CDC warns travelers to Somalia of polio risk

The Centers for Disease Control and Prevention (CDC) issued a travel notice recently for the country of Somalia because of a polio outbreak there.

Somalia is reporting a total of four cases (with a total of 5 viruses) in 2018: one circulating vaccine-derived poliovirus (cVDPV) type 2, two cVDPV type 3 and one case with both cVDPV type 2 & type 3, with date of onset of the most recent case on 26 May 2018.An outbreak of polio has been reported in Mogadishu and the Hiran and Middle Shabelle regions of Somalia.

cVDPV is a marker of poor coverage of the oral polio vaccine (OPV).

A vaccine-derived poliovirus (VDPV) is a strain of the weakened poliovirus that was initially included in oral polio vaccine (OPV); because it has passed from child to child so many times, it has changed over time and behaves more like the wild or naturally occurring virus.

This means it can be spread more easily to people who are unvaccinated against polio and who come in contact with the stool or respiratory secretions, such as from a sneeze, of an infected person. These viruses may cause illness, including paralysis.

CDC recommends that all travelers to Somalia be fully vaccinated against polio.

Long-term travelers to Somalia (staying more than 4 weeks) may be required to show proof of polio vaccination.

Adults who have been fully vaccinated should receive a single lifetime booster dose of polio vaccine before travel.

Polio is a crippling and potentially deadly disease that affects the nervous system. It is spread through contact with the feces (poop) of an infected person. It is also spread by drinking water or eating food that is contaminated with infected feces.

Most people with polio do not feel sick. Some people have only minor symptoms, such as fever, tiredness, nausea, headache, nasal congestion, sore throat, cough, stiffness in the neck and back, and pain in the arms and legs. In rare cases, polio infection causes permanent loss of muscle function (paralysis). Polio can be fatal if there is loss of function of the muscles used for breathing or an infection of the brain.

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Officials target 21,000 Kenyan and Somali children in Lamu Polio vaccination

An anti-polio vaccination campaign launched in Lamu County on Thursday seeks to cover 21,000 children including thousands from Somalia, officials announced. 

Officials said the exercise will cover children in Ras Kamboni and other towns of Somalia close to Kenya's Kiunga to avoid the polio virus spreading from the wartorn nation. 

Medical services and vaccination cover in Somalia which has been at war for about three decades is poor and most of the latest polio discoveries in Kenya have been traced to refugees and migrants entering Kenya from the Horn of Africa nation. 

According to Dr Victor Tole, the director of medical services for Lamu County said on Thursday that children from Somalia are among the 21,000 children targeted in the vaccination effort. He said medical workers have been sent to give the vaccination in far flung areas and targeted towns in Somalia. Tole said that the initiative is to make sure that the virus does not cross over to Kenya through Kiunga as many people who live in Raskiamboni do business in Kiunga, citing that if there is no vaccination done, then the virus will be spread in the area, spreading to other parts of the county due to movement. 

We have undertaken the initiative of extending the polio vaccination to Somalia so as to prevent the virus from spreading to Kenya," said Dr Tole adding that although Lamu is vulnerable to infection because of its proximity to Somalia not a single case of the virus has been detected in the Kenyan border county. 

Lamu is among 11 counties that the ministry of medical services will have polio vaccine done due to its closeness with Somalia. 

"We have placed focus on Somalia since there are no health facilities and if a virus is detected and the children are not vaccinated against the virus, then they cross over to Kenya through the borders, our children whose immune system is low or have not been vaccinated will definitely get infected with the virus," Dr Tole added.

 Areas of Lamu East whose mobility is hampered by impassible road due to numerous Improvised Explosive devices being placed on the road making it dangerous, the ministry together with multiagency team joined hands in taking the service in the whole of Basuba ward. 
He has however warned parents who might try to block their children from getting vaccinated on religion grounds saying that the government is determined to see that the virus is out of Kenya completely. Parents who might block our officers from vaccinating their children are doing injustice to their children, the government is determined to wipe out polio in Kenya and resistance is denying the child a chance to the right to medication Tole added.

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10-year-old Somali girl dies after female genital mutilation

A 10-year-old girl has bled to death after undergoing female genital mutilation in Somalia, an activist said, a rare confirmed death in the country with the world's highest rate of the practice.

The girl died in a hospital on Monday, two days after her mother took her to a traditional circumciser in a remote village outside Dhusamareb town in central Galmudug state, Hawa Aden Mohamed with the Galkayo Education Center for Peace and Development said in a statement.

                                                                                                                                                                  Picture source

"The circumciser is suspected to cut an important vein in the course of the operation," Mohamed said.

About 98 percent of women and girls in the Horn of Africa nation undergo female genital mutilation, according to the United Nations. While Somalia's constitution prohibits the practice, Mohamed said no laws have been enacted to ensure that those who perform the circumcisions are punished.

Lawmakers are "afraid of losing their political clout among the all-powerful conservative traditional and religious groups bent at retaining the practice," she said.

Health workers have warned against the risks of the practice which in most cases the external genitalia is removed and the vagina is sewn almost closed.

Despite campaigns in Somalia against the practice it is "clouded in secrecy, so reducing it has been a massive challenge," said Brendan Wynne with the New York-based Donor Direct Action, which connects women's activists worldwide.

Over 200 million women and girls in 30 countries across three continents have experienced genital mutilation, U.N. Secretary-General Antonio Guterres said earlier this year, calling it a "gross violation of the human rights of women and girls."

The U.N. Population Fund projects that the estimated 3.9 million girls subjected to genital cutting every year will rise to 4.6 million by 2030 due to expected population growth unless urgent action is taken.

The Associated Press
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Public Health Management Course Offered by one of the Best USA Universities.

Population Health Management Course Announcement

Starting on :	06:00 AM 06 August, 2018	Venue:	HeSMA (Blended Online Learning)
Ending on :	06:00 AM 15 October, 2018	Max Credits:	80
Moderator:	No Activity Moderator	Activity Cost:	Free Order

Presenters

1. Mr. Mark Tozzio, M-IHHS, LFACHE 
Adjunct Instructor Health Care Administration Degree and Continuing Education at Northeastern State University, Certified Blackboard (online) Instructor (Levels 1+2) 918-521-7468 cell tozzio@nsuok.edu marktozzio@aol.com Skype.com: Mark.Tozzio

2. Mr. Fredrick Kimemia, MSc, FeHSM, PhD (In progress) 
Healthcare Management Specialist, Board Secretary & CEO-Health Systems Management Association (HeSMA) Lecturer- Kenya Methodist University Consultant- HeSPA Limited

Description

Health systems globally are experiencing dramatic changes and constant restructuring due to services demand and regulatory forces. HSA, HeSMA East Africa and AZV in partnership with Northeastern State University (NSU) have developed a specialized Leadership, Management and Governance (LMG) Program for healthcare professionals. This program is designed to offer practical solutions that not only help participants survive the present healthcare challenges, but enables leaders to thrive in these challenging times. Courses are tailored to reflect applicable circumstances in international markets (locally relevant topics). Courses include opportunities for international participant-exchanges in order to share diverse perspectives.

Objectives

This course explores in detail the process of emphasizing primary and preventive care in order to improve health status of populations and manage the growing cost of traditional acute inpatient care. The PHI processes aim to enhance the individual and cohorts (targeted groups) health status and wellbeing rather than rely solely on the acute care system. PHI combines the benefits of public health and medical interventions with preventive care and socioeconomic interventions in regards to Universal Health Coverage (UHC)

Course outline

This course explores in detail the process of emphasizing primary and preventive care in order to improve health status of populations and manage the growing cost of traditional acute inpatient care. The PHI processes aim to enhance the individual and cohorts (targeted groups) health status and wellbeing rather than rely solely on the acute care system. PHI combines the benefits of public health and medical interventions with preventive care and socioeconomic interventions in regards to Universal Health Coverage (UHC).

Key topics in this course include:

1. Define Population Health Improvement (PHI) and its applications for improving community health status

2. Understand the core concepts of PHI from an interdisciplinary perspective

3. Understand lifestyle and demand management strategies for PHI 

4. Understand chronic disease and catastrophic management strategies for PHI

5. Apply PHI concepts and strategies to health status situations and chronic diseases problems

6. Integrate strategic planning and manpower needs analysis with PHI initiatives

7. Evaluate the critical role of information technology for achieving successful PHI operations

8. Preparing a sample PHI initiative or process to enhance the wellbeing of a targeted population cohort

Enrollment Information

Eligibility criteria:

1. Diploma in a health related discipline with 2 or more years of work experience

2. Degree in a health related discipline, medical practice, or management / administration

This advanced e-Learning program starts August 2018 (date TBD).  The syllabus is available upon request – Mark Tozzio, 918-531-7468; or tozzio@nsuok.edu. 

Mode of Study

The NSU-HeSMA courses are designed to meet the needs of busy professionals, self-paced and learning while doing at their own workplace using NSU’s proprietary Blackboard e-learning system. All learning materials are 100% Internet accessible. This course runs for 10 weeks (4 contact hours of instruction per session and is based on approximately 32 contact hours of study and instruction for the course and it is part of a five-course series leading to a Certificate of Healthcare Leadership over a 12- 18-months period. 

Partial Scholarship

If enrolled to this course, all potential learners from Somalia and Somaliland will be entitled to receive a $150 tuition fee waiver where they will pay for special affiliate tuition discounted fee of $250 to honor HeSMA SOM Branch, please contact Dr. Mohamed Y. Dualeh, MD Branch Chair and Country Representative for NSU CE (USA) Program 00252634417945; or drdualeh@hesma.or.ke . The fees include all required learning materials, e-textbook, tuition, CEUs, and taxes.

Certification

Upon successful course completion, CPD Points will be awarded by the local licensing or certification agency. Participants will receive a Certificate of Completion and 3.2 Continuing Education Units (CEUs) from NSU (USA university partner). The points earned in this course may also apply to the International LMG Certification Program, and Continuing Medical Education Credits for physicians.

Figure 1. Dr. Nigel Boothe, Co-Director of A&E for Cayman Islands Health Services Authority proudly holding his Program Certificate, June 2018

Figure 2.  Program Certificate material delivered online during 12-18 months learning opportunity

Figure 3. Prof. Mark Tozzio pictured with Certificates of the first program graduates ready for shipment

Note that similar course announcements appeared at Somali Jobs and SYG Jobs 

Qatar Charity Implements Health Projects in Somalia

Qatar Charity (QC) has implemented a number of health projects in Somalia during the first half of 2018.

The implementation has come as part of its development intervention in the field of health, which is based on the integration of the curative and preventive aspects, QC has said in a statement.

QC's health interventions focus on countries that lack sufficient primary health care services and suffer from the spread of infectious and endemic diseases and high mortality rates, especially child and maternal mortality.

Qatar Charity implements various health and medical projects in Somalia, such as building health clinics, organising medical caravans for disaster relief and providing first aid, giving priority to the neediest areas and people.

The organisation implements these health projects in co-ordination with the Somali Ministry of Health and Mogadishu University.

Qatar Charity is also working on the construction of many health centres and clinics.

Other five multi-service centres will be constructed in Kismayo, Baidoa, Dusamareb and Middle Shabelle during the second half of this year until the beginning of next year.

In July and August, medical convoys will be despatched to camps in capital Mogadishu, which will provide free health services for the displaced.

Each convoy is expected to provide medical services and consultations for 80 people, in addition to holding regular meetings with the displaced to provide instructions on public health and health education.

Somalia suffers a civil war that has cause 20 thousand dead and around a million displaced.

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This doctor wants to make sure no patient is out of reach

It is amazing how many lifesaving tools you can carry on your back.

I was meeting with Dr. Raj Panjabi, and he was showing me one of the backpacks created by Last Mile Health, the nonprofit he co-founded in Liberia. Raj reached into the bag and took out a vial of medicine to treat pneumonia. Next he pulled out rapid test kits for malaria and HIV. Then, rehydration salts for children with diarrhea. A measuring tape to screen kids for malnutrition. A thermometer to check for fevers. A blood pressure cuff. And so on. It was like watching a magician pull rabbits out of a hat. 

The backpack is a key part of Last Mile Health’s effort to deliver basic health care to people who live beyond the reach of the health system. Raj was born in Liberia and fled the civil war there with his family when he was 9. When he returned as a medical student years later, he was shocked to learn that there were only 51 doctors for a country of 4 million people. So he and his co-founders set out to recruit, train, and equip a cadre of community health workers who would provide a range of 30 basic services in remote areas of Liberia.

Thanks to Last Mile Health, more than 500 trained workers now serve 280,000 people in two of Liberia’s most far-flung counties. “These are community members,” Raj told me, “who may have a middle-school to a high-school education and can be trained and equipped to provide high-impact medical care just within a matter of weeks.” (Our foundation helps fund some of their work.)

Other countries use community health workers too—I’ve written before about Ethiopia’s success with them and will be posting soon about Rwanda’s—but Last Mile Health is putting some clever twists on the idea. For example, they’re on the cutting edge when it comes to using digital tools. Their staff use smartphones to collect data about their work with patients, which helps identify health trends and improve the program. They’re also developing a training platform where you could watch video lessons on, say, how to vaccinate children, or hear a podcast on how to distribute bednets, and then take a quiz to test your understanding.

Ultimately, there’s no getting around the need for a primary health care system with well-stocked clinics and staff. Community health workers are a good complement to a functional primary health care system, and a step in the right direction for places that don’t yet have one (like Liberia). As Raj says, no one should die simply because they live too far from a doctor. It’s great to see him and his colleagues trying to make that idea a reality. We need more passionate innovators like them.

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Tribute to Death of Dr Ahmed Mohamed Hassan

Dr. Ahmed Mohamed Hassan, simply known as “Dr Ahmed Food-Adde” by most, is a cardiologist by profession, graduated from Padova University of medicine, Italy, in 1965. He also attained a Diploma in Cardiology in 1969 from the same University and in 1973; he received MS in Health Administration in Alexandria, Egypt. 

As a practitioner, he became one of the elite medical doctors in Somalia before being appointed Director of the Medical Services Department of the Ministry of Health in 1970. In 1972, he was elected President of the Somali Red Crescent, the National Society of the nascent state of Somalia since 1965. End of 1980, he handed over responsibility to the National Society to the Vice President and left Somalia to work with World Health Organisation Regional Office in Alexandria, Egypt. After four years, he resumed his duties as president of the Somali Red Crescent. 

For the past two and a half decades in one of the most difficult and challenging political and security environment marred by political divide and armed conflict, Dr Ahmed’s wisdom, humility and strict commitment to the Fundamental Principles of the Red Cross and Red Crescent Movement have allowed him to maintain the Unity of the Somali Red Crescent, ensuring that the National Society could deliver vital services to vulnerable people across the country. Dr Ahmed’s legacy is evident in the high esteem in which the Somali Red Crescent is held, both within the Movement, by partners in the humanitarian sector and, most importantly, by the local communities he has done so much to serve.

During all those years, Dr Ahmed has also represented the Somali Red Crescent Society at international events and conferences where SRCS was awarded different medals including a Gold Medal by the Spanish Red Cross and the Henry Davison Award (an award conferred to National Societies or individuals who have given outstanding services to the benefit of IFRC) in 2009. 

He also received the Peace and Humanity Award from the Queen of England on 29 October 1993. Overall, Dr Ahmed has greatly contributed to the work and unity of the Red Cross and Red Crescent Movement. 

Dr Ahmed has greatly contributed to building successful partnerships with Movement partners in order to enhance the effectiveness of the humanitarian response carried out by the National Society in Somalia. His wisdom and ability to find consensus was invaluable throughout the two terms he served as a member of the IFRC Governing Board between 2001 and 2009 and also with the different Commissions and Advisory Bodies. 

Dr. Ahmed has been a friend to all and spoke for the vulnerable people in Somalia especially in the area of building the resilience of communities affected by the conflict and natural disasters. He will be remembered for his exemplary leadership and promoting the good image of the National Society as a principled, respectable, reliable indigenous organization, well recognized and acknowledged for its outstanding humanitarian services to the Somali people.

By: Abdulkadir Afi

One in Five Displaced Children in Somalia is Malnourished, New Data Shows

The international humanitarian organization Action Against Hunger warns that one in five young displaced children living in settlements in Somalia is suffering from acute malnutrition. Recent rains and a surge in humanitarian assistance have improved food security in areas hardest hit by crippling drought and the threat of famine. Despite that, new evidence shows that the prevalence of acute malnutrition among vulnerable displaced children exceeds the internationally recognized emergency threshold in many areas.

"We are encouraged by recent reports that food security is getting better," said East Africa Regional Director for Action Against Hunger, Hajir Maalim,

 "However, true recovery will take years and our data shows that Somalia is still facing a severe nutrition emergency. We are deeply concerned that 20 percent of displaced children under five are suffering from malnutrition in areas across the country, without access to health services."

Rigorous assessments conducted by Action Against Hunger and Save the Children in 10 districts¹ of Somalia reveal that displaced children living in camps are the worst-affected, particularly in Mataban, Dollow, Garowe, Galkayo and Mogadishu. Prevalence of Global Acute Malnutrition in all the settlement camps for displaced people surveyed by the two humanitarian agencies exceeds the 'emergency' threshold of 15 percent. The prevalence of malnutrition in the city of Mataban in Hiraan region, which was recently devastated by floods, was 20.5 percent, indicating a critical emergency, and was the highest among all 10 districts.

Malnourished children are particularly vulnerable to preventable diseases. The new data indicates that deaths among children have increased in settlements for displaced people in Mogadishu and Mataban.  Half of child deaths were caused by malaria in Mataban, and in Mogadishu, respiratory illnesses such as pneumonia remain the leading cause of death among young children. 

Without sustained, adequate funding for humanitarian assistance, progress in reducing malnutrition in areas where famine was narrowly averted last year could be at risk. For example, the new data found that:

• Prevalence of acute malnutrition in Beletweyne, in the Hiraan region, of South Central Somalia, is 15.9 percent, signalling a nutrition emergency. Half a million people in the region were affected¹ by the recent floods, which destroyed latrines, contaminated water supplies and contributed to a cholera outbreak, putting children's lives in further danger. Ongoing heavy rains in the area are increasing the risk of waterborne disease among vulnerable displaced people.
• Acute malnutrition has recently spiked from 6.8 per cent to 13.7 per cent in Burao, in the Togdheer region of northwest Somalia, where the threat of famine was successfully averted last year after a massive humanitarian response.

Across Somalia, an estimated 2.6 million have been uprooted from their homes by climate shocks and conflict.² Severe, extended drought devastated crops, killed livestock, and destroyed livelihoods, forcing one million people in 2017 to abandon their homes in search of food and water. In 2018, an average of 2,777 people have been displaced every day.

"Somalia has experienced better rainfall that what was predicted for this season, but people are still caught in a deadly cycle of climate shocks, conflict and hunger," said Dr. Patrick Mweki, Country Director for Action Against Hunger's operations in Somalia.

"In 10 districts of Somalia, 90,000 children are malnourished and 45,000 children are severely malnourished and at risk of death. They need treatment today. We call on the international community to release immediate funding to scale up nutrition programs to save lives and alleviate suffering." 

Data collected and validated from the SMART assessments indicated that 90,000 children between six months and five years of age across the 10 districts are suffering from acute malnutrition, and 45,000 children under five are suffering from severe acute malnutrition and in immediate need of lifesaving treatment.

Source

Africa: Somalia, DR Congo report more polio cases

The total circulating vaccine-derived polio cases (cVDPV) cases has risen to 13 globally after additional cases have been reported in the African countries of Somalia and the Democratic Republic of the Congo (DRC).

According to new information from the Global Polio Eradication Initiative (GPEI), in Somalia, one cVDPV case combining type 2 and type 3 in Hiran province with onset on 11 May and two cVDPV cases type 3 in Middle Shabelle with onset on 16 and 23 of May.

This brings the total in Somalia to five in 2018.

Outbreak response to both strains is currently being implemented, in line with internationally-agreed guidelines. Large-scale supplementary immunization activities (SIAs) have been implemented in Banadir, Lower and Middle Shabelle regions, Somalia, with additional SIAs planned in the affected zones of the Horn of Africa.  Special surveillance activities are being undertaken to determine the origin of the viral circulation.

In DRC, three new cases of circulating vaccine-derived poliovirus type 2 (cVDPV2) were reported in the past week. One in Mongala province with onset on 26 April, a second one in Ituri province with onset on 5 May and a third one in Haut Katanga with onset on 14 May.

The total number of officially reported cVDPV2 cases in the DRC in 2018 is 7.

by ROBERT HERRIMAN

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Qatar Charity opens dispensary in Mogadishu

Qatar Charity’s (QC) office in Somalia, in co-operation with the Benadir Regional Administration opened a dispensary in Wadjer, an impoverished neighbourhood in Mogadishu and 93,000 needy people are expected to benefit from the health services.

Most residents of the area are poor and suffer from the lack of basic health services, as they are not able to afford the costs of private hospitals, QC said in a statement.

The 300sqm dispensary is expected to provide the required health services, mostly children, women and elderly.
The opening ceremony was attended by a number of Somali ministers and local figures, including Abdurahman Yarisow, governor and mayor of Mogadishu, who lauded the Qatari donations that contribute to helping the needy.

The ceremony was also attended by Osman Mohamed Abdi, deputy minister of ports and marine resources, who noted the importance of the development and relief projects implemented by QC for the benefit of the Somali people.
In February, QC’s office in Somalia handed over three ambulances to hospitals in Mogadishu to support the country's health services. The ambulance donation came at a time when many hospitals in Somalia were suffering from a severe shortage in the patient transport services, especially for urgent cases, as many vehicles were not designed to provide first aid, which had maximised the risk to the lives of many patients.

In March, QC interacted with the operation of mobile health clinics in Somalia, especially in the southern provinces, which are still ongoing in the field. 
Medical convoys provide primary health services to the displaced and the poor, especially mothers and children under the age of five. So far, around 27,300 people have benefitted from this project.

At the end of last year, QC’s office in Somalia handed over medicines and medical supplies to the Mogadishu City Hospital as part of the emergency relief project for the victims of the bombing to minimise the serious impact of the accident.
As Somalia was facing a worsening humanitarian situation at the beginning of 2017, due to the drought, which caused an increase in the number of displaced persons from 1.1mn to 2.1mn in a few months, QC launched a relief intervention for the displaced in the camps. The number of beneficiaries reached more than 27,975 persons in six provinces of Somalia through the operation of 15 medical convoys.

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