Archive for category: Health

Information and stories on health topics.

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Female Genital Mutilation and Immigration Reform

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Immigration in the United States has been an issue throughout this millennium. Reform for the immigration system has been discussed in various forms, yet presently there still seems to be no progress on the issue. This deadlock affects immigrants of all forms, but particularly for many potential immigrants in the West African region.

A recent PBS Newshour report detailed the plight of a family living in Baltimore struggling to deal with the intricacies of the immigration system. This family left their home in Mali after worries that their daughter would be subjected to the female genital mutilation (FGM) that is a common practice in that part of the world. The mother, who still suffers pain from her mutilation, says that at any time someone “can just come and take your daughter, and just do it.”

FGM is a practice that has deep roots in the West African region. The practice has been mentioned as far back as the Ancient Greek historians, like Herodotus. Community members consider it shameful for women to not undergo the process, leading to the sort of animosity that lead the Newshour profiled family to leave for the U.S.

Health issues and the difficulties in adjusting to a new country lead the family to miss the initial application for asylum that is required after one year of residency. Since they missed that initial application, the members of the family have no path to citizenship under the current system and are left to appeal annually for residency. There is still a definite risk that their requests could be denied by the courts, leading to their final deportation.

This difficulty in applying for asylum will remain until the immigration issue is finally settled in Congress. The Fofana family profiled by PBS Newshour is not alone in its struggles. Reports from the BBC describe Gambian women seeking asylum for the same reasons in the United Kingdom with hundreds being rejected for using the peril of mutilation as a basis.

The World Health Organization states that over 125 million females are living today after undergoing genital mutilation. Like the matriarch of the Fofana family, many times the procedure is involuntary and will cause the females lasting pain down the road. One can only imagine if this was a practice that was prevalent in the Western world and the outcry that would come about because of it.

Studies on the practice of genital mutilation show the benefits of educational programs in the areas that still carry it out. The Tostan program in Senegal shows how the end of the practice will provide health benefits for women and will bring about better overall respect for women in the community. However, programs like that one are few and have to be much more prevalent to have a serious impact in Western Africa.

For nations in the Western world, spreading education about the female body could bring benefits in Africa and the West. A successful program could lessen the immigration demands on the West and give women a better chance at being leaders in the communities of Africa. For the women that live in fear and pain due to this practice, funding by the nations of the Western world might go a long way towards improving the world as a whole.

– Eric Gustafsson

Sources: Stanford University, BBC, World Health Organization, PBS
Photo: MintPress News

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Myanmar Government Bans Doctors Without Borders

The Myanmar government banned Doctors Without Borders (DWB) from operating in one of its most impoverished states, following rumors of ethnic tension.

Most of the disenfranchised Muslim minority reside in the Rakhine State. The government accused the DWB of favoring this minority over its rival group, the Rakhine Buddhists. This tension led to widespread violence, killing 100 people and displacing nearly 140,000 others. The government regards Muslims as “interlopers” from Bangladesh, as opposed to a legitimate minority. President Thein Sein granted DWB permission to resume its work in other regions, but continued its ban on operations in Rakhine.

Presidential spokesman Ye Htut accused DWB of “not following their core principle of neutrality and impartiality.”

Rakhine State government accused the NGO of intentionally fueling tension between the minorities, according to Htut. The perception of bias led to large-scale protests in the state capital against DWB.

The organization responded to these accusations in a statement, asserting “services are provided based on medical need only, regardless of ethnicity, religion, or any other factor.”

This January, DWB released a statement contradicting the government on an alleged massacre in Rakhine. This reportedly “triggered” the ban on its operations in the region. The United Nations report the death of more than 40 Rohingya Muslims, and DWB confirmed treating 22 victims. Wounds occurred at the hands of state security forces, yet the government denounced these claims, reporting the death of one police officer.

Following the ban, the Ministry of Health plans to provide health services for the “whole community.” Myanmar President Thein Sein also dispatched the emergency response workers and ambulances to the region, replacing the DWB clinics.

These services cannot match those provided by the NGO. The national health services rank “among the most rudimentary in Asia,” according to the New York Times. The government also confines Muslims to their villages, preventing the group from receiving medical care.

Banning DWB deprives nearly 750,000 people of proper healthcare.

The NGO acted as the largest provider in northern Rakhine, a region largely populated with Muslim Rohingya. It managed five permanent clinics as well as 30 mobile units. Within these clinics, workers operated an intensive feeding center for undernourished children. Medical professionals report diagnosing more than 20 percent with acute malnourishment.

The government ban forced these centers to close, following the removal of DWB.

The organization also served those living in displaced camps outside the state capital, Sittwe. Tuberculosis, a disease endemic to Muslim neighborhood Aung Mingla, threatens the health of displaced Muslims. HIV and malaria also threaten resident health. With limited medical attention, the supplies of medicine continue to dwindle.

The government prevents these patients from leaving the area, surrounding the camp with “barbed-wire security posts and police officers.”

As head of the U.N. Office for the Coordination of Humanitarian Affairs in Myanmar, Mark Cutts expresses concern for the present healthcare shortage. Rather than antagonizing the government, though, the U.N. has chosen “quiet diplomacy.”

For the time, the International Committee of the Red Cross and other organizations can provide care. Myanmar deputy health director Dr. Soe Lwin Nyein plans to accept tuberculosis and HIV medication from DWB. These concessions help patients in the region receive more than the minimum government care, yet negotiations over the medicine distribution appear ongoing.

Cutts plans to coordinate with the government and reinstate DWB “as soon as possible,” protecting the minority from disease. As ethnic tension continues to incite violence, the government banned professionals in the best position to serve its people.

– Ellery Spahr

Sources: CNN, New York Times
Photo: Richard Roche

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School Lunch Program in Thailand Targets Malnutrition

Thailand is known for having one of the best nutritional programs in Asia. According to the World Food Programme (WFP), Thailand has successfully dropped child malnutrition from 36% to approximately 8.42% within 30 years.

Thailand’s success stemmed from an in-depth look at growth rates, nutritional education, supplementation of iron and vitamins, as well as a focus on health coverage. It was also one of the primary countries to reach out to the community as a basis for promoting an end to malnutrition – specifically in children.

One method for reducing malnutrition in Thailand among school-aged children is the School Lunch Program, which supplies lunch at no cost to children struggling to maintain a healthy weight, or students who are unable to afford lunch. These lunches also aim to “educate students about desirable eating habits, values, and social manners.”

Students from rural areas have specifically been the victims of malnutrition in Thailand. Although rice is a staple food, the large amount of production does not necessarily correlate with balanced meals or eating a satisfactory amount required for healthy growth, both physically and mentally. Since diet is mainly based on rice, a lack of protein in diets are a large contributor to malnutrition in Thailand; also among the nutrients lacking in diets are iron, iodine and vitamin A.

SLP is currently providing all kindergarten and elementary public schools, reaching about 30,000 schools and 700,000 preschoolers. School Lunch Program currently provides meals for students for 200 days during the school year. The program started off by focusing merely on the amount of meals that were able to reach students. Now the meals are geared around the nutritional value.

With the help from the School Lunch Program many students whose diets are lacking in balance, or worse nonexistent, now receive meals at school that they may not have been able to receive at home.

The meals that Thailand is able to provide to children not only helps their struggle with malnutrition, but also helps with their ability to focus, gain weight, and grow cognitively.

– Rebecca Felcon

Sources: Rappler, Right To Food Campaign, World Food
Photo: IIRR

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Doctors Without Borders expelled from Myanmar

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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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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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Ending the Practice of Female Genital Mutilation

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Female genital mutilation (FGM) or female circumcision, has been occurring for hundreds of years in mostly sub-Saharan and northeast African regions. The term “female genital mutilation” encompasses every procedure where partial or total removal of the external female genitalia occurs, as well as any general injury to those organs without a distinct medical purpose.

The practice of FGM is internationally seen as a violation of human rights for women and young girls because it emulates the inequality between genders and represents extreme discrimination against women. On top of this, the following rights are also violated: the right to security, physical integrity, health, freedom from torture and from inhumane treatment–especially when the procedure can result in death.

There are four general classifications of FGM: clitoridectomy, excision, infibulation and an “other” category. Clitoridectomy entails the removal of part of or the entire clitoris and is one of the most common types. Excision is where they remove part of or the entire clitoris and labia minora, and this can be with or without cutting the labia majora. Infibulation includes the reduction of the vaginal opening by cutting and repositioning the labia majora to make a covering, with or without removing the clitoris. The “other” category classifies any other harmful procedures to a woman’s reproductive organs in a non-medical way.

FGM is in no way beneficial to a woman’s health, and in fact, it is harmful in several ways. Short-term effects include hemorrhage, severe pain, tetanus and urine retention. Long-term effects include cysts, recurrent urinary tract and bladder infections, infertility, childbirth complications and newborn deaths. This kind of procedure is mostly done to newborns or girls around 15 years of age that are going through puberty. Today, over 125 million women and girls in the Middle East and Northern Africa have been circumcised. By 2030, it is estimated that a further 86 million young women around the world will experience this procedure as well.

Many officials at UNICEF disagree with the practice of FGM and state it is not necessary in Islamic countries. They say it is a very old practice, traced back to the Egyptian pharaohs, and that the Koran says how humans were created in the perfect way, so changing them is not justified by religion.

Fahma Mohamed, a 17-year-old student that leads the Guardian’s campaign to end FGM, has acquired over 212,000 signatures in her petition against the issue. She has even gotten recognition from the United Nations Secretary General, Ban Ki-moon, who has made it a priority to end FGM because of how it threatens the empowerment of women.

There have been progressive signs in the worldwide campaign to end the practice of female genital mutilation with multiple countries like Kenya, Uganda and Guinea-Bissau adopting laws against it. The girls themselves understand the risks of being circumcised, and mothers who have dealt with the ordeal are fighting more and more to protect their daughters from the same fate. Schools can be directed to address the issue so that the people in these countries can learn about the issue and how to shield their young women from it.

– Kenneth W. Kliesner 

Sources: The Guardian (1), The Guardian (2), World Health Organization
Photo: Girls’ Globe

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Physical Inactivity Taking a Toll in Middle East

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As life expectancy across the globe steadily increases, chronic and degenerative diseases are becoming the norm in many countries, fueled by the rapid rise of obesity due to physical inactivity.

The World Health Organization (WHO) and the Ministry of Health of the United Arab Emirates (UAE) convened in Dubai, UAE on February 23 for a two-day ‘Move for Health’ forum to address just that.

The push for the forum came following recent statistics naming the Middle East as the most unfit region for young adults, age 15 to age 29. It is also the second-most unfit region for adults and the most unfit region for women worldwide. Approximately 50% of Middle Eastern women are deemed physically inactive.

Given what people know about global inactivity trends, these statistics are not so shocking.

Physical inactivity is the fourth-leading risk factor for global mortality, accounting for 3.2 million deaths worldwide. It is also directly responsible for 27% of diabetes cases, 30% of heart diseases, and 21-25% of breast and colon cancer cases. More than 30% of people over the age of 15 are physically inactive, 28%t of them men and 34% of them women.

Given these daunting numbers, it is no surprise that physical inactivity is one of the most pressing global health challenges at present.

Among those who spoke at the forum was Dr. Ala’a Alwan, the regional director of the Eastern Mediterranean Region at the WHO. Noting the severity of the issue, Alwan reiterated the importance of making efforts to recognize physical inactivity as a public health priority by developing national awareness campaigns.

The forum also shed light on a new policy to be implemented in the UAE, as well as 34 other signatory countries. The policy follows a multi-sectoral approach and pledges to reduce physical inactivity levels by 10% by the year 2025. Included is a seven-step program targeting public education, school-wide programs, community programs, healthcare, sports awareness, urban design and transport policies.

Specifically, the policy aims at communicating to the general public the idea that physical activity is not limited to sports. It also includes any bodily movement produced by skeletal muscles that uses energy, from walking or cycling to dancing and swimming.

The WHO and UAE’s Ministry of Health are promoting having people exercise five days each week for 30 minutes to reduce current levels of inactivity across the globe, and in the Middle East.

– Mollie O’Brien

Photo: Niwemang
Sources: Emirates 24/7, Zawya, World Health Organization

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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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Exclusive Breastfeeding Promotes Infant Health

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Children ages 12 to 23 months receive an estimated 30-40% of total energy from breast milk. This milk serves as a source of energy and essential fatty acids for them and the fat content appears critical for utilizing pro-vitamin A carotenoids, which exist predominantly in plant-based diets. Moreover, these nutrients offer necessary protection against diseases and help children recovery from infections.

Breastfed children face a significantly reduced risk of chronic illness. The contribution of breast milk to overall nutritional status protects children from developing noncommunicable diseases as adults. Breast milk also improves cognitive development. This benefit could serve to assist with the second Millennium Development Goal of achieving universal primary education. Education coupled with decline of disease increases productivity in developing countries subsequently offering greater food security and the reduction in poverty.

For young girls, greater learning potential offers financial independence. Mothers, in addition to their daughters, benefit from exclusive breastfeeding as well. Breastfeeding naturally delays fertility and as a result, this increases the period between births in populations without contraception. At this time, developing nations account for 99% of global maternal deaths.

A delay in childbirth protects the lives of many women who marry young and give birth frequently. Those who give birth before the age of fifteen risk dying during childbirth at five times the rate of those in their twenties. The World Health Organization offers a number of guidelines to improve breastfeeding and complimentary feeding practices. The annual loss in GDP to vitamin and mineral deficiencies far exceeds the cost of these interventions. For instance, Peru loses $637 million a year to malnutrition. Yet increasing its micronutrient interventions costs less than $16 million annually. To promote the timeline of exclusive breastfeeding, the organization could implement these low-cost interventions:

  • Advocate for natural breastfeeding, as opposed to the use of water-based substitutes
  • Adopt and enforce maternity leave policies
  • Provide training on infant and young child feeding to health care professionals
  • Implement a cash-conditional program for mothers to breastfeed and regularly visit clinics
  • Develop and support work sit lactation programs

Exclusive breastfeeding within the first six months nourishes infants and acts as a safeguard against the spread of diseases. However, globally, less than 40% of infants benefit from exclusive breastfeeding. Affordable and direct solutions to this issue exist, holding the potential to drive this rate to 100%worldwide.

– Ellery Spahr

 

Photo: She Rights Sources: WHO, World Bank

 

Unauthorized Clinics in Cameroon Shut Down

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In the midst of a looming health crisis, a troublesome ethical dilemma is presented: small and privately run centers are appealing to people that need certain types of emergency care in Cameroon, where public health care tends to be expensive and not widely available. The country faces numerous public health threats, with a population of 22 million and high HIV, malaria, tuberculosis and infant mortality rates. Because of these ubiquitous health issues, easily accessible clinics may be the difference between life and death for many rural populations.

Cameroon’s government has already identified 600 illegal hospitals and health centers since beginning a campaign to shut down unauthorized clinics.

Family Health Medical Center, in Cameroon’s largest city, Douala, is run by Sylvestre Mebam, who treats about 10 to 15 patients per day. Clinics like Mebam’s exist all around the country, with hundreds of similar family-run medical facilities throughout. Mebam’s clinic often receives patients from nearby government hospitals when people run out of money for treatment there.

The busiest public health facility in Douala, Laquintinie Hospital, is known for slow service and lack of medical staff. When the country already has one of the world’s highest infant mortality rates, the clinics are sometimes the only options when women go into premature labor. When interviewed by NPR, Mebam said he always sends patients to a public facility when the situation is beyond his ability. This unauthorized clinic may be the closest stop for many pregnant women seeking emergency care, but is it slowing down their access to proper treatment?

Although the government is seeking to shutdown some clinics, those that meet staffing, equipment and hygiene standards will be asked to register with the Ministry of Public Health. Dr. Henry Luma, the medical director of the General Hospital in Douala, says, “most of these clinics do not have qualified personnel … There is no way that they have a system to control the quality of care [that] they are providing.” Luma believes the ill-equipped, unregulated clinics should, in every right, be closed.

According to the health ministry, thousands of hospitals that operate without proper authorization are responsible for numerous untold deaths. Although the clinics may offer services and treatments for people with limited access or inadequate funding for public hospitals, they often have infrastructure problems and are not equipped to properly handle emergencies.

Many of these problems stem from counterfeit drugs in unregulated settings. The World Health Organization (WHO) estimates that 200,000 people worldwide die from preventable deaths related directly to counterfeit drugs provided in illegally-run hospitals. Many of these drugs are malaria and tuberculosis treatments, which are two widespread pandemics in sub-Saharan Africa.

Cameroon’s National Medical Council will continue to pursue order by declaring doctors that are not members of the National Medical Council illegal. The WHO continues to “promote evidence-based health policymaking through comprehensive and rigorous analysis of the dynamics of health situations and health systems in the country.” Without government-regulated clinics, the WHO data collected is inefficient and inaccurate.

With approximately two physicians for every 10,000 people, can care in these regulated, government facilities adequately meet the needs of patients?  Does investment in such regulated healthcare trump the fact that 32.8% of Cameroon’s population is living in absolute poverty? Can medical costs actually be feasible for those living on less than a dollar per day?

– Maris Brummel

Sources: NPR, Voice of America
Photo: Jezebel