Mission Trip to Port-Au Prince, Haiti

Our Haiti global health fitness mission went very well. Haiti occupies the western third of the Caribbean island of Hispaniola, sharing a border with the Dominican Republic. Over 10 million people live in Haiti with a large portion of its population being young people, in part because of a high birthrate and shorter life expectancy. 37% of Haitians are younger than 14, 59% are between 15 and 64 years old, and just 3% are 65 and older. 

Our global health fitness mission to Haiti focused on non-communicable disease prevention through health and wellness biometric screenings and counselling and physical activities such as Zumba dance fitness class. We partnered with the YMCA D’Haiti / YMCA of Haiti to offer free health and fitness services. YMCA d’ Haiti is a community-based organization committed to building spirit, mind and body. The organization develops youth, teens and adults through education and character building programs, to help them become leaders in creating a stronger community in Haiti.

Watch the video below to learn more about the work of the Haiti YMCA and what they consider to be Haiti’s biggest health challenges.

 

During this trip, we were only able to perform a few biometric screenings due to limited supplies and human resources. We were able to take blood pressure readings, body composition measurements which include height, weight and body fat. We also gave health advice based on the person’s screening results.

Based on our health screening results and general observation, some Haitians were under weight, while some of them were within their healthy weight based on age and height. The younger people had a normal blood pressure. However, most of those those above 30 and the elderly had high blood pressure, mostly due to blood pressure. High blood pressure is a silent killer and most people have no clue if they are a walking time bomb until they get regular health screenings and get the right treatment or medication to contain it. Unfortunately, most of the people we saw don’t have adequate access to health care, especially the elderly who are on blood pressure medication but go months without refills because they don’t have the money to refill their prescriptions and they don’t have transportation to take them to get their medications.

Haiti’s Health Profile:

Haiti reports some of the world’s worst health indicators, which continue to inhibit the country’s development. The problem with healthcare in Haiti it is almost nonexistent. There’s no system, structure or plan that has been implemented. What healthcare facilities that exist are not adequate. There’s insufficient medical staff, support staff, equipment and treatment. The little healthcare system that Haiti has depends heavily on medical NGOs such as MSF, the Cuban Brigade and a few faith-based and charity clinics to fill the void. Haiti needs a permanent, modern health care infrastructure that can respond to the medical needs of all Haitians and one that is organized and staffed mostly by Haitians.

Environmental health wise, Haiti suffers from a deforestation problem which partly contributes to its devastating natural disasters. With oil being too expensive to the average person, charcoal from burnt trees has provided 85% or more of the energy in Haiti for decades. Despite the Haitian government discouraging its citizens against deforestation, Haitians have relentlessly hunted and chopped down huge amounts of forest. In the past couple of decades, the US Agency for International Development (USAID)  planted over 60 million trees. However, an estimated 10 to 20 million of these are cut down each year.

Although Haiti didn’t have much of a healthcare structure to destroy, the earthquake of January 12, 2010 caused damage to the health care infrastructure in Port-au-Prince and shut down basic services critical.  A few months after the earthquake, Haiti’s health care network was further strained by the country’s first cholera outbreak in a century. Cholera is an acute dehydrating bacterial infection spread through water and food contaminated by human faeces. The illness is exacerbated by heavy rains, poor sanitation, and limited clean water, and associated poor hygiene, such as failure to wash hands after going to the toilet. Treatment for most people is through oral rehydration and, in severe cases, an intravenous rehydration with antibiotics.  

Key Challenges to Haiti’s Health status include:

A weak health system: Roughly 40 percent of the population lack access to essential health and nutrition services; only 45 percent of all children (12-23 months) are fully vaccinated and 22 percent of children under 5 years old are stunted.

Funding environment: Government spending for health is low and only represents 6 percent of all government expenditure for the country. There is still heavy reliance on international funding to provide Haitians access to health care services.

Human resources for health: Attracting and retaining qualified health professionals is a chronic struggle, with as few as six health professionals per 10,000 people.

Health infrastructure: The destruction created by the 2010 earthquake and Hurricane Matthew exacerbated an existing lack of adequate health infrastructure, such as health care and storage facilities, as well as access to electricity, clean water and sanitation systems.

According to CDC, Haiti Top 10 Causes of Death are:

Cardiovascular Diseases

Diarrhea/LRI/Other

Neoplasms

HIV/AIDS & Tuberculosis

Diabetes/Urog/Blood/Endocrine Diseases

Neonatal Disorders

Unintentional Injuries

Chronic Respiratory Diseases

Transport Injuries

Other Non-Communicable Diseases

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Click here to see more pictures from our Haiti mission trip

Global Health Fitness work in Dominican Republic

Had a memorable global health mission in Santo Domingo, Dominican Republic, in partnership with the YMCA of the Dominican Republic. Dominican Republic has a population of over 10 million people. It sits on the island of La Hispaniola which is one side Dominican Republic and the other side is Haiti. Santo Domingo is a modern and cosmopolitan city. It is an attractive and versatile city with modern shopping malls and entertainment. The people are also very warm and hospitable.

The YMCA of the Dominican Republic / ACJ-Republica Dominicana just celebrated its 50^th anniversary this year. It was formed in 1967. Their focus is more on early child development and youth educational programs. They have a fitness center at their headquarters in Santo Domingo, where they also offer swimming. They operate a number of branches in Santo Domingo and have programs in other parts of the country.

Our work in Dominican Republic:

The goal of the Global Health Fitness Initiative (GHFI) is to inspire the world to health, fitness and wellness, with a focus on preventative medicine. Our efforts in Dominican Republic focused on physical activities such as Zumba and dance fitness classes, with biometric health screenings. During this trip, we were only able to perform a few biometric screenings due to limited supplies and human resources. We were able to take blood pressure readings, body composition measurements which include height, weight and body fat. We also gave health advice based on the person’s screening results.

From our observation, Dominicans love to look good so they do take their fitness seriously. People are mostly within their healthy weight. However, during our health screening sessions, we had a lot of cases of people with high blood pressure, mostly due to blood pressure. High blood pressure is a silent killer and most people have no clue if they are a walking time bomb until they get regular health screenings.

Dominican Republic Health Profile:

The Dominican Republican government only spends about 5.9% of GDP on health, in comparison to 7.6% for the region and 16.2% for the United States. The world average is 9.9%. However, Dominican Republic has one of the most advanced healthcare systems in the Caribbean. While at the airport on the way to Dominican Republic, our team member met two people who were traveling to Dominican Republic for “Medical Tourism” as they called. One of them was going to a rehab house for six months to get help with their addiction. The other person was going for a weight loss surgery. Their reason for choosing Dominican Republic versus the USA for these services was because it was much cheaper and the quality of the service was comparable to the USA.

The Dominican Republic’s health care system is three-tiered. At the bottom, the poorest in society are guaranteed access to free, socialized care. People who work in the Dominican Republic and earn less than RD$4,000 a month make social security contributions through their paychecks. As a result, they are automatically entitled to government health care services. Also, many employers provide something called an “Iguala” which is a monthly subscription to use the services of a specific clinic at no cost. Most people still end up paying out-of-pocket  for medical supplies and other services because the government doesn’t spend enough on health care so the people have to pay a big chunk of their healthcare out of pocket. In public, government operated hospitals, patients often need to provide their own supplies. Friends and family tend to look after them when it comes to meals and other needs.

According to the Center of Disease Control, the top causes of Death in DR non-communicable diseases and lifestyle related:

1. Ischemic Heart Disease
2. Stroke
3. Road Injury
4. Diabetes
5. Lower Respiratory Infections
6. Prostate Cancer
7. Hypertensive Heart Disease
8. HIV/AIDS
9. Preterm Birth Complications
10. Cirrhosis

The Life expectancy at birth is W 77/M 71 yrs. The Infant mortality rate is 31/1000 live births.

Here are more pictures from The Dominican Republic

Global Health Mission in Namibia

We recently had our global health fitness mission in Windhoek, Namibian, in partnership with One Economy Foundation. One Economy Foundation is an organization founded by the First Lady of Namibia, Monica Geingos, which aims to build a bridge of economic opportunity between the dual economy. We lead group fitness class and performed biometric health screenings, as can be seen in the video below.

Namibia is a large and sparsely populated country in the southern part of Africa, with only 2.5 million people. On its west coast, there’s the Namib Desert along its Atlantic Ocean. Windhoek is the capital city.

Namibia’s Health Profile

In Namibia, the government funds most of the healthcare. The country has a dual system of public (serving 85% of the population) and private (15%) health care providers. Namibia has made progress in the last decades when it comes to general health and communicable diseases, but despite this progress, HIV/AIDS still is one of the big reasons for health loss in the country. In recent year, about 9% of the country’s GDP accounted for government and private health expenditure. The world average is 9.9%.

Namibia has the three major health financing sources:

1. The general government revenue at 54% of total health expenditure (THE)
2. Employers’ contributions to private medical aid schemes (at 11% of THE)
3. Household contributions through pre-payments and out of pocket payments (at 16% of THE)

According to the most current available date from CDC, the Top 10 Causes of Death in Namibia are:

1. HIV/AIDS
2. Lower Respiratory Infections
3. Ischemic Heart Disease
4. TB
5. Cerebral Vascular Disease
6. Diarrheal Diseases
7. Road Injuries
8. Diabetes
9. COPD
10. Neonatal Preterm

It also worth noting that life expectancy at birth is: W 67/M 62 yrs. Infant mortality rate is: 39/1000 live births.

Click here are more pictures from Namibia

Rio, Brazil Global Health Mission

We partnered with the YMCA of Rio de Janeiro to offer free dance fitness classes. The classes were very well received and we look forward to go back to Brazil for more global health fitness initiatives. It’s important to note that this is thee first and oldest YMCA in South America. It was founded in Rio de Janeiro in 1893. The YMCAs look for helping to meet the needs and hopes of the community throughout social, cultural, spiritual and physical education programs, contributing to a better quality of life.

A little bit about Brazil…. It’s a big South American country with a population of about 200.7 million people (as of 2016). The country stretches from the Amazon Basin in the north to vineyards and massive Iguaçu Falls in the south. Rio de Janeiro where we travelled for our global health fitness mission is a city famous for its tall and big Christ the Redeemer statue which sits on top of Mount Corcovado. The city also has busy and beautiful beaches such as Copacabana and Ipanema beaches. Every year, this city hosts the largest Carnival in the world, which features samba music and dance, flamboyant costumes, parade floats and flamboyant costumes, and samba music and dance. Brasilia is the capital city.

Brazil’s Health Profile

The healthcare in Brazil is a constitutional right. All Brazilian permanent residents or legal citizen, foreign residents included are entitled to receive free public healthcare through the national universal healthcare system known as SUS. To receive care, they need to produce a Brazilian identification card and a SUS card. Both the private and government institutions provide the health care. However, primary healthcare is solely the responsibility of the federal government, which some elements of it being overseen by the local government, such as the operation of hospitals. A majority of Brazilian residents, round 70 per cent, use public hospitals.

Although government hospitals and clinics offer good medical services, they are often crowded because they are free and there’s a long waiting time to receive care in facilities that may not be as good as the private ones with better medical equipment and air condition, especially in rural areas. As a result, about 30 per cent of Brazilian residents opt for private hospitals where they pay out of pocket or use private medical insurance.

According to the current information available on the Center of Disease Control (CDC), here are the Top 10 health issues (deaths) affecting Brazil:

1. Low Back & Neck Pain 6%
2. Ischemic Heart Disease 6%
3. Cancer 4%
4. Diabetes 4%
5. Lower Respiratory Infections 3%
6. Diarrheal Disease 2%
7. Diabetes 2%
8. Interpersonal Violence 3%
9. Iron-deficiency anemia 2%
10. HIV/AIDS 2%

It is also important to note that the life expectancy at birth is 79 (women), 71 (men). The informant mortality rate is 19/1000 live births.

According to Brazil’s Ministry of Health, the country is committed to reducing obesity in its population by 2019. This will be achieved mainly by reducing the consumption of sugary beverages by 30% and by increasing consumption of fruits and vegetables. The ministry also vows to strengthen health promotion and disease prevention activities, improving information systems for better management and transparency, and expanding the use of electronic health records to avoid duplication of diagnostic exams and to better monitor prescription medications.

An interesting health fact about Brazil is that, it has the largest organ transplantation system in the world, with about 24.9 million transplants a year.

It is also interesting to note that Brazil is one of the leading medical tourism destinations in South America and most of the private hospitals in there have excellent medical facilities.

See more pictures from Rio: https://flic.kr/s/aHsm9VTb4i

A case for non-communicable diseases (NCDs)

Our focus at GHFI is on preventing and minimizing the risks of con-communicable diseases. Non-communicable diseases risk factors are:

• Dietary changes
• Lack of physical activity
• Reliance on automobile transport
• Smoking
• Stress
• Urbanisation

The risk factors are mostly lifestyle-based and preventable, minimized and managed through primary health care and health promotion strategies. Interventions include nutrition, exercise, and no smoking and reduce alcohol as it affect the condition of our arteries and hearts.

Globally, the rate of deaths from noncommunicable causes, such as heart disease, stroke, and injuries, is growing. At the same time, the number of deaths from infectious diseases, such as malaria, tuberculosis, and vaccine-preventable diseases, is decreasing.

According to the 2015 Global Burden of Disease Study, NCDs accounted for 71%, or 40 million, of the 56 million deaths globally in 2015. NCDs are now the leading cause of death in many low- and middle-income countries, with cardiovascular disease, cancers, respiratory disease, and diabetes accounting for the largest number of NCD-related deaths.

Many in the global health field believe that reducing the burden of NCDs is essential to ending extreme poverty, reducing inequality, and improving health and wellbeing. The World Health Organization’s Global Action Plan calls for health systems strengthening that can improve prevention, early detection, treatment, and sustained management of people with or at risk of cardiovascular disease, cancer, diabetes, and other NCDs. This systems strengthening must include the strengthening of primary care systems and the integration of NCDs into programs targeting other priority health issues, such as nutrition, HIV, tuberculosis, malaria, reproductive health, and maternal and child health.

Most developing countries are not prepared to deal with the rising rates of noncommunicable diseases that can come with age, poor diet, and better detection. One-third of adults over age 25 or about one billion people suffer from high blood pressure, the world’s number one cause of premature death and disability.

Global Health Fitness Issues

Global Health and Fitness impacts us all:

• During the last two decades there has been a fundamental shift in global patterns of disease.
• New epidemics of chronic illness are following in the wake of rapid urbanization and economic change.
• Communicable vs non-communicable disease
• A non-communicable disease (NCD) is a medical condition or disease that is not caused by infectious agents.
• NCDs refer to chronic diseases which last for long periods of time and progress slowly.
• NCDs are the leading cause of death globally.

 

Here are the leading global health fitness issues:

• NCDs: Cancer, heart disease, and diabetes
• Mental Health
• Nutrient levels fall, obesity rates rise
• Youths and substance abuse
• Dangerous complacency towards HIV
• Shortages of primary healthcare workers and doctors.

Mental Health – The mental health consequences of war, displacement, gender-based violence, natural disasters, and other trauma. Depression, post-traumatic stress disorder, dementia, substance abuse, and other mental health challenges that affect mental health and well-being are fundamental to our collective and individual ability as humans to think and interact with each other, earn a living, and enjoy life,” says a World Health Organization.

Nutrient levels fall, obesity rates rise – Hunger goes hand-in-hand with poverty, and food scarcity is still a huge health care challenge around the world. We’re seeing the effects of a high-calorie, low-nutrient diet in our rising rates of obesity, diabetes, and heart disease, ailments that overburden our health sectors. The same dangerous food trends (and the noncommunicable diseases that result) are now spreading into poorer nations.

Cancer, heart disease, and diabetes – Cancer kills more people in low- and middle-income countries than HIV, malaria, and tuberculosis combined.

Youth – Today we have the largest population of youth in human history. Of the seven billion people on the planet, more than three billion are under the age of 25. More than 80% percent of 15- to 25-year-olds live in developing countries.

Dangerous complacency around HIV – Great strides in HIV treatment and management over the past decade, along with successes in reducing the stigma against people who live with the virus, have had some troubling side effects. In some areas, such as northern Namibia (where HIV rates among women in particular reach almost 31%, many have come to think of HIV as a normal part of life, a manageable issue like any other chronic condition. The results can include a loss of caution and more new infections.While UNAIDS and other major organizations have vowed to end the AIDS epidemic by 2030. We’re now at a crucial point from which it will be all too easy to backslide.

Strikes, shortages and other labor woes in the health workforce – Specialized nurses leave the country en masse for jobs in North America and Europe. And massive strike amongst health workers demanding better working conditions has left millions of people without access to health care. The global shortage of health workers is getting worse. And in many countries, it’s leaving doctors, nurses, midwives and others to burn out in bad working conditions – or leave their countries altogether – while their communities suffer under lower-quality care.

What is Fitness

Fitness refers to general physical fitness which is a state of strength and well-being, and the ability to comfortably perform aspects of sports, occupations, and daily activities required for survival. Our bodies are created to move, constantly.  It is also our duty to nourish our bodies well.

 

 

What is Global Health?

The world is becoming more globalized socially and therefore it is necessary to think about health in a global context.

Global Health is an area of study, research, and practice that places a priority on improving the health for all people around the world, using a full range of public health and health promotion strategies. There are different definitions of global health but this is the one we prefer to use, partly from Kaplan JP etal. Lancet 2009, 373:1.

Global health crucial and affects everyone:

1.Rarely a week goes by without a headline about the emergence or re-emergence of an infectious disease or other health threat somewhere in the world.

2.Example of Ebola and Zika virus

3.You can travel to certain countries without being vaccinated in the hope that you don’t get sick and bring the sickness back to your home countries

4.You can’t travel to certain countries if you have certain infectious diseases

5.A sickly nation can be a burden to itself and other nations who have to spend resources to reduce the impact of the disease instead of funding infrastructure, money is going to fighting preventable diseases.