The elderly population around the world has been growing steadily ever since they have been treated as a separate demographic group. People over the age of 60 made up 9.2 percent of the population in 1990, 11.7 percent in 2013 and they are projected to hit 21.1 percent by 2050. As of 2013, two-thirds of the elderly population live in developed countries. However, the aging population in developing countries is growing faster than in developed countries. Eight in 10 elderly people will be living in developing regions by 2050.

While these statistics are interesting, they are a cause for concern when taking into account the amount of abuse that the elderly population is subject to in developing regions. Abuse against elders ranges from sexual,psychological and emotional abuse, financial abuse, neglect and physical violence. This is especially frightening considering the elderly demographic is one of the most under-acknowledged social, public health and human rights issues.

Because women live longer than men, they tend to become the most common target for abuse. This is only amplified by the increasing trend of women living alone. Often times this abuse manifests itself in claims of witchcraft. This might seem like an outdated notion, but the trend continues to this day and has been reported in 41 countries such as Burkina Faso, Cameroon, India, Kenya and Nepal.

While there is data out there regarding elder abuse, there is a considerable lack of statistics regarding this issue. The World Health Organization has found that prevalence rates and estimates of elder abuse only exist in select developed countries, ranging from 1 to 10 percent. Outside of developed countries, the WHO says that abuse is under-reported by as much as 80 percent. This is further emphasized by the sharp decrease in support structures for the elderly population, particularly in developing countries, which points toward increasing neglect and poverty. The relative poverty of the elderly tends to be higher than the population average, no matter how developed the region they live in.

Thankfully, there are organizations to help combat this issue. The International Network for the Prevention of Elder Abuse, founded in 1997, has since gained consultative status with the UN Department of Economic and Social Affairs. By utilizing international collaboration, the INPEA aims to raise awareness and knowledge on these issues, advocate on behalf of the elderly, increase society’s ability to recognize and respond to abuse and research the causes and consequences of abuse.

While there is work being done to help decrease abuse, more needs to be done as elder abuse is proving to be an increasingly pressing issue considering the steady increase in the aging population.

 —  Andre Gobbo

Sources: UN 1, UN 2, WHO
Photo: World Crunch

unauthorized clinics
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: NPRVoice of America
Photo: Jezebel

The passing of four years signifies the completion of an important unit of time for the sporting world, a marker that brings the World Cup and the Olympic Games back, blissfully, to the forefront of the global stage with 2014 being no exception. This year, Brazil will host the FIFA World Cup and Sochi will host the Winter Olympics, to begin June 12 and February 6, respectively.

Headlines anticipate security concerns for both events, which include the threat of terror attacks, widespread protests and general mayhem.

In Sochi, officials have mobilized thousands of security cameras, instituted new security checks and passport screenings, deployed scores of military personnel and amped up surveillance to ensure that “everyone in the city… feel[s] at home and safe.”

Authorities in Brazil are making similar arrangements in hopes that extensive precautionary measures will entice tourists despite the nation’s — particularly, Rio de Janeiro — volatile and violent history. Furthermore, Colonel Alexandre Augusto Aragon, head of the Brazilian National Security Force, recently revealed that 10,000 hand-selected riot troops would police the 12 cities hosting soccer matches this summer.

These reports serve as reminders that mass gatherings, even of sportsmen, can spell danger for participants and fans alike. These events are, moreover, virtual breeding grounds for another invisible threat: pathogens.

The less-publicized public health risks inherent in occasions similar to the Olympic Games are familiar to virtually every global health organization. The World Health Organization (WHO) maintains a Global Alert and Response page dedicated to mitigating risks associated with mass gatherings, which top officials consider “a stress test for public health.”

Even nations with well-established health services and fully-briefed support staff can be overwhelmed by the burden associated with an unexpected outbreak in a mass gathering situation. Not only do gatherings draw visitors from a variety of geographic areas (read: different regions of germs) but they are also, by nature, densely packed and fraught with opportunities for transmission.

WHO officials employ the International Health Regulations to govern disease surveillance programs in the 196 countries that have agreed to certain legal rights and obligations described in the regulations in applicable circumstances. Should unexpected cases of influenza, polio or respiratory illness surface, Russia and Brazil will undertake highly targeted, pre-mediated actions to prevent a public health nightmare.

Unfortunately, very real risks to traveler and fan health go generally unmentioned by the press, whose stories generally touch on political and public interest stories associated with the Olympic Games and the World Cup. Any participant in 2014’s festivities should ensure that they are up-to-date with annual and seasonal vaccines, including the flu and measles.

Appropriate action and active awareness will spell gold for Russia and Brazil, nations hoping to leave a positive public health legacy on the landscape of sports history.

Casey Ernstes

Sources: CBS News, The Huffington Post, The New York Time, The World Health Organization

Photo: The Age

overpopulation public health
There is much debate whether overpopulation poses public health risks. Some believe it is the cause of hunger and poverty throughout the world while others feel that it has never been a problem.  It is important to shed light on this fear of overpopulation as its consequences are said to be evident in all developing countries.

Several reports about Africa’s growing population has been connected to the starvation of millions of people. Every year 32.5 percent of children in developing countries suffer from malnutrition. Sustainable population advocates have pointed to the approximate 200 million hunger-related deaths in the past twenty years. Deterioration in global biodiversity has also been linked to overpopulation. Substantial data of species loss has been presented by countries such as China, Brazil and Mexico. Human settlements that are gradually increasing according to the rate of population is said to ruin the benefits of nature and destroy habitats. The consequences of overpopulation is also suggested in access to education, primarily in Africa. In African classrooms, children are unable to learn due to overcrowding.  Access to water, medical care and housing are all diminished when there are more people that require aid. Data from the United Nations further suggests that by 2050, 10 percent to 15 percent of land that is farmed today will not be available. This could potentially lead to a food crisis as the current population increases at a faster rate.

Those supporting a sustainable population see hope in public policies being employed in countries such as Bangladesh, Iran and Thailand. Results from securing social services to women and families indicate a large decrease in undernourished people in Asia, from 23.7 percent to 13.9 percent. This downward trend from simply giving access to birth control and adopting policies that give aid to small families suggests that overpopulation is an issue that can be solved.  Policies that provide family planning to those in remote, rural areas in Asia has led to stability in undernourishment over time. By merely shifting the focus on public policy these countries quickly witnessed better health standards, quality of education and housing availability, all of which offer hope to the remaining developing nations.

– Maybelline Martez

Sources: Scientific American, Huffington Post, World Hunger

Imprisoned for Miscarrying
Last month in El Salvador, a judge sentenced 19 year-old Glenda Xiomara Cruz to prison for 10 years. Her crime? Miscarrying.

In October of 2012, Xiomara, experiencing excruciating abdominal pain and bleeding, sought medical treatment at a public hospital. Unaware that she was even pregnant, as she’d experienced no weight gain and a pregnancy test had come back negative, doctors told her she’d lost a baby. Four days later, the teenager had been reported by the hospital to the police for suspected abortion and charged with aggravated murder. A year later, she’s been sentenced to ten years in prison by a judge who told her “she should have saved her baby’s life.”

Xiomara’s unfortunate fate is the result of El Salvador’s strict abortion law. The law is so strict, in fact, that since 1998 abortions have been completely banned without any exception, even in cases of rape, fetal deformity, or if the mother’s life is at risk.

Twenty-eight year-old Maria Teresa Rivera’s story parallels Xiomara’s and further illustrates the tragic consequences of such a harsh law. Last year, she too sought medical treatment for bleeding and abdominal pain and was reported to authorities by the hospital after suffering a miscarriage. Teresa was sentenced to 40 years in prison for aggravated murder. A textile worker and her family’s main provider, going to jail meant leaving her eight year-old son in extreme poverty.

A study done by the Citizens’ Group for the Decriminalization of Abortion supports the statement that this law overwhelmingly affects those living in poverty. The study found that, since 2000, more than 200 women have been reported to the police on abortion charges — the vast majority of these women were poor, unmarried and with little education. Comparatively, not a single woman has been reported from the richer private healthcare sector — where abortions are believed to be performed regularly.

More than unfairly imprisoning women and tearing apart families, the law also has devastating consequences for women’s health. Bessy Ramirez of San Salvador enunciates one of the numerous harmful effects of the law: “I would be terrified to go a public hospital as there is no benefit of doubt given to young women, we are presumed guilty and jailed.” For poor women, however, public hospitals represent their only medical treatment option.

In addition to deterring women from seeking medical treatment, the law likely also has a role in boosting the occurrences of suicide. Health Ministry figures from 2011 identify suicide as the most common cause of death for 10-19 year-old girls; half of these girls were pregnant. Further, because it is illegal for women to terminate pregnancies even in cases where the mother’s health is threatened, the inability to treat pregnancy complications is the third most common cause of maternal mortality.

Amnesty International’s El Salvador expert Esther Major calls the abortion law “cruel and discriminatory” saying that “women and girls end up in prison for being unwilling, or simply tragically unable, to carry the pregnancy to term. It makes seeking hospital treatment for complications during pregnancy, including a miscarriage, a dangerous lottery.” Unfortunately, as in innumerable other instances, it’s a lottery women in poverty are most likely to lose.

– Kelley Calkins

Sources: BCC, Slate

Photo: Vice

Management Sciences for Health (MSH) has one mission: to save lives and improve health of the world’s poorest and most vulnerable by closing the gap between knowledge and action in public health. This global health non-profit organization uses proven approaches to help leaders, health managers, and communities in developing countries create stronger health systems for a greater health impact. Since its founding in 1971, MSH has left its mark in over 150 countries working with policy makers, health care consumers, and health professionals to improve the overall availability, affordability and quality of health services.

The work of MSH is centered on four core beliefs and values: effective local leaders and local institutions are key to creating lasting health impact; health is a basic human right, realized through healthy living conditions and access to health care for all; healthy people and communities are more able to contribute to economic growth and political stability; and better evidence to scale up current methods and technologies will fuel widespread health impact.

Since it’s founding, MSH’s operations have been based on the 3,500 year old Tao (Way) of Leadership, working shoulder-to-shoulder with local partners and colleagues and empowering them to succeed. In the 1960s, MSH’s founder Dr. Ron O’Connor, was taught the principles of the Tao of Leadership by Dr. Noobora Iwamura, a mentor and friend. Dr. Iwamura, as the only survivor of his high school class in the Hiroshima bombing, decided to lead a life of service in the remote, rural areas of Nepal. Through his work he discovered that creating sustainable changes meant much more than medical care on its own: it meant engaging communities actively in their own health needs.

The mission and work of MSH is based on Dr. Iwamura’s concern that communities be empowered with the knowledge of solutions to basic health problems and challenged to take control of their own health. These values are resonated today in MSH’s staff of over 2,400 based in over 65 countries. MSH focuses its efforts on strengthening health systems in the priority health areas: HIV & AIDS; tuberculosis; family planning and reproductive health; maternal, newborn, and child health; malaria and other communicable diseases; and chronic diseases.

In the organizations’ 2012 Annual Report, MSH outlined universal health coverage (UHC) as the framework for maximizing health impact. More than 50 countries have achieved universal health coverage, with an additional 50 countries working towards the same goal. MSH is contributing to this UHC movement through its coordination with local communities to develop health system innovations, such as the scaling up of community health shops, and by directly building local ability to deliver health services through training health workers and staff. There is much work to be done, but MSH is pushing to make effective healthcare available to anyone in need.

– Ali Warlich

Sources: MSH,WHO

Poison Corn_opt
Of the many climatic, soil, and logistical challenges the Ghanaian agricultural industry has had to overcome in order to encourage economic growth and production capacity, none have posed a greater threat to crop efficacy than that of aflatoxin exposure. Aflatoxin – a cancer caused by product of the fungi Aspergillus – found in yam chips, groundnuts, cassava, and maize has been a chronic public health concern faced by much of the local farmers and agribusinesses of the sub-Saharan country. In an effort to ameliorate the carcinogenic side effects of the compound, health officials are working to implement a policy of aflatoxin prevention in Ghana.

Thanks in part to the increased coordination between the Food Research Institute (FRI), Ministry of Food and Agriculture (MOFA), and support funding from the Southern African Trust, a newly invigorated policy of aflatoxin prevention in Ghana will be launched. What exactly does the new prevention program entail? FRI officials are asking for mechanical driers – needed to quickly dry the grains – along with requisite storage facilities in order to prevent contamination during the rainy season. Once implemented, this robust policy of quick drying and storage is expected to mitigate the public health effects of the aflatoxin compound.

In regards to aflatoxin prevention in Ghana, FRI official George Anyebuno noted that, “These toxins are also potent causes of cancer and suppress the immune system, causing humans and animals to be more susceptible to diseases… But they are not often visible on the corn when purchased; once the maize is infected, nothing can be done to remove the toxins as they are very stable compounds even at high temperatures making the maize unwholesome.”

Thanks to a newly energized policy of aflatoxin prevention in Ghana, the chronic health and agricultural problems caused by the hazardous compound will now be addressed. Furthermore, through the deployment of a policy that includes public health awareness, prevention, and interdepartmental cooperation, the resulting health problems caused by aflatoxin contamination will finally be eliminated.

– Brian Turner

Source Ghana Business News
Photo Tree Hugger

A new study led by Harvard Medical School researcher Matthew Bonds is linking an environment’s biodiversity and public health, namely its susceptibility to the spread of disease. Bonds found that countries with decreased biodiversity “will have a heavier burden of vector-borne and parasitic diseases,” an assertion which has drastic implications for public health systems worldwide.

Previously, some might have suggested that a lack of funding is the biggest roadblock to protecting people from pathogens. These new findings indicate that governments may be well-served in their quests for healthy citizens by protecting natural ecosystems. Bonds explains that “the more organisms you have out there, the more things there are that can interrupt the life cycle of disease, and the less concentration you’ll have of any vector.” When humans urbanize an area, many species are forced out of their natural habitats and end up dying off in large numbers. Pests and other disease-carrying creatures breed freely, resulting in a much greater risk of exposure for humans.

The United Nations estimates that one out of every three species on Earth faces extinction. Bonds uses this statistic to demonstrate how a country like Indonesia faces a grave threat from losing its biodiversity: given a 15% decline in this metric, the country would face a 30% larger disease burden. By elucidating biodiversity’s link to public health, Bonds demonstrates yet another area in which undamaged ecosystems provide major benefits to humans who can exist alongside natural cycles, instead of in place of them.

Jake Simon

Source: NPR
Photo: About Indo

Polio Vaccine
Nine public health workers were recently killed by gunmen in Nigeria, according to The New York Times. The women were giving the polio vaccine to patients as part of a drive to eradicate the disease. The United Nations Children’s Fund and the World Health Organization both have a hand in funding and running the aid effort. No group has claimed to have committed the murders but local militant groups are suspected.

Polio has not been an epidemic in the developed world for quite a long time. The polio vaccine is easily found and administered in most areas of the world. Nigeria is one of the few countries in which polio continues to cause a real threat to the population. A large factor in this deadly situation is a high level of mistrust of the vaccine. Rumors about the CIA and Western governments using the vaccine to spread AIDS and sterilize women have both been spread.

It is surprisingly easy to believe that such things would be happening since such things have indeed been done before. Building trust on both personal and international levels is important to defeating the last holdouts of polio. The absence of the disease from the rest of the world can’t be the only proof that health workers can bring to their communities, there needs to be greater trust and less fear.

To combat the myths about the polio vaccine and the fear of receiving it, Bill Gates of  The Bill & Melinda Gates Foundation has begun to address those issues head-on. Bill Gates recently gave a lecture outlining the importance of the vaccine’s availability and dispelling the popular myths about what it does.

The presence of a big name like Gates will go a long way in getting rid of these misconceptions that are putting people’s lives in danger. Watch Bill’s lecture here.

– Kevin Sullivan

Sources: The New York Times, BBC
Photo: Vaccine Truth