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  • Kebijakan Kesehatan Indonesia

    World Health Day 2015 to Focus on Food Safety

    The World Health Organization (WHO) has announced plans to focus on food safety for World Health Day––April, 7, 2015. WHO has pinpointed this particular topic due to the increasing globalization of our food supply, which requires additional and improved systems both in and between all countries.

    According to WHO, food safety is increasingly threatened by a number of factors––food production, distribution and consumption; changes to the environment; new and emerging pathogens and antimicrobial resistance. The spread of contamination is also made possible with increases in travel and trade.

    In conjunction with their food safety campaign, WHO will also release estimates of how much foodborne diseases––the cause of 2 million deaths annually, mostly children––cost on a global scale. This will be the first time such numbers are published.

    WHO's overarching goal is to provide various sectors within the food industry––farmers, health practitioners, farmers, government agencies––with the food safety knowledge they need in order to ensure safe food for all. In fact, WHO developed its own Five Keys to Safer Food for both vendors and consumers:

    Key 1: Keep clean

    Key 2: Separate raw and cooked food

    Key 3: Cook food thoroughly

    Key 4: Keep food at safe temperatures

    Key 5: Use safe water and raw materials

    Visit WHO.int for more information.

    source: http://www.foodsafetymagazine.com

     

    Widodo's health care reform must cover poor with HIV, protect youth

    HIV/AIDS knows no boundaries. The virus spreads to every corner of the country, including Aceh, where sharia law takes effect and gives no room for promiscuity. It has infected people from all walks of life, including loyal housewives.

    The constant rise of the number of people in Aceh infected with the virus over the past 10 years to a current total of 272 has shocked Hayati, a local female politician from the Muslim-based Prosperous Justice Party (PKS). We will all closely watch the statistics for HIV infections every time we commemorate the World AIDS Day on Dec. 1.

    As of Sept. 30 of this year, HIV has infected 150,296 people in Indonesia, including 55,800 with AIDS, according to the Health Ministry. The virus has killed nearly 9,800 people since April 1, 1987.

    What should give us cause for concern is the fact that citizens of productive age between 19 and 40 years old make up the majority of people with HIV/AIDS. More worryingly, though, there is a phenomenon in the pattern of the global spread of HIV that youths are becoming easy prey.

    UNICEF data revealed that the virus claimed the lives of about 110,000 young people aged between 10 and 19 years old in 2012, up by 50 percent within only seven years. Indonesia must not be complacent about the trend, given a finding that the young generation in the country is mostly uninformed and, hence, unaware of HIV/AIDS despite a widespread campaign.

    A Health Ministry study in 2010 discovered young people's poor understanding of reproductive health, especially when it comes to risky sexual behavior, prevention of unwanted pregnancy, perceptions about the dangers of the virus and stigmas embedded about people with HIV.

    Such lack of knowledge, if not ignorance, comes on the heels of the mushrooming new values and easy access to drugs, which have given a boost to HIV spread. Without knowledge, youth are more vulnerable to HIV.

    Youths account for one-fourth of the Indonesian population today and their bill of health will determine whether the country will profit from its demographic bonus in the next few decades.

    It is therefore the responsibility of the state and society, including parents and NGOs, to protect the young generation. The initiative of the National Population and Family Planning Board (BKKBN) to join the fight against HIV through educating youths is therefore worth merit.

    No less challenging is the fact that many people with HIV live in destitution and therefore are deprived of access to antiretroviral medication, which has proven to improve the quality of life of those infected and help curb virus infection.

    The Indonesia Health Card (KIS), launched by President Joko "Jokowi" Widodo, should and could include poor people with HIV among its beneficiaries. There will be a question of moral hazard if the national medical program also covers people with HIV, but for the sake of our as well as our children's future, such a move will do more good than harm.

    This is an editorial published by The Jakarta Post on Dec. 1.

    source: http://www.chinapost.com.tw/

     

    Open dataset of the week: Healthcare in Jakarta

    Primary health centres are the most basic unit of the public healthcare network. Jakarta's open dataset on its primary health centres can uncover a host of services for Indonesians and benefits for the government. This is why FutureGov has chosen this dataset as its open dataset of the week.

    The dataset lists the names, addresses and contact details of 394 clinics across Jakarta. It also indicates a breakdown of staff and the state of infrastructure in each of these clinics, including the condition of the buildings, ambulances, internet connections.

    The locations and names of clinics in the city can be mapped out if combined with their geographic coordinates. This could be turned into a handy application for residents which lights up the nearest clinics on a map.

    The government can use the information on the staff and the condition of infrastructure to create a dashboard of its primary health network. It could use this to plan when a clinic needs a new ambulance or when it's time for an internet connection.

    Both of these ideas can be improved if the government can combine the existing data with the number of patients visiting each of these clinics. The app could then show residents the closest clinic with the shortest queue, so that patients can plan their visits better. The dashboard could predict more accurately how resources should be allocated across the clinics based on the number of patients they receive.

    Some rows in the dataset are still incomplete and the latest data is from 2012, so there is potential for the data to be more accurate and comprehensive.

    FutureGov also loved the graph and map tools built into Indonesia's open data portal, so you can have a peek at how a visualisation might look without even downloading the dataset. However, this doesn't seem to be available for all of the datasets and it would surely be useful to make that happen.

    source: http://www.futuregov.asia

    Is the Black Death Coming and Who's to Blame?

    The country of Madagascar is known for its tranquil beaches, exotic wildlife and rich culture. But something else also inhabits the island that is now making headlines: The Black Death.

    Perhaps best known as the Bubonic Plague that is generally associated with the Middle Ages when rats, fleas and poor hygiene resulted in the deaths of approximately 200 million people, the disease remains an enduring threat in third-world nations.

    Madagascar has been one of the world's last remaining hotspots for the plague but the illness has been mostly isolated in rural villages and self-contained... until now.

    On Friday, Nov. 21, the World Health Organization announced an "outbreak of the plague" in Madagascar, with two people in the country's capital being infected and one having died from the disease.

    Cases have been reported in 16 districts of the seven regions, according to WHO, and the health ministry said there had been 138 suspected cases since the beginning of the year and warned that the death toll was likely to rise in the coming months.

    Now that the disease has made it to a densely populated area, a major outbreak seems inevitable. The capital of Madagascar, Antananarivo, houses the prime conditions for a disease such as the plague to spread, similar to those in 14th century Europe – garbage is dumped in the streets and public restroom conditions are terrible. Black rats, which were the primary vector for the disease in the Middle Ages, also roam freely between buildings.

    "There is now a risk of a rapid spread of the disease due to the city's high population density and the weakness of the health care system," the WHO said in its report, while noting that a national task force has been activated to manage the outbreak.

    Contraction of the bubonic plague results in the swelling of the lymph nodes, but can be treated with antibiotics. The pneumonic version, affecting the lungs, can be spread from person to person through coughing. Death can result in as little as 24 hours. The third form of the disease, septicemic plague, is the rarest form and occurs when the blood is directly infected.

    Whichever variety of the plague, as the disease progresses its victim lapses into recurrent seizures, Alzheimic confusion, coma and internal hemorrhaging.

    The plague is almost impossible to eradicate from Madagascar, due to interaction of natural and sociocultural factors. According to a 2013 report by the US National Library of Medicine, the high percentage of animals carrying the disease lays the foundation for transmission, and social and economic conditions further encourage the periodic leap to humans.

    Outbreaks of the plague usually occur in villages at high altitudes in the northern region of Madagascar, spiking between October and April when the warm rainy season keeps temperatures well above 70 degrees day and night.

    Without funds coming in from developed nations, the country doesn't have much to work with to fight the plague. The African Development Bank is allocating $200,000 however, but those resources could quickly dwindle in the coming months. All of these conditions leading up the outbreak mirror those that caused the Ebola virus to spread throughout West Africa.

    "Belief in old practices, rampant misinformation, and apathetic, corrupt politicians have combined to make the current outbreak much more widespread than it should be," VICE correspondent Ben Shapiro said in a documentary that was released in September where he helicoptered into a village about 1,000 kilometers north of the capital that was considered a hot zone. "For Madagascar, though, it's unclear how many more people will die of plague before things start to change."

    For now, the World Health Organization does not recommend any travel or trade restriction based on the current information available.

    source: http://www.healthcareglobal.com

     

    War costs the U.S. more than smoking or obesity

    What are the world's most expensive avoidable problems? The graphic below, drawn from a recent report on combatting obesity by consultancy McKinsey & Company, attempts to quantify the total economic cost of different human-created social burdens, such as smoking, obesity, armed violence and alcoholism. The graphic draws on data from the World Health Organization Global Burden of Disease database, which quantifies the number of productive years of human life lost due to early death and disease.

    In the U.S., armed conflict ranks as having the highest economic impact, due mostly to America's substantial spending on the military. Obesity ranks second: The report estimates that obesity cost the U.S. $663 billion in 2012, equivalent to 4.1 percent of GDP. In France, Japan, Indonesia and the U.K., smoking is still the most expensive social problem. China is the only country in which outdoor air pollution tops the list, while armed violence is the biggest burden in Brazil and Morocco.

     

    source: http://www.washingtonpost.com/

     

    Deadly Plague Surfaces in Madagascar

    The World Health Organization is reporting an outbreak of plague in Madagascar, and warns the disease could spread quickly in country's capital, Antananarivo.

    The United Nations agency said Friday that 119 cases of plague have been confirmed in the African island nation, with 40 deaths.

    It said only two cases and one death have been recorded in Antananarivo, but said "there is a risk of a rapid spread of the disease due to the city's high population density and the weakness of the healthcare system."

    The first case was identified August 31 in the village of Soamahatamana.

    Plague, a bacterial disease, is mainly spread from one rodent to another by fleas. Efforts to control it have been complicated by a "high level of resistance" to the insecticide deltamethrin that has been observed in the country, the WHO reported.

    When an infected flea bites a human, a bubonic form of plague can develop, with characteristic swollen lymph nodes. Untreated, it can lead to pneumonia, an infection readily spread by coughing and one that can be deadly. But, if caught early, the disease can be successfully treated with antibiotics. Only 2 percent of the reported cases in Madagascar are of the pneumonic form.

    The WHO said government and health partners including the Red Cross are implementing measures to contain the outbreak. Personal protective equipment, insecticides and antibiotics have been made available in the affected areas, it said.

    The agency did not recommend any trade or travel restrictions.

    It says personal protective equipment, insecticides and antibiotics have been made available in the affected areas. The agency notes that high levels of resistance to deltamethrin, an insecticide used to control fleas and other insects could complicate the effort.

    source: http://www.voanews.com/

     

    More Have Access to Cell Phones Than Toilets

    Wednesday is World Toilet Day, created by the United Nations in 2001 to raise awareness about lack of available sanitation around the world. Currently, 2.5 billion people globally don't have access to improved sanitation facilities – meaning more people have access to mobile phones than to toilets.

    Lack of access to sanitation creates a host of health problems, making it easier for diseases to spread, infecting drinking water and contributing to undernourishment and poverty. A child dies every 20 seconds because of poor sanitation, according to the U.N. It can also impact future economic opportunities because lack of sanitation can negatively affect school attendance, especially for girls. In 2013, 1,000 children died every day due to diarrheal disease because of poor sanitation.

    The U.N. campaign to end open defecation seeks to eliminate the need for people to defecate outside, frequently with no privacy. According to a joint report from the World Health Organization and UNICEF, 1 billion people are forced to defecate in the open due to lack of sanitation facilities. This causes a range of diseases from cholera and typhoid to polio and hepatitis. It also costs the world $260 billion a year, with 20 of the most affected countries in South Asia and sub-Saharan Africa.

    The U.N. promotes access to safe and clean toilets as a part of its 2015 Millennium Development Goals, a series of benchmarks countries strive to reach to reduce poverty, mortality rates and inequality around the world. Seventy-seven countries have met the goal for sanitation. U.N. Secretary-general Ban Ki-moon says 1.25 billion women and girls would have better health and safety with the improvement of sanitation facilities.

    Catarina de Albuquerque, the U.N. special rapporteur on the right to water and sanitation, said women and girls in particular are negatively impacted by lack of access to sanitation facilities. Gender-based violence and sanitation is the theme of this year's World Toilet Day.

    "In many countries, social or cultural norms prevent girls and women from using the same sanitation facilities as male relatives, for instance the father-in-law, or prohibit the use of household facilities on the days women and girls menstruate," de Albuquerque said.

    Improved sanitation is also harder to come by in rural areas than urban ones. In 2012, nearly 1.8 billion people living in a rural area lacked access, while 756 million did in urban areas.

    Oceania is the only developing region not to see an increase in improved sanitation between 1990 and 2012. Open defecation was highest in Southern Asia at 65 percent in 1990 but fell to 38 percent in 2012, marking the largest drop in any region. Western and Eastern Asia only rates of 3 percent and 1 percent respectively. India is the country with largest population practicing open defecation, with 597 million people lacking access to proper sanitation facilities.

     

    source: http://www.usnews.com

     

     

    Environmentalist Calls On Jokowi To Address a Health Emergency

    Mercury contamination is a "public health emergency," according to a prominent Indonesian environmentalist, and the new government of President Joko Widodo should move quickly to halt trade in the toxic heavy metal.

    Yuyun Ismawati, a 2009 winner of the Goldman Environmental Prize for her work on sustainable waste management, called on Mr. Widodo to halt the illegal smuggling of hundreds of tons of mercury into Indonesia, most of which is used in small-scale gold mining operations.

    Ms. Ismawati, a co-founder of the environmental group BaliFokus, said doctors have identified more than three dozen suspected cases of advanced mercury poisoning. She estimates that at least 5 million people are exposed to the toxic heavy metal in the air and food in mining communities.

    The amount of mercury illegally brought into Indonesia has been rapidly increasing, reaching about 500 tons in 2013, she said in an interview with the Wall Street Journal.

    "We have to stop the mercury from coming into the country," she said. "This is a public health emergency."

    Mr. Widodo, who took office four weeks ago and is still organizing his administration, campaigned on a platform of improving health care and other social services.

    BaliFokus is among several environmental groups that have met over the past two weeks with newly appointed Forestry and Environment Minister Siti Nurbaya to talk about environmental priorities.

    Much of their discussion has focused on complaints by environmentalists that President Widodo combined forest management and the environment in one ministry, which advocates fear could weaken environmental protection.

    Sonia Buftheim, a BaliFokus toxics program officer who attended one session, said she told the minister that the widespread use of mercury in small-scale gold mining was creating a public health emergency. She said Ms. Nurbaya noted her concerns but did not comment on the issue.

    An assistant to the minister confirmed that the discussion took place but the minister and her staff did not respond to questions from the Journal about the threat posed by mercury.

    Small-scale gold miners use the liquid metal to bind tiny particles of gold and create a small lump of amalgam. Miners and traders then burn off the mercury with a blowtorch, leaving only the gold.
    Typically, they use no protective gear to keep from inhaling the mercury vapors.

    Most of the airborne mercury settles into the soil and water, where it can be absorbed by fish and rice and enter the human food supply, endangering the health of the entire community.

    Mercury poisoning can cause tremors, headaches, muscle weakness and mood swings, among other symptoms. It often goes unrecognized because it can take years to develop and its symptoms are similar to other ailments. It also can cause birth defects.

    Ms. Ismawati said an estimated 2 million gold miners operate in 22 of Indonesia's 34 provinces, including on Java, Sumatra, Sulawesi, Borneo and Lombok. Mercury is sold openly at shops in mining communities, she said.

    She urged the government to ban the use of mercury in gold mining and to provide treatment for people suffering from mercury poisoning.

    source: http://blogs.wsj.com/