What is the face of noma?
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Mothers in Africa have one more thing to worry about in addition to all the usual things all moms are concerned with. Children between the ages 2 and 12, if malnourished, are susceptible to noma – a gangrenous disease leading to tissue destruction of the face, especially the mouth and cheek.
It starts as a sore or lesion in the mouth. If it is not treated within a few days it results in the necrosis of the tissue in the face and bone. The necrotic damage is irreversible. Only 20% of the children live though and are then left with large disfiguring holes in their faces and enough damage to prevent normal jaw movement, feeding and breathing.
If it is treated quickly with antibiotics, vitamins and disinfecting mouthwash victims of the horrible disease can be cured and live normal lives.
Like obstetric fistulas, noma was common around the world until improvements in hygiene and nutrition became possible. It is still found in poor countries in Africa and also in Asia and South America – in fact around 100,000 to 140,000 children get it each year.
Noma is yet another example of the huge disparities between the developed and developing world. On one hand we have wealthy societies with many people ingesting too much food and calories resulting in heart disease, diabetes, etc. – and then there’s the poorest of the poor who cannot get enough nutrition to save them from a disfiguring and often deadly disease like noma.
What is the face of noma? The face of noma is no more than a reflection of the disparities between the rich and the poor.
More information about noma can be found at the following web sites:
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August 7, 2007
Health care reform
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I saw an article last week from Reuters (unfortunately I lost the link) about reforming health care in the U. S.. A couple of points stood out to me:
1) Dr. Julie Gerberding – the director of the CDC was quoted as saying “If we are seriously thinking about building a health system, then we need to be training professionals in a collegial and collaborative manner.”. It was explained that she thinks that the way doctors, nurses, veterinarians, pharmacists and dentists are educated needs to be changed – that they need to start their educations all together to “to foster cooperation and a sense of common mission”. I agree but think they should add eye doctors to that list too. Vision is a vital part of a healthy person as any other function or part of the body. I never understood why teeth and eyes were somehow separated from the rest of our bodies when getting health care or insurance.
2) She also said that the “system is focused on treating disease and on end-of-life care, with little attention paid to preventing disease and helping people lead healthier lives.”. That’s bothered me for a long time too. How frequently have you had a doctor talk to you about what you can do to be as healthy as possible? I’ve never had a doctor initiate a discussion like that. And have you ever tried asking a doctor questions about nutrition or fitness? They don’t seem to know a lot about it. Maybe that’s not what they are trained for and can’t be expected to know everything – but then our health insurance needs to include visits to professionals who can help us with nutrition and fitness. Diet and exercise are the two most important things a person can control to stay healthy and yet our doctors don’t know enough about them to help people do the right thing. We’re left on our own and most people don’t know enough themselves or can’t afford to pay a nutritionist or personal trainer to help them.
What do you think?
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July 30, 2007
Help! Our hospitals are filthy!
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According to an article by Betsy McCaughey in the U.S. News &World Report Best Hospitals issue hospitals in the U.S. are not inspected for cleanliness.
I would love to hear what others have to say about this – especially health and medical bloggers. Does the article seem accurate to you? Reasonable? Overreactive?
Personally I found it alarming, but I’m a scientist and I don’t work in medicine so maybe I just don’t understand the situation well enough. Please enlighten me.
Here are a few quotes from the article:
“The Joint Commission, which inspects and accredits U.S. hospitals, doesn’t measure cleanliness. Neither do most state health departments, nor the federal Centers for Disease Control and Prevention.”
“Sad to say, cleanliness is not a priority for hospital administrators or most medical professionals. “
“A new University of Maryland study shows that 65 percent of physicians and other medical professionals admitted they hadn’t washed their lab coat in at least a week, even though they knew it was dirty. Nearly 16 percent said they hadn’t put on a clean lab coat in at least a month.”
“In a recent Johns Hopkins Hospital study, 26 percent of supply cabinets were contaminated with a dangerous bacterium, methicillin-resistant Staphylococcus aureus (MRSA) and 21 percent with another stubborn germ, vancomycin-resistant Enterococcus (VRE).”
“Stethoscopes, blood pressure cuffs, and EKG wires are used on successive patients without being cleaned. Studies published as long ago as 1978 warn that blood pressure cuffs frequently carry live bacteria, including MRSA, and are a source of infection. In a newly released British report, one third of blood pressure cuffs were found to be contaminated with Clostridium difficile, a germ that can cause lethal diarrhea if it enters via the mouth. “
“Hospitals once tested surfaces for bacteria, but in 1970, the CDC and the American Hospital Association advised them to stop, saying testing was unnecessary and not cost effective.”
“Asked whether bacterial levels should be measured, Wise [Robert Wise, Joint Commission] answers: “You can only ask hospitals to do so much.”
For more information read the article: Why Aren’t Hospitals Cleaner? and visit the web site of the Committee to Reduce Infection Deaths (chaired by the author of the article).
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