Climate change endangers health in fundamental ways. The warming of the planet will be gradual, but the effects of extreme weather events – more storms, floods, droughts and heatwaves – will be abrupt and acutely felt. Both trends can affect some of the most fundamental determinants of health: air, water, food, shelter, and freedom from disease.
Climate change is a significant and emerging threat to public health, and changes the way we must look at protecting vulnerable populations.
The most recent report of the Intergovernmental Panel on Climate Change confirmed that there is overwhelming evidence that humans are affecting the global climate, and highlighted a wide range of implications for human health. Climate variability and change cause death and disease through natural disasters, such as heatwaves, floods and droughts. In addition, many important diseases are highly sensitive to changing temperatures and precipitation. These include common vector- borne diseases such as malaria and dengue; as well as other major killers such as malnutrition and diarrhoea. Climate change already contributes to the global burden of disease, and this contribution is expected to grow in the future.
Although climate change is a global phenomenon, the impacts of climate on human health will not be evenly distributed around the world. Developing country populations, particularly in Small Island States, arid and high mountain zones, and in densely populated coastal areas, are considered to be particularly vulnerable.
Climate change can no longer be considered simply an environmental or developmental issue. More importantly, it puts at risk the protection and improvement of human health and well-being. A greater appreciation of the human health dimensions of climate change is necessary for both the development of effective policy and the mobilization of public engagement.
Fortunately, much of the health risk is avoidable through existing health programmes and interventions. Concerted action to strengthen key features of health systems, and to promote healthy development choices, can enhance public health now as well as reduce vulnerability to future climate change.
What should we do to reverse Climate Change?
The enormity of global warming can be daunting and dispiriting. What can one person, or even one nation, do on their own to slow and reverse climate change?
Forego Fossil Fuels—The first challenge is eliminating the burning of coal, oil and, eventually, natural gas. This is perhaps the most daunting challenge as denizens of richer nations literally eat, wear, work, play and even sleep on the products made from such fossilized sunshine. But we have to try to employ alternatives when possible—plant-derived plastics, biodiesel, wind power—and to invest in the change, be it by divesting from oil stocks or investing in companies practicing carbon capture and storage.
Infrastructure Upgrade—Buildings worldwide contribute around one third of all greenhouse gas emissions (43 percent in the U.S. alone), even though investing in thicker insulation and other cost-effective, temperature-regulating steps can save money in the long run. energy-efficient buildings and improved cement-making processes (such as using alternative fuels to fire up the kiln) could reduce greenhouse gas emissions in the developed world and prevent them in the developing world.
Move Closer to Work—Transportation is the second leading source of greenhouse gas emissions in the world. One way to dramatically curtail transportation fuel needs is to move closer to work, use mass transit, or switch to walking, cycling or some other mode of transport that does not require anything other than human energy. There is also the option of working from home and telecommuting several days a week.
Consume Less—The easiest way to cut back on greenhouse gas emissions is simply to buy less stuff. Whether by forgoing an automobile or employing a reusable grocery sack, cutting back on consumption results in fewer fossil fuels being burned to extract, produce and ship products around the globe.Think green when making purchases and when purchasing essentials, such as groceries, buying in bulk can reduce the amount of packaging—plastic wrapping, cardboard boxes and other unnecessary materials. Sometimes buying more means consuming less.
Be Efficient—A potentially simpler and even bigger impact can be made by doing more with less. Citizens of many developed countries are profligate wasters of energy, whether by speeding in a gas-guzzling sport-utility vehicle or leaving the lights on when not in a room. Employing more efficient refrigerators, air conditioners and other appliances can cut electric bills while something as simple as weatherproofing the windows of a home can reduce heating and cooling bills. Such efforts can also be usefully employed at work, whether that means installing more efficient turbines at the power plant or turning the lights off when you leave the office.
Eat Smart, Go Vegetarian—University of Chicago researchers estimate that each meat-eating American produces 1.5 tons more greenhouse gases through their food choice than do their vegetarian peers. It would also take far less land to grow the crops necessary to feed humans than livestock, allowing more room for planting trees.
Stop Cutting Down Trees—Every year, 33 million acres of forests are cut down. Timber harvesting in the tropics alone contributes 1.5 billion metric tons of carbon to the atmosphere. That represents 20 percent of human-made greenhouse gas emissions and a source that could be avoided relatively easily. Improved agricultural practices along with paper recycling and forest management—balancing the amount of wood taken out with the amount of new trees growing—could quickly eliminate this significant chunk of emissions.
Unplug—Televisions, stereo equipment, computers, battery chargers and a host of other gadgets and appliances consume more energy when seemingly switched off, so unplug them instead. Purchasing energy-efficient gadgets can also save both energy and money—and thus prevent more greenhouse gas emissions. To take but one example, efficient battery chargers could save more than one billion kilowatt-hours of electricity—$100 million at today's electricity prices—and thus prevent the release of more than one million metric tons of greenhouse gases.
One Child—More humans means more greenhouse gas emissions. There are at least 6.6 billion people living today, a number that is predicted by the United Nations to grow to at least nine billion by mid-century. The U.N. Environmental Program estimates that it requires 54 acres to sustain an average human being today—food, clothing and other resources extracted from the planet. Continuing such population growth seems unsustainable. Falling birth rates in some developed and developing countries (a significant portion of which are due to government-imposed limits on the number of children a couple can have) have begun to reduce or reverse the population explosion. It remains unclear how many people the planet can comfortably sustain, but it is clear that per capita energy consumption must go down if climate change is to be controlled.
Future Fuels—Replacing fossil fuels may prove the great challenge of the 21st century. Many contenders exist, ranging from ethanol derived from crops to hydrogen electrolyzed out of water, but all of them have some drawbacks, too, and none are immediately available at the scale needed. Massive investment in low-emission energy generation, whether solar-thermal power or nuclear fission, would be required to radically reduce greenhouse gas emissions. And even more speculative energy sources—hyperefficient photovoltaic cells, solar energy stations in orbit or even fusion—may ultimately be required.
The solutions above offer the outline of a plan to personally avoid contributing to global warming. But should such individual and national efforts fail, there is another, potentially desperate solution:
Experiment Earth—Climate change represents humanity's first planetwide experiment. But, if all else fails, it may not be the last. So-called geoengineering, radical interventions to either block sunlight or reduce greenhouse gases, is a potential last resort for addressing the challenge of climate change.
Among the ideas: releasing sulfate particles in the air to mimic the cooling effects of a massive volcanic eruption; placing millions of small mirrors or lenses in space to deflect sunlight; covering portions of the planet with reflective films to bounce sunlight back into space; fertilizing the oceans with iron or other nutrients to enable plankton to absorb more carbon; and increasing cloud cover or the reflectivity of clouds that already form.
All may have unintended consequences, making the solution worse than the original problem. But it is clear that at least some form of geoengineering will likely be required: capturing carbon dioxide before it is released and storing it in some fashion, either deep beneath the earth, at the bottom of the ocean or in carbonate minerals. Such carbon capture and storage is critical to any serious effort to combat climate change.
Reference:
1.Climate Action Network Australia : Solutions to climate change
http://www.cana.net.au/bush/solutions.htm(visited in 13.11.09)
2.Stop climate change http://www.greenpeace.org/international/campaigns/climate-change(visited in 13.11.09)
3.Ten solution for climate change http://www.scientificamerican.com/article.cfm?id=10-solutions-for-climate-change&page=4(visited in 13.11.09)
4. WHO, Protecting health from climate change top 10 actions for health professionals
5. WTO, Climate change is affecting our health_ something should be done now
2009年11月18日星期三
2009年11月13日星期五
2009年11月12日星期四
Infectious diseases
How to prevent malaria:
The main objective of malaria vector control is to significantly reduce the rate and number of cases of both parasite infection and clinical malaria. This is achieved by controlling the malaria-bearing mosquito and thereby reducing or interrupting transmission.
1. Apply insect repellent to skin. The US Center for Disease Control recommends the following repellents: (DEET, Picaridin, Oil of Lemon Eucalyptus or PMD, IR3535)
2. Use bed nets, which can be used to provide protection to risk groups, especially young children and pregnant women in high transmission areas. This provides personal protection. The nets can also protect communities when coverage is high enough.
3. Use insecticide and flying insect sprays to reduce the number of mosquitoes, indoor residual spraying is the most effective means of rapidly reducing mosquito density. Its full potential is obtained when at least 80 % of premises with malaria vectors are sprayed.
4. Wear long-sleeved clothing.
5. Avoiding camping or spending prolonged amounts of time in areas where standing water is present. Keep pots and pans emptied of water. Open vessels for drinking water should be covered. Mosquitoes use areas of standing water to lay their eggs.
6. If possible, stay in screened quarters or quarters with air conditioning.
Beside, early diagnosis and prompt treatment are two basic elements of malaria control. Access to disease management should be seen not only as a component of malaria control but a fundamental right of all populations at risk.
HIV and TB form a lethal combination, each speeding the other's progress. HIV weakens the immune system. Someone who is HIV-positive and infected with TB bacilli is many times more likely to become sick with TB than someone infected with TB bacilli who is HIV-negative. TB is a leading cause of death among people who are HIV-positive.
How to prevent Tuberculosis and HIV/Aids effectively at the global level:
1.Strengthening health system. Contributing to overall strategies to advance financing, planning, management, information and supply systems and innovative service delivery scale-up.
2.Empowering people with TB and HIV/Aids, and communities. Mobilizing civil societies and also ensure political support and long-term sustainability for TB and HIV/Aids control programmes.
3.Strengthen education. Do more propaganda through communities and schools to tell people the route of transmission, the perniciousness, the precautions.
4.Vaccination. BCG, or bacillus Calmette-Guérin, is a vaccine for tuberculosis disease. But for HIV/Aids, we haven’t found yet, do more research.
5.Screening methods/ Get tested. Good way to find out TB or HIV/Aids in time, to make diagnosis and to give treatment at early stage.
6.Enabling and promoting research. While current tools can control TB and HIV/Aids, improved practices and elimination will depend on new diagnostics, drugs and vaccines.
7.Something special for HIV/Aids. Use barrier protection(like condoms and dental dams) consistently and every time; Reduce the number of sexual partners; Use clean and sterile needles; Clearly label and properly dispose of sharps; Use personal protective gear(Health care practitioners (and those who live with people with AIDS or are HIV positive) should use gloves, face masks and shields).
8.The control method of TB and HIV/Aids. Besides some I mentioned above, there are still: Engaging all care providers. TB and HIV/Aids patients seek care from a wide array of public, private, corporate and voluntary health-care providers. To be able to reach all patients and ensure that they receive high-quality care, all types of health-care providers are to be engaged. Pursuing high-quality control strategy and enhancement. Making high-quality services widely available and accessible to all those who need them, including the poorest and most vulnerable, requires expansion to even the remotest areas. Addressing TB/HIV, MDR-TB and other challenges.
In a word, there is no single best approach to TB and HIV prevention; the response must be designed to fit local conditions and the state of the epidemic. Nevertheless, most of the successful programmes do have at least four features in common.
Firstly, encouraging open communication about TB and AIDS and the activities that put people at risk of infection, while at the same time combating stigma and discrimination.
Secondly, it should be pragmatic. Especially for AIDS, rather than just trying to eliminate certain types of sexual behavior or drug use, they recognize that some people will continue to do these things, and that they should be helped to do so more safely.
Thirdly, we should involve the affected communities themselves in programme design and implementation. This ensures that the programme is carefully tailored to the communities’ needs, and that it is seen as something done “with them” rather than “to them”. The work of small community-based organizations has been vital to each of these successful programmes.
Last but not least, strong leadership is essential for TB and HIV prevention campaigns to have a far-reaching and sustained impact. This means that politicians, religious leaders and others in authority must become actively involved in the response, and must ensure that it receives adequate resources. If all of the world’s leaders truly committed themselves to this cause then a great many lives would be saved.
The main objective of malaria vector control is to significantly reduce the rate and number of cases of both parasite infection and clinical malaria. This is achieved by controlling the malaria-bearing mosquito and thereby reducing or interrupting transmission.
1. Apply insect repellent to skin. The US Center for Disease Control recommends the following repellents: (DEET, Picaridin, Oil of Lemon Eucalyptus or PMD, IR3535)
2. Use bed nets, which can be used to provide protection to risk groups, especially young children and pregnant women in high transmission areas. This provides personal protection. The nets can also protect communities when coverage is high enough.
3. Use insecticide and flying insect sprays to reduce the number of mosquitoes, indoor residual spraying is the most effective means of rapidly reducing mosquito density. Its full potential is obtained when at least 80 % of premises with malaria vectors are sprayed.
4. Wear long-sleeved clothing.
5. Avoiding camping or spending prolonged amounts of time in areas where standing water is present. Keep pots and pans emptied of water. Open vessels for drinking water should be covered. Mosquitoes use areas of standing water to lay their eggs.
6. If possible, stay in screened quarters or quarters with air conditioning.
Beside, early diagnosis and prompt treatment are two basic elements of malaria control. Access to disease management should be seen not only as a component of malaria control but a fundamental right of all populations at risk.
HIV and TB form a lethal combination, each speeding the other's progress. HIV weakens the immune system. Someone who is HIV-positive and infected with TB bacilli is many times more likely to become sick with TB than someone infected with TB bacilli who is HIV-negative. TB is a leading cause of death among people who are HIV-positive.
How to prevent Tuberculosis and HIV/Aids effectively at the global level:
1.Strengthening health system. Contributing to overall strategies to advance financing, planning, management, information and supply systems and innovative service delivery scale-up.
2.Empowering people with TB and HIV/Aids, and communities. Mobilizing civil societies and also ensure political support and long-term sustainability for TB and HIV/Aids control programmes.
3.Strengthen education. Do more propaganda through communities and schools to tell people the route of transmission, the perniciousness, the precautions.
4.Vaccination. BCG, or bacillus Calmette-Guérin, is a vaccine for tuberculosis disease. But for HIV/Aids, we haven’t found yet, do more research.
5.Screening methods/ Get tested. Good way to find out TB or HIV/Aids in time, to make diagnosis and to give treatment at early stage.
6.Enabling and promoting research. While current tools can control TB and HIV/Aids, improved practices and elimination will depend on new diagnostics, drugs and vaccines.
7.Something special for HIV/Aids. Use barrier protection(like condoms and dental dams) consistently and every time; Reduce the number of sexual partners; Use clean and sterile needles; Clearly label and properly dispose of sharps; Use personal protective gear(Health care practitioners (and those who live with people with AIDS or are HIV positive) should use gloves, face masks and shields).
8.The control method of TB and HIV/Aids. Besides some I mentioned above, there are still: Engaging all care providers. TB and HIV/Aids patients seek care from a wide array of public, private, corporate and voluntary health-care providers. To be able to reach all patients and ensure that they receive high-quality care, all types of health-care providers are to be engaged. Pursuing high-quality control strategy and enhancement. Making high-quality services widely available and accessible to all those who need them, including the poorest and most vulnerable, requires expansion to even the remotest areas. Addressing TB/HIV, MDR-TB and other challenges.
In a word, there is no single best approach to TB and HIV prevention; the response must be designed to fit local conditions and the state of the epidemic. Nevertheless, most of the successful programmes do have at least four features in common.
Firstly, encouraging open communication about TB and AIDS and the activities that put people at risk of infection, while at the same time combating stigma and discrimination.
Secondly, it should be pragmatic. Especially for AIDS, rather than just trying to eliminate certain types of sexual behavior or drug use, they recognize that some people will continue to do these things, and that they should be helped to do so more safely.
Thirdly, we should involve the affected communities themselves in programme design and implementation. This ensures that the programme is carefully tailored to the communities’ needs, and that it is seen as something done “with them” rather than “to them”. The work of small community-based organizations has been vital to each of these successful programmes.
Last but not least, strong leadership is essential for TB and HIV prevention campaigns to have a far-reaching and sustained impact. This means that politicians, religious leaders and others in authority must become actively involved in the response, and must ensure that it receives adequate resources. If all of the world’s leaders truly committed themselves to this cause then a great many lives would be saved.
2009年11月6日星期五
maternal & child health
1) The main reasons for maternal and child mortality in developing countries:
For child mortality:
The diseases (pneumonia, diarrhoea, malaria, measles and HIV)
Malnutrition
accident
As I see, the root cause is poverty and low educational level.
For maternal mortality:
Pregnancy and childbirth (severe bleeding, infections, unsafe abortion, hypertensive disorders ,obstructed labour and HIV)
Pregnancy-related illness after childbirth (fever, anaemia, fistula, incontinence, infertility and depression)
Some other factors related: Adolescent mother, Poor and less educated, lack of antenatal care visits and skilled care
Besides the poverty and low educational level, there is gender inequality which is also a root cause.
2) How people can try to reduce maternal and child mortality:
Reducing child mortality:
Investing in strong health systems, providing high-impact health and nutrition interventions: quality care during pregnancy; safe delivery by a skilled birth attendant; and strong neonatal care: immediate attention to breathing and warmth, hygienic cord and skin care, early initiation of exclusive breastfeeding, vaccines, antibiotics, micronutrient supplementation.
Improving family care practices: access to solid knowledge: helping families to learn essential skills and basic health knowledge, particularly in the care of newborns. This includes best practices in breastfeeding and complementary feeding, hygiene and safe faeces disposal; support and basic supplies: supporting better parenting, the care of mothers, infant feeding, care-seeking practices among families and communities in favour of disease prevention, and optimal management of childhood illness.
Increasing access to improved water and sanitation: develop systems to control water-borne diseases like Guinea worm and cholera that undermine child survival and development; reduce productivity and raise health-care costs; Struggle to find water and hygiene resources also primarily increase burdens on girls and women; strengthen policies and budgets and support technical capacities in programmes for hygiene promotion, sanitation, cost-effective water supply options and water quality, particularly for poor rural and urban families.
Reducing maternal mortality:
Enhancing the skills of health professionals to improve the quality and availability of services: support of scaling up of a training model for preventing maternal mortality with government health workers; preparing general practitioners to provide quality emergency obstetric care in rural areas; strengthening public sector delivery of reproductive health services; developing system to improve skilled attendance at birth in rural indigenous areas and generate support for midwifery training systems; increasing the availability and improving the quality of legal abortion services.
Promoting informed advocacy on critical issues related to maternal mortality to ensure that policymakers have the evidence and motivation to successfully address the problem;
Supporting research on leading causes of maternal mortality, covering topics such as political commitment, budget analysis and computer modeling of real-life scenarios.
Supporting education: not only to strengthen medical school curricula and teaching related to reproductive health and maternal mortality, but also to improve the level of education, especially let more girls enter the school.
3) Similarities in reducing maternal and child mortality:
The basic cause of maternal and child mortality is poverty and low level of education, so the interventions and policies have inevitability to some extent. Main is investing in strong health systems, supporting education, improving family care practices, increasing access to improved water and sanitation.
Reference:
Reducing maternal mortality http://www.macfound.org/atf/cf/%7Bb0386ce3-8b29-4162-8098-e466fb856794%7D/MATERNALMORTALITY-INFO.PDF
WHO 2008. 10 Facts on child health.
WHO 2008. 10 Facts on maternal health.
WHO 2008. What are the key health dangers for children?
UNICEF. Goal: Reduce child mortality. http://www.unicef.org/mdg/childmortality.html
http://www.globalhealthtv.com/news/the_effort_to_reduce_maternal_mortality/
For child mortality:
The diseases (pneumonia, diarrhoea, malaria, measles and HIV)
Malnutrition
accident
As I see, the root cause is poverty and low educational level.
For maternal mortality:
Pregnancy and childbirth (severe bleeding, infections, unsafe abortion, hypertensive disorders ,obstructed labour and HIV)
Pregnancy-related illness after childbirth (fever, anaemia, fistula, incontinence, infertility and depression)
Some other factors related: Adolescent mother, Poor and less educated, lack of antenatal care visits and skilled care
Besides the poverty and low educational level, there is gender inequality which is also a root cause.
2) How people can try to reduce maternal and child mortality:
Reducing child mortality:
Investing in strong health systems, providing high-impact health and nutrition interventions: quality care during pregnancy; safe delivery by a skilled birth attendant; and strong neonatal care: immediate attention to breathing and warmth, hygienic cord and skin care, early initiation of exclusive breastfeeding, vaccines, antibiotics, micronutrient supplementation.
Improving family care practices: access to solid knowledge: helping families to learn essential skills and basic health knowledge, particularly in the care of newborns. This includes best practices in breastfeeding and complementary feeding, hygiene and safe faeces disposal; support and basic supplies: supporting better parenting, the care of mothers, infant feeding, care-seeking practices among families and communities in favour of disease prevention, and optimal management of childhood illness.
Increasing access to improved water and sanitation: develop systems to control water-borne diseases like Guinea worm and cholera that undermine child survival and development; reduce productivity and raise health-care costs; Struggle to find water and hygiene resources also primarily increase burdens on girls and women; strengthen policies and budgets and support technical capacities in programmes for hygiene promotion, sanitation, cost-effective water supply options and water quality, particularly for poor rural and urban families.
Reducing maternal mortality:
Enhancing the skills of health professionals to improve the quality and availability of services: support of scaling up of a training model for preventing maternal mortality with government health workers; preparing general practitioners to provide quality emergency obstetric care in rural areas; strengthening public sector delivery of reproductive health services; developing system to improve skilled attendance at birth in rural indigenous areas and generate support for midwifery training systems; increasing the availability and improving the quality of legal abortion services.
Promoting informed advocacy on critical issues related to maternal mortality to ensure that policymakers have the evidence and motivation to successfully address the problem;
Supporting research on leading causes of maternal mortality, covering topics such as political commitment, budget analysis and computer modeling of real-life scenarios.
Supporting education: not only to strengthen medical school curricula and teaching related to reproductive health and maternal mortality, but also to improve the level of education, especially let more girls enter the school.
3) Similarities in reducing maternal and child mortality:
The basic cause of maternal and child mortality is poverty and low level of education, so the interventions and policies have inevitability to some extent. Main is investing in strong health systems, supporting education, improving family care practices, increasing access to improved water and sanitation.
Reference:
Reducing maternal mortality http://www.macfound.org/atf/cf/%7Bb0386ce3-8b29-4162-8098-e466fb856794%7D/MATERNALMORTALITY-INFO.PDF
WHO 2008. 10 Facts on child health.
WHO 2008. 10 Facts on maternal health.
WHO 2008. What are the key health dangers for children?
UNICEF. Goal: Reduce child mortality. http://www.unicef.org/mdg/childmortality.html
http://www.globalhealthtv.com/news/the_effort_to_reduce_maternal_mortality/
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