Showing posts with label Dr Michael Meegan. Show all posts
Showing posts with label Dr Michael Meegan. Show all posts
Tuesday, August 9, 2011
Updates ICROSS
Updated Resume
Dr Michael Meegan
Founder International Director ICROSS
ICROSS Rural Health Programmes, P. O. Box 507, Ngong Hills, Rift Valley, Kenya
mikemeegan@gmail.com
www.icrossinternational.org http://www.icross-africa.net/ http://icrosskenya.org/
www.michaelmeegan.com www.michaelmeegan.net
+ 254 721737394 (Kenya Office)
Consultant International health, Epidemiology, analysing health problems, belief systems, cultural public-health processes. Community based health programmes . Creating effective long term health changes, design of research systems Africa, Asia. Author, lecturer.
Doctorate in Medicine ( D.Med Hon, C) National University of Ireland 2006,
M.Sc (Community Health)1989, Trinity College Dublin, Ireland
B.Phil (Hons) 1979 Milltown Park, Holy See
Ongoing learning: Ph.D “The importance of local appropriateness in the development of health programmes in Africa” Global Health (Dept International Health, Faculty of Medicine, Tampere University, Finland ) 2009-2012
FRAMI Fellow of the Royal Academy of Medicine of Ireland
East African Association of Anthropology, co-founder
Senior Research fellow, Centre of Culture and Development Baroda, Gujarat
Melvin Jones Fellow
Trinity College Association, life member
Languages : English ,French, Samburu, Maasai, Swahili
Areas of Professional Experience:
Programme Management and Development
• Thirty years in strategic public health planning, project development and successful fundraising for community based health and development projects. Experienced in negotiating with donors and the government. Negotiated Global fund and multi/bi lateral grants of over $12 million.
• Designed and developed culturally appropriate health care based programmes for nomadic peoples in East Africa.Developed Strategic public health Plan 2011-2016.
• Established and designed numerous community based projects with emphasis on development of community systems, including women’s development and youth programmes
• Provided programmatic management and directed famine relief operations across 21,000 sq. miles reaching 32,700 including follow-up and rehabilitation of severely malnourished children 2009Programmatic management including human and financial resource management to ICROSS to achieve project goals, including personnel management and organisational restructuring for Kenyan and Tanzanian Programmes
• Provided monitoring and evaluation of internationally funded projects in the ICROSS programme including supervision of project feedback, development of proposal design and undertaking feasibility studies
• Pioneered the use of dialogic methodology for education and facilitation at community level.Pioneered the use of cultural linguistic ethnography and the application of epistemological and epidemiological disciplines to PLWA and programme development
• Designed, developed and monitored the implementation of competency based and problem oriented training system, for traditional birth attendants, in collaboration with Ministry of Health Tanzania (village and District level)
• Provided team leadership, drawing together multi disciplinary teams from widely differing ethnic, religious and cultural backgrounds into cohesive effective teams.
Research and Consultancy
Areas of specialization.
Anthropology
19 years living among Samburu and Maasai pastoral nomadic tribal communities in semi-arid rural areas. Cultural ethnography, applied medical anthropology, application of belief systems to public health policies, academic and ethnographic interpretation of data using cultural mechanisms.
The use of community concepts such as meaning, religion, symbol, value, systems and behavioral modeling, truth and acceptance in structuring development strategies.
International Health
Experienced in developing community centered evaluation systems through the use of epistemology (ethnic cognitional theories) and cultural epidemiology.
Key consultancies include:
• Principal Investigator Kenya, International Consortium ,Alternative methods for mass water protection , led by Royal College of Surgeons 2007-10
• Visiting Lecturer , Dept International Health, Faculty of Medicine Tampere University 2008-2011
• Principle investigator Kenya , International collaborative study on Solar disinfection of drinking water, EU funded multi country research, RCSI 2005-2010
• Visiting lecturer, Gujarat, Centre for Culture and Development Baroda Jan 2008
• Community based new born care, 2007, CARE International Cambodia
• Women’s health and Safe Motherhood Programme, Ministry of Health, Manila, Philippines June 2002 – December 2005. European Union.
• Development on extended medical anthropological studies and field research components for malaria control: Surat Malaria Control and Research Project. India (1999) (DFID funded project)
• Epidemiology advisor to the Rapid Response Mechanism component for malaria control; Surat Malaria Control and Research Project. India (1998) (DFID funded project)
• Social Development Advisor to Surat Malaria Control and Research Project. Development aspects of malaria control in Surat District, Gujarat State India 1997-98 (DFID funded project).
• Clinical epidemiological and statistical advisor, Central Leprosy Teaching and Research Institute, Tamil Nadu, India, Government of India, 1998 (DFID funded project). Clinical epidemiological and statistical Advisor, Central Leprosy Teaching and Research Institute, Tamil Nadu, India, Government of India, 1999 (DFID funded project)Project preparation, communications component Child-to-Child modules (1995) (Kenya).
• Project appraisal: community participation/education and communication components of regional health care programme (Population and Health Services, Kenya 1994)
Programme Experience:
2000- to date: Founder and International Director ICROSS, Head Public Health Research Programme. Based in Kenya. Overseeing the development of ICROSS as a local NGO in Kenya, and Tanzania, providing technical support to policy and planning.
• Founder , International Director ICROSS , established registered charities in 5 countries.
• Founder, New World International Kenya, NWI UK , an advocacy, awareness and action group for Global development 2008 / NWI Kenya 2008
• Designed participatory systems, models of impact analysis and mechanisms for evaluation surveillance for long-term programmes.
• Training Kenyan and Tanzanian programme managers in problem solving skills and developing line management systems
• Director of research ensuring ongoing analysis of development impact supervising 11 collaborative medical research programmes in East Africa.
• Production of project write-ups including financial profiles, cost benefits analysis and impact assessments totaling $4 million in 05-06
• Responsible for the Africanisation of all ICROSS programmes 2001-2009
• Advisor to numerous official bodies including; REHAB Ireland, Consultants in Public Affairs, Dublin, Japanese Embassy, Nairobi, DANIDA, Local NGOs, local grassroots development groups and the Centre for Social Studies Gujarat, India.
• Sourced over $28 million in grants for ICROSS health programmes in Kenya while International Director between 1997-2004
1987 –1999 Director of Rural Health Programmes, ICROSS
Based in Kenya; Responsible for establishing ICROSS Tanzania as an autonomous NGO, assisting local NGOs in the development of self-sustaining strategies.
• Ensured capacity building through human resource development. Responsible for 47 separate health project activities, through 36 local NGOs in Kenya.
• Advisory Board member for the Kenya Association of Professional Counselors Adolescent project.
• Initiated and ensured epidemiological and anthropological research to support the development of indicators for impact assessment.
1981-1986 Field Director
Based in Kenya. Responsible for implementation and coordination of multiple development activities in Kenya, Somalia and Uganda, including: -
• Evaluation of projects already in place, looking particularly at their impact on vulnerable local communities, including women and the internally displaced.
• Networking of NGOS and field supervision of famine relief logistics of supplementary feeding and emergency relief activities in three semi desert areas.
• Evaluation of micro-credit options available to disadvantaged groups in rural areas, research into options and secure, where appropriate, alternative micro-credit schemes to establish small scale enterprises. Recommend new avenues for continuing support between ICROSS international, and UK/USA solidarity groups and local initiatives.
• Research and implementation of multiple development projects in partnership with nomadic people, local NGOs and government departments, focus areas included health care interventions, water conservation and appropriate agricultural development planning for semi arid areas.
• Evaluation and assessment of field projects in Mogadishu, Somalia
Illustrative awards
2008
-Premio internazionale Exposcuola per l'impegno civile Italy, International Humanitarian award of the Exposcuola.
-International Angelo della Pace for 2008 The Rachel Foundation Italy
2006
Fellow of the Royal Academy of Medicine in Ireland 10 May 2006
Doctorate in Medicine D.Med (Honoris Causa) National University of Ireland 10 April 2006
2003
International Person of the year,
Irish National Awards , November 2003
1995
Melvin Jones Fellow
Humanitarian services
Lions Clubs International 1995
1988
Past Pupil of the Year
Terenure College 1988
Illustrative Research Articles and Publications
1. Elmore-Meegan M, Conroy RM, . Sex workers in Kenya,
numbers of clients and associated risks: an exploratory survey.
Reprod Health Matters 2004;12(23):50-7.
2. Meegan ME, Conroy RM, Lengeny SO, Renhault K, Nyangole J. Effect
on neonatal tetanus mortality after a culturally-based health
promotion programme. Lancet 2001;358(9282):640-1.
3. Conroy RM, Meegan ME, Joyce T, McGuigan K, Barnes J. Solar
disinfection of drinking water protects against cholera in children
under 6 years of age. Arch Dis Child 2001;85(4):293-5.
4. Meegan M, Morley DC. Growth monitoring: family participation:
effective community development. Trop Doct 1999;29(1):23-7.
5. Conroy RM, Meegan ME, Joyce T, McGuigan K, Barnes J. Solar
disinfection of water reduces diarrhoeal disease: an update. Arch Dis
Child 1999;81(4):337-8.
6. Meegan M, Morley D, Chavasse D. Fly traps. Lancet 1997;349(9055):886.
7. Meegan M, Morley DC, Brown R. Child weighing by the unschooled: a
report of a controlled study of growth monitoring over 12 months of
Maasai children using direct recording scales. Trans R Soc Trop Med
Hyg 1994;88(6):635-7.
8. Conroy RM, Meegan ME. Dwindling donor aid for health programmes in
developing countries. Lancet 1994;343(8907):1228-9.
9. Meegan MK. Rethinking famine relief. Lancet 1992;340(8830):1293-4.
10. Konings E, Anderson RM, Morley D, O'Riordan T, Meegan M. Rates of
sexual partner change among two pastoralist southern Nilotic groups
in east Africa. Aids 1989;3(4):245-7.
11. Meegan M, McCormick J. Prevention of disease in the poor world.
Lancet 1988;2(8603):152-3.
12. Meegan M. Starvation and suffering. Lancet 1983;2(8365-66):1506.
13. Meegan M. The reality of starvation and disease. Lancet 1981;1
(8212):146.
In Preparation
Solar disinfection of drinking water (SODIS) in the prevention of dysentery in Kenyan children aged under 5 years, Environmental Science and Technology Journal,September 2011
Martella du Preez1, Ronan M. Conroy2, Sophie Ligondo3, James Hennessy3, Michael Elroy-Meegan3, Allan Soita3, Kevin G. McGuigan4
Published Books
Changing the World
Feb 2009 256 pgs www.eye-books.com
Take my hand, a spiritual journey
With Sharon Wilkinson, Forward by T Hogan, 58 pgs www.michaelmeegan.com July 2008
Surprised by joy; a story of hope in the midst of tragedy ( forward by Stephen Sackur BBC ) 156 pgs July 2006 www.maverickhouse.com
All Will be Well (Forward by John Hurt) Eye-Books, 149 pgs
May 2004. ISBN 1903070279 www.eye-book.com
All Shall be Well, Forward by John Powell SJ, ISBN 000-627006-9, Collins. 146 pgs. First edition 1986, Reprint Jan 1999.
In preparation
The path of change
Meegan M ,Conroy R Scrima M
Eye Books May 2012 www.eye-books.com
The Tribe of One With Colin Meagle www.eye-books.com
May 2012
So you want o be a volunteer A guide for International volunteers
Journies in the underworld: a novel
With Thomas Ernst, Penelope Shales, Sharon Wilkinson, Allberto Bellu
The secret of Light Fortress monastery on Montpellier, guarding the secrets of the last mystics of Jerusalem 1200 pgs, historical Novel 2013
Illustrative general articles
AFRO Journal Italy, regular contributor on Global health, poverty and International health trends and patterning Oct 09 Feb 09 Dialogue on Diarrhoea , regular contributor
World Health Organsation (WHO ) guidelines Trachoma prevention, fly traps , M Elmore-Meegan Prof D Morely et al, Geneva, Switzerland. 2001
Peer Reviews for key publications & major conferences and journals incl Int AIDS Conference
Scientific conferences and presentations (illustrative)
Health care in regions of absolute Poverty
Seminar , Dept International health, Faculty of Medicine
University of Tampere, Finland 30th November 2009
SODIS in KENYA, 20 years of field implementaton
SODIS International Conference Phnom Phen Cambodia
International seminar of the impact of Solar disinfection
International Research Colloquium of the Network to promote
Household Water Treatment and Safe Storage (HWTS), Twenty years of SODIS in Kenya.
Royal College of Surgeons in Ireland, Dublin 21st - 23rd September 2009
Changing dynamics of Morbidity, Mortality and poverty of children in the Third World.
Senate Hearing, Italian Senate, Rome
Senatorial Commission on International Children’s Rights , At the request of Italian Senate Commission, Rome , 31st April 2009
Global health and interdependency,
The Royal College of Surgeons Charter day lecture 2009
Royal College of Surgeons,Dublin. 12th Feb 2009
Emerging mega-trends in Global health
Future shocks; disasters and relief in a changing world, RedR Conference, Royal College of nursing, London, 5th December, 2007
Locally appropriate technologies in low income settings, Dept International health, Tampere University, Finland. 29th Nov 2007
Applied operational study of pain determinants in terminally ill patients in Bondo, Kenya XVI International AIDS Conference,Toronto, August 06 Francis,P,Meegan,M
The 46th Robert Graves Lecture
Royal Academy of Medicine in Ireland
Creating long term change through culturally acceptable cost effective public health interventions.
Dublin 10 May 06
IFCW World Forum. “AIDS orphans & Vulnerable Children; an evidence-led response.” Cape Town, South Africa. 2003
Annual Consultative Review, Manitoba and Nairobi Universities Collaborative Conference. “An assessment of home-based care interventions among 2,116 terminally ill patients in Bondo and Siaya using clinically validated scales.
Interim results.” Nairobi, Kenya. 2003
"AIDS and the changing face of Africa: The impact on children, WUSC-Carleton, Médecins Sans Frontières, CARE Carlton University Canada, 25th Nov 2002
Annual Consultative Review, Manitoba and Nairobi Universities Collaborative Conference. “Modeling cultural determinants of sexual behavior” - A Pilot Study. Nairobi, Kenya. 2002
Annual Consultative Review, Manitoba and Nairobi Universities Collaborative Conference. “AIDS, children and poverty, an alternative model to international Aid, ‘Love, evidence and common sense.” Nairobi, Kenya. 2002.
WHO Trachoma conference
. “Effect of fly control using sustainable interventions on the prevalence of Trachoma in five pastoral tribes in Kenya.” Geneva, Switzerland. 2001
Child Survival. Alternative strategies in reducing infant mortality” International Conference on Child survival. Nairobi, Kenya. 2001
Identifying emerging needs among AIDS orphans in Kenya. “Multicentre Matched Perspective Control Study of 2,786 Children Orphaned by AIDS, 2,420 other Orphans and 3,400”
Nairobi, Kenya. 2000
AIDS orphans. “An emerging crisis: a USAID sponsored conference.” Nanyuki. Kenya. 2000
Annual Consultative Review, Manitoba and Nairobi Universities Collaborative Conference. “Multi centre Matched Perspective Control Study of 2,786 Children
Orphaned by AIDS, 2,420 other Orphans and 3,400.” Nairobi, Kenya. 2000
East African Association of Anthropologists inaugural Conference. “Anthropology and ethnography.” Nairobi, Kenya. 2000
Thursday, June 23, 2011
ICROSS women's health programme 2011
ICROSS creating long range women's health programmes
ICROSS has focused on women's health and reproductive health care in its expansion of Maternal and child health programmes. ICROSS health services have provided comprehensive care for mothers and children for 30 years in Africa in a wide range of evidence based health projects.
Our health projects focus since 1983 on mothers and children in community owned initiatives.
These are the most vulnerable to disease and malnutrition. The International Director/Founder Dr Michael Meegan said today " We are really interested in increasing the capacity of the communities we live with to deliver long term health services and change. This is a dynamic shared learning with a wide range of partners and friends"
Saruni Ole Lengeny added " Our work includes includes training local ICROSS health volunteers as counsellors, and carers community health. ICROSS is focused on interventions ranging from prevention, diarrhoea control and reducing blindness, nutrition and education to birth spacing and clinical services. Our reproductive health projects include family planning. We are planning new maternity units to improve prenatal care, labour and delivery services, and the prevention, detection and treatment of STDs, including HIV/AIDS."
There are more facts on women's health at http://www.who.int/features/factfiles/women/en/
you can google scholar search our publicaltions through searching ICROSS Kenya at google scholar http://scholar.google.com/scholar?hl=en&q=ICROSS+KENYA&btnG=Search&as_sdt=0%2C5&as_ylo=&as_vis=0
and more on our web sites www.icrossinternational.org
www.icross-africa.net You can help by buying from our online store and by donating to our partners and network organisations.
You can learn more about ICROSS projects on http://www.icrossinternational.org/about/index.asp
For decades ICROSS has worked with mothers and children in building long term safe motherhood projects
There are many problems Ordinary woman in Kenya are unable to afford basic sanitary protection.
⇒ One pack of sanitary pads costs more than 50% of the average monthly wage for women.
⇒ Millions of Kenyan women are forced to replace tampons with newspapers and dirty rags.
• This can lead to vaginal infections for which there is no available medication.
• These vaginal infections are often mistaken to be sexually transmitted infections leading to social embarrassment and domestic violence.
⇒ Wives and mothers are unable to work when they have their periods, further hindering already impoverished families.
⇒ Girls are forced to take time off school, further jeopardizing their education.
• Because of the economic and cultural crises in Africa, its schools serve as more than academic centers. They provide community resources where young people receive basic care and services, such as food programs, clean water and counseling.
ICROSS has focused on women's health and reproductive health care in its expansion of Maternal and child health programmes. ICROSS health services have provided comprehensive care for mothers and children for 30 years in Africa in a wide range of evidence based health projects.
Our health projects focus since 1983 on mothers and children in community owned initiatives.
These are the most vulnerable to disease and malnutrition. The International Director/Founder Dr Michael Meegan said today " We are really interested in increasing the capacity of the communities we live with to deliver long term health services and change. This is a dynamic shared learning with a wide range of partners and friends"
Saruni Ole Lengeny added " Our work includes includes training local ICROSS health volunteers as counsellors, and carers community health. ICROSS is focused on interventions ranging from prevention, diarrhoea control and reducing blindness, nutrition and education to birth spacing and clinical services. Our reproductive health projects include family planning. We are planning new maternity units to improve prenatal care, labour and delivery services, and the prevention, detection and treatment of STDs, including HIV/AIDS."
There are more facts on women's health at http://www.who.int/features/factfiles/women/en/
you can google scholar search our publicaltions through searching ICROSS Kenya at google scholar http://scholar.google.com/scholar?hl=en&q=ICROSS+KENYA&btnG=Search&as_sdt=0%2C5&as_ylo=&as_vis=0
and more on our web sites www.icrossinternational.org
www.icross-africa.net You can help by buying from our online store and by donating to our partners and network organisations.
You can learn more about ICROSS projects on http://www.icrossinternational.org/about/index.asp
For decades ICROSS has worked with mothers and children in building long term safe motherhood projects
There are many problems Ordinary woman in Kenya are unable to afford basic sanitary protection.
⇒ One pack of sanitary pads costs more than 50% of the average monthly wage for women.
⇒ Millions of Kenyan women are forced to replace tampons with newspapers and dirty rags.
• This can lead to vaginal infections for which there is no available medication.
• These vaginal infections are often mistaken to be sexually transmitted infections leading to social embarrassment and domestic violence.
⇒ Wives and mothers are unable to work when they have their periods, further hindering already impoverished families.
⇒ Girls are forced to take time off school, further jeopardizing their education.
• Because of the economic and cultural crises in Africa, its schools serve as more than academic centers. They provide community resources where young people receive basic care and services, such as food programs, clean water and counseling.
Friday, April 15, 2011
Compassion as an ICROSS Value,
" Be kind, always be kind, everyone we meet needs a little more kindness, a little more compassion. You can lighten their load, touch their hearts , bring just a little more joy into their journey. Be kind , always , always be kind"
Michael Meegan ALL WILL BE WELL
International Director ICROSS
http://www.michaelmeegan.net/
www.michaelmeegan.com
Michael Meegan ALL WILL BE WELL
International Director ICROSS
http://www.michaelmeegan.net/
www.michaelmeegan.com
Thursday, April 7, 2011
I held him in my arms and wept
I Held Him in My Arms and Wept
THis article first appeared in the Journal of the American Medical Association
http://jama.ama-assn.org/content/284/2/152.extract
THe full story of Atria appears in "ALL WILL BE WELL" www.michaelmeegan.net
Michael K. Elmore-Meegan
A year before his death, 17 year-old Atria weighs 7 stone (98 pounds). He has left his village. He is afraid and he is ashamed. He is embarrassed to be here. He is sweating, he fights. His hands tremble. His pulse is rapid. He tries to smile. His problems aren't only the rashes and the intestinal worms. These are easily cleared up. But you can't "clear up" anger and fear, or sleepless nights and panic attacks, or how long a few minutes can seem...or the sense of powerlessness watching your own body fall away, the humiliation of disintegration.
Some infections are harder to deal with: a mouth filled with ulcers, an inflamed penis. As the disease progresses so do the nausea, the backpain, the headaches. Muscle cramps always hurt, especially when one has very little muscle. Atria has severe diarrhea and the dull aches in his stomach become sharp pains. Despite our best efforts he becomes anemic. His sight fades, as well as his concentration. Atria has stinging burning pain from urinary tract infections, as his urinary tract is blood red and raw.
Moving his bowels has become a feared ordeal, as his anus has lost its muscular contractility and often gets infected. He has no buttocks, not really, just skin stretched over bone, sore to lie on. His joints are hypersensitive. Above all, Atria finds it difficult to breathe. His dreadful wheezing-gurgling prevents sleep and he moans a lot because the painkillers are useless.
Over the coming months Atria finds some support and friendship, some dignity and encouragement. He was a beautiful young man with stunning eyes. A proud, energetic guy, very popular and ambitious with a deadly sense of fun. Now, most of all he hates that he leaks and drips, smells bad, and often cannot control his bowel movements or urination. He gets angry at himself. He is weak and dizzy and has constant headaches. He cannot eat easily and his ability to digest is deteriorating, as his enzymes are breaking down. The slightest knock causes a painful bruise. Atria is now 6 stone (84 pounds). After another few weeks, the boy is drained; his mouth full of thrush, a thick, white fungus over his tongue and gums - and ulcers - he has difficulty swallowing. Breathing is increasingly labored. By now, pneumonia is taking over.
All movement is acutely painful and distressing. Intestinal worms are back again. Atria's limbs are stiffening and his back is covered with ulcers that leak and bleed but do not heal, impossible to manage in a small hut. His issues are controlling pain, managing extreme distress, reducing humiliation, creating dignity, reducing multiple infections, reducing cross-infection to others. But the worst thing is loneliness. To die of AIDS in Africa is an intensely humiliating ordeal, slow . . . obscene. Atria is now in his last days of life. His tear ducts have dried up, his hair has fallen out, his bones are brittle. He has no muscle or fat and his heart is 70% weaker than pre-HIV. He has been eaten alive and he has no resistance. All of Atria's senses are shutting down.
His fingernails and toenails have fallen out. His skin is blistered and scaly, and scabs cannot form. The bedsores and ulcers have spread, sources of multiple deep infections. Breathing is almost impossible and the slightest movement is slow and full of dreadful anxiety. I give him water drop by drop through a straw. I hold his frail, stiffened hand. He is cold, he has no tears. I look into his eyes. I whisper to him, and kiss him. He slowly inhales, half closes his eyes. He breathes out, very slowly.
Atria's face relaxes, his tormented body sags. He is gone.
I held him in my arms and wept.
I cannot describe the fear and emptiness watching such disintegration. As I write this, the images that flash across my mind are not the data, the plan, the project, but the faces, the faces of those who have had no one else to love them . . . nowhere else to go - dumped, neglected, unwanted. I feel so inadequate, so useless and unworthy, flawed and pathetic, so utterly overwhelmed. I want to be somewhere else. I am not able for all of this. The horror of the holocaust revolts me. I have sights so unspeakable in my mind. What has humanity done? Why do we allow people to die this way? What manner of beast are we?
In my aloneness, in my fear, in my pathetic inadequacy, in my own humanity, despite myself, I fall before the feet of God and cry: Why? Yet in the end, I find the only thing that matters is to do the best I can.
I leap into the darkness and find myself in a sweltering, disease-ridden place, full of flies and gross smells - and a child is crying. I reach out to gently grasp his small, withered hand, too weak to tremble. I am here. I am here.
www.icrossinternational.org
www.icrosskenya.org
www.michaelmeegan.com
http://www.michaelmeegan.net/
http://icrossprojects.blogspot.com/
http://twitter.com/#!/ICROSSprojects
THis article first appeared in the Journal of the American Medical Association
http://jama.ama-assn.org/content/284/2/152.extract
THe full story of Atria appears in "ALL WILL BE WELL" www.michaelmeegan.net
Michael K. Elmore-Meegan
A year before his death, 17 year-old Atria weighs 7 stone (98 pounds). He has left his village. He is afraid and he is ashamed. He is embarrassed to be here. He is sweating, he fights. His hands tremble. His pulse is rapid. He tries to smile. His problems aren't only the rashes and the intestinal worms. These are easily cleared up. But you can't "clear up" anger and fear, or sleepless nights and panic attacks, or how long a few minutes can seem...or the sense of powerlessness watching your own body fall away, the humiliation of disintegration.
Some infections are harder to deal with: a mouth filled with ulcers, an inflamed penis. As the disease progresses so do the nausea, the backpain, the headaches. Muscle cramps always hurt, especially when one has very little muscle. Atria has severe diarrhea and the dull aches in his stomach become sharp pains. Despite our best efforts he becomes anemic. His sight fades, as well as his concentration. Atria has stinging burning pain from urinary tract infections, as his urinary tract is blood red and raw.
Moving his bowels has become a feared ordeal, as his anus has lost its muscular contractility and often gets infected. He has no buttocks, not really, just skin stretched over bone, sore to lie on. His joints are hypersensitive. Above all, Atria finds it difficult to breathe. His dreadful wheezing-gurgling prevents sleep and he moans a lot because the painkillers are useless.
Over the coming months Atria finds some support and friendship, some dignity and encouragement. He was a beautiful young man with stunning eyes. A proud, energetic guy, very popular and ambitious with a deadly sense of fun. Now, most of all he hates that he leaks and drips, smells bad, and often cannot control his bowel movements or urination. He gets angry at himself. He is weak and dizzy and has constant headaches. He cannot eat easily and his ability to digest is deteriorating, as his enzymes are breaking down. The slightest knock causes a painful bruise. Atria is now 6 stone (84 pounds). After another few weeks, the boy is drained; his mouth full of thrush, a thick, white fungus over his tongue and gums - and ulcers - he has difficulty swallowing. Breathing is increasingly labored. By now, pneumonia is taking over.
All movement is acutely painful and distressing. Intestinal worms are back again. Atria's limbs are stiffening and his back is covered with ulcers that leak and bleed but do not heal, impossible to manage in a small hut. His issues are controlling pain, managing extreme distress, reducing humiliation, creating dignity, reducing multiple infections, reducing cross-infection to others. But the worst thing is loneliness. To die of AIDS in Africa is an intensely humiliating ordeal, slow . . . obscene. Atria is now in his last days of life. His tear ducts have dried up, his hair has fallen out, his bones are brittle. He has no muscle or fat and his heart is 70% weaker than pre-HIV. He has been eaten alive and he has no resistance. All of Atria's senses are shutting down.
His fingernails and toenails have fallen out. His skin is blistered and scaly, and scabs cannot form. The bedsores and ulcers have spread, sources of multiple deep infections. Breathing is almost impossible and the slightest movement is slow and full of dreadful anxiety. I give him water drop by drop through a straw. I hold his frail, stiffened hand. He is cold, he has no tears. I look into his eyes. I whisper to him, and kiss him. He slowly inhales, half closes his eyes. He breathes out, very slowly.
Atria's face relaxes, his tormented body sags. He is gone.
I held him in my arms and wept.
I cannot describe the fear and emptiness watching such disintegration. As I write this, the images that flash across my mind are not the data, the plan, the project, but the faces, the faces of those who have had no one else to love them . . . nowhere else to go - dumped, neglected, unwanted. I feel so inadequate, so useless and unworthy, flawed and pathetic, so utterly overwhelmed. I want to be somewhere else. I am not able for all of this. The horror of the holocaust revolts me. I have sights so unspeakable in my mind. What has humanity done? Why do we allow people to die this way? What manner of beast are we?
In my aloneness, in my fear, in my pathetic inadequacy, in my own humanity, despite myself, I fall before the feet of God and cry: Why? Yet in the end, I find the only thing that matters is to do the best I can.
I leap into the darkness and find myself in a sweltering, disease-ridden place, full of flies and gross smells - and a child is crying. I reach out to gently grasp his small, withered hand, too weak to tremble. I am here. I am here.
www.icrossinternational.org
www.icrosskenya.org
www.michaelmeegan.com
http://www.michaelmeegan.net/
http://icrossprojects.blogspot.com/
http://twitter.com/#!/ICROSSprojects
Thursday, March 24, 2011
ICROSS comprehensive care centre Kenya
ICROSS continues to fight HIV AIDS with long term support of prevention and support programmes. Sub-Saharan Africa has over 70% of the Worlds AIDS cases. This causes terrible suffering. For 30 years ICROSS has been fighting AIDS in Kenya.
An estimated 22.5 million people are living with HIV in Africa. In 2009 around 1.3 million people died from AIDS in sub-Saharan Africa and 1.8 million people became infected with HIV. Since the beginning of the epidemic 14.8 million children have lost one or both parents to HIV/AIDS. ICROSS has been fighting AIDS through
* Prevention and Education
* Safe sex programmes
* HIV Awareness campaigns
* Home based care and support of carers
* Comprehensive training, referral, support, back up and orphan support activities.
As part of this committment ICROSS built the Bondo Comprehensive care centre in Bondo, Western Kenya. Danny Ngwiri, Country Director announced today;
" we will develop with the Ministry of health programmes that will strengthen comprehensive support. "
Danny began the first ICROSS HIV programme in western Kenya 15 years ago then established two other AIDS projects in Bondo. "the need is so widespread and the suffering is worse for children, whole villages have been devastated by AIDS "
Danny was in Bondo planning with the Ministry of health team future joint strategies. If you would like to know more about our AIDS programmes, please download our reports and look at the project section on our web site.
Dr Michael Meegan toured the programme this month
An estimated 22.5 million people are living with HIV in Africa. In 2009 around 1.3 million people died from AIDS in sub-Saharan Africa and 1.8 million people became infected with HIV. Since the beginning of the epidemic 14.8 million children have lost one or both parents to HIV/AIDS. ICROSS has been fighting AIDS through
* Prevention and Education
* Safe sex programmes
* HIV Awareness campaigns
* Home based care and support of carers
* Comprehensive training, referral, support, back up and orphan support activities.
As part of this committment ICROSS built the Bondo Comprehensive care centre in Bondo, Western Kenya. Danny Ngwiri, Country Director announced today;
" we will develop with the Ministry of health programmes that will strengthen comprehensive support. "
Danny began the first ICROSS HIV programme in western Kenya 15 years ago then established two other AIDS projects in Bondo. "the need is so widespread and the suffering is worse for children, whole villages have been devastated by AIDS "
Danny was in Bondo planning with the Ministry of health team future joint strategies. If you would like to know more about our AIDS programmes, please download our reports and look at the project section on our web site.
Dr Michael Meegan toured the programme this month
Tuesday, February 15, 2011
http://news.bbc.co.uk/1/hi/programmes/hardtalk/4675531.stm
http://news.bbc.co.uk/1/hi/programmes/hardtalk/4675531.stm
The recent G8 Summit at Gleneagles ended with an agreement to boost aid for developing countries by $50 billion.
The debt of some of Africa's poorest countries is also being cancelled. Michael Meegan runs a small charity trying to help some of Africa's poorest.
He doesn't think debt relief and more aid are the answer to the complex issue of lifting people out of poverty.
He talks to Stephen Sackur near one of his clinics in the Rift Valley - the home of the Masaai people.
HARDtalk can be seen on BBC World at 03:30 GMT, 0830 GMT, 1530 GMT, 1830 GMT, 2330 GMT
It can also be seen on BBC News 24 at 04:30 and 23:30
The recent G8 Summit at Gleneagles ended with an agreement to boost aid for developing countries by $50 billion.
The debt of some of Africa's poorest countries is also being cancelled. Michael Meegan runs a small charity trying to help some of Africa's poorest.
He doesn't think debt relief and more aid are the answer to the complex issue of lifting people out of poverty.
He talks to Stephen Sackur near one of his clinics in the Rift Valley - the home of the Masaai people.
HARDtalk can be seen on BBC World at 03:30 GMT, 0830 GMT, 1530 GMT, 1830 GMT, 2330 GMT
It can also be seen on BBC News 24 at 04:30 and 23:30
Saturday, February 12, 2011
Lectures on Global health
Dr Michael Meegan is in Europe this week meeting with ICROSS Ireland Directors. ICROSS Ireland was created by Michael Meegan and Joe Barnes in 1979. The team is developing strategies to implement the new five year plan for ICROSS Rural health programmes in Africa. The ambitous expension of our health programmes builds on three decades of experience in African health care
Sunday, February 6, 2011
" Do not sleep today without reaching someone, an act of kindness, a moment listening, a smile. Sometimes changing the World can be in little things " Michael Meegan Changing the World www.michaelmeegan.com www.michaelmeegan.net
" Do not sleep today without reaching someone, an act of kindness, a moment listening, a smile. Sometimes changing the World can be in little things " Michael Meegan
Changing the World
www.michaelmeegan.com
www.michaelmeegan.net
Changing the World
www.michaelmeegan.com
www.michaelmeegan.net
Sunday, January 23, 2011
ICROSS Mother and Child health and infant care programmeas 2011
ICROSS and women’s health programmes , creating long term change 2011
2010 marks a significant milestone as we reach 30 years of public health programmes. When Dr Joe Barnes and I began our work, we never realised that it would become such a significant contribution in reducing poverty and disease. In this annual review, we will look back on some of the highlights over the last thirty years. Before looking at the new challenges, as we build the organization over the next decade. Together with our friends and partners, we have managed to extend our long term public health programmes despite extraordinary challenges and demand on our limited resources thanks to the dedication of hundreds of volunteers.
We have been able to achieve improved health services and significant reductions in water borne diseases. The great strength of ICROSS has always been a unique combination of long term commitment and evidence based research. Because we built all of our work through our local belief systems and traditions, this year has shown how effective the ICROSS model can be. This report marks a further milestone following the restructuring of the charity like all dynamic organizations we are constantly incorporating new ideas and improved practices. This report outlines a series of new steps we have taken to prepare ICROSS for the years ahead. On behalf of Dr Evan Sequiera and our board of directors, as well as our programmes and management teams, I thank you for sharing our work in this annual report.
Over 35% of children in ICROSS projects are underweight or stunted. Kenya has a population of 36.b million. Its life expectancy is 35 and falling. The average age of Kenyans is 17 years old and the chances of dying before the age of 30 are ten times higher than living in Europe. ICROSS remains committed from the last 30 years to the improvement of health in vulnerable communities and tribal groups. ICROSS has worked over the decades with many endangered tribes suffering from high infant mortality and maternal deaths. Infant mortality in Kenya in 2009 was 55 per 1000 compared with 4.6 per 1000 in the UK. With infant disease 200 times higher than in Western Europe, ICROSS is dedicated to reducing this suffering. In Finland, infant mortality rate is 3.47 per 1000, France, 3.3 per 1000. Kenya ranks 181st in the world with one of the highest death rates in East Africa.
Together with a strong policy of holistic obstetrics and gynaecology, ICROSS is building sustainable women’s health. For 15 years
Dr Michael Meegan, Founder
SAFE MOTHERHOOD
A critical part of improving health care is the priorities for safe motherhood. As part f ICROSS’ campaign for advocating for mothers rights, we focus on empowering mothers and involving them in decision making. As part of the millennium goals, we are committed to reducing maternal deaths. Together with our partners, we understand that basic health care alone is not sufficient to improve safe motherhood. Maasai mothers often have their first child at the age of 17yrs. ICROSS seeks to delay marriage and first birth. This campaign has been effective and has attributed to more girls staying in school. Through community based education in the local language, we are encouraging families to delay marriages and first birth until girls complete their education.
Risks in pregnancies: there are many life threatening complications and risks that occur in pregnancy. Sub-Saharan Africa has the highest death rate in the world. It is essential that all pregnant women have access to a qualified midwife. They require guidance and support during their pregnancy and after child birth.
Improved delivery: ICROSS is working to establish the most critical intervention of safe motherhood. This is to ensure skilled delivery at birth. ICROSS remains committed to building maternity units in all its clinics Reproductive health services: developed through local culture and language, we continue to provide high quality reproductive health services. These interventions are culturally sensitive and help individuals and communities be empowered by making their own choices. Since Sharon Wilkinson introduced reproductive health education into ICROSS health programmes in 1993, we have continued to provide education and information in homes, villages and clinics.
Prevention of unwanted pregnancy and unsafe abortion: over 75 million unwanted pregnancies occur every year; mostly in the poor world. Without effective family planning, unsafe abortions can kill and cause permanent harm. By ensuring effective family planning, contraceptive advice and trained counselling, we can greatly reduce risk.
Safe Motherhood Research: for 30 years, ICROSS has studied the impact of its safe motherhood programme. The longest and most significant of these studies took 20 years to complete. This study examined the reduction of no natal tetanus in new born children.
Partnerships in Safe Motherhood: in 2010, ICROSS extended its network of community based organisations, women’s groups and self help societies. Together with a growing number of partners including the ministry of health, we have continued to strengthen our capacity to provide safe motherhood.
CHILD SURVIVAL
Every day, over 30,000 children under 5years die from preventable causes. The vast majority of these deaths cost very little to prevent or treat. With over 30% of Maasai children endemically malnourished, it weakens their ability to fight illness. More than a third of all child deaths are related to malnutrition in the poor world.
The principle causes of infant deaths are neo0natel (37%), pneumonia (19%), diarrhoea (17%), and Malaria (8%). These four causes account for the great majority of preventable deaths. Our child survival programme is based upon effective immunisation, childhood nutrition and essential supplementation. The prevention diagnosis and treatment of respiratory diseases diarrhoea and malaria.
HYGIENE AND SANITATION
Over half of the poor world (OVER 2.5 BILLION PEOPLE) lack sanitation facilities. Over 1.6 billion do not have safe water to drink. This lack of hygiene and sanitation worsens poverty killing thousands of children every day. In rural schools, millions of girls are denied education because of the absence of private sanitation facilities. The burden of poverty is greatly increased by the lack of access to basic toilets and simple hygiene. ICROSS promotes and supports hand washing, personal cleanliness, health promotion and education.
Among these interventions is child to child, where elder children teach the younger children how to stay safe through washing. ICROSS continues to develop and build pit latrines which are ventilated and clean. It continues to provide sanitary towels to girls and improve access to water. In 2010, we extended our hygiene and sanitation education to more rural schools serving rural communities. With the help of friends and supporters, we have been able to make new commitments to build more latrines for primary schools in 2011
HIV/AIDS AND TUBERCULOSIS
Over 70% of the AIDS victims live in Africa. Africa has less than 6% of the worlds AIDS budget. The leading cause of death in adults in Africa is HIV related followed by Malaria. Both are preventable. In 2010, 2 million Africans became infected with HIV.
According to UNAIDS, 14.8 million children have lost one or both parents because of AIDS. Life expectancy had fallen by over 20 years across the continent. Kenya has one of the highest infection rates in the world; with over 1.5 million people infected (population 34.6 million).
1.2 million Children in Kenya, were orphaned by AIDS and in 2009, 80,000 people died in Kenya from AIDS related disease. HIV prevalence has reduces because of nationwide education and awareness campaigns. Only one in three patients is receiving effective treatment.
The national prevalence has fallen from 13.4 % in 2000 to 6.7% in 2008. ICROSS has been directly involved in a wide range of HIV programmes since 1992. Following the strategic plan 1995 to 2005, ICROSS implemented wide ranging prevention programmes. With AIDS education and family planning strategies, ICROSS extended its work into central and western Kenya. Following long term home care for terminal patients, ICROSS extended its support programmes tripling the number of patients reached between 1996 and 2002.
The comprehensive strategy included:
• increasing third level care facilities in three districts
• creation of comprehensive AIDS resource centres at district level
• Provision of support to over 400 community groups.
• Pioneering in Kenya, home based health care at grass roots level
• Community owned support programmes for AIDS orphans and vulnerable children
• Creation of networks to support carers • Locally developed ways of identifying
children most in need
• Emergency grant program for AIDS orphans
• Anti-retroviral drugs for AIDS orphans infected with HIV
Tuberculosis is a bacterial infection of the lung which is increasingly serious involving easily identifiable symptoms. Tuberculosis has risen sharply with 15 million sufferers at any one time in 2010. TB kills more than 1.6 million people a year (4,400 people every day, 1 person every 20 seconds). 98% of TB deaths occur in poor countries; the vast majority in Africa. Kenya has one of the highest numbers of TB victims in the world with over a third of a million. 28% of adult Tb patients also have HIV.
Since 2002, ICROSS has a specific TB support intervention programme. This programme is primarily focused in three districts; Bondo, Kisii and Nakuru and adopts the Directly Observed Therapy (D.O.T.) as part of the WHO strategy.
MALARIA
Over half of the world’s population is at risk because of Malaria. There are a million deaths caused by malaria every year but mostly in Africa. 20% of all childhood deaths in Africa are caused by Malaria. The average Kenyan child has four episodes of malaria a year. Every 30 seconds, a child dies from malaria. Africa accounts for 91% of deaths. 85% of deaths are in children under 5years old. Kenya is in the top five countries on the planet affected by Malaria; 11.34 million cases a year. Six of the millennium development goals depend on fighting malaria. Disease and death from malaria is preventable and curable.
The groups most vulnerable to malaria are young children, pregnant women, patients with HIV/AIDS. ICROSS maintains a long term strategy of research, public health, prevention, treatment and clinical referral in fighting malaria.
In 2011, we have extended our mosquito net programme over 3,500 nets. Our target in 2011 is to distribute a further 10,000 nets in our project areas. Mosquito eradication and breeding site control increased in 2010. Public health awareness programmes to reduce new cases of malaria increased in all programme areas in 2010.
With the partnership of the ministry of health, intervention programmes will increase throughout the 18 months.
PUBLIC HEALTH RESEARCH
Building on the effective research of solar disinfection, we have designed new and improved water projects in urban areas based upon the findings of our research team in Nakuru. Together with the Royal College of Surgeons and our network of collaborators, we have been sharing the results of the SODIS studies internationally. ICROSS Was directly involved in bringing SODIS to Cambodia through Care Cambodia.
An important part of our public health research is to share findings and results with other organisations around the world. The purpose of this research is for us to find out the best possible way of making an impact. As a dynamic learning organisation, we are constantly examining what we are doing and finding ways of doing it better.
The research team at ICROSS will be expanding in 2011 as we take on new challenges exploring new areas of public health and disease control. The research team is lead by Dr Michael Meegan with
Illustrative Research Articles and Publications
1. Elmore-Meegan M, Conroy RM, Agala CB. Sex workers in Kenya,
numbers of clients and associated risks: an exploratory survey.
Reprod Health Matters 2004;12(23):50-7.
2. Meegan ME, Conroy RM, Lengeny SO, Renhault K, Nyangole J. Effect
on neonatal tetanus mortality after a culturally-based health
promotion programme. Lancet 2001;358(9282):640-1.
3. Conroy RM, Meegan ME, Joyce T, McGuigan K, Barnes J. Solar
disinfection of drinking water protects against cholera in children
under 6 years of age. Arch Dis Child 2001;85(4):293-5.
4. Meegan M, Morley DC. Growth monitoring: family participation:
effective community development. Trop Doct 1999;29(1):23-7.
5. Conroy RM, Meegan ME, Joyce T, McGuigan K, Barnes J. Solar
disinfection of water reduces diarrhoeal disease: an update. Arch Dis
Child 1999;81(4):337-8.
6. Meegan M, Morley D, Chavasse D. Fly traps. Lancet 1997;349(9055):886.
7. Meegan M, Morley DC, Brown R. Child weighing by the unschooled: a
report of a controlled study of growth monitoring over 12 months of
Maasai children using direct recording scales. Trans R Soc Trop Med
Hyg 1994;88(6):635-7.
8. Conroy RM, Meegan ME. Dwindling donor aid for health programmes in
developing countries. Lancet 1994;343(8907):1228-9.
9. Meegan MK. Rethinking famine relief. Lancet 1992;340(8830):1293-4.
10. Konings E, Anderson RM, Morley D, O'Riordan T, Meegan M. Rates of
sexual partner change among two pastoralist southern Nilotic groups
in east Africa. Aids 1989;3(4):245-7.
11. Meegan M, McCormick J. Prevention of disease in the poor world.
Lancet 1988;2(8603):152-3.
12. Meegan M. Starvation and suffering. Lancet 1983;2(8365-66):1506.
13. Meegan M. The reality of starvation and disease. Lancet 1981;1
(8212):146.
ADMINISTRATION AND FINANCE DEVELOPING ICROSS
Over 30 years ICROSS has learned to be a dynamic listening and learning engine of change. The many publications, studies and works created from our programmes have taught us four things
1. Everythingisindynamicevolution
2. All that we do needs to be a wake to the past, receptive to the present and embracing of the future
3. Humans generally are poor at learning from their experiences in order to inform future choices based on knowledge.
4. The critical contribution of ICROSS lies in the focus and clarity of its public health research
We will continue to build ICROSS international within the context of evidence based planning, long term disease control and the prevention of infectious morbidity in Africa. In 2011, we are committed to the policy of inclusion, local ownership and cultural transparency.
We remain focused on basic primary health care, gradual reduction of poverty and 20 year programmes of community based health. No short term programme has ever demonstrated a long term effect; we continue to advocate for long term strategies in the reduction of starvation and suffering.
PARTNERSHIPS
2010 saw a series of new partnerships develop with ICROSS and another 35 community based organisations collaborated with our field programmes sharing common goals to reduce poverty and suffering. Building on a long history of community ownership and inclusive planning, ICROSS teams established new and exciting links, bringing in radically new perspectives to local development. All planning is done in the local language in keeping with the ICROSS principles.
b. GOVERNANCE AND RISK MANAGEMENT
ICROSS is committed to meeting the higher standards of best practice. As part of this commitment, our corporate governance policies have adapted and adopted the British Charity commission protocol requirements, stipulations, recommendations and guidelines regarding operational practice, codes of conduct and evaluation. As part of this international gold standard, ICROSS Kenya requires and demands of all of its partners a minimum of the adherence to the same international stipulations.
Available on our websites, we detail the corporate legislation and constitution that govern the transparency of ICROSS. Passed by Annual General meeting, are requirements that detail provisions and contingencies relating to the management of risk in all situations. T is the policy of ICROSS in Kenya to meet the highest standards of external scrutiny, probity and compliance. It is the policy of ICROSS to have a diligent, independent and external scrutiny of management operations and finance. As part of this commitment, in December 2010, the board of members voted two new Directors detailed at the end of the report. These are specialised in governance and law.
Learn more about ICROSS by visiting their web sites and blog
www.icrossinterational.org
www.icrosskenya.org
http://icrossprojects.blogspot.com/
therese de la Croix
2010 marks a significant milestone as we reach 30 years of public health programmes. When Dr Joe Barnes and I began our work, we never realised that it would become such a significant contribution in reducing poverty and disease. In this annual review, we will look back on some of the highlights over the last thirty years. Before looking at the new challenges, as we build the organization over the next decade. Together with our friends and partners, we have managed to extend our long term public health programmes despite extraordinary challenges and demand on our limited resources thanks to the dedication of hundreds of volunteers.
We have been able to achieve improved health services and significant reductions in water borne diseases. The great strength of ICROSS has always been a unique combination of long term commitment and evidence based research. Because we built all of our work through our local belief systems and traditions, this year has shown how effective the ICROSS model can be. This report marks a further milestone following the restructuring of the charity like all dynamic organizations we are constantly incorporating new ideas and improved practices. This report outlines a series of new steps we have taken to prepare ICROSS for the years ahead. On behalf of Dr Evan Sequiera and our board of directors, as well as our programmes and management teams, I thank you for sharing our work in this annual report.
Over 35% of children in ICROSS projects are underweight or stunted. Kenya has a population of 36.b million. Its life expectancy is 35 and falling. The average age of Kenyans is 17 years old and the chances of dying before the age of 30 are ten times higher than living in Europe. ICROSS remains committed from the last 30 years to the improvement of health in vulnerable communities and tribal groups. ICROSS has worked over the decades with many endangered tribes suffering from high infant mortality and maternal deaths. Infant mortality in Kenya in 2009 was 55 per 1000 compared with 4.6 per 1000 in the UK. With infant disease 200 times higher than in Western Europe, ICROSS is dedicated to reducing this suffering. In Finland, infant mortality rate is 3.47 per 1000, France, 3.3 per 1000. Kenya ranks 181st in the world with one of the highest death rates in East Africa.
Together with a strong policy of holistic obstetrics and gynaecology, ICROSS is building sustainable women’s health. For 15 years
Dr Michael Meegan, Founder
SAFE MOTHERHOOD
A critical part of improving health care is the priorities for safe motherhood. As part f ICROSS’ campaign for advocating for mothers rights, we focus on empowering mothers and involving them in decision making. As part of the millennium goals, we are committed to reducing maternal deaths. Together with our partners, we understand that basic health care alone is not sufficient to improve safe motherhood. Maasai mothers often have their first child at the age of 17yrs. ICROSS seeks to delay marriage and first birth. This campaign has been effective and has attributed to more girls staying in school. Through community based education in the local language, we are encouraging families to delay marriages and first birth until girls complete their education.
Risks in pregnancies: there are many life threatening complications and risks that occur in pregnancy. Sub-Saharan Africa has the highest death rate in the world. It is essential that all pregnant women have access to a qualified midwife. They require guidance and support during their pregnancy and after child birth.
Improved delivery: ICROSS is working to establish the most critical intervention of safe motherhood. This is to ensure skilled delivery at birth. ICROSS remains committed to building maternity units in all its clinics Reproductive health services: developed through local culture and language, we continue to provide high quality reproductive health services. These interventions are culturally sensitive and help individuals and communities be empowered by making their own choices. Since Sharon Wilkinson introduced reproductive health education into ICROSS health programmes in 1993, we have continued to provide education and information in homes, villages and clinics.
Prevention of unwanted pregnancy and unsafe abortion: over 75 million unwanted pregnancies occur every year; mostly in the poor world. Without effective family planning, unsafe abortions can kill and cause permanent harm. By ensuring effective family planning, contraceptive advice and trained counselling, we can greatly reduce risk.
Safe Motherhood Research: for 30 years, ICROSS has studied the impact of its safe motherhood programme. The longest and most significant of these studies took 20 years to complete. This study examined the reduction of no natal tetanus in new born children.
Partnerships in Safe Motherhood: in 2010, ICROSS extended its network of community based organisations, women’s groups and self help societies. Together with a growing number of partners including the ministry of health, we have continued to strengthen our capacity to provide safe motherhood.
CHILD SURVIVAL
Every day, over 30,000 children under 5years die from preventable causes. The vast majority of these deaths cost very little to prevent or treat. With over 30% of Maasai children endemically malnourished, it weakens their ability to fight illness. More than a third of all child deaths are related to malnutrition in the poor world.
The principle causes of infant deaths are neo0natel (37%), pneumonia (19%), diarrhoea (17%), and Malaria (8%). These four causes account for the great majority of preventable deaths. Our child survival programme is based upon effective immunisation, childhood nutrition and essential supplementation. The prevention diagnosis and treatment of respiratory diseases diarrhoea and malaria.
HYGIENE AND SANITATION
Over half of the poor world (OVER 2.5 BILLION PEOPLE) lack sanitation facilities. Over 1.6 billion do not have safe water to drink. This lack of hygiene and sanitation worsens poverty killing thousands of children every day. In rural schools, millions of girls are denied education because of the absence of private sanitation facilities. The burden of poverty is greatly increased by the lack of access to basic toilets and simple hygiene. ICROSS promotes and supports hand washing, personal cleanliness, health promotion and education.
Among these interventions is child to child, where elder children teach the younger children how to stay safe through washing. ICROSS continues to develop and build pit latrines which are ventilated and clean. It continues to provide sanitary towels to girls and improve access to water. In 2010, we extended our hygiene and sanitation education to more rural schools serving rural communities. With the help of friends and supporters, we have been able to make new commitments to build more latrines for primary schools in 2011
HIV/AIDS AND TUBERCULOSIS
Over 70% of the AIDS victims live in Africa. Africa has less than 6% of the worlds AIDS budget. The leading cause of death in adults in Africa is HIV related followed by Malaria. Both are preventable. In 2010, 2 million Africans became infected with HIV.
According to UNAIDS, 14.8 million children have lost one or both parents because of AIDS. Life expectancy had fallen by over 20 years across the continent. Kenya has one of the highest infection rates in the world; with over 1.5 million people infected (population 34.6 million).
1.2 million Children in Kenya, were orphaned by AIDS and in 2009, 80,000 people died in Kenya from AIDS related disease. HIV prevalence has reduces because of nationwide education and awareness campaigns. Only one in three patients is receiving effective treatment.
The national prevalence has fallen from 13.4 % in 2000 to 6.7% in 2008. ICROSS has been directly involved in a wide range of HIV programmes since 1992. Following the strategic plan 1995 to 2005, ICROSS implemented wide ranging prevention programmes. With AIDS education and family planning strategies, ICROSS extended its work into central and western Kenya. Following long term home care for terminal patients, ICROSS extended its support programmes tripling the number of patients reached between 1996 and 2002.
The comprehensive strategy included:
• increasing third level care facilities in three districts
• creation of comprehensive AIDS resource centres at district level
• Provision of support to over 400 community groups.
• Pioneering in Kenya, home based health care at grass roots level
• Community owned support programmes for AIDS orphans and vulnerable children
• Creation of networks to support carers • Locally developed ways of identifying
children most in need
• Emergency grant program for AIDS orphans
• Anti-retroviral drugs for AIDS orphans infected with HIV
Tuberculosis is a bacterial infection of the lung which is increasingly serious involving easily identifiable symptoms. Tuberculosis has risen sharply with 15 million sufferers at any one time in 2010. TB kills more than 1.6 million people a year (4,400 people every day, 1 person every 20 seconds). 98% of TB deaths occur in poor countries; the vast majority in Africa. Kenya has one of the highest numbers of TB victims in the world with over a third of a million. 28% of adult Tb patients also have HIV.
Since 2002, ICROSS has a specific TB support intervention programme. This programme is primarily focused in three districts; Bondo, Kisii and Nakuru and adopts the Directly Observed Therapy (D.O.T.) as part of the WHO strategy.
MALARIA
Over half of the world’s population is at risk because of Malaria. There are a million deaths caused by malaria every year but mostly in Africa. 20% of all childhood deaths in Africa are caused by Malaria. The average Kenyan child has four episodes of malaria a year. Every 30 seconds, a child dies from malaria. Africa accounts for 91% of deaths. 85% of deaths are in children under 5years old. Kenya is in the top five countries on the planet affected by Malaria; 11.34 million cases a year. Six of the millennium development goals depend on fighting malaria. Disease and death from malaria is preventable and curable.
The groups most vulnerable to malaria are young children, pregnant women, patients with HIV/AIDS. ICROSS maintains a long term strategy of research, public health, prevention, treatment and clinical referral in fighting malaria.
In 2011, we have extended our mosquito net programme over 3,500 nets. Our target in 2011 is to distribute a further 10,000 nets in our project areas. Mosquito eradication and breeding site control increased in 2010. Public health awareness programmes to reduce new cases of malaria increased in all programme areas in 2010.
With the partnership of the ministry of health, intervention programmes will increase throughout the 18 months.
PUBLIC HEALTH RESEARCH
Building on the effective research of solar disinfection, we have designed new and improved water projects in urban areas based upon the findings of our research team in Nakuru. Together with the Royal College of Surgeons and our network of collaborators, we have been sharing the results of the SODIS studies internationally. ICROSS Was directly involved in bringing SODIS to Cambodia through Care Cambodia.
An important part of our public health research is to share findings and results with other organisations around the world. The purpose of this research is for us to find out the best possible way of making an impact. As a dynamic learning organisation, we are constantly examining what we are doing and finding ways of doing it better.
The research team at ICROSS will be expanding in 2011 as we take on new challenges exploring new areas of public health and disease control. The research team is lead by Dr Michael Meegan with
Illustrative Research Articles and Publications
1. Elmore-Meegan M, Conroy RM, Agala CB. Sex workers in Kenya,
numbers of clients and associated risks: an exploratory survey.
Reprod Health Matters 2004;12(23):50-7.
2. Meegan ME, Conroy RM, Lengeny SO, Renhault K, Nyangole J. Effect
on neonatal tetanus mortality after a culturally-based health
promotion programme. Lancet 2001;358(9282):640-1.
3. Conroy RM, Meegan ME, Joyce T, McGuigan K, Barnes J. Solar
disinfection of drinking water protects against cholera in children
under 6 years of age. Arch Dis Child 2001;85(4):293-5.
4. Meegan M, Morley DC. Growth monitoring: family participation:
effective community development. Trop Doct 1999;29(1):23-7.
5. Conroy RM, Meegan ME, Joyce T, McGuigan K, Barnes J. Solar
disinfection of water reduces diarrhoeal disease: an update. Arch Dis
Child 1999;81(4):337-8.
6. Meegan M, Morley D, Chavasse D. Fly traps. Lancet 1997;349(9055):886.
7. Meegan M, Morley DC, Brown R. Child weighing by the unschooled: a
report of a controlled study of growth monitoring over 12 months of
Maasai children using direct recording scales. Trans R Soc Trop Med
Hyg 1994;88(6):635-7.
8. Conroy RM, Meegan ME. Dwindling donor aid for health programmes in
developing countries. Lancet 1994;343(8907):1228-9.
9. Meegan MK. Rethinking famine relief. Lancet 1992;340(8830):1293-4.
10. Konings E, Anderson RM, Morley D, O'Riordan T, Meegan M. Rates of
sexual partner change among two pastoralist southern Nilotic groups
in east Africa. Aids 1989;3(4):245-7.
11. Meegan M, McCormick J. Prevention of disease in the poor world.
Lancet 1988;2(8603):152-3.
12. Meegan M. Starvation and suffering. Lancet 1983;2(8365-66):1506.
13. Meegan M. The reality of starvation and disease. Lancet 1981;1
(8212):146.
ADMINISTRATION AND FINANCE DEVELOPING ICROSS
Over 30 years ICROSS has learned to be a dynamic listening and learning engine of change. The many publications, studies and works created from our programmes have taught us four things
1. Everythingisindynamicevolution
2. All that we do needs to be a wake to the past, receptive to the present and embracing of the future
3. Humans generally are poor at learning from their experiences in order to inform future choices based on knowledge.
4. The critical contribution of ICROSS lies in the focus and clarity of its public health research
We will continue to build ICROSS international within the context of evidence based planning, long term disease control and the prevention of infectious morbidity in Africa. In 2011, we are committed to the policy of inclusion, local ownership and cultural transparency.
We remain focused on basic primary health care, gradual reduction of poverty and 20 year programmes of community based health. No short term programme has ever demonstrated a long term effect; we continue to advocate for long term strategies in the reduction of starvation and suffering.
PARTNERSHIPS
2010 saw a series of new partnerships develop with ICROSS and another 35 community based organisations collaborated with our field programmes sharing common goals to reduce poverty and suffering. Building on a long history of community ownership and inclusive planning, ICROSS teams established new and exciting links, bringing in radically new perspectives to local development. All planning is done in the local language in keeping with the ICROSS principles.
b. GOVERNANCE AND RISK MANAGEMENT
ICROSS is committed to meeting the higher standards of best practice. As part of this commitment, our corporate governance policies have adapted and adopted the British Charity commission protocol requirements, stipulations, recommendations and guidelines regarding operational practice, codes of conduct and evaluation. As part of this international gold standard, ICROSS Kenya requires and demands of all of its partners a minimum of the adherence to the same international stipulations.
Available on our websites, we detail the corporate legislation and constitution that govern the transparency of ICROSS. Passed by Annual General meeting, are requirements that detail provisions and contingencies relating to the management of risk in all situations. T is the policy of ICROSS in Kenya to meet the highest standards of external scrutiny, probity and compliance. It is the policy of ICROSS to have a diligent, independent and external scrutiny of management operations and finance. As part of this commitment, in December 2010, the board of members voted two new Directors detailed at the end of the report. These are specialised in governance and law.
Learn more about ICROSS by visiting their web sites and blog
www.icrossinterational.org
www.icrosskenya.org
http://icrossprojects.blogspot.com/
therese de la Croix
Thursday, January 20, 2011
ICROSS INTERN PROGRAM 2011-2012
ICROSS INTERN PROGRAM 2011-2012
Internship - volunteer Programme ICROSS 2011-2012
For over 16 years, ICROSS has accepted academic internships and a number of volunteer positions have been available. Since 2002, the internship programme has grown to the point where ICROSS will now be asking interns to contribute to projects. The full details of the internship programme are available on the website www.icrossinternational.org
This internship programme will be expanded in the category of health care, human rights, research and water programmes. In order of this development to take place, ICROSS is developing a comprehensive cross-‐cultural orientation course in order to prepare successful candidates for field experience. The ICROSS Intern programme is building on decades of firld experience and a long history of guiding interns in African field projects. The core management staff each have over 20 years experience in health and development mplementation.
Dr Michael Meegan, Founder and International Director of ICROSS spoke to community leaders this week sharing the concept of the new programme. " This year we will extend the programme . Our indepth intensive programmes will offer unique experences to volunteers and students. "
Danny Ngwiri Country Director of ICROSS Kenya spoke of the cost of the programme .
Cost of intern program
A two week course will be required by applicants. Project fees will range from $500 for two weeks up to $2000 for three months placements ICROSS has announced its latest internship and volunteer placement programme for 2011/2012. With limited placements remaining April -‐ June 2011 the July 2012 -‐ June 2012 program has been released Opportunities for students seeking internships are in; human rights, public health, social science, development programme planning and field operations, community health programming, NGO policy and strategic planning. Limited Volunteer placements are open in the following areas:
␣ Social anthropology ␣ HIV aids programmes ␣ Fundraising ␣ Education ␣ Photojournalism ␣ Orphans and vulnerable children ␣ Women’s Programmes
Accreditation, references and appropriate documentation is required. We receive more applications than places available. In 2011 we will accept only 32 interns and 34 placements across 36 projects in five districts.
more information available www.icrossinternational.org or www.icrosskenya.org
the Assstant Country Director Saruni Ole Lengeny is in charge of the Intern program
saruninanu@gmail.com
Internship - volunteer Programme ICROSS 2011-2012
For over 16 years, ICROSS has accepted academic internships and a number of volunteer positions have been available. Since 2002, the internship programme has grown to the point where ICROSS will now be asking interns to contribute to projects. The full details of the internship programme are available on the website www.icrossinternational.org
This internship programme will be expanded in the category of health care, human rights, research and water programmes. In order of this development to take place, ICROSS is developing a comprehensive cross-‐cultural orientation course in order to prepare successful candidates for field experience. The ICROSS Intern programme is building on decades of firld experience and a long history of guiding interns in African field projects. The core management staff each have over 20 years experience in health and development mplementation.
Dr Michael Meegan, Founder and International Director of ICROSS spoke to community leaders this week sharing the concept of the new programme. " This year we will extend the programme . Our indepth intensive programmes will offer unique experences to volunteers and students. "
Danny Ngwiri Country Director of ICROSS Kenya spoke of the cost of the programme .
Cost of intern program
A two week course will be required by applicants. Project fees will range from $500 for two weeks up to $2000 for three months placements ICROSS has announced its latest internship and volunteer placement programme for 2011/2012. With limited placements remaining April -‐ June 2011 the July 2012 -‐ June 2012 program has been released Opportunities for students seeking internships are in; human rights, public health, social science, development programme planning and field operations, community health programming, NGO policy and strategic planning. Limited Volunteer placements are open in the following areas:
␣ Social anthropology ␣ HIV aids programmes ␣ Fundraising ␣ Education ␣ Photojournalism ␣ Orphans and vulnerable children ␣ Women’s Programmes
Accreditation, references and appropriate documentation is required. We receive more applications than places available. In 2011 we will accept only 32 interns and 34 placements across 36 projects in five districts.
more information available www.icrossinternational.org or www.icrosskenya.org
the Assstant Country Director Saruni Ole Lengeny is in charge of the Intern program
saruninanu@gmail.com
Saturday, January 1, 2011
International Director Founder ICROSS
The Founder and International Director of ICROSS today announced the strategic plan of ICROSS. The updated plan takes into account the Global changes over he last 18 months. ' The strategic direction of our public health programmes focuses as always on Women and childrens health. " Speaking to team leaders today (1st January 2011) Dr Michael Meegan stessed " As the whole world takes account od cut backacks and with the growing needs in all our projects we do need to restructure ICROSS long term planning " In this exercise that has taken 6 months to complete, stakeholders and partners have been closel involved in developing the new strategy.
After all communities and public health teams have shared the new plan with communities we will be sharing the Plan which covers the period 2011 - 2015 , it should be on line by the end of January and available through our sites
the ICROSS information office will be alaso releasing monthly news letters on all ICROSS blogs and sites
www.icrossinternational.org
www.icrosskenya.org
After all communities and public health teams have shared the new plan with communities we will be sharing the Plan which covers the period 2011 - 2015 , it should be on line by the end of January and available through our sites
the ICROSS information office will be alaso releasing monthly news letters on all ICROSS blogs and sites
www.icrossinternational.org
www.icrosskenya.org
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