Sunday, 27 September 2015

Nigeria will need three years without polio cases to be declared free of the disease

polio vaccinationImage copyrightWHO/T.Moran
Image captionNigeria will need three years without polio cases to be declared free of the disease
Nigeria has been removed from the list of polio endemic countries in what is being regarded as a "milestone" on the quest to eradicate the disease.
The announcement by the World Health Organization (WHO), was made at a meeting of the Global Polio Eradication Initiative (GPEI) in New York.
It follows Nigeria going more than a year without a case of wild - naturally occurring - polio.
Three years without cases are required before it can be declared polio free.
The decision means there are just two endemic countries - Pakistan and Afghanistan - where transmission of the paralysing virus has never been interrupted.
Jean Gough, Unicef country representative in Nigeria, told me: "This is an important milestone, but it is too early to celebrate. We need to continue the efforts at every level if polio is to be eradicated."
Polio is spread by poor sanitation and contaminated water and usually affects children.
The virus attacks the nervous system and can cause irreversible paralysis - usually of the legs - within hours.
Ancient Egyptian Polio suffererImage copyrightGetty Images
Image captionThis Egyptian stele (an upright stone carving) dating from 1403-1365 BC shows a priest with a walking stick and foot, deformities characteristic of polio. The disease was given its first clinical description in 1789 by the British physician Michael Underwood, and recognised as a condition by Jakob Heine in 1840. The first modern epidemics were fuelled by the growth of cities after the industrial revolution.
GPEI was established in 1988 when tens of thousands of children in more than 125 countries were paralysed by polio each year.
Partner organisations include the WHO, Rotary International and the Bill and Melinda Gates Foundation.

Challenge

Nigeria's progress against polio has been hard-fought.
In 2003, some northern states boycotted the oral polio vaccine for nearly a year after scare stories that it caused sterilisation.
It led to the virus spreading to many countries that had been declared polio free.
In 2013 nine vaccinators were shot dead in Kano. But instead of being a deterrent, it galvanised support at every level.
The Nigerian government declared polio a national health emergency and greatly increased the number of vaccinators.
And community and religious leaders voiced their support.
As a result, the number of families refusing to have their children immunised has decreased sharply.

Boko Haram

The success has come despite the Islamist militant insurgency in north-east Nigeria.
Earlier this month Unicef said half a million children had fled attacks by Boko Haram over the past five months.
Vaccine teams have been focussing attention on displaced families who have moved elsewhere in Nigeria, as well as fleeing to neighbouring countries like Cameroon, Chad and Niger.
I last visited Kano in northern Nigeria in 2005 and met Aminu Ahmed, and his son Umar - both of whom have been paralysed by polio.
Aminu Ahmed and his son Umar both have polioImage copyrightFergus Walsh
Image captionAminu Ahmed and his son Umar both have been paralysed by polio
Like other children, Umar did not get the drops of polio vaccine and was infected, partially paralysing his right leg.
His father - who runs a charity making hand-operated tricycles for polio sufferers - has become a campaigner for polio immunisation.
I went back to meet the family. Umar is doing well at school and he now joins his father in persuading families to be immunised.
Aminu Ahmed told me: "Ten years ago, it was very common to see families saying no to the vaccine - now they all want it.
"We say you do not want your children to be unable to walk, like me."

Polio progress

Map: Polio in 1988
Image captionBy 1988, polio had disappeared from the US, UK, Australia and much of Europe but remained prevalent in more than 125 countries. The same year, the World Health Assembly adopted a resolution to eradicate the disease completely by the year 2000.
Map: Polio in 2015
Image captionIn 2015, polio remains endemic in only two countries - Pakistan and Afghanistan. No new cases have been reported in Africa for the past year.

Wild polio

Nigeria, like the rest of the world, is switching from the oral polio vaccine, given in two drops into the mouth, to an injectable, inactivated form of polio vaccine (IPV).
The oral vaccine, which contains a weakened vaccine virus, can in extremely rare cases, cause a form of polio - circulation vaccine-derived poliovirus (cVDPV).
There has been one case of cVDPV in Nigeria this year.
I met the family of the last child to be infected with wild polio.
Isau was 16 months old when he was infected in July 2014.
His right arm lies lifeless at his side - the muscles have withered and he cannot use them.
His mother, Kanduwa Ahmadu, has just given birth to another boy. She told me: "I will make sure my baby son gets all the doses of polio vaccine he needs. I know that life will be very hard for Isau."
It's more than a year since there has been a case of wild polio in Africa.
Eradicating the disease from the continent would be a huge achievement.
But health officials fear a resurgence of the disease unless efforts are continued to immunise every child.
India was declared polio free last year.
So far this year there have been 41 cases of wild polio worldwide, compared to 200 at the same point last year.

Friday, 25 September 2015

Care system gets 'biggest shake-up in 60 years'

Care system gets 'biggest shake-up in 60 years'

  • 1 April 2015
  •  
  • From the sectionHealth

Media captionDebra Hoomans, who cares for her husband, says there is "not the support"


Major changes to the care system in England are being introduced in what is being dubbed the biggest shake-up for 60 years.
The Care Act 2014 includes rights for those receiving care and those who provide it to their loved ones.
It includes standards for access to services from care homes to help in the home for tasks such as washing and dressing.
Meanwhile, NHS and care budgets are being merged in Scotland.
The Public Bodies (Joint Working) Act has been described as the most substantial reform north of the border for a generation.
It effectively forces councils and the NHS to work together to provide more streamlined services.
That aim is also a major topic of debate in England in the election campaign with the Conservatives, Labour, Liberal Democrats, UKIP and Greens all having plans for greater integration.


But the changes coming into force in England on Wednesday apply only to the care system for older people and younger adults with disabilities.
Four major changes are being introduced:
  • The creation of national eligibility criteria establishing for the first time when someone should be entitled to help - to date, it has been up to councils to set their own criteria
  • A duty on councils to offer schemes by which those who need to pay for residential care can get a loan from their local council, which is then paid back from their estate after death
  • Giving carers for the first time the same right to assessment and support as the people they care for; before, they had to provide "substantial care on a regular basis" to get an assessment
  • Those who pay for care themselves will be entitled to go to councils to get advice and information about the care system.
To help protect people's assets, a cap on care costs they have to pay for - set at £72,000 for the over-65s - will kick in from April next year. How the cap works for younger people has still to be finalised.
Today's changes, however, still mark a major milestone in care services, which experts say have hardly changed since the current system was created along with the NHS after the Second World War.

BBC Cost of Care project


Hands

The BBC has launched an online guide to the care system for the over-65s. The "care calculator" covers residential care and the support provided in people's own homes, for tasks such as washing and dressing.
Users can submit their postcode and find out how much each service costs where they live in the UK.
There is also a dedicated BBC Cost of Care website, with news stories, analysis and video.

David Pearson, president of the Association of Directors of Adult Social Services, said the changes were "probably the most significant development" since 1948.
But he said there were still issues to resolve on the underfunding of the system. Unlike the NHS, the care system budget has been cut in real terms this Parliament.
Izzi Seccombe, leader of Warwickshire council, who chairs the Local Government Association's Wellbeing Board, agreed with both points.
"Councils simply cannot afford any more financial burdens when social care services are already chronically underfunded," she said.
Janet Morrison, of the charity Independent Age, said the Care Act had the "potential to revolutionise" services.
But she said: "With a rapidly ageing population, we need an honest debate during and after the election about the true costs of care."

Families often charged too much for care, ombudsman says 24 September 2015

Families often charged too much for care, ombudsman says
24 September 2015
     
  • From the section

Carer holding an elderly patient's hand
Image copyright
Science Photo Library
Image caption
The ombudsman received 2,848 complaints about social care from August 2014 to July 2015


Cost of care

'Impossible situation'
Woman helping an elderly man
Image copyright
Science Photo Library
Image caption
Those with assets of less than £14,250 are entitled to have a local authority funded care home place

Families are paying too much for care in England "all too often" because of confusing or incorrect information from councils, a report says.
The Local Government Ombudsman said some people were not offered an affordable care option in their area.
"Top-up fees", payable for things such as a bigger room, were often being incorrectly charged, it said.
There was a 19% increase in complaints about social care from August 2014 to July 2015 compared with a year earlier.
The ombudsman received 2,848 complaints during this period, of which 57.5% were upheld.
Find out more about care at the BBC's cost of care website.
Use the BBC's care calculator to find out how much care costs where you live.
There were 2,397 complaints between August 2013 and July 2014 - 52.5% were upheld - and 2,324 between August 2012 and July 2013, of which 52.6% were upheld.
Its report, seen exclusively by BBC Breakfast, says councils should provide information in writing "at the earliest opportunity" that explains the financial implications of social care and top-up fees, so people can make an "informed decision".
It said: "The decision to place a loved one in a care home can be one of the hardest any family has to make, but all too often families are paying too much for their care because they are not getting the correct, timely information."
Those who have assets of less than £14,250 are entitled to have a care home place paid for by their local authority.
Top-up fees are generally charged for those who want additional facilities, such as a bigger room.
But Tony Cryer said he was charged a "top-up fee" after his council reassessed the amount it was willing to pay at his mother's nursing home.
"They'd decided my mum was going to move elsewhere," he said.
"But we couldn't let it happen. We had to pay the difference... we were put in an impossible situation."
The ombudsman ordered the council to pay the fee shortly before Jean Cryer died. The family are still waiting for repayment.
Care England, which represents care homes, said top-up fees were masking a funding crisis in social care, with some of the poorest people and their families being asked to fill holes in the budgets of local authorities.
Professor Martin Green, of Care England, said care should be available "at a cost which the local authority should be happy to pay".
Andrew Kaye, from the charity Independent Age, said confusion over top-up fees was one of the main reasons why people called its helpline.
"Too many people are paying [them] through necessity rather than choice."
Ray James, president of the Association of Directors of Adult Social Services, said there were "probably colleagues in local authorities feeling between a rock and a hard place" as more people were needing care in the face of funding cuts.
"Even where that is the case, we should always make sure that individuals and their families are clear about the information that they need," he said.

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