Antibiotic Resistance

March 30, 2012 § 1 Comment

Antibiotics are a class of drugs designed to eliminate bacteria and cure bacterial infections–such as appendicitis, tuberculosis, sinus infections, pneumonia,  syphilis and scarlet fever. However, despite their sweeping benefits, antibiotics are quite fickle and have their detriments. In a NYTimes article last year, Jane R. Brody summed up the problem when she stated that, “antibiotics are frequently misused — overprescribed or incorrectly taken by patients… As a result, lifesaving antibacterial drugs lose effectiveness faster than new ones are developed to replace them.” Or, as Shaikh mentions in her book, “if [antibiotics] are used incorrectly, bacteria becomes resistant to them. This happens when someone takes antibiotics for an illness not caused by bacteria, or when a patient fails to finish the full course of antibiotics that is prescribed. The misuse kills the bacteria that are easily affected by antibiotics, leaving the stronger bacteria to multiply and outbreed the weak ones. As a result, more and more bacteria are resistant to antibiotics.”

According to the CDC, this creeping phenomenon of antibiotic resistance is one of the world’s most pressing public health problems. One estimate suggests that our current antibiotics could cease to work in as little as 10 years “completely” (Shaikh).

I didn’t know these particulars regarding antibiotics until just recently…and my ignorance had ramifications.

During the exam period of my  Master’s degree, I was unfortunate enough to come down with bronchitis first, and then with some strange, drowse-enducing illness that caused all my glands and eyelids to swell far beyond normal measure. At the doctor’s office I was quickly prescribed an antibiotic, and sent on my way. Five days later I deemed the antibiotic unuseful, and stopped taking it. I returned to the doctor’s office a week later with worsened symptoms, and was prescribed yet another antibiotic. Once again, the same process ensued. And again. Finally I was prescribed a fourth antibiotic, to which I had an immediate allergic reaction. That’s when I swore off the drugs for this illness.

Two weeks later however, burdened with studies and falling behind, I was still sick. Using webmd (not recommended), I diagnosed myself  with mononucleosis (aptly called “glandular fever” in the UK), but I wanted to be sure. I confidently prodded the doctors to run a blood test. They did so, and I was officially diagnosed with glandular fever a few days later. The doctors then informed me that “the antibiotics didn’t work because antibiotics don’t work for glandular fever.”

We see from my naive  and unfortunate example that at least two cardinal rules were broken:

1. I was perscribed antibiotics for an illness not caused by bacteria, and

2. I was not instructed to finish the full dose of my antibiotic prescription–whether or not it seemed to be working

Now surely mine is an extreme example (then again, surely there are many much worse), nevertheless it highlights a social problem. Doctors must verify bacterial infections before prescribing antibiotics; they also must apprise patients of the need to finish the full cycle of prescriptions. Patients, on the other hand, must stop insisting on antibiotic prescriptions to treat every minor soar throats and tooth ache. If the current antibiotics stop working and no resistance resistant antibiotics are developed to replace them, we could face a world in rewinder, where scarlet fever, tuberculosis, and other such illnesses are once again very, very dangerous.

It may not be profitable for pharmaceutical companies to produce them now, but antibiotic will be invaluable in the future.

To learn more on an introductory level about this topic (for example, about the antibiotic resistant gene NDM-1 that has recently arisen in India, Pakistand and the UK) and other global health issues, I suggest reading What’s Killing Us (which will take about two hours) or scouring BJM for recent studies. The Robert Wood Johnson Foundation is also a great place of access to modern information about this issue.

This bell tolls for everyone, everywhere. We can contract bacterial illnesses quite easily.

 

TEDbooks

March 27, 2012 § 2 Comments

Have you heard about the new TEDbooks? I recommend pursuing them for a topic that interests you. There aren’t many, yet, but there is still some intriguing content. These books are meant to be quick and accessible reads on interesting and innovative topics.

“What’s Killing US,” for example, is a brief guide to major global health issues by a prominent development worker and avid blogger, Alanna Shaikh. It is meant to be both an overview and a starting point. In the authors own words,”if you’ve been thinking you should probably know more about global health, I wrote this book for you.”. Other TEDbooks that seem interesting to me include, Rachel Armstrong’s Living Architecture and Aftercrimes, Geoslavery, and Thermogeddon: Thought-Provoking Words from a Lexicographer’s Notebook by Erin McKean.

I bought two TEDbooks today and will give a short review in the comments section of this post after I finish.

Sex Trafficking

March 26, 2012 § Leave a comment

March 8th was International Women’s Day. In hopes of finding an uplifting and empowering video to share on Bell Tolling, I visited Vimeo and searched the word “women.”

Don’t do this.

What Vimeo retrieved by that one word (a word I proudly associate myself with) was a slush of sexualized films and images. Though I was looking to find the sight of a clothed, empowered, intelligent looking female, what I actually found was a preponderance of sexualization. I left the sight (site) discouraged and disgusted. It’s not that I haven’t recognized this trend of connotation in the word “women” before–or that I haven’t been offended by it–but the concentrated overdose on a popular media site was a bit much to bear.

This experience reminded me, in contrast, of a video I saw a few years ago by Dove, which lightly but poignantly touched upon the effects of sexualization and the female body in popular culture:


There is another video by Dove here, if you happen to be interested.

In the strange proceedings of memory,  my experiences with Vimeo and with the Dove commercial led me yet further to a video in the past.  Though I am two and  a half years late sharing it, this short film by Emma Thompson and Richard Jobson (link below) has nevertheless disturbed and impressed me since my first viewing. I disagree that it falls within the boundaries of sensationalism (though I remain open to debate). It’s shocking, no doubt, but it attempts to tell a tale of reality; and though any “short film” is bound to over-simplify, I contend that, given the time constraints for popular media, only so much can be said. This video catches the attention and hopefully sparks discussion where silence has largely reigned thus far.

Perhaps one would argue that  the topic of this film (sex trafficking) is not appropriate for a short film geared at the general public because of it’s complexity–that it should be preserved for the educated and informed. Perhaps others would argue that such a realistic portrayal of this topic is not appropriate for popular media because it is too offensive. I’m open to listening to these arguments. As for now, however, I think that relegating such topics to lengthy, erudite media alone–or to no media at all–is partly to blame for the lack of conscience felt by our society for these crimes. As one who researches and writes on this topic often, I have read and heard, but not seen, stories like this before. The film is the strongest thing to “stick” with me.4  Most media on this topic isn’t so vivid. But most media doesn’t catch people’s attention. Most media is easy to forget.

At the very least, this film called Journey (also was a traveling exhibit) succeeds by constructing a narrative that is compelling, introductorily informative, and inviting of further discussion. My main critique is that, as usual, the victims have no first person voice. Why do we so often prevent people from narrating their own history?  Nevertheless, here it is: LINK.

WARNINGThe video contains strong sexual and violent images that viewers may [should] find disturbing. For those judging by the American rating system, it is certainly “R” RATED–so view at your own discretion.

If you don’t want to watch, at least learn more about the issue of sex trafficking some other way. 

Educate yourself on this issue.1 Or on other issues surrounding the image of women in our societies. Get involved. It may seem that the answers should be simple–but you’ll quickly find that they aren’t. For instance, shall we legalize prostitution in order to regulate it? There are those who argue that this would raise tax revenue and thereby help girls off the street.  How has legalizing prostitution played out for the Netherlands and other countries? Have their estimated levels of trafficking fallen? Can we rely on these estimates? And how do the victims of trafficking feel about this issue?2 How does the general population of prostitutes feel? Does everyone agree? In fact, what exactly is trafficking (from a legal standpoint)? Does its definition differ from place to place? Is it separate and district from  illegal migration and human smuggling? Can we reasonably tell them apart in reality? What are the rights of a trafficked victim as opposed to an illegal migrant? What punishments do trafficker face for their work? How often are they punished? Why? What is the evidence for and where are the programs for rehabilitation and reintegration of trafficked victims? Do we know that they work? etc., ect., ad infinitum.

I have many sources to suggest if you would like (attempted) answers to these questions.

My stance on this issue must remain transparent: I do not think that prostitution should be legalized. However, I also worry that the term “trafficking” is now used to refer to so many different circumstances that its functionality is being worn thin, if it hasn’t decayed already.3

Don’t be ignorant. Ask questions, seek many perspectives before settling, and find your own way to engage.


Suggested reading on trafficking may include: Methodological Challenges by Brennan (I can email you the article, if you ask), Trafficking and Prostitution Reconsidered by Kempadoo, the Polaris website, and the blogs by Stella Marr et al.

Quick introductions can be found at: New York Times

A video also by NYTimes: http://www.nytimes.com/2012/04/07/world/europe/young-men-flock-to-spain-for-sex-with-trafficked-prostitutes.html?pagewanted=1&_r=1&hp

Interview with Mimi Chakarova, director and narrator of The Price of Sex at the Human Rights Watch film festival: Download Podcast

Rachel Lloyd, author and founder of “Girls Like Us” on the Diane Rehm show: Listen

A related post on Bell Tolling: Read

A follower of Bell Tolling and author of My Body the City: The Secret Life of a Call Girl, Stella Marr, has some interesting posts to share on the topic–as to her associates.

3 In a future post, for example, I will discuss the issue of “child trafficking” in regards to illegal intercountry adoption (i.e. does the abuse of adoption processes truly amount to “trafficking” as so many say?) Until that time, I encourage you to read up about this issue.

4After watching this video, I asked myself “Did it have to be so vivid?” As one who researches and writes on this topic regularly, I have read many true stories similar to the tale told in Journey, and that have likewise offended me. But this film jarred my senses and soul in a way similar to that described by Susan Sontag. It’s never been the same. And though I, like Sontag, claim no more grasp  or understanding of the reality of the victim because of this film, I least won’t forget or feign absolute ignorance anymore. But again, watch at your own discretion.

Wikipedia Random Button

March 24, 2012 § Leave a comment

Today was a bit messy. So, instead of sharing about something I’ve recently learned or thought of, I’d like to share with you one of my favorite, lazyman tricks for learning about something new. It is the Wikipedia “random article” button (found on the left margin of the Wikipedia.org website). Click this button and Wikipedia will automatically generate a random article for you to peruse. It’s a bit addicting, and you often have to click it a few times to get something substantial. Though certainly not deep reading, this button can introduce you to topics and people that you had no idea existed.

My five “random articles” today included: Stuart Murdoch (football manager); Faterville, Tennessee (funny name, beautiful graveyard); Iva Bittova (a Czech avant-garde violinist); Peter Pevensie (a character in C.S. Lewis’ Narnia); and the Standing Rules of the United States Senate (rules that govern the morning business and the opening of a legislative day in the Senate…there are an unsurprising but exorbitant 44 rules)

Enjoy a restful Saturday with some easy reading at the Oracle at Wiki…

Results for Development

March 24, 2012 § Leave a comment

I recently had a meeting at Results for Development (affectionately referred to as R4D) in Washington DC and was pleasantly surprised–not only by their employees, but also by their projects, transparency and educated professionalism. Started by a past Regional Vice President of the World Bank, David de Ferranti, and guided by a highly capable and experienced cast of multi-dimentional characters, R4D is a non-profit that focuses on reducing poverty in low- and middle-income countries by designing and promoting high impact investments. R4D identifies and seeks to amplify what they determine to be “evidence-based”1 programs in health, education, governance, and innovative financing for development. For example, R4D is now partnering with a team with experience in bond insurance to launch Affinity MacroFinance (AMF), a new financial insinuation with potential to leverage billions of dollars using bond guarantees. By lowering risk, AMF aims to unlock capital from pension funds and other sources of capital in developing countries. These funds, says R4D, could be used to pay for health care, small and medium enterprises, education and infrastructure.

Or, as a hypothetical example of the type of work that R4D might do, pretend that a donor organization is giving grants to low-income countries in order to bolster their health infrastructure; and say that one of the recipient countries of this donor is now about to graduate into the status of a middle-income country. R4D may enter this relationship in order to assist the donor organization in determining how to formulate a policy for this situation without harming the recipient country (e.g. they could temporarily co-pay, immediately cut donations, progressively decrease donations, etc., etc.).

In all of its endeavors, R4D does not shun from rigorous analysis and works diligently to partner with experienced groups such as the Brookings Institution, Aspen Global Health and Development, Freedom from Hunger, the Harvard School of Public Health, the Rockerfeller Foundation, the Global Alliance for Vaccines and Immunizations, and the Bill and Melinda Gates Foundation to bridge the gap between innovation and implementation. I encourage anyone who is interested in development to follow this group and stay up to date on its projects and endeavors. From what I can tell, there is much to see in the future.

 

 


1 Their definition of “evidence-based” was not something that I got a clear definition of in my meeting, but it was obvious to me that this group was knowledgable about the use and benefit of randomized controlled trials, wherever possible, and cognizant of the need to adapt evaluation design to the intervention at hand. What was quite clear about R4D was that they intend to innovate with transparency and a scientific discernment.

International Water Day

March 23, 2012 § 1 Comment

Me: It’s International Water Day!

Guy in lobby: That’s only a holiday for people who don’t have water.

Is he right? No. At least, I don’t think so. To me, International Water Day is the exact opposite–or at least it should be. International Water Day is about rekindling (or sparking for the first time) an awareness that water plays a vital role in our survival, and therefore in our human rights. Assuming you’re in reasonable shape and in ideal conditions — that is, not in the heat or cold and not heavily exerting energy (neither of which are likely during a drought), you can probably live for about 3 to 5 days without any water.  I don’t dare you to try.

According to one estimate, 884 million people lack access to an adequate supply of safe water. Children in high-income nations will consume 30-50% more water than their low-income counterparts. I don’t mean to add to the deluge of statistics that we see today, but such things  can help put things in perspective. Are we grateful enough? Do we even pay attention? As a future parent, I can’t imagine being asked to deprive my child of water for a single day. And I can’t imagine asking my daughter to skip school in order to go fetch it (this isn’t meant to be a condemnation of those who must do so, just a recognition that it is unfortunate). But this speaks only in terms of water for drinking; it says nothing about water for agriculture, and it says nothing about water for sanitation (e.g. washing hands and food to avoid illness, flushing waste and cleaning wounds). Inadequate sanitation claims the lives of almost one quarter of children who die each year worldwide.  In places that water is scarce, the lack not only kills directly, but indirectly as well through such things as land disputes and rationing. It is a deadly and prevalent killer that should never have lasted so long.

But I don’t want this post to be only doom and gloom. I am grateful for the five faucets of my home that bring me clean water at the twist of a wrist. I am grateful for those working successfully to bring a similar benefit to communities worldwide.1 Charity:water, for example, has some interesting and effective projects worldwide. Though I’m not a fan of their idea to “look to the stars2 and would like to see someone other than Harrison speak in the video below (i.e. a Bayakava perhaps?!), I do appreciate the aesthetic of charity:water and their rating on charity navigator. Here is their annual report, for transparency’s sake. And a video t’boot, from their campaign last September (find updates here):


Water, with it’s unassuming translucence, is the liquid of life; it shows its power not only in tsunamis and hurricanes, but also in our everyday survival. Though it boggles me there are still people who live an entire life without ever seeing the ocean or ice (because they lack electricity and temperatures never reach freezing in their village), it boggles me even more that there are still people who live without access to water in it’s most basic and useful form. Celebrate International Water Day by educating yourself on some aspect of of this issue (i.e. water rights, access, disputes and technology). Learn about what is being done on the policy level, and what interventions are taking place at the grassroots. At the very least, celebrate with a dedication to drink more gratefully, shower more conscientiously and  educate your children on the situation of their global peers.


For those of you who are surfers, swimmers, wake boarders, ice skaters, ice hockey players, curlers, or otherwise water aficionados, this bell of water rights worldwide may ring louder for thee. After all, it is apropos to your athletic passions and therefore may be  a great entry point for you to find a “cause” to get involved with.

1(Organizations concerned with water protection include International Water Association (IWA), WaterAidWater 1stAmerican Water Resources Association. The International Water Management Instituteundertakes projects with the aim of using effective water management to reduce poverty. Water related conventions are United Nations Convention to Combat Desertification (UNCCD), International Convention for the Prevention of Pollution from ShipsUnited Nations Convention on the Law of the Sea and Ramsar ConventionWorld Day for Water takes place on 22 March and World Ocean Day on 8 June.)
2 This probably has something to do with my general distaste for the oddity that is “celebrity”

Democracy

March 22, 2012 § Leave a comment

“From a human rights perspective, more is required than periodic elections for a democracy to be genuine. Those elections must be free, transparent, conducted on the basis of “one-person-one-vote”, and people must be able to cast their votes secretly, free from surveillance and intimidation. It is widely believed that the end of the Cold War [and/or the start of the Arab Spring] has resulted in the growth of democracies across the world. They reality is more complex.”1

Here is an insight into some forms of democracy. And arte.tv has come up with a great website to watch the development of 7 democracies around the world…

Democracy by Numbers [arte.tv] is a beautiful series of infographics developed by the data visualization agency Dataveyes for the French-German television channel arte.tv. Since January, the TV network is broadcasting a series of documentaries highlighting 7 countries as they go through a change in their political system. The goal is to take the pulse of democracy in those countries, based on their history of government and social issues (infosthetics.com). The site is in French, but an English speaker can make do.


1The Atlas of Human Rights, Andrew Fagan 2010

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