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Archive for January 2nd, 2012

St Louis Local hospital exec digs into infant mortality gaps

Posted by Administrator on January 2, 2012

 

Rick Majzun, vice president, strategic operations and planning at Children's Hospital, St. Louis, visited a 20 bed hospital in Kenya's Rift Valley as part of his 2011 Eisenhower Fellowship in September 2011. Handout Photo

Rick Majzun, vice president, strategic operations and planning at Children's Hospital, St. Louis, visited a 20 bed hospital in Kenya's Rift Valley as part of his 2011 Eisenhower Fellowship in September 2011. Handout Photo

For babies to survive to their first birthdays, a lot depends on where they  are born.

Infant mortality rates in some corners of the United States, including parts  of the St. Louis region, compare to Third World countries. In other areas, the  low rate of infant deaths resembles Scandinavian countries at the top of the  survival curve.

Rick Majzun, a vice president at St. Louis Children’s Hospital, traveled last  year to Sweden and Kenya to try to understand why infant death rates vary so  widely by geography, and what might be done to reduce the disparities that exist  even among St. Louis-area ZIP codes.

“It patently didn’t seem fair,” Majzun said of the reason he chose infant  mortality as a topic of research for his 2011 Eisenhower Fellowship, an  international exchange program for midcareer professionals.

Infant mortality rates, defined as the number of babies out of every 1,000  who die before turning 1, range from fewer than 2 to more than 175  worldwide.

In Sweden, the rate of infant deaths is under 3. The rate in Kenya is 52. In  the U.S., the death rate is 7 out of every 1,000 babies, which means about 30  countries worldwide fare better on infant survival.

But it’s much worse for certain demographics — an average 14 deaths out of  1,000 black infants in the U.S., and as many as 23 in some ZIP codes in St.  Louis and other cities.

Majzun visited the two countries to meet with hospital leaders, government  officials and health care providers to discuss how children’s hospitals can work  in their communities to prevent infant deaths.

“In an era when hospitals are being held accountable for their community’s  health, what more can we do?” Majzun said in explaining his focus.

Most births in Kenya have historically taken place in the home. Some  hospitals are changing that, while still honoring the tradition by hiring birth  attendants who usually work in homes to encourage and help women deliver in the  hospital. The program has helped reduce infant mortality rates in some  villages.

In Sweden, nurses are assigned to every newborn to help make sure the child  meets his or her developmental targets and gets vaccinations. Nurses are  compared with their peers and graded on a report card with a goal of improvement  through competition, a program Majzun thinks could be applied at Children’s  Hospital.

Majzun learned about the social insurance system that gives residents a sense  of financial and health security.

“The sense of solidarity and brotherhood is so different there,” he said.  “They just take care of each other.”

The Swedish resources made Majzun feel “embarrassed more than proud” of the  American health care system, he said.

“Unlike in Sweden, where health care is viewed as a public good, the American  system is a fragmented, expensive and wasteful patchwork that produces results  that are truly beneath what we are capable of achieving,” Majzun wrote in his  postfellowship report. “Once you get into the hospital, we generally do a pretty  good job. However, we fail to do enough to keep you from arriving at our doors.”

One in 8 babies in Missouri is born prematurely, costing the state an  estimated $500 million a year, according to the March of Dimes. Because the U.S.  insurance system reimburses hospitals for expensive treatments, there is no  incentive — other than a moral obligation — for hospitals to prevent early  births.

“The St. Louis community will spend $1 million for a month of (neonatal  intensive) care for a premature baby, and they will do it many, many times this  year,” Majzun wrote. “But we don’t have an adequately funded, community-wide  approach to reducing the number of late pre-term births.”

The state Legislature created a task force earlier this year to address  Missouri’s infant mortality rate. A proposal from the task force is due in 2013  with ideas for policy changes and other strategies to reduce premature births  and infant deaths.

Part of the focus will be on increasing access and coverage for preconception  care — health concerns specific to women of childbearing age. Because about half  of all pregnancies are considered unplanned, preconception medical visits would  include screenings for conditions that can raise problems in pregnancy, such as  smoking, drinking, high blood pressure, diabetes, obesity and poor nutrition.  The woman’s vaccinations should be up-to-date, and any medications she’s taking  should also be safe for pregnant women.

Another focus of the task force will be on reversing the rise of elective  preterm births, the scheduling of births a couple of weeks before a woman’s due  date for nonmedical reasons.

“There is no substitute for the mother’s womb unless the child is in  distress,” said Mary Elizabeth Grimes, Missouri state director of the March of  Dimes and a member of the task force. “The exponential growth of the child’s  brain and other organs are so significant in the last few weeks prior to 39  weeks, that you are really depriving the child from realizing the fullness of  their development.”

Majzun said part of the challenge will be explaining to people why they  should care about the high prematurity and infant mortality rates in certain  parts of the country. Healthy babies turn into healthy and productive adults who  contribute to a well-functioning society, he said.

“We need to hold our health care institutions more accountable for the  broader health of the communities we serve,” he wrote. “It felt like that  accountability was in place in Sweden. Kenya and the United States have a long  way to go.”

Source: http://www.stltoday.com/lifestyles/health-med-fit/fitness/local-hospital-exec-digs-into-infant-mortality-gaps/article_43245ab9-8fb6-5d36-856a-5bedf82bdb7b.html#ixzz1iKIwiC1o

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Evangel University Alumni help empower Kenyans

Posted by Administrator on January 2, 2012

Freddie Ouma and Patrick Maina work by day to fight human trafficking in their neighborhood of Nairobi, Kenya.

At night, their hip-hop group, BMF, plays concerts for thousands of fans.

And after the music dies down, they walk back to their homes on the outskirts of Nairobi’s most dangerous slum, Mathare Valley.

In a country where “everyone is a musician,” how did these two get their break? Through a Springfield-based connection.

Following his graduation from Evangel University in 2006, Springfield native Nate Kaunley started Dusty Feet as a nonprofit organization to work in Nairobi’s urban communities.

There he met Ouma and Maina, discovered a shared vision and formed a partnership to better the lives of those marginalized by poverty in Kenya.

“Since then, we have built a safe house for youth living on the streets of Nairobi, brought life-saving programs and resources to the slums, and sponsored legislation to outlaw human trafficking in Kenya. That legislation passed in 2010,” Kaunley said.

As Dusty Feet matured, Kaunley put together a team of five Evangel alumni — himself, Grant Heugel, Jess Heugel, Celia Plumb and Andrew Earle.

“We all operate under the same world view,” Kaunley said. “Empowering people is something we learned was important at Evangel; and now, it is what we do.”

Ouma and Maina were among the first to benefit from Dusty Feet.

They credit the partnership with a job, which then led to great exposure in their community and empowerment to pursue their musical dream.

In 2009, BMF took off. Since then, it has been named Best New Artist, Most Promising Group, and Best Group at major African music-awards events.

Yet, Ouma and Maina refuse to give up their day job.

“As country directors, they are Dusty Feet’s hands and feet on the ground,” said Kaunley. “We wouldn’t have had the success that we’ve had without them.”

For more information on Dusty Feet, visit www.dustyfeetonline.com.

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Problems pile up in Kenya’s election year

Posted by Administrator on January 2, 2012

Karibu Kenya, hakuna matata,” – Welcome to Kenya, there are no problems.

So goes the traditional greeting for visitors to east Africa‘s top tourist destination.

But Kenyan wags have come up with a new version: “Karibu Kenya, hakuna matata, hakuna maji, hakuna stima, hakuna gas” – Welcome to Kenya, no problems, no water, no electricity, no gas.

This sarcastic take on the well-known slogan reveals the frustration felt by many in a country that is flexing its military muscles on the regional stage, but failing to deliver on promises at home ahead of critical elections in 2012.

Kenyans will go to the polls, most likely in December, to choose a new president and parliament. The last election in 2007 brought the country to the brink of civil war amid accusations of fraud. Around 1,300 people were killed and hundreds of thousands displaced.

Few analysts are willing to take a punt on whether the 2012 polls will be disrupted by the same toxic mix of ethnicity, politics and greed. Kenya is still struggling with these old demons, but also facing new pressures.

Recent military incursion into Somalia has compounded a sense of uncertainty and insecurity.

Heavy rains have displaced thousands, ruined crops, caused power blackouts and turned Nairobi into a gridlocked quagmire. There was a shortage of water in some places and for weeks, in an unrelated scarcity, cooking gas was unavailable.

The rains and floods, coming as drought continued to bite in the north, laid bare the weaknesses of east Africa’s biggest economy, which has long been at the mercy of endemic corruption and government lassitude.

“The economy has been blinking amber all year,” said Aly-Khan Satchu, an independent Nairobi-based analyst. “The current account deficit has crossed 10%, putting us on a par with Greece and Swaziland.”

The World Bank has revised down growth estimates, and the Kenyan shilling sank to a record low against the dollar in October, pushing food and fuel prices higher. The central bank hiked rates repeatedly as inflation climbed to nearly 20% in November. The currency has strengthened since, but for many the damage has already been done.

Satchu says there are two economies in Kenya – the old one that exists to serves the interests of a ruling elite, and a new economy based on IT and mobile technology. Overall, Kenya has shown resilience, bouncing back from the post-election crisis thanks mainly to tourism, a thriving ICT sector and the mobile money revolution.

Nairobi embodies this dual-track reality. The city where 60% of the population live in slums is also a regional hub for IT development and entrepreneurship.

Politically too, the picture is not uniformly bleak. Last year, a new constitution was ratified in a peaceful vote seen as an important first step towards eradicating the dangers of poll-related violence. But the old demons persist.

“We must continue to work towards national unity rather than balkanise our nation along ethnic lines,” said the prime minister, Raila Odinga, who is the frontrunner to win the presidency.

J Peter Pham, director of the Africa Programme at the Atlantic Council in Washington, says Kenya needs strong political leadership to overcome its many hurdles this year, but that this has been in “critically low supply”.

The first test will come later this month when the international criminal court rules on whether six political figures, including deputy prime minister and presidential hopeful Uhuru Kenyatta, should stand trial for their alleged roles in the post-election violence.

Former UN chief Kofi Annan, who helped mediate the 2008 peace deal, said in December that Kenyans had moved on from the past and wanted no more violence, impunity or corruption. The question is do their leaders want the same.

“I think some of the politicians are behind the curve,” Annan said.

Source: http://www.guardian.co.uk/world/2012/jan/02/problems-kenya-election-year

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