Tag: Causes

  • Maternal infections in health facilities

    Maternal infections in health facilities

    A clearer picture of the global impact 

    New research from the Global Maternal Sepsis Study (GLOSS), a major WHO/HRP initiative, shows that infection has a much larger impact on global maternal mortality and morbidity than previously thought.

    Logo of the Lancet Global HealthThe
    results from GLOSS, published in The Lancet Global Health, are the first to provide data on frequency of maternal infections and
    sepsis across the pregnancy and post-pregnancy period, in a large number of health facilities around the world. 

    Around 11 women per 1000 live births had an infection which resulted in or contributed to what is known as a severe maternal outcome – either they died or nearly died – during their hospitalization. 

    Urgent improvement is needed to manage this life-threatening risk faced by all pregnant and recently pregnant women, wherever they are in the world. 

    What is maternal sepsis and how does it lead to maternal death?

    Maternal sepsis is a life-threatening condition that arises when the body’s response to infection causes injury to its own tissues and organs during pregnancy, child-birth, post-abortion or the postpartum period.

    The latest global estimates place sepsis due to obstetric infections as the third most common cause of maternal mortality. However, this only includes infections as a direct result of pregnancy, such as endometritis or post-caesarean wound infections.

    Few
    previous studies include post-abortion infections. Neither do they address indirect infections such as respiratory and meningitis, which are aggravated by pregnancy but not directly caused by it.

    A better understanding of maternal infection

    GLOSS was a massive facility-based data collection effort led by WHO, accompanied by a ‘STOP SEPSIS!’ campaign to increase awareness among healthcare providers.

    The study gathered data on women who were admitted with suspected or confirmed infection during pregnancy or post-pregnancy over a one-week period in 2017. More than 2800 women participated in the study in 52 countries.

    GLOSS included healthcare facilities that care for women during pregnancy, childbirth or at the end of pregnancy, as well as facilities without maternity service but where women could be hospitalized during or after pregnancy, and data on infections
    which are not usually recorded as maternal sepsis, including post-abortion and indirect infections. 

    The result is a more complete understanding of the frequency and impact of maternal infections in health facilities. 

    GLOSS calls attention not only to the wider range of risks faced by pregnant women but also to the long period of time during which they are at risk. 

    Putting global numbers on maternal infection and sepsis

    Overall, around 70 pregnant or recently-pregnant women per 1000 live births were found to have a maternal infection needing hospital management. 

    Across the study, 11 women with either direct or indirect infection per 1000 live births developed a severe maternal outcome, but in low- and middle-income countries up to 15 women per 1000 births were affected.

    Infections were the underlying cause of most of the deaths recorded during the study, primarily post-abortion infection and indirect infections. Infections were also present in about a third of deaths attributed to other causes, such as postpartum
    haemorrhage.

    This suggests that the contribution of infection to global maternal mortality and morbidity may be larger than current reports of maternal sepsis mortality suggest.

    Preventing, identifying and treating maternal infection and sepsis

    Some of the most common maternal infections found in the study, such as urinary tract infections, post-caesarean and post-abortion infections, are largely preventable and treatable.

    GLOSS results suggest that current levels of monitoring and clinical care across health facilities are not enough to prevent, identify and treat levels of maternal infection effectively. 

    For instance, a complete set of vital signs was not reported for a third of the women in the study, on the day their infection was suspected or diagnosed. Delays in antimicrobial therapy were frequent.

    GLOSS also shows marked differences across countries, with the highest burden in low- and middle-income countries, compared with high-income countries.

    This may reflect the impact of broader health determinants in different country contexts. Challenges of overcrowding, limited access to water and sanitation and constraints to safe births by skilled birth attendants can reduce the ability of healthcare
    providers to manage the frequency and outcome of maternal infections.

    An opportunity to implement evidence-based practice

    GLOSS gives healthcare providers, policy-makers, and the public at large an opportunity: to mobilise around these data improve evidence-based practice, and save lives. 

    WHO has produced a number of resources which can support timely action to prevent, diagnose and treat maternal infection, as well as activities such as the upcoming SAVE LIVES: Clean Your Hands campaign
    on 5 May which celebrates the central role played by nurses and midwives in clean health care. 

    In addition, WHO will publish a global sepsis epidemiology report around the 73rd World Health Assembly (WHA) in May, as requested in the
    2017
    WHA Resolution on Improving the prevention, diagnosis and clinical managementof sepsis.

    Understanding why and how infection affects women is essential for equipping healthcare providers with life-saving knowledge and enabling health care systems to bring down global maternal mortality and morbidity.

    Related publications

    WHO recommendations for prevention and treatment of maternal peripartum infections

    WHO Clinical practice handbook for safe abortion

    Global guidelines on the prevention of surgical site infection

    WHO statement on maternal sepsis

    World Health Assembly resolution on Improving the prevention, diagnosis and clinical management of sepsis

    Health Topics

    Antimicrobial resistance

    Infection Prevention and Control

    Water Sanitation Hygiene

    Other links

    Global Maternal Sepsis Study

    SAVE LIVES: Clean Your Hands 5 May 2020

     

     

    Maternal infections in health facilities
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    https://www.who.int/news-room/detail/27-04-2020-maternal-infections-in-health-facilities

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  • THE DETERMINATION OF SEX

    THE DETERMINATION OF SEX

    The term “The Determination of Sex” is employed in two general senses in scientific circles.

    The first usage is that of the biologist, and it includes within its scope merely the discovery and understanding of the causes which determine whether the embryo shall develop into a male or into a female. In the discussion of the subject from this standpoint there is but little, if any, attention given to the question of whether the sex of the unborn child may be determined by methods under the control of man. The biologist simply studies the causes which seem to lead to the production of an individual of one or the other sex, without regard to whether these causes, when discovered, may or may not be amendable to human control.

    An authority, speaking of this standpoint concerning the question referred to, says: “We may discover the causes of storms or earthquakes, and when our knowledge of them is sufficiently advanced we may be able to predict them as successfully as astronomers predict eclipses, but there is little hope that we shall ever be able to control them. So it may be with sex; a complete understanding of the causes which determine it may not necessarily give us the power of producing one or the other sex at will, or even of predicting the sex in any given case. Whether we shall ever be able to influence the causes of sex-determination cannot as yet be foretold; at present, biologists are engaged in the less practical, but immensely interesting, problem, of discovering what those causes are.”

    The second usage of the term, includes and embraces the idea of the voluntary determination or control of the sex of the future child, by means of certain methods or certain systems of treatment, etc. Of recent years, science has been devoting considerable attention to the question of whether or not man may not be able to produce any particular sex at will, by means of certain systems or methods of procedure. Many theories have been evolved, and many plans and methods have been advocated, often with the expenditure of much energy and enthusiasm on the part of the promulgators and their adherents.

    In this lesson there will be briefly presented to you the general consensus of modern thought on the subject, with a general outline of the favorite methods and systems advocated by the several schools of thought concerned in the investigation.

    Professor Doncaster, the well-known authority on the subject, says: “But little progress has been made in the direction of predicting the sex of any child, and, if possible, even less in artificially influencing the determination of its sex. When the general principles arrived at are borne in mind, it must be confessed that the prospects of our ever attaining this power of control or even of prediction are not very hopeful, but the possibility of it cannot be yet regarded as entirely excluded. The general conclusions arrived at are that sex is determined by a physiological condition of the embryonic cells, that this condition is induced, at least in the absence of disturbing causes, by the presence of a particular sex-chromosome. [A “chromosome” is a portion of the chromatin, or substance characteristic of the nucleus of the cell, this nucleus seemingly controlling the life-processes of the cell.] But there is evidence, which for the present at least cannot be neglected, that certain extraneous conditions acting on the egg or early embryo may perhaps be able to counteract the effect of sex chromosome.

    “Quite generally, then, there are two conceivable methods by which the sex might be artificially influenced in any particular case; firstly, if means could be found of ensuring that any particular fertilized ovum received the required chromosomes; and, secondly, by the discovery of methods which always effect the ovum or embryo in such a way as to produce the desired sex. Many suggestions for applying both methods have been made, some of which have attained considerable notoriety, but hitherto none of them has stood the test of practical experience. In the case of the higher animals, especially of the mammals, in which the embryo develops in the maternal uterus until long after the sex is irrevocably decided, it is obviously difficult to apply methods which might influence the sex after fertilization, even if it were certainly known that such methods were ever really effective.

    “Apart from the few experiments like those of Hertwig on rearing tadpoles at different temperatures, there have been a very few cases in which there is even a suggestion that the sex of the fertilized egg can be modified by environment, and the belief that this is possible has been entirely abandoned by many of the leading investigators of the subject. It is probable, therefore, that if it will ever be possible to predict or determine artificially the sex of a particular child, the means will have to be sought in some method of influencing the output of germ-cells in such a way that one kind is produced rather than the other. It is in this way that Heape and others interpret the results of their investigations; they find that certain conditions affect the sex-ratio of cells, and they explain the result by assuming that under some circumstances male-determining ova are produced in excess, and under other circumstances, female-determining.”

    Professor Rumley Dawson holds to the opinion that the male-determining and female-determining ova are discharged alternately from the ovaries. In woman one ovum is usually discharged each month, and it is maintained that on one month the ovum is male-determining, and in the next, female-determining. It is obvious that exceptions must occur, for boy and girl twins are quite common, but if the cases which support the hypothesis are taken by themselves, and the exceptions explained away, it is possible to make out a strong case in favor of this theory. Some authorities hold that the right ovary produces male-determining ova, and the left ovary female-determining, and that the two ovaries discharge an ovum alternately, but an impartial examination of the evidence for this belief shows that it rests on very slender foundations. Experiments on the lower animals have shown that after the complete removal of one ovary the female may produce young of both sexes. Women, also, have produced children of a particular sex after the corresponding ovary has been removed, and it is hardly possible to believe that the removal in all these cases was incomplete. On the whole it must be concluded that the theory is insufficiently supported by the evidence.

    Another widely promulgated and vigorously supported theory is that which holds that the sex of the future child may be determined by specific nutrition of the mother before conception, and in some cases after conception. Schenk’s theory, advanced about 1900, attracted much attention at the time. He based his method on the observation that a number of women whose children were all girls all excreted sugar in their urine, such as happens in the case of persons affected with diabetes. From this he suspected that the physiological condition which leads to the excretion of sugar was inimical to the development of male-determining ova, and that males could be produced by its prevention. He therefore recommended that those who desire a male child should undergo treatment similar to that prescribed for diabetes for two or three months before conception, and held that a boy would be produced by these methods. Although this method has had considerable vogue, it cannot be held to have been established on a scientific basis.

    Doncaster says “The general conclusion with regard to man must therefore be that if sex is determined solely by the spermatozoon there is no hope either of influencing or predicting it in special cases. On the other hand, there is considerable evidence that the ovum has some share in the effect, and if this is so, before any practical results are reached it will be necessary to discover which of two conceivable causes of sex-determination is the true one. It is possible that there are two kinds of ova, as well as two kinds of spermatozoa, and that there is a selective fertilization of such a kind that one kind of spermatozoon only fertilizes one kind of ovum, the second kind of spermatozoon the second kind of ovum. If this should prove to be the case, it is possible that means might be found of influencing or predicting that kind of ovum which is discharged under any set of conditions. Secondly, it is possible that the ova are potentially all alike, but that their physiological condition may under some circumstances be so altered that the sex is determined independently of the spermatozoon. * * * It is hardly possible to avoid the conclusion that the sex of the offspring may be influenced, at least under certain circumstances, by the mother. The search for means of influencing the sex of the offspring through the mother is not of necessity doomed to failure. No results of a really positive kind have been obtained hitherto, and some of the facts point so clearly to sex-determination by the male germ-cell alone in man and other animals that many investigators have concluded that the quest is hopeless; but until an adequate explanation has been given of certain phenomena discovered in the investigation of the subject, it seems more reasonable to maintain an open mind, and to regard the control of sex in man as an achievement not entirely impossible of realization.”

    Another writer on the subject has said: “Every individual among the higher animals, whether male or female, begins as an impregnated ovum in the mother’s body. Any such ovum contains elements of constitution from both of its parents. In the earliest existence of this impregnated ovum, there is a season of sexual indifference, or indecision, in which the embryo is both male and female, having the characteristic rudiments of each sex, only indifferently manifested. In this stage, the embryo is susceptible of being influenced by external conditions to develop more strongly in the one or the other direction and thus become distinctly and permanently male or female. It is evident that this is the season in the development of the individual in which influencing conditions and causes must operate in deciding its sex, although it is possible in some of the lower animals to alter the tendency of sex in the embryo from one sex to the other, even after it has been quite definitely determined. It is well established, in fact, that differences do not come from a difference in the ova themselves; that is, there is not one kind of ova from the female which becomes female, while other ova become male, for it is possible to alter the tendency toward the one sex or the other after the ovum has been fertilized and the embryo has begun its career of development. This possible change in sex tendency in the embryo also proves that sex is not decided by a difference in the spermatozoa; that is some of the sperm cells from the father are not male, while others are female, in their constitution.

    “It is incorrect to suppose, as has been held by some theorists, that one testicle give rise to male spermatozoa and the other to female spermatozoa, for both male and female offspring have been produced from the same male parent after one testicle or the other has been removed. The same is true in cases in which either ovary has been removed from the mother; that is, male and female offspring are produced from mothers in whom either ovary has been removed. In like manner, the sex of offspring is shown not to be materially affected by the comparative vigor of the parents; thus, a stronger father than mother does not necessarily produce one sex to the exclusion of the other. These negative decisions are important because they simplify the solution of the problem of sex-determination, by excluding, more or less fully, various causes which have been supposed to operate quite forcibly in deciding the sex of offspring. Some of the more positive agencies that enter into the determination of sex are found (1) in the influence of nutrition upon the embryo during its indifferent stage of sexual development, and (2) in the constitution and general condition of the mother before and during the early stages of pregnancy. These two factors appear to enter more fully than any others in the decision of the sex in offspring, and deserve the greatest consideration. The influence of food in supplying the embryo with nourishment for its development is, perhaps, the most potent of these determining causes.”

    Investigators along the line of theory indicated in the above last quotation, i. e., the theory of sex determination by means of nourishment of the mother and embryo, have presented a volume of reports which demand respectful consideration. The general report may be said to be the discovery that abundant nourishment during the period of sexual neutrality tends to produce females; while lack of abundant nutrition during such period tends to produce males.

    These experiments, of course, have been chiefly performed upon the lower animals. The frog has been a favorite subject of such experiments—the tadpole stage being the one selected, because in that stage there exists a lack of sex, the stage being one of sex neutrality. Professor Yung’s celebrated experiments will illustrate this class of experiments. Here were chosen 300 tadpoles, which when left to themselves manifested a ratio of 57 prospective females to 43 prospective males. These were divided into three classes of 100 tadpoles each. Each class was then fed upon one of several kinds of nutritious diet in order to ascertain the change in sex-tendency due to such food. The first set, with an original ratio of femaleness of 54 to 46, were fed abundantly on beef, and the ratio of femaleness was changed to 78 to 22. The second class, with a ratio of femaleness of 61 to 39, were fed on fish (specially nourishing to frogs), and the ratio changed to 81 to 19. The third class, with a ratio of 56 to 44, were fed upon a still more nutritious diet (i. e., that of frogs’ flesh), and the ratio was raised to 92 to 8. In short, the experiments showed that the increase of nourishment in diet changed every two out of three male-tendency tadpoles into females. The experiment was held to prove that a rich diet, affording nourishment, during the period of sexual neutrality in the embryo, tended to develop femaleness.

    The advocates of this theory also point to the instance of the bees. With the bees, the larva of ordinary worker-bees are fed ordinary food, and do not develop sex; while the larva which is intended to produce the queen-bee is fed specially nutritious “royal food,” and consequently develops larger size and full female sex powers. If the queen is killed, or dies, the hive of bees proceeds to produce a new queen by means of feeding a selected larva with the “royal food” and thus developing full femaleness in it. It is said by some authorities that in cases in which some other of the larva accidently receive, through mistake, crumbs of the “royal food,” they, too, grow to an extraordinary size, and develop fertility. This fact is held by the advocates of the nutrition theory to go toward establishing the fact that abundant nourishment of the embryo, during the neutral stage, tends to produce femaleness in it. They also claim that caterpillars which are very poorly nourished before entering into the chrysalis stage usually develop into male butterflies, while those highly nourished in the said stage tend to become females. Experiments on sheep have shown that when the ewes are particularly well nourished the offspring will show a large proportion of females.

    A writer, favoring the theory in question, says: “In general, it is reasonable to infer that the higher sexual organization which constitutes the female is to be attained in the greatest number of cases by embryos which have superior vital conditions during the formative period. Among human beings, some facts of general observation become significant in the light of the foregoing inferences. After epidemics, after wars, after seasons of privation and distress, the tendency is toward a majority of male births. On the other hand, abundant crops, low prices, peace, contentment and prosperity tend to increase the number of females born. Mothers in prosperous families usually have more girls; mothers in families of distress have more boys. Large, well-fed, fully developed, healthy women, who are of contented and passive disposition, generally become mothers of families abounding in girls; while mothers who are small or spare of flesh, who are poorly fed, restless, unhappy, overworked, exhausted by frequent childbearing, or who are reduced by other causes which waste their vital energies, usually give birth to a greater number of boys. As a general proposition, the facts and inferences tend to establish the truth of the doctrine with women, that, the more favorable the vital conditions of the mother during the period in which the sex of her offspring is being determined, the greater the ratio of females she will bear; the less favorable her vital conditions at such times, the greater will be her tendency to bear males. That many apparent exceptions occur does not disprove the general tendency here maintained. Moreover, it is impossible to know in all cases what were the conditions of the mother’s organism at the time in which her child was in its delicate balance between predominant femaleness and maleness; else many cases which seemingly disprove the proposition would be found to be forcible illustrations of its truth. Still further, it is probable that other causes besides those here mentioned act with greater or less effect in determining the sex of offspring.”

    Based upon this general theory of the relation of nutrition to sex-determination, many methods and systems have been devised by as many authorities, and have been followed and promulgated by as many schools. Without going into the almost endless detail which would be necessitated by a synopsis of these various methods and systems, it may be said that they all consist of plans having for their object the decrease of nutrition of the woman in cases in which male children are desired, and the increase of nutrition in cases in which female children are sought for. This increase or decrease in nutrition is enforced for a reasonable period before the time selected for the conception of the child, and also for a reasonable period after the time of conception. The decrease in nutrition does not consist of “starvation,” but rather of a “training diet” similar to that followed by athletics, and from which dietary all rich foods, sweets, etc., are absent. In fact, the average dietary advocated by the “Eat and Grow Thin” writers would seem to be almost identical with that of the “male offspring” theorists.

    Many persons who have followed the methods and systems based on the nutrition theory above mentioned claim to have been more or less successful in the production of the particular sex desired, but many exceptions to the rule are noted, and some writers on the subject are disposed to regard the reported successes as mere coincidences, and claim that the failures are seldom reported while the successes are widely heralded. The present writer presents the claims of this school to the attention of his readers, but without personally positively endorsing the idea. He is of the opinion that the data obtainable is not as yet sufficient to justify the strong claims made for the theory in some quarters; but, at the same time, he does not hesitate to say that there are many points of interest brought out in the presentation of the theory, and that many thoughtful persons seem to accept the same as reasonably well established and logical.

    Another theory which has been heard of frequently of late years is that in which it is held that the ova are expelled in alternating sex, each month. Thus, if a male ovum is expelled in January, the February ovum will be a female one, according to this theory. Under this theory if the date of conception of a child be ascertained, and the sex of the child noted at its birth, it is a simple matter to count forward from the menstrual period following which the child was conceived, and thus determine whether the ovum of any succeeding period is male or female. It should be noted, however, that the periods are regulated by the lunar months, and not the calendar months. The fact that twins of different sexes are sometimes born would seem to disturb this theory—but not more than any other theory of sex-determination voluntarily produced, for that matter. The several schools explain this apparent discrepancy by the familiar saying that “exceptions prove the rule.”

    Another theory of sex-determination is that which holds that when conception occurs within a few days after the last day of menstruation, the child will be a girl; and that when conception occurs at a later period, the child will be a boy. Methods and systems based upon this theory are also reported as being reasonably successful in producing satisfactory results. But, inasmuch as there appears to be a great difference in individual women in this respect (even according to the claims of this school of sex-determination), it would seem that it would be difficult to proceed with certainty in the matter in most cases. One of the writers advocating this method, says: “Conception within five days after the end of the menstrual period is almost certain to produce a girl child; within five days to ten days, it may be either a boy or a girl; from ten to fifteen days, it is almost sure to be a boy; from eighteen to twenty-five days is the period of probable sterility, in which conception is extremely unlikely to occur.”

    In conclusion, it may be said that Nature undoubtedly has certain rules of sex-determination which govern in these cases; and that it is possible if not indeed probable that these rules may some day be discovered by man, and turned to account; but that it is very doubtful whether the secret has as yet been solved by the investigators. The writer may be pardoned for suggesting that, in his opinion, if the discovery is ever made it will likely be found to be very simple—so simple that we have probably overlooked it because it was in too plain sight to attract our attention. Nature’s methods are usually very simple, when once discovered. She hides her processes from man by making them simple, it would seem.

    PRIVATE Sex Advice to Women By R. B. Armitage, M. D.

    For Young Wives and those who Expect to be Married.

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  • GENERAL ADVICE TO WOMEN ON SEX SUBJECTS

    GENERAL ADVICE TO WOMEN ON SEX SUBJECTS

    In this lesson the writer seeks to direct the attention of his women readers to certain subjects upon which the average woman is not well informed, and upon which she usually requires sound, sane, clean, frank information. In many cases women hesitate to ask even their family physicians for such information, and, although there is no rational reason for it, they even shrink from consulting better informed and capable women concerning these subjects.

    Sexual Feeling. Owing to erroneous teachings, and irrational prejudices arising from ancient distorted and perverted ideals of sex, many women have grown to maturity under the erroneous belief that it is a sign of immorality, or at least low ideals and depraved nature, for a woman to experience sexual emotions or feelings, wishes or desires. So true is this that even many married women seek to withhold from their husbands the knowledge that any sexual feeling is experienced by the wife.

    Such a belief is of course absurd. It is as natural for a woman to experience normal sexual feeling as it is for her to experience any other feeling aroused by natural instincts and organism. Without such instinct and the feelings arising therefrom, there would be no mating or marriage, and no perpetuation of the race. The woman experiencing such feelings should not allow herself to imagine that she is depraved or perverted, or immoral in thought and feeling. Incredible as it may appear to a normal, healthy-minded man, it is true that thousands of young women have lost self-respect, and have lapsed into a morbid state of mind, because of the occasional manifestation of their normal sexual feeling.

    This does not, of course, mean that the woman must necessarily manifest into action the feeling experienced by her. On the contrary, she must acquire self-mastery and self-control, just as she must in other phases of her life. It may help some women of this kind to realize that the sex feeling and impulses, arising unbidden (and often unwelcomed) from the depths of their subconscious mentality, are essentially creative impulses. If the woman be unmarried, or if married and placed under conditions in which the marital relation with the husband is impossible or undesirable, then she can transmute this creative energy in some form of creative work—in work which leads to the creation, manufacture, building-up, or composing something. There is a hint here which will prove a great blessing to the woman who will understand and apply the principle suggested—for many other women have found it so.

    As for the married woman, there is no reason whatsoever why she should seek to withhold from her husband the knowledge that she is possessed of normal, natural, healthy sexual feeling. In fact, the withholding of such information, and the concealment and deception arising therefrom, has often done much to bring marital inharmony between husband and wife. If there is any deception to be practiced in the marital association of husband and wife, it should rather be in the opposite direction, i. e., in the direction of pretending the emotional feeling when it exists only partially or is absent. The last matter, however, is one for the exercise of the judgment and conviction of each individual woman; but the first mentioned admonition is one which should be observed, as it is based on honesty, truth, and good judgment as well.

    Alcohol and Sexuality. It needs no extended argument to convince the average person that an individual will do things when under the influence of drink that he or she would not do when perfectly sober. It is an old saying that “When the wine is in, the wits are out.” But there is a deeper connection and relation between alcoholic drink and sexual indiscretions than is usually realized by the average person. Besides the commonly known weakening of will-power and self-control arising from the influence of strong drink, there are certain influences concerning the sexual nature and arising from the presence of alcohol in the system, which are not known to most persons. So true is this that the writer has thought it well to utter a few words of warning to his women readers concerning these things.

    In the first place, there is an exhilarating effect arising from certain kinds of liquor, wines, and other forms of alcoholic drinks, which manifests directly in an excitement of the sexual centers and organism. In many cases a strong sexual excitement, absent at other times, is aroused, and the person is carried away with the force of passion unknown under other circumstances. Added to this the weakened will-power arising from too much drink, and we have an explanation of many cases of “mistakes” of women. It would appear that women are even more susceptible than are men to unusual sexual excitement arising from alcoholic drinks; and that, therefore, they should be especially cautious in the indulgence in such drinks, particularly when in the company of strange men, or men careless in regard to sexual morality and respect for women in their company.

    But there is still a deeper reason, based upon the latest discoveries in psychology, why caution in this respect should be observed by women. We allude to the discovery that alcohol first affects the mental and emotional tendencies of more recent racial acquirement, acting so as to paralyze and inhibit the activities thereof, and to thus release the activity of the more primitive emotions and motive activities. Thus, the woman under the influence of alcohol finds that the more recent racial traits, such as sexual control, restraint, sexual morality, conventional observations, etc., are practically temporarily paralyzed in inhibitual—or to use the current slang phrase, are “put out of commission” for the time being; and, at the same time, the old elemental, savage, barbaric, “cave man” instincts, habits, and methods of action, are brought to the surface, and proceed to manifest their activity if opportunity be granted for the same—and the opportunity is usually granted. This being seen to be true, it is seen that the woman so under the influence of liquor is, for the time being, little more than a “cave woman,” or barbarian, with all the lax sex morality of the latter, and with all the tendencies to manifest into activity the primitive impulses arising in her nature and demanding expression. Added to this the weakening of will-power always accompanying the alcoholic influence, it is seen that the woman under the influence of strong drink is an easy prey to designing men, and a willing victim to her own lower passions.

    An authority of sex subjects says: “That Bacchus, the god of wine, is the strongest ally of Venus, the goddess of love, using the term Love in its physical sense, as the French use the word ‘amour,’ has been well known to the ancient Greeks and Romans, as it is well known today to every saloon-keeper and every keeper of a disreputable house. And all measures to combat venereal diseases and to prevent girls from making a false step will only be partially successful if we do not at the same time carry on a strong educational campaign against alcoholic indulgence. * * * Of what use are warnings to a girl, when under the influence of a heavy dinner and a bottle of champagne, to which she is unaccustomed, her passion is aroused to a degree she has never experienced before, her will is paralyzed and she yields, though deep down in her consciousness something tells her she shouldn’t? She yields, becomes pregnant, and is in the deepest agony for several months, and has a wound which will probably never heal for the rest of her life. Of what use have all the lectures, books, and maternal injunctions been to her? * * * I believe that the sex instinct can be stimulated artificially beyond the natural needs, and among the artificial stimulants of the sex instinct alcohol occupies the first place. And bear in mind that alcohol produces even a stronger effect upon women, in exciting the sexual passion, than it does on men. Women are more easily upset by stimulants and narcotics, and that is the reason why it is more dangerous for women to drink than it is for men. It is impossible to give statistics and exact or even approximate figures. But there is no question in my mind, in the mind of any careful investigator, that if alcoholic beverages could be eliminated, the number of cases of venereal infection would be diminished by about one-half. And what is true of venereal disease is also true of the seduction of young girls. Alcohol is the most efficient weapon that either the refined Don Juan or the vulgar pimp has in his possession.”

    Our advice to the woman who is asked to drink liquor when in the company of a man outside of her immediate family circle is emphatically this: DON’T DO IT!

    The Menstrual Period. As strange as it may appear to those women who have had the advantage of intelligent maternal advice, it is a fact known to all physicians that many mothers permit their young daughters to enter into the stage of puberty, with the accompanying menstrual flow, without having first instructed the daughter as to the meaning and character of this phenomenon of her nature, and without having given her advice concerning the proper care of herself during this period.

    Physicians constantly experience cases in which the young girl to whom the first menstrual flow having come, without previous knowledge on her part, has supposed it to be the result of a wound, or of a diseased condition, and has attempted to stop the flow by the application of cold water. Even where a partial knowledge has been attained by the girl, she is found to lack the knowledge of the proper hygienic care of herself during the period. The mothers in such cases are criminally negligent, and have alluded a false modesty or prudery to interfere with a natural and necessary maternal duty.

    The approach of the first menstruation is often accompanied by unusual physical, mental and emotional changes in the young girl. Her nervous system is affected, and she is apt to become irritable or morbid, or even somewhat “flighty.” Her appetite may become irregular, and there is often present a craving for indigestible food. A physical languor is often experienced, and there may be pains in the back and legs, chilliness and headaches, and a general upsetting of the usual physical condition, accompanied by a manifestation of peevishness and irritability. These unpleasant symptoms usually disappear when the periodical menstrual flow is permanently established. In fact, they are frequently superseded by the awakened energy and heightened spirits of healthy, normal adolescence.

    The time of the beginning of the menstrual period varies according to climate, race, condition of health, and temperament. In the tropical countries, menstruation begins from the tenth to the fourteenth year; in temperate countries, from the thirteenth to the sixteenth; in cold countries, from the fifteenth to the twentieth year. The Italian, Hebrew, Spanish, or French girl is apt to menstruate earlier than the English, German, or Swedish girl. The Negro girl menstruates early, as a rule. The full-blooded girl usually menstruates earlier than the anemic one.

    Normally, menstruation should proceed naturally and without pain or suffering. When pain or suffering is experienced in connection with menstruation, it is simply because of some lack of health in the general system; and when such general health is restored, the trouble ceases. Painful menstruation is called “dysmenorrhea,” and arises from several causes, principal among which are the following: Errors in diet, errors in dress, undue exposure, constipation, lack of proper exercise, or to a contracted or congested condition of the Uterus or the Fallopian Tubes. The pain, however, cannot be considered as a feature of normal menstruation, for the latter is no more painful than a normal movement of the bowels—the painful condition results from abnormal conditions, the removal of these conditions resulting in the cure of the complaint.

    Dysmenorrhea should be treated by the discarding of all unhygienic clothing, tight shoes, etc., and their replacement by rational clothing; the dietary should be carefully scanned, and improper articles replaced by nourishing elements of food—discard the pastries, pickles, confections, and stimulants, and substitute sensible articles of diet; if constipation is present, remove it by eating articles of food which promote free movements of the bowels, and drink more water each day; take a proper amount of exercise—housework is as good a form of exercise as any; many authorities advocate the free drinking of water prior to and during the menstrual period—some going so far as to say that where there is painful menstruation there is always a lack of a proper amount of water taken into the system. In some cases Dysmenorrhea is due to disorders of the general nervous system, and treatment therefore should be sought at the hands of a capable physician.

    Amenorrhea, another disorder arising in connection with the menstrual process, consists of the retention or suppression of the menses, or of “scanty” menses, or occasional “skipping” of the periods. This condition is apt to be manifest in cases of extreme obesity or “fatness;” the nervous system being burdened with superfluous flesh, its menstrual rhythm is often affected. Suppression of the menses also sometimes results from exposure and disturbing mental emotions. The most approved treatment is that of remedying the abnormal general physical condition, proper diet, and the use of hot drinks, hot sitz baths, and hot enemas about the time of the beginning of the normal period.

    Menorrhagia, another menstrual-period disorder, consists of very profuse flowing—it is, in fact, a mild form of hemorrhage. It usually arises from general debility, shocks, too violent exercise or labor, and also in many cases from undue and too frequent sexual intercourse. Sometimes the excessive flow occurs during the regular menstrual period, while in other cases it may manifest itself out of season—sometimes as often as two or three times a month. The duration of the normal period of menstrual flow, however, varies greatly among different women; the normal period may be said to last from two to six days, so what might be an excessive flow for one woman would be only normal for another—temperament plays a large part in determining the quantity of the menses.

    Some of the accompanying symptoms of Menorrhagia, or profuse flow, are lassitude, shortness of breath, faintness, dizziness, headache, irritability and nervousness, and often also leucorrhea between periods. The general treatment consists in measures calculated to bring the general health of the woman back to the normal. The building up of the general system, by means of nourishing food, proper exercise, etc., will almost always result in curing this disorder.

    A well-known authority has well said: “The hygiene of menstruation can be expressed in two words: Cleanliness and Rest.”

    So far as Rest is concerned, the woman need not be urged to take it at this period—that is, if she is able to do so. Care should be taken not to exercise unduly at this time, and under the head of exercise may be included dancing, horseback riding, and automobiling, as well as the more common forms of athletic work.

    It would seem that common sense and the general desire for cleanliness and daintiness would cause all women to observe the plain hygienic laws of Cleanliness at the time of the menstrual period. And, indeed, it is probable that such would be the case were it not for the fact that some ancient superstitions still exert their power over the mind of many women, in regard to the use of water during the menstrual period. While it is true that cold baths, or cold-water bathing, are not advisable for the average woman during the menstrual period (although some especially robust women bathe and swim as usual during this period), this prohibition does not apply to the use of warm water during the period. Lukewarm baths are permissible at this time; and the woman should wash the external genital parts with warm water, with soap if desired, every morning and evening of the period. A vaginal douche of lukewarm water is an excellent adjunct to the bathing of the parts.

    It is astonishing to meet with the superstitious prejudice existing in the minds of some women concerning the use of the vaginal douche; these good creatures seem tothink that it is either unnatural and unhealthy, or else is something “not respectable,” and fit only for the use of immoral women. These women should get in touch with modern hygienic methods, and learn to use the douche at least during their menstrual periods. At this time, if the plain rules of cleanliness are not observed, there often occurs a decomposition of the blood which has gathered in or about the genitals, and an offensive odor is manifested. Some women, while feeling distressed about this odor, are afraid to use lukewarm water in washing themselves, owing to some old unexplored superstition handed down from the great-grandmother’s time.

    The napkins should be changed at least every morning and evening. Unclean napkins may lead to infection, and it is probable that many cases of leucorrhea have their origin in lack of cleanliness concerning the napkins, cloths, or rags, used during menstruation. It may seem almost incredible to the average woman reader, but physicians know of cases (usually among the poorer and more ignorant foreign classes) in which the girl is instructed by her mother, grandmother, or aunts, that she must wear the original cloth or rag during the entire period, as she will “catch cold” by a change to a clean, fresh cloth while the flow continued. Imagine the result of such a practice! This last is an extreme instance, of course, but it will serve to show the absurd and harmful notions prevalent concerning this important natural function, and its incidents.

    Leucorrhea. A very common disorder among women is that known as Leucorrhea, or “the whites.” It consists of a discharge from the Vagina, or the Uterus through the Vagina. It is, in fact, of a catarrhal nature, and results from an over-secretion of the mucus fluids which, in proper quantity, keep the mucus membrane of the said organs in good condition. The discharge manifests in various shades and degrees of consistency. From the character of the discharge, physicians are able to determine whether it comes from the Vagina or the Uterus. The discharge from the Vagina usually is a light creamy fluid; that from the neck of the Uterus is a sticky, thick fluid flowing rather freely; that from the lining of the Uterus is alkaline, and generally precedes and follows menstruation; and that accompanying ulceration of the womb is semi-purulent and offensive in odor.

    Leucorrhea has many causes, among which may be mentioned the following: getting chilled feet or body, particularly during the menstrual period; over exertion and overwork standing on one’s feet; chills following dancing in overheated rooms; excessive worry or emotional strain, etc. It is a quite common complaint, and some assert that fully twenty-five per cent (perhaps more) of all women suffer from it to at least some extent.

    The general treatment of Leucorrhea consists of the building up of the entire system by the proper hygienic methods. Constipation should be removed, and the system is built up by the proper articles of food, exercise, etc. The use of the proper douches are also advised by the best practitioners. Physicians also treat inflamed areas by local treatments consisting of painting the Vagina or neck of the Uterus with certain medicinal solutions. Certain suppositories and douches are also employed in some cases. It is always better to consult a good physician in these cases, particularly where the trouble is aggravated or of long standing.

    A popular writer on the subject gives the following prescription for a vaginal injection: White Fluid Hydrastics, 2 ounces; Borax, 1/2 ounce; Distilled Witch Hazel Extract, 1 pint. Use of this preparation one ounce, diluted in a pint of lukewarm water, as a vaginal injection, taken twice each day.

    A well-known authority gives the following advice concerning treatment of Leucorrhea: “One of the simplest things is an alum tampon. You take a piece of absorbent cotton, about the size of a fist, spread it out, put about a tablespoonful of powdered alum on it, fold it up, tie a string around the center, insert it in the vagina as far as it will go, and leave it in twenty-four hours. Then pull it gently by the string and syringe yourself with a quart or two of warm water. Such a tampon may be inserted every other day or every third day, and I have known where this simple treatment alone produced a cure. In some cases, however, douches work better, and the two best things for douching are: tincture of iodine and lactic acid. Buy, say, four ounces of tincture of iodine, and use two teaspoonsful in two quarts of hot water in a douche bag. This injection should be used twice a day, morning and night. Of the lactic acid you buy, say, a pint, and use two tablespoonsful to two quarts of water. The lactic acid has the advantage over the tincture of iodine that it is colorless, while the iodine is dark and stains whatever it comes in contact with. Sometimes I order the use of the tincture of iodine and the lactic acid alternately: for one douche the tincture of iodine, for the next the lactic acid, and so on. When the condition improves, it is sufficient to use one teaspoonful of the tincture of iodine and one tablespoonful of the lactic acid to two quarts of water. These injections are quite efficient and have the advantage of being perfectly harmless. One point about the injections: they should be taken not in the standing or squatting position (in which position the fluid comes right out), but while laying down, over a douche pan. The douche bag should be only about a foot above the bed, so that the irrigating fluid may come out slowly; the patient, after each injection taken in the daytime, should remain at least half an hour in bed (in the nighttime she stays all night in bed.) This gives the injection a better chance to come in contact with all the parts of the vagina, and a portion of it comes in contact with the cervix, where it exerts a healing effect. Avoid the use of patent medicines.”

    Uterine Displacement. The woman suffering from Uterine Displacement should, of course, consult a competent physician and be governed by his advice. The following suggestions, however, will be found to be of service in many cases:

    In the case of Prolapsus, or falling of the womb, many women have found great relief, and in many cases permanent improvement, by taking occasional rests in bed for an hour or so, with the feet and lower part of the legs raised at least eight inches above the level of the head. In this plan, the Uterus is replaced by gravitation. Some authorities advise practicing waist-breathing while lying in this position, thus exercising the abdominal muscles. Dr. Taylor says: “Increase the pump-like action of the chest, and it will be found that the displaced viscera will return to their normal position.” Some have also found relief from the use of alum-water vaginal injections once or twice each day. The alum-water is prepared by dissolving one heaping teaspoonful of powdered alum in a pint of lukewarm water. This last treatment often strengthens the vaginal muscles whose yielding has at least partially been the cause of the falling womb.

    In cases of Retroversion, in which the Uterus is turned or bent backward, the “knee and chest” position will often aid in causing the organ to regain its normal position. In this position the woman kneels, and rests her chest upon the bed, thus causing the hips to be elevated.

    In cases of Antroversion, in which the Uterus is turned or bent forward, relief is often obtained by the woman resting upon the back, using a pillow to elevate her hips.

    Intercourse During Menstruation. It would seem that the natural esthetic repulsion to the exercise of the marital relations during the menstrual period should be sufficient to deter men and women from indulgence at this time; but many seem to have overcome this instinctive repulsion, and to these a stronger reason must be given—and the reason is at hand. The reasons in question are as follows: first, that congestion of the Uterus and Ovaries sometimes results from this unnatural practice; second, that the man may possibly contract an inflammation of the urethra by infection from the degenerated membrane, tissue, blood, etc., of the menstrual flow; and third, that such practices may result in the aggravation of discharges from the woman, such as leucorrhea, etc.

    Intercourse During Pregnancy. The best authorities advise total abstinence from sexual intercourse during the period of pregnancy; but in view of the fact that such abstinence is very difficult for most men, and that few will persist in it, it is thought well to point out the fact that at least an extreme moderation is desirable in such cases. A leading authority says on this point: “During the first four months of pregnancy, no change need be made in the usual sex relations; their intensity should be moderated, their frequency need not. During the fifth, sixth, and seventh months, intercourse should be indulged in at rarer intervals—once in two or three weeks—the act should be performed without any violence or intensity. During the eighth and ninth months relations had best be given up altogether. And this abstinence should last until about six weeks after the birth of the child. During this period the uterus undergoes what we call involution; that is, it goes back to the size and shape it had before pregnancy, and it is best not to disturb this process by sexual excitement, which causes engorgement and congestion.”

    Sterility in Women. Sterility, or barrenness, i. e., the inability to bear children, is frequently met with among married people. It is usually blamed upon the woman, whereas in at least one-half of the cases the fault is with the man.

    The causes of sterility in women are usually one or more of the following: Inflammation of the Fallopian Tubes, which may have been caused by gonorrhea or ordinary inflammation—in some rare cases childbirth has been known to set up an inflammation in this region, which has prevented the woman from future childbearing—the inflammation causes the tubes to clog up or become closed, so that no more ova can pass through them from the ovaries to the womb; in some cases, also, severe cases of leucorrhea have caused sterility, as the discharge is sometimes fatal to the life of the spermatozoa and destroys them; in other cases misplacement of the womb causes sterility; also severe inflammation of the neck or mouth of the womb operates in the same way, in some cases. In cases of sterility, the woman should have an examination made by a competent physician, and it often will be found that the cure of the disorders above noted will work a cure of the sterility.

    But, in all cases of sterility, it will be found that the husband should be examined as well as the wife—in fact, many authorities insist that the husband should be examined first. Venereal diseases frequently produce sterility in the man, although he is loath to admit this and is apt to place the blame entirely upon the woman.

    Miscarriage and Abortions. The terms “miscarriage,” and “abortion,” respectively, mean the expulsion of the fetus from the womb before its natural time of delivery. In common usage, the term “miscarriage” is usually employed to indicate instances in which the premature delivery has occurred without any voluntary act on the partof the woman, or other persons acting with her permission; the term “abortion” being reserved for instances in which the miscarriage has been voluntarily produced.

    When the fetus dies within the womb of the mother, it is usually expelled spontaneously within a few days or even a few hours. Some women suffer from certain weakness which result in habitual miscarriage; such women seem unable to carry the child for the full natural term, and lose it at some time during the period of gestation. Like results often arise from certain diseases, principal among which is syphilis. In some cases the physician produces what is known as “therapeutic abortion,” for the purpose of saving the life of the woman—this is sanctioned by medical custom and by law. Other forms of abortion, performed for the purpose of preventing the progress of the gestation, and designed for the destruction of the embryo or fetus, are known as “criminal abortion,” and are punishable by several legal penalties.

    Abortions are frequently followed by severe illness, invalidism, or even death for the woman. Many women have had their entire lives ruined by this evil practice. It is one of the curses of modern civilization, and one which must be removed by means of rational instruction and education along the lines of sexual science if the race is to be prevented from deterioration. The subject will be further considered in the subsequent lessons in this book.

    The best advice to those who have contemplated the performance of abortion is simply this: Don’t; Don’t; DON’T!

    PRIVATE Sex Advice to Women By R. B. Armitage, M. D.

    For Young Wives and those who Expect to be Married.

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  • YOUTH FAULTS, LIES, AND CRIMES

    YOUTH FAULTS, LIES, AND CRIMES

    Classifications of children’s faults—Peculiar children—Real faults as distinguished from interference with the teacher’s ease—Truancy, its nature and effects—The genesis of crime—The lie, its classes and relations to imagination—Predatory activities—Gangs—Causes of crime—The effects of stories of crime—Temibility—Juvenile crime and its treatment.

    Siegert[1] groups children of problematical nature into the following sixteen classes: the sad, the extremely good or bad, star-gazers, scatter-brains, apathetic, misanthropic, doubters and investigators, reverent, critical, executive, stupid and clownish, naive, funny, anamnesic, disposed to learn, and blasé; patience, foresight, and self-control, he thinks, are chiefly needed.

    A unique and interesting study was undertaken by Közle[2] by collecting and studying thirty German writers on pedagogical subjects since Pestalozzi, and cataloguing all the words they use describing the faults of children. In all, this gave 914 faults, far more in number than their virtues. These were classified as native and of external origin, acute and chronic, egoistic and altruistic, greed, perverted honor, self-will, falsity, laziness, frivolity, distraction, precocity, timidity, envy and malevolence, ingratitude, quarrelsomeness, cruelty, superstition; and the latter fifteen were settled on as resultant groups, and the authors who describe them best are quoted.

    Bohannon[3] on the basis of questionnaire returns classified peculiar children as heavy, tall, short, small, strong, weak, deft, agile, clumsy, beautiful, ugly, deformed, birthmarked, keen and precocious, defective in sense, mind, and speech, nervous, clean, dainty, dirty, orderly, obedient, disobedient, disorderly, teasing, buoyant, buffoon, cruel, selfish, generous, sympathetic, inquisitive, lying, ill-tempered, silent, dignified, frank, loquacious, courageous, timid, whining, spoiled, gluttonous and only child.

    Marro[4] tabulated the conduct of 3,012 boys in gymnasial and lyceal classes in Italy from eleven to eighteen years of age (see table given above). Conduct was marked as good, bad, and indifferent, according to the teacher’s estimate, and was good at eighteen in 74 per cent of the cases; at eleven in 70 per cent; at seventeen in 69 per cent; and at fourteen in only 58 per cent. In positively bad conduct, the age of fifteen led, thirteen and fourteen were but little better, while it improved at sixteen, seventeen, and eighteen. In general, conduct was good at eleven; declined at twelve and thirteen; said, to its worst at fourteen; and then improved in yearly increments that did not differ much, and at seventeen was nearly as good as at eleven, and at eighteen four points better.

    [Illustration: Percentage x Age]

    He computed also the following percentage table of the causes of punishments in certain Italian schools for girls and boys near pubescent ages:

                                             Boys Girls
    Quarrels and blows 53.90 17.4
    Laziness, negligence 1.80 21.3
    Untidiness 10.70 24.7
    Improper language .41 14.6
    Indecent acts and words 1.00 .24
    Refusal to work .82 1.26
    Various offenses against discipline 19.00 19.9
    Truancy 9.60 .0
    Plots to run away 1.70 .0
    Running away .72 .0

    Mr. Sears[5] reports in percentages statistics of the punishments received by a thousand children for the following offenses: Disorder, 17-1/3; disobedience, 16; carelessness, 13-1/3; running away, 12-2/3; quarreling, 10; tardiness, 6-2/3; rudeness, 6; fighting, 5-1/3; lying, 4; stealing, 1; miscellaneous, 7-1/3. He names a long list of punishable offenses, such as malice, swearing, obscenity, bullying, lying, cheating, untidiness, insolence, insult, conspiracy, disobedience, obstinacy, rudeness, noisiness, ridicule; injury to books, building, or other property; and analyzes at length the kinds of punishment, modes of making it fit the offense and the nature of the child, the discipline of consequences, lapse of time between the offense and its punishment, the principle of slight but sure tasks as penalties, etc.

    Triplett[6] attempted a census of faults and defeats named by the teacher. Here inattention by far led all others. Defects of sense and speech, carelessness, indifference, lack of honor and of self-restraint, laziness, dreamy listlessness, nervousness, mental incapacity, lack of consideration for others, vanity, affectation, disobedience, untruthfulness, grumbling, etc., follow. Inattention to a degree that makes some children at the mercy of their environment and all its changes, and their mental life one perpetual distraction, is a fault which teachers, of course, naturally observe. Children’s views of their own faults and those of other children lay a very different emphasis. Here fighting, bullying, and teasing lead all others; then come stealing, bad manners, lying, disobedience, truancy, cruelty to animals, untidiness, selfishness, etc. Parents’ view of this subject Triplett found still different. Here wilfulness and obstinacy led all others with teasing, quarreling, dislike of application and effort, and many others following. The vast number of faults mentioned contrasts very strikingly with the seven deadly sins.

    In a suggestive statistical study on the relations of the conduct of children to the weather, Dexter[7] found that excessive humidity was most productive of misdemeanors; that when the temperature was between 90 and 100 the probability of bad conduct was increased 300 per cent, when between 80 and 90 it was increased 104 per cent. Abnormal barometric pressure, whether great or small, was found to increase misconduct 50 per cent; abnormal movements of the wind increased it from 20 to 66 per cent; while the time of year and precipitation seemed to have almost no effect. While the effect of weather has been generally recognized by superintendents and teachers and directors of prisons and asylums, and even by banks, which in London do not permit clerks to do the more important bookkeeping during very foggy days, the statistical estimates of its effect in general need larger numbers for more valuable determinations. Temperature is known to have a very distinct effect upon crime, especially suicide and truancy. Workmen do less in bad weather, blood pressure is modified, etc.[8]

    In his study of truancy, Kline[9] starts with the assumption that the maximum metabolism is always consciously or unconsciously sought, and that migrations are generally away from the extremes of hot and cold toward an optimum temperature. The curve of truancies and runaways increases in a marked ratio at puberty, which probably represents the age of natural majority among primitive people. Dislike of school, the passion for out-of-door life, and more universal interests in man and nature now arise, so that runaways may be interpreted as an instinctive rebellion against limitations of freedom and unnatural methods of education as well as against poor homes. Hunger is one of its most potent, although often unconscious causes. The habitual environment now begins to seem dull and there is a great increase in impatience at restraint. Sometimes there is a mania for simply going away and enjoying the liberty of nomadic life. Just as good people in foreign parts sometimes allow themselves unwonted liberties, so vagrancy increases crime. The passion to get to and play at or in the water is often strangely dominant. It seems so fine out of doors, especially in the spring, and the woods and fields make it so hard to voluntarily incarcerate oneself in the schoolroom, that pubescent boys and even girls often feel like animals in captivity. They long intensely for the utter abandon of a wilder life, and very characteristic is the frequent discarding of foot and head dress and even garments in the blind instinct to realise again the conditions of primitive man. The manifestations of this impulse, if read aright, are grave arraignments of the lack of adaptability of the child’s environment to his disposition and nature, and with home restraints once broken, the liabilities to every crime, especially theft, are enormously increased. The truant, although a cording to Kline’s measurements slightly smaller than the average child, is more energetic and is generally capable of the greatest activity and usefulness in more out-of-door vocations. Truancy is augmented, too, just in proportion as legitimate and interesting physical exercise is denied.

    The vagrant, itinerant, vagabond, gadabout, hobo, and tramp, that Riis has made so interesting, is an arrested, degenerate, or perverted being who abhors work; feels that the world owes him a living; and generally has his first real nomad experience in the teens or earlier. It is a chronic illusion of youth that gives “elsewhere” a special charm. In the immediate present things are mean, dulled by wont, and perhaps even nauseating because of familiarity. There must be a change of scene to see the world; man is not sessile but locomotor; and the moment his life becomes migratory all the restraints and responsibilities of settled life vanish. It is possible to steal and pass on undiscovered and unsuspected, and to steal again. The vagabond escapes the control of public sentiment, which normally is an external conscience, and having none of his own within him thus lapses to a feral state. The constraint of city, home, and school is especially irksome, and if to this repulsion is added the attraction of a love of nature and of perpetual change, we have the diathesis of the roadsman already developed. Adolescence is the normal time of emancipation from the parental roof, when youth seeks to set up a home of its own, but the apprentice to life must wander far and long enough to find the best habitat in which to set up for himself. This is the spring season of emigration; and it should be an indispensable part of every life curriculum, just before settlement, to travel far and wide, if resources and inclination permit. But this stage should end in wisely chosen settlement where the young life can be independently developed, and that with more complacency and satisfaction because the place has been wisely chosen on the basis of a wide comparison. The chronic vagrant has simply failed to develop the reductives of this normal stage.

    Crime is cryptogamous and flourishes in concealment, so that not only does falsehood facilitate it, but certain types of lies often cause and are caused by it. The beginning of wisdom in treatment is to discriminate between good and bad lies. My own study[10] of the lies of 300 normal children, by a method carefully devised in order to avoid all indelicacy to the childish consciousness, suggested the following distinct species of lies. It is often a well-marked epoch when the young child first learns that it can imagine and state things that have no objective counterpart in its life, and there is often a weird intoxication when some absurd and monstrous statement is made, while the first sensation of a deliberate break with truth causes a real excitement which is often the birth pang of the imagination. More commonly this is seen in childish play, which owes a part of its charm to self-deception. Children make believe they are animals, doctors, ogres, play school, that they are dead, mimic all they see and hear. Idealising temperaments sometimes prompt children of three or four suddenly to assert that they saw a pig with five ears, apples on a cherry tree, and other Munchausen wonders, which really means merely that they have had a new mental combination independently of experience. Sometimes their fancy is almost visualisation and develops into a kind of mythopeic faculty which spins clever yarns and suggests in a sense, quite as pregnant as Froschmer asserts of all mental activity and of the universe itself, that all their life is imagination. Its control and not its elimination in a Gradgrind age of crass facts is what should be sought in the interests of the highest truthfulness and of the evolution of thought as something above reality, which prepares the way for imaginative literature. The life of Hartley Coleridge,[11] by his brother, is one of many illustrations. He fancied cataract of what he named “jug-force” would burst out in a certain field and flow between populous banks, where an ideal government, long wars, and even a reform in spelling, would prevail, illustrated in a journal devoted to the affairs of this realm—all these developed in his imagination, where they existed with great reality for years. The vividness of this fancy resembles the pseudo-hallucinations of Kandinsky. Two sisters used to say, “Let us play we are sisters,” as if this made the relation more real. Cagliostro found adolescent boys particularly apt for training for his exhibition of phrenological impostures, illustrating his thirty-five faculties. “He lied when he confessed he had lied,” said a young Sancho Panza, who had believed the wild tales of another boy who later admitted their falsity. Sir James Mackintosh, near puberty, after reading Roman history, used to fancy himself the Emperor of Constantinople, and carried on the administration of the realm for hours at a time. His fancies never quite became convictions, but adolescence is the golden age of this kind of dreamery and reverie which supplements reality and totalizes our faculties, and often gives a special charm to dramatic activities and in morbid cases to simulation and dissimulation. It is a state from which some of the bad, but far more of the good qualities of life and mind arise. These are the noble lies of poetry, art, and idealism, but their pedagogic regime must be wise.

    Again with children as with savages, truth depends largely upon personal likes and dislikes. Truth is for friends, and lies are felt to be quite right for enemies. The young often see no wrong in lies their friends wish told, but may collapse and confess when asked if they would have told their mother thus. Boys best keep up complotted lies and are surer to own up if caught than girls. It is harder to cheat in school with a teacher who is liked. Friendships are cemented by confidences and secrets, and when they wane, promises not to tell weaken in their validity. Lies to the priest, and above all to God, are the worst. All this makes special attention to friendships, leaders, and favorites important, and suggests the high value of science for general veracity.

    The worst lies, perhaps, are those of selfishness. They ease children over many hard places in life, and are convenient covers for weakness and vice. These lies are, on the whole, judging from our census, most prevalent. They are also most corrupting and hard to correct. All bad habits particularly predispose to the lie of concealment; for those who do wrong are almost certain to have recourse to falsehood, and the sense of meanness thus slowly bred, which may be met by appeals to honor, for so much of which school life is responsible, is often mitigated by the fact that falsehoods are frequently resorted to in moments of danger and excitement, are easily forgotten when it is over, and rarely rankle. These, even more than the pseudomaniac cases mentioned later, grow rankly in those with criminal predispositions.

    The lie heroic is often justified as a means of noble ends. Youth has an instinct which is wholesome for viewing moral situations as wholes. Callow casualists are fond of declaring that it would be a duty to state that their mother was out when she was in, if it would save her life, although they perhaps would not lie to save their own. A doctor, many suggested, might tell an overanxious patient or friend that there was hope, saving his conscience perhaps by reflecting that there was hope, although they had it while he had none. The end at first in such cases may be very noble and the fib or quibble very petty, but worse lies for meaner objects may follow. Youth often describes such situations with exhilaration as if there were a feeling of easement from the monotonous and tedious obligation of rigorous literal veracity, and here mentors are liable to become nervous and err. The youth who really gets interested in the conflict of duties may reverently be referred to the inner lie of his own conscience, the need of keeping which as a private tribunal is now apparent.

    Many adolescents become craven literalists and distinctly morbid and pseudophobiac, regarding every deviation from scrupulously literal truth as alike heinous; and many systematized palliatives and casuistic word-splittings, methods of whispering or silently interpolating the words “not,” “perhaps,” or “I think,” sometimes said over hundreds of times to neutralize the guilt of intended or unintended falsehoods, appear in our records as a sad product of bad methods.

    Next to the selfish lie for protection—of special psychological interest for adolescent crime—is what we may call pseudomania, seen especially in pathological girls in their teens, who are honeycombed with selfishness and affectation and have a passion for always acting a part, attracting attention, etc. The recent literature of telepathy and hypnotism furnishes many striking examples of this diathesis of impostors of both sexes. It is a strange psychological paradox that some can so deliberately prefer to call black white and find distinct inebriation in flying diametrically in the face of truth and fact. The great impostors, whose entire lives have been a fabric of lies, are cases in point. They find a distinct pleasure not only in the sense of power which their ability to make trouble gives, but in the sense of making truth a lie, and of decreeing things into and out of existence.

    Sheldon’s interesting statistics show that among the institutional activities of American children,[12] predatory organizations culminate from eleven to fifteen, and are chiefly among boys. These include bands of robbers, clubs for hunting and fishing, play armies, organized fighting bands between separate districts, associations for building forts, etc. This form of association is the typical one for boys of twelve. After this age their interests are gradually transferred to less loosely organized athletic clubs. Sheldon’s statistics are as follows:

    Age 8 9 10 11 12 13 14 15 16 17 Total No. of predatory 4 5 3 0 7 1 1 3 1 0 25 = Girls societies 4 2 17 31 18 22 (11) 7 1 0 111 = Boys

    Innocent though these predatory habits may be in small boys, if they are not naturally and normally reduced at the beginning of the teens and their energy worked off into athletic societies, they become dangerous. “The robber knight, the pirate chief, and the marauder become the real models.” The stealing clubs gather edibles and even useless things, the loss of which causes mischief, into some den, cellar, or camp in the woods, where the plunder of their raids is collected. An organized gang of boy pilferers for the purpose of entering stores had a cache, where the stolen goods were brought together. Some of these bands have specialized on electric bells and connections, or golf sticks and balls. Jacob Riis says that on the East Side of New York, every corner has its gang with a program of defiance of law and order, where the young tough who is a coward alone becomes dangerous when he hunts with the pack. He is ambitious to get “pinched” or arrested and to pose as a hero. His vanity may obliterate common fear and custom as his mind becomes inflamed with flash literature and “penny dreadfuls.” Sometimes whole neighborhoods are terrorized so that no one dares to testify against the atrocities they commit. Riis even goes so far as to say that “a bare enumeration of the names of the best-known gangs would occupy the pages of this book.”[13] The names are sufficiently suggestive—hell’s kitchen gang, stable gang, dead men, floaters, rock, pay, hock gang, the soup-house gang, plug uglies, back-alley men, dead beats, cop beaters, and roasters, hell benders, chain gang, sheeny skinners, street cleaners, tough kids, sluggers, wild Indians, cave and cellar men, moonlight howlers, junk club, crook gang, being some I have heard of. Some of the members of these gangs never knew a home, were found perhaps as babies wrapped in newspapers, survivors of the seventy-two dead infants Riis says were picked up on the streets in New York in 1889, or of baby farming. They grow up street arabs, slum waifs, the driftwood of society, its flotsam and jetsam, or plankton, fighting for a warn corner in their resorts or living in crowded tenement-houses that rent for more than a house on Fifth Avenue. Arrant cowards singly, they dare and do anything together. A gang stole a team in East New York and drove down the avenue, shopping to throw in supplies, one member sitting in the back of the wagon and shooting at all who interfered. One gang specialized on stealing baby carriages, depositing their inmates on the sidewalk. Another blew up a grocery store because its owner refused a gift they demanded. Another tried to saw off the head of a Jewish pedler. One member killed another for calling him “no gent.” Six murderous assaults were made at one time by these gangs within a single week. One who is caught and does his “bit” or “stretch” is a hero, and when a leader is hanged, as has sometimes happened, he is almost envied for his notoriety. A frequent ideal is to pound a policeman with his own club. The gang federates all nationalities. Property is depreciated and may be ruined if it is frequented by these gangs or becomes their lair or “hang-out.” A citizen residing on the Hudson procured a howitzer and pointed it at a boat gang, forbidding them to land on his river frontage. They have their calls, whistles, signs, rally suddenly from no one knows where, and vanish in the alleys, basements, roofs, and corridors they know so well. Their inordinate vanity is well called the slum counterpart of self-esteem, and Riis calls the gang a club run wild. They have their own ideality and a gaudy pinchbeck honor. A young tough, when arrested, wrenched away the policeman’s club, dashed into the street, rescued a baby from a runaway, and came back and gave himself up. They batten on the yellowest literature. Those of foreign descent, who come to speak our language better than their parents, early learn to despise them. Gangs emulate each other in hardihood, and this is one cause of epidemics in crime. They passionately love boundless independence, are sometimes very susceptible to good influence if applied with great wisdom and discretion, but easily fall away. What is the true moral antitoxin for this class, or at least what is the safety-valve and how and when to pull it, we are now just beginning to learn, but it is a new specialty in the great work of salvage from the wreckage of city life. In London, where these groups are better organised and yet more numerous, war is often waged between them, weapons are used and murder is not so very infrequent. Normally this instinct passes harmlessly over into associations for physical training, which furnishes a safe outlet for these instincts, until the reductives of maturer years have perfected their work.

    The causation of crime, which the cure seeks to remove, is a problem comparable with the origin of sin and evil. First, of course, comes heredity, bad antenatal conditions, bad homes, unhealthful infancy and childhood, overcrowded slums with their promiscuity and squalor, which are always near the border of lawlessness, and perhaps are the chief cause of crime. A large per cent of juvenile offenders, variously estimated, but probably one-tenth of all, are vagrants or without homes, and divorce of parents and illegitimacy seem to be nearly equal as causative agencies. If whatever is physiologically wrong is morally wrong, and whatever is physiologically right is morally right, we have an important ethical suggestion from somatic conditions. There is no doubt that conscious intelligence during a certain early stage of its development tends to deteriorate the strength and infallibility of instinctive processes, so that education is always beset with the danger of interfering with ancestral and congenital tendencies. Its prime object ought to be moralization, but it can not be denied that in conquering ignorance we do not thereby conquer poverty or vice. After the free schools in London were opened there was an increase of juvenile offenders. New kinds of crime, such as forgery, grand larceny, intricate swindling schemes, were doubled, while sneak thieves, drunkards, and pick-pockets decreased, and the proportion of educated criminals was greatly augmented.[14] To collect masses of children and ram them with the same unassimilated facts is not education in this sense, and we ought to confess that youthful crime is an expression of educational failure. Illiterate criminals are more likely to be detected, and also to be condemned, than are educated criminals. Every anthropologist knows that the deepest poverty and ignorance among primitive people are in nowise incompatible with honesty, integrity, and virtue. Indeed there is much reason to suspect that the extremes of wealth and poverty are more productive of crime than ignorance, or even intemperance. Educators have no doubt vastly overestimated the moral efficiency of the three R’s and forgotten that character in infancy is all instinct; that in childhood it is slowly made over into habits; while at adolescence more than at any other period of life, it can be cultivated through ideals. The dawn of puberty, although perhaps marked by a certain moral hebetude, is soon followed by a stormy period of great agitation, when the very worst and best impulses in the human soul struggle against each other for its possession, and when there is peculiar proneness to be either very good or very bad. As the agitation slowly subsides, it is found that there has been a renaissance of either the best or the worst elements of the soul, if not indeed of both.

    Although pedagogues make vast claims for the moralizing effect of schooling, I cannot find a single criminologist who is satisfied with the modern school, while most bring the severest indictments against it for the blind and ignorant assumption that the three R’s or any merely intellectual training can moralize. By nature, children are more or less morally blind, and statistics show that between thirteen and sixteen incorrigibility is between two and three times as great as at any other age. It is almost impossible for adults to realize the irresponsibility and even moral neurasthenia incidental to this stage of development. If we reflect what a girl would do if dressed like a boy and leading his life and exposed to the same moral contagion, or what a boy would do if corseted and compelled to live like a girl, perhaps we can realize that whatever rôle heredity plays, the youth who go wrong are, in the vast majority of cases, victims of circumstances or of immaturity, and deserving of both pity and hope. It was this sentiment that impelled Zarnadelli to reconstruct the criminal law of Italy, in this respect, and it was this sympathy that made Rollet a self-constituted advocate, pleading each morning for the twenty or thirty boys and eight or ten girls arrested every day in Paris.

    Those smitten with the institution craze or with any extreme correctionalist views will never solve the problem of criminal youths. First of all, they must be carefully and objectively studied, lived with, and understood as in this country Gulick, Johnson, Forbush and Yoder are doing in different ways, but each with success. Criminaloid youth is more sharply individualized than the common good child, who is less differentiated. Virtue is more uniform and monotonous than sin. There is one right but there are many wrong ways, hence they need to be individually studied by every paidological method, physical and psychic. Keepers, attendants, and even sponsors who have to do with these children should be educators with souls full of fatherhood and motherhood, and they should understand that the darkest criminal propensities are frequently offset by the very best qualities; that juvenile murderers are often very tender-hearted to parents, sisters, children, or pets;[15] they should understand that in the criminal constitution there are precisely the same ingredients, although perhaps differently compounded, accentuated, mutually controlled, etc., by the environment, as in themselves, so that to know all would, in the great majority of cases, be to pardon all; that the home sentiments need emphasis; that a little less stress of misery to overcome the effects of economic malaise and, above all, a friend, mentor, adviser are needed.

    I incline to think that many children would be better and not worse for reading, provided it can be done in tender years, stories like those of Captain Kidd, Jack Sheppard, Dick Turpin, and other gory tales, and perhaps later tales like Eugene Aram, and the ophidian medicated novel, Elsie Venner, etc., on the principle of the Aristotelian catharsis to arouse betimes the higher faculties which develop later, and whose function it is to deplete the bad centers and suppress or inhibit their activity. Again, I believe that judicious and incisive scolding is a moral tonic, which is often greatly needed, and if rightly administered would be extremely effective, because it shows the instinctive reaction of the sane conscience against evil deeds and tendencies. Special pedagogic attention should be given to the sentiment of justice, which is almost the beginning of personal morals in boys; and plays should be chosen and encouraged that hold the beam even, regardless of personal wish and interest. Further yet benevolence and its underlying impulse to do more than justice to our associates; to do good in the world; to give pleasure to those about, and not pain, can be directly cultivated. Truth-telling presents a far harder problem, as we have seen. It is no pedagogical triumph to clip the wings of fancy, but effort should be directed almost solely against the cowardly lies, which cover evil; and the heroism of telling the truth and taking the consequences is another of the elements of the moral sense, so complex, so late in development, and so often permanently crippled. The money sense, by all the many means now used for its development in school, is the surest safeguard against the most common juvenile crime of theft, and much can be taught by precept, example, and moral regimen of the sacredness of property rights. The regularity of school work and its industry is a valuable moralizing agent, but entirely inadequate and insufficient by itself. Educators must face the fact that the ultimate verdict concerning the utility of the school will be determined, as Talleck well says, by its moral efficiency in saving children from personal vice and crime.

    Wherever any source of pollution of school communities occurs, it must be at once and effectively detected, and some artificial elements must be introduced into the environment. In other words, there must be a system of moral orthopedics. Garofalo’s[16] new term and principle of “temibility” is perhaps of great service. He would thus designate the quantum of evil feared that is sufficient to restrain criminal impulsion. We can not measure guilt or culpability, which may be of all degrees from nothing to infinity perhaps, but we can to some extent scale the effectiveness of restraint, if criminal impulse is not absolutely irresistible. Pain then must be so organised as to follow and measure the offense by as nearly a natural method as possible, while on the other hand the rewards for good conduct must also be more or less accentuated. Thus the problem of criminology for youth can not be based on the principles now recognised for adults. They can not be protective of society only, but must have marked reformatory elements. Solitude[17] which tends to make weak, agitated, and fearful, at this very gregarious age should be enforced with very great discretion. There must be no personal and unmotivated clemency or pardon in such scheme, for, according to the old saw, “Mercy but murders, pardoning those who kill”; nor on the other hand should there be the excessive disregard of personal adjustments, and the uniformitarian, who perhaps celebrated his highest triumph in the old sentence, “Kill all offenders and suspects, for God will know his own,” should have no part nor lot here. The philosopher Hartmann has a suggestive article advocating that penal colonies made up of transported criminals should be experimented upon by statesmen in order to put various theories of self-government to a practical test. However this may be, the penologist of youth must face some such problem in the organization of the house of detention, boys’ club, farm, reformatory, etc. We must pass beyond the clumsy apparatus of a term sentence., or the devices of a jury, clumsier yet, for this purpose; we must admit the principle of regret, fear, penance, material restoration of damage, and understand the sense in which, for both society and for the individual, it makes no practical difference whether experts think there is some taint of insanity, provided only that irresponsibility is not hopelessly complete.

    In few aspects of this theme do conceptions of and practises in regard to adolescence need more radical reconstruction. A mere accident of circumstance often condemns to criminal careers youths capable of the highest service to society, and for a mere brief season of temperamental outbreak or obstreperousness exposes them to all the infamy to which ignorant and cruel public opinion condemns all those who have once been detected on the wrong side of the invisible and arbitrary line of rectitude. The heart of criminal psychology is here; and not only that, but I would conclude with a most earnest personal protest against the current methods of teaching and studying ethics in our academic institutions as a speculative, historical, and abstract thing. Here in the concrete and saliently objective facts of crime it should have its beginning, and have more blood and body in it by getting again close to the hot battle line between vice and virtue, and then only, when balanced and sanified by a rich ballast of facts, can it with advantage slowly work its way over to the larger and higher philosophy of conduct, which, when developed from this basis, will be a radically different thing from the shadowy phantom, schematic speculations of many contemporary moralists, taught in our schools and colleges.

    [Footnote 1: Problematische Kindesnaturen. Eine Studie für Schule und
    Haus. Voigtländer, Leipzig, 1889.]

    [Footnote 2: Die pädagogische Pathologie in der Erziehungskunde des 19
    Jahrhunderts. Bertelsman, Gütersloh, 1893, p. 494.]

    [Footnote 3: Peculiar and Exceptional Children. Pedagogical Seminary,
    October, 1896, vol. 4, pp. 3-60.]

    [Footnote 4: La Puberté. Schleicher Frères, Paris, 1902, p. 72.]

    [Footnote 5: Home and School Punishments. Pedagogical Seminary, March, 1899, vol. 6, pp. 159-187.]

    [Footnote 6: A Study of the Faults of Children. Pedagogical Seminary,
    June, 1903, vol. 10, p. 200 et seq.]

    [Footnote 7: The Child and the Weather, by Edwin G. Dexter.
    Pedagogical Seminary, April, 1898, vol. 5, pp. 512-522.]

    [Footnote 8: Psychic Effects of the Weather, by J.S. Lemon. American
    Journal of Psychology, January, 1894, vol. 6, pp. 277-279.]

    [Footnote 9: Truancy as Related to the Migrating Instinct, by L.W.
    Kline. Pedagogical Seminary, January, 1898, vol. 5, pp. 381-420.]

    [Footnote 10: Children’s Lies. American Journal of Psychology,
    January, 1890, vol. 3, pp. 59-70.]

    [Footnote 11: Poems. With memoir by his brother, 2 vols., London, 1851.]

    [Footnote 12: American Journal of Psychology, July, 1898, vol. 9, pp. 425-448.]

    [Footnote 13: How the Other Half Lives. Scribner’s Sons, New York, 1890, p. 229.]

    [Footnote 14: The Curse in Education, by Rebecca Harding Davis. North
    American Review, May, 1899, vol. 168, pp. 609-614.]

    [Footnote 15: Holtzendorff: Psychologie des Mordes. C. Pfeiffer,
    Berlin, 1875]

    [Footnote 16: La Criminologie. Paris, Alcan, 1890, p. 332]

    [Footnote 17: See its psychology and dangers well pointed out by M.H.
    Small: Psychical Relations of Society and Solitude. Pedagogical
    Seminary, April, 1900, vol. 7, pp. 13-69]

    Extract from Youth: Its Education, Regimen, and Hygiene, by G. Stanley Hall

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  • Armed Conflicts, State Repression Causing Human Rights Abuses In Africa, Says Amnesty International

    Armed Conflicts, State Repression Causing Human Rights Abuses In Africa, Says Amnesty International

    Armed Conflicts, State Repression Causing Human Rights Abuses In Africa, Says Amnesty International 1

    Armed Conflicts, State Repression Causing Human Rights Abuses In Africa, Says Amnesty International 2


     

    Amnesty International has said that armed conflicts and state repression were causes of human rights abuses in Africa.

    The organisation in its annual review of human rights in the region on Tuesday said rights defenders in Africa were persecuted and harassed for standing up and speaking out against governments.

    According to the report, there are major developments from the past year, which include the deposition of Sudanese President Omar al-Bashir, Zimbabwean Government’s response to mass protests, and increasing attacks on civilians in Mozambique and Mali.

    “In 2019, we saw incredible people power in mass protests which swept across Sub-Saharan Africa. From Sudan to Zimbabwe, and Democratic Republic of Congo to Guinea, people braved brutal crackdowns to stand up for their rights,” said Deprose Muchena, Amnesty International’s East and Southern Africa Director.

    “In some cases, these protests led to major changes, following the toppling of Sudan’s long-time leader, Omar al-Bashir, the new authorities promised human rights friendly reforms and following protest a raft package of human rights reforms was introduced by the Ethiopian Government.

    “Sadly, other changes needed are being blocked by repressive governments, who continue to carry out violations with impunity.

    “In Sudan’s Darfur region, government forces continued to commit possible war crimes and other serious human rights violations including unlawful killings, sexual violence, systematic looting and forced displacement.

    “In DRC, dozens of local and foreign armed groups together with the country’s security forces continued to carry out human rights abuses resulting in more than 2000 civilian deaths and at least one million were forcibly displaced in the course of 2019.

    “In Somalia, civilians continued to live with attacks from the armed group Al-Shabaab, while government and allied international forces failed to take sufficient precautions to spare civilians from their attacks targeted at Al-Shabaab. 

    “Armed groups carried out attacks directed against civilians in Cameroon, Central African Republic and Burkina Faso, while governments failed to protect civilians,” he added.

    The organisation said access to healthcare remains a major concern for people across the region, with underfunded health budgets leading to shortages of beds and drugs in hospitals.

    It said, “Governments from Angola to Zimbabwe, Burundi to Cameroon have failed to respect the right to health, and conflicts have exacerbated the situation.

    “With the COVID-19 pandemic looming, there is no time to waste in addressing the inequalities and human rights violations which make healthcare inaccessible for so many.”

    The organisation also condemned the persecution and harassment of human rights defenders for standing up and speaking out against governments.

    It said Burundi, Malawi, Mozambique, Eswatini, Zambia and Equatorial Guinea all saw surging crackdowns on activism in 2019.

    “In 17 countries across sub-Saharan Africa, journalists were arbitrarily arrested and detained in 2019. In Nigeria for example, 19 cases of assault, arbitrary arrest, and detention of journalists were recorded, with many facing trumped up charges.

    “In Burundi, authorities continued to crack down on the work of human rights defenders and civil society organisations including by subjecting them to prosecution and lengthy prison terms.

    “Human rights violations forced hundreds of thousands of people in the region to flee their homes in search of protection. There were about 600,000 internally displaced people in CAR; more than 222,000 people in Chad, and over half a million in Burkina Faso,” the report added.

     

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  • Virtual Press Conference on COVID-19- 06 April 2020

    Virtual Press Conference on COVID-19- 06 April 2020

    Originally broadcast live on 06 April 2020, the daily press briefing on coronavirus COVID-19, direct from WHO Headquarters, Geneva Switzerland with Dr Tedros WHO Director-General, Dr Micheal Ryan, Executive Director of the Health Emergencies Programme, and Dr Maria Van Kerkhove, Technical lead, WHO Health Emergencies Programme with special guests Lady Gaga and Hugh Evans, CEO and Co-founder of Global Citizen.

    Transcript:

    Speaker key:

    TJ        Tarik Jasarevic

    TAG    Dr Tedros Adhanom Ghebreyesus

    LG       Lady Gaga

    HE       Hugh Evans

    MR      Dr Michael Ryan JA  Jamie

    MK      Dr Maria Van Kerkhove KA Kai

    KT       Kate

    IN        Innocent

    YA      Yang

    00:00:19

     

    TJ        Good evening to everyone from Geneva and WHO headquarters. Welcome to the regular press conference on COVID-19. Journalists who are online can ask their questions by clicking  raise hand if  you are
    on Zoom.  Today we have a special guest but  I will  let Dr Tedros do his opening remarks and introduce them.  Before I give  the floor  to Dr Tedros, just to remind you, we will also be sending you some news from other
    WHO offices around the world with the audio file  from this  press briefing a little  bit  later. I give  the floor  immediately to Dr Tedros.

     

    00:01:07

     

    TAG    Good morning, good  afternoon and good  evening.  The COVID-19 pandemic continues to take a heavy toll on families, communities and nations the world over but it’s also giving rise to incredible acts of generosity,
    solidarity and co-operation. We have said consistently that we’re all in this together and we can only succeed together. We need an all- of-society approach with everyone playing their part. That includes  people  in  the entertainment
    industry.

     

    Today I’m very delighted to be joined by one of the biggest names in entertainment in the world, Lady Gaga, and my friend Hugh Evans, the founder and CEO of Global Citizen.

    WHO has been working with Global Citizen for several weeks on the Together At Home concert series with artists like Chris Martin and John Legend giving free online performances.

    Now we’re working with Lady Gaga and Global Citizen to take this concept and make it even bigger through the  One World  Together  At Home virtual  global  special on Saturday 18th April. It’s now my great pleasure to invite
    Lady Gaga and Hugh Evans to say more about this very special event, One World.

    00:03:10

     

    LG       Thank you very much, Dr Tedros. Good morning, good afternoon  and good  evening to everyone who’s listening and watching. I would  like  to thank the World  Health Organization and the
    United Nations as well as Global Citizen; thank you very much, Dr Tedros and Hugh Evans, for all of your leadership in this fight against COVID-19 and thank you very much to the World Health Organization  for asking  me to collaborate 
    with  you on this special.

    We are also very grateful to all of the healthcare professionals across the country and around the world who are on the front lines during COVID-19. This  global  pandemic  is  a catastrophe. I’m so thankful to them and I’m also
    praying for those who are sick. It’s been a pleasure to partner with Global Citizen  and we’ve been working  all together  behind  the scenes to raise money for the World Health Organization.

    I would also like to send my prayers as well to people  that are losing  their  jobs  and are having a hard time feeding themselves  and their  children.  We are raising  money  for  the World Health
    Organization’s COVID-19 Solidarity  Response  Fund and seven days ago we held a  call with more than 68 corporate leaders from some of the world’s biggest and most generous companies and I asked them to join my corporate kindness
    list as there have been many corporations and philanthropists that have been very, very generous during this time.

    00:04:38

     

    Since then we have also been calling on philanthropists around the world as well and tech companies included. I’d like  to reiterate our deep gratitude  to the medical  community.  My heart is very, very aching and warm for those
    who are ER doctors as well as nurses who are sleeping in cars to make sure they don’t infect their families  or  their  patients.  What you’re doing is putting  yourselves  in  harm’s way to help the world 
    and we all salute  you and you are a triumph truly.

    I am proud to say that over the past seven days we’ve raised a total of $35 million for the Solidarity Fund. This money will [inaudible]  essential PPE, supplies  and testing kits around  the world and will help improve lab capacity
    to rapidly process tests. It will also [inaudible] research development. It is so important to think globally and to support the World Health Organization to curb the pandemic and prevent future outbreaks.

    I know Dr Tedros is particularly concerned about Africa and [inaudible]. We also need to act globally by supporting local charities  and initiatives so that the front-line health  workers in most immediate need have the resources they need
    to survive during this time. It has been an honour to help with this huge broadcast event, which will take place on April 18th, where we need to tell the stories of and celebrate the front-line community, healthcare workers and their acts of kindness.

    We will be on different networks, many networks actually and I want to [inaudible] about what we’re going to be doing. What’s very important is that two things happen for all of us; that we celebrate and we highlight the singular, kind global community
    that is arising right now. Two, we want to highlight the gravity of this historically unprecedented cultural movement and, three, we want to celebrate and encourage the power of the human spirit.

    00:06:47

    I would like to, on behalf of  the World  Health Organization  and Global  Citizen,  thank Dr Tedros as well as everyone that has donated so far. We are going to continue fundraising but I would like to also let you know that
    this broadcast special is not actually a fundraiser. We all wanted to raise the money before we went on air so when we do  air  live  on  April  18th  put your wallets away, put your credit  cards away, anything 
    away that you need to and just  sit back and enjoy the show that you all very much deserve.

    I’d like to pass this now to Hugh Evans, who’s been a wonderful partner of mine. Hugh, thank you so much and thank you, Dr Tedros.

    HE       Good morning, good afternoon,  good  evening  and thank you,  Dr Tedros  and thank you, Lady Gaga. Your Excellencies,  ladies  and gentlemen;  Lady Gaga, Dr Tedros, 
    you’ve both demonstrated extraordinary leadership at an unprecedented moment when our society is being challenged like never before and we are so thankful for your leadership. I’d like to echo Lady Gaga’s sentiment and commend the incredible acts
    of bravery demonstrated by the front-line community  health  workers around the world  and I hope  that we as a shared humanity emerge from this moment forever grateful for the work of doctors, nurses, teachers, grocery store workers and all of those who are
    the backbone of our communities.

    Global health is at the very core of the global citizen mission and we must  ensure that the world’s poorest and most  marginalised  people  have  access to resources to cope with and tackle this health crisis. Through One
    World:  Together At Home on April 18th  we’ll be calling on philanthropists, corporations and governments to fund critical global COVID-19 response efforts including distribution of resources and PPE to critical front-line healthcare
    workers.

    00:09:09

    In our partnership with the WHO and United Nations Global Citizen is committed to driving action to help ensure our global health systems are strong enough to stop a future pandemic before it happens. April 18th is going to be a moment of global unity
    connecting the world through a historic global broadcast. We are bringing together the greatest artists in the world under the passionate and extremely talented curation of Lady Gaga.

    In alphabetical order some of the artists we’ll be announcing today include Alanis Morissette, Andrea Bocelli,  Billie  Eilish,  Billy  Joe Armstrong  of Green Day, Burna Boy, Chris Martin, Sir David Beckham, Eddie Vedder,
    Sir Elton John, Finneas, Idris and Sabrina Elba, J Balvin, John Legend, Kacey Musgraves, Keith Urban, Kerry Washington,  Lang Lang,  Lizzo, Maluma, Sir Paul McCartney, Priyanka Chopra Jonas, Shah Rukh Khan, Stevie Wonder and many more to be announced over the coming weeks from all corners of the globe under the passionate and extremely talented curation of Lady Gaga.

    We’re grateful to all of you for participating and supporting this critical effort. One World Together At Home will be broadcast live on Saturday April 18th 2020 at 5:00pm PDT, 8:00pm EDT and 12:00am BST, airing on ABC, NBC, Viacom and CBS networks,
    IHeartMedia, and Bell media networks and platforms in Canada. Internationally BBC1 will run the programme on Sunday April 19th and additional  international  broadcasters include BN Media Group, Multi-Choice Group and RTE in Ireland.

    00:11:43

    The digital broadcast will celebrate and support brave community  health workers who are doing life-saving work on the front line and we’ve all seen the limitations of world leaders around this world to step up and face this extraordinary challenge 
    and we want to do our best to support the essential work of the World Health Organization, driving action and raising critical funds. Thank you again, Dr Tedros, and thank you, Lady Gaga, for your leadership.

    Thank you all.

    TJ        Thank you very much to our guests for their remarks. Dr Tedros, I guess you would like to thank them too.

    TAG    Once again I would like  to thank Lady Gaga and Hugh Evans for their  partnership. We had a call last week and I was so amazed by the energy and passion of Lady Gaga. It’s incredible commitment to humanity and that’s
    when I said, I think what she has planned can happen. It’s bringing the world together to improve awareness and to mobilise  resources to fight the pandemic so I thank her for her incredible passion and commitment  and leadership and
    also to my friend, Hugh Evans, for connecting all the dots and for his leadership.

    We all look forward to joining you for the One World: Together  At Home concert on 18th April. As the pandemic continues we recognise that individuals and governments want to do everything they can to protect themselves and others and so do we.
    We understand that some countries have recommended or are considering the use of both medical  and non-medical masks in the general population to prevent the spread of COVID-19.

    00:14:21

    First and foremost medical masks must be prioritised for health workers on the front lines  of  the response. We know medical masks can help to protect health workers but they’re in short supply globally.  We’re concerned that the mass
    use of medical  masks by the general population could exacerbate the shortage of these specialised masks for the people who need them most. In some places these shortages are putting health workers in real danger.

    In healthcare facilities WHO continues to recommend the use of medical masks, respirators and other personal protective equipment for  health workers. In the community we recommend the use of medical masks by people who are sick and those who
    are caring for a sick person at home.

    WHO has been evaluating the use of medical and non-medical masks for COVID-19 more widely. Today WHO is issuing guidance and criteria to support countries in making that decision. For example countries could consider using masks in communities where other measures such as cleaning hands and physical distancing are harder to achieve because of lack of water or cramped living conditions.

    If masks are worn they must be used safely and properly. WHO has guidance on how to put on, take off and dispose of masks. What’s clear is that there is limited research in  this  area. We encourage countries that are considering the use
    of masks for the general population to study their effectiveness so we can all learn. Most importantly masks should only  ever be used as part of a comprehensive package of interventions. There is no black or white answer and no silver bullet.
    Masks alone cannot stop the pandemic. Countries must continue to find, test, isolate and treat every case and trace every contact. Mask or no mask, there are proven things all of us can do to protect ourselves and others.

    00:17:13

    Keep your distance, clean your hands, cough or sneeze into your elbow  and avoid  touching your face. Less than 100 days since WHO was notified about the new coronavirus  research has accelerated at incredible speed. The viral genome
    was mapped  in  early January and shared globally, which enabled tests to be developed and vaccine research to start. More than 70 countries have joined WHO’s Solidarity Trial to accelerate the search for an effective treatment and about
    20 institutions and companies are racing to develop a vaccine.

    WHO is committed to ensuring that as medicines and vaccines are developed they’re shared equitably with all countries  and people.  I want to thank the  Medicines  Patent Pool and Unitaid for the initiative they announced last
    Friday to include medicines and diagnostics for COVID-19 in their licensing pool.

    I also want to thank the President of Costa Rica, President Carlos Alvadaro, and the Health Minister, Daniel Salas, for their proposal to create a pool of rights to tests, medicines and vaccines with free access or licensing on reasonable and affordable
    terms for all countries. Muchas gracias, Mr President. I support this proposal and we’re working with Costa Rica to finalise the details.

    00:19:09

    Poorer countries and fragile  economies  stand to face the biggest  shock from this  pandemic and leaving anyone unprotected will  only  prolong  the health crisis  and harm economies  more.  I call
    on all countries, companies and research institutions to support open data, open science and open collaboration so that all people can enjoy the benefits of science and research.

    Finally we’re nearing the end of the Ebola outbreak in the Democratic Republic of the Congo. This is one piece of good news. If there are no more cases the Government of the Democratic Republic of Congo could declare the outbreak over  as early
    as this  Sunday.  We’re not  there yet and we remain in full response mode. We’re continuing to investigate alerts and to test samples.

    This would not have been possible without the incredible  health workers who have put themselves at risk for more than 18 months to stop this outbreak, just as health workers are putting themselves in danger to save lives from COVID-19. Health
    workers in DRC faced the 
    double threat of fighting a deadly virus in one of the world’s most dangerous and unstable regions, exposing themselves to Ebola and bullets.

    Tomorrow, as you know, is WHO’s birthday, a day we celebrate each year as World Health Day. This year we’re paying tribute to the incredible contribution of all health workers, especially nurses and midwives. Nurses and midwives are the backbone of
    every health system. They’re there from the first moments of life to the last. Tomorrow we’re publishing our first report on the state of the world’s nursing which highlights gaps and makes recommendations for all countries.

    00:22:00

    One of the lessons I hope the world learns from COVID-19 is that we must invest in health workers, not only to protect lives but also to protect livelihoods. I thank you.

    TJ        Thank you very much, Dr Tedros. Also, as always, we have Dr Mike Ryan and Dr Maria Van Kerkhove, who will be answering questions. We will  now open the floor.  I will  go to one question
    that I received by email this morning and I promised to answer; that’s Ankit Kumar from India Today. Ankit is asking; we have recently seen a spike in  cases caused through religious gatherings in India, in fact almost a third of new cases
    were linked to one gathering in India. We have also seen incidents of violence against health workers due to fear and misinformation. Is WHO concerned with these developments, what is WHO’s message to religious and community leaders and their
    followers?

    MR      First and foremost the idea of violence against health workers is driven by fear and it’s driven by misunderstanding but it’s  really  unacceptable. We ask everyone and every community to see our health workers
    as our heroes and to support them in every way we can.

    With regard to gatherings of any type, be they religious or be they for other  purposes,  there are always risks associated with such gatherings in the midst of a major epidemic. WHO has issued guidance on that. Many of these gatherings
    are now postponed or cancelled.  We’ve been working very, very closely with religious  and faith-based organisations  all  over the world including  groups  from the Islamic  tradition,  Christian 
    traditions  and others and continue to work through faith-based organisations to communicate  using  our  Epiwin platform.

    00:24:21

    We’re also continuing to develop guidance specifically  for the holy  month  of Ramadan and are working through our Eastern Mediterranean regional office to be able to advise governments and religious institutions on how best to manage
    the risks associated with such holy events.

    But it’s very important again; having COVID-19 is not anybody’s fault. Every case is a victim and every case needs to be  treated with sensitivity,  as the health workers who treat them so it’s very important that we’re not profiling COVID-19
    along  racial,  along  religious,  along ethnic lines. This is not helpful.

    TJ        Thank you very much. This was a question  from Ankit  Kumar from India  Today. Now we will go to journalists online. We will start with Jamie from Associated Press. Jamie, can you hear us?

    JA        Hi, yes. Can you hear me? TJ            Yes. Please go ahead.

    JA        Great, thank you very much. I wanted to ask you about… Over the weekend Dr Anthony Fauci mentioned that – if I understood it correctly – as much as 50% of transmission could be asymptomatic. Just aligned 
    with that, if  you could  give  us a little  bit  more  about what you’re thinking about the fact that some countries have said that this outbreak is more infectious than influenza. The CDC is saying that it’s up
    to three times more infectious than influenza so what do you have to say about that? Thanks.

    00:26:13

    MK      I’ll start and then perhaps Mike or DG would like to supplement. The modes of transmission and the way in which this virus is transmitted  are of significant  interest to all of us. What we are doing is working
    with member states, we’re working with everyone that’s affected by this, looking through the research and trying to understand  when most transmission is happening, when any transmission is happening.

    What we know from reports, what we know from published literature is that the predominant way in which transmission is occurring is amongst symptomatic individuals  and these are people that can be very early on in symptoms, even when they start
    to feel a little bit unwell. This is supported by some data that attempts to catch a virus from individuals who are symptomatic.

    We also know that it’s possible that people can transmit in the few days before they become symptomatic or in their pre-symptomatic  phase. There have been some studies  that have come out and we learned about this when we were on mission
    in China back in January or early February, that there are individuals that can shed virus one to three days before they develop symptoms.

    However it’s very important to note that even if you are pre-symptomatic or even if you don’t have any recognised symptoms you still have to transmit through  droplets,  you still  have to have these infectious particles that come out
    of your nose and your mouth. So while we know that that is possible we do not believe that it’s a major driver of transmission.

    00:27:42

    We’ve also seen modelling estimates that suggest that there’re large numbers of unrecognised transmission and I used unrecognised on purpose because I’m not saying asymptomatic. I’m saying that we may be missing people who are out there who are infected
    but we’re missing them because of current surveillance strategies. That is certainly possible in many parts of the globe.

    Whether or not those individuals are asymptomatic; we will have to wait until we see the results of serologic studies, which we hope we’ll be seeing in the coming days if not weeks.

    So what we can say is that most people are transmitting this virus while they are symptomatic.

    JA        Hi, Jamie. Just in addition because I think – I would never in any way contradict my good friend, Tony Fauci, such an eminent man. There are many different estimations of what might represent asymptomatic
    transmission or other infections in the community and we do know and everyone accepts that when the seroepidemiology studies do come online we will probably find more people who’ve been infected unknowingly; there’s no question of that.

    The thing we need to address in all of this is  very often the idea of  severity versus infection and there is a huge association  between the dose  of exposure  and the severity  of infection. We see this in many other
    infectious diseases so we also probably need to look  at who is getting sick and very sick and is the dose and the type of exposure they’re getting different to those who may be exposed and seroconverted in the community.

    00:29:26

    So it’s not just a matter of looking at how many people in the community are infected but are there specific elements  of exposure  that cause individuals  to have  a higher dose of exposure or a specific route of exposure 
    that causes more severe infection?  There is  also that concept of infectious dose when we talk about the different types of transmission. If somebody is exposed to a high dose from another individual directly or from a surface that’s
    heavily contaminated you can imagine the large dose.

    In other circumstances individual particles or virus particles potentially floating through  the air; it can be demonstrated that that may happen in certain circumstances, certainly in healthcare settings. But is that significant  in 
    terms of driving  infection,  is  that significant, does that produce an infectious dose that can successfully infect another individual?

    These are all very important things that still need to be studied. Again we’re only a number of weeks into this. I think we need to have the seroepi studies. I think  we need more information on what is the infectious  dose  and particularly 
    the relationship  between the dose  of exposure or infection and the severity of disease subsequently, which has been seen with many, many other diseases in the past including cholera, Ebola and others.

    TJ        Thank you very much, Mike and Maria. We will go now to our next question; that’s Kai Kupferschmidt. Kai, can you hear us?

    00:31:01

    KA      Yes, Tarik. Thanks a lot for taking my question. I wanted to ask about the global  push  to try and find a pre-exposure  prophylaxis  or a post-exposure  prophylaxis. I understand there’re
    several trials going on, most of them with chloroquine  or hydroxychloroquine.  I was just wondering whether you can speak a little bit to what role this could potentially play.

    Of course also there’re a lot of smaller studies going on. Is there any way to make sure that they all lead to results that can be proved in the end?

    MR      Maria can give you more detail but certainly one of the Solidarity trials – I think Solidarity 3 or 4 – we have one of the trials under design which will be a multi-centre study which will look at prophylaxis in healthcare workers to see whether there’s evidence that giving lower doses of drugs like chloroquine or hydroxychloroquine to healthcare workers would reduce their risk of becoming infected in a healthcare environment.

    Those studies are certainly underway and again there are a number of those studies underway in smaller studies around the world but again as WHO we’re trying  to bring  together  a larger set of collaborative studies that will give
    us the answers we need.

    In terms of post-exposure prophylaxis I don’t believe  we have at the moment  studies  planned but Maria can speak to that but there is certainly evidence for the use of – not proven  evidence of effectiveness but there are a number
    of studies underway and trials underway that use hyperimmune globulin  in  the treatment  of disease; in  other words  they use that purified plasma of recovered individuals to give an antibody boost to people who are
    suffering the disease.

    00:32:49

    Similar approaches have been used in post-exposure prophylaxis for other diseases but Maria may be aware of studies underway in that area.

    MK      Only to add that, as you mentioned, there are a number of smaller studies that are happening globally and across a large number of countries.  We have teams through  our science division and through GOARN,
    through the Global Outbreak Alert Network, who are pulling together  available  literature  on a number  of topics,  one  of which is  looking  at different types of therapeutics and drugs.

    The idea is until we can have a study that pulls together enough of a sample size to get these answers to these questions we’re trying  to evaluate  every piece of evidence  that is  published so that we can look at the way in
    which these studies were done, we can look at the strengths, we can look at the limitations so that can help guide us closer  towards an effective treatment for COVID-19.

    TJ        Thank you very much. The next question is from BFM Radio. Is is Kate who is with us?

    KT       Yes, hi. Good evening or good morning.  I’m from BFM Radio  Malaysia. My question is, many countries around the world have imposed lock-downs or some sort of restrictions on movement. I was wondering
    what WHO’s guidance would  be; what’s the sweet spot, the kind of data that governments need to consider before lifting or relaxing  some  of these lock- downs? Thank you very much.

    00:34:29

    MR      Thank you. It is a difficulty for governments right  now  because the lock-downs  in many situations are proving effective in dampening the flames of the epidemic  in  those countries but those
    lock-downs are also causing great economic hardship and everybody especially in the developing world needs to get to a more sustainable way of managing this epidemic and controlling COVID-19 without continuing to damage economic and social life.

    The transition strategy out  of lock-down  requires  a calibrated,  step-wise approach.  It would be probably very inadvisable just to lift a complete lock-down, all of the measures because lock-downs are a general term that
    include closure of schools, closure of  churches, stay-at- home orders, closure of workplaces. It’s a mixture of different things and I think each government needs to break out, what does our lock-down actually constitute, what are the elements
    of our lock-down, where is that happening in the country, do we now understand the epidemiology of the disease in each area in which we have an element of lock-down or shut- down.

    Then to chart the path out, you have to build strong public health capacity to take over from the lock-down. In other words the lock-down is pushing the disease down by putting people back in their homes, by separating communities. Once you raise
    the lock-down you have to have an alternative method to suppress the infection. The  way to do that is active  case finding, testing, isolation of cases, tracking of contacts, quarantining of contacts and strong community education and
    participation and ownership around normal physical distancing, hygiene and giving communities the power to control infection by in effect managing their own physical distance, managing their own capacities to support the response.

    00:36:32

    In that situation, if you’ve strong public health capacity, if you’ve got a community that’s mobilised and empowered and if you’ve strengthened your health system then you’re potentially in a position to start unlocking or unwinding the lock-down.
    The specific parameters you need to be looking at are on two sides.

    One is, it would be very inadvisable to lock down [sic] if the number  of cases coming  through the hospital is already at a level where your  occupancy of  beds is  nearly at 100%.  You need to be in a position where
    you now have free beds in your system so that you’re managing and coping with the caseload and that means you have some absorption capacity left.

    You need to look at things like the doubling  rate; how  many days does it  take for the  number of cases to double? You need to look at positivity rates; what proportion of all samples that we test are positive? You’ll see in
    somewhere like Korea two to 6% of the samples  they test are positive. Last week in New York 37% of tested samples were positive so you need to carefully look at what proportion of people you test are positive.

    00:37:45

    You need to look at the number of contacts that are generated per case and it goes on and on and WHO will be issuing guidance to countries that is a much more specific around the parameters they should be looking at. There are no absolutes here, there
    are no answers, there are no numbers that say if this number is this then you do that. That doesn’t exist but what we can do is offer countries very specific  measurements  that they need to look  at to chart the path out of lock-down.

    That step-wise approach of unlocking somewhat and then waiting to see; I think you need to say, we will stop doing this element of the shut-down  and then we will  wait and we will  look at the data and if that works we go to the next
    stage and the next stage. So a careful, calibrated, step-wise exit from lock-down with putting in place public health capacities, putting in place community capacity, building the capacity of the health system to cope should the disease bounce back up; that’s the safe path out of lock-down.

    We want to achieve it as quickly as possible and we want to avoid many countries going  into that circumstance and we still have many countries around the world who are not in a locked- down situation. In fact their epidemiology would suggest
    they can avoid the worst of this and we need to support them to avoid them going into that situation.

    The most damaging lock-downs are in many developing countries  where people  – as the  DG has said many times – can live from hand to mouth, not from pay cheque to pay cheque but from day to day and we have to find adaptive solutions
    around lock-down and around disease control in vulnerable periurban populations living in poverty,  in  poor  rural communities.  We have to find alternative, adapted ways to manage lock-downs or slow-downs or shut-downs in
    those situations.

    00:39:41

    TJ        Thank you very much. This was Kate from BFM Radio in Malaysia. Now we will  go to Nigeria to Natural Star and it’s Innocent. Innocent, can you hear us?

    IN        Thank you. Can you hear me?

    TJ        Not very well but we will try. Please go ahead.

    IN        Okay, thank you for taking my questions. I have two questions to ask. One; how will WHO assess African countries on what they’ve done concerning the lock-down and management of COVID-19?

    Then the second one; there’s news going around that vaccines are to be tested on Africans when they’re developed. How true is that and is there a window that’s in the nearer future when a vaccine will be developed for COVID-19? Thank you.

    Hello?

    TJ        Yes, we are just trying to make sure that we understood the question but we will try. MR     I think this is Nigeria. Is it?

    TJ        Yes.

    00:41:08

    MR      Maria may answer the question around vaccine development. With regard to our general assessment on lock-down – and the Director-General may wish to comment on this because he’s been speaking with many leaders in Africa
    and, I believe, spoke with  the whole of the African Union leadership and countries late last week so therefore is in a much better position than me to speak about that.

    We would characterise so far, Africa’s actually doing well in this response thus far. Countries have essential capacities for testing, many countries are taking strong action and want to really focus on finding cases and doing contact tracing and trying to stop this disease becoming much more extensive given the fact that health systems are not as strong in many countries. 

    They need support in that though, they need support in testing, they need support with protective gear and they need to be given the resources to be able to mount those types of responses so I would characterise that Africa has not suffered the worst
    of this pandemic so far. The worst of it can be avoided with very, very swift action to support those countries in Africa who really do want to take a comprehensive approach to this disease.

    With the many vulnerable  people  including  refugees and migrants  who live  in  those countries it is our responsibility to provide that support but, DG, you may wish to speak about your interactions with the African
    Union countries.

    00:42:46

    MK      I’ll answer the question  around vaccines. What we can say is  that there are a number of vaccines that are in development and vaccines will be tested through clinical trials with all ethical considerations
    in place in whichever  populations  are under  study  with informed consent, with open and transparent communication. This is of the utmost importance, that not only do we have strong, robust  scientific  evidence 
    but  we ensure that all  of the studies  that are done are done with appropriate and the highest level of ethical considerations.

    One thing on the first question around Africa is that there are a number of countries in Africa right now which have very few cases and Mike has alluded to this in his earlier response.

    Some only have imported cases and there is an opportunity here, this  window  of opportunity that the DG has spoken about exists  in  many countries  still.  There is  an opportunity to prevent the worst from happening
    in a number of countries across Africa and across countries that are still seeing their first case; in some island countries.

    We need to support those governments, those countries, all of the people in those areas to prevent the worst from happening, to prevent these individual cases from becoming clusters, these clusters from becoming community transmission. I think that’s
    where we need to put  a lot of emphasis and support so that we can prevent countries  from reaching a point  where they need to put in these very restrictive movement restrictions.

    TAG    Thank you. Thank you for that question, my brother from Nigeria. On the situation, as Mike said, of course when you see the number of cases the African continent has the lowest number of cases so far but that doesn’t mean that
    the situation will not deteriorate. It may.

    00:45:06

    So Africa should do everything to prevent this situation from getting worse and that’s why African leaders are doing their best. I had a chance to participate in a meeting, a Leaders’ Coalition which was arranged or invited by the current Chairperson
    of the African Union, the President of South Africa, President Ramaphoza and many leaders from all corners of the continent have actually participated.

    The main agenda is to have a continental strategy and also make sure that that continental strategy helps the national strategy but in addition to a coalition of political leaders or the heads of state and government they have also agreed to have a coalition of business leaders. Business leaders in Africa are also getting together because Africa will need resources and one of the major problems that was identified during the discussion
    was especially shortage of equipment starting from medical equipment, PPE and test kits and so on.

    The leaders have agreed to look for concrete solutions to address the problem and they also believe that considering the number of cases we have in the continent testing cases, tracing contacts and isolating them, meaning using the comprehensive approach,
    will actually  help. They believe that lock-downs alone may not help or the physical distancing alone cannot help and they have agreed to do everything to follow the comprehensive approach.

    From WHO’s side we have been supporting and we increased, improved  the testing capacity in Africa significantly in the past two months and many countries in Africa have now testing capability although we may have a shortage of test kits but 
    we’re working  on that too and we’re finding different ways of addressing the gap.

    00:48:06

    But we will support the African Union, we will support the Africa CDC and also we will continue working through our WHO regional office in Congo Brazzaville and continue to support and fight the pandemic together.

    Then on the vaccines issue there was, I think, a comment last week from a couple of

    scientists who said the testing ground for the new vaccines will be Africa. To be honest,  I was so appalled and it was a time when I said, when we needed solidarity these kind of racist remarks actually would not help, it goes against the solidarity.

    Africa cannot and will not be a testing ground for any vaccine. We will follow all the rules to test any vaccine or therapeutics all over the world using exactly the same rules. Whether it’s

    in Europe, Africa or wherever we will use the same protocol and if there is a need to be tested elsewhere to treat human beings the same way, equally.

    The hangover from a colonial mentality has to stop — and WHO will  not  allow  this  to happen. It was a disgrace actually  and appalling  to hear during the 21st century from scientists that kind of remark and we condemn
    this in  the strongest  terms possible  but  we assure you  that this will not happen in Africa and will not happen elsewhere, in any country. Proper protocols will be followed and human beings will be treated as human
    beings because we’re all human beings.

    00:50:37

    Then after saying this the vaccine development; we’re addressing two issues and we will be announcing as soon as possible, hopefully during this week, a big initiative to accelerate the research and development and production of vaccines and also
    design mechanisms for equitable distribution of the vaccines.

    While we’re looking for vaccines, unless we break the barriers to equitable distribution of the products, whether it’s vaccines or therapeutics, we will have a problem, so we need to address the problem ahead of time, we need to address the problem
    of access or challenges to access ahead of time.

    That’s why we will put together a mechanism and we will appoint senior people from the North and South that will work out the details on how they can accelerate production but at the same time how they can ensure equitable distribution. Solidarity
    is very important here. When a vaccine or a medicine is ready we have to be able to deliver it all over the world.

    There should not be a divide between the haves and the have-nots.

    If we say solidarity, solidarity should be in its full form and I hope each and every individual, each and every human being will go for that kind of solidarity. I thank you.

    TJ        Thank you, Dr Tedros. We’ll take a couple more questions. We go to Yang from Xinhua news agency. Yang, can you hear us?

    00:52:58

    YA      Can I hear you?

    TJ        Yes, we can hear you. Please go ahead.

    YA      As World Health Day is approaching  what do you  have to say to the  front-line medical workers in China and around the world in  the global  anti-virus  efforts? This  question is
    for Dr Tedros. Thank you.

    TJ        If we understood well, the question is what is the message to health workers in China and around the world. Maybe you can repeat the question one more time, please.

    YA      Okay. As World Health Day is approaching what would you say and what message do you want to deliver to the front-line medical workers in China  and around the world  in  the global anti-virus effort?

    TAG    I think I have said it earlier;  as you  know,  this  is  the year of  the nurse and the midwife, 2020. We were ready to celebrate it in a big way and it was supposed to be the main event in our
    Assembly in mid-May. Unfortunately we’re in this situation but  we will  be launching a report tomorrow which is the first of its kind.  It’s a report on the  state of nursing. We will launch it tomorrow during the World Health
    Day.

    00:55:01

    But while launching that report, although it’s about nursing, we will celebrate all health workers, midwives, pharmacists, doctors, you name it. I think the world is now seeing the importance and the central role that health workers play. People,
    when they’re asked, of course, to choose they would say health first because it’s only when you’re healthy that you can aspire to anything, whether it’s wealth or fame or anything. It doesn’t matter if you’re not healthy.

    If you’re not healthy the first thing you ask for is to get back your health and our health workers are making sure that happens and they’re central and very important for any individual. So not only during COVID but during other times too health
    professionals are very important because they are safeguarding that very important aspect of life — that’s health.

    So we have to celebrate them every day. Of course during COVID we can see to what extent they’re sacrificing. We have lost many of them. They’re dying while  saving lives  so my message first is to the public at large; that each and every individual 
    should  recognise, whether it’s during normal times or pandemics like now, the role of health  professionals  and help them, protect them, really appreciate and respect what they are doing.

    To the health workers, although especially during this COVID pandemic you’re working in a difficult situation you should know that your work is the most blessed one, your work is something  special to the extent of losing  your  life 
    while  helping  others to live.  We respect you and appreciate you for that and we also believe in you and that you will do everything to control this pandemic.

    00:58:11

    But you should know that you have – and the world understands – the most important job. We can see the humility which is coming from some leaders because of this pandemic. I know they’re seeing, starting from their own lives, the whole world through 
    a different  prism  and they will also see your role.

    But the most important is not the recognition from the public or from leaders but the internal commitment and passion you have and believing that you’re doing the most blessed thing  and you have all our respect and appreciation and we believe in 
    you,  that together  we will  finish this pandemic. All the respect and appreciation we have to you, the greatest respect and appreciation ever. Thank you.

    TJ        Thank you very much, Dr Tedros. I think this important message will be heard from everyone and we will  conclude  this  press briefing with these important  words from Dr Tedros. We will
    have an audio file available in the minutes to come and we invite you for our next briefing on Wednesday. Thank you.

    TAG    [Inaudible] and see you on Wednesday – tomorrow actually for the launch. Yes, see you tomorrow.

    01:00:18

    Virtual Press Conference on COVID-19- 06 April 2020
    Read More
    https://www.who.int/news-room/detail/06-04-2020-virtual-press-conference-on-covid-19–06-april-2020

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  • WHO and Global Citizen announce: ‘One World: Together at home’ Global Special to support healthcare workers in the fight against the COVID-19 pandemic

    WHO and Global Citizen announce: ‘One World: Together at home’ Global Special to support healthcare workers in the fight against the COVID-19 pandemic

     

    ‘One World: Together At Home’ global special to air on Saturday, 18 April 2020 in celebration and support of healthcare workers, broadcast to feature real experiences from doctors, nurses and families around the world.

    Powered by commitments from supporters and corporate partners in benefit of the COVID-19 Solidarity Response Fund, Broadcast special to also benefit local and regional charities that provide food, shelter and healthcare to those that need help most.

    Historic broadcast to be hosted by Jimmy Fallon of ‘The Tonight Show,’  Jimmy Kimmel of ‘Jimmy Kimmel Live’ and Stephen Colbert of ‘The Late Show with Stephen Colbert,’ Friends from Sesame Street Also on hand to help unify and inspire people around the world to take meaningful actions that increase support for the global COVID-19 response.

    Curated in collaboration with Lady Gaga, broadcast to include Alanis Morissette, Andrea Bocelli, Billie Eilish, Billie Joe Armstrong of Green Day, Burna Boy, Chris Martin, David Beckham, Eddie Vedder, Elton John, FINNEAS, Idris and Sabrina Elba, J Balvin, John Legend, Kacey Musgraves, Keith Urban, Kerry Washington, Lang Lang, Lizzo, Maluma, Paul McCartney, Priyanka Chopra Jonas,  Shah Rukh Khan and Stevie Wonder.

    ——————————————

    Geneva/New York – International advocacy organization Global Citizen and the World Health Organization today
    announced the One World: Together At Home — a globally televised and streamed special in support of the fight against the COVID-19 pandemic. One World: Together At Home will be broadcast live on Saturday, 18 April 2020 at 5:00
    p.m. PDT/8:00 p.m. EDT/12:00 a.m. GMT airing on ABC, NBC, ViacomCBS Networks, iHeartMedia and Bell Media networks and platforms in Canada. Internationally, BBC One will run the program on Sunday 19 April 2020. Additional
    international broadcasters include beIN Media Group, MultiChoice Group and RTE. The virtual broadcast will show unity among all people who are affected by COVID-19 and will also celebrate and support brave healthcare
    workers doing life-saving work on the front lines.

    Hugh Evans, Co-Founder and CEO of Global Citizen, said “As we honor and support the heroic efforts of community health workers, ‘One World: Together At Home’ aims to serve as a source of unity and encouragement in the global fight
    to end COVID-19. Through music, entertainment and impact, the global live-cast will celebrate those who risk their own health to safeguard everyone else’s.”

    One World: Together At Home will also be a multi-hour digital broadcast streaming online on multiple global platforms, including: Alibaba, Amazon Prime Video, Apple, Facebook, Instagram, LiveXLive, Tencent, Tencent Music Entertainment Group, TIDAL, TuneIn, Twitch, Twitter, Yahoo and
    YouTube. This digital special will include additional artists and performances from all over the globe as well as unique stories from the world’s healthcare heroes. For information about how to tune in and take action, visit 
    www.globalcitizen.org/togetherathome.

    “The World Health Organization is committed to defeating the coronavirus pandemic with science and public health measures, and supporting the health workers who are on the frontlines of the response,” said Dr Tedros Adhanom Ghebreyesus,
    Director-General of WHO. “We may have to be apart physically for a while, but we can still come together virtually to enjoy great music. The ‘One World: Together At Home’ concert represents a powerful show of solidarity against
    a common threat.”

    “The United Nations system is fully mobilized: supporting country responses, placing our supply chains at the world’s disposal and advocating for a global cease-fire. We are proud to join forces with ‘One World: Together At Home’
    to help suppress the transmission of the virus, minimize social-economic impacts on the global community and work together now to advance Global Goals for the future,” said António Guterres, Secretary-General of the United Nations.
    “There is no greater case for collective action than our joint response to COVID-19 – we are in this together and we will get through this together.”

    Last month in response to the global pandemic, Global Citizen launched an urgent campaign in support of the COVID-19 Solidarity Response Fund for WHO, powered by the UN Foundation. Calling on individuals to take action,
    and asking world leaders and corporations to support the response with sufficient resources, Global Citizens from over 130 countries around the world have taken tens of thousands of actions in support of the response fund.

    At this critical moment in history, Global Citizen is also calling on philanthropists to join and support immediate COVID-19 response efforts as part of the organization’s Give While You Live effort. Investors, changemakers and foundation
    leaders are being urged to actualize their giving and invest quickly in related efforts like stronger health systems and vaccine development.

    Over the past three weeks, the Together At Home series has featured performances from artists including,
    Chris Martin, John Legend, Charlie Puth, Common, Shawn Mendes, Camila Cabello, Ryan Tedder of OneRepublic, Niall Horan, Steve Aoki, Jennifer Hudson, Miguel, H.E.R., Anthony Hamilton, Rufus Wainwright, Hozier and Julianne Hough, among others in
    support of WHO and Global Citizen’s campaign.

    Commitments from supporters and corporate partners will go to the COVID-19 Solidarity Response Fund for WHO to support and equip frontline healthcare workers around the world, with masks, gowns and other vital equipment, and to local charities that provide food, shelter, and healthcare to those that need it most. These local groups have been verified
    to ensure that they are helping communities impacted by COVID-19.

    For more information about Global Citizen and the campaign to support the WHO’s Solidarity Response Fund, please visit globalcitizen.org and
    follow @GlblCtzn Twitter, Facebook and Instagram using #GlobalCitizen. 

    To learn more about WHO’s response to the pandemic and the COVID-19 Solidarity Response Fund, please go to www.who.int/COVID-19 and follow @WHO on Twitter, Facebook, Instagram,
    LinkedIn and TikTok.

     

    ###

    About Global Citizen:

    Global Citizen is the world’s largest movement of action takers and impact makers dedicated to ending extreme poverty by 2030. With over 10 million monthly advocates, our voices have the power to drive lasting change around sustainability, equality,
    and humanity. We post, tweet, message, vote, sign, and call to inspire those who can make things happen to act — government leaders, businesses, philanthropists, artists, and citizens — together improving lives. By downloading our
    app, Global Citizens learn about the systemic causes of extreme poverty, take action on those issues, and earn rewards, which can be redeemed for tickets to concerts, events, and experiences all over the world. To date, the actions of our community,
    along with high-level advocacy efforts and work with partners, has resulted in commitments and policy announcements from leaders valued at over $48 billion, affecting the lives of more than 2.25 billion people by 2030. For more information, visit
    www.GlobalCitizen.org.

     

    About the World Health Organization:

    The World Health Organization (WHO) is the United Nations’ specialized agency for health. It is an inter-governmental organization and works in collaboration with its Member States usually through the Ministries of Health. The World Health Organization
    is responsible for providing leadership on global health matters, shaping the health research agenda, setting norms and standards, articulating evidence-based policy options, providing technical support to countries and monitoring and assessing
    health trends. Learn more at www.who.int.

     

    About the United Nations Foundation:

    The UN Foundation brings together the ideas, people, and resources the United Nations needs to drive global progress and tackle urgent problems. To support the work of the World Health Organization (WHO) in its global work on COVID-19, UN Foundation
    helped launch the COVID-19 Solidarity Response Fund that has raised more than $100 million in less than two weeks for lifesaving work around the world.  Learn more about the COVID-19 Solidarity Response Fund at www.covid19responsefund.org. Learn more about the UN Foundation at www.unfoundation.org.
    Follow @unfoundation on Twitter and Instagram, and @United Nations Foundation on Facebook.

    —————-

    Note to Editors:

    Resources donated to the COVID-19 Solidarity Response Fund will be spent in alignment with the WHO Strategic Preparedness and Response Plan and support the work of multiple organizations. These include WHO, for tracking the virus spread, equipping
    health workers, making lab and testing tools available, and providing communities and frontline responders with the latest guidance; enabling UNICEF to equip children and families globally with evidence-based guidance to protect them from COVID-19,
    providing water, sanitation and hygiene, and basic infection prevention and control measures to vulnerable countries, and caring for vulnerable families and children; and to CEPI, the Coalition for Epidemic Preparedness Innovations, a key partner
    leading the financing for research and development for novel vaccines to combat COVID-19.

     

     

     

     

     

     

    WHO and Global Citizen announce: 'One World: Together at home' Global Special to support healthcare workers in the fight against the COVID-19 pandemic
    Read More
    https://www.who.int/news-room/detail/06-04-2020-who-and-global-citizen-announce-one-world-together-at-home-global-special-to-support-healthcare-workers-in-the-fight-against-the-covid-19-pandemic

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  • Women in the New Age

    Women in the New Age

    42. The Transvaluation of Values

    The gradual emancipation of ladies that has been happening for the final century has nonetheless a protracted technique to proceed earlier than they’re wholly delivered from their conventional burdens and so stand away from the oppressions of males. But already, it should be plain, they’ve made monumental progress—maybe greater than they made within the ten thousand years previous. The rise of the commercial system, which has borne so harshly upon the race normally, has introduced them sure unmistakable advantages. Their financial dependence, although nonetheless adequate to make marriage extremely enticing to them, is nonetheless thus far damaged down that giant lessons of ladies are actually virtually free brokers, and fairly impartial of the favour of males. Most of those girls, responding to concepts which can be nonetheless highly effective, are but intrigued, after all, by marriage, and like it to the autonomy that’s coming in, however the truth stays that they now have a free alternative within the matter, and that dire necessity now not controls them. After all, they needn’t marry if they do not need to; it’s doable to get their bread by their very own labour within the workshops of the world. Their grandmothers had been in a much more troublesome place. Failing marriage, they not solely suffered a merciless ignominy, however in lots of instances confronted the menace of precise hunger. There was merely no respectable place within the economic system of these occasions for the free girl. She both needed to enter a nunnery or settle for a disdainful patronage that was as galling as charity.

    Nothing might be plainer than the impact that the rising financial safety of ladies is having upon their entire behavior of life and thoughts. The diminishing marriage fee and the much more quickly diminishing delivery charges present which manner the wind is blowing. It is frequent for male statisticians, with attribute imbecility, to ascribe the autumn within the marriage fee to a rising disinclination on the male aspect. This rising disinclination is definitely on the feminine aspect. Even although no appreciable physique of ladies has but reached the particular doctrine that marriage is much less fascinating than freedom, it should be plain that giant numbers of them now method the enterprise with far better fastidiousness than their grandmothers and even their moms exhibited. They are tougher to please, and therefore happy much less usually. The girl of a century in the past may think about nothing extra beneficial to her than marriage; even marriage with a fifth fee man was higher than no marriage in any respect. This notion is progressively feeling the opposition of a opposite notion. Women normally should desire marriage to work, however there may be an rising minority which begins to understand that work could supply the better contentment, notably if it’s mellowed by a certain quantity of philandering.

    There already seems on the planet, certainly, a category of ladies, who, whereas nonetheless not genuinely averse to marriage, are but free from any idea that it’s needed, and even invariably fascinating. Among these girls are an excellent many considerably vociferous propagandists, virtually male of their violent earnestness; they vary from the man-eating suffragettes to such preachers of free motherhood as Ellen Key and such skilled shockers of the bourgeoisie because the American prophetess of birth-control, Margaret Sanger. But amongst them are many extra who wake the world with no such noisy eloquence, however content material themselves with finishing up their concepts in a quiet and respectable method. The variety of such girls is way bigger than is usually imagined, and that quantity tends to extend steadily. They are girls who, with their financial independence assured, both by inheritance or by their very own efforts, mainly within the arts and professions, do precisely as they please, and make no pother about it. Naturally sufficient, their superiority to conference and the frequent frenzy makes them extraordinarily enticing to the higher form of males, and so it isn’t unusual for certainly one of them to seek out herself voluntarily sought in marriage, with none preliminary scheming by herself—certainly an expertise that only a few odd girls ever get pleasure from, save maybe in desires or delirium.

    The previous order changeth and giveth place to the brand new. Among the ladies’s golf equipment and within the girls’s faculties, I’ve little doubt, there may be nonetheless a lot debate of the previous and foolish query: Are platonic relations doable between the sexes? In different phrases, is friendship doable with out intercourse? Many a girl of the brand new order dismisses the issue with one other query: Why with out intercourse? With the decay of the traditional idea of ladies as property there should come inevitably a reconsideration of the entire intercourse query, and out of that reconsideration there should come a revision of the mediaeval penalties which now punish the slightest frivolity within the feminine. The notion that honour in girls is completely a bodily matter, {that a} single aberrance could convert a girl of the best deserves into a girl of none in any respect, that the only real invaluable factor a girl can convey to marriage is virginity—this notion is so preposterous that no clever particular person, male or feminine, truly cherishes it. It survives as one of many hole conventions of Christianity; nay, of the levantine barbarism that preceded Christianity. As girls throw off the opposite conventions which now bind them they are going to throw off this one, too, and so their advantage, grounded upon fastidiousness and self-respect as an alternative of upon mere concern and conformity, will grow to be afar extra laudable factor than it ever may be below the current system. And for its absence, in the event that they see match to get rid of it, they are going to no extra apologize than a person apologizes immediately.

    43. The Lady of Joy

    Even prostitution, in the long term, could grow to be a roughly respectable occupation, because it was within the nice days of the Greeks. That high quality will certainly connect to it if ever it grows fairly pointless; no matter is pointless is at all times respectable, for instance, faith, modern clothes, and a information of Latin grammar. The prostitute is disesteemed immediately, not as a result of her commerce entails something intrinsically degrading and even unpleasant, however as a result of she is presently assumed to have been pushed into it by dire necessity, towards her dignity and inclination. That this assumption is normally unsound is not any objection to it; practically all of the pondering of the world, notably within the area of morals, is predicated upon unsound assumption, e.g., that God observes the autumn of a sparrow and is shocked by the autumn of a Sunday-school superintendent. The fact is that prostitution is without doubt one of the most tasty of the occupations virtually open to the form of girls who have interaction in it, and that the prostitute generally likes her work, and wouldn’t trade locations with a shop-girl or a waitress for something on the planet. The notion on the contrary is propagated by unsuccessful prostitutes who fall into the fingers {of professional} reformers, and who assent to the imbecile theories of the latter as a way to domesticate their good will, simply as convicts in jail, questioned by tee-totalers, at all times ascribe their rascality to alcohol. No prostitute of something resembling regular intelligence is below the slightest duress; she is completely free to desert her commerce and go into a store or manufacturing facility or into home service each time the impulse strikes her; all of the prevailing gabble about white slave jails and kidnappers comes from pious rogues who make a dwelling by feeding such nonsense to the credulous. So lengthy as the common prostitute is ready to make an excellent dwelling, she is sort of content material together with her lot, and disposed to distinction it egotistically with the slavery of her virtuous sisters. If she complains of it, then you might ensure that her success is under her expectations. A ravenous lawyer at all times sees injustice, within the courts. A nasty doctor is a bitter critic of Ehrlich and Pasteur. And when a suburban clergyman is pressured out of his treatment by a vestry-room revolution he virtually invariably concludes that the sinfulness of man is incurable, and typically he even begins to doubt among the typographical errors in Holy Writ.

    The excessive worth set upon virginity by males, whose esteem of it’s primarily based upon a mix of vainness and voluptuousness, causes many ladies to protect it in their very own individuals with a jealousy far past their non-public inclinations and pursuits. It is their idea that the lack of it could materially impair their probabilities of marriage. This idea isn’t supported by the information. The fact is that the girl who sacrifices her chastity, all the pieces else being equal, stands a significantly better probability of creating a creditable marriage than the girl who stays chaste. This is very true of ladies of the decrease financial lessons. At as soon as they arrive into contact, hitherto socially troublesome and typically virtually unimaginable, with males of upper lessons, and start to tackle, with the curious facility of their intercourse, the refinements and tastes and factors of view of these lessons. The mistress thus gathers allure, and what has begun as a sordid sale of amiability not uncommonly ends with formal marriage. The variety of such marriages is enormously better than seems superficially, for each events clearly make each effort to hide the information. Within the circle of my essentially restricted private acquaintance I do know of scores of males, a few of them of wealth and place, who’ve made such marriages, and who don’t appear to remorse it. It is an previous commentary, certainly, {that a} girl who has beforehand disposed of her advantage makes an excellent spouse. The frequent idea is that it’s because she is grateful to her husband for rescuing her from social outlawry; the reality is that she makes an excellent spouse as a result of she is a shrewd girl, and has specialised professionally in masculine weak spot, and is thus extra-competent on the conventional enterprise of her intercourse. Such a girl usually reveals a really magnificent sagacity. It could be very troublesome to deceive her logically, and it’s unimaginable to disarm her emotionally. Her revolt towards the pruderies and sentimentalities of the world was proof, to start with, of her mental enterprise and braveness, and her success as a insurgent is proof of her extraordinary pertinacity, resourcefulness and acumen.

    Even probably the most lowly prostitute is healthier off, in all worldly methods, than the virtuous girl of her personal station in life. She has much less work to do, it’s much less monotonous and dispiriting, she meets a far better number of males, and they’re of lessons distinctly past her personal. Nor is her occupation hazardous and her final destiny tragic. A dozen or extra years in the past I noticed a considerably amusing proof of this final. At that point sure sentimental busybodies of the American metropolis during which I lived undertook an elaborate inquiry into prostitution therein, and a few of them got here to me prematurely, as a sensible journalist, for recommendation as to the way to proceed. I discovered that each one of them shared the frequent superstition that the skilled lifetime of the common prostitute is simply 5 years lengthy, and that she invariably ends within the gutter. They had been enormously amazed after they unearthed the reality. This fact was to the impact that the common prostitute of that city ended her profession, not within the morgue however on the altar of God, and that those that remained single usually continued in follow for ten, fifteen and even twenty years, after which retired on competences. It was established, certainly, that absolutely eighty per cent married, and that they virtually at all times obtained husbands who would have been far past their attain had they remained virtuous. For one who married a cabman or petty pugilist there have been a dozen who married respectable mechanics, policemen, small shopkeepers and minor officers, and a minimum of two or three who married well-to-do tradesmen {and professional} males. Among the 1000’s whose careers had been studied there was truly one who ended because the spouse of the city’s richest banker—that’s, one who bagged the perfect catch in the entire group. This girl had begun as a home servant, and deserted that harsh and dreary life to enter a brothel. Her experiences there polished and civilized her, and in her previous age she was a grande dame of nice dignity. Much of the sympathy wasted upon girls of the traditional occupation is grounded upon an error as to their very own angle towards it. An educated girl, listening to {that a} frail sister in a public stew is anticipated to be amiable to all kinds of bounders, thinks of how she would shrink from such contacts, and so concludes that the precise prostitute suffers acutely. What she overlooks is that these males, nonetheless gross and repulsive they could seem to her, are measurably superior to males of the prostitute’s personal class—say her father and brothers—and that communion with them, removed from being disgusting, is usually relatively romantic. I effectively keep in mind observing, throughout my collaboration with the vice-crusaders aforesaid, the delight of a girl of pleasure who had attracted the discover of a police lieutenant; she was intensely happy by the concept of getting a consumer of such haughty manners, such sensible costume, and what appeared to her to be so dignified a occupation. It is at all times forgotten that this weak spot isn’t confined to prostitutes, however run by the entire feminine intercourse. The girl who couldn’t think about a bootleg affair with a rich cleaning soap producer and even with a lawyer finds it fairly simple to think about herself succumbing to an envoy or a duke. There are only a few exceptions to this rule. In probably the most reserved of recent societies the ladies who characterize their highest flower are notoriously complaisant to royalty. And royal girls, to finish the circuit, not sometimes yield to actors and musicians, i.e., to males radiating a glamour not encountered even in princes.

    44. The Future of Marriage

    The transvaluation of values that’s now in progress will go on slowly and for a really lengthy whereas. That it’s going to ever be fairly full is, after all, unimaginable. There are inherent variations will proceed to point out themselves till the top of time. As girl progressively turns into satisfied, not solely of the potential for financial independence, but in addition of its worth, she’s going to in all probability lose her current overmastering need for marriage, and tackle herself to assembly males in free financial competitors. That is to say, she’s going to tackle herself to buying that sensible competence, that prime expertise for puerile and mainly mechanical expertness, which now units man forward of her within the labour market of the world. To do that she must sacrifice a few of her current intelligence; it’s unimaginable to think about a genuinely clever human being turning into a reliable trial lawyer, or buttonhole employee, or newspaper sub-editor, or piano tuner, or home painter. Women, to get upon all fours with males in such silly occupations, must commit non secular suicide, which might be a lot additional than they are going to ever truly go. Thus a shade of their current superiority to males will at all times stay, and with it a shade of their relative inefficiency, and so marriage will stay enticing to them, or in any respect occasions to most of them, and its overthrow might be prevented. To abolish it completely, as sure fevered reformers suggest, can be as troublesome as to abolish the precession of the equinoxes.

    At the current time girls vacillate considerably absurdly between two schemes of life, the previous and the brand new. On the one hand, their financial independence continues to be stuffed with circumstances, and however they’re in revolt towards the immemorial conventions. The result’s a normal unrest, with many signs of extravagant and unintelligent revolt. One of these signs is the looks of mental striving in girls—not a striving, alas, towards the real pearls and rubies of the thoughts, however one merely towards the acquirement of the rubber stamps that males make use of of their so-called pondering. Thus we’ve girls who launch themselves into get together politics, and fill their heads with an enormous mass of ineffective information about political methods, customs, theories and personalities. Thus, too, we’ve the girl social reformer, trailing alongside ridiculously behind a tatterdemalion posse of male utopians, every with one thing to promote. And thus we’ve the girl who goes in for superior knowledge of the kind on draught in girls’s golf equipment—in short, the form of knowledge which consists completely of a physique of beliefs and propositions which can be ignorant, unimportant and unfaithful. Such banal striving is most prodigally on show within the United States, the place superficiality quantities to a nationwide illness. Its reputation is because of the comparatively better leisure of the American individuals, who work lower than another individuals on the planet, and, above all, to the comparatively better leisure of American girls. Thousands of them have been emancipated from any compulsion to productive labour with out having acquired any compensatory mental or creative curiosity or social obligation. The result’s that they swarm within the girls’s golf equipment, and waste their time, listening to dangerous poetry, worse music, and nonetheless worse lectures on Maeterlinck, Balkan politics and the unconscious. It is amongst such girls that one observes the periodic rages for Bergsonism, the Montessori methodology, the twilight sleep and different such follies, so pathetically attribute of American tradition.

    One of the evil results of this tendency I’ve hitherto descanted upon, to wit, the rising disposition of American girls to treat all routine labour, notably within the residence, as infra dignitatem and therefore insupportable. Out of that notion come up many lamentable phenomena. On the one hand, we’ve the spectacle of a large number of wholesome and well-fed girls engaged in public actions that, 9 occasions out of ten, are meaningless, mischievous and a nuisance, and however we behold such a decay within the home arts that, on the first onslaught of the late conflict, the nationwide authorities needed to import a overseas professional to show the housewives of the nation the veriest components of thrift. No such instruction was wanted by the housewives of the Continent. They had been merely informed how a lot meals they may have, and their pure competence did the remainder. There is rarely any avoidable waste there, both in peace or in conflict. A French housewife has little use for a rubbish can, save as a depository for uplifting literature. She does her finest with the means at her disposal, not solely in conflict time however always.

    As I’ve stated over and over on this inquiry, a girl’s disinclination to accumulate the intricate expertness that lies on the backside of fine housekeeping is due primarily to her lively intelligence; it’s troublesome for her to pay attention her thoughts upon such silly and meticulous enterprises. But whether or not troublesome or simple, it’s clearly vital for the common girl to make some effort in that course, for if she fails to take action there may be chaos. That chaos is duly seen within the United States. Here girls reveal certainly one of their subterranean qualities: their deficiency in conscientiousness. They are fairly with out that dog-like constancy to obligation which is without doubt one of the shining marks of males. They by no means summon up a excessive pleasure in doing what’s inherently unpleasant; they at all times go to the galleys below protest, and with vows of sabotage; their basic philosophy is nearly that of the syndicalists. The sentimentality of males connives at this, and is thus largely accountable for it. Before the common puella, apprenticed within the kitchen, can choose up a fourth of the culinary subtleties which can be commonplace even to the cooks on eating vehicles, she has caught a person and want concern herself about them no extra, for he has to eat, within the final evaluation, no matter she units earlier than him, and his lack of intelligence makes it simple for her to close off his tutorial criticisms by bald appeals to his feelings. By a straightforward course of he lastly attaches a optimistic worth to her indolence. It is a proof, he concludes, of her fineness of soul. In the presence of her lofty incompetence he’s abashed.

    But as girls, gaining financial autonomy, meet males in progressively bitterer competitors, the rising masculine mistrust and concern of them might be mirrored even within the enchanted area of marriage, and the husband, having yielded up most of his previous rights, will start to disclose a brand new jealousy of those who stay, and notably of the fitting to a good quid professional quo for his personal docile trade. In transient, as girls shake off their historic disabilities they will even shake off a few of their historic immunities, and their doings will come to be regarded with a soberer and extra exigent scrutiny than now prevails. The extension of the suffrage, I consider, will encourage this awakening; in wresting it from the reluctant male the ladies of the western world have planted dragons’ tooth, the which can presently leap up and gnaw them. Now that girls have the political energy to acquire their simply rights, they are going to start to lose their previous energy to acquire particular privileges by sentimental appeals. Men, going through them squarely, will think about them anew, not as romantic political and social invalids, to be coddled and caressed, however as free opponents in a harsh world. When that reconsideration will get below manner there might be a normal overhauling of the relations between the sexes, and among the truthful ones, I believe, will start to marvel why they did not let effectively sufficient alone.

    45. Effects of the War

    The current sequence of wars, it appears seemingly, will proceed for twenty or thirty years, and maybe longer. That the primary conflict was inconclusive was proven brilliantly by the preposterous nature of the peace lastly reached—a peace so synthetic and dishonest that the signing of it was virtually equal to a brand new declaration of conflict. At least three new contests within the grand method are plainly perception—one between Germany and France to rectify the unnatural tyranny of a weak and incompetent nation over a powerful and enterprising nation, one between Japan and the United States for the mastery of the Pacific, and one between England and the United States for the management of the ocean. To these should be added numerous minor struggles, and maybe one or two of just about main character: the trouble of Russia to regain her previous unity and energy, the trouble of the Turks to place down the slave rise up (of Greeks, Armenians, Arabs, and so on.)which now menaces them, the trouble of the Latin-Americans to throw off the galling Yankee yoke, and the joint effort of Russia and Germany (maybe with England and Italy aiding) to do away with such worldwide nuisances because the insane Polish republic, the petty states of the Baltic, and maybe additionally many of the Balkan states. I cross over the chance of a brand new mutiny in India, of the rising of China towards the Japanese, and of a normal battle for a brand new alignment of boundaries in South America. All of those wars, nice and small, are possible; most of them are humanly sure. They might be fought ferociously, and with assistance from harmful engines of the utmost effectivity. They will result in an unparalleled butchery of males, and a big proportion of those males might be below forty years of age.

    As a consequence there might be a scarcity of husbands in Christendom, and as a second consequence the survivors might be appreciably tougher to snare than the lads of immediately. Every man of agreeable exterior and straightforward means might be pursued, not merely by just a few dozen or rating of ladies, as now, however by entire battalions and brigades of them, and he might be pushed in sheer self-defence into very sharp bargaining. Perhaps in the long run the state must intervene within the enterprise, to forestall the potential husband going to waste within the turmoil of alternative.

    Just what kind this interference is prone to take has not but appeared clearly. In France there may be already a wholesale legitimization of kids born out of wedlock and in Eastern Europe there was a clamour for the legalization of polygamy, however these gadgets don’t meet the principle downside, which is the encouragement of monogamy to the utmost. A plan that means itself is the amelioration of the place of the monogamous husband, now rendered more and more uncomfortable by the legal guidelines of most Christian states. I don’t assume that the extra clever form of girls, confronted by a deadly scarcity of males, would object severely to that amelioration. They should see plainly that the current system, whether it is carried a lot additional, will start to work powerfully towards their finest pursuits, if solely by significantly reinforcing the disinclination to marriage that already exists among the many higher form of males. The girl of true discretion, I’m satisfied, would a lot relatively marry a superior man, even on unfavourable phrases, than make John Smith her husband, serf and prisoner at one stroke.

    The legislation should finally acknowledge this truth and make provision for it. The common husband, maybe, deserves little succour. The girl who pursues and marries him, although she could also be moved by egocentric goals, needs to be correctly rewarded by the state for her service to it—a service certainly to not be flippantly estimated in a navy age. And that reward could conveniently take the shape, as within the United States, of statutes giving her title to a big share of his actual property and requiring him to give up most of his revenue to her, and releasing her from all obedience to him and from all obligation to maintain his home so as. But the girl who aspires to increased sport needs to be fairly prepared, it appears to me, to resign a few of these benefits in compensation for the better honour and satisfaction of being spouse to a person of benefit, and mom to his kids. All that’s wanted is legal guidelines permitting her, if she’s going to, to resign her proper of dower, her proper to upkeep and her immunity from self-discipline, and to make another phrases that she could also be led to treat as equitable. At current girls are unable to make most of those concessions even when they might: the legal guidelines of nearly all of western nations are rigid. If, for instance, an Englishwoman ought to agree, by an ante-nuptial contract, to submit herself to the self-discipline, not of the present statutes, however of the elder frequent legislation, which allowed a husband to right his spouse corporally with a stick no thicker than his thumb, it could be competent for any sentimental neighbour to set the settlement at naught by haling her husband earlier than a Justice of the Peace for carrying it out, and it’s a secure wager that the Justice of the Peace would jail him.

    This plan, nonetheless novel it might appear, is definitely already in operation. Many a married girl, as a way to maintain her husband from revolt, makes roughly disguised surrenders of sure of the rights and immunities that she has below current legal guidelines. There are, for instance, even in America, girls who practise the home arts with competence and diligence, regardless of the plain indisputable fact that no authorized penalty can be visited upon them in the event that they failed to take action. There are girls who comply with exterior trades and professions, contributing a share to the household exchequer. There are girls who obey their husbands, even towards their finest judgments. There are, most quite a few of all, girls who wink discreetly at husbandly departures, overt or in mere intent, from the oath of chemical purity taken on the altar. It is a commonplace, certainly, that many completely happy marriages admit a celebration of the third half. There can be extra of them if there have been extra girls with sufficient serenity of thoughts to see the sensible benefit of the association. The hassle with such triangulations isn’t primarily that they contain perjury or that they provide any basic offence to the spouse; if she avoids banal theatricals, in truth, they generally have the impact of augmenting the husband’s devotion to her and respect for her, if solely because the fruit of comparability. The hassle with them is that only a few males amongst us have sense sufficient to handle them intelligently. The masculine thoughts is instantly taken in by specious values; the common married man of Protestant Christendom, if he succumbs in any respect, succumbs to some meretricious and flamboyant creature, bent solely upon fleecing him. Here is the place the cruel realism of the Frenchman reveals its superiority to the sentimentality of the lads of the Teutonic races. A Frenchman would no extra consider taking a mistress with out consulting his spouse than he would consider standing for workplace with out consulting his spouse. The result’s that he’s seldom victimized. For one Frenchman ruined by girls there are a minimum of 100 Englishmen and Americans, even supposing 100 occasions as many Frenchmen have interaction in that form of recreation. The case of Zola is typical. As is well-known, his amours had been rigorously supervised by Mme. Zola from the primary days of their marriage, and in consequence his life was wholly free from scandals and his thoughts was by no means distracted from his work.

    46. The Eternal Romance

    But no matter the way forward for monogamous marriage, there’ll by no means be any decay of that agreeable adventurousness which now lies on the backside of all transactions between the sexes. Women could emancipate themselves, they could borrow the entire bag of masculine methods, they usually could treatment themselves of their current need for the vegetable safety of marriage, however they are going to by no means stop to be girls, and as long as they’re girls they are going to stay provocative to males. Their chief allure immediately lies exactly in the truth that they’re harmful, that they threaten masculine liberty and autonomy, that their sharp minds current a menace vastly better than that of acts of God and the general public enemy—and they are going to be harmful for ever. Men concern them, and are fascinated by them. They know the way to present their tooth charmingly; the extra enlightened of them have perfected an outstanding strategy of fascination. It was Nietzsche who known as them the recreation of the warrior—not of the poltroon, keep in mind, however of the warrior. A profound saying. They have an infinite capability for rewarding masculine trade and enterprise with small and irresistible flatteries; their acute understanding combines with their capability for evoking concepts of magnificence to make them incomparable companions when the intense enterprise of the day is finished, and the time has come to increase comfortably within the interstellar ether.

    Every man, I daresay, has his personal notion of what constitutes good peace and contentment, however all of these notions, regardless of the elemental battle of the sexes, revolve round girls. As for me—and I hope I could also be pardoned, at this late stage in my inquiry, for intruding my very own persona—I reject the 2 commonest of them: ardour, a minimum of in its extra adventurous and melodramatic features, is just too thrilling and alarming for therefore indolent a person, and I’m too egoistic to have a lot need to be mothered. What, then, stays for me? Let me attempt to describe it to you.

    It is the shut of a busy and vexatious day—say half previous 5 – 6 o’clock of a winter afternoon. I’ve had a cocktail or two, and am stretched out on a divan in entrance of a fireplace, smoking. At the sting of the divan, shut sufficient for me to succeed in her with my hand, sits a girl not too younger, however nonetheless handsome and well-dressed—above all, a girl with a delicate, low-pitched, agreeable voice. As I snooze she talks—of something, all the pieces, all of the issues that girls speak of: books, music, the play, males, different girls. No politics. No enterprise. No faith. No metaphysics. Nothing difficult and vexatious—however keep in mind, she is clever; what she says is clearly expressed, and sometimes picturesquely. I observe the positive sheen of her hair, the gorgeous lower of her frock, the glint of her white tooth, the arch of her eye-brow, the sleek curve of her arm. I take heed to the beautiful murmur of her voice. Gradually I go to sleep—however just for an immediate. At as soon as, observing it, she raises her voice ever so little, and I’m awake. Then to sleep once more—slowly and charmingly down that slippery hill of desires. And then awake once more, after which asleep once more, and so forth.

    I ask you severely: may something be extra unutterably stunning? The sensation of falling asleep is to me probably the most beautiful on the planet. I enjoyment of it a lot that I even stay up for demise itself with a sneaking marvel and need. Well, right here is sleep poetized and made doubly candy. Here is sleep set to the best music on the planet. I match this example towards any that you just ran consider. It isn’t solely enchanting; additionally it is, in a really true sense, ennobling. In the top, when the woman grows prettily miffed and throws me out, I return to my sorrows one way or the other purged and glorified. I’m a greater man in my very own sight. I’ve grazed upon the fields of asphodel. I’ve been genuinely, utterly and unregrettably completely happy.

    47. Apologia in Conclusion

    At the top I crave the indulgence of the aesthetic reader for the imperfections essentially seen in all that I’ve right here set down—imperfections not solely resulting from incomplete data and fallible logic, but in addition, and maybe extra importantly, to sure basic weaknesses of the intercourse to which I’ve the honour to belong. A person is inseparable from his congenital vanities and stupidities, as a canine is inseparable from its fleas. They reveal themselves in all the pieces he says and does, however they reveal themselves most of all when he discusses the majestic thriller of girl. Just as he smirks and rolls his eyes in her precise presence, so he places on apathetic and unescapable clownishness when he essays to dissect her within the privateness of the laboratory. There is not any e book on girl by a person that’s not a stupendous compendium of posturings and imbecilities. There are however two books that present even a superficial need to be trustworthy—”The Unexpurgated Case Against Woman Suffrage,” by Sir Almroth Wright, and this one. Wright made a gallant try to inform the reality, however earlier than he obtained half manner by his job his ineradicable donkeyishness as a male overcame his scientific frenzy as a psychologist, and so he swiftly washed his fingers of the enterprise, and affronted the even handed with a half baked and preposterous e book. Perhaps I’ve failed too, and much more ingloriously. If so, I’m stuffed with honest and indescribable remorse.

    Extract from IN DEFENSE OF WOMEN by H. L. Mencken

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  • WHO to continue support for Chagas disease programme that promotes patient self-care

    The World Health Organization (WHO) and the Catalan Ministry of Health say they’ll collectively support the dissemination of a programme that gives support to sufferers affected by Chagas disease to handle their very own well being and promote self-care.

    The Catalonian ‘Expert Patient Programme on Chagas disease’ includes interplay and sharing of knowledge amongst individuals affected by the disease and is performed by an knowledgeable patient. The programme is taken into account to have completed very properly because it was first initiated in 2017.

    “Over the previous few years we now have seen exceptional improve in consciousness and confidence amongst sufferers to pursue medical care and follow-up with physicians” stated Dr Pedro Albajar Vinas, who’s accountable for WHO’s Chagas disease programme. “When sufferers discuss to each other there may be higher deal with general perceptions of well being, life-style, bettering shallowness, self-care and particular person satisfaction.”

    The programme additionally encourages self-responsibility and features as a part of the Chronic Disease Prevention and Care Programme of the Government of Catalonia. It is predicated on three key approaches:

    • support supplied by sufferers and observing professionals to these in power part of the disease;
    • promote interplay in teams by 9 fastidiously deliberate periods;
    • consider efficiency of previous periods by questionnaires earlier than a brand new session begins.

    Many individuals who attended the programme over time say they might suggest it to household and associates because it vastly helps to enhance information about disease.

    Initiators of the programme are assured that the methodology used, and classes discovered can type a part of a broader technique to push for complete care for a disease that continues to be largely uncared for. For instance, regardless of the efforts of the previous decade, the worldwide detection fee for Chagas disease is lower than 10%.

    Through this settlement, WHO will present support in facilitating the interpretation of supplies and paperwork in languages utilized in its Member States in addition to help within the improvement of any mobile-based software if the necessity arises. The Government of Catalonia will print and distribute for advocacy functions.

    To promote international advocacy for the disease, the World Health Assembly – WHO’s decision-making physique – in 2019 adopted a call to have a good time World Chagas Disease Day on 14 April.

    The disease

    Chagas disease was as soon as confined to rural areas of Latin American international locations the place the primary route of transmission is vectorial transmission.

    But over the previous many years, the disease has been more and more reported in lots of international locations exterior Latin America primarily due to motion of populations and migration.

    According to WHO estimates, round 6-7 million individuals are contaminated with Trypanosoma cruzi – the protozoan parasite that causes Chagas disease.

    Vectorial transmission happens when people are available in contact with the faeces or urine of triatomine bugs (referred to as ‘kissing bugs’, amongst many different native names).

    These bugs – the vectors that carry the parasites – reside within the wall or roof cracks of properties – the place they disguise in the course of the day and lively at evening after they feed on human blood. They often chew an uncovered space of pores and skin such because the face (therefore its widespread identify ‘kissing bug’).

    Right after a chew, the bug defecates/urinates shut to the chew space. The parasites enter the physique when the particular person instinctively reacts to the chew and smears the bug faeces or urine into the chew, the eyes, the mouth, or into any pores and skin break.

    The parasite may also be transmitted by:

    • consumption of meals contaminated with T. cruzi by, for instance, contact with faeces or urine of contaminated triatomine bugs or marsupials (this type of transmission sometimes causes outbreaks with extra extreme morbidity and better mortality – infecting teams of individuals concurrently with extra frequent instances of extreme disease and better variety of deaths);
    • blood or blood product transfusion from contaminated donors;
    • passage from an contaminated mom to her new child throughout being pregnant or childbirth;
    • some organ transplants utilizing organs from contaminated donors; and
    • laboratory accidents.

    There is not any vaccine in opposition to Chagas disease. Domiciliary vectorial management and transfusional management, along with congenital transmission, stay the simplest strategies of stopping transmission in Latin America.

    Chagas disease was named after Carlos Ribeiro Justiniano Chagas, a Brazilian doctor and researcher who found the disease in 1909.

    WHO to continue support for Chagas disease programme that promotes patient self-care
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  • WHO to accelerate action to reduce the harmful use of alcohol

    The
    harmful use of alcohol causes roughly Three million deaths yearly and the
    general burden of illness and accidents attributable to alcohol consumption
    stays unacceptably excessive. The tempo of improvement and implementation of
    alcohol insurance policies has been uneven in WHO areas, and assets and capacities
    for implementation of the WHO Global technique to reduce the harmful use of
    alcohol 10 years after its endorsement don’t correspond to the magnitude of
    the issues. On this foundation, the WHO Executive Board in its choice EB146
    (14)
     known as for accelerated action to reduce the harmful use of
    alcohol. 

    The Board thought of the report on the political declaration of the third high-level meeting of the General Assembly on the prevention and control of non-communicable diseases, notably Annex 3, entitled “Implementation of the global strategy to reduce the harmful use of alcohol,” and the report on the findings of the consultative process on implementation of the global strategy to reduce the harmful use of alcohol and the way forward.

    The Board, in its choice EB146 (14),  requested  the WHO Director-General, inter alia, “to develop an action plan (2022-2030) to effectively implement the Global strategy to reduce the harmful use of alcohol as a public health priority, in consultation with Member States and relevant stakeholders, for consideration by the 75th World Health Assembly through the 150th session of the WHO Executive Board in 2022”, and “to develop a technical report on the harmful use of alcohol related to cross-border alcohol marketing, advertising and promotional activities, including targeting youth and adolescents, before the 150th session of the WHO Executive Board, which could contribute to the development of the action plan”,  in addition to “to adequately useful resource the work on the harmful use of alcohol.

    In response to choice EB146 (14), the WHO Secretariat will implement the following:

    • March– April 2020: Commissioning of the scoping evaluate on the harmful use of alcohol associated to cross-border alcohol advertising and marketing, promoting and promotional actions, together with concentrating on youth and adolescents.  Commissioning background papers for the report improvement. 
    • ­April-May 2020: Producing zero draft of the working doc for improvement of an action plan (2022-2030) to successfully implement the Global technique to reduce the harmful use with proposed important parts and parts.  
    • ­June 2020: Technical professional conferences organized by WHO headquarters to talk about zero draft of the working doc for improvement of the action plan and the content material of the technical report on the harmful use of alcohol associated to cross-border alcohol advertising and marketing, promoting and promotional actions.  
    • ­July-September 2020: Finalization of the working doc for subsequent session course of. Web-based session on the working doc for improvement of the action plan open to Member States, UN organizations and different worldwide organizations, and non-State actors. All related suggestions acquired will probably be revealed on WHO web site. 
    • ­October 2020 – March 2021: Regional technical consultations with Member States on the working doc for improvement of the action plan (2022-2030). 
    • ­March– April 2021: Development of the first draft of the action plan primarily based on the enter acquired on the working doc in the course of of the regional consultations.
    • April -June 2021: The web-based session on the first draft of the action plan open to Member States, UN organizations and different worldwide organizations, and non-State actors.  All related suggestions acquired will probably be revealed on WHO web site. Discussion of the first draft at the Third WHO Forum on alcohol, medication and addictive behaviours attended by technical focal factors from Member States, representatives of UN entities, civil society organizations, WHO collaborating centres, and academia. Consultation with financial operators in alcohol manufacturing and commerce on their contribution to decreasing the harmful use of alcohol inside their core roles.  An casual session with Member States on the first draft of the action plan.
    • ­July-August 2021: Development of the second draft of the action plan primarily based on the suggestions acquired on the first draft throughout the earlier levels of the session course of. 
    • ­August-November 2021: Briefings on the second draft of the action plan organized at the Regional Committee conferences.  Release of the technical report on the harmful use of alcohol associated to cross-border alcohol advertising and marketing, promoting and promotional actions, together with concentrating on youth and adolescents, with a abstract of fundamental findings and conclusions out there in six languages.  A proper assembly of Member States for consideration of the second draft of the action plan. Finalization of the draft action plan considered suggestions and inputs acquired from Member States and different stakeholders throughout the session course of in April -October 2021.  Development and submission of the report by the Secretariat to 150th session of the Executive Board. 
    • ­January/February 2022: The 150th session of the WHO Executive Board will think about the report of the WHO Director-General containing the draft action plan (2022-2030) to successfully implement the Global technique to reduce the harmful use of alcohol.

     

    WHO to accelerate action to reduce the harmful use of alcohol
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