Personal COVID-19 Experience and Motivation

• Shahed Alam arrived in US fall 2021 after 2 years separation from parents
• Coming from Bangalore, India after devastating second COVID wave
• Within weeks: father, then Shahed, then mother all contracted COVID
• Parents' age and medical conditions made each day potentially more severe
• Despite medical training, felt overwhelmed
• Challenges faced:
  • Testing sites booked for days
  • Doctors unavailable
  • Monoclonal antibodies difficult to obtain, becoming less effective daily
  • Basic care needs (food, comfort) while managing illness
• All recovered but experience left lasting impact of helplessness and desperation

Noora Health's Core Philosophy

• Founded by Shahed Alam and Edith Elliott
• Central belief: love is most powerful, untapped resource in healthcare
• Love manifests as:
  • Dogged determination for aging parents' medication management
  • Tenacious energy getting children to ER
  • Family advocacy fuel
• Healthcare systems traditionally view family involvement as nuisance or ignore it
• When valued and made visible, love can transform health systems

Healthcare Context in South Asia

• Work locations: India and Bangladesh
• Hospital conditions:
  • Crowded facilities
  • Patients doubled up on beds
  • Hallways and waiting areas filled with families and belongings
  • Families move to hospital to stay with loved ones
• Families anxiously waiting while providers struggle with intense demand
• Global healthcare worker shortage: nearly 18 million by 2030
• Overburdened systems with life-and-death consequences
• South Asia statistics: nearly 1.5 million children under 5 die annually
• Many deaths preventable with better health practices at home

Noora Health's Approach and Methods

• Train and support families with life-saving skills
• Work with hospitals and clinics at point of care:
  • Patient bedside
  • Hallways
  • Waiting areas
• Train nurses to run group sessions with families
• Teach actionable skills:
  • Wound care
  • Warning sign recognition (jaundice in newborns, slurred speech for cardiac patients)
• Sessions include ample time for questions and demonstrations
• Post-discharge support:
  • Messages, videos, reminders relevant to specific conditions
  • Available for questions
• Approach works across all care types: new parents, surgical, oncology patients
• Common thread: loved ones present and wanting to help

Key Learnings and Principles

• Deep listening is essential:
  • Nurses, patients, families guide program development
  • They are the visionaries
  • Training incorporates household objects, community visuals, common language vs medical jargon
• Trust and timing fundamental to behavior change:
  • Nurses and healthcare providers are trusted sources
  • Training provided when and where families need it most
• Build on existing infrastructure:
  • Not creating new systems
  • Working with and through existing structures
  • Noora kick-starts and supports
  • Trainings designed for sustainable continuation

Impact and Results

• Reach: hundreds of hospitals and clinics across India and Bangladesh
• Changed care delivery methods
• Trained over 5,000 nurses
• Reached over 2 million family caregivers
• Cardiac surgery complications reduced by 71%
• Early data: newborn deaths reduced by 18%
• Impact calculation: over 9 babies' lives saved per 1,000 live births
• Extremely low cost due to leveraging existing resources

Case Study: Bino and Sunita

• Bino: young man with heart surgery in Kolkata
• Accompanied by wife Sunita and uncle, both trained
• Home visit observations:
  • Sunita performed wound care, left undressed per training
  • Used thermometer, checked pulse
  • Knew normal ranges for blood pressure, heart rate, temperature
  • Dietary changes: more fish, less red meat, avoided high vitamin K foods due to medication
• Uncle reported avoiding local clinic visits for basic wound care
• Saved travel costs and $1.50 per visit
• Significant savings for family who sold property to finance operation
• Sunita never learned to read/write but confidently led recovery hundreds of kilometers from major hospital

Future Vision and Goals

• Six-year plan: train over 70 million family caregivers
• Geographic expansion: India, Bangladesh, Indonesia, Nepal
• Support health systems serving over 1 billion people
• Ultimate dream: global health systems adoption
• Standard practice should include:
  • Caregivers as part of healthcare team
  • Confidence, skills, training for caregivers
• Collective call to action for worldwide implementation

Personal Reflections and Core Mission

• Shahed sees his mother caring for grandmother through neurological condition
• Mother was powerful care steward but invisible in system
• Edith recalls age 13 helping mother recover from brain surgery
• Relearning walking, talking, feeding
• Intimate understanding of responsibility, pride, relief in healing participation
• Core mission: honoring ancient human practice of helping loved ones
• Compassion and community as essential medicines
• Vision: world where everyone knows how to care for loved ones and receives acknowledgment for essential work
• Belief: changing healthcare takes a family