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Sochi, Brazil and a Global Health Nightmare

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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

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Overpopulation and Public Health

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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

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Imprisoned for Miscarrying?

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

What Is Management Sciences for Health?

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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

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New Public Health Policy of Aflatoxin Prevention in Ghana

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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

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Biodiversity and Public Health

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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