Here's a really nice video clip from PBS on the new resistance in Malaria in Cambodia. The video includes descriptions of ways that resistance has developed.
http://www.pbs.org/newshour/bb/asia/july-dec09/cambodia_08-25.html
Monday, August 31, 2009
Monday, August 24, 2009
Migrant care in Italy
An interesting set of short articles in a recent edition of The Lancet discuss the challenges to those who provide care to migrant workers in Italy.
Interestingly, those who are illegal migrant workers are afforded free health care under the Italian Constituation.
Now, "An amendment to the law concerning
public order measures, approved
on May 14, 2009, by the Chamber
of Deputies and now to be approved
by the Senate, introduces thecrime of illegal immigration, and
consequently obliges by law all civil
servants to report undocumented
migrants. Public health workers
are civil servants. Notwithstanding
previous legislation forbidding them
to report undocumented migrants,
this new legislation risks creating
fear among migrants, preventing
them from attending health facilities
and exposing both migrants and the
whole community to higher health
hazards."
So this would create a 'right' to health-care but no access.
Here is a link sent by one of our students with some very compelling photos:
Multimedia from NYTimes.com:
A Powerful Truth
Finally, from the Kaiser Foundation, here are a number of online modules with some information related to health policy.Saturday, August 8, 2009
Obstetrical Fistula
Article from Sojourners.org
Obstetric fistula could be a curse from the book of Job, if Job were a woman: A girl or woman is in labor in rural Africa. Forced to marry when still a child, she is only 13 or 14. Or she is 18 or 20, but malnutrition has stunted her growth. Her pelvis is too small to allow the baby to pass, and she has at most a traditional birth attendant to help her; her obstructed labor lasts days. Sometime during this agony the baby dies, and, eventually, the lifeless body is delivered. The mother, exhausted and grieving, might assume the worst of her physical suffering is over. Then she discovers that the worst may have just begun.
The prolonged pressure of the baby’s head in the birth canal killed tissue, causing a hole between the vagina and bladder or rectum. Urine or feces leak constantly. The odor becomes overwhelming. The woman is likely rejected by her husband. Without medical help, she spends the rest of her life on the fringes of her community.
Precise counts aren’t available, but an estimated 2 million women have obstetric fistula worldwide. Between 50,000 and 100,000 new cases occur each year, mostly in sub-Saharan Africa and parts of Asia. Fistula is virtually nonexistent in countries with widely available emergency obstetric care. Most fistulas occur in childbirth, but others come from the use of rape as a weapon of war, as in Congo and Sierra Leone.
The root causes of fistula are extreme poverty, inadequate health care, and the low social status of women, which deny them basic rights, education, and the capacity for self-determination. For example, when girls are allowed to continue their education at least through adolescence and delay marriage until adulthood, their risk of complicated childbirth is drastically lowered.
Key to reducing fistula is the improvement of women’s health care in the poorest part of the world—creating a network of medical facilities, identifying and monitoring pregnant women susceptible to birth complications, and training surgeons to treat the many who are already injured. A relatively brief operation, costing only about $300, can repair fistula in 60 to 90 percent of cases. Facilities such as the Addis Ababa Fistula Hospital in Ethiopia, which I visited in 2006, do nothing less than give girls and women their lives back. It is featured in the award-winning documentary A Walk to Beautiful, an engaging and inspiring window into the experience of women with fistula.
Worldwide, only a few thousand women a year receive treatment for fistula. Dr. Lewis Wall, founder of the Worldwide Fistula Fund (WFF) and a professor of obstetrics and gynecology at Washington University in St. Louis, proposes a major initiative: A 13-year program creating 40 fistula treatment and prevention outreach centers throughout Africa. The estimated cost—$1.5 billion over 13 years—is equivalent to less than 4 percent of the money the U.S. government has committed to fighting HIV/AIDS over just the next five years. Wall is partnering with Michael Horowitz of the Hudson Institute to build a broad coalition reaching across right-left and religious-secular divides to support this initiative.
As Wall, who is a Christian, writes of fistula repair surgery, “The affluent world needs to understand the profound impact that $300 can have on the lives of these impoverished, suffering women. The ‘widow’s mite’ is not only noble; when used in the right way it can be world-shaking.”
A new United Methodist campaign, Operation Healing Hope, is developing faith-based resources to raise awareness and promote action on fistula among church members. And Addis Ababa Fistula Hospital, WFF, and many other organizations have joined forces with the United Nations Population Fund in the Campaign to End Fistula. Visit www.endfistula.org to see how you can help the cause.
Julie Polter is an associate editor of Sojourners.
Obstetric fistula could be a curse from the book of Job, if Job were a woman: A girl or woman is in labor in rural Africa. Forced to marry when still a child, she is only 13 or 14. Or she is 18 or 20, but malnutrition has stunted her growth. Her pelvis is too small to allow the baby to pass, and she has at most a traditional birth attendant to help her; her obstructed labor lasts days. Sometime during this agony the baby dies, and, eventually, the lifeless body is delivered. The mother, exhausted and grieving, might assume the worst of her physical suffering is over. Then she discovers that the worst may have just begun.
The prolonged pressure of the baby’s head in the birth canal killed tissue, causing a hole between the vagina and bladder or rectum. Urine or feces leak constantly. The odor becomes overwhelming. The woman is likely rejected by her husband. Without medical help, she spends the rest of her life on the fringes of her community.
Precise counts aren’t available, but an estimated 2 million women have obstetric fistula worldwide. Between 50,000 and 100,000 new cases occur each year, mostly in sub-Saharan Africa and parts of Asia. Fistula is virtually nonexistent in countries with widely available emergency obstetric care. Most fistulas occur in childbirth, but others come from the use of rape as a weapon of war, as in Congo and Sierra Leone.
The root causes of fistula are extreme poverty, inadequate health care, and the low social status of women, which deny them basic rights, education, and the capacity for self-determination. For example, when girls are allowed to continue their education at least through adolescence and delay marriage until adulthood, their risk of complicated childbirth is drastically lowered.
Key to reducing fistula is the improvement of women’s health care in the poorest part of the world—creating a network of medical facilities, identifying and monitoring pregnant women susceptible to birth complications, and training surgeons to treat the many who are already injured. A relatively brief operation, costing only about $300, can repair fistula in 60 to 90 percent of cases. Facilities such as the Addis Ababa Fistula Hospital in Ethiopia, which I visited in 2006, do nothing less than give girls and women their lives back. It is featured in the award-winning documentary A Walk to Beautiful, an engaging and inspiring window into the experience of women with fistula.
Worldwide, only a few thousand women a year receive treatment for fistula. Dr. Lewis Wall, founder of the Worldwide Fistula Fund (WFF) and a professor of obstetrics and gynecology at Washington University in St. Louis, proposes a major initiative: A 13-year program creating 40 fistula treatment and prevention outreach centers throughout Africa. The estimated cost—$1.5 billion over 13 years—is equivalent to less than 4 percent of the money the U.S. government has committed to fighting HIV/AIDS over just the next five years. Wall is partnering with Michael Horowitz of the Hudson Institute to build a broad coalition reaching across right-left and religious-secular divides to support this initiative.
As Wall, who is a Christian, writes of fistula repair surgery, “The affluent world needs to understand the profound impact that $300 can have on the lives of these impoverished, suffering women. The ‘widow’s mite’ is not only noble; when used in the right way it can be world-shaking.”
A new United Methodist campaign, Operation Healing Hope, is developing faith-based resources to raise awareness and promote action on fistula among church members. And Addis Ababa Fistula Hospital, WFF, and many other organizations have joined forces with the United Nations Population Fund in the Campaign to End Fistula. Visit www.endfistula.org to see how you can help the cause.
Julie Polter is an associate editor of Sojourners.
Friday, August 7, 2009
Diarrhea: The Great Zinc Breakthrough
Time Magazine has an article on the use of Zinc to treat diarrhea. Here's a snippet:
"Exactly how zinc stops diarrhea is not entirely clear. Olivier Fontaine, a diarrhea specialist for the WHO, believes that since the mineral is an essential ingredient in about 300 enzymes, boosting zinc levels strengthens the body's immunity, thus preventing diarrhea from turning deadly. A single course apparently also staves off further bouts of diarrhea for about three months — long enough to see a community through the deadly rainy seasons."
"Scientists first hit on zinc's effectiveness in the early 1990s, when researchers from the Johns Hopkins School of Hygiene and Public Health in Baltimore, Md., gave children in New Delhi a daily dose of syrup containing 20 mg of zinc. The rate of diarrhea dropped dramatically. "Nobody believed the results," Fontaine says. "No one had an explanation why zinc worked."
"As TIME pointed out in an international cover story three years ago, celebrities don't hold concerts for diarrhea. "Compared with malaria and AIDS, we are totally underfunded," says Fontaine. "This is truly a neglected disease."
Diarrhea: The Great Zinc Breakthrough
"Exactly how zinc stops diarrhea is not entirely clear. Olivier Fontaine, a diarrhea specialist for the WHO, believes that since the mineral is an essential ingredient in about 300 enzymes, boosting zinc levels strengthens the body's immunity, thus preventing diarrhea from turning deadly. A single course apparently also staves off further bouts of diarrhea for about three months — long enough to see a community through the deadly rainy seasons."
"Scientists first hit on zinc's effectiveness in the early 1990s, when researchers from the Johns Hopkins School of Hygiene and Public Health in Baltimore, Md., gave children in New Delhi a daily dose of syrup containing 20 mg of zinc. The rate of diarrhea dropped dramatically. "Nobody believed the results," Fontaine says. "No one had an explanation why zinc worked."
"As TIME pointed out in an international cover story three years ago, celebrities don't hold concerts for diarrhea. "Compared with malaria and AIDS, we are totally underfunded," says Fontaine. "This is truly a neglected disease."
Diarrhea: The Great Zinc Breakthrough
Sunday, August 2, 2009
Final Post from Laura Spece
Hello!
I returned safely back to the States on July 29th after 20+ hours of
travel. It's really good to be home, though I'm having quite the
adjustment period. My tummy isn't too fond of American food quite
yet, but thankfully jet lag has been much better than on my arrival
trip to India. Though I do currently wake up at 5 am for no reason
whatsoever. Relative to India, everything is really quiet here, there
isn't any honking, squawking crows, or cows in the streets to make all
of that noise. Everything is also really clean and really sprawled
out. I miss India greatly, though I am glad to be home and with my
family. I'm currently feeling a little out of place, like I have one
foot here and one foot there. I'm also not used to having this much
access to people: via internet, mobile phones, etc. It can be a
little overwhelming and is making me a bit socially awkward. Though
it has been nice to catch up with the people I have seen! Not to
worry, if I haven't contacted you yet, I will. I'm still trying to
clean all of the belongings I took with me (it's all covered in dust
or mud).
I had a wonderful time traveling after my experience at CRHP in the
villages of India. I spent a day in Mumbai, which I loved (Del, you
must visit Bob and Aditi). Though the humidity was unbelievable!
Kerala was beautiful. I flew into Kochi, spent a night on the
backwaters near Alleppey, took an 8 hour bus ride to Kumily in order
to visit Periyar National Park. We hiked a small mountain of the
Western Ghats, saw 2 herds of wild elephants, plenty of scat from
various Indian animals and got attacked by a million little leeches!!
Never fear, to combat the leeches, the guide gave us these hilarious
army green socks that go up to your knees and then doused your
feet/lower legs in a tobacco powder/salt mixture. It actually worked,
the little buggers just curled up and didn't bite my feet. After all
of that adventuring, I relaxed back in Kochi for a day before heading
to Delhi. In Delhi, Rohit (a public health professor at UNC) hooked
me up with a wonderful family who helped to show me around. I took a
bus ride to the Taj Mahal/Agra Fort. The temp was around 100 degrees,
so not only was I way too melted to get a good photo (a la Princess
Diana... the original goal) but I also burnt the bottoms of my feet on
the tiles. :) Totally worth it though. The Taj was spectacular. I
also went around to see the India gate, the parliament area, the Raj
Ghat where Gandhi's ashes are interned and the Lotus Temple. I loved
it all, my only regret is not knowing much Hindi. Like I've said
before, for my return to India, I will make a more concerted effort to
learn the language. Some of the best parts of my travel was being
able to chat with Rohit and his friends' family, Aditi and Bob about
my experiences in the villages of India. It was good to decompress
and hear the opinions of people who have lived in/born in India.
School starts again on August 10th. I'm excited, but I'm having a
wonderful time relaxing at home in Lancaster with the fam. :) I have
plenty to do before school starts, there are still many photos I
haven't processed yet from my trip, plenty of life things I need to
catch up on and LionCare (the student-run free clinic in Harrisburg
that I chair) is beckoning me with responsibility. I am also trying
to pull together a presentation of sorts, not only as a requirement to
the scholarships that enabled me to make this journey, but also to
help the CRHP get some moolah. It's tough. I feel all of this
momentum to get out there and "save the kids" but my mind is sort of
mushy. :)
So this will be the final edition of "Slumdog Healthcare" (for now...
next trip won't be for awhile due to school). The next edition will
probably require a new title, since I'm thinking either Nepal or
Africa. :) Anyway, I hope you enjoyed these stories and that they
were not too dense. If you want to hear more, or see all of my
pictures, please let me know! Feel free to give me a holler be it via
phone or e-mail, I'm back on the grid. :) Can't wait to see all of
you and hear how your summers went. I hope all is well!
All my best,
Laura
I returned safely back to the States on July 29th after 20+ hours of
travel. It's really good to be home, though I'm having quite the
adjustment period. My tummy isn't too fond of American food quite
yet, but thankfully jet lag has been much better than on my arrival
trip to India. Though I do currently wake up at 5 am for no reason
whatsoever. Relative to India, everything is really quiet here, there
isn't any honking, squawking crows, or cows in the streets to make all
of that noise. Everything is also really clean and really sprawled
out. I miss India greatly, though I am glad to be home and with my
family. I'm currently feeling a little out of place, like I have one
foot here and one foot there. I'm also not used to having this much
access to people: via internet, mobile phones, etc. It can be a
little overwhelming and is making me a bit socially awkward. Though
it has been nice to catch up with the people I have seen! Not to
worry, if I haven't contacted you yet, I will. I'm still trying to
clean all of the belongings I took with me (it's all covered in dust
or mud).
I had a wonderful time traveling after my experience at CRHP in the
villages of India. I spent a day in Mumbai, which I loved (Del, you
must visit Bob and Aditi). Though the humidity was unbelievable!
Kerala was beautiful. I flew into Kochi, spent a night on the
backwaters near Alleppey, took an 8 hour bus ride to Kumily in order
to visit Periyar National Park. We hiked a small mountain of the
Western Ghats, saw 2 herds of wild elephants, plenty of scat from
various Indian animals and got attacked by a million little leeches!!
Never fear, to combat the leeches, the guide gave us these hilarious
army green socks that go up to your knees and then doused your
feet/lower legs in a tobacco powder/salt mixture. It actually worked,
the little buggers just curled up and didn't bite my feet. After all
of that adventuring, I relaxed back in Kochi for a day before heading
to Delhi. In Delhi, Rohit (a public health professor at UNC) hooked
me up with a wonderful family who helped to show me around. I took a
bus ride to the Taj Mahal/Agra Fort. The temp was around 100 degrees,
so not only was I way too melted to get a good photo (a la Princess
Diana... the original goal) but I also burnt the bottoms of my feet on
the tiles. :) Totally worth it though. The Taj was spectacular. I
also went around to see the India gate, the parliament area, the Raj
Ghat where Gandhi's ashes are interned and the Lotus Temple. I loved
it all, my only regret is not knowing much Hindi. Like I've said
before, for my return to India, I will make a more concerted effort to
learn the language. Some of the best parts of my travel was being
able to chat with Rohit and his friends' family, Aditi and Bob about
my experiences in the villages of India. It was good to decompress
and hear the opinions of people who have lived in/born in India.
School starts again on August 10th. I'm excited, but I'm having a
wonderful time relaxing at home in Lancaster with the fam. :) I have
plenty to do before school starts, there are still many photos I
haven't processed yet from my trip, plenty of life things I need to
catch up on and LionCare (the student-run free clinic in Harrisburg
that I chair) is beckoning me with responsibility. I am also trying
to pull together a presentation of sorts, not only as a requirement to
the scholarships that enabled me to make this journey, but also to
help the CRHP get some moolah. It's tough. I feel all of this
momentum to get out there and "save the kids" but my mind is sort of
mushy. :)
So this will be the final edition of "Slumdog Healthcare" (for now...
next trip won't be for awhile due to school). The next edition will
probably require a new title, since I'm thinking either Nepal or
Africa. :) Anyway, I hope you enjoyed these stories and that they
were not too dense. If you want to hear more, or see all of my
pictures, please let me know! Feel free to give me a holler be it via
phone or e-mail, I'm back on the grid. :) Can't wait to see all of
you and hear how your summers went. I hope all is well!
All my best,
Laura
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