0415 - Suffering and social inequality - EG Flashcards
Know and apply epidemiological triad to disease outbreaks, use in social context. Explain to someone the frameworks that can be used to explain why the poor are more likely to suffer epidemics and malnutrition.
What is the epidemiologic triad?
A triangle that connects:
Agent; Host; Environment
Agent
(factors to do with bacteria/virus, such as virulent factors),
Gost (factors to do with the human and individual behaviour, such as cultural or biological factors), and
environment (factors to do with the environment, such as poverty of environment and service delivery failure).
What does Sir Macfarlane Burnet imply with his quote (1962):
“At times one feels that to write about infectious disease is almost to write of something that has passed into history.”
That he believed that infectious diseases would become a thing of the past.
Describe the Ebola outbreak in Uganda with the epidemiologic triad
Agent: Ebola, highly virulent bug
Host: Cultural factors around burial
Environment: failure of health services; significant rural poverty, refugee camps, civil war
Describe the measles outbreak in Papua New Guinea with the epidemiologic triad
Agent: measles highly infectious agent.
Host: mistrust of immunisations and malnourished services.
Environment: underfunded services. ongoing violence in highlands. overpopulation with limited land.
Describe the pellagra epidemics in refugee camps in Angola.
Agent: Niacin deficiency, Tx fortifying food.
Host: dependent on maize diet. Tx with consumption of fortified foods. Sx pellagra,
Environment: refugee camps, rebels preventing fortification of the foods by blocking the road to the mill. Tx by creating a safer environment
What is the view of the Malthusian corrective thesis for understanding outbreak occurrences and poverty?
Nature’s way of sorting out the overpopulation
What is the view of the Reverse McKeoqn’s theory for understanding outbreak occurrences and poverty?
Nutritional and environmental improvements will stop outbreaks
What is the view of the Roadstops on the road to health transition for understanding outbreak occurrences and poverty?
things will get better as part of the transition process due to health technology
Describe the decline of TB death rate with McKeown’s thesis, who are those who support and how it was critiqued.
That the introduction of antibiotics and vaccinations were not the major factor in the decline of the TB death rate, other factors, possibly improved diet and environment, were the main factors.
Anti-vaccinators support.
Critiqued that he inaccurately used his data, ignoring the role of other health advances and ideologically viewing the statistics.
What is the Malthusian argument?
Plagues act as a natural way of sorting out overpopulation.
As “population increases in a geometric ratio, while the means of subsistence increases in an arithmetic ratio…"”crime, disease, war and vice are … necessary checks on population.”
What are some of the recurring debates about improving health services in poor communities?
Biomedical approaches vs environmental approaches [often references McKuen]
Environmental vs political approaches [why fix up the immediate environment/health services when the whole system is wrong]
Low cost health solutions vs best practice health solutions
Which countries are coping well with meeting the Millennium Development Goals and what characteristics do they share?
(inc: 1.To eradicate extreme poverty and hunger
2.To achieve universal primary education
3.To promote gender equality and empowering women
4.To reduce child mortality rates
5.To improve maternal health
6.To combat HIV/AIDS, malaria, and other diseases
7.To ensure environmental sustainability
8.To develop a global partnership for development[1]
)
Bangladesh; Costa Rica; Kerala state; Sri Lanka
Characteristics:
- sustained political commitment to social equality
- investment in education, esp. female
- health infrastructure
- health worker training.
What diseases are included in MSF’s Drugs for Neglected Diseases Campaign?
Neglected diseases
- sleeping sickness
- chloroquine-resistant malaria
- chagas disease
- visceral leishmaniasis
Seen in third world countries. In many cases medication has been the same for the past half decade as no investment return like medications delivered to first world countries.
What is the desire of Paul Farmer?
Wants developing countries to have access to better technology.
