Global Health

Global Communities Capacity in Preventing, Mitigating and Responding to Outbreaks of Infectious Disease

Global Communities has extensive experience responding to public health emergencies during the course of development and humanitarian assistance programming.  Our programs strengthen access to water and sanitation while promoting healthy behavior change and linkages to local primary healthcare networks to prevent and mitigate infectious disease transmission. We work with communities, local and national government agencies and other development partners to combat infectious diseases including Ebola, cholera, HIV/AIDS, malaria and Zika.  We also provide critical hygiene support in ongoing humanitarian emergencies in Syria and Yemen. Our efforts leverage strong collaborative relationships with communities and their leaders where we work to encourage positive, healthy behaviors and support local and national governments to coordinate and roll out locally-led responses.

Current Response to COVID-19

As of March 2020, multiple Global Communities projects are currently exploring options for pivoting activities in response to the COVID-19 pandemic.  In Rwanda, our USAID/PEPFAR funded Improved Services for Vulnerable Populations (ISVP) program (2015 – 2020) has a project goal of assisting 50,000 vulnerable households to reduce economic vulnerability by empowering parents to make investments that meet the unique needs of their families, particularly young children and adolescents.  The project’s regular activities include a combination of interventions such as health and hygiene promotion, creation of clinical-community linkages, and economic strengthening in ways that the Government of Rwanda and local communities can sustain over time. In response to the COVID-19 crisis, the ISVP team has submitted a concept note to USAID, detailing how it can utilize its current structure to provide technical response to this pandemic through messaging and provision of handwashing facilities to communities and business centers, as well as linkages to care for suspected COVID-19 cases.  Proposed COVID-19 activities include provision of handwashing facilities and personal protective equipment (PPE), dissemination of prevention messages, and supporting and training local emergency response teams.

In Sri Lanka, USAID’s Social Cohesion and Reconciliation Activity (SCORE):the USAID-funded Social Cohesion and Reconciliation Activity (SCORE) program (2018-2021) is working to advance social cohesion and reconciliation, reduce socio-economic disparities and enhance community resilience, in part through its support to local community-led platforms, as well as multiple local partner organizations. The SCORE team has proposed to the US mission in Sri Lanka ways that SCORE sub-grantee organizations, in collaboration with government health authorities, can work to protect communities from COVID-19.  Activities proposed include addressing the urgent needs of  hospitals, health facilities and health workers for personal protective equipment (PPE), disinfectant equipment, setting up isolation units and other items, and  social messaging to raise awareness in targeted populations about how the virus is transmitted and simple measures that they can take to slow and stop new infections.

In Honduras, Global Communities is a Principal Recipient of the Global Fund combined HIV/TB program Moving the HIV and TB Responses toward 90-90-90 and Sustainability with a Focus on Key and Vulnerable Populations, a sub-award for TB to the Ministry of Health, to focus on prevention and improved access to testing and services, and Integrated Strategy for Malaria Elimination aiming to achieve zero registered indigenous malaria cases by December 2020. The program focuses on women and children under five; indigenous peoples, Afro-Hondurans (Garífuna); and migrants and other mobile populations. The Global Fund malaria program is pivoting to support the procurement of medical supplies and equipment to support the COVID19 response in Honduras.

Global Communities’ Watershed Management Program (2017-2020) generates investments and improves management of river micro-basins in the Dry Corridor, and is now working with the Honduran government’s INVEST-H mechanism to support the purchase of agricultural inputs to strengthen the productive capacities of  farms, and support food biosafety, including safe transport of goods from the countryside to the main cities in western Honduras.

Global Communities Capacity in Responding to Health Emergencies

Ebola Response in Liberia

Global Communities’ close relationship with Community Health Workers, Environmental Health Technicians, USAID, and the communities we work with allowed us to quickly respond and refocus USAID-funded WASH activities in March 2014. Our IWASH program began to use its network of communities and their Natural Leaders to mount effective public awareness campaigns about the virus, complemented by the delivery of PPE, soap and disinfectants to clinics and hospitals, and to train clinic staff and environmental health technicians to prevent transmission. After the initial outbreak, GC’s Ebola response included significant community engagement to counter Ebola denial and promote safe health behaviors, to support contact tracing and to active case search to identify potential Ebola patients, and nationwide provision of safe and dignified burials to reduce the risk of community transmission from contact with the deceased.

Global Communities took a comprehensive approach to Ebola programming by coupling infrastructure development, community mobilization and behavior change communications to improve sanitation and hygiene practices. An adapted Community Led Total Sanitation (CLTS) methodology reduced open defecation and helped build local health system capacity to monitor communities to confirm ODF progress. This CLTS+ approach introduced an “Essential WASH Package” that leverages demand for safe water, improved sanitation and healthy hygiene developed through standard CLTS with support to WASH goods and services supply and strengthened local government capacity to manage WASH infrastructure and services.

The Assisting Liberians with Education to Reduce Transmission (ALERT), a $32.1 million, OFDA-funded program, provided awareness to communities on safe and hygienic methods to reduce the risk of exposure to and contraction of Ebola. Working with International Rescue Committee, Liberian Red Cross and other Liberian partners, Global Communities provided burial team support in all 15 counties of Liberia and helped establish a safe burial site for Ebola victims. The program targeted residents in rural border communities to create and maintain border surveillance checkpoints. From 2014-2016, ALERT facilitated safe and dignified burials for over 7,500 deceased persons, with an average of 96% of bodies buried within one day of notification of death.  This rapid communications network to safely and quickly bury Ebola victims was critical in stemming further transmission.  Global Communities engaged over 1,500 communities in outreach activities to improve health action planning, trained contact tracers and active case searchers, and mobilized 72 burial teams and 57 disinfection teams at the height of the outbreak.

In 2016, Global Communities participated in the Epidemic Preparedness and Response Consortium which worked to ensure continued ability of communities to respond to an outbreak of Ebola by providing training and support to 3,832 Community Health Workers.

Honduras Zika Response

From September 2016 through September 2019, Global Communities worked with the Government of Honduras’ Ministry of Health to mobilize a rapid response to the mosquito-borne Zika. Global Communities’ strategy centered on best practices from its Ebola response in Liberia, namely on community meeting and dialogue sessions (CMDS), which engaged local leadership and community members in the active prevention of Zika transmission.  Nuestra Salud targeted poor and dense urban areas in six of the hardest Zika-hit municipalities in Honduras. To ensure the program’s effectiveness and sustainability, Global Communities applied both its in-country proficiency in vector-borne diseases and its international expertise in leading community-driven responses to public health emergencies. This expertise was coupled with Global Communities’ partners’ expertise in behavior change communication. Moreover, by focusing efforts on the two largest and most populous urban centers and their surrounding municipalities, Nuestra Salud interventions – coupled with a mass media campaign – were targeted to reach more than half of the country’s most at-risk communities.

Ghana Cholera Response

Tapped to lead coordination for USAID-funded projects and affiliated NGOs to respond to Ghana’s rapidly expanding cholera outbreak in 2014, Global Communities convened over a dozen international NGOs in less than 48 hours to assess needs and determine response activities. Using our GIS capacity, we worked with the group to map all eight affected regions to locate NGO actors and activities, and identify areas of service overlap and gaps. With this information, Global Communities, through USAID and with the support of the Ministry of Health, launched a three-week distribution campaign to provide water purification tablets to more than 500,000 individuals in some of the hardest-hit communities. This successful coordination of NGO actors continued throughout 2015 and also included  the promotion of healthy behaviors such as handwashing to stem the spread of cholera, targeting communities that were epicenters of previous outbreaks. The current USAID-funded WASH for Health Project also responds to cholera outbreaks as needed.

Haiti Cholera Response

The 2010/2011 Cholera Prevention Initiative, under the post-earthquake OFDA-funded KATYE, promoted disease prevention in Port au Prince, Gonaives, Cap Hatien, Carrefour and Leogane. Over a critical three-week period, community mobilizers disseminated cholera awareness and prevention messages in high-risk areas. Mobilizers surveyed 24,000 households to collect data on vulnerability to cholera as determined by existing knowledge of cholera and hygiene precautions and access to sanitation.  The data was shared with stakeholders responding to the outbreak including OFDA, UNICEF, IOM and others. Global Communities leveraged support from IOM, which contributed over thirty thousand flyers with cholera prevention and hygiene messages.

Global Communities WASH Capacity in Humanitarian Emergencies

Ensuring access for vulnerable populations to clean water and adequate sanitation during emergencies is a core component of Global Communities’ humanitarian response programming. In developing countries where clean water may already be scarce, conflicts, natural disasters, and effects of climate change can devastate water and sanitation infrastructure, and reduce people’s abilities to access this key resource. Contaminated water and poor quality sanitation services can increase the prevalence of diseases and deteriorate hygiene and productivity.

Global Communities designs emergency WASH programs to provide immediate access to clean water and sanitation facilities, while improving hygiene practices and laying the groundwork for longer-term, sustainable WASH solutions. GC WASH programming adheres to internationally recognized standards and best practices, ensuring that services are provided in line with the Do No Harm framework, Sphere standards, and humanitarian principles, while ensuring  that services are of the highest quality. 

Programming is designed to address the specific needs of the most vulnerable populations who cannot afford, or physically do not have access to, water or basic hygiene items. We support particularly vulnerable individuals, such as the elderly, disabled, pregnant women, and new mothers, with customized interventions and support, such as provision of hygiene items designed specifically for new mothers and their infant children.

Global Communities also rehabilitates or repairs water supply and sanitation systems, and trains beneficiaries in their use, maintenance and oversight.  We deliver important WASH information – such as proper handwashing methods – through simple, context appropriate, picture-based hygiene promotion messaging.

Syria

Global Communities has been implementing WASH programming in Syria since 2016, with support from OFDA and UNOCHA. Our work has focused on the provision of basic WASH services to a large cluster of formal camps in northwest Syria, reaching 153,000 individuals with water system maintenance, sanitation services, and water trucking. Every day we provide 3.6 million liters of potable water to camp residents, via trucking and through water networks, which is the equivalent to 25 liters of potable water per person per day. 

Our programs have also improved hygiene practices in the camp through the distribution of 43,639 hygiene kits, and 500 community waste bins. Electronic vouchers have enabled nearly 14,000 families to purchase critically -needed hygiene goods.

As part of our commitment to implementing sustainable, longer-term WASH solutions, our programs consistently include rehabilitation activities, which target water and sanitation assets. Within the camp, we have constructed a sewage system benefitting approximately 50,000 camp residents, and have further provided 275 private latrines. Outside of camps, we have rehabilitated five water supply systems, five water stations, and 12 sanitation networks benefitting and strengthening 59 conflict-affected communities.

Yemen

Global Communities has been responding to the crisis in Yemen with WASH services and programming since 2009 with OFDA funding. Our programs have been implemented in small rural communities, and have provided assistance to 317,408 people in need. Our programs have rehabilitated public water supply infrastructure, including 29 rural community water points; sanitation facilities in five schools, benefiting 5,729 students; four water points and two water reservoirs.

To support health and hygiene outcomes, our teams have trained 461 hygiene promoters to provide WASH messaging to 14,100 beneficiaries. We also distributed hygiene kits to 18,878 households, and provided hygiene awareness messaging to kit recipients, reaching 142,599 beneficiaries including 9,345 (50%) women.  We have also  trained 181 water committee members, who are entrusted to ensure that the newly rehabilitated WASH assets are effectively operated and managed, and are responsible for regular maintenance, chlorination, implementing the established cost recovery system, and water governance.

To address the risk of cholera, which is a direct result of the impact of war on WASH infrastructure, particularly water networks, our teams have distributed cholera prevention hygiene kits to 3,611 households. Our teams have also distributed hygiene kits to 4,520 households and 16 schools, reaching 9,600 students.

Ghana

Global Communities’ five-year WASH 4 Health program in Ghana accelerates sustainable improvement in water and sanitation access while improving hygiene behaviors in targeted districts to complement other USAID health investments. As of January 2020, the project had constructed 210 boreholes, 275 institutional latrines and 16,750 household latrines. Additionally, WASH for Health in Ghana has a strong hygiene behavior change component, including promotion of handwashing with soap. 

Global Communities’ Water Access, Sanitation and Hygiene for the Urban Poor (WASH-UP)  (2009-2016) improved water supply and sanitation infrastructure while promoting good hygiene behaviors. The project constructed almost 15 kilometers of water pipelines into four urban communities, with 885 household water connections, and two mechanized pipe water supply schemes. More than 40,000 people gained access to improved drinking water sources, 21,000 people gained access to improved sanitation, and more than 69,000 people accessed behavior change communication messages.

West Bank and Gaza

The Local Government and Infrastructure (LGI) program, (2010-2017) improved the quality of life for Palestinians throughout the West Bank and Gaza for both long-term development and emergency response. Water-related infrastructure under LGI included construction of a ground water tank connected to the main water supply line and water network to ensure continued access for nearly 3,000 individuals. It also  incorporated  a storm water harvesting system on the roof of a community center, collected in an existing well, with excess water piped to agricultural land. Our outreach also included  hygiene behavior change mechanisms.

South Sudan

From 2015 to 2018, the USAID-funded Promoting Resiliency through Ongoing Participatory Engagement and Learning (PROPEL) Program strengthened the social cohesion of 13 targeted communities along with capacity to direct development to improve their lives. PROPEL worked with residents to complete 37 WASH and small infrastructure projects, and improved hygiene behaviors which benefited  48,102 people. To support project sustainability, 1,000 people were trained as water-use committee members, volunteer hand-pump mechanics, sanitation and hygiene promoters, and parent-teacher association members.

Liberia

Global Communities, as a partner to IRC, implemented the $6.5 million USAID-funded program Partnership for Advancing Community-based Services (PACS) program from 2015-2019 with the goal of improved health-seeking behavior and practices and improved access to safe WASH services. GC was responsible for organizing community engagement meetings to help communities move up the sanitation ladder, encouraging local governments to enforce sanitation laws at the community level, and providing financial and technical support and supervision for the construction of hand-dug wells. In total, PACS facilitated CLTS activities in 1,490 non-open defecation free (ODF) communities in Bong, Lofa, and Nimba counties, resulting in 1,225 new ODF-verified communities, and ODF certification of 953 communities in 21 districts.

Through the USAID-funded $10 million Improved Water, Sanitation and Hygiene (IWASH) program from 2009 to 2015, Global Communities helped residents in six counties in Liberia and targeted neighborhoods in the capital Monrovia to improve their overall health through better water supply systems, sanitation facilities and hygiene practices. IWASH supported the CLTS National Technical Coordinating Unit and county- and district-level structures to adapt CLTS to the Liberian context and triggered 370 communities, 311 (84.1%) of which were verified ODF. Eighty-four teams of Natural Leaders also helped to expand CLTS to 364 Natural Leader Network members.