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A diverse look at global health issues.

How India's hospitals fall short, in photos

Across the country, many urban hospitals are under-staffed and under-resourced—unable to meet patient demand. Photographer Sami Siva documents the challenges.

WEST BENGAL, India —Across the country, access to health care is still a challenge for many people. Most government-run primary health centers in rural areas lack good hygiene, infrastructure and the medical staff to provide first-rate treatment for patients. Such shortcomings result in the overcrowding of hospitals in urban areas. In cities like Calcutta, the bigger hospitals face such an overwhelmingly high number of patients that they have insufficient doctors and resources to provide good medical care.

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Sending deepest thanks to 18 strangers whose blood saved my life

Commentary: World Blood Donor Day is June 14. Just 8 percent of Americans eligible to give blood do so each year.
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Bags with human complete blood are filtrated and scanned at the production and logistics center of the Bavarian Red Cross (BRK) blood donation service in Wiesentheid, southern Germany, on July 24, 2012. (AFP/AFP/Getty Images)

LONDON — Donating blood is, for the most part, a comfortable experience. The clinicians are friendly. The chairs are soft. You get cookies. You get stickers. You get endless compliments on your veins.

It’s so easy to give blood that I fear it may lull donors into thinking of their gift as an anodyne act of do-goodism, the human tissue equivalent of chucking a Pepsi bottle into the recycling bin. It’s not.

Having recently been at the other end of this particular supply chain, I’d like to offer some perspective on how much these pints matter.

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Heroin epidemic takes hold of people—and politics—in India’s Punjab state

A widespread problem, with official estimates that more than 50 percent of youth are using drugs, is finally triggering government action.
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(Emily Judem/GlobalPost)

AMRITSAR, India — On a recent sweltering summer day, 27-year-old Gaurav Sharma tossed and turned on a small bed in the corner of a well-lit room. He buried his face in the pillow to try and forget the aches in his legs. A plaque hanging on the wall behind him spoke to his anguished state: “Drug addicts are not bad people who need to be made good, they are sick people who need to be made well.”

Sharma had not had any heroin for 24 hours. The withdrawal symptoms had begun.

“When it is really bad, it feels like I’m drowning and can’t breathe,” he said.

Drug use has become an epidemic here in the city and throughout the northern Indian state of Punjab, with officials estimating that more than 50 percent of people between 18 and 35 are using illegal drugs, including heroin and prescription opiates. More than two-thirds of the state’s rural households have at least one drug addict. 

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Partnering to protect women from HIV

Guest post: Women and girls continue to bear a disproportionate and unacceptable burden of HIV. A new public-private partnership could ensure they have the tools to protect themselves from infection.
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New HIV prevention technologies on the horizon, pursued in the new public-private partnership by International Partnership for Microbicides and the Janssen Pharmaceutical Companies of Johnson & Johnson, include monthly rings and gels that deliver ARVs and that could be combined with contraceptives. (Andrew Loxley/Courtesy) (Andrew Loxley/Courtesy)

The world is making tremendous progress to curb the course of the global HIV/AIDS epidemic. Since peaking in 2005, AIDS-related deaths have decreased by nearly one-third, and new HIV infections in children have fallen by more than half since 2001.

But not everyone is benefitting equally from these advances. Women and girls continue to bear a disproportionate and unacceptable burden of the disease. A new public-private partnership agreement announced last week between our organizations – the International Partnership for Microbicides (IPM), a nonprofit product developer, and the Janssen Pharmaceutical Companies of Johnson & Johnson, a major research-based pharmaceutical company – could help address this and ensure women have the tools to protect themselves from infection.

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How do journalists and policy analysts choose what to cover in global health?

Deputy editor Marissa Miley joined a panel discussion about “the story behind the story” for global health reporting at the annual meeting of the Consortium of Universities for Global Health.
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Elina Makopo, left, and her 12-month-old daughter, Jane, visit with community health worker Elizabeth Kafumo at the Kamupundu Primary Health Care Unit in Lufwanyama, Zambia. (Marissa Miley/GlobalPost)

WASHINGTON — How can a start-up global health NGO get its work featured in the press?

(Answer: Don’t use “academese,” but do send your peer-reviewed paper.)

How can medical students seeking to do video reporting get their foot in the door?

(Answer: Pick a narrow topic, make sure editorial and technical standards are up to par.)

And why doesn’t veteran reporter Don McNeil tweet? (Answer: He’s concerned his candor would be too much.)

These were among the questions raised by audience members at a panel discussion called “How the Media Chooses Global Health Stories” held on Monday at the Consortium of Universities for Global Health (CUGH) meeting

It’s not often I get the chance to step outside of my day-to-day role as journalist and editor to reflect on how I cover global health—or to connect with those who are making similar editorial decisions every day. But participating in the panel, I was able to do just that.

Joining me for the discussion were New York Times global health correspondent McNeil, NPR senior health editor Joe Neel, and Kaiser Family Foundation director of global health and HIV policy Jen Kates. The conference was organized by CUGH, a coalition of universities seeking to share expertise and best practices in order to better address global health problems.

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International Nurses Day: A time to call for medical neutrality

Commentary: It's time that the world’s health organizations and governments adopt and implement protections for all medics — demanding medical neutrality bylaws and amendments to the Geneva Convention of 1948.
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(Emily Judem/GlobalPost)

MANAMA, Bahrain — In February of 2011, when the Bahraini government violently cracked down on peaceful pro-reform protesters in Pearl Roundabout, I immediately knew what I had to do.

As a nurse who had spent 18 years training and working in the United States, I decided to go and assist in the emergency room at Salmaniya Medical Complex, the main public hospital, which was flooded by injured protesters hurt by government forces during the demonstrations. Although, at the time, I was an assistant professor and head of an emergency nursing program, president of the Bahrain Nursing Society and not a staff member at Salmaniya, I saw that the doctors needed all the help they could get.

Many of my colleagues and I could not have known that our decision to uphold our medical duty would place us in danger. Several weeks later, I was blindfolded and handcuffed upon entering a government building. During the nightmare days of my five months of detention I was beaten, shocked with stun guns, sexually harassed and threatened with rape.

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A Daughter's Journey: Reflections on Mother's Day

Moms making a difference when it comes to HIV
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(Emily Judem/GlobalPost)

I remember the day my mom died. The night before, we’d fallen asleep together in her room. I was wrapped up tight in my Princess Jasmine sleeping bag at the foot of her bed as she slept delicately next to my grandmother.

Then everything changed.

I woke up the next morning in a panic on the floor of my own bedroom, still zipped in my sleeping bag, while my dad slept on my bottom bunk. When I got up and ran for the door my dad suddenly awoke. He tried to stop me, but before he could say a word, I’d already run down the hallway into my parents’ room. She wasn’t there. I stared at her empty bed for what seemed like forever.

No one had to say a word. I knew she was gone.

Today is Mother’s Day. It is also my 25th birthday. And it is 20 years since I stood in the doorway of my parents’ bedroom not understanding why my 35-year-old mother had just died from AIDS.

Even now I can’t say that I fully understand why she died or why my father and I are HIV free, but I can say that I am learning to answer questions about the life my mother may have lived had she been diagnosed at a time when HIV wasn’t a death sentence.

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How humanitarian crises impact maternal and child health

This year's Save the Children's State of the World's Mothers report profiles four countries — including the US — that have seen particularly poor health outcomes for the most disadvantaged women and their children following crises.
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Women hold babies in their arms at the maternity ward of Binza, outside Kinshasa, in The Democratic Republic of Congo. (Junior D. Kannah/AFP/Getty Images)

It’s not often that you see the United States grouped together with the Democratic Republic of the Congo, Syria, and the Philippines – particularly when it comes to health care.

But in the 2014 Save the Children’s State of the World’s Mothers report, published Monday, those four countries were the featured subjects of an in-depth look at how humanitarian crises are negatively impacting maternal and child health.

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When life-saving surgery turns life-threatening

Of the 234 million major surgeries that occur around the world each year, 31 million lack a simple, but crucial, device to monitor blood oxygen levels.
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(Emily Judem/GlobalPost)

AMRITSAR, India—On my first day in an operating room as a medical student here in my home city in 2007, I studied our professors as they prepared a 34-year-old man for shoulder surgery. As part of the pre-operative steps, I watched closely as the anesthesiologist clipped a small sensor on the patient’s fingertip, and within seconds a nearby monitor lit up with a blue line and the number 97.

The simple clip, called a pulse oximeter, was checking the level of oxygen in the patient’s blood and would sound an alarm if it detected even a minor, unsafe change—typically, anything below the number 95, which reflects the blood oxygen saturation level. Dips in blood oxygen are risks during surgery because there is a change in the normal mechanics of breathing, especially with a co-existing illness. In school, we had learned that brain damage and heart failure could occur after just three minutes of severe lack of oxygen, usually below 85 percent, leading to permanent damage or even death.

Early detection was critical, and this device did the job.

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Curbing the HIV/AIDS epidemic one wall post at a time

How a new wave of public health workers is using social sites like Facebook to reach communities at risk for transmitting the virus.
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The Facebook and WhatsApp app icons are displayed on an iPhone on February 19, 2014 in San Francisco. (Justin Sullivan/Getty Images)

“Despite 30 years of living with HIV within the gay community there is still MAJOR stigma attached to being poz from neg guys…Welcome to the Scarlet ‘H.’”

“I agree [testing] is a personal responsibility, but on some level I feel it is a social one as well… Let’s just do it!”

“Hope everyone had a ‘safe’ weekend!!! What’s up with this weather?”

These aren’t the usual posts you might see on your Facebook wall when you log in, but for some health professionals and populations at risk for contracting HIV, these conversations are becoming the norm.

While outreach to online dating sites for people who are HIV positive, such as H-YPE, PositiveSingles, and PositiveSaathi, is not new, increasingly, public health researchers and activists are turning to social media sites like Facebook to reach communities at high risk for transmitting the virus.

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