International Translation Day Spotlight: AVADAR

By Adaeze Obiako

“If you talk to a man in a language he understands, that goes to his head. If you talk to him in his language, that goes to his heart.”

— Nelson Mandela

This year, the United Nations is celebrating “International Translation Day” for the first time. The celebration is an opportunity to pay tribute to language professionals, whose work plays an important role in bringing nations together, facilitating dialogue, fostering understanding and cooperation, and contributing to the development and strengthening of world peace and security.

For eHealth Africa (eHA), translation has been instrumental to the success of several projects, particularly the Auto-Visual AFP Detection and Reporting (AVADAR) project.

When AVADAR commenced in 2016, we knew it was a worthwhile intervention towards the eradication of polio in Nigeria; however, we could not have anticipated just how much of a positive impact it would end up having on the Acute Flaccid Paralysis (AFP) surveillance system across Africa. Between 2016 and 2018, AVADAR grew from a small pilot in two states in Nigeria to a full-fledged project across 8 West and Central African nations. Several factors contributed to the success and scale of the project, one of which was the educational AFP video embedded in the AVADAR mobile app used to train community informants on proper detection (and subsequent reporting to health authorities) of AFP cases within their communities.

This is where language came in.

The project management team, made up of the World Health Organization (WHO), country Ministries of Health, the Bill and Melinda Gates Foundation, Novel-T, and eHA, knew early on that the key to ensuring accurate AFP detection and proper use of the AVADAR app for case reporting lay with developing a sense of connectedness and trust between all stakeholders (from project implementers to health workers to community informants) through the breakdown of language barriers.

Part of the pre-implementation phase in each country included research into what languages were spoken by indigenes using the AVADAR app and the AFP video, and the entire app was translated into each applicable language. Below is an example of the AFP video translated into Hausa, a local language commonly spoken in northern Nigeria, Niger, Chad, Cameroon and the Central African Republic.

In addition to the AFP video and app being translated into multiple languages, the training facilitators (who train informants on how to use the app) and field officers (who provide weekly phone troubleshooting support to informants) were all indigenes of the implementing regions and fluent in the local languages to ensure ease of communication and understanding for the AVADAR informants.

As AVADAR continues operation across Africa, it is clear that we have the power of translation to thank for bridging the gap and allowing thousands of community members and health workers across different African nations to support the fight against polio. At this rate, it won't be too long before polio, like smallpox, is considered a public health issue of the "past".

Meet the Team - Adanna Alex

Meet Adanna Alex, Senior Coordinator with our Geographic Information Systems (GIS) team at our Kano Campus in Nigeria. She manages the Nigeria master geodatabase by ensuring that all updates and new data such as boundaries, settlement features, hamlets and other points of interest are integrated into the database and that all the microplan settlements in our database are validated.

This is very key for projects like the Vaccinator Tracking System, Polio Immunization Plus Days (IPD) tracking and the Geo-Referenced Infrastructure and Demographic Data for Development (GRID3) which rely heavily on geospatial data for their implementation.

Adanna has been with eHealth Africa for almost five years and has focused on building on her skills and knowledge everyday and helping to develop others. She trained the pilot team to manage the integration of Borno State data into the master geodatabase. In addition, she is currently responsible for supervising all interns with the GIS department.

Describing her work experience with eHA as fulfilling, Ada believes in doing every little task  diligently because it amounts to something big.

“ I joined eHA as a GIS analyst, editing and moving boundary points. Now, I manage the core geodatabase and support the VTS project by ensuring that the dashboard is up to date. I have grown over the years because eHealth Africa encourages personal development. In all this, I am most proud of my contribution to the eradication of the Poliovirus in Nigeria”

Are you inspired by Adanna’s story? Click here to join our team!

eHealth Africa supports cholera Simulation as part of its Emergency Preparedness

By Umu McCarthy and Sahr Ngaujah

Sierra Leone is known for persistent heavy rains that sometimes lead to public health emergencies including the August 2017 mudslides and cholera outbreaks. As of June 2012, a total of 25,000 people were affected by cholera in Sierra Leone & Guinea, with 399 deaths in Sierra Leone. It was the country's largest outbreak of cholera since the disease was first reported in 1970 and the deadliest since the 1994–1995 cholera outbreak. This has been the largest outbreak in the West Africa region.

eHealth Africa (eHA) partnered with U.S. Centers for Disease Control (CDC), Sierra Leone’s Ministry of Health and Sanitation and the World Health Organization (WHO), in a Cholera Simulation Exercise conducted in the Kambia District, in Northern Sierra Leone. A total of 36 healthcare workers and Health Management Teams  across the country, represented their various Districts in the simulation exercise. The key objectives of the simulation exercise were to:

• promote awareness of cholera to emergency response staff

• assess the effectiveness of the surveillance, laboratory and logistics capabilities of the selected districts to respond during outbreaks

• discuss the roles and responsibilities of Public Health National Emergency Operations Center (PHNEOC) personnel during a potential outbreak activation in accordance with the district and national plans

• test existing communication and coordination structures  implementation of emergency preparedness and response operations

“Usually during the rainy season there is an increase in the trend of diarrhea cases. This puts the country on red alert to heighten its surveillance and preparedness plans. This simulation exercise was a deliberate and proactive step to addressing cholera crisis, should they come up”

— Alusine Kamara

Alusine Kamara, the Public Health Operations Coordinator at the Sierra Leone National Emergency Operations Center, was key facilitator of the simulation exercise alongside  Dr. Claudette Amuzu, National Professional Officer, Emergency Preparedness Response, WHO.

CDC is funding eHA’s Emergency Management and Preparedness Project in Sierra Leone. The goal of this project is to enhance the capacity of the Ministry of Health and Sanitation’s ability to prepare, prevent and adequately respond to current and future outbreak of diseases including Ebola Virus Disease.

eHA’s role is to build the capacity of Ministry of Health and Sanitation personnel on key emergency management concepts in line with the Global Health Security Agenda. Scenarios, plenary sessions and presentations were used to test participants’ knowledge on cholera response. After the exercise, participants now have knowledge on how to control the spread of cholera during an outbreak.

“Emergency Operation is new to Sierra Leone’s Ministry of Health and Sanitation. Ebola crisis was our very first experience and we are still using the lessons learnt to inform future emergencies . The simulation exercise could not have come at a better time. Partners were able to identify relevant players at the District levels. This makes it easier for response teams during an emergency. If there is a cholera emergency now, I am better placed to mobilize both human and logistical resources to respond to it.”

— Sahr Gbandeh, Emergency Operations Center Focal Person for Western Area Urban

The simulation exercise, if properly implemented, goes to also benefit thousands of Sierra Leoneans during an outbreak of cholera.

Celebrating the International Day of Charity

By Emerald Awa-Agwu

The UN International Day of Charity is celebrated every September 5, and this year is focused on the Sustainable Development Goals. While the projects that eHA implements provide data-driven approaches towards the goals of “Good Health & Well-Being” and “Zero Hunger”, we also recognize the central role of volunteering and philanthropy in creating global change.

This is a belief shared and supported by eHA and demonstrated by a team that frequently engages in various charitable outreach projects to support the communities that we live and work in.

This year on the International Day of Charity, we would like to thank those who have contributed to our civic engagement and corporate social responsibility projects, including eHA staff and community members that participated in our donation drives. Your generous volunteering of time, as well as your donations of clothing and food items were vital to our charity projects at a retirement home in Freetown, Sierra Leone and a children’s home in Kano, Nigeria.

We also want to thank the almost 50 members of eHA staff, including our Executive Director Evelyn Castle, who participated in the blood drive organized at at our Kano campus on World Blood Donor day.

At eHealth Africa, we are passionate about impacting lives and investing in the places that we call home. This International Day of Charity, we encourage everyone to do the same.

eHealth Africa supports training for Hepatitis B community-based Serosurvey

By Uche Ajene and Sahr Ngaujah

eHealth Africa (eHA) and Statistics Sierra Leone are implementing the Hep B Community-based Serosurvey project funded by U.S. Centers for Disease Prevention and Control (CDC). Technical leadership for the survey is being provided by CDC and Dr. Dennis Marke, Program Manager for the Government of Sierra Leone’s Child Health Program. The purpose of the survey is to

• assess the impact of the current childhood Hepatitis B immunization program in Sierra Leone on the prevalence of chronic hepatitis B infections among children

• evaluate the need for the Hepatitis B- birth dose in Sierra Leone by determining the burden of chronic hepatitis B virus among mother/child pairs.

In preparation for the survey eHA  supported the training of phlebotomists and surveyors for data and sample collection in the field.

Practical session on processing and tracking of venous blood specimen

Strong human resource capacity is crucial to manage a household survey that consists of a detailed questionnaire and a rapid diagnostic test administered to the participant in their home. eHA and CDC trained a team of 50 people (13 surveyors, 13 team supervisors and 3 district coordinators and 20 phlebotomists) from Statistics Sierra Leone and the Ministry of Health and Sanitation. The training took place at Sierra Leone’s Public Health National  Emergency Operations Center (EOC) in Freetown, from 20th - 25th August 2018.

The 5-day training consisted of 3 full classroom days and a 2 days of field work. The following topics were covered:  

• Overview and relevance of the Hepatitis B Serosurvey

• Household identification procedure for enrollment

• Counseling families about Hepatitis B results

• Conducting Hepatitis B rapid diagnostic test

• Processing and tracking of venous blood specimens

“I have never worked in a survey field. However, this training did not only add to my knowledge about Hepatitis B, it also gave me the opportunity to go out in the field during the training and conduct a phlebotomy exercise on participants.”

— Sahr Joseph, Phlebotomist

Key beneficiaries of the project are Sierra Leone’s Expanded Programme on Immunization (EPI), Sierra Leone’s Ministry of Health and Sanitation (MOHS), mothers and children in Sierra Leone and the wider public. Participants testified to the value of the training to facilitate learning valuable information needed for effectively administering the questionnaire and conducting rapid diagnostic tests in the field.

Practical sessions with phlebotomists on the use of the mobile refrigerator to store blood samples

“The training was intense. However, I was able to master the purpose of the survey, became conversant with the questions and how to determine the eligibility of participants.”

— Tamba Fatorma, Surveyor

eHA provided the phones and internet data for the survey and installed the open data kit (ODK) app (which is used for data collection in the field), the age= app for age calculation, and the  ODK dashboard. eHA’s provision of the android phones for the survey discourages potentials errors via paper-based methods by presenting an automated approach to health data collection. With ODK, data collection will be done easily and survey activities monitored in near real time.

 

Next Steps

The Western Area Urban, Bo and Bombali districts have been identified as target areas for the  survey. After this training, eHA, CDC, Statistics Sierra Leone and the MOHS (including those trained)  will Implement the serosurvey through June 2019, at 14, 200 households in the areas identified. The survey will include infants in the following age categories: 4–24 months; 5-9 year olds and their mothers to evaluate the risk of mother to child transmission (MTCT) of Hepatitis B. Evidence from the survey will be presented to the Sierra Leonean government to inform decision makers on whether to introduce administration of the Hepatitis B vaccine at birth.