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global health

Chris​ Simms: Deracination—Canada’s aboriginal suicides

29 Apr, 16 | by BMJ

Chris_simsFour aboriginal boys, two aged 8 and two aged 9, bolted midday from their school, half-clad, mid-winter, to make the 12 mile trek to their families in Nautley Reserve. When they were found the next day in the slush-ice on Lake Fraser less than a mile from home—arms wrapped around one another in a frozen embrace—few could have guessed the circumstances.

When, 80 years later, the community of Attawapiskat (population 2000) declared a state of emergency on 9 April 2016, reporting 11 attempted suicides in one day (and 100 attempts over the winter), Canadians may have been shocked, yet few would have been surprised. Several pieces of evidence including audio and video clips explain why.

Both events trace back to the federal government’s paradoxical policies of marginalization and assimilation. more…

Jane Parry: Organ donation is an emotive topic, and rightly so

28 Apr, 16 | by BMJ

jane_parry3Recently, there was a very moving piece in The Guardian about a doctor’s experience of a family donating their dead child’s organs for transplant. It got me thinking about organ transplantation here in Asia, specifically in Singapore, and why donation rates there are so low.

Singapore has an opt-out organ donation policy: a 2009 amendment to the Human Organ Transplant Act (HOTA) allows for “the kidneys, liver, heart, and corneas to be recovered in the event of death from any cause for the purpose of transplantation, applicable to all Singapore Citizens and Permanent Residents 21 years old and above, who don’t have mental disorders, and who have not opted out.” Opting out of HOTA means that you are lower priority on the waiting list for an organ transplant. more…

Fionnuala Finnerty: Lessons must be learned from the Calais “jungle” camp

6 Apr, 16 | by BMJ

fionnula_finnertyProtection against sexual and gender based violence is imperative in the current refugee crisis

Last autumn, I began to volunteer in the Calais “jungle” camp with the Hummingbird medical project in a weekend first aid clinic. Travelling by Eurotunnel, it took less than three hours from my comfortable home in Brighton to arrive at a squalid camp described in a University of Birmingham environmental report as a humanitarian emergency. The camp had minimal non-governmental (NGO) input with Médecins Sans Frontières being the only NGO present running an overstretched primary care clinic. Calais has been described as the largest slum in Europe and probably the worst. more…

Canada’s First Nations: The social and political determinants of health

1 Apr, 16 | by BMJ

Chris_simsTo what extent are the social determinants of health (SDH) political determinants, and which of these are the most amenable to policy reversals that will increase or decrease inequalities? Reviewing the actions of the conservative government under Prime Minister Stephen Harper (2006-15), together with early initiatives taken by the just elected Prime Minister Justin Trudeau, may help answer these questions.

The Harper government: The rise in inequalities among Canada’s 1.4 million aboriginals during the conservative decade may surprise some SDH experts. At the last World Medical Association meeting its president and leading SDH expert, Sir Michael Marmot, more…

Aeesha NJ Malik: Teaching surgery in rural China—who are we benefitting?

31 Mar, 16 | by BMJ

aeesha_malikI recently bumped into a colleague I hadn’t seen for a while at a conference. He started asking me about a short trip I had made with a Chinese charity to teach cataract surgery in rural China. They had asked him to teach too and he was wondering what it was like and, importantly, what he could contribute.

My trip to China started in the most civilised way. A very articulate and successful entrepreneur from Hong Kong was speaking at a meeting I attended in London to explain the work her charity did and why the contribution of UK ophthalmologists was needed in teaching rural eye doctors cataract surgery. more…

Shakir Mustafa: A return to Nepal after the earthquake

30 Mar, 16 | by BMJ

Shakir MustafaIn the immediate aftermath of last year’s earthquake in Nepal I took part in an emergency mission. A few weeks later we returned for an aid and education mission. And now, here we are again, in Dharan, East Nepal for another mission to support local doctors and empower them to implement change and drive healthcare and medical education forward. This is part of a project led by the British Association of Oral & Maxillofacial Surgeons (BAOMS) and its international education subcommittee, the Norman Rowe International Education Foundation (NRIEF). more…

Vector-borne diseases in Europe: far more than Zika virus

30 Mar, 16 | by BMJ

SAMSUNG CSCAser-García-Rada_2016_picCertain emerging vector-borne diseases are entering high income countries’ attention in an unprecedented way.

Two years ago we wrote about chikungunya, a disease that most Spaniards—including doctors—had not even heard of, but which has already become far more familiar. Now Zika virus disease is gaining broad interest in the wake of its impact on foetal development and in the detection of imported cases, including in the United States and Europe. Without dismissing Zika as a public health priority, we may need a broader perspective on a problem that certainly will not stop growing during the next decade.

Let’s start with a summary of the main factors favouring the transmission of emerging vector-borne diseases in our environment more…

Arthy Santhakumar: Taking stock—Exposing the multi-billion pound medical gloves industry

24 Mar, 16 | by BMJ

arthy-santhakumarTops, frocks, bananas, and coffee—these are likely to be your top answers when asked to think of “fair trade.”

Historically, the fashion industry and agriculture sector have claimed the top spots for industries most likely to violate workers’ rights.

But is it time we applied the same scrutiny to the healthcare industry and promoted the same kind of awareness of consumer behaviour and demand witnessed in other sectors?

Wide scale abuses have been reported in the manufacture of several commodities used routinely in the NHS more…

Jay Achar: Drug resistant tuberculosis—not just a precursor to the post-antibiotic apocalypse

24 Mar, 16 | by BMJ

Jay_AcharIn 2015 the world woke up to the idea that the spread of antimicrobial resistance (AMR) will ultimately lead to a post-antibiotic era in which even simple medical treatments will cease to be possible.

Over the past decade the infectious disease medical community has looked on in horror as NDM-1 (New Delhi metallo-beta-lactamase-1—an enzyme rendering bacteria resistant to many antibiotics) has spread across the globe, causing havoc wherever it is detected. Furthermore, last year the first plasmid-meditated resistance mechanism to the antibiotic colistin, active against gram-negative bacteria, was identified in Chinese animals and humans. Since plasmids are efficient vehicles for the rapid transfer of resistance between bacteria, this is a huge threat to the last line of defence against gram-negative infections. more…

Mohammad Razai: What have we learnt from our work in Botswana?

23 Mar, 16 | by BMJ

Mohammad_RazaiThree years ago I travelled to Gaborone, Botswana for my medical elective. I was there to learn about glaucoma—the complex eye disease and so called “silent thief of sight.”

After the initial excitement of arriving in a country known for its dazzling birds, savannahs, and pristine natural beauty, came the challenge.

Glaucoma is the second leading cause of blindness globally and a major cause of visual impairment and blindness in sub-Saharan Africa. Throughout the two months I spent seeing, examining, and interviewing patients across Botswana more…

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