eLetters

183 e-Letters

  • Excellent summary of the context to the current flare-up of violence in the Middle East.

    The authors and the editors at BMJ GH should be greatly commended for producing such an honest and informative piece about the context and background to the current flare-up of violence in Palestine. I hope they are able to stay firm, true to their convictions, and withstand the backlash they will inevitably receive from some of their employers/affiliated institutions. Taking a stand for an oppressed and largely voiceless people with little agency is always the right thing to do.

    Kind regards,

    Osman A Dar

  • Dr Ann Robinson

    Humanitarian crises require a response that demonstrates compassion and concern for all concerned. This editorial failed to do that. If doctors cannot acknowledge the suffering of all humanity, what hope is there? I despair.

  • The roots of the Israeli Palestinian conflict

    The recent war that was forced on Israel by war criminals who committed war crimes killing hundreds of children, women (including pregnant women), and octogenarians, youngsters in a peace festival, whose only crime was that they dreamed to live in harmony and peace with the people of Gaza. The civilians who live in the Kibbutzim near Gaza believed for dozens of years that peace and cooperation are feasible with their neighbors who live in Gaza. They were murdered brutally, cutting arms and legs of children and women while they were alive begging for some mercy or burning them alive.
    The state of Israel was under the British Mandate from 1917 till 1948. Before that the Turkish Empire ruled the whole region starting in 1516. The state of Israel was born in 1948, with a United Nations partition plan for Palestine with a clear statement that the land will be shared between Jews and Arabs. The Arabs refused to accept the UN decision and opened a war, with a clear declaration to kill all the Jews who arrived to Israel after escaping the horrors of the Holocaust. The Jews had no option but to fight back and they won the war against all odds (even though they were numerically inferior). The Arabs who ran away became refugees.
    This is the true and the only story. Instead of focusing on development of science, education, industry, medicine and tourism, the people of Gaza decided to be led like sheep by Iran who is using them for its own geopolitical ambitions.
    Afte...

    Show More
  • Artificial intelligence as a threat for global health

    Federspiel et al. (1) argue that the health literature on AI focuses on its benefits but neglects its potential harms, particularly in clinical settings. They highlight four concerns: disinformation and surveillance, lethal autonomous weapon systems, job loss, and the existential threat of artificial general intelligence (AGI). To mitigate these threats, the authors propose supranational regulations and increased awareness. However, further exploration is needed regarding overlooked threats, the impact of AGI on global health, and appropriate responses.

    The widespread adoption of AI in healthcare systems poses new threats that often go unnoticed. First, integrating AI into healthcare blurs the boundary between clinical care and population health, making it difficult to separate the global from the individual. This creates challenges when using AI to connect personalized medicine and precision public health, as it can impact social determinants of health and exacerbate disparities in healthcare accessibility and discrimination. Second, the success of AI systems can lead to a two-tier healthcare system that would lead to diminished ability to provide human-centred care and may incur high costs with suboptimal outcomes if AI systems are ineffective or only benefiting some peoples. Third, the growing creation and use of synthetic data to optimize AI systems present a solution for more comprehensive models, but it also poses a risk of bias and tropism as it aims to incre...

    Show More
  • We do not need more International Health Regulations - It is the WHO that needs to reform

    We read with interest the suggestions of Jackson and colleagues (1) in the context of the revision of the International Health Regulation and the WHO’s proposed pandemic treaty. By narrowly framing the acrimony around the COVID-19 pandemic responses, as a dispute between resource-poor countries (LMICs) on the one hand and industrially developed countries on the other, the authors seem to be missing the woods for the trees.

    The lockdowns, vaccine mandates and restrictions on the freedom of movement of the unvaccinated, were violations of the Nuremberg Code (2) and an assault on the freedoms enshrined in the Universal Declaration of Human Rights (3). People from both rich and poor nations were adversely affected.

    The prescriptions were irrational as they were unreasonable. Children were kept out of schools although the majority were not at risk of harm from contracting COVID-19 and they had the potential to safely increase herd immunity if only the vulnerable were isolated. Vaccine passports, which allowed vaccinated persons travel privileges, were perpetuated even after it was known that the vaccine would not stop the person-to-person spread of the disease.

    The public protested these encroachments on their freedoms and rights in many industrialised countries, in both democratically elected countries like Canada (4) France (5) Australia (6) New Zealand (7) and also in China with its draconian laws (8). In the end, even China was forced to bow down to...

    Show More
  • Breast feeding increases Prolactin and DHEA

    I suggest the basis of Mineva, et al., is dehydroepiandrosterone (DHEA). A case may be made that breast feeding increases DHEA; prolactin is directly connected with secretion of breast milk. Prolactin is a direct and specific stimulus for DHEA production. Low prolactin is frequently found in viral infections, including RSV.

  • The CoViD-19 pandemic at the human-animal interface: Lessons for the present and the future

    Since the start of the CoronaVirus Disease-2019 (CoViD-19) pandemic, which has hitherto killed almost 7 million people worldwide - although the true mortality figures could be much higher -, we have witnessed a progressively expanding number of domestic and wild mammalian species acquiring Severe Acute Respiratory Syndrome CoronaVirus-2 (SARS-CoV-2) infection, both spontaneously and experimentally (Di Guardo, 2022b).
    The progressively expanding SARS-CoV-2 host range, hitherto encompassing more than thirty wildlife and domestic species, could be plausibly linked, among others, to the development of new, highly contagious and/or pathogenic variants of concern (VOCs) and variants of interest (VOIs) of this pandemic betacoronavirus.
    Over the past three years, in fact, a huge number of mutational events were recorded in the genetic make-up of SARS-CoV-2, with this leading to the global appearance of several VOCs and VOIs (such as those termed "alfa", "beta", "gamma", "delta" and the highly contagious and immune-evasive "omicron", alongside its BA.1-BA.5 subvariants and the more recently identified ones named "Centaurus”, “Chiron”, “Gryphon”, “Cerberus”, followed by the newly emerged and highly transmissible "Kraken"). The progressive acquirement of “non-silent” mutations in the SARS-CoV-2 genome is directly connected to enhanced viral replication and, provided that the virus genetic make-up consists of...

    Show More
  • Better Support is Needed for Individuals with Hearing Loss

    During the Covid-19 pandemic, I became acutely aware of my own worsening hearing issues. As I struggled to hear what my colleagues, patients and friends were saying muffled behind masks, I realized that I needed hearing aids. Even though I work closely with deaf and hard of hearing patients, I was shocked by the expense. The average cost of a pair of prescription hearing aids is $2500 US.1 As a physician, I could pay out of pocket, but most of my own patients can’t afford this luxury.
    Approximately 17% of American adults have some hearing loss, with over 28 million potentially benefiting from hearing aids.2 However, many insurances, including traditional Medicare plans, currently do not cover this benefit. Paying for hearing aids out of pocket is unrealistic, as on average, individuals who are hard of hearing more likely to be unemployed or underemployed and have lower incomes compared to those who are not.3
    We now have lowered the costs for hearing aids and made them more easily accessible, but for those who need assistance, over the counter hearing aids may not be enough. We need to ensure access to the latest technology and the proper tools to use hearing aids effectively.
    We also must remember that individuals who are deaf or hard of hearing continue to face significant barriers to accessibility, especially in the healthcare system. Video technologies used in lieu of in person interpreters, may be unreliable and difficult to operate. As a result, p...

    Show More
  • Author equity of access guidelines: at least there has been some progress

    I am very glad to see this article and the research that went into it. Although the findings are disappointing on their own, an historical perspective would show they are certainly a sign of some progress compared to the days when no journal at all considered the issue of equity in authorship, let alone in peer review or subject matter. In 1992, Sundari Ravindran and I founded the journal Reproductive Health Matters (RHM). We published an issue twice a year with an editorial and 20-25 articles that included features, original research, commentaries and news summaries. We formed an Editorial Advisory Board and a Board of Trustees so as to become a charity early on, and began listing their names in the journal in 1997. One of the most important policy decisions our joint board meetings made, also around 1997, was related to equity of authorship and equity in other forms of participation, e.g. in peer reviewing. We also began to publish shorter editions of the journal with some the papers, which were translated into Spanish, French, Arabic, Chinese, and Hindi by editors from the countries/regions represented by those languages.

    The journal, published by Elsevier Science, was open access throughout the time RHM existed, because we raised donor funds to pay them for this. In my opinion, if a journal is not open access, then ensuring equity of access to publication is not possible, because the authors most likely to be given grants to pay for open access are more likely...

    Show More
  • Reduction in neonatal mortality

    To,
    The Editor,
    We read with interest the article on ‘Deliberation-based learning: strengthening neonatal care in China’ by Yingpeng et.al. that has appeared in the September 2022 issue of BMJ Global health. The strategies evolved by the Govt. seem to have worked. They held detailed deliberations with staff and patients that helped in better neonatal care. On this backdrop, we submit observations from India to accentuate their study.
    The Sample Registration System of India released its data on 22nd September 20222, which has shown some promising figures.SRS data shows that U5MR( Under 5 mortality rate) to be 32 per thousand live births, IMR(Infant mortality rate) to be 28(87.5%) and NMR(Neonatal mortality rate) to be 22 (68.75% of total and 78.5 % of the IMR). This more than amply describes divergent age pattern in mortality statistics of India in 2020.
    In 2014 U5MR was 45, IMR 39(86.6%) and NMR 26(57.7of total and 66.6% of the IMR).It is thus clear that neonatal mortality as a subcomponent of IMR has declined more in terms of percentage. This probably is the result of many policy changes in national programs started by the Govt. of India like HBNC3(home based new born care), HBYC( Home based young child care), exclusive breast feeding , MAA( mother’s absolute affection)and KMC( Kangaroo mother care) . All these programs involve health professional staff to advocate and parents (caregivers) to participate. Empowerment of the mother is critical....

    Show More

Pages