More from AHILA14: Information literacy, ICT and the problems in rural areas

AHILA Congress2
AHILA14 delegates. Courtesy of Jean Shaw, Phi.

Report from Jean Shaw of Partnerships in Health Information, attending the 14th biennial AHILA congress.  Dar Es Salaam, Tanzania. AHILA14 Days 2-4.

The papers at the past three days at the AHILA Congress have covered a wide spectrum of subjects reflecting the Congress themes: ICTs and access to information and knowledge. Information seeking behaviours, access to and resources for health information have been extensively reported in papers covering disparate groups ranging from academic researchers and students to mothers and students, teenage pregnant girls and older people (60 onwards).

Health information in rural areas..the role of community health workers

The problems of providing health information in rural areas, where some religious and cultural values can be a barrier to western medicine were the subject of a number of studies and lengthy discussion. They were enhanced by a session organised by Dr. Neil Pakenham-Walsh of HIFA, who had invited community health workers and their Project Manager, Dr. Edoardo Occa, to describe the work of CUAMMDoctors with Africa (an Italian organization involved in the training of Community Health Workers at the grassroots level in seven African countries). 

 

AHILA Congress4_crop

Dr.Occa with Tanzania community health workers & trainers, CUAMM. The NGO works in Angola, Ethiopia, Mozambique, South Sudan, Sierra Leone, Tanzania and Uganda.

 

IT was an eye-opener to learn of the tremendous workload and the problems they met.

Neither of the two health workers who spoke had ever been to Dar es Salaam and their presentations were given in almost instant translation by Mr. G. Faresi a community health worker trainer with the project. To round it off we were shown all the books and equipment that has to be carried by visiting health workers as they cycle great distances. It is obviously very heavy.

This was followed up by an excellent and complementary description of training Community Health Extension Workers in Kenya – an initiative carefully planned and carried out by the Kenya Chapter of AHILA (Ken-AHILA).

This blog also appears on Global Health Knowledge Base

 Editors comment

  •  the 3rd day of AHILA 14 was devoted to the  2nd HIFA conference.
    The session on community health workers & CUAMM, formed part of the HIFA conference.
  • CABI's Global Health database has 1030 records on community health workers (FREETEXT search).  Even more records can be achieved using this searchstring:  "community health" and "medical auxillaries".

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

  Who_029547_usedtyres_WHO_JGusmo
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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The 2014 World Health Day focuses on Vector-Borne diseases

WHO_SHollyman_woman&net Tanzania
Image : WHO/S.Hollyman

From guest blogger: Dr Joseph Ana, Editor-in-Chief, BMJ West Africa and member of the steering group of the health information forum HIFA2015 . He can be contacted directly by email: jneana@yahoo.co.uk

It
is right that the World Health Organisation (WHO) should focus on vector borne diseases this year, and by so doing raise awareness, disseminate information and improve, hopefully prompt, more effort at preventing and managing the myriad diseases that vectors inflict on man, especially in the Tropics and Sub-tropics.

Whether it is from the arthropod invertebrates of mosquitoes (malaria, dengue, yellow fever), sandflies (skin and systemic Leishmaniasis), bugs (Louse-borne typhus), and ticks (Lyme disease); or from crabs/crayfish (paragonimiasis) and snails (schistosomiasis), or from vertebrate vectors like bats (rabies, ebola disease), vectors are responsible for a large chunk of the disease burden thathealth systems across the globe have to deal with, particularly in the poorer tropical and sub-tropical parts. There is a popular saying that the Traditional African way of cooking all meals ‘well done’ and avoiding eating raw sea food (crabs and crayfish) has helped to keep to a minimum diseases from these vectors.  Snail is also a very popular delicacy which is served ‘well cooked’ for the same reason.

The World has experienced increased incidence of arthropod borne disease since the 1970s 1,2,4, especially in the regions with the weakest health systems such as the tropics and subtropics. But for several reasons the temperate parts of the globe are also affected, which is why it is apt and timely that the WHO is focusing world attention on vector-borne diseases this year (2014). The reasons that account for the global nature of the menace of vector-borne diseases include increased travel by all modes; poor public health practice and infrastructure; massive population increases with urbanization and slums; poor surveillance and control measures; changing agricultural practices and deforestation; lack of effective drug and insecticide control leading to resistant vectors and pathogens; inadequate political will;  etc.

The World should recognize, support and assist those countries where good public health practice has shown that control (and elimination) of vectors leads to decrease in vector borne diseases and help to extend such best practices to regions that are lagging behind. A good example of such best practice in the tropics is Cross River State of Nigeria which has a deliberate Public Health Policy of making its major urban areas ‘Clean and Green’ beginning from Calabar, the state capital.

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Nodding syndrome raises its head

In a previous blog, Mystery
disease outbreak in Ethiopia solved
, I mentioned in passing Nodding Syndrome (NS), a neglected
condition that is epidemiologically associated with onchocerciasis and affects children
5-15 years old. 

The syndrome causes epileptic seizures where the afflicted
suffer from involuntary head nodding, usually triggered by food or cold. They end
up severely disabled and, without treatment, finally die.   It is
devastating communities in northern Uganda, South Sudan, Tanzania and Cameroon.

As I reported at the time: “The USA’s Centre for Disease
Control is working to identify the cause: so far, the best guess is that it’s
linked to the parasite that causes river blindness combined with an autoimmune
reaction, and exposure to chemicals could predispose.”

I now hear that an international workshop was held on this
subject in Uganda, First
International Scientific Meeting on Nodding Syndrome (NS)
, with
the key objective to set a standardized case definition for suspect
and probable cases of NS.

I also hear that the journal African Health Sciences is to
devote an entire issue to the syndrome and is currently looking for authors to
contribute papers on NS/epilepsy. (Very necessary since there are literally just
a handful of research papers on the subject so far).

You can submit papers online to the journal at:  http://mc.manuscriptcentral.com/mums-ahs
and
queries can be sent to: James K Tumwine, Editor in Chief African Health
Sciences: Email: kabaleimc@gmail.com;
kedgart@gmail.com;

I acquired this information through my membership of HIFA2015 and would encourage readers to
join this excellent forum of health workers, publishers, librarians,
information technologists, researchers, social scientists, journalists,
policy-makers…(you name it we have it).  HIFA2015
is a campaign and knowledge network with more than 5000 members
representing 2000 organisations in 167 countries worldwide, with
the aim that “By 2015, every person
worldwide will have access to an informed healthcare provider”.

You might even wish to become a HIFA2015
Country Representative
: their
role is to engage new members
and champion HIFA2015 goals in their countries. We are currently looking for  country representatives in China, Central and
Eastern Europe, Central Asia, and Eastern Mediterranean Region. YOU can
register your interest when you join via the website.

References

Uganda: Nodding Syndrome
Symptoms Controlled, Hunt for Cure Continues

Investigation into
the Nodding syndrome in Witto Payam, Western Equatoria State, 2010.
[South
Sudan] This url takes you to our Global
Health database
record

CDC Responds to Nodding
Disease in Uganda
  Youtube video