Paddling trip = 13 nights; 14 days (or 164.5 km total and 40.865 km portaging) across Algonquin park
Here is the route we will take heading West to East.
pbjpaulito's posterous
Planning the Rest of Your Life
Conflicts, Contagions and Catastrophes: The Epidemiology of Disrupted Environments
Conflicts, Contagions and Catastrophes: The Epidemiology of Disrupted Environments
Independent Reading Elective – Clerkship Block
Duration: 1 week (February 28th – March 4th, 2011)
Define Catastrophes (i.e. compare and contrast man-made versus natural
disasters/ hazards). Define Contagions (Diseases caused by Viruses,
Bacteria, Parasites or Helminthes). Define bio-surveillance and
epidemiological monitoring and reporting. Investigate how the
coordinated response between State and non-state actors such as Aid
organizations/NGOs. Investigate the leading causes of morbidity and
mortality in disrupted environments.
Learn about key public health and humanitarian measures to prevent and
treat the above causes of morbidity and mortality in affected
populations. I will read from a list of relevant textbooks, journals
and humanitarian/disaster response manuals. I will use a resource list
approved by Dr. (Blank) and discuss what I have read with her after
the completion of the elective.
Potential Reading List (in no particular order) The Public Health Consequences of Disasters [Hardcover]
Eric K. Noji War and the Health of Nations [Hardcover]
Zaryab Iqbal War and Public Health [Paperback]
Barry S. Levy, Victor W. Sidel War and Public Health. Handbook on War and Public Health [Paperback]
Dr. Pierre Perrin War Epidemics: An Historical Geography of Infectious Diseases in
Military Conflict and Civil Strife, 1850-2000 (Oxford Geographical and
Environmental Studies) [Hardcover]
M. R. Smallman-Raynor, A. D. Cliff Innovation in Global Health Governance: Critical Cases Edited by
Andrew F. Cooper, The Centre for International Governance Innovation,
Canada and John J. Kirton, University of Toronto, Canada Partner to the Poor: A Paul Farmer Reader (California Series in Public
Anthropology) [Paperback] Paul Farmer, Haun Saussy, Tracy Kidder AID WORKER'S HANDBOOK 2007 - Fondation Médecins Sans Frontières Centre
de réflexion sur l’action et les savoirs humanitaires (CRASH)
SALVADORAN REFUGEE CAMP IN HONDURAS (1998)
Binet, Laurence October 2003 FLU: FROM UNCERTAINTY TO ILLUSION...
Bradol, Jean-Hervé July 2009 Statement by James M. Wilson V, MD1 Before the Senate Homeland
Security & Government Affairs Subcommittee on Oversight of Government
Management, the Federal Workforce, and the District of Columbia
October 4, 2007.
1Research Faculty of Department of Pediatrics and Director of Division
of Integrated Biodefense, Imaging Science and Information Systems
(ISIS) Center at Georgetown University Statement by James M. Wilson V, MD Chief Technical Officer and Chief Scientist
Veratect Corporation Before the House Homeland Security Committee July 16, 2008 Global Public Health Intelligence Network (GPHIN)
http://www.phac-aspc.gc.ca/media/nr-rp/2004/2004_gphin-rmispbk-eng.php Tool Kit Pandemic Influenza Exercise for the Health and Emergency
Social Services Sectors
http://www.phac-aspc.gc.ca/publicat/2008/influenza_et-bo/pdf/influenza_et_bo-... Public health management of disasters: the practice guide Landesman,
Linda Young The Public health consequences of disasters, 1989
Gregg, Michael B. Centers for Disease Control (U.S.) Public health & preventive medicine 15th ed.
Kohatsu, Neal. and Wallace, Robert B., Oxford textbook of public health 5th ed. Detels, Roger. Oxford ; New
York : Oxford University Press, 2009. Concepts of epidemiology: integrating the ideas, theories, principles,
and methods of epidemiology Bhopal, Raj S. Oxford ; New York : Oxford
University Press, c2008. Risk mapping of Rinderpest sero-prevalence in Central and Southern
Somalia based on spatial and network risk factors. BMC Veterinary
Research 2010, 6:22. Angel Ortiz-Pelaez, Dirk U Pfeiffer, Stefano
Tempia, F Tom Otieno, Hussein H Aden and Riccardo Costagli (PDF)
Honduran Public Hospitals
Newly created map of public hospitals in Honduras.
Fools Rush In
Yesterday I spent the evening listening to Rex Murphy on CBC's Cross Country Checkup. The topic this week was "Haiti one year later: Has progress been too slow?"
The program asked the following questions: What happened? How could the best intentions of so many, amount to so little? Has progress been too slow?I was amazed by the number of calls from ordinary Canadians who have recently been to Haiti to work with various NGO/Charitable groups to provide aid/assistance to Haitians. It reminded me of the similar influx of charitable groups into Honduras after Hurricane Mitch in 1998, Indonesia after the 2004 Tsunami, and Pakistan after the 2010 Floods.While some of the callers were highly skilled in their respective fields and veterans of other humanitarian missions after natural disasters, the vast majority were not. Most were ordinary Canadians who felt compelled to act. Some callers talked about providing money, others talked about providing materials (shoes, books, tarps, toiletries etc) still others talked about providing their time by going to Haiti to volunteer.
I couldn't help but be somewhat sceptical about the impact of these short term volunteer "humanitarian" missions. Don't get me wrong there is a time and place for humanitarian emergency relief operations, but I tend to think that often in these crisis situations the old adage "many hands make light work" might be somewhat misleading. There are countless stories of conflict amongst NGOs (large and small), poor communication and at very worst poorly prepared "humanitarians" becoming victims themselves. I find myself wondering about the net impact of these types of short term missions to countries and regions in crisis. In situations where it is difficult enough to feed/cloth and shelter the local populations, is it really appropriate to embark on a short term volunteer mission? I do not mean to be critical of the countless numbers highly qualified and expert Search and Rescue Personnel, Doctors, Nurses, Logisticians, Engineers, Military Personnel who often find themselves on the front-lines of humanitarian responses to disasters. What I am critical of is the many "mom and pop" NGOs who tend to appear over night, like flies on a carcass.
Some questions worth asking is who stands to gain more from these short term volunteer missions? The locals you intend on "helping" or you? What are the unintended consequences of my actions? What is the true cost of my time in country? Housing, food, transportation, security, translators, travel? Could the cost associated with all of this be better used in some other way to make a more positive impact? What skills/resources can I provide which could not otherwise be provided by locals? Am I needed/wanted?
This little rant of mine may leave you wondering, what can I do? Well, in the words of Dr. Samantha Nutt, founder of War Child Canada, "Social change begins with knowledge and information. So start reading and learning about the world around you." I would urge you to become as informed as you possibly can about the world around you, so that you are not simply a fool rushing in. Hopefully this will start you thinking about the value and impact of short term humanitarian missions. Remember as Margaret Mead said, "Never doubt that a small group of thoughtful, committed people can change the world. Indeed, it is the only thing that ever has."
Honduran Aid Map
Is there a place for Black Comedy or Gallows Humour in Medicine?
Recently I heard a physician make a comment that this patient is "a classic case of FTD".
I as a naive medical student enquired what "FTD" meant?The physician responded drly, "failure to die". This comment left me with a deep sense of discomfort and reminded me of the type of humor I had witnessed many times before in the ER, OR and ICU. Often in the health care profession we are placed under extraordinary amounts of pressure where human lives hang in the balance. Doctors and nurses say things which would horrify the lay public (or even sometimes ourselves in any other context).
Some say "laughter is the best medicine".
Others reply, "Actually, medicine is the best medicine".
The great authoritative source on everything Wikipedia says:
Black comedy or dark comedy is a sub-genre of comedy and satire in which topics and events that are usually regarded as taboo, are treated in an unusually humourous or satirical manner while retaining their seriousness. The intent of black comedy, therefore, is often for the audience to experience both laughter and discomfort, sometimes simultaneously. Gallows humour is a type of humour that arises from stressful, traumatic, or life-threatening situations; often in circumstances such that death is perceived as impending and unavoidable. It is similar to black comedy but differs in that it is made by the person affected.
What do you think? Is there a place for Black comedy and Gallows humour in Health Care?
Dealing with Dengue
Honduras 2010 © Juan Carlos Tomasi
Spraying homes in Tegucigalpa. (Image from FIELD NEWS - Honduras: MSF Tackles Dengue Outbreak AUGUST 27, 2010)
Below is an article I recently co-authored about Dengue Fever entitled "Dealing with Dengue: Power, Politics and Pathology". I would be happy to hear your comments and feedback about this article. Hopefully you will find it an informative and enjoyable read. It will be published in the upcoming issue of Placebo (A McMaster University Medical student newsletter).
Authors’ note: The goal of the continuing Global Health Committee (GHC) article series in Placebo is to provide you with an introduction to neglected infectious diseases and raise awareness about issues relevant to international health. While the actual cases discussed are fictional, we have tried our best to ensure that the natural history, clinical manifestations, investigations and treatments are true to life.
From Basic Care to Comprehensive Care for the People of the Frontier [Honduras]
Here is a long document from an organization called Shoulder to Shoulder, Inc (Hombro a Hombro) that I think is worth skimming at your leisure.It is probably the most interesting, visionary and comprehensive proposal I have ever seen for improving health in Honduras.
Some highlights:
"The WHO in 2006 estimated that basic health care (to meet the Millennium Development Goals) could be provided in any poor country for $34 per person per year.
According to Shoulder to Shoulder Comprehensive Care includes seven elements that are essential to quality rural health care and yet beyond the definitions of the “basic package”:
1. People must not need to walk more than one hour for basic care.
2. People must have access to 24 hour emergency care within an hour’s drive by car. Emergency care must have the capacity to stabilize critically ill patients and transport them if needed.
3. Women’s health and obstetrical care must be available 24 hours per day and within an hour’s drive.
4. Certain services such as obstetrical ultrasound, cervical cancer screening, plain film radiographs, endoscopy and telemedicine can add to the level of care and
reduce the need for costly transfer to higher levels of care available in Tegucigalpa.
5. Chronic disease care for adults should be available to all communities.
6. Restorative and preventative dentistry should be available to the rural populations.
7. Local and national health priorities should be based on reliable data that is accurately collected and recorded into a common electronic data base. Inputs must be real time and inclusive: from census to diagnostic codes to public health interventions.
Certainly gives me great hope for the future of health care in Honduras. "It has been my philosophy of life that difficulties vanish when faced boldly." - Isaac Asimov
Sounds like it is exactly what is needed! Would be great to see this bold vision implemented across Honduras.
PJ
