Volume XI, Issue 3 Summer 2007 Connections

Highlights from the American International Health Alliance’s Development Programs in the EECA Region

US First Lady Visits Partnership Women’s Wellness Center in Tirana, Learns about Maternal and Child Health Programs US First Lady Laura Bush got a programs,” Mrs. Bush told the Inside this issue: first-hand look at the many group of staff, patients, and positive changes introduced by dignitaries at the Tirana WWC, AIHA partners at Queen Geraldine encouraging them to continue Hospital in Tirana during her visit their work to improve healthcare Wisconsin Partners 2 to Albania June 10. services for Albania’s women and Honored for Voluntarism children. Mrs. Bush toured the Tirana PMTCT Assessment 3 Women’s Wellness Center Through the partnership, the Training in (WWC), which was opened in Tirana WWC emerged as a September 2000 through the pioneer in efforts to improve US First lady Laura Bush and Knowledge Hub Trains 3 efforts of a now graduated AIHA women’s healthcare in Albania. Albanian First Lady Dr. Liri Case Managers in Latvia partnership linking Queen Berisha give special attention Geraldine Hospital — formerly The center now receives more to infants in the Angel’s Cradle Maternity Hospital No. 1 — with than 12,000 patient visits each Nursery at Queen Geraldine ATEC-St. Petersburg Hosts 4 the Women’s and Infants Hospital year, in part because of the Hospital. Regional Faculty Training of Rhode Island in Providence. broad range of clinical services it provides. Patients have access to Moldova PHHP Hosts Blood 4 Mrs. Bush also visited Angel’s family planning, reproductive health, sexually transmitted Donor Safety Events Cradle Nursery, a special unit of health, perinatal care, and infections, menopause, and the hospital that houses or- cancer screening services, as well healthy lifestyles. Partner Appointed Minister 5 phaned or abandoned infants. as primary care and mental of Health in Armenia The nursery is supported by the health screening and counseling. Mrs. Bush learned of these Organization for the Support of It also offers an extensive array accomplishments and got a first- Building HIV/AIDS Care 5 Albania’s Abandoned Babies. of education programs covering hand look at the many innovative Capacity in Belarus topics such as prenatal care, programs partners have imple- “I’ve had a very good chance child birth preparation, newborn mented at the Tirana WWC. Milwaukee Donor Lauded 6 today to see some terrific care, breast feeding, breast for Efforts in Georgia —A more detailed account is available at www.aiha.com. Online Course Focuses on 6 Evidence-based Medicine

HIV Training for Primary 7 Russian Ministry of Health Incorporates Eight AIHA Courses Care Providers into National Master Training Curriculum on HIV/AIDS Orenburg Partners Host 7 The Russian Ministry of Health bed-side training on a particular The AIHA-developed courses are HIV-TB Clinical Course and Social Development approved aspect of HIV-related care, such also among the more than 20 on July 26 a Master Training as prevention of mother-to-child HIV/AIDS care courses taught at New Haven Partners Travel 8 Curriculum on HIV/AIDS. transmission, provision of antiret- the AIDS Training and Education to St. Petersburg roviral therapy, HIV and TB Center established by AIHA, the Designed to enhance the skills of co-infection, and lab diagnostics. St. Petersburg Medical Academy Russian specialists who provide for Postgraduate Studies, and treatment, care, and support Eight of these courses are based various strategic partners last to people living with HIV or AIDS, on training materials developed year in St. Petersburg. These the Master Curriculum is a and piloted by AIHA under the courses are also offered at the compilation of 17 evidence-based framework of the Bratislava Regional Knowledge Hub for the clinical courses. Each interactive Initiatives signed in the Slovak Care and Treatment of HIV/AIDS continuing education course capital by Russian President in Eurasia, which is based in Kyiv, provides 72-144 hours of post- Vladimir Putin and US President Ukraine. graduate level classroom and George W. Bush in 2005. Page 2 Connections

Wisconsin Partners Receive President’s Volunteer Service Awards for Work in Eastern Europe, Caucasus AIHA partners from the Wisconsin programs that addressed issues Georgia (1999-2004); and Gori, cities of Appleton, La Crosse, and ranging from domestic violence Georgia (2004-present). Milwaukee were presented in July to neonatal care. with the President’s Volunteer CIH partners were also Service Award in recognition of La Crosse and Appleton partners recognized for their participation their efforts to improve health- were also active in AIHA’s in a partnership designed to care service delivery in Armenia, Community Leadership Develop- strengthen HIV/AIDS-related Georgia, , and Ukraine. ment Program, funded by the pharmacy services at Pediatric Open World Leadership Center at ART Centers of Excellence in USAID Europe and Eurasia Bureau the US Library of Congress. Zambia. Chief of Staff Brock Bierman presented individual and organ- Bierman presented Life Time Now in its first year, this izational awards to 31 partners Service Awards — given in partnership links CIH with at two ceremonies in La Crosse recognition of 4,000 or more University Hospital in Lusaka and on July 12. hours of service — to Mary A. District General Hospital in Anderson, Sandra J. McCormick, Livingstone. It is funded through Commending them for their and Kermit L. Newcomer. AIHA’s HIV/AIDS Twinning Center Members of the Dubna/La Crosse “courage, generosity, compas- in support of the President’s partnership dedicated the David sion, and extraordinary efforts,” David J. Allen, Montgomery Emergency Plan for AIDS Relief. Bell Rotunda and Russian Garden in Bierman told partners they “have Elmer, Michael Garrity, Agnes E. La Crosse on July 12. lent their considerable profes- Hoeger, Maureen Jameson, Frederick Tavill and John R. sional talents to realize the bold Deborah Lutjen, Cheri L. Olson, Petersen received Life Time vision of a healthier future for Lisa Radtke, and Mary Thompson Service Awards from Bierman. communities clear across the received Gold Awards honoring globe.” 500 or more hours of service. Mark Anderson, Eugenie Hildebrandt, Michael Mazzone, La Crosse has participated in Silver Awards were presented to Peter Sigmann, Jeff Stewart, three highly successful AIHA Karen Beneke, Martha Binn, Peter Clarence Grim, Carlene Grim, partnerships since 1992, effec- M. Keeffe, Elizabeth Leschensky, Mary Newcomb, Darlene Weis, tively harnessing the expertise of Michael H. Mader, John D. and Sue Matson were presented area institutions and healthcare Medinger, Suzanne Merkl, Martha with Gold Awards. providers, and other allied Schwem, and Joyce L. White for professionals to greatly improve their 205-499 hours of service. Silver Awards were presented to health service delivery in Dubna, Iva Bakhutashvili, Lawrence Russia (1992-1999); Kharkiv, Bronze Awards — presented for Clowry, Nino Dgebuadze, Seth Ukraine (1999-2004); and Guria, 100-249 hours volunteered — Foldy, Cesar Gonzalez, Paula Dubna Mayor Valeriy Prokh, AIHA Georgia (2004-present). were given to Julie R. Bartels, Lucey, and Ronald Pruhs. Program Officer Kate Schecter, Nancy R. Bumgarner, Jeff Court, World Services of La Crosse, Inc. Appleton’s primary healthcare David Houge, Jan V. Jarvinen, Mary Jo Baish, Jonathan Crowder, President Sandy McCormick, and partnership with the Russian Mark E. Jolivetter, Don Jobe, David Fay, Chris Wenninger, USAID Europe and Eurasia Bureau cities of Kurgan and Schuche Douglas N. Mormann, Sally S. Gaither Bynum, Kelly Geiger, Chief of Staff Brock Bierman. (1999-2004) resulted in marked Sibbald, and Richard H. Strauss. Warren LeMay, Geoffrey Lamb, improvements in patient care Veronica Pruhs, James Sanders, through community-based In conjunction with the awards Leslie Schulz, David Schieder- ceremony, the La Crosse Dubna mayer, Peter Thornquist, Lora Friendship Association dedicated Taylor, Andrea Zabel, Terry the Russian Garden and the David Tobin, Peter Havens, and Tom Bell Rotunda in the city’s Lausten received Bronze Awards. International Friendship Garden located in Riverside Park on the The President’s Volunteer Service shores of the Mississippi River. Award honors exemplars of the American spirit of altruism and AIHA partners at the Center for encourages all Americans to International Health (CIH) in embrace volunteer service and Milwaukee were honored at a civic participation for the good of ceremony the following day. all people at home and abroad. Bierman presented awards to 34 area healthcare professionals, praising them for their efforts to Staff and volunteers affiliated with the Milwaukee-based Center for improve primary healthcare International Health with AIHA’s Kate Schecter and USAID’s Brock services in Lori, Armenia (2003- Bierman following the award ceremony on July 13. 2004); Mtskheta-Mtianeti, Volume XI, Issue 3 Page 3

AIHA Experts Conduct PMTCT Assessment Training, Site Surveys in Russia’s AIHA conducted a workshop in city of Chelyabinsk, attended the Plus Project, and Irina Shumilova, Orenburg May 16-18 to train a three-day training. information and communication core group of local clinicians on technology/monitoring and how to conduct site preparedness The overarching objective of evaluation coordinator at AIHA’s assessments at area institutions the workshop was to train Office introduced key responsible for providing participants how to effectively elements of survey instruments services for the prevention of monitor and assess PMTCT and helped participants develop mother-to-child transmission services to ensure they are being their own questionnaires. (PMTCT) of HIV. implemented in accordance with national guidelines and interna- The workshop concluded with Workshop participants and AIHA Specialists from AIDS Centers, tional best practices endorsed by practical exercises at four PMTCT PMTCT expert Natalia Nizova maternity hospitals, and WHO, UNICEF, and UNFPA. service sites in Orenburg, (right) visited four clinical sites, children’s polyclinics in the including an antenatal clinic, a where trainees gained practical Orenburg Oblast cities of Gai, To this end, course instructors maternity hospital, a children’s experience in the prevention of Novotroitsk, Orenburg, and , Natalia Nizova, director of AIHA’s polyclinic, and social care center vertical transmission of HIV/ as well as a specialist from the USAID-funded Ukraine PMTCT- for families and children.

AIHA and Regional Knowledge Hub Conduct HIV/AIDS Case Management Training in Estonia AIHA and the Regional Knowledge largely been driven by injecting During the workshop, a good deal Hub for the Care and Treatment drug use and the commercial sex of time was spent familiarizing of HIV/AIDS in Eurasia conducted trade, although in recent years participants with assessment an HIV/AIDS Case Management the virus has increasingly spread tools, service plans, release training course in the Estonian to young people in particular forms, the patient bill of rights, capital of Tallinn June 20-22. through unprotected sex. and other key documents commonly used in case manage- A group of 25 clinicians, allied Nearly half of all new HIV cases ment, Brandt explains. They also care and support professionals, reported in 2006 were among learned about the 21 core duties and representatives of HIV/AIDS people under the age of 25. of case managers. “Our initial service organizations from Women accounted for 36 percent discussions revealed participants Tallinn, Kohtla-Jarve, Narva, of all new infections that same currently perform only five of Parnu, and Tartu attended the year, indicating that mother-to- those, which indicates that three-day workshop. child transmission of the virus is implementing a case manage- also likely to rise. ment system for HIV/AIDS care is Developed at the request of a very new endeavor for every- WHO’s Country Office in Estonia Based on case management one involved,” she points out. — and in close collaboration with training courses conducted in Estonia’s Ministry of Social Affairs Russia and other countries in the “It appears that all of the key Department of Public Health and region, the Tallinn workshop stakeholders in Estonia agree the National Institute for Health focused on introducing the there is a need and that they Development — the training participants to the concept of view case management from the marked an important step toward case management, stressing its appropriate vantage point of improving both access to and utility for ensuring that people increasing the quality of care and Interactive discussions and group quality of HIV and AIDS-related living with HIV have access to a improving access to care for activities allowed participants to care and support in this Baltic comprehensive, integrated those people who are most diffi- learn what their contemporaries nation of 1.3 million inhabitants. network of clinical care and cult to serve,” Brandt concludes. are doing to improve care and social support services. “The goal is to train the HIV support for people living with HIV. The latest government statistics service and healthcare provider At the same time, they were given indicate that Estonia is home to Case management expert and communities to effectively coor- tools and materials that will assist nearly 5,800 people living with long-time AIHA consultant Linda dinate care. This training laid a them as they work to implement HIV, but the actual number is Brandt, former executive director firm foundation for this to occur case management strategies in projected to be higher. Similar to of the Rural AIDS Action Network in all five cities represented at their own communities. most countries in Eastern Europe, in St. Paul, Minnesota, conducted the workshop.” Estonia’s HIV/AIDS epidemic has the training. Page 4 Connections

AIHA and ATEC-St. Petersburg Conduct Training Workshop for Medical Faculty from Eastern Europe, Central Asia Specialists from the Saint retroviral therapy (ART) for adult burg and several other Russian Petersburg Medical Academy of and adolescent patients. regions. Workshop participants Postgraduate Studies (MAPS) discussed possible ways of recently conducted a training-of- Participants also studied adult integrating updated HIV curricula Workshop participants trainers workshop for 14 medical learning techniques and enhanced at their own institutions, using the discussed possible ways educators from four Eurasian their communication and interac- MAPS experience as a springboard. of integrating updated nations at the AIDS Training and tive teaching skills during the HIV curricula at Education Center May 21-25. five-day workshop. Through the Knowledge Hub, AIHA procured substantial funding for their own institutions, Faculty teams from undergraduate The ART curriculum that served as direct participant costs from using the MAPS and postgraduate medical schools the basis of the training was WHO/Belarus, WHO/Moldova, experience as a in Belarus, , Moldova, developed by AIHA and the Kyiv- WHO/Uzbekistan, and GTZ, thus springboard. and Uzbekistan gathered in St. based Regional Knowledge Hub for significantly leveraging donor Petersburg to update their the Care and Treatment of HIV/ resources and increasing long- knowledge of the latest evidence- AIDS in Eurasia. It has since been term credibility of the project’s based trends in HIV and AIDS- certified by MAPS and integrated results throughout the region. related treatment and care, into the postgraduate medical particularly the provision of anti- education systems of St. Peters-

Leading by Example, Minister of Health and US Ambassador Seek to Increase Voluntary Blood Donations in Moldova In celebration of World Blood Minister Ababii and Ambassador be done to further improve the Donor Day, Moldovan Minister Kirby kicked off the conference safety of the country’s blood of Health Ion Ababii and US and scientific experts included supply. Ambassador to Moldova Michael NBTC Director Larisa Catrinici D. Kirby donated blood at a and Moldova’s Chief Specialist on Giving blood is a safe process for mobile blood drive outside Hematology and Transfusions Ion donors in Moldova because all Chisinau’s Nicolae Testemiţanu Corcimaru. Presentations were related supplies are used only State University of Medicine and also made by a specialist from once then disposed of in accor- Pharmacy on June 14. the American Association of dance with universal precautions. Blood Banks, NBTC’s quality man- Moldova also tests 100 percent of With local media snapping photos ager, USAID PHHP chief of party, its blood supply for HIV, Hepatitis US Ambassador to Moldova Michael and rolling video, the pair set an and AIHA’s blood safety team B and C, and Syphilis. Attracting D. Kirby (above left and in the example that was followed by 32 leader. donors who are at low risk for photo below) and Moldovan participants who had just blood-borne infections is another attended a one-day conference Access to safe blood and blood important element of the Minister of Health Ion Ababii were conducted by Moldova’s Ministry products is crucial to any nation’s country’s strategy to ensure the the first to donate at a public blood of Health and the National Blood healthcare system and to the safety of its supply of blood and drive following the conference. Transfusion Center (NBTC) with welfare of all citizens who need blood products. Their example prompted 32 support from the American life-saving transfusions and other conference participants and some people through USAID’s related services. Through the PHHP, USAID is 200 private citizens to voluntarily Preventing HIV and Hepatitis B supporting Moldova’s efforts to donate blood during the event. and C Project (PHHP). Another Global research has shown that establish a blood safety program 200 people donated blood later the prevalence of blood-borne in keeping with international that day at an NBTC blood drive. infections is lowest among quality standards by providing individuals who donate blood technical assistance and targeted Attended by more than 200 voluntarily and for altruistic training. To this end, PHHP’s representatives of the healthcare purposes. blood safety team conducted a community, NGOs, local donor recruitment seminar June government agencies, patient Through Moldova’s National 8-10 that was attended by blood associations, and international Program for Blood Transfusion service professionals representing donor groups, the conference Safety, voluntary and non- all of Moldova’s districts. Topics marked the culmination of two remunerated blood donations covered included recruitment weeks of activities and events have increased from zero percent techniques and building commu- designed to increase voluntary of all donations in 2004 to 18 nity partnerships to increase blood donation in Moldova. percent in 2006. Still more must voluntary donations. Volume XI, Issue 3 Page 5

AIHA Partner Harutiun Kushkyan Appointed Minister of Health of Armenia Harutiun Kushkyan, general took over as the lead US partner ships in Armenia and the rest of director of Yerevan’s Erebuni with Beth Israel continuing to the region. Medical Center and one of AIHA’s provide technical assistance on first partners in the Caucasus, women’s reproductive health. Other priorities include establish- was appointed Minister of Health ing model clinical centers for of Armenia in June 2007. A strong proponent of the cancer diagnosis and treatment partnership model, many of and primary care and prevention; Kushkyan was a driving force Kushkyan’s priority health system developing new evidence-based behind AIHA’s partnership linking development targets for the next clinical protocols that will be Erebuni with Boston’s Beth Israel five years — including expanding introduced throughout the coun- Hospital. Established in 1993, the nursing services and launching a try; and strengthening emergency partnership focused primarily on magnet program similar to the medical services by upgrading improving women’s healthcare one piloted at Erebuni in 2001 facilities and improving training services, neonatal care, and through AIHA’s Nursing Quality programs for first-responders and Harutiun Kushkyan, MD, PhD. nursing care and education. In Improvement Initiative — mirror urgent care professionals. April 1995, UCLA Medical Center key focus areas of AIHA partner-

Knowledge Hub, ATEC-St. Petersburg Spearhead Efforts to Build HIV/AIDS Treatment and Care Capacity in Belarus AIHA, the Regional Knowledge represented the Belorussian Pain assessment — including how Hub for the Care and Treatment cities of Gomel, Minsk, Pinsk, to determine both type and of HIV/AIDS in Eurasia, and the Svetlogorsk, and Zhlobin. severity of a patient’s suffering — AIDS Training and Education was one area that most partici- Center (ATEC) in St. Petersburg The training gave an overview of pants struggled with, according are working together to train palliative care and explored to Levetown. As a result, she healthcare professionals, social topics such as HIV stigma and spent additional time explaining workers, and lay counselors in discrimination, psycho-social pain assessment tools and Belarus how to provide compre- support for people living with describing the correlation hensive treatment, care, and HIV, patient counseling, spiritual between specific types of pain support services to people living care, home-based care, and and associated treatments prior with HIV or AIDS. effective communication. Other to embarking on the clinical subjects covered were pain and portion of the training course. A group of social workers discuss To date, five training courses symptom management, palliative effective ways to promote patient have been conducted in Belarus care for children, bereavement “The site visits are critically adherence during an Advanced ART by Knowledge Hub experts thanks counseling, and the importance important because they give for Adults training conducted in to a USAID grant to WHO-Europe. of the multidisciplinary team participants an opportunity to Minsk last April. Two courses, Initiation of ART for approach to HIV/AIDS care. interact directly with patients Adults in Correctional Settings and put what they have learned and Initiation of ART for Adults, “Virtually everyone in the group into practice,” Levetown were conducted in late 2006. recognized the value of the team explains. Clinical mentoring courses were approach to care and seemed to conducted in Minsk and Gomel in listen openly to the input of One participant, a member of an January, and an Advanced Adult participants from different NGO for people living with HIV, ART and Opportunistic Infections professions,” says palliative care made a case for ongoing training, Management course was held in educator Marcia Levetown, who saying, “The classroom sessions Minsk April 23-27. served as one of the trainers. and site visits gave me a more complete understanding of pallia- Most recently, a sixth training Through a combination of tive care, as well as just how was conducted on Palliative Care lectures, small group discussions, complicated HIV care is. I hope Participants and trainers work for People Living with HIV/AIDS and practical exercises, faculty with more trainings, peer coun- together during the palliative at ATEC-St. Petersburg. This were able to ascertain the selors can become an important care training held May 21-25 at workshop was attended by 18 strengths and weaknesses of and respected part of HIV/AIDS ATEC- St. Petersburg. clinicians, social work volunteers, participants and tailor sessions care teams in Belarus.” and HIV activists. Participants accordingly. Page 6 Connections

Philanthropist Daniel E. Meehan Honored for Contributions to Georgia’s Primary Healthcare Reform Efforts The Republic of Georgia Thompson and Mtskheta partner retraining, and continuing educa- presented Daniel E. Meehan with Ketevan Loria presented the tion courses in family medicine the Order of Honor in recognition award in Milwaukee June 22. for physicians and nurses of his contributions to primary throughout Georgia. Classroom healthcare reform efforts in the Opened in October 2003, the sessions are reinforced with Caucasus nation of 4.6 million. Family Medicine Clinic provides a skills-based practical training in broad range of primary care, the clinic. As president of the Meehan dental, and specialty services, Family Foundation, Mr. Meehan including diagnosis and treatment The Regional Training Center is supported the work of AIHA’s of TB, cancer, blood disorders, accredited by Georgia’s Ministry Mtskheta-Mtianeti/Milwaukee and mental and behavioral condi- of Labor, Health, and Social Laurie Lukaszewicz, Daniel E. partnership, donating funds to tions. The clinic also piloted a Affairs, and recognized by the Meehan, Dr. Ketevan Loria, build the Mtskheta District Family community-based hypertension Georgian National Postgraduate and Dr. Shulva Bratchuli pose Medicine Clinic and Regional control program that is slated for Medical Academy, the World for a photo following the award Training Center. national dissemination. Bank, Europe Aid, and other ceremony in Milwaukee June 22. international donor agencies. Former US Secretary of Health The Regional Training Center and Human Services Tommy G. provides graduate-level training,

LRC Distance Learning Courses Teach Healthcare Professionals About Evidence-based Medical Practices In 2004, AIHA introduced an Participants are also familiarized practices at their institution. The e-mail-based distance learning with key tools and resources that course also allows participants to course to help both current and will help them to introduce discuss clinical concerns with graduated partners — along with evidence-based medicine into colleagues from other countries. any other healthcare profession- their own daily practice, explains als who are interested in the Ibraghimova, who developed the Promoting evidence-based topic — learn more about course and related materials clinical practices has long been a evidence-based medicine. Since based on a format and delivery key component of AIHA’s strategy then, staff have conducted a system created by Andrew Booth to improve patient outcomes in total of seven courses, four in at the University of Sheffield’s partner communities around the Russian and three in English. School of Health and Related globe. Evidence-based medicine Research. supports both immediate and Three course participants from Titled “Introduction to Evidence- long-term improvements in care Tashkent Medical Academy based Practice,” these courses Practice Standard Reviews are at individual, institutional, and display the certificates they were have attracted more than 260 one way to integrate evidence- systemic levels. It also helps awarded for completing the healthcare professionals from 12 based medicine into clinical care, ensure the best possible patient distance learning class on countries in Eastern Europe and Ibraghimova says. The course outcomes and the most rational evidence-based clinical practice. five in Africa. Of that number, 55 provides step-by-step guidance use of medications and other participants have submitted through the process of examining resources. completed e-portfolios with all a current medical protocol to course activities. determine if the practice not Through AIHA’s network of some only ensures the best possible 150 Learning Resource Centers “The course is designed to patient outcomes, but also make (LRCs) in Central and Eastern introduce participants to the sense from a cost perspective. Europe and Eurasia, more than basics of evidence-based 70,000 healthcare practitioners practice in healthcare,” says Participants learn how to working at partner institutions AIHA Information and Medical formulate answerable clinical have access to information and Resources Coordinator Irina questions and identify the best communications technologies Ibraghimova. sources of evidence for each type that put a wealth of clinical of question, as well as a research at their fingertips. Through the online course, corresponding search strategy. Another 30,000 researchers, healthcare providers, medical They also learn how to critically students, clinicians, and patients librarians, and other allied appraise resources and identify use the LRCs’ services or attend professionals learn the principles methods that will best help them classes conducted by information of evidence-based medicine. introduce new, evidence-based coordinators and staff. Volume XI, Issue 3 Page 7

St. Petersburg Seminar Focuses on Educating Primary Care Providers About HIV, Increasing Tolerance for PLWH Through the HIV/AIDS Treatment, planned and was facilitated by stand their own possible fears, Care, and Support (TCS) Project a team of three instructors — a prejudices, and negative atti- in Russia, AIHA conducted a physician, a psychologist, and a tudes related to HIV and people training seminar designed to nurse — who were trained during living with the virus. provide primary care practitio- the first phase of the TCS ners in St. Petersburg with an Project. Specific topics covered by the overview of HIV epidemiology and training include effective ways of treatment while at the same These HIV education and communicating with patients, time helping build tolerance for tolerance building seminars have how to diagnose and treat people living with HIV and AIDS. three main goals: to increase common opportunistic infections, practitioner knowledge about how to recognize substance Held April 11-13, the three-day HIV, including the basics of abuse and addiction problems, event brought together 21 treatment and prevention; to and the basics of infection During sessions on communicating general practitioners and nurses strengthen HIV-related treatment control and prevention. with patients, participants learn who work at polyclinics in St. and care skills among infectious how to broach sensitive subjects, Petersburg’s Frunzensky District. disease specialists, nurses, and Additional seminars are planned It was the first in a series of other providers of primary care; for the fall in Orenburg and St. including condom use. district-based training events and to help caregivers under- Petersburg.

Orenburg/New York City Partners Conduct HIV-TB Clinical Course in Orenburg AIHA and its partnership linking Kutval and Adherence Counselor possibility to test patients of TB the Orenburg Oblast AIDS Center Carol Cardenas — were in clinics for HIV onsite. Instead, in Russia with Elmhurst Hospital Orenburg at the time of the patients are shuffled from one Center in New York City workshop and facilitated a specialty care facility to another conducted a regional training on session on treatment adherence. and many are lost in the process. HIV and Tuberculosis co-infection June 25-29 at the Orenburg The workshop’s format included Lack of rapid testing supplies for Oblast TB Dispensary. both scientific lectures and both HIV and TB also hamper clinical training at the TB effective treatment. TB special- Some 25 HIV and TB specialists Dispensary’s 60-bed HIV-TB unit. ists are themselves at risk of from Orenburg, Gai, Orsk, and infection because they currently Novotroitsk attended the event, Participants had the opportunity use surgical masks for routine which focused on the clinical to conduct clinical examinations work with patients rather than aspects of managing patients of patients under the supervision the internationally recommended infected with both HIV and TB. of US and Russian faculty and respirators that offer more This was the first training event later share their findings with protection. in the region to bring together others during interactive case clinicians from both disciplines. study discussions.

US partner George Alonso, head Key challenges to providing care of Mount Sinai School of for individuals co-infected with Medicine’s Infection Control HIV and TB were discussed during Department, served as faculty for the event. Lack of coordination the course along with specialists at both regional and federal from the Orenburg Oblast TB levels, along with discrepancies Dispensary, Orenburg Oblast in referral recommendations and Medical Academy, and Botkin record-keeping, were cited by Hospital in St. Petersburg. participants and trainers alike.

Another barrier described by Two other Elmhurst partners — TB and HIV specialists from Orenburg Oblast attend a Russian specialists is the limited Clinical Pharmacologist Ranja lecture during the June training. The American International Health Alliance Creating Vision, Strengthening Systems, and Making a Difference Through Volunteer-based Partnerships and Initiatives

AIHA, its partnerships, and programs represent one of the US American International Health Alliance healthcare sector’s most coordinated responses to a broad range of issues affecting global health. Our programs contribute to 1250 Eye Street, NW sustainable change by providing the broad-based management Suite 350 and programmatic support necessary to help donor institutions Washington, DC 20005 USA and health systems coordinate other forms of government or Phone: 202.789.1136 privately-sponsored development assistance. Fax: 202.789.1277 www.aiha.com AIHA operates under various cooperative agreements and grants from US and international donor agencies including the United The information contained in this newsletter is States Agency for International Development (USAID); the US made possible by the generous support of the Department of Health and Human Services, Health Resources and American people through the United States Services Administration (HRSA); the World Health Organization Agency for International Development and the (WHO); the Global Fund to Fight AIDS, Tuberculosis and Malaria; President’s Emergency Fund for AIDS Relief. The contents are the responsibility of AIHA and do not and the German Society for Technical Cooperation (GTZ). necessarily reflect the views of the United States Government or any other funders. For more information about AIHA, please visit us on the Web at www.aiha.com

St. Petersburg/New Haven Partners Conduct Exchange, Focus on Scaling Up Treatment and Caregiver Training AIHA partners at Yale University Implementation of a similar working with injecting drug users School of Medicine traveled to mentoring program for newly and palliative care for people Russia May 15-26 to review the trained infectious disease spe- living with HIV or AIDS for progress made through their cialists in St. Petersburg was practicing nurses. twinning alliance with colleagues discussed, with both the AIDS at the St. Petersburg AIDS Control Center and Botkin Hospital slated In a related session conducted at Center and to chart a course for to serve as clinical sites. the request of faculty at the future efforts to improve and Pavlov Medical Academy, one expand HIV-related care and Partners also discussed the Yale partner provided a lecture support services. possibility of initiating an ART on the structure of nursing adherence program at the AIDS schools in the United States and US partners provided onsite Center. Yale partners provided the role of nurses in the public mentoring for their counterparts, extensive information on the health system. Both faculty and shadowing St. Petersburg roles of various adherence team nursing school students attended. physicians as they consulted with members, along with models for patients and conducted physical implementing and monitoring the Future exchanges will focus on exams in both inpatient and effectiveness of such a program. scaling up ART and other HIV care ambulatory settings at the AIDS As a result, partners decided to and support services at the Center and Botkin Hospital. More collaborate on the development district level through practitioner than 30 patients were examined of a unified approach to training and other capacity by the partners, offering a varied designing an ART adherence building activities. cross section by which to assess program for use throughout St. improvements as well as areas Petersburg. During the recent for expanded training. exchange, Yale partners To that end, partners suggested The US partners also presented creating a working group to shared some of the AIHA and AIDS Center staff with develop local guidelines that strategies they use to the mentor’s assessment tool will include descriptions of improve the adherence used to evaluate the clinical skills implementation strategies and of patients undergoing of physicians and nurses newly effectiveness assessments. antiretroviral therapy. trained in the provision of anti- retroviral therapy (ART) at Yale US partners also conducted University School of Medicine. clinical training on topics such as