BlessWorld Foundation International

Affecting the World Through Health
A Global Health Initiative

Archive for September, 2018

Conflict can be described as a form of dissonance or disharmony arising within or among groups as a result of differences and disagreements regarding beliefs or actions. When conflict arises within a group, it is termed intragroup conflict while conflict among two or more groups is called intergroup conflict. Conflict usually involves violence, interpersonal discord, and often follows a particular course. In the face of conflicts, routine group interaction is interrupted due to differences of opinion or other types of disagreements between members. These threaten the unity of the group- and may cause separation, alliances or violence. The effects of conflict on human health can be broad and devastating- including:

  • Direct physical impact or injury from fighting
  • Indirect morbidity and mortality as a result of collapse or deterioration of public health
  • Psychological and emotional effects of conflicts which have long-term effects on quality of life, disability, and survival.

Democratic Republic of Congo (DRC) is a case at hand, vividly illustrating how conflict cripples the healthcare system and consequently, the health of the populace. The country which was once known for its network of clinics and quality health care professionals has been experiencing political and economic downfall for the past three decades. Currently in DRC, hospitals and clinics have zero to limited qualified healthcare professionals as well as insufficient equipment, medicine and other medical supplies. Life expectancy is below average and government expenditure on health per capita remains one of the lowest in the world. Consequently, about 70% of the population lack or have limited access to health care. Malnutrition rate- both chronic and acute has remained over 43% for up to 2 decades and is reflected in the stunted growth and wasted look of many children. Additionally, approximately 39% of younger women anemic and about 14% are underweight. Needless to say, infectious diseases remain a major health problem with malaria resulting in an estimated 40% of outpatient visits, and causing nearly 1 in 5 deaths of children below 5 years of age. DRC has the 2nd and 6th highest global cases of malaria and Tuberculosis respectively, singlehandedly accounting for 11% of the global burden of malaria in 2013.

Improving the health care system is essential to improving the health of Congolese citizens. DRC has recently made significant progress following enhanced leadership and investments in priority health issues by the government and international partners. In general, the number of children between 12 and 23 months who received all recommended vaccines moved up from 31% in 2007 to 45% in 2013. From the year 2007 to 2013, the mortality for children below the age of 5 reduced from 148 to 104 deaths per 1,000 live births. The country has also been polio-free for over three years- a worthwhile progress given the conflict in the country.

Spirituality is a universal human experience which acknowledges the existence of a spiritual being- a higher power that is believed by many to give life a meaning; bring forth hope for an after-life and offers peace of mind or general wellbeing of the soul. It refers to all efforts to discover purpose and destiny in relation to a sacred or significant being which may have a secular, religious, philosophical, humanist or personal facet. More so, spirituality and spiritual activities are rooted in values, beliefs, practices and philosophies that may impact peoples’ cognition, emotion, and behavior. Most people connect spiritually through religion and religious objects viewed as sacred or through a deep sense of awareness and consciousness. Others feel connected to spirituality through music, arts, values, moral principles or nature. It is believed that spirituality is related to- and in fact, plays a role in quality of life, wellbeing, health and wellness. However, the exact means by which spirituality relates to health unclear; except for the wide-held belief that the spirit, soul, mind and body are connected, and that the wellness of any one of them seems to affect the other significantly. It is believed that spirituality is beneficial for health and healing possibly because it teaches abstinence from unhealthy behaviors such as smoking and excessive drinking.

According to some research, there exists a link between beliefs and sense of well-being. More specifically, positive beliefs and energy as well as the comfort, and confidence conferred by spirituality through religious acts such as mindfulness meditation, yoga, rituals, prayer and religious activities promote healing, contribute to general well-being and may improve mental health. They may also prevent some health problems, promote a feeling of wellness and help one cope better with ill-health, stress or loss.

Mind-body medical research, a field that focuses on the complex relationship between social and spiritual elements and their influence on health and disease, involves investigating and promoting positive spiritual coping strategies used by patients to manage stress and disease. Despite the several published studies examining the connection between spirituality and health, outcomes have remained multifaceted and complicated with methodological controversy due to confounders including specific attitudes, behaviors, beliefs, emotions and practices unique to individuals.

Research suggests that individuals who participate in spiritual activities or acknowledge that spirituality is a source of strength and comfort are healthier and may possess greater healing capabilities. Additionally, some studies report positive associations between spirituality and life expectancy, decreased rates of stroke, cancer, cardiovascular disease, hypertension, drug abuse, suicide, and general mortality. To improve the benefits of spirituality to health, one must identify and spend time in the activities that foster a sense of inner peace, comfort, strength, love, and connection. Some of these activities may include selfless community service, volunteering, praying, meditating, singing devotional songs, reading religious books, watching inspirational videos, taking nature walks, having quiet times, thinking, yoga, playing sports, fellowshipping with people of the same faith, travelling and attending religious services. Noteworthy, it is important to share one’s beliefs with his/her physician, especially when being treated for a specific illness. This is because spiritual activities may influence feelings, understanding, decisions and adherence to instructions or medications in medical situations. Due to the complexity of spirituality-health relationship, an interdisciplinary perspective is required for further research and clinical care

Undoubtedly, commitment to the global prevention and control of HIV/AIDS pandemic continues to increase with great significance in recent years. However, the virus has remained persistent in spreading- almost to the point of ridiculing the much effort and work put into its control. According to a report by UNAIDS, an estimated 40 million people were living with HIV infection or disease by the end of 2005; a notable increase compared to the about 35 million people living with the virus in 2001. Additionally, about 5 million new HIV infections and 3 million AIDS deaths occurred in 2005- much more in both cases when compared to the previous years.

Despite these discouraging statistics about the rapid spread of HIV, some countries have achieved significant progress through successful projects and programs in reducing this spread and transmission. The much effort and corresponding progress of HIV prevention and control is demonstrated by the many success stories and programs in different countries and regions across the world:

  • Thailand’s 100% condom program
  • Uganda’s remarkable decrease in HIV prevalence
  • Tanzania’s community-based management of sexually transmitted infections (STIs)
  • Development and effective use of highly sensitive and specific HIV screening tests, which have nearly eliminated blood infection in the developed world and in some parts of the developing world
  • Introduction of anti-retroviral drugs (ART) in the late 1980s which commenced a revolution in the management of HIV that can be compared to the advent of penicillin in the 1940s
  • Administration of ART to mothers during labor and to newborns post-partum which reduces the risk of mother-to-child transmission (MTCT) by about 47%
  • Use of combination ART, which is much more effective than mono-therapy
  • Decrease in the cost of antiretroviral therapy in developing countries, prompting its expansion through the public sector

Good as the many success stories and achievements in HIV/AIDS prevention and control seem, a few woes, challenges or drawbacks are not lacking. Some of these obstacles include:

  • Viral mutation: Mutations in HIV type 1 are a major impediment to the achievement of successful treatment and the development of vaccines. Although treatment has made long-term suppression of HIV a reality, drug resistance, drug toxicity, drug penetration and poor adherence to therapy are some of the most significant challenges that hinder cure and eradication of the virus.
  • Lack of access to services: Irrespective of the progress in treatment of HIV, global efforts have not proved adequate to control the spread of the pandemic or to extend the lives of those infected. The desired level of success has not yet been achieved because many people who could benefit from available HIV control strategies and services; including treatment, lack access to them.
  • Lack of Rigorous Evaluations: In addition to the above mentioned challenges, lack of reliable evidence to guide the improvement and selection of interventions for specific areas or populations has remained a barrier to effective HIV/AIDS control.
  • Funding cuts: UNAIDS and the US-based Kaiser Family Foundation report that international AIDS funding was stagnant at $7.6 billion in 2009- the first year ever without an increase. More so, the funding for 2010 further declined, showing an actual drop from 2009 levels, the first significant decline in AIDS donor funding since the beginning of the pandemic.

It is important to continue studying and understanding the factors that place individuals and populations at risk of HIV as well to identify safe, acceptable, accessible and cost-effective interventions that can be implemented and evaluated for improvement. It is only through a continued commitment to HIV research, prevention, treatment and control that this generation can conquer the HIV pandemic, and declare it history.