Here’s another short animation I worked on for Al Jazeera’s medical show ‘The Cure’.
After witnessing a cholera outbreak in what is now Bangladesh in the 1960s, David Nalin helped to develop an oral rehydration therapy which has saved the lives of over 50 million people.
In emergency situations, Nalin noted that the traditional cholera treatment of intravenously hydrating patients was prohibitively slow and expensive.
Instead, Nalin researched oral rehydration and realised that each cholera patient needed to be given the same amount of rehydration fluid as they had lost due to diarrhoea.
By mixing potassium chloride, sodium chloride, sodium bicarbonate and glucose into water and giving each patient as many litres as they were lacking, Nalin and his team demonstrated, for the first time, a 70-80 percent reduction in the amount of intravenous fluid needed to save cholera sufferers.
The simple solution was easy to administer and revolutionised the treatment for diarrhoeal disease.
The prestigious medical journal The Lancet described David Nalin and his team’s findings as “potentially the most important medical advance of this century.” In this animation for The Cure, we mark Nalin’s pioneering work in the world of medicine.
New pharmaceuticals can help combat the deadly disease, but delivering it to the people in need remains an obstacle.
by Arwa Aburawa
As the narrow, hollowed out canoe glides up the River Uele in the Democratic Republic of Congo, Dr Javid Abdelmoneim gestures to the surrounding wilderness and says “sleeping sickness affects people this isolated, people this poor”. And this, in sum, is the challenge facing those attempting to eradicate the deadly disease which leads to serious brain damage, disrupted sleep patterns and eventually death.
A parasitic infection that poses a risk to 70 million people across 36 sub-Saharan African countries, sleeping sickness has been declared a “neglected” tropical disease by the World Health Organisation (WHO). The organisation assigns this classification to various diseases where no significant treatment has been developed for decades. “Why are they neglected?” asks Abdelmoneim. “The cold light of truth is they are neglected because poor people are affected.”
In the case of sleeping sickness, which is also known as human African trypanosomiasis, the last significant medical breakthrough occurred in 1949. That was until Medecins Sans Frontieres (MSF), the international medical aid organisation, funded the Drugs for Neglected Diseases Initiative (DNDI) to help eliminate the infection. In 2009, DNDI delivered a new treatment which combined two drugs, nifurtimox and eflornithine, offering real hope that the parasitic disease would be eliminated as a health problem by 2020. The combined drugs provide an alternative to the previous arsenic-derived medication, melarsoprol. It is estimated that one in 20 patients were killed by the toxic treatment.
This development, however, is only part of the solution – the real challenge is delivering it to the people who need it most. “We don’t have a clue how many are living on the river. They are really, really remote,” explains Marie Cleret from MSF. “It’s not even villages, sometimes it’s just a few people living on the banks of the river.” It’s these people that MSF’s Democratic Republic of Congo (DRC) team are hoping to screen for the disease. Although deadly in the later stages, a person can be infected for months – even years – without displaying any major symptoms. By the time the disease kicks into the second phase, where parasites cross the blood-brain barrier and attack the central nervous system, it is harder to treat.
In Bunia, in north-eastern DRC, MSF’s mobile sleeping sickness teams prepare supplies and co-ordinate their movements which often take them between planes and motorbikes to canoes to reach far flung communities. With more than 85 percent of all reported cases occurring in the former Belgian colony, MSF launched an extensive campaign to screen those living in the most remote communities of the country. In 2012, they screened 60,000 people and treated more than 1,000 for the disease.
The team’s next journey is to Nekpotolia, a fishing village on an island in the middle of the River Uele, as the waterway snakes its way through the north of the DRC. Tables and chairs are loaded onto the canoes – alongside refrigerators keeping medical equipment between 2°C and 8°C.
MSF first visited Nekpotolia around six months ago, and found a sleeping sickness prevalence of 3.57 percent. Anything higher than one percent is considered an epidemic. This time they find another positive case of sleeping sickness. “Jean Pierre’s now got to have a lumbar puncture to stage the disease,” said Abdelmoneim. “We’ve got to get fluid from his spine so we know at what stage the disease is, how severe it is.”
Following the painful procedure – performed without anaesthetic – Jean Pierre is found to be a stage one patient, meaning he can be treated onsite. Another patient in the village of Kayibi wasn’t so lucky. Winston was diagnosed with stage two sleeping sickness and joined the MSF team for the ride back to the town of Dingila to undergo a treatment programme.
In developed cases of sleeping sickness such as Winston’s, the patient receives an intravenous infusion, twice a day, every day for ten days. The infusions, which come in heavy glass bottles, must be administered by a nurse or doctor restricting treatment to only those who have access to a hospital.
The latest development in the treatment of the disease is a drug, fexinidazole, currently being clinically trialed by MSF. The drug comes in tablet form, it’s light, it’s easy to administer and could be another step towards eradicating the disease. Although still in the early stages, if successful, “fexi” could be used to treat both stage one and two patients – which would simplify the treatment regimen. Dr Michel Sambili, an MSF doctor working on the trial, is optimistic. “With fexi, we will resolve above all the logistical headache,” he says. “It will solve lots of problems – especially for the poor population.”
In 1995, the WHO estimated the number of sleeping sickness cases at more than 300,000. Today the number of cases is just 10 percent of that. “When you think about where we were years ago and the situation we have now in the DRC, it’s clear we’ve made lots of progress,” remarks Jeroen Beijnsberger, an MSF coordinator.
“Yes, we still have a lot of work left, in terms of simplification of diagnosis and treatment – and monitoring will always be important – but I think the goal of elimination by 2020 is certainly attainable.”
Here’s a little animation on an unsung medical hero which I worked on for Al Jazeera’s medical show – see below.
It is 1847 and the death rate among pregnant women in the Viennese obstetric clinics where the physician Ignaz Semmelweis works is high. Puerperal fever, which is an infection of the female reproductive organs following childbirth, is a common cause of death and is almost seen as inevitable by medics at the time.
However, a worrying trend in the clinics which Semmelweis supervises in Vienna catches his eye.
After dealing with women so desperate to avoid one clinic that they would rather give birth in the street, Semmelweis decided to look into mortality rates.
He found that the student-run clinic had a much higher mortality rate from puerperal fever than the clinic run by midwives; sometimes three times higher.
Semmelweis came to the conclusion that the students carried something from the mortuary where they carried out autopsies, to the women they later examined. He ordered the students to wash their hands with chlorinated lime solution before every examination. Almost immediately, the mortality rate fell from 18 percent to one percent.
Despite the successful hand-washing policy, Semmelweis could offer no acceptable medical explanation for its effectiveness. The idea that germs exist and cause infections was not developed at the time.
After struggling for years to promote his hand disinfection policies, Semmelweis was admitted to an insane asylum at the age of 47, and he died 14 days later.
In this animation for The Cure, we explore Semmelweis’s ground-breaking contribution to the field of medical hygiene.
I hate to start this blog like so many absentee bloggers but… sorry about the lack of updates! I got myself a new job working on Al Jazeera English’s environmental show called ‘earthrise’ about six months ago now. It’s been manic but seriously good fun so far. It’s a different world to writing but it’s lovely being part of a bigger team and slowly seeing a story idea develop into a 3-page pitch, a full-on budget and then seeing the film shot, cut, edited and finally polished into the final product.
As part of my job, I also work on a medical show called ‘The Cure’ (points for the hat-tip to a great band ) which has been surprisingly good fun. I know more about tropical diseases than my little sister who is a final year medic. Whoop!
Comma Press, a great not-for-profit publisher based in Manchester is looking to take on a paid intern who can translate Arabic. It’s for three months, there’s a decent monthly wage and also some money if you don’t live locally. Really worth checking out!
Please pass on and share with anyone you think might be interested. Here’s the full details:
Arabic Translation Internship Opportunity with Comma Press
This autumn Comma Press is offering a unique three month internship for an Arabic translation graduate, to be based within the publisher’s Manchester office. With the support of CASAW, this will be a paid position and will provide the successful candidate with a unique introduction to the literary publishing industry. The intern will be charged with helping the press set up a permanent Arabic translation imprint, and will cover all aspects of the editorial process: commissioning, acquisition, production, digital production, sales, marketing and editorial. The role will also require a degree of research into creative writing activities across a range of countries, liaising with universities in the Middle East, developing contacts, and building links with authors and readers. Applicants must have a Masters degree, or the equivalent or higher, from a UK HEI, or be enrolled in a PhD programme at a UK HEI, and be able to secure a leave of studies for the period of the internship. Eligibility follows AHRC-PG studentship guidelines. (Applications from on-course MA students will also be considered providing they can get leave of absence from their course for the period of the internship).
The internship will run: 16 Sep – 13 Dec (flexible if necessary). Full time Monthly stipend: £1132 Accommodation allowance if the intern is not based within commuting distance: £750 per month
Essential requirements:
Proficiency in spoken and written Arabic (Standard Modern Arabic).
Copy writing skills in English.
Interest in (and some familiarity with) the literary/publishing scene in the UK.
Excellent project management skills.
Ideal:
Familiarity with at least one Arabic regional dialect (ameya).
Familiarity with the literary and cultural scene in the Arabic world.
For more information about the post email: Ra.Page (AT) commapress.co.uk For a more detail job description see here. To apply email a CV and a letter of introduction to the above address, explaining in less than 500 words why you feel you would be suited to the internship. Deadline for applications: 20th August.
In conjunction with the Centre for the Advanced Study of the Arab World, at Edinburgh University. www.casaw.imes.ed.ac.uk
Here’s a very sneaky peek of my article on the environmental and also human rights implications of throwaway fashion. I wrote the article for Aquila Style Magazine in the wake of the Rana Plaza factory collapse in Bangladesh which left over a 1,000 people (mostly Muslim women) dead. To read the full article, download the online magazine for a couple of dollars here.
Here’s my latest piece for DW. It’s actually a collaboration with another journalist – Vanessa O’Brien who helped with the audio to accompany the online article. Check out the audio piece here: Jordan expands its nuclear plans.
As Jordan works on plans to build its first nuclear plant, protestors are still criticizing the country’s decision to go nuclear in the first place. They say it wastes water and ignores the nation’s renewables potential.
Safa Al Jayoussi, an activist with Greenpeace in Jordan, becomes concerned when she starts to explain why Jordan won’t be able to cope with the country’s impending turn towards nuclear power. She says Jordan is one of the five driest countries in the world and that the new power plans are just going to put the nation under even more pressure.
“Nuclear power plants require large quantities of cooling water, usually from a large river or a large lake,” she told DW. “But, in Jordan, we don’t really have any sources of water.”
She’s also worried about a possible nuclear disaster, similar to what happened at the Fukushima Daiichi plant in March 2011.
“It is proposed that grey water be used from a waste water plant for cooling,” Al Jayoussi explains. “Any shortage in water from that facility, which is likely to happen, will cause a huge problem very much like what we saw in Fukushima.”
Plans taking shape
Back in 2009, Jordan’s newly formed Jordan Atomic Energy Commission (JAEC) declared its plans to build five nuclear reactors for the country. The first would be operational by 2020, they said, and would generate 44 percent of Jordan’s energy mix.
A hot and arid country sandwiched between Israel and Syria, Jordan doesn’t boast substantial oil reserves of its own. In fact, according to government officials, in 2012 the country imported 95 percent of its energy. It’s this dependency that the country hopes to solve with nuclear reactors.
“Right now, we pay around $1.8 billion (1.35 billion euros) a year for the additional electricity Jordan imports,” explains Kamal Araj, Vice Chairman of the JAEC.
Araj argues that nuclear power will bring energy security to Jordan, something that it has struggled with in the past.
“Nuclear runs for 60 years and although there’s a lot of fluctuation in the oil pricing or gas and diesel pricing, for nuclear the price is fixed for a lifetime,” he said, in interview with DW. Araj says that, in his view, renewables aren’t viable as “they only run for 25 to 30 years.”
When the first plant opens, Jordan plans to buy the electricity from the plant’s operator at a fixed unit price, considerably cheaper than the price the state pays now for electricity.
What about solar?
But Safa Al Jayoussi and Basel Burgan from the environmental group, Jordanian Friends of the Environment, both disagree with Araj’s appraisal of renewables. Jordan has 330 days of sunshine a year and is, according to Burgan, the perfect candidate for solar.
“The European Union is hiring out land in North Africa for solar projects,” he said. “So why are we turning to nuclear without exploring the possibilities of using solar? For one, solar has become cheaper.”
Professor Steve Thomas, a nuclear policy expert from the University of Greenwich in London, also questions the argument that renewables aren’t a realistic option for Jordan.
“Although the government have been saying that they aren’t viable, what really isn’t viable is their nuclear plans,” he told DW.
Thomas doubts whether Jordan will be able to get finance for the nuclear project due to the country’s weak credit rating. And, he’s concerned about whether there will be proper design and safety reviews of the plants.
“They don’t have the slightest chance of achieving their 2020 deadline,” he said.
The rising need
In Jordan’s capital, Amman, ceiling fans whirr inside crowded shops, music blares and young men gather on corners talking on their mobile phones. The busy streets here are alive, and the energy bills of the country are growing every year.
Despite a recent parliamentary motion to halt all works on the nuclear reactors and the complaints of activists, the plans for nuclear power in Jordan seem to be forging ahead. The personal involvement of Jordan’s King Abdullah II has no doubt helped dampen any dissent.
Kamal Araj of JAEC says that construction on the first reactor won’t start until 2017 and admits his organization face lots of challenges before then.
“In those four years there will be discussion about contracts, location studies and a work agreement,” Araj said.
“A lot of countries have gone through this and decided not to build. We are not going to cancel. But, we want to make sure that all the conditions are conducive to building a safe and cost-effective nuclear plant before we start,” he said.
My interview with the very lovely Saudi filmmaker Haifaa Al Mansour is now out – see the full article at Aquila. I was lucky enough to meet Haifaa when she was in London promoting her debut film Wadjda about a young Saudi girl’s battle to cycle. See the trailer above. We got talking about the rise of female Middle Eastern filmmakers, the importance of personal victories, filming in Saudi and also cycling (of course!).
Got my copy of Make/Shift magazine through the post recently with my little article in it. My piece is a Q&A with Sarah Irving who talks about the rise and fall of the Palestinian political left and Leila Khaled’s life after the (in)famous hijackings.
I genuinely love flicking through this mag as I always find something which blows my mind. Love.Love.Love. There’s a snippet of my article below but before that, the article (well, edit of lots of articles) that I really loved in this issue was about activism, burnout and caring for ourselves.
“I feel no different when I read posts like these than I did when I was working as a consultant in corporate america and the boss would send me emails on my “sick days” asking if I’d gotten a chance to review those documents, because, you know, above all, we gotta make sure we think of the company…. Last I checked, activists in the non-profit industry were accusing corporations of being greed, exploitative, blood-sucking a**holes who didn’t care about “people”, just “money.” I’m ashamed to say that after years of working with people in the non-profit industry, there’s not that much difference; just replace money with “self-righteous political agendas.”
To be completely honest, when I think about the times when I’ve been at my lowest and most strained, it’s been due to other activist guilt-tripping me into over-extending myself for some agenda I don’t even remember signing up for.
I’m lucky that I’ve been able to find others like myself, who believe just as much in caring for their communities as they do taking care of themselves, not necessarily as interdependent ideologies, but because — dare I say it — it’s possible to want to improve the world and have other interests that are not necessarily connected, including your own dreams, ambitions, peace of mind. God forbid the word “self” ever finds its way into the mouth of an activist. God forbid we actually practice the “self-love” slogans we slap on so many protest signs.”
“i often struggle with copious amounts of shame, frustration and confusion over the fact that right now in my life all i have to give is going towards helping raise 2 children. It can feel deeply unradical, ordinary and anonymous. it is adding exponentially to my already intense isolation. While not my intention, my world has become this house, this home. As someone who is disabled and chronically ill, i am tapped…and this is capitalism at work yeah? its a set up. there is not enough. not enough time/money/energy.
and revolution. well…it’s THE thing.
but heres the thing, the front lines aren’t linear. they aren’t always dramatic. they
aren’t -out-there-. they are everywhere, including the kitchen. including the bedtime story and the hands on love of being present for need.
i’m learning to think less in terms of productivity, esp. since framing life that way will certainly end me, and think more in terms of sustaining… sustenance… support. this flies in the face of my lower class life that screams produce, keep the cards close or die. it challenges the ableism in my working class roots, the internalized high stakes drive to succeed. to avoid being trash. or criminal.”
Here’s another short animation I worked on for Al Jazeera’s medical show ‘The Cure’.
New pharmaceuticals can help combat the deadly disease, but delivering it to the people in need remains an obstacle.
Arwa's Freelance Site 