Urban Health, Slums Conditions, Air and Seaports - Essay Example

Urban Health Urban health involves the wellbeing of the people who live in cities and towns sharing common water supply and the same environment. These places are commonly residential residences with high populations. According to World Health Organization, urban areas are unhealthy for human lives in that they are characterized by traffic jams, violence, pollution, social isolation for old and young families and diseases such as pneumonia, TB and diarrhea. Moreover, diseases such as asthma, cancer, diabetes and cancer are common in urban centers. The environment where people live determines their health so much. It is tabulated that about two-thirds of Europeans lives in towns and cities (WHO, 2010, p. 1). It is estimated that, by 2050, 70% of the people will migrate and live in cities. Urban health is known to depend on factors such as governance, characteristics of the population, food security, social and economic developments (Which, 2010, p. 2). This paper deals with TB as an urban health hazard in Newham, London boroughs. We will discuss how determinants of health contribute to TB infection. Moreover, the infection and transmission mechanisms of the diseases will be discussed under various sections of urban life. Finally, strategies and recommendations in control of the disease will be highlighted. Introduction According to Centre for Disease Control, TB is an airborne disease that is caused by bacterium Mycobacterium tuberculosis (CDC, 2013, p. 2). The disease was declared a global disaster in 1993 with a campaign plan against it being scheduled in 2006 to save about 14 million victims by the year 2015 (WHO. 2011, p. 23).The pathogen specifically attacks the lungs, but other parts such as spine, kidney and brain are attacked. Extra pulmonary TB occurs outside the lungs. On the other hand, pulmonary TB occurs in the lung. However, the two types can co-exist. Improper treatment of the disease is fatal and may lead to death. Its spread through the air makes it transmittable through coughs, sneeze and other respiratory droplets. It is recorded that in every ten case of TB, half the number that is left untreated leads to 50% deaths (WHO, 2011, p. 3). A third of the whole world’s population is assumed to be affected by M. tuberculosis. Approximations of 1% of new infections are known to occur each year (WHO, 2002, p. 4). In 2007, 13.7million cases of active chronic infections were reported globally. However, in 2010, the number reduced to 8.8 million cases with an approximation of about 1.5 million global deaths. Most of the cases were reported in developing countries especially to the immune-compromised persons with HIV infections (WHO, 2011, P.6). The disease is linked with overcrowding and malnutrition due to poverty. Persons who use illicit drugs and occupants of crowded places are vulnerable to TB. Medically underprivileged communities and the health care to serve these individuals face high risk of the disease. Smokers have twice the likelihood of infection. This IS because smoking weakens their lungs strength besides frequent sharing of the cigarettes from one mouth to another (Smits, Pai, Yew, Leung, Zumla, Bateman & Dheda, 2010, p.8). Newham, London London borough has the highest TB infection in the western countries. Newham has its residents suffering from poverty and ethnicity. These factors have led to TB infection in the area to increase (Buckhurst, Evans and Packer, 2000, p.28). In fact about 108 cases are reported among every 100,000 people (Dailymail, 2014, p. 1). An average of about 7 patients shows signs of TB in that they have persistent coughs, chest pains and abnormal sweats. Of the victims, majorities are aged between 20 and 29 years, and they are mainly the male. Indians in London gave the highest rates of TB. They were followed by African sand Pakistan groups. It is claimed that social factors such as homelessness, drug abuse, mental illnesses and imprisonment contributes so much in spreading of the disease. Despite the vaccine BCG against the disease, the disease rose in England with a 10% IN 2007 (Dailymail, 2014, p. 1). In Leicester, 75 cases were diagnosed one person died of TB. It is estimated that half of the TB victims in Newham are asylum seekers from Bangladesh, sub-Saharan Africa and India (Office for National Statistics International Migration. 2001, p.45). The overcrowded condition in the places the asylums settles increases the chance for infections. In fact the spread is being associated with the increased cheap air travel hence facilitating the diseases spread from other countries which are infected (Dailymail, 2014, p. 1). The country is afraid that a super-contagious strain of the TB pathogen may arise due to drug resistance and genetic exchange among different strains from different countries. A case example happened in china when the Beijing strain emerged. Dr. Watson who is a medical expert in UK said that is important for all visitors entering the country to undergo an X-RAY-Ray scan in the detection of the disease (Dailymail, 2014, p. 1). Newham in London is classified among the 5th most deprived areas of England (APHO. 2013, p.30). About 86 % of the residents live in the deprived areas hence they have short life expectancy besides high chances of an attack from infectious diseases such as TB (APHO. 2013, p.3). According to a BBC report (2013), London remains the worst city in TB infection in that it has the highest rate among the European capital. The homelessness high rate in the region leads to poor families leaving crowded in streets hence increasing risk factors of TB infection. Theses poor families have minimal access to health facilities for TB scanning and by the time they discover tat they are infected, it is too late. By then they will have spread it among the nearby people whom they socialize with (Sycamore, 2002, p. 25). The capital has a record of 42 cases in every 100,000 people (BBC, 2013, p. 1). The rate is very high in that the whole country has a national figure of 14 victims per every 100,000 people. In 2012, there were about 3,400 cases of TB, a statistics of 40% in United Kingdom. In general, Newham is the most affected region with 119 cases in every 100,000 persons. Paris and Copenhagen have recorded 23 and 17 cases respectively (BBC, 2013, p. 1). Slums Conditions Urbanization has led to the development of many urban centers with many industries and other sources of employment. This has led to many rural people to migrate into the urban centers in search of jobs. This has led to increased population in urban areas leading to overpopulation. Such people have engaged in energy demanding jobs in factories, manual and service works. The pay is poor hence the people live ion extreme poverty in that they can not fully cater for their basic needs. Only a few of the lucky workers are accommodated in large dormitories by their employees. This has led to some of the people setting up small living environments in the form of slums. People living in such areas are of poor and low living standards. This leads them to suffer from common diseases that reduce their immune system potential. Tuberculosis pathogen being opportunistic pathogen attacks them, and they are infected. Overcrowding increases the chances of spread in that the mingling provides an ample environment for its spread. A single person within the family has the potential to spread TB to all his family who spreads it to the nearby persons. For example, a single school child from the slums may spread the disease to most of his schoolmates during class time and games. In return, the infected school children will spread it to their friends at home. The cycle continues and within a short time the whole slum will be infected by the disease (Poole and Simjee, 2007, p.46). Presence of unhealthy slums and high populations in urban centers prone the residents there into contacting infectious diseases that spreads so fast than in rural areas. Slums are residential bases for poor people within a town or city. These areas grow very fasts besides their accumulation with poor people, young families and less educated people. These areas lack basic and vital services such as a portable water, electricity and health services. Unsanitary areas due to poor sewage and drainage disposals provide breeding grounds for epidemic diseases such as cholera and other diarrhea diseases. The dwellers are at high risk of infectious diseases such as TB due to overcrowding, chemical and toxic substances due to their location in polluted and damping sites. Overcrowding and poor ventilation of the house increases the chances of TB spread. Hygiene conditions in the areas are so low in that the people share most of the things such as drinking cups and plates. Such practice leads to further spread of the disease. Poverty levels in the region lead to the majority of the people there being jobless hence they spend most of the time accumulated in single areas as they socialize. Both infected and healthy persons meet during the time leading to spread of the disease. Therefore, poverty accelerates infections within a population very much (Godfrey-Faussett et al., 2002, p.47). Air and Seaports Moreover, it is only in developed cities that large airports and seaports are built. Many people settle around those areas to venture in businesses and jobs. Presence of international terminus creates the possibility of residents into import of disease from the foreign visitors in the area (Lutton and Howard, 2003, p. 12). This is because cities attract a huge number of people as well as animals and their products that are potential carriers of infections agents. Visitors in a new city tend to adopt new behaviors such as eating different foods, socialize with different groups and try different sex partners. Contact with these new people increases the spread of TB disease in a particular pattern (Lutton and Howard, 2003, p. 12). Hospitals Moreover, cities are known to compose advanced hospitals than the rural areas. Therefore, all new and unusual illnesses that are beyond the capacity of the rural hospitals are referred to city hospitals. This increases the risk of health workers and nearby persons. Before the disease is identified, majority will have already been infected. Furthermore, the infrastructure of cities makes them harbor large laboratories and biotechnological centers among other research centers. Presence of the facilities increases the chances of epidemics and malicious poisoning (Godfrey-Faussett et al., 2002, p.47). Infections Spread Infectious diseases such as TB have high spread rate in urban centers. This is because people are in constant proximity with each other; they mingle as they enjoy cultural events, sports, restaurants, buses, drinking joints and working places. Communicable diseases especially the airborne ones will spread at a vey high rate than in rural areas (Poole and Simjee, 2007, p.46). Therefore, urban areas have contributed vey much in the spread of diseases increasing the epidemic rates. However, towns and cities with perfect transport means of roads and railway, the infections became pandemic in that there is frequent movement of people in different areas to and out of the areas. It was noted that diseases spreads at varying rates with cities. A huge building with many apartments and an elevator is at a higher risk of infections than a residential street. Therefore, it is not sensible to say that a particular section of the city is safer than another (Godfrey-Faussett et al., 2002, p.47). Determinants of Health In respect to WHO argument, health is a state of complete mental, social and wellbeing but not absence of sickness. Health determinants play an important role to the wellbeing of a person. These factors are physical environment, social and economic status and individual behaviors. The environment matters a lot in that a filthy environment with poor sanitation increases the likelihood of infection (Story, Roberts, Hayward and Verheyen, 2007, p. 266). Crowded areas with many people increase the chances of TB spread. Physical environment determines the healthy of people in that they will have access to good working conditions hence reducing transmission rate of TB. Educated people are much aware of the current trends in health issues. Therefore, education determines how people improve and maintain their hygiene. Educated persons will know the mechanisms of how TB is spread and how to prevent transmission besides the importance of seeking medical assistance. On the contrary, illiterate people assume this action of TB awareness. Personal behaviors such as drug and substance abuse determine the infection of TB. Persons who engage in drinking, drugs abuse and bad sexual activities are prone to diseases such as HIV/Aids. Such diseases reduce the immune strength of the victims making them immune-compromised. This leads them to contact opportunistic diseases such as TB (Godfrey-Faussett, Maher, Mukadi, Nunn, Perri, 2002, P.47). In London homelessness, drug abuse and detention of prisoners are the key factors that lead to increased levels of TB within the area. This is because the determinants of health in the affected areas are not positively achieved. Drug and substance abuse leads to the street children and the drug abusers to share drugs especially those that are taken through the mouth such as cigars and marijuana. During the sharing, salivary droplets from infected persons are spread to the healthy ones leading to further spread of the disease. Prisoners are always overcrowded besides having poor hygiene. Since the opportunistic disease is an airborne one, the spread is achieved very effectively among the prisoners due to the overcrowding and weakened immune systems due to poor diet and hygiene (Story et al., 2007, p. 266). Impacts of TB TB stops economic development in the country in that it attacks the productive age group. The disease being an airborne one has led to the loss of jobs in many people especially to those working in food industries. This is because such victims do not meet the standards of hygiene in fear of transmission. Patients who get no medical attention died leaving hopelessly infected children to suffer. In fact, the disease has a high mortality rate among children of the poor families. Stigmatization has increased in that the infected persons are being segregated by their fellow healthy friends. Such people feel distressed and sorrowful leading them to commit suicide among other stupid activities. Moreover, such people may be silly in that they may intentionally pass it to other people as a way of achieving revenge of being segregated. The government uses a lot of money in treatment of the diseases in that its drugs are expensive, and they require a long duration intake. Eruption of multi-resistant forms has led to much research in the diseases wasting a lot of money. Such researches would be more productive if applied in developmental projects that can increase and improve the countries economy. Such money can be used to gear forward economic development projects (TB Alliance. 2013, p. 3). Strategies to Control TB Full achievement of the 6th millennium goal that attempts to combat HIV/AIDS, malaria and other infectious diseases such as TB is one of the strategies. Another method is through application of DOT strategy that involves surveillance of the victims under treatment (Baltussen, 2005, p.1). Strategic positioning of health facilities within the country to provide regular test within the residents is another effective method. Moreover, offering free treatment to the affected victims can help so much in TB control. Timely surveillance will always ensure that the disease is detected earliest possible. Economic and social status improvement of the residents will help in improving their health. Conclusion It is now clear that urban centers are at a higher likelihood of infections compared to the rural areas. Thanks to the huge population whereby few people know each other. Rural areas have proper information about each other in the village. This makes them aware of victims of infectious diseases such as TB hence they protect themselves from the infection so much (Anderson and May, 1991, p. 46). Urban people do not know each other well hence the high probability of spread and infection. Loss to follow up care, poor adherence and drug resistance are indications that TB management among prisoners, homeless people and drug users in London is not effective. Discontinuation of the TB drug leads to elevated transmissions and development of resistance strains (Ruddy, Davies, Yates, 2004, p.38; Volmink and Garner, 2006, p. 35). Poor adherence to the treatment is one of the main factors that hinder complete treatment in London. TB treatment is manageable if the disease is detected early and there is complete adherence to treatment by the patient. Malnutrition and diseases such as HIV/AIDS that weaken the body immune system increases the chances of TB infection (Godfrey-Faussett et al., 2002, p.47). Recommendations The Directly Observed Therapy (DOT) should be adopted and be used as the standard for TB care (Volmink, Matchaba and Garner, 2010, p. 26). Problems of homelessness should be solved, and proper housing provided by the relevant authorities. This will help in a reduction of overcrowding. Prisoners should have access to health facilities for regular check-ups and treatments. Drug abuse especially among the youths should be combated in that it is one of the risk factors that promote TB infection and spread. Foreign visitors entering the country should have checked up of medical to check the presence of the disease to avoid further spread. TB patients require completing a six months regular treatment dose against the disease to prevent further spread and eruption of multi-drugs resistant forms. The government should set aside extra funds in TB treatment in caring for the victims especially the risk groups. More research centers should be constructed to help in research about the pathogenic microbe of TB. Regular vaccinations should be carried in the whole country especially to the children to create immunity against the diseases. The hot spots in Newham should be given the priority during the vaccination besides regular immunizations. Public awareness among the public should be created to inform the residents of maintaining hygiene and the importance of regular medical checkups. Drugs and substance use among the deprived families should be combated, and the victims rehabilitated. Respective agencies should co-ordinate screening programs for people from high risk countries and groups. Bibliography Anderson, R. M. and May, R. M. 1991. Infectious Diseases of Humans: Dynamics and control. Oxford: Oxford University Press. APHO. 2013. Health Profile 20134, Newham. Accessed on 2014 February 18th from http://www.apho.org.uk/resource/item.aspx?RID=127144 Baltussen, 2005. 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