Kidney disease kills thousands in sugar cane fields
Filed under: Government, Health policy, Hot Health Headline, Public health
In The Center for Public Integrity’s iWatch News, Sasha Chavkin and Ronnie Greene write that, “Little noticed by the rest of the world, chronic kidney disease (CKD) is cutting a swath through one of the world’s poorest populations, along a stretch of Central America’s Pacific Coast that spans six countries and nearly 700 miles. Its victims are manual laborers, mostly sugarcane workers.”
Each year from 2005 to 2009, kidney failure killed more than 2,800 men in Central America, according to the International Consortium of Investigative Journalists‘ analysis of the latest World Health Organization data. In El Salvador and Nicaragua alone over the last two decades, the number of men dying from kidney disease has risen fivefold. Now more men are dying from the ailment than from HIV/AIDS, diabetes and leukemia combined.
Unlike in more developed nations, neither diabetes nor hypertension can be blamed for the widespread kidney ailments. Instead, the duo found, scientists suspect possible environmental toxins and strenuous labor conditions, both linked to the cane fields, as well as alcohol abuse and anti-inflammatory drug use. At present, researchers seem to be focusing on heat stress as the most likely culprit, and plantation owners seem to concur
Internal studies by Nicaragua Sugar, owners of one of Central America’s largest sugar plantations, provided by the company to ICIJ, show that the company has long had evidence of an epidemic tied to heat stress and dehydration. In 2001, company doctor Felix Zelaya conducted an internal study on the causes of CKD among its workers. “Strenuous labor with exposure to high environmental temperatures without an adequate hydration program predisposes workers to heat stress syndrome [heat stroke], which is an important factor in the development of CKD,” Zelaya concluded.
Nicaragua Sugar and other companies say they have acted voluntarily to protect workers by improving hydration, reducing work hours, and strengthening oversight of labor contractors.
Chavkin and Greene dig deep into the economic and political factors underlying the global response to the epidemic, as well as the day-to-day impact it all has on workers’ lives. For more, read their full investigation.
Reporter predicts Houston to emerge as global health hub
Jaclyn Schiff, writing for the UN Dispatch, makes the case that journalists should look to Houston as the emerging hub of the global health universe, predicting that it may even supplant hotspots like Washington, D.C. and Seattle.
The foundation for Houston’s emergence, she writes, will be built on its already powerful medical community, built on Baylor College of Medicine, the mammoth Texas Medical Center and the MD Anderson Cancer Center, all of which are stepping up their global health efforts.
Photo by Houston TranStar via Flickr
Beyond that pedigree, the particular catalyst for her story is Dr. Peter Hotez’ move from D.C. to work with Baylor and the Texas Children’s Hospital. Hotez is a bit of a global health rock star (Wikipedia bio), known for his work with vaccines and tropical diseases, and he’s bringing his work to Houston with him.
Part of his nonprofit organization, the Sabin Vaccine Institute, is also moving down to Houston, which Hotez calls a “gateway to Latin America.” Hotez will also be the founding dean of the first U.S.-based school of tropical medicine. Its exclusive mandate and Hotez’s track record of achievement are likely to attract some of the brightest physicians with an interest in global health, which is huge for creating a bustling global health community.
Schiff finishes with another prediction, writing that “the Houston Chronicle hasn’t traditionally been a major source of global health news, but I’d start paying closer attention. There’s too much going on for there not to be a story.” For the record, reporters interested in adding the Chronicle to their regular health reading lists can subscribe to its RSS at http://feeds.chron.com/houstonchronicle/health.
As an alternative or supplement to the Chronicle’s coverage, Carrie Feibel covers the Houston health beat for the local NPR affiliate, and you can keep up with her reporting by following her on Twitter at @KUHFHealth.
The UN Dispatch is sponsored by the United Nations Foundation, a private organization which supports UN efforts worldwide, particularly in the public health arena.
Institute launches global health data clearinghouse
Filed under: Health data, Health journalism, Public records, Tools
Last month, the University of Washington’s Institute for Health Metrics and Evaluation (about) launched the Global Health Data Exchange (or GHDx), a sort of clearinghouse for global public health data sets. At launch, the site boasted about 1,000 data sets and promised it will index and host “information about microdata, aggregated data, and research results with a focus on health-related and demographic datasets.”
The data is accompanied by visualization and GIS tools. For updates on the site, add the GHDx blog to your RSS. And, if you’re looking for a more direct connection, you can plug right into the RSS of new databases.
At present, the data is global in nature, though there are still plenty of domestic and comparative sets that will be of use to just about any U.S. reporter. Many of them will be familiar to data-heads, but it’s still handy to have it all in one place. The site will point directly to data providers when possible, and will work to provide public data for direct download. Free site registration is required before downloading.
Gates’ funding of journalism raises ethical questions
Filed under: Conflicts of interest, Europe, Health journalism, Hot Health Headline
In our coverage of the Kaiser Family Foundation’s report on the present and future of the global health beat, we noted the influx of the Bill and Melinda Gates Foundation’s largesse ($1 billion in the past decade) [correction] into that particular sphere of the health journalism world. The foundation has gone beyond supporting the training for journalists to now funding specific reporting enterprises – such as a recent ABC News special “on an incubator to boost preemie survival in Africa and a new machine to diagnose tuberculosis in the developing world.”
Now, Seattle Times reporters Sandi Doughton and Kristi Heim look at the logical question brought about by all that money: “Does Gates funding of media taint objectivity?”
I don’t think there’s a journalist among us who will be able to resist reading the whole thing, if only to see just how much certain organizations have been given and which stories the foundation has been pushing. Nonetheless, I’ll run through a few of the highlights.
The Seattle Times reporters touch on some high-profile pieces funded through partnerships between the foundation and top media organizations, but write that the Gates effect runs much deeper than investigations that say “Funded in part by the Bill and Melinda Gates Foundation” at the end. After all, they write, “The Gates Foundation spends more on policy and advocacy than most big foundations — including Rockefeller and MacArthur — spend in total.” It accounts for a tenth of their annual $3 billion budget.
To garner attention for the issues it cares about, the foundation has invested millions in training programs for journalists. It funds research on the most effective ways to craft media messages. Gates-backed think tanks turn out media fact sheets and newspaper opinion pieces. Magazines and scientific journals get Gates money to publish research and articles. Experts coached in Gates-funded programs write columns that appear in media outlets from The New York Times to The Huffington Post, while digital portals blur the line between journalism and spin.
As the reporters note, their sources point that that, “While the aims may be laudable, the ability of one wealthy foundation to shape public discourse is troubling to some.”
“Even if we were to satisfy ourselves that the Gates Foundation were utterly benign, it would still be worrisome that they wield such enormous propaganda power,” said Mark Crispin Miller, professor of media, culture and communications at New York University.
For their part, foundation folks say they’re trying to raise the profile of undercovered issues, not manipulate the world’s media.
“We’re trying to do everything we can to make sure people understand not just the need, but the opportunity, to make a huge difference in the lives of millions of people around the world,” said Joe Cerrell, who oversees the foundation’s policy, advocacy and communications work in Europe. “For us, it’s about making sure that these stories get told.”
For a more critical take, see Humanosphere blogger Tom Paulson’s review. In addition, David Jacobs, director of foundation information management at the Foundation Center, raises the question of whether it’s ethical for media outlets to accept donations from large foundations whose activities they may have to scrutinize one day.
Oh, and by the way, the reporters write, “The Seattle Times received a $15,000 Gates grant through Seattle University for a series of stories on homelessness in 2010.”
Update:
Christopher Williams, senior communications officer of The Gates Foundation, has written to Covering Health to clarify: “In fact, the foundation has spent approximately $50 million on media grants and partnerships over the past decade. We have spent approximately $1 billion on all advocacy efforts, for all of the issues that are important to the foundation. This includes research, policy work, and other advocacy of our issues that is not necessarily media focused.”
Global health journalism, a beat in flux
Filed under: Europe, Health journalism, Hot Health Headline, Studies
If it’s 32 pages on the present and future of journalism and major global health issues you seek, look no further than the Kaiser Family Foundation’s Taking the Temperature: The Future of Global Health Journalism (PDF). The paper’s authors, Nellie Bristol and John Donnelly, interviewed 51 reporters, editors, freelancers and producers from across the media landscape and assembled their findings into a sort of “state of the industry” report.
Their report opens with a bit of a paradox. At the very moment that the news industry in general and global health coverage in particular is on the decline worldwide, overall funding for global health has surged, thanks in large part to the American federal government and high-profile private organizations like the Gates Foundation. That isn’t to say, of course, that those organizations have been absent from the media arena either.
In fact, throughout the course of the report, you can’t help but notice just how many global health reporting efforts are funded by public media or Gates and company. Thanks to these funds and the evolution of media in the United States, the global health reporting landscape seems to be shifting as more journalists exit the discipline and more purpose-driven organizations slide in to take their places. Furthermore, these new pressures, both positive and negative, have arrived alongside a shift in the focus of the beat itself.
Many interviewees noted that increasingly, stories they covered tended towards infectious disease outbreaks, like influenza, and disaster related health issues. This was not only a resource issue, but what some saw as story fatigue or lack of fresh angles on health stories in developing countries, especially related to HIV/AIDS. Many, though not all, found policy angles, such as U.S. government efforts to improve global health, difficult to incorporate into their stories, much less serve as a focal point.
Major news organizations like The Associated Press and New York Times have shuttered foreign bureaus and tightened their travel budgets, and the funds allocated for freelancers are falling across the board.
The current financial reality for many global health freelancers, whose work is viewed as filling the gap created by media staff reductions, is pretty grim. Samuel Loewenberg who has written on global health issues for publications ranging from The New York Times to The Lancet, said freelance rates for many publications have fallen. Arthur Allen, a former AP staff writer and now an author and freelancer, said a prominent online publication recently dropped its rate from $1,000 to $500 a story. Another pays $300 a story. “I asked why they are decreasing payment and they say, ‘Some people are writing for nothing,’” Allen said. “It’s a hobby for people who have other gigs. …Certainly doctors and lawyers have a lot to say about things, but it’s difficult for people like me who are journalists.”
As an interesting aside, The Boston Globe has replaced those traditional coverage extenders, travel and freelance, with something more direct: Skype and the cell phones that are now commonplace in even the more remote bits of the planet.
Amid the tales of industry-wide retreat that fill the report, there’s one clear bright spot: academic and professional journals. The authors found journal staffers to be particularly optimistic about their profession and optimistic about the future.
Medical, science and health policy journals have expanded their global health reach, supported both by grants and a larger global health professional audience. While the journals’ primary purpose is to publish research, several also now offer news columns or field-based reporting that focus on global health.
The health highlights of two years of Guardian data
Filed under: Europe, Health data, Health journalism, Public health, Public records, Tools
In two years, the Guardian’s data blog has published more than 600 data sets. I know this because, thanks to their nifty summary post, I just browsed the full list. In addition to more than a few UK analogues to the sort of stuff we see from AHRQ and NCHS, such as UK life expectancy, birth rates and aging populations and public spending, they’ve also got the sort of global health stuff that any journalist or blogger could pull out and use in a post tomorrow. I’ve collected some of my favorites and tried to strike a good balance between unique stuff and broad-spectrum, widely available global health data.
- Cancer rates: see how countries compare worldwide
- Assisted suicide statistics: the numbers Dignitas helps to die, by country
- What’s happened to measles immunisation - and how do we compare to the rest of the world?
- There’s more to life than GDP
- Hunger by numbers: How we are losing the battle against worldwide malnutrition
- The world in drugs use
- Condom use around the world
- Obesity around the world
And finally, for no particular reason, here’s the outcome of every freedom of information request ever filed by the BBC. Also in the category of “data for curious journalists/insiders”? Several years of UK libel cases.
Reporter looks at black infant mortality in Wis.
Filed under: Children, Health data, Hot Health Headline
The Milwaukee Journal Sentinel’s Crocker Stephenson took a look at disparities in infant mortality in that area and explored both their cases and ramifications. In Wisconsin, black babies die at twice the rate of white babies, a finding which may just be the tip of the iceberg. For national and international comparisons, see the companion infographic. According to Stephenson, infant mortality rates are an early indicator of a community’s degeneration. When mortality rises, so do other dire indicators.
The bottom third - the group of ZIP codes with the most poverty and lowest college graduation rates - had the highest infant mortality rate.
It also had the highest premature death rate, chlamydia rate, HIV rate and teen birthrate.
It had the greatest percentage of low birth weights; preterm births; uninsured adults; people who hadn’t seen a dentist in a year; births to mothers who received no prenatal care during their first trimester; smokers; pregnant smokers; obesity; violent assaults within the past year; single-parent households; and children who tested positive for lead poisoning.
Milwaukee’s health commissioner called it a “crisis,” one that Stephenson found is as much a social matter as it is one of access to proper care. For more, see the “Problem Areas” section of the story.
International cooperative to share health data
Filed under: Europe, Health data, Health policy, Hot Health Headline, Public health, Public records, Tools
Writing that “the importance of data sharing in advancing health is becoming increasingly widely recognised,” 17 major public health players entities, from the CDC and AHRQ to the Bill and Melinda Gates foundation and the World Bank, have banded together to form a sort of data cooperative around the Wellcome Trust and the Hewlett foundation. In a Lancet commentary announcing the initiative, Wellcome director Mark Walport and Hewlett president Paul Brest write that, while fields such as genetics and molecular biology, a mature data-sharing system has sped up discoveries and increased efficiency, public health is lagging behind.
Much of the infrastructures, technical standards, and incentives that are needed to support data sharing are lacking, and these data can hold particular sensitivities. And some researchers are reluctant to share data. Too often, data are treated as the private property of investigators who aim to maximise their publication record at the expense of the widest possible use of the data. This situation threatens to limit both the progress of this research and its application for public health benefit.
Each organization will work within its own structure and their initial goals include the creation of data standards to facilitate sharing as well as increasing the prestige of creating public data sets. They acknowledge there will be some bumps along the way, but call on other organizations to join the initiative and to pursue the long-term goal of the widespread, fair and privacy-respecting sharing of public health data.
ABC News launches global health project
Tonight at 10 Eastern, ABC News anchor Dianne Sawyer will host “Be the Change: Save a Life,” a program which will profile “innovative” solutions to global health problems across Asia and Africa. To accompany what is planned to be a yearlong effort, ABC News is launching saveone.net, a site which will be updated throughout the year with information on health issues in developing nations. That reporting will be combined with the request implicit in the program’s “Be the Change” title and a site which blurs the lines between journalism and activism.
The heart of the network’s online call to action is a page referring readers to specific charity efforts and encouraging them to donate. All the project donations are hosted by GlobalGiving.org, an organization which says it pre-screens grassroots charity efforts.
(Hat tip to Media Bistro’s WebNewser)
Barlett & Steele uncover chaos, peril of global drug industry
Filed under: Conflicts of interest, Europe, Government, Health data, Health policy, Hot Health Headline, Pharmaceuticals, Public health
In Vanity Fair, Donald Barlett and James Steele have devoted more than 6,000 words to chronicling the gaping holes in the global pharmaceutical industry, particularly as pertains to the globalization of clinical trials. Even if you’re familiar with many of the specific incidents covered, their cumulative effect, driven home with forceful and authoritative prose, is brutal. Each paragraph holds another tale of trials gone wrong, children killed and bad results that somehow never came to the attention of American regulators.
Photo by amyvdh via FlickrIt used to be that clinical trials were done mostly by academic researchers in universities and teaching hospitals, a system that, however imperfect, generally entailed certain minimum standards. The free market has changed all that. Today it is mainly independent contractors who recruit potential patients both in the U.S. and—increasingly—overseas.
They devise the rules for the clinical trials, conduct the trials themselves, prepare reports on the results, ghostwrite technical articles for medical journals, and create promotional campaigns. The people doing the work on the front lines are not independent scientists. They are wage-earning technicians who are paid to gather a certain number of human beings; sometimes sequester and feed them; administer certain chemical inputs; and collect samples of urine and blood at regular intervals. The work looks like agribusiness, not research.
After neatly setting up each pin with demonstrations of how international the pharmaceutical industry has become, then proceed to knock them all down with examples of industry impunity and FDA weakness.
The F.D.A., the federal agency charged with oversight of the food and drugs that Americans consume, is rife with conflicts of interest. Doctors who insist the drug you take is perfectly safe may be collecting hundreds of thousands of dollars from the company selling the drug. … Quite often, the F.D.A. never bothers to check for interlocking financial interests. In one study, the agency failed to document the financial interests of applicants in 31 percent of applications for new-drug approval. Even when the agency or the company knew of a potential conflict of interest, neither acted to guard against bias in the test results.
Related
WikiLeaks cables: Pfizer used dirty tricks to avoid clinical trial payout in Nigeria
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