This is a blog run by mediPhone interns on healthcare in Japan and around the world.

Wednesday, July 8, 2015

Poliomyelitis


Poliomyelitis, know as polio, describes a highly infectiouse disease caused by a virus. While anyone can become infected by polio, this virus primarily targets young children under 5

Although polio cases have been decreased dramaticlay since 1988 (over 99 percent), it still exists today. In 1988, 350,000 cases were reported, but by the year of 2013, the number decreased to 416 infected people. While this sounds like a great achievement, Polio will continue to be a threat as long as there is even a single child in the world who carries the disease. This is because the virus can easily be imported into a polio-free country and distributed rapidly to people who are not immunized against polio.

Polio is spread through person-to-person contact via fecal-oral transmission. In other cases it can be spread by a common vehicle, like a container of water or food, and then multiply in the intestine. Because of this, is can spread especially fast in a community with a low standard of hygiene and sanitation.

Once a person gets infected with the virus, different outcomes can be noticed. Most of the infected people (90 percent) don’t show any symptoms and just carry the virus in them, while in other cases victims can have symptoms like fever, fatigue, headache, vomiting, stiffness in the neck and pain in the limbs. However, one in 200 infections can lead to irreversible paralysis, which usually pertains to the legs. This can happen in a matter of hours. In 5 to 10 percent of infections, respiratory mussles get immobilized, leading to death.

Today, Polio remains in 3 countries. Nigeria, Pakistan and Afghanisatn. In Afghanistan, there have been a total of 4 cases in 2015. In Nigeria there have been no new cases in this year, but in 2014 a total of 6 was noticed and in Pakistan there is a total number of 26 cases in 2015.

Unfortunately, no real cure exists. However, the eradication of polio can be achieved by prevention, though the use of vaccines. Two different kinds of vaccines exist: the intactivated poliovirus vaccine (IPV) and the oral poliovirus vaccine (OPV). IPV is used throughout much of the world and must be given multiple times, but once finished, the child is immunized for his or her entire life.

One private-public partnership that continues to strive for polio eradication is the Polio Eradication Initiative. This partnership was a product out of the forty-first World Health Assembly in 1988 with the aim to eliminate polio from the world. National governments are collaborating with the World Health Organization, Rotary International, the US Center for Disease Control and Prevention, United Nation Inernational Children`s Fund, and others. Through its multi-pronged programs consisting of research, new product development, strategy formulation and policy development, polio is being eradicated.
When this goal is achieved everyone in the world will benefit equally, as the danger of polio will be eradicated and no child will have to suffer from the paralysis anymore.

- Jay






Polio Global Eradication Initiative:
http://www.polioeradication.org/Polioandprevention.asp

WHO - Polyomyelitis:
Center for Disease Control and Prevention:
http://www.cdc.gov/polio/about/index.htm

Tuesday, July 7, 2015

Heat Waves: The Silent Assassin



The scorching heat baked roads, trees, and anything else that dares to stand in its way. At 44.7 degrees Celsius, Karachi, the largest metropolitan area in Pakistan, bore the brunt of the heat. After months of sizzling temperatures, casualties became devastatingly commonplace. Humans weren’t the only victims. At this temperature, asphalt roads began melting, adding to a long list of heat-related damages in the city. People strove to provide a logical reason for this event. Was this due to climate change? Atmospheric fluctuation? Mother nature? While opinions differed, one thing was certain: these were no ordinary summer days. This was a heat wave[i].

It’s common knowledge that the average body temperature is about 98.6 degrees Fahrenheit, or 37 degrees Celsius. This optimal temperature strikes a perfect balance, preventing bacterial infection while maintaining an efficient metabolic rate. In short, it’s the ideal temperature to maintain homeostasis. If our surrounding environment is too cold, our bodies respond by inducing reflexive muscle movement to warm our bodies, otherwise known as shivering. Conversely, when the environment is too warm, a human’s natural response is to cool down by sweating. But what happens when the surrounding temperature is simply too hot for the body to handle?[ii]

This year’s summer forced countries like India and Pakistan to grapple with that very question. While regular summers in places like Karachi and New Delhi often reach 40 degrees Celsius, this year’s heat wave has approached record-breaking levels. The effects have been tragic. As of July 1st, over 3,000 people in the region have died from heat wave-related conditions. Karachi alone has accounted for 1,200 deaths. Roughly 50 times as many people, or around 65,000, have flocked to hospitals to be treated for heat stroke[iii].


So what exactly is heat stroke? Heat stroke is a condition in which prolonged exposure to heat leads to an inability for the body to maintain regular body temperature. Consequently, this can lead to seizures, stroke, comas, and even death.[iv] To exacerbate the situation, both frequent power outages throughout countries like Pakistan and abstention from water during the month of Ramadan have heightened the number of casualties, where fasting is observed from dawn to sunset.[v]
But Southeast Asia isn’t the only region affected by the heat wave this summer. Last week, the German town Kitzingen recorded a brutal 40.3 degrees Celsius, the highest temperature ever recorded in the nation since record keeping began in 1881. The same week also brought temperatures of 36.7 degrees Celsius to Britain, a record temperature for the month of July.[vi] Heat waves in other European nations, including France, Poland, Portugal, and Spain, have also threatened citizens. While fatality rates have not been on the same scope as in Southeast Asia, babies, older adults, and those with chronic health problems remain susceptible to dehydration, fever, and heat stroke.[vii]

As a result of heat waves occurring around the world, the World Health Organization and World Meteorological Organization released its first ever guideline to address heat-related concerns. Titled Heatwaves and Health: Guidance on Warning-System Development, the report describes human physiology in increased temperatures, societal impacts of sustained heat, and intervention strategies to reduce potentially fatal effects of heat waves. On a more practical level, the publication gives helpful tips for anyone wishing to avoid the potentially detrimental effects of heat. These include drinking fluids that contain little to no sugar, putting on sunscreen with a protection factor of 15 or higher when going outside and avoiding rooms with dark curtains.[viii]Despite the fact that heat waves rarely drive the same attention-grabbing headlines as hurricanes and earthquakes, they are nevertheless among the most dangerous of natural hazards. Exposure to prolonged heat can cause severe dehydration and heat stroke, both of which can lead to death. In areas like Southeast Asia, over 3,000 deaths have been recorded this summer alone.[ix] As simple as it may seem, drinking cold fluids regularly and remaining indoors as much as possible are critical choices that can ultimately be the difference between life and death. While heat waves are far over, it is important to keep these tips in mind to enjoy a safe and sunny summer.
-Kai






[i] Iyengar, Rishi. "A Heat Wave in Pakistan Has Killed Around 140 People."Time. Time Inc. Network, 22 June 2015. Web. 7 July 2015.

[ii] WebMD. "Body Temperature." WebMD. Healthwise, 14 Nov. 2014. Web. 07 July 2015.

[iii] Iyengar, Rishi. "A Heat Wave in Pakistan Has Killed Around 140 People."Time. Time Inc. Network, 22 June 2015. Web. 7 July 2015.

[iv] WebMD, LLC. "Heat Stroke: Symptoms and Treatment." WebMD. WebMD, LLC, 27 Sept. 2014. Web. 07 July 2015.

[v] Iyengar, Rishi. "A Heat Wave in Pakistan Has Killed Around 140 People."Time. Time Inc. Network, 22 June 2015. Web. 7 July 2015.

[vi] Bacon, John. "Europe Sizzles as Heat Wave Smashes Records." USA Today. Gannett, 06 July 2015. Web. 07 July 2015.

[vii] WebMD, LLC. "Heat Stroke: Symptoms and Treatment." WebMD. WebMD, LLC, 27 Sept. 2014. Web. 07 July 2015.

[viii] "Heatwaves and Health: Guidance on Warning-System Development."World Health Organization. Ed. G.R. McGregor. United Nations, July 2015. Web. 7 July 2015.

[ix] Iyengar, Rishi. "A Heat Wave in Pakistan Has Killed Around 140 People."Time. Time Inc. Network, 22 June 2015. Web. 7 July 2015.

Tuesday, June 23, 2015

MERS Outbreak Continues in South Korea



MERS. In the past three months, this four-letter word has quickly risen from obscurity to become a household name in South Korea. MERS, or Middle East Respiratory Syndrome, has led to the temporary closure of hundreds of schools, economic turbulence, and 27 deaths. Since it's initial diagnosis in South Korea on May 20, 2015, it has rapidly spread throughout the nation. Today, over 6,700 people have been placed in quarantine as the East Asian nation struggles to contain this deadly outbreak[i].

So what exactly is Middle East Respiratory Syndrome? As the name indicates, MERS was discovered three years ago in the Middle East as a novel respiratory virus. Prior to South Korea, incidences of the illness were almost exclusively in Saudi Arabia. Common symptoms include fever, coughing, and shortness of breath[ii]. Like the infamous SARS (Severe Acute Respiratory Syndrome), both derive from the same viral family, target the respiratory system, and seem to be able to transmit from animals to humans (known as zoonotic virus).

Given its relatively recent discovery, information regarding the origin, behavior, and treatment of MERS remain scarce. Strains of the virus have been found in dromedary camels in the Middle East. As a result of these discoveries, one possible source of transmission may be from direct contact with camels. Once infected, it appears that limited human-to-human transmission is possible. This seems particularly prevalent in healthcare facilities with limited hygienic protocol[iii]. Currently, no vaccine exists. While health organizations like the U.S. National Institute of Health may seek possibilities of developing a cure, current treatment emphasizes prevention and relief of symptoms[iv].

So how did a virus transmitted from camels outbreak in South Korea? On May 4th, 2015, a 68-year-old man returned to South Korea after visiting a few Middle Eastern countries. After a little over 2 weeks, the man was officially diagnosed with MERS. Despite government reassurances of containment, the virus has now spread to 84 hospitals, 175 individuals, and nearly 7,000 people are in quarantine [v].

Amid escalating fears, the South Korean economy, especially tourism, has taken a hit. According to the Ministry of Culture, Sports, and Tourism, more than 120,000 tourists have cancelled their trips to South Korea since June 1st [vi]. Total economic growth is expected to slow down from 3.3% last year to around 2.8% this year, with fears of MERS cited as a  major reason for the decline [vii].

However, the probability of MERS escalating into a pandemic remains scarce. Although the fatality rate is around 14%, almost all of the 27 deaths have occurred in elderly patients or those with pre-existing illnesses. Furthermore, an epidemic curve recently published by the World Health Organization indicates that the prevalence of MERS in South Korea is clearly falling from its peak in early June [viii].

While data points to the slow but steady decline of MERS in South Korea, it remains to be seen what the total effects of this outbreak will be. Often times, public perception of a disease as a far greater impact than the number of fatalities itself.  But for now, South Korea continues to fight this national outbreak with hopes of eradication in the near future.

-Kai







[i] Shankar, Sneha. "MERS Outbreak 2015: South Korea Death Toll Rises To 23, 3 New Cases Diagnosed." International Business Times. IBT Media Inc, 18 June 2015. Web. 23 June 2015.

[ii] Zaki, Ali Moh. "Brief Report: Isolation of a Novel Coronavirus from a Man with Pneumonia in Saudi Arabia." New England Journal of Medicine N Engl J Med 369.4 (2013): 394. Virology-Bonn. New England Journal of Medicine, 12 Oct. 2012. Web. 23 June 2015.

[iii] WHO. "Frequently Asked Questions on Middle East Respiratory Syndrome Coronavirus (MERS‐CoV)." WHO. World Health Organization, 12 June 2015. Web. 23 June 2015.

[iv] CDC. "Prevention & Treatment." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 02 June 2015. Web. 23 June 2015.

[v] Shankar, Sneha. "MERS Outbreak 2015: South Korea Death Toll Rises To 23, 3 New Cases Diagnosed." International Business Times. IBT Media Inc, 18 June 2015. Web. 23 June 2015.

[vi] Lee, Jiyeun. "Your Web Search Tells Us MERS Is Hurting Korea's Economy."Bloomberg.com. Bloomberg, 22 June 2015. Web. 23 June 2015.

[vii] Sang-hun, Choe. "South Korean Retailers Pinched by MERS." The New York Times. The New York Times, 22 June 2015. Web. 23 June 2015.

[viii] Butler, Declan. "‘Reassuring’ Data Show Slowdown in South Korean MERS Outbreak." Nature.com. Nature Publishing Group, 16 June 2015. Web. 23 June 2015.

Tuesday, June 9, 2015

Medical Volunteers to help victims of the Nepal Earthquake


The April 2015 Earthquake in Nepal with a magnitude of 7.9 caused big damage to the country and people. Around 8, 800 people were killed, 23 000 injured and hundreds of thousands became homeless. The 150 aftershocks made the situation even worse, especially the one on May 12th, that brought about another 218 deaths and injured around 2500 people. Many health facilities were unable to cope and handle the enormous amount of causalities. Beside the lack of trained staff the emergency supplies were also very limited.


The country is still depended on donations from all over the world. Medical volunteers are needed to help out the doctors and nurses in the troubled areas. With the help of skilled medical volunteers, more of those injured can have access to healthcare.


As it is difficult to get an overview of how to help Nepal, here is some information on how to volunteer, donate or where you find more general information about Nepal. Of course there are many other options but we hope this may help you to start getting involved.


The homepage from Humanity road helps relief groups to deploy their resources in an effective way. There are lists of location coordinates of communities in need and they also request specific medical services for the injured. You can find real time situation reports to keep updated.


If you want to do volunteering and you are highly skilled you can get involved through “Doctors Without Borders”. They’ve already sent eight teams out to help the victims in Nepal.


Another option to help is with the organization “Volunteer FDIP” - if you are a nurse a doctor or any other healthcare service provider you can volunteer with this organization. http://www.volunteerfdip.org/support-nepal-earthquake-victims


International Federation of Red Cross and Red Crescent Societies - The IFRC does not recruit volunteers to work overseas but a small number of National Societies do send some volunteers overseas and many do receive international volunteers. Therefore you could contact the National Society directly. 


Another volunteering option is the “Project Hope”. They are deploying medical volunteers to Nepal and also have a disaster relief expert team who is coordinating with the WHO, UN and Nepal's Ministry of Health.
There is also a Facebook group: “Nepal Earthquake Relief Volunteer Coordination” where you can find posts about different volunteering options in general.


If you search for ways to donate reliable money to the Earthquake victims there are several options. CNN provided a good overview about different organization where you can donate money.
Even if it is just a small amount, putting all donations together will help a lot!


I hope everyone can do his or her small part to help the earthquake victims either as a volunteer or by donating.


- Jay

Friday, May 29, 2015

Introducing Watsi - Healthcare. For every person



As mentioned in our introductory post, we hope to use this platform to share more about how we can work towards achieving our goal of creating a world where healthcare is accessible for all. Today, we'd like to introduce Watsi, a non-profit crowdfunding platform organised by a group located in San Francisco, USA, that is working to provide healthcare for those in need by gathering donations from all around the world.

Watsi's goal is the same as mediPhone's - to "make healthcare a reality for everyone". 
They currently have over 10,000 donators from across the world contributing to their goal by providing funds (at a rate that the donators themselves choose) monthly. These donations are then directly delivered to their patients and all transactions are made transparent through their website. Watsi also have medical partners such as the African Mission Healthcare Program and Floating Doctors that they fund in addition to financial backers and individual contributors who fund Watsi's operational costs. 

mediPhone may currently be limited to providing healthcare support in Japan. However, we hope to introduce other platforms and services such as Watsi that are working towards the same goal yet in a different niche or through a different platform and thus contribute towards improving healthcare access around the world.

To learn more about Watsi, visit: https://watsi.org/

- Jay