Category Archives: Social Progress

Treating cancer in low-income countries

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Kerr DJ, Midgley R. Can we treat cancer for a dollar a day? Guidelines for low-income countries. N Engl J Med. 2010 Aug 26;363(9):801-3. PubMed PMID: 20818843.

Writing from the Sidra Medical and Research Center in Qatar and Department of Clinical Pharmacology, University of Oxford, David Kerr and Rachel Midgley propose a multidisciplinary approach to cancer treatment in low-income countries.

They begin with some revelatory statistics:

“In 2002, approximately 7.6 million people worldwide died of cancer. These deaths accounted for 13% of all deaths worldwide in that year and, perhaps surprisingly, exceeded the number of deaths from HIV–AIDS, tuberculosis, and malaria combined (which totaled approximately 5.6 million). The World Health Organization has estimated that if current trends continue, the global cancer burden will increase from 10 million new cases per year in 2000 to 16 million by 2020. Remarkably, 70% of these cases will be in the developing world, where the number will grow from 5.2 million annually to 8.8 million by 2020.”

Kerr and Midgley note that in low-income countries where the simplest generic treatments are often beyond the reach of the average citizen, oncologists with access to the latest online clinical guidelines can find them frustrating. They find that very little has been done to develop evidence-based guidelines for cost-effective cancer treatments that they can use.

The authors posit that an interdisciplinary task force could adapt existing pharmacoeconomic models to assess the cost-effectiveness of previously established chemotherapy regimens and develop cost-effective cancer-treatment guidelines for low-income countries without establishing a permanent two-tier global system:

“Does this mean that cancer medicine in low-income countries will always be rooted in the past? Not necessarily, for we have seen some innovative and successful projects in which pharmaceutical companies have provided new drugs free of charge to poorer countries — for example, the Glivec International Patient Assistance Program for patients with chronic myeloid leukemia. More could be made of these open access projects, especially if they are sufficiently flexible to answer key research questions about tolerability, efficacy, and pharmacokinetics, to help refine treatment regimens that would be feasible for treatment of people in developing countries who have cancer.”

The full text is freely available via PubMed.

A low-cost, integrated treatment for lymphedema

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de Godoy JM, de Godoy Mde F. Godoy & Godoy technique in the treatment of lymphedema for under-privileged populations. Int J Med Sci. 2010 Apr 15;7(2):68-71. Review. PubMed PMID: 20428336

José Maria Pereira de Godoy and Maria de Fátima Guerreiro de Godoy have developed a treatment regimen for lymphedema that integrates manual lymph drainage, mechanisms of compression using a low-cost cotton-polyester material, active and passive exercise apparatuses, and adaptation of daily activities.

In the North, lymphedema is largely known as a side effect of breast cancer surgery; however, lymphedema also affects poor populations in the South, where there is a need for low-cost therapies. The Godoys describe an integrated therapy with a delivery system involving professionals trained in lymphedema, psychologists, nutritionists, occupational therapists, physiotherapists, seamstresses, and social assistants.

Among the innovations developed by the Godoys are the development of a technique of manual lymph drainage that aims at draining lymph and stimulating the flow of lymph, and the use of a low-cost material (known in Brazil as gorgurão), to produce compression stockings, sleeves, and gloves.

In their article, the Godoys note that they have established a model center for the treatment and research of lymphedema in Brazil.

The free full-text article is available via PubMed.

The information on my blog is not intended as a substitute for medical professional help or advice but is to be used only as an aid in understanding current medical knowledge. A physician should always be consulted for any health problem or medical condition.

The use of medicinal plants in Mustang district, Nepal

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Bhattarai S, Chaudhary RP, Quave CL, Taylor RS.
The use of medicinal plants in the trans-Himalayan arid zone of Mustang district, Nepal.
J Ethnobiol Ethnomed. 2010 Apr 6;6:14.
PubMed PMID: 20370901

Investigators at the Nepal Academy of Science and Technology conducted field research in the Mustang district of north-central Nepal from 2005 to 2007 to document the use of medicinal plants in traditional botanical medicine.

Interviewing residents of 27 communities, the investigators recorded traditional uses of 121 medicinal plant species, mostly herbs, but also including shrubs, trees, and climbers. Plant-based medicine is used extensively in the region, within a number of medical systems including Ayurveda, traditional Chinese medicine, Unani (a tradition of Graeco-Arabic medicine), and Tibetan Amchi medicine.

Recent loss of biodiversity in Mustang – a fragile, mountainous ecosystem – prompted this ethnobotanical project to document the use of medicinal plants and indigenous ethnobotanical knowledge. The investigators interviewed Amchi healers, medicinal plant traders, farmers, hotel and shop owners and managers, traders, homemakers, and village elders.

The study found that medicinal plants play a pivotal role in primary healthcare in Mustang, that traditional Amchi medical practitioners maintain deep knowledge about their use, and that, “while over-harvesting of some important medicinal plants has increased, many Amchi are working towards both biological conservation of the medicinal plants through sustainable harvesting and protection of wild species and conservation of their cultural heritage.”

To maintain biodiversity and ethnobotanical knowledge, the authors recommend collaborative research projects between the local people and national and international partners with relevant expertise.

Foreign Affairs – The World Ahead

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“The World Ahead,” a special issue of Foreign Affairs, presents essays on the impact of resurgent religions, transforming technologies, demographic implosions, food shortages, energy competitions, and educational rivalries.

U.S. Secretary of State Hillary Rodham Clinton writes on civilian power abroad. Roger C. Altman, CEO of Evercore Partners, and Richard N. Haass, President of the Council on Foreign Relations, propose that the US end its debt addiction now, before global markets turn punitive. Leslie H. Gelb, President Emeritus of the Council on Foreign Relations, offers evidence that economic security and not military security is the key to US foreign policy. And Arne Duncan, US Secretary of Education, writes on enhancing US education and competitiveness.

A Call for International Collaboration on Cancer

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Gospodarowicz MK, Cazap E, Jadad AR. Cancer in the world: a call for international collaboration. Salud Publica Mex. 2009;51 Suppl 2:s305-8. PubMed PMID: 19967286.

Doctors in Toronto, Geneva, and Argentina collaborated on this call to improve cancer control globally. From the introduction:

“Almost 70% of all deaths in the world from cancer occur in the low- and middle-income countries…. While over 40% of all cancers in the Western world are due to tobacco consumption and poor diet, in sub Saharan Africa the most common cancers are those related to infection.”

The authors make specific reference to The International Union Against Cancer or Union Internationale contre le Cancer (UICC – www.uicc.org), a 70-year-old non-governmental organization purely dedicated to the fight against cancer.

Download the open-access full text.

The information on my blog is not intended as a substitute for medical professional help or advice but is to be used only as an aid in understanding current medical knowledge. A physician should always be consulted for any health problem or medical condition.

Open Society Report – Muslims in Berlin

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Muslims in Berlin
At Home in Europe Project
New York: Open Society Institute, 2010

[Read the report]

The second of 11 city reports to be produced this year by the Open Society Institute At Home in Europe Project, based on research undertaken on the integration of Muslims in cities across Europe.

Muslims in Berlin examines the political, social, and economic participation of Muslim communities living in Berlin, focusing on the district of Friedrichshain-Kreuzberg. The 212-page report examines the experiences of Muslims in a broad range of areas including education, employment, health, housing and social protection, political participation, policing and security, and media.

From the Executive Summary:

  • The inhabitants of Kreuzberg in Berlin perceive their neighbourhood as a place in which the people living there have very diverse sets of values. Yet it is also a place in which people get on well together, work to improve the neighbourhood, and help each other. This important finding runs counter to the dominant belief that shared values are necessary for successful integration.
  • The overwhelming majority of Muslim and non-Muslim respondents said that Kreuzberg is an enjoyable and safe place to live. The study of the district of Kreuzberg highlights the success of an integrated structure and approach by citizens and policymakers to create a socially diverse environment. It is a part of Berlin in which individuals of differing ethnic and religious affiliations are able to successfully live together. The district’s experiences offer lessons to European cities with large minority groups on how to meaningfully adapt and accommodate the needs and concerns of their inhabitants. For a long time, Kreuzberg has perceived its multicultural character as an asset, and has encouraged the participation in public life of all different social groups, including Muslims from various ethnic backgrounds and communities.
  • For many Muslim respondents, Kreuzberg offers not only safety, but also refuge from other parts of the city (as well as the country as a whole), where they often feel alienated and excluded. The attribute that gives their district this safe character is its highly diverse nature. This creates a more welcoming feeling of multiculturalism and belonging than monocultural environments elsewhere. In Kreuzberg, unlike in other districts of Berlin, Muslim organisations have a strong presence within various political bodies. Local-government funding is distributed to Muslim groups, and district authorities and religious associations cooperate on local projects. This is particularly encouraging given the widely perceived stigmatisation and marginalisation of many religious Muslim associations in Germany.
  • Muslim inhabitants of Kreuzberg are not immune from discrimination. Respondents report difficulties in finding housing outside the district, gaining meaningful employment and apprenticeships, and, at times, obtaining culturally sensitive health care. The perception of unequal treatment is by no means restricted to religious affiliation. Muslims often perceive the multicausal experience of exclusion as anti-Muslim. Being labelled a Muslim does not only affect those who identify with Islam and are visible Muslims. It also affects those who may be non-religious and non-Muslim, yet whose skin colour, ethnic background, and perceived origin are viewed as signs of belonging to the Islamic faith.
  • The strategies and policies deployed in Kreuzberg offer an inspiring example that could help transform other cities even as Kreuzberg continues to learn from positive practices initiated elsewhere.

Download the full report, which includes recommendations and a comprehensive bibliography.

Indigenous knowledge of medicinal plants used by Saperas community of Khetawas, Jhajjar District, Haryana, India

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Panghal M, Arya V, Yadav S, et al. Indigenous knowledge of medicinal plants used by Saperas community of Khetawas, Jhajjar District, Haryana, India. J Ethnobiol Ethnomed. 2010 Jan 28;6:4. PubMed PMID: 20109179 PubMed Central PMCID: PMC2826346 [full text]

Researchers at Maharshi Dayanand University, Rohtak, undertook oral interviews with traditional herbal medicine practitioners of the Nath community in Jhajjar District, Haryana, India.

From the background:

“The indigenous community of snake charmers belongs to the ‘Nath’ community in India have played important role of healers in treating snake bite victims. Snake charmers also sell herbal remedies for common ailments. In the present paper an attempt has been made to document on ethno botanical survey and traditional medicines used by snake charmers of village Khetawas located in district Jhajjar of Haryana, India as the little work has been made in the past to document the knowledge from this community.”

The investigation found the people of the snake charmer community used 57 medicinal plants for the treatment of various diseases.

From the conclusion:

“This community carries a vast knowledge of medicinal plants but as snake charming is banned in India as part of efforts to protect India’s steadily depleting wildlife, this knowledge is also rapidly disappearing in this community. Such type of ethno botanical studies will help in systematic documentation of ethno botanical knowledge and availing to the scientific world plant therapies used as antivenin by the Saperas community.

Read the full article.

The information on my blog is not intended as a substitute for medical professional help or advice but is to be used only as an aid in understanding current medical knowledge. A physician should always be consulted for any health problem or medical condition.

Ethnomedical survey of plants used by the Orang Asli in Kampung Bawong, Perak, West Malaysia

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Samuel AJ, Kalusalingam A, Chellappan DK, et al. Ethnomedical survey of plants used by the Orang Asli in Kampung Bawong, Perak, West Malaysia. J Ethnobiol Ethnomed. 2010 Feb 7;6:5. PubMed PMID: 20137098; PubMed Central PMCID: PMC2843656. [full text]

Investigators at Masterskill University College of Health Sciences in Malaysia carried out a qualitative ethnomedical survey among a local Orang Asli tribe to gather information on the use of medicinal plants in the region of Kampung Bawong, Perak of West Malaysia to evaluate the potential medicinal uses of local plants used in curing different diseases and illnesses.

Their survey revealed 62 medicinal plant species that grow in the wild naturally and have medicinal properties that are crucial in traditional medicine of the Orang Asli.

From the conclusions:

“…The local government and village authorities need to act fast to conserve the ethnomedical knowledge of Orang Asli in the village Kampung Bawong, and the medicinal plants require preservation in addition to the ethnobotanical and ethnomedical knowledge recording. The preservation of these herbs along with the traditional knowledge of how to use them is an indispensable obligation for sustaining traditional medicine as a medicinal and cultural resource. Thus a future extensive research of these plants in this locality is recommended to identify and assess their ethnomedical claim.”

The information on my blog is not intended as a substitute for medical professional help or advice but is to be used only as an aid in understanding current medical knowledge. A physician should always be consulted for any health problem or medical condition.

Ethnozoology of the Garasiya, State of Rajasthan, India

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Jaroli DP, Mahawar MM, Vyas N. An ethnozoological study in the adjoining areas of Mount Abu wildlife sanctuary, India. J Ethnobiol Ethnomed. 2010 Feb 10;6:6. PubMed PMID: 20144243; PubMed Central PMCID: PMC2836285. [free full text]

Zoologists at the University of Rajasthan and Govt. P.G. College did a study of the use of animal products among the Garasiya people of Rajasthan, a large, geographically diverse state in northern India. The team focused on areas around the Mount Abu wildlife sanctuary in the Aravalli Range, one of the world’s oldest mountain ranges.

The team documented a total of 24 animal species used for medicinal and religious purposes, including five species considered endangered, vulnerable, or near threatened. From their conclusion:

“Our study also shows that the Garasiya people have very rich folklore and traditional knowledge in the utilization of different animal[s]. So there is an urgent need to properly document to keep a record of the ethnomedicinal data of animal products and their medicinal uses. Further studies are required for scientific validation to confirm medicinal value of such products and to include this knowledge in strategies of conservation and management of animal resources. We hope that this information will be helpful in further research in the field[s] of ethnozoology, ethnopharmacology and biodiversity conservation…”

The article includes a comprehensive background section, outlining the history of zootherapy in India and documented in works like Ayurveda and charaka Samhita.

Important note: The information on my blog is not intended as a substitute for medical professional help or advice but is to be used only as an aid in understanding current medical knowledge. A physician should always be consulted for any health problem or medical condition.

Medicinal plants in Babungo, Northwest Region, Cameroon

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Simbo DJ. An ethnobotanical survey of medicinal plants in Babungo, Northwest Region, Cameroon. J Ethnobiol Ethnomed. 2010 Feb 15;6:8. PubMed PMID: 20156356; PubMed Central PMCID: PMC2843657. [free full text]

An investigator at University of Antwerp Groenenborgerlaan reports on a survey that identified and recorded 107 plants species from 54 plant families, 98 genera used for treating diseases in Babungo.

From the conclusion:

“The survey shows that a large number of medicinal plants are used in Babungo for treating different ailments. The knowledge of the use of plants to treat diseases has been with the people for generations but has not been recorded. This knowledge remains mostly with the traditional medical practitioners who are mostly old people. Most of the medicinal plants are sourced from the wild. In addition to their medicinal uses, some of these plants have other uses. The local population should be educated on sustainable methods of harvesting plants to treat diseases today without compromising their availability for future use. The youth should also be encouraged to learn
the traditional medicinal knowledge to preserve it from being lost with the older generation.”

Important note: The information on my blog is not intended as a substitute for medical professional help or advice but is to be used only as an aid in understanding current medical knowledge. A physician should always be consulted for any health problem or medical condition.