scholarly journals Caring for Children With Life-Limiting Illness in Bloemfontein, South Africa: Challenging the Assumptions of the ‘Good Death’

2020 ◽  
pp. 003022282094409
Author(s):  
Callie Daniels-Howell
Keyword(s):  
Hospice Care ◽  
Meaning Making ◽  
Good Death ◽  
Resource Limited Settings ◽  
High Resource ◽  
Resource Limited ◽  
Resource Setting ◽  
Alternate Forms ◽  
Open Discussion ◽  
And Control

Theories of good death focused on acceptance, control, and meaning-making inform adult palliative care in high-resource settings. As children’s palliative and hospice care (CPHC) develops in resource-limited settings, critical conceptualisations of a good death for children across these diverse settings are unknown. Assessed against high-resource setting tenets of good death from carer perspectives, results suggest: carer agency is limited; advanced discussion of death does not occur; distress results from multiple burdens; basic survival is prioritised; physical pain is not an emphasised experience; and carers publicly accept death quickly while private grief continues. Hegemonic conceptions of ‘good death’ for children do not occur in contexts where agency is constrained and discussing death is taboo, limiting open discussion, acceptance, and control of dying experiences. Alternate forms of discourse and good death could still occur. Critical, grounded conceptualisations of good death in individual resource-limited settings should occur in advance of CPHC development to effectively relieve expansive suffering in these contexts.

scholarly journals Establishment and Management Of COVID-19 Testing Molecular Laboratory in Minimal Resource Setting, Challenges and Issues Reported From Birgunj, Nepal – An Experience of Pathologist

Med Phoenix ◽  
2021 ◽  
Vol 6 (1) ◽  
pp. 66-70
Author(s):  
Neera Pathak ◽  
Madan Kumar Upadhyay ◽  
Varsha Manandhar
Keyword(s):  
Economic Status ◽  
Temporal Distribution ◽  
Geographic Location ◽  
Molecular Testing ◽  
Resource Limited Settings ◽  
Testing Laboratory ◽  
Resource Limited ◽  
Resource Setting ◽  
Suitable Space ◽  
A Chain

The Coronavirus pandemic is recording numerous deaths worldwide. The temporal distribution and burden of the disease varies from setting to setting based on economic status, demography and geographic location. Nepal reported the first COVID-19 case on January 23, 2020. A rapid increase in the number of COVID-19 cases was being reported in Nepal as of June 2020. Limited molecular laboratory capacity in resource limited settings is a challenge in the diagnosis of the ever-increasing cases and the overall management of the disease. In this article, we share the experience, challenges and prospects in the rapid establishment of  COVID-19 testing laboratory in Birgunj from available resources. We provide empirical evidence from Parsa district, as this is one of the SARS-CoV-2 transmission hotspots in Nepal and it  is likely generalizable to other similar settings in the country. The first step in establishing the COVID-19 molecular testing laboratory were i) identifying a suitable space ii) renovating it and iii) mobilizing materials including consumables, mainly from the hospital store and administration. A chain of experimental design was set up with distinct laboratories to standardize the extraction of samples, preparation of the master mix and detection. At the commencement of sample reception and testing, laboratory contamination was among the primary challenges faced. The source of the contamination was identified in the master mix room and resolved. In summary, the established COVID-19 testing lab (Narayani PCR Lab) has tested more than 40,000 samples (January 2021) and is now the preferred setting for CoVID-19 testing. The lessons learnt may benefit the further establishment of testing laboratories for COVID-19 and/or other epidemic/pandemic diseases in resource-limited settings.

scholarly journals Cardiac ultrasound in resource-limited settings (CURLS): towards a wider use of basic echo applications in Africa

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Michaëla A. M. Huson ◽  
Dan Kaminstein ◽  
Daniel Kahn ◽  
Sabine Belard ◽  
Prakash Ganesh ◽  
...  
Keyword(s):  
Heart Failure ◽  
Point Of Care ◽  
Left Ventricular ◽  
Sub Saharan Africa ◽  
Point Of Care Ultrasound ◽  
Cardiac Ultrasound ◽  
Resource Limited Settings ◽  
High Resource ◽  
Resource Limited ◽  
Context Specific

Abstract Background Point-of-care ultrasound is increasingly being used as a diagnostic tool in resource-limited settings. The majority of existing ultrasound protocols have been developed and implemented in high-resource settings. In sub-Saharan Africa (SSA), patients with heart failure of various etiologies commonly present late in the disease process, with a similar syndrome of dyspnea, edema and cardiomegaly on chest X-ray. The causes of heart failure in SSA differ from those in high-resource settings. Point-of-care ultrasound has the potential to identify the underlying etiology of heart failure, and lead to targeted therapy. Based on a literature review and weighted score of disease prevalence, diagnostic impact and difficulty in performing the ultrasound, we propose a context-specific cardiac ultrasound protocol to help differentiate patients presenting with heart failure in SSA. Results Pericardial effusion, dilated cardiomyopathy, cor pulmonale, mitral valve disease, and left ventricular hypertrophy were identified as target conditions for a focused ultrasound protocol in patients with cardiac failure and cardiomegaly in SSA. By utilizing a simplified 5-question approach with all images obtained from the subxiphoid view, the protocol is suitable for use by health care professionals with limited ultrasound experience. Conclusions The “Cardiac ultrasound for resource-limited settings (CURLS)” protocol is a context-specific algorithm designed to aid the clinician in diagnosing the five most clinically relevant etiologies of heart failure and cardiomegaly in SSA. The protocol has the potential to influence treatment decisions in patients who present with clinical signs of heart failure in resource-limited settings outside of the traditional referral institutions.

scholarly journals Social Stigma and Other Consequences of COVID-19 Pandemic in Low Resource Setting, in Eastern Africa: The Need to Increase Preventive Efforts and Addressing the Consequences, 2020

2020 ◽  
pp. 1-4
Author(s):  
Shewangizaw Haile Mariam ◽  
◽  
Mengistu Abayneh ◽  
Keyword(s):  
Social Stigma ◽  
Health Impact ◽  
Social Consequences ◽  
Eastern Africa ◽  
Care Services ◽  
Resource Limited ◽  
Resource Setting ◽  
Low Resource Setting ◽  
Health Related ◽  
And Control

Since the emergency of COVID-19 pandemics, many countries have been encountered a multitude of challenges. People have been facing health related and other social consequences throughout the world. It is too early to know the aggravated impact of COVID-19 on people living in resource-limited setting, like east Africa countries. In these countries, besides direct public health impact, the COVID-19 pandemic has provoked social stigma and discriminatory behaviors against people of certain ethnic backgrounds as well as anyone perceived to have been in contact with the virus. Social stigma can negatively affect those with the disease, as well as their caregivers, family, friends and communities. COVID-19 pandemics have also been provoked great impacts on daily social consumptions such as food and other food supplements. In addition, COVID-19 pandemic were overshadowed endemics diseases such as malaria, TB and HIV related care and antenatal care services as well as other non-communicable diseases prevention and control. Social stigma coupled with other consequences could result in more severe health problems, can undermine social cohesion and prompt possible social isolation of groups, which might contribute to a situation where the virus is more, not less, likely to spread and difficulties controlling a disease outbreak. Therefore, how we communicate about COVID-19 is critical in supporting people to take effective action to help combat the disease and to avoid fuelling fear and stigma. An environment needs to be created in which the disease and its impact can be discussed and addressed openly, honestly and effectively. This is a message for government, media and local organizations working on the COVID-19 infections.

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