Wateraid in Tanzania: The babies who die for want of clean water

Cherrill Hicks; http://www.telegraph.co.uk/health/children_shealth/11198148/Wateraid-in-Tanzania-The-babies-who-die-for-want-of-clean-water.html#disqus_thread

The author describes  the extent of water problems in Tanzania and its effects on the health of mothers and children.

Here are some important quotes: 

Aisha ( who lost a baby)

'' Aisha is convinced her baby’s fatal illness was caused by dirty water, dug from beneath a dried-up riverbed by relatives, and transported in jerrycans to the clinic’s delivery room for the birth''

 

''The same thing had happened at the births of her other children [three girls, aged eight, 13 and 16], when relatives fetched water from a nearby river''

 Health center nurse

 “Sometimes a woman goes into labour straight from the fields; she will need to wash but there will be no water in the clinic for a shower or bath.

 ''Skin and eye diseases are easily transmitted and there are high rates of infection among both mothers and their newborns, who commonly get either sepsis – a dangerous blood infection – or diarrhoea''

 “We only used unsafe water because we didn’t have any alternative,” 

 Wateraid actors

'' In 2000 you could drill for 50 m and find water; now you have to drill for 70m making boreholes more expensive, because the water table has gone down,” says Francis Mtitu, senior programme co ordinator for WaterAid Tanzania. “Even in rivers the water levels are going down''

 ''A poor quality infrastructure is at least partly to blame''.

 ''The good news is that Mlali Health Centre now has a brand new water tank''.

''Workmen are still busy on eight new toilets to the back of the clinic; they are still basic squat types, without a flush, but built to ensure wastewater is safely separated from the environment and with five designated for women only, as well as disabled-access''

''But providing a safe supply of water is not just a question of donating and building a tank. “You have to ensure that there is an infrastructure for it to be maintained,Dr Kabole had told me back in Dar, earlier in the trip. “This isn’t just about providing water for the poor. There has to be a mutual commitment – to continue it''

Conversation and observations at the Minstry of Health  

 ''He talks of the problems of water and sanitation, of the challenges posed by climate change, with heavy rains and flooding putting the water supply at risk of contamination''

'' Afterwards,I visit the ministry toilet, the usual squat with spray attached, to be used for rinsing off excreta. Astonishingly, in the Ministry of Health, when I go to wash my hands, no water comes out of the taps. But the design of these taps is unfamiliar, to say the least – and it is just possible that I don’t know how to use them''.

Mothers and children wait at a postnatal clinic held at the Mlali Health Centre, Tanzania Photo: Eliza Deacon

 

And the band played on.....going to the roots of discovery of HIV/AIDS

Yesterday was first of December, and it  was the World AIDS day. It was  a day to reflect on  what  so far has been done in fighting the HIV/AIDS pandemic. This year's theme is "Focus, Partner, Achieve: An AIDS-free Generation." The world was talking and is continuing to talk on social media about the day using the hashtag #WAD2014. To commemorate this day, I watched a movie that describes the way the HIV virus was discovered and the whole multilayer story around reactions of the scientific community, the gay community, the politicians and the general public to this epidemic.

The movie presents the early years of AIDS crisis in the US. It describes the initial efforts of the scientists at the center for Disease control (CDC) in Atlanta to identify the cause, mode of transmission and methods of fighting the epidemic. It presents the battles of two scientists at CDC;Dr. Don Francis, the young lead investigator, and his boss, Dr. Jim Curran.  A second facet of the story centers on the gay community in San Francisco, and the balancing act gay advocates and public health officials in the city have to do to protect the gay population from what is largely seen initially as a gay disease, yet not further stigmatize and suppress an already largely stigmatized and suppressed gay population in the US. A third facet of the story centers on the work by academics to identify what many believe is a retrovirus cause of the disease.

Finally, the film deals with the rivalry between Dr. Robert Gallo, the American virologist who previously discovered the first retrovirus and his French counterpart at the Pasteur Institute, Dr. Luc Montagnier, that led to disputed claims about who was first to identify the AIDS virus. Through these three facets, personal stories of individual AIDS victims are presented, at that early stage where there mortality rate was 100%

From the roots of the virus (1981) to Getting to Zero ( 2013) to "Focus, Partner, Achieve: An AIDS-free Generation ( 2014) , we might be going to the point when HIV infection will be a history just like small pox. This needs all the actors in the fight of the pandemic to have the same understanding on what ’’AIDS-free generation'' means.

Promising steps in HIV research

Melbourne is hosting the 20th International AIDS Conference

In a recent post in AIDS 2014 blog, Edwina Wright explores the  breakthroughs in HIV research. The five most significant are:
Treatment as prevention 
- Treatment of HIV positive people prevents onward HIV transmission
Pre-exposure prophylaxis
-This involves people at risk of infection taking a daily antiretroviral tablet in conjunction with other HIV prevention measures, such as condom use and regular testing for HIV and other sexually transmitted infections.
Antiretroviral therapy
-A number of combinations of antiretroviral agents are available for people living with HIV who choose to start this treatment. Several of these regimens require only tablet daily
- A promise of injectable long-acting  antiretroviral regimen 
Co-infection of HIV and Hepatitis C
- People with co-infection are at high risk of developing liver cancer
Towards cure 
- Initiatives to prevent HIV from establishing latency and to remove latent HIV from reservoirs during chronic HIV infection, including boosting the immune system with vaccines. Participants in the 20th International AIDS Conference to be held in Melbourne July 20 to 25, will have the chance to hear  the results of the ongoing research in HIV. This year the conference is focusing on the stigma and discrimination attached to the virus and it goes with the theme ''stepping up the pace ''. 

Countdown to 3rd Global Symposium on Health Systems Research

The 3rd Global Symposium on Health Systems Research is scheduled to take place in Capetown from 30th September - 3rd October 2014. Organized by the Health Systems Global and its partners, the symposium will bring together its members with full range of players involved in health system and policy research. The participants will include researchers , policy makers , implementers , civil society and other relevant stakeholders from national and regional associations and professional organizations. There is a lot of enthusiasm already on what is going to happen in this symposium. In the recent blog post , Kristof  puts it  in perspective on  the Neymer  Hazard and Messi of health system research who are expected to contribute to the symposium. The Emerging voices for Global health will join the old dinosaurs ( as he puts it )  to make the ball rolling in health system research.
The theme for this conference is ''People- centered health systems'', that is reorienting health systems to be people-centered.
In order to overcome the current challenges in the health systems (especially in developing economies where there is considerable fragmentation of the health system building blocks), the relevance of this symposium need not be overemphasized.
The core values of people-centered health systems ; empowerment , participation , the central  role of family and community in in any process of development and ending gender and all other forms of discrimination, will be met by the health systems if the patient is considered across all levels of the system.
Will this symposium give solutions to contemporary challenges in governing health systems?- For example the low participation of civil society organizations and in particular the crackdown on civil societies that are in the front line of giving voice  to the people.The fact that there are still many patients who suffer from catastrophic expenditures ( as  a result of out of pocket payments) when they fall ill   and the limited funding to health care interventions (Most African countries for example have never reached the Abuja Declaration target of allocating 15% of the country budget to health care).
Many more challenges still:- human resource for health crisis, poor information on health services and policies  and the problem of counterfeit medicines.
Okay,amid such challenges, I am optimistic that  the symposium is going to shade light on the possible solutions.