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This Week's News
23-27 August 2010
Weekly news clippings service featuring articles on the Global Health Workforce Alliance and
selection of articles from around the world on the issue of the health workforce crisis
The Global Health Workforce Alliance ¦ News from WHO and partners ¦
Africa & Middle East ¦ Asia & Pacific ¦ North America ¦ Europe ¦ Latin
America & Caribbean
This compilation is for your information only and should not be redistributed
Global Health Workforce Alliance
Date
Headline
Publication
19.08.10
Migration of health personnel: interviews with country delegations at
the World Health Assembly 2010 
The Alliance
News from WHO and partners
Date
Headline
Publication
18.08.10
Alongside Syrian health workers, UNICEF battles varied causes of
malnutrition
UNICEF
23.08.10
Canada and Mali Sign Agreement to Advance Canada’s G-8 Muskoka
Initiative Commitment to Save the Lives of Mothers, Newborns and
Children Under Five
CIDA
18.08.10
Aid donors in Nepal agree to joint financing of better maternal and
child health 
GAVI Alliance
20.08.10
We are Treating Up To 800 Patients a Day 
Global Health
Council
Africa & Middle East
Date
Headline
Publication
18.08.10
Budaka transfers 39 health workers
20.08.10
Stakeholders urged to expand access to HIV treatment 
23.08.10
State goes to court over essential service workers
20.08.10
Angola com mais de mil 800 unidades sanitárias até 2009
Daily Monitor,
Uganda
Walfa Info.
Ethiopia
Dispatch Online,
SA
Angola Press
23.08.10
Strike Update: Health Workers in the Western Cape
24.08.10
Strike Jeopardizes HIV Treatment
24.08.10
Uganda: Breastfeeding Dilemma for HIV-Positive Mothers
1
Cape Gateway,
SA
IRIN PlusNews
Catholic
Information
Service for Africa
19.08.10
Health Workers Demand More Pay
19.08.10
Health Workers' Phones Making Impact - MOH
26.08.10
Cholera death toll rises to 352 
The Informer,
Liberia
New Times,
Rwanda
Nigerian Tribune
Asia & Pacific
Date
Headline
Publication
20.08.10
FP campaign to encourage couple to seek services, not population
control
PIA Daily News,
Philippines
25.08.10
PM: 3.5 mln Pakistani children at risk of waterborne diseases
China.org
20.08.10
Money, scholarships woo health, education workers to villages
Jakarta Post
26.08.10
Health workers refuse to join immunisation drive
Times of India
25.08.10
Hope Persists for Jailed Health Workers in Philippines
25.08.10
Aussies touch down in Pakistan
23.08.10
Regional health groups like poll result
18.08.10
Pregnant women warned — Hames
22.08.10
UN - UN DPI/NGO Conference in Australia to Attract Unprecedented
Number of Workshops, Wide Range of Round Tables on Global Health
Goals, 30 August – 1 September 
Inter Press
Service
Sydney Morning
Herald
Sydney Morning
Herald
Collie Mail,
Australia
ISRIA.com
North America
Date
Headline
Publication
20.08.10
Training lay health workers envisioned
The Herald-Sun
NC
20.08.10
Obama Seeks Boosts In Funds For AIDS Prevention, Research
18.08.10
Hillary Clinton Touts Global Health Initiative as Key Foreign Policy
Tool 
Wall Street
Jornal
Politics Daily
16.08.10
Smart Health | Simple Mobile Services Improve Maternal Health Care
in Developing Countries
TMCNet
21.08.10
Marshall University midwifery program off to slow start
21.08.10
Stanley says health care worker bill puts patients at risk
19.08.10
U.S., International Aid Helps Fight Disease in Pakistan Floods
Charleston
Gazette
Eagle-Tribune,
Mass
Media Newswire
18.08.10
ASEAN Workers Train for Pandemic Response
24.08.10
HHS Secretary Announces $32 Million to Support Rural Health
Priorities 
Voice of America
News
ExecutiveGov
Back to top
Europe
Date
Headline
Publication
21.08.10
Membership exams overseas in light of new global code of
practice
The Lancet, UK
22.08.10
S African strikers set to defy court order
22.08.10
Mother told to clean own room after caesarean
Financial Times,
UK
The Loca, Sweden
2
21.08.10
Foreigners queue up for nursing vacancies
Times of Malta
25.08.10
Healthcare workers raise 'SOS' over threats to services
Irish Independent
16.08.10
Expansion of cancer care and control in countries of low and middle
income: a call to action
The Lancet, UK
28.08.10
Chinese doctors are under threat (Editorial)
The Lancet, UK
18.08.10
NÎMES - Cruel manque d'infirmières dans les maisons de retraite
Midi Libre, France
23.08.10
Horário de 40 horas traz mais meio milhão de consultas
22.08.10
Málaga tiene la mitad menos de enfermeros que la media europea
Diário de
Notícias, Portugal
Malaga Hoy,
Spain
Latin America & Caribbean
Date
Headline
Publication
25.08.10
Health sector on track for MDGs — CMO
Jamaica Observer
23.08.10
Padece hospital de Tehuacán falta de médicos y enfermeras
19.08.10
Gestiona ante el IMSS incremento de personal para el Hospital
Ixtlero 
e-Consulta,
Mexico
Vanguardia,
Mexico
18.08.10
São Paulo pode se tornar um polo mundial de saúde
Abril.com, Brazil
19.08.10
REUNIÓN BILATERAL PERÚ - BRASIL Y TRANSFERENCIA DE LA
CORDINACIÓN TITULAR DE RECURSOS HUMANOS DE UNASUR
SALUD
Ministerio de
Salud, Peru
24.08.10
Inicia protesto de médicos residentes em Belém
Diário do Pará,
Brazil
Global Health Workforce Alliance
Migration of health personnel: interviews with country delegations at the World Health Assembly
2010
The Alliance
19/08/2010
As announced in May following the closure of the 2010 World Health Assembly, the Alliance recognizes the
newly adopted WHO Global Code of Practice on International Recruitment of Health Personnel as a major step
towards alleviating the global health workforce crisis. At the Assembly, members of the WHO Department of
Human Resources for Health together with the Global Health Workforce Alliance interviewed delegates from
select North and South countries to get their impressions on the code.
Botswana, Norway and Brazil took part in the interviews and commented on the adoption of the Code with
what they believed to be the salient points around the development process, the negotiations, the potential
benefits and the challenges ahead. The interviews were edited as a part of the WHO podcast series and are
now available from the link below.
Rhee Hetanang, counsellor at the Permanent Mission of Botswana in Geneva spoke about the long and intense
negotiations at the Assembly. "The negotiations for the WHO code of practice is a major milestone in Botswana
because we believe it is a delicate balance following negotiations that were tough." he said. "the code will be
particularly useful for Botswana as a tool that we can use to strengthen our health system" he added.
Clearly looking at his country's management and education responsibilities rather than relying on migrants, Dr
Bjorn Inge Larssen, Norway's Chief Medical Officer said "Norway is one of those countries where we […] will
need a lot more health resources because the population is ageing and this code clearly states that countries
need to plan for their own needs of health personnel." Dr Larssen also noted the importance of education "The
education of health personnel will probably now be more important when we are working with other countries
to improving their systems."
Dr Francisco de Campos, Secretary for Labour and Education Management in Health within Ministry of Health
Brazil and member of the Alliance Board, told us about the complexity of health worker migration issues and
the balanced approach that countries need to work towards: "We in Brazil respect that the international
solidarity will be of value in the international diplomacy and this Code will be in our point of view the first step
in order to have in the world a better system of health, universal access that are the values we have been
3
pursuing for a long while." He also stated that " this code really means […] is creating a system of information
and evidence-based data, that can allow in the future to have further decisions that go beyond the voluntary
Code."
RELATED LINKS
:: Alliance statement including link to download the Code
:: Task Force on Migration - Health Worker Migration Policy Initiative
:: WHO Human Resources for Health Department web site
:: Doctors and Nurses
Back to top
News from WHO and partners
12
Alongside Syrian health workers, UNICEF battles varied causes of malnutrition
UNICEF
18/08/2010
By Rob Sixsmith
AL-HASAKEH, Syrian Arab Republic, 18 August 2010 – Syria’s Al-Hasakah governorate is no more than two
hours away from Euphrates. One of the biggest challenges facing children here is an alarming rise in
malnutrition perpetuated by a constant drought.
The country’s children suffer from high levels of malnutrition and many exhibit a low weight-to-height ratio – a
worrying statistic.
Faltering nutrition
In this region, malnutrition is caused by several factors, including the lack of rainfall – which reduces the
amount and quality of food available – and a number of misconceptions related to nutrition.
But another, less common problem is the traditional practice of tea drinking among children.
“Bad habits start from the first minute of giving birth,” said Dr. Abdul Kareem Hammaadi, a local physician.
“Tea leads to anaemia in small children but unfortunately [caregivers] barely respond to our advice. They need
to be well educated, which requires the efforts of national and international organizations.”
UNICEF is working with the Syrian Ministry of Health to educate parents on healthy habits for their children. By
using Syria’s dedicated public health teams as a conduit for better nutrition education, UNICEF is implementing
short- and long-term solutions to Syria’s nutrition problems.
Uneven progress
Operating alongside local teams, UNICEF experts assess the extent of the problem and train public health
centre staff to track children’s growth and treat malnutrition.
“We started in February,” said health centre nurse Abeer Mash’a. The teams weigh children, she said, and then
distribute bags of therapeutic food like Plumpy’nut, a nutrient-rich peanut paste. But aside from treating
malnutrition, they also have the essential task of educating caregivers.
“Most importantly, we teach parents what food is good for the children,” said Ms. Mash’a.
In some areas, Syria is making considerable leaps towards fulfilling the United Nations Millennium Development
Goals by their deadline of 2015. But the progress is uneven, often favouring accessible urban areas. In Syria,
as around the world, there is increasing evidence that the global push to achieve the MDGs is leaving behind
the most vulnerable and marginalized children.
Foundation for growth
Just five years ahead of the MDG deadline, high malnutrition levels in rural parts of Syria threaten to pose a
considerable problem for the future of the country.
“Nutrition is actually the foundation of a child’s physical and intellectual growth and important for the economic
development of a country,” said UNICEF Representative in Syria Sherazade Boualia. “We do have an issue in
Syria where the level of malnutrition is alarming to a certain degree, so we’ve decided to take action in
collaboration with the Ministry of Health.”
Evolving attitudes and softening tradition in favour of better nutrition is a long process. But the reduction of tea
drinking among children is essential to guard against malnutrition and give children a healthy start to life.
4
3
Canada and Mali Sign Agreement to Advance Canada’s G-8 Muskoka Initiative Commitment to Save
the Lives of Mothers, Newborns and Children Under Five
CIDA
23/08/2010
Bamako, Mali/Ottawa, Canada ― The Honourable Beverley J. Oda, Canada's Minister of International
Cooperation, and Mali's Minister of Territorial Administration and Local Communities, Général Kafougouna
Koné, today signed a Letter of Intent confirming a renewed maternal, newborn and child health (MNCH)
partnership between Canada and Mali.
"With this Letter of Intent, Canada is taking an important step forward in its Muskoka Initiative to assist Mali in
improving the health of mothers, newborns, and children," said Minister Oda. "Working together, within the
Mali Health Program, we will build on the progress currently being achieved in Mali. I appreciate the confidence
the Government of Mali has expressed in Canada's development programs, and we are confident that this
partnership will result in healthier mothers and children ready to realize a better future."
The Canada-Mali partnership will concentrate on training health workers, strengthening Mali's comprehensive
primary health systems at the local level, improving nutritional health, and reducing the effects of diseases on
mothers, newborns, and children under five. The two countries have also agreed to enhance the coordination
and integration of Canada's development efforts in order to achieve greater effectiveness and lasting results in
reducing maternal and child mortality.
"I welcome the opportunity to emphasize a renewed partnership with Canada," said Mr. Oumar Ibrahima
Touré, Minister of Health. "This partnership is important to us because it allows us to accelerate the reduction
of maternal and child mortality in Mali. Canada's support will help us achieve the Millennium Development
Goals."
During his participation at the G-8 Development Ministers Meeting in Halifax and at the African Partnership
Forum in Toronto in April, Minister Touré reiterated the importance of donor countries supporting Mali's
national plan. Under Canada's leadership in Halifax, all G-8 development ministers agreed that supporting
national health plans was an effective development principle to achieve sustainable results. The Government of
Mali's Health and Social Development Program is designed to provide an integrated and comprehensive MNCH
package of activities to all levels of the health system, including the local level.
Canada has had a long history of development assistance in Mali. For a full list of CIDA programming in Mali in
maternal and child health, and other areas, please visit the CIDA website at www.cida.gc.ca
4
Aid donors in Nepal agree to joint financing of better maternal and child health
GAVI Alliance
18/08/2010
Kathmandu, Nepal, August 18 , 2010 - The Government of Nepal received a significant boost to its efforts to
reduce maternal and child mortality and illness after its leading aid donors signed a new unprecedented joint
financing arrangement today.
Under the terms of the Joint Financing Arrangement (JFA), Nepal’s leading aid donors― DFID, World Bank,
GAVI, USAID, UNFPA and UNICEF ― will funnel their financial support to the country’s new national health plan
through one simplified aid management system that will sharply reduce the reporting that donors require from
low-income countries such as Nepal. The JFA is one of the first steps to implementing the Health Systems
Funding Platform* in Nepal.
The Nepal JFA now brings together donors which are able to ‘pool’ their development funds in support of the
Government’s health programs (World Bank, DFID and GAVI) with those such as USAID, UNFPA and UNICEF
that provide on-budget resources but do not pool their funds. The Australian Government has also already
announced its commitment to continue supporting the government’s health program.
By committing its health donors to this new simplified approach, the Government of Nepal hopes to further
accelerate progress in improving access to essential maternal and child health services including immunization
and HIV/AIDS. Nepal is one of the first countries to implement the Health Systems Funding Platform.
Rameshore Khanal, Secretary, Ministry of Finance, who signed on behalf of the Government said: “The signing
of the Joint Financing Arrangement is an important step by an increasing number of development partners in
their commitment to strengthen government systems. It is our strong belief that the strengthening of our own
systems is, even when it would take time, in the end the best value for aid money”.
Susan Goldmark, World Bank Country Director for Nepal mentioned: “This is an important and satisfying
moment in the harmonization process – I know how much work has gone into it. At the same time we know
that the harmonization agenda is far from completed. In the countdown to the MDGs I’m excited to hear about
the ongoing efforts in the health sector to harmonize the technical support agenda and to move ahead with the
5
mutual accountability issues related to our pledges for financial and technical support as well as to our
behavior”.
“The Platform is about applying the principles of aid effectiveness to make health dollars go farther and
produce greater impact,” said Julian Lob-Levyt, CEO of the GAVI Alliance. “Collective financial management
through the Platform will translate into more predictable funding that will enable countries to plan and
implement with more confidence. I’m eager to see this approach replicated in many more countries,” Dr LobLevyt added.
USAID Mission Director Dr. Kevin A. Rushing noted: “Including all funding – both pooled and direct – is a very
positive move by the donors and the Government. Uniting around a single, focused plan for investment is
essential to improving the national health system effectively. We see this furthering government ownership and
leadership and helping to build greater equity in health service utilization.”
Ian McFarlane, signing as UNFPA Representative and speaking as Chair of the External Development Partner
group in the Health Sector in Nepal, urged government to “sustain its progress towards making the healthrelated MDGs meaningful for the most marginalized, and called on other EDPs to join the efforts to align with
and support national systems”.
*The Platform
The Health System Funding Platform (the Platform) will facilitate collaboration among development partners to
improve how they work together in countries. It will also enable countries to use new and existing funds more
effectively for health systems development, and help them access donor funds in a less complicated manner
that is more aligned to their own national processes.
Established in 2009, at the recommendation of the High Level Taskforce on Innovative International Financing
for Health Systems, the Platform is being developed initially by the GAVI Alliance, the Global Fund and the
World Bank, facilitated by the World Health Organization, in consultations with countries and other key
stakeholders, including civil society. The Platform is part of the broad international effort in strengthening
health systems to accelerate progress towards the targets for the health related Millennium Development
Goals.
5
PAKISTAN: We are Treating Up To 800 Patients a Day
Global Health Council
/04/2010
Global Health Magazine Blog
The latest government figures indicate:
* 1,400+ fatalities
* 1.5 million forced to flee their homes
* 20 million affected
* Displaced people are struggling to acquire basic resources and medical care with the threat of waterborne
disease looming
Immediately following the onset of flooding, International Medical Corps mobilized local staff to operate six
mobile medical units serving the hardest hit areas. We have been treating as many as 800 patients a day, in
addition to providing psychosocial support - an often neglected area in the midst of a catastrophic emergency
such as this. But resources and funding are woefully inadequate and our teams are struggling to meet the
immediate needs - much less prevent the risk of future outbreaks.
Along with massive shortages of food, clean water and shelter, water-borne diseases like acute respiratory
infections and diarrhea are on the rise. In some areas the health-care infrastructure has been completely
washed away. The situation in all likelihood will worsen. The rains are expected to continue and supply routes
for delivering relief are already treacherous. Compounding the physical toll this disaster has taken on
Pakistanis is the immense psychological toll - many of those affected, particularly in the Swat Valley, had
already been displaced by conflict in the region over the past year.
At a school in Peshawar, where International Medical Corps set up an emergency clinic, thousands of terrified
Pakistanis took refuge from the floodwaters. An 8-year-old boy told doctors of watching his mother drown
before his eyes. One man described how floodwaters engulfed his home, causing it to collapse on him, trapping
him for days without food or water. He was rescued by the Pakistani army and reunited with his family at the
school - except for his son, who had drowned. International Medical Corps is providing individual and group
psychosocial support sessions to those devastated by the floods.
By International Medical Corps Staff.
Back to top
Africa & Middle East
6
1
Budaka transfers 39 health workers
Daily Monitor, Uganda
18/08/2010
By Mudhangha Kolyangha
Thirty-nine health workers across Budaka have been transferred to various health units in the district in a
move aimed at improving efficiency and effectiveness. This comes after several complaints of absenteeism and
negligence by health workers.
Positive measure
“We have taken this positive measure by carrying out massive transfers because most health workers had
overstayed at their work stations for more than 10 years” Mr Elias Byamungu, the Budaka chief administrative
officer, said.
According to their transfer letters dated August 2, signed by Mr Byamungu, all the affected health workers
upon receipt of these transfer letters should immediately report to their duty stations.
Budaka District has 13 health centres. “This serves to notify the officers as per the attached list that with effect
from August 2 , they have been transferred. The transfers is in accordance with public service employment
guidelines and the approved health sector staffing structure at all levels of health service delivery, ” the letter
reads in part.
Complaints
Some health workers who talked to Daily Monitor expressed dissatisfaction, saying the exercise was not
transparent, adding that there were some loopholes in the exercise.
They claim the exercise was politically motivated.
However, Mr Byamungu said the exercise was done in good faith.
2
Stakeholders urged to expand access to HIV treatment
Walfa Info, Ethiopia
20/08/2010
Addis Ababa, August 19 (WIC) – The Clinton Foundation HIV/AIDS Initiative (CHAI)-Ethiopia said all
stakeholders need to exert maximum efforts in order to improve and expand access to HIV treatment on a
large scale.
Speaking at a panel discussion organized here today on HIV/AIDS related issues, CHAI Ethiopia Office
Manager, Dr Yigeremu Abebe, said integrated effort of health professionals, people living with HIV/AIDS
(PLwHA) and the community is needed to expand and improve HIV treatment in the country.
According to Dr Yigeremu, HIV treatment includes prevention and treatment of HIV-related infections. The
number of people receiving HIV treatment is on raise in the country, he added.
Network of Networks of HIV Positive in Ethiopia (NEP+) Board member, Solomon Worku, on his part said lack
of health professionals and laboratory equipment, as well as inaccessibility of health institutions are factors
that are hindering the expansion of HIV treatment.
NEP+ Communication Officer, Johnny Ayele, on his part said the network is working closely with people living
with the virus, HIV/AIDS prevention and control offices, mass media and donors to combat HIV/AIDS.
Representatives drawn from various organizations working on HIV/AIDS took part at the half-day panel
discussion.
3
State goes to court over essential service workers
Dispatch Online, SA
23/08/2010
UNIONS have vowed to continue striking this week despite a court interdict ordering nurses and other essential
services staff to return to work.
Government made an urgent application to the Johannesburg Labour Court at the weekend ordering strikers to
get back to work.
However, the National Education, Health and Allied Workers’ Union (Nehawu) provincial secretary Xolani
Malamlela yesterday said despite “tactics” used by the government to end the strike, they would continue with
their action today.
Malamlela said that while the majority of health workers fell under essential services, government had not
come forward with a minimum service agreement to specify the conditions for a strike.
“We are not allowing the employer to mess around with us like this. They have now resorted to intimidation
and that is not going to work,” Malamlela said.
7
The national strike action, driven by Cosatu, has seen public servants demand an 8.6 percent wage increase, a
R1000 housing allowance, and the equalisation of medical aid subsidies.
Government, however, has not budged on its offer of a seven percent increase and a R700 housing allowance.
The provincial Department of Health confirmed that a copy of the interdict secured by government had been
circulated to all striking unions and that should the unions continue with their action, they would be breaking
the law.
Health spokesperson Sizwe Kupelo said workers who continued to strike would be in contempt of court, while
they would also face the department’s internal disciplinary processes.
Kupelo said during the weekend the situation at the province’s State hospitals had been under control except
for minor incidents where nurses at Mthatha General Hospital were intimidated.
He also said the situation at Eastern Cape hospitals was under control and there had not been a need to deploy
members of the South African National Defence Force (SANDF) to provide extra security. However, the SANDF
was still on standby.
A member of the strike committee at Cecilia Makiwane Hospital in Mdantsane said yesterday that hospital
complex CEO Vuyo Mosana had told staff the hospital did not require a skeleton staff as he had sourced his
own team.
“He said he had his own people and that we should leave,” committee member Monde Ntshebe said.
Mosana denied Ntshebe’s allegations and branded them nonsense.
“ They are trying to make themselves famous by saying something meaningless.
“The point is they should be at work as they fall under the essential services.
“We need a full complement of staff,” he said.
Meanwhile, the South African Democratic Teachers’ Union and National Professional Teachers’ Organisation of
South Africa (Naptosa) will also continue with their strike this week. Naptosa joined the stayaway on Friday
and members were also encouraged to stay away today, chief executive Peter Duminy said.
Suid-Afrikaanse Onderwysersunie (SAOU) president Dr Jopie Breed said the union would participate in
industrial action with effect from today until Thursday. “The nine provincial structures of the SAOU will each
decide on the nature and extent of the industrial action at the provincial level.”
SANDF spokesperson Siphiwe Dlamini said in a statement yesterday afternoon that a multi-disciplinary team
had been sent to help out at Pretoria’s Mamelodi Hospital.
Earlier yesterday, Dlamini said the SANDF had already deployed multi- disciplinary teams of the SA Military
Health Service at 32 hospitals.
These included the Natalspruit, Chris Hani Baragwanath, Helen Joseph, Kalafong, George Mukhari, Steve Biko
and Tshwane District hospitals in Gauteng.
In the North West, teams were deployed at the Brits Hospital, Bophelong in Mafikeng, and the JT Tabane
Hospital in Rustenburg.
Further military help was provided at the Dora Nginza and Livingstone hospitals in the Eastern Cape, while in
KwaZulu-Natal teams were deployed to the King Edward III, Mahatma Ghandi Memorial, Chief Albert Luthuli,
Prince Mshiyeni and Stanger hospitals.
In Limpopo, medical teams were sent to the Van Velden, Polokwane, Lebowakgomo, St Rita’s and MaphuthaMalatji hospitals, and to the Bongane, Katlego and Pelonomi hospitals in the Free State.
In Mpumalanga, military teams were deployed at Witbank, Tonga, KwaMahlanga, Mapulaneng, Rob Fereira,
Ermelo and Themba hospitals.
No teams were deployed to hospitals in the Western and Northern Cape. — By ASA SOKOPO,
[email protected] with additional reporting by Sapa
4
Angola com mais de mil 800 unidades sanitárias até 2009
Angola Press
20/08/2010
Luanda – Angola conta com duas mil 355 unidades sanitárias, dos quais 1.841 postos de saúde, 359 centros e
115 hospitais municipais,
Segundo o ministro da Saúde, José Van-Dúnem, há um aumento de 33 maternidades em 2005 para 45 em
2008, o que representa uma contribuição significativa para a melhoria do sistema de referência para os casos
complicados.
Os recursos humanos configuram uma componente essencial do sistema de saúde, colocando-se num patamar
de relevância ao nível das infra-estruturas, o que significa que deve existir um número adequado de
profissionais capacitados de forma a satisfazer as expectativas da população.
As áreas rurais são, de acordo com o ministro, lamentavelmente, as mais afectadas pela carência de
profissionais, mas, contudo, verificam-se avanços notáveis na redução da mortalidade materna no país, com
particular realce para o meio urbano.
8
Reconheceu que a situação ainda não é satisfatória, particularmente nas áreas rurais, onde é necessário
revitalizar a atenção primária através da expansão da prestação de cuidados materno e infantil com qualidade
e de acesso generalizado, assegurados por profissionais motivados e capacitados.
Este processo, frisou, exige o reforço do Sistema Nacional de Saúde, fundamentalmente ao nível dos
municípios, dada a sua proximidade à maioria da população.
5
Strike Update: Health Workers in the Western Cape
Cape Gateway, SA
23/08/2010
Today's strike did not impact on the delivery of health services to patients in the Western Cape.
Out of a total staff complement of twenty eight thousand and sixty seven (28 067) employees seventy two
(72) reported on strike this morning and two hundred and eleven (211) (0.7%) this afternoon. The majority of
those are non-health professionals, e.g. porters, cleaners and catering staff.
There were reports of picketing at Tygerberg Hospital, Somerset Hospital and George Hospital.
Western Cape Minister of Health, Theuns Botha, said, "I am so grateful for our employees who throughout this
strike have shown their spirit of commitment and care to patients. I realise that the unions put them under
tremendous pressure. I want to thank the many companies, even private hospitals, and volunteers who have
phoned in to our offices to offer their services and assistance. At this point in time we are functioning normally,
despite minor sporadic incidents."
Issued by: Theuns Botha, Western Cape Minister for Health
6
Strike Jeopardizes HIV Treatment
IRIN PlusNews
24/08/2010
Johannesburg — A strike for better wages by South African health workers is putting the lives of HIV-positive
people on the line as industrial action disrupts treatment programmes.
Services providing antiretroviral (ARV) and tub erculosis (TB) treatment, and prevention of mother-to-child
transmission (PMTCT) of HIV are among the programmes disrupted by the public sector strike, which is about
to enter its second week.
Local health lobby groups like the Treatment Action Campaign (TAC) are trying to ascertain the extent of
disruptions nationally, but in townships outside Johannesburg and the capital, Pretoria, the strike has already
closed smaller clinics that dispense HIV treatment, and disrupted some of Johannesburg's largest ARV and
PMTCT programmes. Disruption of HIV/AIDS programmes have also been reported in Mpumalanga and
KwaZulu-Natal provinces in eastern South Africa.
An estimated 1.2 million public sector workers, including nurses and teachers, downed tools on 18 August as
wage negotiations stalled. Unions have rejected the government's latest offer and protests are scheduled for
Thursday 26 August, with additional unions threatening to join the mass industrial action in solidarity.
Service disrupted, doctors pushed
Johannesburg's Rahima Moosa Mother and Child Hospital treats about 30,000 patients annually. Dr Ashraf
Coovadia, head of the hospital's paediatric HIV section, said outpatient services, including antenatal care, were
simply not available.
"Women in labour are still being received by the hospital's casualty section but antenatal services - where
PMTCT starts - have been shut down," Coovadia told IRIN/PlusNews. "Patients are not getting the medication
or services they deserve; they're being turned away."
Staff have been telephoning patients taking HIV and TB medicine to ensure they have sufficient drug supplies
to prevent treatment disruptions that could increase the likelihood of drug resistance and treatment failure.
Staff have also been arranging to give them their medication at the facility's gates because many patients were
too intimidated by striking workers to enter the hospital.
At the Charlotte Maxeke Johannesburg Hospital, another of the city's large ARV clinics, fear of violence and
intimidation by striking workers has also reduced patient attendance, but director Dr Jeff Wing said HIV
services had been minimally affected.
South Africa's largest hospital, Chris Hani Baragwanath, has seen the army and police deployed to guarantee
service delivery and guard against possible strike-related violence, said hospital spokesperson Nkosiyethu
Mazibuko, who maintained that HIV services had not been affected by the strike.
9
However, health workers who wished to remain anonymous reported that the hospital's pharmacy was
understaffed and had been closed most of the time since late last week, with doctors forced to fill their own
prescriptions to ensure HIV-positive patients could get top-up supplies of ARVs or TB medication.
The Gauteng provincial government has won a court interdict against striking workers to prohibit acts of
intimidation against health workers still reporting for work in and around Johannesburg, but TAC and the Rural
Doctors Association of Southern Africa have called on the national government to take further measures to
guarantee the provision of essential services while the strike continues.
[ This report does not necessarily reflect the views of the United Nations ]
7
Uganda: Breastfeeding Dilemma for HIV-Positive Mothers
Catholic Information Service for Africa
24/08/2010
The new World Health Organisation (WHO) recommendation that HIV-positive mothers on antiretroviral
therapy (ARVs) can exclusively breastfeed their babies for up to twelve months without infecting them has
created confusion among HIV-positive mothers in Uganda as information about the new guidelines struggles to
reach them.
For the last decade the policy in Uganda had been to advise HIV-positive mothers to exclusively breast-feed for
three months.
But phone calls during a television talk show on the benefits of breastfeeding exposed the confusion among
HIV-positive mothers about the new recommendations. Many mothers said they needed to clarify and
understand how best they can protect their babies from HIV infection.
"I am now confused," said Maria Sebadukka, an HIV-positive mother," we are being given conflicting
information on how to feed our children. Some health workers say we should not breastfeed. But now you say
we can?" she asked.
"I am HIV-positive and my child is negative. Should I start breastfeeding her now?" another caller asked.
During the 2010 HIV Conference in Vienna in July, the WHO passed new recommendations saying mothers
may safely breastfeed provided they or their infants receive ARVs during the breastfeeding period of up to one
year. This has been shown to give infants the best chance of protection against HIV transmission.
Dr. Elizabeth Madraa, head of Food and Nutrition at the ministry of health explained that six to 12 months of
breast feeding is adequate to cover the initial immunity a baby needs. However, mixed feeding is not
recommended as the baby's gut is vulnerable to infection.
But Madraa admits that it may be difficult to convince some mothers of the new guidelines.
"People are not ready for the new guidelines. We really need to come out and sensitise pregnant HIV-positive
mothers very well on these new recommendations because they are still not yet convinced," she said.
Dr Lydia Mungherera, executive director of The AIDS Support Organisation (TASO) and patron of Mamas Club,
an organisation for HIV-positive mothers agrees.
"Many are still very scared of infecting their children. Many are not yet aware of these new guidelines so this
needs a lot of awareness raising and the training of health workers including midwives," she said.
She also said that new policies are not as widely circulated in Uganda as they should be: "Community nurses
and midwives should be trained and any new policies should be quickly circulated."
Lack of access to antenatal care, ARVs and information also affects the implementation of the new guidelines.
While antenatal visits are vital for prevention of mother-to-child transmission (PMTCT), 58 percent of births in
Uganda still take place at home, according to the Uganda Demographic Health Survey (UDHS) 2006.
There are also rural-urban disparities with the proportion of births occurring in a health facility being higher in
urban areas (79 percent) than rural areas (36 percent) thus leaving a dilemma of how rural women can be
sensitised about the new guidelines.
Access to health care is also a challenge with 86 percent of women saying they encounter at least one serious
problem in accessing it. Sixty five percent of women say they have financial constraints while 55 percent find
the distance to the health facility is very far.
Florence Mukhaye Buluba, programme officer for the International Community of Women living with HIV and
AIDS Eastern Africa added that stigma also discouraged women from following clinical instructions of exclusive
breastfeeding following pressures from in-laws and spouses.
10
In Uganda mother-to-child transmission is estimated to have contributed to 20,500 new HIV infections,
according to the 2009 Uganda AIDS Commission report. Without treatment, around 15 to 30 percent of babies
born to HIV-positive women will become infected with HIV during pregnancy and delivery.
A further five to 20 percent will become infected through breastfeeding, says the 2009 UNAIDS Epidemic
Update.
The health ministry said they are doing something about this. "We have planned for a massive public
awareness campaign. The plans are there to make sure that women get access to information and understand
these new guidelines," said Samalie Namukosa Bananuka, Head of Nutrition, PMTCT department in the health
ministry.
The new WHO guidelines recommend that national authorities in each country decide which infant feeding
practice should be promoted and supported by their maternal and child health services.
Uganda is yet to take an official stand based on its capacity to universally roll out the PMTCT programme and
sensitise women countrywide about the new recommendations.
"Government is to hold a meeting next month to discuss the implementation of the new guidelines. If Uganda
does not find its implementation feasible, then we shall not adopt it but rather stick to the current policy.
That's what we are yet to discuss," National PMTCT Coordinator, Dr. Godfrey Esiru told IPS.
8
Health Workers Demand More Pay
The Informer, Liberia
19/08/2010
Buxton A. Davies
The President of the Health Workers Association of Liberia Mr. Joseph Tamba is calling on the Liberian
government to pay health workers attractive salaries nation wide. According to Mr. Tamba health workers are
workers that responsible to save lives, therefore it is important that they receive attractive salaries to enhance
their living conditions.
Speaking to the Informer on Monday August 16 2010, at his health Ministry Office on Capitol Hill, Mr. Tamba
said if employees in such sector are given good salaries and incentives, this will enable them to pay more
attention to patience. He furthered that low salary scale and the lack of incentives brings about lapses in the
job.
Mr. Tamba indicated that health workers are civil servants that need to be respected in the society and not to
be taken for granted. "We are important people so we need to be well paid and given better incentives." he
pointed out seriously.
He later called on his colleagues to be united as one body so as to move the association forward. He also
stated that it is only unity that can make them move the association in a positive direction. According to him
disunity among themselves will not do any good but rather kill their dreams for prosperity.
The president of the health workers urged his fellowmen to take care of the patience in various hospitals for
medical treatments. "Do your best in saving the lives of your brothers and sisters," he emphasized. Mr. Tamba
concluded by lauding members of the association for attending their monthly meeting and to encouraged
others to emulate their good example.
9
Health Workers' Phones Making Impact - MOH
New Times, Rwanda
19/08/2010
Jean Baptiste Ndabananiye
Kigali — An official in the Ministry of Health (MoH) has said that mobile phones that were given to community
health workers to facilitate their outreach programmes are having a positive impact on the provision of health
services to the population.
Speaking to The New Times yesterday, the head of the ICT in the ministry, Daniel Murenzi, said the mobile
phones have tremendously improved information flow between the health workers and the ministry.
Giving an example of monthly reports compiled by the health workers on expectant mothers and infants,
Murenzi, said this helped the ministry in the immunization, monitoring and administering medicines to the
communities.
He said that the ministry is currently undertaking a programme to train all the health workers who are not able
to use the applications to be able to use them before the end of the year.
11
"We're training trainers in all districts who will go to train others and we should have finished the project before
the year ends," he explained.
Under the Mobile Phone for Health Workers programme, each village was allocated three mobile phones by
President Paul Kagame during last year's Itorero.
The Presidential pledge to provide mobile phones to facilitate communication for health development was
launched in Kibeho Sector, Nyaruguru District in the Southern Province when over 2,500 community-based
health workers (CBHWs) acquired phones.
During the launch of the programme the Minister of Health, Dr. Richard Sezibera, told the beneficiaries that
this is just a part of the government's plan to foster e-Health, a measure that will ensure that all Rwandans
acquire quality health care.
The programme which is supported by MTN and Voxiva, a technology partner, enables the health workers to
send monthly health reports to health facilities, call ambulances and communicate with health experts at no
cost.
10
Cholera death toll rises to 352
Nigerian Tribune
26/08/2010
Written by James Bwala and Segun Olaniyan, with Agency Reports
CHOLERA death toll in Nigeria has climbed to 352, according to an update from the Federal Ministry of Health.
The death toll, as confirmed on Wednesday in Abuja by the Director of Public Health, Dr Mike Anibueze,
emanated from Jigawa, Bauchi, Gombe, Yobe, Borno, Adamawa, Taraba, FCT, Cross River, Kaduna, and Rivers.
“As of today, a total of 352 deaths out of 6,497 suspected cases of cholera have been recorded in 11 states,’’
he said.
According to him, most of the outbreaks occurred in the North-West and North-East zones but epidemiological
evidence indicated that the entire country was at risk.
“The disease is endemic in most parts of Nigeria but often occurs in epidemic proportion at the onset of the dry
season.
“This is because people scramble for drinking water from doubtful sources and during rainy season when
contaminants are washed into surface and underground water sources,’’ Anibueze said.
He said that the outbreaks in most states, particularly in the north eastern part, were as a result of heavy rains
in most parts of the country.
He said that a survey by the ministry revealed that less than 40 per cent of the entire population in the
affected states had access to toilet facilities of any description.
“Another major factor responsible for the epidemic is the fact that 66 per cent of the rural dwellers lack access
to safe drinking water, while the wells from where drinking water is drawn are without cover, hence open to
contamination,’’ he stated.
The director also confirmed that 83 deaths and 5,073 cases of measles had been reported this year in 11
states.
Health Minister, Professor Onyebuchi Chukwu, had earlier confirmed that 231 persons had died of the disease
with 4,600 others receiving treated at various health institutions.
Experts say the disease causes serious diarrhoea and vomiting that lead to dehydration within a short period of
incubation.
Also, on Wednesday, the Kaduna State government said that no fewer than 60 people had been treated of a
disease suspected to be gastroenteritis, while four deaths had been recorded.
Mrs Charity Shekari, the state Commissioner for Health, made this known to the News Agency of Nigeria (NAN)
in Kaduna shortly after an assessment tour of some affected areas.
Shekari said: “Fifty victims were treated and discharged at Birnin Gwari with eight hospitalised and another two
victims receiving treatment at Giwa.”
She attributed the death in Birnin Gwari LGA to late reporting of the disease.
According to her, the victims suffered severe vomiting and diarrhoea.
12
The commissioner said health workers and drugs had been dispatched to the affected areas to contain the
situation.
Shekari also stated that technical teams, comprising staff members of the ministry, local government health
personnel, UNICEF, WHO and community leaders had been put on the alert to monitor and report suspected
cases.
She advised residents to keep their surroundings clean and avoid drinking dirty water.
In another development, no fewer than 42 people, including children, died on Wednesday after taking
contaminated water drawn from wells and ponds in 10 council areas of Yobe State, with 484 other people
infected with gastroenteritis.
Confirming the outbreak of the water-borne disease at the National Immunisation Programme (NIP) office in
Damaturu, the state coordinator of the World Health Organisation (WHO), Dr Adamu Isa, disclosed that the
disease, which was first recorded on July 27, at Mutai, in Gujba Council area, had not been confirmed even
though there were physical symptoms of cholera.
He said the present outbreak of the water-borne disease was known to be gastroenteritis, stating that the
disease had the symptoms of frequent stooling and vomiting.
Dr Isa, however, noted that the situation was worsened by lack of public health laboratory (PHL) in the entire
North-East zone for gram staining and to carry out culture and sensitivity to ascertain whether or not it was
gastroenteritis or cholera.
He disclosed that the test on the first sample failed at the University of Maiduguri Teaching Hospital (UMTH),
while seven other samples of patients were rejected, because the equipment at UMTH was not accredited to
carry out such tests for cholera.
He said that each of the 36 states in the country required PHL facilities so that they could quickly intervene
appropriately to prevent further spread of cholera and water and air-borne diseases in the country.
Dr Isa noted that “it is difficult to isolate any bacterium ideally after two hours drive for test and a special
transport medium containing certain chemicals is needed to keep bacteria intact for four to six hours to enable
isolation for test.”
On the affected council areas and measures taken to prevent further spread, the press secretary to the deputy
governor, Mallam Musa Alaraba, disclosed that the Commissioner for Health, who is also the deputy governor,
had directed the deployment of over 100 health workers with intravenous drugs, antibiotics and water
treatment chemicals worth N2 million to the cholera treatment camps in Damaturu and nine other centres.
Alaraba said the drugs were to aid the victims to replenish lost fluids, while they would also receive other
antibiotics, as the state government continued to explore other intervention measures to save the lives of the
people.
On the breakdown of deaths and the affected council areas, he said out of the 484 cases of gastroenteritis,
Potiskum had the highest cases of 102 with five deaths, while Gulani and Damaturu had 70 and 67 cases with
eight and five deaths respectively.
Other council areas affected by the outbreak include Gujba, 53 with 10 deaths; Fika, 48 with six deaths;
Nguru, 38 with three deaths; Jakusko, nine with no loss of life; Fune , 46, with three deaths; Nangere, two
with one death and Karasuwa, eight with a record of death of one person.
He said out of the 484 cases, 48 people were still hospitalised at the treatment camps, while other patients had
been discharged on Tuesday.
In Katsina State, seven people have been reportedly dead of cholera in Kurfi Local Government Area of the
state, barely a week after the outbeak of the disease.
Investigations carried out by the Nigerian Tribune also revealed that nine cases of measles had been reported
at Babban Gida village in Rawayau area in the same local government area.
Speaking with newsmen, the health supervisory councillor of the council, Alhaji Sule Amadu Birchi, said
already, the council had provided drugs and deployed casual health workers to control the diease in the area.
He, therefore, called on people in the area to ensure proper ventilation and avoid congestion in rooms while
sleeping.
In a related development, the Joint Health Workers Union in Katsina State has called off its strike, to address
the outbreak of cholera in the state.
Addressing newsmen in Katsina, the chairman, Joint Health Workers Union, Aminu Usman, said thought the
state government was yet to meet their demand, the union decided to call off the strike as a result of the
cholera outbreak.
13
He urged all health workers in the state to resume work, as the union would continue with its negotiations until
their demands were met
Back to top
Asia & Pacific
1
FP campaign to encourage couple to seek services, not population control
PIA Daily News, Philippines
20/08/2010
by Jean Duron-Abangan
Davao City (20 August) -- In its bid to intensify the Family Planning campaign, the Department of Health aims
not to bring down population growth but to entice couples to seek services with regards to their reproductive
health.
Guesting at Club 888, Assistant Secretary of Health Nemesia T. Gako explained that the campaign is aimed at
ensuring "health of the mother, health of the child and health for the entire family."
"Reduction of the population would be just a result of the (family) planning," he said.
In collaboration with the Health Promotion and Communication Project (HealthPRO) of the United States
Agency for International Development (USAID), DOH Thursday launched its Family Planning campaign bearing
the theme, "May Plano Ako, Kaya Mo Ring Magplano."
Dr. Analiza Jabonero, medical specialist of DOH XI, said population growth rate of the Davao Region is pegged
at 2.8 percent which is much lower than the above 3 percent national growth.
She also noted a higher rate of women using family planning methods at 55.5 percent at the regional level,
than the 50.7 percent rate at the national level.
But Dr. Nemesia encouraged family planning stakeholders of the region to improve their performance
especially with regard to moving couples to seek family planning services.
He saw the need to network with other government line agencies, non-government organizations, local
government units and other sectors which could help DOH widen its campaign.
Dr. Nemesia, however, admitted the shortage of health service providers at the grassroots level, but he said
DOH is encouraging sons and daughters of barangay health workers (BHWs) to become midwives by availing of
scholarship grants given by DOH.
In a ratio of one midwife per barangay, the Davao Region is still in need of 600 midwives to respond to family
planning service needs at the grassroots level, Dr. Jabonero revealed.
Pending hiring of more midwives whose local employment and deployment is under the local government units,
HealthPRO is empowering concurrent service providers by giving them technical assistance to do better
counseling.
In a separate interview, HealthPRO Mass Media and Communication Advisor Nilo A. Yacat said HealthPRO is
teaching service providers to shift from specific and technical method of explaining Family Planning to benefits
method.
"Who doesn't want to have a much better quality of life?" he ask He explained that the new Family Planning
campaign is designed to deliver the message that through Family Planning, couples get quality time and
economic-well being, and that mothers get good health.
In the same occasion, Danilo Case, 28 years of age of Mapawa, Maragusan, Compostela Valley said that he is
using artificial family planning method with his wife saying "it is much safer."
Case has a nine-month-old girl child and that he wants to have another one ten years after through
continuously adopting family planning.
"Mas maayo mag-family planning aron dili ta magkalisod. Kay kung daghang anak mas dako ang
responsibilidad, may daghang gastos," he said. (PIA XI)
2
PM: 3.5 mln Pakistani children at risk of waterborne diseases
China.org
25/08/2010
14
Xinhua - Pakistani Prime Minister Syed Yousuf Raza Gilani has said that over 3.5 million children are at risk
from deadly water-borne diseases in the flood-hit areas.
"Besides, acute respiratory infections, skin diseases and malnutrition are spreading in many flood affected
regions," the prime minister told a meeting on Tuesday to review health situation in the flood-affected areas.
He said the country's health system has come under great stress due to the devastation of floods as it has
damaged more than 200 health facilities.
"About 35,000 Lady Health Workers, out of a total of 100,000 throughout the country, have been displaced.
Doctors, nurses, Lady Health Visitors, and paramedical staff have also been dislocated in the affected areas,"
Gilani said.
"As human misery continues to mount, we are seriously concerned with spread of epidemic diseases. There is
likelihood of water borne diseases such as cholera, diarrhea and dysentery, especially in children who are
already weak and vulnerable to disease," he said.
Gilani said the flood has affected approximately 20 million people to date, damaged more than a million
houses, causing 1,534 deaths and injuring 2,062 people.
He informed the meeting that more than 200 tons of medicines have been supplied for 2.2 million affectees so
far. "We have also provided 42,106 hygiene kits including women hygiene kits, as it is estimated that more
than 500,000 mothers will give birth in the next 6 months in the affected areas," he said.
The prime minister said reproductive health kits for 35,000 population for three months have been given to the
provinces in this regard. "More than 2.5 million aqua tablets have been sent to the provinces to ensure safe
drinking water."
"Since stagnant water may lead to cases of malaria, nets for 300,000 people along with anti-malaria tablets
have provided. Field hospitals are being set up to ensure adequate health service, " he said.
Gilani lauded the work of the UNICEF, WHO, Office for Coordination of Human Affairs (OCHA) and other UN
Agencies who have done exemplary work and shown tremendous spirit, supplemented by invaluable services.
UN officials said though the flood deaths are still relatively low at this point they are concerned about
communicable illnesses breaking out among the millions of displaced victims.
The World Health Organization announced Sunday that more than 200,000 cases of acute diarrhea have been
diagnosed among flooded Pakistanis, and there are more than 250,000 cases of disease including scabies.
3
Money, scholarships woo health, education workers to villages
Jakarta Post
20/08/2010
Dina Indrasafitri
Ministries are offering rewards in the form of anything from financial aid, scholarships to civil servant
status, to health and education workers willing to be stationed at remote areas to overcome manpower
shortages.
“Conditions tend to be tougher [in remote areas]. Teachers are scarce and that’s why we want to make sure
that those who are dedicated enough to work there are given adequate financial support,” National Education
Ministry director general for quality improvement Baedowi said Thursday.
He added that, overall, Indonesia currently had a satisfactory teacher to student ratio but that the teachers
were concentrated in more developed areas.
“[The number of teachers] is more than enough. The ratio of primary school teachers to students is one to 19,
while the national standard is at least one to 20 and one to 32 at the most. But they are not well distributed,”
Baedowi said.
He added that the ratio of junior high and senior high teachers to students was one to 17 and one to 15
respectively.
The central government is offering support to teachers in remote areas by giving them financial incentives to
“boost their motivation”, such as a Rp 1.3 million grant for public school teachers who have attained civil
servant status and Rp 200,000 for those who have not.
However, the regional authorities are ultimately responsible for the distribution, Baedowi said.
“Regional autonomy is aimed at easing problems of [distribution], but the fact remains [that teachers are still
not well-distributed],” he said.
15
However, the issue with health workers revolves around both the number and distribution.
“We still lack the sufficient number of healthcare workers,” Kemas M Akib, the Health Ministry’s head of health
worker planning and management center, said.
He added that the country currently had around 85,000 general practitioners and 35,000 specialist doctors.
Akib said his ministry was aiming for a doctor to patient ratio of 30 to 100,000. The current ratio is 25 to
100,000.
Proper distribution is being held back in part because newly graduated medical students were often reluctant to
return to their home villages and preferred to work in cities due to better working conditions, he said.
He added that the ministry had been working with 13 medical schools in the country to hand out scholarships
to those studying for specialist degrees if they were willing to serve six months in designated regions.
During the Soeharto era, medical students were required to serve in various regions for a designated period
after graduation. “However, we can no longer force doctors do that,” Akib said.
Menaldi Rasmin from the Indonesian Medical Council said doctors needed several assurances to work
effectively in remote areas.
“First, they need to be sure that they can continue their education at a higher level [after their service].
Second, they need secure facilities,” he said.
Health Ministry secretary-general Ratna Rosita Hendardji said the government planned to send healthcare
teams consisting of doctors, sanitarians, nutritionists, midwives and pharmacists to the regions, news portal
kompas.com reported.
Indonesia’s remote regions have poor public health records, including high maternal and infant mortality rates,
as well as other poor social conditions such as a lack of teachers and schools.
4
Health workers refuse to join immunisation drive
Times of India
26/08/2010
TNN - LUCKNOW: The high-power committee constituted by the UP government to conduct a death audit of the
Mohanlalganj tragedy, in which four kids died after vaccination, formally submitted its report to health
department on Wednesday evening. According to reports, vice-chancellor, Chhatrapati Shahuji Maharaj Medical
University (CSMMU), Prof Saroj Chooramani Gopal handed over the report to principal secretary, health,
Pradeep Shukla. The Central government team on the other hand left for Delhi in the evening.
In a related development, health workers in several hamlets of Mohanlalganj refused to participate in the
ongoing routine immunisation (RI) programme on Wednesday. The director general (family welfare), Dr SP
Ram, however, claimed that the programme would not be deferred.
The health workers claimed that as the probe was not yet completed and they had not been given clean chit, it
would be difficult for them to continue with the immunisation programme. They also cited hostile conditions in
the villages of Mohanlalganj locality following the incident. The workers claimed that villagers have refused to
cooperate and are not allowing their children to be immunised under RI programme. The villagers had even
refused to allow the pulse polio campaign in their villages during coming days.
The news created a panic among the health officials who remained concerned about the fate of the RI
programme. Ram admitted that such protests had been reported from Mohanlalganj. "They are shocked by the
tragedy and have demanded proper protection. We will ensure safety of our health workers and the
programme will not be deferred. We will organise training modules for the workers to cope up with the stress
and also to update them about the RI programme," said Dr Ram.
He also stated that such an outburst of reaction was normal, but the whole RI programme could not be be
blamed for the Mohanlalganj tragedy. "The programme was kicked off across the state the same day. Nearly
two lakh villages were covered and 20,000 children were immunised. In Lucknow, itself, the RI programme
was held in 278 villages covering nearly 3,000 children. It is unfortunate that such a tragedy took place in
Mohanlalganj," claimed Dr Ram.
5
Hope Persists for Jailed Health Workers in Philippines
Inter Press Service
25/08/2010
Beatrice Paez
16
MONTREAL, Canada, Aug 25 (IPS) - A mother accused of backing insurgents in the Philippines and her newborn
son are awaiting their release from prison, in a case that has gained international attention. Amaryllis Enriquez,
the head of Karapatan, an alliance of individuals and organisations that investigate human rights cases, told
IPS a new motion was filed Monday by the lawyers of Judilyn Oliveros, who gave birth in July and was brought
back to prison last week after the court denied an appeal to extend her temporary release for six months to
nurse her baby.
Oliveros is among a group of 43 people - two doctors, one registered nurse, two midwives and 38 volunteer
health workers - who were arrested on Feb. 6 for the illegal possession of explosives and firearms. Five have
allegedly admitted to being members of the New People's Army (NPA) but Karapatan stands behind all 43,
insisting that they were tortured into confessing.
The NPA is the armed wing of the Communist Party in the Philippines, which has been waging an insurgency
since 1969. The police and military operative responsible for the arrest claim to have seized three grenades,
improvised landmines, a pistol with seven bullets and C4 explosives from the residence of Dr. Melecia
Velmonte, an infectious disease specialist who is one of the detained. The military charge that the so-called
Morong 43 serve as medical assistants to the guerilla platoons of the NPA. "The government forces were able
to prevent a possible major attack to be perpetrated by the NPA bandits during its anniversary," says the press
release issued by the Philippine army.
The Morong 43 counter that they had gathered for a health training session and that the warrant issued was
defective because it did not contain any of the names of those who were arrested.
The prisoners deny allegations of ties to the NPA, and instead claim membership to a joint initiative led by two
NGOs, the Community Medicine Development Foundation (COMMED) and the Council for Health and
Development (CHD). These community health workers administer services otherwise unavailable when a
natural disaster strikes or where medical services are unaffordable to the community.
Enriquez explained to IPS that the police were searching for someone by the name of Mario Condes, and that
the warrant did not specify an address but in effect covered the entire neighbourhood.
"When they rounded up the Morong 43, there was no Mario Condes. The commissioner asked the arresting
officer - so you haven't got Condes but are you still looking for him? 'No sir', was his response," said Enriquez.
The police and the army dismiss accusations that the warrant was invalid, arguing that they had undertaken
extensive intelligence and surveillance work and that the search had occurred in the presence of a caretaker
and two local government officials.
Given the presence of explosives and other devices, their work must not be limited to attending to the health
concerns of the NPA, said Lt. Col. Marcelo Burgos Jr., the Army spokesman.
This is not the first time the military has targeted health workers. Enriquez says the arrest is linked to a larger
operation at stake for the government - its counterinsurgency initiative to eliminate armed revolutionary
movements. Known as Operation Freedom Watch, the previous administration of Gloria Macapagal-Arroyo has
committed the military to a 2010 deadline to eliminate communist insurgency in the country.
Karapatan documents that the crackdown has resulted in 1,206 extrajudicial killings, 205 people disappeared,
and many more subjected to torture.
A habeas corpus petition was filed but dismissed by the Court of Appeals, which ruled that it could not release
the detainees under the presumption of an illegal detention because they had been charged with a criminal
offence in the local court.
The Free the 43 campaign, which calls for the immediate and unconditional release of the Morong 43, has been
taking its message to the international stage, where Enriquez and the husband of one of the prisoners brought
the case to the attention of the U.N. Human Rights Council last June.
Enriquez also helped launch a campaign at this year's CIVICUS World Assembly, which took place from Aug.
20-23, a platform where civil society organisations can build partnerships to solve global issues and address
human rights abuses.
"We are partners in a project at CIVICUS called the Early Warning system, which acts as an urgent alert to
sound out a situation in our country and enables civil society organisations across the world to respond to the
threats against civil society," Enriquez told IPS. "We would like to pressure CIVICUS to do more. We also hope
that the new president, [Benigno] 'Noynoy' Aquino, will respond to increased pressure from our international
supporters."
7
Aussies touch down in Pakistan
Sydney Morning Herald
25/08/2010
AAP - More than 50 Australians have touched down in Pakistan to help flood victims.
17
The 51-strong medical task force arrived near Multan in the Punjab province on Tuesday, and a second
contingent is in the air after leaving Australia on Wednesday morning.
Up to 180 people will be deployed in the federal government taskforce, including Defence personnel, health
workers from state and territory health departments, and aid staff.
A statement from Foreign Minister Stephen Smith said more than 30,000 people had been displaced by the
floods in the area around Multan.
An estimated 20 million people - almost as many as the population of Australia - have been affected by the
emergency.
The health workers will be tackling outbreaks of waterborne diseases and cases of malnutrition.
© 2010 AAP
8
Regional health groups like poll result
Sydney Morning Herald
23/08/2010
AAP
Two lobby groups representing the health interests of rural and regional communities believe a hung
parliament could mean a better deal for people living outside metropolitan areas.
Three country-based independents will have the balance of the power in the new parliament following
Saturday's federal election.
The Rural Doctors Association says that could mean more money for the bush.
"Those that live in rural Australia have worse (health) outcomes than those... in urban areas, and die sooner,"
association president Nola Maxfield told ABC Radio on Monday.
The group representing regional health professionals says the focus of any deal to form government should
centre on the sustainability of rural Australia.
"The infrastructure and services available in rural areas are key determinants of health and wellbeing,"
National Rural Health Alliance chair Jenny May said in a statement.
Some retailers are concerned the political stalemate could affect consumer confidence.
However a major business group says caretaker periods don't tend to disrupt the wider economy.
Australian Chamber of Commerce and Industry chief executive Peter Anderson says the economy won't stop.
"We need to get on with business," he told ABC Radio.
Communications Minister Stephen Conroy says Labor will deliver better telecommunications to the bush - a key
concern flagged by the independents.
Only 10 per cent of Opposition Leader Tony Abbott's $6 billion broadband plan would be spent in regional areas
over a first term of government, he said.
"This man (Mr Abbott) is locking in a digital divide, denying millions of... rural Australians access to future
health and education services," he told ABC Television.
"He is... treating... rural Australians like second-class citizens," Senator Conroy said, noting Labor's plan would
give high-speed broadband to all Australians.
Senator Conroy later told ABC Radio that Prime Minister Julia Gillard was willing to discuss any proposal put
forward by the independents.
"We need to ... focus on Julia Gillard delivering a stable government, albeit a minority (one)," he said, noting
the independents also wanted stability.
Former Queensland premier Peter Beattie says Bob Katter will be seeking everything he can in the interest of
his electorate.
"Bob's (Katter) not hard to read, he's all about Kennedy, Kennedy, Kennedy," he told ABC Radio.
"Don't get between him and something for Kennedy, that's my advice."
Mr Beattie conceded Labor's performance in Queensland, where they likely will lose nine seats, was "a
shocker".
18
He put it down to the snap poll and cabinet campaign leaks which prevented Ms Gillard from having a "smooth"
campaign transition.
"That ugly political wrangle cost us two weeks of momentum and a big slice of the vote," he said.
The toppling of former prime minister Kevin Rudd was also a factor in Queensland.
"Kevin coming from Queensland meant that that (leaks) had greater impact here."
But Senator Conroy said the NSW and Queensland state governments were to blame.
"Clearly in two states there were (state) factors in play."
© 2010 AAP
9
Pregnant women warned — Hames
Collie Mail, Australia
18/08/2010
“COLLIE Hospital’s maternity unit has an adequate number of midwives to meet current and expected needs,”
Health Minister Dr Kim Hames told the Collie Mail.
“The hospital and the Collie Combined Service Clubs have delivered a student midwifery training program
Growing Our Own.
“Two students have completed their training and are both working 64 hours a fortnight and a third student is
currently in training.
“This program has been successful in lowering the average age of the midwife pool and means that Collie
Hospital can maintain midwifery services in the future.
“The Combined Services Clubs has assisted in the training by providing the students with, travel, books and
incidentals.
“WA Country Health Service-South West has fully supported the training and ongoing development of these
student/junior midwives with financial remuneration.
“Collie Hospital also recently recruited a local midwife and offered her a permanent contract. There are also two
midwives who are employed on a casual basis when they are needed.
“The offering of permanent contracts depends on what services the hospital is required to deliver, how many
positions (FTE) are vacant and recruitment processes.
“Midwives at Collie Hospital work in collaboration with the general practitioners in the care of pregnant and
labouring women.
“There is one anaesthetist on 24-hour call at Collie and the hospital is attempting to recruit another
anaesthetist. The WA Country Health Service has advertised nationally to overcome a shortage of specialist
medical practitioners in Western Australia including consultant anaesthetists.
“Pregnant women who book to birth in Collie are informed well in advance of their baby’s birth that an
anaesthetist may not be available for epidural pain relief and/or elective caesarean section. They are advised
that they may require transfer to Bunbury Hospital.”
10
UN - UN DPI/NGO Conference in Australia to Attract Unprecedented Number of Workshops, Wide
Range of Round Tables on Global Health Goals, 30 August – 1 September
ISRIA.com
22/08/2010
As planning for the United Nations Sixty-Third DPI/NGO Conference continues apace, registration numbers are
presently higher than in previous years and attention is now focused on the programme for this flagship United
Nations-non-governmental organization event, which, this time, has set for itself the twin goal of galvanizing
support for improving global health and achieving the Millennium Development Goals.
The Conference, which takes places in Melbourne, Australia, from 30 August to 1 September, under the official
banner “Advance Global Health: Achieve the MDGs”, marks the first time in the three years since the event has
taken place away from United Nations Headquarters, that it is being held in the Asia-Pacific region.
Australian Convener of the NGO Focal Group of the Sixty-Third Annual Conference, Philip Batterham, says of
the host city: “Modern Melbourne is a home for people of all nations, one of the happiest multicultural cities in
the world — a city that generously gives to NGOs working in the developing world. Melbourne is a centre of
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learning, with a global reputation for health research, so Melbourne is engaged with this Conference – heart
and mind.”
The Conference is being held at the state-of-the-art Melbourne Convention and Exhibition Centre, situated
beside the South Wharf on the Yarra River. It kicks off with an opening ceremony, which will showcase the
multicultural metropolis with an indigenous welcome to Australia. This will be followed by welcoming remarks
from senior representatives of the United Nations and the Australian Government.
Among those slated to deliver the keynote addresses are Michel Sidibé, Executive Director of the Joint United
Nations Programme on HIV/AIDS (UNAIDS) and a driving force behind promoting universal access to HIV
prevention, treatment, care and support. In the course of the Conference, non-governmental organizations are
anticipating solid recommendations towards meeting Millennium Development Goal 6, which addresses the
issue of combating HIV/AIDS, malaria and other diseases, from Mr. Sidibé, who brings 27 years of experience
in international public health, development, and AIDS, to his new post.
A number of activities, including a church service at the main cathedral in Melbourne and a cultural
extravaganza, have been organized both within the Conference site and off-site to mark the event, the first
United Nations Conference of this size to be held in Australia. Melbourne, as host city, will showcase many of
the country’s premier medical, neuroscience and biotechnology research institutions — in the effort to
stimulate Governments, non-governmental organizations, businesses, researchers and the general public to
better contribute to fostering global health and meeting the internationally agreed development Goals.
Helping to define the Conference as a dynamic and interactive milestone in that endeavour will be four round
tables focusing on four major themes: “The Role of the NGOs and Civil Society in Helping Achieve the MDGs”;
“Equity, Rights and Progress towards the MDGs”; “Strengthening an Integrated and Systems Approach to
Achieving the Health MDGs”; and “Achieving the MDGs in Our Changing World”. A Committee of experts
comprised of members of the non-governmental organization community, in both Australia and New York,
assisted in the selection of the round-table speakers.
Indeed, the round tables have attracted a diverse group of panellists, including Dr. Sakena Yacoobi, Founder
and Executive Director of the Afghan Institute of Learning (AIL), an Afghan women-led non-governmental
organization that has established itself as a visionary association working at the grass-roots level to empower
women and communities to bring education and health services to poor rural and urban girls and women, as
well as to other disenfranchised Afghans.
Other notable speakers will include Samina Naz, a native of Punjab, Pakistan, whose family of physicians
actively engaged in social service influenced her choice to become involved in civil society advocacy. Ms. Naz is
currently Health Coordinator of Godh (meaning “mother’s lap”), a non-governmental organization based in
Lahore, Pakistan, where she is directly in charge of the maternal and child health programmes for marginalized
communities, affecting mainly the Gypsies and Pakistani Nomads.
As the Conference is in the Asia-Pacific region, it has attracted several local participants, among them, Dr.
Shichuo Li, President of the China Association Against Epilepsy (CAAE), who is dedicated to the research of
neurological diseases. The host country is also very well represented. Among other key speakers in the round
tables is former Special Adviser to the Director-General of the World Health Organization (WHO), Tim Costello,
who currently heads World Vision Australia. Considered the voice of social conscience for Australians, Mr.
Costello has led national debates on such issues as gambling, urban poverty, homelessness, reconciliation, and
substance abuse.
Another major highlight of this year’s Conference is the unprecedented number of 54 workshops — peer-topeer discussions among the non-governmental organizations — on various global health topics. “This year the
planning committee is delighted to have adequate time and space to invite maximum participation of NGOs
from throughout the world in the Conference,” says Mary Norton, Chair of the Conferenceand Co-Chair of the
Planning Committee. “Because the topics of global health and Millennium Development Goals are
multidimensional, we have increased the time frame for workshops from once a day to twice a day, allowing for
20 workshops a day. More NGOs will have time to present their views and stimulate rich dialogue on fostering
global health.”
Co-chair of the Workshop Sub-Committee — comprised of NGOs in both the host country and New York —
which selected this year’s workshops, Elisabeth Shuman, says the broad range of workshops is a unique
opportunity to hear the voice of regional non-governmental organizations on a global problem. “Many of the
co-sponsors of workshops are NGOs from Australia and the Pacific Region who are newly affiliated and have
never before participated in a DPI/NGO Conference. These include NGOs and speakers from the host country,
as well as from Fiji, Papua-New Guinea, Samoa, Tuvalu and Timor-Leste, who will give us insights into
universal health issues, as well as local challenges specific to their area,” says Ms. Shuman.
Included in the line-up of workshop speakers and topics is Carlitos Corriea Freitas, Head of Health Promotion
and Education Department in Timor-Leste’s Ministry of Health, who will lead a panel discussion on the topic
“Coming into Its Own: Hygiene Promotion for Health and Development”.
In addition to speakers from Australia and the Pacific region, Ms. Shuman notes, “We also have many
contributors from Asia, Europe, Africa, and the Americas”. Among them are Carol Nawina Nyirenda from
Lusaka, Zambia, who has lived with HIV for many years, survived tuberculosis and is currently an international
treatment activist for HIV, tuberculosis and malaria. She will moderate a workshop entitled “Slipping through
the Cracks: Women and Infectious Diseases”.
20
The Conference will also feature some 50 exhibits and 10 topic-specific displays by non-governmental
organizations promoting ways and means of achieving the Millennium Development Goals. One of the displays
will be an “ MDG Youth Village”, an interactive exhibit created by members of the Youth Sub-Committee of the
Sixty-Third Annual Conference Planning Committee. Students from universities in New York and Australia have
produced multicultural and multimedia designs to capture the essence of the Goals in this exhibit.
The Conference is due to conclude on Wednesday, 1 September, with a Declaration and statements by keynote
speakers, such as Mick Gooda, Board Member of the Centre for Rural and Remote Mental Health Queensland
and the Australian representative on the International Indigenous Council, which focuses on healing and
addictions. Mr. Gooda is a descendent of the Gangulu people of central Queensland. He is expected to
contribute his extensive knowledge of the diversity of the circumstances and cultural nuances of Aboriginal and
Torres Strait Islander peoples throughout Australia.
Another important speaker at the closing meeting will be Sir George Alleyne of Barbados, former Director of
the Pan American Health Organization, the regional office of the World Health Organization. Sir George, who
was knighted in 1990 by Her Majesty Queen Elizabeth II for his service to medicine, is Chancellor of the
University of the West Indies and currently serves as the Secretary-General’s Special Envoy for HIV/AIDS in
the Caribbean region. He is expected to focus on non-communicable diseases, which, to date, have not
received as much attention, but are critical to attaining the health-related Goals.
Source: http://www.un.org/News/Press/docs//2010/ngo702.doc.htm
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North America
1
Training lay health workers envisioned
The Herald-Sun NC
20/08/2010
By Neil Offen
[email protected]; 419-6646
DURHAM -- N.C. Central University and Lincoln Community Health Center are in the very early stages of a
potential collaboration that could bring lay health workers to underserved neighborhoods in the city.
The idea is to train well-known and respected community members to help work with patients suffering from
chronic diseases, coaching them on how to check their blood sugar, for instance, or reminding them to take
their medications or arranging transportation to a clinic for an examination.
"What we're talking about is people who are popular opinion leaders in their communities, people who others
go to for information, whom people listen to," said La Verne Reid, interim associate dean of public health
education at NCCU. "With just a bit of training they could really help advance good health in their
communities."
The actual role that such lay health workers would serve is "still very much being worked out," said Brian
Bramson, chief of adult medicine at Lincoln. "It's important to realize that all of this is in very preliminary
discussions, and is very crucially contingent on us obtaining funding for the program, which we don't have at
the current time. But we've very excited at this point in pursuing the idea."
Lay health workers have been widely used for many years, particularly in areas that have a dearth of
traditional health care providers, such as inner cities and developing nations. A recent peer-reviewed paper on
their effectiveness, compared to usual health care services, found that they "provide promising benefits in
promoting immunization uptake and breastfeeding, improving TB treatment outcomes and reducing child
morbidity and mortality."
Bramsom, who had experience with the concept while working as a physician in the African nation of Malawi,
said it was easy to imagine the benefits for Durham.
"At the health center, we are seeing a lot of patients with chronic diseases, like diabetes and hypertension," he
said. "We have a very, very good health care staff, who are doing a very good job, but we're not always seeing
good disease outcomes. A lot of that is because many of our patients don't spend a lot of time within our four
walls.
"If we want to see disease outcomes improve, the place where there's the greatest bang for the buck is to try
to improve what happens when the patients are not in our four walls. And that means getting people in the
community involved."
Bramsom recently came to NCCU with the idea.
Under the possible collaboration, the university would provide the actual training for the lay workers, perhaps
resulting in the granting of a certificate.
21
"It would need to be interdisciplinary, covering public health, psychology, nursing, biology and more," Reid
said. The certificate, she explained, would say to an employer, for instance, that the individual has training in
anatomy, physiology or chronic disease prevention. "We've thought about it for a long time. The concept has
been of interest to us for any number of years."
Reid and Bramsom have already met once to discuss the possibility and have scheduled another meeting for
next month. They both acknowledge that there's a long way to go before anything substantial emerges.
But while there is much work to still do, both sides are excited about the possibilities.
"I would envision that there is definitely a role for this type of individual although we have not yet processed
how it would work," Reid said. "We've often thought we could do more for the health of the community, and
this would be a way to do that."
The concept "certainly has seen drastically improved outcomes in other parts of the world, and I would think it
would work here," Bramson said. "I'm confident in our context it would improve disease outcomes. We don't
know how it will be worked out in practice and whether we can afford this is very much in question. But we're
excited at this very, very very preliminary stage."
Obama Seeks Boosts In Funds For AIDS Prevention, Research
Wall Street Journal
20/08/2010
By Jared A. Favole
Of DOW JONES NEWSWIRES
WASHINGTON (Dow Jones)--U.S. President Barack Obama wants Congress to boost funding for AIDS virus
services and research, according to a letter the president sent Friday to House of Representatives Speaker
Nancy Pelosi (D., Calif.).
Obama is seeking $400 million from Congress to help fight the AIDS virus, train health-care workers and to
increase an account for state high-risk health insurance pools, according to a copy of a letter the White House
released Friday. The request is part of amendments to Obama's fiscal year 2011 budget and would be offset by
reducing funding in other areas.
About $55 million would go toward AIDS virus prevention, services and research while $250 million would be to
help enhance health-care training programs the government operates. The remainder would be to boost state
high-risk insurance pools and health insurance information for consumers.
The money would be offset by decreases from the Centers for Disease Control and Prevention and National
Institutes of Health.
-By Jared A. Favole, Dow Jones Newswires; 202-862-9256; [email protected]
4
Hillary Clinton Touts Global Health Initiative as Key Foreign Policy Tool
Policy Daily
18/08/2010
"What exactly does maternal health or immunizations or the fight against HIV and AIDS have to do with foreign
policy?" Secretary of State Hillary Rodham Clinton queried a packed crowd of faculty and students at the Johns
Hopkins School of Advance International Studies on Monday. "Well, my answer is 'everything.' "
With a careful nod to the Bush administration's major efforts in global health – the President's Emergency Plan
for AIDS Relief (PEPFAR) and the President's Malaria Initiative -- Clinton introduced what she called the "next
chapter in America's work in health care worldwide" and laid out the basic outline of the Global Health Initiative
(GHI), a "new approach, informed by new thinking and aimed at new goal: to save the greatest possible
number of lives, both by increasing our existing health programs and building upon them to help countries
develop their own capacity to improve the health of their own people."
The GHI may be new, but it is not exactly news. Rolled out over the last few months, GHI will invest $63 billion
over the next six years to help partner countries through integrated health systems with a renewed focus on
maternal and infant health. The speech at SAIS was meant as a branding of sorts, a popularizing and
contextualizing of the massive project.
To do so, Clinton spent the better part of 90 minutes making the case for an integrated, diplomatic approach to
global health care policy and the impact of international health on U.S. interests abroad. "From the very
beginning of my time as secretary of state," Clinton said during a Q&A session, "I've talked about elevating
diplomacy and development alongside defense -- the three D's of 'smart power,' if you will."
Arguing that health is essential to bolstering fragile or failing states, Clinton grounded the GHI in a larger
nonpartisan context and the recent history of U.S. global health policy.
22
"No nation in history has done more to improve global health. We have led the way on some of the greatest
health achievements in our time," she told the audience, listing advancements ranging from eradicating
smallpox in the 1960s and 1970s to addressing neglected tropical diseases, to preventing and treating malaria.
Today, the secretary explained, "we provide nearly 60 percent -- 60 percent -- of the world's donor funding for
HIV and AIDS. All told, 40 percent of the total global funding for development assistance for health comes from
the United States. "
But she also made digs at her predecessors. "The United States was once at the forefront of developing and
delivering successful family planning programs. But in recent years we have fallen behind. With the Global
Health Initiative, we are making up for lost time."
That was a nudge at the Mexico City Policy -- otherwise known as the global gag rule -- which forbade any U.S.
funds from going to a clinic or provider that mentioned abortion, a policy that went above and beyond the Hyde
Amendment, which assures no U.S. funds will be used for abortions abroad. (By the summer of 2008, the
policy had undermined contraception distribution throughout the developing world.)
Clinton outlined a global-health-supports-security argument, a global-health-as-compassionate-policy
argument, and a global-health-as-practical-solution argument.
"We're shifting focus from solving problems, one at a time, to serving people, by considering more fully the
circumstances of their lives and ensuring they can get the care they need most over the course of their
lifetimes," Clinton explained, and then used an illustrative anecdote about a theoretical rural village woman
who can reach a clinic stocked with anti-retroviral medication (to fight HIV) but cannot get antibiotics or
contraceptives -- nor can she give birth locally, should her birthing process require intervention. Her children
have been protected from malaria, but they may die from dirty water. The moral of the story is one of
integrated services and of an assessment of needs on the ground.
"The list of diseases and deficiencies that threaten lives and livelihoods across the world is nearly limitless,"
she said, "but our resources are not. So therefore we must be strategic and make evidence-based decisions in
targeting the most dangerous threats."
Calling for integration, bundling of treatments and coordination, Clinton decried the "vicissitudes of funding
cycles and development trends." And, perhaps to quell the concerns of those who fear the Global Health
Initiative will negatively affect PEPFAR, she used the latter as an example of why the GHI would be successful.
"We are raising our goal for prevention," she said. "We aim to prevent 12 million new HIV infections. To do that
we are embracing a more comprehensive approach and expanding on what we know works. We are moving
beyond ABC -- abstinence, be faithful, consistent and correct use of condoms," the phrase is from the Bush
era, "to an A to Z approach to prevention. . . . We know we need to confront 2.7 million new infections every
year. So in order to win this war, we need better results in prevention. . . . So the immediate impact for
PEPFAR is clear. Its funding will increase, its impact will increase, and its prevention strategies will be more
comprehensive."
The twitter feed #saisevents was buzzing with commentators throughout and after the event. Mostly positive,
there were those, however, who feared Clinton lost a chance for greater substance.
"After the secretary's speech, I have more questions than answers about the Global Health Initiative," Jirair
Ratevosian, deputy director of public policy at amfAR, the Foundation for AIDS Research, tweeted (privately,
not on behalf of amFAR) to Politics Daily after the talk. "What are the tangible changes? Budget? Integration?"
Agreed Nandini Oomman, director, HIV/AIDS monitor at the Center for Global Development: "While it was
encouraging to hear about the US commitment to global health, the 'HOW' " -- as in how to accomplish these
goals -- "isn't being shared and it makes people wonder: why?"
5
Smart Health | Simple Mobile Services Improve Maternal Health Care in Developing Countries
TMCNet
16/04/2010
By Harald HimselManaging Director, AGEG eG
The last two weeks have been particular demanding for ACEG International Consulting Services. Contracted by
the German government, we are building new hospitals and a central tuberculosis laboratory in North-western
Pakistan. The flood with all its force has brought our projects to a halt. Some of our staff there have lost their
homes, some have even lost family members. The health situation cannot be any worse. This came to my mind
when I came across another project in Pakistan dealing with maternal health.
Not only in Pakistan but worldwide millions of women die or develop pre-natal illnesses. Millions of newborns
also die each year due to lack of access to adequate health services. The overwhelming part of these women
and babies die in developing countries.. Qualified health care staff is rare and very often concentrated on the
areas in and around the capital. Out in the rural areas it all depends on an efficient communication system.
In order to improve maternal health care service in rural areas of Pakistan, the Pakistani government trained
Lady Health Workers, the so-called LHWs. They provide preventive, curative and rehabilitation services. The
problem was that these workers had no means to properly communicate with their supervisors in the health
23
centers in various district capitals. Especially when it came to refer serious cases, the LHWs were more or less
on their on. In a pilot project, LHWs received mobile phones for simple communication needs, but also to
connect directly with hospitals and ambulances. Results show that simply satisfying communication needs at
this level reduced mortalities through referring serious cases in time. The LHW pilot created another positive
outcome; in an area where women are very often limited in their status and right, the ability to communicate
and to quickly resolve problems improved the status of LHWs considerably. In the long run this type of simple
mobile communication access may help to reduce or even close the gender gap.
Another positive example comes from Uganda where maternity health workers using mobile phones has a
much longer tradition. Here, results show a dramatic decline of more than 50 percent in maternal mortality
over the last three years. As in Pakistan, the program focuses on improving the basic communication and
transport systems to bring to speed life-saving referrals. But this project had another very interesting
objective. It was designed to bridge the distance between traditional healers and the public health services.
Maternity health workers received mobiles and walkie-talkies and so did the traditional mid-wives, thus
extending the maternal health service into the traditional health environment
Some of you may have been to South America, trekking through the Andes for example. You will therefore
know that the more isolated the region is the longer the journey takes, sometimes up to a week. In Peru, a
phone- and web- based maternal health care information and communication system was established which
allows nurses, doctors and gynecologists to exchange and discuss relevant and critical information among
themselves and if need be with experts in regional hospitals. Using mobile phones, Internet, satellite and fixedline communication, or even community phones they analyze the cases in remote locations. The program not
only serves to treat patients; it is also used monitor patients, and tracking of supply as well as improving
disease surveillance.
In Aceh Besar in Indonesia midwives are provided with mobile phones as well in order to improve coordination
and exchange of information between community and district levels. It is reported that since the introduction
of modern means of communication such as mobile phones to basic health service providers in rural areas the
gaps in the medical infrastructure and constraints in access –previously resulting in critically delayed
interventions-- have been bridged to a large extent.
In Rwanda, the Ministry of Health has issued mobile phones to over 3,700 community health workers working
at grass root village health centers in the three districts of Kigali City. The phones are intended help health
workers at village level send reports easily to the district health center; which will provide instant feedback to
the village workers, in particular maternity health workers. This initiative comes in response to the fact that
communication was rather well organized between doctors and nurses, but excluded the health workers at the
grass root level. However these were considered to be at the forefront of health services in Rwanda. Including
them in the communication process allows the villagers a far better access to the general health services.
I know: these are stories about basic, simple mobile communication. However, this is what millions of people
around the world need most urgently today. It is the basis upon which more sophisticated smart mobile health
systems may be developed and implemented.
Back to Pakistan: it is said that the monsoon rains will continue at least for another three weeks. After a first
wave of death by water, the WHO expects a second wave of death soon caused by diseases. We can only try to
mitigate the impact this catastrophe has on the people. Efficient communication is one important cornerstone
of such an aid strategy dealing with emergency situations. Next I will provide some information about the
European Space Agengy’s (ESA) program on eHealth in Sub-Saharan Africa.
Harald Himsel is managing director and partner at consulting firm AGEG eG
6
Marshall University midwifery program off to slow start
Charleston Gazette
21/04/2010
, By Veronica Nett
The Charleston Gazette
CHARLESTON, W.Va. -- Marshall University's nurse midwifery master's program is off to a slow start.
The School of Nursing opened the 44 credit hour certified midwife program to students last year, but has yet to
have anyone sign up.
The first five years of any new track are usually slow, said Madonna Combs, professor emeritus and former
director of Marshall's graduate nursing program.
The master's program is the only one in the state. It operates through a collaboration with Shenandoah
University in Winchester, Va.
Students are supposed to complete about 25 credit hours at Marshall's Huntington campus. They would also
travel to Shenandoah University for one week at the beginning of the each semester to take all midwifery
classes, in conjunction with online courses.
24
"The interest is there, but for a person starting out, it is a big commitment," Combs said. "It's expensive, it's
hard, and there are many hoops to get through. I think that is why we do not have a lot, or any, students at
this point."
Nurse-midwives are trained to provide care to women during pregnancy, labor and delivery, and the
postpartum period.
The midwife practice focuses on preventive care and the overall health, diet, exercise practices, and emotional
state of the mother, said Angy Nixon, a certified nurse-midwife who practices out of Putnam County. They
track the health of the mother and child, and families usually get more face time than with a physician.
Many nurse-midwives work in conjunction with OB/GYNs.
"The practice of midwifery is strong in West Virginia," Combs said, "but the numbers have gotten smaller over
the years, particularly because of the OB/GYN shortage."
From 2007 to 2009, about 64 midwives were registered with the state Board of Registered Professional Nurses.
About seven practice in Berkeley County; eight in Kanawha County; nine in Monongalia County; and five in
Putnam County, according to an annual report from the board. Twelve to 15 practice in other states.
About 162 OB/GYNs are licensed in West Virginia and list their primary offices in the state, according to data
from the state Board of Medicine.
CHARLESTON, W.Va. -- Marshall University's nurse midwifery master's program is off to a slow start.
The School of Nursing opened the 44 credit hour certified midwife program to students last year, but has yet to
have anyone sign up.
The first five years of any new track are usually slow, said Madonna Combs, professor emeritus and former
director of Marshall's graduate nursing program.
The master's program is the only one in the state. It operates through a collaboration with Shenandoah
University in Winchester, Va.
Students are supposed to complete about 25 credit hours at Marshall's Huntington campus. They would also
travel to Shenandoah University for one week at the beginning of the each semester to take all midwifery
classes, in conjunction with online courses.
"The interest is there, but for a person starting out, it is a big commitment," Combs said. "It's expensive, it's
hard, and there are many hoops to get through. I think that is why we do not have a lot, or any, students at
this point."
Nurse-midwives are trained to provide care to women during pregnancy, labor and delivery, and the
postpartum period.
The midwife practice focuses on preventive care and the overall health, diet, exercise practices, and emotional
state of the mother, said Angy Nixon, a certified nurse-midwife who practices out of Putnam County. They
track the health of the mother and child, and families usually get more face time than with a physician.
Many nurse-midwives work in conjunction with OB/GYNs.
"The practice of midwifery is strong in West Virginia," Combs said, "but the numbers have gotten smaller over
the years, particularly because of the OB/GYN shortage."
From 2007 to 2009, about 64 midwives were registered with the state Board of Registered Professional Nurses.
About seven practice in Berkeley County; eight in Kanawha County; nine in Monongalia County; and five in
Putnam County, according to an annual report from the board. Twelve to 15 practice in other states.
About 162 OB/GYNs are licensed in West Virginia and list their primary offices in the state, according to data
from the state Board of Medicine.
"It's hard to recruit midwives or any health care professional to West Virginia, so having a local program for
students to go and train as a nurse-midwife benefits the state because [those students] will most likely return
to their community and stay in that community," Nixon said.
State and federal funding is available students interested in the Marshall program, which could help keep
healthcare professionals in West Virginia, Combs said.
More than 90 percent of certified midwives work out of hospitals, community health centers and physician
offices, Nixon said. She is unique in that she works independently and focuses more on home birth and care.
"Over the last 75 years, home birth has become less and less common and it's at about half a percent in West
Virginia," Nixon said.
25
Natural births have also fallen out of popularity, and about 35 percent of West Virginian mothers deliver their
baby by Caesarian section. That's the fifth highest rate in the nation.
West Virginia's shortage of OB/GYNs and midwives contribute to the high C-Section rate, Nixon said. Women
and their doctors have to plan and coordinate the birth because the physician may not be available when she
naturally goes into labor. Other reasons include fears of litigation and changes in the way physicians do their
jobs.
She also attributes the nation's rising maternal mortality rate to a move away from the midwife system and
toward physician-based care.
In 1987, the U.S. maternal mortality rate was 6.6 deaths per 100,000, according to Amnesty International.
The rate increased to 13.3 per 100,000 in 2006,
"We're just not used to moms dying anymore. We kind of consider that a thing of the past, but for the first
time the numbers have gone up," Nixon said. "We're getting worse and more mothers are dying."
The midwife system is the accepted practice across Europe, and their birth mortality rates are some of the
lowest in the world, she said.
The midwife program is a good step for West Virginia and for Marshall, Nixon said. Now, it's just a matter of
recruiting students, she said.
For more information about Marshall University's graduate midwifery program visit
www.marshall.edu/graduate/. To contact Angy Nixon, call 304-757-9006 or email [email protected].
Reach Veronica Nett at [email protected] or 304-348-5113.
7
Stanley says health care worker bill puts patients at risk
Eagle-Tribune, Mass
21/08/2010
By Kyle Cheney, State House News Service
BOSTON — Community health workers — who help steer patients through the health care system - would be
offered certification training under a bill nearing Gov. Deval Patrick's desk, despite warnings from a Merrimack
Valley lawmaker it could diminish patient safety.
Backers of the bill argue that community health workers, often unpaid volunteers, should be viewed as part of
the medical community, are not subject to uniform standards of training and have few career opportunities.
Establishing a voluntary certification program would help strengthen their standing, supporters say,
guaranteeing a minimum level of knowledge for these workers, who often make the first contact with patients
in hospitals or community health centers.
The bill, with Senate amendments, cleared the House Thursday over the objection of state Rep. Harriett
Stanley, the House's Health Care Financing Committee chairwoman. She said it could mislead patients into
presuming all community health workers had training, increase health costs and put patients at risk.
Community health workers, who often provide health education in urban communities, may share a common
language or culture with patients and are picked by hospitals or health centers because of their ties to the
community that patients tend to be from. Community health workers lead counseling sessions, advocate for
patients and offer outreach through schools, shelters and businesses.
The Department of Public Health in 2009 issued a report recommending that certification standards be
developed for community health workers. According to the report, 2,932 community health workers were
identified across the state in 2008.
Stanley, D-West Newbury, said a voluntary process doesn't go far enough and relayed those concerns in a
memo to House Speaker Robert DeLeo a day before the House passed the bill.
Stanley said the Senate "basically gutted the bill" by removing the licensing requirement.
"If you believe they're a certified community health worker, the public believes they have a certain degree of
training. In this case, the bill has the potential to actually mislead people into thinking that these folks have a
higher level of formal training," Stanley said
8
U.S., International Aid Helps Fight Disease in Pakistan Floods
Media Newswire
19/08/2010
26
Media-Newswire.com) - Washington — Waterborne and other infectious diseases threaten more than 15 million
people in Pakistan, where the July-September monsoon season has already produced floodwaters that have
killed at least 1,500 people, left an estimated 20 million homeless and now cover a fifth of the country.
The United States, whose donations to Pakistan so far total about $90 million, is a prime donor to the World
Health Organization ( WHO ), the United Nations Children’s Fund ( UNICEF ) and other U.N. partners. They,
along with international organizations, companies and individuals around the world, are contributing to
desperate efforts to make sure populations have water and food and stay free of disease.
“The United States has a history of working with the government of Pakistan to respond to natural disasters,”
Secretary of State Hillary Rodham Clinton said August 4 from Washington, describing the U.S. response to that
country’s natural disaster.
“We’ve been working hard over the past year to build a partnership with the people of Pakistan,” she added,
“and this is an essential element of that partnership; reaching out and helping each other in times of need.”
At the briefing, Dr. Rajiv Shah, administrator of the U.S. Agency for International Development ( USAID ),
outlined the work of his agency to help national disaster authorities and provide food and water for Pakistan’s
flood assistance.
“We believe the establishment of a disease early warning system to track and make sure that we do not have
subsequent public health diseases that spread in this critical time period is important as part of an effort to
protect the Pakistani people,” Shah added.
HEALTH IN ACTION
In flood-affected communities, the leading causes of illness are skin infections, watery diarrhea and respiratory
infections. Between July 29, when the floods began, and August 12, WHO and mobile and stationary medical
centers partnering with the organization reported treating 143,870 skin infections, 115,922 cases of acute
diarrhea and 113,981 respiratory tract infections.
Through WHO, essential medicines and supplies were distributed to Pakistan’s Ministry of Health and WHO
partners to cover the health needs of 1.8 million people. Supplies included 179 emergency health kits, 700
vials of anti-snake venom, 1.8 million water purification tablets and 152 cholera-treatment kits.
Cholera is a diarrheal illness caused by infection of the intestine with the waterborne bacterium Vibrio cholerae.
The infection is often mild or without symptoms but it can be severe, with profuse watery diarrhea, vomiting
and leg cramps. The disease can spread through contact with feces. Rapid loss of body fluids leads to
dehydration and shock.
“We urgently need to scale up the distribution of water,” Martin Mogwanja, UNICEF’s representative in
Pakistan, said in an August 17 statement. “If we are not able to do so because of lack of funding, water-borne
diseases such as cholera, diarrhea and dysentery will spread and begin killing affected populations, especially
children, already weak and vulnerable to disease and malnutrition.”
He said UNICEF was providing enough clean water to an estimated 1.3 million people every day, but millions
more remained in need. USAID has also provided shelter materials, emergency food supplies and preventive
medical care to curb potential disease outbreaks.
Polio and measles are also threats to children’s health in Pakistan, according to UNICEF, which is working with
WHO and the government to carry out vaccinations against the diseases in relief centers. UNICEF is supplying
oral rehydration salts, a home-based diarrhea treatment, but funding constraints mean that supplies are
limited.
MONITORING AND TREATMENT
Through the USAID Office of U.S. Foreign Disaster Assistance, the United States has provided $3 million to
WHO to expand Pakistan’s Disease Early Warning System, called DEWS nationwide, and to establish the first
15 treatment centers for waterborne illness, located in high-risk flood-affected areas.
"The centers,” Ambassador Anne Patterson said August 13, “will diagnose and treat illness and will be staffed
with trained international and local health workers."
Monitoring for waterborne diseases after a flood is the task of Pakistan’s disease early warning system, a
network of health care providers to which the United States has been contributing since 2008.
On August 9, 56 of 62 flood-affected districts in four provinces provided daily disease surveillance data to
DEWS, allowing health workers to monitor reports of illness. To help curb the spread of illness, the United
States is distributing hand soap and has provided mobile water-treatment units that can provide clean drinking
water for 10,000 people a day.
The United States also is working with the humanitarian community to promote health and hygiene messages
in some of the most affected areas. The messages, which include advice on preventing waterborne diseases
through proper hand-washing, are being broadcast on radio stations and reinforced by hygiene workers who
are going door to door in affected areas.
27
WHO and its international partners are responding to multiple health threats, including waterborne diseases
such as cholera and vector-borne diseases such as malaria, and delivering health care and medicines after
floods destroyed more than 200 hospitals and clinics throughout Pakistan.
More than 30 international humanitarian health organizations participate in these activities, including Care
International, Medical Emergency Relief International ( MERLIN ), Save the Children, the Pakistan Red Crescent
Society and Médecins du Monde–France.
More about the U.S. response to Pakistan’s flooding is available on the State Department website.
9
ASEAN Workers Train for Pandemic Response
Voice of America News
18/08/2010
Public health workers from nearly a score of countries gathered in Cambodia to play a game - a game they
hope will help make Southeast Asia better able to handle pandemic disease.
In this game, the goal is to manage a severe pandemic that breaks out in a fictional region - known as
Pandemica - that is comprised of six countries.
The players - public health workers from the Association of Southeast Asian Nations, the United Nations, the
European Union, the United States and other countries - are deadly serious about this game.
At the start of the five-day exercise this week in Phnom Penh, ASEAN Secretary-General Surin Pitsuwan said
the attendees will be able to learn best practices from each other. And, he said, just as importantly, they will
get to know their counterparts in other countries.
"I think a closer network of not only health workers, but all sectors in the national preparedness for such a
catastrophe will be a most practical outcome. That is they know each other, they know each other's numbers,
they know each other's addresses, and they will continue to inform each other what situation is occurring in
their particular member state so that a quick collective action can be taken as an organization," he said.
Surin added that challenges such as pandemics, financial crises and climate change are too big for individual
countries to deal with, and require regional or even global responses.
Within nations, he says, combating a pandemic requires a "whole of society" approach extending beyond the
health sector to include those who provide food, utilities, public security and transportation.
And he warned that failure to respond appropriately could lead to severe social and economic disruption.
"If we are not careful it will certainly undermine our own economic growth and our own resilience in the
region," he said. "It's natural that all these countries should come together and make sure that each will not be
affected more severely, and no-one wants to be that weak link in the chain of defense."
Surin says the world escaped relatively lightly with the 2003 SARS outbreak. Then, a new virus appeared in
southern China and quickly spread around the world. Thousands were hospitalized with severe pneumonia and
more than 800 people died before strict quarantine measures in several countries brought it under control.
The outcome of this week's exercise, he says, ought to be a region that can deal with the worst-case pandemic
scenarios with a minimum of losses, and help the rest of the world learn the right lessons, too.
10
HHS Secretary Announces $32 Million to Support Rural Health Priorities
ExecutiveGov.
24/08/2010
Written by Camille Tuutti
HHS Secretary Kathleen Sebelius announced yesterday more than $32 million in FY 2010 funds to make
healthcare more accessible for Americans living in rural areas.
“These funds reflect the priorities spelled out by President Obama in providing the best healthcare possible to
rural Americans,” she said. “The ultimate goal is to build healthier rural populations and communities.”
The grants will boost partnerships among rural health providers, said HRSA Administrator Dr. Mary Wakefield.
“Funds will be used to recruit and retain rural healthcare professionals and modernize the healthcare
infrastructure in rural areas,” she said.
More than $22 million will go toward the Medicare Rural Hospital Flexibility Program, which supports
enhancement in healthcare quality in communities served by Critical Access Hospitals, efforts to improve the
28
hospitals’ financial and operating performance, and the development of collaborative regional and local delivery
systems.
Rural Health Workforce Development Program, which supports the development of rural health networks that
seek to improve the recruitment and retention of emerging health professionals in rural communities, will
receive more than $3 million.
More than $3 million will to toward two telehealth programs: the Telehealth Network Grant Program, which
helps communities build capacity to develop sustainable telehealth programs and networks, and the Telehealth
Resources Center Grant Program, which provides technical assistance to help healthcare organizations,
networks and providers implement cost-effective telehealth programs serving rural and medically underserved
areas and populations.
The Flex Rural Veterans Health Access Program, a new program that will help eligible entities coordinate
innovative approaches, will receive nearly $1 million. The grants aim to improve mental-health services
through the use of health information exchange and telehealth in states where veterans comprise a high
percentage of the total population.
Additional programs awarded funds include the Frontier Community Health Integration Demonstration
Program, and the Rural Training Track Technical Assistance Demonstration Program, which, respectively, will
receive $770,000 and $500,000.
Back to top
Europe
1
Membership exams overseas in light of new global code of practice
The Lancet, UK
21/08/2010
Volume 376, Issue 9741, Page 594
Kate Mandeville a, Delan Devakumar a
In light of the 63rd World Health Assembly resolution on the global code of practice for the international
recruitment of health personnel (May 15, p 1673),1, 2 we question the notion of holding membership
examinations to UK colleges in low-income and middle-income countries.
For example, the Royal College of Physicians holds its Part 1 examination in 25 overseas centres and the Royal
College of Paediatrics and Child Health recently extended its sphere with the commencement of the MRCPCH
examination in India.3
For candidates in pursuit of an internationally recognised qualification, it is undoubtedly more convenient to
take these examinations in their home countries. For the UK, the colleges benefit from increased revenue and a
wider reputation. And, in shortage specialties, recruitment for vacant posts in the National Health Service is
facilitated by a larger pool of qualified candidates.
Exporting an examination to countries with limited postgraduate education has some merit. However, it can
undermine the capacity and development of domestic postgraduate education, particularly in countries (such
as India) that have well established and longstanding postgraduate systems. Moreover, we wonder how the
syllabi of UK-focused examinations expand the skills of trainee doctors in countries with very different health
needs.
We believe that exporting UK qualifications encourages migration and that this is particularly disingenuous in a
time of tightening visa regulations for graduates who are not citizens of the European Economic Area.4 More
importantly, many countries face a critical shortage of health workers, including eight of the countries in which
the Royal College of Physicians conducts its MRCP examinations.5
We feel that this practice contradicts the new global code of practice and should be discouraged.
We declare that we have no conflicts of interest.
References
1 Taylor AL, Gostin LO. International recruitment of health personnel. Lancet 2010; 375: 1673-1675. Full Text
| PDF(60KB) | CrossRef | PubMed
2 WHO. Sixty-third World Health Assembly closes after passing multiple resolutions.
http://www.who.int/mediacentre/news/releases/2010/wha_closes_20100521/en/index.html. (accessed Aug 2,
2010).
3 Newell S, Muir G. An RCPCH passage to India. Royal College of Paediatrics and Child Health Spring 2010
newsletter. http://www.rcpch.ac.uk/doc.aspx?id_Resource=6474. (accessed Aug 10, 2010).
4 British Medical Association. BMA statement on the international migration of health workers.
http://www.bma.org.uk/international/international_development/migration/migrationstatement.jsp. (accessed
Aug 2, 2010).
29
5 Global Health Workforce Alliance. List of 57 countries facing human resources for health crisis.
http://www.who.int/workforcealliance/countries/57crisiscountries.pdf. (accessed Aug 2, 2010). a Infection and
Population Health Department, University College London, Royal Free Hospital, London NW3 2PF, UK
2
S African strikers set to defy court order
Financial Times, UK
22/08/2010
By Simon Mundy in Gaborone
South Africa’s trade unions on Sunday signalled that a big public sector strike, which has shut down much of
the government, would continue in spite of a court ordering essential staff to return to work.
Schools, hospitals and courts have been severely affected by the action, which began last Wednesday after the
government failed to resolve a dispute over wage increases. Volunteers and military medics have stepped in to
keep 32 hospitals functioning, with troops deployed after some protests became violent
On Saturday, the labour court formally banned essential staff, including doctors, nurses and teachers, from
participating in the strike. Themba Maseko, a government spokesman, said the ruling had also declared
unlawful any “intimidation, assault, molesting, victimisation of non-striking public service employees and
members of the public” by those taking part in the action.
But Patrick Craven, from the Congress of South African Trade Unions, said on Sunday that the order would not
make “any fundamental difference to our overall strategy”. The unions would consult lawyers today before
deciding on their next step.
Mr Craven added: “A lot of confusion is bound to occur here because the term ‘essential workers’ has never
been properly defined.” Nurses and all other participants in the strike would stay away from work until further
notice, he said.
Cosatu is formally part of South Africa’s governing alliance, supposedly ruling in partnership with the African
National Congress and the Communist party. But the strike shows the acute tension within this coalition.
Months of negotiations between the government and the unions failed to reach agreement over pay rises. The
unions want an increase of 8.6 per cent and a monthly R1,000 ($137, €108, £88) housing allowance, but the
government said that it could go no higher than 7 per cent with a R700 allowance.
Nurses and other health workers have blockaded hospitals. Suraya Jawoodeen, a regional official of the
National Education, Health and Allied Workers’ Union, claimed to have “totally shut down” three hospitals in
Western Cape province. She added that critically ill patients should “negotiate” with those on the picket lines.
Media reports have linked the strike with deaths, including those of two premature babies who were not
properly fed.
Aaron Motsoaledi, health minister, said: “I’m not only surprised but shocked at the willingness to murder,
because we can’t have that kind of country.”
Jacob Zuma, the president, received crucial support from the unions during his rise to power. But he
condemned the strikers on Saturday, saying they were tarnishing the image of the country. “Even during the
campaigns against the apartheid government we did not prevent nurses from going to work,” he said.
Police fired rubber bullets at protesters in Johannesburg on Thursday and used water cannon to disperse
people who started a fire outside the entrance to a hospital.
An official spokesman said that the government’s pay offer would cause the state to exceed its wage budget by
R5bn. The increase would be imposed unilaterally after three weeks if the unions did not accept it, he added.
South Africa’s consumer price inflation for the year to June was only 4.2 per cent, and a mid-ranking public
servant’s monthly pay of R8,800 is already 40 per cent above the national average.
However, unions argue that above-inflation increases are vital to tackling income inequality.
David Shapiro of Sasfin, a financial services group, said the government was struggling to deal with “a public
sector that goes on strike at the drop of a hat”.
Copyright The Financial Times Limited 2010
3
Mother told to clean own room after caesarean
The Local, Sweden
22/08/2010
30
Mother-of-two Elin Andersson has highlighted staffing shortage problems at a maternity ward in Sundsvall in
northern Sweden after she was asked to clean out her own hospital room just two days after giving birth by
caesarean section.
Every time Andersson required medicine she had to call staff to remind them, she told local newspaper
Sundsvalls Tidning. The new baby's father meanwhile was requested to aid in the care of his partner.
Two days after the operation, the recovering mum decided she was ready to go home.
”That was when the midwife said I had one final task to perform. Then she went and got a big white laundry
bag and asked me to clean out the room and the bed where I had lain,” she told the newspaper.
Two midwives at the Sundsvall maternity ward admitted that Elin Andersson painted an accurate picture of
their workplace.
”She describes precisely those bits that we don't have time for,” said Gunnel Westerlund.
”Medical safety always comes first and you can't leave a mother while she's giving birth. It's true that we
sometimes need to make use of the parents and that doesn't feel good at all.”
TT/The Local ([email protected]/08 656 6518)
4
Foreigners queue up for nursing vacancies
Times of Malta
21/08/2010
Juan Ameen
A total of 300 nurses, mainly foreign, have applied to work within the public sector, the Health Ministry said
yesterday.
Of these, 50 applications were from Maltese, some of whom have just completed their studies and will be
called to work in the near future, the ministry said.
It was reacting to statements made by the Emergency Nurses Union and the Medical Association of Malta which
lamented the shortage of nursing staff and the long waiting hours to be given a bed in the hospital’s
emergency ward.
The nurses’ council, an auto-nomous body, has received 300 applications since January, after the government
issued a call, which will remain open until 2011, for nurses of any nationality to apply for the job.
The majority of these – 250 applications – were submitted by foreign nurses, mainly non EU-nationals, a
ministry spokesman said.
So far, 125 have passed the first phase of the selection process. The council has given the go-ahead for 46
Pakistani nurses to work as staff nurses from next month while a further 79 nurses would be scrutinised, the
ministry said.
In a statement, the nurses’ council said it was committed to providing the best service possible by closely
vetting the qualifications, while making sure the nurses were able to communicate without any problems.
To overcome language barrier problems, foreign nurses will follow proficiency studies and ensure they adapt to
work and the Maltese culture.
The vetting process took time because the council had to check the qualifications while other departments had
to approve a work permit and a visa, it added.
Health Minister Joe Cassar said the figures were the result of the government’s commitment to strengthen the
health services.
But Malta Union of Midwives and Nurses president Paul Pace said the problem of long waiting times at Mater
Dei Hospital’s emergency ward was more complex than the shortage of nurses.
“There is more to it than a lack of nurses and we are short by around 700. Among other things, a lot of
repetitive work is done by the casualty and ward doctors. There is also a massive shortage of beds,” he said.
He said 84 per cent of patients at Mater Dei Hospital were elderly people who could not be taken home because
both spouses had to work. “It’s not a matter of dumping – lifestyles have changed,” he said.
Mr Pace condemned the decision to leave patients waiting in a corridor, describing it as undignified and highly
irresponsible.
The union was tackling the shortage of nurses on all fronts. “We are leaving no stone unturned,” Mr Pace said.
31
The union is meeting the ministry next week to discuss several proposals, including changing the hospital’s
admission and discharge policy, while increasing the bed complement and the intake of new nurses.
5
Healthcare workers raise 'SOS' over threats to services
Irish Independent
25/08/2010
By Brian McDonald
Around 100 health workers yesterday raised an 'SOS' over threats to hospital services from a major budget
shortfall.
The protest at University Hospital Galway was also to launch a joint inter-union campaign, entitled Save Our
Services (SOS), to drum up public support for opposition to cuts.
The unions and HSE West are already engaged in talks, exploring all options in tackling a potential €91m
deficit. The negotiations are taking place at local level across the region, stretching from Limerick to Donegal.
SIPTU, IMPACT and the Irish Nurses and Midwives Organisation fear that up to 1,000 jobs could be at risk.
In the past fortnight, protests in Roscommon and Ballinasloe have drawn thousands of people on to the streets
to issue a 'hands off our hospitals' warning to the HSE.
Galway IMPACT official Padraig Mulligan said the 'SOS' campaign was working to resist what he insisted were
HSE plans to cut €24m from the budget at UCH Galway and more than €18m from community services in the
area.
"It is important for us to stand strong and put on a determined show of strength in support of our health
services. The planned cuts would result in the decimation of our services, jobs and the local economy," he said.
6
Expansion of cancer care and control in countries of low and middle income: a call to action
The Lancet, UK
16/08/2010
Prof Paul Farmer MD a, Julio Frenk MD b, Dr Felicia M Knaul PhD c , Lawrence N Shulman MD d, George Alleyne
MD e, Lance Armstrong f, Prof Rifat Atun FFPHM g, Douglas Blayney MD h, Lincoln Chen MD i, Prof Richard
Feachem PhD j, Mary Gospodarowicz MD k, Julie Gralow MD l, Sanjay Gupta MD m, Ana Langer MD b, Julian
Lob-Levyt MD n, Claire Neal MPH f, Anthony Mbewu MD o, HRH Dina Mired BSc p, Prof Peter Piot MD q, K
Srinath Reddy MD r, Prof Jeffrey D Sachs PhD s, Mahmoud Sarhan MD t, John R Seffrin PhD u
Summary
Substantial inequalities exist in cancer survival rates across countries. In addition to prevention of new cancers
by reduction of risk factors, strategies are needed to close the gap between developed and developing
countries in cancer survival and the effects of the disease on human suffering. We challenge the public health
community's assumption that cancers will remain untreated in poor countries, and note the analogy to similarly
unfounded arguments from more than a decade ago against provision of HIV treatment. In resourceconstrained countries without specialised services, experience has shown that much can be done to prevent
and treat cancer by deployment of primary and secondary caregivers, use of off-patent drugs, and application
of regional and global mechanisms for financing and procurement. Furthermore, several middle-income
countries have included cancer treatment in national health insurance coverage with a focus on people living in
poverty. These strategies can reduce costs, increase access to health services, and strengthen health systems
to meet the challenge of cancer and other diseases. In 2009, we formed the Global Task Force on Expanded
Access to Cancer Care and Control in Developing Countries, which is composed of leaders from the global
health and cancer care communities, and is dedicated to proposal, implementation, and evaluation of
strategies to advance this agenda.
Introduction
Once thought to be a problem almost exclusive to the developed world, cancer is now a leading cause of death
and disability, and thus a health priority, in poor countries. Low-income and middle-income countries now bear
a majority share of the burden of cancer, but their health systems are particularly ill prepared to meet this
challenge.1—6 The rising proportion of cases in these countries is caused by population growth and ageing,
combined with reduced mortality from infectious disease. In 1970, 15% of newly reported cancers were in
developing countries, compared with 56% in 2008.4 By 2030, the proportion is expected to be 70%.2, 4, 6
Almost two-thirds of the 7·6 million deaths every year from cancer worldwide occur in low-income and middleincome countries, making cancer a leading cause of mortality in these settings.2, 6 Furthermore, increases in
age-adjusted mortality rates have been recorded in certain developing regions and for specific cancers, such as
breast cancer.7
Low survival rates in poor countries and improved survival in developed countries contribute to the disparity in
the burden of cancer deaths. Overall, case fatality from cancer (calculated as an approximation from the ratio
32
of incidence to mortality in a specific year) is estimated to be 75% in countries of low income, 72% in countries
of low-middle income, 64% in countries of high-middle income, and 46% in countries of high income.2 Survival
is closely and positively related to country income for certain cancers—such as cervical, breast, and testicular
cancer, and acute lymphoblastic leukaemia in children—and hence the scope for action on these diseases is
particularly large (figure)…….Continued
a Harvard Medical School, Boston, MA, USA
b Harvard School of Public Health, Boston, MA, USA
c Harvard Global Equity Initiative, Boston, MA, USA
d Dana-Farber Cancer Institute, Boston, MA, USA
e Pan American Health Organization, Washington, DC, USA
f Lance Armstrong Foundation, Austin, TX, USA
g Global Fund to Fight AIDS, Tuberculosis and Malaria, Geneva, Switzerland
h American Society of Clinical Oncology, Alexandria, VA, USA
i China Medical Board, Cambridge, MA, USA
j Global Health Group, University of California, San Francisco and Berkeley, CA, USA
k Princess Margaret Hospital, Toronto, ON, Canada
l Seattle Cancer Care Alliance, Seattle, WA, USA
m CNN, Atlanta, GA, USA
n Global Alliance for Vaccine and Immunization, Geneva, Switzerland
o Global Forum for Health Research, Geneva, Switzerland
p King Hussein Cancer Foundation, Amman, Jordan
q Institute for Global Health, Imperial College London, London, UK
r Public Health Foundation of India, New Delhi, India
s Earth Institute, Columbia University, New York, NY, USA
t King Hussein Cancer Center, Amman, Jordan
u American Cancer Society, Atlanta, GA, USA
Correspondence to: Dr Felicia M Knaul, Harvard Global Equity Initiative, 651 Huntington Avenue, FXB Building
632, Boston, MA 02115, USA
Full-text: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)61152-X/fulltext
7
Chinese doctors are under threat (Editorial)
The Lancet, UK
28/08/2010
Volume 376, Issue 9742, Page 657
System change, the theme of the World Cancer Congress in Shenzhen, China, Aug 18—21, was a central
message in the opening address by the Chinese Minister of Health, Chen Zhu, as he described current healthcare system reforms in China. At the Congress many international health policy makers and physicians led
discussions on frameworks and actions for system change, but there was little participation from local Chinese
doctors.
To understand why there were so few Chinese delegates in the plenary sessions on system change compared
with sessions on patients' care, one must first understand that for many Chinese doctors personal safety is of
greater concern. Chinese doctors are often victims of terrible violence. In June this year, a doctor and a nurse
were fatally stabbed in Shandong Province by the son of a patient who died of liver cancer 13 years ago, and a
paediatrician in Fujian Province was injured after leaping out of a fifth-floor window to escape the angry
relatives of a newborn baby who had died under his care. Thus, it is not surprising to see that in July police
officers were invited to be the vice-presidents of 27 hospitals in Shenyang. With hospitals turned into
battlegrounds, being a doctor has become a dangerous job in China.
The problem may be largely one of perception. Many Chinese patients believe that doctors and hospitals
conspire to increase charges by providing unnecessary examinations, investigations, and treatments.
Additionally, some doctors accept red envelopes (a monetary gift in exchange for favourable service) against
the rules. Many patients blame the deterioration of their health directly on doctors, claiming that doctors lack
devotion and skills. The intellectual ideals of ancient China were “either to be a good prime minister or to be an
excellent doctor”, while in modern China doctors and nurses used to be worshipped as “angels in white”. How
has the perception of Chinese doctors become so eroded?
The Chinese media certainly have an important role in provoking tension between doctors and patients. There
is disproportionate coverage in newspapers, television, and on the internet of how health professionals have
cheated patients. Just a few weeks ago the Southern Metropolis Daily (the most popular newspaper in
Guangdong) falsely accused a midwife, who had treated haemorrhoids for a patient after childbirth, of stitching
the patient's anus closed on purpose. In November, 2009, one of China's most authoritative media outlets,
CCTV (China Central Television), reported that the renowned Peking University First Hospital was carrying out
illegal medical practices by allowing medical students to do surgical procedures, and as a result a patient had
died. Even though the hospital and the Ministry of Health made it clear that involving medical students in
clinical procedures including surgery under the supervision of licensed doctors is legal, trust in doctors and
hospitals was seriously damaged. It is hard to tell whether the misreport resulted from a lack of medical
knowledge on the parts of the Southern Metropolis Daily and CCTV, or whether it was motivated by a desire for
33
a sensational story. However, the public misunderstanding of the medical profession will surely hurt both
doctors and patients in the end.
Most hospitals in China, especially the large ones such as Peking Union Medical College Hospital and Huashan
Hospital of Fudan University, are run by the government. Public hospitals in China enjoyed full government
funding before 1985. After economic reforms, the hospitals now receive very limited financial support from the
government, with the result that hospitals must generate income to cover costs. As the main source of
hospitals' income is from diagnostics and treatment, there is a financial incentive to over-investigate and overtreat. To minimise inappropriate conflicts of interest, the Chinese Government passed laws to prevent doctors
receiving financial kickbacks from drug companies. Because the standard salary of a doctor is modest, even by
Chinese standards, many doctors struggle to balance professional ethics and making ends meet in an
economically booming China. Such pressures, coupled with a sense of feeling seriously undervalued by the
government and society as a whole, drive many doctors out of medicine into other jobs.
China's health-system reforms cannot be successful without reforming the social and economic status of
doctors. Chinese doctors should be involved more in shaping health policy, by giving voice to their own
experiences and constructive ideas about the health system.
8
NÎMES - Cruel manque d'infirmières dans les maisons de retraite
Midi Libre, France
18/08/2010
Claude Caléro, directeur de la maison de retraite de château Silhol et président de la fédération
départementale des directeurs de maisons de retraite (25 établissements adhérents sur la soixantaine de
maisons de retraites, tous statuts confondus, que compte le département), demande aux pouvoirs publics
d’agir: « C’est la première fois qu’on manque à ce point d’infirmières dans nos établissements. L’intérim
n’arrive plus à fournir, on ne sait pas comment faire, nous ne sommes plus en capacité d’assurer la sécurité
médicale de nos résidents ».
9
Horário de 40 horas traz mais meio milhão de consultas
Diário de Notícias, Portugal
23/08/2010
FNAM fez contas aos ganhos para o SNS caso os clínicos que fazem 35 passem a 40 horas semanais: 'mais'
800 a 900 médicos
Os utentes do SNS podem beneficiar de mais meio milhão de consultas anualmente, caso os médicos que
trabalham hoje 35 horas semanais passem a um horário de 40. Este é apenas um cenário que a Federação
Nacional dos Médicos (FNAM) está a traçar, caso as negociações com o Ministério da Saúde sobre as grelhas
salariais cheguem a bom porto, e se concretize o alargamento de horário. O SNS ganhará "o equivalente a
mais 800 a 900 médicos, calcula o dirigente Sérgio Esperança.
Actualmente há entre 5400 e 6000 médicos com horário de 35 horas, ou seja, sem o regime de exclusividade
que abrange 42 horas e que impede os médicos de exercer fora do serviço público.
A FNAM ainda não sabe a distribuição destes meios por cuidados primários ou hospitalares, mas calcula que
"cada médico faça mais 14 consultas por semana (hospital ou centro de saúde) ou que, por cada dois médicos,
haja mais duas ou três cirurgias (mínimo de 72 mil cirurgias/ano)".
O problema é que se aguarda desde o início do ano uma proposta do Ministério da Saúde sobre as grelhas
salariais, que tem de ter negociação conjunta com o Ministério das Finanças. "Há um protelar deste processo e
não há ainda uma proposta. Apresentaram vários cenários, mas com definição do que serão os gastos, e, com
a crise, os gastos são limitados. Percebemos isso, mas o ministério tem de analisar as duas vertentes: gastos e
benefícios", sublinhou.
O ministério calcula gastos entre 50 e 150 milhões de euros com as alterações às grelhas salariais. Neste caso,
ultrapassariam a poupança de cem milhões de euros prevista com as medidas de austeridade anunciadas,
como a redução do preço de medicamentos.
Os sindicatos não estão muito voltados para fazer mais horas nas urgências porque já têm "de fazer um
período semanal de 12", referem. Mas esse não é o entendimento do ministério. O DN apurou que o Governo
continua a querer usar grande parte do aumento horário para dar resposta às urgências. A juntar à falta de
médicos, a partir dos 50 anos podem deixar de fazer urgência nocturna. A partir dos 55 ficam dispensados de
qualquer uma.
Para o Estado, esta carência tem saído cara, porque tem obrigado a pagar horas extras aos médicos e preços
elevadíssimos aos das empresas, que garantem um terço da resposta. Há casos em que os preços por hora
ainda chegam a ultrapassar os valores definidos por lei (até 35 euros).
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A FNAM refere que "só a passagem de 35 para as 40 horas vai poupar mais de cem milhões de euros, mas os
gastos com horas extras também têm de ser contabilizados". Já as verbas para "tarefeiros" somaram 40
milhões só em 2009, segundo dados da tutela.
Os sindicatos dizem que se espera há um ano pelas grelhas. Fonte do Governo diz que "está empenhada em
manter um bom clima de diálogo com os sindicatos na regulamentação da carreira especial médica, estando
previsto a continuação das negociações logo após o actual período de férias".
10
Málaga tiene la mitad menos de enfermeros que la media europea
Malaga Hoy, Spain
22/08/2010
Leonor García / Málaga
La reivindicación viene desde hace años: en la provincia faltan unos 800 enfermeros para cubrir un déficit
estructural que se acentúa con el incremento de la población, el envejecimiento demográfico y el aumento de
las prestaciones. El Sindicato de Enfermería (Satse) ya hizo hace tres años movilizaciones para exigir que se
reforzaran las plantillas e incluso logró un acuerdo verbal con la Administración sanitaria de que se
incrementarían. "Pero con la crisis ha habido un parón", se queja el secretario provincial de Satste, Eugenio
Pérez.
Los datos que aporta la organización sindical dejan a la provincia muy mal parada en recursos de enfermería.
Según Satse, la media de enfermeros por 100.000 habitantes en la Unión Europea es de 843. En Málaga, la
relación es de 387 por cada 100.000; la mitad menos. En general, en España la situación no es buena, pero la
proporción en la provincia es de las peores tanto en comparación con el territorio nacional como autonómico.
En España, hay 531 enfermeros por 100.000 habitantes y en Andalucía, 410; cifras ambas que se sitúan por
encima de la proporción de 387 por 100.000 de Málaga.
"Sólo dos países de la Unión Europea tienen menos enfermeros que España en relación con su población;
Grecia y Bulgaria", apuntó Pérez. De hecho, nuestro país ocupa el puesto número 22 del ranking en la
proporción de ATS por 100.000 habitantes.
En la provincia trabajan unos 5.500 diplomados en enfermería dentro de la sanidad pública. La Organización
Mundial de la Salud recomienda que por cada centenar de profesionales sanitarios haya un 30% de médicos y
un 70% de enfermeros, es decir, dos ATS por cada facultativo. Según Satse, en la provincia la relación está
prácticamente en la mitad. El sindicato sitúa el déficit más acuciante en los hospitales, donde calcula que hace
falta medio millar de profesionales. El Colegio de Enfermería ya estimó hace tiempo que en la provincia -en
todos los niveles asistenciales- se necesitaban entre 600 y 800 ATS, una cifra que coincide con la reivindicación
de Satse.
El tema incluso ha llegado al Senado. A finales de junio pasado, la Cámara alta aprobó la Ponencia sobre
Necesidades de Recursos Humanos, que concretaba el déficit de enfermeros en 122.400 en toda la sanidad
pública española.
Saste demanda un incremento de las plantillas ya que "las difíciles condiciones de trabajo en un ambiente de
elevado estrés y en contacto permanente con el dolor y la muerte se traducen en la aparición temprana de
problemas de salud y un apreciable deterioro de la calidad de vida de las enfermeras".
Ante el déficit de plantillas, el secretario provincial de Saste reclama que se cubra el 100% de las bajas. No
obstante, recuerda que el colectivo tiene un nivel de absentismo bajo, que es de alrededor de un 4%. Además,
el sindicato demanda al Servicio Andaluz de Salud (SAS) que no cierre plantas en los hospitales -como ocurre
todos los veranos- porque eso agrava la sobrecarga laboral ya que cada enfermero debe llevar a más
pacientes. Pérez insistió: "Que ya que hay tanto déficit, que donde hay tres enfermeras siga habiendo tres
enfermeras; que no se aproveche esta coyuntura de crisis para contratar aún menos".
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Latin America & Caribbean
1
Health sector on track for MDGs — CMO
Jamaica Observer
25/08/2010
DESPITE the numerous challenges facing Jamaica's health sector, including the mass migration of health
workers, chief medical officer at the Ministry of Health Dr Sheila Campbell-Forrester, yesterday sought to
assure the sector that the country was still on target to meet the 2015 Millennium Development Goals.
"We are right on target as we as a country seek to become very efficient (and) cost-effective in what we do -provide quality care -- and as we seek to re-orient our health systems and health service delivery to be more
people focused," she said.
35
Dr Campbell-Forrester was addressing health officials gathered at the Medallion Hall hotel in St Andrew
yesterday for a two-day workshop to measure Jamaica's human resources in the health sector.
"There will always need to be checks and balances and so monitoring and evaluation are critical components of
the human resource process," she said.
Meanwhile, PAHO/WHO representative to Jamaica Dr Ernest Pate, said serious consideration needs to be given
to the quality of care that is given in the sector. He believes that assessing the skills of the workforce;
improving the working environment and addressing the migration of health workers are just some of the ways
healthcare can be improved.
"Where we are losing most of our professionals is in the middle management level -- those people who have
had 12-15 years of experience; those individuals who would be the leaders and supervisors and the guiding
force in our health care work force," he said in reference to a recent World Bank report that looked at nurses in
the region.
Health minister Rudyard Spencer said the workshop would allow health workers to design a measurement
methodology for human resources in health.
"I believe that the public sector in general has a deficiency in the areas of monitoring, measurement and
evaluation that must be addressed with some urgency. In health, we are dealing literally with life and death
issues," he said.
He, too, believes that Jamaica has made significant strides in improving the health sector.
"Indeed, we have achieved much, but we are engaged in a daily struggle to maintain our goals and to move
forward in the achievement of a broader range of freedoms for our people to enjoy," he said.
--Nadine Wilson
2
Padece hospital de Tehuacán falta de médicos y enfermeras
e-Consulta, Mexico
23/08/2010
Por Lucero Hernández García
Falta de médicos y enfermeras, así como escasez de material de curación, son los mayores problemas que
enfrenta el Hospital General de Tehuacán, afirmó el jefe de la jurisdicción sanitaria No. 10 de la Secretaría de
Salud estatal, Alejandro Jiménez Espinosa
En entrevista vía telefónica, el directivo negó que el abasto de medicamentos represente problema alguno para
el nosocomio, como lo reveló la Secretaría de Salud federal a través del Observatorio de Desempeño
Hospitalario, que ubica a este nosocomio con un desabasto de hasta 42.2 por ciento.
Aunque existen problemas en la entrega de los fármacos, refirió que éstos se deben a que los pacientes no
acuden a la farmacia a intercambiar su receta, pese a que se les otorgan sin costo.
Por atraso en licitaciones falta material de curación
Indicó que el nosocomio recibe pacientes de más de 20 localidades aledañas al municipio, de diversos extractos
socioeconómicos que desconocen el movimiento de un hospital, por lo que salen a comprar sus medicamentos
cuando pueden obtenerlos sin costo en el Hospital.
Además de ello dijo, enfrentan la creciente baja en la afiliación de derechohabientes al IMSS, quienes en busca
de atención médica, generan una mayor demanda a los Servicios de Salud del estado de Puebla (SSEP).
Precisó que el hospital maneja más de 300 claves en medicamentos, de las cuales sólo 4 o 5 escasean por el
alto costo que representan, empero, en un lapso no mayor a 24 horas se hace efectiva la entrega a los
pacientes que así lo requieren.
Afirmó que los mayores problemas se concentran en el material de curación, ya que las últimas licitaciones se
retrasaron, lo que origina la escasez de los productos.
Pese a ello, se dijo confiado en que durante los próximos días se licite el material y con ello se haga efectiva la
entrega del equipo, siendo la mayor demanda: gasas, guantes y jeringas.
De cubrir esta demanda en este periodo, se alcanzaría a completar el faltante hasta abril del 2011.
Jiménez Espinosa refirió que ante este problema, el personal médico se ha visto obligado a utilizar con cautela,
el equipo y material, a fin de mantener un resguardo en tanto se apresura el proceso de licitaciones.
Faltan especialistas y enfermeras
36
El déficit de personal es uno de los mayores conflictos, ya que actualmente la atención demanda al menos 25
nuevos médicos especialistas y 30 enfermeras, para completar una plantilla de 300 enfermeras y 125
especialistas, principalmente en las áreas: ginecología, pediatría y medicina general.
Una vez que la Secretaría de Salud estatal cubra las vacantes necesarias en los Hospitales Generales del Norte
y Sur de la capital poblana, confió en que arranque la cobertura médica al interior del estado.
Finalmente, reconoció que existe un atraso en la atención de pacientes que llega a prolongarse más de 15
minutos, sin embargo justificó esta situación debido al número de usuarios que reportan al día, el cual rebasa
las mil personas.
Hospital General de Teziutlán
Por su parte, el director general del Hospital General de Teziutlán, Rafael Montes Utrera, descartó problemas
en el abasto de medicamentos, por lo que calificó como erróneos los resultados del Observatorio del
Desempeño Hospitalario, que reportan un déficit de medicamentos del 28.9 por ciento.
En entrevista vía telefónica, detalló que la labor de abastecimiento de medicinas corresponde a la Farmacia
Fénix, la misma que surte al Hospital General de Tehuacán desde hace dos años, a través del programa Seguro
Popular.
3
Gestiona ante el IMSS incremento de personal para el Hospital Ixtlero
Vanguardian, Mexico
19/08/2010
Jesús Jiménez
SALTILLO, COAH.- Para gestionar ante el IMSSOportunidades un mayor número de médicos, enfermeras y
personal técnico para el Hospital Ixtlero Número 33 de Ramos Arizpe, viajó ayer a la capital del país el
delegado del Seguro Social en Coahuila, José Luis Dávila Flores, quien informó que los trabajos de
remodelación y ampliación de dicha unidad registran un 93 por ciento de avance.
“Vamos a platicar con la gente de IMSS-Oportuniddes para empezar a ver el tema de las plazas que se van a
necesitar para el Hospital Ixtlero 33, donde obviamente al duplicarse la cantidad de camas y de personas que
vamos a atender, se va a requerir de mayor número de personal, entonces de una vez presentaremos el
planteamiento respectivo”, expuso el funcionario.
Entrevistado ayer en el Aeropuerto Internacional Plan de Guadalupe antes de abordar el vuelo 227 de Aeromar,
el Delegado expuso que se incrementará la capacidad de 33 a 54 camas, “por lo que vamos a solicitar que
venga el personal especializado en este tipo de temas para que realice a la brevedad el estudio que determine
el número de plazas que se van a requerir.
“Ya entregamos la remodelación de Urgencias, que se remodeló completamente, área a la que se dotó también
de aire acondicionado que no tenía, mientras que en Laboratorio se triplicó la capacidad y en Rayos X se
duplicó, por lo que ahora, contaremos con un hospital preparado para dar servició médico a un mayor número
de pacientes”, dijo Dávila Flores, quien aseguró estar en el tiempo adecuados para dichas funciones.
El delegado del IMSS en Coahuila también informó que en la capital del país participaría en una reunión
nacional sobre las nuevas rutas de abasto de medicamentos, aspecto del que aseguró no existen problemas en
hospitales, clínicas y unidades del Seguro Social en Coahuila, “porque aquí no representa un problema ya que
estamos en un 98 por ciento de la entrega, es decir, de cada 100 medicamentos siempre contamos con 98 de
ellos, por encima de la meta nacional que se incrementó el año anterior de 94 a 96 por ciento”.
Sí faltan especialistas
En torno a las declaraciones del doctor Miguel Ángel Trujillo, secretario General de la Sección 12 del SNTSS, en
el sentido de que el IMSS Coahuila presenta un déficit de 200 especialistas, el delegado reconoció el problema,
“y si bien es cierto que batallamos con médicos especialistas, esto no sucede sólo en Coahuila, sino que se
batalla en todo el país, porque desgraciadamente hay una seria carencia a nivel nacional, y en todas las
instituciones de salud. “Lo positivo es que tenemos las plazas autorizadas y los recursos listos para que cuando
se presenten tengan su trabajo listo”, expresó Dávila Flores.
Llegan productores
En el vuelo 226 de Aeromar llegaron ayer Luis de Llano y Marco Flavio, productores de Televisa, quienes
sostendrían ayer diversas reuniones de trabajo con funcionarios de la Sectur Estatal y de Gobierno del Estado,
como parte de los preparativos para la realización aquí del Certamen Nuestra Belleza 2010. Los reconocidos
personajes del mundo del espectáculo fueron recibidos por el Secretario de Turismo, José Luis Moreno Aguirre.
4
São Paulo pode se tornar um polo mundial de saúde
Abril.com, Brazil
18/08/2010
Por AE
37
São Paulo - A cidade de São Paulo reúne todos os requisitos para se tornar um polo mundial de atividades
ligadas às ciências da vida humana. Com 15,4% dos pesquisadores brasileiros na área de medicina, responde
por 30,3% da produção científica nacional. Além disso, abriga 10 mil empresas do setor e contribui com 12,8%
das internações para procedimentos de alta complexidade no Sistema Único de Saúde (SUS).
Os dados são de um levantamento da Fundação Seade que será divulgado hoje. Mas o relatório também
enumera os principais problemas enfrentados pelo setor na cidade: carência na oferta de serviços para
determinados problemas de saúde, demanda reprimida de atenção básica que sobrecarrega hospitais
universitários, falta de contato entre academia e indústria, etc.
Dezenas de profissionais de institutos de pesquisa, universidades, agências de fomento e empresas foram
entrevistados para traçar o diagnóstico das atividades em ciências da vida, encomendado pela Prefeitura.
Até agora, o setor caminhou sem uma política pública coordenada. "Para criar uma política assim, é necessário
primeiro mapear o que existe", afirma Maria Aparecida Orsini de Carvalho, assessora especial da Prefeitura.
"Com o levantamento pronto, podemos traçar estratégias para potencializar o setor."
O objetivo é fomentar iniciativas semelhantes ao Biopolo de Lyon, na França, ou o Aglomerado de Ciências da
Vida de Montreal, no Canadá: projetos de expressão internacional, conduzidos por governos, que transformam
ideias em riqueza. As informações são do jornal O Estado de S. Paulo .
5
REUNIÓN BILATERAL PERÚ - BRASIL Y TRANSFERENCIA DE LA CORDINACIÓN TITULAR DE
RECURSOS HUMANOS DE UNASUR SALUD
Ministerio de Salud, Peru
19/09/2010
Los equipos de conducción de recursos humanos de los Ministerios de Salud de Perú y Brasil desarrollaron una
importante reunión de trabajo, en el marco del Seminario de Gestión del Trabajo y Educación en Salud que se
realizó en Brasilia DF entre los días 19 y 21 de julio. Esta reunión permitió evaluar los avances desarrollados en
cada uno de nuestros países, identificar las fortalezas nacionales y las áreas prioritarias de intervención, así
como analizar los niveles de cooperación bilateral desarrollados hasta el momento, particularmente en recursos
humanos. Asimismo, el Dr. Francisco Campos – Secretario de Gestión de Trabajo y Educación en Salud del
Ministerio de Salud de Brasil, entregó la Coordinación Titular del Grupo Técnico de Recursos Humanos de
UNASUR - Salud, al Dr. Manuel Núñez Vergara – Director General de Gestión del Desarrollo de Recursos
Humanos en Salud, en representación del Ministerio de Salud del Perú. El Dr. Núñez expresó el compromiso del
Ministerio de Salud del Perú de ejercer esta conducción reafirmando la vocación de integración y cooperación
regional, particularmente ante los grandes desafíos que enfrentan nuestros países.
Finalmente, se revisó el Plan Quinquenal aprobado por el Consejo de Salud Sudamericano, y los encargos
realizados al Grupo Técnico de Recursos Humanos, en particular en lo concerniente al Instituto Sudamericano
de Gobierno en Salud, el Programa Regional de Becas y la organización de Redes de Intercambio entre
Instituciones de UNASUR-Salud. Este tema se revisó en profundidad con el Dr. José Ferreira, Secretario del
Grupo Técnico, en la sede de la Fundación Oswaldo Cruz, institución que viene brindando un valioso apoyo al
proceso de cooperación e integración desarrollado por UNASUR – Salud.
El Grupo Técnico de Recursos Humanos está integrado por los representantes de los 12 Ministerios de Salud de
UNASUR (Argentina, Bolivia, Brasil, Colombia, Chile, Ecuador, Guyana, Paraguay, Perú, Surinam, Uruguay y
Venezuela), contando con la valiosa cooperación de la Organización Panamericana de la Salud, el Convenio
Hipólito Unanue – Organismo Andino de Salud y Mercosur, entre otras instituciones.
6
Inicia protesto de médicos residentes em Belém
Diário do Pará, Brazil
24/08/2010
Quase 30 médicos residentes estão reunidos em frente a Santa Casa de Misericórdia do Pará fazendo uma
mobilização, com faixas, para que a população tenha conhecimento das reivindicações que eles estão fazendo
ao MEC e ao Ministério da Saúde.
>> Médicos residentes fazem passeata em Belém
"Estamos esperando aumentar o número de médicos residentes na nossa mobilização para podermos iniciar a
caminhada, que acontece hoje, em todo o Brasil. A nossa expectativa é de pelo menos 60 participantes",
explica o médico residente Marcos Damasceno.
A caminhada sairá da Santa Casa, pela avenida Generalíssimo Deodoro, e seguirá para o Conselho Regional de
Medicina (CRM), que fica na mesma via, e em seguida para o Sindicato dos Médicos, na rua Diogo Moia. "Nós
queremos que a greve termine, queremos estudar, aprender. Porém, esperamos que o MEC e o Ministério da
Saúde sejam mais sensíveis as nossas reivindicações", diz Marcos Damasceno.
38
Os médicos residentes estão reivindicando seis pontos: reajuste na bolsa de 38,7%; reajuste anual da bolsa;
décima terceira bolsa, como se fosse o décimo terceiro salário; auxílio moradia e alimentação; insalubridade; e
a licença maternidade de quatro, para seis meses. (Diário Online)
Back to top
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39