Top Eleven Countries(Suicide Rates), Guyana tops the list!
Nepal earthquake and emergency preparedness!
On unfateful morning yesterday, Himalayan kingdom of Nepal, sharing border with China and India , suffered earthquake of magnitude 7.8. Last major esrthquake in Nepal was reported in 1934. It is true that we hardly have any control over the natural calamities like Tsunami,or earthquake. We merely can do anything to avert it. Forecasting of such dangers are still not accurate. Only perfect scientific invention and technology, if discovered in future, might help in preventing human lives from it, if people are given pre warning about it. But to tackle emergencies stemming from such natural disaster is one of the big challenges for public health professionals. Patterns of natural calamities can help in understanding and responding to deal with it. For example , Bangladesh is well prepared for cyclones and flood, because it faces any of these calamities every three four years.
2011 earthquale in Japan resulted in loss of $365 Billion US dollars. Hurricane Katrina of 2005 was 45Billion dollars loss for United States. Because of lack of insurance, the loss might not be that huge when compared with US and Japan loss. However, in confrimance with the Nepal economy, this loss might be more difficult for Nepal to meet. Other health priorities, such as achieving millennium goals take backside, because of such emergencies,which have long run consequences. First and foremost challenge before government remain for the government is providing basic needs to affected people and then rehbiliating them. Nepal like country whose GDP is $ 67Billion and which depend largely on international aid(especially India), would completely fall if international agencies community do not come forward to provide assistance.
I witnessed two natural calamities so far, first was Mumbai deluge in 2005 and then Sandy in New York. Mumbai deluge was complete administration failure , most of the portion of city was submerged in water , and thousand of people lost their lives in few hours , and unfortunately, I don’t think any lesson were learnt from it. On the other side, Sandy was effectively handled. Though I was in San Fransisco, I observed it very closely. One major difference observed was that how quickly administration responded to calamity. Then Mayor Bloomberg gave warning signs and evacuated major areas to make sure that Sandy loss is minimized. And then once Sandy passed, Bllomberg administration wisely managed the quick response in all asoects. But again, it was emergency response in difference setting (developed vs developing).
To survive an earthquake and reduce its health impact, three Ps Preparation, Planning, and Practice are required. Mortality stems from trauma, asphyxia, burns, and dust impacting in the Lungs. People are left with disabilities. Surgical need are very important in first few weeks . Sufficint supply of suturing materials, instruments and disinfectants is need of hour. Severe cases of burns were also reported from previous earthquakes. All wounds and burns should be carefull checked as clostridium titani spores are present int the soil and can infects wounds and burns. Adequate stocks of tetanus vaccines for children is important to prevent tetanus related morbidities. Case fatality rate of tetanus is very high if left untreated. Dysphagia and trismus are few of first symptoms of tetanus, hence, cases with these symptovs should be reported to epidemiologists and surveillance officers. Good surveillance and collection of data helps in any future disasters. Few studies have reported increased cases of HIV/AIDS, perhaps because of faulty blood donation or unprotected sex (since unavailability of condoms and other barrier methods). Overcrowding of people cane xpose peole to scabies like infectious diseases. Surgical team, equipments, well trained CPR team, and blood availability (blood bank with standard storage facility) is the cornerstone of saving human lives in medical point of view. If people are given CRP training and for genral wound management, in emerncy situation, physician and nurses can handle cases on priority bases ,and over-burdened health professionals can be used judiciously to give adequate timely treatment to patients. Infectious dieseases (waterborn like cholera , diarrhea), food born diseases such as dysentery become rampant. Timely measure to remove dead bodies animal corpses , and cleaning and applying disinfectiong methods can help
Earthquake survivors are exposed to post traumastic syndrome, hypertension , insomnia and depression. It is worth to mention one movie I watch recently, based on tsunami (I watched Spanish version), in which one married couple of Germany visited Phuket of Thiland with their two gorgeous kids.Tsunami stuck just after two days of their stay and wife lost her husband and children. She wanders one hospital to another, she couldn’t, but only thing she could see the dead body of one of her kids. Her life was devastated in minutes, natural calamity changed her life totally. Eventually she returned Germany, her family gave her support and she was provided psychiatric help. Finally she was able to get over the trauma. This is very nice movie to know how to treat patients with post traumatic stress syndrome (one of therapies). Distruction of homes and inappropriate living condition add up their stress level.
Linnen et al study, conducted in Harvard medical school (2011) vividly describe how fear and pain are affected in post traumatic stress syndrome. It implied that putamenand caudate activity is increased in post traumatic syndrome when subjected to heat pain, in addition, Biologically point of view speaking. Prefrontal cortex and amygdala is involed with emotion and behaviorVery few studies of its kind, Khachadurian (2015) et al reported that earthquake related loss and concurrent psychopathological stress affect adversely on their quality of life. Rwanda was exposed to terrific war in 1990s and their were huge human lives. Boston massachusset depaArtment sent few of their psychiatrist to help people to deal with post traumatic stress syndrome stemming from war. Talk therapy, cognitive behavioral therapy and support from family friends also can be useful Sometimes antidepressant (though black box sign by FDA) can be sueful innot all patients though.. But question crops up, do they have those resources, do they have human resources and experts to tackle it, do they have trained peole , and more importantly money. Here timley international help can make wonder.
International agencies like UNICEF, World Health Organization and World Bank have big role to play. For example, world bank helped Pakistan (project:P099110) to build 80,000 houses under team leader Raja Arshad. It was possible with the assistance of US $ 400 millions. I was reading tweets from Alex Gavan , mountaineer, who has pleading for immediate help for Nepal to avoid further damages. It is scary to imagine rock and ice falling on the mounaineers. I am worried about rurtal pockets aroung Kathmandu. Media, government officials and international agencies focos on big cities, but I think, rural help should be managed through effective measures. Technology is again going to be blessing here. Gis role in earthquake: Google use in finding the person.Facebook and twitter are part of emergency preparedness.Facebook can creates pages for earthquake survivors to connect with each other.
Public health communication plays very important role in first few weeks of earthquakes. People should be educated about emergency preparedness. It also included educating them about safe water and food preparation. They should be stressed on maintaining hygience . Since Nepal is zone for malaria and dengue, use of mosquito nets should be emphasized.
The Ebola Crisis: Is Being Black to Blame? (by Ariong Moses)
Ariong Moses is my good friend from Uganda. He is global health leader and potential leader for Uganda who would like to change global health dimensions of Uganda in positive ways!! Here is his article which he shared with me last week.
The Ebola Epidemic has claimed over 4,500 deaths since it began around January 2014. Most of its victims are allegedly the women who have endured the suffering of their loved ones as they writhe and die painfully. Heroes are being made every day in the worst hit countries of Sierra Leone, Guinea and Liberia as medical workers – local and foreign, struggle to contain a ‘war’ that, if not well fought within the shortest time possible, might explode in to a 4th World War of sorts. The spread however continues at alarming rates with WHO warning that over 10,000 new infections per week will be recorded if greater efforts are not put in place within the next 2 months.
Several reasons have been alluded to the failure to contain the virus by the affected countries. It is a known fact that health systems in Africa have a lot to be desired especially in countries like Liberia and Sierra Leone. It would be unwise to ask of them to handle a crisis of this nature to its logical conclusion knowing that any failures will be felt by the rest of the world.
Support has been obtained from USA, UK, China and many other nations to combat Ebola. We should however note that West Africa does not simply need some support, the people of West Africa and the rest of the world need Ebola to be dealt with to its logical conclusion. This Crisis has instilled fear among the people around the world as much as Terrorism has. Infact, a Student from sierra Leone was denied accommodation in Newcastle by three Landlords due to the fear of Ebola – I call it Ebophobia. Being black itself is now associated with Ebola in some parts of the world with the thinking that one might be coming from the hotspots of Ebola, Africa.
The mind boggling question though is that terrorism is being fought world over for a similar reason- to avoid deaths and fear that it brings to the innocent people around the world. A lot of resources are usually committed for this cause and countries are willing to unite and find the terrorists wherever they are. It is the reason my country Uganda contributed troops to fight in Somalia and recently South Sudan so as to stem any terrorist acts around the world. It is clear that Ebola is among these categories, claiming over 2000 lives within 06 months at an alarming death rate of 70%. Why is the world not doing enough to unite against Ebola? Several reports by WHO and other organisations on the ground indicate that the response has been slow as compared to the situation on the ground.
Well, one may be tempted to think that the world does not care much about those in this predicament. These are the sort of thoughts that run through a desperate mind. These are the thoughts that are running through thousands of people living in quarantined areas, faced with looming food shortages that could cost lives.
If the world is truly a Global Village, we should view the plight of the people of West Africa as our own. Let’s not give opportunity to those who need an excuse to humiliate black people around the world in the name of Ebola. Joyous will that day be when the mothers of West Africa stop crying for the loss of their children. I believe it is time to act and end Ebola!
Why Growing Old is admirable no more in many parts of the world.
The word ‘old’ used to be synonymous with the words; respect, wisdom, intelligence, experience, seniority, blessings, leadership as well as being a preserve of those blessed by God – a belief among those who acknowledge presence of a supreme being. Old persons (The elderly) were seen as a source of inspiration and were responsible for nurturing future generations based on their long life experiences with the notion “Experience is the best teacher” being widely accepted.
My father once told me of how his Grandfather handed over a special gift of his to his Son (My Grandfather), a gift that he had attained through several years of learning and practice. He took his Son to a place with many trees and shrubs and pointed at them. He asked, “Do you see all those Cattle and property all over this place?. There was obviously no wealth visible among this shrubs and bushes. My Great Grandfather was a medicine man just like many other persons at the time who had discovered medicinal properties of the elements of nature, the special gift that God had given to them. To him (The Great Grand), these were the ‘cattle’ and property that he was passing on to his Son, my Grandfather. Through practicing traditional medicine, he was able to raise his family and educate some of his children.
The African greats like Nelson Mandela (RIP), Desmond Tutu, Kenneth Kaunda of Zambia, Mzee Arap Moi of Kenya, Olusegun Obasanjo of Nigeria, Tata Awayo Mary of Uganda among others, have continued to inspire the current and the future generations in ways that I cannot explain due to the magnitude of its effect.
By now, I guess you (the reader) is asking yourself why you have not heard about the so called great Tata Awayo of Uganda. Awayo is a deaf and dumb neighbor of mind in the Town of Soroti, Eastern Uganda. She is about 75 years old and leaves alone in a grass thatched mud and wattle house. Awayo did not learn the sign language from any special needs training centre due to the challenges in Uganda’s education system that we ought to know by now.
With a smile on her face, Amojong Awayo waves me good bye almost every morning as I go to work but as well welcomes be back from the long day’s work. Awayo has been neglected by her own children and family members who fear to shoulder the burden of taking care of the now old and needy Awayo. Because the world has turned its back on her, she has to wake up very early in the mornings to show her love to everyone passing around (especially me) as she begs for; a daily meal to keep her precious life going, support for medical care to mitigate the now chronic illnesses that she has, emergency roofing of her hut that leaks now and then when it rains heavily, for Love and companionship when she is lonely and needs to be heard just like any other human being and the list goes on and on.
On the day the Hybrid Solar Eclipse caught the attention of almost every individual in Awayos’ vicinity, she was left wondering why it was not shining as it was supposed to be – I learnt this through the crude sign language interactions that I held with her. I tried to explain to her that the moon was passing below the sun and covering its rays from reaching earth, it was a hard one to explain but I made my point by showing her the eclipse using a film strip. Awayo had a hearty laugh and pated me on the back as she was expressing her deep appreciation of my intervention to address the ‘mystery’.
Awayo Mary and several other old persons are being abandoned by us, the able and productive group in the society. I learnt that even in developed countries, the elderly are treated like Animals and are dumped in care centres. Why the hell would I dump my mother or my father or any of my close relatives that brought me up and natured me, to a care centre? And to make it worse, some relatives never bother to check on them and give them the Love and company that every human being inherently deserves. I recently read an article where robots are being developed to care for the elderly, to feed them, to move them around and to “give them some Love”. This killed me internally and made me wonder where the human race is heading to.
As I blog about this, I am shedding invisible tears because of the old men and women that I have seen rotting away with Jiggers and several other treatable illnesses in my own home country, Uganda. They are given names like ‘the father of jiggers’, ‘a cursed old man or woman’, beggars among others. The health service providers have as well focused their attention on mothers and children leaving the elderly to be ‘hosts’ to several diseases as they die and disappear slowly from the face of the earth.
Who will mentor us? Who will bridge the past and the present future for the good of the current generation and the future? Who will inspire us with those lovely old age stories and remind us of the struggle that our forefathers went through to achieve what we are enjoying today?
President Obama, while eulogizing Tata Madiba (Nelson Mandela), said that we will never see a person like Mandela again. It’s true that Madiba has passed on with all his brilliance and courage, but we still have a role to play to emulate his works, to fight for Justice for all, to respect and adore humanity and to preserve the unique brains that we have among our elderly persons. Let’s give ourselves a reason to live long and inspire the world without fear that our very own will abandon us in time to come.
By ARIONG MOSES
GLOBAL HEALTH CORPS FELLOW (2012-2013)
UGANDA
Major global health challenges!
1)Chronic diseases
2)aging population with chronic diseases
3)infectious diseases
4)Future of healthcare workforce
5)QUality care
6)Investment in biomed technology
7)Health system, incrses burden of providing healthcare access to growing population.
8)Health economy and trade
9)Evidence based health care! Yesterday, Dr.Kalniki stressed on evidence based health care during his brief talk.
Trichinosis in China
In the United States, , between 2002 to 2007, only 7 cases of Trichinosis were detected, China leads the world in trichinosis infection incidences . It is estimated that more than 8,000 cases are detected every year in china. Trichinosis is parasite born diasese and its host is pig. So undercooked pork meat usually invite this infection. Thanks to stringent policy of USDA, United States has almost eradicated Trichinosis.
So be careful when visiting China and eating pork. I need to check mortality and case fatality and mortality rate of Trichinosis.
How did I jump from cancer to infection. Actually I was reading Zenker’s diverticulum. Zenker, German Parthologist who is celebrated for discovering Trichinosis. So I gave quick revision to Trichinosis.
Canada offers helping hand to Senegal!
Canada’s help to Senegal!
Great boon for African country: Canada is preparing a of
Of security and nutrition projeect to help Senegal,in it’s fight against malnutrition. Thanks to Canadian Prime Minister Stephen Harper.
It is three years initiative with determination to address immediate needs such as food assistance to struggling families and nutritional supplements to pregnant women and children. It is also providing Argo-based support.
In light of this noble project, Canada is partnering with world food program, Food and Agricultural organization and UNICEF.
