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New York Times Series Examines Maternal Mortality In Tanzania
The New York Times on Sunday examined maternal mortality in Tanzania, in the opening of a three-part series on maternal mortality in Africa. According to the Tanzanian Ministry of Health, the country has a maternal death rate of 578 per 100,000 births, though the World Health Organization puts the count at 950 maternal deaths per 100,000 births. Roughly 13,000 Tanzanian women die of pregnancy- or childbirth-related causes annually, giving it "neither the best nor the worst record in Africa," the Times reports. Tanzania is one of the world"s poorest countries and faces shortages in several areas -- including health workers, drugs, equipment and infrastructure -- that contribute to maternal mortality.The Times profiled obstetrical care at a rural hospital in Berega, Tanzania, that typifies efforts to reduce maternal mortality in Africa. Facing a shortage of doctors and nurses, the hospital has been training "assistant medical officers" to perform caesarean sections and other procedures. Meanwhile, the government also is attempting to train more assistants and midwives, build more clinics and nursing schools, offer housing to attract health workers to rural areas and provide places for pregnant women to stay closer to hospitals.According to the Times, many women who die in childbirth are young and healthy, and most maternal deaths are preventable with basic obstetrical care. The five leading causes of maternal death are bleeding, infection, high blood pressure, prolonged labor and complications resulting from abortions, the Times reports. In discussing maternal mortality, experts often refer to what are known as "the three delays": a woman"s delay in going to the hospital, the time spent traveling there and the hospital"s delay in starting treatment upon the woman"s arrival. Although only around 15% of births have dangerous complications, the problems are almost impossible to predict, and seemingly normal labors can quickly progress into serious emergencies. Worldwide, more than 536,000 women die annually from pregnancy or childbirth, according to WHO (Grady, New York Times, 5/24). Buy arimidex to treat cancer.

House Rejects Amendment To HHS Bill To Limit Funding To Planned Parenthood Clinics
The House on Friday voted 264-153 to approve its fiscal year 2010 Labor-HHS-Education spending bill (HB 3293) after voting on five amendments addressing price and policy issues, CQ Today reports. The bill would appropriate $730.5 billion. The Senate Appropriations Committee is scheduled to begin markup of its version of the bill on July 28.The House voted 183-247 to reject an amendment offered by Rep. Mike Pence (R-Ind.) that would have prohibited family planning funding through the Title X program to Planned Parenthood clinics. The House also voted 211-218 to reject an amendment by Rep. Mark Souder (R-Ind.) that would have stripped language to lift the ban on federal funding for needle-exchange programs. Lawmakers did approve an amendment offered by Rep. Darrell Issa (R-Calif.) to strip $5 million in funding for three NIH grants to study the HIV/AIDS risks associated with alcohol and substance use among sex workers in Asia and alcoholics in Russia (Wolfe, CQ Today, 7/24).

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Swine Flu Daily Update Issued At: 11am Wednesday 1 July 2009, Wales

-- 30 confirmed cases in Wales, with 4 new cases: - A 64-year-old female from the Vale of Glamorgan who has stayed in an area where there is sustained community spread. Close contacts have been identified. She has been offered antiviral medicine and is recovering well. The NPHS is investigating the of the infection. - A 23-year-old male from Swansea who is a direct contact of a confirmed case in Exeter. Close contacts have been identified. He has been offered antiviral medicine and is recovering well. - A 21-year-old female from Newport. Her illness is linked to travel from Spain. She was admitted to hospital and has been discharged. Close contacts have been identified. She has been offered antiviral medicine and is recovering well. - A 9-year-old male from Newport. His illness is linked to travel from Spain. Close contacts have been identified. He has been offered antiviral medicine and is recovering well. -- There are 8 clinically presumed cases in Wales with 3 new cases: - A 19-year-old female from Bridgend County Borough who is a household contact of a confirmed case in Exeter. Close contacts have been identified. She has been offered antiviral medicine and is recovering well. - A 21-year-old female from Wrexham who is a household contact of a confirmed case in Scotland. Close contacts have been identified. She has been offered antiviral medicine and is recovering well. - A 21-year-old female from Wrexham who is a household contact of a confirmed case in Scotland. Close contacts have been identified. She has been offered antiviral medicine and is recovering well. Up until last week, the NPHS had been testing everyone who has potentially come into contact with swine flu and who has symptoms. We are moving to the position where swine flu is circulating so freely in the community that we will test very few people as patient"s doctors will assume that anyone with flu-like symptoms has contracted swine flu. As part of the transition towards this phase, we are now reporting clinically presumed cases. They are household contacts of confirmed cases of swine flu, who have symptoms of swine flu and are presumed to have swine flu but will not be laboratory tested. In such cases, there is enough evidence that the patient has contracted swine flu for their doctor to treat them and testing is unnecessary to reach a diagnosis. -- 217 people have been under investigation in Wales. Of these, swine flu has been confirmed in 30 cases, clinically presumed in 8 cases and ruled out in 157 cases, leaving 22 still under investigation. All of these are displaying, or have displayed, mild symptoms. -- Of the 22 people under investigation, 7 were well when first identified, but reported recent flu-like symptoms following travel to affected areas. Blood tests are being undertaken on these individuals to see if they had the flu and to help the NPHS understand the pattern of the disease from the past. Their symptoms may or may not have been due to swine flu. Testing will be conducted in a number of weeks to check whether these people did have swine flu - scientifically it won"t work before that. Investigations have shown that people they had close contact with did not catch flu from them when they were ill. -- Two people with swine flu have been hospitalised in Wales and have been discharged. -- No further details will be confirmed or denied about cases in order to protect their right to confidentiality. -- There are now 6,542 laboratory confirmed cases in the UK - 30 cases in Wales, 1,118 cases in Scotland, 5,362 cases in England and 32 in Northern Ireland. -- Three people in the UK with swine flu have died. All had underlying health conditions. -- Swine flu cases have been confirmed in 116 countries. For the latest international figures for the spread of swine flu, visit the website of the World Health Organization at http://www.who.int Comment from Welsh Assembly Government and National Public Health Service for Wales -- Chief Medical Officer for Wales, Dr Tony Jewell, said: "The number of cases is continuing to increase in Wales. This is to be expected given the increase in other parts of the UK. "People should not be alarmed by this increase, but it is natural for people to be apprehensive. "So far, in the UK and other countries where the virus is circulating, in the majority of cases, it remains mild, but proving more severe in a small number of people, and three people have died. "We expect that with large numbers of people contracting swine flu, there will be deaths, particularly in patients with underlying health conditions. Even with the seasonal flu, we do see deaths occurring. "I would reasure the public that we have been planning and working to prepare for the arrival of the virus for many years and have robust procedures in place. We have the added benefit of learning from the experience of other countries who have been dealing with significantly more cases than us. "While we are prepared for this, we are not complacent and people must be vigilant. Our advice to the public remains the same, people should follow good respiratory and hand hygiene to help prevent the spread of influenza - always using a tissue to catch sneezes, throwing away used tissues where germs can linger and killing germs by regularly washing your hands, or cleaning them with a sanitising gel. In short, catch it, bin it, kill it." -- Dr Roland Salmon, Director of the Communicable Disease Surveillance Centre, National Public Health Service for Wales, said: "Because this particular type of swine flu is new, people have little or no immunity to it. For this reason, we know it will spread across the country eventually. "The pandemic will reach different countries at different times. While the outbreak is dying away in Mexico it is still growing here. "Whereas we are currently investigating and responding to individual cases but there will come a time when it is sensible to change this approach so that our focus moves to treating people who are ill and most at risk. There will be a greater emphasis on local risk assessments by public health professionals. "The World Health Organization considers the overall severity of the pandemic to be moderate. This means that most people recover from infection without the need for hospitalisation or medical care. Levels of clinically severe or fatal cases appear similar to levels seen with seasonal influenza. "Nevertheless, the death of a third patient in the UK shows we must not be complacent about the effects of the virus in those with pre-existing health conditions. "Seasonal flu can be severe, particularly for elderly and vulnerable people, so there is still good reason for us all to take action to reduce its effects. Flu is often confused with a bad cold but is in fact far more serious and leads to many deaths each year in Wales. "We continue to advise that anyone who has flu-like symptoms and has returned from an area where swine flu is circulating, or who has been in close contact with a confirmed case, should stay at home and phone their GP or NHS Direct Wales on 0845 46 47. "People should not go to Accident and Emergency Departments or to their GP surgery without ringing first, as this may risk spreading the infection. It also places undue pressure on the emergency services. "The National Public Health Service for Wales will continue to assess any person with flu-like symptoms." Public health advice and messages -- If you have flu-like symptoms and have returned from an area where swine flu is circulating or have been in close contact with a confirmed case, stay at home, phone your GP or NHS Direct Wales and you will be assessed and receive treatment if necessary. Do not go into your GP surgery or Accident and Emergency department unless you are advised to do so or are seriously ill, as you may spread the illness to others. -- It is always good practice to follow respiratory and hand hygiene such as: - Covering your nose and mouth when coughing or sneezing, using a tissue when possible. - Disposing of dirty tissues promptly and carefully. - Maintaining good basic hygiene, for example washing hands frequently with soap and water to reduce the spread of the virus from your hands to face or to other people. - Cleaning hard surfaces (e.g. door handles) frequently using a normal cleaning product. - Helping your children follow this advice. Facemasks -- Although we are aware that facemasks were being given out to the public in Mexico, the available scientific evidence does not support the general wearing of facemasks by those who are not ill whilst going about their normal activities. We are, however, reviewing NHS supplies and stockpiles of facemasks for healthcare workers who are likely to come into regular contact with people who may have symptoms. The UK will receive an additional 227 million surgical facemasks and 34 million respirators. Wales will receive its proportionate share. Control measures -- Agreements have been signed between the UK Government and vaccine manufacturers to secure supplies of up to 90 million doses of H1N1 vaccine by the autumn. This will not affect the usual seasonal flu vaccination and will be made available to frontline healthcare workers and vulnerable people. Advance purchase arrangements are also in place to buy enough vaccine for the whole population. --The Welsh Assembly Government"s Health Emergency Preparedness Unit has issued guidance to Local Health Boards on anti-viral distribution. The unit is co-ordinating work on identifying appropriate collection points and the necessary arrangements to support this process. -- People who have flu-like symptoms and have returned from an area where swine flu is circulating or who have been in close contact with a confirmed case have been advised to stay at home and call NHS Direct Wales on 0845 4647 or phone their GP for health advice. -- The National Public Health Service for Wales has

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