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Introduction to Global Health and Tropical Medicine

Introduction to Global Health and Tropical Medicine

Introduction to Global Health

Introduction to Global Health

Global Health introduction

Definition of global health

  • Collaborative trans-national research and action for promoting health for all
  • Achieving health equity by study, research and practice

Cost effectiveness is a very important aspect of Global Health.

Career in Global Health

  • National representative
  • Netherlands course in Global Health and Tropical Medicine, 28 months
 

 

Determinants of health

Health

  • WHO: a state of complete physical, mental and social wellbeing, and not merely the absence of disease or infirmity → practically impossible to achieve
  • S. van der Geest: the proper functioning of the body
  • M. Hubert: the ability to adept and self-manage

Determinants

  • Determinant: a factor that decisively affects the nature or outcome of something

Models of determinants of health are:

  • Lalonde framework: assumes no interaction between determinants of health
  • Skolnik model: more complex model used in this course

Different determinants influence each other. Health care has a relatively low impact on health status. Social determinants of health are particularly important for the wellbeing of patients.

According to epidemiologists Wilkinson and Pickett, “equality” in itself is a determinant of health.

Long and healthy life is a precondition for development, which stimulates participation in the society. Generally, high income relates to a good health status. Therefore, economic development is a precondition for a long and healthy life.

However, the Blue Zone Project shows that there are additional factors such as social cohesion and lack of stress that stimulate a long and healthy life.

Health indicators

Indicators

Indicator: measure that tells something about the state or level of something. Health indicators are often ratios or rates with a numerator and a denominator.

  • Ratio: compares two measures of the same dimension
  • Rates: compares two measures of different types

Key Health Status indicators:

  • Life expectancy at birth: the number of years a newborn baby would live if subjected to the present mortality risks prevailing for each age group in the population
  • Child mortality: low income countries have a high child mortality under 5 years due to malnutrition
    • Categories: perinatal, neonatal, postneonatal, infant, under 5 years
    • Infant mortality rate: the number of deaths of infants under age 1 per 1000 live births in a given year
    • Neonatal mortality rate: the number of deaths to infants under 28 days in a given year per 1000 live births in that year
    • Under-5 mortality rate: the probability that a newborn baby will die before reaching age 5, expressed as a number per 1000 live births
  • Maternal mortality ratio: the number of maternal deaths per 100.000 live births
  • Maternal mortality rate: the number of maternal deaths per woman of reproductive age per time period
  • DALY: disability adjusted live year, YLD + YLL
    • YLD: years of life lost due to disability → number of incident cases, average duration, how severe the disability is
    • YLL: years of life lost due to death → number of deaths and age of death
  • HALE:
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Global Health: Neglected Tropical Diseases

Global Health: Neglected Tropical Diseases

RC NTDs – an introduction

Definition

NTD is a relatively new identity. The term NTD was first used in 2003. It was coined by Peter Hotez and colleagues to counterbalance the attention given to HIV/AIDS, tuberculosis and malaria.

The list

There are 20 NTDs on the list, even though different sources give different numbers of NTDs. This is relevant because it is very difficult for diseases not on the list to find money for research and therapy. The 3 most recent diseases listed by the WHO are mycetoma, scabies and snakebites. Snakebites is the only non-infectious disease on the list.

Several NTDs are not restricted to the tropics, such as:

  • Snakebites
  • Scabies
  • Rabies
  • Echinococcosis
  • Leprosy

 

NTDs which are restricted to the tropics because of climate are:

  • African Sleeping Sickness
  • Chagas
  • Onchocerciasis
  • Schistosomiasis
  • Dengue
  • Buruli ulcer
  • Leishmaniasis
  • Soil-transmitted helminthiases
  • Mycetoma
  • Yaws
  • Lymphatic filariasis

These diseases all need a vector, which can only survive in tropical areas.

Causes

NTDs occur in the most poor communities of the world:

  • Common, poverty related, risk factors
  • Occur in 149 endemic countries
  • People are infected with at least one NTD

Often, if one has 1 NTD, they have many NTDs because the risk factors are the same. The advantage of this is that multiple diseases can be controlled at the same time.

Microorganisms

NTDs can be caused by:

  • Bacteria
    • Buruli ulcer
    • Leprosy
    • Trachoma
    • Yaws
  • Viruses: the rarest
    • Rabies
    • Dengue and chikungunya
  • Parasites
    • Protozoa
      • Chagas disease
      • Leishmaniasis
      • Human African Trypanosomiasis
    • Helminths: occur the most often
      • Cysticercosis
      • Guinea-worm disease
      • Echinococcosis
      • Foodborne trematodiases
      • Lymphatic filariasis
      • Soil-transmitted helminthiases
      • Schistosomiasis
      • River blindness

There is no existing vaccine against helminths.

Epidemiology

Most NTDs have a high morbidity and disability, while the mortality is low → many NTDs are chronic and don’t immediately cause death. This is why the diseases are so often neglected. NTDs promote poverty and interfere with economic development.

Prevalence

The most prevalent NTDs are the soil-transmitted helminths (STH):

  • Roundworms
  • Whipworms
  • Hookworms

1,5 billion people have a STH. The NTD intestinal nematodes (STH) costs the highest burden of disease around the world, because so many people are infected with them.

Fatality

3 NTDs with the highest case fatality rate are:

  • Rabies
    • 99% fatality
  • African trypanosomiasis
    • 100% fatality
  • Visceral leishmania

In case of these diseases, as soon as there are symptoms and there is no treatment, the patient dies.

Blindness

2 NTDs which cause blindness are:

  • Onchocerciasis
  • Trachoma
    • Causes infections of the eye

Stigma

3 NTDs which are a stigma, causing high social-economic impact, are:

  • Lymphatic filariasis
  • Buruli ulcer
  • Yaws

Treatment and intervention

Multiple NTDs have a common treatment and share a similar way of intervention:

  • MDA
  • Vector control
  • Safe water, sanitation and hygiene

For example, by deworming communities and schools, the burden of helminthic diseases can

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Global Health: Non-communicable diseases and the "Big 3"

Global Health: Non-communicable diseases and the "Big 3"

RC HIV control in Africa

Epidemiology of HIV in Africa

37,7 million people are living with HIV globally, of which 25,4 million live in Africa. Especially in southern African countries, the prevalence of HIV is very high:

  • Zambia
  • Botswana
  • Namibia
  • South Africa
  • Eswatini/Swaziland
  • Mozambique
  • Zimbabwe

Although the number of new infections is declining worldwide, the majority of new infections occur in Africa. These infections mainly (>60%) occur among women, while in Western Countries mainly men are affected. In general, the transmission rate from men to women is higher, women in Sub-Saharan Africa aren’t in the position to negotiate about safe sex and are often involved with older men.

Subtypes

There are different HIV subtypes circulating. In Africa, HIV-1 subtype C is most common, while in Western Countries most infections are HIV-1 subtype B. This means that research mainly is done for HIV-1 subtype B, while in Africa medication for subtype C is necessary. Subtype C and D also appear more pathologic than subtype B.

Antiretroviral treatment and HIV control in Africa

In 1996, a life-saving combination triple therapy was found. This therapy was very effective in suppressing the virus. However, ART (antiretroviral treatment) was hardly covered in the African region. This was the cause of many protests → ART for Africa. This led to an international response to AIDS:

  1. 2000 Durban conference “Breaking the Silence” → the first conference held in an African country
    • It finally became clear how big the problem was
  2. 2001 UN Declaration of Commitment on HIV/AIDS
    • Made sure that people who needed it, would get their medication
  3. 2002 Global Fund to Fight AIDS, TB and Malaria (GFATM)
    • A lot of money was necessary to get the drugs where they were needed
  4. 2003 PEPFAR
    • Emergency plan for AIDS relief

Meanwhile, UNAIDS was in discussion with several pharmaceutical companies to reduce the price of ART’s → the price reduced from $10.000/year to $900/year.

However, around 2004, there were challenges for ART access in Africa:

  • Shortfalls in health services
  • Lack of knowledge about treatment
  • Making decisions about newer treatments
  • Risk of resistance to ART

Nevertheless, after 2004 the number of people on ART started rising and is now similar to the numbers in Western Countries. This led to a huge increase in life expectancy → a 25-year-gap. The availability of ART also resulted in less people getting infected with HIV.

WHO guidelines

In 2002, the WHO made guidelines for when to start ART in LMIC. These guidelines evolved over time:

  1. 2002: ART for everybody with a CD4-cell count of <200
    • Normal: CD4-cell count is >500
  2. 2006: ART for everybody with a CD4-cell count of <200 or with a CD4-cell count <350 and TB
  3. The treatment started being given earlier and earlier

In 2015, the START and TEMPRANO trials looked into when ART should be started. It appeared that when ART was initiated immediately, the CD4-cell

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Global Health: Nutrition, culture & technology

Global Health: Nutrition, culture & technology

Malnutrition

Malnutrition

Nutrition is part of a balance:

  • Undernutrition: immunosuppression and susceptibility to infection
  • Optimal nutrition: normal immune function
  • Overnutrition: immune-activation and susceptibility to inflammatory diseases

There is malnutrition in case of undernutrition and overnutrition.

Undernutrition and overnutrition

Undernutrition is an insufficient intake of macro- or micronutrients to meet nutritional needs. Macronutrients are proteins and fat, micronutrients are vitamins and minerals. There are 2 types of undernutrition:

  • Growth failure
  • Micronutrient malnutrition

Overnutrition is an excess amount of energy leading to overweight and possibly chronic disease.

Nutritional transition

Besides a demographic and epidemiologic transition, there also is a nutrition transition. There is interaction between these 3 transitions. Nutrition transition is the pattern from scarcity to over-consumption → a change from an active lifestyle and whole grain foods to a sedentary lifestyle and ready-made convenience foods. A nutritional transition has different stages:

  1. Paleolithic man/hunter-gatherers
  2. Settlements begin → famine emerges → high prevalence of undernutrition
  3. Industrialization → receding famine → slow mortality decline
  4. Nutrition related noncommunicable diseases predominate
  5. Desired societal/behavioral change → focus on medical intervention, policy initiatives and behavioral changes

Macronutrient deficiencies

There are different types of macronutrient undernutrition:

  • Normal: normal weight and height
  • Wasted: thinner than normal
  • Stunted: shorter than normal
  • Wasted and stunted: thinner and shorter than normal

Wasting is indicative of acute undernutrition, such as in famine or emergencies requiring humanitarian assistance. Stunting is indicative of chronic undernutrition and is common in low income populations in non-emergency cases.

Child undernutrition

  • Wasting: extreme thinness → weight for height below -2 SD
  • Stunting: extreme shortness → height for age below -2 SD
  • Underweight: composite measure of undernutrition capturing thinness and/or shortness → weight for age below -2 SD

Protein energy malnutrition

Protein energy malnutrition, also known as Marasmos, is an extreme protein and energy deficiency. It results in an appearance of skin and bones with little or no subcutaneous fat and a pronounced loss of muscle mass. It can lead to limited brain growth and development. It is a very serious condition of undernutrition.

Protein and vitamin deficiency

Protein and vitamin deficiency, is also known as Kwashiorkor. It can lead to oedema, retention of some subcutaneous fat, red coloring of the hair, apathy and growth retardation. It is a very serious condition of undernutrition.

Micronutrient deficiencies

The 4 most prevalent micronutrient deficiencies are:

  • Vitamin A: xerophthalmia/blindness
    • Important to mucous membranes → dryness causes temporary night blindness of permanent damage leading to blindness
    • Important to immune function: supplementation has resulted in reduced risk of measles and diarrhea
    • Dietary sources: liver, yellow/red vegetables
  • Iodine: cretnism, goiter
    • Needed for thyroid hormones
      • Regulates the basal metabolic rate
      • Important to early development of the fetus
    • Insufficient iodine → overactive pituitary gland → TSH production → thyroid gland produces more TH → increase in activity and size of the thyroid gland
    • Dietary sources: sea foods, iodized salt
  • Iron: anemia
    • Necessary component of hemoglobin
    • Deficiencies related
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SPOTLIGHT

Teaching material: health awareness & mental well-being

Teaching material: health awareness & mental well-being

True or False game HIV/Aids

True or False game HIV/Aids

Education Category: Health
Ages:

What is HIV/AIDS?
Before we can explain what HIV is you have to know that your body exists of billion cells. Every cell has got its own task to fulfill in your body. Some of these cells are like tiny little soldiers. These little soldiers protect you from viruses. These viruses are like bad intruders. If these bad intruders are inside your body then your soldiers are working hard to get them out. Sometimes you can feel sick because there are a lot of intruders in your body, but mostly the soldiers accomplish to get rid of these intruders.

HIV is also a bad intruder, but HIV works a little bit different than most of the intruders. The HIV intruder can only enter your body by some of your bodily fluids such as blood, semen, vaginal fluids and breast milk. When an HIV intruder is inside your body it is able to kill the soldiers.
So, when an HIV intruder is inside your body, it kills the soldiers which are supposed to protect you. When the number of soldiers reduces until a certain low concentration, you are diagnosed with AIDS.

However, you should know that an HIV intruder and the disease AIDS are not the ones who can actually make you sick or eventually kill you.
Normally your soldiers are with enough men to win the battle against the intruders, but with HIV in your body the amount of soldiers is reduced. So now there are not enough soldiers and your body becomes vulnerable to other intruders (other infections). This is beneficial for the development of infections. Diseases which normally can be fought off by the soldiers can now be lethal. For example, diseases like the common cold, severe pneumonia, tuberculosis, and malaria, of which you can eventually die. These diseases are called opportunistic diseases, they benefit from the presence of the HIV intruder. Thus, the HIV intruder and the disease AIDS are the ones who make your body vulnerable to other intruders, and the opportunistic diseases can eventually kill you.

The disease AIDS is very dangerous for our health, therefore it is important to know how you can get infected. So we are going to play a game. Let’s see how much you already know about HIV/AIDS!


Activity: True or False Game 1
This game is a fun way to test the knowledge of children about HIV and AIDS.

You need: Three areas.

How to:
As the teacher you say what the area’s represent. The first area is “False”, the second area is “I don’t know” and the third area is “True”. Then explain that you are going to read statements and the children should go to the area which area represents for them as best answer. Now read a statement (the statements are underlined). Give them the correct answer after they have all chosen an area and explain why this is the correct answer.

  1. It is possible to get HIV from hugging someone who is HIV positive or someone who has AIDS
    FALSE!
    You cannot get HIV/AIDS from;

- holding hands, hugging, caressing, kissing
- Close contact with infected people at school, work, or in your village
- Sharing clothes, food, bed towels, etc.
- Insect bites
- Coughing, sneezing
- Swimming
- Using public toilets

  1. It is not safe to share razors, syringes, tooth brushes and needles with someone who is HIV positive or with someone who has AIDS
    TRUE!
    It is not safe to share sharp piercing objects like needles, razors, syringes or a tooth brush which has blood on it, because then you can come into contact with infected blood.

  2. HIV is the same as AIDS
    FALSE!
    HIV is the virus (intruder) makes you vulnerable for other diseases by killing the soldiers of your body (immune system). AIDS is the combination of several opportunistic diseases that have attacked the body.

  3. If I have HIV… I cannot have children
    FALSE!
    This used to be true but not anymore.
    Women living with HIV can and do have families. Certain medical steps and precautions have to be taken to protect the child from getting HIV from the mother.

Lessons on Gender (1)

Lessons on Gender (1)

gender

Education Category: Health
Ages: 12-16, 16+

Donated by Ron Haarms

Donated by Ron Haarms

NOTE: This is the first file for this module. Download the first file here.

Information on Gender

Often, ‘gender’ and ‘sex’ are understood to be the one and the same. In reality, they are quite different. There is a difference between what our bodies are physically able to do, such as producing sperm or giving birth, and what our society expects us to do. Sex is determined by our bodies: a person is either male or female from before the

Moment he or she is born. Gender, on the other hand, is socially defined. Gender depends on historic, economic and cultural forces, and by definition is constantly changing. This means that people have different understandings of what gender is, depending on their context. People learn about what it means to be male or female from many places, including from their families, communities, social institutions, schools, religion and media.

 

The result of traditional gender roles is often that people are not able to reach their full potential. Both men and women would benefit from a perspective that does not limit what people can and cannot do. To stereotype is to categorize individuals or groups according to an oversimplified standardized image or idea. For example, in many cultures, education for girls and women is given a lower priority than for boys and men. However, according to UNICEF, girls denied an education is more vulnerable to poverty, violence, abuse, dying in childbirth and at risk of diseases including HIV/AIDS (State of the World’s Children 2004, press release). As another example, in many cultures, men are expected to display traditional traits of masculinity. This can often result in sexual promiscuity, heavy alcohol consumption, or violence, all of which are unhealthy behaviors, both for men and their families.

 

 All people can be ‘feminine’ in some ways, and ‘masculine’ in other ways. There is a diversity of masculinities and femininities that exist beyond the narrow gender models they are familiar with. There is no one way to be a man or be a woman. Our goal is to promote a flexible and tolerant attitude toward gender, rather than reinforcing rigid roles and expectations w

Gender is hierarchical; in most societies, it gives more power to men than to women. Also, it preserves the existing power structure. Work that women do revolve around the physical, emotional and social wellbeing of other people, especially, their husbands/partners and children. Work that men do is related to their role as bread winners/providers for their families, which leads them to seek out paid work. For example, many women love to cook, and many women cook better than men. Then why is it that mostly men are cooks at hotels and restaurants while women cook at home, unpaid?

 

Often, society defines what is right for men and women. It is not our fault that the system is that way. However, when we recognize that there is injustice, we can do something to change it. Society is made up of people, and people are capable of change. This is a very personal process. First we have to recognize what is happening in our own lives, and then we can begin to make changes.

 

Most of us feel that culture, religion, tradition, and social norms dictate gender roles. But where does change happen if not in our individual circumstances? How does a fashion trend start if not by one or two people one day starting to wear or do a certain thing? Ideas about gender affect us both privately and publicly; that means we have the opportunity to make changes at both the personal level, as well as in society

Information on HIV/AIDS

What is HIV/AIDS?

The Human Immune Deficiency Virus (HIV) is a virus that attacks the body’s immune system. HIV leads to acquired Immune Deficiency Syndrome (AIDS). AIDS refers to a state where the immune system is extremely weak and prone to severe opportunistic infections.

 

How is HIV transmitted?

HIV is transmitted primarily through blood, semen and vaginal fluid. The main modes of transmission are:

1. Unprotected sexual contact where body fluids are exchanged (vaginal, anal or oral intercourse);

2. Infected blood transmission;

3. Sharing infected needles/syringes; and

4. Infected mother to child during pregnancy or childbirth.

HIV is not spread through casual contact such a hugging, sneezing, mosquito bites, or sharing utensils with a person who is infected.

 

What are the symptoms of HIV/AIDS?

People infected with HIV often have no symptoms for many years. Once HIV enters a person’s body, s/he may experience flu-like symptoms within 2 to 6 weeks. After infection, there is a window period of between 6 to 12 weeks during which a routine blood test will not show a positive result. HIV can be transmitted during this time, even before symptoms appear. Persons living with HIV may experience chronic fever, diarrhea and weight loss. As the disease pr ogresses, the body is prone to opportunistic infections such as thrush, pneumonia and tuberculosis.

How is HIV prevented?

There is no cure for HIV, although antiretroviral (ARV) drugs help boost the body’s immune system to fight opportunistic infections and increase the life span.

HIV can be prevented through:

1. Safer sex: Abstinence, being faithful in a monogamous relationship, or using condoms correctly and consistently for every sexual act can prevent sexual transmission; 2. Using sterilized needles and syringes and avoiding sharing needles; 3. Screening blood and blood products and avoiding transfusion of untested blood; and 4. Preventing mother to child transmission through counseling on the options and risks involved, provision of available drugs during pregnancy and appropriate breastfeeding practices.

Women and HIV

Women are biologically, culturally and socially more vulnerable to HIV. Women are more likely (four to ten times) to contract HIV through vaginal intercourse, as there is more entry points for the virus in the female genitalia compared to men. Gender dynamics render women more vulnerable through discriminatory practices, lack of decision making power and unequal status in social or cultural affairs. Women are thus often placed in circumstances in which it is difficult to negotiate the terms or safety of sex

Attachment: 

9983_gender_workshop_care_isofi_module_intro.pdf

Lessons on Gender (2)

Lessons on Gender (2)

gender

Education Category: Health
Ages: 12-16, 16+

Donated by Ron Haarms

Donated by Ron Haarms

NOTE: This is the second file for this module. Download the first file here.

Information on Gender

Often, ‘gender’ and ‘sex’ are understood to be the one and the same. In reality, they are quite different. There is a difference between what our bodies are physically able to do, such as producing sperm or giving birth, and what our society expects us to do. Sex is determined by our bodies: a person is either male or female from before the

Moment he or she is born. Gender, on the other hand, is socially defined. Gender depends on historic, economic and cultural forces, and by definition is constantly changing. This means that people have different understandings of what gender is, depending on their context. People learn about what it means to be male or female from many places, including from their families, communities, social institutions, schools, religion and media.

 

The result of traditional gender roles is often that people are not able to reach their full potential. Both men and women would benefit from a perspective that does not limit what people can and cannot do. To stereotype is to categorize individuals or groups according to an oversimplified standardized image or idea. For example, in many cultures, education for girls and women is given a lower priority than for boys and men. However, according to UNICEF, girls denied an education is more vulnerable to poverty, violence, abuse, dying in childbirth and at risk of diseases including HIV/AIDS (State of the World’s Children 2004, press release). As another example, in many cultures, men are expected to display traditional traits of masculinity. This can often result in sexual promiscuity, heavy alcohol consumption, or violence, all of which are unhealthy behaviors, both for men and their families.

 

 All people can be ‘feminine’ in some ways, and ‘masculine’ in other ways. There is a diversity of masculinities and femininities that exist beyond the narrow gender models they are familiar with. There is no one way to be a man or be a woman. Our goal is to promote a flexible and tolerant attitude toward gender, rather than reinforcing rigid roles and expectations w

Gender is hierarchical; in most societies, it gives more power to men than to women. Also, it preserves the existing power structure. Work that women do revolve around the physical, emotional and social wellbeing of other people, especially, their husbands/partners and children. Work that men do is related to their role as bread winners/providers for their families, which leads them to seek out paid work. For example, many women love to cook, and many women cook better than men. Then why is it that mostly men are cooks at hotels and restaurants while women cook at home, unpaid?

 

Often, society defines what is right for men and women. It is not our fault that the system is that way. However, when we recognize that there is injustice, we can do something to change it. Society is made up of people, and people are capable of change. This is a very personal process. First we have to recognize what is happening in our own lives, and then we can begin to make changes.

 

Most of us feel that culture, religion, tradition, and social norms dictate gender roles. But where does change happen if not in our individual circumstances? How does a fashion trend start if not by one or two people one day starting to wear or do a certain thing? Ideas about gender affect us both privately and publicly; that means we have the opportunity to make changes at both the personal level, as well as in society

Information on HIV/AIDS

What is HIV/AIDS?

The Human Immune Deficiency Virus (HIV) is a virus that attacks the body’s immune system. HIV leads to acquired Immune Deficiency Syndrome (AIDS). AIDS refers to a state where the immune system is extremely weak and prone to severe opportunistic infections.

 

How is HIV transmitted?

HIV is transmitted primarily through blood, semen and vaginal fluid. The main modes of transmission are:

1. Unprotected sexual contact where body fluids are exchanged (vaginal, anal or oral intercourse);

2. Infected blood transmission;

3. Sharing infected needles/syringes; and

4. Infected mother to child during pregnancy or childbirth.

HIV is not spread through casual contact such a hugging, sneezing, mosquito bites, or sharing utensils with a person who is infected.

 

What are the symptoms of HIV/AIDS?

People infected with HIV often have no symptoms for many years. Once HIV enters a person’s body, s/he may experience flu-like symptoms within 2 to 6 weeks. After infection, there is a window period of between 6 to 12 weeks during which a routine blood test will not show a positive result. HIV can be transmitted during this time, even before symptoms appear. Persons living with HIV may experience chronic fever, diarrhea and weight loss. As the disease pr ogresses, the body is prone to opportunistic infections such as thrush, pneumonia and tuberculosis.

How is HIV prevented?

There is no cure for HIV, although antiretroviral (ARV) drugs help boost the body’s immune system to fight opportunistic infections and increase the life span.

HIV can be prevented through:

1. Safer sex: Abstinence, being faithful in a monogamous relationship, or using condoms correctly and consistently for every sexual act can prevent sexual transmission; 2. Using sterilized needles and syringes and avoiding sharing needles; 3. Screening blood and blood products and avoiding transfusion of untested blood; and 4. Preventing mother to child transmission through counseling on the options and risks involved, provision of available drugs during pregnancy and appropriate breastfeeding practices.

Women and HIV

Women are biologically, culturally and socially more vulnerable to HIV. Women are more likely (four to ten times) to contract HIV through vaginal intercourse, as there is more entry points for the virus in the female genitalia compared to men. Gender dynamics render women more vulnerable through discriminatory practices, lack of decision making power and unequal status in social or cultural affairs. Women are thus often placed in circumstances in which it is difficult to negotiate the terms or safety of sex.

Brain Gym

Brain Gym

brain gym

Education Category: Health
Ages: 4-8, 8-12, 12-16, 16+

Donated by Jeffrey

What do you need?
Motivated students

How does it work?
'Cross Crawl'
This exercise helps coordinate right and left brain by exercising the information flow between the two hemispheres. It is useful for spelling, writing, listening, reading and comprehension. Stand or sit. Put the right hand across the body to the left knee as you raise it, and then do the same thing for the left hand on the right knee just as if you were marching. Just do this either sitting or standing for about 2 minutes.

'Hook Ups'
This works well for nerves before a test or special event such as making a speech. Any situation which will cause nervousness calls for a few 'hook ups' to calm the mind and improve concentration. Stand or sit. Cross the right leg over the left at the ankles. Take your right wrist and cross it over the left wrist and link up the fingers so that the right wrist is on top. Bend the elbows out and gently turn the fingers in towards the body until they rest on the sternum (breast bone) in the center of the chest. Stay in this position. Keep the ankles crossed and the wrists crossed and then breathe evenly in this position for a few minutes. You will be noticeably calmer after that time.

“Figures of eight’’ 
This is excellent to stimulate both sides of the brain. Using the index finger of your left hand draw a large figure of eight in front of you. Practice a few times and then repeat using the right hand. Then repeat but complete figures of eight with both hands at the same time.

“Nose and ear swap”
Place one hand on the opposite ear and the other hand on your nose. On the given instruction swap your hands over but your hands must cross in the middle. It is really fun and if you’re an expert try it quicker (but don’t poke yourself in the eye). It can be carried out with a partner with your hands on their ear and nose!! Great fun!

“Tummy rub and head tapping” 
This is a well known exercise but is great for the coordination. In a circular motion rub your tummy and at the same time pat your head. Ensure it is two separate actions not both tapping or rubbing. Really funny to watch!

What else do I need to know? 
There is a lot of literature written on using both the left and right hand side of the brain to become stimulated. U can use this literature to come up with your own exercises and expand the brain gym.

What is the purpose of the game? 
We have provided a few brain gym activities in this pack. Brain gym activates the brain for optimal storage and retrieval of information. Every nerve and cell is a network contributing to our intelligence and our learning capability. Many educators have found this work quite helpful in improving overall concentration in class. There is a lot of literature written on using both the left and right hand side of the brain to become stimulated. I have limited experience in this reasonable new science but have a few fun energizers to use with the children.

What to do to stay healthy in quarantine times: 11 tips

What to do to stay healthy in quarantine times: 11 tips

So, the situation has escalated quite a bit over the past few weeks. Not just in Europe and Asia, but all over the world rules are implemented restricting people to go out, socialise etcetera. I, being a social little beast (which is a very strange translation of the Dutch expression "sociaal beestje"), needed to find some ways to adjust to the whole situation. But I have, and even though I miss my friends and family, staying indoors and in quarantine is much more important to me. So I thought I'd share my tips with you, to help you get through this time as well!

1. Learn to enjoy doing nothing

Nowadays we often have busy schedules; work, seeing friends, working out, trying new things, watching all series on Netflix, etc. I always feel like I have to try and do everything, and that if I spend a day doing nothing, I have wasted that day. This is something that really bothers me and I do not know why I feel like I must do something all the time. This quaranty time has really changed that. Now that I basically CANNOT do anything, it really has brought some breathing space into my life. This is also what I try to remind myself of, as to not become too negative. If there is one positive side to this whole situation, it is that I get the chance to reset my brain, to rediscover myself and my creativity and to rethink my life choices. That also brings me to my second tip: 

2. Discover your creativity

While I do not have a lot of free time, in the time that I have I try to find creative things to do and I really enjoy it. For example, I still had a lot of seeds that I planted in my garden, I picked up my tin flute again, my mum gave me a drawing book etc. One of the most important things in these times is to stay active and to keep stimulating your brain. Actually, challenging yourself is one of the best things to do! It also gives a rewarding feeling afterwards. Do not forget that there are a lot of things you can do without going outside. Make the most out of your time and try the things you have always wanted to do. Even on a low budget there is a lot you can do; buy things on second hand websites, facebook pages, look for things you can make yourself on Youtube, try to make fermented food, get a chess app to practice playing chess, etcetera!

3. Sports, sports, sports

Whatever you do, avoind becoming inactive! Stimulating your body by doing sports activates your immune system and helps you in fighting off diseases. Even if you are not a sports lover, there is still a lot you can do. There are so many fun, weird, exhausting Youtube videos for every level of sports. Give yoga a try, or karate training, or even a lindyhop dance class for example. If it is allowed and you are disciplined enough to abide by the rules, you can of course go for a run, bike-ride, rollerskating round, but always maintain enough distance from others and avoid busy areas. 

4. Contact your friends

Staying in touch with your friends and family is both important for you and for them! I actually feel like my relationship with my parents has become better over the past weeks since we have more time to call each other, message each other and send each other funny videos. With my friends I sometimes video call, but I also recently started a groupchat to find games to play together. On my birthday two days ago we already tried playing "The Jackbox" through screen sharing on Google Hangouts, and soon we will try "Who am I", but there are many other games you can play online together! 

5. Set a daily target

It might feel useless to be at home all the time, but it does not have to be! So set yourself a daily target! Targets can be anything; cooking a fresh meal, trying a new hobby, getting yourself out of bed, NOT watching Netflix all day. Try to find targets that are realistic and good for you. If you never work out for example, you do not have to set a target to suddenly work out for 1 hour a day, but you can also be proud of yourself if you only do five minutes of yoga! You can increase this target every day, find new targets, set more targets, play with this idea as you like!

6. Stick to a healthy routine

Try to stick to a healthy routine. This is very important to keep you active, healthy and happy! Get out of bed in the morning, make your bed, open the curtains, brush your teeth, eat breakfast (or the other way around), start working, hobbying, sports, whatever, go to bed and get enough sleep. Doing this will ensure you do not screw up your biological clock and it might actually feel quite rewarding as well! 

7. Focus on the positive things and do not focus on the news too much

The first weeks of quarantine I was addicted to checking the news. I watched everything on the news channels, listened to the news radio and checked the news app 10 times a day. This drained me, I felt all my positivity fly away with every news item I read. So I quit. Not entirely, but I dosed my news consumption to only around dinner times and to government briefings. Of course, I still worry about the people that work hard, and the people that are in a really tough situation, and I follow our government's rules, but I realised that becoming depressed myself was not helping anyone. So stay up-to-date, do what you can, care for other, but do not let yourself drown in negative news. Another way to avoid this is to find positive news. While the situation is currently super bad, and it might be hard to find positive things to focus on, it is still possible; better air quality, time to rethink your life, fewer deaths than yesterday (instead of "the total death toll has risen") and so on. 

8. Create a nice working environment

If you have to work from home, make a nice area for yourself where you can totally focus on work and where other things do not distract you. Work from a desktop or laptop with keyboard and mouse, put a nice plant on the table, a bottle of water and you can start working! Do not forget to take regular breaks though. For me a schedule helps to have things to look forward to. For example, after two hours of working, I have 10 minutes to check my phone and play wordfeud, after another 1,5 hours I have 30 minutes to have lunch, after another two hours I water my plants and sit in the garden for 5 minutes, one more hour of work and I can play wordfeud again and another hour of work and my working day has already finished! I also try to start early (8 o'clock) so that I have enough time in the afternoon to do fun stuff at home. 

9. Be honest about your feelings

Getting things off your chest is so important in these crazy times. Hardly anyone from our generation has experiences something like this, or knows how to deal with it. This can be super stressful, scary and lonely. It is important to talk to your friends about this. Let them know you feel alone, or feel stressed. Let them know you need someone you can call sometimes to talk about this, or to simply feel like you are still connected to other people. This is not strange, it is very normal and I can assure you, many people feel like this. If you have good friends they will understand you and probably love to help you out and call you a bit more. 

10. Eat healthy

This is always important, but especially when you are less outside, less active and your daily schedule is messed up or does not exist. Stick to a healthy, varied diet, take extra vitamins if needed, drink enough water throughout the day and so on. 

11. If you have depressed friends, call them

This last tip is a bit different from the other ones, it is a call for action. There are many depressed people in the world, and from my own experience I can say that even in normal times, this is a horrible feeling. Being depressed in times like this... well it only intensifies the feelings depressed people already had. It is therefore very important to stay in touch with them, help them, listen to them, motivate them. Really, I can assure you that it already helps so much when someones lets you know they think of you or that they wonder how you are doing. So maybe spend a bit more time on these friends, to make sure they are okay :). 

Well, hopefully this helps in getting you through these difficult times. If you have any tips to add, please let me know in the comments. Remember, stay healthy, follow the rules and keep an eye on the vulnerable. 

 

Lesson 1 on Healthy Nutrition

Lesson 1 on Healthy Nutrition

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Education Category: Health
Ages: 8-12, 12-16, 16+

This booklet guides health workers to educate children about healthy nutrition, in an appropriate way.

Note: the discription below describes lesson 1 of an educational program on healthy nutrition. In total the program comprises 5 different lessons, which are all available in the World School Bank. Please find the program's introducation as well as extra lesson 1 material attached.

Lesson 1 - Nutrition

Materials

  • Internet for the informative song
  • Chalk board or big sheet of paper
  • Markers

Preparation

  • Read through the lesson
  • Make sure you have enough knowledge on nutrition
  • Familiarize with the environment and society to see solutions
  • Video clip ready to show and know the content of the video

Lesson

What is nutrition?
The word nutrition is very vague for children. In this lesson, the main goal is to define to the children what nutrition is and why it is important for our bodies. Topics that are worth mentioning are attached to this program. The fact sheet that can be found in the attachment can be copied and handed out to the students. At the end of class, please hand out the strip-cartoon added as an attachment.

How can we influence our physical well-being?
Children at a young age are not aware of consequences of a bad diet or the positive effects of a healthy diet. You have to show them, in a playful manner, what they should consume and why they should consume those products. Show the video clip ‘Food Pyramid – Full Episode’:

To make the video clip easier to comprehend, the lyrics are added as an attachment. Copy these for the children. After showing the clip, make sure the message has come across and let the children discuss about what they have just seen. In this way, they will understand and remember it better.

How to Handle Stress

How to Handle Stress

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Stress

75 to 95 percent of visits to the doctor are for stress-related conditions

Allostatic load: a physiological and neurological state caused by your body being on constant alert. It damages your health and cognitive performance

  • Prolonged levels of high cortisol (stress hormone) in the bloodstream lead to shrinkage of the hippocampus, which is important for long-term memory and the intake of new information
  • Stress causes a reduction in serotonin in the brain, which can lead to depression and burnout
  • The more stress we perceive, the more overactivated our amygdala becomes. As a result, chronically stressed people become hypersensitive to any potential stressor

Key to emotional regulation: strengthening your ability to handle stress and training the conscious mind to control our primitive/automatic responses.

How to Handle Stress

  1. Sleep
  • Sleeping a sufficient amount helps us withstand stresses and aggravations
  • Sleep loss:
    • makes us more short-tempered, impatient, and moody
    • diminishes our ability to judge the emotions in other people’s faces
    • interferes with decision making, productivity
    • increases our risk of cardiovascular and gastrointestinal problems
  1. Exercise
  • Engaging in regular exercise:
    • Improves our cognitive test scores
    • Enhances our long-term memory, reasoning and attention
    • Makes us better at problem-solving and fluid intelligence tasks
    • Regulates the release of serotonin, dopamine, and noradrenaline
    • Eases depression and anxiety
    • Makes us less tense and more refreshed
  1. Nature
  • Time spent in nature can improve emotional regulation and diminish stress
  • Even sitting by the window, or looking at pictures of nature can make us feel more at ease
  1. Food
  • Change in nutrition changes our mental fitness
  • There are certain foods that enhance our emotional well-being:
    • Nutrient-rich vegetables and fruits
    • Healthy fatty acids, such as olive and canola oils
    • Protein in moderate quantities
    • Whole-grain complex carbohydrates, such as oatmeal
  1. “Acting as if”
  • According to the facial feedback hypothesis, our physical expressions send signals to our brains to produce the appropriate emotional response
  • Studies have found that by simply putting a pencil in our mouth and thus being forced to smile actually makes us happier
  • Expansive posture makes us feel more confident:
    • Crossing legs instead of keeping them together
    • Draping an arm over the back of a chair instead of placing hands under legs etc.
  1. Physical contact
  • Physical contact in general has been shown to reduce stress more than soothing words
  • Giving or receiving a hug can trigger a huge release of oxytocin
  • Even shaking hands can release a bit of oxytocin and make us have a greater sense of connection
  1. Deep breathing:
  • Deep breathing makes us more relaxed
  • How to do it:
    • Inhale through your nose
    • Use each new breath to expand your abdomen instead of your chest
    • When you exhale do it through your mouth, slowly
  1. Progressive muscle relaxation
  • This method strengthens our ability to recognize and remedy feelings of stress
  • How to do it:
    • Tense a muscle group in your body
    • Relax that muscle group
    • Move onto the next muscle group and repeat until you feel you have moved through all parts of your body
  1. Autogenic training
  • This practice increases our awareness and control of our autonomic nervous system, enabling us to switch from our sympathetic nervous system to the more soothing parasympathetic system
  • Ways to do it:
    • By sitting quietly and comfortably and focus on a sound, word, phrase or object
    • By consciously focusing on relaxing your body
    • By shifting your posture and moving around frequently
  1. Gratitude
  • A change in attitude follows a change in self-image and stress levels
  • Gratitude is about redirecting your attention, instead of suppressing something
  • 3 weeks of gratitude training has been shown to improve personal well-being, psychological health and to increase energy levels
  • Gratitude should be directed on people or things around us that make life better
  • A simple way to practice gratitude is by writing down 3 to 5 things each morning you are grateful for
  1. Building on Success
  • Approaching difficult tasks as challenges rather than threats has a positive effect on our emotions
  • How to do it:
    • Whenever you make a mistake, dismiss it as temporary
    • Gain support from someone you respect
    • Compare yourself favorably to your peers (“If they can do it, so can I”)
    • Celebrate your small victories
  1. Labeling and reframing
  • Acknowledging our feelings in words helps us regain control
  • Finding a way to interpret setbacks in a more positive way helps our emotional well-being

Based on the book: The Leading Brain: Neuroscience Hacks to Work Smarter, Better, Happier by Hans W. Hagemann and Friederike Fabritius

Childhood: Developmental Psychology – Article overview (UNIVERSITY OF AMSTERDAM)

Childhood: Developmental Psychology – Article overview (UNIVERSITY OF AMSTERDAM)

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This bundle contains a summary of all the articles that are needed for the course "Childhood: Developmental Psychology" given at the University of Amsterdam. It includes the following articles:

  • Bjorklund & Causey (2017). Biological bases of development” – Article summary 
  • “Kuppens & Ceulemans (2019). Parenting styles: A closer look at a well-known concept”. – Article summary 
  • “Taraban & Shaw (2018). Parenting in context: Revisiting Belsky’s classic process of parenting model in early childhood.” – Article summary 
  • “Tucker-Drob, Briley, & Harden (2013). Genetic and environmental influences on cognition across development and context.” – Article summary 
.......read more
Health care abroad: main content and contributions - Bundle

Health care abroad: main content and contributions - Bundle

How to avoid malaria, diagnose malaria and what to do during a long stay in a malaria area?

How to avoid malaria, diagnose malaria and what to do during a long stay in a malaria area?

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What do you have to know about malaria, mosquito's and prevention?

  • Mosquito stings spread the malaria disease.
  • Malaria is one of the most common causes of death in the world and exists in any (sub)tropical area.
  • Malaria is caused by parasites, plasmodium, which are being spread from human to human by a mosquito sting (it can also be spread by blood to blood contact of blood transfusion). These parasites first multiple in the liver and then in the red blood cells.
  • Not all forms of malaria are equally dangerous. Malaria tropica is the most common form of malaria and, in general, the most serious form. It is caused by a parasite, called the Plasmodium falciparum. If malaria tropica is treated properly a person will recover completely. If this disease is not treated on time a person can die in a couple of weeks (depending on the time of diagnoses, in some cases a person can die within a few hours)
  • If you take anti malaria tablets it will reduce the chances of getting malaria dramatically.
  • There are no malaria tablets that offer full protection. The chance that you get malaria while taking tablets is still there.
  • Avoiding mosquito stings will reduce the chance of getting malaria dramatically. You still have to take anti mosquito measures when taking malaria tablets.
  • Malaria is becoming more and more difficult to fight as mosquitoes are becoming resistant to anti-malaria means.
  • Cases of malaria usually occur with travelers (and people who mostly stay abroad) who take no (or insufficient) malaria medicine.
  • Most fatal malaria cases among travelers are caused by an incorrect or late diagnoses.
  • Malaria is extremely dangerous to pregnant women and children. Pregnant women are advised not to go to malaria areas.
  • Malaria does not occur above 2500 meters.
  • In certain countries there can be different malaria recommendations in different areas (such as Thailand, coastal areas much safer than the northern part)
  • Malaria mosquitoes are mainly active at night (although dengue mosquitoes are active during the day).
  • If you take a malaria tablet do keep in mind that you will have to take another dosage when you vomit within an hour.
  • For more information about Malaria please check the WHO, Malaria en de CDC website.
  • Don’t panic; almost every traveler will return home safe and healthy. Take the right precautions and enjoy your trip!

What is Malaria tropica?

  • Malaria tropica is the most dangerous form of malaria. If not treated properly it can lead to death in a couple of weeks. Malaria tropica is caused by a parasite, called Plasmodium falciparum. The fever attacks are unpredictable.
  • If you take the malaria tablets as prescribed, chances of getting malaria tropicana are very slim. When traveling through resistant areas you have to be aware that that malaria can still strike.
  • Malaria tropica is very common in areas such as tropical Africa, South East Asia and South and central America.

What is Malaria tertiana?

  • Malaria tertiana is a form of malaria caused by a parasite, called Plasmodium vivax and/or Plasmodium ovale. This disease is characterized by fever attacks that occur in frequent peaks of 48 hours. The parasites can stay in your liver and cause a “delayed first attack” months or even years later. Malaria tertiana can only be prevented by taking profylaxe.
  • Malaria tertiana can mainly be found in South East Asia, Central and South America and Ethiopia.

What is Malaria quartana?

  • Malaria quartana does not differ from malaria tertiana, except for the characteristic fever attacks that occur every 72 hours (instead of every 48 hours.) Malaria quartana is caused by a parasite called Plasmodim malariae and is a very rare disease.
  • At the moment Malaria quartana is prevented by decent malaria tablets.

What are the symptoms of malaria?

  • Malaria can occur as a severe attack of cold shivers and fever, but also as a feverish feeling with headaches, but without any clear fever. It usually starts as a fever attack, cold shivers, muscles aches and headaches. This symptoms will return frequently every few days, if the infection is not treated. It can also be accompanied with vomiting, diarrhea, coughing and jaundice.
  • It is very important to know that Malaria can spread to different parts of the body in as short as 24 hours!!! Any cold or fever that lasts longer than 2 days should be considered as malaria, until the contrary has been proven. If you think that you might have malaria you have to get your blood tested in the hospital or by a doctor. Malaria can be treated very well as long as it is discovered on time.

What are Malaria tablets (Profylaxe)

  • Which malaria tablets are most suitable for you depends on your destination and the period of your stay. There are different forms of malaria in each area and in some areas mosquitoes can be resistant to anti-malaria tablets.
  • Main Malaria tablets
    • Paludrine (Proguanil-hydrochloride
    • Nivaquine (chloroquine
    • Lariam (Mefloquine)
    • Malarone: (Combination of Atavaquon-Progunail)
    • Doxycycline:
    • Other
      • Fansidar: Not prescribed against malaria because of the serious side effects, but is still used to cure malaria.
      • Maloprim: Due to the heavy side effects only used as a spare remedy.
      • Halofantrine: Due to the side effects it is not used very often any more.
      • Quinine: Used as a treatment against malaria.
      • Artemesia annua (sweet wormwood) natural product available in many tropical countries. It has very little side effects, but it is not tested enough to pass western tests.
      • Qinghaosu: A natural product
      • Arteflene
      • Artemether
      • Artesunate

What to do during a long stay in a malaria area?

There are two options:

  • Keep taking malaria pills, especially Lariam is suitable for longer periods, if you don’t suffer from any negative side effects. This can be expensive.
  • Stop taking malaria tablets. If you do this you have to make sure to: avoid getting stung by mosquitoes. And make sure that you know where to find a doctor or hospital in case you get a malaria attack.
  • PS: Be aware that no matter how long you stay in a malaria area, you do not become immune to malaria. You always run the risk of getting malaria.
How to solve and prevent the 9 most common health problems during backpacking, living, studying, traveling or working abroad?

How to solve and prevent the 9 most common health problems during backpacking, living, studying, traveling or working abroad?

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How to solve and prevent the 9 most common health problems during backpacking, living, studying, traveling or working abroad

1. Acclimatize

  • What ever kind of medicine you take, do keep in mind that for hundreds and hundreds of years people still get ‘tropical frenzy’ (due to food, climate, tiredness, new impressions etc). Take into account that some people just cannot stand tropical conditions. This is something you don’t have to be ashamed about. On your arrival take it easy for a few days, so that you can adjust to the new conditions. Do not start doing heavy duties, make sure that you have a relaxed program.

2. Travel sickness

  • Anti-motion sickness pills are usually indispensable in every medical box, even though you think that you might never get nauseous. A bus ride through the mountains of Nepal, a boat ride in a tropical storm or a flight during rough weather can even break the toughest guys. Also the fact that you will be able to read a book on an eight hour bus ride on a winding road will make anti-motion sickness worth carrying with you.

3. Sun, Heat & Dryness

  • A basic rule for travelers who are going to travel to the tropics is that you need to drink a lot of water, this way you will avoid a lot of problems.
  • Make sure that you urinate enough. This is the best indicator for dehydration. Diarrhea is an important cause for dehydration. A package of Oral Rehydration System (ORS) can create miracles. If you suffer from dry eyes during your flight, bring some cucumber slices and put them on your eyes, or you can buy sleeping glasses/eye mask.

4. Sun allergies & Sun buns

  • In countries near the equator, such as Australia and Indonesia, there are very big chances of getting your skin burned. Every skin gets burned if it is exposed too much to the sun. How long it takes for this to happen depends on what kind of skin you have and where you are (in the mountains and around the equator the sun is much more there). The protection factor (Sun Protection Factor) mostly indicators how long you can stay under the sun. You can duplicate the time you would like to stay under the sun by applying more of the sun cream. During the first days your skin will get burned within 5 minutes without sun cream. If you use sun scream factor 15 than you can stay for about 75 minutes without getting burned to much. Do not take a lot of risk when you are traveling, for your own safety make sure you have done enough research. A backpack might not feel very nice when carrying it, if you are burned. When burned you consume more heat.

5. Sun stabs

  • This comes around because you are loosing a lot of moisture (without you noticing).

Symptoms:

  • Headaches
  • Dehydration
  • Nauseous / throwing up

Treatment to dizziness

  • Get the person out of the sun
  • Cool them down by giving them a cold shower.
  • Drink a lot, or use ORS.

6. Food

  • Do not eat vegetables or fruits that are not washed. You might come across it during your journey. You might consider the possibility of becoming a vegetarian or being very selective with where, when and what kind of meat you eat.
  • Make sure that you always have enough food when you are traveling (it can happen that during a slow bus ride, slow boot ride, closed shops or restaurants you find yourself short of food or drinks).

7. Drinking water & water purification

  • Purifying water has become less and less necessary. Even in the most remote areas, you can buy bottled water. They might not be cheap but water is some that you do not economize, especially in tropical areas, drinking water is very essential.
  • Are you going to the jungle or to mountainous areas, climbing a volcano or are you going to an island where they have limited water supplies, a water purification equipment is the best way to purify tap water.

How can you purify water?

  • Sodium is the best way to purify water, but it will make the taste different from normal water. Tincture of iodine (2%, 4 drops in a liter of water, wait for half an hour before you drink it). Note: Sodium for disinfecting water is not suitable for pregnancy. Chlorine purifies water from viruses and bacteria’s, but not from parasites.
  • Micro infiltration can be found in equipments where water is very shattered. Here the bacteria’s and parasites are caught. Because there are a lot of viruses that still stay behind in the water, micro infiltration is used to capture the remaining viruses that stay behind. A very popular combination is sodium resin and micro infiltration coal brush where the coal brush takes away the chemicals. With this combination also pregnant women can drink the water.

Tips:

  • When you have treated the water, pour it in a cup with a tea bag and let most of the dirt disappear.
  • To boil water abroad it is better to use kettle in combination with a cosmic plug. This way you can make a cup of coffee or tea.
  • When purchasing bottled water make sure that the seal has not been opened; it happens that people sell water that is refilled or water that is not pure for drinking. Try and buy water that have a seal on them.
  • Watch out for local drinks, it can happen that they are diluted with unpurified water.
  • If you have a drink that is open make sure that you have it with you at all times. When asking for ice blocks, first ask from what kind of water they have been made from or just ask for a drink without ice blocks. Freezing does not kill any kind of bacteria.

8. Infections, accidents, Wounds

  • If you are going on a trip to a remote and primitive area it is very convenient to have a variety of antibiotics with you. Discuss with your doctor which ones are the best to take with you.
  • Small skin wounds can grow into a bad infections in the tropics. Treat every wound that you might get very well. Protect infected wounds well from any type of bacteria. If the wound is still there after a couple of days it best to take antibiotics. Watch out for wounds that have been caused by chorister, because this can slowly lead to a very bad infection. Clean it very well and make sure that you get rid of all the chorister that is there.

9. Ticks

  • If you are going to travel in Europe, be aware of ticks. Ticks can be found in forests, gardens and on the beach and can bite into your skin. If a tick is long enough on your skin, you can obtain diseases such as the Lyme disease, CEE or RSSE encephalitis, Ehrlichiose and Fièvre boutonneuse.
  • You can protect yourself from ticks by wearing long sleeves and pants and by using anti-tick spray on non-covered body parts. Always check yourself after spending a day in the forest or on the beach, as young ticks can only be 1 mm.
  • In case you find a tick on your body, remove it with a special tick picker or a tick spoon. Make sure to not damage the tick, as the tick can still inject its poison into your skin. Do not treat the tick with oil or alcohol. However, after you have removed the tick with a picker, you should disinfect your skin with alcohol. If you do not have a tick picker or spoon, you should remove the tick by softly making circles on the tick with a wet finger. After a few minutes the tick will let go of your skin. Make sure to kill the tick between your nails, because the tick is not dead yet.
  • If you have removed the tick within 24 hours, without damaging it, the chances for Lyme disease are small. In case a red circle is developing around the bite, or if you are experiencing symptoms of Lyme disease (head ache, stiff neck, fever etc.), you should contact a doctor.
  • A vaccin excists against CEE or RSSE encephalitis . In some European countries this is even part of the national vaccination program.
How to stay healthy when you are backpacking, living, studying, traveling or working abroad?

How to stay healthy when you are backpacking, living, studying, traveling or working abroad?

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What are the main remarks about staying healthy abroad?

  • Staying healthy during your trip to a foreign country is very important. For each trip you need to think what kind of medicine you have to bring and which extra measures you have to take to stay healthy.
  • Vaccines are not perfect. New vaccines are constantly being released but diseases continue to evolve
  • Some vaccines require a long period to take effect, but it is never too late to vaccinate
  • Health risks within a country can vary from locality to locality and local authorities may be slow to announce outbreaks of disease
  • Common infections contracted by travelers include those which follow contaminated food or water. Find out whether tap water and local food is safe to consume before you depart
  • There are a number of mosquito-born illnesses you can contract while overseas particularly in tropical areas. Be sure to take measures to avoid being bitten such as wearing light colored, loose fitting clothing that covers your arms and legs, regularly applying an appropriate insect repellent and staying in mosquito proof accommodation.
  • Travel websites, such as Lonely planet or Footprint, have useful health information as well.

How can you plan and organize that you stay healthy abroad?

  • The World Health Organization (WHO) recommends that all travelers should be covered from diphtheria, tetanus, measles, mumps, rubella and polio, as well as Hepatitis B, regardless of their destination. Since most vaccines don’t produce immunity until a couple of weeks after they’re given, it is advised to visit a physician a couple of weeks before you travel.
  • Make an appointment with your doctor or travel clinic to have a basic check-up and find out if any vaccinations or health checks are required at least 6-12 weeks before you depart.
  • Not all travelers to countries where there is a potential risk of infection need to be vaccinated but it is important that you discuss your personal travel plans with a doctor so they can determine the correct vaccinations for your trip.

How can you travel with medicine?

  • Before leaving home, you should check that your medications are legal in the country you are visiting. You can do this by contacting the country’s embassy or high commission or by looking at official websites.
  • Since the National Health Act was amended in 1999, it is an offense to carry or post Pharmaceutical Benefits Scheme (PBS) medicines overseas unless they are for your personal use, or the use of someone traveling with you.
  • There are restrictions on the amount of PBS medicine that can be carried or sent overseas. When planning to travel overseas with PBS medicine it is important that you:
  • Talk to your doctor and discuss the medicine you will need to take (if you need to take any medicine at all).
  • Carry a letter from your doctor detailing what the medicine is, how much you will be taking, and stating that it is for your own personal use.
  • Leave the medicine in its original packaging so it is clearly labeled with your name and dosage instructions.
  • If you intend to travel with large quantities of medicine, including over-the-counter or private prescription medications, you should ask your doctor, dentist or pharmacist to provide you with a letter explaining why you need to carry such quantities.
  • If you have to inject your medication it might be preferable to carry your own needles and syringes but you should check with the embassy or consulate of the country you are visiting to make sure that this is acceptable. If you buy needles and syringes while overseas, be sure that you buy packs that are sealed and sterile. If you need to carry needles and syringes with you on the plane, inform your airline before you travel and if necessary, arrange a letter from your doctor explaining why you need to carry them.
  • It is important to be aware that some items purchased overseas may be packaged under a different brand name to those of the country of your destination. Keep an eye on the strength and active ingredients of similar-sounding medications overseas, they can vary.

 

Staying healthy abroad and health insurances abroad - WorldSupporter theme
What are the most common vaccinations when you you are backpacking, living, studying, traveling or working abroad?

What are the most common vaccinations when you you are backpacking, living, studying, traveling or working abroad?

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When to get vaccinations for yellow fever when you go abroad?

  • Yellow fever is a potentially fatal disease carried by certain mosquitoes in parts of South America and Africa. If traveling to these areas you should check with your travel clinic or doctor whether a vaccine is required. Yellow fever vaccine is only available from approved medical practitioners and must be given at least 10 days before traveling to infected areas.
  • Yellow fever is contagious and can be spread by infected travelers, so if you are traveling to a country where yellow fever is a risk, you may need a certificate showing proof of yellow fever vaccination. Without this certificate you may be refused entry to some countries, or required to be vaccinated upon arrival.
  • If you have stayed overnight or longer in a declared yellow fever infected country in Africa or South America, within six days prior to your arrival, you will require a valid international yellow fever vaccination certificate.
  • The World Health Organization closely monitors reports of yellow fever infection and periodically publishes a list of countries where the disease occurs.

When to get vaccinations for diphtheria, tetanus and polio when you go abroad?

  • Vaccination and validity: always recommended for far away destinations and Eastern Europe (also in East Europe)
  • Last minute travelers (=two weeks before departure) who have not received a standard vaccination before: 2 weeks before leaving there are 2 possible injections left. They protect you for a maximum period of 8 months.
  • Last minute travelers who are not going to diphteria endemic areas: If the trip is shorter than two months it is not necessary to get a DTP vaccination, except for persons who have never received the vaccination before. If your trip is shorter than 8 months only persons who have received just one DTP vaccination need an extra one.
  • Background information: Diphtheria is a common disease in certain countries. This bacteria can cause a seriously swollen throat that makes it more difficult to breathe. If this bacteria gets into the blood it can infect the heart and can lead to death. The bacteria can also cause serious skininfections, although this form of dipthteria is less serious. It is highly recommended get a vaccination against this disease.
  • Tetanus is found everywhere around the world. You can get this disease through street dirt, soil, manure or dust getting in a wound. When this happens the poison substances can cause the muscles all over your body to cramp. It can even cause breathing problems leading to death. A vaccination again tetanus every 10 years is recommended.
  • The polio virus is highly contagious. It is passed on through faeces, contaminated food or drinking water. Polio is very common in places of less hygienic places, such as certain areas in Asia and sub-Saharan Africa. Contamination with the polio virus can cause permanent paralysis of the muscles. If it has been more than ten years since you have had your last vaccination against polio you need another vaccination before you leave.

When to get vaccinations for hepatitis A when you go abroad?

  • Vaccination and validity: Recommended when traveling to almost every far away destination. The gamma globulin injection is only effective for a few months and works passively. Nowadays you can also get a vaccination called Epaxal. It works actively for a minimum of 10 years and maybe longer. You can also get a vaccination of Hepatitis A+B (Twinrix) all at once.
  • Background information: Hepatitis is a liver infection caused by bad hygiene or transmitted by infected water or food. It does not only exist in the tropics, but also in Turkey and East Europe.

When to get vaccinations for stomach typhus when you go abroad?

  • Vaccination and validity: Often recommended for Asia and Latin America. There is a medicine that you can swallow and an injection.
  • Background information: It is a life threatening disease of the gastro-enteric channel. This disease is caused by the Salmonella typhus bacteria. This is an infection related to bad hygienes. If you have had your vaccination, it will only protect you for about 70-90%. Therefore, you still need to be careful with what you take in.

When to get vaccinations for hepatitis B when you go abroad?

  • Vaccination and Validity: a form of jaundice. Only high risk groups, (such as doctors, certain expats, and people who have intercourse with different partners) and travelers who are traveling longer than three months in an hepatitis B area need to get this vaccination. It is also possible to get the vaccination for Hepatitis A+B at once.
  • Last minute: It is possible to get an accelerated injection, although this does not give similar protection.
  • Background information: Hepatitis B is caused by a virus spread through blood to blood or through sexual contact. For example non sterile applied piercings, tattoos etc.

When to get vaccinations for Japanese encephalitis when you go abroad?

  • Vaccination and validity: Recommended for people who are going to the countryside in the area between India and Japan.
  • Background Information: Japanese encephalitis is a virus infection that is spread by by mosquitoes. People who are staying on the the countryside for a longer period during the season when the disease is spread run a higher risk.

When to get vaccinations for tuberculoses (TBC) when you go abroad?

  • Vaccination and validity: sometimes recommended to people traveling for a long time to areas where TBC can reign.
  • Details: The procedure is very complicated. Therefore, consult your personal doctor.

When to get vaccinations for rabies when you go abroad?

  • Vaccination and validity: Only recommended to around the world travelers and expats.
  • Details: expensive vaccine

When to get vaccinations for meningitis when you go abroad?

  • Rarely given vaccination and hardly ever recommended

When to get vaccinations for cholera when you go abroad?

  • This vaccination is very rarely given, but some countries do ask for a vaccination stamp. This stamp is available at any vaccination institute.

 

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