Saturday, January 30, 2010

Parasites and Sustainability

In just 16 hours of class we learned about over 40 parasites. We covered hosts, transmission and medication in everything from Plasmodium falciparum (malaria) to Wuchereria Bancrofti (elephantitis) and loads of everyday illnesses inbetween. Luckily, we had a Professor that also covered the socio-economic implications of parasites as well. Parasites don't distinguish between the developed and developing world, with large outbreaks of Cryptosporidium affecting cities such as Milwaukee (and, I will note, not every water treatment plant in the US can eliminate Cryps!).

But, as is commonly known, parasites have a particularly devastiting effect on impoverished areas with lack of access to proper sanitation, drinking water and medications. I list those three things in order of importance, because for the majority of parasites we covered in the course were passed through improper sanitation as well as lack of clean water. Medication is important to treat those infected and in usually to stop the spread of established diseases, but for the most part if we took the first two steps many diseases would not have the means to spread or even appear in the first place.

Possibly the worst part about these parasites as their impact on mental development (especially in children), productivity and overall quality of life. Areas where parasites spread tend to be impovershed, they do not have access to the proper facilties mentioned above. Then once infected, their children and families often have trouble finding the energy or capacity to do something about their situation, in some cases are physically unable to better their situation. This in turn leads to a cycle of poverty, parasites and lack of any method to get out, generation after generation. As Bill Gates recently pointed out, this cycle also contributes to overpopulation.

This brings me to the point of sustainability, or more properly sustainable development. The goal of sustainable development is to essentially to alleviate poverty without destroying the environment through western style consumption and infrastructure patterns. When looking at impovershed areas through the lens of Parasitology, it appears there could be a way to break the cycle of poverty without massive, expensive (economically and carbon wise), and ultimately unlikely infrastructure investments. This could be done through empowering local citizens with the means to combat disease utilizing local materials and detached or standalone sustainable solutions. This is already happening as was demonstrated in the course in the case of Tsetse fly traps maintained by locals, the easily constructable and safe VIP latrines, and this neat solar-powered water purifier.

Taking this a step further with the use of renewable energy, which can be implemented locally (and in the case of some wind turbines even mainly constructed locally) and now you have detached electricity to power communication devices such as laptops and cell phones. Now, suddenly, you can communicate health problems over the web to doctors in bigger cities and feel connected socially to the world at large. And, for parasites, you can improve disease surveillance to continuously updating and mapped outbreaks on the ground. Think about education access online as well!

Back to Bill Gates. One thing he mentioned was that as people improve economically and health wise, they start to have smaller families. This is seen again and again in developed countries. So if we improve health, sanitation and education we can start to tackle that elephant in the room of sustainability: overpopulation.

These are only some of the solutions, but the understanding of the links between health, development and sustainability are crucial if we are to make it out of the 21st century with the planet intact.



I've been meaning to put up a full post on Haiti and will once I am better educated about the situation and implications. For now you can check out the coverage and links to how you can help at AMSA's Global Pulse blog and Doctors Without Borders. As in every natural disaster, there is the opportunity to rebuild in a better, more sustainable way than was done in the first place. Check out some of the emerging green plans and ideas at

Wednesday, January 20, 2010

Med Students Say Conventional Medicine Would Benefit By Integrating Alternative Therapies

Interesting study showing the future physician workforce is much more open to CAM, but the "lack of research" conundrum still exists:

" 84 percent of participants agreed to some extent that the field contains beliefs, ideas, and therapies from which conventional medicine could benefit.

- 49 percent of participating medical students indicated that they have used complementary and alternative treatments however few would recommend or use these treatments in their practice until more scientific assessment has occurred."

The problem here is that less research is done on CAM because there is less funding, in part because in many cases there is less money to be made so no individual organization will fund the research to determine efficacy, safety and drug interactions that are all done when a pharmaceutical company develops a new drug for FDA approval. The difference is the pharma company has a financial interest and seeks the financial benefit of the drug getting approved, so they put up the money to do the studies. One could argue about the rigor and speed of the pharma studies, but they are at the least uniform and provide with which to compare information about therapuetics. That, unfortunately, is not the case with the majority of CAM treatments, hence the 84% saying medicine could benefit but 49% thinking they are safe to use

Saturday, January 9, 2010

Epidemiology of Emotions

Interesting article on public reactions on the swine flu. In many ways, the it is related to the growing anxiety over vaccines, but is there a deeper undercurrent of ignorance or suspicion of medicine at work? This paragraph seemed to capture the mood nicely:

When the inoculum of dramatic illness is first introduced into society, the public psyche rapidly becomes infected. Almost like an IgE-mediated histamine release, there is an immediate flooding of fear, even if the illness — like Ebola — is infinitely less likely to cause death than, say, a run-in with the Second Avenue bus. This immediate fear of the unknown was what had all my patients demanding the as-yet-unproduced H1N1 vaccine last spring.

As the novel disease establishes itself within society, a certain amount of emotional tolerance is created. H1N1 infection waxed and waned over the summer, and my patients grew less anxious. There was, of course, no medical basis for this decreased vigilance. Unusual risk groups and atypical seasonality should, in fact, have raised concern. By late summer, the perceived mysteriousness of H1N1 had receded, and the number of messages on my clinic phone followed suit.

But emotional epidemiology does not remain static. As autumn rolled around, I sensed a peeved expectation from my patients that this swine flu problem should have been solved already. The fact that it wasn't "solved," that the medical profession seemed somehow to be dithering, created an uneasy void. Not knowing whether to succumb to panic or to indifference, patients instead grew suspicious.

No amount of rational explanation — about the natural variety of influenza strains, about the simple issue of outbreak timing that necessitated a separate H1N1 vaccine — could allay this wariness."
Aside from the vaccine angle, the idea of surveillance epidemiology applied to emotions, fears and their spread is an interesting one.... anyone out there know of more research on topics like this?