Private Sector – Making it work for the people

I steered away from business classes in college, and am still far from being business savvy, but the need for private sector involvement in global public health issues is undeniable. It seems as though the key issue here is creating the ability to reach an integrated relationship that builds on mutual trust, the kind Dr. Shahi expresses in his lecture. Equally important is the ability to recognize opportunities and being ready to jump on board while convincing others you have a solid profit building idea while valuing the social impact more than potential generated profits. This social entrepreneur ideology isn’t easy to come by, especially when profit driven Corporate America focuses primarily on profit margins. I like how Jordan’s presentation highlights the importance of collaboration between partners, not only to generate profits, but for a general betterment of global health that in essence is essential for international economies. Establishing this relevant interconnectivity between health and business is essential to the improvement of both.

Healthcare as a right for all

The recent experiences I have encountered with my boyfriend’s spinal cord injury have brought personal light to the fact that good health insurance coverage although somewhat of a luxury in this country is essential to get adequate health care. Healthcare expenses are so high, and in countries that are fortunate enough to have up to date technology that can benefit the patients, access to that care may be hard to come across. Although wellness and health expenditures do seem to be correlated more governmental spending does not always ensure quality healthcare as we sometimes see in this country. Although the US is the highest healthcare spender worldwide, some would argue that we do not have the best healthcare system. Other countries with well established ethics, stewardship, and health goals can manage to produce better health outcomes and provide more equitable healthcare with less personal and governmental expense.

The healthcare costs in California can be reformed by the proposed single payer universal healthcare system. The system seems promising, ensuring proper healthcare for everyone, and cost effective at the same time. The proposition highlights something that I am a big advocate of: quality healthcare is a right, not a luxury… check out this proposed reform at onecarenow.org

Response to Disaster

Public health is all about prevention, but it is equally essential to be well prepared for emergency/disaster situations since they cannot always be prevented. Airport security/safety is a great proponent of this prevention. The technology we have available allows for screening of explosives and other weapons. Something we face with increases in technologies is more advances threats. Bioterrorism and infectious disease outbreaks has become an issue that is difficult to control with the traditional methods. I recently heard about an Ozone machine that cleans the air in hospital rooms. One hospital that has used it for two years has not seen one case of staff infection since they started using the machines. Such machines also propose to be useful in killing/preventing the spread of infections on airplanes. With the potential of an avian flu outbreak, and the increased threat of bioterrorism, such machines that can detect viruses in the air and contain them in order to prevent a further, detrimental spread could be very cost-effective and beneficial in preparing/containing a disaster.

Controlling the financial issues associated with natural disasters seem to be just as important as the infrastructure system in place to react to the disaster. To take Katrina as an example… I was living in Houston around the time all the evacuees were sent to the area and directly witnessed the despair and inhumane conditions the victims of the hurricane encountered. The streets were filled with homeless evacuees and the shopping centers were surrounded with people asking for food, money, and housing for the night. The unemployment that followed the disaster, as is usually experienced in such cases did not have to reach such critical levels. The disaster itself created great job opportunities for people to rebuild their own community, both making it easier for them to sustain themselves as well as provide them with a feeling of ownership and ability to take back what they knew as home.

Surfer's Meylopathy

As some of you may have noticed I have been absent from class since spring break. Although this is not particularly relevant to the week’s topic, I wanted to share my story with you and hopefully prevent this from happening to any of you or your loved ones in the future.

My boyfriend, Joe, and I went to Hawaii over spring break for a wedding and decided to stay some extra days to enjoy the sun. The morning after all the wedding festivities were over we went surfing on Waikiki. I had been surfing a few times before, but this was Joe’s first (and unfortunately last) time. Joe suffered an extremely rare and scarcely studied injury called "surfer's myelopathy". There was no "accident" in the sense of a bad fall or crash. He was simply laying on the surfboard stomach-down look up for waves, paddling and standing up on the board. He was a great first time surfer, he caught the first four waves! Somewhere in that flow of movements, he apparently cut off blood circulation by hyper-extending his spine, resulting in a severe spinal cord injury. The paralysis took about 6 hours to fully set it. We had not idea it was as serious as it turned out to be. After surfing, we stopped by the lifeguard station because both of us were pretty badly cut up by the reef, I had a cut on my foot that was almost "stitch-worthy", and Joe had a sea urchin stuck in his foot. We got all that taken care of and we both limped back to the hotel room. We went to a Mexican restaurant to catch lunch and drink margaritas to make our pains go away. The pain in Joe’s back, something he thought was normal for a first time surfer using muscles not normally used, was beginning to concern both of us so we went to the on call hotel doctor. He immediately diagnosed Joe and showed grave concern for his condition, he was rushed to the hospital in an ambulance and was taken to get an MRI. The MRI showed severe swelling of the spinal cord from the mid thoracic (around T6) all the way down to the lower lumbar. Joe’s mobility and sensation in his legs slowly dissipated throughout the day, until he lost all mobility as well as pain and temperature sensation.

We spent almost two weeks in Hawaiian hospitals, getting the minimal care that a spinal cord injury patient needs, until he was transferred to Craig Hospital (great rehabilitation hospital specializing in spinal cord injuries) in Denver where we currently are. Despite the lack of improvement in his condition and the lack of available treatment or research provided by the doctors this last month, we are still hopeful. There is no real prognosis for this type of atraumatic injury, so we are just waiting, and being patient.

I wanted to share this story with you in hopes that you can pass it on to anyone you may know that will be trying surfing out for the very first time. Through this I have learned that the doctor who has seen the most cases of this warns first time surfers to stay in the water for only 30mins and to come out of the water immediately if they experience any lower back pain. We have been told that Joe’s condition would not have been as bad if he had come out of the water when he first experienced the pain in his back. Hopefully, this challenging experience that we have been confronted with will serve as a tool to help prevent future cases.

Thanks for taking the time to read this. Hope the rest of the semester goes well for all of you!

Health Improvements with New Technological Innovations

The Disease Management Strategies (DM) described by this week’s case study highlight interesting components of both the needs of our society and the ability we have with new technologies to aid in producing more productive and effective care. Many of the programs described have found cost-effective ways to manage patient health and address the needs of our aging population. The added management has helped patients control chronic diseases and as a result has saved a substantial amount of money that would have been spent to treat the patients individually. The patient centric, individualized care has brought a much needed focus to a personal responsibility that patients themselves need to address. Using various routes of program dissemination, such as other allied health workers besides doctors and implementation of technology use helps promote healthy, preventive aims for the patients that in turn have positive effects for all stakeholders involved. Disease Management sounds like a wonderful alternative to the way medicine is currently delivered; I know some of my elderly relatives could stand to greatly benefit from it.

Importance of Sanitation

Water sanitation as we have known for many years and was demonstrated by the broad street pump and cholera outbreak many years ago in London, is essential to the health and well being of the community. The readings and videos for this week make one thing clear, far too many people in this world lack adequate sanitation. It is no wonder why children are sick and are forced to miss school when their water system is contaminated by their own human excrement. I’m sure as we all know, our case study, http://www.un.org/esa/sustdev/csd/csd13/documents/bground_2.pdf points out that “Access to safe drinking water is a basic human right and essential for achieving gender equality.” When women have to travel several hours to get water, and then several hours back as they carry the water barrels on their backs, they are deprived of any potential promise of an education, and are continually subjected to multiple health hazards. The lack of healthy water not only posses a health risk to the entire community, but these societal norm have caused grave gender inequalities. Good, healthy water is an essential building block for all other health and wellness concerns; therefore, knowing that good water sanitation is part of the MGD’s is a start to alleviating the burden some of these developing countries are facing.