The BMJ Today: Taking a global view of health

navjoyt_ladherListening to the news here in the UK this past week, you would find it easy to forget that there is a world outside this small island. But visit and you get a different perspective, with a range of international stories.

First, to the Netherlands, where Tessa Richards describes how Radboud University Medical Centre has transformed from a hospital rocked by scandal and poor outcomes in 2006 to a model of high quality care. Key to this improvement has been a focus on patient participation. Radboud have implemented a number of patient centred measures, including access to personal health records, video consultations, and employing a chief listening officer.

Jan Kremer, Radboud’s professor of patient centred innovation, thinks that we should call time on the term “patient.” “It conjures up an image of passivity which is not appropriate in an era where people are—and must increasingly—assume responsibility for their own health.” He favours a new acronym: TIFKAP (The Individual Formerly Known As a Patient).

Next we move to China to look at a research paper published yesterday. If you give children with myopia free glasses in school, are you more likely to improve their exam performance than if you just gave them a prescription or voucher? The answer, according to this cluster randomised controlled trial, is yes—if the glasses are worn.

Myopia, or near sightedness, is thought to be responsible for 90% of poor vision in China, and there is a widespread perception that wearing glasses can harm children’s vision. Another major barrier is cost, so it’s good to hear the positive outcome of this research: “As a result of this project, pilot programs have now started in Shaanxi and Gansu Provinces to provide free glasses to children, with the possibility of expansion if successful.”

And finally, we arrive in India, with two contrasting accounts of massive strides in medical care and the ongoing challenges the country continues to face.

Access to sanitation is a major issue in many Indian areas. As Jocalyn Clark describes in a blog published yesterday: “Almost 600 million people in India defecate in fields, forests, bodies of water, or other open spaces rather than in closed latrines or toilets—that’s more than 10 times the number of any other single country, and 60% of the world’s total.” Jocalyn explores what India might learn from Bangladesh, which has achieved sanitation success despite facing many of the same barriers as India.

On a more positive note, The BMJ Awards were held last weekend in New Delhi. Richard Hurley’s feature describes a fabulous celebration of Indian healthcare, with projects involving robotic spinal surgery, hospital stewardship of antibiotics, and primary care for hill tribes among the winners on the night.

Our journey ends here, although if you still have itchy feet go to our website where you can visit—to name just a few—Guinea, the USA, Syria, and, of course, this small island.

Navjoyt Ladher is a clinical editor, The BMJ.