) traveled again to Kiribati in May. On this trip, they continued to identify patients, trained local staff, and helped prepare and coordinate the treatment program.

As well as treating adults with chronic hep B, we have written a proposal to help fund a treatment program for pregnant women infected with hepatitis B. This is important to prevent hep B infection from mother to child at birth, one of the most common ways hep B is spread.

Our next trip is being planned for mid-July.

Plans Progressing in Papua New Guinea

As we write this update, our co-director Sue Huntley is in Papua New Guinea attending a World Health Organization summit on hepatitis. Sue had the privilege of meeting the First Lady of Papua New Guinea who has graciously agreed to be a spokeswoman for World Hepatitis Day!

We are soon hoping to start a hepatitis B treatment program in Papua New Guinea using the model of treatment and care we have used in other countries. The PNG government and our partners, whom we have worked with for several years, have shown much support for our proposals.

Clinical Work Resumes in North Korea

We are happy to report that we were able to obtain licenses from the US government and the United Nations to import necessary supplies to our hepatitis clinics in North Korea.

In June, three members of our team will be traveling to North Korea to see some of the more than 800 patients on treatment for hepatitis B. As well as visiting clinics at Pyongyang and Kaesong, we will also start work at our newest site at Hae-Ju. It will be a busy trip with long hours and lots of travel.

Thanks once again for joining us on this journey. Our job won't be done until the world is free of hepatitis B!

Patients waiting outside the clinic in Kiribati
Patients waiting outside the clinic in Kiribati
Sue Huntley meets with the First Lady of PNG
Sue Huntley meets with the First Lady of PNG

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Organization Information

Hepatitis B Free

Location: Linley Point - Australia
Website:
Facebook: Facebook Page
Twitter: @hepatitisbfree
Project Leader:
Alice Lee
Linley Point, Australia
$35,205 raised of $95,000 goal
 
149 donations
$59,795 to go
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