One Health: free online course from FutureLearn features CABI authors

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One Health is about connectedness: "the collaborative efforts of multiple disciplines working locally, nationally, and globally to attain optimal health for people, animals, plants and our environment”.

On One Health Day, November 3rd 2016, CABI's editors held a One Health (#OneHealth) Blogathon to focus attention, contributing a total of 6 blogs to Handpicked… and Carefully Sorted, each written from the viewpoint of a different sector.   Our Plantwise Blog contributed One Health: Plantwise’s ambition to improve the health of people, plants and animals.

We hope you found them informative but your learning need not be confined to our blogs!

Sign up to a free online One Health course from FutureLearn: starts November 7th 2016, runs for 6 weeks. Lecturers are the CABI authors Esther Schelling,  Jakob Zinsstag and Bassirou Bonfoh of Swiss Tropical & Public Health Institute.

Esther, Jakob  and Bassirou are all authors of chapters in CABI’s  book One Health: The Theory and Practice of Integrated Health Approaches [2015].  Indeed Esther and Jakob are also co-editors.

FutureLearn  courses are easy to follow and well-paced: you get one unit per week.  I speak from experience as because of my interest in evidence-based medicine, in October 2015, I took "Informed Health Consumer: Making Sense of Evidence". 

I hope you can make use of this One Health course.

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One Health working will improve health and well-being of us all: plant, animal, human and ecosystem!

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    Pastoralists, Mongolia. Image courtesy of Esther Schelling, Swiss TPH.

 One of a series of blogs written by CABI editors for One Health Day on November 3rd 2016
 
It's always nice to meet up with a CABI author at a conference especially when they are giving a talk around a theme dear to CABI‘s heart,  namely “One Health”: the concept of working across the interface of animal, plant, human  and environment  to achieve health  & development  which is sustainable and fair. CABI has been gathering, managing and generating research information across all these sectors since 1912.  We know “its all connected”.

The conference was the RSTMH biennial meeting [Cambridge UK, Sept 12-16th, 2016], and the author in question, Esther Schelling, co-editor  of CABI’s  book One Health: The Theory and Practice of Integrated Health Approaches [2015].    To read a  free e-chapter, use this link.

In One Health beyond early detection and control of zoonoses Esther talked about her long-time project with nomadic pastoralists in Chad and a rift valley fever (RVF) control project in Kenya.  She drew attention to the need for:

  • more interdisciplinary studies to include an evaluation of One Health working
  • involvement of social scientists
  • engagement of key stakeholders

And tellingly she provided a cost-benefit analysis to society of controlling zoonoses when the disease is in its animal host before it infects human beings. 

Those cost-benefit analyses made a deep impression on the delegates, many of whom were involved in zoonotic neglected tropical diseases. Perhaps for the first time they were appreciating the added benefits and synergies that a transdisciplinary approach between science, society, humanities and medicine could bring.

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Accurate and timely communication is key to stopping transmission of Ebola

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Ebolavirus: coverpage for CABI's print journal Tropical Diseases Bulletin

Ebola brings out the worst and the best in mankind.

Global coverage of the Ebola outbreak in West Africa began with (the best) courageous foreign health care workers (HCWs) being flown home by their governments in a desperate attempt to save their lives, and rapidly moved on to the sheer panic amongst the local populations experiencing the outbreak: riots, health care workers and government officials abandoning their posts (the worst). Somewhere imbetween mention was made, usually by the foreign HCWS, of their local colleagues left behind who struggled on without resources and personal protection (the best).

Medicin Sans Frontiers highlighted the slow response of the international community.

Misinformation, public panic and stigma

Ebola haemorrhagic fever (caused by different ebola virus strains) has been around since 1976, with regular self-limiting outbreaks, usually in remote areas of one country. Index cases always involve some contact with animal reservoirs (bushmeat (wild animal meat), bats, rodents, monkeys), and its then spread by person-to-person transmission through contact with bodily secretions or with objects contaminated with secretions. It’s infamous for its high case-fatality rate and the ease with which it spreads among contacts of the diseased.

What makes this time different is the Zaire strain has now reached West Africa: there  it has spread from remote regions into highly populated urban areas, and it has crossed borders so that there are escalating outbreaks in 3 adjacent countries (Guinea, Sierra Leone and Liberia), with no end in sight. The epidemic (for that is what it is now), has resulted from sustained person-to-person transmission.

Cases have also been reported in Nigeria and Senegal but these countries seem to have contained the transmission of the virus. DR Congo  has an outbreak.   An up-to-date Ebola Healthmap can be found here.

Ignorance and fear, drivers of disease

Misinformation among health workers and the public fuelled panic and contributed to the spread of Ebola-zaire over the last 6 months.  HCWs abandoned their posts or were the source of rumours that created riots, government officials got out whilst they could. [The index case for Nigeria, was an official who left Liberia, who knowingly had had contact with an Ebola victim].

Fear has not just caused civil breakdown.  It is masking the magnitude of the outbreak, especially in Liberia and Sierra Leone. Families fear stigma so hide sick relatives or consider the hospitals as death sentences (breaking relatives out!) or indeed consider them the cause of the illness in the first place. Cases being cared for outside hospitals do not enter the statistics.   

Unlike the “Black Death” in medieval Europe, it’s not lack of real clinical knowledge that’s the problem but:

  1. Weak health systems, lacking skilled HCWs and resources
  2. Lack of knowledge amongst the general public
  3. Lack of community involvement & mistrust of government
  4. Misinformation among health workers, ministries of health and the public
  5. Lack of effective drugs and vaccines…supportive therapy only is current medical response.

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Dengue situation in a Southern Indian state (Andhra Pradesh) – Gaps and opportunities in Community Awareness

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Photo: WHO/J.Gusmao. Used tyes are an ideal habitat and breeding ground for mosquitoes carrying dengue

Our guestblogger is Dr Manoj Aravind, a researcher in Community Medicine, Hyderabad, India and member of the health information forum HIFA2015.  Under World Health Day 2014's theme "Small bite, big threat" with its goal of better protection against vector-borne diseases, he describes the case for community action against dengue in his home state of Andras Pradesh. He can be contacted directly by email: aravindbm@gmail.com

Dengue is the fastest growing vector-borne disease (VBD) worldwide, and Andhra Pradesh (a Southern Indian state) is no exception. Here, the cases of dengue reported have been steadily rising from 313 in 2008 to 2299 in 2012. The issue of missed cases due to the partial reporting of dengue positive cases by private hospitals and clinics, which are the most commonly used heathcare facilities in our state, make us sceptical of the true burden of this potentially deadly disease. Having a tropical climate, with increasing urbanization, mostly unplanned, and not much “people participation” in health issues increases our cause for concern.1

Mosquitoes are the most common insects today that city dwellers encounter and one species, Aedes aegypti,  are the vector for dengue, transmitting the disease to people via their bite: they are day-biting and breed in clean water collected inside and around houses, especially in urban areas.2 As dengue does not have vaccine or cure, the emphasis is on prevention. The World Health Organization is using this year's World Health Day to build awareness about VBDs and reinforce the need for community empowerment in terms of protecting against these small creatures which are a huge threat to the health of the entire community.3 Andhra Pradesh’s state health machinery is using this opportunity to reach out & empower different stakeholders with effective communication and information.

Awareness of people regarding dengue

When there is no biological vaccine for a disease, knowledge of how this disease spreads and how to prevent this becomes very important. It may then be apt to say that health education leading to healthy behaviours acts as a social vaccine.

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BBC launches Woman’s Hour Power List 2014: highlights FGM in time for International Woman’s Day

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ON February 26th, BBC Radio 4 programme Woman’s Hour launched the Woman’s Hour Power List 2014, which this year will identify the top 10 female ‘game changers’ operating in the United Kingdom today. Women resident in the UK  who are “changing the rules in culture, society and business” in our country.

The Power List will be drawn up by a panel of 5, from candidates suggested by expert witnesses and Radio 4 listeners. In the programme, Emma Barnett (panel chair) and Rachel Johnson (panel member) were interviewed live as to their criteria for choosing the 10 (we also heard from other panel members via taped interviews).

It became clear that though they expected to be considering high profile whistle-blowers and twitter campaigners, they were not looking for women already household names but those who within their sphere had “game-changed”.  Women who were not close to traditional sources of power i.e. with easy access to parliament, but who were influencing lives to make them better.  

Age was not to be a limitation, for teenage girls have game-changed on the world stage, such as Malala Yousafzai who has influenced education of girls in the Arab world and in Pakistan.

Last year’s Woman’s Hour Power List had 100 names, an average age over 50, and many well-known. They want this 2014 list to be younger and have unexpected names:  a list to make people sit up and think “wow I never knew about her!”

The interviewer suggested a name, which they all agreed was exactly the kind of person for the list, and this name caused my ears to perk up!  It was Fahma Mohamed, the teenage female genital mutilation (FGM) campaigner who, supported by the Guardian newspaper, recently ran a petition to lobby the government to address FGM in the UK. Here in the UK, schoolgirls are sent away for "summer cutting".

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Angry and sad at Xmas: victims of adolescent bullying

FACES_Tiny_with_creditThere have been far too many stories recently of desperate teenagers committing suicide, and an unknown number of families today will be reeling from the discovery that their teenager is seriously self-harming because of bullying. Mobile phones and social networking sites have exacerbated an age-old problem so that there is nowhere to hide. 

Poison-pen letter writers are no longer adults in detective stories. They have been brought right up-to-date, and are alive and well reincarnated in teenagers. Incapable of empathy with their victim, remote bullying via texts, phones, videoclips and the internet makes it so easy & so much more devastating, reaching  beyond a school, covering entire towns & counties,  and as its not face-to-face, even less likely for the teenage bully to empathise.

There also seems to be more serious consequences to bullying these days:  beyond loss of confidence, our society is experiencing a rise in self-harming and suicide amongst teenagers. Is it because teenagers these days are so interested in relationships & celebrity, following soaps avidly, that they are posting the minutiae of their lives online for all to see as if they were part of a soap opera?

What is the research evidence available to understand what’s going on?

I took a look and discovered to my horror that being bullied in primary schools can set you up to self-harm when you are a teenager in your next school.  Being Bullied During Childhood and the Prospective Pathways to Self-Harm in Late Adolescence ,  was co-authored at Warwick University, UK. Their press release reveals that 16.5% of 16-17 year olds had self-harmed in the previous year, and 26.9% of these did so because they felt as though they ‘wanted to die’. Those who were subjected to chronic bullying over a number of years at primary school were nearly five times more likely to self-harm six to seven years later in adolescence.[see press

Furthermore, other research shows being both the bully and the bully-victim is linked to an increased risk of suicide or mental illness. I also discovered that self-harming is a very difficult habit to break.

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Low salt diets could allow iodine-deficiency diseases to re-emerge

Salt has been used for thousands of years to flavor
& preserve food BUT reliance on fast food, biscuits and tinned goods, with
their hidden salt content, has created for us a high salt diet and with it an
alarming rise in cardiovascular disease.
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Reducing our salt intake, by working
with food industry and educating the public (World Salt Awareness Week), should
counter this disease epidemic.  BUT take this too far, and could an old
disease re-emerge? I speak of iodine deficiency in the diet, which can cause abortion,
stillbirth, goitres, mental retardation & birth defects: iodized salt
solved it.

WHO recommend universal salt
iodization for developing countries as a simple, safe and cost-effective
measure to address iodine deficiency, and many developed countries follow this
too. 

                                                                        Image: Amanda Mills, USDA. 

People afraid of salt so a disease re-emerges or is unaddressed?

If we ever needed
a reminder of the importance of iodized salt & public attitudes to health, you
only had to read “salt
rumors add to health crisis in pakistan
” (Washington Post).

A fuller discussion of these issues can be found in the March issue of Global Health Knowledge Basealong with the latest research on iodine
deficiency and salt iodisation.

 

 


 

 

 

 

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