The Social and Political Dimensions of the Ebola Response: Global Inequality, Climate Change, and Infectious Disease

The 2014 Ebola crisis has highlighted public-health vulnerabilities in Liberia, Sierra Leone, and Guinea – countries ravaged by extreme poverty, deforestation and mining-related disruption of livelihoods and ecosystems, and bloody civil wars in the cases of Liberia and Sierra Leone. Ebola’s emergence and impact are grounded in the legacy of colonialism and its creation of enduring inequalities within African nations and globally, via neoliberalism and the Washington Consensus. Recent experiences with new and emerging diseases such as SARS and various strains of HN influenzas have demonstrated the effectiveness of a coordinated local and global public health and education-oriented response to contain epidemics. To what extent is international assistance to fight Ebola strengthening local public health and medical capacity in a sustainable way, so that other emerging disease threats, which are accelerating with climate change, may be met successfully? This chapter considers the wide-ranging socio-political, medical, legal and environmental factors that have contributed to the rapid spread of Ebola, with particular emphasis on the politics of the global and public health response and the role of gender, social inequality, colonialism and racism as they relate to the mobilization and establishment of the public health infrastructure required to combat Ebola and other emerging diseases in times of climate change

A review of patients with advanced cervical cancer presenting to palliative care services at Queen Elizabeth Central Hospital in Blantyre, Malawi

Background Cervical cancer is the commonest cancer affecting women in Malawi, which has the highest rate of this disease in the world. Most cases are diagnosed at an advanced stage .Aim To describe the symptom burden, palliative care interventions, and outcomes of cervical cancer patients who entered care at Tiyanjane Clinic in Blantyre, Malawi, between January and December 2012.Methods We reviewed the case files of 72 patients presenting to our hospital-based palliative care service over one year.Results The mean age was 49.5 years. Twenty-six patients (36%) were HIVpositive and the majority of these (n = 22; 85%) were on antiretroviral medication at presentation to palliative care. Pain (n = 66; 92%), vaginal discharge (n = 44; 61%), and unpleasant odour (n = 37; 51%) were commonly reported. Over a third of patients (n = 26; 36%) reported pain in two or more sites. Fourteen patients (19%) reported vaginal bleeding. Spousal breakdown (through widowhood or divorce) was noted in over half (n = 41; 57%) of all cases. Pain relief was provided to 69 (96%) of the patients (morphine to 40 patients; 56%). Common interventions provided included metronidazole tablets (used vaginally), sanitary items, and counselling. At the end of the study period, 18 patients (25%) were still under the care of palliative services.Conclusions Access to medications such as morphine, metronidazole and tranexamic acid can improve quality of life, even when radiotherapy is limited. Health care teams require necessary skills and training, including how to perform a comprehensive assessment, with an emphasis on the provision of psychosexual counselling, to assist with the complexity of symptoms occurring in this vulnerable group

Transmission Risk of Malaria via Gas Flares in Africa

Gas flaring occurs at oil drilling sites around the world. It is a method to get rid of the extra gas, as well as to release pressure in emergency situations. The pollutants that are contributed to the air through routine gas flaring can be extremely harmful. Chemicals such as sulfur dioxide and methane are burned into the air we breathe (Baker Hughes, 2019). Not only does this have a direct impact on our health, but also on greenhouse gas emissions. The effects on greenhouse gas emissions impact diseases such as Malaria by increasing the temperature of our planet. The purpose of this research is to examine what gas flaring is, how it impacts the environment, and how that impacts malaria. This is to exemplify the impact we have on people\u27s health around the world. Studies were done to assess the negative impacts that gas flaring has on the health of those living near oil drilling sites, as well as how it contributes to climate change. They compared health documents in six communities between 2013 and 2016, and collected primary data through surveys that asked residents a series of questions on how they believe their health is impacted by gas flaring. Research on how climate change impacts malaria is also examined. This study used progression data of malaria cases and the climate over the past 40 years to assess a correlation. They assessed the current state of malaria in Africa, and projected two scenarios of how malaria could spread throughout Africa by 2030, 2050, and 2080. The results of the first study show that those residing in areas near gas flaring sites in Africa are seeing increases in respiratory illnesses, eye irritation, chest pains, and asthma (Ryan et al., 2020). Rising temperatures due to climate change are projected to increase the transmission ability of malaria into new areas of Africa that have never carried the burden on this disease, as well as increase the severity and commonness of the disease in areas where it currently resides (Ryan et al., 2020). Concluding that health is statistically impacted by gas flaring and climate change

Transmission Risk of Malaria via Gas Flares in Africa

Gas flaring occurs at oil drilling sites around the world. It is a method to get rid of the extra gas, as well as to release pressure in emergency situations. The pollutants that are contributed to the air through routine gas flaring can be extremely harmful. Chemicals such as sulfur dioxide and methane are burned into the air we breathe (Baker Hughes, 2019). Not only does this have a direct impact on our health, but also on greenhouse gas emissions. The effects on greenhouse gas emissions impact diseases such as Malaria by increasing the temperature of our planet. The purpose of this research is to examine what gas flaring is, how it impacts the environment, and how that impacts malaria. This is to exemplify the impact we have on people\u27s health around the world. Studies were done to assess the negative impacts that gas flaring has on the health of those living near oil drilling sites, as well as how it contributes to climate change. They compared health documents in six communities between 2013 and 2016, and collected primary data through surveys that asked residents a series of questions on how they believe their health is impacted by gas flaring. Research on how climate change impacts malaria is also examined. This study used progression data of malaria cases and the climate over the past 40 years to assess a correlation. They assessed the current state of malaria in Africa, and projected two scenarios of how malaria could spread throughout Africa by 2030, 2050, and 2080. The results of the first study show that those residing in areas near gas flaring sites in Africa are seeing increases in respiratory illnesses, eye irritation, chest pains, and asthma (Ryan et al., 2020). Rising temperatures due to climate change are projected to increase the transmission ability of malaria into new areas of Africa that have never carried the burden on this disease, as well as increase the severity and commonness of the disease in areas where it currently resides (Ryan et al., 2020). Concluding that health is statistically impacted by gas flaring and climate change

Experiences of having HIV and the support of a community organization- a qualitative study

The objective of this qualitative study was to explore how six South African HIV-diagnosed persons experience the social and emotional consequences of being infected and how the support structure provided by the non-governmental organization Keiskamma affect their everyday lives. The qualitative approach consisted of semi-structured interviews with six of Keiskamma’s patients and observations of the village inhabitant’s life in the Ngqushwa municipality, Eastern Cape to give a wider picture of the respondent’s context and life situation. Theories used to analyse collected data was stigma (Goffman 1973), sense of coherence (Antonovsky 2005) and coping (Lundin et al 2009). Six themes were identified: faith, knowledge, network, belonging, people’s view of them, frustration and emotions during the time of diagnosis, these together increase our understanding of how it is to live with HIV in rural South Africa at a micro level. However, deficits at macro level were also identified that interfered with the respondent’s quality of life. These are poverty, lack of access to health facilities and bad roads. Through advocacy and collaborate efforts in cooperating with the Department of Health the Keiskamma tried to bring a change to their situation at a structural level. A difference found was that the village of Hamburg, where the Keiskamma was located, had less HIV stigma and the disease was more explicit compared to the villages outside. This can perhaps be viewed as an unequal knowledge distribution and the impact of the work Keiskamma did

Risks for HIV Infection Among Adolescent Girls and Young Women in Mozambique

Adolescent girls and young women (AGYW) living in Sub-Saharan African countries constitute 17% of the population, yet they account for one third of all new human immunodeficiency virus (HIV) infections. To prevent HIV infections among AGYW, it is necessary to understand why they are disproportionally infected. The purpose of the dissertation was to identify risk for HIV among AGYW living in a southern district of Mozambique. The analysis was driven by the Modified Socio Ecological Model and performed using a quantitative dataset collected for the Chokwe Combination Prevention of HIV (N=3354). Logistic regression analysis was conducted to assess whether an association existed between selected characteristics of AGYW (e.g., HIV prevention behaviors, attitudes, experience of gender-based violence), characteristics of their male sexual partners and the HIV status of the AGYW. The result of the analysis showed that being in school, always using condoms, never having experienced sexually transmitted infection, having an HIV-negative partner, having a faithful partner, and having a student as a partner were associated with lower odds of being HIV-positive. Age difference with the sexual partner, experience of gender-based violence, being pregnant in the last year, HIV knowledge, and HIV beliefs were not associated with being HIV-positive. The implications for positive social change from this research include providing policy makers and stakeholders with specific information on vulnerabilities and protectors to HIV of AGYW living in Mozambique and AGYW living in similar contexts. Addressing the specific risks of AGYW to HIV could help prevent new HIV infection among AGYW and could help improve the lives of AGYW and of their families

Understanding Boko Haram

There are two lenses through which Boko Haram is commonly viewed. The first focuses on ideas of Islamic extremism and religious violence, explaining the insurgency as an outgrowth of an ideology. The second uses theories of relative deprivation and frustration-aggression to find motivation in the harsh socioeconomic reality faced by the majority of people in northern Nigeria. This project demonstrates that both of these lenses are problematic and allow for only a partial understanding of Boko Haram. Instead, this project analyzes all of the factors that have allowed and facilitated Boko Haram\u27s transition from a localized, grassroots organization into the wide-ranging, violent insurgency it is today. This includes discussion of the development of multiscalar divisions and contradictions among Nigerian Muslims from the introduction of Islam into the region, through colonial rule, and up to the present day. The examination of these ideological and religious factors is combined with an analysis of the economic geography, political manipulation of religion, poverty and inequality, and failures of the Nigerian state. In doing so, this project demonstrates that no single factor, variable, or theory can be used independently. The full context -- religious, historical, political, and socioeconomic -- of the crisis must be examined in order to fully understand Boko Haram

Ebola, en komparativ studie av Sierra Leone och Nigeria

När ebola, en smittsam virussjukdom med dödlighet upp till 90 procent drabbade Nigeria höll världen andan. Utbrottet i Västafrika, som redan hade krävt flera hundratals dödsoffer, riskerade att bli en global epidemi. Via en flygresenär från Liberia som trodde att hans symptom var malaria, smittades först nio doktorer och sjukskötare, fyra av dem dog. Totalt omkom 8 personer i Nigeria av 20 smittade. Sierra Leone, ett land som gränsar till Guinea och Liberia där smittan först bröt ut, blev långt värre drabbat. Tio tusentals människor smittades av ebola under 2014-2015 vilket resulterade i tusentals dödsoffer. Var det tur och otur att det ena landet lyckades stoppa spridningen och det andra inte, eller låg någonting annat till grund? Vi kommer att undersöka institutionella skillnader och statligt agerande mellan länderna för att se ifall dessa är avgörande vid epidemier likt ebolavirusets spridning

Determinants of Health Professionals’ Migration in Africa: a WHO based Assessment

Abstract Purpose – How do economic prosperity, health expenditure, savings, price-stability, demographic change, democracy, corruption-control, press-freedom, government effectiveness, human development, foreign-aid, physical security, trade openness and financial liberalization play-out in the fight against health-worker crisis when existing emigration levels matter? Despite the acute concern of health-worker crisis in Africa owing to emigration, lack of relevant data has made the subject matter empirically void over the last decades. Design/methodology/approach – A quantile regression approach is used to assess the determinants of health-worker emigration throughout the conditional distributions of health-worker emigration. This provides an assessment of the determinants when existing emigrations levels matter. Findings – Findings provide a broad range of tools for the fight against health-worker brain-drain. As a policy implication, blanket emigration-control policies are unlikely to succeed equally across countries with different levels of emigration. Thus to be effective, immigration policies should be contingent on the prevailing levels of the crisis and tailored differently across countries with the best and worst records on fighting health worker emigration. Originality/value – This paper has examined the theoretical postulations of a WHO report on determinants of health-worker migration

Progress report on maternal, new born and child health (MNCH) and report on the international conference on maternal, new-born and child health, Johannesburg, South Africa, 1-3 August 2013

Assembly of the union sixteenth ordinary session 30 – 31 January 2014 Addis Ababa, Ethiopi