Health Programs. Waging Peace. Fighting Disease. Building Hope.

Transcription

1 Health Programs Waging Peace. Fighting Disease. Building Hope.

2 We believe good health is a basic human right, especially among poor people afflicted with disease who are isolated, forgotten, ignored, and often without hope. Just to know that someone cares about them not only can ease their physical pain but also remove an element of alienation and anger that can lead to hatred and violence. Former U.S. President Jimmy Carter 2002 Nobel Peace Prize laureate Cover photos by Emily Howard Photo this page by Mark Pelletier

3 Fighting Disease Fighting Disease: measuring hope by the numbers Fighting Disease: emphasizing action and results Fighting Disease: delighting in hopeful faces A drastic reduction in the number of the world s cases of Guinea worm disease. The real possibility of eradicating river blindness in the Americas. Farmers in Africa tripling or quadrupling crop yields. Preventing disease in the developing world through village-based, cost-effective health education. Spreading the word far and wide that mental illnesses can be treated. Creating a new public health training system in Ethiopia. Healthier children returning to school. Fathers and mothers once again tending their crops and caring for their families. Entire villages lifted from the burden of age-old diseases. Across the globe, The Carter Center builds hope among the world s poorest people by alleviating unnecessary suffering and showing people how they can take steps to transform their own lives. Hand in hand with its efforts to promote peace worldwide, the Carter Center s health programs address two of the challenges to world peace disease and hunger. An emphasis is placed on building partnerships for change among international agencies, governments, nongovernmental organizations, and corporations and on strengthening or establishing permanent health care delivery systems in the poorest nations. The Center s efforts are guided by a unique resource, the International Task Force for Disease Eradication, a group of eminent scientists and public health experts who evaluate the potential for eliminating diseases that have plagued humankind for centuries. Underlying every effort is the belief that health care is a basic human right.

4 Guinea Worm Eradication Program Guinea worm disease will soon be eradicated from the world, the first disease to be conquered without a vaccine or treatment. The end of this debilitating sickness will come as people are educated about its origin and empowered to take action to prevent it. The Carter Center joined the fight in 1986 by helping Pakistan and Ghana start their national eradication efforts. Since then, the Center has assisted all 20 Guinea worm-endemic countries and has celebrated the eradication of the disease in seven of them. These results were due to an unprecedented public health campaign led by the Center, which coordinates the resources of international donors, national and international health care agencies, corporations, village-based volunteers, and national ministries of health. This international coalition soon will close this chapter in human health history, making Guinea worm the first parasitic disease to be eradicated. Guinea worm disease is contracted when a person drinks water that contains fleas harboring larvae of a parasite. Inside the abdomen, the infective larvae mature and grow, sometimes to a length of three feet. After a year, a Guinea worm slowly emerges through an agonizingly painful blister in the skin. Often people suffer from more than one worm at a time, and the A woman protects her family from Guinea worm disease by straining their drinking water through a nylon cloth filter. incapacitating wounds caused by the worms typically take up to two months to heal. Also, secondary infections usually ensue. People who have emerging worms must be taught not to enter sources of drinking water, so they don t unwittingly allow worms to release larvae into the water and continue the life cycle of the parasite. Everyone in the community must be trained to use cloth filters to strain Guinea worm larvae from their drinking water. Water fleas must be controlled by treating stagnant ponds with the insecticide Abate, donated by BASF Corporation. And communities must be taught how to keep their drinking water safe. Emily Howard

5 Sudan has most of the cases of Guinea worm disease left in the world and remains the biggest obstacle to eradication. A country mired in a cycle of violence, poverty, and disease, it is a focus of the Guinea Worm Eradication Program s efforts. Since civil war broke out in 1983, more than 2 million people have died in fighting or through warrelated famine, and more than 4 million have been dislocated, left homeless, or forced into exile. The Carter Center is one of few international organizations doing health work in areas controlled by both the government of Sudan and opposition forces. Eradicating Guinea worm disease in Sudan is challenged not only by inaccessibility to war-torn areas of the south but also by infected people fleeing to the north or to neighboring countries. Keeping the worm from migrating is as important as killing it where it lives. Dr. Ernesto Ruiz-Tiben, program director The Center has addressed unique challenges to the eradication effort in Sudan; for example, collaborating with private and nongovernmental organizations to produce and distribute pipe filters worn on a string around the neck that enable nomadic people to filter their drinking water anywhere. More than 9 million pipe filters one for every man, woman, and child at risk of Guinea worm disease have been distributed. Emily Howard

6 River Blindness Program Of the 18 million people infected with river blindness worldwide, more than 500,000 are blinded or visually impaired. River blindness, or onchocerciasis, is spread through the bite of a small black fly that breeds in rapidly flowing rivers and streams along fertile riverbanks. When an infected fly bites, it deposits millions of microscopic worms that cause incessant, debilitating itching; eyesight damage; and sometimes, blindness. The Carter Center is the only organization battling river blindness in both Africa and the Americas. The misery caused by this disease results in severe economic and social consequences, as adults often cannot farm or care for their children. In Africa, which accounts for 99 percent of river blindness, people have abandoned rich bottomland near fly-infested rivers to farm less fertile areas, disrupting stable village economies. In the late 1980s, Merck & Co. found that the drug ivermectin could safely and effectively fight river blindness. Merck offered its brand of ivermectin, Mectizan, free of charge to governments and nongovernmental organizations in an initiative that today is considered a model for how international organizations, donors, and national ministries of health can work together toward a common goal. Since 1996, the Carter Center s River Blindness Program has helped to deliver over 50 million Mectizan treatments, more than any other nongovernmental organization combating the disease. The Center s program works with national health ministries fighting this preventable disease; has helped to secure funding for the African Program for Onchocerciasis Control to establish community-based programs; and in Latin America, leads an effort to eradicate river blindness regionally through a coalition known as the Onchocerciasis Elimination Program for the Americas. Emily Howard

7 Trachoma Control Program Trachoma is the world s leading cause of preventable blindness, yet it can be easily prevented through improvements in personal and environmental hygiene. Almost all of the 146 million people who suffer from trachoma live in developing countries in Africa, the Middle East, and Asia. A bacterial infection that spreads easily from person to person, repeated infections of trachoma may cause the eyelashes to turn inward, abrading and scarring the cornea, and leading to irreversible blindness. Jim Zingeser Most inflammatory trachoma patients are children, and 75 percent of people blinded by the disease are women. Because trachoma can be prevented through simple hygiene, the Center has focused on hygiene education initiatives, reaching more than 3,000 villages in six countries. One initiative is the Zinder latrine project, begun in Niger by a Carter Center resident technical adviser. Latrines, which are scarce in the Zinder region, can prevent trachoma because they remove from the environment the preferred breeding sites of flies that carry the disease. With Carter Center assistance, more than 1,000 latrines were built in less than a year in Zinder, helping more than 7,000 villagers prevent blinding trachoma. The program trained dozens of sanitary technicians, local masons, and hygiene education volunteers. The Carter Center also assists partner organizations to import and deliver antibiotics, including Zithromax, donated by Pfizer, and to help train and equip eye surgeons to correct deformed eyelids. With assistance from ministries of health and partners, The Carter Center is making steady progress on a tough problem.

8 United States Mexico Health Work Around the World Current Work Work Complete Guatemala Ecuador Venezuela Colombia Brazil Americas Brazil River blindness Colombia River blindness Ecuador River blindness Guatemala River blindness Mexico River blindness United States Mental health Venezuela River blindness Africa Benin Agriculture (work complete), Guinea worm Burkina Faso Agriculture, Guinea worm Cameroon Guinea worm (work complete), river blindness Central African Republic Guinea worm Chad Guinea worm Cote d Ivoire Guinea worm Eritrea Agriculture Ethiopia Agriculture, Guinea worm, river blindness, trachoma, public health training Ghana Agriculture, Guinea worm, trachoma

9 Pakistan Mauritania Niger Chad Sudan Mali Eritrea Yemen Senegal Burkina Guinea Faso Cote Nigeria Central African d Ivoire Ethiopia Republic Cameroon Ghana Benin Uganda Togo Kenya Map Based on Hobo-Dyer, ODT, Inc. Tanzania Guinea Agriculture Kenya Guinea worm Malawi Agriculture Mali Agriculture, Guinea worm, trachoma Mauritania Guinea worm Mozambique Agriculture Niger Guinea worm, trachoma Nigeria Agriculture, Guinea worm, river blindness, trachoma, lymphatic filariasis, schistosomiasis Senegal Guinea worm Sudan Agriculture (work complete), Guinea worm, river blindness, trachoma Tanzania Agriculture Zambia Mozambique Malawi Togo Agriculture (work complete), Guinea worm Uganda Agriculture, Guinea worm, river blindness Zambia Agriculture Middle East Yemen Guinea worm, trachoma Asia Pakistan Guinea worm

10 Lymphatic Filariasis Elimination Program Adisease of poverty, lymphatic filariasis is a leading cause of permanent and long-term disability. It affects 120 million people in 73 endemic countries in Africa, Asia, the Western Pacific, and Latin America. An additional 900 million people are at risk. Among the world s most disfiguring diseases, lymphatic filariasis often called elephantiasis is one of only six infectious diseases in the world considered eradicable. The disease is caused by a parasitic worm and transmitted from person to person by mosquitoes. It results in hideously swollen extremities and genitals. In Africa, elimination requires annual doses of the drug Mectizan in combination with albendazole, donated by GlaxoSmithKline, which prevent the disease from spreading and can eliminate it in the next generation. Capitalizing on the Carter Center s efforts to eradicate Guinea worm disease and control river blindness, the Center added a program to prevent lymphatic filariasis in Currently, the Center works in two states in Nigeria, the third most endemic country in the world, by assisting the ministry of health to administer annual, single-dose drug therapy to millions of people at risk for the disease. Field staff emphasize health education and the training and supervision of local village health workers who distribute the tablets. The Carter Center is the only nongovernmental organization assisting this disease in Nigeria. The hope is that within 15 years lymphatic filariasis will no longer be a public health problem in the country. The disease has an enormous social and economic impact on both men and women, inflicting tremendous psychosocial losses characterized by rejection in the community. GlaxoSmithKline

11 Schistosomiasis Control Program Schistosomiasis is a frightening disease that often affects schoolage children. It cannot be eradicated but can be treated and controlled with a single annual dose of a drug called praziquantel. People become infected with schistosomiasis when swimming, wading, or washing clothes in contaminated fresh water. A parasite lives for years in the veins near the bladder or intestines, where it lays thousands of spiny eggs that tear and scar tissues of the intestines, liver, bladder, and lungs. Many victims suffer from bloody urine, diarrhea, poor growth and development, bladder dysfunction, kidney and liver disease, and sometimes, cancer. J.D. Scott An estimated 200 million people in 74 tropical countries are infected, 100 million in Africa. Treatment once a year with praziquantel tablets results in improved nutrition and better cognitive ability, especially in children. The Carter Center s program concentrates on urinary schistosomiasis in Nigeria, as the need is greatest there. Working with federal, state, and local ministries of health, the Center has focused on Plateau and Nasarawa states, where more than 150,000 children have been treated. Using dipsticks, staff tested children for blood in the urine and found a great number of villagers in the two states were infected. School-age children are the most heavily infected. They also tend to be the main disseminators of the infection through urinating and defecating in or near fresh water. Carter Center efforts focus on health education as well as drug distribution.

12 Ethiopia Public Health Training Initiative Health challenges in Ethiopia are staggering. Infant diarrhea, malnutrition, malaria, and HIV AIDS are all potential killers, and less than half of Ethiopia s population has access to modern health services. Participants report their work is making a real difference in the competency of future health center staff. Dr. Joyce Murray, director Ethiopia Public Health Training Initiative Conditions such as these led to talks between former U.S. President Jimmy Carter and Prime Minister Meles Zenawi in 1991 regarding the need for the government and international agencies to help improve public health in Ethiopia. One notable outcome of the talks was formation of the Carter Center s Ethiopia Public Health Training Initiative, designed to help train staff for 500 government-sponsored health centers that would reach underserved rural populations. Training workshops, seminars, and conferences take place at five Ethiopian universities in Gondar, Dilla, Alemaya, Jimma, and Addis Ababa. Participants practice teaching, discuss problems with senior staff, and develop learning modules and lesson plans to help local health centers promote health and prevent disease. A unique aspect of the initiative is Ethiopian involvement in and ownership of the process. International experts work side by side with Ethiopian teaching staff, training health center teams and developing learning materials based on Ethiopian experience and directly relevant to the country s health problems. In turn, health center staff train and supervise community health workers, including traditional birth attendants and community health agents. Once the Carter Center s assistance is no longer needed, Ethiopians will have created a public health education system specifically prepared by and for that country. Dennis Carlson Although English is commonly spoken in Ethiopia and the program is taught in English, health education must be provided to the general public nationwide in more than 87 languages.

13 Mental Health Program When Rosalynn Carter began working on mental health care issues more than 30 years ago, few people even spoke the words mental health. Mental health meant only mental illness, and mental illness was shrouded in such shame and stigma that many people avoided and neglected the issue. We have to get the word out that mental illnesses can be diagnosed and treated and almost everyone suffering from mental illness can live more normal lives. Rosalynn Carter, former First Lady Public attitudes toward mental illnesses have shifted as knowledge of the brain and mental disorders has grown, but despite advances, stigma and ignorance remain. The Carter Center s Mental Health Program coordinates the efforts of mental health leaders and national organizations, promotes awareness, and addresses public policy issues. The program pursues its goals on multiple levels. The annual Rosalynn Carter Symposium on Mental Health Policy addresses issues of national and international interest, and the Rosalynn Carter Georgia Mental Health Forum, also held yearly, hosts state mental health organizations. Both the symposium and other program activities are guided by the Mental Health Task Force, formed to identify major issues in the field and develop initiatives to reduce stigma and discrimination. Media coverage plays an important role in educating people that mental disorders have a physical basis and can be treated effectively. Recipients of the Rosalynn Carter Fellowships for Mental Health Journalism, from the United States and New Zealand, have produced books, hundreds of newspaper articles, and numerous radio and video documentaries covering, among others, subjects such as mental health care for the homeless, suicide, and aging and mental health. Carl Ginsburg and his wife, Helen Demeranville, journalism fellowship recipients, found that many communities lacked juvenile justice facilities for youth with mental health problems.

14 Agriculture Program Every day, an estimated 40,000 people die of illnesses related to malnutrition. More than 820 million people in the world are hungry and malnourished. In addition to great human suffering, the associated loss of manpower hinders economic growth and human development. Agriculture is the engine that stimulates change in rural development. A farmer s neighbors come to see the results of using new methods, and a village is transformed very quickly. Dr. Norman Borlaug, senior consultant Agriculture Program and 1970 Nobel laureate Since 1986, the Carter Center s Agriculture Program has worked with national ministries of agriculture in 15 sub-saharan African countries, helping more than 4 million farmers increase productivity in countries where malnutrition is a constant threat. The program is a partnership between the Sasakawa Africa Association and The Carter Center. The program s six country directors currently work in nine countries, training extension workers to help small-scale farmers develop demonstration plots large enough to represent conditions in the area. The program teaches cost-efficient, environmentally sound techniques that have shown that farmers, many of whom are women, can double, triple, and sometimes quadruple the yields they were getting with traditional practices. Since corn, or maize, is the world s most widely adapted crop plant, much effort goes to increasing its production and nutritional value. Another Carter Center partner, the International Maize and Wheat Improvement Center, promotes expanded use of quality protein maize, which has approximately twice the usable protein of regular maize. In many countries, it is both an important weaning food for children and animal feed. Encouraging farmer groups is an important aspect of the program s work, as groups have better bargaining power in negotiating seed and crop prices and are better able to market their crops. One farmer association even has started its own savings and loan program. Chris Dowswell

15 The potential for disease eradication to permanently improve quality of life worldwide is tremendous. By working to eradicate these diseases, we are helping millions of povertystricken people see how they can make improvements in their own lives. Families and communities can fulfill their potential, and people regain their faith that government and public services can change things for the better. Dr. Donald Hopkins, Carter Center associate executive director for health programs Thank You. The Carter Center s work to prevent disease, increase crop production, and encourage mental health would not be possible without the generous support of our donors. To contribute or receive information, contact the Center s chief development officer for health at (404) , fax to (404) , or visit The Carter Center was founded in 1982 by former U.S. President Jimmy Carter and his wife, Rosalynn, in partnership with Emory University, to advance peace and health worldwide. A nongovernmental organization, the Center has helped to improve life for people in more than 65 countries by resolving conflicts; advancing democracy, human rights, and economic opportunity; preventing diseases; improving mental health care; and teaching farmers to increase crop production.

16 Health Programs The Carter Center One Copenhill 453 Freedom Parkway Atlanta, GA (404) Fax (404)