World Blood Donor Day 14th June

This year's the theme is “Blood Connects us all”.

WHO began celebrating World Blood Donor day in 2004 to 

1.  recognise and thank blood donors around the world
2. raise awareness on the need for safe blood and blood products 

June 14th was chosen as World Blood Donor Day to recognise birthday anniversary of Karl Landsteiner. 

Karl Landsteiner

Karl Landsteiner is an Austrian American biologist and physician who won the 1930 Nobel Prize in Physiology or Medicine for his discovery of human blood groups.   However this is not his only contribution to medicine, Karl Landsteiner working with Constantin Levaditi and Erwin Popper discovered the polio virus in 1909. His Nobel Prize award ceremony speech can be found here: here .

Interestingly, there are stark differences in who receives donations in different countries - 76% of all transfusions in high income countries go to those over 65 years whilst 65% of donations in low income countries are given to children under 5.

For high income countries blood transfusions are used for massive trauma, supportive care in cardiovascular and transplant surgeries and in the treatment of solid and haematological malignancies.   Pregnancy related complications, childhood malaria complicated by anaemia and trauma are the most common reasons for blood transfusions in low and middle income countries. 

As voluntary unpaid donors have the lowest prevalence of blood borne infections adequate and reliable supply of safe blood needs to be from a stable base of regular, voluntary unpaid blood donors.  Though 73 countries collect 90% of their blood from this source 72 countries still collect more than 50% of their supply from family/replacement or paid donors. 

Some other facts about blood donations

• Blood donation by 1% of the population can meet a nation’s most basic requirements for blood
• 62 countries collect 100% of their blood supply from voluntary unpaid blood donors
• Blood donation rates vary from 3.9 donations per 1000 population in low income countries to 36.8 donations in high income countries 

• 108 million blood donations are collected globally every year with only 50% from low and middle income countries where 80% of the population lives 
• Unfortunately there are still 25 countries who are not able to screen all donated blood for HIV, hepatitis B and C and syphilis prior to transfusions 
• Blood can be separated into various components to benefit several patients 

So on World Blood Donor Day please share life and give blood.

Disclaimer: The opinions expressed within this article are the personal opinions of the author. The facts and opinions appearing in the article do not reflect the views of AarogyaSeva and AarogyaSeva does not assume any responsibility or liability for the same.

To get in touch with the author or to join our team write to us at – Volunteer@aarogyaseva.org

Who is Sir Ronald Ross?

Did you know that the man behind the research on the transmission of malaria was born in India on May 13, 159 years ago?   He won the Nobel prize for Physiology or Medicine in 1902 for this work.

Sir Ronald Ross was born in Uttarakhand, India on May 13 1857.  Though he is actually British by nationality he spent a large part of his early career in the Indian Medical Service and it was in India that he did the majority of his malaria research. 

His breakthrough discovery was identifying how malaria is transmitted via mosquitoes specifically via malaria parasites which laid the foundation of the methods to fight the disease today. 

A link to his acceptance speech for the Nobel prize is here

Sir Ronald Ross has left quite legacy including: 

• World Mosquito Day (August 20) to commemorate the day that he made the breakthrough discovery
• The Sir Ronald Ross Institute of Parasitology Osmanai University Begumpet, Hyderabad is named in his honour.  
• There is a memorial at SSKM Hospital Kolkata to commemorate the discovery
• University Liverpool named their new Bio-Science facility Ronald Ross Building in 2010 in his honour
• The Ross Institute and Hospital for Tropical Diseases was opened in London in 1926 though has unfortunately since lost its separate identity due to financial issues/reorganisation/absorption by the London School of Hygiene and Tropical Medicine

So today on May 13 lets remember Indian born Sir Ross Ronald on his birthday for his pioneering work on malaria which done in India.

If you would like additional information about Malaria, please head to the blog I wrote a couple of weeks ago to celebrate World Malaria Day here.

You too can be be part of medical research- to get connect to opportunities, drop us a line.

Disclaimer: The opinions expressed within this article are the personal opinions of the author. The facts and opinions appearing in the article do not reflect the views of AarogyaSeva and AarogyaSeva does not assume any responsibility or liability for the same.

To get in touch with the author or to join our team write to us at – Volunteer@aarogyaseva.org

World Malaria Day 25th April

WHO estimated that in 2015 nearly 3.2 billion people or about half the world’s population were at risk of malaria across 97 countries and territories.  Though the majority of these cases and deaths occur in sub-Saharan Africa  those in Asia, Latin America and even the Middle East are at risk.

It is estimated that there were 214 million cases of malaria and 438,000 deaths.  It’s not all bad news though as since 2001 it is estimated that 6.2 million lives have been saved.  Furthermore between 2000 and 2015, malaria mortality rates among populations at risk has decreased by 60% with the incidence among populations at risk falling by 37% globally. 

So just what is Malaria?  It is a a preventable and curable disease caused by parasites spread through bites from infected female mosquitoes.  Those most vulnerable are young children, pregnant women and non-immune travellers from malaria free areas.

Symptoms 

Initial symptoms include fever, headache chills and vomiting which can make it hard to diagnose and recognise as malaria especially given symptoms usually occur 10-15 days after being bitten  In severe cases multi organ involvement is frequent.  For those who live in malaria endemic areas they may have developed partial immunity allowing asymptomatic infections to occur 

Treatment

As with most diseases, early diagnosis and treatment is the aim to reducing further spread and mortality.  Unfortunately like TB, resistance to antimalarials is one of the challenges to effective treatment. Fortunately at this time anti-malarial drug resistance is geographically isolated in the Greater Mekong Subregion (Cambodia, Laos, Myanmar, Thailand and Vietnam.  As such additional support is being provided to strengthen the prevention, diagnosis and treatment of malaria in this region. 

Source: WHO World Malaria Report 2015

Prevention

• WHO recommends the following vector controls: 

1. Insecticide Treated Mosquito Nets 
2. Indoor Residual Spraying 

• Use of antimalarial medicines for travellers, pregnant women and children living in malaria prone areas 

Clinical trials of the most malaria vaccine (RTS, S/AS01) is underway and shows promising results. The vaccine was developed as a partnership between GSK (GlaxoSmithKline Biologicals) and MVI (PATH Malaria Vaccine Initiative) with support of the Bill and Melinda Gates Foundation as well as network of African research centre.

RTS, S/AS01 works against the most deadly form of malaria which also happens to be the most prevalent in Africa.  It is being used alongside other more established preventative techniques given that additional trials and registration/testing is still underway. 

Research and development of other malaria vaccines is also underway though are not as far advanced nor show as much promise as RTS, S/AS01. 

It is noted that there are no licensed vaccines against malaria or any other human parasite. 

The World Health Assembly adopted an ambitious but achievable strategy in 2015 by 2030

• Reducing by at least 90% the rate of new malaria cases
• Reducing the death rates of malaria by 90% 
• Elimination of malaria in at least 35 countries
• Ensuring that malaria-free countries remain that way 

Unfortunately it is estimated that to reach these goals the spending for malaria treatment and prevention needs to triple over the next 15 years to US$8.7 billion by 2030. 

One can donate to help end Malaria: The Global Fund

Disclaimer: The opinions expressed within this article are the personal opinions of the author. The facts and opinions appearing in the article do not reflect the views of AarogyaSeva and AarogyaSeva does not assume any responsibility or liability for the same.

To get in touch with the author or to join our team write to us at – Volunteer@aarogyaseva.org

World Tuberculous Day 24th March

Did you know Tuberculous (TB) ranks alongside HIV as a leading killer worldwide? 

I noticed it was World Tuberculous Day this Thursday and did a little research on it and was surprised and shocked by the findings particularly as this is a completely preventable and curable disease.

Every day over 4,000 people are dying from TB which is horrendously unacceptable especially when it is a curable disease.   This includes 383 children a day. It is among top 5 causes of deaths for women between 15-44.

According to UN Global Tuberculous Report the worldwide incidence has fallen 1.5% per year since 2000 for a total reduction of 18% and still in 2014 1.5 million people died from TB.  In 2014 9.6 million people fell ill with TB.

Photo Credit: World Health Organisation Global Tuberculous Report 2015

Yet it is not all bad news, we have made much progress with the death rate 47% lower than it was in 1990 and an estimated 43 million people saved between 2000-2015.

54% of the world’s TB cases occurred in China, India, Indonesia, Nigeria and Pakistan though there is a significant gap in diagnosis of TB.

So just what is TB?  

It is a bacterial infection which most often affects the lungs spread through the air.  Scarily about 1/3 of the world’s population has latent TB which means that they have the disease but are not yet ill and cannot transmit the disease.  However there is a 10% risk of falling ill with TB which increases for those with compromised immune systems such as those who are HIV positive, are malnourished or use tobacco.

Without treatment 45% of HIV negative people and nearly all HIV positive people with TB will die.   In 2013 86% of people who were treated fro TB were cured. 

Photo Credit: World Health Organisation

Why is there a TB day? 

World TB Day is the opportunity to raise awareness about the burden of TB and also provide an update on the status of TB prevention and treatment. 

Included in the UN Sustainable Development Goals is the aim to reduce TB incidence by 80% and TB deaths by 90% as well as the burden of the disease on the family by 2030.

Photo Credit: World Health Organisation 

Challenges of TB

• symptoms of TB (cough with sputum and blood, chest pains, weakness, weight loss, ever and night sweats) can present mildly for several months which leads to treatment delays and continual spread of TB to the community
• The length of treatment is from 6 months to up to 2 years which do not come without side effects leading to low adherence rates
• Access to and cost of diagnosis and treatment hinders prevention and treatment
• The emergence of not only Multi Drug Resistance TB (MDR-TB) but also Extensively drug-resistant TB (XDR-TB) where both first and second line medicines fail to work

What can we do? 

• Enourage family and friends who have the symptoms of TB to see a Dr
• Support those on TB treatment to continue the entire course
• Donating to The Global Fund which will lead to additional research to improve access to and diagnosis and treatment of TB (as well as AIDS and Malaria). There is an estimated $1.3 Billion Dollar shortfall. Donate here
• Ensure children in India and other countries at risk are vaccinated against TB
• Listen to World TB Day 2016 To be continued 24 hour music event About World TB 2016 24 hour Music Event  Listen to the Event here

Photo Credit: WHO Global Tuberculous Report 2015

Disclaimer: The opinions expressed within this article are the personal opinions of the author. The facts and opinions appearing in the article do not reflect the views of AarogyaSeva and AarogyaSeva does not assume any responsibility or liability for the same.

To get in touch with the author or to join our team write to us at – Volunteer@aarogyaseva.org

Sanitary Napkins and Feminine Hygiene

Seeing the sanitary napkins women empowerment project whilst as part of 2016 Medical Yatra made me want to look into this topic a bit more.

For someone from a developed country we do not think much with regards to this area of female hygiene nor do we generally have any issues with access to sanitary napkins or tampons. Yet many women around the world still use scraps of dirty cloths which they cannot clean or sanitise properly.  Alarmingly I read that up to 70% of all reproductive diseases in India are caused by poor menstrual hygiene.

For so many women around the world menstruation is still a taboo subject with many restrictions placed on the women particularly around isolation as they are considered unclean.  Yet I can see why the commercially available products are not used openly and freely as women especially in rural villages have trouble to access, afford and dispose of them properly.  Further to this there is still much lacking on education on menstruation and female hygiene.

Fortunately there are several different projects currently in place using different approaches to address this issue including the use of cloths and menstrual cups.

This is the first time I’ve come across menstrual cups like SheCup or Ruby Cup. Both use a medical grade silicon cup which is inserted in the vagina like a tampon. The benefits of these are that they are much cheaper and better for the environment than commercially available sanitary napkins.   

Another project/initiative is Goonj’s Not Just a Piece of Cloth (NJPC) which was established in 2005 and has expanded globally.  They use old/discarded cloth to create reusable sanitary napkins and use this as platform to engage and educate about female hygiene whilst also providing job opportunities.  

The basis of the project that I saw at the Gram Seva Trust Hospital is related to the work Arunachalam Muruganantham and his company Jayaashree Industries.  What is particularly inspiring about Arunachalam is that he did not finish high school and that what began as a way to impress his new bride has evolved to something so much more which included him testing sanitary pads himself with the use of animal blood. I highly recommend watching Arunachalam TED talk from 2012. A documentary called 'Menstrual Man' has been created about him and his work.

What I love about the project I saw is that it is run by women for the women giving them a much needed low cost solution and income. Furthermore the pads are biodegradable reducing our impact on the environment particularly given that waste disposal is another burden particularly in rural areas.

As with all things I believe that a variety of different solutions are needed to address this issue as there is never a one size fits all to any problem.

I’d like to leave you all with an amusing advertisement we have in Australia which shows the marked difference between the countries views on the topic. https://www.youtube.com/watch?v=rg2-ZzSBl5s

Links on that mentioned above can be found below.

• RubyCup www.ruby-cup.com
• SheCup www.shecup.com
• Goonj NJPC http://njpc.goonj.org/
• Arunachalam's TED talk https://www.ted.com/talks/arunachalam_muruganantham_how_i_started_a_sanitary_napkin_revolution?language=en
• 'Menstrual Man" Documentary http://www.menstrualman.com/  
• Arunachalam's company Jayaashree Industries http://newinventions.in/

Disclaimer: The opinions expressed within this article are the personal opinions of the author. The facts and opinions appearing in the article do not reflect the views of AarogyaSeva and AarogyaSeva does not assume any responsibility or liability for the same.

To get in touch with the author or to join our team write to us at – Volunteer@aarogyaseva.org

2016 AIPNO Medical Yatra

 

As was previously noted, Aarogyaseva was again part of 2016 Medical Yatra in Gujarat which ran from 23rd January to 30th January in connection with the following organisations

• Association of Indian Physicians of Northern Ohio (AIPNO)
• Action Research in Community Health (ARCH)
• Rotary Club of Dharampur 
• Shabri Chhatralaya
• Intal

It brought 37 both medical professionals and general volunteers from USA, UK, India and Australia in conjunction with local health workers, Rotarians and ARCH workers.  We had with us a mix of internal/family doctors, emergency physicians, paediatricians, obstetrics/gynaecologists, dentists and an orthopaedic surgeon.  Apart from seeing the patients we also conducted CPR and dental hygiene education sessions as well as have patients take part in blood pressure research.

AIPNO was founded in 1983 and is a non-profit membership organisation of physicians of Indian origin in Northern Ohio. It has membership of 300 physicians and have they organised Medical Yatras since 2001.  They have provided aid to Mexico, Haiti, Peru, Ecuador, Uganda, Kenya, Honduras, Dominican Republic, Burundi and India. What is amazing is that the volunteers who came were in the late 60s and 70s who were either semi retired or retired.  Visit their website http://www.aipno.org/ for more information

ARCH currently provides provides primary health care services to approximately 25,000 patients along with basic health education and preventative services such as vaccinations and prenatal care. In addition they provide movie health camps in surrounding villages.  More about them can be found here: http://www.archgujarat.org/ 

We were split into 2 groups each visiting 5 locations over 5 days seeing up to 1,000 patients daily and ~4,000 patients in total. (The exact numbers are still to be finalised.)  People came from nearby villages and waited patiently for several hours to be seen. At each spot we spent 4-8 hours depending on the number of patients that presented.   For some of us we stepped into unfamiliar roles of dental, paediatric, gynaecology or pharmacy assistants, whilst others had to recall prior knowledge to diagnose, prescribe and dispense medications.   All of us had to improvise with limited supplies and diagnostic tools whilst working in a team to provide the best possible outcome.

Each stop was unique with a different variety of diagnosis and facilities. On some days it took us only about 30 minutes to get there and on others over 90 minutes across dirt roads. The majority of time we were situated within the local school which meant the kids had a disruptive day and were free to interact with the group, be seen by paediatricians or dentists and/or attend educational sessions being run. Regardless of where we were, the locals were all very welcoming and patient. It was heartwarming to see some of the older children assist with translation, directing people and/or helping the older patients to where they needed to go. 

Undernutrition was massive problem with 14-16 year old teenagers looking like they were 9-10 years old. The adults on the other hand looked much older than they should be due to physical outdoor labour with in many cases extremely high blood sugars and blood pressures. 

Language was a massive issue with local tribal languages being spoken in many instances as opposed to Gujarati or Hindi which become a case requiring up to 3 interpreters sometimes depending on the translator and Doctor.   

Observations

• all who came were strong, happy and didn’t complain about the wait or their lot in life with physical examinations easy due to the lack of fat (many of those in their 40s/50s had six pack abs!) 
• Biggest issues were undernutrition, undiagnosed hypertension, diabetes, goitres, cataracts, dry skin and cavities 
• Introduction of fluoride, reduced salt and sugar diets and iodised salt would greatly assist these communities as part of preventable health schemes  
• Girls were particularly shy with all being curious particularly around the tall Americans, our smart phones and cameras 

Outcomes from 2016 Medical Yatra

• Recommendations to reduce cavities and improve teeth health particularly in children to be provided to local government officials 
• ARCH has committed to follow up patients seen including scheduling of 33 cataract surgeries 
• A piece for AJ+ (on online news and current events channel by Al Jazeera Media Network AJMN) is being finalised.  

All of us came with open hearts, warm smiles, positive and flexible attitudes and a sense of humour but left with so much more.  We have much to learn from each other and language is not a barrier.

I would highly recommend going on Medical Yatra as it is so much more than volunteering with an amazing bunch of people and seeing the countryside and interacting with the locals in a unique way as it includes component of spirituality as we stayed at Shrimad Rajchandra Mission Dharampur and were even fortunate enough to have an audience with Baba Pujya Gurudevshri Rakeshbhai.  More about the Ashram and their work is here: http://www.shrimadrajchandramission.org/

More photos are available here: https://www.facebook.com/media/set/?set=a.1582019118687142.1073741860.1384301005125622&type=1&l=4335feceba 

Number of Doctors: 14 including 2 dentists

Total number of volunteers: 37

Number of patients seen: ~4000

Number of sites visited: 10 

Volunteer hours (based on average 6 hour day for 37 volunteers) : 1110 hours

Sneha G Bapat

Sneha G Bapat is a standard 12 student from Pune, Maharashtra. She has decided to dedicate her summer holidays to do what her heart tells her and volunteer with AarogyaSeva in Bangalore for 4 weeks. At 16 she is our youngest intern and has already participated in the TCS Majja Run to support the cause of rape and abuse in India. She is going to spend her time learning, participating in seva activities and helping us with various tasks. Here is what she has to say:

"All our lives, we negotiate about what we want, what we like and what the world wants and likes… We keep on thinking whether to stick to our own choices or to go with the world (flow)(other people’s opinion). There is this conflict between our mind and out heart, where generally the mind wins and we end up putting our choices aside, end up giving up on our dreams. We just tend to go with the world. Follow the Trend! Follow, like Sheep…! We walk the same trodden path rather than making our own trail.

We keep on running round the clock , don’t even have time for our own thoughts forget the others.

We don’t LIVE, we just “E-X-I-S-T”, in a false world, go round in an illusion. Believe and conquer lies. We don’t even know when the day starts and when it ends. So busy with our so called “MODERNESS” , we don’t even breathe leisurely. We follow the same routine everyday, which has somehow become the part of our lives. Everything is so fast-paced that everything else around us is a blur…! We don’t have life in us, we are machines which have been set to do work. We breathe for working, for toiling, for spending our lives in boring and bare office rooms, tying and clicking our soul (life) away.

When we live life happy, sad happy- sad, little do we know what lies ahead or what life has in store for us. It is so true when it is said “ Time is money” people run around the clock doing so many things (chores), laboring themselves till they are all weak and grey and then sit and remember all the days behind and repent and regret and think/imagine how nice it would be if they could just go back and change things, so they could have a cup of tea now with a smile on their lips whenever they think of their past."

Law, Human Rights and Public Health

Law, Human Rights and Public Health

An interaction with Vinay Sreenivasa at the Alternative Law Forum.

Time: 2pm
Date: 18th June 2013
Venue: ALF Office, 122/4, Infantry Road, Opposite Infantry Wedding Hall, Bangalore, India 560001

ALF was started in March, 2000, by a collective of lawyers with the belief that there was a need for an alternative practice of law. We recognize that a practice of law is inherently political. We are committed to a practice of law which will respond to issues of social and economic injustice. Over the past few years ALF has grown from being a legal service provider to becoming a space that integrates alternative lawyering with critical research, alternative dispute resolution, pedagogic interventions and more generally maintaining sustained legal interventions in various social issues. We are also commited to an inter disciplinary interrogation of the law using creative forms. ALF perceives itself simultaneously as a space that provides qualitative legal services to marginalized groups, as an autonomous research institution with a strong interdisciplinary approach working with practitioners from other fields, as a public legal resource using conventional and unconventional forms of creating access to information, as a centre for generating quality resources that will make interventions in legal education and training, and as finally a platform to enable collaborative and creative models of knowledge production.