Raj Panjabi has ten years since his family joined the civil war in Liberia. For the past three decades, Harvard Medical School instructor has been working to increase access to health in its native countries and other developing countries, as a delegate and founder of the NGO Last mile health.
The focus of its focus, centered on communal health, catapults into the list of the 100 most influential people in the world following the review Time af 2016. This year, he owned medical on a first-line basis against the pandemic. Although the vacancies against the covid-19 are nearing the end of the tunnel, these can be delayed until they reach millions of vulnerable people around the world.
Question: How is coronavirus affecting rural communities in both low-income and low-income media?
Answer: The rural communities he has tenid to challenge this indulgence. If we observe any pandemic in the history of mankind, we know that the poor and marginal are the ultimate in accessing laboratory exams, treatments and vacancies. This is the history of each historic pandemic. Y, unfortunately, the covid-19 pandemic is causing a viral apartheid, in that only the rich have access to the services and adequate treatment. For example, access to the test is more common in rural areas than in cities. Treatment is delayed because dexamethasone oxygen therapy is not available. In addition, rural areas are the ultimate source of some new medicines.
Raj Panjabi, Harvard Medical Professor.
When it comes to vacations, the experience of previous campgrounds shows us that the poor and rural regions are the ultimate in reclaimers.
In terms of vacancies, the experience of previous munitions campaign shows that poor and rural regions are the ultimate reclaimers. We know, according to the current information on global ammunition, that 13 million minor children of one year do not receive a single dose of vaccine. We are dealing with sarampión, polio and other vacancies that are known and used, because there are fires in aliyad rural areas and, in particular, in urban areas due to the limitation on the poorness and lack of services hello. I believe that for all this, the communities are not well prepared at the moment.
P: Mention that some rural communities have made similar remarks to covid-19. What lessons have you learned from your experiences?
R: One of the keys is to incorporate health workers and coordinate its action with medical and nursing teams. The countries that are responsible for the health of the pandemic are relatively higher. A good example is the one from Liberia, where it was founded Last mile health.
Hace años, tuvimos la Ebola epidemic which caused much pain and suffering in our country. 11,000 people lost their lives in the region and 30,000 became infected. Pero pudo haber sido mucho peor.
At some point, the projections were made that one million people would have been infected, among them, killing the most dead people. Entones, when the Ebola star was doubling down on humanitarianism in Liberia, the paper said it would make communion workers of enormous health care. Fueron ellos quienes, en equipo con enfermeros, examineron pasientes.
In a district, we examined 10,000 people; apenas 42 trabajadores que puerta a puerta prestaban attención a los sintomas. Our same workers also maintain contacts and connect with the health care services. These workers, who provide service to approximately 80% of Liberia’s rural population, are now capable of identifying coronavirus cases and restraining contacts to ensure that the health system does not collapse completely.
P: Usted insists much on the importance of the health communion, with community workers actively attending to families, in low-income countries. Do you think this model will be forced to pay high interest rates like Spain?
R: Creo que sí. For example, in Brazil, health workers worked with chronic illnesses that asolan had many rich countries and poor country areas, such as hypertension and diabetes; enfermedades that end up producing cardiac attacks or cerebral palsies that severely disable patients and including deaths. Hecho, the well-known Brazilian health program contributes to the reduction between 15 and 20% of the mortality rate associated with cerebral palsy and cardiac attacks. We can obtain similar results in rich lands, but do not dedicate the necessary resources. For example, the Office of Labor Statistics states that here, in the United States, only 56,000 health workers work. We need at least 300,000. Some times, the people create that the labor cost of the health service is a guest, not an inversion.
Raj Panjabi, Harvard Medical Professor.
According to the world population, 3,700 million people have access to health services. Inside this group, there are hundreds of millions who live in the most remote communities.
P: More about the covid-19 pandemic, do you think there are any challenges to accessing a universal health service in the world, including rural areas?
R: Mientras haya un pasiente fuera de nuestro alcance, quiere decir que no hemos hecho lo suficiente. Unfortunately, there are many patients who suffer from nausea. For me, this is the mayor’s problem that, in addition to being addressed by the general, the information that he has about himself is insufficient.
We deal with frequency due to the lack of attention to specific methods. The child does not have sufficient access to the treatment of VIH, tuberculosis, hypertension, certain parts … , we meet the rural people and take them to the cabeza.
According to the world population, 3,700 million people have access to health services. Inside this group, there are hundreds of millions who live in the most remote communities. In the meantime, we will build a primary health care system that is available to both children and families.
P: How can technology, including Artificial Intelligence and telemedicine, help increase access to health care in poor social contexts?
R: To build a robust health system, four pillars are needed: personal; material medicine and medicine; a space where you can provide the service and, ultimately, technology.
When we have programs all over the world, the most exiting guests are in their four areas. The technology can improve training, with virtual tools, assist in diagnostics, improve follow-up and facilitate access to health services, as well as telemedicine. Without embargo, there is a dolorous paradise: there are many places in the world where technology can mark a big difference, as in rural areas, but it is just that there is no infrastructure to approve the technology. Therefore, among other things, we need the best infrastructure models that reduce energy requirements.
About Artificial Intelligence (IA): I believe there is a lot of publicity going on about it. For a community health worker who needs to diagnose 20 different pathologies, the IA is relevant only when one of those 20 cases is very rare and the IA can be identified. Si no, no es tan relevant.
To me, I have to work hard to guarantee the technological infrastructure, to provide telemedicine and to provide tele-education. The IA has only sent if it supports other areas of technology for health attention.
P: More about technologies, do you think primary care and community health should reduce mental health?
R: Desde luego, my parece crucial. One of the studies that hicimos in Liberia was followed by the civil war that lasted 15 years and produced a lot of trauma. We collected 1,600 hogares in the year 2008, with the Governor of Liberia. Between 40 and 44% of the adult population has symptoms that are classified as depression or severe post-traumatic stress disorder.
It is imperative that community health can ignore a problem of this magnitude. Communal health is unfinanced. By the way, the mental health communication also.