To improve global health, you can track sneezes. Or you can track bullets.
That’s what Rodrigo Guerrero did after he became mayor of Cali, Colombia, in 1992, an era when the South American nation led the world in intentional homicides (93 per 100,000 people).
Not only did he bring down the murder rate, but now he is being rewarded for his efforts. Monday, Guerrero became the first winner of the Roux Prize, a $100,000 award given by the Institute for Health Metrics and Evaluation at the University of Washington to someone who used evidence to have an impact on health.
Guerrero had no idea that guns would become a defining issue. “I wasn’t really interested in violence,” says the Harvard-trained physician, now 76, who had previously worked as an epidemiologist and president of the city’s university.
That’s not to say he was oblivious. Homicides were on his radar. But his priority as a new mayor was to improve public health.
"Once we obtained and cross-checked records, we saw that homicides were the No. 1 one cause of death, well beyond chronic and contagious diseases," Guerrero says. In Cali, the nation’s third-largest metropolis, the medical examiner recorded about five murders a day, and the homicide rate was five times greater than a decade ago.
Taking a lesson from his Harvard training, Guerrero led an unbiased, clinical examination of the killings.
He mimicked what doctors do when confronted with a disease outbreak. Violence often spreads like the flu in urban areas, and the key is to find the source.
Photo: As the mayor of Cali, Colombia, epidemiologist Rodrigo Guerrero (left) meets with the police once a week to review murder statistics. (Courtesy of Prensa Alcaldía de Calí)
Colon cancer screening tests save lives – just like breast exams and mammograms. During October, we’re asking you to not only remember your breast health by thinking pink, but for you to consider your colon, too. That’s why we created the, “Screen This Too!” campaign.
Start colon cancer screenings at age 50, or earlier if you have symptoms or are high risk. Other diseases, such as breast cancer and diabetes, can also put you at a higher risk for colon cancer. When in doubt, talk to your doctor.
Join our fight to increase survivorship by giving your friends this cheeky reminder to go blue while thinking pink! When you talk to your doctor about your breast health, make sure you say, “Screen this too!”
(From Colon Cancer Alliance)
Dr. Aaron Motsoaledi had arrived in the U.S. for a two-week visit. “I’m here to meet influential people,” he says energetically despite having just gotten off a transatlantic flight.
Motsoaledi became the South African Minister of Health in 2009. He took over a national health system attempting to deal with the worst HIV/AIDS epidemic in the world, with nearly 30 million cases. His highly controversial predecessor, Manto Tshabalala-Msimang, was possibly best-known for claiming that AIDS could be cured with a cocktail of garlic and beetroot.
Tshabalala-Msimang was forced out in September 2008 and briefly replaced by an interim minister. Then Motsoaledi took over. Here are excerpts from his conversation with NPR.
Motsoaledi oversaw the expansion of anti-retroviral drug treatment for HIV to public clinics across South Africa.
Motsoaledi: “One of the weaknesses in South Africa [in the past] was a wrong HIV/AIDS policy. I’m sure you know about that. It’s legendary. So we started five years ago to put together huge programs on HIV/AIDS. That’s why now our program is one of the biggest in world. Thirty percent of all the people who are in treatment for HIV in the world are in one program — the South Africa program. It’s huge, but we’re actually planning to double it in the next 24 months. Now it’s got 2.4 million people on treatment. We want to raise it to 4.6 million people in the next 24 months.”
Photo: South Africa Health Minister Aaron Motsoaledi has no patience for people who abuse their health and expect the government to fix things. (Alexander Joe/AFP/Getty Images)
CDC confirmed on September 30, 2014, through laboratory tests, the first case of Ebola to be diagnosed in the United States in a person who had traveled to Dallas, Texas from West Africa. The patient did not have symptoms when leaving West Africa, but developed symptoms approximately five days after arriving in the United States.
The person sought medical care at Texas Health Presbyterian Hospital of Dallas after developing symptoms consistent with Ebola. Based on the person’s travel history and symptoms, CDC recommended testing for Ebola. The medical facility isolated the patient and sent specimens for testing at CDC and at a Texas lab participating in CDC’s Laboratory Response Network. CDC and the Texas Health Department reported the laboratory test results to the medical center to inform the patient. Local public health officials have begun identifying close contacts of the person for further daily monitoring for 21 days after exposure.
The ill person did not exhibit symptoms of Ebola during the flights from West Africa and CDC does not recommend that people on the same commercial airline flights undergo monitoring, as Ebola is only contagious if the person is experiencing active symptoms. The person reported developing symptoms several days after the return flight.
CDC recognizes that even a single case of Ebola diagnosed in the United States raises concerns. Knowing the possibility exists, medical and public health professionals across the country have been preparing to respond. CDC and public health officials in Texas are taking precautions to identify people who have had close personal contact with the ill person and health care professionals have been reminded to use meticulous infection control at all times.
We know how to stop Ebola’s further spread: thorough case finding, isolation of ill people, contacting people exposed to the ill person, and further isolation of contacts if they develop symptoms. The U.S. public health and medical systems have had prior experience with sporadic cases of diseases such as Ebola. In the past decade, the United States had 5 imported cases of Viral Hemorrhagic Fever (VHF) diseases similar to Ebola (1 Marburg, 4 Lassa). None resulted in any transmission in the United States.
In the central market in San Salvador, you can buy just about anything you want: tomatoes by the wheelbarrow full. Fresh goat’s milk straight from the goat. Underwear. Plumbing supplies. Fruit. Hollywood’s latest blockbusters burned straight onto a DVD.
And in the back of the market, in a small stall lined with jars of dried herbs, roots and mushrooms, you can buy an abortion.
"I have all types of plants to treat all kinds of diseases," the woman who runs the shop says through a translator. "For example, problems with your liver, your kidneys, stomach problems, nerves, for cancer — for everything."
She says she also has a bitter tea that can take care of an unwanted pregnancy.
Abortion is completely banned in El Salvador and punishable with a prison term of anywhere from two to 50 years in prison. So this woman asks that we not use her name.
Her tea only works, she says, in the first six weeks of pregnancy. If a woman is seeking an abortion later than that, the herbalist arranges to get something far stronger from a local pharmacy: pills used to treat stomach ulcers that are sold generically as misoprostol.
"They come asking for help," the woman says. "The majority of them are minors — young girls who say they were raped by their stepfathers or by people a lot older than they are."
Photo: In the markets of San Salvador, El Salvador, you can have your palm read, you can buy plumbing tools … and you can purchase abortion pills. (John Poole/NPR)
Harrison Sakilla, a 39-year-old former teacher, can’t stop smiling.
"I have to smile," he says. "I’m the first survivor for the case management center here from Ebola."
Former patients like Sakilla, who’ve recovered from the virus, lift the collective spirit at at the Doctors Without Borders Ebola center in Liberia’s northern town of Foya. He was admitted to the high-risk isolation unit, which is part of a cluster of large tents that make up the bulk of the center.
While health workers busy themselves caring for patients on one side — with all the stress, hard work, death and sorrow that entails – there’s an oasis of joy and relief on the other side, where a few brick buildings stand to the right.
That’s where Ebola survivors congregate.
But their smiles may mask deep sorrow. “I’m very fine, even though I’ve lost seven [family members],” says Sakilla.
He starts to list them: “My father, my mother, my sister, my niece, my big brother and my niece’s daughter,” he says. “But right now I’m alive, I’m very, very, very happy. You see me smiling — nothing but smiling.”
Sakilla and other survivors gather together in their own little center, beyond the pop-up tents. Several are helping Doctors Without Borders, looking after orphaned children and performing other tasks.
Photo: Bendu Borlay, 21 and an Ebola survivor, is caring for an infant whose mother died of the disease. (Tommy Trenchard for NPR)
Why Public Health? Jennifer Atlas
(From Harvard School of Public Health)
(From Bloomberg Philantropies)
World Rabies Day is September 28. On this day, begin to take steps to keep yourself and your family free from rabies. Look for events in your area that provide an opportunity to celebrate World Rabies Day and get the facts on rabies prevention and control.
Rabies is a deadly virus that can kill anyone who gets it. Every year, an estimated 40,000 people in the U.S. receive a series of shots known as post-exposure prophylaxis (PEP) due to potential exposure to rabies. In addition, the U.S. public health cost associated with rabies is more than $300 million a year. Each year around the world, rabies results in more than 55,000 deaths – approximately one death every 10 minutes. Most deaths are reported from Africa and Asia with almost 50% of the victims being children under the age of 15.
The Challenge of Rabies
Rabies is present on every inhabited continent. People usually get rabies when they are bitten by an animal that has the virus. In the U.S., the animals that most often get rabies are wild animals. Fortunately, the U.S. has been successful in eliminating a particular kind of rabies – known as canine rabies – that is responsible for rabies spreading from dog-to-dog.
However, canine rabies has not been controlled in many regions of the world, further threatening the health of humans and animals in these areas. In addition, some areas of the world have problems with large numbers of stray dogs, which can often come in contact with wild animals that have rabies. This often causes an increased number of rabid animals that have the potential to transmit the virus to humans.
The good news is that people can easily take steps to help prevent and control rabies.
(Picture from Global Alliance for Rabies Control)
Activists, celebrities and policy makers from around the world show their support for climate action in this UN Climate Summit video.
Climate Summit 2014 website: