2017年08月21日

WITH 1 MILLION DYING ANNUALLY OF TB, RJ AND OTHER AGENCIES GOT REASON TO FIGHT ON STILL

By ABUTA OGETO

Tuberculosis kills over a million people each year, mostly in developing countries, where poor public health systems hamper efforts to diagnose and treat it. But NGOs are now embracing new mobile health technologies that could help fight the disease more efficiently and cost-effectively.
As one of the world’s deadliest communicable diseases, TB presents a massive public health challenge. Due to the high costs of fighting it in places with weak institutions and infrastructure, the WHO reports a $2 billion annual funding shortfall for TB prevention, diagnosis, and treatment. And as the disease festers in densely populated cities and remote areas, new antibiotic-resistant strains are gaining strength. It’s not implausible that one of these strains could morph into a superbug that causes the next big global pandemic.
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To be sure, extensive work by The Global Fund, the World Health Organization, the United States Agency for International Development (USAID), and other large organizations are making a big difference. Worldwide incidence of TB declined at a rate of 1.5% each year between 2000 and 2013, according to the WHO’s Global Tuberculosis Report in 2014.

Yet further progress will require expensive efforts in low-resource settings where administering drugs and monitoring compliance can be a logistical nightmare. Most normal cases of TB require patients to take six months of antibiotics on a daily basis. Adherence to this regimen will usually cure the patient, but missing doses or failing to complete the regimen exposes the patient to treatment failure. It also allows TB bacteria in their bodies to develop into multi-drug-resistant tuberculosis (MDR-TB), which is substantially more difficult and costly to treat.

To work around this challenge, many budget-strapped NGOs have turned to mobile tech for health worker education, field management, data collection, patient tracking, and improved diagnostics.
The Results Japan Kenya Office, a Nairobi-based NGO, has joined hands with the Kangemi TB Centre to take up a door-to-door campaign and screen slum residents to curb tuberculosis. The organisation hopes to spread awareness about TB especially the stigma associated with it.

While the plan is to reach out to slums in urban areas across the city, special attention will be paid to neighbourhoods in Kangemi. The incidence of the disease in some pockets is a cause for concern.

According to Edwin Shikanda, The head of the Kangemi Health Centre, the stigma associated with the disease prevents some people from talking about it, and at times, from seeking treatment. "There are areas where we found the incidence very high. Since this is a door-to-door screening, community and religious leaders will be part of it. These people will counsel residents about the need to be aware of the disease and seek medical attention," he said.

The NGO, which recently conducted a health survey of residents in Kangemi, has started training more volunteers who will collect sputum samples from residents, teach them basic hygiene, and conduct awareness campaigns in the slums.

"We have seen that people who have been diagnosed with TB, abandon treatment midway for a variety of reasons. The idea is to encourage them to continue the treatment," Lilian Njoroge, the head of the CHVs said.

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RESULTS Japan Volunteers first collect sputum samples from people and send them for microscopic analysis. People whose samples show TB positive, will be asked to take up treatment. Those whose samples yield a negative result will be encouraged to get an XRay done. The NGO help desks at government area hospital will provide assistance required to other patients as well.

Over the last one year, the NGO has renovated the facility, trained hundreds of locals on how to act on TB, and facilitated free treatment of TB patients.
posted by resultsjp at 23:36| Comment(1) | 情報

A sorry tale to tell in Results Japan’s fight against TB in Kenya slums.

BY ABUTA OGETO

KAROI − The long journey travelled by 42-year-old Sylvia Mudoka in the fight against tuberculosis is a typical case that calls for the scaling up of the fight against the disease from the Kenyan Government. Were it not for NGOs work, the deaths could be in tens of thousands.

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Her sorry tale highlights the importance of awareness among TB patients and the community at large.
Soon after she was diagnosed, Mudoka discovered that she was about to travel a long journey to defeat the scourge.

She had nowhere to stay, after her brother evicted her from their family home.
Although her electrifying smile greets any visitor in Nairobi’s oldest high-density slum suburb of Kibera, the battle she went through in the last seven years is still fresh in her mind.

A single mother of two children, aged eight and 11, Mudoka has somehow managed to overcome the social outcast jacket she wore for several years and also the disease.

“It all started in early October 2010 when I developed cold fever,” she recalled.
“I went to the hospital and was given amoxicillin drugs. The doctor recommended that I must have my sputum tested.”

It took some time before Mudoka could get results and the feedback that she was to undergo TB treatment.

All hell broke loose as she could no longer afford to fend for herself because of the burden brought by the disease.

“I had to move to our family house, but my brother, Stephen, could not accept me,” Mudoka says.
Her neighbour, Ambuya Jennifer Mapanga, says Mudoka was a social outcast after her brother evicted her.

“We were touched by Mudoka’s plight after eviction. She was a social outcast,” she said.

Without anyone to turn to for solace and shelter, Mudoka went to Mbagathi General Hospital, where officials understood her plight and accommodated her.

“For six months, my brother never visited me, but I used to get regular visits from other friends,” she says. “But eventually, I fought through and won the battle with the help of strangers.”

Mudoka’s plight aptly explains how TB should be treated as a cause of concern by both the government and co-operating partners.

HIV and Aids advocate Moses Mukamuri notes that TB patients face more pronounced stigma, compared to other patients, making it a barrier to accessing treatment and adherence.

“Stigma must be fought from all angles, starting at family level, health care givers and the community at large. Awareness must be included with easy-to-read materials in vernacular,” Mukamuri says.

“Political commitment and will must be reflected in costing it through the health budgets allocation. As long as the health budget continues to be as it is, we may make as much noise as possible, but we may not achieve any tangible results”-Results Japan Kenya

The Global TB Report 2016 lists Kenya as among the 30 high burdened countries, with a triple burden of TB, TB-HIV and MDR-TB.

The other countries on the list are Angola, Bangladesh, Cambodia, Central African Republic, China, Congo, the Democratic People’s Republic of Korea, the Democratic Republic of Congo, Ethiopia, India, Indonesia, Lesotho, Liberia, Mozambique, Myanmar, Namibia, Nigeria, Pakistan, Papua New Guinea, Philippines, Russian Federation, Sierra Leone, South Africa, Thailand, Tanzania, Vietnam and Zambia.

“The 30 high TB burden countries accounted for 87% of all estimated incident cases worldwide,” the report reads in part.

“The six countries that stood out as having the largest number of incident cases in 2015 were (in descending order) India, Indonesia, China, Nigeria, Pakistan and South Africa (combined, 60% of the global total).
“Of these, China, India and Indonesia alone accounted for 45% of global cases in 2015. The annual number of incident TB cases relative to population size (the incidence rate) varied widely among countries in 2015, from under 10 per 100 000 population in most high-income countries to 150–300 in most of the 30 high TB burden countries.”

TB has attracted the attention of Parliament. The Parliamentary Portfolio Committee on Health in February 2016 produced a report painting a gloomy situation with regards to the disease.
While TB treatment for six to nine months costs $31, it was discovered that MDR-TB treatment for 20 to 24 months goes for $2 571.

The situation is worse for another TB strain called Extensively Drug Resistant-TB costing $31 000 to treat for 24 to 36 months.

“In this regard, with the economic strains facing the country, prevention and control of the disease becomes key to TB management in the country,” the legislators noted in their report.
They recommended government moves swiftly and reduces the exorbitant costs of the second line TB treatment.

Riku Shiraishi, The Director of RJ Kenya says TB campaign, especially in Kangemi is now a success story through community involvement.

“The programme on TB has been very successfully because we have rapidly decentralised diagnosis, care and treatment to the house/home level and successfully adopted a community based approach,” he says.

Kenya Minister for Health, Dr. Cleopa Maillu says they are working with the National TB Control Programme to strengthen TB control in Kenya in the next nine years.

“Current interventions include enhancing access to quality patient centered care for TB, TB/HIV and MDR-TB services; prevention of transmission and disease progression through active case finding; and strengthening TB platforms including political commitment to end TB,” he says, adding that although funding is always not enough, financial challenges always hinder the provision of adequate services, the government has, however, helped in lessening the financial burden in the TB programme.

Mudoka, free from the disease, had to go through what she termed “hell”, especially after her rejection by relatives because she had contracted the disease.

posted by resultsjp at 02:34| Comment(3) | 情報

2017年08月20日

ナイロビ生活vol40 "記事紹介A"

皆さん、こんにちは。
白石です。

前回のブログ"ナイロビ生活vol39"はこちら
ナイロビ生活vol39 "記事紹介"

今回も面白い記事をご紹介いたします。
===

Screen Shot 2017-08-20 at 3.29.05 PM.png

Obama’s response to Charlottesville violence becomes most 'liked' tweet in the history of Twitter
http://www.independent.co.uk/news/world/americas/us-politics/barack-obama-charlottesville-twitter-violence-mandela-a7895546.html

この記事はオバマ全大統領のTwitterでのつぶやきが世界で1番「いいね」を獲得したというニュースですが、その「つぶやき」が素晴らしいものでした。

1つの「つぶやき」- 5:06 PM - 12 Aug 2017
"No one is born hating another person because of the color of his skin or his background or his religion..."
「肌の色や出自や信仰の違う他人を、憎むように生まれついた人間などいない。」

Screen Shot 2017-08-20 at 3.35.05 PM.png

2つの「つぶやき」- 5:06 PM - 12 Aug 2017
"People must learn to hate, and if they can learn to hate, they can be taught to love..."
「人は憎むことを学ぶのだ。そして、憎むことを学べるのならば、愛することも学べるだろう。」

3つの「つぶやき」- 5:06 PM - 12 Aug 2017
"...For love comes more naturally to the human heart than its opposite." - Nelson Mandela
「愛は憎しみよりももっと自然に、人の心に根付くはずだ。―ネルソン・マンデラ」

これらは12日にオバマ氏がつぶやいたもの。
米バージニア州のシャーロッツビルで白人至上主義者やネオナチの支持者らと反対派の間で激しい衝突が起き、1人が死亡、19人が負傷した。これに対し人種差別の排除運動に尽力し、リザルツの応援団であり、イボンヌ氏の恩師である南アフリカの故ネルソン・マンデラ氏の発言を引用して発言した。

故ネルソン・マンデラ氏の自叙伝『自由への長い道』からの引用であると知り、すぐに電子書籍を購入して読んでみた。

自由への道はなだらかではない。
しかし、自らを抑圧から解き放つためなら、どんな苦しみにも耐えるだろう。
非暴力を貫くか、暴力に訴えるか、その狭間で葛藤する若き日のマンデラの姿がここにある。

南アフリカの小村で生まれ育ったマンデラは、若くしてアフリカ民族会議(ANC)の黒人解放運動に身を投じる。国内では、白人が黒人を搾取することで経済成長を遂げる一方、抑圧に対する不満が高まっていた。弁護士業と自由への闘争に奔走するマンデラは、志の高い同胞たちと非暴力の不服従運動を展開。しかし、政府による容赦ないアパルトヘイト(人種隔離政策)に強い憤りを感じ、軍事組織の司令官として運命の一歩を踏み出していく。


https://www.amazon.co.jp/dp/B00KO4YERC/ref=cm_sw_r_tw_dp_x_ZoyMzbS6JK5H2

===

12日に発生した、白人至上主義者と反対派の衝突についての記事もご紹介します。


[HuffPost] - White Supremacist Rally Triggers Violence In Charlottesville
http://www.huffingtonpost.com/entry/white-nationalist-charlottesville-virginia_us_598e3fa8e4b0909642972007?ncid=inblnkushpmg00000009

それに伴う”A monumental week of debate over the nation's identity”と題した1週間の記録

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[CNN] - Charlottesville: A monumental week of debate over the nation's identity
http://edition.cnn.com/2017/08/18/us/charlottesville-week-in-review/index.html

[BBC Japanese]
トランプ米大統領、バージニア州での衝突は双方に責任と
http://www.bbc.com/japanese/40944966

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しらいし
posted by resultsjp at 21:59| Comment(3) | 情報

ADBが保健分野にも力を!

日本リザルツは国際保健の改善に向けて取り組みを行っています。
今日は日本が主導する国際機関、アジア開発銀行(ADB)の興味深い動きをご紹介させていただきます。

ADBって何?らぽーるがやっているADRに似てない!?というそこのあなた!アジア開発銀行についてご説明させていただきます。

ADBは、アジア・太平洋における経済成長及び経済協力を助長し、開発途上加盟国の経済発展に貢献することを目的に設立された国際開発金融機関です。

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設立当時から日本が深く関わっており、現在の総裁も財務省出身の中尾武彦氏が務めています。
ちなみにADBに対抗し、中国がAIIB(アジアインフラ投資銀行)を立ち上げたことは日本でも話題になりましたね。

今まではインフラ整備や経済開発がメインだったのですが、ADBは今、新たな動きを見せています。
それが、保健分野へのコミットメントです。

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今年5月には、JICAと保健分野で提携しています。

もっと知りたい方はこちらをチェック。
http://www.nikkei.com/article/DGXLASFS04H05_U7A500C1000000/

ADBが保健分野に力を入れることで、アジアの人たちがますます健やかで笑顔に暮らせることを願っています。
(はるか)
posted by resultsjp at 20:27| Comment(3) | 情報

ポリオはイギリスが熱い!

残暑お見舞い申し上げます。

皆様、夏休みは取れましたでしょうか?
日本リザルツも東京オフィスは16-20日までは「一応」お休みになっております。
ただ、ご察しの通り、霞が関の魔法使いドーラは24時間365日閃いてしまうので、職員一同、ドーラのアイデアを形にすべく夏休み度外視で奮闘しております(笑)

そんな最中、BBCで面白いニュースを見つけたので共有させていただきます。
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なんと、遺伝子改変タバコ植物を使って、ポリオウイルスと同じに見える無害な模倣物質を製造することに成功したそうです。弱毒化した生ウイルスに比べて扱いやすいため、ポリオワクチンの開発に何らかの効果があるかもしれません。

原文はこちらを参照。
http://www.bbc.com/news/health-40925343

イギリスはワクチン接種に関して、造詣の深い国です。GaviワクチンアライアンスにはG7最大の 26.9億ドルの拠出をしています。日本もグローバルファンドやUHCに力を入れています。

折しも、メイ首相は8月30日から9月1日まで来日されます。 国際保健に関して、日英が連携することで、ポリオ根絶に向けた動きが、ますます加速するといいですね。
(はるか)
posted by resultsjp at 10:00| Comment(3) | 情報