Tag Archives: Health

Once the dust had settled following the devastating Ebola outbreaks in West Africa, it was discovered that deaths resulting from Ebola were disproportionately concentrated among health care workers. Based on some estimates, .11% of Liberia’s entire general population had died due to Ebola, compared with 8% of its health care workers. In Sierra Leone, the loss was 0.06% of the general population compared with 6.85% of the health workers, while 0.02% of Guinea’s overall population had died compared with 1.45% of all health workers, according to May 2015 data from the World Bank. It was this situation that partly led to the creation of a company called Kinnos, which invented a new substance to decontaminate health care and other potentially contaminated facilities.

Kinnos posited that regular bleach disinfectant was not always sufficient to protect all health workers from highly contagious viruses such as Ebola. Although bleach is recommended by the World Health Organization and other international health agencies as the best and most cost efficient disinfectant for surfaces contaminated by infectious disease, its effectiveness is limited by the fact that it is clear. This makes it easy to “miss spots” and leave gaps in coverage of disinfection. Kinnos created Highlight, a patent-pending powdered additive that colorizes disinfectants. This makes it easier to visualize, ensure full coverage, and adhere to surfaces. The color is only temporary, however; it fades once decontamination is complete.

Highlight is being used by the New York Fire Department and was a winner of the USAID Fighting Ebola Grand Challenge. It has also been field tested by health care workers in Liberia and Guinea. The new technology was spotlighted at TEDMED 2016, taking place this week in Palm Springs, CA.

One of the co-founders of Kinnos, Kevin Tyan, spoke to attendees about the company, which was founded by him and two others when they were undergraduates at Columbia University in 2014. Responding to TEDMED 2016’s overarching question to attendees, “What if?”, Tyan and his colleagues asked, “What if we could highlight invisible threats for our lifesavers?” The development of products such as Highlight could be part of the answer. Another component of fighting emerging diseases such as Ebola and Zika is detecting them early so that proper treatment and precautions can be taken. TEDMED 2016 speaker Charles Chiu, an infectious disease physician and researcher, detailed the development of a tiny next-generation sequencing device (from Oxford Nanopore Technologies) that could improve how quickly and effectively we can diagnose and respond to the next deadly disease. Chiu’s talk fed into the overarching theme of this year’s TEDMED – “What if?” – by posing the question, “What if next generation sequencing could help us diagnose mysterious infectious illnesses.” The device can “detect any infectious agent…no matter whether it is a bacteria, virus, fungus, or parasite” in a single test, and can do so in a matter of hours and in remote, low-resource settings, Chiu explained.

By working with a number of national and international partners, the researchers have been able to bring this instrument and its associated protocols and laptop software to remote areas around the world – Barbados, Brazil, Democratic Republic of the Congo, and Ethiopia – for diagnosis and surveillance of acute febrile illness from pathogens such as Zika virus, Ebola virus, and Plasmodium falciparum malaria. The way this technology works is like quickly finding a needle-in-a-haystack. Clinicians collect a sample – blood, spinal fluid, nasal swabs, or tissue – and generate hundreds of millions of sequence reads. They then diagnose infection by identifying sequences corresponding to all potential viruses, bacteria, fungi or parasites using a bioinformatics program called SURPI, which stands for sequence-based ultra-rapid pathogen identification. “SURPI can analyze 300 million sequences within hours, and is available on servers, the cloud, and even on a laptop,” Chiu noted.

This is warp speed compared to conventional testing, which often involves using cultures, where you grow the organism from days to weeks and can waste “precious time retesting limited amounts of sample looking for an endless array of potential agents,” Chiu explained. By implementing all of this in a single test, patients can obtain “targeted, timely, and effective treatment before it’s too late.”

In addition to testing the technology in other countries, in June 2016 Chiu and his colleagues launched a multi-hospital study on the “Precision Diagnosis of Acute Infectious Diseases.” Over one year, they will enroll 300 patients and compare the metagenomic next-generation sequencing test, which has now been clinically validated in a licensed diagnostic laboratory, to conventional testing. This demonstration project aims to establish the clinical utility and cost-effectiveness of this test for diagnosis of meningitis and encephalitis. Their efforts are particularly timely given that the FDA in May of this year released draft guidance for next-generation sequencing diagnostic devices.

“We are currently in the process of seeking FDA approval for this test, and hope that approval for tests such as these can be fast-tracked as soon as possible and made widely available to patients,” Chiu said. They are also working with NASA on potentially sequencing in space.

In August of this year, astronaut Kate Rubins reported for the first time a successful sequencing run in space on the MinION nanopore platform. “Ultimately, the goals of sequencing in space will include diagnosing infections in astronauts, environmental surveillance, and even the discovery of new life,” Chiu stated. To see these space-age goals realized, the populace will have to live long enough.

Another TEDMED 2016 speaker, Dr. Nir Barzilai, an Israeli internist, is examining a way to target the process of aging to help us live longer, healthier lives. He is spearheading a randomized controlled trial of a medicine, metformin, that aims to interfere with the aging process. Meformin, Barzilai explained, is a generic drug that has been used for over 60 years to treat patients with type 2 diabetes. It directly targets several important mechanisms of aging, and has been shown to extend the health and life spans in organisms including worms and mice. In humans, metformin prevents type 2 diabetes in those at high risk and has been associated with reduced cardiovascular disease risk. In patients who already have type 2 diabetes, metformin is associated with a 30% reduction in cardiovascular risks and death, and a 20-40% reduction in cancer risk. It is also associated with a decrease in cognitive decline and Alzheimer’s disease.

With those preliminary results as a backdrop, Barzilai and his colleagues have launched a study, Targeting Aging with MEtformin (TAME). They will be studying 3,000 elderly volunteers who will be assigned to either placebo or metformin. They will attempt to measure the time it takes for any of age-related diseases — cardiovascular disease, cancer, diabetes, Alzheimer’s disease and death – to manifest. Because the study aims to show how metformin affects the rate of aging, the researchers are working with the FDA so that the drug will carry an “anti-aging” indication if it is proven to be effective for that purpose. Gaining this indication will spur more companies to pursue the development of anti-aging medications, Barzilai stated. He is hopeful that the study will show that “metformin will probably add healthy years to life.”

But metformin is only the beginning: he predicted that next generation drugs will be better and better,” Even a “modest change in people’s health span,” he added, “will be translated into $50 billion in health care savings by the year 2050.”

TEDMED 2016 was held in Palm Springs, CA from 30 November through 2 December 2017. Visit www.TEDMED.com for more information

Guest blogger is Tula Michaelides – has 25 years of professional experience writing for a variety of audiences, predominantly in the fields of global and U.S. public health. She attended TEDMED 2016

Article originally written by Tom Fowler for Medgadget – November 20, 2015.


 

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Anna Young, co-founder of MakerNurse, is bringing rapid prototyping tools into hospital units to enable nurses, other providers, and even patients to problem-solve with innovative do-it-yourself labs within hospitals, with the end goal of ultimately improving patient care. Anna and her team at MIT’s Little Devices Lab bring rapid prototyping tools into hospital units creating “Maker Health Spaces”. They recently spunoff Pop Up Labs, a privately held company to take these tools to scale across clinical environments. Supported by the Robert Wood Johnson Foundation, MakerNurse aims to empower nurses and bring nurse “making” to helm of changing the face of health care. I had the opportunity to meet with Anna at this year’s TEDMED conference in Palm Springs, CA, to talk about her work.

MakerNurse co-founder Anna Young

MakerNurse co-founder Anna Young

Tom Fowler, Medgadget: So Anna, have you always been a tinkerer?

Anna Young: I walked into MIT as a trained economist 6-years ago and it was there that I learned how to teardown medical devices, learn how they work and modify them through design and prototyping. If I could do it, I knew anybody could do it. That became my main interesting: how do you develop democratizing tools for medical device design and prototyping.

Medgadget: What type of traction do “Medical Maker Spaces” see in hospitals? What percentage of nurses will take the leap of faith into becoming device developers?

Anna Young: Across the board, 1 in 5 nurses is what Eric von Hippel will call, a “lead user”, they are faster than a device firm to identify a gap in a product and to spot an opportunity for problem solving. Hospitals are loving the notion that they get to transform themselves from problem spotters in need of design and engineering partnerships to developers of their own solutions.  And it’s not just traditional research hospitals. Our biggest opportunities are in regional and community hospitals with large volumes of patients.

Medgadget: Provide an example of one awesome, and one terrible product that has come from a Maker Health Space.

Anna Young: Best example, wearable google to control hydration in eyes for burn patients.  Worst example, an anatomical wound model that burned through 5lbs of 3D printer filament only to create a very awkward looking mold. To be fair, we love both of them. We think everyone deserves the chance to experiment and prototype. I’d rather see 20 failed prototypes than 1000 post-it notes of ideas for products that never get created.

Medgadget: Does this model have legal dilemmas running into the FDA?

Anna Young: We shepherd the prototyping process to make sure our medical makers meet every regulatory guideline at different levels. Whether it’s an internal IRB study or a 510k submission. Our Maker Health Spaces come wrapped with an ethical and legal advisory board that makes sure the prototypes meet regulatory guidelines. That means that you can prototype a device, take through an internal research study to learn how well it performs and be faster at designing its pathway into patient care.  At the end of the day though, safety is always #1.

Medgadget: If I donated $1 billion to you for any project, what would you do?

Anna Young: Build a network of lending libraries of Maker Health prototyping kits around the country so that prototyping tools become more accessible and we remove the digital device in health technology.


Tom Fowler worked as a programmer in the healthcare IT industry before settling back in school to learn how to become a doctor. He likes to dabble with biotech startups, write postcards to his relatives, and play his ukulele. He was a TEDMED ’13 scholar, has published research in biomedical informatics, and continues to advocate for international maternal and child health. Currently in the SELECT MD leadership program at USF Health Morsani College of Medicine.


Another Option is proud to be a part of TEDMED 2015.

 

 

Congressman Raul Ruiz and TEDMED Chief Operating Officer Shirley Bergin.
Photo credit: Jarod Harris

The Honorable Congressman Raul Ruiz, representative of California’s 36th district, visited the 2015 TEDMED conference on Friday, November 20th. The Congressman is a medical doctor whose background includes working abroad in Mexico, El Salvador, and Serbia, and serving as an emergency physician at a nonprofit hospital in his district’s Coachella Valley. Congressman Ruiz is dedicated to improving health care and addressing health disparities, topics that are closely tied to TEDMED 2015 host city Palm Springs. Palm Springs is an exemplar of a city with a strong, functional health care system: it is a highly diverse community with high quality, accessible health care providers.

TEDMED has announced that their 2016 conference will be held in Palm Springs again next year.


Another Option is proud to be a part of TEDMED 2015.

Content originally written by Andrea Kissick for KQED – November 18, 2015.


I am addicted to TED talks. They breath new life into what was once the boring lecture.

Some of the smartest people have now become some of the most inspirational, thanks to the TED format and delivery.  TED is now its own global industry which includes smaller, more affordable, TED X talks,  a TED video channel and NPR’s TED Radio Hour.

TEDMED, which is kind of the sci-fi edge of medicine, is one of the biggest gatherings in the TED culture.

The TEDMED stage.

This year’s conference, which begins today in Palm Springs, is a who’s who in medical innovation. The list includes several people we  interviewed for KQED stories, including consumer genetics guru, Anne Wojcicki, scientists from UCSF’s genome editing project Crispr, and physicians specializing in mobile health.

There are also a number of speakers that are new to me.  Here are five topics that caught my eye.

MakerNurse co-founder Anna Young

Inventive nurses have been doing workarounds for decades, cobbling together broken medical devices or adapting a dressing for a tiny patient’s wound.   Think about it, who really knows more about how to improve patient care then the person who is at their bedside every day?  I initially heard about Maker Nurse at a conference last year, so I am looking forward to meeting Anna Young and her team from MIT’s Little Device’s Lab.  They are using the ideas behind the Maker Movement to help bring rapid prototyping of tools to patient care.

UCSD sensor innovator Todd Coleman

Todd Coleman is a UC San Diego Bioengineering Professor who develops tattoos for health monitoring in order to make medicine less invasive.  He is also a staunch public health advocate who is looking for ways to deliver sustainable innovations to under-served groups.  Click here for our recent story on KQED’s Future of You about the use of ‘smart tattoos’ to revolutionize diabetes treatment.

Bioengineer Sangeeta Bhatia

Sangeeta is both a trained engineer and physician — a rare combination. In her lab at MIT she works with technologies from the computer industry, like semiconductors, to figure out how to make livers for off-the-shelf transplants that don’t depend on a dying patient’s donation. Her team has developed breakthroughs in cancer treatment and Fast Company named her one of the most creative people of 2014.

Electrified Biogeochemist Kenneth Nealson

What is an electrified biogeochemist? Just the title is enough to peak my interest for this session.

Microbiome researcher Chris Mason

Chris Mason is best known for his recent project to map the New York subway’s DNA, which too more than a year to complete.  But Mason’s interests go beyond swabbing subway trains and urban mircrobiology. His research extends to cruise ships,  Chernobyl-struck villages and outer space.  The Cornell professor is currently working with NASA on a long-term survival plan for interplanetary survival.

You can follow the conference at #TedMed and @andreakissack.  All talks will be available on the TEDMED site after the conference.


Another Option is proud to be a part of TEDMED 2015.

Article originally written by Barrett Newkirk for The Desert Sun – November 18, 2015.

Health and wellness reporter Barrett Newkirk can be reached at (760) 778-4767, barrett.newkirk@desertsun.com or on Twitter @barrettnewkirk.


The annual meeting of minds known as TEDMED got underway in La Quinta on Wednesday with hundreds of attendees hearing from a diverse lineup of experts discussing work that often overlaps medicine and technology.

The annual conference, which is the independent and medically focused offshoot of the TEDTALK series, continues through Friday at the La Quinta Resort & Club. As many as 800 were expected to attend, many of them students, medical professional or entrepreneurs.

Chris Bi, a cancer drug researcher with Pfizer in San Diego, took a moment to snap photos of palm trees lit up at night just before the first round of speakers began. Bi said he came to hear from innovators who may help his own research, but also to get exposure to people working in areas far different from his research lab.

“I want to see how things can intersect to help with work in a lot of fields,” he said.

For those who can’t attend in person, live-streaming events are happening around the world. Talks will also be posted on the TEDMED website after they’re completed.

Speakers Wednesday ran between humorous and deadpan serious. They included people working with the latest in human gene technology and a part-time cardiologist/part-time folk singer who is about to have her second child.

Physician Pamela Wible speaks at TEDMED 2015. Photo credit: Jerod Harris/provided photo

Physician Pamela Wible speaks at TEDMED 2015.
Photo credit: Jerod Harris/provided photo

Family physician Pamela Wible began her 15-minute talk in a light mood before calling an alarm on the medical profession.

“I love the three things that people fear the most,” Wible said, “death, disease and public speaking.”

She then discussed the problem of physician suicide, reading suicide notes and showing photos from three cases. She said it’s “medicine’s dark secret, and it’s covered up by our hospitals, clinics and medical schools.”

Conference speakers Karen Stobbe and Mondy Carter stood in the conference’s social lounge after traveling from North Carolina. Their work also crosses unusual boundaries. They use techniques from improvisational theater to help caregivers relate with Alzheimer’s patients.

Stobbe explained that like with improv, caregivers often need to follow someone else’s lead.

“If you’re on stage and someone says ‘I have a duck in my room,’ and you say ‘No you don’t,’ you get into a horrible argument on stage,” she said. “With Alzheimer’s, if someone says ‘I have a duck in my room,’ you go see the duck in their room.”

Stobbe and Carter’s talk is set for Thursday morning as part of a session all about the human mind.


Another Option is proud to be a part of TEDMED 2015.

Article originally written by Barrett Newkirk for The Desert Sun – November 17, 2015.

Health and wellness reporter Barrett Newkirk can be reached at (760) 778-4767, barrett.newkirk@desertsun.com or on Twitter @barrettnewkirk.


Dozens of people touted as innovators in health and medicine will be in the Coachella Valley for TEDMED, the health-conscious offshoot of the TED Talks speaker series.

As many as 800 people are expected to fill the La Quinta Resort & Club for the annual conference, which will be held Nov 18 to 20.

The 50 speakers slated for the conference range from big names in public health like U.S. Surgeon General Vivek Murthy and renowned HIV researcher Tony Fauci to business people like “insect protein marketer” Shobhita Soor and researchers like Laura Schmidt, a sugar policy expert from the University of California San Francisco.

TEDMED 2015 speakers include (clockwise from top left) Roberta Ness, Kevin Tracey, Daria Mochly-Rosen, Laurie Rubin, Elizabeth Iorns, and Tony Fauci. Photo credit: provided photos.

TEDMED 2015 speakers include (clockwise from top left) Roberta Ness, Kevin Tracey, Daria Mochly-Rosen, Laurie Rubin, Elizabeth Iorns, and Tony Fauci.
Photo credit: provided photos.

Chris Elliott of Palm Springs made plans to attend TEDMED 2015, but as of this week it looked increasingly as if his job might keep him in Washington during the conference.

“TEDMED tends to be on the leading edge of things,” Elliott said by phone Wednesday. “It’s really looking into what health care is going to be 10 years or even 20 years from now.”

Elliott was a neuroscience researcher at the University of California San Diego before he founded MyBrainTest, a market research firm for products that evaluate brain health.

He’s attended TEDMED once before and remembered a speaker discussing the future use of smartphones to negate the need for patients to see doctors in person for routine diagnoses such as the flu.

This year, if he is able to attend, Elliott was looking forward to a session on the mysteries of the brain, which relates directly to his work. The session includes Roland Griffiths from John Hopkins University, who’ll speak on the use of psychedelic drugs to create life-changing experiences for patients.

Elliott said he was particularly interested to learn how those drugs might improve end-of-life care or even assisted suicide.

“That’s what TEDMED does, bring up topics that aren’t usually discussed openly,” he said.

With an attendance price of nearly $5,000, TEDMED in unlikely to attract people just curious to hear a few smart people talk science on stage. Livestreaming events are taking place across the country and internationally, but none have been announced in the Coachella Valley.

Talks will also be posted on the TEDMED website after they’re completed.

TEDMED 2015’s valley location is a departure from past years. TEDMED was held in Washington for four years until 2014 when the nation’s capital and San Francisco split hosting duties.

The change to the desert was an intentional effort to get away from big cities, and give attendees a calmer setting where they would have fewer outside distractions and not be scattered between several hotels, said TEDMED COO Shirley Bergin.

“We hadn’t really been under one roof in four years,” she said. “We wanted to feel like a community. We wanted it to feel like a place where people could relax, let their guard down and really start to dig into the issues at hand.”

The La Quinta Resort & Club is also known as the place Frank Capra wrote the Christmas classic “It’s a Wonderful Life.” That history of storytelling appealed to TEDMED organizers, and Bergin said they are already in talks with the resort about returning next year.

Unlike many medical conferences that focus on a particular specialization, TEDMED takes on broad subject matters that Bergin said draws professionals from a variety of disciplines. Doctors and medical researchers can end up sitting down next to designers and tech entrepreneurs.

“Every year is a slightly different year,” Bergin said. “Different delegations repeat year after year. We infuse it with new and old, those that understand TEDMED and know TEDMED and those who have never come before.”


Another Option is proud to be a part of TEDMED 2015.

SOCIAL AND BEHAVIOR CHANGE COMMUNICATION:

Factors Influencing Rural Women’s Decisions about Sanitation in Lao PDR

Another Option’s social and behavior change communication (SBCC) is designed to reflect target audiences’ personal motivations and beliefs and the cultural and environmental factors that influence them. SBCC strategies range from mass media and digital communication to social impact gaming. It also includes interpersonal communication (IPC) and peer education, and advocacy and public relations to affect policy change and cultural and social norms.

Creating an enabling environment that supports individual and societal change requires a strategic approach. Societal and cultural norms as well as policy and regulations are the barriers that prevent change. Advocacy activities range from strategic public relations, thought-leader meetings, and engagement or participation in problem solving.

Program design begins with data and Another Option has extensive experience in designing qualitative and quantitative research to offer insights and information about key populations and segment audiences and to design effective programs.

Under a World Bank-funded program, Another Option developed a social and behavior change communication program on rural sanitation in Lao PDR. Other donors include UNICEF, Plan International, and SNV Netherlands Development Organisation. Dr. Cecile Lantican led the Lao activity and following a field visit meeting with women in the communities and rural areas she captured her observations in the following blog.


What motivates women?

By Cecile Lantican, Ph.D.

From June 7-13, 2015 I joined the team of Another Option LLC, commissioned by World Bank under the Water and Sanitation Program in Lao PDR to observe people’s motivation to change and improve their sanitation practices. This is a new assignment for me after six years working in this country on changing people’s mindset and behaviors that put them to risk when they interact with their domestic animals and wildlife that carry zoonotic diseases.

I attended a ceremony hosted by the Pinh District government in Savannakhet to recognize villages that have made progress in addressing poverty and achieved improved sanitation status (declared Open Defecation free). I talked with Lao women and listened to their stories about their aspirations, needs and motivations that may have influenced their decision to seek for better status in life. I was amazed and fascinated interacting with Lao women from the south who I saw to be very hardworking, loyal to their families, hospitable and warm to visitors.

Young Lao Loum girls in their traditional Lao dresses.

Outlining the situation of rural women in Lao

I have worked with rural and urban women in this country, but I noticed that there is limited scientific information about how Lao women make decisions that affect their lives. Ethnic, geographic, and ecological differences create variations in the Lao women’s way of life. Ethnicity persists through language and dress patterns.

Illiteracy among rural women is high, especially in certain ethnic groups where cultural attitudes hinder girls from going to school. Parents force them to drop out to assist with the farm or domestic chores. Their capacity to obtain employment and participate in decision-making is severely hampered by their low level of education.

Early marriage is common among rural women. Most of them marry at the age of 16 or 17 years. A UN report in 2012 revealed that almost twice as many women marry and bear children before the age of 18 in rural areas (43%) than urban areas (23%). The total number of children of women with no education is nearly three times greater than that of women with higher education1.

The majority of women, especially those in ethnic communities, suffer from poverty, food insecurity, and unavailability of health services. The Lao women carry a great responsibility in the family. Apart from housework, and child rearing, they are also engaged in generating income for the family through labor-intensive work like collecting non-timber forest products including wild animals, weeding in the rice paddy, harvesting, planting cash crops and selling these products in the local markets, tending their animals, weaving, and managing family food stores.

More women are engaged in earning income for the family.

Rural women face complex decision-making when it comes to meeting their basic needs. Most often, they follow their elders’ advice. They feel restrained from expressing what they actually have wanted to happen in their lives.

The critical role of education for women

In Ban Sa-phang village, Mounlapamok district in Champasack province, a young mother of a three-year old boy married when she was nineteen. She did not finish primary school because she had to stop and help her parents on the farm. She married the first man who came into her life who promised her a better future since he was working in Thailand.

She was emotional when she sad, “I dreamt of living in a big house and wanted to earn money to buy food for my family, but that did not realize. My husband’s income from being a construction worker at the border, and most of the times seasonal, is not even enough for us.”

“If I was given the chance to have full control of my life, I would finish schooling. I think my life today would be different,” – Mother in Ban Sa-phang

She recognized that lack of education hampered her from finding work outside the farm. Unlike other women in her village who had entered their first year of secondary school and worked as migrant workers, she could not find work off the farm.

Women supporting their families

Anecdotal evidence showed that an increasing number of undocumented Lao women migrate to Thailand as workers in service and domestic sectors, vulnerable to abuse, exploitation and human trafficking.

Madame Bunkhong, 55 years old, was one among the attendees of the ceremony in Pinh district. She married at twenty-two and had four children.

After college, she worked in a private bank. But after two years, she had to stop working to take care of her sick father and to help her mother manage a small food stall at home. “I gave up my desire of being an employed and earn money for myself because I needed to follow my family’s decision.”

“ I wish good life for my family – to have a home and always have food on the table.” – Mdm. Bunkhong

“If I had complete control of my life before, I wouldn’t give up my dreams.” She affirmed that she is happy with her own family now, but it could have been more self-fulfilling if she had decided for herself.

Making decisions to improve sanitation

Looking closely at rural women who chose to access improved sanitation, I approached a woman who attended the PSI and district Nam Saat-led sales event for latrines. Her name is Madame Tongkham, 30 years old.  She has three children.  She married at eighteen.  Six months ago, her husband left them. She was aware that he may never comeback having heard that he has another woman.

“I should decide now for me and my children’s life.” – Mdm. Tongkham, Ban Pinh, Muang Pinh, Champasack.

It was her third time attending the latrine sales event in the village. The village council members encouraged her to attend. Earlier, she could not decide for herself because she needed to consult her husband. During this event, she ordered from the sales agent the delivery of one latrine package worth LAK 500,000. She made a deposit of LAK 50,000. “I felt devastated when my husband left. I worry about my three boys, and my old and sickly mother living with us. I have no regular income. My family now only relies on my niece who works in Thailand,” she said. “I did not finish school. I can only do farming and sometimes go with neighbors to the nearby village to harvest coffee beans. From these activities, I earn some amount to buy food for the boys,” she added.

I asked if someone had discussed the health risk of defecating in the open with her.  She replied, “ No one gave us briefing on the health risk. But I do remember that sales agent told us that having a toilet would give us convenience, safety and privacy.”

What made you decide to have the toilet this time?, I asked. “I have waited for my husband to decide.” She continued in her low voice. “ I need this toilet. I have fears when my boys defecate in the river along with other young boys. Many young boys have died of drowning in the river. My old mother needs it too,” she said.

Laotian women as community leaders

Laotian women’s confidence and self-esteem increase when they have greater knowledge, economic assets and income-earning capacity. Their low participation in decision-making is often due to stereotypes in their culture, which assign men the role of decision maker in the family and domestic affairs.

I met two Lao Women Union (LWU) community leaders at the ceremony. The district government recognized their unwavering support to uplift the living conditions and promote the role of rural women through training and participation in community affairs where their knowledge, skills and decision-making are essential.

Mdm. Phavoun (left) and Mdm. Khamphet (right) display their certificates of recognition.

The two women received training on various women-related issues from the national chapter of LWU that would empower rural women. Under the rural poverty reduction program of their district, they include provision of information on importance of education, sanitation and hygiene.

This travel provided me anecdotal evidences that rural women in Lao PDR can decide for themselves and their families. Under difficult circumstances, they can cope with their situation and can find solutions to their problems. They can improve their social status if given the opportunity of social support, correct information and networking.


1 Country Analysis Report: Lao PDR. Analysis to inform the selection of priorities for the next UN Development Assistance Framework (UNDAF) 2012-2015, UN in Lao PDR , Vientiane.

SDI

The World Bank launched in Nairobi today its new Service Delivery Indicators Initiative – www.sdindicators.org and @WBAfrica – a rigorous evidence-based tool that provides a status report on health and education service delivery.

Working initially in six countries – Kenya, Tanzania, Nigeria, Uganda, Togo, and Senegal – with plans to expand to a total of  30 African countries….SDI makes available to policy leaders and decision makers as well as the general public information (data) so they can adequately assess the quality of health and education services and help in making informed decisions related to resource allocations.

Twenty indicators – 10 in health and 10 in education –

Visit the web site – www.sdindicators.org and congratulations to WB for this unique initiative