Environment &Mental Health &NGOs &WASH &water Bill Brieger | 21 Aug 2024
Haiti: Addressing lead exposure in a low- or middle-income country, a multipronged approach
Mickelder Kercy (mkercy1) posted this entry on lead exposure in Haiti in the class blog of the course, Social and Behavioral Foundations of Primary Health Care at the Johns Hopkins Bloomberg School of Public Health
Graph Data Source: American Heart Association
Recent studies conducted in Haiti revealed that lead exposure increases the risk of hypertension, a major cardiovascular or non-communicable disease. Among children, lead is responsible for several mental and behavioral disorders. Sources of lead exposure includes contaminated drinking water, paint, and batteries.
Laws have been enacted to regulate the prevention and management of exposure to environmental toxicants. These laws mandate institutions to supply safe water, ministry of health to provide adequate care, and companies to sell and safely dispose of their products without harm to population members. Currently, these overarching laws are not being implemented due to political instability, poor governance at the national and municipality levels, and deteriorating socio-economic conditions nationwide.
Several initiatives have been taken that could address lead exposure in Haiti:
- The Ministry of the Environment (MdE) sought the financial assistance of the Global Environment Facility (GEF) to improve the drinking water system.
- The Global Environment Facility (GEF) has allocated $4.5 million from the Least Developed Countries Fund (LDCF) to the Ministry of the Environment project to help strengthen policies, regulatory bodies, and organizations in support of the management, supply, and access to clean drinking water (SDG 6) in Haiti starting 2023.
- The Presidential Transitional Council (CPT) plans to budget $7,590,221 for waste management in the capital of Haiti.
Current initiatives are promising stirring up among population members the optimistic view that they could signal a departure from decades of inefficiency and ineffectiveness in government affairs. As recommended,
- The Ministry of the Environment (MdE) and Presidential Transitional Council (CPT) should demonstrate accountability, transparency, and proficiency in current projects.
- The Presidential Transitional Council (CPT) should prioritize waste management according to international standards in the triage and disposal of hazardous wastes such as lead-based batteries.
- The Ministry of Public Health and Population (MSPP) should promote lead exposure prevention in businesses and at the population level, and management across all primary health care facilities.
- Sustainable lead exposure mitigation is a necessity. Based on current human capital and financial resources, the MdE and MSPP could potentially seek out-of-country technical assistance from
- The Lead Exposure Elimination Project to inventory lead-based paints and reformulate them into safer products nationwide, and
The Pure Earth to train employees in the Initial Site Screening (ISS) protocol application to update current maps of lead contaminated sites across all 10 departments in Haiti.
Community &Mental Health &Peer Education/Counseling Bill Brieger | 12 Mar 2024
Sudan’s Mental Health Crisis: Community-Led Peer Mental Health Counseling
Sudan’s Mental Health Crisis: Community-Led Peer Mental Health Counseling
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Omnia Hassan has posted about a unique program of peer-led mental health counseling. Read her thoughts below and check them in the class blog of Social and Behavioral Foundations of Primary Health Care. As Sudan faces persistent war and conflict, the focus must turn to Sudanese internally displaced persons (IDPs) who are unable to escape the country, facing increasing incidence rates of several serious mental health burdens.
A successful example of this program in Uganda with Rwandan and Somali refugees with PTSD where the evidence demonstrated that 65% of participants no longer fulfilled the criteria for PTSD. Universities in Sudan, such as Ahfad University of Women, have committed themselves to the education and training of community members to equip them with the knowledge and skills to provide mental health counseling for their peers. The Sudan Ministry of Health (MoH) has lent staff and workers to increase the numbers of those being trained to become lay counselors. Funding is a particular point of discussion, and the United States has frequently sent funds to Sudan for humanitarian assistance. The U.S. Department of State funded a grant for the Ahfad University of Women before as part of the University’s Trauma Training Treatment Center.
The UN Refugee Agency acknowledges the displacement issues brought upon the Sudanese population during the war. They have explicitly commented on the displacement of Darfuris in the western region of Sudan, sharing the interventions they have implemented to mitigate mental health issues, such as promoting social cohesion. With over 10 million people uprooted and 9 million people internally displaced, Sudan’s war fuels the largest displacement crisis in the world. The mental health of these individuals needs to be addressed as they endure the most grueling event of their lives. |
Mental Health &Morbidity Bill Brieger | 16 Sep 2007
Malaria and Mental Health
The Lancet has been running a series on Global Mental Health. In the opening article of the series, “No health without mental health,” Martin Prince and colleagues examine the “interconnectedness” between mental health and malaria, among other conditions. Some of the possible connections between malaria and mental health may include –
- association of P falciparum with self-limiting psychiatric disorders
- psychiatric effects of some malaria treatments
- complication or delay of malaria diagnosis in presence of psychiatric disorders
- association between parasitaemia and anxiety, depression, and total psychological symptoms
- deficits in memory, language and attention
- short term effects of malaria on cognitive function and long term effects on cognitive development
- somatization leading to incorrect self-diagnosis of malaria
The foregoing require further research. Areas that have yet to be researched include the role of mental health on malaria medication adherence and adoption of preventive practices, as well as the general possibility that mental disorders might increase the susceptibility to malaria.
Of particular interest in terms of malaria prevention and care of newborns would be research on the effects of postpartum depression (PPD) on malaria. Research by Minkovitz and colleagues in the US has shown that postpartum depression, which can last 2-4 months, has a serious effect on mothers’ parenting skills. A PPD prevalence of 18.6% of mothers at the primary care level in Nigeria was similar to the nearly 18% reported in the US study.
the Lancet makes the point that Mental Health is a neglected issue. Malaria, too, despite new funding being made available, is still neglected based on the 48 million disability adjusted life years attributed to the disease annually. The interconnectedness between malaria and mental health is another reason to stop the neglect of both.