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global health

Jocalyn Clark: Are slums creating equality?

30 Jan, 15 | by BMJ

Jocalyn_Clark1When you fly into Mumbai from the east, there is an extraordinary descent passing over mounds of lush green foothills reminiscent of Hawaii. It’s quite mesmerising. And then even more so is what lays at the foot of these foothills: a vast sprawl of tin roofed shanties, which I later learn is a slum of over 300 acres housing nearly 100 000 people. The slum literally encroaches upon the airfield, creating the illusion of a patchwork carpet leading on to the runway.

Inside the international airport are all the flashy trappings of a modern, bustling air and shopping terminal. Perhaps, I wonder, this is how the pace of development in South Asia is to be measured—not by absolute economic measures, but instead by how wide the gap is between the slum and the slick. more…

Rosalind McCollum: Reflections on Ebola from my time in Sierra Leone

28 Jan, 15 | by BMJ

Rosalind McCollumIt was a rare privilege to return to Sierra Leone for a couple of months on a break from my PhD studies, where I joined former colleagues at Concern Worldwide in training health workers, volunteers, support staff, and community members on infection prevention and control at peripheral health units as part of the response to Ebola. Concern Worldwide has worked in Sierra Leone since the civil war in 1996, initially providing humanitarian assistance before transitioning to development work. more…

Sarah Kessler interviews Atul Gawande

21 Jan, 15 | by BMJ

Sarah KesslerAtul Gawande, surgeon, author, and indie DJ (check his Twitter feed for mini playlists between the policy), just delivered the Reith Lectures for BBC Radio 4.

Broadcast to more than 50 million people worldwide, “The Future of Medicine” ranged across the UK, the United States, and India in a quest to navigate “the messy intersection of science and human fallibility.” more…

Guddi Vijaya Rani Singh: What matters—medicine, culture, and the space in between

16 Jan, 15 | by BMJ

guddiMy grandfather passed away last year. Surrounded by travel weary loved ones (from an extended family that also extends across continents), this man from rural India was promised a peaceful death in dignity.

Except that he died in 2013 in one of Delhi’s largest private hospitals, with every medical test and procedure made available by his anxious progeny. In the last 42 days of his life, he sustained two chest drains, urinary catheterisation, daily blood tests, and repeated intubation and ventilation; he became a pin cushion for Delhi’s doctors. more…

John Middleton and Jim Parle: Food crime—why should doctors care?

15 Jan, 15 | by BMJ

john_middletonJim-ParleFood crime is big business. It is everywhere. It is international. The same organised crime networks that profit from drugs, cigarettes, booze, people, or any other kind of international traffic also profit from food crime. You can call it food fraud if you wish. But we should not be tempted to think that the “horsegate” scandal was a novelty, a one off, a “fraud” with no health risks. It was a lucky accident if horsegate did not damage public health; in practice our surveillance systems and knowledge of the provenance of the meat are inadequate to tell us whether it did or not. These were the conclusions of Professor Chris Elliott of Queens University Belfast, presented last month at a meeting of the newly formed Birmingham Food Council, on which we sit. more…

Sandra Lako: The impact of Ebola in Sierra Leone

14 Jan, 15 | by BMJ

sandra_lakoToday is the 228th day of the Ebola outbreak in Sierra Leone. A year ago I would not have believed anyone who told me that I would be in the middle of an Ebola outbreak in January 2015. A confirmed Ebola case in West Africa never crossed my mind. Even in May of last year, when the first positive case in Sierra Leone was announced, I could not imagine the extent to which this virus would spread throughout Sierra Leone. No one was ready for the battle we are up against.

To date there have been 7696 confirmed cases in the country, affecting people in every district. Still the virus is looming. It has been an incredibly challenging time for Sierra Leone. Life and work for many people has been consumed by this outbreak and sometimes it is hard to remember a time without Ebola. more…

Christmas Appeal: The 12 days of constructing an Ebola management centre

12 Jan, 15 | by BMJ

OLYMPUS DIGITAL CAMERASunday: As soon as you touch down in Freetown, Sierra Leone, Ebola hits you—or the awareness of it. Health forms to fill in, chlorine handwashes before you even enter the terminal building, zapped with a temperature gun before you step outside.

Public health messages and precautions continue throughout the city: big posters announcing that “Ebola is Real so ABC: Avoid Body Contact!” dominate the main thoroughfares. Chlorine handwashes are at the entrance to restaurants and supermarkets—but even so, I’m careful not to touch the doors with my hand. Even as medics, we have never been so clean, so hygiene aware. And we’re all getting acclimatised to the no touch policy: no touching even among the team, no handshaking when you meet someone. Instead, a crossed arm against your chest. more…

Shinjini Mondal: Reframing the challenge of urban slums from Cape Town to Mumbai and beyond

9 Jan, 15 | by BMJ

Shinjini_MondalRecently, I had the opportunity to visit South Africa and learn about the health system in Cape Town and the health issues of Khayelitsha, an informal (and notorious) township in Cape Town. I was part of the 2014 Emerging Voices for Global Health group of young health systems researchers, who were attending the third Global Health Symposium on Health Systems Research in Cape Town.

We were given a brief but thought provoking presentation on the numerous challenges in these informal settlements, which was followed by a visit to Khayelitsha. Our tour guide, a self-declared “experience expert” of the settlement, “entertained” us with lively stories about his past in a local gang and by detailing what life was really like in a tough place such as Khayelitsha; for example, for kids trying to go to school. We learnt a great deal from his insights, in a way that dry statistics and figures can never achieve. more…

K M Venkat Narayan: Is health simply organized kindness?

30 Dec, 14 | by BMJ

My big public health hero (who is a hero to many) Dr Bill Foege once said that, “Civilization is organized kindness,” and my three days in Copenhagen made me feel that the Danish have mastered this principle as a fine science and art.

When you arrive in Copenhagen, it is hard for a visitor to miss the big, proud sign on the wall by the baggage claim: “Welcome to the World’s Happiest Country.” Indeed, Denmark ranks number one as the “happiest country” in the world—and scores high on several indices: with great healthcare and health, parental leave policies, prioritization of gender equality, active promotion of social capital, low crime rates, high levels of education, emphasis on equality, low corruption, terrific public transportation, and a welfare state at large with considerable social solidarity and collectivism backing it. In many ways, Denmark is a remarkable example of the practice of the lofty idea of “organized kindness.” more…

Christmas Appeal 2014: A silent hunger

23 Dec, 14 | by BMJ

Nikola MortonI have been in Pakistan for six months, two thirds of the way through my nine month mission. Before working in Pakistan, I had spent some time working in the north of Australia with the Aboriginal community. In the Northern Territory of Australia, there is a big issue with malnutrition in the Aboriginal population, especially in the remote communities. Having worked there for some time, I thought it would prepare me for working here . . . but it does not even compare. more…

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