Author Archives: derisnor

The Unfortunate Misconception of ORT

One of the leading causes of death and hospitalizations for infants and children within the global health community is attributed to diarrheal diseases. It is estimated that this preventable and treatable condition annually kills 760,000 children under the age of five. (WHO, 2013)  And from a global health perspective, there are nearly, 1.7 billion cases of diarrheal disease. (Ibid) And in developing countries, extremely high infant and children mortality rates are caused by dehydration which in turn is a major symptom of diarrheal disease. One must wonder why a treatable and preventable condition is effecting the global health community at such a morbidity and high rate.

Oral Rehydration Therapy (ORT) was created in the early 1960s to treat cholera patients in the Philippians and East Pakistan (which is also known as Bangladesh). And in 1971, ORT was identified as an effective solution in treating a diarrheal disease such as cholera during crisis situations. (Qureshi, 2010) The original ingredients of ORT combined a fairly simple mixture of sugar, salt and clean water. When compared to intravenous treatment for dehydration, ORT was considered the most cost-effective and efficient strategy in treating diarrheal diseases in both children and adults. Administering the ORT mixture did not require any medical personnel and the ingredients are considered cheap.

So why are there still high morbidity and mortality rates for diarrheal diseases among children? One issue can be credited to the lack of access to clean water in some regions of developing countries. Another cause could be related to the current health status of an individual. Malnourished and chronically ill patients have an increased risk of dying from a diarrheal disease. And while these causes are serious and require further attention, a common misunderstanding of ORT may also be a possible contributor in the morbidity and mortality rates of diarrheal disease.

While ORT is still considered an “important medical advancement” as declared by the Lancet in 1978, there are some disadvantages which may impact the utilization rate of ORT. (Ibid) One major issue of ORT is that while an individual is on the ORT regimen, they may continue to experience diarrheal symptoms. Also some ORT kits are packaged as being unflavored but there are many reports of a strong salty taste which makes it difficult to administer to children. And lastly, the various versions of ORT may confuse an individual in properly creating an ORT mixture.

While the benefits of ORT greatly outweigh the disadvantages mentioned, more attention needs to be focused on why so many children are dying across the world from an avoidable and preventable condition.

References

Qureshi, N. A. (2010). Oral Rehydration Therapy. Boston: Harvard Business School Publishing.

WHO, W. H. (2013, April). Diarrhoeal Disease Fact Sheet. Retrieved from http://www.who.int/mediacentre/factsheets/fs330/en/

Tobacco’s Role in Developing Countries

From a global perspective, tobacco use has declined over time.[1]  But the decrease rate of tobacco use among developed and developing countries greatly vary from one another.  One might simply attribute this disparity to increased public health efforts on the harms of tobacco use in developed countries when compared to developing countries.  However, further research of the tobacco companies’ approach at engaging its customers can provide another reason for the difference in tobacco use rates among developed and developing countries.

Historically speaking, a major strategy of tobacco companies includes targeting vulnerable populations that may not be informed on the harms of smoking, tobacco advertisement which displays tobacco use as being socially acceptable, tobacco companies sponsoring community events as well as influencing political systems for their advantage.  And as of present, not much has changed.

Tobacco companies have strengthened their strategies in marketing their products towards individuals living in specific areas that also happen to have the least restrictive tobacco control policies in place.   An example of this would be the 40% increase of tobacco users that is expected in Africa by 2030.  This is also the largest expected increase of tobacco users within the global community.[2]  Several current roles tobacco companies have in Africa include: (1) delaying the implementation of tobacco control policies by influencing politicians to support their agendas, (2) increasing the financial dependency of tobacco farmers on tobacco companies, (3) earning the trust of community members by addressing some of the needs within their community such as providing electricity and hospital supplies, as well as (4) creating advertisements that specifically appeal to women and children.

While some of these roles appear to help individuals living in Africa by providing opportunities of employment and addressing some serious needs within African communities.  The long-term effect of tobacco promotion within these African communities may not be as beneficial.  Tobacco related deaths have been attributed to nearly six million deaths per year, worldwide.[3]   Moreover, when compared to non-tobacco users, tobacco users have higher rates of poor health status, reduced household incomes and increased healthcare expenditures which are may be related to the treatment of their tobacco related conditions. For instance, in some countries, children from poor households work in tobacco farming as a source of family income.  And unfortunately, these children are at a high risk of “green tobacco sickness”, which is caused by the absorption of nicotine through the skin from the handling of wet tobacco leaves.[4]

The short-term contributions of tobacco companies to developing countries appear to benefit both tobacco companies and the communities they target.  Tobacco companies are able to increase their profits by expanding their consumer base and the communities they target are offered opportunities of employment or other types of support.  But the long term health impacts and financial burden of tobacco use and tobacco-related conditions may far exceed the short term outcomes.

[1] Jackson RR. Ebola may be in the headlines, but tobacco is another killer in Africa. The Guardian. October 2014

[2] Ibid

[3] WHO. Tobacco Fact Sheet. May 2014. http://www.who.int/mediacentre/factsheets/fs339/en/. Accessed on November 2, 2014

[4] Ibid