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South Asia

Soumyadeep Bhaumik’s review of South Asian medical papers—June 2016

23 Jun, 16 | by BMJ

soumyadeep bhaumik“Water, water, everywhere, Nor any drop to drink,” said a mariner, who had returned from a long sea voyage, to a man on his way to wedding ceremony in The Rime of Ancient Mariner.

The sea level in Bangladesh is rising as a consequence of all the evil we are doing by polluting Mother Earth on our journey to be more prosperous. One of its many consequences is the intrusion of saline water in the coastal region which puts people living there at a higher risk of hypertension. A study from Bangladesh found that Bangladeshis did not recognise that salt can occur naturally in water and food and they believed that the cooking process makes it harmless. To top that the risk perception about excessive salt consumption was low. This makes public health communication very challenging in the region, but at least now the scale of the issue is known. more…

Priyanka Shah: Antimicrobial Resistance—a ticking time bomb

9 Jun, 16 | by BMJ

Priyanka ShahIt is estimated that by 2050 infections that have become drug resistant will result in a global loss of 10 million lives annually. This chilling revelation was the crux of a report released last month, titled “Tackling Drug-Resistant Infections Globally: Final Report and Recommendations,” commissioned by the UK government, and led by renowned economist Jim O’Neill.

At present over 700 000 people die annually due to drug resistant infections. According to O’Neill’s report, by 2050 AMR will cost over $100 trillion annually. more…

Madhukar Pai and Barry R Bloom: TB elimination—India can lead the way

8 Jun, 16 | by BMJ

Public hospital microscopy centerAs the Prime Minister of India speaks to the US Congress today, a neglected epidemic threatens India’s progress. It’s not Ebola or Zika, but rather tuberculosis—an ancient disease that silently kills one Indian every 90 seconds. In one year’s time TB will sicken over 2.2 million Indians and kill 300 000. Between 2006 and 2014, TB cost the Indian economy a staggering $340 billion. Because TB strikes people in the prime of their lives, it’s the third leading cause of healthy years of life lost.

India also has the highest number of patients with multidrug resistant TB in the world, including cases that are nearly impossible to cure. more…

The SOCHARA Team on providing community health in India

27 May, 16 | by BMJ

The Society for Community Health Awareness Research and Action (SOCHARA), an Indian NGO, is recognised widely for its promotion of community health through networking, innovative training, research, policy engagement, and solidarity with movements and networks such as the People’s Health Movement, medico friend circle, and COPASAH. Recently the occasion of SOCHARA’s silver jubilee gave us the opportunity to reflect on 25 years of experience. The SOCHARA family is large not just because of the “once you enter, you will always be a part” culture but also for its partnerships and solidarity. This was well reflected in the diversity of participants at the meeting. Also in attendance were those who received and continue to receive mentorship in their respective community health journeys from SOCHARA members over the years. Our ethos of social justice, scholar activism, and non-hierarchy have reportedly played a role in shaping the work culture of several individuals and organisations. more…

Soumyadeep Bhaumik’s review of South Asian medical papers—May 2016

24 May, 16 | by BMJ

soumyadeep bhaumikIt is summer in South Asia, and it seems to be getting hotter than ever before (though I have been spared this year). Climate change is expected to have major consequences in the region with Bangladesh at the top of the risk index for global climate change by the Intergovernmental Panel on Climate Change (IPCC) for nine consecutive years now. Recently the baseline results of a cohort study to see the health effects of climate change in Bangladesh were published. The future will unfold through the lens of this cohort and hopefully force the global leaders to act before the damage becomes irreversible.  more…

Yogesh Jain, R Srivatsan, and Antony Kollannur: Heatwave in India

6 May, 16 | by BMJ

india_heatwaveSevere heat wave conditions have been reported across India through the month of April this year. The situation has been especially severe in Telangana, Andhra Pradesh, and Tamilnadu. Most affected are the vulnerable poor, the elderly, and those with health complications.

We spoke to some people to see how they cope with the heat:

“We have to work to earn our living. Drink water and keep moving. We can’t stop.”

“I take care to sit in the shade and sell bananas. I drink water, buttermilk, and lime juice.” 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…

Vivekanand Jha: National dialysis programme in India—how to get it right

15 Apr, 16 | by BMJ

vivek_jhaWith the announcement of a National Dialysis Service, India is set to join the growing list of nations that provide free or highly subsidised treatment to patients with end-stage kidney failure.

Dialysis is expensive—it consumes 2–6% of the healthcare expenditure [1], even though end stage kidney disease (ESKD) patients account for only 0.1–0.2% of the total population. Any proposed service must therefore be cost efficient. The proposed service focuses on haemodialysis (HD), while neglecting other options such as kidney transplantation, and peritoneal dialysis (PD), which is cheaper to the healthcare system and can be done at home, hence it is the preferred treatment modality for state-funded dialysis programmes [2]. more…

Meena Putturaj: The art of data collection in health systems research

11 Apr, 16 | by BMJ

meena_pData collection is a crucial aspect of any research project. Depending on the nature and scope of the research question, collecting quality data requires considerable investment of time and resources. Indeed, any research endeavour is handicapped without the relevant data.

During a recent health systems research project, I had to collect a lot of information from government agencies, which turned out to be no cake walk. There were occasions when I had to wait for hours at a time to collect documents, to meet officials, and to conduct interviews. Those waiting periods gave me sufficient time to observe and reflect on the functioning of some of the government agencies in India. more…

Soumyadeep Bhaumik’s review of South Asian medical papers—April 2016

7 Apr, 16 | by BMJ

soumyadeep bhaumikDespite the enormous diversity that South Asia encompasses, it has its fair share of common problems in which there is a need for greater co-operation and learning. A key issue is the neglected problem of arsenic groundwater contamination. A study from the Gangetic plains of India found that 100% of the samples analyses had higher than normal levels of arsenic in hair, nail, and urine samples. Another study estimated that more than 13 million people are exposed to higher than normal arsenic levels in drinking water around the course of the Indus river in Pakistan. There is no dearth of such studies from Bangladesh including the one published this month which studied the relation between cognitive scores in Bangladeshi children and elevated blood lead and arsenic and manganese exposure in drinking water. Irrespective of the country, the response has been suboptimal and much more needs to be done to improve the provision of “clean water” in the region. more…

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