global health

Why health matters

By Alanna Shaikh | | 7 Comments |

Health is sometimes downplayed as a development priority. Governments and donors often prioritize economic growth and education, on the assumption that better health will automatically follow. The most compelling arguments that we health types make in response are as follows:

1) ill health is a drag on the economy by reducing worker productivity

2) when a family member is sick, families will bankrupt themselves in getting care for that individual

Point two is really about love. When a loved one is ill, you do your best to save them, even if you have to sell your assets, exhaust your savings, or move from the country to the city. You most certainly do not continue your education, start a microenterprise, or try to increase the productivity of your farm. This is especially true when your loved one in question is a child.

I always knew that had to be true, but I know it painfully in my heart now. My best friends just lost their baby daughter. She had Rubenstein-Taybi Syndrome, a rare genetic disorder that includes physical and developmental disabilities. Her illness meant that her family couldn’t get medical clearance, so her dad had to leave his job working abroad and they dipped into their savings to survive. He looked for a new job in the US, but it was hard to schedule around the time spent talking to doctors and looking after his baby.

No one questioned the family’s decision to focus on their daughter. If asked, I would have dipped into my own savings, unquestioning. When a family member is sick, you do what you have to do. Here in the US, the family had health insurance that covered most of their costs. In the developing world, the expense would probably have pushed an entire extended family into poverty.

You can’t improve the world around you if your baby is sick. You can only try to save your baby. Which is why the rest of us need to make a world where babies grow up strong and healthy and no one has to make terrible choices.


Sakina Nurulimon Hunsicker had a sweet smile, an infectious little giggle, and propensity for cuddling. She was almost eleven months old when she died suddenly from complications of pneumonia and dehydration caused by diarrhea. She leaves behind her parents, a devoted older brother, and a large extended family. She touched the lives of many, many people, and we miss her.

Jargon – Emergency acronyms

By Alanna Shaikh | | 0 Comments |

ECHO – ECHO is an acronym that doesn’t seem to stand for anything. It’s the European Union humanitarian aid department. ECHO actually gives grants to NGOs for humanitarian response, but everyone hates taking their money because they only provide 7% overhead. http://ec.europa.eu/echo/index_en.htm

GBV – Gender based violence, which means exactly what you think it does. Also referred to as SGBV, sex or gender based violence. A major problem in emergency situations, and may be perpetrated by the aid workers who are there to help.

HDR – Humanitarian daily ration. Produced (or purchased, anyway) by the military, each HDR will feed one person or one day. They are designed to feed large populations such as refugees or displaced people. http://www.dscp.dla.mil/subs/rations/programs/hdr/hdrabt.asp

MUAC – Mid Upper Arm Circumference. A measure which can indicate malnutrition. Very frequently used by aid agencies to determine eligibility for feeding programs. http://www.unsystem.org/SCN/archives/adults/ch06.htm

NEHK – New Emergency Health Kit. The old name for the Interagency Emergency Health Kit. Assembled by Mission pharma and sold to NGOs and other emergency responders, the NEHK has all the medicines necessary to care for 5000 people in an emergency situation. The drugs contained are all far from their expiration dates and the cartons are clearly marked, which makes them very efficient for emergency use. WHO often provides NEHKs to governments and NGOs during emergency situations. http://www.missionpharma.com/content/us/about_us/news/news_archive/nehk_under_revision_198-05

OCHA – United Nations Office for the Coordination of Humanitarian Affairs. OCHA is supposed to coordinate all donors in emergency situations. Since they don’t have any enforcement power, that rarely actually happens, even though everyone agrees that donor coordination is a good thing. OCHA’s annual budget for 2007 was $159,079,639. http://ochaonline.un.org/AboutOCHA/tabid/1076/Default.aspx

OFDA – Office of U.S. Foreign Disaster Assistance. An office within USAID that functions essentially autonomously. It is responsible for US government-funded emergency response overseas, including war, natural disasters, and other emergencies. Most emergency-response NGOs based in the United States receive all or some of their funding for their work from OFDA. OFDA is known for its ability to quickly identify an emergency and make funding available. OFDA support is especially valued because it has 100% line-item flexibility – organizations can make changes to their budgets as needed in rapidly changing emergency situations, as long as they stick to the correct total amount. OFDA focuses on immediate disaster response; therefore sustainability is not a priority and money comes from OFDA in a 6 or 12-month funding cycle. http://www.usaid.gov/our_work/humanitarian_assistance/disaster_assistance/

Depo Provera is not infected with HIV

By Alanna Shaikh | | 0 Comments |

The poor public affairs officer must be really frustrated to give interviews on a subject this ridiculous. There’s a rumor spreading in Zambia that the USAID-distributed Depo Provera (injectable contraceptive) is infected with the HIV virus. A rumor being promulgated by the Minister of Health, Brian Chituwo. There is a BBC article from 2006 that says he’s been moved into the Ministry of Education, but apparently he wasn’t.

I am not really sure what lesson to learn from this. Well, one maybe. In a well-educated society with access to information, these kinds of rumors are not able to take flight.

Premature babies at risk

By Alanna Shaikh | | 0 Comments |

Very premature babies aren’t getting the follow-up care that they need. Premature babies are very often born to women who have risk factors, including low-income and drug use. This means that medically fragile, high needs babies are going home to women who may not have the resources to care for them or even get appropriate medical care.

The best answer would be an integrated medical system, where hospital care is automatically connected to social services and outpatient care. Right now, parents have to find follow-up services themselves in most places, assisted perhaps by a booklet or a list of phone numbers.

Folic acid – not so great after all?

By Alanna Shaikh | | 0 Comments |

This is a great example of the kind of trade-offs you find in public health decision-making. Folic acid prevents birth defects, but it may be causing bowel cancer. In an ideal world, you use data to decide what to do – look at the frequency and severity of birth defects in a world with no folic acid fortification, and compare that to the extra cancers resulting from the fortification. The you choose the option that leads to less disease.

In the world we live, there probably isn’t enough data to make an informed decision, and there will be political pressure involved in the decision as well.

Friday Fear – 1 February 2008

By Alanna Shaikh | | 0 Comments |
Friday Fear:Friday fear is a new weekly feature which offers you a list of five or six things to be very, very, afraid of.

1. Internet outage in the Middle East Aside from losing access to your gmail, can you picture what would happen to the US economy if we lost internet access completely? Also – could terrorists do this on purpose?

2. Double dipping your chips really does spread bacteria. Perhaps someone at the party with you has XDR TB ?

3. You can’t trust your doctor. Or the FDA. Or the coroner.

4. Bats and bees are dying.

5. And, finally: Weaponizing the Climate.