Lifestyle Diseases in India
India, a third world country by economic profile, has morphed its morbidity profile to that of a first world nation. Lifestyle diseases in India are cropping up increasingly under the scanner making it a ticking time bomb with an alarming rise in cardiovascular disease, diabetes, hypertension, asthma and respiratory diseases as well as cancers.

Termed non-communicable diseases (NDC), many of these are found to be equally prevalent among the poor. In fact, ongoing studies prove they are increasing among the poorest. Sixty-six percent of the disease burden is borne by lifestyle diseases consequently cutting into the most productive asset of contemporary India- its people.

India has the highest number of diabetics at 50.8 million per the WHO, though only 11 percent of the population has health insurance. This figure, set to increase to 73.5 million by 2025, will include many of the poorest since India has one of the largest populations of the poor. Twenty-five million suffer from cardiovascular disease, 60 percent of the global total.

According to national diabetes expert Dr. Anoop Misra, diabetes is on the rise because the poor make bad and cheaper nutritional choices based on high fat and carbohydrates intake in their diet leading to malnutrition. They forego vitamins, proteins, and micronutrients as carbohydrates push up their insulin resistance and increase sugars. Diabetes is the forerunner to many opportunistic infections- fatty livers, high cholesterol leading to coronary heart disease and organ failures. Overcrowding and bad living conditions also increase stress leading to coronary heart diseases, asthma and cancers. Urbanization makes for a sedentary life leading to greater obesity. Mass migration from rural to urban areas has made it likely that nearly 60 percent of India will be urban by 2030.

One of the biggest problems with lifestyle diseases in India is that a large part of treatment is through self-monitoring and self-reporting. The high level of ignorance and lack of education about the ramifications of food and lifestyle choices amongst the urban poor leads to these diseases having the worst impact on them. Data collection in India is negligible and there is a large quantum of underreporting and underestimation among poorer patients.

India spends 4.2 percent of its GDP on health for its population of over a billion people. In comparison, Germany spends 11.3 percent for its relatively small population. Per capita spending on health amounts to 34 euros per person whereas in Germany it is over 4000 euros. Eighty percent of health care in India is dominated by the private sector. As a result, the poor become almost invisible for health care providers, leading to undetected and untreated morbidity.

Lifestyle diseases in India require prolonged treatment for a lifetime, including lasting changes in lifestyle. Without better and more consistent healthcare services being provided for the poor, NCDs could be the next big epidemic wiping out large parts of the Indian population.

Mallika Khanna

Photo: Flickr

Water Quality in Syria
As the conflict in the country continues, water quality in Syria worsens, leaving the population more susceptible to diseases and forced to migrate in unsafe conditions.

Poor water quality in Syria is caused by damage and lack of maintenance to infrastructure as well as poor sanitation. Low power supply and lack of sewage sanitation also contribute to an insufficient clean water supply.

Water is also used as a weapon. For example, in Aleppo, pumps and electricity stations that fuel the water are controlled by different fighting parties. The water supply is often deliberately turned off for long periods of time as a tactic to wear the other side down.

As a result, civilians suffer and must resort to whatever supply of water they can find, such as wells, which are not guaranteed to be clean. Those who drink unsanitary water are at risk for developing diarrhea, typhoid, hepatitis and other health problems.

The Middle East has the lowest per capita water availability in the world as well as one of the highest rates of population growth, according to Ashok Swain, director of the International Center for Water Cooperation.

Syria and other nearby countries such as Iraq suffered a severe drought from 2007-2010, which severely lessened agricultural productivity and forced farmers and herders to migrate for water.

“The inability of Syria and Iraq to meet the demand for water — due to growing populations and/or decreasing supply and flawed water policies — has only exacerbated problems caused by drought conditions,” wrote Marcus King, associate professor of International Affairs at George Washington University, in his essay “The Weaponization of Water in Syria and Iraq.”

“Water scarcity played a meaningful but complicated role in creating conditions that led to political unrest and ultimately violent insurrection in Syria in spring 2011 and the spillover into Iraq,” said King.

According to the U.N. Refugee Agency, 6.5 million people have been displaced inside Syria, and 4.8 million have fled to nearby countries such as Jordan, Lebanon, Turkey, Iraq and Egypt since the conflict began in 2011. Neighboring countries are also experiencing clean water shortages as a result of the influx of refugees.

The U.N. Children’s Fund brings portable water to refugees in Syria and other affected nations as well as implements cost-effective, sustainable water systems for communities in need. UNICEF is also working to relieve nations hosting refugees by augmenting existing water, sewage and waste collection systems to accommodate the increased demand.

Other relief efforts headed by UNICEF include:

  •  Improving access to quality education;
  •  Children’s programming and protection services;
  •  Providing vaccinations and nutritional supplements;
  • Issuing emergency cash assistance to families in need;

You can help Syrian refugees by making a tax-deductible donation to UNICEF.

Cassie Lipp

Photo: Flickr

Indonesia Facing Diseases
Humans struggle with diseases all around the world, but they become much more life threatening in impoverished countries. As a tropical country, Indonesia facing diseases is paramount in the attempt to improve development.

In Java, Indonesia there is a resurgence of diphtheria in children, mainly due to parents’ resistance to vaccinating their children. Lymphatic Filariasis (elephantiasis), polio and bird flu have all taken a great toll on Indonesia and its inhabitants. These diseases in Indonesia not only affect individuals’ lives, but also negatively impact Indonesia’s social and economic development. In order to control infectious diseases, the government must be able to implement effective interventions.

For bird flu specifically, all suspected infected poultry must be reported and then killed. The government has been very inconsistent in applying this rule but must take action if it wants to eliminate bird flu. Many farmers hide their flocks in fear of having their birds killed; the farmers care more about their loss of livelihood than the spread of disease.

In the peer-reviewed journal, PLOS Neglected Tropical Diseases stated that Indonesia has some of the world’s highest concentrations of tropical diseases, holding back Indonesia’s emerging market status. High rates of disease are commonly found in low-income countries due to poor economic growth. However, Indonesia has experienced economic growth at an average of 6 percent over the recent years and its middle class is projected to double in size over the next decade.

Indonesia is the only country in Southeast Asia with prevalent schistosomiasis, a parasitic disease prevalent in communities deprived of potable water or sufficient sanitation. Adding to that, almost 10 percent of the world’s leprosy cases are in Indonesia. Additionally, the World Health Organization is cautioning individuals about the emerging threat from dengue fever in Indonesia, which Indonesia is already spending a lot of money on — 323 million in 2010.

If Indonesia does not implement better controls to reduce these diseases, their future growth and economic gains could easily be thwarted, mainly due to the country’s negative impact on child development, labor and health.

In order to start controlling these infectious diseases USAID and other NGOs are working to improve health efforts in Indonesia. USAID currently has programs in both maternal and child health, infectious diseases (TB, HIV/AIDS), pandemic threats, neglected tropical diseases as well as water and sanitation issues.

To control infectious diseases USAID is partnering with Indonesia’s National TB Program to help treat and combat the disease for Indonesia’s future. One big step that was made was in 2012 when USAID introduced GeneXpert technology, which diagnoses multi-drug resistant TB in hours instead of months; this act alone has helped save countless lives. For HIV and AIDS, USAID is providing technical support to the Ministry of Health (MOH) to hasten prevention measures being used by the Indonesian individuals.

Lastly, Indonesia facing diseases has caused pandemic threats to the country. USAID has been engaging in a multitude of actions to stop these outbreaks. Along with plenty other assistance, USAID helps the Indonesian government identify and respond to risks as quickly as possible, in addition to increasing access to safe water and sanitation efforts.

Clearly, USAID and other public-health measures have made some progress. A recent study indicates that if it wants to keep the growth train running, Indonesia facing diseases will need to step up its outreach to better eliminate disease, which USAID has started. Hopefully, these positive impacts will end disease in Indonesia soon.

Bella Chaffey

Photo: Flickr

Clean Lahore
Dengue fever is a mosquito-borne illness that causes sudden fever and acute pain in the joints. This illness is prevalent in many places throughout the world, including Lahore, Pakistan. In recent years, a new technology known as the Clean Lahore app has been designed to prevent the disease.

In 2011, there was an outbreak of dengue fever during which 20,000 citizens in the Punjab region of Pakistan were affected. Pakistani government officials were looking for a way to slow the spread of the disease. Created and developed by Umar Saif, Clean Lahore allows officials to track efforts taken to prevent the spread of the fever. This new app allows an investigator to photo-log crews of sanitation workers as they complete their jobs. More specifically, the app logs workers as they clear out pools of standing water, which act as breeding grounds for the mosquitoes that carry the illness.

Saif used his app to then map out locations of both sick people and mosquito larvae while making sure workers were doing their jobs to the fullest. This allows officials to develop preventative measures and communicate with workers about what they need to do on their part. Government officials implemented the app post the 2011 outbreak. By 2013, results proved the positive effect of the app. Compared to the 2011 outbreak, in 2013 only a few dozen cases of dengue fever were recorded.

Investigators learned that many workers were unaware of their impact on stopping an outbreak from occurring: “Whatever I do, it’s just to provide for my kids,” one 30-year-old worker stated. By making the worker aware of his impact, he can change how he handles operations in his job.

Dengue fever is found all over the world including Africa, Central and South America and the Caribbean. This new technology can be used to help government officials stop the spread. Progress against dengue fever, in addition to aid from the Clean Lahore app, paves the way to eventually stop the spread of countless diseases in Punjab as well as other regions.

Casey Marx

Photo: Flickr

Opiate Addiction TreatmentOpioid addiction is an emerging epidemic. Traditionally, the most commonly abused opiate drugs were morphine and heroin. Today, the problem is complicated by the rising use of opiate painkillers, such as oxycodone and hydrocodone.

While opiate pills are incredibly effective at managing pain in the short-term, usually after surgery or injury, they pose a serious risk of long-term dependence, abuse and overdose. In fact, the World Health Organization (WHO) estimates that 15 million people worldwide are addicted to opiates and 69,000 die from overdose every year.

Because they affect the part of the brain responsible for respiratory regulation, a high dose of opiates can cause a person’s heart to stop beating. Even in the case of a non-fatal overdose, a prolonged lack of oxygen can still cause irreversible brain damage.

There are growing concerns within the global health community over the strong link between opiate painkillers and heroin use. In the 1960s, more than 80% of people following an opiate addiction treatment reported starting with heroin. Newer research from the early 2000s reveals that 75% of people receiving opiate addiction treatment reported starting with prescription opiate painkillers.

Naloxone, a powerful emergency drug that reverses the effects of overdose, is used worldwide to prevent death once an overdose occurs. In most countries, naloxone is only available to health professionals and emergency responders.

This means a person must receive immediate medical attention at the onset of overdose symptoms. However, the people most likely to witness overdose include friends and family members. WHO recommends that naloxone be made available to friends and family members as well as health care workers in order to increase people’s chances of surviving an overdose.

It’s important to note that preventing overdose does not in itself control opiate abuse. People also need to stabilize their health in order to control their addiction in the long run. Canada recently pioneered an experimental health policy with that intention. September’s amendment to the nation’s Controlled Drugs and Substances Act will allow doctors to prescribe controlled amounts of heroin to addicts in order to stabilize their dependence.

The policy aims to achieve two main goals. First, by administering addicts a controlled amount of heroin under professional supervision, doctors hope to avoid the type of overdose wherein someone takes a lethal amount of an opiate substance at one time. Second, they hope that the provision of medically “clean” heroin will prevent the spread of HIV/AIDS and other infectious diseases through intravenous needle sharing.

Canada’s new policy reflects a global movement to rethink opiate addiction treatment. Whereas the traditional view on drug policy has been to incarcerate drug users, some countries are implementing legally-sanctioned alternatives.

For instance, Switzerland, Germany, the Netherlands, Norway, Luxembourg, Spain, Denmark, Australia, and Canada have supervised injection centers where opiate addicts can get safe injection kits, information about addiction and overdose, treatment referrals and access to medical staff. Some centers also offer counseling and hygienic amenities, like toilets and showers.

What supervised injection centers and Canada’s new policy have in common is the belief that addiction is a disease before it is a crime, and should be treated as such. Thus, it becomes the responsibility of a country’s health care system and government to provide safe care.

But what would Canada’s new policy look like in a global context? To start, countries looking to implement a similar policy would need to have reliable health care infrastructure — that means sanitary medical facilities, trained health workers and strong security. Unfortunately, that rules out many low-income nations who don’t have the financial means to uphold such standards.

On the other hand, the United Nations predicts that drug use over the course of the next 35 years will have a disproportionately high effect on urban populations in developing nations. Finding new ways to manage addiction could help developing nations spend less money on prisons where addicts typically end up serving long sentences at the cost of the state.

Moreover, if intravenous drug use happens under medical supervision, then people in condensed urban communities would be less exposed to contaminated needles, illegal drug sales or other intoxicated people.

The amendment to Canada’s drug policy demonstrates how drug policy is changing worldwide. Opiate abuse is just one example of how trends in drug use are an important factor in policy reform.

Jessica Levitan
Photo: Flickr

Haitian Cholera Outbreak
The Haitian cholera outbreak in 2010 became endemic, after at least a century of the disease not posing a threat.

Spread through contaminated water, the infectious disease causes dehydration and severe diarrhea. It can even lead to death if left untreated, sometimes in just a few hours. The outbreak transpired just after a fatal earthquake occurred in the country.

The United Nations (U.N.) sent peacekeepers to Haiti to help with the damage but failed to screen them for cholera or build them sufficient toilet facilities. As a result, cholera-infected wastewater flowed into Haiti’s main river — a main source for washing, cooking, cleaning and drinking. By 2011, over 470,000 cases of cholera were reported, with 6,631 connected deaths.

Immediate Response

Within days of the Haitian cholera outbreak, the Ministry of Public Health and Population (MSPP), along with the Centers for Disease Control and Prevention (CDC) and its partners, established a national surveillance system to track cases of the disease.

Treatment and prevention materials were also quickly developed, and thousands of healthcare workers were trained. Together, the organizations reduced the initial mortality rate of four percent to less than one percent, saving an estimated 7,000 lives.

However, thousands of people continue to become sickened each year by cholera. Haiti’s water and sanitation infrastructure require major improvement for any significant, long-term progress to be made.

The U.N.’s Reaction

After denying any responsibility for over five years, the U.N. has now officially admitted to a role in the Haitian cholera outbreak.

The deputy spokesman for the Secretary-General, Farhan Haq, recently sent out an email saying, “over the past year, the U.N. has become convinced that it needs to do much more regarding its own involvement in the initial outbreak and the suffering of those affected by cholera.” He wrote that a “new response will be presented publicly within the next two months, once it has been fully elaborated, agreed with the Haitian authorities and discussed with member states.”

Although this statement fails to put blame on the U.N. or to indicate a change in its legal position — that it is absolutely immune from legal actions — it does represent a significant step forward for the U.N.

Looking Forward

Haiti launched a National Plan to eliminate cholera from the country in 2013. The 10-year-long plan focuses on water and sanitation, health and preventing further infections.

However, the plan is terribly underfunded. The U.N. Office for the Coordination of Humanitarian Affairs (OCHA) pledged over $125 million toward this program, $19 million of which was received; the plan is anticipated to top a total of $2.2 billion in investments.

Nigel Fisher, Special Representative of the U.N. Secretary-General in Haiti said, “It’s a big challenge. We have to raise literally billions of dollars. And this requires sustained support and commitment. That’s what we are here for. We, all of us partners, have a moral obligation to stay the course with cholera. Not just to lower the incidence of cholera, but to eliminate it from Haiti.”

Alice Gottesman

Photo: Flickr

Sanitation in Developing Countries
Sanitation in developing countries is a very pressing issue. Globally, almost 2.5 billion people live without proper sanitation and almost 1 billion of these people practice open defecation. Poor sanitation not only leads to the rapid spread of disease, but can also affect education and the environment.

Though improper sanitation affects both rural and urban communities, open defecation is more common in rural communities, often resulting from traditional beliefs or a lack of education.

While traditional beliefs are important, some beliefs can be damaging in terms of sanitation. For instance, some communities in Madagascar believe that using an outhouse can cause an expecting mother to lose her child. There is also a common belief that defecating in the ground is disrespectful to those who have died and been buried.

These myths create an environment where poor sanitation practices like open defecation are commonplace. Unfortunately, these practices can lead to contaminated food and water sources. Consuming contaminated food or water causes high rates of bacterial diarrhea, which is the second largest killer of children under the age of five in the world.

To fight the effects of beliefs that lead to poor sanitation in developing countries, education programs must be implemented. In fact, in addition to avoiding deaths due to diarrhea, communities benefit in multiple ways from hygiene and sanitation education.

According to the World Health Organization, when educated about the link between sanitation, hygiene, health and economic development, communities have a higher demand for improved sanitation facilities. Additionally, when children are not sick from consuming contaminated food or water, they are able to attend school more often and focus on their studies.

For children in developing countries, every moment of schooling can have a large impact. It has even been found that one additional year of schooling can increase a woman’s income potential by up to 20 percent in developing countries.

Yet in order for education effectively improve sanitation in developing countries, it must be implemented correctly. Education has the largest impact on children, and they can take hygiene practices home and show them to their family members. When children eventually grow up to be parents, they can raise their children with the hygiene practices instilled in them.

Education is even possible in illiterate communities. One organization offers sanitation education in the form of puppet shows.

Global sanitation has a lot of room for improvement, but by implementing simple yet effective hygiene and sanitation education programs, the world could take an important step forward in the fight against not only poor sanitation in developing countries, but global poverty as a whole as well.

Weston Northrop

Photo: Flickr

Health Service_IndiaMedical researchers hailing from Punjabi, and fellow contributors M. Teotia and Rinku Sharma, have closely examined the effects of pollution on children in India.

In a 1998 document, Teotia relays that Indian children bearing low calcium levels are the most susceptible to bodily distortions after drinking polluted water. One of the noted disfigurations included clubfoot, an occurrence that totals 500,000 cases per native children on an annual basis.

Follow-up reports by Sharma’s team found that infants suffering from air pollutants can develop heart defects and Down Syndrome. It is further described that the recent influx of unplanned pregnancies and poor nutritional status oftentimes worsen the defects.

In the late 2000s, health investigators learned of compound Uranium’s effects. This element not only held notoriety as the power wheel for India’s money making markets, but it also was accountable for mobile and mental disability in natives.

Experts dug deeper and soon found that the early 1960’s Euro-run firm Uranium Corporation of India Limited (UCIL) played a large role in the pollutant crisis, especially given that records showed the company designating small units to nearby villages of indigenous people, thereby exposing them to radiation.

These findings have since met debatable terms. One side defends that uranium power has been essential in saving noted regions from debt, while the other dissents that no native benefits financially other than accumulating “cancer[ous] diseases.”

In 2009, threats were made against international researchers that if they did not keep quiet about their findings, the medical professionals would be stripped of their legal visitation and have their operated clinics within the country closed.

In one scenario, friction was ignited when The Guardian was notified by a classified health operative that his Indian-based resource center was aborted and redirected to Germany after it was found that his reports contained “unflattering” text about massive mining firms. When The Guardian attempted to get a word from Indian industrial powers, officials declined to comment.

With little to no assistance from the Indian health service in terms of a complete outlook on the situation, several locals have taken matters into their own hands.

Under the guidance of a 2010 “Indian Express” write-up, handicapped children are encouraged to eat vitamin B9-enriched foods to reduce and reverse certain deformity effects. Meals containing flour or leafy greens have also been considered.

The report informs natives that an Indian health service like CURE International could limit high chances of accumulating bodily deformities. Moderating long-held customs like incestuous marriage and outdoor defecation should also be evaluated, for these practices can create the development of further defects.

Other solutions vary. Experts have noted many Indian natives oftentimes succumb to the lack an Indian health service to treat a deformity when medical insurance is not cost-effective, and as a result, many of them have no choice but to turn to a personal homemade solution.

Many have yet to answer why there are such restrictions on thorough research regarding the dangers of uranium production. However, the bigger question remains: how much longer until change ends such continually distressing events?

-Jeff Varner

Photo: Flickr

Myths in Mozambique
Along the Indian Ocean lies a southeastern African country called Mozambique. At nearly 800,000 square kilometers, the country is almost twice the size of California. With this size comes great diversities of habitat and life. Many of the country’s 5,500 plant, 220 mammal and 690 bird species live nowhere else in the world.

Yet despite its richness in resources and biodiversity, Mozambique is one of the poorest countries in the world. Of the over 25 million people who reside in Mozambique, nearly 60 percent make less than $1.25 per day. The country also faces education challenges, with an adult literacy rate of just over 50 percent.

Unfortunately, one of Mozambique’s worst problems is the prevalence of HIV. Within the country’s borders, nearly 1.5 million people are estimated to live with HIV. Over 100,000 of those affected are believed to be under the age of 15.

These staggering numbers are largely the result of misinformation, gray areas and health myths about proper medical treatment and disease prevention. Clearly, the health myths in Mozambique need to be addressed with public health education. In that interest, many organizations have implemented innovative medical and education programs.

In October 2015, UNICEF launched a text-messaging-based program called SMS BIZ to confront health myths in Mozambique. This program was created to provide people aged 10 to 24 with reproductive health counseling services.

By allowing young adults to ask questions, talk about what is happening in their communities and gain critical information, SMS BIZ hopes to create educated communities armed with facts that allow them to reduce the occurrence of HIV in Mozambique.

By offering weekly discussion questions, SMS BIZ can assess the effectiveness of health services in specific communities. When subscribers answer a discussion question, SMS BIZ collects data regarding their gender, age and area. If surveys reveal that a community lacks knowledge about a specific reproductive health or HIV prevention issue, UNICEF can target the community and help bridge the knowledge gap with constructive feedback.

Services such as SMS BIZ by UNICEF are critical in dispelling health myths in Mozambique. Unwanted pregnancies and HIV contraction often occur when people lack education about reproductive health. Fortunately, over 41,000 people in Mozambique are subscribed to SMS BIZ, and more are joining every day.

Weston Northrop

Photo: Flickr

GaviThe Global Alliance for Vaccines and Immunization (Gavi) is a global organization whose goal is to create equal access to vaccines for children living in the word’s poorest countries. Gavi’s new country portal makes it easier for countries to apply for, report on, renew support and keep track of collaboration to make vaccines work and protect people’s health.

Documents are accessible for updates at any time, proving convenient for managing and viewing the latest information with partners.

Gavi’s New Country Portal

Before the creation of Gavi’s new country portal, processing important information between certain health ministries, representatives and vaccine manufacturers could take up to 13 months. “With the Country Portal, we expect to improve this time by 25 percent by 2017. This means we can get life-saving vaccines to children faster,” explains David Nix, Gavi’s Chief Knowledge Officer.

Equally helpful, the portal is user-friendly with guidelines in English, French, Spanish and Russian, the main languages of Gavi-supported countries, making the application process for vaccines much more efficient.

There is great value in vaccination; regular vaccines protect people’s overall health, as well as their incomes and savings. Healthier communities play a large role in promoting economic growth, saving up to $6 billion on health treatment costs.

Children and Vaccination

Children who avoid getting sick do better in school because they are able to attend, understand concepts and perform well on assessments, all of which contribute to better employment in the future. It goes without saying that more often than not, preventing diseases is a lot easier than treating them and spares individuals any additional struggles.

In the past, the cost of vaccines and immunizations has been a hindrance to millions of children living in poorer countries. New life-saving vaccines failed to reach children in developing countries where they were needed the most.

In January 2000, the Bill & Melinda Gates Foundation’s $750 million five-year pledge funded Gavi as a new approach to the global problem. Gavi’s public-private partnership brings together UN agencies and governments to improve childhood immunization coverage and make vaccines more affordable globally.

An Organization Making Change

Gavi has already produced remarkable results. By 2015, the development model served 500 million additional children since its creation and prevented more than seven million deaths. Between 2016 and 2020, Gavi sets to extend care to an additional 300 million children.

Gavi’s new country portal and humanitarian approach have yielded effective methods for improving global health and providing assistance to the world’s poor. The hope is that as the number of vaccinated children increases, the rate of disease will significantly decline.

Mikaela Frigillana

Photo: Flickr