H5N1

Uganda: Only 62% of AIDS patients on antiretroviral drugs

Via The East African: Uganda puts 62pc Aids patients on ARV treatment. Excerpt:

Uganda needs to do more to achieve its goal of ensuring that 80 per cent of people living with HIV receive antiretroviral drugs (ARVs) by 2015, according to the Uganda Aids Commission (UAC). 

Some 62 per cent of those needing treatment were on ARVs in March 2012, up from 50 per cent in 2010. Uganda managed to enrol an estimated 65,493 new HIV cases on ARVs in 2012, bringing to 356,056 the number of those receiving the life-prolonging drugs, according to UAC statistics. 

To improve the prevention of mother-to-child transmission of HIV, the government launched the UN World Health Organisation’s “Option B+” strategy in September 2012. It involves giving HIV-positive mothers triple-therapy ARVs as soon as they are diagnosed, and continuing treatment for life, regardless of their CD4 count. 

Recent statistics show that Uganda’s HIV prevalence has risen from 6.4 per cent to 7.3 per cent over the past five years. 

Health facilities face frequent drugs stock-outs, inadequate CD4 count machines and are understaffed. Additionally, Uganda’s HIV programmes have been hit by a funding crunch limiting their ability to function. 

Of the 700 health facilities listed as offering antiretroviral therapy (ART), only 532 were doing so by end of March 2012. 

The government acknowledges more must be done, saying it will focus on HIV prevention and allocate more funds to fighting the disease.

Indonesia: 250,000 lose water after flood contamination

Via The Jakarta Globe: Palyja Cuts Water Supply to 250,000 Jakarta Customers After Oil Contamination. Excerpt:

Water operator PAM Lyonnaise Jaya has cut its clean water supply to 250,000 customers in Jakarta, after its reservoir was contaminated by oil as a result of the floods. 

The private company, known as Palyja, said the supply had been cut since Friday evening after they discovered that engine oil had contaminated its reservoir in Bekasi. 

“To protect the health of our customers and production facilities, Palyja decided yesterday night to temporarily halt operations of the water installation facility in Pejompongan [in West Jakarta],” Palyja spokeswoman Meyritha Maryanie said in a press statement on Saturday. 

“As an impact of this disruption, approximately 62 percent or 250,000 of our customers are not receiving their normal clean water supplies,” she added. 

Palyja, which manages the western half of Jakarta, said supplies were also cut in Slipi, Petamburan, Tomang and Grogol in West Jakarta; Bendungan Hilir, Menteng, Manggarai and Kebon Sirih in Central Jakarta; and in Ancol, Penjaringan, Pluit and Muara Angke in North Jakarta. 

Palyja also reported reduced water supplies for areas such as Kalideres and West Cengkareng in West Jakarta and Kapuk Muara and Pejagalan in North Jakarta. 

State-owned water operator PDAM Jaya, which is responsible for Jakarta’s piped water system, admitted that the Bekasi reservoir had been contaminated by oil after a generator in a shopping mall in the West Java town was inundated by water.

Haiti, cholera, and PAHO

The last time I checked PAHO's Haiti Emergency blog, a few days ago, the latest post on it was dated October 17. This afternoon I checked again and found a new post—datelined December 11, but published on January 10: PAHO Director welcomes U.N. support for cholera elimination in Hispaniola. Excerpt:

The Director of the Pan American Health Organization (PAHO), Dr. Mirta Roses Periago, today strongly welcomed the announcement by the United Nations’ Secretary-General of support for efforts to eliminate cholera transmission from Haiti and the Dominican Republic. 

Secretary-General Ban Ki-moon announced $23.5 million in new funds from the United Nations and $215 million in existing bilateral and multilateral funds to support the ongoing cholera elimination efforts. Just over the next two years, $500 million will be needed in Haiti alone. 

The announced funding will reinforce the broader “Call for Action for a Cholera-free Hispaniola” launched in January 2012 by the Presidents of Haiti and the Dominican Republic with support from the Pan American Health Organization/World Health Organization (PAHO/WHO), the United Nations Children’s Fund (UNICEF), and the United States Centers for Disease Control and Prevention (CDC).

You're welcome to click through to read the whole post, which is just more of the same self-serving bureaucratic bumph, full of initialisms and acronyms of agencies full of well-paid officials. 

The post itself is not exactly breaking news; it just recycles the same $23.5 million number Ban himself trotted out last year. And it smoothly ignores the fact that if "$500 million will be needed in Haiti alone," no one has promised anything like that sum. Like Mr. Micawber, PAHO seems to hope that the money will turn up somehow.

It's not exactly a shocker that PAHO's director would "strongly welcome" the announcement; as the Americas branch office of WHO, PAHO is just another branch office of the UN itself. It would be real news if Dr. Mirta Roses Periago had said: "We brought cholera to Haiti, we apologize, and we will convert every UN dollar we have into building infrastructure and compensating the victims of our incompetent and unsanitary behaviour."

Judging from the stories on the UN News Centre this weekend, the organization is trying to deal with everything from the terrorist attack in Algeria to rape and torture in Mali to the violence in Syria and the general issues of disarmament. It's the only agency trying to do something about wars we don't even bother to notice, like those in the Democratic Republic of Congo and in the Darfur region of Sudan. 

Those are serious issues, and people are dying because of them even as I type these words. I think I have some sense of the political constraints under which UN agencies must operate when they try to address such issues. I believe the world would be much worse off without the UN.

But it becomes a matter of medical ethics when UN health agencies, staffed by medical personnel, fail to admit UN responsibility for disasters like cholera in Hispaniola. Trying to spin their feeble response into a Good News Story only spins those agencies out of medical ethics into outright, abject moral bankruptcy.

If we can't trust these well-paid, well-educated, well-tailored people to tell the truth about Haiti, how can we trust them to deal with any of the other global health issues they're tasked with?

Haiti: A drop in cholera deaths

MSPP has posted three days of cholera statistics on its Documentation page, covering January 11-13. The January 10 death total was 7,964; for January 11 it's 7,959—and that's with four new deaths.

Another person died on January 12, bringing the new total to 7,960. Your guess is as good as mine as to what caused the change in numbers. 

All told, MSPP now tallies 639,574 persons with cholera since the outbreak began. In these three days, 430 persons contracted cholera, although as many as 5 departments including Port-au-Prince did not report. Since January 1, Haiti has recorded 2,436 cholera cases and 19 deaths. As always, we should consider these numbers an undercount, and maybe a large one.

Paraguay: 8 dengue deaths so far this year

Via hoy.com.ec in Ecuador, a January 18 report from Paraguay: Ocho muertos por dengue, con más de 8.500 casos sospechosos este año. [8 dead from dengue with over 8,500 suspected cases this year] Excerpt, with my translation

Ocho personas han muerto por dengue en lo que va de año en Paraguay, con más de 8.500 casos sospechosos notificados, informó hoy la directora general de Vigilancia de la Salud, Celia Martínez. 

Eight persons have died from dengue so far this year in Paraguay, with over 8,500 suspected cases reported, according to a report today by Celia Martínez, Director General of Health Surveillance.

Según Martínez, son 8.526 las notificaciones de casos sospechosos de dengue desde principios de año, de los que "715 fueron confirmados en la primera y segunda semana de enero". 

According to Martínez, 8,526 suspected cases have been reported since the start of the year, of which "715 were confirmed in the first and second weeks of the year."

Citada en un comunicado del Ministerio de Salud, Martínez informó de que 8 personas han fallecido a causa del dengue y una novena "con dengue", aunque no fue esta enfermedad la causante de su muerte, mientras que hay otros diez casos de fallecidos "en estudio". 

In a release from the Ministry of Health, Martínez reported that 8 persons have died from dengue and a ninth "with dengue," though the disease was not the cause of death. Meanwhile, another ten deaths are "under study."

La enfermedad ha causado ya la hospitalización de 670 pacientes, de los cuales 34 se encuentran en cuidados intensivos. 

The disease has so far caused the hospitalization of 670 patients, of which 34 are in intensive care.

El dengue mató a 70 personas en Paraguay el año pasado, en el que se registraron un total de 30.823 contagios confirmados.

Dengue killed 70 persons in Paraguay last year, when a total of 30,823 confirmed cases.

Cambodia's malaria death toll halves in 2012

Via Xinhua: Cambodia's malaria death toll halves in 2012: health official. Excerpt

Forty-seven Cambodian people were killed by malaria last year, down 50 percent compared with 94 deaths in a year earlier, a health official said Friday. 

"This is the first largest drop in the last decade," Dr. Char Meng Chuor, head of the National Center for Parasitology, Entomology and Malaria Control, told Xinhua. "We are saving many lives now." 

During the 2000-2010 period, the average decrease in each year was only around 6 percent per year, he said, attributing the sharp decline last year to the National Strategic Plan on Elimination of Malaria, which was announced by Prime Minister Hun Sen in March, 2011. 

He said through the strategic plan, the Health Ministry has invested a lot of money on health education by producing spots and advertising them on TVs, radios and print media. 

Moreover, over a million of mosquito nets were distributed last year to the vulnerable groups of people. 

He said that based on the figures, it is believed that the country will be able to eradicate the death from malaria by 2015.

Indonesia: Flood victims face hunger, overcrowding

Via The Jakarta Post: Flood victims face hunger, overcrowding. Excerpt:

More than 18,000 people have been displaced by the floods that have struck Jakarta. Some report facing hunger, dysentery and poor sanitation. Others have taken shelter in Transjakarta bus stops. 

In Bendungan Hilir, Central Jakarta, hundreds of people have temporarily taken refuge in a low-rent apartment building. 

Bukhori, a resident of the inundated subdistrict, one of 102 of 267 flooded subdistricts in Jakarta, has been occupying a space in the building since Tuesday. 

The 38-year-old said that several aid posts had been established nearby the apartment building, although aid distribution had been uneven, with some buying their own food. 

“Some of us have been lucky enough. We still have some money to buy food. But some of us are starving and haven’t received any aid,” Bukhori, who works as a vendor at the Bendungan Hilir traditional market, said. “We are in dire need of help, be it from political parties or other organizations. It doesn’t really matter where it comes from.” 

Another evacuee in the apartment building, Ruminah, 38, said that many children were suffering dysentery due to poor sanitation on the building’s first two floors, where most of the evacuees have been staying. 

“We received medicine from the PMI [Indonesian Red Cross], but that’s not enough. A lot of people have started to suffer from colds as well, because some of us sleep on cold floors without any floor mats or blankets,” she said.

Cuba: Havana's cholera "in phase of eradication"

Via Prensa Latina, Cuba's official news agency: Cholera Outbreak in Havana In Phase of Eradication. The full report as published in English:

The outbreak of Cholera in Havana, Cuba, which the authorities reported in recent days, is almost rid. 

Manuel Santin, the Health Ministry National director for Epidemiology, and Mariano Bonet, director of the National Institute for Hygiene, Epidemiology and Microbiology, told Granma Daily the watch and warning network will remain activated along the efforts to shield vulnerability and risk threats. 

They reminded of the infrastructure in force and available logistics to treat and prevent the disease from spreading. 

Physicians and family doctors together with the specialists working in every territory are set and ready to intervene should any suspicious case is detected during the home-to-home quest for cases with diarrhea. 

The above include hygiene and epidemiology control and educating the people as part of their role as preventers with daily follow-up in the areas with environmental hazards, for cholera and for the reminder of the communicable diseases. 

Granma reminds there have been some outbreaks from June 2012 "but the National Health Care System non-stop vigil and fast response terminated the threat." 

This January 15th, the Health Ministry confirmed the cholera outbreak in Havana is in the phase of eradication.

Cuba: More on cholera in Havana

The foreign media are still mostly recycling the government's admission of 51 recent cholera cases in Havana. Meanwhile, Hablemos Press keeps digging: En policlínicos y escuelas, medidas extraordinarias por el cólera y en la prensa mentiras. [In polyclinics and schools, extraordinary measures over cholera; in the media, lies] Excerpt, with my translation:

A las puertas del policlínico de Santos Suárez, en Cocos y Rabí, y en la escuela Jesús María Heredia, antigua escuela Pía, perteneciente a una orden religiosa, las autoridades han dispuesto la desinfección del calzado y manos de todos  los  que entran, explicando que las medidas se deben al brote de cólera; mientras, la prensa afirma que la “Transmisión de esta enfermedad se encuentra en fase de extinción”. 

At the doors of the Santos Suárez polyclinic in Cocos y Rabí, and in the Jesús María Heredia School (formerly the Pía, belonging to a religious order), authorities require disinfection of shoes and hands of everyone who enter, explaining that the measures are due to the cholera outbreak. Meanwhile, the media say that "Transmission of this disease is being extinguished."

Empleados de guardia, en las entradas, mandan a limpiarse las suelas de los zapatos en unos paños colocados en bandejas con desinfectantes y le vierten en las manos un líquido, orientándole frotárselas bien. 

Guards working in the entries demand the cleaning of shoe soles with cloths soaked in trays of disinfectants, and they put liquids in their hands, telling them to scrub them well.

En las cercanías del policlínico, y por todo el barrio habanero de Santos Suárez existe, desde hace tiempo, un salidero de aguas albañales, y según rumores, esta puede ser la causa de que una embarazada haya contraído el cólera. 

Around the polyclinic, and throughout the Havana neighbourhood of Santos Suárez, there has been for some time a leak of sewage water, and rumours say this could be the cause of a pregnant woman's contracting cholera.

Éste policlínico, fue recientemente trasformado en Hospital pediátrico por la necesidad que creó el cierre,  y por el peligro de derrumbe del Hospital Marta Abreu, Hospital materno-infantil ubicado en la calle de Línea, en el vedado, La Habana. 

This polyclinic was recently converted into a pediatric hospital for the same reason it was closed, and because of the danger of the collapse of Marta Abreu Hospital, for mothers and infants, on Línea Street in Havana.

En los centros hospitalarios, de otros territorios con casos de cólera, toman estas medidas de desinfección y limitan las visitas, y hay escuelas cerradas o aplican en ellas medidas de desinfección. 

In hospital centres in other areas with cholera, they are taking these measures of disinfection and limiting visits, and schools are either closed or being disinfected.

Desde hace meses, el gobierno declaró falsamente la erradicación de las enfermedades diarreica, y aún persiste el silencio oficial  sobre el progreso de la epidemia del cólera.

Months ago the government falsely declared the eradication of diarrheic disease, and official silence still persists about the progress of the cholera epidemic.

Cholera in Cuba isn’t keeping Canadians away

Thanks to my reader (and former student) Ross Ballantyne, who sent the link to this Canadian Press report in the Halifax, Nova Scotia Chronicle Herald (which reports the current temperature in Halifax as -17ºC): Cholera in Cuba isn’t keeping Canadians away. Excerpt:

Authorities in Cuba are acknowledging a spate of new cholera cases in the capital, but the outbreak doesn’t seem to be keeping Canadians away. 

Travel agents say January is always a popular time for bookings to Cuba and they say business hasn’t tailed off in the least. 

Some agents say word of 51 new cholera cases in the Havana area has only sparked a handful of inquiries from people who have no plans to cancel their trips. 

The Public Health Agency of Canada has issued a low-key advisory about the outbreak, but says most travellers are at low risk of contracting the intestinal illness. 

Cuba’s health ministry says no one has died from the latest batch of cases, which began surfacing earlier this month. 

It says the country has taken preventive measures to quash the disease for good.