23/01/2016 Health Check

headlines. That is it from me. Here on BBC, it is time the health

check. Dr Ayan Panja gives you the best of the month's health stories.

Hello and welcome to health check. Your monthly dose of health

stories. This month we're looking at health on the move. Coming up.

Getting people moving by keeping prosthetics free in Cambodia. How

social mobility in Brazil is changing the face of healthcare.

Going evidence for a new ways to prevent the spread of HIV in Kenny.

And a novel way opening healthcare closer to those who need it in

Bangladesh. First two-day to a disease on the move. It is estimated

that 37 million people around the world I hate to be positive. While

drugs can keep the virus to a minimum in the body, once somebody

is infected, the disease will beware them for life. Testing and condom

use can help stop the spread of the disease. Now there is growing

evidence for another way of doing it. There are over a quarter of a

million couples in Kenny where only one partner is positive and the

other is negative. -- Kenya. A new generation of drugs that can block

HIV transmission has recently been trialled. This man is HIV positive

and lives with her HIV-negative partner John. Throughout the trial

John took the drugs which act as a barrier to the disease. And I find

out that I was HIV-positive in the year 2007. Being in a situation like

that we'll partner is HIV positive, sometimes many people would find it

ethical. -- difficult. A condom is sometimes cumbersome to use

throughout your life. So if there was another solution, maybe like the

one we are looking for with the drug. So how does it work Australia

what's inside your body the virus represented by the red sweets height

in inaccessible areas around the body creating reservoirs meaning

never be flushed out. The drugs represented by the blue sweet attack

the virus. Research shows that if a non- infective dose and has a drugs

when the virus enters the system it gets killed. This means it does not

have a chance to hide in reservoirs. To that person does not get

infected. The team behind the trial monitor the couple's progress

topping together with a number of other case studies. It was one of

many studies. It was conducted in Uganda and we were very excited

about our results. In that study we were able to demonstrate a 75% load

of risk of acquiring HIV amongst those who took the drug compared to

those who did not take the drug. This year the pharmacy board

approved the use of the drug full three -- preexposure. We're hoping

that the next step will be the government taking it up. The couples

achievement of such attempts offer a ray of hope for living healthier

lives. That was Michael reporting from Kenya on the partner's prep

study. It looked at a study where one person was infected and the

other person was not. Another study in the UK is looking at whether prep

might work in a different community for people who are at a higher risk

of contracting HIV. Could you tell us a bit about the background to

your study? We looked to recruit with men who has sex with men and

transgender women and followed them in a way that is as close to our

real world as possible. We're looking at people who were not using

condoms at least some of the time. At half of the artist spends were

allocated not to start at four a year. That is how we started a prep

versus no prep scenario. It was like a real-world study if this was

actually happening. There were two groups who start immediately and one

who was delayed after a year. What did you find? We found that it was

true that our participants were very motivated to take their prep if they

had it straightaway. What was found there was most shocking with those

who did not have prep, how the rate of new infections was. And those who

were taking prep, we saw an 86% reduction. That is profound and we

would expect that to make a very big impact on our epidemic if it was

rolled out more widely. And quite striking, very impressive results,

as a public health Doctor, how do you keep the prevention message

going because surely that is the most important thing? Absolutely.

You have to really dig in to why people put themselves at risk.

Change it takes time. It will only happen if the person wanted to

happen. At least this is a way to engage people and hope they have

access to that support. Thank you for joining us and it is absolutely

fascinating. A -- HIV is an infectious disease and can spread

very quickly impacting a large number of people very shortly in

time. It is important to pin down where they begin. Sometimes, a

little helpers needed. -- a little help is. Enter the disease

detectives. Like the investigators of the scene of the crime they begin

I looking at clue. They look at what is causing the illness and see how

it is transmitted. Many funky travel through the air. Bacteria often

relying on water. Some viruses need more intimate contact. They also

Kerkow infectious diseases. A very infectious disease like measles can

have a founder of up to 18. That hate IT is lower with a number of

around two. -- but HIV. Detectives find out where patients had to track

the source. This is not as always as simple as it sounds. Weather

patterns are changing the way that illness spreads and increase travel

means it can spread quickly around the world. Despite these challenges,

disease detectives are often successful. American detectives

found that a frog breeding ground was response will first am another

outbreak five years ago. Infectious diseases can cause serious

disability and even death. As countries get richer, the number of

people with these illnesses tend to fall. In countries like Brazil,

social mobility and changing habits bring other diseases instead, such

as diabetes. This family have benefited from was ill's rise to be

a leading global colony. Like 40 million other Brazilians they have

left poverty behind and entered the middle class. -- economy. They are

warning that the changes are leading to new health problems TRANSLATION:

My dad used to swim in the river and play football when he was a child.

We still use to go outside and ride bikes. Today it is all about the

TV, mobile phones and social media. I encourage my son to go outside

when I realise he has been in front of the TV too long. He gets a far

better start in life but easy access to fact and sugary foods is pushing

up obesity rates and not just in young people. The senior citizens

are also starting to be affected wide the conditions that their

ancestors never worried about. I went to the doctors for some routine

tests and they found that I had type 2 diabetes. Now I have to take

tablets and my diet has changed tragically. I had to eat less and

restrict sweeping. I'm also doing more exercise. 40 million adults

have diabetes here. It has managed to lift many people into the middle

classes. That has come at a price and now Brazil's doctors and nurses

are treating more people with first world issues. Diabetes and heart

issues at the top of the list. This doctor is a specialist in chronic

diseases and is trying to change his patients over the past few years.

You think that changes the lifestyle of the people. We became more

sedentary and began to eat worse. The consequences of this is an

increasing number of diseases such as diabetes, high blood pressure,

high cholesterol and the consequences of these diseases, such

as heart failure, kidney failure and arthritis. All of Brazil's

generation has piled on the pounds but with nearly one in five adults

are obese, some believe it could be the fattest nation in the world by

2030. They've introduced lessons in how to improve their lifestyle. The

grandmother has made pudding for the family. Doctors orders means that

she is not having any. Family keeps an eye on her diet and make sure

that she takes a medicine at the right time. But not everybody had

this level of help so ending Brazil's love affair with fatty

foods could prove tricky. The coastal cities of southern

Bangladesh are mostly found on the banks of rivers that flow into the

Bay of Bengal. Infrastructure is poor in the area is prone to

disasters such as tidal surges. One charity is using a novel approach to

bring healthcare to the region. This man lives in a remote region in

southern Bangladesh. For a long time he has needed to see a doctor. I

have become old and I cannot see things properly. I hope I will get

well soon. I can see only with one eye and my other eye has lost its

vision. I can't walk properly and cannot read anything. I can't even

go to the mosque and offer prayers. In this rural area many live in the

banks of rivers or low-lying coastal areas where there is few medical

facilities. The rivers are the lifeblood of Bangladesh. But the

rivers are not constant in their shifting all of the time. You cannot

have a land hospital on the river banks, and yet, it is the people on

the river banks who are the most hard to reach. To tackle this, her

colleagues have turned to the water. They have transformed a

former Greenpeace ship into a floating hospital to bring free

healthcare to those in need. The river is going into the most from

it, the poorest, the most unaddressed communities. Is on the

roads do not go to. The objective of friendship is to reach the poorest

of poor and the most hard to reach and the river is the best means or

tools by which we can carry out to the people. Hence, hospital ships.

They offer it right to the doorstep of these remote communities. They

offer simple medicines to surgery. It is a fully equipped hospital and

it has Doctor's rooms, paediatric, general doctors, dentistry, a fully

equipped pathological centre, a Ward and where we have too many people,

they are on the deck. The medical staff on the ship carry out

countless procedures helping up to 45,000 people every year. Ago

treatment is this man. Today that cataract in his right eye will be

removed. A short time later his cataract is

gone and his vision should improve soon. TRANSLATION: I am feeling good

after the surgery. It was a smooth operation. I like this hospital. Now

I think they will be able to regain my vision. It was unthinkable in my

life. I feel like getting a second life. This ship can spend a few

months in each location before moving on. Along with two other

ships, this hospital will continue to use Bangladesh's waterways to

improve the health of hard to reach communities.

That was reported at an ingenious moving medical facility. -- a report

about. You have been to one of these floating hospitals? There's another

one in the north of Bangladesh that I went to and it was remarkable. We

got there early in the morning and there were people camped out all

along the banks, waiting to get onto the ship. You got onto it via a

rather rickety gangway and then people were queueing up to have

cataract operations, operations on their hands, children often fall

into fires and if their hands have been burned and it hasn't been

treated properly it curls up and they can't use them properly. At the

cataract operations were really amazing. One little girl had her

operation done and the next morning she was having the baggage taken off

and we saw her see for the first time in her life. Unfortunately what

she saw was me with a microphone, but she saw for the first time in

her life. Amazing. Next to Cambodia, where people injured in landmines

often need to use prosthetics to keep them on the move. Devote years

ago a British charity set up a clinic to give artificial limbs to

the people who need it the most. -- 35 years ago. But as the number of

landmines have decreased, so has the funding, is another clinic has found

a new way of raising its own funds. This man has had his pathetic leg

for more years than he can remember. -- prosthetic leg. A soldier during

the Civil War, he stepped on one of the millions of landmines that once

deterred the countryside. TRANSLATION: It changed my life when

I got the slim. I was able to walk again, to live my life and support

my family. -- this limb. I am so grateful for getting this prosthetic

leg and it has lasted a long time. The school in Cambodia provides this

life changing limbs free of charge but times are changing. Cambodia

still has a significant problems with landmines, but it is the longer

the mine infested country it was what -- once was. The funding has

decreased, threatening their ability to offer this free prosthetics. But,

as a wealthier middle class and mergers, the school has set its

sights on attracting a client ace who wants and wants to afford more

than the standard was that equally. Offering these top of the range

devices, for those clients who can afford them the school can still

make its free prosthetics service available to those most in need. We

have to find an innovative way to secure the funding and we explain to

our client that we have this initiative, the private clinic, that

we would be able to use the advanced technology and the profit from this

clinic would be put back to the free care that we provide.

This man lost his left leg in a motorbike accident almost ten years

ago. But with money to pay for a state-of-the-art titanium

prosthesis, he has come to this new clinic. TRANSLATION: I am very happy

to be able to have a choice of prosthesis now in Cambodia. This new

titanium limb is much better. It is much the poor -- it is much more

renewable. Anti-Gaddafi, it is much easier to use. Demand for both their

free pathetic and this top of the range models is decreasing. People

trust us and the quality we are producing. The poor who can't afford

to pay can still get the service for free. Income we generate from the

patients who pay for it comes back to this charity work. The school

also welcomes students, local and international, which provides a

further vital source of income. With the money earned from training in

new generation of doctors and with its new clinic allowing people to

pay for premium artificial limbs, the Cambodian school of prosthetics

and are -- templating to support people like this for many years to

come. Prosthetics are expensive all around

the world, not just in Cambodia. That means millions of people who

need them can't afford them. Organisations are doing their best

to make them cheaper and easier to access and I am joined now by the

managing director of 3D Life Prints. How important is it to get

people access to prosthetic limbs? We first have to work out how many

people have lost limbs in the world. It could be up to 15 million

people who have amputations or are in need of prosthetics. Of that

number we believe two thirds are on or beneath the property loan. That's

very important you think about what could rate cut cycle of poverty.

Correct prosthetic, provided you one of those individuals, can break that

cycle and bring them back to the world of employment, so they can

support themselves and their family. What kind of prosthesis has

3D Life Prints come up with? We designed our own lower arm

prosthetic, which is a 3D-printed semi flexible plastic pathetic.

Importantly, it is purely mechanical, so it has no electronic

parts, it is cheap to manufacture and is very hard wearing. You have

some examples? The point about this, it is functional, so you can grasp

with it, pick things up, hold things with it. What have we got here? A

leak prosthesis? -- leg. You don't 3D-printed because of the stresses

involved, what we work in partnership with a company that

supplied lower limb extremity prosthetics. What we do is we print

a cosmetic cover to those, so that the previously ugly limb looks more

socially acceptable and we match the cover to the patient's skintone and

shape. What are the benefits of 3D printing in a developing country?

Specifically, you can create something that the spoke and in

country. So rather than sitting in the Western world and sending stuff

out there that would work, we can be on the ground in the country,

finding out ways to solve these problems and carry out the

operations there and then. We wish you the best of luck with the rest

of your project. Thank you for joining us.

Sadly that's all we've got time for this month. If you want more on

health you will find it on BBC World News every Wednesday and Saturday

and don't forget you can catch Claudia's radio programme on the BBC

World Service. And you can follow up on these programmes online. If

you've got any comments or ideas, do e-mail us at:

for now, goodbye from us and the rest of the Health Check team.

Goodbye! Across the Atlantic,

in the north-east of the US, the