PIH's Emergency COVID-19 Response

by Partners In Health (PIH)
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PIH's Emergency COVID-19 Response
PIH's Emergency COVID-19 Response
PIH's Emergency COVID-19 Response

Nurse practitioner Lazara speaks with an Immokalee resident before she gives him the Covid-19 vaccine at a Healthcare Network of Southwest Florida vaccine inoculation site in Immokalee, FL on Thursday, May 20, 2021. (Photo by Scott McIntyre for Partners In Health)

Dear Friends,

First and foremost, thank you so much for your generous support of PIH’s Emergency COVID-19 Response. Your gift helps battle the lasting effect of COVID-19 while transforming the lives of so many people in need of hope and health care.

Despite a recent rise in COVID-19 cases, many communities across the country are grasping for a return to normal: vaccine mandates are being rolled back, masks are increasingly optional, and people are returning to their everyday social activities.

But local leaders and community-based organizations in Immokalee know the country––and their southwestern Florida town––are far from returning to normal. So, they continue scheduling testing fairs, prepping food packages for people in isolation, and conducting vaccine outreach and education. For them, adapting to shifting federal guidance is nothing new. And with COVID-19 likely to continue disrupting the lives of their community, local leaders are prepared to respond to COVID-19 long after the news cycle moves on.

Even as national cases increase and more subvariants emerge, federal funding is drying up. Medical care reimbursement funds for many millions of uninsured COVID-19 patients have already run out of cash. Claims for testing and treatment are being denied, leaving states scrambling to figure out their own short-term fixes. And lawmakers have not yet agreed to extend even a portion of the $22 billion in emergency funding requested by President Joseph Biden. Failure to pass this means fewer tests available to people living in the United States, less surveillance for future variants, and a risk of running out of vaccines and affordable treatments.

So, if nearly a million deaths since the start of the pandemic isn’t enough to generate political resolve and the federal dollars never appear, where does that leave us?

In the absence of a cohesive and comprehensive federal plan, local health departments, community-based organizations, and others across the country are stepping up to assume the responsibility of accompanying their communities through this new phase, just as they have throughout the entire pandemic.

At Partners In Health, we’ve seen the consequences of congressional inaction play out among individuals and families as we’ve worked with public health departments and local leaders to successfully navigate the impacts of COVID-19 on those most affected by this health crisis.

When elites – the predominantly white cadre of Americans with political and financial power – feel safe, the impetus and political will for protective measures evaporates, further exacerbating health inequities. But local leaders continue to forge ahead, adapting COVID-19 guidance, delivering resources, and providing critical support to ensure communities they deem most in need and at risk remain protected—and prepared.

In Immokalee, PIH and our partners have bridged gaps in response efforts by serving as community-based public health navigators to meet the needs of Immokalee’s residents. Through a group of health promotores, we worked alongside our partners at the Collier County Department of Health, the Coalition of Immokalee Workers, Healthcare Network, and Mision Peniel to provide individualized help to members of the community, from securing transportation to testing and vaccination sites, to delivering food and providing rental assistance, labor protections, and cash to help cover costs during quarantine and isolation.

Through this partnership, over $950,000 in direct transfers have been provided to over 800 households. This crucial support protected the livelihoods and well-being of local farm and packinghouse workers.

Departments of health in other parts of the country are applying a similar approach. Despite an uptick in cases across the state, the rate of COVID-19 infections in the port city of New Bedford, Mass., continues to decline. When Omicron threatened to reverse the progress New Bedford had made in controlling COVID-19, the local health department pivoted existing efforts, devising a strategy that doubled-down on access to testing and vaccination.

In December, even before the White House began distributing free, at-home tests to households across the country, the health department in New Bedford worked with community organizations to distribute 38,000 testing kits to local populations that were the least vaccinated and therefore most at risk for illness, as well as those that have seen disproportionately high case rates.

Across the country, local health departments and community leaders have developed and modified strategies, and built the human resources and infrastructure required to execute them. Federal funding must come through, full stop. If it doesn’t, we could be sending ourselves back to the darkest days of the pandemic, competing for limited tools to combat the spread of a debilitating disease. Such a scenario all but guarantees ongoing inequity in COVID-19 impact falling along familiar fault lines of historical and structural injustice.

In the meantime, while organizing for change, we can lift up and learn from the community preparedness and ingenuity exhibited in places like Immokalee and New Bedford as local response strategies that can both succeed on their own and inform the development of future interventions when federal funding does come through.

Your solidarity with our staff and patients helps us continue to respond to the pandemic in four different continents and bring quality health care to people in the most impoverished communities all over the world. This work would not be possible without you! Thank you again for your kindness. Together we can prove that injustice has a cure!

In Solidarity,

Partners In Health

Photo of Luis receives the Covid-19 vaccine from nurse practitioner Lazara at a Healthcare Network of Southwest Florida vaccine inoculation site in Immokalee, FL on Thursday, May 20, 2021 and photo of main Street in Immokalee, FL on Thursday, May 20, 2021. (Photos by Scott McIntyre for Partners In Health) 

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Thousands of vulnerable patients are about to breathe easier, thanks to a new oxygen plant installed by Socios En Salud and partners earlier this month.

More than 36,000 people requiring medical oxygen in the La Libertad region of Peru will benefit from the oxygen plant, which was installed at Belén Hospital by Socios En Salud, as Partners In Health is known in Peru, the Ministry of Health, USAID, and Build Health International.

The oxygen plant comes as COVID-19 cases in Peru surge amid the highly-contagious Omicron variant, which has brought the country’s total coronavirus-related deaths to 204,404 and total infections to more than 2.9 million, according to Reuters.

“Since the beginning of the pandemic, we have fought to help close the oxygen gap,” said Dr. Leonid Lecca, executive director of Socios En Salud. “With this new oxygen plant…we ensure that more patients have access to timely and quality care.”

Oxygen is one of the last lines of defense against COVID-19, which attacks the respiratory system and, in its most severe form, requires intubation. Hospitals put patients on oxygen in hopes of preventing them from needing an ICU bed.

But the lifesaving resource is difficult to get—especially in Peru, where logistical challenges such as irregular access to electricity and the country’s electrical specifications stymied the supply chain for months.

Oxygen plants—which fit in standard-size shipping containers—are essential in oxygen production, because they enable hospitals to fill dozens of portable tanks each day. This onsite supply of concentrated, high-purity medical oxygen prevents health workers from having to travel to the nearest oxygen plant, sometimes hours away.

But oxygen plants are costly and cumbersome to install—making Socios En Salud’s efforts all the more critical.

The oxygen plant in La Libertad can produce 20,000 liters of oxygen per hour, strengthening the hospital’s response to COVID-19 and other respiratory diseases, such as pneumonia.

It’s the second that Socios En Salud has provided in partnership with USAID and the Ministry of Health. The first was installed in November at the San Martín Health Center in Iberia district, near the border with Brazil and Bolivia.

Socios En Salud has worked in Peru since 1994, where it responded to a deadly outbreak of multidrug-resistant tuberculosis and ultimately changed World Health Organization policy, leading the WHO to revise its global treatment recommendations for the disease. In the decades since, Socios En Salud has continued to provide medical care and social support in Carabayllo and beyond, focusing on strengthening the country’s health system.

As part of those system-strengthening efforts, health workers at Belén Hospital will receive training on how to use and maintain the oxygen plant, which is Socios En Salud’s latest effort to boost oxygen capacity in Lima and beyond.

Since November, Socios En Salud has delivered more than 120 oxygen concentrators and 90 oxygen tanks to hospitals across Peru, as well as installed 260 oxygen outlets directly into hospital walls, beside patient beds.

Socios En Salud also established a temporary oxygen center in Carabayllo for patients with dangerously low oxygen levels. A second such center is planned to open later this month.

The COVID-19 pandemic persists.

As we enter the third year of the global public health emergency, the virus continues to mutate and spread in the absence of worldwide vaccination. Omicron, the latest highly contagious variant, has caused COVID-19 cases to skyrocket in many countries. In early 2022, a world record was set: more than 9.5 million new COVID-19 cases were reported within a week, according to the World Health Organization. In total, more than 5.5 million people have died from COVID-19 and more than 332 million cases have been reported. Hospitalizations–mostly among unvaccinated people–are rising too.  

This has been a challenge for already strained hospitals and health care workers at Partners In Health (PIH) sites around the globe, including in Kazakhstan, Peru, Rwanda, and Sierra Leone, among others.

In Kazakhstan–where the president called for a two-week state of emergency on January 5 following political unrest and violence–clinicians are seeing a surge in cases, which the country’s ministry of health has attributed to the Omicron variant. In addition, the Delta variant is still present more than a year since it was first detected globally.

In Peru, the rate of infected people doubled last week compared to the previous week. PIH-supported facilities in the country have seen a rise in infections and hospitalizations, mostly among those who are not fully vaccinated. Compared to most countries, Peru is ahead of the curve with vaccination: about 80% of people have received two doses and 14% received a booster. 

Rwanda is not far behind. As of January 9, about 60% of the population have received two doses. Unlike many sites, PIH-supported facilities in Rwanda have not seen an increase in hospitalizations. However, they are still experiencing a fourth wave of COVID-19 due to the Omicron variant. While cases have been mild or asymptomatic, there are still many people at risk who have yet to be vaccinated.

Although the Omicron surge is flattening across many parts of Africa, the impact of the variant continues to be felt in countries such as Sierra Leone. The surge affected many PIH staff members, who were unable to go to work during the holiday season, which put additional stress on service delivery. In communities across Kono District in the east, the spread of COVID-19 has mostly gone undetected due to a widespread shortage of tests. Most of the reported cases have been among inbound and outbound international travelers. There is a significant need for more tests and vaccines. Less than 4% of the population is vaccinated and less than 0.1% has received a booster shot. 

Recently, PIH experts and fellow researchers published a report that highlighted the need for more mRNA vaccines–22 billion, to be exact, which they estimate is the number that must be manufactured and administered to control COVID-19 globally. Meanwhile, clinicians continue to build health systems by focusing on the vital 5 S’s–staff, stuff, space, systems, and social support–which are needed to respond to emergencies and provide lifesaving health care now–and beyond the pandemic. 

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Dear Friends,

First and foremost, thank you so much for your generous support of PIH’s Emergency COVID-19 Response. Your solidarity with our staff and patients helps us continue to respond to the pandemic in four different continents and bring quality care to so many people in need of health care and hope.

Since March 2020, PIH has led targeted interventions in the United States and across the globe to respond to urgent needs, such as training contact tracers and providing stocks of PPE and rapid tests, while also strengthening health systems so that they can better respond to future pandemics. Alongside our partners, PIH will continue to save lives, positively change the course of the pandemic globally, demonstrate what aggressive action can achieve, and ensure a healthier future for all. This important work is only possible because of contributions and support by dedicated supporters like yourself.

As COVID-19 remains a threat worldwide, lifesaving vaccines continue to be inaccessible for the majority of the world’s population—including Indigenous communities in Latin America and the Caribbean. PIH in Mexico calls for vaccine campaigns to address the needs of Indigenous peoples in these regions. By August, 17% of Mexicans had been fully vaccinated, and 26 million had been given at least one dose. Across the country, 91 million people are still waiting for vaccines, even as the third wave of the pandemic triggers a surge of new cases in several areas.

Dr. Popoca conducts a consultation with a patient in the Respiratory Disease Center, Susana, from Jaltenango. She had tested negative for COVID-19 but had respiratory symptoms.

During COVID-19, Compañeros En Salud which is known as PIH in Mexico rapidly mobilized to respond to a pandemic that has devastated millions worldwide. We have been providing the PIH-supported community hospital in Jaltenango with training, resources, and staff; implementing strict infection and prevention control measures; and opening a brand new, seven-bed Respiratory Disease Center for patients with severe COVID-19, in an area where such facilities are extremely rare.

Miguel is currently the only paramedic for the hospital in Jaltenango, which is supported by Compañeros En Salud. Photo by Caitlin/ Partners In Health.

In Peru, where has the highest COVID-19 deaths per capita in the world, the pandemic continues to devastate communities across Peru. Socios En Salud—as PIH is known locally—has delivered more than 120 oxygen concentrators and 90 oxygen tanks to hospitals nationwide, as well as installed 260 oxygen outlets directly into hospital walls, beside patient beds.

Socios En Salud staff, including Marco, participate in a training on the installation and maintenance of oxygen equipment, held at a health center in Comas and organized by the Center for Global Health. Photo by Fernando/ PIH.

Oxygen concentrators are a huge help in caring for patients with respiratory difficulties and prevent them from landing in an ICU bed,” Dr. Muñoz, a physician at the oxygen center. “With this technology, we can save the lives of thousands of people.

During these difficult times, we must stand in solidarity and act together now, more than ever, as the virus continues to spread globally, new variants emerge, and vaccines remain out of reach to millions. We are part of a global community. Until everyone is protected, no one is protected.

Last but not least, we are so thankful for all of your tremendous support and your commitment to our mission that enable us to provide equitable health care and urgent support to the poor and the marginalized around the world. We wish you all the best, and thanks again for your partnership!

In solidarity,

Partners In Health

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A COVID-19 ICU in Rwanda
A COVID-19 ICU in Rwanda

The COVID-19 pandemic isn’t over yet. 

Although some businesses have re-opened and restrictions have loosened in the United States and Europe, a third wave of infections is affecting countries around the globe, including ones where Partners In Health (PIH) works. 

The most recent wave, which is when there is a surge in the number of cases over a period of time in a particular region, has been documented in Haiti, Lesotho, and Sierra Leone, among other countries. While there are many factors that contribute to waves, one currently is the emergence of virus variants, such as the highly contagious Delta variant identified in 92 countries, as of June 21. First detected in India in October 2020, the variant continues to spread.

PIH’s approach to building strong health systems and responding to emergencies relies on the five S’s: staff, stuff, space, systems, and social support. In Haiti, a lack of “stuff,” namely vaccines, has had a significant impact on the country’s 11.5 million residents. As of June 30, COVID-19 vaccines have yet to become publicly available in the Caribbean nation. Additionally, “space” has posed a challenge, as some hospitals have reached their limit on the number of COVID-19 patients they can accommodate. Within the the network of hospitals and clinics supported by Zanmi Lasante, PIH’s sister organization in Haiti, there are 73 beds—33 of which were occupied, as of June 28— for COVID-19 patients at Hôpital Universitaire de Mirebalais and Hôpital Sainte-Thérèse in Hinche, which are the only two ZL-supported facilities providing direct care to patients with COVID-19.

Across Africa, COVID-19 cases are surging by 20% on a weekly basis and are quickly approaching numbers documented during the peak of the first wave in July 2020. In Lesotho, where an influx of people are crossing the border from neighboring South Africa—which has the highest number of COVID-19 cases on the continent, cases are rising and particularly affecting Leribe and Butha-Buthe districts, which are supported by the country’s national health reform, and Maseru district, where the central office is based. In response to the current wave, PIH Lesotho continues to supply oxygen to hospitals; provide logistical support to transport vaccines and health care providers throughout the country; run a mental health and staff wellness program to help health care workers cope with COVID-related stress; and get more rapid antigen test kits, in addition to the 10,000 they recently donated to Lesotho’s Ministry of Health.

In Sierra Leone, COVID-19 cases are increasing and are at their highest since the beginning of the pandemic. There is a significant need to increase surveillance, prevention, and case management.  As PIH Sierra Leone responds to the current wave, the team is focused on treating patients and providing social support, as they prepare for anticipated challenges, including oxygen and ICU bed shortages. Amid the third wave, new restrictions including a curfew, suspended religious ceremonies, and limited occupancy on social gatherings, were announced on July 1.

The number of COVID-19 cases, and the resulting death toll, will only continue to rise in countries unable to properly prevent the virus’ spread, care for and support the sick, and conduct comprehensive vaccination campaigns. PIH continues to advocate for equitable global COVID-19 vaccination distribution, especially considering only 0.9% of people in low-income countries have received at least one dose of a COVID-19 vaccine compared to 45% of people in high-income countries. 

At PIH, we believe that no one is safe from COVID-19 until everyone is safe.

Jacqueline, a COVID-19 lab technician
Jacqueline, a COVID-19 lab technician
Patient receiving oxygen in Freetown, Sierra Leone
Patient receiving oxygen in Freetown, Sierra Leone
Felix, a COVID-19 survivor in Carabayllo, Peru
Felix, a COVID-19 survivor in Carabayllo, Peru
Community Clinic in Chiapas, Mexico
Community Clinic in Chiapas, Mexico

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Nurse is prepped for COVID-19 vaccine in Chiapas
Nurse is prepped for COVID-19 vaccine in Chiapas

Due to the support of donors around the world, Partners In Health staff have begun to receive COVID-19 vaccines. Starting in late January, staff members in Chiapas, Mexico, began receiving their first dose of the vaccine, the first step of many in the long journey back to a post-COVID world.

When COVID-19 arrived in Mexico in late February last year, clinicians in Chiapas held their breath. The pandemic would not arrive in the southwestern state until March and, even then, would remain in the single digits for weeks. But doctors knew the worst was coming—it was only a matter of time.

“It took so long for the pandemic to reach Jaltenango,” says Dr. Selene Chacón of Compañeros En Salud, as Partners In Health is known locally. Chacón is based at the community hospital in Jaltenango de la Paz.

When the virus did arrive, it would leave no community unaffected. In late March, cases jumped from single to double digits, passing the 1,000 mark in May. By June, the surge had begun; Chiapas joined the rest of the country at the maximum “red light” level on the Mexican Ministry of Health’s stoplight map.

Compañeros En Salud has worked since 2011 in Chiapas, where it has focused on strengthening health systems in Jaltenango and surrounding rural communities. That work has included a mentorship program for first-year

 state until March and, even then, would remain in the single digits for weeks. But doctors knew the worst was coming—it was only a matter of time.

“It took so long for the pandemic to reach Jaltenango,” says Dr. Selene Chacón of Compañeros En Salud, as Partners In Health is known locally. Chacón is based at the community hospital in Jaltenango de la Paz.

When the virus did arrive, it would leave no community unaffected. In late March, cases jumped from single to double digits, passing the 1,000 mark in May. By June, the surge had begun; Chiapas joined the rest of the country at the maximum “red light” level on the Mexican Ministry of Health’s stoplight

clinicians, a community health worker program, and support for the public health system, including a community hospital, a birthing center, and rural primary care clinics.

From the moment it arrived, COVID-19 put that system to the test—challenging doctors, nurses and care delivery teams to think quickly on their feet and improvise when necessary, in response to a pandemic that often showed little sign of relenting.

As cases ticked upwards, clinicians delivered critical treatment at all hours of day and night, tending to patients as they recovered, or as they took their last breath.

That care has made an impact. Although cases are ticking upwards, as expected following the holidays, clinicians are better prepared. The mortality rate in Chiapas has steadily declined since August. And the state was no longer “red” on the stoplight map, as of mid-January.

Now, as the fight against COVID-19 continues, clinicians are leveraging their expertise and experience to respond with compassionate care, applying lessons learned over the past several months. That work has made one thing clear: investing in public health systems is crucial—for the pandemic response and beyond.

A Race To Respond

When Selene Chacón finished medical school, she took a leap of faith and decided to do her year of social service, required by the Mexican government for all university graduates, with Compañeros En Salud through its pasante program.

The program, designed for first-year doctors and nurses, placed Chacón in a rural community clinic, where she provided primary care and received training and mentorship from experienced physicians. Chacón was so moved that, after the program ended, the newly minted doctor decided to continue her work with Compañeros En Salud.

Then, COVID-19 struck.

What followed was a race to respond to a public health emergency that intensified by the day. As COVID-19 cases mounted in Chiapas, clinicians scrambled for resources that were scarce, including tests, and struggled to keep up with rapidly evolving public health guidance.

“There was not much information at the time or guidelines on how to treat patients,” says Dr. Ana Rodríguez, who supervises the COVID-19 medical team at PIH-supported Angel Albino Corzo Community Hospital. “The protocols were based on very new information.”

But that didn’t stop clinicians. In her new role as infection and control coordinator, Chacón sprang into action, working with her team to establish a triage system at the hospital and to coordinate the pandemic response across all of Compañeros En Salud’s care delivery sites. And Rodríguez, based in the community hospital’s COVID-19 unit, treated patients, trained doctors, and managed care delivery.

None of those things were small feats.

Mexico provides universal health care to citizens, but that care can be hard to access in states like Chiapas, where the majority of people live in poverty, and in rural areas, where travel can be cumbersome and costly, often on poorly paved roads. For many rural communities, the nearest hospital is hours away.

‘We Are In This Together’

Despite the initial hurdles, Compañeros En Salud has delivered care to an increasing number of patients over the past several months as resources, staffing and capacity have improved. Since April, the team has treated at least 526 suspected and 16 confirmed cases at the community hospital and clinics.

In July, Compañeros En Salud partnered with Angel Albino Corzo Community Hospital to open the Respiratory Disease Center, a 5-bed facility equipped with oxygen concentrators to treat patients with severe COVID-19—care that once would have required a long, costly journey to another hospital at least two hours away. Within weeks, the center saw its first patients and helped them recover and return home to their families.

Compañeros En Salud also worked with hospital leadership to introduce a new policy that allows family members to visit their loved ones with personal protective equipment—the only hospital in the area that offers such visitation. That decision has been crucial in helping patients recover and fighting the disinformation about the virus that once ran rampant, encouraging more people to seek medical care.

“Patients now have more information and less stigma,” says Rodríguez.

She has seen that shift first-hand. Nowadays, patients come to the hospital early on, when their symptoms are still mild, instead of waiting until they worsen—a sign that gives clinicians hope that communities now have a better understanding of the virus and when to seek care.

“At Compañeros En Salud, we are already more prepared,” says Chacón. “We already have experience, and this is a strength.”

Still, the doctor urges caution. “We cannot lower our guard,” she says. “There will still be peaks…people must know that we are still here and we are in this together.”

PIH doctor holds baby Naphtal in Sierra Leone
PIH doctor holds baby Naphtal in Sierra Leone
CHW's spread information in Immokalee, FL
CHW's spread information in Immokalee, FL
Supporters of the People's Vaccine, Cambridge, MA
Supporters of the People's Vaccine, Cambridge, MA
Community health workers in Lima, Peru
Community health workers in Lima, Peru
Mother and child at home visit in Malawi
Mother and child at home visit in Malawi

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Organization Information

Partners In Health (PIH)

Location: Boston, MA - USA
Website:
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Twitter: @PIH
Project Leader:
Aicha Belabbes
Boston, MA United States
$6,676 raised of $50,000 goal
 
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$43,324 to go
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