Category: Health and Wellness

  • It is up to all of us to stand up to bullies

    It is up to all of us to stand up to bullies

    In the northern part of the country of a thousand hills, amidst volcanoes and the freezing air, there resides a Catholic high school. My name is Anderson and this is my story. I went to study there right after finishing my primary school.

    The school was competitive; the smartest, most intelligent and most talented students were found there. It was a school of sciences and it used to be in the top five best high schools in the country. It had an amazing environment. Though strict academically, the teachers were among the best.

    When I arrived, it wasn’t that hard to fit in because my elder sister had studied there before me. Some senior students recognized the resemblance and helped me get used to the school. This also gave me the privilege of not being bullied.

    Normally, new students in S1 were bullied by seniors and couldn’t report it because they were scared of what might happen. The bullying was actually different based on gender. Boys were beaten severely, while girls were pressured into “dating” seniors. You might think dating sounds harmless, but it often involved bullying too.

    There was a male friend of mine who was told to sit on his fork (the one used when we are eating) and say his weight — if he didn’t, the other students would beat him badly. This was also ridiculous because a fork cannot be used to measure someone’s weight. Another was given a leaf from a tree and told to use it to call his parents — again, he was beaten. This was a type of bullying because obviously you can’t talk on the leaf; they wanted him to pretend that the leaf is the phone.

    On the other hand, my girlfriend was called out by senior boys, made to greet each one in a way they preferred and surrounded by a big circle of them. In summary, the first year was really hard for some students.

    The bullied become bullies

    By the second year, we were seniors to new students and some of us began to bully them. At this point, I understood the perspective of bullies — though it didn’t justify their actions. Seeing new students, you feel the tendency to assert your seniority and demand respect.

    Some classmates acted out of revenge, targeting new students for what they had endured. On my side, I welcomed them with kindness and tried to help them adapt, knowing how hard it had been.

    We used to have shows, which were my favorite part. I loved fashion and wanted to model in the shows, but I was always scared. During the shows, boys would often stand at the entrance, waiting to touch the girls’ bodies; breasts, buttocks, even private parts. Girls could complain, but some students and authorities argued that some girls “wanted to be touched.”

    Others said that if girls didn’t want it, they could avoid participating or avoid wearing revealing clothes. Though some authorities promised to investigate, they often ignored the problem. Shows were considered entertainment, so the school left the organization to students. At some point, students feared reporting, worried the school might ban shows entirely.

    It wasn’t only during shows. In class, we had a group of bullies we studied with. When the lights went out, girls would run outside immediately, because boys would touch them by force in the darkness.

    When harassment is condoned

    Once, I was sitting in class, my head on the desk, taking a nap. The lights went out and I didn’t notice. I woke up surrounded by boys. When I tried to leave, they blocked my way. One of them, called Chris, touched my breasts and others grabbed me as well. I felt scared, ashamed and angry. They were about to do more, but fortunately, other students started entering the class, and they left.

    I laid my head back on the desk and cried. When people asked what was wrong, I couldn’t say. I had few friends; just my twin sister and another girl. When I reached the dormitory, I cried the whole night. My friend checked on me and though I hesitated at first, she comforted me.

    I opened up and told her the story. To my surprise, she had also been harassed by the same boy, Chris. He was undisciplined and we didn’t know how to report him; there was no evidence and I wasn’t ready.

    I spent months blaming myself. I was ashamed, hated myself and even had suicidal thoughts. My heart felt broken into pieces and no day passed without crying. But my twin sister was there for me. We cried together and I felt comforted. She suggested that we learn karate so no boy would dare harass me again.

    We joined a karate club at school. It was amazing. The group was friendly, teaching discipline, teamwork and flexibility. Chris still mocked me, but I knew he was scared. In class, he never bullied me again. I continued learning karate even in other schools.

    Fighting harassment

    At other schools, I began my journey in leadership. I was voted Head Girl at two schools, started reading about feminism and realized I was a feminist. I began challenging unfair school policies that hindered one gender. On many campuses, girls were forced to do cleaning chores because culture expected them to be “decent” and “clean.”

    Boys were allowed privileges girls could not have, without clear reason. It was a hard battle because authorities were biased. When I finished high school, I was voted Minister of Gender Promotion at my campus.

    Reflecting on my high school experience, I realized many other girls knew stories of friends who were sexually assaulted and who couldn’t report it. Sometimes it was done to them by teachers or fellow students or authorities.

    Schools often silence reports to protect their reputation. I understand that, but it shouldn’t come at the cost of student safety. There weren’t reporting platforms in place, but when girls tried to report, they were sometimes blamed, told they “wanted it.”

    All of this motivated me to start a high school research project to assess the impact of school policies, sexual harassment and sextortion (this means when someone asks for sexual intercourse in exchange for a certain favor. In this context it may be to give you grades or other favors which you can get after having sex with that person offering it) on gender equality outcomes in high schools.

    I am still working on my proposal, applying feedback and hoping for approval. As a survivor, I want to help my younger sisters get justice. I want to ensure no other girl cries alone at night, hiding the trauma she endured. I want to be their voice and advocate for solutions as youth.

    This is my story — though it is still being written and it is far from over.

    Questions to consider:

    1. How can someone who is bullied become a bully?

    2. Where do you think that some people get the idea that sexual harrassment is acceptable?

    3. Have you ever been bullied or felt harrassed at school?

    Source link

  • How one young woman broke free of a media addiction

    How one young woman broke free of a media addiction

    I knew every word to the saddest songs on my playlist. Not because I loved music, but because depression had become my language. I was 14, lying in my room with my family just beyond the door, close enough to hear their voices, far enough that they might as well have been in another country.

    I had been expelled from school months earlier. “Disciplinary issues,” they called it. My family’s disappointment sat heavy in our home, unspoken but everywhere. We lived together, ate together, but there was no closeness, no one I could talk to.

    I tried to find help. I downloaded mental health apps, desperate for someone, anyone, to talk to. Every single one wanted money: subscriptions, fees, payments I couldn’t afford. I stared at those payment screens feeling like I was drowning, watching help float just out of reach.

    That’s when the screen became my only escape. It started two years earlier, in Primary 6, when house workers casually showed me explicit images on their phones. I was just a child; curious, confused, not understanding what I was seeing. Then it continued at school with friends, and something awakened in me that I didn’t know how to name or control.

    Now, alone and depressed, pornography became my refuge. Not because it made me happy, but because for a few minutes, it made me feel something other than suffocating sadness. It was free. It was always available. And unlike everyone in my life, it didn’t judge me.

    A cycle begins

    I didn’t wake up one morning and decide to be addicted. At first, it felt harmless, a way to escape. I told myself, It’s just this once. I’m in control. But addiction is a liar. Soon, it wasn’t me making the choices, the choices were making me.

    I became a professional actor: smiling, joking, saying “I’m fine.” Inside, I was drowning. Mornings brought disgust and broken promises. “This is the last time,” I would whisper. By evening, I was back in the same cycle.

    Being a Christian made it worse. How could I worship on Sunday and fall back into the same pit during the week? I carried my Bible with trembling hands, wondering: Does God still want me? Is He tired of forgiving me?

    What made everything harder was the silence; not just mine, but from my entire community.

    In many African homes, conversations about struggles don’t happen. Children are raised to “be strong,” “obey,” and “not bring shame.” So, when addiction creeps in, we already know: I can’t tell my parents because we know the response is often punishment and disappointment rather than compassion and feeling secure.

    The things we don’t discuss

    My family was no different. We shared meals, went to church together. But I couldn’t tell them about the depression that made me want to die, or the addiction consuming me. Not because they were cruel, but because we’d never learned how to talk about things that hurt.

    In many communities, struggles like pornography are labeled as spiritual weakness rather than human pain. Youth are told to “pray harder” while root wounds remain untouched. Girls especially face pressure to be “good daughters” because any confession can bring family shame.

    After my expulsion, I carried not just my own shame, but my family’s disappointment, the fear of being labeled a failure, the burden of disgrace.

    Addiction thrives in that silence. It feeds on fear; fear of punishment, of shame, of losing respect. So, we hide behind grades, church attendance, fake smiles. Inside, we are prisoners.

    For Christians struggling with addiction, the battle isn’t linear. One day you pray and feel close to God; the next, guilt crashes down. You confess, repent, hope but relapse comes again. I can’t get free. I’m weak. I keep failing.

    Faith meets struggle.

    Each fall reinforces the lie that you’re beyond redemption. You watch others grow in faith and compare your hidden failures to their visible victories. The church can make this harder. Fear of gossip or rejection stops you from seeking support. If they knew, would they still respect me?

    I struggled with this constantly. Sundays brought worship and hope. By Tuesday, I’d be back in the cycle, convinced I’d disappointed God one too many times. Everyone seemed to have faith figured out while I failed again and again.

    It’s strange having a full contact list but feeling completely alone. People assume you’re fine. “You’re always smiling,” they say. That image becomes a trap. If you break the mask, they might judge.

    The worst I’ve discovered is that the more people around you, the lonelier you feel. Addiction thrives in isolation. Your mind becomes a battlefield of self-condemnation and guilt. You wonder if anyone could love you as you are not as the image you show.

    When you reach out, friends often laugh it off or assume you’re exaggerating. Each failed attempt reinforces that isolation is safer than vulnerability. Trust issues build. You question whether anyone can handle your truth.

    Small steps forward 

    I haven’t stopped struggling. But I’ve discovered steps that help me keep moving forward. God’s presence never left me, even when I couldn’t feel it. Even in the darkest moments, there was a whisper: You are not finished. I’m still here.

    I’ve learned to pray honestly. One night I prayed: “God, I’m tired. I failed again.” That messy prayer brought relief. God doesn’t need eloquence, He wants honesty.

    Scripture became my anchor: “My grace is sufficient for you, for my power is made perfect in weakness” (2 Corinthians 12:9). These words remind me that weakness doesn’t disqualify me.

    I’ve sought godly friendship. Sharing my struggle with a mentor brought prayer, guidance, and relief I hadn’t felt in years. Accountability isn’t about judgment; it’s about having allies who speak truth when you’re too weary.

    I celebrate small wins: resisting harmful content one morning, admitting a relapse to a friend, choosing honesty over shame. These moments prove God is working, even if change feels slow.

    Most importantly, I keep returning to God. After rough weeks, I kneel and whisper, “I’m here again, God,” and find quiet peace. The journey isn’t linear, but persistent return is how healing begins.

    Lessons and hope 

    Silence makes struggle worse; speaking lifts the burden. Faith doesn’t remove struggle, but gives hope and a path forward. Vulnerability is strength. Grace works in the mess. Small wins matter.

    If you feel trapped by addiction, shame or loneliness: you are not alone, and your story isn’t finished. God sees every hidden struggle, every tear, every relapse, every moment you’ve smiled while breaking inside. His love is stronger than any fear or guilt you carry.

    Change may be slow. You may stumble again. But every honest step toward God, every whispered prayer, every confession is victory. The times you felt weakest may be when God was shaping your heart for strength.

    Do not be discouraged by setbacks. Healing is a process. God’s timing is perfect, his grace persistent. You are not defined by your struggles; you’re defined by the God who pursues you relentlessly and turns brokenness into testimony.

    To my fellow young Africans carrying battles in silence: I see you. Your pain is real. The silence in your home is real. But so is God’s grace, the possibility of healing, and the chance that your story could be the hope someone else needs.

    I am still on this journey. There are days when old habits call, when depression threatens, when I feel eight years of struggle. But I’m learning that every day I turn back to God, I choose life over death, hope over despair, truth over silence.

    Remember: hope is not passive. It’s a daily choice to trust that God sees you, values you and has a purpose for you. Your story is not over. It is still being written, and your struggles are chapters, not the conclusion. Break the silence. Reach out. Trust that there is grace enough for every fall, love enough for every shame and hope enough for every tomorrow.

    You are not alone.

    Questions to consider:

    1. Why might someone turn to media, like pornography, as a way to escape depression or loneliness?

    2. Why do you think media addiction is so difficult to break from?

    3. If you knew of someone with an addiction, how might you help them free themselves from it?

    Source link

  • The high costs of cheap food

    The high costs of cheap food

    From New York to Jakarta, the scene is the same: Shelves overflowing with cheap, ultra-processed snacks and sugary drinks have become the new normal for millions of children. As a result, for the first time in history, more children are obese than underweight.

    UNICEF’s new Feeding Profit report explains why: Across the globe, cheap and intensely marketed ultra-processed foods dominate what families are able to put on the table, while nutritious options remain out of reach.

    Across the world, one in 20 children under five and one in five children and adolescents aged five to 19 are overweight. The number of overweight children and teens in 2000 almost doubled by 2022, with South Asia experiencing an increase of almost 500%. In East Asia, the Pacific, Latin America, the Caribbean, the Middle East and North Africa, the increase was at least 10%.

    Ultra-processed foods and beverages, defined as industrially formulated, are composed primarily of chemically-modified substances extracted from foods, together with additives and preservatives to enhance taste, texture and appearance as well as shelf life.

    These foods — which are often cheaper, nutrient poor and higher in sugar, unhealthy fats and salt — are now more prevalent than traditional, nutritious foods in children’s diets.

    Can we wean ourselves off ultra-processed foods?

    Studies show there’s a direct link between eating a lot of ultra-processed foods and an increased risk of overweight and obesity among children and adolescents. Among teens aged 15-19 years, 60% consumed more than one sugary food or beverage during the previous day, 32% consumed a soft drink and 25% consumed more than one salty processed food.

    Today, children’s paths to healthy eating are shaped less by personal choice than by the food environments that surround them. Those are the places where and conditions under which people make decisions about what to eat. They connect a person’s daily life with the broader food system around them, and are shaped by physical, political, economic and cultural factors that help determine what foods are available, affordable, appealing and regularly eaten.

    Such environments are steering children toward ultra-processed, calorie-dense options, even when healthier foods are available.

    Around the world, countries are beginning to push back. In Mexico, where nearly four million children aged 4-10 are obese, the government took a bold step in March 2025. It banned the sale of ultra-processed foods and sugary drinks in schools.

    The new rules go beyond restriction: Schools must offer fresh, regional foods such as fruits, vegetables and seeds, promote water as the default beverage, and establish health education programs. The policy also calls for regular health monitoring, mandatory fortification of wheat and corn flours, and more opportunities for physical activity, with penalties for schools that fail to comply.

    Taking steps to slim down our diets

    In September 2025, Malaysia’s Ministry of Education followed similar steps. It now prohibits 12 categories of ultra-processed foods and drinks in school canteens, from instant noodles and skewered snacks to frozen desserts and candy.

    But even as countries rewrite their food policies, millions of families still face difficult choices at the market.

    Shauna Downs, associate professor of food policy and public health nutrition at Rutgers University, has seen firsthand how hunger and obesity can coexist within the same communities in her research on informal settlements in Nairobi, Kenya.

    “People are able to find nutrient-rich foods, like leafy greens, fruits, and vegetables, and animal-source foods, but they’re often expensive, and what they can get that’s cheaper is things like mandazi [fried dough], which provide energy, and they taste good, but they’re not getting the nutrients they need,” she said.

    Families that want to buy the nutrient-rich foods are forced into heartbreaking choices, Downs said.

    “So now they’re making a decision between ‘Am I gonna buy this food from the market, which my family needs, or am I gonna pay for my child to go to school?’” she said.

    Looking at food environments

    By spotlighting the food environment, consumers and researchers alike can move past the tired “eat less, move more” narrative to fight childhood obesity and ask a better question: Why wasn’t the healthy plate the obvious, easy and most affordable choice in the first place?

    Long before ultra-processed foods flooded grocery shelves, they quietly took over another key part of children’s lives: school cafeterias. Back in 1981, the Reagan administration cut US$1.5 billion in U.S. school food funding, pushing public institutions to rely on convenience over nutrition.

    Pamela Koch, associate professor of nutrition and education at Teachers College, Columbia University, said that one of the things cut was for funding for schools  upgrade their kitchens.

    “That was the same time as the food supply was becoming more and more [saturated] with highly-processed food, and a lot of food companies realized, ‘Wait, we could have a market selling to schools. Schools don’t have money to buy supplies’,” Koch said.

    Companies began offering deals: Sign a long-term contract and receive a free convection oven to reheat ultra-processed foods. For schools facing budget cuts and limited staffing, the decision was simple. The cost of that convenience would echo for decades.

    Let’s start with school meals.

    The nonprofit Global Child Nutrition Foundation, highlights school meals as an essential lever for transforming food systems: Create demand for nutritious foods, improve the livelihoods of those working in the food system and promote climate-smart foods. However, the cost of scaling up national programs depends on the strength of supply chains, underlying food markets, logistics and procurement models.

    Countries that depend on imported food, already challenged by infrastructure and expensive trading costs, will face additional challenges in delivering healthy school meals.

    In much of the world, climate stress and weak infrastructure are making nutritious food both more difficult to grow and more expensive to purchase.

    Small-scale farmers, sheep and cattle farmers, forest keepers and fishers — known collectively as smallholder farmers — grow much of the food in low-income countries. They face worsening yields due to climate change, land degradation and lack of access to the technology and resources that support sustainable food production.

    At the same time perishable foods are becoming more expensive because the global supply chain — how food gets shipped from a farm in one country through distribution networks to store shelves in another country — is increasingly threatened by political tension, the lasting effects of the COVID-19 pandemic and climate change.

    Durability over nutrition

    Kate Schneider, assistant professor of sustainable food systems at Arizona State University, said that smallholder farmers grow food as their livelihood. “They’re not able to grow enough food, which is partly a story of climate change,” Schneider said. “Multiple generations now have been farming … year after year on the same land, but without external inputs –– fertilizers and modern, high-yielding seeds –– they are resulting in very low yields.”

    Even when fresh fruits and vegetables are available, logistical barriers make it easier to sell ultra-processed foods. Fresh produce is heavy, vulnerable to spoilage and expensive to move, especially in countries with poor transport networks.

    “When we’re thinking about fresh items, they’re perishable, and they need a cold chain,” Schneider said. “You’re paying, when you buy an apple, for the three that also rotted.”

    Meanwhile, ultra-processed products like soda avoid this problem entirely: “It’s cheaper for them to have a ton of different bottling plants around countries than to distribute long distances,” Schneider said.

    The result of these challenges is a global system that rewards durability over nutrition and continues to make healthy food increasingly out of reach.

    Connecting sustainability of diets and the environment

    The EAT-Lancet Commission 2.0, a scientific body redefining healthy and sustainable diets, offers a different view: The ultra-processed foods fuelling obesity are also pushing food systems beyond climate and biodiversity limits.

    Its newly published report says that nearly half the world’s population can’t afford a healthy diet, while the richest 30% generate more than 70% of food-related environmental damage.

    The planetary health diet suggests a plant-rich diet that consists of whole grains, fruits, vegetables, nuts and beans, with only moderate or small amounts of fish, dairy and meat.

    To build healthier and more just food systems, experts also recommend a whole list of other things: make nutritious diets more accessible and affordable; protect traditional diets; promote sustainable farming and ecosystems; reduce food waste.

    And all of this should be done with the participation of diverse sectors of the society.

    The responsibility of transforming food systems falls not only on governments but also on donors and financial partners, development and humanitarian organizations, academic institutions and civil society. The stakes are high, but so is the potential to change. With bold, coordinated action, the next generation of children can be nourished by healthy food, while building food systems that sustain both people and the planet. 

    Questions to consider:

    1. How is obesity connected to the environment?

    2. What are some governments doing to try to tackle the obesity crisis?

    3. What changes could you make to your diet to make it healthier?

     

    Source link

  • When life is bitter, don’t lose hope

    When life is bitter, don’t lose hope

    When life takes away your greatest support, it can feel as if the world is falling apart. For me, losing my father as a child was more than heartbreaking. It was a true test of strength. Yet in a world that often seemed bitter, the kindness of strangers and the power of personal dreams helped me rise above my sorrow and shape a future full of hope.

    My family and I live in the Eastern province of Rwanda. I was only five years old when one morning, my father packed his bag and left the house. He didn’t say where he was going and he never came back. Days turned into weeks, weeks into years, but there was no sign of him. No call. No letter. Nothing. 

    At first, I didn’t understand what was happening. I kept asking my mother, “When is Papa coming back?” But she would just smile sadly and say, “One day, maybe.”

    In her heart, she knew he was not coming back. 

    Life changed quickly after that. Without a father and without money, things became hard for the family. My mother, Catherine, had no job. She had never worked outside the home before. Now, she had to take care of me and my four siblings alone. 

    Struggling with little

    We had no house of our own. We moved from one place to another, staying with kind neighbors or sleeping in small, broken huts. During rainy nights, water would leak through the roof and we had to stay awake holding buckets. Sometimes, we didn’t even have enough food to eat. Many nights, we went to bed hungry. 

    My siblings were in high school at the time, but the family could not afford school fees anymore. One by one, they dropped out and stayed home. It was painful for me to watch them suffer. I loved them deeply and wanted a better life for all of them. 

    Despite everything, I stayed in school. My mother worked hard doing small jobs washing clothes, digging gardens or selling vegetables in the market. She never gave up. “You are our hope,” she would tell me. “Even if your father left, we must move forward.”

    I listened. I promised myself that no matter how hard life became, I would not give up. I wanted to finish school, go to university and one day help my family live a better life. 

    But it was not easy. 

    Help can come from surprising places.

    I often went to school with old shoes. I had no school bag only an old plastic bag to carry my books. I had no lunch and many times, I sat in class with an empty stomach. But still, I worked hard. I listened carefully, asked questions and always completed my homework, even if it meant studying by candlelight or by the dim light of a kerosene lamp. 

    Many teachers began to notice me. They saw that even though I had nothing, I had determination and a kind heart. One teacher gave me exercise books. Another helped pay part of my school fees. A neighbor who owned a small shop gave me a few snacks sometimes. A church group gave my mother food and clothes once in a while. 

    These acts of kindness kept me going. 

    I studied harder than anyone else and soon became the best performer in my class. Every year, I got top marks. My name was always on the honor list. At school, students looked up to me. But at home, things were still hard. My siblings had lost hope, but I kept believing in a better future. 

    After many years of struggle, I finally finished high school. I was the first in my family to do so. On the day I received my final results, my mother cried tears of joy. You did it, my son. You made me proud, she said, hugging me tightly.

    But my journey wasn’t over. 

    I had one more goal: to go to university. That meant more fees, laptop, more books, more challenges, but I didn’t stop. I applied for scholarships and after many rejections, I finally got accepted to a university with some financial support. 

    Now, I’m 22 years old. I’m in university, studying hard every day. I met with a kind person again, who gave me a place to sleep and dinner. Even though I have that support, I’m still facing challenges. I still lack proper shoes, clothes and transport money, but I keep going. My dream is to become a professional, get a good job first, then become self-employed and return home to support my mother and siblings. 

    I remind myself: “My father left us when I was just a child. We had no house, no food and no money. My siblings could not finish school. But I decided to fight. Kind people helped me and I stayed strong. Now I am at university. I will not stop until I help my family rise again.” 

    I hope my story will teach young people that even when life feels bitter and people let you down, you must not give up. Strength is not about having everything. It is about standing tall even when you have nothing. This is the reason why I’m writing my story. 

    Even when life is painful and people walk away from you, never lose hope. With hard work, faith and the help of kind people, you can still rise, succeed and help others do the same. 

    QUESTIONS TO CONSIDER:

    1. What was one thing the author promised himself when things got really hard for his family?

    2. In what ways did people help the author succeed?

    3. When have people helped you when you were having difficulty?

    Source link

  • Can you get better medical advice online than from a doctor?

    Can you get better medical advice online than from a doctor?

    PCOS is a metabolic and reproductive condition. Although it’s the most common hormonal disorder in women of reproductive age, up to 70% of women affected by it never get diagnosed. Dr. Jamie Benham, an endocrinologist and principal investigatorat the EMBRACE Women’s Health Research Lab at the University of Calgary, said that because patients with PCOS can have a variety of experiences and symptoms, it can be challenging for doctors to diagnose. 

    For Joslin, it wasn’t until she began to struggle with infertility that she finally received a proper diagnosis. “When I saw the infertility doctor … he looks at me [and the] first thing he said to me was, ‘You are textbook PCOS’,” she said.

    Joslin said that if it weren’t for the online community, PCOS wouldn’t have been on her radar at all. Through treatments from her fertility doctor and naturopath, she was able to start a family.

    Taking symptoms seriously

    Jade Broughton, a member of the PCOS Patient Advisory Council at the University of Calgary, said she initially downplayed her own symptoms for years. She assumed they were stress-related from her shift work as a nurse and she was told her symptoms were normal.

    “I started noticing, quite a few years ago, my hair started falling [out] in clumps,” Broughton said. “I was just gaining weight so rapidly, I started having facial hair, all that stuff. I went to my doctor, and she was like, ‘You just turned 30, that’s just normal’ … So, I felt like I was just being gaslit for years and years.”

    Through internet searches and the PCOS Reddit page, she was finally able to understand what her symptoms might mean. After about seven years of advocating for herself, she finally received a diagnosis from her family doctor.

    “I feel like women’s health is still not taken seriously when it should be,” Broughton said. “Just stand up for yourself and trust your gut if you know something’s wrong.”

    Lisa Minaker, a legal assistant student in Winnipeg, Canada said that her irregular periods were concerning to her family physician, who referred her to an endocrinologist. Through blood work, her endocrinologist diagnosed PCOS. Although she received a diagnosis relatively quickly, Minaker said she felt that her doctors were not always “overly helpful” when it came to managing her symptoms. She thinks that doctors lack sufficient training in women’s health.

    “Not that it’s their fault,” she said. “Finding out how women don’t metabolize things like men, and how it’s dependant on where you are in your cycle … we’re still treated as basically a smaller version of men.”

    Why expertise matters

    Due to the complexity of PCOS and its diverse range of symptoms, a team of healthcare practitioners can be helpful. Joslin and Minaker both say that including other healthcare professionals, such as a naturopathic doctor and acupuncturist, helped with symptom management.

    “The [naturopathic doctor] was that complement to the medical world,” Joslin said. “My fertility doctor would prescribe me medication, and the naturopath would talk to me about my blood work [and supplements] … It was the hand holding and just someone talking you through [your results] to make sure you know what’s going on.”

    “I 100% credit the fact that I’m a mom to my naturopath,” Joslin said. “I would not be a mom without her.”

    Minaker said that in her own health journey she learned more from social media than from any doctor. “The girls in the [Facebook] group are pretty helpful,” she said. “I had to do my own research because I wasn’t really given a choice.”

    Although social media has played a big role in educating women about PCOS and other health problems, it can sometimes provide misinformation. A common misconception Broughton hears from patients is that they’re afraid to exercise, believing it’s bad for their health because of internet claims that it will raise cortisol levels — a hormone released in response to physical or emotional stress.

    “This is not consistent with what we know about the condition and exercise is recommended for all people with PCOS,” said Benham. “Unfortunately, we’re limited in that PCOS is not well studied. It’s not well understood. It hasn’t been funded from a women’s health research perspective. So there’s a lot of people that are profiting off nutrition plans or exercise plans or giving different advice around supplements.”

    Combatting misinformation

    Minaker said she found it difficult in the beginning to distinguish which resources were helpful and which were targeted marketing scams.

    “I wasn’t always that intuitive to be able to tell who was truthful,” Minaker said. “[I was] trying to find as many answers as possible.”

    In some Facebook groups, women share their symptoms, medications and diagnostic test results. Chats in these groups often involve consultations, advice and, sometimes, bullying.

    Joslin said that instead of lifting others up, some members of fertility groups for women with PCOS create guilt, embarrassment and shame around a vital aspect of life that PCOS can affect — being able to start a family.

    “In some groups, like the PCOS groups that focus specifically on trying to get pregnant, I had to leave right away,” Joslin said. “It was very toxic … where, truthfully, in this journey you need support. I’ve found much more success with smaller localized groups.”

    Information from medical organizations

    To combat misinformation, some medical organizations have created their online forums and portals. Broughton pointed to Monash University in Australia, which released new PCOS guidelines and launched a phone application called Ask PCOS.

    “They actually have an app that has tons of resources on weight management, food, insulin resistance, all of that stuff,” Broughton said. “And they’re actually one of the big players that’s trying to have it renamed as well.”

    Since PCOS affects more than ovaries, a new name would reflect that and might make it less confusing for women with symptoms to get the help they need.

    Other institutions are bringing women together in person to share experiences face-to-face.

    The EMBRACE Lab at the University of Calgary, for example, formed a PCOS Patient Advisory Council to conduct patient-oriented research earlier this year. The council, which meets monthly, is a space for community.

    “It’s such an amazing experience to sit in the room with all these women,” Joslin said. “Knowing all the struggles I’ve had … and sitting with people who are newly diagnosed or on their fertility journey … I’m able to share my advice and say, ‘You’re not alone.’”

    Community, whether found online or through research, has been an important part of the journey for these patients.

    Benham said that PCOS is a lifelong condition, whose symptoms can be managed although it cannot be cured. Joslin adds that it’s important to bring awareness to the condition. “Because there’s so many of us that have it, let’s make this more known.”

    Questions to consider:

    1. Why might someone trust a random person on an online forum over a doctor for medical advice?

    2. How can medical information you find online leave you more confused?

    3. If you felt unwell where would you turn for information about your condition?

     

    Source link

  • Food: The one thing everyone needs

    Food: The one thing everyone needs

    On World Food Day we present you with a smorgasbord of stories to consume to show how food and the need to eat connects us all.

    Source link

  • When you feel sick but are embarrassed to say so

    When you feel sick but are embarrassed to say so

    When Annick Bissainthe was diagnosed with irritable bowel syndrome (IBS) in 2018 it destroyed her relationship with food and that affected her relationship with people. 

    She said it restricted social interactions and prevented her from doing activities she used to do before her diagnosis. “Like two days before, I would agree that, yes, I’m going to meet you at a certain point,” Bissainthe said. “But something happens one hour before that [gets me] sick and I can’t go anymore.”

    IBS is a common condition afflicting 5-10% of the world’s population but its symptoms are things few people want to talk about: abdominal pain, cramping, diarrhea, constipation, bloating and excessive gas. 

    Preventing these symptoms often requires adjustments to a diet. It is easy to explain to someone why you can’t eat certain foods if you are allergic to those foods. But many people find it embarrassing to explain that they can’t eat those foods because of an irritable bowel.  

    Dairy, added sugars and spices are among Bissainthe’s top triggers for IBS symptoms, but they comprised a large part of her diet prior to being diagnosed. 

    “Everyone else in your culture eats it,” said Bissainthe. “Food is not just about eating, but there’s also a sociocultural aspect … it’s difficult especially being in an environment where you’re not understood.” 

    Symptoms of IBS go untreated.

    IBS is particularly prevalent among young adults but often undiagnosed. Living with IBS as a young person can be especially difficult. “I was in my late 20s, so I was like, ‘I’m a healthy young adult but not able to eat [certain foods]’,” Bissainthe said. “I felt like my body was letting me down.”

    Dr. Miranda van Tilburg, professor of Health Systems Science at Methodist University in the U.S. state of North Carolina, said that IBS has no known physical cause, so it is often poorly managed, treatment efficacies vary widely and patients’ concerns are frequently dismissed. 

    “There are no tests that we can do, biomedical markers, no radiography, nothing we can do to look at your body and say, ‘You have IBS,’” van Tilburg said.

    Dr. Irma Kuliavienė, a gastroenterologist at the Lithuanian University of Health Sciences, said that while the symptoms are real and have biological underpinnings, unlike a tumor, they can’t be “seen” such through endoscopy or colonoscopy scans.

    Jeffrey Roberts, an IBS patient advocate, said that he often wondered whether he was the cause of his symptoms and if it would restrict what he could do in life. He said the diagnosis of IBS is often dismissed as “just IBS” or brushed off as “all in the head.”  

    In the media, when bowel problems are raised, it is often to produce laughs, he said. 

    No laughing matter

    Treating IBS as a joke can be detrimental to IBS patients’ mental health and quality of care. Van Tilburg said IBS can be the primary source of stress in someone’s life but telling people to reduce stress when they have these symptoms is counterproductive. 

    The reasons why IBS occurs are unclear, although several possible contributing factors have been proposed. They include the interaction between the gut and the brain, known as the gut-brain axis, and the gut microbiome — the ecosystem of microorganisms in your gut.

    Because many potential biological mechanisms could be at play, it is difficult to identify a common therapy that will work for everyone, Kuliavienė said.  

    Dr. Shefaly Shorey, associate professor at the National University of Singapore, said that talking about gastrointestinal symptoms such as flatulence, diarrhea and constipation is considered taboo, especially in many Asian cultures. Shorey was diagnosed with IBS in 2017 and said this avoidance of open conversations about bowel problems can hinder needed care. 

    “These are not glamorous topics to talk about,” Shorey said. Lack of support and acceptance, especially from family members, can lead IBS patients to avoid opening up about their symptoms. 

    Finding the right treatment

    In some countries, dieticians and access to lab tests are not widely available and that can also affect whether someone can get properly diagnosed. Van Tilburg said that a key first step to helping people who have IBS is for doctors and nurses to accept symptoms as genuine. “We need to do a better job of educating physicians on how to talk to these patients,” she said. 

    This is important because IBS is a chronic condition that many patients will deal with for life, and while there are different therapies that can help reduce or eliminate symptoms, there is no one-size-fits-all treatment.

    Extensive trial-and-error is often needed to find what approaches will work best for each individual, a process that requires close collaboration between the patient and practitioner. Bissainthe still lives with IBS but having tried so many different treatment options over the years, is better aware of what management strategies work for her.

    Kuliavienė said that to find the right treatment there needs to be a trusting relationship between doctor and patient.

    “When we talk with our patients, when we hear our patients, we can see which pathway is better and choose specific treatments for specific patients,” she said. 

     

    Questions to consider:

    1. What is irritable bowel syndrome?

    2. Why are people embarrassed to talk about IBS?

    3. What things are you embassed to talk about with a doctor? 

     

    Source link

  • Is climate change carcinogenic?

    Is climate change carcinogenic?

    A study in California this year found that cancer patients were much more likely to die from the disease if they breathed in air pollution from wildfires a year after their diagnosis. 

    In 2020, flooding in Spain caused by Storm Gloria forced 118 cancer patients to cancel their radiotherapy treatment. And in 2019, researchers from the University of Michigan found a higher death rate among adult cancer patients who were affected by Hurricane Katrina. 

    It turns out that in many ways, climate change affects our health. We can see this directly when looking at cancer — something that affects one in five people around the world directly, and just about everyone else connected to those people indirectly.

    I know this first hand. Four years ago a close family member was diagnosed with cancer. It made me wonder: What could we have done to prevent it? Was it something they ate? Their amount of exercise? 

    At the time, we were living in South Korea, a country notorious for its heavy air pollution days, and I couldn’t help but wonder if that might have had an impact on the diagnosis. 

    Then, as I watched them go through multiple recurrences of cancer, the question gradually evolved into this: How can you ensure successful cancer treatment? And subsequently, how can you ensure that everyone has access to safe cancer treatment?

    Supply chain disruptions

    It turns out that air pollution isn’t the only problem. Extreme weather events caused by climate change can disrupt supply chains which results in shortages of critical medical supplies.

    In 2017, an intravenous fluid manufacturing company in Puerto Rico, for example, was destroyed by Hurricane Maria. The company was a major supplier of IV fluids for hospitals in the United States and the destruction led to a shortage in essential IV fluids. 

    In an attempt to investigate further, I contacted Dr. Kishan Gupta, a specialist in comprehensive ophthalmology, cornea and external diseases, at the Kaiser Downey Medical Center in California. Over a WhatsApp chat, he told me that Hurricane Maria not only led to major disruptions in eye drop manufacturing but also in IV saline for surgery and intraoperative anesthetics at his hospital. 

    Dr. David Kim, an orthopedic surgeon at the Worcester Medical Center in the U.S. state of Massachusetts, then told me that when IV supplies are disrupted, all surgeries that require such fluids are delayed — anything from hand and hip replacement surgeries to the removal of cancer tumors.

    IV saline and intraoperative anesthetics are crucial for cancer patients, especially IV saline, which helps to dilute toxic fluids and dehydration as a result of chemotherapy.

    Medical needs not met

    Crucially, climate change-induced extreme weather events damage infrastructure, preventing important medical equipment and supplies from reaching destined locations at an appropriate time.

    On the note of promptness, one of cancer’s most threatening characteristics is its fast, uncontrolled growth. In the field of medicine, this means that cancer treatment must be administered at the correct time, with the correct steps. 

    After Hurricane Maria in Puerto Rico, a 70% cancel rate was observed for brachytherapy, a form of radiation therapy. In Mexico after the 2017 earthquake, cancer surgeries were canceled with a median delay of 22.5 days. 

    During natural disasters, transportation networks and electrical systems break down. This means that people are unable to get to their hospital for treatment, and additionally, treatments like radiation which depend on electricity, can’t be administered.

    The COVID-19 pandemic, while not a climate change-induced event, showed what happens when supply chains break down. Needed supplies of everything from towels to anti-septic solutions became unavailable and as a result, people died.

    Lack of blood donors

    Of course, cancer isn’t the only health concern related to climate change. Rising temperatures and more frequent natural disasters can create favorable conditions for insects such as ticks and mosquitoes that transmit harmful pathogens. 

    Hurricanes, tornados and other extreme weather events also discourage people from traveling and that can cause a consequent lack in blood donations at hospitals, according to Dr. Sung Eun Yang at the Kaiser Panorama City Medical Center in California. “Blood and blood products are a limited precious resource,” Dr Yang said. “Donor turn out may be dependent on the weather. I recall in Boston we had a terrible winter storm with no donor turn out and experienced significant shortages in blood products.”

    In the United States, roughly 25% of blood donations in the United States go to cancer treatments. 

    Furthermore, it turns out that severe heat and humidity can affect medications — how they operate or their very properties. A number of common cancer medications are highly heat-sensitive. This means that as the Earth’ s climate warms, cancer patients who live in hot places will have a more difficult time storing and accessing safe medication, particularly in economically poor areas that can’t invest in energy-consuming storage. But even those in wealthier, cooler countries will be affected if they import products from those regions. 

    Finally, because of climate change, we are also seeing an increase in wildfires due to extreme and sustained drought conditions and wildfires too, ultimately leading to increases in cancer. 

    For instance, cancer is the number one cause of death in the fire fighting industry, accounting for 70% of all deaths.  

    Where there’s smoke, there’s cancer?

    Harvard University researcher Mary Johnson told the publication E&E News this year that potentially harmful chemicals are released every time a structure burns.

    “Plumbing has copper and lead in it,” she stated. “Paint has toxic chemicals. Electronics, plastics have really nasty stuff in them. All these chemicals we don’t think of occurring in a wildland fire are now part of the smoke.”

    So what can we do? 

    In preparation for all potential disasters, hospitals could have a disaster plan to help ensure that patients receive any and all important data during a future disaster. For example, the United States Department of Health and Human services has released a study on the efficacy of electronic health records during disasters. If a storm is forecasted in a region, an electronic emergency chart could be made for each patient. This plan could also come in the form of new infrastructure or mechanisms meant to keep the hospital safe from floods or fires. 

    Patients should also be provided with alternate ways to access healthcare information in order to connect with local healthcare teams, and the American Association of Colleges of Nursing recently added climate change education to the list of required skills for nursing education programs. 

    Finally, past cancer survivors of disasters have suggested that countries like Puerto Rico can be more prepared and adaptable in terms of exploring alternatives like renewable energy, that aren’t as susceptible to power outages from storms. 

    As the climate deteriorates, our responsibility in pushing back against the climate crisis will expand in multiple ways. 

    Our health and the health of the people we love will depend on the health of our planet. That means that it is our responsibility to protect ourselves, our loved ones and all of those currently battling cancer from climate change.

     

    Questions to consider:

    1. What connection is there between climate change and cancer rates?

    2. What can be done to keep people from dying of climate-change related cancer?

    3. What, if anything, can you do to help cool down our planet?

     

    Source link

  • Want to be a drummer? Grab a bucket.

    Want to be a drummer? Grab a bucket.

    The tent donated by the Mani Tese association swayed every 10 minutes. In May 2012, aftershocks from the Emilia earthquakes in Northern Italy shook the ground. But inside that precarious structure, dozens of people played music together as if nothing could stop them. 

    Oil buckets transformed into drums, pots hung from metal nets, plastic bins resonated like timpani. What might have seemed like an improvised concert was actually the birth of something revolutionary.

    “That was truly an unforgettable moment for all of us,” said Federico Alberghini, the head and founder of Banda Rulli Frulli. “We realized we had something huge in our hands, a project with such vision and energy that telling it now still moves me.”

    Founded in 2010, Banda Rulli Frulli is an inclusive and accessible music project that brings together young people of all abilities to build instruments from recycled materials and create music as a collective. Born as an educational experiment, it has grown into a community movement combining creativity, craftsmanship and social inclusion.

    In that tent, among young people who had lost their homes and families uprooted from their lives, an experiment was being born that today counts 2,400 participants in 12 bands spread across Italy, with the first international expansion planned for New York in autumn 2025.

    Hearing the beat of a different drum

    The story of Rulli Frulli begins long before the earthquake. Alberghini was just 11 years old when, accompanying his father to a vintage car show in the Modena area in the early 1990s, he noticed a door with the inscription, “Quale percussione?” or, “Which percussion?” Beyond that threshold awaited Luciano Bosi, a collector of percussion instruments and pioneer of construction workshops using recycled materials.

    “He was sitting on the floor,” Alberghini said. “He performed a solo for me with two sticks using four volumes of the [telephone book], without even greeting me first. When I saw all this I told myself that this was what I wanted to do when I grew up.”

    Bosi is now part of the Rulli Frulli staff and has donated his entire instrument collection to the project. His philosophy is simple: any object, even the most mundane, can be a musical instrument. In the 1970s he had been the first to bring workshops for building instruments from recycled materials to Italian schools.

    That encounter planted a seed that germinated years later. Alberghini, after pursuing a career as a drummer in various bands, became a music teacher at the Fondazione Scuola di Musica Carlo e Guglielmo Andreoli. It was then that he began experimenting in his grandmother’s garage with a small group of young people from the area. 

    “In 2009 I had to climb over the fence of the Finale Emilia dump because I couldn’t find anyone to give me a bucket to play,” Alberghini said. “Today we receive containers of buckets and bins to supply the more than 2,400 girls and boys who are part of the Rulli Frulli bands scattered across Italy.” 

    Among these bands is the one from Finale Emilia municipality. Rulli Frulli now has dozens of concerts to its name and has released six albums in collaboration with some of the biggest names from the Italian independent music scene.

    A generative method of inclusion

    What makes the Rulli Frulli project unique is not only the use of recycled materials, but its natural approach to inclusion for people with disabilities. “Any potential disabilities are never ‘announced,’” Alberghini said. 

    The result has attracted the attention of the Catholic University of Milan, which in 2022 conducted and published a scientific study on the so-called “generative method” of the band. The research revealed, among other things, how the group’s sound environment — dozens of people playing self-built percussion instruments at very high volume — can have unexpected therapeutic effects.

    A child with autism who cries at the noise of a vacuum at home can, in the context of the band, find comfort in equally loud, deafening sounds that might otherwise be overwhelming — sounds that become less disturbing when created in a group.

    “When you watch the Banda Rulli Frulli on stage today, you see 80 people engaged in a performance so solid, so impactful that it doesn’t even cross your mind to look for disability,” Alberghini said. “You don’t notice it because you’re overwhelmed by the impact of those who are playing.”

    From tent to national spotlight

    The turning point came in 2016, when the band was selected to participate in a May Day Concert in Rome. The scene that presented itself to the event’s historic sound engineer has become legendary: from a double-decker bus that arrived in Piazza San Giovanni, dozens of people poured out, all dressed in blue-and-white striped shirts, and invaded every space in the backstage area.

    “The sound engineer arrives, looks at me, consults a folder and says: ‘So, you are guitar, bass and drums, right?’” Alberghini said, reconstructing those moments. “‘No,’ I replied, ‘we are those over there,’ pointing to the sea of people in striped uniforms.”

    After that concert social media exploded, the band became known throughout Italy and received an invitation to appear on the prime-time national television program of pop star Mika. “When I watched the episode again, I saw 60 people moving as if there were 10: perfect, organized, like true professionals,” Alberghini said.

    Since 2018 the project has spread throughout Italy according to a structured three-year process: in the first year the educators from Finale Emilia go to the headquarters of the band that is being formed once a week; in the second year they go every two weeks; in the third once a month. From the fourth year, the new band is autonomous, but remains connected to the network through a collaboration contract that establishes common practices, including ethical policies on sponsorships.

    “We receive requests from individuals, from associations, from local institutions, from cooperatives,” Alberghini said. Among the most significant projects is “Marinai,” [Sailors] a band composed of 25 boys from the Ivory Coast seeking asylum in Reggio Emilia. “I remember the first rehearsal with them: we went there, we unloaded buckets, sticks, bins, etc. I turned around for a moment and, without me doing anything, a beautiful samba started.”

    From ruins to rebirth

    In May 2022, Italian President Sergio Mattarella inaugurated the Stazione Rulli Frulli, a multifunctional hub created from the former bus station of Finale Emilia. The renovation cost more than €1 million. Today the structure houses a rehearsal room, a radio station, a completely soundproofed construction laboratory, the Astronave Lab (a social carpentry workshop for young people with disabilities) and a restaurant open every day.

    “Every week our spaces are frequented by 700-800 young people and employ 25 people,” Alberghini said. “Our goal is not to do activities only with young people with disabilities, but to mix everything together: the Station must be a beautiful and welcoming place for anyone.”

    The success is tangible: reservations at the restaurant, where young people with disabilities also serve at tables, are so numerous that there is no space for months. “A parent kept telling me to forget about it, because he was afraid that our idea would scare the rest of the community,” Alberghini said. “Well, he was wrong.”

    What was born in a small town in Emilia after an immense catastrophe is transforming into a global model. Rulli Frulli will soon become a foundation, and there are plans for the first band on foreign territory at La Scuola d’Italia Guglielmo Marconi in New York City.

    “The goal is to export the Rulli Frulli model outside Italy as much as possible,” Alberghini said. “Because this is a big and new project, which we want to expand as much as possible in Europe and in the world.”

    The message coming from Finale Emilia is as simple as it is powerful: when a community faces difficulties together, transforming waste into opportunities and differences into wealth, it can build something that goes far beyond the sum of its parts. In an increasingly divided world, the sound of plastic buckets and pots could be exactly the symphony we need.

     

    Questions to consider

    1. How can a collective tragedy transform into an opportunity to create more inclusive and resilient communities?

    2. How does Rulli Frulli’s “natural” approach to inclusion differ from traditional methods of social integration?

    3. What kind of music could you make from things you find in your home?

     

    Source link

  • Call an ambulance! But be ready to pay.

    Call an ambulance! But be ready to pay.

    Quick-commerce service Blinkit — best known in India for delivering groceries in 10 minutes — rolled out an ambulance service last winter promising the same speedy service and setting the nation off on a new debate about privatized medicine.

    Five ambulances equipped with lifesaving medical equipment, emergency medicines and a three-person team, including a paramedic, are now operating in Gurgaon, a relatively wealthy city north of Delhi, at 2,000 rupees or about US $23 per trip. That’s affordable for less than a third of the population.

    Touted as India’s first app-based private emergency healthcare service, this has set off a debate about its implications for a sprawling public health system that is notoriously overstretched, with only one ambulance per five million people.

    A few weeks after the service launched, one of its ambulance teams was able to stabilize a trauma patient on the way to the emergency department. This led neurosurgeon Deepak Agarwal at All India Institute of Medical Sciences, a premier medical college and hospital to laud the new service on social media. He called it a “healthcare revolution” that offers care he had only read about happening in developed countries.

    It was a stark contrast, though, with the experience of Roopa Rawat Singhvi, a regional nursing lead in emergency and trauma care, who encountered a road accident victim near the hospital on 3 March.

    “I continued to call 108 and 102 (India’s version of 911) to reach ambulance services,” she said. “However, the calls were not going through.”

    After call finally went through, it took half an hour for the first responders to arrive and they were police, not an ambulance, she said.

    Healthcare for those who can pay

    This contrast — one patient whisked away with ventilatory support and trained staff, another left waiting while vital minutes passed — captures the growing debate around Blinkit’s entry into emergency healthcare.

    This contrast shows the need to explore India’s first app-based private ambulance initiative as more than just a tech innovation story, but as a symptom of a deeper tension between privatization and public neglect.

    As India’s public health infrastructure is eroding, private players are stepping into the vacated spaces under the guise of innovation. The question is: Will this be a temporary fix or a long-term threat to equitable emergency care?

    It wasn’t meant to be this way. In 2007, P.V. Ramesh was the principal health secretary of the Indian state of Andhra Pradesh and worked on the first National Health Mission project to establish emergency ambulance services.

    He said that the public sector ambulance services that evolved into the current nationwide emergency service started as a partnership in Andhra Pradesh between the government and a not-for-profit entity, Byrraju Foundation.

    There was a clear understanding, he said, that it would be operated strictly as a public service without a profit motive.

    “It combined the ambulances equipped with essential emergency care infrastructure, trained human resources and a call center provided by the Byrraju Foundation with the funding, hospital network and effective oversight from the public sector that served all citizens of Andhra Pradesh in case of medical or surgical emergencies,” Ramesh said.

    A dire need for ambulances

    That not-for-profit plan quickly collapsed.

    “Ambulance drivers started taking money from the private hospitals to take patients there and the private sector companies that oversaw the operations also began to cut corners,” Ramesh said. “Even doctors became complicit in the slow rotting of the system. The system deteriorated when the political and bureaucratic masters stopped monitoring the system after awarding the contracts to their favorites.”

    Pre-hospital care is far from ideal in both the public and private sectors in India, says Gayatri, an emergency medicine physician in Mumbai. Gayatri, who asked that her last name not be used, has worked in both public and private hospitals.

    “I used to work in villages in Chhattisgarh and Bihar,” she said. “In some areas, we used to call the government ambulance, but they would often refuse to come, either because it was a conflict-ridden area or because the road was in poor condition. If we put pressure and keep calling, the ambulance would come, but then the driver would ask for 3,000 to 5,000 rupees from the patient to transfer them.”

    Gayatri said that because many of her patients feel scared and disempowered, they agree to pay. “Sometimes we have to fight with the ambulance drivers and tell them not to ask for money,” she said.

    Stalling for time when saving lives

    Gayatri vividly remembers a night when she was transferring a patient in a vehicle and the patient had a cardiac arrest. She called for an ambulance, but it arrived without essential medications or even an oxygen cylinder. They had to borrow an oxygen cylinder from a referral center in a nearby village, losing time.

    “In emergencies, every minute counts,” she said. “And not having access to even an oxygen mask or cylinder in the ambulance was shocking and distressing for me.”

    But even private sector hospitals where she has worked used to send doctors trained in traditional medicine who are not qualified to administer emergency care in place of paramedics to attend home emergencies or to transport patients from emergency sites to the hospital.

    India currently has an almost non-existent emergency response system.

    According to Indian government data, there are a total of 28,250 ambulances across its states and Union Territories such as Jammu and Kashmir. This includes ambulances with advanced medical services and paramedics, vehicles that only transfer patients in non-emergency conditions, even bicycles.

    Meeting international standards

    While international standards recommend one ambulance for every 50,000 population, with one basic life support ambulance or BLS and one advanced cardiac life support ambulance or ACLS per 100,000 population, India has one ACLS ambulance for every five million people — the number in the United States is one per 25,000 population — and one BLS ambulance for every 100,000 people.

    Meanwhile, quality is a more persistent issue than quantity. According to a 2020 study by the All India Institute of Medical Science in Delhi and the National Institution for Transforming India, 90% of ambulances lacked essential medical equipment and 95% were operated by untrained professionals.

    “The corruption and deterioration of the service, coupled with a lack of infrastructure to provide adequate emergency referral systems, has created a vacuum that has invited private players to reframe this as a business opportunity,” Ramesh said.

    That’s why, he said, it makes sense for Blinkit to fill that hole. They recognized that the current system doesn’t meet the demand for reliable ambulance service in case of medical and surgical emergencies and realized they could develop a service to cater to those with the means to pay for it.

    Singhvi believes there are lessons to be learned from Blinkit’s efficiency. “They’ve hired trained paramedics, optimized logistics and used technology effectively,” Singhvi said. “Public systems could adapt these strategies to improve accessibility and response times.”

    Profits and regulations

    Ramesh said that with the current public infrastructure in shambles, he only hopes that the private ambulance companies run this service ethically and that there isn’t a monopoly that will allow them to charge unreasonable rates.

    But Gayatri does not offer them the benefit of the doubt. “Blinkit is a private company and private companies operate on the principle of making a profit,” she said. “It is unreasonable to expect that they will function in a way that keeps the welfare of the people in mind.”

    Gayatri believes that the gap is intentional. It is because of lobbying by the private sector that has made the public sector reluctant to invest in strengthening its health systems. Good regulatory oversight from the government, could prevent private companies from charging too much, but Ramesh is not optimistic it will happen.

    “Even if robust regulations are formulated and a law is enacted, does the government have the capacity to enforce it?” he said. “Regulations have not been successful in the health sector.”

    Instead, Ramesh said that the emergence of private ambulance services should be seen as a wake-up call to the government to strengthen public sector ambulance services.

    Ramesh acknowledges that Blinkit fills a need. But ultimately, while Blinkit’s initiative may cater to a small, affluent population segment, it underscores the urgent need to address the systemic inadequacies plaguing public healthcare.

    “If they provide equitable, high-quality service at a fair price, without bias toward certain hospitals, they could complement existing healthcare services,” he said. “But private models inherently exclude the poor. In a country where universal health care isn’t prioritized, do people have an alternative?”

    Questions to consider:

    1. What are the concerns some people have over private ambulance services?

    2. How can a government ensure that an ambulance service won’t gouge people in need?

    3. Do you know how to call for an ambulance and do you know how long it might take to reach you if you needed one?

     

    Source link