Public Health Perspective (PHP) Newsletter February 2013 Issue


Published on


Myths and Misconceptions about Cancer
National News:
Air pollutants threatening public health: Study
‘Health for Life’ drives to strengthen government capacity
‘19 percent women practice Chhaupadi’
MoHP to operate pharma-cies at all hospitals under it
HIV-infected women’s drive against AIDS
Workers from India prone to HIV/AIDS
Featured Articles:
An overview of Cervical Cancer [T.Nagamma, Melaka Manipal Medical College]
World Cancer Day
Global Health:
Avian influenza – situation in Cambodia – update
Poliovirus detected from environmental samples in Egypt
Polio in Niger
Yellow fever in Chad
Novel coronavirus infection - update
India: Swine flu kills more than 260 this year
Journal Watch:
Tuberculosis practices among private medical practitioners in Kaski district, Nepal
Climate Change Section:
What WHO is doing for climate and health?
Being Healthy:
Health is Wealth
WHO Publications:
Bulletin of WHO Vol. 91, No. 02, 2013
Achieving the Health-related Millennium Development Goals in the South-East Asia Region

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Public Health Perspective (PHP) Newsletter February 2013 Issue

  1. 1. Public Health Perspective the first public health online newsletter of Nepal Vol. 3 Issue 2 February 2013 Editorial: Myths and Misconceptions about Cancer Lack of information and disproportionate burden. physical activity and main- Inside This Issue awareness about cancer is a Cancer not only affects the taining a healthy body weight critical obstacle to effective elderly, but young men and could prevent around a third cancer control and care in women, often in their prime of the most common cancers. developing countries, espe- working years, particularly in cially for the detection of can- the developing world. Ap- Based on current trends, to- cers at earlier and more treat- proximately 50% of cancer in bacco use is estimated to kill able stages. It is often exacer- developing countries occurs one billion people in the 21st bated by the myths and mis- in individuals less than 65 century. Addressing tobacco conceptions. years of age, according to use, which is linked to 71% of all lung cancer deaths, and As the world is celebrating the Union for International Can- accounts for at least 22% of World Cancer Day highlighting cer Control (UICC). This is a all cancer deaths, is therefore the myths about it, we tragedy for families and for critical. thought our readers might populations, and has the find them useful and have potential to have a long-term For developing countries, the thus summarized them in this impact on economic develop- situation often goes beyond issue editorial. One aspect of ment. addressing behavioral this effort is conveying clear change, with many countries messages to the public to Many cancers that were once facing a ‘double burden’ of improve general knowledge considered a death sentence exposures, the most common about cancer. can now be cured and for of which is cancer-causing many more people, their infections. Chronic infections There are basically four dam- cancer can be treated effec- are estimated to cause ap- aging myths and misconcep- tively. Advances in under- proximately 16% of all can- tions about the disease. standing risk and prevention, cers globally, with this figure early detection and treat- rising to almost 23% in de- The first myth is "Cancer is ment have revolutionized the veloping countries. Several of just a health issue". However, management of cancer lead- the most common cancers in the truth is that it is not just a ing to improved outcomes for developing countries such as health issue. It has wide- patients. Still people consider liver, cervical and stomachPublic Health Important "Cancer is a death sentence" cancers are associated with reaching social, economic,Days (February) development, and human which is a third myth. With infections with Hepatitis B rights implications. It consti- few exceptions, early stage Virus (HBV), the HumanFebruary 4: World Cancer Day cancers are less lethal and tutes a major challenge to Papilloma Virus (HPV), and development, undermining more treatable than late the bacterium HelicobacterFebruary 6: International Day social and economic advances stage cancers. pylori (H. pylori), respec- of Zero Tolerance to Female throughout the world. tively. Exposure to a wide Genital Mutilation "Cancer is my fate" is the range of environmental The sec- fourth myth regarding causes of cancer in our per- ond myth cancer. Nevertheless, sonal and professional lives, related to with the right strate- including exposure to indoor this dis- gies, a third of the air pollution, radiation and ease is most common cancers excessive sunlight are also t h a t can be prevented. Pre- major preventable causes of "Cancer is vention is the most cost cancer. a disease -effective and sustain- of the able way of reducing Happy readings! wealthy, the global cancer bur- elderly den in the long-term. and de- Promoting healthy life- veloped styles can substantially countries". The fact is that it reduce cancers that are is a global epidemic which caused by risk factors such affects all ages and socio- as alcohol, unhealthy diet economic groups, with devel- and physical inactivity. In oping countries bearing a addition, improving diet, Amrit Banstola
  2. 2. February 2013 P U B L I C H E A LT H P E R S P E C T I V E ( P H P ) Page 2 National News tion in Kathmandu — and the sons learned and best prac- Surprisingly, the survey shows problem is exacerbated be- tices to policy-makers coun-Air pollutants threaten- cause more than a third of trywide. The MoHP and USAID that 48 percent women of that age group were okay with abuseing public health: Study vehicles fail to comply with have signed a partnership by their husbands if they went emission standards. Urban agreement for the implemen- out without informing spousesKATHMANDU, JAN 30 - development and ever - tation of the program that will were negligent in taking care of increasing number of vehicles be implemented by RTI Inter- children, refused to have sexH igh concentrations of at- have far outpaced the city’s national, together with with them and burned food while mospheric pollutants capacity to maintain the road Jhpiego, an international or- cooking. It showed that 16 per-pose serious threat to the network on a regular basis. ganization, and multiple Nepali cent of the women surveyed hadhealth of Kathmandu Valley’s NGOs. married before reaching 15 yearsresidents‚ especially during Source: thehimalayan- while 60 percent did so beforethe dry winter months. Ac- Source: reaching 18 years. It was foundcording to a study ‘Rapid Ur- ‘Health for Life’ drives that 45 percent women had theirban Assessment of Air Quality ‘19 percent women health examined by trainedfor Kathmandu‚ Nepal’ com- to strengthen govern- practice Chhaupadi’ health workers during pregnancymissioned by International only once, 29 percent had givenCentre for Integrated Moun- ment capacity DHANGADHI, FEB 10 – birth under the supervision oftain Development (ICIMOD)‚ trained midwife and 30 percentacute respiratory disordersare among the most common KATHMANDU, FEB 05 - N ational The Nepal Multi- had given birth at health cen- Index Survey 2010 paints ters .five diseases reported in Ne-pal. In urban areas particu- A n $18 million program has been launched strengthen the government’s to a grim picture of the situation of women and children in the Source: Mid-West and Far-West re-larly‚ about 16 percent of hos-pital visits and a dispropor- capacity to plan, manage and gions of the country. The sur- MoHP to operate pharma-tionate number of premature deliver high quality and equi- vey, which was made public table family planning, mater- amid a program on February cies at all hospitals underdeaths have been attributedto them. Studies have high- nal, newborn and child health 09, was conducted among itlighted increased incidence of services. The ‘Health for Life’ 7,372 women of 15-49 agerespiratory disorders and eye‚ campaign aims to address key group and 3,574 children be- KATHMANDU, FEB 20 -throat‚ and skin conditions‚ as health system constraints in low five years of age from Twell as increase in cardiovas- the areas of local health sys- 6,000 households in 24 dis- he Ministry of Health andcular-related problems among tems governance; data for tricts in the regions. According Population (MoHP) is going topeople living in Kathmandu. decision-making and evidence to the survey, 83 percent of operate pharmacies itself at all“An estimated 30 million ru- -based policy development; the total population of the the hospitals under it. The Minis-pees (US$ 400‚000) in hospi- human resources; quality regions has access to potable try says the preparation of policytal costs could be saved every improvement systems; logis- water sources while only 36 to run pharmacies has reachedyear by reducing the level of tics systems; and knowledge percent was using im- the final phase. MoHP is to runairborne pollutants to meet and behavior change. The proved sanitation facilities. pharmacies at the hospitals un-World Health Organization Ministry of Health and Popula- Likewise, 56 percent women der it after public complaintsguidelines‚” the study sug- tion (MoHP) and the US of 15-49 age groups have were received against pharma-gested. Agency for International De- general knowledge about HIV/ cies selected through open com- velopment (USAID) launched AIDS while only 22 percent petition by hospitals. Secretary atFrom 2000 to 2009‚ the num- the program on Saturday. has extensive knowledge the Ministry, Dr. Praveen Mishra,ber of cars in Kathmandu Val- ‘Health for Life’ builds on ac- about it. The survey has also said that the Ministry has di-ley increased at an unprece- complishments from the collected basic data on the rected hospitals to make neces-dented rate. In 2000 there MoHP’s Nepal Health Sector Chhaupadi practice that is sary preparation to run pharma-were less than 200‚000 regis- Program II and USAID- widespread in the regions, the cies itself and not to call for newtered vehicles but by 2009 supported health sector in- first in the country. The bids.there were half a million vehi- vestments, said a statement Chhaupadi is a cultural prac-cles; more than 60 percent of issued by the US Embassy. tice in which women have to Health services have been pro-all the vehicles registered in The program will work in close live in a special shed away vided through more than 100Nepal. Despite increase in the coordination with the Nepal from the rest of the family hospitals including central, zonalnumber of vehicles‚ the total government, the MoHP and during menstruation. and district level hospitals underlength of the road network in other health sector develop- the Ministry. Pharmacies havethe valley is only about 1‚200 ment partners at the central, The survey shows that nearly been run at the premises of suchkm. Only of the road network district and community levels. 19 percent of women of the hospitals and outside of hospitalin Kathmandu is black topped 15-49 age groups lived in this by private sector through openand each vehicle has less than In addition to national-level way during menstruation. Fifty competition. Meanwhile, the Min-2.5 m of road available. The inputs, ‘Health for Life; will -two percent women in the istry has got permission from thereport said vehicle exhaust is have a presence in 14 dis- mountainous region of the Mid cabinet to assign 330 specialista major contributor to in- tricts within the mid-western -West and 50 percent in the doctors to fulfill the vacant posts.crease in inhalable particulate and western regions, with a hilly region of the Far-West Chief of the Medical Division atmatter and noxious gases — mandate to ensure adequate faced extreme discrimination the Ministry, Prof. Dr. Tirthathe major causes of air pollu- and effective transfer of les- during their regular periods. Continued on page 4
  3. 3. February 2013 P U B L I C H E A LT H P E R S P E C T I V E ( P H P ) Page 3 An overview of Cervical Cancer T.Nagamma, Senior Grade Lecturer, Department of Biochemistry, Melaka Manipal Medical College (Manipal Campus), Karnataka, India Cervical cancer is the second most common cancer in the world. It was responsible for 2, 75,000 deaths, about 88% of which occurred in developing countries in 2008, says International Agency for Research on Cancer (IARC). Nepal Cervical Cancer Prevention Situation Analysis, 2008 estimated that there were about 10,020 new cases of invasive cervical cancer and about 26,000- 45,000 pre-cancerous lesion. In addition, World Health Organization (2010) ranked cervical cancer as the most frequent cancer among women age 15 to 44 years of age in Nepal. Cervical cancer starts in the squamous cells on the surface of the cervix. The development of cervical cancer is very slow process. It starts with a precancerous condition called dysplasia and can be detected by pap smear test. Most of the cervical cancers are caused by Human Papilloma Virus (HPV). There is probably no one single cause of cervical cancer or pre cancer, but epidemiological evi- dence points to a sexually transmitted agent or agents. It is associated with sexual activities that include sex at an early age, frequency of the sex, and number of sexual partners. In addition, poor “The development of economic status, not getting HPV vaccine, drug (diethylstilbestrol) intake during pregnancy, and weaken immune system also causes cervical cancer. cervical cancer is very Cigarette smoking is an independent risk factor. Some content of cigarette smoke, which can be slow process. It starts detected in cervical mucus, may act as co-carcinogenic agent. The polycyclic aromatic hydrocar- bons in cigarette smoke form damaging adducts with DNA. These have been demonstrated in cer- with a precancerous vical tissue at higher level in current smokers. condition called The morbidity and mortality rates of cervix cancer are very high, so early detection and treatment is the only solution to it. Most of the time, early cervical cancer has no symptoms. However, dysplasia and can be symptoms that may include: abnormal vaginal bleeding between periods, after intercourse, or after menopause, continuous vaginal discharge, periods become heavier and last longer than detected by pap smear usual. Patients with cervical cancer do not usually have problems until the cancer is advanced and has spread to other organs. test.” Primary prevention of cervical cancer is thus possible by abstinence from sex which will prevent the infection by HPV. Early immunization of female adolescents with a vaccine is also effective against HPV. “Primary Secondary prevention of cervical cancer is also possible through periodic screening of sexually active prevention of females by pap-smear. It can diagnose early forms such as in-situ malignancy which can thus be treated before changing into invasive cancer. Pap-smear screening can significantly help reduce cervical cancer cervical cancer is rates. thus possible by Precancerous changes of the cervix and cervical cancer cannot be seen with the naked eye. Pap smears abstinence from screen test (a cotton swab is used to take exfoliates of cervical cells for observation under the micro- sex which will scope, it is not the final diagnostic test) for precancer and cancer is found to be useful. If abnormal changes are found, the cervix is usually examined under magnification. This is called colposcopy. Pieces prevent the of tissue are surgically removed (biopsied) during this procedure and sent to a laboratory for examina- infection by tion. HPV.” The treatment of cervical cancer depends on the stage of the cancer, size and shape of the tumor, woman’s age and general health. Early cervical cancer can be cured by removing or destroying the pre- cancerous or cancerous tissue. There are various surgical ways to do this without removing the uterus or damaging the cervix. Treatment for more advanced cases is mainly by radiotherapy and chemotherapy. Mitomycin C, carboplatin is first line choice of drugs. Sometimes radiation and chemotherapy are used before or after surgery. PHP is now on facebook! Public Health Perspective Online Newsletter Click button of the page and get connected with us. The instant access to the news and updates of PHP begin from here! Recommend it to your friends! We look forward to have more fans of our page.
  4. 4. February 2013 P U B L I C H E A LT H P E R S P E C T I V E ( P H P ) Page 4 World Cancer DayFebruary 4th is the World Cancer Day (WCD), a day dedicated to raising awareness and education about cancer, and encouraginggovernments and individuals across the world to take action against the disease. This year’s WCD will focus on Target 5 of theWorld Cancer Declaration: Dispel damaging myths and misconceptions about cancer. The aim is to improve general knowledgearound cancer and dismiss misconceptions about the disease.One in three people will be affected by cancer at some stage in their life. In 2008, there were 7.8 million cancer deaths and 12.7million cancer cases. Without intervention, the global cancer burden is projected to increase by 75% in the next 20 years. Everymonth 600,000 people die of cancer and many of these deaths may be avoided with increased support and funding for prevention,detection and treatment programs.The greatest increase in cancer is projected to hit low- and middle-income countries, those least equipped to cope with the socialand economic impact of the disease. Of the 7.8 million global deaths from cancer in 2008, more than 55% occurred in less devel-oped regions of the world. By 2030, 60-70% of the estimated 21.4 million new cancer cases per year are predicted to occur indeveloping countries. Cervical cancer is just one example of the disproportionate burden borne in the developing world. Over 85%of the 275,000 women who die every year from cervical cancer are from developing countries.Hopefully, initiatives such as World Cancer Day will help achieve the targets outlined in the World Cancer Declaration, which are toplace cancer on the political agenda, improve cancer prevention and early detection, and enhance access to and treatment forcancer patients."Did you know?" is the question posed for World Cancer Day 2013, which focuses on debunking damaging myths and misconcep-tions about the disease, reinforcing that there are still too many preconceived ideas about cancer that need demystifying and put-ting right. Prevention involves various approaches, and one aspect of this many-pronged effort, led by multiple agencies, is con-veying clear messages to the public to improve general knowledge about cancer.Myth 1 - Cancer is just a health issueTruth: Cancer is not just a health issue. It has wide-reaching social, economic, development, and human rights implications.Myth 2 - Cancer is a disease of the wealthy, elderly and developed countriesTruth: Cancer is a global epidemic. It affects all ages and socio-economic groups, with developing countries bearing a dispropor-tionate burden.Myth 3 - Cancer is a death sentenceTruth: Many cancers that were once considered a death sentence can now be cured and for many more people, their cancer canbe treated effectively.Myth 4 - Cancer is my fateTruth: With the right strategies, a third of the most common cancers can be prevented. Source: >> >> NewsContinued from page 2 tion only because of a lack of awareness. “The number of HIV-infected people is on the some HIV-infected people are deprived of medicines as local health institutions do not have M ost of the workers, who have returned from India, are in a high risk of HIV / AIDSBurlakoti said that works re- rise. This is not a good trend,” such service and they cannot in Kanchanpur district. Ashoklated to this would be for- said Banjade. According to the afford to travel to Butwal and Pandey, Coordinator of the Dis-warded soon. District AIDS Coordination Kathmandu. Both Banjade and trict AIDS Coordination Commit- Committee, the number of Thapa were infected with HIV tee said that the workers re-Source: people living with HIV in the through their husbands, who turned from India and their district was 25 six years ago had worked in India. Their hus- families are affected byHIV-infected women’s while the figure stands at 103 bands both died of AIDS- the AIDS. Some 175 males anddrive against AIDS now. Many HIV victims do not related complications many 148 women and their 46 children come out openly due to social years ago. Thapa and Banjare are affected by it in the district,ARGHAKHANCHI, FEB 27 - stigma, said Banjade. She work for local NGOs working for Pandey said. Some 71 victimized also said though they urged the welfare of HIV victims. here in the district died dueB ipana Thapa of Kimdanda and Parbata Banjade ofDivarne in the district, both the District Development Committee, party leaders and VDC secretaries to provide Thapa said though they were shunned by locals in the begin- ning, things have changed now. to HIV / AIDS since 2006 to 2012, Pandey added. An aware- ness program targeting theliving with HIV, have been adequate funds for awareness workers should be launched be-actively involved in an aware- campaigns and also to man- fore they go to India, locals said.ness campaign against HIV/ age medicines as well as jobsAIDS. Banjade said they de- for the victims, their demands Workers from India Source:thehimalayantimes.comcided to be engaged in the are yet to be addressed. prone to HIV/AIDSdrive so that others will notfall victim to the health condi- The campaigners also said KANCHANPUR, MAR 16 -
  5. 5. February 2013 P U B L I C H E A LT H P E R S P E C T I V E ( P H P ) Page 5 Global HealthAvian influenza – situa-tion in Cambodia – up- I n Egypt, Wild Polio Virus Type 1 (WPV1) was isolated from sewage samples collected Genetic sequencing con- firmed that the virus was a T he Ministry of Health of Chad is launching an new importation into Niger, emergency mass-vaccinationdate on 2 and 6 December 2012 in campaign against yellow fever two areas of greater Cairo. from 22 February 2013, follow-1 February 2013 – Virus has been detected in ing laboratory confirmation ofT he Ministry of Health (MoH) sewage only; no case of para- of the Kingdom of Cambodia lytic polio has been reported.reported five new human cases Genetic sequencing shows thatof avian influenza that were the virus strains are closelyconfirmed positive for the H5N1 related to virus from northernvirus in January 2013. Sindh, Pakistan. Pakistan is one of three countries worldwide affected by ongoing indigenous most closely related to virus transmission of WPV (together circulating in Kaduna state, with Nigeria and Afghanistan). Nigeria. The isolates were detected through routine environmental The Government of Niger is two cases in the country in surveillance in Egypt that in- December 2012. continuing to implement a volves regular testing of sew- age water from multiple sites. comprehensive response in line with international out- The two cases from Goz Beida Following detection of these break response guidelines and Guereda districts wereCase details include an 8 month isolates, the Government of issued by the World Health laboratory confirmation by aold male from Phnom Penh with Egypt is implementing a com- Assembly (WHA) in Resolu- WHO regional reference labo-onset 9 Jan 2013, a 17 year old prehensive response in line tion WHA59.1. Following an ratory for yellow fever, Institutfemale from Takeo Province with international outbreak initial supplementary immu- Pasteur in Dakar, Senegal.with onset 11 January, a 35 response guidelines issued by They were identified through nization activity (SIA) on 15year old male from Kong Pisey the World Health Assembly January 2013 to reach ap- the national surveillance pro-district, Kampong Speu Prov- (WHA) in Resolution WHA59.1.ince with onset 13 January, a proximately two million chil- gramme for yellow fever, fol-17 month old female from Kong dren with bivalent oral polio lowing intensive surveillancePisey district, Kampong Speu vaccine (OPV), nationwide which was triggered in re-Province with onset 13 January SIAs were conducted from 2- sponse to the outbreak of yel-and a 9 year old female from 5 February 2013, targeting low fever in neighbouring Su-Toeuk Chhou district, Kampot dan’s Darfur region. The inten- more than five million chil-province with onset on 15 Janu- dren with trivalent OPV. sive surveillance in Chad alsoary 2013. reported 139 suspected casesThe cases all presented with A second nationwide SIA is and 9 deaths.fever, cough and other ILI On 2-6 February, supplemen- planned for 2-5 March withsymptoms. Four of the cases tary immunization activities (SIAs) were conducted in the bivalent OPV. Previously, The vaccination campaign willdied, with 1 case, the 8 month two areas of Cairo from where nationwide SIAs had been be conducted in 3 districtsold male, recovering after onlyexperiencing mild ILI. Labora- the environmental samples had conducted on 23 November bordering Darfur, Sudan,tory samples were tested by the been collected, reaching more 2012 with bivalent OPV. A namely Goz Beida, GueredaNational Institute of Public than 155,000 children with joint national and interna- and Adré, targeting over a trivalent oral polio vaccine .Healths laboratory and by the tional team of epidemiolo- million people, including in-Institut Pasteur du Cambodge. Source: WHO gists and public health ex- habitants of refugee camps in Polio in Niger perts has been deployed by the area. The campaign is sup-Preliminary evidence does not the World Health Organiza- ported by the Chad’s Ministrysupport human-to-humantransmission and four of the 12 February 2013 - tion’s (WHO) Regional Office of Health, the Internationalcases are known to have hadclose contact with sick/deadpoultry. F ollowing the notification on 3 January 2013 of a wild poliovirus type 1 (WPV1) case for Africa to assist the Gov- Coordinating Group on Yellow ernment of Niger in the in- Fever Vaccine Provision (YF- vestigations, help plan re- ICG1), and GAVI Alliance .Source: WHO in Niger, outbreak response is sponse activities and support Source: WHOPoliovirus detected from continuing in the country. A active searches for additional Novel coronavirus infec- WPV1 case had been detected cases of paralytic polio. tion - updateenvironmental samples in from Tahoua region, with onset Source: WHOEgypt of paralysis on 15 November 21 February 2013 – T Yellow fever in Chad he Ministry of Health in 2012 (the first case in the11 February 2013 – country since December 2011). 14 February 2013 - Continued on page 6
  6. 6. February 2013 P U B L I C H E A LT H P E R S P E C T I V E ( P H P ) Page 6 Journal Watch Tuberculosis practices among private medical practitioners in Kaski district, How to join PHP? Nepal Practice of Tuberculosis (TB) management is not much satisfactory among private medical practi- tioners in Kaski district of Nepal, according to the study published in 2012 issue two of Int J Infect e-Mail: Microbiol. A descriptive cross sectional study, applying quantitative method, was conducted at Pokhara sub- website: municipality and Lekhnath municipality of Kaski among 30 private practitioners, 142 private phar- macies, and 42 private laboratories through self administered questionnaire and structured inter- publications.php view schedule. According to the study, nearly one fourth of the TB suspects in the district were found to have consulted private providers with about 20.0% of the total smear positive cases diagnosed in pri- vate laboratories. Beside sputum microscopy, Private Medical Practitioners (PMPs) were also found to prefer other tests like X-ray, culture for TB diagnosis. Similarly, PMPs’ varying prescription of Benefits of anti TB drugs beyond National TB Programme (NTP) recommendation along with their weak re- cording and case holding were noteworthy, and the cost of TB treatment seemed higher in private Being a PHP sector. As per the study, only one third of private institution had their staff trained in TB. Except some informal linkage, no collaboration between public and private sector was noted. Subscriber The study concluded that NTP should take effective measures for Public Private Mix and to make them aware of the standards through training and orientation in order to improve the quality of  Can submit articles to care. PHP newsletter Full text article is available at:  Heavy discount rate in Int J Infect Microbiol 2012;1(2):68-75 DOI: PHP trainings, work- Author: Nepal AK, Shrestha A, Baral SC, Bhattarai R, Aryal Y shops, seminars, con- ferences Indias health ministry said  Get acquainted with Global Health bers of the family tested posi- tive for NCoV infection. One Rajasthan saw 107 deaths public health news from because of swine flu, with member of this family, who Continued from page 5 Gujarat coming in second with around the nation and had an underlying health con- Saudi Arabia has informed 51, Haryana with 36 and Pun- globe at a time dition, has died. jab with 32 deaths, News WHO of another confirmed  Enhances professional case of infection with the Track India reported. The min- To date, WHO has been in- istry also noted that in the writing skills novel coronavirus (NCoV). formed of a total of 13 con- past four years, the highest number of swine flu cases was firmed cases of human infec- The patient was hospitalized in 2009 at 27,236, followed by tion with NCoV, including on 29 January 2013 and died 20,604 cases in 2010 and seven deaths. 5,054 in 2012. Send Letters to the on 10 February 2013. The Source: WHO Editor India: Swine flu kills more The highest number of deaths due to swine flu was in 2011, than 260 this year with 1,763.  All readers can post 28 February 2013 - S comments on articles wine flu has killed 261 One India News noted that and news mentioned in people in India this year, since the number of swine flu PHP or could be sugges- with most deaths reported in cases has been increasing, tions and compliments. Rajasthan. Chief Minister Sheila Dikshit  Send letters to: has launched a campaign to Some 2,329 people have combat the problem. case was laboratory-confirmed  Word limit 150 max. and on 18 February 2013. Further tested positive for Influenza A, With disastrous public hygiene the title of news or arti- investigation into this case is also known as H1N1, which causes swine flu, across 35 and a failed health care sys- cles of critique. ongoing. states and union territories tem critics say disregards the  Email should include poor, India is highly vulner- The Times of India reported. ‘letters to the editor’ In the United Kingdom, the able to disease. The highest number of cases, in email subject line. Health Protection Agency con- 834, was in Delhi, followed by 564 in Rajasthan and 305 in Source: tinues to investigate the fam- ily cluster where three mem- Haryana.
  7. 7. February 2013 P U B L I C H E A LT H P E R S P E C T I V E ( P H P ) Page 7 What WHO is doing for climate and health? WHO Workplan on climate change and health WHO was requested by the 61st World Health Assembly in 2008 to develop and implement a workplan to support member states in the protection of human health from climate change. The workplan approved by the Executive Board in 2009, orients WHOs priorities to carry out activities in four key areas. Learn more about WHOs activities and available resources on Climate and Health below. The climate change and health workplan aims to:  support health systems in all countries, in particular low- and middle-income states and small island states, in order to en- hance capacity for assessing and monitoring health vulnerability, risks and impacts due to climate change;  identify strategies and actions to protect human health, particularly of the most vulnerable groups; and  share knowledge and good practices Priorities and areas of work in climate and health 1. Advocate and raise awareness WHO is raising awareness of climate risks to health through advocacy campaigns, publications and policy briefings, encouraging representation of WHO and health actors in key climate forums, and providing multimedia products which raise the prominence of health issues on the climate agenda and stimulate appropriate health protection by decision-makers. Objective Raising awareness of the effects of climate change on health, in order to prompt action for public health measures. A better un- derstanding of the risks and effects of climate change on health will motivate and facilitate both behavioral change and societal support for actions taken to reduce greenhouse gas emissions. Improved awareness will help health-sector professionals to pro- vide leadership in supporting rapid and comprehensive strategies for mitigation and adaptation that will both improve health and reduce vulnerability. 2. Strengthen partnerships WHO, as the specialized UN agency for health, actively engages in the UNFCCC and One UN initiatives for Climate Change. Part- nerships, networks, and collaborations can improve knowledge and evidence, enhance protection of health from climate risks, and enhance health benefits of low carbon energy choices. Objective Engage in partnerships with other United Nations organizations and sectors other than the health sector at national, regional and international levels, in order to ensure that health protection and health promotion are central to climate change adaptation and mitigation policies. Partnerships will be sought at all levels. This requires the public health sector to play a stewardship role in fostering policy coherence across sectors, and to influence policies and actions that can benefit health. 3. Enhance scientific evidence WHO works with leading experts and institutions worldwide to improve the understanding and evidence base of the linkages of health and climate, the burden of disease attributable to climate change, and economic costs of climate change adaptation and mitigation to protect health. Read more about WHOs research agenda, tools, and studies on climate change. Objective Promote and support the generation of scientific evidence. There are some important gaps in our knowledge, in particular about the current and potential future impacts of climate-related risks, the degree of population vulnerability, characteristics of vulner- able groups, the type of surveillance and alert and emergency management systems, the most useful indicators for monitoring and evaluation of the criteria for action, as well as the comparative effectiveness of different adaptation and mitigation policies for health promotion and protection. 4. Strengthen health systems WHO supports member states to strengthen health systems to improve population health, and increase climate resilience of com- munities and the health system to identify, monitor, respond, and prepare for changes in health and disease burdens related to climate. Read more about WHOs six steps to climate resilient health systems. Objective Strengthen health systems to cope with the health threats posed by climate. Health-system action to protect populations from the impacts of climate change will need to encompass public health interventions within the formal health sector, such as control of neglected tropical diseases and provision of primary health care, and actions to improve the environmental and social determi- nants of health, ranging from access to clean water and sanitation to enhancing the welfare of women. A common theme must be ensuring equity and giving priority to protecting the health security of particularly vulnerable groups. In addition, there is a par- ticular need to control and reduce health risks, and strengthen coordinated preparedness and response in respect of the health effects of acute emergencies and other crises that may be exacerbated by climate variability and change. Available from:
  8. 8. February 2013 P U B L I C H E A LT H P E R S P E C T I V E ( P H P ) Page 8 Being Healthy Generally speaking, a person with both Everyone wants a sedentary life. However, HEALTH IS WEALTH hands live a sedentary life (series of coffee most of us do not realize the person living this cups, lack of exercise, high calorie intake, kind of life is not in good health.No doubt, everyone lives their overload, cigarette smoking and alcoholown life. However, the concern consumption) compared to a person with Series of coffee cups is a risk factor for how one hand. In addi- Lack of exercise and fatty food consumptionpeople live tion, their life is are risk factors for diabetes. Overload, hectictheir life easier and comfort- schedule, tension cause migraine and highand make able. blood pressure. Road accident may result oft h e i r late night drinking. From thishealth —a However, people perspective, a personr e a l with no hands live a with handswealth. different life. Gen- erally, their dayLet us starts with aconsider a walk for food.differently They mightable peo- not haveple and a higher earningn o r m a l but a satisfac-people. A tory for water,differently breads, andable per- pulse. Their andson, say with no hand, can be schedule for food and sleep is usually on a good in-wealthier than a normal one (a time. come is not wealthy forperson with both hands). Here, his property but for the diseases.wealth does not only represents This is the real scenario of our society. Whatthe money and property, rather we see, we judge the same. Gist of all this discussion is to aware publica healthy way of living. about the hidden part of the disease causation. Tips for balanced mind and body: Diseases such as diabetes, hyperten- sion, asthma, heart  Mind should be free from any kind of stress, pain, anxi- attack, stroke, ety, worries, trauma, and pressure. Humor, good emo- chronic obstructive tions, joy, and happiness are the influential tools for the pulmonary dis- mind to be in good mood. eases, cancer not only affect health  Timely schedule for exercise, meal, work, sleeping hours, but also disturb and rest is the key for better health. All of your life goes body and mind. The naturally and radically if every of them are treated at the consequences of right time and in the proper manner. these d i s -  Our body needs a balanced diet eases and no more. It asks for the har- a r e mony of all required food items in a irreversible. To add, no medication can completely proper manner not for the mass of cure them and if medicine is available, it is expen- the items. sive and should be used for the whole life.  Your mind and body should con- Your body does the same what your mind orders it trol you not vice-versa. You should to do. It can only do the best when control alcohol not you by alcohol. the order is healthy. Now it is time All the bad habits like smoking, con- to think for balanced mind and suming alcohol, oversleep, and over body to be healthy as well as workload need to be eliminated. wealthy. >> By Anoj Gurung  Your body shows how fit you are. For this reason, you should make yourself fit and Public Health Perspective (PHP) Online Newsletter fine by jogging, swimming, joining aerobic and fitness club, yoga and so on.
  9. 9. February 2013 P U B L I C H E A LT H P E R S P E C T I V E ( P H P ) Page 9 WHO PublicationsBulletin of WHO Vol. 91, No. 02, 2013The Bulletin is one of the worlds leading public health journals. It is a peer-reviewed monthly with a special focus on developingcountries, giving it unrivalled global scope and authority. The Bulletin is one of the top 10 public and environmental health jour-nals with an impact factor of 5.4, according to the Institute of Scientific Information (ISI). It is essential reading for all publichealth decision-makers and researchers who require its special blend of research, well-informed opinion and news. Full bulletinis available at: the Health-related Millennium Development Goals in the South-East Asia RegionMember States of the WHO South-East Asia Region have made considerable efforts at providing an extra surge to their effortsdown the road to achieving the targets set by the United Nations Millennium Declaration in 2000, the core values of which havebeen enshrined in the Millennium Development Goals. Since 2000, these goals have been an important yardstick for the interna-tional community to measure its progress on select vital health and socioeconomic indices. The report is available for download at: FOR CAMPUS LIASIONParticipation on the PHP team is an opportunity to get involved in PHP activities, develop and demonstrate leadership skills, as wellas work with some terrific colleagues. The campus Liaisons will have opportunities to shape the activities and strategic directions ofPHP. In addition, Liaisons serve as their college representative to the PHP by helping to: reporting news from their college in gen-eral and the program of study in specific.Serving as a campus liaison does not require a large time commitment. Campus liaisons distribute information, for example, byspeaking at new student orientations and to your student society or association about PHP. PHP will provide necessary materialsneeded for this position. This position will also provide students with a unique opportunity to become more cognizant of healthnews around the nation.Being a campus liaison for PHP is a great way to demonstrate the team work ability with the professional development as campusliaisons names and their colleges are mentioned in every issues of PHP.If you are interested in participating as a Campus Liaison and have any questions about the Liaison position, please contact us.Email: newsletter.php@gmail.comOUR CAMPUS LIASIONS Call for Articles for March/April Issue  500-700 words on any topic of public health importance  Do not include any graphs, tables and citations  PP size photo in jpeg format  email your articles to with the subject ‘article for PHP’  For more information:
  10. 10. February 2013 P U B L I C H E A LT H P E R S P E C T I V E ( P H P ) Page 10 Public Health Perspective (PHP) Team International Honorary Editorial Advisories Dr. Santosh Raj Dr. Anis Rehman Poudel Associate Chief Editor at Editorial Advisories Dr. Duk Bahadur Residency (MD) in Inter- Journal of Pakistan Medi-Ms. Rose Schneider -- Chhetri nal medicine cal Students (JPMS) RN MPH MD, Pathologist Interfaith Medical Cen- HIFA 2015 Country Rep- Chair of the Climate Western Regional Hos- ter, New York resentative for PakistanChange Working Group pital Lab. of the APHA Interna- Pokhara Dr. Krishna Chandra Chief Executive Officer tional Health Section. RijalSenior Health and HIV/ Mr. Balram Banstola Dept. of Otorhinolaryn- Ashik Banstola AIDS Specialist Managing Director, gology and Head & Neck M. Pharm Health Systems Man- Senior Pharmacist Surgery, College of (Pharmacology), PDCR agement Banstola Medical Hall Medical Sciences and Rajiv Gandhi University1414 Perry Place NW - Kaski Teaching Hospital Bangalore Suite 100 Bharatpur, ChitwanWashington, DC 20010 Board of Advisories Newsletter Team Ms. Sami Pande Mr. Chandra Bhushan Editor-in Chief B. Pharm, MPH Yadav Amrit Banstola Australian Leadership Information Officer Dr. Margaret Steb- Scholar, 2009 (MLIS) Section Editors bing Kathmandu Nepal Health Research Anoj Gurung PhD, Master of Public Council (NHRC) Sandeep Pahari Health, Dip App Sci Dr. Sitaram Khadka MOHP, Kathmandu Sangita Shrestha Nursing Pharm D, Pakistan Subash TimilsinaPopulation Health Aca- Birendra Hospital Contributing Writers demicSchool of Rural Health, Dr. P. Ravi Shankar Madan Kc Professor, Clinical Phar- Monash University Msc. Medical and Australia macology & Medical Edu- Health Care Devices cation Uni. of Bolton, UK KIST Medical College Lalitpur, Nepal.Welcome to New SubscribersNepal InternationalDevaki Pradhan Ravi SinghTikaram Bahsyal David StebbingSitaram Bhandari Melissa RussellAacika PoudelRita KarkiMamta NeupaneArticles appearing in Public Health Perspective (PHP) Online Newsletter do not necessarily reflect the views of the PHP team but are in-tended to inform and stimulate thought, discussion and comment. The PHP newsletter do not discriminate on the basis of race, color, gender,religion, age, sexual orientation, national or ethnic origin, and disability . Contributions are welcome and should be sent to:The Editor, Public Health Perspective Online Newsletter,Banstola Medical Hall, Milanchowk, Hemja-8 VDC, Pokhara, Kaski, Nepal, or email