Friday, February 10, 2012

Public Health Crisis in Madagascar -- Ascaris


By Kevin Yuan

Ascaris lives in the intestine, and Ascaris eggs are passed in the feces of infected individuals. Ascaris lumbrocoids or Ascariasis infections are usually treated using benzamidazoles, such as Mebendazole or Albendazole. Although these anti-parasitics are chemically similar and both are extremely effective, the recommended dosage may vary. In the current state of our economy, expenses allocated regarding health issues are severely limited, especially when those allocations are towards topics affecting other countries. Given the limitations, countries that are determined to help Madagascar with its current Ascariasis crisis should allocate their  available funds should be used to hire teachers and build latrines, than to purchase anti-parasitics for those at risk in Madagascar.

The money in place should be used to fund teachers and latrines, because Ascariasis is a perpetual problem for Madagascans. The vulnerability of the 20 million people in Madagascar to Ascaris demands that long-term measures must be taken in order to provide the greatest benefits for reducing Ascaris infections in the future. Although the anti-parisistics used to treat Ascariasis are effective, the money available would not be able to treat all the children in Madagascar; in addition, Ascaris is an infection that can be acquired repeatedly, even after one gets treatment. The source of transmission is from ingestion of eggs from soil contaminated with human feces and is prevalent in areas with poor hygiene. With over 85% (as indicated by GEXSI) of the country’s inhabitants living in rural areas, the lack of hygiene, nutrition, and access to drinking water enables great susceptibility to Ascariasis. 
A significant portion of revenue available should be distributed to establishing latrines to reduce open defecation. With communal latrines costing from 250, low-cost communal latrines can be established. The money should be distributed to schools in rural villages where not only students will have access to the latrines, but also inhabitants of homes located near the schools. As Kightlinger et al mentions, “children were allowed to defecate in the village with 13% habitually defecating within 10m of their house.” The lack of sanitary measures illustrates the susceptibility of people, especially children, to Ascariasis. Ultimately, with the establishment of latrines, the benefits will drastically improve sanitary conditions.  

Part of the funds available should be used for hiring teachers who are well-informed about sanitation, especially regarding Ascaris infection. With money distributed towards education, health teachers can be hired to educate schoolteachers about hygiene, and that information can be passed to students. Hygiene education should build children’s knowledge to transmit information on appropriate health practices to families and communities. This education will also incline children that live near the school to utilize the latrines. Harnessing the health skills will provide long-term benefits. The half million should also be spent on “materials to support health promotion activities and habits, including posters, exercise books, and stickers posted on latrine and classroom doors” as suggested by UNICEF. Bringing teachers to educate about the importance of sanitation will show significant benefits in the long-run. 

In conclusion, we can clearly see that in order to generate the greatest benefit from the money, the funds should be utilized in a way to educe a long-term solution contrary to a short-lived solution by using the money for antiparistics.

Sunday, February 5, 2012

Gay Marriage: What Does It Mean For Public Health?

By Marvin So






Last weekend, one of my friends sent me this awesome video called “It’s Time”. Filmed by the Australian community advocacy group GetUp, the 2-minute video chronicles the ups and downs of a relationship in a strikingly beautiful way, check it out below!
The Advocate, an LGBT interest magazine, called the video possibly the most beautiful ad for marriage equality we’ve seen”. For me, I think it really hits home because relationship they illustrate is a completely normal, and would be completely socially acceptable save for the couple’s genders. The heart-breaking reality the video showcases really got me thinking about same-sex marriage in the United States, where it is currently not federally legalized, and how that relates to sexual health.

From the get-go, it’s been established that men who have sex with men (MSM) are at greater risk for STI’s and HIV. According to a recent study by Emory University, banning same-sex marriage was positively associated with risky homosexual behavior, and that in California, which has the largest population of gay men in the nation, the estimates for the prevalence of STI’s were substantially lower – this shows that homosexual behavior could really be shaped by marriage bans. This seems to make sense when one considers that even among heterosexual couples, if people were denied civil union - which represents to many people the emblem of their commitment to each other – I could foresee a greater amount of polygamous relationships, riskier sexual behaviors, and overall lack of benefits you usually see in strong, committed, and healthy relationships.  
Beyond sexual health, there is a plethora of other public health concerns to ponder as well. Being married does confer a degree of stability, as well as financial and legal benefits for both spouses and children, which can contribute greatly to individuals’ and families overall health. Kinsey Confidential notes that among LGBT people in the U.S., there were a much greater rates of mood, alcohol use, and anxiety disorders than compared to the rest of the world.

According to Advocates for Youth, “millennial youth” – those of us currently aged 18-29, are about 15% more supportive of same-sex marriage than any other age group in the population, and that this backing coincides with support for comprehensive sex education, family planning services, and the morality of same-sex relationships. Again, this makes sense to me; with the greatly increasing amount of people coming out in the past few decades, and stigma surrounding homosexual relationships slowly eroding, it’s easy to see how our generation’s attitudes have shifted surrounding non-vanilla sexual practices, and the need to protect all people. It seems as if the lack of same-sex marriage is directly reflective of homophobia in our society. The direct health outcomes that this systematic discrimination causes must be considered. 

A quick glance at the Youtube video’s comment section and you can already see the conflicts the issue of same-sex marriage creates. I really don’t know what the immediate future holds for same-sex marriage, but what do you think? Regardless of your stance on the matter, do you think continuing the ban on gay marriage in the U.S. will really have an impact on these individual’s health? What about our nation’s health as a whole?  For what other reasons should we or should we not care about gay marriage? 


For more information about same-sex marriage, here are some good sites to look into:
  1. 1. New York Times’ Topic Page on Same-sex Marriage
  2. 2. About.com Guide on ways to support same-sex Marriage
  3. 3. Freedom to Marry, a campaign win marriage nationwide