Category Archives: Random Musings

Thoughts on medicine,health,ethics and everything else that crosses the mind

The impact of climate change on the burden of snakebite: Evidence synthesis and implications for primary healthcare

Snakebite is a public health problem in rural areas of South Asia, Africa and South America presenting mostly in primary care. Climate change and associated extreme weather events are expected to modify the snake-human-environment interface leading to a change in the burden of snakebite. Understanding this change is essential to ensure the preparedness of primary care and public health systems.

An evidence synthesis to better understand this aspect was published in Journal of Family Medicine and Primary Care and is available (open acess) here.

Ensuring continuum of care in child and adolescent primary care: how evidence synthesis shaped the space

Syntheses of evidence are of immense importance to clinical medicine, health systems and policy decision-making as well as in program implementation. The synthesis of evidence in a timely manner, using a fit-for-purpose approach, with clear articulation of purpose and proposed use, is a crucial component the global health ecosystem. Evidence syntheses can not only effectively illuminate global health problems but can also help challenge policy assumptions and offer implementation recommendations across diverse contexts. This seminar is one of a series on evidence synthesis for global health.
The first seminar hosts Dr Zohra Lassi, who would deliver a lecture on how evidence synthesis shaped the space of child and adolescent primary care followed by audience interaction and a fireside chat hosted with Dr Devaki Nambiar. Dr Soumyadeep Bhaumik will deliver the welcome note for the series.
The seminar is free to attend : https://www.georgeinstitute.org.in/events/evidence-synthesis-for-global-health

Transitioning medical education towards trans-disciplinarity

Community medicine training consists of a bit of family medicine and a bit of public health- with no advanced competencies on either. Family medicine is now an established discipline with its own scholarly niche, a clear generalist approach towards clinical care rooted in the philosophy of primary care. Public health developed outside medical universities, and global scholarly work has meant it has a strong but continually evolving philosophical basis. Both family medicine and public health have some commonalities – they do not shy away from integrating concepts from various disciplines; are collaborative in nature; and its post-graduates are job-ready. Community medicine on the other end has been not able to move away from the clinical lens and has no clear philosophical leanings.[5] Surely teaching medical students alone cannot be an enough justification for continued investment on community medicine. 

The full article in Journal of Family Medicine & Primary Care is available open access here .

Photo by Polina Zimmerman on Pexels.com

Need for transdisciplinary systems thinking to address snakebite

Snakebite, a major public health issue but a hugely neglected problem continues to affect millions of people with death and disability worldwide. In 2018, the first ever International Snakebite Awareness Day was celebrated on September 19, to emphasize on awareness and actions needed to tackle the burden of snakebite. The George Institute for Global Health (TGI), will be organizing a seminar on the topic ‘Need for transdisciplinary approach for addressing snakebite burden’ on this day. The deliberations of the seminar aim to expand the lens from the current clinically dominant approach to address snakebite to include learnings from other disciplines and enable systems thinking to solve the issue.

Mark your calendars for 19th September 2021, Sunday, 14:00 -15:00 hours IST

Key Focus & Our Speakers 

  • Introduction to event: Snakebite – an issue like no other
  • Talk 1: Why ‘Neglected Tropical Disease’? The politics of ‘Otherization’ of snakebite in India
    • Dr Rahul Bhaumik, Department of History, Women’s College, University of Calcutta, West Bengal, India,
  • Talk 2: Snakebite & climate change: preparedness for the imminent crisis  
    • Dr Soumyadeep Bhaumik, Injury Division, The George Institute for Global Health, India; Meta-research and Evidence Synthesis Unit, The George Institute for Global Health
  • Talk 3: Using snake rescue data to develop snakebite mitigation strategies
    • Mr. Vishal Santra, Society for Nature Conservation, Research and Community Engagement, West Bengal, India; Captive and Field Herpetology, Wales, United Kingdom
  • Fireside Chat with audience interaction: Transdisciplinary systems approach for snakebite – challenges and way forward 

The session concludes with a Q&A session where the audience can engage with the panelists.

More information here . Register here .

Stronger together: a new pandemic agenda for South Asia

The global increase in COVID-19 cases in 2021 has primarily been due to an uncontrolled surge in South Asia. It is estimated that by 1 September 2021, approximately 1.4 million in South Asians will die due to COVID-19 alone. The total number of excess deaths will be much higher—including non-COVID causes, as health systems are on the brink of collapse. With 33.4% of South Asians being extremely poor and the large-scale loss of livelihood being reported, the region faces a potentially catastrophic future for the ongoing decade. However, countries in South Asia continue to remain divisive. This differs from other geographic ‘blocs’ that frequently cooperate on mutual interest issues. Tensions in South Asia are shaped by complex domestic, bilateral, intra-regional and international geopolitical factors, despite the region’s obvious geographic, economic and cultural interdependence. A key lesson from the current pandemic is that countries need to share lessons and actively coordinate, complement and supplement each other’s public health responses, especially between neighbours.

Read the Editorial published in BMJ Global Health with Dr Soumyadeep and his colleagues which presents a pragmatic ‘Stronger Together’ agenda on critical areas of concern for political, social, medical and public health leaders in South Asia to consider and build on here (open access)

Photo by Min An on Pexels.com

Snakes, the ecosystem, and us: it’s time we change

Snakes are often killed at sight, even if not venomous. Social and cultural connotations, some more negative than others, and fear of snakebite shape our attitudes towards snakes and lead to human snake conflict. But snakes play an important role in our ecosystem and provides us economic and therapeutic benefits. It is high time we now start valuing the importance of snakes in biodiversity to make our societies healthier.

Read the working report released on the occasion of World Snake Day , July 16, 2020 here ( open access)

Going beyond access to health information: a pandemic call to action

About a decade earlier we brought to attention that the lack of access to health information is ‘a social injustice that the global health community cannot afford to ignore’. We argued that governments are morally and legally obliged to ensure access to health information. In the backdrop of the COVID-19 pandemic, we have seen significant investments from multinational agencies, governments, non-profits and private actors to disseminate health information. However, a narrow focus on providing access to health information alone, without any investment or thought on how information can be translated by people to meaningful health outcomes, is proving to be counterproductive.

Read the Editorial by Dr Soumyadeep Bhaumik and Dr Pranab Chatterjee in BMJ Global Health (Open access)

Low-value medical care in the pandemic-is this what the doctor ordered?

The humanitarian crisis India faces in the second wave of COVID-19—the rapid surge of cases, the collapsing health system, and the death and despair—are being documented in real time. However, the large-scale practice of low-to-minimal value care and its consequences have escaped notice.

A majority of those with COVID-19 disease have mild-to-moderate symptoms and are managed by qualified doctors out of hospital. A typical prescription for COVID-19 in India includes azithromycin, doxycycline, ivermectin, hydroxychloroquine, vitamin C, vitamin D, zinc, acetylcysteine, and inhaled budesonide or dexamethasone. The antiviral favipiravir became the top selling drug in India in April, 2021 despite not being recommended for COVID-19 by any major guidelines. Anticoagulants such as rivaroxaban are prescribed in outpatient settings, even for patients without increased thrombotic risk, against the recommendations of most international expert panels. Broad-spectrum antibiotics are added under the pretext of treating secondary infections.

In India, a battery of diagnostic tests is also being conducted for patients with COVID-19—blood counts, blood sugar, kidney and liver function tests, D-dimer, interleukin-6, procalcitonin, C-reactive protein, ferritin, and lactate dehydrogenase. Diagnostic laboratories are offering COVID-19 test packages.

Read the full article by Dr Soumyadeep Bhaumik and colleagues in The Lancet Global Health (Open Access)

Podcast: view on COVID-19 in West Bengal

India is breaking records of COVID-19 positive cases across the world. Daily cases in the country have hit a new high of over three lakhs. In West Bengal too, one in every three people in West Bengal is testing positive. For the past few days, there have been calls on social media pleading for beds in Kolkata. The election climate though seems apathetic to the pandemic.

In a podcast with Suno India, India’s leading podcast platform, Dr Soumyadeep Bhaumik discusses with Ms Suryatapa Mukherjee talks about :

  • how lack of national #lockdown is killing the poor – no equity
  • need to focus on prevention & think beyond biomedical lens- not just vaccines
  • Need to fix accountability.
  • Learnings which Delhi offers for West Bengal \

Click icon below to listen (opens in new window).

Headphone

Depression & PTSD in snakebite survivors: need for more research — Snakebite Research Network

Snakebite is a neglected tropical disease that causes death and disability, particularly in rural and tribal people in South Asia, Africa and Latin America. Death, permanent disabilities and long-term physical sequalae due to snakebite has been much discussed and talked about. But are there any mental health manifestation in snakebite survivors? Keen to understand this […]

Depression & PTSD in snakebite survivors: need for more research — Snakebite Research Network