23/01/2016 Health Check


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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


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