Every five years, the National Statistics Office conducts a National Demographic and Health Survey which mainly looks at the health of women and children. The earliest surveys focused on family planning, but over the years it has expanded to become the most comprehensive source of information on other health issues in the country.
Just to give a few examples, you can find statistics on the use of tobacco, domestic violence and sexual behavior. There is also information on households’ access to safe water, ownership of durable goods, exposure to mass media. What I find most useful in the NDHS is the breakdown of statistics according to urban/rural residence, region, age groups and, in more recent surveys, income.
Except in 2003, all the surveys have been limited to women respondents, but the information remains important because our women play so many important roles in health care, within and outside the home.
The final results from the 2008 survey, with 13, 594 women interviewed from all the regions in the Philippines, were presented last week. The NSO asked me to respond to the findings concerning HIV/AIDS and TB during the dissemination symposium, and I thought I’d share my thoughts about the findings about TB.
Tuesday, January 19, 2010
Tuesday, June 30, 2009
Too young, too curious
Adolescence is a period marked by confusion, as adolescents try to make sense of the changes in their physical appearance, as well as to establish their own identity. It is a crucial stage where being curious is not enough; that curiosity has to be satisfi ed, and the consequences can often be dire. One of the pressing concerns facing adolescents is the rise of unwanted pregnancy and incidences of sexually transmitted infections (STI) among this particular age group.
Sexual initiation among adolescents is occurring at a younger age; the typical age for boys is 13 and 14 for girls. More alarming, most of fi rst time sex were either
unplanned or non-consensual. The 2002 Young Adult Fertility and Sexuality Study (YAFS) conducted in the Philippines showed that 57 percent of fi rst time sex fell in
the unplanned or non-consensual category. For unplanned - and therefore unsafe - sex, the risk of unwanted pregnancy and/or getting STI becomes higher.
Sexual initiation among adolescents is occurring at a younger age; the typical age for boys is 13 and 14 for girls. More alarming, most of fi rst time sex were either
unplanned or non-consensual. The 2002 Young Adult Fertility and Sexuality Study (YAFS) conducted in the Philippines showed that 57 percent of fi rst time sex fell in
the unplanned or non-consensual category. For unplanned - and therefore unsafe - sex, the risk of unwanted pregnancy and/or getting STI becomes higher.
Thursday, June 18, 2009
Similarities and Differences of Traditional and Professional Health Care Systems
This study examines the convergence and divergence of traditional and professional health systems among the B’laan communities in the municipality of Sarangani in the context of their child health care services. The B’laan is an indigenous tribe living in the southern island of Mindanao, in the Philippines.
Background of the Study
The Alma Ata Declaration in 1978 enunciated health as a basic human right. This reserves the right of individuals to access the highest attainable standard of health through the provision of basic health and social services. Specifically, the principle has defi ned access to health care as the affordability, accessibility, availability, and cultural acceptability of health care services amongst peoples across cultures. It also identifi ed the roles of governments, non-government organizations (NGOs), and international institutions in providing the health care needs to achieve a better health for all. This international pact also identified the basic elements of health that are vital to the management and provision of services to the people.
Background of the Study
The Alma Ata Declaration in 1978 enunciated health as a basic human right. This reserves the right of individuals to access the highest attainable standard of health through the provision of basic health and social services. Specifically, the principle has defi ned access to health care as the affordability, accessibility, availability, and cultural acceptability of health care services amongst peoples across cultures. It also identifi ed the roles of governments, non-government organizations (NGOs), and international institutions in providing the health care needs to achieve a better health for all. This international pact also identified the basic elements of health that are vital to the management and provision of services to the people.
Child Labor
Child labor is actual manpower coming from people below the age of 18. It is work that exceeds a minimum number of hours, depending on the age of a child and on the type of work. For children aged fi ve to 11, beyond one hour of economic work or 28 hours of domestic work per week already constitutes child labor. The hours increase as the child becomes older. For children 12 to 14 years old, 14 hours of economic work or 28 hours of domestic work per week is considered child labor. For minors 15 to 17, the minimum is 43 hours of economic or domestic work per week.
It comes in different forms. Children can work as household help or as workers in farming and fishing industries. Some are given work in quarries, mines, brick kilns and construction sites. On an even more dangerous note, children are increasingly becoming more involved in the drug trade or serve as providers of sex services. It is reported that children living in the poorest households are most likely to be involved in child labor, especially those in the rural areas.
It comes in different forms. Children can work as household help or as workers in farming and fishing industries. Some are given work in quarries, mines, brick kilns and construction sites. On an even more dangerous note, children are increasingly becoming more involved in the drug trade or serve as providers of sex services. It is reported that children living in the poorest households are most likely to be involved in child labor, especially those in the rural areas.
Wednesday, June 10, 2009
Domestic Violence in Vietnam: Situations and Challenges
Though national level statistics on gender-based violence do not exist, existing research shows that domestic violence is a problem in North Vietnam. A number of
recent studies in North Vietnam suggest that about one third of women experience domestic violence, and one in every three abused women suffer more than one kind of violence.
Social norms and cultural attitudes pose a challenge in program intervention. Violence against women is a socially acceptable behavior amongst Vietnamese men; it is seen as a punishment for their wives when they transgress the traditional roles. In addition, Vietnamese women are expected to quietly endure the hardships and protect the harmony and reputation of the family. Many abused women, therefore, do not seek support.
Multisectoral action against domestic violence Vietnam has made many efforts in response to this issue. In 2007, the government issued a Law on Domestic Violence Prevention and Control, which clearly defined domestic violence as “any intentional action by a family member to cause damage or potentially cause damage in terms of physical, spiritual, and economic damages to another family member” and provides a legal framework for the intervention and prevention of domestic violence.
recent studies in North Vietnam suggest that about one third of women experience domestic violence, and one in every three abused women suffer more than one kind of violence.
Social norms and cultural attitudes pose a challenge in program intervention. Violence against women is a socially acceptable behavior amongst Vietnamese men; it is seen as a punishment for their wives when they transgress the traditional roles. In addition, Vietnamese women are expected to quietly endure the hardships and protect the harmony and reputation of the family. Many abused women, therefore, do not seek support.
Multisectoral action against domestic violence Vietnam has made many efforts in response to this issue. In 2007, the government issued a Law on Domestic Violence Prevention and Control, which clearly defined domestic violence as “any intentional action by a family member to cause damage or potentially cause damage in terms of physical, spiritual, and economic damages to another family member” and provides a legal framework for the intervention and prevention of domestic violence.
Tuesday, June 09, 2009
The ties that bind: untangling the socio-political context of Maternal and Child Health
Maternal and child health (MCH) is not an entirely new concern, but its inclusion in the Millennium Development Goals (MDG) gave its attainment priority status. Goal 4 calls for the reduction of under-fi ve mortality by two-thirds by 2015, while Goal 5 aims to reduce maternal mortality rate by three-quarters.
Barely six years before the deadline, the global community still has a lot of catching up to do. At best, efforts to reduce maternal and child mortality ratios produce patchy results, with some countries attaining a level of success, while
others further slide down the ladder.
Maternal health
According to The Millennium Development Goals Report 2007, while child mortality
is on the decline, more than half a million women worldwide still die of pregnancy and/or childbirthrelated complications every year. In the Asia-Pacific region, South Asia posted the highest maternal mortality ratio of 546 deaths per 100,000 live births in 2000. East Asia, on the other hand, had the lowest ratio of 55 per 100,000 live births. From 1997 – 2002, 31 percent of maternal deaths in Asia was due to hemorrhage.
Barely six years before the deadline, the global community still has a lot of catching up to do. At best, efforts to reduce maternal and child mortality ratios produce patchy results, with some countries attaining a level of success, while
others further slide down the ladder.
Maternal health
According to The Millennium Development Goals Report 2007, while child mortality
is on the decline, more than half a million women worldwide still die of pregnancy and/or childbirthrelated complications every year. In the Asia-Pacific region, South Asia posted the highest maternal mortality ratio of 546 deaths per 100,000 live births in 2000. East Asia, on the other hand, had the lowest ratio of 55 per 100,000 live births. From 1997 – 2002, 31 percent of maternal deaths in Asia was due to hemorrhage.
Maternal & Child Health: the unpleasant truth
Mother and child has been a recurring theme in arts, owing mainly to the powerful images it evokes - that of the mother as a life-giving and caring creature, and that of the child as a personifi cation of purity and innocence. But the adage of art
imitating life certainly does not apply to this particular theme, for the truth about maternal and child health (MCH) situation is far from pleasant.
The latest issue of Health Alert Asia Pacific newsletter, provides untangles the sociopolitical context of Maternal and Child Health (MCH), providing an overview of the scope of the problem -- high incidences of maternal and child deaths, and mother to child transmission of HIV-- making MCH one of the pressing health concerns worldwide. This also features domestic violence situation in Vietnam which details the learnings of a Vietnamese organization in handling a gender-sensitivity and anti-violence against women program. The article also provides a few insights on how other organizations can help eliminate gender inequality and violence against women in their respective areas. Another article provides comprehensive look at the global burden of child labor including using children as child-warriors. Another article entitled, “Similarities and Differences of Traditional and Professional Health Care System in B’laan Communities,” explores the divergence and convergence between Western medicine and the traditional beliefs and practices of the B’laan tribe, an indigenous peoples living in the Philippine island of Mindanao. This issue of Health Alert also focuses on adolescent reproductive health and how the lack of information and services makes the youth more vulnerable to sexually transmitted infections and early pregnancy.
To request for copies of the newsletter, please write to hain@hain.org.
Thursday, June 04, 2009
HEAD on drugs in the Philippines: “Still neither affordable nor accessible”
One year after the Universally Accessible Cheaper and Quality Medicines Act of 2008 (Republic Act 9502) was signed into law by Mrs. Gloria Macapagal-Arroyo, medicines are still neither affordable nor accessible.
According to Health Alliance for Democracy (HEAD), this is not surprising since the law is inherently flawed, especially when the more salient provisions like regulation were removed before it was passed.
“The landscape of the pharmaceutical industry has not changed because the law is anchored on deregulation than on regulation, and because the law favors the business sector rather the consumers,” said Dr. Gene Alzona Nisperos, HEAD vice-chairperson.
According to HEAD, the law perpetuated, instead of dismantled, the status quo. As such, the monopolies enjoyed by transnational corporations as well as the practice of monopoly pricing persist.
According to Health Alliance for Democracy (HEAD), this is not surprising since the law is inherently flawed, especially when the more salient provisions like regulation were removed before it was passed.
“The landscape of the pharmaceutical industry has not changed because the law is anchored on deregulation than on regulation, and because the law favors the business sector rather the consumers,” said Dr. Gene Alzona Nisperos, HEAD vice-chairperson.
According to HEAD, the law perpetuated, instead of dismantled, the status quo. As such, the monopolies enjoyed by transnational corporations as well as the practice of monopoly pricing persist.
Monday, May 25, 2009
Health Issues and Situation in the Philippines
Eighty percent of the Philippine population, or about 69 million Filipinos, struggle to survive on P96.00 or less (about US$2). The US$2 benchmark is based on World Bank’s defi nition of poverty threshold. The threshold for the Millennium Development Goal is lower at less than US$1. Of the fi gure, 46 million Filipinos go
hungry everyday.
Based on the projection of the National Wages and Productivity Commission, a family of six living in the National Capital Region needs a living wage of P911.00, but the daily minimum wage is only P382.00. The low wage is a part of the conditions of the International Monetary Fund to ensure that the Philippines would be able to pay its debts.
The gap between the rich and the poor is getting wider, with the net worth of the ten richest Filipinos (US$12.4 billion in 2006) equivalent to the combined annual income of poorest 9.6 million families.
hungry everyday.
Based on the projection of the National Wages and Productivity Commission, a family of six living in the National Capital Region needs a living wage of P911.00, but the daily minimum wage is only P382.00. The low wage is a part of the conditions of the International Monetary Fund to ensure that the Philippines would be able to pay its debts.
The gap between the rich and the poor is getting wider, with the net worth of the ten richest Filipinos (US$12.4 billion in 2006) equivalent to the combined annual income of poorest 9.6 million families.
Wednesday, April 15, 2009
Crash and Burn
Humanitarian aid workers and staff of non-government organizations (NGO) are often praised for their selfless devotion in making the world a better place to live in. But put the accolades aside, and the question begging to be asked will surface: who takes care of this sector’s mental health needs?
NGO staff and aid workers are often at the forefront of humanitarian work. It is inevitable that in the course of their work, they are exposed to a dreadful environment where death and suffering are common occurrences. In some instances, they themselves are threatened with bodily harm. In his paper, “Mental Health and Aid Workers: The Case for Collaborative Questioning,” Thomas Ditzler of the Center of Excellence in Disaster Management and Humanitarian Assistance, asserts that “the nature of humanitarian assistance puts workers in contact with the local environment in ways that can erode the normal personal / professional boundaries which provide some measure of psychological protection.”
A 2001 study published in the Journal of Traumatic Stress showed that 30 percent of returning aid workers reported being stressed, while ten percent could be suffering from PTSD.
NGO staff and aid workers are often at the forefront of humanitarian work. It is inevitable that in the course of their work, they are exposed to a dreadful environment where death and suffering are common occurrences. In some instances, they themselves are threatened with bodily harm. In his paper, “Mental Health and Aid Workers: The Case for Collaborative Questioning,” Thomas Ditzler of the Center of Excellence in Disaster Management and Humanitarian Assistance, asserts that “the nature of humanitarian assistance puts workers in contact with the local environment in ways that can erode the normal personal / professional boundaries which provide some measure of psychological protection.”
A 2001 study published in the Journal of Traumatic Stress showed that 30 percent of returning aid workers reported being stressed, while ten percent could be suffering from PTSD.
Sunday, March 08, 2009
Community-based Mental Health Programs: Back to Basics
In the report ”Integrating mental health into primary care : a global perspective,” the World Health Organization and the World Organization of Family Doctors bat for the integration of mental health care program with primary health care since it results in greater access to much needed services.
The report resonates with truth, considering that confinement in mental asylums or rehabilitation centers is a common treatment modality for mental disorders. For poor countries dealing with fund scarcity and the lack of specialists, a psychiatric hospital-based approach alone may not work. However, there are cost-effective models of community- and home-based programs that work well.
Community-based mental health program
A community-based mental health program is not meant to replace the treatment and services offered in hospitals; it rather complements these services by making these more accessible to the people.
Such a program is also more culturally appropriate and capitalizes on the tightly-woven social fabrics of most Asia-Pacifi c countries. The involvement of the
community and family members in caring for a patient helps ease stigma and provide a more healing and nurturing environment for a patient.
The report resonates with truth, considering that confinement in mental asylums or rehabilitation centers is a common treatment modality for mental disorders. For poor countries dealing with fund scarcity and the lack of specialists, a psychiatric hospital-based approach alone may not work. However, there are cost-effective models of community- and home-based programs that work well.
Community-based mental health program
A community-based mental health program is not meant to replace the treatment and services offered in hospitals; it rather complements these services by making these more accessible to the people.
Such a program is also more culturally appropriate and capitalizes on the tightly-woven social fabrics of most Asia-Pacifi c countries. The involvement of the
community and family members in caring for a patient helps ease stigma and provide a more healing and nurturing environment for a patient.
The Hidden Battlefield
The destruction brought about by war and armed confl icts transcends the structure of cities and communities and encompasses the mortality and overall well-being of those who engage in it and those who are dragged into it. The victims, the perpetrators, and defenders may not share the same goals in war but they all share the trauma and suffering surfacing from such violent events.
The effects of war, according to a study by R. Srinivasa Murthy and Rashmi Lakshminarayana of the Regional Offi ce for the Eastern Mediterranean of the World
Health Organization (WHO), are varied and some are not even included in most available literature.
The known effects, the study said, included endemic poverty, malnutrition, disability, economic/social decline and psychosocial illness, among others. The
authors said that only when confl icts and mental health problems are fully understood can effective strategies be developed to deal with the effects of war.
"The effects of war include long-term physical and psychological harm to children and adults, as well as reduction in material and human capital. Death as a result of wars is simply the 'tip of the iceberg,'" the authors said.
The effects of war, according to a study by R. Srinivasa Murthy and Rashmi Lakshminarayana of the Regional Offi ce for the Eastern Mediterranean of the World
Health Organization (WHO), are varied and some are not even included in most available literature.
The known effects, the study said, included endemic poverty, malnutrition, disability, economic/social decline and psychosocial illness, among others. The
authors said that only when confl icts and mental health problems are fully understood can effective strategies be developed to deal with the effects of war.
"The effects of war include long-term physical and psychological harm to children and adults, as well as reduction in material and human capital. Death as a result of wars is simply the 'tip of the iceberg,'" the authors said.
Thursday, March 05, 2009
Intended Death: A look at suicidal behavior
The World Health Organization (WHO) noted that suicide is taking the lives of more and more people worldwide. In the year 2000, the WHO revealed that approximately one million people died from suicide, representing a mortality rate of 16 per 100,000 or one death every 40 seconds.
In the last 45 years, it also noted that suicide rates have increased 60 percent worldwide; suicide is now among the three leading causes of death among those aged 15-44 (both sexes). These fi gures, however, do not include suicide attempts that are up to 20 times more frequent than completed suicide.
Further, suicide worldwide is estimated to represent 1.8 percent of the total global burden of disease in 1998, and 2.4 percent in countries with market and former socialist economies in 2002. Although suicide rates have been traditionally highest among the male elderly, rates among young people have been increasing to such an extent that they are now the group at highest risk in a third of both developed and developing countries.
In the last 45 years, it also noted that suicide rates have increased 60 percent worldwide; suicide is now among the three leading causes of death among those aged 15-44 (both sexes). These fi gures, however, do not include suicide attempts that are up to 20 times more frequent than completed suicide.
Further, suicide worldwide is estimated to represent 1.8 percent of the total global burden of disease in 1998, and 2.4 percent in countries with market and former socialist economies in 2002. Although suicide rates have been traditionally highest among the male elderly, rates among young people have been increasing to such an extent that they are now the group at highest risk in a third of both developed and developing countries.
Sunday, March 01, 2009
Untangling the Mental Haywire
Globally, an estimated 450 million are suffering from mental and neurological disorders such as epilepsy, dementias (e.g. Alzheimer’s disease, vascular
dementia), and bipolar affective disorder. According to the 2001 World Health Report entitled “Mental Health: New Understanding, New Hope,” depression ranked fourth in the global disease burden; it is projected to jump to second place by 2020.
In the Asia-Pacific region, an estimated 13.7 million have dementia; as the region’s population ages, the number of those with dementia is expected to hit 64.6
million by 2050.
Substance addiction, whether alcohol, drugs, or tobacco, is also considered a mental health issue. Asia accounts for close to 55 percent of amphetamine-type stimulants (ATS) abuse worldwide, and majority of ATS addicts are youth. Alcohol abuse, on the other hand, account for 5.5. percent of the Asia-Pacifi c region’s burden of disease. In some Pacifi c countries, the percentage of alcohol-related abuse and violence is staggering: in Papua New Guinea, close to 90 percent of emergency room trauma are due to alcohol; while in Guam, 62 percent of murders are also alcohol-related.
dementia), and bipolar affective disorder. According to the 2001 World Health Report entitled “Mental Health: New Understanding, New Hope,” depression ranked fourth in the global disease burden; it is projected to jump to second place by 2020.
In the Asia-Pacific region, an estimated 13.7 million have dementia; as the region’s population ages, the number of those with dementia is expected to hit 64.6
million by 2050.
Substance addiction, whether alcohol, drugs, or tobacco, is also considered a mental health issue. Asia accounts for close to 55 percent of amphetamine-type stimulants (ATS) abuse worldwide, and majority of ATS addicts are youth. Alcohol abuse, on the other hand, account for 5.5. percent of the Asia-Pacifi c region’s burden of disease. In some Pacifi c countries, the percentage of alcohol-related abuse and violence is staggering: in Papua New Guinea, close to 90 percent of emergency room trauma are due to alcohol; while in Guam, 62 percent of murders are also alcohol-related.
Sunday, January 18, 2009
First Aid for Panganganak
*What will you do if you happen to be with a pregnant woman who, all of the sudden, goes into labour?
In emergencies such as this, it is important that we equip ourselves with pieces of information on initial steps to aiding parturients.
I am to share an article, which was published in Reader’s Digest (November 2008), entitled Call 999! by Leo Hickman. This tells the writer’s experience of attending to his wife’s delivery. Because this was their third child and Jane Hickman’s previous labour had only lasted 45 minutes, they were advised to have a home birth. Unfortunately, the midwives were stuck in traffic so he made an emergency phone call.
Here is the recorded call that details the whole procedure.
17:28:12 (Call answered)
Operator: Emergency ambulance. What’s the problem? Tell me exactly what’s happened.
Leo: Hello, my wife is in labour and is having the baby at home, but she’s really feeling the urge to push. (Leo gives her his address, postcode and telephone number and answers her questions about Jane’s medical history, condition and contractions.)
Operator: OK, I’m organising help for you now. Just stay on the line and I will tell you what to do next. Allow her to sit in the most comfortable position and have her take deep breaths between contractions. Have you got clean towels and blankets?
Leo: Yep.
Operator: Right, I want you to look at her vagina very closely to see how close the baby is being born. (Pause.) OK, do you see any part of the baby now?
Leo: Yeah, I think I can see a head. Yes, I think the top of the head. I think.
Operator: With each contraction, place the palm of your hand against the vagina and apply firm but gentle pressure to keep the baby’s head from delivering too fast and tearing. (She asks who else is in the house and says someone should open the front door for the ambulance crew.)
Jane: (Screaming.) Ohhh, I need to push! I NEED TO PUSH!
Leo: Hang on.
(Long pause while Leo does an examination.)
Operator: How are you doing?
Leo: OK. You know, I don’t think it is the head actually.
(Leo is very scared now: instead of a smooth baby’s head, what he is looking at has become rippled and ridged in appearance and blotchy in colour. He realises that telling the operator he has doubts that it is a head will frighten Jane, but he knows he has to tell the operator everything.)
Leo: Something’s coming out, but I don’t know what it is.
(Jane moaning in the background.)
Operator: You don’t know what it is?
(Jane experiencing another contraction in the background.)
Leo: I think . . . I think it’s part of the sac that hasn’t burst yet. It’s got liquid in it.
Operator: Liquid in it? You need to get a safety pin in case the baby is born in the sac. You need to burst the sac. You need to do that now.
Leo: OK. (To Jane.) OK, wait there, Jane.
(While Jane moans and screams, Leo leaves the bedroom. He runs out on to the landing and freezes, trying desperately to think where he might find a safety pin. After 30 seconds of panic and incoherence, he returns to the bedroom to see that the waters have now started to break.)
Leo: There’s a lot of meconium.
(Meconium - the baby’s first poo - can cause complications, especially in a home birth.)
Operator: There is? (Pause.) OK, you’re still going to need to support the baby. Is it the sac coming out? The baby must be in the sac.
Leo: Yep.
Operator: Is the head coming out?
Leo: OK, the head’s coming!
Operator: Right, you need to support the head and shoulders and hold the hips and legs, OK? It will be slippery so don’t drop him!
Leo: I can see the head. I can see the face!
(The baby’s eyes and mouth are closed and there is no movement in his face at all. Leo had expected the baby to breathe as soon as the head was born, so is feeling frightened now.)
Operator: OK, that’s fantastic. Just keep supporting the baby, OK?
Leo: OK. (Pause.) Jane, you’re doing really well.
Operator: Tell her she’s doing fantastic, OK?
Leo: There’s lots of waters breaking. Come on, little baby. (Jane screaming and moaning.) OK, one shoulder’s coming.
(One arm is now out – in the panic, Leo has said “shoulder” by mistake.)
Operator: OK.
Leo: Come on, little baby. OK, the baby’s out!
Operator: Is the whole baby out?
Leo: It’s quite messy. There’s a lot of meconium.
Operator: Right, what I want you to do is wipe the baby clean. (Pause.) Right, is the baby crying or breathing?
Leo: It’s not fully out yet.
(Perhaps it’s the sight of the thick umbilical cord that makes Leo say this. The baby has in fact been born; he is covered in meconium, including all over his face. The clean towel referred to earlier is now dirty and of no use. Leo is on his knees holding the baby up off the floor, unable to put him down to run for a towel. Jane is unable to turn round to hold him because she can’t get her leg over the cord. Both parents are worried because the baby is only making very small body and facial movements. He looks very blue.)
Operator: Is the baby crying or breathing?
Leo: Yes, it’s crying.
(The baby is making small crying noises.)
Operator: Right, what I want you to do is gently wipe off the baby’s mouth and nose. And dry the baby off with a clean towel. Then wrap the baby in a clean, dry towel, OK?
(Leo shouts t his mother-in-law to bring more towels.) . . .
. . . (Long pause as towels arrive and baby is cleaned and swaddled.)
Leo: Shall I give the baby to Mum?
Operator: Is he wrapped up in a towel?
Leo: Yes.
Operator: Don’t pull the cord too tight and put the baby in mother’s arms. Now make sure to keep the baby and the mother warm.
(Knocking heard downstairs.)
(Two midwives enter he room.)
17:39:28 (Recording ends.)
-Amanah Busran Lao
HAIN Research Associate
Citation:
• Leo Hickman “CALL 999!” Reader’s Digest, November 2008, page 121-125.
In emergencies such as this, it is important that we equip ourselves with pieces of information on initial steps to aiding parturients.
I am to share an article, which was published in Reader’s Digest (November 2008), entitled Call 999! by Leo Hickman. This tells the writer’s experience of attending to his wife’s delivery. Because this was their third child and Jane Hickman’s previous labour had only lasted 45 minutes, they were advised to have a home birth. Unfortunately, the midwives were stuck in traffic so he made an emergency phone call.
Here is the recorded call that details the whole procedure.
17:28:12 (Call answered)
Operator: Emergency ambulance. What’s the problem? Tell me exactly what’s happened.
Leo: Hello, my wife is in labour and is having the baby at home, but she’s really feeling the urge to push. (Leo gives her his address, postcode and telephone number and answers her questions about Jane’s medical history, condition and contractions.)
Operator: OK, I’m organising help for you now. Just stay on the line and I will tell you what to do next. Allow her to sit in the most comfortable position and have her take deep breaths between contractions. Have you got clean towels and blankets?
Leo: Yep.
Operator: Right, I want you to look at her vagina very closely to see how close the baby is being born. (Pause.) OK, do you see any part of the baby now?
Leo: Yeah, I think I can see a head. Yes, I think the top of the head. I think.
Operator: With each contraction, place the palm of your hand against the vagina and apply firm but gentle pressure to keep the baby’s head from delivering too fast and tearing. (She asks who else is in the house and says someone should open the front door for the ambulance crew.)
Jane: (Screaming.) Ohhh, I need to push! I NEED TO PUSH!
Leo: Hang on.
(Long pause while Leo does an examination.)
Operator: How are you doing?
Leo: OK. You know, I don’t think it is the head actually.
(Leo is very scared now: instead of a smooth baby’s head, what he is looking at has become rippled and ridged in appearance and blotchy in colour. He realises that telling the operator he has doubts that it is a head will frighten Jane, but he knows he has to tell the operator everything.)
Leo: Something’s coming out, but I don’t know what it is.
(Jane moaning in the background.)
Operator: You don’t know what it is?
(Jane experiencing another contraction in the background.)
Leo: I think . . . I think it’s part of the sac that hasn’t burst yet. It’s got liquid in it.
Operator: Liquid in it? You need to get a safety pin in case the baby is born in the sac. You need to burst the sac. You need to do that now.
Leo: OK. (To Jane.) OK, wait there, Jane.
(While Jane moans and screams, Leo leaves the bedroom. He runs out on to the landing and freezes, trying desperately to think where he might find a safety pin. After 30 seconds of panic and incoherence, he returns to the bedroom to see that the waters have now started to break.)
Leo: There’s a lot of meconium.
(Meconium - the baby’s first poo - can cause complications, especially in a home birth.)
Operator: There is? (Pause.) OK, you’re still going to need to support the baby. Is it the sac coming out? The baby must be in the sac.
Leo: Yep.
Operator: Is the head coming out?
Leo: OK, the head’s coming!
Operator: Right, you need to support the head and shoulders and hold the hips and legs, OK? It will be slippery so don’t drop him!
Leo: I can see the head. I can see the face!
(The baby’s eyes and mouth are closed and there is no movement in his face at all. Leo had expected the baby to breathe as soon as the head was born, so is feeling frightened now.)
Operator: OK, that’s fantastic. Just keep supporting the baby, OK?
Leo: OK. (Pause.) Jane, you’re doing really well.
Operator: Tell her she’s doing fantastic, OK?
Leo: There’s lots of waters breaking. Come on, little baby. (Jane screaming and moaning.) OK, one shoulder’s coming.
(One arm is now out – in the panic, Leo has said “shoulder” by mistake.)
Operator: OK.
Leo: Come on, little baby. OK, the baby’s out!
Operator: Is the whole baby out?
Leo: It’s quite messy. There’s a lot of meconium.
Operator: Right, what I want you to do is wipe the baby clean. (Pause.) Right, is the baby crying or breathing?
Leo: It’s not fully out yet.
(Perhaps it’s the sight of the thick umbilical cord that makes Leo say this. The baby has in fact been born; he is covered in meconium, including all over his face. The clean towel referred to earlier is now dirty and of no use. Leo is on his knees holding the baby up off the floor, unable to put him down to run for a towel. Jane is unable to turn round to hold him because she can’t get her leg over the cord. Both parents are worried because the baby is only making very small body and facial movements. He looks very blue.)
Operator: Is the baby crying or breathing?
Leo: Yes, it’s crying.
(The baby is making small crying noises.)
Operator: Right, what I want you to do is gently wipe off the baby’s mouth and nose. And dry the baby off with a clean towel. Then wrap the baby in a clean, dry towel, OK?
(Leo shouts t his mother-in-law to bring more towels.) . . .
. . . (Long pause as towels arrive and baby is cleaned and swaddled.)
Leo: Shall I give the baby to Mum?
Operator: Is he wrapped up in a towel?
Leo: Yes.
Operator: Don’t pull the cord too tight and put the baby in mother’s arms. Now make sure to keep the baby and the mother warm.
(Knocking heard downstairs.)
(Two midwives enter he room.)
17:39:28 (Recording ends.)
-Amanah Busran Lao
HAIN Research Associate
Citation:
• Leo Hickman “CALL 999!” Reader’s Digest, November 2008, page 121-125.
Shattering Myths About Menstruation
First woman: Noong ako, tumalon pa talaga ako ng tatlong hagdan para maging tatlong araw ang mens ko kada-buwan.
Second woman: Ako naman, pagkatapos kong labhan ang panty kong nalagyan ng unang regla, ipinahid ko ito sa mukha.
Young girl: Ei, para saan naman po ‘yan?
Second woman: Para hindi tagihawatin.
Young girl: Talaga po? Sino po nagsabi niyan sa iyo?
Second woman: Nanay ko.
This is the conservation I accidentally overheard one late afternoon on my way home. Apparently, there are plenty of myths that have been and are still being said about menstruation and it is, usually, the young females who become susceptible (just as shown above).
Also contained in KIKAY KIT, (Kaalama’t Impormasyon sa Katawan at kAlusugan nating Youth) a booklet which was distributed by Institute for Social Studies and Action (ISSA), are the five common myths. I have chosen not to translate these into English in order to avoid changing the thoughts expressed by the production team.
1) SABI NILA: Bawal maligo habang may regla dahil baka maloka.
SA TOTOO LANG: Mahalagang mapanatiling malinis ang katawan sa lahat ng panahon, lalo na kapag may regla. Walang kinlaman ang pagliligo habang may regla sa pagkabaliw. Sa katunayan, mas nakagagaan ito ng pakiramdam. Siguraduhin ding magpalit ng sanitary napkin o pasador kung kinakailangan.
2) SABI NILA: Bawal kumain ng maasim kapag may regla.
SA TOTOO LANG: Ang mga pagkaing maaasim ay mayaman sa Vitamin C na kainlangan ng ating katawan. Tumutulong itong magpalakas ng resistensya na panlaban sa sakit kaya’t OK na OK lang kung type mong kumain ng bayabas, sampalok o maggang hilaw. Mahalaga ring kumain ng sapat na mga masustansiyang pagkain.
3) SABI NILA: Mainam ipahid sa mukha ang unang regla para hindi tagihawatin.
SA TOTOO LANG: Bahagi ng pagdadalaga ang pagiging malangis ng balat na siyang nagiging dahilan sa pagtubo na tagihawat. Ang pagpapanatiling malinis ng balat ay makatutulong para maiwasan ito, hindi ang pagpapahid ng unang regla.
4) SABI NILA: Bawal lumangoy, magbisikleta, sumayaw, mag-ehersisyo o gumawa ng mabigat na gawain kapag may regla.
SA TOTOO LANG: Kahit ano ay puwedeng gawin kahit may regla. Sa katunayan, pansamantalang tumitigil ang daloy ng regla kapag lumalangoy kaya pwedeng-pwedeng mag-swimming kahit first day. Nakakatulong pa nga ang regular na pag-e-exercise para mas maging malakas at handa ang katawan sa mga nararanasang pagbabago kapag may regla. Sa mga unang araw lang ng regla, kadalasan ay mabigat ang pakiramdam kaya dapat hinay-hinay lang at huwag namang sobrahan ang gagawin. Tantiyahin kung ano ang kaya ng katawan.
5) SABI NILA: Handa ang magka-baby ang babae kapag nagreregla na.
SA TOTOO LANG: Kahit na ang pagkakaroon ng regla ay paghahanda sa katawan ng babae para sa posibilidad ng pagbubuntis, hindi ito nangangahulugan ng kahandaan niyang manganak.
Kinakailangang lubusang handa at nadebelop na ang mga sistemang reproduktibo ng babae. Hindi ito pare-parehong nangyayari sa lahat ng mga babae. Maraming babaeng irregular pa ang pagdating ng regla sa mga unang dalawa hanggang tatlong taon pagkasimula ng pagreregla. Nangangahulugang hindi pa handa ang mga obaryo nila at malamang ay wala pang ovulation na nagaganap. Gayunpaman, para sa ibang babae, posibleng nag-o-ovulate na sila at maaari nang mabuntis.
Marahil ang pinakamahalagang tandaan ay hindi lamang mga obaryo at matris ang kailangan sa pagbuntis. Bukod sa pisikal na paghahanda, kinakailangang psychologically, emotionally at financially prepared ang babae upang magampanan ng mabuti ang mga responsibilidad ng pagkakaroon ng anak.
by Amanah Busran Lao
HAIN Research Associate
Citation:
• Ma. Georgianna Villar, Maria Melinda Ando, Rodelyn Marte, Luz Escubil “Mga Sabi-sabi Tungkol sa Pagreregla” KIKAY KIT Kaalama’t Impormasyon sa Katawan at kAlusugan nating Youth, Institute for Social Studies and Action (ISSA), The David and Lucile Packard Foundation, Quezon City, Philippines 2003
Second woman: Ako naman, pagkatapos kong labhan ang panty kong nalagyan ng unang regla, ipinahid ko ito sa mukha.
Young girl: Ei, para saan naman po ‘yan?
Second woman: Para hindi tagihawatin.
Young girl: Talaga po? Sino po nagsabi niyan sa iyo?
Second woman: Nanay ko.
This is the conservation I accidentally overheard one late afternoon on my way home. Apparently, there are plenty of myths that have been and are still being said about menstruation and it is, usually, the young females who become susceptible (just as shown above).
Also contained in KIKAY KIT, (Kaalama’t Impormasyon sa Katawan at kAlusugan nating Youth) a booklet which was distributed by Institute for Social Studies and Action (ISSA), are the five common myths. I have chosen not to translate these into English in order to avoid changing the thoughts expressed by the production team.
1) SABI NILA: Bawal maligo habang may regla dahil baka maloka.
SA TOTOO LANG: Mahalagang mapanatiling malinis ang katawan sa lahat ng panahon, lalo na kapag may regla. Walang kinlaman ang pagliligo habang may regla sa pagkabaliw. Sa katunayan, mas nakagagaan ito ng pakiramdam. Siguraduhin ding magpalit ng sanitary napkin o pasador kung kinakailangan.
2) SABI NILA: Bawal kumain ng maasim kapag may regla.
SA TOTOO LANG: Ang mga pagkaing maaasim ay mayaman sa Vitamin C na kainlangan ng ating katawan. Tumutulong itong magpalakas ng resistensya na panlaban sa sakit kaya’t OK na OK lang kung type mong kumain ng bayabas, sampalok o maggang hilaw. Mahalaga ring kumain ng sapat na mga masustansiyang pagkain.
3) SABI NILA: Mainam ipahid sa mukha ang unang regla para hindi tagihawatin.
SA TOTOO LANG: Bahagi ng pagdadalaga ang pagiging malangis ng balat na siyang nagiging dahilan sa pagtubo na tagihawat. Ang pagpapanatiling malinis ng balat ay makatutulong para maiwasan ito, hindi ang pagpapahid ng unang regla.
4) SABI NILA: Bawal lumangoy, magbisikleta, sumayaw, mag-ehersisyo o gumawa ng mabigat na gawain kapag may regla.
SA TOTOO LANG: Kahit ano ay puwedeng gawin kahit may regla. Sa katunayan, pansamantalang tumitigil ang daloy ng regla kapag lumalangoy kaya pwedeng-pwedeng mag-swimming kahit first day. Nakakatulong pa nga ang regular na pag-e-exercise para mas maging malakas at handa ang katawan sa mga nararanasang pagbabago kapag may regla. Sa mga unang araw lang ng regla, kadalasan ay mabigat ang pakiramdam kaya dapat hinay-hinay lang at huwag namang sobrahan ang gagawin. Tantiyahin kung ano ang kaya ng katawan.
5) SABI NILA: Handa ang magka-baby ang babae kapag nagreregla na.
SA TOTOO LANG: Kahit na ang pagkakaroon ng regla ay paghahanda sa katawan ng babae para sa posibilidad ng pagbubuntis, hindi ito nangangahulugan ng kahandaan niyang manganak.
Kinakailangang lubusang handa at nadebelop na ang mga sistemang reproduktibo ng babae. Hindi ito pare-parehong nangyayari sa lahat ng mga babae. Maraming babaeng irregular pa ang pagdating ng regla sa mga unang dalawa hanggang tatlong taon pagkasimula ng pagreregla. Nangangahulugang hindi pa handa ang mga obaryo nila at malamang ay wala pang ovulation na nagaganap. Gayunpaman, para sa ibang babae, posibleng nag-o-ovulate na sila at maaari nang mabuntis.
Marahil ang pinakamahalagang tandaan ay hindi lamang mga obaryo at matris ang kailangan sa pagbuntis. Bukod sa pisikal na paghahanda, kinakailangang psychologically, emotionally at financially prepared ang babae upang magampanan ng mabuti ang mga responsibilidad ng pagkakaroon ng anak.
by Amanah Busran Lao
HAIN Research Associate
Citation:
• Ma. Georgianna Villar, Maria Melinda Ando, Rodelyn Marte, Luz Escubil “Mga Sabi-sabi Tungkol sa Pagreregla” KIKAY KIT Kaalama’t Impormasyon sa Katawan at kAlusugan nating Youth, Institute for Social Studies and Action (ISSA), The David and Lucile Packard Foundation, Quezon City, Philippines 2003
Monday, December 15, 2008
Drop of Life
A person can live without food for three weeks, but only three days without water.
Water is vital to the metabolic process, aiding in the digestion, absorption, and transportation of nutrients in the body. The recommended daily water intake is eight
glasses of water or about two liters. This, however, is just the minimum. Depending on the activity, location, and temperature in the area, a person may actually need more than that.
Unfortunately, water scarcity affects four in ten people and the World Health Organization predicts that the number of affected people may rise given the growing global population. While much of the earth is surrounded with water, only three percent are considered freshwater; the rest are too saline for human consumption.
Agricultural demand for water
There are varied factors for the depletion of water sources, including climate change and environmental degradation, but a major culprit was agriculture. With about 70 percent of the world’s water supply consumed by the agriculture sector, it is easy to see why. In the Asia-Pacific region alone, 81.3 percent of freshwater is utilized for agricultural purposes.
While potable drinking water is a key element in nutrition, the paradox is that huge amount of it is required by the agricultural industry to produce food items. Increased agricultural output has been at the forefront of the global fi ght against food insecurity. As the demand for food rises, so is the demand for water needed to
produce these items. While the daily water requirement for each individual is just about two to four liters, the amount of water needed to produce a person’s daily food
requirement ranges from 2,000 to 5,000 liters.
The solution to this problem is not to limit agricultural output, but rather the adoption of sustainable farming practices, as well as a change in food consumption pattern.
When it comes to food consumption pattern, there is a global shift to a meat-based diet, which means more water is needed to produce meat product. As a comparison, producing a kilo of wheat requires about 1000 liters of water. A kilo of meat, on the other hand, requires fi ve to ten times more water to produce.
The next conflict point?
In Tajikistan, people in the town of Taboshar are leaving the community due to acute water shortage, with the local water agency hardly able to meet even just 15 percent of the town’s water needs.
There are two confl icting views on whether water may be the next fl ash points for geo-political confl icts. The US Central Intelligence Agency is but one of the groups
predicting that this might very well be the case; after all, the UNESCO said that one-third of 262 international river basins are shared by two or more countries.
In the Middle East, five countries are sharing the Jordan River basin: Israel, Palestine, Jordan, Lebanon, and Syria. In 2001, tension erupted between Lebanon and Israel when the former attempted to build a pipeline on the Wassani River, which contributes 150 cubic meter of water to the Jordan River. Only the timely intervention of the international community prevented the tension from escalating.
Although there is no major war fought over the control of a water source, there have been periodic clashes, which tend to be localized. In 2000, Chinese police and farmers in Shandong province clashed over the planned diversion of irrigation water to cities and industries.
The other view is more circumspect; water is so vital that nations would benefit more from cooperation in the management of a water source, rather than fi ghting a war for its absolute control.
Prof. Asit Bikwas, a 2006 Stockholm Water Prize awardee, argued that the main issue is not really water scarcity but “bad water management.” He is not alone in this assessment. In the book “Water, a shared responsibility,” the UNESCO – World Water Assessment Programme, acknowledges that “the problem we face today is largely one of governance: equitably sharing this water while ensuring the sustainability of natural ecosystems. At this point in time, we have not yet achieved this balance.”
Addressing the threat of a global water shortage does provide a glimmer of hope, with countries willing to sit down and come up with a compromise on how to better
share a water source. However, it also highlights once more the vulnerability of the poor.
Indeed, when it comes to water allocation, the poor, as always, are left holding an empty jerry can.
Source: Health Alert Asia Pacific, Issue 13, 2008
Thursday, December 11, 2008
The pangs of hidden hunger
Micronutrients defi ciency is another indicator of poor nutritional status, and is one that cuts across economic class. Iodine defi ciency, for instance, is a continuing problem even in the affl uent European continent. A 2004 estimate showed that 20 percent of the global population at risk of iodine defi ciency reside in the region.
According to Unicef, for every four persons in the planet, one is suffering from micronutrients defi ciency. The health impacts of micronutrients defi ciency are varied and can be quite staggering: blindness, mental retardation, and even death, particularly for anemic pregnant women.
Iron deficiency
The World Health Organization characterized iron deficiency as “the most common and widespread nutritional disorder in the world.” Establishing the exact magnitude of the problem is hard, but since iron defi ciency is closely tied to anemia, the global prevalence of iron deficiency anemia (IDA) is used as a proxy indicator. IDA is a key indicator of a country’s maternal and child health, and its prevalence refl ects socio-economic disparity: in developing countries, 52 percent of pregnant women are affected with IDA, while the fi gure is down to 23 percent of pregnant women in developed countries.
While the general population is at risk, a new study published at the Pediatrics Journal showed that overweight children are more than twice as likely to have iron deficiency than children with normal body weight. Iodine deficiency A 1994 study showed that there was a drop of up to 13.5 points in the intelligent quotient of populations living in areas with severe iodine defi ciency, as compared to the
population of non-iodine defi cient areas.
The land-locked region of Central Asia is particularly vulnerable to iodine defi ciency due to its mountainous terrain. UNICEF nutrition specialist Arnold Timmer
attributes the depletion of iodine in the region’s soil to erosion and rainfall. The collapse of the Soviet Union, which used to supply the region with iodized salt, added to the problem.
A 2004 study in Uzbekistan showed that prevalence of goiter – an indicator of iodine defi ciency – was 49.6 percent for children and 41.6 percent for adults. Kazakhstan, meanwhile, had a goiter prevalence of 56.5 percent.
Vitamin A deficiency (VAD)
An estimated 21 percent of children worldwide are Vitamin A-defi cient, with the highest concentration located in Asia and Africa. On top of causing blindness, VAD also increases a child’s susceptibility to malaria and diarrhea. Food fortification and breastfeeding The international community is responding to the problem with the adoption of two key strategies: the promotion of breastfeeding and food fortification. Breast milk contains all the essential nutrients needed for a baby’s full development. However, there is still a low adoption of exclusive breastfeeding particularly in poor regions.
With regards to food fortification, it is undeniably a costeffective way of combating micronutrients defi ciency. The Central Asian region’s adoption of salt iodization program has effectively reduced, if not totally eliminated the prevalence of iodine deficiency. Food fortification is indeed effi cient, but policymakers must not make this the major cornerstone of their micronutrients program. Food manufacturers have jumped in on the fortifi cation bandwagon, with the market for fortified foods expected to grow by an average of 10.1 percent between 2005 and 2012. While some of these manufacturers are really driven by a sense of responsibility, governments must still exercise some caution.
The Philippines, for instance, has a Sangkap Pinoy program where food fortifi ed with micronutrients are given a seal. But here lies the problem: some of the products
bearing the Sangkap Pinoy seal are junk foods. Another thing to be considered is economics. Even if fortifi ed foods are readily available, do the people have the means to buy these items?
Sources:
Eliminating Iodine Deficiency in Central Eastern Europe,Commonwealth Independent States and the Baltics by Arnold Timmer. http://www.iccidd.org/media/IDD%20Newsletter/1991-2006/nov2004.htm#g
Iodine deficiency in Europe: a continuing problem. Published by the WHO and UNICEF. http://www.who.int/nutrition/publications/VMNIS_Iodine_defi ciency_in_Europe.pdf
Assessment of Iodine deficiency disorders and monitoring their elimination: A guide to program managers, third edition. Published by the WHO, UNICEF and ICCIDD. http://whqlibdoc.who.int/publications/2007/9789241595827_eng.pdf
http://www.who.int/rhl/pregnancy_childbirth/medical/anaemia/cfcom/en/
http://www.nutraingredients.com/Industry/Vitamin-enrichedfoods-growing-faster-in-SE-Asia-than-Europe8
According to Unicef, for every four persons in the planet, one is suffering from micronutrients defi ciency. The health impacts of micronutrients defi ciency are varied and can be quite staggering: blindness, mental retardation, and even death, particularly for anemic pregnant women.
Iron deficiency
The World Health Organization characterized iron deficiency as “the most common and widespread nutritional disorder in the world.” Establishing the exact magnitude of the problem is hard, but since iron defi ciency is closely tied to anemia, the global prevalence of iron deficiency anemia (IDA) is used as a proxy indicator. IDA is a key indicator of a country’s maternal and child health, and its prevalence refl ects socio-economic disparity: in developing countries, 52 percent of pregnant women are affected with IDA, while the fi gure is down to 23 percent of pregnant women in developed countries.
While the general population is at risk, a new study published at the Pediatrics Journal showed that overweight children are more than twice as likely to have iron deficiency than children with normal body weight. Iodine deficiency A 1994 study showed that there was a drop of up to 13.5 points in the intelligent quotient of populations living in areas with severe iodine defi ciency, as compared to the
population of non-iodine defi cient areas.
The land-locked region of Central Asia is particularly vulnerable to iodine defi ciency due to its mountainous terrain. UNICEF nutrition specialist Arnold Timmer
attributes the depletion of iodine in the region’s soil to erosion and rainfall. The collapse of the Soviet Union, which used to supply the region with iodized salt, added to the problem.
A 2004 study in Uzbekistan showed that prevalence of goiter – an indicator of iodine defi ciency – was 49.6 percent for children and 41.6 percent for adults. Kazakhstan, meanwhile, had a goiter prevalence of 56.5 percent.
Vitamin A deficiency (VAD)
An estimated 21 percent of children worldwide are Vitamin A-defi cient, with the highest concentration located in Asia and Africa. On top of causing blindness, VAD also increases a child’s susceptibility to malaria and diarrhea. Food fortification and breastfeeding The international community is responding to the problem with the adoption of two key strategies: the promotion of breastfeeding and food fortification. Breast milk contains all the essential nutrients needed for a baby’s full development. However, there is still a low adoption of exclusive breastfeeding particularly in poor regions.
With regards to food fortification, it is undeniably a costeffective way of combating micronutrients defi ciency. The Central Asian region’s adoption of salt iodization program has effectively reduced, if not totally eliminated the prevalence of iodine deficiency. Food fortification is indeed effi cient, but policymakers must not make this the major cornerstone of their micronutrients program. Food manufacturers have jumped in on the fortifi cation bandwagon, with the market for fortified foods expected to grow by an average of 10.1 percent between 2005 and 2012. While some of these manufacturers are really driven by a sense of responsibility, governments must still exercise some caution.
The Philippines, for instance, has a Sangkap Pinoy program where food fortifi ed with micronutrients are given a seal. But here lies the problem: some of the products
bearing the Sangkap Pinoy seal are junk foods. Another thing to be considered is economics. Even if fortifi ed foods are readily available, do the people have the means to buy these items?
Sources:
Eliminating Iodine Deficiency in Central Eastern Europe,Commonwealth Independent States and the Baltics by Arnold Timmer. http://www.iccidd.org/media/IDD%20Newsletter/1991-2006/nov2004.htm#g
Iodine deficiency in Europe: a continuing problem. Published by the WHO and UNICEF. http://www.who.int/nutrition/publications/VMNIS_Iodine_defi ciency_in_Europe.pdf
Assessment of Iodine deficiency disorders and monitoring their elimination: A guide to program managers, third edition. Published by the WHO, UNICEF and ICCIDD. http://whqlibdoc.who.int/publications/2007/9789241595827_eng.pdf
http://www.who.int/rhl/pregnancy_childbirth/medical/anaemia/cfcom/en/
http://www.nutraingredients.com/Industry/Vitamin-enrichedfoods-growing-faster-in-SE-Asia-than-Europe8
Wednesday, December 10, 2008
Obesity in the Asia-Pacific Region
With much of the focus resting on under-nutrition and micronutrients defi ciency, it is easy to dismiss obesity as nothing but a disease peculiar to affl uent nations. However, experts warned that obesity is reaching an epidemic proportion, and should thus be treated as a valid health concern.
Consider these statistics: in 2005, 1.6 billion adults over the age of 15 are overweight and at least 400 million of this number is obese. By 2015, the World Health Organization calculates the number of overweight adults to increase to 2.3 billion, with 700 million of them clinically obese. Each year at least 2.6 million people die from health complications resulting from all the excessive weight.
Sunday, December 07, 2008
A wake-up call for a return to nutrition basics
More than 800 million people, or about 13 percent of the global population, are classifi ed as undernourished. The defi ciency in essential nutrients is said to be the underlying cause of an estimated 3.5 million deaths each year, mostly in young children and pregnant women. Under-nutrition among pregnant women in developing
countries is reported to lead to one out of six infants born with low birth weight.
In Malaysia, diabetes has reached very alarming proportions. In the first National
Health and Morbidity Survey (NHMS)carried out in 1986, the prevalence of diabetes was 6.3 percent. Just ten years later this figure increased to 8.3 percent. Now, based on the latest NHMS III, conducted in 2006, diabetes prevalence has increased to 14.9 percent.
Diabetes Type II is strongly linked to high sugar consumption and obesity.
Nutrition can be defi ned as the process of taking in the substances needed to nourish and support life and growth. Access to nutritious food is a key element in
achieving a well-balanced nutrition. But as the world becomes more dependent on artifi cially processed food, balanced nutrition is compromised, resulting in chronic
health problems. Worsening the problem is the addition of toxic chemicals on essential food products.
Tainted milk
The recent scandal where four children in China died following the consumption of baby formula milk contaminated with the toxic chemical known as melamine should serve as a wake-up call.
Melamine, used as an ingredient in the manufacture of some plastics and fertilizers, has found its way into food products such as infant formula and confectionaries. It
is abhorrent that melamine has been deliberately added to milk to give the false
impression of higher levels of protein than actually exists.
Authorities try to allay the fears of the public by announcing that the levels of melamine in certain foods are within “permissible levels”. This term should be questioned.
Melamine is a synthetic chemical. It does not occur naturally in food. Should permissible levels be set for substances that are not naturally occurring in food?
By law, there should be a zero tolerance for melamine, as well as other synthetic toxic chemicals in food, rather than waiting for all the evidence to come in, which might be too late – when harm has already been done.
There is the danger of the cumulative doses or ingestions that enhance the harm posed by such chemicals. Furthermore, the full effects of chemicals not meant for humans may not have been studied fully, and for over a suffi ciently long period of time. It is not ethical to conduct such tests on people. In cases such as these, the *Precautionary Principle should be applied and the consumption of this chemical should be fully avoided.
In the case of infants, breast milk is the safest and healthiest choice – fully for the fi rst six months, and thereafter as a complement to solid foods right up to at
least two years. Governments and the community as a whole would need to make a commitment to move in this direction and create a supportive environment.
Buyers beware
Overall, the Consumer Association of Penang (CAP) believes that it is timely for people to move away from eating so much artifi cially-processed foods, and instead
move towards natural healthy produce and home-cooked meals. There are countless additives included in many of the highly-processed foods in the market. Foods are altered so far from their original state. We did not require all these artificial additives at one time. If really needed, there are numerous natural substances such as natural colours or flavours that can be used for food. We do not see that it is possible for the public to take any realistic precautions themselves when it comes to
products on the shelves as it is impossible for people to know which foods contain dangerous chemicals. At the very least, food manufacturers should be required
to list the common names of all additives, such as preservatives, coloring, fl avors, flavor enhancers, antioxidants and conditioners, on the food labels and outer
packaging - as opposed to using numerical or alphabet codes or merely using phrases such as “Permitted Coloring” or “Permitted Conditioners” under the ingredients list. Information on the concentrations of these additives should also be provided.
The excuse sometimes given is that there is not enough space on the food label. We ask - should there be so many additives in a product that the information cannot even fit on a label, and should this be permitted by the authorities?
In view of the rise of critical chronic diseases such as heart disease, diabetes, obesity and high blood pressure, the information on salt, sugar, saturated fats and trans fats should be listed on current food labels. These particular components should be separated out from the general “Nutrition facts” or “Nutritional Labelling” so that the public is not lulled into a false sense of security. Rather, the attention of consumers can be immediately drawn towards taking special note of these ingredients that are linked to adverse health outcomes.
In view of our country’s alarming diabetic rates, which are only expected to worsen over the coming years, CAP believes that much more needs to be done, and with greater sense of urgency. Firm action needs to be taken against the numerous sweets and confectionaries that have fl ooded the market. These products that are being marketed to children are not conducive to health. They contain basically nothing more than sugar, coloring and other additives, which are not even labeled on the
packaging. Children received no nutritional benefit from consuming these products.
Sugary soft drinks, either carbonated or non-carbonated, used to be more of a luxury in the past and they were consumed as a treat. Nowadays, these drinks are sold in abundance everywhere. Vending machines proffering these drinks are also found at many locations, including airports, hospitals and schools. It is also becoming
increasingly common to see these drinks being offered in “jumbo” portions at various restaurants and food joints.
S.M. Mohamed Idris is the president of the Consumers’ Association of Penang (CAP). The organization may be contacted at Tel. No. 60-4-8299511, or through its website at www.en.cap.org.my. Graphics from Consumer Association of Penang.
This article appeared in the Health Alert Asia Pacific newsletter, Issue 13 2008. For copies of the newsletter, please write to hain@hain.org