Sleep is a state of rest in which the eyes are closed, muscles relaxed and mind is unconscious. Sleep disorders are conditions that interfere with or change normal sleep patterns. Disorders affect the timing, quality, and quantity of sleep in such ways that cause distress during the day as well as impair one’s ability to perform to their maximum capacity. These disorders limit the amount of sleep one gets and therefore affect the overall health and quality of life. When the body is deprived of sufficient amount of sleep, the risk of other health problems increase. Some markers or factors associated with sleep disorders include excessive body movement or speech while sleeping, sleeping at odd times or in odd places,  difficulty sleeping, constant sleepiness during the day, abnormal breathing while asleep, and irregular sleep cycle.

Fundamentally, sleep is critical to physical and psychological health in humans. According to the National Sleep Foundation (NSF), adults need about eight hours of sleep nightly. Since the body works on a 24-hour cycle (circadian rhythm), it helps us know when to sleep. An average person sleeps for one third of the day which adds up to one third of a lifetime. Clearly, sleep is an important part of living and is required to continue living. In general, the body sleeps in two different ways which are expressed in different cycles:

• Rapid Eye Movement (REM): As the name suggests, the eyes move around rapidly in a range of directions in this stage of sleep, but no visual signals or notifications are sent to the brain. This phase of sleep usually begins 90 mins after one falls asleep and is also where dreams happen. The first cycle of REM typically lasts 10 minutes, and becomes longer in subsequent cycles, with the final one lasting up to an hour. REM is a very important sleep phase because it stimulates protein production as well as the areas of the brain that enhance learning. Unlike adults, infants spend up to half of their sleep period in the REM stage.

• Non-Rapid Eye Movement (NREM): This stage of sleep happens in three phases, and each of these lasts for about 10 minutes. These three stages of NREM happen before the REM. In the first stage which lasts 10 minutes or less, the eyes are closed, but it’s easy to wake up. In the second stage of NREM, sleep is light as the body prepares for deep sleep by reducing both the heart rate and body temperature. In the third and final stage of NREM, the body is in deep sleep and will be difficult to wake. Disruption of sleep at this age would result in disorientation for a few minutes and may require some time to regain consciousness. Tissue growth, bone and muscle building, immune strengthening and repair all occur during the deep stage of NREM sleep.

Most people do not get the required amount of sleep, reporting their sleep quality as poor. About 30% adults sleep less than six hours each night and research shows that over 50 million Americans experience sleep disorders. Sleep helps the brain function properly, so, insufficient sleep or poor-quality sleep causes fatigue, moodiness, poor decision making, low energy, depression, anxiety, irritability, heart diseases, diabetes, and lack of focus. These disorders may also be warning signs for medical or neurological problems, such as congestive heart failure, osteoarthritis, and Parkinson’s disease. Sleep disorders treatable and preventable following accurate and timely diagnosis. They are  classified either by their causes or symptoms, and include:

• Insomnia: Difficulty falling asleep or staying asleep throughout the night.
• Sleep apnea: Abnormal patterns in breathing while sleeping
• Narcolepsy: Sudden or excessive sleepiness during the day 

Eating disorders are recurring food-related behaviors and conditions that adversely affect wellbeing, emotions, and energy levels throughout the day. Eating disorders are quite common and may not appear to be serious conditions, but they are dangerous. Additionally, these disorders can affect overall health and ability to function properly or carry out daily activities. More so, the relationship with food as well as a person’s attitudes and behaviors towards food can significantly impact the body’s nutrition. Food nourishes the entire body and eating disorders can cause diseases that affect all the body organs including the heart, kidneys, liver, lungs, and the brain. The most common causes of eating disorders include exaggerated focus on weight loss, body shape and fear of weight gain. Most eating disorders begin at ages when good looks and weight loss is often prioritized such as teen and young adult years, however, they can also begin at other ages.

Although the exact cause is not always known, there are several sources and risk factors associated with eating disorders and they include genetic makeup, biological composition, psychological and emotional health, family history, age, preexisting mental health conditions, dieting and stress. Described below are the most common eating disorders including anorexia nervosa, bulimia nervosa and binge-eating disorder

Anorexia nervosa: Anorexia, simply put, is an eating disorder characterized by factors such as extreme fear of weight gain, low body weight and unrealistic perception of body size. People experiencing anorexia try to control their weight by using adverse means and methods including calorie restriction, excess exercise, induced vomiting, laxatives, and diet aids. These means and methods can cause starvation, negatively affecting health and the ability to engage in or carry out routine activities.

Bulimia nervosa: Bulimia is a severe, potentially life-threatening eating disorder reflected by cycles of bingeing and purging. Individuals who have this condition enjoy the thrill of eating but not the consequences of overeating. For this reason, they induce purging to prevent food from being stored in their bodies as well as prevent or reduce associated weight gain. These individuals may also restrict their eating by following  very strict diets, then overcompensate by eating large amounts of food in a short period of time. Many people with bulimia also restrict their eating during the day, which often leads to more binge eating and purging. Like Anorexia, guilt from overeating and fear of weight gain leads to using adverse methods such as purging and laxatives, to get rid of the calories.

Binge-eating disorder: Binge-eating disorders are characterized by frequent overeating and a feeling of lacking control. People who have this condition may eat quickly, ear more food than planned, and may continue eating even when no longer hungry. This habit is followed by feelings of guilt, disgust, shame, and embarrassment, and may lead to hiding while eating.

Rumination disorder: Rumination disorder involves the constant regurgitation of food after eating. This disorder is not associated with mental health and may be natural and unintentional. In this disorder, food is clawed back into the mouth without vomiting. Sometimes, the clawed back food may be chewed again and swallowed or discarded. This disorder is predominant in infants and people who have an intellectual disability.

Avoidant/restrictive food intake disorder: In this disorder, food is not avoided for fear of gaining weight but due to specific sensory features, such as color, texture, smell, or taste. People with this disorder may lack interest in food and eventually fall below daily calorie requirement given their constant food avoiding or restricting behaviors. This eventually leads to significant weight loss and nutritional deficiencies that result in health problems.

Eating disorders are both preventable and treatable. These are some of the ways to prevent or overcome them:

• Diet with caution and cultivate a positive body image
• Be informed about eating disorders and their symptoms as well as factors that can contribute to them 
• Live a healthy, balanced lifestyle because health and well-being are possible in any shape and size.
• Do not engage in discussions and entertainment that reinforce body shaming or ideal body types
• Develop a healthy self esteem
• Visit a licensed health practitioner for advise

From time to time, we all get anxious. In fact, anxiety is a normal part of life because most people worry occasionally about life and things such as health, the future, money, problems, and life situations. However, there is a borderline to what constitutes “normal’.

Anxiety disorder is a medical condition characterized by symptoms of long-term intense and irrational worry, panic, and fear. In general, these disorders may result directly from physical health problems, and is reflected by persistent and excessive anxiety about ordinary things and routine activities. These symptoms frequently impair one’s quality of life by interfering with daily activities such as work, school, and life. In these situations, the feelings of anxiety do not just vanish or go away but instead, they increase and continue to get worse with time. Consequently, patients who suffer anxiety disorders require professional help and medical treatment to recover. Research shows that both genetic and environmental factors contribute to the risk of developing an anxiety disorder. Although risk factors for each type of anxiety disorder may vary, general risk factors are shyness, trauma, and genetic predisposition. In addition, some illnesses such as thyroid or heart conditions, as well as substances such as caffeine may aggravate anxiety disorders.

There are various types of anxiety disorders depending on the symptoms, and they include:

1. Generalized anxiety disorder (GAD): This involves a constant feeling of fear beyond what is considered normal for months or years, hindering daily life. Symptoms may include restlessness, fatigue, lack of concentration, irritability, body aches and insomnia.
2. Panic disorder: People experiencing panic disorder suffer recurrent and sudden panic attacks. These are periods of intense fear, irritation, or feelings of loss of control, especially without any cause or impending danger. Some people experience occasional panic attacks and are not considered to have a panic disorder. This disorder is characterized by profuse sweating, increased heartbeat, chest pain, quivering and lack of control.
3. Phobia-related disorders: Phobia is an extreme fear of, or aversion to specific things or places. It is characterized by disproportionate amount of fear compared to the actual danger caused by the situation or object. Symptoms include irrational or excessive fear about facing an object or situation, taking active steps to avoid the feared object or situation and experiencing immediate and extreme anxiety on facing the feared object or situation. Types of phobias include specific phobia such as phobia for heights, social phobia, agoraphobia, and separation anxiety disorders. 

Treatment options for anxiety disorders are Psychotherapy and Medication

1. Psychotherapy: Psychotherapy may help people with anxiety disorders if directed at their specific anxieties by a professional therapist. Cognitive Behavioral Therapy (CBT) is an example of psychotherapy that helps people feel less anxious by teaching them different ways of thinking, acting, and responding to situations. Another example of Psychotherapy is Exposure therapy which focuses on confrontation and facing one’s fears. Finally, Acceptance and commitment therapy (ACT) is a Psychotherapy that uses methods like mindfulness and goal setting to reduce discomfort and anxiety. Stress management methods such as exercise, and meditation may reduce anxiety symptoms and improve the results of psychotherapy.
2. Medication: Medication does not cure anxiety disorders but can help relieve symptoms. Health care providers, such as a psychiatrist or primary care providers, can prescribe medication for anxiety. Some of these medications include antidepressants, anti-anxiety medications and beta-blockers. Some medications may work better for specific types of anxiety disorders, so it is necessary to work closely with a health care provider to identify the best option as self-medication is deadly. More so, substances such as caffeine, some drugs, and herbal supplements may interact with prescribed medication.
3. Support and Self-help groups: Problem sharing, accountability and learning from others can help people to cope with anxiety disorders. These groups are often confidential and convenient- available in person and online. It is important to remain cautious with suggestions from these groups and they should not replace treatment recommendations from health care providers. 

Vape or electronic cigarette, is a device that heats up liquids to create a vapour for inhaling chemicals such as nicotine, marijuana, or other drugs. Inhalation occurs through a mouthpiece into the lungs which is then expelled via the mouth or nose.  There are various types of vaping devices including pens, e-cigarettes and hookahs. Vaping became very popular as one of the smoking cessation tools for people already struggling with nicotine addiction. However, they have not been effective for quitting smoking. Concerns over the health effects of vaping as well as the recent evidence of its harmful effects are on the rise. Research shows sudden spikes in respiratory conditions in vaping populations, as well as the risks and unknown long-term health effects. Consequently, vaping is only recommended for people already smoking as a less harmful, but not a harmless option. Young people and non-smokers are encouraged to avoid vaping because it can lead to nicotine addiction and potentially hinder brain development in teenagers. Additionally, vaping can cause damage to the lungs due to exposure to toxic chemicals and metals such as formaldehyde and nickel respectively. More so, some components of the vaping liquid, such as vegetable glycerin and propylene glycol may be considered safe in cosmetic products but it is still unknown how safe these substances are when inhaled long-term.

 In a survey, only 9% of teenagers wanted to quit or cut down on smoking cigarettes as their main motivation for vaping compared to about 30% for youths. The problem here is that a very large proportion of a very sensitive part of the population is engaging in vaping for the wrong reasons with the assumption that it is harmless. The idea of nicotine replacement or substitution have been around for a while in the fight against nicotine addiction. It is important to reconsider and reassess whether or not vaping is the best solution in this case. E-cigarettes contain many chemicals already known to cause injury to the respiratory system. These problems have been lumped together under the term ‘e-cigarette or vaping use-associated lung injury (EVALI)’. Several cases of these conditions and even deaths have been reported in many countries with vaping products. There is also increased risk of heart diseases such as hypertension and stroke.

Further, there is a growing concern that vaping products could also be as addictive as conventional cigarettes since they contain nicotine. Sometimes, e-cigarette users get even more nicotine than they would from a combustible tobacco product. Also, e-cigarettes is bad for dental health and has been linked to increased incidence of mouth or gum diseases in users. Other side effects include: cough, dizziness, dry/sore mouth and throat, headache, nausea, heart palpitations, shortness of breath, sleepiness, eye irritation, weakened taste and burning or scratchy feeling in mouth, lips and throat.

It is important to create awareness of the health effects of vaping. While research about the long term effects are inconclusive, the composition of vaping products make it hard to believe that they are harmless. For example, several additives like flavours, metals, rubber, silicone, and ceramics found in vaping products are listed in the FDA’s list of Harmful and Potentially Harmful Constituents in Tobacco Products. 

Finally, for individuals who use vaping to help with nicotine addiction, there are several recommendations by the CDC including: not using THC-containing e-cigarettes or vaping products due to higher risk of EVALI, avoiding informal sources, such as friends, family or online dealers to obtain vaping devices and not modifying or adding substances that are not intended by the manufacturer to vaping devices. Additional effective options to help with cigarette smoking and nicotine addiction are nicotine patch or gum.

Inflation is one of the most common terms in economics, finance, and government. It is a very important word in our society and affects everyone. Inflation is defined as the measure of the degree to which goods and services increase in cost over a specified period. The common time frame used to describe or assess the impact of inflation is one year. It is used to measure and understand how much the cost of living, particularly basic needs such as housing, food and utilities have increased over a definite timeline. The economic and financial status of a country is often a function of inflation. In 1974, President Gerald Ford described inflation as the number one enemy in the United States. Till date, inflation has remained an economic thorn globally, plunging countries into long periods of instability. The consequences are dire and causes a ripple effect in all areas of the society including health and healthcare.

These days, the impact of inflation is felt everywhere including grocery stores, gas stations, and pharmacies. For the farming industry, it is the high cost of seed and farming equipment; For the construction industry, it is supply chain backlog and demand for higher wages; and for healthcare industry, it is increased cost of products, services, and labour. In the US healthcare industry more specifically, there has been a decline in profits for providers. Additionally, pressures and rising costs due to inflation continue to negatively affect healthcare projects, patients, and providers. The consequences of inflation in healthcare can be dangerous. When healthcare becomes unaffordable or when people must pay more for services, they are more likely to stay home and avoid going to the hospital. This can lead to severity of medical conditions or even death.

The relationship between inflation and health are complex and extensive. The major challenge healthcare systems face due to inflation is the rising cost of care. In a recent study sampling random physicians at the American Medical Association, no issue came close to high cost of health services, as the major concern for the impact of inflation in healthcare. Governments have continued to find ways to subsidize the cost of health services and reduce the impact of inflation while maintaining the quality of health care provided. In their report, John Virts and George Wilson showed that inflation contributes to rising health care costs and predicted the potential outcome of governments regulating health care prices.

For Nigeria, the healthcare inflation rates increased by about 17% in October 2022 according to the report by the National Bureau of Statistics (NBS). This is the highest recorded rate in the last thirteen years and is worsened by the persistent public health challenges and weak health system.
Like most countries, everything seems to be getting more expensive, including healthcare. This all-time inflation rates are increased by a complex range of factors including supply chain dynamics, border constraints, public procurement issues, public and private insurance, producers, resellers, and health companies. These factors interact to cause delays in delivery and shortages of medical supplies. They also affect pharmaceutical giants and producers of medical devices and are worsened by the past pandemic and global tensions caused by the Russian-Uranian war.

Given the constantly high demand for health products, low supplies translate to inflation- increasing prices. In Canada, Health Canada regulates the prices of health care products such as medical masks, sample bottles, ventilators, and other essential healthcare goods for the most part. Currently, these products have been in shortage of supply- a recent survey of Canadian producers showed that about 90% of businesses reported significant interruption in business and have increased prices of healthcare products to make up for these disruptions.

There is no perfect solution to inflation; in fact, some economists believe that it is inevitable. Although the recent pandemic resulted in worsened rates of inflation, things are likely to get better with the new stability in the economic environment. According to a report by Rosalie Wyonch- a Senior Policy Analyst at the C.D. Howe Institute, safely recycling possible supplies and better liaison between the government and suppliers will cushion short term disruptions and reduce effects on healthcare consumers.

Food-borne illness or food poisoning is an illness caused by consuming foods that have been contaminated with harmful organisms or germs. These organisms or germs include bacteria, viruses, and a host of other parasites. Common sources of organisms that cause illnesses include uncooked meat, unwashed fruits and vegetables, poorly preserved foods such as chicken, fish, and eggs. However, they can easily cross contaminate other foods. Sometimes, these organisms are introduced to foods by unhygienic food handling processes such as not washing hands before touching foods or storing contaminated food close to other foods. Food can get contaminated during any of the many stages of food production including preparation, processing, cooking, and handling.

Most times, foodborne illnesses are mild and may disappear after some days. Other times, they may be more serious and lead to dehydration and other complications that require hospitalization. The major symptom of foodborne illness is diarrhea, other symptoms include nausea, vomiting, cramping, fever, and bloody stool. The severity of the illness caused is dependent on the immunity of the individual and the organism causing the infection

As already mentioned, foodborne illnesses often clear up without treatment in a few days, it is important to rest and consume lots of fluids to prevent dehydration during this period.Water, soups, or rehydration drinks such as Pedialyte are excellent ways to stay hydrated why sugar containing drinks should be avoided. Drugs that prevent diarrhea (antidiarrheals) can be helpful but must not be given to infants or young children and should not be taken in severe cases of illness.

The good news is that food borne illnesses are preventable. Most cases can be prevented by the following:

•Follow proper hygiene standards when preparing food by washing hands often and always before handling food.

• Always keep all cooking utensils clean and sterile by washing with hot soapy water or dishwasher

• Disinfect kitchen counters regularly

• Always wash fruits and vegetables before eating

• Keep raw meat and foods, away from cooked and ready-to-eat foods or fruits and vegetables

• Ensure that foods regularly contaminated with organisms that cause food borne illnesses such as meat, chicken, fish, and eggs, are fully cooked.

• Store leftovers immediately in the refrigerator and consume foods at room temperature as soon as possible

• Discard spoilt food properly and do not consume unsafe foods

Time and time again, we are reminded of the importance of public health interventions as opposed to total reliance on hospital care. Whether it’s the recent surge of non-communicable diseases like diabetes, cancer and hypertension; or epidemic proportions or the ongoing infectious Covid-19 pandemic, a common theme of overwhelming hospitals is evident. Modern healthcare, in understanding of this, has increasingly advocated for preventive approaches to healthcare. High income countries tend to place emphasis on public health intervention as it tends to actually cut down the burden of diseases and healthcare expenditure in the long run.
For example: In the Covid-19 expenditure, Canada allocated about 15% of its total covid funds to screening alone. Screening, though not commonly heard in the news like vaccination, is a very important preventive health practice. It relies on strong evidence based scientific principles and regular research to investigate conditions when it is most likely to occur and in people most susceptible to it. Screening has produced tremendous benefits in modern healthcare; specifically, a decline in most diseases have been recorded with its incorporation.

The success and actualisation of screening, however, requires both a preventive-conscious health system as well as compliance of the population involved.This is why it is important for better education and media coverage on the necessary screening needed by people so as to increase awareness.This is because a woman would likely seek help from a physician when she notices a bloody discharge from her nipple but would neglect an asymptomatic mass she occasionally feels on her breast. When she knows that a mass like that needs to be investigated, she is likely to seek care which would lead to earlier detection and cure of cancer.
Some people may not visit their caregivers due to fear. Hence, it is important that these fears are allayed by the health media as early detection can be the difference between life and death. People should be made to understand that late presentation is always worse than early presentation. Screening ought to be viewed as a form of self care much like vaccination.
Screening guidelines vary from country to country and also from one individual to another. For example: a traveller, foreigner, immigrant or visitor from a Tuberculosis prevalent country is expected to be screened for TB.

The Canadian Task Force on Preventive Health Care (CTFPHC) recommendations on screening are so broad that it would be difficult to exhaust them. However, there are some common ones people should be aware of, they include:
 Screening for chlamydia and gonorrhoea in young sexually active adults
 HIV screening
 Regular breast exam
 Regular testicular exam
 Cervical cancer screening every 3-5 years
 Pap smears from 21 to 65 years
 Regular blood pressure checks
 Lipid studies
 Colonoscopy every 10 years for those above 50 years for colon cancer screening
 Diabetes screen for individuals > 45years
 Screening for common elderly problems like osteoporosis and abdominal aortic aneurysm in women and men more than 65years of age
 Screening in elderly men and women who have smoked for lung cancer, the commonest cause of cancer deaths in both men and women

Although there have been concerns about increased risk of unnecessary interventions due to screening, it is important to understand that screening is backed by scientific principles and health systems always research to know if it is beneficial to the individuals recommended. Regardless of any controversies, healthcare data support the truth that screening, just like vaccination, deserves the attention of any preventive health system.

Despite the lifting of bans and restrictions surrounding Covid in almost every part of the world, the virus is still very much with us. Some people may even argue that-like the flu, COVID has become the new norm. Globally, as of April 15, 2022, there have been over four hundred and ninety-seven million (497,960,492) confirmed cases of COVID-19, including about six million (6,181,850) deaths. Additionally, as of 5 April 2022, a total of 11,250,782,214 vaccine doses have been administered- these numbers, according to World Health Organization, continue to rise daily.

Certainly, the pandemic continues to affect the world both socially and economically. Economically, the world GDP has been negatively impacted to a large extent. Since World War II, the COVID-19 global recession is the toughest recession faced by humankind, affecting virtually every part of the world. According to the International Monetary Fund’s World Economic Outlook Report published in April 2021, global economy decreased by 3.5 percent in 2020, a 7 percent loss compared to the 3.4 percent growth forecast back in October 2019. This decrease in economic growth was most vivid in the poorest parts of the world, although almost every country was affected.

As Organization for Economic Co-operation and Development (OECD) succinctly puts it, the COVID-19 pandemic worsened already present social and economic inequalities within and between societies. During the peak of the pandemic, pregnant women, low-income households, sick individuals, disabled people and seniors, were disproportionally affected. These already vulnerable groups experienced increased vulnerability to infection by covid, as well as, faced barriers to accessing healthcare. Pregnant women could not have their partners or family present during childbirth, this decreased the amount of support received by these women in such crucial times. On the other hand, seniors- due to lowered immunity, experienced increased susceptibility to COVID-19 and its complications. These groups are still recovering from the traumatic experiences faced during the peak of the pandemic.

Similar to Covid-19, the present war between Russia and Ukraine, like adding fuel to fire, is creating a major humanitarian crisis which has affected millions of people. Additionally, the war has caused an extreme economic shock of significant magnitude that will potentially linger for an extended period of time. Over three million people have already fled Ukraine- a significantly higher number than the number of asylum-seekers that moved into European countries at the height of the Syrian refugee crisis in 2015-16. Certainly, accommodating and providing for these numerous Ukrainian refugees will strain the receiving countries. In the midst of the already strenuous economic conditions caused by COVID, the cost of housing, food, healthcare and childcare will have to be provided by these countries, a totally unplanned economic expenditure.

As an organization whose aim is to affect the world through health, Blessworld Foundation International is available to partner with individuals, government, international organization and other charities in providing support for people impacted negatively by both COVID and the war. Please reach us via our contact numbers.

Conflict and war are ingrained in human history. Historically, groups have always fought against groups, cities against cities, and nations against nations. Most independent countries have had their fair share of war. In the first and second world wars, Canada was a crucial part of the western alliance, and was involved in the long Military Intervention against the Islamic State of Iraq and the Levant. Conflict and war arise for various reasons including money, power, territorial control, ideologies, and a combination of these reasons. Similar to several social factors, armed conflict is a pervasive man-made public health problem.

Regarding the current Russia-Ukraine war, it is important to give a brief background and back story. In February 2014, Russia’s annexation Crimea was followed by war in Donbas and subsequently, the declaration of Independence of separatist states (Luhansk, Donetsk). The fear of Russia losing control of countries formerly part of the Soviet Union, to the western alliance, combined with Ukraine’s desire for autonomy from Russia, made Russia place a ban on Ukraine from joining NATO. This deteriorated into a full blown war on 24th February, 2022 in an attempt to demilitarize Ukraine.

Modern warfare differs significantly from those of the past. A combination of multiple treaties, alliances and highly destructive nuclear weapons create horrific possibilities of another world war, and in extreme cases, an end to current civilization. Due to much more advanced weapons in modern warfare, damages can be terrible and unfathomable. The statistics for the Russo-Ukrainian war- in just a month are already alarming. The Office of the United Nations High Commissioner for Human Rights (OHCHR) has confirmed over a thousand deaths, and much more injured. It is challenging to precisely quantify the impact of this war, or any other war for that matter, because the long term destructive effects go way beyond bullets and bombs. The current war is especially worse considering that the world is still recovering from the Covid-19 pandemic.

An already existing public health challenge from this conflict was the removal of opioid substitution therapy on May 2014, after Russia annexed Crimea. This resulted in increased breakout of infections related to intravenous drug use. These infections, often called syndemics- as a result of common association with each other, include HIV and Tuberculosis. Concerns around the potential of biological warfare has led the World Health Organization (WHO) to advise Ukraine to destroy high-threat pathogens housed in the country’s public health laboratories. This would prevent any potential spills that may spread disease among the population. Anxiety, PTSD and other mental health problems are also expected to increase due to this war. If not for anything, the thought of escalation to nuclear warfare is enough to cause mental health anguish- just like the the nuclear attack on Hiroshima/Nagasaki which lasted for decades after the Second World War.
Armed conflict like this leads to increased incidence of traumatic injuries- not just among soldiers but also among civilians; men, women and children. News reports in the past weeks have captured gruesome scenes of the destruction of essential health facilities such as Mariupol Maternity hospital, and a psychiatric hospital in Izyuum. In a desperate effort to force the Ukrainian leaders to submission, these destructions by the Russian military have resulted in massive civilian casualties. Russia has inflicted significant damage on Ukraine since the war is fought on Ukrainian soil. Overwhelmed by the pressure from the Russian military, Ukrainian citizens continue to feel unsafe and anxious, this has led to increase in the number of refugees in neighbouring countries. The number of refugees are now as high as 3.16 million- mostly moving to Poland, creating a major public health crisis.

Citizens of other countries like Ghana, India, Zimbabwe,Nigeria have been trapped In Ukraine due to difficulties leaving the country.
Since the onset of the war, Russia has received multiple sanctions from western allied countries, international organizations like EU, council of Europe ,UN and many others. This has caused significant economic consequences for the country, in addition to the usual economic decline that come from war.
Notable economic outcomes of war include:
• Ban on Russia oil, gas and coal on March 8 by the US president
• Freezing of foreign exchange reserves worth over $1 trillion
• Suspension of Visa and MasterCard in Russia
• Inflation rates of about 9.15 percent
• Sanctioning of important Russian oligarchs

Other countries have also seen economic decline due to the nature of global economics today. Interest rates in US are now as high as 25%. In Canada,Inflation rates have risen to a 30 year high of around 6% leading to sharp increase in the prices of oil and other commodities.
Ukraine has attracted massive support from international organizations, national governments all over the world and NGOs. Canada, amongst other nations, continue to provide financial and humanitarian support, armed support and standby UNIFIER troops.
Whether the Russo-Ukrainian conflict is resolved by the ongoing war is left for the future to decide. What is known, however, is that the public health effects and resulting social change will be felt for many years to come.

Social change explains how the world changes overtime with respect to human behavior, interactions and relationships as well as social and cultural norms. Social change is a force that drives institutions, world views, opinions, standards and laws which ultimately transform the society. These changes can be positive or negative, they may take years, or even decades to become evident since they are usually subtle and observable only after long periods of time. Here, we focus specifically on positive social change- particularly how education and health determinants create social change. Significant outcomes of positive social change over the years include:
• Abolition of slave trade
• Civil rights and democracy
• Feminist movement- women being able to vote, attend university and gain employment
• The LGBTQ+ rights movement
The Social determinants of health are social factors that directly or indirectly impact health. These factors, such as education, income, housing and employment, are agents of social change. This is because they are able to significantly influence our lives, ways of thinking and reasoning. These internal changes in our thoughts and attitudes, in turn, influence our external actions that contribute to social change in societies. All forms of change usually begin when human beings are open minded, interactive and engage on ideological, political, and social levels. This also involves listening to other peoples opinions and potentially engaging in difficult conversations or dialogues. Open-mindedness means listening to other people’s views and perspectives on diverse issues, as well as agreeing to disagree.
Social change can be influenced by:
• Social order
• Technology
• Environment
• Social institutions
• Population
• War and conquest
• Diffusion
• Values and beliefs

As a social determinant of health, an agent of change and a major method of distributing information, education is an essential tool that drives positive social change. Parents and teachers impact wards with social, moral, and cultural values and skills needed to become agents of social change. These are done through activities, games and storytelling. Education gives us information about government, history, and our rights as citizens, as well as teaches us the roles and responsibilities of citizens. In fact, most forms of interaction, including dealing with disagreements, forming opinions, problem solving, exercising self control, relations with various personality types, are learned in school. Although these may not be true for all, another form of education called edutainment, is usually one we can all relate to. Edutainment uses entertainment to teach and inspire social change- this may be by role plays, fictions, revealing what’s happening in other parts of the world and learning about society in general.
Social change is an ongoing, inevitable and ever-present phenomenon that is often used as a marker of development. Most times, social change follows predictable patterns that can either be continuous or cyclic. Continuous forms of social change include changes that happen constantly , but on a smaller scale. These changes are always happening in our societies but may not be immediately observable. They become evident after a long period of time, particularly when we look back in time, historically. Patterns of social change are regarded as cyclic when everything follows a distinct cycle. This is similar to the annual cycle of seasons that come and go, as well as economic booms and dooms that are continuously experienced in the world. Other examples include fashion trends and social expectations. Some cycles are more predictable than others, while others can take decades to recur. Due to the natural ability of human beings to learn, adapt and grow, it is necessary to constantly change with the changing environment around us. We are able to continuously inspire social change, both personally and socially.