Public Health
Public Health is the science of protecting and improving the health of communities through education, promotion of healthy lifestyles, and research for disease and injury prevention. (What is Public Health? Association of Schools of Public Health )

Five Minutes Or Less For Health


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nprglobalhealth:

UNICEF Report On Female Genital Mutilation Holds Hope And Woe
Women and girls are less likely to undergo female genital mutilation, or FGM, than 30 years ago. That’s the encouraging news from a UNICEF report on the controversial practice, presented this week at London’s first Girl Summit.
The rate has dropped in many of the 29 countries across Africa and the Middle East where FGM is practiced. In Kenya, for example, nearly half the girls age 15 to 19 were circumcised in 1980; in 2010 the rate was just under 20 percent.
But there’s a sobering side to the report. In countries like Somalia the rate has gone down slightly but is still over 90 percent.
And because the population is growing in parts of the world where the practice takes place, total numbers are on the rise. Unless the rate of decline picks up, another 63 million girls and women could be cut by 2050.
The report is “exciting and worrying,” says Susan Bissell, the chief of child protection at UNICEF. “The population growth will far surpass the gain we’ve been seeing if we don’t step it up.”
The report shows that more than 130 million girls and women have experienced some form of genital cutting or mutilation in 29 countries across Africa and the Middle East.
The practice involves removing, partially or completely, the female genitalia — sometimes just the clitoris, other times also the labia or “lips” that surround the vagina. In extreme cases, the vaginal opening is narrowed by sewing up the outer labia.
In many communities, the custom has long been perceived as a rite of passage into womanhood. Because sexual contact is painful, the practice is also seen as a way to prevent a woman from losing her virginity before marriage. Some see it as ensuring fidelity during marriage, as the procedure eliminates sexual pleasure.
Continue reading.
Graph: This chart tracks the changing rates of female genital mutilation in a sampling of countries — and projects the rate needed to end FGM by 2030. (via UNICEF)

nprglobalhealth:

UNICEF Report On Female Genital Mutilation Holds Hope And Woe

Women and girls are less likely to undergo female genital mutilation, or FGM, than 30 years ago. That’s the encouraging news from a UNICEF report on the controversial practice, presented this week at London’s first Girl Summit.

The rate has dropped in many of the 29 countries across Africa and the Middle East where FGM is practiced. In Kenya, for example, nearly half the girls age 15 to 19 were circumcised in 1980; in 2010 the rate was just under 20 percent.

But there’s a sobering side to the report. In countries like Somalia the rate has gone down slightly but is still over 90 percent.

And because the population is growing in parts of the world where the practice takes place, total numbers are on the rise. Unless the rate of decline picks up, another 63 million girls and women could be cut by 2050.

The report is “exciting and worrying,” says Susan Bissell, the chief of child protection at UNICEF. “The population growth will far surpass the gain we’ve been seeing if we don’t step it up.”

The report shows that more than 130 million girls and women have experienced some form of genital cutting or mutilation in 29 countries across Africa and the Middle East.

The practice involves removing, partially or completely, the female genitalia — sometimes just the clitoris, other times also the labia or “lips” that surround the vagina. In extreme cases, the vaginal opening is narrowed by sewing up the outer labia.

In many communities, the custom has long been perceived as a rite of passage into womanhood. Because sexual contact is painful, the practice is also seen as a way to prevent a woman from losing her virginity before marriage. Some see it as ensuring fidelity during marriage, as the procedure eliminates sexual pleasure.

Continue reading.

Graph: This chart tracks the changing rates of female genital mutilation in a sampling of countries — and projects the rate needed to end FGM by 2030. (via UNICEF)

Chief Ebola doctor contracts the deadly virus
The doctor leading the fight against the world’s deadliest Ebola outbreak in Sierra Leone has contracted the virus, according to government officials.
Sheik Umar Khan has been admitted to a hospital in the Eastern province of Sierra Leone and is undergoing treatment.
The 39-year-old doctor is considered a national hero and is credited for treating scores of people suffering from the virus.
Health Minister Miatta Kargbo said she would “do anything and everything in my power to ensure he survives.”
Ebola is spread by a virus that is initially transmitted from wild animals; it has a high fatality rate and no cure. The virus kills up to 90 percent of those infected, however patients have a better chance of survival if the virus is detected early on.
According to the United Nations, 630 people have died since the virus was detected in Guinea in February and the virus has spread across borders and into several West African countries like Liberia. Symptoms of Ebola include high fever, vomiting, internal and external bleeding as well as diarrhea.
Khan seemed aware of the risks involved with dealing with Ebola, telling Reuters late last month “I am afraid for my life, I must say, because I cherish my life.”
He also said “Health workers are prone to the disease because we are the first port of call for somebody who is sickened by disease.”
(From PBS NewsHour)

Chief Ebola doctor contracts the deadly virus

The doctor leading the fight against the world’s deadliest Ebola outbreak in Sierra Leone has contracted the virus, according to government officials.

Sheik Umar Khan has been admitted to a hospital in the Eastern province of Sierra Leone and is undergoing treatment.

The 39-year-old doctor is considered a national hero and is credited for treating scores of people suffering from the virus.

Health Minister Miatta Kargbo said she would “do anything and everything in my power to ensure he survives.”

Ebola is spread by a virus that is initially transmitted from wild animals; it has a high fatality rate and no cure. The virus kills up to 90 percent of those infected, however patients have a better chance of survival if the virus is detected early on.

According to the United Nations, 630 people have died since the virus was detected in Guinea in February and the virus has spread across borders and into several West African countries like Liberia. Symptoms of Ebola include high fever, vomiting, internal and external bleeding as well as diarrhea.

Khan seemed aware of the risks involved with dealing with Ebola, telling Reuters late last month “I am afraid for my life, I must say, because I cherish my life.”

He also said “Health workers are prone to the disease because we are the first port of call for somebody who is sickened by disease.”

(From PBS NewsHour)

nprglobalhealth:

Feeling The Heat, Burning The Suits: Reporting On Ebola From Sierra Leone

NPR’s Jason Beaubien is in Sierra Leone, covering the Ebola outbreak that began in March in Guinea and has spread to neighboring countries. When we spoke Thursday, he had just toured the treatment center built by Doctors Without Borders in the town of Kailahun. With 64 beds, it’s the largest Ebola isolation ward ever built. Currently there are 31 patients.

How’s it going?

Never a dull day here.

Can you describe the treatment center?

It’s basically a compound with a series of different tents. There are tents where people get suited up to go in. Another tent seems to be for storage, and one of the tents contains a lab. Then there’s a double fence about 3 1/2 feet high, made of orange plastic mesh. They designed the fence so people can see where the patients are, so it wouldn’t seem as if the patients are completely walled off.

Why a double fence?

So no one can get within 6 feet of someone who has Ebola. In case a patient from the isolation area reaches out or vomits, [Doctors Without Borders] wants to make sure there won’t be any accidental contamination.

How do the doctors record information on the patients?

Doctors go into the isolation area completely suited up, do their rounds and write down what’s happening with patients. Then they stand next to the fence and shout out to people on the other side of the fence [information about each patient]. Say, for patient 105, the doctor says, “diarrhea, vomiting.” Then the doctor’s notes [made inside the isolation area] are burned.

Where do they burn the notes?

They have a big pit in the back.

What else do they burn?

They burn everything. They say nothing comes out of isolation — although obviously they’re taking blood samples out. People come out. They strip off their protective gear, the Tyvek suits they put over their entire body and shoes.

Continue reading.

Top: Construction workers repair the roof inside the isolation area at the Doctors Without Borders treatment center in Kailahun.

Bottom: All workers in the isolation area must wear a head-to-toe protective suit.

Photos by Tommy Trenchard for NPR

nprglobalhealth:

Facing A Toxic Dump In South Africa, He Cleaned Up
Desmond D’Sa helped shut down a toxic landfill.
The landfill was located in South Durban — an industrialized city teeming with petrochemical plants, paper mills and oil refineries. D’Sa and his family had been forcibly relocated to the area by the apartheid government in the 1970s, together with thousands of other Indian and black South Africans. The apartheid government was notorious for forcing nonwhite laborers to live in the industrial areas where they worked.
In 2009, the landfill — which had operated for nearly 20 years — was looking to extend its lease. That’s when D’Sa, the coordinator of the South Durban Community Environmental Alliance, began fighting back. Earlier this year, he was awarded the prestigious Goldman Environmental Prize for his efforts. We asked D’Sa about his quest to keep his community clean.
Why did you become an environmental activist?
In the early 1990s, I was working for the state oil corporation. I worked in a chemical plant, and I had done safety and risk [assessment], so I saw the damage to workers and that made me realize that the work we were doing was quite toxic and dangerous, and could affect our community as well.
At night I started to go to the [safety research] lab to get documents, and I would read up and try to understand what was going on [with hazardous waste disposal]. When I confronted management, they said, “We don’t need people like you here.” In 1998, I was fired while I was on holiday. That’s when I began working full-time as an environmental activist. They unleashed a monster.
What was the key to your campaign against the landfill?
Carefully documenting everything. We brought in health experts and researchers from the Durban University of Technology and from the U.S. We got people in the community to write down the problems they were experiencing. We took photos and videos, and collected [water and air] samples and worked with researchers to analyze them.
Beyond that, the key is very simple: Work all the time and talk a lot. Get up early in the morning, and get on the road. Talk to people in communities and churches. Leave your cellphone on.
Continue reading.
Photo: Desmond D’Sa stands by the landfill he helped shut down in Durban. (Goldman Environmental Prize)

nprglobalhealth:

Facing A Toxic Dump In South Africa, He Cleaned Up

Desmond D’Sa helped shut down a toxic landfill.

The landfill was located in South Durban — an industrialized city teeming with petrochemical plants, paper mills and oil refineries. D’Sa and his family had been forcibly relocated to the area by the apartheid government in the 1970s, together with thousands of other Indian and black South Africans. The apartheid government was notorious for forcing nonwhite laborers to live in the industrial areas where they worked.

In 2009, the landfill — which had operated for nearly 20 years — was looking to extend its lease. That’s when D’Sa, the coordinator of the South Durban Community Environmental Alliance, began fighting back. Earlier this year, he was awarded the prestigious Goldman Environmental Prize for his efforts. We asked D’Sa about his quest to keep his community clean.

Why did you become an environmental activist?

In the early 1990s, I was working for the state oil corporation. I worked in a chemical plant, and I had done safety and risk [assessment], so I saw the damage to workers and that made me realize that the work we were doing was quite toxic and dangerous, and could affect our community as well.

At night I started to go to the [safety research] lab to get documents, and I would read up and try to understand what was going on [with hazardous waste disposal]. When I confronted management, they said, “We don’t need people like you here.” In 1998, I was fired while I was on holiday. That’s when I began working full-time as an environmental activist. They unleashed a monster.

What was the key to your campaign against the landfill?

Carefully documenting everything. We brought in health experts and researchers from the Durban University of Technology and from the U.S. We got people in the community to write down the problems they were experiencing. We took photos and videos, and collected [water and air] samples and worked with researchers to analyze them.

Beyond that, the key is very simple: Work all the time and talk a lot. Get up early in the morning, and get on the road. Talk to people in communities and churches. Leave your cellphone on.

Continue reading.

Photo: Desmond D’Sa stands by the landfill he helped shut down in Durban. (Goldman Environmental Prize)

Last call. Game over. Polio ends with us.

When Rotary set out to end polio more than 25 years ago, there were over 350,000 cases of this crippling disease every year. Children in 125 countries lost their ability to run, walk and play–forever. Since then, we’ve eradicated 99% of this devastating disease. The end is so close we can see it. Our generation will be the last to see the crippling effects of polio. What else will your generation be the last to see?

unicef:

“I told my parents I would not get married now; I am too young for that. I would not be able to continue my study if I get married.” 

Kalpona was 12 when her parents arranged for her to marry a man more than twice her age. A few days before the wedding, they agreed to let her continue with school instead.

In Bangladesh, 65% of girls are married as children. Pledge your support for ending child marriage within a generation:http://uni.cf/GS14

unicef:

“I told my parents I would not get married now; I am too young for that. I would not be able to continue my study if I get married.”

Kalpona was 12 when her parents arranged for her to marry a man more than twice her age. A few days before the wedding, they agreed to let her continue with school instead.

In Bangladesh, 65% of girls are married as children. Pledge your support for ending child marriage within a generation:http://uni.cf/GS14

nprglobalhealth:

Pathogens On A Plane: How To Stay Healthy In Flight
From Ebola in West Africa to chikungunya in the Caribbean, the world has had plenty of strange — and scary — outbreaks this year.
Some pathogens have even landed in the U.S. Just a few months ago, two men boarded planes in Saudi Arabia and brought a new, deadly virus from the Middle East to Florida and Indiana.
Nobody along the way caught Middle East respiratory syndrome. But all of these plane-hopping pathogens got us wondering: How easily do bacteria and viruses spread on commercial jets? And is there anything we can do to cut our risk?
Microbiologist James Barbaree and his team at Auburn University have been trying a few simple experiments to figure out the first question.
The airlines gave the scientists parts on commercial jets where spread might take place — a steel toilet button, the rubber armrest, the plastic tray table and, of course, “the seat pocket in front of you.”
Barbaree and his team sterilized the surfaces and then painted on two dangerous microbes: the antibiotic-resistant superbug MRSA and E. coliO157, which will give you an unforgettable case of diarrhea.
Several days later, the microbes were still happily thriving on the plane parts. E. coli survived about four days. MRSA lasted at least a week, the team reported at a scientific meeting in May.
Such hardiness is common for MRSA and E. coli, Barbaree says. “I’m not surprised at all the bacteria survived so long on the surfaces,” he says. “MRSA has been tested on other surfaces. And in one case, it lasted over a year.”
In general, the bacteria tended to stick on the plane surfaces instead of hopping onto a pig skin — an experimental proxy for a traveler’s hand. But some of the bugs did make the jump from the plane onto the fake hand.
Continue reading.
Illustration by Benjamin Arthur for NPR

nprglobalhealth:

Pathogens On A Plane: How To Stay Healthy In Flight

From Ebola in West Africa to chikungunya in the Caribbean, the world has had plenty of strange — and scary — outbreaks this year.

Some pathogens have even landed in the U.S. Just a few months ago, two men boarded planes in Saudi Arabia and brought a new, deadly virus from the Middle East to Florida and Indiana.

Nobody along the way caught Middle East respiratory syndrome. But all of these plane-hopping pathogens got us wondering: How easily do bacteria and viruses spread on commercial jets? And is there anything we can do to cut our risk?

Microbiologist James Barbaree and his team at Auburn University have been trying a few simple experiments to figure out the first question.

The airlines gave the scientists parts on commercial jets where spread might take place — a steel toilet button, the rubber armrest, the plastic tray table and, of course, “the seat pocket in front of you.”

Barbaree and his team sterilized the surfaces and then painted on two dangerous microbes: the antibiotic-resistant superbug MRSA and E. coliO157, which will give you an unforgettable case of diarrhea.

Several days later, the microbes were still happily thriving on the plane parts. E. coli survived about four days. MRSA lasted at least a week, the team reported at a scientific meeting in May.

Such hardiness is common for MRSA and E. coli, Barbaree says. “I’m not surprised at all the bacteria survived so long on the surfaces,” he says. “MRSA has been tested on other surfaces. And in one case, it lasted over a year.”

In general, the bacteria tended to stick on the plane surfaces instead of hopping onto a pig skin — an experimental proxy for a traveler’s hand. But some of the bugs did make the jump from the plane onto the fake hand.

Continue reading.

Illustration by Benjamin Arthur for NPR

nprglobalhealth:

In West Africa, Officials Target Ignorance And Fear Over Ebola

There’s growing concern in West Africa about the spread of the Ebola virus that has killed hundreds of people. Health ministers have formed a regional response, but fear and a lack of knowledge about Ebola threaten their efforts.

Liberian musicians are joining the campaign, taking to song to educate people about the Ebola virus. Their tune is called "Ebola in Town," and warns people to beware of close contact with those who fall ill. The song warns, “Don’t touch your friend.”

Since the outbreak was first detected in Guinea in February, the U.N.’s World Health Organization has reported more than 500 deaths there as well as neighboring Sierra Leone and Liberia.

Almost 850 cases have been recorded to date.

Ebola is highly contagious through contact with bodily fluids like blood, vomit or saliva. And it’s generally fatal. But there is a chance for survival if infected people can get medical attention.

West African government health officials have agreed to a coordinated strategy, aware that a contagious disease will cross borders as people travel for commerce or work. But their effort is hampered by fear and ignorance about the disease.

For example, families sometimes hide relatives with Ebola rather than take them for treatment. They fear the panic and ostracism that the disease may provoke from others nearby.

That’s why Liberia’s President Ellen Johnson Sirleaf is warning her country that anyone caught hiding suspected Ebola patients will be prosecuted.

"Here, we’re talking about a deadly disease — a disease that can kill people. And we’re obliged to also protect the lives of people," Sirleaf said. "There’s a law that says they must do that. And if they don’t, then there are penalties."

Continue reading.

Related: Ebola 101: The Facts Behind A Frightening Virus

nprglobalhealth:

Last-Resort Antibiotics In Jeopardy As Use Rises Globally
The total doses of antibiotics sold in clinics and pharmacies around the world rose 36 percent from 2000 to 2010, scientists reported Wednesday.
The current study found that three-quarters of the increase in antibiotic consumption occurred in Brazil, Russia, India, China and South Africa — countries where most people have incomes high enough to buy the drugs. Last-resort antibiotics are available over-the-counter throughout these nations.
The finding, published in The Lancet Infectious Disease, comes from the first study to look at global antibiotic consumption in the 21st century. And it seems like good news, right?
"More people in poor countries are getting livesaving drugs," says the study’s lead author, Ramanan Laxminarayan, who directs the Center for Disease Dynamics, Economics & Policy. “That’s absolutely good news.”
But the world’s insatiable need for penicillin and Cipro also has a dark side: the rise in drug-resistant bacteria.
Now, even the last-resort antibiotics — the ones that are used after all others fail — are in jeopardy of losing their effectiveness, Laxminarayan says.
"The concern is that the consumption of last-resort drugs has also gone up significantly since 2001," he says. "If drug resistance develops to these antibiotics, we have nothing else left to use."
Over the past decade, bacteria have evolved to evade nearly every type of antibiotic. Most of us are familiar with MRSA (methicillin-resistant Staphylococcus aureus), which causes deadly skin infections. But there’s also a superbug version of gonorrhea, and a vicious gut pathogen,called carbapenem-resistant Enterobacteriaceae, or CRE, which may kill up to 50 percent of people it infects.
Doctors still have a few potent weapons against these pathogens, such as cephalosporins for gonorrhea and polymixins for CRE. But to keep these antibiotics effective, we need to make sure their use is limited.
"These are second- and third-line drugs that need to be used carefully," Laxminarayan says. "Unfortunately, there’s not a lot of guidance for how these drugs are being used."
Continue reading.
Photo: Medical illustration of the the superbug version of gonorrhea, called Neisseria gonorrhoeae. (Courtesy of Centers for Disease Control and Prevention)

nprglobalhealth:

Last-Resort Antibiotics In Jeopardy As Use Rises Globally

The total doses of antibiotics sold in clinics and pharmacies around the world rose 36 percent from 2000 to 2010, scientists reported Wednesday.

The current study found that three-quarters of the increase in antibiotic consumption occurred in Brazil, Russia, India, China and South Africa — countries where most people have incomes high enough to buy the drugs. Last-resort antibiotics are available over-the-counter throughout these nations.

The finding, published in The Lancet Infectious Disease, comes from the first study to look at global antibiotic consumption in the 21st century. And it seems like good news, right?

"More people in poor countries are getting livesaving drugs," says the study’s lead author, Ramanan Laxminarayan, who directs the Center for Disease Dynamics, Economics & Policy. “That’s absolutely good news.”

But the world’s insatiable need for penicillin and Cipro also has a dark side: the rise in drug-resistant bacteria.

Now, even the last-resort antibiotics — the ones that are used after all others fail — are in jeopardy of losing their effectiveness, Laxminarayan says.

"The concern is that the consumption of last-resort drugs has also gone up significantly since 2001," he says. "If drug resistance develops to these antibiotics, we have nothing else left to use."

Over the past decade, bacteria have evolved to evade nearly every type of antibiotic. Most of us are familiar with MRSA (methicillin-resistant Staphylococcus aureus), which causes deadly skin infections. But there’s also a superbug version of gonorrhea, and a vicious gut pathogen,called carbapenem-resistant Enterobacteriaceae, or CRE, which may kill up to 50 percent of people it infects.

Doctors still have a few potent weapons against these pathogens, such as cephalosporins for gonorrhea and polymixins for CRE. But to keep these antibiotics effective, we need to make sure their use is limited.

"These are second- and third-line drugs that need to be used carefully," Laxminarayan says. "Unfortunately, there’s not a lot of guidance for how these drugs are being used."

Continue reading.

Photo: Medical illustration of the the superbug version of gonorrhea, called Neisseria gonorrhoeae. (Courtesy of Centers for Disease Control and Prevention)

nprglobalhealth:

Going, Going, Almost Gone: A Worm Verges On Extinction

Guinea worm is about as close to a real-life Alien event as you can get — a parasitic worm mates inside a person’s abdomen, grows up to 3 feet long and then exits (painfully) from a blister.

But the worm’s final chapter is near: The world is closer than ever to wiping the parasite off the face of the Earth.

There were only 17 cases of Guinea worm in the first five months of this year, the Carter Center reported Monday. That’s a 75 percent reduction from this time last year, when 68 people reported infections.

Back in the mid-’80s, more than 3 million people were catching the parasite each year. Then an international campaign started slashing cases, year after year.

"We anticipate we’ll end 2014 with less than 100 cases," says Dr. Ernesto Ruiz-Tiben, who leads the Guinea worm eradication effort at the Carter Center. “The data speak for themselves. Great strides have been made against Guinea worm.”

Now Guinea worm has been eradicated in 17 of the 21 countries where it ever existed. And the worm has cropped up in only two countries this year: South Sudan and Chad.

Most of us aren’t familiar with Guinea worm. (It’s never existed in the Western Hemisphere.) But once you hear how it infects people, you probably won’t forget it.

Continue reading.

Top: Nakal Longolio Acii, 9, had to stay several weeks at a Guinea worm clinic in Eastern Equatoria, South Sudan, while health workers coaxed the parasite out of her leg.

Bottom: A health worker extracts a Guinea worm from a person’s foot at a clinic in Eastern Equatoria State, South Sudan.

Photos by Louise Gubb/Courtesy of The Carter Center