Polio Eradication by the Numbers.


http://www.ozy.com/acumen/polio-eradication-by-the-numbers/3274.article#b10g24f20b13

Pakistani quakes leave scientists debating tech’s role.


 In the wake of a series of large earthquakes that have struck Pakistan over the past few weeks, the country’s scientists are debating howtechnology might help limit the devastation caused by future disasters.
 
A day before the first quake, which hit southwest Pakistan on 24 September, a collaboration between US and Pakistani geoscientists was announced. The project, which has been allocated US$451,000 over three years by the US Agency for International Development, will unite researchers to study the Chaman Fault — the location of the recent earthquakes.
 

Shuhab Khan, associate professor of geology at the University of Houston, United States, is leading the US side of the project. “There have been multiple big earthquakes in the area over the last 35,000 years,” he says. “The city of Quetta is particularly in danger as it lies near the fault. Bigger earthquakes could even affect the wider area — Karachi and its surroundings, and possibly some cities in Afghanistan as well.”
 
He hopes that modern technology — including lidar, a form of radar that uses laser radiation — will help Pakistan prepare better for earthquakes.
 
“This technology has been used successfully to identify the direction of movement and major cracks in faults,” Shuhab Khan tells SciDev.Net. “So if we can use it to study the Chaman Fault, it should help Pakistan understand the risks of earthquakes better and prepare better.”
 
Currently, the Chaman Fault is one of the least studied in the world, he says.
 
Zahid Rafi, director of the National Seismic Monitoring Centre at the Pakistan Meteorological Department in Islamabad, says that he and his team have been working to improve their understanding of local seismic activity.
 
Before the devastating earthquake that struck Kashmir in 2005, Rafi says his department was using manual seismometers, but since then they have introduced automated seismometers, accelographs and GPS (global positioning systems) worth 500 million Pakistan rupees (around US$4.7 million). These are all networked with a central databank in Islamabad.
 
But Shuhab Khan remains unconvinced that the national network of seismometers set up after the 2005 quake has helped matters. “I haven’t seen much improvement in seismic research in Pakistan,” he says.
 
Asif Khan, the director of the National Centre of Excellence in Geology at the University of Peshawar, Pakistan, says the establishment of the countrywide network of seismological stations is a “healthy sign” for future earthquake mitigation measures. But there is still a “lack of seismological research and records,” he adds.
 
“Academic research was being hampered by a lack of seismic technologies. Productive research in this area needs old and new seismic data but, unfortunately, Pakistan’s old seismic data is either not reliable or of poor quality,” he says.
 
Ali Rashid Tabrez, director general of the National Institute of Oceanography in Karachi, says that “data gathering with new seismic gadgets will enable the government to create a seismic databank. This should help identify quake hot spots and seismic activity on the seabed while informing building codes and disaster management strategies.”
 
According to its ten-year National Disaster Management Plan, Pakistan’s National Disaster Management Authority is starting a US$1.4 billion project to produce national earthquake hazard maps, contingency plans and risk assessments.
 

Source: SciVx

How polio changed my life.


Pulmão de Aço (Iron Lung), published this year in Brazil, tells the story of Eliana Zagui, a polio survivor who has lived for decades in a hospital in Brazil.

Pulmão de Aço (Iron Lung), published this year in Brazil, tells the story of Eliana Zagui, a polio survivor who has lived for decades in a hospital in Brazil.

By Eliana Zagui, author of Pulmão de Aço (Iron Lung)

Before it was eradicated through the effort of massive immunization campaigns in 1989, poliomyelitis was prevalent in Brazil. The lack of vaccine and poor sanitation in small towns resulted in thousands of victims a year. Avoiding polio was often a matter of luck.

In January 1976, at the age of two, my luck ran out. I woke up with a fever and weak lower limbs. Although my parents were used to my recurrent episodes of sore throat, they brought me to the nearest city of Jaboticabal for medical treatment. The next day, lacking a diagnosis, I was sent to Ribeirão Preto, a larger city with better medical facilities. By the time the doctors came to the conclusion that I had contracted polio, the virus had already started its devastating muscular paralysis process.

We lived in Guariba near São Paulo, more than 180 miles from the major polio treatment center in Brazil. Getting to the ‘Hospital das Clínicas’ in São Paulo was a struggle. But after several hours, we received a ride from a charitable individual. By that time, I was already paralyzed from my neck down, and my breathing was restricted by the paralysis of my diaphragm.

I was placed in an iron lung a number of times in an attempt to reverse the respiratory failure, but eventually the doctors concluded the battle was lost. I was tracheotomized and connected to an artificial respirator. More than 36 years later, I still depend on the artificial respirator to breathe.

I have lived the rest of my life at the same ‘Hospital das Clínicas.’ Out of  hundreds of children admitted to the hospital in the ‘60s and ‘70s, seven of us formed a family, and developed bonds with the doctors and nurses who looked after us. Five of our family died in the ‘80s, and now only Paulo Henrique Machado and I remain. We still share a room in the Intensive Care Unit.

It was in that room that Paulo and I learned how to read and write. While Paulo has limited hand movements, I can only move my neck and head. Everything I can do with some autonomy has to be done with my mouth. That includes my paintings, which are sold around the world through an association.

Satellite measures ‘quake island’.


The “quake island” that rose from the sea off Pakistan this week is pictured clearly in a new satellite image.

It was acquired by the French Pleiades high-resolution Earth-observing system, and has enabled scientists to map the muddy mound’s precise dimensions.

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It is almost circular – 175.7m on the long axis and 160.0m on the short axis, giving a total area of 22,726 sq m.

The island, sited near the town of Gwadar, came up after the 7.7-magnitude tremor in the region.

Scientists say the intense shaking likely disturbed previously stable sediments and gas at the sea floor, which then oozed to the surface rather like a mud volcano.

The feature is not expected to persist. The ocean will erode the soft sediments, like it has with similar quake islands in the past.

The Gwadar mound is reported to be the fourth in the region since 1945, and the third during the last 15 years.

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Pleiades is primarily a French national space project. It comprises two satellites that can resolve features on the ground as small as 50cm across.

The pair were built by Astrium, Europe’s largest space company; the imaging instrument was supplied by Thales Alenia Space (France).

Pleiades has both a civilian and a military role, and a number of European countries (Austria, Belgium, Spain and Sweden) have part-funded the project to get access to the pictures.

Polio Crusade: The Success Staircase.


 

Following two long hauling decades of global vaccination campaign, the world is at the edge of eradicating polio. Pakistan is one of the only three countries, labouring under a huge burden of polio, Afghanistan and Nigeria being the other two. The national campaign to wipe out polio and various deadly diseases from the roots have feared failure for the past few years and very recently, a devastating blow when the murders of the aid workers made headlines and pushed the agencies to suspend the Polio Crusade. Over 90 percent of the polio cases being reported are from four major transmission zones in Fata, Khyber-Pakhtunkhwa (K-P), Baluchistan, central Punjab and Sindh.

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Pakistan declared a national health emergency in January 2011 uncovering an action plan with a singular goal of disrupting transmission of the disease by the year’s end. Unfortunately, the initiative failed. A recent intensification of the disease with emerging violence has been highlighted, which unfortunately continues up to date. The incidence of the highly infectious disease is relatively low in the peaceful areas, Punjab and Sindh and high in KPK, FATA and Baluchistan.

In 2011, Pakistan reported 198 fresh cases, being the highest in the world. Over 188 out of the 198 new infections reported to have emerged from the violence-plagued areas. Similarly, 55 out of 58 cases in 2012 emerged from Baluchistan, FATA and KPK. The ruling under the new leadership could have the government to eradicate polio from Pakistan; a goal we have almost achieved. However, in the light of recent attacks on the health care personnel, which included women, have raised fear and subsequent departure from respective duties, abandoning the vaccination campaigns and various health associated activities.

Many have spoken about the government responsibilities, highlighted the need for education of the masses, remote accessibility, promising security services and making this world an infection-free place to live in. However, Polio and I sat down with the Pakistani dilemma where we discussed weaknesses thereafter coming up with a plan we called the Success Staircase. Polio highlighted the first step towards eradication – Health education, which by definition is a positive impact on individual, which results in a favourable behavioural change, leading to good health. Health education in primary health care aims to foster activities that encourage people to want to be healthy, know how to stay healthy, do what they can to maintain health and seek help when needed.

It remains the duty of all conscientious persons dealing with each other in everyday life. Therefore, it starts form “Us”. – The second step towards enlightenment as mentioned by polio was sensitization. This step is overlooked by the authorities who race towards achieving bigger goals neglecting the basics.

Therefore, the nation can come up with new ideas, polices and agendas once we have successfully eradicated polio. Those who have access to health care services should be given a tutorial supplemented with visuals (as seeing is believing) whereas those who remain unattended and unreachable should be approached through media and community leaders. In health campaigns driven in the country so far, no special efforts have been dedicated to reach to the illiterate population. Do we and our future really require clothing labels, processed food, tea and telecommunication plans to recover our health liabilities?

How about we incorporate polio awareness regimens with the existing advertisements. We can target the product consumed/adopted widely by the masses to spread knowledge. For example, through the mobile facility, we can extend text/pictorial messages and offer free tele-health services. Polio and Publicity go hand in hand.

Back in my childhood days, I memorized a jingle that played in a short advertisement of a family planning service. I sang it like all other poems from the recitation classes. A very good example in today’s time emanates from the practice of hand-washing which is a primary step towards nipping the disease in the bud. The hand-wash product came up with a good theme and a child friendly song, bagging nationwide incentive.

My idea was to contemplate campaigns and advertisements in an entertaining approach to grab mass appeal. Instead of having crippled children look at the sight of ordinary kids performing daily activities coupled with a distressing melody in the backdrop, make the practice of inoculation fun and enamouring. Bright colours, energetic theme and lively environment is definitely heartening. Even the census participation was made encouraging due to the cheerful rattle; it ran over the tube a hundred times in a day resultantly.

Polio asked to re-establish priorities. In addition to door-to-door services, establish and push school-to-school and community–to-community agenda forward. Bangladesh is becoming an emerging economy showing cohesive tendencies to various changes and demands. It achieved a huge reduction in poverty; there has been a growth in trade and education, overcoming most of their challenges.

Therefore, in order for Pakistan to grow into a healthy nation, we need a collective collaboration and sustenance program and adequate funds free of manoeuvre. Continued education and training of the health care personnel is a very important step towards the quality of implementation. The trainees should be motivated and expectant for absolute health care delivery. A very important aspect of this exercise remains bridging the communication gap.

Special attention should be given to areas of barriers such as social and cultural divide, negative attitudes, insufficient emphasis and contradictory messages. The trainees should also be offered attractive quality packages keeping in mind the objectives of occupational health; thereby encouraging performance and dedication. Special training and advancements should be offered to promote remote access and healthcare relief. Considering the recent event in the lawless areas, operations and killings of the charity and aid workers had gripped the localities with fear.

Polio emphasized upon security as a requisite for the protection of the conduct. All health associated movements and activities should have satisfactory safety arrangements due to various events in history that have endangered medicine and medical practice. Polio and I spent hours discussing the merits of pressing a campaign in a low profile manner where authorities could inoculate children in phases, with adequate security arrangements instead of pulling off a nationwide campaign which may not only be strenuous to supervise but also under-productive. Another idea that hit us was to offer general healthcare facilities which obviously encased the polio proposal instead of highlighting special polio camps and workers.

This attempt could smash its way into successful inoculation of a child at a routine visit and subsequent education of the guardian. Polio called in for an enterprise which could regain trust. The government should re-think the measures previously taken for the medical movement; making nationwide announcements for a child friendly campaign. Local authorities should scheme initiatives entitled to gain confidence of the masses which is the gateway to reliance upon the government.

Pharmaceutical fraud is the biggest threat to the integrity of the global drug supply. With meager training and knowledge, the criminals have made their way in the market generating illegitimate profits. The impact of the convincing fakes has a potential to contribute to world health crisis. The government should run and revise inspection and subsequent quality control programs and announce strict penalties to the offenders.

Our great emphasis has been on the government abilities. Our system should realize the crisis Pakistan is falling into. We as health officials should join forces to formulate a singular agenda instead of feeding our personal motives, with a sole purpose of a Healthy Nation, Healthier Environment, and the Healthiest People.

References:

http://www.emro.who.int/countries/pak/ http://europe.wsj.com/home-page http://tribune.com.pk/




2018 must be the final target for polio eradication.


Since the eradication of smallpox in the late 1970s, no other diseases have followed suit; the goal that has come closest so far is eradication of polio. The development of vaccines in the 1950s led to cases of polio plummeting: whereas hundreds of thousands were affected annually in the middle of last century, in 2012 around 250 people were paralysed by the disease. But the final stages of eradication are proving more difficult than the early phases. The disease remains entrenched in three countries—Afghanistan, Nigeria, and Pakistan—where social, political, and logistical factors prevent effective vaccination campaigns and lead to export of virus to countries that have previously been free of the disease.

As Haris Riaz and Anis Rehman reported in the journal last month, the global polio eradication programme suffered a grave setback in December last year when seven vaccination workers were shot dead by terrorists as they took part in a 3 day campaign to deliver vaccine in Karachi and Peshawar. At the end of January, two more vaccine workers were killed in a landmine explosion in the Kurrum tribal region. These two latest casualties are not thought to have been directly targeted, but unwitting victims of sectarian violence.

Such events are not only tragic losses—people dedicating their time to a global health effort senselessly killed—but also they leave children who would have received vaccine unprotected and allow the virus to continue to circulate. The consequences of which can be extremely far reaching: in January, poliovirus related to strains circulating in Pakistan was detected in sewage samples in Cairo, Egypt, more than 3000 km away (the last case of polio in Egypt was recorded in 2004). No new cases of polio have been recorded in Cairo, but health authorities are surveying the impoverished districts of Al Salam and Al Haggana where the virus was found for recent cases of paralysis, and vaccination campaigns have been initiated.

In the middle of the 20th century, children in developed countries of Europe and North America would return to school at the end of the summer break and look around to see empty chairs of classmates who had not returned because they had been crippled or killed by polio. When the global polio eradication initiative (GPEI) was launched in 1988, the disease was endemic in 125 countries and caused paralysis in around 350 000 people every year. Recent events highlight how a threat that for many is thankfully a distant memory—or for younger generations in some developed countries unknown—remains a real and present danger.

The Bill & Melinda Gates Foundation is one of the major contributors of financial aid to the polio eradication effort, and speaking recently in London at the Richard Dimbleby lecture, Bill Gates reiterated his commitment to wiping out the diseases, highlighting the new eradication target of 2018. On January 23, the GPEI published a draft Polio Eradication and Endgame Strategic Plan (2013—18). The plan has four main objectives and four milestones for eradication. The four objectives are, detection and interruption of wild poliovirus, strengthening of routine immunisation and withdrawal of the oral polio vaccine, containment and certification (enabling some facilities to store poliovirus and outlining the processes for certification of eradication), and legacy planning to ensure that resources put aside for polio eradication are repurposed when the goal is achieved. The milestones for the new strategic plan are for the last case of wild polio by 2014, withdrawal of type 2 oral polio vaccine by 2015—16, worldwide certification of polio eradication by the end of 2018, and cessation of bivalent oral polio vaccination during 2019.

This is not the first deadline for polio eradication. When the GPEI was set up, the planned date for eradication was 2000. As the cases become fewer, the problems become knottier, and hindrances to final eradication become ever more dependent on localised factors and characteristics of the virus’s remaining toeholds. As the saying goes, the devil is in the detail.

The new plan encouragingly contains intricate analyses of recent outbreaks in the three remaining countries, reasons for programmatic declines, and reflection on the lessons learned from success in India, which has not recorded a case in more than 2 years. It is an excellent example of how data, local knowledge, and experience can be synthesised to provide clear goals and realistic targets. 2018 seems soon, but for some children it will not be soon enough. And for the vaccination workers who have lost their lives, eradication of polio within 5 years would be a tribute to their efforts.

Source: lancet

 

Poliomyelitis in Pakistan: time for the Muslim world to step in.


polio

Global poliomyelitis eradication is almost within reach—this disease persists only in Nigeria, Afghanistan, and Pakistan, which are countries with substantial Muslim populations.1 Today this ambitious goal is threatened, partly by misinformed and politicised religious views that not only seed suspicion about polio vaccination but recently led to murder of polio workers. In Pakistan, 16 workers engaged in a polio vaccination campaign have been killed since December, 2012, halting vaccination in many parts of the country and placing Pakistan’s 2012 gains in poliomyelitis eradication at risk.2 Copycat attacks followed in Kano, Nigeria, and were thought to be the work of extremist group Boko Haram.3 Although Pakistan’s Government, civil society, and religious factions have condemned the killings, action is urgently needed to dispel public misperceptions and deter ongoing violence.

Saudi Arabia and its health authorities are uniquely placed to bring about change in Pakistan for two reasons. First, as the site of Mecca and Medina and host to the Hajj, Saudi Arabia wields enormous influence in Muslim Pakistan. Second, Saudi Arabia has experience of introducing new public health recommendations and strengthening public health outreach by legitimising new public health measures with both formal Islamic authority, in the form of fatwas, and informally, through public opinion.4

Saudi theocrats and public health officials are experienced in effective public health messaging in the diverse Muslim public space. Despite a widely held perception of narrow interpretations of Islamic tradition, Saudi Arabia’s advanced medical academe and traditional religious theocracy have forged imaginative partnerships to solve public health challenges so that advanced therapies—whether living or cadaveric organ harvesting, genetic counselling, care of terminally ill patients, or therapeutic abortion—are available in Saudi society.5 A nexus of science, medicine, and religion has enabled a smooth introduction of advances in every aspect of health care into Saudi Arabia’s medical system, which successfully operates in a conservative Muslim society. This collaborative approach is one Pakistan must emulate to the benefit of its imperilled polio programme.

Pakistan’s Taliban views vaccination programmes as not being Islamic and a western innovation to be repudiated, at the peril of the murder of health workers and the inexorable rise of poliomyelitis.6 Saudi Arabia’s clerics have shown the opposite view through their willing and engaged acceptance of diverse forms of advanced medicine—eg, the use of alcohol-based hand hygiene agents, and use of porcine medicinal products if no alternative is available.

Pakistan could benefit from such a collaborative approach, and Saudi public health officials are ready to engage international Islamic organisations to issue religious edicts lending vital legitimacy to Pakistan’s programme for eradication of poliomyelitis. Similar partnerships have been deployed between local religious clerics and public health officials in Nigeria,7where polio vaccination campaigns were once boycotted, and Indonesia,8 which has also legitimised health programmes with the help of religious theocracy.

Saudi Arabia has a strong national interest in controlling the spread of the poliovirus in Pakistan. Every year, over the past decade, more than 10% of all pilgrims, nearly 200 000 Muslims, travelling to Hajj were Pakistanis (figure). Only Indonesia sent more pilgrims to the Hajj, and Pakistan is predicted to surpass Indonesia in population size by 2020.9 Host to pilgrims from more than 187 nations10 arriving in Saudi Arabia, the massive influx of Pakistan’s pilgrims can be a risk for new polio outbreaks in the Hajj cohort, the domestic population, and, through returning pilgrims, globally. Such an outcome could set the global polio eradication programme back by decades. The existence of poliomyelitis in Pakistan already poses a regional risk, as recently described in Afghanistan and China.

Saudi Arabia has enforced strict public health interventions for the millions of people who travel to Mecca each year, linking the issue of a visa to documented vaccinations, deploying thermal cameras to quarantine pilgrims with fever, and denying entry to people who might pose public health risks.12 Currently, Saudi Arabia recommends the administration of two doses of oral polio vaccine to all pilgrims coming from countries with active circulation of poliovirus. Saudi Arabia requires one dose 6 weeks before arrival (tied to Hajj visa issue) and a second dose on arrival. During Hajj 2012, nearly 500 000 doses of oral polio vaccine were administered at Saudi Arabia’s expense to pilgrims coming from countries with poliovirus circulation.13

Saudi authorities have a lead time of about 9 months before the Hajj season begins, allowing swift and specific planning for each Hajj. Saudi Arabia’s legitimacy in managing Hajj-related health is demonstrable. During Hajj 2012, the Saudi Ministry of Health banned all Muslim pilgrims from Uganda and the Democratic Republic of Congo, because of reports of Ebola outbreaks, to safeguard pilgrims. Although this decision could have been contested as not Islamic if not sanctioned by religious authorities, and Saudi authorities vilified for denying the divine rights of African Muslims, the ban was peacefully enforced and accepted because of the religious legitimacy afforded by clerics.12 Similarly, Saudi clerics have supported public health rulings deterring certain Muslims from Hajj during the recent influenza A H1N1 pandemic, which was a particular threat for pregnant women, elderly people, and those with comorbidities—a sensitive matter because all Muslims should attend the Hajj while they are able bodied.1314

Saudi Arabia’s experience has benefited from the Mecca-based World Muslim League’s ratification of medical recommendations, facilitating their wider adoption in Saudi Arabia and beyond. This unified approach avoids the opposition seen by extremist groups claiming to act in the name of Islam, despite motives clearly anathema to Islam. Saudi Arabia’s experience can inform the debate about eradication of poliomyelitis in Pakistan with similar approaches to management of public opinion through officially sanctioned public health and religious messaging, supported by the international religious theocracy and by the Saudi monarch, the apical authority for Islam in Saudi Arabia.

Although counteraction of the Taliban with a fundamentally Islamic position might seem inflammatory, this approach is rooted in Islamic teachings guaranteeing the sanctity of human life above all religious rites. Enlisting local mosques and community centres to promote polio vaccination as sanctioned by Islam to preserve life could lend Pakistan’s polio programme immeasurable authority. These measures, if ratified by national and international Muslim organisations, when supported by the world’s health agencies and leading public health academics of Muslim heritage, provide the authority needed.

Pakistan’s demoralised public health workers must be supported by a robust international approach that combines both traditional diplomatic and imaginative political responses to draw on the powerful authority of the international Muslim community, including the Organization of the Islamic Conference, the International Fatwa Body in Mecca, and Al Azhar in Egypt. Only then can we relegitimise infection control authorities and engender confidence in both public health officials and the vulnerable Pakistani population.

The Muslim world is responding emphatically. Sheikh Mohammed bin Zayed Bin Sultan Al Nahyan of Abu Dhabi is partnering with the Bill & Melinda Gates Foundation in a US$100 million commitment to the Global Polio Eradication Initiatives and Endgame Strategic Plan 2013—18 to be announced at the Global Vaccine Summit, Abu Dhabi, during World Vaccination Week (April 24—30). Such endorsement emphasises the recognition of poliomyelitis eradication as both a prime challenge and an extraordinary opportunity for the Muslim world. The Taliban’s intimidation must be excoriated by the Muslim community, for Pakistan has a truly critical role in global poliomyelitis eradication, which, with definitive Muslim intervention, will finally be relegated to history.

Source: lancet

Girls Rising: From Anne Frank to Malala Yousafzai.


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“Stories can conquer fear,” Nigerian novelist Ben Okri once said. “They can make the heart bigger.”

There’s a world of truth to that statement. As someone who comes from a long line of storytellers, I’ve always felt that our lives are just long and rich stories, knit together over the years, that tell us not only about ourselves, but the human condition, as well.

Which is why, I believe, the Women in the World Summit, which opened on Thursday night in New York City, is such an important gathering — because it is dedicated to championing women and girls around the world, and not just through their compelling stories, but through the actions that those stories inspire.

This year, the summit was attended by no shortage of admirable women — from Hillary Rodham Clinton and Ambassador Susan Rice, to Meryl Streep and Somali human rights activist Dr. Hawa Abdi. But my eye was especially trained on the big opening night event, in which actress and activist Angelina Jolie honored 15-year-old Pakistani schoolgirl Malala Yousafzai, who has come to symbolize both the plight of young women around the world, and the courage to fight for justice.

Yousafzai was only 11 years old when, under a pseudonym on a BBC blog, she began to write about the life under the brutal Taliban regime in Pakistan’s Swat Valley, particularly the violently enforced edict banning girls from obtaining an education. Yousafzai’s undercover reporting was hard-hitting and painful; and once her identity became known, her bravery was no less boundless.

“I don’t mind if I have to sit on the floor at school,” she told a TV audience. “All I want is education. And I am afraid of no one.”

Yet as her popularity grew, so, too, did her vulnerability — and last October, Taliban gunmen shot her in the head while she was riding on a school bus. She survived the assault and was sent to the United Kingdom for hospitalization, where she continues her rehabilitation today. But the world has taken up her cause. She has been nominated for the Nobel Peace Prize, and the U.N. has launched a petition in her name, calling on organizations worldwide to ensure education for all of the world’s children by 2015.

Most important, Yousafzai’s bold fight lives on in the hearts of her peers.

“Every girl in Swat is Malala,” a classmate commented through Twitter two days after the assassination attempt. “We will educate ourselves. We will win. They can’t defeat us.”

History has been replete with girls and young women whose stories, often of sacrifice, have driven others to reach for greater ideals. Anne Frank still stands as a shining testament to the unbreakable will — and unchecked optimism — of the human spirit. And Helen Keller came to exemplify the determination that is required to face down disability.

In my own life, I’ve personally witnessed how the seeds of goodness planted in children have blossomed into something beautiful and powerful. In 1972, I watched kids embrace, almost by instinct, the deeper lessons of Free to Be…You and Me, which taught them about their bottomless potential and the injustice of racial and gender discrimination. And today, I continue to be awed by the girls and boys of St. Jude Children’s Hospital, who remain the definition of inner-courage. These children truly inspire me.

Although most Americans weren’t in attendance at the Women in the World Summit, fortunately, we will all be given the opportunity to share in a similarly rousing event. This week, a 100-minute documentary entitled Girl Rising will debut in more than 500 screenings across the country — and it is an astonishing achievement. Executive produced by Holly Gordon, the film tells the stories of nine heroic girls from around the globe who, like Pakistan’s Malala Yousafzai, overcame nearly insurmountable adversity to claim their right to an education.

Like Sokha, an orphaned Cambodian who rose from the filth of a garbage dump to become a prize pupil in a top school, where she also teaches younger students. Or Wadley from Haiti, who was just 7 when the 2010 earthquake devastated her home and school, but didn’t keep her from seizing an education that has made her a promising science student and budding photographer. Or Nepal’s Suma, who, forced into bonded labor at 6, found solace in writing music and learning to read, then forged a battle to win an education for other young girls.

And then there’s Azmera of Ethiopia, who defied the traditional demand that she be married at 13, and instead, remained in school where she continues to excel in English and mathematics. Azmera plans to become a teacher.

Girl after girl, each of these stories jolts us into a deeper awareness of the unconscionable injustices that still exist throughout the world, and the triumph of rising above them. I hope you’ll take a look at our slide show, which previews these young women’s remarkable journeys. And then I hope you’ll see the movie.

Meanwhile, to all the girls and women of the Women in the World Summit, we salute you. And to Malala Yousafzai, God’s speed for a safe and complete recovery. The world treasures your voice.

 

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ist:Is�e>(� �� style=’font:7.0pt “Times New Roman”‘>         Many indicators have been independently associated with prognosis after traumatic brain injury, but they are of limited clinical use when considered separately and current prognostic models do not have sufficient discriminative capacity to inform clinical decision making

 

  • S-100β protein concentrations have been shown to increase in blood and cerebrospinal fluid after a wide range of diseases or conditions leading to brain damage
  • S-100β protein serum concentrations correlate significantly with unfavourable prognosis in patients with moderate or severe traumatic brain injury, as defined by mortality, Glasgow outcome score ≤3, or brain stem death, with or without concomitant traumatic injuries
  • The association between serum concentrations of S-100β protein and prognosis was observed at discharge from intensive care and at one, three, and six months.
  • Serum threshold values ranging from 1.38 µg/L to 10.50 µg/L and from 2.16 µg/L to 14.00 µg/L were associated with 100% specificity for mortality and a Glasgow outcome score ≤3, respectively.
    • Source: BMJ

What this study adds

 

United Nations declares November 10 as ‘Malala Day’.


The United Nations has declared November 10 as ‘Malala Day’ in honour of Pakistani teeenage rights activist Malala Yousafzai, who was shot in the head by the Taliban last month for campaigning for girls’ education.

UN Secretary General Ban Ki-moon‘s Special Envoy for Global Education, former British Prime Minister Gordon Brown, has said November 10 has been declared Malala Day.

“This Saturday (November 10th) will see Malala Day, a global event to show the world that people of all creeds; all sexes, all backgrounds and all countries stand behind Malala,” Brown said.

“We are Malala – This is Malala day. The world to walk in the footsteps of this girl of courage. Malala Yousafzai has become a global icon of hope, an international symbol of courage, a schoolgirl who has won the hearts of millions through her bravery.

“Malala’s dream is a Pakistan where she, her friends and future generations of girls could attend school, walk freely into a classroom, learn and reach their full potential.”

The UN chief said citizens from across the globe are speaking out for Yousafzai and on behalf of the 61 million children who do not go to school.

“I am adding my voice to the messages from over one million people across the globe. Education is a fundamental human right. It is a pathway to development, tolerance and global citizenship,” Ban said in a brief video message posted on the UN website.

He called the international community to join the UN campaign to put education first “for Malala and girls and boys throughout the world”.

Events have been planned in over 100 countries, from the UK and USA to Mexico, India, Australia and Sierra Leone to mark the day.

In the UK where there is a host of local events, the most poignant event will take place in Lozells, Birmingham only a few miles away from Malala’s hospital.

Baroness Sayeeda Warsi, Britain’s Senior Minister of State at the Foreign Office and Minister for faith and communities, hailed Malala Yousufzai’s inspirational activism ahead of Malala Day today.

Baroness Warsi, said: “Through her inspirational activism Malala has bravely highlighted the need for education to be accessible to all children in Pakistan.

“Education is the single most important factor that can transform Pakistan’s future.”

Thousands of people from across the world have signed a global petition calling for her to be awarded the Nobel Peace Prize. Malala is recovering in a British hospital from gun shot wounds and has received messages of support for her cause from global leaders, including US President Barack Obama.

Pakistan ‘to pay cash to poor to send kids to school’


http://m.bbc.co.uk/news/world-asia-20278768 Today is International Malala Day.