Have we now entered the era of the super obese?

After the news story regarding 70 stone Paul Mason, a man who meant doctors coined the term superobese it seems that we have now entered the era of extreme eating and consequent bariatric surgery.
His care costs taxpayers an approximated £100,000 a year, he needed a forklift to transport him and now he needs a £20,000 surgery to help save him from death. This seems like a one in a million storyline but the frightening truth is that this scenario is becoming more and more common in Britain. In a report carried out by Office of Health Economics commissioned by the Royal College of Surgeons in England it was stated that more than 140,000 people in England alone qualify for bariatric surgery. Bariatric surgery first started out in America due tot eh huge impact that obesity was having on the nation. It was thought of due to the huge amounts of people that were failing to keep up with the diet and exercise regime set out by their doctors and other medical professionals. Bariatric surgery includes things such as gastric bands, intragastric balloons and gastric bypass all of which, although risky are very successful with a small death rate of only 1 in 300.
However despite this success of bariatric surgery, is it right that people are being allowed to bypass the natural way to lose weight in preference of the drastic surgery options? Could bariatric surgery become a way to reduce the number of obese patients without thought of the huge consequences it may have in the future?
It is thought that bariatric surgery could be wrong route for the NHS and NICE to take against obesity as many people are more in favour of the education schemes set out by the government to stand against obesity. These schemes are hoped to stop obesity and bad eating habits get out of hand.
Despite these concerns however, the number of people getting bariatric surgery in the UK is set to rise. At the moment it is said in a BMJ article that 'surgery isn't being led by clinical need' and thus the NICE is set to ask for more bariatric surgery to be carried out to reduce the pressure on the remainder of the NHS services. Even thought, Dr Haslam, a physician dealing with patients before and after surgery says that ' when bad service fail, it is the NHS who has to pick up the pieces.' Thus should more research be done into more patient and cost effective methods for obesity treatment, or should we stay firmly stuck in the era of surgery for the 'superobese.'

Health is now higher on the international agenda than ever before...

We have all heard of the DMT (Demographic Transition Model), a graphical representation of the interrelationship between birth and death rates and development. However, now there are now somenew players in the world of geographical modelling such as EMT (Epidemiological Transition Model). The introduction of further examination into new transitions stems from the main criticism of the DMT; it's assumption that 'modernisation; is the only form of development. As proved by countries such as India and Vietnam, vast areas of a country may be modernised technologically but this does mean that the development status of the country as a whole is sufficient as factors such as developments in health care, education and nutrition also need to be considered. Transitions is epidemiology and nutrition have been calculated in order to curve this lack of consideration of other factors in a different direction.

In 1971 the Epidemiological Transition Model was formed showing 3 main stages of health; an age of pestilence and famine, an age of receding pandemics and an age of degenerative diseases. Although this model may seem quite dated it still fits in with a global health transition made by the WHO (the World Health Organisation). This transition suggests that infectious diseases (Group 1) are now being replaced by non-communicable diseases (Group 2) which fits in well with the thinking of the EMT, stage 2 which suggests that pandemics due to infectious diseases will reduce.

By 2030, the WHO predicts that death from infectious diseases will decrease further, (excluding AIDS), deaths from group 2 diseases will increase, probably due to these being diseases related to affluent populations. Lastly Group 3 diseases will increase greatly.

This means that with the majority of countries putting most of their money, resources and attention towards Group 1 diseases, may be it is time to rethink this policy and focus more on the prevention of Group 2 or 3 conditions becoming more virulent in populations already under attack from Group 1 diseases. Overall, it seems that a countries health can be modelled and tracked in this way and that lacking to acknowledge their importance could lead to development being compromised.

A nation of bachelors and little emperors

After 31 years in place China announced earlier this month that it planning to remove the controversial and extreme one child policy. At the schemes birth the slogans used were phrases such as 'Have fewer children, live better lives,' or 'Stabilize family planning and have a brighter future'. However, with occurences such as forced abortions and infanticide based solely on gender and country wide outrage at the scheme no-one can say the future has been particularly bright since its introduction.

Far from it, in fact, with 40 million men unable to find wives due to the huge gender gap created by the preference of parents to boys babies rather than girls. China now has a gender imbalance of 120 boys to every 100 girls. This is a problem not only in terms of social upset and imbalance but also due to the rising amount of crime due to the problem; little girls are being stolen for sale to parents of young boys as a future wife for their only son who they know may never find a wife.

The economic effects of the one child policy have also hit China hard. When the scheme was introduced 30 years ago many demographers pointed out the risks of a shortage of labour force and an ageing population and now it seems these effects are coming to a head. The dependency ratio already has the nation at it's knees with lone children saving rather than spending to support their 4 grandparents and 2 parents. This in turn is having a knock effect to the Chinese economy because as people don't spend they are harming the country's efforts to reduce reliance on exports, thus raising export rates.

China took the advice of Thomas Malthus when they employed this population control strategy but now it seems they should have looked more to his controversial rival; Marquis de Condorcet who thought that the population growth problem could be solved by increases in productivity and improved female education. This now seems to be the better option and now people are calling for the scheme to be removed and relaxed in order for the populaiton probems to be recovered. It is now thought that the best policy is to take responsibility from the State and give it to the mother.

Myths, distortions and fabrications?

Today, Texaco, one of America's biggest energy corporations and oil provider to just over 180 countries worldwide is under attack from human rights activists from Ecuador. This problem which started off as a seemingly small molehill is now definitely changing into a mountain and as it is continuing to gain momentum and support from all around the world Texaco is finally coming forward with it's side of the story.

To begin with the claim the from the activists and attorneys on the side of Ecuador is that Texaco is responsible for health and environmental impacts form oil operations in Ecuador over 16 years ago. This had led to unusable land, water supplies and the inability for anything in that area to flourish in the area due to the extreme pollution. As well as damage done to the environment there are also claims that the pollution has incidence of cancer in the area. The area did undergo 'cleansing' carried out by Texaco before they left the area but with the effects of the oil still heavily evident, there are calls from the locals for Texaco to pay for the probably irreversible destruction they have caused to the land.

The officials on the side of the Ecuadorian people have collected soil, and water samples, held and rallies and launched a lawsuit against the company but Texaco has refuted the supposed evidence with a lot of equally substantial evidence. This evidence refutes not only their oppositions original claims of damage but the means by which they came to this conclusion. It argues against many things including; the legitimacy of scientific evidence of judicial inspection, the amount of toxic waste and water produced, the over estimation of remediation of the area, Petroecuadors responsibility to the area, the question of fraud, the down fall of health in the area, the accusation of genocide, the over estimation of Texaco's earnings in Ecuador.

The evidence shown in the articles produced by Texaco are, it has to be said, very convincing but can we trust them alone?

Therefore, I looked upon a few other seemingly impartial articles from other sources and one in convertible but equally balanced one was one by Michael A. Kelsh, a public health administrator. His report outlines the issues surrounding the accusations of health issues as a direct result of Texaco's activities in Ecuador and analyses the evidence given for and against the claim. His report ends with the statement,

'The national mortality collected and summarized by the INEC does not currently support a relationship of oil extraction activities and adverse health outcomes in potentially exposed communities.'

This I think is an interesting twist to the tale the Texaco vs. Ecuador battle, because now it is evidence from sources outside of the Texaco corporation which are backing up their rebuttals of claims.

In conclusion, I think there is no way to deny that this case is an extremely complex and intricate one. I think that the time given to it over the past few years has definitely been worthwhile because we need to really come a true conclusion at the end of it. Despite the seemingly overwhelming evidence against Texaco given by the Ecuadorian authorities we still need to discover whether a country angry at being left stripped of its resources is exaggerating the effects of the company's presence there. But we equally need to be wary of the potentially huge power a multi-billion pound company has over so many influential people in this case.

Is the world doing enough to help in Haiti?

With 200,000 predicted dead and million without food, water and shelter is the world doing enough to tackle the Haiti earthquake?

It is the worst death toll from an earthquake since the 2004 Asian Tsunami, and the second-highest death toll form an earthquake in more than 3 decades, according to the U.S. Geological Survey. The impact of the earthquake seems to be much increased by the poor social and economic status of the country.

''The impact of this earthquake is magnified because it has hit a country that was already desperately poor and historically volatile,'' said British Development Secretary Douglas Alexander.

As a LEDC the country is not well equipped to deal with such a huge disaster this has meant that the country has had to ask other countries for pledges of money to help them get through the crisis. Currently, only $500 million has been pledged by the EU. This is only fraction of the total amount needed to get the country back on its feet and into recovery stages.

Even with this money the country is still finding it difficult to delegate and share out the supplies they have. This has meant that millions of people are left starving and in danger in the aftermath of the quake. in a minor attempt to combat this, the USA took over the controlling of the only airport in the country. This has meant that the huge surplus that had built up was soon dissipated and was on its way to reaching the needy.

Another problem facing those in Haiti is the fact that many of the officials of the country, who normally, in a situation such as this would taking control and delegating were killed in the quake. The USA has once again stepped in and offered its services help saying it was 'ready to provide whatever humanitarian aid may be required.'

The armies of foreign countries will play a vital part in the clear up of Haiti and therefore many other countries are also mobilising their troops and aid workers to send out to Haiti to work. Before the official rescue mission ended last Friday 134 people had pulled alive from the rubble showing the huge difference these teams make in situations such as this. However, some rescue teams are being hindered by daylight and safety restrictions.

Nevertheless, even with these promising hopes of increased aid being sent to Haiti the fact still remains that the country is facing the biggest earthquake aftermath in 30 years. It will most certainly be an epic clear up act for the individuals of Haiti, the country itself and the world.

Click on the link below for more information on the aid being sent to Haiti.

http://www.cn.com/2010/WORLD/americas/01/23/haiti.earthquake/index.html