Namati: Innovations In Legal Disempowerment For Health? A Sierra Leonean Case Study

Drawing on eleven weeks of fieldwork for Namati’s Health Accountability and Social Empowerment Program, this case study investigates whether Namati interventions reinforce existing formal and customary structures for the amelioration of grievances between health clinics, their associated staff, and intended beneficiaries. Furthermore, this study questions Namati’s role as an organization that fosters sustainable change at: the level of the grassroots in its ability to influence government health policy, and at the level of the elites in its ability to improve administrative and policy deficiencies in the area of health access. Finally, this study answers critical questions on the equity-enhancing effects of paralegal interventions towards beneficiaries of health services. An analysis of Namati using concepts developed in Harri Englund’s Prisoners of Freedom showed that: 1) Namati is not above scholarly critiques of development and multilateral institutions; 2) Namati works to enhance preexisting governance capabilities in the area of health access; 3) Namati works to enhance partnerships with local engines for health service delivery as a way to augment its interventions and solve the sustainability question; 4) Namati works to enhance the ability of claimants to understand the relevant health-related laws and maneuver within them; 5) Namati – unlike NICE in Malawi – works to contextualize its interventions by engaging with higher-level policy and administrative organs, despite some deficiencies and; 6) Namati paralegals are not immune to desires for status distinctions. The findings in this case study should be combined with future fact-finding missions in other districts in Sierra Leone to determine whether Namati and its donor partners should recommend scaled-up interventions

Effects of Hypercapnic Hypoxia on Inactivation and Elimination of Vibrio campbellii in the Eastern Oyster, Crassostrea virginica▿

The Eastern oyster, Crassostrea virginica, inhabits shallow coastal waters that frequently experience periods of low dissolved oxygen (hypoxia) and elevated CO2 (hypercapnia) levels. Bacteria are extremely abundant in these environments and accumulate in large numbers in filter-feeding oysters, which can act as passive carriers of human pathogens. Although hypercapnic hypoxia (HH) can affect certain specific immune mechanisms, its direct effect on the inactivation, degradation and elimination of bacteria in oysters is unknown. This research was conducted to determine whether exposure to HH reduces the ability of C. virginica to inactivate and eliminate Vibrio campbellii following its injection into the adductor muscle. Oysters were held in fully air-saturated (normoxic; partial O2 pressure [PO2] = 20.7 kPa, CO2 < 0.06 kPa, pH 7.8 to 8.0) or HH (PO2 = 4 kPa, CO2 = 1.8 kPa, pH 6.5 to 6.8) seawater at 25°C for 4 h before being injected in the adductor muscle with 105 live Vibrio campbellii bacteria and remained under these conditions for the remainder of the experiment (up to 24 h postinjection). Real-time PCR was used to quantify the number of intact V. campbellii bacteria, while selective plating was used to quantify the number of injected bacteria remaining culturable in whole-oyster tissues, seawater, and feces/pseudofeces at 0, 1, 4, and 24 h postinjection. We found that oysters maintained under normoxic conditions were very efficient at inactivating and degrading large numbers of injected bacteria within their tissues. Moreover, a small percentage (∼10%) of injected bacteria were passed into the surrounding seawater, while less than 1% were recovered in the feces/pseudofeces. In contrast, HH increased the percentage of culturable bacteria recovered from the tissues of oysters, suggesting an overall decrease in bacteriostasis. We suggest that poor water quality may increase the risk that oysters will harbor and transmit bacterial pathogens hazardous to human and ecosystem health

Concentrations of Heavy Metals in Soil and Cassava Plant on Sewage Sludge Dump

The study examined the concentration of heavy metals (Ni, Zn, Cu, Pb and Cd) in the sewage sludge dump soil and Cassava tuber harvested from cassava plant grown by farmers on the sewage sludge dump site along Owerri-Onitsha road Imo state, Nigeria, a dump site that was subjected to severe and intense sewage sludge dumping for about 2 years, abandoned for about 3 years and then cultivated with cassava plant. Soil and Cassava tubers were sampled and analysed using Atomic Adsorption Spectrophotometer. Concentration of the metals both in the soil and plant were found to be in excess but all, were not within critical concentration range except for Ni and Cu with concentrations within soil critical range (20-70, 50-250 mg kg-1 respectively). In all cases, the concentration were not above the established maximum tolerable limits. Thus, Ni , Zn ,Cu, Pb, and Cd concentrations in the soil were 25.15, 59.7, 68.2, 10.85, and 8.38 mg kg-1 respectively. For cassava plant, heavy metal concentration were 38.25, 138.7, 125.8, 5.50 and 3.60 mg kg-1 respectively. The concentrations were consistent with the findings of previous studies of sewage sludge contaminated soils

Concentrations of Heavy Metals in Soil and Cassava Plant on Sewage Sludge Dump

The study examined the concentration of heavy metals (Ni, Zn, Cu, Pb and Cd) in the sewage sludge dump soil and Cassava tuber harvested from cassava plant grown by farmers on the sewage sludge dump site along Owerri-Onitsha road Imo state, Nigeria, a dump site that was subjected to severe and intense sewage sludge dumping for about 2 years, abandoned for about 3 years and then cultivated with cassava plant. Soil and Cassava tubers were sampled and analysed using Atomic Adsorption Spectrophotometer. Concentration of the metals both in the soil and plant were found to be in excess but all, were not within critical concentration range except for Ni and Cu with concentrations within soil critical range (20-70, 50-250 mg kg-1 respectively). In all cases, the concentration were not above the established maximum tolerable limits. Thus, Ni , Zn ,Cu, Pb, and Cd concentrations in the soil were 25.15, 59.7, 68.2, 10.85, and 8.38 mg kg-1 respectively. For cassava plant, heavy metal concentration were 38.25, 138.7, 125.8, 5.50 and 3.60 mg kg-1 respectively. The concentrations were consistent with the findings of previous studies of sewage sludge contaminated soils

Children's Rights and the Environment

This chapter offers critical analysis on the normative basis for articulating children’s environment-related rights as well as the key pathways to expanding the core content and scope for such rights. Recognizing that a healthy environment is a prerequisite to the enjoyment of all rights, it is crucial to focus attention on the environmental dimensions of children’s rights so that the role that children’s rights frameworks can play in managing environmental quality is strengthened. The Convention on the Rights of the Child offers an excellent normative basis for reinforcing our understanding and approaches to children’s environment-related rights because it already contains provisions that make explicit reference to the environment and many others that have strong environmental dimensions. Beyond these normative prescriptions, it is critical to engage with the Convention’s monitoring and enforcement mechanisms, particularly those presided over by the Committee on the Rights of the Child, with a view towards achieving a more systematic and coherent treatment of the environmental dimensions of certain children’s rights. Such an approach, it is argued, will likely result in better articulation of the relationship between children’s rights and the environment and could form the basis for the definition of a children’s right to a healthy environment at international law

How to manage cigarette smoking in kidney transplant candidates and recipients?

Tobacco smoking is a frequent problem affecting many kidney transplant (KT) candidates and recipients. The negative impact of active smoking on KT outcomes has been demonstrated. Consequently, most guidelines strongly recommend quitting smoking before considering kidney transplantation. However, nicotine addiction is a complex multifactorial disease and only 3–5% of the patients who try to quit by themselves achieve prolonged abstinence. Smoking cessation programmes (SCPs) have proven their efficacy in the general population to increase the rate of quitting and should therefore be proposed to all smoking KT candidates and recipients. Nevertheless, SCPs have not been evaluated in the KT field and not all KT centres have easy access to these programmes. In this work, we aim to review the current knowledge on the subject and provide an overview of the available interventions to help smoking patients quit. We detail non-pharmaceutical and pharmaceutical approaches and discuss their use in KT candidates and recipients