A few months ago, Bangladesh witnessed a major emergency situation when Rana plaza building at savar collapsed that left thousands dead and many more disable. It had a devastating impact on their mental health also. Situations like these are likely to trigger or worsen existing mental health problems, especially whereas at the same time existing mental health infrastructure is weakened. However, Emergencies, in spite of their tragic nature and adverse effects on mental health are opportunities to build better mental health systems for those who need it.

Mental health is crucial to the overall well-being, functioning, and resilience of individuals, societies and countries recovering from emergencies. During and after emergencies, people are more likely to suffer from a range of mental health problems. A minority develops new and debilitating mental disorders; many others are in psychological distress. And those with pre-existing mental disorders often need even more help than before. When the plight of those suffering becomes known to the nation and the world, others often become motivated to provide assistance.

In spite of their tragic nature, many countries have capitalised emergency situations to build better mental health systems. In order to ensure that those faced with emergencies do not miss the opportunity for mental health reform, World Health Organisation published a new report "Building back better: sustainable mental health care after emergencies. The report documented cases from around the world show that it is possible to build mental health systems in the context of emergencies.

In a matter of years following the tsunami in 2004, mental health services in Indonesia's Aceh province were transformed from a sole institutional hospital to a functioning system of care, revolving around primary health care services and supported by secondary care through general hospitals.

The influx of displaced Iraqis into Jordan enabled pilot community-based mental health clinics to be established. The success of these clinics built momentum for broader reform across the country.

Sri Lanka is another fine example that was able to capitalise on the resources flowing into the country following the 2004 tsunami to leap forward in the development of its mental health services. Today, this community-based mental health system reaches most parts of the country.

Emergencies are not only mental health tragedies, but also powerful catalysts for achieving sustainable mental health care in affected communities. The surge of aid, combined with sudden, focused attention on the mental health of the population, creates unparalleled opportunities to transform mental healthcare for the long term.

We do not know when the next major emergency will be, but we do know that those affected will have the opportunity to build back better. We should take the Rana Plaza tragedy as an opportunity to transform our mental healthcare.

source: www.thedailystar.net

More than 300,000 people across Sudan have been affected by floods which killed almost 50 people this month, the UN's World Health Organisation said in a statement.

The data came as a new thunderstorm and strong winds on Thursday night rattled the Khartoum region, already suffering from what the UN said was the worst inundation in 25 years.

"Heavy rains and floods in Sudan have affected lives and properties of some 65,957 families or 320,000 people," WHO said in a report.

As of Wednesday, 48 people had been killed and 70 injured, while property damage has been reported in 14 of the country's 18 states, WHO said.

Interior Minister Ibrahim Mahmoud Hamed gave a higher death toll of 53 last week.

The WHO said one of the major health concerns was the collapse of almost 53,000 latrines.

In addition to damage from the flash floods which struck urban neighbourhoods earlier this month, the Blue Nile river in Khartoum has risen.

AFP reporters on Thursday saw the river had washed over about one kilometre (half a mile) of farmland in the east of the city, but a sand berm appeared to have been erected in an effort to block further intrusion.

"This is a huge disaster," Mark Cutts, who heads the UN's Office for the Coordination of Humanitarian Affairs in Sudan, said last week.

He said the UN is ready to support the government to help those affected by the floods, even though UN humanitarian operations in Sudan "have been severely underfunded" in 2013.

Aid workers were also assisting hundreds of thousands displaced this year by worsening fighting in the western Darfur region.

More than one million more have been uprooted or severely affected by war in South Kordofan and Blue Nile.

source: www.telegraph.co.uk

Health officials called Thursday for urgent action to tackle "alarming" rates of drug-resistant tuberculosis in Myanmar where nearly 9,000 people catch the strain of the infectious disease each year.

Treatment programs in the impoverished nation — where the healthcare system was left woefully underfunded during decades of military rule — are expensive and ineffective leaving the deadly illness to spread unchecked, experts warned at a Yangon forum on the issue.

"Forms of TB that cannot be treated with standard drugs are presenting at an alarming rate in the country, with an estimated 8,900 people newly infected each year," Doctors Without Borders (MSF) said in a statement.

The drug-resistant strain can still be treated, but analysis has shown that patients often have to take up to 20 pills a day and endure months of painful injections — although even up to two years of medication is not guaranteed to work.

"Yet only a fraction — 800 by the end of 2012 — receive treatment. Untreated, the airborne and infectious disease is fatal," it said, adding care for the drug-resistant strain must "scale up country-wide to save lives and stem the unchecked crises."

Myanmar, which is undergoing sweeping political and economic reforms, will publish results of a nationwide TB survey by the end of the year, a health ministry official said, adding currently there is enough medicine for just 500 patients with the drug-resistant strain.

They have been identified in just 38 townships across the vast country and there is so far no accurate measure of the disease's spread.

Resistance to TB drugs develops when treatment fails to kill the bacteria that causes it — either because the patient fails to follow their prescribed dosages or the drug does not work.

"The gap is enormous," said Thandar Lwin who manages the country's TB program for the Ministry of Health.

"We need laboratory facilities, human resources and funding," she said, adding treatment is made more complex because up to 10 percent of people with the illness also suffer from HIV. TB was declared a global health emergency by the World Health Organization (WHO) 20 years ago, but remains a leading cause of death by an infectious disease.

On its website, the UN agency says at least $1.6 billion is needed annually to prevent the spread of the disease.

Estimates for 2011 put the prevalence of TB in Myanmar at 506 sufferers per 100,000 of the population, compared to a regional average of 271 and a global figure of 170.

Over 95 percent of TB deaths occur in low and middle-income countries. Global health experts warned in March of the looming risk of an entirely untreatable strain of TB emerging. — AFP

source: www.saudigazette.com.sa

A new World Health Organization's (WHO) report has noted that humanitarian agencies work hard to help people with their mental health and psychosocial needs in the aftermath of emergencies.

It however, said too often opportunities are missed to strengthen mental health systems for the long-term.

The report provides guidance for strengthening mental health systems after emergencies and examples from Afghanistan, Burundi, Indonesia (Aceh Province), Iraq, Jordan, Kosovo, Somalia, Sri Lanka, Timor-Leste, and West Bank and Gaza Strip.

The report, "Building back better: Sustainable mental health care after emergencies," released to mark World Humanitarian Day (August 19), was made available to the Ghana News Agency on Monday by Tarik Jasarevic, WHO Communications Officer.

Contributors from each area reported not only their major achievements, but also their most difficult challenges and how they were overcome.

"In spite of their tragic nature, emergency situations are opportunities to improve the lives of large numbers of people through improving mental health services," says Dr Bruce Aylward, WHO's Assistant Director-General overseeing the Organization's work in humanitarian emergencies. "We can do better for emergency-affected populations by working with the government on sustainable mental health care from the outset."

It provides guidance for strengthening mental health systems after emergencies, and focuses on 10 cases, where countries have taken advantage of this opportunity.

It said Aceh like many provinces in Indonesia, had only institution-based care before the tsunami of 2004, however, today, most districts have primary mental health services supported by secondary care at district general hospitals.

The report noted that in Iraq since 2004, significant progress has been made toward the creation of a comprehensive mental health system, with more than 50 per cent of general practitioners having received mental health training.

It said in Sri Lanka, since the 2004 tsunami, a new national mental health policy has guided reform, which now extends to most parts of the country. Several new cadres of community-based mental health workers have been developed.

It held that the possibilities presented by emergency situations are significant because major gaps remain worldwide in the realization of comprehensive, community-based mental health care.

"The current situation is alarming," says Dr Shekhar Saxena, WHO Director for Mental Health. "Health systems have not yet adequately responded to the burden of mental disorders. We know that the vast majority of people with severe mental disorders receive no treatment whatsoever in low-income and middle-income countries."

Transforming the mental health care systems in turn would improve the well-being, functioning, and resilience of individuals, societies, and countries recovering from emergencies, the report notes.

By releasing this report, WHO aims to help guide policymakers to reform their mental health systems, especially those which may be susceptible to future emergencies.

Already in 2013, the world has witnessed numerous emergency situations, from the crisis in Syria and neighbouring countries to heavy fighting in Mali and the Central African Republic, major flooding in parts of the Americas, Africa, and Asia, and others.

source: www.ghana.gov.gh

The World Health Organization (WHO) recently released new clinical guidelines for health care workers treating the mental health needs of people who have experienced trauma and loss. These guidelines are particularly significant because they reinforce the importance of including mental health care in humanitarian responses post-crisis.

As one of the largest torture survivor rehabilitation centers in the world, the Center for Victims of Torture provides mental health care to survivors of torture and war atrocities in areas of the world where few mental health resources are available.

Despite the widespread need for mental health services among populations coping with the aftermath of brutal conflicts, there are often few, if any, resources to address their complex needs. The psychological effects of torture and traumatic experiences during war can include anxiety, depression, and post-traumatic stress disorder. However, many primary care professionals are under-equipped to deal with these needs, leaving symptoms go untreated, and the increased potential that individuals, families, and communities are unable to rejoin society in a meaningful and productive way.

Fortunately, the WHO guidelines emphasize the need for integrating and understanding reactions to extreme stress and trauma in primary care. For survivors of psychological trauma and their mental health care providers, this increasingly comprehensive set of guidelines is essential.

The WHO guidelines are also an important next step in advancing access to mental health care in places of great need across the globe. Though this is an important step, it is not the final step. CVT joins WHO in the call for governments and donors to include funding for quality mental health interventions. Funding for training and supervision is essential in order to implement the guidelines, and further research is needed in order to expand the understanding of recommended effective interventions.

At a time when thousands of survivors of torture and war atrocities are waiting to receive the mental health care they so urgently need, increased financial support from the international community must be forthcoming.

source: www.huffingtonpost.com

A 9-year-old boy from northwestern Battambang province died of Avian Influenza H5N1 at Sunday night, bringing the death toll to ten and the number of the cases to 16 so far this year, a World Health Organization official confirmed Monday.

"The boy, contracted with H5N1 human avian influenza, passed away late last night in the Jayavarman VII Hospital in Siem Reap province," Sonny Inbaraj Krishnan, media relations officer at the World Health Organization-Cambodia, said Monday.

The boy was admitted to the hospital with fever, cough, vomit, abdominal pain and dyspnea and was confirmed positive for human H5N1 avian influenza on Aug. 9.

"On hospital admission, he was initially in a stable condition. However, his condition deteriorated on Sunday and he passed away last night," he said.

"There were recent deaths among chickens and ducks in the village. The boy carried dead and sick ducks and chickens from a cage for food preparation by his sister before he became sick," he added.

Cambodia sees the worst outbreak of the virus this year since the disease was first identified in 2004. To date, the country has recorded 37 human cases of the virus, killing 29 people.

H5N1 influenza is a flu that normally spreads between sick poultry, but it can sometimes spread from poultry to humans, the World Health Organization said, adding that it is a very serious disease that requires hospitalization.

source: www.globaltimes.cn

Somalia is suffering an "explosive" outbreak of polio and now has more cases than the rest of the world combined, an official said Friday.

Vaccine-wielding health workers face a daunting challenge: accessing areas of Somalia controlled by al-Qaida-linked militants, where 7 of 10 children aren't fully immunized.

Polio is mostly considered eliminated globally except mainly in three countries where it is considered endemic: Afghanistan, Nigeria and Pakistan. India marked a major success in February 2012 by being removed from the World Health Organization's list of countries plagued by the disease.

Somalia now has 105 cases, figures released Friday show, and another 10 cases have been confirmed across the border in a Kenyan refugee camp filled with Somalis. Globally there have been 181 cases of polio this year, including those in Somalia and Kenya.

Vaccination campaigns in Somalia have reached 4 million people since the outbreak began in May, but those health officials have limited access to about 600,000 children who live in areas of Somalia controlled by the armed Islamist group al-Shabab.

"It's very worrying because it's an explosive outbreak and of course polio is a disease that is slated for eradication," said Oliver Rosenbauer, a spokesman for the Global Polio Eradication Initiative at the World Health Organization in Geneva. "In fact we're seeing more cases in this area this year than in the three endemic countries worldwide."

In a bit of good news, Rosenbauer said in a phone interview with The Associated Press that polio numbers are down in the three remaining endemic countries.

"The only way to get rid of this risk is to eradicate in the endemic countries, and there the news is actually paradoxically very good," he said.

Somalia was removed from the list of endemic polio countries in 2001, and this year's outbreak is the second since then.

It began one month after Bill Gates helped unveil a six-year plan to eradicate polio at the Global Vaccine Summit. That effort will cost $5.5 billion, three-quarters of which has already been pledged, including $1.8 billion from the Bill and Melinda Gates Foundation.

The outbreak in Somalia does not set back the six-year plan, said Rosenbauer, because unpredictable and intermittent outbreaks were programmed into the timeline.

In al-Shabab controlled south-central Somalia, disease surveillance is functioning, but health officials are likely not able to detect all polio cases.

Mohamud Yasin, a retired doctor who has treated polio throughout his career, said: "It's indeed worrying because this comes at a time when the country is still hugely affected by the raging fighting, which prevents volunteers from accessing people in need of vaccines. It may take time before we can confidently say we have universal coverage of the immunization."

In a sign of how difficult it is for medical providers to operate in Somalia, the aid group Doctors Without Borders announced this week it was pulling out of the country after 22 years because of attacks on its staff members. MSF, as the group is also known, was not taking part in the polio vaccination campaign.

Somalia shares one significant trait with the three endemic countries: pockets of severe violence where populations can be hostile to health care workers. In February, gunmen believed to belong to a radical Islamic sect known as Boko Haram shot and killed at least nine women taking part in a polio vaccination drive in northern Nigeria.

Polio, for the moment, has been defeated in two areas of Pakistan. But in one region where the disease persists — the dangerous North and South Waziristan region near the Afghanistan border — local authorities have banned immunization campaigns since mid-2012. Vaccination programs, especially those with international links, have come under suspicion since a Pakistani doctor ran a fake vaccination program to help the CIA track down Osama bin Laden.

"So no immunizations are taking place, and sure that's a challenge and that has to be addressed," said Rosenbauer. Still, he noted that nine times out of 10 when a child isn't immunized in Pakistan it's because of operational issues, not social resistance.

Southern Afghanistan hasn't recorded any polio cases since November, a story of success after years of failure there. Afghanistan saw 37 polio cases last year but only four so far this year. Polio cases are also down in Nigeria year-over-year, but about the same in Pakistan.

When the Global Polio Eradication Initiative was launched in 1988, the disease was endemic in 125 countries and paralyzed about 1,000 children per day. Since then the incidence of polio has decreased by more than 99 percent. Five children have been paralyzed in Somalia's recent outbreak.

At the April summit, Gates talked about the need to vaccinate the hardest-to-reach children in the endemic countries.

Eradicating the last cases has proved difficult. The World Health Organization knows the Somalia outbreak came from West Africa but can't say exactly where. In 2011, the virus jumped from Pakistan to China, and the year before that to Tajikistan. There have been more than 50 outbreaks in the last decade.

Poliovirus is very contagious. The virus lives in an infected person's throat and intestines. It spreads through contact with the feces of an infected person and through droplets from a sneeze or cough.

source: www.trivalleycentral.com

Healthcare-associated infections (HAIs) are costly and deadly and becoming a national crisis, according to the Alliance for Aging Research.

Some 1.7 million Americans develop hospital-acquired HAIs each year at a cost ranging from $28.4 billion to $5 billion, the Washington nonprofit noted in a fact sheet released Monday.

And roughly 45% of hospital-acquired HAIs are in patients older than 65, according to Thomas File, MD, president of the National Foundation for Infectious Diseases.

"I think there's a huge emphasis on prevention and control of healthcare-associated infections and antimicrobial resistance among the infectious disease physician and nurse community," Victoria Fraser, MD, a professor of infectious disease at the Washington University School of Medicine in St. Louis, said. "I think the importance of this fact sheet is making it more broadly emphasized across other industries and other populations."

File and Fraser spoke Monday on a call with reporters about the fact sheet, the latest addition to the Alliance's "Silver Book," a searchable database.

"When infections do occur in the older population, the burden of illness is high and often the outcome is less favorable," File added.

With 10,000 baby boomers turning 65 every day, there are more opportunities to increase prevention efforts and research activities, they said.

For example, more work is needed to understand HAIs outside the intensive care unit, in long-term care, rehab and dialysis facilities, and ambulatory surgical centers, Fraser said.

"We also need specific research programs focused on cancer patients and the elderly that will deal with how to improve our environmental decontamination, cleaning, and disinfecting to reduce the burden of antimicrobial organisms," Fraser said.

Aging contributes to decreased protections from infections such as changes to the skin and lungs. Immune response is weakened by more chronic conditions such as heart disease which accumulate through time. As a result, older patients are two to five times more likely to develop a HAI.

The most common types of HAIs are bloodstream infections related to central lines, catheter-associated urinary tract infections, ventilator-associated pneumonia, and surgical site infections. Clostridium difficile infections are another common HAI -- and 75% of those start outside the hospital, in nursing homes and physician offices.

The rise in antibiotic resistance just adds to the problem -- about 70% of hospital-acquired HAIs are resistant to at least one drug.

The Alliance for Aging Research hopes release of the fact sheet will spur activity in fields beyond infectious disease.

"I think we're trying to ramp up interest and emphasis in geriatrics, in endocrinology, in cardiology, among multiple subspecialties, not just infectious disease about this important problem," Fraser said.

The six-page fact sheet compiles information from previous reports such as the number of hospital-linked infections.

There is also a large section devoted to proven prevention efforts.

source: www.medpagetoday.com