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Beijing: beware of smog and dog
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By Michael Woodhead, 6minutes editor
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Let the games begin. I for one will be glued to the TV tonight watching the opening ceremony for Beijing 2008 Olympics. There's already been a sneak peek, thanks to a Korean TV camera crew who infiltrated the rehearsals, and it looks like martial arts and whales will play a big part. And was that a cloud of dry ice, or did someone leave a door open and let the smog in?
Of course we have all seen the images of Beijing’s appalling smog and heard predictions of how the sky high (pardon the pun) pollution levels (link) will affect the athletes’ performance. How much of this speculation is evidence based is hard to say.
One group of sports medicine researchers have predicted (link) that athletic performance will be limited by Beijing’s cocktail of carbon monoxide (CO), ozone, nitrogen oxides (NO and NO2), sulphur dioxide (SO2) and particulate matter. This breathable soup will not only cause respiratory problems, but also effects on renal function, they say, potentially causing false positive or negative doping results. Their advice for athletes is to breath through the nose as much as possible – probably not very helpful if you’re in the marathon.
For visiting spectators in Beijing there may be other things to worry about as well as respiratory problems – such as dog bites and Beijing belly. A review (link) of almost 2500 health problems reported by visitors to China over the last year found that dog bites and traveller’s diarrhoea topped the list of ailments. They point out that China has the second highest rates of rabies in the world – with almost 3300 deaths a year.
And what about the mental health aspects of the games? A Beijing briefing (link) prepared some Kiwi doctors warns athletes to be prepared for the intense mental pressures that form the “Olympic Village experience”, not to mention the hazards of a 24-hour dining hall and the post-competition partying.
My own experience of living in Beijing taught me that the traffic was one of the main health hazards of the city – crossing the road was a daily gamble with death and disability. I presume that drivers have been instructed to be on their best behaviour during the games. It will also be interesting to see whether Beijing’s other unhealthy pastime – spitting is put on hold for the next three weeks.
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Phone helplines don't connect
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By Michael Woodhead, 6minutes editor
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What is it about phone helplines that so appeals to politicians and health providers?
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Hardly a week goes by without an announcement that the government – Federal or State – is putting millions into a new XXXX name-your-problem helpline. Drugs? Pregnancy? Call Centre Phobia? We have a helpine, just call 1300 …
It would be interesting to know how many of these phone services are now being funded with public money and what results they get. And are they evidence based and safe? Pharmaceuticals have to be reviewed by the TGA and then the PBAC for cost effectiveness before they get a subsidy, while medical procedures have to get the nod from the Medicare Services Advisory Committee. But when it comes to phone services, well, if it sounds like worthy cause and gets lots of calls then it surely must be A Good Thing. And most importantly the minister for this or that can be seen to Be Doing Something.
Interestingly, we haven’t heard much of Tony Abbott’s controversial pregnancy counselling service since the Coalition left government. This is the service that is costing is almost $4 million a year and according to the Australian is fielding just over 300 calls a month (link)
My back of an envelope calculations suggest that it’s costing $1000 a call. It would be cheaper to give pregnant women and their partners a free weekend at the Hilton to think about their options.
However, the 800 pound gorilla in the room of telephone services is HealthDirect. Already up and running in Western Australia, South Australia, the ACT and the Northern Territory, we are now about to get access to this nurse-based telephone triage service in NSW.
It costs literally hundreds of millions of dollars – jointly funded by the Commonwealth and States – but what does it actually deliver? I’m sure that worried parents feel reassured when they can call for help advice for an ailing child in the early hours, but is that the best way to spend scarce health dollars? Especially when Medicare is putting GPs’ after hours services under increasing scrutiny? The whole helpline service sounds like an expensive gimmick, and it’s time it was disconnected.
What do you think?
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There's always someone worse off
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By Michael Woodhead, 6minutes editor
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Compiling the news headlines from around Australia for 6minutes every day can give you a pretty bleak view of what's happening in this country.
Day after day we hear about doctor shortages, treatment delays, hospital services being downgraded, increasing rates of obesity, diabetes and worrying levels of violence against doctors and others working in health roles. And if that’s not enough to get you down, try reading the weasel words and management gobbledegook from politicians and bureaucrats justifying why they can’t justify any more funding for sorely needed services but somehow have bags of money to spend on implementing yet more layers of red tape.
But as the saying goes, there’s always someone worse off than yourself.
Browsing through the online news this week I came across a staggering statistic which seems to have barely made any impact on the world news. It was a report from Zimbabwe which mentioned almost as a footnote that the country now has almost two million people (out of a population of 12 million) infected with HIV. That figure includes about 400 000 children with HIV through mother-to-child transmission.
In the absence of treatment, half he children born with HIV die before they are two years old.
And yet only 5000 people are able to access antiretroviral treatment.
When you read on, the picture just gets worse. Life expectancy in Zimbabwe has fallen dramatically, from 60 for males in 1990 to 37 now - the lowest in the world. Life expectancy for females is even lower at 34 years. Infant mortality rates have climbed to 81 deaths per 1,000 live births in the same period.
The country is in economic meltdown, the currency is worthless, crop failures are causing widespread infant malnutrition and the country is run by a murderous president-for-life seemingly for the benefit of his political cronies.
This recent report (link ) on health services in Zimbabwe makes for sobering reading.
What did the people of Zimbabwe do to deserve this? Without getting into the politics of the whole situation, I can only say thank goodness I live in Australia. The news here doesn’t seem so bad after all.
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