Reports from the field
With a population in excess of 150,000,000 people, Global Medic Force considers Nigeria a very high priority African deployment environment.
Nigeria is the 8th most populous country in the world and, in addition to a variety of endemic primary healthcare issues confronting Global Medic Force’s medical volunteers, Nigeria has the 3rd highest HIV/AIDS rate globally.
Global Medic Force has recently completed initial deployments to Nigeria with mentors deploying to numerous hospitals and clinics throughout Lagos, Abuja and across the adjoining Nasarawa State. Due to the success of these programmes, negotiations are now ongoing to expand Global Medic Force deployments nationally across Nigeria.
This is especially important in light of the very high infant mortality rate in Nigeria, which currently hovers at 95 deaths per every 1,000 live births, and which is higher than the infant mortality rate in Sudan, Equatorial Guinea and higher than rates experienced by Global Medic Force deployments in Congo, Rwanda and Burundi.
Specific primary healthcare issues encountered in Nigeria are varied but include: food and waterborne diseases such as diarrhoea, hepatitis A & E, and typhoid; vector borne diseases including malaria and yellow fever; respiratory diseases with complications being most typically tuberculosis; aerosolised dust or soil contact diseases; and animal contact diseases including rabies and hand, foot and mouth disease.
Very limited international assistance is available in the far northwest regions of Nepal given the harsh geographical conditions that volunteers face there. The health facilities in the districts in this remote region are plagued by the unavailability of manpower and resources. Many posts for doctors and nurses remain permanently vacant and the shortage is borne by the local people who do not have access to even the most basic healthcare facilities.
Additionally along the Nepalese / Indian border one also finds one of the areas hardest hit by the HIV/AIDS epidemic due to the high concentration of migrant workers who transmit the virus to their partners upon returning home from labour camps abroad.
Global Medic Force has been deploying to this region for 5 years and, working together with groups such as the Elton John AIDS Foundation, has been giving Nepalese health workers in hospitals and clinics throughout the region, critical medical skills and clinic operations expertise in infectious diseases with an emphasis on HIV/AIDS.
We seek to expand this program to 10 more sites in the coming year. This will create immediate access to quality care and disease prevention for a population of over 1,000,000 people. Thousands of patients will receive access to proper care and treatment, resulting in reduced morbidity and mortality, and with fewer new infections, a reduction in the rising number of AIDS orphans.
Vietnam continues to represent a priority deployment country for Global Medic Force, as the rapid economic growth and urbanisation of the country has transformed the national epidemiology from one of infectious diseases to one of chronic diseases. What this means in practical terms is that more than 70% of people in Vietnam are now dying of conditions that are entirely treatable.
As the 88,500,000 population base of Vietnam is increasingly exposed to the hazards of a new "westernised lifestyle" we see a daily national increase in conditions such a diabetes, chronic obstructive pulmonary disease, hypertension, cardiovascular disease, cancer etc slicing through the entire population.
The public healthcare system in Vietnam is not free and is currently past capacity with tens of thousands of patients sharing beds and co-infections. 35,000,000 Vietnamese have been diagnosed with at least one chronic disease, and 11% of the population has two or more chronic diseases that will certainly kill them if they are not diagnosed and treated. Specifically :
- Vietnam now has the highest rate of chronic obstructive pulmonary disease (COPD) in Asia-Pacific. COPD kills one person every 10 seconds in the world. $77.5 million is spent annually in Vietnam treating late stage COPD;
- Vietnam has the highest growth rate of diabetes type 2 in the world. 18,000,000 Vietnamese are now at risk for the disease, which is equal to one third of the entire population of the UK. 65% of the affected population do not even know that they have diabetes. Only 85 doctors in all of Vietnam know how to treat diabetes;
- 10% of all Vietnamese have been diagnosed with hypertension, while 77% of people with hypertension do not know that they have it;
- 60,000,000 people in Vietnam have parasitic worm infections;
- 200,000 Vietnamese contract cancer each year, with mortality rates reaching 50%;
- Hepatitis B and C infection rates are 10 times higher in Vietnam than in comparable developing countries.
Global Medic Force has launched a public-private initiative to provide affordable, quality healthcare for 22,500,000 patient visits nationally per year, within the next 5 years.
South Africa’s Northern Cape Province is the largest and most sparsely populated province in South Africa. With an estimated population of +1,100,000 people living in an area larger than Germany, it is comprised mostly of desert and semi-desert areas. The landscape is characterised by vast arid plains with outcroppings of haphazard rock piles, vast expanses of space and silence, drought and blazing summer sunshine. About one third of the population lives outside urban areas without reliable transportation or access to healthcare services.
Due to the vast distances involved and limited local resources in the rural areas in this region, doctors are rarely seen and nurses must set priorities to see the most critically ill patients.
Community home-based caregivers are currently very limited in their scope, primarily providing comfort measures to homebound, often terminally ill patients. In this extreme environment, preventative and primary care at the home and community level would greatly impact the critical health issues afflicting these communities: cardiovascular disease, TB, HIV, a high infant mortality rate, and alcoholism.
To meet these unique challenges, Global Medic Force is developing a complete primary and preventative health care system for 100,000 rural residents in the Northern Cape, the addition of a telephonic consultation and referral system for more complicated conditions, and the set-up of community-run health education programs.
The Global Medic Force initiative in the Northern Cape Province follows extremely successful ongoing deployments to Limpopo, Mpumalanga, Gauteng and Easter Cape Provinces, combined with the contiguous states of Swaziland and Lesotho.
Global Medic Force has recently completed an initial evaluation deployment to Honduras. Concentrating on the northwestern regions of Honduras in the Cortes and Bay Islands Departments, this initial assessment incorporated an 850,000 general patient base and concentrated on the availability of infectious disease care in the region.
The initial public hospital and clinic sites that were selected to provide an overview of the entire region included San Pedro Sula, the second largest city in Honduras, the mountain community of Siguatepeque and the Roatan Island area.
While local community medical staff demonstrated excellent core competencies in basic primary care for patients, there is clearly a significant need for a wide variety of Global Medic Force medical specialists to help deal with the regional infectious disease issues. This is especially true in primary healthcare areas such as nursing, paramedical support and pharmacy.
Immediate areas of concern include the fact that Honduras is limited to 200 genotypes per year in the ‘general’ population; there is increasing drug resistance in the population being treated for infectious diseases; no programme is available for vaccinations for patients infected with hepatitis A, pneumococcus or influenza; no protocol exists for treating co-infections with hepatitis B or hepatitis C; there are no psychiatrists and no drug rehabilitation progammes; and the pharmacokinetics of medications needs to be taught formally to the pharmacists of the region.
Once full Global Medic Force deployment status has been achieved nationally, Honduras will constitute a model for Global Medic Force deployments throughout the South American continent.