In addition to Carbohydrates and proteins, fats are a major source of energy, providing structure and cushion to cells and membranes. Fats are more energy dense than carbohydrates and proteins and contain 9 calories per gram, in contrast to 4 calories per gram of carbohydrates and proteins. Fats are fundamental part of a healthy, balanced diet and are the body’s only source of essential fatty acids, since these can not be made by the body. Similar to carbohydrates and proteins, unused fat is converted into body fat and stored as residual energy sources.

The following are the functions of Fats in the body:

• Prevent damage to the organs by providing cushion.
• Absorb nutrients such as vitamins A, D, E, and K
• Maintain normal levels of cholesterol and blood pressure. 
• Store and provide energy. 
• Support cell growth.

According to the American Heart Association, there are four major dietary fats in food including:

• Saturated fats
• Trans fats
• Monounsaturated fats
• Polyunsaturated fats)

Monounsaturated and polyunsaturated fats are types of unsaturated fats.The different types of fat have varying chemical composition and structures, and consequently, vary in their physical properties. Based on these, saturated fats and trans fats are considered ‘bad’ and appear solid in room temperature while unsaturated fats- monounsaturated fats and polyunsaturated are considered ‘good’ fats remain liquid in room temperature. Fats play an essential role in determining the cholesterol level of the body. Good and bad fats have various effects on the body’s cholesterol level. For instance, diets high in good fats increases the body’s good cholesterol level, also called high-density lipoprotein (HDL). In the same vein, diets high in bad fats increases the body’s bad cholesterol known as low-density lipoprotein (LDL).

Sources of good fat include tofu, flaxseed, avocados, olives, soy, sesame seed, nuts, dairy, fatty fish, canola, and coconut. On the contrary, baked foods, pizza dough, chips, vegetable shortening, fried foods, margarine, hydrogenated or partially hydrogenated vegetable oil are sources of bad fat, particularly trans-fat. Although both bad fats, Trans fats are worse than saturated fats and are not recommended for a healthy diet. However, red meat, chicken skin, ice cream, cheese, cream, butter are sources of saturated fats which are only recommended in small quantities, even though they are considered  bad fats and increase bad cholesterol.

As advised by the World health Organization, Centers for Disease Control and Prevention and National Health Services, it is important to consume more polyunsaturated and monounsaturated (good) fats than saturated and trans (bad) fats. Bad fats, particularly Trans fats have been shown to increase the risk of heart disease and increase levels of bad cholesterol (LDL). In contrast, Unsaturated fats (monounsaturated and polyunsaturated fats) reduce the risk of heart attacks by decreasing the levels of bad cholesterol (LDL) cholesterol and increasing the good cholesterol level (HDL).

Food is anything consumed by living organisms in order to stay alive. Foods offer nutrients, energy and growth, they can be of plant, animal, or fungal origin. All living organisms, including plants and animals, need food to survive. While plants produce and store their own food, animals depend on this stored food. Also, higher animals depend on lower animals for food. Components of food include carbohydrates, proteins, fats, vitamins and minerals. These components determine the appearance, texture, taste and benefits of the food. To effectively provide the desired benefits, food  is ingested, digested and then absorbed by the cells of an organism.

In general, foods consumed by humans are grouped in various ways depending on several factors. These factors may include the building blocks of the food, processing methods or relative benefits of the food. Fundamentally, the four basic food groups used by many systems describe their origin and relative nutritional function: Fruits and Vegetables, Cereals and Bread, Dairy, and Meat. The World Health Organization uses a broader, more specific system with nineteen food types:

• cereals, beverages, milk
• roots, pulses, nuts
• fish and shellfish
• meat, insects
• vegetables, fruits
• fats and oils
• sweets and sugars
• spices and condiments
• food additives

Based on the nutritional components, there are six main classes of food as mentioned earlier which are: carbohydrates, proteins, fats, vitamins, minerals, and water. Carbohydrates, proteins, and fats are macronutrients because they provide calories and are energy giving while vitamins, minerals, and water are micronutrients because they do not give energy. All nutrients including macro and micro nutrients are important for health,  and beneficial to the body. 

Carbohydrate is a major macro nutrient that provides energy. These carbohydrates consists of sugars or starches that are broken down by the body and stored in the muscles and liver as glycogen. Carbohydrates are stored to ensure the body has enough energy for activities, especially during fasting.When needed, the stored carbohydrates are broken down into glucose which is used by the body cells for energy. Common sources of carbohydrates are fruits, grains, rice, beans, and numerous vegetables. Some carbohydrate-rich vegetables are potatoes, yams, and corn.

Proteins are the building blocks with which the body builds cells and other tissues. When ingested,  proteins are broken down into amino acids, which are basic components of growth, development, repair, and maintenance of body tissues. Proteins provide structure to muscle and bones and helps to repair damaged tissues. The skin contains a protein called keratin which helps to repair and heal damaged skin layers.  Major sources of protein include beef, pork, chicken, fish, beans, eggs, and dairy products. Proteins come from both plant and animal sources, however ,research shows that  animal proteins are better absorbed by the body  when compared to plant proteins.

It was a beautiful Sunday noon to have some fried rice and a glass of apple-grape juice. So I thought, until the juice glass broke in my hands leaving a deep ugly tear on my left pinky finger! What an inconvenience, I just wanted to eat and my day was already planned.

Too bad… an emergency that would reroute my entire day had just begun.

Thank God my sister was home. I screamed and sent my little one running up the stairs to get her aunt. I stood still, isolated by glass and a pool of blood as I watched my poor finger…  wondering how much damage was done and if she’d ever make it alive. My sister came running, screaming at the gory sight and ready to dial 911. She immediately  grabbed a bandage from her first aid kit and gave me to wrap the wound and stop the bleeding. While she dialled 911, I ran my finger over the kitchen tap and wrapped the bandage around the wound.

“Hello, how can I help you?” asked the emergency respondent. “I have a deep cut and I need help!” I blurted. After a few more questions bordering on  violence, our call was redirected to EMT and we were  asked for our address so an ambulance would be dispatched.

I’m not sure what discouraged me. It could be  the sudden realization of the cost of an ambulance, or the fact that being quite conscious, I could definitely afford to get to the ER myself, at least, leaving the limited EMT for life threatening emergencies. At once, I declined the offer, and my sister booked an uber instead, headed to the nearest emergency room. I grabbed my health-card, IDs and wallet while my sister prepared to clean the glass-juice-blood mess and take care of my little one. Off I went (around 1pm), and in about 26 minutes, I was in one of Canada’s Emergency Room.

It didn’t matter if you came by EMT or uber, you were greeted by a most likely nonchalant lady (in my case) and then asked a redundant question:” Are you here to see a Doctor?” “Well, I don’t know. I’m here to see whoever the hell will suture my wound” I thought. I certainly didn’t think I needed a doctor but I guess that is the only profession that can suture a wound in Canada. A pinky finger wound. And clearly, it didn’t matter if you had to wait 5 hours for one. So, I said yes and was pointed to the line up of “emergency” patients waiting to be registered to see a doctor.

When you hear emergency room, what comes to mind? 

If you’ve ever watched a series on medical  movies such as Greys Anatomy or New Amsterdam, you’d  think an ER as a busy, fast paced environment where injured and sick people who need urgent care are treated and given immediate attention. Have you ever been to a real life ER? Quite the opposite… more like a dull room filled with long line ups,  check-in desk, long wait times and even longer wait times!

Maybe a deep cut on the finger that gushed blood wasn’t “emergency” enough. Maybe reporting I felt numb when asked to rate my pain level on a scale of 1 to 10 was the problem. Maybe it didn’t matter the kind of ailment one had, the same fate awaited us all. I was not alone.  After hours of waiting, I was moved to yet another wait room and then finally, to the suture room at 6pm  where the good  doctor showed up after a while. At this time, the wound which was just fresh and numb when I arrived had become painful and swollen. I could never understand why the problem of long wait times have lingered in the Canadian health care system and to be fair, many  publicly funded healthcare systems. Hundreds of research and millions of dollars later, it doesn’t seem like there’s been much of a headway- at least, in this case.

A potential solution to this persistent problem of long wait times may be increasing the training and clinical privileges of non-doctor health professionals to reduce the burden on Doctors. Research documents a similar method termed task-shifting which was adopted during the covid-19 pandemic to maximize human resources in healthcare.

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.

Our world is constantly changing in population composition and structure. According to the World Health Organisation (WHO), 1 in 6 people globally will be aged 60 and over by 2030, and by 2050, the world’s population of people aged 60 and above  will double ( about 2.1 billion people). This impending demographic shift will certainly unmask major problems, persuading us to answer the question: Are healthcare systems prepared to handle this increasing ageing population?

It is no news that the older we get, the greater the risks of chronic conditions, and subsequently, the increased need for health care resources. For instance, Canadians over the age of 65 consume more than 40% of provincial healthcare budgets. These figures remain similar across countries globally.

Ageing, at the cellular level, is a result of the accumulation of damage to cells over a period of time. There is a distinction between healthy ageing and pathological ageing. The Public Health Agency of Canada (PHAC) defines healthy ageing as “the process of optimising opportunities for physical, social and mental health to enable seniors take an active part in society without discrimination and to enjoy independence and quality of life.” Pathological ageing, however, is an increase in diseases and chronic conditions, since the elderly population is predisposed to several health challenges.

There is a public health lapse in handling these chronic conditions as there are limited access to caregivers, social workers, legal and social welfare systems specific for older people. More so, health institutions are mostly over-burdened or under-funded to take on this responsibility. Major chronic conditions associated with ageing include:

• Psychological/ cognitive issues like Dementia and Depression 
• Increase risk of Falls
• Incontinence
• Limited mobility
• Hypertension
• Cancer
• Osteoporosis  and Osteoarthritis 
• Hearing, walking and vision problems
• Multiple sensory loss and reduced immunity

Given these many health problems, and the resulting increase in the utilisation of healthcare resources by the ageing population, the elderly could wrongly be perceived as a burden to the society. These ageism  attitudes or perceptions about the elderly could lead to abuse, neglect or discrimination and should be discouraged appropriately. To this effect, WHO’s initiative, “The Decade of Healthy Ageing (2021–2030) “ seeks to reduce health inequities and improve the lives of older people, their families and communities through collective action in changing how we think, feel and act towards the elderly. Additionally, this initiative aims to develop communities in ways that foster the abilities of older people to access to quality long-term care.

Public health experts believe that more expensive and intensive care may not be sustainable and there needs to be focus on effective strategies to improve seniors health. The Canadian Medical Association (CMA) advises that investments should be made in programs that support or promote healthy living such as access to initiatives that improve physical activity, injury prevention, mental health and nutrition, education, and early screening. CMA also recommends investments to improve comprehensive continuum of care, restructure welfare plans and develop age friendly environment.

Effecting these policies that address the public health issue of ageing, will  result in minimal disease and disability, high cognitive and physical functioning, and meaningful engagement in life. 

We contribute to caring for the elderly by supporting BlessWorld Foundation international to develop initiatives that support the elderly.

After all, we all get old!

Monkey pox is a an ongoing disease outbreak which was initially confirmed in May 2022. The first cluster of cases were identified in the United Kingdom, and the first case was confirmed on the 6^th of May, in an individual who had recently travelled to Nigeria.

What is this virus? How did this virus come about?  How is it transmitted? What symptoms and signs should I watch out for? Who is at risk? What can I do to prevent infection?

The monkeypox disease is a viral disease caused by the monkeypox virus, a type of pox virus closely related with smallpox virus. It is primarily a zoonotic disease since rope squirrels, tree squirrels, Gambian pouched rats, dormice, non-human primates and other species are hosts for the virus. The origin of the virus ties in well with the history of vaccines. Like most great discoveries, the discovery of vaccines was a combination of accident and impressive observation. It was in the early times when the first smallpox outbreaks started; then Edward Jenner found out that people who suffered from cowpox were either protected from smallpox infection or experienced less significant symptoms. He then injected people with cowpox virus to prevent them from infection with smallpox virus; it was crude but it worked!

With the elimination of smallpox in most countries by 1980s, the reduction in vaccination efforts is what led to the emergence of the monkeypox virus. However, it was not a global health problem as it was localised in west and central Africa. It wasn’t until 2003 that the first monkeypox outbreak outside of Africa occurred. The outbreak began in the United States of America and was linked to contact with infected pet prairie dogs. These pets had been housed with Gambian pouched rats and dormice that had been imported into the country from Ghana. There have been many cases in the American and European region linked to travellers coming from African countries. In May 2022, multiple cases of monkeypox were identified in several non-endemic countries like the United Kingdom, Spain and Canada.

The World Health Organisation (WHO) has consequently tagged this outbreak as  a Public Health Emergency of International Concern because cases of monkeypox have been reported in 93 Member States across all 6 WHO regions. As of August 17 2022, a total of 37,736 laboratory confirmed cases and 179 probable cases, including 12 deaths, have been reported. 

There are many routes of transmission of the monkey pox virus. In places that have host animals, infection can occur by direct contact with the blood, bodily fluids and cutaneous or mucosal lesions of infected animals. Similar to Smallpox, Human-to-human transmission can result from close contact with respiratory secretions, skin lesions of an infected person or recently contaminated things like a mother’s placenta. When infected, the incubation period of the virus is highly variable but generally ranges from 5 to 21 days. Clinical presentations are similar to flu but more intense, in addition, specific features such as lymphadenopathy and painful skin eruptions characterise monkeypox disease. The appearance of the skin eruptions is highly variable depending on the skin, complexion, severity of infection, age etc. They generally appear as bumps, then evolve to a volcano-looking erosion of the skin which crusts with time.

Monkey pox is a self limiting disease, and complications such as secondary infections, bronchopneumonia, sepsis, encephalitis, and infection of the cornea with ensuing loss of vision can occur. There is also risk of more severe infection in younger children and immunocompromised individuals particularly people living with HIV/AIDS, men who have sex with men, health workers and immune-compromised individuals. Although there are no specific treatments for monkeypox virus infection, anti-viral drugs used to protect against smallpox may be effective in  treating or preventing monkeypox due to the genetic similarity of the two viruses. 

Prevention begins with an understanding of the monkeypox disease, and that is the aim of this article. It is also important to cut down on any links to human transmission whether from animals, humans or infected objects. This would involve avoiding rodent meat or cooking meat properly before consumption and wearing masks when necessary. The US Centres for Disease Control and Prevention (CDC) and  Public Health Agency of Canada (PHAC) recommend the following:

• Stay at home and isolate if you suspect symptoms 
• Maintain good hand hygiene 
• Clean and disinfect high touch surfaces
• Practice safe sex
• Prevent travel to high risk countries