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Healthcare Disparities in Rural and Remote Areas in America

HEALTHCARE ACCESS TO REMOTE AREAS IN AMERICA: 

The rural population in America is estimated to be 15-20% of the whole population. They face healthcare disparities that leads to worse healthcare as compared to urban and suburban regions. This inequities in healthcare is due to economic, social, racial, ethnic, geographic and health workforce factors (Kelleher & Gardner, 2017).

Increase in population and disparity in distance has been proven to be problematic in accessing medical and emergency healthcare services in first world countries such as Canada, United States of America and Australia. Inequities in healthcare accessibility and underutilization of emergency hospital services are a result of geographical distance among rural and remote areas. Meanwhile, there are pressures to downgrade hospital infrastructure, centralize more specialized medical functions to ensure that there is an appropriate level of procedures and quality of care and attempt moving hospitals services to rural areas. Small hospitals in rural and remote regions have struggled to sustain their financial status which has further become a major problem in terms of both capital expenditure and expenses; at the same, maintaining and attracting highly skilled healthcare professionals in remote locations is another challenge of its own. Hospital closure is often considered as a political charge that is restricted by the local population. This implies that primary healthcare is of great significance either by preventing unnecessary hospital admissions or providing the necessary emergency care, which can also be assisted by telemedicine (Rechel et al., 2016).


 REFERENCES:

Kelleher, K. J., & Gardner, W. (2017, April 6). Out of sight, out of mind - behavioral and developmental care for rural children. New England Journal of Medicine, Vol. 376, pp. 1301–1303. https://doi.org/10.1056/NEJMp1700713

Rechel, B., Džakula, A., Duran, A., Fattore, G., Edwards, N., Grignon, M., … Smith, T. A. (2016). Hospitals in rural or remote areas: An exploratory review of policies in 8 high-income countries. Health Policy, 120(7), 758–769. https://doi.org/10.1016/j.healthpol.2016.05.011

Prevalence of Corporal Punishment among Nigerian Students Between the Age of 2-14 Years


Related imageChild abuse and neglect is known as a major public health problem diminishing the health and wellbeing of a child and an adolescent across the world. The Centers for Disease Control and Prevention uses the term child maltreatment in a general concept that includes “abuse”, and “neglect” even though the terms “maltreatment and abuse” are mutually used in the literature. According to CDC (2008) this is defined as any act or series of acts of commission1 or omission by a parent2 or other caregiver that results in harm, potential for harm, or threat of harm to a child (Leeb, Paulozzi, Melanson, Simon, & Arias, 2008). Furthermore, World Health Organization defines “Child Abuse and Neglect” as ‘Every kind of physical, sexual, emotional abuse, neglect or negligent treatment, commercial or other exploitation resulting in actual or potential harm to the child’s health, survival, development, or dignity in the context of a relationship of responsibility, trust or power. Several studies have shown that children who have been abused or neglected tend to show signs of developmental issues, impaired cognition, eating and sleeping disorders, poor academic performance, poor relationship, PTSD, depression, suicidal behaviors and themselves may inherit the trait of abusiveness (Olatosi, Ogordi, Oredugba, & Sote, 2018).

For over a century, according to the Nigerian culture, children are perceived to be an instrument or property that has no rights of its own. The belief states that children should be seen on occasions, but not heard; they are not permitted to listen to the discussions of that of an adult or make contributions to their conversation. Not only was the situation prevalent in the Nigerian society, it continued its way into the educational system of the country. Unfortunately, children were only authorized to contribute in a class activity when the teacher deems it as necessary. The educational curriculum in Nigeria is recognized as a means of establishing a free democratic and equal community that is strong, united and independent with a land full of opportunities and potentials for the citizens to grow and prosper (Umobong, 2015).

The African custom detects that the parents are the solely responsible for training their child, and a member of the community also has the right to discipline and correct a child who misbehaves or acted in a wrong way. The parents are to teach their children in a suitable and acceptable way according to the standard of the society. However, in recent times, as a result of the introduction of nursery and pre-schools, parents pushed the responsibilities such as directing, guiding, counselling and role modeling to the academic institution; hence, contributing to the demands of the curricular of the school. Children at the age of two years, who are supposed to be at home to receive the warmth and nurture of a mother are enrolled into schools. The school is therefore faced with managerial challenges on how to manage the children and train them. This eventually leads to the lack of provision of human rights for the children; children are further subjected to physical abuse and neglection; emotional abuse from the teacher and other inhuman treatments (Umobong, 2015).

Academic institutions go beyond gathering children to enroll them for learning sessions; it is a way of addressing behavioral problems among students. Schools are challenged with numerous acts of misconduct from students. Although it has been argued by a lot of teachers that punishment is an answer to misconduct, others tend to enact discipline among the students. Therefore, teachers and academic administrators inflict corporal punishments on students for several reasons. Pupils are beaten for receiving a poor grade in an exam, for talking in the class etc. A considerable number of teachers, administrative staff and parents have the belief that these punishments are essential in the upbringing of a child; to teach the child a lesson or discourage misbehaviors in the future(Yemi, 2018) .

According to a survey conducted by UNICEF which focused on violence on children by caregivers or family members, authority figures, peers and strangers, showed that over 60% of adults in Nigeria agree with the method of physical punishment as an act of discipline towards children to raise and educate them. 91% of children between the age of 2-14 years have experienced violent discipline such as psychological aggression/physical punishment by a parent or a teacher. Over 30% of Nigerian children have been subjected to severe case of physical punishment from hitting the child on the head, ear or face to hitting the child with objects such as canes or sticks(UNICEF, 2014).
Another survey that studies eye injuries caused from corporal punishments in Nigerian academic settings that involved 172 primary school teachers in Ilorin, Kwara state, Nigeria, indicates that 80% of participants had witnessed students undergo punishments by the teachers with a cane, 46% students were subjected to horse-whip and 30% were slapped by the teacher’s hand; 61% of the students were flogged on their buttocks, while 49% of them on their backs, 52% on the palms of the their hands, 20% on the head and 16% received beatings on their face (Mahmoud, Ayanniyi, & Salman, 2011).



REFERENCES:

Leeb, R. T., Paulozzi, L. J., Melanson, C., Simon, T. R., & Arias, I. (2008). CHILD MALTREATMENT SURVEILLANCE Uniform Definitions for Public Health and Recommended Data Elements Version 1.0.
Mahmoud, A. O., Ayanniyi, A. A., & Salman, M. F. (2011). Observations of teachers in llorin, Nigeria on their practices of corporal punishment that are potentially injurious to their pupils eyes. Annals of African Medicine, 10(2), 150–154. https://doi.org/10.4103/1596-3519.82075
Olatosi, O. O., Ogordi, P. U., Oredugba, F. A., & Sote, E. O. (2018). Experience and knowledge of child abuse and neglect: A survey among a group of resident doctors in Nigeria. The Nigerian Postgraduate Medical Journal, 25(4), 225–233. https://doi.org/10.4103/npmj.npmj_92_18
Umobong, M. E. (2015). CHILD ABUSE AND ITS IMPLICATIONS FOR THE EDUCATIONAL SECTOR IN NIGERIA.
UNICEF. (2014). HIDDEN IN PLAIN SIGHT A statistical analysis of violence against children. New York, NY.
Yemi, F. (2018). Journal of Education and Practice www.iiste.org ISSN (Vol. 9). Retrieved from Online website: www.iiste.org

Sickle Cell and Thalassemia Disease

Sickle cell disease and thalassemia are both genetic disorders that resulted from genetical errors for hemoglobin-a substance that is made up of protein and iron molecule responsible for carrying oxygen in the red blood cells. These orders can lead to fatigue, jaundice and episodes of pain ranging from mild to very severe. Sickle cell and thalassemia can be inherited especially from parents who pass an abnormal gene. When this occurs, both diseases can be severe or fatal.

SICKLE CELL DISEASE:

Related imageSickle Cell Disease was discovered in the 1900s, formerly known as "peculiar, enlongated sickle-shaped erythrocytes (red blood cells)". Advancement in studies indicated that the pain sickle-cell patient go through is caused from a blockage of tiny blood vessels. Furthermore, several studies concluded that sickle cell disease is caused by an abnormality in the hemoglobin, referred to as "hemoglobin S". This is disease among other identified diseases was the first to be understood by scientists at the biochemical level due to the fact that researchers learned that the abnormal hemoglobin is actually changing form (called sickling) because of a single amino acid error in the hemoglobin S.

The underlying molecular cause of the disease has been understoond for over a century. Yet, progress in translating the knowledge to improvde patient care is slow; that is, reflects the challenges of treating the disease. In United States, health research and treated were neglected among the underserved population where they are more prone in developing the disease. In the early 1970s, just after the civil rights movements that it was recognized the fact that patients with sickle cell disease were an example of racial inequality in the healthcare. In addition to this, the Sickle Cell Disease Association of America was founded and eventually helped to establish the Sickle Cell Amemia Control Act of 1972. The government provided grants for screening research and treatment programs.

New treatment for the sickle cell disease were discovered as scientific progress and technology evolved. The Prophylactic Penicilin Study (PROPS) shows that administering penicilin (an antibiotic) to unsick patients could prevent death caused by serious infections in sickle cell disease. Also, the Multicenter Bone Marrow Transplant Study illustrated that 84% of children who were diganosed with the disease could be cured after receiving  a bone marrow transplant from a matched donor or family member. Mid 1990s, the U.S Food and Drug Administration authorized a new therap called Hydroxyurea as a form of treatment to reduce further complications of the disease. "Hydroxyurea works in part by stimulating the body to resume production of fetal hemoglobin (hemoglobin F), a normal hemoglobin in the fetus that prevents sickling".

THALASSEMIA:

This is an inherite blood disorder characterized by low hemoglobin and fewer red blood cells in the body compared to normal. In 1925, Thalassemia or Mediterranean Anemia was first described by a Detroit physician who studied Italian children with severe anemia (low levels of red blood cells), poor growth, huge abdominal organs and early childhood death. In 1946, the cause of thalassemia was discovered to be an abnormal structure in the hemoglobin. The body destroys the red blood cells, resulting to Anemia. The body tries to make red blood cells quicker than normal as a means of compensating for the loss; however, this can lead to other thalassemia complications such as bone abnormalities and spleen enlargement.

Related imageIn the year if 1960, doctors started transfusing fresh red blood cells to patients with thalassemia every month to treat the disease. This mitigated most of the symptoms in childhood and had a huge impact in the survival rate of thalassemia patients; this treatment is currently in practiced. Nonetheless, since blood contains a large amount of iron, most patients died during their teenage years from the damaged caused by too much iron. Moreover, researched discovered that surplus iron amount can be removed from the body through by a drug called desferoxamine. The drug has prevented iron-induced heart disease and has improved the life expectancy of patients. Recently, there is availability of two oral drugs that aid in removing iron, which has improved the quality of life of the patient with excess iron from blood transfusion for thalassemia. On the other hand, specialized imaging test can detect iron in the heart and also permit patient to be treated to prevent iron-related heart failure.


https://datri.org/i-want-to-be-a-donor/

REFERENCES: 

https://rarediseases.info.nih.gov/diseases/10333/sickle-beta-thalassemia

https://www.hematology.org/About/History/50-Years/1534.aspx

https://www.mayoclinic.org/diseases-conditions/thalassemia/symptoms-causes/syc-20354995


Violation Of Human Rights in Nigeria: What Is Going On Now!

Infringement of human rightsIn Nigeria, human rights are being violated by the justice system such as the police. These days, the police have broken the code of conduct of human rights that includes unlawful killings, torture and other ill-treatment as well as enforced disappearances. The conflict in Niger Delta poses as a threat to the safety and lives of the Nigerian residents. Human right advocates and journalists are intimidated and harassed for expressing their voice. Women still face the violence, which is widespread across the country, and unfortunately the government has shown no interest so whatever to protect the rights of the children. Furthermore, millions of citizens face eviction in the country.  

Although the government has given its pledges to foresee the challenges in the criminal justice system of Nigeria, there is little or no progress to address the issue. The Nigerian Police Force (NPF) has no regard for human rights; people are subjected to illegal killings by the police either during or before arrest, or along the streets. A majority of the armed forces that perform such crimes are left unjustified by the legal system of Nigeria (the court).  

REFERENCES:

Understanding The Aboriginal People

The residential schools were government owned and sponsored by a religious system established to assimilate the aboriginal children in the Euro-Canadian tradition. Despite the fact that the first residential facilities were in the New France, it was usually referred to as a custodial school that was introduced after the
1880s. Originally created by the Christian churches, the Canadian government attempted not just to educate them and convert their culture and adapt them into the Canadian society, but the residential schools also disrupted the lives of the native population and communities; thereby, resulting to a long-term problem among the indigenous persons.  

The institution forcefully separated children from their families for a long period of time and banned them to recognize their Aboriginal heritage and culture or speak their native languages. The children were critically sanctioned if they did not obey the strict rules enforced by the school. The children faced abuse from the staff of the residential school staff such as physical, sexual, emotional, and psychological abuse. They were taught with an inferior curricular structure, which is normally taught up to the 5th grade. These lessons were focused mainly on manual labor in agriculture, light industry (e.g woodworking), domestic work such as laundry and sewing. Furthermore, any studies indicated that a lot of children were beaten and strapped, shackled on their beds and the rest of the children were punished by having needles shoved on their tongues as a consequence of speaking their language. These abuses were also followed with overcrowding, poor sanitation and inadequate food and access to healthcare. The medical inspector PH Bryce reported 24% of death rate among the aboriginal population within the school around the year of 1907.  

 REFERENCES: 
https://www.thecanadianencyclopedia.ca/en/article/residential-schools

https://indigenousfoundations.arts.ubc.ca/the_residential_school_system/