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The Great Circus of Mocorongo was conceived in 1984 with funds from the state and various educational institutions to disseminate health messages to communities with scarce economic and human resources in Para State, Brazil. The show was aimed at 15,000 people scattered in 13 remote communities afflicted with malnutrition as well as high morbidity and mortality. It used a methodology consisting of medical and pedagogical techniques showing in dramatical and amusing scenes everyday human encounters with diseases, microbes, the problems of hygiene, and various aspects of community health (proper nutrition, diarrhea, use of medicines, respiratory infections, and vaccinations). The central characters of the show entitled "Health and Merriment" were: the housewife Larimunda, the druggist Salim, and the clowns Banziero, Xulex, and Primentinha. It is difficult to measure the effect of laughter and mirth on changing one's mindset, but in 12 months not a single instance of death of a child occurred resulting from diarrhea or malnutrition. Children played with the characters in scenes that stressed good nutrition in anemia or during diarrhea, they used Salim's medicines for rehydration and vaccination and they witnessed Larimunda's victory over microbes. The goal was to transform the village in a grand scene stressing prevention of ailments. The circus was a timid and hesitant venture at its inception involving children,violence, starvation, hope, and fantasy. Still, it contributed to formal research by introducing innovative approaches to nursing materials and methods.
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PMID:[Circuses and clowns. Experimental contribution to nursing methodology]. 211 75

Many adolescent affective disorders are rooted in biological vulnerability to stress and a predisposition to mood variations that are latent in childhood. As these stress-sensitive children encounter the normative helplessness and struggle for autonomy of adolescence, they may use violence, explosive rage, self-starvation, grandiose self-idealization, drug abuse, and suicidal behavior to relieve psychological helplessness and tension. They may begin a lifelong cycle of failure, disruption, and rejection by family and schools. The author describes adolescent depression and its biological underpinnings, deprivation syndromes, and manic-depressive illness, as well as the concept of affective violence in organic affective syndromes and episodic dyscontrol syndromes. These disorders call for multimodal treatment in which appropriate medication facilitates psychosocial intervention.
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PMID:Affective disorders and violence in adolescents. 301 50

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

Twenty five child homicides investigated in the Cologne University Institute of Forensic Medicine from 1985-94 were retrospectively analysed with special reference to the evidential value of the autopsy findings and possible peculiarities related to the infants' physiological condition. About 65% of the victims were boys younger than 3 years. About 65% of the child homicides were committed by the mother in the parental flat, predominantly in the early hours of the evening during the weekend. The mode of death were 10x blunt injury, 6x sharp violence, 6x strangulation, 3x smothering, 2x drowning, 2x gunshot and 5x neglect (starvation). The defenseless, helpless and immobile condition of the infant particularly favours a homicide by manual assault, smothering or neglect (starvation).
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PMID:Child homicide in Cologne (1985-94). 869 92

Brain injury, stressor severity, depression, premorbid vulnerabilities, and PTSD are frequently intertwined in trauma populations. This interaction is further complicated when the neuropsychologist evaluates refugees from other cultures. In addition, the observed psychiatric symptoms reported in refugees and victims of mass violence may in fact not be the primary features of PTSD and depression but psychiatric symptoms secondary to the effects of traumatic brain injury. This paper reviews the occurrence of starvation, torture, beatings, imprisonment, and other head injury experiences in refugee and POW populations to alert treators to the presence of chronic and persistent neuropsychiatric morbidity, with implications for psychosocial adjustment. The concept of fixed neural loss may also interact with environmental and emotional stresses, and a model of neuropsychological abnormalities triggered by traumatic events and influenced by subsequent stress will also be considered. Neuropsychologists working with refugees play an important role in assessing the possibility of traumatic brain injury with tools that are relatively culture-fair.
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PMID:Neuropsychological issues in the assessment of refugees and victims of mass violence. 1179 40

While war, torture, and sexual violence threaten children's health, poverty is the most dangerous and widespread threat to children. However, while societies may react strongly to the most apparent forms and instances of violence against children, they fail to take the measures needed to effectively reduce the prevailing levels of poverty afflicting the world's children. For example, in 1998, the global starvation rate among children reached its 600-year peak; in Africa, 15% of children die before reaching age 5 years; and 200 million children under age 5 years are malnourished, with half of all deaths in that age group due to malnutrition. Lack of water, clothing, shelter, food, or medicine causes about 16.5 million deaths annually. Furthermore, current global military spending has reached $781 billion/year, more than the total income of the poorest 45% of the global population, while current annual world spending on education is only $80 billion. The world is becoming an increasingly hostile place for most people, but especially for children. Yet, as global economic and political conditions increasingly endanger children and their families, young people seem to be noticed only as certain kinds of problems.
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PMID:The violence of poverty victimizes children. 1214 61

This address was given by Dr. Gro Harlem Brundtland at the ICPD+5 Forum in The Hague, Netherlands, 8-12 February, 1999. He commented that failure to respond to the reproductive health needs of the people is a matter of human rights and social justice. People have the right to make free and informed decisions on their reproductive lives. The right to have an information and care that would allow them to decide whether or not to protect their reproductive health and that of their loved ones. Moreover, a freedom to benefit from scientific progress in health care. In addition, the right to equality and nondiscrimination on the basis of sex, marital status, race, age and class should never be forgotten. People have the right to maintain their privacy and to freedom from sexual violence. Defining reproductive ill health as not merely a health issue, but rather, a matter of social justice offering legal and political grounds for governments to take action. Government and civil society need to develop a public health approach to reproductive health that is cost-effective and has the maximum impact of addressing the underlying social causes of poverty, starvation, and ill health.
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PMID:Reproductive health: a matter of social justice. 1229 49

This article provides a summary and excerpts from a speech given by Her Royal Highness Basma bint Talal, sister of His Majesty King Hussein of Jordan, before the International Institute for Labor Studies of the International Labour Organization on March 26, 1996. Princess Talal spoke about the conditions among Arab women, their contributions to work and political life, and suggestions for the increased participation of women. Reference is made to the UN Development Report for 1995 that indicates a very low (under 20%) level of participation among Arab women in the labor force and a modest literacy rate of 40%. The developing country averages are higher than the averages for Arab women. Arab family networks and practices have benefitted women. Even the poorest Arab countries have less hunger and starvation than other developing countries. Rape is almost "nonexistent" and drugs and prostitution are limited. There are few births outside of marriage and few single parent families. Community violence is generally low, except within less-advantaged groups. Labor statistics do not count women engaged in farming and other domestic production activities. Low labor force participation rates among Arab women are attributed to high illiteracy, high fertility, and social customs. Almost 50% of Arab women are under 15 years old, and there is difficulty in creating opportunities for new female labor entrants due to the high unemployment rates for men (12.6%) and women (29.4%). The future looks more hopeful as literacy rates among women rise and school enrollment rates for women rise. Arab women are legally entitled to equal opportunities for work with men of the same qualifications. Women need to be encouraged to take up productive work and income generation and to assume political leadership roles. The Jordanian National Forum for Women and the Jordanian National Committee for Women are active at the grassroots and national levels.
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PMID:Arab women and the labour market. 1234 73

Accompanying the fall in birth rate, problems pertaining to the child's mind such as school in attendance, bullying, violence in the school, intrafamilial violence, eating disorders, substance abuse, and child abuse have rocketed and diversified, in addition to affecting increasingly lower age groups. The importance of child and adolescent psychiatry has never been more profound, but our country, without a chair in Child and Adolescent Psychiatry in the medical school framework, and lacking recognition of Child and Adolescent Psychiatry as a clinical department has undoubtedly become an underdeveloped country in terms of child and adolescent psychiatric care. The medical schools have been in the process of review and reorganization these past few years. The range of mental science is wide, and despite being a major discipline constituting one of the two arms of medical science together with somatic medicine, it is regarded as a minor existence in our country. This is the time to re-establish mental science, with areas such as child and adolescent psychiatry, geriatric psychiatry, social psychiatry, and crime psychiatry placed on an equal footing with general psychiatry. Turning our eyes on the world, the children are being robbed of their mental health as refugees, through child labor, starvation, and civil war. The demand of this age is true symbiosis, surpassing differences in race, religion, language, and culture, which is probably the indispensable element in the quest for a happy future for the children of this age.
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PMID:[Child and adolescent psychiatry its problems and foresight]. 1260 20

This study examined the elder abuse cases that occurred in Gifu Prefecture, Japan between 1990 and 2000. We conducted a retrospective study of all the cases in which the victim was 65 years or older and autopsied in the Department of Legal Medicine, Gifu University School of Medicine. Fifteen victims were classified as elder abuse victims: five men and ten women. The victims ranged in age from 66 to 87 years (mean age, 74.5 years). The types of abuse were as follows: physical abuse, 13 cases; emotional abuse, five cases; neglect, four cases; and financial abuse, three cases. In eight cases, the victims were subjected to two or more types of abuse. The cause of death of the victims varied with the type of abuse. In the physical abuse cases, subdural hemorrhage was the most common cause, followed by other violence-related deaths and hypothermia. In the neglect cases, the victims died of either starvation or suffocation after the aspiration of food into the airway. In the domestic abuse cases, one of the victim's sons was the most common perpetrator, and little or no income was considered to be a risk factor for perpetrators. In the neglect cases, dementia and difficulty in performing activities of daily living were considered to be risk factors for victims, in addition to living in social isolation.
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PMID:Elder abuse and neglect: social problems revealed from 15 autopsy cases. 1293 44


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