Water Solutions in Disasters and for Every Day

Several years ago, a company called Vestergaard Frandsen created a device called a LifeStraw. The device looks exactly like a very large straw and it can theoretically be used to drink water out of nearly any water source and the straw itself, stuffed with different filters and disinfectants, will remove bacteria and parasites. Problems began to arise with the LifeStaw soon after its creation. As of now, the LifeStraw costs about $3.50 a piece to produce and would last for about six months or more. The device has drawn various criticisms from being too slow to actually provide enough water to not changing the root cause of the clean water shortage problem. The biggest debate about this seems to be whether or not that amount of money is feasible for the countries in which such a product would be most necessary. Would that money be better spent on solving a root problem such as education?

More recently, a company named Hydration Technology Innovations has come up with a similar, though possibly more feasible idea, this time directed toward disaster relief. Their device is called the HTI HydroPack and it is referred to in the article as a “Capri Sun pouch for disaster relief.” The idea is that once the pouch, containing powdered nutrients while empty, spends about half a day in a water source will be filled with potable, nutrient-fortified water. The HydroPack seems to have some advantages over the LifeStraw, particularly in disaster or temporary relief situations. First of all, while the pack does take a considerable amount of time to fill, it does not require the direct activity of a person such as the LifeStraws do. Secondly, the addition of nutrients into the pack would be an excellent way to improve nutritional health in a way that requires no additional effort from the users beyond getting the water. The pack seems easier to distribute in a hurry which, as the article mentions, is probably better than the current method of distributing bottled water since the weight and volume of the actual water is not a factor in transportation. A big question right now seems to be the production costs of the pack.

Although both of these devices seem more like a Band-Aid than a true solution to the world’s aggravated water problems, they seem to be a step toward more efficient and effective disaster relief and temporary water-shortage relief. I’ll be interested to see what becomes of these two products and if either of them makes its way into mainstream use.

A Price Tag on Health

Recent research has discovered a strong connection between failing to take a prescription and the inability to pay for that prescription. According to an article I read in The Chicago Tribune, a large portion of people—maybe as many as twenty percent—fail to take their medication because they are not able to afford the prescription. The study showed that the people at risk of non-adherence were people who had money issues, and people who came from difficult, disorganized lives.

The problem with this non-adherence is that many of the health issues that are left untreated can eventually lead to many more health issues, sometimes more severe than the initial. These more sever issues tend to bring about more prescriptions and more medical costs. It is an endless cycle due to the inability to treat the initial illness. Unfortunately, Doctors rarely ask patients whether they can afford their medication or not. The patients on the other hand, do not offer up this information because they fear embarrassment in their inability to pay. Instead, the prescriptions are written under the assumption that the patient will take them. So how do we fix this problem? How do we devise a system to make sure patients can afford and are actually taking their medicine once they leave the office?

I think this article presents a good barrier to effective change in public health. That is, the inability to control a person’s behavior. Instead, what we must do is make sure we provide necessary means for them to achieve maximum help. In this case, that would require making sure the prescriptions are affordable, or creating payment plans to assist in payments of the drugs.

I think this article also brings up an important point in drug delivery in general. With all of the patents on prescription drugs, it is not easy to administer drugs to those that need them. It is a constant battle to afford drugs necessary for the betterment of a group of people or even for the individual. So what can we do to make access to improved health possible for all? How can we work around these patents and not let cost of prescription get in the way of treatment and prevention of future health problems?

Philadelphia School Battles Students Bad Eating Habits

This New York Times article discusses a school in Philadelphia that is attempting to change the eating habits of their students. Philadelphia has one of the biggest problems with kids being overweight in the nation. The school is attempting to curve these kids' eating habits during school, but they are also pleading to the community to help. Many kids buy sweets at nearby shops in addition to eating many unhealthy choices at school. This is a very difficult public health issue because it requires change at many levels. The kids have to make better choices in their eating, but they need proper education about how to make the right nutritional companies. It also takes companies willing to adjust their products which is a problem because the sweeter products taste better to the kids. The issue of childhood obesity is a problem that continues to grow in this country, and it will take a large effort to bring an end to the problem.

The issue of childhood obesity is difficult to control because the change does not have to happen in just one person or group of people. Much of the blame falls on the parents for not providing kids with healthy food and educating them about what to eat. Schools have let kids down by providing candy and soda very easily for so many years. Companies make unhealthy foods and snacks that target kids as well. I think the school in Philadelphia is taking positive steps towards helping their students become healthier. Implementing education about healthy eating into gym class at a young age is important because kids need to learn the right amounts of food for their body. I'm reminded of the lunchroom we discussed during the behavior change topic in class about nudging people to make decisions by putting fruit at eye level for example. Public health needs to take advantage of this more to try and curve children's behavior because if they can promote healthy eating at school, this will eventually carry over to their home as well.

Childhood obesity is affecting the overall health of our population. More people are becoming diagnosed with diabetes and heart disease at a younger age. A healthy lifestyle that starts as a child can translate into better health as an adult. Childhood obesity is probably on of the major reasons this generation has a lower life expectancy than their parents. It is important for schools to also teach eating everything in moderate amounts. There is nothing wrong with having a soda or candy bar every once in a while, but making these very accessible to kids everyday will not help the problem. Kids are going to buy what they like to eat best, and that usually does not include fruit. Making candy and soda more expensive and fruit a little cheaper may be a way to change the behavior of the kids in the school. After reading this article, I am wondering what is the best way to teach kids to eat healthy without taking away all their options for meals at school? Also, what role can public health/government play in changing the options that are offered?

A Public Health Nightmare: The Nuclear Disaster in Japan

Helen Caldicott, a strong nuclear power opponent, the head of the Helen Caldicott Foundation for a Nuclear-Free Planet and a leading pediatrician on faculty at Harvard Medical School, was interviewed by CNN about the health risks of the nuclear situation in Japan. She describes that there is no way to estimate risk with a nuclear disaster of this type. Public Health officials will have a very hard time determining who is being affected by this radiation. While studying risk in class, we talked about the ratio of those infected over all of those at risk. If no denominator can be determined, the best plan of action is extremely unclear. While public health officials are used to fairly inaccurate data, the difficulties of measuring radiation and the lack of short term effects makes this case especially difficult. Once a person is exposed to radiation in food, water, or air, there are very few resources available to help them. It is nearly impossible to provide enough clean water to support a large population whose drinking water has been poisoned and nothing can be done to prevent people from breathing in toxic air particles. These barriers severely limit primary and secondary levels of care in public health. The only option left is treatment after the damage has already been done. It is impossible to stop this disaster from happening, and its effects cannot really be slowed. To make matters more complicated, the effects of radiation are extremely long lasting. The rate of disease in this affected area will be extremely high for a long time to come.

Are there any solutions for these extremely important public health questions? Even if the chances of these disasters are extremely low, are the severe health risks high enough to question the shut down of all nuclear power plants? How prepared is the United States to deal with a problem like this? If we have no preventative plan in place, how can any other public health plans be made?

Wealth and Health: The Case of Melanoma

The Article

Melanoma is the most dangerous type of skin cancer. With the ability to spread rapidly, it the leading cause of death from skin disease. Living in sunny climates or at high altitudes, long-term exposure to high levels of strong sunlight, and the use of tanning devices are all attributed to the cause of melanoma.

In recent studies of women developing melanoma, or skin cancer, results have shown that the number of young white women diagnosed with melanoma has more than doubled in the past three decades.

A further analysis provides even more shocking results. The classification of women in which this increase has been seen is in women who are wealthier and more educated. Why? Experts believe it is because they are spending more leisurely time outdoors and more time tanning.

"Melanoma rates increased significantly during the study periods only among higher-income women, the researchers found. Women from the highest-income areas were nearly six times as likely to be given a diagnosis of malignant melanoma than those in the poorest areas."

Despite the ability of more educated and higher income women to access healthcare and treatment for cancer, invasive cancers are diseases that are not fully preventable by medicine.

Christina Clarke, researcher, summarized the findings: "We think this has to do with cultural preferences in higher-income groups for tanning, having the time to tan and the means to pay for tanning beds, and sun exposure on vacations in the middle of winter."

So this yet again brings up the question, should tanning devices be banned by the government in an effort to decrease the number of skin cancer cases? If the eradication of tanning devices or the taxation on tanning devices was placed into effect, would this be considered an infringement upon human rights, even though it could possibly save thousands of lives?

Brain Freeze: How the Deluge of Information Paralyzes Our Ability to Make Good Decisions

In this article by Sharon Begley, researchers explore how information-overload plays a role in our decision making.

They conducted various scenarios such as selection of apartments, combinatorial auctions, etc. and then giving the participants either some or no information and having them choose at random or on a gut selection or giving them a wealth of data and information regarding their choices. In almost all cases they found that as the amount of information increased, people's selections inevitably became worse (they picked pricier apartments with worse features or lost money on the combinatorial auctions). In essence, they suffered from "information fatigue".

Is this sounding familiar yet? Remember last Thursday? Remember all of the information we had on Japan, and how by the time we were introduced to the second round of events we had all basically burnt out? Public health is very much an information oriented field. And as we saw last class, it takes a lot of information to coordinate any sort of effective response to a crisis.

The article details how often an overload of information can be completely debilitating, resulting in no decision at all. In the public health field if this happened, individuals would suffer greatly as a quick response is often necessary. They also detailed how information overload results in diminished returns. We have all the information, so that by the time we do make a decision, we regret it because we already know so much that we can imagine how the other options may have played out more positively. Text messaging is now a daily part of our lives--think about all the daily conversations you have with someone over texting. Which do you remember? The most recent bit of data trumps what may have occurred only a few minutes beforehand. Just because it's recent, does nothing to ensure that it's accurate either. In the Japan exercise, an organization reported that there was no radiation contamination risk, and at that time that was the most recent information. By the next day, abnormal radiation levels had been detected in vegetables, later milk, later other produce, and now water.

More importantly, data overload causes us to neglect one of our most important decision making tools--our unconscious, our gut, that little voice inside your head. In public health where time is of the essence and we must often make split-second decisions, the unconscious is an important tool, but if it is diminished we often make bad decisions. The article says, "a constant focus on the new makes it harder for information to percolate just below conscious awareness, where it can combine in ways that spark smart decisions". This is not saying that your gut is the best option for all decision making, but rather that when it is necessary to use it, it's important to have that tool. Creativity too can become suppressed by overwhelming the mind with information.

Clearly all of these concerns are very relevant to public health. In the moment thinking, creative solutions, multiple options, a need for action all pertain to the ways in which we come up with effective action plans in public health. With the information from this article in hand, perhaps next time we are presented with a complex array of events to put in order we will be better prepared to handle them.

Dire Situation in Misrata Hospital

I don't know about you, but if I had just had an arm or a leg amputated, the last thing that I would be able to muster the strength to do is be alone. In Libya currently, protests have been raging for a long time over political strife, with loyalists to Libyan leader Moammar Gahdafi.

The article that I found today focuses on a centralized hospital located is Misrata. This hospital should be regarded as a safe haven by the people that are being harmed in this conflict- however, the scene has turned from an oasis into a gruesome play of hallway operations and weary physicians trying to keep up.

The Misrata hospital only has 60 beds, and at one point for an extended period of time was operating on only generator power with no electricity. This issues however have been even more numerous than that. Doctors have been operating in the hallways of the hospital because there simply are not enough beds to keep up with the maladies, for example 109 people in Misrata have been slain in the past week. Doctors have also been asked to operate without anesthesia, which is giving both patients and physicians a great test of their patience and ability to handle the pain.

Bombs fell very near the hospital this week as well, leaving many wondering how much longer the hospital can operate while it is constantly being targeted by snipers. The snipers were even shooting at ambulances arriving at the Misrata hospital.

This combines both the situation of disaster as we discussed this week in class as well as its merging with the physical medical facility of the hospital. The myriad of public health concerns that this situation brings forth is, in many ways, to large for me to fathom. What about all of the bacteria that can be entering patients bodies as they are making their way through the chaos outside the hospital as well as inside? And how can the doctors fairly be asked to risk their lives 24 hours a day as snipers watch the hospital and bombs nearly destroy them? Is it fair to ask them not to try and protect themselves and seek shelter? And how long can a situation as scattered as this honestly continue before there is no longer hope?