In this post in the IntraHealth “Global Health Blog,” Kate Tulenko, senior director of health systems innovation at IntraHealth, provides an excerpt of her recently published book, “Insourced: How Importing Jobs Impacts the Healthcare Crisis Here and Abroad,” in which she argues that the practice of “relying on foreign-born health workers to fill health care gaps, particularly in providing primary care … has dire economic and social consequences, threatening the quality of medical care in both source countries and the U.S.” (8/30). The blog also links to a recent interview by IntraHealth in which Tulenko discusses the issues raised in her book (8/29).
Health Workforce & Capacity
“Abortions are just as safe when performed by trained nurse practitioners, midwives and physician assistants as when doctors do them, a new review of the evidence suggests,” Reuters reports. “Researchers analyzed five studies that compared first-trimester abortion complications and side effects based on who performed the procedures in close to 9,000 women — and typically found no differences,” the news service writes. The review is published in BJOG: An International Journal of Obstetrics and Gynaecology, according to the news service.
This Lancet editorial reflects on a medical crisis in Syria, highlighting a new report (.pdf) by Amnesty International that “documents the human rights abuses already occurring in the city.” The editorial states, “A disturbing feature of modern conflicts and, indeed, the Arab uprisings, has been the flagrant disregard for the Geneva Conventions, including targeting of civilians, persecution of health workers, and attacks on hospitals, alongside the failure of the U.N. system to prevent these violations,” and it highlights several examples cited in the report.
Communal Violence In India Forces Up To 400,000 Into Overcrowded Camps Without Sufficient Food, Water, Medicine
“Hundreds of thousands of people sheltering in squalid, overcrowded camps in India’s northeast desperately need food, water and medicines after fleeing some of the worst communal violence in a decade, officials and aid workers said on Monday,” AlertNet reports. Up to 400,000 people have fled to government-run camps in Assam state, the news service notes, adding Assam’s Health Minister Himanta Biswa Sarma said, “We are in a state of high alert. … People in the camps are suffering from diarrhea, dysentery, malaria and high fever. We are concerned about the condition of the babies and pregnant women.” According to AlertNet, “Sarma said around 8,000 children under two-years-old are sick, while hundreds of others have tested positive for malaria. There are also around 4,000 pregnant women in the camps who need medical support, he added.” The news service notes that at least 12 people have died, including four children (Bhalla, 8/6).
The following blog posts were published in recognition of World Humanitarian Day, which was observed on Sunday, August 19.
On World Humanitarian Day, recognized August 19, “United Nations Secretary-General Ban Ki-moon has highlighted the power of individual actions to spark global changes, and praised the work of humanitarian workers who provide assistance to vulnerable people around the world,” the U.N. News Centre reports (8/17). In a press release, “UNICEF called on all parties in conflicts around the world to allow humanitarian workers safe, unimpeded access to reach children and women in need” (8/19). “World Humanitarian Day gives us the opportunity to show our appreciation to the thousands of workers … who are working every day in difficult circumstances,” the WHO writes in an article on its webpage, noting, “Health is one of several critical dimensions of humanitarian response, and the sustainable recovery of people under hardship” (August 2012).
In a post in the Guardian’s “Comment is Free” blog, Kristalina Georgieva, the European Commissioner for International Cooperation, Humanitarian Aid and Crisis Response, writes that World Humanitarian Day, observed August 19, “is a day to pay tribute to all humanitarian personnel who have lost their lives in the line of duty and to all those who continue to take risks to relieve the suffering of the less fortunate.” She continues, “Humanitarian work is one of the world’s most dangerous professions. Kidnappings, shootings and death threats are all part of the job description in places such as Sudan, Syria, Somalia and others blighted by conflict,” adding, “Those who work in this rocky terrain are increasingly exposed to risk while maintaining a lifeline to the victims of wars and disasters.”
The number of confirmed or suspected cases of Ebola in Uganda has risen to 36, according to a WHO spokesperson, who added the disease remains confined to the rural Kibaale district, NPR’s health blog “Shots” reports. “A team, led by the CDC, WHO and Uganda’s Ministry of Health, are now on the scene to determine the scope of the outbreak and then control it,” according to the blog (Doucleff, 7/31). CNN’s “The Chart” blog reports that 14 people have died of the disease, which has a 25 to 90 percent fatality rate in African outbreaks, according to a WHO fact sheet (7/31).
Inter Press Service reports on the successful efforts of Tanzania’s Kigoma Region “to train assistant medical officers to conduct life-saving c-sections at its rural health centers,” allowing pregnant women with complications to deliver at more local facilities instead of having to travel to regional or district hospitals. Tanzania’s maternal mortality rate is high, at 578 deaths for every 100,000 live births, IPS notes. “[A]t one point the Kigoma Region had the highest rate in the country, at 933 per 100,000 live births in the early 1980s,” but “maternal mortality in this region [now] is considered to be lower than in the rest of the country,” according to the news service.
“The U.K. government has activated a Â£2 million [$3.16 million] emergency plan to help tackle a cholera epidemic sweeping through Sierra Leone,” the Press Association reports, adding, “The Department for International Development (DfID) says it is using a network that includes private businesses and specialist aid organizations to deliver emergency medical, water and sanitation assistance to affected people in the west African state” (8/25). “It is the first time [DfID] has activated its Rapid Response Facility,” the Guardian notes, adding, “The network was established in March and allows the U.K. government ‘to commit to rapid humanitarian funding’ within 72 hours in response to disasters and rapidly escalating humanitarian emergencies,” (Adetunji, 8/25).