(I am not a) Vessel: the importance of women’s reproductive rights

(I am not a) Vessel: The importance of women’s reproductive rights
Rebecca Blaylock is a student on the Master of Public Health programme at Imperial and here makes the case for increased access to reproductive healthcare.


Students from Imperial’s Master of Public Health programme recently organised a screening of the award-winning film “Vessel”. Vessel chronicles the story of Dr Rebecca Gomperts – a former doctor on a Greenpeace ship – who had an innovative idea to provide women with vital reproductive health services. During her time travelling the world with Greenpeace, Gomperts witnessed the unbearable suffering caused by unsafe abortions. She saw women haemorrhage to death, die from sepsis and sustain life-long disabilities, and refused to “stand there and just let that happen”. Around 25 million unsafe abortions take place every year, accounting for between 4.7 and 13.2% of global maternal deaths.

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Leprosy in 2018: an ancient disease that remains a public health problem today

World Leprosy Day. Image courtest of Wellcome Collection.

28 January 2018 is World Leprosy Day

I have always found leprosy a fascinating disease. It is an incredible example of how microbiology, immunology, and social sciences can collide and impact significantly on human health.

Leprosy has been affecting humans for at least 4000 years. It has played a huge part in teaching us about disease caused by bacteria. In 1873 when Hansen discovered Mycobacterium leprae in tissue samples from patients with leprosy, this became the first bacteria to be directly linked to causing disease in humans. Since then we have developed an understanding of the complex range of types of leprosy that occur depending on how an individual’s immune system responds to the challenge of infection with Mycobacterium leprae. We have also observed the consequences of the deformities and disability caused by the body responding to Mycobacterium leprae, which favours human nerves and skin. In turn, we have seen how the appearance of individuals with disability and disfigurement from leprosy has driven stigma, misinformation, and the discrimination of those affected by the disease.

For many people in the UK and around the world, leprosy, or Hansen’s disease, is an ancient condition of our ancestors. It is something that we hear about in religious scripture or watching films like Ben-Hur or the Life of Brian.  Associated with exile from communities, deformity, and poverty. Something that no longer affects the modern world that we now live in.

Leprosy is often referred to in Sanskrit from around 1400 BC, with the term “kushtha” used to describe it. This translates to “eating away”. Courtesy of Wellcome Collection.

In 2000, the World Health Organisation (WHO) made an announcement that leprosy had been eliminated as a public health issue, with the global prevalence finally falling below one case per 10,000 people. This was the culmination of many years of identifying and treating patients with leprosy. This included the development of multi-drug therapy – a real game-changer in the treatment of Hansen’s disease. In total, over 16 million people affected by leprosy were treated, often free of charge. This was a great success.

And so for the elephant in the room. If we have eliminated leprosy as a public health problem, why do we still need to worry about World Leprosy Day?

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TB or not TB? Why tuberculosis remains one of the top 10 causes of death today

Tuberculosis

I was always a sickly child – when I was eleven years old, doctors injected my forearm with tuberculin in order to check whether my immune system raised a response to the bits and bobs of dead tuberculosis (TB) bacteria in it. If it did, it meant my immune system had already been prodded into battling TB, that is, it had previously encountered or was currently encountering an infection with TB bacteria. The injection site swelled like a furious bee sting, the doctors decided TB was the root cause of all my troubles, and I was intensely medicated for the next six months. My symptoms improved, and I have since evolved (visibly even!) towards the hale and hearty end of the healthiness spectrum.

In retrospect, now that I am medically trained and pursuing a PhD in TB immunology, I can appreciate all that my care team must have had to consider before starting an eleven-year-old child on a rigorous anti-TB treatment based on an educated guess. My symptoms were not typical of classical lung TB, the most common and infectious form of TB, they were mostly gastrointestinal, but then TB has also been known to stitch the gut into uncomfortable knots. My mother had recently been diagnosed with a cold abscess, due to TB of the bone, and though this could not possibly be infectious (based on centuries of observation) it still raised flags as it meant I had a history of contact with a TB patient. I showed an immune response to the tuberculin skin test (TST), but then I had received the BCG vaccine, which is a close relative of TB bacteria. This meant I could elicit a cross-reactive immune response and result in a positive TST even in the absence of TB infection due to the similarity of the two bacteria. (more…)

Ten minutes in Beirut: the harsh struggle for health and life facing Middle-Eastern refugees

Beirut, Lebanon
Beirut, Lebanon

20 June is World Refugee Day, and my short morning walk to the American University of Beirut (AUB) provides a daily and grim taste of the global refugee crisis. At 8:50am I take a right out of my Beirut flat onto a bustling and polluted Lebanese street. I live opposite a cheap hotel that hosts medical tourists – Iraqis, mainly – due to crippling of health systems in the region. A quick glance to my left and I’ll see two women outside a supermarket holding babies and pleading with ingoing shoppers for a small bottle of milk. To my right I see a large but flattened cardboard box, knowing this will soon become the cushion for a young mother and her two children. I’ll see them on my way home and I’ll worry about the toddler, who looks thin and tends to wander into the road.

By 8:55am I’m on a steep descend towards the main entrance of AUB. As I pass by a beautifully colourful series of flower shops on my left, I see an elderly man in plain clothes sitting on a white, plastic chair and holding a cup of tea. He has an expressionless face, he has damaged red skin around his ankles, he is obese, and he is silent. We exchange a look and I feel despair; not just for him, but for the nine year old girl who used to be in his place up until April this year. Also silent, she would sit and curiously watch passers go by. She was from Aleppo, a city brought down to its knees in recent years, and she told me her mum wouldn’t let her go to school in Lebanon. I dare not ask the elderly man what happened to her, but let’s not be under illusions – gender-based violence and early marriage are a feature of armed conflicts. (more…)