New year and "new" idea!

This last new year was probably the most uneventful one I've had in recent memory. In the last 5 years I've spent my new years' eves under the Sydney Harbour Bridge, in beautiful Cape Town, in snowmageddon Baltimore, in smog-filled Jakarta, and in a secure compound in Nigeria. This year however I spent it on a remote sheep farm in the Little Karoo of South Africa. I'm even a little embarrassed to say that I didn't even stay up for it!

It was on another night, when I happened to be struggling to sleep, that I conceptualized my personal philosophy on health and wellness. I wasn't on the farm this night so counting sheep was not an option. There are many ancient belief systems and contemporary ones that see the healthy human frame as being in perfect balance or harmony (or ease), and the unwell as being out of sync or imbalanced (or dis-eased). Similarly my approach to my patients is to explore their person to begin to understand the origin of the disharmony. This may be challenging in a 15-minute consultation which is often the case, but as I've begun to gain the confidence of particular patients through repeated visits, I have become more aware of the factors, events and behaviours that disrupt their homeostasis.

And with this word, HOMEOSTASIS, I would like to summarize my philosophy/approach to maintaing health. How-you-stay-as-is (homeostasis) is essentially the biological process whereby an organism maintains a constant internal environment. I'll elaborate further on some ideas relating to this concept with regards to how it may improve and furthermore maintain your health in subsequent posts. This isn't a new idea but is essentially a novel way of exploring the concepts related to maintaining your homeostasis.

Have a balanced year!

Cancer Hopes - Burzynski Clinic

If you have researched the Burzynski Clinic and Research Institute on the internet then I have no doubt that you have encountered very polarized opinions ranging from the avid supporter to the vehement sceptic. I would like to give you an overview of the treatment they offer and my personal perspective as to why Healtheon is collaborating with them.

The media and internet comments generally portray The Burzynski Clinic as an alternative cancer treatment facility. This is where the majority of the scepticism comes from I believe, as they have been lumped together with the likes of Gerson and other treatment modalities that truly have no scientific evidence. Burzynski has also been labelled as pseudo-science, in attempting to gain credibility in scientific eyes by publishing loads of poorly designed data. This is what formed the basis of my initial scepticism.

The buzz word in cancer therapy now is gene-targeted therapy. The largest oncology centres around the world are increasingly using gene targeted medication which is seen as the future of oncology, of which there are over 40 registered now I believe, in treating the various kinds of cancer that patients present with. Each medication has a particular indication for which it has gained FDA and other medicines control councils' registration (so for example x drug is indicated for colon cancer with x gene marker). This is exactly what the Burzynski clinic has been doing, but to a greater degree, and with more individualized therapy.

Why Invest in Health in Indonesia

What determines the health of a nation? How does one determine the burden of disease that the population has? Is it the average life expectancy? Or is it a series of statistics reflecting child and maternal mortality/morbidity? While the most accurate answer is likely a combination of these suggestions and others, child and maternal mortality statistics are frequently used to ascertain the state of a population’s health.

Personal leadership philosophy

During my Public Health studies at Hopkins I concentrated on Health Leadership and Management and found The Foundations of Leadership to be my most enjoyable course. This was my final paper reflecting my leadership philosophy which is bound to evolve as I do.

Introduction

The Collins English Dictionary defines a leader as “a person who rules, guides, or inspires others”, or simply as the “head”.1 Assuming a role of leadership may be considered both a privilege and an honor, but is also invariably a tremendous responsibility. In exploring leadership in terms of the innate qualities required, role of leadership and core values that should be engendered, and skills essential for successful practice, an amalgamation of various theories and philosophies as well as some personal insights have been utilized for the purposes of this paper. Specific leadership theories such as “great man”, trait or contingency theories were not specifically evaluated.

Memory Foam: Friend or Fume?

My earliest encounters with “memory foam” was some 15 years ago when my aunt brought a memory foam pillow from the USA to South Africa, where I was living at the time. I remember being amazed at this apparent new technology that I heard had been developed by NASA for use in space. No one else in the country had such a pillow of what I believed to be cutting edge technology that would magically conform to the shape of your face. How cool is that? I don’t sleep comfortably unless I use my “memory foam” pillow.

Roll forward to today and the marvel of this product has worn off somewhat. Maybe it has to do with the fact that I am further chronologically challenged, have a small child now, and am studying public health, but when I opened up the mattress-in-a-box “memory foam” mattress, I excitedly purchased last week, I was suddenly overwhelmed by extremely noxious fumes that emanated from the strange foam that popped out of the box. Thinking to myself that this cannot be healthy for a small child and pregnant wife, I began looking closer at what I previously thought to be a technological wonder was exposing us to so intimately.

Speed: To thrill or to kill?

My childhood memories of things I aspired to acquire later in life revolved predominantly around a series of super-charged automobiles, each surpassing the previous, sometimes due to aesthetic beauty but always due to performance. There was the Diablo, the F40, and then the Bugatti Veyron. Today the fastest production car is the SSC Ultimate Aero with a top speed of 257mph.  I recall paging through my dad’s old magazines to find a test for a car and flipping forward to find its performance ratings. I would avidly read up about its acceleration, top-speed and power to mass ratio. Once licensed to drive, I reveled in the thrill of driving rather too fast and too reckless. While I never had a major disaster, and thus lived to write this piece, in one piece, I did have several narrow scrapes which inevitably preempted a period of more responsible driving (lasting only until I forgot that I wasn’t totally invincible).

Smoking Cessation

One of the tasks I would often be asked to support would be the creation of posters for the clinics. When I had a bit of time or a hint of inspiration then I'd usually create something a little more interesting.

The poster created which has become the topic for this post is smoking cessation. Tobacco usage has in more recent times become recognized as one of the major public health issues facing both the developed and now developing parts of the globe. Over 50 percent of the male population are smoking in China now. Thats over 250 million people! Tobacco related diseases are expected to be responsible for 10 million tobacco related deaths per year by the year 2030, with 80% of these in the developing world. At the moment, tobacco has been implicated as a risk factor for 6 out of the 8 leading causes of death worldwide.



You see, once the tobacco companies were restricted from advertising and their use in public spaces prohibited in the developed world, they concentrated all their considerable marketing muscle in the developing world. The largest business transaction ever in Indonesia was when Sampoerna, a local cigarette manufacturer was bought out by Philip Morris.


Anyway, the poster was quite well received. I hope it gives you some ideas or at the very least some information.

Living in Indonesia

As with all manner of animals, one of the primary survival instincts or needs for humans is to find shelter. The ability to feel comfortable and secure in Indonesia, being the shelter you have “chosen”, may be regarded as vitally important, as this safety and security may be the foundation upon which you justify your choices.

In the Universal Declaration of Human Rights, there may not be a specific reference to medical care being a basic human right, but in Articles 3 and 25(1), where “Everyone has the right to life, liberty and security of person…” and “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services…”, respectively, reference is made to security and medical care. These aspects are vital to your sheltering in Indonesia.

We need someone to give a Sex Ed lecture... Hey! Where did everyone go?

Many of the initial posts on this blog will be referring to incidents or projects in the preceding 3 years, and won't be in chronological order. I've only just now become blog-literate and as such it may take quite a number of posts to get everything up to real time.

As you may have gathered already from the title of this post, I was asked to speak to the International School here in Jakarta. Twice a year, an International SOS doctor would visit the grade 9 and 10 (I think is the equivalent) to give lectures on Sexually Transmitted Disease and Contraception. As you can imagine, these aren't topics that doctors would be jumping at the opportunity of delivering. Nevertheless I accepted the "assignment" as it would get me out of the office, but immediately regretted my situation once I reviewed the material that had been traditionally used.

It was pretty bland, and used a scare/gross-you-out sort of tactic that strongly reminded me of what I didn't miss about purely clinical medicine. They grossed me out too!

Anyway, I set about completely redesigning the presentations and figured the only way I'd be able to present these topics to these kids, who probably knew a helluva lot anyhow, was to incorporate humour, graphics and diagrams where needed. Previous presentations were either too graphic, in response to requests from the school to "scare" the students, or too text-based and boring, in response to criticisms of the graphic nature of the presentations. You can never please everyone!

As it turned out, the presentations went really well, and the students were that much more comfortable to be able to ask questions in an open discussion afterwards. I've been back 3 times since to that school and have actually enjoyed giving these lectures; the questions these teenagers come up with never ceases to surprise me.

The Contraception presentation can be found here while the STD presentation may be found here.

Getting Started

So I finally decided to start my own blog, and populate it with interesting material that I've been creating for International SOS and stories/images from some of the sites I've visited.

To get the ball rolling, lets start with a simple poster designed for the World Blood donation day. International SOS has 3 very busy clinics in Indonesia to support its members and also to provide general medical assistance to the communities. There is a Blood Donation drive annually that is held at the clinic, and I was asked to design a flyer come poster to advertise the subsequent day.

I found so many interesting posters out already and couldn't find a way to integrate all the wonderful ideas until I thought of incorporating the posters I liked into the overall design. You'll see what I mean when you look at it. Anyhow, it was really well received, and in fact one of the editors of a chamber of commerce magazine liked it so much they printed it in their monthly magazine.

A month in Equatorial Guinea

In 2004 I had the amazing opportunity of working in Malabo, the island capital of Equatorial Guinea. I found some photographs of my trip recently and decided to post some of my experiences and memories. I've pre-dated the post back to 2004 to maintain a timeline even though I'm actually writing this January 2012.

This was to be my first locum contract with International SOS who had only contacted me 2 weeks previously (May 2004) with the plan that I'd work in Nigeria in August sometime. It just so happened that there was an attempted coup-de-tat in Equatorial Guinea and the hired mercenaries included some South African ex-soldiers. So I was asked to urgently fly in to provide medical cover for the Marathon LNG plant there since most of the South African doctors needed to return home to get a police clearance, which can take months.

I arrived in Malabo via Zurich (I had to fly from Windhoek to Johannesburg, then to Zurich, and then back down to Malabo! Windhoek is geographically closer to Malabo than Johannesburg or Zurich). I was greeted by the immigration security and ushered to a back room, which was probably the only back room in the tiny airport. A security officer in military attire sat at a table with his back to me while I stood in the doorway surrounded by a few other guards. He proceeded to question me about why I was there, why I had visited South Africa so many times, why I had my visa granted in Paris instead of South Africa among a few other questions. He then opened up my computer and found a directory with photographs I'd taken from home and recent travels to Istanbul and Israel and then asked me who each and every person was. I approached to try point out people and had taken no more than a couple steps when he abruptly put his hand up and said I need to stay back. He never turned to me so I never saw his face through this entire interrogation. The paranoid and aggressive state of the immigration personnel was to reflected by the military and police throughout my stay.