KARACHI, Pakistan — Measles cases surged in Pakistan in 2012, and hundreds of children died from the disease, an international health body said Tuesday.

In recent days Pakistani officials said they launched an immunization campaign to reach children in the worst-hit areas. But the country still struggles with a beleaguered health care system, unsanitary conditions in many regions and a lack of education about how to prevent disease. All those factors make it difficult to combat infectious diseases such as measles and polio.

Also, many oppose vaccinations, suspecting they are meant to harm their people.

A spokeswoman for the World Health Organization, Maryam Yunus, said that 306 children died in Pakistan of measles in 2012, compared to 64 the year before.

She said the jump was most pronounced in southern Sindh province, where measles killed 210 children in 2012. She said 28 children died there in 2011.

The World Health Organization did not give a reason for the increase in deaths, but a provincial health official in Sindh said that the disease hit areas where poor families did not vaccinate their children.

Provincial health minister Saghir Ahmed said 100 children died in Sindh province in December alone, mostly in areas where many people were not vaccinated.

He said health officials recently launched a campaign to vaccinate 2.9 million children in the affected areas of the province and urged parents to get their children vaccinated.

Many Pakistanis, especially in rural areas, view vaccinations campaigns with suspicion as a Western plot to sterilize Muslims. In December, nine health officials working to immunize Pakistanis against polio were killed by militants opposed to the campaign. Pakistan is one of three countries in the world where polio is endemic.

Sindh province, the area hardest hit by the measles outbreak, has also been battered by repeated floods in recent years that have damaged hospitals and clinics.

Measles is an extremely infectious disease spread by coughing and sneezing or personal contact. It causes a fever, cough and a rash all over the body. Most people who contract the disease recover, but it can be fatal for malnourished children.

Complications from the disease can include blindness, an infection that causes brain swelling, dehydration and diarrhea, and pneumonia.

According to WHO, 139,300 people died of measles worldwide in 2010.

Copyright 2013 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

(sumber: www.washingtonpost.com)

Jakarta:To date, there are 383 districts that do not have health centers (Puskesmas). This means that 6.2 million people in Indonesia do not have access to primary health care facilities.

On a higher level, 42 regencies do not have hospitals, meaning that 36 million Indonesian citizens cannot access secondary health facilities.

This information is gleaned from the rural infrastructure census (SID) conducted by the World Bank in collaboration with the Vice President's Office's National Team for Accelerating Povery Reduction (TNP2K), the National Community Empowerment Program (PNPM Mandiri) and the Central Statistics Agency (BPS).

They conducted a survey on 166,506 health facilities and 164,561 education facilities all over Indonesia. "People do not have alternatives. Menawhile, the available primary health care facilities are insufficient," said World's Bank senior economist Vivi Alatas in Jakarta on Dec. 18.

Vivi cited several factors causing region by region differing performances, the most fundamental being availability or non-availability of human resources and infrastructure.

Vivi believes that infrastructural problems in villages are sometimes more complex than that found in metropolitan areas.

Unfortunately, availability of a facility is not enough to provide sufficient healthcare for people. She pointed to the fact that 852 units, or nine percent of all health centers in Indonesia did not have running water installations.

Moreover, 732 health centers do not have an attendant physician, while 10,629 others do not have electricity.

In the field of education, although the nine-year compulsory program has been applied by the government since 1994, 230 districts still do not have a Junior High School (SMP). This means that 9,5 people in Indonesia do not have access to secondary education.

On top of that, around 8,000, or 36 percent of existing Junior High Schools do not have laboratory facilities.

Overall, from the level of Elementary School (SD) to Senior High School (SMA), 21,653 public schools (13 percent) do not have electricity, while another 30,207 schools do not have bathrooms with running water.

Most of the regions that lack health and education facilities are located in eastern Indonesia. "Papua does not have enough health facilities even in urban areas," Vivi said.

On the contrary, Java and Bali are equipped with good healthcare facilities right down to the rural areas.

Chief economist and adviser to the World Bank Indonesia, Ndiame Diop, said that real income of Indonesian people had increased rapidly since entering the new millenium. However, this is only applicable at the national level, but not in the regions. Each region do not enjoy show the same levels of progress. "Thi is worrying," he said.

(source: www.tempointeractive.com)

A 4-year-old Indonesian boy has died from bird flu, bringing the death toll to 160 in the country hardest-hit by the deadly virus, a health official said Tuesday.

While the H5N1 bird flu virus has killed relatively few people, scientists have been closely monitoring it for its potential to mutate and affect humans worldwide.

The boy died Dec. 6 in Tangerang city, just west of Jakarta, the capital, said Health Ministry official Rita Kusriastuti. He developed symptoms of a cold and fever on Nov. 30 and was treated at a public health centre before being hospitalized the same day he died.

Kusriastuti said the boy, from the West Java district of Bogor, was believed to have been infected with the H5N1 virus after having direct contact with dead fowl around his house.

Bird flu has killed at least 360 people worldwide since 2003. It remains hard for people to catch, but experts fear it could mutate into a more deadly form that spreads easily from person-to-person.

So far, most human cases have been linked to contact with infected poultry.

Last week, Kusriastuti said a form of the H5N1 virus not previously detected in Indonesia had killed hundreds of thousands of ducks on the main island of Java. The type of virus has been found circulating in a number of other countries and does not indicate any change that makes humans more susceptible.

The new form of the virus is believed to have entered Indonesia through imported ducks, but Kusriastuti said it's also possible it may have evolved on its own from existing strains.

Bird flu remains entrenched in Indonesia and elsewhere. It typically flares up during the winter months in affected countries with increases in poultry outbreaks and human cases.

(source: www.cbc.ca)

During the last three decades, the World Health Assembly (WHA) agreed upon two interventions, which can have far reaching and lasting impacts on global health, if implemented (and not merely endorsed) in their true spirit and letter by the member states.

The first one is The International Code of Marketing of Breast milk Substitutes (The Code), which is an international public health recommendation to regulate the marketing of breast milk substitutes. The second is the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) which is the world's first global corporate accountability and public health treaty to regulate the sale and consumption of tobacco products. While one aims to protect infant health and reduce mortality by promoting breastfeeding, the other safeguards adult health from the devastating effects of tobacco use.

The Code was adopted by the WHA in 1981 to be implemented 'in its entirety' as a 'minimum requirement' to protect infant health. It called for: all formula labels and information to state the benefits of breastfeeding and the health risks of substitutes; no promotion of breast-milk substitutes; no free samples of substitutes to be given to pregnant women, mothers or their families; and no distribution of free or subsidized substitutes to health workers or facilities.

It also covers ethical regulations for the marketing of feeding bottles and teats. In 2010, the WHA added two new resolutions to this Code. The first Resolution called for member states to implement a set of Recommendations on the Marketing of foods and Non-alcoholic Beverages to Children – which aim to reduce the impact of 'junk' foods on children by restricting its marketing including in 'settings where children gather' such as schools, and to avoid conflicts of interest. The second Resolution on Infant and Young Child Nutrition highlighted the damaging impact of commercial promotion of baby foods on the health and survival of children and envisaged that there should be an 'end to all forms of inappropriate promotion of foods for infants and young children and that nutrition and health claims should not be permitted on these foods'.

Although less binding than a treaty or a convention, implementation of the International Code and Resolutions is recognised as one measure for countries to take to protect infant and child health and fulfil a country's obligations under the Convention of the Rights of the Child. Although it has the support of every member state, yet as of December 2011, out of the 103 countries (including India where legislation requires that tins of infant formula carry a conspicuous warning about the potential harm caused by artificial feeding, placed on the central panel of the label) that had some legal regulatory measures in place, only 37 countries had made a serious enforcement of the Code's provisions.

The World Health Organization Framework Convention on Tobacco Control (WHO FCTC) is the world's first global corporate accountability and public health treaty that was adopted by the WHA in 2003 (and came into force in 2005) under article 19 of the WHO constitution. The FCTC seeks "to protect present and future generations from the devastating health, social, environmental and economic consequences of tobacco consumption and exposure to tobacco smoke" by enacting a set of universal standards stating the dangers of tobacco and limiting its use in all forms worldwide. It calls upon the governments to: adopt tax and price measures to reduce tobacco consumption; ban tobacco advertising, promotion and sponsorship; create smoke-free work and public spaces; put prominent health warnings on tobacco packages; and combat illicit trade in tobacco products. The treaty is legally binding in 176 ratifying/accessioned countries.

However, the lucratively profitable and powerful baby food and tobacco industries continue to use dubious methods to circumvent the Code and the FCTC, and peddle their poisonous goods. While one continues to endanger the health of infants and children by promoting the use of formula and growing milk, the other finds innovative marketing tactics to hook the youths for a lifelong addiction to nicotine worldwide.

According to The Tobacco Atlas, in 2011, the global tobacco industry made an estimated profit of US $35 billion and was also responsible for 6 million deaths with nearly 80% of these deaths occurring in low- and middle-income countries. Similarly the size of the Global Baby Food Market in 2010 was US$ 36.7 billion (of which formula milk contributed US$ 25.2 billion) which is forecast to reach US$55 billion by 2015.

Two conferences were held recently in different parts of the world, where Citizen News Service – CNS had on-site reporting teams, to discuss the obstacles and find solutions thereof in the path of enforcing the Code (the 1st World Breastfeeding Conference in India) and the FCTC (the 5th Conference of the Parties (COP 5) to WHO FCTC in South Korea), with a view to let the world's babies and youths lead a healthy and productive life and save them from premature deaths.

At WHO FCTC COP-5 held in November 2012 in Seoul, despite continued pressure tactics from the industry, countries stood firm against Big Tobacco's obstructionist tactics and adopted measures that, when fully implemented will save 200 million lives by 2050. These included:

- Adopting the world's first public health and corporate accountability treaty-- Protocol to Eliminate Illicit Trade in Tobacco Products to rein in illicit trade in tobacco products that undermines tobacco control and costs governments billions of dollars in lost tax revenue, law enforcement and health care expenditures

- Taking steps to hold the tobacco industry liable for its abuses and opening up the potential to generate revenue to treat tobacco-related disease

- Adopting a set of guiding principles/recommendations that provide a solid basis for better tobacco tax policies around the world

- Strengthening action to prioritize public health over trade and protect public health policies from Big Tobacco.

Likewise the 1st World Breastfeeding Conference 2012 held in December 2012 in New Delhi exhorted nations to protect every feeding mother by joining the fight against the devious and misleading tactics of baby food industry because Babies Need Mom-Made, And Not Man- Made. It called for reducing neonatal mortality by 20% by simply ensuring initiation of breastfeeding within the first hour of birth and then continuing it exclusively up to 6 months to avert at least 20% (1.5 million) of the 7 million deaths of children under five occurring globally every year. Mother's milk gives infants all the nutrients they need for healthy development and contains antibodies that help protect infants from common childhood illnesses.

Optimal breastfeeding is not only a cost effective intervention to improve child survival, it also has enormous benefits for maternal health, and reduces the mother's risk of post-partum haemorrhage and breast and ovarian cancer.

The conference draft declaration expressed concern at the continuing inequality in health and nutrition and the subjugation of these concerns to the business objectives of corporations. It called upon all concerned to adopt human rights based set of measures (which should be entrenched in the governments' policies and programmes) that protect, promote and support breastfeeding and optimal infant/child feeding and protect it from the commercial sector.

Let us all be a part of these mega efforts to make our babies and youths lead a healthy and artificial milk/tobacco free life. Amen!

(source: asiantribune.com)

The UN's adoption of a resolution on affordable universal healthcare (pdf) was momentous, according to its advocates.

The resolution, adopted by consensus in the general assembly on Wednesday, urged member states to develop health systems that avoid significant direct payments at the point of delivery and to have a mechanism for pooling risks to avoid catastrophic healthcare spending and impoverishment.

There was unusually wide support for the resolution. It came from the global north and south, including the US, the UK, South Africa and Thailand. By gaining support from every corner of the globe, the resolution recognised enthusiasm for universal healthcare from diverse countries and economies, said the Rockefeller Foundation, which has funded research on universal health systems.

According to the foundation, 150 million people worldwide face high healthcare costs, which push around 25m households into poverty each year. More than 3 billion people have to pay for healthcare themselves, forcing many – particularly women and children – to choose between healthcare and education.

Ceri Averill, Oxfam's health policy adviser, said significant momentum around the vote had been building for the past two years, partly through the efforts of the World Health Organisation's director, Margaret Chan, and showed real public commitment to universal healthcare. "We can hold member states to account because of the resolution," she said.

For Averill and Jeanette Vega, managing director of Rockefeller, endorsement of the resolution means universal healthcare will now be on the agenda of the UN high-level panel – co-chaired by the UK prime minister, David Cameron, President Ellen Johnson Sirleaf of Liberia and President Susilo Bambang Yudhoyono of Indonesia – discussing the post-2015 development goals.

"There have been lots of discussions of what health goals should be, for example on non-communicable diseases. This resolution gives weight to health systems as a whole and questions of equity. It ensures that universal healthcare stays on the agenda as one of the post-MDG goals," said Averill.

Supporting universal healthcare is one thing, funding it is another. As the UN delegate from Singapore, Lee Boon Beng, said: "The path to achieving universal health coverage is complex and there is no universal formula. Instead, member states should adopt different solutions to their unique circumstances."

Here the debate revolves on the use of highly contentious user fees, insurance or general taxation. For Averill the problem with user fees and insurance is that the poorest people will not be able to afford them. Citing Ghana, she said no matter how low the insurance premiums are set, these will be out of reach of the poorest people and contribute very little in terms of funding. Many Ghanaians work in the informal sector, for example as street vendors, which makes it difficult to collect premiums.

Thailand is held up as a pioneer in developing universal health coverage. The south-east Asian country introduced free universal healthcare at the point of delivery in 2002 and has shown the concept is not out of reach of middle-income countries. Around 99% of the Thai population is covered through a comprehensive healthcare package. It ranges from health prevention and primary care, to hospitalisation due to traffic accidents, to more expensive services such as radiotherapy and access to antiretroviral therapy treatment for people with HIV. Indonesia, the Philippines and China have rolled out insurance-based health coverage that includes almost their entire populations.

Poorer countries, however, will have to rely on external help to extend affordable healthcare. Zambia on Thursday said it has been steadily increasing spending on healthcare, which is treated as a fundamental human right, but will have to rely on foreign help. "External financing equally remains an important factor in Zambia's resource mobilisation," said the country's delegate, Dr Mwaba Kasese-Bota.

(source: guardian.co.uk)

JAKARTA: Global health workers are already concerned about recent findings in Indonesia that suggest they have discovered a new strain of the deadly H5N1 Avian Flu that is more dangerous and virulent than others.

The new strain killed hundreds of thousands of ducks in the past few weeks and there are concerns that the virus could spread to humans.

"We found a highly pathogenic avian influenza sub-type H5N1 (virus) with clade 2.3..." the agriculture ministry's veterinary chief Syukur Iwantoro said in the letter obtained by AFP and quoted on Tuesday in a report.

"This clade is a new clade found for the first time in Indonesia, that is very different to the avian influenza found before, which is clade 2.1."

A clade is a group of organisms, usually species, with a common ancestor, doctors said.

A poultry breeders' association had reported the death of more than 300,000 ducks in several provinces on Java island since November to the ministry.

The veterinary office found the H5N1 virus involved was a different clade to that usually found in Indonesia, said Iwantoro's letter to local government offices and the World Health Organization (WHO).

Avian Flu has killed scores of people and millions of birds over the past few years, but is not transmittable from human to human contact, but medical professionals fear that if the virus were to mutate and be communicable for humans, it could devastate populations.

(source: www.bikyamasr.com)

(6/15/2012) BIMC Hospital Group has formed a partnership with the Courtyard by Marriott Bali to pioneer Bali's first-ever medical tourism packages and services to inbound travelers visiting Asia's most popular island destination.

Inaugurated on May 5, 2012 by Indonesian Minister of Tourism and Creative Economy, Mari Elka Pangestu, along with officials from the Ministry of Health and the Balinese government, the internationally managed BIMC Hospital in addition to outpatient, inpatient and emergency medical care, offers the country's most advanced dialysis treatments, surgical and non-surgical cosmetic procedures as well as dental care.

Its second hospital after the long established BIMC Hospital in Kuta, the BIMC Hospital in Nusa Dua, located along a palm-fringed boulevard in the integrated resort complex of Nusa Dua. Adjacent to the new hospital, the Courtyard by Marriott Bali is complementing the services provided by BIMC Hospital by with specific aftercare services to its guests seeking treatment from the neighboring medical facility.

"Ahead of BIMC Hospital opening, we began planning and training for the best of comfort and care the moment a guest returns to the resort from their medical procedure," said Courtyard by Marriott general manager, Jeff Tyler. "We carefully looked at services that aid in recuperation such as special diets and nutrition, unique spa and wellness programs as well as ensuring wheel chair access to all areas of the property."

The resort is the first property in Indonesia to coordinate specialized medical services such as aftercare visits by BIMC Hospital nurses.

"We value the partnership with the Courtyard by Marriott resort as care and safety should carry on after our clients complete their medical procedures," said BIMC Hospital Group founder and CEO, Craig Beveridge. "The Courtyard resort is conveniently located nearby and offers complementing services and standards not to mention an ideal spot for pre –and-post procedure rest and relaxation."

BIMC Hospital chief medical director, Dr. Donna Moniaga, presides over a team of medical professionals from Australia, Indonesia, USA, UK, Germany, Sweden and New Zealand.

"The hospital is equipped for complex surgeries with three operating theatres along with our CosMedic™, dialysis and dental facilities all of which could easily rival any hospital anywhere," said BIMC chief marketing officer, Roland Staehler. "We refer to our elective programs as our three 'centers of excellence' and true to the nature of medical tourism, we are further distinguished by offering affordable healthcare."

The 50-bed hospital is set in a lush, one-hectare site planned with a 24-hour medical emergency entrance and hotel-like foyer at the front of the building servicing the hospital's medical, dialysis and dental centers. The facility is also boast a private entrance that leads to the CosMedic Centre with its contemporary interior and views onto a golf course.

"I can't think of a better place in the sun to visit for medical reasons," said Tyler. "With the convenience of BIMC's location and professional services within what is a completely integrated resort experience, medical tourism in Bali will no doubt add to the long list of reasons to visit the island."

(source: www.balidiscovery.com)

Nearly 80 percent of Indonesians aged 15 to 24 are at risk of being infected with sexually transmitted diseases, including HIV/AIDS, due to lack of knowledge.

"According to our rapid survey in 2011, only 20.6 percent of youths aged 15 to 24 have comprehensive knowledge [about sexually transmitted diseases]," Minister of Health Nafsiah Mboi told a press conference on Wednesday ahead of the annual National Condom Week.

The figure makes reaching this year's target of 85 percent awareness about sexually transmitted disease among Indonesian youths seem far-fetched. For 2014, the ministry has set a seemingly unattainable goal of 95 percent awareness.

But Nafsiah said her office is not giving up on that dream yet, refusing to settle on a more realistic target highlighting a recent study that found that 42.3 percent of people with HIV/AIDS are between the ages of 20 and 29 while 33.1 percent are between 30 and 39.

"These people were infected years ago, which means that they were still teenagers [when they contracted HIV]," she said of the first age group. "Which is why we target teenagers."

Nafsiah said that if low HIV/AIDS awareness continued, the rate of high-risk sexual activity would remain high.

"There are a lot of Indonesian youths committing high-risk activities, particularly in having sex. Abortion among youths is also on the rise," she said.

The National AIDS Commission estimated in 2025 there would be 1.8 million people with HIV/AIDS in Indonesia but added that a proper prevention program would save around 1.1 million lives.

Data gathered in the January to September period by the West Java Health Agency showed 7,308 new HIV cases and 319 new AIDS cases in West Java.

The data also revealed a shift in the groups being infected, with 747 housewives infected with HIV over the past two years compared to only 464 cases reported from commercial sex workers.

The cumulative amount of HIV/AIDS cases in West Java since 1989 has reached 14,596, the fourth highest in the country after Jakarta, East Java and Papua.

Cianjur district head Tjetjep Muchtar Soleh said that the high number of housewives infected meant that many of their husbands visited prostitutes.

Several groups like the Indonesian Family Planning Association have called for a regulation penalizing those who visit prostitution dens. But the Indonesia AIDS Coalition executive director Aditya Wardhana said the move would be counterproductive.

"Criminalizing [those visiting prostitution dens] will not solve the root cause of the problem ... which we all know stems from poverty, human trafficking and low access to education among women," he said.

"Instead of providing protection, regulations [like this] will make the 'key population' more vulnerable to HIV infection. It is wrong for Indonesia to apply policies other countries have proven to be counterproductive in AIDS prevention."

(source: www.thejakartaglobe.com)