Promises and challenges of faith-based AIDS care and support in Mozambique.
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OBJECTIVES: We sought to examine the role of religious organizations in the provision of HIV/AIDS-related assistance in Africa. METHODS: We used data collected from Christian religious organizations in southern Mozambique. Bivariate comparisons and logistic regression analysis of survey data were performed. We conducted an analysis of the qualitative data to complement the quantitative results. RESULTS: Our analysis revealed little involvement of religious organizations in provision of assistance. Most assistance was decentralized and consisted of psychological support and some personal care and household help. Material or financial help was rare. Assistance to nonmembers of congregations was reported more often than to members. Members of larger and better-secularly connected congregations were more likely to report assistance than were members of smaller and less-secularly engaged ones. Assistance was reported more in cities than in rural areas. Women were more likely than men to report providing assistance to congregation members, and the reverse was true for assistance provided to nonmembers. The cooperation of religious organizations in provision of assistance was hindered by financial constraints and institutional rivalry. CONCLUSIONS: Policy efforts to involve religious organizations in provision of HIV/AIDS-related assistance should take into account that organization's resources, institutional goals, and social characteristics. (+info)
John Flynn meets James Mackenzie: developing the discipline of rural and remote medicine in Australia.
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This commentary is a reflection on the lives of two men, whose qualities seem to reflect those needed in the establishment of the academic discipline of rural and remote medicine in Australia. The two men displayed three characteristics which those involved in change require: they were there; they equipped themselves to make a difference; they were not afraid of where change might take them. If rural and remote Australasia is to receive appropriate health care, the main medical workforce has to be made up of contextually trained rural generalists. This rural doctor will be a general practitioner with the additional competencies of paediatrician, internist, obstetrician, anaesthetist, surgeon, emergency physician and so forth, depending on the needs of both rural hospital and community. Without training for this role, our ageing rural workforce will never be renewed. Our medical schools, postgraduate councils and colleges are currently failing to provide appropriate numbers of such Australian trained graduates to fulfil the needs of rural communities. That task needs to be carried out by an academic discipline of rural and remote medicine, working through all these bodies. The current tripartite structure of medical education (4-6 years medical school, 2-3 post-graduate years, 4 years vocational training) with metropolitan domination and frequent transfer of responsibility, is directly contributing to the crisis in rural medicine, where 'rural and remote' is seen as an occasional tourist destination, rather than the centre of the process. The Rural Clinical Schools model needs to be expanded to provide a platform for appropriate education and a training pathway not only for medical students, but also for prevocational, vocational and established rural generalists. Only in this way will we be able to convert the 'Tsunami of medical graduates' expected in 2010 to an adequate supply of rural and remote generalists into the future. (+info)
A survey of the health of British missionaries.
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The results of medical examinations carried out on 212 missionary personnel from one missionary society returning on leave to the UK are presented. The great majority of missionaries worked in developing countries. They served in 27 countries altogether and for a total of 488 person years. The commonest illnesses reported overseas were malaria (87.3 per 1000 person years at risk), diarrhoea (63.5), anxiety (63.5), depression (41.0) and giardiasis (38.9). More illnesses were reported from West Africa (698 per 1000 person years at risk) than from any other region. Ten people (4.7%) were repatriated for health reasons and 10 relatives also returned as a consequence. Sixty per cent of those returning did so because of psychiatric illness. The highest rates of immunization achieved were for yellow fever (100% of those travelling to affected countries), tetanus (93%), polio (85%), typhoid (71%) and tuberculosis (53%). The results of urinalysis (100% of adults), full blood counts (78% of adults) and stool tests (74% of all people) are reported. The study shows that the history and psychiatric examination are an important part of the medical examination of people returning from overseas. Physical examination and urinalysis did not contribute much information, although the full blood count and absolute eosinophil count were useful tests. (+info)
Outbreak of histoplasmosis among travelers returning from El Salvador--Pennsylvania and Virginia, 2008.
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Histoplasmosis is a fungal disease caused by infection with Histoplasma capsulatum. Histoplasmosis, which can be acquired from soil contaminated with bird or bat droppings, occurs worldwide and is one of the most common pulmonary and systemic mycoses in the United States. However, among international travelers returning from areas in which histoplasmosis is endemic, histoplasmosis is rare, accounting for <0.5% of all diseases diagnosed in this group. During February-March 2008, the Pennsylvania and Virginia departments of health investigated a cluster of respiratory illness among three mission groups that had traveled separately to El Salvador to renovate a church. This report summarizes the results of the investigation. Of 33 travelers in the three mission groups for whom information was available, 20 (61%) met the case definition for histoplasmosis. Persons who reported sweeping and cleaning outdoors (relative risk [RR] = 2.1, 95% confidence interval [CI] = 1.3-3.6), digging (RR = 2.6, CI = 1.1-6.1), or working in a bird or bat roosting area (RR = 1.8, CI = 1.3-2.4) had a greater risk for illness. The findings emphasize the need for travelers and persons involved in construction activities to use personal protective equipment and decrease dust-generation when working in areas where histoplasmosis is endemic. Clinicians should consider histoplasmosis as a possible cause of acute respiratory or influenza-like illness in travelers returning from areas in which histoplasmosis is endemic. (+info)
Determinants of compliance with malaria chemoprophylaxis among French soldiers during missions in inter-tropical Africa.
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Dengue fever among U.S. travelers returning from the Dominican Republic - Minnesota and Iowa, 2008.
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In February 2008, a group of U.S. residents became ill with symptoms and clinical findings suggestive of dengue fever after returning from the Dominican Republic, where they had traveled to work as missionaries. Dengue is endemic in the Dominican Republic and most tropical and subtropical areas of the world, including the Caribbean, and represents a known health risk for U.S. residents traveling to or working in those areas. Subsequent investigation by the Minnesota Department of Health (MDH), the Iowa Department of Public Health (IDPH), and CDC determined that at least 14 (42%) of 33 missionaries traveling to the Dominican Republic met the case definition for dengue fever, and 12 had cases that were confirmed serologically. Of the 13 patients interviewed, all had weakness and fever, with 12 reporting chills and body or joint pain. Ten patients had noticed mosquitoes inside or outside their house in the Dominican Republic, but only three had used repellent. Before departing on their trip, none of the 13 ill travelers interviewed had been aware of dengue in the Dominican Republic, and only two had sought pre-travel medical advice. The Dominican Republic is a frequent destination for U.S. travelers providing missionary and humanitarian services and also for vacationers. These cases indicate a need to increase awareness of dengue prevention measures among U.S. travelers to areas where they might be at risk for dengue. (+info)
Chronic microsporidial enteritis in a missionary from Mozambique.
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