This document summarizes a board meeting discussing strategies to address tropical diseases in underdeveloped areas like Malawi. It outlines key tropical diseases like malaria and cholera, their symptoms, treatments, and prevention methods. It discusses factors exacerbating tropical diseases like poverty and sanitation. It also summarizes the purpose and strategic approaches of A Project of Hope (APOH) to deliver relief and promote health in developing nations through partnerships and a comprehensive strategic plan.

1. Tropical Disease and Wellness Promotion: Healthful Interventions A Project of Hope (APOH) Board Meeting February 21, 2010 Presented by: Susan Sanner, Ph.D., R.N., ACNS-BC, CNE

2. Objectives Discuss the factors and conditions that increase the development of tropical diseases. Define tropical diseases prevalent in Malawi and under-developed areas in general. Discuss the general treatment of tropical diseases. Identify strategies aimed at promoting the health and wellness of individuals living in high risk areas. Recognize the multiple approaches and possibilities available to address health issues of people living in under-developed areas.

3. Factors Which Aggravate Tropical Diseases Poverty Poor sanitation Climate

4. Centers for Disease Control and Prevention’s Healthy People in a Healthy World Global Health Promotion: Global health will improve by sharing knowledge, tools and other resources with people and partners around the world. Global Health Protection: Americans at home and abroad will be protected from health threats through a transnational prevention, detection and response network. Global Health Diplomacy: CDC and the United States Government will be a trusted and effective resource for health development and health protection around the globe.

5. CDC Global Health Promotion Objectives Prevent and control infectious diseases and their consequences globally. Prevent infant and child morbidity and mortality globally. Prevent non-communicable diseases and their consequences globally. Prevent injuries and their consequences globally. Promote safe, healthy, and accessible physical environments globally.

6. CDC Global Health Protection Objective Prepare for, prevent, detect, respond to, and contain health threats globally.

7. CDC Global Health Diplomacy Objectives Support achievement of international and national goals for the acceleration of control, and the eradication and elimination of diseases. Develop sustainable public health capacity among partner organizations and governments globally. Prevent maternal morbidity and mortality globally. Improve response to natural and manmade disasters, including complex humanitarian emergencies globally.

8. CDC Activities in Malawi CDC Malaria Malawi Program (CDCMMP) (http://www.cdc.gov/malaria/cdcactivities/malawi.htm CDC Global HIV/AIDS Activities – Malawi (http://www.cdc.gov/globalaids/Prevention/)

9. WHO Strategic Plan (2008-2013) Created the Biennial Work Plan to support work in emergencies and crises. Priority Areas: Emergency preparedness and capacity development; Emergency response and operations; Recovery and transition; Partnerships and coordination WHO Strategic Plan: Global Initiatives are focusing on health and nutrition tracking and providing support during crises and disasters.

10. Health Indicators Malawi is one of the world's poorest nations and has among the worst health indicators (164th out of 175, according to UNDP's Human Development Index). Life expectancy is declining, the maternal mortality rate has almost doubled in the last decade, and the infant mortality rate has improved only marginally in the last 10 years.

11. Health Delivery Systems in Malawi A number of public and private organizations and individuals provide health services: Government (60%) Christian Hospital Association of Malawi (CHAM) (receives some funding from government) (37%) Ministry of Local Governments (1%) Other providers, chiefly private hospitals, commercial companies, and army and police (2%)

12. Malawi Ministry of Health (MoH) Has major hospitals in all three regions. Seeks to achieve health for all Malawians by delivering health services and disseminating health information to the general public.

13. MoH Mission Raise the level of health status of all Malawians by reducing the incidence of illness and occurrence of death in the population; Accomplished through the development of a sound delivery system capable of promoting health, preventing, reducing and curing disease, protecting life and fostering general well being and increased productivity.

14. MoH Objectives Range and quality of health services for mothers children under the age of 5 years expanded Better quality health care provided in all facilities Health services to general population strengthened expanded and integrated Efficiency and equity in resource allocation increased Access to health care facilities and basic services increased Quality of trained human resources increased, improved equitably/efficiently distributed Collaboration and partnership in health sector strengthened Overall resources in health sector increased

15. Malaria Is a disease caused by a parasite that can infect people’s blood cells. Spread by the bites of infected mosquitoes

16. Malaria Signs and Symptoms Flu-like symptoms High fever Chills Muscle pain Diarrhea A more serious form of malaria can cause heart, lung, kidney, brain problems, and death. Symptoms may appear in cycles and is a major indicator that one may have malaria.

17. Malaria Treatment If a person gets malaria, it is treated with a drug. Drug treatment is based on the species of the parasite. Chloroquine is the drug of choice for treating infection.

18. Malaria: Reducing the Risk Take steps to prevent mosquito bites Insecticide-treated bed nets Take preventative medication: will reduce the chances of getting the infection if bitten by a mosquito carrier. Malarial vaccines-no evidence if they are effective.

19. Drugs Used to Prevent Malaria Chloroquine Mefloquine Doxycycline Primaquine Malarone

20. Malaria: Healthful Interventions (CDC) Focus on prevention efforts Educate about the need to comply with preventative medication: e.g. it is necessary to take the medication exactly as prescribed. Education on the signs and symptoms of the disease and the need to seek early treatment. Close tracking and follow up of high-risk individuals and those on preventative therapy. *Use of mosquito nets treated with long-lasting insecticide, a very cost-effective method; *Indoor residual spraying of insecticides.

21. Cholera Cholera is an acute, diarrheal illness caused by infection of the intestine with the bacterium Vibrio cholerae . is still common today in other parts of the world, including the Indian subcontinent and sub-Saharan Africa. The infection is often mild or without symptoms, but sometimes it can be severe. Approximately one in 20 infected persons has severe disease characterized by profuse watery diarrhea, vomiting, and leg cramps. In these persons, rapid loss of body fluids leads to dehydration and shock. Without treatment, death can occur within hours.

22. Getting Cholera Drinking water or eating food contaminated with the cholera bacterium. In an epidemic, the source of the contamination is usually the feces of an infected person. The disease can spread rapidly in areas with inadequate treatment of sewage and drinking water. The cholera bacterium may also live in the environment in brackish rivers and coastal waters. The disease is not likely to spread directly from one person to another; therefore, casual contact with an infected person is not a risk for becoming ill.

23. Cholera Treatment Cholera can be simply and successfully treated by immediate replacement of the fluid and salts lost through diarrhea. Patients can be treated with oral rehydration solution, a prepackaged mixture of sugar and salts to be mixed with water. Severe cases also require intravenous fluid replacement. With prompt rehydration, fewer than 1% of cholera patients die. Antibiotics shorten the course and diminish the severity of the illness, but they are not as important as rehydration. Persons who develop severe diarrhea and vomiting in countries where cholera occurs should seek medical attention promptly.

24. Prevention and Education is Best Healthful Interventions Sterilization: Proper disposal and treatment of the germ infected fecal waste produced by cholera victims. All materials (such as clothing and bedding) that come in contact with cholera patients should be sterilized in hot water using chlorine bleach. Teach proper hand washing techniques. Sewage: Treatment of general sewage before it enters the waterways.

25. Prevention and Education is Best Healthful Interventions-Continued Water purification: All water used for drinking, washing, or cooking should be sterilized by boiling or chlorination in any area where cholera may be present. Water filtration, chlorination, and boiling are by far the most effective means of halting transmission. Cloth filters have significantly reduced the occurrence of cholera when used in poor villages that rely on untreated surface water. Public health education and appropriate sanitation practices are important to help prevent and control transmission.

26. Other Diseases Having a Significant Impact HIV/AIDS: issues related to HIV testing; stigma; cost of medications; compliance with medication; safe sex practices. Tuberculosis

27. A Project of Hope (APOHE) ARTICLE II of our Bylaws - PURPOSE The purpose is to acquire and administer funds and property, which, after payment of necessary expenses, shall be devoted exclusively to : serve individuals and families in the poorest communities of developing countries promoting symbiotic, sustainable solutions to problems having poverty and illiteracy as their root causes; promoting health, hope, and lasting change by strengthening capacity for self-help and delivering relief during periods of emergent need.

28. Comprehensive Approach to Addressing Health-Related Needs Strategic plan to set priorities Establishment of subcommittees to work on specific areas Align ourselves with the vision and missions of global organizations (CDC, WHO and others) Build partnerships (extremely importantly when trying to secure funding) Seek funding based on priorities identified in the strategic plan.

29. Preparing to Seek Funding as a Non-Profit Organization http://foundationcenter.org Specific training aimed at non-profit organizations. Provides a combination of free webinars and some classes requiring a fee.

30. Conclusions The effects of tropical diseases or any disease has devastating effects on vulnerable populations. Treatment and prevention measures are not complicated. But, in under-developed countries unique and comprehensive approaches are needed to improve human capacity to manage disease. APOH can provide a service and ultimately make a global impact on the lives of vulnerable populations and under served nations.

31. Thank You!