RotaFlash, April 2016
Say sayonara to Star Trek because this summer’s biggest blockbuster isn’t playing at your local theater. The most compelling drama comes to you right here, as superheroes and villains face off in the fight to defeat diarrheal disease!
That sight, that sound, that super-strength?!? It’s WASH, Nutrition, Vaccines, and ORS + Zinc to the rescue. With their powers combined, these superheroes help children, families, and communities conquer the biggest bugs terrorizing towns and sickening kids with diarrhea—Rotavirus, ETEC, Shigella, and Cryptosporidium.
But they’re not the only heroes in this story! There are lots of everyday folks who are committed to saving more lives and helping children around the world grow healthy and strong. We’re paying tribute to just a few of them below.
Dr. Richard Walker of PATH (left) and Dr. Lou Bourgeois of Johns Hopkins University (right) are a dynamic duo of skilled scientists working vigorously to vanquish the vile intestinal vermins ETEC and Shigella! Passionate about protecting children from the two leading bacterial causes of diarrhea, this powerful pair is fighting fiercely alongside private- and public-sector partners to advance vital new vaccines to add to the repertoire of resources to tackle these bacterial brutes. With vaccine candidates now in clinical trials, victory may finally be in sight! But their benevolent battle will continue. Even after vaccines are approved, they’ll need help from heroes around the world to ensure access for all who need them.
Germs can run, but they can’t hide from the microscopic vision of Johann Perez, microbiologist-in-training at the National Autonomous University of Nicaragua. Every day, more global recruits join DefeatDD’s Halls of Health: boots on the ground finding new ways to outsmart the diarrhea menace with local resources, solutions, and know-how. With the help of national champions, Nicaragua added rotavirus vaccines to their arsenal in 2006, but the vaccines need their team players – including next-generation champions like Johann – to keep vicious villains at bay.
Two fearless fighters, Dr. Anita Zaidi and Dr. Duncan Steele, lead the charitable charge at the Bill & Melinda Gates Foundation, having dedicated decades to defeating diarrhea. Together, they bridge science and strategy to rally a revolution against common childhood threats.
Applying medical microbiology to pediatric perspectives, Dr. Zaidi is a Pakistani powerhouse and a champion for child health. Directing diarrheal disease efforts, she pioneers programs poised to eliminate enteric evil-doers at the eminent Gates Foundation.
Dr. Duncan Steele is deputy director and strategic lead for enteric vaccines, and this seasoned scientist from Southern Africa is a formidable foe. Take the case of rotavirus: Duncan’s research recorded the tremendous toll rotavirus wreaked on African communities, paving a path for vaccines that are dramatically diminishing death and disease.
As a member of Team DefeatDD, Hope Randall slays the foolish faux pas prohibiting poop from polite conversation and drops needed knowledge into the global dialogue on child health. Corralling conversations is her specialty as she unifies messages across interventions in support of an integrated approach to defeat diarrhea. Whether she’s punning on social media, presenting to a crowd, or producing an infographic, she puts her whole heart into the fight against this ferocious fiend. In the words of the warrior herself: “No mercy against diarrhea!”
See more photos of DefeatDD heroes on Facebook. Inspired by the champions highlighted here? Add your support by sharing with your friends and tweeting #DefeatDD. Join the fight by following us on Facebookand Twitter.
Photo credits, top to bottom:
Dr. Richard Walker (left), PATH; and Dr. Lou Bourgeois (right), Johns Hopkins University. Photo: PATH/Laura Edison.
Johann Perez, National Autonomous University of Nicaragua. Photo: PATH/Hope Randall.
Dr. Anita Zaidi, Bill & Melinda Gates Foundation. Photo: PATH/Laura Edison.
Dr. Duncan Steele, Bill & Melinda Gates Foundation. Photo: PATH/Laura Edison.
Hope Randall, DefeatDD. Photo: PATH/Laura Edison.Read more
Richard Heinzl (center) went to Sisophon, Cambodia, on his first mission with MSF in 1991.
I used to work in some of the poorest places in the world with Doctors Without Borders. The local people were wonderful and intelligent but poor because they were immersed in war and other forms of violence. The places they lived in were terribly insecure. War, even a little bit of it, wreaks havoc on the infrastructure of a society. The things that we take for granted in the rich parts of the world all fall apart. If a power generating station is broken, there’s no electricity. And when there’s no electricity, water purification systems don’t work. Diarrhea pathogens like Shigella and ETEC love these conditions. They thrive. People drink contaminated water because they have no choice. They naturally become sick, especially the kids. I’ve seen it a thousand times.
All of this happens rather silently. These kinds of war-related problems don’t go off with a bang. You don’t see it on the evening news. I often say that it’s not the bombs and bullets in war that hurt the most people, it’s the invisible microbes that thrive in broken cities affected by war that hurt the most people. Let me say the obvious: War is bad for your health.
The other problem about war and violence is that as soon as it happens, those who have the means, the professionals and their families do what any of us would do: they leave. They’re the ones with cars and enough money to do so. They’re gone in a hurry. I’m talking about doctors and nurses and all of the important healthcare professionals who run clinics and hospitals. So now all of the people and systems meant to help people who get sick have all left. No one is there to help. The infections start taking an enormous toll. Intestinal disease runs rampant.
I guess the greatest thing we could do is prevent war and violence. I know that’s a bit utopian. But I learned about something that was anything but utopian recently at the VASE conference in Washington: I learned about the possibility of vaccines and other successful treatments. I had the tremendous privilege of addressing the delegates there this past June. My very high opinion of the people attending this conference got even higher after I met them personally and learned how sincerely dedicated they are to the kinds of issues I’m writing about in this blog. They are heroes of mine because they are working on finding solutions to some of the most important and difficult problems in the world, problems that don’t often make the headlines. In fact,these problems almost never make the headlines and yet they are a burden to humanity on the same level as their more famous cousins such as tuberculosis, malaria, and HIV.
And while I say that preventing war is a utopian idea, one that we may never realize, developing vaccines against Shigella and ETEC is a very real near-term possibility and one that should be supported in all ways. Having been on the frontlines, tending to very real patients who have these maladies, I know how crucial it is to find solutions. And that is why I would like to lend my voice in support of people everywhere who are trying to bring an end to these tremendous problems confronting human health.
Photo credits: Richard Heinzl.Read more
Sweltering summer heat is in full swing here in Washington, DC, and many of us are seeking relief at the neighborhood pool. This year, with a baby to introduce to the pool, it’s been a whole new experience. No longer can I throw a towel into the bag and settle in with a good book. Instead, I have to think about pool toys, baby sunscreen, and the rules for baby swim diapers. Rules for swim diapers, you ask? There are many.
However, as I did my research to ensure my wee one was appropriately clad with the right swim diaper underneath a water resistant “outer” diaper (I kid you not), I was struck by the irony of double protection in already chlorinated water that is only intended for swimming. Of course we all swallow the occasional mouthful of pool water, and no one wants to swim next to a baby’s latest poop. I am grateful for these policies – and the procedures in place for when someone’s diaper doesn’t quite hold up. But if we can manage all this attention for policies and rules for a swimming pool, can’t we put some of that same protective effort into water that people are actually going to drink?
Globally, 748 million people lack access to improved drinking water and WHO estimates that 1.8 billion people use a source of drinking water that is fecally contaminated. Forget the child who pees in the chlorinated pool, we’re talking water intended for drinking that contains feces. You don’t need me to tell you that this can lead to all sorts of illnesses and diseases, not to mention the general poor health that results from repeated illness and infection.
Many people live in countries where there are policies about clean water, laws about sewage and sanitation, and enough rules about pool diapers to make your head spin. But the majority of people live in countries where such policies do not exist – or are inadequately funded for implementation. Too many people – many of them women and children – continue to suffer the short and long term consequences that result from a lack of clean water (and a dearth of improved sanitation facilities). And those consequences aren’t just health-related; they’re cultural, social, and economic.
Ensuring access to clean water is no easy task. If it were a simple solution, the world would have figured it out already. The reality is that each community may need a slightly different solution, something that works for their culture and environment. However, the need for policies to govern these issues is consistent. When policies exist, governments can be held accountable, and citizens and communities can advocate for their rights to clean water.
In a world where we can manage to govern the clean (and chlorinated) water of swimming pools, why is it we can’t manage access to clean water for the world’s 748 million people who continue to go without? Access to a clean chlorinated pool is a luxury. Access to safe drinking water is a human right. If we can ensure our kids are safe and clean as they splash in the pool, we can certainly ensure that the world’s children are safe when they’re born, when they’re thirsty, or when someone makes them dinner. Clean water isn’t a question: for many families and communities, it’s the answer.Read more
Matching the new India country program leader’s steps is not for the faint-hearted. Deep diving into PATH’s global depth and breadth of work – he knows he is in the right place at the right time. He attributes his move from the private sector to the development sector to a chance conversation on how things in India were not working and how children were dying in India often for lack of the right attention or immediate and critical medical help. Around this discussion, he was asked, "So what are you doing about it?"
That was the turning point for Neeraj, who, as a parent to two young boys, decided that he was no longer going to sit on the fence on these important issues. "Imagine if something happened to my boys- what that would do to me!" Keen to make a difference, he jumped in to look for avenues to work towards changing things. Coming to PATH from WaterAid India, Neeraj has been on the forefront of catalysing the conversation around water and sanitation in India. DefeatDD is sure that he will continue to be an advocate for addressing diarrheal disease and caught up with him – over break – that the leader in a hurry allowed himself.
Tell us about your work as Chief Executive of WaterAid India.
Following the Prime Minister of India’s call the Clean India Mission in 2014. WaterAid convened the India water, sanitation, and hygiene (WASH) Summit in February 2015. The first event of its kind, it brought together practitioners, policymakers¸ thought leaders, the private sector, government officials, and NGOs working to make a clean India a reality by 2019. More than 600 people attended the discussion on how to get things done.
WASH cuts across all sectors and impacts poverty, education, and health. Apart from building toilets, it was important to understand where the water would be sourced from and discuss issues around hygiene and behavior, all of which is critical if we need to have a long term impact in the WASH space. It was also important to work towards ensuring that the poor have the basic facilities that are available to us and that we take for granted.
While representing WaterAid India at numerous forums on WASH in India and globally the focus has been to promote the importance of WASH in improving child health. I have been part of dialogues with senior government officials, both at the central and state levels, at the World Water Week in Stockholm, and SACOSAN (South Asian Conference on Sanitation).
Over the past few month the series of dialogues have resulted in a very important milestone – the establishment of the India Sanitation Coalition. The Coalition, launched in June 2015, is leading the sanitation conversations in India by bringing together organizations and individuals to find sustainable solutions for sanitation.
You have been bold about the most whispered four letter word in your TEDx talk in December 2015.
The event used the TED conference format but was independently organized by a local community. This is designed to help communities, organizations, and individuals to spark conversation and connection through local TED-like experiences. I titled my talk “Shit Matters.” And I spoke about the fact that 145,000 children die every year because they are exposed to pathogens from an unhealthy environment.
With your experience in WASH and nutrition what are your immediate tasks at PATH?
PATH is seen as the leader in cutting edge innovations in the health sector. We have a diverse portfolio on maternal and newborn health and I am looking forward to trying to connect the dots and being able to take PATH’s innovations forward to make survival a must for children and women in India. I am hopeful that innovations and technologies will help India achieve its Sustainable Development Goals. Without India catching up, most of the SDG’s will remain a pipe dream.
I believe that organisations are built by people. Each individual has a critical role to play within the organization. How, for example, do we make sure that each individual is able to deliver their creative best by getting out of their assigned boxes? Only when people put in their cerebral, critical thinking will they deliver collectively as one team. I like challenges, and I am curious and creative about finding solutions for the developmental crisis in India.
In my previous avatar in the private sector I understood the importance of collaborations. I feel that collaborations will be critical for India to achieve her SDGs. I will also be keen to follow PATH’s impact on the ground and see that it is scaled up.
Tell us more about your desire to travel
Having lived across three continents and five countries over my lifetime, the nomadic lifestyle has trained me to explore. I invest in travelling because I like to meet people, explore local cultures and cuisine. I like reading of writing about global developmental views, issues, people, journeys, and autobiographies.
Photo credit: PATH/Satvir Malhotra.Read more
Eight-year-old Dipesh can tell his class everything about ‘dast’ (diarrhea) and what to do if anyone gets diarrhea. He says if oral rehydration salts (ORS) don’t give you relief, you need to go see a doctor.
Like Dipesh, many other children in Shivpuri, Madhya Pradesh now confidently talk about the link between soap and germs, the importance of clean water, and other concrete ways to defeat diarrhea. Sesame Workshop in India’s (SWI) initiative “Building Communities of Change” has been instrumental in bringing about this awareness in Shivpuri. We employed mobile technologies and the popular Galli Galli Sim Sim characters to empower children as agents of change.
During the needs assessment study we observed that while people in Shivpuri did recognise the habit of handwashing, they lacked knowledge about why washing hands with soap that kills germs is important. People perceived soap as a beautification tool and did not associate it with health and hygiene. Hence, the need was for a programme that would educate them about the critical health messages around hand washing, while helping them build healthy habits for a lifetime. We also observed that while Shivpuri was a media-dark region, still there was high mobile phone penetration. People were hooked on to their mobile phones and radios. So we combined these two technologies to reach out to disenfranchised populations.
We merged radio, mobile technology and on-ground activation to improve knowledge, attitude and practices around diarrhea prevention and management among communities. We developed 14 Galli Galli Sim Sim radio episodes about handwashing, the importance of soap, boiling and safe storage of drinking water, preparing ORS, and many such preventive and treatment steps for diarrhea. The radio shows were specially timed to broadcast over a 12-week period during the monsoon season when diarrhea is most prevalent. It wasn’t just radio sets, communities could access the episodes even on their mobile phones by simply giving a missed call to a toll-free IVRS (Interactive Voice Response System) number. We adopted a dynamic process which continuously modified as per the feedback from the targeted community and determined messages which focussed on helping children understand what diarrhea is and giving them appropriate language to talk about it.
Lakshmi Garg, one of the facilitators for the program shared that the IVRS was a big hit among kids as they could easily access these radio episodes on their parents’ phones. It was motivating to see how kids had started taking charge of their health. 6 years old Sonali had even memorized the IVRS phone number so that she didn’t need to refer to the sticker every time to call. Kids could now recognise diarrhea and its symptoms and could recollect how Chamki advised them to take ORS in case of diarrhea.
All children deserve to live healthy and happy lives and realize their full potential. Yet diseases like diarrhea have been taking away many lives in the early years. Diarrhea kills 225,000 children every year in India. This is a tragedy, more so because it is usually an entirely preventable disease. A wide body of research shows that knowledge about washing hands with water and soap and administering oral rehydration salts (ORS) as the first line of treatment can reduce diarrheal deaths by 93%.
The “Building Communities of Change” project reached 1.5 million people (200,000 children) through All India Radio (AIR) Shivpuri and eight community radio stations. By empowering children to be agents of change we were able to help communities take the first step towards preventing diarrhea and its related deaths.
To learn more, visit www.sesameworkshopindia.org.Read more