From the Front Line in Romania to Washington, DC: Project HOPE Supporting the Refugee Crisis   

Project HOPE – CEO Rabih Torbay and Director Tom Cotton

[Music]
Marianne O’Hare: Welcome to Conversations on Health Care . This week , we welcome
Project HOPE CE O Rabih Torbay , and h is Emergency Preparedness
Director Tom Cotter , w ho ’ s on the groun d in Romania , providing
medical support for Ukr ai nian war victims a n d refuge es.

Rabih Torbay : Even if the war ends today , o ur work wil l be there for a long, long
time in terms of rebuilding the health care syst em.

Marianne O’Hare: Lori Robertson checks in from FactCheck.org . And we end with a
bright idea , improving health a n d wellbein g in everyday lives. Now ,
here a re your hosts Mark Masselli and M argaret Flinter .

M ark Masselli: As the war in Ukraine escalates before our eyes so does the scope of
the unfolding humanitarian crisis. M illions of ref ugees are fleeing in to
neig h bo ring countries , while a id agencies are flocking into the region.
O ne such agency is Project HOPE , which has brought aid to disaster
areas for more than 60 years . T oday , we are joined by its President
and CEO Rabih Torbay from their headquarters in Washi n gt on DC.

Margaret Flinter: And also by Tom Cotter, Project HO PE ’ s Director of Emergency
R esponse and Preparedness. Mr . Cott er is joining us from Bucharest ,
Romania , where he is overseeing the effo rt to provide desperately
needed medical and human itarian a s si stance on the ground.
Gentlemen, we welcome you to Conversations on Health Care.

M ark Masselli: Rabih and Tom, you know this war is u nfol ding in real time for the
whole world to see, and the images are devastating . Bombed
children ’ s hospitals and matern i ty wards, entire cities being levelled ,
and millions of desperate refugees flooding in to neighboring
countries . Rabih , let ’ s start with you. Project HOPE has been
delivering medical assi stance and humanitarian aid in war zones and
disaster areas for decad e s, but the magnit ude of this crisis is being
calle d un precedented in the war zone , and in mass exodus of
refugee s. W hat are your gravest humanitarian concerns as this war
escal ates ?

Rabih Torbay : Well Mark, as you mentioned, this is something that we have n ’ t seen
ye t, not in the recent history . W e are talking over 1.5 million that have
crosse d within two weeks, in addition to probably millions of
internally displaced inside Ukraine. W e are talking about women and
children who are flee ing the conflict. T hos e a re vulnerable people ,
leaving everything behind . T he separation of the f amilies is so mething
that is of concern as well.

But also in addition to that, the health of people that are left behind
with hardly any medicines or medical supplies, in addition to tho s e
that are fleeing, is something that is of great concern. And we ar e
talking abo ut both physical health , as well as mental hea lth. T his is

Project HOPE – CEO Rabih Torbay and Director Tom Cotton

something that we are looking at. T his is something of great concern.
T his is something that we will h ave to deal w it h for a long time.

Margaret Flinter: Well Tom, you are in Romania, and that’s one of se veral countries
that has responded to taking upwards of 3 million refugees so far.
M or e people to come, and suffering from hunger, from illness and
tr auma. W hat kind of infrastructure do you have or are you trying to
e stablish to meet this overwhelming need?

Tom Cotter : This is, as Rabih said, this is a cris is that’s re latively unprece dented in
near his tory , so a lot of the systems that are abso rbing the refugees
are b ei ng built as they are being run. T his is -- you know, we like to say
this is building the airplane while it ’ s flying in the sky. And the systems
will continue to improve. R i ght now, the host countries are doing a lot
in terms of making sure that refu g ees ha ve ac cess t o existing health
care infrast ructure that th e normal popul ations of the hos t countries
have, as well as making sure that incoming refugees are being
screened for vaccines , including let ’ s not fo rget we are still very much
in the middle o f th e p andemic in various stages . And that’s still a
loo ming threat to make sure that countries like Romania, which have
been doing quite well on their COVID - 19 outbreaks , don’t experience
a surge .

Then on the mental health si de, this is a particularly di ffic u lt challenge
I think for hos t countries, especially with linguistic an d cultural
differ ences. M ental health is very much reliant on what I call the
cru cible of culture, and there is no getting around it . I f you are trying
to help someone through a cri s is , yo u need to really be able to
connect with them at a very human level , a nd those of us who have
work ed in the field really understand that. With language difficult y
and folks not speaking langua ge fluently, that can be a challenge. So ,
the ways around this are fi nd ing local resources and engaging
refugees themselves who are able to be hi red and can work within
this infrastructure, to help and adjust and surge to meet the needs of
p eople coming.

M ark Masselli: Project HOPE has a no reg ret app roach t o di ving headlon g into crisis.
Y ou sa y there is a critical window when lives are at stake and the
im pact could be the greatest. So you jump in the fi re, yo u adapt as
you go. T ell us abou t that approach and how it ’ s been formed.

Rabih Torbay : You know, in medic ine , and espe ci ally for emergency responders,
there ’ s something called the golden hour. W hen an accident happens
you need t o g o in immediately . T hat’s your golden hour to save the
patient . And we are looking at it the same way. W e need to go in
when the ne eds are the h ig hest. W hen we are going into a situation
knowing what we know , but we know there are a lot of things that we
do not know much about. T aki ng a risk, taking a chan ce, knowing that
we are going to learn on the way, and it ’ s proven to be ver y ef fective.

Project HOPE – CEO Rabih Torbay and Director Tom Cotton

We ha ve got on the ground in Ukraine, as well as Romania, Moldova ,
and Poland in no time, and we started providing medicines, medical
sup plies , sending the teams in to assess the needs and addressing it.
And as Tom mentioned, one thing that is re ally critical a s well is the
culture, being culturally appropriate in terms of what we do . Learning
what works and what doesn’t work in eve ry different culture and
adapt ing , is something that we do very well , and it ’ s critical.

Margaret Flinter: Tom, I kno w that an imp or tant element of what you are doing is
coordinatin g w ith the other aid agencies that are on site. W e are
seeing Doctors Without Borders, UNICEF, the World Food Program.
You have got a particular , in Project HOPE, focus on supporting the
medic al infrastruc tu re . I am sure you have played this out in other
areas of response before this coordination of your unique
contributions. H ow is that going? M aybe tell us a little bit about that.

Tom Cotter : Well, it is a bit different in every disaster. A nd I think the sc al e and
scope of this are really pushing the limit s of how we appr oach the
actual management of a response at this scale. T his is f our - five
countries, and then if you look at refug ees that are coming and then
moving on towards other places i n Western Eur op e, the scale is really
hard to even define at this point t his early on. S o , coordinating is
really important. I t happens at a local level , it happens at a nationa l
level, and it happens at an international level. And making sure t hat
we are tapped into e xi sting in fra structure , I think that ’s really
important.

W e don’t want to take a system and create a par allel siloed system to
[inaudible 00:06:41 ] something that already exists. Y ou know, part of
what we are doing is helping ho st government surge to meet the
needs . I t ’ s not creating new clinic s , it ’ s what can we do to support
what already ex ists so that it can meet the needs. And we do that
with the host government , we do that with local partners, and who
be st to address the needs of people b ut people who share the ir
cul ture. So any way that we ca n find local partner that th en we can
support and partner with and he l p them scale, that’s the best way we
think to do a lot of our work.

T his is going to be a very long crisis , and so finding ways to get
every one at the ta ble and making sure that there are no gaps , and
there is no overlap as well. W e don’t want to waste resource s. So ,
partnering a health NGO like Project HOPE that does health, we want
to work with a food NG O, a child protection NGO , a water NGO , and
making sure that we are providing comprehensive care and nobody i s
left b ehin d.

M ark Masselli: You know, Rabih , I am interested in how you build th e supply chain
for a situation like this . And w e have seen w ith p andemics , supply
chains get disrupted , and I am wonder ing if you could just walk us

Project HOPE – CEO Rabih Torbay and Director Tom Cotton

through the pro cess from the United States over to Ukraine , and to
the other points of how this gets set up . I f i t was easy anybody could
do it, but it ’ s not . I t ’ s a very complicated and dem anding pro cess that
you have develope d.

Rabih Torbay : Supply chain is one of the most critical aspect s of any response , right?
W e can send doctors, we can send nurses , we can send experts , but if
we don’t have medicine s and medical supplies that go with them
there i s really not much they could provi de in terms of treating a
patient . And we have developed a very robust supply chain. F irst of
all, I mean donors in the US are some of the most generous people in
the wo r ld. T hey reach out wanting to support , whether by do nating
resources or funds, o r supplies, medicines, medical supplies and
equipment.

And we have different partnerships with companies, with
organization s, with corporations that alwa ys reach out to us and
donate some of the ir supplies. But also, we do some pro curement as
well in the U S and Europe. And as you said, in any emergency, the
supply chain can become a bottleneck first of all, because a lot of
supplies are going into the region , and airports and ports have limited
capacity, but also the demand is h igh and sometimes the supply cha in
is not there to meet that demand. S o , we tend to diversify in terms of
where we get some of those medicines and med ical su pplies as long
as they have the quality that we want , and they have the expiration –
the long expir ation date that we need. And we send them by air, by
sea freight, whatever we can, to the ports.

We are re lying heavily now on bu yi ng in Europe as well . Because of
the pro ximity , we can get them in there sooner. But also, we have a
lot of flights that are going in with medicines and med ical supplies
from the US . And it ’ s something that we manage very closely. W e
have a team of exper t logisticians and they are the ones that act ually
handle the cargo from the minute it’s given to us , all the way to the
deliv er y point to Tom an d his colleag ues as well.

Margaret Flinter: Well Tom, I would like to talk about th e millions of refugees who we
have seen leave Ukraine and go into other countries , and at the same
time the wh ole world has been moved by the way people i n these
countries have opened th eir homes, their hearts to bring people into
their homes , and probably not for a few days. A nd I wonder, and I
don’t know if this is outside the scope of what you do, but preparing
people who are bringing individuals into th eir homes who have been
traumatiz ed, how are you working with people on the g round to
prepare them to help the people w hom they move into their homes?

Tom Cotter : It ’ s an astoni shing thing to watch . T he outpouring of love and care
from commu nities in liter ally throwing open their doors an d receiving
people, I have never seen anything like it in my career t o this scale.

Project HOPE – CEO Rabih Torbay and Director Tom Cotton

It ’ s really encouraging and it really does matter. I t ’ s making a big
difference in integrating people fleeing violence , into new
communities . B ut as you said, there are some co nsiderations that
need to be f orefront of mind , one of w hich is folks coming with
specific needs. Y ou mentioned men tal health needs. I t ’ s a very
deli cate thing to receive someone and interact with somebody who ’ s
experien ced such acute trauma at their own home . And there is a tool
called psychological first ai d that allows yo u, a llows any layperson
who is not a psychologist or psychiatrist , to essentially validate those
fee lings that a person might have fleeing vi olence , a nd allows you to
help the m return.

N ow, most people by and large are not going to need any additional
support other than some sort of normalcy. W e find this in most
disasters. I t ’ s not that everyone needs to see a psychiatrist or
psy chologist , and these t rainees ca n help. So , rig ht now Project HOPE
is actually working with, as I said, local partners in Romania to provide
that training for psych ological first aid for volunteers working at the
b order , and the people handing out the toys and the food and the
water at the border , and also the people who are receiving refugees
in their home.

T he other thing that’s really important for folks that are receiving
refu gees is helping them navigate their he alth care system. T here was
a case where someone who had canc er showed up in a Romanian
person ’ s home , throwing up at their doors. And they need to help
them get appropriate care in the health care system in t he
neighborhoods they are in.

M ark Masselli: Rabih , I want to talk a little bi t about the scenario planning that you
a re doin g. W e just witnessed an attack close to the Polish border. I am
wondering how you are thin king about it, contemplating what
happens if th ere is other scenarios happening and how you prepare
for what we hope won ’ t be an expanding wa r, but w hat ’ s your
thoughts there?

Rabih Torbay : I mean let ’ s ho pe there is no ex pansion to this war , a nd let ’ s hope
that this war ends soon. Because even if the war ends today , our work
will be there for a long , long time in terms of rebuilding the health
care sy stem. B ut you are right on point , Mark. I mean we do work
with cont ingenc ies. T he sit uation changes every minute. A ny time
there is an incident , or there is even a r umor of an incident, we start
preparing in terms of okay if this happ ens what do we do , wha t do we
do with our team. I mean the safety for our team is paramount as
well. W e want to make sure that Tom and all of our colleagues , their
safety is our number one priority .

A nd this is where training of our local counterparts is critical , beca u se
at t he end of the day our job is not to re place the Ukraini an health

Project HOPE – CEO Rabih Torbay and Director Tom Cotton

workers that are wo rking in L viv or in Kyiv , or the Romanian health
workers . O ur job is to empower them and give them the tools that
t hey need to do the work them selves . And that helps us als o with the
contingenc ies in terms of how much are we needed be yon d sending
supplies an d suppo rting them and training them.

I mean we are looking at the team that’s in Ukraine , and with the war
raging and going further west , what do we do with our team ? W h en
do we e vacuate ? W hat happen s if the supply ro ad s also are cut off?
So, we are pulling lot of those contingenc ies in place to make sure
first of all that people c o ntinue to be able to provide medical services
even as the war rages on. W e need to make sur e that ou r team a re
safe, but also at the same time the patients that we serve are also
safe and getting the health care that they need .

I mean this is something that all the countries are working on,
whether it’s Poland or Roman i a or Moldova or Hun gary . T hey are
w or king on what happens if this escalates . A nd we are part of the
coordination mechanism with other organizations , because one
organization cannot do it alone . I mean over 1.5 million re fu gees i n
two weeks, who woul d have expected that? Yet, we pi voted . We
provided support . We’re sending additional teams . We’re sending
additional supplies to try to cope with it as much as possible .

Margaret Flinter: Well, we w atch with just awe and admiration , th e sheer bra very of
clinicians who are choosing to sta y in Ukrain e amid the bombings and
the rocket fire. W e had the honor of speaking to a clinician from a
polyclinic not long ag o , and I think we will always remember her
saying , “ We run . We hid e when we hear the alarms . W e go back to
work. W e take care of ou r patients . ” T h e commit ment is
extraordinary . B ut we know th at t hey are also running out of basic
medici nes and food and water and fuel. A re you able to actually get
supplies into Ukraine?

Tom Cotter : Believe it or not, yes, and it ’ s a pretty complex mecha nism to get
supplies into what is essentially a war zone. T her e is complexities by
the availability of drivers for example. Men 18 t o 60 can ’ t l eave the
country . So we are having to work with the government directly , the
Ukrainian government and the embass ies , an d the ho st country
government s to move things across the border . O ne of the ways that
we are preparing some of these contingencies , and one of the ways
that we are making this as flexible as possible , is by having as m any
pathway s into Ukraine as po ssibl e .

So , we don’t just get one road or one particular city, we ar e going to
cover as many as we can and find every op tion and use them because
if any particular pathway gets closed the supply chain doesn’t end.
W e still can boost up by othe rs. S o , one of ou r ke y par tnerships is
actually c hildren ’ s ho spital in Lviv . A nd we are able to partner with a

Project HOPE – CEO Rabih Torbay and Director Tom Cotton

hospital in Krakow in Polan d and move supplies from that hospital
into the other hospital in Lviv that needs them desperately . T hese
hospitals in places that aren ’ t f eeling direct impact, are receiving
patients from the other hospital s. A nd it ’ s not just the war wo unded,
it's also people who need heart transplants , it ’ s people with cancer as
I said before.

S o the supply chain is flow ing , and it always needs t o be more
because essential ly the n ormal pathway s that Ukraine gets its
medici nes have been cut off. S o , we are creating a system with as
many branches as possible to get things in countr y.

M ark Masselli: You know Rabih , Tom was talking earlier about certa in di fficulty of
providing direct culturally appropriate sup port to families . B ut one of
the force mul tipliers that have come out of the sort of COVID
pandemic if you will has been telehealth interventions . Talk to us a
little bit about how telehealth has been leveraged by your
organization , or how have you seen it scale up d uring this crisis .

Rabih Torbay : Telehealth has become a critical component of what we do . Right ?
W e le arned it in the pandemic that if you can ’ t treat people physically
you can reach t hem i n other ways. I mean the fact that we are having
this conversation on Zoom is an example of what coul d be done. A nd
we are exploring the same thing in U kraine, because certain areas we
might not be abl e to send trainers or additional docto rs and nurse s to
work with them. But as long as they have connectivity we can do it ;
we can continu e to provide either the training component or eve n
consu ltation with experts in the region, or even here in the US as long
as there is a common language .

Thi s is someth ing t hat’s bec oming more integrated into what we do
rather than an afterthought, which is what telehealth used t o be in
the past. N ow it ’ s become integrated into what we do. W h en we loo k
at options, we look at the telehe alth option as one of the critical
c ompon ent t hrough which we can provide patient care , also at the
same time we can provide adv ice and training to doctors and nurses
on the ground . A nd those are some of the solutions that we look at in
a situation like Ukraine. I mean we don’t know what roa ds ar e open
today. W e don’t know what city or town is going to hav e connectivity
today or not. And telehealth helps us reach the patients , reach the
providers without taking great ri sk and at a very reduced cost. I m ean
it ’ s much cheap er to do that than to do a nyth ing else.

So it ’ s become a component of wha t we do. And we are looking –
actually right now we ar e looking at different trainings that we can do
based on demands from doctors and nurses in Ukraine. T hey said,
“ Can you help us with this? ” And we a re lo oking at those components
t o see how we can do that from the US, or from Poland, or Roman ia,
and making sure that they still get the quality care that they need . I

Project HOPE – CEO Rabih Torbay and Director Tom Cotton

mean Margaret, you mentioned the Ukrainian doctors and nurses that
are st aying behind. I mea n we owe it to the m. T hose are heroes . T hey
are staying behind . T hey are risking their lives to save others. W e owe
that to them. W e ow e it to them to find every single solution that we
can to suppo rt them , and this is one of them definitely .

Margaret Flin ter: Well, Rabih and Tom, that is a great example of how people around
the world can help, but we want to make sure we give you an
opportunity , because every body watching this field is compelled to
help in some way volunteer , amassing medi ca l supplies . T ell the
people viewing or listening to this what ’ s the best way for people to
help in this ca use right now. W hat do you need that people in the
United States and around the country can do to he lp?

Tom Cotter : You know, Project HOPE, we are not just here for t he acute phase of
this . You know a s Rabih said, we get there, we get there soon and we
get there quickly . B ut we also recognize if the war ends right now ,
there are going to be years of work , not only in the host countri es but
also to rebuild the hea lth sy stems of Ukraine . So , every ounce of
support is absolutely needed . I t is all hands on deck for a crisis of this
size. People can visit us at www.projecthope.org , follow us on our
social media, see what we ar e up t o . Any thing anybody can do to
support is greatly needed . Thank yo u.

M ark Masselli: And Rab ih, the Project HOPE really has so many other humanitarian
cr ises that it’s also addr essing . W e are still in the pandemic. T here is
ong oing refuge e crisis in Syria an d other hotspots . Just let our
listeners know a little more about the sc ope of Project HOPE.
Obviously the tip of the spear right now is focused in on the battles
that are happening in Europe, but you also have a much b roader
agenda that you are focu sed in on as well.

Rabih Torbay : T he world didn’t stop. T he disease did not stop because of the war in
U kraine. Y ou know, people are still struggling all over the worl d. For
us at Project HOPE we are currently working in about 30 c ountries
around the world in Africa, in the Americas , in Asi a , and in Europe.
And we are focusing on differ ent thi ngs . Y ou know, infec tious disease.
I mean we are still dealing with the pandemic, as you said, glo bally,
and it ’ s still raging in certain parts of the world. S o this w ill co ntinue
to be o ne of our fo cus.

Focusing on maternal and child health . I mean the pandemic sent us
back decades when it comes to maternal morta lity and infant
morta lity . So , we are pu tting a lot of focus on that as well to make
sure that w o me n and ch ildren don’t di e un necessarily because of lack
of medicine or because of lack of vaccine or because of lack of
training. Loo king at non communicable diseases , I mean one of the
main issues that ’ s comi ng out of Ukraine is diabete s , cancer, is chronic
disease s that are not being treated. I n addition to all the hot spot that

Project HOPE – CEO Rabih Torbay and Director Tom Cotton

we are dealing with around the world, w hether that’s what ’ s going on
in Venezuela in the region, or what ’ s going on in certain parts of
Africa , in Nigeria, or in Ethiopia , the wa r in Ethiopi a as well, this is
something that we continue to work in.

And we hav e our teams all over the world that are providing those
services . And we urge everybody to go to ww w.projecthope.org , learn
more about the organ izati on, s upport us in whatever way you can. If
yo u can donate, fantastic, if not , volu nt eer. A nd if we don’t fall within
what you are interested in, v et other organizat ion s that you are
intere sted i n. The most important th ing is for you to do something,
b ecaus e the worst thing that we can do to Ukraine , and to the world
at large, is to s it back and do nothing. And thi s is what we urge
people, just do something t o help. If Project HOPE , if you lik e what we
d o, that’s fantastic. I f not, we are grateful fo r w ha tev er support you
give to other organizations as well.

Margaret Flinter: We have been speaking with Rabih Torbay, CEO of Project HOPE, and
Tom Cotter, Project HOPE ’ s Director of Emergency Respon se and
Prepare dness . Learn more about the ir effor ts in the w ar in Ukraine
and the refugee crisis by going to www.projecthope.org . Ra bih, Tom,
thank you so much for your humanitarian efforts, for your leadership in this work, and for joining us today on Conversations on Hea lth C are.

Tom Cotter : Thanks for having us .

Rabih Torbay : Thank yo u for having us.

[ Music ]

Mark Mass e lli: A t Conversations on Health Care , we wan t our audience to be truly in
the know w hen it comes to th e facts about he alth care reform and
policy. Lo ri Rob ert so n is an award - win ning journalist and Mana ging
Editor of FactCheck.org, a no npartisan, nonprofit consum er advocate
for voters that aim to red uce the level of deception in U.S. Politic s.
Lo ri, what ha ve you got for us this week?

Lori Robertson : The Cent ers f or Disease Contro l and Prevention and Pfizer tweeted in
February abou t the dangers of blood clots in veins, which are
r elatively common, and affect as many as 900 ,0 00 Amer icans each
yea r. A story shar ed on social media however, misleadingly linked
tho se pub lic health reminders to the COVID - 19 va c cines. B lood
clotting in the deep v eins , or deep vein thrombosis , is a seriou s and
relatively common medical condition . C lots that form in the legs or
pelvis can also travel to the l ungs and bl ock bloo d flow. T hat’s known
as pu lmonary embolism which is often lethal.

Up to 900,000 in the US each year are affected by these conditions ,
and as many a s 100,000 die according to the CDC. H al f of bloo d clots
occur after ho spitalization or surgery . I t also highlights th e risk o f

Project HOPE – CEO Rabih Torbay and Director Tom Cotton

being immobile for long periods of time . S ome of these factors also
can apply to athle t es who get injur ed, or who travel a lot. T he CDC
highlighted the risks in a Super Bowl themed tweet , reminding the
public that DVT can happen to anyone . Online post s h owever , have
misleadingly used the public hea lth message to suggest that the
COVID -1 9 va ccines inclu ding the two mRNA vaccines ar e a major
cause of clotting.

One COVID - 19 vaccine aut horized in the United States, the Johnson &
Johnson v accine can c ause a v ery particular blood clotting problem ,
b lood clotting combi ne d with low levels of blood platelets , but it is
extremely rare. T he condition has not been linked to either of the
mRNA vaccines which account for the vast majority of doses
administered in the U S. N o COVID - 19 va ccine appears to cause blood
clo t s generally. And mRNA va c cines have not been associated with
any kind of clot ting problem. And in fact, evidence suggests COVID - 19
vaccination preven ts blood clots by protecting against COVID - 19
whi ch raise s the ri s k of clott ing.

And t hat's my fact check for this w eek. I'm Lori Robertson , M anaging
Editor of F actCheck.org.

Margaret Flinter: FactCheck .org is committed to factual accur acy fr om the c ountry’s
major politic al players , and is a project of the Ann e nberg Pu bli c Poli cy
Ce nter at the University of P enns ylvania . If you have a fact that you
wou l d like chec k ed , email us at www.chcradio.com . We’ll have
FactCheck .org’s L ori Rob ertson check it out for you here on
Con v ersation s o n Heal th Ca re.

[Music]

Mar garet Flinter : E ach week C onversations highlights a bright idea abo ut h ow to make
wellness a part of our communities and everyday lives. Sub - Saharan
Afri ca leads the world in maternal and inf ant deaths each year . A n
est imated 397,000 babies died at birth in that region in 2013 , and
some 550 mothers die d per day as well. M os t of the causes have to do
with lack of access to m edi cal care in these lo w resource regions , and
often the local midwives lack formal medic al trainin g to prepare them
to conduct interventions in the event of a life - threatening event like a
hemorrhage or an infection.

Anna Frellsen : We know that 90% of all the dea ths that we see today could be
prevent ed if the mother had access to this really ba si c skill ed care
during the childbirth.

Mar garet Flinter : Anna Frellsen is CEO of the Maternity Foundat ion. T heir organization
has created an intervention for midwives living in low resource areas
if they just have access to a smartphone . It’ s called th e S afe De livery
App , and it provides comprehensive training for midw ives tha t teach

Project HOPE – CEO Rabih Torbay and Director Tom Cotton

them and guide them on what to do in the event of a birthing crisis.

Anna Frellsen : This is really a matter of building the skills of the health work ers who
are already out th er e , a nd empower them to be able to better h andle
the emergencies that may occur during a childbirth such as the
woman starts bleeding , or the newborn is not breathing and so forth.
So, first and foremost it ’ s a matter of finding a way that we can reach
th e heal th workers and build their skills .

Mar garet Flinter : Frellsen says the real promise of the Safe Delive ry a pplication lies in
its ability to provide on going obstetric and neonatal training so that
local midwives can gain important clinical knowledge o vertim e. T he
Safe Delivery App has been designed to be culturally relevant and
easily understood and it ’ s received the United Nations’ approval for
w ider deploy ment. A low cost , culturally sensitive mobile app that
offers immediate guidance and assistance to mi d wives a nd health
work ers , the backbone of the hea lth care system in low resource
areas, emp owering them with ongoing support and knowle dge that
can improve birth outcomes, now that’s a bright idea.

[ Music]

Mark Massel l i: You've been listening to Conv ersati ons on Health Care . I'm Mark
Massel li .

Margaret Flinter: And I'm Margaret Flinter.

Mark Masselli: Peace and health.

Marianne O’Hare: Conver sations on Health Ca re is record ed at WESU at Wesle yan
University, streaming l i ve at www.chcradi o.com , iTunes, or wherev er
yo u listen to podcasts. If you have co mments, pleas e e - ma i l us at
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he a ring from you. This show is brou ght to you by the Commun ity
Health Center.