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This article reports survey results to Ghanaian nursing students' perceptions of public health issues. Their views were ascertained through a questionnaire designed to capture ratings of educational curriculum concerns and perceptions of the importance of public health factors. Both frequency data and chi-square analysis were used to assess the ordinal position of health factors and gender differences, respectively. Chi-square analysis was also done to assess differences by age. Differences between men and women respondents existed on six of 15 health factors (p less than .05) including malaria, heart disease, measles, cancer, malnutrition and car accidents, while differences between age groups were found on two of the 15 factors (violence and cancer). Based on the ascertained student perceptions, current efforts in Ghana suggest that preventive health is an emerging concern to public health officials. As such, Ghanaian nursing students hold perceptions not dissimilar to those of U.S. health professions students.
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PMID:Nursing student perceptions of public health issues in Ghana. 155 72

US secretary of Health and Human Services Sullivan addresses the issue of the role the US has now and the role it may play in improving health across the African continent. Progress made is attributed to the courageous individual commitment of many dedicated health care problems, and substantial cooperative international efforts. The 1990 US contribution through USAID is 80 million dollars for child survival in Africa and 80 million dollars for voluntary family planning activities. The 1991 figures increased in the total development fund from 560 million dollars to 800 million dollars. AIDS activities receive 11 million dollars out of a total world budget of 52 million dollars. An additional 14 million dollar grant was awarded for a Ugandan effort to fight AIDS and child health care problems and 242,000 dollar grant was given to the Soweto Township AIDS program and AIDS prevention and treatment. The future emphasis was directed to providing a steady, cooperative partnership with African countries, to increasing support for political stability and ending violence, and continuing US policy based on broad based economic growth which fosters sustainable and effective health assistance programs. Support must be provided to assist programs which develop indigenous primary health care systems. Work must be focused on helping Africans learn and practice personal health promotion and disease prevention, which is also of particular significance in breaking the AIDS transmission chain. Increased efforts must address malaria through applied and basic research and malaria control programs. US information technology in the form of, for instance, technical training in epidemiology, disease surveillance, and computer science and data use, needs to be provided to African health professionals. Utilitarian means in international cooperation and relief must be used to foster economic development, democracy, and delivery of health care improvements. The role for health professionals in the US must be to mobilize efforts to share information and expertise with their African counterparts; i.e., through University sponsored meetings and conferences, and private foundation efforts. The reach is with compassion, advanced technology and medical expertise and financial support.
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PMID:A bridge to Africa: how health professionals can help in development. 202 54

During the past 20 years, millions of people have died in Cambodia as the result of violence, starvation, and preventable diseases. During this period, the public health system was also decimated as health professionals were killed. Efforts to provide health care were further stymied by inadequate training and low salaries that forced doctors to depend upon private practices in urban areas for their income. The health indicators in Cambodia reflect this situation, with life expectancy at 47 years for men and 49 for women, infant mortality at 120/1000 live births, child mortality at 190/1000, and maternal mortality at 9/1000 births. Malaria causes 5000-10,000 deaths each year, and the annual incidence of pulmonary tuberculosis is 250/100,000. The spread of HIV in South East Asia is also posing a major threat to Cambodia, and each month 300-400 people are injured or die as a result of the explosion of 1 of the 13 million land mines (scattered throughout the country of 9 million inhabitants). Many Cambodians suffer mental illness as a result of the decades of violence and displacement. Today Cambodians are struggling to reestablish their public health system with the help of international donor agencies, and there is hope that an appropriate and sustainable system will be in place within 10 years.
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PMID:Cambodian health in transition. 764 May 94

The challenge of achieving health for all is enormous in the face of 500,000 maternal deaths a year; the fact that 2.9 billion people lack clean water and sanitation; the AIDS epidemic and malaria prevalence; substance abuse; population aging; runaway urbanization; environmental degradation; and violent human conflicts. To develop new ways of thinking and approaches, programs initiated by the Health Foundation of the Rogosin institute of New York entitled Problem-Solving for Better Health. The basic concept was that available limited resources (preventive, therapeutic, information, talent, and community) are seldom fully utilized, rather than are often wasted. The program involves attendance of a workshop lasting 3-5 days by 60 health professionals. The problem-solving strategies are discussed in large groups with a handbook for supporting presentations. Community involvement and international collaboration are stressed, and follow-up site visits take place after 6 months. The Health Foundation's INFO-MED computer program and interactive information centers provide up-to-date information for professionals working on health problems. In China, 54 professionals collaborated to solve health problems. In 1992, progress reports for 21 projects dealt with anxiety, violent behavior, attention-deficit disorders, hyperlipidemia, and wound healing. In Brazil, 53 health professionals were enrolled in 1990 and prepared some 50 solutions to problems, including patterns of violence among young males in Sao Paulo and nutritional deficiencies in slums. Six projects were implemented with 36 under development. In Ghana, 65 professionals devised solutions to problems in 1991, 12 projects are under way, and 1 on hearing problems in school children is ready for national implementation. In the US, a team from the University of Illinois Medical School launched a program in 1992 on geriatric, pediatric, and women's health issues. In Guyana, 70 professionals participated in a workshop in 1992 to strengthen community-based programs. In Nigeria, also in 1992, 78 participants prepared protocols on family planning, guinea-worm eradication, and environmental health.
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PMID:Problem-solving for better health. 814 91

Populations affected by armed conflict have experienced severe public health consequences mediated by population displacement, food scarcity, and the collapse of basic health services, giving rise to the term complex humanitarian emergencies. These public health effects have been most severe in underdeveloped countries in Africa, Asia, and Latin America. Refugees and internally displaced persons have experienced high mortality rates during the period immediately following their migration. In Africa, crude mortality rates have been as high as 80 times baseline rates. The most common causes of death have been diarrheal diseases, measles, acute respiratory infections, and malaria. High prevalences of acute malnutrition have contributed to high case fatality rates. In conflict-affected European countries, such as the former Yugoslavia, Georgia, Azerbaijan, and Chechnya, war-related injuries have been the most common cause of death among civilian populations; however, increased incidence of communicable diseases, neonatal health problems, and nutritional deficiencies (especially among the elderly) have been documented. The most effective measures to prevent mortality and morbidity in complex emergencies include protection from violence; the provision of adequate food rations, clean water and sanitation; diarrheal disease control; measles immunization; maternal and child health care, including the case management of common endemic communicable diseases; and selective feeding programs, when indicated.
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PMID:The public health aspects of complex emergencies and refugee situations. 914 21

Approximately 250,000 Vietnam veterans suffered cerebral malaria, an illness that often results in damage to subcortical white matter and fronto-temporal areas of neocortex. Case reports dating back 2500 years indicate that survivors of cerebral malaria show depression, poor memory, personality change, and irritability/violence. The purpose of the present study was to compare the neuropsychiatric status of Vietnam veterans who had suffered cerebral malaria in the remote past (i.e., 1966 to 1969) with that of Vietnam veterans wounded in combat who had not suffered malaria or other neurological conditions. Findings indicate that cerebral malaria results in multiple, major, substantially underappreciated neuropsychiatric symptoms in Vietnam veterans, including poor dichotic listening, "personality change," depression, and, in some cases, partial seizure-like symptoms. Findings strongly suggest that history of malaria should be considered in any medical, psychological, or psychiatric workup of a Vietnam War veteran because a positive response could result in substantial changes in diagnosis and treatment.
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PMID:Neuropsychiatric sequelae of cerebral malaria in Vietnam veterans. 936 47

Neuropsychiatric disorders make up a large proportion of medical conditions causing disability and death worldwide. This paper reviews the most significant neurological disorders, emphasizing the preventability of most of them. The worldwide impact of cerebrovascular disease, protein-energy malnutrition causing cognitive impairment, tetanus, dementia, meningitis, and epilepsy is summarized. The burden of neurological dysfunction as a complication of tuberculosis, measles, road accidents, congenital anomalies, malaria, falls, war, violence, alcohol, HIV, diabetes, syphilis, and rheumatic heart disease might also be lessened by preventive measures. As in other health problems, major risk factors are poverty, poor access to health care, and social instability.
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PMID:Preventable neurological diseases worldwide. 959 82

Large numbers of tourists visit South Africa every year. Travelers to urban areas are at little risk of contracting an infectious disease, however the adventure traveler is at increased risk. Yellow fever is not known to occur in South Africa. Malaria is endemic in Mpumalanga and KwaZula-Natal. Schistosomiasis is endemic in large parts of the country. Although rabies is found throughout the country, only a small number of human cases is reported. High risk areas are KwaZulu-Natal, the eastern Cape and Mpumalanga provinces. The incidence of human immunodeficiency virus (HIV) infection is high and counseling regarding sexually transmitted diseases is important. Sanitation of water is excellent in most large cities and towns; however travelers to rural areas should exercise caution. Arbovirus infections do occur but relatively few cases are reported. The hiker is at risk for tick bite fever and should be counseled. Since the abolition of apartheid, South Africa has been seen as an inexpensive, high quality destination by many tourists. In 1997, a total of 5,436,848 travelers from many different countries visited the country. Areas most frequently visited include Johannesburg, Cape Town, Durban, the Garden Route, Kruger National Park, KwaZulu-Natal and Pretoria. The most common reason for visiting the country was holiday (44%), followed by visiting friends and relatives (23%), business travel (27%) other (6%).1 Travelers, to the larger cities such as Johannesburg, Cape Town and Durban are at little risk of acquiring an infectious disease. The adventure traveler however is at greater risk as parts of the country are endemic for malaria, schistosomiasis, rabies, food and waterborne diseases, sexually transmitted diseases and arbovirus infections. Accidental deaths due to motor vehicle accidents and interpersonal violence are important health risks in South Africa. Travelers visiting popular attractions are at significantly lower risk. However this has never been quantified. This review aims to address the occurrence of infectious diseases and attempts to give guidelines to practitioners caring for travelers.
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PMID:Health risks of travelers in South Africa. 1046 56

Specific health problems in Surinam include high prevalence of infections, mostly gastrointestinal infections in young children, malaria and injuries due to violence. The public health care and medical and surgical training are hampered by a lack of funds, as are most things in the country. Relatively much of the surgery in Paramaribo University Hospital in 1991-1998 was performed because of complications of a diabetic foot (128.17%) and breast lesions (76.10%). No scientific research is being carried out either in the hospital or at the faculty of Anton de Kom University. Retrospective registration of operations may give a new impulse to scientific research.
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PMID:[General surgery in Paramaribo University Hospital]. 1060 79

This article highlights the crisis experienced in the beleaguered Democratic Republic of Congo (DRC). The peace talks to be conducted beginning January 20, 2000, will focus on the near-total collapse of health services and the impending humanitarian megacatastrophe in the country. The two civil wars for the past decades have resulted in an essentially bankrupt health sector and a widespread inaccessibility of basic health care. On December 1999, the UN Security Council president described the situation as the major challenge facing Africa, the UN, and the international community. Reports continue of outbreaks of epidemic infections, including vaccine-preventable diseases and hemorrhagic fevers, and unchecked diseases such AIDS, malaria, and sleeping sickness. On the other hand, the chronic malnutrition rate was reported to be as high as 31%, with some cities on the brink of famine. In addition, life expectancy has fallen by 5 years and maternal mortality has doubled, with hundreds of thousands of displaced people in refugee camps unable to sustain themselves. The meeting on January 10, 2000, will tackle the AIDS epidemic in Africa, and the DRC will be the major test of this policy, since its infection rate reached 4.35% in 1997. The withdrawal of international cooperation, which was blamed for worsening the situation, was refuted by another author stating that war and political violence killed the people.
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PMID:Agency warns of crisis in beleaguered Democratic Republic of Congo. 1067 31


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