Hello, Hello... It's Time to Vaccinate Your Baby

Can technology be harnessed to improve the health of the world’s poor?  The Ministry of Health in India thinks it can improve the country’s dismal child vaccination record by calling mothers on their mobile phones to remind them when vaccinations are due.  As reported by the Wall Street Journal, India’s vaccination rate is low, with only about 72% of babies receiving a full course of the critical DPT vaccine, compared with 95% in neighboring Bangladesh and 83% in Indonesia (WHO estimates). 

The Health Minister himself demonstrated the cell phone system in a meeting with WHO officials, but alas only about 60% of the phone numbers were correct.  So is this the most effective approach to reaching these moms?  Health workers in rural areas are underpaid, overworked and under motivated.  Do they have any incentive to get the data (phone numbers) right?  And will moms maintain their phone lines (usually prepaid phones)?  Will they even answer a call and will the person on the other end be able to speak their language?  Many of these issues will have to be resolved if cell phones are really going to make a difference in child vaccination rates. 

The Wall Street Journal article points out that high level political commitment is necessary to bump up vaccination rates.  India’s five year national vaccine policy is being finalized. How much will it rely on high tech solutions remains to be seen.  Maybe we still need “boots on the ground.”

http://blogs.wsj.com/indiarealtime/2011/08/04/india-turns-to-mobile-phones-in-bid-to-improve-vaccination-rate/?mod=wsj_share_facebook

New Year's Mayhem in Manila Brings Many Casualties

On any New Year's Eve Manila is a battle zone. Explosions, smoke, and gunshots fill the air as the megacity's residents celebrate the new year. The tradition stems from a Chinese belief that loud noises will ward off evil spirits. By mid-night, the smoke is so thick that flights in and out of the city have to be postponed or diverted.

Unfortunately, every year, hundred of revilers are injured by fire crackers, gun shots and burns. This year the New York Times reported that almost 500 people were seriously wounded. Many of the injured are the poor residents of Manila's slums. On any night they may be injured or killed by knives, guns and other lethal weapons. But New Year's Eve is particularly dangerous. This is not to say that the rich are unaffected. Their neighborhoods also descend into mayhem as the New Year comes in.

This year Manila's authorities, ranging from local officials to the President, mounted an unprecedented public health campaign to encourage people to celebrate in a safer way. Grisly posters were displayed ly showing mangled fingers and doctors appeared on TV with their bone saws to warn would be revilers. One politician did a funky dance on TV to demonstrate a safer option to usher in the new year.

Statistics showed that the campaign resorted in reduced causalities, but interviews with health workers in emergency rooms did not seem to bare this out. Expats who have lived through many New Year's Eve sieges are highly skeptical of the public health community's ability to stem the tide. And according to the Wall Street Journal, even the Health Secretary, Enrique On, admitted the campaign had failed.

Mounting an effective public health campaign to reverse deeply ingrained social behaviors is a huge challenge for the public health community. And is it worth it? After all New Year's comes but once and year, and maybe the perceived benefits of this mayhem outweigh the costs. What public health experts do know is that changing such behaviors is a long-term process that will require sustained and innovative approaches on a range of levels.

Here is a link to the NY Times article: http://www.nytimes.com/2012/01/02/world/asia/despite-crackdown-philippines-new-year-is-marred-by-fireworks-injuries.html?ref=world

And here is the link to the Wall Street Journal Article: http://blogs.wsj.com/searealtime/2012/01/02/philippines-tallies-cost-of-firecracker-binge/

Thanks to Paul McCabe for pointing me to these two articles.