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CASE STUDY 5: GOSH/ICH Child Health Portal | 2001 – 2003

Expertise: Strategy, vision, team leadership, managing suppliers, design vision, digital strategy, content creation, editing, project management, innovation, child health, public health, modernising large institutions. 

Location: London, UK 2001 to 2003

Project Manager: David South

Charity Content Coordinator: Ramita Navai

Click here to view images for this case study: CASE STUDY 5: GOSH/ICH Child Health Portal | 2001 – 2003 Images

Abstract 

In 2001 I was hired to project manage and deliver a Child Health Web Portal for the prestigious Great Ormond Street Children’s Hospital NHS Trust (GOSH)/Institute of Child Health (ICH) based in London, UK.  

The project was intended to lead on innovation at the institutions and in the wider National Health Service (NHS) and was delivered in three phases. Screen grabs can be viewed below:  

Phase 1 

Phase 2

Phase 3

About

From the start, the project begged the question: Could we take a complex (and complicated) mandate and successfully achieve it in just two years? All under great public and media scrutiny (London being a world centre for media)? And how do you innovate for the 21st century in a major health care institution and build on its already high reputation?

Britain’s best-loved children’s hospital and charity, Great Ormond Street Hospital for Children NHS Trust (GOSH), contracted me to lead a two-year project to modernise the hospital’s web presence and take its brand into the 21st century. GOSH is both Britain’s first children’s hospital and a pioneering child health institution (along with its partner the Institute for Child Health). The hospital’s outstanding reputation meant the project was carried out under intense public, media and professional scrutiny, and required a keen awareness of new media developments and the needs of the hospital’s patients, their families and the public. It drew on an extensive public consultation and the NHS Modernisation Plan and the Information for Health strategy – which had identified strong demand for services and information to be made available online – to develop this innovative online offering. The NHS had also set the goal of having 25 per cent of all its services accessible via the web. 

From the start, the project represented a new phase in how the institutions communicated. An announcement in PR Week in April 2001 acknowledged this, declaring the role will deal “with what is increasingly becoming an important part of the press office and the hospital”. Prior to beginning the two-year project in 2001, the existing website was an amateurish affair and not suitable for an internationally renowned centre for paediatric treatment, training and research. 

The UK had become out of step with wider web developments at that time and had to do a lot of catching up. But there was a ready audience for better web content already established in the country. By 2001, data showed 3 million children in the UK were using the Internet and 33 million UK citizens could access it through work, school or home. 

By 2001, the Internet offered an estimated 100,000 health-related websites (most based in the United States, leaving a gap for high-quality information based on UK research and experience). Trust was key and this was a crucial part of the content strategy that was developed. 

As lead staff member for the website, I was in charge of recruiting and managing staff and suppliers, liaising with stakeholders inside and outside the organisations, planning work and seeking opportunities and partnerships.

The project was developed in three, distinct phases. Screen grabs from these phases are available for download and evaluation. They also include web traffic statistics. This unique snapshot of a complex project as it unfolded, should prove useful for other e-health practitioners. 

As an innovator, the project became a catalyst for numerous online and offline initiatives across the institutions. The website made enormous strides, winning a number of national and international awards and leapfrogging to become one of the best NHS-linked sites in the UK. Areas radically improved included the design and navigation, patient information for families, press office, and the development and launch of the award-winning children’s website. 

Phase 1 

Phase 2 

Phase 3 

Each stage was transparently communicated and accompanied by high-profile publicity campaigns: a necessity because the hospital relies heavily on public trust and funding to function. 

The first phase involved getting buy-in on a new design vision, assembling a team, extensive work on migrating the very large legacy website into the new template, and exciting colleagues on the potential of the new child health portal vision. It was launched in September 2001.  

Ask Dr Jane Collins, a regular column written by the Chief Executive Dr. Jane Collins for The Times newspaper, was one of the more popular features of the child health portal. The portal was also directly connected to the NHS Direct service with its extensive online health encyclopedia.  

In 2001, the project launched an interactive Christmas child health advent calendar offering top tips from health professionals on how to have a safe holiday season. It showed what could be done with the improving web design and production skills of the team. The PDF can be viewed here: http://www.scribd.com/doc/44905926/Christmas-Advent-Calendar-for-GOSH-Child-Health-Portal-2001.

As another example, the hospital’s 150th birthday celebration on 14th February 2002, attended by Her Majesty the Queen (and celebrities, including Madonna), was accompanied by an online interactive history prepared by the project and was used to inform the wider public about the child health portal.  

Phase two involved the launching of new content developed by some of the world’s top child health experts and scientists, substantial new resources for sick children and their families, an online awareness-raising campaign to drive traffic to the health portal as a trusted and reliable resource, plus a wider media campaign. Based on user experience testing and user feedback, changes were made to the design and content structure to make the portal more user-friendly and to follow best practice in web design at that time.  

The overall child health portal also gave birth to a highly successful new resource, the award-winning Children First website in May 2002. This resource was a year in development and was calibrated by age to provide relevant resources to guide children through the hospital experience. It used high-quality animation and partnered with BBCi and BBC Science to create resources that would resonate with children and youth. It included high-profile elements such as the Write4GOSH children’s writing prize, attracting entries from around the world, with winners receiving prizes from Cherie Booth QC, Dannii Minogue and children’s writer Jacqueline Wilson.  

Children First attracted an average of 700,000 visitors each month with over 800 children in its first year contributing to the site. It addressed a gap in the online marketplace for health resources written for children rather than for their parents and families. It also gave birth to its own project: The Virtual Children’s Hospital (VCH). Funded by the PPP Foundation in August 2002, it worked with a team of psychologists to meet the social, psychological and information needs of ill children. 

In March 2003 the Commission for Health Improvement (CHI) in its review and assessment found, in answer to the question “What, if anything, did CHI find that the rest of the NHS can learn from?” at the hospital, it was the child health portal, because “The trust’s website has different sections for children and families as well as for health professionals. The website also has sections for children of different ages and a broad range of information leaflets is available to download. The website has 3.5 million hits per month.”  

In 2003, the UK’s Guardian newspaper called the Children First website one of the “three most admired websites in the UK public and voluntary sectors,” and a UK government assessment called the overall GOSH child health web portal a role model for the NHS. Children First also won the prestigious Cable and Wireless Childnet Award that year as well. And was short-listed for the New Stateman’s New Media Awards. 

In 2006, The Times of London called Children First the Top Child Health Website in its Wellbeing on the Web: The Best Portals survey (November 11, 2006). 

Phase three saw online traffic growing at a steady clip, the portal gaining accolades, awards and positive reviews; it also helped the hospital to gain the highest rating in a government review (5*), and Children First was awarded significant further funding so it could expand its resources. The award-winning team also re-developed thewww.gosh.org charity website (one of the highest profile charity brands in the UK) and launched it in 2003 as well.  

A great way to track the historical development of a web project is to use the Wayback Machine’s Internet archivehere (https://archive.org). By typing in the web address (for example, http://www.gosh.nhs.uk, and http://www.gosh.org), you can see a chronological history of the website by month. 

Timeline 

2001: Initial design vision articulated and team assembled. First phase of content creation and ‘soft launch’ of portal in September 2001. Begin experiments with new graphic design, including an online interactive Christmas advent calendar with health tips.  

2002: Launch new content during the hospital’s 150th anniversary celebrations; begin development work on Children First content. Partnering with BBCi and BBC Science to improve quality of child and youth resources. Significant new content is launched throughout the year as the portal sees month-on-month growth in web traffic. Awarding of further funding for Children First and the Virtual Children’s Hospital. 

2003: Winning of Childnet Award; launch of new GOSH Charity website. Record web traffic to the website.

Testimonials

“As a parent, I recognise how important it is to help your child understand all that they can about their stay in hospital and their care and treatment. Time spent in hospital can often be a very frightening experience. Making sure that your child has helpful, easy to read information will make a significant difference to their time in hospital. 

I am sure that this website will prove very useful for children and their families.” Prime Minister Tony Blair, May 2002

“A highly attractive website written by and with children at Britain’s biggest specialist hospital for children. The site is carefully segmented for different age groups and provides a powerful platform on which children can reach out from the confines of their hospital wards, share their experiences and learn about a range of medical issues as well as have access to fun interactive resources.” Childnet Award 2003

“I am glad you mentioned the web site. If you can access it and haven’t recently please have a look. It has vastly improved and both David Latchman and I (it is a joint site with ICH) are very pleased.” Dr Jane Collins, Chief Exec’s Corner, Roundabout newsletter, February 2002

“I never thought that GOSHKids would be so valuable to the hospital or, more importantly, to children and young people attending the hospital or simply interested in health matters. I think that this reflects my age, though!

“Many of us over 30, even if we use the internet ourselves, are surprised how much children and young people use it both as a source of information and for entertainment. 

“Even quite young children are using it routinely now and as an increasing number of families have access to it, either at home and/or at school or work, presumably more and more will do so. 

“There are over 42,000 hits per day (1,260,000 a month) on our GOSHKids website already. Of course, part of the success of the website is down to its design and content. I would like to take this opportunity to congratulate Gary Loach, David South and the whole team who have worked so hard to make it successful.” Dr Jane Collins, Chief Exec’s Corner, Roundabout newsletter, June 2003 

“The GOSH/ICH web site to date has been a notable success. Not only has it met a majority of its objectives as delineated in the PIN report of 2000 and achieved recognition as ‘exemplary’ among NHS resources, but it has also generated a number of spin-off projects, including Children First (as a successor to GOSHKids) and The Virtual Children’s Hospital.

“It has moved from providing a poor representation of the organisations, to above average for corporate web resources, and compares highly favourably with those of other NHS sites and departments. The most notable success lies in the resource it now provided for the public, especially GOSHKids.

“In a context in which less than 25% of all projects realise even 50% of their benefits, the satisfaction of 75% of the original objectives set out in the PIN report must rank as a significant achievement.” Website Project Audit by Passmasters Limited, 17 April 2003

“Great Ormond Street Hospital has launched this health site targeted specifically at childen, with a separate version aimed at young teenagers. The site aims to give young ‘uns information about health, illness and treatment in an easily digestable, non-threatening manner.” Internet Magazine, July 2002

“… it’s a good site and not just for those about to go into the hospital.” New Media Age, 20 June 2002

“The project was instrumental in pulling together a number of key strategies (including the NHS’s Modernisation Plan, and its Information for Health Strategy), and acting as a catalyst for numerous online and offline initiatives. Critical to these strategies is the need to provide information and services online and in an accessible way. The aim has not only been about serving the specific needs of the institutions, but also to become a broader child health portal.  

“The website in 2001 was an amateurish affair and a disgrace to an internationally renowned centre for paediatric treatment, training and research. Run largely from the Research Office it was focused on one particular audience, uninspiring in design, reactive in updating and made little use of the potential of the internet. We needed someone to take it forward …

David [South] was lead staff member for the website, recruiting and managing staff and suppliers, liaising with stakeholders inside and outside the organisations, planning work and seeking opportunities and partnerships. It is fair to say that the site made enormous strides under his leadership, winning a number of national and international awards, and leapfrogging to become one of the best NHS-linked sites in the UK. 

 “A number of areas were drastically improved, including design and navigation, patient information for families, press material, and the award-winning children’s site, which is now an international project with many different partners. David [South] project managed many projects in this time including linked sites for London IDEAS Genetics Knowledge Park, and the hospital charity site …” Stephen Cox, Chief Press Officer, Great Ormond Street Hospital for Children NHS Trust and the Institute of Child Health

Impact 

Micro

  • took public consultation and consultant’s report and crafted and developed a strategy to implement the GOSH Child Health Web Portal
  • assembled team across two institutions
  • set clear milestones and brought project management methodology previously deployed with the United Nations
  • led on teaching new ways of project management for results
  • took GOSH brand forward for the digital age
  • advised colleagues on digital publishing and design
  • awarded additional funding

Macro 

  • role model for NHS and government/charity sector. Awarded five stars in government review
  • Childnet Award
  • launched major milestones with well-known figures, including Her Majesty the Queen, Madonna, and pop stars
  • significant media coverage of project
  • attracted funding not only for the GOSH Child Health Portal but also for other projects at the institutions
  • grew web traffic month-on-month, becoming one of the top online child health resources
  • website cited in many other resources. One of the goals of the project was to increase access to high-quality child health resources and to have them cited in books etc.

Citations

The Great Ormond Street Hospital Manual of Children’s Nursing Practices by Susan Macqueen, Elizabeth Bruce and Faith Gibson, John Wiley & Sons, 2012

Help! My Child’s in Hospital by Becky Wauchope, Marbec Family Trust, 2012

Oxford Desk Reference: Nephrology by Jonathan Barratt, Peter Topham and Kevin P.G. Harris, Oxford University Press, 2008

Research Review 2001: A Year of Excellence and Innovation, Institute of Child Health and Great Ormond Street Hospital for Children NHS Trust, 2001

Research Review 2002: Building on Success, Institute of Child Health and Great Ormond Street Hospital for Children NHS Trust, 2002

Other Resources

GOSH Child Health Portal Phase 1a

GOSH Child Health Portal Phase 1b

GOSH Child Health Portal Phase 2a

GOSH Child Health Portal Phase 2b

GOSH Child Health Portal Phase 3 

GOSH Project Launch Brochure and Screen Grabs, 2001-2003

GOSH Child Health Portal 2001 to 2003 Resources

DSC web address in green_mini (1)

© David South Consulting 2017

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COVID-19 Timeline

This timeline is an aid to decision-making during the recovery from the pandemic and how to better prepare for outbreaks in the post-COVID-19 pandemic policy environment.

2015

2016

Domestic Resource Mobilization in
Global Health Security

This session will explore the issue of major infectious disease outbreaks as a threat to economic and human security, and the need for domestic resource mobilization for pandemic preparedness. Emphasis will be placed on the situations within lower-middle and low-income countries, which often lack the financial, human, and physical resources required to strengthen their global health security infrastructure. This includes but is not limited to emergency response, health workforce, surveillance, procurement of countermeasures, cold and supply chain management, and adequate health systems.”

2019

October

Event 201: The Johns Hopkins Center for Health Security in partnership with the World Economic Forum and the Bill and Melinda Gates Foundation hosted Event 201, a high-level pandemic exercise on October 18, 2019, in New York, NY.

“The exercise illustrated areas where public/private partnerships will be necessary during the response to a severe pandemic in order to diminish large-scale economic and societal consequences.

Statement about nCoV and our pandemic exercise

In recent years, the world has seen a growing number of epidemic events, amounting to approximately 200 events annually. These events are increasing, and they are disruptive to health, economies, and society. Managing these events already strains global capacity, even absent a pandemic threat. Experts agree that it is only a matter of time before one of these epidemics becomes global—a pandemic with potentially catastrophic consequences. A severe pandemic, which becomes “Event 201,” would require reliable cooperation among several industries, national governments, and key international institutions.”

Human Extinction and the Pandemic Imaginary by Christos Lynteris is published on 8 October 2019 in London (ISBN 9780429322051).

“This book develops an examination and critique of human extinction as a result of the ‘next #pandemic’ and turns attention towards the role of pandemic catastrophe in the renegotiation of what it means to be human.”

The Times: En suite loos, wi-fi and showers . . . but our trains can’t keep up with China’s

“Anyone with a real interest in business and global trade will have been in London last week. To look on as the government tried to enact Brexit legislation? No — to attend the World Chinese Entrepreneurs Convention.”

“… It is 30 years old, but came to Europe for the first time only last week. …

3,000 delegates from Chinese-owned businesses representing a large part of world trade were at the ExCel centre in Docklands for three days.

“What’s a girl to do when she gets an invitation to the key dinner for this event?.”

November

Johns Hopkins University: Pandemic simulation exercise spotlights massive preparedness gap: Event 201, hosted by the Johns Hopkins Center for Health Security, envisions a fast-spreading coronavirus with a devastating impact

“ONCE YOU’RE IN THE MIDST OF A SEVERE PANDEMIC, YOUR OPTIONS ARE VERY LIMITED. THE GREATEST GOOD CAN HAPPEN WITH PRE-PLANNING.”Eric Toner, Senior scholar, Johns Hopkins Center for Health Security

2020

Nature: Two decades of pandemic war games failed to account for Donald Trump

The scenarios foresaw leaky travel bans, a scramble for vaccines and disputes between state and federal leaders, but none could anticipate the current levels of dysfunction in the United States.

January

On January 20, 2020, CDC received a clinical specimen collected from the first reported U.S. patient infected with SARS-CoV-2. CDC immediately placed the specimen into cell culture to grow a sufficient amount of virus for study.

February

December

Reuters: Fact check: The virus that causes COVID-19 has been isolated, and is the basis for the vaccines currently in development

2021

Bulletin of the Atomic Scientists: The origin of COVID: Did people or nature open Pandora’s box at Wuhan?

Further Reading:

Global health and the new world order: Historical and anthropological approaches to a changing regime of governance Edited by Jean-Paul Gaudillière, Claire Beaudevin, Christoph Gradmann, Anne M. Lovell and Laurent Pordié

“The phrase ‘global health’ appears ubiquitously in contemporary medical spheres, from academic research programs to websites of pharmaceutical companies. In its most visible manifestation, global health refers to strategies addressing major epidemics and endemic conditions through philanthropy, and multilateral, private-public partnerships. This book explores the origins of global health, a new regime of health intervention in countries of the global South born around 1990, examining its assemblages of knowledge, practices and policies.

The volume proposes an encompassing view of the transition from international public health to global health, bringing together historians and anthropologists to analyse why new modes of “interventions on the life of others” recently appeared and how they blur the classical divides between North and South. The contributors argue that not only does the global health enterprise signal a significant departure from the postwar targets and modes of operations typical of international public health, but that new configurations of action have moved global health beyond concerns with infectious diseases and state-based programs.

The book will appeal to academics, students and health professionals interested in new discussions about the transnational circulation of drugs, bugs, therapies, biomedical technologies and people in the context of the “neo-liberal turn” in development practices.”

Global health and the new world order: Historical and anthropological approaches to a changing regime of governance Edited by Jean-Paul Gaudillière, Claire Beaudevin, Christoph Gradmann, Anne M. Lovell and Laurent Pordié

My background:

CASE STUDY 7: UNOSSC + UNDP | 2007 – 2016

CASE STUDY 5: GOSH/ICH Child Health Portal | 2001 – 2003

CASE STUDY 4: UN + UNDP Mongolia | 1997 – 1999

Hannah Institute For The History Of Medicine | 1992 – 1994

Lamas Against AIDS

Mongolian AIDS Bulletin

Philippine Conference Tackles Asia’s AIDS Crisis

Taking Medicine To The People: Four Innovators In Community Health

Take Two Big Doses Of Humanity And Call Me In The Morning

ORCID iD: https://orcid.org/0000-0001-5311-1052.

© David South Consulting 2021

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Study Says Jetliner Air Quality Poses Health Risks: CUPE Takes On Airline Industry With Findings Of Survey

By David South

Now Magazine (Toronto, Canada), March 11-17, 1993

Canada’s troubled airline industry is about to face some more turbulence, as the union representing more than 6,000 flight attendents presses its concern that many of its members’ health problems are related to poor air quality in jets.

The Canadian Union of Public Employees (CUPE) says its locals have compiled data that paints a fairly stale profile of in-flight air quality and its relationship to altitude, passenger load and length of flight. As part of the survey, the union recorded flight crews’ complaints of chest pains and lack of oxygen, as well as other work-related problems like back injuries, hearing loss and high incidence of colds and flu.

Of more interest to frequent fliers might be the opinion of some experts that even the more common jet lag may be caused by excess carbon dioxide, ozone and radiation. More than half the air in many aircraft is recirculated, “stale” air that is high in carbon dioxide and may be carrying bacteria and viruses, according to some experts.

CUPE health and safety chair Tracy Angles says the union now has enough evidence to at least pressure the carriers to undertake more comprehensive air quality studies. CUPE represents workers at Air Canada, Canadian, Nationair, Air Transat and some smaller feeder carriers.

While the union’s study is the first of its kind in Canada, a survey by the US department of industrial relations found, among other things, that flight attendents had 20 times the expected frequency of respiratory illness.

Flying mines

“Flight attendants have been equated with coal miners in terms of the bad air they have to breathe,” says Angles. “But this is not something the companies want to study.”

However, spokespeople for Air Canada and Canadian Airlines say they have not heard of such health problems. Jerry Goodrich of Canadian simply says, “It’s not an issue.”

However, while earlier-model jets supplied the cabin with 100 per cent fresh air, increasing fuel costs led to some modification. Modern jets mix fresh air – expensive to produce – with stale air from inside the cabin, which is passed through filters. The percentage of recirculated air in some aircraft, such as the popular Boeing 747-400, could be as high as 52 per cent, Boeing’s figures show.

Boeing’s Tom Cole says air circulation in Boeing’s jets is better than in an average office building, and that the passengers are “washed” with air to eliminate carbon dioxide and other hazards.

Critics like Georgia doctor William Campbell Douglass, publisher of the health newsletter Second Opinion, charge that the high rates of recirculated air, and the reliance on passengers’ own breath and perspiration to humidify the dry air, provide a perfect environment for bacteria and viruses. Douglass even speculates that planes could transmit serious diseases like tuberculosis. He suggests jet leg could be “nothing more than CO2 intoxification and oxygen starvation.”

“There is no doubt if you are in a confined space, you are at greater risk,” says University of Toronto microbiologist Eleanor Fish. “Aircraft filter systems aren’t sophisticated enough to filter out all the bacteria and viruses. But I’d be hard pressed to believe that you are at greater risk traveling on airplanes than on elevators.”

It is difficult for public health authorities to pin down the health risks of airplane travel because passengers disperse immediately after a flight. However, medical journals have documented two cases where virus transmission could be established because the passengers were easily traceable.

In 1977, 38 of the 54 passengers on a plane grounded in Alaska for a four and a half hours came down with the same strain of flu.

“We consistently hear complaints about certain aircraft,” says Angles. “The Airbus 320 is one of the worst.”

Angles says many airlines exacerbate the problem by over-crowding planes and flying them longer and farther than they were designed for.

Cut corners

“With deregulation, they have more people in there than was ever planned on. Nationair is a good example. A normal class Air Canada 747 carries about 420 people. In the all-economy configuration the load is upwards of 496.”

Angles also says airlines have been known to cut corners by turning down air flow to save money. In their 1990 book The Aircraft Cabin: Managing the Human Factors, Mary and Elwin Edwards cite a study indicating a 1 per cent saving on a fuel bill can be achieved by reducing the ventilation rate in a McDonnel-Douglas DC-10.

More resources: 

April 2021

Airqualitynews.com Terror at 20,000 feet

A new global campaign and film asks whether the air we breathe on commercial flights is as safe as we think it is.

Another issue, which frequently gets overlooked, is the quality of the air passengers breathe onboard

In February, a global campaign was launched by the Global Cabin Air QualityExecutive (GCAQE), which called for the mandatory introduction of effective filtration and warning systems, to be installed on all commercial passenger jet aircraft.

According to the GCAQE, there have been 50 recommendations and findings made by 12 air accident departments globally over the last 20 years, directly related to contaminated air exposures on passenger jet aircraft.

However, commercial aircraft continue to fly, with no contaminated air warning systems to inform passengers and crews when the air they are breathing is contaminated.”

Jetliner Cabins Are Quickly Cleared of Virus, Pentagon Says

“Particles the size of the new coronavirus are quickly purged from a commercial aircraft cabin, according to a U.S. Defense Department study touted by United Airlines Holdings Inc. in its effort to reassure wary travelers.

Filtration systems and rapid air-exchange rates mean that only about 0.003% of infected particles entered a masked passenger’s breathing zone, said the report, released Thursday.”

Aircraft Air Quality – Protecting Against Contaminants, Association of Flight Attendants

“On October 5, 2018, a 5-year FAA bill became law. Included in the bill is a study on technologies to combat contaminated bleed air. This is significant progress!”

‘Contaminated air’ on planes linked to health problems, 21 June 2017

AEROTOXIC SYNDROME: A NEW OCCUPATIONAL DISEASE?, Public Health Panorama, Volume 3, Issue 2, June 2017

Influenza Air Transmission, Influenza A (H1N1) Blog, September 28, 2009

“What does this tell us? Aerosols, very small particles of saliva containing the virus we exhale when we sneeze or even when we breathe if we have the flu, probably have an important role in the transmission of influenza. In addition to that we have public transportation, with a great number of people circulating in a place that may be closed and badly ventilated at times and we may have a notion of the importance of public campaigns that promote education and awareness of contaminated people to avoid leaving their homes when they have the flu and that they cover their mouth and nose with a disposable tissue when they sneeze and discard it right after that.”

2006

Tuberculosis and Air Travel: Guidelines for Prevention and Control

“The revised International Health Regulations, adopted in 2005, provide a legal framework for a more effective coordinated international response to emergencies caused by outbreaks of infectious diseases. A number of provisions are relevant to the detection and control of TB during air travel, strengthening the authority of WHO and of national public health authorities in this domain. Because of these important developments since the original guidelines were issued in 1998, WHO has prepared this revised version to take account of current public health risks that may arise during air travel and new approaches to international collaboration in dealing with them. The guidelines were developed with the collaboration of international experts in air travel medicine and other authorities. Implementing the recommendations will help to reduce the spread of dangerous pathogens across the globe and decrease the risk of infection among individual travellers.

An outbreak of influenza aboard a commercial airliner, American Journal of Epidemiology, Volume 110, Issue 1, July 1979

“A Jet airliner with 54 persons aboard was delayed on the ground for three hours because of engine failure during a takeoff attempt. Most passengers stayed on the airplane during the delay. Within 72 hours, 72 per cent of the passengers became III with symptoms of cough, fever, fatigue, headache, sore throat and myalgia. One passenger, the apparent Index case, was III on the airplane, and the clinical attack rate among the others varied with the amount of time spent aboard. Virus antigenlcally similar to A/Texas/1/ (H3N2) was Isolated from 8 of 31 passengers cultured, and 20 of 22 ill persons tested had serologic evidence of infection with this virus. The airplane ventilation system was inoperative during the delay and this may account for the high attack rate.”

The Airliner Cabin Environment and the Health of Passengers and Crew.

“At the end of its review of health data in the 1986 report The Airliner Cabin Environment: Air Quality and Safety, the National Research Council (NRC) committee concluded that “available information on the health of crews and passengers stems largely from ad hoc epidemiologic studies or case reports of specific health outcomes [and] conclusions that can be drawn from the available data are limited to a great extent by self-selection…and lack of exposure information” (NRC 1986). This chapter reviews data on possible health effects of exposure to aircraft cabin air that have emerged since the 1986 report and the emergence of data resources (e.g., surveillance systems) and studies that have particular relevance for the evaluation of potential health effects related to aircraft cabin air quality. Selected earlier sources are also reviewed. The decision to ban tobacco-smoking on domestic airline flights in 1987 and on flights into and out of the United States in 1999 reduces the relevance of some studies of exposures and reported signs and symptoms that clearly could have been related to the products of tobacco smoke.” 

ORCID iD: https://orcid.org/0000-0001-5311-1052.

© David South Consulting 2021

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Philippine Conference Tackles Asia’s AIDS Crisis

Mongolians attend for first time

By David South

UB Post (Ulaanbaatar, Mongolia), October 28, 1997

Manila, Philippines – More than 2,500 delegates have gathered in the steamy hot Philippine capital to renew the fight against HIV and AIDS.

Working up a sweat alongside other participants at the Fourth International Congress on AIDS in Asia and the Pacific are nine Mongolians – a first that isn’t going unnoticed.

The Congress opened Saturday (October 25) to the pounding beat of a theme song performed by teenagers, championing defiance of death and celebration of life.

That tone was echoed by Dr Peter Piot, executive director of UNAIDS, the Joint United Nations Programme on HIV/AIDS. He said the epidemic can be slowed down with the right public health measures – a positive message for Mongolia as it grapples with an STD crisis that many believe leaves the country at risk of an HIV/AIDS epidemic.

The magnitude of that epidemic outside Mongolia is startling. Around the world, 23 million people are infected with HIV, the virus that causes AIDS. Between 5 and 7 million of them live in the Asia/Pacific region.

“The point is that prevention is feasible,” Piot told the Congress. “The results can be seen in those countries in the Asia-Pacific region where the epidemic has stalled or is in retreat.

“A good indicator for unsafe sexual behaviour is the STD rate. I am impressed at the sustained decline in STD rates in Australia, Hong Kong, Singapore and Thailand over the past decade.

“But I am concerned actual declines in HIV in this region have occurred only in Australia, New Zealand and Thailand.”

The countries to Mongolia’s immediate south and north are experiencing exploding health crises. In China, HIV/AIDS is increasing at a rapid rate due to factors including growing prostitution, drug use and travel – all by-products of a booming economy. The infected population is estimated at 400,000 and is expected to reach 1.2 million by the year 2000, according to China’s national AIDS committee.

To the north in Russia, a complete collapse in the public health system has dramatically slashed life expectancy and led to an upsurge in many diseases, including tuberculosis and HIV/AIDS.

With many Mongolians doing business in both these countries, there are numerous opportunities for AIDS to enter the country.

A wide range of topics is under discussion at the gathering, with women, youth and STD-control measures of particular interest to the Mongolian delegates.

For the Mongolians, the Congress is an opportunity to learn from other countries’ successes and failures in the fight against AIDS.

Mongolia’s nine-member delegation includes four doctors – Dr K. Davaajav, head of the AIDS/STD Department of the Research Centre for Infectious Diseases, Health Ministry representative Dr S. Enkhbat. Medical University director Dr Lkhagvasuren and Dr Darisuren from the United Nations Population Fund.

Also in the team are Democrat MPs B. Delgermaa and Saikhanbileg, UNICEF’s B. Bayarmaa and two representatives from women’s NGOs: S. Tsengelmaa from the Women’s Information and Research Centre and N. Chinchuluun, executive director of the Mongolian Women Lawyers Association.

On Sunday, several presentations focused on the difficulties of getting people to use condoms.

In Fiji, studies found the majority of the population was aware of AIDS and had access to condoms, but still chose not to use them.

Lisa Enriquez, a Filipino woman who is HIV-positive, gave a sobering speech on the epidemic.

“One of the most important things I’ve learned from the epidemic is human nature. AIDS is such a humanizing disease. It reminds us of being human, complete with all the weaknesses and imperfections of being human.

“Let us not kid ourselves: changing behaviour is not easy. One doesn’t change because somebody tells him or her to do so.

“We will need to get our act together, institutionalize our efforts and continue working harder with passion and perserverance.”

The Congress continues until October 30.

More on the Congress here: Fourth International Congress on AIDS in Asia and the Pacific

“The Fourth International Congress on AIDS and Asia in the Pacific convened 3,000 scientists, people working in the communities, and people living with HIV/AIDS to discuss the state of AIDS in Asia and the Pacific and how the problem is being addressed now and into the future. The following topics addressed at the Congress are explored: the extent of the HIV epidemic, HIV risk behaviors, women and HIV, clinical manifestations of HIV infection, antiretroviral therapy, and perinatal HIV transmission. HIV is spread differently among these countries and a nation’s wealth largely determines its ability to execute prevention programs and patient access to therapy. Most patients in Asia pay for their own medications. It is hoped that more prosperous and technologically advanced nations will demonstrate stronger leadership and commitment in the fight against AIDS in the region.” Phanuphak P. Fourth International Congress on AIDS in Asia and the Pacific. J Int Assoc Physicians AIDS Care. 1998 Feb;4(2):22-5. PMID: 11365085.

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