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WHO report finds rich and poor nations now battle all kinds of diseases

Tue, 17 May 2011 00:00:00 -0700

The Guardian - May. 17 - Progress has been made on key MDG health targets, but non-infectious diseases have spread to developing countriesThe world is experiencing a change in the geographic distribution of diseases. Traditionally, infectious diseases, which claim the lives of so many children, have affected poor countries and non-communicable diseases, such as diabetes, cardiac ailments and cancer, have plagued rich countries.But the latest statistics released by the World Health Organisation (WHO) on Friday show that the income level of nations is no longer so important, and that all countries now face the burden of both kinds of diseases.Up to now, non-communicable diseases tended to be identified as the ills of opulence, limited to high-income countries, WHO's director of health statistics and informatics, Ties Boerma, told IPS.However, due to changes caused by the ageing population, improvements brought about by the global effort to meet the millennium development goals (MDGs), changes in birthrates and other factors, developing countries are now also fighting non-infectious diseases, he said.Boerma noted that the phenomenon began in urban areas of developing nations, among the most highly educated population groups, but it is now expanding rapidly. That was one of the central conclusions reached by WHO experts on the basis of the World Health Statistics 2011 report published on Friday.The study confirms that important progress has been made in improving the main health indicators, fighting poverty, bolstering gender equality and education, and moving towards the other goals outlined in the eight MDGs, which were agreed by the international community in the 2000 UN general assembly and have a 2015 deadline, Boerma said.Over the past 10 years, the rate of improvement of infant and maternal mortality rates – key MDG targets – has been twice as fast as progress made in the 1990s.Many countries are still lagging, some of them considerably, which means a huge effort is needed over the next five years to meet the MDGs, Boerma said. Nevertheless, the rate of progress is speeding up overall, he added.In the case of child mortality, the world is only halfway to the MDG target, while in the case of maternal mortality, the world is only one-third of the way there, the WHO expert said.The question of infant mortality will be evaluated again in September, when WHO and Unicef, the UN children's fund, release new statistics. For now, "we are still standing at 8.1 million" children under five who died in 2009, Boerma said, compared with 12.4 million in 1990.With respect to the situation in the Americas, he said the statistics show that "very good progress" has been made in many countries.In Brazil, Argentina and Chile, for example, "there have been steady but relatively fast declines in child mortality, and coverage intervention is high. And they also reduced the inequity between the poorest and the richest. Brazil has been a very good case study of where the poorest have benefited," he said, adding that Mexico has also progressed.At the other extreme, of course, is Haiti, he said, adding that the health indicators are still worrying in countries like Bolivia and Peru, which have made some advances but "still have a much longer way to go".Boerma cited the case of Cuba, pointing out that although it is not a rich country, it "spends quite a lot on health" and does so "in a very equitable way."Everybody has (free) access to health services," he said. "So in terms of life expectancy it ranks quite high and it has low child mortality and high coverage of intervention. So it is very successful in reaching the whole population and getting good value" for its investment, he added.The expert noted that the US "is not at the top" in terms of health statistics in the Americas. He said: "They are at the top when it comes to the amount of money they spend on health. But they are not at the top in terms of getting good results for their investments in health services."One reason," he said, "may be that coverage of the whole population is not so good. So much of the expenditure goes to relatively expensive curative interventions or interventions that benefit a smaller proportion of the population."The WHO study reported that average global life expectancy rose from 64 years in 1990 to 68 in 2009. In poor countries, the average is 56 years, while it has climbed to 80 years in wealthy countries.Life expectancy for women is five years longer on average than for men. That difference has held fairly steady, between four and five years, over the past two decades.The WHO figures show there is still a huge gap in health spending between low and high-income countries, averaging an annual $32 per capita in the former and $400 per capita in the latter.The study reports that high-income countries have, per capita, 10 times more doctors, 12 times more nurses and midwives and 30 times more dentists, on average, than low-income countries.HealthWorld Health OrganisationAids and HIVMillennium development goalsInfant mortalityMaternal healthMaternal mortalityUnited StatesBrazilArgentinaCubaBoliviaPeruHaitiUnited Nationsguardian.co.uk © Guardian News & Media Limited 2011 | Use of this content is subject to our Terms & Conditions | More Feeds

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Like oil and water in the gulf

Mon, 14 Mar 2011 00:00:00 -0700

Los Angeles Times - By Sarah Stephens - Mar. 14 (Opinion) - As Cuba explores for oil in the Gulf of Mexico, the U.S. embargo could hurt both countries. Cooperation and engagement, however, could benefit American firms and protect the environment.

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In Sudan, Possible New Country Poses Health Care System Challenges

Mon, 03 Jan 2011 23:28:00 -0800

NewsHour - Jan. 03 - Listen to the Audio GWEN IFILL: Next tonight: the health care challenges that threaten to overwhelm an African nation as it prepares to cast a critical vote on independence.Special correspondent Jeffrey Kaye reports from Southern Sudan.JEFFREY KAYE: On the banks of the Nile River in South Sudan, entrepreneurs pump water to fill up tankers. Private water collection and sales from rivers and wells is big business here, particularly during the dry season. But, for customers, the water often comes at a high cost.DR. JUSTIN BRUNO, Al Sabah Hospital: It is a good business for them, but this is spreading diseases.JEFFREY KAYE: Dr. Justin Bruno directs the Al Sabah children hospital in the town of Juba.JUSTIN BRUNO: The water is not treated. It is just flowing naturally. And then it comes into the tanks and the tankers sell it to the people. And the people just drink them. It's not boiled. It's not treated.JEFFREY KAYE: And what happens as a result?JUSTIN BRUNO: Diarrheal diseases. People get acute diarrhea. People get what are bloody diarrhea and typhoid fever. And that is rampant in this town and in Southern Sudan.JEFFREY KAYE: And you can trace that right back to those tanks?JUSTIN BRUNO: Right back to the river water.JEFFREY KAYE: Patients suffer not only from preventable diseases, but, even if they make it to a health care facility, often from inadequate treatment.This is essentially the waiting room of the only children's hospital in South Sudan. The health care system, such as it is here, is barely functioning. Most people have no access to health care. So, the challenge is not so much to improve the system. It's to create one.JUSTIN BRUNO: The most pressing medical need is lack of medical supplies. The medical supplies is not enough for the patient.JEFFREY KAYE: What do you mean?JUSTIN BRUNO: The medications are not enough for the patients.JEFFREY KAYE: Besides the lack of drugs, the hospital's single X-ray machine is broken. It shares a storage room with a busted blood bank refrigerator. There's no ultrasound or C.T. machine. And even though there's an emergency ward, the hospital has no anesthesia.Inpatients here, most suffering from malaria, malnutrition, respiratory infections and diarrhea, often share beds or sleep on the floor.Mary Camisa (ph) walked here barefoot from her village 50 miles away, carrying her 3-year-old son suffering from convulsions brought on by cerebral malaria.JUSTIN BRUNO: They are very far distances to walk in. Some, they often drive two days to arrive here to get health care services here. So, we need to decentralize more these health centers, so that they're closer to the people.JEFFREY KAYE: South Sudan's dire health conditions are reflected in a recent United Nations compilation of what it calls ‘scary statistics.' Most people have no access to safe drinking water or sanitation. Malaria is hyperendemic. A 15-year-old girl is more likely to die in childbirth than finish school.Katie Morris is a program manager for Catholic Relief Services, which, among other projects, provides support for 43 health facilities in Southern Sudan.KATIE MORRIS, Program Manager, Catholic Relief Services: If you look at it by the numbers, it paints quite a grim picture. Maternal and infant mortality are among the highest in the world. Vaccination coverage is among the lowest for children and -- and pregnant women. It's a very sad picture.JEFFREY KAYE: Changing that picture will be among the biggest challenges facing an independent South Sudan if, as expected, people here vote to separate from the North in a referendum that begins January 9.Even now, South Sudanese officials are planning how to build a medical system, virtually from scratch. Member of parliament Dr. Martha Martin heads the legislature's health committee.DR. MARTHA MARTIN, Southern Sudan Legislative Assembly: So, we need to think about rural areas to be developed. Develop them through the primary health care.JEFFREY KAYE: A family doctor trained in Cuba, Martin says family health centers can be used as building blocks of a national system.MARTHA MARTIN: If have primary health care, you won't have difficulties when you have somebody. You receive first the patient in the center. You give them the first aid and then you send them to a big hospital. The patient will be saved.JEFFREY KAYE: So the first thing to do is develop a primary health care system?MARTHA MARTIN: We have to have a good, big hospital, well-equipped.JEFFREY KAYE: It's an ambitious undertaking. Clinics like this one, the Saint Kizito primary health care center in the town of Juba, are scattered throughout the country. But less than 30 percent of South Sudan's population has access to health care services. And, like the hospitals, many clinics also lack resources. When we arrived at the health center, women were waiting to have their children vaccinated. The mud floor clinic has no running water, no toilets, no delivery routes, no doctor. Medications were running low, and the staff of 10 shared two stethoscopes.This clinic is funded by the Catholic Church. Outsiders, including the U.S. government, the U.N., evangelical groups, and aid organizations, pay for most of South Sudan's health care.KATIE MORRIS: Over 60 percent of the health facilities in Southern Sudan are supported financially and in some cases operationally by international or national non-governmental organizations. So, the idea is that, over time, the government capacity will grow and that they will be able to absorb some of these facilities and take staff on to their payroll.JEFFREY KAYE: What few services the government currently provides are inefficient. After several hours at the Saint Kizito clinic, many women had given up waiting for vaccinations. The serum hadn't come, so patients had drifted away.Some clinics are trying to reduce maternal and child mortality rates by sending community health workers into villages. In the shanty neighborhood of Lologo on the outskirts of Juba, midwives from a U.S.-funded clinic visit huts to provide women with pre- and post-natal instructions and care. One in seven pregnant women in South Sudan is likely to die as a result of the pregnancy. Fourteen percent of children die before their fifth birthday.Midwife Rajibia Ahmad says simple lessons can save lives.RAJIBIA AHMAD, Midwife, Lologo Clinic: I will come here to see the baby, to see the mother, to check them, and to give her -- answer the question again, give them hygiene, how to eat, how to birth the baby.JEFFREY KAYE: Breast-feed.RAJIBIA AHMAD: Yes, breast-feeding.JEFFREY KAYE: Ahmad had delivered baby Emanuel (ph) seven days earlier. That's a rare occurrence in South Sudan, where only 10 percent of births are attended by a health care worker. The midwives urge pregnant women to deliver their babies in the clinic, to use clean water, and to avoid putting ashes on severed umbilical cords, a traditional treatment.Officials say they are optimistic about building a health care system in South Sudan. South Sudanese professionals who trained abroad during decades of civil war are returning to the country to practice medicine, among them, Dr. Bruno, who attended medical school in neighboring Uganda, where, as a teenager, he had fled by foot, a yearlong trek from his home. Bruno believes that independence might lead to less spending on the military and more on health.JUSTIN BRUNO: At the moment, more than 50 percent of our resources, of our budget go for security.JEFFREY KAYE: To the military?JUSTIN BRUNO: For the military.If independence comes, the reverse will be true. There will be less spending in the army and then there will be more spending in health care system and other service delivery. So, independence will mean a lot of development coming in, a lot of health care system improving, because the fact the money that go for security will have been put in development, the special health care system.JEFFREY KAYE: How much South Sudan spends on its military is likely to depend in part on whether the independence vote and its aftermath will be peaceful. In any event, economic development should go a long way to help reverse the abysmal health statistics by spurring the creation of water and sanitation systems. South Sudan's interim constitution guarantees free primary health care to all, clearly a long-term goal.For now, officials and health workers are combating preventable diseases with more basic steps: education, better nutrition, and simple drugs.

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How does US healthcare compare to the rest of the world?

Mon, 22 Mar 2010 00:00:00 -0700

The Guardian - Mar. 22 (Opinion) - So we spend 2 fifths of what the US spends on healthcare, live 2 years longer and have by far and away the most nurses per capital than any other country on this list. What could any American ever dislike about that? They should be ashamed that they

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A terrorism designation Cuba doesn't deserve

Mon, 04 Jan 2010 00:00:00 -0800

Washington Post - By Eugene Robinson - Jan. 04 (Comment) - There is no history of radical Islam in Cuba. In fact, there is hardly any history of Islam at all. With its long-standing paranoia about internal security and its elaborate network of government spies and snitches, the island nation would have to be among the last places on Earth where al-Qaeda would try to establish a cell, let alone plan and launch an attack.

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Neither Engagement Nor Isolation Have Worked in Cuba

Mon, 13 Apr 2009 00:00:00 -0700

Wall Street Journal - By Maria Werlau - Apr. 13 (Opinion) - The ascendancy of Raúl Castro to Cuba's presidency has fueled expectations of reform in the 50-year-old dictatorship. Next week, President Barack Obama will be pressed on the issue at the Summit of the Americas in Trinidad-Tobago.

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Real W.M.D.'s

Sun, 22 Jun 2008 00:00:00 -0700

New York Times - By Richard Holbrooke - Jun. 22 (Review) - Any new entry in the crowded field of books on the 1962 Cuban missile crisis must pass an immediate test: Is it just another recapitulation, or does it increase our net understanding of this seminal cold war event? By focusing on the activities of the American, Soviet and Cuban militaries during those tense October days, Michael Dobbs's "One Minute to Midnight" passes this test with flying colors. The result is a book with sobering new information about the world's only superpower nuclear confrontation -- as well as contemporary relevance.

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Bush pushes democracy for Cuba

Sat, 08 Mar 2008 00:00:00 -0800

Seattle Post Intelligencer - By Deb Riechmann - Ap - Mar. 08 (Press Release) - President Bush chastised most other countries Friday for "a sad and curious pattern" of doing little to speak out against human rights and political abuses in Cuba. "Unfortunately, the list of countries supporting the Cuban people is far too short and the democracies absent from that list are far too notable," Bush said at the White House. The "small band of brave nations" speaking out for freedom in Cuba include, Bush said, his own administration as well as nations that were in the Communist bloc but are now democratic such as the Czech Republic, Estonia, Hungary, Latvia, Lithuania, Poland, Slovakia and Slovenia.

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Castro's legacy

Sat, 23 Feb 2008 00:00:00 -0800

Economist - Feb. 23 (Opinion) - Look a bit further ahead, and two broad scenarios seem possible in Cuba. The first is one in which the Communist Party oversees the introduction of capitalism while retaining political control...The other scenario is the one long dreamed of in Miami and in Washington, of the regime's sudden collapse and, it is assumed with a confidence many Iraqis may find worryingly familiar, a swift move to liberal democracy....a policy that has failed to hurt the Castros for four decades is unlikely to work now. America risks leaving the field to Mr Chávez, who wants Venezuela to become more like Cuba rather than the other way around (he is already giving Cuba fast internet access because America won't). And what if pressure "worked"? The result at the moment could be chaos and violence. Cuba needs not just to dismantle Fidel's Communism but to construct the state institutions that might underpin capitalist democracy. The country can prosper only if the two Cubas--the entrepreneurial diaspora of 1.5m Cuban-Americans and the 11m on the island--work together, rather than against each other. But that, too, will take time.

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