Clean water is a prerequisite for good health

According to World Water day webpage, there are more than 1 billion people in the world living without access to safe drinking water. 2.6 billion people also lack access to sanitation. Many infectious diseases are spreading through the polluted water. Unclean water, improper hygiene and the lack of sanitation causes diarrheal diseases and vector-related diseases like malaria or dengue. Diarrhoeal diseases alone are killing 1.8 million people every year, most of them are children under 5 years. Poisonous drinking water is a huge problem for example in Bangladesh where over 28 million people are consuming arsenic-containing drinking water. Most of the people living without proper drinking water live in sub-Saharan Africa or East and South Asia. Because of the fast urbanisation, many million people live in slums. They often don’t have safe drinking water or sanitation. The need to carry water from long distances leads to inequality when girls and women need to use most of they days to get water to their families ant therefore they don’t have time to go to study or work.

The complete lack of water is a big problem for many people. Four of every ten people is already suffering from water scarity. Because of the population growth, the amount of people with not enough water is increasing all the time.

Solutions

All the environmental problems are very difficult to understand and they are linked together. We cannot find solution to water problems, if at the same time we don’t fight against population growth, which causes water shortage in many areas, climate change that makes droughts and rainy season worse in many places and so on. In many environmental problems it is the case of choice between clean environment and the possibility to keep one’s family alive and these cases lead to conflicts with environment in many countries. It has been said that many wars in the future can be caused by water shortage, because the areas that are already dry can be even drier in the future, because of the climate change. There is a paradox because at the same time in western countries we use almost 200 litres water per day and flush our toilets with clean water.

Pollution is a big problem in many developing countries, that have factories and industry near the lakes and rivers, but no strict environmental regulation that prevents factories for polluting the water. Often big, multinational firms are operating in developing countries because it is cheap for them and they don’t have any responsibilities because of the poor legislation. By improving the environmental legislation the pollution can prevented and often water purifies itself over time and the fishes and other animals returns. In Bangladesh the arsenic-poisoned water can be replaced with low arsenic water sources, if possible, or using removal systems that remove arsenic from the water.

Many solutions can improve the water situation in dry areas. Building at least one tap that brings clean water to slums can ease the hygiene situation and prevent many infectious diseases. This may also help in villages, where women and girls have to use most of they days carrying heavy water bottles from far away and the water in open water areas can be contaminated. In slums the most efficient way is to build a covered sewage so that all the waste water does not run straight to the river and thus keeps the water in river cleaner to use in other purposes. The sewage water can also be purified and thus used again in hand or laundry washing. When the water used in everyday life is not pure, there is also some simple ways to make it safer at home, like boiling, solar disinfection (standing water in the sun) or purifying it with cheap filters made for these kind of purposes. Also chemical tablets can be used to purify water.

People should harm the natural water cycle as less as possible. For example, building big dams can make harm for water and cause drought. For keeping the water cycle going it is vital to retain the natural vegetation. If all the trees are cut they don’t bond water anymore and also the moisture balance of the area will alter. In many countries the cultivation of wrong kind of plants that don’t naturally crow in that area causes the land to become dry and unfertile and thus makes it even harder to grow anything there. Many developing countries are growing products and exporting them abroad, such as coffee, cocoa or cotton. These kind of plants usually needs a lot of water to grow so the farmers are forced to use clean water in irrigation that would be needed more elsewhere.

What is needed in giving more people access to safe drinking water is multinational co-operation and education. Co-operation makes sure that there are right policies and programmes to ensure that water resources in the world are taken care of. Also the fight against the climate change that strongly affects to water situation has to happen in a global scale. Education in less developed countries is vital. People should learn the importance of hygiene and how to improve the quality of water at home. Also the engineering counselling can help people in poor countries when they are building water supplies. And one of the important things, of course, is the international financing. The poor countries cannot resolve the problem alone. They need co-operation and money for building sanitary systems and water tubes. For example in St. Petersburg the sewage water plant was built with the financial help from Finland.

References:

http://www.worldwaterday.org/

http://www.who.int/water_sanitation_health/2005advocguide/en/index.htm

http://www.who.int/features/factfiles/water/en/index.html

The global prevention of infectious diseases

There is a huge amount of people dying worldwide because of infectious diseases every year. Many of these deaths could be prevented by changing policies, informing people, giving hand-to-hand-help, delivering medicines and so on. I will now examine how can three of the biggest infectious diseases in the world, Malaria, Tuberculosis and HIV/AIDS, be prevented. What is common to all of these three diseases is that the highest infection rates are in developed countries and thus all these diseases are again linked with the poverty, bad hygiene and sanitation, bad quality drinking water and other diseases, such as anaemia.

Malaria is a preventable disease

Malaria can be transmitted to people in every age. Malaria is caused by parasites which are spreading via mosquitoes. If not treated properly, malaria can be fatal.

Most of the people suffering from malaria live in developing countries. They lack the information needed to understand how the virus can spread and they lack money to buy malaria-nets that are protecting them form mosquito bites. Especially important these nets would be for children and pregnant women, who are most vulnerable for having malaria. One in five of all the deaths of children in developing countries are caused by malaria. Malaria-nets can also protect communities, if at least 80 per cent of all the people in the village is protected by malaria-nets. Other effective way is residual spraying inside. In developing countries, for example DDT is used. But one should notice that there is many other harmful impacts in the use of DDT.

When it comes to treatment, early diagnosis is important so there should be at least one medical person in every village who can recognize the symptoms and help person suffering from malaria. There should also be access to further treatment, if necessary. In community-level there should be access to good quality malaria-medicines. In rich countries malaria is almost non-existent disease but they can help poor countries by insuring to medical firms, that if they succeed to create effective vaccination the wealthy countries are going to buy them to secure the production.

WHO has a Global Malaria Programme which makes research, monitoring and evaluation concerning malaria. They help to countries forming policies and strategies that prevent malaria. They also offer technical assistance and coordination for developing countries. The information that lies in develop countries can be transformed into poor countries with international programmes and through the work of NGO’s. The education is important in preventing malaria, and NGO volunteers can offer malaria-education in places, where the risk of malaria is big.

Tuberculosis and HIV/AIDS prevention in global level

In the world approximately two billion people are infected with TB bacilli. The globalization and increasing mobility of people, food and commodities helps it to spread more effectively. HIV is also one of the biggest reasons of death in less developed countries. Tuberculosis (TB) and HIV are linked, because HIV weakens the immune system. Approximately 200 000 people with HIV dies every year because of TB. By preventing HIV also the number of TB deaths can also be decreased.

When one looks for the information that there is about these diseases, it is obvious that we globally we have almost all the information needed. What is more important is the global will power to do something to really fight against these diseases. The goals (like Millennium Development Goals) need to be set to

Much money should be placed on developing the vaccines, improving the health care and access to it in poor countries and increasing the amount of education so that people becomes aware of all the ways how these infections are spreading. Also by decreasing poverty and poverty related problems these infections can be reduced, so it is important that rich countries support prevention programmes financially.

The increasing amount of the information about these diseases is essential when trying to prevent them globally. All the statistics, information about the prevention methods and so on can help to create more effective strategies and policies. Poor countries are often lacking the opportunity to collect the data or to research the diseases. The role is thus given to rich countries who therefore has also the responsibility to use the knowledge they have in educating poor people, developing new medicines and helping poor countries to change their policies.

World Health Organization (WHO) is an important actor in a worldwide work against TB and HIV. WHO can make strategies (like The Stop TB Strategy) and it has a power to make most of the countries part of those strategies, policies and international agreements. But also national policies must be changed and improved because the inequality, poverty and bad living conditions are often partly a result of bad policies and the lack of will power to change things. There is also other worldwide health organisations like The Communicable Disease Surveillance and Response Unit (CSR) which is strengthening the capacity to detect, identify and respond to international pandemic threats.

Education is a simple but effective way to prevent the spreading of TB and HIV. Teachers and volunteers can tell people about these diseases, deliver condoms, assist in many projects etc. To reach the population effectively, it is easier for big NGO’s to educate teachers in target countries and they can further educate local people.

References:

http://www.healthmatters.org.uk/issue41/globalsneezes

http://www.who.int/mediacentre/factsheets/fs094/en/index.html

http://www.who.int/malaria/

http://www.euro.who.int/surveillance

http://www.who.int/mediacentre/factsheets/fs104/en/index.html

http://www.who.int/features/factfiles/tb_facts/en/index.html

Maternal & child health

In Sub-Saharan Africa the chance for woman to die during pregnancy or delivery is 1 in 16. In highly developed countries, like Ireland, it is 1 in 48 000. The amount of women staying alive after the birth is a good indicator of how developed the country is. Few simple acts can make a big change in mother and child mortality. Investments to the education and to the access and quality of health care can reduce the complications during pregnancy and birth and thus more children have a chance to stay alive. Abortions and unsafe deliveries and pregnancies can also be prevented by a careful family planning and contraception.

Women have a key role

Women are responsible for their own health and the health of their child. If the mother dies the chances for children to stay alive are threatened. During the first months of child’s life the breastfeeding and care giving by mother is vital.

Every day 14 000 women are dying because of pregnancy or birth. There are five main reasons for mother mortality in developing countries. These are hemorrhage, infections, unsafe abortion, pre- eclampsia and obstructed labour. These five diseases are causing 70 per cent of all the deaths in the world. Most of them can be prevented but it requires the help of professional medical staff and good hygiene during the pregnancy and delivery. Antenatal care is also important. It can prevent several diseases and also gives vital information about the hygiene and delivery for mother. The problem is that many women do not have access to a proper health care  because of distances, money or cultural reasons. There should be at least one medically educated person in villages but even she/he cannot do lot if there is no equipments and medicines to help the woman if some problems occur.

A woman genital mutilation, which is a common habit in some countries, is dangerous and often done by a non-professional person. This can lead to an increased risk of birth complications and deaths of infants. Mutilation of women can only be reduced with education.

Often women are also suffering for many after-birth symptoms. These can be for example fever, infertility and depression. Women suffering from post-birth diseases are often rejected by their husbands or communities they live in.

If a mother dies it can often drive children to the circle of poverty, when they need to work to have money, girls need to stay home taking care of other sisters and they don’t have time to go to school.

Simple acts could prevent the deaths of children

There are several reasons for child mortality in developed countries. The most common reasons are deseases like pneumonia, diarrhoea, measles, malaria, malnutrition and HIV. Most of these could be easily prevented with a right medical care, for example giving antibiotics to infectious deceases or mixture of salt and zinc to a child suffering from diarrhoea. Pneumonia can be prevented by not burning wood in an open fire inside the house and by taking care of the proper nutrition. Malaria is easily reduced by buying nets which protect child from insects.

In many countries where there are armed conflicts many children die because of war or because of the side effects like diseases, malnutrition and bad hygiene caused by unstable living conditions and population displacement.

Malnutrition makes children more vulnerable to illness and early death. Ready-to-use foods can significally improve the health of children because they include all the nutrients and energy needed. It is important to notice that the maternal risk of complications often comes from the girlhood. If woman’s growth has been disturbed by chronic malnutrition, there is bigger risk that she will have obstructed labour. Suffering from anaemia can easily lead to haemorrhage or sepsis during delivery.

It is important to notice that almost 40 per cent of all under-five deaths occur during the first month of life. Over half of these are caused by severe infections which are caused mostly by pneumonia or sepsis. These can both be treated with antibiotics. The medical care of infants and young children is therefore a vital factor when fighting against child mortality.

Care of mother is vital to an infant

Especially during the first months, the care of mother is vital to child. Breastfeeding protects child from many deseases. The most important fact common in reducing mortality of both mother and child is a good health care which continues from antenatal care to postnatal. It has to include basic medical services, professional staff, good equipments and a possibility to do surgical operations. It is important to notice that factors leading to maternal death are also affecting to the survive of foetus or newborn babies. Approximately 8 million infant dies every year because of diseases or weakness of mother. So improving the maternity health could also prevent child mortality.

Education is a basic value when we try to improve the situation in many countries. When young girls are educated they have also other options in life and they are not so easily forced into marriages and making children before they are ready. Education also helps them to understand how the most common sexually transmitted diseases can be prevented and thus they can improve the health of their own and their future children. With education girls and women can also fight against genital mutilation, which leads often to birth deaths. Educated mothers know better why to breastfeed, how can they recognize a disease’s symptoms or why immunization is vital for them or the children. The high-quality medical education would also be important for the people living in developing countries, because there is often a lack of professional staff when the help is most needed. So it is equally important to educate children and adults.

Improving the hygiene and sanitation helps mothers and children to prevent infectious diseases and parasites. Also a good nutrition makes mothers and babies stronger and prevents weakness which can expose to illness. Purifying the drinking water, for example, we can prevent infectious diseases that kill 2 million children every year. At the same time it improves the healthiness of mothers. Money is also an important factor because it is shown that rich women and their children can gain better care and services than poor people living in rural area. So with money, NGO’s could help the poorest people living in the countryside.

Worldwide acts have already deducted the amount of child mortality but no progress has happened in Sub-Saharan Africa, where the conditions are the worst. The poorest people are the most challenging group to help, because they don’t have any prerequisites to improve the situation. Progress worldwide in reducing mortality has been under 1 per cent when the goal is 5,5 per cent.

References:

http://www.childinfo.org/statsbyarea.html

http://www.who.int/features/factfiles/en/

http://www.unicef.org/health/index_problem.html

Gender equality

I wrote 2 comments about the equality of genders to:

1) Loviisa: http://hanna-thoughtson.blogspot.com/

2) Justyna: http://viki-public-health.blogspot.com/

Education around the world

Education should be a basic human right. It gives individuals skills, values and knowledge that profit the whole society. In many countries, still, education is not self-evidence. There are several reasons for that:

1) Poverty

2) Gender equality

3) Long distances to school makes it impossible to go there

4)The lack of educated teachers and good learning materials

5) Bad health can inhibit many children to take part of studying

6) War and other conflicts can make it impossible to maintain a school network

7) Many countries don’t understand the necessity of studying and thus don’t support schools

If we look at the UNICEF’s table and examine, for example, Burkina Faso, which is one of the poorest countries in the world, we see that it has a very low literacy rate. The secondary school net enrolment ratio is only ca. 10 percent. That means that almost no one has a chance to go to secondary school. According to the World Bank, also HIV rates are high in Burkina Faso. Poverty and education are thus forming a circle when people don’t have skills to lift the country up from its poverty. When we add to this the corruption of the covernance and the ill health of the population, it is a long way  for country to recover.

In many countries only boys are allowed to study or they are treated better in schools. Literacy rate is higher in the world between men than between women, and in least developed countries the difference is 15 percent, as we can see from the table. As it is shown, the education of women is one of the best ways to refuse poverty, because it leads to the smaller amount of children. Educated women also can establish their own business and thus make some money to their selves and to their families. Many countries women are not allowed to be part of decision-making and governance but they can have their own meetings in villages, for example.

It seems that in least developed countries the amount of children attending to primary school from all the children in primary school age is a little bit lower than in developing countries. Poverty often leads to the situation where children have to work to gain some money for the family and thus they cannot attend to school. More educated population seems to make a country wealthier and when a country starts to put effort on education, it leads to development. But we need to ask if the development is always sustainable? Socially maybe, if everyone has a right to attend to school. But what about the environmetn? If the country starts to develop it also increases the consumption of raw materials and environment. But it is true that also poor countries are misusing environment by cutting trees, burning forests, polluting rivers and so on. So I think the most important question is, how we educate population? What is it that we want them to learn and how they use their knowledge?

It is shown in the table that although the amount of children attending primary school in many least developed countries is over 50 percent of all the children in primary school age, the number of children attending secondary school is remarkably lower, fewer than 50 percent. The figures are worst in Sub-Saharan Africa, where only ca. quarter of all the boys and girls are attending to secondary school. The important thing is not only the access to school but also that people are studying long enough to get all the skills needed. Poor countries, however, cannot offer higher education, because they don’t have money and they don’t have enough educated people who can teach in schools. So the only solution seems to be, that people from those countries educate themselves in universities abroad and then maybe return back to their home country. Only a few of them returns if there is nothing for them: no job opportunities, no possibilities for good life. So in many developing countries the problem is the brain drain. Many people from poor countries working abroad send some money to their relatives but that is not a very sustainable way to make a country healthier, because it makes a country dependent for external money.

NGO’s have a big role in educating people in developing countries. They can raise money, start village schools, make learning materials and organize learning tools like pen and paper to schools. Also the values of decision making are important. If the society highly appreciates education, it is ready to put money and effort into it. So it is important that in worldwide meetings and conversations the importance of education is one of the top priorities.

References:

http://web.worldbank.org/

http://www.unicef.org/girlseducation/index_1.php

http://www.unicef.org/sowc08/docs/sowc08_table_5.pdf

Poverty and health

Poverty goes hand in hand with health. If the health conditions are poor people cannot work or educate themselves. And if there is no chance to work, people become even poorer. Without education the society can never develop or have more power to chance the circumstances that keeps it poor. Poverty also makes many diseases more severe because the living conditions are poor. There is no food, sanitation or hygiene and no preventive measures like vaccination. That is why many diseases kills more people in development countries that it does in developed countries.

Stuctural violence

Sturctural violence means that structural circumstances of individuals, groups or societies are blocking them from reaching their full potential. Examples about these forms of “violence” are poor health care, the lack of education and political power and so on. These inequalities in society are mostly kept up by people who hold the power. They can be caused by policies, laws or just the lack of money. In the article it is mentioned, that often national healthcare authorities are the ones who are resisting new good ways of thinking or acting in health care. This can be because of corruption, for example. Structures around poor people in society make them powerless. They can’t change them because they are bounded into their everyday life, e.g. how to find food or water. In the society poverty is also one of the structural barriers that causes people a) to get ill more easily (because of the malnutrition, bad hygiene…) and b) difficulties to healthcare (because of the distances, money and bad infrastructure). So poverty and poor health are forming a circle where they are at the same time fault and result.

Structural interventions

By creating new ways to act in global and local level we can affect to these structural injustices. In the article there was an example about structural interventions where researches removed some barriers that prevented poor people from having a decent healthcare. When they were making several improvements to poor people possibilities to reach the health care (e.g. paying their transportation to health care or bringing health care into the community where poor people are living) the results were remarkable. They found out that many the social disparities disappeared among the study population. This was example about how to make structural interventions in a smaller scale.

But to really affect to these social injustices in society we need international co-operation and programmes and working with national legislation and policy. To prevent structural violence it is essential to change the legislation plus national social and health policies and this doesn’t happen without the pressure from international organizations. In Finland both, health and social policy are universal meaning that everyone living in here have equal chances to get good health care and services. That has improved the health condition of finnish people dramatically and made it possible for everyone to be part of health care no matter how poor they are.

Conclusion

It is said in the article that medical professionals are not trained to see and change the structural background of patients. And still the history of almost all the diseases lies in the social and environmental conditions. So when we talk about health it is important to take into account structural factors in society that makes poor people even poorer and worsen their ways to control their own life. Also to understand why poverty keeps growing, it’s essential to listen to poor people and their opinions. It was mentioned, that too often all the decisions considering poverty are made by rich people who have money and power. Can they really understand all the aspects of poverty?

References:

http://siteresources.worldbank.org/INTPAH/Resources/Publications/Dying-for-Change/dyifull2.pdf

http://model.pih.org/files/PLoS-Medicine_2006_Farmer-et-al.pdf

http://www.unmillenniumproject.org/documents/TheLancetHunger.pdf

Why does health has to be considered globally?

What is our ideal world like? There’s no poverty and no diseases. Environment is clean. People are free to live a kind of life they want to. Unfortunately there are many barriers in front of this picture and the poor health of the people is the major problem in many countries. Today’s world all problems are global and diseases are spreading fast from country to another without respecting the nation borders. Therefore we need global systems and a global way of thinking.

The term Global health is multidisciplinary and it has a lot of common with the term “Sustainable Development”. Proper health for all in a global level cannot be achieved if at the same time the environmental, economical and social questions are not taken into a consideration. Complex linkages between different areas of politics needs to be understood to be able to really improve health in a global scale. Improving health has to be seen as a question of security too. Threats are different than 30 years ago and infectious diseases like HIV, SARS are spreading faster because of the increased movement of the people between nations.

Cooperation

Important aspect in global health is that individuals, or today even nations, cannot work alone. They need organized systems, partners and governments, who can make common decisions to improve the state of global health. To put global health into a practise programs, partners and organizations (like WHO and Red-Cross) are needed. Governments cannot fight alone. Developed countries are important sources of knowledge and resources for less developed countries in health issues.

Many good health practises in development countries are invented in grass root level by different NGO’s. When health questions in less developed countries are tried to be solved, the grass root level is essential. People going from village to another, telling people about health questions, are equally important than all the “official” medical staff. In countries where most of the people cannot read or write, very simple methods can be used when educating people in health issues.

But to put these projects into practise, politics are needed. Politicians needs to integrate health policy into the other areas of politics. Also worldwide agreements have an important role.For example the major sources of greenhouse gases are western countries but poor countries are the one who will first suffer the effects of climate change. These kind of problems cannot be prevented without global cooperation. All the global health questions needs to be solved in global level. Also media and information technology has a big role. Media can spread good practises around the world.

Setting worldwide targets

The 8 Millennium Development Goals were set by United Nations Development Programme and they are to be achieved in 2015. At the moment it seems that many of those targets are hard to gain this fast. There are many good solutions invented to resolve these major problems. A huge amount of resources and common understanding between nations is still needed.

We also need a raise of global responsibility. Its easy to ignore problems that are happening in another part of the world. However, rich countries have a responsibility to answer to the agony of those that are facing poverty, nature catastrophes and other big problems. There is still a huge gap between rich and poor countries in the world when it comes to health issues. As long as this gap exists we need actions and programmes make things better. It’s a basic question of human rights.

References:

http://phigc.wikispaces.com/1.+Public+Health

http://en.wikipedia.org/wiki/Prevention_(medical)

http://www.unicef.org/sowc08/docs/Figure-1.9.pdf

http://www.paho.org/English/DPI/100/100feature20.htm

http://www.whatispublichealth.org/what/index.html

http://www.oppi.uku.fi/opk/video/kansanterveystiede/kauhanen200810.wmv