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Treat Patients with Life-Saving Hepatitis B Meds

by Hepatitis B Free
Treat Patients with Life-Saving Hepatitis B Meds
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

Links:

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

Links:

HBF & Kibibati health workers at training sessions
HBF & Kibibati health workers at training sessions

Hepatitis B can be treated effectively with medications. Yet every day, around 1500 people in the Asia Pacific Region die from hepatitis B and its deadly complications. In this report, we update you on what we’ve been up to fighting hepatitis B in the Asia Pacific.

KIRIBATI

We’re getting ready to treat hepatitis B patients in Kiribati, a Pacific Island nation of around 110,000 people.

In January 2018, our team members were deployed to the main referral hospital on the island of Tarawa, the capital of Kiribati. With the support of the World Health Organization (WHO), we presented lectures to the local hospital staff about the diagnosis and treatment of viral hepatitis (including ultrasound and Fibroscan), the use of lab testing, and clinical documentation.

Kiribati has one of the highest rates of hepatitis B in the world, estimated at 15% of the population.  In addition, 40% of these patients are co-infected with hepatitis D, for which reliable treatment is not generally available. 

During this trip, we evaluated about 80 hepatitis B patients, seeing them alongside local practitioners to allow for clinical teaching. These patient sessions are important to prepare before we start treatment. By the end of the trip, twelve patients were identified to start treatment with antiviral medications, which will arrive soon. Our team will continue to collaborate with the government and other experts around the world.

This program is the first of its kind in the Western Pacific Region. The WHO hopes it will be a model for starting similar programs in other islands.  We are very encouraged by the initial success.

NORTH KOREA

We’re continuing to grow our project in North Korea (DPRK) treating hepatitis B patients. Currently, we are treating around 800 patients and monitoring nearly 1500 patients through the program, called HOPE.

Over the coming year, we'll be working to set up a new third clinic in the city of Hae-Ju to help more patients. We plan to see these patients for the first time during our trip in May-June.

This work isn’t without its challenges. Because of UN sanctions on North Korea, our scheduled trip in March to the DPRK had to be postponed.  We hope logistical issues such as licenses and exemptions will be resolved so we can return in May-June. Our American volunteers have received US State Department approval to travel again, and we are one of the few NGOs still providing humanitarian aid to North Korea.

PAPUA NEW GUINEA

Chronic hepatitis B is a major issue in PNG, with a prevalence of 14%. Having worked in the Oro Province, PNG since 2013, we’re now in the early stages of developing a program to deliver hepatitis B treatment.

In February 2018, Sue Huntley (Co-Director) travelled to PNG to meet with stakeholders in Port Moresby and Popondetta, the capital of the Oro Province. Setting up a project requires detailed logistical planning, including establishing medicine procurement pathways, assessing laboratory and clinical facilities, and building relationships with partners on the ground. We are excited to provide you with more updates as this PNG project grows.

THANK YOU!

We thank all of our donors for their monetary support and encouragement. We couldn’t be doing this without you.  Please feel free to write or contact us if you have suggestions or questions!

Evaluating hep B patients for treatment
Evaluating hep B patients for treatment
Big smiles from kids in Oro, PNG!
Big smiles from kids in Oro, PNG!

Links:

Patient receiving hep B medicines
Patient receiving hep B medicines

Thank you for helping us bring hep B medications to the people in the Democratic Peoples’ Republic of Korea (DPRK). We are so excited to see the program continue to grow and to keep you posted on our progress! 

Here's a snippet of where the project has come so far, in the words of our Co-Director Dr Alice Lee...

It has now been 12 months since we started our first cohort of patients on therapy for hepatitis B. I recall clearly the emotions of our trip last year, the expectant faces and the overwhelming relief and joy. We now have over 800 patients on treatment, and very sadly, we have lost 15 patients to the disease. Some were as young as 22. When faced with this brutal reality, the sense of urgency to expand our program becomes quite desperate.

There is now a quiet rhythm to the program, broken by bursts of energy when faced with technical challenges or with moments of happy joy.  The clinics now seem to hum along, the smiles on patient’s faces, the contentment of the local physicians now familiar with the program as they finally have the empowerment to help their ailing patients. Witnessing the physical, emotional and spiritual change is something hard to describe – many are unrecognisable, a little shy about sharing how they feel, they too find it hard to explain what it is like to not be constantly suffering. They now dare to hope, to expect a different ending. At the same time, there is complete acceptance of whatever fate one is given; the calm way a diagnosis of liver cancer is received, when all we can do is say how sorry we are that we have nothing we can offer.

The delights are real: receiving our second shipment of medicines and seeing it in the storerooms, the smiles of the patients as they came to say hi, that they are feeling better, and the many new patients having heard what we are about tentatively exploring whether they too might trust us, familiar nods from waiting patients passed in the corridors of the hospitals, doctors with a sense of purpose - so many tasks to attend to. Rain and more rain, detours with streets flooded, doctors in their singlets and pants rolled up clearing the debris from the flood, I wondered if there was anything that the staff would not do.

Hepatitis B is an infection of the liver caused by the hepatitis B virus. It can't be cured, but it can be treated with life-saving antiviral medications that help people to live longer and reduce their chances of developing liver cancer and scarring.

What have we achieved so far?

  • 1400 patients screened by physicians for hepatitis B and C
  • 800 patients on life-saving hepatitis B treatment in the DPRK
  • 2 treatment sites: Pyongyang (capital) and Kaesong (a rural town)
  • 4 annual medical team trips in 2016 and 2017 to screen patients, start treatment, train physicians and monitor/evaluate the program

What next for DPRK?

Currently, our program is providing antiviral therapy for hepatitis B. We also screen all patients for hepatitis C, another blood-borne virus that causes liver disease in nearly 100 million people worldwide. So far, we've found around 50 patients infected with either hepatitis C or both hepatitis B and C. But the good news is that hepatitis C can be cured with 12-24 weeks of treatment, by a different type of antiretroviral medicines. So in the future, we hope to add hepatitis C treatment into the HOPE program.

Your support is helping people with hepatitis B to live longer and healthier lives, and on behalf of the entire team we wish to say a huge THANK YOU for making this happen! It has been an incredible journey and a privilege to share it with you!

You can also keep in the loop by checking out our websiteFacebook page and Twitter @hepatitisbfree!

Patient receiving hep B meds
Patient receiving hep B meds
Dr Lee & patient on hep B treatment in Kaesong
Dr Lee & patient on hep B treatment in Kaesong
In the clinic
In the clinic

Links:

 

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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
$33,775 raised of $95,000 goal
 
132 donations
$61,225 to go
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