Physical Health North Korea Project #29023

Treat Patients with Life-Saving Hepatitis B Meds

Project Report | Jun 4, 2018
Hepatitis B Free projects continue to make headway

By Dr David Hilmers | Medical Officer

Assessing patients in the Kiribati clinic

Thank you for your generous donations and continued support of our projects. Through your generosity we have been able to expand our programs and increase the number of patients on treatment for hepatitis B (and C). We are privileged to have you as partners as we care for patients and their families in the Pacific and in Asia affected by these deadly diseases. Your support has changed lives!

Treatment begins in Kiribati

In our last report we told you about our initial trip to the island nation of Kiribati in which we trained health care professionals and identified patients to start treatment for hep B.

Since then, we are happy to report that antiviral medications have arrived in country, and the first cohort of patients have been started on therapy. Two members of Hepatitis B Free (Dr Thao Lam and Co-Director Sue Huntley) traveled again to Kiribati in May. On this trip, they continued to identify patients, trained local staff, and helped prepare and coordinate the treatment program.

As well as treating adults with chronic hep B, we have written a proposal to help fund a treatment program for pregnant women infected with hepatitis B. This is important to prevent hep B infection from mother to child at birth, one of the most common ways hep B is spread.

Our next trip is being planned for mid-July.

Plans Progressing in Papua New Guinea

As we write this update, our co-director Sue Huntley is in Papua New Guinea attending a World Health Organization summit on hepatitis. Sue had the privilege of meeting the First Lady of Papua New Guinea who has graciously agreed to be a spokeswoman for World Hepatitis Day!

We are soon hoping to start a hepatitis B treatment program in Papua New Guinea using the model of treatment and care we have used in other countries. The PNG government and our partners, whom we have worked with for several years, have shown much support for our proposals.

Clinical Work Resumes in North Korea

We are happy to report that we were able to obtain licenses from the US government and the United Nations to import necessary supplies to our hepatitis clinics in North Korea.

In June, three members of our team will be traveling to North Korea to see some of the more than 800 patients on treatment for hepatitis B. As well as visiting clinics at Pyongyang and Kaesong, we will also start work at our newest site at Hae-Ju. It will be a busy trip with long hours and lots of travel.

Thanks once again for joining us on this journey. Our job won't be done until the world is free of hepatitis B!

Patients waiting outside the clinic in Kiribati

Sue Huntley meets with the First Lady of PNG

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Mar 6, 2018
Treating Hepatitis B in the Pacific Islands (and more!)

By Carrie Lee | Project Manager Assistant

HBF & Kibibati health workers at training sessions

Hepatitis B can be treated effectively with medications. Yet every day, around 1500 people in the Asia Pacific Region die from hepatitis B and its deadly complications. In this report, we update you on what we’ve been up to fighting hepatitis B in the Asia Pacific.

KIRIBATI

We’re getting ready to treat hepatitis B patients in Kiribati, a Pacific Island nation of around 110,000 people.

In January 2018, our team members were deployed to the main referral hospital on the island of Tarawa, the capital of Kiribati. With the support of the World Health Organization (WHO), we presented lectures to the local hospital staff about the diagnosis and treatment of viral hepatitis (including ultrasound and Fibroscan), the use of lab testing, and clinical documentation.

Kiribati has one of the highest rates of hepatitis B in the world, estimated at 15% of the population. In addition, 40% of these patients are co-infected with hepatitis D, for which reliable treatment is not generally available.

During this trip, we evaluated about 80 hepatitis B patients, seeing them alongside local practitioners to allow for clinical teaching. These patient sessions are important to prepare before we start treatment. By the end of the trip, twelve patients were identified to start treatment with antiviral medications, which will arrive soon. Our team will continue to collaborate with the government and other experts around the world.

This program is the first of its kind in the Western Pacific Region. The WHO hopes it will be a model for starting similar programs in other islands. We are very encouraged by the initial success.

NORTH KOREA

We’re continuing to grow our project in North Korea (DPRK) treating hepatitis B patients. Currently, we are treating around 800 patients and monitoring nearly 1500 patients through the program, called HOPE.

Over the coming year, we'll be working to set up a new third clinic in the city of Hae-Ju to help more patients. We plan to see these patients for the first time during our trip in May-June.

This work isn’t without its challenges. Because of UN sanctions on North Korea, our scheduled trip in March to the DPRK had to be postponed. We hope logistical issues such as licenses and exemptions will be resolved so we can return in May-June. Our American volunteers have received US State Department approval to travel again, and we are one of the few NGOs still providing humanitarian aid to North Korea.

PAPUA NEW GUINEA

Chronic hepatitis B is a major issue in PNG, with a prevalence of 14%. Having worked in the Oro Province, PNG since 2013, we’re now in the early stages of developing a program to deliver hepatitis B treatment.

In February 2018, Sue Huntley (Co-Director) travelled to PNG to meet with stakeholders in Port Moresby and Popondetta, the capital of the Oro Province. Setting up a project requires detailed logistical planning, including establishing medicine procurement pathways, assessing laboratory and clinical facilities, and building relationships with partners on the ground. We are excited to provide you with more updates as this PNG project grows.

THANK YOU!

We thank all of our donors for their monetary support and encouragement. We couldn’t be doing this without you. Please feel free to write or contact us if you have suggestions or questions!

Evaluating hep B patients for treatment

Big smiles from kids in Oro, PNG!

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Dec 8, 2017
Thank you for helping us to treat 800 patients with hep B medicines in the DPRK!

By Carrie Lee | Project Manager Assistant

Patient receiving hep B medicines

Thank you for helping us bring hep B medications to the people in the Democratic Peoples’ Republic of Korea (DPRK). We are so excited to see the program continue to grow and to keep you posted on our progress!

Here's a snippet of where the project has come so far, in the words of our Co-Director Dr Alice Lee...

It has now been 12 months since we started our first cohort of patients on therapy for hepatitis B. I recall clearly the emotions of our trip last year, the expectant faces and the overwhelming relief and joy. We now have over 800 patients on treatment, and very sadly, we have lost 15 patients to the disease. Some were as young as 22. When faced with this brutal reality, the sense of urgency to expand our program becomes quite desperate.

There is now a quiet rhythm to the program, broken by bursts of energy when faced with technical challenges or with moments of happy joy. The clinics now seem to hum along, the smiles on patient’s faces, the contentment of the local physicians now familiar with the program as they finally have the empowerment to help their ailing patients. Witnessing the physical, emotional and spiritual change is something hard to describe – many are unrecognisable, a little shy about sharing how they feel, they too find it hard to explain what it is like to not be constantly suffering. They now dare to hope, to expect a different ending. At the same time, there is complete acceptance of whatever fate one is given; the calm way a diagnosis of liver cancer is received, when all we can do is say how sorry we are that we have nothing we can offer.

The delights are real: receiving our second shipment of medicines and seeing it in the storerooms, the smiles of the patients as they came to say hi, that they are feeling better, and the many new patients having heard what we are about tentatively exploring whether they too might trust us, familiar nods from waiting patients passed in the corridors of the hospitals, doctors with a sense of purpose - so many tasks to attend to. Rain and more rain, detours with streets flooded, doctors in their singlets and pants rolled up clearing the debris from the flood, I wondered if there was anything that the staff would not do.

Hepatitis B is an infection of the liver caused by the hepatitis B virus. It can't be cured, but it can be treated with life-saving antiviral medications that help people to live longer and reduce their chances of developing liver cancer and scarring.

What have we achieved so far?

1400 patients screened by physicians for hepatitis B and C
800 patients on life-saving hepatitis B treatment in the DPRK
2 treatment sites: Pyongyang (capital) and Kaesong (a rural town)
4 annual medical team trips in 2016 and 2017 to screen patients, start treatment, train physicians and monitor/evaluate the program

What next for DPRK?

Currently, our program is providing antiviral therapy for hepatitis B. We also screen all patients for hepatitis C, another blood-borne virus that causes liver disease in nearly 100 million people worldwide. So far, we've found around 50 patients infected with either hepatitis C or both hepatitis B and C. But the good news is that hepatitis C can be cured with 12-24 weeks of treatment, by a different type of antiretroviral medicines. So in the future, we hope to add hepatitis C treatment into the HOPE program.

Your support is helping people with hepatitis B to live longer and healthier lives, and on behalf of the entire team we wish to say a huge THANK YOU for making this happen! It has been an incredible journey and a privilege to share it with you!

You can also keep in the loop by checking out our website, Facebook page and Twitter @hepatitisbfree!

Patient receiving hep B meds

Dr Lee & patient on hep B treatment in Kaesong

In the clinic

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