Health for All!

World Food Day 2011 - Starved for Attention

2011-10-16T22:14:00.002-04:00

Click the video below for an introduction to Medicines Sans Frontiers (MSF)'s brilliant campaign for World Food Day 2011. To view more photos and videos and to help rewrite the story of malnutrition, click here.

Norway brings the conditions of everyday life to the heart of health policy

2011-10-13T19:06:00.000-04:00

Norway has just released its new Public Health Act, which aims to bring the social determinants of health to the heart of health policy at the national, regional, and local level. From the Norwegian Ministry of Health and Care Services:

"Minister of Health and Care Services Anne-Grete Strøm-Erichsen will attend the World Conference on Social Determinants of Health on 19-21 October 2011 in Rio de Janeiro, Brazil. The conference will bring together Member States and stakeholders to share experiences on policies and strategies aiming to reduce health inequities. As of 11 October 103 Member States have confirmed their attendance, including 60 ministers.

In the Norwegian context an important step in implementing Report No. 20 to the Storting (2006-2007) National strategy to reduce social inequalities in health is the newly launched Public Health Act which places reducing health inequalities through action on social determinants of health at the heart of Public Health nationally, regionally and locally."

Norwegian Public Health Act (pdf)
Norwegian Public Health Act short introduction (pdf)

To learn more about public health policies across Europe, download or order a copy of Health for all? A Critical Analysis of Public Health Policies in Eight European Countries, a brilliant book published by the Swedish National Institute of Public Health, featured here in 2009.

Marmot's "evidence-based optimism" on global action for health equity

2011-10-03T13:23:00.000-04:00

Sir Michael Marmot, Bulletin of the World Health Organization, October 2011:

“Closing the gap in a generation is a rousing call. Didthe World Health Organization’s Commission on Social Determinants of Health(CSDH) really believe it to be possible? Technically, certainly. Yes, there isa greater than 40-year spread in life expectancy among countries and dramaticsocial gradients in health within countries. But the evidence suggests that wecan make great progress towards closing the health gap by improving, as theCSDH put it, the conditions in which people are born, grow, live, work and age.

...In the three years since Closing the gap in a generation waspublished, there is no question that there is much to make us gloomy...On the positive side, however, much has happened to support my claim that I am an evidence-based optimist...

...The ambition of the CSDH was to create a global movement for social determinants and health equity. As the global community gathers in Rio de Janeiro in October for the conference on social determinants of health, we are at a crucial juncture. Will the call for social justice and the need to formulate all policies to benefit health equity remain something, at best, honoured in speech alone? Or will the global community recognize that action on social determinants of health is not only vital for health equity but has other highly desirable societal outcomes including social cohesion, reduction of crime and civil unrest, a more educated workforce and the freedom for people to lead lives they have reason to value."

Read Sir Michael Marmot's full piece in the WHO Bulletin

Learn more about the WHO Commission on the Social Determinants of Health

Follow PAHO/WHO Equidad on Twitter: http://twitter.com/eqpaho

WHO: Action on social determinants of health is essential to tackle noncommunicable diseases

2011-10-03T12:58:00.001-04:00

Bulletin of the World Health Organization, October 2011:

“…..Noncommunicable diseases cannot be effectively addressedwithout action on social determinants of health. Without addressing socialinequalities and the conditions in which people are born, grow, live, work andage, along with the reasons that health systems work better for some populationgroups than for others – that is, adopting a social determinants approach –prospects for reversing the noncommunicable diseases epidemics are poor.

This year’s United Nations General Assembly High-LevelMeeting on Prevention and Control of Noncommunicable Diseases (in New York) andthe World Conference on Social Determinants of Health (in Rio de Janeiro)provide a unique opportunity for progress.

 There may never be a better global platform for countries,civil society and international organizations to commit to a coherent socialdeterminants approach to tackling noncommunicable diseases and other globalpriorities at local, national and global levels. In this context, we explainwhy a social determinants approach is essential for combating noncommunicablediseases, discuss what such an approach entails, and identify priority actionsfor the global community…”

Partners In Health publishes Program Management Guide

2011-10-02T18:45:00.004-04:00

Congratulations to Partners In Health (PIH) for publishing this important resource, and thanks to the PIH Institute for Health and Social Justice for publishing their excellent reader (see below).

“Based on PIH’s experiences over the last 25 years, this guide offers an approach to starting, revamping, or expanding a healthcare program in resource-poor settings. PIH has received many inquiries from nascent organizations and established practitioners who are working to promote a rights-based approach to care. This guide discusses complex challenges that implementers commonly face, and shares lessons we have learned and the strategies that have helped us implement programs in collaboration with a wide range of partners.” -Jill Hackett, PIH Training Director

Read the PIH Program Management Guide.

Read more via the Health and Social Justice Reader.

UNICEF - Austerity measures threaten children and poor households

2011-10-02T18:21:00.005-04:00

UNICEF, Isabel Ortiz et. al, September 2011

"A new UNICEF study warns of the "irreversible impacts" of International Monetary Fund (IMF) austerity measures on children and poor households. The authors argue that excessively restrictive policies undermine IMF pledges to build social safety nets to protect the vulnerable. Instead of increasing investments in life-saving health, education and other social programs, in 2010, more than a quarter of developing nations were struggling to reduce spending to pre-2007 levels IMF-imposed fiscal policies must be carefully reviewed and replaced with alternative policies aimed at strengthening the social safety net for the most vulnerable." - IHSJ

Read more via the Institute for Health and Social Justice (IHSJ) reader.

Read the full article at the UNICEF website.

Grappling with the tensions around non-communicable diseases (NCDs)

2011-09-11T14:21:00.007-04:00

From the Institute for Health and Social Justice (IHSJ) Reader:

"By 2030, the burden of disease from noncommunicable diseases (NCDs) will be three times greater than that of communicable disease and maternal, perinatal, and nutritional conditions combined. The upcoming United Nations High-Level Meeting on NCDs has stirred tensions around global health funding. However, these conflicts could be allayed by redirecting focus to strengthening health systems so they deliver comprehensive, integrated care rather than debating whether communicable or noncommunicable diseases should receive more funding." - Sir George Allyne, Alafia Samu els, Karen Sealey, Global Health Magazine.

Read more: full article at Global Health Magazine.

Learn more with updates from the Institute for Health and Social Justice.

Informing the 2011 UN Session on Noncommunicable Diseases: Applying Lessons from the AIDS Response

2011-09-11T14:09:00.007-04:00

From the Institute for Health and Social Justice (IHSJ) Reader:

"In two weeks, the United Nations (UN) High-Level Meeting on Noncommunicable Diseases will begin, providing the first formal UN opportunity for the international community to raise awareness of the burden of noncommunicable diseases (NCDs). Global advocates are hoping to apply the lessons learned in the global response to HIV to inform the structure of the NCD response. In order to prevent, diagnose, and treat the dual burden of communicable and noncommunicable diseases that are disproportionately felt among the poorest billion people in the world, plans must focus on strengthening health care from the community to the tertiary care centers."

Read more: link to full article on PLoS Medicine
Learn more with updates from the Institute for Health and Social Justice.

Compulsory licensing of generic drugs remains in quagmires

2011-08-26T12:23:00.003-04:00

From the Institute for Health and Social Justice (IHSJ) Reader:

"Nearly a decade after the Doha Declaration determined that countries facing public health emergencies have the right to import generic drugs from developed countries, there has only been one instance in which a drug was successfully delivered to a developing country. Though several countries have enacted compulsory licensing legislation, the complicated application process deters low- and middle-income countries from turning to the EU or Canada to access cheaper treatment. Meanwhile, India, which has long served as the “pharmacy to the developing world,” is being forced to comply with international trade law by halting the production of generics patented after 1995."

Read more: link to Canadian Medical Association Journal.

Visit the IHSJ, the advocacy arm of Partners In Health.

Action: Tell the UN to Focus on Poverty-Related Diseases

2011-08-25T14:50:00.001-04:00

From Partners In Health: "In September 2011 the United Nations will hold a High-Level Meeting (HLM) on the prevention and control of Non-Communicable Diseases (NCDs). Much of the attention leading up to the conference has been focused on preventing NCDs by addressing lifestyle factors including diet, tobacco use, etc.

At Partners In Health we are particularly concerned with NCDs which are highly prevalent among the world’s poorest billion but are more often caused by poverty-related factors including indoor cooking stoves, malnutrition, etc.

Please add your name to the statement below to highlight and request attention to these causes of NCDs. We will share the statement and total numbers of signatories with the official delegations attending the HLM from the countries where PIH works and request that they also focus on solutions to the poverty-related causes in the outcomes document and programs developing from the HLM."

Download the full statement here.

DRC: Fighting A Cholera Epidemic

2011-08-16T16:03:00.001-04:00

A cholera epidemic is sweeping down the Congo River in the Democratic Republic of Congo. Originating in the distant centre of the vast central African country it has now reached the capital, Kinshasa, more than 1,000 miles southwest. People are sick and dying and desperate for help. Robin Meldrum went to the town of Mbandaka, where an MSF emergency team is responding to the crisis.

WHO Bulletin: Health inequalities in Bangladesh

2011-08-16T15:41:00.002-04:00

Bangladesh is one of the most densely populated and disaster-prone countries in the world. Although absolute poverty has declined in the country in recent years, the gap between the rich and poor has further widened.

A new report in the Bulletin of the World Health Organization (WHO) highlights this widening gap, concluding that "progress towards achieving national and international health goals will only be accelerated by mainstreaming equity in health policies and programmes. In short, Bangladesh needs concerted, integrated and holistic efforts based on the fundamental principle of equity to bridge the gaps between the rich and the poor and usher in an era of more progressive, equitable and sustainable socioeconomic development."

To read more from the report, click here.

MSF rapidly scaling up in Somalia

2011-08-15T16:13:00.001-04:00

"This week, Médecins Sans Frontières (MSF) has sent medical teams and four charter planes carrying 55 tonnes of medical equipment, medicines and therapeutic food to Mogadishu in response to the crisis in Somalia. In the past weeks, an estimated 100,000 people have fled from south and central Somalia to the capital to seek assistance. They are settling in numerous camps in and around Mogadishu, with little or no access to healthcare.

"MSF has started measles vaccination campaigns in dozens of makeshift camps where thousands of people have gathered after fleeing the exceptional drought and the violence in other parts of the country. Almost 3,000 children have been vaccinated so far. Around 1,000 children have been screened for malnutrition. More than half of them were indeed malnourished.

"MSF is extremely worried about the situation of the displaced. The situation is critical. MSF has begun reinforcing its operations in Mogadishu and is assessing areas around the capital in order to adequately respond to this crisis,” says Unni Karunakara, a doctor and MSF’s international president."

Read more: click here.

"Partners in Help: Assisting the Poor Over the Long-Term"

2011-08-08T11:51:00.007-04:00

Summary: Paul Farmer reflects on aid, his theory of accompaniment, and Haiti after the earthquake. From Foreign Affairs, July 29th, 2011.

"In 1848, Rudolf Virchow, one of public health's heroes, contended that "medicine is a social science, and politics is nothing other than medicine writ large." It would please me greatly to think that Virchow's point has been taken. Although I'm a physician, these past two years have been an object lesson about the difficulties of scaling up and of moving from caring for individual patients to building health systems in settings of privation and disarray.

A few years ago, building health systems was precisely what I thought I knew most about. But the January 2010 earthquake that ended so many Haitian lives and destroyed so much of its infrastructure was a grim reminder that we still lack the ability to translate goodwill and resources into robust responses. Reflect, for a minute, on the limits and the potential of the activity that used to be called "charity" or "foreign aid" but that I prefer to call "accompaniment."

"Accompaniment" is an elastic term. It has a basic, everyday meaning. To accompany someone is to go somewhere with him or her, to break bread together, to be present on a journey with a beginning and an end. There's an element of mystery, of openness, of trust, in accompaniment. The companion, the accompagnateur, says: "I'll go with you and support you on your journey wherever it leads; I'll share your fate for a while. And by 'a while,' I don't mean a little while." Accompaniment is about sticking with a task until it's deemed completed, not by the accompagnateur but by the person being accompanied...."

To continue reading the complete article, click here.

Malnutrition crisis in East Africa

2011-07-15T16:54:00.012-04:00

Médecins Sans Frontières (MSF): "As prolonged drought grips Somalia, people are losing their livestock, homes and lives. Poor harvests, rising food prices, continuing violence and chronic poverty have further contributed to a sudden rise in malnutrition rates. Almost one in three children is suffering from severe malnutrition with extremely low weight, signs of wasting and nutritional oedema. Until now the crisis has been underreported in the press, however malnutrition rates amongst Somalia’s children are now double the threshold for a full-scale emergency and the problem is worsening daily. The security situation in Somalia is complicated, but because we are an impartial medical organisation and rely on charitable donations instead of government funding, we continue to be the only medical charity working in many areas. There are hundreds of children and adults arriving at our clinics every day. Many of them need expert medical care for malnutrition, often whilst battling other severe conditions such as malaria and pneumonia."

To donate to MSF's Somalia Appeal, click here. To hear from frontline healthcare providers about current conditions in Somalia, click here. To visit MSF Somalia, click here.

First, do no harm: MSF criticizes CIA's alleged fake immunization programme

2011-07-15T16:14:00.002-04:00

Médecins Sans Frontières is challenging the CIA for allegedly using a fake vaccination programme for counter-terrorism purposes, saying it constitutes "a grave manipulation of the medical act". "The risk is that vulnerable communities – anywhere – needing access to essential health services will understandably question the true motivation of medical workers and humanitarian aid," said Unni Karunakara, MSF's international president. "The potential consequence is that even basic healthcare, including vaccination, does not reach those who need it most."

To read MSF’s full press release, click here.

For commentary from the Centre for Global Development, click here.

For background from the Guardian, click here.

How structural violence impacts maternal health

2011-06-13T12:18:00.009-04:00

'“When unjust systems or structures prevent people from achieving good health, and from achieving good lives, this is structural violence in action,” says Donna Barry, Director of Policy and Advocacy for Partners In Health (PIH).

In an article entitled “Structural Violence: A Barrier to Achieving the MDGs for Women,” published recently in the Journal of Women’s Health (JWH), PIH Medical Director Joia Mukherjee, Barry, and several other co-authors argue that maternal mortality continues to plague poor women in poor communities because public health interventions have not addressed the impact of structural violence. Drawing on examples from PIH’s work in Haiti and Lesotho, the authors also clearly demonstrate how women’s lives can be saved and transformed by programs that combine quality health care with determined efforts to uproot structural violence and the social determinants of disease, especially poverty, sexism, and gender-based violence.

In the late 1980s, 99 percent of the half million maternal deaths occurring each year took place in poor countries. Nearly a quarter century later, 350,000 women still die every year from pregnancy-related causes, the vast majority in the poor world. In a 2010 report on maternal mortality, the United Nations Population Fund (UNFPA) found that complications from pregnancy and childbirth are the leading causes of death for 15-19 year old women and adolescent girls in developing countries.'

Read the complete article from Partners In Health

Watch the PIH video below on maternal global health delivery

Watch live streaming video from global_health_equity at livestream.com

Target of 15 million people on HIV treatment by 2015 secured at AIDS summit

2011-06-09T16:37:00.001-04:00

MSF: Funds and affordable drugs needed to turn target into treatment NEW YORK, 9 June 2011 – On the heels of new evidence that shows HIV treatment is also HIV prevention, governments meeting at a UN Summit on AIDS have taken a critical step by committing to reach 15 million people with HIV treatment by 2015 – but they must take immediate concrete action to make this treatment target a reality, the international medical humanitarian organization Médecins Sans Frontières (MSF) / Doctors Without Borders said today. “By agreeing to expand HIV treatment to 15 million people in four years, governments are committing to take the latest science that treatment is prevention and turn it into policies that save lives and can stop the virus,” said Sharonann Lynch, HIV/AIDS Policy Advisor for MSF’s Campaign for Access to Essential Medicines. “The clock starts now – everyday, we need to get more people on treatment than the day before.”

Fresh scientific evidence shows that treatment is also a form of prevention, as it reduces the risk of transmission of HIV from one person to another by 96 percent. By ambitiously expanding treatment, according to new research by UNAIDS, twelve million infections and more than seven million deaths can be averted by 2020. It could also reduce by more than half the number of new infections by 2015. This will require an additional $6 billion top up each year until 2015. However, funding for AIDS declined in both 2009 and 2010, leaving the Global Fund to Fight AIDS, TB and Malaria, the US-government’s PEPFAR and other programs short of resources.

“There are nine million people waiting for HIV treatment today,” said Dr Tido von Schoen-Angerer, Executive Director of MSF’s Access Campaign. “This whole AIDS Summit will have been a farce if we don’t see real plans to ramp up treatment so we can get ahead of the wave of new infections.”

Countries also need to ensure that the medicines needed to break the back of the epidemic remain affordable. This means not just supporting policies that drive down prices, but refraining from pushing policies that drive up prices by imposing ever tighter intellectual property protection. In particular, free trade agreements negotiated by the US, the EU and others with developing countries are creating further barriers to price-busting generic competition, and threaten access to affordable newer medicines.

“Without affordable medicines, access to treatment cannot become a reality,” said Michelle Childs, policy/advocacy director of MSF’s Access Campaign. “Over six million people are on treatment today, largely because generic production drove the price of the first generation of AIDS medicines down by 99% since 2000. This success can only be repeated with newer and more potent medicines if barriers to low-cost drug production are removed. But countries are making promises to treat AIDS in one meeting and working hard to keep prices out of reach behind closed doors in other meetings. This double-speak has to stop.” The final declaration ending the UN General Assembly High-Level Meeting on HIV/AIDS is expected to be formally endorsed by countries on 10 June. MSF currently provides antiretroviral treatment to 170,000 people living with HIV/AIDS in 19 countries and sources more than 80 percent of the antiretroviral medicines it uses in its projects from generic manufacturers in India.

Time to act: Save a million lives by 2015 - Prevent and treat tuberculosis among people living with HIV

2011-06-09T12:36:00.004-04:00

'A new epidemiological model shows it is possible to sharply reduce AIDS deaths worldwide by preventing and treating tuberculosis (TB). At present one in four AIDS-related deaths is precipitated by TB; the vast majority of these could be averted, since TB is curable.

The model, which provides a clear blueprint for saving lives, was produced through a joint effort by the Stop TB Partnership, World Health Organization (WHO) and the Joint United Nations Programme on HIV/AIDS (UNAIDS). Building on well-established methods for preventing and treating HIV-associated TB that are recommended by WHO and UNAIDS, the model shows that by scaling up these approaches worldwide a million lives could be saved by the end of 2015.

"There has been a surge in awareness about the deadly TB epidemic among people living with HIV, but insufficient action. Now new scientific work has shown that we can prevent a million deaths among people living with HIV by end 2015 by providing integrated HIV and TB care," said Dr Jorge Sampaio, the UN Secretary-General's Special Envoy to Stop TB and former President of Portugal. "I call on the world's leaders to take up this challenge. It is time to take bold action. Not to do so would be an outrage."'

To learn more, visit the Stop TB Partnership

Download the document

Download the fact sheet

HIV treatment is also HIV prevention

2011-06-08T18:40:00.005-04:00

"This week in New York, heads of state and health ministers from the around the world will make decisions that will impact the lives of millions of people. At the UN General Assembly High-Level Meeting on HIV/AIDS beginning June 8, officials are expected to hammer out a blueprint for the next decade of the global response to the epidemic. The meeting takes place exactly 30 years since the discovery of HIV/AIDS and ten years after HIV/AIDS treatment started in developing countries..."

To learn more, visit:
Médecins Sans Frontières - Frontline Reports Podcast
Dignitas International - HIV/AIDS and Human Rights

Partners In Health - HIV/AIDS Equity Initiative

UN General Assembly - Watch live

PIH proposes Cholera vaccination campaign in Haiti

2011-06-06T12:33:00.002-04:00

"As Haiti’s cholera epidemic enters its ninth month, the country’s rainy season has begun, further stressing and disrupting the country’s woefully inadequate water and sewage systems. According to the World Health Organization (WHO) and Haiti’s Ministry of Health, increasing numbers of people are falling ill and dying from the illness.

Debate about the public health response to the crisis has also been underway, with some experts arguing that a vaccination campaign in Haiti would be neither feasible, nor cost-effective. But a coalition of medical and public health researchers, policymakers, and practitioners, led by PIH co-founder Paul Farmer, argue that a universal vaccination campaign is essential to ending the crisis in an article published in the May 31st issue of the open-access journal PLoS Neglected Tropical Diseases."

Meeting cholera's challenge to Haiti and the world: A joint statement on cholera prevention and care

Institute for Health and Social Justice

2011-06-03T09:56:00.002-04:00

Partners In Health was founded in 1987 to provide a preferential option for the poor in health care, and has since become a global leader in the struggle for health and social justice. As PIH explains, "[our] conviction that health care is a human right stems from our service to vulnerable communities and their daily struggle with the grim realities of poverty. The Institute for Health and Social Justice (IHSJ) is the advocacy and policy arm of Partners In Health. The mission of the IHSJ is to analyze the impact of poverty and inequality on health, and to use these findings to educate and train students, academics, donors, policy makers, and lay people."

The IHSJ Reader offers a great summary of global health news and events, and can be accessed by clicking here. To learn more about the IHSJ, visit their website by clicking here.

Stay connected with the PIH Blog, Facebook, Twitter, and YouTube pages

April 25th - World Malaria Day

2011-04-25T14:21:00.009-04:00

April 25th is World Malaria Day. Take a moment to learn a bit more about this deadly but preventable disease, about ongoing efforts to make progress towards zero malaria deaths by 2015, and about the obstacles to meeting this important goal. In 2008, there were 247 million cases of Malaria and over 1 million deaths, mostly among children living in African countries, where the disease accounts for about 20% of all childhood deaths. The WHO offers a good introduction to the disease:

"Malaria is caused by a parasite called Plasmodium, which is transmitted via the bites of infected mosquitoes. In the human body, the parasites multiply in the liver, and then infect red blood cells. Symptoms of malaria include fever, headache, and vomiting, and usually appear between 10 and 15 days after the mosquito bite. If not treated, malaria can quickly become life-threatening by disrupting the blood supply to vital organs. In many parts of the world, the parasites have developed resistance to a number of malaria medicines. Key interventions to control malaria include: prompt and effective treatment with artemisinin-based combination therapies; use of insecticidal nets by people at risk; and indoor residual spraying with insecticide to control the vector mosquitoes."

To learn more about Malaria and efforts to promote health for all, visit:

http://www.ghdonline.org/malaria/

http://www.rollbackmalaria.org/worldmalariaday/

http://www.who.int/malaria/en/

http://www.who.int/topics/malaria/en/

Paul Farmer on Non Communicable Disease in Poor Countries

2011-03-27T19:00:00.002-04:00

Watch live streaming video from global_health_equity at livestream.com

World TB Day (March 24th, 2011)

2011-03-24T19:48:00.007-04:00

Tuberculosis (TB) is a preventable and treatable disease caused by Mycobacterium tuberculosis. TB is spread by person-to-person contact via droplets from the lungs and throat of people with active respiratory TB disease.

Two billion people, fully one-third of humanity, are infected with latent TB. While healthy immune systems are often able to contain the bacteria, people with latent TB remain susceptible to developing active TB disease, with symptoms including productive coughing, chills, night sweats, fever, easy fatigue, loss of appetite, and weight loss. Each year there are 9.4 million new case of active TB cases, resulting in 1 million deaths.

TB closely follows social gradients in income, housing, and other social determinants of health. It is at once a completely curable disease, and a leading cause of death worldwide. While effective antibiotic treatment has existed for over 50 years, poor and inconsistent access to care has facilitated the rise of multi-drug resistant TB (MDR-TB). TB and MDR-TB remain preventable and treatable.

Preventing and treating TB involves the practice of social medicine, and a commitment to pragmatic solidarity - "a commitment to struggle alongside the destitute sick and against the economic and political structures that cause and perpetuate poverty and ill health" (PIH 2003).

To learn more about TB, click the links below:

WHO - Tuberculosis

Partner's in Health

PIH Model Online

Maliketso's Story - from Partner's In Health

Global Health Delivery Online - MDR-TB Treatment and Prevention

Stop TB Partnership

Addressing Non-communicable Diseases of the ‘Bottom Billion’

2011-03-13T19:33:00.008-04:00

From Global Health Delivery Online

"Non-communicable diseases (NCDs) like coronary disease, adult-onset diabetes, and some cancers have attracted a great deal of attention and resources in wealthy and middle-income countries, where they have emerged as leading causes of death and disability among populations who eat too much, exercise too little, and are heavy consumers of tobacco and alcohol. “The NCDs that afflict people living on less than a dollar a day in countries like Rwanda or Haiti have received far less attention and have very different causes,” says Partners In Health physician Gene Bukhman. “For this ‘bottom billion,’ NCDs like rheumatic heart disease, type 1 diabetes, mental illnesses, epilepsy, and cervical cancer are often the result of lack of access to food, shelter, education, and health care interventions readily available in developed countries.”

When looking at a graph plotting out the diseases that most affect a population, communicable diseases like HIV and malaria are at the top of the curve, causing more deaths, but NCDs like epilepsy or heart disease are on the ‘long tail.’ No single condition has a dramatic prevalence but together they impose a heavy burden that is not effectively addressed by disease-specific strategies that have been used for communicable diseases.

Read More

100 Years of International Women's Day: Time to Make the Promise of Equality a Reality

2011-03-08T09:46:00.006-05:00

"This year marks the 100th anniversary of International Women’s Day. The day was commemorated for the first time on 19 March 1911 in Austria, Denmark, Germany and Switzerland, following its establishment during the Socialist International meeting the prior year. More than one million women and men attended rallies on that first commemoration. read more »

The United Nations observes International Women’s Day this year on 8 March 2011. The theme is “Equal Access to Education, Training and Science and Technology: Pathway to Decent Work for Women.” UN Women is organizing or cosponsoring a number of events around the world to commemorate the day."

Indigenous health promotion in Canada

2011-03-04T17:38:00.011-05:00

While much of the Canadian population enjoys good health, health status in Canada still follows steep social gradients of inequality. From obesity and cardiovascular disease, to sexually transmitted infections, tuberculosis, and suicide, Indigenous people in Canada face a disproportionate burden of disease. It doesn't have to be this way, and Indigenous peoples across Canada are pouring energy into creative calls for action.

This video by Anishinaabe hip hop artist and CBC producer Wab Kinew video translates data from youth participants in the First Nations Regional Longitudinal Health Survey into hip hop lyrics for a youth audience. Congrats to Wab Kinew and the FNIGC for their great work! For more info, visit the the First Nations Information Governance Centre.

The living history of colonialism in Canada is a reminder that public health involves a commitment to pragmatic solidarity - a commitment to struggle alongside Indigenous peoples to address the political and economic conditions that cause and perpetuate poverty and poor health.

Polio eradication efforts are a global public health success story - but it's not over yet

2011-01-27T14:12:00.002-05:00

Cornel West speaks to American Public Health Association about health and social justice

2010-11-13T13:21:00.009-05:00

Part 2 (click here)
Part 3 (click here)

Some highlights:
-"There's too much moral constipation: you know what's right, but you just can't get it out"
-"the unexamined life is not worth living...and the examined life is painful. To acknowledge the conditions of truth is to allow suffering to speak"
-‎"there is a deep connection between socratic questioning and loving - and I use the word love explicitly - a steadfast commitment to the wellbeing of others."
-"Justice is what love looks like in public"

Dr. Evan Lyon: "Cholera will not go away until underlying situations that make people vulnerable change"

2010-11-07T07:42:00.006-05:00

What's Happening in Haiti? A Report from the Cuban Medical Brigade

2010-11-05T21:39:00.006-04:00

By Emiliano Mariscal, Argentine doctor, Graduate of the Latin American School of Medicine (Cuba) and member of the Cuban medical brigade in Haiti

To view the Spanish original of this item is at the ALBA-TCP website, click here.
To view a pdf of the English translation by Norman Girvan, click here.

To my friends and family,

These lines are meant to provide information on the health situation in Haiti, as a result of the concern of many friends who have written asking about conditions here.

The first thing I can say is that we have a disease, cholera, which has not been reported in this country for over 100 years. Secondly, that it is one of the most dreaded diseases here, given the ideal conditions that exist for its persistence and spread.

Briefly, my first experience of the disease was this: two days before its presence in Haiti was confirmed, we accompanied an epidemiologist, a microbiologist and an entomologist to Mirebalais, a community in the Centre Department where the Cuban medical brigade stationed at a hospital had reported an outbreak of diarrhea of such unusual severity that it had already killed three people. During the tour of the community we frequently had occasion to recall the work of Dr. John Snow, the forerunner of modern epidemiology, because when we visited the locations from which the deceased originated, they all had a common element--proximity to the Artibonite River. People have no piped water supply, so they obtain water from the river, whether for drinking, washing utensils, personal hygiene, etc. Another common element is the absence of latrines, so it is usual for them to relieve themselves outdoors.

We also observed overcrowding, extremely poor housing conditions, small garbage dumps scattered throughout, malnutrition, a low educational level, helplessness and resignation. Patients admitted to hospital had watery diarrhea, whitish, accompanied by profuse vomiting; the most severe cases arrived with dehydration. There were three deaths. Water samples were taken, as well as feces and vomit samples on behalf of the authorities of the Ministry of Health of Haiti. Our conclusion: the source of infection is contaminated water, by reason of clinical characteristics indicating an extremely aggressive bacteria that is spread by water, the existence of environmental conditions for its persistence and spread, an incubation period of around 24 hours, and the fact that in the space of a few hours it can result in complications, which, if untreated, can cause premature death.

Cholera having been absent for one hundred years, we could not be sure that this was what we were dealing with until there was laboratory confirmation. The report was turned over to Haitian authorities and the next day, the outbreak occurred in Saint Marc. Soon after came the confirmation that this is indeed a Vibrio cholerae. 16 days have elapsed from the beginning of the epidemic; to date, Haitian authorities have reported 330 deaths and approximately 4600 inpatients. There are several international institutions such as PAHO and the CDC who are advising the Haitian Ministry of Health, but the lead role, although you don’t hear about it in the mass media, is played by Cuba in close coordination with the health institution in Haiti. (1) The reality is that the action of the Cuban Medical Brigade has delayed the spread of the epidemic to Port au Prince (which is the most feared, as there are 1 500 000 people living in settlements there in extremely precarious conditions).

The town of Arcahaie (part of the West Department) leads directly to Artibonite (and especially to Saint Marc). Our brigade provides medical care in two institutions as part of the strategy for reconstruction and strengthening of the health care system developed together with Ministry of Health of Haiti. They have been turned into Cholera Care Centers. Up to October 30, the two institutions had treated 1182 patients, confirming at the same time, the presence of transmission in the sub-communities of Arcahaie, finding in them the conditions described in the first focus control area in Mirebalais. You don’t need to be a health specialist to work out that if the 1,182 patients had not been referred to these centers, they would have sought assistance in Port au Prince; and that's exactly the way the epidemic spreads (described extensively in the literature)--sick people come in search of health institutions and others who are not yet sick, but are in the incubation period, move away from the place for fear of contracting the disease. As a result many people would have moved to Port au Prince where there are no conditions to contain the influx sick people.

The fundamental tasks are to carry out health education and to provide safe sources of water supply for the population. Both elements are difficult to achieve, the first because it is difficult to change long ingrained habits in the population; the second, because although there are resources (grants), establishing the organizational capacities needed to bring it about is a complex matter. The work is going forward. The Cuban Medical Brigade is ready to continue contributing to the fight against this terrible epidemic together with the Haitian authorities. Their presence in the community through health education activities linked with community leaders and Cholera care centres are high expressions of the principles of solidarity and internationalism. Fifty-one young graduates of the Latin American School of Medicine are now in the forefront of this hard battle, working arm in arm as one with their Cuban brothers and teachers. The others continue working in positions throughout the country, many of them ready to go to the front line as necessary. The prospect is that the disease will remain in the country for several years, with outbreaks happening as water sources are polluted. A hurricane is now approaching, which is forecast to reach Haiti today. No doubt this will aggravate the situation, providing conditions for the further spread of the disease to places where it had not reached. There are also areas of high flood risk.

Cuba has been here for 12 years. Since the earthquake, the commitment is to rebuild and strengthen the health care system. Cuba will be here during the cholera epidemic and in the wake of the Hurricane. Just ask any citizen of this country about the Cuban doctors and you will see their faces blossom.

Proud to be part of another page of the many pages of Cuban internationalism; proud to be a member of the Cuban Medical Brigade; proud to be a child of the Americas, committed above all to my homeland that is Latin America and to my compatriots who are the children of this soil.

(1) Translator’s note: it is not clear if this refers to the Haitian Ministry of Health. The Spanish reads “la institución sanitaria de Haiti”.

Identifying the source of Haiti's cholera outbreak

2010-11-04T21:29:00.007-04:00

(AP) PORT-AU-PRINCE, Haiti -- Researchers should determine whether United Nations peacekeepers were the source of a deadly outbreak of cholera in Haiti, two public health experts, including a U.N. official, said Wednesday.

The U.S. Centers for Disease Control and Prevention found that the strain of cholera that has killed at least 442 people the past three weeks matches strains found in South Asia. The CDC, World Health Organization and United Nations say it's not possible to pinpoint the source and investigating further would distract from efforts to fight the disease.

But leading experts on cholera and medicine consulted by The Associated Press challenged that position, saying it is both possible and necessary to track the source to prevent future deaths. "That sounds like politics to me, not science," Dr. Paul Farmer, a U.N. deputy special envoy to Haiti and a noted expert on poverty and medicine, said of the reluctance to delve further into what caused the outbreak. "Knowing where the point source is - or source, or sources - would seem to be a good enterprise in terms of public health."

The suspicion that a Nepalese U.N. peacekeeping base on a tributary to the infected Artibonite River could have been a source of the infection fueled a protest last week during which hundreds of Haitians denounced the peacekeepers.

John Mekalanos, a cholera expert and chairman of Harvard University's microbiology department, said it is important to know exactly where and how the disease emerged because it is a novel, virulent strain previously unknown in the Western Hemisphere - and public health officials need to know how it spreads. Interviewed by phone from Cambridge, Massachusetts, Mekalanos said evidence suggests Nepalese soldiers carried the disease when they arrived in early October following outbreaks in their homeland. "The organism that is causing the disease is very uncharacteristic of (Haiti and the Caribbean), and is quite characteristic of the region from where the soldiers in the base came," said Mekalanos, a colleague of Farmer. "I don't see there is any way to avoid the conclusion that an unfortunate and presumably accidental introduction of the organism occurred."

To read more, click here.

PAHO Responds to Cholera Outbreak in Haiti

2010-10-26T22:05:00.001-04:00

Washington, Oct. 26, 2010 – The MSPP (Ministère de la santé publique et de la population) is leading the response to the cholera outbreak and has prepared the National Response Strategy to the Cholera Epidemic. This strategy is organized around thrree levels

1. Protection of families at the community level;

2. Strengthening of the 80 centers of primary health care in the metropolitan area;

3. Reinforcement of the network of 10 Cholera Treatment Centers (CTC) and 8 hospitals for the management of severe cases.

Work has also started on establishing community rehydration centers that provide oral rehydration by community workers. This will be introduced in phases using priority areas identified by the MSPPP.

Technical Information

The Global Task Force on Cholera Control [English]

Acute diarrhoeal diseases in complex emergencies: critical steps [English] [French]

First steps for managing an outbreak of acute diarrhoea [English] [French]

Cholera fact sheet [English] [French] [Spanish]

Cholera outbreak: assessing the outbreak response and improving preparedness [English]

Management of Dead Bodies after Disasters: A Field Manual for First Responders [English] [French] [Spanish]

Click here for more information from PAHO

Cholera outbreak in Haiti

2010-10-22T06:43:00.000-04:00

Joel Gutierrez: Cuba's Health System and Global Health Innovations

2010-10-16T20:26:00.007-04:00

Joel Gutierrez: Cuba's Health System and Global Health Innovations from chris keefer on Vimeo.

Joel Gutierrez, Chair, Clinical Neurophysiology Dept and Deputy Research Director of the Cuban Institute of Neurology and Neurosurgery Professor at the Havana Medical University.

Since the 1959 revolution Cuba has developed one of the most successful healthcare systems in the world, particularly considering its low-income status. Cuba has accomplished this feat through a focus on primary preventative care integrated within the community as well as incorporating a public health lens into its general policy making. Remarkably Cuba's impressive health indicators have weathered the contraction of its economy following the collapse of the Soviet Union and the ongoing hardships faced by the island in the face of the current global economic crisis and the ever-present economic blockade imposed by the USA.

In addition to these domestic accomplishments Cuba has developed and maintained an unprecedented capacity for medical solidarity sending tens of thousands of health professionals to countries across the global south including most recently Venezuela, Pakistan, Bolivia and Haiti. Finally Cuba is reversing the brain drain suffered by countries of the global south by educating tens of thousands of low-income international medical students on full scholarships through its flagship program the Latin American School of Medicine.

Debating the future of Canada's health care system

2010-10-11T13:08:00.004-04:00

Debate organized by Students for Medicare on October 4th, 2010 in Toronto, Ontario.

"Would Canada benefit from greater privatization of health care?"

YES: Dr. William Orovan, Urologist, Professor and Chair of the Department of Surgery, McMaster University

vs.

NO: Dr. Danielle Martin, Family Physician, Board Member and Founder of Canadian Doctors for Medicare.

Debate: Would Canada benefit from greater privatization of health care? Part 1 of 4 from Students For Medicare on Vimeo.

No time to quit: HIV/AIDS treatment gap widening in sub-Saharan Africa

2010-10-02T13:50:00.002-04:00

New therapies have had great benefits for people living with HIV/AIDS, but looming funding cuts could undo many of the gains. To learn more, visit aids2010.msf.org. And for a brief MSF (Medicines Sans Frontiers) report on the growing funding gap, click here.

Addressing cancer in the developing world: Health equity and an overlooked public health crisis

2010-09-28T09:13:00.002-04:00

Want to learn more? Watch a panel session on “Addressing Cancer in the Developing World: Health Equity and an Overlooked Public Health Crisis” from the 2010 Clinton Global Initiative annual meeting.

Tackling acute and chronic disasters: Lessons from Haiti

2010-09-16T12:10:00.004-04:00

Partners in Health (PIH) holds its 17th Annual Thomas J. White Symposium this September 25th, 2010. The event is live-streamed via the PIH website beginning at 3:00pm EDT, and can be viewed at www.pih.org/symposium. Each year this event brings together PIH staff, family, friends, and fellow advocates for health and social justice. This year's Symposium features keynote speeches from

-PIH co-founder Dr. Paul Farmer

-PIH Executive Director Ophilia Dahl

-PIH leaders from around the world

"For over 20 years, PIH has worked to tackle the chronic but devastating disasters that stifle the lives and hopes of millions of people - lack of access to medical care, food, clean water, decent housing, schools and jobs. This year's Symposium will explore how acute disasters like the earthquake in Haiti impact communities already ravaged by poverty and disease, and how our commitment to breaking this vicious cycle has enabled us to respond effectively to the need for both emergency relief and long-term recovery."

Flooding and public health crisis in Pakistan

2010-08-19T15:33:00.012-04:00

"More than two weeks of floods in Pakistan have left well around 2000 people dead and more than 20 million displaced. And the country is set for more troubled times ahead. The UN has warned that up to 3.5 million children are at risk of contracting water-borne diseases. As many as 300,000 people could contract Cholera - a disease that can spread quickly in areas where the water is contaminated. The first case has been reported and a failure to contain the disease could spell further disaster for Pakistan. So just what will it take to avert this and how are relief efforts being hindered by the growing health crisis?"

For updates, visit the website of the WHO in Pakistan

WHO Technical Hazard Sheet - Flooding

UNCHR - The UN Refugee Agency

UNICEF - Support UNICEF's appeal for children in Pakistan

UNICEF - Funding appeals and humanitarian action updates

MSF - Medicines Sans Frontiers

Debating The Spirit Level: "Smaller income differences result in better health"

2010-08-16T10:40:00.024-04:00

by Andrew Bresnahan

In their recent book "The Spirit Level: Why More Equal Societies Almost Always Do Better", epidemiologists Richard Wilkinson and Kate Pickett marshall the evidence on income inequality and a range of different health and social problems - including physical health, mental health, drug abuse, education, imprisonment, obesity, social mobility, trust and community life, violence, teenage births, and child well-being. Across all 11 of these indicators, outcomes are substantially worse in more unequal societies, and substantially better in more equal societies.

Perhaps the book's biggest achievement is it's popularity in the UK, which Wilkinson and Pickett hope is a move towards a more "evidence-based politics". The authors hope their research will shift inequality from being seen only as a left-wing issue, and make addressing it a key metric for success across the political spectrum.

But their book has also produced a backlash from a few writers, often associated with right-wing institutes, who have positioned themselves as "professional idea wreckers". Their idea isn't so much to produce counter-evidence as it is to plant doubt, making it more difficult to build alliances across partisan lines. As Wilkinson and Pickett explain in response, "It was inevitable that these attacks would appear sooner or later. But it is important that people are aware of how ill-founded and easily rebuffed they are. That three sustained attacks from those opposed to greater equality can be dealt with in relative ease should increase our confidence in the case for a more equal society."

Wilkinson and Pickett engage these challengers head on, and if anything, offer a chance for all of us to strengthen our fluency with the evidence. There are two great places to look if you want to get more aquatinted with the critiques and Wilkinson and Pickett's responses. First, Wilkinson and Pickett respond brilliantly in the FAQ section of The Equality Trust website, and in a comprehensive response to three most influential critiques, published by right-wing think tanks.

Also, in recent months the British RSA (Royal Society for the encouragement of Arts, Manufactures and Commerce) has hosted two excellent talks on the Spirit Level. The first features Wilkinson and Pickett introducing their book. The second features a live debate between Kate Pickett and Richard Wilkinson, co-authors of The Spirit Level, and Peter Saunders, author of the Policy Exchange report Beware False Prophets: Equality, the Good Society and The Spirit Level and Christopher Snowden, author of The Spirit Level Delusion. The RSA debates on the Spirit Level are available for download here.

If we're committed to learning from them, these debates will help strengthen our fluency with the evidence. And the better we're able to marshall the evidence on health inequalities and social wellbeing, the closer we'll be to becoming the social movement that evidence calls for us to become.

The Cost of Care: What quality of care, for who, financed how?

2010-08-12T15:04:00.003-04:00

"The United States spends more on medical care per person than any country, yet life expectancy is shorter than in most other developed nations and many developing ones. Lack of health insurance is a factor in life span and contributes to an estimated 45,000 deaths a year. Why the high cost? The U.S. has a fee-for-service system - paying medical providers piecemeal for appointments, surgery, and the like. That can lead to unneeded treatment that doesn't reliably improve patients health. Says Gerard Anderson, a professor at Johns Hopkins Bloomberg School of Public Health who studies health insurance worldwide, 'More care does not necessarily mean better care'" - Michelle Andrews, National Geographic, January 2010

A Worker's Speech to a Doctor

2010-08-08T16:45:00.000-04:00

When we come to you

Our rags are torn off us
And you listen all over our naked body.
As to the cause of our illness
One glance at our rags would
Tell you more. It is the same cause that wears out
Our bodies and our clothes.

The pain in our shoulder comes
You say from the damp: and this is also the reason
For the stain on the wall of our flat.
So tell us:
Where does the damp come from?

-Bertolt Brecht

Charity or social justice? Financing global health

2010-08-08T11:06:00.047-04:00

by Andrew Bresnahan

In August 2010, Bill Gates and Warren Buffet, two of the richest people in the world, revealed they had persuaded 40 US billionaires to sign the "Giving Pledge", an agreement to use a majority of their wealth for philanthropy. So is there anything wrong with such an extraordinary act of charity?

Perhaps quite a lot. As Reinhold Niebuhr pointed out in the 1930's, "philanthropy combines genuine pity with the display of power, which explains why the powerful are more inclined to be generous than to grant social justice." Healthy systems of social welfare depend on equitable financing and coherent investment - and there are convincing arguments that charity tends to deliver neither. Many of these arguments are explored in a brilliant piece on the BBC's website reviewing ethical arguments against charity.

As response to the January 12th earthquake in Haiti demonstrated, questions of financing and accountability are of urgent importance for global health delivery, especially when acute disasters are layered on top of "the chronic but devastating disasters that stifle the lives and hopes of millions of people - lack of access to medical care, food, clean water, decent housing, schools, and jobs". In the face of these real needs, Partners in Health (PIH) has established a 20-years tradition of working alongside local Ministry's of Health. While so much of their work is made possible through private fundraising, PIH frame their practices not as charity but as "'pragmatic solidarity - a commitment to struggle alongside the destitute sick and against the economic and political structures that cause and perpetuate poverty and ill health."

Another example of global health solidarity in action is the March 2010 agreement between Cuba, Brazil, and Haiti to build a public health care system in Haiti. The agreement builds on Cuba's long-term commitment to medical internationalism in Haiti which predates the January 12th earthquake, and is based on an $80 million funding commitment from Brazil to set up a network of primary care and epidemiological surveillance facilities staffed by Haitian, Cuban, and Latin American personnel trained at the Latin American School of Medicine in Cuba.

In the context of the global financial crisis and fiscal austerity in Europe and North America, questions of financing primary health care are all the more important. Proposals for a "windfall tax" for environmental and social justice, a global "Robin Hood tax" on international financial transactions, and better progressive taxation are suggestive of the innovative alternatives to a dependence on charity for financing health and human development.

We shouldn't shy away from questions of financing global health. Indeed, they are essential not only for ensuring access to essential medical services, but also to broader systems of social welfare capable of addressing the social determinants of health. Every disease has a biological story and a social story, and our solutions to disease need to be both medical and social. As British epidemiologist Geoffrey Rose writes in the closing words of his Strategy for Preventative Medicine: "the primary determinants of disease are mainly economic and social, and therefore its remedies must also be economic and social. Medicine and politics cannot and should not be kept apart." The challenge of global health financing is to discover how best they can be brought together.

Global Justice and the Social Determinants of Health

2010-08-07T14:01:00.006-04:00

Sridhar Venkatapuram - Ethics & International Affairs, Volume 24.2 (Summer 2010)

Sridhar Venkatapuram is an ESRC-DFID Research Fellow at University College London and an affiliated lecturer in sociology at Cambridge University. He has written on social and global justice theories, ethics of health inequalities, human rights, and health sociology, and has worked with Human Rights Watch, Open Society Institute, and the Population Council. He is currently writing a book on health justice and the capabilities approach.

Click here for the full text of his most recent article, Global Justice and the Social Determinants of Health.

Health gap in Britain "wider than in great depression"

2010-07-23T06:42:00.002-04:00

By Nick TriggleHealth reporter, BBC News

The health inequality gap in Britain is greater than it was during the post-World War I slump and the Great Depression, a study suggests. Despite the continued rise in life expectancy, it is well documented that the gap between richest and poorest has actually been widening in recent years. Researchers from Sheffield and Bristol looked at early death rates since 1921...Lead researcher Professor Danny Dorling said the findings were a "stark reminder" of the challenge facing the nation. "Health and wealth are directly linked and, unless we tackle the income gap, we could well see life expectancy actually starting to fall for the first time in the poorest areas."

Professor Sir Michael Marmot, a leading health inequalities expert who has advised both the government and World Health Organization, said: "There are two major challenges: to improve health for everybody and to reduce inequalities. In Britain, we have done well on the first - not on the second. "This should not be taken as a counsel of despair. Over the last decade, life expectancy for the bottom quarter of the population increased significantly, but their health did not catch up with the average, because of persisting social and economic inequalities."

Access the original article from the British Medical Journal here Access the full BBC article here

African Medical Corps launched by African Students of the Latin American School of Medicine

2010-07-17T16:37:00.003-04:00

The Organization of African Doctors’ (OAD) African Medical Corps presents the Yaa Asantewaa Medical Brigade that will be dispatched to Ghana, West Africa from August 15 – September 5, 2010. This medical-research brigade will collaborate with Cuban doctors working in rural Ghana to conduct a baseline health assessment where access to healthcare and infant mortality rates present outliers far below the national statistics. The assessment will focus its investigation on the access to medical facilities in rural areas, community infrastructure, malnutrition, and infectious diseases; including HIV, AIDS and malaria that contribute to almost half of all deaths reported in Ghana (World Bank 2002; World Development Indicators Database 2003). Using a series of qualitative and ethnographic methods for data collection, the brigade will obtain a practical picture of the communities’ epidemiological profile that will include documenting the role of Traditional African Medicine (TAM) in primary care delivery. The Health Brigade, composed of medical students and professionals trained in Cuba, will work under the training of Cuban doctors stationed in the region in order to accurately evaluate the health status of the community. Students will participate in a critical praxis model that includes identification of an urgent problem, conducting research, developing a solution-based plan, implementing the plan, and evaluation the plan, in hopes to use the healthcare model developed in Ghana´s in other African communities with even greater disparities.

The Organization of African Doctors is a group of medical students and doctors founded in 2009 on the campus of the Latin American School of Medicine in Havana, Cuba with the goal of developing a new breed of African doctors, with a high level of discipline, consciousness, and dedication. The mission of OAD is to develop programs, projects and institutions with the objective of producing an organized, politically-conscious and socially-responsible medical body able to meet the needs of African people suffering from health related issues throughout the African World. The African Medical Corps, is the central program of OAD linking the ideological development of African doctors with the practical training necessary to meet the health needs of African people within our communities. OAD is composed of 160 students, interns, and residents trained in Cuba currently representing over 35 countries.

The African Medical Corps represents the best sons and daughters of Africa from around the world, united in our mission to expand our capacity to sustain Africa from the grasps of the healthcare crises that is confronting the continent. OAD’s commitment to service is the fundamental basis for the work that the Yaa Asantewaa Brigade will implement this summer 2010.

A New Way of Ranking Medical Schools: Social Mission

2010-06-30T12:45:00.002-04:00

"In the June issue of the Annals of Internal Medicine, Fitzhugh Mullan, Candice Chen, Stephen Petterson, Gretchen Kolsky, and Michael Spagnola, mostly from the Department of Health Policy at the George Washington University (and one from the Robert Graham Center) report on “The social mission of medical education: ranking the schools”. This study, sponsored by the Josiah Macy, Jr. Foundation as part of the Medical Education Futures Study (MEFS) is the first report to look at this area, and should be eye-opening to those who assume that “good” medical schools are “good” at everything. Most ranking systems, most notably those of US News and World Report, are based on NIH research funding, grades and test scores of entering students, “competitiveness” (how low a percent of applicants they accept) and reputation. Obviously, the grades and test scores are related to competitiveness and reputation is a tautology, because it reinforces itself. It should depend upon what you are looking at, of course. I addressed this in “Rankings of Medical Schools: Do they tell us anything?” (September 25, 2009), and observed that what they tell us is who does well in what is measured, and that this should only be important to us if those are the outcomes we value.

Mullan and colleagues evaluate different outcomes, the degree to which medical schools meet their “social mission”, or to put it another way, the degree to which they produce the physicians that will take care of the American people. More to the point, since it can be argued that most medical school graduates take care of some American people, physicians who will take care of those people who need it the most because they don’t already have doctors. This means largely those in poor communities, rural communities, and minority communities (and especially those communities that are two or three of these). They look at 3 characteristics of graduates: 1) what percent of their graduates are practicing primary care, 2) what percent of their graduates are practicing in designated Health Professions Shortage Areas (HPSAs), and 3) what percent of their graduates are members of underrepresented minority groups? This is pretty straightforward, and they take two other steps to try and ensure that this is an accurate reflection..."

To read more, visit Dr. Josh Freeman's brilliant site Medicine and Social Justice

Video: What G20 Leaders Will Not See in Toronto

2010-06-25T15:27:00.018-04:00

Scott A. Wolfe, Health and Social Policy Advisor with One World Partners

As world media attention turns to Toronto and many important issues of global concern, perhaps what's receiving least attention is Canada's own local and national stories of human crisis. This video from the Toronto Star provides images and stories from the "Toronto" that G20 leaders and international media are unlikely to see. Below the video are some statistics and points of information that might surprise many non-Canadians and Canadians alike.

-As of 2009 Canada ranked 18th out of 30 wealthy (OECD) countries in terms of equitable income distribution

-Canada has the 2nd highest increase in income inequality among OECD countries, from the mid-1990s to mid-2000s

-Canada has the 12th highest overall poverty rate among the world's 30 wealthy (OECD) countries, and 10th highest child poverty rate

-While poverty in Canada actually declined from the mid-1980s to mid-1990s, Canada has the 2nd highest increase in poverty rates among OECD countries from the mid-1990s to mid-2000s

-Canada has the 5th lowest level of public social spending among 30 OECD countries. Only the United States, Turkey, Korea and Mexico spend less, as a percentage of national income

-Despite this very low overall social spending, Canada ranks 8th in terms of health care spending. This means that while Canada provides very low investment on social programs compared to other wealthy countries, it provides an especially low level of investment on social supports outside of health care (ie, housing, child care, employment benefits, other social programs).

-The impact of poverty, and this low social spending has a particularly serious impact on a number of sub-population groups in Canada, including Aboriginal people, other racialized groups and recent immigrants. For instance, while Canada ranks high overall on the United Nations Human Development Index, First Nations people in Canada rank 63rd according to these UN indicators.

Sources: Society at a Glance 2009 - OECD Social Indicators and Assembly of First Nations

Who will care for the underserved? The role of off-shore medical schools

2010-06-15T13:55:00.008-04:00

Josh Freeman June 2nd, 2010

I have written in several previous posts (most recently Universal Coverage and Primary Care: The US needs both, May 27, 2010) about the challenges facing American medicine, particularly regarding specialty choice (= not primary care, not rural, notunderserved) of US allopathic graduates, and the problems this has already created in providing health care to the American people, which is only likely to worsen as this trend continues. I have noted that, in the production of physicians as in any other process, the outcome results from variables in inputs (who is admitted in this case), the process itself (in education, the curriculum, both formal and informal), and output variables (in the case of physicians, what the practice environment is: reimbursement, work load, quality of life, respect and regard within the profession and community). I have argued that, while output variables may be the most important in terms of specialty choice and practice location, it is the one over which medical educators have the least control. While the curriculum, the process through which we educate medical students, is critical (see Are we training physicians to be empathic? Apparently not., Sept 12, 2009), it is likely that the characteristics of the students selected is most important in determining practice location, particularly for rural areas, but also for urban underserved settings (Medical Student Selection, Dec 14, 2008). Selecting students who grew up in the suburbs of major cities (what Robert Bowman, MD, who has done much research in this area, calls “major medical centers”) in homes with high socioeconomic status and excellent high school and college educations (which is what is mainly done) will result in students with excellent test performance and is likely to produce skilled physicians, but not ones likely to practice in rural or underserved areas.

Students from rural areas, from underserved communities, from low socioeconomic status backgrounds, and from underrepresented minority groups are much more likely to serve these populations, as are students who are older at the time of matriculation. But their lower grades and MCATs, may make them less likely to be accepted, and to have difficulty with the pre-clinical medical curriculum. Students, even from privileged backgrounds, whose prior life history includes significant service are also more likely to work in urban underserved settings; less so (although more than their colleagues without these characteristics) in rural areas. But what about schools of other types or medical schools not in the US?

Click here to read more

Health-related events at the 2010 Peoples Summit in Toronto, Canada

2010-06-15T12:19:00.004-04:00

1. Creating Health for All - From the Ground Up
June 20th, 10-noon
Ryerson University, Student Campus Centre - Room G. 55 Gould St.

Despite Canada's perceived 'universal' health care system, thousands of people residing in Canada are actively excluded from health care access on the basis of 'immigration status'. This interactive participatory workshop facilitated by the local migrant justice group Health For All explores the causes of forced migration and discusses the systemic denial of healthcare access to migrants in Canada. The workshop will highlight how local community based campaigns, such as Access Without Fear, are fighting back to create health for all from the ground up.

2. Emancipatory Healthcare: Local Resistance to Global Neoliberalism
June 20th, 1-2:50pm
Ryerson University, VIC 209- Victoria Building, 285 Victoria St.

This panel explores the ground level impact of neoliberal economics on the health of communities within this country. From moves to privatization of medicare, to cuts in the Special Diet Allowance in Ontario, to the systemic denial of healthcare access to migrants- the deep and broad undermining of public services to further profit motives is being met by significant resistance from an emerging radical left health sector within Canada. Join local organizations- Health Providers Against Poverty, Justicia For Migrant Workers, Health For All and Students For Medicare in a discussion on local community resistance against neoliberal attacks on health.

3. Globalization, the G20, and the Attack on Healthcare as a Human Right
June 19th, 10 am - 12 pm
Ryerson University, VIC 204- Victoria Building, 285 Victoria St.

This panel focuses on the impact of globalization and the policies of the G20 as they link to forces supporting privatization. We will further discuss why privatization can lead to negative consequences in our health system,
and what better solutions we can find within the public system, as well as how best to organize around these issues.
with Gareth Blair, Ontario Health Coalition Research Director, Pam Beck, activist, Ritika Goel, Students for Medicare

Red Cross declares opposition to Israeli blockade of Gaza

2010-06-14T09:53:00.004-04:00

On Monday, June 14th, 2010, the International Committee of the Red Cross (ICRC) declared their opposition to the Israeli blockade of the Gaza Strip. Noting the blockade's devastating effects on the social determinants of health, the prevalence of disease, and the availability of health care, the ICRC recognized the blockade as a form of collective punishment and a violation of the Geneva Conventions.

The ICRC statement, entitled "Gaza Closure: not another year!" reads: "Humanitarian aid cannot address the hardship faced by Gaza's 1.5 million people. The only sustainable solution is to lift the closure. The blockade imposed on Gaza is about to enter its fourth year, thwarting any real chance of economic development. As Gazans endure unemployment, poverty and warfare, the quality of their health care has reached an all-time low."

To read the ICRC's full statement on their website, click here.

Social Medicine as Human Rights Praxis

2010-06-04T20:25:00.011-04:00

As HR activists working in health, we face a double challenge. We must work for fundamental economic, social and political changes underlying what we know as the social determinant of health and, at the same time, we must work on changes in the specific field of health where additional localized resistance (often by doctors) is to be reckoned with. We thus need to set-up networks –not forgetting the health workers, organized or not– to integrate our health and our human rights (HR) aims in what will inevitably become a political challenge.

Actually, it is the HR-based framework that contains the powerful ideas; ideas that are at odds and counter neoliberal ideology, ideas that are a counter-power to the prevailing market forces –and, let’s face it, that is why the spreading of the HR idea is opposed. The powers-that-be fear HR as they entail an emancipatory praxis, a praxis that eventually is a counter-hegemonic force against globalization. The HR-based framework legitimizes power in the hands of claim holders, away from male, adult, middle and upper-class property owners. In so doing, the HR framework confers on rights holders a legitimate claim on the resources necessary to fulfill specific HR –and that is feared. HR are ultimately the legal expression of a collective will –and that is feared. Moreover, the HR-based framework prioritizes dignity and solidarity over accumulation, over competition, and over the market, as well as the inclusion of environmental rights –and that is feared. (I think I am not being harsh in my analysis here; I am just calling a spade, a spade)

To read the rest of the article, click here to visit the Social Medicine Portal

Ideas and Action for Global Maternal Health

2010-06-04T10:40:00.005-04:00

The Lancet: Special-themed issue on Maternal-Child Health

"Large numbers of the public remain unaware of the health issues facing women and children. Women and girls make up 60% of the world’s poorest and two-thirds of the world’s illiterate. Yet with education and empowerment, they can lead healthy lives and lift themselves and their families out of poverty. This week a themed issue of The Lancet covers a range of global issues on maternal, child, and newborn health."

Women Deliver: brining together voices for global maternal health

"Launched at a groundbreaking conference in 2007, Women Deliver works globally to generate political commitment and financial investment for fulfilling Millennium Development Goal #5 — to reduce maternal mortality and achieve universal access to reproductive health. The initiative builds on commitments, partnerships, and networks mobilized at the conference, fighting to end the deluge of preventable deaths that kill between 350,000 - 500,000 girls and women from pregnancy-related causes every year. Women Deliver’s message is that maternal health is both a human right and a practical necessity for sustainable development."

Israel attacks Gaza aid fleet

2010-05-31T10:28:00.000-04:00

Israel attacks Gaza aid fleet

Al Jazeera's report on board the Mavi Marmara before communications were cut

Israeli forces have attacked a flotilla of aid-carrying ships aiming to break the country's siege on Gaza.

At least 19 people were killed and dozens injured when troops intercepted the convoy of ships dubbed the Freedom Flotilla early on Monday, Israeli radio reported.

The flotilla was attacked in international waters, 65km off the Gaza coast.

Avital Leibovich, an Israeli military spokeswoman, confirmed that the attack took place in international waters, saying: "This happened in waters outside of Israeli territory, but we have the right to defend ourselves."

Footage from the flotilla's lead vessel, the Mavi Marmara, showed armed Israeli soldiers boarding the ship and helicopters flying overhead.

Al Jazeera's Jamal Elshayyal, on board the Mavi Marmara, said Israeli troops had used live ammunition during the operation.

LIVE BLOGGING


	Aftermath of Israel's attack on Gaza flotilla

The Israeli military said four soldiers had been wounded and claimed troops opened fire after "demonstrators onboard attacked the IDF Naval personnel with live fire and light weaponry including knives and clubs".

Free Gaza Movement, the organisers of the flotilla, however, said the troops opened fire as soon as they stormed the convoy.

Our correspondent said that a white surrender flag was raised from the ship and there was no live fire coming from the passengers.

Before losing communication with our correspondent, a voice in Hebrew was clearly heard saying: "Everyone shut up".

Israeli intervention

Earlier, the Israeli navy had contacted the captain of the Mavi Marmara, asking him to identify himself and say where the ship was headed.

Shortly after, two Israeli naval vessels had flanked the flotilla on either side, but at a distance.

IN DEPTH


	Focus: On board the Freedom Flotilla
	Focus: 'The future of Palestine'
	Focus: Gaza's real humanitarian crisis
	Outrage over Israel attack
	Tensions rise over Gaza aid fleet
	'Fighting to break Gaza siege'
	Aid convoy sets off for Gaza
	Programmes: Born in Gaza
	Video: Israel's Gaza PR offensive
	Video: Gazan's rare family reunion abroad
	Video: Making the most of Gaza's woes

Organisers of the flotilla carrying 10,000 tonnes of humanitarian aid then diverted their ships and slowed down to avoid a confrontation during the night.

They also issued all passengers life jackets and asked them to remain below deck.

Al Jazeera’s Ayman Mohyeldin, reporting from Jerusalem, said the Israeli action was surprising.

"All the images being shown from the activists on board those ships show clearly that they were civilians and peaceful in nature, with medical supplies on board. So it will surprise many in the international community to learn what could have possibly led to this type of confrontation," he said.

Meanwhile, Israeli police have been put on a heightened state of alert across the country to prevent any civil disturbances.

Sheikh Raed Salah,a leading member of the Islamic Movement who was on board the ship, was reported to have been seriously injured. He was being treated in Israel's Tal Hasharon hospital.

In Um Al Faham, the stronghold of the Islamic movement in Israel and the birth place of Salah, preparations for mass demonstrations were under way.

Protests

Condemnation has been quick to pour in after the Israeli action.

Mahmoud Abbas, the Palestinian president, officially declared a three-day state of mourning over Monday's deaths.

Turkey, Spain, Greece, Denmark and Sweden have all summoned the Israeli ambassador's in their respective countries to protest against the deadly assault.

Worldwide outrage has followed the deadly Israeli attack of Gaza aid convoy [AFP]

Thousands of Turkish protesters tried to storm the Israeli consulate in Istanbul soon after the news of the operation broke. The protesters shouted "Damn Israel" as police blocked them.

"(The interception on the convoy) is unacceptable ... Israel will have to endure the consequences of this behaviour," the Turkish foreign ministry said in a statement.

Ismail Haniya, the Hamas leader in Gaza, has also dubbed the Israeli action as "barbaric".

Hundreds of pro-Palestinian activists, including a Nobel laureate and several European legislators, were with the flotilla, aiming to reach Gaza in defiance of an Israeli embargo.

The convoy came from the UK, Ireland, Algeria, Kuwait, Greece and Turkey, and was comprised of about 700 people from 50 nationalities.

But Israel had said it would not allow the flotilla to reach the Gaza Strip and vowed to stop the six ships from reaching the coastal Palestinian territory.

The flotilla had set sail from a port in Cyprus on Sunday and aimed to reach Gaza by Monday morning.

Israel said the boats were embarking on "an act of provocation" against the Israeli military, rather than providing aid, and that it had issued warrants to prohibit their entrance to Gaza.

It asserted that the flotilla would be breaking international law by landing in Gaza, a claim the organisers rejected.

Source:

Al Jazeera and agencies

CUBAN-TRAINED DOCTORS IN HAITI FOR THE LONG HAUL

2010-05-25T15:50:00.001-04:00

CUBAN-TRAINED DOCTORS IN HAITI FOR THE LONG HAUL

Story and Photos by Conner Gorry

When the earthquake hit Haiti on the sunny afternoon of Jan.12, Cuban doctors serving throughout the country’s health system were among the first responders. Within 24 hours, these health professionals were joined by Cuban specialists trained in disaster response and epidemic prevention. Members of Cuba’s Henry Reeve Emergency Medical Contingent, many of these volunteers had served in post-disaster situations in Pakistan, Indonesia, China and elsewhere.

A confluence of factors – the scope and location of the earthquake, the number of victims, the tenor of the destruction, and its disproportionate impact on vulnerable populations including pregnant women and children – make the Haitian scenario more complex than those in which the Henry Reeve Contingent has previously served. Innovation, combined with a targeted scaling up, was clearly needed. Enter doctors trained at Havana’s Latin American Medical School (ELAM).

“When I saw the images, I knew I had to help. Even before they asked for volunteers, I was ready to go to Haiti,” Dr. Carlson George, an ELAM alum, told me on the eve of his departure for Port-au-Prince on Feb. 11. Today, there are more than 700 ELAM-trained doctors and students from 27 countries providing free primary care, vaccinations, rehabilitation and other specialized services alongside Cuban colleagues as members of the Henry Reeve Contingent – now numbering 1,452.

THINKING GLOBALLY, ACTING LOCALLY

Cuban-Haitian health cooperation, initiated in 1998, has been marked by its collaborative approach, involving Haitian stakeholders in program design, implementation and evaluation. The earthquake response upholds this tradition: more than half of the ELAM-trained professionals in the Contingent are Haitian. This includes residents, family doctors, and 5th-year medical students.

The presence of Haitian doctors and medical students is critical to the Contingent’s efficacy. Not only do they serve as translators – essential to any relief effort in this French and Creole speaking country – but they bring indispensable cultural competencies to health services provision. The importance of understanding the culture of health here cannot be understated: in Haiti, a country where 71 percent of the population lived in poverty before the quake, the public health system is financed by patient fees – everything from gloves to anesthesia must be paid for before treatment. Not surprisingly, this means most people have limited experience with formal health care services since they can’t afford to see a doctor (or go broke trying). Haitian members of the Contingent not only understand these realities, they’ve lived them, so they’re careful to explain to patients – in Creole – that Cuban services are free, plus basic health promotion and prevention concepts like how vaccines work and the importance of breast feeding. Sometimes, however, the health education gap looms large: many surgeons, like Costa Rican orthopedic surgeon resident Dr. Douglas Valverde, explained how difficult it is to convince patients of the necessity of amputation, with some ultimately refusing the procedure.

As the emergency phase formally draws to a close (and the rains arrive), most international medical relief teams are scaling back their Haitian efforts. Unfortunately, the health picture remains dire, taking onnew urgency with increased risk for malaria, typhoid, leptospirosis, and meningococcal meningitis projected through June. After nearly 12 years of health cooperation with Haiti – through hurricanes, flooding, social unrest, and now a catastrophic earthquake – Cuba has favored engagement over withdrawal. The strategy continues: Cuban members of the Henry Reeve Contingent were given the opportunity to transition into the Comprehensive Health Program, making its standard two-year commitment, while ELAM doctors were given the option of remaining between three months and two years. “I’ve committed to stay here a year. The Haitian people need us,” Dr. Sindy Gómez from El Salvador told me. Those committing to stay beyond the emergency phase have been posted to 20 community hospitals and 39 health clinics throughout the country.

When I asked Dr. Patrick Dely, a Haitian doctor currently serving in Port-au-Prince how he sees Haiti’s future, he took several moments to respond. “This earthquake makes me want to work harder, fight harder for change,” he told me. “People talk about the reconstruction of Haiti, but for me Haiti was never constructed. We have to talk about construction.” In hospitals and health posts throughout Haiti, Cuban-trained doctors are dedicating themselves to that construction, helping rebuild the health system one patient, family and community at a time.

Conner Gorry is senior editor of the MEDICC Review. This report is the result of Conner Gorry’s month-long assignment covering the Henry Reeve Contingent in Haiti. For more, see MEDICC Field Notes.

Cuban Medical Interationalism (an overview)

2010-05-25T15:11:00.002-04:00

By Andrew Jack

Published: May 15 2010 00:21 | Last updated: May 15 2010 00:21

Cuban medical personnel assembled and waiting to assist Louisiana after Hurricane Katrina; the US did not take up its neighbour’s offer of help

When word reached Juan Carrizo that Hurricane Katrina had struck New Orleans on August 29 2005, he reacted with military precision. From his office in a former Cuban naval base just west of Havana, while Washington um-ed and ah-ed over its own response, he began mobilising specialists to assist the thousands of Americans affected by the disaster.

Cuba itself had been scarred by Katrina, but Carrizo’s focus at the former Granma Naval Academy – a concrete campus on a balmy, palm- lined beach – was the other side of the Gulf of Mexico, as he helped to co- ordinate an unprecedented humanitarian mission to his country’s giant neighbour and arch political rival. Within three days, Carrizo, dean of the Latin American Medical School (Elam), had assembled 1,100 doctors, nurses and technicians, and 24 tonnes of medicine, all ready to fly to Louisiana. They were dubbed the Henry Reeve Contingent, in honour of a New York-born Cuban hero who fought against the Spanish in the 19th century.

Cuba: Anatomy students at Elam, the medical school set up after hurricanes Georges and Mitch devastated the Caribbean in 1998

Fidel Castro, still president of Cuba at the time, said in a speech he made later that month: “Our country was closest to the area hit by the hurricane and was in the position to send over human and material aid in a matter of hours. It was as if a big American cruise ship with thousands of passengers aboard were sinking in waters close to our coast. We could not remain indifferent.”

But the US didn’t respond to the offer of assistance. It didn’t even acknowledge it. “We prepared more than 1,500 doctors with all the necessary knowledge, equipment and supplies, who were ready to start work as soon as we entered the country,” recalls Carrizo, shaking his head. “The US government didn’t accept them, and many people died who could have been saved. That was a sad day for medicine, and for American society.”

Since 1998, when Hurricanes Georges and Mitch devastated the Caribbean and Castro resolved to train one doctor for every person killed by the storms, Carrizo had been set to work establishing Elam, the Latin American Medical School. It has since trained more than 33,000 students from 76 countries, who then return home to practise, largely among poor patients. This year, for the first time, some of its foreign graduates formally joined Cuban medical specialists on Henry Reeve Brigade missions to Haiti and Chile, following the most recent earthquakes.

Such “medical diplomacy” has been part of Cuba’s foreign policy almost since the revolution – and has grown in intensity over the past few years, fuelled above all by strong demand from Venezuela. In some of the most remote and neglected parts of the world, where western countries have “brain drained” away most of the medical expertise, Cuban personnel are winning friends while helping to fill a desperate need. In the past half century, some 130,000 have worked abroad, and today, 37,000 – half of them doctors, the rest nurses and other specialists – are spread across more than 70 countries. Now Elam is training many more from these nations too.

Haiti: A Cuban doctor treats patients at a mobile clinic in Chansolme; while abroad, Cuban medics earn up to 10 times their local salary

Havana’s approach irritates many, including doctors in other countries who feel undermined by rivals parachuted in to provide free services, and western nations whose health systems are very differently structured. At home, Cuban doctors face modest pay and limited choices, tempting them to volunteer overseas despite regrets about abandoning their own communities and concerns over intimidation while abroad. Some have even defected, although Cuba’s tough emigration controls seriously weaken the impact of the brain drain that prompts so many of their low-paid peers in other countries to pack their bags. Medical diplomacy is a potent form of “soft power” – but one with a hard edge.

Cuba answers the call for doctors

2010-05-04T08:48:00.001-04:00

Havana’s Latin American Medical School takes passionate young people from developing countries and sends them home as doctors. It’s all about driving health equity, writes Gail Reed. Now the challenge is to get medical societies to accept them.

Dr Midalys Castilla is animated as she talks about the graduates of Havana’s Latin American Medical School (ELAM) who are serving with Cuban medical teams in post-’quake Haiti. By the end of February, 557 of these ELAM graduates from 27 countries had made their way to Port-au-Prince, swelling the ranks of teams that will staff public health facilities past the emergency phase. “Doctors willing to go where they are most needed for as long as they are needed: this is the reason our school was established,” says Castilla, academic vice-rector and a founder of the institution that was created after another disaster hit the region over a decade ago.

In 1998, hundreds of Cuban doctors were dispatched to the Dominican Republic, Guatemala, Haiti, Honduras and Nicaragua after two devastating hurricanes. Their services in remote, underserved communities begged the question of what would happen when they returned home.

Eduardo Añé

Dr Midalys Castilla, one of the founders of the Latin American Medical School in Cuba.

This dilemma of sustainability prompted the decision to establish ELAM, its central campus located on Havana’s western shoreline. The first students from Central America arrived in February 1999 and graduated from the six-year curriculum in 2005. Since then, 7248 physicians from 45 countries have obtained ELAM degrees, with current enrolment being 9362 students from 100 countries mainly in the Americas, the Middle East, Africa, Asia and the Pacific Islands.

In addition to its size, ELAM has other distinguishing features that align it with a handful of similar institutions worldwide founded expressly to address inequities in access to medical care. Medical schools in countries such as Australia, the Bolivarian Republic of Venezuela, Canada, the Philippines and South Africa share “social accountability” as their premise. The World Health Organization defines social accountability of medical schools as “the obligation to direct their education, research and service of activities towards addressing the priority health concerns of the community, region and/or nation that they have a mandate to serve”.

ELAM’s aim is to educate physicians primarily for public service in disadvantaged urban and rural communities, developing competencies in comprehensive primary care, from health promotion to treatment and rehabilitation. In exchange for a non-binding pledge to practise in underserved areas, students receive a full scholarship with a small monthly stipend, graduating debt-free.

Student recruitment processes for ELAM vary from country to country, where school administrators may involve representatives from Cuban embassies, local civil society, grassroots organizations or government in the selection process. Candidates must have at least a high-school diploma, a good academic record, aptitude and pass the admissions exam. Numbers of applicants can be daunting: third-year student Javier Montero from southern Chile recalls that more than 600 people applied for 60 places the year he was admitted to ELAM.

Preference is given to low-income applicants, who otherwise could not afford medical studies. “The result is that 75% of our student body comes from the kinds of communities that need doctors, including a broad representation of ethnic minorities and indigenous peoples,” explains Castilla. For example, student Alfredo Cayul’s family is indigenous Mapuche and makes its living by subsistence farming in Chile; Jamaican Shereka Lewis’s mother is a secretary, her stepfather a carpenter; Keitumetse Joyce Let’sela’s widowed mother in Lesotho is a schoolteacher; and Vanessa Avila, from California, United States of America (USA), comes from a first-generation family of Mexican immigrants, her father being a gardener and her mother a housewife.

One of the World's Best Kept Secrets: Cuban Medical Aid to Haiti ( 3)

2010-04-28T15:30:00.002-04:00

One of the World's Best Kept Secrets: Cuban Medical Aid to Haiti ( 3)

By Emily J. Kirk and John M. Kirk. Black Agenda Report

Thursday, Apr 8, 2010

Consumers of U.S. corporate media were given the impression that the American invasion/disaster relief action was the primary foreign benefactor to Haiti’s hundreds of thousands of earthquake victims. Not so, not by a long shot. Cuba, Venezuela and the neighboring Dominican Republic were first on the scene with the most help, and have committed to building a comprehensive health care system for Haiti.

“The Cuban medical contingent was roughly three times the size of the American staff, although they treated 260.7 times more patients than U.S. medical personnel.”

Cuba and Haiti Pre-Earthquake
“Cuba agreed to train Haitian doctors in Cuba, providing that they would later return and take the places of the Cuban doctors.”
In 1998, Haiti was struck by Hurricane Georges. The hurricane caused 230 deaths, destroyed 80% of the crops, and left 167,000 people homeless.¹ Despite the fact that Cuba and Haiti had not had diplomatic relations in over 36 years, Cuba immediately offered a multifaceted agreement to assist them, of which the most important was medical cooperation.
Cuba adopted a two-pronged public health approach to help Haiti. First, it agreed to maintain hundreds of doctors in the country for as long as necessary, working wherever they were posted by the Haitian government. This was particularly significant as Haiti's health care system was easily the worst in the Americas, with life expectancy of only 54 years in 1990 and one out of every 5 adult deaths due to AIDS, while 12.1% of children died from preventable intestinal infectious diseases.²
In addition Cuba agreed to train Haitian doctors in Cuba, providing that they would later return and take the places of the Cuban doctors (a process of "brain gain" rather than "brain drain"). Significantly, the students were selected from non-traditional backgrounds, and were mainly poor. It was thought that, because of their socio-economic background, they fully understood their country's need for medical personnel, and would return to work where they were needed. The first cohort of students began studying in May, 1999 at the Latin American School of Medicine (ELAM).
By 2007, significant change had already been achieved throughout the country. It is worth noting that Cuban medical personnel were estimated to be caring for 75% of the population.³ Studies by the Pan American Health Organization (PAHO) indicated clear improvements in the health profile since this extensive Cuban medical cooperation began.
Improvements in Public Health in Haiti, 1999-2007⁴
Health Indicator 1999 2007
Infant Mortality, per 1,000 live births 80 33
Child Mortality Under 5 per 1,000 135 59.4
Maternal Mortality per 100,000 live births 529 285
Life Expectancy (years) 54 61
read more

Dr Luther Castillo reports back on ELAM students work in Haiti

2010-04-25T14:11:00.001-04:00

“I for you and you for me”

Garífuna ELAM graduates Wendy Pérez (l) and Luther Castillo (r), members of the group of students who founded “For the Health of our People¨, at the house where Cuban medical personnel live in Ciriboya. (Photo courtesy of Diane Appelbaum of MEDICC)

By Joanne Shansky

“¡Elsa! ¿Cómo estás?” exclaimed Dr. Luther Castillo with a huge smile and a very warm hug. In a rare relaxing moment during a recent whirlwind visit to Milwaukee, Wisconsin, Dr. Castillo was reunited with a family friend from his Garífuna community on the northern coast of Honduras.

Dr. Castillo, founder of the first Garífuna hospital and head of the largest international team of physicians working in Haiti, was in town to share his experiences and speak on the topic of health care as a universal right. He traveled with Dr. Juan Almendares, rector of the National University of Honduras, long-time human rights activist, and highly-respected leader of the resistance movement against the June, 2009 military coup.

In several talks, Dr. Almendares addressed the ongoing crisis caused by the coup, which overthrew democratically-elected president Manuel Zelaya. Since the coup occurred, there have been widespread reprisals against coup resistance leaders, labor union activists, farmers and others. The situation continues to be grave. Since early March, six journalists have been murdered, and a teacher who had been active in the resistance was killed in front of his students. In fact, both doctors themselves have received serious threats for speaking out against the coup, and friends in both Honduras and the US fear for their safety. Father Ismael Moreno (Padre Melo), a Jesuit priest who spoke in Milwaukee in early March, is director of Radio Progreso, one of the few independent media outlets left in Honduras. He, too, has received a recent series of new death threats.

Dr. Almendares spoke of the current struggle between campesinos and wealthy landholders in the area of Bajo Aguán in northern Honduras. There the interests of local people who want to farm in the traditional manner clash with the desire of agribusiness to control the land in order to grow African Palm, which can be used to produce biodiesel. And, according to a 2008 report from the US embassy in Tegucigalpa titled “The Future of African Palm in Honduras”, it appears that the US has taken an interest in this matter, too.

Tensions escalated in the area during the last few weeks when thousands of Honduran soldiers were sent to Bajo Aguán. A massacre was feared, but was averted with the signing of a preliminary agreement regarding land use between the government and the campesino group MUCA , the Unified Movement of Aguán Farmers.

Dr. Almendares noted that the same people who led the coup are now in power in Honduras, following an election in November that was widely boycotted because of the repressive conditions under which it was held, such as the frequent closing of independent media by the coup leaders in the months leading up to the vote. He emphasized that the resistance movement is a nonviolent movement, but is continually being met with violence and serious human rights violations. But he also said that the resistance movement is the strongest political force in the country. In his opinion, the coup represents an international phenomena and he stressed the importance of international support for the resistance.

During an event at a local church, Dr. Castillo described the history of his community. As descendants of escaped African slaves and indigenous people, the Garífuna developed a common solidarity from their suffering, as expressed in their saying “I for you and you for me”. As he stated, they definitely “did not come to Honduras for tourism.” They share a unique culture, language and a proud history of struggle against discrimination.

Dr. Castillo is a 2005 graduate of the Latin American Medical School (ELAM) in Havana, Cuba. While studying medicine, he and other students returned home to Honduras during summers, and with the help of Cuban medical personnel and international organizations such as MEDICC (Medical Education Cooperation with Cuba), they created the Luaga Hatuadi Waduheñu Foundation (“For the Health of our People” in the Garífuna language). This led to the construction of the hospital in the village of Ciriboya, clinics in 12 other remote areas, the establishment of free and preventive health care following the Cuban model, and training of local people as nurses and health promoters. As the Cuban medical school emphasizes, and as Dr. Castillo stated, “We have a responsibility to return back to help our community.”

Dr. Castillo described how after the coup last year, the military raided the Garífuna hospital, breaking down the door in an attempt to intimidate the community. But when the military arrived a second time, they were met by a large group of local people who were not about to give up the care they had been receiving. The hospital is vital to the community whose health problems include, according to Dr. Castillo, women who suffer complications during labor and have to travel 16 hours to get to the nearest hospital – 4 hours carried in a hammock, 4 hours by canoe, and 8 hours in the back of a car. Life expectancy is 50-52 years.

As critical as is the need for medical care in Honduras, the January earthquake in Haiti presented an even more urgent crisis. Dr. Castillo was instrumental in contacting his former classmates from ELAM to form an international medical team for Haiti. These doctors had learned the importance of humanitarian work and living in solidarity with “the poorest of the poor” from their training in Cuba. They responded enthusiastically. Today approximately 300 doctors from more than 20 countries, including the US, work under the direction of Dr. Castillo and others, including 400 Haitian doctors. As Dr. Castillo put it, “It is a great honor to be there, and with the Haitians, to rebuild the health system in the spirit of solidarity we learned at ELAM in Cuba.”

When Dr. Castillo was asked what was his greatest challenge in Haiti, he spoke of the difficulty of leaving his work in Honduras where “we have… an earthquake every day”. He also pointed out the importance of communicating directly with the Haitian people whose greatest need is for food, health care, education, not “US Marines with guns in the streets.”

The medical team in Haiti is young, with the oldest just 35 years old. In describing some of the conditions they are working under, Dr. Castillo said that in many cases, they have to sleep two persons to a one-person tent. Some of the male doctors don’t want to do this, and “you snore too much” is commonly heard.

But Dr. Castillo laughs and keeps it all in perspective. He says simply, “They get used to it.”

_____________________________________________

The documentary film ¡Salud! highlights the international work of Cuban-trained doctors, including Dr. Castillo. Go to: www.saludthefilm.net

For more information or how to donate to the ongoing medical projects in Honduras and Haiti, visit theMEDICC website.

Cuba Outlines Plan to build Haitian National Healthcare System

2010-04-25T10:38:00.002-04:00

Speech by Bruno Rodríguez Parilla, Cuban minister of foreign affairs, at the Haiti donors meeting

New York, 31 March, 2010

Mr. President,

The international community has a tremendous debt with Haiti where, after three centuries of colonialism, the first social revolution on the American continent took place, an act of boldness that the colonial powers punished with close to 200 years of military dictatorships and plunder. Its noble and hardworking people are now the poorest in the Western hemisphere.

We all have the moral obligation to contribute additional financial resources and greater cooperation to Haiti, not only for its reconstruction but, in particular, for its development.

In order to have an idea of the magnitude of the human tragedy in Haiti, suffice it to note that the death of 230,000 people in its small and high-density population, is equivalent to the death of more than 30 million people in a country such as China, whose population reaches a total of 1.3 billion inhabitants; an unimaginable tragedy.

In the wake of this devastating earthquake that shook the conscience of humanity, we trust that the numerous promises heard will be converted into action, that Haiti’s independence and sovereignty will be respected and ennobled, that the government of President René Préval and Prime Minister Jean Max Bellerive will be facilitated to exercise all its faculties, and that it will be able to benefit, not the whites and foreign companies, but the Haitian people, especially the poorest.

Generosity and political will is needed. Also needed is the unity of that country instead of its division into market plots and dubious charitable projects.

The program for the reconstruction and strengthening of the Haitian national healthcare system, drawn up by the Haitian government and Cuban governments, with the cooperation of the Bolivarian Republic of Venezuela and other countries and humanitarian organizations, will guarantee wide health coverage for the population, in particular the low-income sector.

Journal of Health and Human Rights

2010-02-20T15:23:00.009-05:00

Human rights are an aspirational and obligatory framework for social justice and international solidarity that articulate people's shared entitlements and responsibilities, to ensure that all people can live lives that they value. The Journal of Health and Human Rights is an extraordinary resource based at the Harvard School of Public Health and the François-Xavier Bagnoud Center for Health and Human Rights. In 2007 Dr. Paul Farmer, co-founder of Partners In Health, became the journal's Editor and helped it transition into a fully open-access and online journal - because, as the journal puts it, "excluding the poor from accessing biomedical literature [is itself] a rights violation that impedes global health". The site’s blog, OpenForum, is also full of great reading and videos. Do check it out!

The Robin Hood Tax: Turning a Crisis for the Banks into an Opportunity for the World

2010-02-18T19:26:00.005-05:00

This tax on banks – not you or I - has the power to raise hundreds of billions every year. It could give a vital boost for global health delivery, national health programs, public education, and the fight against child poverty – as well as for tackling poverty and climate change around the world.

Not complicated. Just brilliant.

Learn more and add your voice to the campaign at www.robinhoodtax.org

Harvard and Haiti: A Collaborative Response to the January 12 Earthquake

2010-02-16T22:21:00.015-05:00

Click here for Streaming video (1:15:40; requires RealPlayer).

Ophilia Dahl, Paul Farmer, and colleagues from Partners In Health (PIH) and the Department of Global Health and Social Medicine at Harvard Medical School provide an update on the situation in Haiti since the January 12 earthquake. PIH's activism, research, and health care delivery is guided by a commitment to 'pragmatic solidarity' - a commitment to struggle alongside the destitute sick and against the economic and political structures that cause and perpetuate poverty and ill health.

As the Harvard Medical School website explains, this approach positioned PIH as an essential partner for primary health care following the earthquake: "Working alongside the [Haitian] Ministry of Health to serve a catchment area of 1.2 million people, PIH has become one of the largest health care providers in the country. PIH had more than 100 doctors, 600 nurses, and a total of 4,000 employees on the ground in Haiti working from twelve existing PIH medical facilities in Haiti before the earthquake struck on January 12." For more information on Partners In Health, visit the Health and Social Justice Video Network and www.pih.org.

Building Primary Health Care in Nepal

2010-02-15T15:53:00.008-05:00

Nyaya Health ("Health Justice") is an NGO working alongside the Nepalese Ministry of Health and Population to provide public health, hospital, and mobile medical care services in Achham, a large district in Nepal. As they explain on their website, the region's health care infrastructure has been ravaged by a decade of civil conflict and steep gradients of social inequality. Rooted in a commitment to health equity, "Nyaya provides essential primary care to the region, as requested and directed by community members. We work in partnership with local government officials as part of an initiative to rebuild the public sector health system. We construct healthcare infrastructure, train local health workers, and provide direct medical services. Our organization employs an all-Nepali staff with supervision and training from volunteer public health experts. We maintain an “open source” approach involving complete transparency in our expenditures, operations protocols, and clinical outcomes, which are detailed on this website."

To learn more, visit the Nyaya Health website, or read more here.
Click here for the second part of the video.

Haiti: The Politics of Rebuilding

2010-02-15T12:19:00.003-05:00

"Just weeks after the earthquake that took more than 200,000 lives and devastated Haiti's capital city, a new normalcy is taking shape in Port-au-Prince. The shock of so much loss has barely worn off, but the mountains of rubble are slowly being cleared. And where landmarks like the national palace and the cathedral once towered a new architecture has appeared. Hundreds of tent cities have been set up, camps of internally displaced people who have lost their homes. Food distribution points dot the city, run primarily by the UN, with support from US troops.

These structures might be temporary, but at the makeshift government head quarters, in donor conferences, and in the boardrooms of international financial institutions, attention is turning to the long-term plan. As pledges of billions of dollars of international aid and investment are made, Avi Lewis travels to Port-au-Prince and to the Plateau Central and finds that debates over the vision of a new Haiti are already underway."

Fair Society, Healthy Lives: Marmot Review Publishes Final Report

2010-02-12T01:37:00.002-05:00

The Review followed the publication of the global Commission on Social Determinants of Health, also chaired by Sir Michael Marmot and published by the WHO. The CSDH advocated that national governments develop and implement strategies and policies suited to their particular national context aimed at improving health equity. The English review is a response to that recommendation and to the government's commitment to reducing health inequalities in England. It concludes that, although health inequalities are normally associated with the poor, sickness and premature death affect everyone below the wealthiest tier of English society.

Click here to view the report or an executive summary.

Access Denied: A Conversation on Unauthorized Im/migration and Health

2010-02-08T00:54:00.002-05:00

"Do unauthorized im/migrants have a right to health? To medical care? To publicly funded care? In this blog, medical anthropologists host a lively conversation among scholars, activists, policymakers and others on the complex and contentious issue of unauthorized migration and health. We approach the issue comparatively, with attention to power, cultural context, and historical depth. Through empirically grounded, critical dialogue, we aim to rethink current debates and inform policy about unauthorized migration and the right to health care."

Click here to join the conversation...

Linking the determinants of health to Sen's "capabilities approach" to development and social justice

2010-02-05T15:57:00.007-05:00

Keep your eyes peeled for new writings from Dr. Sridhar Venkatapuram and Sir Michael Marmot (Chair of the WHO's Commission on the Social Determinants of Health) linking Sen's capabilities approach to development and social justice with social epidemiological research on the distribution and determinants of health. If you are new to these ideas, the UNDP website offers an excellent introduction to human development and the capabilities approach, while the WHO website offers similarly brilliant descriptions of the evidence on the social determinants of health.

The capabilities approach is the paradigm of the United Nations system, and argues that human development is best though of in terms of the choices people have to live lives they value. Rather than focusing on economic growth (which can at best be instrumental for health but can also worsen health disparities and population health outcomes), human development focuses on the expansion of peoples capabilities - the range of things that people can do or be in life. This approach also complements Dr. Paul Farmer's writings on social medicine and structural violence, which promote an ethic of pragmatic solidarity as the basis of medicine and public health - a commitment to struggle alongside the destitute sick and against economic and political structures that constrain choice, causing and perpetuating poverty and ill health. Marmot and Venkatapuram's writings are exciting precisely because they make these connections, and strengthen arguments for health equity.

DETERMINE: An EU Consortium for Action on the Socio-Economic Determinants of Health

2010-01-29T11:07:00.004-05:00

Working Together for Health Equity

This Portal is a tool to promote health equity amongst different socio-economic groups in the European Union. Here, you can find information on policies and interventions to promote health equity within and between the countries of Europe, via the socio-economic determinants of health. The information presented is the result of the collaboration of a wide range of health and social actors in the EU, that have come together in the context of a pan-European initiative that aims to stimulate action for greater health equity. The initiative, DETERMINE (2007-2010) establishes an EU Consortium for Action on the Socio-economic Determinants of Health (SDH).

Click here to see a short film introducing the DETERMINE Project

Click here for three films (Approx 8 minutes each) following the work of three ground-breaking projects taking place across Europe that address the social determinants of health.

The first film focuses on a project that is incorporating health in a local development strategy in Glasgow, Scotland. The second film follows a project providing help to people with drug addictions in Copenhagen, Denmark. The third film looks at a public health initiative aiming to improve diets and lifestyles in the Pomurje region of Slovenia.

With Foreign Aid Still at a Trickle, Devastated Port-au-Prince General Hospital Struggles to Meet Overwhelming Need

2010-01-26T23:12:00.008-05:00

Amy Goodman of Democracy Now! reports on the situation in Haiti. She spoke extensively with Dr. Evan Lyon from Partners In Health at the general hospital campus in Port-au-Prince about the lack of supplies and the misconceptions about security in Haiti. In keeping with their commitment to serving the poor through the public sector, Partners In Health has been directing the General Hospital in Port-au-Prince since the earthquake killed many of its staff.

Click here for transcript.

Earthquake Frees Haitian Prisoners from Port-au-Prince Jail, 80% Never Charged with a Crime

All the prisoners jailed at the National Penitentiary in Port-au-Prince escaped in the earthquake. Amy Goodman speak with leading Haitian human rights attorney Mario Joseph, who says 80 percent of all prisoners in Haiti were not charged with a crime. She also speak with Dr. Evan Lyon of Partners in Health about the issue of prisons.

Click here for transcript.

Cuban Doctors Unsung Heroes Of Haitian Earthquake

2010-01-25T16:08:00.003-05:00

"Haiti's medical needs were dire before the earthquake devastated what little infrastructure was available. Among those providing free medical were nearly 400 Cuban health workers. The day after the earthquake struck the Cuban doctors reopened two hospitals. Since the Cubans live in the poorest neighborhoods amongst the most disadvantaged Haitians they were actually the first responders."

Click here to listen to the story on NPR
Click here to support Cuban-trained Haitian Doctors

Securing Disaster in Haiti

2010-01-24T23:19:00.002-05:00

Peter Hallward

"Nine days after the devastating earthquake that struck Haiti on 12 January 2010, it's now clear that the initial phase of the U.S.-led relief operation has conformed to the three fundamental tendencies that have shaped the more general course of the island's recent history. [1] It has adopted military priorities and strategies. It has sidelined Haiti's own leaders and government, and ignored the needs of the majority of its people. And it has proceeded in ways that reinforce the already harrowing gap between rich and poor. All three tendencies aren't just connected, they are mutually reinforcing. These same tendencies will continue to govern the imminent reconstruction effort as well, unless determined political action is taken to counteract them."

Click here for complete article
Click here for an interview with Peter Hallward on CBC's Dispatches (Starts part 1, minute 13)
Click here to donate to Partners in Health in Haiti
Click here to donate to Cuba's long term medical work in Haiti

Demand that France repay the 21 billion dollars it extorted from Haiti

2010-01-19T13:44:00.008-05:00

Chris Keefer

The January 12th Haitian earthquake is now being described as one of the worst and most intense earthquakes, in terms of loss of life and devastation, recorded in human history. Estimates are that Haiti, the western hemisphere's poorest country, with a population of 9 million, has lost between 100,000-500,000 lives, and that 50% of the buildings of its capital Port au Prince, where 80% of the Haitian population resides, have been destroyed in the immediate aftermath of this disaster. It must be stressed that many more deaths are likely to follow as a result of devastated infrastructure, lack of clean water and the high rates of malnutrition all of which preceded and have exacerbated this disaster making it part natural and part man-made. Many observers have tried to understand the factors which have made Haiti, which was once the crown jewel of new world colonies, providing approximately one half of Europe's sugar and coffee and unimaginable wealth to its colonial masters, so vulnerable to this calamity.

To continue reading the article please go to comments.
To sign a petition calling for restitution to Haiti of the French ransom, click here.

Donate to Support Cuban Earthquake Disaster Response

2010-01-19T00:51:00.001-05:00

Give your donation staying power....with MEDICC and Global Links

The effects of the disastrous earthquake in Haiti will be long term. That's why MEDICC and Global Links (Pittsburgh, PA) are sending material aid to the Cuban-trained Haitian doctors on the front lines in Haiti's public hospitals and clinics. Now 400-strong, they were already on the ground when disaster struck, serving in 120 communities throughout the country, including the hard-hit capital of Port-au-Prince.

Graduates of the Latin American Medical School in Cuba, these doctors come from some of Haiti's poorest regions, and will stay long after the initial disaster response is over. Like the 370 Cuban medical personnel who work with them, they are committed for the long-term to improving health and health care in Haiti.

And so are Global Links and MEDICC: together, we are organizing a recovery and long-term medical assistance program relying on decades of experience in regional material aid cooperation, and with Cuba and Haiti in particular. We will be working with representatives of the Haitian graduates of the Latin American Medical School to identify needs for medicines, medical supplies and equipment. And we will get these supplies directly to them.

While US law does not allow Cuban doctors in Haiti to receive these essential medical materials--the US embargo taking its toll post-disaster--the MEDICC and Global Links team will help ensure distribution to the young Haitian physicians working in public hospitals and clinics alongside the Cuban team, seeing hundreds of patients daily.

For health's sake....

We need your help to raise the funds for this joint effort--and to raise the policy bar by replacing hostility towards Cuba with cooperation when it comes to the health of the hemisphere--Haiti deserves nothing less. And Haiti's young doctors need your support now.

Donate on our secure donation page and please select "HAITI EARTHQUAKE APPEAL" or send your check to: MEDICC, PO Box 361449, Decatur, GA 30036, and indicate "Haiti Appeal" on your check.

Check our website or follow us on Twitter for updates. Also, learn more about Global Links our partner organization.

MEDICC (Medical Education Cooperation with Cuba), www.medicc.org, is a US non-governmental organization working to enhance cooperation among the U.S., Cuban and global health communities aimed at better health outcomes.

UN confronts "worst ever disaster"

2010-01-16T18:10:00.003-05:00

The United Nations says Haiti's earthquake is the worst disaster it has ever had to deal with. Aid is now pouring in, with a steady flow of relief getting through the nation's only airport. The World Food Programme says it expects to feed a million people. But survivors say help is not happening fast enough as dead bodies lie scattered on the capital's streets. Tarek Bazley reports.

Our role in Haiti's plight

2010-01-13T22:38:00.011-05:00

Our Role in Haiti's Plight
by Peter Hallward

Any large city in the world would have suffered extensive damage from an earthquake on the scale of the one that ravaged Haiti's capital city on Tuesday afternoon, but it's no accident that so much of Port-au-Prince now looks like a war zone. Much of the devastation wreaked by this latest and most calamitous disaster to befall Haiti is best understood as another thoroughly manmade outcome of a long and ugly historical sequence [click here for complete article].

Avi Lewis brilliantly (and concisely) contextualizes the history that leaves Haiti particularly vulnerable to "natural" disasters:

"Too Much Health Care" -- Why we can’t afford life’s creeping medicalization.

2010-01-10T14:16:00.006-05:00

Published November 1, 2009

The general health of the population today must be considered one of the greatest marvels of human civilization and ingenuity. Pregnant women no longer have to dread the 10 percent risk of death at childbirth that used to be usual; a newborn in Canada today can expect to live 80 years; death related to childhood infections is now rare; the long-term outcome of childhood leukemia has changed from 85 percent mortality to 85 percent survival; patients with cataracts, osteoarthritis and heart disease benefit from surgery that was unimaginable 40 years ago; many cancer patients can now be offered substantial relief and some even long-term survival. The focus now in well-developed countries such as Canada is on personal healthcare services, but we still must keep in proper perspective the indirect societal factors that are mainly responsible for making and keeping people healthy.

I learned a salutary lesson as a young and enthusiastic surgeon, a member of the team sent from Glasgow University in 1966 to help establish the new medical school in Nairobi. At a meeting with the Kenyan minister of health, we were complaining about the lack of drugs and equipment at the hospital when he interrupted, thanked us warmly for our service and politely explained that his major priorities as health minister were schools, safe water, houses, sewers and nutrition. We did not find this very endearing at the time, but he was displaying an excellent understanding of the determinants of human health.

continued

Something's Not Right Here: an analysis of US Healthcare "reform" with Bill Moyers - Mat Taibbi - Robert Kuttner

2009-12-27T23:05:00.005-05:00

"One year after the great collapse of our financial system, Wall Street is back on top while our politicians dither. As for health care reform, you're about to be forced to buy insurance from companies whose stock is soaring, and that's just dandy with the White House. Truth is, our capitol's being looted, republicans are acting like the town rowdies, the sheriff is firing blanks, and powerful Democrats in Congress are in cahoots with the gang that's pulling the heist. This is not capitalism at work. It's capital. Raw money, mounds of it, buying politicians and policy as if they were futures on the hog market.

Here to talk about all this are two journalists who don't pull their punches. Robert Kuttner is an economist who helped create and now co-edits the progressive magazine THE AMERICAN PROSPECT, and the author of the book OBAMA'S CHALLENGE, among others. Also with me is Matt Taibbi, who covers politics for ROLLING STONE magazine where he is a contributing editor. He's made a name for himself writing in a no-holds-barred, often profane, but always informative and stimulating style that gets under the skin of the powerful. His most recent article is "Obama's Big Sellout," about the President's team of economic advisers and their Wall Street connections. It's been burning up the blogosphere. Welcome to both of you...."

video link here

2009-12-06T23:09:00.003-05:00

Exporting healthcare to Africa

By Tom Fawthrop in Cienfuegos, Cuba

Globalising healthcare: African medical students are training in Cuba [FAWTHROP]

In universities across Cuba, the next generation of African doctors are being trained on scholarships that may prove more valuable than any foreign aid package to their continent. When they graduate, the doctors will return home to treat patients in some of Africa's poorest countries, equipped with some of the best medical training in the world. Their education and training will not have cost them anything, and many say they plan to use their skills to help those too poor to pay for treatment. "I am from a very poor family in Eastern Cape," says Sydney Mankale Moroasale, a South African medical student currently studying at Cienfuegos University in Cuba. "People all around me were suffering. I said to myself 'Why couldn't I be the one to help them?' It was my dream to be a doctor."

A further 125 South African medical students study alongside Moroasale at Cienfuegos, while another 224 are enrolled in other Cuban universities. None of them would have been able to study medicine at all had it not been for the scholarship programmes. A total of 286 African doctors have graduated from Cuba since the first batch in 2005. After the 1959 revolution, Fidel Castro, the former Cuban president, pioneered the creation of a dynamic and comprehensive public health system which has been praised by the World Health Organization for providing free healthcare to all its citizens. Even doctors working in countries ideologically opposed to communist Cuba admit that the system works. "It is internationally known that medical standards are very high in Cuba, and medical training is very good," says Dr Arachu Castro, a Spanish specialist in social medicine at the Harvard Medical School.

[Visit Al Jazeera English here for more on Cuba's community-based approach to reversing the brain drain and globalizing healthcare]

"the most powerful tool we have in our health-care armamentarium is income redistribution"

2009-11-29T22:08:00.003-05:00

Rich vs. Poor: The lives we can expect from our income
Both longevity and quality of life are now measured by statisticians, but however you parse the data, Canada's poor have worse life expectancy than the well off.

Andre Picard

Published on Wednesday, Nov. 25, 2009 7:40PM ESTLast updated on Friday, Nov. 27, 2009 2:20AM EST

.....There are a lot of numbers to digest here, but the bottom line is this: People's income (or lack thereof) has about twice the impact on their health as cancer does. That is a humbling bit of data. It also raises the question: Why is tackling poverty not a health priority?

Patching and mending is all well and good, and our sickness-care system does a good job of it. But the data tell us that the most powerful tool we have in our health-care armamentarium is income redistribution. The most powerful drug we have – money – is pretty plentiful in Canada. But it is not being prescribed to everyone who would benefit. Yesterday, the group Campaign 2000 released its 2009 Report Card on Child and Family Poverty in Canada. It showed that 637,000 children are still living in low-income families – two decades after federal politicians vowed to eradicate child poverty. One can only despair that, in a country with one of the highest life expectancies in the world, these children are being deprived of almost a decade of life from the get-go, and we seem largely indifferent.

Release secret RCMP file on Tommy Douglas

2009-11-26T19:50:00.004-05:00

The family of Canadian icon Tommy Douglas is urging the government to make public RCMP intelligence on the socialist firebrand and father of medicare, while an expert calls it ludicrous to claim any national security grounds to keep them secret...The document battle began in November 2005, when Canadian Press reporter Jim Bronskill requested the RCMP dossier on the fabled Prairie politician under access to information laws. A year later, Library and Archives Canada handed over some of the material, which showed RCMP spies had shadowed Tommy Douglas for more than three decades.

The Canadian Press (click here for full story)

Dennis Kucinich on passage of Obama's health reform

2009-11-08T19:35:00.006-05:00

“We have been led to believe that we must make our health care choices only within the current structure of a predatory, for-profit insurance system which makes money not providing health care. We cannot fault the insurance companies for being what they are. But we can fault legislation in which the government incentivizes the perpetuation, indeed the strengthening, of the for-profit health insurance industry, the very source of the problem. When health insurance companies deny care or raise premiums, co-pays and deductibles they are simply trying to make a profit. That is our system.... Notwithstanding the fate of H.R. 3962, America will someday come to recognize the broad social and economic benefits of a not-for-profit, single-payer health care system, which is good for the American people and good for America’s businesses, with of course the notable exceptions being insurance and pharmaceuticals.”

For the full text of Kucinich's speech, click here.

Community Health in India and Beyond

2009-10-30T01:54:00.010-04:00

Join us in exploring this inspiring resource from our friends/colleagues in India: "communityhealth.in is an experimental project aimed at creating a comprehensive resource on community health and the Health For All movement in India put together by people actually working in the field...

We hope not to merely reflect the existing ground reality of health in India but also be part of the process of working towards Health For All through the creation of a number useful resources for practical use in the struggle for a healthier nation and world."

Health Services for Vulnerable Populations

2009-10-17T10:23:00.010-04:00

Join Dr. Jeff Turnbull, long term anti-poverty advocate, Chief of Staff at The Ottawa Hospital, and current president-elect of the Canadian Medical Association, as he speaks about how Canada can provide fair and equitable health care to all, especially vulnerable populations. Brought to you by Students for Medicare, Medical Reform Group, Canadian Doctors for Medicare.

WHEN: Thursday, October 22nd, 7pm
WHERE: (Canada) Toronto, 155 College St, Health Sciences Bldg, Rm 610

Avi Lewis on US Healthcare Reform

2009-08-20T11:43:00.006-04:00

"It is the biggest challenge Barack Obama, the US president, has to face in his first year in office: fixing a healthcare system in crisis. Plagued by both spiraling costs and tens of millions uninsured, lawmakers have worked at a feverish pitch debating how to re-tool what accounts for nearly one fifth of the American economy. Meanwhile, this broken system is highly profitable for many. In the back rooms a battle is raging as the powerful healthcare industry pushes for change that will not change their bottom line.

On this week's episode of Fault Lines, we look at the US healthcare system, expose its cracks, and uncover the forces that are spending millions of dollars every day to influence the debate over the US healthcare reform."

http://english.aljazeera.net/programmes/faultlines/2009/08/20098663722846685.html

The Doctor Who Became Public Enemy #1

2009-07-23T13:15:00.005-04:00

Update from Post-coup Honduras by Robert Huish
Dr. Luther Castillo’s voice is heard across Cuba every night. From somewhere in Honduras, Dr. Castillo calls into the television program Mesa Redonda (The Roundtable), a nightly news and opinion program broadcast out of Havana. Using his cell phone, and the cell phones of others, he tells Cubans about the military coup in his homeland. He talks about how the situation is unfolding from the point of view of those who need medical care as a result of the military’s brutality.

“They Dump the Sick to Satisfy Investors”: Insurance Exec Turned Whistleblower Wendell Potter Speaks Out Against US Healthcare Industry

2009-07-20T19:05:00.005-04:00

Courageous interviews on Democracy Now! and Bill Moyers Journal

From Democracy Now!: "As the debate over healthcare reform intensifies on Capitol Hill, we spend the hour with a former top insurance executive who’s now exposing the industry’s dirty secrets. Wendell Potter once served as the head of corporate communications at CIGNA, one of the nation’s largest health insurance companies. We speak to Potter about his own transformation from industry mouthpiece to whistleblower, the healthcare industry’s extensive PR and lobbying machine, the campaign to discredit Michael Moore’s film Sicko, and the insurance industry’s most pressing task: the fight against a public option, let alone a single-payer system. [includes rush transcript]"

International Congress on Circumpolar Health

2009-07-09T13:21:00.002-04:00

In mid July, the capital of Canada's Northwest Territories will host the International Congress on Circumpolar Health. The Congress offers a forum for the exchange of health-related knowledge amongst scientists, health care professionals, policy analysts, government agencies, and community leaders committed to the health and wellbeing of northern peoples. Delegates from across Canada, Greenland/Denmark, Scandinavia, Russia, and Alaska will meet to exchange knowledge on: chronic disease, environmental and occupational health, ethics and Indigenous research, food security, health impacts of demographic change, infectious disease, injury prevention, mental health and wellness, newborn and child care, population health science, service delivery and infrastructure, women's health, and the social determinants of health in the north. For details on the conference visit: http://www.icch2009.com/

WHO Strongly Reaffirms the Values and Principles of Primary Health Care

2009-05-27T10:28:00.007-04:00

In two resolutions issued today, the World Health Organization is “strongly reaffirming the values and principles of primary health care, including equity, solidarity, social justice, universal access to services, multisectoral action, decentralization and community participation as the basis for strengthening health systems….”

(1) WHO Resolution on Primary Health Care and Health Systems Strengthening
(2) WHO Resolution on Reducing Health Inequities through Action for the Social Determinants of Health

From Knowledge to Action for Health Equity

2009-05-22T15:25:00.009-04:00

Dr. David Butler Jones, Chief Public Health Officer of Canada, used the opportunity of his first Report on the State of Public Health in Canada to call for action on the social determinants of health, and the patterns of health inequality that shape the distribution of sickness in Canada. While the majority of Canadians enjoy good health, many face structural barriers that make it profoundly difficult to live healthy lives. As David Butler Jones points out, these populations are "more likely to need the health-care system for what are largely preventable health issues".

In a brilliant article published last month, health policy researcher Dennis Raphael suggests that although the social determinants of health are widely acknowledged in Canada, actual public health activities to strengthen the determinants of health are "sporadic at best". Ontario's growing system of Community Health Clinics offer one example of this sort of practice, and there are other valuable examples to learn from Europe, Latin America, and elsewhere in the world. This work reaffirms the need to transform our knowledge of the production of health and sickness into public health practices that actively enable people to live healthy lives. Equally important though, is the political task this work suggests: in a setting where evidence is clear and action is slow to follow, it's clear that evidence is not a substitute but a basis for politics and public action.

Health for All: Health Care Provision and Direct Action Politics Panel

2009-05-21T17:09:00.014-04:00

[Click above for more information, or email
studentsformedicare@gmail.com]
7-9pm Friday May 22, 2009, Ryerson University, Thomas
Lounge, 63 Gould Street, Toronto, Canada.

Join Students for Medicare and No One is Illegal as we bring together health professionals, organizing alongside their communities in the fight for health for all!

Panelists include:
-Bethany Schroeder, Executive Director, Ithaca Free Clinic, Ithaca, New York
-Roland Wong, M.D., Toronto
-Samir Shaheen Hussain, M.D, Solidarity Across Borders Montreal
-Cathy Crowe, R.N., Toronto Disaster Relief Committee, Toronto

Crisis Brings Opportunity: Building a Global Health Workforce

2009-05-10T22:06:00.004-04:00

Crisis Brings Opportunity, by Robert Huish

"Amidst the current global financial crisis we face an enormous global health crisis that has left close to a billion people without any access to affordable health care. The inequality between those who can afford care and those who go without has never been worse. Consider that while Canada struggles to improve its ratio of one doctor for every 440 people, Malawi has only one physician for every 50,000 people. Despite predictions that global health inequity will worsen in a time of economic peril, we actually stand in front of a great opportunity to make the world healthier for all....A global health-care workforce offering much-needed care for billions, even if charging only pennies per patient, musters more economic potential, humanity and long-term strategic interests than any products currently on offer from Wall Street or Detroit."

Health for All? A Critical Analysis of Public Health Policies in Eight European Countries

2009-04-30T15:30:00.005-04:00

(2008) Christer Hogstedt, Henrik Moberg, Bernt Lundgren, Mona Backhans

"In recent years, a considerable number of countries have developed and implemented strategies aiming at reducing inequalities in health. However, knowledge of effective policies or strategies to reduce socioeconomic inequalities in health is still very fragmented. The aim of this book is to describe and compare different European health equity strategies and their potential successes.

The main part of the material comes from a comparative study of national public health strategies for equity in health with the following participating countries: Denmark, Finland, England, Italy, Netherlands, Norway, Spain and Sweden. National experts wrote the country chapters which not only cover questions concerning whether their countries were taking measures on the individual public health problems – such as smoking, alcohol or physical activity – but also if the policies had considered the wider, social determinants of health and experiences of the potential implementation processes."

"Everyone is affected by a pandemic, but not everyone is affected equally"

2009-04-28T15:00:00.006-04:00

Just posted on the Wellesley Institute web site at www.wellesleyinstitute.com:

"Everybody is affected by a pandemic, but not everyone is affected equally. That’s the sobering conclusion of a new research and policy paper released today by the Wellesley Institute. As the world braces for a possible swine flu pandemic, the need for proper pandemic planning and effective emergency responses is drawn into sharp focus. Ontario’s current health disaster plans recognize the need to address inequities and inequalities, but fail to deliver the funding or resources to meet the requirements of all Ontarians."

Research paper: “Bridging the Preparedness Divide ”
Policy paper: “When It Comes to Pandemics, No One Can Be Left Out ”
Media advisory: “Pandemic plans need to recognize not everyone is affected equally ”

Special thanks to Michael Shapcott, Director of Affordable Housing and Social Innovation at the Wellesley Institute for posting this information to the Social Determinants of Health Listserve.

WHO: Emergent Swine Flu "At a Turning Point"

2009-04-28T09:45:00.005-04:00

WHO spokesman Gregory Hartl says the swine flu outbreak is at a "turning point" as more countries confirm cases of swine flu. Visit the BBC for an updated map of confirmed cases around the world.

April 25th - World Malaria Day

2009-04-25T10:36:00.007-04:00

Malaria is a disease of poverty, and the struggle for health equity is a struggle against Malaria. Malaria is caused by a parasite transmitted by mosquito, but its etiology is also deeply social. Take a few minutes today to learn more about how to prevent this deadly disease: 10 Pictures ; WHO - Malaria ; Malaria Factsheet ; Q & A ; Roll Back Malaria ; The Lancet ; Global Health TV

Queen's Park Rally For Increased Hospital Funding

2009-04-24T10:34:00.004-04:00

ON WEDNESDAY, APRIL 29th--11:30AM Rally at Queen's Park to Save Our Local Hospitals!

Thousands of people from cities and towns across Ontario facing major hospital cuts or closures are joining in solidarity to demand that Premier McGuinty protect our local hospitals. Hospital cuts place an increased burden on remaining hospitals and staff. For Ontario residents, this means longer waits, worse overcrowding, traveling further, higher infection rates, paying out of pocket, and lower levels of care. Across the province, people are mobilizing for increased funding for hospitals: click on the title for more information about mobilizations in your part of the province.

Honoring a Canadian Hero: The Right Honourable Adrienne Clarkson on Norman Bethune

2009-04-24T09:44:00.010-04:00

Today's Globe and Mail features a brilliant article written by The Right Honourable Adrienne Clarkson, former Governor General of Canada, on the importance of honoring a Norman Bethune, a Canadian surgeon and humanitarian who developed the fist mobile blood transfusion unit while fighting alongside other Canadians and socialists during the Spanish Civil War.

Bethune is seen as a hero in China and Spain, but is largely unknown in Canada. As Clarkson points out, there are many Toronto connections in this story: Born in Northern Ontario, Bethune studied medicine at University of Toronto Medical School, "from which he graduated in 1916 in the same class as Frederick Banting, the co-discoverer of insulin...When he returned from Spain in June of 1937 to raise money for the Republican side in the Spanish Civil war, under the auspices of the Canadian Committee to Aid Spanish Democracy, he attracted a crowd of 5,000 in Toronto - and they marched with him from Union Station to Queen's Park...Norman Bethune is commemorated in Montreal, China and Spain. It's time for Toronto to show that he means something to us as Canadians today."

Health Indicator	1999	2007
Infant Mortality, per 1,000 live births	80	33
Child Mortality Under 5 per 1,000	135	59.4
Maternal Mortality per 100,000 live births	529	285
Life Expectancy (years)	54	61