The Parent of All Virtues

The Roman statesman and philosopher Cicero observed that “Gratitude is not only the greatest of the virtues but the parent of all others.” Acknowledging every good thing in our lives, no matter how brief or small, at all times, helps fuel kindness, benevolence, and other positive traits. Numerous schools of thoughts, as well as every major religion, have affirmed the importance of gratitude to both individual and societal well-being. I can attest to the importance of gratitude for my own mental and emotional health, but fortunately there is lots of evidence to back it up, too.

In light of the universal importance of gratitude, psychologists and social scientists have increasingly focused their attention on exploring the benefits of gratitude. Multiple studies have shown a correlation between gratitude and increased well-being—not only for the individual exercising gratitude, but for their recipients and even third parties. Continue reading

America’s Uniquely Bad Gun Problem

Whatever your view on guns, the causes of gun violence, and the best solutions, we should all agree that the data are overwhelmingly clear: for one reason or another (likely multiple reasons) the U.S. has an unusually high rate of violent gun deaths (which doesn’t include accidents and suicide, as these tend to inflate the figures).

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Note that even countries that are poorer and more unstable have fewer gun deaths than the U.S., including those with vast black markets or active gangs or militias. As NPR  reports:

When you consider countries with the top indicators of socioeconomic success — income per person and average education level, for instance — the United States is bested by just 18 nations, including Denmark, the Netherlands, Canada and Japan.

Those countries all also enjoy low rates of gun violence. But the U.S. has the 28th-highest rate in the world: 4.43 deaths due to gun violence per 100,000 people in 2017. That was nine times as high as the rate in Canada, which had 0.47 deaths per 100,000 people — and 29 times as high as in Denmark, which had 0.15 deaths per 100,000.

The numbers come from a massive database maintained by the University’s Institute for Health Metrics and Evaluation, which tracks lives lost in every country, in every year, by every possible cause of death. The 2017 figures paint a fairly rosy picture for much of the world, with deaths due to gun violence rare even in many countries that are extremely poor — such as Bangladesh, which saw 0.07 deaths per 100,000 people.

Prosperous Asian countries such as Singapore and Japan boast the absolute lowest rates, though the United Kingdom and Germany are in almost as good shape.

“It is a little surprising that a country like ours should have this level of gun violence,” Ali Mokdad, a professor of global health and epidemiology at the IHME, told NPR in an interview last year. “If you compare us to other well-off countries, we really stand out.”

Source: NPR

The Benefits of Indoor Plants

Though I cannot confirm the efficacy of the many studies cited in the following
Vice article, I can speak from experience that gardening and caring for indoor plants has always been therapeutic for me; in fact, I attribute it to helping me cope with many a stressful or melancholic episode.

What’s good for the body is good for the brain, and the toxin-absorbing, air-purifying abilities of plants like pothos, aloe vera, and ivy are worth considering on your next trip to the nursery. Scented plants have health benefits, too: the smell of flowers like jasmine and lavender have been shown to lower anxiety and stress, and promote a good night’s sleep.

Researchers have been promoting the mental health benefits of horticulture for decades, and for good reason. Studies have repeatedly shown that the act of tending to plants can take our minds off the bad stuff, relieve stress, and have an overall calming effect. Gardening is so good for your brain that it’s even thought to lower the risk of dementia.

[…]

One recent study was able to demonstrate that a group of people in their early twenties experienced a massive decrease in blood pressure and other physical stress symptoms when they followed a computer-related task with an indoor gardening session; the results suggested that tending to indoor plants “reduced physiological and psychological stress, especially in comparison to mental tasks performed using technology.

[…]

The science is pretty clear on all this: humans are happier when they’re close to aesthetically-pleasing living things. Office workers have been found to be more productive and happy when surrounded by indoor plants, and having plants in hospital rooms helps surgical patients recover faster by lowering blood pressure, pain, and fatigue levels. Studies have found that even the literal act of looking out the window at a tiny strip of sad urban park can have restorative mental health properties—which means by investing in a couple of hanging baskets, you’ll actually be ahead of the game. Eyeballing the colour green has been found to promote emotional stability, whereas the presence of bright-coloured flowers can provide an instant mood booster.

Perhaps this isn’t too surprising, given that we did evolve and live in nature across millennia, after all.

Schola Medica Salernitana

Founded in the ninth century in Salerno, Italy, the Schola Medica Salernitana was the first medical school of its kind, aimed at expanding medical knowledge and professionalizing the practice of medicine. It rose to prominence as one of the most important sources of medical knowledge in the world, due largely to Salerno’s cosmopolitan outlook – like most Italian city-states, it had diplomatic and commercial relations beyond Europe, particularly with the Muslims and Byzantines, who had a wealth of medical knowledge, both preserved and of their own making.

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A depiction of the medical school in one of Avicenna’s medical works, The Canon of Medicine (Wikimedia Commons)

Continue reading

Fifty Cents to Avoid a Lifetime of Debilitation

Some weeks ago, I read a piece in The Economist that has stayed with me. It was about the efforts of Sierra Leone, among the world’s poorest countries, to combat “neglected tropical diseases” (NTD), a family of 17 diverse communicable diseases that afflict over 1.5 billion in tropical and subtropical areas worldwide.

It featured one victim named Hannah Taylor, who woke up one day with a fever, followed by her legs swelling up to four times their normal size. The physical damage was irreversible, and the subsequent appearance and putrid smell led to her being ostracized by her community. She was a victim of lymphatic filariasis (a.k.a. elephantiasis), a mosquito-borne infection that could have been treated safely with a pill costing no more than fifty cents before it progressed.

But instead, the microscopic worms infested her body, debilitating her. For years she thought she had been a victim of evil witchcraft and was deeply depressed.

Eventually, Taylor put on a brave face and campaigned to raise awareness about the disease, its causes, and why victims shouldn’t be stigmatized. She passed away some weeks prior to the publishing of the article; she was quoted as expressing  happiness that her children would not suffer the way she would, thanks to Sierra Leone’s remarkable progress in fighting the disease.

Progress or not, it is incredible to think that billions of lives are negatively impacted by something as mundane to most of us as a mosquito bite. It is even more incredible that a mere fifty cents – spare change we’d throw in a tip jar without a thought – is all that stands between someone and a debilitating disease. It is utterly senseless that in a world with so much wealth and resources sloshing around that we have not been able to address this vast disparity in health outcomes and quality of life.

 

When Schizophrenia Isn’t a Mental Illness

Culture may play a huge role in how schizophrenia manifests, according to one study published in a leading British psychiatric journal. It interviewed 60 adults diagnosed with schizophrenia – 20 each from the U.S., Ghana, and India – and found one stark difference between the nationalities: while American subjects were likelier to report violent, sadistic, and hateful voices, most of the subjects from Africa and Asian claimed to hear generally positive voices – which not a single American reported. Continue reading

America’s Baffling Opposition to the WHO’s Breastfeeding Resolution

It seems that any institution that is global or multilateral in nature or name elicits visceral opposition by huge swathes of the American public. While there has long been an undercurrent of insularity and outright hostility in America towards the rest of the world, it goes without saying that under the present administration — which came to power on a platform of nationalism, protectionism, and revanchism against foreigners — the sentiment has been worsened to the point of absurdity.

The most salient recent example is our strange response to a sensible resolution at the World Health Organization (WHO) that no one would have imagined was controversial. Continue reading

The Hungarian Doctor Who Pioneered Handwashing

Handwashing is easy to take for granted. It is one of the earliest and most basic forms of etiquette and hygiene we that we learn, not to mention a major pillar of our individual and collective health.

But like so many other “givens” in modern medicine and public health, hand washing was not always so accepted, even among health professionals. In fact, it practically came down to one person to discover and advocate the importance of washing one’s hands: NPR tells the story of Hungarian medical underdog Ignaz Semmelweis and his semi-successful attempts to improve the lives of millions through this deceptively simple practice.

Semmelweis was a man of his time, according to Justin Lessler, an assistant professor at Johns Hopkins School of Public Health.

It was a time Lessler describes as “the start of the golden age of the physician scientist,” when physicians were expected to have scientific training.

So doctors like Semmelweis were no longer thinking of illness as an imbalance caused by bad air or evil spirits. They looked instead to anatomy. Autopsies became more common, and doctors got interested in numbers and collecting data.

The young Dr. Semmelweis was no exception. When he showed up for his new job in the maternity clinic at the General Hospital in Vienna, he started collecting some data of his own. Semmelweis wanted to figure out why so many women in maternity wards were dying frompuerperal fever — commonly known as childbed fever.

He studied two maternity wards in the hospital. One was staffed by all male doctors and medical students, and the other was staffed by female midwives. And he counted the number of deaths on each ward.

When Semmelweis crunched the numbers, he discovered that women in the clinic staffed by doctors and medical students died at a rate nearly five times higher than women in the midwives’ clinic.

But why?

Like any rational, scientifically-minded individual, Semmelweis carefully assessed the data and sought out some empirical basis for this pattern.

“What Semmelweis had discovered is something that still holds true today: Hand-washing is one of the most important tools in public health. It can keep kids from getting the flu, prevent the spread of disease and keep infections at bay.

Semmelweis kept trying to convince doctors in other parts of Europe to wash with chlorine, but no one would listen to him.

Even today, convincing health care providers to take hand-washing seriously is a challenge. Hundreds of thousands of hospital patients get infections each year, infections that can be deadly and hard to treat. The Centers for Disease Control and Prevention says hand hygiene is one of the most important ways to prevent these infections.

Over the years, Semmelweis got angrier and eventually even strange. There’s been speculation he developed a mental condition brought on by possibly syphilis or even Alzheimer’s. And in 1865, when he was only 47 years old, Ignaz Semmelweis was committed to a mental asylum.

The sad end to the story is that Semmelweis was probably beaten in the asylum and eventually died of sepsis, a potentially fatal complication of an infection in the bloodstream — basically, it’s the same disease Semmelweis fought so hard to prevent in those women who died from childbed fever.”

An ignoble and cruelly ironic end to a man whose findings are now the bedrock of public health and sanitation worldwide. Semmelweis was ridiculed, marginalized, and ultimately forgotten because his observations conflicted with the established scientific and medical opinions of the time; indeed, many doctors took offense at the idea that they should wash their hands — at the cost of their patients’ lives.

It was only two decades after his sad death that Semmelweis’s recommendations gained widespread acceptance: Louis Pasteur’s confirmation of the germ theory of disease, followed by Joseph Lister’s use of hygienic methods during surgery both validated the Hungarian doctor, who lacked the scientific means to explain his findings.

But given his dedication to the well being of patients, I would like to imagine Semmelweis would be pleased to see his ideas become conventional wisdom. He might also be amused that his name is used for the eponymous “Semmelweis reflex” or “Semmelweis effect”, which describes a tendency for new evidence or knowledge to be viscerally rejected because it contradicts established norms, beliefs, or paradigms.

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Hero Highlights: Project Prakash

Of the world’s 1.3 million blind children, India is home to the world’s largest population, with estimates ranging from 200,000 to 700,000. As in many developing countries, a child born blind faces enormous social and economic hurdles: in addition to being stigmatized and marginalized in their communities, the vast majority of blind children are unable to get an education or a job. Many face physical and sexual abuses. At least half do not survive to adulthood.

In addition to regressive social attitudes, a lack of medical care access, and little to no disability-friendly institutions and infrastructure, the problem is made worse by the pervasive idea that, once a child reaches seven or eight years of age, their blindness is irreversible and untreatable. Yet the prevailing cause — congenital cataracts — is an otherwise easily treatable condition in the developed world. Imagine a lifetime of being disadvantaged and ostracized for something beyond your control and which could easily be addressed if there was the will and money. It is a disease of poverty.

Enter Project Prakash, founded in 2002 by Dr. Pawan Sinha, an Indian-born graduate of MIT. Named after the Sanskrit word for “Light”, he started the organization after a trip to rural India, where he witnessed the first hand the scale and severity of child blindness. After obtaining a grant from the U.S. National Eye Institute, he assembled team of about 20 clinicians, scientists, and outreach personnel to provide cataract surgery for as little as $300 per patient (though those too poor to pay get it for free). He tells the story in great detail Scientific American (sorry for the paywall.) Continue reading

The Impact of Vaccines

Most of developed world take vaccines for granted. Indeed, there is a growing number  of people in wealthy countries, often the most privileged, who outright fear and dislike vaccines. Yet the data are overwhelming: vaccines have not only been pivotal to virtually extinguishing all sorts of previously common diseases (measles, polio, pertussis, etc.), but they have continued to reap dividends for the millions of human who live in the developing world, where public health otherwise remains weak.

As reported in IFLS:

Vaccines are well regarded as one of the most cost-effective health care actions that a country can pursue, and since 2001 the United Nations has been running a program in 73 low and middle-income countries to prevent 10 diseases. It is now expected that when the project is completed in 2020, it will have resulted in averting around 20 million deaths, while at the same time saving a staggering $820 billion.

“Our examination of the broader economic and social value of vaccines illustrates the substantial gains associated with vaccination,” explained Sachiko Ozawa, who led the research, in a statement. “Unlike previous estimates that only examine the averted costs of treatment, our estimates of the broader economic and social value of vaccines reflect the intrinsic value that people place on living longer and healthier lives.”

And these economic benefits, it turns out, are huge. The researchers have calculated that when the vaccination program comes to an end in 2020, it will have saved around $350 billion when it comes to health, but overall this balloons to an astonishing $820 billion across the 73 low and middle-income countries in which Gavi is operating.

This is not only through reduced health care costs as diseases are prevented before they become an issue, but also due to those who are vaccinated being healthier and so working for longer and thus increasing productivity in these nations over their entire lifetimes.

Social and economic benefits aside, the most important results are the human ones: the prevention of over 500 million illnesses, 20 million child deaths, and 9 million cases of long-term disabilities. So much pain and suffering and loss will be unknown — and unfortunately unappreciated — because of such a cheap and relatively easy intervention.