H5N1

With more than one crop, Kenyan farmers weather armyworm attacks

Via Thomson Reuters: With more than one crop, Kenyan farmers weather armyworm attacks. Excerpt and then a comment:

In the fields visible from the bumpy dirt road leading to Ongare Owuoda's home, acres of maize plants with sagging leaves suggest farmers here will reap a poor harvest this season. 

Owuoda, however, is not worried.  

"I am relying on my green gram harvest this season," said the farmer in southwest Kenya. "I do not expect much (harvest) from my maize crop because it has all been damaged by the pest."  

An infestation of crop-eating caterpillars known as fall armyworm have ravaged harvests in Kenya and neighbouring countries, exacerbating damage already caused by prolonged drought.  

James Ndanda, a government agricultural officer, estimates that about 40 percent of farms in western Kenya have been affected by the pest. 

"Farmers will get a poor maize harvest this season," he predicted. "That could lead to food insecurity as the region is a big producer of maize." 

BETTER ODDS 

To protect themselves from total crop failure, Owuoda and over 50 other farmers in Nyatike village grow pulses alongside their traditional crops like maize – a practice known as intercropping.  

"I grow green gram with maize, so that if one crop fails I can get a harvest from the other," he explained. 

His three acres of maize are infested with the fall armyworm, while his one acre of green gram - along known as mung bean - is so far intact. 

Other farmers in the village have diversified their production, some by growing soy beans as well as mung bean, and many said they expect to reap at least one harvest despite the drought.  

But about 20km (12 miles) from Owuoda's farm, George Onyango is not expecting a good harvest. 

Almost all of his 10 acres of maize have been destroyed by armyworm. During a good harvest, he can get 200 bags of maize and sell it for 100,000 Kenyan shillings (about $1,000), he said. A bad harvest gives him less than half of this.  

"I am not sure how I will feed my family and pay school fees for the rest of the year," he said.  

According to the Ministry of Agriculture, Livestock and Fisheries, about 143,000 hectares (350,000 acres) of land have been affected by the pest in the Rift Valley, Western and Nyanza regions of Kenya. 

Ndanda, who through the government trains farmers in western Kenya on better farming practices, said farmers need to diversify their production to avoid losses caused by repeated pest attacks on maize.

This is a good report, but it buries the lede: Mr. Onyango needs a good crop so he can afford to send his kids to school. That is completely typical of poor countries worldwide.

A wise government, however poor, would make education both free and mandatory, not contingent on some goddam caterpillar, and by 2050 all those educated kids would have made their country safe and secure. Maybe even less poor.

White House opioid commission to Trump: “Declare a national emergency” on drug overdoses

Via The Washington Post: White House opioid commission to Trump: “Declare a national emergency” on drug overdoses. Excerpt:

The White House Commission on Combating Drug Addiction and the Opioid Crisis issued a preliminary report on Monday stating that its "first and most urgent recommendation" is for the president to "declare a national emergency under either the Public Health Service Act or the Stafford Act."  

"With approximately 142 Americans dying [of drug overdose] every day," the report notes, "America is enduring a death toll equal to September 11th every three weeks." 

The commission, led by New Jersey Governor Chris Christie, states that the goals of such a declaration would be to "force Congress to focus on funding" and to "awaken every American to this simple fact: if this scourge has not found you or your family yet, without bold action by everyone, it soon will."

In 2015, according to CDC figures, heroin deaths alone surpassed gun homicides for the first time. More than 33,000 people died of opioid overdose, with another 20,000 dying from other drugs. A recent federal study found that prescription painkillers are now more widely used than tobacco. 

Prescription overdose deaths began to rise in the mid-2000, following aggressive marketing and widespread prescribing of the drugs starting in the late 1990s. In response, state and federal authorities began cracking down on prescription opiate availability, introducing "abuse-deterrent" formulations, tighter prescribing guidelines, and operations targeting so-called "pill mills" that made the drugs widely available. 

But in response to these interventions, many painkiller abusers appear to have switched to illicit street drugs. As prescription painkiller deaths started to fall, heroin overdoses increased dramatically. The latest development has been the emergence of powerful synthetic opiates like fentanyl, which are sometimes mixed with heroin with fatal consequences for unsuspecting users.  

In his inaugural address, President Trump cited "drugs that have stolen too many lives and robbed our country of so much unrealized potential," vowing that "this American carnage stops right here and stops right now." 

Trump established the opioid commission to study the issue in March, with a mandate to "study ways to combat and treat the scourge of drug abuse, addiction, and the opioid crisis."

Only six nations have evaluated readiness for global pandemic

Via The New York Times: Only Six Nations Have Evaluated Readiness for Global Pandemic. Excerpt:

Of the world’s countries, only six — three rich ones and three poor ones — have taken the steps they should have to evaluate their ability to withstand a global pandemic, according to a recent report sponsored by the World Bank.  

Just three wealthy countries — Finland, Saudi Arabia and the United States — have gone through two external evaluations of their readiness to face pandemics, one for human diseases and one for animal outbreaks, the study found. 

As of last April, only three poor countries — Eritrea, Pakistan and Tanzania — had undergone both evaluations and had described how they planned to find the money to rectify their weaknesses.  

The unusually concise and crisp report, “From Panic and Neglect to Investing in Health Security,” was written by experts from the World Bank, the International Monetary Fund, the African and Asian development banks, and finance officials from various governments. 

Under Dr. Jim Yong Kim, its current president, the World Bank has strongly advocated creating emergency funds to fight disease outbreaks. In 1987, Dr. Kim helped found Partners in Health, which provides medical care in Haiti and other poor countries and which fought Ebola in West Africa in 2014.

‘Inferno: A Doctor’s Ebola Story’

The Tyee has published my review of Dr. Steven Hatch's book ‘Inferno: A Doctor’s Ebola Story’. Excerpt:

Early in the 2013-2015 Ebola outbreak, blogging here in Vancouver, I was baffled by reports that a treatment centre run by Médecins Sans Frontières had been attacked by mobs of young men. Eight people on a team of health communicators were murdered by villagers who thought the outsiders were coming to spread Ebola, not to stop it. And even when West African funeral customs were known to be a key factor in the spread of the disease, people kept holding such funerals.

Such reports taught me that culture plays a major role in the spread or containment of a disease outbreak. West African culture is strongly skeptical of the value of government (both Liberia and Sierra Leone are just a few years out of horrible civil wars). That includes government-supported health care, which can’t do much in facilities like Liberia’s John F. Kennedy Medical Center. In West Africa, hospital is where you go to die, which becomes a self-fulfilling prophecy: no one seeks help until it’s too late. 

Western cultural attitudes, however, can be just as limiting. The World Health Organization didn’t respond to reports of an unidentified hemorrhagic disease until late March 2014, some three months after the first cases in eastern Guinea. Only in August was Ebola formally named as a “PHEIC”: a public health emergency of international concern. 

Dr. Steven Hatch, an assistant professor at the University of Massachusetts Medical School, also ran into cultural barriers when he tried to help fight Ebola. His new book is blunt, well written and honest about culture as a hazard to public health — not just West African culture, but ours as well.

Saudi Arabia: No new MERS cases, one recovery on July 31

Via the KSA MOH Command and Control Center: MOH: 'No New Corona Cases Recorded. A 57-year-old expatriate man in Riyadh has recovered. No deaths are reported.

WHO epidemiological bulletin: 32,978 cholera cases in Yemen in week 30

WHO's Eastern Mediterranean Regional Office has published its Weekly epidemiological bulletin for week 30. The highlights:

• During week 30 (from 23 to 29 July 2017), 32 978 suspected cholera cases and 24 deaths were reported in Yemen.

• Since the beginning of this outbreak second wave (from 27 April to 30 July 2017), 430,401 suspected cholera cases, and 1 903 deaths (CFR: 0.4%) have been reported in 21 of the country 23 governorates (91.3%), and in 88.9% of the districts (296/333).

• The number of suspected cholera cases started to decline week 27. In some governorates, the decline started even earlier (e.g. week 25 in Amanat Al Asimah)

How a 20-million-person crisis goes unseen

Via The Christian Science Monitor: How a 20-million-person crisis goes unseen. Excerpt:

The world is facing its worst humanitarian crisis since World War II, with 20 million people on the brink of famine, and hardly anybody knows about it. 

Out of the media spotlight, the droughts and civil conflicts that are pushing the Horn of Africa, Yemen, and Nigeria into starvation are going unnoticed. And the humanitarian agencies trying to help are struggling to collect the money they need to help. 

“We’ve found it very difficult to raise funding for this set of emergencies,” says Carolyn Miles, head of the US branch of Save the Children, “just because we have had such a hard time breaking through in the media.” 

The effects are clear: only 15 percent of Americans are aware of the current hunger crisis, according to a poll released July 12 by the International Rescue Committee, an independent humanitarian agency. But once they are informed of the depth of the problem, 73 percent say it is one of their top global concerns, just behind North Korea’s ballistic missile capability.

Global humanitarian agencies such as Save the Children and Oxfam get most of their money from governments and foundations – sometimes, in response to public pressure. But public appeals can raise millions of dollars, too, and the fact that it is not happening this time has pushed eight big US charities to join forces.

They have launched a common fund-raising campaign (July 17-28) to raise awareness of the situation. “Given our inability to get people to pay attention, we are getting together to try in a group,” explains Ms. Miles. (At press time, the campaign had raised $3.3 million.)  

But any campaign’s success with the general public depends on humanitarian organizations’ ability to first get media coverage. 

“People will only donate if they know there’s a problem,” says Ian Bray, humanitarian press officer for Oxfam. 

Getting outlets’ attention  

Victims of sudden natural disasters, such as the 2004 Indian Ocean tsunami or the Nepal earthquake in 2015, attract public donations easily. But starvation is a long, slow process, “and it’s difficult for the media to deal with that if there are no events” to hang a story on, says Mr. Bray.  

Publishers hesitate to spend resources on a story they fear won’t feel fresh to far-away readers. Essentially, editors are asking, “‘How much deader are the camels going to be than the last time we covered this story?’ ” Bray adds.  

Programs designed to build up long-term resilience against famine, from waterholes to nutrition education, also face an uphill battle for airtime. And on-the-ground reporting is costly.  

And in the United States, aid agencies face a particular problem: Donald Trump’s presidency has absorbed an unusual amount of media bandwidth. 

Canada: Toronto police urge caution after series of suspected fentanyl overdoses

Via The Globe and Mail: Toronto police urge caution after series of suspected fentanyl overdoses. Excerpt:

Toronto police are warning the public about a sudden spike in suspected fentanyl overdoses throughout the city’s downtown core. 

On Saturday afternoon, city police attributed four deaths and 20 overdoses to the potent opioid over the previous three-day period. 

Throughout the weekend, Toronto Public Health increased its distribution of naloxone, the opioid reversal agent. “We had two vans out, in addition to responding to regular calls, our staff are focusing efforts on connecting people in the downtown core to ensure they have naloxone,” Eileen de Villa, Toronto’s medical officer of health, said in an e-mailed statement. 

The first reported victim, a 27-year-old man, died on Thursday, according to police. Investigators suspect he bought fentanyl-laced heroin in the Yonge and Dundas area of the city. He later died near the intersection of Queen Street West and Bathurst Street. 

On Friday, a second man died within blocks of the first. And on Saturday, a woman was discovered in a Moss Park-area stairwell. First responders pronounced her dead on the scene. Police released no details about the fourth death.  

Constable Craig Brister said only a lengthy testing process can confirm definitively whether the overdoses are related, but all exhibited similarities. 

Toronto Public Health issued an alert about the overdoses on Friday, noting the particular toxicity of the street drug in question. “Some people who overdosed were thought to be tolerant opioid users,” it stated. “Some people had injected, and some had snorted the drug.” 

Public health officials are urging drug users to carry naloxone and to use drugs only in the presence of another person.

US: White economic privilege is alive and well

Via The New York Times: White Economic Privilege Is Alive and Well. Excerpt:

Is the white working class losing economic ground because of policies intended to improve the lives of black people? Anxiety and resentment among some white voters about those policies certainly seemed to benefit Donald Trump’s campaign last year, with its populist, ethno-nationalist message. 

The problem with this belief is that it is false. The income gap between black and white working-class Americans, like the gap between black and white Americans at every income level, remains every bit as extreme as it was five decades ago. (This is also true of the income gap between Hispanic and white Americans.)  

In 2015 — the most recent year for which data are available — black households at the 20th and 40th percentiles of household income earned an average of 55 percent as much as white households at those same percentiles. This is exactly the same figure as in 1967. 

Indeed, five decades of household income data reveal a yawning and uncannily consistent income gap between black and white Americans across the economic spectrum. Fifty years ago, black upper-class Americans had incomes about two-thirds those of white upper-class Americans, while the black middle class — those in the 60th percentile — earned about two-thirds as much as its white counterpart. Those ratios remain the same today. 

These numbers should shock us. Consider that in the mid-1960s, Jim Crow practices were still being dismantled and affirmative action hardly existed. Yet a half-century of initiatives intended to combat the effects of centuries of virulent racism appear to have done nothing to ameliorate inequality between white and black America.

And done precious little to improve the health and life expectancies of those on the wrong side of the income gap.

US: New Jersey accepts rights for people in quarantine to end Ebola suit

Via The New York Times, a July 28 report: New Jersey Accepts Rights for People in Quarantine to End Ebola Suit. Excerpt:

A nurse who worked with Ebola patients in West Africa in 2014, only to wind up isolated in a tent behind a New Jersey hospital, ended her lawsuit against the state on Thursday with a settlement that spells out rights for people in quarantine.  

The nurse, Kaci Hickox, arrived in the United States shortly after a doctor who had returned from Guinea became New York’s first Ebola case. After his diagnosis, the governors of New York and New Jersey said they would begin quarantining travelers who had been in contact with Ebola patients in West Africa.  

Ms. Hickox flew into Newark Liberty International Airport on Oct. 24, 2014, and, although she later tested negative for the deadly virus, she was nonetheless forced into quarantine and initially prohibited from seeing a lawyer or receiving visitors. After three days, she was allowed to return to her home in Maine, but only with an escort and on the condition that she would remain in isolation.  

Her case reflected both the hysteria stirred up by Ebola at the time and the haphazard, varying rules governing public health emergencies across the country.  

Many public health officials viewed the governors’ quarantine policy as overbroad and worried that it would have a chilling effect on health care workers who were desperately needed in West Africa to combat the virus.  

“I am scared about how health care workers will be treated at airports when they declare that they have been fighting Ebola in West Africa,” Ms. Hickox wrote in an essay on the website of The Dallas Morning News, in collaboration with a friend who works for the paper. “I am scared that, like me, they will arrive and see a frenzy of disorganization, fear, and most frightening, quarantine.”

The American Civil Liberties Union of New Jersey and Ms. Hickox’s lawyers, Norman Siegel and Steven Hyman, filed a civil rights lawsuit on her behalf in Federal District Court in Newark. Gov. Chris Christie and the former state health commissioner, Mary E. O’Dowd, were named in the suit. Ms. Hickox initially sought at least $250,000 in compensatory and punitive damages.  

Mr. Siegel said it became clear during negotiations that if Ms. Hickox allowed the state to escape financial liability, she could do something more important: bring about systemic change. Under the settlement, anyone quarantined in New Jersey can contest the order and has the rights to have legal counsel, to be given prior notice of any hearings and to send and receive communications. It also guarantees a person the right to privacy so long as it does not interfere with vital public health needs.