Archive for category: Global Health

Information and stories about global health.

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Tsetse Fly Repellant in the Near Future?

The people of sub-Sahara Africa may no longer need to fear the bite of the tsetse fly. In an April 24, 2014, Business Weekly article, “Net Closing On Serial Killer Parasite,” Kate Sweeney reported, “Cambridge genome scientists and international colleagues are closing in on new weapons to eradicate deadly diseases spread by the tsetse fly.”

According to the World Health Organization, tsetse flies, blood-sucking insects, transmit Trypanosomiasis, commonly known as sleeping sickness, as well as other diseases to humans and animals in over 30 African nations. Sleeping sickness initially causes joint stiffness, weakness and fever. Over time though, it results in neurological damage and eventually, death. If one identifies the disease early enough, there are drugs to cure sleeping sickness in its initial stages. In 2001, the World Health Organization initiated a large campaign against the disease via early detection and reduced the number of reported cases significantly. In 2010, the number of cases reported dropped below 10,000 for the first time in 50 years.

In 2014, scientists believe a better understanding of the tsetse fly will help eliminate African sleeping sickness completely. The Cambridge genome scientists contribute to a team of 146 scientists from 78 research institutes. The Business Weekly article stated that this international team, “analyzed the genome of the tsetse fly and its 12,000 genes that control protein activity.” This analysis found that tsetse flies have very actives tsal genes in their salivary glands that crave blood.

According to The New York Times’ article, “New Tool to Fight Deadly Tsetse Fly”, a team at Yale University, one of the 78 universities, “found several spots on the genome they hope will eventually lead to better insecticides or repellents.” When studying other insects, such as fruit flies and mosquitos, scientists created repellants after determining weaknesses in their genetic composition. Therefore, this new understanding of the tsetse fly’s tsal genes could lead to new repellant technologies.

As stated in the Huffington Post article, “Tsetse Fly Genome Decoded, May Hold Clues to Fighting African Sleeping Sickness” John Reeder, head of the World Health Organization’s program for research and training in tropical diseases, said, “Sleeping sickness threatens millions of people in 36 countries in sub-Saharan Africa. Many of the affected populations live in remote areas with limited access to adequate health services, which complicates the surveillance and therefore the diagnosis and treatment of cases.” His words illustrate the importance of tsetse fly genome decoding for Africa. A repellant or insecticide to fight tsetse flies would be a more feasible solution compared to the difficult detection of the disease and distribution of drugs to cure it in Africa.

– Jaclyn Ambrecht

Sources: The Huffington Post, The New York Times, Business Weekly, WHO

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Curbing the Spread of Vector-Borne Disease

The theme of this year’s World Health Day, held annually on April 7th, was to promote the awareness of vector-borne diseases. Vector-borne diseases are transmitted through the bites of infected mosquitoes, flies, ticks and water snails, among other disease-carrying pests.

This year the World Health Organization (WHO) promoted the slogan “small bite, big threat,” in the hopes that they would be able to increase awareness on how people across the globe can protect themselves and their families from these pests and the viruses that they may transmit.

Vector-borne diseases have radically increased in the past few decades, aided by an increase in urbanization, international travel and environmental changes.

More than one billion people each year are affected by these diseases, which include malaria, dengue fever, Lyme disease, schistosomiasis and yellow fever.

Efforts to control the spread of these diseases have included the distribution of bed nets and insecticides, the use of body repellents and protective clothing, and the push for clean water and adequate sanitation.

WHO Director-General, Dr. Margaret Chan, noted, “A global health agenda that gives higher priority to vector control could save many lives and avert much suffering. No one in the 21st century should die from the bite of a mosquito, a sand fly, a blackfly or a tick.”

The focus this year is on dengue fever, which is currently the most rapidly spreading vector-borne disease in the world.

Dengue fever, also known as “breakbone fever” due to its symptoms, is a severe flu-like disease marked by vomiting, bleeding, body aches and difficult breathing. There is no known vaccine or cure available.

During the past 50 years, dengue fever has spread rapidly to more than 100 countries. Prior to 1960, dengue had seen some 15,000 cases, whereas now over 380 million cases of dengue fever persist.

The U.S. Centers for Disease Control and Prevention (CDC) is currently working on a vaccine for dengue fever in partnership with a company specializing in vaccine development, Inviragen. They have gone through clinical trials in a number of countries including Singapore, Colombia, Thailand and Puerto Rico, and analysis of those findings is still underway.

The International Federation of Red Cross and Red Crescent Societies is campaigning alongside the WHO to address this growing concern.

Previous programs to curb the spread of vector-borne diseases have proven successful, for example, the United States’ effort to combat malaria.

Malaria is the most deadly of vector-borne diseases, killing 1.2 million people every year. Multiple campaigns have been launched to prevent the spread of this disease, including the President’s Malaria Initiative (PMI) and the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria. PMI has distributed more than 120 million bed nets since 2006, as well as delivered more than 135 million doses of combination drug therapy.

These success stories provide hope for current efforts to control other vector-borne diseases such as dengue fever and schistosomiasis.

– Mollie O’Brien

Sources: Mission of the United States, Voice of America

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Project Hope Preserves the Legacy of the U.S. Navy

In the world of global development, Project Hope honors the legacy of the U.S. Navy and its service during World War II. Impassioned and committed to serving others, Dr. William Walsh returned to the U.S. from the South Pacific. Across the region, countless children died too young from preventable diseases. He then envisioned a “floating medical center” to provide health education and advanced care. In 1958, it became a reality.

Dr. Walsh directly lobbied U.S. President Dwight D. Eisenhower, persuading him to donate a U.S. Navy ship. As a hospital ship, the USS Consolation developed to serve the most at-risk countries. For two years, these partnerships “refitted and equipped” the ship it became the SS Hope. With $150, Dr. Walsh and the Navy converted this war-time ship into a peace-time ship. Individuals and corporations partnered to improve the care offered to those in need.

The Navy recruited doctors, nurses, and technologists throughout the country. For every U.S. citizen on-board, he or she had a counterpart in the country served. This counterpart received the necessary training, sustaining U.S. efforts to reduce the burden of disease.

On September 22, 1960 the SS Hope began its initial journey from San Francisco to Indonesia. The ship provided training and direct treatment to the following countries: Vietnam, Ecuador, Peru, Nicaragua, Indonesia, Columbia, Brazil, Jamaica, Ceylon (Sri Lanka), Guinea, and Tunisia. Fourteen years and eleven voyages, and the its spirit endures today through the work of Project Hope.

The ship retired in 1974, but Project Hope continues to honor its partnership with the U.S. Navy. Medical volunteers from the Navy provide land-based support, learning from the testimonies of HOPE alumni.

Project Hope advances the health care in developing regions by offering “training, technical assistance, and expert mentoring.” To build the capacity of local healthcare systems, this program must partner with local governments and private corporations. This ensures sustainable improvement, as opposed to immediate relief. Currently, the program aligns with traditional “train the trainer model.”

In times of crisis, its mission to enact lasting change persists. Those serving the region care for those in immediate need but instruct locals throughout the process and restores health facilities.

In addition to promoting health training, this program rehabilitate health facilities. Donations allow Project Hope to improve the distribution of medication and vaccines. Every year, it ships commodities worth 200 million dollars. The U.S. State Department serves as one of the largest donors, and Project Hope ensures this funding arrives safely to the necessary site.

Charity Navigator rates it 67 out of 70 in transparency and accountability. 95.1 percent of its total expenses directly fund services in developing regions, with an estimated three percent contributing to fundraising and two percent to administrative costs. This low overhead cost indicates a commitment to the service.

The SS Hope voyaged the world and today, its destination remains in the hands of those it served. Rather than passively providing resources, it empowers local men and women to steer the program.

– Ellery Spahr

Sources: Project Hope, Charity Navigator
Photo: Wikimedia

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Doctors Without Borders expelled from Myanmar

expelled
Doctors without Borders, also known as Medecins Sans Frontiers, is one of the most respected aid organizations in the world. It was created in 1971 by a group of doctors who desired to have a more direct approach to aiding those in need. It has provided aid to many countries that desperately need it. Doctors without Borders won the Nobel Peace prize in 1999 for its work helping those in war torn countries around the world.

In accepting the award in 1999, former head of the organization Dr. James Orbinski said, “Silence has long been confused with neutrality, and has been presented as a necessary condition for humanitarian action. From its inception, MSF (Medecins Sans Frontiers) was created in opposition to this assumption.”

The situation in Myanmar for the Rohingya could not be more dire and the comments of Orbinski could not be more apt. The Muslim Rohingya are the minority in Myanmar and are one of the most persecuted groups in the world, according to the United Nations.

Doctors Without Borders was an integral part of ensuring that the Rohingya received basic medical care and the services that they desperately need. The situation is more complex however as the government of Myanmar does not recognize the Rohingya as a legitimate ethnic group and persecutes and block their basic human rights at every turn.

Doctors Without Borders has been providing aid to citizens in Myanmar for the last 22 years, according to CNN, and was the largest non-governmental organization in the Rakhine state where the Rohingya live. The group was banned by the Myanmar authority for allegedly showing a “bias” towards the Rohingya who are termed Bengali by the Myanmar government which views them as illegal aliens.

There is speculation by a number of sources that the ban originated because Doctors without Borders put out a statement regarding a massacre of 44 Rohingya by state security officials. The UN and Doctors Without Borders maintain that the Rohingya were targeted by security forces and a mob of local Buddhist.

Myanmar’s government maintains that just one police officer was killed and no other violence occurred.

Doctors Without Borders was operating medical clinics for basic needs as well as HIV/AIDS clinics that were providing treatment to over 30,000 people. The NGO was Myanmar’s largest supplier of HIV medicine and the lack of treatment for this many could and will have devastating consequences in the long term.

Representative Joe Crowley is an outspoken voice on Myanmar and recently tweeted, “It is the responsibility of the Burmese government to protect its civilians. This is deeply troubling.” The Rohingya need more outspoken representatives in international governments around the world if they are to continue to be under the thumb of Myanmar’s oppressive government.

– Arthur Fuller

Sources: ABC, CNN, Doctors Without Borders, Los Angeles Times, Fox
Photo: Apologetics Press

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Will E-Cigarettes Tackle China’s Tobacco Monopoly?

e-cigarettes
Since 1982, the China National Tobacco Corporation (CNTC) has grown to be the world’s largest tobacco company, contributing almost 10 percent of total tax revenue to the central government. The state-backed monopoly has remained stubborn to reform in the wake of the roughly one million smoking-related deaths the country sees each year.

The World Health Organization (WHO) has recently released a statement saying that China needs to take a firmer stance against its giant tobacco industry if it hopes to reduce these numbers.

China has the world’s largest tobacco consumer base, home to more than 300 million smokers. In 2012, the CNTC had an annual net income of $18.6 billion, in contrast to the American-owned company, Phillip Morris International, with an annual net income of $8.57 billion.

So how do we tackle a multi-billion dollar monopoly?

The biggest problem is that the government itself is in the business. This creates a strong conflict of interest, which is proving difficult in weeding out the destructive habit.

In recent months, China has adopted several anti-tobacco measures, including banning government officials from smoking in public areas and banning smoking in schools. However, the tobacco monopoly has managed to continuously oppose reforms such as raising cigarette prices and using stronger health warnings on cigarette packs.

It seems that all hope is not lost.

A pair of tobacco industry manufacturers from southern China launched a joint venture on February 25 aimed at tackling the tobacco monopoly once and for all.

The collaboration between FirstUnion Technology, the world’s largest e-cigarette producer, and Jinjia, China’s biggest maker of cigarette packaging products, is an entrepreneurial match made in heaven. Both companies have achieved massive success in the southern city of Shenzhen and hope to rise among the ranks by manufacturing China’s first mass-market e-cigarettes.

E-cigarettes first entered the Chinese market in 2004 and have since been exported to major markets worldwide.

Their significance?

They have become the new alternative for tobacco smokers who want to avoid inhaling smoke. Also known as electronic cigarettes, or vaporizer cigarettes, they emit doses of vaporized nicotine, or non-nicotine vaporized solution, that is inhaled. E-cigarettes have been found to have comparable rates of success in helping smokers quit as nicotine patches.

Overall, this is good news for China, but bad news for the tobacco monopoly.

The partnership between the two Chinese companies is receiving a start-up investment of just over $16 million, but they might need support from the central government if they hope to succeed.

– Mollie O’Brien

Sources: The Street, Medical News Today
Photo: Carbonated

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Cuban Health Care System: A Model for All?

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Just last week, Cuba celebrated the 16th annual Havana Cigar Festival, despite the increase in anti-smoking measures around the world.

The festival, which began February 24, is the world’s premier cigar event, with more than 1,500 enthusiasts flocking to Cuba’s capital for the week. The annual occasion is meant to introduce tobacco specialists and cigar lovers to new cigars and how they can combine with haute cuisine. Among the events at the festival were visits to tobacco farms and factories, the launch of new cigar labels and visits to locally-grown tobacco markets.

The festival concluded on Friday with a real twist: a gala dinner and humidor auction, where $1.1 million was raised for Cuba’s public healthcare system.

The festival sparked much public interest into the current state of Cuban health care, often noted as a public health care model that could inform other developing countries.

Cuba’s health care system is a private-payer system managed by the government. Its focus is on prevention and community health, with 1,000 patients per physician in urban areas. Primary care is highly valued and physicians tend to live in the same communities as their patients.

Virtually all citizens of Cuba have been vaccinated and the life expectancy of 78 is almost identical to that of the United States. The infant mortality rate is lower than that of the U.S., with fewer than deaths per 1,000 births. The literacy rate is 99 percent and health education is a mandatory part of school curriculum.

These improved health outcomes are largely due to the fact that the healthcare system addresses immediate bio-medical concerns as well as the social determinants of health such as nutrition and education.

Despite these advances, there are still major problems occurring within Cuba’s health care system. The country is far from developed and lacks basic infrastructure needed to maintain a healthy population. Resources are limited, technology is at a minimum and the Internet is often hard to obtain.

Some of these obstacles are beginning to be addressed by the Cuban government. For example, resources have been invested in developing more advanced biotechnology at the level seen in countries such as the U.S.

With the help of the generous donation to Cuba’s health care system made Friday, people might see some of these advances in the near future.

– Mollie O’Brien

Sources: Daily Journal, Chicago Tribune, The New England Journal of Medicine
Photo: National Turk

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Asthma in Developing Countries

Asthma in Developing Countries
Asthma is often considered a burden of wealthy countries.

However, asthma is a public health problem that is increasing with globalization and modernization. Although diagnoses may differ, symptoms are present across all regions of the world. Sociological, economic and educational differences play a large part in the lack of diagnoses in developing nations.

Despite being a burden to high-income countries, most asthma-related deaths occur in low to middle-income countries.

According to the American Academy of Allergy Asthma and Immunology, an estimated 300 million people worldwide suffer from asthma, with 250,000 annual deaths attributed to the disease.

However, there have not been reliable epidemiological studies to determine the magnitude of the disease in many developing countries.

Asthma is a difficult disease to tackle in developing countries. The limited data and the expense of the problem makes it difficult to diagnose. It typically takes two different asthma exacerbations less than six months apart for an individual to be officially diagnosed by a physician.

This can be troublesome for developing countries who may have as little as one physician for every 10,000 people. Rural locations can also have compliance and testing issues.

However, because the effects of asthma go hand-in-hand with the social determinants of health, impoverished countries are at a high risk for this “wealthy-nation-disease.” Increasing air pollution and rapid industrialization create ideal environments for asthma to thrive. Asthma is further complicated by poor access to medical services and high drug prices.

Chelsea Stone, a student at Drexel University’s School of Public Health, studies epidemiology and focuses on asthma in developing countries.

While Stone was conducting research in Haiti, she found that education was the biggest hurdle to treatment. Only half of the families surveyed in the Croix des Bouquets community knew or had heard of asthma, revealing a large gap in health education. Asthma surveys have to be worded in concise, culturally appropriate ways.

In other asthma studies, rates have varied from 3% to 30% depending on location and survey methods. Solomon, an older man, willingly discussed his asthma with Stone.

Asthma typically beings in early childhood, as it had with Solomon.

He explained that his symptoms are better than they were while living in New York City because of the climate. Solomon was educated on the disease, a significant factor in controlling asthma attacks. Since there wasn’t always medications available or access to the emergency department, Solomon used natural remedies, such as coconut oil, to help with asthma flare-ups.

Asthma education is a substantial part of controlling the disease and preventing asthma-related deaths. Since there is limited data on asthma in developing countries, there is little education as a result.

This lack of research generates an under-diagnosed and under-treated disease.

The burden imposed on individuals and families is restricting and socioeconomically hindering. The availability of modern medications can complicate treatment and management. Even if there is access to an emergency department, they may not be equipped with proper medication to control asthma.

Avoiding asthma triggers all together can also reduce the severity of asthma. Some argue that there is not enough education centered on asthma awareness and signs of these triggers. Asthma education and management should be taught not just at the community level, but also integrated into nation-wide health staff education.

– Maris Brummel

Sources: Elsvier, World Health Organization, NCBI

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5 Facts About Hunger in Rwanda

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The Republic of Rwanda is a small sovereign state in the Eastern part of Central Africa. Rwanda ranked at 166 of 187 countries on the UNDP Human Development Index in 2011. Rwanda also has the highest population density in the region with 416 people per square kilometer.

Low income, limited natural resources, and food and water insecurity pose a problem for citizens in Rwanda every day. In the years following the Rwandan Genocide in 1994, international rebuilding efforts have been on the ground trying to make sustainable changes to alleviate some of the hunger and water issues.

Here are five facts that explain the state of hunger in Rwanda and how it may change in the coming years:

  1. The 1994 Rwandan Genocide marked the end of the ceasefire signed the year before that stopped the fighting of the Rwandan Civil War. The war began between two ethnic groups the Hutu and Tutsi. The Genocide began when the plane carrying the Hutu supported president Juvenal Habyarimana was shot down and he, along with several other members of the government, were killed. The genocide lasted 100 days and an estimated 800,000 to 1,000,000 people were killed. The fallout from the Rwandan Genocide is the cause for much of the instability in the region that lasts today.
  2. Secondary school attendance in Rwanda is one of the lowest in the world and the literacy rate is 55%.
  3. Approximately 65% of the population has access to safe, clean drinking water
  4. 45% of children under 5 years of age are malnourished.
  5. Over 67,000 refugees from neighboring countries currently reside in Rwanda.

Even though there is a lot of strain on the country today, organizations have been working with the government to address one of Rwanda’s major problems: food insecurity. Agriculture was the country’s main sector before the genocide, and since then, major efforts have been made to make it profitable one more.

Updating the agricultural practices is what the World Food Programme credits with directly reducing the number of food insecure people.

The country hopes that with the reliance on agricultural programs it will improve its GDP to US$900 by the year 2020, up US$380 from its current GDP. Rwanda was also the first country to sign the Comprehensive Africa Agriculture Development Programme (CAADP), meaning that addressing malnutrition and food insecurity is one of the government’s main priorities.

Even though Rwanda still has a long way to go, the government has been taking steps in the right direction that could provide a template for other countries in the region to follow.

– Colleen Eckvahl

Sources: World Food Programme, World Vision
Photo: Rising Continent

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4 Issues Contributing to Malnutrition in the DRC

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Kinshasa, DR Congo

The second largest country in Africa and is located in the middle of the continent. Since the 1990’s the country has been in a state of political unrest and civil war which is the cause of many of the other problems in the region, such as disease, food insecurity, human rights violations, and violence against women.

Here are four issues that contribute to nearly 6.3 million people remaining food insecure and over half of the children under the age of 5 classified as malnourished in the DR Congo:

  1. Political instability between the government and several militia and rebel groups. Peace talks have been ongoing since 2009 with little progress. Since 1998, 5.4 million people have been killed. Less than 10% were killed during the fighting, instead the majority have died from diseases and malnutrition.
  2. 2.7 million people are internally displaced within the DRC as a result of the civil war. 1.6 million are in the North and South Kivu region, where much of the heavy militia activity takes place. There are an additional 116,000 refugees from neighboring countries currently living in the DRC. The large number of displaced people and perpetual fighting in the country has led to a high rate of abuse and sexual assault of women and children. It is estimated that 400,000 women between 15 and 49 were raped between 2006 and 2007. This is the equivalent of 48 women being assaulted every hour.
  3. 3.71% of the population lives below the poverty line, meaning they live on less than two dollars per day.
  4. Rampant infectious diseases are common across the country such as Malaria, Dengue Fever, Typhoid Fever, and HIV/AIDS. The ministry of health said that Malaria was their number one disease concern and in 2011 alone there were 4,561,981 reported cases.

– Colleen Eckvahl 

Sources: The International Campaign to Stop Rape and Gender Violence in Conflict , WFP, WHO
Photo: This is Africa

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Female Genital Mutilation and Poverty

Female Genital Mutilation
Female Genital Mutilation (FGM) ruins countless lives every day. FGM is a humiliating torturous cutting of the female genitalia carried out by various groups of the community, including health practitioners, elderly people and female relatives. According to the World Health Organization (WHO,) four types of FGM procedures exist:

Clitoridectomy

The partial or complete removal of the clitoris.

Excision

Involves removal or partial removal of clitoris, as well as labia.

Infibulation

Narrowing of the vaginal opening.

Other

This includes other forms of FGM not classified above, such as, burning, piercing or scraping. Any one of these types of FGMs is carried out on a female at any time in her life.

Millions of cases of FGM are reported each year. According to the WHO, over 100 million women and girls have had their human rights violated.

FGM is considered a human rights violation because it inflicts unnecessary pain and harm to unwilling women and girls. Laws against FGM practices have been created in 18 African countries. If caught sentences from three months up to life in prison are given.

There are also 12 industrialized nations that have passed laws criminalizing FGM.

An 8-year-old girl from Djibouti died from the effects of FGM. She was held down by friends and neighbors while a “practitioner” subjected her to FGM. Her clitoris, labia minora and labia majora, all external genitalia, was cut away causing uncontrollable bleeding.

After the procedure was done the girl’s legs were tied shut to promote “healing” and she was refused water because the need to pass urine was thought to introduce bacteria to the wounds. The young helpless girl continued to bleed throughout the evening and sob uncontrollably due to pain.

Eventually the girl was taken to the hospital and given a blood transfusion. Sadly, it was too late to save her life.

FGM has been reported in 28 African countries and various Asian countries.

According to data from the WHO, seven countries: Djibouti, Egypt, Eritrea, Guinea, Mali, Somalia and Sudan have a FGM prevalence rate affecting 85 percent or more women. Other African countries have only slightly lower prevalence rates; a large portion of the African continent has not received FGM rates.

FGM is most likely performed in lower class poverty-stricken communities. This is due in part to the fact women and girls do not know FGM is against the law. Most believe that it is there duty as a woman to have FGM performed and if they refuse, they will be harshly criticized and shamed. These are the ones who are not held down and forced against their will.

Several campaigns to eradicate FGM from the world are underway. One government organization, the United Nations, has been tackling it as one of the world’s Millennium Development Goals. Also, Women against Female Genital Mutilation leads campaigns to increase awareness of FGM laws and harmful health and psychological effects of FGM on females.

The continuation of advocacy for women and girls suffering from Female Genital Mutilation needs to last until FGM prevalence is zero. People should continue to call their congressmen, write their legislature, and advocate for worlds helpless.

Hopefully, through the increased awareness, global campaigns, and laws FGM will become a thing of the past and no female will have to endure torturous inhumane pain ever again.

– Amy Robinson

Sources: World Health Organization, All Africa, WHO, UNICEF, Center for Reproductive Rights
Photo: International Business Times