Friday, September 28, 2007

20:80

Is anybody else shocked by the fact that funding towards any public health intervention in Africa should be spent 20% on prevention and control measures, and 80% on treatment. And in fact, that you cannot receive funding unless you adhere to these rules. Well, firstly, I do not see how that makes any sense in a time and place run by infectious diseases. Find me a group of people in Tanzania, Malawi and Nigeria that are worried about cardiovascular disease and sense organ disorders. Yeah right. Not to downplay chronic diseases, but if we all had the billions of shillings just flying through the atmosphere, I'm sure it would be a perfect world. Seeing as we are pressed for funding, why would we want to spend 80% of Gates' millions on "treating" HIV patients? When we know that the nitty gritty virus we all love to hate will just keep spreading around our polygamous neighborhoods like ebola in the DRC. Not that we should be relying on Gates' millions for our every drop of water...but that is a blog for another day.

We always throw around words like "sustainable", "development", "longevity", "improvement". The truth of the matter is all these idealistic words we throw around are based on PREVENTION, not cure. Growing up, I was always taught "ubolibamba lingashoni"...um, I dont know if I can do justice to the translations but literally it means hold the sun before it sets. Ok, so I didnt do justice to it, but you get the point. Yes, it is true that in some cases, situations arise where we need to find quick cures, effective quarantines etc, but the real deal is at the end of the day, we all need to sit down and be forward-thinkers. Thinking forward does not mean we think about when the next big epidemic will occur and which foreign, world-renowned doctors we will hire to find an effective cure. It's about looking at now, what are our people going through? What do they need? Are our children living in the safest, and healthiest of environments? Do we have the appropriate education to let people know what's best? And most importantly : When we are gone, will those who come after us suffer the same troubles we did? No sir! Take HIV for instance, the most obvious case...destroying millions of Africans, most of them of reproductive and productive age, not the best boost for our already staggering economies. Thousands of orphans, 15 000 in Swaziland alone (out of a million people, u do the math). Our elders are having to take care of their children, their children's children, their cildren's children's children, the neighbors, and the market. Another one...malaria. Responsible for most of infant and child deaths in Sub-Saharan Africa. Still a huge public health problem.

We do need to worry about our brothers and sisters who have contracted the virus, yes. But not to an 80% degree. Especially not if we havent found a cure yet. And definitely not in Africa. What happens to the infected orphans? Wont they grow up to be just like that too? Complete nonsense...we should be spending 80% on preventative methods, and 20% on "trying to find effective treatment". In the end, we're all dead. How we die, and what we experience in the meantime...is all that matters. It pains me to see my people all over the continent living a life of doom. Ok, so we are encouraged to go for testing, lekker...its a start. Now, Nozipho goes and tests, finds out she's HIV positive, gets a little bit of counselling, but still cant afford the optimal diet to stay free of opportunistic illnesses and infections. Not only that, she will be discriminated upon like a cockroach in an urban kitchen. If she is the average African, she probably wont be able to afford the sky-rocketing price of ARVs (pharmaceutical corruption...a story for another sunset), and when she does fall ill, she will either be denied a hospital bed, or, simply, wont have access to one. Her sister Nothando...will look at this situation and go "he! i am NOT testing. Id rather not know". It may seem like crappy logic, but I tell you, its what happens and it is sad. There are many ways we can combat this. HIV? A speck of dust compared to what we're worth. Africans need to do some African work for their African people. Uganda is our glimmer of hope. They did it, everyone else can. But first we need to deal with this 20:80. Ideas?

Wednesday, September 12, 2007

Ebola Outbreak in the DRC

News source: www.bbc.co.uk

Major Ebola outbreak in DR Congo
An outbreak of the deadly Ebola virus in the Democratic Republic of Congo has been confirmed by the World Health Organization in Kasai province.

At least 166 people have died and WHO says it is aware of 372 other cases.

International agencies have begun airlifting emergency medical supplies and setting up isolation tents to try to contain the outbreak.

Ebola is highly contagious. People contracting the disease suffer severe stomach pain and internal bleeding.

'Ebola kits'

Medecins sans Frontieres has reinforced its medical personnel and has flown three tonnes of supplies to the provincial capital Kananga, to be distributed in the affected areas.

The supplies include tents and plastic sheeting to build isolation facilities. Medicines, water and sanitation materials are also being sent.

"Ebola kits" have been provided for the medical teams - they include protective gloves, boots and uniforms which are designed to be destroyed after use.

Local health authorities are helping to disinfect contaminated areas.

The fatality rate for Ebola, which has no known cure, is as high as 90%.

Specialist laboratories in Gabon and Atlanta in the US confirmed Ebola from blood samples, saying they also showed the presence of Shigella dysentery - which is hampering efforts to identify Ebola victims.

WHO has also requested additional support from the global outbreak alert and response network, and says specialised laboratories in Gabon, Canada and the US will share the analysis.

They say there could be a "possible concurrent outbreak of another etiology".

Quarantine

It is three months since people started falling sick from a mystery virus in several villages around Kananga, the capital of West Kasai region.

Several villages are under quarantine, but WHO says so far there is no need for any further restrictions on travel or trade with DR Congo.

The incident is the worst for several years and is likely to have serious consequences for some time to come - even if the spread has been contained.

It is thought to be transmitted through the consumption of infected bush meat and can also be spread by contact with the blood secretions of infected people.

DR Congo's last major Ebola outbreak killed more than 200 people in 1995 in Kikwit, about 400km (250 miles) west of the current outbreak.

The last major incidence of the disease was in Uganda in 2001 when more than 400 cases were reported and more than half of the patients died.

Uganda has issued a red alert to border posts neighbouring the DR Congo and has instructed staff at Entebbe international airport to be on the lookout for passengers who show symptoms of fever.

Thursday, September 6, 2007

39 and counting!



Happy Swazi Independence Day!
09.06.68

Sunday, September 2, 2007

Saving Lives -- Millions at a time

Read this if you're interested in Public Health.
Or if you may be considering doing work in the health sector at some point or the other in your life/career.
Or, if, you just love me, cos thats okay tooooooooo.

So, we all know no one grows up aspiring to be a public health professional, an epidemiologist, a biostatician, or a volunteer. Apparently, 100% of my incoming class never thought they would go into Health. Growing up, I think I changed careers (aspiring) mebbe an average of 12 times a day. I would wake up convinced I would be a doctor one day, by the end of the day, various adults got different answers from me. Anything from boxer to pilot. Clearly, I didn't know where my life is going. But atleast I knew it was going somewhere right? So, well, had fun a la process. High School was the usual. If you went to boarding school in Africa you'll know what I'm talking about. A section for the math and science whizz kids, B section for the ones that aspired to be in the A section and weren't too far from the dream, and the C class was the class that hated the A class with a passion. No need to explain why. So, high school is the 5 years of your African life where you are being trained to want to be a doctor, an engineer or ...a doctor. Naturally, I developed a love for the biological science and hmm, wasn't too bad at it either, so med school here we come!
Things got confusing when I reached IB, where the hot kids were the art kids and econ was now the in thing. Physics was alrighhhtt, I guess but damn those English A1 higher level kids were the truth! Ok, so this was 2 years of confusion. Next step...liberal arts. We get to play around and choose a major that we will probably never use (half of Wesleyan went into investman banking, and most people were either a Bio major, a dance major or any such combination). Next thing, it's 3 months to graduation and you're wondering what the heck to do with yr life. Is thisyr story too? Read on. Not yr story? Read on.

Getting into Public Health, for most people, is influenced (at any point in their careers) by some event or experience they have, usually in a low-income, pretty messed up country/town/state/village. The first thing a professor told me when I started classes was : If you're looking for a quick way to get rich, please apply to Harvard Buisness School. Public Health is not yr place. Ok so maye u CAN be rich doing Public Health, but if it's yr number 1 goal, you'll be very frustrated for a while. Lesson number 1, if you plan on going into public health -- marry rich. Cos the income sure as hell wont be coming from you! Im now patiently waiting for my business/engineering man to come take me for a carpet ride! (while I vaccinate 30 kids in Nakuru. Where are you, my lover! I need u and I need your money. For real. (Attention men: I really do have a heart, i promise to love and cherish too neh. The bride price will be worth it).Which brings me to point number 2. Public Health is for people WITH a heart. You have to feel connected to the people that you want to reach. It's not just about medical care, its about culture too. So, if u have those 2 down, we are free to move on to the most important thing abt Pub Health (PH).

The reason I love P.H., other than that I believe it's part of God's purpose for my life and for the life of others that I will meet along this wonderful journey, is the fluidity of the discipline. I walk into a health management and policy class and there's 3 great professors there to just pour out the knowledge. An MBA, an MD and some random PHD geek who happened to work for a pharmaceutical company for 18 years. PH is not a concrete science! (I am beginning to understand why i absolutely hated organic chemistry). It's a great mixture of medicine, economics, biostatistics, engineering, anthropology, politics, linguistics, u name it, its all in there baby. And the truth is, anyone can go into Public Health, whether you are fresh out of college and you were a history major, or you are a 60 yr old doctor thats decided to go a little more global. Its about populations, social groups, countries, governments...it's about love, smiles, solutions and dreams. And if you love Africa (and other developing regions) as much as I do, you'll realize that the health sector needs you, too! Whether you're a biochem student looking to get into law, or maybe you're a dancer and you taught some Swazi kids how to dance over a summer (I don't see how that is possible), or you're just someone with a passion and fire for a place where thousands and millions of your countryboys and girls never get the chance to see, live, talk, love, dream, smile, play soccer, feel the rain, drink clean water, get married, run in the sand...because their lives are claimed by things such as HIV, malaria, hunger, war, stupid governments, terrible decision-making, etc. You too can do something. Seriously, it's been said, again and again and again. Yes, yes, we must be the change we want to see...but really I've discovered that just saving one life, saves millions thereafter. For real though, I don't want to be the last remaining Swazi on earth (although that would be kinda cool no? Would they frame me and put me in a museum outside La L'ouvre?)...so I'm just doing my best...to heal and deliver to those I love the most...and in the process, save the world...millions at a time.