sicko

Here is the trailer to Sicko, the new Michael Moore movie on the healthcare industry. It's going to be exciting to see so much attention brought to the points we've been discussing all year.

backlog: week 9

I really enjoyed the ideas put forth on the Health Records of the Future video. The video describes a shift from electronic medical records to personal health records to a lifespan planning record that emphasizes a holistic view of health and preventive measures. A lifespan planning record sounds almost too good to be true. It is a complete change in paradigm, considering that I myself have never seen most of my health records, and that they have never contained any information regarding my "economic, social, educational, and spiritual goals", and that it does not utilize prevention in the least. How amazing would this be! However, I am left thinking that if this does come to fruition, would only the rich have access to such records? If this could be provided to all, regardless of race or SES or even residency status... but then that would be part of universal health care (which is another story).

Continuing on the sanitation theme (aka Google has a sense of humor)

I don't know if anyone noticed today, but Google has announced a new way to get free wireless broadband, called Google TiSP (beta). It is innovative, to say the least. As you can see here, once you sign up, you get a package containing all the essentials, including a spindle of fiber optic cable that you flush through your toilet to plug into the "global data networking system".


My favorite part:

In-Commode Package Delivery
With professional installation service, you can also have your Google Checkout purchases delivered directly through the sewage network into your bathroom. Each package comes pre-sealed in a watertight and nanobot-resistant bag made of biodegradable corn-based plastic. For a limited time, TiSP subscribers who sign up for a Checkout account will receive free bathroom delivery on their first ten Checkout purchases.

Also:

How can Google offer this service for free?
We believe that all users deserve free, fast and sanitary online access. To offset the cost of providing the TiSP service, we use information gathered by discreet DNA sequencing of your personal bodily output to display online ads that are contextually relevant to your culinary preferences, current health status and likelihood of developing particular medical conditions going forward. Google also offers premium levels of service for a monthly fee (see below).
Note: We take your privacy very seriously. So we treat all TiSP users' waste-related personal information with tremendous discretion, in accordance with our Privacy Policy.

Ah, the joys of a central sewer system.

backlog: week 8

Regarding the reading from the medical technology session, what struck me the most was a rapid diagnostic that distinguishes between viral and bacterial ALRI (acute lower respiratory infections). This would be amazing, because of the number of people that are receiving antibiotics unnecessarily. This is hazardous both for these people, as well as those that actually need antibiotics but can't get them. I myself have been put on antibiotics many times when it hasn't been necessary, and the havoc that it wreaks on your digestive system is horrible! Not to mention resistence. I think this would be a huge step for both developing and developed countries.

In doing research, I found some interesting things..

Dr. Malamud's research at NYU in oral-based diagnostics
some more saliva stuff
Gates-funded research in point-of-care diagnostics

backlog: week 7

It is ironic that a year ago, I got extremely annoyed when I told a person at a party that I was about to start grad school in public health and he said "You're going to be working with sewers?!" and now I'm writing my topical paper on sanitation. It is more ironic how much I'm interested in it. Ever since watching this UN HDR video, I can't get it out of my head that 2.6 BILLION people don't have access to basic sanitation, and what this means especially for women. Open defecation and flying toilets are unaccceptable in this day and age, yet they are the only options for so many people. This is in such stark contrast to our lives and anything we've experienced...

"Have these numbers lost their ability to shock or even move us? What are the human values in question when we hear, and fail to react to, the news that each day thousands die of these maladies unattended? Where, amid all these numbers, is the human face of suffering? What values might guide our response to such suffering?"

Today I was able to sit in on a presentation by Paul Farmer to a group of doctors at Harbor-UCLA (thanks to someone commenting on Payam's blog about Dr. Farmer's visit to Los Angeles and Farah posting the events on the discussion board).

Some things he mentioned:

- The importance of community health workers in not only developing countries (like Haiti, Rwanda, etc.) but also in the US (!!!!). He mentioned PACT (and here), a new project in Boston that provides DOT to HIV/AIDS patients that have a CD4 count below 150 and drug resistance.

- Applying community-based care to chronic disease(!!!).

- He couldn't seem to stop talking about community health workers and how important and successful they are in increasing treatment adherence (to greater than 90%!). Someone asked about family members providing DOT, and he said that they must be stipended regardless of relation, and that non-family members generally work better.

- (Concerning this week's discussion re Eastern European men) Having worked in Tomsk Oblast, Siberia treating MDR-TB, he said that progress in Russia has been due more to economic progress than anything else. Surprise surprise.

- Trying to make it easier for medical students to focus on global health rather than just having to tack it on to their residencies. A Global Health Equity and Internal Medicine residency program, initiated in 2004 at Harvard, is doing just this. He mentioned other schools that are interested in doing this (UCSF and University of Miami are the ones I remember).

It was so exciting listening to him discuss PUBLIC HEALTH to a room full of INTERNS and RESIDENTS! Talk about shifting the paradigm. Seeing all our theories actually being practiced was thrilling. I began having thoughts of DOT right here in LA. Is it happening right now? We need to find out! I could see it being its own program at AIDS Project Los Angeles. Possible?

All in all, totally worth losing the one participation point from leaving 501 thirty minutes early.

Nutriset and Plumpy'nut

I was really intrigued by Liyan's presentation last week on ready-to-use therapeutic food for the treatment of severe childhood malnutrition. CNN recently published an interesting article on Nutriset, the company that manufactures only treatments for malnutrition. The article reported that Nutriset made $25 million in 2006, mostly from buyers like Unicef. There is a huge market for treating malnutrition, but I guess this shouldn't be surprising, considering that there were 67 million people in 2002 experiencing severe food shortages and thus requiring international food aid.

The good thing is that they put 80% of the profits back into developing more products, and they are working on African franchises (for-profit) that will produce Plumpy'nut locally.

The Project Peanut Butter website also has a lot of information regarding this topic. The organization was formed by Dr. Mark Manary, the author of Liyan's article. What a small world! Or not..