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60 Minutes broadcast raises awareness and support

The 60 Minutes segment featuring PIH broadcast on May 4 reached an estimated audience of more than 10 million people. If you weren’t among them, you can still view the show online by clicking here. Many viewers responded to the broadcast with messages and contributions of support for PIH and the poor communities we serve. At last count, PIH had received more than $400,000 in donations linked to the show.

Many of the contributions were accompanied by moving messages of support. One viewer wrote:

“After watching the 60 Minutes episode I sat numb for nearly a half hour. I was devastated by the idea that the richest country in the world is wasting billions on a war and we could be wiping out hunger & Malaria.

“I changed the channel and found a couple debating whether to spend 20 thousand dollars to remodel their kitchen or to put in a pool. How would that affect their resell value? Shame on us!

“I don’t have alot of money, but I will help. I will donate and I’m going to

In this issue

1. From the desk of Donna Barry PIH’s Advocacy and Policy Manager talks about the accomplishments and

rewards of her work.2. Fighting hunger and malnutrition in Lesotho Hunger and malnutrition were major problems for Lesotho and other poor

countries long before skyrocketing prices triggered talk of a global food crisis.3. With a lot of help from our friends Corporate donations, a high school fashion show and grade school candy

sales support the poor in Haiti and Rwanda Corporate donations, a high school fashion show and grade school candy sales support the poor in Haiti and Rwanda.

4. Dateline PIH Rwinkwavu’sfirst“RunforWomen”;Motorcycletrainingformedicalstaffin

Lesotho;andsuccessfulheartsurgeryforaHaitianboyinBoston.5. Plus 60 Minutes broadcast, Op-Ed on maternal mortality by Paul Farmer

and Ophelia Dahl, PIH weighs in on the food crisis, and Paul Farmer interviewed on DemocracyNow!.

From the desk of... Donna Barry

Dear Friends,

In our e-Bulletin last September, Dr. Joia Mukher-jee highlighted the renewed work of PIH’s re-search and advocacy arm—the Institute of Health and Social Justice (IHSJ). After leading our Russia project from its inception and working on women’s health in Haiti for PIH, it’s now my great pleasure to be working closely with Joia on our IHSJ efforts as PIH’s Advocacy and Policy Manager. Supported by a generous grant from the Skoll Foundation and some private donors, we have intensified our efforts over the past year to in-fluence policy and practices in our four key advocacy areas: the health worker crisis; food security; Haiti; and funding for global health. And our efforts are paying off, as evidenced by some initial successes that I would like to share with you this month.

First, the renewal of the President’s Emergency Plan for AIDS Relief (PEPFAR) has passed the House with a request for $50 billion over the next five years. If that figure becomes law, it will more than triple the funding for PEPFAR’s first five years and will represent an increase of $20 billion above the amount requested by the Bush ad-ministration for renewal of the plan. To the best of my knowledge, Joia was one of the first people to advocate publicly for $50 billion in funding. When she mentioned the number during testimony be-fore the House Committee on Foreign Affairs last September, house members chuckled audibly. Today, they wholeheartedly support it.

In addition to advocating for increased funding, we collaborated very closely with several other non-governmental organizations (NGOs) to include recommendations based on our program experi-ence from the first five years of PEPFAR implementation. Our joint

DonnaBarry

May 2008

talk to our local businesses and try to get them to donate. I’ll talk to our local hospital and see if they have equipment to donate.

“I don’t really know what I can get accomplished,butIWILLNOTSITONTHESIDELINESANYLONGER!”

Washington Post Op-Ed on maternal mortality by Paul Farmer and Ophelia Dahl “ ‘Obscene’ is still the word that comes to mind when we think ofmaternalmortality,”PIHco-founders Paul Farmer and Ophelia Dahlwroteinanop-edarticlepublished on Mother’s Day in the WashingtonPost. The article outlines steps that must be taken to end the obscenity of more than half a million preventable deaths in childbirth each year.

efforts are reflected in many improvements to the bill, including large increases in funding for TB and malaria, specific language that supports nutrition programs, language to encourage paying commu-nity health workers and an end to the restriction on use of PEPFAR funds to improve health system infrastructure.

All of these components are critical to the PIH model of care and were strongly encouraged by our staff in meetings, briefings and hearings on Capitol Hill. The bill is currently waiting to be brought to the Senate floor for a vote. We urge you to contact your senators to move this bill to the floor before the July recess.

Immediate cancellation of Haiti’s external debt has been another leg-islative priority for us over the past year. We have been collaborating with several other Haiti-focused NGOs to encourage passage of the Jubilee Act for Responsible Lending and Expanded Debt Cancellation and also on House Resolution 241, which is specifically focused on debt relief for Haiti.

Pierre Paul, one of our Haitian physicians, participated in a staff briefing in the House of Representatives last October. Through our phone calls and meetings, we succeeded in enlisting several local House members to support these pieces of legislation. The Jubilee Act passed the House on April 16, with a vote of 285 – 132. While H. Res. 241 was not brought to the floor, Representative Alcee Hastings submitted an amendment to the Jubilee Act to encourage the US Treasury Department to pressure the World Bank and other interna-tional financial institutions to relieve Haiti’s debt immediately.

We actively supported this amendment and called upon several congressional members and other NGOs to support it as well. The amendment passed by unanimous voice vote. We are now working on getting the Jubilee Act through the Senate and on ensuring that the Haiti amendment is also introduced in the Senate. We hope it will be “marked up” in committee in early June and passed in the Senate before the G-8 meetings in July.

Finally, in collaboration with our Communications team, we have re-ceived and placed some very good media hits recently. In addition to the 60 Minutes piece on PIH in early May, Joia and I wrote an Op-Ed article on the food crisis and Haiti that was published in The Boston Globe. PIH co-founders Paul Farmer and Ophelia Dahl published an Op-Ed on maternal mortality in The Washington Post on May 11. Joia and Evan Lyon, another of our doctors who works in Haiti, were guests on two NPR shows -- On Point and Here and Now -- focusing on the food crisis. And Paul Farmer was featured this week on De-mocracy Now!—a daily news show broadcast on more than 700 radio and television stations in North America. In a wide-ranging, 45-min-ute interview with host Amy Goodman, he discussed the work of PIH, the food crisis in Haiti, the connections between health and social justice, and ways for people to get involved.

These victories in building awareness and improving legislation are hard won and fascinating to work on. Fortunately, we have ter-rific NGO, advocacy and congressional partners who are as deeply committed to rooting out the causes and consequences of poverty, injustice and disease as we are. The rewards of this work are not as tangible or immediate as those from treating a sick child or building a house for a destitute family. But when policy change in Washington

PIH weighs in on the food crisis in HaitiPIH Medical Director Joia Mukherjee and PIH Advocacy Director Donna Barrypennedanop-edfeaturedin the May 5 issue of the BostonGlobe. The piece focuses on the reasons why the situation has become so serious, and the actions thatneedtobetakentobringlong-term relief to millions. In addition, Dr. Mukherjee also spoke about the foodcrisisonNPR’sOnPoint.Youcan listen to or download a podcast of the program here.

Paul Farmer interviewed on Democracy Now!OnMay28,PIHco-founderPaulFarmer discussed the work of PIH, the food crisis in Haiti, the connections between health and social justice, and ways for people togetinvolved,duringa45-minuteinterviewwithhostAmyGoodmanonDemocracyNow!Theinterviewcan be viewed online or downloaded here.

can help provide better care for our patients, salaries for our com-munity health workers and additional food for the hungry and mal-nourished children we see every day at the sites where we work, it’s well worth the effort. I feel both proud and fortunate to be part of it.

– Donna BarryAdvocacy and Policy Manager, PIH

Fighting hunger and malnutrition in Lesotho

In August 2007, the staff at PIH’s clinic in Nohana confronted an alarming increase in the number of malnourished children arriving from the surrounding mountain villages. Within a single week, more than 100 children were diagnosed as malnourished in Nohana. Most were suffering from moderate malnutrition and several exhibited symptoms of wasting (marasmus) and swelling (kwashiorkor) associated with severe lack of calories and protein. Months before headlines and television reports announced a global food crisis, these children alerted PIH to a spike in the hunger and malnutrition that chronically afflict poor communities in Lesotho and other countries where we work.

Statistics reveal the scale of the persistent “silent tsunami” of hunger that only captured the attention of the media and the world when people took to the streets to protest soaring food prices. More than 800 million people suffer from chronic hunger. Nearly 10 million of the world’s children die each year before reaching the age of five. Sadly, two out of three of these children die from easily preventable and treatable diseases such as diarrhea, pneumonia and malaria, and most would survive if they had not been weakened by hunger and malnutrition.

Conditions in Lesotho reflect these global trends. It is estimated that 40 percent of children under five are stunted and 20 percent are underweight, which are respectively signs of chronic and acute

Patients picking up food on horseback in Nohana

undernourishment.Even before the recent upsurge of hunger in Lesotho and around the world, PIH-Lesotho had teamed up with the World Food Program to provide monthly food rations to all tuberculosis and HIV patients. This program reflects our belief that prevention and treatment of HIV are impossible without adequate nutrition. Numerous studies have confirmed what our experience tells us every day – that HIV patients are more likely to contract severe illnesses due to the weakness of their immune systems if they are not well-nourished.

When cases of severe malnutrition shot up last year, PIH launched a supplementary feeding program to provide nutritional support to all malnourished children in the mountains. Every child enrolled in the program receives a package containing 60 kilograms of maize meal, 9 kilograms of beans, 4 liters of cooking oil, and 6 kilograms of a nutritious corn-soy blend to help them gain weight. In addition, all severely or moderately malnourished children older than six months receive a special high-protein, high-energy peanut butter fortified with vitamins and sugar. This “Ready-to-Use Therapeutic Food” requires no preparation or special supervision and can be delivered to malnourished children at home by their parents or any other untrained adult.

Each child’s file at the clinic includes an intake form that records his or her weight, height, and upper arm circumference—all of which are used to measure nutritional status. Progress is monitored on a follow-up form that requires children to come back to the clinic both for a regular assessment and to pick up their monthly food rations.

The benefits of the program extend far beyond what can be gauged by measuring upper arm circumference. The regular visits also provide opportunities to:• vaccinate many children who have

never been immunized test a large number of children and their parents for HIV (in a country where nearly a quarter of the adult population is HIV positive);

• distribute vitamin A to improve eyesight and reduce child mortality exacerbated by the high incidence of vitamin A deficiency;

• supply iron supplements for a population where more than half of all children under five suffer from iron deficiency anemia.

For a child like Malipho Ramahapa, the Plumpy’nut and food packages are just as essential as the other medicines that spell the difference between life and death. Malipho, a 19-month-old boy, weighed only 5.2 kilograms (11.5 pounds) in October 2007, when he was brought to the clinic at Nohana. According to his mother, little Malipho was suffering from a daunting array of

Malipho before (above) and after (below) receiving food

and treatment

symptoms – a very high fever, oral thrush (a fungal infection in his mouth), chronic diarrhea, vomiting, loss of appetite and weight loss. An examination confirmed the symptoms and a diagnosis of both severe malnutrition (marasmus) and pulmonary tuberculosis. Results of an HIV test revealed that he was also suffering from advanced HIV progressing to AIDS.Just two months after starting treatment and a diet of Plumpy’nut, Malipho was barely recognizable. Gone was the child so weak and wasted that he could barely sit up, replaced by a robust boy with an engaged look and a ready smile.

Malipho’s mother was so overjoyed by her son’s recovery that she chose to speak out and urge other parents to bring their children to the clinic. Just 20 years old and HIV positive, she had been reluctant to undertake the long trip to the clinic herself. But with her only child on the brink of death, she finally decided to come. “I took the decision to come to this clinic just because my child was so sick,” she recalled. “And also because the village health worker forced me to. I remember that it took me two days to get to the clinic, for a trip that would normally take about eight hours for a health person on horseback.”

Now, she says, “I really appreciate all the help that I got from this clinic, which keeps my child from dying today. It may be difficult for patients to come to the clinic, but all of them should do so in order to save their children’s lives. Saving lives is more important than worrying about the two-day trip.”

– Betty Rigodon and Dr. Jonas Rigodon

With a lot of help from our friends

Crocs come to Haiti’s central plateau

They’re bright. They’re sturdy. They’re trendy. They’re Crocs – the often gaudily colored plastic shoes worn on playgrounds, hospital floors, beaches and hiking trails all across the United States. And as of this month, they’re on the feet of thousands of children, women and men on the central plateau of Haiti.

The sudden popularity of Crocs in poor Haitian communities wasn’t dictated by fashion. It was prescribed by doctors. Going barefoot in the rocky hills and muddy valleys of Haiti isn’t just uncomfortable. It leads to a major public health problem – an epidemic of tungiasis, an infestation of sand fleas that can cause pain, itching, swelling, open sores and, if left untreated, sepsis, tetanus or gangrene.

So when they learned that 40,000 pairs of Crocs were available, Zanmi Lasante (ZL, PIH’s partner organization in Haiti) and the

A Zanmi Lasante doctor examines a patients’ feet for signs of sand flea

infestation

Haitian Ministry of Health jumped at the offer.The donation included not only the value of the shoes contributed by Crocs Footwear but all the costs of shipping them from the factory in China to the docks in Port-au-Prince.

The initiative was orchestrated by Kageno Worldwide, a non-profit dedicated to “transform[ing] communities suffering from inhumane poverty into places of opportunity and hope.” Kageno solicited the shoes from Soles United, Crocs’ program for donating shoes made from recycled material. They also negotiated steeply discounted shipping terms with Cargo Services and arranged to split the costs of the shipping with Pearson Publishing. Brothers Brother, another nonprofit, took charge of getting the shoes into a container and onto the dock. ZL and the Ministry of Health assumed responsibility for distributing the shoes through mobile clinics.

Frank Andolino of Kageno traveled to Haiti to witness the beginning of distribution first-hand. In an email to other contributors, he reported: “I wish you all could be here! It has been amazing. 10,000 pairs of CROCS have safely made it from China to Haiti and 4,000 individuals have already benefited from your generosity.”

10-year-old sells candy to feed Haitian children

Eliza Forrest was troubled. She had heard about the food shortages and rampant poverty in Haiti. A young friend had told her about how she had gotten very sick while visiting family in Haiti, did not have access to medical care, and had to fly back to the US without even seeing a doctor. Eliza realized that her friend was lucky, that millions of Haitians don’t have the option of coming to the US if they are sick or hungry. Eliza’s heart went out to them, and she decided to take action. But as a 10-year-old fifth grade student, what could she do? How could she help hungry children in Haiti?

On a Friday morning this spring, the staff at the Boston PIH office was surprised when a small, smiling girl in a bright pink sweater popped in with a candy box stuffed with money. The enterprising Eliza had single-handedly fundraised $160 by selling bubble gum and lollipops at her church and school in Somerville, MA. As it costs about 25 cents to provide a child with a warm school lunch in Haiti, Eliza’s donation provided 640 meals to students who would otherwise have gone

A Haitian girl styles her new shoes

Eliza with one of the boxes of candy she sold to raise funds for PIH

without, said Christine Hamann at the PIH development office. “To see a student like Eliza realize that a project feasible for a fifth-grader could make a significant difference in the lives of our patients in Haiti is inspiring,” said Christine. “We’ll be very lucky if other kids her age become engaged in social justice issues.”

Fashion Lives in Wellesley to help the poor in Rwanda

Mothers Day 2008 was a day for several mothers in Wellesley, Massachusetts, to feel even prouder than usual of their children. Led by Colby Kotzen and Taylor Ahearn—two high school juniors who had been inspired by reading about PIH—a group of Wellesley teenagers staged “Fashion Lives,” a charity fashion show that raised more than $21,000 so support PIH’s work in Rwanda.

“Rwanda is in dire need of support. That’s why we’re doing this,” Colby explained to a local newspaper reporter.

The two girls organized the entire event – a champagne reception overlooking the gardens of the Elm Bank Horticultural Center, followed by a silent auction, and capped off by a half-hour show in which Colby, Taylor and several of their friends strode down a 30-foot runway to show some of the latest spring fashions from shops in Boston and nearby communities.

“We both read Tracy Kidder’s book, Mountains Beyond Mountains, about Paul Farmer and his work with Partners In Health, and reading about someone who has devoted his whole life to helping people just really touched us,” Taylor said. “This gives us a chance to use something we love to help something we really want to help.”

Dateline PIH: Project updates from all over

RWANDA: First run for women in RwinkwavuMore than 300 girls from surrounding communities participated in the first “Run for Women” in Rwinkwavu, Rwanda. The run was organized by social workers from PIH’s partner organization, Inshuti Mu Buzima, and Margaret Butler of PIH and the Clinton HIV/AIDS Initiative. Scholarships were awarded to 10 girls who took part in the run.

LESOTHO: Motorcycle training for medical staffAfter several months of delay, trainers from Riders for Health kickstarted motorcycle training for the first group of medical staff from PIH’s mountain clinics. The first of four training groups included Dr. Nico Lesia, Dr. Tinahs Chinyanga, Me Nophumzile Mzamo and Mapalang Maesa. The motorcycles and training provided by Riders for Health will allow PIH staff to reach patients much more quickly in the rugged mountain terrain.

Taylor Ahearn and Colby Kotzen at the head of the

Fashion Lives runway

HAITI: Right to Health Care Project brings Haitian boy to Boston for heart surgery

At the age of three, Zachary Antoine weighed only 20 pounds and could not stand, walk or eat without feeling suffocated. Zachary was born with Tetralogy of Fallot, a heart defect that can only be treated successfully with heart surgery that is routinely available in rich countries. But no hospital can perform the surgery in Haiti, where Zachary lives with his mother and older sister in home made of thin wooden planks, a banana leaf roof, and a dirt floor. His father works as a mason across the border in the Dominican Republic to support his family.

PIH arranged to bring Zachary to Boston and mobilized donations to cover the travel costs and hospital expenses at Children’s Hospital, where surgeons waived their fees to perform the operation free of charge. Barely a week after his open heart surgery, Zachary visited PIH and showed off his rapid recovery by kicking and dribbling a soccer ball around the office.

Zachary visited PIH just a week after successful heart

surgery