Medical/Public health interventions

[Alle-ubaahne]

Haye wiilo waan qaatay xaalka, wiilal baana kuugu duceynay.

 

raula, haye adi miyaa qofkaan aad moodid karaasiidada camal, alow alle, maxaay is dhuujisay gabartu!

[Wiilo]

Aamiin Aamiin

[raula]

Basic public health hygiene and as well its related in our religion is to "WASH YOUR HANDS ALWAYS". Simple and Clear.

[raula]

salaamz,

check out SOMALIA's Health Statistics (compiled by WHO)-very very interesting(although the stats are about 1.5 yrs old already).

 

http://www.emro.who.int/somalia/countryprofile.htm

 

NB:the stats are not pleasing, in particular when you survey the health indicators (life expectancy, infant mortality rate, GDP, physicians per capita etc)-but they are BETTER compared to other african regions-in regards to all other LOOMING CALAMITIES (war, political unrest, infectious disease like AIDS, Malaria, etc).

[Alle-ubaahne]

Medical-ka bal inoogu yara kaadiya aan intervention gabay ah ku sameeyee. Marka hore, waxaan rabay inaan sheego tix yar oo gabay ah oo aan ugu tala galay iney dadweynaha aqristaan laakiin ujeedooyin kala oo aan halkaan lagu faafaahin karin la socdaan. Waxaana runtii garan kara macnaha iyo nuxurka tixdan qof sifiican u dhuuxa oo fahma dulucdiisa. Waxaana iri sidatan:

 

Abdibeyba gabay kuma hawoon iyaba geeraare

Inkastoon ka gaban maansada waan ku guudmariye

Bal aan gabyo galabtey arin ila gudboon tahaye

 

Wax lagalo guur baa u weyn oo lana go'aansho

Gaarimaayo ruuxaan gacloon gabar asaagiise

Gabar baan u haasaawe tagay goordhaw aan fogine

Geeskaan ka eegaba ilaah qurux ku gaaf weeray

Garaadkiyo caqliga ilaah garasho waa u uumay

Gabigeedba kuma an arag gayiga aan joogo oo

Geenyaan ku matalay qurux ku goobataye

 

Gablamiwaa kii ilaah tan gees mariyo

Guri ninkeey kula jirtaa gooriyo ayaan leh

Oo Guur inta ugu dhacoo malin la gudoonsiiyo

Aleylahey soo guul ma'ahan iyo jano lasoo gaabshay?

 

________________

 

Bal soo duceeya inuu ilaah midaas ka dhigo caruurta mustaqbalka hooyadood, .

[Wiilo]

Bal inagu celiya Medical/Health Issueskii,,,,

 

 

Somalia's angels of mercy

By Joseph Winter

BBC News, Mogadishu

 

 

An armed security guard sits at the entrance to the Hayat Hospital in the centre of Somalia's capital, Mogadishu, to ensure that no-one takes their weapons inside, turning a place of healing into a place of killing.

 

 

Somalis were in desperate need of medical services

And the doctors and nurses who work inside the hospital are only too well acquainted with the results of Somalia's 13 years of lawlessness.

 

"Gunshots are one of our most serious problems," says Dr Mohammed Mahmut Hassan. But there is a sign of hope.

 

He says that as the attempts to set up a new government have made progress, the number of gunshot victims has fallen.

 

"We used to have 10 gunshot victims a day. Now, we see just four or five a month," he says.

 

While Dr Mohammed is keenly waiting for the days when Somalia again has a government, the Hayat Hospital is also a sign of how well Somalis have coped without a central authority.

 

He and other Somali doctors working abroad got together and in 1998 set up the hospital to try and fill the gap.

 

"We had to help our people, even though we ourselves were safely living abroad," he said.

 

Aids threat

 

In order to meet its running costs, the hospital charges for every visit - nobody is paying any taxes which could be used to provide a free service - but Dr Mohammed says they try to keep charges as low as possible.

 

 

We can offer counselling but we cannot distribute condoms

Dr Mohammed Mahmut Hassan

 

Every Friday, 200 people who cannot afford the $3 fee are treated free of charge and long queues form overnight.

 

While Hayat, and Mogadishu's four other hospitals, are able to provide a basic medical service, the Aids pandemic highlights the need for a government to tackle the problem at the national level, for example by running public awareness campaigns.

 

The most recent statistics show that about 1% of Somali adults are HIV positive - low by African standards - but Dr Mohammed believes the numbers are rising quickly.

 

"We come across about five new positive cases every week," he says.

 

One reason is the high number of Somalis living in refugee camps in the region, some of whom are now able to go home as fighting subsides.

 

But Somalia remains a very traditional society, where Islam is strong and Dr Mohammed says that the hospital does not stock condoms - a key part of the fight against Aids - because the people do not accept them.

 

"We can offer counselling but we cannot distribute condoms," he says.

 

One hospital working alone will be unable to change such a deeply-entrenched mindset.

 

Water lifeline

 

In another sign of the entrepreneurial spirit and self-reliance shown by Somalis, those Mogadishu residents with some form of income are also able to go to school and university and get running water and electricity.

 

We must think out of the box for Somalia

 

Western diplomat

These are services not enjoyed by all of those who live in African cities with functioning governments.

 

Until 2000, Hawo Mohammed Khalid got her water delivered in a barrel carried on a donkey cart. Now, she just has to turn the tap.

 

"I feel happy now because I have water 24 hours a day. Before I might need water in the middle of the night and I didn't have any," she says.

 

Hawo, married to one of the few Somalis with a regular job, also enjoys regular electricity - and says there are rarely any power-cuts.

 

 

Facts and figures about life in Somalia

 

 

At-a-glance

 

Her water and electricity are supplied by Abdoulkadir Hassan Issa, who runs the Isaf Water and Electricity Supply company in Bulo Hubey's south Mogadishu suburb.

 

"We are doing this to provide a public service until the government comes," he says.

 

"Then they can provide water and electricity or they might give us a contract and then we could continue. That's what we'd really like."

 

Wire thieves

 

Mr Abdoulkadir says they used to use an open well but some customers complained about their water quality, so they dug a bore hole and add chlorine to prevent infection.

 

It may not taste like mineral water but Hawo is not complaining.

 

 

Mr Abdoulkadir's generators serve 180 families

Generators provide electricity along very precarious-looking wires and Isaf has even hooked up fluorescent lights as makeshift street lamps.

 

Isaf provides running water to 800 families and electricity to another 180 across a large part of south Mogadishu, he says.

 

The biggest problem Mr Abdoulkadir faces is that thieves take advantage of the absence of law and order to steal the wires and pipes he used to provide his services.

 

"But at least the militia which controls this area doesn't ask us for protection money," he says.

 

'Wait and see'

 

Nobody says that such services mean that a government is not needed but one western diplomat closely involved with the peace process says they mean "we must think out of the box for Somalia".

 

When a new government is eventually installed in Mogadishu, it would make no sense for it to take over all these services which are already functioning.

 

 

Some street lights are better than none - unless there is a short circuit

"It would be a tragedy to fall into the trap of having a massive state sector, which would inevitably fuel corruption as we have seen elsewhere in Africa," he says.

 

"Maybe the health ministry could set policies and targets for hospitals, which would remain in private hands, for example."

 

But while arguments continue about how to bring the Kenya-based government back to Somalia, such questions remain academic.

 

In the meantime, Dr Mohammed is not making any predictions about whether the fall in shootings will continue, or whether the latest attempt to set up a Somali government will fail, like the 13 which have gone before.

 

"We're just waiting to see, like everyone else," he says.

[xiinfaniin]

I vehemently oppose the notion that condom usage is “key part of the fight against Aids.†And even thought I appreciate Dr. Mohamed’s work in Somalia, I can’t help but question his intent of distributing condoms had the environment was permissible—he seems to imply. The current prevention strategy of fighting against Aids is un-Islamic and can’t be applied without altering it substantially to adhere cultural sensitivity of Muslim societies.

 

I also take issue with those who assert that Islamic nature of Somalis would be enough to shield the far-reaching health consequences of this epidemic. So what is the correct approach to bring about a comprehensive strategy to fight this epidemic Islamicly?

[raula]

Wiilo ""We come across about five new positive cases every week," he says."... :eek: :eek: this numbers are shocking to say the least and I dont need to be a statician to guess the "perceived catastrophic detriments" it will entail if we dont have EFFECTIVE strategic interventions to stop this epidemic.

 

Originally posted by xiinfaniin:

I vehemently oppose the notion that condom usage is “key part of the fight against Aids.†And even thought I appreciate Dr. Mohamed’s work in Somalia, ........ The current prevention strategy of fighting against Aids is un-Islamic and can’t be applied without altering it substantially to adhere cultural sensitivity of Muslim societies.

 

I also take issue with those who assert that Islamic nature of Somalis would be enough to shield the far-reaching health consequences of this epidemic. So what is the correct approach to bring about a comprehensive strategy to fight this epidemic Islamicly?

I totally agree with you-Indeed the current interventions of treating the pandemic is very much ingrained in western ideologies that have no principality in religion and cultural guidelines.

 

From a personal perspective-the best intervention is to as the doctors says in the above article-implement interventions that are CULTURALLY SENSITIVE AND COMPETENT {that adhere} to the cultural and religious principles of the community(in this case the somalis) the schema is geared to. For instance, community forums that involve all walks of life from the vast somali societies(e.g sheikhs, ulamaa, women, scientists, socialists, economists etc) to get a COHESIVE and FUSED public support, in response to hampering this catastrophe. I believe public awareness such as community education about the problem should be the next step in reducing the risks and numbers of infected individuals.

 

 

Thx for the article Wiilo.

[xiinfaniin]

.....community forums that involve all walks of life from the vast somali societies(e.g sheikhs, ulamaa, women, scientists, socialists, economists etc) to get a COHESIVE and FUSED public support, in response to hampering this catastrophe. I believe public awareness such as community education about the problem should be the next step in reducing the risks and numbers of infected individuals

That is very sound strategy in-deed. The injection of religious scholars—Culamaa u-Diin –in the public awareness campaign is a crucial component that has been missing so far in the current strategy.

 

I would add two more long-term steps that need to be given a thought: in the process of devising comprehensive strategy to fight and prevent Aids in Somalia, the first order of business ought to be addressing the source of all diseases, which is the border between Ethiopia and Somalia. For the last number of years Ethiopia flooded us not only with weapons but also with HIV infected folks who traverse us with ease and in the process carry the virus to the heart of our cities and little villages. Given the current political instability and the lack of government in Somalia I don’t know what the solution would be for this real problem.

 

The second order of business should be, I think, to address the problem of porn movies and the indecency that comes with it, which is another source of this disease. My source tells me that in some cities in Somalia these un-Islamic and sinister materials are produced LOCALY. This shows that Somalia is not only a failed state in political and economic terms but also in social and communal as well. In the areas where there is a regional government bringing local authorities attention to the issue of pornography may help but more effective strategy is critical.

 

I don’t have easy answers but I know this: unless we attack the source of the problem and dry it up, combating the demand will befutile.

[Wiilo]

UNAIDS 2004 Report on the Global AIDS Epidemic - Executive Summary

 

Bringing comprehensive HIV prevention to scale

 

Although prevention is the mainstay of the response to AIDS, fewer than one in five people worldwide have access to HIV prevention services. Comprehensive prevention could avert 29 million of the 45 million new infections projected to occur this decade. Although antiretroviral treatment is bringing hope to millions, without sharply reducing the number of new HIV infections, expanded access to treatment becomes unsustainable. Providers of antiretroviral treatment will be swamped by demand.

 

Prevention programmes are not reaching the people who need them, especially two highly vulnerable groups – women and young people. In order to prevent the high infection rates among women, the root causes of their vulnerability – their legal, social and economic disadvantages – must be addressed.

 

For young people, knowledge and information are the first line of defence; AIDS education is still far from universal. In sub-Saharan Africa, only 8% of out-of-school young people and slightly more of those in-school have access to education on prevention. They also need access to confidential health information and condoms. Protecting the rights of young girls is also key to lowering HIV prevalence among young people.

 

There are success stories. A number of countries, including Brazil, the Dominican Republic, Uganda and Thailand, have succeeded in reducing HIV infection. There is also a need for HIV prevention to evolve and be more innovative in addressing changes in the epidemic. In high-income countries, for example, risk behaviours and new infections are rising again, particularly among young men who have sex with men. The reasons probably include ‘prevention fatigue’ and complacency rising from the availability and promise of antiretroviral treatment.

 

Expanded access to antiretrovirals and other treatment offers a critical opportunity to strengthen prevention efforts by encouraging many more people to learn their HIV status. The promise of treatment should encourage greater use of voluntary counselling and testing. The current reach of HIV testing is poor. The proportion of adults needing voluntary counselling and testing who received it ranged from almost none in South East Asia to 7% in sub-Saharan Africa, and 1.5% in Eastern Europe. Where services do exist, uptake is also often low because of fear of stigma and discrimination.

 

Comprehensive prevention

Key elements in comprehensive HIV prevention include:

 

AIDS education and awareness

Behaviour change programmes especially for young people and populations at higher risk of HIV exposure, as well as for people living with HIV

Promoting male and female condoms as a protective option along with abstinence, fidelity and reducing the number of sexual partners

Voluntary counselling and testing

Preventing and treating sexually transmitted infections

Primary prevention among pregnant women and prevention of mother-to-child transmission

Harm reduction programmes for injecting drug users

Measures to protect blood supply safety

Infection control in health-care settings

Community education and changes in laws and policies to counter stigma and discrimination

Vulnerability reduction through social legal and economic change

 

Next agenda:

 

Create policies that help to reduce the vulnerability of large numbers of people – in effect, creating a social, legal and economic environment in which prevention is possible. This includes access to education, empowerment of women and international cooperation to prevent human trafficking for sexual exploitation.

Close the ‘prevention gap’ – in 2004 less than one in five people has access to HIV prevention services.

Ensure that prevention is comprehensive and involves a variety of interventions (see above), since no single element is enough.

Eliminate AIDS-related stigma and discrimination through effective legal frameworks and by protecting the rights of all individuals.

Tailor prevention to the specific needs of people, including vulnerable groups such as injecting drug users and men who have sex with men. Worldwide there are more than 13 million injecting drug users and in some regions more than 50% of them are infected with HIV. Experience in cities such as Dhaka, Bangladesh, and London, United Kingdom, shows it is possible to prevent and even reverse major epidemics among injecting drug users.

Men who have sex with men account for 5-10% of all HIV cases worldwide. Prevention programmes must take into account that this group is highly stigmatized throughout much of the world – some 84 countries in 2002 had legal prohibitions against sex between men – and this hampers prevention efforts.

[SURAMBAYA]

Look under demographic indicators for population percentage below 15 years......51% :confused: ...AND THAT COUNTRY HAS NO FUTURE????/

 

 

http://www.emro.who.int/somalia/countryprofile.htm#morbidity

[raula]

^^^well wat do you expect after 13-14yrs of civil turbulence alongside bloody battles, ecological degradations, and some of the nastiest infectious epidemics sweeping around the country

 

From the above article: INFANT MORTALITY RATE PER 1000 LIVE BIRTHS 132 2000

PROBABILITY OF DYING BEFORE REACHING 5TH BIRTHDAY PER 1000 LIVE BIRTHS 224 2000

 

**Infant mortality is one of the indicators of a country’s healthy living. The numbers above are sure disquieting, mind you remember its calculated per 1000(and its 132). Neva mind that, look at the 2nd stat-bisinka.

Iam sure the numbers are higher than this but will leave it to that.

 

 

CHOLERA 2775 2002

MALARIA 2 000 000 2002 :eek:

 

**Cholera (illahi nooma keeno-Amin) but we will see some Flares of this after the devastating TSUNAMI that hit some parts of Somalia. As for the KILLER DISEASE (MALARIA)-studies are underway to find the most effective intervention for preventing or curing this RESISTANT-VECTOR.

[Wiilo]

Carbohydrate Type, Not Amount, Linked to Obesity

 

Wed Feb 16, 2:46 PM ET Health - Reuters

 

 

By Alison McCook

 

NEW YORK (Reuters Health) - When it comes to carbohydrates, it's not how much you eat, but which kind, that makes a difference to your bathroom scale, new research shows.

 

People who are overweight do not appear to eat more carbohydrates overall than people who weigh less, the researchers report in the American Journal of Epidemiology. However, they found that overweight people tend to eat more refined carbohydrates, such as white bread and pasta, which cause a rapid spike in blood sugar.

 

"Total amount of carbohydrate is not related to body weight," Dr. Yunsheng Ma of the University of Massachusetts Medical School in Worcester told Reuters Health. "It's the type of carbohydrate that's important."

 

These findings suggest that low-carbohydrate diets, which recommend people cut back on all carbohydrates, are missing the mark, Ma added.

 

"Carbohydrates are not the enemy," he said in an interview. "But you have to watch the kind of enemy."

 

Ma explained that refined carbohydrates are often found in processed foods that contain a lot of sugar. This type of carbohydrate has what's called a high glycemic index, meaning it causes a rapid increase in blood sugar. The body stores that sugar in muscle, but if it is not used, it becomes fat, he noted.

 

In contrast, whole grains, fruits and vegetables have carbohydrates that don't have such high glycemic index, Ma said.

 

In the report, Ma and his colleagues note that in the last 20 years, the rate of obesity has increased, despite the fact that people are eating less fat. To help investigate the role carbohydrates play in obesity, the researchers measured the height and weight of 572 healthy people, and asked them to regularly report what carbohydrates they ate. Ma's team followed study participants for one year.

 

They found that people with a higher body mass index -- a measure of weight that factors in height -- tended to eat carbohydrates with a higher glycemic index. The amount of carbohydrates people ate had no influence on body mass index.

 

"Refined carbohydrates are no good, but the total amount of carbohydrates is okay," Ma noted.

 

He added that some countries now include a food's glycemic index on the labeling, which can be helpful for people trying to lose weight or deal with diabetes.

 

SOURCE: American Journal of Epidemiology, February 15; 2005

 

 

Wed Feb 16, 2:46 PM ET Health - Reuters

 

 

By Alison McCook

 

NEW YORK (Reuters Health) - When it comes to carbohydrates, it's not how much you eat, but which kind, that makes a difference to your bathroom scale, new research shows.

 

Yahoo! Health

Have questions about your health?

Find answers here.

 

 

 

 

 

 

People who are overweight do not appear to eat more carbohydrates overall than people who weigh less, the researchers report in the American Journal of Epidemiology. However, they found that overweight people tend to eat more refined carbohydrates, such as white bread and pasta, which cause a rapid spike in blood sugar.

 

 

"Total amount of carbohydrate is not related to body weight," Dr. Yunsheng Ma of the University of Massachusetts Medical School in Worcester told Reuters Health. "It's the type of carbohydrate that's important."

 

 

These findings suggest that low-carbohydrate diets, which recommend people cut back on all carbohydrates, are missing the mark, Ma added.

 

 

"Carbohydrates are not the enemy," he said in an interview. "But you have to watch the kind of enemy."

 

 

Ma explained that refined carbohydrates are often found in processed foods that contain a lot of sugar. This type of carbohydrate has what's called a high glycemic index, meaning it causes a rapid increase in blood sugar. The body stores that sugar in muscle, but if it is not used, it becomes fat, he noted.

 

 

In contrast, whole grains, fruits and vegetables have carbohydrates that don't have such high glycemic index, Ma said.

 

 

In the report, Ma and his colleagues note that in the last 20 years, the rate of obesity has increased, despite the fact that people are eating less fat. To help investigate the role carbohydrates play in obesity, the researchers measured the height and weight of 572 healthy people, and asked them to regularly report what carbohydrates they ate. Ma's team followed study participants for one year.

 

 

They found that people with a higher body mass index -- a measure of weight that factors in height -- tended to eat carbohydrates with a higher glycemic index. The amount of carbohydrates people ate had no influence on body mass index.

 

 

"Refined carbohydrates are no good, but the total amount of carbohydrates is okay," Ma noted.

 

 

He added that some countries now include a food's glycemic index on the labeling, which can be helpful for people trying to lose weight or deal with diabetes.

 

 

SOURCE: American Journal of Epidemiology, February 15; 2005

[raula]

New flares of TB in African regions.

 

The scare of TB never seems to slouch to bearable rates. Here again we see the lethal combination of TB with HIV. Although, South-East Asia has the largest cases, the incidence rate in Sub-Saharan Africa is swiftly intensifying to disquiet waves. And with the new initiatives to give INDIA license to manufacture their own generic drugs the question now is why aren’t some African countries given the chance as well when indeed they are the ones who suffer the most? (Yes its just a baseless Q) in fact when INDIA "supposedly" will be supplying generic drugs countries devastated with AIDS, if indeed waivered or loosened patent laws by responsible multi-national pharmaceuticals .

 

read below

 

http://www.who.int/mediacentre/news/releases/2005/pr14/en/index.html

[STOIC]

DDT (DICHLORODIPHENYLTRICHLOETHANE)was first synthesized in 1877 but it was not until 1940 that a swiss chemist discovered that it could be sprayed on walls and would cause any insect to die within the next six month.DDT was introduced into widespread use during world war two and became the single most important pesticide against malaria elimination.The scientist who discovered it Dr Paul Muller was awarded the 1948 Nobel prize in physiology and Medicine.In America cases of malaria fell from120,000 in 1934 to 72 in 1960 and cases of yellow fever droped from 100,000 in 1878 to none.Insect became quickly resistant to the insecticide after a while. Marine scientist Rachel Carson demonstrated that DDT was concentrated in the food chain and effected the reproduction of predators such as Hawks and eagles.Malria is one of the leading killer disease in Africa.According to one of the chief malaria expert for the US Agency for international development, malaria would have been 98% eliminated had DDT continued to be used.Malaria is clouding the economic future of many countries in Africa.Today malaria is African problem but until 1920's it was American and European problem.Is it fair to ban DDT when the international community with all its might is not doing anything to fight malaria parasite other than preventive measures?.Do you think that DDT should be banned just because it is enviromental hazard to the birds? Should we meet human needs regardless of enviromental pollution or should we protect the water and the air we breath even if somehuman beings are dying by the thousands each year?.