SuSanA - Forum Kunena Site Syndication http://forum.susana.org/ Sat, 28 Mar 2015 03:57:01 +0000 Kunena 1.6 http://forum.susana.org/components/com_kunena/template/default/images/icons/rss.png SuSanA - Forum http://forum.susana.org/ en-gb Re: Sanitation in Hospitals - by: Marijn Zandee http://forum.susana.org/forum/categories/26-health-issues-and-connections-with-sanitation/12537-sanitation-in-hospitals#12593 http://forum.susana.org/forum/categories/26-health-issues-and-connections-with-sanitation/12537-sanitation-in-hospitals#12593
How to engage a government, that often is a complicated question .

For the project at BIR, what happened (in summary) is that some very motivated Nepalis, with technical support from international organizations, convinced the hospital director that this could happen. Thankfully the director was convinced and supported the project fully, this was very important!

BIR is now an example in Nepal, and with a lot of lobby work from HECAF and some big and small international organizations the government is now pushing hospitals to follow the lead of BIR. The big question here now is how to manage the correct implementation of a quite complicated system (complicated in terms of behavior changes and management)in a large number of hospitals in a relatively small amount of time.]]>
Health issues and connections with sanitation Tue, 24 Mar 2015 10:48:07 +0000
Re: Sanitation in Hospitals - by: F H Mughal http://forum.susana.org/forum/categories/26-health-issues-and-connections-with-sanitation/12537-sanitation-in-hospitals#12547 http://forum.susana.org/forum/categories/26-health-issues-and-connections-with-sanitation/12537-sanitation-in-hospitals#12547
That Bir Hospital video, though very short, is extremely interesting and useful. In the video, what you see in the first few frames, is the situation here in Pakistan. It was great to see how Bir Hospital changed its waste management. If possible, please post more such videos. Make sure, it is not on youtube, as it is banned in Pakistan.

The names of the editors of the WHO Blue Book are enough to suggest that the book is full of useful information. I see some big names as editors.

Just 1 minor query: how can be the government here be sensitized to improve the hospital waste management?

Smiles,

F H Mughal]]>
Health issues and connections with sanitation Sat, 21 Mar 2015 10:06:37 +0000
Re: Sanitation in Hospitals - by: Marijn Zandee http://forum.susana.org/forum/categories/26-health-issues-and-connections-with-sanitation/12537-sanitation-in-hospitals#12545 http://forum.susana.org/forum/categories/26-health-issues-and-connections-with-sanitation/12537-sanitation-in-hospitals#12545

Thanks for sharing this report. Healthcare waste management is a field that is close to my heart. In Nepal, some very interesting and pioneering work is done by friends of mine. In the article linked below, you will find a video (vimeo.com/90137654) showing that healthcare waste management can be done right in the developing world.

noharm-global.org/articles/news/global/h...ty-health-care-nepal

Further, for anyone involved in waste, or waste water, management solutions in hospitals or other healthcare facilities, I would really recommend the “ WHO Blue Book”.

apps.who.int/iris/bitstream/10665/85349/1/9789241548564_eng.pdf

Regards

Marijn]]>
Health issues and connections with sanitation Sat, 21 Mar 2015 03:56:38 +0000
Sanitation in Hospitals - by: F H Mughal http://forum.susana.org/forum/categories/26-health-issues-and-connections-with-sanitation/12537-sanitation-in-hospitals#12537 http://forum.susana.org/forum/categories/26-health-issues-and-connections-with-sanitation/12537-sanitation-in-hospitals#12537
Sanitation in Hospitals

Sanitation in government hospitals in poor developing countries is pathetic. Solid waste produced by the hospitals, is simply dumped outside, along the boundary wall of the hospitals. In some cases, a cement-concrete bunker, with open top, is constructed just outside of the hospitals’ premises, where all solid waste is dumped.

The sanitation aspect in hospitals is most hopeless. Inadequate and poorly ventilated toilets exist in most government hospitals. The toilets are cleaned only once in a day and, they remain dirty all day long. Coupled with safe water and hygiene, clean toilets are critical for health in hospitals.

A WHO brief (WHO/UNICEF Report: Water, Sanitation and Hygiene in Health Care Facilities: status in low-and middle-income countries and way forward - Question and Answer), gives health consequences of inadequate WASH services in hospitals. The brief says:

Healthcare associated infections affect hundreds of millions of patients every year, with 15% of patients estimated to develop one or more infections during a hospital stay (Allegranzi et al., 2011). Among newborns, sepsis and other severe infections are major killers estimated to cause 430,000 deaths annually. The risks associated with sepsis are 34 times greater in low resource settings (Oza et al., 2015). Lack of access to water and sanitation in health care facilities may discourage women from giving birth in these facilities or cause delays in care-seeking (Velleman et al., 2014). Conversely, improving WASH conditions can help establish trust in health services and encourage mothers to seek prenatal care and deliver in facilities rather than at home -important elements of the strategy to reduce maternal mortality (Russoet al., 2012).

A recent (2015) WHO-UNICEF publication titled: “Water, sanitation and hygiene in health care facilities Status in low- and middle-income countries and way forward – WASH in Health Care Facilities for better health care services,” is available at:

apps.who.int/iris/bitstream/10665/154588...1508476_eng.pdf?ua=1

The publication is useful and informative and, is expected to be of great interest to the forum users.


F H Mughal]]>
Health issues and connections with sanitation Thu, 19 Mar 2015 16:59:59 +0000
Re: Question re: latrine sludge temperatures and Ebola - by: JKMakowka http://forum.susana.org/forum/categories/26-health-issues-and-connections-with-sanitation/11541-question-re-latrine-sludge-temperatures-and-ebola#12458 http://forum.susana.org/forum/categories/26-health-issues-and-connections-with-sanitation/11541-question-re-latrine-sludge-temperatures-and-ebola#12458 joeturner wrote:
New research just published on Ebola survival in faeces:

pubs.acs.org/doi/abs/10.1021/acs.estlett.5b00029


Can't access the full article, but I would advise caution with the 30°C figures. The longer survival times of the substitute bacterio-phage at 22°C is likely an adaption to natural environment. The Ebola virus might on the other hand show the opposite pattern as its "natural" environment should be closer to body temperature.

Edit: it should also be noted that the infectious dose of Ebola is relatively low and thus 99.99% reduction of highly contaminated faeces might not be sufficient.

Btw for reference, I came across this article describing the occurance of Ebola virus in stool samples, but the urine seems to be not a transmission vector: m.jid.oxfordjournals.org/content/196/Supplement_2/S142.long]]>
Health issues and connections with sanitation Thu, 12 Mar 2015 12:34:11 +0000
Re: Question re: latrine sludge temperatures and Ebola - by: joeturner http://forum.susana.org/forum/categories/26-health-issues-and-connections-with-sanitation/11541-question-re-latrine-sludge-temperatures-and-ebola#12453 http://forum.susana.org/forum/categories/26-health-issues-and-connections-with-sanitation/11541-question-re-latrine-sludge-temperatures-and-ebola#12453
pubs.acs.org/doi/abs/10.1021/acs.estlett.5b00029]]>
Health issues and connections with sanitation Thu, 12 Mar 2015 06:48:05 +0000
Sanitation in Pakistan - by: F H Mughal http://forum.susana.org/forum/categories/26-health-issues-and-connections-with-sanitation/12425-sanitation-in-pakistan#12425 http://forum.susana.org/forum/categories/26-health-issues-and-connections-with-sanitation/12425-sanitation-in-pakistan#12425
Sanitation in Pakistan


Ms. Geeta Rao Gupta, Deputy Executive Director, UNICEF, recently visited Pakistan. According to the news (Dawn, 9 March 2015, www.dawn.com), she said that there are 41 million people who do not have access to a toilet in Pakistan and as a result they are defecating in the open. Open defecation has significant health and nutritional consequences, Ms. Geeta Rao Gupta said.

She further said: “Open defecation is a major contributor to stunting and that’s why we’ve got to do all we can to stop it.” Pakistan is the third largest country when it comes to people going to the bathroom in the open, behind India and Indonesia. The problem can spread disease and lead to intestinal infections, which can contribute to stunting in young children, she said. Stunting means children don’t grow as tall as they would otherwise, and it can also affect a child’s brain development. Stunted children are more at risk of disease, don’t do as well in school and stunted mothers can also give birth to stunted children.

UNICEF is working with the Pakistani government to improve sanitation by doing things like encouraging people to wash their hands more often. They’re also working with communities to help them build toilets so they don’t have to use the bathroom in a field or elsewhere. Building more toilets is also vital for empowering women and girls and keeping them in school, Ms Gupta said. If women have to walk long distances to find a private place to relieve themselves, they are more vulnerable and exposed to attack. They’re also less likely to go to school if there are no toilets. “Having toilets is a big advantage to girls,” she said.

F H Mughal]]>
Health issues and connections with sanitation Tue, 10 Mar 2015 06:18:34 +0000
Re: 3rd WHO on Report on NTD's (Neglected Tropical Diseases): Opportunities and Challenges - by: muench http://forum.susana.org/forum/categories/26-health-issues-and-connections-with-sanitation/12262-3rd-who-report-on-ntds-neglected-tropical-diseases-opportunities-and-challenges#12312 http://forum.susana.org/forum/categories/26-health-issues-and-connections-with-sanitation/12262-3rd-who-report-on-ntds-neglected-tropical-diseases-opportunities-and-challenges#12312
Thanks for your post. Could you tell us a bit more about yourself, namely in which capacity did you attend that launch in London? Were there others from the WASH sector as well or were you a "lone voice"?

I find the discourse on neglected tropical diseases (NTDs) very interesting. I learnt a lot about it by reading and improving the Wikipedia article on NTDs. I think it is quite a good article now, and I inserted some links to WASH issues and focussed in particular on the helminthiasis as I find that very important.

en.wikipedia.org/wiki/Neglected_tropical_diseases

The article should have more photos though, at the moment it only has one. If you can think of other improvements that should be made, in particular to strengthen the links to WASH issues, please let me know (or edit them directly in Wikipedia).

One important reason why this article is so good is because it was once a student assignment and this student was rather good! See here on the talk page from one year ago:

Plans for Editing Article

I am an undergraduate student at Rice University in Houston, TX and am planning on editing this article as part of a Poverty, Justice, and Human Capabilities class. I would like to expand this article and add more information about the specific diseases and their sociological impact. [...]

I understand the reasoning behind removing the “tropical” aspect of neglected tropical diseases, but since this is a specific term for a category of diseases recognized by the WHO, CDC, and many researchers, that occur primarily in the tropics, I think it is better to keep the term “tropical” in the title. I will, however, research whether there are any other diseases that “neglected” by the neglected tropical disease category.

I would welcome any feedback that anyone has on this.Juliannadrew (talk) 21:58, 20 February 2014 (UTC)


I am just mentioning this as an example because I always encourage lecturers to get their students involved in editing Wikipedia articles...

One thing I didn't realise until working on these articles is that not all helminth infections fall in the category of NTDs! To make this point clearer, I wrote this section on the helminthiasis page:

en.wikipedia.org/wiki/Helminthiasis#Neglected_tropical_diseases

Neglected tropical diseases
Among all helminthiases, the following helminth infections are classified under neglected tropical diseases:[2][27]

  • All soil-transmitted helminthiases
  • Roundworm infections such as lymphatic filariasis, dracunculiasis and onchocerciasis
  • Trematode infections such as schistosomiasis and food-borne trematodiases (including fascioliasis, clonorchiasis, opisthorchiasis, and paragonimiasis)
  • Tapeworm infections such as cysticercosis, taeniasis, and echinococcosis



I would have thought that it's easier to put simply all helminthiasis into the group of NTDs - does anyone know why this wasn't done?

Regards,
Elisabeth]]>
Health issues and connections with sanitation Mon, 02 Mar 2015 13:18:58 +0000
Re: 3rd WHO on Report on NTD's (Neglected Tropical Diseases): Opportunities and Challenges - by: F H Mughal http://forum.susana.org/forum/categories/26-health-issues-and-connections-with-sanitation/12262-3rd-who-report-on-ntds-neglected-tropical-diseases-opportunities-and-challenges#12297 http://forum.susana.org/forum/categories/26-health-issues-and-connections-with-sanitation/12262-3rd-who-report-on-ntds-neglected-tropical-diseases-opportunities-and-challenges#12297
This is a interesting WHO, and your question on WASH integration is most pertinent. The WHO report does not carry names of authors. I suggest that, if you can hold of focal person at WHO, perhaps, you can send email to that focal person and seek the answer.

Regards,

F H Mughal]]>
Health issues and connections with sanitation Sun, 01 Mar 2015 06:52:38 +0000
3rd WHO Report on NTD's (Neglected Tropical Diseases): Opportunities and Challenges - by: RobynChristine http://forum.susana.org/forum/categories/26-health-issues-and-connections-with-sanitation/12262-3rd-who-report-on-ntds-neglected-tropical-diseases-opportunities-and-challenges#12262 http://forum.susana.org/forum/categories/26-health-issues-and-connections-with-sanitation/12262-3rd-who-report-on-ntds-neglected-tropical-diseases-opportunities-and-challenges#12262
While attending the launch event in London, I posed a question to donors in the room seeking a response on their intentions of ensuring WASH integration in future investment. Not much of a response was given. There is more work to be done to integrate WASH into NTD policy to ensure the sustained elimination of disease. Stayed tuned for the results of a project WaterAid is currently working on with SightSavers and Emory - the development of proposed WASH and NTD sector joint monitoring (with prioritized indicators and feasible metrics).

Report attached and accessible from: www.who.int/neglected_diseases/en/]]>
Health issues and connections with sanitation Thu, 26 Feb 2015 14:52:41 +0000
Re: Geophagy - the cultural practices of eating soil - common in many sub-Saharan countries? - by: joeturner http://forum.susana.org/forum/categories/26-health-issues-and-connections-with-sanitation/8092-geophagy-the-cultural-practices-of-eating-soil-common-in-many-sub-saharan-countries?limit=12&start=12#12249 http://forum.susana.org/forum/categories/26-health-issues-and-connections-with-sanitation/8092-geophagy-the-cultural-practices-of-eating-soil-common-in-many-sub-saharan-countries?limit=12&start=12#12249
A study conducted in rural KwaZulu Natal among school children (median age 11) found that 53% of girls and 37% of boys practiced geophagia; the practice decreased with age for boys but not for girls and was more common among children from families of higher socio-economic status
]]>
Health issues and connections with sanitation Wed, 25 Feb 2015 09:34:34 +0000
Re: Geophagy - the cultural practices of eating soil - common in many sub-Saharan countries? - by: SudhirPillay http://forum.susana.org/forum/categories/26-health-issues-and-connections-with-sanitation/8092-geophagy-the-cultural-practices-of-eating-soil-common-in-many-sub-saharan-countries?limit=12&start=12#12247 http://forum.susana.org/forum/categories/26-health-issues-and-connections-with-sanitation/8092-geophagy-the-cultural-practices-of-eating-soil-common-in-many-sub-saharan-countries?limit=12&start=12#12247
You may contact Bobbie herself ( This e-mail address is being protected from spambots. You need JavaScript enabled to view it ) or Jay Bhagwan ( This e-mail address is being protected from spambots. You need JavaScript enabled to view it ).]]>
Health issues and connections with sanitation Wed, 25 Feb 2015 08:58:27 +0000
Re: Geophagy - the cultural practices of eating soil - common in many sub-Saharan countries? - and helminthic therapy - by: hadley http://forum.susana.org/forum/categories/26-health-issues-and-connections-with-sanitation/8092-geophagy-the-cultural-practices-of-eating-soil-common-in-many-sub-saharan-countries?limit=12&start=12#12233 http://forum.susana.org/forum/categories/26-health-issues-and-connections-with-sanitation/8092-geophagy-the-cultural-practices-of-eating-soil-common-in-many-sub-saharan-countries?limit=12&start=12#12233 [Start of Page 2 of the discussion thread]

Hi Joe,

I'm new to this forum, so please excuse any breaches of etiquette. I haven't read the whole thread, so forgive me if you've heard all this before.

The area of my practice is largely subtropical with hot and humid summers and warm dry winters. I suspect that the summer months, December, January and February, are the ones most enjoyed by helminths. There are two possible depths at which the ova could be acquired. Where "night soil" (human faeces) is used as a fertilizer it may be dug into the field or garden. Viable ova may then be deposited a spade's depth into the soil. More commonly surface contamination results in easier access! We looked at ova counts as an index of the severity of infestation and found some of our children were excreting 30,000 ova per gram of stool. If the worms all matured and were laid end to end they would stretch over 4 kms. Multiply that by the mass of the stool and the scale of the problem becomes clear!! I don't know anything about the survival of buried ova but their environment is likely to be warm and damp which would surely aid their survival.
I'm not aware of any data relating to soil temperatures, but there are a lot of things of which I am not aware. They probably exist somewhere.

Children may eat soil accidentally by sucking dirty fingernails or it may be given as part of a traditional potion. Pregnant women apparently do it to address a real or perceived mineral deficiency.
Hakuna matata

Larry Hadley]]>
Health issues and connections with sanitation Tue, 24 Feb 2015 11:35:19 +0000
Re: Geophagy - the cultural practices of eating soil - common in many sub-Saharan countries? - by: muench http://forum.susana.org/forum/categories/26-health-issues-and-connections-with-sanitation/8092-geophagy-the-cultural-practices-of-eating-soil-common-in-many-sub-saharan-countries?limit=12&start=12#12216 http://forum.susana.org/forum/categories/26-health-issues-and-connections-with-sanitation/8092-geophagy-the-cultural-practices-of-eating-soil-common-in-many-sub-saharan-countries?limit=12&start=12#12216 en.wikipedia.org/wiki/Helminthic_therapy

The first sentence states:
"Helminthic therapy, an experimental type of immunotherapy, is the treatment of autoimmune diseases and immune disorders by means of deliberate infestation with a helminth or with the ova of a helminth."

I have no idea whether this Wikipedia page is accurate or not, I just wanted to mention its existence.

Apart from that I personally think this thread is becoming off-topic now (see Rule number 8 here: forum.susana.org/forum/rules) as the purpose of this forum is not to discuss all sorts of health hypotheses and alternative treatment methods for all sorts of ailments. There is other discussion forums for that out there. This is my personal opinion.


[End of Page 1 of the discussion thread]]]>
Health issues and connections with sanitation Mon, 23 Feb 2015 21:09:54 +0000
Re: Geophagy - the cultural practices of eating soil - common in many sub-Saharan countries? - by: KeithBell http://forum.susana.org/forum/categories/26-health-issues-and-connections-with-sanitation/8092-geophagy-the-cultural-practices-of-eating-soil-common-in-many-sub-saharan-countries?limit=12&start=12#12215 http://forum.susana.org/forum/categories/26-health-issues-and-connections-with-sanitation/8092-geophagy-the-cultural-practices-of-eating-soil-common-in-many-sub-saharan-countries?limit=12&start=12#12215 Health issues and connections with sanitation Mon, 23 Feb 2015 18:07:38 +0000