Thursday, November 3, 2011

International Sector: Haiti, and Africa Short-Term Missions

http://www.lottcarey.org/


2012 SHORT-TERM MISSION ASSIGNMENTS

Pignon: Hosean International (Haiti)
Hosean International a service-based ministry, has been receiving teams and coordinating outreaches in Haiti since 1981. Mission service opportunities include: Children’s Ministry (Intensive English and Vacation Bible School) and Construction: Camp Grounds, Disaster Preparedness Warehouse and School.
Dates: Dec. 1 -9, 2011;
            Mar.16 - 23; 

            Jun 23 -30, 2012

Grand Goave: Cooperative Baptist Fellowship (Haiti)
Cooperative Baptist Fellowship (CBF): The small CBF Mobile Medical clinic at Siloe is a clinic without beds. The clinic is in need of medical teams to participate in ‘mobile clinics’ to the villages in the mountain region of Grand Goave. Significant time will be spent seeing patients and addressing both emergency treatment, and providing ongoing care. Medical personnel such as: Doctors, nurses, dentists, technicians, EMTs, and more are needed.
Dates: February 8 - 15, 2012; 
            May 9 - 16, 2012


Addis Ababa: African AIDS Initiative International (Ethiopia)
African AIDS Initiative International (AAII): Offers care and support programs for at-risk populations exposed to the transmission of HIV/AIDS. AAII also helps poor women forced into sex-work to support their families. This ministry opportunity is for women only.
Date: May 14-22, 2012

Illegal to photocopy Gov't ID


Monday, October 31, 2011

Louisiana Public Health Emergency Preparedness

Louisiana Earns Perfect Score in Public Health Emergency Preparedness

State is tops in readiness for health emergencies

Tuesday, September 20, 2011  | 
Contact: Bureau of Media & Communications (225) 342-7913
 
BATON ROUGE, La.—For the second consecutive year, Louisiana scored a perfect 100 on the Centers for Disease Control and Prevention's (CDC) evaluation of the state's public health emergency preparedness and response capabilities. Louisiana and seven other states scored 100 two years in a row. Louisiana's public health laboratories also received exemplary marks. The CDC's "Public Health Preparedness: 2011 State-by-State Update on Laboratory Capabilities and Response Readiness Planning" report released today evaluates the state over a three-year period, from 2007-2010.

Louisiana Department of Health and Hospitals (DHH) Secretary Bruce D. Greenstein says the report reaffirms what he saw in action during the recent Pearl River fish kill, New Orleans marsh fires and Tropical Storm Lee. "Governor Jindal has challenged every state agency to execute our disaster preparedness and response functions flawlessly. I am so proud of our team at DHH, our sister agencies and all of our partners who have together proved that Louisiana is tremendously well prepared to respond to a health crisis. Whether it's been in the face of a hurricane, an oil spill or a pandemic flu, they have proven that fact time and again," Greenstein said.

DHH's Center for Community Preparedness Director Doris G. Brown, RN, MEd, MS, CNS, said the perfect score is a direct reflection of the hard work of the state and its partners through the Public Health Emergency Preparedness Cooperative Agreement between the Office of Public Health, the federal Centers for Disease Control and Prevention and the U.S. Department of Health and Human Services' Hospital Preparedness Program. "We plan and train with our partners so that when we are faced with a man-made or natural disaster we are ready," Brown said.

In the report, all 50 states and 4 localities directly funded by the Public Health Emergency Preparedness Cooperative Agreement were graded on their ability to effectively receive and distribute the CDC's Strategic National Stockpile (SNS), a cache of drugs and medical supplies to protect the American public if there is a public health emergency severe enough to cause local supplies to run out. The CDC and state public health departments conduct annual technical assistance reviews (TAR) to assess emergency preparedness plans for receiving, staging, storing, distributing and dispensing the SNS to ensure continued readiness for all disasters. The state must attain a score of 79 or higher in order to continue to receive preparedness funding from the federal government.

The report also evaluated states' public health laboratories. The DHH labs received high marks for their ability to test for and detect chemical and biological agents and their ability to assist DHH epidemiologists in carrying out epidemiological surveillance for early detection of potential threats. The DHH labs test daily for bacteria in foods and human samples to ensure rapid response to public health emergencies. The labs also help the state's public drinking water systems maintain federal Safe Drinking Water Act standards by testing for contamination. The state has four public health labs.

The Louisiana Department of Health and Hospitals strives to protect and promote health statewide and to ensure access to medical, preventive and rehabilitative services for all state citizens.

To learn more about DHH, visit http://www.dhh.louisiana.gov/.

For up-to-date health information, news and emergency updates, follow DHH's blog, Twitter account and Facebook.

Trauma: Grant Funding. Crisis Counseling Assistance

https://www.rkb.us/contentdetail.cfm?content_id=56827

Crisis Counseling Assistance and Training Program  



Department of Homeland Security
Department of Homeland Security

Sunday, October 30, 2011

Trauma: Healing from Trauma.

 http://www.samhsa.gov/nctic/healing.asp#atrium

Healing from Trauma

Trauma-Specific Interventions

Following are some well-known trauma-specific interventions based upon psychosocial educational empowerment principles that have been used extensively in public system settings. Please note that these interventions are listed for informational and educational purposes only. NCTIC does not endorse any specific intervention.

Addiction and Trauma Recovery Integration Model (ATRIUM)
Essence of Being Real
Risking Connection
Sanctuary Model
Seeking Sanctuary
Trauma, Addiction, Mental Health, and Recovery
Trauma Affect Regulation: Guide for Education and Therapy (TARGET)
Trauma Recovery and Empowerment Model (TREM and M-TREM)

 

Addiction and Trauma Recovery Integration Model (ATRIUM)

ATRIUM is a 12-session recovery model designed for groups as well as for individuals and their therapists and counselors. The acronym, ATRIUM, is meant to suggest that the recovery groups are a starting point for healing and recovery. This model has been used in local prisons, jail diversion projects, AIDS programs, and drop-in centers for survivors. ATRIUM is a model intended to bring together peer support, psycho-education, interpersonal skills training, meditation, creative expression, spirituality, and community action to support survivors in addressing and healing form trauma.

Dusty Miller, author and creator of ATRIUM, is available for training, consultation, workshops, and keynote presentations. She works with groups that address issues of self-sabotage, traumatic stress, trauma re-enactment, substance abuse, self-injury, eating disorders, anxiety, body-based distress, relational challenges, and spiritual struggles.

For more information, visit www.dustymiller.org or contact:
Dusty Miller, Ed.D.

dustymi@aol.com

 

Essence of Being Real

The Essence of Being Real model is a peer-to-peer structure intended to address the effects of trauma. The developer feels that this model is particularly helpful for survivor groups (including abuse, disaster, crime, shelter populations, and others), first responders, and frontline service providers and agency staff.
The developer feels that this model is appropriate for all populations and that it is geared to promoting relationships rather than focusing on the “bad stuff that happened.”

The Sidran Institute provides educational materials, training, and implementation support.

For more information, visit www.sidran.org or contact:
Elaine Witman
P: 410-825-8888 x211
elaine.witman@sidran.org

 

Risking Connection®

Risking Connection is intended to be a trauma-informed model aimed at mental health, public health, and substance abuse staff at various levels of education and training. There are several audience-specific adaptations of the model, including clergy, domestic violence advocates, and agencies serving children.
Risking Connection emphasizes concepts of empowerment, connection, and collaboration. The model addresses issues like understanding how trauma hurts, using the relationship and connection as a treatment tool, keeping a trauma framework when responding to crises such as self-injury and suicidal depression, working with dissociation and self-awareness, and transforming vicarious traumatization.

The Sidran Institute provides educational materials, training, and implementation support.

For more information, visit www.riskingconnection.org or contact:
Barbara Levin
P: 410-825-8888 x206
training@sidran.org

 

Sanctuary Model®

The goal of the Sanctuary Model is to help children who have experienced the damaging effects of interpersonal violence, abuse, and trauma. The model is intended for use by residential treatment settings for children, public schools, domestic violence shelters, homeless shelters, group homes, outpatient and community-based settings, juvenile justice programs, substance abuse programs, parenting support programs, acute care settings, and other programs aimed at assisting children.

The developer indicates that the Sanctuary Model’s approach helps organizations to create a truly collaborative and healing environment that improves efficacy in the treatment of traumatized individuals, reduces restraints and other coercive practices, builds cross-functional teams, and improves staff morale and retention.

The Sanctuary Leadership Development Institute provides on-site assessment, training, and implementation support.

For more information, visit www.sanctuaryweb.com or contact:
Sarah Yanosy, LCSW
P: 914-965-3700 x1117
syanosy@jdam.org

 

Seeking Safety

Seeking Safety is designed to be a therapy for trauma, post-traumatic stress disorder (PTSD), and substance abuse. The developer feels that this model works for individuals or with groups, with men, women or with mixed-gender groups, and can be used in a variety of settings (e.g. outpatient, inpatient, residential).

The developer indicates that the key principles of Seeking Safety are safety as the overarching goal, integrated treatment, a focus on ideals to counteract the loss of ideals in both PTSD and substance abuse, knowledge of four content areas (cognitive, behavioral, interpersonal, and case management), and attention to clinician processes.

Seeking Safety provides on-site training sessions and telephone consultation.

For more information, visit www.seekingsafety.org or contact:
Lisa Najavits
P: 617-731-1501
info@seekingsafety.org
Back to the top

 

Trauma, Addiction, Mental Health, and Recovery

Developed as part of the first phase of the SAMHSA Women, Co-Occurring Disorders and Violence Study, TAMAR Trauma Treatment Group Model is a structured, manualized 15-week intervention combining psycho-educational approaches with expressive therapies. It is designed for women and men with histories of trauma in correctional systems. Groups are run inside detention centers, in state psychiatric hospitals, and in the community.


The Trauma Addictions Mental Health and Recovery Treatment Manual provides basic education on trauma, its developmental effects on symptoms and current functioning, symptom appraisal and management, the impact of early chaotic relationships on healthcare needs, the development of coping skills, preventive education concerning pregnancy and sexually transmitted diseases, sexuality, and help in dealing with role loss and parenting issues.

For more information contact:    Marian Bland, LCSW-C
Maryland Mental Hygiene Administration
p: 410-724-3242
blandm@dhmh.state.md.us

 

Trauma Affect Regulation: Guide for Education and Therapy (TARGET)

TARGET is a model designed for use by organizations and professionals with a broad range of experience with and understanding of trauma. The developer feels that TARGET works with all disciplines and can be used in all levels of care for adults and children.

The developer indicates that TARGET is an educational and therapeutic approach for the prevention and treatment of complex Post Traumatic Stress Disorder (PTSD). The developer feels that this model provides practical skills that can be used by trauma survivors and family members to de-escalate and regulate extreme emotions, manage intrusive trauma memories experienced in daily life, and restore the capacity for information processing and memory.

The University of Connecticut’s Research and Development Corporation is creating a behavioral health service company to provide training and consultation in the TARGET model which will include training, long-term small group consultation, quality assurance, and program evaluation.

For more information, visit www.ptsdfreedom.org or contact:
Julian Ford, Ph.D. or Judith Ford, M.A.
P: 860-679-8778 or 860-679-2360
ford@psychiatry.uchc.edu or fordj@psychiatry.uchc.edu

 

Trauma Recovery and Empowerment Model (TREM and M-TREM)

The Trauma Recovery and Empowerment Model is intended for trauma survivors, particularly those with exposure to physical or sexual violence. This model is gender-specific: TREM for women and M-TREM for men. This model has been implemented in mental health, substance abuse, co-occurring disorders, and criminal justice settings. The developer feels this model is appropriate for a full range of disciplines.

Community Connections provides manuals, training, and ongoing consultation in TREM and M-TREM.

For more information, visit www.ccdc1.org or contact:
Rebecca Wolfson Berley, MSW
P: 202-608-4735
rwolfson@ccdc1.org

Friday, October 28, 2011

Snow removel and exercise. Community Participation. Whole Community Approach

SNOW EMERGENCIES.   “ONE BLOCK AT A TIME.”

Many individuals treat snow emergencies as just an inconvenience or interruption to normal individual and community routines.  But, snow emergencies have physical & mental health, financial and economic impacts on a community.   

Treating snow emergencies with the same planning requirements, and preparedness as earthquakes, tornadoes, flooding, and man-made disasters will contribute to decreasing health effects, and the financial and economic impacts.   

Communities can plan block traffic parking patterns, and block snow removal plans that can greatly increase the movement of neighbors and emergency personnel.  Planning with public safety and transportation departments on snow removal plans have to be considered long before these events occur.   

A weekend snow emergency exercise with neighbors can provide assurance that each neighbor knows what will be the procedures for parking, snow shoveling, and assistance to those that are unable to remove even small amounts of snow due to physical limitation.   

Contact your local public safety, transportation, or other authority for snow removel on public roads and residential areas.  Communities with home owner or other residential associations have snow removal plans.  Contact them for snow removal patterns in your area.

Thursday, October 27, 2011

Recovery from Disasters. Secondary Effects. Sanitation.

http://new.paho.org/disasters/index.php?option=com_content&task=view&id=543&Itemid=904

Cholera in Disaster Situations

Cholera Bacteria
Cholera is an intestinal infection caused by toxigenic Vibrio cholerae, group O-1 or O-139. Natural and man-made disasters which produce overcrowding, a scarcity of safe drinking water, improper elimination of human waste, and the contamination of food during or after its preparation are risk factors for the spread of the disease.

Description

In areas where cholera has not been confirmed, a suspected case is defined as severe dehydration or death from acute watery diarrhea in a patient over 5 years of age.

In areas where an epidemic is under way, a suspected case of cholera is defined as acute watery diarrhea, with or without vomiting, in a patient over 5 years of age.

A confirmed case of cholera is defined as the laboratory-confirmed presence of V. cholerae 01 in any patient with diarrhea. Once the presence of the disease has been confirmed, it is unnecessary to examine specimens from all cases or contacts. Monitoring should include ongoing laboratory confirmation of a small proportion of cases.

It is important to adopt this definition. However, for clinical management of cases of acute watery diarrhea in an area in which an epidemic is under way, cholera should be suspected in all cases in patients aged 2 or older. It should be noted that in Central America, cholera primarily strikes adults, with 80% of the recorded cases representing individuals 5 years of age or older, while 80% of diarrheal diseases from other causes occur in children under 5.

There are more than 60 serogroups of Vibrio cholerae, but only the O1 serogroup causes cholera. V. cholerae occurs as two biotypes: classical and El Tor. Each biotype has two serotypes: Ogawa and Inaba. The El Tor biotype (first isolated in Egypt in 1905) is responsible for almost all the recent outbreaks of the disease, producing a greater proportion of asymptomatic infections than the classical biotype and surviving longer in the environment. This biotype can live in association with certain aquatic plants and animals, which makes water an important reservoir of the infection.

History of Cholera in the Region

The second cholera pandemic spanned the period 1826 to 1837. This was the first pandemic that ravaged England and Western Europe, causing thousands of deaths in early 1830. The epidemic spread to Canada, the United States, and Mexico in continental North America, to Guyana in South America, and to Cuba.

In January 1991 Vibrio cholerae 01 reached a town on the coast of Peru, trumpeting the arrival of the seventh cholera pandemic in Latin America. By the year 2000 the epidemic had spread to 21 of the 35 countries of the Region of the Americas, with Canada, Uruguay, and the Caribbean remaining free of the disease.

Moreover, in 1999 Argentina, Bolivia, Chile, Costa Rica, French Guiana, Guyana, Paraguay, Panama, and Suriname did not report cases of the disease.

In the 19th and early 20th century cholera was a predominantly urban phenomenon with high case-fatality rates (30-50%). In contrast, the Latin American epidemic of the 1990s was rural, with lower case-fatality rates (around 2%). The disease is also becoming endemic, and an incipient seasonal epidemiological model can be observed.

Risks for the Traveler

People who follow the usual tourist itineraries and observe food safety recommendations face practically no risk when visiting countries that have reported cases of cholera.

The 10 Most Frequently Asked Questions

Q. When we speak of cholera we often refer to it as a pandemic. What is a "pandemic"?
A pandemic is a disease that strikes the majority of the population in a large region, emerges simultaneously in different parts of the world, and is a long-term phenomenon.

Q. Is cholera as widespread and serious now as it used to be?
No. In the 19th century cholera was found in major cities, causing high case-fatality rates (30%-50%), while today the infection is often mild, self-limiting, or subclinical and is found in rural areas, with relatively low case-fatality rates (2%).

Q. What led to the changes in the model of the disease?
The following factors can be mentioned: (a) El Tor, a biotype of V. cholerae in circulation, which produces a greater proportion of asymptomatic cases than the classical biotype; (b) greater access to safe drinking water; (c) better excreta disposal systems; (d) health education, and (e) primary health care.

Q. Is it possible to contract V. cholerae through person-to-person contact?
It is possible, but this type of transmission is very rare.

Q. What are the main steps in managing a suspected case of cholera?
The main steps are: assess for dehydration, rehydrate with a solution of oral rehydration salts, observe the patient, replace missing fluids, administer oral antibiotics only to patients with serious dehydration, and feed the patient.

Q. Do we need a health system with a high level of complexity to treat cholera?
Fluids and simple electrolyte replacement therapy produce excellent results in the majority of cases. Serious cases may require antibiotics (doxycycline or tetracycline for adults; trimethoprim sulfamethoxazole for children). These interventions can be carried out at the primary level.

Q. Are travel and trade restrictions recommended in outbreaks of cholera?
No. Travel and trade restrictions between countries or between different areas of a country do not prevent the spread of cholera. Not only are they ineffective, they lead to the suppression of information on outbreaks of the disease. WHO modified its International Health Regulations in 1973 so that travelers would no longer be required to show a certificate of vaccination against cholera.

Q. Are vaccinations recommended for cholera control?
No. The traditional vaccine against cholera (based on whole, killed cells) is characterized by low levels of efficacy and high reactogenicity. Therefore, it is not recommended for the control of epidemics. The new vaccines might be considered, but with these, there is a rapid loss of protection, giving people a false sense of security. Resources should be channeled to the most useful control methods.

Q. How do we protect young children against cholera?
In infants under 6 months, breast-feeding protects against the disease. Careful preparation of formula and food with safe drinking water should protect infants who are not breast-fed.

Q. Is it mandatory to report cholera outbreaks?
Yes. The diseases listed as reportable by the International Health Regulations are cholera, yellow fever, and the plague. WHO publishes the data on cholera outbreaks in the Weekly Epidemiological Record; the CDC publishes its semiweekly "Health Information for International Travel" to inform the public about where cholera and yellow fever have been reported.

What to Do at the Institutional and Community Level

  • Adopt long-term policies to ensure that all populations have access to adequate systems for excreta disposal and the provision of safe drinking water;
  • Offer basic health services through primary health care systems. The majority of cholera cases respond well to simple therapies; Prescribe antibiotics only for cholera cases showing signs of severe dehydration;
  • Monitor the susceptibility of V. cholerae to antibiotics; 
  • Maintain specificity in reports, employing the case definitions developed by PAHO/WHO; 
  • Update the epidemiological profile of areas with cholera or considered at risk for the disease; 
  • Offer periodic training to physicians and paramedical personnel for the clinical management of patients with acute diarrhea; 
  • Maintain a stock of essential emergency supplies, especially oral rehydration salts (ORS) and solution and appropriate antibiotics. 
  • Maintain a buffer stock of drugs at appropriate points in the drug administration system; 
  • Emphasize safe disposal of human excreta through health education; 
  • Construct sanitary systems for human waste disposal, suited to the local conditions. 
  • Promote community production of chlorine so that it can supply itself.

What to Do at the Personal Level

  • Drink only safe water (tap water, boiled for a minute or more, or water that has been disinfected with chlorine or iodine tablets);
  • Avoid raw food (except fruits or vegetables that can be peeled); 
  • Cook food until hot both inside and out and eat while still hot; 
  • Carefully wash and dry kitchen or serving utensils; 
  • Wash hands carefully with soap after using the toilet and before preparing or eating food or feeding children; 
  • In emergencies, while a better latrine is being constructed, a simple pit (0.3m x 0.3 m x 0.5 m) can be dug at least 30 meters from the well or other source of drinking water. Latrines should be located below the level of the water source. Avoid swampy ground.

What Not to Do

  • Do not eat mollusks, shellfish, or other fish or seafood from polluted waters, unless they are cooked thoroughly;
  • Do not eat raw vegetables; 
  • Do not wash kitchen utensils or eat with water known to be contaminated; 
  • Do not bathe in water known to be contaminated; 
  • Do not mix raw food with cooked food; 
  • Do not drink milk that has not been pasteurized, unless it has been boiled adequately; 
  • Do not eat ice cream or use ice, unless it is from a safe source; 
  • Do not take antibiotics, unless prescribed by a health worker; 
  • Do not issue a quarantine in an effort to control the spread of cholera.

Suggested Readings

  • "WHO Guidelines for cholera control", Revised 1992 WHO/CDD/SER.80.4 REV 4 (1992) Orig. English. Spanish version: "Lineamientos para el control del cólera".
  • WHO "Guidance on formulation of national policy on the control of cholera" WHO/CDD/SER/92.16 REV.1 Original Spanish-English version: "Lineamientos de la OPS para formular una política nacional de control del cólera".
  • WHO "Diarrhea management training course: guidelines for conducting clinical training courses at health centers and small hospitals" Geneva, WHO, 1990 WHO/CDD/SER/90.2 (English only)
  • WHO "Guide to simple sanitary measures for the control of enteric diseases". Geneva, WHO, 1974 (English only)
  • Manual for laboratory investigations of acute enteric infections. WHO/CDD/83.3 Geneva, WHO, 1987
  • The treatment and prevention of acute diarrhea: practical guidelines. 2 ed. WHO, 1989 (Available in English, French, Portuguese, and Spanish)
  • Manejo de los pacientes con cólera. WHO/CDD/SER/91.15 Rev. 1 (1992) Geneva, WHO, 1992
  • CDC -Centers for Disease Control and Prevention "Health Information for International Travel" 1999-2000 DHHS, Atlanta, GA. On-line version.
  • "Textbook of International Health" by Paul F. Basch (Chapter 1 - Historical Background) Department of Health Research and Policy, Stanford University School of Medicine. Oxford University Press (1990)
  • La Investigación de las Dolencias Infecciosas en la Historia (Las seis primeras pandemias - pp 274-284) Arturo Romero B, MD Academia Colombiana de Ciencias Exactas, Físicas y Naturales. Colección Enrique Pérez Arbeláez, No. 12 Santafé de Bogotá, DC Colombia, 1997

Contact

Dr. Marlo Libel
Phone: (202) 974-3129
Email: libelmar@paho.org

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