Category: Health and Wellness

  • Is social media turning our hearts to stone?

    Is social media turning our hearts to stone?

    As global digital participation grows, our ability to connect emotionally may be shifting. Social media has connected people across continents, but it also reshapes how we perceive and respond to others’ emotions, especially among youth. 

    Empathy is the ability to understand and share another’s feelings, helping to build connections and support. It’s about stepping into someone else’s shoes, listening and making them feel understood.

    While platforms like Instagram, TikTok and X offer tools for global connection, they may also be changing the way we experience empathy.

    Social media’s strength lies in its speed and reach. Instant sharing allows users to engage with people from different backgrounds, participate in global conversations and discover social causes. But it also comes with downsides. 

    “People aren’t doing research for themselves,” says Marc Scott, the diversity, equity and community coordinator at the Tatnall School, the private high school that I attend in the U.S. state of Delaware. “They see one thing and take it for fact.”

    Communicating in a two-dimensional world

    That kind of surface-level engagement can harm emotional understanding. The lack of facial expressions, body language and tone — key elements of in-person conversation — makes it harder to gauge emotion online. This often leads to misunderstandings, or worse, emotional detachment.

    In a world where users often post only curated highlights, online personas may appear more polished than real life. “Someone can have a large following,” Scott said. “But that’s just one person. They don’t represent the whole group.” 

    Tijen Pyle teaches advanced placement psychology at the Tatnall School. He pointed out how social media can amplify global polarization. 

    “When you’re in a group with similar ideas, you tend to feel stronger about those opinions,” he said. “Social media algorithms cater your content to your interests and you only see what you agree with.” 

    This selective exposure limits empathy by reducing understanding of differing perspectives. The disconnect can reinforce stereotypes and limit meaningful emotional connection.

    Over exposure to media

    Compounding the problem is “compassion fatigue” — when constant exposure to suffering online dulls our emotional response. Videos of crisis after crisis can overwhelm users, turning tragedy into background noise in an endless scroll.

    A widely cited study published in the journal Psychiatric Science in 2013 examined the effects of exposure to media related to the 9/11 attacks and the Iraq War. The study led by Roxanne Cohen Silver, found that vicariously experienced events, such as watching graphic media images, can lead to collective trauma.

    Yet not all emotional connection is lost. Online spaces have also created powerful support systems — from mental health communities to social justice movements. These spaces offer users a chance to share personal stories, uplift one another and build solidarity across borders. “It depends on how you use it,” Scott said.

    Many experts agree that digital empathy must be cultivated intentionally. According to a 2025 Pew Research Center study, nearly half of U.S. teens believe that social media platforms have a mostly negative effect on people their age, a significant increase from 32% in 2022. This growing concern underscores the complex nature of online interactions, where the potential for connection coexists with the risk of unkindness and emotional detachment. ​

    So how do we preserve empathy in a digital world? It starts with awareness. Engaging critically with content, seeking out diverse viewpoints and taking breaks from the algorithm can help. “Social media can expand your perspectives — but it can also trap you in a single mindset,” Scott said. 

    I initially started thinking about this topic when I was having the same conversations with different people and feeling a sense of ignorance. It wasn’t that they didn’t care — it was like they didn’t know how to care. 

    The way they responded to serious topics felt cold or disconnected, almost like they were watching a video instead of talking to a real person. 

    That made me wonder: has social media changed the way we understand and react to emotions?

    Ultimately, social media isn’t inherently good or bad for empathy. It’s a tool. And like any tool, its impact depends on how we use it. If we use it thoughtfully, we can ensure empathy continues to grow, even in a world dominated by screens.

    Questions to consider:

    1. What is empathy and why is it important?

    2. How can too much time spent on social media dull our emotional response?

    2. How do you know if you have spent too much time on social media? 

     

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  • Kidney disease doesn’t have to be a death sentence

    Kidney disease doesn’t have to be a death sentence

    At first, Carolyn Atim thought the headaches she was experiencing were just the residual echoes of pregnancy. Consultations then indicated she had high blood pressure. Slight of frame, barely out of her twenties, Atim had given birth to a boy in 2013. 

    Nine months later, the headaches hadn’t gone away and she was feeling unrelenting fatigue. She brushed them off.

    “I was so tiny,” she said. “And you know the perception that a tiny person doesn’t suffer from high blood pressure!” 

    Her doctor suggested she take some comprehensive tests. So she did them: renal function, liver function and complete blood counts. The verdict came as a blow. “You have end-stage kidney disease,” the specialist said.

    Atim didn’t know where to place that phrase. End-stage. It sounded so final. “You look at yourself, and you’re told you have a chronic illness,” she said. “You see yourself dying. I had hallucinations of being buried. I saw myself in a coffin.”

    The holistic costs of kidney disease

    In Uganda, kidney disease is not just a medical condition — it’s a verdict with economic, emotional and systemic implications. The country is slowly clawing its way toward better care, thanks in part to pioneers like Dr. Robert Kalyesubula, one of Uganda’s first nephrologists. 

    When he began his profession 15 years ago, he was only the third in the nation. Today, there are 13 kidney specialists and two more are expected. That’s progress, but measured against a growing burden.

    “About seven in every 100 Ugandans are living with kidney disease,” Kalyesubula said. 

    That translates to 7% or roughly 3.2 million people — a statistic that may not seem extraordinary at first glance. After all, the global burden is heavy. 

    A 2023 report in Nature Reviews Nephrology estimated that 850 million people — one in 10 worldwide — live with some form of chronic kidney disease. In the United States, the rate climbs to 15% of adults; in Europe, it ranges from 10 to 16% depending on the country.

    But prevalence tells only part of the story. 

    Inequity in healthcare

    In high-income countries, there are safety nets: screening programs, subsidised treatment and specialist care. In much of sub-Saharan Africa, the same illness unfolds without a cushion or warning.

    The World Health Organisation already ranks chronic kidney disease among the top 10 causes of death globally. The trajectory is alarming. By 2040, researchers expect it to become the fifth leading cause of years of life lost, overtaking many cancers. 

    The drivers are familiar: longer life spans, surging rates of hypertension and diabetes and widespread neglect of early detection. In countries like Uganda, where comprehensive testing is still a luxury, the disease often makes itself known only when the body is in full collapse.

    “Fifty-two percent of our patients come when they are already at stage five,” Kalyesubula said.

    By then, treatment is no longer medical alone — it is economic. Stage five is the red zone: dialysis or death. Dialysis, in Uganda, will demand four million shillings per month — about US $1,100, cash on delivery — just to keep the body’s silent custodian from shutting down.

    A transplant? That fantasy starts at 100 million shillings (about US $27,000). This, in a nation where only 1% of about 23 million working Ugandans earn more than a million shillings a month. Nearly half survive on less than 150,000 shillings. 

    An economic death sentence

    In countries like Uganda, kidney failure isn’t just a medical crisis, it’s an economic death sentence. But Atim’s story didn’t end at diagnosis.

    She found herself clawing at survival — medical appointments twice a week, pill regimens that bloated her cabine and a spiritual fog that refused to lift. Her saving grace came in a rare combination: a devoted husband, an unusually supportive employer and a doctor who didn’t just treat her but stood by her.

    “Dr. Kalyesubula told me, ‘You’re still a young girl. Get me a donor, and we shall find the money. God will help us,’” she said.

    Atim did find a donor. Her sister stepped forward. Her employer, moved by her story, urged her to go to the media — not to plead, but to make a case to headquarters for support. Her husband’s workplace did the same. Friends, colleagues, family — they all mobilized.

    “I was lucky,” Atim said. “Other people go to the media to beg. For me, my company said, ‘Go, so we can help you.’”

    A new lease on life

    The transplant took place in India in 2015. The morning of the operation, someone unexpected showed up at her bedside.

    “I opened my eyes, and there he was — Dr. Kalyesubula. I didn’t even know he had flown in. That humbled me,” she said. “He had seen the journey through.”

    For Kalyesubula, his work is a calling. “One day I was with my family at school — visiting day,” he said. “I had promised my daughter I won’t work. But then I got this call — ‘You are the one who has to save me.’ I had to leave.”

    Uganda now has over 300 dialysis machines — up from just three when Dr. Kalyesubula started — and more than 25 centers spread across the country. 

    Kidney care is expanding, even if slowly. Yet transplants within Uganda remain rare, and still rely heavily on partnerships with hospitals in India. The selection process is tight: donors must be related, young and a near-perfect match. Atim knows how slim her chances were.

    “If Dr. Kalyesubula hadn’t insisted on a preemptive transplant, I would have gone on dialysis,” she said. “And with our income, that might have been the end.”

    Instead, she got her life back. She’s gained weight. “From 40 kilos to 72,” she said, laughing. And she works full-time. 

    Their bond has grown beyond prescriptions and reviews. They speak quarterly, consult online and even banter like old friends. “We call each other ‘dear’ — like family,” she said. “We even joke now. He says he won’t compete with me again on weight loss — I always win.” 

    Expanding treatment for all

    Kidney disease still looms in Uganda, but progress is undeniable. Over 300 dialysis machines now serve patients in multiple districts. Transplants are possible — though limited to close relatives — and awareness is growing.

    Dr. Kalyesubula doesn’t mince words when it comes to the kidney’s role in the body. “If it’s not working well, you die,” he said. “Its importance is in making blood. Its importance is in removing toxins. Its importance is in controlling your blood pressure, regulating electrolytes, maintaining your internal environment — so that everything else can function at all.” 

    Think of it as the body’s meticulous custodian — part janitor, part electrician, part life support, he said. It scrubs the blood clean, balances the chemistry of survival and even directs traffic, ensuring oxygen-rich blood reaches the brain, the heart, the muscles. Without it, the delicate machinery of the body grinds to a halt.  

    But here’s the twist: Since only 7% of the country is living with kidney disease, he said, what are the rest doing that they’re not? Is it luck? Genetics? Or something more mundane?

    The best treatment, it seems, is prevention. “Drink enough water, avoid excessive salt and alcohol, eat fruits and fresh foods, move your body — exercise — don’t take over-the-counter drugs carelessly,” he said. “And once you click 30 — at least do a body check-up once a year.” 

    Raising awareness

    Prevention is simple and inexpensive advice, but ignoring it carries a steep price, especially in Uganda, where a kidney disease diagnosis can unravel the life of an ordinary working person faster than the disease itself.  

    That’s why Atim has become a leader in the silent, underserved world of kidney patients in Uganda, sharing her story when asked, opening up her pain so others might find their way out of theirs.

    She’s become a relentless advocate for affordable medication, creating and distributing kidney disease awareness, chasing down funding and forging hospital partnerships, all in the name of accessibility. It’s a fight born of necessity. She knows too well the scramble for kidney drugs, the way they vanish from pharmacy shelves, the maddening logistics of imports when the local supply runs dry.  

    She still sees Dr. Kalyesubula quarterly. She still worries about infections and relapses. But she is alive and raising her son. She is living. 

    “The transplant gave me a second chance,” she said. “I think that’s what many people don’t realize — it’s not about being whole again. It’s about having time. A support system, and never losing hope. Saying to death, ‘not today’. And for me, that’s everything.”

     

    Questions to consider:

    1. Why do fewer people in the United States die from kidney disease per capita than in the Uganda?

    2. What are some ways to prevent kidney disease?

    3. Do you think young people need to worry about diabetes? 

     

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  • To combat obesity, let’s change how we measure ourselves

    To combat obesity, let’s change how we measure ourselves

    When Mary Garrett was a child, kids walked to school and played outside after school. But today is a different world. Now Garrett worries about the lifestyles of the children she sees at the Tatnall School, in the U.S. state of Delaware, where she is a nurse. 

    “I don’t think kids have that kind of opportunity anymore,” she said. “I think the lifestyle changes, even having fewer sidewalks, like the neighborhood we live in now doesn’t have sidewalks.” 

    Kids, she said, don’t have that flexibility and freedom anymore. And that could be a big reason that so many young people are overweight.

    According to the U.S. National Institutes of Health (NIH), 1 in 6 children ages 2-19 in the United States are classified as overweight, while 1 in 5 children are diagnosed with obesity. Severe obesity has also increased from 7.7% of the population to 9.7% in two years. On the global scale, obesity has similarly skyrocketed. 

    The World Health Organization (WHO) reports that obesity has more than doubled in adults since 1990 and more than quadrupled in adolescents. 

    According to the WHO, in 2022, 2.5 billion adults were overweight. 37 million children under the age of 5 are classified as overweight. 

    Changing the way we measure weight

    Many factors contribute to obesity, such as genetics, types and amount of food and drink consumed, physical activity, sleep habits and access to necessities like areas to exercise and food. Nurse Garrett concludes that two key factors are physical activity and the rising convenience and prevalence of processed snacks. As the rise of a more sedentary lifestyle, for instance, not walking to school, becomes more popular, the need to spend time outdoors engaging in activity becomes even more critical. 

    In a report published in The Lancet Diabetes & Endocrinology journal, a group of 58 experts are recommending that obesity should no longer be defined by a BMI, or body mass index that is calculated according to height and weight, but by a combination of measurements, including waist circumference and evidence of health issues.

    The new classification for BMI makes it easier to determine obesity, which begins to tackle the issue of where obesity stems from and how to prevent it in children as young as age two.

    The NIH defines being obese as “a person whose weight is higher than what is considered to be a normal weight for a given height is described as being overweight or having obesity.” 

    However, Garrett said that that definition is not that simple. “BMI was actually based on a white man’s profile. So it doesn’t take into account females versus males, Latino versus white,” Garrett said.

    Yet, obesity is not restricted to one demographic. According to the National Center for Health Statistics, the prevalence of severe obesity is 9.4% higher in women than in men in the United States, while it is significantly lower in adults with at least a bachelor’s degree.

    Keeping kids healthy

    Access to nutritional food, outdoor spaces in which to exercise, and unhealthy sleep habits are a global concern, particularly in developing countries. Wilmington, Delaware, is no exception. Doctors calculate a person’s weight status from a young age, beginning with a child’s pediatrician.

    The weight of a child is calculated based on comparison with other same-age and same-sex children using charts from the U.S. Centers for Disease Control. The subject of obesity and living a healthy lifestyle is a critical conversation for parents to have as they raise the next generation.

    There are an endless number of factors that can lead to a person being overweight or being diagnosed with obesity. 

    The NIH says that genetics and medical conditions, two variables outside of anyone’s control, can make it difficult to maintain a healthy weight. Obesity can also increase the risk of health problems like type 2 diabetes, high blood pressure and heart disease. Yet, there are modern societal factors besides just potato chips and soda that have emerged that play a large role in the rising rate of obesity in the United States. 

    Garrett sees kids eating processed foods a lot. “I think there’s also changes in our food and eating habits that could have an impact,” she said. “I think a lot of our food choices have been impacted by marketing.” 

    Pushing junk food

    A rise in advertising for processed foods on television, which the overwhelming majority of children have access to in the United States, contributes to this. 

    Researchers at the University of Ottawa in 2021 found that on average, children see approximately 1,000 food-related advertisements on television each year. Yet, can you remember the last time you saw an ad for a salad, or maybe grilled salmon with vegetables? Probably not. But it’s likely you saw a Burger King ad in the past day, maybe even twice or more a day. 

    Most advertised products boast organic ingredients or appeal to certain dietary plans. Garrett, on the other hand, questions whether a vegan and gluten-free protein bar is healthier than simply making a peanut butter sandwich on homemade or whole bread. 

    This poses the question: What role are parents playing in a child’s view of what is healthy and what isn’t?

    Kids can’t be expected to be well-versed in healthy choices from the moment they are born. It is up to the parents or guardians to educate and provide an example for children as they learn to make their own choices. 

    Tackling family obesity

    Globally, there is a clear relationship between parent and child obesity. In a study published in 2021, researchers from Sungkyunkwan University School of Medicine in South Korea found that children with overweight or obese parents are 1.97 times more likely to be overweight or obese than peers with healthy-weight parents.

    Garrett is a parent and believes that a lack of education could be one of the reasons why so many parents struggle to properly educate their children on healthy choices. 

    “I don’t think we learn enough about nutrition and guidance for families to best raise their children as healthy eaters and healthy people,” Garrett said. She pointed to the ‘MyPlate’ symbol created by the U.S. Department of Agriculture to showcase the five food groups and how much of each should be consumed at each meal. “I’m not really sure that the [U.S. Department of Agriculture] is always giving us the most comprehensive healthy information,” she said.

    What we need, she said, is to teach more about nutrition. When giving students guidance on what healthy eating looks like, as well as educating parents on nutritional components, a healthy diet is sure to be an easy skill to master. 

    Another flaw with how we define obesity is its lack of incorporation of athletes. Researchers in Australia in 2018 found that athletes, or those who train daily for a specific sport, have a significantly lower BMI than the average person. 

    Weight differs from person to person

    Garrett said that the absence of a clearly specified description of BMI for athletes can pose many types of problems.

    “You could put an athlete who weighs, I’m just making this up, but say 5’10” weighs 160 next to another person who’s 5’10” and weighs 140 and their BMI could be the same, but the athlete is more muscle and the other person is perhaps more fat,” Garrett said. 

    This explains what many athletes struggle with: knowing what is healthy when performing and exercising at a high level.  Two teens may have a similar height and weight, but one may be a top-notch athlete who practices their sport for up to three hours a day. This difference completely changes what the USDA or other medical resources may say about appropriate nutrition. 

    This factor, which includes many school-age children who participate in school or club sports, adds another layer to the question of whether the body mass index is a good way to measure obesity and being overweight or not. 

    As a distance runner since the sixth grade, proper fueling has long been a topic of both interest and necessity for me. However, with the rise of ads for different processed foods and fitness influencers online, I began to question my own relationship with food. Was what I was eating healthy enough? Would eating less make me faster?

    Food and health

    Food not only provides for your body physically, but also mentally. A positive relationship with nutrition has long been something I have worked on achieving, particularly as I became more competitive in my sport. I learned that not only does food give me strength, but it also gives me the power to perform to my best ability. 

    Underfueling can be the source of injury and a negative and self-deprecating mindset, and is not talked about enough when discussing an athlete’s mental and physical health.

    I can’t compare my body to another that doesn’t run 40-mile weeks or who doesn’t race competitively. Learning about the right choices to keep my body healthy and ready to perform at a high level has been one of the most critical aspects of my athletic career. 

    As obesity rates continue to rise, it is critical to continue educating the next generations on the right steps to take in making healthier choices. It can be as simple as promoting fruits and vegetables over a bag of chips at school or planning a family bike ride instead of playing video games. 

    With new definitions for BMI adding a new complex layer to the quest to reduce obesity, nothing is as important as staying on top of suggestions and guidelines from medical experts. Becoming well-educated on healthy habits can affect not only an individual but also the people around them. 

    As Garrett concludes: “I think we could change a lot by teaching our kids and families.”


    Questions to consider:

    • How is obesity measured?

    • What are some factors that contribute to weight problems?

    • Can you think of ways schools can help children and teens live a healthier lifestyle?

     

     

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  • Can we de-stress from climate change distress?

    Can we de-stress from climate change distress?

    Consider that BP, one of the world’s biggest oil companies, popularised the term “carbon footprint”, which places the blame on individuals and their daily choices. 

    Anger also comes up a lot, Robinson said, particularly for young people. 

    “They’re angry this is happening,” she said. “They’re angry they have to deal with it. They’re angry that this is their world that they’re inheriting and that all totally makes sense. It’s not fair to burden young people with this. It’s really important that they have support and action by adults in all kinds of ways throughout society.”

    Working through our feelings

    Then there’s sadness and grief. 

    “We have of course loss of life in many climate disasters,” Robinson said. “That’s really significant. And loss of habitat, loss of biodiversity, loss even of traditions and ways of life for a lot of people, often in Indigenous cultures and others as well.”

    One of the most simple and effective ways we can deal with climate distress is by talking about it, and by giving young people the opportunity and space to do so. 

    “One of the hardest things is that people often feel really isolated,” Robinson said. “And so talking about it with someone, whether that’s a therapist or whether that’s in groups … just anywhere you can find to talk about climate emotions with people who get it. Just talk about climate change and your feelings about it.”

    Having a space to discuss climate change and their feelings associated with it can help a young person feel understood. Talking about feelings in general, known as “affect labelling”, can help reduce the activity of the amygdala — the part of the brain most associated with fear and emotions — in stressful times.

    Unplug yourself.

    Unlimited access to the internet does allow young people to connect with like-minded people and engage in pro-environmental efforts, but the amount of information being consumed can also be harmful. 

    Climate change is often framed in the media as an impending environmental catastrophe, which studies say may contribute to this sense of despair and helplessness, which can lead to young people feeling apathetic and being inactive. 

    Robinson said that while you don’t need to completely cut out reading the news and using social media, it is important to assess the role of media consumption in your life. She suggested setting a short period of time every day where you connect to the media, then try your best to refrain from scrolling and looking at your phone for the rest of the day. 

    “Instead, look outside at nature, at the world we’re actually a part of instead of what we’re getting filtered through the media,” she said.

    For some people, looking at social media around climate is a way of connecting with a community that cares about climate, so it can still be a useful tool for many people. 

    “Our nervous systems can get really hijacked by anxiety,” Robinson said. “We know that when mindfulness is a trait for people, when it really becomes integrated into who they are, that it does help. It’s associated with less climate anxiety in general.”

    Take in the nature around you.

    Studies show that mindfulness can improve symptoms of anxiety and depression. Robinson says this is partly due to it allowing us to be present with whatever feelings come up, that it helps us to stay centred throughout the distress. 

    It can be as simple as taking a mindful walk in a nearby forest or green space. While of course forests are helpful in absorbing carbon and reducing emissions, they can also help us reduce stress. Some studies have shown that spending more than 20 minutes in a forest — noticing the smells, sights and sounds — can reduce the stress hormone cortisol. 

    Robinson said that one of the more powerful things you can do is to band together with others. 

    “Joining together with other people who care and who can have these conversations with you and then want to do something along with you is really powerful,” she said. “We’re social animals as humans, and we need other people and we really need each other now during all of this. And it’s so important to be building those relationships if we don’t have them.”

    It is possible that climate anxiety can increase when young people learn about climate change and the information is just thrown out there, Robinson said, and the opportunity to talk about emotions should be incorporated into learning. 

    “It is different than learning math, or learning a language,” she said. “It’s loaded with all kinds of threat. Kids need to know what to do with that because there is going to be an emotional response.”

    Take climate action.

    It has also been shown that action can be an “antidote” for climate anxiety and that education centred around action empowers youth, when providing ways of engaging with the crisis collectively. 

    Teachers can then help students connect their feelings with actions, whether that be in encouraging their participation in green school projects or on a broader level in their communities. 

    “That action, it helps, it really gives people a sense of agency and they know that they are making a difference,” Robinson said.

    We need to come together, she said, not just to help us feel better, but to find solutions. “I really think that our connection, our systemic issues that we have, are so profound and they really push us away from each other in so many ways.”

    Our societies often favour consumption over connection, she said. “As human beings we developed in the context of nature, evolutionarily,” she said. “We were immersed. We were part of nature, and we are still, but we have increasingly grown apart from that relationship.”

    That changed over time. Now people spend little time in nature even though it’s often all around them.

    “From an eco-psychological sort of point of view, we’re embedded in that system, and we’re harming that system because of that separation that’s developed,” she said. 

     

    Questions to consider:

    1. What is “climate anxiety”?

    2. What is the connection between climate anxiety and education?

    3. How do you handle the stresses that you are under?

     

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  • Why some viruses are so difficult to stamp out

    Why some viruses are so difficult to stamp out

    The United States is fighting an unexpectedly big measles outbreak, with hundreds of cases in the state of Texas alone. Health experts expect it will last for a year or longer, because the virus has a long incubation period — people can be infected for days before they begin to show symptoms. That, in turn, means it can spread silently.

    Another virus that’s spreading silently right now is polio. Tests of wastewater around the world have turned up alarming levels of the virus, notorious for paralyzing children, in Afghanistan and Pakistan, according to the World Health Organization (WHO), but also in Europe, in Spain, Poland, Germany, the United Kingdom and Finland.

    These two viruses should not still be around. They only infect human beings, and mass vaccination campaigns have been ongoing for decades to try to wipe them out. And the medical profession keeps coming so close to success. 

    And where do these viruses come from that keep returning despite our attempts to wipe them out? The answer is from us — from other people.

    Smallpox is the only human disease to have been completely eradicated. That was done with a dedicated global vaccination effort in 1972. Because the smallpox virus doesn’t infect any other animal, there wasn’t another place for it to survive and come back to reinfect people. 

    The same should be true for measles and polio, but war, disruption, poverty and a mistrust of vaccines make it difficult.

    Where viruses hide

    So even as vaccine campaigns come close to succeeding, the viruses can still hide out in unvaccinated and undervaccinated people. Travel and human contact do the rest to keep both measles and polio circulating. When an infected traveler hits a community of unvaccinated people — say a neighborhood of ultra-Orthodox Jews in London or a rural West Texas county full of vaccine skeptics — a contagious virus such as measles or polio can take off. 

    With both measles and polio, it takes immunization rates of more than 90% to protect a population. When rates drop below that, a community becomes vulnerable to outbreaks. A virus can take hold and spread among people, picking up steam.

    That’s happened in Pakistan and Afghanistan with polio, where efforts to reach remote populations fall short because of geography, conflict and mistrust. And in Gaza, where continuous Israeli attacks have destroyed virtually all healthcare facilities, United Nations agencies have struggled to vaccinate Palestinian children against polio outbreaks. 

    Polio is also complicated because of the different vaccine types. One of the vaccines is given orally, and it’s made using a live, but weakened, form of the virus. This gives good immunity but in rare cases the virus can mutate in someone’s body and return to infectious strength — becoming what’s called vaccine-derived virus. 

    A follow-up vaccination with a second type of vaccine made using a fully killed virus will protect against this, but when vaccine campaigns can’t be completed, vaccine-derived viruses can emerge.

    How viruses spread

    In Europe, no cases of polio have been seen, but wastewater evidence suggests the virus is surviving in people’s bodies, and could burst out to cause sickness if it gets to someone unvaccinated. Polio spreads via the fecal-oral route — in contaminated water, via poorly washed hands, on surfaces and also via sneezes and coughs.

    Fully vaccinated communities are safe but in 2022, an unvaccinated man in New York State became paralyzed after he caught polio. Investigation showed a vaccine-derived strain had been spreading quietly in the state.

    Measles is the most infectious disease known and that makes it particularly hard to eradicate. In a podcast interview I did for for One World, One Health, Dr. Peter Hotez, a pediatrician and vaccine scientist at the Baylor College of Medicine, explained just how infectious it is. 

    “If someone has measles, and especially before they get the virus and stop feeling very sick, they’re releasing the virus into the atmosphere,” Hotez said. 

    Even if they leave the room, that virus will linger in the atmosphere for a couple of hours.

    “So you can walk into an empty room that has the measles virus from someone who was there a couple of hours before and become infected,” he said, noting that one measles patient will infect up to 18 other people.

    A virus reemerges.

    Nine out of 10 unvaccinated people who are exposed to the measles virus will become infected. What is disappointing to public health experts in the latest U.S. outbreak is that so many people have become infected when measles was eliminated in the United States in 2000 and in all of the Americas in 2016.

    But pockets of people who are not vaccinated against measles can act like tinder. The spark is usually a traveler who goes to a country where measles is still common because vaccination rates are low — usually due to poverty. 

    In a November 2024 report the WHO said that measles is still common in many places, particularly in parts of Africa, the Middle East and Asia.

    “The overwhelming majority of measles deaths occur in countries with low per capita incomes or weak health infrastructures that struggle to reach all children with immunization,” the report said. Measles kills more than 100,000 people a year, mostly children. But before the vaccine was introduced in the early 1960s, it killed 2.6 million a year.

    The COVID-19 pandemic badly hurt all childhood immunization efforts, WHO and other global health authorities say. Routine childhood vaccines have not caught back up to where they were before the pandemic, leaving children and adults susceptible to vaccine-preventable diseases including measles and polio but also meningitis, hepatitis, tetanus, cervical cancer and rotavirus — a disease that causes diarrhea and vomiting in babies and young children. 

    The retreat of the United States from global health efforts — the dismantling of the U.S. Agency for International Development, its plan to cut $1 billion in funding to Gavi, the Vaccine Alliance, and its withdrawal from the World Health Organization — will further weaken global vaccination, experts say.

    And that means many more children will likely die who might otherwise live healthy lives. 

     

    Three questions to consider:

    1. How can vaccines help prevent the spread of diseases?

    2. What role should personal choice play in being vaccinated against deadly diseases?

    3. How can global cooperation help in fighting the spread of disease?

     

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  • When musicians get the blues

    When musicians get the blues

    Music is known to boost cognitive and emotional wellbeing, yet those who pursue it professionally experience greater levels of psychological distress compared to the general population.

    Psychological distress among professional musicians is a global phenomenon, shown in studies from Norway, the United Kingdom, Australia and South Korea. More than two-thirds of professional musicians in the UK suffer from depression, according to a 2016 study involving over 2,000 musicians. In Canada, as many as one in five professional musicians experience suicidal ideation.

    Now, musicians are calling on the industry for change. In February, Grammy-winning artist Chappell Roan used her Best New Artist acceptance speech to advocate for healthcare and a living wage for developing artists.

    “I told myself if I ever won a Grammy, and I got to stand up here in front of the most powerful people in music, I would demand that labels in the industry profiting millions of dollars off of artists would offer a livable wage and healthcare, especially to developing artists,” Roan said.

    Major record labels have now provided commitments to the mental health of their artists. Universal Music Group recently partnered with Music Health Alliance to launch the Music Industry Mental Health Fund, which provides a new suite of outpatient mental health support for musicians.

    A lack of support systems

    Musicians’ mental health suffers from a paucity of institutional protections for freelancers, irregular work schedules and profound financial instability. This is often exacerbated by high instances of performance anxiety and perfectionism among professional musicians, said Dr. George Musgrave, senior lecturer in cultural sociology at Goldsmiths, University of London.

    “When people talk about music being good for health and wellbeing, they’re not talking about working musicians,” Musgrave said. “Those who are doing it for leisure or creation are not anxious and depressed in the same way that those who do it for their job are.”

    Unpredictability also characterizes the career trajectories of many professional musicians, said Noah Fralick, artist manager at Huxley Management.

    “You don’t really go to school, get training, then work your way into the workforce and slowly build up,” Fralick said. “There’s no linear path. You might go from total obscurity to huge amounts of popularity quite quickly.”

    Emotional labour is also inherent in this line of work, which can put musicians at risk for mental health pressures, said Dr. Sally Anne Gross, principal lecturer at the University of Westminster.

    “There’s an interrelatedness to sport, where the body’s running so fast and in doing that, you would expect it to get injured,” Gross said. “If you’re working with your emotions in your working environment … you can expect that you might have emotional injuries.”

    The strains of a music career

    The traditional trope of the “tortured artist” — the idea that an artist must suffer pain to generate authentic creative output — has taken on new significance in the digital age.

    “The digital world is desperate for real things,” Gross said. “The artist now has to be larger than life …  in this atmosphere, at this point in time, if you are a young emerging artist or a current artist, you have to engage in a way that is seen to be authentic and there’s nothing more authentic than pain.”

    Mass democratization of music creation has made it easier than ever for musicians to enter the industry, but with no guarantee that their music will find an audience. Musicians feel pressure to show vulnerability as a way to stand out in a market flooded with options.

    “About 100,000 new songs are uploaded to Spotify every day,” Fralick said. “Streaming has sort of eliminated the barrier to access the music industry, but diluted the potential for any one [musician] to be successful.”

    This creates an environment in which consumers fall back to familiar tunes and artists, as deciding between a multitude of new options can feel overwhelming. As a result, it’s a rare artist who becomes a star. But these success stories become well-known, and the dramatic publicization of those who succeed can explain part of the allure of the music business, Fralick said.

    “I always use this analogy of a lottery winner, and the way that lotteries are set up, we see the winner,” Fralick said. “We think ‘I’m going to buy a ticket because that could be me,’ because your brain is only seeing the success story.”

    Pressure to succeed

    Musgrave said that this mindset can be detrimental for musicians. “Many of them are afflicted with what I’ve referred to as cruel optimism. The optimism is cruel because it’s keeping them tethered to an unrealizable ideal,” he said.

    Aside from emotional investment, launching a professional music career can also entail hefty financial costs. These costs could include paying distributors, shooting music videos, receiving coaching and joining premium memberships.

    The opportunity cost can also be significant. “You give up a lot of earning potential in order to invest in this craft,” Musgrave said. 

    For female musicians, age can be a critical stressor and determining factor of success. As the marketability of their music often hinges upon maintaining a youthful image, it can place additional pressures to find success faster.

    Many female musicians see the age of 30 as a hard cut-off, Musgrave said. “Age is a spectre that haunts women’s musical lives in a way that doesn’t haunt men’s,” he said. 

    Getting help to those who need it

    The last 10 years has seen a sea of change regarding mental health interventions for musicians. 

    In the UK, all three major record labels — Universal Music Group, Warner Music and Sony — have mental health support offerings either in-house or through outsourcing. But in-house mental health counselling could present potentially challenging scenarios for conflict of interest, Musgrave said.

    Currently, the biggest source of musicians’ mental health support is the charitable sector. Organizations such as MusiCares, Music Minds Matter, Music Support and the Man Down Programme provide various offerings such as weekly support groups, 24/7 crisis support lines and training packages for music industry workers.

    Gross said that while poor mental health among professional musicians is an urgent concern, that shouldn’t stop schools from providing music education. Instead, the occupational health hazards of professional music careers should be clearly communicated, so that young people can make informed decisions.

    “I think we have to reassess and re-evaluate the ways in which creative industry jobs have been sold to the next generation,” Gross said. “We have to really think about what’s happening in the educational space … and it’s absolutely essential that we deal with the issues and challenges of the working environment for all professionals.”  

     

    Three questions to consider:

    1. What unique pressures do professional musicians face?

    2. What is meant by the term “cruel optimism”?

    3. Why do so many people dream of becoming famous performers?

     

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  • Too much of what’s healthy can be harmful

    Too much of what’s healthy can be harmful

    Some TikTok videos about health and fitness are hard to resist. People describe how they lost weight by eating only raw fruits and vegetables for a month or by substituting protein powder in place of flour or sugar. How many people take these recommendations to heart? What happens if they do?

    Jason Wood was one of them. “I would sprinkle [protein powder] on top of a peanut butter sandwich or a yogurt just to make what I was eating seem healthier,” he said.

    But Wood’s practice of adding protein powder to make his foods healthier wasn’t healthy. Eventually, Wood was diagnosed with orthorexia, an obsession with nutrition. Orthorexia is an eating disorder that differs significantly from better-known eating disorders like bulimia — bingeing and vomiting the food afterwards — and anorexia — not eating at all.

    Wood now works with the National Association of Anorexia Nervosa and Associated Disorders and speaks to audiences about eating disorders. 

    Studies in Australia, Turkey and the United States have found that the viewership of TikTok lifestyle influencers has led to an increase in orthorexia symptoms, which are not well understood by popular culture and are not explicitly defined in psychiatric textbooks. 

    Avoiding what’s bad isn’t always good.

    Rachel Hogg, psychologist and researcher at Charles Sturt University School of Psychology in Australia, defines orthorexia as “the avoidance of foods that are unhealthy or impure.” 

    The term was first coined in 1996 by California doctor Steven Bratman after he decided to eat only clean, nutritious foods. Eventually his research led him to narrow his food options so much that he cut out entire food groups which caused him physical suffering.

    Wood recalls being freezing cold in the middle of summer with his whole body hurting and frequent dizzy spells. Because it’s an outgrowth of healthy eating, the condition is difficult to identify, says Hogg, who calls it “the wolf in sheep’s clothing.”

    Experts feel it is time people paid attention to the risk of developing orthorexia when exposed to high amounts of TikTok content. 

    Todd Minor Sr. lost his youngest son Matthew in 2019 to the TikTok “Blackout Challenge”; people who took the “challenge” would have themselves choked till they blacked out. In a January 2025 edition of Tech Policy Press, Minor called for social media warning labels as a public health tool. “These labels have a proven track record of raising awareness about the risks of dangerous products, especially among young people,” he wrote. 

    People don’t know what’s bad for them.

    Warning labels inform the consumer of the potential risk of product use and advise limiting dangerous exposure to vulnerable groups of people to avoid premature death or disability. According to orthorexia experts, all of these needs exist when it comes to TikTok. 

    Hadassah Johanna Hazan, a licensed clinical social worker in Jerusalem, knows firsthand how the public is painfully unaware of the dangers of orthorexia from talking to her patients. She describes how over the last 10 years ideal beauty has increasingly been defined as a fit and toned physique for both men and women. 

    This has led people to normalize eating patterns that Hazan describes as “very limiting at best and very harmful and unhealthy at worst.” She said constant and regular avoidance of food groups such as carbs or regularly substituting protein powders for ingredients such as sugar become addictions that her patients do not know how to stop. 

    Even those who teach healthy eating can fall into the orthorexia trap. Research published in the June 2021 supplement of American Society of Nutrition by a group of researchers in the U.S. state of Washington indicated that knowledge of orthorexia was low both in the general public sample group and in the sample group of nutrition students.  

    In fairness to TikTok, the social media giant has established an eating disorder safety page but the term orthorexia is never mentioned and there is no mention of content on TikTok being linked to eating disorders. 

    A balanced diet is best.

    Another group of people who seem ignorant of the risk is the group of TikTok health and fitness influencers who are the ones putting out #WIEIAD (What I Eat In A Day) video diaries and other similar content. 

    Elaina Efird, registered dietician nutritionist and TikTok body positivity influencer, said that influencers don’t realize how much they are entrenched in the problem. What motivates these influencers, she said, is that they either truly believe what they are advertising is healthy or they are so distressed by the alternative of being in a larger body that they overlook the harm in what they promote.

    As a TikTok influencer, Efird creates a space where all body sizes are valued and she wants viewership of her positive message to grow. But as a provider of healthcare to eating disorder patients, she also recognizes her moral responsibility.

    “I tell my clients that if they’re struggling, don’t be on TikTok,” she said. This insight comes from an understanding that certain groups of people are at a higher risk of being triggered by TikTok videos than others. 

    Hogg shares this understanding and even used it when co-designing a research study with fellow researcher Madison R. Blackburn that was published in the peer-reviewed journal PLOS One in August 2024. 

    Each participant was screened to make sure they did not have past or present eating disorders before being asked to watch up to eight minutes of TikTok content, which is the equivalent of just over 50 videos. 

    Algorithms don’t know what’s best for us.

    Hogg said that the sad truth is that an eating disorder patient in remission might search for a body positive video but then suggestions pop up on the TikTok homepage, which is called #ForYou, that might tout orthorexia.  She called the algorithm of TikTok a “blunt instrument.”

    Another vulnerable population with strong connections to TikTok are teens and pre-teens. According to a Statistica 2022 survey, 68% of pre-teens were using social media applications and 47% of respondents ages 11–12 were using TikTok in particular.  As Hogg put it, TikTok is powered by “young people creating content for young people.” 

    The disturbing reality known by psychiatrists is that pre-teens are at the highest risk of developing eating disorders because symptoms manifest typically during adolescence. 

    But what scares the public most about any disease is its lethality. According to an article published in February 2021 by the American Society of Nutrition, some 10,200 people die each year in the United States from eating disorders. 

    Even when death is avoided, an obsession with nutrition can lead to nutritional deficiencies, compromised bone mass, extreme weight loss and malnourishment, including brain starvation, even if that seems counterintuitive. And none of that even touches on the effects on mental or emotional wellbeing. 

    Now that Wood is in remission he wants the label “healthy” to be redefined to indicate support of mental, emotional, social and spiritual health and not just support of physical health. 

    Individuals, he said, should stick to positive reasons for engaging with social media such as community building and avoid using it to make harmful comparisons. 


    Questions to consider:

    1.  How do psychologists define orthorexia?
    2. How does orthorexia differ from anorexia or bulimia?
    3. Has social media influenced what you eat? 

     



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  • What’s all the flap about bird flu?

    What’s all the flap about bird flu?

    Avian influenza has scared doctors and scientists for a generation. But its arrival in the United States might finally give the H5N1 bird flu virus the combination of factors it needs to cause a global pandemic.

    Those factors include a new carrier; dairy cattle; a regulatory system that protects farmers at the expense of human health; and a government bent on taking down an already weak public health infrastructure.

    The H5N1 avian influenza virus making headlines around the world — and driving up the price of eggs — in the United States is no youngster. It’s been around since at least 1996, when it was first spotted in a flock of geese in Guangdong in southern China.

    Since then it has spread around the entire world, tearing through flocks of poultry in Asia, Europe and the Americas and wiping out birds and mammals on every continent, including Antarctica. H5N1 bird flu only rarely infects people but as of the end of January 2025, the World Health Organization reported 964 human cases globally and 466 deaths, although many milder cases are likely to have been missed.

    Vets and virus experts have had their eyes on H5N1, in particular, for decades. It didn’t look like a serious threat when it killed geese in 1996. But the next year the virus caused an outbreak in people just over the border from Guangdong in Hong Kong.

    It infected 18 people and killed six of them before it was stopped. That got people’s attention. A 30% fatality rate is exceptionally high for a virus — something approaching the mortality of smallpox.

    Mutations and swap meets

    The virus gets its name from two prominent structures: the hemagglutinin, or H designation, and the neuraminidase, or N. All influenza A viruses get an HxNx name. The current circulating viruses causing human flu misery right now are H1N1 and H3N2, for example, as well as influenza B, which doesn’t get any fancy name.

    But influenza viruses are exceptionally mutation-prone, and even the extra designation doesn’t tell the whole story about the changes the virus has undergone. Every time a flu virus replicates itself, it can make a mistake and change a little. This is called antigenic shift. As if this wasn’t enough, flu viruses can also meet up inside an animal and swap large chunks of genetic material.

    The result? The H5N1 viruses now circulating are very different from those that were seen back in 1996 and 1997, even though they have the same name.

    This is what’s been going on over the past 30 years. H5N1 has been cooking along merrily in birds around the world. So, after the 1997 outbreak, not much was seen of H5N1 until 2003, when it caused widespread outbreaks in poultry in China. Researchers discovered it could infect wild waterfowl without making them sick, but it made chickens very sick, very fast. And those sick chickens could infect people.

    The best way to control its spread among poultry was to cull entire flocks, but if people doing the culling didn’t take the right precautions, they could get infected, and the virus caused serious, often fatal infections. Doctors began to worry that the virus would infect pigs. Pigs are often farmed alongside chickens and ducks, and they’re a traditional “mixing vessel” for flu viruses. If a pig catches an avian flu virus, it can evolve inside the animal to adapt more easily to mammals such as humans. Pigs have been the source of more than one influenza pandemic.

    Pandemic planning

    In the early 2000s, scientists and public health officials took H5N1 so seriously that they held pandemic exercises based on the premise that H5N1 would cause a full-blown pandemic. (Journalists were included in some of these exercises, and I took part in a few.)

    But it didn’t cause a pandemic. Vaccines were developed and stockpiled. Pandemic plans were eventually discarded, ironically just ahead of the Covid pandemic.

    However, flu viruses are best known for their confounding behavior, and H5N1 has always been full of surprises. It has evolved as it has spread, sometimes popping up and sometimes disappearing, but never causing the feared human pandemic. It has not spread widely among pigs although it has occasionally infected people around the world, as well as pet cats, zoo animals, wild seals, polar bears, many different species of birds and, most lately, dairy cattle.

    It’s this development that might finally be a turning point for H5N1.

    For a virus to start a human pandemic, it must acquire the ability to infect people easily; it must then pass easily from person to person; and it must cause significant illness.

    Competing interests

    So far, this hasn’t happened with H5N1. It has infected 68 people in the United States, mostly poultry or dairy workers. Mostly, it causes an eye infection called conjunctivitis, although it killed one Louisiana man. But it is spreading in a never-before-seen way — on milking equipment and in the raw milk of the infected cattle.

    “The more it spreads within mammals, that gives it more chances to mutate,” said Nita Madhav, a former U.S. Centers for Disease Control and Prevention researcher who is now senior director of epidemiology and modeling at Ginkgo Biosecurity. I interviewed her for a podcast for One World One Health Trust. “As it mutates, as it changes, there is a greater chance it can infect humans. If it gains the ability to spread efficiently from person to person, then it would be hard to stop,” Madhav said.

    And while some states are working to detect and control its spread, the federal government is not doing as much as public health experts say it should. Two agencies are involved: the U.S. Department of Agriculture (USDA) and the Centers for Disease Control (CDC).

    Dr. John Swartzberg, a health sciences clinical professor emeritus at the University of California, Berkeley said in an interview with the UC Berkeley School of Public Health that the USDA is charged with two responsibilities that only sometimes work in concert.

    “One of the responsibilities they have is to assure a healthy agricultural industry for the United States,” Swartzberg said. “The second responsibility is to assure safety of the human beings who consume agricultural products in the United States.”

    More information, not less, is needed.

    Dairy farmers feared they’d lose money if their farms were identified as sources of infection. And it’s a lot more expensive to cull cattle than it is to cull chickens.

    “And I think what we’ve seen with this bird flu problem is that the USDA is tilted in favor of protecting the industry, as opposed to protecting the health of humans,” Swartzberg said. “CDC is also involved, but the CDC has no authority to go into states and tell them what to do. It has to be done state by state.”

    On top of that, U.S. President Donald Trump has ordered the CDC to take down websites reporting on avian flu and other issues. He is withdrawing U.S. membership from WHO, crippling the ability to coordinate with other countries on controlling outbreaks of disease.

    He notably tried to suppress reporting about Covid during his previous presidency and promoted unproven and disproven treatments.

    His newly confirmed Health and Human Services Secretary, who will oversee CDC and other agencies charged with human health, Robert F. Kennedy, Jr, is a vaccine denier, proponent of raw milk and has no public health qualifications.

    The stubbornness of people in the United States doesn’t help. When public health officials warned against drinking raw milk last year, raw milk sales actually went up.

    “Food safety experts like me are just simply left shaking their heads,” Donald Schaffner, a Rutgers University food science professor, told PBS News.

    The big fear? That in flu season, someone will catch both seasonal flu and H5N1, giving the viruses a chance to make friends in the body, swap genetic material and make a deadly new virus that can infect people easily.

     

    Three questions to consider:

    1. How can politics affect public health risk?
    2. How does public understanding and trust affect the risk of disease?
    3. Countries often blame one another for the spread of disease, but should they?

     

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  • Decoder Replay: Bacteria doesn’t stop at the border

    Decoder Replay: Bacteria doesn’t stop at the border

    During the Covid pandemic, nations realized they needed to work together to keep their people safe. That’s where the World Health Organization comes in. 

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  • Bite of the Big Four: India’s deadly snakebite crisis

    Bite of the Big Four: India’s deadly snakebite crisis

    Every year, an estimated 5.4 million people worldwide are bitten by snakes, resulting in as many as 138,000 deaths and three times as many cases of permanent disability.

    The World Health Organization classified snakebite as a neglected tropical disease in 2017 and set a target to halve related deaths by 2030.

    India, home to over 300 snake species, is at the heart of this global health issue, accounting for half of all snakebite-related deaths.

    While 95% of Indian snakes are non-venomous, it’s “The Big Four” species — the Indian cobra, common krait, Russell’s viper and saw-scaled viper — that cause the most harm said Dr. Sushil John, a public health doctor and amateur herpetologist from Vellore.

    “These snakes cohabit in the same spaces as humans, thriving in India’s agricultural fields, forests and urban outskirts,” said John. “So, they often come into close contact with people and might bite them.”

    A study conducted between 1998 and 2014, called the Million Death Study, found that almost 58,000 people in India died from snakebite each year. Second to India in recorded snakebite deaths is Nigeria, with a reported 1,460 deaths per year. 

    The missing data

    “Though India had a severe snakebite problem, accurate data on snakebite deaths in India was elusive for a long time,” said Dr. Ravikar Ralph, a physician at the Poison Control Centre at CMC Vellore.

    In 2011, the official reported number of snakebite deaths was only 11,000. The deaths reported in the Million Death Study highlighted the severe underreporting of snakebite mortality in the country.

    “This is because most studies available at the time were hospital-based, which led to the gross under-reporting of this issue,” said Ralph. “We knew from grassroots work that most patients were not reaching hospitals on time.”

    “Either people didn’t realize that being bitten by a snake required medical management, or they went to traditional healers, causing fatal delays in hospital-based care,” said Ralph. “The Million Death Study used community-based data collection to circumvent that barrier and document accurate numbers.”

    Harvesting the cure

    Snakebites are unique compared to other health issues. Snake venom, a potent mix of proteins, can destroy tissue, paralyze muscles and impair blood clotting, often leading to severe disability which is most likely loss of limbs which were bitten or death if untreated.

    “Unlike diseases caused by other agents such as viruses or bacteria where one can eliminate the causing agent, a similar approach cannot be taken for snakebites,” Ralph said.

    Antivenom is the only specific treatment that can prevent or reverse many of the effects of snakebite, when given early and in the right dosage.

    To produce antivenom, snake venom must be first collected, or “milked,” from live snakes kept in a specialized facility. Only one facility in India, located in Tamilnadu, harvests venom for anti-venom production in India.

    The venom is then diluted and injected in small doses into animals like horses, prompting their immune systems to produce antibodies. These antibodies are then harvested, purified and processed into antivenom.

    But India’s only anti-snake venom treatment targets only The Big Four snakes.

    “There are over 50 venomous snake species in India,” said Gnaneshwar Ch, project lead of the Snake Conservation and Snakebite Mitigation project at the Madras Crocodile Bank Trust.

    “The anti-snake venom’s limited scope means bites from less common species remain inadequately treated,” he said

    Despite its importance, antivenom is also not widely available, and its cost can be prohibitive for many rural families. The gaps in stocking and distribution further worsen the issue.

    While many countries produce antivenom, they tend to cater to the locally available species of snakes making it impractical to import it from other countries to India in order to solve the availability crisis.

    A national action plan

    The WHO has called for concerted global action to reduce deaths and disability in priority nations. In 2019, the WHO launched an international strategy for preventing and controlling snakebite, which was then regionally adapted for Southeast Asia and published in 2022.

    The Indian Union Health Ministry then launched the National Action Plan for the Prevention and Control of Snakebite Envenoming (NAPSE) in March 2024. The NAPSE aligns strategically with the WHO’s global roadmap and its regional adaptation for Southeast Asia.

    Many stakeholders need to join forces in order to balance snakebite mitigation with snake conservation, experts say.

    “Snakes tend to be very important to every ecosystem they are found in,” said Dr. Sushil John. “If snake numbers fall, we would see an increase in rodents which the snakes keep in check by eating. They would then destroy crops and spread diseases to animals and people.”

    While this strategy appears to be heading in the right direction, some experts caution that there might be barriers to implementation.

    “While public hospitals may adopt the reporting system, many Indians seek private health care,” said Professor Sakthivel Vaiyapuri, a venom pharmacologist at the University of Reading in England. “Mechanisms to ensure private hospitals comply with reporting requirements are essential.”

    Vaiyapuri helped work on the National Action Plan. He said health workers who are to report snakebite must understand the significance of their role which will motivate them to record the data accurately. He also said someone must verify the entered data independently to ensure accuracy. He suggests developing a mobile app to streamline data collection.

    While Vaiyapuri worries about the logistics of implementing such a plan for massive surveillance, there are also other worries about unintended consequences for snakebite victims, according to Dr. Anand Zachariah, a toxicologist at CMC Vellore.

    “When India made maternal deaths notifiable, many private clinics in India stopped treating high-risk pregnancies because they worried about the reporting process getting them in trouble if something went south,” said Zachariah. “I fear snakebite becoming a notifiable disease might trigger such defensive practices among physicians.”

    But he admits that at this point, the fear is only theoretical; what will eventually happen remains to be seen.

    “Despite the challenges, I think [the National Action Plan] is a pivotal initiative in tackling snakebite envenomation in India,” Vaiyapuri said.

    “By fostering accurate data collection, promoting intersectoral collaboration and engaging communities, the plan holds significant potential to drive meaningful change — ensuring effective prevention, timely treatment and a significant reduction in snakebite-related deaths and disabilities,” Vaiyapuri said.

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