Treat Patients with Life-Saving Hepatitis B Meds

We continue to be grateful for the efforts of those who support our cause of eradicating hepatitis. We are pleased to provide an update on our programs with some new successes to report and continued challenges in other areas.

North Korea (DPRK)

One of our team members, Sue Huntley, travelled to the DPRK in September for the scheduled quarterly visit. The treatment program continues to enrol new patients with hepatitis B, and over 1200 individuals are now receiving life-saving therapy.

A new challenge to our efforts was the US State Department’s refusal to grant exemptions to the travel ban to the DPRK for any humanitarian organization beginning in October. Thus, American members of Hepatitis B Free and our US partners were denied permission to travel to the DPRK for the scheduled November visit. We are hopeful that this ban on humanitarian aid will soon be lifted, and we ask your assistance in expressing your concern to legislators over this policy.

A scholarly paper which describes our DPRK program was published online in the journal Gut and Liver in September.

Fiji

We are pleased to announce that a national program of hepatitis B treatment is beginning. This represents the culmination of several years of hard work on the part of HBF. Two members of the team are currently in Fiji to train local providers and to support local government health officials as this program gets underway.

Kiribati

We see steady progress in the hepatitis B treatment program in Kiribati. Turnover in local medical personnel and a lack of resources always provide challenges in these remote islands. After a successful visit in August, two members of the team are travelling to Kiribati this week for training and patient care. Regular training also takes place through teleconferencing.

Papua New Guinea (PNG)

Another significant advance to report is the approval of a hepatitis B treatment program in the Oro District in PNG. Government endorsement of the project, acquisition of drugs at a discounted price, identification of supporting clinics, and laboratory support have all been achieved. As soon as an import license is approved, treatment with antivirals can begin. The first training session of local providers was accomplished by HBF last week through teleconference. We are hopeful that the drugs will arrive, and patients will start treatment during the first quarter of 2019. A team from HBF will travel to PNG to support the rollout of the program at that time.

Myanmar

Two members of the team will travel to Yangon in December to provide technical support and patient care for patients co-infected with hepatitis C and HIV. Our partners on this project Medical Action Myanmar (MAM) have done an outstanding job of providing patient care, detailed documentation, and management of medications.

FibroTouch

A welcome addition to our clinical capabilities was the provision of a FibroTouch transient elastography machine by HI SKY corporation from Beijing, China. This device is more portable and lighter than our current equipment, and, best of all, is battery operated. This will expand our capabilities to test for liver fibrosis and cirrhosis.

We are excited about the prospects for the coming year and thank each one of you for your support and encouragement!

The Hepatitis B Free Team

Photo credit: Christian Friends of Korea (2018)

Links:

• Hepatitis B Free website

Since the last project update, we've been busy working to support hep B treatment for people in the DPRK and Kiribati.

DPRK

Robyn Laube, gastroenterology trainee & medical officer for Hepatitis B Free

Almost two years since the first patients were started on hep B antiviral medicines in the DPRK, volunteer teams have been returning four times each year. During these clinics, the international and local doctors see patients together, monitoring their response to treatment and starting new patients on treatment. Now, there are three clinic sites - Pyongyang, Kaesong, and Haeju.

Since our scheduled trip in March was unable to proceed due to the political circumstances, our June trip was the first this year. It was long awaited by both the hepatitis B patients and the local doctors. Together with Christian Friends of Korea (CFK), over seven days we saw a total of 978 patients across three different cities. Our joint team consisted of Heidi, Terry, Marcia and Stone and five doctors (Alice, David, Sissel, Christine, and myself).

Our clinics in Pyongyang and Kaesong are now well established and beginning to pick up pace, and this trip marked the first time we saw patients in Haeju. Haeju is located three hours south of Pyongyang by road, a beautiful drive through rice paddies, cornfields and breath-taking mountain ranges.

The electricity for our clinic was provided by a portable generator, and the water for the hospital was sourced from a single pump previously donated by CFK. The hospital laboratory contained only basic equipment such as test tubes and pipettes. Plans are currently underway to construct a new building for the hospital, including a well-equipped laboratory.

The patients in Pyongyang and Kaesong are now more familiar and comfortable with our program. They greeted us with warmth and smiles, remarking that they were happy to see us and had been looking forward to our arrival. It was heartwarming to see their faces light up as they saw their blood tests improving, signifying the success of their antiviral therapy.

The local doctors are eager to learn and have a fantastic sense of ownership of their patients. Despite their limited resources, they do whatever they can for their patients. They enjoyed having this opportunity to ask questions and practice their English skills as well as their hepatitis knowledge. They even took time out to play a game of basketball with us outside the hospital!

Our next visit in September will mark two years since the first patients were commenced on therapy, and already we cannot wait to return!

Kiribati

Since this year, hepatitis B treatment has been made available for people in Kiribati, a Pacific Island nation home to 114,000 people. Our team members have been supporting local physicians and health workers to deliver this program via regular teleconferences and training sessions, as well as in-country visits every few months. The remote distance of places like Kiribati makes it challenging to engage in education and training, but with growing mobile and internet connectivity, technology offers a way to make this possible. In collaboration with other organisations with training experience in the Pacific, we'll be continuing to build on a curriculum for health workers and doctors in order to upskill local health professionals to manage and care for people with hepatitis B.

Recently in August, Sue Huntley travelled to Kiribati and met with health professionals and patients, hearing stories about how this treatment has impacted their lives. In places where treatment has never before been available, hepatitis B has been known and feared as the cause of 'big belly, skinny legs' - meaning that people without access to treatment developed complications of severe liver disease. However, now that treatment is available, people have been able to get back to work, support their families, and have a sense of future.

Thank you!

We are truly grateful for your support and contributions which make these projects possible. It is incredibly rewarding to see the impact of these treatments on peoples' lives and are grateful for the opportunity to share these updates with you!

If you would like to know more or get involved, we would love for you to visit our website, Facebook page, or get in contact with us directly.

Photos by Robyn Laube (DPRK) and Sue Huntley (Kiribati)

Links:

• DPRK Trip Report (June 2018)
• Facebook