Tag: Living

  • WHO teams with partners to mitigate the potential impact of the COVID-19 pandemic in malaria-affected areas

    The rapid spread of COVID-19 is testing the resilience of robust health systems around the world. WHO and its partners are taking measures to mitigate the potential impact of sustained transmission of the coronavirus in malaria-endemic settings –
    particularly in sub-Saharan Africa, which shoulders more than 90% of the global malaria burden.

    To date, a small proportion of the global COVID-19 cases have been identified in malaria-affected countries. However, as of 17 March, 25 countries in the African Region had reported cases of COVID-19, and local transmission of the disease had been detected
    in 6 countries (Algeria, Cameroon, Kenya, Rwanda, Senegal, South Africa).

    “At this point, we still don’t know what the COVID-19 pandemic will look like in sub-Saharan Africa,” said Dr Pedro Alonso, Director of the WHO Global Malaria Programme. “But we do know that when public health emergencies have
    hit parts of Africa with weak health systems and high malaria transmission, the impact on malaria disease and death has been very severe.”

    The 2014-2016 Ebola outbreak in Guinea, Liberia and Sierra Leone, for example, undermined malaria control efforts and led to a massive increase in malaria-related illness and death in the 3 countries.

    Joint action 

    To support malaria-affected countries, WHO has identified the need for a set of inter-related actions among global partners: 

    • generating, using and disseminating accurate information; 
    • mitigating against health system disruptions; and 
    • ensuring the continuity of routine malaria-specific interventions while also providing, where needed, additional emergency measures, such as mass drug administration, in health systems significantly impacted by COVID-19. 

    The Organization convened partners on 17 March to discuss areas of collaboration, coordination and next steps.

    WHO has begun monitoring the evolving geographic location of COVID-19 cases to understand the extent to which the coronavirus and malaria affect the same target groups. This information will reveal who is likely to be at greatest risk, where and when,
    and thus inform the need for malaria-specific interventions to save lives.

    In parallel, WHO is working across the 3 levels of the organization to ensure that any advice intended to curb coronavirus transmission and to guide COVID-19 disease management is appropriate in malaria-affected settings.  

    In recent days, there have been reports of disruptions, as a result of COVID-19, in the production and global supply chains of essential malaria commodities, such as the long-lasting insecticidal nets, diagnostic testing and antimalarial medicines. Coordinated
    efforts are required to ensure the availability of key malaria control tools – particularly in countries with a high burden of the disease – and that efforts to limit transmission of COVID-19 do not compromise access to malaria prevention,
    diagnosis and treatment services. 

    Malaria-affected countries may also experience disruptions in health systems in the coming months. A marked increase in febrile patients seeking treatment for COVID-19 at health facilities, for example, would present a significant challenge for a health
    workforce that may itself be depleted by the disease.

    Policy guidance

    WHO is developing guidance for national malaria control programmes and implementing partners to prepare them for the challenges they may face as result of COVID-19.  Among other areas, the guidance will address the mitigation of stockouts of
    malaria medicines and commodities; the use of preventive malaria therapy for health workers; the deployment of emergency measures in some settings; and the generation of information relating to the geographic distribution and populations affected
    by COVID-19 in malaria-endemic settings.  

    Restrictions around grouping people together – for training, social and behavior change communication activities, fixed-site distribution and clinical care – as well as the restrictions around movement of people in the country, will require
    significant adaptations in order to deliver quality interventions and care.

    All people living in malaria-affected areas are advised to follow same precautions as the general population, including: frequent hand-washing, respiratory hygiene, social distancing, seeking prompt medical care if symptoms arise (cough, fever,
    difficulty breathing), and other WHO-recommended actions. 

    WHO stands ready to work with countries and other stakeholders to mitigate the negative impact of the coronavirus on malaria responses worldwide and, where possible, contribute towards a successful COVID-19 response.  

    About COVID-19

    COVID-19 is the infectious disease caused by the most recently discovered coronavirus. This new virus and disease were unknown before the outbreak began in Wuhan, China, in December 2019. Essential information on the COVID-19 pandemic can be found in
    a dedicated WHO site.

    About malaria

    Malaria is a preventable and treatable disease caused by parasites that are transmitted to people through the bites of infected female Anopheles mosquitoes. In 2018, there were an estimated 228 million cases of malaria worldwide and
    405 000 malaria-related deaths. For more on malaria, visit: www.who.int/malaria

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    https://www.who.int/news-room/detail/18-03-2020-who-teams-with-partners-to-mitigate-the-potential-impact-of-the-covid-19-pandemic-in-malaria-affected-areas

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  • Analysis reveals photovoltaic systems in U.S. operating as expected

    Analysis reveals photovoltaic systems in U.S. operating as expected

    The vast majority of solar panels are living up to expectations for energy production after five years, according to a new analysis of 100,000 photovoltaic (PV) systems across the United States.

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    https://techxplore.com/news/2020-03-analysis-reveals-photovoltaic.html

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  • ‘Bonehenge’: Stone Age structure of mammoth bones discovered in Russia

    ‘Bonehenge’: Stone Age structure of mammoth bones discovered in Russia

    People living in Russia about 20,000 years ago built a “bonehenge” – a circular structure made of mammoth bones that could have been used to store food
    ‘Bonehenge’: Stone Age structure of mammoth bones discovered in Russia
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    https://www.newscientist.com/article/2237336-bonehenge-stone-age-structure-of-mammoth-bones-discovered-in-russia/?utm_campaign=RSS%7CNSNS&utm_source=NSNS&utm_medium=RSS&utm_content=home

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  • Mid-term review of the UN Decade of Action on Nutrition

    It is almost five years now since the Nutrition Decade was declared. It is time to reflect back on its achievements so far. FAO and WHO are convening an open and inclusive dialogue with stakeholders for the mid-term review of the Nutrition Decade.  DOA_logo2

    This review follows the ECOSOC Resolution 1989/84 regarding international decades, which provides that an appropriate inter-governmental body should appraise the implementation of a decade’s programme of work at the mid-point and at the end of the decade.

    The objectives of the Mid-term Review of the Nutrition Decade are to assess and evaluate the achievements in individual policy areas of the ICN2 Framework for Action, as reflected in the actions areas of the Work Programme of the Decade, over the time period from 2016 to 2020. The Mid-term Review aims to identify focus areas for priority action and promising opportunities in each of the six action areas for future progress from 2021 to 2025. This assessment will guide the revision of the ‘living part’ of the Work Programme of the Nutrition Decade as appropriate.

    The process will include a series of consultations and dialogues with member states, civil society organizations, private sector, UN partner agencies and others, as well as an open online consultation. Finally, a global event is envisioned to be organized to underscore the achievements of the first half of the Nutrition Decade and set the stage for the priorities during the second half. More information is provided in the concept note.

    The joint FAO/WHO Nutrition Decade Secretariat has developed the Mid-term Review Foresight paper, which will serve as the background paper for the consultation process. Reflecting on the broader development in nutrition globally, this paper develops a vision on actions to be taken in the different areas of the Work Programme of the Nutrition Decade, considering specific advances and opportunities in individual policy areas.

    Background documents for the consultation process of the Mid-term Review of the UN Decade of Action on Nutrition 2016-2025 can be downloaded here. We will add the other 5 languages when they are available, and meanwhile, publish some in English only.  

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    https://www.who.int/news-room/detail/12-03-2020-mid-term-review-of-the-un-decade-of-action-on-nutrition

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  • Cervical cancer elimination initiative updates

    Cervical cancer elimination initiative updates

     

    Banner of the Cervical cancer Elimination newsletter

    February: Garnering international support on the path to eliminate cervical cancer

    On
    5 February, the WHO Executive Board recommended to the 73rd World
    Health Assembly the adoption of the draft Global Strategy to accelerate
    the elimination of
    cervical cancer as a public health problem, and urged its
    implementation. The proposed resolution urges Member States to implement
    the strategy, calling for the support of international organizations
    and other relevant stakeholders, and includes a request
    for the Director General to support Member states in this endeavor.
     The WHA will consider the resolution when it convenes in May 2020.  The
    session included 23 interventions from EB Member States, most of them
    in full support of the Strategy and resolution;
    18 from other Member States, 6 observers and 6 non-state actors. Dr
    Nono Simelela, ADG and Special Adviser to WHO Director-General Dr
    Tedros, responded at the end of the session, thanking delegates for the
    broad support, and addressing some of the comments
    by sharing some of the ongoing work such as the efforts with the
    immunization partners to address HPV vaccine supply challenges and
    transparency in pricing.

    Read the full story

    Read the full draft resolution

    Download the
    Draft Strategy


    Dr Nono Simelela presented the draft Global Strategy towards Eliminating Cervical Cancer as a Public Health Problem during a webinar with partners. This presentation was given as part of
    the Us vs. HPV Prevention Week webinar series hosted by the Global
    Initiative Against HPV and Cervical
    Cancer. While highlighting WHO’s life-course approach to cervical
    cancer control, Dr Simelela also explained the proposed elimination
    threshold and targets as laid out in the strategy. She also discussed
    addressing salient challenges such as redressing inequities
    and taking special considerations for women living with HIV.

    Read the full story

    Listen to the full webinar “Gathering momentum for the global elimination of cervical cancer”

    Watch the video: Cervical Cancer Elimination – developed by Basic Health International (BHI), Union for International Cancer Control (UICC) and the Global Initiative Against HPV and Cervical Cancer (GIAHC)

    Read the story:To eliminate cervical cancer in the next 100 years, implementing an effective strategy is critical


    Dr
    Simelela was invited to Rwanda to support the kick off for a national
    cervical screening program set to put Rwanda on the path towards the
    Global Strategy goals
    for elimination of cervical cancer.

     

    Dr Simelala with the 1st Lady of of the Republic of Rwanda, Mrs. Jeannette Kagame

     

    HPV DNA test self-sampling demonstrated at cervical cancer screening facility, Muhoza Health Center

    Radiotherapy facility at Rwanda Cancer Center, colleagues from MOH, WHO, RBC and CHAI

     

    Amongst
    others, Rwanda’s First Lady Jeannette Kagame received her for a
    discussion on how WHO can support efforts against cervical cancer in her
    own country and
    throughout Africa. Dr Simelela held discussions on cervical cancer
    screening and treatment services, including building radiotherapy
    capacity, with the dedicated staff of Ruhengeri Hospital, Butaro
    Hospital, the Muhoza health center and hospital and the Rwanda
    Military Hospital. While cervical cancer and breast cancer are the most
    prevalent cancers among the women in the country, Rwanda has
    impressively reached a 97% HPV vaccination rate since introducing a
    vaccination programme in 2011, with a target to reach 70%
    screening coverage in five years. We look forward to a continuing and
    fruitful partnership with Rwanda and all the countries who have pledged
    their commitment to eliminate this preventable cancer. Together we can
    answer WHO’s call and improve the lives of
    girls and women around the world. 


    Follow us for more updates!

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    Cervical cancer elimination initiative updates 1For
    news and real-time updates from around the world,
    follow Dr Princess Nono Simelela on Twitter
    @DrNonoSimelela
    ADG, Special Adviser to the Director-General on Strategic Programmatic Priorities

    Upcoming events

    International Women’s Day
    8 March 2020
     
    64th Session of the Commission on the Status of Women/Beijing+25
    9 – 20 March 2020

    World Immunization Week
    24 – 30 April 2020

     

     

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    Cervical cancer elimination initiative updates
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  • The economic cost of female genital mutilation

    The economic cost of female genital mutilation

    An interactive data tool launched by WHO reveals for the first time the current and future financial cost of health care for women living with conditions caused by female genital mutilation (FGM).

    The total costs amount to USD 1.4 billion annually.

    fgm-cost-thumbnail

    The FGM Cost Calculator is being launched on this year’s International Day of Zero Tolerance for FGM. This new tool shows that if FGM were abandoned now the associated savings
    in health costs would be more than 60% by 2050. This data, available for 27 of the 30 countries where FGM is practiced, will strengthen the economic argument of community activists, policy makers, programme planners and donors working to end this
    human rights violation.

    Q&As on the FGM Cost Calculator
    Access the FGM Cost Calculator

    A human rights violation with economic costs

    FGM includes procedures that intentionally alter or cause injury to the female genital organs for non-medical reasons. More than 200 million girls and women alive today have been cut in 30 countries in Africa, the Middle East and Asia where FGM is concentrated.
    [1] An extreme form of gender discrimination, it is recognized internationally as a violation of the human rights of girls and women: including the right to health, security and physical integrity and the right to be free from torture and cruel, inhuman
    or degrading treatment.

    FGM has no health benefits and causes only harm. Women and girls who are subjected to FGM are at risk of both short- and long-term negative health consequences – including for their physical, sexual, mental, and social well-being.

    The direct financial cost of treating the negative health complications caused by FGM can span generations, starting as early as childbirth. This puts a significant economic burden on health systems and national budgets, especially in countries with rates
    of FGM greater than 10%.

    Until now, there have been limited data on the financial costs associated with FGM, making it hard to demonstrate the cost-effectiveness of programmes and policies that can prevent FGM by 2030 – a global priority in the Sustainable Development Agenda.
    The new WHO Cost Calculator now provides an economic argument which can be used by those advocating for an end to FGM.

    Calculating health care costs of FGM

    Users of the new FGM Cost Calculator can choose a country and identify current costs of treating health conditions caused by FGM. Since the tool is interactive, it produces bespoke graphs showing the potential amount of money saved if FGM is prevented
    by a selected percentage.

    If no action is taken to prevent FGM, it is estimated that related health costs will soar by 50% by 2050, as populations grow and as more girls undergo the procedure.

    How it works

    The FGM Cost Calculator combines data on health risk associated with FGM, health costs and national FGM prevalence to analyze the economic impact on national health services of treating the consequences of these harmful practices.

    Health risk data were taken from a WHO database created for this analysis, pooling all available information from systematic reviews of health consequences of FGM. The following categories were used, each with a biological link to FGM: gynaecological,
    obstetric, urological, mental and sexual, as well as the immediate health complications that can result following the cutting.

    To be included in the calculator, a health condition needed to show evidence of increased risk when comparing women with and without FGM. It also needed to have a treatment which could be implemented and costed in the health sector.

    Health costs were calculated from the WHO One Health Tool and other data. The financial burden of treating selected health conditions was calculated at a national level.

    A strong case for investment in preventing FGM

    Rates of FGM have declined over the past 30 years, but not fast enough to keep up with population growth. If trends continue, the number of girls and women undergoing FGM will rise significantly in the next 15 years, in turn raising national health care
    costs of caring for them.

    Additional resources are urgently needed to scale up interventions that can prevent FGM in the future and reduce health complications.

    By providing quantifiable numbers on the cost of treating health conditions directly linked to FGM, for the first time, the FGM Cost Calculator can be a crucial tool in building an investment case for a future where no girl or woman is cut.


    [1] Female Genital Mutilation/Cutting: A Global Concern, UNICEF, New York, 2016
    The economic cost of female genital mutilation
    Read More
    https://www.who.int/news-room/detail/06-02-2020-economic-cost-of-female-genital-mutilation

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  • WHO Global Initiative for Childhood Cancer: progress on all fronts

    WHO Global Initiative for Childhood Cancer: progress on all fronts

     Peru shows the way forward and the courage of Ander Martinez

    “When Ander was diagnosed, I didn´t have the possibility to cover the cost of the treatment. It was very expensive, and I had nothing,” says Rosalina Tocto, 29 years mother of Ander Martínez Tocto. Ander had just been diagnosed with acute leukemia at the young age of 6 years. From the beginning, the odds were stacked against him. He and his family lived in a rural town, six hours from the nearest city. His parents did not have a formal job, placing the family under financial strain.

    Ander and his family were not alone in this situation. “In Peru, nearly 1800 children and adolescents are diagnosed with cancer every year; however, up to 70% will have a late stage, often metastatic due to delays in diagnosis,” says Dr. Juan García, medical chief of the Pediatric Department of in the National Institute of Neoplastic Diseases (INEN) in Lima, Peru. “Most of our patients come from outside Lima and the majority of parents do not have formal employment and therefore do not have any type of insurance.”

    Fortunately, Peru has made a strong commitment to Universal Health Coverage. In 2009, a law was passed to improve access to care by introducing a mandatory health insurance system and registering everyone living in extreme poverty under Seguro Integral de Salud (SIS), regardless of age or circumstance.  

    Dr. Reina Bustamante, Executive Director of the Division of Prevention and Control of Cancer of the MINSA says “UHC is an important step in public health particularly for those who lack public or private insurance like Ander. In this context, we are trying to follow WHO guidance to achieve UHC and ensure all individuals and communities receive the health services they need without suffering financial hardship.”

    In 2019, Peru was selected as a focus country for the WHO Global Initiative for Childhood Cancer as the first focus country in the Region. The Global Initiative aims to improve survival for all children with cancer to at least 60% by 2030 while reducing suffering, altogether with the potential to save an additional one million lives.

    Four main goals were formulated for the national pediatric cancer plan: (1) improve early diagnosis of childhood cancer, (2) decrease treatment abandonment, (3) implement a national pediatric cancer registry and (4) improve the quality of services in pediatric oncology units.

    Dr. Liliana Vasquez, pediatric oncologist who works as an external consultant for the Division of Prevention and Control of Cancer of MINSA said, “Ten working groups have been established to achieve the goals.”

    Dr. Vivian Perez, advisor of the Non-Communicable Diseases Office in PAHO-Peru added “the initial focus for the Initiative will be on six cancers selected as tracers for monitoring progress across the health system, alongside engagement of at least six focus countries with a record of strong political commitment and foundational efforts supporting children with cancer.”

    For Ander, his health care team, the commitments from the government of Peru and partners and Global Initiative have made it possible to be successfully treated and will now allow him to dream of a healthy future though better access to surveillance monitoring and psycho-oncological support aimed at childhood cancer survivors.

    Peru is showing what is possible for all countries. By concerted action and promoting universal health coverage, every child in the world can have access to high-quality care with the greatest likelihood of survival, and every family should be protected from financial hardship. We can do more together. 

     

    WHO Global Initiative for Childhood Cancer: progress on all fronts
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    https://www.who.int/news-room/detail/14-02-2020-who-global-initiative-for-childhood-cancer-progress-on-all-fronts

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  • Pregnancy and breastfeeding during an Ebola virus outbreak

    Pregnancy and breastfeeding during an Ebola virus outbreak

    Women who are pregnant or breastfeeding in an Ebola outbreak face similar challenges as other population groups, but they have specific health needs which must be met.

    As the second largest Ebola outbreak in history continues in the Democratic Republic of Congo, WHO has released new clinical guidelines for healthcare providers supporting pregnant or breastfeeding women in the context of Ebola virus disease.

    Improving clinical care and reducing mortality

    92-4-000138-1Clear and coherent guidance is needed to meet the combined needs of women requiring Ebola treatment, pregnancy care and management of complications.

    Information on how to protect breastfeeding children and other members in the community from transmission of the disease is also critical.

    Limited scientific evidence on how to best manage these needs has previously been a challenge for affected countries. In addition, misconceptions that pregnant women have a higher mortality rate than other populations with Ebola may in some contexts have put pregnant women at risk of not receiving standard care.

    WHO’s Guideline on the management of pregnant and breastfeeding women in the context of Ebola virus reviews existing evidence and provides a single set of recommendations on the care continuum for women exposed to, diagnosed with, or recovered from Ebola.

    This will enable healthcare providers, emergency response teams and health policy-makers to improve prevention and treatment measures in an Ebola outbreak.

    Obstetric care at an Ebola Treatment Centre

    Optimal supportive care should be offered to all pregnant women with Ebola. Likewise, they should be offered experimental treatment and vaccination under the same conditions as non-pregnant populations.

    Ebola virus disease does increase the risk of miscarriage and early labour, requiring close clinical management at Ebola treatment centres. It is important to engage both obstetric providers and those trained in Ebola response.

    This dual expertise is also important because early Ebola and pregnancy-related symptoms can overlap. Pregnant women should be prioritised for testing to confirm an Ebola infection.

    Ebola virus can persist in pregnancy related fluids as well as breastmilk. If healthcare providers are not clear on how to manage Ebola infection risk, they may be less willing to provide care. This stigma can be life-threatening for women who experience complications during delivery.

    The new WHO guidelines advise healthcare workers on how to protect themselves while caring for pregnant women with Ebola virus disease. This includes induced labour or surgical procedures, which carry greater risk of transmission in cases of acute infection. Any invasive treatments should be carried out in full personal protective equipment.

    Breastfeeding recommendations in an Ebola outbreak

    WHO recommends that women with suspected or confirmed Ebola immediately stop breastfeeding and are prioritised for diagnostic testing. Any child exposed to Ebola through breast milk should be placed into safe care, closely monitored for symptoms over a 21-day period and fed with an appropriate breast milk substitute.  

    The guidelines strongly recommend that breastfeeding is only restarted following two consecutive negative tests of breast milk, separated by 24 hours.

    A breast milk substitute should be used even if infection is confirmed for both the mother and her child. Exceptions can be made for infants under 6 months of age who are already infected, if breast milk substitutes are not feasible, affordable, sustainable or safe and separation cannot be implemented safely.

    Women’s health and rights in a disease outbreak

    A disease outbreak does not change women’s and adolescent girls’ fundamental human right to sexual and reproductive healthcare, including evidence-based care during pregnancy and childbirth.

    Women need support to make informed reproductive health care choices for themselves and their children. Women living in an Ebola outbreak should have access to all relevant reproductive options, regardless of economic, cultural, racial or religious status, including contraception and safe abortion to the full extent of the law.

    Pregnant and breastfeeding women across affected communities need equitable and respectful care that considers the risks they face and supports the choices they make.

    Accessing the guidelines and further research

    These guidelines are now available online and may be freely downloaded. The executive summary will be available in French.

    WHO will closely monitor new data as it emerges, as there is still a pressing need to prioritise ongoing research related to Ebola virus transmission.

     

     

     

    Pregnancy and breastfeeding during an Ebola virus outbreak
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    https://www.who.int/news-room/detail/10-02-2020-pregnancy-and-breastfeeding-during-an-ebola-virus-outbreak

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  • Female Genital Mutilation Hurts Women and Economies

    Female Genital Mutilation Hurts Women and Economies

    Female genital mutilation (FGM) exacts a crippling economic as well as human cost, according to World Health Organization (WHO).

    “FGM is not only a catastrophic abuse of human rights that significantly harms the physical and mental health of millions of girls and women; it is also a drain on a country’s vital economic resources,” said Dr Ian Askew, Director of WHO’s Department of Sexual and Reproductive Health and Research. “More investment is urgently needed to stop FGM and end the suffering it inflicts.”

    New modelling reveals that the total costs of treating the health impacts of FGM would amount to USD 1.4 billion globally per year, if all resulting medical needs were addressed. For individual countries, these costs would near 10% of their entire yearly expenditure on health on average; in some countries, this figure rises to as much as 30%.

    The interactive modelling tool that generated these data was launched on the International Day of Zero Tolerance for Female Genital Mutilation.

    Severe physical and mental health impacts for women and girls

    Women and girls living with FGM face serious risks to their health and well-being. These include immediate consequences after being cut, such as infections, bleeding or psychological trauma, as well as chronic health conditions that can occur throughout life.

    Women who have undergone the procedure are more likely to experience life-threatening complications during childbirth. They may face mental health disorders or suffer chronic infections. They may also have pain or problems when they menstruate, urinate or have sexual intercourse. 

    All of these conditions warrant much-needed medical attention and care.

    “High healthcare costs for countries mount because of the tragic personal impacts on women and girls. Governments have a moral responsibility to help end this harmful practice,” says Dr Prosper Tumusiime, Acting Director for Universal Health Coverage and the Life Course in the African Regional Office of WHO. “FGM hurts girls, imposes lifelong health risks on the women they become, and strains the healthcare systems that need to treat them.”

    Preventing FGM brings major benefits for women, girls, communities and economies

    Using data from 27 high-prevalence countries, the Cost Calculator demonstrates clear economic benefits from ending FGM. If it were abandoned now, it shows that the associated savings in health costs would be more than 60% by 2050.

    In contrast, if no action is taken, it is estimated that these costs will soar by 50% over the same time period, as populations grow and as more girls undergo the procedure.

    Since 1997, great efforts have been made to end FGM, through work within communities, research, and changes in legislation and policy. 26 countries in Africa and the Middle East now explicitly legislate against FGM, as well as 33 other countries with migrant populations from FGM-practicing countries.

    WHO is also working with countries to raise awareness of the harmful impacts of the practice among their health workers, and to engage them in prevention efforts.

    “Many countries and communities are showing that abandoning female genital mutilation is possible,” states Dr Christina Pallitto, scientist at WHO. “If countries invest to end female genital mutilation, they can prevent their girls from undergoing this harmful practice and promote the health, rights and well-being of women and girls.”

    Female genital mutilation is internationally recognized as a human rights violation. It has no medical benefits and causes only harm. WHO’s position is that FGM must never be carried out.

    Further information

    The FGM Cost Calculator will be available here, as of 00:30 CET 6 February 2020:
    www.who.int/news-room/detail/06-02-2020-economic-cost-of-female-genital-mutilation

    More on FGM

    Notes for Editors

    About FGM

    FGM includes procedures that intentionally alter or cause injury to the female genital organs for non-medical reasons. More than 200 million girls and women alive today are estimated to have undergone the practice across 30 countries in Africa, the Middle East and Asia where FGM is concentrated.

    FGM is mostly carried out on young girls between infancy and 15 years of age.

    About the FGM Cost Calculator

    The WHO FGM Cost Calculator shows the economic cost of treating the health complications caused by FGM across 27 high-prevalence countries. These costs were calculated using the WHO One Health tool and other available scientific evidence.

    Users of the tool can calculate costs by country in a ‘business as usual’ scenario; a scenario of partial abandonment of FGM, and full abandonment of FGM over a 30-year period. In addition, the distribution of costs by different types of health complications is presented by country.

    The tool does not consider other indirect costs that hit families and communities, or the socio-economic impacts of the practice, which would be significantly higher still.

    The 27 countries modelled include Benin, Burkina Faso, Central African Republic, Còte d’Ivoire, Cameroon, Chad, Djibouti, Egypt, Eritrea, Ethiopia, Ghana, Guinea, Gambia, Guinea-Bissau, Iraq, Kenya, Mali, Mauritania, Niger, Nigeria, Soudan, Senegal, Sierra Leone, Somalia, Togo, United Republic of Tanzania, Yemen.

    Female Genital Mutilation Hurts Women and Economies
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    https://www.who.int/news-room/detail/06-02-2020-female-genital-mutilation-hurts-women-and-economies

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  • Spinoza’s Ethics of Strength of the Emotions in W Somerset Maughm’s Of Human Bondage

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    The writer probes on the complex world of W. Somerset Maughm’s protagonist in the novel Of Human Bondage, using the propositions the Jewish Portuguese philosopher Baruch Spinoza postulated in his book Ethics in 1674. Some of Spinoza’s propositions are as follows( Morgan, 2006, pp 108-120):

    The following propositions of Spinoza enlighten the changing character of Philip in his own bildungsromans of his life. The force and increase of any passive emotion and its persistence in existing is defined not by the power whereby we ourselves endeavour to persist in existing, but by the power of external causes compared with our own power;

    The force of any passive emotion can surpass the rest of man’s activities or power so that the emotion stays firmly fixed in him;

    An emotion cannot be checked or destroyed except by a contrary emotion which is stronger than the emotion which is to be checked;

    Knowledge of good and evil is nothing other than the emotion of pleasure or pain insofar as we are conscious of it;

    An emotion whose cause we think to be with us in the present is stronger than it would be if we did not think the said cause to be with us;

    We are affected toward a future thing which we imagine to be imminent mo intensely than if we were to imagine its time of existence tofarther away from the present. We are also affected by a remembrance of a thing we imagine to belong to the near past more intensely if we were to imagine it to belong to the distant past;

    An emotion toward a thing which we think of as inevitable [necessarius] is more intense, other things being equal, than emotion toward a thing possible or contingent, that is, not inevitable;

    Emotion toward a thing which we know not exist in the present, and which we imagine to be possible, is, other things being equal, more intense than emotion toward a contingent thing;

    Emotion toward a contingent thing which we know not to exist in the present, is, other things being equal, feebler than emotion toward a thing past;

    No emotion can be checked by the true knowledge of good and evil, insofar as it is true, but only insofar as it is;

    Desire that arises from the true knowledge of good and evil can be extinguished or checked by many other desires that arise from the emotions by which we are assailed;

    The desires that arises from a knowledge of good and evil insofar as this knowledge has regard to to the future can be the more easily checked or extinguished by desire of things that are attractive in the present;

    Desire that arises from the true knowledge of good and evil insofar as this knowledge is concerned with contingent things can be even more easily checked by desire for things which are present;

    Desire arising from pleasure is, other things being equal, stronger than desire arising from pain;

    Every man, from the laws of his nature, necessarily seeks or avoids what he judges to be good or evil.

    The more every man endeavours and is able to seek advantage, that is, to preserve his own being, the more he is endowed with virtue. On the other hand insofar as he neglects to preserve what is to his advantage, that is, his own being to that extent he is weak.

    Philip is highly affected by nature. There is in Nature no individual thing that is surpassed in strength and power by some other thing. Whatsoever thing there is, there is another more powerful by which the said thing can be destroyed. And he was able to surpass all his problems because of the incoming different emotions, problems which proved to make him stronger if not released from “Human Bondage”.

    The force whereby a man persist in existing is limited, and infinitely surpassed by the power of external causes.

    Philip’s deformity limits his own persistence to live. But his meeting with Hayward, Clutton and Lawson, his former classmates in France, who taught him that life is all about passion and the pursuit of it, he became engross in his art. France did not also care about his clubfoot. Cronshaw taught him more philosophy in life about living in let live. Cronshaw even on his death bed, defied doctors’ prohibition. His life is anyway to end just like any other’s lives.

    Set in Kent, England, a sub-urban near London, the novel presents the multifaceted personal, social, political and religious experiences of Philip carey from his childhood to his middle age of thirty. A bildungsroman (1991, Smiley) in style, which highlights the formation of a youngman’s character through education, travels and early life experiences. Philip at the age of nine, as a young boy, is set apart from his peers by some misfortune and undergoes a humiliating experience that later proves strengthening. his first experience of love is unsuccessful or problematic one that nevertheless paves the way to a happy marriage with a suitable mate. The novel has ample observation, if not criticism, with the character’s institutions such as schools, churches and class structures.

    Philip’s personal life is truly an amalgam of life’s tragedies. But how he surpassed the seemingly insurmountable heap of oppressing weight, if not the meaninglessness or nothingness of life, is the focus of this attempt anchored on Spinoza’s propositions. To enumerate, at an early age, his mother died of tuberculosis and his father, a medical doctor, died of lung cancer. His innocence never understood the situation. He has only the temporary joy of travelling to Blackstable to live with his uncle William and childless Auntie Louisa. Forcibly liking his second family as an orphan, he is left reading his books without noise for his uncle, a Vicar in the community, is irated with children’s unruly behaviour. Aunt Louisa is incapable of understanding Philip. he is left with the care of the governess. His personal disability or deformity, being born with a club-foot, proves to be the stigma of his life forever. His early education in Kingston School, caused his early childhood bitter as his peers laughed at him, mocked and physically abused him because of his physical abnormality. Then, his adolescence which brings him to Heidelberg, Germany to study foreign languages, is never sweet. Girls chided him for his deformity. the consolation is meeting friends like Hayward and Miss Wilkinson, who flirted with him, to his disgust. His sojourn to France, albeit, his uncle’s disappointment, proves to be annihilating. His lack of talent in painting plus his deformity, made him a mediocre student. His classmate Fanny Price, who fell in love with him, on the pretext of sharing the same abnormality (hers is lack of beauty), committed suicide out of hunger and wretchedness.

    Then everything escalated to its height, when realizing that painting is not his passion, he goes back to England. He decides to change again to pursue what his uncle William tells him to do: to follow the footsteps of his father. To be a doctor. feeling he has nothing to do, he embraces the new idea. Sauntering along the Parliamentary Street of London, he is driven to dine in a cafe where he meets the slatternly waitress Mildred Rogers who awakens his sexual desire. But his languid mien, caused by his club-foot proves to be a disadvantage. the waitress prefers rugged and rich men. But his desire to pursue the pale, anaemic, aloof Mildred, beomes a challenge to him. Gradually, the two becomeclose. But the ambitious and materialistic waitress always insults him because of his deformity. to slander him cripple, would totally “cripple” his mood and emotion. Even when Philip is generous to the moody Mildred, she hurt him by marrying a German businessman Miller. His desperation is tantamount to his yearning for Mildred. He is left believing that one day, he would see Mildred again. His concentration with his medical study is forlorned. And Mildred came back,looking sickly, with a child. His generosity and forgiveness for his first love, who hurts him the most, is even greater than life. The ingrate waitress after a little recovery from poverty, elopes with Griffith, Philip’s handsome and robust classmate. That is the height of Mildred’s shamelessness. So her expected return is welcomed with derision by the newly awakened Philip. Even when Mildred turns into a prostitute, Philip is only capable of compassion, without passion or sexual desire. She is freed at last. And Philip is extricated from the pains excruciatingly caused by the destitute Mildred.

    His obsession to Mildred costs Philip his fortune and gradually his savings is left with seven pounds. He is forced to stop from his medical studies that brings him to experience unbelievable poverty. He meets the generous Athelneys who fed and sheltered him in his misery. His uncle’s death, leaving an average fortune, helps him to finish his medical studies. His fateful shelter with the Athelneys brings him to his final, harmonious and peaceful resolution to marry Sally Athelney and go on with his life beautifully. Shakespeare is affirmed by saying that “all is well that ends well.

    At this juncture, it is noteworthy to enumerate Spinoza’s propositions to elucidate Philip’s “bondage” and his strength of his emotion. Spinoza in his preface to his philosophical treatise wrote:

    I assign the term “bondage” to man’s lack of power to control and check the emotions. For a man at the mercy of his emotions is not his own master but is subject to fortune, in whose power he so lies that he is often compelled, although he sees the better course, to pursue the worse. In this Part I have set myself the task of demonstrating why is so, and also what is good and what is bad in emotions. But before I begin, I should like to make a few preliminary observations on perfection and imperfection, and on good and bad ( Morgan, 2006).

    In the beginning, Philip is a slave if not a victim of his emotion. His physical deformity, his club-foot, caused him too much pain. He learned to hate his classmates and,worst, abandoned his belief in God. He could not appreciate the God of his uncle vicar when God cannot give him the miracle he wanted to have normal feet. His painful childhood in school changed him to be rough character. He never wanted to become a vicar anymore. His obsession to Mildred indeed showed his real weakness as a man, and even wretchedness as a human being because of his deformity. he would always think that women cannot love him as he is because of his deformity.

    He who has undertaken something and has brought it to completion will say that the thing is completed; and not only he but everyone who rightly knew, or thought he knew, the intention and aim of the author of that work. For example, if anyone sees a work (which I assumed is not yet finished) and knows that the aim of author is to build a house, he will say the house is imperfect. On the other hand, as soon as he sees that the work has been brought to the conclusion that its author had intended to give it, he will say that the house is perfect. But if anyone sees a work whose like he had never seen before, and he does not know the artifecer’s intention, he cannot possibly know whether the work is perfect or imperfect.

    This appears to have been the original meaning of these terms. But when men began to form general ideas and to devise ideal type of houses, buildings, towers, and so on, and to prefer some models to others, it came about that each called “perfect” that which he saw at variance with his own preconceived ideal, although in the artifecer’s opinion it had been fully completed. There seems to be no other reason why even natural phenomena (those not made by human hand) should commonly be called perfect or imperfect. For men there are wont to form general ideas both natural phenomena and artifacts, and these ideas they regard as models, and they believed that Nature (which they consider does nothing without an end in view) looks to this ideas and holds them before herself as models. So when they see something occurring in Nature at variance with their preconceived ideal of the thing in question, they believed that Nature has then failed or blundered and has left that thing imperfect from their own preconceptions rather than from true knowledge.

    So perfection and imperfection are in reality only models of thinking, notions which we are wont to invent from comparing individuals of the same species or kind; and it is for this reason that I previously said (Def. 6, II) that by reality and perfection I mean the same thing. For we are wont to classify all the individuals in Nature under one genus which is called the highest genus, namely, the notion of Entity, which pertains to all the individuals in Nature without exception. Therefore insofar as we classify individuals in Nature under this genus and compare them with one another and find that some have more being or reality than others, to that extent we say that some are more perfect than the others. And insofar as we attribute to them something involving negotiation, such as limit, end, impotence and so on, to that extent we call them imperfect because they do not affect our minds as much as those we call perfect, and not because they lack something of anything except that which follows from the necessity of nature of its efficient cause; and whatever follows from the necessity of the nature of its efficient cause must be necessarily be so.

    To be a master of his emotion is to attain perfection. It may not be physical but spiritual, mental and emotional. His challenges may have hardened him but enlightened him to loosen up and later, embrace the beauty of life. The unattainable perfection, was answered, through his friend Cronshaw, a poet whom he met in France, that the meaning of life cannot be answered unless one lives it. he realized that men are born, study, work, marry, have children and die is the most beautiful pattern that the Persian rug edifies.

    As for the terms “good” and “bad,” they likewise indicate nothing positive in things considered in themselves, and nothing but models of thinking, or notions which we form from comparing things with one another. For one and the same thing can at the same time be good and bad, and also indifferent. For example, music is good for one who is melancholy, bad for one in mourning, and neither good or bad for the deaf. However, although this is so, these terms ought to be retained. For since we desire to form the idea of man which we may look to as model of human nature, we shall find it useful to keep these terms in the sense I have indicated. So in what follows I shall mean by “good” that which we certainly know to be the means for our approaching nearer to the model of human nature that we set before ourselves, and by “bad” that which we certainly know prevents us from reproducing the said model. For it is important to note that when I say somebody passes from a state of less perfection, to a state of greater perfection, and vice versa, I do not mean that he changes from one essence or to form to another (for example, a horse is as completely destroyed if it changes into a man as it would be if it were to change into an insect), but that we conceive his power of activity, insofar as this is understood through his nature, to be increased or diminished.

    Philip may have been both good and bad due to circumstances. he was good in the Blackstable with his Auntie Louisa and Uncle William. he became bad in school because his classmates taunted him because of his clubfoot. In Heidelberg, he is good to all the people even if he did not understand their silence and even their insolence. In France, was forced to become bad, to protect himself from the looming abuses of other foreigners. The death of an anti-social fanny Price, showed him to be the only compassionate painting student.

    Hence, after a series of Philip’s tragedy, his experiences, his meeting with different people, his education, his travel to Heidelberg, to Paris and to London, his affluence and reversal of his fortune to poverty taught him greatest lessons in life. That life can be beautiful if man knows to master his emotion, moderate his desire and be reasonable in every decision. A man is finally freed from the chains and cufflinks ” Of Human Bondage”.

    References:

    Maughm, Somerset W. (1991). Of Human Bondage.

    Canada: Bantam Book Doubleday.

    Morgan, Michael (ed.). (2006). The Essential Spinoza: Ethics And Related Writings.

    Cambridge: Hackett Publishing, Inc.

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    Source by Wilfredo M. Valois

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