Cholera: Description (Blog 9)

A public health topic that I find very interesting is cholera; a disease that causes diarrhea and can kill a person in a few hours if treatment is not received. Cholera spreads through unclean water and poor sanitation. According to the WHO, every year there are about 3-5 million cases of cholera and 100,000-120,000 resulting deaths. The WHO estimates that up 80% of the cases can be treated with oral rehydration salts. (http://www.who.int/mediacentre/factsheets/fs107/en/index.html)

The most severe outbreaks of cholera occur after natural disasters and areas of unrest. The Democratic Republic of Congo is in the middle of civil unrest which has lead to a a serious contamination of the water and very rudimentary (to be polite) sanitation system. In January 2011 there were “at least 22,000 cases and 584 deaths”. (http://www.passporthealthusa.com/localvaccines/travel-health-alerts.php) However, data in areas like the DR Congo is very difficult to find and if there is data, it is most likely untrustworthy. If a country depends on tourism, the government is likely to under-report the number of cases. On the other hand if the government wants more money, they are likely to inflate the number of cases. Due to these issues I will have to focus on an area that has hard data – a country that has experienced a natural disaster that received a lot of aid.

In January 2010, Haiti experienced a magnitude 7.0 earthquake. Like many other countries, the Haitian government seems to have tampered with some numbers. The Haitian government stated that about 316,000 people perished while USAID (US Agency for International Development) puts the death toll at 46,000-85,000. (http://www.bbc.co.uk/news/world-us-canada-13606720) In spite of this, statistics regarding Haiti are likely to be accurate than the DR Congo. As there were many governments and organizations were involved with the relief effort there should be a lot of reliable data on the situation.

One of the results of the earthquake was water contamination. Because of this water contamination, cholera was soon spread. I would like to study the outbreak of cholera in Haiti during 2010-2011 resulting from water contamination from the January 2010 earthquake.

As the numbers suggest, cholera is a very serious worldwide issue. Studying how an area that has dealt / is dealing with an outbreak of cholera (Haiti), may be applicable to other countries. In countries like the DR Congo, even a slight improvement in people’s lives brings an enormous social shift – people simply have more hope, which is crucial in the development process. As you might be able to tell, DR Congo holds a special place in my heart. According to aid workers and economists, DR Congo is an un-developing nation. (I was in Goma, DR Congo in the summer of 2010 on an aid trip and it must be one of the bleakest corners of the word.) The multi-decade civil unrest is slowly destroying everything that had been accomplished. Because of the dangers, many aid organizations have pulled out of DR Congo though a few are still there (including the UN). But DR Congo has essentially been left to its own devices. Even if the cholera prevention/intervention is unsuccessful, there may be a social impact. Hopefully, the Congolese will see the international effort and will no longer feel abandoned and alone.

Maternal and Human Rights (Blog 8)

“Human rights are basic rights and freedoms that all people are entitled to regardless of nationality, sex, national or ethnic origin, race, religion, language or other status.”  (http://www.amnestyusa.org/research/human-rights-basics) An example of a human right is that “all humans are born free.” (http://www.un.org/en/documents/udhr/) Human rights are important to public health and public health is important to human rights, because without both people will have neither. As such, the right is in protected in the Declaration and without that, it may not be honoured.

A certain standard of living is necessary to be healthy and therefore is included in Article 25 of the UDHR. If a person has no money, they are unable to buy proper food and clean water and are subsequently more susceptible to diseases. According to Dr. John Butterfly, executive director of Dartmouth-Hitchcock Medical Center, “chronic malnutrition often leads to a compromised immune system and makes a person unable to fight off organisms ‘that a normally fed human would barely notice’.” (Wall Street Journal. “Starving in India: The Forgotten Problem”) This is not just a problem in other countries. The University of Wisconsin did a study of 3,000 counties in the USA. “The five least-healthy counties generally had more than twice the teenage birth rate of the five healthiest counties, and more than twice the share of poor children.” (The Economist. “Beyond the mandate: Improving America’s health will take more than universal insurance”) Clearly there is a link between a good standard of living and one’s health As the Wall Street Journal article points out, without a basic standard of living people die, thus it is a major human right.

States must guarantee “women of all racial and economic backgrounds timely and non-discriminatory access to appropriate maternal health services”. (Maternal mortality and human rights: Landmark decision by United Nations human rights body) A committee made some recommendations on how to provide “appropriate maternal health services”. There should be emergency obstetric care, professional training for healthcare providers, ensure that facilities are up to standards, and monitoring of maternal deaths.

Motherhood is specifically mentioned in the UDHR and addressed by the Committee of the Elimination of Discrimination Against Women simply because mothers are very vulnerable. Furthermore, because pregnancy is a cumbersome, long, and risky condition, women must be given further protection. Obviously, pregnant women have more physical limitations than they would have otherwise. Any risk that a pregnant woman faces also could harm the baby. Mothers are also specifically mentioned because women are generally the primary caregivers. Protecting the mother is protecting the children. For example, in countries where there are not a lot of infant food options, infants rely on breastfeeding. If the mother has died or is unable to care for her child, that child’s risk of mortality would be higher and their development would also be hindered which will impact their lifelong well-being.