(Mt) – Public Health Discussion Response

International and Humanitarian Disaster Management. Week 7 – Public Health Tools: Epidemiological Studies, Surveillance, and Monitoring Teaching Points This is a short video that provides a nice over of epidemiological studies. https://youtu.be/Jd3gFT0-C4s Another short video on public health surveillance. https://youtu.be/3IpE8dE4cVc Readings Kapur and Smith – Chapter 9 Epidemiological Studies, Chapter 10 Surveillance and Monitoring Discussion Bored Questions 1. Evidence is a key component in identifying trends and changing practice especially in the public health field. Choose a public health topic that you are especially passionate about. (e.g. water and sanitation, vaccinations, infectious disease, etc.) Discuss how studies/research support your views (for or against). 2. Choose a recent international or humanitarian disaster.What public health issues were associated with this incident? How would you manage these issues? Discussion Response – Look at three of my classmate’s posts. I need you to respond to each one separately. Don’t write about how good their posts or how bad. All you need to do is to choose one point of and explore it a little bit with two sources support for each response. In you will find all the classmates posts. – APA Style. – At least 2 references for each response – Use your opinion and your critical thinking on response. – A note on Discussion Board etiquette – students are expected to respond to their classmates’ answers with substantial comments, demonstrating that they are actively engaged in the various threads that will emerge. In the form of ideas, it is appropriate to respectfully disagree with a classmate’s conclusions as long as you are willing to defend your own. It is also appropriate to propose a novel or controversial opinion, particularly if it prompts thoughtful discussion. My post: Question I Urbanization Urbanization of towns in many areas in the world has brought changes in the environment, health sectors, and to the economy. The development of cities has been the source of technology necessary for running a variety of activities in different fields in the country. Technology has improved the health sectors by enhancing effectively delivery of health care services to the patients. Besides, urbanization causes rural-urban migration, where many people move to urban centers for several reasons, such as looking for jobs. The congestion in urban centers promote poor sanitation, poverty, health hazards from the environment; thus, promoting the spread of disease among the people. There are a variety of industries in urban centers that brings a negative impact on the environment due to their exposal of waste materials to the environment (Vlahov, Boufford, Pearson, & Norris, 2011). Thus, People may contract diseases as a result of industrial waste channeled to the rivers causing water pollution. Water and Sanitation Water and sanitation facilities are most associated with urbanization issues in urban centers due to the high population and sometimes poor housing. Water and sanitation are vital issues that are essential in determining or promoting the health quality of the citizens. A variety of diseases arises as a result of dirty water and poor sanitation, such as cholera outbreaks that affect and weakens the health of citizens (Medicine, Board on Global Health, & Threats, 2010). However, urbanization brings congestion to the towns whereby the essential services are not delivered adequately due to high demands from the people. The public health is, therefore, associated with water and sanitation, focusing on the quality of sanitation evidenced in urban centers. The patient safety will be weak due to inadequate access to clean water and sanitation following the high cost of living and exposal of waste products to the environment. Moreover, the issues of water and sanitation, is an international concern where the government should come up with effective strategies to improve public health. Educating the citizens on the benefits of observing proper hygiene to reduce outbreaks of diseases such as typhoid and cholera could be an essential response. The government should ensure the supply of clean water in urban centers to promote health conditions among the citizens. Therefore, public health and patient safety will be improved, provided there are freshwater and sanitation in urban centers. Question 2 Humanitarian needs in Syrian Arab Republic The Syrian Arab republic focuses on humanitarian needs to come up with an effective response to address the crisis. Humanitarian consequences of the disaster continue to generate adverse impacts at a similar rate in every year in the country. The Ongoing hostilities in parts of the country still expose civilian populations to violence and threats to their lives, particularly in the north-west. The protection of humanitarian workers, including health care professionals, as well as damage to civilian infrastructure leading to civilian casualties, remains a significant concern. The protracted nature of the crisis and the extended displacement of millions of people has eroded safety nets and often generated harmful to public health. Many people face severe risks in the environment based on the negative influence of pollution from different fields in the country. Poor housing, poverty, land, and property issues are associated with public health as people will severely suffer due to difficulties in accessing the necessary services (“Syrian Arab Republic: 2019 Humanitarian Response Plan Monitoring Report (January – May 2019),” n.d.). Therefore, the threat of dangerous diseases and hazards remains a significant protection concern, with many people estimated to live in contaminated areas. Recommendations & Interventions I would respond to this crisis by enhancing sustained quality access to improve the quality of humanitarian access to people in different parts of the country. Humanitarian funding is another strategy to react to the issue, as funds will promote quick response to emergency needs risks to provide basic service effectively. Moreover, financial commitments are critical for the humanitarian community to sustain and scale up operations and respond to both new and existing needs. Therefore, the humanitarian issue can be effectively managed, provided the public health are patient safety are promoted. References Medicine, I. O., Board on Global Health, & Threats, F. O. (2010). Global Issues in Water, Sanitation, and Health: Workshop Summary. Washington, DC: National Academies Press. Syrian Arab Republic: 2019 Humanitarian Response Plan Monitoring Report (January – May 2019). (n.d.). Retrieved from https://reliefweb.int/report/syrian-arab-republic/syrianarab-republic-2019-humanitarian-response-plan-monitoring-report Vlahov, D., Boufford, J. I., Pearson, C. E., & Norris, L. (2011). Urban Health: Global Perspectives. John Wiley & Sons. Student 1 post: Public health professionals have relied on expert opinion in the past. More experienced professionals provided their input on matters of public health; expert opinion relies on what they think, what they learned in school, and their intuitions. The biggest challenge with this practice is that experience is flawed by biases and what we learn in school is subject to changes. Recent studies have discredited this approach to public health, and in answering clinical questions regarding infectious diseases. The new standard practice is the development of guidelines using systematic reviews. One of the most valuable approaches to interventions in infectious diseases is the Randomized controlled trials (RCTs) (Harder et al., 2014). If RCTs are conducted well, they minimize bias and therefore increase the accuracy and value of decisions. When dealing with Infectious diseases, professionals need to consider the consequences an intervention is likely to have on the population. Evidence is necessary to know how the chosen prevention and control techniques can affect the spread of pathogens to the total population (Harder et al., 2014). The use of evidence allows for consideration of information from various sources, i.e., Patient’s value and circumstances, best research evidence, information from practice context, and clinical expertise. They all come together to help in coming up with the best decision by considering the full causal chain, from intervention to outcomes, in a given context (Jacobs et al., 2012). The civil war in Yemen has led to what is thought to be the worst humanitarian crisis. The war has displaced millions of people and thousands of civilians killed, and now over 22 million people need humanitarian assistance. Public health issues associated with this crisis include cholera outbreaks which have affected one million people. Thousands of airstrikes launched by a coalition trying to regain control of the country have hit homes, schools, and health facilities. The general population has no access to health care facilities, food, and clean water. The situation is made worse because humanitarian organizations cannot send help due to the dangers involved (“Why Yemen,” 2019). These health concerns facing Yamens can be solved by prioritizing the risks. The people affected must be taken to safety first where they can be attended to by humanitarian organizations. This means that designated refugee camps should be set up where the affected and infected can find help. The cholera outbreak needs a coordinated rapid response to prevent further deaths and infections. In my opinion, the dependency on expert opinion to answer complex clinical questions is a fallacy. The integration of research from various sources makes more sense because of it takes into consideration all the changes in the field and the uniqueness of each case. However, I believe expertise can provide some valuable information and insight on individual cases since experienced professions have handled similar incidents over a long period that they can draw certain conclusions. The only problem is when all decisions are based on their experience without exploring the possibility of changes in the behavior of pathogens. References Harder, T., Takla, A., Rehfuess, E., Sánchez-Vivar, A., Matysiak-Klose, D., Eckmanns, T., Wichmann, O. (2014). Evidence-based decision-making in infectious diseases epidemiology, prevention, and control: matching research questions to study designs and quality appraisal tools. BMC medical research methodology, 14, 69. doi:10.1186/1471-2288-14-69 Jacobs JA, Jones E, Gabella BA, Spring B, Brownson RC (2012). Tools for Implementing an Evidence-Based Approach in Public Health Practice. Retrieved from http://dx.doi.org/10.5888/pcd9.110324. Why is Yemen the world’s worst humanitarian crisis? (2019). Retrieved from https://www.rescue.org/article/why-yemen-worlds-worst-humanitarian-crisis Student 2 post: water sanitation and hygiene I believe that access to plenty of water for appropriate washing is the basis for the prevention of a public health crisis. Proper sanitation is key in preventing many diseases, and lack of access to enough water is the cause of thousands of illnesses and deaths in the world. My view is that before focusing on anything else regarding public health, access to water and sanitation must be covered. After a crisis or disaster, water supply and disposal of the stool have to be implemented quickly in order to minimize mortality and disease. A sufficient amount of water is more important than having perfectly clean water- this means that the water needs to be sufficient but not perfectly clean, and there has to be plenty in order for it to fulfill its purpose. The construction of one latrine for every 20 persons is the guideline, but this is unfortunately rarely possible (Noji, 2005). Noji bases this information on different studies that serve as evidence for his points. For example, a 2001 study about the impact of access to clean water after a cyclone in Madagascar (Mong et al., 2001). A second article by Jamie Bartram et al., (2005) based on data from the World Health Organization and the United Nations, supports my view by giving out some key facts: In the world, more people suffer from lack of access to water and sanitation than from the effects of war, terrorism, and weapons of mass destruction. Almost half of the world’s population suffers from one of the diseases caused directly by the lack of water and sanitation, including diarrhea (which kills infants), trachoma (which causes blindness), intestinal helminths and schistosomes. Venezuela’s humanitarian crisis Venezuela is going through a humanitarian crisis caused by the failure of its current regime. The inflation rate is the highest in the world, and 66% of Venezuelans live in extreme poverty. On top of that, medical experts and other scientists have fled or are fleeing the country. The humanitarian crisis has caused many public health issues in the country. Vector-borne and vaccine-preventable diseases have seen outbreaks that have extended even to neighboring countries. Measles and diphtheria have appeared, while there is also a possibility for the return of polio (Paniz-Modolfi et al., 2019). Infant mortality rates have gone higher, and the lack of access to contraception and birth control is creating problems of unwanted pregnancies. Malaria cases have increased because of the lack of treatment and lack of action to control mosquitoes. Tuberculosis and HIV have seen a rise in mortality due to a lack of testing and treatment (HRW, 2018). The Venezuela public health issues are results of a political and economic crisis that put the country in poverty. This suggests that a change of regime is necessary in order to address the root of the problem. However, it would take years before Venezuela goes back to normal after many years of crisis. In order to manage the public health issues, it is essential to negotiate with the Venezuelan government so that it gives access to NGOs and governmental organizations to bring water, food, and medicine to vulnerable people inside the country. Secure access to volunteers and medical staff as well as resources is necessary. Secondly, refugee camps in neighboring countries have to be adequate to receive the massive numbers of Venezuelans who are leaving. These camps need access to water and sanitation, latrines, fumigation of vectors, and access to medical services. Doctors Without Borders and the Red Cross would be useful both inside Venezuela and in refugee camps. References Bartram, J., Lewis, K., Lenton, R., & Wright, A. (2005). Focusing on improved water and sanitation for health. The Lancet, 365(9461), 810–812. doi: 10.1016/s0140-6736(05)71007-2 Human Rights Watch. (2019, April 11). Venezuela’s humanitarian emergency: large-scale UN response needed to address health and food crises. Retrieved from https://www.hrw.org/report/2019/04/04/venezuelas-humanitarian-emergency/large-scaleun-response-needed-address-health. Mong, Y., Kaiser, R., Ibrahim, D., Rasoatiana, Razafimbololona, L., & Quick, R. E. (2001). Impact of the Safe Water System on Water Quality in Cyclone-Affected Communities in Madagascar. American Journal of Public Health, 91(10), 1577–1579. doi: 10.2105/ajph.91.10.1577 Noji, E. K. (2005). Public health issues in disasters. Critical Care Medicine, 33(Supplement). doi: 10.1097/01.ccm.0000151064.98207.9c Paniz-Mondolfi, A. E., Tami, A. E., Grillet, M. A., Márquez, M. M., Hernández-Villena, J. G., Escalona-Rodríguez, M. A., … Oletta, J. undefined. (2019). Resurgence of vaccine-preventable diseases in Venezuela as a regional public health threat in the Americas. Emerging Infectious Diseases, 25(4), 625–632. doi: 10.3201/eid2504.181305 Student 3 post: Sanitation and safe drinking water are crucial to people’s health and well-being. Studies show that the consumption of unsafe water can impair the health of a population by causing diarrhea and other water-borne illnesses (World Health Organization [WHO], 2018). Furthermore, inadequate water makes it difficult to maintain the required sanitary and personal hygiene conditions in homes. Globally, around 1.1 billion people live without clean water supply (WHO, 2019). Currently, people living in war-torn areas such as Yemen are struggling to find sufficient water supply for their basic needs—a condition that has led to the recent outbreak of diarrheal diseases such as cholera. The ongoing conflicts in Yemen have displaced millions of people and destroyed both food and water supplies, leaving the country vulnerable to a devastating famine. According to the International Committee of the Red Cross (ICRC, 2019), more than eighty percent of people in Yemen lack fuel, drinking water, food, and access to vital health care services, making them particularly susceptible to illnesses that are generally eradicated or cured in other parts of the world. Outbreaks of cholera, diphtheria and other contagious illnesses have been reported across the country. The ICRC continues to provide the much-needed support to these people by supplying emergency and medical supplies to health facilities and hospitals (ICRC, 2019). However, more needs to be done in order to reduce the adverse effects of inadequate water supply. Several measures need to be taken to address the public health emergency in Yemen. An epidemiological study needs to be conducted to identify the areas most affected by the conflicts and gather data that will direct response activities as well as disease control strategies. Additionally, a shelter-based surveillance program must be implemented in the displacement camps to help reduce the number of casualties and enable humanitarian organizations to promptly and effectively treat new cases of disease outbreaks (Kapur and Smith, 2010). These two measures require collaborative efforts by the humanitarian agencies and the government of Yemen. References International Committee for the Red Cross. (2019). Health crisis in Yemen. Retrieved from https://www.icrc.org/en/where-we-work/middle-east/Yemen/health-crisis-Yemen. Kapur, G. B., & Smith, J. P. (2010). Emergency public health: Preparedness and response. Jones & Bartlett Publishers. World Health Organization. (2018). WHO Water, sanitation, and hygiene strategy 20182025. World Health Organization. (2019). Water and sanitation. Retrieved from https://www.who.int/ceh/risks/cehwater2/en/

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