hope for hepatitis b
We are working with multiple partners to improve long-term access to therapies that suppress the hepatitis B virus and prevent liver damage which preserves health and alleviates suffering. In 2016, renovations of the clinical laboratories at the two pilot program sites (Pyongyang #2 Hepatitis Hospital and Kaesong #2 Hepatitis Hospital) were completed.
In June 2017, we agreed to expand the HOPE program to a third site—South Hwanghae #2 Hepatitis Hospital. Program expansion will require renovations of the lab to support ongoing diagnostics for the patients who live in this province.
Contaminated water supplies contribute to high rates of diarrhea and other gastrointestinal diseases, exacerbating endemic hunger and malnutrition, and further weakening the already compromised immune systems of patients. This makes them more vulnerable to contracting TB and other life-threatening diseases.
When we learned that care centers were relying on hand-dug, shallow, often contaminated wells, or unprotected streams and springs for their water, we began working to support clean, protected water sources for these facilities, their staff, and the patients.
First, we begin by assessing each local care center’s situation then devising a low energy-input solution that will work over the long term. Because we are generally limited to two technical visits a year to complete technical projects, it can take anywhere from 1–3 years to finish a project. During that time, funds have to be raised. First, a deep-water well needs to be successfully drilled and then a hand-pump installed immediately for patients to access clean water. Then, if a water distribution system is planned for a location, more funds need to be raised, materials have to be purchased and shipped to the site. Later, an expert volunteer team is assembled to work alongside local staff to install the materials to create a fully functional system. Thus far, we have installed solar-powered, gravity-fed water systems at 15 care centers; three more are planned for 2017.
Water Filter Buckets
While facilities wait for a permanent source of clean water solutions, we send Sawyer water filter buckets to provide filtered water to patients and staff for drinking and cooking. These filters last up to 10 years and only require simple maintenance in order to keep them fully functional. This year, we hope to start a pilot program to send filter buckets home with patients who do not have access to clean water at home.
renovations and technical assistance
Technical assistance inludes: installation of diesel generators in a hospital, renovation and re-equipping of an operating room, and installation of solar-powered, gravity-fed water systems at rural rest homes. Projects are identified by local partners, and resource needs are discussed and coordinated with provincial and central level colleagues; priorities are determined through mutual consultation. CFK engages in fundraising for material costs; skilled volunteers self-fund travel expenses and donate their time to work side-by-side with local staff to complete projects. In this way, local buy-in and investment is leveraged with externally provided materials and skills, resulting in lasting improvements and knowledge transfer. In the process, relationships are strengthened.
We are grateful for the longstanding partnerships with several organizations who provide ongoing support to TB, hepatitis, and pediatric patients through the donation of nutritious food, hygiene kits, warm blankets, medicine, and other support. CFK sends such support in sea containers throughout the year and confirms the arrival, distribution, and use of support on regular confirming trips that normally take place in the early spring and late fall. Supplemental food is critically important to support patients trying to recover from diseases like TB and hepatitis.
Since 2008, in partnership with the MoPH, Stanford University School of Medicine, the Bay Area TB Consortium, Global Care Partners, and other experts, CFK has provided ongoing training at the NRL. North Korean doctors and lab professionals continue to improve their skills in TB diagnosis and treatment.
Ongoing skills transfer is also a critical aspect of the hepatitis B treatment program. Staff (doctors, nurses, lab doctors, pharmacists, and others) regularly participate in workshops to increase their knowledge and skills base.
These kits include the most basic diagnostic tools a doctor or nurse needs every day, such as a stethoscope, blood pressure cuff, thermometers, hand crank battery lanterns, and other items in a bag printed with CFK's logo. We have distributed hundreds of doctors kits, and there is a continuing need for more.
Nutritious food is central to recovery from malnutrition and disease. CFK has provided hundreds of greenhouse kits of all sizes to help rural places grow vegetables year round. This work began in 1997 when five prototype greenhouses (designed by the late Dr. John Wilson) were taken to North Korea as the first stage of a program to provide tools for growing more food. In November of 1997, two hundred more greenhouses were delivered. Since then, we have continued sending and building greenhouses at specific facilities throughout the provinces we support.
Over time, our greenhouses have evolved and improved, becoming larger and more efficient while including many small heat-retention modifications. North Koreans are using greenhouses to grow spinach, lettuce, cabbage, carrots, cucumbers, melons, and other vegetables rich in vitamins and minerals vital to their health. Through improved nutrition made possible by greenhouse-grown vegetables, donated food including canned meat and protein rich soup mixes, TB medicine and supportive care, 85–90% of patients treated at hospitals and rest homes are cured and return to their homes, families, and communities.
Other agricultural assistance provided by CFK includes irrigation sets, small tractors and cargo tricycles to help with the transport of supplies and crops, preparation of fields for planting and harvesting which improves yields.
Transportation: motorcycles and ambulances
Walking tractors come in sets that include the tractor, a trailer, tiller, plow, and irrigation pump. They are used by rural facilities 5–8 hours a day to help care centers grow more food for patients year-round and to carry supplies between care centers. Each tractor generally lasts 5–6 years before needing replacement. We send tractors to all of our supported facilities, and we need to provide ongoing support with parts and consumables.
Many of our supported facilities are located in very remote areas—miles from the county center where they receive their supplies; the roads are narrow and often in poor repair. Cargo motorcycles provide an efficient and practical means for local rest homes to carry support and patients longer distances. In 2014, we were able to send 17 motorcycles and 10 cargo motorcycles to directors at our care centers providing better transportation for patients, gathering supplies, and other aspects of their work.
After sundown, utter darkness describes most TB and hepatitis B care centers due to the lack of grid-supplied electrical power. In 2014, we began a project to equip facilities with solar powered lighting that allows staff to read, work, and care for patients after the sun goes down. The lighting system is a self-contained solar rechargeable system supporting 12V LED lighting and USB charging ports for rechargeable lights and cell phones.
We recently introduced Luci inflatable solar lights that include a small solar panel at the top of the light providing a way to recharge them in direct sunlight during the day and supplying 6–8 hours of light at night. The lights can last up to two years if used everyday and longer if used less frequently.