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By: Anonymous

In 1999, when I was just six months old, my mother was diagnosed with a rare form of cervical cancer after going in for a routine Pap smear. Thankfully, she survived it, but many women across the world are not so lucky. According to the World Health Organization, cervical cancer is the fourth most frequent cancer in women (Human papillomavirus (Hpv) and cervical cancer, n.d.). There were an estimated 570,000 new cases in 2018, along with an estimated 310,000 deaths (Human papillomavirus (Hpv) and cervical cancer, n.d.), with more than 85% of those occurring in low- and middle-income countries in Africa, Asia, and Latin America and the Caribbean (Fawcett, n.d.). This infographic illustrates the incidence and mortality of this cancer worldwide. One of the most common causes of cervical cancer, the Human Papillomavirus otherwise known as HPV, is a sexually transmitted infection so common that nearly all sexually active individuals will contract it at some point in their life, if not multiple times (Human papillomavirus (Hpv) and cervical cancer, n.d.). In 2006, when I was eight years old, Gardasil, a vaccine to prevent HPV was introduced in the United States. The HPV vaccination is recommended for children to receive around the ages of 9 to 11, typically before the onset of sexual activity. The development of this vaccination was huge because it not only protected against an STI, but also would be a preventative measure against cancer – what many might think of as killing two birds with one stone. However, as of 2018, approximately 25% of the world’s 10-year-old girls live in countries that have introduced the HPV vaccination (Goodman, n.d.). Stigma around STIs and vaccinations, along with underfunded health care systems likely contribute to this[KKJ1] .

 Screening and prevention for cervical cancer through Pap smears and HPV vaccinations are readily available here in the United States and do a lot to lessen the burden of disease. In fact, with the combination of the vaccination and screenings to prevent and control cervical cancer, the US has seen a 50% decrease in diagnoses from 1975-2010 (Fawcett, n.d.). This leaves the burden of disease to weigh heavily on the shoulders of LMICs, something Dr. Weyinshet Gossa describes as a tragedy due to inadequate funding and attention (Fawcett, n.d.). I believe she is right. Why do we see such inequities in cervical cancer despite having the tools to help prevent and treat it efficiently?

The inequities in cervical cancer we see between LMIC and high-income countries are largely explained by cultural, economic, and social factors (Gossa & Fetters, 2020). In a New York Times op-ed, Mia Armstrong tells the story of Micaela Yac Jeteya of Guatemala who is battling cervical cancer and urging other women in her community to get screened (Armstrong, 2019). Many in her community feel ashamed and submitting an exam as personal as a Pap smear is difficult when one lives in a country where the health system has often failed them. The health systems in LMICs often do not have the resources to obtain regular Pap smear exams, but public health officials are experimenting with other screenings that are cheaper, simpler, and less invasive such as vinegar and HPV DNA tests. Guatemala has also introduced an HPV vaccination campaign where community health workers go door to door to vaccinate young girls who may not have received it elsewhere (Finding the lost girls, n.d.), what they refer to as finding their lost girls. This work is promising and brings hope that other countries can see similar success in reducing the burden of HPV and cervical cancer for women.

The unique ability we have to prevent and treat cervical cancer needs to be acknowledged and used to help women worldwide. I believe sometimes when we see such success in reducing the burden of a disease in the United States, we forget about the countries that are carrying it which is why inequities so often persist. With appropriate prevention and screening measures established in LMICs, the incidence of both HPV and cervical cancer would decrease as seen in the US. My mom was lucky to survive her cancer through screening and I feel lucky to be protected through the HPV vaccination. With a stronger global push for adequate funding and attention, I want other women to say the same.

References

Armstrong, M. (2019, June 10). Opinion | We have the resources to prevent cervical cancer. Do we have the will? The New York Times. https://www.nytimes.com/2019/06/10/opinion/guatemala-cervical-cancer.html

Fawcett, N. (n.d.). The global incidence of cervical cancer is a ‘tragedy.’ Retrieved February 28, 2020, from https://labblog.uofmhealth.org/rounds/global-incidence-of-cervical-cancer-a-tragedy

Finding the lost girls. (n.d.). PAHO. https://www.paho.org/hq/index.php?option=com_content&view=article&id=14663:en-busca-de-las-ninas-perdidas&Itemid=72383&lang=en

Goodman, T. (n.d.). Update on HPV vaccine introduction and programmatic perspectives. https://www.who.int/immunization/sage/meetings/2018/october/SAGE_october_2018_HPV_Goodman.pdf

Gossa, W., & Fetters, M. D. (2020). How should cervical cancer prevention be improved in lmics? AMA Journal of Ethics, 22(2), 126–134. https://doi.org/10.1001/amajethics.2020.126.

Human papillomavirus (Hpv) and cervical cancer. (n.d.). Retrieved February 26, 2020, from https://www.who.int/news-room/fact-sheets/detail/human-papillomavirus-(hpv)-and-cervical-cancer


By: Maren Strootman

COVID-19 on the Rise

COVID-19, also known as “coronavirus,” is the most recent infectious disease outbreak to make the news. Originating in Wuhan, China, COVID-19 has had its largest impact on China with more than 78,000 people infected as of February 27th. Despite travel bans and quarantines, COVID-19 has rapidly spread throughout the world, with over 3,000 cases being reported outside of China. The New York Times is tracking the spread of the outbreak here.

Despite this rapid rise in new infections, the death toll due to COVID-19 has remained relatively low, with an estimated 2% of people infected dying due to complications from the virus. However, the World Health Organization (WHO) warns of drawing any solid conclusions about the mortality of this novel virus just yet. “I think it’s very early to make any conclusive statements about what the overall mortality rate will be,” Dr. Maria van Kerkhove of the WHO said in an interview on January 29th. “2% case fatality is still a tough case fatality when you compare it to the case fatality for seasonal flu or other things […] a relatively mild virus can cause a lot of damage if a lot of people get it and this is the issue at the moment” (Ryan, Jasarevic, von Kerkhove, & Ghebreyesus).

To this date, the mortality rate of COVID-19 has yet to be formally announced, and as more and more people fall ill, the public is getting worried. Even those from relatively unaffected countries have expressed fear over this novel virus, and with anxiety and fear comes a whole host of other problems.

Racist Reactions

As fast as COVID-19 has spread, so too have the jokes, memes, and stereotypes. Just casually scroll through Twitter or Facebook and you’ll be exposed to an astonishing number of tweets and posts about “coronavirus.” Posts often insinuate that the Chinese are solely responsible for this outbreak, and racist tropes about Chinese cuisine are often cited as if they are fact. “This all could have been avoided if we all just stuck to eating normal [things] instead of heading home after a night out with a pangolin supper,” writes one twitter user. Tweets like this aren’t fact checked and are seen by broad audiences, who often don’t look to credible sources for information.

Jokes about eating exotic animals such as bats and pangolins, not properly cooking food, and generally being unsanitary have been aimed at Chinese people and this goes beyond words on the internet. A student at Boston University was shocked when a classmate called COVID-19 “the China-virus.” “I was surprised that someone would say something like that, especially in immunology class,” he told me, “I guess I was surprised that he only associated it with China.”  Additionally, according to a CNN article, Chinese restaurants in large cities around the world have been reporting an extreme decrease in business, with some reporting a 70-80% loss in business. Racist and xenophobic tirades and general harassment have become more and more common as the spread of COVID-19 has invoked fear and distrust of anyone wearing a precautionary face mask or who even appears to be of Chinese descent.

A History of Fear and Distrust

The widespread fear aimed at COVID-19 is not a new phenomenon. Historically, pandemics have been met with large amounts of fear, scapegoating, and distrust worldwide. The bubonic plague of the 1300s was blamed on merchants and travelers and cholera in the 1800s was blamed on the poor. In more recent history, the HIV/AIDS outbreak of the 1980s was blamed on gay men and the Ebola Outbreak of 2014 was blamed on African people as a whole (Allgaier & Svalastog, 2015). Distrust of minority groups and marginalized people are common, even in times of satisfactory world health, and during times of pandemics, this fear and distrust is amplified. Adeyinka Omotoyinbo, a student at the University of Minnesota, says that he distinctly remembers when the Ebola outbreak happened. “People made jokes all the time because I was Nigerian,” he said, “even though Nigeria didn’t have Ebola, they still teased and joked about me having Ebola.” Omotoyinbo’s story is not uncommon, and as COVID-19 spreads, fears that anti-Chinese sentiments will broaden to a widespread fear of Asian people of all nationalities.

Conspiracy Theories and Misinformation

Beyond the stereotypes and racism, conspiracy theories surrounding the COVID-19 outbreak have run rampant. A general lack of knowledge about how and why the disease spreads has created room for conspiracy theories to flourish. Even on national television networks, conspiracy theories and speculations about COVID-19 have been presented to viewers without any fact checking. In this video clip from Tucker Carlson Tonight, Carlson can be seen interviewing the President of the Population Research Institute (PRI), Steven Mosher. Mosher, who is a prominent pro-life social scientist, claims on live television “I think that [COVID-19] escaped from the lab […] they mishandled the virus they were experimenting on in their lab in Wuhan.”  Carlson’s show has an astonishingly large audience, and when misinformation and conspiracy theories are promoted as fact on his platform, it is unsurprising that feelings of suspicion and doubt arises in viewers.

But that is not to say that nothing is being done about this rapid spread of misinformation. Twitter has adopted a new feature that shows a warning when people use the search function to look up “coronavirus,” “COVID-19,” and “#CoronavirusOutbreak.” This feature shows a warning at the top of the twitter search results urging users to “Know the facts” and refers users to the Centers for Disease Control (CDC) for accurate information.

Although Wuhan, China, does have a virology laboratory, it is important to note that there is no evidence to support the theory that COVID-19 was created in a laboratory. Leading scientists suspect that the virus originated in an animal and mutated before infecting humans. This is the same way that almost all pandemic viruses originate, such as H1N1 influenza, SARS, and MERS.

What’s Next?

Fear and anxiety when it comes to disease outbreaks are common and understandable. However, when that fear turns into anger, racism, xenophobia, and scapegoating of one demographic group, it becomes a problem that we can’t ignore. COVID-19 is a threat globally, and although the thought of contracting any type of virus is scary, it does not excuse racism or the promotion of conspiracy theories. On the individual level, it will take all of us to stop this spread of misinformation and racist jokes online. Make sure that all posts and tweets you share are science-based, and if you see misinformation being shared, speak up and report the post. COVID-19 is a rapidly emerging threat, but the racism and conspiracy theories surrounding it can be contained.

References:

  1. Retrieved from https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6
  2. Allgaier, J., & Svalastog, A. L. (2015, October). The communication aspects of the Ebola virus disease outbreak in Western Africa–do we need to counter one, two, or many epidemics? Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4655935/
  3. Retrieved from https://www.who.int/docs/default-source/coronaviruse/transcripts/who-audio-script-ncov-rresser-unog-29jan2020.pdf?sfvrsn=a7158807_4
  4. Solomon Yue on Twitter. (n.d.). Retrieved from https://t.co/4d0Wgj8N0t?ssr=true
  5. Wallace, G. (2020, February 26). This all could have been avoided if we all just stuck to eating normal s*** instead of headin home after a night out with a pangolin supper #CoronavirusOutbreak pic.twitter.com/PbWYbnQwCX. Retrieved from https://twitter.com/grant_wallace/status/1232569464408956928
  6. Yan, H., Chen, N., & Naresh, D. (2020, February 21). What’s spreading faster than coronavirus in the US? Racist assaults and ignorant attacks against Asians. Retrieved from https://www.cnn.com/2020/02/20/us/coronavirus-racist-attacks-against-asian-americans/index.html

The Gift of Sight

By: Mackenzie Starnes

As students of public health, most of us agree that access to affordable and quality health care is a human right. But what about the facets of health care that are often overlooked, such as vision and hearing care? Certainly one’s vision and hearing play an enormous role in daily functioning, especially in one’s ability to go to school or make a living. One in seven people around the world lack access to basic vision care. In the United States, 20% of children have vision problems, but less than 15% receive an eye exam before entering kindergarten, a critical age that sets the precedent for years of academia (CDC, 2018). 

Six-year-old student Daisy struggles to see the board in class, outlined in an article from Kaiser Health News (2020). She is able to get a prescription for eyeglasses, and thanks to an organization called OneSight, is able to get them at no cost. School districts partner with OneSight and other organizations like Saving Sight and ReSpectacle to provide low-income families an opportunity to receive eye examinations and prescription eyeglasses at little to no cost to them. As an agricultural community, taking time off of work for an optometry appointment is usually not possible. With free transportation, examination, and eyeglasses, Daisy gets access to an incredible opportunity (and a fun breakfast). She might not know it yet, but her life has been drastically changed with a simple prescription, a snazzy pair of pink glasses, and a little bit of compassion.

OneSight works in forty-six countries across the globe, providing hands-on care and donations through their clinics (2017). Saving Sight works with Lions Clubs and ReSpectacle to accept thousands of pairs of gently used glasses, then cleaning them, processing them, and putting them in an online catalog that anyone can order from– completely free of charge. I have made it my personal mission to do as much as I can to help alleviate the barriers and burdens to optometric care. To date, I have collected and donated more than two thousand pairs of glasses, whose value is not measured in dollars, but in the improved quality of life that their recipients attain. 

I know first-hand what it is like to suffer from extremely poor eyesight. I was born with amblyopia– a condition in which the nerves connecting the eye to the brain don’t function properly, so the brain favors the other eye. Neurons are not transmitted correctly from the eye back to the brain, which results in severely blurred vision. If not treated in time, the affected eye will become legally blind. I am fortunate to have always had access to ophthalmologic and optometric services, without which I would not be where I am today. With OneSight and ReSpectacle, underserved individuals are able to achieve goals hindered by the lack of access to services that so many of us take for granted. 

I encourage students of public health and medicine to read articles like this one about Daisy; often in school, we are discouraged by assignments and exams. We forget that the public health interventions we study are a powerful form of preventative medicine.  When we read about how programs like this are actually being implemented and changing lives, our passion for our academia and careers is reignited. 

When we see better, we live better. If you have an extra pair of prescription glasses around the house, consider donating them to your local optometrist or ReSpectacle. You might just inspire and help a young student become a scholar of public health. 

Works Cited

“Keep an Eye on Your Vision Health.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 26 July 2018, http://www.cdc.gov/features/healthyvision

Marco, Heidi de. “Your School Assignment For The Day: Spelling And Specs.” Kaiser Health News, 27 Feb. 2020, khn.org/news/your-school-assignment-for-the-day-spelling-and-specs/.

Parsons, Ford. “About.” ReSpectacle, 2018, respectacle.org/about.

“Solutions.” OneSight, 2017, onesight.org/solutions.

By: Candace Yu

Today, HIV and AIDS continues to be an ongoing struggle for some families. According to the Joint United Nations Programme on HIV and AIDS, as of 2018, 37.9 million people around the world are living with HIV and among this, 1.7 million children younger than 15 years old live with HIV (UNAIDS, 2020). One of the main causes of children under 15 becoming infected with HIV is through mother-to-child transmission. When a mother is HIV-positive, she can transmit HIV to her child during pregnancy, labor, delivery, or by breastfeeding (World Health Organization, 2020). If mothers do not participate in any form of prevention or intervention during these periods, it is possible that 15% to 45% of children can transmit HIV, thus placing children as a population at risk (WHO, 2020). Unfortunately, whenever people talk about HIV, they tend to focus on the impact it has on adults while neglecting to recognize the ramifications that HIV has on children.

            One area that needs to be focused on is sub-Saharan Africa – nearly 9 out of 10 children and adolescents are living with HIV (UNICEF, 2019). From the 9 out of the 10, thousands of babies, infants, and toddlers die each year due to lack of access and proper treatment to combat HIV and AIDS. Current medications either come in the shape of hard pills which is hard for small children to swallow or have a bitter taste, which they will tend to avoid (McNeil, 2019). In addition, the children need to take a few different types of drugs a day which can make it even harder to convince them to take (McNeil, 2019). However, even if the children do agree to take the medications, there is the problem of accessibility. Medications are expensive and the costs add up with multiple drugs and doses per day. Depending on the medication, some drugs like the current pediatric drug for HIV require to be stored in a cool space such as a refrigerator (McNeil, 2019). This can create problems when most families in Africa are poor and live in rural areas, where a refrigerator is not available. Children are the future – if given more accessible and proper treatment, they would be able to live longer lives, would be less likely to pass on HIV to their own children when they are adults, and it would further decrease the incidence of HIV and AIDS in sub-Saharan Africa.

            Luckily, in response to inaccessibility to the proper treatment for babies living with HIV, Cipla, a generic drug manufacturer, announced their new drug, Quadrimune, last November (McNeil, 2019). Reporter Donald G. McNeil Jr. covered the news in a New York Times article, highlighting the new drug as a great improvement for babies in Africa. Quadrimune will be strawberry-flavored and the size of small grains of sugar, allowing for easier convenience by adding it to milk or food (McNeil, 2019). In one dose, it will contain all four of the HIV drugs needed for treatment and will only cost $1 a day for children weighing between 20 and 30 pounds (McNeil, 2019). Newborns will not need the full dose, as most weigh less than 20 pounds, and it will cost less than $1 a day for them (McNeil, 2019).

            McNeil’s article was informative and interesting as it presented Cipla’s proposed solution to the HIV mortality rate of babies in sub-Saharan Africa. Quadrimune has not yet been approved by the FDA, but if approved it can save thousands of newborns and babies’ lives. By merging four HIV drugs into one medication and improving the taste, less babies will refuse to take the medication and it ensures that babies will receive the proper dosage. The cheaper cost will make it more accessible for families, and health services in Africa might even be able to keep a full stock of the drugs in clinics.

            The concept that Cipla has in creating Quadrimune could be integrated into other drugs for babies. If babies dislike current pediatric HIV medications (the bitter taste of syrups or the hard to swallow pills), they probably dislike other pediatric medications. Other drug companies focusing on different treatments for diseases with high infant and child mortality rates might consider the methods that Cipla had in creating Quadrimune. This can further revolutionize the accessibility of treatments along with the prevalence of diseases around the world, specifically in less developed countries.

References

McNeil, D. G. (2019, November 29). New strawberry-flavored H.I.V. drugs for babies are offered at $1 a day. The New York Times.

UNAIDS. (2020). Global HIV & AIDS statistics – 2019 fact sheet. https://www.unaids.org/en/resources/fact-sheet

UNICEF. (2019, November). Children, HIV, and AIDS. data.unicef.org/resources/children-hiv-and-aids-global-and-regional-snapshots-2019/

World Health Organization. (2020). Mother-to-child transmission of HIV.

https://www.who.int/hiv/topics/mtct/about/en/

Brown Skin Girl

By: Anonymous

This past summer, my younger sister and mother were able to visit our family in India after almost a decade. My sister was so eager to see our grandparents, cousins, and other distant relatives. She was ecstatic to try all the different street foods, clothing, and immerse herself into her culture that she nearly had forgotten back in 2008. This year was also a special year for my maternal grandparents; they hit the fifty-year mark on their loving marriage, and a surprise party was in the making to celebrate this achievement.

            During the party planning, my sister curated a delightful speech which encompassed all the love she felt for her grandparents and family back in India. She called everyone to the living room, stood up, and began to tell her speech, when suddenly the mood turned sour.

            “She would have looked more beautiful if her skin was fair like her father’s.”

            “She got her mother’s dark skin color; she doesn’t look nice.”

            “If only she bleached her skin, she would look absolutely stunning.”

            My sister was only fourteen years old when she was told this. When I was told the news, I was furious.

            India, like many other countries around the world, has a booming cosmetics industry that focuses on the whitening or bleaching of the skin on the face and neck. For decades, women in India would spend hundreds of thousands of rupees on brands like Fair & Lovely to lighten their skin. This societal expectation is very damaging to men, women and children who are darker than their peers; by enforcing this colorist culture, people who are of darker tones are looked down upon and seen as ugly, given less job opportunities, and have a damaged self-esteem.

https://www.flipkart.com/fair-lovely-winter-fairness-cream/p/itmf3ccdjyyubnbj

            Unfortunately, my sister is not the first to hear that she needs to be lighter. According to a study conducted by Cynthia Sims and Malar Hirudayaraj, [the girls who participated in their study] were constantly told to keep their skin fair and to stay away from the sun by family members, friends, teachers, and classmates (2015). One participant even stated that her family did not encourage her to wear bright, playful colors as a child because it would not look aesthetically pleasing against her dark skin. Such words and negative behavior towards dark skin is harmful to a child’s and adolescent’s health.

            Promoting lighter skin to be superior than darker skin has fared negatively financially as well; according to a participant in Sims and Hirudayaraj’s study, a maid who works for the family spends the money she earns on fairness creams rather than food or clothing. She states, “people who don’t have food to eat will buy skin lightener, [rather than purchasing essential groceries]” (2015). Darker skinned women have stated that they feel inadequate when it comes to job searching; “several of the participants had shared experiences regarding the stifling of the career aspirations of women in India, particularly in specific career fields. These careers are jobs that either interact with customers, that is, salesperson and flight attendant, or provide a forum for exposure to customers…” (2015). This mindset is very destructive; some people who are adequately equipped with the proper skillset to perform a task in a given job position belittle themselves because of their skin tone, when this shouldn’t be the case at all.

            Though I was raised in the United States, my family did their best to try to maintain their culture in our home. On Friday nights, my family and I would finish dinner and sit on the couch to watch Bollywood and Tollywood films. Something I would notice in these movies is the lack of representation for darker skinned women. Many actresses would be fairer in tone, and I would often wonder why I was not that skin color. I think a wonderful solution would be incorporating more dark-skinned actors and actresses in films to show Indian youth that being dark is perfectly fine, and that they are beautiful.

            I want to conclude by saying that all skin tones are beautiful, and that there is no skin tone that is superior or more powerful than the other. To promote a healthy relationship with one’s skin, we should tell our children, friends, family, and peers to be kind to themselves by loving the skin they’re born with and that they’re beautiful.

References

  Sims, C., & Hirudayaraj, M. (2016). The Impact of Colorism on the Career Aspirations andCareer Opportunities of Women in India. Advances in Developing Human Resources,18(1), 38–53. https://doi.org/10.1177/1523422315616339.

Trigger warning- This blog discusses sexual violence around the world and may be disturbing or upsetting to readers.

By: Isabella Pompa

            I am a young woman attending a large college in a bustling city in the United States. While sexual harassment and violence might not be on other people’s radar, sexual assault has affected my life and many of my friends’ lives. Whether it’s being catcalled every time we go out or being harassed by a coworker in the workplace. According to the National Sexual Violence Resource Center, one in five women are sexually assaulted while attending college (White Law PLLC, 2018). However, sexual violence is not just an issue on college campuses. Sexual harassment and violence is a global issue, perpetuating a history of inequality and misogyny.

            A man might say, “Someone called you beautiful as you walked by them on the street, so what?” Catcalling is demeaning and frightening, and women live in fear that catcalling can turn into inappropriate touching. Women across the globe can relate to this issue, having to prepare for the worst as they walk by a group of men. In fact, 35% of women globally have experienced physical or sexual violence (Meera, 2017). Sexual assault is sexual contact or behavior that occurs without explicit consent of the victim (RAINN, 2020). This can include fondling or unwanted touching, forcing a victim to perform sexual acts, and rape (RAINN, 2020). Approximately eight out of ten sexual assaults are committed by someone known to the victim (RAINN, 2020). I understand that this is extremely difficult to read; I feel myself getting upset writing it. However, sexual violence is not talked about, and it needs to be in order to end this major global health problem affecting women all over the world.

            Rape has been historically used as a weapon of war as a way to exert power and instill fear in victims and their community (Dr. Denis Mukwege). It is used to destabilize communities, destroying the cohesion of families and societies. In the past two decades, rape and sexual violence has been prevalent in the Democratic Republic of the Congo, used as tools to maintain authority over civilians in territories occupied by rebel groups. In 2012, according to data collected from local health centers in Kivu, about 40 women were raped every day (Nanivazo, 2012). 13% of these victims were under 14 years of age, 3% died as a result of the rape, and 10-12% contracted HIV/AIDs (Nanivazo, 2012). In the Kivu conflict, innocent civilian women are targeted, inflicting life-long physical and psychological trauma on them, that affects their ability to take care of their families and contribute to their community (The Polynational War Memorial, 2018).  Similar to sexual assault victims all over the world, most victims do not report the crime for fear of no one believing them, or of being outcast and stigmatized. Their perpetrators roam free, escaping from the punishment they deserve, contributing to a woman’s fear that it might happen again.

            So, how does sexual violence affect women’s health? Women die from violence during rape, and if women contract HIV/AIDs and it goes untreated, women can die from HIV-related infections. Also, women may contract other sexually transmitted diseases, or have an unwanted pregnancy. Unwanted pregnancies can lead to either unsafe abortions or potentially dangerous childbirth due to poor access to health care. Psychologically, the victim will have to raise a child conceived through rape, a daily reminder of a traumatic event, and the victim may develop post-traumatic stress disorder. Sexual violence can also result in depression and anxiety in the victim, and the victim may cope with the trauma through the use of drugs and alcohol (womenshealth.gov, 2019).

            In the Democratic Republic of the Congo (DRC), donors and other international agencies fund projects providing medical assistance and psychological support to the victims, including microcredit, daycare programs for mothers who are schoolgirls and were impregnated by rape, and literacy and nutrition programs (Nanivazo, 2012). While the DRC adopted a new constitution ruling sexual violence as a crime against humanity in 2006, the judiciary is unable to uphold the rule of law due to corruption and political interference (Nanivazo, 2012). This is completely unacceptable and something more needs to be done to fight sexual violence. In the Democratic Republic of the Congo, and in every country in the world. Acts of sexual violence destroy the health of women, decreasing women’s ability to be contributing members of society, enforcing men’s power and control over women. In order to fulfill humanity’s full potential, women and men must be completely equal, which starts with the respectful treatment of women.

This video shows the amazing Congolese woman, Mama Masika, who started a village in the DRC for victims of rape with no home to go back to and no source of income.

Works Cited

“FAQ: Understanding Sexual Violence and Sexual Assault.” FAQ: Understanding Sexual Violence and Sexual Assault | Sexual Violence Prevention & Response, sexualviolence.universityofcalifornia.edu/faq/.

“Health Effects of Violence.” Womenshealth.gov, 30 Jan. 2019, http://www.womenshealth.gov/relationships-and-safety/effects-violence-against-women.

“Kivu Conflict: the Polynational War Memorial.” Kivu Conflict | the Polynational War Memorial, war-memorial.net/Kivu-Conflict-3.262.

“Rape as a Weapon of War.” Dr. Denis Mukwege Foundation, http://www.mukwegefoundation.org/the-problem/rape-as-a-weapon-of-war/.

Senthilingam, Meera. “Sexual Harassment: How It Stands around the Globe.” CNN, Cable News Network, 29 Nov. 2017, http://www.cnn.com/2017/11/25/health/sexual-harassment-violence-abuse-global-levels/index.html.

“Sexual Assault.” RAINN, http://www.rainn.org/articles/sexual-assault.

Nanivazo, Malokele. “Sexual Violence in the Democratic Republic of the Congo.” United Nations University, 24 May 2012, unu.edu/publications/articles/sexual-violence-in-the-democratic-republic-of-the-congo.ht.

White Law PLLC. “College Campus Sexual Assault Statistics.” White Law PLLC, 19 Jan. 2018, http://www.whitelawpllc.com/blog/2018/january/college-campus-sexual-assault-statistics/.

By: Frances Camacho

Now that I have your attention, let’s talk about anti-vaxxers! It is well known that there is a growing population of Americans that choose not to get themselves and their children vaccinated. This is mostly due to the fear that vaccines cause more harm than good, such as the debunked myth that vaccines cause autism… via GIPHY

There are no statistics indicating how much of the US population is anti-vaxx, but the rise in measles cases is indication enough that it is not an insignificant number. In just one year the number of cases of measles rose by almost 350%, from 375 cases in 2018 to 1,282 in 2019. A lot of attention is focused on anti-vaxx here in the US, but what about other countries? While browsing the internet, I was shocked to find this video of an Australian anti-vaxx rally.

https://www.youtube.com/watch?v=iCAm3WVH8bE&feature=youtu.be.

This video is of a young Australian man going up to random participants of the rally and asking them what makes them qualified to have such a stance against vaccines. Spoiler: nothing. The participants interviewed were not able to provide any reliable evidence that vaccines are harmful to the public. As hilarious as this video is to watch, I can’t help but be discouraged at how the anti-vaxx mindset is present in other countries too. We have already seen a resurgence of measles which was once thought to be eradicated in the US. If the sentiment continues to spread to other regions of the world, what other previously controlled diseases will rear their ugly heads?

The good news is, there may be a glimmer of hope. In 2016, the Australian government proposed a new bill that they called ‘No Jab, No Pay’. Essentially, the bill requires all recipients of family financial aid to follow standard vaccination guidelines. This includes the recipient of the aid and children under the recipient’s care. The goal of this bill is to ensure sufficient rates of vaccination are maintained in the country, particularly in children, as they are most at risk for contracting and succumbing to communicable diseases. While I applaud the Australian government for taking steps toward ensuring a healthy population, I do have some issue with the fact that this bill only applies to families who are in need of financial assistance. This bill only targets poor families who qualify for aid, which is not enough of the population to create a large enough safety net. I may be thinking too deeply about this, but I also get a sense of classism from this, as if poor people are the main cause of spreading disease. Singling out this demographic may lead to the public spreading these false and damaging ideas.

Rather than singling out poor families, I would like to see a law put into place that requires children and public service workers to be vaccinated. Children are at a high risk of contracting and suffering complications from communicable diseases, and so I think the government should do its part in protecting this vulnerable population. I also think it is reasonable to require public service workers to be vaccinated because of the nature of their work. They come into close contact with dozens of people and can be carriers for diseases they don’t even know they have. This would protect the workers and the general public that they come into contact with. I would suggest this measure be applied not only in Australia, but in all countries of the world in an effort to stop the spread of these preventable diseases.

In the future, I hope more can be done to stop the spread of misinformation about vaccines. The anti-vaxx movement started because of falsified data created by a now discredited doctor, and yet the mindset of anti-vaxx continues to spread and grow stronger. More should be done by governments to ensure the health and safety of all of their citizens. Having a small unhappy population is better than the thousands that could die if people continue to have a fear of vaccinations.

Works Cited

Commonwealth Parliament, and Parliament House. “’No Jab No Pay’ and Other Immunisation Measures.” Home – Parliament of Australia, CorporateName=Commonwealth Parliament; Address=Parliament House, Canberra, ACT, 2600; Contact= 61 2 6277 7111, 25 May 2015, http://www.aph.gov.au/about_parliament/parliamentary_departments/parliamentary_library/pubs/rp/budgetreview201516/vaccination.

“Measles Cases and Outbreaks.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 3 Feb. 2020, www.cdc.gov/measles/cases-outbreaks.html.

By: Emma Schroeder

            Today, global media outlets, medical professionals, and the average civilian are all focused on this year’s big outbreak: Coronavirus. It seems like just yesterday the unknowns of the Ebola Virus were being discussed in panicked voices with anecdotes regarding the unknown African origins. As Western patient’s health improved, attention began to fade away from the disease and individuals traveled and lived their lives as normal. Unfortunately, there are still people being diagnosed with Ebola every day. The current outbreak in the Democratic Republic of Congo has been going on since August of 2018 and is growing daily (Pro-MED, 2020). It makes one wonder, even after an outbreak clears up, are we all safe?

            The Democratic Republic of Congo (DRC) is a prime target for Ebola for many reasons. Right now, the main factors of the spread and continuation of Ebola are the lack of preventative support and the quick spread within urban regions. A major area for improvement following the 2014 outbreak has been community engagement, and organizations like ‘Doctors without Borders’ have put the time to earn the trust previously so hard to acquire in the DRC. Their efforts are beginning to see success because they shifted their practices to “recruited trusted community members and trained them in active listening and communication techniques, discussing how to address questions they would receive from the public,” (Nguyen VK, 2019). Ebola incidence has been down, but they still face challenges and according to Pro-Med digest, there are still 3,310 confirmed cases. There is still so much hope for this region in the fight against Ebola, especially considering the recent advances with the investigational vaccine (WHO 2020). Currently, it has been implemented in 4 countries, the Democratic Republic of the Congo, Burundi, Ghana, and Zambia, with 290,000 have been vaccinated in the DRC (WHO, 2020). WHO Director-General Dr Tedros Adhanom Ghebreyesus states that “the approval of the Ebola vaccine by these countries is another milestone in the fight against this unforgiving disease,” (WHO). These efforts and advances are instrumental in fighting Ebola and serve as a model to analyze for future outbreaks in following the development of the disease.

            As we deal with the current outbreak and other infectious diseases, it is important to take the responses of various influential sources into account. The way media and information is spread plays a big role in the efforts and attention that the cause will see, with a major part of this is being who the diseases are affecting. As seen with Neglected Tropical Diseases, many lower socioeconomic African countries are forgotten in the fight for health. While there are community health workers and Ebola clinics, there is minimal information on the outbreak outside of scholarly sources. The irony is that just 3 years ago when Ebola was a threat to the Western world, it was on every news station with status updates and countless public service announcements to the public. The way that various health problems get media attention (and thus funding, volunteers, and additional efforts) is often skewed to focus on what can be the best “story” will be, often skipping over wide-scale, legitimate health concerns for people in poverty.           

As we deal with the current infectious disease outbreaks and other health concerns, it is important to take into account where these diseases are coming from and how we can further support these often marginalized communities. In the United States, these diseases are often “threats” but for millions of people, they are a reality that their community members are pushing through daily. There is a responsibility to be a voice and ally as health professionals that hopefully can begin to transfer into how we share important medical updates. This Ebola outbreak is just one cause (and honestly one with more attention than countless other problems) that remains quiet in today’s media coverage. The more work that is done to fund, understand, and work with these communities, the better we can respond to health inequities globally.


*This map shows is an outbreak map from the 2018 outbreak through February of 2020, demonstrating the incidence of infection in different regions throughout the area.

Bibliography:

2018 Eastern Democratic Republic of the Congo Outbreak (ongoing). (2019, November 5).

Retrieved from https://www.cdc.gov/vhf/ebola/outbreaks/drc/2018-august.html

Ebola outbreak in the Democratic Republic of the Congo. (2020, February 24). Retrieved from

https://www.ecdc.europa.eu/en/ebola-virus-disease-outbreak-democratic-republic-congo-ongoing

Ebola outbreak in the Democratic Republic of the Congo declared a Public Health Emergency of

International Concern. (2019, July 17). Retrieved from https://www.who.int/news-room/detail/17-07-2019-ebola-outbreak-in-the-democratic-republic-of-the-congo-declared-a-public-health-emergency-of-international-concern

Ebola virus disease. (2020, February 10). Retrieved from

https://www.who.int/news-room/fact-sheets/detail/ebola-virus-disease

Four countries in the African region license vaccine in milestone for Ebola prevention. (2020,

February 14). Retrieved from https://www.who.int/news-room/detail/14-02-2020-four-countries-in-the-african-region-license-vaccine-in-milestone-for-ebola-prevention

Nguyen, V.-K. (2019). An Epidemic of Suspicion — Ebola and Violence in the DRC. New

England Journal of Medicine, 380(14), 1298–1299. doi: 10.1056/nejmp1902682

Promed Post – ProMED-mail. (2020, February 27). Retrieved from

The Next Pandemic

By: Elle McGeary

The recent outbreak of COVID-19 has put the entire globe on high alert. In a world of antibiotics and modern medicine, it’s easy for those living in high income countries to forget that infectious disease is a serious threat. But every so often, a disease like coronavirus reminds us that we do not have total control; in fact, the reality is far from it. World health experts give us a grim prediction: there will be another pandemic like coronavirus again.1 It will be an emerging disease which will probably kill thousands and spread quickly around the earth. The reason this foreboding prediction is true is because coronavirus is a zoonotic disease.

Zoonotic diseases are infections that spread between animals and humans. These diseases normally reside in animal hosts, but in events called spillover, germs make the interspecies jump to cause human illness. (TED-ed made a helpful video explaining the mechanism of how that can occur in the video linked here.2) How common are zoonotic diseases? They account for approximately 6 out of 10 of all infectious diseases.3 When you hear about zoonotic disease, you should think of the 1918 Spanish Influenza, HIV, Ebola, SARS, and most recently, coronavirus. Experts at the CDC estimated that 3 out of 4 emerging infectious diseases are zoonotic in origin. But the question is, why is this proportion so high?

It’s no surprise that humans are changing the planet in numerous and profound ways. We tear down forests, clear land for agriculture, and mine deeper into the earth. As the human population continues to skyrocket as it has done for the past 150 year, we do all these things more often. The problem is that these areas are teeming with life, most of which we’ve never seen before. According to a 2011 study,  it’s estimated that 86% of land-dwelling species have yet to be discovered.4 These animals live in the ecosystems which we encroach on. Not only does this irrevocably disrupt wildlife, but it also leads to an ever increasing contact between animals and humans.

Next, we have to think about what else is lingering in those forests, fields, and mines: microbes such as bacteria, viruses, fungi, and protists. We call these organisms “germs” which evokes the prejudice that these are tiny killing machines, but in most cases, they are quite happy in their native ecosystem. Especially if these microbes have been living with an animal species for millions of years, they often cause no symptoms in their animal hosts.

The jump between animals and humans is a rare one for a microbe. Oftentimes a pathogen will not be able to gain a foothold in an entirely foreign host species, but it does happen. When we cut down the forests and bring animals closer to our doorstep, we raise the odds that through some extraordinary event of bad luck, a microbe will successfully make that leap. Once spillover has occurred, our increasing connectedness can quickly turn a localized epidemic into a pandemic, an outbreak of disease that has spread around the globe. There are over 100,000 airplane flights per day and all it takes is one person unknowingly carrying a new bug to infect an entire new city or country.5

Ultimately, we don’t live on this planet alone, even if we act as though we do. Human disruption of natural habitats and ecosystems has already had massive consequences. 50 million dead from the 1918 Spanish Flu6, 2 million killed during the Hong Kong Flu in 19687, and 32 million killed by HIV as of 2018.8 With increased human-animal contact due to widespread ecosystem destruction and the nature of globalization, the question of the next emerging zoonotic disease is not if, but when.

References

[1] Quammen, David. Spillover. The Bodley Head Ltd., 2012.

[2] Longdon, Ben, director. How Do Viruses Jump from Animals to Humans? – Ben Longdon. YouTube, TED-Ed, 8 Aug. 2019, www.youtube.com/watch?v=xjcsrU-ZmgY.

[3] “Zoonotic Diseases.” Centers for Disease Control and Prevention, CDC, 14 July 2017, www.cdc.gov/onehealth/basics/zoonotic-diseases.html.

[4] Mora, Camilo, et al. “How Many Species Are There on Earth and in the Ocean?” PLoS Biol, vol. 9, no. 8, 23 Aug. 2011, doi:e1001127. https://doi.org/10.1371/journal.pbio.1001127.

[5] Cox, John. “The Year in Aviation: Billions of Passengers, Two High-Profile Accidents.” USA Today, 26 Dec. 2018, http://www.usatoday.com/story/travel/columnist/cox/2018/12/26/aviation-review-record-number-passengers-flights/2375060002/.

[6] “The Deadly Virus: The Influenza Epidemic of 1918.” National Archives and Records Administration, National Archives and Records Administration, www.archives.gov/exhibits/influenza-epidemic/.

[7] Rogers, Kara. “Hong Kong Flu of 1968.” Encyclopædia Britannica, Encyclopædia Britannica, Inc., 9 Jan. 2018, www.britannica.com/event/Hong-Kong-flu-of-1968.

[8] “HIV/AIDS.” World Health Organization, World Health Organization, 19 Aug. 2019, www.who.int/gho/hiv/en/.

[9] Markieta, Michael. “Global Flight-Path Maps.” BBC News, BBC, 29 May 2013, www.bbc.com/news/magazine-22690684.

By: Adiba Gaffar

It was only thirty minutes before sunset until I heard the tunes of Rabindranath Tagore begin to ring through the corridors. My grandmother’s voice and the windows were in sync; the glass was hazing up from water droplets, as her words danced from each phrase to the next. From love to loss and with each new lyric, the room began to get warmer and warmer. The sound of her voice slowly began to submerge beneath the sound of buzzing. “Itch… itch… itch until it goes away”, she began to sing.

            Each summer, I visit my grandparents’ village to spend time with my loved ones, take photographs, and work at the eye clinic. My parents were raised in Northern Bangladesh before I was born here in New York. My heart never ceased to grow more fond of the country each year I visited. From its beautiful culture to its mouth-watering food, Bangladesh’s diversity is portrayed in its many different languages, foods, and weather. However, the downfall with diversity is the variate, unpredictable weather patterns seen throughout the season of monsoon .

            Bangladesh’s unpredictable weather patterns and infrastructure issues have posed a recent epidemiological threat to the country’s health: a dengue fever outbreak. In 2019, a shocking Al Jazeera article was posted stating that 2,428 new patients were admitted into the hospital within 24 hours. Even more surprisingly, this broke the previous 24 hour admission record of 2,348 patients that had been set only a day earlier (Mahmud, 2019).

            Since 2014, there has been a sharp rise in mosquitoes due to climate change and urbanization in Dhaka. A staggering total of nearly 30,000 dengue cases have been recorded from January to August 2019 (Mahmud, 2019). According to CNN (2017), diverse and unpredictable weather within Asian countries have led to increased flooding, open rain puddles, warmer temperatures and more breeding grounds for Aedes mosquitoes. Moreover, trash sites are homes for mosquitoes due to the presence of stagnant water containers and trash. The heights of overflowing waters have been carrying trash from nearby rivers back into communities, including my own. During my visit in July 2019, I photographed areas in Shahzadpur and witnessed changes that I hadn’t noticed before.

 Raised water levels in Shahzadpur: Adiba Gaffar

 Trash deposited near torn homes: Adiba Gaffar    

            Needless to say, most of the dengue cases mentioned in the Al Jazeera (2019) article took place farther out from Shahzadpur and, of course, more within Dhaka, the country’s urbanized capital. The article states that the city’s development has been growing in an unplanned manner, leading to open and broken grounds for mosquito sites. The number of deaths had been unidentified, due to issues in record-gathering (Mahmud, 2019). Pools of stagnant waters in city trash sites, which are far worse than in rural villages, have caused overcrowded hospitals and a city’s cry for help.

            A clear-cut answer for the prevention of future outbreaks is of course, a better vaccine. Now, this may not sound like the most jaw-dropping call for a solution made by a health science major, but this can hopefully benefit all other affected countries as climate worsens. Bangladesh’s funding has not been adequately provided towards research facilities, and rather towards overcrowded public medical facilities. According to Cousins (2019), the only existing vaccine for dengue fever is Dengvaxia. Its utilization is complicated because it can cause severe health defects for those who were uninfected beforehand. The double-edged sword is apparent when all four serotypes of Dengue are at hand; the vaccine has trouble combating all four, since the pathogenesis of dengue has yet to be properly analyzed and determined. As mentioned by Al Jazeera, Bangladesh has experienced outbreaks of DEN-1 and DEN-2 strands, but DEN-3 and DEN-4 has been more prevalent since 2019 with this highest incidence of cases (Mahmud, 2019). The prevalence of infrastructure maintenance issues in Dhaka also dictates that funding must be allocated towards sanitation regulation efforts and climate change resistance programs  in order to avoid standing breeding grounds for mosquitoes.

The fact that remains is that Bangladesh is one of the many countries that are facing the adverse health consequences of infrastructure instability. Funding is not allocated towards vital issues, such as climate effects and sanitation maintenance and prevention research. Hopefully, policy makers will soon input more money into public health research rather than towards their next trip to a tropical paradise.

References

Cousins, S. (2019). Dengue Rises in Bangladesh. The Lancet Infectious Diseases, 19(2), 138.

doi: 10.1016/s1473-3099(19)30008-8

Country Studies. 2019. Retrieved from http://countrystudies.us/bangladesh/23.htm.

Mahmud, F. (2019, August 7). Why is Bangladesh grappling with a record dengue fever

outbreak? Retrieved from https://www.aljazeera.com/news/2019/08/bangladesh-grappling-record-dengue-fever-outbreak-190807091210915.html

Pokharel, S. (2019, July 30). Bangladesh hit by worst dengue outbreak on record. Retrieved from

https://www.cnn.com/2019/07/30/asia/bangladesh-dengue-outbreak-hnk-intl/index.html.