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Rural healthcare center running without facilities

Rafiullah Mandokhail

ZHOB: It is quite astonishing that the health sector has never ever remained the top priority of the government.

Despite the tall claims made by the government it could be judged from the pathetic condition of rural healthcare facilities in the district, where patients pass through great hardship due to non-availability of public health services.

The Health department is finding it hard to ensure the presence of doctors at rural hospitals.

The people blame negligence by the elected representatives and district administration, mismanagement, unequal distribution of equipments and medicines for the poor state of health centers in the district.

The Rural Health Centre Omza, surrounded by over a dozen villages receives hundreds of patients from far-flung areas on daily basis.

The RHC is catering thousands of inhabitants not only from Killi Omza but also caters to people from adjoining villages including Narezai, Khwazekzai, Omza Yaseenzai, Zebai, Shin Ghar Ibrahimkhail, Kamalzai, Hassanzai, Dwal Gad, Kazha Malezi, Trei, Samazi Malayan and Branj area, but it lacks equipments, sufficient medicines and health staff. Although the RHC is considered to be the largest health facility in the entire area, but it faces numerous problems since long. The punctual, regular and committed Medical Technician Niamatullah Mandokhail hailing from Killi Omza is the one who serves the ailing community round-the-clock with devotion.

He says the RHC is supposed to cater to the needs of few hundred patients, but the surrounded villages are touching a figure of over forty thousand population. The area people have no option but to rush their patients to the facility.

“Although the medicine is available at the centre but not sufficient to meet the growing need of the center”, adding the government should increase its budget to address the existing problems. Besides treating tuberculosis patients, he says the children suffering from malnourishment are also treated here and provided with free nutritious food supplements.

He maintains that the RHC needs a state-of-art and well-equipped labor room in order to handle delivery cases and expectant mothers. Moreover appointment of a lady health worker and an ambulance is immediately needed for the facility.

A solar system of energy should also be installed at the center to ensure uninterrupted supply of power and enable the patients to get smooth health services.

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Germany to finance 5m Euro for polio eradication

F.P. Report

ISLAMABAD: Germany will provide Euro 5 million to Pakistan for Polio eradication in order to completely eliminate this menace from the country by the year 2020. In this regard, KFW Germany and Economic Affairs Division have signed an agreement for strengthening the efforts to eradicate the menace of polio, a finance ministry press release said.

Economic Affairs Division Secretary Noor Ahmed and Country Director, KFW, Germany Wolfgang Moeller, signed Financing Agreement for Polio Eradication Phase II worth Euro 5 Million equivalent to Rs790 million.

The agreement envisages to exclusively finance polio vaccines as well as vaccination campaigns to strengthen measures for the implementation of Pakistan’s 2018-2019 National Polio Emergency Action Plan.

The programme is to be executed by UNICEF and WHO and is in continuation of Polio Eradication Programme Phase I. The National Task Force for Polio Eradication headed by the prime minister has led to marked reduction in the numbers of polio cases from 306 in 2014 to 54 in 2015, 20 in 2016, 8 in 2017 and only 4 in 2018.

The turnaround has been widely appreciated at national and international forums. The Ministry of National Health Services, Regulation and Coordination is hoping to eradicate the menace of Polio from Pakistan till the year 2020.

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Sleeping too much links higher risk of health problem

Monitoring Desk

LONDON: Sleeping too much may be a sign you have an underlying health problem that needs to be addressed.

You know sleeping too little can bring consequences to your health and well-being. But that doesn’t necessarily mean that extremely long sleepers are the picture of health.

New research suggests that sleeping for more than six to eight hours a day (including naps), is linked to a higher risk of death and cardiovascular disease, according to a large study published in the European Heart Journal on December 5, 2018.

The researchers note that the findings do not mean that too much sleep necessarily causes worse health. The findings of the study, rather, may mean that too much sleep may be a warning sign of another health problem.

“Given that the nature of observational studies is that they present the association rather than prove a causal relationship, we cannot say that too much sleep per se causes poorer health,” says Chuangshi Wang, the lead study author and a PhD student at the Chinese Academy of Medical Sciences Peking Union Medical College in Beijing. “It’s possible that too much sleep is a marker for other causes of cardiovascular diseases and death.”

The study used self-reported survey data from 116,632 adults from 21 countries, all between ages 35 and 70, who were part of the Prospective Urban Rural Epidemiology (PURE) study. The study followed the individuals for a median of 7.8 years, during which 4,381 deaths and 4,365 major cardiovascular events were reported.

The data showed that individuals who reported sleeping six to eight hours per night were least likely to have cardiovascular disease or die during the nearly eight years over which the data were collected.

Those who reported sleeping eight to nine hours had a 5 percent increased risk of developing cardiovascular disease or dying compared with those who slept six to eight hours per night; those who reported sleeping 9 to 10 hours had a 17 percent increased risk of cardiovascular disease or dying compared with those who slept six to eight hours per night; and those who reported sleeping more than 10 hours per night had a 41 percent increased risk of cardiovascular disease or dying compared with those who slept six to eight hours per night.

Individuals who slept six or fewer hours had a 9 percent increased risk of cardiovascular disease or dying compared with those who slept six to eight hours per night, though the researchers determined that finding was not statistically significant because of the data (likely that there were not enough individuals sleeping fewer than six hours per night to make a reliable comparison, as had been done for the other groups).

While the study findings may seem to suggest that too much sleep could hurt your health, experts agree it’s more likely that the study findings are a hint that too much sleep is a sign of other health issues.

“We know that too little sleep is a problem; there’s risk of cardiovascular problems, quality of life,” says Alcibiades Rodriguez, MD, the medical director of New York University Langone Health’s Comprehensive Epilepsy Center and Sleep Center in New York City. Dr. Rodriguez was not involved in the study. “But for sleeping too much, the question is really what is the underlying cause.”

Researchers did not collect information for this study on those potential underlying problems that may be related to a higher risk for death or cardiovascular disease, such as sleep disorders including sleep apnea.

“If sleep apnea is left untreated, it’s associated with heart failure, high blood pressure, arrhythmia,” says Andrew Freeman, MD, a cardiologist at National Jewish Health in Denver. Freeman was not involved with the study. “One thing I hear very commonly from my sickest patients with systemic and severe disease is that they’re sleeping a lot.”

A key take from this new research may be that oversleeping is a warning sign of other health problems, Dr. Freeman says.

According to Wang, the researchers did adjust their analyses for people who showed a high likelihood of sleep apnea and excluded those they suspected of having sleep disorders. Doing so did not change the results, Wang says.

Others say that approach may not have adequately controlled for how much those sleep disorders may have influenced the results.

“They’ve adjusted statistically, but maybe there are confounding factors in the background that are not being taken into consideration, and that’s why we’re seeing the relationships. We still don’t completely understand, from a basic level, why these findings are there,” says Reena Mehra, MD, the director of sleep disorders research in the Sleep Center at Cleveland Clinic’s Neurological Institute.

She says the sleep apnea patients she sees need 9 to 10 hours of sleep nightly, and nap a lot during the day because they don’t get good quality sleep at night.

“That’s a big confounding factor,” she says. “Many studies have shown that, with increasing severity of sleep apnea, there’s an increased risk for mortality over follow-up periods ranging from 5 to 10 years.”

The new data showed that napping was associated with higher risks of negative outcomes in people who slept over six hours at night. People who slept less than six hours a night appear to mitigate their risks by taking naps, according to the research.

For adults who work during the day and sleep at night, their circadian rhythms naturally make them most likely to want to nap (if at all) between 2 p.m. and 6 p.m., Rodriguez says.

“The question is how many of the [study participants] didn’t nap, and then started to nap around age 55 to 60. Is it a sign of an underlying [health] issue or that they’re not getting enough sleep at night?” Rodriguez says.

In Dr. Mehra’s clinical practice, she generally discourages patients from napping because it reduces the pressure to sleep at night. But if there’s a sleep disorder, such as untreated sleep apnea, you’re not getting good quality sleep and napping can help compensate for that, she says.

So, What Is the Ideal Amount of Sleep I Need?

Another interesting question this study begs is if there is an ideal not-too-much, not-too-little quantity of nightly sleep that is a sign of good health, what is it?

The National Sleep Foundation (NSF) recommends adults get seven to nine hours of sleep; no less than six hours or more than 10 hours. The American Academy of Sleep Medicine and the Sleep Research Society recommend adults get seven or more hours of sleep and do not recommend an upper limit. For this data, individuals who slept six to eight hours per night saw the least amount of cardiovascular problems and early mortality.

“There’s never one optimal number for every single person. There’s always going to be a bit of a range. If you sleep five hours and 58 minutes, you’re not in immediate trouble,” Freeman says. “It’s hard to say the exact amount of sleep you need, but [the study found] there’s a ‘Goldilocks’ time right around six or seven hours a night.”

But you don’t necessarily need to panic if your normal sleep patterns fall outside that range. Rodriguez says that you’ll know your ideal amount of sleep when you are in a pattern of getting sleepy at the same time of day, fall asleep, and wake up at a regular hour without an alarm, feeling awake and alert.

“If you function well with six hours of sleep per night, that’s probably normal for you,” he says.

Most important is recognizing what’s normal for you and paying attention to whether your sleep pattern changes, Rodriguez says — which could be a sign there’s an underlying health problem you may need to address.

“It may be a sign of a sleep or medical disorder and you should see a clinician,” he says. “If you’re sleeping nine hours, and all of a sudden it’s not enough, you’re tired in the afternoon, you need to be aware. If you’re sleeping that much and feel healthy, and have no medical problems, you don’t need to feel worried about it.”

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Sindh govt spends Rs 2b annually to control hepatitis

F.P. Report

KARACHI: Sindh Chief Minister Syed Murad Ali Shah has said that the provincial government spends a notable amount of two billion rupees annually to control hepatitis disease in the province.

 The Chief Minister stated this while talking to Dr. Nancy Ascher, Dr. Norah Terraut and Mr. Bial Hameed M.D University of California who called on him in Karachi on Thursday.

 Murad Ali Shah said that the provincial government is committed to provide basic health facilities to the people of province and all out efforts were being put in this connection. He said that besides spending huge resources, steps also being taken for awareness among the people to control certain diseases and timely curing them.

Speaking on the occasion, Dr Nancy expressed her interest to work with Sindh government in the field of liver transplantation.

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Breast cancer awareness session held in Lakki

Ghulam Mursalin Marwat

LAKKI MARWAT: A nongovernmental organization organized an awareness session about breast cancer at a local private girl’s high school in Lakki city.

The school’s students and females attended the session wherein a prominent gynecologist Dr Memoona Azam delivered lecture on symptoms and treatment of breast cancer. She stressed the need for raising awareness about the disease and said that detection of breast cancer in time could prove helpful to start appropriate treatment.

“Through such awareness and orientation sessions we can reduce the stigma of breast cancer which the most common disease in women in Pakistan”, she added. She called upon the females to consult their doctors regularly for breast examination.

The foundation’s official Miftah Marwat said that the organization would continue holding such awareness session in future.

“Through awareness and education we can control diseases especially in women and children”, he maintained, adding that the foundation extends all out support and assistance to marginalied segments of society for their betterment and welfare.

He thanked Shaukat Khanum Memorial Cancer Hospital and Research Centre Peshawar, health department and the school management for their support in successful conduct of event.

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Officials showing leniency to face strict legal action

Rafiullah Mandokhail

ZHOB: “The recent anti-polio drive that began today will be more effective and well organized. It will be ensured that every child is vaccinated. All available resources would be utilized to stave-off the paralyzing disease,” vowed Deputy Commissioner Abdul Jabbar Baloch during the inauguration of the three-day anti-polio campaign here at the historical point Castle on Monday. He administered anti-polio drops to children under five to inaugurate the drive in the entire district. The drive will be continued in 30 union councils of the district that falls in the route of Afghan nomads.

District Health Officer Dr. Muzafar Shah, Communication Officer UNICEF Samad Hariphal, N-Stop Officer Dr. Muhammad Amin and Kaleemullah Mandokhail were also present on the occasion.

Talking on the occasion Deputy Commissioner said that it was the top priority of the government, as efforts were being made for complete eradication of polio from the country. Resultantly, there has been a significant improvement.

“Negligence on the part of officials will not be tolerated at all. Those officials and health workers showing leniency would face strict legal action,” He warned. According to the officials at District Polio Control Room the targeted population is 68310 including nomad children. Communication Officer UNICEF Samad Hariphal said that polio is a disease that cripples a child for the entire life. He asked the educated segments of the society to sensitize the parents about the crippling nature of the disease. Zhob falls in the international route of Afghan nomads pass here twice every year. They (High Risk Mobile Population) are considered to be the biggest carriers of poliovirus.

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Child malnutrition worsened in Nigeria

LAGOS (AA): Apart from having the world’s largest mortality rate of under-fives, a UNICEF nutrition expert said Nigeria now has at least 35 million severely malnourished children. UNICEF nutrition experts say the crisis is most prevalent in Adamawa, Borno and Yobe the three states in the country’s northeast worst hit by the Boko Haram insurgency. They call the crisis a national emergency which deserves prompt attention.

“One in six children in northeastern (Borno, Yobe and Adamawa) suffers from severe malnutrition. Indeed, one in every two children (50 percent) are stunted in the region,” Davis Bamidele Omotola, UNICEF nutrition consultant, said at a media dialogue on malnutrition in Yola, the capital town of Adamawa, last week. These are not just figures, experts warned, saying the statistics mean the affected children are either destined for early death or a life of unfulfilled dreams since they are unable to cope in school or any vocation. “If Nigeria overcomes the menace of malnutrition, 33 percent of poor people will get out of extreme poverty and give their own children a better chance at life,” Omotola said. He added that the cycle of generational poverty may also be broken if proper attention is given to nutrition.

Investing in children’s nutrition offers some of the greatest opportunities for social and economic change in Africa. Experts say there is a return on investment of $16 on every dollar spent to raise nutrition level. “There will be grave implications if we ignore malnutrition,” Sesugh Akume, a former spokesman for the #BringBackOurGirls movement, told Anadolu Agency. “This issue must be on top of the agenda if we are serious about the future of this country.” Martin Jackson, UNICEF nutrition officer in northeastern Bauchi State, said non-profit organizations have done a lot to save the children but such efforts are not enough.

Jackson called on government and the parliaments at the national and state levels to not just allocate enough funds to address the crisis but to also ensure that the funds are released to execute the plan. But there is more to the crisis than government committing huge funds to fight malnutrition. Experts have called for increasing awareness among the public on the consequences of malnutrition and how to prevent it. This begins with giving better education to children, especially the girl child, and empowering women to be economically viable and self-reliant, according to researchers.

“It is proven, for instance, that educated women tend to practice exclusive breastfeeding for the first six months more than those who are not educated. This is the product of education. Such educated women are also more likely to know what kind of food should be given to their children to prevent malnutrition,” Omotola said. Odoh Diego Okenyodo, a resource person at the media dialogue, said information must get to every segment of the society as government and other stakeholders step up the campaign. “Information helps build awareness and awareness often leads to people practicing the right behaviors. The drivers of malnutrition lie in the actions that people take or do not,” he told Anadolu Agency.

Geoffrey Njoku, communications specialist at UNICEF, agrees with Okenyodo. “The problem is not the lack of food in the northeast, for instance. The question is what kind of food and that is where building the capacity of mothers and caregivers becomes very important,” Njoku said. “Mothers and caregivers will need to know what kind of food is necessary to boost the nutrition level of their children. A child should not be given just one class of food to the exclusion of others,” he added.

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African swine fever cases reported in China

BEIJING (Xinhua): China has confirmed new outbreaks of African swine fever in the northern province of Shaanxi and southern province of Guizhou, the Ministry of Agriculture and Rural Affairs said Monday.

On a farm in Shenmu City, a county-level city of Shaanxi, 19 pigs were confirmed infected with the viral disease and all were dead, the ministry said, citing a China Animal Disease Control Center report.

Outbreaks were also found in the Baiyun District of Guiyang City, where five pigs have been infected and confirmed dead, it said.

A team was dispatched to Shaanxi and Guizhou immediately, and local authorities have initiated an emergency response to block, cull and disinfect the affected pigs.

African swine fever is believed to infect only pigs, and no humans or other species have thus far been infected.

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Admin to include female health workers in polio drive

F.P. Report

BAJAUR: The local administration and health department in Bajaur tribal district have decided to include female health workers in the upcoming anti-polio drive scheduled to be launched from Monday.

The decision was made during a meeting of senior officials of the local administration and health department held here at the district headquarters hospital Khar Sunday.

Senior officials of the local health department and world health organization including agency surgeon Dr Wazir Khan safi briefed the meeting about the arrangements for the three-day anti-polio drive launched from tomorrow.

The participants were told that almost all arrangements have been finalized for the drive while teams have already been formed for the campaign.

Dr Wazir Khan said that total 232,200 children, below the age of five years, will be vaccinated with only oral polio vaccination in the district during the anti-polio drive.

He told that 829 teams including mobile, fix and transit have been formed for the drive which include a number of female workers.

The official told that number of polio teams have been increased for the current drive which was more than 120 compared to the previous drives.

About the logic of increasing the number of polio teams, the participants was told that the purpose of the addition of 120 new teams was to administer polio drops to maximum number of children in the drive.

Senior officials of the local administration have showed satisfaction over the arrangements being taken for the polio drive. They assured the health officials for making foolproof security arrangements for the polio teams in the drive.

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Rwanda vows to end HIV epidemic

KIGALI (Xinhua): Rwanda is committed to achieving the UNAIDS 90-90-90 target that helps end the HIV/AIDS epidemic, Rwandan minister of health Diane Gashumba said here on Friday.

Rwanda has strengthened efforts to contain the deadly virus by launching a nationwide awareness and prevention campaign aimed at stemming new HIV infections in the country, Gashumba said at an UNAIDS conference in Kigali, capital city of Rwanda.

The 90-90-90 target aims to realize that by 2020, 90 percent of all people living with HIV will know their HIV status; 90 percent of all people with diagnosed HIV infection will receive sustained antiretroviral therapy; and 90 percent of all people receiving antiretroviral therapy will have viral suppression.

By June 2018, about 89 percent of Rwandans living with HIV knew their status, of which 92.3 percent were on treatment and 91 percent of those on treatment had their viral load suppressed, the minister said.

More than 97 percent of health facilities in Rwanda offer prevention of mother-to-child transmission of HIV service, which has reduced the mother-to-child transmission to 1.5 percent, she said.

Rwanda is on track to eliminate the deadly virus and hit the UNAIDS target, said Michel Sidibe, executive director of UNAIDS.

The conference, organized by UNAIDS and the government of Rwanda, aimed at reviewing the current status of global HIV response in context with 2018’s World AIDS Day campaign.

HIV prevalence rate in Rwanda has been at 3 percent since 2005, Rwanda Biomedical Center said in November.