The Hillman Medical Education Fund
What We Do
The Hillman Medical Education Fund of Rose Charities was founded by Prof. Elizabeth Hillman to support health education and to foster future leaders in medicine, particularly in East Africa. All our projects are developed and led by local researchers and project leaders. Their local knowledge of needs and resources and their skills have created small projects with very big impacts on tiny budgets
Family Planning and Safe Motherhood in Afghan Refugee Camps in Kabul.
- The mother and child mortality rates in these camps are among the highest in the world. Many girls marry as young teenagers and have one pregnancy after another. With so many children, so close together, the mothers, newborns and older children’s health and well being all suffer. The extra babies are often unplanned and become a practical and financial burden to the family, consequently, family violence, poverty and stress increase.
Challenges faced to overcome –
- Knowledge of safe-birthing, hygiene, family planning and birth spacing is very limited in the camps. In Afghan culture all decisions are made by the men, including intimate decisions directly impacting a woman’s health. Husbands also often agree with their wives that they do not want more children, but most do not know what to do about it. Some know about contraception, but have fears and misconceptions, such as it is anti-Islamic, or dangerous in some way.
- Compounding all this is a social taboo on speaking about or asking for advice on such matters.
Solution Approach –
- A simple solution was to promote the use Family Planning (FP) not just to the women but also to create a safe forum for men to learn and speak about these issues. That way the men would learn the advantages to themselves, their wives and families. They would explore the issues of planned pregnancies and wanted children. If a woman waits 2 or 3 years between babies, her body has a chance to recover, she is less likely to become seriously anemic, her baby is given adequate time to breast-feed increasing the chance of being optimally nourished and her toddler gets more maternal attention which promotes bonding and improves the child’s social and emotional development.
- We established men’s groups in 3 camps to create a space for men to talk and learn.
- We engaged with respected elders and Imam’s who then took part in the groups and shared essential facts about FP, and endorse the religious acceptance, and financial and health benefits. By enabling such discussion in this safe environment, it is clear that the men learned the facts that change their attitudes and behaviour and now freely speak about FP. More spousal dialogue now occurs and there has been an exponential increase in the number of women able to access FP, and who now report using it.
- To support this change we also worked with the women . Four local midwives trained traditional birth attendants (TBA’s); together, they run women’s ante- and post natal groups, deliver babies and provide FP information and access to related products and services. During this period no mothers or babies died, there were no cases of fistula and very few cases of other Pelvic inflammatory infections. The women reported a marked reduction in spousal violence which was in the past associated with a lack of husbands understanding of these birth complications
- To date, the number of families now using contraception has increased by 738 (well above the prediction of 300 set to define success for Grand Challenges Canada). Not only did many participants within our program begin to use FP for the first time, but “word has spread” throughout the camps resulting in other families coming forward and asking to also receive FP. This project has been very successful in our own evaluation basis.
- Nearly 3000 male and females have received different type of services as part of this project.
- We are in the process of completing a formal evaluation survey; this will provide final numbers for the beneficiaries, and allow reporting of where men’s and women’s knowledge, attitudes and behaviors changed. The sheer number of new users of FP, and clear indications that new knowledge was acquired and more women are now using FP are powerful indicators that change has occurred.
- These facts, and the evidence in all 3 refugee camps that benefits extend beyond the immediate intervention group into the broader community, strongly support the validity and benefits of our men’s group model as a way to facilitate and promote use of FP among this vulnerable population.
- From robust prior research, a positive impact from more use of FP on better birth spacing can be expected to benefit the whole family, but the probable improvement in maternal and infant mortality and morbidity expected, even from such a successful model, can only be measured over time, and will require larger rollout of our intervention.
- In 3-5 years, it is likely that measurably smaller families, a reduction in maternal anemia, longer duration of breastfeeding after birth (leading to greater post-natal weight gain), and increased maternal/infant interaction and (better social and emotional development) will be evident.
Treating Malaria in Schools in Uganda
Imagine going to school with no malaria; no blinding headaches, fever, nausea and fatigue, no days missed from school, instead of the usual 2 weeks at home sick and debilitated. This is what we have achieved in 4 primary schools in the heart of Uganda’s Malaria region. In the past between 10% -20% of children are absent from these school at any given time. Some of these children died others were permanently affected and all suffered. Now, however, thanks to the use of simple well-tested kits the children are diagnosed and treated immediately- and usually miss only a day of school. The simple solution has been to train the teachers to identify children with early symptoms, test them for malaria and treat those who tested positive. We have coupled this with a malaria awareness program embraced by the whole community with a resultant drop in transmission.
Training in Cambodia
Physiotherapy in Cambodia is gradually becoming better understood and more widely practiced. In a country with high accident rates there is a great need for rehabilitative therapy. The Hillman Fund supports the Cambodian Physical Therapy Assoc in 3 training sessions per year to upgrade professional skills of Physiotherapists This project is now being supported by Rose Charities New York.
Hillman Scholars and Leadership Awards
The Hillman Fund supports university scholarships for outstanding students, who have demonstrated leadership potential in their field. Our first scholar, Dr Vicent Okuuny, has graduated with a Masters degree in Family medicine in Makerere and has taken over the the position of head Physician at the rural Family medicine teaching facility next year. The other is a young nursing student who came top of her class in her first year and is well on her way to completing year 2 of her training. We supply funding for 3 Ugandan researchers to attend the annual East African Family Medicine Conference. We award Hillman Prizes to Medical and Paediatric Students in Kenya. We fund the health research projects of past and present Hillman Scholars. Projects including a Child Malnutrition Study and Training in Rural Uganda, and An Ebola Preparedness Training and Study Program around Kampala.
Often the role of the Hillman Fund is to provide the first funding for newly emerging leaders and projects which lack the experience and track record to apply successfully for larger grants. On occasions our Canadian volunteers assist in grant proposal writing to help these projects move ahead. we are happy to report that several wonderful small projects have flown away from us into greater and bigger success. Here are a few that no longer need us.
Frontier Primary Healthcare was supported by HMEF for several years. We provided flood relief and funds for safe motherhood programs. They are now fully funded and doing important work with refugees in the Pakistan/Afghan Borders
ETAT+ Training program in Kenya which provides skills to physicians in Emergency Triage and Treatment was funded initially by HMEF but is now fully funded and expanded into Uganda
If you share the vision of Don and Liz Hillman please support the work of the Hillman Medical Education Fund with a donation. We are all volunteers so that your donation will be spent directly on the projects in Africa or Pakistan and not be wasted on overheads.