The following pieces were written by my students.
- Mental illness and its stigmatization – Marie Schmitz
- Veganism – lifestyle trend or key to a long life? – Sarah Lehr
- Stormont Stalemate: Northern Irish Healthcare Provision in Uncertain Times – Peter Magill
- Health in an achievement-orientated society – Katharina Novak
- Global Health and the burden of a disease long forgotten in the western world – Christoph Palatzke
- HIV/Aids – an epidemic of women? – Hanna Grauert
- Why are parents deciding to not let their children get the important vaccinations against childhood diseases anymore? How can we solve this problem? – Jennifer Schlachter
- The Western Approach to Health – Janina Jacob
Mental illness and its stigmatization
The following was written by Marie Schmitz.
Marie Schmitz is a student of Political Science at the University of Konstanz. She has taken part in the course “Global Health Challenges: HIV, AIDS and Other Epidemics” because she thinks this is a topic that affects us all and therefore deserves public attention.
What would you think if someone tells you about a mentally ill person? Most people in that situation feel the urgent wish to change the topic. Stigmatization against mental illnesses makes it harder for the people concerned to recover. This could be prevented by abolishing the phrase mental disease.
With a prevalence of 13 percent (aertzteblatt, November 2011), mental disorders are the leading disease around the world. An estimated number of 4.4% of the world populace suffer from depressions (aerzteblatt, February 2017). Almost ten times more people around the world suffer from depressions than from any kind of cancer (aerzteblatt, February 2017). And still, mental illness stays a taboo topic. People concerned face uncertainty about what is happening to them and often try to hide their problem. Mental illness should be shifted out of this shame afflicted stigma by making them akin to a physical disease.
According to WHO, “Stigma and discrimination against patients and families prevent people from seeking mental health care” (WHO). Depressions cause feelings like self-doubt and shame. People tend to put the blame on themselves, although there may be multiple causes for depressions. Causes can be of a psychic, physical or genetic kind. Physical reasons for depressions are chronic diseases and pain, disturbance in hormone regulation and dread diseases like cancer and HIV. Strokes of fate like the death of a family member or friend, stress in the daily life and conflicts may also cause depressions (volkskrankheit.net).
It is commonly assumed that some people have a genetic predisposition that makes them prone to mental diseases. Aside from that there are certain personality traits like sensitivity, empathy and a tendency towards self-criticism, that makes it easier to fall mentally sick (PAL Ratgeber Verlag). Combined with an unfortunate event this may cause a serious mental disturbance. Although genetic predispositions play a role, mental illness can happen to anyone.
During a depression there are biochemical changes in the brain. Second messengers as serotonin and noradrenalin, that affect the mood positively, get into imbalance. It is not clear if this imbalance of second messengers is the cause or the consequence of mental illness. It is known though that we can manipulate these biochemical processes by taking antidepressants.
Because antidepressants work so smoothly, Doctors tend to prescribe medicaments very quickly and sometimes without looking for the causes. An individual investigation for what caused the depression is necessary in order to achieve a long-term recovery. If the patient suffers from stress, changes in his or her daily life might be necessary. Persons concerned might think about changing their working place or taking some time off work. If the regulation of hormones is malfunctioning, medication might help. Or maybe someone has lost a beloved person and needs professional help to cope with it. In any case doctors should not only seek to treat the symptoms but to eliminate the causes of any illness, mental or physical. This is where our health care system has potential to improve. Doctors should encourage their patients to live a healthy life and help them become aware of unwholesome habits. Sanity is as important as physical health. We should take care of our mind by not exposing us to immoderate strain just as we should try to avoid an excessive exertion of our body. With a common awareness that we must guard our body and mind we can combat illnesses in the forefront.
Knowing that mental and physical health are deeply interconnected we should ask ourselves if it is reasonable to make a difference between them. By talking of mental diseases we risk pigeonholing the persons concerned. Being mentally sick in that case means that something went wrong with your mind, neglecting the fact that causes for depression often lie in the outside or in chemical processes.
We should not make a functional differentiation between physical and mental health as the treatment should be the same. First the causes need to be found, then a medication or alternatively changes in lifestyle should be arranged. Antidepressants may have serious side effects and cause dependency. There are various other ways of helping people out of depression. They may be send to health resort or simply see a therapist regularly.
We do not only need a change in terminology. We also need a change in society. Perception of and attitude towards mental illness and those who are concerned must be changed. This is made as we talk about it and create a dialogue instead of stigmatizing and making the topic taboo. The numbers of those who are concerned are too high for anybody to pretend not to be effected by mental diseases in some way.
- WHO: http://www.who.int/features/factfiles/mental_health/mental_health_facts/en/index5.html
- Volkskrankheit.net: https://www.volkskrankheit.net/a_z/depression-ueberwinden/
- Aerzteblatt, February 2017: https://www.aerzteblatt.de/nachrichten/73297/WHO-Millionen-leiden-an-Depressionen
- Aertzteblatt, November 2011: https://www.aerzteblatt.de/archiv/112800/Psychische-Erkrankungen-Eine-weltweite-Epidemie
- PAL Ratgeber Verlag: https://www.palverlag.de/Depressionen-Ursachen.html
Veganism – lifestyle trend or key to a long life?
The following was written by Sarah Lehr.
Sarah Lehr is currently studying Politics and Public Administration in the 7th semester and writing her bachelor thesis at the University of Konstanz, Germany.
During the semester break this summer a few friends and I visited another friend who went to university in Berlin. She told me that she and her flatmates are currently doing the 30 day vegan challenge. They will try to live without any animal products for 30 days, and after that decide, whether they liked it, and if they will continue doing it. After these few days in Berlin, we could easily see, that being vegan in a big city like this is really not a problem. There are more than enough trendy vegan cafes and restaurants around every corner.
These days, especially in big cities, it is not unusual anymore to have your coffee with soy milk or almond milk instead of dairy milk. Over the past few years the range of animal free and plant based products in the supermarkets increased immensely. Today there are so many animal free alternatives like vegan cheese, vegan sausages made of tofu, vegan spreads and so on. The Huffington Post claims veganism as one of the fastest growing lifestyle movements. In Germany there are recently 8 million vegetarians and in 2016 approximately 1,3 million Germans are vegans. In 2006 there were, according to the “Nationale Verzehrsstudie”, only 80.000 vegan people. I think that veganism has become a real trend in our society these days, especially among younger people.
But what does it mean to be vegan? People who decided to live vegan relinquish not only animal sourced foods, such as meat, poultry and fish, but further all other animal products like eggs, honey, milk, yoghurt or any other dairy products. They strictly live on vegetables, fruit, nuts, beans and grains. Most vegans like to adapt a whole other lifestyle and this means to completely refuse all products of animal origin. Vegans also avoid wearing shoes or clothes made of leather, as well as wool or even non-vegan cosmetics. According to “the Vegan Society”, veganism is defined as a “philosophy and way of living which seeks to exclude – as far as is possible and practical – all forms of exploitation of, and cruelty to, animals for food, clothing or any other purpose; and by extension, promotes the development and use of animal-free alternatives for the benefit of humans, animals and the environment. In dietary terms it denotes the practice of dispensing with all products derived wholly or partly from animals.” (the Vegan Society, 2017)
For people who live as vegans, it is more than a diet. For them veganism describes a way of life. But is veganism just a mainstream trend or has it any beneficial results for individuals and the environment? Like the definition by “the Vegan Society” already mentioned there are various reasons why people should become vegan. I think one of the main reasons for becoming vegan could be the ethical issue of eating or wearing animal products. These people think it can’t be justified that animals are killed or held in factory farms just for human purposes.
Apart from the ethical reasons my personal question was, if being vegan could really be the key for a long and healthy life? Research showed me that vegan diets can be associated with a lot of health benefits. Besides younger looking skin and more energy, a strict vegan diet can improve your general health. According to “the Vegan Society”, vegan diets can also improve long term health and contribute to prevent from severe diseases. Vegan diets are linked with a lower risk of obesity, lower blood pressure, lower cholesterol and a lower risk of type-2-diabetes as well as lower risk of getting cardiovascular diseases. Plant based diets can even reduce the risk of certain kinds of cancer like prostate or breast cancer and can guard against strokes.
Except for the health benefits of a vegan diet, veganism is supposed to be more environmentally sustainable. Raising animals for food is one of the largest sources of greenhouse gases and expedites the problem of the climate change.
All in all, it can be said that veganism is more than a trend and it has a lot of benefits for long-term health condition, the environment, and of course for the animals. Although critical voices say that eliminating dairy products from your nutrition does remove an important source of calcium and meat is a great source of protein, iron, zinc and selenium.
I personally couldn’t imagine stopping eating any kind of dairy products like yoghurt or cheese or even eggs. But the more I research into this whole topic and about the benefits and advantages, the more interested I get. Maybe I should try to do the 30-day vegan challenge one day.
- Vegan Society – Definition of Veganism
- Vegan Society – Health
- Anzahl der Veganer in Deutschland
- How Many Vegans? One of the Fastest Growing Lifestyle Movements
- Skopos (2016): “1,3 Millionen Deutsche leben vegan”
- BMEL (2008): “Nationale Verzehrsstudie II: Wie sich Verbraucher in Deutschland ernähren”
Stormont Stalemate: Northern Irish Healthcare Provision in Uncertain Times
The following was written by Peter Magill.
Peter Magill is a student of International Politics and Conflict Studies at Queens University Belfast, UK, where his interests lie in Global governance and security.
Northern Ireland is seemingly in a state of perpetual political crisis. The latest dilemma originated in December 2016, when our devolved government in Stormont collapsed, after it emerged that First Minister Arlene Foster had allegedly poorly implemented a renewable energy initiative during her tenure as Enterprise Minister. This scheme is said to have wasted in excess of £1 billion of taxpayer’s money. To provide some context this is equivalent to 20% of the Northern Ireland Annual budget allocated for health care. As a consequence of this, for the past ten months, Northern Ireland has been without a functioning government, and whilst this is the longest period of crisis in recent years, it is but the latest in a series of crises that have paralysed the Stormont Executive.
Symptomatic of both the current political stalemate and its predecessors is a National Health Service (NHS) that has suffered from serious structural flaws, that have only been exasperated by the political climate.
The BBC recently conducted an extensive investigation into the operation of the NHS within Northern Ireland with particular emphasis on the Emergency Departments and Surgical waiting times. This investigation highlighted some of the serious issues faced by the NHS in Northern Ireland. For example, it found that many patients who require urgent surgery, face waiting times of up to three years to see a specialist consultant. Given that the NHS has established waiting time targets ranging from nine to fifteen weeks depending on the procedure, yet some patients are waiting approximately 155 weeks, this highlights the pressures within health care.
Equally, the BBC also identified that the NHS did not achieve any of the Accident and Emergency targets within Northern Ireland during 2009. These revelations have compounded the view that Northern Ireland officially has the most underperforming service provision within the United Kingdom NHS. This generated significant discussion within the local Media in October 2017.
Although the Healthcare providers within Northern Ireland have developed strategies to resolve these issues, will such measures be effective given the current political climate? In recent years there have been two major reports into reforming the NHS in Northern Ireland. In 2014 the former Health Minister Edwin Poots, commissioned the Chief Medical Officer of England, Professor Sir Liam Donaldson, to review the NHS in Northern Ireland and to recommend proposals for its reform. The subsequent Donaldson report was published in January 2015 under the auspices of the new Health Minister Jim Wells. This wide-reaching report contained several significant proposals. Most notably was the need to consolidate healthcare services across Northern Ireland. The report identified that Northern Ireland contains several small scale local hospitals that provide inadequate care. It proposed that it would be best to consolidate these services into larger regional hospitals to provide specialised higher quality care.
Then in November 2015 Health Minister Simon Hamilton commissioned Professor Rafael Bengoa to produce another report that built upon the Donaldson Report. When this was published a year later in October 2016, it contained several strategies for healthcare reform, and a stark warning that if the NHS did not reform then it would encompass Northern Ireland’s entire block grant by 2035. This report was warmly received and praised by Simon Hamilton’s successor Michelle O’Neil.
Disappointingly however the enthusiasm for political action has been profoundly lacking. After the Donaldson Report was published, the Health Minister Jim Wells paid lip service to the proposals it outlined but undertook little concrete action to implement them. It is perceived that this was partly because implementing the report would have most likely forced him to close the Down Hospital, located within his own constituency of South Down, which would have undoubtedly proved to be electorally unpopular. Consequently, the Donaldson Report was quietly side lined. Furthermore although Michelle O’Neil was enthusiastic with regards to the Bengoa Report, she took little concrete action to implement it during her tenure as Deputy First Minister in late 2016. The subsequent political stalemate has further compounded the situation and prevented progressive decisions from being taken.
The ongoing deadlock has also left Northern Ireland without an agreed financial budget, which has stranded the Health Service in a state of limbo with health staff unsure what their future operating budgets will look like. This has rendered the Department of Health in the unenviable position of asking Northern Ireland’s five health trusts to make combined savings of £70 million in the current financial year in order to balance their budgets. To further complicate matters, at the eleventh hour an additional £40 million was transferred from other departments to the health budget which partially delayed the implementation of these cuts in the short term.
All of these contributing factors have placed Healthcare provision within Northern Ireland in a precarious position. Given that a solution to the continuing political impasse appears increasingly unlikely after nearly a year of negotiation, and the future of power sharing itself in doubt these are indeed uncertain times for the NHS in Northern Ireland. It is therefore vital that politicians put aside their differences and work together to protect the NHS and ensure that it continues to be the bench mark for the rest of the world.
- BBC News – NHS surgery waits run into years in Northern Ireland, 17 October 2017
- BBC News – NI has never met key NHS cancer target, 18 October 2017
- Belfast Telegraph – Northern Ireland health service waiting times ‘worst in UK’, 18 October 2017
- Belfast Live – Northern Ireland Health Cuts, 24 August 2017
- The Department of Health – The Donaldson Report,
- The Department of Health – The Bengoa Report,
- Northern Ireland Executive – 2016-2017 Budget,
13 January 2016
Health in an achievement-orientated society
The following was written by Katharina Novak.
Katharina Novak is a student of Politics and Public Administration at Universität Konstanz, Germany. Additionally she is doing teacher training in politics and economy. Her research interests are in public health and human well-being.
Every time the clocks are changed, this means to me that winter is coming. Days get shorter, darkness descends early, and it usually gets a little colder every day. This goes hand in hand with the yearly recurring wave of influenza. Especially in this time, I become aware of the way people treat their health in a Western society.
If you take the train, you see many people with a runny nose. You hear a heavy “hatschiii” every few minutes, and nearly everybody is holding a handkerchief in their hand. You may wonder what they are doing on a train. First you may think: “Poor you, you must see a doctor, then go to a pharmacy to get some medicine and afterwards drive home and spend the next few days in bed to recover.”
But you are probably wrong. Most of them are in fact on their way to work, university or school even though they are obviously ill. This is something that can be seen occurring much more frequently. It seems like people don’t think about their health anymore. They don’t even take a cold seriously. They think they can determine their health on their own. It is crazy what we observe in daily life.
If you ask your colleagues at work why they aren’t at home recovering instead of working and spreading bacteria all over the office, you may hear things like: “I have so much work to do, I can’t be ill because of the deadline tomorrow.” Or you will hear worse things: “I don’t go to the doctor because he only gives me a sick note so that I have to stay at home and can’t continue my social life.” Yes, of course the doctor gives you a sick note, because you are sick.
Why don’t people accept that their body needs a break to recover when there are clear signs of an illness? With this thoughtless behavior a minor disease becomes serious, even though there is no need for it. People challenge their health for no reason. This seems irresponsible to me.
Sometimes people don’t seem to be aware of what they cause with their behavior. If you don’t take a fever seriously and keep on going as if you were well and maybe even go exercise, you may risk pneumonia or an inflammation of the heart muscle. This means a very serious disease that may lead to death even for young people. A rule is if the infection is not above the chest yet it is a cold and you can carry on but be aware of PUBLIC HEALTH, if it is in the chest then stop and rest.
In addition their behavior also affects the people around them in a negative way. They spread bacteria and viruses and may infect other people. With frequent social contact you may contribute to a wave of influenza. In case of children’s diseases it may also happen that a kindergarten has to be closed because of a mass infection. This may also seriously affect adults e.g. in the case of chickenpox, if the adults did not have it in their childhood and get infected in adulthood this is more severe.
On top of that, people are not that efficient if they are ill at work. Furthermore, they need more time to recover completely. However if they would have stayed at home for a few days, they would have recovered quicker. At the same time everyone is expected to be healthy all the time. People feel guilty if they have to stay at home because of a cold for two days. We all know that healthy people work efficiently. Because of that, it should be in all our interests to ensure we remain healthy, so that our economy runs as well as possible.
There is a paradox: You need healthy people to work efficiently but our society states that a cold is no reason to stay at home and recover – this again causes inefficiency. You face huge pressure to be healthy all the time. It seems that it is only possible or allowed to be ill on a weekend or during your holidays. Maybe this pressure is the key to the frequency of mental diseases in the Western world, e.g. burnout. Maximizing efficiency as the highest virtue at work leads to an achievement-orientated society and its values lead to a peculiar idea of health.
What kind of insanity is this? We life in a country without any serious communicable diseases, good hygiene and high living standards, insurances and a working public health system as well as a wealthy economy dominated by the service sector. In general, you don’t have to be afraid of getting ill because of heavy physical activity caused by bad working conditions. We all have the potential for a long healthy life. Why do we endanger this deliberately? Is it that the better the environment, the more we take our health for granted? Why don’t we use the opportunities we’re given?
What I would wish for our society? Take health as a present that has to be taken care of every day. Health does not last forever – not even in our environment. Cherish this gift and be responsible with it – it’s the most valuable thing that has been given to you in your life!
Global Health and the burden of a disease long forgotten in the western world
The following was written by Christoph Palatzke.
Christoph Palatzke is a B.A. student of sociology and in minor political science at the University Konstanz, Germany.
It was a Tuesday evening when I came back home from the University, had dinner and watched TV. I switched to the news right before primetime and followed the news anchor through the program. In the second half of it he presented a snippet from Madagascar. The outbreak of the pneumonic plague has killed a 100 people in about two weeks. I was shocked because in school we learned about the Black Death and that it was cured and beaten in Europe for a long time.
The plague in Madagascar is a little bit different from the one that decimated Europe. Once it infects humans it is airborne and attacks the lungs. In the news they showed footage from Madagascar and the fight of Médecins sans Frontières against the spreading of the disease. They reported that it came in smaller outbreaks from time to time in the last 10 or 20 years. They showed children sitting in garbage and an interviewed person complained about the circumstances they live in. The news explained that the circumstances on the island are well fitting for the agent to survive. Yersinia Pestis is transmitted from rats to fleas and from fleas to the human and the rats like dirty, food rich environments.
I was shocked that in the 21st century we still have to struggle with such a grave disease caused by bacteria. Especially when it is treated easily with antibiotics as MSF explained in the news. I started to research about the topic and found that this disease, or more correctly the bacteria causing it isn’t extinct at all. In a few regions of the world it is still endemic and for example in the US Southwest there are a few registered cases every year. But the number of deaths seams manageable compared to other diseases like AIDS or Ebola. From 2010 to 2015 according to the WHO there were about 584 reported deaths.
Madagascar experiences about 400 cases annually. Especially from September to April during rain period the numbers rise. With this new outbreak, just in a few weeks there were 1100 reported cases and about a 100 deaths. The rainy period has just begun. Checking the website of the Institute of Health Metrics and Evaluation for Madagascar we can see that the pneumonic plague doesn’t show up as a separate entry. Probably it is summed up with Other group I diseases but even than it is only at rank 7 and makes up for 3.8 per cent of deaths in 2016. So maybe it doesn’t seem like much but these lives could easily be saved with the amount of medicine we consume every day in the western world.
The WHO reacted quickly to this fast spreading disease and sent medicine and staff. They are still asking for money to train local health workers to diagnose new cases. According to my research 55% of the cases are located in cities so the transmission could go on faster.
Thinking about all that I came to two alarming thoughts. We are aware of the amount of antibiotics in our food because of diseases like the swine flu for example. Not just because of the consequences of this zoonotic diseases and the possibility of a spillover to the human, but for the resistance some pathogens can develop or have already developed. Hospitals are in a constant fight against these pathogens and though they handle the problem there are still big risks. People go to hospitals to get healthy and may come back sicker.
So we are talking about organic farming. We are willing to pay more money for our food to avoid the massive use of antibiotics. But meanwhile people are getting sick and die because there are not enough antibiotics to fight the plague. Of course there is a problem of financing in a globalized and capitalized world. When the WHO first calculated a high risk that the pneumonic plague could spread easily from Madagascar to the neighbor countries we should probably rethink our priorities. Additionally, when looking at the spreading in cities and taking into account the risk of more dangerous diseases coming up the ongoing trend of urbanization becomes even more frightening.
I’m glad we have organizations like the WHO that can react mostly independent on those threats. But it needs permission from the governments to help and has to operate worldwide. Improving the circumstances people live in maybe a tricky thing but it shouldn’t be too difficult to distribute medicine where it is needed. Also the improvement of the hygiene should be possible. For example the United States of America with its responsive health care system, disease control and awareness for hygiene can handle a few pneumonic plague cases a year but Madagascar can’t. After all we can only hope that our health care systems all over the world and organizations are able to respond fast enough and maybe one day we can defeat those diseases.
- Business Insider – A disturbing plague outbreak has killed 124 people and infected more than 1,000 in Madagascar
- Business Insider – Fleas carrying the bubonic plague have been found in Arizona
- WHO – Plague Outbreak Madagascar – External Situation Report 01
- IHME – Viz Hub
- WHO – Plague
- ZDF – Lungenpest in Madagaskar
HIV/Aids – an epidemic of women?
The following was written by Hanna Grauert.
Hanna Grauert is student of Sociology and Political Sciences at University of Konstanz, Germany. Her research interests include mental health and migration.
I am a young, independent and healthy woman, well aware of the right to control my body and health and free from any interference. These rights are securely established in the country I live. In the following I will discuss why I shouldn’t take this for granted, especially as a young women:
The World Health Organization defines the right to health as ”the enjoyment of the highest attainable standard of health” (WHO, 1948). According to the WHO Constitution this enjoyment of health is a fundamental right of every human being. Human Rights and the right to health are closely linked to each other but unfortunately not every human has the same access to a “right of health”.
Although these rights are written black on white in constitutions of many countries and organizations, we face a different reality because especially women face lack of equal effective enjoyment of their rights and health, and experience them differently than men. I particularly want to point out, how the HIV/Aids epidemic has had an adverse effect on women’s life and their health worldwide:
“This epidemic unfortunately remains an epidemic of women” (Michel Sidibé, Executive Director of UNAIDS, 2010)
More specifically I want to draw attention to South Africa, because it has one of the highest rates of HIV/Aids infections worldwide. Nearly 1 in 5 of those living with HIV globally live in South Africa (Across Women’s Life, 2017). But whereas media often focus on so called high risk groups like the “homosexual community”, “drug scene” or “sex workers” women are often underrepresented and forgotten in statistics. For example in South Africa, young women’s HIV rate is twice as high as young men’s. This leads to the question WHY young women in South Africa have such a tremendously higher risk to be infected by HIV than German women such as me?
Because of their unequal economic, social and cultural status in their societies they face bigger challenges in life. The poorest women have little choice to improve their lives so they enter for example into a relation with a so called #blesser out of economic reasons. This is a relationship between a young women with an older, wealthier man also known as “sugar daddy” (Across Women’s Life, 2017). These intergenerational relationships are of transactional nature with the motivation of many young women that sex will be exchanged for something with a tangible value. The problem of these intergenerational relationships is the risky sexual behaviour. On the one hand many older men resist protection out of conservative and also self-pleasing beliefs. On the other hand girls resist carrying a condom with them because of the fear being perceived as promiscuous. Of course not every “sugar daddy” is HIV positive but it can be seen as a driving cycle of infections when older men have several sexual relationships with younger women.
A second major problem is in South Africa for transmission of HIV is intimate and gender based violence. South Africa has one of the highest rates of rape in the world and especially young women at age from 15 to 24 are victims of it (see statistic, 2012). The sad truth is, that women experienced violence in their partnerships or rape are 50% more likely to acquire HIV than women who don’t.
Gender based violence is not only a problem in South Africa, it is a reality in many countries and societies. Almost one third of all women worldwide reported they have experienced some form of physical or sexual violence by their partner (UNAIDS, 2013). Of course this violence against women can have an adverse impact not only on their physical, mental and sexual health, but can also increase the vulnerability to HIV. In 2015, 20% of new HIV infections were among women aged 15-24. These figures hide and do not sufficiently emphasize that these infections of young women are due to intergenerational relationships, violence and rape.
Intergenerational relationships, gender based violence and the HIV risk for young women needs further discussion. It requires a multi-sectoral response to achieve changes. On the one hand it is important to enact stronger legislation against discrimination of women and to enforce gender equality. On the other hand these changes must also be culturally and socially accepted to stop gender based violence and to achieve behavioural changes in societies.
Women and girls have the right to live free of violence and inequities and to protect themselves against HIV (Michel Sidibé, Executive Director of UNAIDS, 2010)
Although women have a high risk to acquire HIV, we here in Germany are not facing the same risk for these dangers. As I mentioned in the beginning I feel as a young, strong and independent women protected by law and also living with the confidence that I have the same rights as men in my country. But not every women in our world can feel so confident about her rights and health. Gender-based violence and inequality is a violation of human rights and its need to change is not only about stopping HIV infections and protecting women from it- it is also about eliminating gender gaps in general!
- Across Women’s Lives (2017). In South Africa, HIV rates are rising in young women and girls. Our new series looks at the reasons why. [01.11.2017].
- Constitution of the World Health Organization. Geneva: World Health Organization. 1948.
- Shisana O, Rehle T, Simbayi LC, Zuma K, Jooste S, Zungu N, Labadarios D, Onoya D et al. (2014) South African National HIV Prevalence, Incidence and Behaviour Survey, 2012. Cape Town: HSRC Press.
- UNAIDS (2013). UNAIDS calls for an end to gender-bases violence. [01.11.2017].
- United Nations News Centre (2010) ‘Noting progress to date, Ban urges greater efforts against HIV/AIDS’ [01.11.2017].
Why are parents deciding to not let their children get the important vaccinations against childhood diseases anymore? How can we solve this problem?
The following was written by Jennifer Schlachter.
Jennifer Schlachter is a bachelor student of Sociology and Political Sciences at Universität Konstanz, Germany. She visited to seminar „Global Health Challenges: HIV and other Epidemics“ by Dr. Alan Whiteside in winter semester 2017/2018 and is interested in doing her master in the research field „Global Health“.
In Germany it is common for children to get vaccinations against the common childhood diseases during their early childhood. According to the Bundeszentrale für gesundheitliche Aufklärung (Federal Center for Health Education; BZgA) these are measles, whooping cough, mumps, diphtheria, tick-borne encephalitis (TBE), flu, hepatitis, HIB, HPV, tetanus, meningococcal infection, pneumococcal infection, polio, rotavirus, rubella and chickenpox.
Because most of the children get these injections these diseases have become very rare. That’s why most people have forgotten about the risk. Without these vaccinations communicable diseases might become a serious problem again. That’s why it´s important that the majority of the population gets these injections during childhood. The costs for the recommended vaccinations are paid by statutory health insurances to make sure that every child has the chance to get them (Cf. Bundeszentrale für gesundheitliche Aufklärung).
On the other hand, during recent years many campaigns have developed that see all kinds of vaccinations critically. In Germany there are campaigns like “Impfen? – Nein Danke!” (Vaccinations? – No, thanks.”) or “Impfschaden” (Vaccination damage) who raise their voices against children getting vaccinations in their early years, and who inform the people about the risks and damages caused by vaccinations.
But what are the arguments of so-called opposing vaccinations? First of all they see vaccinations as medical interventions on a healthy child. Another argument is, that these early diseases would strengthen the immune system.
Children´s doctor and homeopath Martin Hirte explains in a German TV-Production that not all recommended vaccinations for young children are necessary. This TV-Production that was produced by the German channel “3-Sat” also gives Ulrich Fegeler a chance to speak. He belongs to the supporters of vaccination and recommends that children get vaccinations against communicable diseases during their first two life years. He argues that even if you haven´t seen your enemy (the diseases) for years, this doesn´t automatically mean that its gone. But people might get the feeling that the disease never existed. He warns that if people don’t get vaccinations anymore, illnesses would increase and spread dramatically (Cf. 3-Sat (2014): Impfen – Nein Danke?”).
When parents decide against vaccinations, diseases that are believed to be extinct like measles might come back. This is what happens nowadays in industrial countries. In 2015 the number of measles case in Germany was about 2,464 people (Cf. Robert Koch Institut). All these people could have been healthy if they got vaccinations against measles in their early childhood. Without these vaccinations the disease could lead to death.
One big problem in Germany is that vaccinations are voluntary. So parents don’t have to protect their children of becoming infected with childhood diseases. But the name childhood disease doesn´t mean that these diseases can only infect children. They could become a problem and danger for everybody who didn´t receive the vaccinations during childhood. That’s why we should take this problem very serious.
To bring attention to childhood diseases and the recommended vaccinations around the BZgA started the campaign “Deutschland sucht seinen Impfpass” (Germany searches for its vaccination certificate). The campaign works with posters, all over the country and, of course, via the Internet. On their webpage people can inform themselves about the recommended vaccinations and test if they received all of them or should revaccinate for some.
One big issue for this campaign is measles, which are as mentioned before still a problem in Germany because not everybody got the recommended vaccinations during childhood. Supported by famous German Youtubers and amusing quizzes the campaign tries to raise awareness in the population, especially on young people, their most important target group (Cf. Bundeszentrale für gesundheitliche Bildung).
This campaign is a first step to raise awareness on this important topic. But what we could also think of is the implementation of a ‘vaccination duty’ for some serious diseases like measles. But then there is the question how much influence the state may have on people´s decisions. Health and medicine is always a difficult topic, because also within the medical scene there are contrary opinions like those of two doctors on the topic mentioned before. Maybe it would be a good step to find a consistent solution, which is obligatory for everybody, even if people lose a little part of their freedom. I think a healthy population should come first, especially concerning diseases which can lead to death without vaccinations.
Another challenge for our future is the question of immigrants receiving the recommended vaccinations. In their countries of origin these diseases might be a more serious problem, and some might be infected when they arrive in Germany. That’s why it’s very important that the state makes sure that everybody is vaccinated and make epidemics unlikely.
- Bundeszentrale für gesundheitliche Aufklärung. 2017.
Impfempfehlungen für Kinder (0-12 Jahre) (30.10.17)
- Bundeszentrale für gesundheitliche Aufklärung. 2017.
Deutschland sucht den Impfpass. (01.11.17)
- 3-Sat (2016). Impfen – nein danke? (01.11.17)
- Robert Koch Institut (2017). Aktuelle epidemiologische Situation der Masern und Röteln in Deutschland (01.11.17)
The Western Approach to Health
The following was written by Janina Jacob
Most of us have taken medication at some point in our life, starting with a sweet cough syrup tasting like cherries or oranges, going on with painkillers for different reasons. If you are a woman, you maybe swallow a pill almost every day for many years to not get pregnant. When you fall ill in old age you may, like my late grandmother, have to take a whole cocktail of pills to survive.
When I was in London with my school, we visited the British Museum and their gallery “living and dying”. In the center of the room was a long table, displaying a 14-meter long fabric which incorporated pills and capsules taken by an average man and woman though their life. Next to it, the life story of these two people was provided with some pictures and explanations why they had taken the medications displayed. This installation, called “Cradle to Grave” focuses on “the Western biomedical approach to ill health with its reliance on medicines, which we take in ever increasing amounts as we move from birth, childhood and adulthood into old age and eventually death.” Pharmacopoeia, is a medical-art collaboration between the artists Susie Freeman and David Critchley and the family doctor Liz Lee.
At an age of barely eighteen I was extremely impressed by the huge amount of -mostly chemical- medication I probably already had and still will allow to enter my organism. Because, like the artist criticized, I take the easy approach and why should I suffer hour and hours in my bed with a headache when I can easily take a pill and go on with my life? I do this, believing this pill only helps me and not do me damage. But does it? And how can I be so sure of it? Has anyone really read the leaflet?
For one, I trust that the government of my country will only allow active substances that have none to low negative effects on health. But how is that tested? To be sure new medications and active substances are not only digestible but have the desired effect, animal testing, no matter how disputed, will not suffice. To have a chance to get a license for the new product, pharmaceutical industries have to test on humans, especially on humans who suffer the illness they are trying to cure.
To get a license that authorizes you to sell the medication in Germany you must send your application to the federal institute of pharmaceuticals and medical products. This includes information about preclinical and clinical studies about the finished product. Usually this means testing in different phases. After scientists found an active substance that reacts for example with a virus, they test the said substance on 60-80 healthy people for its safety. In this part, they also decide on the form of administration. If the active substance survives this test, it is now tested for its therapeutic effect on 100-500 real patients. Now the dose of the medicine will be determined. In the last phase, the finished product is tested on several hundreds to thousands real patients, including control groups, on its specific use and possible side effects.
Before they can sell the new drug, pharmaceutical industries therefore have to test on many patients. Since they bear most of the costs themselves and only a small number of new products survive all tests, pharmaceutical companies are trying, like every economic thinking company, to be cost effective. Often, they turn to developing countries, because they have laxer legal regulations, the people are poor and lack education and have higher occurrences of illnesses.
Testing new medication can have risks, too, shown by litigation between Pfizer and the state of Kano of Nigeria. It is alleged eleven children died due to testing a new antibiotic against meningitis during an epidemic in 1996. Although it makes sense to test the new drug on these people, and Pfizer claimed the deaths were results of the illness, the Guardian reported that “Pfizer did not have proper consent from parents to use an experimental drug on their children and question were raised over the documentation of the trial.”
In the end, we all should keep in mind that even licensed medication only has a good use-risk-ratio but must not be completely harmless. Many people are risking their health and sometimes life by testing new active substances and medications for the greater good and hope of healing. But Pharma industries also want to earn money and for one good selling drug they are willing to take risks. Maybe if we had chosen a different lifestyle the world would look a bit different.