Alison Coulter (MSc Public Health, 2004) is the Director of Health Services for Thrive Worldwide. In this post she talks about what her organisation is doing to help people’s well-being during these uncertain times and how her work has changed throughout the pandemic.
How has the COVID-19 outbreak affected your work?
I work with clinicians to deliver our clinical services, and our clients to understand their needs. It has felt like falling off a cliff together -we have absorbed the shock of change in our lifestyles and our work as we try to understand how to navigate the new normal together.
Thrive Worldwide serves about 200 different non-governmental organisations, humanitarian aid and mission organisations providing specialist occupational health, travel health services, psychological and training services. Thrive is based in 3 areas: the UK, Nigeria and Kenya. We are a virtual organisation and don’t have offices, so one benefit of lockdown for us is that our way of working has not changed, we were already using Zoom for everything! However, we have had to adapt some of our medical services to telemedicine, but as we already provided telemedicine that change has not been too difficult. What we have noticed is that the focus of our work has shifted, particularly with people not being able to travel. Initially people wanted information about coronavirus but now we are seeing and focusing on the psychological effects of anxiety, fear and uncertainty.
How have you been responding to the outbreak?
We have been responding to our client’s needs. Initially this was for information where we provided a number of free webinars, hosted by myself and a doctor and psychologist colleague. In the early days this included information about what COVID-19 was, how to reduce infection risk and psychological self-care. We are still providing a series of free open webinars, but have now moved away from the medical details as this is much better understood now, and we are focusing on working at home and living with uncertainty. These webinars and online training have been providing clients the chance to talk about the uncertainty they are facing and for us to talk about the importance of building resilience, how to take care of your mental and physical health, and how to work well as a team remotely.
We are also providing medical advice, psychological counselling and support to aid workers, with some still stuck in remote places. There have been a few instances of people who cannot leave and having issues with their medication running out. We have been working with them to find alternatives and to explore options. We have continued to offer psychological support to individuals, some of who are distressed at this time for many different reasons including being far from loved ones and unable to travel home. Others are working in low income countries with poor health systems and are already feeling overwhelmed by the developing situation.
We are also recognising that at some point people in aid organisations will begin to travel again and that there is a potential humanitarian crisis developing in countries that do not have good healthcare systems. So we are looking at how we can support people with travel health and medical advice before they travel, and what we can do to support our client organisations as they plan for future travel.
One unknown is the financial aspect of the crisis. Most of our clients are charities and some are facing huge financial shortfalls. This will affect us too, so we are looking at how to manage on a reduced budget.
How has LSHTM’s training helped you during this outbreak?
I work with different clinicians and organisations and, particularly at this time, it is really helpful to maintain the ‘population health’ perspective that I learned during my MSc. What is best for one person is not necessarily best for an organisation or a population, I find I bring that perspective. I also think that the different determinants of health are very important, we have focused to date on physical health and stopping/slowing the viral infection. However, as I talk to our clients about hunger and distress in the countries where they work it is helpful to understand that health is not the absence of the disease but about thriving, hence our name – Thrive. In Kenya, more people have died because of police brutality as a result of the lockdown than have died from COVID-19, which cannot be thriving. I really appreciate the time I had at LSHTM to give a vision for what good health looks like, both for my clients and the people they serve.
Any other comments?
I love the smallpox plaque in the entrance hall of LSHTM and I am sure that if the work done at LSHTM helped eradicate smallpox from the world, then work at LSHTM can eradicate COVID-19.