Landmines in Sudan

This weeks article discusses the clearing of landmines from South Sudan. Since this area used to be a full on war zone, there are many landmines left over and still active. Reportingly, there have been, “a total of 1,243 injuries and 3,158 deaths from landmines”. These numbers show that when people experience these landmines, over 50 percent of them die and are lucky if they survive. This makes sense because landmines are designed to do just that, kill the enemies. However, now they are killing the innocent civilians that were left behind. This is why a private contractor, Mechem, was called to take action. They came in with vehicles that were mine resistant, sniffer dogs, and metal detectors and located all the landmines that they could. “According to the government’s South Sudan Demining Commission (SSDC), 1,653 dangerous areas have been identified. Of those, 559 were cleared of mines by the end of 2010”. There have been many other demining teams that have come in as well.

            The main problem of the landmines was obviously the deaths that came from it, but another reason is because people would not use it. Refugees would not come back, and therefore the place where they left now has less workers, and that leads to less money to spend in the markets, and that whole cycle. Another important aspect is trade. No one is going to travel to these areas because they are in fear of being killed by the mines. This just means that they are not getting any goods that they cannot grow themselves, and it is known that Sudan is not able to support themselves without aid. However, if they continue to de-mine the land, Southern Sudan could have a better future.

http://www.newsfromafrica.org/newsfromafrica/articles/art_13066.html

Libya

This article discusses Libya and the aftermath after they killed their ex- leader Muammar el-Qaddafi. Qaddafi was pushed out of power by a revolt in August, and then sure enough he was killed at the end of October. His followers were killed as well. Since then, the country has decided to write a new constitution and a whole new elected government. One of the main issues now is with the militia. After Qaddafi was thrown out of power, the militiamen were supposed to give up their guns, and they are not. They say that they, “they intend to preserve their autonomy and influence political decisions as ‘guardians of the revolution’.” Since then, there has been revenge killings and clashes between militias in general. Meaning that there is still conflict in Libya even after the main source is gone. On the other hand, the oil production has been restored. The destroyed tanks and land have been patched and made to work again. This is a good thing.

            Change overall is not instant, and even though there is still violence in Libya, surely it is less than it was before. It is likely that the people are happier, but it can also be true that they still do not feel one hundred percent safe and relieved with the fighting still happening. It is not a guarantee that the new constitution will solve all the problems, but it is likely to help. Also, now that the oil production is back, that is going to help their economy, and give people jobs, which will help their economic issues as well. Overall, it is looking more positive for Libya at this point.

http://topics.nytimes.com/top/news/international/countriesandterritories/libya/index.html

Norman Daniels, a philosopher attended the University today to present a lecture called, ““The Hewett Conference on International Migration of Health Care Workers.” The lecture presented arguments and points about the issues of hiring immigrants or recruiting them to work as health care workers. The presentation started off by discussing the right that everyone has to migrate. Basically, every person has a right to leave his or her country and return. However, this is not a free pass for anyone to go anywhere. The country has to be a willing recipient. In summary, it does not give a person an open door to anywhere.

            Generally, developing countries are willing to let immigration happen when it involves health care workers. There is always a shortage of nurses, so recruiting people from the developing countries definitely goes on. This can lead to good or bad things. The majority of the time was spent talking about the Models and how they affect the “brain drain” of the developing countries. In reality, brain drain is happening. Infrastructure of a health care system is the basis of a good health care system, but the developed countries are taking the people that are willing or capable of being trained.  Yes, the individuals need to be trained, but should there be a law stating that they have to go back. I am sure that people that come here are going to want to stay depending on the situation they came from, but should developed countries be allowed to recruit and keep these workers. It seems the developing countries are becoming better and the poor and becoming poorer and in worse shape. There is no balance, but one sure needs to be found. 

Mexico and Witch Craft.

This article talks about the drug cartels that are becoming worse in Mexico. Drug cartels have always been a bad event in Mexico, but now they are involving the witchcraft for protection because the drug lords are becoming so deadly and harmful to families. Children are being abducted daily, along with women. This truly is a terrible occurrence. Naturally people want answers and their answer is witchcraft. Police, family, and drug lords themselves are all paying these witches and warlocks to put a protection spell over them. These spells and charms cost about 100 to 180 US dollars each. It is pretty known that an average Mexican family barely makes that much in one month. This means they are spending this money, and cutting other resources out of their budget. This can only be detrimental the health and infrastructure of town.

            People are spending what is an absurd amount of money for their culture for a protection charm, so what are leaving behind? The drug lords and maybe the policemen can afford it, but what about the average Mexican family. They have to not buy something. Generally, if the money is scarce, people tend to leave out health care. This means people are becoming sick and have no care or comfort. Not only is that a burden and risk to their family, but to the neighborhood. They are putting viruses and germs out there that can be easy contained. Another issue this shows is how bad of an infrastructure Mexico has. From lectures and other articles, we all know that corruption leads to a bad healthcare system and people not being able to access it in the first place.

            http://www.nytimes.com/2011/11/02/world/americas/mexicans-turn-to-witchcraft-to-ward-off-drug-cartels.html?_r=1&ref=mexico

Lecture on Islam

Last night  Dr. Muhammad Kahlil’s  gave a lecture titled, “Islam, Terrorism, and Osama Bin Laden.” He has a doctorate in religious studies and his focus for this lecture dealt with the Islam religion and it’s response to the 9-11 terrorist attacks. It was very intriguing and very evident that Dr. Kahlil has done vast amounts of research on this. He discussed many examples from the Qur'an that were taken out of context and made it seem violent, and that is what Islam is about. The Qur'an holistically is not one bit violent, but it does allow them to fight when they need to defend themselves. Another aspect that was mentioned was the Jihad, which means a noble struggle. Jihads can encompass almost anything, but from the 100 listed from medieval Muslim scholars, only 5 had to deal with violence. Jihad is what the people struggle with, now it is being twist and turned to make things fit so it can be “noble”.

Dr. Kahlil did not directly state that this affects the health of the Islam people, but it does. Infrastructure is almost impossible to keep in a country that has people like Osama, making Muslim people whole-heartily believe that they are doing something that is righteous when clearly some aspects do not follow the guidelines of the Qur’an. Nonetheless, Osama Bin Laden was very charismatic and could play on people emotions that truly made them believe in the cause. Hatred leads to violence, and when there is violence this leads to people not being able to live their lives’ as they would normally because just walking outside could harm them.  Thus, leading to children not being able to go to school, and simple resources not being got. Then as discussed many times, people would be displaced because they fled. Ultimately, it’s a pitfall trend.

Polio

http://www.nejm.org/doi/full/10.1056/NEJMp1104329

This article, “The Polio Endgame” discusses polio. Polio is not a problem in developed countries. The last recorded case was reported in 1999 from the US. Polio in the developing countries is not as big of a problem as HIV or other diseases, but different wild polio types are starting to appear and ultimately the developing countries are at risk. The authors of this articles have proposed a way to decrease the infection rates of the wild types of polio by, “Achieving a polio-free world will eventually require stopping routine immunization with OPV and eliminating vaccine-derived polioviruses (VDPVs), particularly circulating VDPVs, which are Sabin-strain viruses that have acquired both neurovirulence and the capacity to circulate.” The polio “endgame” has never really been able to be achieved till now. Shockingly, in all the chaos of all the other epidemics and pandemics around the world, polio may be once and for all be eradicated. Another issue would be to make sure that the viruses do not get out of the laboratory from the tests for this to be possible.

            If polio were to start infecting a big mass of people, this would become a world problem. There are so many people who travel to other countries and go back to their homes. Also, people in the militaries would bring it back to their homes. Especially for Americans this is a risk. Afghanistan is one of the developing countries that would be most likely infected, and we have troops there. The men would be susceptible to this wild strain, and could bring it back. Ultimately, putting their families and friends at risk. If polio were eradicated for good, the world be able to check one thing of the checklist of problems. 

TB: Good News and Bad

This article talks about good news and bad news about tuberculosis. TB is the second, behind HIV, infectious killer to adults. The good news, TB rates have dropped from nine million to 8.8 million. Also, data show that the death rates have dropped by 40% within the last decade, except Africa. This is not a surprise however. The biggest drop however, was by China. China dropped rates by 80%! This is interesting, but it makes sense. China is on the rise to becoming a developed country, and has a “stable” government compared to the developed countries. Their IMR is low as well. A stable government is the key to being able to control pandemics and epidemic outbreaks. The infection needs access to health care, and in developed countries they are more likely to have that access. Maybe not every person that needs it, but more than just a few. Also, a non-corrupt government is more likely to let foreign aid in and help out without a threat to those workers. In corrupt governments, they do not care about their people, and aid sometimes is denied. It is a global problem.

            The bad news, multi-drug strain resistant TB is spreading at a fast and scary rate, and there are not as many drugs to cure it anymore. Unfortunately, this is going to affect the developing countries the most because of the lack of a stable government. To keep this from becoming a crisis, the country needs to be defensive against it. Some developing countries do not have prevention, but try to react. However, sometimes they cannot even react defensively against it and are helpless. New strains are being tested everyday, so for the countries that can be preventative and fight against it they are in decent shape, but what about the developing countries?

http://www.care2.com/causes/world-health-organization-reports-first-ever-decline-in-tb.html

Land rights for Africans

This article discusses the land rights of Africa and how they are going to change for the better. The land in Africa is very useful, and when put into perspective most of the income made from the African people is from farming. Therefore, they want to focus on getting land out to those people who need it most, and shockingly they want to work on women’s rights to land. The article did not address the effects of this besides that it will alleviate some poverty; it was more on the how this program was going to work.

            Without saying it directly, they are going to empower women. Giving them land to farm and sell goods ultimately gives them the power to handle the finances. This would be an incredible step if it works out. It is proven that women handle money much better than men. When the female spends the money, the family strives. The money she spends goes to essentials, such as food. When males handle money, they will spend some of it on pleasure items, like beer. Also, if more people have farms, they are making food for themselves. The next step to this would be teaching women about microfinance, but in hindsight this could be pushing it too much. Men would not truly allow women to have “ALL” the power.

            Another aspect would be that it would alleviate some poverty. If poverty is alleviated even by a small amount, things are subject to change. It would be a positive for progression. Africa could truly start developing. Although, when reading all this, there is still that saying, “The more things change, the more they stay the same.” Overall, this action plan, “Nairobi Action Plan” would be a positive step into the future.

http://www.newsfromafrica.org/newsfromafrica/articles/art_12946.html

Tuberculosis and HIV

http://www.nejm.org/doi/full/10.1056/NEJMoa1005136#t=articleDiscussion

This article, “New Regimens to Prevent Tuberculosis in Adults with HIV Infection,” discusses the new ways to prevent people living with HIV form getting Tuberculosis. Since the majority of the time when people have HIV they die from something other than the virus, such as Tuberculosis, this is important. An experiment was done to test three new drug regimens that could be more potent than what they are giving now, which is soniazid. In the experiment people living with HIV in South Africa were given “receive rifapentine (900 mg) plus isoniazid (900 mg) weekly for 12 weeks, rifampin (600 mg) plus isoniazid (900 mg) twice weekly for 12 weeks, isoniazid (300 mg) daily for up to 6 years (continuous isoniazid), or isoniazid (300 mg) daily for 6 months (control group).” Their findings were that it lowered the chances of getting Tuberculosis by 32-64%. These findings may be great, but nowhere in the article did it mention the price that the people would have to pay to get this new regiment of prevention. It may work better, but if it costs too much, or really anything at all in the case of South Africa, the access to these new drugs will not be available. It truly does not matter how much better the drug is than the previous because it is still not accessible to the people. Uneducated people do not know how important prevention is when you have HIV and your immune system is suppressed anyway. They just know people are dying from AIDs. If there was a way to get this to the people for very little or no charge, this would be an amazing thing. Very little people would die from HIV induced Tuberculosis. However, everything costs money, and the regimens have to be maintained and taken for months at a time. There is no way to make sure the regiments are going to be taken properly for 3-6 months. If only there were a way to make amazing new discoveries, like this one, possible to be used to their full potential. 

Malaria, and how to erradicate it.

This article discusses how areas, such as South East Asia, are having problems with resistant strain of malaria. The new goal is to eradicate the strain so it is no longer a problem. The WHO and other health organizations are all trying to find a way to do this. One of the actions would be to keep this strain in one specific spot. Like quarantine almost, until the problem is solved. The authors of this article have stated their plan, which seems easy. However, nothing is that easy. In reality, the strain will not simply be kept in one area. Also, bed nets and the usual method of prevention are not working, which will lead to more people being infected. The problem will not be fixed until a new strain of drugs is invented. Although that strain could be eradicated, there will be a new form that will become resistant to that drug also. It is a vicious cycle, that is stressful to keep up with. This specific instance is just for malaria, but this issue occurs for many other viral/bacteria strains.
http://www.nejm.org/doi/full/10.1056/NEJMp1108322

Brazil

So tonight I attended a movie for class at the YMCA. The movie was called "The Tenants." In summary, an average Brazilian family's life is changed when new neighbors move in. They are 3 boys that party all night, sleep all day, and have no job. No one will say anything to them, even though they are disrupting everyone. They eventually murder people and shout about it clearly saying they did it. They do what they want and they don't believe in authority. This movie puts into perspective what Brazil deals with from day to day, VIOLENCE. No one does anything about it. To Americans doing something about a problem is the right thing to do, but in developing countries if you were to do that, you are basically asking to be their next victim. No political leadership leads to this, and all it is doing is put people in constant stress of getting through the day. If something does not change fast, there ultimately will not be a way to change; if the government even wants change. The latter is probably true, and the people will continue to live thinking violence is just the way life is.

HIV and Children

http://www.nejm.org/doi/pdf/10.1056/NEJMp1107275

This article discusses the children with HIV due to their mothers passing in on during pregnancy in low-income countries. The children themselves can not do anything about it and are "voiceless".  However, the authors mention that there needs to be a batch of first-line drugs available for these children with HIV, and that will solve most of the problem. In all reality, the medication would save some lives of children yes, but it would not solve the problem. This complicated situation will not be solved unless you start with educating women. This could involve changing entire cultures depending on which country is being regarded. Women need to be educated, and told how they can prevent passing HIV to their infants. Also, it is just as important to inform the men as well because they need to understand how important this really is too.

Another issue is access to these drugs and prenatal care for these mothers and infants. The family, no matter how educated, needs access to those before they can even take action to prevention. This all takes MONEY, and that just is not possible for these places that need it the most. All in all, yes new drugs would help out the HIV infected children, but they are virtually useless if there is no access to healthcare facilities, money, or education of the HIV situation. This does not mean, that new drugs should not be created and the effort should just stop, but before we put all of our efforts into these drugs, the real issues need to be addressed.

global health

Pediatric HIV — A Neglected Disease?

Marc Lallemant, M.D., Shing Chang, Ph.D., Rachel Cohen, M.P.P., and Bernard Pecoul, M.D., M.P.H.

(Just in case the link does not work, because I had to subscribe to the New England Journal of Medicine)

Danielle Frye

Good News about Malaria

http://www.npr.org/blogs/health/2011/08/31/140069350/a-remnant-from-algae-in-malaria-parasite-may-prove-its-weakness

So I found this article and it is super interesting. It does go along more with biology, but it also could do so much for tropical areas of the world. Most people know of Malaria, a disease from a parasite usually in tropical places, but they really have never pinpointed a way to fight it off completely. Recently, they think they found some way to start trying. It has to do with the metabolic pathways of the parasite. The malaria cells have what is called an apicoplast, which is not in any other bug or it might be but they have never seen it. Scientists were doing some research, and they found that the apicoplasts were they only way for the cells to do metabolic activity. Therefore, if they find a drug that could target and attack the specific part of the cell, the problem would be solved. They are working now on that drug. What would this do for the people of tropical areas? In a perfect world it should save many people from disease. However, would we, as in USA, be able to support getting this drug over to where it is needed? I think it is a great find, and I think it will save lives. I just can't help but think about the people who wont take medicines in different countries because of culture. I like to think optimistically though so overall, I think its awesome!

Danielle Frye