The MSF Scientific Day held on the 10th June 2005 was a jam-packed affair! It was really useful to hear first-hand experiences of what it is like to work/conduct research in the developing world/conflict situations.
The day was divided into five sections with 3 speakers for each section:
Particular challenges in emergencies
This is probably the area that MSF is most well-known for.
Francesco Grandesso (Epicentre, Paris) offered a unique insight into what it was like to deliver interventions in the Indonesian Aceh province, post-tsunami. He made a number of interesting points e.g. the claim by WHO that the death toll would double due to inadequate sanitation and immunisation has not borne itself out; there is a need for stronger co-ordination between national and international relief organisations; media pressure aggravated the situation.
Approaches to HIV & TB care in resource-poor settings
Rony Zacariah (MSF, Belgium) stressed the importance of community support for antiretroviral treatment outcomes and suggested that the community might be a potential resource in resource-poor countries. As an aside, the idea of using the community to deliver interventions has been put into practice with regard to AIDS orphan support, particularly in Zimbabwe through Families, Orphans and Children Under Stress (FOCUS), a program run by volunteers in the community with support from the Family AIDS Caring Trust (FACT). These volunteers visit the households of orphans within their locality, with greater support being given to child-headed households (DeJong, 2001).
Tom Ellman (MSF, UK) offered a different perspective based on his experiences of treating HIV in a migrant worker population in Ethiopia. Despite the fact that migrant workers are a major risk group for HIV they are often excluded from HIV treatment programmes because it is believed that they will not be adherent to treatment. This programme found that migrants were able to adhere to treatment. In fact, being away from their homes seemed to lessen the stigma for them.
Changing models: scaling up care in resource-poor settings
The lack of human resources was again touched upon in Wim Van Damme's presentation (Institute of Tropical Medicine, Antwerp, Belgium). He focused on the shortage of nurses in Swaziland – there is a 10% depletion in nurses per year for a number of reasons:
- Nurses dying from HIV/AIDS
- Work absenteeism due to nurses' families affected by HIV/AIDS – illness, funerals
- 'Brain drain’ – nurses moving into private sector and abroad
He talked about ways of overcoming the human resource shortage e.g. through 'expert patients' (he cited an example whereby patients learnt how to operate on fistulas!), group treatment.
Financial barriers and opportunities in malaria programmes
Many countries have changed their national treatment protocols to using artemisinin-based combinations (ACTs) when treating malaria. However, there are problems in delivery. For example, only four countries in Africa are actually treating people with ACTs.
New approaches to neglected diseases
This section concentrated on two diseases that are highly neglected in terms of resource allocation – visceral leishmaniasis and human African trypanosomiasis. Research was presented on new treatments e.g. miltefosine versus sodium stibogluconate for visceral leishmaniasis in Ethiopia and DFMO compared to melarsoprol to treat human African trypanosomiasis in the Republic of Congo. The presentation were quite technical but very informative!
The full agenda can be viewed here
References
DeJong, J. (2001) A Question of Scale: The challenge of expanding the impact of non-governmental organisations’ HIV/AIDS efforts in developing countries. New York: Horizons Project of the Population Council & International HIV/AIDS Alliance.
Aska Leslie
Postgraduate Education Editor
aska.leslie@almamata.net
