Current treatments including opioids, injections and surgery to treat lower back pain — the leading cause of disability globally — are useless, unnecessary and harmful, finds a series of studies in The Lancet. Globally, lower back pain affects more than 540 million people and the condition has doubled in the last 25 years.
The prevalence of the condition is expected to continue to increase with an ageing and increasingly obese population. Medical care with inappropriately high use of imaging, rest, opioids, spinal injections, and surgery is making the problem worse in both developed and developing countries, the findings showed.
“The burden from low back pain has reached a tipping point where the condition is growing rapidly, is poorly understood and is being mismanaged medically — at cost both to the patient and to the healthcare system,” said Rachelle Buchbinder, Professor at the Monash University in Melbourne.
“Low-and middle-income countries are already emulating the low-value care that is endemic in high-income countries. “Across the globe (there is) inappropriately high use of imaging, rest, opioids, spinal injections and surgery. Doing more of the same will not reduce low back pain disability nor its long term consequences,” Buchbinder said.
People with physically demanding jobs, physical and mental comorbidities, smokers, and obese individuals are at greatest risk of reporting low back pain.
The researchers call for a coordinated international leadership to drive transformational change across health and social services and occupational settings to stop fragmented and outdated models of care. They also call for avoidance of the harmful and useless medical treatments through the adoption of a similar framework to drug regulation.
Public health campaigns need to address the widespread population and health professional misconceptions about the causes and prognosis of low back pain and the effectiveness of different treatments. IANS
A medical facility specifically catering North Korea’s privileged elites has been forced to open its doors to common citizens in exchange for bribes, in an effort to stem financial difficulties, sources say.
Pyongyang’s Bonghwa Medical Center offers top-notch medical care, but has officially only been available to Kim Jong Un and Workers’ Party officials of the highest ranks.
Now strapped for cash, the hospital will admit anyone who greases the palms of the right people. While health care is officially free for all citizens, hospitals for elites, like Bongwha are a step above what citizens typically have access to.
“My nephew is a doctor and he has been suffering from stomach problems for more than 10 years. He was [recently] treated at Bonghwa Medical Center and has been healed completely,” said a source from North Pyongan province in an interview with RFA’s Korean Service.
“It cost him a lot of money to get treated [there], but now I have come to realize that money can do anything,” said the source.
The source said Bonghwa is known as “the best hospital in the Republic,” and that it is reserved for politically important people, expressing disgust that it could now be bought into.
“It is surprising that ordinary people can [get] medical treatment [there] if they bribe them. I feel bitter because there’s nothing money can’t do in this society,” said the source.
The source noted that bribery is not unique to Bonghwa — other well-regarded hospitals are doing the same.
“Well-known hospitals in Pyongyang, including Kim Man-yu Hospital, Namsan Hospital, and the Red Cross Hospital are treating a number of ordinary patients from other regions. They are getting medical treatment because they have bribed high-rank officials,” said the source.
The source said that patients of Bonghwa and the other hospitals have access to medicines that aren’t available to the general public, but these too come with a hefty price tag for the patients who have bribed their way in.
“Since they are not high-ranking officials, ordinary patients have to pay a lot for these prescription drugs. It’s like the hospitals are earning foreign cash off patients,” the source said.
Even if a patient has the means to get into the good hospitals, the level of care can still differ depending on how much was paid in bribe.
“If you give a large amount, they will even treat you better than a high-ranking official from the Central Committee [of the Workers’ Party.]”
A North Korean defector surnamed Lee who settled in South Korea confirmed the North Korean medical industry’s state of affairs.
“In the past, hospitals that have been designated only for high-ranking officials in Pyongyang have ignored their mandate and provided care to ordinary patients,” said Lee, adding, “Without taking bribes from these people, it would be difficult for hospitals to stay open, and for doctors to make an actual living.”
“That’s just how things are in the North Korean medical industry,” said Lee.
“Medical equipment and hospital supplies provided by the outside world, supposedly as humanitarian aid, all go to these elite hospitals,” said Lee.
“The hospitals are for privileged people, but since state support is so small, they would be difficult to run properly without extra money from ordinary patients,” Lee said.
In 2010, the World Health Organization controversially described North Korea’s universal health care system as “the envy of the developing world,” contradicting a report from Amnesty International that same year that said the country’s hospitals were barely functioning and unable to deal with epidemics and rampant malnutrition.
In February, The New Humanitarian published a report describing North Korea’s “silent health crisis,” which acknowledged a recent improvement in public health within the country, but described its health system as inadequate. The Geneva-based news outlet founded by the United Nations said that a formal peace agreement with the United States and South Korea would not in and of itself improve North Korea’s health care situation. (IANS)