POVERTY AND HEALTH: Access to Medicine

The International Policy Network has a summary of a new report that claims that Governments are responsible for the fact that poor people in developing countries do not have access to medicines and medical care. It isn't the big drug companies fault that medicines are too costly.

Find it at http://www.policynetwork.net/main/press_release.php?pr­_id=89


An opposing viewpoint is found in an editorial against big medicine companies. The author claims that children in developing countries are dying because they can't get medicines for treatable diseases due to their poverty.
This is found at: http://www.stopchildpoverty.org/learn/bigpicture/health/pharmaceutials.php


A CNN news report says that poor heart patients in the USA reduce their purchases of medicine that they should be taking in order to by food for their families. Due to their poverty, they prioritize between food and medicine.

It was written in 1998 but this report is at:
http://www.cnn.com/HEALTH/9803 /31/cardiology.wrap/index.html


Several years ago Sepp Hasslburger wrote how traditional medicines are more prevalent in many parts of the world and the poor use these rather than new products. In South Africa, it may be that traditional medicines are use for AIDS treatment more than ARV's.

Read about this at:
http://www.newmediaexplorer.org/sepp/2004/02/16/south_africa_traditional_medicine_to_fight_aids_poverty.htm


Medicines Transparency Alliance (MeTA) held a workshop in October of this year but only the goals and agenda was found. They are concerned with increasing accessibility of medicines for the poor. I'd like to find out what conclusions they may have made.

http://www.dfidhealthrc.org/meta/documents%5CMeta%20equity%20meet%20Oct%2007%5CMeTA%20worshop%20%agenda%20final.pdf


An interesting site that I found offers free medicine – but not any kind or all medicines – to those who qualify who live in the USA. These are provided by the drug manufacturers. The site is http://www.themedicineprogram.com/free-medicine.html

TRENDS OF TOBACCO USE WORLDWIDE

I grew up in a home where smoking was a constant practice by my mother.
Because I seemed to be always having respiratory problems, perhaps
that's why I never chose to pick up this habit. After moving out during
college years, I discovered that these allergy problems re-occurred whenever I was around someone smoking. My mother quit very late in her life (after age 70) but I believe it was only because she went to a hypnotist, as she always said that it was impossible for her to stop. She died of congestive heart failure at age 81 - I wonder how long she could have lived if she hadn't smoked? If Tobacco use would be stopped, there would be a great effect on global health!

Here are some sites which give information on trends - they also have links to many more sites with good information.

(1)
Child and Teen tobacco use – primarily concerned with the USA, but has
good information about reasons young people become smokers and
discusses some tobacco products that are produced in India and Malaysia
that I was not aware of that are being introduced into world markets.

http://www.cancer.org/docroot/PED/content/PED_10_2X_Child_and_Teen_Tobacco_Use.asp


(2)
World Health Organization’s index including the WHO’s Tobacco Treaty,
the initiatives that they are promoting for tobacco free environments
and how reported deaths from other causes really should be attributed
to smoking.

http://www.who.int/tobacco/en/


(3)
Smoking Statistics – worldwide statistics are staggering. Did you know
that about one third of adult males around the world smoke? Between
80,000 and 100,000 youth start smoking every day? How about one death
due to smoking every 8 seconds! The Chinese smoke 3 million cigarettes
every minute! This site also gives the suggested trend of smoking on
the globe as well as the advertising expenditures that promote this
practice.

http://quitsmoking.about.com/cs/antismoking/a/statistics.htm


(4)
The Food and Agriculture Agency of the United Nations predicts that the
growth rate of smoking will be slowing – but it is still about one and
a half percent a year.

http://www.fao.org/english/newsroom/news/2003/26919-en.html


(5) ProCor’s
Global Tobacco News Update [Thanks Liz for a Smoking reference in your
blog] has many stories of what is happening around the world concerning
the use of tobacco.

http://www.procor.org/section_news.asp?section=S1&SiteCode=procor〈=L1&pn=1

Information on Bilharzia or Schistosomaisis

Here are some sources of information about this disease which is found mainly in Africa, but also Central and South America, China and Japan, Southeast Asia and the Western Pacific.


healthlink.mcw.edu/article/935097450.html

goafrica.about.com/od/healthandsafety/p/biharzia.htm

www.studenthealth.co.uk/advice/advice.asp?adviceID=21

SHISTOSOMIASIS OR BILHARZIA

This disease was well known to me when I worked in Africa. In Kenya, we were aware that our children needed to avoid swimming in "still" water as lakes and ponds often had the intermediate host snail. In Egypt, one of our Sudanese workers was often sick – suffering from this liver fluke which he had contracted earlier in his life. When I was in Sudan, I prayed that I would not contract this disease as I baptized new converts in a number of locations where the water may have been infected.


Greenwald B., (2005)Gastroenterol Nurs. 2005 May-Jun;28(3):203-5
Schistosomiasis ranks second, behind malaria, among human parasitic diseases in terms of public health and socioeconomic importance in tropical and sub-tropical areas. Worldwide, 1 of 30 people has schistosomiasis. Up to 300 million people are infected, and 600 million live in environments where infection is a risk. Tourists from non-endemic areas are contracting schistosomiasis due to the rise in "off-the-beaten-track" tourism.

The best information on the worldwide situation is from a report by the World Health Organization found at this site:

http://www.who.int/wormcontrol/wer8116.pdf

Transmission cycle
Causal agents of the disease are fluke worms (schistosomes). Their eggs leave the human body in urine (in urinary schistosomiasis) or faeces (in intestinal schistosomiasis), hatch in water and liberate larvae (miracidia) that penetrate into freshwater snail hosts. After several weeks, cercariae emerge from the snails and penetrate the human skin (during wading, swimming, washing). Cercariae develop to maturity within the body and subsequently migrate to the lungs, the liver, and the veins of the abdominal cavity or the bladder plexus. Eggs escape through the bowel or urinary bladder.

In an attempt to find out how international health data is collected, I found this article which gives a number of difficulties in collecting data in the USA. Then there was a brief comment, which I have copied, concerning international health data.

from:

http://www.lib.uchicago.edu/e/su/med/healthstat/#Challenges%20to%20finding%20data

International Data

Finally, a note about obtaining international data. Locating international health statistics is usually more problematic than locating U.S. data. Resources, particularly in developing countries, may not be available to collect data as extensively or comprehensively as in the United States. Data collecting efforts therefore vary considerably around the world and comparative data may not be available. In fact, there are really only two international agencies whose mission and budget allow for international data collecting. The World Health Organization and the United Nations. Consult the publications of these two agencies first when seeking health and medical statistics.

• See the International Health Research Guide for additional help locating these elusive statistics.
• To locate data collecting agencies by country consult International health systems : a chartbook perspective. Crerar Reference, floor 1 RA395.A3I5650 199

The following article really was interesting to me. Having lived in Africa and knowing that some of the same difficulties occur here in Cambodia – no addresses, etc. this new technology is an answer to me as to how information and data can be collected.

from:

http://www.undispatch.com/archives/2007/09/how_pdas_are_sa.php

September 4, 2007

How PDAs Are Saving Lives in Africa

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By Joel Selanikio, MD, co-founder of DataDyne.org (UNF-Vodafone partnership)

Masaiti District, Zambia, July 2007 -- The vaccination assessment team from the capital city of Lusaka listens intently as a village official describes local participation in the recent measles vaccination campaign. He believes that all eligible children in the village were taken to the vaccination posts, but urges the team to verify this for themselves.

In a nation where many households have no phone and no address, collecting health data is a daunting task.

It means getting out into some of the most remote districts, like the Masaiti District, and going from house to house, asking "Did your children get vaccinated? May I see the vaccination card?" This kind of fieldwork can generate hundreds of pages of paperwork: multiple sheets of information for each household multiplied by the hundreds or even thousands of households that are visited.

But through a year-old pilot program, Zambia is replacing paper-based health surveys with those used on PDAs (personal digital assistants). This means no data entry, no cumbersome clipboards, and most importantly no waiting weeks or months for data entry clerks to enter stacks of paper into a computer for analysis.

Zambia today is helping to lead a public health revolution that has the potential to improve the lives of millions of people in the developing world. By switching from paper-based to mobile-enabled digital health systems, Zambian health workers are empowered with new 'eyes and ears' in the field-devices that increase the speed and accuracy with which vital health information can be collected and recorded. These PDAs, sometimes more powerful than laptops of the recent past, quickly are becoming a vital public health management tool.

DataDyne.org, the non-profit organization I co-founded, is helping to forge this promising new path. Through the course of my work as a Wall Street IT consultant, a pediatrician, and a medical officer at the U.S. Centers for Disease Control and Prevention, I developed an interest in applying computer science to the public health domain. The result is EpiSurveyor--a free, easy to use, open source software solution.

Prior to the use of EpiSurveyor, handheld data collection was gathered using commercial software that required expensive consultant programmers every time a new form was needed, or an old form needed to be modified. Now, with support from the United Nations Foundation and Vodafone Group Foundation, and in partnership with the UN World Health Organization and national governments, EpiSurveyor is putting effective health data-gathering tools in the hands of country health officials.

EpiSurveyor operates using a Java-based engine and a Windows-based Designer application that allows fast and easy creation of forms and data systems. It allows anyone with average computer skills--the ability to use a word processor or email, for example--to create and share mobile data collection systems in minutes, and without the need for consultant programmers.

In keeping with its mission to break down the barriers that block access to health data in developing countries, EpiSurveyor is free--anyone with internet access can download the program. EpiSurveyor is also open source, enabling those with higher-level programming skills to manipulate the program to respond to health needs as they arise. Finally, EpiSurveyor is built to run on mobile devices, providing maximum mobility and ease-of-use for health workers who spend most of their time in the field. Pilot project training is conducted using the Palm Zire.

So far, year-old pilot projects in Zambia and Kenya are showing that data received from the field has streamlined the inoculation of children against measles, collected information on HIV, and has even helped to contain a polio outbreak. For some, PDAs are mostly a convenient way to check email and keep up with schedules. In the developing world, these devices perform many of the same tasks--but when equipped with EpiSurveyor can help save lives.

Posted by Mark Leon Goldberg - September 4, 2007 01:31 PM - Delegates' Lounge

Although I have copied only the abstract of this article here, it might be interesting to read the whole thing. Non-response and bias are things that students need to be aware of when conducting surveys and collecting data. The health data collection process also should be aware of these items.

http://healthaff.highwire.org/cgi/content/full/26/6/1599

Twenty-Five Years Of Health Surveys: Does More Data Mean Better Data?

Marc L. Berk, Claudia L. Schur and Jacob Feldman

Abstract

Major increases in the resources devoted to the collection of health-related data and advances in survey methodology may be offset by more non-response and coverage bias resulting from privacy concerns, technological changes, and an increasingly complex health care environment. Hence, it is unclear whether policymakers today are basing their decisions on data that are of higher or even the same quality as those collected twenty-five years ago. We offer several recommendations for improving data quality, including changes related to Office of Management and Budget review, broad reexamination of the federal health survey portfolio, and greater investment in survey methods research.

Health according to Buddhists

Living in a Buddhist country, I want to understand more of how this belief system is influencing the health care practices of Cambodia. I looked up a few references that you might find interesting if you do not know a lot about Buddhism.

www.shindharmanet.com/writing/healing.htm is a source of information that gives a background for Buddhism and includes a little information about thoughts they have concerning health.

Another site, www.buddhistinformation.com/buddhist_healing.htm has several interesting topics. This web page has no page numbers but there is an interesting section about the effect SPIRITS have in the ideas of health for Buddhists. Another section which is in bold print Taking is talking about the effect of faith in healing. This artcle gives me an idea of how "good" or true information can be mixed with false.

Paonil, W. and Sringernyuang, L. (2002). "Buddhist perspectives on health and healing." Chulalongkorn Journal of Buddhist Studies, 1, 2 is an academic study on Buddhist healing that has a number of interesting concepts. The most useful pages I read were from page 97 until the end. You might be interested in page 98 where Buddha taught that it was alright to drink blood and eat flesh! Page 102 also begins a section on the medicines that Buddha recommended. Remember, he lived at the same time as Daniel, so this is not modern medicinal techniques. I found this at http://www.stc.arts.chula.ac.th/CJBS/Buddhist%20Perspectives%20on%20Health%20and%20Healing.pdf

There are two health practices that I see taking place here that are very unique. One of them is known as "coining." This involves the healer taking a coin, holding firmly and rubbing it across the body (usually the trunk area) of the sick person. This abrasive action creates a very red, area on the skin that lasts for quite a while. Often it is done on the back or chest of someone who has a pain in either of these places.

The other action is taking a cup and heating it, then placing the hot cup on the temple, forehead or other place on the body. This burns the skin (about 2nd degree) and thus "removes" the headache, or other pain from the patient. Whether these are "traditional" healing techniques or somehow related to Buddhist healing, it seems to me they are quite common among Cambodians. We see these marks on the skin very often, including among baptized Seventh-day Adventists, as they believe that this will cure their problem.

At a

Khmer

wedding