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South Asia

Aarefa Johari: Why doctors need to speak out against female genital cutting in India

20 Jan, 17 | by BMJ

Female circumcision, known around the world as female genital mutilation or cutting (FGM or FGC), is recognised as a human rights violation by the World Health Organisation. It involves cutting or altering parts of the female genitalia for non-medical reasons. It is not much talked about in India and is known so far to be limited to a single community—the Dawoodi Bohra community. Although more severe types of FGC are practiced by several African communities, the kind that Bohras practice—cutting all or part of the clitoral hood—falls within WHO’s definition of Type 1 FGC. The practice is illegal in at least 40 countries, because there are no medical benefits to cutting any part of the female genitalia. In fact, even the mildest form of FGC can have harmful health consequences, including bleeding, swelling, painful urination, infection and reduced sexual sensitivity. more…

Ramya Madhireddi: The underestimated burden of NTDs in India

8 Dec, 16 | by BMJ

ramya-madhireddiNeglected tropical diseases (NTDs) are a diverse group of conditions that affect more than a billion people worldwide. With India bearing one of the heaviest burdens of NTDs in the world (58% of leprosy cases, 40% of lymphatic filariasis cases, and 34% of cases of dengue fever), it needs to give them their due share of attention alongside diseases such as tuberculosis (TB), HIV/AIDS, or malaria.

Although the mortality rate for NTDs is not as high as for the aforementioned conditions, one study estimated that NTDs cause 56.6 million disability adjusted life years (DALYs). The multidimensional impact of NTDs takes an economic, social, and psychological toll on those affected. more…

Andrew Jenkinson: The Indian rural surgeon

11 Nov, 16 | by BMJ

andrew_jenkinsonI pinch my patient’s abdomen with toothed forceps to check his spinal anaesthesia has worked and I feel I should pinch myself. I am about to start an inguinal hernia repair using a sterilised mosquito net.

After completing my foundation training, I was keen to work abroad. I had a simple set of criteria: a surgical job, a developing country with a low HIV prevalence, and somewhere my English would be understood. I have now been in Uttarakhand, Northern India, for three months and have fallen in love with the country, the hospital, and the job. more…

Madhukar Pai and Nimalan Arinaminpathy: How can India overcome tuberculosis?

3 Oct, 16 | by BMJ

tb_indiaIndia reports more cases of tuberculosis than any other country. This much is well known. However, nobody quite knows the true magnitude of the TB problem in the country.

For one, we do not know the number of TB patients who do not seek care or who remain undiagnosed, but we refer to this often as the “missing million.” Also, until recently, we did not have the foggiest idea of the number of TB patients treated in India’s vast, fragmented private sector. Currently, many private providers and hospitals do not notify the government of TB cases, despite TB being made a notifiable disease in 2012.

This can change. more…

Pradip Kharya: Delhi’s chikungunya outbreak

27 Sep, 16 | by BMJ Group

photo-1-1In 2006 India experienced one of its worse chikungunya outbreaks, when more than 1.5m cases were reported. The current outbreak in Delhi has claimed at least 15 lives so far, and the city’s hospitals are overloaded because of demand from neighbouring states such as Rajsthan, Uttar Pradesh, and Haryana. more…

Soham D Bhaduri: How we can improve the specialty status of family medicine in India

15 Sep, 16 | by BMJ

Soham Dinabandhu BhaduriA few weeks ago I was interviewing Dr Ashoka Prasad, a psychiatrist and campaigner for improving the rights of those with mental illness, for a popular Indian medical news portal, and was grabbed by a point that he made. The interview was mainly about the state of mental healthcare in India, yet Prasad stressed the role of primary healthcare in providing a foundation for effective psychiatric care, and the criminal under-emphasis of the importance of primary care that we see in India today.

Dr Prasad also expressed his disappointment that only two institutions in the country have thus far expressed their interest in offering a postgraduate course in family medicine. more…

Madhukar Pai: New insights into the tuberculosis problem in India’s private sector

26 Aug, 16 | by BMJ

Madhukar Pai

As a result of the overuse or misuse of antibiotics, antimicrobial resistant superbugs represent an extraordinary threat to global health. This threat is particularly great in India, the world’s largest consumer of antibiotics and the country facing the highest burden of tuberculosis (TB) in the world. Two studies, published simultaneously in The Lancet Infectious Diseases this week, provide several new insights into the problem of tuberculosis in India’s vast, mostly unregulated private sector. more…

Tanoubi Ngangom on India and Africa’s partnership for access to medicines

9 Aug, 16 | by BMJ

tanoubi_ngangomPrime Minister Modi’s recently concluded four-nation tour to Africa is primarily regarded as part of his larger energy diplomacy outreach. However, what is often overlooked are the enormous investment opportunities that African markets offer—especially in the midst of stagnating markets elsewhere. The agenda for this visit was centred on two themes: (a) mutual economic interests, and (b) common development aspirations. The pharmaceutical sector presents a meeting point for both goals—of exporting medicines to Africa, as well as creating manufacturing bases in Africa. more…

Madhukar Pai: How drug resistant TB can show the path to tackling antimicrobial resistance

18 Jul, 16 | by BMJ

Madhukar PaiAntimicrobial resistance (AMR) is a global health threat, and it is estimated that if we do not find solutions to tackle the rise of drug resistant pathogens, by 2050 10 million lives a year and a cumulative 100 trillion USD of economic output will be at risk.

Since the introduction of antibiotics, microbes have evolved a variety of methods to resist antibiotics. We are now dealing with “superbugs” that are virtually untreatable, including colistin resistant E coli, drug resistant gonorrhoea, carbapenem resistant enterobacteriaceae, methicillin resistant Staphylococcus aureus, extensively drug resistant tuberculosis, and extended-spectrum beta-lactamase producing strains. The antibiotic pipeline is running dry, and AMR is threatening to undo major gains made in the control of infectious diseases. more…

Jane Parry: Without incentives, health data sharing systems don’t work for patients

5 Jul, 16 | by BMJ

jane_parry3In the multi-payer systems that characterize primary health care in Asia and the Pacific, both developed and developing countries suffer a way of delivering care that works against data sharing.

Even in Hong Kong, China—which has one of the highest standards of health care in the region—services are rendered without a sharable electronic medical records system, as I witnessed in a recent encounter with the medical profession that gave me first-hand insight into the matter. more…

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