63% of accidental child deaths in UAE due to traffic accidents

Traffic accidents are the cause of 63% of accidental child deaths in the UAE according to a recent study by researchers at the University of the UAE. Further, a survey among the local population showed that more than 90% had never used car child-seats and that they rarely used seatbelts or child restraints when children were seated in the car.

These shocking statistics were made public during a policy session for injuries among children at the Arab Children Health Congress held in Dubai in March. They are the results of a study entitled “Epidemiology and Prevention of Child Injuries in the United Arab Emirates” carried out by Dr Michal Grivna, Associate Professor, Faculty of Medicine & Health Sciences, of the University of the UAE, with the support of Johnson & Johnson Corporate Citizenship Trust.

According to the study accidental injuries are the leading cause of death among children under 14 in the UAE. Drowning and falls each account for 10% of accidental deaths among children.

The exceptionally high proportion of accidental deaths due to traffic accidents has prompted calls for the improvement of traffic safety.

“There are environmental risk factors that need to be addressed such as ensuring appropriate traffic and urban planning around schools and safe drop off and pick up sites for children. We have found for example there are few school warning signs, speed signs, bumps or radars to slow down traffic and that in about 80% of cases children are dropped off into the main road or opposite of the road instead of directly into the sidewalk,” noted Dr Grivna.

The report calls for the introduction and enforcement of the use of child safety restraints in vehicles and effective traffic control measures in and around schools.

“Creating child friendly environments through innovative integrated legislation and enforcement combined with training and education has the potential to eliminate most accidental injuries and deaths in traffic and at home,” said Dr Grivna.

Representatives from government authorities, international organisations such as UNICEF, WHO and the Arab League, as well as academics and young people attended the policy roundtable. Key policy recommendations included strengthening and combining efforts in the areas of surveillance and research, building capacity in these areas, developing a regional strategy on child injury prevention, identifying clear indicators and targets as well as creating a culture of safety through awareness and education campaigns towards families and children.

Meanwhile, Dr Ayesha Abdullah, Senior Vice President, Dubai Healthcare City, speaking at the Arab Children Health Congress called for better data collection on the causes of child injuries. She also stressed the urgent need for implementation of appropriate legislation to ensure a safer environment for children in the region.

“In order to create policies that can really make an impact on child health, we need to analyse trend data over a long period of time – and currently, there is a knowledge gap in the region as far as statistical collection and analysis is concerned. As well as understanding the incidence of diseases amongst children, we also need to understand the level of investment being made in preventative versus curative care,” she said.

Iraq’s MoH says health system needs years of work

Much more time and effort is needed to improve Iraq’s health system and institutions, which have been battered by decades of conflict, underinvestment and neglect, the country’s top health official said on 3 April.

“Our health facilities have not seen any development for 35 years. The last health facility built in the provinces was during the 1970s, and in Baghdad was in 1984- 85,” Iraqi Health Minister Salih al- Hasnawi told IRIN, adding that these facilities had not seen any development since then.

At a health workshop organised by the US-based NGO International Medical Corps (IMC), the minister said “the process of developing them to reach international standards is a long and complicated one”. The two-day workshop was part of IMC’s initiative to assist Iraqi government officials providing health care at the local, regional and national level.

“I think it will be an effort to move [health] facilities forward, but this is why we’re here to help the [health] ministry and Iraqi people and it may take months or years,” Gerald Evans, director of IMC’s health programme in Iraq, told IRIN. “It’s a never-ending process. I would not say that we have a benchmark approach, I say that we have a process started and that’s a success for us.”

According to the World Bank’s World Development Indicators 2009, life expectancy in Iraq was 65 in 1990, up to 71 by 1996, but down to 67 in 2007.

The 2003 US-led invasion of Iraq to topple former president Saddam Hussein was a big setback for the country’s health infrastructure, experts say.

“The war’s impact on the nation’s medical infrastructure can be seen in the trend in vaccinations against key diseases, which is a good indicator of preventive healthcare provisions,” Steven Levingstone, a guest blogger with the Washington Post, wrote in a blog on 30 March, quoting from the book War and the Health of Nations by Zaryab Iqbal, an assistant professor of political science at Pennsylvania State University.

He noted that immunisation levels against polio, diphtheria, whooping cough, tetanus and measles had all fallen 10-20% between 1999 and 2005. “This trend of reduced immunisation rates could lead to serious repercussions for the population’s health and the prevalence of disease in the future,” Levingstone wrote.

Al-Hasnawi said the government was working to modernise the country’s health facilities, draw up a list of medicines to be made available countrywide and facilitate health workers’ access to training courses abroad.

“Our health system is not too far now from the region’s other countries, especially after signing contracts last year to modernise health facilities with new equipment, including cancer-related ones, and make available all the medicines we need,” he said.

FGM continues in Yemen despite ban

Nearly a decade after a ban on health workers performing female genital mutilation/cutting (FGM/C) in Yemen, the harmful practice continues unabated, with the government saying more research is needed before an outright ban can be imposed.

“Nine years after the ban we see that it works the opposite of what was intended,” said Wafa Ahmad Ali, a leader of the Sanaa-based Yemen Women’s Union (YWU). “Now instead of going to the hospital where the tools are at least clean, FGM is carried out at home.” The Ministry of Human Rights supports a new study on the practice.

“If the study proves that the practice is still being carried out, we will push for a new law,” Huda Ali Abdullatef Alban, minister of human rights, told IRIN. “We hope this new law can be in place within the next four years,” she said. FGM/C is a practice which includes the mutilation, scarring, partial or full removal of a woman’s genitals for non-medical reasons.

It leads to a range of serious reproductive and other health problems, according to the WHO.

The UN Population Fund (UNFPA) and the UN Children’s Fund (UNICEF) recently estimated that worldwide 120-140 million women have been subjected to the practice and three million girls continue to be at risk each year.

“The practice persists because it is sustained by social perceptions, including that girls and their families will face shame, social exclusion and diminished marriage prospects if they forego cutting.

These perceptions can, and must, change,” said a joint UNFPA, UNICEF statement on 6 February, the international day against FGM. A study of over 2,000 women in Yemen in 2001, carried out by the Ministry of Heath in coordination with the Women’s National Committee, found FGM/C particularly widespread in five coastal governorates.

In Hodeidah, Hadhramaut and al- Maharah an average of over 96% of women had undergone FGM/C. In Aden it was 82%, and in al-Amanah 46% of women. The waiting room in a Sanaa health clinic is full of women waiting to see a leading gynaecologist, Arwa Elrabee.

The doctor had just seen a patient who has undergone FGM/C. “She is married, but she does not want to have intercourse with her husband because of the pain,” she said. “In many cases the pain is physical, but often it is psychological. “I view it as a criminal attack on children,” said Elrabee.

“Often people don’t use anaesthetic and they risk giving the girl both physical and psychological traumas.” “Simply put, FGM/C is violence against girls,” said the YWU’s Ali. “There are laws against it in Yemen, but they are not adequate and they are not enforced.”

Meanwhile, the YWU argues the position of the government on FGM/C has “never been assertive” and allows for the custom to continue being carried out privately. Ali and others acknowledge that ending FGM/C in Yemen will require changing society’s attitude towards women in a country which in 2009 was rated by the World Economic Forum as having the world’s largest gender disparity for a third consecutive year. (The Global Gender Gap Report 2009 <http://tinyurl.com/6pghel>). “At the heart of this problem is the lack of equality between men and women,” said Ali. “We are struggling for our rights in Yemen. Personally I am angry, but we need to take baby steps when it comes to changing Yemeni society.”

Nature Middle East website launched

A new website Nature Middle East has been launched. Part of the Nature Publishing Group (NPG) the website will showcase scientific and medical research from the Arabic-speaking Middle East region. It will be continuously updated with articles in English and Arabic.

The King Abdullah International Medical Research Center (KAIMRC), at King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Saudi Arabia, is sponsoring Nature Middle East. ● Visit: www.nature.com/naturemiddleeast (registration is required)

New obs-gyn facility opens at DHCC

N9NE, a unique obstetrics and gynaecology facility, has opened at Dubai Healthcare City offering cutting-edge design with personal service.

Discussing the unique design features of the facility, Dr Amir Nasseri, Managing Director, N9NE Medical Institute, said: “A patient’s reaction to the interior of a clinic can have a huge impact on the recovery process.

Our goal was to create a welcoming atmosphere where a patient’s first interaction with a gynaecologist leaves an impression of comfort. Many people feel apprehensive about seeking medical care but in my experience, positive and pleasant surroundings will make a huge difference to the treatment process, resulting in easier follow-up and eventually effective preventative care.”

Dr Ayesha Abdullah, Senior Vice- President, Dubai Healthcare City, said: “Through the Center for Healthcare Planning and Quality (CPQ), our independent regulatory body, we work with all the clinics to identify and implement best practice in clinical design and can help these facilities develop the necessary design standards before securing official accreditation.”

In implementing best practices, the CPQ considers many design principles that have shown to improve patient safety, patient outcome, staff performance and overall satisfaction.

These principles include building for patient privacy, noise reduction, incorporating nature, adding artwork, internal aesthetics close to the home environment, coordinating signage systems, improving air quality, encouraging hand washing, natural lighting and energy efficiency.

SKMC performs complex living donor kidney transplantation

The first successful positive cross match (PXM)-desensitization living donor kidney transplantation was performed recently at Sheikh Khalifa Medical City (SKMC) in Abu Dhabi.

Abdul Ameer, 50, suffered from kidney failure for the past three years and had been on hemodialysis at SKMC. There was no transplant programme at the time his kidneys failed.

His wife, 36, offered her kidney for transplant. However, tests in India indicated that the kidney was not a good match due to antibodies and would be rejected and thus the transplant could not be done. Several months after returning to Abu Dhabi Ameer was told of SKMC’s multiorgan transplantation programme and that he would be a good candidate despite the mismatch of his wife’s kidney.

The transplant team at SKMC spent three months removing antibodies from the patient’s blood to ensure the kidney would not be rejected. Dr Abrar Khan, Senior Consultant and Director, Transplantation and Hepatobiliary Surgery, said: “We arranged a series of tests for them to make sure both were fit for transplantation and donation.

The transplantation team at SKMC worked very hard with both to make sure that their journey was as smooth as possible. The removal of antibodies went smoothly and the transplant went well. We were delighted with the outcome of the surgery.”

“We are proud that SKMC is now capable of performing such state-of-the-art surgery. The techniques used in preparing the patient and his wife for surgery are cutting edge in the field of organ transplantation.

Additionally, the wife’s kidney was removed using the latest laparoscopic techniques,” Dr Khan added. “The patient is very happy with his new kidney and is totally functional at this time,” he said.

Doctors speak out against smoking in global STOP smoking survey

Nine out of ten doctors in the Middle East feel that smoking is more dangerous to a patient’s long term health than other factors such as obesity, lack of exercise, alcohol consumption or drug abuse. Eight out of ten physicians want to classify smoking as a medical condition. When asked to consider common health risk factors, doctors rank tobacco addiction as the most difficult to treat

These findings were the result of STOP – Smoking: The Opinion of Physicians – one of the largest global surveys conducted to investigate the attitudes and behaviours of doctors towards smoking and smoking cessation.

For the STOP survey some 3,535 physicians from 23 countries were interviewed. These included 699 doctors from across Africa and the Middle East, namely Algeria, Egypt, Morocco, Saudi Arabia, South Africa, Tunisia and the UAE.

According to the survey 89% of doctors said it was part of their role to assist their patients in quitting. Almost half of physicians surveyed do not feel properly trained to treat tobacco addiction. Yet studies show that the support of a physician can go a long way to help smokers give up the habit and stay quit.

Andrew Pipe, Professor of Medicine at the University of Ottawa, Canada, explained that a brief intervention by a doctor is enough to make a positive impact.

“A simple question and a brief discussion about the dangers of smoking are a good start. If the smoker wants to quit there are many therapies out there to help them, including some that only a doctor can prescribe,” he said.

Dr Yousef N Nawas, a Pulmonologist and a smoking cessation expert from Amman, Jordan, said: “This survey shows that the medical community recognises the importance of treating smoking as a risk factor for major diseases.

The nature of tobacco addiction makes it difficult to quit, but with help and support from a healthcare professional, motivated patients can be successful in stopping smoking.’’

Other Findings UAE

● 92% of doctors spontaneously mentioned smoking as the top activity which is harmful to the long term health of their patients

● 4 out of 5 doctors think that it is the patient’s responsibility to quit. Less than half feel they have a role to play KSA

● 88% of doctors feel it is their role to help patients quit smoking, however many do not have the time

● Nearly all physicians believe that the greatest barriers to help their patients stop smoking are patient related Egypt

● 65% of doctors claim to talk to their patients about the risks of smoking on their health

United Arab Emirates University launches UAE Global Health Institute

The UAE’s first national, United Arab Emirates University (UAEU), launched on 9 March the UAE Global Health Institute. The institute, which will be based at the UAEU campus in Al Ain in the emirate of Abu Dhabi, will address immediate health problems for the nation and the region. The institute will draw on partnerships with the best global health scholars from around the world, including the research staff based at UAEU. The initial areas of research will be epidemiology, ethnography, migrant health issues, epidemic disease and air transport and areas surrounding refugee health.

The primary partnership will be with the University of California System-wide Global Health Institute, which has become the global health research hub for the Americas. The wider international network will also draw on partnerships with Yale, Bergen, Hong Kong and Kuala Lumpur.

UAEU is developing the Europe-Africa network and expects to be able confirm additional partners in the coming months. The capabilities of the UAEU Institute for Integrated Information and Communications Technology will be leveraged, both for data management and for the creation of new technologies for diagnosis, decision-making and communications.

The output from the Institute will inform policy across the global medical profession and policy decisions across all other sectors affecting global health and the flow of disease, from the aviation sector through to conflict resolution and humanitarian work.

Remarking on the launch of the institute Dr Abdullah Al-Khanbashi, Vice- Chancellor of UAEU, said: “We are absolutely delighted to be announcing the launch of this pioneering and exciting institute.

The primary mission of UAEU is to be a research engine to benefit the people of the UAE and its future generations. It is therefore fitting and timely that the university should be drawing together the greatest global health scholars from around the world to provide research on the health issues our great nation and wider region are facing.

“The UAE is a vital hub in the global network and is therefore ideally suited to house this new global health institute. In addition to partnering with the leading centres of global health research around the world we will also recruit high quality talent from within the UAE.

In collaborating with our partners and training national undergraduate and graduate students the UAE will become the world’s global health hub for the Middle East and Asia.”

Vaccination Week spurs regional commitment

 The week of 24 to 30 April saw health authorities from countries across the region coming together in a spirit integration, commitment and cooperation to implement the first Vaccination Week in the Eastern Mediterranean. This initiative was led by the World Health Organisation (WHO) Regional Office for the Eastern Mediterranean (EMRO) and coincides with similar endeavours established in two other WHO regions – Vaccination Week in the Americas and European Immunisation Week.

According to WHO EMRO Vaccination Week in the Eastern Mediterranean provided a unique opportunity to revive the region’s commitment and increase public awareness on the importance of immunisation through advocacy, education and communication. The initiative received overwhelming support, with participation from the 22 countries of the Eastern Mediterranean Region. A variety of activities were be carried out during the week including outreach, campaigns, workshops, training sessions, social mobilisation, round tables, exhibitions and media events addressing a wide range of vaccinerelated issues. The target audiences for these activities included parents, caregivers, health workers, mass media, decisionmakers and stakeholders.

The Vaccination Week was launched in Beirut on 24 April by Her Excellency Wafaa Michel Sleiman, First Lady of Lebanon. Her status and commitment to public health was expected help attract key decision-makers and stakeholders in the region to the message that an immunised and healthy child will have a better chance at education and development. Despite substantial progress in immunising more people over the past two decades, the region continues to face major challenges. Every day, more than 5,500 infants are not fully immunised and an estimated 2.1 million children did not receive DTP3 (diptheria-tetanus-pertussis) vaccine in 2009. Moreover, a large number of child deaths due to penumococcal disease and rotavirus diarrhoea can be prevented through vaccination with newly available vaccines.

Introducing these vaccines into national immunisation programmes will require additional financial commitment from countries and donors. 


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