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Medical/Public health interventions

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Meelaadan waligaa arkin waa iska dacaayadeen kartaa. If only you had seen. Ask Yaabane asagaa arkee.


Waxaaba i soo xasuusisay markaa dalalka kale tago oo dadka qaarkood i weydiiyaan intee ka imaatay, markaa ku jawaabo 'Toronto.' Waa wareey, meel shidan ahaa lasoo boodaan. I can barely imagine their reaction if I instead said Minnesota. Lord. 046.gif

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^^^hedhe..waxba TO hanoo faanin..ilaahey korontodana ha idin daayo..waayo hadey shidnaan laheen wale ma adan meesha sii fadhin laheen...Hokey!


MMA..I wouldn't care less for TO dee..I am a country gal..I would rather set my senses on rural Montana rather than big flashy, action..lights city like such. As long as waxaradeeyda ey meel ii daaqaan helaan..its all good!

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SUPERBUGS...& resistance. This is an increasing problem in western socieities in terms of Antibiotics and/or alternative ways to combat supermutants. Even the House Democrats want's to hear of this "imminent threat".


here are some highlights from CDC :


Deadly bacteria are called carbapenem-resistant Enterobacteriaceae

50% of patients with CRE bloodstream infections die

CDC has detailed a "detect and protect" plan for doctors, hospitals


Here is a link to the article...& the full article.


CDC: 'Nightmare bacteria' spreading

By William Hudson, CNN

updated 11:02 AM EST, Thu March 7, 2013


CDC warns about drug-resistant bug CRE


Deadly bacteria are called carbapenem-resistant Enterobacteriaceae

50% of patients with CRE bloodstream infections die

CDC has detailed a "detect and protect" plan for doctors, hospitals

(CNN) -- Hospitals need to take action against the spread of a deadly, antibiotic-resistant strain of bacteria, says the Centers for Disease Control and Prevention. The bacteria kill up to half of patients who are infected.

The bacteria, called carbapenem-resistant Enterobacteriaceae or CRE, have increased over the past decade and grown resistant to even the most powerful antibiotics, according to the CDC. In the first half of 2012, 200 health care facilities treated patients infected with CRE.

"CRE are nightmare bacteria," CDC director Dr. Tom Frieden said in a statement. "Our strongest antibiotics don't work and patients are left with potentially untreatable infections. Doctors, hospital leaders and public health must work together now to implement CDC's 'detect and protect' strategy and stop these infections from spreading."

That strategy includes making sure proper hand hygiene policies in health care facilities are actually followed.

Patients should also be screened for CREs, according to the CDC. Infected patients should be isolated, or grouped together to limit exposures.

Why 'nightmare bacteria' on the rise

The good news is that not only is CRE seen relatively infrequently in most U.S. facilities, but current surveillance systems haven't been able to find it commonly in otherwise healthy people in the community, says Dr. Alex Kallen, a CDC medical officer.

"Of course, if this were to (spread to the community), it would make it much more difficult to control," he said.

Each year, hospital-acquired infections sicken about 1.7 million and kill 99,000 people in the United States. While up to 50% of patients with CRE bloodstream infections die, similar antibiotic-susceptible bacteria kill about 20% of bloodstream-infected patients.

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Providing surgical care in Somalia: A model of task shifting


PDF document.






Somalia is one of the most political unstable countries in the world. Ongoing insecurity has forced

an inconsistent medical response by the international community, with little data collection. This paper describes

the “remote” model of surgical care by Medecins Sans Frontieres, in Guri-El, Somalia. The challenges of providing

the necessary prerequisites for safe surgery are discussed as well as the successes and limitations of task shifting

in this resource-limited context.



In January 2006, MSF opened a project in Guri-El located between Mogadishu and Galcayo. The

objectives were to reduce mortality due to complications of pregnancy and childbirth and from violent and nonviolent

trauma. At the start of the program, expatriate surgeons and anesthesiologists established safe surgical

practices and performed surgical procedures. After January 2008, expatriates were evacuated due to insecurity and

surgical care has been provided by local Somalian doctors and nurses with periodic supervisory visits from

expatriate staff.



Between October 2006 and December 2009, 2086 operations were performed on 1602 patients. The

majority (1049, 65%) were male and the median age was 22 (interquartile range, 17-30). 1460 (70%) of

interventions were emergent. Trauma accounted for 76% (1585) of all surgical pathology; gunshot wounds

accounted for 89% (584) of violent injuries. Operative mortality (0.5% of all surgical interventions) was not higher

when Somalian staff provided care compared to when expatriate surgeons and anesthesiologists.



The delivery of surgical care in any conflict-settings is difficult, but in situations where international

support is limited, the challenges are more extreme. In this model, task shifting, or the provision of services by less trained cadres, was utilized and peri-operative mortality remained low demonstrating that safe surgical practices can be accomplished even without the presence of fully trained surgeon and anesthesiologists. If security improves in Somalia, on-site training by expatriate surgeons and anesthesiologists will be re-established. Until then, the best way MSF has found to support surgical care in Somalia is continue to support in a “remote” manner.

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HIV prevalence and characteristics of sex work among female sex workers in Hargeisa


AbstractObjective: To measure prevalence of HIV and syphilis and describe characteristics of sex work among female sex workers (FSWs) in Hargeisa, Somaliland, Somalia.


Methods: A cross-sectional survey recruited 237 FSWs using respondent-driven sampling (RDS). A face-to-face, structured interview using handheld-assisted personal interviewing (HAPI) on personal digital assistants (PDAs) was completed and blood collected for serological testing.


Results: FSWs 15–19 years old accounted for 6.9% of the population; 20–24 year-old constituted an additional 18.0%. The majority (86.6%) never attended school. International (59.0%) and interzonal (10.7%) migration was common. Most (95.7%) reported no other source of income; 13.8% had five or more clients in the last 7 days. A minority (38.4%) had heard of STIs, even fewer (6.9%) held no misconceptions about HIV. Only 24% of FSW reported using a condom at last transactional sex, and 4% reported ever been tested for HIV. HIV prevalence was 5.2% and syphilis prevalence was 3.1%.


Conclusion: Sex work in Hargeisa, Somaliland, Somalia, is characterized by high numbers of sexual acts and extremely low knowledge of HIV. This study illustrates the need for targeted HIV prevention interventions focusing on HIV testing, risk-reduction awareness raising, and review of condom availability and distribution mechanisms among FSWs and males engaging with FSWs.

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From diagnosis to health: a cross-cultural interview study with immigrants from Somalia


SOURCE: WILEY online library


Objective:  Being diagnosed as having a chronic disease gives rise to emotions. Beliefs about health are culturally constructed and affect people’s decisions regarding treatment. No studies have been reported that focus on the health beliefs of immigrants of Somalian origin with diabetes and how these people experiences the diagnosis. Therefore the aim of the present study was to investigate how immigrants from Somalia living in Sweden experienced receiving the diagnosis and describe their beliefs about health.


Method:  The sample consisted of 19 adults with diabetes born in Somalia and now living in Sweden who were interviewed with the aid of an interpreter. The interviews were subjected to qualitative content analysis.


Results:  From the analysis of what the participants said about their experiences of the diagnosis there emerged three themes: ‘Existential brooding’, ‘Avoiding the diagnosis’ and ‘Accepting what is fated’. Three themes also emerged from the analysis of what they said about beliefs about health: ‘Health as absence of disease’, ‘Health as general well-being’ and ‘Fated by a higher power’. A major finding was that women when they communicated their experiences regarding the diagnosis and health beliefs made more use of supernatural beliefs than men did. The participants, irrespective of gender, did not immediately respond with shock or other strong emotion when they received the diagnosis.


Conclusions:  The study provides health-care staff with knowledge concerning a minority group’s experiences of being diagnosed as having diabetes and their beliefs about health. The findings indicate that men and women differ in how they experiences the diagnosis and how they described their health beliefs. The quality improvement of health education and nursing for patients with diabetes calls for consideration of the variation of beliefs related to cultural background and gender.

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Health service providers in Somalia: their readiness to provide malaria case-management



Studies have highlighted the inadequacies of the public health sector in sub-Saharan African countries in

providing appropriate malaria case management. The readiness of the public health sector to provide malaria casemanagement

in Somalia, a country where there has been no functioning central government for almost two decades, was



Three districts were purposively sampled in each of the two self-declared states of Puntland and Somaliland

and the south-central region of Somalia, in April-November 2007. A survey and mapping of all public and private health

service providers was undertaken. Information was recorded on services provided, types of anti-malarial drugs used and

stock, numbers and qualifications of staff, sources of financial support and presence of malaria diagnostic services, new

treatment guidelines and job aides for malaria case-management. All settlements were mapped and a semi-quantitative

approach was used to estimate their population size. Distances from settlements to public health services were



Results: There were 45 public health facilities, 227 public health professionals, and 194 private pharmacies for

approximately 0.6 million people in the three districts. The median distance to public health facilities was 6 km. 62.3% of

public health facilities prescribed the nationally recommended anti-malarial drug and 37.7% prescribed chloroquine as

first-line therapy. 66.7% of public facilities did not have in stock the recommended first-line malaria therapy. Diagnosis of

malaria using rapid diagnostic tests (RDT) or microscopy was performed routinely in over 90% of the recommended

public facilities but only 50% of these had RDT in stock at the time of survey. National treatment guidelines were available

in 31.3% of public health facilities recommended by the national strategy. Only 8.8% of the private pharmacies prescribed

artesunate plus sulphadoxine/pyrimethamine, while 53.1% prescribed chloroquine as first-line therapy. 31.4% of private

pharmacies also provided malaria diagnosis using RDT or microscopy.


Geographic access to public health sector is relatively low and there were major shortages of appropriate

guidelines, anti-malarials and diagnostic tests required for appropriate malaria case management. Efforts to strengthen

the readiness of the health sector in Somalia to provide malaria case management should improve availability of drugs

and diagnostic kits; provide appropriate information and training; and engage and regulate the private sector to scale up

malaria control.

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Ahleen, reer SOL. Gosh, so much has changed, didn't know how to navigate this new platform..


Raula, are you aware of any studies focusing on breast cancer screening in Somali women (quantitative/qualitative)? Much of the research emerging from MN seems to be focusing on maternity health issues. Please let me know if you know of researchers who focus on broader health issues of Somalis in MN.



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