Adonis Diaries

Posts Tagged ‘infant mortality

 Hunger’s spread in Yemen:

Thousands of infants pointing their fingers to this brutal pre-emptive war: Infant mortality on the rise exponentially

He vomited yellow fluid from his nose and mouth. Then he stopped breathing.

He didn’t cry and there were no tears, just stiff,” said his mother, Intissar Hezzam. “I screamed and fainted.”

The spread of hunger has been the most horrific consequence of Yemen’s war since rebels and the regular army seized the capital Sanaa.

Saudi Arabia and its allies, backed by the United States, responded with a campaign of airstrikes and a naval blockade a year ago.

The impoverished nation of 26 million, which imports 90 percent of its food, already had one of the highest malnutrition rates in the world, but in the past year the statistics have leaped.

The number of people considered “severely food insecure” — unable to put food on the table without outside aid — went from 4.3 million to more than 7 million, according to the World Food Program. Ten of the country’s 22 provinces are classified as one step away from famine.

Where before the war around 690,000 children under five suffered moderate malnutrition, now the number is 1.3 million.

Even more alarming are the rates of severe acute malnutrition among children — the worst cases where the body starts to waste away — doubling from around 160,000 a year ago to 320,000 now, according to UNICEF estimates.

Exact numbers for those who died from malnutrition and its complications are unknown, since the majority were likely unable to reach proper care. But in a report released Tuesday, UNICEF said an estimated 10,000 additional children under five died of preventable diseases the past year because of the breakdown in health services, on top of the previous rate of nearly 40,000 children a year.

“The scale of suffering in the country is staggering,” UNICEF said in the report, and the violence “will have an impact for generations to come.”

The Saudi-led coalition launched its campaign on March 26, 2015, aiming to halt the advance of Shiite rebels known of Houthis who had taken over the capital, Sanaa, drove out the internationally recognized government (that had actually resigned) and stormed south.

The Houthi advance was halted. But they continue to hold Sanaa and the north. In the center of the country, they battle multiple Saudi-backed factions (mostly mercenaries from Columbia, Sudan, Pakistan…) supporting the government that tenuously holds the southern city of Aden.

Ground fighting and the heavy barrage of airstrikes have killed more than 9,000 people, including more than 3,000 civilians, according to the U.N. Human Rights Office.

More than 900 children have been killed and more than 1,300 wounded, 61 percent of them in airstrikes, according to UNICEF.

Coalition airstrikes appear to be “responsible for twice as many casualties as all other forces put together,” Zeid Ra’ad Al Hussein said. The coalition argues that the rebels often use civilians and civilian locations as shields for their fighters. It also disputes U.N. figures on how many deaths are caused by strikes, saying they are based on statistics from the Houthis.

Around 2.3 million people have been driven from their homes.

Strikes have destroyed storehouses, roads, schools, farms, factories, power grids and water stations. The naval blockade, enforcing a U.N. arms embargo on the rebels, has disrupted the entry of food and supplies.

The ripple effects from war have tipped a country that could already barely feed itself over the edge. The food, fuel and other supplies that do make it into the country are difficult to distribute because trucks struggle to avoid battle zones, fear airstrikes or need to scrounge for gas. Under control of Houthi fighters, government services from Sanaa are largely paralyzed.

The fate of Udai illustrated the many factors, all exacerbated by war, that lead to the death of an infant.

His family lives off the pension that Udai’s father, Faisal Ahmed, gets as a former soldier, about $200 a month for him, his wife and nine other children ranging from 2 years old to 16.

The father used to sometimes work construction, but those jobs disappeared in the war. With food prices rising and supplies sporadic, the family eats once a day, usually yoghurt and bread, peas on a good day, said Udai’s parents, both in their 30s.

The day Udai was born, warplanes from the Saudi-led coalition were striking an army base used by Houthi rebels in their district of Hazyaz, a shantytown on the southern edge of Sanaa. Shrapnel hit their one-bedroom house where Udai’s mother was in labor.

“She was screaming and delivering the baby while the bombardment was rocking the place,” the father said.

Hezzam breastfed her newborn son for about 20 days, but then her milk stopped, likely from her own malnutrition. Even after childbirth, she had to collect firewood for the mud brick stove at the doorstep of her house.

Like much of the country, electricity has long been knocked out in their neighborhood, either because of airstrikes or lack of fuel, and there’s rarely cooking gas.

“I go every day to faraway places to search for the wood then carry it home on my head,” she said.

The family turned to formula to feed Udai, but it wasn’t always available and they couldn’t always afford it.

So every few days, Udai got formula and the other days he would get sugar and water. Water trucks occasionally reach the area, but otherwise his parents had to use unclean water.

In the past year, the number of people without regular access to clean water has risen from 13 million people to more than 19 million, nearly three-quarters of the population.

Within three months, Udai was suffering from diarrhea. His father took him to local clinics but they either didn’t have supplies or he couldn’t afford what they did have. Finally, on March 20, he made it to the emergency section at al-Sabeen Hospital.

Udai was suffering from severe malnutrition, diarrhea and a chest infection, said Saddam al-Azizi, head of the emergency unit. He was put on antibiotics and a feeding solution through the nose.

The AP saw Udai at al-Sabeen on March 22. His arms were convulsing, his emaciated legs motionless, his face gaunt and pale. When he cried, he was too dehydrated to produce tears. At around five months old, he weighed 2.4 kilograms (5.3 pounds).

“Unstable,” his chart read for every day he’d been there.

Two days later, his parents took him home. His father told the AP it was because the doctors told them it was hopeless, and he complained the staff was not giving him enough treatment. Al-Azizi said he suspected it was because the family couldn’t afford the medicines. The hospital stay is free, but because medicines are in such short supply, families must pay for them, he said.

“It was a mistake to take him out,” he said. The treatment needed time to work.

Still, al-Azizi had given Udai only a 30 percent chance of survival.

Al-Sabeen was already dealing with dozens of malnourished children. In the first three months of the year, it has treated around 150 children with malnutrition, double the same period last year, al-Azizi said. Around 15 died, not counting Udai.

Some parents managed to get there from remote parts of the country. One woman described walking for four days from her mountain village outside Sanaa, carrying her emaciated daughter, who at two years old weighed only four kilograms (8.8 pounds).

Mohammed Ahmed brought his son here from the city of Ibb because the hospital there had no supplies. He drove the 90 miles (150 kilometers) through rebel checkpoints while warplanes struck, he said. His 10-month-old son Marwan, after 15 days in the hospital, now weighs 3.5 kilograms (7.7 pounds).

Hospitals and clinics around the country have suffered shortages of medicines and fuel, meaning millions live in areas that have virtually no medical care. UNICEF said nearly 600 health facilities nationwide have stopped working.

The Saudi-led coalition allows humanitarian flights bringing medical supplies as well food and water in to Sanaa as well as shipments into Hodeida port, the closest one to the capital. But getting the supplies around the country is difficult. Even pre-war transportation infrastructure was poor, and now trucks often can’t get through battle zones. Drivers fear getting hit by airstrikes or have to scrounge to obtain expensive gas.

Hospitals and clinics have been hit by airstrikes or caught up in fighting. In the battlefield city of Taiz, the Yemeni-Swedish Hospital for Children was damaged as rebels and Saudi-backed fighters fought over it. Parents had to rush their children being treated there back to their homes, and their fate is unknown.

Udai hardly lasted three hours after being brought home, his parents said. Ahmed, his father, said he blames Saudi Arabia’s air campaign for his son’s death.

“This is before the war,” he said, holding up his 2-year-old son Shehab to show the difference between a child born before the war and after.

They buried the infant at the foot of the mountains nearby. His father read the Quran over the tiny grave marked only by rocks, reciting, “On God we depend.”

__

Michael reported from Cairo. Associated Press Writers Maad Al-Zikry in Sanaa, Yemen, and Lee Keath in Cairo contributed to this report

Andrew Bossone shared this link

Don’t turn away. These people are suffering from Saudi’s war backed by the US and Europe.

HAZYAZ, Yemen (AP) — The baby was born in war, even as planes blasted his village in Yemen.
Five months later, Udai Faisal died from war: his skeletal body…
bigstory.ap.org

 

Austerity Has Failed: An Open Letter From Thomas Piketty to Angela Merkel

Five leading economists warn the German chancellor,

“History will remember you for your actions this week.”

Internationally Comparing U.S. Health Care System  

Mirror, Mirror on the Wall, 2014 Update:

How the U.S. Health Care System Compares Internationally

Publications Fund Reports Mirror, Mirror on the Wal…

Executive Summary

The United States health care system is the most expensive in the world, but this report and prior editions consistently show the U.S. under performs relative to other countries on most dimensions of performance.

Among the 11 nations studied in this report—Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States—the U.S. ranks last, as it did in the 2010, 2007, 2006, and 2004 editions of Mirror, Mirror.

Most troubling, the U.S. fails to achieve better health outcomes than the other countries, and as shown in the earlier editions, the U.S. is last or near last on dimensions of access, efficiency, and equity.

In this edition of Mirror, Mirror, the United Kingdom ranks first, followed closely by Switzerland (Exhibit ES-1).

Expanding from the seven countries included in 2010, the 2014 edition includes data from 11 countries. It incorporates patients’ and physicians’ survey results on care experiences and ratings on various dimensions of care.

It includes information from the most recent 3 Commonwealth Fund international surveys of patients and primary care physicians about medical practices and views of their countries’ health systems (2011–2013).

It also includes information on health care outcomes featured in The Commonwealth Fund’s most recent (2011) national health system scorecard, and from the World Health Organization (WHO) and the Organization for Economic Cooperation and Development (OECD).

Overall health care ranking

Click to download Powerpoint chart.

The most notable way the U.S. differs from other industrialized countries is the absence of universal health insurance coverage.

Other nations ensure the accessibility of care through universal health systems and through better ties between patients and the physician practices that serve as their medical homes.

The Affordable Care Act is increasing the number of Americans with coverage and improving access to care, though the data in this report are from years prior to the full implementation of the law. Thus, it is not surprising that the U.S. underperforms on measures of access and equity between populations with above- average and below-average incomes.

The U.S. also ranks behind most countries on many measures of health outcomes, quality, and efficiency.

U.S. physicians face particular difficulties receiving timely information, coordinating care, and dealing with administrative hassles. Other countries have led in the adoption of modern health information systems, but U.S. physicians and hospitals are catching up as they respond to significant financial incentives to adopt and make meaningful use of health information technology systems.

Additional provisions in the Affordable Care Act will further encourage the efficient organization and delivery of health care, as well as investment in important preventive and population health measures.

For all countries, responses indicate room for improvement. Yet, the other 10 countries spend considerably less on health care per person and as a percent of gross domestic product than does the United States.

These findings indicate that, from the perspectives of both physicians and patients, the U.S. health care system could do much better in achieving value for the nation’s substantial investment in health.

Major Findings

  • Quality: The indicators of quality were grouped into four categories: effective care, safe care, coordinated care, and patient-centered care.
  • Compared with the other 10 countries, the U.S. fares best on provision and receipt of preventive and patient-centered care. While there has been some improvement in recent years, lower scores on safe and coordinated care pull the overall U.S. quality score down. Continued adoption of health information technology should enhance the ability of U.S. physicians to identify, monitor, and coordinate care for their patients, particularly those with chronic conditions.
  • Access: Not surprisingly—given the absence of universal coverage—people in the U.S. go without needed health care because of cost more often than people do in the other countries. Americans were the most likely to say they had access problems related to cost.
  • Patients in the U.S. have rapid access to specialized health care services; however, they are less likely to report rapid access to primary care than people in leading countries in the study. In other countries, like Canada, patients have little to no financial burden, but experience wait times for such specialized services.
  • There is a frequent misperception that trade-offs between universal coverage and timely access to specialized services are inevitable; however, the Netherlands, U.K., and Germany provide universal coverage with low out-of-pocket costs while maintaining quick access to specialty services.
  • Efficiency: On indicators of efficiency, the U.S. ranks last among the 11 countries, with the U.K. and Sweden ranking first and second, respectively. The U.S. has poor performance on measures of national health expenditures and administrative costs as well as on measures of administrative hassles, avoidable emergency room use, and duplicative medical testing.
  • Sicker survey respondents in the U.K. and France are less likely to visit the emergency room for a condition that could have been treated by a regular doctor, had one been available.
  • Equity: The U.S. ranks a clear last on measures of equity. Americans with below-average incomes were much more likely than their counterparts in other countries to report not visiting a physician when sick; not getting a recommended test, treatment, or follow-up care; or not filling a prescription or skipping doses when needed because of costs.
  • On each of these indicators, one-third or more lower-income adults in the U.S. said they went without needed care because of costs in the past year.
  • Healthy lives: The U.S. ranks last overall with poor scores on all three indicators of healthy lives—mortality amenable to medical care, infant mortality, and healthy life expectancy at age 60. The U.S. and U.K. had much higher death rates in 2007 from conditions amenable to medical care than some of the other countries, e.g., rates 25 percent to 50 percent higher than Australia and Sweden.
  • Overall, France, Sweden, and Switzerland rank highest on healthy lives.

Summary and Implications

The U.S. ranks last of 11 nations overall. Findings in this report confirm many of those in the earlier four editions of Mirror, Mirror, with the U.S. still ranking last on indicators of efficiency, equity, and outcomes.

The U.K. continues to demonstrate strong performance and ranked first overall, though lagging notably on health outcomes.

Switzerland, which was included for the first time in this edition, ranked second overall.

In the subcategories, the U.S. ranks higher on preventive care, and is strong on waiting times for specialist care, but weak on access to needed services and ability to obtain prompt attention from primary care physicians. Any attempt to assess the relative performance of countries has inherent limitations.

These rankings summarize evidence on measures of high performance based on national mortality data and the perceptions and experiences of patients and physicians. They do not capture important dimensions of effectiveness or efficiency that might be obtained from medical records or administrative data.

Patients’ and physicians’ assessments might be affected by their experiences and expectations, which could differ by country and culture.

Disparities in access to services signal the need to expand insurance to cover the uninsured and to ensure that all Americans have an accessible medical home. Under the Affordable Care Act, low- to moderate-income families are now eligible for financial assistance in obtaining coverage.

Meanwhile, the U.S. has significantly accelerated the adoption of health information technology following the enactment of the American Recovery and Reinvestment Act, and is beginning to close the gap with other countries that have led on adoption of health information technology.

Significant incentives now encourage U.S. providers to utilize integrated medical records and information systems that are accessible to providers and patients. Those efforts will likely help clinicians deliver more effective and efficient care.

Many U.S. hospitals and health systems are dedicated to improving the process of care to achieve better safety and quality, but the U.S. can also learn from innovations in other countries—including public reporting of quality data, payment systems that reward high-quality care, and a team approach to management of chronic conditions.

Based on these patient and physician reports, and with the enactment of health reform, the United States should be able to make significant strides in improving the delivery, coordination, and equity of the health care system in coming years.

us health care ranks last


adonis49

adonis49

adonis49

September 2020
M T W T F S S
 123456
78910111213
14151617181920
21222324252627
282930  

Blog Stats

  • 1,418,738 hits

Enter your email address to subscribe to this blog and receive notifications of new posts by email.adonisbouh@gmail.com

Join 770 other followers

%d bloggers like this: