Health Effects Of Low-Intensity Warfare

For nearly two decades, Ivy Pike, an associate professor of anthropology at the University of Arizona, has been studying ethnic groups in rural northern Kenya to understand how violence shapes the health of those eking out a living there.



The results of her and her colleagues' research," Documenting the health consequences of endemic warfare in three pastoralist communities of northern Kenya: A conceptual framework," is currently published in a special edition of Social Science and Medicine, in collaboration with the British medical journal The Lancet and the Journal of the Danish Medical Association.



These studies also set the stage for Global Response 2010, an international conference on violent conflict and health worldwide. The conference begins Jan. 22 in Copenhagen and is geared for humanitarian workers, physicians, political leaders and academicians working on violence and health.



Pike said their paper offers a "conceptual framework that lays out the importance of methods and approaches to document violence." While considerable research has documented social responses to the ongoing and chronic warfare among groups, there is much less data on how conflict affects community health.



Pike has been studying three nomadic communities - the Pokot, Samburu and Turkana. Like other groups that live in northen Kenya, all are pastoralists, herding cattle, goats, sheep and camels between pasture and water. The region, about the size of Texas, has virtually no infrastructure. Literacy hovers at between 7 and 8 percent.



For hundreds of years, friction between these groups has centered largely on access to scarce grazing and water, and by livestock theft. Persistent drought over the last several years has raised tensions all the more, aggravated further by the introduction of firearms, especially automatic weapons in recent years.



Pike said that households she first studied in the early 1990s that might have had military-issue rifles, by mid-decade all had AK-47s.



"It's easy to treat this violence as cattle rustling, but it's much more complicated, with disparate impacts on people's daily lives and health," Pike said.



"We're documenting nutritional change over time. That's important because families that are nomads are very dependent on their livestock, so any shift in holdings or their animals' access to food and water impacts food security," she said.



While young men are killed or wounded by gunfire in raids, Pike said women and children also bear a considerable load from the violence. "The tendency is to say more young men are dying, but I can't substantiate that at this point. It looks like the fallout for women and children is just as high."



Men generally have better health because they travel with the herds and consequently have better access to meat and milk. Women will sacrifice to feed their children and older women will protect young mothers. All women will forego food when their children are hungry. This makes women an important barometer of health and well-being, especially when their specific group has born the brunt of a violent attack.



Still, there is almost no data on the links between violence and armed conflict to shifts in health. Pike said pursuing this line of research has implications for many of the under-developed and developing regions of the world, especially in sub-Saharan Africa and Asia, where violence has increased dramatically related to displaced populations.



Source: Ivy L. Pike


University of Arizona

Improving The Lives Of Torture Victims From Around The World

The Robert Wood Johnson Foundation (RWJF) has announced its selection of Dr. Uwe Jacobs, clinical and executive director of Survivors International, San Francisco, to receive a Community Health Leaders Award. He is one of 10 extraordinary Americans to receive the RWJF honor for 2009 at a ceremony at the Mayflower Hotel in Washington, D.C.



Jacobs has provided therapeutic care to more than 1,000 individuals who have experienced torture. He is also a leader in efforts to officially recognize and define gender-based violence as torture. "Dr. Jacobs has organized an outstanding interdisciplinary team of individuals from the health professions and the legal profession to help victims of torture to heal and rebuild their lives," said Janice Ford Griffin, national program director for the award. "He is a leader in the effort to expand the legal definition of torture to encompass individuals who have suffered at the hands of non-uniformed actors."



In working with a wide array of people from different nations and backgrounds, and with victims of genocide from around the world, Jacobs realized that a lot of the people who were being persecuted were victims of domestic violence, female genital mutilation, sex trafficking and the threat of honor killings. Seeing the tremendous need, he developed a program to provide services to victims of gender-based violence who seek asylum in the United States. This program has demonstrated that survivors of gender-based violence have levels of trauma that are comparable to those of most torture victims.



"I am deeply honored by this award, and I hope it brings attention to the importance of helping victims of torture to heal," said Jacobs. "I owe a tremendous debt of gratitude to all the lawyers who help these victims obtain asylum so that they can truly begin to rebuild their lives."



Jeffrey S. Kaye, Ph.D., a staff clinician at Survivors International, said that in his opinion, "Dr. Jacobs' greatest contribution - possibly his greatest talent - is his ability to transfer his considerable clinical experience and knowledge to the greater community."



The Community Health Leaders Award honors exceptional men and women from all over the country who overcome significant obstacles to tackle some of the most challenging health and health care problems facing their communities and the nation. The award elevates the work of the leaders by raising awareness of their extraordinary contributions through national visibility, a $125,000 award and networking opportunities. This year the Foundation received 532 nominations from across the United States and selected 10 outstanding individuals who have worked to improve health conditions in their communities with exceptional creativity, courage and commitment.



There are nine other 2009 Community Health Leaders in addition to Jacobs.



Source:
Jennifer Combs


Robert Wood Johnson Foundation Community Health Leaders

Blogs Comment On Emergency Contraception Access, Abortion-Rights Compromises, Other Topics

The following summarizes select women's health-related blog entries.

~ "Walgreens Continues Gender Discrimination at the Pharmacy," Lisa Graybill/Brigitte Amiri, American Civil Liberties Union's "Blog of Rights": Grayball, of ACLU of Texas, and Amiri, of ACLU's Reproductive Freedom Project, write that "local Walgreens in Texas have repeatedly refused to sell contraception to men, despite corporate headquarters policy and federal guidelines to the contrary." In a recent case, Adam Drake tried to purchase emergency contraception at a Walgreens in Houston but was told he could not buy the product because he is a man. Although "no one should face gender discrimination at the pharmacy," the Drake case is "even more troubling" because ACLU "had already asked Walgreens earlier this year to ensure that its stores sell [EC] to men" after similar incidents in Mississippi and Texas, according to the blog. In June, Walgreens responded that it had notified all stores that they must sell EC to men. "Apparently, the Walgreens that Mr. Drake went to did not get that message," Graybill and Amiri write. As a result, ACLU has "asked Walgreens to train its pharmacists and store managers and send secret shoppers to its stores to ensure that corporate policy is followed," they add (Graybill/Amiri, "Blogs of Rights," ACLU, 11/17).

~ "Bullying and Post-Abortion Trauma," Feminists for Choice: Recent widely publicized bullying cases -- especially ones directed toward lesbian, gay, bisexual and transgendered individuals -- have prompted many celebrities to "voic[e] their belief that life will get better for those bullied," the blog states. However, "it only gets better if individuals grow stronger against criticism or if society becomes more accepting of differences," it notes. The blog adds, "Bullying does not magically disappear once one gets older as we would like to believe, as evidenced from antiabortion bullying" by protesters outside abortion clinics. "While there are many [protesters who] just want to inform women of their options, there are also those who outright pressure and scare women seeking abortions" in an attempt to make them "believe they have done something inherently wrong that they should regret." The blog notes, "Ironically, antiabortion advocates use the emotions felt by a woman after an abortion to evidence that abortion indeed is wrong, even if they may cause the negative emotions (not the abortion itself)." The blog questions whether the symptoms of so-called post-abortion syndrome -- which abortion-rights opponents claim exists but is not medically recognized -- are actually the result of bullying. Therefore, "we, as individuals of society, need to consider what causes the emotions felt by a woman after abortion," it argues (Feminists for Choice, 11/17).














~ "Fight for Health Care Reform or Lose It," Amanda Marcotte, RH Reality Check: Republicans gained a significant number of House seats in this month's elections, boosting their hope that "by continuing to make health care reform (PL 111-148) a contentious, news-grabbing issue, they can make people even more wary of it," Marcotte writes. According to Marcotte, overturning the health reform law is "a tactic favored strongly by the anti-choice movement." She writes, "Knowing that most Americans favor reproductive rights, ... anti-choicers instead just kick up a lot of dirt and make themselves so annoying that the general public is open to making concessions in exchange for some relief." Marcotte adds, "Basically, it's bullying," and "[a]s anyone who spent time in middle school can attest, sadly, bullying often works" (Marcotte, RH Reality Check, 11/17).

~ "Center for Reproductive Rights Sues FDA for Limiting Access to Emergency Contraception," Kelly Castagnaro, International Women's Health Coalition's "Akimbo": Castagnaro reports that the Center for Reproductive Rights on Wednesday filed "a motion for contempt against" FDA for "failing to follow a 2009 court order that would make emergency contraception available over the counter for women of all ages." She notes that in 2005, CRR sued FDA "for failing to grant over-the-counter status for [EC], and in 2006, the FDA agreed to make EC available without a prescription -- but only to women 18 and over, and only behind the pharmacy counter." The center "then pursued legal action to ensure that EC would truly be available over the counter for all women, including young women," she continues. FDA made EC available over-the-counter to individuals 17 and older but has not considered making it available to younger youth. CRR President Nancy Northup said, "FDA has had ample time, countless opportunities, and overwhelming scientific evidence put before it to make a decision." She noted that President Obama "promised that his administration would reverse the [George W.] Bush policy of politics trumping science. But when it comes to emergency contraception, it’s a new administration playing the same old games" (Castagnaro, "Akimbo," IWHC, 11/16).

~ "Couple Asks Web: Should We Abort?" Tracy Clark-Flory, Salon's "Broadsheet": A Minnesota couple is using their blog, birthornot, to ask "anonymous Internet strangers to vote on whether or not they abort" their 17-week pregnancy, Clark-Flory writes. "Cleary, this screams 'pro-life' Internet prank," she says. The website is "chock full of ultrasound images and updates on their perfectly healthy" fetus, she continues, adding that the couple "say this is a way for Americans to really make their vote matter." Clark-Flory notes that the couple's "Web trail" suggests they are not serious about aborting, as they have indicated support for social conservative figures like Glenn Beck and President George W. Bush. "If this is indeed a prank -- and either way, it's scary to think of these two procreating -- it's a perfect illustration of just how poorly some anti-choicers understand the pro-choice position," Clark-Flory argues, concluding, "The [pro-choice] belief is that the choice of whether or not to abort should be left up to a woman and her doctor, not to the entire Internet" (Clark-Flory, "Broadsheet," Salon, 11/18).

~ "This Won't Work," Scott Lemieux, American Prospect's "Tapped": Lemieux writes that there were "some good points" in William Saletan's recent Slate columns about finding common ground on abortion. "In the abstract, it might be possible to generate a strong consensus by combining a legal regime of legal, safe, accessible abortions with measures dedicated to reducing unwanted pregnancies," Lemieux writes. However, "in the current American political universe, this deal isn't going to happen," as Republicans have "if anything become more hostile to providing adequate support to poor mothers and expanding access to contraception," he continues. "Any analysis [of] American abortion politics that doesn't recognize that the organized opposition to abortion is not just about protecting fetal life but is bundled up with a whole set of reactionary assumptions about gender and sexuality isn't going to get you very far," Lemieux argues. He notes that Saletan's columns also "consist of arguments for more moral hectoring of women." Lemieux adds that "it's hard to see the causal logic where repeatedly criticizing women who have abortions for reasons Saletan considers inadequate is going to increase support for the legal access to abortion that is a central part of the alleged compromise" (Lemieux, "Tapped," American Prospect, 11/18).

~ "Feminist Health Center Closes After Thirty Years, What Does It Mean For Women?" Amie Newman, RH Reality Check: "Feminist women's health centers may be a dying breed," RH Reality Check Managing Editor Newman writes, adding, "Of the over fifty or so operating over the years, only fourteen remain." She asks, "What makes feminist health centers so vulnerable, and what does Planned Parenthood have to do with it (if anything)?" Newman writes that unlike smaller clinics, Planned Parenthood is able to receive government funding because it has the means to separate public money for family planning services from any funding streams for abortion care. By contrast, "feminist health centers are locally grown, small businesses at heart," and they easily "fall prey to a variety of factors, from increased competition from larger-sized providers to a challenging economic environment," according to Newman. She notes that many feminist clinics continue to accept Medicaid patients, despite low reimbursement rates, meaning that they are "literally giving away thousands of dollars in care each year. That's not sustainable without immense support from the public." Feminist Abortion Network President Anita Kuennen has said the closing of a Cedar River Clinics' branch in Yakima, Wash., this week should serve as a "wake-up call to all who support access to choice and access to health care." Newman concludes that if the "closure is a wake-up call, I think we've hit snooze one too many times" (Newman, RH Reality Check, 11/18).


Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families.


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Breastfeeding More Than Three Months Helps Prevent Obesity In Kids

Breastfeeding longer than three months can cut a child's risk of later becoming overweight or obese by more than 40 percent, if the child was born to an overweight mother diagnosed with diabetes during her pregnancy, according to a study published in the May issue of Diabetes Care.


Researchers in Germany found that the longer a woman breastfed, the less likely her child was to become overweight or obese before the age of 8. The study included 324 children born between 1995-2000 to women with gestational diabetes.


Gestational diabetes refers to a condition that occurs when a woman who has never been diagnosed with diabetes exhibits high blood sugar levels during her pregnancy. This type of diabetes, which affects roughly 4 percent of all pregnant women, goes away after the baby is born but both mother and child are at increased risk for type 2 diabetes later in life.


In the study, more than 37 percent of those children who were never breastfed had become overweight by the age of 8. Of those who were breastfed for up to three months, 32.5 percent became overweight children. But of those who were breastfed longer than three months, only 22 percent became overweight.


The study also found, however, that women who were obese (and whose children were therefore at greater risk for obesity) were less motivated to breastfeed than non-obese women. Obese women were twice as likely to forego breastfeeding their children as women of healthier weights, the researchers noted.


"It's important to find out why these women resist breastfeeding and help them overcome whatever barriers there are," said Dr. Ute Schaefer-Graf, lead researcher on the study. "We know that obesity and overweight contribute to numerous health problems in adults and we are increasingly seeing these problems in children. Since the children of obese parents and, in particular, of women who are diagnosed with gestational diabetes, are at greater risk for gaining excessive amounts of weight as they grow up, breastfeeding becomes more important than ever as a means of getting children started on a path to good health. We strongly anyone diagnosed with gestational diabetes to breastfeed for as many months as possible."


Diabetes Care, published by the American Diabetes Association, is the leading peer-reviewed journal of clinical research into the nation's fifth leading cause of death by disease.


Diabetes is also a leading cause of heart disease and stroke, as well as the leading cause of adult blindness, kidney failure and non-traumatic amputations.


diabetes