The Guinea Worm in Northern Ghana

The guinea worm is due to inflection usually through ingestion of the nematode called Dracunculus medinensis this disease is extremely painful to those that are affected by the illness. The parasite travels through the body and then tries to pierce the skin often in the lower appendages of the infected person. it is prevalent in Africa and Central Asia. The parasitic worm lives within drinking water of the people in these areas usually the neighboring ponds and lakes. For those living in countries in these areas going to get the day’s water can serve as a social event. It is a chance for the women of the village to get together and walk down to the lake and gather water. This is a similar to how in developed countries like the US mother will grocery shop together to catch up and gossip about things going on in the town. Water is also viewed as a source of life for civilizations. Water is something your body needs to keep going. You use water to cook, bathe, wash clothing, etc. These lakes can also be seen has a lavatory for some villagers which means that the water is not the pure life source the locals view it as. In Ghana, and other West African countries getting access to clean filter drinking water such as that you buy at the grocery store is not an option. It is too expensive and often not store nearby due to the lack of widespread urbanization. In other countries such as India, that have development methods of irrigating water to the rural areas there has been the development of gangs that attempt to regulate the access to the water taking as much money from families as possible. During the Jimmy Carter administration an effort was started to eradicate this water borne parasite and its associated illness.

I decided to take a look at the work the anthropologist Bernhard Bierlich who was studying the belief systems of northern Ghanaians and how that was affecting their inflection with Guinea Worm disease. Most importantly he wanted to know how they people would feel about their water being treated with chemicals to kill the parasite to that they would be able to ingest the water. He found that the people believed the water was not the source of their sickness but in fact it was something that was a part of the human body and that getting the illness was not something that you could easily avoid. Which I thought was interested because it showed just how common the disease was in the area that they felt they were bound to get it.

Sources:

http://www.sciencedirect.com.proxy2.cl.msu.edu/science/article/pii/0277953694003754

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC118073/

Epidemiology and Medical Anthropology

According to the World Health Organization (WHO), Epidemiology is the study of the distribution and determinants of health-related states or events (including disease), and the application of this study to the control of diseases and other health problems. I picked the intersection of these two fields because Epidemiology is something that I have been interested in for a long time. I am currently in the undergraduate program here at Michigan State and this summer I had my first experience with Epidemiological research that I shall continue in the fall. I think that Epidemiology is an interesting field because it in itself is an interdisciplinary field and then combining the viewpoint of an medical anthropologist add an additional layer of understanding the group one is studying. Taking into account medical anthropology will cause you to think more about the culture of the area. Because often Epidemiologist find themselves asking why do we see the distribution that we have. It will be difficult to understand why people are still be infected with cholera in a small village. That is until you realize that the people of the village believe that the fluorine and chlorine compounds you provided to clean the water are seen as toxins and therefore they do not add them to the water source. It is the job of the anthropologist to learn more about the culture so that the team can come up with other methods of providing safe sustainable drinking water for the village without offending them. Another great example would be from the youtube video in this week’s lesson. It is a recording made by a medical anthropologist who mentions some of the possible ways of applying medical anthropology. The one I found very interesting was the women who of the village who during their period where been essential kicked out during those few days. This might they did not have access to things that others in the village had like water, food, and other resources. So when they starting giving women the IUD devices to decrease the rate of pregnancy they we causing the women to be isolated from the village for a longer period of time which is not going to be helpful when you think about the fact that many of the women have quite a few children to care for. This is a great example of where the anthropologist taking the time not only to learn the language but the culture and why they do the things they do can come in handy. It will allow for a level of care that may not be high but may end up being a program that individuals will follow because it goes along with their beliefs.

Sources
1. http://www.who.int/topics/epidemiology/en/
2. Tribal Jazzman Medical Anthropologist http://www.youtube.com/watch?v=NjDPwF9uV58

Depression

Depression is considered a mental illness that often inhibits the daily activities of some poeple. Symptoms of depression include irritable mood most of the time, loss of enjoyment in usual pastimes , difficulty sleeping, fatigue, and issues with concentration. Not being to contribute due to an illness makes one look for a possible solution. In US culture the first solution is often medication. But how often is medication really the best solution? Medication is more easily justified to insurance companies versus expensive therapy sessions which may allow people to discuss possible roots of the problem. We are taught as children to get along with one another bit those with depression sometimes find that they do not enjoy time with others. If there is a medication that you could take to help you in social situations giving an extra boost of confidence that the sufferers need. Depression can have a negative effect of the economy because if you do not find joy in your previous activities then you are not going to continue spending money in sector. For example say you were an avid painter you may decrease the amount of paints you buy. The use of medication adds money into pharmaceutical sector either by the patient directly or insurance coverage.

The commercial I watched was for Abilify an antidepressant that has been placed on the market in recent years.
The ad discusses the experiences that the main character experienced with depression. How he felt withdrawn from his friends and colleagues and friends. This decreased his quality of life. That is to say until he started taking abilify. Afterwards he became much more outgoing and interacting with others. This commercial did not show much of doctor patient interactions but other drug ads I have seen show the relationship as one that is very understanding and supportive. It was interesting to take a more critical look at the commercials that they have for medication advertisements especially towards the end when there is the long list of side effects.

Sources:
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0003697/
http://www.youtube.com/watch?v=Uv2hS_NulHU

True Life: I Have NF

NF stands for Neurofibromatosis which is a disease that results in the growth of tumors at random points within the body. It can also cause changes in the rate of growth of tissues and bones of the body. This disease has three classes: NF-1, NF-2, and schwannomatosis. Type 1 affects the formation of the bones and spine; sometimes tumors grow in the nervous tissues. Most of the type 1 tumors occur below the skin. With NF-2 the tumors are mainly concentrated on the nerves both cranial and spinal. Schwannomatosis is very rare and much of this type of NF is still unknown. One of the characteristics of schwannomatosis include the development of a certain type of tumor that contains schwannomas.

I decided to watch this episode of True Life because I had never heard of NF before so after google it I thought it would be interesting to learn how people live their life with this disease. During this episode three teens with NF show how they cope with daily life and the process of preparing, and going through a tumor surgery. Surgery is a common part of their daily existance since some of these tumors with grow in the brain, spinal column and other nervous tissue. The teens were Phillip, 16, Amber 19, and Behka, 19; they all have type 1 NF. Since this is a genetic disorder we got to see how Philip and Amber interacted with their NF parents and siblings. But Amber’s NF appeared suddenly as a genetic mutation so she the only person in her family to have the illness. This illness narrative was a Restitution narrative for the teens in the aspect they yes they knew that they would have NF for the rest of their lives but they continue to believe that with tumor removal surgery they will be able to live a normal life. By watching the narrative I understand how the teens felt, I learned more about the issues they face and what kind suffering they have to go through. For those less severe forms of NF the associated stigma is not as significant because not everyone call tell you have to the disease. But for those like Philip and Amber their large visible growths make them stand out and get treated differently. Since each of the teens were pursuing a surgery the audience was able to see how they interacted with the health care providers. The doctors were very comforting and made an effort to explain the reasons for their course of treatment. In my opinion the teens embraced the sick role very much by seeing their doctor with is seemed that things were changing like Amber did because she was having more difficulty walking.

After watching the true life episode I think that creating an illness narrative helped relieve the sufferers. They able to be themselves without worrying what others thought and share what they have to experience. Even for the family the illness narrative can be a great way to almost feel the way the NF family member feels day to day. This is very similar to the ideas of the second lecture when we discuss the benefits and cons to being the listen in this sort of situation.


Source:
http://www.ctf.org/Living-with-NF/what-is-nf.html
http://www.ninds.nih.gov/disorders/neurofibromatosis/neurofibromatosis.htm

Fibromyalgia

One of the blog posts that we read this week was about fibromyalgia I thought that is was an interesting disease before because people do not understand the disease mechanism. Fibromyalgia is overall a mystery disease. According to PubMed Health, fibromyalgia is a systemic disease that causes pain and tenderness throughout the body, mainly in the joints, muscles and soft tissues. Sometimes the symptoms that can come along with this disease include Irritable Bowel Syndrome, migraines, memory/focus problems, and extreme fatigue. There is no approved cure for fibromyalgia; treatment is prescribed to deal with the symptoms of the disease. These treatment plans usually are things like painkillers and muscle relaxants to deal with the systemic pain. Some that suffer from fibromyalgia feel down because of this relentless disease that they must deal with therefore many have depression which requires antidepressants. These sorts of symptoms make daily life difficult and uncomfortable. I find that some often American culture does not want to recognize sickness as a reason for not being able to go about many everyday tasks, especially when the symptoms of your illness are not visible. People will have a harder time understanding what is going on because they cannot see the proof. As we saw in the fibromyalgia blog the women had many issues being able to go out to meet with friends. Overall the our culture feels that fibromyalgia is not a real disease because of the way it presents while the medical professional used many medications in hopes to help by treating the patients symptoms.

When looking at the treatments that people are prescribing it seems to mainly focus on medications which fall in line with American culture. We tend to believe that the best way to cure things is with a pill and then it is all better. But in fact it is so much more; people need to be looked at holistically instead of just from a drug treatment perspective so that the best treatment plan can be provided.
After watching Cracking the Code I found the effects of the placebo to be quite impressive. By looking at the stories of patients who went into experimental studies full of hope the connection of belief and healing was very pronounced. For example the mother that was dealing with depression was so very excited and prepared to become about of the experimental study that was filmed. Her hope  and faith made  her believe that she was going to receive the actual drug  during the study but she did not. Beliefs gives people something that they can hope for it helps to get them to hope for the best outcome. By mentally ‘preparing’ themselves their body will have high levels of endorphins which can actually create better outcomes.

Source:
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001463/
http://www.blogher.com/fibromyalgia-type-personality-chaos-frustration-and-near-insanity?page=full
http://youtu.be/QvbQnMvhQFw

Kuru in New Guinea

The article that I found using pubmed discuss all the major forms of the group of disease which Kuru falls into which are called spongiform encephalopathies. The major forms included: Sporadic Cruetzfeldt-Jacob disease (spCJD), fatal familial insomnia (FFI), sporadic fatal insomnia (sFI), familial or genetic CJD (f/g CJD), Iatrogenic CJD (iCJD), Kuru, new variant CJD (vCJD), and variably protease-sensitive. These spongiform encephalopathies use an infectious protein called a prion as the agent for the diseases. Not much is known about these sort of diseases. The article does state that prions appear because something has caused a protein to misfold into a much more stable from. Once they appear prions are so stable destroying them is impossible. Sometimes the damage caused goes unnoticed until much later in life. In the culture-bound syndrome (CBS) Kuru, the spongiform encephalopathy affects mainly children and women.
In the native cultures of Papau New Guinea they believed that in order to show respect to a person who has died the entire tribe much gather for a celebration in which they eat the body of the lost comrade. Men are allowed first pick at the cuts of meat and often select the lean muscle portions of the corpse. This leaves the fatty organs such as the intestines, liver, and nervous tissue for the women and children. Because there was no capability to have a cause of death determined so of the dead bodies could had already been inflicted with Kuru. Since the women were stuck eating the tissue that contained high levels of fat which was where this protein often occurs the women and children had a high risk of getting the disease.
Because this disease is often found in the brain there is not for sure way to test for the illness unless the individual is dead so that an autopsy can be performed. Since the prion protein is view difficult to destroy or remove, currently there is no cure for Kuru except for ending the cycle of cannibalism that started the problem. Presently work is being done around to world to figure out a way to reverse the misfolding of prion proteins, denature the protein or to get rid of it completely.

Article: Overview of Human Prion Diseases
http://www.ncbi.nlm.nih.gov/pubmed/22196171

Japanese Healthcare System

I decided to focus on the Japanese healthcare system as was in he frontline film that we watch. I selected this because I thought Japan is a country that I would be interested in visiting at some point in my life therefore how one would receive care is an important thing to know. This film followed a journalist as he travel to and from five different countries to examine how the health care system there worked. he went to the UK, Japan, Germany, Taiwan, and Switzerland. During his investigation the journalist gathers information about the system from doctors, patients, and even health care policy administrators. By Doing this the audience was able to get a good understanding of the healthcare, how it affected the people and how they felt about the way that the program was set up.

With in this film I found that the healers where the Japanese doctors. Their social status is reasonable though it is difficult to become rich because of the regulated price list. The interactions between patients and doctors were very different than than in America. The average appointment last roughly 3 minutes so the patient has to be very to the point about what it is that is a concern of theirs. Another interesting thing about the primary care visits is that you never have to call ahead to make an appointment, the patient can come as often as they want, and primary visits are not might to keep them from seeing a specialist. Overall the patients are very comfortable with their doctors but the visits are very focused and quick not allowing for a deep connection to form between doctor and patient.

In Japan they have what they call social health care insurance which are these insurance policies that everyone has to buy into. This policy is obtained through an individual’s job, a community based program, or if the individual is too poor the government pays for their policy. Almost every doctor’s office is a private business. The patients enjoy going to the doctor so much that they visit the doctor about 3 times more than the average American. The Japanese also get medical scan done at a larger rate. In Japan the government makes a detail list of how much each medical procedure/item will cost. If doctors try to complete more of a certain task for additional income the next year the price of the task will go down. This price list is negotiated yearly.

Heart Disease among African Americans

According to PubMed Heart Disease is referred to as a narrowing of blood vessels that supply the heart with critical nutrients such as oxygen. These arteries narrow because of the cholesterol that is produced and ingested by the individual. The fat molecules stick to each other and even the side of the blood vessel at random points. When the fats stick and form a plaque it continues to grow until it potentially blocks of a vessel, which would result in an heart attack. This is a health issue that affects many Americans overall because of the foods they are provided with a home are not extremely nutritious.

I choose to work with the heart disease a disparity because I am very much interested in Cardiology as I mention in my introduction post. Also I feel that by potentially creating some community based programs the prevalence of the disparity could be reduced. When looking at African-American culture we see that having some excess weight is considered a good thing to show that you can  afford to sustain yourself and also it is usually attractive to males of the same culture. This sort of mentality makes is more difficult to get African-Americans to go on diets, and/or exercise regularly. Foods that are normally found in an African-American household does not help to prevent heart disease either. The foods tend to be those that are high in fat, sugar, and salt (for example: cheese, shortening, etc). When foods have a high fat content it can cause a rise in cholesterol which will slowly narrow major arteries over time. Many neighborhoods on the social extremes are homogeneous therefore these poor lifestyle patterns are protected because many of those that the individual is surrounded by believe the opposite of clinicians thereby continuing the health issue.

Race, genetics, and health are definitely connected to each other in a very complicated fashion. These three things are affected by outside sources as well as affecting each other. For example depending on your race you may have either experienced or witnessed racism in a health care setting which may have put you off from receiving preventive care. Therefore it is common for you to experience a disease much further along. For example African-American men and prostate cancer, when these men are diagnosed with the affliction it is often in one of its later stages because they may not be comfortable having the routine check done. Genes can also impact the health because certain diseases are passed down through the family like sickle cell anemia. This means that environmental and other outside factors are not going to prevent someone from getting the illness.

Sources:

Photo: http://www.indiana.edu/~k562/athero.html

Info: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0004449/

 

 

 

 

 

 

 

 

 

 

Unnatural cause 7-Not just a paycheck

When I took the Health Equality Quiz I got a 7 out 10. The question which I found the most surprising was the one about the differences among life expectancy for various counties. There was a side note about the difference in a county in new jersey having a 33 year long life expectancy than another county in North Dakota. To me something that drastic shows just much inequality in health care we have here in the United States. Just because of affluence someone can on average live almost a generation longer than another is kind of ridiculous. I understand that class distinctions are necessary and common place but they should not have such a strong effect on an individual’s life.

The Case study that I found the most interesting was entitled “Not just a paycheck”. This segment focused on a major refrigeration company that closed down their American factory in order to move overseas. This resulted in lots of people being laid off a few years from retirement unable to receive their full pensions and stuck taking minimum wage jobs just to make ends meet. For many this caused them to live on fifty percent or less of their normal (prior to layoff) income. While many of these upper middle class families moved out because they could no longer afford the taxes, much of the lakefront property was being redeveloped into larger homes. No only did this clip give a view to the urbanization of the property but it also the effect that the psychological stress had on the laid off employees. Some struggled with depression, drinking issues, and even health problems from internalized stress such as headaches and jaw clenching.

The spread and treatment of a disease or illness incorporates many factors: politics, economics, environment, and culture. Policies development can lead to ordinances that require quarantines, or vaccines, or even provide general health care for citizens. By enacting these things the spread of disease is halted, or slowed down so that not as many can be infected. Politics also impacts which drugs are permitted for prescribed use. The economy can impact what policies would be passed. It can also affect drug development, if a company is worried about losing its patent on one of its major drugs they may redesign it to sell it under different circumstances, as was done with the drug BiDil. By spending time designing narcotics companies are missing opportunities to discover the cure for something else.

Ethno-Medical Approach

I picked Ethno-medical because this is the field that I am most interested in. It covers the differences of cultures and look to see what and why they do things differently than the traditional Western culture. I find this interesting because I feel that it gives some sort of glimpse into what life in their shoes must be like.  I think that it is the approach that brings the others together because it covers a large variety: the behaviors, a look at the health care systems, types of healing, and etc. It is very well rounded.

Disease is actually having a ailment that can usually be defined by a medical dictionary. It is something that is real, and capable of being proven by some sort of test result. Illness on the other hand could possibly be a disease or  not. It is involved with the mental status of the individual. Sometimes this is based on what is happening around, ie. a news report is broadcasted warning about a flu outbreak. The individual will then take note of possible ‘symptoms’ and carry on from there decided that they do indeed have the disease (in this example the flu). Illness about include the feelings of sickness that one experiences when they actually have a disease which makes it difficult to tell the difference between the two. Personally sometimes I have a hard time distinguishing the two terms. They are linked to the same concept of being sick, and have definitions with fuzzy boundaries because one could occur with the other. (you could have a disease and an illness at the same time).

Upon my first read of this article I thought that Nacerima was the culture that the author was describing, and it wasn’t until the second read that I notice the comments such as market economy and the obsession with appearance that made me think of American culture. These are two things that we are known for worldwide. One of the rituals that I found to be very telling was the shrine box it contains objects that owner doesn’t really need but keeps anyway even after they lose their usefulness the item is keep in the box. I enjoy the way that Miner describes the “mouth-rite” ritual which is basically daily brushing of the teeth and mouth. this ritual shows that the “Nacerima” people find the mouth to be an important body part that aligns itself with the health the body as a whole. He also elevates the dentist to the level of a holy mouth man. The last ritual that I will talk about are visits to the doctors offices where they perform “ritual purification”. Miner says that the people find it so helpful that even one who can does the ritual. It shows that health is important and that also those that cannot afford it do not have the opportunity for purification, just like in the US.