World Health Day 2018: Universal health coverage: everyone, everywhere

This year, the theme of World Health Day is ‘Universal health coverage: everyone, everywhere’ under the slogan ‘Health for All’. Access to universal health coverage can prevent people from being pushed into poverty because they are forced to pay for the costs of their health care. Without it, the lives and welfare of millions of people and communities around the world are negatively affected, particularly in low-income countries. Universal health coverage increases people’s opportunity to work and earn a living, increases children’s chances of reaching their full academic potential and forms the basis for long term economic development.

WHO is founded on the principle that it is the right of everyone to enjoy the highest attainable standard of health. However, almost 100 million people are being pushed into extreme poverty, forced to survive on just US$ 1.90 or less a day, because they have to pay for health services out of their own pockets.

In the Eastern Mediterranean Region, 40% of health expenditure comes directly from people’s pockets; people on low incomes and without social protection are the hardest hit. As many as 55.5 million people across the Region face financial hardship as a result of out-of-pocket health expenditure; and as many as 7.7 million are pushed into poverty due to these costs. In some countries of the Region, out-of-pocket payments for health services account for over 70% of total national spending on health.

“Universal health coverage is a fundamental human right,” stated Dr Jaouad Mahjour, acting WHO Regional Director for the Eastern Mediterranean. “Ensuring the right to health for all people and universal health coverage are two sides of the same coin and have been the driving force behind WHO’s work since its foundation. World Health Day this year coincides with two special events – the seventieth anniversary of the establishment of WHO and the fortieth anniversary of the Alma Ata Declaration on Primary Health Care”.

World Health Day 2018 serves as a reminder to countries of the commitments they made when they adopted the Sustainable Development Goals and committed to taking concrete steps to advance the Health for All agenda.

Universal health coverage means that all individuals and communities receive the health care services they need without suffering financial hardship. Universal health coverage enables everyone to access the services that address the most important causes of disease and death, and ensures that those services are of sufficient quality to improve the health of the people who receive them.

“Universal health coverage is also about ensuring access to essential quality care and financial protection,” Dr Mahjour added. This not only enhances people’s health and their life expectancy, it also protects countries from epidemics, reduces poverty and the risk of hunger, creates jobs, drives economic growth and enhances gender equality.

On the occasion of World Health Day 2018, and as part of regional celebrations, the WHO Regional Office for the Eastern Mediterranean will host a panel discussion on universal health coverage, focusing on vulnerable and refugee populations on 4 April 2018. The panel will consist of senior global and regional public health experts and leaders. They will share global and regional success stories highlighting financial protection, population coverage and service coverage. The panel will also emphasize the need for private and civil society partnerships.

“Universal health coverage has a special relevance to people living in countries with acute and prolonged emergency situations. This is unfortunately the case in our Region, noting that half of the world’s internally displaced populations (IDPs) are living in some countries of the Region and more than 60% of the world’s refugees and migrants originate from the Region. As such, we are placing a special focus on universal health coverage for refugees and migrants,” said Dr Zafar Mirza, Director of Health Systems Development in the WHO Regional Office for the Eastern Mediterranean.

World Health Day represents an opportunity to shed light on the need for universal health coverage and the positive outcomes for health. On this occasion, WHO reiterates its commitment to promoting health for all, without discrimination, to ensure that no one, anywhere, is left behind.

PM announces grant for Al-Shifa Eye Hospital

RAWALPINDI: Prime Minister Shahid Khaqan Abbasi on Saturday announced Rs200 million grant for children eye hospital being constructed by Al-Shifa Eye Hospital Trust.

Speaking at the 27th Annual Day Celebrations of the Al-Shifa Trust, the prime minister said that the planned Children Eye Hospital will go a long way in providing state-of-the-art facilities to the parents for treatment of their children’s eye diseases.

The PM lauded the contribution of local and foreign donors including Oil and Gas Development Company Limited (OGDCL) and Pakistan Petroleum Limited (PPL) and promised to serve the cause of Al-Shifa Eye Hospitals.

He lauded General Jahandad Khan for establishing this facility which has now become an institution of international repute.

He said that he had been associated with this institution in one way or the other and intended to remain linked with it in the future.

He also gave away awards to the doctors and paramedics of Al-Shifa Eye Hospitals of Rawalpindi, Sukkur, Kohat and Muzaffarabad.

Speaking at the occasion, President of the Al-Shifa Trust retired Lt-Gen Hamid Javaid expressed his commitment to the eradication of blindness.

“So far we have been able to treat more than eight million patients in the OPDs and perform more than 60,000 surgeries,” he said.

Four milk brands sold in Sindh declared ‘unsafe for human consumption’ by SC

The Supreme Court of Pakistan on Saturday banned packaged milk sold under four brands until further notice.

Chief Justice Mian Saqib Nisar headed the three-judge bench that made the decision while hearing a case regarding the use of illegal chemical injections on farm cows.

Sindh’s authorities have subsequently been told to remove milk belonging to four brands including Day fresh, Nurpur and Day Fresh UHT from sale racks.

The ban on the four companies was put in place after the court reviewed a report on the matter compiled by Advocate Muhammad Vawda, who is assisting the court in the case.

According to the report, the Pakistan Council of Scientific and Industrial Research has declared milk from all four companies unfit for human consumption.

The report further pointed out that milk from three more companies had not met the standards set by the Pakistan Standards and Quality Control Authority.

It was stated in the report that a total of 53 brands were tested for a quality check, out of which these four brands turned out to be below standard.

While adjourning the case till the next session of the SC’s Karachi registry, Justice Nisar ordered companies producing tea whiteners to state on the packaging that their product is not a substitute for milk.

A similar case was also heard in the Lahore registry of the SC on January 8. There, too, Justice Nisar had prohibited dairy farmers from injecting hormones in cows and buffaloes to increase milk production.

Seasonal influenza claims three more lives in Multan

Multan: Another three patients of seasonal influenza have passed away, raising the influenza death toll in Multan to 37.

According to details, 40-year-old Nasir, 45-year-old Amir and 50-year-old Dolat Bibi have lost their lives during the treatment in Nishtar Hospital.

The increasing patients of influenza have been creating panic amongst the citizens of Multan. This is an alarming situation for Nishtar Hospital as the influenza virus is rapidly spreading across the Southern Punjab region.

119 patients were admitted to Nishtar Hospital that was looking after people carrying the influenza virus.

Doctors advised people to take precautionary measures to keep their lives safe and also referred them to visit doctors for the identification of virus.

The ruling party of Punjab, the Pakistan Muslim League (N) had earlier submitted a resolution in the Punjab Assembly against the increasing patients of influenza virus.

The resolution notified that the virus is spreading to other cities from Multan.

Dry milk samples found tainted with high levels of lead

KARACHI: Samples of unbranded powdered milk recently analysed by a Karachi University (KU) team have been found to be contaminated with high concentration of lead.

According to experts, chronic exposure or short-term overexposure to lead carries serious health risks, especially for children.

The analysis, part of a study, was carried out at KU’s Institute of Environmental Studies (IES) by Prof Moazzam Ali Khan, Dr Aamir Alamgir and Hira Irshad.

Thirty three samples of dry milk were collected from Quaidabad, Nazimabad, Malir, Shah Faisal Colony, Saddar, Orangi, Korangi and Gulistan-i-Jauhar.

Often used in bakery items and teas, unbranded dry milk available at low rates all over the city is also considered a nutritional source for children by poor mothers.

The analysis showed that lead concentration ranged from 0.58ppm to 4.52ppm with mean concentration of 2.412ppm; the maximum allowable limits set by the Food and Agriculture Organization (FAO) and World Health Organization (WHO) for lead in food products is 0.1ppm.

“Lead was found in high concentrations in all samples, though few other metals were also detected. It indicates that the milk is contaminated, carrying serious health risks especially for children,” Dr Alamgir, an assistant professor at IES said, adding that the highest concentration of lead was detected in samples collected from Quaid­abad (4.52ppm).

In the samples collected, concentration of chromium and iron ranged from 0.023ppm to 0.65ppm (mean value 0.184ppm) and 0.58ppm to 4.12ppm (mean concentration 1.959ppm) respectively. Cadmium was present only in six samples with mean concentration of 0.007ppm while arsenic was found only in four samples with average concentration of 0.003ppm. The concentration of nickel was below detectable limits in all samples.

According to FAO and WHO, maximum allowable limit in food products for nickel is 0.2ppm, 0.1ppm for arsenic, and 2ppm-5ppm for iron. There are no guidelines available for chromium in food.

On the source of contamination, Dr Alamgir explained that processes like heat treatment, homogenisation, vacuum evaporation, seeding and packaging were carried out during preparation (of dry milk) and metal contamination could occur at any of these stages, if substandard material was used or might be derived from contaminated raw milk.

It was also possible that the dry milk was prepared in unhygienic environment or prepared with chemicals.

“Workers we spoke to during our visits to packing units particularly in Quaidabad, Gol Market in Nazimabad and Jodia Bazaar in Saddar, were not willing to share much information and the environment they worked in was secretive. In fact, there was a security threat at some places as we felt that our movement was being closely watched,” Dr Alamgir recalled.

At one place, however, a worker did reveal that dry milk, either expired or rejected from factories, was also used in preparation as an ingredient. The team couldn’t visit a single dry milk processing unit and found the packaging process being done in small houses in areas like Quaidabad and Malir.

“It didn’t seem possible to visit processing units. However, I can say that contamination could also come through poor fodder and unsafe water used for raising cows and buffaloes, if the milk is indeed prepared with fresh milk.”

According to Dr Alamgir, lack of national guidelines on food products and absence of a monitoring and regulatory system particularly in Sindh have made public health quite vulnerable to disease.

“A lot of work needs to be done on how to regulate and monitor preparation and sale of food products, especially in Sindh. We haven’t seen any related activity here for a long time, though the Punjab government has taken a lot of interest in this serious public health issue,” he said.

According to the WHO, lead is a toxic metal whose widespread use has caused extensive environmental contamination and health problems in many parts of the world.

“It is a cumulative toxicant that affects multiple body systems, including the neurologic, hematologic, gastrointestinal, cardiovascular, and renal systems. “Children are particularly vulnerable to the neurotoxic effects of lead, and even relatively low levels of exposure can cause serious and in some cases irreversible neurological damage,” the WHO website says.

SC orders to seize prohibited injections used for enhancing milk production

KARACHI: The Supreme Court on Sunday ordered the Sindh government to seize the prohibited injections used to increase milk production in cattle from the market during a hearing at Karachi Registry.

A three-member bench of the apex court, headed by Chief Justice Mian Saqib Nisar is in Karachi hearing cases of public importance including sub-standard packaged milk, contaminated water and supply of clean drinking water.

The SC on Saturday had turned down the dairy farmers’ request for suspension of court orders to ban the prohibited injections and warned that the dairy farmers will be sent to prison if they tried to pressurise the administration by creating artificial milk shortage.

CJ Saqib Nisar observed that the dairy farmers will not be given extension even by one day as it is a matter of public health and lives of the girls cannot be jeopardised for saving the dairy farming business. The court observed that injections given to cattle lead to cancers in girls and adults consuming the milk.

The bench thanked the officers for appearing before the court on Sunday.

The CJP directed Secretary Health Dr. Fazlullah Pechuho to seize all the stock of prohibited injections from the market and make a report of ready stock with the help of Federal Investigation Agency (FIA).

The representatives of companies producing packaged milk submitted their replies. They informed the court that milk and tea whiteners are two different products. On this, the CJP issued instructions to mention this clearly on the packaging and in advertisements.

The court appointed a commissioner to carry out laboratory tests of packaged milk brands from the Pakistan Council of Scientific and Industrial Research and directed the commissioner to submit report within 15 days.

MD Karachi Water & Sewerage Board Hashim Raza Zaidi faced the bench’s ire for the water shortage and its failure to control tanker mafia.

Why the city is facing shortage and what are the plans to overcome this, asked CJ Saqib Nisar.

The official informed the court that tankers provide water to slum areas as the KW&SB has no supply lines there.

The CJP observed that water tankers have become a mafia and billions of rupees are minted through this but the court will not let this go on unhindered.

Influenza virus death toll reaches 21 as two more die in Multan

MULTAN: The numbers of H1N1 influenza virus suspects and death tolls have been increasing since December last after two fresh deaths were reported in Multan and Khanewal while numbers of suspects reached to 152 after nine new virus suspects admitted in southern Punjab hospitals, health officials said on Friday.

Those died were under treatment at Nishtar hospitals’ isolation ward.

The numbers of 21 deaths have been reported in southern Punjab hospitals in the last 27 days. 80 suspects were carrying H1N1 positive out of total 152 admitted suspects.

The numbers of admitted suspects reached to 91 from 87 in Multan. The second most vulnerable district is Muzaffargarh where numbers of admitted suspects climbed from 17 to 19 while one suspect died in Khanewal. The Vehari numbers of admitted suspects reached to five from four, Layyah five suspects from four.

Senior physician Dr Sheikh Abdul Khaliq said that prevention from H1N1 is possible by using some precautionary measures.

He said that one of the most important things you can do to avoid getting H1N1 and many other viruses is to wash your hands before eating meals.

Dr Sheikh Abdul Khaliq said that getting enough sleep eight to ten hours each night for school going children through adults can be one of the best things you can do to help boost your immune system.

Make sure you’re getting enough vitamin C. Oranges, orange juice, grapefruit, kiwi, strawberries and other fruits and vegetables are all good natural sources. Keep your kids (and yourself!) home from school or work if you are feeling ill.

Here’s how you can make a delicious hot cup of Kashmiri chai right at home

Kashmir is not only known for its unrivalled natural beauty — snow-covered mountain peaks, blue rivers and rich culture — but also for its mouthwatering traditional food like rogan josh, dum olav, matschgand, goshtaba, modur pulav, aab gosht and many more.

To wash all the lovely food down, the Kashmiris have a special pink-coloured tea called noon chai which has a creamy, buttery and slightly thick consistency but is thin enough to sip gently.

The word noon means salt in Kashmiri and several other Indo-Aryan languages such as Bengali, Rajasthani and Nepali. That’s why one can easily guess that traditional Kashmiri noon chai will be salty. Yes, if tea can be sugarless then why not salty? However, sugar can be added if one prefers their chai sweet.

The popularity of noon chai across the South Asia region can be guaged by the many names it is known by. Noon chai is also served in many parts of Pakistan as Kashmiri chai, often with sugar and nuts at special occasions, weddings, and during the winter months. Kashmiri people in Pakistan also call it sabz chai. It is also served in Afghanistan, where it is known as shor chai. Pink tea and sheer chai are also Kashmiri chais by another name.

The origins of Kashmiri tea are unknown though it most likely emerged in the area — the green tea leaves used to make it are found in abundance in Himalayan regions such as China, Pakistan, Nepal, India and Bhutan.

There is no specific season or time for enjoying a cup of noon tea, though it is associated with cold weather because of its warming ingredients. It is an integral part of Kashmiri tradition and is consumed at least two to three times daily with accompaniments such as kulchas, sheermaal, Kash­miri breads, kandir tchot and baqarkhanis.

Green tea leaves used in the brewing of Kashmiri tea are a powerful antioxidant and come from the camellia sinensis plant. It inhibits formation of blood clots, and wards off chances of stroke and heart attack.

It is believed in Kashmiri folklore that noon chai is refreshing in the heat while in winters it warms you up. Not only is it nutritious, L-theanine, an amino acid component of the tea helps in reduction of stress and anxiety.

“In Ramazan particularly, when the digestive tract is a bit disturbed due to binging after iftar, sipping a cup of Kashmiri tea can help relieve heartburn, bloating and spasmodic pain in the tummy as it contains cardamom and baking soda,” says Shugufta Sheikh, a senior government teacher in Muzaffarabad.

“It is also a great way to wake up in Sehri,” she adds. “Generally, anaemics should avoid Kashmiri tea as it can cause a drop in iron levels because of polyphenolics in the green tea which function as iron chelators [small molecules that bind very tightly to metal ions] and prevent absorption of iron.

Kashmiri tea is energising, increases mental alertness, reduces headaches and upholds fluid levels in the body. Joint pains are also known to disappear to some extent if a pinch of cinnamon is added to the brew. Similarly, the saffron which is added to the tea can lift your spirits on a cold, miserable day.

“Traditionally noon chai, or Kashmiri chai is served saltish but many people prefer sweet tea. I like both,” says Shaista Rehman, a Muzaffarabad-based youth activist. “Usually, our breakfast consists of Kashmiri tea, omelette and traditional baqarkhani. Though there are number of recipes of Kashmiri tea, I like the one which is made of herbs from the forests of the scenic Neelum Valley.”

Kashmiris, living on both sides of the divided state and anywhere in the world equally enjoy its delicate flavour and have at least one cup a day, mostly in the evenings. In Muzaffarabad, the capital city of Azad Jammu and Kashmir, tourists from every nook and corner of the country run around asking for a traditional cup of noon chai, and flock to Madina Market, Main Bazaar and other adjacent areas to enjoy some with a piece of traditional flatbread.

Making a cup of Kashmiri chai is a labour of love but the taste is worth the time and effort. Apparently a cup of homemade-Kashmiri tea contains 115 calories, 9g fat, 35mg cholesterol, 12g carbs, 7g sugars and 9g protein.

Here’s a recipe that makes two cups of noon chai:

Ingredients

4 cups of water (2 cups of cold water)

2 to 3 tsp green tea leaves

Salt and/or sugar (according to your taste)

4 green cardamoms

2 cups milk

A pinch of baking soda or saffron (for the beautiful pink hue)

Crushed dry fruits (almonds and pistachios preferably)

Cream (optional)

Method

Pour two cups water in a pot and make sure that the pot you are using has a broad base. Crush green cardamoms in your hand until seeds come out. Add both the seeds and shell in the water. Add the green tea leaves. Add baking soda or saffron; it will give the pink colour to the tea.

Let the mixture simmer and boil for about 20 minutes until the water is reduced to half. Now add two cups of cold water while it’s boiling and stir the mixture. After adding water, let it simmer for five to 10 minutes. While it simmers, boil the milk in another pot (you can add more cardamoms to milk, if you want). Keep stirring the mixture.

Add the tea mixture to the milk. Then add salt or sugar or both, according to your preference. Keep boiling the tea; the more you boil, the stronger the tea will be. Now finally pour tea in cups, add crushed dry fruits and enjoy a hot cup of noon chai.

Slash antibiotic use in animals to buck resistance in humans: WHO?

The World Health Organization on Tuesday urged farmers to stop using antibiotics in healthy animals to help ensure the drugs remain effective in fighting life-threatening diseases in humans.

Overuse and misuse of antibiotics in animals and humans is contributing to the growing threat of “superbugs”, which become immune to existing drugs and allow minor injuries and common infections to become deadly.

“A lack of effective antibiotics is as serious a security threat as a sudden and deadly disease outbreak,” WHO chief Tedros Adhanom Ghebreyesus said in a statement launching the UN agency’s new recommendations.

“Strong, sustained action across all sectors is vital if we are to turn back the tide of antimicrobial resistance and keep the world safe,” he added.

Millions could die
Action is certainly needed: Researchers estimate that by 2050 some 50 million deaths globally will be attributable to antimicrobial resistance.

A world without functioning antibiotics would be like “going back to the dark ages,” warned Marc Sprenger, who heads WHO’s Antimicrobial Resistance Secretariat.

“People will just die because of (regular) infections,” he told reporters in a phone conference, warning that common procedures like hip replacements would also no longer be possible since the risk of infection would be too great.”

A review of nearly 200 separate studies, commissioned by the WHO and published in The Lancet Tuesday, indicated that cutting antibiotic use in food-producing animals could have a significant impact on the problem.

Restricting antibiotic use in livestock and on fish farms led to a clear reduction in antibiotic-resistant bacteria in those animals, the review showed.

A review of a far smaller number of studies meanwhile suggested “a similar association in the studied human populations, particularly those with direct exposure to food-producing animals,” it said.

Antibiotics have long been routinely used in healthy animals to promote growth and prevent diseases.

In some countries, around 80 percent of the total consumption of medically important antibiotics is used in the animal sector, according to WHO numbers.

This is believed to have contributed to a situation where “some types of bacteria that cause serious infections in humans have already developed resistance to most or all of the available treatments and there are very few promising options in the research pipeline,” WHO said.

The UN health agency is now calling for a complete halt to the use of antibiotics for growth promotion, and also for disease prevention, except in cases where disease has been detected in other animals in the same flock, herd or fish population.

And it said it “strongly recommends an overall reduction in the use of all classes of medically important antibiotics in food-producing animals.”

WHO categorises antibiotics currently used in humans and animals according to their importance to human medicine.

It said animals should be treated with the drug listed as “least important” to human health, and not with those classified as “highest priority” or “critically important”, which are often the last resort or only option for treating serious bacterial infections in humans.

WHO stressed that there were numerous options to using antibiotics for disease prevention in animals, including improving hygiene and better use of vaccination.

Smog in Lahore crosses global benchmarks

LAHORE: Smog in the provincial capital has crossed all the international benchmarks as PM2.5 level, which is termed the most dangerous pollutant in the air across the world, remained between 450ug/m3 and 500ug/m3 against the notified standards of 35ug/m3 per day.

As per World Health Organisation (WHO) standards, the daily average level of PM2.5 should not be more than 10ug/m3 and aggregated annual mean 25ug/m3 in a day whereas as per a gazette notification of the Punjab government, the daily limit of PM2.5 is 15ug/m3 and aggregated annual mean 35ug/m3 per day.

It is pertinent to mention that Environmental Protection Department (EPD) is concealing data about air quality and pollutants present in it whereas the above-mentioned scary data was revealed by air monitoring laboratories established by private sector.

As per Section 6 (O) of Punjab Environmental Protection Act, 1997, the department is bound to “provide information and guidance to the public about environmental matters,” but for the past several years EPD had not released any kind of data about different kinds of pollution, especially air quality, in the provincial metropolis as well as rest of the Punjab.

Around 2004-05, EPD had installed digital screens at various points of the city where levels of air pollutants were displayed while data about air pollutants was also released to media on a daily basis but after sometime they suddenly removed those digital screens and stopped issuance of data to media. Since then, data about pollution was kept in lock and key and no one was allowed to share it with anyone.

According to Section 6 (d) of Punjab Environmental Protection Act, 1997, the department should have published Punjab Environment Report on an annual basis to describe the state of the environment but ironically this report was not issued in the year 2016 as well as no homework has so far been done to issue this report in the present year.

Abid Omar, founder of Pakistan Air Quality Initiative, a Karachi-based organisation, said his company has installed two ambient air quality monitors in Lahore, one in the Lahore Cantt near airport and the other one on Upper Mall. “For the past one week, level of PM2.5 in Lahore remained between 450 and 500ug/m3, which is considered to be extraordinary high and needs a state of emergency to handle this situation, “he claimed. Pakistan Air Quality Initiative provides community-driven air quality reports to increase social awareness, he said, adding he himself is monitoring the situation and ambient air quality of Lahore is made public on twitter after every hour with a hash tag of #LahoreSmog for the information of the general public.

Aleem Butt, owner of a private environmental testing laboratory in Lahore, said he had tested the air quality of Lahore on October 31, 2017, and the results were shocking. He said as per the report, the average level of PM2.5 was 211.78ug/m3. He said his testing machine was the same as of EPD but he can’t test ambient air quality on a daily basis because of its high cost. “It is the statutory duty of EPD to test and notify results of ambient air,” he maintained.

As per WHO’s report, 98 percent of cities in low- and middle income countries with more than 100,000 inhabitants do not meet WHO air quality guidelines. As urban air quality declines, the risk of stroke, heart disease, lung cancer, and chronic and acute respiratory diseases, including asthma, increases for the people who live in these polluted cities, the report warned.

Dr Tariq Chishti, a family physician, said air pollution is a major cause of disease and death. He said PM2.5 includes pollutants such as sulfate, nitrate and black carbon that penetrate deep into the lungs and cardiovascular system, posing a greater risk to human health. He said it is crucial for the city and governments to make urban air quality a health and development priority because when air quality improves, health cost from air pollution-related diseases shrinks, worker productivity expands and life expectancy grows. Environmental experts said if such a situation had happened in any developed country, they should have declared a national emergency. Rafy Alam, an environmental expert, said the government needs to take immediate and radical short-term solutions, including closing of schools, banning of all kinds of vehicular movement at points of concentration, closing down smoke-emitting industrial units and educating farmers and garbage disposal companies on hazards of trash burning.

When contacted, Provincial Minister for Environment Zakiya Shahnawaz admitted the fact that EPD lacks on various counts. She, however, didn’t give any data about air pollution to the scribe and asked him to come to her office and then she will see what kind of data she can give.

The scribe repeatedly tried to contact the EPD secretary EPD to get official data about ambient air but he didn’t come online. A detailed SMS regarding the issue was also sent to the secretary but he didn’t reply.