Inadequate sex and relationships education (SRE) in schools is creating “a ticking sexual health time bomb”, councils are warning, amid concern over high numbers of sexually transmitted infections (STIs) among young people.
The Local Government Association (LGA), which represents 370 councils in England and Wales, has joined the growing clamour urging the government to make sex education compulsory in all secondary schools. Currently it is mandatory in local authority-maintained schools, but not in academies and free schools which make up 65% of secondaries.
Izzi Seccombe, chair of the LGA’s community wellbeing board, said it was a major health protection issue. “The lack of compulsory sex and relationship education in academies and free schools is storing up problems for later on in life, creating a ticking sexual health time bomb, as we are seeing in those who have recently left school.
“The shockingly high numbers of STI diagnoses in teenagers and young adults, particularly in the immediate post-school generation, is of huge concern to councils.
The LGA argues that it is a health protection issue, with 141,000 new STI diagnoses for 20- to 24-year-olds in England in 2015 and 78,000 for those aged 15-19. Sexual health is one of local government’s biggest areas of public health spending, with approximately £600m budgeted annually.
The LGA appeal came as the government was reported to be close to making an announcement regarding SRE and PSHE (personal, social, health and economic education), after the education secretary, Justine Greening, flagged up the issue as a priority for government.
Campaigners hope the announcement will be made during the next stage of the children and social work bill, which is passing through parliament. An amendment with cross-party support was tabled last week which, if carried, would would amount to the biggest overhaul in sex education in 17 years, but it is not yet clear what the government announcement will amount to, and crucially whether it will make SRE compulsory.
Izzi Seccombe, chair of the LGA’s community wellbeing board. Photograph: None
Seccombe said: “We believe that making sex and relationship education compulsory in all secondary schools, not just council-maintained ones, could make a real difference in reversing this trend, by preparing pupils for adulthood and enabling them to better take care of themselves and future partners.”
The LGA says while SRE should be made compulsory for secondary school children, with statutory guidance on key issues including sexual health, parents should still be given the option of taking their children from the lessons.
Tory MP Maria Miller was among those proposing the amendment to the bill last week. It followed an inquiry by the women and equalities committee, chaired by Miller, which heard that most children have seen online pornography by the time they leave primary school and two thirds will have been asked for a sexual digital image of themselves before they leave secondary school.
According to Miller, research has shown that just one in four children at secondary school receives any teaching on sex and relationship issues, and Ofsted has said that when it is taught the quality of teaching is often poor.
“Different interest groups cannot agree on a way forward that suits them and in the meantime we are letting down a generation of children who are not being taught how to keep themselves safe in an online, digital world,” said Miller.
“We are not teaching them that pornography isn’t representative of a typical relationship, that sexting images are illegal and could be distributed to child abuse websites and how to be aware of the signs of grooming for sexual exploitation.
“Overwhelmingly parents and children are fed up and want change. They want compulsory lessons in school to teach children and young people about consent and healthy relationships.”
What greater indictment of a system could there be than an epidemic of mental illness? Yet plagues of anxiety, stress, depression, social phobia, eating disorders, self-harm and loneliness now strike people down all over the world. The latest, catastrophic figures for children’s mental health in England reflect a global crisis.
There are plenty of secondary reasons for this distress, but it seems to me that the underlying cause is everywhere the same: human beings, the ultrasocial mammals, whose brains are wired to respond to other people, are being peeled apart. Economic and technological change play a major role, but so does ideology. Though our wellbeing is inextricably linked to the lives of others, everywhere we are told that we will prosper through competitive self-interest and extreme individualism.
In Britain, men who have spent their entire lives in quadrangles – at school, at college, at the bar, in parliament – instruct us to stand on our own two feet. The education system becomes more brutally competitive by the year. Employment is a fight to the near-death with a multitude of other desperate people chasing ever fewer jobs. The modern overseers of the poor ascribe individual blame to economic circumstance. Endless competitions on television feed impossible aspirations as real opportunities contract.
Consumerism fills the social void. But far from curing the disease of isolation, it intensifies social comparison to the point at which, having consumed all else, we start to prey upon ourselves. Social media brings us together and drives us apart, allowing us precisely to quantify our social standing, and to see that other people have more friends and followers than we do.
As Rhiannon Lucy Cosslett has brilliantly documented, girls and young women routinely alter the photos they post to make themselves look smoother and slimmer. Some phones, using their “beauty” settings, do it for you without asking; now you can become your own thinspiration. Welcome to the post-Hobbesian dystopia: a war of everyone against themselves.
Social media brings us together and drives us apart, allowing us precisely to quantify our social standing
Is it any wonder, in these lonely inner worlds, in which touching has been replaced by retouching, that young women are drowning in mental distress? A recent survey in England suggests that one in four women between 16 and 24 have harmed themselves, and one in eight now suffer from post-traumatic stress disorder. Anxiety, depression, phobias or obsessive compulsive disorder affect 26% of women in this age group. This is what a public health crisis looks like.
If social rupture is not treated as seriously as broken limbs, it is because we cannot see it. But neuroscientists can. A series of fascinating papers suggest that social pain and physical pain are processed by the same neural circuits. This might explain why, in many languages, it is hard to describe the impact of breaking social bonds without the words we use to denote physical pain and injury. In both humans and other social mammals, social contact reduces physical pain. This is why we hug our children when they hurt themselves: affection is a powerful analgesic. Opioids relieve both physical agony and the distress of separation. Perhaps this explains the link between social isolation and drug addiction.
Experiments summarised in the journal Physiology & Behaviour last month suggest that, given a choice of physical pain or isolation, social mammals will choose the former. Capuchin monkeys starved of both food and contact for 22 hours will rejoin their companions before eating. Children who experience emotional neglect, according to some findings, suffer worse mental health consequences than children suffering both emotional neglect and physical abuse: hideous as it is, violence involves attention and contact. Self-harm is often used as an attempt to alleviate distress: another indication that physical pain is not as bad as emotional pain. As the prison system knows only too well, one of the most effective forms of torture is solitary confinement.
It is not hard to see what the evolutionary reasons for social pain might be. Survival among social mammals is greatly enhanced when they are strongly bonded with the rest of the pack. It is the isolated and marginalised animals that are most likely to be picked off by predators, or to starve. Just as physical pain protects us from physical injury, emotional pain protects us from social injury. It drives us to reconnect. But many people find this almost impossible.
It’s unsurprising that social isolation is strongly associated with depression, suicide, anxiety, insomnia, fear and the perception of threat. It’s more surprising to discover the range of physical illnesses it causes or exacerbates. Dementia, high blood pressure, heart disease, strokes, lowered resistance to viruses, even accidents are more common among chronically lonely people. Loneliness has a comparable impact on physical health to smoking 15 cigarettes a day: it appears to raise the risk of early death by 26%. This is partly because it enhances production of the stress hormone cortisol, which suppresses the immune system.
Studies in both animals and humans suggest a reason for comfort eating: isolation reduces impulse control, leading to obesity. As those at the bottom of the socioeconomic ladder are the most likely to suffer from loneliness, might this provide one of the explanations for the strong link between low economic status and obesity?
Anyone can see that something far more important than most of the issues we fret about has gone wrong. So why are we engaging in this world-eating, self-consuming frenzy of environmental destruction and social dislocation, if all it produces is unbearable pain? Should this question not burn the lips of everyone in public life?
There are some wonderful charities doing what they can to fight this tide, some of which I am going to be working with as part of my loneliness project. But for every person they reach, several others are swept past.
This does not require a policy response. It requires something much bigger: the reappraisal of an entire worldview. Of all the fantasies human beings entertain, the idea that we can go it alone is the most absurd and perhaps the most dangerous. We stand together or we fall apart.
Scientists have edged closer to an effective Zika virus vaccine after demonstrating that three different formulations can protect monkeys from the disease.
The results suggest that the virus can be repelled by even low levels of immunity and have boosted confidence that a viable vaccine for humans is on the horizon.
Tests on 16 animals found that all three experimental vaccines offered complete protection against Zika infection one month later, though how long the protection could last for remains an urgent question for longer-term trials.
“We don’t want to overstate it, but we hope for protection that is long-lasting,” said Dan Barouch, who co-led the studies at Beth Israel Deaconess Medical Center in Boston. “Ideally we’d have protection induced by a single shot vaccine or a two shot vaccine and for that to last for years.”
When vaccinated, the animals churned out antibodies that were more than sufficient to overwhelm the virus.
The Zika virus has swept through Latin America and left behind a trail of birth defects, such as microcephaly, which causes children to be born with small heads. This week, Florida reported the first US cases of local transmission of Zika virus. All previous cases were in people who had travelled to affected regions.
Of the three vaccines tested by Barouch and others, the most conventional and ready for development is a whole, killed Zika virus, which is being pursued by the Walter Reed Army Institute of Research in Maryland.
The other two vaccines are more novel. In one, a single and harmless Zika virus gene is stitched into a loop of DNA. When injected into the body, cells take up the DNA loop and from it produce Zika proteins that trigger an immune response against them.
The third and final vaccine adds the Zika virus gene to a harmless adenovirus. This behaves like a Trojan horse and smuggles the DNA into cells, which then produce antibodies to wipe out the whole virus.
No DNA or adenovirus vaccines have been approved for use in humans before, but clinical trials are underway. The vaccine based on the whole, killed virus will go into human trials this autumn.
Barouch said the findings increase optimism that a safe and effective human vaccine against Zika virus might be successful. “Our data encourage the development of these vaccines in clinical trials as quickly as possible,” he said. Details are reported in the journal Science.
Gavin Screaton, an immunologist at Imperial College London, said the results were “positive early steps”, but whether the vaccines will work in humans and offer long term protection against Zika must still be determined. “A human response will need to last years to be useful,” he said.
Despite the encouraging progress, the path to a viable vaccine in humans may not be straightforward. Recent work by Screaton’s group found that previous exposure to dengue virus could potentially make Zika infections more serious. If the opposite holds too, as some researchers suspect, a vaccine that floods the body with antibodies against Zika virus could make common dengue infections life-threatening.
The problem arises because Zika and dengue, which both belong to a group called flaviviruses, are so similar at the genetic level. This can confuse the immune system. Should a person catch dengue and later catch Zika virus, their body may attempt to fight off Zika with “old” antibodies raised against dengue. Rather than overwhelming the Zika virus, the antibodies might simply draw them into cells and cause the infection to take hold more quickly. Known as cross-reactivity, this raises a second potential hurdle: a person who has fought off dengue or similar flavivirus infections may have antibodies that destroy the Zika vaccine before it has had time to work.
Another issue scientists face comes from the natural immunity people will acquire to Zika as the infection spreads through the population. When people are already immune to a virus, it can be very hard to tell whether a vaccine on trial is helping to protect them.
“Whilst these vaccine studies are promising there are some really important questions that need to be addressed,” said Jonathan Ball, professor of molecular virology at the University of Nottingham.
Does your workplace stress you out? With assist from Jenny Foss, a recruiter, author, occupation coach and founder of JobJenny.com, Sherry Burton Methods, an interior designer, color therapist, and author of Come to feel Great Spaces: A Manual to Decorating Your House for Entire body, Thoughts And Spirit, and Susan Kousek, a Certified Professional Organizer (CPO), I discovered 9 methods to produce a anxiety-free of charge function setting.
A top US biological-warfare unit is creating a remedy for the deadly Ebola virus and could have it in the field within two many years.
The virus, which has killed a lot more than 800 men and women in West Africa as of 4 August, is a “Category A Bioterrorism Agent” along with anthrax, botulism, bubonic plague and smallpox, in accordance to the US Centers for Condition Management.
Coming up with countermeasures for Ebola and its closest relative, the Marburg virus, “is a best biodefense priority for the United States,” stated Colonel Erin Edgar, the commanding officer of the Fort Detrick, Maryland, bio-war unit.
The US Army Health care Investigation Institute of Infectious Ailments is one particular of only a handful of labs around the world outfitted to deal safely with such killer conditions.
Healthcare employees throughout the Ebola crisis in Guinea (Credit: EU Humanitarian Support and Civil Protection)
Scientists have to wear pressurised, spacesuit-like protective gear and breathe filtered air when doing work with the bug.
The new drug, BCX4430, works by blocking the reproduction of the virus inside contaminated cells.
Chemically, it is related to adenosine, one of the 4 letters of the genetic code.
But when the virus tries to develop new copies of itself using BCX4430 as an alternative of adenosine, the process comes to a grinding halt.
Crucially, the contaminated cells can inform the variation among the two molecules and ignore the drug.
Bio-warfare unit USAMRIID at Fort Detrick, MD (Credit: Wikipedia)
Scientists contact BCX4430 a “nuke”, short for “nucleocide”, a class of drugs that also involves remedies for HIV.
It has been examined on mice, curing far more than 90 per cent of them in trials reported in the respected scientific journal Nature earlier this year.
The drug was also examined on crab-consuming macaque monkeys towards Marburg with a comparable accomplishment charge.
The two viruses cause haemorrhagic fever, which normally kills up to 90 per cent of individuals, says the Planet Wellness Organisation.
The scientists doing work on BCX4430 are optimistic that the drug will show successful towards Ebola in humans due to the fact it is a “wide spectrum” agent, with evidence that it could also operate against SARS and Yellow Fever.
A lot more physician pay is getting tied to patient satisfaction metrics, an additional indicator health care may possibly be coming far more client-friendly, according to a new national analysis of doctor compensation.
Currently, doctors and hospitals more and more have far more of their spend tied to health outcomes and related clinical measures as medical care moves towards value-primarily based compensation rather than fees for support.
But momentum is slowly constructing for physicians to also be measured on how speedily telephone calls are returned to how lengthy a patient sits in a physician office waiting spot as part of “patient satisfaction metrics” insurers are doing work into contracts with medical-care suppliers.
The Health care Group Management Association’s yearly compensation examination, unveiled final week, displays two.31 percent of specialists’ physician shell out was tied to patient satisfaction in 2013 compared to one.61 percent in 2012. Meanwhile, major care compensation tied to patient fulfillment experienced a “slight increase” from 2012 when it accounted for much more than two % of spend.
Although nonetheless quite modest percentages, doctors and people who run their practices are paying near interest to patient fulfillment, particularly provided the momentum clinical outcomes and worth-based mostly care has taken on in overall health care.
“Physicians have previously been patient-centered but the other scenario is a organization scenario . . . a buyer service scenario,” says Todd Evenson, vice president of consulting services and data solutions at MGMA, which looked at more than 66,000 healthcare care companies as component of its evaluation. “(Physicians) could be measured on how effectively the sufferers perceive the service they acquire.”
For instance, physicians could be measured on whether they have after-hours office hrs or regardless of whether patients recognize their expenses or can even pay out on the internet, Evenson said.
It is not just physicians.
More and more, firms and wellness insurance coverage firms are pushing for a lot more patient fulfillment metrics, adopting the “triple aim” framework designed by the Institute for Healthcare Improvement. The triple aim methodology operates to improve a patient’s knowledge and health care care by way of good quality and fulfillment, enhance the well being of populations, and reduce the per capita expense of wellness care.
Underneath the Medicare health insurance plan for the elderly, the star-rating method for privately-run “Advantage” programs that contract with the government to supply benefits to seniors incorporate particular top quality measures a lot of see as much more about consumer satisfaction than clinical.
Far more than half of seniors enrolled in so-referred to as Medicare Advantage strategies are now enrolled in programs with ratings of four stars or more on a five-star scale, a ranking method developed beneath the Cost-effective Care Act to guidebook seniors to expense-effective and larger quality advantages.
Strategies – offered by the likes of Aetna Aetna (AET), UnitedHealth Group UnitedHealth Group (UNH), Humana Humana (HUM) and Cigna (CI) – are rated on such measures like cutting phone waiting instances as properly as how well they encourage preventive care this kind of as getting typical blood exams for diabetes.
A rating of four is regarded over common and a rating of five is outstanding and the highest rankings give well being plans a bonus payment and the capability of the insurers to tout their improvement.
The whole well being care industry sees patient fulfillment only becoming a lot more important and physicians will be a portion of that.
“We realize the place the industry is moving,” Evenson mentioned. “Reimbursement designs are not going to be a single-size fits all. “We know it is crucial.”
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Youngsters inquire, occasionally, but I don’t consider an adult ever has. What do you see with that eye – the undesirable a single? I say: nicely, you know when you go into a very dark space and shut the door and close your eyes? That. Which is what I see.
There’s absolutely nothing there, just a vaguely electrical disturbance, a dim blank of black and dark red. If I cover my proper eye, the eye that still operates, and flip the other one in direction of a candle flame or fireworks, practically nothing registers. No light, no movement. The eye itself is perfectly healthy, but the pupil won’t expand or contract simply because the optic nerve has atrophied. No information gets through.
This is the hole in my vision. It is a hole I frequently fall into: bumping into folks, doors, shopping trolleys, lamp-posts tripping more than uneven paving stones, kerbs and children’s scooters sending glasses of water flying. Strangers should believe I am clumsy and absent-minded and irritatingly hesitant. I have been given a white stick but I can’t bear to use it, although there are occasions – on unfamiliar streets following dark, or on station concourses for the duration of rush hour – when it would possibly help, if not as a tool then as a signal.
I wasn’t meant to lose the sight in that eye but it took place, and now the good eye takes the hit. A whole lot of peripheral vision has gone colors and lights are not as sharp and clear as they utilised to be (though I’m now spared the horror of comparison). I struggle with pale fonts, best-by dates. But it’s fine. I can get about. I can study with out also a lot difficulty. I would be delighted if I knew my sight would keep like this, but which is not the way it appears to perform. You see exactly where I’m going with this.
Worry can be as disabling as loss of vision. For the initial year, I ran on pure unadulterated horror. Each and every morning right after waking I would lie there for a minute, unwilling to open my eyes, unwilling to confront what was constantly fading away (the lettering on Mother’s Day cards, the data ticker-taping more than the panel on the digital radio), and I would truly feel it once more, fresh and appalling, as the day’s adrenaline began to barrel via my veins. This is my lifestyle. This is actually taking place.
I initial realised something was affecting my vision in April 2008. It has been all downhill from there: the substantial everyday dose of steroids (we have tried a great number of other treatment options without a lot luck) seems to be no match for the total force of whatever-it-is, the issue that has taken up residence and bides its time, waiting to consume up the light. My physician, a distinguished expert, is pretty confident I have an autoimmune disorder affecting the optic nerves (continual relapsing inflammatory optic neuritis) but he cannot tell me why it started, how to cease it, or why – regardless of the steroids – it keeps flaring up so destructively. I have come to enjoy his honesty. No false hope. Hope tends to make you so vulnerable.
The 1 thing he’s confident of is that my situation is extremely uncommon. It really is a lonely enterprise, being a health care freak. I sit on the ward listening to individuals with terrible circumstances assess notes, and on the undesirable days I truly feel a small envy: you’ve identified each other, you know what you have got. You believe the therapy you are getting has a good possibility of operating.
At first it felt like a series of bereavements. I was shedding the future I had so idiotically imagined I was entitled to, but there have been other losses as effectively, and at first they came thick and rapidly. A lower complete moon that a relapse rendered dingy as a penny. Blossom that I knew to be the colour of raspberry ripple became a dull beige. I stopped looking up when individuals said, “Oh, wow, the stars!”
But that sucker-punch of shock every time I believed about what was occurring to me, that trapdoor into terror: I am pleased to find that is unsustainable. You cannot dwell at that pitch for ever. Slowly you come to terms with a new actuality. You find out to accommodate it it turns into standard. And this feels like a reprieve. You are getting spared anything, and that in itself is really worth celebrating. Of course, each relapse revives the worry but probably, even as your world narrows and darkens, you’re pondering: this is acquainted, I’ve been here ahead of.
I try out extremely challenging not to anticipate. When I had a sense of autonomy I invested a lot of time worrying about the future, in a occupied and superstitious style, as if by anticipating the pratfalls I may be spared them. That habit caught even when I was coming to terms with my powerlessness, and it did me no favours. I believed about the long term and what it may possibly hold, and I did not see anything at all great lying up ahead. Just a sense of the blackness greedily closing in, attacking all the factors I held valuable. As I was spending so a lot time in hospital, my perform as a journalist was the very first to go but that, I knew, was just the starting.
I felt myself becoming diminished in increments. The National Hospital for Neurology and Neurosurgery is exactly where I want to be when factors go incorrect. Other institutions inevitably remind you of your insignificance. Foods is awful, notes go missing. A brisk supercilious GP pretends she knows much more than she genuinely does. Medical doctors go over your case (“this could be very serious”) on the other side of a curtain. A nurse at a single of London’s major teaching hospitals, a good man with whom you’ve had a number of exciting conversations, can make you sit in a wheelchair and then drags – as opposed to pushes – it along the corridors, as if you are cargo, barely even a individual.
Confronting my uselessness, my new dependency, I discovered an additional way to be totally free. In my previous lifestyle, I had never actually regarded as fiction, and even when I found myself creating a novel in 2010 I could hardly bear to acknowledge what I was performing. Sitting around, generating things up? How silly, how shameful. Who did I think I was? But it felt so excellent to be creating again. The delight of generating an environment, summoning up character, and of finding exactly the correct word: the issues I’d loved most about my previous task. But this time, I was also allowed to choose what should occur and to whom. I did not want to quit.
I kept it a secret. At very first I concerned I wouldn’t finish the guide and then, when I had completed it, I anxious that no a single would be interested in it. I’d witnessed people’s expressions modify as they saw me method, as they steeled themselves to inquire how I was, and I didn’t want to give them an additional cause to really feel sorry for me. But that book (Alys, Usually) identified a publisher, and went out into the globe, and then I wrote yet another a single (Her).
Possibly this is what I have carried out with the dread: perhaps I have collected it up, a wonderful dark tangle of dread, and worked it into my books. Each novels look to be powered by a minimal-level anxiety, an underlying sense that something’s not quite appropriate, and making this atmosphere beneath laboratory situations feels fully proper and delightful. Economical, also: very good housekeeping. I’m up to my ears in the stuff, why not place it to some use? My story, my guidelines.
This, then, is exactly where I have all the energy.
At times I wonder if I have a ration of sight left, like sand in an hourglass, and 1 day it will dwindle to a trickle, and then it will just run out. There’s absolutely nothing like living at the pointy finish of a stick to make you emphasis. Whenever my sight suffers a setback, I seem to be flooded with suggestions. There seems to be a direct correlation. I sit on plastic chairs in windowless corridors, waiting to be called for tests and consultations, and even though I wait I scribble in my orange notebook. It is escapism, of course, a way of dodging reality, and in some ways it feels a foolish and frivolous issue to be undertaking but at the identical time, it is needed. It truly is the thing that offers me goal and tends to make me satisfied a great point to do with the time and sight I have left.
On the corner of a bumpy, red-soil road in the rural town of Iganga in eastern Uganda, there lies a small store. A handful of people mill around the entrance in the glaring sun, waiting for their turn to enter. They are the main source of activity on this placid street, but their patient presence barely betrays the hubbub within.
Inside, almost a dozen people sit crammed on makeshift benches around two edges of the stifling room. Most of the remaining space is taken up by a shop counter, behind which are shelves piled high with vibrantly coloured health products covered in Chinese characters.
A couple of customers compete with a baby wailing as they read out lists of products to the shop attendants who pick them off the shelves. Every now and then, the door in the corner opens. Someone steps out, and the person sitting closest steps in.
Beyond that doorway is an even smaller room, windowless and illuminated by a single light. As I peer in, three people are undergoing diagnostic tests; a woman is standing on a machine that hums loudly as it vibrates, and a few more patients are waiting slumped along the wall.
Wasswa Zziwa Edrisa − or “Doctor Wasswa” as he is known here − stands in the centre wearing a fresh, chequered shirt on his back and an unwavering grin on his face.
“I will show you how we help so many people,” he says, beaming. “Let me show you the machines.”
‘Organ scanners’
“This is one of the scanners,” he explains, pointing to a piece of kit that looks a bit like a 1970s radio. “It shows everything. We can see if you have diabetes, kidney deficiencies, liver problems, eye problems. Everything.”
Wasswa explains that the test works using a traditional Chinese understanding of the body whereby different points of the hand relate to different internal organs. We watch as an attendant prods a patient’s left palm with a metal tip, making a little meter light up. When the light goes green, he explains, it means that part of the body is fine, but if it goes orange it indicates a problem.
Next, Wasswa points me to the corner where a woman is standing on a small machine and holding onto a pair of handlebars, to which she is harnessed. Her whole body blurs in the dim light as the platform beneath her vibrates rapidly, its droning buzz filling the room.
Similar machines can be found in many gyms these days and are meant to help tone muscle, but the uses Wasswa presents are quite different.
“This is a blood circulation massager,” he announces. “You see how she sweats. It opens the vessels and deals with paralysis. It helps people with stroke.”
A woman stands on a machine Wasswa claims ‘deals with paralysis’. Photograph: James Wan
Wasswa then shows me another diagnostics machine, this one connected to a laptop. As the patient holds on to an appliance plugged into the computer, pictures of different organs flash up on the screen for a few seconds each as a dial next to it oscillates erratically. After a minute, a one-page document pops up, detailing how well his organs are functioning.
In the airless room, Wasswa runs through a few more devices − a face pain remover, a blood pressure reducer, a necklace that removes radiation − before squeezing past bodies and chairs to get back to the first patient we met. By now his diagnostic test is complete. The patient tells me that he came to the store because of some mild pain around his mouth. Wasswa breaks the news that there are more serious things about which he ought to be concerned.
“He has a problem with his spleen,” says Wasswa. “At times, he gets constipation and some swelling in the legs and arms. There is also some paralysis in the legs. He gets headaches. At times he feels dizziness. His brain arteries need to be detoxified. He has kidney deficiencies. He has bad chest pain. He has high cholesterol. He has poor circulation. And he has problems with his stomach.”
The man looks young and healthy. Wasswa is not perturbed.
“He needs to improve his circulation by using our machines and he will need to take our products. If he uses them, he will be fine,” he says.
‘Radiation cure’
Back in the waiting-room-cum-pharmacy, Wasswa shows me some of these products. He picks goods off the shelves – capsules, toothpastes, body creams – and stacks them on the counter as he explains what they do.
“This takes away all the radiation in your body. This helps with diabetes. This treats ulcers. This is for slimming. This adds more white blood cells to your system. This is for people who are mentally disturbed,” he says.
“These medicines are good for everything,” he concludes finally, the pile of products on the counter now complete. “If you have cancer, we can help. If you have HIV, we can help. Even if you have a hernia or a tumour or appendicitis, you just take our products and they will disappear.”
Even if you have a hernia or a tumour or appendicitis, you just take our products and they will disappear
This small store in eastern Uganda employs a handful of staff and, according to Wasswa, receives dozens of people each day. Wasswa is also frequently heard on local radio advertising his services and has made quite a name for himself in the area.
Wasswa was previously a school teacher and says his parents were “peasants”, but now, in his 30s, he is anything but. These days, he drives a shiny four-wheel drive, wears sharp suits and travels around the world. All this makes him quite the exception in Iganga, but across Uganda this young man is by no means a solo pioneer and his store is by no means unique.
Similar stores can found all across the country, from Kasese in the west to Soroti in the east, and from Gulu in the north to Entebbe in the south. There are four outlets in the capital Kampala. All the stores offer the same diagnostic tests, stock the same range of products, and above their doors, there hangs the same innocuous green and orange sign which reads: “Tiens: Together We Share Health And Wealth.”
Tiens − also known as Tianshi − is a multinational company based 10,000 miles away in the Chinese metropolis of Tianjin. It was founded in 1995 by Li Jinyuan, who has since become a billionaire from the venture. The company has established branches in 110 countries, including 16 in Africa, employs over 10,000 staff globally, and reportedly enjoys net profits worth hundreds of millions of dollars each year.
Tiens in Uganda
Tiens first began tapping into the Ugandan market in 2003 and it has grown steadily ever since. There are now around 30 stores across the country. Its distributors regularly engage in outreach programmes to rural communities, and according to the company’s national chairperson, Kibuuka Mazinga Ambrose, Tiens-Uganda has an annual turnover of around $ 6m.
The company has even bought the most prominent advertising spot on the Health Ministry’s official calendar, despite no Tiens outlet being explicitly registered as a health facility.
People who come to the stores seek help for a whole range of conditions, but they tend to tell similar stories of how they arrived. Typically, they say that they first went to public health facilities (some told me they had even visited two or three), but were either not seen or found the treatment ineffective. Tiens is almost always a last resort. But in a country whose healthcare infrastructure is struggling and which, by some measures, ranks as one of the worst in the world, the last resort is often one that needs to be taken.
In many areas of Uganda public health facilities are virtually inaccessible, and those who do manage to reach them may find their walls crumbling, clinics under-staffed, and shelves empty of drugs. Although the government has promised to invest more in healthcare, much of the infrastructure is in decay. Doctors and nurses are over-worked and underpaid, and although services are meant to be free, in reality patients face many hidden costs.
In this context, stores such as Wasswa’s − with its quick turnaround, attentive staff and fully-stocked shelves − offer an appealing alternative. The conclusive diagnostic tests are highly convenient; attendants’ claims about the healing powers of Tiens products may well be reassuring; many patients say the fact the medicines travelled thousands of miles from China suggest they must work.
Satisfied customers
On the Friday morning after my tour of Wasswa’s clinic, the courtyard next to the outlet is packed. More than 100 people sit on plastic chairs facing forwards while latecomers lean against the back wall. A red tarpaulin sheet shields the crammed attendees from the sun and gives the whole atmosphere an eerie pink hue.
“Doctor Julius” stands at the front. He has just finished explaining the healing powers of Tiens toothpaste. As well as cleaning teeth, he says, it can be used to treat ulcers, skin problems and even angina, among many other conditions. He invites attendees who have used the product to give testimony. Four hands go up immediately.
“I had terrible problems with my teeth,” says the first speaker. “I went to see doctors but a new tooth had to be uprooted every week. When I started to use Tiens toothpaste, the pain went away.”
The next person tells a similar story. Two mothers relay how the toothpaste cleared up their respective children’s skin rashes and burns.
Every now and then over the next few hours, many more attendees are invited to recount their experiences of using Tien products. We hear how a man with back pain can now walk, how another man was cured of vertigo, and how a woman’s child was once bed-ridden but is now running around. At one point, Wasswa looks particularly pleased as a mother tells of how her young son − who she had taken to three public healthcare facilities before he was cured of cerebral malaria by Tiens − now wants to change his name to Doctor Wasswa.
At hospitals, they will ask you how you feel, but here, we tell you how you feel
“You see, these products work,” Wasswa announces after one of the testimonies. “At hospitals, they will ask you how you feel, but here, we tell you how you feel. At hospitals, they treat signs and symptoms. Here, we treat causes. At hospitals, they give you medicines made from chemicals which are harmful and can give you ulcers. Here, we use herbal medicines which have no side-effects.”
“This is real,” he continues. “This is Chinese herbal medicine based on 5,000 years of traditional medicine and it works.”
Personal experience
In Kampala, I test this out for myself. I visit a couple of the company’s stores, nestled in the city centre’s endless bustling plazas, and in one of them, managed by a man named Frank, I get tested.
Frank, the self-declared “best in the business” at doing diagnostic tests, seems thrilled at my presence and bundles me across to the end of the room. He sits me down and pulls across a thin curtain to give us a modicum of privacy from the handful of waiting patients. He takes out a battered looking hand-held device, pushes a 9-volt battery into its back, and plugs a wire into it that branches into two metal tips. He gives me one of the electrified points to hold in my right hand and says he will use the other to press points on my left palm. With a grave look on his face, Frank instructs me to tell him when I feel a tingling. This seems to be a more basic version of the first test I’d seen in Iganga.
To begin with, I report whenever I feel something, which is every single time the tip touches my hand, completing the basic electric circuit. Frank nods excitedly when I do so and explains that I have a serious problem in whichever part of my body he is testing. After a while, however, I decide to stop reporting every time I feel a tingling. Frank lets me get away with one, but after that he frowns when I stay silent and simply keeps the metal point on my hand until I give in, sometimes rubbing my hand and even licking the metal tip if I am being particularly resistant.
In the end, Frank writes out a list of around 25 health conditions including “liver disorder”, “STROKE”, and “enteric fever [severe typhoid]“, and prescribes a list of products that comes to over USH 1 million ($ 400).
I get tested. Frank writes out a list of around 25 health conditions including ‘liver disorder’, ‘STROKE’, and ‘enteric fever’, and prescribes a list of products that comes to over USH 1 million ($ 400)
Before committing to his costly regimen, I decide to get a second opinion.
In the bright, clean reception of Beijing Clinic, a private health facility in Kampala, I relate my experience to a young Ugandan doctor, who trained and qualified in China, specialising in traditional Chinese medicine. The doctor, who prefers not to be named, laughs as I explain the machines I saw in Iganga and the test I underwent in Kampala. “No machine can test all those things like they claim,” he says.
Next, I show him the Tiens Information Guide, a booklet from which it seems Julius and Wasswa get much of their information. On page three of the booklet, a short disclaimer warns: “Tianshi Company does not make any medical claims whatsoever.” However, the next 60 pages are filled with bold declarations about the powers of its products and instructions on how to treat different diseases.
The Chinese-trained doctor says this is not Chinese medicine as he knows it. He chuckles as he reads how Tiens medicines are supposed to treat about a dozen different conditions each, from preventing cancer to reversing impotence to promoting “the growth of children’s reproductive organs”.
But the doctor’s amusement turns to horror as he reaches the section of the booklet advising distributors on what steps to take when patients are suffering from different diseases.
If patients have already been given a diagnosis, the company guide offers clear and easy instructions on what they should be prescribed. Of the few hundred conditions listed − which span from Aids to Yellow Fever − a handful include the recommendation to “see a doctor”. But the rest just list a few products to be taken.
One of the most repeated claims is that because the products are herbal they have no side-effects. This is used to show their superiority to western medicines, which they say are made from chemicals and so can be harmful, but the claim is also used to suggest that there are no dangers involved in taking them.
“Even if I tell you to swallow one and you swallow four, there will be no problems,” Wasswa had insisted. But when put to the Chinese-trained doctor in Beijing Clinic, he just shakes his head.
At another private clinic in Kampala, Dr Wen, a highly experienced practitioner, is similarly concerned. “This is not medicine,” he says, “but it is still dangerous. Everything has side-effects. Even herbal medicines and herbal supplements used wrongly can kill.”
I contacted Uganda’s health minister, Ruhakana Rugunda, repeatedly for comment, but received no reply.
Supplements
Tiens products are not registered medicines. Some of the company’s goods have been registered with Uganda’s National Drugs Authority as food and dietary supplements.
Stories about the products not fully working are common, even among fans.
Back in Iganga, with the courtyard seminar over and Wasswa busy talking to a small circle of attendees eager to hear more, Sarah*, 25, moves towards the back of the courtyard closer to where I am sitting.
During the seminar, she had given testimony telling of how she’d taken her baby boy, who was suffering from sickle cell anaemia, to several hospitals before she came to Tiens. Many of those who told their stories directed them matter-of-factly at Julius or Wasswa, but Sarah had turned to face the crowd and spoken passionately as she’d explained how the products worked wonders.
The Tiens seminar. Photograph: James Wan
Asked a few more questions after the symposium, however, her story reveals itself to be far less straightforward. Her son is still ill. So ill, in fact, that she recently quit her nursing job to look after him full-time.
Sarah nevertheless insists that the Tiens medicines work and says the reason her son is still suffering is because his treatment is incomplete. She bought half the products the boy needs for a full recovery but is struggling to find the money to purchase the rest.
Sarah and Robert reveal that they have each spent USH 460,000 ($ 180) on products so far, paying in instalments from what they could borrow or scrape together
Robert, 30, tells a similar tale. He too claims to be a firm believer in the healing powers of Tiens, and acted as my translator throughout the seminar, seemingly on Wasswa’s instruction. Robert says he came to Tiens with kidney problems and maintains the products worked where hospital treatments failed. However, he admits that he is still in pain.
Firstly, he attributes this to the fact that his kidney treatment is incomplete; he too has had financial difficulties. Secondly, he explains that the Tiens diagnostic test revealed his kidneys are not his only problem; while his original condition may have improved, he now knows he is suffering from other conditions that need to be cured too.
Sarah and Robert reveal that they have each spent USH 460,000 ($ 180) on products so far, paying in instalments from what they could borrow or scrape together. Sarah says she needs USH 500,000 ($ 200) more to complete her son’s treatment, but doesn’t know where the money will come from given that she is now jobless and that the father of her son is in school. Robert says he needs around USH 200,000 ($ 80) more, but says that as a “peasant”, he too will struggle.
“I haven’t balanced it well,” he says, “but I hope it will balance out soon. I am still feeling pain.”
It is not a coincidence that Robert, Sarah and a few others who spoke to me had all purchased exactly USH 460,000 worth of products. Nor is it an inexplicable peculiarity that people with no reliable source of income had shelled out what little they had, and more, on Tiens products. After all, Tiens is more than just a supplier of health supplements.
Pyramid scheme
In the symposium in Iganga, once Julius had waxed lyrical about various products, it was time for Wasswa to take over the stage to talk about another benefit of Tiens. Though not before Julius had the opportunity to rouse the crowd.
After finishing his demonstration of Tiens’ disease-curing sanitary pads, Julius put down the product and strolled along the front of the courtyard before turning to face the audience. “Tianshi!” he shouted suddenly. “Together we share!” came back the reply on cue, a hundred voices amplified by the concrete walls. “Tianshi!” Julius proclaimed a second time, a little louder. “One dream!” came the soaring response. “Tianshi!” yelled the doctor a third time. “The best of all!!” bellowed the crowd.
Next, Julius taught the audience a new trick. Since all points in ours palms relate to different internal organs, he explained, clapping stimulates the whole body and works as a kind of “first aid”. He held his hands apart and, together with the crowd, clapped out a rhythm that crackled across the courtyard. Julius explained that the louder you clap, the greater the benefits to your internal organs, before holding out his hands and going again. And again.
Finally, looking satisfied, Julius completed his session and handed over to Wasswa.
“Tiens is not just good for your health,” the salesman proclaimed, taking to the stage, “it is also good for your wealth. If you register with Tiens, they will start to pay you. You come here for treatment, but over time, you will start to get a salary.”
Tiens is not just good for your health,” the salesman proclaimed, taking to the stage, “it is also good for your wealth”
Over the next few minutes, Wasswa explained that this is what he had done and that he was not only receiving thousands of dollars every month now, but had been taken on international trips by the company, received huge cash bonuses and been given a brand new car.
“When you reach a certain level, you start earning,” he said. “And it does not matter if you have no qualifications or education. Tiens does not care if you are educated. Tiens only cares how many products you buy and how many people you recruit.”
Wasswa said these words with a weighty earnestness, but they were not news to half the courtyard. Robert, Sarah and many others around them − all recognisable by the golden lion-shaped badges they were wearing − were not just Tiens patients, but members and distributors already. They were here on Wasswa’s instructions to give testimony and help convince others to join too. For these returning members, Tiens is not just a medical supplier, but a livelihood, an investment, and a chance to follow in Wasswa’s jet-setting footsteps.
When you reach a certain level, you start earning. And it does not matter if you have no qualifications or education. Tiens does not care if you are educated. Tiens only cares how many products you buy and how many people you recruit
Joining fee
Sitting behind his desk at the Tiens-Uganda headquarters, located at the top of King Fahd Plaza on a busy street in Kampala, Kibuuka Mazinga Ambrose is delighted to explain how the business model works in more detail.
“Anyone can join,” says the company chairperson, wearing a bright yellow Tiens-branded cap. “All you need to do is pay a small initial fee of $ 20.” Once you have done this, you can buy products at wholesale prices and sell them on at a profit. However, this is just the start, he says. You don’t get rich by selling a few bottles of herbal supplements. Under Tiens’ model, there are eight ranks and you need to move up the levels to really start enjoying the benefits.
The first few levels can be reached simply by buying more products, which essentially brings with it a small discount on goods. However, to get to the bigger rewards, you need to start recruiting others. This way, you receive a commission whenever they make purchases and also get rewarded if they recruit their own followers.
Tiens refers to itself as a “multi-level marketing” scheme. The more people you recruit and the more they recruit in turn, the higher you move up the rankings, and soon you can just sit back and watch as the commissions roll in. Furthermore, once you’ve reached the 8-star level and keep growing your network, you will eventually become a Bronze Lion, then a Silver Lion, then a Gold Lion, and enjoy rewards of cash prizes, international trips, a brand new 4×4 car, a luxury yacht, a private jet, and finally a “Luxurious Villa Palace”.
“It’s all about growing your network; their success is your success,” says Ambrose cheerily. “Tiens does not care who you are. Anyone can do it, and there is no limit on what you can earn.”
As the Tiens guide puts it, joining the company means: “You stop struggling financially,” there is “little risk of losing”, and “if you work for five years you can retire.”
According the company website, over 200,000 Ugandans have joined Tiens, eclipsing the number of government school teachers in the country
According the company website, over 200,000 Ugandans have joined Tiens, eclipsing even the number of government school teachers in the country.
Given Uganda’s high rates of unemployment − youth unemployment is over 80% according to some estimates − the appeal of membership is clear. Decent jobs are scarce and rags-to-riches stories like Wasswa’s are even scarcer.
The company’s image is significantly helped by the Ugandan government. Not only does Tiens advertise on the Health Ministry’s calendar, but according to Wasswa, around 10 MPs are members of the company. At the Iganga seminar, Stephen Wante, the mayor of Bugembe, made a guest appearance. In 2011 meanwhile, vice-president Edward Ssekandi officiated a ceremony in which a distributor was awarded a car and organised for Tiens to donate some of its products to a government health centre. A photograph of the Ssekandi shaking hands with Tiens’ president also has pride of place on the company website.
Given Uganda’s high rates of unemployment − youth unemployment is over 80% according to some estimates − the appeal of membership is clear
However, at the Tiens headquarters, where members can print out their balance sheets, most leave the office holding spreadsheets indicating that they are owed almost nothing, if anything at all. Back in Iganga, several members who had joined several months ago, attended every biweekly seminar, bought lots of products, and gone on recruitment drives, revealed that they had not earned any notable income either. It seems many others have also abandoned the scheme after finding they could not make it work.
According to most Tiens members − both those who are profiting and those who aren’t − the reason for these failures is simple: the individual did not work hard enough. When I asked Sarah why she thought she hadn’t made any money after being a member for five months, for example, she hesitated before Robert chipped in to say “it means she is not performing well”. Yet Robert had barely received any income either, despite having been a member for six months and having recruited nine people. Other members who had yet to make money also suggested their situation was down to bad luck or poor performance.
I asked Wasswa how long it typically takes to break even. “Some people can take a month, but sometimes maybe two months,” he replied.
What if someone has been working hard but hasn’t started getting an income after six months, I followed up. “Six months?” Wasswa exclaimed. “No, it’s rare. Very rare. If someone is serious, they should be on a high level and earning well after six months.”
I looked at the three recruits who all just stared at the floor.
Not only does each distributor have to compete with 200,000 other sellers as well as 30 well-established stores, it doesn’t make economic sense for customers to buy from individual members when they could sign up to Tiens themselves and get much lower prices anyway.
This is perhaps why Wasswa and other recruiters barely even mention selling products and why the emphasis instead is very heavily on “growing your network”. The incentives for signing up new members are higher than those for sales; the training sessions teach recruits how to sell membership rather than goods; and the Tiens guide’s main advice is a six-step plan of how to “make a name list of at least 100 in a shortest time possible”.
A Tiens Uganda booklet. Photograph: James Wan
I later contacted Ambrose, Wasswa and Jamba George, another 8-star recruiter, for their response to the points made in this article, but they all declined to comment. The manager of Tiens-Uganda, a Chinese expatriate, and the company’s global headquarters in Tianjin also declined to comment.
It should also be noted that Tiens is not just in Uganda, nor is it the only scheme of its kind. While Tiens’ presence on the continent seems to be particularly strong in west Africa, Ethiopia and Zimbabwe, the company also has offices in many western countries, though its products are marketed more directly as food supplements and “wellness equipment’”.
Last hope
Back in the courtyard in Iganga, Robert is listing the products he was prescribed six months ago. Like so many others faced with Uganda’s struggling healthcare system, Robert ended up seeking alternatives and eventually ended up at Wasswa’s busy but welcoming clinic.
The products worked, Robert insists. Up to a point. He just wishes, he says, that he could finish the treatment and be fully cured of his kidney problems as well as the other health conditions detected by the diagnostic test he underwent. But he cannot afford it.
Robert has no other work − he says there are hardly any jobs available in the area − and has five children to support. When he joined the company half a year ago, he thought Tiens was the answer to all his prayers, but he is still in pain and deeper in debt.
“Money is a problem, he says. “It is not easy to recruit people and I spend USH12,000 ($ 5) every week on transport to come to these seminars.”
I ask him why he is still part of the company despite losing money each week. He pauses for a moment before answering, “I believe I will balance my accounts soon. And I am close to moving up to the next level when I will be able to earn more.”
He explains that a technical misunderstanding delayed him moving up a rank, but that it should be sorted out soon. I point out that even if he moves up a level and earns slightly more than now, he will still be earning a tiny fraction of what he has invested. He nods in agreement, but adds, with a faint smile, “But with Tiens, time is on your side.”
But what if it still doesn’t work out, I push. What if Wasswa is the exception that proves the rule? What if it never works out?
Robert looks me in the eye for a few seconds before gazing out across the courtyard where a few groups of attendees are still standing around chatting.
“If the money defeats me, ” he says quietly, turning back to me, “I will disappear.”
* some names have been changed to protect interviewees’ identities.
This article was made possible by a grant from the China-Africa Reporting Project managed by the Journalism Department of the University of Witwatersrand
I’m afraid we can appear forward to a good deal much more of this sort of nonsense.
Numerous days ago an article titled “Is Your Shower Curtain Generating You Unwanted fat?” appeared in the magazine Spry and was then reprinted in the Dodge City Everyday Globe. The article drew readers’ focus to the dangers of endocrine disrupting chemicals (EDCs), giving 5 examples of chemicals utilised in each day client merchandise (BPA, phthalates, PVC, PFC’s, and PBDFs).
With a quote from a professor of pharmacology and references to a couple of crude, published research, the writer, Catherine Winters, conveyed the message to her readers that they are surrounded by merchandise containing EDCs that can play havoc with hormonal signaling and induce ailment. The shower curtain reference was primarily based on a examine that located that shower curtains containing PVC, or polyvinyl chloride, “release up to 108 volatile organic compounds (VOC), some of which could be detected in the air 28 days following the curtain had been hung.”
Nowhere in the article is there any mention of the kind of publicity to the chemical compounds needed to cause the adverse health results mentioned. You would consider that she is speaking about occupational publicity where 1 is breathing in dust and fumes from these chemical compounds 40 hours a week, week-in and week-out. In truth, exposures encountered in daily existence are likely to be trivial to non-existent.
English: Plastic bottles in the back of a pickup truck, ready for recycling (Photograph credit: Wikipedia)
I refer to this article not simply because of the wide reach of these publications but simply because the story is symptomatic of anything that is really widespread, not to say pervasive. We read through and see claims and suggestions of this kind, if somewhat significantly less clearly silly, in newspapers, including the New York Instances, the media a lot more generally, and, even in supposedly peer-reviewed scientific journals.
So this is truly a general, society-wide phenomenon. In portion, the media and the public are encouraged to think these unfounded scares by bad studies that get published in journals, due to the fact scientists and institutions that should know greater give them currency. The media can then be depended on to pick up the titillating benefits of these sloppy studies.
If, in truth, as I wrote final week, we are far from comprehending the causes of the weight problems epidemic, we can be sure that in the coming many years a excellent deal of interest will be targeted by researchers on achievable variables that have received significantly less focus but that Could play a role in the improve in weight problems above the past 3 decades.
A hint of a new tidal wave of research that will undoubtedly make numerous new linkages between a variety of exposures and a multitude of overall health effects is contained in a 2009 paper entitled “Ten Putative Contributors to the Obesity Epidemic.” The paper has 22 authors and is 79 pages extended. The lead authors are from the Pennington Biomedical Investigation Center at LSU and the University of Alabama at Birmingham.
Along the very same lines as I discussed last week, the authors commence out by calling into question the typical explanations of the weight problems epidemic. They publish that, “Marketing practices of energy-dense meals and institutionally-driven declines in physical exercise are the alleged perpetrators for the epidemic, regardless of a lack of reliable evidence to demonstrate their causal role.” They refer to these widely cited factors as the “Big Two.”
Even though making it possible for that the Large Two – extreme intake of calorie-dense meals and lack of bodily action – play a position, the authors make the situation that other factors, which have obtained minor attention, may contribute to fat gain. For every single of the 10 “putative” elements, they summarize the various varieties of evidence (experimental, ecologic, epidemiologic, and so on.) and examine how every single issue may possibly contribute to the problem.
The ten aspects are:
Microorganisms
Epigenetics – that is, variables that affect which genes get expressed
Growing maternal age
Greater fecundity amid individuals with greater unwanted fat retailers – that is, the chance that body fat individuals could be a lot more probably to have young children
Assortative mating – i.e., a unwanted fat particular person may possibly be much more probably to marry a unwanted fat particular person
Rest deficit
Endocrine disruptors
Use of prescribed medicines
Reduction in the temperature assortment we are exposed to
and intrauterine and intergenerational effects.
This definitely represents an ambitious study system. Some of the products signify more centered hypotheses that could be tested (assortative mating rest deficit increasing maternal age), whereas other individuals represent whole new disciplines (i.e., the microbiome endocrine disruptors).
These factors might nicely merit review in relation to weight problems, but it ought to be pointed out that, at current, the evidence for some of them is quite slight.
To the extent that these inquiries are properly-formulated and higher-high quality scientific studies are carried out to handle them, this proposed system is a constructive advancement and is most likely to create new and valuable expertise.
Even so, even though the authors do a credible job of laying out the scientific proof for their 10 elements, there is a disturbing lack of essential viewpoint on some of the data they current. For example, in their discussion of endocrine disruptors they refer to the truth that most of the population has measurable amounts of these chemical substances in their blood and urine, but they do not query whether these trace quantities are likely to have any biological effect. They also refer to an association of levels of phthalate breakdown goods in urine with stomach obesity in the NHANES, with out any qualification regarding the uninterpretability of this kind of an association in a cross-sectional study (i.e., in which are the data have been collected at one particular point in time).
It is fine to study these things, and, if carried out right, we are very likely to acquire new and crucial knowledge. But the final results are unlikely to bear out simplistic suggestions. They are a lot more probably to flip our interest to things that we didn’t suspect heretofore.
With broad-eyed enthusiasm I started out telling close friends who I knew were struggling how wonderful these tablets had been, urging them to get some too. It was then that I realised I was a little late to the celebration. Turned out it was previously very a bash. From the buddy who didn’t adore her husband but stayed for the youngsters, to the one with the nerve-racking profession, the single mother struggling to make ends meet and the colleague who had been on Prozac for 20 many years – all of a sudden it appeared as even though each female I knew was propping up her mental well being with pills. In a straw poll of ten fast female close friends, I identified eight of them had been taking or had taken antidepressants.
In which as soon as our coffee mornings had been all bitching about husbands and discussing strategies for the evening meal, they grew to become a kind of antidepressants drop-in clinic. None of us was judging any person – how could we? – but the scale of use astounded us all.
Was this a regional phenomenon? Was the town exactly where I lived facing an epidemic of middle-class misery? Apparently not. In accordance to the Well being & Social Care Data Centre, prescriptions for antidepressants stood at about 28 million in Britain in 2003. By 2012 the figure was 50 million. Meanwhile, a survey by the charity Platform 51 discovered a single in three British ladies had utilised antidepressants. (Figures for men are tougher to come by, but anecdotally they are nearer 1 in 10.) So it wasn’t just me and my friends.
Why then? What was taking place that we felt we essential pharmaceuticals just to get through the day? The causes were a lot of, but underlying everyone’s story was a sense that daily life hadn’t turned out how we had expected. There was a disconnect between our expectations and the actuality of our everyday grind.
Emma, a nurse and mother of two, felt the stress soon after obtaining her first youngster: “I imagined there was a proper way to do issues and if I didn’t do it that way then I would mess up my kid’s daily life permanently. I gave myself no room for error. When my daughter couldn’t breast-feed I felt like a failure. I believed that was motherhood, and daily life would be misery from there on. Taking antidepressants lifted a veil.”
Buddies with out youngsters were also buckling. Sophia, a civil servant in London, discovered herself unable to get out of bed a single morning: “I’d been doing work prolonged hrs, holding down this huge crucial work, hunting to all the planet like a high-flyer, whilst trying to manage quite a destructive romantic relationship at home. I just imploded. I couldn’t end crying. Antidepressants produced me feel the happiest I’ve ever been. I fret because now I’m attempting for a infant and I’m not sure I need to stay on them, but I genuinely do not ever want to stop.”
Certainly it’s not information that today’s girls are facing enormous pressures: to have a brilliant occupation, a meaningful romantic relationship and excellent children, whilst curating a capsule wardrobe, saving the planet and doing naked yoga. The complicated issue, says Cosmo Hallström, a advisor psychiatrist and a fellow of the Royal College of Psychiatrists, is that daily life – on the surface at least – is greater than ever for most of us. “Services are much better, education is better, we have cozy properties and lots of entertainment,” he says. “But, as the regular of residing has accelerated, our expectations have grown. We are bombarded with messages about how wonderful life ought to be and truly feel like failures when factors really don’t turn out like that.”
But then haven’t there constantly been pressures, as any loved ones gathering involving a grandparent or two tends to propose? Our contemporary woes, with their emphasis on unrelenting happiness and private fulfilment, look rather vain and self-obsessed in contrast with those of women in the past. Have we merely lost our backbone? Are we a generation so cosseted that we’re no longer ready to cope with standard human trials and tribulations?
As my late grandmother always appeared to take pleasure in telling me, “Nobody mentioned it was straightforward.” While the notion of mother’s little helpers is nothing new – our mothers had Valium, their mothers gin and reduced expectations – when you are confronted with the substantial actuality of it, when practically each and every female you know is on antidepressants, that is very a massive deal, is not it? You can’t assist asking yourself whether or not we’re taking them because we actually need to have to or just simply because we can. Are we like children who, getting opened a forbidden packet of biscuits, gorge away right up until a grown-up stops them or right up until they make themselves sick? Does the biscuit tin require to be positioned on a increased shelf?
The Council for Evidence-primarily based Psychiatry (CEP) undoubtedly thinks so. The CEP is a body of top medics, psychiatrists and academics who have come collectively to deliver a collective wake-up contact, highlighting what they say are the potentially hazardous results of antidepressants and the “medical model” for treating psychological-well being disorders.
Dr James Davies, a psychotherapist and a co-founder of the CEP, thinks that as a society we are progressively lowering the bar on what constitutes psychological illness. “More and far more of our normal, normal, albeit painful experiences are getting wrongly classified as psychiatric situations – all of which leads to more prescriptions for strong psychotropic medicines,” he says.
The comedienne and mental-health campaigner Ruby Wax, whose very own battle with depression has been nicely documented, has characteristically powerful views on the topic. As she puts it, “We’re all going to the doctors saying, ‘Mummy, correct me,’ when we should be taking charge of our personal minds, obtaining out how the machine works.”
Wax argues that we have misplaced many of the local community connections that employed to aid us deal naturally with reduced mood – locations this kind of as church, and chats more than the garden fence – and have become as well reliant on GPs for our salvation. In her manifesto for mental overall health, Sane New Planet: Taming the Thoughts, she suggests drop-in centres the place folks can share their experiences, as happens at Alcoholics Anonymous meetings, and accessibility talking therapies this kind of as mindfulness and cognitive behavioural treatment (CBT). “How did they [AA] organise these get-togethers so nicely? They have meeting locations on every corner – much more than there are Starbucks – and these individuals are drunks!”
It’s a brilliant thought – I for one particular would be a normal at my local centre – but it would almost certainly need the kind of investment from government that is not going to take place any time quickly. Nevertheless, “talking therapies” along the lines of CBT and mindfulness-based mostly cognitive therapy (MBCT) are more and more getting observed as credible options to prescription medication: my local wellness authority in Dorset, for instance, has recently launched its own talking-therapies scheme, allowing patients to self-refer with no very first obtaining to seek advice from their GP. Though slightly different in their strategy, CBT and MBCT function on equivalent principles: encouraging an understanding of how our thoughts, emotions and behaviours interact and a emphasis on the present. The thought is that greater awareness of our feelings and considering helps us deal with rather than feel overwhelmed by them. (You can get began on MBCT on your personal with a book this kind of as Mindfulness: A Useful Guidebook to Obtaining Peace in a Frantic World by Prof Mark Williams and Dr Danny Penman.)
For Fran, a 45-12 months-old self-employed mom who has taken antidepressants in the previous, CBT sessions offer you the perfect thoughts-maintenance regime: “I really feel happier realizing I’m finding out the tools to deal with my nervousness naturally. It’s like carrying out yoga or Pilates for the mind. The pills numbed me to the encounter totally, whereas CBT assists me put issues into viewpoint by myself.” But access to these therapies is patchy at best. Waiting times vary in between regional authorities and can be something from a fortnight to a yr – and even two weeks can appear like a lifetime when you are feeling minimal.
Jim Woods, a GP primarily based in Devon, says that the lengthy wait for counselling appointments is sometimes the purpose why he prescribes antidepressants. “You get a holistic view and speak about how they can enhance items,” he tells me. “But you also want to help, and there is typically a long wait for CBT and counselling. If they want aid and you can’t prescribe some thing that will function instantly, then you are not actually helping. And antidepressants do operate.”
Just how protected the pills are and managing daily life right after them are the other elephants in the doctor’s waiting-room. Google “side effects of antidepressants” at your peril – or only if you are on a very higher dose of them and for that reason couldn’t care what you learn – since the stories of collateral harm can appear terrifying: reduction of libido and sexual function, headaches, memory reduction, dizziness, insomnia, issues urinating… Prolonged use has also been linked to sort-two diabetes and, in excessive instances, suicidal ideas.
Prof Jonathan Haidt, an American social psychologist, TED Talks poster-boy and the writer of The Happiness Hypothesis, says that we come to feel unpleasant and tend to moralise when individuals try out to boost their great deal, specifically if they do so with “short cuts” such as pills. But, he adds, that doesn’t indicate it is wrong for them to consider. “I feel it’s misguided and intolerant to insist that every person need to only accomplish personal modifications by means of challenging function, and not by means of some thing as basic as a pill. Several individuals find SSRIs assist them be the particular person they constantly wished to be and want they’d found them 20 many years earlier.”
It is a dizzying image. The rights and wrongs, the causes and cures – they are almost adequate to make any person truly feel depressed. What is crystal clear is that numerous females genuinely come to feel unable to cope with the predicament in which they locate themselves. And although we would welcome far more treatment and counselling, in a time of mental crisis we’ll take what ever we can get our hands on when such options are not immediately accessible.
As for me, I’m off antidepressants now, navigating daily life fairly anxiousness-cost-free. Medicine restored my cheery disposition, but it also manufactured me truly feel weirdly numb. I missed emotional contrast, the light and shade of life, which had been eclipsed by the dazzle of artificial sunshine. So I’m undertaking all the boring factors, currently being more mindful and going gently by means of existence. And it feels Okay.
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Co-authored with Nic Horton, Policy Analysis Analyst at the Foundation for Government Accountability.
Increased Medicaid enrollment has extended been heralded as a rare “success” of the ObamaCare rollout. Lately, CMS launched a new report boasting about growing enrollment in Medicaid. “These gains are produced attainable by collaboration among CMS and the states that operate these applications,” CMS explained. But how many of the new 6 million enrollees actually meet the eligibility demands for Medicaid?
Some state officials have began to push back on the claims of the Obama Administration on Medicaid, and a number of have quietly began to eliminate ineligible people that have been enrolled due to continued concerns with the federal website. The number of examples that have grow to be public from about the nation call into query the validity of these Medicaid enrollment numbers, painting a dire picture for taxpayers and the actually needy.
Last July,the Obama administration announced that — by executive directive — it would delay ObamaCare’s income verification needs. As an alternative, men and women who wanted to obtain overall health insurance via the ObamaCare exchange would be on the “honor system” and self-report their earnings without having any evidence necessary. This modify was only supposed to impact enrollees in state-based exchanges, but troubles with HealthCare.gov have produced chaos for states with a federal exchange as effectively.
States proceed to grapple with the collateral harm of ObamaCare’s implementation. However, the bungling of the overall health law’s rollout is wasting even far more taxpayer bucks and hurting even far more sufferers in need.
Quickly to be Secretary of HHS Sylvia Mathews Burwell may possibly have to answer for the developing variety of improperly enrolled folks onto Medicaid under the ACA due to continued problems with healthcare.gov. (AP Photograph/J. Scott Applewhite)
The Federal “Fix”
The federal government’s failure to confirm applicant earnings has put states in an unworkable circumstance: there is no way to establish if an applicant should go into Medicaid, into an exchange plan, or if that applicant is eligible for any sort of taxpayer-funded subsidies at all. To “solve” this dilemma, the administration announced in December that it would offer states “flat files” of incomplete eligibility data obtained for the duration of the exchange application approach, but, in the meantime, would let states to go ahead and enroll people in Medicaid. Even the loudest cheerleaders for ObamaCare could’ve envisioned how horribly incorrect this might go.
Politico stated at the time that this maneuver by the administration forced states to:
make a decision whether they’re prepared to chance the integrity of their Medicaid plans to sign up people more rapidly.
Some states rolled the dice now individuals and taxpayers are getting forced to settle up with the property.
Fraudulent Medicaid Enrollment Surges
Final December, HHS spokeswoman Joanne Peters said, “Claims from some states about our process for testing the Medicaid eligibility and enrollment systems are inaccurate.” It appears her data is as incomplete as the fed’s earnings verification information.
Texas
Take, for illustration, Jason Hawkins of Plano, Texas. Mr. Hawkins Hawkins earns $ 50,000 a yr and has a family of 3. Primarily based on his cash flow, he is ineligible for Medicaid, but the fed’s HealthCare.gov gave him the go-ahead for free taxpayer-funded wellness care.
Texas officials also confirmed other significant flaws in the files they received from the federal government. A lot of of the candidates supposedly eligible for Medicaid in Texas included people who did not even reside in the state and folks who are previously signed up for Medicaid.
Florida
By February, the federal government offered data on tens of thousands Floridians it determined to be eligible for Medicaid based on applications processed by the ObamaCare exchange. After overview, Florida officials found that significantly of the data was totally unreliable, containing duplicate applicants and candidates that had been certainly ineligible for Medicaid.
The Urgency Network is a Los Angeles-based mostly startup that partners with nonprofits to offer when in a lifetime experiences as a way of bringing increased visibility to social and environmental causes that want support. The two founders, Donald Eley and Brandon Deroche, launched the organization in July of 2013 with some huge names involved – Sir Richard Branson, Paul McCartney, Thom York and Ram Dass, to identify a couple of – likely arousing at least a smidge of envy in other entrepreneurs functioning tough to stand out from the crowd. So how did they pull it off? Most often, the prizes are sourced from the nonprofit’s donor checklist – influential men and women who previously assistance the organization financially are generally satisfied to offer additional perks as a way of helping out. But that is only component of the story.
Eley and Deroche first crossed paths in 2011 at the Hangout Music Festival in Alabama, where they connected more than a shared passion for dwell music and free booze. Both have deep histories as musicians themselves – Deroche played guitar in a band that was productive enough to consider him straight from high college to touring the U.S. and Europe, and contemplating a variety of options with main record labels. But right after six years of growing annoyed with the music sector, he ended up taking a task at Causecast – a result in advertising business that, at the time, permitted him to operate with musicians from the other side of the table. A single of the initiatives he became deeply involved with was Music for Relief’s “Download to Donate,” which leveraged exclusive tracks to raise money for relief efforts following the Haiti & Japan Earthquakes, and featured over 400 well-liked artists. He then left Causecast to turn out to be the Director at The Make Your self Foundation, a nonprofit started by the band Incubus.
Eley knew from a younger age that he wished to be an entrepreneur and keep away from the circumstance his father found himself in, in which he’d spent his life working in the oil sector and was abrubtly allow go soon after becoming injured on the task. At age 19 Eley started to DJ, and this ultimately led him to touring the planet and launching a label that was accountable for putting out in excess of a hundred releases from electronic music artists. Then the web boom hit, and people stopped getting music in the exact same way. He grew to become obsessed with making a digital download retailer, and whilst doing work on this new venture crossed paths with Rob McDaniels of INgrooves, a behind-the-scenes leader in digital music distribution, marketing and advertising and publishing solutions. He worked as their Director of Industry Development for a year, and then moved to Texas the place he started out a true estate brokerage company with a friend that was later on acquired by Keller Williams, managing the branding and advertising facets of the organization.
Following Eley and Deroche’s first meeting in Alabama they reconnected back in Los Angeles, exactly where they grew to become roommates and began mapping out the details for what would later grow to be The Urgency Network. Even though the concept began with a focus on utilizing music as a device to drive social and environmental progress, they expanded their vision to incorporate a better diversity of memorable experiences. One particular thought they’ve pursued because the early days was sending a person to outer area – the reason becoming that civilian area travel is presently restricted to the super wealthy, and what far better way to show the power of their platform than to blast a person into orbit. Three years later on, in partnership with VICE Media’s Motherboard, their dream is coming accurate with the launch of Ticket To Rise – a campaign that permits you to help a trigger of your choice, and be entered to win a journey to area on XCOR’s Lynx Spacecraft (watch video right here).
What differentiates Eley and Deroche’s giving from firms like Omaze, which applies a fairly straight forward “donate to win” fundraising model for nonprofits, is that each campaign they develop is extremely personalized primarily based on their client’s particular objectives. Some of the nonprofits they operate with are interested in educating (e.g., watching awareness vids, reading through articles or blog posts, and so forth.) even though other people are driven to enhance engagement (e.g., signing petitions, participating in mass tweets, connecting by means of social media etc.). And for people looking to fundraise, The Urgency Network uses nonprofit organization Network for Good to processes monetary transactions, making certain donations are tax deductible while retaining ten% of the total sum raised to cover their operating expenditures. They’ve outsourced design and style and development to imaginative shop Ludlow Kingsley, who they see much more as a long-term partner provided the firm’s high degree of strategic input, and commitment to The Urgency Network’s vision moving forward.
As for the instant street ahead, Eley and Deroche are currently hyper-centered on the Ticket To Rise campaign, and are also in the midst of raising a Series A round of financing. This will permit them to increase their team and invest far more time and vitality in organization advancement, which involves functioning with leading-tier brand names, evolving the platform based mostly on lessons discovered, and creating much more social action campaigns linked to attention-grabbing experiences. They both admit to becoming exhausted, and when asked what keeps them going Eley says, “We’re constantly surrounded by good individuals and we know what we’re doing is functioning – so truly, it is a dream job.” To this, Deroche nods his head and smiles, proving magical partnerships can certainly start over also several drinks at a music festival in Alabama.
If you are a nonprofit interested in joining Ticket To Rise click right here. Other inquiries can be sent to area@urgencynetwork.com.
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