November 13, 2016: According to United States Centers for Illness Control, in developing countries, a woman dies every two minutes from cervical cancer. Cervical cancer is the leading cause of deaths from cancer among women. This is a tragedy as cervical cancer is preventable as well as treatable.
This situation usually occurs where routine gynecological tests are not commonly available. Every year more than 4,000 women die from cervical cancer in Tanzania, despite the disease being preventable. The Precancerous lesions can be detected in time and removed.
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A new smartphone application known as cervical is created in Tanzania to help the women of Tanzania fight against cervical cancer.
Dr. James Edward said, “When I take the image, I can zoom it and see it in good view instead of going there to the cervix but when you take the image you can zoom in and see if there is a lesion.”
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For the women living in the foothills of Kilimanjaro, the burden of cervical cancer is all too familiar. A patient Frida Mtale said, “One day my aunt started to see a little liquid like she was menstruating. She went to the doctor. She was told it was cancer. “
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Karen Yeats leads the Kilimanjaro Cervical Cancer Screening Project in Tanzania. The team uses Smartphone to screen women for cervical cancer. Non-physician health workers use their phones to take a photo of the cervix which is then sent to an expert in the country. If cancerous areas are present, the expert transmits back the treatment instructions within minutes. The quick diagnosis is a boon to women in Tanzania.
The project is a government sponsored program, funded as Canada’s Grand Challenges. The project supports bold ideas in Science, business, and technology.
Health workers who aren’t able to make a diagnosis on their own use the app to send the photos to an expert in the country who receives a notification and in just a few minutes the expert helps the worker on the scene make a diagnosis. They have already trained over 100 health providers and screened thousands of women. Dr. Karen Yeats said, “We predict that by the end of the year we will probably be up around 7 to 8 thousand.” Because the Technology is mobile, she says her team will be able to reach even the remote parts of the country.
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The team has already received numerous requests to export the technology to other African countries.
For many cancer patients, this situation is a living nightmare as they face not only the threat of Covid-19, the pressure of lockdown restrictions but also intense uncertainty regarding the future of their cancer treatment and its associated outcome
The newly emerged Covid-19 virus has changed our lives in many ways. The lockdowns imposed by many countries have closed all but essentials services to prevent community transmission of the virus, with more stringent steps threatened as case numbers and mortality data grow by the minute.
Healthcare, an essential service at any time but never more so than in a crisis such as this, has been severely affected as the primary focus is shifted to the management of the crisis and other health emergencies rather than routine care.
Many elective surgeries are being deferred or delayed and patients are being advised to avoid non-essential hospital visits and switch to tele-consultation for arising problems.
For many cancer patients this situation is a living nightmare as they face not only the threat of Covid-19, the pressure of lockdown restrictions but also intense uncertainty regarding the future of their cancer treatment and its associated outcome.
Cancer patients are facing a stark choice regarding continuing treatment or delaying it to mitigate the Covid-19 risk. Many cancer patients in India travel huge distances to receive treatment but right now they cannot access treatment even if they wish to proceed as airlines and rail services are not operating.
Understandably, patients want concrete answers about when they can start cancer treatment, what the implications are if there is a gap in their treatment on their chances of recovery and the risks for their safety if they do attend the hospital.
There is no one-size-fits-all answer to these questions.
The psychological impact on patients and their families is starting to reveal itself.
The son of a recently diagnosed patients wrote to us: “My father has been diagnosed with kidney cancer with lung metastasis 21 days ago. His immunohistochemistry sample could not be processed in this lockdown and he was advised to stay at home considering his age of 83 years. I am worried about his cancer but at the same time this infection too.”
Another patient’s family wrote: “Is it safe to visit hospital for PET-CT as I have heard that cancer patients are more prone to catch infection?” His mother has colorectal cancer and is post-surgery and post four cycles of chemotherapy. She was scheduled for PET-CT for evaluation but was frightened to approach to the hospital in the lockdown.
In ordinary times, cancer patients face uncertainty and have to fight on many fronts to deal with the economic, social, family and personal challenges that a cancer diagnosis brings. During active treatment cancer patients require frequent hospital visits, pre-operative & post-operative stays, chemotherapy sessions, laboratory tests and radiological imaging, daily appointments for radiotherapy sessions (often over weeks). Extended hospital visits mean that cancer patients, many of whom are immunocompromised as a result of the side-effects of treatment, are more likely to be exposed to infection.
Data emerging from many countries affected by the pandemic suggests that the majority of the Covid-19 patients who require hospitalisation are suffering from heart disease, respiratory disease, diabetes, hypertension or cancer.
Here we have tried to address many of the concerns of cancer to minimise the fear and uncertainly related to cancer treatment and its outcome amidst this Covid-19 crisis.
Which cancer patients are at high risk for coronavirus infection?
Cancer patients who are older (more than 70) and having one or more associated co-morbidities, i.e., cardiovascular diseases, hypertension, diabetes, and lung diseases are at high risk for coronavirus infection.
What are the symptoms of coronavirus disease in cancer patients?
Coronavirus diseases are associated with symptoms which include fever, a new persistent dry cough, difficulty in breathing, fatigue, sore throat. New evidence suggests some patients are experiencing the loss of smell and taste. Presentation of the disease is not different in cancer patients but chances of progression to severe or critical diseases are more common with cancer patients.
What are the chances of getting coronavirus infection if cancer patients come to hospital for their treatment?
Chances of getting coronavirus infection does increase with frequent hospital visits. It has been reported between 10 – 30% in reports from different hospitals in China where Covid-19 patients were getting treatment.
Should I visit the hospital?
In this present scenario, the best advice is to minimise the hospital visits for cancer patients and that tele-consultation can be a good alternative to avoid direct contact between patients and cancer care provider for the vast majority of routine appointments.
I am currently having cancer treatment. Should I continue my treatment or stop it as I have to go to hospital frequently for my treatment.
No cancer patients should halt, postpone or cancel their treatment as stated in guidelines from various cancer institutions/societies/hospitals. Patients who are in hospital must adopt the contact and droplet precautions, which means wearing a mask, covering outdoor clothes and extra sanitation steps. Hospital staff should be following the same guidelines. Discuss how to minimise visits with your healthcare provider or if any procedures can be done at home.
My cancer doctor has advised to me delay the surgery/chemotherapy/radiotherapy. Should I follow my doctor’s advice or get surgery/chemotherapy/radiotherapy done at another hospital?
There is a time limit on how long someone can delay cancer treatment without it impacting their recovery. Patients need to have a discussion with their cancer care provider about their unique circumstances. One size does not fit all. In some cases, patients may be reasonably advised to switch to other treatment modalities. If there is an issue related to transportation and stay, patients are encouraged to start the treatment at the nearest cancer centre where appropriate treatment is available rather than travel.
What precautions should cancer patients take amidst the coronavirus crisis?
Cancer patients are advised to practice social distancing, maintaining at least a two-metre distance from anyone who does not share their home. Regular handwashing with soap or alcohol-based hand rub is a necessity. If a member of your household develops Covid-19 symptoms such as cold, cough or fever they should self-isolate as much as is reasonably practical. Patients are advised to avoid crowded places and stay in well-ventilated rooms. Patients are advised not to shake hands and organise longer prescriptions for regular medicines well in advance of running out.
I have been receiving information on WhatsApp, Facebook and other sources about coronavirus prevention and treatment. How can I confirm what is real and what is fake?
A lot of incorrect information has been circulating leading to fear and uncertainty. There are trustworthy information sources available, being updated regularly as new evidence emerges and is evaluated by experts such as the World Health Organization (WHO) and the Indian Council of Medical Research (ICMR). Patients and their caregivers should use these and not rely on social media.
In conclusion, cancer patients and caregivers are facing difficult decisions to understand and weigh up the risk and benefits of continuing treatment in its current form in this crisis.
Although current guidelines support the continuation of treatment where possible, patients must talk to their individual cancer care provider to explore if their treatment should be reasonably modified in the ways outlined above to reduce their individual risks of exposure to Covid-19.
(Dr. Abhishek Shankar is Assistant Professor in Radiation Oncology at Lady Hardinge Medical College & SSK Hospital, Delhi. Dr. Deepak Saini is Project Officer at Cancer Control and Prevention Division of Indian Society of Clinical Oncology, Delhi. Views expressed are personal.)
As the coronavirus pandemic dominates global news in the United States, progress toward the next presidential election scheduled to be held on November 3 moves slowly forward. President Donald Trump had no real opposition in the Republican party and is running for re-election. And it has now become apparent that former Vice President Joe Biden will be his opponent as the Democratic candidate for president.
What would a Trump victory bode for the future of US-India relations? What would a Biden victory bode? Let me answer each of those questions in turn.
Given the love fests of Prime Minister Narendra Modi’s ‘Howdy Modi’ event in Houston, Texas, in which Trump participated in September of 2019, and Trump’s ‘Namaste Trump’ event hosted by Modi in India in February of this year, it might be assumed that the future for US-India relations is a splendid one. This would be an incorrect assumption.
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Both of these events were more symbolic than substantive. Trump’s participation in them undoubtedly helped to persuade some — perhaps many — Indian American Modi supporters who voted for Hillary Clinton in 2016 to cast their ballots for Trump in 2020. Trump’s campaign team took steps to ensure this by holding an event at his Mar-a-Lago resort in which a group of prominent Indian Americans announced their plans to work for his re-election and to mobilize Indian Americans on his behalf.
To understand the future potential of India’s relations with the US. with Trump as president, however, it is necessary to look beyond these political moves and to examine the present state of those relations and Trump’s personal style.
In a word, the best way to characterize the current relations between the US and India is “functional”. The relationship was relatively good for the first two years of Trump’s presidency. In fact, near the end of 2018, Alice Wells, the Acting Assistant Secretary of State for South and Central Asia, was quoted in the media s saying: “This has been a landmark year for US-India ties as we build out stronger relationships across the board.”
Then, in 2019, the relations went off the track in the first half of the year after the US and India got into a tit-for-tat tariff war after the US terminated India’s Generalized System of Preferences which allowed India to send certain goods to the US duty-free. There have been continuing efforts to structure a “modest” trade deal since then. It was thought there might be some type of deal done in September of 2019 while Modi was in the US by year’s end, and then during Trump’s India visit. But, as of today, there is still no deal.
This inability to get any meaningful trade agreement in place speaks volumes about India’s potential future relations with India with Trump as president. So, too does Trump’s style.
Trump’s campaign slogans this time around are “Keep America Great” and “Promises Made, Promises Kept.” Trump is not a policy wonk and most of his effort will go toward “America First”. This involves making the US more isolated by withdrawing from international agreements, restructuring trade agreements, emphasizing building walls to stop immigrants at the border, using tariffs to block trade with countries who are taking away American jobs, and confronting businesses who are allegedlly stealing American trade secrets.
This perspective suggests what India can expect for its relations with the US if it has to deal with Trump for a second term as president. The relations will stay functional at best. As I have said before, that’s because the words partnership, cooperation and collaboration are not in Trump’s vocabulary. Nationalism, isolationism and protectionism are.
Joe Biden stands in stark contrast to President Trump both professionally and personally. Biden is a strategic thinker and doer with a solid eight-year track record of leadership experience as Vice-President in forging alliances that have made a difference around the world and he has also been a long-standing friend of India.
He was chairman of the Senate Foreign Relations Committee and a leading advocate for the Congressional passage of the Indo-US civic nuclear deal in 2005. At a dinner convened 10 years later in 2015 by the Confederation of Indian Industry and the Carnegie Endowment for International Peace, Vice President Biden discussed the tremendous joint progress that had been made by the two countries in the past and declared “We are on the cusp of a sea change decade.”
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Early in his campaign for the Democratic nomination for president in July of 2019, in laying out his foreign policy vision, Biden stated that the US had to reach out to India and other Asian partners to strengthen ties with them. The items on Biden’s foreign policy agenda for strengthening which are of importance for India include climate change, nuclear proliferation and cyberwarfare.
During his vice presidency, Biden worked side by side with President Barack Obama to do things that would contribute to achieving Obama’s vision stated in 2010 of India and America being “indispensable partners in meeting the challenges of our time.” In 2020, those challenges are even greater than they were a decade ago.
That is why it is so essential that India and the US develop a strategic relationship that enables them to become those indispensable partners. That can happen if Biden assumes the presidency on January 20, 2021. It cannot happen if Donald Trump remains as president for a second term.
The results of this upcoming election in the US matter greatly for the future of the United States. They matter greatly for the future of India-US relations as well. Time and the American electorate will tell what that future will be. (IANS)
Health Minister Dr. Harsh Vardhan emphasised on Social Distancing saying, “Social Distancing and lockdown are the strongest vaccine against COVID-19 at the moment,” during an International Conference on COVID-19: Fallout and Future.
Dr. Harsh Vardhan addressed the International Conference on COVID-19: Fallout and Future organized by Bennett University on April 9, 2020.
Dr. Vardhan spoke about how India has taken all the necessary steps to prevent coronavirus in India and also gives the latest updates on COVID-19 news.
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The minister said that more than a lakh people were trained and educated about the COVID-19 pandemic. These included aviation crew, airport staff, healthcare professionals, etc. Over 2,500 Indians have been evacuated from various countries. There have been dedicated ICU beds and ventilators for COVID-19 patients.
The health minister highlighted that the even bigger challenge than containing COVID-19 is to stop the spread of misinformation. The minister said, “Anyone who wants authentic information about coronavirus should go through the website of Ministry of Health and Welfare to obtain information.”
He also thanked healthcare professionals saying, “I would like to thank all the COVID-19 warriors to fight this war against coronavirus.”
The health minister advises that N95 and surgical masks aren’t to be worn by all citizens but only medical staff due to the shortage. The basic necessity is to cover your mouth using any cloth or cotton mask which can also be homemade.
Talking about the positive aspects, Health Minster Dr. Harsh Vardhan said, “COVID-19 is a blessing in disguise. Most of the medical equipments used to be imported but now with the help of Ministry of Textiles, we have found manufactures in India.”
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“We are in constant touch with the World Health Organization and the WHO has appreciated the efforts taken by the Government of India and Ministry of Health to contain coronavirus,” said Dr. Vardhan.
Many other professionals were present in the conference. These include. Dr. David Nabarro, the special envoy for WHO, Mr. Arvind Virmani, an economic advisor, Mr. Subash Chandra Garg, the former finance secretary of India,Gurcharan Das, Prof. Wenjuan Zhang, Prof. Beatrice Gallelli, Eoghan Sweeney, Irene Jay Liu, a data journalist, Prof. Rasmus Nielsen, Prof. Ashish Kumar Jha and many more.
Other presenters talked about the economic, social and political impacts of the pandemic.
Dr. David Nabarro, the special envoy for the World Health Organization said that all the information given by WHO is based on researches done by scientists and doctors.
Gurcharan Das, an Indian author said, “Biggest failure of the government is not testing enough.” He also said that the Modi government is in a ‘Dharam sankat’ and faced a challenge on whether to lift the lockdown or not.
Mr. Subhash Chandra Garg, the former finance secretary of India believes that there should be a partial lockdown in India.