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Archives for : World Health Organization

One woman in three , worldwide suffer domestic violence: WHO #Vaw #Womenrights

VAW

Agence France-Presse | Updated: June 20, 2013 20:55 IST

Geneva: More than one woman in three around the globe is a victim of domestic violence, with those in Asia and the Middle East most-affected by the scourge, the World Health Organization said on Thursday.


In what it billed as the first-ever systematic study of global data on the prevalence of violence against women and its health impact, the UN agency said 30 percent worldwide faced such abuse at the hands of their partners.

“These to me are shocking statistics,” said Flavia Bustreo, head of the WHO’s family, women’s and children’s health division.
“It’s also shocking that this phenomenon cuts across the entire world,” she told reporters.

The WHO blamed taboos that prevent victims from coming forward, failings in medical and justice systems, and norms that mean men and women may see violence as acceptable.
The findings were extrapolated from figures provided by 81 countries which maintain data, and did not single out individual nations.

The scale of abuse was highest in Asia, where data from Bangladesh, East Timor, India, Myanmar, Sri Lanka and Thailand showed that 37.7 percent of women were affected.
Next was the Middle East, where prevalence averaged at 37 percent. Sub-Saharan Africa followed, with 36.6 percent.

An average of 23.2 percent were affected in a group of high-income countries including North America, the European Union, Japan, South Korea, Australia and New Zealand.
“These data really show the tremendous toll violence has on the health of women,” said Claudia Garcia-Moren, a WHO specialist on gender, reproductive rights, sexual health and adolescence.

Underlining the impact of such abuse, the WHO said that globally, 38 percent of female murder victims were killed by their partners.
In addition, it said, violence also leaves scars long after bruises disappear and broken bones heal.

Women with a violent partner were twice as likely to suffer from depression and develop an alcohol problem, compared to women who did not experience abuse.
Victims of violence were also found to be far more likely to contract a range of sexually-transmitted diseases, from syphilis to HIV.

The study also flagged the higher likelihood of abused women having an unwanted pregnancy, an abortion, or an underweight baby — and their children were more likely to become abusers or victims in adulthood.

 

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#India must address worrying stock out of tuberculosis drugs #healthcare

 

 

Indian government drug tender process leads to deadly delay in drug supply

 

New Delhi, 17 June 2013 – The Indian government must urgently address the persistent issues and almost routine delays of procuring drugs to treat tuberculosis, international medical humanitarian organisation Médecins Sans Frontières (MSF) said today. The issues are behind a worrying stock out of TB drugs which the country is currently experiencing.

 

“As a country with such a high burden of tuberculosis, MSF is deeply disturbed that India is experiencing stock outs of critically needed drugs to treat children and those with drug-resistant TB”, said Leena Menghaney, India Manager of MSF’s Access Campaign. “In this instance, it’s a stock out that can cost people’s lives and the government must act urgently to fix the problems.”

 

India is currently experiencing stock outs across the country of both paediatric TB drugs and those used to treat drug-resistant TB (DR-TB). Under India’s public TB treatment program, the government is responsible for buying drugs and distributing them to the states which then provide treatment.

 

The stock out is related to the never-ending issues with drug procurement that India faces in many of its public health programmes – the routine but deadly delay in tendering for these drugs – and the resulting drug stock outs are one of the reasons why India has one of the world’s highest burdens of DR-TB.

 

“As a TB treatment provider, MSF is witnessing the impact this is having on our own patients”, said Dr. Homa Mansoor, the TB Medical Referent for MSF India. “In our Mon, Nagaland project, I’ve seen a 12 year-old girl on treatment arrive with her father after a long journey to get her medicine. The medicines were out of stock, but luckily we had six days’ worth of drugs available from a patient who had died. Otherwise, we’re having to resort to breaking adult pills to give to children, which is really dangerous as it could over- or under-dose them.”

 

Other patients have been forced to purchase medicines from private pharmacies, but have received lower-dosage drugs, which – if it causes a patient to under-dose on that drug – could lead to resistance.

 

“A continuous, sustainable supply of quality-assured medicines is vital for TB patients to have even half a chance of being cured”, Dr Mansoor said. “As a doctor, I know the disease, I know how to manage it, but I feel powerless because we don’t have the medicines to treat.”

 

“It’s just not good enough that India talks of scaling up DR-TB treatment, but finds the medicine cabinet empty at a time when the most vulnerable patients – those diagnosed with DR-TB – are most desperate to get the medicines that can treat them”, Dr Mansoor added.  “The Indian Government must act now to address this dire situation.”

 

The stock outs in India are occurring as the World Health Organization late last week issued interim guidelines on bedaquiline, the first new drug to treat TB in 50 years, approved by the US Food and Drug Administration at the end of 2012. MSF has welcomed the release of the guidelines, but has said use of the new drug needs to be regulated and controlled, and studies must be undertaken to find combinations with the new drugs in shorter, more effective and less toxic treatment regimens.

 

 SOURCE- http://www.msfaccess.org/

 

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#India – Cost of cancer treatment could drop to Rs 1,000 a month #goodnews #Health


Author(s):
Akshay Deshmane
Issue Date:
2013-6-7

Tata Memorial Hospital’s preliminary studies of combination therapy prove successful; clinical trials to begin soon

Treatment for cancer may become far more affordable and cost less than Rs 1,000 per month in coming years, if an ongoing research project at the Tata Memorial Hospital in Mumbai is successful. The treatment currently being researched combines low dosage metronomic therapy—administration of chemotherapy at low, minimally toxic doses every day –with drug repositioning, which is the use of low cost drugs usually administered for ailments other than cancer.

The treatment of the commonest form of cancer in India – head and neck cancer– usually costs between Rs. 15,000-20,000 a month. With the new form of drug therapy, a patient’s cost of treatment could be reduced to as low as Rs 500 per month, or even Rs 250 per month if the treatment is carried out at the Tata Memorial Hospital.

Testing efficacy

A review of the preliminary studies of the method which proved successful was published in the May issue of British medical journal Lancet. Researchers are now set to begin randomised clinical trials of the combined approach of treatment on patients with head and neck cancers from next month. Confirming the development, Shripad Banavali, head of medical oncology department at Tata Memorial Hospital, said the institutional review board of the hospital has recently given clearance to begin randomised trials on patients suffering from head and neck cancer.

“More than 400 patients suffering from head and neck cancer will undergo randomised trials over three years at the hospital, beginning next month. We are starting with this (type of cancer) as it is the commonest cancer in India. Once we conduct these trials, we will have conclusive evidence about the effectiveness of the therapy,” said Banavali.

The drugs Celicoxib and Methotrexate, usually used as anti-inflammatory drugs, are also considered useful in treating head and neck cancer. Low chemotherapy doses of these drugs will be administered on patients and their effects studied closely to gauge efficacy.

Drug repositioning

The current method of treatment of cancer is called maximum tolerated dose therapy. This involves administering heavy doses which target the tumour every three or four weeks. A gap between two doses is maintained to ensure that the patient has enough time to recover from the overwhelming effects of the treatment. This treatment, however, is very expensive and not widely available. In metronomic therapy, daily low doses are administered not only on the patient’s tumour but also in areas surrounding the tumour; the blood supply is cut off and resistance power of the body is increased.

The drug discovery system followed in the West involves making new inventions and discoveries for the treatment of ailments. However, this method does not solve the problem of affordability and access to treatment in most of those suffering from ailments. In our context, we need to follow drug re-positioning method, says Banavali.

“We use drugs which are already there in the market for treatment. Also, our effort is to ensure that the drugs are among those included in the World Health Organisation’s Essential Drugs list as they are not only cheap but affordable and available the world over,” adds Banavali.


 

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Socioeconomic Inequality in Disability – A Multi Country Study

 

A Multicountry Study Using the World Health Survey.
disability-discrimination1

 

Ahmad R. Hosseinpoor, Alana Officer, Emese Verdes, Nenad Kostanjsek, and Somnath Chatterji are with the World Health Organization, Geneva,Switzerland. Jennifer A. Stewart Williams is with the University of NewcastleNewcastle, New South Wales, Australia. Jeny Gautam is with Dianella Community Health, Melbourne, Victoria, Australia. Aleksandra Posarac is with the World Bank, Washington, DC.

 

“……We compared national prevalence and wealth-related inequality in disability across a large number of countries from all income groups.

Methods. Data on 218737 respondents participating in the World Health Survey 2002–2004 were analyzed.
A composite disability score (0–100) identified respondents who experienced significant disability in physical, mental, and social functioning irrespective of their underlying health condition. Disabled persons had disability composite scores above 40. Wealth was evaluated using an index of economic status in households based on ownership of selected assets. Socioeconomic inequalities were measured using the slope index of inequality and the relative index of inequality.

Results.
Median age-standardized disability prevalence was higher in the low- and lower middle-income countries. In all the study countries, disability was more prevalent in the poorest than in the richest wealth quintiles. Pro-rich inequality was statistically significant in 43 of 49 countries, with disability prevalence higher among populations with lower wealth. Median relative inequality was higher in the high- and upper middle-income countries.

Conclusions.
Integrating equity components into the monitoring of disability trends would help ensure that interventions reach and benefit populations with greatest need. …”

DOWNLOAD FULL STUDY HERE

(Am J Public Health. Published online ahead of print May 16, 2013: e1–e9. doi:10.2105/AJPH.2012.301115)

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World Health Statistics 2013 show narrowing healthgap

 


World Health Organization – May 2013

Available online at: http://bit.ly/12uJNUs

“….15 May 2013 – The world has made dramatic progress in improving health in the poorest countries and narrowing the gaps between countries with the best and worst health status in the past two decades, according to the World Health Statistics 2013. “Intensive efforts to achieve the Millennium Development Goals have clearly improved health for people all over the world,” says Dr Margaret Chan, Director-General of WHO.


World Health Statistics 2013 contains WHO’s annual compilation of health-related data for its 194 Member States, and includes a summary of the progress made towards achieving the health-related Millennium Development Goals (MDGs) and associated targets.

This year, it also includes highlight summaries on current trends in official development assistance (ODA) for health.

Progress on the health – Available in 3 languages English French Spanish

DOWNLOAD THE REPORT IN ENGLISH, BY SECTION

 

Table of contents and introduction

Part I. Health-related Millennium Development Goals

Part II. Highlighted topics

Part III. Global health indicators

Annex 1: Regional and income groupings


THE INDICATOR COMPENDIUM

World Health Statistics 2013 – Indicator compendium

 

 

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#India – Unhealthy Health Governance

EPW Vol – XLVIII No. 20, May 18, 2013 | Ravi Duggal
Global Health Governance by Jeremy Youde (Cambridge, UK: Polity Press), 2012; pp 176, $26.95 (paperback).

Ravi Duggal ([email protected]) is an independent health researcher and is associated with the International Budget Partnership and the People’s Health Movement.

Good governance has in recent times emerged as the new mantra to address the failures of public systems. Especially so, in the arena of public health where there is a clear divide between the front line providers of healthcare who face the public and the bureaucracy that makes the decisions. There is growing literature both at the country level1and globally2 on the criticality of governance in delivering efficient and good quality services. Jeremy Youde’s book is an addition to this literature focusing on global governance in health.

Global Issues

Governance implies the exercise of political and administrative authority and within countries this is derived from the sovereignty of the nation state. At the global level such sovereignty is absent and this poses a major challenge to address inter-country or global issues. In the health arena there are numerous global challenges and the difficulties in meeting them hinge on governance failure.

In a recent article in the New England Journal of MedicineFrenk and Moon have identified three global health challenges that are difficult to realise because of governance failure – the unfinished agenda of infections, undernutrition and reproductive health problems; rising global burden of non-communicable diseases and associated risk factors like smoking and obesity; and the challenges arising out of globalisation itself such as health effects of climate change and trade policies.3 Youde’s book deals precisely with these issues and how global mechanisms for dealing with this have been coping.

An Overview

Global Health Governance by Youde begins with an overview of the historical evolution of international health governance efforts and then moves to discuss how some of the key actors like the World Health Organisation (WHO), World Bank, Global Fund, Gates Foundation, Treatment Action Campaign, among others have played their roles to reign in various global health challenges, and finally, discusses some key issues like infectious disease surveillance, health security and access to pharmaceutical as examples of the struggle to address global health governance challenges.

While the book does justice to documenting the evolution of global health governance and some of the key events which shaped its form, functioning and influence, it fails to adequately capture the political-economy context under which such governance efforts developed or rather failed to sustain. Historically WHO (emerging from its precursor the Health Organisation of the League of Nations) was mandated by nation states to engage with global health governance issues with a clearly defined constitution to direct it, but the character of the global political economy prevented it from achieving its goals. The profit-first nature of global capitalism, exemplified by the global pharmaceutical industry, and the cold war did not permit WHO to exercise its authority in right earnest. Due to these political-economy factors the evolution of global health governance assumed a direction in which a fragmented and selective approach developed leading to the spawning of a number of other players like the Global Fund and UNAIDS – the United Nations Programme on HIV/AIDS – on one hand, and private players like the Bill & Melinda Gates Foundation and the Clinton Foundation on the other.

Youde recognises the problems of these developments, but does not attribute the failure of WHO to these developments. Rather, Youde mentions that the failure of WHO was responsible for emergence of these mechanisms. This may appear to be true when we view it from the evolutionary perspective, but if we recognise the political economy context, then the story is very different. Let me summarise Youde’s trajectory of arguments.

Evolutionary History

Youde begins with identifying four key attributes of effective global health governance – it must focus on factors that cross and ignore geographical boundaries, it must employ multisectoral and multidisciplinary approaches to craft effective interventions, it should give voice to a wide range of actors and it needs to rely on transparent and accountable systems. No disagreement with this. But for governance to be effective two other factors are critical. First an adequate budget to deal with its mandate, and second a political backing to make it work. Later in the book Youde does identify these factors while discussing why WHO failed, but if Youde had recognised these upfront, then the trajectory of arguments could have developed differently.

The evolutionary history of global health governance is very well-documented by Youde from the international sanitary conferences of 19th century to the role of the Rockefeller Foundation post-first world war and right through to today. But there is one factual issue that needs to be addressed. There seems to be an assumption that the cross-border spread of disease was an east to west phenomena. While many diseases emerged in Asia and Africa, the west also contributed through syphilis, typhus, tuberculosis, etc, which spread to the east through trade.

The earliest response to contain epidemics was quarantine and this was done on country borders and entry points, but traders did not like it as it affected movement of goods, and consequently, their profits. Soon international conventions emerged like the International Sanitary Bureau in Americas, International Office of Public Hygiene in Europe and ultimately culminating into the Health Organisation of the League of Nations and post-second world war, WHO.

Key Players of Global Health

In the next section Youde discusses the key players like WHO, World Bank, Global Fund and a few non-state actors who are presently part of the global health governance mechanism. Again each organisation that Youde discusses is done quite thoroughly and here Youde does factor in the influence of the political economy context, especially in the discussion of the WHO. Youde tells us that over time WHO does evolve into a strong organisation and the Alma Ata Declaration forms a key watershed of its strength as a global organisation addressing global health challenges as well as supporting public health issues within countries, especially the developing world. It reaches its peak under the leadership of Halfdan Mahler with Health for All as the epitome of its success – what Youde calls the activist orientation phase of WHO which promoted health equity.

This phase of WHO demonstrated that global health governance is feasible – there was a political leadership under Mahler and its finances were quite robust. Youde acknowledges this but does not go far enough to say that this in itself posed a threat to global capitalism which in the health sector operates primarily through the pharmaceutical industry. After Mahler, the next director general of WHO, Hiroshi Nakajima, was indeed, a pharmaceutical man (who had earlier worked for Roche in Japan), who changed the trajectory of WHO setting it on a path of destruction. This changed political economy destroyed WHO and opened up the arena for new players in the global health governance arena led by the World Bank.

WHO under Nakajima

The fact that the World Bank entered the scenario, not only undermined WHO, which under the two terms of Nakajima’s leadership (incidentally Nakajima died recently on 26 January 2013 and the world over obituaries focused on how under his leadership WHO became fragmented and deteriorated as an organisation) was considerably weakened through under-financing of the core budget – a clear shift of resources of WHO from the dominance of its regular budget that member countries contribute to a dominance of programme – and project-based budgets that donors contribute and then dictate the agenda.

Youde has captured this quite well. This budget shift also began the process of fragmentation of WHO’s strategy into dealing with global health challenges as vertical programmes. The latter was already happening with public health programmes across most developing countries and this clearly moved the agenda from Health for All, a universal access approach, to a selective and fragmented approach to deal vertically with specific diseases and health issues like polio, malaria, immunisation, tobacco control, and later HIV/AIDS and reproductive and child health (RCH). This shift has been largely under the leadership of the World Bank,4 Global Fund and various private players like Gates, Ford and Clinton Foundations, among others, as also various bilaterals like the United States Agency for International Development (USAID) and Department for International Development (DFID).

Fragmenting Global Health

Youde has again documented very well the roles of the World Bank, UNAIDS, the Global Fund and the Clinton and Gates Foundations in supporting this new trajectory in global health governance where the control shifted from nation state controlled-WHO to these other so-called “non-political” players. It is precisely the change in politics of health that changed the lead players in global health governance and Youde acknowledges this by quoting Nuruzzaman5 – the World Bank’s strategy as a change from understanding health as a fundamental right to a conception of health as a private market-based good. This, in turn, changed the political economy of global health governance. User fees, public-private partnerships, privatisation, outsourcing, health insurance, etc, are some of the strategic changes that the structural adjustment policies of the World Bank brought to global health governance. WHO, unfortunately now follows this along with most other key players in global health, and primarily because WHO’s budget is predominated by donor contributions who call the shots.

Youde explains that UNAIDS actually emerged out of a conflict situation within the WHO, whose Global Program on AIDS (GPA) was headed by Jonathan Mann, who was a great fundraiser and helped raise the profile of HIV/AIDS globally that attracted huge funding and this created strong jealousies and disagreements with the leadership of WHO under Nakajima forcing Mann to quit, and subsequently, the GPA was transformed into an independent agency of the United Nations (UN) christened as UNAIDS under the leadership of Mann’s assistant Peter Piot. Since UNAIDS focused on providing technical and informational support, another agency to play the funding support role called the Global Fund to Fight AIDS, tuberculosis and malaria was created. This maintained the continuum of fragmenting global health governance and reducing the importance and strength of the WHO.

Youde describes all this very illustratively. One question comes to mind when reading Youde’s discussion of these institutions: What was the underlying reason of setting up these institutions and moving it out of WHO’s control? Was it the new patents regime and the need to facilitate pharmaceutical industry’s profit-making by keeping the control of governance of global health outside the nation state-controlled WHO? And a related question – despite having strong oversight mechanisms in the Global Fund, why has there never been an audit of pharmaceutical purchases by the Global Fund?

The private actors discussed by Youde, Gates and Clinton Foundations, basically fell in line with the World Bank strategy and supported the need to raise substantially the involvement of non-state actors in global health governance. Both these institutions also helped raise further the HIV/AIDS profile globally with more resources being committed to it and also advocated for a more market-oriented approach, for instance, in the procurement of antiretroviral (ARV) medicines. In reality what they were doing is trying to address market failures in health so that the larger health system can be made more market-oriented.

Conclusions

The chapter on civil society organisations (CSOs) focuses on the role that CSOs have played in global health, primarily representing the interests of the common people, as Youde puts it – as voices for the voiceless. Youde illustrates this with the examples of OXFAM International and the Treatment Action Campaign from South Africa.

In the last section Youde goes back to the key issues around which he has built his discussion on global health governance – surveillance of infectious diseases, framing health security and access to pharmaceuticals, mainly ARVs. The first two issues revolve around global regulation of communicable diseases and the response of the international community and how the global health governance mechanisms discussed above have at best been able to engage in firefighting. In the case of access to pharmaceuticals, the access to ARV campaign is viewed as one that could possibly lay the basis for a larger campaign for access to free medicines – regarding medicines and public goods. The Twelfth Five-Year Plan in India, based on the experiences of Tamil Nadu and Rajasthan, is promising access to free medicines in all public health institutions. Will this become a stepping stone towards universal access to healthcare and take us back to the Health for All intiative?

Youde concludes by saying that global health governance has evolved from being a technical issue addressing mechanism until the 1970s to a more rights- and equity-based phase during the 1970s and 1980s, when WHO was in control and since then has entered its neo-liberal phase under the tutelage of the World Bank and various non-state actors, though in recent years, there is a clear effort with pressure from civil society to bring back the Health for All agenda under universal access to healthcare. But this would cost money, conservatively at least 5% of gross domestic product (GDP). Is there the political will of the G-8 or G-20 or other G’s to muster these resources by putting the burden on capitalism by imposing the Tobin tax or financial transaction tax, for instance, which can rein in huge resources in this era of finance capital, and of course, we do not want to forget the old Rio commitment of developed nations to contribute their 0.72% GDP for the global development agenda. The shaping of the post-2015 development agenda goals needs to emphasise this very strongly.

To conclude, Youde’s book is a very good documentation of how global health governance has evolved in the last 150 years or so but it is limited in its conclusions because Youde opted to use the lens of communicable diseases. Today, as Youde acknowledges in his conclusions, non-communicable diseases are much larger global health challenges, but governance issues for these would be very different from what he has discussed in the present book. To deal with these we will have to steep much deeper into issues governing global political economy.

Notes

1 Kumar (2005) 38-53 also see website http: //indiagovernance.gov. in Rao (2013).

2 See for example: Demmers et al (2004); see alsohttp://www.ohchr.org/EN/Issues/Development/GoodGovernance/Pages/Good-Gov… accessed 25 March 2013.

3 Julio Frenk and Suerie Moon, “Governance Challenges in Global Health”, NEJM, 368: 10, 7  March 2013, pp 936-42.

4 See the 1993 World Development Report – Investing in Health, OUP, New York, which became the Bible of this new approach to healthcare.

5 Quoted by Youde from Nuruzzaman, Mohammad (2007).

References

Demmers, Jolle, Alex E Fernández Jilberto and Barbara Hogenboom, ed. (2004): Good Governance in the Era of Global Neoliberalism: Conflict and Depolitisation in Latin AmericaEastern Europe, Asia and Africa (London: Routledge).

Frenk, Julio and Suerie Moon (2013): “Governance Challenges in Global Health”, The NewEngland Journal of Medicine(NEJM), 368: 10, 7 March, pp 936-42.

Kumar, G Narendra (2005): “An Institutional Framework for Good Governance in India”, ASCI, Journal of Management,34(1&2), Administrative Staff College of India, Hyderabad, available at http://journal.asci.org.in/Vol 34 (2005)/04.% 20G N.%20Kumar.pdf accessed on 25 March 2013.

Nuruzzaman, Mohammad (2007): “The World Bank, Health Policy Reforms and the Poor”, Journal of Contemporary Asia, 37(1), pp 59-72.

Rao, N Bhaskara Rao (2013): Good Governance – Delivering Corruption-free Public Services, (New Delhi: Sage).

 

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#India- Sex Education is Effective for Unschooled Teens

By Swapna Majumdar

WeNews correspondent

Tuesday, April 2, 2013

And that can be life-saving in a place such as Gujarat, India, where 40 percent of brides are under 20 and anemia is a major threat. A three-year awareness campaign shows how much can be changed by education and information.

Indian girl with hands behind her back

 

Credit: Kara Newhouse on Flickr, under Creative Commons (CC BY-NC-SA 2.0).

NEW DELHI (WOMENSENEWS)–When Nandi Jhala got married eight years ago at the age of 11 she didn’t know the man she married.

She’d left her village school in the western part of Gujarat state at 8, after a couple of years of schooling, and understood nothing about pregnancy or reproductive and sexual health.

All she knew was that, like her elder sister, she would soon have to produce children.

So far, though, she’s defied the odds. She has no children yet.

“I am only 19 and I know I should not have children until my body is capable of childbearing,” Jhala toldWomen’s eNews. “Also, I want to plan my family, unlike my older sister who already has three children. I have conveyed this to my husband.”

Jhala added that she has also started looking after her health. “I know now how to maintain menstrual hygiene,” she said.

That information can be life-saving for a young woman such as Jhala, who lives in the Indian state of Gujarat, where about 40 percent of brides are under the age of 20.

Six thousand adolescent mothers die each year in India, according to the latest National Family Health Survey (2005-06). At present, the maternal mortality rate in India is 212 per 100,000 live births, whereas the country’s target is to reduce it to 109 per 100,000 live births by 2015.

Jhala has benefited from a government program called Mamta Taruni (Adolescent Girls), which is run by the state government in conjunction with the Center for Health Education Training and Awareness, an advocacy group based in Gujarat.

The program provides information and services on reproductive and sexual health and nutrition to out-of-school female adolescents between 10 and 19 years old.

Three-Year Trial

The center was asked to implement its “sustained awareness” program in 53 villages with a high number of out-of-school young women in a district of Gujarat. The program ran for three years, between 2009 and 2012.

Jhala’s village was among those selected and now she belongs to a group of out-of-school female adolescents trained as peer educators by the center. The peer educators share information about nutrition and reproductive and sexual health to other out-of-school young women to help combat the challenges of early marriage, early pregnancy, diseases related to risky behavior and sexual exploitation.

When the center carried out a study to measure the impact of their intervention on 256 young women, they found that the percentage of out-of-school female adolescents who were aware of HIV-AIDS, condoms and the importance of nutrition almost doubled after they were linked to related information and services.

The center, which released its study in New Delhi last month, found that knowledge of anemia rose to almost 100 percent among the young women surveyed, from 73 percent three years earlier.

This is significant, as over 56 percent of female adolescents in India are anemic, according to the government’s most recent survey. The World Health Organization says the disorder–which remains the biggest indirect cause of maternal mortality– weakens the blood’s ability to clot, increasing the risk of postpartum hemorrhage.

The center’s study also found that respondents’ awareness of reproductive tract infections and the importance of using condoms all rose significantly. Participants in the survey were also seeking medical care more frequently.

“Health challenges can be overcome if adolescents are able to access information and services,” said Pallavi Patel, director-in-charge of the Center for Health Education Training and Awareness.

Swapna Majumdar is based in New Delhi and writes on gender, development and politics.

 

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What is it like to have undergone female genital mutilation ? #Vaw #FGM #Womenrights

image by iranian artist activist Parastou Forouhar

image by iranian artist activist Parastou Forouhar

Out in the open

What is it like to have undergone female genital mutilation, asks NID student’s film

Jyoti Punwani mirrorfeedback@timesgroup.com

 

When a 24-year-old student of film and video communication at the National Institute of Design (NID) in Ahmedabad received a special mention at the 60th National Film Awards, it was for showing nerve.
Although devoid of sting operations and hidden cameras, Priya Goswami’s 27-minute documentary goes where no one has. In A Pinch of Skin, the young filmmaker gets a string of women to openly share the horror of female genital mutilation (FGM), a practice so secretive, often brothers aren’t aware their sisters have undergone it. The one-million strong community of Dawoodi Bohras, a sect of Ismaili Shias concentrated in trade-focused centres of Maharashtra and Gujarat, carry out the practice citing ‘faith’ as reason, although Islamic scholars say Islam doesn’t sanction it.
The World Health Organisation defines FGM as all procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organ for nonmedical reasons. The procedure, according to the WHO website, holds no health benefits for women, and consequences can range from severe bleeding and infection to complications in childbirth. About 140 million girls and women worldwide livewith the consequences of FGM.
Unlike male circumcision, khatna as FGM is called locally, is carried out in secrecy by senior women of the community using blades without medical supervision on seven-year-olds, who the film says are “old enough to remember”. The logic is this: as adults, the girls will practice the ceremony on their children, and since they are pre-adolescent at seven, they are unlikely to suffer severe physiological damage.
That Goswami managed to get the women to talk — albeit without revealing their identity — despite being an outsider, is remarkable. It’s also reflected in the approach she chooses; the community becomes irrelevant. It’s the practice and belief she chooses to focus on, as is evident from her statement at the start of the film: For this film, I have no religion nor am I born into any community. All I know is that I am just a woman and that is my only identity.’
Goswami’s interviewees tell her the aim of khatna is simple —to curb “the urge” in women. Satisfied with their husbands, the women are unlikely to seek pleasure outside the marriage.
A young interviewee admits to Goswami that unlike her friends, she isn’t terribly attracted to men. Another articulate woman, angry that a part of her body was removed without explanation or permission, remains silent when asked if circumcision is aimed at denying women orgasm. “Ask the priests,’’ she finally says.
Intercourse is painful, a third admits. “I guess it is so for all women.”
And so, Goswami succeeds in starting a conversation on the practice within the community. She says it amazed her that women themselves justify the practice and have made peace with it. The term used for the clitoris by the women — “haraami boti’’ — reveals a deep-seated revulsion towards their own anatomy and sexuality. This is hardly community-specific, Goswami observes. “Don’t our grandmothers say, women are the root of all trouble?” she asks. “Don’t we banish young widows to Brindavan?”
Although the filmmaker interviewed men, she chose to leave them out of the film. “I wished to depict the practice as one done on women by women, although instituted by patriarchy.’’
Goswami’s film includes strong voices of dissent, although they are outnumbered. A mother who decided to skip the tradition when it came to her own daughters admits she kept her act of defiance a secret. If the film encourages more women to speak out, Goswami says her efforts will be worth it.
The film will be screened at the Al Jazeera International Documentary Festival in April.

In a still from the film, the interviewee masks her identity while talking about her experience of female genital mutilation

 

 

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Mumbai- Sick treating the sick at Sewri’s TB hospital #healthcare

Probable tuberculosis

 

 

Published: Sunday, Mar 24, 2013,
By Maitri Porecha | Place: Mumbai | Agency: DNA

 

 

After nearly twenty-five years of selfless service at Asia’s largest tuberculosis hospital situated in the heart of Mumbai, Barkhu Pandurang Kharat (53) was perhaps destined to die of tuberculosis (TB). Kharat’s death in January this year raised the number of employees to have died after contracting tuberculosis, at BMC-run Sewri TB Hospital to 42.

“In 2008, my husband started working in the mortuary at the hospital, transporting infected dead bodies from wards to morgue and back. The hospital alone sees close to 150 deaths every month. In 2008, he was first diagnosed with TB. He was hospitalised multiple times as he transgressed to multi drug resistant TB (MDR-TB) and later extensively drug resistant TB. His condition worsened by the start of this year and he succumbed on January 30,” said his widow Sunita Kharat.

Kharat is not the only one. Since 2005, more than 70 workers in Sewri TB Hospital have contracted the infection, 42 among them died. Official figures obtained from the hospital state that two employees in their twenties contracted TB within six months of joining service.

Even though the hospital is quoting conservative estimates, unofficial figures of infected employees roll much higher, say sources. BMC has made tall promises to manage TB on a war footing in its 2013-14 strategy on the World Tuberculosis Day but the civic body would do well to introspect on the appalling conditions prevailing in its own backyard. “Of 12 MDR-TB cases amongst the hospital employees, most of them are relapse cases. In case of these patients, tuberculosis has gripped them as many as three times over the past ten to twelve years. After a brief period of treatment, they resume work in the same wards which makes them all the more vulnerable to contracting TB repeatedly,” said a senior labour union member, Sewri TB Hospital.

What’s worse is that even as a large number of employees including doctors and nurses contract tuberculosis rapidly in the hospital, they are not taken care of in the hospital. A disheartening case in point is the treatment meted out by BMC officials to 38-year-old Balaji Amjuri, a permanent employee of the hospital and a TB patient for the past 12 years.

Amjuri is an extensively drug resistant (XDR-TB) patient. Such patients are advised complete rest but Amjuri is compelled to do his daily duties including sweeping, disposing garbage, washing infection-laden clothes from the ward, all because he has exhausted his three-years’ worth of sick leave. “The head clerk instructed me that I will not be entitled to any more leave.

Inspite of being an XDR-TB patient I am compelled to work. I have spent more than Rs3 lakhs for my treatment. I have to continue working to support my family,” said Amjuri. “BMC rules for availing leave are the same for all employees. However, we may sanction special leave inAmjuri’s case,” said Dr Rajendra Nanavare, medical superintendent at the hospital.

A measly diet and a defunct operation theatre to perform TB surgeries only add to the woes of the employees and patients at the hospital. In 2012, BMC had assured that the high protein breakfast to be provided to its 1,000-odd employees including doctors and nurses will be adequate and palatable. Workers complain that the diet has fallen short on both these grounds.

“The diet chart clearly mentioned that two eggs and 150ml milk is to be provided. We don’t get more than 50ml of milk and one boiled egg. This is grossly inadequate,” said an employee requesting anonymity.

Doctors have not performed a single surgery since the past two months for the lack of surgical equipments. “The anaesthesia machine is not in place for performing surgeries. The OT is temporarily shut,” added the medical officer.

Doctors say that the high rate of deaths in the hospital occur as early diagnosis of tuberculosis is not possible. “Samples for culture tests or Line Probe Assay (LPA) which confirm if the patient has MDR-TB are still outsourced to JJ or Hinduja Hospital. Basic infrastructure is not in place. It takes up to a month for results to arrive,” said a seniormedical officer at Sewri TB Hospital.

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WHO downplays the health impacts of Fukushima nuclear disaster, a ‘PR Spin’

Published on Thursday, February 28, 2013 by Common Dreams

Greenpeace says report ‘shockingly downplays’ increased cancer risk for thousands of Japanese

– Jon Queally, staff writer

A new study released by the World Health Organization says that women, and especially female infants, exposed to radiation released following the Fukushima nuclear disaster in Japan are at a significant risk of developing cancer later in life.

 A child is screened for radiation contamination before entering an evacuation center in Fukushima, Japan, Friday 1 April 2011. (Photograph: Wally Santana/AP) Despite those announcements by the WHO, critics of the new report say that overall the organization has done a great disservice by downplaying the overall dangers posed by the leaked radiation and accused the report of hiding “crucial information” about the ongoing dangers faced by those living in and beyond the Fukushima Prefecture.

“The WHO report shamelessly downplays the impact of early radioactive releases from the Fukushima disaster on people inside the 20 km evacuation zone who were not able to leave the area quickly,” said Dr. Rianne Teule, Greenpeace International nuclear radiation expert.

“The WHO should have estimated the radiation exposure of these people to give a more accurate picture of the potential long-term impacts of Fukushima. The WHO report is clearly a political statement to protect the nuclear industry and not a scientific one with people’s health in mind.”

Specifically focused on the threat to girls and women, Reuters reports on the WHO findings by explaining:

In the most contaminated area, the WHO estimated that there was a 70% higher risk of females exposed as infants developing thyroid cancer over their lifetime. The thyroid is the most exposed organ as radioactive iodine concentrates there and children are deemed especially vulnerable.

Overall, however, it was the WHO’s conclusion that “predicted risks” of cancer for Japanese generally “are low and no observable increases in cancer rates above baseline rates are anticipated,” that Greenpeace aggressively pushed back against.

Pointing out that the WHO only releases its radiation assessments only with the approval of the International Atomic Energy Agency—often criticized as an advocate for, not a regulator of, the global nuclear industry—Greenpeace says the entire report should be looked on suspiciously as more “public relations spin” than good science.

According to Greenpeace scientists, the WHO “shockingly downplays” the cancer impacts on the population by emphasizing small percentages increases in cancers, but fails to adequately describe how those seemingly small numbers translate into the risks posed ot many thousands of people.

“The WHO’s flawed report leaves its job half done,” said Teule. “The WHO and other organizations must stop downplaying and hiding the impact of the Fukushima disaster and call for more emphasis on protecting the millions of people still living in contaminated areas.”

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