Paul Whitelegg - Volunteer Support Worker for Project:London

Paul Whitelegg is a second year student on the four-year graduate entry programme into medicine. He wants to be a doctor with the NHS when he qualifies. Paul first heard about Project: London when Doctors of the World UK came to St. George's Hospital in Tooting earlier in 2005 to give a talk about opportunities for volunteering overseas. The speaker, Dr. Shera Chok who is a GP in east London, also mentioned that Project: London was being planned.

"I want to help people who are less fortunate than me to get back on track," said Paul when asked about what prompted his decision to get involved. "I had been interested in voluntary work for some time, and wanted to do some medically-related voluntary work that would contribute to the course. Longer-term, I'm very interested in volunteering for an overseas project, maybe in Africa. I think it's a great idea to start the process of getting involved with voluntary work in my home country first of all."

"As a first or second year medical student, there is still a reasonable amount of spare time available to do other activities. Wednesday afternoons are currently free from lectures, which is why my voluntary sessions with Project: London will be on Wednesdays - one session (four-hours) every fortnight. The role of a support worker is great for a medical student although, of course, support workers are not involved in giving medical care. The training sessions given by DOW UK

"It is so helpful to get used to taking people's social histories, as well as working with people who are all part of the cultural diversity of London. I speak fluent Spanish, and when Project: London ran pilot sessions in December 2005, I was able to put this skill to good use with Spanish-speaking service users who came to seek advice. Solving language barrier issues is part of the role of the support worker."

For more information about Project:London and how to volunteer, visit our website.

Liz Annun - Volunteer Nurse for Project:London

Liz Annun is a nurse with 34 years of experience working in the NHS. She says "I enjoy nursing and was considering getting involved with voluntary work at some stage of my career." To find out more she attended a study day organised by the RCN, where she heard Karen McColl, former director of Doctors of the World UK give a talk about opportunities overseas and in the UK. This was in January 2004, soon after Doctors of the World UK started its needs assessment, so Liz has been involved with Project: London from the very early stages.

She continues: "As I found out more about Project: London, I realised there was an opportunity to become involved in my spare time. I've agreed to volunteer for one afternoon a fortnight, which fits in very well with my current job at a Walk In Centre.

Project: London is not taking workers away from the NHS. From my own perspective it is helping me to widen my skills base."

She continues: "The training provided by Doctors of the World UK has helped me to understand the expectations of the project and to prepare me to work as a volunteer.

Now I am looking forward to working with other volunteers in helping service users obtain the levels of healthcare they need. It is good to be part of a team with principles like Doctors of the World UK's."

Next week, read about Paul Whitelegg, our volunteer support worker at Project:London.

For more information about Project:London and how to volunteer, visit our website.

Judith Cook - Volunteer Doctor for Project:London

Dr Judith Cook qualified as a GP in the mid 1960s and worked in general practice in north London for 20 years. Since then, Judith has worked with vulnerable groups including homeless people, asylum seekers and refugees, people dependent on drugs and others who find access to healthcare difficult. Judith has been involved in the work of several health NGOS. She volunteered with Doctors of the World (DOW) in Afghanistan and Liberia. She currently does work in primary care for people who are drug dependent, and continues to work on issues relating to the health of asylum seekers and refugees in the UK.

"Because I had experience working with vulnerable groups in the UK, the DOW UK team came to me early in their needs assessment process, before setting up Project: London, and I offered some suggestions from my experience with these groups. I am aware of the great difficulties that they have accessing healthcare, and I am also aware of the other problems they contend with in their lives, and the fact that they have very important health needs. Many of their health problems are linked to broader issues such as destitution, anxiety and uncertainty about their status, and often to past experiences of abuse, ill-treatment or torture.

I want to work with Project: London to help identify the health needs of these vulnerable people and help them reach mainstream services. Also, because it is an DOW UK project - and I've worked with DOW UK before - and I support the principles on which DOW UK 's work is based."

Next week, read about Lizz Annun, our volunteer nurse at Project:London.

For more information about Project:London and how to volunteer, visit our website.

Haiti, 3 months after the earthquake: a continuing emergency

The situation remains urgent. 1.3 million people are without shelter and the rainy season will make their living conditions even worse.

Humanitarian and health needs remain huge, especially for those without shelter and for the thousands of people displaced within the country. With a health system that has been completely destroyed, aid for reconstruction and healthcare will be a long term commitment.

The earthquake on the 12th January hit a country with more than half the population living on less than $1.25 a day, 65% unemployed, and a life expectancy not beyond the age of 61.

Doctors of the World (DOW), has had a presence in the country for 25 years, is committed to the people of Haiti in the long term and is continuing its work with the disaster victims of Port-au-Prince, Petit Goâve and in Grande Anse.

700,000 people are without shelter in Port-au-Prince.

Sheltered in 400 camps the earthquake victims cram into them and remain extremely vulnerable. There is limited access to water, food and sanitation. Three months after the earthquake, Doctors of the World is still providing daily health care daily in 8 of the districts of Port-au-Prince, based in clinics covering the emergency camp and surrounding area where there are around 10000 - 15000 people.

In large tents erected in the heart of the camps, each team is made up of 10 Haitian staff, everyday they provide:

- General medical consultations : More than 5500 basic health consultations are carried out each week
- Vaccinations for pregnant women and young children.
- Screening for malnutrition in 7 of the clinics. This affects many children: for many the situation was bad before the earthquake, now it is even worse.
- Reproductive health activity (family planning, gynaecological consultations, pre- and post-natal consultations) which make up 20% of the consultations.

"Fok Nou Pale!" - We've got to talk!

A team of some 50 Haitian community workers go to one or two camps every day. They provide a link between the mobile sites and the health care structures. They organise games at workshops for the children but also provide discussion and support groups for the adults.
Doctors of the World staff walk through the camps with megaphone to let everyone know about the free clinics. At the same time it is an opportunity to inform people about disease prevention, hygiene, contraception, as well as about violence and psychosocial support.
"Fok Nou Pale!" In the local patois Magna says, "we've got to talk! It does you good, come and see us at our clinics." Armed with her megaphone, she makes her way, with difficulty, between the tents. "Don't overlook your health! DOW clinics are not only for the injured but for everyone, boy and girl, young and old, and for expectant mothers as well! "
The people of Haiti are affected and will be affected for a very long time. Aftershocks provoke renewed fear, sleeplessness and anxiety attacks. The earthquake has also revealed important psychoses, especially amongst adolescents. After 3 months, certain cases prove the need for psychiatric help but at the moment healthcare provision for this is almost non-existent.

For information more on the following aspects of our work there, please visit our website:

An upsurge in cases of sexual violence.

Rebuilding a health system with free access for those who need it. 

Doctors of the World's call for the continuation of free healthcare, at least initially, for pregnant women and children under 5.

Fundraising and funds spent.

Clive, Myanmar (Burma) - We have arrived in Yangon

These are a few pictures of our first 3 weeks in Yangon. We arrived in December 2009 and were met at the airport by Erwin the Doctors of the World employee who I am replacing.

The final pictures are of the Shwedagon Pagoda which has more gold on it than is in the vaults of the Bank of England. Its massive 2500 years old and is set on a hill in Yangon about 3 miles from our home.

Emily Denness - November - Impressive midwifery skills reach ECHO

The European Commission for Humanitarian Organisations (ECHO), one of our biggest donors, is arriving today to assess the clinic. We also receive word that a woman from a community in Tabasa, about an hour and a half’s drive away from here, is in labour and is coming to the clinic.

She has been in labour for two days and it’s her first baby. There is thick, thick meconium (a tar-like substance that lines a baby’s intestines during pregnancy and usually excreted through bowel movements after birth) in the waters.

The presence of meconium during the labour can be a sign of fetal distress. The baby isn’t happy and the woman is 7cm dilated. She just needs a little push with a drip, but I insist that we rehydrate her and give her something to eat first. Once born, the baby will need resuscitation, I’m certain of it.

Dipping heartbeat

The baby’s heartbeat is dipping. It takes the mother a while to master pushing, as it does with most first timers. Finally we see the baby’s head. The resuscitation equipment is ready, and the adrenalin starts pumping. The baby comes out but it’s not responding, breathing or moving.

We start resuscitation even before the cord is cut. I’m not sure if this one will pull through. We cut the cord on a flat surface. It’s a girl. The heartbeat is good, but there’s still no breathing so we have to do it for her.

Dr Eoin and I take turns in resuscitation. We use suction to get loads of meconium from the lungs. We keep going, and just hope that she makes it. It feels like we’re not breathing either.

The mother is watching with baited breath, as is the grandmother. Ten minutes pass before the baby takes a gasp. She’s still unresponsive and still not breathing by herself, but there’s hope! 

Sigh of relief

Another five minutes pass before she starts breathing. She’s breathing! Yes! She’s not opening her eyes and is still a bit floppy, but she’s breathing! Everyone breathes a sigh of relief and we keep watching her like a hawk.

After ensuring that the baby’s not going to suddenly stop breathing we hand her over to her mum. Babies always recover so much better when they are held by their mothers. After a while she even opens her eyes.

The placenta still hasn’t come out yet, so I give the mother an injection to help. She coughs and the placenta pops out! She wants to keep it, so we seal it up in a bag, otherwise there will be a trail of blood following them home.

The woman starts bleeding. The uterus is high so I press on it but there’s more blood. I remove some large clots which are stopping the uterus from contracting. She has lost a lot of blood, more than half a litre, but the bleeding is starting to settle. They could have both been close to death if they had stayed at home.

Reputation intact

We tell ECHO the good news and they’re all relieved and amazed by the story. My reputation as a midwife is intact. So what if I’m not good at big speeches, I can do my job as a midwife and that’s why I’m here. Dr Eoin is very relieved, because I was in Feina the last time there was a case like this.

The team from ECHO is having a long meeting with the general coordinator and the desk coordinator who’s visiting from Paris. They seem very impressed, and we’re pushing for more donation money to support and help grow the mission for next year. It looks promising!

In the morning we wave off ECHO in the helicopter, and EID, a national holiday lasting five days, begins. It sounds like a nice break, although I know that there’ll be more on days when I’m off! I plan an afternoon nap to help prepare for the days ahead.

I love this job.

Emily Deness - November - Septic Shock

“It starts off as a quiet day, with most of the team away at the other base in Feina. It’s warm during the day but the evenings are getting cooler, with jumpers and scarves starting to make an appearance, along with blankets for sleeping.

I decide to have an early night and start dozing off at about 9.30pm. At 11.30pm the guard knocks on my door saying that Zakia, the midwife, needs me now. Zakia tells me that a woman who gave birth two days ago is being carried to the clinic by her family. Eclampsia instantly comes to mind.

I head straight to the clinic with Dr Eoin O’Donoghue, an Irish doctor who has been in Darfur since July. She hasn’t said anything since giving birth and has been experiencing fits. The fits last less than a minute, but she’s just not coming round properly.

Her eyes are open, but there’s no response. Surprisingly, her blood pressure is totally normal, if rather low. We were expecting it to be through the roof, so that pretty much rules out eclampsia.

We revise the magnesium sulphate protocol together, as we believe that it’s the only way to stop her fits and save the woman’s life.

Septic shock

The family says that she has lost a lot of blood. Her blood sugars are fine, but she has a slight temperature and a very high pulse. I suspect septic shock, so we give her antibiotics immediately. She has another fit, though thankfully it still lasts less than a minute.

We keep her airways clear and stop her from pulling the drip out; if she is suffering from septic shock, it’ll take at least 24 hours to ease off. We tell the midwife to make observations every hour and write down when the fits occur until we return first thing in the morning to give the next lot of antibiotics.

I give Zakia a radio and tell her to call me if the fits occur more frequently or are longer in duration.

In the morning I want to check on her straight away, but there’s an emergency in the clinic. A little boy, probably about eight years old, is crying relentlessly as some other boys have cut in a private place.

The staff sedate him, clean everything thoroughly, and stitch him up. We only hope that he won’t be scarred for life.

Thankfully it didn’t go through any vessels or tubes. We don’t want him to have problems urinating so we empty his bladder with a catheter before he comes round and give him antibiotics as a preventative measure and paracetamol. He comes round and his big tear-filled eyes are heartbreaking.

Still unresponsive

Meanwhile, the woman who has been fitting is still unresponsive, but didn’t have any more fits until the morning. Suddenly she has three within an hour. We give her more antibiotics as we want to cover everything.
My main concern is that the patient doesn’t hurt herself, so we make sure everything is clean.

Dr O’Donoghue administers diazepam to help stop the seizures. She has another fit within 20 minutes, but they seem to settle, so we are less worried about her pulling out her IV line or choking. 

The next day she seems a lot better and will go by truck to the hospital in Nyala.

Clive, Myanmar (Burma) - Leaving via Paris

Clive and Jackie in Paris

We went to Paris for a week of meetings with Doctors of the World (Médecins du Monde) in preparation for the commencement of our "mission" as HQ described it.

We did a bit of sightseeing and had some nice meals but were mainly waiting to set off for Burma and start this exciting year.

Our main worry was about our passports which we did not get back from the Myanmar (Burma) embassy until 4.30pm on the Friday and we were booked to fly on the Saturday Thai Airways via Bangkok.

Clive Mellor our volunteer in Myanmar (Burma)

 

Clive on a visit with Dr Hein Latt Aung (Project Officer) to see the work in the Delta area hit by Cyclone Nargis in May 2008.

Clive Mellor, 45, from Lancashire is volunteering with Doctors of the World in Myanmar (Burma) where he is working as a Finance and Admin Coordinator overseeing two projects in the country.  He is living and working abroad on a year long mission with his wife Jackie who has also been volunteering for the organisation.

Clive spoke to Frontline Diaries about his experiences and why he decided to go to Myanmar.

What was your background experience leading up to volunteering with Doctors of the World?
I had over 22 years work experience mainly in Finance and Health Services, working at a senior level. I worked all over the UK but never overseas, but have travelled widely.

I’m a qualified accountant with 22 years experience including 13 years NHS experience working as a Director.
 
What projects are you working on in Myanmar?
Doctors of the World have been working in Myanmar since 1995. They work in Yangon (the capital formerly Rangoon) and in Kachin near the Chinese border. Since 2008 they also work in the Delta area hit by Cyclone Nargis. I started in December 2009 and will be based in Yangon.

In Yangon Doctors of the World works on Aids prevention and treatment for sex workers (i.e. the highest risk groups) and does outreach work using peers to talk to those at highest risk and promoting the use of our Drop in Clinic. The prevalance of Aids is highest in these risk groups. Our work in Kachin is similar but targets Intravenous Drug Users.
The work in Pyapon in the Delta area is community health work, where we help train community health workers, who are villagers in remote areas, keeping them supplied with medical supplies and supporting their work. Most of these villages can only be reached by boats taking up to 10 hours to reach them.


Why did you decide to go to Myanmar?
My wife Jackie and I had been to Asia many times and love the people, so this opportunity seemed ideal for us to experience a different culture for a longer period and make a contribution towards improving healthcare in Myanmar.

What is your role and day-to-day job in Myanmar?
My role is as head of Finance, HR and Admin. Key aspects of the role include bidding and reporting to donors. Also we have the regular monthly financial reporting to do to HQ in Paris and ensuring financial procedures, plans and budgets are adhered to. A new HR policy has just been implemented for local staff and so there is some work in ensuring it is delivered effectively.
My wife Jackie has started helping an AIDS self help group which is run by locals involved with Doctors of the World. They make and sell bags to raise funds and she has been helping them with their costings and marketing.

How do you think it will impact on your working life when you return to the UK?
Difficult to say – I think it will add something to my CV, but this is more about an experience that will remain with me for the rest of my life.

Emily, Doctors of the World UK's midwife in Darfur

From the silence in Darfur, a handful of awe inspiring photos have appeared, taken by the expert hands of our volunteer midwife out there, Emily Denness …
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Our Annual Conference - Climate Change and Health: Understanding the Impact before it is too late

Lead experts in the field, including Sir Jonathon Porritt, Sir Andrew Haines and Jean Lambert MEP, set out the key issues around climate change and consequences for health.

We explored a range of subjects from changing migration patterns to new conflicts and the global impact on public health.

Visit our website to watch the video highlights from the conference or our photos from the conference.

Read all about it: read the proceedings from the conference and find out the next steps that we can all take together to effectively reduce our own carbon emissions and push health to the top of the climate change political agenda.

Results of Conference Day Survey were:

What do you expect from this conference?

•    learn more about DRR
•    meet people with whom to discuss and share these issues, gather useful knowledge and then take action! 

What is the most important climate change issue for you?

•    the effects on poverty in the developing world
•    migration
•    effects on underlying causes of malnutrition
•    homelessness/pregnancy/children
•    injustice of distribution impact
•    impact on livelihoods and wellbeing, especially for youth