Archive for category: Health

Information and stories on health topics.

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Gaza: Sewage System in Crisis

Gaza’s sewage system is in crisis.

According to The Independent, “War has stopped the plant doing the job it was built for: limiting the pollution of the Mediterranean by semi-treating the 40 million litres a day it pumps into the sea.” Sewage leakage goes directly into the sea and dirty water seeps into the ground and groundwater. The sewage system has been rendered ineffective due to Israeli restrictions on imports, infrastructure errors, continuing violence and increases in population.

Hamas’s takeover of the enclave last year was met with an Israeli embargo, limiting imports to mostly food and medicines. According to the U.N. Office for the Coordination of Humanitarian Affairs, this has affected the ability of aid groups (including the United Nations, the International Committee of the Red Cross and CARE International) to import equipment like pipes in sufficient quantities on a regular basis.

The sewage crisis is not only a result of poor maintenance, for the population of Gaza has increased from 380,000 in 1967 to nearly 1.5 million, therefore adding pressure to an already insufficient sewage system. The ongoing violence and security situation has been an ongoing threat and hindrance to the sewage crisis as well, for resources are being directed elsewhere.

The Israeli embargo limits the amount of aid and supplies that can be imported, therefore acting as a significant prevention to resolving the issue. The humanitarian situation in Gaza is exacerbated by the sewage crisis, for it has fomented issues with clean water and sanitation.

There are three treatment plants in Gaza: one in the north, Beit Lahiya, one near Gaza City and one near Rafah. The treatment plan in the south, near Rafah, is the primary treatment lagoon; however, it lacks the capacity to treat a majority of the sewage it receives. Citizens near Khan Younis are still using septic tanks, and the overload on the Beit Lahiya plant led to the creation of a “great lake” of waste water that multilateral bodies and nongovernmental organizations are attempting to slowly drain. Five people have died in a torrent of filth from a smaller lake in 2006.

According to the ICRC, “The environmental situation in Gaza is bad and getting worse…While exact statistics are unavailable, 30,000-50,000 cubic meters of partially treated waste water and 20,000 cubic meters of raw sewage end up in rivers and the Mediterranean Sea. Some 10,000-30,000 cubic meters of partially treated sewage end up in the ground, in some cases reaching the aquifer, polluting Gaza’s already poor drinking water supply.”

While there have been plans to build new plants or fix existing ones, the problem of sewage is critical. Most of the financing is currently coming from donors, though the medium and short term goals are to continue to drain the Beit Lahiya basins and work to at least partially treat all waste water. This approach, however, depends on the borders opening up and full donor cooperation, along with the willingness of companies to bid on tenders.

– Neti Gupta

Sources: Electronic Intifada, The Independent
Photo: Flickr

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Malnutrition in Myanmar

malnutrition in myanmar
Myanmar, formerly known as Burma, has an estimated population of 53 million people. Of this population, 2.5 million children in Myanmar suffer from stunted growth as a result of being malnourished over an extended period of time. Malnourished children often experience long term debilitating mental and psychical effects. These effects also impact the community and health resources available.

Currently, the rate of malnutrition in Myanmar is staggeringly high. The western area of the country, where 1.3 million Rohingya Muslims live, has unprecedented levels. More than 140,000 people are subjected to living in filthy, overcrowded camps. Others face restricted movement from villages and a lack of access to basic needs, such as clean water, food, education and healthcare. Political issues and ethnically motivated crimes have caused over 200,000 people to flee to neighboring areas such as Bangladesh to save their lives.

Human Rights Watch reports have indicated that ethnic cleansing and crimes against humanity have occurred in Myanmar as a result of the atrocities faced by the Rohingya people. However, this minority is not recognized by the government, and the term Rohingya is prohibited from being used by the government in Myanmar.

In accordance with Millennium Development Goal One, to end hunger and extreme poverty, Myanmar has attempted to make progress. As of 2013, it has been collaborating with UNICEF in order to help combat child malnutrition. Myanmar has joined other countries in the global ‘scaling up nutrition’ movement.

The United States and other countries need to work with the government of Myanmar to help it create reform programs that provide equality to all its people, including equal rights protection and access to food, clean water and sanitation. Progress has been made, but the potential for more is great.

– Erika Wright

Sources: The Parliament Magazine, UNICEF
Photo: Flickr

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Poverty-Induced Self-Medication

The connection between health and poverty is not a new one. The lack of access to healthcare, overcrowded healthcare facilities and the sometimes high costs of medications are major barriers for the poor to take appropriate steps to treat any health problems. Often, people turn to self-medication as an alternative to the expense of consulting a physician.

Paul J. Gertler, professor at the University of California Berkeley’s School of Public Health, said for the Washington Post, “Delaying medical care is a characteristic of poverty. For people living close to the edge, taking off a day to visit a doctor or staying home sick is literally taking food out of their mouths.”

It is no wonder that people facing such circumstances seek healthcare where they can get it cheaply. Sometimes this means going to a spiritual or traditional healer or taking the advice of family or friends. However, it can mean sharing medication, self-medicating or not completing a full-dose of a prescription so that it can be saved for another rainy day. These practices can be more dangerous than they seem.

Self-medicating can of course lead to using an incorrect medication, unsuitable for the medical condition, but it can also lead to overuse or underuse of the correct medication. A study based in a Nigerian community hospital concludes that a whopping 85 percent of the patients practiced self-medication and used an array of analgesics and anti-malarials either alone or in combination. According to Leadership, a local Nigerian newspaper, 75 percent of the populace rely on self-medication. This allows the market to flood with counterfeit drugs, low quality alternatives and charlatans selling ineffective herbal remedies.

From a public health point of view, incorrect usage of medication is a major cause of the rise in drug resistant infections. When patients do not complete a full dosage of antibiotics or use anti-malarials to treat unrelated infections, the disease-causing organisms have the chance to evolve to become resistant to these medications. Such resistant organisms then become untreatable and the resistant infection spreads among the population. Furthermore, the longer it takes to cure an infection due to use of incorrect medication, the higher the chances of an infection spreading.

The incorrect use of anti-malarials led to treatment failure and resistance to mainstay drugs like Chloroquine. This led to a shift in treatment policies worldwide and treatment with Artemisin Combination Therapy (ACT) began. Now, malarial infections resistant to ACT are spreading across Southeast Asia much faster than expected and can soon spread rapidly across the world if not contained. This story is frighteningly similar for a whole range of infections.

As science struggles to keep up with the evolution of drug resistance, policy can do its part. Increasing awareness and education about the disease causing organisms and the dangers of self-medicating is one approach. Improving infrastructure, the accessibility of healthcare facilities, resources at existing healthcare facilities and subsidies for medications will go a long way toward weaning the population away from self-medication.

There is another angle to this problem. In a survey in a district of Bangladesh, 100,000 doses of antibiotics were dispensed without a prescription. In Manila, Philippines, 66 percent of antibiotics were dispensed without a prescription. Heavily regulating pharmacies and preventing the sale of medication without a prescription can cut off one of the sources of self-medication.

More avenues will have to be explored to provide adequate healthcare and make good health a fulfilled right for each individual person so that the global population benefits.

– Mithila Rajagopal

Sources: Annals of Ibadan Post-Graduate Medicine, Devex, Journal of the American Board of Family Medicine, Leadership, Malaria Journal, Washington Post
Photo: Flickr

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Ceramic Filters for a Cleaner Future

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Rural South Africa faces many challenges. The prevalence of HIV/AIDs is partnered with high rates of other diseases, both infectious and non-communicable.

Limpopo Province is among the poorest of South African communities, with a 34 percent poverty rate. In addition, Limpopo also has one of the lowest rates of accessible drinking water. Only 44 percent of the population has regular access to potable water. The Mukondeni Filter Factory located in Ha-Mashamba is addressing limited water access with a new kind of water filter that could be a game-changer for communities where access to clean water is a challenge.

Pure Madi is a nonprofit run by the University of Virginia in partnership with the University of Venda in Thohoyandou, South Africa. Pure Madi designed the ceramic water filter of the same name to provide a sustainable solution to the world’s growing water problems. Pure Madi, named after the Tshivenda word for water, is cheap to make, simple to use and long-lasting.

The ceramic filters are flowerpot-shaped clay pots that can treat between one and three litres of water in an hour. Local clay is mixed with sawdust and shaped into a pot, then fired in a kiln. As the ceramic hardens, the sawdust burns away, leaving a porous matrix that will filter particulates out of the water. It is then treated with a dilute solution of silver nanoparticles inside and out. These nanoparticles lodge in the pores of the filter and kill pathogens like Eschericia coli and Vibrio cholera.

The filters are designed to fit into five gallon buckets that rural families commonly use to haul water. By the time water has passed through the filter, a reported 99.9 percent of all pathogens have been killed and filtered out. The filters last for about five years and are inexpensive, as a result, there is almost no access barrier.

Access to clean water is crucial to the development of communities. Without clean water, hygiene and health are almost impossible to maintain and agriculture suffers from low yields and substandard product. One could say that development grows from the groundwater up. Without access to clean water, communities lack functional sanitation services, experience constant illness and unproductive farms. Such hindrances keep a population from exploring the business and education opportunities required for further development.

Every year, between three and four million people die from waterborne diseases easily preventable with modern technology. Cholera and E. coli, rare in the developed world, are a major threat in areas without water filtration services.

The Mukondeni Filter Factoy will eventually be able to produce over 500 filters a month. Pure Madi’s 10-year plan is to build sister factories all over rural South Africa and eventually other countries as well. Pure Madi has stated that its ultimate goal is to serve 500,000 people with new filters every year.

– Marina Middleton

Sources: How Stuff Works, Azo Materials, Tree Hugger, Gizmag, UVA Today
Photo: Flickr

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VisionSpring Provides Eyeglasses for the Poor

visionspringWith all the issues around the globe, the world’s lack of eyeglasses probably does not occur to some people. However, around 703 million people have a vision problem that requires the use of glasses—and few of these 703 million people ever get them.

VisionSpring, an organization that provides glasses to the poor, realizes that more than 90 percent of these people live in a developing country. It also realizes that simply providing a worker with reading glasses for a mere $4 can improve his or her wage by up to $108 dollars per year. For citizens of developing countries, this amount could change the quality of someone’s life.

Founder and chairman of VisionSpring, Jordan Kassalow says that the organization’s operations rely on the motto “See to Learn, See to Work, and See For Safety.” Giving a pair of glasses to a student can equate to advancing his or her education up to a year, and glasses prevent injuries on the road and on the job.

Every dollar donated to VisionSprings adds up to an economic impact of $23 dollars. The organization sends out “vision entrepreneurs” to asses a community’s vision and spread the word about the opportunities available to that community. They travel around the world to the most impoverished places to advocate for this cause. This is nice because that means the help is coming to those who need it instead of vice versa—for example, in India someone could lose up to $10 dollars traveling to purchase a $4 dollar pair of glasses.

After performing vision tests for customers and providing them with glasses, a person can see his or her work productivity increase by 35 percent. VisionSpring also aims to consider the cultural differences between these various locations to best suit that community’s needs. For example, the organization has come up with a special pair of clear glasses for UV protection that can still shield eyes from the sun but are not the traditionally dark-shaded sunglasses the Western world is accustomed to.

“As I placed the glasses on the boy’s nose, I watched as the blank stare of a blind person transformed into an expression of unadulterated joy—I was witnessing someone seeing his world for the first time,” recounts Kassalow after giving one of his first pair of glasses to a seven-year-old boy in Mexico. VisionSprings considers a little-known issue that can bring big results—not only higher literacy and productivity rates but simply joy.

– Melissa Binns

Sources: The Christian Science Monitor, Forbes, VisionSpring
Photo: Boston Big Picture

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Providing Diagnostics to All

diagnostics
While medication treats an ailment, it is the rapid diagnosis of the ailment that is critical to saving many lives. With the rising rate of antibiotic-resistant infections, the need to diagnose quickly and correctly to facilitate accurate choice of medication has grown exponentially. The rapid diagnosis issue is compounded in resource-poor settings that are mired with lack of easy access to affordable healthcare and infrastructure.

Consider the example of tuberculosis (TB), a deadly infectious disease that can take up to six months or more to treat completely. In 2013, there were more than nine million new cases of TB. Most of these occurred in Africa and Asia. The standard-of-care diagnostic, a sputum smear, is slow and can take multiple health visits, which many people can ill afford. Additionally, the sensitivity of the test is variable and is worse when the patient is HIV positive, which almost 13 percent of TB patients are.

Now multiple-drug resistant TB (MDR-TB) infections, where most of the available antibiotics are no longer effective, are a huge concern. MDR-TB develops because of the incorrect use of antibiotics. The more rapidly TB is diagnosed and the more often correct treatment is prescribed, the less the incidence of MDR-TB and the less the chance of it spreading. As the ceiling of new antibiotic development is being pushed, drug-resistant infections urgently need to be controlled.

Rapid and accurate diagnosis is a necessity not just for TB but for everything ranging from malaria to diabetes. Both academics and the industry are hard at work to develop techniques that can provide results in a matter of hours. Some, especially those related to telemedicine like new iPhone blood glucose testing, can do this from the convenience of one’s home. However, the real conundrum has been how to make this cheap to manufacture, affordable to buy for resource-poor populations who need it and easy to use when there is no infrastructure in place.

Diagnostics For All is a nonprofit organization that aims to produce technology particularly for the 60 percent of the developing world that lack easy access to healthcare. Its projects range from a simple, easy-to-use liver function test to monitor the efficacy of HIV anti-retroviral therapy, to detecting micronutrient levels in children so that appropriate nutritional supplements can be provided. Its systems are based on a patterned paper technology developed at Harvard University. Since the paper takes up the test sample easily and micro channels made on the paper allow the sample to flow into tiny wells of chemical indicators, there is no need for any external power. The indicator changes color based on a component in the sample, allowing an easy read out. The patterned paper can be manufactured cheaply on large scale. Diagnostics For All supports its work with philanthropic grants and partnerships with the for-profit sector.

Foundation for Innovative New Diagnostics (FIND) is another international nonprofit organization that builds partnerships with enterprises and assists in developing novel diagnostic techniques through expertise and capacity building. It supports the discovery and scale-up of diagnostic tools bridging the gap between development and delivery, and ensures that these technologies are made available to high-burden countries at preferential pricing. It has developed several techniques among which are an HIV viral load detection system co-developed with California based, Cepheid and malaria and sleeping sickness diagnosis methods with Massachusetts based, Alere.

There are several other organizations out there, including those making strides in telemedicine, that are working to make diagnosis faster, cheaper and more accurate. As science makes progresses towards developing these new techniques, markets, nonprofit and for-profit business models, and governments all have to play their part in keeping up with strides being made and ensuring that these new methods are realized in practice.

– Mithila Rajagopal

Sources: Alere, NCBI, Sanofi, San Francisco Business Times, WHO 1, WHO 2
Photo: Fashion For A Cause

Teixobactin: The First New Antibiotic in Decades

Teixobactin
As the growing resistance against drugs becomes more disturbing, a new discovery has the potential to dramatically alter the situation.

Teixobactin is the first new antibiotic to be discovered in almost 30 years. Safely tested on mice, not only is the drug capable of fighting both drug-resistant bacteria and common drug bacterial infections such as tuberculosis, septicaemia and clostridium difficile colitis, but it could also pave the path for a host of new antibiotics through the method in which the drug was discovered.

The soil has always had the potential to reveal many new antibiotics. Scientists have noted the interesting and innovative ways many microbes have managed to fight off other microbes, but they found that 99 percent of microbes would not grow under laboratory conditions. This obstacle prevented scientists from unlocking the potential wave of antibiotics that could be developed.

A group of researchers at Northeastern University in Boston has overcome that barrier. Essentially deceiving the bacteria, soils with the microbes were sandwiched between two semi-permeable membranes to imitate a natural environment.

With that method, the researchers were able to grow 10,000 different strains of bacteria and isolate 25 potential antibiotics. Ultimately, Teixobactin was the most promising antibiotic that they discovered.

Teixobactin is especially unique due to its mechanism of targeting two different lipids that are required for cell wall production in bacteria. Its innovative process will most likely prove to prevent the development of resistance for quite some time.

In cell cultures and later on with mice, Teixobactin was capable of successfully killing MRSA and drug-resistant TB. The antibiotic was so effective that the researchers were concerned that the drug would fail to make a distinction between the mammalian cells and the bacteria when testing on mice. Surprisingly, Teixobactin performed exceedingly well, killing the bacteria while leaving no notable side effects.

Still there is a long way to go before Teixobactin becomes available for human use. It has yet to be tested on humans so its effectiveness and side effects are unknown. Even if the drug passes all the required tests, it is estimated that it will be five to six years before it becomes available.

Furthermore, due to its function of destroying the cell walls of bacteria, Teixobactin is ineffective against gram-negative bacteria such as E. coli and many sexually transmitted diseases which have outer membranes that the antibiotic cannot penetrate.

But the main issue concerning Teixobactin is the potential overuse of the drug once it does become available. The growing threat against antibiotics and their overuse is that it may develop into the “post-antibiotic era,” referring to a time when a number of infectious diseases will be unresponsive to antibiotic treatments.

While the development of antibiotics is essential, the culture of over-prescribing antibiotics must change. A continuation of that culture would further the course toward a post-antibiotic era and limit the effectiveness of Teixobactin and other potentially effective antibiotics.

Nevertheless, this development could begin the transition away from building resistances in bacteria and open whole new channels for better and more innovative drugs to save lives all around the world.

– William Ying

Sources: The Guardian, Washington Post, Telegraph UK, The New York Times, Smithsonian,Live Science, Time, Newsweek
Photo: Independent U.K.

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Winter Brings Health Risks for Syrian Refugees

syrian refugees
As winter storms move into the Middle East, the most vulnerable populations will be the millions of Syrian refugees fleeing from a violent and long civil war. Perhaps the most affected areas are in the Beqaa Valley in Lebanon, where some 400,000 Syrian refugees live in temporary, informal tent camps under harsh winter conditions.

Temperatures in the Beqaa Valley have dipped well below freezing for long periods of time, compounding the unforgiving effects of a wet, windy winter. Snow and ice in recent weeks has led to the closure of roads surrounding the camps, making access for aid workers even more difficult. The UN reports that over 100 tents have collapsed under the weight of ice and snow. The UNHCR has set up six emergency shelters to try to negate the risk of collapse, but resources are running low around the camps.

Lebanon has no formal camps, but is now the home of 1.12 million Syrian refugees. This means that one out of every four people in Lebanon is now a Syrian refugee. Because the official policy of the Lebanese government is non–intervention in Syrian internal affairs, civic organizations have had to take the lead on caring for the millions of Syrian refugees now living in the country.

The UN estimates that there are approximately 3.2 million Syrian and an additional 7.6 million people displaced by the conflict still living in Syria. Most refugees are living in Turkey, Jordan, Lebanon and Iraq. This will be the fourth winter since the beginning of the war.

Other refugees affected by winter weather live in Jordan, Turkey, Palestine, Israel and Iraq. In Jordan, only 100,000 of a total 620,000 refugees live in formal camps. In Iraq, violence in the past year has displaced hundreds of thousands of people who are now are facing similar winter risks as Syrian refugees.

The winter months bring a whole new set of health risks to refugees, especially those living in tent camps. Besides cold-weather exposure risks like hypothermia, frostbite and chilblains, wet conditions lead to a higher risk of disease and low levels of resources and closed roads increase the risk of malnutrition and dehydration. Children and the elderly are the most vulnerable populations.

Winter also brings higher risk of accidental deaths, from collapsed tents and fire-related deaths from indoor flames and heaters.

This past November, two Syrian babies died because of winter conditions. In Palestine this month, a fire killed a refugee child. And two Syrian refugees crossing into Lebanon earlier this month, a 30-year-old man and a seven-year-old child, were killed in the mountains because of exposure to extreme cold.

A shortfall of 50 percent of international funding for U.N. assistance to refugees means that Syrian refugees are getting even less help this winter than in the past. There are no additional ration cards or oil for heaters. Even though the percent of refugees living in harsh winter conditions is small compared to the overall number of people displaced by the conflict, a disproportionate amount of funding is going to them, removing funding options for other refugee settlements.

– Caitlin Huber

Sources: The Guardian, Washington Post, NPR, The Weather Channel, National Resource Council, Center for Disease Control, Relief Web, Syrian Refugees
Photo: YouTube

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The Health Impacts of Poverty

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There is a substantial relationship between poverty and health. Long-term poverty and economic insecurity have broad-reaching long-term ill- health consequences. In addition to creating stress, which causes a myriad of health problems, poverty also results in low levels of sanity, high incidences of infectious disease and mental health issues.

Prime indicators that poverty directly affects health are life expectancy, prevalence of chronic or communicable diseases, behavioral and self-control issues and high levels of long-term stress. Long-term poverty imposes a huge burden of stress on the impoverished. The hardships of finding permanent work, taking care of children, finding affordable food and clean water can all take an enormous toll on physical and mental health.

Long-term stress also creates hormones that compromise the immune system, opening the door for communicable diseases. Women who experience high levels of stress during pregnancy are more probable to have children who are predisposed to developing diabetes.

Children are especially susceptible to the health consequences of poverty. Bernard Fuemmeler, associate professor in Community and Family Medicine at Duke University School of Medicine, says that “poverty during childhood not only appears to affect child development, but can have lasting effects on the types of health choices made during adolescence and early adulthood.” His research finds that economic insecurity in the home during childhood can permanently affect the way people make decisions and their ability to self-regulate.

Urban poverty is characterized by crowded, unsanitary conditions that lead to higher incidences of communicable disease. Transmission becomes very easy for highly-infectious diseases the closer people are to one another. Dirty water, unclean food and cook spaces and improper waste disposal are common in crowded areas.

Poor countries as well have high public health obstacles to overcome. Lack of funding, stigma and myth, bureaucratic complications and limited infrastructure all contribute to a reduction in capacity to deal with health crises and public health issues. Low access to vaccines and medication is a particular public health nightmare for poor countries because it creates not only drug resistance but also black markets for hard-to-get medicine.

– Caitlin Huber

Sources: Think Progress, News-Medical, Jama Network, NAS, UN, Wisconsin-Madison
Photo: TIME

Movement for Global Mental Health

The Movement for Global Mental Health (MGMH) is a coalition of individuals and institutions aimed in eliminating the treatment gap for people living with mental disorders worldwide. It is the Movement’s mission to have full and effective participation in society of people with disabilities, including those with mental illnesses. The organization is based on two fundamental principles: scientific evidence and human rights.

The movement began in 2007, stemming from a Call for Action produced in the Lancet series, groups of articles addressing important topics of health that are often neglected by mainstream medical publications. Through a joint effort with partners, MGMH has formed into a space where members are able to discuss ideas and implement activities and programs to assist those with mental illnesses. MGMH aims to improve the availability, accessibility and quality mental health services for people all over the world.

Currently, members consist of over 200 institutions and 10,000 individuals, many of whom are family members of those affected by mental disorders, as well as health care providers, researchers and activists.

MGMH mainly focuses on low- and middle-income countries (LAMI), where people with mental disorders face the most amount of discrimination at all levels in society. Overcoming these social barriers to receive help often poses greater difficulty then dealing with the mental disorder on a personal level.

Although laws are widely in place to protect those with mental illnesses, they are still seen as one of the most vulnerable and marginalized populations. Thus, the MGMH website serves as a platform to share resources, advocacy articles and personal experiences of human rights violations.

The Movement seeks to emulate HIV/AIDS campaigns that have been successful in mobilizing global resources for people in LAMI countries. These types of movements were specific in the call for action and set clear guidelines in how to provide resources for testing and decrease the stigma associated with HIV/AIDS. MGMH hopes to mimic their successes by collaborating with human rights organizations, non-profits and universities to provide higher quality treatment for people with mental disorders, while protecting their basic human rights and increasing research in developing countries.

– Leeda Jewayni

Sources: British Journal of Psychiatry, Movement for Global Mental Health
Photo: Patch