Coalition calls for better response to mental health, addiction

Article credits Health-e

by on September 25, 2014 in Addiction & Rehabilitation, Alcohol & Drugs, Human Resources, Mental Health, Rural Health
Health organisations have launched a new push to address what some have called a “mental health pandemic” fuelled by drug abuse in the country.

The Rural Doctors Association of Southern Africa, Rural Rehab South Africa (RuReSA) and other health organisations launched the Rural Mental Health Advocacy Campaign yesterday at the close of the Rural Health Conference in Worcester, Western Cape. The campaign aims to advocate for mental health services, including those aimed at addressing drug and alcohol addiction.

“We are facing a mental health pandemic,” said Ruresa chairperson Kate Sherry. “It’s everywhere, and the health system is not prepared to deal with it.”

Although statistics are inconsistent, it is estimated that 15 percent of South Africans are affected by drug abuse – a proportion double the world average, according to University of KwaZulu-Natal researcher and occupational therapist December Mpaza. Alcohol, cannabis, heroin and mandrax are amongst the most abused substances in the country, he added.

UKZN research highlighted the extraordinary measures taken by health care workers to reach rural populations

Mpaza recently investigated drug abuse in the province’s northern Umkhanyakude district. He found that a range of issues including poverty and a lack of opportunities fuelled substance abuse in the area. Mpaza alleged that unregistered stimulants from China were being sold at shops illegal substances were also being coming into the area via Mozambique and Zimbabwe.

“Dagga is so common that many parents don’t see it as a problem and therefore don’t discourage their children from using it,” Mpaza told Health-e News.

“Some cultural practices also promote the use of substances,” he added. “At certain ancestral ceremonies family members are actually expected to drink excessively.”

Extreme poverty and few job opportunities in the region – coupled with low levels of education – also led people to brew and sell substances for income, or to use the widely available substances because “there is just nothing else to do,” he added.

However, Mpaza highlighted health care workers’ extraordinary efforts to help patients who have asked for help to deal with substance abuse.

in some cases, health care workers negotiated with shebeen owners to limit the amount of money certain individuals spend at their bars to help patients regulate their alcohol intake and the household expenditure they spend on liquor.

“One area is so remote that the health care workers have to take a boat to get there,” he said. “When the tide is low, the boat gets stuck and they have to walk more than a kilometre in knee-deep water to reach the community.”

Quick summary: NCDs in the Department of Health Strategic Plan 2014/15 – 2018/9

A quick review of where issues related to NCDs may be found in the National Department of Health’s (NDoH’s) strategic plan 2014/15- 2018/19.

What is missing?

  • We might have been too quick and missed the National Health Commission. Can you find it? Please let us know if you do.

What is in it?

Page 13: NCDs burden of disease

Page 14: NDoH goal to prevent disease and reduce its burden, & promote health. Relate to National Development Plan goal 2030 ↓ prevalence of NCDs.

Page 19: Programme 2: NHI, planning & enablement

Develop and implement integrated monitoring & evaluation plan.

Sector-wide procurement very important for essential medicine and equipment access. EDL are revised on a 3 year cycle and available via book, web and cell phone application format available. The material is also peer reviewed. Medicines availability; a central chronic medicines dispensing and distribution network availability in order to improve access.

Page 24: Programme 3: HIV/AIDS, TB, Maternal & Child Health (includes child, youth and school Health sub-programme)

  • HPV target by 2018/19 = >70% coverage.
  • Strategic objective indicator cervical cancer screening 2013/14 baseline 55% coverage 2018/19 >70% coverage

Page 27: Primary health care (PHC) services (also includes district health services and communicable diseases.)

Health promotion subprogramme focus on implementing a mass mobilization strategy on healthy options.
NCDs subprogramme includes mental health focus points:

  • ↓ NCDs risk factors
  • ↑ health systems and services for the detection and control of NCDs
  • ↑ service delivery platform for PHC focused eye care, oral health, care of elderly, rehabilitation, disability and mental health
  • Mental health ↑ awareness of- & ↓ stigmatization by sectoral collaboration
  • ↑ services to prevent disability by co-ordinated interdisciplinary services
  • ↑ decentralised integrated PHC services at clinic, community and district hospital level.

Page 29 & 30: Indicators and targets (2018/19)

  • NCDs % ↓ of obesity. Target: ↓ by 10% men to 21% and women to 55%
  • No. people counselled & screened & for high blood pressure & raised blood glucose with 5 million people target. Baseline not available.
  • No. people screened & treated for mental disorders. Target: 35%  prevalent population
  • No. districts implementing the framework and model for rehabilitation services. Target: 52 districts implementing (draft framework and model available 2013/14)
  • Cataract surgery rate. Target: 1700 cataract surgeries per million uninsured population (increase from 1000 2013/14)

Page 30: Resource considerations.  The “spending focus (for this period)… will be on health promotion and the prevention of NCDs such as diabetes and hypertension.”

Page 31: Risk management Risk: under-resourced District Health System with mitigation strategy to ring fence the funding for district management and service provision.

Download the strategic plan: SA DoH Strategic Plan 2014 to 2019

NDoH and the WHO need your help to fight Ebola

The National Department of Health (NDoH) in conjunction with the WHO are pleading to local companies to pledge toward the fight against Ebola.

To date in West Africa Ebola has claimed the lives of close to 2,500 people. Sierra Leone is the hardest hit country with infection rates rising faster than any other place. The infection rate has risen 21% in the last month. Of particular concern is rate of infection among healthcare workers is primarily due to a lack of formal training on how to deal with a highly infectious disease like Ebola.

The NDoH is aiming to set up a 40 bed mobile hospital in Sierra Leone with fully trained staff to provide treatment and diagnoses. The NDoH is also be sending healthcare workers into the more remote areas with small scooters and motorbikes. These healthcare workers are to educate and train the people of Sierra Leone while serving as disease tracers to cut the rate of infection. All the healthcare workers sent to Liberia will be volunteers who have had experience in similar conditions.

South Africa will also aid Guinea and Liberia with laboratories, equipment, and consumables. This is the particular plea to South Africa.

Government cannot do this alone and together with WHO are appealing to the South Africans and the private sector for help. This 9 month mission will cost in excess of R120 million.

Donation can be made in any form time, money, services, or equipment. You will find a full list of what is needed below and the costing of the mission.

Does Volunteering and Community Involvement Reduce NCDs Risk In Older Adults?

Existing evidence supports the notion that making a contribution to the community is good us and for older people in particular. Evidence come mainly from self-reported studies. But what if it actually has physical benefits like lowering inflammatory levels that are linked to NCDs?

This is just what Kim and Ferraro in The Gerontologist investigated – the link between productive activity and reduced inflammation in later life. In addition to the usual self-reported measures like feelings of value and depression, a biomarker of inflammation, C-reactive protein (CRP), was measured via a blood test.
Let’s back up a step or two so we can clarify terms here. A productive activity = a paid or unpaid action that makes a contribution to the life of the community. Examples are employment, volunteering, caregiving and other forms of social participation for the greater good.

CRP is linked to inflammation and modifiable risk factors such as smoking, obesity and physical activity. An increased CRP may be an indicator CVD and future health problems.
The results indicate that community engagement as measure by productive activity, especially volunteerism, is associated with a lower CRP.

Of course, there are all kinds of cautions attached to the finding: doesn’t apply to those in care facilities, overdoing it may be bad etc. However, the intriguing question remains: Are we hard wired to serve because it is actually good for our health?
Read more and decide for yourself.