Travel and health

 

International travel can pose various risks to health, depending on the characteristics of both the traveller and the travel. Travellers may encounter sudden and significant changes in altitude, humidity, microbes, and temperature, which can result in ill-health. In addition, serious health risks may arise in areas where accommodation is of poor quality, hygiene and sanitation are inadequate, medical services are not well developed and clean water is unavailable.

photo edited to keep privacy

corneille Killy
rwandahealthnews

Deafness and hearing impairment

Hearing impairment is the inability to hear as well as someone with normal hearing. Hearing impaired people can be hard of hearing (HOH) or deaf. If a person cannot hear at all, then they have deafness.

Hearing impairment may be inherited, caused by maternal rubella or complications at birth, certain infectious diseases such as meningitis, use of ototoxic drugs, exposure to excessive noise and ageing.
Around half of all deafness and hearing impairment can be prevented if common causes were dealt with at primary health care level.

• In 2004, over 275 million people globally had moderate-to-profound hearing impairment, 80% of them in low- and middle-income countries.
• Infectious diseases such as meningitis, measles, mumps and chronic ear infections can lead to hearing impairment. Other common causes include exposure to excessive noise, head and ear injury, ageing and the use of ototoxic drugs.
• Half of all cases of deafness and hearing impairment are avoidable through primary prevention.
• A large percentage can be treated through early diagnosis and suitable management.
• Depending on the cause of hearing loss, it may be treated medically, surgically or through devices such as hearing aids and Cochlear Implants.
• Production of hearing aids meets less than 10% of global need. In developing countries, fewer than 1 out of 40 people who need a hearing aid have one. 
• in 2004, over 275 million people globally had moderate-to-profound hearing impairment, 80% of them in low- and middle-income countries. 
• In Rwanda there is no data nor a study conducted on such topic but I m doing it and you will be communicated later the results 

  Types of hearing impairment

  Deafness refers to the complete loss of hearing in one or both ears. Hearing impairment refers to both complete and partial loss of the ability to hear.
  There are two types of hearing impairment, according to which part of the ear is affected.
  
• Conductive hearing impairment is a problem in the outer or middle ear. It is often medically or surgically treatable. A common example is chronic middle ear infection.
• Sensorineural hearing impairment is a problem with the inner ear or the hearing nerve. It is mostly permanent and requires rehabilitation such as the use of a hearing aid.

Causes of hearing impairment and deafness

Congenital causes which may lead to deafness present at or acquired soon after birth

• Hereditary hearing loss where deafness is inherited from a parent. If one or both parents or a relative is deaf, there is a higher risk that a child could be born deaf.
• Hearing impairment may also be caused by problems during pregnancy and childbirth. These include:
• low birth weight: either due to premature birth or a 'small for date' baby;
• birth asphyxia or conditions during birth where a baby suffers lack of oxygen;
• rubella, syphilis or certain other infections in a woman during pregnancy;
• inappropriate use of ototoxic drugs (a group of more than 130 drugs, such as the antibiotic gentamicin) during pregnancy;
• severe jaundice, which can damage the hearing nerve in a newborn baby.

Acquired causes which can lead to hearing loss at any age

• Infectious diseases such as meningitis, measles and mumps can lead to hearing impairment, mostly in childhood, but also later in life.
• Chronic ear infections, which commonly present as discharging ears can lead to hearing loss. In certain cases this condition can also lead to serious, life threatening complications, such as brain abscess, meningitis etc.
• Use of ototoxic drugs at any age, including some antibiotic and anti-malarial drugs, can damage the inner ear.
• Head injury or injury to the ear can cause hearing impairment.
• Excessive noise, including working with noisy machinery, exposure to loud music or other loud noises, such as gunfire or explosions, can damage the inner ear and weaken hearing ability.
• Age related hearing loss (presbyacusis): As people age, there may be a deterioration in the levels of hearing due to ageing.
• Wax or foreign bodies blocking the ear canal can cause hearing loss at any age. Such hearing loss is usually mild and can be readily corrected.

Social and economic burden

Hearing impairment can impose a heavy social and economic burden on individuals, families, communities and countries.
Hearing impairment in children may delay development of language and cognitive skills, which may hinder progress in school. The extent of delay depends on the degree of hearing loss. In adults, hearing impairment often makes it difficult to obtain, perform, and keep jobs. Hearing-impaired children and adults are often stigmatized and socially isolated.
The poor suffer more from hearing impairment because they cannot afford the preventive and routine care to avoid hearing loss. They often do not have access to ear and hearing care services and are unable to obtain suitable hearing aids to make the disability manageable. Hearing impairment may also make it more difficult for them to escape poverty by hindering progress in school or in the workplace and by isolating them socially.
For countries, the cost of special education and lost employment due to hearing impairment can burden the economy.

Prevention

Half of all cases of deafness and hearing impairment are avoidable through primary prevention. A large percentage can be treated through early diagnosis and suitable management.
Solutions to hearing impairment focus on primary ear and hearing care in order to promote the concepts of prevention, early detection, management and rehabilitation.
Some simple strategies for prevention include:

• immunizing children against childhood diseases, including measles, meningitis, rubella and mumps;
• immunizing of adolescent girls and women of child-bearing age against rubella before pregnancy;
• screening and treating syphilis and other infections in pregnant women;
• improving antenatal and perinatal care, including promotion of safe deliveries;
• avoiding the use of ototoxic drugs, unless prescribed by a qualified physician and properly monitored for correct dosage;
• referring high risk babies (such as those with family history of deafness, those born with low birth weight or suffering birth asphyxia, jaundice, meningitis etc) for assessment of hearing, diagnosis and treatment, where required;
• reducing exposure (both occupational and recreational) to loud noises by awareness creation, use of personal protective devices, and implementation of suitable legislation.

Conductive hearing impairment can be prevented by healthy ear and hearing care practices. It can be suitably dealt with through early detection, followed by appropriate medical or surgical interventions.

The journey home after having tested negative for Ebola

WHO/B. Sensasi

 

An outbreak of Ebola haemorrhagic fever in Uganda’s Kibaale district, about 220 km west of the capital Kampala, in July/August 2012 has affected the lives of many.

The Ebola virus can cause severe haemorrhagic fever, which kills up to 90% of those infected. Although the origins of the virus are still imperfectly understood, its home is the rainforests of central Africa. Humans are often infected after contact with infected animals such as primates, and the virus is transmitted from human to human through contact with bodily fluids. Symptoms include fever, intense weakness, muscle pain, followed by vomiting, diarrhoea, rash, impaired kidney and liver function, and sometimes bleeding. There is no antiviral medicine or vaccine for Ebola.

WHO helps countries with Ebola outbreaks by providing expertise and documentation to support disease investigation and control and helps coordinate the response.

Magdalena Nyamurungi*, who lives in Kibaale district and fell ill at the time of the outbreak, was a suspected case of Ebola. She was taken to the isolation ward at Kagadi Hospital for testing and treatment. After laboratory tests showed that Magdalena was not infected with Ebola, WHO and partners supported her return to her community. This is the story of Magdalena’s journey home.

* name changed to protect privacy

Ebola in western Uganda: answers and actions

23 August 2012 -- An outbreak of Ebola in western Uganda in July/August 2012 has affected many lives. WHO has provided expertise and documentation to support investigation and control of the disease. As part of the response, WHO and partners are supporting people who have tested negative or recovered from Ebola to reintegrate into community life.

source:who.int

Cucumber Good for Eyes,Skin

Cucumber is a very edible fruit which comes from the cucumber plant cucumis sativus in the gourd family.
This fruit can be eaten raw or cooked. With so many health benefits, it is one of the most important parts of food diet as well as skin diet. 

Cucumber for eyes: it is believed that cucumber helps in reducing swelling around the eyes or the dark circles under your eyes because it is an anti- inflamentory, hydrating and cooling snack.
This is an easy homemade and natural treatment friendly with sensitive, allergic skins. They are the most wonderful and natural eye pads you can find for yourself.

The puffiness and tiredness in your eyes may just leave you if you do this in a relaxed fashion.

Cucumber for skin: if you have a rough or very sensitive skin (against sun rays), cucumber is good for you.
Both the cucumber and your skin share the same level of hydrogen. Cucumber helps soothing and softening your skin and gets you relaxed in no time.

Cucumber for headache: after a long hectic day, chances are you are to get a headache, avoid it by eating a few cucumber slices before going to bed and wake up refreshed and headache free.

Cucumber for cellulites: try rubbing a slice or two of cucumber along your problem area for a few minutes.
The phyto chemicals in the cucumber cause the collagen in your skin to tighten firming up the outer layer and reducing the visibility of cellulites. It works great on wrinkles too.

Cucumber for shoes: Rub a cucumber over your shoe, its chemicals provide a quick and durable shine that repels water.

Cucumber for fresh breath: After a meal or drink, take a slice of cucumber, press it on the roof of your mouth with your tongue for 30 seconds.

Cucumber as an eraser:Take the outside of cucumber and slowly use it to erase the pen, pencil or marker writing.

Why is it important to donate blood – to the patient and donor?

Blood donation can be defined as a process by which a blood donor voluntarily has some blood drawn for storage in a blood bank for subsequent use in blood transfusion for the benefit of a patient. Human blood is an essential element of human life without substitute, composed of cells (Red blood cells, White blood cells and Platelets) suspended in liquid called plasma that flows everywhere through the human body. Blood plays crucial role in the human body including oxygen transport ( by Red Blood Cells) from lungs to the rest of body tissues, defense of the body ( by White Blood Cells), blood Clotting ( by Platelets and Coagulation factors) and regulation of blood pressure (by plasma: albumin). What is blood transfusion? A blood transfusion is a procedure in which blood is given to a patient through an intravenous (IV) line in one of the blood vessels. Blood transfusions are done to replace blood lost during surgery or a serious injury. A transfusion also may be done if a person’s body can't make blood properly because of an illness. One single donation can be split into three separate parts, helping save or improve the lives of up to three patients. What are steps involved in blood donation? Blood donation is a safe and easy process which takes approximately one hour and comprising mainly the following steps: registration, health history and mini physical exam, blood donation and refreshments. Registration consists of checking, entering or writing down your name, address, phone, e-mail, donor card and donor identification number. Health history and mini physical exam involves answering questions in a donor questionnaire regarding your health status, signing a consent form, holding a confidential health interview with a medical doctor or a nurse, taking your blood pressure, pulse, temperature and measuring your hemoglobin level. Blood donation itself consists of taking your blood using needle and equipment that are pre-packaged, sterile and disposable and the blood bag is to be filled in 8-10 minutes. The blood bank is under strict regulation and nothing is ever re-used on another donor to ensure safety of blood donation. The last step consists of taking refreshments which allow your body time to adjust to the slight decrease in fluid volume and then you leave after 10 to 15 minutes to continue your normal daily activities. How much blood can be taken? We have, in our adult bodies depending on size, between 4 and 6 liters of blood, of which only 450 ml of blood is taken. The withdrawn blood volume (blood plasma) is restored within 24 hours, red blood cells in about 6 weeks, platelets and white blood cells within minutes. Therefore it is safe to donate blood every 3 months. What is post donation advice? Drink lots of fluids for next 24 hours, avoid smoking for one hour and alcohol till after a meal, and avoid highly strenuous exercises and games for a day. If you feel dizzy, lie down and put your feet up. You will be alright in 10 to 20 minutes. If you have any other questions, call toll free 1011. Who can donate blood? A blood donor should be in good health, be aged between 17 and 60 years of age with a weight of at least 50 kg with normal pulse rate, body temperature and blood pressure . Both men and women can donate. There are some conditions in which donors are permanently excluded like  abnormal bleeding , cardiovascular , kidney and liver disorders, AIDS or Positive HIV test, epilepsy,  mental disorders, insulin dependent diabetics, and uncontrolled high blood pressure. Donors presenting with tattooing or body piercing, dental extraction, root canal treatment, endoscopy or abortion are deferred for 6 months in Rwanda. Female donors cannot donate blood during pregnancy and after delivery for one year. They cannot donate when lactating, during menstrual period and for 7 days thereafter. No one can donate blood if they have consumed alcohol in the previous 24 hours. What is done with the blood collected? The blood collected in sterile, pyrogen free containers with anticoagulants like CPDA or CPDA with SAGM. This prevents clotting and provides nutrition for the cells. This blood is stored at 2-6 C or -30 C depending on the component prepared. Donated blood undergoes various tests like blood grouping antibody detection, testing of infections like hepatitis, HIV/AIDS and syphilis and before it reaches the recipient it undergoes compatibility testing with the recipient blood. In which conditions do patients need blood? Most of patients need blood transfusion in the following conditions: surgical procedures, chronic anaemia,  haemorrhage due to trauma or other causes, cancer patients, blood disorder patients and premature or pre term  birth. It has been revealed that 1 out of 7 to 10 hospital patients needs a blood transfusion globally and In Rwanda 35,118 blood units were distributed in hospitals in 2011. What are blood donation benefits for blood donors? Blood donation benefits extend beyond those who receive blood. Donors also receive numerous health benefits. Blood donation benefits to donors include: •    Free health screening: Every time you give blood, a medical technician, doctor or nurse will check your blood pressure, pulse, temperature and give you a free health screening. •    Reduced risk of heart disease: Giving blood may prevent heart disease. Although no conclusive evidence is available, numerous physicians have noted that blood donors typically have fewer cases of heart disease than non-donors. Reducing blood iron through regular blood donation is a healthy way to potentially lower your risk of heart disease. •    Acts of altruism make you feel good! Blood Donation gives the wonderful feeling of saving someone's life. •    One can diet or remain fit by donating blood regularly. One pint of blood (450 ml) when donated burns 650 calories in donor’s body. •    After donating blood, the count of blood cells decreases in our body, which stimulates the bone marrow to produce new red blood cells in order to replenish the loss. So, it stimulates the production of new blood cells and refreshes the system. •    Regular blood donation helps especially males in loosing iron on regular basis. It helps in reducing the chance of heart attack. Regular blood donation (2-3 times a year) lowers cholesterol, lipid levels and hence decreases incidence of heart attacks or strokes. What can you do about blood donation?  Make blood donation a habit, donate regularly after every 3 months, and motivate others to donate, refer your friends and relatives to donate blood. Do always remember that if you donate money, you give food!  But if you donate blood, you give life! The blood you donate gives someone another chance at life. One day that someone may be a close relative, a friend, a loved one – or even you.

Health Centre of Excellence opens in Kigali

THE Centre of Excellence (CoE) for Health Systems Strengthening was yesterday officially opened in Kigali despite being operational for the last one year.
The CoE was established by the National University of Rwanda/School of Public Health with the aim of strengthening the health systems in the country.

Health Minister Dr Agnes Binagwaho (R) chats with Rockefeller Foundation Managing Director Dr Jeannette Vega during the tour of the University. 

 

The centre performs and develops research agenda for health system strengthening and universal health coverage, according to Collins Kamanzi, the Project Coordinator.

Kamanzi explained that the centre also contributes to capacity building at national and regional level in the field of designing and studying health system strengthening approaches.

“So far more than 17 countries have come here to learn about the best practices in Rwanda’s health systems. Rwanda was recommended by WHO as a model to other countries due to its success in community health based financing (mutuelle),”he said.

Over 90 percent of Rwanda’s population are subscribed to the health insurance cover which he said is worth learning from.

During the launch of the centre, the Minister of Health, Dr Agnes Binagwaho, noted that this was an example of policies backed with evidence in Rwanda’s health systems.

“We can’t bring policies without evidence, which is why Rwanda is doing well. The policies implemented are supposed to have an impact on the population,” she said.

She stated that Harvard has introduced a course for health ministers of various countries, and because Rwanda’s has some of the best policies, the global health course for ministers will be conducted in Rwanda.

Prof Jean Baptiste Kakoma, the Director of NUR/School of Public Health, said that in only one year, the centre has achieved tremendous result in terms of capacity building to health professionals through on-site trainings.

“The centre envisions developing the concept of study tours through making follow ups of the conducted visits to assess the impact realized from these tours and attaching their importance,” he said.

It also plans to start offering short courses in the region and beyond for countries that need to learn Health System strengthening as many have expressed the need to do so, he added.

This centre is funded by the Rockefeller Foundation, a US-based charity organisation.

source: TNT

Slow renewal of health insurance in Northern Province

A Mutuelle de santé card. Photo:The New Times / File.

Residents in the Northern Province are still reluctant to pay this year’s contribution for the community medical insurance cover commonly known as mutuelle de santé.

On average, available statistics show that less than 10 percent of the total population in the province has so far paid their annual premiums.

According to John Gasaraba, an official in charge of the insurance scheme at the province, Gicumbi District leads with 13 per cent of the total population while Musanze lags behind with only six percent.

“We have not received full statistics from all the districts but the performance is still relatively low,” Gasaraba said.

He could not specify whether the situation was exacerbated by a recent payment increase or the residents are deliberately reluctant to adhere to the stipulated directives.

Each individual was supposed to have paid health cover at the end of June 2012 but the grace period was extended for an extra month.

The Director of Health in Musanze District, Celestin Gasana, said that a sensitisation campaign is underway to create awareness about the value of medical insurance.

Health workers allege that the delay in payment is occasioned by patients shying away from seeking medical attention at health centres and hospitals.

Officials at Ruhengeri Hospital told The New Times yesterday that most of the patients received on a daily basis do not have medical insurance cover.

“Most of the cases we have received in recent times lack medical insurance cover including expectant mothers and accident victims, while the rest fear to seek medical care,” said a nurse who preferred anonymity because she is not authorised to speak to the press on behalf of the hospital.

She said that in case of such an occurrence, patients are treated and pay later as their health is considered as the first priority.

Meanwhile, Dr. William Namanya, the Director of Kibungo Hospital confirmed a fall in the number of patients visiting the hospital.

“Our average daily patients reduced by 60 percent...we used to handle at least 100 patients daily, but now we deal with not more than 40 patients a day. I am not yet sure of the reasons,” he said.

A number of nurses at Rwamagana Hospital, who talked to The New Times also said the number of patients had drastically reduced.

“We at last got time to relax...in the afternoons there are no more patients to treat. Most of malaria cases who formed a majority of our patients are nowadays handled by community health workers,” said one nurse.

Mutuelle de Santé holders have access to all public and private non-profit health centres in the country.

The Director General of Mutuelle de Santé in the Ministry of Health, Andre Makaka told The New Times that the number of people visiting health facilities was expected to reduce further after the enhancement of the status of community health workers.

Reacting to reports that the low turn up of patients in health centres was due to the public’s failure to pay for mutuelle de santé cover, Makaka said the idea of health insurance was well conceptualised, adding that the most risky groups had paid their medical cover in advance.

He noted that the government’s commitment to bolster the health sector targets the construction of 20 health centres annually.

“There is no more ignorance...delays in payments are experienced when people are busy attending to their farms (in rural areas). This is common and has nothing to do with failure or ignorance about health insurance.

“We have developed strong community healthcare (structures), malaria tests are done by community health workers. Very soon, they will also handle family planning issues so that people do not need to go to hospitals. I was in Nyamata hospital at 11.00am and there were no more patients,” he noted.

Makaka further disclosed that the government annually uses a total of $4 million to subsidise the mutual health insurance programme, The Global Fund chips in with about $5million, while the population contributes about $30 million.

He noted that excellent performance of the medical insurance scheme in the country had attracted the attention of many countries across the world wishing to learn further about it.

“Challenges are there, but benefits supersede them by far. We broke the financial barrier to healthcare hence improving people’s livelihoods.”

There are three categories of medical insurance cover. These include  people considered to be very poor who pay an annual charge of Rwf2,000 that is settled by government on their behalf. 

The rest are expected to pay for themselves with charges standing at Rwf3,000 and Rwf7,000, respectively based on category.

source:the newtimes

Government Alerts Public on Spread of Ebola Virus in neighbouring country

Following reported outbreak of the deadly Ebola hemorrhagic fever in neighboring Uganda, the Government of Rwanda has put in place stringent measures that will ensure the safety of Rwandan from this deadly virus. Over the weekend, Uganda’s Ministry of Health and WHO confirmed an outbreak of Ebola hemorrhagic fever in Kibale district in Western Uganda near the border with Democratic Republic of Congo (DRC).

Twenty people have been affected so far and 14 people have died as of 29^th/07/2012. Kibale district is approximately 300 Km from the Rwandan border and specifically the districts of Musanze, Nyagatare, Gicumbi and Burera.  Due to high traffic and population movements, there is risk that Ebola can be imported to Rwanda at any time.

Ebola hemorrhagic fever is a highly contagious disease transmitted from person to person and characterised by fever, headache, joint and muscle pain, sore throat, weakness, diarrhea, vomiting, abdominal pains and bleeding from all orifices. Though no case has been reported in Rwanda for the 15 years, government has put in place measures aimed at protecting Rwandans from this deadly disease but is also cautioning Rwandans to remain vigilant and report any suspected cases immediately.

Ministry of Health in collaboration with its partners and through the emergency preparedness team is taking actions for preparedness and response to prevent potential health risks that might be caused by the deadly disease. Specifically, the Ministry of Health has issued alert warnings to all health centres on how to detect and handle cases should they arise.

The Ministry is also training health care providers especially in districts neighbouring Uganda on case management and preventive measures. In addition, all the necessary kit and medical supplies needed have been assembled and dispatched to health facilities in the bordering districts.

                    What is required from the public 

• To immediately seek medical attention at the nearest health facility in case of suspicion of Ebola
• Any person who visited Uganda  and had contact with someone presenting signs and symptoms of Ebola should  immediately inform  the nearest health facility 

Current situation 

No cases of Ebola Hemorrhagic Fever have so far been reported in Rwanda. The Ministry of Health has elaborated plans to effectively respond should the disease occur within our borders. We request public to stay calm and continue business as usual.

source: moh.gov.rw