MERS Outbreak in South Korea Hits Record High, 3 New Cases, 2 More Die

who says south koreas mers outbreak large and complex, photo courtesy of ritika patel

who says south koreas mers outbreak large and complex, photo courtesy of ritika patel

SOUTH KOREA - An outbreak of MERS (Middle East Respiratory Syndrome) in South Korea has led to 138 confirmed cases and 14 deaths, according to the World Health Organization (WHO). Just 17 hours ago news outlets reported 3 new cases with 2 more deaths.

A single traveler brought the disease to South Korea last month and since then it has spread exponentially overwhelming the healthcare system. Contributing factors include overcrowded emergency rooms, the sick and worried returning numerous times to hospitals, additional delays as medical professionals seek second opinions, coupled with an ill-trained medical community unfamiliar with the disease.

Currently, all cases have occurred have been traced back to a hospital where patient zero contracted the disease. Many citizens have started wearing surgical masks to protect themselves from infection. However, the larger community isn't taking any chances either and have subsequently closed more than 2,900 schools and quarantined 3,680 people. (Source: BBC).

An early setback has been a lack of government transparency. President Park Geun-hye has been accused of not being pro-active in his response and of withholding information about who has been infected. The mayor of Seoul, Park Won-soon, said that a now quarantined doctor attended a gathering of more than 1,500 people the day before he was diagnosed with the disease. (Source: New York Times)

However, the WHO has issued a statement that human-to-human transmission of the virus is only possible through very close contact. As long as reasonable measures are taken there is no need for panic. Currently, the WHO is working with scientists to better understand the disease, develop treatment strategies, and determine the best way to respond to the outbreak.

Although the disease is not well understood and has no cure, the spread of it has thus far been predictable. Most contagious diseases are opportunistic and are most easily incubated and spread in hospitals and other healthcare facilities due to close proximity of the infected. Although doctors and scientists are struggling to find a way to treat the infected, predictive and statistical models have proved invaluable in anticipating what part of the population is at greatest risks and thus help communities implement proactive precautions.

The disease originated in Saudi Arabia in 2012, and according to the Center for Disease Control (CDC) there is currently no vaccine to prevent MERS-CoV infection, but the South Korea outbreak is the largest outbreak outside of the Middle East. “MERS-CoV is thought to spread from an infected person to others through respiratory secretions, such as coughing. In other countries, the virus has spread from person to person through close contact, such as caring for or living with an infected person. (Source: CDC)

Contributing Journalist: @SJJakubowski
Facebook: Sarah Joanne Jakubowski

The Dirty Little Secret of Abuse of Old People

grandma got screwed, photo by ashley hill3

grandma got screwed, photo by ashley hill3

On Monday, June 15, nations around the world commemorated World Elder Abuse Awareness Day (WEEAD). Elder Abuse continues to be a significant issue in many societies as reports of mistreatment against older people is increasing.

The thought of harming an older person suggests severe dysfunction in the perpetrator, and with the plethora of local and international cases of abuse receiving public attention, governments are starting to create policies designed to institute safeguards against this type of abuse.

However, elder abuse cases remain, and with global recognition of the gravity and ubiquity of this crime, the healthcare establishment, in particular geriatric and psychology professionals have redoubled their efforts to analyze the root cause of this type of abuse while simultaneously working with law enforcement agencies and legislators to develop strategies to protect the rights of older people.

According to HelpAge International, an organization that “helps older people demand their rights, challenge discrimination and overcome poverty,” older people’s right to be free from violence is not protected under international law. This problem is especially prevalent in East Africa where much of HelpAge's work on elder abuse is focused on, and there are a significant number of cases.

One case involves a 67-year-old woman from Kenya who was abused by a relative, an attack that resulted in the death of her 90-year-old mother. The details of the attack are very disturbing as the woman narrated the incident:

“The man slashed me on my head and I immediately fainted. I still don't know what the reason was for that kind of brutality. I am very scared. I don't sleep well. When I hear any noise I am alarmed. In my dreams I see that person following me."

The unfortunate part is that her attacker was arrested but later released on bail. While the facts about bail are unknown, this calls into question the laws of protection in the region. Relatives are known to be one of the main perpetrators of elder abuse especially as the abuse by caregivers is a worldwide and complex issue. Stresses, caregiver burden, criminal history and substance abuse among other issues are risk factors that can lead to elder mistreatment, which in turn leads to poor health. Governments can improve their law enforcement agencies as well as the quality of life of caregivers and older people.

It is encouraging to know that governments will attend the Open-ended Working Group on Aging this July and support a United Nations (UN) convention to protect older people's rights. The purpose of the working group is to strengthen the protection of older people’s human rights around the world. Hopefully, this objective will achieve great strides as inadequate research into elder abuse makes the problem difficult to tackle. This is because elder abuse is largely a hidden problem.

According to Bridget Sleap, Senior Rights Policy Advisor at HelpAge International, “elder abuse is the least studied of the different types of violence in low-income countries as stated by the Global Status Report on Violence Prevention 2014”. This report, produced by the World Health Organization (WHO) and UN agencies, stated that of the 133 countries studied, two thirds do not have adult protective services to support older people.

Governments can do more to stop elder abuse and protect the rights of older people. It is vital that societies raise awareness, challenge and recognize that elder abuse and discrimination against older people are issues that deserve attention.

Contributing Journalist:  @SophieSokolo

WHO, West African Ministers of Health Develop Ebola Strategy

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Sarah Joanne Jakubowski, Ghana CorrespondentLast Modified: 13:50 p.m. DST, 07 July 2014

Ebola outbreak in Guinea, Photo by Photo by International Federation of Red Cross and Red Crescent Societies

ACCRA, Ghana -- Last week an Emergency Ministerial Meeting was held in Accra to discuss the growing Ebola epidemic.

The disease, which can have up to a 90% fatality rate, started in rural Guinea then spread to neighboring Liberia and Sierra Leone. Without intervention, it will continue its international invasion.

The World Health Organization (WHO) says the proposed strategy to treat, control and prevent Ebola will cost $10 million and would need to be put into place within the next six months.

Representatives called on the African Union and The Economic Community of West African States (ECOWAS) for the funds.

The plan would set up an Ebola treatment and research center in Guinea as well as smaller centers in other affected areas. Funds will go to training and deploying staff, providing medical equipment and supplies to affected or at-risk regions and educating the public.

An emphasis was placed on research, both to develop treatments and cures and also social research to gauge public understanding and reaction to the disease. However, Africa's research facilities were described as "weak" and a request for global collaboration among scientists was issued.

When asked if border control was a viable solution to control the spread of the disease, the idea of country-wide quarantines was shot down.

Ministry of Health & Social Welfare (MOHSW) Liberia explained that there were so many border crossing points it would be impractical to watch all of them. The Minister went on to say that while his country was able to stop several travelers who were carrying the disease, there were many false positives and possibly cases where infected travelers were not yet showing symptoms and so got through. A key problem was that Ebola can incubate unnoticed for up to 21-days in a seemingly healthy person.

Some traditional practices can help spread diseases, and doctors across the region are urging people to seek assistance from trained doctors or one of the international organizations that are on the ground providing help, education, and intervention. Organizations such as UNICEF Liberia, The International Federation of Red Cross and Red Crescent Societies (IFRC), and Medicins Sans Frontieres.

These organizations in conjunction with local doctors and government health officials urged all West African citizens to take precautions when handling the sick and deceased. Practices involving delayed burials and prolonged contact with the dead facilitate disease spread.

"People don't know what they're dealing with" explained, emphasizing the need to especially educate churches, those whose jobs involve handling the dead, as well as the need to educate family members about Ebola so that the sick can seek immediate treatment to avoid infecting others.

This is a very urgent issue, and though citizens in the West may feel that they are immune from this disease, it takes just one person to breach the borders of any Asia, Middle East, European Union, or North/South American countries for the deadly virus to become a global pandemic.

Follow Sarah on Twitter Twitter: @nahmias_report Africa Correspondent: @SJJakubowski

Is Clean Water Technology a Solution for Africa?

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Sarah Joanne Jakubowski, Africa CorrespondentLast Modified: 21:25 p.m. DST, 30 June 2014

Chief Executive Officer of N&M Technologies, Head Office, South Africa

GHANA, Accra -- Earlier this month, Medwyn Jacobs, CEO of New and Master Technologies (N&M) once again presented at Annual Ghana National Health Environment and Safety (NAHES) Conference where he reintroduced N&M’s water harvesting machine that can take water out of the atmosphere and filter it into usable drinking water.

N&M Technologies is a proud South African registered and based company that was established in 1989 by the current CEO, Mr. Medwyn Jacobs. N&M's focus has always been to meet the challenges facing South Africa and Africa through new and innovative means, and addressing Africa's clean water problems is one of them.

Mr. Jacob's had hoped to convince NAHES participates in 2013 to adopt the clean water generating solution that his company offered; however, the lack of enthusiasm has Jacobs worried because a year later nothing has changed. Yet, the stakes are higher than ever since groundwater sources across Africa have been depleted and people on the Continent are running out of places to look for water.

"Your country has so much humidity," Jacobs said to conference attendees. "You will never be short of water." Even better, he promises to open factories in Ghana that produce the machine, creating jobs and keeping resources local. However, reception of the machine during this conference remained half-hearted.

The audience questioned the machines safety. Had it been tested in a variety of humidities? Perhaps it would act differently in different settings? They questioned its efficiency. Can you reuse the filter? What if somebody didn't follow directions, reused the filter and gets sick?

Those at the conference did choose to sample the water produced by the machine, raising their glasses in a toast to N&M and Ghana before ceremoniously drinking the pristine water; but at the end of the day, Jacobs was no closer to deploying his company's solution than in 2013.

Potable water is a grave problem in many countries with emerging economies. It is especially dire in Asia, Africa, and South America. According to the World Health Organization there are “780 million people don't have access to clean water, and 3.4 million die each year due to water-borne diseases.”

N&M’s machine could be one remedy to this problem, and the fact that Africans seem reticent to deploy this on a larger scale is problematic. The technology of water reclamation from the air is not new. There is an Israeli company called Water-Gen that has developed an Atmospheric Water-Generation Units using its "GENius" heat exchanger to chill air and condense water vapor.

Their solution has been deployed on a large scale and according to an April 2014 article by CNNco-CEO Arye Kohavi explained that "The clean air enters our GENius heat exchanger system where it is dehumidified; the water is removed from the air and collected in a collection tank inside the unit.

From there the water is passed through an extensive water filtration system which cleans it from possible chemical and microbiological contamination," he explains. "The clean purified water is stored in an internal water tank which is kept continuously preserved to keep it at high quality over time."

The system produces 250-800 liters (65-210 gallons) of potable water a day depending on temperature and humidity conditions and Kohavi says it uses two cents' worth of electricity to produce a liter of water.” (Source: CNN)

N&M often researches foreign ideas and technology to develop innovative solutions, and perhaps if the idea of large-scale water reclamation from the air is not readily adopted, Ghanians and other Africans may be open to another aspect of water generating systems like portable water purification systems.

These machines may be of great assistance to communities where the people are subject to the daily backbreaking tasks of carrying water for cooking, washing, and bathing over many miles in hostile conditions, often in contaminated, non-biodegradable containers, such as plastics that previously contained toxic liquids/materials.

“Water-Gen has developed a portable water purification system. It's a battery-operated water filtration unit called Spring. Spring is able to filter 180 liters (48 gallons) of water, and fits into a backpack -- enabling water filtration on the go. You can go to any lake, any place, any river, anything in the field, usually contaminated with industrial waste, or anything like that and actually filters it into the best drinking water that exists," says Kohavi.” (Source: CNN)

This is not to say that individuals in Africa can afford a single device, but perhaps in the near future, the South African company N&M could partner with a company like Water-Gen to increase market share in Africa. Through the economies of scale, such a partnership could potentially introduce life-saving alternatives to porting and drinking contaminated water. The most important aspect of this opportunity is that the solution to address this critical issue is available and now it is just a matter of scaling and adoption, and with this, perhaps N&M will receive a warmer reception at the 2015 NAHES conference.

Follow Sarah on Twitter Twitter: @nahmias_report Africa Correspondent: @SJJakubowski

Just a Beer, a Glass of Wine, What's the Harm?

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Michael Ransom, Contributing EditorLast Modified: 05:57 a.m. DST, 15 May 2014

"Bourbon Please" Photo by: Thomas Hawk

GENEVA, Switzerland -- The recently published Global status report on alcohol and health, 2014 is an extensive study conducted by the World Health Organization. The 378 page document is a well-coordinated look at the international consumption of alcohol and the implications for individuals and communities.

Their findings are sobering. Researchers conclude that in 2012, 3.3 million people died from alcohol or alcohol-related incidents, amounting to 5.9% of deaths during that year.

Alcohol remains a ubiquitous global indulgence and a pervasive threat to public health everywhere. WHO meticulously dissects worldwide data according to gender, age, socioeconomic status, and nationality to provide cultural context to the statistics. Among the notable trends--men imbibe more often and more recklessly than women, wealth and alcohol use are positively correlated, and the religion observed in a given area is a strong consumption predictor.

Of the 3.3 million reported dead in 2012, alcohol played a role in 7.6% of male fatalities, and contributed to only 4% of female deaths. Higher rates of temperance among women explain this twofold gap. In Africa, 40.2% of males aged 15 and over are at least occasional drinkers, compared to only 19.6% of females. Similarly, 7.4% of men and 3.3% of women consume alcohol in the WHO designated eastern Mediterranean region. The greatest disparity between the drinking habits of sisters and brothers occurs in southeast Asia region, where men imbibe at more than four times the rate of women.

When controlling all other variables, age factors heavily into international trends of alcohol use. While Canada, France, Germany and the United Kingdom are home to the highest incidence of binge drinking among young people age 15-19, these tendencies wear off as nationals enter adulthood. In fact, the overall populations of France and Germany practice among the "least risky" drinking habits in the world. Data that includes older generations in Canada and the United Kingdom reflect more acceptable alcohol usage as well. Russia is the only country where adolescents are more responsible drinkers than their seniors.

Another valuable lens in the report is the change in global alcohol consumption from 2006-2010. During that time, countries like China, Peru and India have seen significant increases in intoxication rates. At the same time, other nations have weaned off the habit. Among them are Venezuela, South Africa and Ethiopia. The eastern Mediterranean region has remained largely alcohol free as Islamic populations widely avoid the practice.

Responsible alcohol use is key for the wellbeing of individuals and aggregate communities. Serious outcomes such as fetal alcohol syndrome, cirrhosis of the liver and a host of cancers are possible in regular users. But data compiled by WHO also indicate several other concerns. Of all global suicides, 22% are connected to alcohol use. 16% of traffic fatalities involve inebriation. And over one out of every 7 drownings are alcohol-related. According to the WHO report, over half a million deaths in 2012 were due to unintentional injuries incurred while intoxicated.

The investigation is not wholly dismal. Authors praise various nations for their preventative efforts aimed at limiting harm due to alcohol. For instance, South Africa created a national committee to bring Ministers of Health, Correctional Services and Education together to address drunk-driving and rehabilitate individuals struggling with alcohol addiction. An initiative to limit crimes connected to alcohol and address the dangers of alcohol poisoning is underway in Belarus, which has already proven largely effective. And the report puts Mongolia in the limelight for their efforts to bring together the president, alcohol distributors and various organizations to create an "Alcohol Free Mongolia."

In addition to these measures, WHO advocates community mobilization to combat personal and community overindulgence. Moreover, the authors also argue for forceful solutions such as additional taxes, further governmental regulation and a crackdown on the ubiquitous production of unregulated, black market beverages. These ideas are as beneficial for the immune system of society as they are the organs of the individual. But all the while, responsible consumption begins with the well-educated and accountable individual.

Follow Michael on Twitter Twitter: @nahmias_report Contributing Editor: @MAndrewRansom

Saudi Arabia Blames Camels for MERS Outbreak in US

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Allyson Cartwright, Contributing JournalistLast Modified: 20:24 p.m. DST, 14 May 2014

Riyadh Camel Market, Photo by Charles Roffey SAUDI ARABIA, Riyadh— A second case of an American infected with the MERS virus has been confirmed in Orlando, Florida. As MERS breaches the US border, death tolls of those infected with the virus in Saudi Arabia continue to rise. MERS originated in Saudi Arabia, where they claim that camels are the source of the pathogen that causes the respiratory virus.

There are near 500 diagnosed cases of MERS—short for Middle East Respiratory Syndrome— in Saudi Arabia alone. The Saudi health ministry reports that half of these MERS victims were diagnosed in April of this year. According to Ahram Online, the death toll of MERS victims in Saudi Arabia stands at 121 deaths, four of those within the last week.

The Saudi Ministry of Agriculture has issued a state public health through the official Saudi Press Agency. They urge people who are handling animals to “exercise caution and follow preventive measures”. This kind of warning has not come from Saudi officials since the MERS virus was discovered in 2012. Health experts conclude that the most dangerous animals to handle are camels, a vital livestock for the nomadic culture of Saudi Arabia.

The Ministry of Agriculture suggests when dealing with camels, "It is advisable to wear protective gloves, especially when dealing with births or sick or dead.” The National Turk says that the ministry has also warned that any camel milk should be boiled and camel meat thoroughly cooked before consumption. Also, gloves and face masks should be worn when handling animals or coming in contact with infected people. Despite the link between the MERS pathogen and camels, ABC News says that scientists do not know how the virus is spreading from the animal to people.

There is international concern as the virus is spreading globally. The hajj, the pilgrimage of Muslims to the Saudi cities of Mecca and Medina, will be occurring in this fall as well as during the Ramadan holy month of July. The large numbers of people, estimated at two to five million, will be travelling to Saudi Arabia from all over the world and putting themselves at risk of MERS infection. Some countries have even considered imposing travel restrictions to Saudi Arabia.

In Egypt, where their first case of MERS was diagnosed this April, there is deliberation on banning pilgrims from participating in the Hajj. Ahram Online reports that former Egyptian health minister and member of the special task force for the MERS virus, Mohammed Awad Tag El-Din, said if the “epidemic status of the virus and its development” gets worse then travel restrictions will be considered.

The World Health Organization (WHO) conducted a 5-day mission to the kingdom of Saudi Arabia to evaluate the outbreak of the virus. WHO determined that they “recommend the application of any travel or trade restrictions, including for upcoming pilgrimage travel to Saudi Arabia.”

NBC News reports that 17 countries, mostly on the Arabian Peninsula, currently have cases of infected individuals. Countries that have reported MERS infections include Kuwait, Oman, Qatar, Tunisia, United Arab Emirates, the United States and several countries in Europe. NBC News also say that with Dubai being the world’s busiest airport and the Middle East’s growing role in international trade, the MERS virus could eventually have economic implications that go beyond its dangers to health.

Follow Allyson on Twitter Twitter: @nahmias_report Contributing Journalist: @allysoncwright

Will Liberia Let Them Eat Dust?

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Ayanna Nahmias, Editor-in-ChiefLast Modified: 14:16 PM EDT, 8 May 2012

African Man Carrying Potable Water, Photo by Oxfam InternationalMONROVIA, Liberia – Across Africa water shortages and drought are an increasingly prevalent phenomenon. Some instances are a consequence of natural disaster, but in some cases clean water is being hoarded by powerful factions and used to extort impoverished people, or as a means to subjugate a war-weary population.

According to the World Health Organization, “Africa has the lowest total water supply coverage of any region, with only 62% of the population having access to improved water supply. This figure is based on estimates from countries that represent approximately 96% of Africa's total population.

The situation is much worse in rural areas, where coverage is only 47%, compared with 85% coverage in urban areas. Sanitation coverage in Africa also is poor, with only Asia having lower coverage levels. Currently, only 60% of the total population in Africa has sanitation coverage, with coverage varying from 84% in urban areas to 45% in rural areas.” (Source: WHO)

This endemic problem continues unabated despite the United Nations passing Resolution: 64/292 on 28 July 2010, which decreed that every human being has the right to have access to water and proper sanitation, and to deny access to these is deemed a human rights abuse.

The West African nation, Liberia, is a country of firsts and lasts, the first African nation to have elected a female head of state, President Ellen Johnson-Sirleaf, and last according to the UN Human 2011 Development Index which ranks it at the bottom percentile of all countries and territories at 182 out of 187.

Monrovia, the capital of Liberia, is home to 1.1 million people in a country with a total population of nearly 4 million who live on less than US$1 per day according to 2010 World Bank data. As with most countries there is a growing divide among the rich and the poor, but in Liberia, unlike other nations with social service nets, the poor are subjected abject poverty exacerbated by abysmal living conditions.

Most of the city’s residents live in burned out buildings without access to running water, sanitation, or potable drinking water. Many have to walk miles to fill numerous small plastic jugs, large 'jerry' jugs, or empty petrol barrels which can weigh from 40 lbs. (80 Kgs) to 70 lbs. (32 Kgs) once filled. (Source: The Water Project.org)

Women, who are typically responsible for collecting the water, are often forced to walk miles to communal water pumps or rivers. In the case of water pumps, the water is often untreated, and in cases where river water is used, there is a high probability of exposure to water-borne illnesses which can be as life threatening as dehydration.

In West Africa, during what is called the Harmattan season, dry and dusty West African trade wind blows south from the Sahara, which starts in early November and last through April. During this time water tables also fall precipitously low, forcing people to walk longer distances to find water which has not been muddied by the fine particulates of sand which cover everything. Those who cannot afford to pay for water, or do not possess the constitution to walk the many miles to transport water to and from hand pumps and wells are most at risk of death.

Because of the lack of response from the government to this pressing human rights issue, many entrepreneurs, some unscrupulous, have developed profitable businesses selling bottled water at grossly inflated prices to city dwellers. The water which they sell is often untreated though marketed to the contrary.

According to the Liberian Ministry of Information, Culture and Tourism (MICAT), in the vast slums of Monrovia water is sold on the black market where “five liters of clean water is sold for LD$ 20 Liberian dollars (US$0.28); while the same quantity is sold for LD $40-50 in areas with severe shortage of water.”

The lack of access to clean water and a working sanitation system is one of many complaints against President Sirleaf’s government. During her first term stated that if elected her government had “plans to construct 25 borehole wells in five counties to increase access to clean water, construct or rehabilitate 150 sanitation facilities in 10 of the 15 counties, and repair hand pumps, among other things. (Source: MICAT)

Though this did not materialize, President Sirleaf’s government cannot bear the entire blame, since the major infrastructure which would have been in place to repair and facilitate access to clean water and sanitation were destroyed during the nearly 11 years of constant civil war which began under Charles Taylor, the recently convicted war criminal and former president of Liberia.

According to the Liberian Ministry of Health and Social Welfare statistics, about 100,000 children under five and infants die annually from water borne diseases and related illnesses. Because of the lack of access to sanitation, many people are forced to relieve themselves in outhouses, ‘hanging toilets,’ or whatever secluded place they can find.

This results in the contamination of ground water and provides a fertile breeding source for various transmission vectors via insect or human to human contact. Some of the diseases to which people without proper access to clean drinking water can be exposed to are:

1. Diarrhea 2. Dysentery 3. Enteric Fever 4. Worm Infection 5. Louse Borne Fevers

Equally debilitating are the infectious diseases the populace can be exposed to as a consequence of lack of adequate sanitation:

1. Soil Transmitted Helminthes 2. Tape Worm 3. Filariasis (Elephantiasis) 4. Schistosomiasis

(Source: http://content.alterra.wur.nl/Internet/webdocs/ilri-publicaties/publicaties/Pub52/pub52-h4.0.pdf)

As stated in the beginning of this post, the problem of access to clean water is not unique to Liberia, or West Africa; however, it seems prudent that a implementing a substantive, quantitative, and verifiable resolution to this issue is essential to the economic recovery and growth of the country.

Now that oil reserves have been identified off the coast, it is incumbent upon President Sirleaf’s government to make sure that any proceeds from the sale of natural resources is poured back into the country to make the necessary improvements that will ultimately strengthen the country both economically, socially, and politically.

In her second term, President Sirleaf campaigned on an anti-corruption platform and it remains to be seen if she and her government do the right thing for their countrymen or like other African leaders, choose instead to line their pockets while their citizens ‘eat dust.”