This Week's News 25-29 January 2010


Defence battles health problems



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9

Defence battles health problems
PS News, Australia

27/01/2010


New medical services that improve the treatment of wounded servicemen and women in the Australian Defence Force have been announced by the Minister for Defence Personnel, Greg Combet.
Mr Combet said the health and wellbeing of Defence personnel was a top priority for the Government.

“That is why we are putting considerable funding into new and improved Defence health initiatives,” he said


Mr Combet said the initiatives included the ADF Rehabilitation Program, which would receive more than $150 million over 10 years to help ADF members return to service or transition to the care they need.
He said the program achieved an 87 percent return to work rate in 2009, which was above the national average for similar programs.
Mr Combet said the Government had also completed a review of mental health within Defence and had provided a further $83 million to implement its recommendations.
“This includes enhancing the mental health workforce, improving mental health training and expansion of programs to support members who are suffering from post traumatic stress disorder,” he said.
“These funds are also targeted at improving the transition services provided to members.”

Mr Combet said the Government was exploring new health care technologies to support troops in the field, including digital radiology and enhanced surgical capability.


“We will continue to provide our personnel with world class health care, that is why we are also funding a comprehensive e-health system to improve the maintenance of ADF health records,” he said.

10



Prime Minister told to tackle doctor drought
The Australian

27/01/2010


Matthew Franklin, Chief political correspondent
INDEPENDENT federal MP Bob Katter has demanded Kevin Rudd stop talking about health reform and act immediately to ease a shortage of doctors which he says is "killing" his electorate.
Mr Katter, whose northwest Queensland electorate of Kennedy includes some of the most remote communities in the nation, said yesterday that the bush had been starved of doctors for years and the Prime Minister must act.
Mr Katter, whose concerns were backed by the Rural Doctors Association, said he was dismayed that a government-commissioned independent review of the health system conducted last year, which Mr Rudd is using as the basis for a reform plan, had barely considered health workforce issues.
He also said current arrangements discouraged medical graduates from starting their careers in the bush because their service did not count towards qualifying them to receive Medicare provider numbers, allowing them to bill under Medicare when they moved to cities.
"Our problem is absolutely acute," Mr Katter said. "We still have the problem that half of our hospitals are manned by doctors from overseas and many of them have problems with English."
The comments follow Mr Rudd's declaration on Sunday that increases in health spending were unsustainable and he would this year finalise reforms of the health system.
The Prime Minister's pledges come more than two years after he was elected promising major reform, and follow last year's completion of a reform study by his National Health and Hospitals Reform Commission.
Mr Katter said doctor shortages had plagued his electorate for years and a recent count put the total doctors in all of northwestern Queensland at 26 -- 15 of whom trained overseas.
The creation in recent years of medical schools in regional universities, such as the school at Townsville's James Cook University, had eased the situation, but major reforms were required to encourage doctors to work outside cities.
"The critical issue of the provider numbers was not addressed at all by the (NHHRC) report and it is at the heart of our problems," Mr Katter said.
Mr Katter said he was increasingly frustrated with the Prime Minister producing "too much talk and not enough action".
RDA president Nola Maxfield was also critical of the NHHRC report's scant attention to medical workforce shortages.
"They have got to put in place a raft of measures -- more medical school places; positive affirmative action.
"We think $500 million would go a long way to solving the problem."
A spokeswoman for Health Minister Nicola Roxon last night said the NHHRC had considered rural and regional access to health services and that the government had consulted widely on the issue.
Earlier yesterday, Ms Roxon launched a new program offering extra training in emergency medicine to up to 150 city general practitioners in return for them working as regional locums.

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North America

1



California to Set Time Limit to See Doctors
Wall Street Journal

19/01/2010


LOS ANGELES—California is poised to become the first state to set time limits for doctors to see patients, the Department of Managed Health Care said.
Regulations to be announced Wednesday require family practitioners in health maintenance organizations to see patients seeking an appointment within 10 business days. The deadline for specialists is 15 days.

A patient seeking urgent care that does not require prior authorization must see a doctor within 48 hours.

However, doctors can extend the waiting period if they determine it will not harm the patient's health.

The rules, set to take effect in January 2011, "set reasonable expectations about when care should be provided," Department of Managed Health Care Director Cindy Ehnes said.


The regulations follow years of negotiations between state officials, doctors, hospitals, HMOs and consumer and health care activists. A 2002 state law mandated more timely access to medical care but didn't provide specifics.
The rules could be an important change for the 21 million Californians who subscribe to HMO plans, state officials said.
"These regulations ... will not only get people access to care when they need it but will reduce unnecessary use of the emergency room," Anthony Wright, executive director of the consumer group Health Access California, told the Los Angeles Times.
With California facing a shortage of doctors, some physicians said HMOs will only be able to comply with the new deadlines if they hire more medical staff.
"A regulation like this will certainly add another challenge," said Charles Bacchi, executive vice president of the HMO trade group California Association of Health Plans.
Kaiser Permanente, the nation's largest nonprofit HMO, should be able to comply with the new regulations, said Patti Harvey, vice president for quality in Southern California. She declined to estimate potential costs.

Copyright 2010 Associated Press



2

LeTourneau University joins U.T. Tyler nursing program
KLTX, Texas

20/01/2010


By Morgan Chesky - bio | email
TYLER, TX (KLTV) - The nursing shortage is a national problem, but especially here in Texas. Today two East Texas schools took the first steps to solve it.
In a special ceremony today, LeTourneau University and U.T. Tyler became partners in nursing, creating a rare connection by opening facilities and transfer hours between a public and private university.

Students will now be able to earn undergraduate degrees in health sciences and science nursing from LeTourneau and U.T. Tyler in a four and a half year program.


The program features classroom study, online courses, and hands on hospital experience prepping students for their R.N. exam upon graduation.
"The main thing it gives us is more opportunities to get the education, to get the registered nurse credential," says College of LeTourneau Arts and Sciences Dean Amiel Jarstfer, "And to go on to immediate service as a nurse in our hospitals in our clinics in our doctor's offices.

"It's a win win for both universities, I increase my enrollment in nursing, I increase my output to help with the nursing shortage with very highly qualified students," says Dr. Pam Martin with the U.T. Tyler nursing program, "Both universities come out ahead."


Representatives from both schools say the program will not only increase the number of qualified healthcare workers in East Texas, but let nurses take their education and use it to help those in need around the world.

Program entrants will have to transfer after earning the required pre-requisite hours from LeTourneau but will be able to remain in Longview.


The U.T. Tyler-Longview branch will offer the four semester nursing curriculum.

©2009 KLTV. All rights reserved.



3

Recession Proof Jobs
Fox News

25/01/2010


by: Anita Vogel

Blog
With unemployment in double digits it's very easy to get discouraged if you're out of work and looking for a new job. However there are at least a few industries out there that might be considered recession-proof.


According to a recent survey by Forbes magazine, health care is the most solid industry offering careers with job security. Registered nurses topped the list as the number one most recession proof job, in part because there is a nursing shortage across the country
Trang Guzze, a registered nurse at the University of California in Los Angeles told Fox News as long as there are patients and hospitals nurses will always have jobs.
"I feel very lucky actually," Guzzi told Fox News. "I have many friends who have been laid off and they are engineers and lawyers and they are going back to school to get their nursing degree and I'm amazed that wow, I have all this experience and I didn't have to go back to school again."
Also on the list, retail or sales associates, accountants, occupational therapists and financial advisors. Yes, even in this economy, financial advisors are in demand. Economics professors say companies are certainly concerned about their bottom line and they are going to need good financial people to help them weather the economic storms.
"Companies are going to find shortages of bright, smart skilled people, says David Smith, economics chair at Pepperdine University. "Those people are going to valuable to companies over time."
According to the bureau of labor statistics, the health care industry was the leading industry for job gains last year, and that means more than just nurses. Occupational therapists are also in demand as well as many other types of support jobs.
And as the baby boomer generation ages, there will be even more of a need for nurses and other healthcare workers... Which by the way pay well too. Nurses in particular can earn anywhere from 50 to 100 thousand dollars a year depending upon their specialty.

4

A remedy for Mississippi's health blues
Los Angeles Times

25/01/2010


By Bob Drogin
Reporting from Greenwood, Miss. - Dr. Aaron Shirley has devoted his career to serving the rural poor in the Mississippi Delta, but now the 77-year-old pediatrician believes the key to reducing the nation's highest infant mortality rates lies in a surprising place: the Islamic Republic of Iran.
Never mind that America and Iran broke diplomatic relations after militants seized the U.S. Embassy in Tehran in 1979, or that the White House is seeking new United Nations sanctions to punish the regime for its nuclear development program.
In May, Shirley and two colleagues flew to Iran for 10 days to study a low-cost rural healthcare delivery system that, according to the World Health Organization, has helped cut infant deaths by 70% over the last three decades.
In October, four top Iranian doctors, including an official from Iran's Ministry of Health, visited Mississippi for a week. They spoke at a conference in Jackson, the state capital, and toured the Delta.
"Sometimes communication was not easy," Dr. Hossein Malekafzali, a professor in the School of Public Health at Tehran University, recalled in a phone interview. "But they can understand our system and translate it to Mississippi."
Iran and healthcare are politically toxic topics in Washington these days. But Shirley and a colleague are to go to Capitol Hill today to seek funding to open an Iranian-style "health house" in Baptist Town, an impoverished neighborhood on the edge of Greenwood, and in 14 other Delta communities.
"We played black gospel and blues for those Iranians," said Sylvester Hoover, 52, owner of Baptist Town's only business, a one-room grocery, laundromat and barbecue grill. "They were just hugging us they were so excited. They loved it."
Tensions between the United States and Iran dominate daily headlines, but both governments have given quiet support to the little-known initiative in the Delta.
In Tehran, the Foreign and Health ministries approved a memorandum of agreement to authorize collaboration between Shiraz University of Medical Sciences and Shirley's team, which includes Jackson State University.
In Washington, the Treasury Department granted the Mississippians a license to ensure they were not violating sanctions on Iran. The National Institutes of Health also signaled its approval.
A posting on the NIH website notes that the "remarkable success of Iran's health house concept . . . is providing hope and inspiration to officials in the Mississippi Delta."
Iran has 17,000 health houses, essentially rural medical outposts staffed by community health workers. The proposed Mississippi version calls for training nurses' aides in each community, and then sending them door to door to help with basic needs, such as taking blood pressure and improving sanitation. The health workers would refer patients to clinics or hospitals for more advanced care and follow up with home visits.
"The community health workers will know who has diabetes, who has high blood pressure, who is 10 or 12 years old and pregnant," Shirley said. "They will know it because they live in the neighborhood and see them at church or the corner store."
Over the years, the federal government has poured tens of millions of dollars into primary healthcare research and delivery programs in the Delta, but the effect has been limited.
"The system is broken," Shirley said in frustration. "It's time to try something new."
Mississippi ranks at or near the bottom of most healthcare indexes. Obesity is rife among children, and teenage pregnancies, hypertension and diabetes are all too common. The state suffers the nation's worst infant mortality rate -- about 50% higher than the national average -- and the lowest life expectancy.
The uninsured mostly go to hospital emergency rooms for basic care, from colds to toothaches. Better preventive care could ease that traffic and lower costs, so local hospital administrators are receptive to a new system.
"People will be skeptical at first because of Iran," said Paula Lang, chief nursing officer at the 34-bed Patients' Choice Medical Center of Humphreys County in Belzoni, which is slated to get a health house. "But I think they will embrace the concept when they see how it works."
Jennifer Tate Hibbler, payroll administrator at the Greenwood Leflore Hospital, the largest in the area, said health workers could help with problems such as identifying children about to quit school because their families couldn't afford glasses.
"I was a senior in high school before I saw a dentist," she said. "Our community definitely needs this."
Shirley's group is seeking $30 million in federal funds for a three-year pilot project and has lined up support from Rep. Bennie Thompson (D-Miss.), who represents the area. But Thompson said colleagues facing reelection could balk at backing anything tied to Iran.
"It's fine with me," Thompson said. "To be honest, anything that can improve deplorable health conditions in the Delta, I'm going to support. Even ideas that are foreign to a lot of people."
The proposal to emulate Iran came from James Miller, a medical services consultant in Oxford, Miss. He first heard of the Iranian health houses several years ago at a conference in Germany.
"I realized this was a model that worked," Miller said. "Plus the Iranian model seemed most transferable to the Delta situation."
He took the concept to Shirley, who has a much-deserved reputation for challenging the status quo in Mississippi.
Raised in poverty, Shirley became the state's first black pediatrician in 1965. He endured police brutality as a civil rights activist, helped create the state's largest community health center and won a MacArthur "genius" award in 1993. He now heads a nonprofit group that turned a former shopping mall into a medical center for Jackson's poor.
Going to Tehran didn't faze him. "I felt safer in Iran than I felt in Mississippi in the 1960s," he said with a laugh.
An Iranian American professor at Jackson State University, Dr. Mohammad Shahbazi, reached out to Shiraz University of Medical Sciences in southwest Iran. The university agreed to sponsor a visit, and Iranian authorities approved visas for the three Americans.
"When we went, all we received were open arms and 'How can we help you?' " Miller said. "They were just amazed that Americans would come and ask for their help."
The Iranians who were brought to Mississippi got a shocking view of rural American poverty when they arrived in Baptist Town.
The blighted warren of muddy streets, weed-filled lots and about 500 shotgun shacks -- each has three rooms in a line so a shotgun fired through the front door supposedly would exit the back door -- is isolated between two railroads and a bayou.
The all-black community boasts a proud history as a front line in the civil rights struggle and a cradle of the Delta blues. The local cemetery is one of three that claims to be a final resting place for Robert Johnson, the blues legend who died in 1938.
But unemployment is widespread. There is no school, medical clinic nor community center, and many occupied houses look as decrepit as those that are abandoned.
In one, retired cotton worker Erleen Smith, 80, huddled on a folding chair by a space heater as a frigid draft blew through her ill-fitting door on a recent afternoon. She had lit all four burners on the kitchen stove to help fight the cold.
She grabbed a pill for her blood pressure, swigging it down with water from a jelly jar. Old vinyl records hung on the wall as the only decoration. She can't afford a TV, but friends stop by to check in and chat.
Told about the proposed health house, she shrugged.
"I ain't never heard of Iran," she said. "But we could sure use somebody's help."
bob.drogin@latimes.com

Copyright © 2010, The Los Angeles Times



5

As search and rescue winds down, focus turns to rebuilding
Miami Herald

25/01/2010


BY LESLEY CLARK AND JACQUELINE CHARLES, jcharles@MiamiHerald.com
PORT-AU-PRINCE -- Nearly two weeks after Haiti's horrific earthquake, the government and international relief officials focused on rebuilding the ravaged country, while continuing to funnel aid and find shelter for hundreds of thousands of homeless.
A key step in the recovery phase begins Monday, when 20 donor countries from around the world meet in Montreal to find the money and assistance needed to reconstruct the country and its shattered economy. Among those in attendance will be Haitian Prime Minister Jean-Max Bellerive, who left Port-au-Prince Sunday morning.
As part of the rebuilding strategy, the United Nations is hoping to put hundreds of Haitians to work in cleaning up their battered capital and cities affected by the disaster by removing rubble, U.N. Secretary General Ban Ki-moon said in a meeting with former U.S. President-turned U.N. Special Envoy Bill Clinton.
``By creating jobs, by creating work for all these people, this would contribute to revitalize their economy,'' said Ban, who tapped Clinton to help with the Cash-for-Work program.
The Haitian government warns that the amount needed to rebuild could easily triple or multiply as the death toll pushes toward 200,000.
Dr. Ariel Henry, chief of staff at the Haitian Ministry of Health, called the death toll from the quake a ``sensitive issue.''
He said the government has counted some 115,000 deaths as of Friday, but noted that the number is likely higher because some people buried their own relatives.
``We don't have an official death count,'' he said.
On Sunday, Marie-Laurence Jocelyn Lassegue, Haiti Communications Minister, told The Associated Press the death toll topped 150,000 just in the area of Port-au-Prince, with thousands more dead around the country.
Haitian government officials and relief agencies were still struggling to deliver food and water to survivors.
Henry said food distribution has been ``very difficult,'' and that the food hasn't reached everyone, especially in some of the areas hardest hit by the quake south of the capital, but he said he did not believe anyone is at risk of starving.
Also Sunday, Haitian National Police also shot and killed the country's most wanted gang member, Police Chief Mario Andresol said.
Jean Wilson Delesca, a former Haitian SWAT member who allegedly ran a car ring involving Haitians and Dominicans, was killed after he fired on police, Andresol told The Miami Herald.
``Today the Haitian National Police is in the streets,'' Andresol said.
Charles Clermont, tasked with relocating quake victims for the Haitian government, said he toured the cities south of Port-au-Prince struck by the quake and found they are in need of quick assistance because distributions are not reaching many of them.
While the immediate medical needs of those in Haiti remain a concern, health workers are starting to shift to the demands of long-term care.
``For the first 10 days, search and rescue has been the priority, and care for trauma, burns, limbs and internal injuries,'' said Mirta Roses, director of the Pan American Health Organization. ``Now the profile is going to be different, the needs for post-operative care.''
She said there will be a need for another facility for post-acute care patients -- those who need more nursing than medical care.
The country's 48 hospitals are filled to capacity. Two floating hospitals are moored off the coast, and 12 mobile clinics have been set up.
Health organizations are also stepping up efforts to track potential communicable diseases, she said, though no outbreaks have been reported.
Search-and-rescue efforts were winding down over the weekend, with teams scattered about the city at a few locations.
For the two South Florida urban search-and-rescue teams, the mission in Haiti is over. They left Port-au-Prince on Sunday on buses en route to the Dominican Republic, said Capt. Pete Gomez, a spokesman for Florida Task Force 2.
Three search-and-rescue teams, however, will remain on standby ``for at least the next 10 days to respond to calls if there is a credible report that someone may be alive and trapped,'' said Nicholas Reader, spokesman for U.N. Office for the Coordination of Humanitarian Affairs.
Haiti's government has not called the search and rescue over, saying it's waiting for the experts to make that decision.
Haiti and international relief efforts are keeping close tabs on mounting numbers of homeless. More than half a million people do not have shelter in Port-au-Prince. Hundreds of thousands are living in squalor in makeshift settlements.
There are about 20,000 family-sized tents in the country, but about 100,000 are needed to hold about 500,000 people.
Rick Bauer, a shelter expert with Oxfam, the international aid agency, said Sunday that the camps should not be a long-term solution for Haiti's homeless.
``While it's easier to provide water, latrines, food and shelter in an organized camp than in the myriad vacant lots and churchyards where people have taken refuge, we can't lose sight of the need for permanent housing,'' he said in a statement.
Jacqueline Charles and Lesley Clark reported from Haiti. Staff writer Jennifer Lebovich reported from Miami.

6

Job market for nurses tightens in New York state, study says
The Post-Standard, NY

25/01/2010


By James T. Mulder / The Post-Standard
Syracuse, NY -- The nursing job market in New York state, long thought to be recession-proof, is starting to feel the effects of the economic downturn, according to a study.
Job opportunities for newly trained registered nurses are dwindling at a time when nursing schools are churning out more and more RNs, according to The Center for Health Workforce Studies at the University at Albany, which released a report earlier this month.
Central New York nursing schools and hospital officials say RN positions are still relatively plentiful here and they have not seen much evidence yet of a tighter job market. Nursing students graduating this spring, however, may find the job market more competitive than in past years, officials said.
Nursing jobs across the state are less abundant because the credit crunch and declining reimbursement rates have prompted some hospitals to postpone expansions and cut costs, said Jean Moore, the center’s executive director. At the same time, the recession has discouraged some older nurses from retiring and lured some former nurses who quit to work in other fields back into the profession, she said.
The job market for nurses will heat up again as the economy improves, according to Moore. “The nursing shortage is not over by a long shot,” she said. More nurses will be needed as the population ages, she said.
About 9,300 people graduated from RN education programs in New York in 2009, 9 percent more than 2008, according to the study. It was the seventh consecutive year the number of RN grads increased.
In Central New York, 394 people graduated from RN programs in 2009, the same level as 2008. That number is expected to grow to 466 this year, a more than 18 percent increase, according to the study.
Upstate University Hospital in Syracuse employs more than 1,000 RNs. It hired more than 80 last year when the hospital expanded by opening a new East Tower housing a children’s hospital and other patient floors, according to Jodie Purdy, Upstate’s director of nurse recruitment and retention.
Some of the nurses Upstate hired were from New York City and Long Island, areas Upstate does not usually draw from. “They couldn’t get jobs in their area,” Purdy said.
She expects the job market in the Syracuse area to be a little tighter for nurses graduating this spring. “They are going to have to work a little harder and it’s going to be more competitive,” Purdy said. “We may not be able to accommodate every single one of them like we used to.”
Graduates of the nursing school at St. Joseph’s Hospital Health Center in Syracuse have not had trouble finding jobs, said Marianne Markowitz, the school’s dean. St. Joe’s has not turned down any graduates who want to work at the hospital, she said.
St. Joe’s received more than 800 applications to its nursing school last year, a record high. It accepted 100.
Once the economy improves, Markowitz expects many older nurses who deferred retirement because of the recession to leave. “That’s why we have to keep the pipeline filled,” she said.
Hospitals and nursing homes are under increasing pressure to cut costs, according to Tom Dennison, a Syracuse University professor and health care expert. That’s because of proposed cuts in state reimbursement and anticipated reductions in Medicare spending.
“That means you have to find a way to do things less expensively,” Dennison said. “Nurses are expensive.”
Moore of the Center for Health Workforce Studies said she’s worried the temporary tightening of the job market will lead to declines in nursing school enrollments.
That will make it difficult to meet projected increases in demand for nurses as the elderly population increases, older nurses retire and more Americans get access to medical care as a result of health care reform, according to Moore.
“It could create long-term problems down the road if the word on the street is, ‘Don’t go into nursing.’”

Contact James T. Mulder at 470-2245 or jmulder@syracuse.com.



7

Report: Retirements could thin ranks of nursing assistants
La Crosse Tribune, Wisconsin

23/01/2010


By TERRY RINDFLEISCH | trindfleisch@lacrossetribune.com
The La Crosse area could face a shortage in certified nursing assistants after a recent study indicated almost half of those now working here plan to retire in the next five years.
Another 21 percent intend to retire in the next 10 years, according to the La Crosse Medical Health Science Consortium report.
More classes and training programs will be needed to ensure enough new people are available for the entry-level positions, said Joanne Sandvick, project specialist for the La Crosse Medical Health Science Consortium.
Western Technical College already has struggled to meet student demand for CNA training, Sandvick said. Gundersen Lutheran has provided training for its staff and now is certified to train CNAs, she said.
The consortium and the Western Wisconsin Workforce Development Board Inc. sponsored the 7 Rivers Region Healthcare Retirement and Departure Intentions report. Two other regions in Wisconsin - Fox Valley and Southwest - did similar reports.
The 2009 report indicated health care employment was steady in the area, Sandvick said. In the next five years, 15 percent of licensed practice nurses and 13 percent of registered nurses plan to retire.
Overall, 13 percent of health care workers plan to retire in five years and another 16 percent plan to retire in six to 10 years.
"There are no gaping holes in the work force, but nursing employment fluctuates and could pose challenges in rural areas," Sandvick said. "We know the economy is a major factor."
Financial security ranked as the top factor influencing retirement decisions in the report, with the desire to pursue leisure activities second and reaching the appropriate retirement age third.
She said the rural areas weren't as well represented in the report as she hoped. But the survey included 11 hospitals, five clinics and 19 long-term care institutions, mostly in Wisconsin.
Half of employees in medical records plan to retire in 10 years, but fewer will be needed with the transformation to electronic medical records, Sandvick said. About 47 percent of CT, MRI and imaging technicians intended to retire in the next 10 years.
The consortium's Healthcare Workforce Shortages Committee also will look at ways to provide more nursing educators, Sandvick said.

8

G8 agenda: Focus on human welfare
The Toronto Star

26/01/2010


This week, many global leaders and members of the international business community will meet at the World Economic Forum in Davos, Switzerland. There, Canada will set out its plans as president of the G8 and host of the G20 Toronto summit in June. We remain committed to working with our partners to keep our commitments – including fully implementing government stimulus measures and opposing trade protectionism.
The G20 has emerged as the world's premier forum for fiscal and economic cooperation. Its members include developed and developing nations alike. Previously, this responsibility belonged to a club of developed nations, the G8. Going forward I believe the smaller, but still influential, G8 will focus on security concerns and human welfare. It is incumbent upon the leaders of the world's most developed economies to assist those in the most vulnerable positions.
The plight of the people of Haiti concerns us all and the world's response has been uplifting and encouraging. Within hours of the devastating earthquake demolishing the capital, governments around the world mobilized and coordinated a massive relief effort. Soon after, donations began pouring in as people opened their hearts and wallets to help. It serves as a reminder of the innate human kindness we hold toward one another.
Yet, it should not take a natural disaster to turn our attention to the less fortunate. The world's poor have been hit hardest by the global economic downturn and in these difficult times we must address their pressing needs.
Indeed, all too frequently, tragedy strikes those who can least afford it. The lack of the most basic services can lead to dire consequences, especially for the world's most vulnerable populations. Each year, it is estimated that 500,000 women lose their lives during pregnancy or childbirth. Further, an astonishing 9 million children die before their fifth birthday.
This is simply not acceptable. The United Nations had hoped to reduce the number of deaths related to pregnancy by 75 per cent by 2015 as part of its Millennium Development Goals. It now appears this target will go unfulfilled. What makes it worse is that the bulk of the deaths during pregnancy – experts claim as many as 80 per cent – are easily preventable. There is a pressing need for global action on maternal and child health.
As president of the G8 in 2010, Canada will champion a major initiative to improve the health of women and children in the world's poorest regions. Members of the G8 can make a tangible difference in maternal and child health and Canada will be making this the top priority in June. Far too many lives and unexplored futures have already been lost for want of relatively simple health-care solutions.
The solutions are not intrinsically expensive. The cost of clean water, inoculations and better nutrition, as well as the training of health workers to care for women and deliver babies, is within the reach of any country in the G8. Much the same could be said of child mortality. The solutions are similar in nature – better nutrition, immunization – and equally inexpensive in themselves.
As its contribution to this G8 initiative, Canada will look to mobilize G8 governments and non-governmental organizations as well as private foundations. Setting a global agenda for improving maternal and child health is an ambitious plan. But working with other nations and aid agencies on the ground where the need is greatest makes it an achievable goal.
There is other business to be transacted at the G8 as well as informal discussions on security, nuclear proliferation and the environment. But our focus on maternal and child health will be a priority.
As the Haitian emergency demonstrates, our humanity spans borders as developed nations coordinate efforts to help the sick, people lost under rubble and those left hungry by tragedy. Together, we must do so again. As leaders of the most developed economies of the world, we have an obligation to assist those who are most vulnerable to hardship. Canada hopes members of the G8 will rally together on this.

9

Practical nurses staying in HEU
BC Local News, Canada

22/01/2010


By Tom Fletcher - Burnaby NewsLeader
VICTORIA – The B.C. Nurses’ Union has dropped its bid to represent more than 5,000 licensed practical nurses, ending a bitter dispute that divided nurses and sparked a backlash from the B.C. Federation of Labour.
A chronic shortage of registered nurses has made LPNs the fastest growing sector in B.C. health care, as health authorities expand their role to include emergency, operating room and other duties traditionally restricted to RNs. The BCNU, which represents RNs, began signing up LPNs last year to switch from the Hospital Employees’ Union, and by the end of 2009 it had collected about 3,000 memberships.
The BCNU announced Monday it has withdrawn its application to the Labour Relations Board for a formal vote. In a brief statement on its website, the union said updated employer figures show the number of LPNs has grown to the point where the BCNU may not have the majority support it needs.
HEU president Judy Darcy had been urging LPNs to reject the overtures of the BCNU, arguing that registered nurses fought for years to keep LPNs from expanding their duties. The HEU has negotiated larger pay increases for LPNs than those given to health care support staff who make up the majority of the HEU membership.
tfletcher@blackpress.ca

10

Screening in the blood system (Letter)
Globe and Mail, Canada

20/01/2010


Linda Haslam-Stroud

André Picard's column about Quebec's no-fault insurance for those who suffer harm from blood transfusions or other tainted-blood-related errors is a timely reminder of how much harm and human suffering can and has resulted from the Canadian blood system (Let's Take The Cue From Quebec On Patient Safety - Jan. 14).

What is alarming is that Canadian Blood Services plans to eliminate the stringent blood donor screening process currently performed by registered nurses. The Krever commission's recommendations following the tainted-blood scandal emphasized the importance of safety in blood donor screening. Yet, Canadian Blood Services (CBS) is seeking to eliminate RNs from its clinics' screening process and replace them with unregulated workers.
CBS says the nursing shortage is the reason for the change. I suspect cost cutting is the reason - but it's a false economy. RNs have the knowledge, education and experience to identify potential donors with health issues and they often recognize these conditions even before a donor has a diagnosis. Eliminating RNs from donor screening will result in a much less stringent process.
President, Ontario Nurses' Association

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Europe

1



UWE midwife supports expectant mothers in Sierra Leone
HealthCanal, UK

19/01/2010


A career in midwifery can take you in many different directions, as discovered by University of the West of England graduate, Zoe Vowles who has recently embarked on an inspirational year long sabbatical from January 2010 to train and support maternity health workers and midwives in Sierra Leone, West Africa.

Sierra Leone has the highest maternal mortality rate in the world. In this very poor country, the cultural preference is for the majority of expectant mothers to give birth at home. In villages without access to treatment from midwives and facing long distances on bad roads to get to hospital, conditions that can easily be treated in the UK often result in devastating consequences for women in Sierra Leone.


Zoe is being sponsored through the Vodafone World of Difference programme to work for the charity, Health Unlimited. She arrived in the Bombali District, Sierra Leone on 6 January 2010 to begin her placement.
Northern Bombali district is a remote area and the last to be disarmed after the civil war which ended in 2002. The area has a very small number of trained midwives and Zoe will work in a community based role providing training and support to carers to strengthen existing teams.
Zoe graduated from UWE in July 2000 and spent a year working in St Michael's Maternity Hospital, Bristol before working in the United Arab Emirates and then moving to London. Zoe really enjoyed her experience at UWE and believes that the placement opportunities she had access to on the course have helped her successful development as a midwife.
Zoe explains, “I had always wanted to become a volunteer with Voluntary Service Overseas (VSO) before I began my midwifery training at UWE. But first I wanted to make sure I had built up enough experience before applying so I could make best use of my skills and training in this environment.
“In 2008 I spent six months as a volunteer with VSO in Makeni, Sierra Leone helping to improve care for mothers in a small community hospital. My experience had many highs and lows, it was heartbreaking to see mothers and babies die unnecessarily because of a lack of knowledge of pregnancy related complications and problems with infrastructure. We only had electricity for a few hours each day and there is a massive problem with mosquitoes and malaria. However, it was so rewarding to see what a difference I could make. I was able to train staff in new areas such as newborn resuscitation and facilitate setting up a much needed new Antenatal Clinic which provided an invaluable service to local women.
“In return, the midwives shared their knowledge with me. I learnt about conditions I'd never encountered back home and developed a greater understanding of Sierra Leone's culture which I was able to put into practice when I returned to London, caring for many women from West Africa.”
Zoe says Bristol is a great city to study in with great links to the healthcare sector. She explains, “We were really fortunate to have been taught by good lecturers with a real cross-section of experience. They've established good clinical partnerships with local hospitals; I got to do placements at both St Michael's and Southmead Hospitals. It was such a confidence booster to get real world experience of different maternity care settings and made it much easier to integrate when I started out as a midwife.
“It's nearly 10 years since I first graduated as a midwife from UWE, I've been fortunate to have worked in a supported environment with good access to high quality training. It's so rewarding to be able to work to improve health for women and children in Sierra Leone, through sharing the knowledge and skills I have had access to at home, with health workers there.”
There are many opportunities to work/volunteer abroad as a midwife, as training in the UK is so highly regarded. Julie Hobbs, Professional Lead (Midwifery) and Lead Midwife for Education said “It's wonderful to hear that Zoe is devoting her experience and skills to such a rewarding cause and that she feels the training and education she received at UWE, helped provide her with the resilience and willingness to travel and provide midwifery care in countries such as Sierra Leone.”
To learn more about Zoe's experience in Sierra Leone, visit http://www.zoevowles.blogspot.com

For more course information see: (BSc Hons) Midwifery



2

US nurse shortage boost for locum supplier
Financial Times, UK

26/01/2010


By Gill Plimmer
Healthcare Locums, the UK's largest supplier of short-term healthcare professionals, is poised to benefit from rising demand for nurses in the US should Congress pass Barack Obama's health reform bill.
More than 1.2m new nurses are needed in the US by 2014 - a shortage that could be exacerbated if a potential 46m people gain access to the healthcare system for the first time.
Kate Bleasdale, founder and vice-chairman of Healthcare Locums, which supplies doctors, social workers and other health professionals, said it was an "exciting opportunity".
"Our investment in international work is bearing fruit; if Obama's reforms go through, growth will increase exponentially and we are ready to take advantage of that," she said.
Recruiters have suffered during the recession as companies have axed staff and stopped hiring. But healthcare has remained a rare bright spot as the ageing population, combined with a shortage of nurses and doctors, has maintained demand for services.
London-based Healthcare Locums has boosted its US staff from three to 20 in the past year and opened offices in Australia, Canada and Abu Dhabi. In November it agreed a training and development deal with the South Korean government.
The recruiter has benefited from the European working time directive, which limits trainee doctors' hours to 48 a week. In the UK, it gained from more stringent requirements for overseas doctors and tougher educational standards for social workers, restricting the supply of skilled staff.
While the National Health Service, its largest customer, may face budget restraints, analysts said the company should stay resilient because it specialises in providing cheaper temporary staff.
In a trading update for the 52 weeks to December 31, Healthcare Locums said it expects to report results in line with expectations at the end of March.
Merchant John East Securities said pre-tax profits should almost double from £18.7m in 2008 to £32m in 2009, and rise to £43m in 2010. The shares, which have risen 112 per cent in the past 12 months, yesterday closed up 1p at 270p.

Copyright The Financial Times Limited 2010



3

Budget Must Provide 'Stimulus Package' For Health - Australian Medical Association
Medical News Today, UK

19/01/2010


AMA Federal Budget Submission 2010-11
AMA President, Dr Andrew Pesce, said today that the May Federal Budget must provide a significant 'stimulus package' for the Australian health system.
Releasing the AMA's Federal Budget Submission, Dr Pesce said the health system is in desperate need of strategic investment across the whole range of programs and services - from primary care to hospitals to mental health and Indigenous health.
Dr Pesce said the AMA has identified the elements of the health system in most urgent need of reform and is offering the Government real solutions to real problems.
"Health should be a priority for the Government in an election year Budget," Dr Pesce said.
"We need to improve productivity in the health system, place a greater focus on people and their health needs, and improve the safety and quality of health care.
"First, there must be funding for the Prime Minister's promise to fix our hospitals, and there must be funding for the reforms necessary to fix other areas of our ailing health system.
"The AMA has identified key sectors that need immediate attention. These include Indigenous health, mental health, general practice, sub-acute care, long term care for people with serious disabilities, medical training, rural and remote health, and e-Health.
"The AMA is calling for the Commonwealth to be the single public funder for public hospitals and the Budget must reflect the processes and funding necessary for this major reform.
"Our proposal involves retaining local governance arrangements for the hospitals.
"The Commonwealth should also be the single public funder for primary care and aged care.
"In our submission, we are also calling on the Government to use the Budget to support GP Practice Nurses, preventative health, Medicare Easyclaim, temporary resident international medical graduates, and pre-vocational and specialist medical training through the new Health Workforce Australia Agency.
"The AMA Budget Submission provides the Government with a plan to fix our hospitals and set the health system up for the current and future growing demand for quality accessible health services.
"Our plan is simple, it is immediate, it is affordable, it is practical, it is common sense - and it should be funded in this year's Budget," Dr Pesce said.
Source

Australian Medical Association



4

Stillborn babies, births in cars... the real cost of midwife
The Sun, UK

21/01/2010


By KATE WIGHTON, NIKKI WATKINS and CHARLOTTE MARTIN
"THE unit was chaotic and short-staffed. I felt I had to shout to be heard. No one seemed to listen to me."

It sounds like a typical hectic Saturday night in A&E.


But the anonymous patient quoted above is actually a new mum describing her short stay on a maternity ward in a top British hospital.
NHS birthing services have received a £330million cash boost over the past five years. This record investment was coupled with the promise of 4,000 new midwives from Department of Health chiefs.
Yet many units still struggle to cope because of severe staff shortages.
"Baby factories" - the nickname for units in large hospitals - have a high turnover of staff and are the least likely to offer one-to-one midwife care.
Only last year Amanda McCall, 18, lost her newborn, Ebony, in an overstretched ward in Milton Keynes General Hospital because of a "scandalous" shortage of midwives.
And a Royal College of Midwives (RCM) poll shows that a third of mothers-to-be who felt anxious during labour were left alone by staff.
In the survey, 3,500 women were questioned by the RCM about the standard of NHS care they received. Many felt that they "weren't listened to" when they raised concerns.
Shortages

Bed shortages pose further problems. Scores of those questioned complained that they were repeatedly turned away from hospital until the last minute because wards were full.


And nearly 4,000 mothers were forced to deliver their babies outside maternity units in 2008, figures obtained under the Freedom of Information Act show.
The UK has one of the world's best records when it comes to safe childbirth. But the RCM has warned that more needs to be done to preserve this.
And it says 5,000 new midwives are needed to replace those due to retire and to cope with a rising birth rate.
RCM general secretary Cathy Warwick says: "One of our biggest challenges is the rising birthrate in the UK. It is much greater than anyone expected.
"Since 2001, the birthrate in England has risen by 19 per cent. The number of full-time midwives rose by eight per cent in the same period.
"Our members are working incredibly hard, but we need more midwives to ensure they don't get overloaded.
Training

"Although we have enough people who want to enter the profession, there simply are not enough training places available.


"Some areas have asked former midwives to come out of retirement to support student midwives.
"Over the past few years midwives have had to do an increasing amount of paperwork. One of the current challenges is ensuring midwives focus on midwifery and not data entry.
"We're worried that the reorganisation of maternity services could lead to big maternity units. Some may have to cope with up to 10,000 births a year.
"Midwives like to stay with a woman throughout her labour - not look after three women at a time. One-to-one care is good for women and good for midwives.
"Some units are achieving this target but at the expense of antenatal and postnatal care. We need enough midwives to help women through all stages of pregnancy, birth and aftercare."
Today, The Sun is backing the RCM's call for one-to-one care to maximise the chance of a safe delivery.

5

Healthcare providers sometimes take part in torture and ill treatment, report alleges
British Medical Journal, UK

21/01/2010


Peter Moszynski

1 London


Healthcare workers in medical facilities, juvenile detention centres, orphanages, drug treatment centres, and other institutions are sometimes forced to withhold care or engage in treatment that intentionally or negligently inflicts severe pain or suffering for no legitimate medical purpose, Human Rights Watch claims.
In its annual World Report for 2010 the group summarises major trends in human rights issues worldwide, and this year has a section documenting healthcare providers’ alleged complicity in torture or in cruel, inhuman, or degrading treatment in countries throughout the world. The cases it highlights include:
· Government physicians conducting forcible anal examinations of men suspected of engaging in homosexual activity in Egypt, and forcible vaginal examinations to assess virginity in Libya and Jordan
· Lay midwives practising female genital mutilation in Iraqi Kurdistan, while government physicians there promote the practice and dispute negative health consequences
· Staff at drug treatment centres in China and Cambodia denying care for drug users in withdrawal and subjecting individuals who depend on drugs to forced labour or exercise instead of providing evidence based treatment
· Physicians in Nicaragua denying women lifesaving abortions, resulting in preventable deaths, and
· Health providers in India withholding pain relief drugs for patients with severe chronic pain.
The report maintains that in each of these cases the healthcare providers’ conduct amounted to cruel, inhuman, or degrading treatment because they "unjustifiably or deliberately caused severe mental or physical suffering."
Joe Amon, health and human rights director at Human Rights Watch, said, "Ethical guidelines and international human rights law expressly condemn health providers’ involvement in torture or ill treatment. Yet providers engage in a wide range of abuses in the name of medical treatment, often because they are following abusive government health policies."
Although there have been calls for medical societies to educate their members about the ethical and legal responsibility of physicians and other healthcare professionals in regard to the detention and interrogation of political detainees and suspected terrorists, Dr Amon said that less attention has been given to the everyday abuse that can occur even in hospital settings.
He said this is especially true of people in socially marginalised groups—such as people infected with HIV, people in sexual and gender minorities, people who use drugs, and people with intellectual disabilities or mental health problems—who may be deemed "deviant," "incompetent," and in need of evaluation or "curative" treatment.
The report says, "It is shocking that forced sterilization is still occurring in countries around the world; drug users are put in ‘treatment’ centres where the ‘treatment’ provided is forced labour or physical abuse; and cheap pain relief medicine is denied to patients suffering severe, chronic pain. Patients in psychiatric institutions are routinely denied their basic rights by medical providers.
"The Hippocratic Oath declares that physicians must treat all patients to the best of their abilities and do them no harm or injustice. Medical societies need to show leadership to empower health providers to act to prevent patients from being tortured or abused and the international human rights community needs to join in these efforts."

Cite this as: BMJ 2010;340:c329


"Abusing Patients: Health Providers’ Complicity in Torture and Cruel, Inhuman or Degrading Treatment" appears in World Report 2010, available at www.hrw.org.

6

Maisons de santé : un rapport prône des rémunérations plus incitatives
AFP

19/01/2010


PARIS — Un rapport remis au gouvernement mardi prône de nouveaux modes de rémunération pour les professionnels de santé intervenant en maisons de santé et un nouveau cadre juridique, pour accélérer la mise en place de ces établissements.
Les maisons de santé regroupent sous le même toit médecins, kinés, infirmiers etc... pour permettre un accès aux soins coordonné dans des zones où on manque de professionnels de santé.
Le rapport remis à la ministre de la Santé Roselyne Bachelot relève en matière de créations de maisons de santé un "foisonnement d?initiatives, difficile à quantifier car ne faisant pas l?objet d?un recensement exhaustif".
Le document évalue toutefois à 160 le nombre de maisons de santé à la fin 2009 et à 25 celui des pôles de santé ayant reçu un financement du fond d?investissement à la qualité et à la coordination des soins.
Si "la montée en charge de nouvelles structures est en voie d'accélération rapide", il existe des "obstacles" à la création de nouveaux établissements, déplorent les auteurs du rapport, dont le sénateur UMP Jean-Marc Juilhard et le professeur Guy Vallancien.
Ces obstacles portent essentiellement "sur une fragilité juridique et financière" qui "oblige les promoteurs-professionnels de santé à des montages complexes, introduit des risques sociaux, fiscaux et de responsabilité professionnelle".
La mission estime aussi que "les modalités classiques de rémunération" des professionnels de santé, basées sur le paiement à l'acte, ne permettent pas de valoriser les missions des professionnels intervenant dans ce type de structures, surtout pour les infirmiers.
Elle prône donc notamment un nouveau cadre juridique "spécifique" et de "nouveaux modes de financement", avec une rémunération "mixte, forfaitaire et à l'activité" pour les professionnels et un "fonds national pérenne" pour les structures elles-mêmes.
Le ministère de la Santé indiquera dans les prochaines semaines de quelles recommandations du rapport il compte s'inspirer, a-t-il indiqué à l'AFP.
Copyright © 2010 AFP. Tous droits réservés

7

HAÏTI : 4 axes prioritaires de prise en charge sanitaire
Santé Log

26/01/2010


C’est un hôpital gonflable que MSF vient de développer à Port-au-Prince, adapté à la chirurgie, aux soins et au traumatisme subi par les Haïtiens qui craignent, après le séisme du 12 janvier, l’effondrement des structures en dur. Les équipes subissent la double pression des besoins médicaux, en chirurgie et en soins post-opératoires. La Pan-américan health organization (PAHO), bureau régional de l’OMS et le Ministère de la santé haïtien travaillent aussi au rétablissement des services de soins primaires.
4 axes de prise en charge sanitaire sont développés par les différentes organisations sur place, chirurgie, soins post-opératoires, soins de santé primaires et soins psychiques.
Interventions chirurgicales : L'hôpital gonflable de MSF a pu être installé et les équipes ont déjà commencé à y mener des interventions chirurgicales et peuvent accueillir quelque 180 personnes dans les unités sous tente. Avec le traumatisme qu'a connu nombre de patients suite à l'effondrement des structures en dur pendant le séisme, la plupart craignent de se trouver à l'intérieur d'un hôpital normal. C'est pourquoi, avec ses murs souples et légers, le nouvel hôpital de campagne leur est particulièrement adapté. « Les patients sont moins nerveux ici », explique l'infirmière Veronica Chesa qui travaille dans cette structure baptisée Hôpital Saint-Louis. « Ils ont moins de mal à s'endormir, et j'ai remarqué une baisse dans les demandes de sédatifs. ». 48 hôpitaux identifiés fonctionnement à Port-au-Prince et 12 hôpitaux de campagne, précise la PAHO mais on manque d’infirmières, de kinésithérapeutes et de chirurgiens orthopédistes.
Assurer les soins post-opératoires : Tandis qu'un grand nombre de personnes ont subi une opération et requièrent désormais des soins post-opératoires, la capacité d'accueil et de prise en charge dans certaines structures de santé devient de plus en plus difficile, précise MSF. Selon le Ministère Haïtien, des milliers d’amputés ont besoin de thérapie physique, de soins en santé mentale et de soutien psychosocial. Dans cet objectif, les organisations MSF, Love a Child et Vida viennent d’aménager un espace pour faciliter un rétablissement postopératoire. Le Brésil vient également d’approuver un projet pour 70 millions d’euros, concernant la mise en place de 10 unités de soins urgents, de 50 unités mobiles pour les soins d’urgence, d’un laboratoire et d’un hôpital, entre autres services de santé.
Rétablir les services de soins primaires : Le Ministère de la santé d’Haïti procède de son côté à une révision de sa stratégie de réponse d’urgence et devrait, selon l’OMS, réorienter ses efforts pour pouvoir augmenter l’offre de soins primaires. Lors d’une conférence de presse commune, la Directrice de l’OPS/OMS, le Dr. Mirta Roses, et le Ministère de la santé haïtien, ont ainsi mis l’accent sur l’importance de rétablir et de renforcer les services de soins primaires de santé et d’installer des réseaux de surveillance en vue de dépister les transmissions. L’OMS, l’UNICEF, la Croix-Rouge américaine et d’autres organismes organisent une surveillance des cas de blessures et de trauma avec vaccination anti-tétanos. Une campagne de vaccination d’urgence contre la rougeole, la rubéole et le DPT est en préparation ainsi que la distribution de suppléments de vitamine A destinés aux enfants de 6 mois à 5 ans.
Prendre en charge les traumatismes psychiques : Les répercussions psychologiques du séisme représentent un immense défi pour tous ceux qui l'ont vécu, explique MSF qui met actuellement en place une équipe de spécialistes pour y faire face dont 18 psychiatres et psychologues soutenant autant les patients que le personnel médical qui travaille dans ce contexte de crise. « La première étape est de fournir des informations psychologiques de base et d'expliquer qu'ils ne sont pas fous en dépit du stress qu'ils ressentent », affirme le docteur German Casas, psychiatre MSF. Son message est simple : « C'est normal d'être nerveux, c'est normal d'avoir peur. La peur a une utilité : elle nous protège. »
Sources : MSF, MINUSTAH, PAHO (Visuel), mise en ligne Yann-Mickaël Dadot, Santé log, le 26 janvier 2010

8

Saint-Gaudens. Centre hospitalier : 34 nouveaux aides-soignants diplômés
La Depêche.fr

19/01/2010


Diplôme d'aide-soignant en poche il n'est guère difficile de trouver du travail. Ce n'est pas Catherine Barnay, la directrice de l'institut de formation des aides-soignants qui dira le contraire. La dernière promotion comptait 34 élèves. Tous ont été reçus, 28 en formation initiale et 6 en formation partielle. Aujourd'hui, 33 d'entre eux exercent comme aide-soignant et tous ont trouvé un emploi dans la région Midi-Pyrénées comme ils le souhaitaient.
«J'AIME LE CONTACT AVEC LES GENS»

C'est le cas de Prema Lim. « Je travaille en cardiologie à l'hôpital. J'ai été très vite intégrée. Dans ce métier, ce qui me plaît c'est le contact avec les personnes. »


Major de la promotion, Fanny Latour ne dit pas autre chose. « J'ai travaillé comme ASH à la maison de retraite Orelia. J'ai eu envie d'accroître mes compétences. Aujourd'hui je travaille en médecine générale. Après l'obtention de ce diplôme d'aide-soignante je vais passer le concours d'infirmière. Pour moi, il s'agit d'un engagement, d'une passion ».
La remise des diplômes a été l'occasion pour Jean-Jacques Lasserre, qui représentait la municipalité de constater : « On parle de l'hôpital 2 014. Si on construit sans moyens humains cela ne sert à rien. » Félicitant les récipiendaires, il a regretté : « On manque cruellement, sur le territoire, d'aides médico psychologique. Cette formation spécifique validée par la plateforme des métiers du Comminges éviterait de devoir se rendre à Toulouse ou à Tarbes. »
On manque, tout autant, d'infirmières. Le centre hospitalier aimerait bien voir s'ouvrir un institut de formation en soins infirmiers. Le directeur du centre hospitalier, Pierre-Yves Gilet précise : « Le conseil régional réfléchit. On espère une telle ouverture. » Ce ne sera pas pour 2010. Mais d'ici la fin de la construction du nouvel hôpital…

9

Benavente quer reunião "urgente" com ministra da saúde
Agência Lusa, Portugal

25/01/2010


O presidente da Câmara de Benavente anunciou hoje ter pedido uma reunião "urgente" à ministra da Saúde, para lhe transmitir a preocupação do concelho face à carência de cuidados primários de saúde, que pode caminhar "para o desastre".
António José Ganhão (CDU) disse à agência Lusa que perante a ausência de resposta a um pedido de audiência enviado, em Novembro, ao presidente da Administração Regional de Saúde de Lisboa e Vale do Tejo, não lhe resta outra saída senão colocar o problema directamente à ministra da Saúde, Ana Jorge.
"Vivemos num concelho com cada vez maior número de habitantes - neste eixo Benavente/Salvaterra de Magos vivem 50.000 pessoas - e não podemos assistir impavidamente à diminuição de cuidados de saúde primários, apesar de conhecermos os esforços para a contratação de médicos para o Serviço de Atendimento Permanente (SAP)", disse o autarca.
Segundo afirmou, as empresas que têm sido contratadas para assegurar o funcionamento do SAP "têm falhado, não funcionam bem", o que está a gerar "muito descontentamento" nas populações.
"Não posso deixar de representar a população e de exigir aquilo a que têm direito. Precisamos encontrar junto da senhora ministra as respostas necessárias", afirmou.
A situação está a gerar o "entupimento" do Hospital de Vila Franca de Xira, cujas instalações assegurou não terem condições nem capacidade para responderem ao acréscimo de procura de situações que nem sequer são urgências.
Na última reunião de Câmara, o autarca admitiu mesmo que a autarquia possa ponderar estabelecer um protocolo com uma cidade cubana, "mas apenas se não tiver outra solução, porque quem governa o país é que tem que tomar decisões adequadas aos problemas".

10

El Defensor del Paciente pide que se investigue de oficio el funcionamiento de los quirófanos del General de Castellón
Europa Press

24/01/2010


CASTELLÓN, 24 Ene. (EUROPA PRESS) -
La asociación el Defensor del Paciente ha remitido una carta al fiscal jefe de Castellón, Javier Carceller, en la que le solicita una investigación de oficio sobre el funcionamiento de los quirófanos de urgencias del Hospital General de Castellón y la "depuración de responsabilidades" de los responsables del Hospital y de la Conselleria de Sanidad.
La entidad presidida por Carmen Flores ha realizado esta petición después de que el pasado viernes el Colegio Oficial de Enfermería de Castellón presentara ante la Fiscalía un informe sobre el "mal funcionamiento", causado por la "falta de personal de Enfermería", en los quirófanos de urgencias del Hospital General.
El Defensor del Paciente solicita que se investigue "la actuación y dejación de funciones que presuntamente está cometiendo la Conselleria de Sanidad al no tomar medidas para que en los quirófanos de urgencias del Hospital General se normalice la asistencia a los pacientes, aumentando la cantidad de enfermeros y personal sanitario en estos servicios".
En el escrito enviado al fiscal jefe de Castellón, la asociación critica que "permanecen dos profesionales desde hace meses trabajando en precario y bajo mínimos y asumiendo, además de una responsabilidad excesiva, una gran carga de trabajo en situación de estrés, con un peligro evidente para los pacientes que son atendidos y que no tienen la obligación de soportar".

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Latin America & Caribbean

1



Hospital Darío Contreras repleto de pacientes; dan de alta a niños
Hoy Digital, Dominican Republic

21/01/2010


Escrito por: ALTAGRACIA ORTIZ G. (a.ortiz@hoy.com.do)
Más de 150 haitianos heridos copan los pasillos y salas del hospital Darío Contreras, mientras las autoridades del centro de salud pedían donativos de material de osteosíntesis (útiles que se usan para traumatizados), sillas de ruedas, clavos y gasas.
El secretario de Salud Pública, doctor Bautista Gómez, valoró el papel que han jugado todos los médicos del sistema para preservar la vida a cientos de haitianos heridos en el terremoto que afectó a ese país el día 12.
Pasillos llenos. Nueva vez el hospital se tornó inmanejable, mientras unos buscaban ayudar o informarse, otros llevaban ayuda y se preocupaban de que hubiera periodistas que captaran sus donativos.
Para facilitar la labor de los médicos, las enfermeras y el personal de socorro, sacerdotes capuchinos alquilaron un local de tres niveles en Los Mina. Allí serán llevados pacientes que fueron dados de alta en los hospitales de Santo Domingo.
El hospital está desbordado de enfermos que son referidos de la frontera y que han sido intervenidos. El personal médico, las enfermeras y los voluntarios trabajan sin cesar.
La misma misión la realizan religiosas de diferentes congregaciones, quienes permanecen en las apretujadas salas del hospital.
Los muertos. Cinco de los haitianos llevados al hospital Darío Contreras han muerto, pero los decesos han ocurrido a la llegada a la emergencia.
Las condiciones en que llegan los heridos son cada vez más críticas, lo mismo que la falta de descanso de los que han sido operados o esperan por una cirugía.
Los pasillos están atestados de pacientes, enfermeras, médicos y voluntarios. El sudor, el calor y el apretamiento de personas hacía difícil el ambiente de trabajo en el centro. Los pacientes ingresados en el Darío Contreras no tienen chance de descansar, razón por la que a medida que mejoren serán trasladados.
Atropello. En medio del protagonismo de algunos sectores que llegan a los hospitales a llevar ayuda para los heridos haitianos que están ingresados en el hospital Darío Contreras, una funcionaria del Despacho de la Primera Dama empujó a la redactora de esta historia.
La funcionaria María lugo vociferó improperios contra la periodista, a quien pretendía impedir el paso al hospital, señalando que los que debían entrar eran los miembros de la delegación del Despacho y los del club Rotario Internacional.
La mujer haló por un brazo y por la chaqueta a la periodista de HOY, cuando ingresaba al edificio, para impedir su ingreso.

2

Faltan especialistas y enfermeras en el IMSSS
La Verdad de Tamaulipas, Mexico

21/01/2010


El Instituto Mexicano del Seguro Social presenta un déficit de cinco mil médicos especialistas y diez mil enfermeras para que se cubra la demanda de los pacientes que acuden a clínicas y hospitales del Seguro Social.
La problemática se viene presentando desde hace varios años en todo el país, debido a que muchos especialistas que capacita el IMSS, se van en busca de mejores oportunidades a clínicas privadas incluso al extranjero mencionó Francisco Crisanto Colunga.

Sin embargo, es una realidad que el IMSS invierte en

la especialización de los médicos para ello invierte grandes sumas de dinero, pero una vez que terminan no se quedan a laborar, como estrategia para evitar la fuga de médicos se está buscando capacitar a los médicos de base con los que ya se cuenta.

El Secretario General del Sindicato Nacional de Trabajadores de Seguro Social, explicó que se está tratando que los médicos de base poderlos capacitar para que se queden en las instalaciones de las unidades de medicina familia y hospitales del IMSS.


“Porque es una realidad que en la recluta de personal médico para las diferentes áreas de la salud, que se hace a través de un examen nacional pasan los mejores y los acapara el Instituto, los prepara y capacita y en muchas ocasiones terminan y se van”.
Para ello los médicos de base son los que se especializarán porque es un verdadero problema que presenta el IMSS por la falta de médicos pero no solo en Tamaulipas sino en todo el País, dijo Crisanto Colunga.

3

Solicitan la contratación de enfermeras para el Hospital Regional Número seis del IMSS
EnLineaDirecta, Mexico

19/01/2010


Liliana Rivera Grimaldo/EnLíneaDIRECTA
Tampico, Tamaulipas.-Por lo menos cien enfermeras se requiere que sean contratadas para laborar en el Hospital Regional número seis del Instituto Mexicano del Seguro Social, ya que en cada piso hay hasta 45 pacientes y resulta difícil atender a todos, y más aún cuando falta alguna, por lo que es necesario que incrementen la plantilla laboral expresó la Secretaria General del Sindicato de trabajadores del IMSS, Rocío Hernández Gómez.
“Como todo, hay deficiencias pero están tratando de llegar a acuerdos, pero creo que si necesitamos aumentar la plantilla laboral,somos un total de 600 enfermeras, a veces son 45 pacientes por piso, o 60, se necesitan unas 100, pero hay 70 eventuales, se trata de equilibrar pero se trata de aumentar la plantilla, porque después no se pueden cubrir ausencias”.
Considero que siempre van a requerir de mas personal, pero se pronunció porque cada vez sean menos, ya que insistió que en periodos vacacionales, o simplemente cuando se reportan enfermas, es cuando se ven apresuradas para atender a cada uno de los pacientes.
Entrevistada en los pasillos del palacio municipal, comentó que acudían a invitar al alcalde Oscar Pérez Inguanzo a la celebración del día de la enfermera, que organizan y que tendrá lugar el próximo viernes 22 de enero.

4

Fundasalud: Sucre tiene un déficit de 300 médicos especialistas
El Tiempo, Venezuela

25/01/2010


Cumaná.- El presidente de la Fundación para la Salud (Fundasalud), Adolfredo Alpino, afirmó que el estado Sucre requiere 300 galenos especialistas en diversas áreas de la medicina para que el sistema asistencial funcione eficientemente.
Alpino señaló que hoy en día sólo 696 doctores laboran en 464 centros de salud pública diseminados en los 15 municipios de la entidad oriental.
“La crisis por falta de médicos no sólo afecta al estado Sucre, es un problema que aqueja a todo el país. Hoy en día el Ministerio del Poder Popular para Salud (Mpps) revisa a fondo posibles acciones para minimizar las carencias de galenos”, comentó.
Las declaraciones de Alpino contrastan con los comentarios emitidos a mediados de 2.009 por Jorge Mantilla, que en el aquel entonces era Ministro de Salud. El funcionario aseguró que el gobierno daría posibilidades para créditos de vivienda o vehículos, pero no aumentaría los sueldos de los médicos.
Realidad local
En Sucre la carencia de personal sanitario se siente con mayor fuerza en el área rural. Aunque Alpino no especificó la cifra de profesionales de la salud que se requieren para cubrir la zona, considera que la oferta salarial actual no es atractiva para los médicos que se requieren en la entidad.
Rafael Peroza, presidente del Colegio de Médicos del estado Sucre, apuntó que “existen ambulatorios de tipo rural que apenas cuentan con dos galenos para atender al público. Hay centros de salud que tienen menos de 40% del personal que requieren. Por ello, los especialistas que allí laboran deben trabajar el doble para atender a los pacientes”.
“La principal carencia que tenemos en la entidad es de médicos cirujanos y anestesiólogos para el área rural. La falta de estos galenos hace que los enfermos se trasladen a los tres hospitales tipo IV de Sucre (Cumaná, Güiria y Carúpano) buscando asistencia.
Alpino relató que en el primer trimestre de 2.010, 80 nuevos galenos graduados de la UDO acudirán a la entidad bajo un convenio firmado en 2009 con esa casa de estudios. Aspira que este contingente sea un paliativo para la situación del área rural”.
Peroza aseguró que la mayoría de los recién graduados de la UDO, prefieren laborar en Anzoátegui, Bolívar y Nueva Esparta.
El Tiempo visitó la Gerencia de Fundasalud para ubicar las nóminas de los centros asistenciales del estado, pero su director, Enrique Guerra, ofreció los datos para mañana.
En cuanto a la red de Centros de Diagnóstico Integral, Alpino destacó que “gracias a la Misión Barrio Adentro”, hoy 213 médicos cubanos trabajan distribuidos a lo largo de 180 consultorios populares del estado.
Agregó que de no ser por los galenos antillanos que laboran en la entidad, “la situación pudiera ser peor”.
El gremialista Peroza recordó que la principal razón del éxodo en Sucre es la deuda que mantiene el ejecutivo regional con el gremio desde 2008.
“Aun no nos han pagado el aumento de salario estipulado en 2008 por el gobierno nacional y tenemos un año que no cobramos el bono de permanencia, de Bs.F 800”.
En tal sentido, Peroza reveló que a principios de febrero el gremio médico celebrará una asamblea para estudiar las medidas de presión que ejercerán, a fin de buscar respuestas por parte del ejecutivo del estado.
Migración

Unos 4.500 médicos han migrado de la profesión asistencial a actividades de tipo informal en Venezuela desde 2007. Así lo reveló Rafael Peroza, presidente del colegió de médicos de Sucre, quien afirmó que la principal razón del éxodo de galenos es el sueldo tan bajo que devengan. El promedio del sueldo nacional es de BsF 1.800 y en contraposición a los 3.500 BsF que perciben en Sucre. “Los sueldos son realmente bajos”.



5

Salario del médico en el país es el más bajo del mundo
El Universal, Venezuela

23/01/2010


Galenos invitaron a marchar en protesta por el deterioro de la calidad de vida
Una crisis severa en los hospitales del país denunció este viernes la Federación Médica Venezolana (FMV), que considera que la salud no ha sido una prioridad para el gobierno de Hugo Chávez sino que ha sido usada para alcanzar rédito político.
Nefasta fue la palabra que empleó Douglas León Natera, presidente del organismo gremial, para describir la actual gestión sanitaria, la cual, aseguró, lejos de contribuir a superar los trances que atraviesa el sector público desde hace 15 años, los ha profundizado.
En este sentido señaló que al déficit de insumos médico-quirúrgicos que padecen los centros públicos de salud desde los años noventa ahora se suman el deterioro de las infraestructuras, la inhabilitación de áreas por el desordenado plan de remodelaciones, y peor aun, el déficit de médicos, enfermeras y personal técnico.
Durante una rueda de prensa realizada en la sede de la FMV, León Natera hizo hincapié en el maltrato que el Gobierno ha dado a los profesionales de la salud, atropellos a los cuales atribuyó la carencia de médicos en los centros públicos de salud que, señaló, se ubica en 50%.
"Sueldos depauperados, difíciles condiciones de trabajo en los centros públicos de salud por inseguridad y la agresividad en el discurso gubernamental", han causado que los galenos tomen la decisión de emigrar a la práctica privada, al comercio informal o a otros países que ofrecen facilidades y una mayor remuneración.
"Un médico gana BsF 1.800 mensuales, cantidad que luego de la devaluación del pasado 8 de enero pasó a ser el salario más bajo del mundo para un galeno en ejercicio", indicó León Natera.
La Federación Médica cuestionó además que la salud venezolana esté dirigida por un grupo de "cubanos que ni son médicos ni son nada (...) el propio Chávez ha dicho que hay 30 mil cooperantes cubanos que ni siquiera están en los módulos, que apenas funcionan en 20%".
El presidente de la Federación Médica subrayó que el balance de los casi once años de gestión de Hugo Chávez es negativo para el país. "Aquí no se ven los 1.000 millones de dólares que ha percibido este gobierno pues, lejos de ser invertidos en el país, han servido para solucionar los problemas de otros países".
En otro orden de ideas, la FMV rechazó la imposición a RCTV de ceñirse a la Ley Resorte, así como "el secuestro del productor agropecuario Franklin Brito en el Hospital Militar".
Por último, el Comité Ejecutivo Ampliado de la Federación Médica Venezolana llamó a marchar hoy 23 de enero para rechazar el deterioro del servicio público de salud y de la calidad de vida, así como el racionamiento de luz y agua, y la devaluación monetaria. Informaron que los galenos se concentrarán en Plaza Venezuela, frente al Seniat.

Vivian Castillo



6

En la glosa del sector salud salió a relucir la falta de insumos y camas
La Jornada Aguascalientes, Mexico

23/01/2010


Influenza humana A/H1N1 otro de los temas de interés de legisladores

El director del Instituto de Salud del Estado de Aguascalientes (ISEA), Gerardo Macías López, durante su comparecencia ante la comisión de Salud del Congreso del Estado, reconoció la saturación que existe en los hospitales de la institución, a excepción del hospital del municipio de Calvillo, ya que actualmente se trabaja por arriba del cien por ciento.


En este sentido manifestó que se está trabajando en la ampliación del número de camas censables en las unidades de segundo nivel de atención. En cuanto al primer nivel de atención el diputado Martín Chávez del Bosque, le inquirió al funcionario sobre las frecuentes quejas que recibe de pobladores de comunidades, sobre el mal servicio que se da en las clínicas, por la falta de personal y medicamentos.
Al respecto Macías López refirió que actualmente se está haciendo una reingeniería administrativa al interior del ISEA, para efectos de eficientar los recursos, y garantizar la calidad del servicio, tanto en la parte del personal como en insumos, asegurando que en cuanto se tenga lista será dada a conocer. Agregó que en noviembre se comenzó la ampliación de 42 centros, apuntó que la obra empezó tarde, debido a que el recurso para tal efecto llegó al ISEA hasta finales del año y señaló que se tiene proyectado que se terminen las remodelaciones en abril próximo.

Durante su derecho de réplica, Chávez del Bosque exhortó al funcionario a realizar un recorrido juntos, de manera aleatoria por alguna de las clínicas de la institución para comprobar el estado en el que operan y las carencias con las que cuenta.


La epidemia de influenza humana A/H1N1, ocupó otro lugar importante durante la glosa del quinto informe de gobierno en materia de salud. El titular del ISEA fue incluso cuestionando por la diputada perredista, Nora Ruvalcaba Gámez, sobre la fidedignidad de la enfermedad, ya que la legisladora, sugirió que fue un ardid, promovido por los medios de comunicación.
Al respecto Macías López, aseguró que fue un problema real de salud, del que poco se sabía en los primeros meses de su aparición. Asimismo se informó a los legisladores sobre el total de enfermos desde el mes de abril a la fecha “mil 707 enfermos, 56 decesos, dos de ellos en 2010- y sobre la dotación de vacunas que ha recibido el estado por parte de la federación -28 mil 370 dosis, distribuidas en tres remesas, 4 mil 770, 9 mil 600 y 14 mil”
Por su parte los legisladores Baudelio Esparza Reyes, Jesús Martínez González y Ruvalcaba Gámez, abordaron cada uno en su participación, los temas de cuidados paliativos y la ley de voluntad anticipada, cuestionando sobre los mecanismos para brindar la atención y aplicar la voluntad de enfermos terminales.

Al respecto, Macías López señaló que anualmente en Aguascalientes 120 personas atraviesan la etapa terminal de alguna enfermedad crónica. Para dar cumplimiento a las leyes recientemente aprobadas, aseguró que se cuenta con un grupo de especialistas en algología, tanatología, psicólogía, para la parte del acompañamiento y médicos de diversas ramas para el otorgamiento de los medicamentos para el alivio del dolor. Además dijo que en breve se dará a conocer un número telefónico que funcionará las 24 horas para asegurar el apoyo emocional de las personas en etapa terminal.


Sobre porque en 2009 no se aplicaron las leyes antes mencionadas, Macías López refirió que se debió a que en el presupuesto del 2008, publicado en el diario oficial, no fue etiquetado recurso para tal efecto, a diferencia del presupuesto del 2010, donde se especificó un monto de 3 millones para cuidados paleativos.

En cuanto a los trasplantes renales realizado en el Hospital Miguel Hidalgo, detalló qe se realizaron 78 durante el 2009, apuntó que no existen metas en cuanto a la realización de trasplantes, aludiendo que esto depende del la disponibilidad de los órganos. En este sentido indicó que hace falta la cultura de la donación de órganos.



7

Sin atención especializada los hospitales
Milenio, Mexico

22/01/2010


La zona norte del estado de Veracruz, municipios de San Luis Potosí y hasta de Hidalgo, durante décadas han tenido una importante dependencia en varios rubros sociales con el sur de Tamaulipas, pero ha sido en materia de salud donde las deficiencias de la infraestructura hospitalaria, ha reforzado esta sujeción, simplemente no cuentan con una atención especializada que en el peor de los casos pueda salvar una vida.
Tan sólo en el Norte de Veracruz hay ubicados nueve hospitales para casi medio centenar de municipios, pero sólo uno es de segundo nivel, aunque según consideran alguna críticas, no cuentan con los aparatos, unidades motrices, ni el personal suficiente para la atención médica, lo cual ha generado desconfianza y críticas en algunos hospitales como casos de Tantoyuca, Pánuco, Tempoal o Naranjos, señalados por actos de negligencia médica.
En la reciente visita del senador panista Juan Bueno Torio a la zona, recalcó la necesidad de buscar alternativas para solventar las necesidades médicas de la ciudadanía, que consideró completamente marginadas para alguna urgencia en materia de salud.
Por su jurisdicción, el distrito 1 no cuenta con un hospital de especialidades y hacer alguna atención médica de índole superior, llevaría un traslado de cuatro horas hasta Poza Rica, lo que deja como única opción acudir a clínicas en la ciudad de Tampico, en el sur de Tamaulipas.
El congresista veracruzano dijo que no se ha buscado incentivar alguna propuesta que reduzca las carencias para esta zona, pese a que hay proyectos no han sido aterrizados y esto representa un serio retraso para la salud de los sectores marginados, y señala que en muchos casos, principalmente de emergencia, ha cobrado vidas.
Para el diputado local del distrito 1, Celestino Rivera el problema es aun mas grave; las inconsistencias parten desde las necesidades más básicas en las clínicas que ya existen, como personal, equipamiento, pero sobre todo la falta de suministro de medicamentos.
Calificó urgente la existencia de doctores calificados, surtido completo de medicinas, aparatos y ambulancias, y recalcó, “recetan pero no dan medicina, y esos son costos elevados para familias marginales, por otro lado, en algunos casos no hay atención en fines de semana, sábados y domingos si te enfermas, te mueres es una realidad lacerante”.
Señaló que para los municipios es incosteable solventar estas necesidades, el recursos es limitado, ante esto, urge la intervención del estado y la federación, por lo cual se debe buscar que sean etiquetados recursos directos a salud que permitan a los municipios dar atención a las familias más necesitadas.

Erik Vargas

8

Aprueban presupuesto para FOSALUD
Diario CoLatino, El Salvador

27/01/2010


Claudia Solórzano, Sonia Escobar

Redacción Diario Co Latino


Los centros asistenciales que dependen del Fondo Solidario para Salud (FOSALUD) ya podrán funcionar sin mayores preocupaciones financieras, ya que los diputados de la Asamblea Legislativa aprobaron con mayoría calificada el Presupuesto para este 2010.
El presupuesto establece 20.9 millones de dólares, financiados por el Fondo General del presente año, los cuales serán utilizados en el pago salarial de 2 mil 395 plazas, divididas entre áreas administrativas, personal de servicio, médicos y técnicos.
Asimismo, se invertirá un millón 804 mil dólares en la compra de medicamentos, más de 526 mil dólares en material instrumental y de laboratorio, y con el resto se pagarán los servicios básicos, arrendamiento de bienes inmuebles, vigilancia y publicidad entre otros.
A parte del millonario monto, los diputados también destinaron otros 150 mil dólares, procedentes de recursos propios, para los gastos financieros e inversiones en activos y fijos.
Francisco Merino, diputado del PCN, dijo que la aprobación del presupuesto era de importancia nacional. “Por primera vez se va a tener un financiamiento garantizado. No vamos a poder decir que no hay dinero”, dijo.
Ante la rápida aprobación, la Ministra de Salud Pública, María Isabel Rodríguez, se mostró satisfecha con el trabajo parlamentario, pues se primó las necesidades de salud de la población.
“Me siento contenta, pues ya podremos hacer varios cambios para beneficio de los más vulnerables”, dijo la titular de Salud mediante una llamada telefónica.
Sin embargo, los diputados dejaron en el tintero la aprobación de la Ley de Vacunas, la cual fue propuesta esta semana, por la Asociación de Infectología y Pediatría de El Salvador.
Según Rodríguez, es necesario que se estudie en profundidad la propuesta de Ley de Vacunas, dado que es la primera que se presenta en el país.
Luego, “hasta nosotros nos podemos acercar a la Asamblea para dar más explicaciones, pero debe ser aprobada porque es necesaria para el actual contexto, y es que todo niño tiene derecho a tener su cuadro de vacunas completo”, señaló la Ministra de Salud.
Hospital Rosales en crisis

Aunque FOSALUD está con más tranquilidad financiera, el Hospital Nacional Rosales vive una situación completamente diferente. Ayer, el Sindicato de Médicos (SIMEHR) denunció falta de presupuesto para suplir necesidades de pacientes.


Para los galenos es necesario que las nuevas autoridades de salud destinen más fondos para dicho hospital, ya que las carencias de equipo, medicamentos, personal, instrumentos quirúrgicos, entre otros insumos, tienen en crisis los servicios que presta dicho nosocomio, uno de los más frecuentados en el país.
“En estos meses, desde que llegó el nuevo gobierno al poder, no hemos percibido mayores cambios. Hay sectores del ala sur del hospital que se dañaron desde los terremotos de 2001 y hasta el momento no se ha hecho nada para repararlas. También hay plazas que en gestiones anteriores fueron otorgadas por complacencia a algunas personas y hasta el momento no han sido investigadas”, denunció Alcides Gómez, secretario general del SIMEHR.
La falta de al menos 50 medicamentos es otro de los señalamientos, sobre todo en áreas como Oncología.
Los médicos también aseguran tener restricciones para la utilización del tomógrafo, ya que únicamente pueden realizar tomografías cerebrales debido a las dificultades para que dicho equipo funcione en análisis de otras partes del cuerpo.
“Otro problema que tenemos es que mucho del instrumental quirúrgico ya pasó de su vida útil y es necesario que sea cambiado para garantizar la seguridad a los pacientes”, afirmó Gómez.
Los miembros del sindicato hacen un llamado a las autoridades de Salud para que provean los insumos necesarios para garantizar las atenciones a los pacientes que como única opción de salud deben acudir al Hospital Nacional Rosales.

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News from WHO and partners

2

Midwifery and Nursing Schools Destroyed by Haiti Earthquake


UNFPA

22/01/2010


PORT-AU-PRINCE — The January 12 earthquake in Haiti didn’t stop at taking lives and crippling people. It also wreaked havoc on the very foundations of the country’s institutions, such as government ministries, hospitals and schools. It has halted, for the time being, the training of much-needed midwives.
Quettely Chevalier, a teacher at Haiti’s only midwifery school, was giving a lecture on obstetric care at the nearby Lumiere University when the earthquake hit. As the rumbling of the quake started, many students panicked and ran for the exit. Chevalier, too, made for the door and escaped unharmed.
The neighbouring nursing school—one of three official nursing schools in the country—was reduced to rubble. When the dust settled, lockers containing hospital gowns peeked through gaping holes in the structure, and the school’s bus was crushed by falling bricks as the walls caved in.
The midwifery school was left standing, but may have structural damage too serious for future use.
At a time when many Haitian health workers have either been killed or are seriously injured and in need of medical care, the recruitment of a new generation of nurses and midwives is all the more urgent.
Whereabouts of teachers and students unknown
The midwifery school had 78 students and turned out about 35 midwives each year—an important and much-needed contribution towards reducing the country’s maternal mortality rate. At 670 deaths per 100,000 live births, it is the highest in the Western hemisphere and one of the highest in the world.
Classes at the midwifery school ended at four o’clock on the day of the earthquake, less than an hour before the disaster struck. By then, students and teachers had scattered, and no one knows where they all are or how they fared. Many of the students had internships at hospitals, and could have lost their lives or been injured there or at the university, where some of them studied.
“We know the director of the school is alive, but we have not been able to communicate with her,” said Chevalier.
Devastation hits all levels of health and women’s affairs
All levels of the health and women’s affairs sectors have been seriously affected. “We lost 90 per cent of our partners in the Ministry of Women’s Affairs when its building collapsed,” said Tania Patriota, UNFPA Representative for Haiti.
It is still too early to start reconstruction efforts. Earthquake victims are still receiving emergency care in and around hospitals and makeshift clinics, rubble is blocking streets and homeless people are sleeping on streets, sidewalks and in parks. The smell of decaying bodies is lingering in the air. However, before too long, Haiti will have to start its long road towards recovery.
“If there is work, I will be there right away,” said Chevalier.
- Trygve Olfarnes

3

Tom Daschle and Nigel Crisp discuss Global Health Care


Aspen Institute

21/01/2010


“It’ll be some time before we can look toward passing something truly comprehensive,” said former Senator Tom Daschle as part of the Institute’s Global Health Roundtable Series on Thursday. In the aftermath of the Democrats’ loss in the special election in Massachusetts, the future of US health care reform was on everybody’s minds. “The fear-mongers in this country won,” Daschle continued, referring to reform opponents’ claims of death panels, government take-overs, and skyrocketing costs. “I think Americans just can’t accept that we aren’t the best,” he said of the health care system. Daschle, who is now advising the administration on health care policy, went on to lambaste the congressional supermajority necessary to passing legislation. Contentious issues requiring a supermajority—from climate change to nuclear proliferation to health care—are “increasingly going to make us less relevant,” he lamented.
Daschle also expressed concern that the public conflates technological progress with excellent health care: “Technology in and of itself is not a good index for quality of care.” It was a point echoed by Lord Nigel Crisp, global health expert, member of the House of Lords in England, and author of Turning the World Upside Down: The Search for Global Health in the 21st Century; Crisp is a proponent of learning from developing nations instead of just bringing science to them. “Western medicine and technology is not what is needed alone,” he said. Crisp pointed to programs that incentivize the poor to get health care (as a pre-condition of benefits or of school enrollment), countries where doctors are trained quickly in specific procedures rather than staying in school for a decade, and communities where health and wellness are valued as a part of everyday life. “It is no surprise,” said Crisp, “that people with so little are so innovative.” He also reminded the audience that global health is not simply a moral duty or a matter of charity. “It is self-interest,” he said, noting that global pandemics have no borders.
Daschle concurred, adding: “There’s an idea that the Third World is irrelevant and dependent,” when in fact developing nations are “relevant and co-dependent.”
Watch the video on Alliance YouTube Channel: http://www.youtube.com/user/ghwavideos#p/c/9E05FB16305D0BF0

4

Update: Emergency surgery and planning for the longer term in Haiti


Merlin, UK

21/01/2010

Merlin’s Haiti medical team has been working tirelessly to meet the overwhelming needs of Haitians.
Our team of 17 specialists, including an orthopaedic surgeon, plastic surgeon, anaesthetist, two A&E consultants and nurses, yesterday treated dozens of patients in need of urgent medical expertise, with more already lined up for today.
Merlin aid worker Alex Cottin says:
“Looking back over the past few days and realising just how much we’ve been able to do – from partnering with local organisations to finding a suitable, secured area to operate in the midst of one of the worst hit areas, to actually saving life after life, I am truly amazed by how much we’ve accomplished.”
As well as performing emergency surgery, our team is treating communicable diseases and respiratory infections.
Our work is currently focused in three areas of acute need in Haiti – Delmas 33, a suburb of Port-au-Prince, and Léogâne and Petit-Goâve, both coastal towns to the west of the capital.
We are operating a surgical unit, triage for screening and referral, setting up mobile medical tents, as well as conducting further assessments to identify unmet needs.
Our longer term plans are to continue working in these three areas to:
•Run a further two month surgical intervention;

•Run 11 static clinics;

•Run three mobile clinics in each area reaching out to people in the surrounding hinterland;

•Continuing to distribute non-food items, including blankets and shelter









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