Health and peace are closely linked. One cannot have one without the other. Although health and peace are desirable conditions, we human beings often thwart our best intentions to achieve and maintain them. War has profound impacts on human health. In addition to direct consequences, including the fact that 90% of all deaths related to recent wars were among civilians, war has several indirect consequences, including long-term physical and psychological adverse health effects, damage to the social fabric and infrastructure of society, displacement of people, damage to the environment, drainage of human, financial, and other resources away from public health and other socially productive activities, and fostering of a culture of violence. Many public health issues can be both a consequence and a cause of war, including infectious diseases, mental health disorders, vulnerability of population groups, disparities in health status within and among countries, and weakening of human rights. We, health professionals, can promote peace in many ways and facilitate this work by demonstrating our values, vision, and leadership. (+info)
General surgery in a district hospital in Tajikistan: clinical impact of a partnership between visiting volunteers and host specialists.
After the collapse of the Soviet Union and 5 years of civil war, health care services in Tajikistan are in disarray. Nongovernmental organizations are playing a key role in recovery programs. A group of volunteer physicians from the West went to Khorog General Hospital in the Pamiri mountains to establish a dialogue with their physician counterparts, recommend evidence-based best practice appropriate for local conditions, and reintroduce a culture of continuing medical education. The arrangements included a group visit to Khorog for 3 weeks annually over 3 years. In this article we describe the experiences of the 2 general surgeons attached to the group in the second year and the status of the partnership 1 year later. (+info)
Obstructed inguinal hernia: role of technical aid program.
AIM: The purpose of the study was to determine the influence of the presence of a surgeon on the outcome of obstructed inguinal hernia at Mongomo, in Equatorial Guinea. METHODOLOGY: A prospective study of patients with obstructed inguinal hernia seen between June 1997 and May 1999 was carried out. During the same period, all uncomplicated hernias seen at the surgical outpatient clinic were noted. RESULT: Fifteen patients presented with obstructed inguinal hernia, while 138 were uncomplicated. All the 15 patients were males, and one of them died. Death resulted from lack of treatment as he presented on our arrival on a technical aid program from Nigeria. The others (N = 14) were operated upon, and eight of them had resection of the intestine because of gangrene. The duration of obstruction was more than two days among those that had bowel resection. COMMENT: Inguinal hernia is a treatable surgical condition. When done electively, the cost and the risk of treatment are very low. Operative treatment can only be offered to patients with inguinal hernia by a surgeon in the community. CONCLUSION: The study has demonstrated that the presence of a surgeon in a community changes the outcome of obstructed inguinal hernia. Sponsorship of medical aid programs should be encouraged. (+info)
Private volunteer medical organizations: how effective are they?
Religious and other secular organizations have been involved with medical missionary work in sub-Saharan Africa for centuries, especially in remote provinces and villages. In times past, most of these countries were under the control of foreign powers. Private volunteer organizations operated within a structured environment, which, perhaps, facilitated their mission and their ability to review and evaluate their effectiveness because of the tight control the colonial powers maintained over every facet of native life. However, the transition from colonialism to independence has resulted in a different environment in which healthcare is fragmented and a low priority in most countries because of financial constraints. The lack of standardization, vintage laboratory equipment, a manual medical record system, lack of a subsidized transportation system, infrequent postal service and the absence of phone systems in the remote provinces and villages make treatment and tracking of patients, monitoring therapy and measuring outcomes/results difficult. Therefore, judging the effectiveness of an initiative in remote district hospitals and village clinics can be difficult. This manuscript addresses some of these issues and provides solutions to some that have been effective for one organization. (+info)
Epidemiological geomatics in evaluation of mine risk education in Afghanistan: introducing population weighted raster maps.
Evaluation of mine risk education in Afghanistan used population weighted raster maps as an evaluation tool to assess mine education performance, coverage and costs. A stratified last-stage random cluster sample produced representative data on mine risk and exposure to education. Clusters were weighted by the population they represented, rather than the land area. A "friction surface" hooked the population weight into interpolation of cluster-specific indicators. The resulting population weighted raster contours offer a model of the population effects of landmine risks and risk education. Five indicator levels ordered the evidence from simple description of the population-weighted indicators (level 0), through risk analysis (levels 1-3) to modelling programme investment and local variations (level 4). Using graphic overlay techniques, it was possible to metamorphose the map, portraying the prediction of what might happen over time, based on the causality models developed in the epidemiological analysis. Based on a lattice of local site-specific predictions, each cluster being a small universe, the "average" prediction was immediately interpretable without losing the spatial complexity. (+info)
Clinical cases seen in tsunami hit Banda Aceh: from a primary health care perspective.
The 2004 Indian Ocean earthquake and tsunami caused catastrophic damage to many cities on the rim of the Indian Ocean. Banda Aceh in Sumatra, Indonesia was particularly badly hit due to its close proximity to the epicenter. The Singapore Armed Forces Medical Team was one of the earliest medical teams to arrive in Banda Aceh, providing primary health care to the survivors. In the first 17 days of its operation, more than 2000 injured and sick were seen by the Medical Team at 2 locations within Banda Aceh. Approximately one-third of the patients suffered from infected superficial wounds on their limbs and faces. Many developed deep-seated necrosis of the skin tissue, requiring repeated wound dressing and debridement. Another one-third suffered from respiratory tract infection, some due to aspiration of sea water. There were relatively few major trauma and fracture cases seen, and there were a few cases of compression barotrauma of the tympanic membranes resulting from underwater immersion in the sea water. The casualty patterns seem consistent with those reported in other tsunami disasters, which differ distinctly from those seen in a pure earthquake disaster. (+info)
Acute respiratory tract infections among Hajj medical mission personnel, Saudi Arabia.
OBJECTIVES: To estimate the prevalence of acute respiratory tract infections (ARI) among 250 personnel serving in a Hajj medical mission, Al-Hada and Taif Armed Forces Hospitals, during the 2005 season and to determine the effectiveness of protective measures, including influenza vaccination, for these infections. METHODS: This was a nested case-control study. A questionnaire was distributed to the study cohort two weeks after the Hajj period and was self-administered by all recruited subjects. In addition, the medical records of study subjects were reviewed at Al-Hada Hospital for the same period in order to document ARI. RESULTS: The attack rate for ARI among study subjects during Hajj season or within two weeks of returning was 25.6% (64/250). Logistic regression analysis of factors related to acquiring ARI revealed that contact with pilgrims imposed an extremely high risk of infection (adjusted OR 13.2, 95% CI 1.5-117.6). Moreover, non-use of alcohol-based hand disinfection carried a more than 8-fold risk of acquiring ARI compared to those who always used alcohol for hand disinfection (adjusted OR 8.4, 95% CI 2.2-32.2). Smoking was also a predictor of ARI in our cohort and influenza vaccination was associated with a 30% reduction in ARI compared to unvaccinated subjects, although this finding was not statistically significant. Unexpectedly, the logistic regression model showed that Saudi nationals were three times more likely to acquire ARI than non-Saudis (adjusted OR 3.1, 95% CI 1.2-8.4). CONCLUSIONS: The common practice among pilgrims and medical personnel of using surgical facemasks to protect themselves against ARI should be discontinued and regular use of alcohol-based hand scrubs should be more vigorously encouraged. Further research is needed to evaluate the protective value of N95 facemasks against ARI during the Hajj period. (+info)
Access to diagnosis and treatment of Chagas disease/infection in endemic and non-endemic countries in the XXI century.
In this article, Medicos Sin Fronteras (MSF) Spain faces the challenge of selecting, piecing together, and conveying in the clearest possible way, the main lessons learnt over the course of the last seven years in the world of medical care for Chagas disease. More than two thousand children under the age of 14 have been treated; the majority of whom come from rural Latin American areas with difficult access. It is based on these lessons learnt, through mistakes and successes, that MSF advocates that medical care for patients with Chagas disease be a reality, in a manner which is inclusive (not exclusive), integrated (with medical, psychological, social, and educational components), and in which the patient is actively followed. This must be a multi-disease approach with permanent quality controls in place based on primary health care (PHC). Rapid diagnostic tests and new medications should be available, as well as therapeutic plans and patient management (including side effects) with standardised flows for medical care for patients within PHC in relation to secondary and tertiary level, inclusive of epidemiological surveillance systems. (+info)