Delivering Healthcare in Somaliland, NW Somalia

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Abstract Limited provision of quality healthcare in Somalia has contributed to infant (109/1000), child (180/1000) and maternal (1,400/100,0000) mortality rates that border the world’s highest (WHO). The self-declared Republic of Somaliland (NW Somalia), with 3.85 million people, is recovering from ruins of conflict. The health sector was hardest hit with distinct challenges in urban and […]

A Student’s Observations on the State of Maternal Care in India

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As the second most populous country in the world, India struggles to provide universal healthcare with an infrastructure that has not kept pace with its economic growth and expanding population. With limited resources, physicians are spread thin and standards of health are low. As a result, the wealthy opt for private healthcare and receive world-class medical attention while the majority subsists on the most minimal treatments. These limitations, in combination with a traditional male-dominated culture, leave women with little freedom of choice when it comes to treatment of their bodies. This gender inequality in healthcare is amplified by a lack of education of family planning strategies. After spending a month shadowing physicians in both private and public hospitals in India, I saw first hand the shortcomings of the Indian health system, particularly in relation to women’s health. Despite the obvious need to repair public healthcare, overpopulation and government corruption prevent improvements in the healthcare infrastructure.

The Ethical Dimensions of Focusing Global Health Efforts on a Single Patient: an Examination of “Funds for Felix”

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This article analyzes the ethical considerations involved in focusing a global health effort on a single patient. The specific case considered is “Funds for Felix”, in which money was raised by students for a patient encountered by the UCLA Global Medical Training trip to Nicaragua in December of 2010. As the leader of the UCLA campus branch of Global Medical Training, I approach this case from a broader, organizational perspective. Although the Global Medical Training at UCLA leadership body was enthusiastic about the Funds for Felix project, we wondered about the potential ethical concerns that arise from devoting so many resources to an individual. Ultimately, the approach taken for the Funds for Felix project was extremely successful. This was due to several factors, including the transparency with which the project was conducted, the involvement of Nicaraguan mentors, and the students’ altruistic motivations. Given the rising awareness of global health issues, the relevant ethical questions of the Funds for Felix project are salient for any student or physician in the field of global health.

The Cultural and Psychological Context of Development and Healthcare in the Tribal Region of Sargur, India

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Located 55km northeast from Mysuru, the isolated region of Sargur, India is a highly forested and remote area. The population of this region is considered a minority and vulnerable due to lack of access to care, low life expectancy, and high levels of poverty. This tribal group has a unique culture, language, and way of life that is novel to outside medical professionals or development leaders that attempt to work in the region. To better serve the community and improve access to care, the Swami Vivekananda Youth Movement (SVYM) created an integrated development model which customizes the current standard development models to accommodate the tribal value system and attitudes regarding education, health, and socioeconomic empowerment. This report summarizes how the revolutionized education and healthcare system addresses the challenges of catering to a population prone to migration through understanding the definition of health according to the local attitudes and interpreting the impact of way of life in the development models appropriate for this population. This report reinforces the integral role of cultural competence when attempting to work with marginalized populations. The local approach varied from the traditional development models and was based off of direct experience with the population and cultural competence. This account analyzes the cultural norms of the tribal individuals, evaluates the appropriate technology and interventions used within the region, and assesses the barriers to healthcare and sustainable development.

Dietary Differences of Ngöbe Living within the Territorio Indigena Guaymi de Coto Brus, Costa Rica: an Indicator for the Development of Chronic Disease

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This study was developed to evaluate the diet and lifestyle of a Latin American indigenous population, the Ngöbe of southern Costa Rica, and provides a baseline to assess whether diet and nutrition-related diseases are emerging within the Ngöbe population. Anthropometric and lifestyle characteristics of 204 male and female Ngöbes over the age of 18 were assessed through interviews, a recollection of dietary intake, and direct body measurements from October 2010 to April 2011. A subset of respondents was administered glucose intolerance (IGT) tests to assess risk factors for type 2 diabetes. These data indicated that there are differences between the general health status of males and females and between young and old adults. Daily diets show discrepancies in nutritional intake that point to both macro and micronutrient deficiencies. Differences in diet diversity for older and younger respondents and negative correlations of these values with Body Mass Index and blood glucose point toward causes of poor nutrition. More specifically, these data suggest a link between the shift in food behaviors away from the diverse and nutritious traditional diet and the increasing rates of diseases such as type 2 diabetes. Proper surveillance, diagnosis, treatment of nutrition-related diseases, implementation of comprehensive programs that work to improve food access, and providing incentives to practice a more active lifestyle, are of the utmost importance to battle the onset of this disease and reduce future health costs.

A Student’s Observations on the State of Maternal Care in India

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As the second most populous country in the world, India struggles to provide universal healthcare with an infrastructure that has not kept pace with its economic growth and expanding population. With limited resources, physicians are spread thin and standards of health are low. As a result, the wealthy opt for private healthcare and receive world-class medical attention while the majority subsists on the most minimal treatments. These limitations, in combination with a traditional male-dominated culture, leave women with little freedom of choice when it comes to treatment of their bodies. This gender inequality in healthcare is amplified by a lack of education of family planning strategies. After spending a month shadowing physicians in both private and public hospitals in India, I saw first hand the shortcomings of the Indian health system, particularly in relation to women’s health. Despite the obvious need to repair public healthcare, overpopulation and government corruption prevent improvements in the healthcare infrastructure.

Health Care Issues Facing the Maya People of the Guatemalan Highlands: The Current State of Care and Recommendations for Improvement

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The indigenous population in rural Guatemala has access to a variety of treatments from both the traditional and biomedical realms. Health care-seeking behavior among the indigenous Maya in the Highlands region has not been well described. A review of the current literature was performed to determine the major factors influencing the decision to seek care and choose a provider. Despite a high prevalence of non-biomedical beliefs among the native population, folk healers are rarely used. Local unlicensed pharmacies are frequently used to obtain advice and medications. Utilization rates of the public health care system in the region are relatively low. Perceived lack of severity of illness, cost, mistrust of the provider, and quality of services as determined by the patient are the major deterrents to seeking medical care in the public health care system. Cost is particularly important as non-traditional medicines are often expensive and biomedical health care providers prescribe medications that patients cannot afford. In addition, government health posts often lack culturally-sensitive care creating a significant barrier for indigenous populations. Access to a government health post does not appear to be a major factor in determining health care-seeking behavior. A system that minimizes cost barriers, while providing culturally sensitive care may lead to greater access and use of the public health care system among the Maya in Guatemala.

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