The Nation Newspaper

Category: Rethink Health

  • Experts urge UN to adopt natural healthy environment

    Experts urge UN to adopt natural healthy environment

    Janefrances Chibuzor

    Following global deaths linked to the damage and destruction of natural environment, Environmental activists from around the world have called on the United Nations (UN), to include new article to the Universal Declaration of Human Rights, noting that such development would preserve universal right to healthy natural environment.

    If successful, this amendment would be the first addition to the declaration since its inception for more than seven decades now.

    According to a statement, Dr. Muhtari Aminu-Kano stated, “#1Planet1Right campaign dedicated to establishing this new human right, and is led by world’s largest conservation partnership, BirdLife International. Joining them are Nigerian Conservation Foundation (NCF) and other civil society organisations such as ClientEarth and the Global Pact for Environment. Dr David R. Boyd, UN Special Rapporteur on human rights and the environment has also endorsed the campaign. #1Planet1Right sent a letter to António Guterres, Secretary General of the United Nations, on Earth Day officially making the request for a new human right, and will now continue putting pressure on the UN by launching a global petition.”

    WHO records that 23% of global deaths are linked to the damage and destruction of our natural environment, while hundreds of millions of people suffer from illnesses related to unhealthy and unnatural environment.

    Climate change is results in more frequent and intense storms, droughts, wildfires and rising sea levels, which in turn threaten the lives of billions of people. The COVID-19 pandemic has its roots in habitat loss and illegal wildlife trade. This new human right can help ensure that the global green recovery the world needs to rebuild society following the pandemic takes both the biodiversity and the climate emergencies into account.

    UN Special Rapporteur on human rights and the environment Dr. David R. Boyd said: “The right to a healthy planet, as a universally recognized human right, would be a powerful addition to the toolkit for saving the planet. The right to a healthy environment already provides the foundation for much of the progress we are seeing in different nations around the globe. What we need to do now is seize this moment of global eco-crisis to secure United Nations recognition of this right so that everyone, everywhere benefits. The human right to a healthy planet, if recognized by all nations, could be the most important human right of the 21st century.”

    READ ALSO: Mastercard: sustainable environment vital

    Chief Executive Officer, BirdLife International Patricia Zurita said: “Our planet’s health is our health. If our planet is sick, we become sick. And right now, our planet has never been more ill. The survival of humanity is already threatened by the climate and biodiversity crises, and this pandemic has pushed us one step closer to the brink. In order to transform, and save society, the starting point must be to ensure that every person has the same baseline – guaranteeing everyone the right to a healthy planet.”

    Lastly Aminu-Kano said, “Humans are completely dependent on healthy and vibrant ecosystems for their health, water, food, medicines, clothes, fuel, shelter, energy and many more. Environment demand more attention from us now, government; corporate organisation and individual should arise and do something to protect it from absolute collapse. We all need a healthy planet.”

    #1Planet1Right is a global campaign demanding the right to a healthy, natural environment to be added to the UN Universal Declaration of Human Rights. The campaign is supported by civil society organisations from over 100 countries and counting and will be running until 2023, when it hopes that the right will be added to the Universal Declaration of Human Rights to mark its 75th anniversary.

  • Impressive health benefits of pineapple

    Our Reporter

    Pineapple (Ananas comosus) is an incredibly delicious and healthy tropical fruit.

    It originated in South America, where early European explorers named it after its resemblance to a pinecone.

    This popular fruit is packed with nutrients, antioxidants and other helpful compounds, such as enzymes that can fight inflammation and disease.

    Loaded with nutrients

    Pineapples are low in calories but have an incredibly impressive nutrient profile.

    One cup (5.8 ounces or 165 grams) of pineapple chunks contains the following (2):

    Pineapples also contain trace amounts of vitamins A and K, phosphorus, zinc and calcium.

    They are especially rich in vitamin C and manganese, providing 131% and 76% of the daily recommendations, respectively.

    Vitamin C is essential for growth and development, a healthy immune system and aiding the absorption of iron from the diet.

    Contains disease-fighting antioxidants

    Not only are pineapples rich in nutrients, they are also loaded with healthy antioxidants.

    Antioxidants are molecules that help your body combat oxidative stress.

    Oxidative stress is a state in which there are too many free radicals in the body. These free radicals interact with the body’s cells and cause damage that is linked to chronic inflammation, a weakened immune system and many harmful diseases.

    Its enzymes can ease digestion

    Pineapples contain a group of digestive enzymes known as bromelain (10Trusted Source).

    They function as proteases, which break down protein molecules into their building blocks, such as amino acids and small peptides.

    Once protein molecules are broken down, they are more easily absorbed across the small intestine. This can be especially helpful for people with pancreatic insufficiency, a condition in which the pancreas cannot make enough digestive enzymes

    Help reduce the risk of cancer

    Cancer is a chronic disease characterized by uncontrolled cell growth.

    Its progression is commonly linked to oxidative stress and chronic inflammation.

    Several studies have shown that pineapple and its compounds reduces the risk of cancers. This is because they minimize oxidative stress and reduce inflammation.

    Boost immunity and suppress inflammation

    Pineapples have been a part of traditional medicine for centuries.

    They contain a wide variety of vitamins, minerals and enzymes like bromelain that  collectively boost immunity and suppress inflammation.

    Read Also: Health benefits of eating carrots

    It ease symptoms of arthritis

    There are many types of arthritis, but most of them involve inflammation in the joints.

    Since pineapples contain bromelain, which has anti-inflammatory properties, it’s commonly thought that they may provide pain relief for those with inflammatory arthritis

    One study in patients with osteoarthritis found that taking a digestive enzyme supplement containing bromelain helped relieve pain as effectively as common arthritis medicines like diclofenac.

    Speed recovery after surgery or strenuous exercise

    Eating pineapples reduce the time it takes to recover from surgery or exercise.

    This is largely due to the anti-inflammatory properties of bromelain.

    Several studies have shown that bromelain reduces the inflammation, swelling, bruising and pain that often occurs after surgery. It also seems to reduce markers of inflammation

    Proteases like bromelain are believed to speed up the recovery of damage caused by strenuous exercise by reducing inflammation around the damaged muscle tissue

    Delicious and easy to add to the diet

    Pineapples are sweet, convenient and easy to incorporate into your diet.

    They are very affordable and available year-round in many American markets, as they can be purchased fresh, canned or frozen.

    You can enjoy them on their own or in smoothies, salads or on homemade pizzas.

    The bottom line

    Pineapples are delicious, low in calories and loaded with nutrients and antioxidants.

    Their nutrients and compounds have been linked to impressive health benefits, including improved digestion, a lower risk of cancer, improved immunity, relief of arthritis symptoms and improved recovery after surgery and strenuous exercise.

    Pineapples are also incredibly versatile and can be consumed in a variety of ways.

    To experience their health benefits, try incorporating pineapples into your diet.

    Source: healthline.com

  • The aftermath of reducing mental health stigma

    Over the past five years, the world has started talking more openly about mental health.

    The conversation about taking care of your mental health can be heard across the world in conversations among friends, all the way up to the highest levels of government.

    In Canada, from we’re I’m writing, an Ipos poll released in 2017 revealed that “85 percent of Canadians surveyed say they consider mental health to be as important as physical health – another 12 percent say it’s even more important.

    Half of Canadians (49 percent) say they’re personally more comfortable talking about their mental health when compared to two years ago.” Similar statistics have been popping up all over the world.

    In my own life, I have seen the same family members who shamed me for dealing with anxiety, depression and other issues, have started to open up about struggling with their own mental health.

    As a kid, I remember struggling to find the space to talk about how I was feeling. I was sad when others were happy and worried when others were excited.

    When I tried to ask for support from my family, school or community, I was often told how I should “be grateful for my life” or “pray to God to feel better and have my pain lessened,” or —on particularly bad days— that I was an “overdramatic attention seeker making things up.” I felt so alone, so burdensome.

    This reinforced the silence and led me to think I was the problem, and that committing suicide would be the answer.

    After my suicide attempt, I was lucky enough to be found on time and taken to a hospital, where a fellow patient and a nurse encouraged me to keep living.

    Thankfully, these experiences are in stark contrast to how things are like today. Thanks to the anti-stigma conversation, my family and friends now realize how harmful their prejudices were to me, how helpful it is to have access to the proper services and why such services should be available for everyone.

    For me, the most important change is to see that my parents, who survived trauma, war and abuse, are finally talking about it and processing it.

    That, as a family, we have come to realize that my struggles with mental illness reminded them of their own — and that’s why they tried so hard to ignore them. Together, we are ending the cycle of trauma that can follow one generation after the other.

    Destroying the stigma around mental health has been an amazing movement to be part of, but also a shortsighted one. As we have dismantled stigma, the wait lists for mental health services have increased, as funding to mental health services has not kept pace.

    We’ve fostered a conversation around mental health while lacking to boost the services needed to ensure its prevention and treatment, leading to the mental health crisis in young people so often portrayed in the media.

    And while more young people speak about their mental issues, our suicide rates keep growing, mainly because we have policies to track suicide but we lack the resources to fight it where and when we need them.

    A 2018 report by the Canadian O’Brien Institute for Public Health for the NGO Children First Canada illustrates the situation: “Over the last 10 years, there has been a 66 percent increase in emergency department visits, and a 55 percent increase in hospitalizations, of children and youth (age five to 24 years) due to mental health concerns.”

    The same report states that, in a year span, there was an eight percent increase in young people having thoughts of suicide.

    I have experienced this trend personally. As someone using her own story to educate people about mental health issues, I remember the first time people told me that my story had encouraged them to ask for help.

    I remember the pain in their voice when they told me they had thought that admitting they weren’t well was “the big step,” only to realize that the system that was supposed to walk along side them in the hard journey of recovery wasn’t there at all.

    I remember how betrayed they felt by me for selling them a dream of recovery and services that they could not access. This led me to walk away from public speaking for a while, and rather focus on creating services to send people to.

    So where do we go from here?

    We need to encourage economic leaders to fund mental health services — whether it’s government, family foundations, businesses or others. We have to focus on helping remove the financial gap and lack of mental health services.

    We also need to make sure the mental health funding goes to innovative services. With the increase in demand, we need to be smart about where we spend the money.

    We need to focus on resources that are lean, show positive changes, and that are accessible to as many people as possible.

    To me, this means directing the funds to mental health services that are operate online, on the phone or in comfortable community spaces rather than in expensive and overcrowded hospitals.

    Finally, we have to keep our leaders talking about mental health.

    We can encourage our local community to keep our political leaders honest about what they are doing to ensure that mental health is being addressed.

    Ask for education where needed, but also services and support for people who are now educated about this issue and realize something is wrong.

  • Screening to Identify Perinatal Depression

    Babies and mothers in the Western Cape of South Africa now have a brighter future, thanks to a provincial government’s decision in September 2018 to start screening the mental health of pregnant women and new mothers during routine checkups.

    Maternal depression and anxiety are estimated to affect roughly one-third of women in South Africa before or after the birth of a child. Routine mental health screening, integrated to primary care, will allow common conditions like these to be picked up and treated early, with benefits for both infants and mothers.

    The screening tool used in the initiative was developed by the Perinatal Mental Health Project (PMHP), led by Dr Simone Honikman, based on research conducted at a midwife obstetric unit in Cape Town.

    A nonprofit entity based at the Department of Psychiatry and Mental Health of the University of Cape Town, the PMHP was launched in 2002 and has been providing counselling services ever since, ensuring screening and support for pregnant women in low income areas dealing with psychological distress.

    “Our screening tool picks up depression and anxiety, and now it is part of the maternal case record. It is brief and simple to use,” Honikman said, describing its adoption by the Western Cape as a victory for mothers and babies.

    The tool consists of a standardised questionnaire, developed by the PMHP team and administered by nurses, midwives or counsellors at the first antenatal visit. The questionnaire is available in the four languages spoken by most of the project’s beneficiaries — English, Afrikaans, isiXhosa and French.

    Infant and child psychiatrist Dr Anusha Lachman, from Stellenbosch University, said the decision to adopt this screening tool was long overdue. “I hope it will be rolled out to the rest of the country,” she added.

    ”Maternal depression in Africa is about three times higher than the international average, which is around 10 percent of pregnant women. The reasons for the high prevalence are clear: people’s socio-economic situations, high levels of intimate violence and substance abuse, and not being able to access support,” said Lachman.

    Support for women’s mental health before and after birth is particularly lacking in underprivileged communities. The PMHP is run by a professional counsellor working at the maternity unit of the Hanover Park Community Health Centre, in Cape Town — an area notorious for gang violence.

    “We see patients whose partners have been killed in gang shootings, who have recently been diagnosed with HIV, who are unemployed, who deal with substance abuse and domestic violence at home, and teenagers whose parents have kicked them out,” said PMHP counsellor Liesl Hermanus.

    Sharmaine Miller, a government health promotion officer who has worked at the maternity unit for 29 years, has taken on the mental health screenings and Hermanus does the counselling. They have developed a positive relationship with the nursing staff.

    “They have really embraced what we do and tell us when they identify vulnerable patients, like a mum who is very tearful in the labour ward,” said Miller..

    Hermanus has worked at the midwife obstetric unit for the last eight years. She usually sees patients in her office, where her energy, organisation and a basket of toys make women feel they are in safe hands.

    “I do lots of listening and psycho-education about bonding, explaining the importance of touch and talking to babies. Later on in a pregnancy, I see patients start feeling better and getting excited about their baby,” she said.

    Since its creation, the PMHP has screened more than 37,000 women, and counselled nearly 7,000 mothers in distress. Miller screens up to 15 pregnant women and new mothers on a daily basis, and teaches them skills such as breastfeeding.

    Practical advice, like how to apply for a child support grant, is also provided to parents, some of whom do not have enough money for the next meal, let alone nappies.

    One of the women helped by the PMHP said she felt so desperate she thought of taking her own life, until her counsellor made her feel safe. “I feel better when I talk to her; she’s always active, taking the positive side,” she said during a consultation.

    Then she addressed her counsellor directly: “I’m here now, I’m fine, because I know I have you on my side. I’m very proud to be a mum.”

    The project also trains nurses and health care professionals from across Africa to respect and care for women before and after childbirth.

    One of its programmes, for instance, teaches patients and health workers to step into one another’s shoes through role play.

    Honikman said that it helped increase empathy and respect between the maternity staff and their patients, which is crucial to screening.

    Cassey Chambers, operations manager for the NGO South African Depression and Anxiety Group, said it was common to get calls from mothers who were overwhelmed months after their babies were born.

    “They are feeling stressed, depressed and anxious. Many feel like they don’t have any support but are too afraid to speak to anyone in case others think they are bad mums or that something is wrong with them,” she said.

    “Everyone assumes that having a baby is the best thing ever, but no one addresses the issue that it is also the most stressful, loneliest and scariest time,” she added, noting that postnatal depression was a serious condition and that new mothers should be encouraged to seek support and treatment.

  • Changing Society’s Assumptions about Mental Disorders

    “Leave me alone, let me die!” yells Hawah Abubakar*, a dozen pills in her hand, as she struggles to free herself from the clutches of a classmate. “I’m tired of this life.” Tears roll down her cheeks.

    A student in her early twenties, Abubakar’s wish is to sleep away her ordeals and never wake up. Perhaps if she dies, she says, she’ll cease to be an object of scorn.

    Abubakar has a mental disorder. Sometimes she loses control, closing her eyes and clenching her fists, making sudden, unpredictable moves and destroying things around her.

    She once attempted to jump from a two-storey building in the middle of a classroom lecture – it took half a dozen men to stop her. When she finally calms down and others tell her about her actions, she remembers nothing.

    In northern Nigeria, where she lives, people believe that she is possessed.

    But this time Abubakar isn’t out of her mind. She says her intention to commit suicide is genuine. “Every man who asks me out jilts me as soon as he finds out about my condition.

    No man wants to marry a girl like me,” she sobs, adding that her friends and classmates have begun to avoid her, afraid her insanity might visit her unexpectedly and make them victims of her violent displays.

    People with mental disorders actually have two conditions to cure: their ailment, and society’s misconceptions about it – also known as stigmatisation.

    According to Aishatu Yushau Armiyau, a lecturer at the Department of Psychiatry, Jos University Teaching Hospital, stigmatisation deprives mental illness victims of their human dignity and participation in society, by undermining social support and compromising opportunities for treatment.

    She notes that stigmatisation is due to “misconception, prejudicial stereotypes, and negative public (and professional) attitudes about mental illness,” owing to the assumption that “persons with psychotic disorders are unpredictable and incapable of being managed, even by the best efforts of the health system.”

    Stigmatisation cuts across social class and demographics. Educated and non-educated people, laymen and even health professionals have been guilty of attaching stigma to persons with mental disorders. Such discrimination is particularly widespread in Nigeria.

    A study published in the South African Journal of Psychiatry in 2010 revealed that 52 percent of respondents believed that witches were responsible for mental illness, 44.2 percent held that it is due to demon possession, and close to one-third felt that it is a consequence of divine punishment.

    Meanwhile, in 2013, a survey of nursing professionals conducted by researchers from the University of Ibadan showed that 26 percent preferred to distance themselves from mentally ill persons.

    The World Health Organization (WHO) observed that mentally disabled people are often excluded from community life, denied basic rights such as shelter, food and clothing, and are discriminated against in the fields of employment, education and housing.

    Many are denied the right to vote, marry and have children. “As a consequence,” WHO says, “many people with mental disabilities are living in extreme poverty which in turn, affects their ability to gain access to appropriate care, integrate into society and recover from their illness.”

    While WHO says that mental health policies and laws are critical to improving conditions, they point out that these are “absent or inadequate in most countries of the world.”

    In Nigeria, where the health budget dedicates only three percent to mental health, the sole available mental health care document is of colonial origin and includes obsolete laws, such as one providing for the imprisonment of suicide survivors.

    In 2003, a Mental Health Act bill was introduced in the National Assembly that would protect the rights of people with mental disorders, ensure equal access to treatment, and discourage stigma. It was withdrawn in 2009. In 2013, the bill was re-introduced, and has been hovering in the House ever since, yet to be passed into law.

    In the meantime, a handful of nonprofit organisations, such as the Mentally Aware Nigeria Initiative (MANI), provide support for people with mental illness and conduct awareness campaigns that have educated thousand of Nigerians.

    While urging Nigerians to challenge the “taboo, stigma and misconceptions about mental health among the general population,” MANI also appeals to the government and other decision-makers to provide necessary legislation, policies and budget allocation to boost mental health services in the country, particularly to ensure mental health first aid and suicide prevention services.

    Also advocating for stronger and more up-to-date policies is the Abuja-based Smart Suicide Prevention Initiative (SSPI), established in 2013.

    It focuses on preventing suicide by raising awareness, provides resources to those affected by suicide, and advocates for policies that will save lives.

    SSPI uses a variety of media to get its message across – for example, it produces a TV show, “Whispers of the Hurting,” to encourage discussion on the subject of suicide.

    The Lagos-based Mental Health Foundation has been operating in Lagos for the past 10 years, bringing together psychiatrists, clinical psychologists and dynamic young volunteers who coach and inspire the numerous depressed and stigmatised people in Nigeria.

    All of these initiatives work with minimal funding and little government policy to guide them. But that hasn’t prevented them from trying to bring about deeper awareness of mental health and help those who suffer.

    * Not her real name

  • Addressing Mental Health in Rural India

    India is home to an estimated 56 million people suffering from depression and 38 million more from anxiety disorders, according to the World Health Organisation (WHO).

    But while 20 percent of the country’s population suffer from mental illness, only 12 percent at most seek aid for their mental health concerns.

    Those who do are more likely to be located in urban areas, perched on top of the socioeconomic ladder, and have access to qualified psychologists, psychiatrists, appropriate medicines and both online and offline social networks that greatly destigmatise mental health disorders.

    These privileges aren’t readily accessible in India’s rural villages.

    “In many of the villages we work in, people consult faith healers for epileptic attacks,” said Amul Joshi, Country Director of the MINDS Foundation, an international organisation based in the United States that works primarily in the western Indian state of Gujarat.

    Since 2016, it has taken its operations to 92 villages in the state to conduct mental health awareness and educational workshops. Nearly 19,000 villagers have participated in these workshops and 193 patients requiring mental health treatment have been taken to city hospitals in Vadodara and Bhavnagar.

    Much of the foundation’s work consists of conducting primary research in these villages. One of its recent studies surveyed awareness about mental health and well-being among families from the Navrachana International School community in rural Vadodara, via standardised questionnaires.

    Another one focused on gender bias against women regarding access to mental health treatment.

    In rural India, the challenges of addressing mental illness are particularly significant. The country lacks resources in the field, and most of the available resources are located in major cities or highly urbanised states.

    According to the 2015-16 National Mental Health Survey, the number of psychiatrists in the country varied from 0.05 for every 100,000 persons in Madhya Pradesh (central India) to 1.2 in southeastern Kerala.

    Except for Kerala, all other states fell short of the WHO’s requirement of at least 1 psychiatrist for every 100,000 persons.

    The survey notes that the prevalence of mental issues – ranging from depression to epileptic disorders – seems to be higher in urban areas, because there are better reporting standards and a lower threshold for active interventions in cities.

    “People are mostly unaware about the mental disorders they are suffering. They take it as their fate: go to quacks or religious healers.

    That’s why there’s stigma attached to the word ‘psychiatrist’ and ‘psychiatric disorders,’” said Dr Rajiv Mehta, Consultant Psychiatrist at the Sir Ganga Ram Hospital of New Delhi. These disorders also include drug dependence, which is rampant in villages, especially among men.

    Dr Samir Parikh, a highly reputed psychiatrist and the director of the Department of Mental Health and Behavioural Sciences at Fortis Healthcare, said mental health awareness is necessary across the country, in both urban and rural settings.

    “The issue is critical in villages because of the high concentration of mental health specialists in urban areas. We need constructive public-private partnerships, where access to mental health prevention and treatment is given to the rural population at minimal cost,” he said.

    The scarcity of medical professionals and healthcare infrastructure deepens the stigma surrounding mental illness in villages.

    However, villages also present opportunities to apply community-based approaches to mental disorders. A bottom-up, grassroots approach such as the one developed by the MINDS Foundation could very well be the answer to unite local communities and health workers, and to end prejudices and misconceptions about mental disease.

    Thanks to a strong sense of community, many socio-psychological issues can now be addressed at a village level.

    “The community takes care of the homeless living with mental illness, or people with developmental delay.

    Without sophistication, the rural folk have their own ways of promoting education and healthy living by being close to nature.

    In contrast, in urban settings, this is largely absent due to the growing trend of nuclear families and independent living,” wrote Pragya Lodha, associate programme developer of the MINDS Foundation, in an article for the Better India website.

    In other words, a close-knit, family-like community, properly educated in mental health, is better equipped to take care of its own, providing prevention, treatment and well-being.

  • Providing support where and when it’s needed

    Refugees have often suffered terrible experiences, but they are generally unable to access psychological support in Germany. Getting help from other refugees can help them overcome their struggle.

    “How are you?” asks Salah in Arabic to begin the session. “Mneh,” replies Farid, waggling one hand in mid-air: “Alright.” Farid was 16 years old when he narrowly escaped a bomb attack in Algeria, his home country – but two of his friends died. He has been taking pills to sleep ever since.

    After the episode, he became a critic of the regime and was persecuted, so he fled to Germany. Now he’s a patient of Salah’s, a psychosocial counsellor at the Soul Talk project who is a refugee, too.

    Created by the humanitarian medical organisation Médecins Sans Frontières (MSF, or Doctors Without Borders), Soul Talk is the first psychosocial aid project of its kind in Germany.

    Since its launch in March 2017, it has been training new psychosocial counsellors who not only speak the same language as the refugees, but also share the same or similar culture and have experienced life as refugees themselves.

    The concept was originally developed for refugee camps in crisis zones, where MSF usually operates. But since access to psychological support for refugees is limited in Germany, MSF set up the project together with St. Josef’s Hospital in Schweinfurt.

    Since then, it’s been up and running at an accommodation center for newly arrived asylum seekers.

    A Syrian teacher of English, Salah was one of Soul Talk’s first three counsellors. Now patients call him Doctor Salah. When he arrived in Germany, he had to spend his first months alone in a refugee accommodation, even though his wife and children were already living in the country.

    He knows how difficult it can be to deal with language courses and authorities when one’s problems, fears and sense of hopelessness are overwhelming. “I had to be strong,” he recalls, noting that he would have benefited from the support that Soul Talk offers.

    While Salah speaks to Farid, three new counsellors are being trained on another floor. The training lasts just three weeks, during which they learn how to become good listeners, support patients, provide techniques for stress management and maintain a certain distance when dealing with hardship stories.

    Everything else is picked up on the job – counsellors work closely with psychologists and learn what psychologists call “strengthening one’s own resources.” Along with the patients, they discover which of their abilities can help them tackle difficult situations, or feel better.

    That’s why Salah encouraged Farid, who speaks Arabic and French and wanted to help others, to consider interpreting for other refugees. He told him he should go out more, since he doesn’t know many people in Germany.

    Farid has also found support in group sessions with refugees, which are part of the programme. “They helped me to see that lots of people are going through exactly the same situation. It’s not good to always keep your problems to yourself,” he says.

    MSF estimates that half of the asylum seekers who arrived in Germany in recent years – more than one million since 2015 – have suffered severe trauma. They have been exposed to violence and their lives have been at risk – either in their homeland or while fleeing.

    As a result, they battle everyday with loneliness, fear for relatives back home, and constant uncertainty as to whether they will be able to stay in the country, which translates into sleeping problems, anxiety and depression.

    “But for us, it’s not about processing trauma,” says Hannah Zanker, one of the two psychologists overseeing the counsellors’ work.

    “It’s about providing support where and when it’s needed, to help stabilise the patients.”

    After discussing each case with the counsellors, Zanker assesses which refugees are in need of more intensive support – those who may be at risk of suicide, for example. Those unable to be helped by the project are transferred to a psychiatric clinic.

    Soul Talk is not a replacement for therapy. “It’s more about prevention. Refugees need to be supported through the difficulties they are experiencing so that they do not develop chronic mental illnesses,” says Zanker.

    For now, St Josef’s Hospital is covering all expenses, and a new site may soon be created through crowdfunding.

    But the programme’s long-term funding remains unclear – so far, it hasn’t had any financial support from the Federal State of Bavaria. And yet the project has been a success.

    More than 450 refugees have received at least one counselling session, and an internal survey has shown that they would like more.

    Parisa, an Iranian woman who, like Salah, is employed as a counsellor for Soul Talk, considers the project a triumph. But at first, she recalls, patients were sceptical: “They were afraid we would deliver them to the authorities, even though we have a duty of confidentiality.”

    While psychosocial counselling is not necessarily well known or recognised in other countries, refugees in Germany have started to recommend Soul Talk to one another. “At the beginning, we were still knocking on doors and asking people how they were doing. Today, people come to us on their own,” says Parisa. “I feel proud, it means we’ve done a good job.”

    Box (optional – additional)
    Soul Talk was established in 2017 as a joint project between Médecins Sans Frontières and St. Josef’s Hospital in Schweinfurt. It is a low-threshold psychosocial counselling option for refugees.

    It is based on a concept developed by Médecins Sans Frontières for crisis zones. People with personal experience as refugees, who share the same language, are trained as psychosocial counsellors over a three-week training period.

    Prior knowledge of psychology is not necessary, but counsellors work closely with two psychologists and participate regularly in additional training sessions. St Josef’s Hospital exclusively funds the project for now. Médecins Sans Frontières is hoping that this model project will be replicated throughout Germany.

  • Could surgery be the answer to obesity?

    A South African woman named Dineo* long struggled with obesity. Her vices included takeout food, creamy desserts and chips, and she drank two litres of sugary drinks a day.

    “It relaxed me,” she recalls. Her weight crept up to 141 kg. Yo-yo dieting never worked. In 2008, she miscarried her second child due to weight-related complications. The stigma of being overweight led to depression.

    Then she learned about bariatric surgery, a procedure that involves reducing the size of the stomach with a gastric band, removing a portion of the stomach, or shortening the intestine to a small stomach pouch.

    “Medical aid covered 80 percent of the cost and the shortfall was over 100,000 rands [USD 6,800],” she says.

    “I needed to do something as I was starting to become immobile. I could drive but barely walk. So I started saving money.” Dineo had the surgery six months ago, and has since lost about 40 kg.

    Around the world, 1.9 billion adults are overweight and 650 million are obese. There is currently no country on track to meet targets to halt obesity, which is a major risk factor for noncommunicable diseases such as cancer, diabetes, cardiovascular and hepatic diseases.

    Together, these count for more than 70 percent of deaths worldwide. The social stigma of obesity can lead to social isolation, suicidal thoughts and avoidance of medical care.

    In South Africa, 30 percent of the population is obese and an additional 20 percent are overweight. Professor Tess van der Merwe, honorary president of the South African Society for Obesity and Metabolism, says there are two approaches that actually work to tackle the disease.

    “The first is intense cognitive behaviour modification combined with the Dash diet [low-sodium foods that help lower blood pressure and are rich in potassium, magnesium and calcium] and weight-bearing exercise, such as Pilates.

    This strategy aims to undo automated learned responses to food,” she explains. “The second option for obese to morbidly obese people is bariatric surgery.”

    Van der Merwe has been studying obesity patterns in South Africa for three decades.

    She believes the first step towards fighting the condition is to foster understanding.

    “Families, the media and the medical community need to get away from the narrative that we have been using with obese patients, the derogatory manner in which we have been treating them,” she says.

    “We now know that obesity is not all about gluttony and sloth. It is a brain-centric issue, not a fat-cell-centric problem ¬– and epigenetic inheritance is far more impactful than we had previously thought.”

    New research shows that the pituitary gland, in the back of the brain, keeps the body at its highest consistent weight in memory. This is called the body stat and is probably an evolutionary response against famine or starvation.

    “What we have done incorrectly in the past is to allocate the disease process to the frontal lobe, the reasoning centre. From that arose terminology like ‘food addiction.’ The ridiculousness of those kinds of statements has only become apparent in the past five to seven years,” says Van der Merwe, noting that, as a result, patients are embarrassed even when they don’t eat to excess.

    “Our calorie intake is only about 180 calories more than it was two decades ago, and our fitness has reduced, but it does not equate to this epidemic,” she notes.

    Bariatric surgery’s immediate benefits include guaranteed weight loss, immediate reversal of comorbidity conditions such as diabetes and high blood pressure, and prevention of long-term health issues related to obesity.

    Preceded and followed by psychological counselling, the intervention requires the patient to follow a strict lifelong diet to avoid complications. He or she must take a lifetime of vitamins and supplements, because the digestive system is forever altered.

    Endocrinologist Dr. Sundeep Ruder says that while surgery is effective, it should be looked upon only as last resort, because of the risks involved.

    “The biggest drivers of obesity are environmental factors,” he says. “It is very expensive to make surgery accessible to the masses of obese people in the world. But it is considered an alternative after we fail with lifestyle interventions.”

    Private healthcare surgery costs up to 500,000 rands in South Africa, but obesity is so prevalent in the country – including in low-income communities– that bariatric surgery is now being tested in the public sector.

    Professor Zach Koto, a renowned surgeon who specialises in minimally invasive keyhole surgery, is leading the multidisciplinary project.

    “There are lots of issues at play, so you need a psychologist, endocrinologist, physiotherapist, anaesthetist and a surgeon,” he notes.

    “We want to offer a comprehensive service in all the academic hospitals in South Africa,” Koto adds, believing there should be dedicated facilities for these procedures. “We want to make this available to those who can’t afford it.”

    But the surgery is far from a miracle solution to obesity. “It is only for patients who qualify and show they are willing to maintain,” Koto says.

    “People think the surgery is a silver bullet, but it needs a support structure and a complete lifestyle change.”

    * Not her real name

  • Knowledge as the First Remedy for Sickle Cell Anemia

    There is a common belief in Nigeria that anybody living with sickle cell anemia, also known as SCD, dies before age 40.

    As a result, they are treated differently, excluded from the job market, and are not considered worth marrying.
    SCD is an inherited blood disorder caused by abnormal hemoglobin – the oxygen-carrying proteins in the red blood cells.

    The distorted red blood cells are fragile and die sooner than regular ones, preventing oxygen from flowing properly through the body.

    According to the World Health Organization, each year more than 100,000 children worldwide die from the disease before the age of five.

    In Nigeria, the worst-hit country, roughly 150,000 babies are born with it every year. Ignorance about the disease and a lack of funding are major challenges. But with proper prevention and treatment, it is possible to survive it.

    Alhaja Laguda, age 92, is the oldest woman living with SCD in Nigeria. She said that being sick while growing up was particularly difficult. She was often too sick to attend school for more than three months a year.

    In the quest to find a cure for an illness people attribute to supernatural causes, Laguda was given all sorts of concoctions from local tribes. “I just took everything they gave me,” she recalled. “They would cut me on every part of my body, but I put up with it because I wanted to live.”

    The disorder can cause everything from acute pain to anemia, swelling of extremities, bacterial infections and strokes – most of which can be prevented or treated when diagnosed early.

    Abimbola Edwin, who comes from a well-off family, recognized the disease as soon as her daughter, Timilehin, began manifesting the symptoms at four months of age.

    Timilehin is now 29, and has suffered much less than if her mother had not been educated about the risks.

    Toyin Adesola, Founding Executive Director of the Sickle Cell Advocacy and Management Initiative (SAMI), has lived with sickle cell for 53 years. For her, early detection can make all the difference.

    “Currently we wait up to two years – or when the symptoms appear – to start a treatment,” she said, adding that Nigeria is behind other African countries in terms of early prenatal and newborn screenings, due to lack of proper facilities. “Prenatal screening is very expensive,” she added.

    “People with low incomes cannot afford it. It’s easier to do with newborns, and public hospitals are supposed to do it.”
    Although Adesola’s pain has left her physically challenged, she’s determined to help others. Her foundation aims to prevent SCD’s prevalence through awareness campaigns – helping people know their genotype and get diagnosed, which is not always easy.

    “A lot of people mistake genotype for blood group,” she said, adding than in many cases, people are misdiagnosed. “We tell people to go to at least three places to carry out the test.”

    SAMI helps parents who are often emotionally and financially overwhelmed by the disease. The organization offers free genotype testing when possible, and runs a free clinic in Lagos, where it is based.

    Adesola said, “The whole aim of this is to act as an intermediary between the hospital and the person with sickle cell, because we find that, due to lack of funds, a lot of people don’t do anything about the illness until they deteriorate and complications arise, and then we spend a lot of money or we lose the person.”

    However, she noted, funding remains a serious limitation for the foundation, too.

    Adesola said that other diseases, such as cancer, tuberculosis or malaria, often receive more attention and funding from the government and organizations, who tend to neglect the issue of sickle cell.

    She noted that the latest statistics for the sickness in Nigeria date back to 1993. These indicate that around 4 to 5 million people are declared to be living with the disease, a number that has surely gone up since then. Furthermore, many families keep it a secret.

    Doris Gbemiloye, popularly referred to as Mama Genotype, created the Genotype Foundation. UNICEF, she said, stipulates that every child has the right to know his or her genotype.

    “We try to educate people at a young age because our major focus is prevention. For years we have been going to schools to run genotype tests for them free through sponsorships and donations, and the more we meet them the more they are being armed with information.” Despite the foundation’s limited means, it manages to carry out its work in cities and rural areas.

    “We have a monthly meeting where we give [beneficiaries] drugs and they see a doctor on duty who talks to them about how to live with sickle cell,” said Gbemiloye.

    “We talk to the parents to balance their psyche because there are parents who have it in mind that their children will die anytime.”

    The foundation invites older survivors of the disease to talk with parents, too. They serve as living proof that knowledge and information can tip the balance for those who are born with SCD.

  • An air pollution filter to prevent heart and lung diseases

    Delhi is one of the most polluted cities in the world. But the Indian capital is also the birthplace of an innovative device that aims to prevent people from suffering the consequences of air pollution, a major contributor to noncommunicable diseases such as cardiovascular and chronic respiratory conditions.

    The invention is called a Nasofilter – literally a filter that covers the nostrils and uses nanofibre-based technology. Its creators claim this is the first device of its kind to prevent up to 90 percent of PM2.5 (particulate matter under 2.5 millimetres in diameter) and 95 percent of PM10 from getting into our lungs through the nose.

    The product was developed by Nanoclean Global, a local startup founded by a team of graduates and faculty members from the Indian Institute of Technology in Delhi.

    It launched in November 2017, just days before a toxic blanket of smog covered the Indian capital. “As soon as we launched we got thousands of inquiries from schools, hospitals and companies in Delhi and across the country,” said one of the company’s co-founders, Prateek Sharma.

    Sharma had grown up watching his mother struggle with asthma and was determined to help her protect her lungs. “No mask seemed to work,” he said. He had the idea for an air pollution filter during his last year of studies.

    In 2016, he joined with fellow graduates Tushar Vyas, Jatin Kewlani, Sanjeev Jain, and faculty members Ashwini Agrawal and Manjeet Jassal to develop the first Nasofilter prototype.

    The filters can be used for up to 12 hours. They are barely noticeable, since the edges that stick to the bottom of the nose are almost transparent.

    “The concept is fairly simple,” Sharma explained. “The fibres allow surface filtration and, when you exhale, the filters clear out all the accumulated harmful particles.”

    Today, the device sells for 10 Indian rupees (USD 0.14) a pair, and the startup is receiving bulk orders nationally and internationally from countries such as Iran, Dubai and Vietnam.

    “The response is very encouraging and we are growing”, said Sharma. “Of course demand grows when we have bad air days.”

    It is no surprise that the product found a growing market in India.

    Between May 2015 and October 2017, Delhi saw only two days of “good” air quality, with the monsoon season bringing some relief, according to the Indian Central Pollution Control Board.

    In 2018 the capital enjoyed a few more precious days of good air quality, only thanks to the rain. But for most of the past 900-odd days, the city’s air quality has varied from severely polluted to very poor to satisfactory, even in the best weather.

    Delhi’s doctors are alarmed about the damage this is causing to lungs and hearts.

    “There has been a huge rise of young, women and non-smoker patients coming in with lung cancer, which previously affected mostly smokers and adult men,” said Dr. Arvind Kumar, Founder and Trustee of Lung Care Foundation and Chairman of the Centre For Chest Surgery at the Sir Ganga Ram Hospital in New Delhi.

    A recent study conducted by the hospital links this trend to air pollution. “The occurrence of the disease in patients under 50 or even under 30 years of age, an increase in the proportion of women, and a nearly 1:1 ratio of non-smokers to smokers all point towards environmental factors such as air pollution as a major causative agent. These are trends that indicate something is terribly amiss,” noted the report.

    But the scope of the problem goes far beyond lung cancer. According to the World Health Organisation (WHO), around seven million people die every year from exposure to fine particles in polluted air.

    As cities’ air quality declines, the risk of stroke, heart disease, lung cancer, and chronic and acute respiratory diseases, including asthma, increases for the people who live in them.

    In 2016, a report in The Lancet noted that air pollution was responsible for 9.8 percent of the total disease burden in India, the second leading risk factor in the country after child and maternal malnutrition.

    Sharma believes the Nasofilter could bend the curve. “People who suffer from allergies and asthma use it year-round,” he said. So far, his company has been recognised by the South Korean government as one of the top 50 technical startups in the world.

    In 2017, it received the Indian government-sponsored Startups National Award, and was the only Indian startup among the 100 finalists of the Elevator Pitch Competition, in Hong Kong.

    Meanwhile, the Nasofilter team is developing another device that could prevent bacteria from entering the body’s system. “We’re hoping to maybe even keep TB and other diseases at bay,” said Sharma. “Work is underway and we are very hopeful.”