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For the differently abled by a differently abled – an inspiration from Tamil Nadu, India

Varalakshmi Vemuru's picture
Mr. Kannan, a differently abled social entrepreneur
Mr. Kannan, a differently abled social
entrepreneur. (Photo: Varalakshmi Vemuru)
During my recent mission visit to Sivagangai District in Tamil Nadu, India, I met with Mr. Kannan, a social entrepreneur. I was visiting communities to understand the latest efforts under the Tamil Nadu Empowerment and Poverty Reduction Project (TNEPRP) to support the differently abled with economic activities following their identification and mobilization. For six months now, Mr. Kannan is running a Community Skills School (CSS), an innovative approach to skills enhancement, in the Kalaikulam Village. At the school, which provides self-identified and motivated trainees with skills to repair home appliances, Mr. Kannan has already trained 70 differently abled men and three women. Among the trainees is his wife, who is differently abled herself, but is of huge support to Mr. Kannan in running the CSS and in working with women. He has an agreement with TNEPRP to train a total of 180 differently abled, including a planned group of 30 women.


He has an agreement with TNEPRP to train a total of 180 differently abled, including a planned group of 30 women. Run on a guild program model, the CSS ensures that upon completion of a one-month program on skills enhancement, the trainees can become self-employed or work in small enterprises repairing home appliances in their own and neighboring villages. The rapid urbanization of rural Tamil Nadu offers plenty of such opportunities.

Mr. Kannan designed the key aspect of the curriculum—which goes beyond technical training—based on his own life experiences. During our conversation, I found out that Mr. Kannan is differently abled himself—he was afflicted with polio at the age of three and has lost the use of both his lower limbs. As a result, Mr. Kannan needed a wheelchair to get around. Nevertheless, he was not deterred and continued his education to receive a diploma in mechanical engineering from a local Polytechnic. He ended up at Samsung’s service center in Chennai, the state capital, where he spent four years acquiring skills in home appliance repair. 
 

Disabled and Forcibly Displaced

Omer Karasapan's picture
Volunteers carry disabled refugee - Nicolas Economou | Shutterstock.com

In February of this year the Syrian Center for Policy Research issued a report stating that 470,000 Syrians had been killed in the war and 1.9 million wounded. That was 10 months ago and with the intensification of the siege and bombardment of Aleppo and ongoing fighting elsewhere in the country, one can only guess at the current toll. What is clear is that each day of fighting adds to the burden that Syria will have to carry for generations to come, not only in terms of the ever mounting physical destruction but also in caring for the growing daily toll of the physically or mentally disabled that the war produces. All this at a time when half the population--nearly 5 million refugees and 6.6 million Internally Displaced Person (IDPs)--have been torn from their homes; and the country’s medical system is in tatters.

Time to be efficient: HIV/AIDS in the Latin America and the Caribbean Region

Fernando Lavadenz's picture


Key achievements and prospective issues

LAC concentrates only 2.3%of the total worldwide HIV/AIDS burden, landing in fourth place after Sub-Saharan Africa, South Asia, and East Asia and the Pacific. From 2000 to 2013, LAC had the second-highest decreasing rate on HIV/AIDS burden worldwide (42 %). At the end of 2015, roughly 1.6m people were living with HIV in a region with more than 500m people (discounting USA and Canada). The same year, Cuba became the first country in the world to receive validation from WHO for eliminating mother-to-child transmission of HIV and syphilis, with another five LAC countries close to achieving the same goal; this was one important step towards having an AIDS-free generation worldwide.

The early introduction of universal access to treatment initiated by Brazil and Argentina, massive social mobilization, new legal regulations, and efforts to control vertical transmission, stigma and discrimination converted the region in a leader in combating the HIV/AIDS epidemic.

HIV program expenditure in LAC, annually is around three billion USD. While substantial, it is under 1% of LAC’s total health expenditure. In the context of less external financing support in future and the need to improve efficiencies, LAC decided to undertake a series of 12 studies within eight countries.
 

How to tackle a growing HIV epidemic with limited resources?

Clemens Benedikt's picture

An experience from Belarus on how allocative efficiency analysis changed HIV budgets

Belarus’ HIV response is faced with the need to provide treatment to a larger number of people living with HIV than ever before and to simultaneously continue scaling up prevention. How to do this in a context of limited resources, poses a major challenge for any planner. Most recent HIV estimates from Belarus illustrate the rapidly growing challenge. UNAIDS estimated that the number of PLHIV in Belarus increased from 5,600 in the year 2000 to 35,000 in 2015. New HIV infections increased from 1,700 per year in 2000 to 2,600 in 2010 and then doubled again to reach 5,300 in 2015.

Using viral load and CD4 data to track the HIV response in South Africa

Nicole Fraser's picture



Sergio Carmona and Tendesayi Kufa-Chakezha are guest blog contributers from South African National Department of Health: National Health Laboratory Services and South African National Department of Health: National Institute of Communicable Diseases, respectively.

South Africa has the largest HIV treatment program in the world with over 3 million people currently on antiretrovirals. Every year, millions of VL and CD4 count tests are carried out to check treatment eligibility for new HIV cases (CD4 count) and treatment success in those on antiretroviral therapy (ART). A VL test monitors viral suppression, the goal of ART given to a HIV-infected person.  The CD4 count checks whether the patient suffers from immune deficiency due to low CD4 counts and tracks recovery of the immune system during ART. In 2014, close to half of all VL tests carried out in lower-middle income countries were done in South Africa. In addition, large numbers of CD4 cell counts have been done routinely to predict patients’ risks for opportunistic infections and provide preventive therapy where indicated. While VL and CD4 testing are essential to monitor individual ART patients, the data is also useful in tracking the impact and performance of the ART program as a whole.
 

Gender-based violence and HIV infection: Overlapping epidemics in Brazil

Kristin Kay Gundersen's picture

One woman is victimized by violence every 15 seconds in Brazil, with a total of 23% of all Brazilian women experiencing violence in their lifetime. There are many notable consequences affecting victims of gender-based violence, yet many health consequences of violence have not been widely addressed in Brazil. This leads to the question: Are victims of gender-based violence at a higher risk for HIV infection in Brazil?
 
Brazil has 730,000 people living with HIV, the largest number in Latin America and the Caribbean. Brazil is also one of 15 countries that account for 75% of the number of people living with HIV worldwide. Although the HIV epidemic in Brazil is classified as stable at the national level, incidence is increasing in various geographic regions and among sub-groups of women.
 
Rates of violence against women (VAW) are particularly high in the Southeastern and Southern regions of Brazil. These regions also have the highest HIV prevalence, accounting for 56% and 20% of all the people living with HIV in Brazil, respectively. Violence and HIV in Brazil are clearly linked, with 98% of women living with HIV in Brazil reporting a lifetime history of violence and 79% reporting violence prior to an HIV diagnosis.
 
Despite these statistics, there is limited research in Brazil examining VAW in relation to HIV. Accordingly, a bi-national collaboration of researchers from the University of California, San Diego, University of Campinas, São Paulo and the University of Rio Grande do Sul, Porto Alegre developed an innovative study to investigate these intersecting epidemics.
 
The focus of the study is in the regions of Brazil with the highest rates of VAW and highest prevalence of HIV: São Paulo in the Southeastern region and Porto Alegre in the Southern region.
 
The aims of the research were to describe the contextual factors of violence victimization among women in Brazil and to examine the association with HIV infection.
 
The study merged two population-based studies with identical sampling methodologies conducted in the São Paulo and Porto Alegre, Brazil. Women ages 18-49 years were sampled from public health centers, including 2,000 women from São Paulo and 1,326 from Porto Alegre. These women were administered surveys that gathered extensive data on violence victimization and social-ecological factors on access to preventative health services.

Campaign Art: Take a good look in the mirror

Darejani Markozashvili's picture
People, Spaces, Deliberation bloggers present exceptional campaign art from all over the world. These examples are meant to inspire.

Road traffic injuries are becoming a major cause of death throughout the world, claiming a total of 1.2 million lives each year. According to the data from the “Global Status Report on Road Safety” of World Health Organization (WHO), road traffic injuries are the leading cause of death among young people aged between 15 and 29 years.  

Alcohol intake increases the risk of traffic injuries and puts millions of lives in danger. Unless progress is accelerated, road injuries, especially involving drunk driving, will remain a major public health challenge. However, many of these deaths are largely preventable.

We Save Lives is a non-profit organization, dedicated to campaigning against drunk driving. In order to raise awareness about their cause, they launched a powerful anti-drunk driving initiative "Reflections From Inside"
 
We Save Lives

Source of the video: We Save Lives

Of quacks and crooks: The conundrum of informal health care in India

Jishnu Das's picture

I usually don’t wake up to hate mail in my inbox. What prompted this deluge is a recent paper that evaluates the impact of a training program for informal health care providers (providers without any formal medical training) in the state of West Bengal, India (paper summary). Training improved the ability of informal providers to correctly manage the kind of conditions they may see in their clinics, but it did not decrease their overuse of unnecessary medicines or antibiotics.

Chart: 2.4 Billion People Live Without Access to Toilets

Tariq Khokhar's picture

The UN estimates that 2.4 billion people still lack access to improved sanitation facilities, nearly 1 billion of which practice open defecation. Good sanitation is a foundation for development - conditions such as diarrhea are associated with poor sanitation, and left untreated, can lead to malnutrition and stunting in children. Read more about World Toilet Day

Helping children survive and thrive: How toilets play a part

Claire Chase's picture



While child mortality rates have plummeted worldwide, nearly one-third of all children under 5 in developing countries are stunted. Children who are stunted (having low height-for-age) suffer from a long-term failure to grow, reflecting the cumulative effects of chronic deficits in food intake, poor care practices, and illness. The early years of life, especially the first 1,000 days, are critical; if a child’s growth is stunted during this period, the effects are irreversible and have lifelong and intergenerational consequences on their future human capital and potential to succeed.  
 
For the water and sanitation community the year 2009 marked a turning point in our understanding of the role that Water, Sanitation and Hygiene (WASH) has on child stunting. A provocative Lancet article (Humphrey 2009) put forth the hypothesis that a key cause of child stunting is asymptomatic gut infection caused by ingestion of fecal bacteria. Small children living in poor sanitary environments are especially at risk, through frequent mouthing of fingers and objects during exploratory play, playing in areas contaminated with human and animal feces and ingesting contaminated food and water (Ngure et al. 2013). Researchers now estimate that up to 43 percent of stunting may be due to these gut infections, known as environmental enteric dysfunction (EED) (Guerrant et al. 2013).
 
Just last week estimates were released suggesting that poor sanitation is the second leading cause of child stunting worldwide (Danaei et al. 2016). In a key departure from previous work, the researchers defined risk as the sanitation level of a community, rather than an individual. This is consistent with mounting evidence showing that a community’s coverage of sanitation is more important than any one household’s (Andres et al. 2013). Across different studies, data sets and outcomes the evidence consistently shows that a threshold of around 60–70 percent household usage within a community is needed before the health and nutrition benefits of sanitation begin to accrue. Studies that have focused on an individual’s toilet use as a predictor, rather than a community’s use, may have vastly underestimated the impacts (Hunter and Prüss-Ustün 2016).  
 
As we advance our understanding of the ways in which a poor sanitary environment impacts growth in small children, we can better design water and sanitation interventions to target these pathways. While there is a role for multi-sectoral interventions, which can simultaneously target the underlying determinants of child undernutrition, such as food security, access to health services, and childcare practices — there are ways that the water sector can adapt its own approaches so that they are more nutrition-sensitive, and more impactful on nutrition. Here are four key actions:


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