Public Health Perspective (PHP) Newsletter August 2012 Issue


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Public Health Perspective (PHP) Newsletter August 2012 Issue.
Inside this Issue:

The Status of Implementation of the Global Strategy for Infant and Young Child Feeding in Nepal
National News:
Policy against random medical referrals on cards
Are you facing any health problems? Dial 1115
HIV-infected faces Bir nurses’ ‘neglect’
Lack of staff affects health service in Far West
World Breastfeeding Week: ‘The number of exclusively breastfed in-fants increases in Nepal’
Many hospitals in sick bed: Report
Free blood for pregnant women
Sanitation summit ends with Kathmandu Declaration
USAID's family health program over
World Breastfeeding Week (2012) Special
World Humanitarian Day (2012) Special
Global Health:
South Africa to Become First President's Emergency Plan for AIDS Re-lief (PEPFAR) Country to 'Nationalize' AIDS Program
Syrians in Urgent Need of Life-Saving Medicines as Fighting Escalates, WHO Warns
Avian influenza – situation in Indonesia – update
Ebola in Uganda – update
Gates Looks To Develop 'Next-Generation Toilets' For Developing World
Journal Watch:
Prevalence of blindness and visual impairment and its causes among people aged 50 years and above in Karnali Zone, Nepal
Being Healthy:
Healthy relationships lead to better lives
WHO Publications:
Bulletin of WHO Vol. 90, No. 08, 2012
Safe Abortion Second edition
Toxicological Evaluation of Certain Veterinary Drug Residues in Food
Global Plan for Insecticide Resistance Management in Malaria Vectors
Resource of the month (Climate Change Action website)
The 10 Essential Services of Public Health, With Climate Change Examples

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Public Health Perspective (PHP) Newsletter August 2012 Issue

  1. 1. Public Health Perspective the first online public health newsletter of Nepal Vol. 2 Issue 8 August 2012 Editorial: The Status of Implementation of the Global Strategy for Infant and Young Child Feeding in Nepal On the auspicious occasion of Non-breastfed children are wealthiest households were World Breastfeeding Week considered to be fed in ac- more likely than their coun- Inside This Issue (August 1- 7), we are cele- cordance with the minimum terparts to receive foods from brating the successes and standards if they consume four or more food groups. achievements Nepal has made milk or milk products, are in Infant and Young Child fed four food groups Seventy-eight percent of National News 2&4 Feeding (IYCF) practices and (including milk products), breastfed children were fed trying to present national and are fed at least four the minimum number of World Breastfeeding work at global arena with this times a day. times in the previous 24 3 piece of writing. hours preceding the survey. Week According to the Nepal The combined percentage of Global Strategy for IYCF was Demographic and Health children who fall in both cate- World Humanitarian 3 introduced by WHO and the Survey (NDHS) 2011, only gories (given foods from four Day UNICEF in 2002. It provides one-fourth of children age 6- or more groups and fed the advice on ways to protect, 23 months are fed appropri- minimum number of times Global Health 5 promote, and support exclu- ately based on recommended per day) is 25 percent. Over- sive breastfeeding for the first IYCF practices in Nepal. The all, 24 percent of Nepalese six months, complementary percent of children aged less children are fed in accordance Journal Watch 6 than six months who are with the three recommended feeding practices with the start of six months and con- exclusively breastfed is 70 IYCF practices. Services of Public tinued breastfeeding for two while the percent of children years or beyond. aged six to eight months old In the past one year, the GoN Health, With Climate 7 (breastfed and non- has done various activities for Change examples breastfed) who are given IYCF is one of the programs the protection and promotion implemented by the Govern- complementary foods at an of IYCF counseling. It has ment of Nepal (GoN) to ad- appropriate time is just 66. carried out training on IYCF Being Healthy 8 dress the nutrition problems counseling in seven districts in young children. As a result, The survey further states namely Doti, Bardiya, Dang, promotion of IYCF via public that, the majority of children Nuwakot, Morang, Mahottari, WHO Publications 9 awareness is one of the spe- are still breastfeeding at the and Sankhuwasabha. Simi- cific strategies to control pro- age of two years (93 per- larly, in four districts (Humla, tein energy malnutrition in cent). The percentage of Jumla, Kalikot, and Dolpa) it New Subscribers 10 Nepal. In Nepal, the IYCF children under six months has integrated IYCF commu- status is assessed by the per- who are predominantly nity promotion program withPublic Health Important centage of children aged less breastfed (exclusively child grant. For promotion of than two living with their breastfed children and those IYCF, the Ministry of HealthDay (August) who receive breast milk and and Population (MoHP) has mothers and who are fed ac- cording to three IYCF prac- only plain water or juice) is linked it with micronutrient tices, by breastfeeding status. 80%. Only six percent of supplementation program in These practices include; the children aged less than two six districts. number of food groups con- years are bottle fed. sumed by the child (food di- The majority of malnutrition versity), the number of times As per the NDHS 2011, related deaths among chil- the child is fed (feeding fre- among breastfed children dren under five years of age quency), and consumption of age 6-23 months, 28 percent are linked with inappropriate breast milk or other types of were given foods from four feeding practices, which occur milk or milk products. or more food groups in the during the first year of life. 24 hours preceding the sur- Thus there is a need to pro- With reference to these prac- vey. Greater percent of chil- tect, promote, and support tices, breastfed children are dren living in the hilly area IYCF practices by breastfeed- considered to be fed within (36 percent) were given ing infants within one hour of the minimum standards if foods from four or more food life, exclusively breastfeeding they consume at least four groups than from children for six months, with timely food groups and receive food residing in the Terai (21 per- introduction of adequate, safe other than breast milk at least cent). Similarly, children and properly fed complemen- twice a day in the case of in- living in the Western region tary foods while continuing fants 6-8 months and at least and Western hill sub-region, breastfeeding for up to two three times a day in the case children of mothers with years of age or beyond. of children 9-23 months. grade ten and higher educa- tion, and children from the Amrit Banstola
  2. 2. August 2012 Public Health Perspective (PHP) Page 2 National News KATHMANDU, JUL 26 - and one of the largest, hospi- the rural areas and lack of re-Policy against randommedical referrals on T he government’s pub- lic health hotline, put into practice six months ago, is tal. Relatives have accused the sources at the health facilities. Almost every year during the monsoon, many hill districts in receiving a slew of phone calls nurses of not attending to the the region face the onslaught ofcards from people needing informa- 27-year-old, behaving rudely communicable diseases like viral tion and doctors’ suggestions toward him and often using fever, diarrhea, cholera andKATHMANDU, JUL 23 – on health conditions. Based at harsh words. They said that jaundice. However, the lack ofI n an attempt to check the the telemedicine centre on the the care-givers were unkind to doctors and other health work- ongoing trend of haphaz- premises of the Patan Hospi- their ailing kin, fearing that ers has added to the suffering ofardly referring patients from tal, Lagankhel, the number the HIV virus he is suffering the people in the region. Re-one health institution to oth- can be reached, toll-free, from might spread to those cently, seven people from ruralers often for no proper rea- from all over the country. The attending him. Bhandari has areas of Doti lost their lives duesons, the Ministry of Health calls are received by the hos- been awaiting an appendicitis to diarrhea. Local people claimedand Population (MoHP) has pital’s resident doctors, who surgery at the hospital for four they died for want of treatment.started preparations for a answer queries to the best of days. “One of the doctor said Many newborn babies are evennational referral policy. Such a their abilities. “People inquire that the nurses were trainees deprived of basic vaccinations aspolicy, which is likely to be about problems ranging from and he would talk to them. the health service in the regionfinalized in August, will incor- an itch in the throat to a Source: is limited to a few areas, owingporate medical referrals as stone in their gall bladder,” to the limited number of medicalwell as mechanisms for recep- said Dr Kishan Mainali. “In Lack of staff affects personnel.tion, said Dr Tirtharaj Burla- response, we suggest over- health service in Farkoti, chief of the Curative Ser- the-counter drugs for short- Chief of Baitadi District Hospital,vice Division at the MoHP. “To term relief and also ask them West Dr Gunaraj Awasthi, said 22date, there is no mechanism to visit the nearest doctor if health workers, including a doc-for referring patients so peo- the case is severe.” KATHMANDU, AUG 02 - tor, were transferred out fromple are often referred toother health institutions and Dr Mainali said people from the 17-21 age groups and H ealth facilities in the Far West are struggling to provide proper medical ser- the district and the vacancies are yet to be filled. Elevendoctors haphazardly,” said Dr health workers were transferredBurlakoti. “For instance, a also those in their late forties vices due to a lack of human from different health facilities ofpatient referred by a senior were frequent callers. Bimal resources. According to a data Bajura, also without any re-doctor from a zonal hospital Gautam, an official looking provided by the Far Western placement. Providing medicalwill be received by an MBBS after the telemedicine service Regional Health Directorate services with limited resourcesdoctor at a central level hospi- at the hospital, said the num- (FWRHD), 39 out of 76 posts and health workers in the regiontal. ber of calls per day is on the of doctors are vacant in the with worse hygiene and sanita- rise, with a current average of region. Similarly, 128 out of tion situation is never going toThere is no point in using this 60 calls per day. He claimed a 885 posts for paramedics are ensure good health and well-haphazard referral method to plan to run the phone service yet to be filled. The Mahakali being of the people there. Con-supposedly get better treat- round the clock was stalled Zonal Hospital in Kanchanpur cerned health officials said it isment in this kind of situation: after some officials lodged a is providing service to a large high time for the government toit has resulted in patients suf- complaint at the Supreme number of patients with only come up with a concrete plan tofering regularly.” Burlakoti Court against appointment of one doctor. The hospital has improve health service in thesaid that the present referral a medical officer for the 24- 18 posts for doctors. Similarly region. Source: ekantipur.comsystem is a trend and repre- hour service. Once the case is at the Seti Zonal Hospital, resolved at the Court, doctors eight out of 20 posts for doc-sents a way for doctors to hopefully will be advising pa- tors are still vacant. World Breastfeedingshun responsibilities.“Currently, it seems as if the tients round the clock, Gau- A dearth of doctors has also Week: ‘The number of tam said. Source: ekanti- hit hospitals and health facili-job of the referring doctor is ties in other districts, including exclusively breastfed in-done when they send the pa-tient elsewhere for treatment. Doti, Achham and Bajura, in fants increases in Nepal’The new policy will have HIV-infected faces Bir the region.mechanisms for proper identi- nurses’ ‘neglect’ KATHMANDU, AUG 05 - Tfication of the type of physi- Health officials said mass he government organizedcian who should receive the KATHMANDU, JUL 30 - transfer of doctors and health various programs from Au-referred patient. And aftertreatment, we will make sure B ir Hospital nurses have reportedly discriminated against a patient suffering workers from the hill districts like Bajura, Achham, Bajhang, Darchula, Baitadi, Doti and gust 1-7 to mark the World Breastfeeding Week under thethat the patients visit their theme of “Understanding thereferring doctor for follow-up.” from jaundice and appendici- Dadeldhura to urban areas Past - Planning the Future.” Source: tis upon knowing that he is has made the matter worse. HIV positive. Ramesh Bhan- Quality and accessibility of The programs, including coun-Are you facing any dari from Nuwakot district health services in the Far West seling, interactions and distribu- (name changed) and his care- is already dismal due to thehealth problems? Dial takers said they have been factors like a limited number tion of posters and pamphlets to health centers across the coun-1115. facing ill-treatment from of health posts to cater timely try, are being organized as per nurses at the country’s oldest, services to the people from Continued on page 4
  3. 3. August 2012 Public Health Perspective (PHP) Page 3 World Breastfeeding Week World Breastfeeding Week is celebrated every year from August 1-7 in more than 170 countries to encourage breastfeeding and improve the health of babies around the world. Twenty years ago, the World Alliance for Breastfeeding Ac- tion (WABA) launched its first World Breastfeeding Week (WBW) campaign with the theme: "Baby-Friendly Hos- pital Initiative". The week is set aside to en- courage breastfeeding and commemorate UNI- CEF and WHO’s Innocenti Declaration on the protection, promotion and support of breast- feeding worldwide. Breastfeeding is the best way to provide new- borns with the nutrients they need. WHO recommends exclusive breastfeeding until a baby is six months old and continued breastfeeding with the addition of nutritious complementary foods for up to two years or beyond. The theme of this year’s World Breastfeeding Week is ‘Understanding the Past, Planning the Future’ a relevant reference to the lessons learnt and the achievements over the past 20 years on infant and young child feeding (IYCF), and is a call to action to bridge existing gaps in policies and programs supporting breastfeeding and IYCF. Breastfeeding plays a great role in countering malnutrition which is tied to approximately one third of deaths amongst children under five; yet, the global exclusive breastfeeding rate of infants 0-6 months is just under 40% (WHO 2012). Over two third of those deaths, often associated with improper feeding practices, occur during the first year of life. By providing infants with the right amount of protein, sugar, fat and most vitamins, breastfeeding is key to healthy child development and is also beneficial to mothers as it reduces risks of breast and ovarian cancer later in life, helps women return to their pre-pregnancy weight faster, and lowers rates of obesity. >>Source: World Humanitarian Day Natural disasters, conflicts and other emergencies threaten the lives and health of millions of people every year. In the middle of such crises, thousands of dedicated humanitarian workers strive to care for those who have been affected and support local authori- ties to deliver assistance. On World Humanitarian Day, WHO and other international bodies are highlighting the roles performed by humanitarian workers, and remembering aid workers who have been killed or injured while performing their vital roles. It is a time to recognize those who face danger and adversity in order to help others. In 2008, the UN General Assembly designated 19 August World Humanitarian Day to raise public awareness of humanitarian assistance worldwide, recognize people who risk their lives to help people in need, wherever they are, to mark 2003 bombing of the United Nations headquarters in Baghdad, Iraq, which killed 22 UN staff. This year’s theme "I Was Here" is about making a mark by doing something good, somewhere, for someone else. “This year’s World Humanitarian Day presents an historic opportunity to bring to- gether one billion people from around the world to advance a powerful and proactive idea: People Helping People. This year, International star Beyoncé, the UN and humanitarian aid organizations have launched a global campaign website – which will provide members of the public with an opportunity to unite and share their individual acts of good. On the Day itself, which falls on 19 August, the campaign aims to reach one billion people in a day with a single message to shine a spotlight on humanitarian work and encourage people around the world to get involved by doing something good for others. World Humanitarian Day offers the chance:  for the public to learn more about the humanitarian community, what aid workers do and the challenges they face;  for nongovernmental and international bodies and UN agencies, to demonstrate their humanitarian activities;  to pay respect to those who have died or been injured in the course of their humanitarian work. World Humanitarian Day is a global day to celebrate humanity and the spirit of people helping people. >> Source: >>;;
  4. 4. August 2012 Public Health Perspective (PHP) Page 4 National News (cont…)Continued from page 2 whether they should be called a hospital.” KATHMANDU, AUG 08 -the Global Strategy for Infant and YoungChild Feeding endorsed by the member The report has also shown that the gov- ernment hospitals are also in very poor condition. Lack of human resources, dilapi- T he first national summit on drinking water and sanitation concluded on August 7 with a Kathmandu Declarationstates of the World Health Organization and dated and poorly managed buildings, ma- urging the concerned actors to workthe UNICEF executive board in 2002. Ne- jority of the equipment in a dysfunctional together to achieve the national targetpal, as a WHO member state, has adopted state and poor management among other of universal access to sanitation bya strategy to promote exclusive breastfeed- factors have affected services of the gov- 2017. The two-day meet was jointlying—the practice of keeping a child on a ernment hospitals, it said. The majority of organized by the Federation of Watersteady diet of nothing but mother’s milk the buildings of the government hospitals and Sanitation Users’ Nepalright from birth up until six months of built years ago, the study stated, needs to (FEDWASUN) and various government,age—as defined by the WHO. All WHO be retrofitted and many private hospitals non-governmental and donor agenciesmember states have recognized breast- run inside the city areas are operating in working in the sector. The declarationfeeding as the single most effective means the buildings initially meant for residential stresses the need to work together andof reducing under-five infant mortality. purpose. In a blow, the inspection process strengthen the coordination in areas in the hospitals of the Kathmandu Valley such as participatory policy-making,The government has envisioned the promo- was halted. According to Surya Acharya, capacity enhancement oftion of breastfeeding along with various joint-secretary of the MoHP and also the the sanitation user groups, institutionalawareness campaigns to inspire mothers coordinator of the inspection team inside development of FEDWASUN, and imple-and families about breastfeeding through the Valley, lack of budget stood in the way mentation of the programs and servicesthe National Nutrition Policy and Strategy and the program will be continued in this through the users’ network. Promotion2004. Stepping up its policy and strategy, fiscal year. The report, which did not in- of social campaigns on sanitation andthe government certified seven hospitals in clude Kathmandu, Lalitpur, Bhaktapur, cleanliness, and documentation of vitalthe country as Baby Friendly Hospital Ini- Sankhuwasabha, Bhojpur among others, achievements in the sector are amongtiatives (BFHI), whose prime focus would has been submitted to Minister Mahato. other priorities of the promoting breastfeeding. However, re- Source: ekantipur.comcent reports have shown that none of the According to the statistics provided byhospitals have followed the BFHI guide- Free blood for pregnant women the Department of Water Supply andlines. “We are working hard to implement Sewerage (DWSS) under the Ministry ofthe BFHI effectively,” said Dr Shyam Raj KATHMANDU, AUG 08 - Physical Planning and Works in 2010,Upreti, director of the Child Health Divi- still around 57 percent of the totalsion. According to Nepal Demographic andHealth Survey (NDHS)-2006, the number T he Family Health Division (FHD), under the Ministry of Health and Population (MoHP), is all set to provide blood free of population is deprived of ba- sic sanitation facilities and around 20 percent people lack access to safeof mothers who are exclusively breastfeed-ing their children has decreased from 68 cost to pregnant women starting this year. drinking water. A majority of the exist-percent in 2001 to 53 percent in 2006. The MoHP has been conducting free ma- ing water supply infrastructure is eitherHowever, new NDHS-2011 brings positive ternal services, from routine check-ups dysfunctional or lacks proper repair andnews with 70 percent of infants being ex- during pregnancy to delivery care, in all maintenance.clusively breastfed. government hospitals, birthing centers and Source: Source: selected private hospitals. “We had been giving all services related to pregnancies USAIDs family health programMany hospitals in sick bed: Report for free, except blood. With the govern- ment now providing blood for free, we can overKATHMANDU, AUG 06 - hope to reduce maternal deaths from KATHMANDU, AUG 17 – blood loss,” said Dr Sinendra Raj Upreti,A n inspection conducted by the Ministry of Health and Population (MoHP) hasrevealed that the majority of the private Director at the FHD. He said that the ser- vices will be carted to selected district hospitals outside the Kathmandu Valley U SAID/Nepal and the Health Ministry commemorated the closure of five- year Nepal Family Health Program IIand state-run hospitals in the country are and other big municipalities. The govern- (NFHP II). NFHP II helped strengthennot up to the standards. The ministry had ment has allocated two million rupees for Nepal governments health systems,formed 14 teams who were deployed in all this purpose. The FHD estimates that policy and leadership and enhance pub-14 zones of the country from October 31, there are around 770,000 pregnant lic health service delivery by increasing2011. Though the monitoring process re- women every year. Although all of them marginalized populations access tomained paused following an instruction do not require blood, the 2008-09 Mater- health services, according to a US em-from Health Minister Rajendra Mahato two nal Mortality Survey showed that 24 per- bassy release. Besides, the programmonths ago, the inspection team covered cent of maternal deaths were due to post- helped increase community participation173 hospitals of around 65 districts. “Most partum hemorrhage, a loss of great in health service management and ad-of the private hospitals have been found amounts of blood from the body during vance global best practices in familyrunning without renewing their licenses, delivery. planning, maternal and child health ser-while many of them are running sans min- Source: vices. The $30 million program wasistry registrations,” an official at the MoHP funded by the USAID and implementedinvolved in the inspection said requesting Sanitation summit ends with in 22 districts.anonymity. “There are private hospitals Kathmandu Declaration Source: ekantipur.comwith only four beds. We are not sure
  5. 5. August 2012 Public Health Perspective (PHP) Page 5 Global Health hemodialysis for kidney dis- total number of human influ- 15 August 2012 –South Africa to Become eases, according to the WHO," enza A (H5N1) cases in Indo-First Presidents Emer-gency Plan for AIDS Re- Reuters notes. “The recent es- calation of clashes had resulted in substantial damages to the nesia is 191 with 159 fatali- ties, 8 (all fatal) of which occurred in 2012. Source: B ill Gates, co-chair of the Bill & Melinda Gates Foun- dation, on Tuesdaylief (PEPFAR) Country to pharmaceutical plants located WHO "announced the winners of theNationalize AIDS Pro- in rural Aleppo, Homs and Ru- Ebola in Uganda – up- Reinvent the Toilet Challenge - ral Damascus, where 90 per- - an effort to develop next-gram cent of the countrys plants date generation toilets that will8 August 2012 – were located, a WHO spokes- deliver safe and sustainable" U.S. Secretary of State person, Tarik Jasarevic, told 14 August 2012 – sanitation to the 2.5 billion Hillary Clinton said during avisit to South Africa that Preto- reporters in Geneva today,” the U.N. News Centre writes. "Prior to the violence which has T he Ministry of Health (MoH) of Uganda contin- ues to work with partners people worldwide who dont have it," according to a foun- dation press release. "To passria will begin taking more of theresponsibilities for its HIV/AIDS wracked the Middle Eastern including WHO, CDC, Red the foundations threshold forprogram, part of a broader ef- country, Syria produced 90 Cross, Medecins Sans Fron- the worlds next toilet, it mustfort to overhaul the U.S. global percent of its medicines and tieres, World Vision, among operate without running water,plan for AIDS relief launched drugs locally," the news service others to control the out- electricity or a septic system,under former President George notes. break of Ebola hemorrhagic not discharge pollutants, pref-W. Bush," Reuters reports. "On fever in Kibaale district. The erably capture energy or otherWednesday, Clinton is expected “In addition to the lack of national and district task resources, and operate at ato sign a deal to rework South medicines, many hospitals and forces continue to meet daily cost of five cents a day," ac-Africas programs under PEP- health centers are also closed to coordinate the response to cording to the AssociatedFAR, allowing the government as a result of the fighting, while the outbreak. To date, 24 Press. "The new commodesto better use the funding in its rising fuel costs are preventing probable and confirmed were showcased at a Reinventfight against the virus," the travel by health workers. Some cases including 16 deaths the Toilet Fair on August 14-news service writes. 1.5 million people in rural areas have been reported. Ten 15 in Seattle," CNN writes, also need food assistance in the cases have been laboratory adding, "The foundation also"U.S. officials said South Africa next three to six months, confirmed by the Uganda announced a second round ofwill be the first PEPFAR country “especially in the areas that Virus Research Institute grants totaling some $3.4 mil-to begin to nationalize its pro- have seen the greatest conflict (UVRI) in Entebbe. The most lion to organizations that aregram, but others would be ex- and displacement,” said the recent confirmed case was working to innovative latrines".pected to follow as their capaci- World Food Programme. admitted in Kagadi isolationties increase and the United Source: facility on 4 August 2012. Gates "handed a $100,000States seeks to more effectively Suspected cases which tested prize to the California Institutetarget its overseas assistance in Avian influenza – situa- negative during the labora- of Technology on Tuesday foran atmosphere of budget aus- tion in Indonesia – up- tory investigations have been its work on a self-contained, discarded as Ebola cases, sun-powered system that recy-terity at home," according to date treated symptomatically for cles water and breaks downReuters. "The United States hasspent $3.2 billion since 2004 on their ailments and discharged human waste into storableanti-AIDS programs in South 10 August 2012 – following recovery. energy," Reuters reports, not-Africa, where 5.7 million peopleare infected -- or close to 18 T he Ministry of Health of Indonesia has notified World Health Organization A total of 43 people have been discharged from the ing, "Gates is focusing on the need for a new type of toilet as an important part of his foun-percent of the adult popula-tion," the news service notes. (WHO) of a new case of human isolation facility including one dations push to improveSource: Source: global- infection with avian influenza A confirmed case. With the health in the (H5N1) virus. The case is a 37 support of the psychosocial world". "Beyond a question of year old male from Yogyakarta team, these 43 people have human dignity, this lack ofSyrians in Urgent Need province. He developed fever been counseled prior to dis- access also endangers peoples on 24 July 2012, was hospital- charge and reintegrated into lives, creates an economic andof Life-Saving Medicines ized on 27 July and died on 30 the community. Even for the a health burden for poor com-as Fighting Escalates, July. Epidemiological investiga- people who were negative for munities, and hurts the envi-WHO Warns tion on the case found that the Ebola, psychosocial counsel- ronment, Gates said," Agency he had four pet caged birds in ing of the communities to France-Press reports, continu-8 August 2012 – his home, which is about 50 which they are returning, has ing, "Food or water tainted" Syrians are in urgent need of meters from a poultry slaugh- been very important. It has with fecal matter causes intes- life-saving medicines follow- ter house and near a farm. allayed fears and reduced tinal diseases that kill 1.5 mil-ing an escalation in fighting, Infection with avian influenza A stigma, enabling them to be lion children annually – a fig-which also threatens further (H5N1) virus was confirmed by accepted back in the commu- ure higher than deaths fromfood shortages, U.N. agencies the National Institute of Health nity. Source: WHO AIDS and malaria combined,warned on Tuesday," Agency Research and Development according to Gates". (NIHRD), Ministry of Health and Gates Looks To DevelopFrance-Press reports. "Drugs fortuberculosis, hepatitis, hyper- reported to WHO by the Na- Next-Generation Toilets Source: globalhealth.kff.orgtension, diabetes and cancer tional Institute of Health Re- For Developing Worldare urgently needed, as well as search Focal Point. To date, the
  6. 6. August 2012 Public Health Perspective (PHP) Page 6 Journal Watch Prevalence of blindness and visual impairment and its causes among people aged 50 years and above in Karnali Zone, Nepal How to join PHP? Cataract and refractive error are the common cause of blindness and visual impairment and fe- males are three times more prone to blindness than male, according to the study published in 2012 Volume 4 Issue 8 of Nepal Journal of Ophthalmology. e-Mail: Twenty four clusters of 50 people aged 50 years and above were selected by stratified cluster sampling. Visual acuity was recorded with simplified vision testing card with one optotype “E” of website: size 60 on one side and size 18 on the other side. Examination by ophthalmologist under mydriasis was done for those with a pinhole visual acuity of less than 6/18. Out of the 1200 enumerated publications.php people aged 50 years or above, only 1174 participated in the study. Among the examined, 545 (46.6%) were between 50-59 years, 417 (35.6%) were between 60-69 years, 171 (14.6%) were between 70-79 and 38 (3.2%) were above 80 years of age. The number of male and female was 646 (55.2%) and 525 (44.8%) respectively. According to the study, the prevalence of blindness in female for available and best correction was 4.8% and 2.3% respec- Benefits of tively and for male it was 2.3% and 1.1%. Overall, the study found the prevalence of blindness with available correction as 3.4% and with best correction as 1.6%. As per the study, the preva- Being a PHP lence of blindness increased with the age, being highest at 70-79 years. The study found cataract as the main cause of blindness for both sexes followed by uncorrected aphakia. Similarly, un- Subscriber treated cataract was responsible for severe visual impairment. The study suggests for accessible and equitable services for blindness prevention.  Can submit articles to Full text article is available at: Nepal J Ophthalmol 2012; 4(8):282-287. PHP newsletter Authors: Dulal S, Sapkota YD  Heavy discount rate in PHP trainings, work- shops, seminars, con- Resource of the Month (Climate Change Action Website) ferences Climate Change Action is a website that provides basic climate change information for health pro-  Get acquainted with fessionals. The website main aim is to support to mitigate and adapt to the effects of climate public health news from change. This website is thought to be useful to those interested in climate change as it contains assessment tools to reduce the carbon footprint of hospitals, clinics, and offices. Other features of around the nation and the website include climate change related documents on lessons learned and success stories, and globe at a time an area for blogging.  Enhances professional Some useful resources and tools include– public health related resources, the health impacts of writing skills climate change Information, URL of some useful links, docu- ments and links on how to change our everyday activities to reduce the effects of climate Send Letters to the change and slow down its proc- Editor ess. The video section of the website is a hub of climate change related videos where  All readers can post you can watch them online. comments on articles The website is developed by and news mentioned in Ms. Rose M. Schneider--RN PHP or could be sugges- MPH, who is a climate change & tions and compliments. sustainability advisor and a  Send letters to: senior health specialist with climate change programming expertise. She has 20 years of public health and clinical experience with USAID, World Bank, UNFPA, NGOs and the private sector. She has also experience linking climate change mitigation and adaptation to health and population  Word limit 150 max. and programming. Ms. Schneider provides senior level advice to missions, ministries, NGOs and pri- the title of news or arti- vate organizations on actions to mitigate and adapt to the effects of climate change. Currently she cles of critique. is working as a chair of American Public Health Association (APHA) International Health Section  Email should include Climate Change Working Group. ‘letters to the editor’ in email subject line. If you are interested in knowing more about climate change action and its work, please contact: Rose Schneider RN MPH,
  7. 7. August 2012 Public Health Perspective (PHP) Page 7 The 10 Essential Services of Public Health, With Climate Change Examples Service Climate Change Example 1. Monitor health status to identify and solve community Tracking of diseases and trends related to climate change health problems. 2. Diagnose and investigate health problems and health Investigation of infectious water-, food-, and vector-borne disease hazards in the community. outbreaks 3. Inform, educate, and empower people about health Informing the public and policymakers about health impacts of issues. climate change 4. Mobilize community partnerships and action to iden- Public health partnerships with industry, other professional groups, tify and solve health problems. faith community, and others, to craft and implement solutions 5. Develop policies and plans that support individual and Municipal heat-wave preparedness plans community health efforts. 6. Enforce laws and regulations that protect health and (Little role for public health) ensure safety. 7. Link people to needed personal health services and ensure the provision of health care when otherwise un- Health care service provision following disasters available. 8. Ensure competent public and personal health care Training of health care providers on health aspects of climate workforce. change 9. Evaluate effectiveness, accessibility, and quality of Program assessment of preparedness efforts such as heat-wave personal and population-based health services. plans Research on health effects of climate change, including innovative 10. Research for new insights and innovative solutions techniques such as modeling, and research on optimal adaptation to health problems. strategies >> Source.
  8. 8. August 2012 Public Health Perspective (PHP) Page 8 Being Healthy director of the Interpersonal Relationships Have you ever wondered why some of your Healthy relationships Laboratory at New York’s Stony Brook Uni- relationships are more effective than others? lead to better lives versity. Researchers have learned a lot in the last 30 years about what makes good relationships The quality of our personal relationships tick, and it boils down to just a few things. also has an enormous impact on our physi- Unfortunately, most folks are only minimallyUnless you’re shipwrecked on a cal health, as evidenced by a hefty number aware of those elements, Aron says, anddeserted island, you probably of research studies. “We support each other therefore aren’t doing everything they could beenjoy a handful of close relation- in getting enough exercise, eating right, doing to improve their relationships.ships. From spouses to children flossing — all the things that make for bet-to friends, parents, siblings and ter health can be supported or undermined Mind your mental healthsignificant oth- by close relation- Withouters, healthy rela- ships,” Aron question,tionships build says. the mentalself-esteem, im- health of allprove mental and In the movie parties isemotional health “Cast Away,” the mostand help you live Tom Hanks’ char- importanta fuller life. acter — stranded element of on an uninhab- a good re-“Relationships ited island — lationship.are — not sur- creates a face on If you suf-prisingly — enor- volleyball and fer frommously important for health, and talks to the ball, which he names “Wilson,” depression,there are lots of studies on the as if it were a person. Though fictional and anxiety,biological processes that account funny, the gesture illustrates something insecurityfor the link between relation- very basic about us: Relationships are im- or low self-esteem, seek help from a healthships and health,” says psychol- portant — so important, in fact, that our professional right away, because it’s not justogy professor Arthur Aron, PhD, brains are hardwired to form them. you, but also your relationship, that will suffer. friends and family members. You can’t always control the stressors in your life, but for your relationships to be effective, try to keep stress to a minimum. Learning to recognize unhealthy relationships should start Also, be understanding when others are going through a tough early. The Centers for Disease Control and Prevention’s Choose time. Someone who loses her or Respect initiative, online at, his job, for example, might be- is available to help teens learn how to make decisions about have negatively for a little while. relationships with their friends, family and dating partners. But things should get better eventually. Build a bridge of support Support from family and a Keep the lines open friend is an ingredient that “We just don’t communicate!” is repeatedly surfaces in a common refrain in relationships good relationships. You — too common in fact, because might need someone to after mental health, effective take the kids for the night, communication is the second most important ingredient in a or help with carpooling. If healthy relationship. Communication is important because con- you have a support system flicts are inevitable in relationships, and “most people are in place, or live near poorly prepared to deal with them well,” Aron says. friends and family, don’t be afraid to ask them for a Watch for unhealthy relationships helping hand, a sympa- Not all relationships are going to be perfect all thetic ear or advice. the time, but for the most part, a good relation- ship makes you feel secure, happy, loved, re- “All relationships require effort and attention,” Aron says. spected and free to be yourself. If you are in a “Sometimes that effort and attention is automatic, such as with relationship that makes you feel fearful, humili- an infant. Beyond what is automatic, for most relationships, we ated or controlled, or are a victim of physical, usually need to put attention and effort into them, and it pays emotional or sexual abuse, consult with your off.” >> Source: Healthy You Public Health Perspective (PHP) Online Newsletter (The Nations’ Health, March 2011)
  9. 9. August 2012 Public Health Perspective (PHP) Page 9 WHO PublicationsBulletin of WHO Vol. 90, No. 08, 2012The Bulletin of the World Health Organization is an international journal of public health with a special focus on developingcountries. Since it was first published in 1948, the Bulletin has become one of the worlds leading public health journals. As theflagship periodical of the World Health Organization (WHO), the Bulletin draws on WHO experts as editorial advisers, reviewers,and authors as well as on external collaborators. Full bulletin is available at: Abortion Second editionIn view of the need for evidence-based best practices for providing safe abortion care and in order to protect the health and humanrights of women, the World Health Organization (WHO) has updated its 2003 publication -Safe abortion: technical and policy guid-ance for health systems. Download is available at: Evaluation of Certain Veterinary Drug Residues in FoodThis volume contains monographs prepared at the seventy-fifth meeting of the Joint FAO/WHO Expert Committee on Food Addi-tives (JECFA), which met in Rome, Italy, from 8 to 17 November 2011. The toxicological monographs in this volume summarizedata on the veterinary drug residues that were evaluated toxicologically by the Committee: the antimicrobial agent’s amoxicillinand apramycin and the anthelminthics derquantel and monepantel. Download is available at: Plan for Insecticide Resistance Management in Malaria VectorsThe next few years will be critical in the fight against malaria and the global health community needs to recognize that mosquitoresistance to insecticides is now also a serious challenge to malaria control efforts. Insecticide resistance has been identified in 64countries around the world, affecting all WHO Regions with ongoing malaria transmission. Download is available at: Welcome Our New Campus LiaisonsAPPLY FOR CAMPUS LIASION Our Campus LiaisonsIf you are interested in participating as a Campus Liaison and have anyquestions about the Liaison position, please contact us.Email: Call for Articles for September Issue  400-500 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. August 2012 Public Health Perspective (PHP) Page 10 Public Health Perspective (PHP) Team International Honorary Editorial Advisories Rajiv Gandhi University Contributing Writers Bangalore Editorial Advisories Dr. Duk Bahadur Dr. P. Ravi ShankarMs. Rose Schneider -- Chhetri Madan Kc Professor, Clinical Phar- RN MPH MD, Pathologist Msc. Medical and Health macology & Medical Edu- Chair of the Climate Western Regional Hos- Care Devices cationChange Working Group pital Lab. University of Bolton, UK KIST Medical College of the APHA Interna- Pokhara Lalitpur, Nepal. tional Health Section. Dr. Santosh RajSenior Health and HIV/ Mr. Balram Banstola Poudel Dr. Anis Rehman AIDS Specialist Managing Director, Residency (MD) in Inter- Associate Chief Editor at Health Systems Man- Senior Pharmacist nal medicine Journal of Pakistan Medi- agement Banstola Medical Hall Interfaith Medical Cen- cal Students (JPMS)1414 Perry Place NW - Kaski ter, New York HIFA 2015 Country Rep- Suite 100 resentative for PakistanWashington, DC 20010 Board of Advisories Dr. Krishna Chandra Ms. Sami Pande Rijal Newsletter Team B. Pharm, MPH Dept. of Otorhinolaryn- Editor-in Chief Australian Leadership gology and Head & Neck Amrit Banstola Dr. Margaret Steb- Scholar, 2009 Surgery, College of bing Kathmandu Medical Sciences and Section Editors PhD, Master of Public Teaching Hospital Anoj Gurung Health, Dip App Sci Arjun Poudel Bharatpur, Chitwan Dikshya Sherchan Nursing Msc. Pharm (Social and Dipendra Malla Population Health Aca- administrative Phar- Mr. Chandra Bhushan Sandeep Pahari demic macy) Yadav Sangita Shrestha School of Rural Health, Universiti Sains Malay- Information Officer Subash Timilsina Monash University sia, Penang , Malaysia (MLIS) Sulochana Prajapati Australia Nepal Health Research Ashik Banstola Council (NHRC) M. Pharm MOHP, Kathmandu (Pharmacology), PDCRWelcome to New SubscribersNepal Kamal Raj Pandit Shanti Shrestha InternationalAjaya Acharya Keshav Rana Shrutee Koirala Chandrakant RevankarAmbika Baniya Krishna Prasad Sapkota Sunita Shrestha Devashish ChhetriAnil Banstola Mahesh Joshi Sunu DulalArun Karki Manisha HamalDeepa Banstola Manisha ChaliseDharmendra Gajurel Namrata BhandariGokul Pathak Rajani BaralArticles 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 don not discriminate on the basis of race, color, gen-der, 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