Political and Socio-Economic Instability: does it have a Role in the HIV/AIDS Epidemic in Sub-Saharan Africa?

Many sub-Saharan African countries are confronted by the HIV/AIDS epidemic. This article reviews academic literature in the social sciences and health to discover why HIV/AIDS has become an epidemic in sub-Saharan Africa and not in other parts of the world. This was studied by examining the social determinants of diminishment of tradition and social cohesion in terms of political; social and economic problems. Four countries in this region were selected for this case study; namely South Africa; Botswana; Uganda and Zimbabwe. The findings showed that instability in socio-economic and political aspects in these nations was responsible for creating a suitable environment for the spread of HIV/AIDS infection. This paper concludes by using the theories of collective action/responsibility and social cohesion to hypothesise that the breakdown of social ties due to various kinds of conflicts and unrest is one of the main contributors to the HIV/AIDS epidemic

Grip and pinch strength in relation to function in denervated hands.

A study was conducted in the Schieffelin Leprosy Research and Training Centre, Karigiri, Tamil Nadu, from March to September 2000 to find out the relationship between grip and pinch strengths and basic activities of daily living (BADL) in leprosy patients. Sixty-two patients (mean age: 36.1 years) suffering from impairment of motor nerve function in one or both hands were included in the study. Grip strength and pinch strength, namely pulp-to-pulp pinch strength, lateral pinch strength, tripod pinch strength, were measured using a hydraulic hand dynamometer and a pinch gauge. BADL was assessed using Karigiri activities of daily living rating scale. Frequency table, mean, median, range, standard deviation, correlation and multiple regressions were used in analysis. The results showed that there was a highly significant correlation (p < 0.001) between the grip and pinch strength and BADL. Multiple regression analysis showed only tripod pinch strength had a significant, independent influence on the BADL. Other two pinch strengths and grip strength were not significant. These results suggest that there is a significant relationship between the grip and pinch strengths and BADL. The tripod pinch strength is the most important hand strength contributing to the problems in BADL. In a measure of association between impairment and disability, the results revealed that out of 62 patients with physical impairment of the hand, 59 (95.2%) had experienced disabilities. This indicated that, despite impairment, 4.8% do not have any disabilities.

Professional freedom of government leprosy personnel.

BACKGROUND. Government employment in India is known for its lack of flexibility. We studied whether this also involved professional freedom among health personnel working for the National Leprosy Eradication Programme. METHODS. The sample population consisted of National Leprosy Eradication Programme employees from Tamil Nadu and Andhra Pradesh and 8 health professional groups. A questionnaire was developed for each of them to elicit information on 5 aspects of their autonomy. They were studied individually and as homogeneous groups so that comparisons were possible both within and between groups in different regions who were conducting similar health programmes. RESULTS. National Leprosy Eradication Programme personnel enjoy a high degree of autonomy within the organization. This autonomy was evident in both states investigated, despite different administrations and it was not connected with the professional positions they held. Professional freedom correlated with the training activities, promotional prospects and commitment to the organization. CONCLUSIONS. The National Leprosy Eradication Programme job is not rigid because the organization is small and the intellectual needs of the professionals are met within it.

Impact of multidrug therapy on health personnel in their level of job satisfaction.

This study examines the "service" factors of the health professionals working in the National Leprosy Eradication Programme (NLEP) resulting from the introduction of multidrug therapy (MDT) technology, and their impact on their job satisfaction. The findings show that both among physicians and paramedicals, the significant chemotherapeutic dissatisfaction observed before the introduction of multidrug therapy has been replaced by a moderately positive satisfaction. This was much higher than the other incentives like pay, promotional prospect and job significance within NLEP and the community. It was also consistent over five years which was not the case with hydnocarpus and monotherapy technologies. Intercorrelation matrix test revealed three positive intercorrelations. First, personnel associated technology with personal progress which provided a sense of accomplishment while also satisfying their economic needs; second, they saw it as a mode of developing relationships with their clients; and third, it improved their self-image in the community. However, this satisfaction may not be static when there is a reduction of work load, or, the leprosy programme is integrated into general health services. Therefore, while planning these changes, care must be taken that the present level of technological satisfaction is maintained or further improved.

Foot soaks for callosities and fissures.

A study to assess the effect of soap soaks and plain water soaks on the dry anaesthetic sole of 15 leprosy patients bearing multiple fissures and callouses is reported. A callous scraper devised by us was found effective. It is recommended that a hypotonic keratolytic solution such as toilet soap or plain water be used for soaking which has the effect of softening the keratin. It may be better to use soap solution for this purpose.