health and diseases: gateway 2

Question 1

what is the scale at which diseases occur?
epidemics

Answer 1

• a common epidemic is cholera
  > a disease that affects the small intestine and is caused by bacteria that grow in unclean food and water
  > a person infected with cholera suffers severe diarrhoea and vomiting
  > can lead to dehydration and sometimes death
• an earthquake in Haiti on 12 January 2010 was followed by a cholera epidemic
  > the epidemic started in October 2010
  > killed 7912 as of 31 december 2012
  > the earthquake damaged the country’s water supply and sanitation infrastructure
• this caused the water supply to be contaminated by waste materials
  > food and water became easily contaminated and cholera spread throughout the communities

Question 2

what is the scale at which diseases occur?
pandemics

Answer 2

• the 1918 Spanish influenza was one of the world’s deadliest pandemics
  > it is an infectious disease, commonly known as the flu
  > outbreak occured during WW1
  > army troops that travelled from the USA brought thte disease to Europe
  > it was first reported in an army training camp in Kansas, the USA in march 1918
  > within a few days 552 others contracted the disease
  > the disease claimed an estimated 50 to 100 million lives from 1918 to 1919
• the first outbreak spread from Europe to Russia, India, China and the continent of Africa
  > subsided by july 1918
• in late august, the second outbreak of the spanish influenca occured
  > by october 1918, the disease had infected troops and civilians throughout the world

Question 3

what is the scale at which diseases occur?
endemic

Answer 3

• malaria is an example of an endemic disease
• asia recorded the second highest proportion of malaria cases
  > especially in India, Myanmar and indonesia
• 117 million people in Indonesia live in areas endemic to malaria
  > cases of malaria are noted across Indonesia’s many islands
  > it is especially concentrated on the outer islands of Papua, Maluku and Nusa Tenggara
  > malaria is less widespread on the islands of Bali and Java
  > where 70% of the populaiton live

Question 4

factors contributing to the spread of malaria
economic factors - limited provision of and access to healthcare

Answer 4

• there is a critical shortage of doctors in india
• the country has 6 doctors for every 10 000 people
• and only 4% of India’s GDP is spent on health care
  > despite india having the highest number of malaria cases in Asia

Question 5

factors contributing to the spread of malaria
environmental factors-poor drainage and stagnant water

Answer 5

-in the state of Rajasthan, India, water from 8000km of canals in the Great Indian Thar Desert leaks into many places
> created swamps which have formed breeding frounds for the Anopheles mosquitoes
> resulting regular outbreaks of malaria in the desert areas of Western india since 1980s
> similar environmental changes in other parts of India and Asia also created new mosquito habitats that have contributed to the spread of malaria

Question 6

what are the impacts of malaria?
social impact- death rate

Answer 6

• in 2010, the WHO estimated that there were at least 216 million malaria cases worldwide
  > 537 000 to 907 000 people were estimated to have died from malaria
• in 2010, less than 2% of all deaths in the world were casued by malaria
  > most of the cases were from LDCs
• the Democratic Republic of the Congo and Nigeria accounted for over 40% of the total global malaria deaths in 2010

Question 7

what are the impacts of malaria?
social impact- infant moretality rate

Answer 7

• out of every 1000 chlidren bron alive in nigeria, 140 die from malaria within their first year of birth
• women who have contracted malaria during pregnancy may infect their unborn child
• it is estimated that between 75 000 and 200 000 infants die every year within their first year of birth due to low birth weight caused by malaria infection during pregnancy

Question 8

what are the impacts of malaria?
economic impact- cost of heath care

Answer 8

• malaria can account for as much as 40% of public health spending in some countries
• funds are used for costs like building maintenance and investments in hospitals and clinics, and the purchase of medication and insecticide-treated nets

Question 9

how is HIV/AIDS transmitted?
sexual contact

Answer 9

LDCs AND DCs
- the most common form of transmission is through sexual contact with a HIV-positive person
> if the person already has a STD, the risk of infection is even higher
> STD weakens the immune system

Question 10

how is HIV/AIDS transmitted?
blood transfusions

Answer 10

LDCs
- between 5% to 10% of the world’s infections occur through blood transfusions tainted with HIV/AIDS
- in africa, an estimated of 250 to 500 people are infected with HIV/AIDS daily because of tainted blood transfusions

Question 11

how is HIV/AIDS transmitted?
sharing of infected needles

Answer 11

DCs
- transmission of HIV/AIDS via needles is increasing
- this form of transmission accounts for one third of HIV/AIDS incidence in North America, China and Eastern Europe

Question 12

how is HIV/AIDS transmitted?
pregnant mother ot baby

Answer 12

LDCS
- HIV/AIDS may be transmitted froma pregnant mother to her baby
- of all babies born to HIV/AIDS infected mothers
>25% are carriers of HIV/AIDS

Question 13

groups vulnerable to AIDS

Answer 13

• women are twice as likely as men to contract HIV/AIDS during heterosexual intercourse
• in some societies, women are more likely to be subjected to sex without their consent
• more than 3.4 million children around the world ar living with AIDS,
  > with 390 000 more being infected each year
  > most children acquire it from their mothers, during breast feeding and during pregnancy
• in 2007, an estimated that 2 million children under 15 were living with HIV/AIDS
  > among whom 90% were in Sub Saharan Africa
  > in the same year, 270 000 children world wide had died of AIDS

Question 14

factors contributing to the spread of HIV/AIDS
social factors- social stigma related to the disease

Answer 14

• social stigma is extreme disapproval associated witha aparticular circumstance or quality of a person
• stigma is commonly associated with AIDS
• HIV/AIDS patients face various forms of discrimination
  > refused access to health care facilieties, rejection by family or community, expelled from school or denial from housing

- due to prejudice against people with HIV/AIDS and ignorance about how the disease is transmitted,
> early intervention of the disease was hindered in both DCs and LDCs during the 1980s

Question 15

factors contributing to the spread of HIV/AIDS
social factors- **education **

Answer 15

• in some places, these people are not aware of how diseases can be transmitted
  > due to the lack of eduction
  > people do not know how to protect themselves and avoid being infected
• there are also cultural practices that keep girls from knowing about sex and sexuality until marriage
• for example, sex is a very private subject in Nigeria and discussion of it is often seen as innappropiate
  > sexuality awareness education is therefore not conducted in schools in Nigeria

Question 16

factors contributing to the spread of HIV/AIDS
social factors - lifestyle choices

Answer 16

• certain lifestyle choices may increase one’s risk of being infected with HIV/AIDS
• eg. drug injection or sharing needles, or refusal to use condoms
• drug abuse can put a person at risk of being infected with HIV/AIDS
• drug and alcohol intoxication may affect judgement and can lead to unsafe sexual practices
  > put people at risk of for getting HIV or transmitting it to someone else

Question 17

factors contributing to the spread of HIV/AIDS
social factors- lapses in medical practices

Answer 17

• mistakes, corruption and negligence associated with medical practices contribute to the spread of HIV/AIDS
• between 5% to 10% of HIV infections were transmitted by blood transfusions taineted with HIV/AIDS
  > occured in countries where there was no effective blood screening before blood was donated
  > blood tainted with HIV/AIDS might have been collected and used on blood transfusions
• for example, 130 000 patients were potentially exposed to HIV between 2001 to 2011 in USA
• because contaminated containers and syringes were used in blood transfusions

Question 18

factors contributing to the spread of HIV/AIDS
economic factors - vice trades

Answer 18

• vice trades refers to business activities such as the involvement in illegal durgs or commercial sex work
• in china, women who move from villages to cities in search of work often have limited access to education and job training
  > women can only find employment in jobs with low pay and no job security
  > often resort to commercial sex work due to their lack of viable options
  > more vulnerable to aids

Question 19

factors contributing to the spread of HIV/AIDS
economic factors - mobility

Answer 19

• mobility refers to the movement of people from one place to another, often for work reasons like searching for better job opportunities
  > mobility is also determined by the type of job a person has
  > a person who works as a miner, truck driver or an executive overseeing operations in many different countries tends to be more mobile than another person who works only at one place
• men who move to cities or mining areas in search of work often leave their families behind
• being separated from their families and living in a foreign place
  > they may feel socially excluded
  > get involved in risk-take behaviours and put themselves at risk of being infected with HIV
• the development of modern transportation has also helped the spread
• eg with the development of airline transportation, HIV was carried rapidly across the globe
  > enable the disease to spread faster and reach more people
• the tourism industry contributes to the spread of HIV/AIDS
• tourists often take risks that they would not take at home
• eg. they may drink more and engage in unprotected sex
• in 2010, Queensland, Australia, recorded its highest incidence of HIV/AIDS with 206 people diagnosed with HIV
  > some tourists were infected with HIV when they travelled for a vacation to Papua New Guinea, a country near Australia that has a high HIV/AIDS prevalence

Question 20

the impacts of HIV/AIDS
social impacts- life expectancy and infant mortality rate

Answer 20

• the disease increase the number of deaths and reduces the life expectancy, population size and population growth
• the large numbers of death occur mostly in LDCs where HIV/AIDS is prevalent
  > Botswana, Kenya, and Uganda
• when prevalent in a country, HIV/AIDS reduces the country’s life expectancy
• in countries most affected by HIV/AIDS, their life expectancies are almost 6 years lower that what it would have been in the absence of the disease
• by 2025, this figure is expectected to be at 10.8 years
• the life expectancies in the Sub-Saharan African countries decreased significantly from the 1980s as HIV/AIDS emerged
• eg. Uganda, life expectancy was between 39 to 51 years from 1950 to 1974
  > this was reduced to 46 years by 1996
  > but availible treatment for HIV/AIDS , as well as awareness of treatment has imporved significantly in recent years
  > many of these countries are stating to experience an increase in their life expectancies

Question 21

the impacts of HIV/AIDS
social impacts- orphan crisis

Answer 21

`- refers to the situations in which large numbers of children lose their parents due to HIV/AIDS
- globally, there are almost 17 million orphans due to HIV/AIDS
- almost 87% of them live in Sub Saharan African countries like Nigeria, Tanzania and Uganda
- many of these orphans are cared my their extended families

• the carers of the orphans due to HIV/AIDS are plagued by deeper poverty due to the medical costs and living expenses incurred when the orphans stay with them
• there are also orphanages built by NGOa to care for the orphans
  > but they are still orphans without any support from adults

-* eg in kenya, about half a million orphans do not have the support of relatives or family friends
> orphans are vulnerable to forced labour, forced into the sex industry and to recruitment as child soldiers*

• the orphans suffer from the emotional trauma of losing their parents
  > also stigmatised by society through association with HIV/AID
  > the children often assumed to be HIV POSITIVE THEMSELVES
• loss of parents can limit a child’s access to basic necessities
  > like shelter, food, clothing, health and education
  > also more likely to suffer from malnutrition and ilnesses and be infected with aids
  >

Question 22

the impacts of HIV/AIDS
economic impacts- cost of health care

Answer 22

• health care costs for HIV/AIDS can be expensive for both individuals and countries
  > costs come in the form of treatment and research
  > come in the form of health care expenditures by governments for treating complications from HIV/AIDS
• medication used to treat HIV/AIDS are called antiretroviral drugs
  > does not cure HIV/AIDS but keeps it from progressing in the body
  > also stop patients from suffering from complications for many years and even decades

-it is expensive in both DCs and LDCs
- in singapore, a combination of antiretroviral drugs can cost from US$160 to US$1200 a month
- in some LDCs, antiretroviral drugs can cost from US$69 to US$900 per year
- in places where the drugs are subsidised or free, the cost is borne by NGOs or by the government
> the antiretroviral drugs will also have to be taken daily for the patient’s entire life

• in addition, pregnant mothers with HIV/AIDS have to go through screening for HIV/AIDS prior to delivery
• the mother then receice antenatal treatment
  > which is treatment prior to delivery that will reduce the risk of passing HIV/AIDS to their babies
• government also has to allocate limited resources to care fro HIV/AIDS patients
  > especially true for those living with the disease in its advanced stages
  > governmtnets divert resources that could have otherwise been used for other purposes

for example, the government of south africa spent US$1.2 billion in 2010 in health care expenditure for HIV/AIDS patients
> if not for the HIV/AIDS epidemic
> this large amount of money could have been spent on other public services such as roads, public transport systems, schools and sanitation in the country

Question 23

the impacts of HIV/AIDS
economic impacts-** loss of productivity resulting in slower economic growth**

Answer 23

• without infrastructures like roads, public transport, schools and sanitation
  > economic growth could be hindered
  > businesses are less likely to invest in places without adequate infrastructure, no skilled labour forcem and a population with poor health
• HIV/AIDS slows economic growth through the shortage of skilled labour in the workforce
  > also causes high death rates which shrink the workforce
  > also lead to illnesses that cause an employee to be absent from work for long periods > reduce labour productivity
• lack of funds will result in a less effective education system
  > results in lower skilled workforce
  > deters foreign investment and hinders economic growth especially when businesses cannot find enough skilled people to employ
  > will slow down economic growth
• eg. Uganda
• economic growth is slowed by 1.2 % each year due to HIV/AIDS
• if this trend continues, the country’s economic growth will have been reduced by up to 39% by 2025