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					JULY-SEPT 2003                      ...CONNECTIONS is a quarterly publication of the
                              Dreyfus Health Foundation, a division of The Rogosin Institute...
  VOL. 9, NO. 3
                                                    JACK DREYFUS
 ONNECTIONS                                CELEBRATES HIS 90 BIRTHDAY
                                           and is awarded an
                              HONORARY Ph.D. by BEN-GURION UNIVERSITY

                     Jack Dreyfus celebrated his 90 birthday on August 27, 2003! The day was marked
                  by a birthday celebration in New York City's Central Park and birthday good wishes
                  from all the PSBH® and CBH® family, as well as Jack's many friends from his lives in
                  finance, tennis, golf, bridge, horse racing, publishing, and the health professions. The
                  many greetings (well over one hundred) are now contained in a book, which Jack
                  continues to read and enjoy. The day was further marked by congratulations on
                  national television and by the release of his latest book, The Story of A Remarkable
                  Medicine, by Lantern
                  Books of New York.
                  All in all, it was an
                  incredible day of
                  celebration for a
                  remarkable, indeed
                  unique, human being!
                  Jack's ninety years
                  have been filled with
                  an incredible number
                  of personal
                  accomplishments and
                  contributions to the
                  betterment of
                  humankind through
                  his strong
                  commitment to the
                  amelioration of
                  human suffering and,
                  in particular, his forty-
                  year work to bring
                  knowledge about
                  phenytoin and its
                  broad range of
                  clinical uses to the
                  world.                                 Jack Dreyfus and Professor Avishay Braverman
                     continued on page 4

            contents   ...inside...inside...inside...inside...inside...inside...inside...

                        Jack Dreyfus............................... 1         Guyana................................... 14

                        Recent Meetings......................... 2            Indonesia................................ 15
                        Local Happenings in                                   Mexico..................................... 16
                          Brazil........................................ 6    Poland..................................... 18
                          Bulgaria.................................... 8      the United States.................... 19
                          China........................................ 10   CBH News................................. 23
                          the Dominican Republic..........              12   Up-Coming Meetings................ 24
                          El Salvador..............................13

                      ·A PSBHN Workshop was held                                   Indonesia
                        in Suprasl, August 18-22 (see                                      ®
                                                                                   ·A PSBH Follow-Up Workshop (July 12)
                            page 18 for more details).                             and a PSBHN™ Workshop (September 15-
                      ·A PSBHN™ Workshop was held                                  17) were held in Malang, East Java.
                           in Torun, September 24-26                                        ®
                                                                                   ·A PSBH Follow-Up Workshop was held in
                       (see page 18 for more details).                             Jakarta on July 19.
                                                         Jordan                    ·A PSBH® (Hospital) Follow-Up Workshop
                                                         A PSBHN™ Follow-          was held in Makassar, South Sulawesi on
                                                         Up Workshop was           September 13.
                    Nigeria                              held in Amman on          ·A PSBH Workshop was held in Surabaya,
                    A PSBH® Follow-Up                    August 16.                East Java, September 19-21.
                    Workshop (August 19)
                    and a PSBH Workshop
                    (August 20-21) were
                    held in Enugu.

                  ·A PSBHI Follow-Up

                    Workshop was held
                      in Cape Coast on
                             August 15.
                   ·A PSBH Workshop
                   was held in Kumasi,
                        September 8-9.                                                     RECENT
                  ·A PSBH® Workshop
                  was held in Kabwe,
                  August 11-13.
                          ®       ™
                  ·A PSBH /PSBHI
                  Follow-Up Workshop
                  was held in Lusaka
                  on August 16.
                  ·A PSBHI Workshop
                  was held in Mpika,
                  Northern Province,
                  September 18-21.

                  Kenya                       India
                  A PSBH® Follow-Up           ·A PSBH® Workshop was held in Loni, Maharashtra, August 4-5.
                  Workshop was held           ·A PSBH® Workshop was held in Indore, Madhya Pradesh, August 5-6.
                  in Kitale, August 22-       ·A PSBH® Workshop was held in Surat, Gujarat, August 7-8.
                  24.                         ·A PSBH® Workshop was held in Mandya, Karnataka, August 25-26.
                                              ·A PSBH® Workshop was held in Bangalore, Karnataka, August 26-27.
                                              ·A PSBH® Workshop was held in Bangalore, Karnataka, August 28-29.
                                              ·A PSBH® Workshop was held in Ahmadabad, Gujarat, September 15-16.
                                              ·A PSBH® Workshop was held in Karamsad, Gujarat, September 17-18.
                                              ·A PSBH® Workshop was held in Rajkot, Gujarat, September 17-18.
                                              ·A PSBH® Workshop was held in Kozhikode, Kerala, September 30-October 1.

            July, August, September
         PSBH® & PSBHI™ & PSBHN™
            Workshops & Meetings

                                                    The Dominican
                                                    A PSBHN Workshop
                                                    was held in Santo
                                                    Domingo on

                                                                                RECENT MEETINGS
                                                    September 19.

      MEETINGS                                Guyana
                                              A PSBH
The United States                             Workshop was
     ·A PSBH® Follow-Up                       held in West
   Workshop was held in                       Berbice, Region 5
Miami, Florida on July 19.                    on August 15.
     ·A PSBH Follow-Up
   Workshop was held in
  Houston, Texas on July                      Brazil
                       25.                    A PSBH® Workshop (Community
·A PSBH Workshop was                          Network Against AIDS) was held
       held in Clarksdale,                    in Rio de Janeiro, August 12-14
  Mississippi, September                      (see page 7 for more details).
  26-27 (see page 22 for
            more details).

       El Salvador
       ·A PSBH Workshop was held in
       Cuidad Merliot on August 15.
       ·A PSBH Workshop (held on 3
       separate days) took place in San
       Salvador on August 23, 31, and
       September 7 (see page 13 for more
       ·A PSBHI Follow-Up Workshop was
       held in San Vicente on September 20.
    continued from page 1

                                              JACK DREYFUS
         Jack's 90th birthday celebration continued with the awarding of an honorary Ph.D. by Ben-Gurion University of
       the Negev, Beersheva, Israel, on September 16, 2003. The President of Ben-Gurion University, Professor
       Avishay Braverman, came from Israel to New York City's Harvard Club for the degree ceremony, which was
       organized and hosted by the American Associates of Ben-Gurion University. The degree citation read as follows:

                                The Senate and the Executive
                                Committee of Ben-Gurion
                                University of the Negev hereby
                                resolve to honor

                                Jack Dreyfus
                                 In honor of a remarkable
                                  individual whose daring
                                   nature, originality, and
                                  intelligence secured him
                                success in all his ventures,
                                from sports to business; in                Jack Dreyfus
                                recognition of a financial
                                      wizard who threw open the doors of Wall Street,
                                    increasing the accessibility of mutual funds to small
                               investors; in deep appreciation of a philanthropist, founder
                               of the Dreyfus Medical Foundation, for over half a century
                               of efforts to advance the research and use of phenytoin, for
                              his important contribution in enhancing the understanding of
                                 depression as a physiological disease and for his role in
                                  easing the suffering of patients; and in gratitude for his
                                support of psychiatric research at Ben-Gurion University
                                  through the establishment of the Jack Dreyfus Chair in
                                Psychiatry (Unit for Phenytoin Research) with the aim of
                                 increasing the body of knowledge on the neurochemical
                                causes of depression and identifying preventive measures
                                against this affliction, so as to restore the joy of living to
                              those whom it eludes, by conferring upon him the degree of

                                          Doctor Philosophiae
                                            Honoris Causa
                                    with all the rights and privileges pertaining thereto
                                Prof. Jimmy Weinblact          Lord Weidenfeld of Chelsea
                                        Rector                      Chairman of the
                                                                  Board of Governors

                                                 Prof. Avishay Braverman

 Earlier on the day of the degree ceremony, Jack heard a series of reports on the clinical uses of phenytoin
being explored in various parts of the world. Professor R.H. Belmaker from the Department of Psychiatry at
Ben-Gurion University summarized the results of studies on phenytoin's therapeutic usefulness in mania,
bipolar disorder, unipolar depression, and schizophrenia. His colleague, Dr. Galila Agam, present holder of
the Jack Dreyfus Chair in Psychiatry at Ben-Gurion, outlined her plans to use DNA microarrays to look at the
genomic changes phenytoin induces in the brain and correlate these changes with its effects on mood
disorders. Dr. Ernest Barratt, professor and chief, Psychodiagnostic Service and Cognitive Neuroscience
Laboratory in the Department of Psychiatry and Behavioral Sciences at The University of Texas Medical
Branch at Galveston, reviewed his now decade-long work on the use of phenytoin in impulsive aggression in
prison inmates and impulsivity more generally. Dr. Matthew Stanford, formerly of the University of New
Orleans and now a professor in the Department of Psychology and Neuroscience at Baylor University in
Waco, Texas, reported on his continuing progress with the investigation of phenytoin's effects on both
explosive aggression and depression in
outpatients. Based on this work, Dr.
Stanford is now also a consultant to the
U.S. Federal Bureau of Prisons, assisting                     Harvard Club, New York City
in the development of a program to treat                           September 16, 2003
impulsive aggression within this prison
system. Both Drs. Barratt and Stanford
are now examining the mechanisms by
which phenytoin is effective and
extending the exploration of its
usefulness beyond impulsive aggression
to other disorders involving impulsivity,
including substance abuse, (especially
that of cocaine) in work Dr. Barratt is
doing with Dr. G.F. Moeller at the
University of Texas Health Science
Center, Houston, Texas. Lynda Arthur,
PSBH coordinator for Ghana, brought
Jack up to date on the use of phenytoin
in the treatment of Buruli ulcers, a project
which is now a national program being
carried out in collaboration with the                            Professor Avishay Braverman,
Ministry of Health. Finally, Dr. Smith filled                Dr. Barry H. Smith, and Jack Dreyfus
Jack in on progress in a number of other
clinical and basic research areas
including the use of phenytoin in the
treatment of burns and other skin
wounds, post-traumatic stress disorder
and protection against the harmful effects
of stress on the brain (more generally),
and spinal cord injury and multiple
sclerosis. Projects in these and other
areas are currently ongoing in the United
States, as well as other countries.
  All in all, and thanks to all of you as well
as many others, Jack's 90 (three- week)
birthday celebration was a wonderful
event capped by the award of the
honorary doctorate from Ben-Gurion.
Jack's remarkable vision, commitment,
courage, and deep humanity remain an                       Jack Dreyfus at the Degree Ceremony
inspiration and challenge to all of us.
        We look forward to
       Jack's 100 birthday!
        Submitted by Dr. Barry H. Smith
                          Director, DHF
         local happenings

                                                        ...IN BRAZIL
                                                PSBHI Projects in Vila Paciencia
                                                       Happy Kids in Vila Paciencia
            Ms. Luciana de Souza Rodriguez developed her project           hosting special events for them.
         after participating in the Vila Paciencia Initiative: Happy         A group of residents that volunteer for an organization
         Kids in Vila Paciencia. She identified the problem in her         of the Catholic Church, Pastoral of the Child, has been an
         community; that many children were idle after school              important partner for Luciana. They offer their modest
         hours, due to a lack of after-school activities. Since there      facilities for the project, some food, and help organizing
         were no recreational or cultural activities for them to           games and other activities for the children. Capacity
         participate in and keep them occupied, they spent their           building in this group of problem solvers was made
         time playing in the streets after school, exposed to serious      possible through the support of the CEDAPS follow-up
         risks, such as traffic accidents, involvement with drug-          team on educational and recreational programs.
         related criminal activities, and violence.                          One result of her project has been a noticeable
            During the workshop, she developed her project plan to         behavior change among usually aggressive kids. She has
         offer a series of different activities for registered groups of   noticed that they are generally calmer, exhibiting less
         20 children, such as drawing, collage, painting, role-            bullying behavior, and kinder to their peers. Luciana plans
         playing, reading, and other games. Also, on                       to further evaluate her project by following-up with the
         commemorative dates, such as Easter and Mother's Day,             participants' performance in school. Thanks to Luciana for
         Luciana reaches dozens more children and families by              her wonderful project helping children in Vila Paciencia!

                                                       Happy Kids in Vila Paciencia Project
                                           Reducing High Blood Pressure in Vila Paciencia
                Ms. Alexandra Mariano Batista, a Vila Paciencia Initiative participant, developed a project, Reducing High
              Blood Pressure in Vila Paciencia. As a person with high blood pressure, Alexandra was concerned that this
              might be more widespread in her community than was previously realized, either because patients were not
              aware of their condition, or because they were unable to access the health care system.
                She developed a project to detect hypertensive individuals and educate them about their condition. The City
              Department of Health in Rio de Janeiro has a good program for hypertension, but Vila Paciencia residents
              simply can't reach it. Vila Paciencia does not have health units, and walking to the nearest one can be risky, due
              to drug mafia rivalry. People are afraid to go, and many times they go and are not even seen by health
                                                                                              local happenings                  7

  The first step Alexandra took was to help her identify how many people were affected with the condition. She
organized campaigns and events that included free blood pressure measurement. At the first two events, she reached
over 200 people, and more than half of them had high blood pressure.
  Her next step will be organizing educational activities for the residents. She plans to invite health professionals from
outside the community to speak to the residents, and to open up channels of communication between them so that
the residents of Vila Paciencia can be considered for inclusion in the treatment program offered by nearby health
  Alexandra is educating herself about the risk factors for development of high blood pressure, especially among
residents of Vila Paciencia. She developed a questionnaire, with the help of the CEDAPS follow-up team, and has
already collected important information that will be passed on to health care professionals outside of her community.
She is very happy with the preliminary results of her project saying, “I feel that I am being useful to my people, and I
intend to expand this project within the whole community!”

                                  Reducing High Blood Pressure in Vila Paciencia Project

                       Second Community Network Against AIDS Workshop
       The second thematic PSBH Community Network Against AIDS workshop was held August 12-14, 2003.
     This network was launched as a result of an initial workshop on AIDS that was held in Rio de Janeiro in 2001.
     The Community Network Against AIDS can be defined as a group of local institutions from Rio de Janeiro,
     working together in low-income communities, whose goal is HIV/AIDS prevention. During the workshop this
     year, 26 leaders took part, and have joined the network of 22 original project leaders, whose goal is to
     develop action plans to fight the spread of AIDS.
       A total of 51 communities are involved in the network, and participants from 48 of them are working on
     implementing their projects. The methodology has been very useful in developing community leadership,
     action, and individual responsibility. The training helps prepare them to write good project proposals for
     community programs, which can eventually be submitted to funding agents.
       The project plans at the end of the workshop revealed that the participants had a clear perception of their
     community problems and resources, and were energized with creative approaches to preventing the spread
     of AIDS.
                                                                                       Submitted by Dr. Daniel Becker
                                                                Regional Coordinator, Latin America & The Caribbean
           local happenings

                                                 ...IN BULGARIA
                                         Site Visits in Pleven, Gabrovo, and Varna
                    A follow-up meeting for project leaders took place July 7, 2003, at the University Oncology Center in
                Pleven. One thing that all the PSBH project leaders at the Center have in common is the support they get
                from one another. For example, Assoc. Prof. Tashko Deliiski, Dr. Roumen Stoyanov, Dr. Georgi Baichev,
                and Dr. Slavcho Tomov all participated in the National Conference on Nursing Care in Pleven and were
                awarded prizes for their outstanding PSBH® projects.
                    The International Nursing Program Coordinator for DHF, Ms. Pamela Hoyt, made project site visits to
                Bulgaria, July 7-11, 2003. Below are several updates from the University Oncology Center:
                                                         · Mrs. Valentina Besheva - Increasing the Early Detection
                                                          of Cervical Cancer. More than 200 women have been
                          One thing that                 examined.
                                                          · Mrs. Ivanka Spasova - Improving Pain Control in Cancer
                       all                t h e            Patients. The newly opened consulting room at the Center
                                                         has greatly helped both patients and their families.
                       PSBH                                · Mrs. Anelia Tzvetanova organized education for 100
                                                         patients undergoing radiotherapy.
                          p r o j e c t                     · Mrs. Viliyana Stoeva - Improving Pain Control in Patients
                       leaders                  at           Treated at the Surgery Clinic. Mrs. Stoeva worked in
                                                         cooperation with Dr. Simeonov, an anesthesiologist, and Dr.
                          the Center have                Stoyanov. This collaboration helped her conduct a worthy
                          in common is                   educational program for both patients and their families.
                                                             · Mrs. Meliana Al Shargabi - Improving Treatment and

                          the                                 Quality of Life in Outpatients Undergoing Chemotherapy.
                          they get from                  Mrs. Al Shargabi started with a small group, and now nearly
                                                         500 patients receiving chemotherapy are included in the
                       o n e                             program.
                                                               Ms. Pamela Hoyt and the local coordinators (Mrs. Yanka Tzvetanova
                       another                    .     and Dr. Angelika Velkova) also visited a nursing project run by Mrs.
                                                        Silvia Vancheva in Riben, a village in the Pleven region. The project
                                                        (which began in 2000) aimed to control hypertension, and was initiated
             in 50 patients between the ages of 50 and 70 years old who were attending the general practice in the village.
             The average blood pressure (BP) at that time was 180/110 mm Hg. After a year it had dropped to 155/90 mm
             Hg. The project has expanded to cover all hypertensive patients in the practice. As a result of patient
             compliance (they all keep diaries to record their BPs) and their joining other blood pressure control programs,
             no dramatic incidents related to hypertension have recently occurred.
               Two projects were visited at the Lung Disease Clinic in Pleven (see January-March 2003 issue of
                  · Training Program for Patients with Bronchial Asthma (BA) and Chronic Obstructive Pulmonary
                   Disease (COPD) - In the last six months, of the 202 COPD patients, 42 re-hospitalizations were
                  necessary (reduction rate = 20%), and among the 75 BA patients treated, 23 re-hospitalizations were
                  necessary (reduction rate = 30%). Mrs. Petya Simeonova plans to work on her project for two more
                   · A project for the continuing education of nursing staff, led by Mrs. Snezhana Petkova, has improved
                    both the quality of nursing care and patient satisfaction, as evaluated by standard questionnaires.
                Two projects at the Clinic of Endocrinology were visited. They both involve educational programs for training
              diabetic patients. Mrs. Tzvetelina Ivanova, coordinator of one of the projects, has announced a 20% reduction in
              re-hospitalization rates among the trained patients.
                Two project sites were visited in Gabrovo, the Gabrovo Regional Hospital and the Regional Pulmonary
              Hospital. Over 20 projects that resulted from a PSBHN workshop in 2002 were seen. Dr. Antoaneta Stoikova and
              Mrs. Nelly Todorova (local project coordinators) and Dr. Bozhidar Paralchev (director of the hospital) were
              pleased with the creativity shown by project coordinators in solving problems at the hospital. The projects have
              helped improve communication between wards and staff and have increased patient compliance and the
              preparation of standard protocols. Some of the projects have the potential to be expanded to the community
              level, involving people outside the hospital in problem solving. The following are results from some of these
             · Mr. Dimitar Dimitrov - Increasing Awareness About Exogenous Poisoning in the Gabrovo Region. As a result of
              this educational campaign (organized in collaboration with Dr. Petar Boyadjiev, a toxicologist at Gabrovo Regional
              Hospital, and Dr. Veselin Dimitrov and Mrs. Ivanka Rouseva of the Regional Hygiene and Epidemiology Station)
              the number of cases registered has dropped from 63.3/1000 in the year 2000, to 47.3/1000 during the period of
              July 2002 - July 2003, and the death rate has decreased from 0.30% to 0.10%.
                                                                                               local happenings           9

· Mrs. Roumiana Ivanova
 - Educational Program on
 the Early Detection and
 Treatment of Osteoporosis
 in Women. So far, 26
 women have taken part in
 this program, but the
 group is expanding since a
 group of highly qualified
 specialists has provided
 the project with
 educational materials.
 · Mrs. Petya Vitanova
  prepared an information
  card that was distributed
  to outpatient clinics
  treating chronic patients,
  general practitioners,
  social services, and other
  organizations dealing with
  the disabled. This has
  improved communications
  between the different
  institutions and has also
  reduced the number of
  violations to patients'
  rights, since these patients

  have now been duly
                                                                   Pediatric Ward, Gabrovo Regional Hospital
  · Mrs. Assya Peikova's project helped raise funds for purchasing new electronic scales for the
   microbiology laboratory. As a result, there has been a reduction in the cost of media preparations by more
   than 50%.
   · The projects of Mrs. Raina Gencheva, Mrs. Ganka Nedelcheva, and Mrs. Daniela Simeonova have
    significantly benefited the pediatric ward, and the results they have achieved serve as a testament to the
    effectiveness of the PSBH approach. Mrs. Nedelcheva's project received a special award at the National
    Conference on Nursing Care in Pleven in May 2003.
    · The projects of Mr. Emil Damyanov and Mrs. Milena Pencheva have proved useful for both patients and
     hospital staff. The recovery period for stroke patients has been shortened, and absenteeism due to back
     pain among staff has been reduced.
     · Mrs. Donka Stefanova's project has raised awareness in the Gabrovo region about Lyme disease.
                                     · Dr. Ivo Stanchev and his team of four nurses have managed to increase
                                      the number of patients undergoing bronchoscopy by 20.7%. As a result,
  Projects                            the number of patients diagnosed with pulmonary tuberculosis and early
                                      stages of lung cancer has increased by 20.9%.
       implemented                    · Mrs. Donka Georgieva organized training in inhalation techniques for 42
                                       asthma patients. As a result, 16 of them can now properly use a pocket-
       a t             t h e           metered dose inhaler.
                                       · Mrs. Radostina Ignatova's project helped assess the knowledge of
  Gabrovo                               tuberculosis and strategies to improve prevention and early detection of the
                                        disease within the Gabrovo region.
       Regional                         · Mrs. Kamelia Dragieva's project focused on reducing the incidence of
       Pulmonary                         decubitus ulcers in bedridden patients. Of 40 patients with first- and
                                         second-degree ulcers, 20 fully recovery, and ten patients showed
       Hospital have                     improvement. Of the ten patients with third-degree ulcers, four showed
       a l s o                           · The training sessions organized by Mrs. Petya Dacheva helped improve

  achieved                                communication between patients and nursing staff.
                                          · Mrs. Michaela Dimitrova organized training for the Intensive Care Unit
                                           (ICU) staff on prevention of infections.
  g o o d                                  · Mrs. Lyubka Dimitrova (head nurse of the hospital) implemented a
                                            project that helped increase the number of people receiving home nursing
       r e s u l t s .                      care, or hospice care in Gabrovo. Compared to the previous year, there
                                            were 621 more home visits paid by nurses, and 233 more hospice visits.
           local happenings

                   Two meetings were held with project leaders from the June 2002 PSBHN™ workshop in Varna. Six projects were
            carried out at the St. Marina University Hospital:
            · Mrs. Angelina Zhelyazkova organized a training program promoting good hygiene for workers in three surgical
            clinics and the Intensive Care Unit. ECOLAB Ltd. presented modern hospital disinfectants and donated dosage
            equipment, and the head nurses of each clinic prepared standard hygiene protocols. As a result, even though
            patients are at higher risk of infection in these clinics, no infections have been registered since initiation of the
            project. Future plans include implementing the program in additional clinics.
             · Mrs. Galina Ganeva's project, organized for mothers, 25 nurses, and 12 hygiene support workers, offered training

            in how to reduce infections in the Pediatric Clinic and Intensive Care Pediatric Unit. As a result, the rate of infection
            was reduced by 50%.
              · Mrs. Dora Vassileva organized postgraduate Continuing Medical Education (CME), including computer skills
            training, for 12 nurses at the Intensive Care Pediatric Unit.
               · Mrs. Nadya Andonova has built a team to improve social integration and follow-up of 26 psychiatric patients. One
            part of the project was improving patients' charts to create better collaboration between social and medical services.
                · Mrs. Krassimira Dimitrova organized postgraduate CME for eight nurses from the eye clinic. After the 15-week
            course, one nurse had increased her level of knowledge by 10%, five by 50%. Two nurses had very good
            placement test results and showed excellent course results.
                 · Mrs. Greta Dermedjieva is working with five acute myocardial infarction (AMI) patients to reduce their lipid levels.
            All of their levels have improved since the start of the project.

                                meeting at the Varna Hygiene and Epidemiology Station revealed the good progress being made

                                by school nurses with their projects (see more details in the September - December 2002 issue of
                                the Bulgaria Health Information Digest at The projects are focused
                                on weight reduction, drug abuse prevention, smoking, sex education, stress reduction, basic
                                hygiene, violence, and prevention and correction of poor posture and minor spinal deformities.
                                The local coordinator, Mrs. Gergana Momova, and the staff of the Health Promotion Department
                                work closely with project leaders and assist them in achieving the remarkable results of which
                                they are so proud.
                                                                                              Submitted by Mrs. Yanka Tzvetanova
                                                                                                PSBH®/CBH® Coordinator, Bulgaria

                                                         ...IN CHINA
                                                     PSBHN Program in China                              There are more than 1.2
                                                                                                       million nurses in China. It is
                                                                                                       clear that they represent a
                                                                                                       tremendous pool of talent,
                                                                                                       skills, experience, and energy
                                                                                                       for the achievement of better
                                                                                                       health in China. With this in
                                                                                                       mind, the School of Nursing,

                                                                                                       Peking Union Medical College
                                                                                                       (PUMC), Beijing, in partnership
                                                                                                       with the Dreyfus Health
                                                                                                       Foundation, have embarked on
                                                                                                       a mission to engage as many
                                                                                                       nurses in China as possible in
                                                                                                       the PSBHN™ program. The
                                                                                                       purpose of this program is to
                                                                                                       encourage nurses to take an
                                                                                                       increasingly active role in
                                                                                                       contributing to better health in
                                                                                                       China and, through the
                                                                                                       Problem Solving for Better
                                                                                                       Health™ process, help them to
                                                                                                       see just how much they can
                                                                                                       contribute. China, of course,
                                                                                                       has provided the world with
            PSBHN™ Workshop, Fuzhou, March 17-19, 2003 - Professor Gao Lan (Middle), Plenary Speaker   many examples of how to
                                                                                       local happenings                11

achieve better health for the people. The nurses of   a significant impact on the health of many lives in China.
China are providing yet another such example.           In 2002, the PSBHN model was incorporated into the
  To date, PUMC has led ten nursing workshops         curriculum of the third-year nursing students at the PUMC
with the participation of more                                                  School of Nursing. More than 30
than 300 nurses representing
several of China's provinces.         When        nurses                        students generated PSBHN
                                                                      are better health projects as part of
Among the latest, in March 2003,                                                their curriculum. We hope to see
PUMC led a workshop in
collaboration with Fuzhou
                                      able to      recognize                    this replicated in many schools of
                                                                                nursing over the coming years.
Provincial Hospital, and they will
lead a nursing workshop in            their individual value                      When nurses are able to
                                                                                recognize their individual value
Macau in October of this year.
PUMC has received requests
                                      a n d i n f l u e n c e , and influence, communities are
                                                                                transformed and health is
from several institutions and
schools of nursing to expand the
                                     communities                                            for all. We look
                                                                      are improved expansion of theforward
                                                                                to further
PSBHN program further. The                                                      PSBHN program in China. Our
PSBHN step-by-step
methodology has enabled many
                                     transformed                      and goal is an auto-replicating
                                                                                program that eventually covers all
nurses to realize their capacity to
implement change for the better
                                     health                            i s schoolsin hospitals andacross the
                                                                                          of nursing

in their environments, both
personally and professionally.       improved                  for all.

These nurses have already had                                                        Submitted by Ms. Liu Huaping
                                                                Associate Dean of PUMC School of Nursing and
                                               Ms. Pamela Hoyt, International Nursing Program Coordinator, DHF

             PSBHN Program and Information Retrieval Skills in Beijing
  Two workshops on improving skills necessary for the retrieval of medical literature for nursing staff were

held in Beijing, in collaboration with the Institute of Medical Information and Health Science Library of the
Chinese Academy of Medical Sciences and Peking Union Medical College (PUMC). The first workshop was
held at the end of October 2002, and the second, during early October 2003.
  Seventy-eight nurses from Beijing Hospital and Peking Union Medical College Hospital (PUMCH)
participated in the workshops, which were divided into two parts: lectures and training. The objectives
    · Raising the awareness of information available for nurses in clinical practice through the use of
     the Internet.
     · Advancing the skills of nurses for retrieving literature, especially through the electronic medium.
      (All workshop participants were trained to search and retrieve information from PubMed/Medline
      and CBMdisc (Chinese Biomedical Literature Database on CD-ROM)).
      · Updating nursing standards of practice and health education.

  A nursing leader from the Office of Nursing Quality Supervision at Beijing Hospital, Zheng Xiaoxia, stated
that she was able “to learn about updated standards of practice for quality improvement in the hospital
setting.” Wang Xiaojing, from the Department of Special Care for Foreigners at PUMCH, and Guo Dongwei,
from the Outpatient Service for Special Care at PUMCH, also expressed appreciation for the informative
workshops. The combination of lectures and hands-on training has added great value to the clinical nursing
practice of the participating nurses.
                                                                              Submitted by Professor Gao Lan
                                                                       The Institute of Medical Information and
                                         Health Science Library of The Chinese Academy of Medical Sciences

        Special Announcement - New Staff Member at DHF
          Name        Kelly Condon
            Title     Database Information Coordinator
    Job Function      I am responsible for gathering and
                      coordinating specific information pertaining to
                      PSBH , PSBHI™, and PSBHN™ workshops
                      and projects and entering that information
                      into the DHF database.
                 local happenings

                                   ...IN THE DOMINICAN REPUBLIC
                                                    Follow-Up Activities for PSBHN™ Projects
                      A number of projects were developed as a result of the first national PSBHN™ workshop held in April 2003. From
                     May 16 through June 7, 2003, five follow-up activities took place, during which, 90% of the projects were followed-
                     up on by members of the PSBHN™ team. The projects were organized into four main groups, one of which was
                     further sub-divided into three groups, according to their geographical location.

                        Eastern Region: We created one group that includes the provinces of San Pedro de Macoris, Hato Mayor,
                        and La Altagracia. A follow-up meeting for this group was held in San Pedro de Macoris.
                        Southern Region: Sub-divided into three groups that include:
                            1. Santo Domingo, together with Villa Altagracia, and Monte Plata. A follow-up meeting was held in Santo
                            2. San Cristobal, Bajos de Haina, and San Jose de Ocoa. A follow-up meeting was held in San Cristobal.
                            3. Barahona. A follow-up meeting was held in Barahona.
                        Northern Region: One group that includes Santiago and Moca. A follow-up meeting was held in Santiago.
                        Northeastern Region: One group that includes Santiago Rodriguez and Valverde. We have not had a follow-
                        up meeting for this group.
                        During the site visits, we confirmed that 80% of the       talks on environmental sanitation and its

                     projects are in an organizational stage. This includes        consequences. They also conducted a census and
                     activities such as forming project teams, project             collected signatures from residents living on a street
                     leaders presenting and promoting projects to the              without asphalt, where the children suffer from
                     organizations they represent, and coordinating with           asthma due to high levels of dust in the air. The
                     other community organizations and groups. Fifteen             project leaders have established communication with
                     percent of the projects have moved on to orientation          the local government, as well as with the town's
                     and group-and community-training activities, while            councilwoman.
                     five percent of the projects have yet to begin. We              For the basic hygiene projects, inquiries have been
                     spent time motivating those participants to take an           made at the Salvador B. Gautier Hospital about
                     initial step in getting their project underway.               obtaining garbage can lids and educating the
                       The environmental sanitation and basic hygiene              cleaning personnel on waste management and
                     projects have developed the following activities: In          disposal.
                     the neighborhood of Sanchez, they have organized                 The teenage pregnancy and abortion project
                     collaboration with the Red Cross and a group of               leaders held several meetings with young people in
                     young people from the Rotary Club and Civil                   their neighborhoods and organized three talks for 7th-
                     Defense groups. In Santo Domingo, they met with               and 8th-grade students. They have also joined forces
                     the presidents of three block associations and                with the local health authorities and trained a group
                     organized diagnostic examinations of cesspools and            of young girls to serve as health promoters.

                                                         PSBHN™ Workshop, Santo Domingo, April 4-5, 2003
                                                                                               local happenings                13

  Project leaders working on malnutrition in children arranged a meeting with a group of
youths from the community who were later invited to participate in the project. They
requested registration forms and questionnaires, medication, and other consumer goods            Conducting

                                                                                                                        DOMINICAN REPUBLIC
from the Director of Health Services in the area, who seemed very enthusiastic about the
project.                                                                                         project site
  The organizers of the project, Creating Space and Respect for Nurses, developed pre-
and post-project tests as the basis for evaluating project success. The project leader,
together with the Director of Nursing, who agreed to let the project leader work two hours
                                                                                                 visits    soon
a week with hospital personnel, organized talks and workshops. This project leader is also
                                                                                                 a f t e r    a
using PSBH® methodology with her university students, who have developed a project to
improve the monitoring of patients' vital signs. For the Humanization and Quality of Patient     workshop
Care project, organizers have carried out three workshops and various talks on the               ends        is a
subject. The participating universities, UASD (Universidad Autonoma de Santo Domingo)
and UCSD (Universidad Catolica de Santo Domingo), are in the process of redesigning
their curriculums to incorporate PSBH® methodology as a way to motivate students.
                                                                                                 great      way to
  Other project leaders are promoting recreational activities, such as a trip to the beach,
and obtaining uniforms for different sports, for teenagers from the Villa Francisca
neighborhood. Project leaders have worked hard at making contacts with other community
groups to collaborate with them on these projects and to coordinate orientation activities       and support
for these teenagers.
  Conducting project site visits soon after a workshop ends is a great way to motivate and
                                                                                                 p r o j e c t
support project leaders!
                                                            Submitted by Dr. Adelaida Oreste
                                                PSBH® Coordinator, The Dominican Republic

                          ...IN EL SALVADOR
  Third Medical Brigade
  Organized in Tepetitan
   On July 27, 2003, as part of
 the activities of the Valle del
 Jiboa Initiative, a group of
 PSBHI participants, together

                                                                                                                        EL SALVADOR
 with the PSBH /MESARES
 team, organized a medical
 brigade at the Pedro Pablo
 Castillo Elementary School in
 Tepetitan, the Third Medical
 Brigade. As part of the Brigade,
 they assessed the health
 problems of area residents,
 screening 500 citizens from the
 municipalities of Nuevo Tepetitan
 and San Vicente. They found
 adults and children with
 respiratory, gastrointestinal, and
 dermatological diseases, as well
 as other illnesses. The Medical
 Brigade activity was an important
 way for PSBHI participants to
 contribute to improving health in
 their community.                                         Third Medical Brigade, Tepetitan, July 27, 2003
           PSBH Workshop for Young Community Leaders Held in San Salvador
     The first part of a PSBH® workshop for young community leaders in El Salvador was held on August 23, 2003, in
   the Northeast region of San Salvador. The participants represented the communities of La Fosa, Tutunichapa, and
   Renovacion; and the educational centers of Instituto Nacional Francisco Menendez (National Institute Francisco
   Menendez), Instituto Tecnico Industrial (Industrial Technical Institute), and the Mugdan School.
     During the workshop, a description of an “ideal youth” was developed by defining the different social and health
   problems that especially affect youths. The second part of the workshop was held August 31 and the third part was
   held September 7.
              local happenings

                                                                                                                  PSBH Drives
                                                                                                                  Youths in Valle
                                                                                                                    del Jiboa

                                                                                                                   As part of a PSBH
                                                                                                                 mental health project,
                                                                                                                 developed under the
                                                                                                                 leadership of Ms.
                                                                                                                 Maria Julia de
                                                                                                                 Alvarado and Ms.
                                                                                                                 Modesto Carballo,
                                                                                                                 uniforms were
                                                                                                                 donated to a soccer
                                                                                                                 team of adolescents
                                                                                                                 who benefited from
                                                                                                                 the project. They will
                                                                                                                 participate in a
                                                                                                                 competition between
                                                                                                                 the different
                                                                                                                 communities in the
                                                                                                                 Valle del Jiboa.
                                                                                                                          Submitted by
                                                                                                                 Dr. Ignacio Paniagua
                                                                                                                  PSBH Coordinator,
                                                                                                                           El Salvador
                                             Donation of Soccer Uniforms

                                                       ...IN GUYANA
                                                       PSBH Projects in Guyana
                                     Project Title: Improved Hygiene in Students of Clonbrook
                                      Primary School, East Coast Demerara - Ms. Carol Daly
                  Ms. Carol Daly, a teacher at the
               Clonbrook Primary School, was
               concerned about the inadequate
               hand-washing facilities at her school
               and its relationship to the increased

               risk of transmission of infectious
               diseases by the fecal-oral route. She
               attempted to solve the problem
               according to her good question, “Will
               a health education program on the
               demonstrated benefits of hand-
               washing, targeting 547 students and
               24 teachers of the Clonbrook Primary
               School, East Coast Demerara, and
               the provision of additional hand-
               washing facilities at the school for
               three months, increase hand-washing
               among the students and teachers by
                  After a few initial problems, Ms.
               Daly, with support from the local
               PSBH® program and some
               fundraising activities, implemented
               this project. Approximately 547
               children have benefited from the                 Carol Daly Proudly Observes Students Using the Hand-Washing Facility
               project, which is now being evaluated
               for replication.
                                                                                              local happenings                  15

                  Project Title: Poor Drainage at Section C 79 Village, Corriverton,
                   Berbice - Ms. Shakuntala Ricknauth and Ms. Hushana Hamid

  The problem of indiscriminate dumping of household          people on July 27 and 28, 2003 and was greatly
garbage resulting in drains being blocked was tackled         appreciated by the community. Educational sessions
by the good question, "Will an educational program            were conducted by the local environmental health
and a clean-up campaign, involving the community              officer on garbage disposal and the importance of
members of Section C 79 Village, over a two-month             maintaining a clean and healthy environment. We are
period, clear blocked drains, achieve free drainage,          pleased to announce that many requests have been
and reduce garbage dumping by 80%?"                           received for more projects to be done in that area.
  This project was implemented by a group of 30                                         Submitted by Mr. Omar Khan
                                                                                   PSBH®/CBH® Coordinator, Guyana

                                         ...IN INDONESIA
                   PSBH in Jakarta and the Prevention of Tuberculosis (TB)
  In order to assist Jakarta's             technicians, and TB information            by the “Monitoring Implementation
national program on the detection          managers. The World Health                 Team (MIT),” established at CFW.
and prevention of tuberculosis (TB),       Organization (WHO), Indonesia,             The MIT is responsible for reporting
the Center for Family Welfare              sent its TB consultant to observe          progress to the WMT. A follow-up
(CFW), in collaboration with the           the workshop process.                      workshop will be held in December
Jakarta Health Services, held a              At the end of the workshop, each         2003. It is hoped that within six
PSBH workshop on March 20-22,              participant made a commitment to           months, several problems with the
2003.                                      implement his/her action plan. The         national TB program will have been
  This was the first workshop of its       head of the TB program in Jakarta          solved and the quality of services
kind ever organized in Indonesia           has also committed herself to close        provided will have improved.
that directly involved the players in      monitoring and follow-up of projects.        For the future, sustainability of
the field. TB workshops usually only         A “Workshop Monitoring Team              successful interventions and
involve program managers at                (WMT)” was established, consisting         expansion to other health centers in

provincial as well as district levels.     of representatives from the Jakarta        Jakarta will be a major effort.
The 48 participants at this workshop       TB program, CFW, WHO, and the              Discussions about expanding the
were drawn mainly from health              Ministry of Health. This group             program with representatives from
centers, several from the city health      developed a comprehensive                  WHO and the Ministry of Health are
services, and hospitals. They              monitoring plan for follow-up of           ongoing. This new collaboration is
included doctors, nurses, laboratory       projects, which is being carried out       being funded in part by the Jakarta
                                                                                      Health Services.

                       PSBH (Hospital): A Model for Improving Healthcare

          Problem Solving for Better Health® in          The following are nine steps we take in developing a
                                                         PSBH (Hospital) program:
        Indonesia was introduced in 1996 and
                                                         · Send a group of staff to a PSBH (Hospital) workshop.
        further expanded to the hospital setting in
        2002. At present, more than 180 projects          · Implement project action plans and conduct close
        have been completed and others are                 monitoring of projects.
        ongoing in many hospitals in Indonesia.            · Involve local unit heads in project planning,
        These projects have improved the quality            implementation, and evaluation.
        of service and hospital efficiency.                 · Establish a PSBH team consisting of selected unit

          Of note, we have found that the program            heads and problem solvers who constantly
        has a better chance for success when                 communicate and discuss projects among themselves.
        workshop participants from a given hospital          · Coordinate similar or related projects.
        attend as a team, rather than individually.
        The probability for improvements in quality           · Develop an internal reward system (by the PSBH®
        of service and efficiency is much higher               team) for successful projects.
        when there is a sense of teamwork.                     · Measure quality improvement and efficiency of
          We have organized one in-hospital                     projects. This should be done by the Hospital Quality
        workshop with 53 participants, including                Assurance Department.
        specialists, managers, nurses, and support              · Introduce successful projects to hospital leadership.
        staff. Four hospitals are in the process of              (This is a bottom-up approach.)
        institutionalizing the PSBH® process as the              · Convince the hospital director to institutionalize
                                                                  successful interventions and the PSBH (Hospital)
        main approach to improving quality of care
        and efficiency of services in their hospitals.            program. Illustrate by these examples that PSBH®
                                                         (Hospital) is a way of life.
        local happenings
                                                 IN MEMORY OF DR. HARDYWINOTO
                                                   Dr. Hardywinoto joined the Center for Family Welfare at the University of
                                                 Indonesia in 1996. He became the Director for Development and was
                                                 instrumental in developing and expanding the PSBH program all over
                                                 Indonesia. He was also an excellent national facilitator.
                                                   Dr. Hardywinoto passed away on June 7, 2003. His sudden departure
                                                 has created an emptiness in our Center that has not, and cannot be
                                                 replaced. May he rest in peace.
                                                                                            Submitted by Dr. Alex Papilaya
                                                                                             PSBH Coordinator, Indonesia

                                                           ...IN MEXICO
                                       PSBHI Workshop: The Villa de Reyes Initiative
                A PSBHI™ workshop was held in Villa                                             initiative. The Director of Sanitation of
                                                                                                the Health Ministry offered to
            de Reyes, in the state of San Luis
            Potosi, June 27-29, 2003. There were 35         Thirty-two                          collaborate and help coordinate
            participants, facilitators from Brazil,                                             activities, and Dr. Daniel Becker,
            Costa Rica, the Dominican Republic, El          c o m m u n i t y                   regional coordinator for Latin America
            Salvador, and Mexico, and we were                                                   and the Caribbean, wished Mexico
                                                            projects were

            especially honored to have an observer                                              success in developing this new
            from Peru.                                                                          initiative.
               Villa de Reyes is a rural community in                                             This is the second PSBHI in the
            the center of Mexico. Poverty, neglect,
            poor hygiene, malnutrition, and
                                                            developed.                          country, and the Colegio de Salud
                                                                                                Publica, a non-governmental
            infectious diseases affect the quality of       These projects will                 organization that includes doctors,
            life of its residents. The civil authorities                                        nurses, dentists, psychiatrists, and
            and community organizations requested
            the support of SOLPROMESA to help               benefit more than                   other health professionals, will also be
                                                                                                the coordinator for this initiative.
            develop projects focused on improving                                                 Thirty-two community projects were
            child and maternal health, and also basic
            hygiene and nutrition.
                                                            5,000 residents of                  developed. These projects will benefit
                                                                                                more than 5,000 residents of ten low-
              During the opening ceremony, the                                                  income communities. The residents of
            Municipal President thanked the Dreyfus
                                                            ten low-income                      these communities are very
            Health Foundation for their support and                                             enthusiastic and committed to the
            expressed his hopes for a successful            communities.                        initiative.
                                                                                                     Submitted by Dr. Hector Marroquin
                                                                                                             PSBH Coordinator, Mexico
                   PSBH Project in Escalerillas: Physical Education for School-Aged Children
                  During childhood, we develop habits that can last a       athlete and was completing her required year of
               lifetime. Maintaining a healthy lifestyle (physically,       community service, assisted the teachers and students
               mentally, and socially) is crucial for disease prevention.   with this project. At the end of the project, the children
               This is why it is important to encourage children to         were followed-up for six months to evaluate whether
               participate in sports and physical education at an early     they were still exercising and doing sports.
               age.                                                           A total of 125 children joined soccer, baseball, and
                  One project, developed during a PSBH workshop,            basketball teams and participated in tournaments and
               began with the good question, "Will physical exercise        competitions. After six months, 112 children had
               and sports, with 120 school-aged children, ages 6-14,        completed the program and were assessed. Of these,
               at the Escuela Primaria de Escalerillas, during the          78 were still involved in these types of physical
               2002-2003 school year, create a habit of exercising in       activities. The soccer and basketball teams now
               50% of the children?" With the teachers' support, we         represent the school in different tournaments, and 16
               formed ten teams that participated in after-school           children have been selected to participate in sporting
               physical education activities, twice a week, for six         events at the regional level. Some activities were also
               months. A nursing student, who is also a professional        organized in local public areas, in addition to the school
                                                                                         local happenings          17

setting. The project resulted in a school marathon in the streets of Escalerillas, where the participation of
the town's residents made for a very festive and supportive environment. The “SOLPROMESA Trophies”
were presented by members of the PSBH® team in Mexico.
  The school continues to include this project as part of its regular curriculum. It was also a great
interactive social experience for the children, teachers, parents, and the community. In addition to all of
these observed results, we also noted secondary benefits of the project, such as promoting healthy and
active lifestyles, developing the children's physical abilities, teaching the children how to make good use of
their free time, promoting integration and socialization among the children, and including the community in
social activities that benefit their overall health and well-being.
                                                                     Submitted by Ms. Janette Quistiano Ramos
                                                                                      PSBH Participant, Mexico

                               Physical Education for Children in Escalerillas Project

                              for the
                               of the        next
                              is DECEMBER 15th!
         local happenings

                                                         ...IN POLAND
                                        PSBHN and the Polish Association of Nurses
           A five-day PSBHN workshop was held August 18-22,                   European Union, including its strategy towards the
         2003. This educational workshop for nurses was held in               handicapped, the European Social Fund, human and
         Suprasl, in the Northeastern part of Poland, to prepare              patient rights, and ethics/bioethics.

         nurses to work in new conditions in the event that Poland              Participants spent 16 hours learning how to prepare
         becomes part of the European Union (EU). The workshop                successful health projects using PSBHN™ methodology.
         was organized by the governing board of the Polish                   They were delighted by the PSBHN process, which has
         Association of Nurses in cooperation with the Faculty of             shown them that can play an active role in solving many of
         Nursing and Health Sciences of the Medical University                the health problems of contemporary society and
         School in Bialystok.                                                 specifically, those relating to their vocation.
           Twenty-two nurses from different regions of Poland                   I would like to express my sincere thanks to Dr. Jan
         participated, and various issues were addressed:                     Sobotka for his assistance and support in bringing PSBHN
         education and professional training of nurses; legal issues          to nurses in Poland.
         of nursing in other EU countries; health policy of the                                    Submitted by Ms. Krystyna Wolska-Lipiec
                                                                                                                 Polish Association of Nurses
                                                                                             PSBHN Workshop Held in Torun
                                                                                                   As part of the Kujawsko-Pomorska
                                                                                                 Initiative, a PSBHN workshop was held at
                                                                                                 the Regional Chamber of Nurses and
                                                                                                 Midwives in Torun, September 24-26, 2003.
                                                                                                 The workshop was organized by the Dreyfus
                                                                                                 Health Foundation, the Polish Society of
                                                                                                 Hygiene, the Regional Chamber of Nurses
                                                                                                 and Midwives, and the University Department
                                                                                                 of Health Care Organization and
                                                                                                 Management in Bydgoszcz, under the
                                                                                                 auspices of the Marshall of the Kujawsko-
                                                                                                 Pomorskie Province, Mr. Waldemar
                                                                                                   Participants represented various levels of
                                                                                                 the health care system. In addition to Mr.
                                                                                                 Waldemar Achramowicz, Ms. Krystyna
                                                                                                 Sienkiewicz, member of the upper chamber
                                                                                                 of the Polish Parliament, Mr. Andrzej Kregiel,
                                                                                                 director of the Department of Health and
                                                                                                 Social Policy of the Marshall's Office in Torun,
                                                                                                 and Ms. Izabela Miloszewska, from the
                                                                                                 Department of Health, City Council in Torun
                                                                                                 all took part in the opening ceremony and
                                                                                                 expressed their support and readiness for
                                                                                                 cooperation with the PSBHN program.
         Marshall of the Kujawsko-Pomorskie Province, Mr. Waldemar Achramowicz (Third from Left)
                                                                                                   The group of international and national
             facilitators included: Dr. Vladimir Gordeiko (Belarus), Mr. Paul Florea (Romania), Ms. Shelagh Murphy (UK), Dr.
             Oleksandra Sluzhynska (Ukraine), Ms. Pamela Hoyt (USA), Dr. Katarzyna Broczek (Poland), Ms. Malgorzata Leznicka
             (Poland), Dr. Jan Sobotka (Poland), Ms. Krystyna Wolska-Lipiec (Poland), and Dr. Jacek Zyrkowski (Poland).
                During the workshop, 58 projects were developed. All of them will become a part of the Strategy of Health Policy of
             the Kujawsko-Pomorskie Province, a program accepted and realized by the local administration of the province. Some
             of these new projects will be included as part of the larger regional programs.
                The workshop participants also had a chance to hear about Dr. Jacek Tejza's project, developed as a result of a
             PSBH workshop in 2002. During a follow-up meeting in May of this year, organized in Ciechocinek, Dr. Tejza was
             chosen to coordinate the regional program, Prevention of Postural Deformities in Children. In August and September
             2003, a group of specialists in this field worked together to define and publicize this regional program. Dr. Tejza
             presented Ms. Pamela Hoyt and Dr. Jan Sobotka with copies of the completed program, and copies will also be sent
             to the Marshall of the Province and to the National Health Fund. In November 2003, the working group will prepare an
             application to the European Union Public Health Program, directed by the European Commission.
                There are currently 210 PSBHI™ project leaders in the Kujawsko-Pomorskie province. New programs are being
             developed with more and more professionalism, creating a strong, expanding network of cooperation. In the last three
             years, health problems in the region have become easier to solve.
                                                                                                          Submitted by Ms. Malgorzata Leznicka
                                     Department of Health and Social Policy, Marshall's Office of the Kujawsko-Pomorskie Province and
                                                                           Dr. Jan Sobotka, Regional Coordinator, Europe & The Middle East
                                                                                             local happenings                19

                        ...IN THE UNITED STATES
                                     PSBHN in Bridgeport, Connecticut
       In January 2003, the Dreyfus Health Foundation (DHF) and Fairfield University School of Nursing
     entered into a partnership to implement the Problem Solving for Better Health Nursing program in
     Bridgeport, Connecticut. One of the unique aspects of this particular effort was the focus on providing
     Fairfield University nursing students with an opportunity to be an integral part of this initiative.
       Seven nursing students participated in a workshop, held April 25-26, 2003, that generated numerous
     individual or joint projects with Bridgeport community members. Projects included a line-dancing group held
     weekly at a local senior residence, a community garden project, a safety program for a senior housing site,
     and a “clean-up-the-beach” project.
       One student, Ms. Susan Everrett, shares her project experience, which focused on homeless
     adolescents in the Bridgeport community:

              Being part of the partnership between the Dreyfus Health Foundation (DHF) and Fairfield
           University's School of Nursing has been a significant part of my nursing education. The first
           time I heard about DHF was from my professor, who is also a PSBHN facilitator, Dr. Dee
           Lippman. I became excited about the prospect of being involved in a grant-funded project and
           having an opportunity to become more involved in community health. As a result of
           participating in a PSBHN workshop, I learned the importance of immersing oneself in the
           community and the necessity of working with the people to be served before implementing any

                                                                                                                        UNITED STATES
           specific programs.
              The PSBHN workshop filled me with inspiration and energy to
           make PSBH a part of my life. The entire weekend was
           empowering and exciting. It was so impressive to see how                     A t t e n d i n g
           facilitators from around the world and within the country put forth
           their ideas on how to improve their communities and then
           developed project plans that they implemented with great success.
              Breaking into small groups with facilitators and participants to          meetings after the
           help one another develop actions plans was very helpful because
           it allowed us to provide one another with different perspectives and
           ideas for available resources, all within a supportive setting.
           Presentation of the action plans was another invigorating                    helped me
           experience. When a participant presented his/her ideas, the others
           shouted out words of encouragement and applauded.
              Another highlight for me was meeting Dr. Barry Smith, Director
                                                                                      realize            that I
           of DHF. It is always exciting to meet the coordinator of such an             n e e d e d t o
           impressive foundation that has helped thousands around the
              I think all the positive energy led me to think “big” when I
                                                                                      simplify                my
           started to plan my project that I wanted to implement with the               p r o j e c t .
           Bridgeport community. Originally, I wanted to create a mobile
           health-care station to assist the homeless. Attending follow-up
           meetings after the workshop helped me realize that I needed to simplify my project. Dr.
           Greiner, a professor at Fairfield University and a facilitator for the program, provided me with a
           very valuable resource, Mr. Rick Denisco, an RN and coordinator of the McKinney Health
           Care for the Homeless project in Bridgeport. I feel more confident that a partnership with the
           McKinney program will allow me to implement a project that will allow nursing students to
           teach and learn from the homeless in Bridgeport.
              I am very glad to have a role in the PSBHN program, made possible through the
           partnership between Fairfield University's School of Nursing and the Dreyfus Health
                                                                           Submitted by Ms. Susan Everrett
                                                                        PSBHN Participant, Bridgeport, CT

  As principal investigator of the Problem Solving        this process as the projects continue to be
for Better Health Nursing™ Older Adults grant, I am       implemented and grow. The impact on the nursing
particularly excited about the success we have had        students, by their own account, has been a
involving the nursing students as partners with           transforming experience that will serve to enhance the
members of the Bridgeport community, in particular        quality of their nursing practice.
the older adults. I look forward to the continuation of                               Submitted by Dr. Dee Lippman
                                                                               Fairfield University School of Nursing
            local happenings
                                                  PSBH Projects in Miami, Florida
                                We Care Kids Newsletter Helps Fifth-Grade Students Learn English
                  The We Care Kids newsletter, a        project was to increase LEP                  with it effectively. They also made
                PSBH project in Miami, is a             students' proficiency in the English         stress-relief care packages for
                monthly health publication designed     language by encouraging                      parents that included things to help
                by kids for kids at Dr. Gilbert L.      involvement in school activities and         them relax, such as soothing music,
                Porter Elementary School. The           increasing health awareness.                 candles, and bath gels. In addition
                objective of this project was to          The teams of student writers               to producing three newsletters and
                increase Limited English Proficient     involved in this project included            putting together the care packages
                (LEP) students' language                third- and fourth-grade LEP                  for parents, the students also
                proficiency, participation in school    students. There are five LEP                 demonstrated how to make healthy
                activities, and health awareness        classification levels for students with      snacks at home for their peers.
                among third- and fourth-grade           English as a second language                   In May, the LEP students were re-
                children at Dr. Gilbert L. Porter       (ESOL): Level 1: Novice, Level 2:            tested to determine if their level of
                Elementary.                             Low Intermediate, Level 3: High              language proficiency had changed.
                  PSBH participant, Ms. Sheila          Intermediate, Level 4: Advanced,             Each student who participated in the
                Brennen, developed this project         and Level 5: Independent. The                project had an increase in language
                after noticing certain behaviors        students participating in this project       proficiency, and seven of the ten
                exhibited by her former fifth-grade     were classed at levels 1, 2, and 3 in        LEP students scored at level five!
                Limited English Proficient (LEP)        September 2002. They were paired               The students were very proud of
                students. Many of them were             with native English speakers and             their newsletters and put a great
                outgoing and social with each other,    proficient readers and writers.              deal of hard work into each issue.
                but were very reluctant to mix with     These pairs of students read,                Thank you again for giving my

                students who were not LEP. They         discussed, and produced the                  students an additional outlet for
                were not getting involved in school     articles for each newsletter.                developing language skills and
                activities that would give them the       Our newsletter reached about 400           building self-esteem.
                chance to socialize and                 students monthly. The students
                communicate with native English         wrote articles on nutrition and the             Submitted by Ms. Sheila Brennen
                speakers. Since school is often the     food pyramid, the benefits and                               Fifth-Grade Teacher
                only place where LEP students can       examples of exercise, and the                                Dr. Gilbert L. Porter
                practice English, the goal of this      causes of stress and how to deal                              Elementary School

                                                Students Involved With the We Care Kids Newsletter Project
                                                                                               local happenings                21

                     Health Education For Girl Scouts
  Girl Scout Troop #1123 in Florida's Liberty City community has been offered
health education workshops from the assistant troop leader, Ms. Trellany
                                                                                         As a result of
McMath. Ms. McMath attended a PSBH workshop in Perrine, Florida last June.
She came to that workshop to address the issue that many girls in her troop              attending these
seemed to lack basic health knowledge about their bodies/selves. Through
PSBH , Ms. McMath decided to supervise a series of health education
workshops for 20 girls in her troop.
                                                                                         workshops ,
  Troop #1123 has been offered 12 workshops per year (one per month). To                 Ms. McMath is
date, the girls have been educated on anatomy of the human body, breast
cancer, exercise/fitness, smoking/drugs, nutrition/dieting, and CPR/first aid. Up-
                                                                                         confident that these
coming workshops will be held on the relationship between physical appearance
and self-esteem, and the importance of etiquette and having good manners.                girls will be better
  In recognition of their participation in these workshops, the girls are awarded
special health-care patches that Girl Scouts receive when they participate in
health programs. As a result of attending these workshops, Ms. McMath is
confident that these girls will be better prepared emotionally to deal with health-      emotionally to deal
related issues as they become teenagers.
                                                 Submitted by Mr. Teddy Harrell, Jr.
                                                 PSBH Coordinator, Miami, Florida
                                                                                         with     health -
                                                                                         related issues as
                                                                                         they           become

                                                                                                                          UNITED STATES

     result of this
  As a
  project , m o s t
                                                 Girl Scouts in Miami Attending Health Education Workshop
  students                                 KidsVoice Community Health Newsletter Empowers Youth
  behaved better in the                   Ms. Gina Crosby, a computer technology teacher at Beckford/Richmond

  classroom    ....
                                        Elementary School in the Perrine/Richmond Heights area of South Miami,
                                        was feeling overwhelmed by the number of students who were “acting out”
                                        (exhibiting poor behavior) at her school. With the help of PSBH®, she
  They now have a                       developed the Media Education and Youth Initiative - the KidsVoice
  much better
                                        community health newsletter. Ms. Crosby was concerned about how some
                                        students were channeling their energies into negative behaviors, and she
                                        wanted to see what she could do to help change that. She decided that
  understanding of the                  what the students needed was an outlet where they could focus their
  importance of                         energies in a more positive manner.
                                          Students were eligible if they had exhibited significant behavioral
                                        problems in school, which often resulted in their having been suspended
  good behavior                         from classes during the previous school year. The project was designed to
                                        help build computer, language, leadership, and socialization skills through
  and how it relates to                 the production of a “youth-developed” community health newsletter. The
                                        students received snacks after their meetings and were given membership
  t h e learning                        T-shirts and other incentives for their participation in the project.
                                          As a result of this project, most students behaved better in the classroom.
  p r o c e s s .                       They really worked on this, since it was critical for remaining in the project.
            local happenings
                 They now have a much better understanding of the importance of good behavior and how it relates to the learning
                   The students took pride in their publications; the brochure, newsletters, and fact sheets they created were all a result
                 of teamwork. They were grouped together depending on which section of the publications(s) they were responsible for.
                 They expressed how much they enjoyed the idea of belonging to a group and bragged to other students in the school
                 about their program. The students were very active about letting other people know about their project and getting the
                 word out in their community. They walked around school with their heads held high. The students also helped plant and
                 care for a “legacy garden” that will be passed on to students the following school year.
                                                                                                 Our meetings always ended with "kid-
                                                                                              friendly" refreshments, such as hot dogs,
                                                                                              chips with juice, ice cream sundaes,
                                                                                              chicken and rice, or a celebration dinner
                                                                                              with all the trimmings. Snack time became
                                                                                              very enjoyable because we continued to
                                                                                              have great after-meeting discussions. It
                                                                                              gave the students time to relax, relate, and
                                                                                              open up to each other. It was like a little
                                                                                              family gathering!
                                                                                                 Evaluation of the project using teacher
                                                                                              testimonies and students' suspension
                                                                                              records following implementation of the
                                                                                              project showed a very good result.
                                                                                              Suspensions were decreased by
                                                                                              approximately 75%.

                                                                                                 The students wrote letters about what the
                                                                                              project meant to them. Overall, they have
                                                                                              found the project to be enjoyable and
                                                                                              rewarding, having a wonderful impact on
                                                                                              their lives.
                                                                                                              Submitted by Ms. Gina Crosby
                                                                                                              Computer Technology Teacher
                                       Students Working on the Legacy Garden                         Beckford/Richmond Elementary School

                                          PSBH Workshop Held in Clarksdale, Mississippi
                  The style of music known as the Blues originated in the rural region of the Mississippi Delta in the early 20th century.
                Blues music was born of the pain and resiliency of African American people who endured and survived the oppression
                of slavery, only to be faced with the hardship and cruelty of segregation under the Jim Crow laws of the South.
                  During the time in America's history when the cultivation of cotton was at its peak (“King Cotton”), Clarksdale,
                Mississippi became an economic hub of the South. According to legend, Robert Johnson, a “Bluesman” who is thought
                to be one of the greatest musicians in this genre, made a bargain with the devil and exchanged his soul for the ability to
                play the guitar.
                 Today, with its high poverty, unemployment rates, and growing health disparities, Clarksdale faces the same plight as
                many other cities and towns across the USA and around the world. Through technological advances, many of the
                Delta's farms are now automated, reducing the need for workers. Factories, which once employed many of the area's
                residents, have now moved overseas to reduce production costs.
                  The first PSBH workshop in
                Clarksdale took place September 26-
                27, 2003. Thirty-eight participants,
                including community residents and
                organizations involved in the health
                and business sectors of Clarksdale
                and its surrounding areas, attended
                the workshop.
                  The workshop was a success! Dr.
                Barry Smith spoke on the legacy and
                spirit of the Blues culture and how it
                can stand as an example to all of us.
                Even in the face of overwhelming and
                sometimes cruel circumstances, the
                human spirit can remain resilient,
                buoyant, and most of all hopeful for a
                better world.
                                           Submitted by
                            Ms. Marsha Copeland-Jacks
                             Regional Coordinator, USA                                 Small Group Session
                                                                                             local happenings                   23

                                            CBH NEWS
        The CBH Digest Contributes to Continuing Medical Education in Uganda
   As part of a larger project, funded by the United Kingdom Department for International Development (DFID) and the
Canadian Government, and administered by the International Institute for Communications and Development (IICD) in
the Netherlands, entitled Catalysing the Creation and Exchange of Local Content, two workshops were held on April
28 and 30, 2003. These workshops, Strengthening the Local Creation, Adaptation, and Exchange of Continuing
Medical Education and Health Information in Uganda: National Perspectives, were held in Kampala and Ntungamo,
   The national CBH® Coordinator in Uganda, Dr. Maria Musoke, presented the CBH® Digest at the Ntungamo
workshop as an example of one successful way of making information available to health workers in rural Uganda who
have no access to the Internet and limited access to other current sources of information. In addition, the Digest
contains topical articles written by senior health professionals in Uganda. This valuable and difficult-to-obtain literature
is published in the Digest and made available to international health professionals who find it difficult to access
literature from African professionals living and practicing in Africa.
   As a result of these two workshops, 26 national concept notes were developed and discussed during a regional
meeting on East African local content capacity building, held in Nairobi, Kenya, in July 2003.The Ugandan perspective
was represented by two members of the CBH editorial committee (Dr. Maria Musoke and Dr. Grace Ndeezi,
pediatrician and lecturer at Makerere University Medical School) and two doctors from upcountry Uganda who
attended the Ntungamo workshop and contributed concept notes for the regional meeting: Dr. Agolor Cuthbert and Dr.
Dennis Mugimba. These participants will serve as the core team responsible for coordinating and implementing the
local content capacity building activities in Uganda. Six of the Ugandan concept notes have been chosen for
consideration for DFID funding.
   Over the next twelve months, reports from these projects will be published in the CBH® Digest, which will be

instrumental in disseminating the important health content generating activities that will take place in the country and
the region.
                                                                                           Submitted by Dr. Maria Musoke
                                                                                                CBH® Coordinator, Uganda
                                           CBH Program Digests

                                          Recently Received at DHF
                Biodiagnostics & Therapy -                            Guyana Health Information Digest
             Knowledge for Health, Cameroon                           Volume 4 - Number 1 - August 2003
                   Number 21 - June 2003                                Please contact Mr. Omar Khan
         Please contact Dr. Paul Tan to receive a copy                         to receive a copy
                e-mail:                            e-mail:

          Comunicando Mejor Salud - El Salvador                             Jordan Health Digest
           Volume 5 - Number 13 - December 2002                       Volume 8 - Number 2 - August 2003
             Please contact Dr. Mauricio Lozano                       Please contact Mr. Mahmoud Alkam
                      to receive a copy                                        to receive a copy
                 e-mail:                                  e-mail:

                         Current-Info,                              Romanian Health Information Digest
          the Nigerian Health Information Digest                              Volume 1 - 2003
       Volume 9 - Number 1 - October-December 2002                     Please contact Mr. Paul Florea
            Please contact Mrs. Helga Faluwoye                               to receive a copy
                      to receive a copy                                e-mail:
                                                                     Tanzania Health Information Digest
          Digest Sante Mali (Health Digest in Mali)                 Volume 8 - Number 3 - April-June 2003
                 Tome 10 - Volume 1 - 2003                            Please contact Mr. Cecil Magembe
                 Tome 10 - Volume 2 - 2003                                     to receive a copy
            Please contact Dr. Abdel Kader Traore                      e-mail:
                       to receive a copy
               e-mail:                         Zambian Health Information Digest
                                                                 Volume 10 - Number 1 - January-March 2003
                    Ghana Health Digest                            Volume 10 - Number 2 - April-May 2003
               Volume 3 - Issue 1 - March 2003                      Please contact Ms. Christine Kanyengo
               Please contact Mrs. Lynda Arthur                                 to receive a copy
                      to receive a copy                                 e-mail:

                                           UP-COMING MEETINGS
                                   October                                    November
                                    Bulgaria                                   Cameroon
                                           ®                                                ™
                             Rouse - PSBH Workshop                  Jakiri, Bamenda - PSBHI Workshop
                                                                             (The Jakiri Initiative)
                           Beijing - PSBHN Workshop                           El Salvador
                        Inner Mongolia - PSBH Workshop
                                        ™                        Cuzcatlan, San Salvador - PSBHI™ Workshop
                      Kunming - PSBHN Follow-Up Workshop                   (The Cuzcatlan Initiative)
                           Macau - PSBHN™ Workshop                San Salvador - 10th Anniversary of PSBH®
                      Nanning - PSBHN™ Follow-Up Workshop
                           Shanghai - PSBH® Workshop
                             Xi'an - PSBH® Workshop

                                                                        Kumasi - PSBHI™ Workshop
                            Xinjiang - PSBH® Workshop
                                                                          (The Kumasi Initiative)
                                  El Salvador                                    Guyana
                      Jayaque - PSBHI™ Follow-Up Workshop
                                                                 West Berbice - PSBH® Follow-Up Workshop
                                     Ghana                                        India
                        Accra - PSBHN™ (Children's Health)
                                                                     Thrissur, Kerala - PSBH® Workshop
                               Follow-Up Workshop
                                                   ®                       Jos - PSBH® Workshop
                       Bijapur, Karnataka - PSBH Workshop
                                                                           The United States
                                   Indonesia                         Houston, Texas - PSBH® Workshop
                          Jakarta - PSBHN™ Workshop
                     Semarang, Central Java - PSBH® (Hospital)
                              Follow-Up Workshop                              December
                                     Jordan                        Bamenda - PSBH® Follow-Up Workshop
                     Maan - PSBH® Follow-Up Workshop (Maan
                      Hospital Group) and PSBH® Workshop                         Ghana
                                                                   Kumasi - PSBHI™ Follow-Up Workshop
                            Focsani - PSBH® Workshop                           Indonesia
                       Ploiesti - PSBH® Follow-Up Workshop          Depok - PSBH® Follow-Up Workshop

                              The United States                                  Jordan
                     Irvington, New Jersey - PSBH® Workshop              Karak - PSBHN™ Workshop

                                    Ukraine                                     Lithuania
                         Lviv - PSBH® Follow-Up Workshop          Vilnius - PSBH® Follow-Up Workshop and
                             Ternopil - PSBH® Workshop                        PSBHN™ Workshop

                                         Please share your news!
                                           Dreyfus Health Foundation
                                         205 East 64th Street, Suite 404
                                               New York, NY 10021
                                                fax: 212-371-2776

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