Archive for category: Health

Information and stories on health topics.

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Anthropologist Comments on Malnutrition in Kenya

Interview With Anthropologist on Malnutrition in Kenya
In Kenya, over 1.5 million people are facing food shortages and high levels of malnutrition. Most of these people live in rural areas, particularly in northern Kenya. The fact that these people are so far away from the more industrialized areas of Nairobi and Mombasa means that they are both more difficult to reach and easier for a country to ignore. Some people live away from areas that are accessible by any sort of road and many people are only reachable by dirt roads, which are often treacherous.

When some people are reached the food is often things such as beans and corn, which do not offer all of the nutrients that people need.

To find out more, I talked to anthropologist Professor Jon Holtzman about his research regarding nutrition in Northern Kenya.

Q: What nutritional research have you done in Kenya?

A: I studied the Samburu in Nothern Kenya. They are pastoralists. They traditionally rely on their herds.

Q: What did you find in the gender differences in nutrition?

A: Both men and women were less well off as they aged, but men tended to be more adversely affected by aging. They tended to get more malnourished as they aged.

Q: Why do you think these differences occur?

A: There’re generally food shortages among the Samburu and although men have more political power, women control the distribution of food in the house. The food is sometimes scarce.

Q: How has the rising population changed the nutrition of the Samburu?

A: They no longer have enough cows to rely on the products of their herds, particularly milk. In 1950 there were probably about 50,000 Samburu and they had about 350,000 cows, so each person could get enough milk. Now there are about 200,000 Samburu and about 200,000 cows, so it isn’t possible to get enough milk. They just sell livestock to buy things like maize meal, which aren’t very nutritious and are low in key nutrients, such as protein.

Q: How is this affecting the health of the Samburu?

A: Generally they are very thin and their growth rate is reduced. They are very vulnerable to diseases associated with poor nutrition, such as tuberculosis and other infectious diseases.

Q: What sort of assistance would be best to help this population?

A: It isn’t an easy problem to solve. More support for health care and programs that bring new and sustainable economic activities to remote areas could be the best hope.

Groups like UNICEF and USAID are doing work to try to help people with low access to nutritious foods and potable water. But without the necessary funding, there is only so much that can be done.

– Clare Holtzman

Sources: UNICEF
Photo: Flickr

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Ready for the Next Global Epidemic?

global_epidemic
Less than one year ago, the Ebola outbreak scared the world and killed over 10,000 people. A recent poll taken by The World Bank Group reports that there are still concerns regarding the policies that are supposed to prevent another outbreak. Citizens in five different countries – France, Germany, Japan, the United States and the United Kingdom – say they are not convinced that the world leaders have taken the proper steps and protocols to prepare their countries for another global epidemic.

The World Bank Group’s article states that the poll reports nearly 6 in 10 people support investments and policy changes in developing countries that will help protect their own country from global epidemics. The first cases of Ebola during the outbreak were seen in some of the poorest countries in the world. These countries lacked the financial resources and manpower to deal with an outbreak that spread past rural villages and major cities, and quickly crossed borders.

What steps need to be taken to bring attention back to the fact that many countries are unprepared? Some responses from the poll state that by raising awareness about policies that help bring doctors, nurses and clinics to developing countries, epidemics can be prevented and policies can be developed to better prepare hospitals in our own countries as well. Policies that strengthen health care and stop a disease before it becomes an outbreak are needed.

With the risk of global outbreaks becoming increasingly common due to an overly connected world, the fact is that a batch of bad fruit on a cargo ship or a single sick person on a crowded airplane can start an outbreak.

– Elizabeth Steadman

Sources: The World Bank, PBS 1, PBS 2
Photo: Flickr

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The Color Blue Puts an End to Sleeping Sickness in Africa

sleeping_sickness
For rural Sub-Saharan Africans, a walk to the riverbank to wash clothes, gather firewood or collect water is a risky business. About 1 in 1,000 Tsetse flies, which swarm by the river’s edge, are carriers of a parasitic disease called sleeping sickness, which eventually infects the victim’s brains, driving them mad before killing them. In 2013, at least 7,000 cases of this rabies-like disease were reported.

Due to vague early symptoms such as headache, joint pain and bouts of fever, the disease is difficult to diagnose in the beginning. Although it is curable with drugs, patients are often experiencing its later stages before they realize they have been infected. True to its name, patients find it impossible to sleep during the night and impossible to remain awake during the daylight in its later stages.

Those living in rural areas may not make it to hospitals because of the far distance, but thankfully today, researchers have found that the number of individuals suffering from sleeping disease in the region of Uganda has been cut by 90 percent. The reason? Scientists have discovered a weakness for these insects with a lethal bite: the color blue. Because these flies search for something to bite which contrasts with green vegetation, bright colors, especially bright blue, drives them crazy.

With this newfound knowledge, along the riverbanks in the West Nile region in Uganda, handkerchief-sized blue squares attached to wooden stakes netted with insecticide are staked about every 50 yards. It only takes 3 minutes before these flies will drop dead. These life-saving fly traps are relatively cheap and have significantly contributed to a decrease in the number of people being affected by the disease. Last year, fewer than 10,000 cases were reported versus about 300,000 cases reported by the World Health Organization (WHO) during the height of its epidemic in the late 1990s.

WHO hopes to eliminate flies carrying the disease within five to six years. Ministry of Health worker Dr. Charles Wamboga has seen fewer cases and believes that a future free from this deadly disease is possible for a people whose very lifeline flows within their rivers.

– Nikki Schaffer

Sources: NPR, WHO
Photo: Flickr

“Internet Hospital” in China Helps Patients Access Care

The "Internet Hospital" in China Helps Patients Access Care
The Internet has proven a great advancement in many fields of work with recent trends of globalization. We are more connected than ever, and access to the Internet is not dependent on economic status. For example, people living in developing countries can access the Internet through inexpensive mobile phones.

What if patients could receive healthcare services via the Internet?

This concept has been actualized in the Guangdong province of China with the innovation of an “Internet Hospital.”

This “hospital” provides outpatient service delivery. Patients only need to travel short distances from their homes to local medical consultation facilities. At the facility, the patient is able to meet with a doctor from a high-level hospital that is more central to the city. The consultation occurs with a webcam and instant messaging.

The doctors ask questions of the patient, who can also send or show images of medical checks. While this takes place, the patient’s body temperature, blood pressure and other medical information are collected. It is then sent to the doctor, who can use the data in combination with the webcam interaction to diagnose the patient and write a prescription immediately.

This type of healthcare service is ideal in China because high-level hospitals are often overcrowded expensive. Patients are less likely to visit local health clinics because they are perceived to provide low-quality care. To some extent, skilled doctors also choose not to work in small communities with fewer opportunities for career growth and increased salaries.

The advantages of the Internet hospital include high-quality and personalized health care accessed from more convenient locations. In high-level hospitals, doctors are likely to spend only a couple of minutes which each patient; however, the Internet hospital allows these same doctors to spend more than 10 minutes with each patient. Furthermore, the average cost of drugs from local clinics is only a quarter of that of drugs purchased at top-level hospitals. While the same skilled doctor writes the prescription, the medicine is purchased from the local clinic versus the large hospital.

Implementation of the Internet hospital has proven successful. More than 500 patients are seen every day and there are now over 1,000 sites for the medical consulting facilities. These facilities have high satisfaction scores.

While health insurance, quality control and the cases of diagnoses that cannot be made via the Internet all pose potential challenges for the Internet hospital, it has helped many people and continues to make healthcare more affordable and accessible.

– Iliana Lang

Sources: The Lancet Global Health, The Journal of Health Economics
Photo: Global Times

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Twin Pregnancy in Developing Countries

Twin_births
Multiple births, two or more babies born at the same time, are a relatively small percentage of all the births worldwide. Twins represent only 3.3 percent of births in the United States (CDC) and, depending on the global region looked at, the rate is even lower in the developing world.

But even with such small numbers, twin births can present a large health concern for both mother and unborn children alike. The risks are even more pronounced in the developing world.

Twins have a much higher chance of being born prematurely, and they can be underweight, which often leads to more time in the NICU. Also, twin-twin transfusion, “when identical twins share a placenta and one baby gets too much blood flow, while the other baby doesn’t get enough,” is a possibility. The most startling statistic is that in the developing world, “among stillbirths, the proportion of twins is probably somewhat higher than among live births, as fetal (and neonatal) mortality is higher among twins.”

Complications arise when mothers do not receive adequate prenatal care. Women in the developing world often do not receive enough care when they are pregnant with a single child, let alone the need for additional monitoring and ultrasounds when having a multiple birth.

A study conducted in urban Guinea-Bissau found that “sixty-five percent (245/375) of the mothers who delivered at the hospital were unaware of their twin pregnancy.” Sometimes a mother will not measure larger than average to indicate a twin pregnancy, a second heartbeat is not always discernable, and/or bloodwork is not drawn to measure hCG (pregnancy hormone). Even if any of those previous criteria were met, only an ultrasound can confirm a multiple birth.

The unborn children are not the only ones at risk; mothers also face pregnancy complications at a higher rate when carrying multiple children, like pre-term labor, anemia, gestational diabetes, preeclampsia, hyperemesis gravidarum (severe morning sickness), polyhydramnios (too much amniotic fluid), miscarriage/stillbirth, postpartum depression and postpartum hemorrhage.

While these issues have the possibility to affect all mothers experiencing a multiple birth, the complications can be exacerbated when they live in poverty. Access to a hospital for an emergency may not be possible, especially in regions that are remote. Finances to afford a hospital stay can also be an issue, especially since many multiple births are delivered through c-section.

A 2008 study done in a rural mission tertiary hospital in Nigeria found that of the twin deliveries that happened there, 60 percent of the twins were delivered c-section, 36.4 percent were vaginal deliveries and the remaining 4 percent had vacuum deliveries. C-sections are often performed due to emergencies, premature delivery and fetal malpresentation.

Even though it seems like twin pregnancy is bleak, the opposite can be true. The UN’s fifth Millennium Development Goal is to improve maternal health. While multiple births are not specifically addressed, the positive improvements to help mothers and their unborn babies will also help those pregnant with twins. Multiple births must be monitored as a high-risk pregnancy but not all (or any) complications may occur. But with improved medical care, when those complications do arise they can be addressed and the rate of stillborn twins can decline even further.

– Megan Ivy

Sources: NIH 1, CDC, March of Dimes, UN, NIH 2, NIH 3
Photo: Babies Magz

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5 Ways to Ensure Effective Health Aid Dispersal

Health AidNot all aid is created equal. In the fight against global poverty, ensuring sufficient funds for aid programs is only half the battle. The other half is ensuring that aid is results-oriented, transparent, expedient and cost-effective.

During the second High-Level Forum on Aid Effectiveness in Paris in 2005, the Organization for Economic Cooperation and Development (OECD) countries formulated the Paris Declaration. This declaration was meant to set benchmarks for how to measure the five key categories of effective aid: ownership, alignment, harmonization, results and mutual accountability.

While these five categories are intended to measure the effectiveness of all kinds of aid, they are particularly pertinent to health aid. Developing public health infrastructure in poorer countries is the “gift that keeps on giving,” ideally continuing to serve local populations well after aid has ceased. Thus, a robust public health outcome is an ideal metric to judge the quality of aid using the five categories of the Paris Declaration.

1. Ownership

Ownership, according to the Paris Declaration, involves partner countries exercising “effective leadership over their development policies and strategies.” This category is a measurement of how much aid recipients are involved in developing and executing programs that actually take advantage of the aid they are receiving. Aid strategies have traditionally assumed that once a country reaches middle-income status, it will have sufficient resources and self-interest to invest in public health, but unfortunately, this is not always the case.

For example, Nigeria is technically a middle-income country, but it spends less on public health than Rwanda, which a low-income country. Health aid can really only be considered effective if countries take ownership of health programs that outlive donor support as the country transitions into middle-income status.

Ownership is especially important given a recent estimate by the World Health Organization that predicts that in the next few decades, there will be a global health workforce shortage of up to 12.9 million. Aid programs need to ensure that recipients are developing adequate long-term strategies, especially when it comes to investing in health training and education.

2. Alignment

The dimension of alignment measures how well aid matches up with recipient strategies for dispersal and development. Development experts often criticize “tied” aid. This is aid that is contingent on the recipient procuring health products from the donor country, using their distribution infrastructure, employing foreign personnel or involving some other condition which is often not the most cost-effective or desirable for the recipient. Alignment essentially means “untying” aid to make sure that it aligns closely with the national development strategy of the recipient country.

A topical example of the alignment of health aid in the Global Food Security Act of 2015. This bill, currently introduced to the House and awaiting consideration, encourages local procurement of food aid for U.S. aid programs (among other things). Traditionally, food aid dispersal from the U.S. has been tied, requiring that a certain percentage of that aid be procured from the U.S. and dispersed using the U.S. merchant marine.

However, this bill seeks to do away with those requirements and favors recipient-country producers. This encourages the growth of local agriculture and health aid infrastructure, rather than out-competing them. Additionally, local procurement is faster, and in the event of a humanitarian emergency, recipient populations would not have to wait as long for foreign aid to reach them.

3. Harmonization

Harmonization involves cutting down on the plurality of programs that may have the same goal yet interfere and undermine each other. An aid recipient country may be host to dozens of organizations or programs that target public health outcomes yet do not communicate with each other, thus creating redundancies or inefficiency.

Harmonization is especially critical to public health, more so in emergencies. Currently, there is no standard system whereby donors can track and share how much and to where health aid is going, making it difficult to determine where it is most needed. The recent Ebola epidemic was a particularly disastrous indication of the need for better logistics and donor coordination; it is difficult to tell if health aid has even reached a recipient population, much less if it is redundant, or necessary.

4. Results

Just as it is important to harmonize aid efforts, tracking the progress of health programs has also been an ongoing challenge for donors and recipients. Health aid, despite good intentions, can be totally ineffective when it isn’t results-oriented. Tracking public health outcomes generally involves better data collection and census practices, which can be incredibly difficult to implement in developing countries that lack basic infrastructure.

Very recently, the Girls Count Act passed the U.S. House of Representatives. This act directs the Secretary of State as well as the United States Agency for International Aid and Development (USAID) to work with developing countries to build adequate civil registration systems as well as create economic and social policies that are deliberately inclusive of women and girls. The idea is that better demographic data and inclusive policy can help traditionally marginalized populations (such as women) take advantage of existing social safety nets. Additionally, better demographic data would lead to more effective health aid, as donors often lack access to accurate census information and thus may be unaware of vulnerable populations, or unable to determine the impact of aid.

5. Mutual Accountability

The final category calls for recipients and donors to exercise “mutual accountability and transparency in the use of development resources.” This emphasis on accountability stems from a history of aid inefficiencies due to a lack of transparency, or even outright corruption in recipient countries. For example, millions of dollars in aid money were simply pocketed by corrupt dictator Mobutu Sese Seko of the Republic of Zaire (now the Democratic Republic of Congo) during the ’70s and ’80s.

Conversely, donor countries must be transparent about where aid flows are going in order to provide recipient countries (as well as other donors) with accurate information they can present to their citizens. In general, developing genuine partnerships between donors and recipients is crucial in ensuring that resulting health and development programs are effective and long-lasting.

– Derek Marion

Sources: Reuters, Devex, Partners in Health, OECD
Photo: OECD

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Life Saving Dot: Iodine Coated Bindis

Life_Saving_Dot
In India, 350 million people are at risk for iodine deficiency. Iodine deficiency leads to a variety of harmful conditions in adults, including hypothyroidism, goiter, an increased risk for breast cancer, and brain damage. In the unborn children of mothers with a deficiency, the condition results in a condition known as fetal hypothyroidism, improper conditioning of the gland in unborn children which can result in cognitive birth defects and even stillbirth.

So when Grey for Good, a charitable branch of the Singapore-based Grey Group, offered a solution to the problem, it needed to be innovative in combatting this very real public health risk. What they noticed is this: many Indian women wear a bindi, or a small red dot in the center of the forehead, for cultural or religious reasons. With this came an idea: is there a way to use the cultural trend to combat the condition?

Grey for Good teamed up with Indian NGO Neelvasant Medical Foundation and Research Center to begin distributing affordable bindis which double as iodine supplements. Called Life Saving Dot, or Jeevan Bindi, the back of each bindi is coated in iodine, creating a “patch” which can deliver up to 150 micrograms of iodine through the skin over the course of eight hours, which is the recommended amount of iodine for women.

Life Saving Dot is also affordable. A pack of 30 bindis is sold for 10 rupees, or just 16 cents. Perhaps this is why the bindis have reached over 300,000 women in 100 villages that the Indian government has deemed at risk for iodine deficiency.

In distributing Life Saving Dot, Grey for Good has taken an innovative approach to solve a problem, uniting medicine, technology, business and culture as a force for good. By bringing these things together, they have created a truly modern solution to the problem of iodine deficiency.

– Andrew Michaels

Sources: Take Part, NPR, UpWorthy, Global Healing Center
Photo: Life Saving Dot/Facebook

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E-Health Point Provides Access in Rural India

E-Health_Point
E-Health Point is a series of medical units owned by Healthpoint Services India that provide medical care, clean water and medicines to families living in rural regions in India. They specialize in unique concepts and models to improve wellness, productivity and quality of life. E-Health Point also follows a Social Business Enterprise Model that demonstrates democratizing healthcare, social impact, sustainability, growth potential and innovation.

The organization was launched in 2009 with the goal of providing preventative and curative healthcare to people in impoverished communities. E-Health Point operates based on Electronic Medical Records which provide doctors and patients knowledge of proper healthcare and real-time disease surveillance capability. Clinics are initially formed as water services and become clinics over time. As of 2011, there were eight clinics and 16 water stations in India.

E-Health Point works with multiple unique technologies and methods like Broadband and Telemedicine and Point of Care/Mobile diagnostics and combines models used by private and public organizations to pioneer the rural health industry. They have collaborated with organizations such as Bhati AirTel, Athenahealth USA and Procter and Gamble to provide funds and resources to ensure physicians and patients give and receive proper medical attention.

E-Health Point treats water for contaminants by using advanced reverse osmosis, a process that uses a semipermeable membrane to remove large particles from drinking water and applied pressure to eliminate chemicals. Reverse osmosis can also remove molecules, ions and bacteria to make water potable.

To democratize the healthcare system in India, E-Health Point provides healthcare to citizens regardless of their gender, caste, social or economic status. They create a social impact by helping residents living in rural regions and semi-urban communities receive access to healthcare especially when the majority of them do not have the funds or resources to obtain it.

E-Health Point was founded by Amit Jain, Dr. Allan Hammond and their team of health and business professionals. With a global and local team, the organization has successfully teamed up with multiple business partners to keep healthcare systems intact in multiple regions in India including Malout, Bathinda and Goniana. The organization hopes to increase its medical coverage to rural regions of Africa and South America.

– Julia Hettiger

Sources: Health Market Innovations, Changemakers, Forbes
Photo: NPR

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Healthcare Workers: The Key to Health Progress

healthcare_workers
One part of healthcare frameworks and policies often overlooks a crucial element of global health — the healthcare workers. They are the ones who work on the ground, who know the issues that plague the people, who work and improvise with the limited resources, and who know the people. Healthcare centers in developing nations are often staffed with low-level medical staff, especially in more rural and hard to reach places. If these health providers had more training or better training, healthcare could improve as the result of workers having better skills to identify and to fix sicknesses and complications.

To become a healthcare worker one must be accepted into an educational establishment; however, often times these require a secondary education, something many poorer people in developing nations do not have access to. Educational reforms are part of the investment for a successful healthcare system. Having training centers that complete their three-part mission of teaching, researching and serving can make huge impacts on the trainees who will go out into the communities.

GE recognized the importance of educating healthcare workers and thus has decided to invest over US$1 billion to train 2 million global healthcare providers. The hope is that GE can establish itself more firmly in developing nations to bring more people access to healthcare.

The GE healthcare president sees that “challenges around localized capacity building, training and innovation are consistent themes for many healthcare systems and Ministries of Health around the world.” The invested money will go towards training people to use GE medical equipment in order to address those challenges. Both local governments and institutions, as well as costumers, will help in the process of determining what the health needs of a particular area are.

GE has long seen the link between healthcare workers and global health progress. They have invested in areas such as Kenya, Turkey, the Middle East, Russia, China and Brazil. In total, GE has invested more than US$118.2 million in healthcare, training more than 100,000 rural doctors and other healthcare givers.

– Katherine Hewitt

Sources: Fierce Medical Devices, WHO
Photo: Healthcare Design Magazine

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Beijing’s Ban on Smoking

Ban_on_Smoking
Though the June 1st ban on smoking wasn’t the first of its kind in Beijing, it may be one of the most effective. The ban comes at a time when China has the highest number of male smokers. It is estimated that one-third of all cigarettes sold globally are produced by China National Tobacco Corporation, with 43% of tobacco produced in China.

The high rates of smoking in China, and in particular Beijing, are especially concerning. About 60% of male doctors smoke and few associate the habit with health problems other than vascular ones. Without the widespread knowledge and dissemination of the risks associated with tobacco smoking, people often have little incentive to stop.

China’s smoking problem is also largely a cultural one, concentrated in masculinity. While an estimated 45% of men smoke, only about 2.1% of Chinese women do. However, when looking at the plethora of health problems that stem from smoking, men, women, and children are all affected. The high volume of smokers combined with the thick covering of smog cloaking entire cities creates a pocket of pollution where the effects of second-hand smoke are exacerbated.

The latest ban introduced in Beijing bans all smoking in indoor places with an added level of severity-fines. People who act against the ban are subject to fines of $32 and businesses that allow people to smoke on their premises will be fined $1,600. In the past two months, about $16,000 has been collected in fines from the ban, but in the coming months that amount may rise. The Beijing Municipal Commission of Health and Family Planning has discussed the possibility of increasing fines for individuals to $800. What’s more is that any person who violates the law three times is subject to being publicly named on a government website, a clause that aims to shame.

Upon the initial implementation, support was strong and people seemed excited. However, as is the case with most past similar bans, the popularity fades and as the attention slips away so does the people’s enthusiasm and commitment. On the contrary, this particular ban has shown more promise. Almost two months post-implementation, the ban still sees support from pop culture icons and a visible decline in indoor smoking. With Beijing getting a little extra focus from the Chinese government for being the capital, perhaps this particular ban will see greater success than past ventures. If the abstinence continues, Beijing will be able to serve as an example to other cities around the country, and the overall rate of smoking will likely decline.

Although such a decline in vast numbers of Chinese smokers will affect the nation’s economy slightly, the overall benefits to health seen in both men and women will create a healthier working class that will reciprocate any losses by boosting the workforce and spending. Also as smoking rates decline, women will face fewer health risks imposed by their male counterparts, which will make for a more fair environment for women, although China continues to struggle in gender equality, it is a step. Like all newly implemented programs and policies, the ban can only restrict smoking so far, but it is a very positive step for Beijing and for China. In order for China to fully reap all of the rewards from smoking reduction, a cultural change is needed, which is often times the harder of the two to enact.

– Emma Dowd

Sources: BBC, CNN, FP
Photo: Flickr