Health in East London: The Effect of Tuberculosis in Newham - Essay Example

Health in East London: The Effect of Tuberculosis in Newham of supervisor Health in East London: The Effect of Tuberculosis in Newham Introduction According to Choudhury and Mayho (2003: p.1), between human beings and microorganisms, there has always been a relationship of interdependence. However, while this is an important connection, one always gains control over the other. One such relationship is that existing between human beings and tuberculosis. Tuberculosis is considered a Public health concern for a number of reasons. For one, the Tuberculosis Working Group (2006) point out that tuberculosis claims close to nine million lives annually. Secondly, it the infectious disease with the highest mortality rate among youths and adults, especially when the patient is HIV positive. The incidence of tuberculosis in the world currently is diminished in comparison to the 19th Century. In the United Kingdom, for example, the beginning of the 19th Century marked a period with the highest number of tuberculosis cases reported. This number reduced drastically, especially with the introduction of new measures against tuberculosis like the BCG immunization (Frieden et al., 1995). Recent years have, however, witnessed a shoot-up in reported cases of tuberculosis in the UK, with Newham East London being one of the areas with the most cases (Chapman, 2013). It is worrying that these incidences have continued to increase by the years, again, targeting Newham as the place with the highest increase recorded. For this reason, a few entities have come together to formulate policies towards fighting tuberculosis in the area. The National Health Service (NHS) is one of the organizations that has been most committed to minimizing the number of tuberculosis patients in Newham. The National Health Service is an organization founded with the sole purpose to overlook issues of treatment and prevention of disease in the United Kingdom. This paper examines the effects of tuberculosis in Newham and how the National Health Service fits into the fight against tuberculosis. Context The borough of Newham has been in existence since 1965 and is located about 8 kilometers from United Kingdom’s London, towards the east. It has its bounds within the Wanstead Flats to the North, River Thames to the South, River Lea to the West and River Roding to the East (Data Management and Analysis Group, 2007). Historically, Newham was mainly an agricultural area. This was up until the mid 19th century, when industrialization attracted many foreigners from numerous countries to the region. This created an atmosphere that was diverse in terms of ethnicity, encountering new entrants in search of jobs or refuge from surrounding regions in Britain. It is from this era that the population of foreigners continued to grow. These foreigners come from Africa, India and Pakistan, among other regions. Diversity of this nature is apparent in the kind of buildings and individuals found in the area. The buildings display an array of cultural practices. The same applies to the diverse designs of restaurants, dressing and food found in Newham. Interestingly, due to the high number of foreigners, data from the 2001 census suggests that there are a higher number of foreigners as compared to the White Britons in Newham. Up to 61% of the population is made up of foreign ethnic groups. This is in contrast to the population of White Britons, which is only 39%. This aspect sets it apart from other boroughs where most of the population is that of White Britons. In addition, the influx of foreigners in the region marks it as one of the boroughs with the highest population growth rate. The 2001 census revealed that the Newham population was about 243,737, which is a 15 per cent growth when compared to the results of the 1981 census (Office for National Statistics 2002). Newham is home to highest population of the young and has one of the lowest White British populations in the United Kingdom according to the 2001 Census. The population comprises of approximately 51% females and 49% males. 63% of the population is of working age. Those aged between 0-15 years of age make up 26% of the entire population. The United Kingdom 2001 census shows that this is the highest population of young people in London when compared to other boroughs (Office for National Statistics 2002). Newham, according to the Indices of Multiple Deprivation 2000, is one of the most destitute boroughs in London. The region faces tough economic conditions, characterized by the poor living conditions the population has to contend with, overcrowding and living in houses that are in poor states. The region experiences one of the highest rates of growth of infectious disease rates when it comes to tuberculosis and HIV/AIDS (Ahmed et al. 2007). Conditions such as overcrowding and generally poor living conditions could explain the fast growth in incidences of tuberculosis. The study of the correlation between the spread of tuberculosis and poverty is important in determining the best course of action for areas like Newham, especially when looking into matters of health and economic development. Review The National Health Service was established in 1948 in order to improve the health of individuals through treatment and prevention of illnesses. As an organization at the forefront of the fight to eradicate tuberculosis in Newham, the NHS activities revolve around provision of timely healthcare to the patients suffering from the disease (Rivett1998; Rivett 2010). In a paper written by Darzi (2007), he asserts that the productivity of the National Health Service in combating tuberculosis depends on the needs of the population, the required means of treatment, and the money at the disposal of the organization. One of the challenges that the NHS has to contend with on a daily basis is the ever-growing population of Newham (Interprofessional Department of Health 2000). Higher numbers of new immigrants spell out the need for more attention in order to curb the risk of an infected immigrant infecting the rest of the population. In this, the NHS has had to make efforts to involve the local authorities to look out for those displaying the common early symptoms of tuberculosis, for example coughing, excessive sweating and drastic weight loss (Love et al. 1998). In addition to the problem of lack of access to some of the infected individuals are the funds necessary to treat the infected patients. The rising number of reported cases means that there is need for more funds directed towards treatment and prevention of tuberculosis. Some of the measures put in place by the NHS to curb the spread of the disease turn out to be too costly for the organization. For example, their endeavour to set apart entire wards or even hospitals for those infected with tuberculosis in Newham and other boroughs (Relph and Lynn, 2011). Another activity that costs the National Health Service in the fight against tuberculosis is the door-to-door free screening exercise the organization conducts. With all these shortcomings to work with, the NHS has welcomes help from other organizations with common goals, collectively forming the Public Health Initiative (Choudhury and Mayho 2003: p.3). The aim of this initiative is to look into health issues and the poor living conditions and housing in Newham due to the suggested correlation between poverty and the rapid spread of infectious diseases. This initiative encourages local authorities to work in conjunction with the National Health Service closely in order to reduce the incidence of tuberculosis in the borough (Interprofessional Department of Health 2000). Successfully diagnosing and treating tuberculosis means that a patient is cured of their disease, hence stopping the transmission to those around them (De Vries & Van Hest 2005). In addition, it eases the financial pressure that comes with constantly struggling to treat the symptoms unsuccessfully. If discovered at the onset, it is a cheap and quick process to treat the disease. Even so, there are numerous cases reported of people paralyzed or disabled from tuberculosis including about 300 fatalities (Department of health, 2004). The effects of tuberculosis, as outlined are detrimental to the economic lives of the affected. This seeps all the way through to other sectors such as their family lives and educational attainment (Bakhsi, 2006: p.98). It is for such reasons that the NHS works to reduce the cases and spread of tuberculosis. Awareness on tuberculosis in the region is still poor. Often, it is easy to overlook the symptoms, especially for those visiting the clinic for the first time. This difficulty may be due to the complexity of establishing a relationship between one symptom and another (National Collaborating Center for Chronic Conditions 2006). In order for one a diagnosis one to think of checking for tuberculosis, one must be aware of the patient’s circumstances. It is even less productive that there is still a certain form of stigma attached to tuberculosis. For this reason, most patients, despite knowing that they are in fact infected, will not seek medical attention due to the fear of the opinions that those around will hold. One of the activities mandated to the National Health Service is to train the residents of Newham on tuberculosis. The NHS applies the Cascade Training Principle; this is whereby they begin by training only a handful of people, who then visit homes or small groups to train people on individual or family level on the disease. This training includes teaching on the symptoms and methods of protecting oneself, colleagues, and family. The training is highly dependent on the passing on of information from one recipient to another. Those that have access to direct training by the National Health Service mainly include those working in social services, education, health teams, and drug teams, who then go door to door to teach other people. The National Health Service plans to extend this training to the police and schools (The Independent Working group on Tuberculosis, 1998: p. 5). One of the most effective training methods has been for those residents cured of tuberculosis to share their experiences with the rest. This, in the course of teaching on how to detect early symptoms, also alleviates the stigma attached to having tuberculosis. It teaches the listeners to be open about their symptoms in order to save their own lives and of those around them. The NHS, in addition to training on tuberculosis works with diagnosed patients to keep them on the treatment regimen until they are free of the disease. A successful therapy period takes not less than six months and therefore, many patients get impatient and stop the treatment. This, however, poses a risk to the patient as they can end up with complications that are more dangerous. These patients also risk developing drug-resistant tuberculosis that can be fatal (National Institute for Health and Clinical Excellence, 2011). This form of tuberculosis also requires more resources to combat, that is, up to twenty times more, and as stated earlier, the economic conditions in Newham do not allow for this level of extra spending. In Newham, the rate of completing treatment has improved. However, there is still need to encourage more patients to go through with the entire process in order to rescue them and those that interact with them from future complications (Department of health, 2007; Health Protection Agency 2006). The National Health Service conducts free screening for active tuberculosis in the population that cannot afford it in Newham. They do this by actually walking through the overcrowded settlements in seek of those that may by susceptible to infection. A team of trained staff is responsible for this, where they move around with a mobile X-ray unit providing free screening. This service is effective as it helps in finding the sick that will not go to the hospitals and helps with early detection, which is cheaper to treat than advanced tuberculosis (Public Health Action Support Team, 2010; Pareek et al. 2011). Conclusion According to the review, the National Health Service undertakings revolve around providing healthcare in such a way that will provide treatment or prevent the breakout of diseases. For areas in which people are prone to being infected with tuberculosis, such as Newham, this means that the NHS organization is in charge of fighting to reduce the incidences of TB in the region. Tuberculosis is however not a problem that is unique to Newham, there are several other boroughs across East London that have to face the challenges that come with tuberculosis (Relph & Lynn 2011). The only difference is that in these other boroughs, the incidences are more contained than in Newham. In addition, some of the other boroughs do not face the same kind of financial constraints that exist in Newham. Tuberculosis has roots in factors such as poverty, overcrowding, and poor living conditions (Bureau of Tuberculosis Control, 2008). All these, unfortunately, are characteristics of Newham, explaining the high occurrence of TB in the region. With this information, policy makers should strive towards spreading the awareness of tuberculosis, provision of preventative measures generously where it is deemed as important; treating those diagnosed with TB freely, and finally, engaging in planning for proper housing- striving towards reducing the overcrowding that causes rapid transmission. The work against tuberculosis involves many concerned entities coming together and joining forces if there is any hope of making a mark. Forming productive partnerships is one of the areas in which the NHS is working at, though the organization can indeed do more. There is definitely need for more coordination and partnerships to widen the pool of resources (Aït-Khaled et al. 2010). The National Health Service is doing a commendable in its war against tuberculosis. For example, by using the door-to-door method of educating potential patients, they save many lives that may otherwise have stayed at home instead of seeking medical attention. In addition, by doing this, the organization helps the public to realize that it is pointless to avoid treatment because of the stigma since in the end it only leads to loss of more lives. The organization also does a good job of providing free screening to patients who cannot afford to pay for it or go in search of this service in the hospitals. The mobile x-rays enable them to cover patients that would have otherwise gone undiagnosed (Griffiths & Martineau, 2007). However, it is recommended that the National Health Service devote more time to monitoring treatment completion rates in Newham as compared to other boroughs. The completion rates in Newham, though improving, have remained below the rates in other boroughs. The organization should work towards setting reasonable completion targets and putting in place measures to meet these targets (Health Pilot Scrutiny Commission n.d.). The NHS is, in addition, advised to pay closer attention to groups that are most susceptible to contracting tuberculosis in the society. These, apart from only the poor in overcrowded areas, also include children and those that have respiratory system disorders. For this function, the organization should invest in modern equipment for purposes of accuracy and efficiency. Thirdly, the National Housing Service should arrange to provide small groups of tuberculosis patients with temporary accommodation in place of hospital stays. This should be more cost effective for the organization in the end (Coker, 2004). In addition, many patients would feel more comfortable with the option of living in temporary accommodation rather than hospitals as they recover. 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