Childhood cancers  – A child health priority for MENA

Childhood cancers – A child health priority for MENA

  by Hedieh Mehrtash The current, and soon to be expired Millennium Development Goal 4 (MDG 4), is to reduce childhood mortality in under-fives by two thirds. In the past decade, global efforts to reach this goal have focused on scaling up access to childhood vaccines, oral rehydration salts, malaria treatment and prevention, and prevention of mother to child transmission of HIV in Southern Asia and sub-Saharan Africa. Since the inception of the MDGs there has been increasing recognition of the burden of non-communicable diseases (NCDs) globally, not just as diseases of high-income countries. The post-2015 development agenda seeks to accommodate this shift as articulated in roadmaps such as the WHO Global Action Plan for NCDs. This blog post looks at where child health and NCDs intersect in the MENA region, with a specific focus on the burden and available treatment for childhood cancers. The unique epidemiological characteristics of childhood cancers make a strong case for studying them separately from adult cancers. The most striking difference perhaps is that cancer is generally a rare disease among children – annual incidence of all cancer in children under 5 years of age in developed countries is only 0.5% (1). Moreover, adult cancers are associated with modifiable risk factors, whereas childhood cancers are not. Consequently, population based screening and prevention programs are not the best recourse for pediatric cases, which benefit instead from accurate early diagnosis and effective treatment (10). When the data on pediatric cancer is stratified by geographic location, the highest incidence of childhood lymphomas occur in North Africa and the Middle East, while leukemia accounts for a quarter of childhood cancers in the...
Far From Home: The Syrian Trojan Women Project

Far From Home: The Syrian Trojan Women Project

  by Amina Foda What began as a response to the mental health needs of Syrian refugees in Amman, Jordan has grown into a captivating platform for the world to hear the voices of Syrian refugees. The Syria: The Trojan Women project produced a theatrical adaptation of Euripides’ The Trojan Women on the grounds of the everlasting themes and consequences of war that continue today in the Syrian crisis. The play, performed by a group of Syrian refugee women, embodies the women’s journey with mental anxiety, depression and PTSD. It provides a sobering view into their lived experiences and raises awareness of their challenges. In the words of one of the Syrian refugee actresses, the sentiments of loss and the pain of displacement found in Euripides’ play, The Trojan Women, resonated with their experiences of the modern day Syrian crisis. “War is eternal, just the weapons have changed” — UK based producer, Charlotte Eagar, introduced the Project to an auditorium of Columbia University students in New York City (an evening organized by the Columbia Global Mental Health Program and co-hosted by Columbia College). The New York audience was connected to a group of Syrian refugee women in Amman, Jordan who shared their experiences and hopes to a growing Western audience. Originally scheduled to travel to the United States to perform their adaptation of Euripides’ classic anti-war tragedy, visa denials prevented their physical presence in NYC. As a saving grace, technology bridged the political roadblocks to sharing their story. The women were thoughtful and purposeful in their discussion with the audience. They shared their lived-experiences of building their new community...

Social barriers to mental health services in Arab populations

  by Aseel Hamid Accounting for 13% of the total global burden of disease,1 untreated mental health disorders are one of the leading causes of disability, causing lasting disruptions in mood, thinking and daily functioning. It has been predicted that by 2030, depression will be a leading cause of the global burden of disease.2 As outlined in “Access to Mental Health Care in the Middle East”, mental health is not a strong priority in the Middle East and North Africa (MENA) region and services are not widespread despite efforts made. The lack of prioritization around mental health means that the available resources are rarely translated into policy or planning for action at a population level by governments. The purpose of this entry is to determine which factors lead to underutilization of the few existing mental health services. After all, if governments invest in services and the respective public does not utilize them then it will inevitably lead to further deprioritization: a perpetual cycle.   Where does this cycle begin? It is highly unlikely that underutilization results from a lack of need. Prevalence rates of mental illness in MENA are similar to the prevalence rates worldwide.3 Furthermore, the MENA region has been greatly affected by conflicts, some of which are ongoing such as in Syria, Palestine and Iraq. A recent study found that countries in MENA affected by conflict tend to report a much higher rate of depression,4 and another study carried out in areas affected by conflicts show rates of 17% for post-traumatic stress disorder; 5 this is almost five times the prevalence rate of PTSD found in the...
Questions asked: Experiences of an Iranian at an oncology ward in Malawi

Questions asked: Experiences of an Iranian at an oncology ward in Malawi

  by Hedieh Mehrtash As members of a globalized world, our communities are increasingly connected by the shared burden and challenge of non-communicable diseases, cancer one of chief among them. My personal experience with family members plagued by cancer has driven a personal commitment to the global cancer care arena and #closingthecancerdivide. [1] After several observational experiences of cancer care in Iran, France and the United States, it is clear that cancer is a disease where finding the appropriate care and treatment is a global challenge. The next step in my journey led to me to Malawi this summer to work on my MPH summer practicum through Global Oncology, an NGO in Boston, and its ongoing collaboration with the oncology ward at Queen Elizabeth Central Hospital (QECH) in Blantyre, Malawi.    Arriving in Malawi     “What have I done?”  Having landed at the “fun-sized” airport, without the fancy jet bridges one sees elsewhere, and having completed the paper work, I was on my way to Blantyre city. As we passed through all the villages on the way, I was shocked by the degree of visible poverty, worried and ready to turn back. Questions kept running through my head: should I really be here? Would my presence as a foreigner be accepted? Will I be able to communicate with people? Once I arrived at the lodge, things took off as I met other students and my coworkers at the hospital; my fears soon forgotten.   Oncology ward 2A at QECH     Here I was, at one of the only public referral hospitals that consult cancer patients in the country....
البدانة في الشرق الأوسط

البدانة في الشرق الأوسط

تقدم هيديه ميهتراش موجزا عن الكلفة الاقتصادية والبشرية للبدانة في الشرق الأوسط، وتدعو إلى ضرورة إدخال سياسات سليمة والقيام بتدخلات في مجال الصحة العامة تحدّياً للجمود الحالي القائم في المنطقة. (ترجمتها للعربية: زينة المحايري) خلال الشهور القليلة الماضية نُشرت العديد من التقارير، مثل تقريري WSJ و Bloomberg ، التي عرضت التحدي المذهل للانتشار الوبائي للبدانة في الشرق الأوسط. العبء الثقيل: ساهمت البدانة وزيادة الوزن بشكل كبير بمشكلة الأمراض غير المعدية (NCDs) في الشرق الأوسط. ومن المثير للاهتمام أن الدراسات المسحية قد أظهرت أن النساء في المنطقة مصابات بالبدانة أكثر من الرجال. 1 وبصورة غير متكافئة يتأثر الشباب أكثر بوباء البدانة. وفي حين أن المنطقة تعدّ أكثر المناطق شباباً في العالم، يزداد انتشار نمط حياة الكسل وقلة الحركة، مع تغيرات في نمط الغذاء مما أدى إلى معدلاتٍ متزايدةٍ من البدانة بين الأطفال واليافعين. 2 وبالتوازي مع انتشار البدانة ارتفعت معدلات الإصابة بالداء السكري وارتفاع الضغط. وقد أشارت التقارير أن منطقة الشرق الأوسط وشمال أفريقيا تعاني من أعلى معدلات للداء السكري بين البالغين في العالم تبلغ حتى 10.9%. تلعب العادات الغذائية السيئة وقلة النشاط الجسدي الدور الرئيسي في البدانة في أي مجتمع. 3 أما في العالم العربي فتُتصف التغيرات الغذائية بازدياد مدخول السعرات، وباستبدال الوجبات الغذائية التقليدية بأخرى معالجة ومعدلة بحيث تحوي نسبةً عاليةً من الدهون والملح. 4 يضاف إلى ذلك نتائج دراسات مسحية في دول مختلفة من المنطقة (مصر، والأردن، والعراق، والكويت، والسعودية، وقطر، وسوريا)؛ والتي تؤكد أن أكثر من 80% من البالغين يتناولون أقل من الحصص الخمسة المنصوح بها من الخضراوات والفواكه يومياً. يترافق هذا النمط الغذائي مع أعلى معدلاتٍ لقلة النشاط البدني في العالم. ومع أنه من المعروف أنّ قلة النشاط البدني بات مشكلةً حقيقية، غير أنّه لا...
Mind the Gap: Arab adolescents in mental health research

Mind the Gap: Arab adolescents in mental health research

  Amina Foda, Adolescent and Mental Health Contributor In this blog, Amina Foda reviews evidence on the relationship between discrimination and mental health among minority adolescents in the United States and questions the absence of Arab adolescents in mental health research. Research and academia can sometimes seem like a black hole of talking heads. It’s a long process to study a population of people and identify causes of disease and develop effective interventions, for example. It also takes a careful blend of corroborated results and social capital to translate research to practice. However, in an age of evidence-based interventions and data driven initiatives, work that uses empirical evidence is critical to developing health services and interventions for vulnerable populations across the globe.  Disparities in health exist along countless demographics, and in order to close this gap, evidence and research is essential. For the Arab population, there is a significant gap in health research. Whether they are Arab immigrants or Arabs living in the Middle East, the level of attention given to this population is scarce. In order to create a healthy society for Arabs, we must begin by collecting and analyzing reliable data and asking thoughtful questions. In my current studies of public health I began my quest towards understanding the Arab American experience and its impact on the health of a seemingly uncategorized minority in the United States (according to the US Census, persons of Middle Eastern descent are categorized as White). To begin, with several classmates, we sought to assess the existing knowledge regarding the mental health of Arab-immigrant adolescents. There is extensive research and documented evidence of the psychological...
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