Continuous Medical Education at Migosi Sub-County Hospital in Kisumu, Kenya

Continuous Medical Education at Migosi Sub-County Hospital in Kisumu, Kenya

Migosi Sub-County Hospital is a government level 4 hospital situated in Migosi sub-location of Kisumu County. The hospital is staffed with a Medical Officer Superintendent, Nursing Officer, Lab Technologists, Clinical Officers, Pharmacy Technologist, Support Staff, HTS Service Providers, Peer Counselors, and a Nutritionist. The facility has a catchment population of over 20,000 and is expected to provide services to over 5,000 women of reproductive age per year. Some of the services offered include Antenatal, MCH services, Anti-Retroviral Therapy, Family Planning, Home-based Care, Basic Emergency Obstetric Care, and Inpatient care. The Hospital has strengthened its cervical cancer department and has been in the forefront of beating cervical cancer. The department embraces a “see and treat” slogan and uses the Visual Inspection with Acetic (VIA) method and treatment by means of cryotherapy. The Hospital has intensively engaged Community Health Volunteers (CHVs) who take advantage of any chance to urge women to come for cervical cancer screening. On 14/02/2019 Dr. Phil Gorrindo visited the facility to...
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Professor Spotlight: Dr. Nunn

Dr. Nunn is a professor of Evolutionary Anthropology and Global Health and is currently teaching the course “Human Health in Evolutionary Perspective” here at Duke. The following is the transcript of an in-person interview conducted with Dr. Nunn. What inspired you to teach “Human Health in Evolutionary Perspective” at Duke? In particular, what long-term perspectives do you hope students will gain from this course? “I came to Duke in 2013 from Harvard where I taught this course and it was called Evolutionary Medicine. I was really excited to teach it there because it was in the General Education Curriculum and a colleague of mine, Peter Ellison, and I developed a course that was aimed at people without any background in evolution or background in pre-med. It was meant to be a course that attracted any student and it was amazing. It allowed me to engage with the material in a more basic level and I came to realize the material is something...
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Pelvic Health Physical Therapy

Pelvic Health Physical Therapy

Part 1: An Introduction to Pelvic Health Therapy Services Throughout my studies in Duke’s Doctor of Physical Therapy program, I have become exposed to many different types of physical therapy that I never knew existed. In addition to the more common fields of physical therapy, such as orthopedics and neurological, physical therapists are critical health care providers for premature infants in the NICU, for injured dogs and horses, and for individuals with pelvic floor dysfunction. Pelvic health physical therapists can help treat patients with such as urinary or fecal incontinence, pelvic organ prolapse, dyspareunia (pain during intercourse), pelvic pain, chronic low back pain, sacroiliac joint dysfunction, and a variety of other conditions. To treat some of these conditions, physical therapists help relax spasming of pelvic floor muscles through manual therapy manipulations, strengthen pelvic floor muscles through biofeedback systems and exercise prescription, and re-educate the bladder with strategies such as bowel/bladder diaries or bladder voiding schedules. As such, physical therapists play a vital...
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The Inaccessibility of Sexual Health Care for Disabled Women in Canada

The Inaccessibility of Sexual Health Care for Disabled Women in Canada

In Canada, standard health protocol recommends that women receive a Pap test every few years in order to detect cervical cancer as early as possible. However, health practitioners at ACCESS, a clinic in Vancouver which provides sexual health services exclusively for disabled women, have identified a significant deficit in the accessibility of such services for the demographic they serve. This inaccessibility is derived in part from a widespread lack of appropriate equipment. Many offices do not possess an accessible exam bed with a lift, preventing gynecological screening for disabled women. Additionally, many doctors, in providing care to these women, draw upon the misguided assumption that individuals with disabilities are not sexually active and thus neglect to ask their patients for a comprehensive history of their sexual health. Because this discourse does not occur, or is  not prioritized due to more immediate health issues directly relating to the disability, cervical cancer is rarely screened for amongst disabled women, and thus persists largely...
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New Studies Relating to the Grandmother Hypothesis

New Studies Relating to the Grandmother Hypothesis

The “grandmother hypothesis” represents the idea that a grandmother has beneficial effects on the reproductive success of her children and the survival of her grandchildren. Therefore, it is predicted that women who have the genes for living longer would then have grandchildren who also carry these genes. Recently, two more studies that further explore the notion of the grandmother effect were published in Current Biology. The first analyzes data of birth, death, and marriages in certain Catholic parishes from 1608 in an area that is present-day Quebec. The findings point to the fact that families who stayed geographically near their grandmas not only created larger family sizes and shifted child mortality rates, but positively promoted mothers to have children at younger ages. The second study was led by Dr. Chapman of the University of Turku in Finland and analyzed data from pre-industrial Finland. Dr. Chapman concluded that specifically, when a grandma is in her 50-70’s, she is most capable of...
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Update on Health Efforts in Nigeria

Update on Health Efforts in Nigeria

Reproductive health supplies are dwindling in Nigeria, with family-planning funds provided by the United States having been revoked two years ago in accordance with Trump’s gag-rule. This revocation of funds was catalyzed by the Trump administration’s accusations that the United Nations Population Fund was facilitating coercive abortions and sterilization- accusations which turned out to be entirely unfounded. Regardless, Nigeria, a country with one of the world’s highest rates of maternal mortality, subsequently lost more than half of its family planning funds within one year, bringing about devastating impacts upon contraceptive accessibility and efforts to address gender-based violence. FP2020 is a family planning initiative launched in 2012 with the goals of improving accessibility to family planning services and commodities, slowing the rate of population growth, and empowering the agency of women within decisions having to do with their bodies and health. However, without U.S. Funding, FP2020 has seen Nigerian health services deteriorate. And yet, despite the gag rule, studies have shown...
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Tumaini La Maisha Health Services Organization

Tumaini La Maisha Health Services Organization

This is a non-profit organization that works jointly with Kisumu Hospice Center established at Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH) on cancer projects. Breast, cervical, prostate and esophageal cancers are its focus. The Kisumu Hospice serves the local community and supports a satellite hospice center at the Siaya District Hospital. On average, the hospice aids 50 patients each month. The organization promotes cancer awareness and helps navigation through patient referall by community screening and linkage. The foundation has established an accommodation unit in Nairobi that hosts a total of six patients at a time who have been referred for radiotherapy. It has also established a school in Nyakach (Kisumu County) for vulnerable children and offers support to the school. The organization works with partners like Aga Khan Health Services, JOOTRH and Oncology Department to offer services to cancer patients. The organization takes the lead in participating in national events, organizing medical camps and community outreach programs with an aim to...
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World Cancer Day

World Cancer Day

Yesterday, on February 4th, the world celebrated World Cancer Day. Initiated in February 2000 at the World Summit Against Cancer for the New Millennium in Paris, the event is an initiative of the Union for International Cancer Control. The Paris Charter aims to promote research, prevent cancer and raise awareness. 2019 marks the beginning of the organization's "I Am and I Will" campaign, which will last till 2021 and emphasize each individual's personal commitment to reducing cancer's impact. In concurrence with World Cancer Day, the UN World Health Organization released a statement explaining that incidences of cervical cancer will likely increase by almost 50 percent in 2040. It noted that the number of new cases could be reduced if all girls between the ages of 9 and 14 are vaccinated for HPV. The organization stressed the importance of collaboration between governments, UN agencies and healthcare professionals to preventing increased rates of cervical cancer....
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New York State Passes Reproductive Health Act

New York State Passes Reproductive Health Act

On the 46th anniversary of Roe v. Wade, the New York legislature passed a law protecting a woman's right to abortions. The most controversial aspect of the law is its provision for abortions after 24 weeks, in cases of fetal in-viability or danger to the woman's life or heath. According to the Guttmacher Institute, only slightly more than one percent of abortions are performed during or after 21 weeks of pregnancy. The law also took abortion off of the state's criminal code, which prevents medical professionals from being criminally prosecuted. The pro-choice community has lauded the law's passage, considering it a protection against possible future decisions by the Supreme Court. The Catholic Bishops of New York State denounced the law, and many critics claim it is too far-reaching....
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Plan International Meeting

Plan International Meeting

I met with Plan International on January 17th. Plan International is an independent children’s rights organization committed to supporting vulnerable and marginalized children and their communities. The organization directly works with the community, schools, Ministry of Health, Ministry of Education and County Government. PLAN International works in 18 counties across Kenya: Nairobi, Machakos, Kajiado, Tharaka Nithi, Siaya, Bungoma, Busia, Taita Taveta, Kilifi, Mombasa, Kwale, Vihiga, Kakamega, Kisii, Migori, Homabay, Kisumu and Marsabit. PLAN’S key areas of focus are; Child protection Improving access to basic, quality education and early childhood development Quality healthcare including water, sanitation and hygiene, as well as adolescent and child health Youth employment and economic opportunities Resilience-building through disaster risk management To achieve part of this core activities, PLAN implements an Adolescent Sexual and Reproductive Health Rights (ASRHR) Project in Kisumu County, in the 2 sub-counties Kisumu West and Seme. The project targets children, parents and the community at large to enhance the wellbeing of the youth. The project implements: Training...
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