Documente Academic
Documente Profesional
Documente Cultură
POVERTY PROGRAMMES
FOR UNDER DEVELOPED
AND DEVELOPING COUNTRIES
■MEDICINE■
■MEDICAL ASSISTANCE■
■EMERGENCY■RESEARCH■
■SOCIO-ECONOMIC DEVELOPMENT■
January 2011
2
Spiritual Attributions
To
To
To
Daniel Sanchez
For your help, when times were down and your understanding towards
human sustainability; you help to titivate the glow in humanity.
3
DEDICATIONS
I dedicate my work to my Masters in Tibet, to which I owe the most
authentic and comprehensive period of my life, for their knowledge and
teachings; showing me the truth, justice, spiritual values and humanity.
And to all the people of Africa, India, Tibet and Nepal, thanks for sharing
with me their spiritual strength.
To Klaudia Ggryga, forgive if you may, love if you must; may your
dreams take you to the end of the rainbow, so that you may see the
glow as you stand on the green meadow.
To Paddy Daniel Franks, to whom I share a great admiration for his ego,
drive and empathy; may the sun rise at noon day give you energy to
deem your perusals and bring forth an abridge version towards your
utmost benefits, a friend to me and a friend to humanity.
To the Pouches, for their oneness and tricks that appeal to their minds
and emotions, just by looking at them with their most eminent
personalities; put you in deep thought and reflection, which meets with a
conviction in the most pressing needs of time; one can put aside their
preoccupation. In their own way they are unique and can be quite
mischievous fellows, giving you a laugh to remember that sink into the
hearts and minds of listeners.
THE POUCHES
4
I. MANAGEMENT PHILOSOPHY 6
V. ORGANISATION STRUCTURE 14
VIII. PRESENTATION 19
XIV. PROJECT 22
XXII. HIV/AIDS 95
5
I. MANAGEMENT PHILOSOPHY
6
II. INFORMATION
Entity Charitable, International Non-Governmental Organisation, Non-Profit
Email merointernational@web.de,merointernational@yahoo.com
ID No. H-99-0371561
31693141
CAC-02498533-96
ITC47-VOL0359DG
J-30688935-3
7
AN OVERVIEW
The aspirations of this work are for those anywhere in the world to correspond to the
desires of the people living without proper medical care and under extreme poverty,
and to the scientists, medical doctors and professionals of healthcare in general,
professors of schools, and the common man; to create a social awareness that shows
the orderly format and the complete contents discipline; to the doctors and all the
other professionals of healthcare a content adapted that makes public health and
living conditions better, alleviating the work that implies to systematise and teaching.
We are not trying to make this work replaces the importance of public health process
and education learning, in which immersed professionals with their work, neither do
we intend to terrify the patients and/or victims; we only release this work as an
obligation to deepen their knowledge and to direct their education towards their
autonomic and the freedom of expression and choice.
This work is going to be very useful not only for the Healthcare Professionals but also
for the Public Prosecutors, Defenders of Human Rights, Lawyers and the common
people; which can be use as a guidance to help solve problems of healthcare and
extreme poverty, whereupon which they face in their exercises and in their daily life.
It constitutes for us a high honour, rejoice and acknowledgement to all the persons
who gave us an improvement in our career and learning light.
Special thanks to the persons who fulfil spiritual emptiness and knowledge when
appears:
Dr. Jorge Escribens a medical doctor, who delegates his profession in assisting others
and a good friend.
Dr. Ibrahim Pazos a medical doctor, with virtue of family values and inspirations
toward humanity, a friend we’ll always remember.
Dr. Joseph F. Buvat a Lawyer at heart, whose wisdom and friendship will travel with
us endlessly.
8
OBJECTIVES
To provide pharmaceutical, nutrition, health supplement
and medical products, healthcare, medicine, medical
assistance, emergency, research, social development,
assist in providing basic necessities in under-developed
and developing countries, emergency relief assistance for
9
III. The Century of Humanity
MERO INTERNATIONAL named the movement ‘The Century of Humanity’ founded on
the principle of our work; which created facilitation and promotion of divinity,
humanitarian activities and social awareness to societies, to improve healthcare, and
abject extreme poverty situation of vulnerable human beings.
In order to carry out these activities we worked in small villages, rural and urban
areas, cities and towns; we later coordinated operatives on preventative medicine,
medication, dentistry, social development and welfare programmes, directed the
attendance of victims of Asthma, Diabetes, HIV/AIDS, Malaria, Rheumatism and
other infectious Diseases. The organisation MERO INTERNATIONAL provides its work
without the aim of profit; impartial, neutral and work independently, the mission is
exclusively humanitarian. The principle purposes of these programmes are to assist
without discriminations, contribute to maintain and promote peace in the world, take
an active part to ‘Help Make The World a Better Place’ in the development of civil,
cultural, social, moral, divinity, healthcare and utter extreme poverty.
Throughout the world, in countries rich and poor, there are people that have no or
little access neither to basic physical and mental healthcare nor to immunizations
from infectious disease. Some people have no access because they lack the
resources to buy and the state does not provide it. Others may be able to afford
healthcare but because there are no services available in their communities they
must do without it. In some countries because of discrimination or social stigmas
such as a person’s status as a prisoner, refugee, immigrant or a member of a lower
class or caste they are deprived of this basic human right. However all people should
have access to affordable universal healthcare, food and housing. In a world of such
wealth and abundance, rights and freedoms, there is no justification for an individual
to be without divinity, healthcare, freedom and better living conditions.
We believe that the right to divinity, health, freedom and better living extends to all
humans and must be promoted to healthcare and well-being and prevention of illness
and disease, not just access to medical care. This includes, among many others, the
right to education, food and shelter, to freedom from discrimination and persecution,
to information, and to the benefits of science. Every woman, man, and child should
have the human right to the highest attainable standard of physical and mental
health, without discrimination of any kind. Enjoyment of human right to health,
freedom and better living, are vital to all aspects of a person’s life and well-being,
and is crucial to the realisation of many other fundamentals.
10
IV. PHOTO GALLERY
SOUTH AMERICA HOW MUCH IS ENOUGH NATURAL DISASTERS GLOBAL RESPONSIBILITY CLEAN WATER
HOMELESSNESS A WORLDWIDE PROBLEM
11
MERO INTERNATIONAL
MEDICINE-HCare PROGRAMMES
MEDICINE MEDICAL ASSISTANCE EMERGENCY R& D SOCIAL DEV
OBESITY STUDENT
EXCHANGE
INTERNSHIP
H-FOODS VOLUNTARY
NATURAL
PHNOMENON
FOOD
PROGRAMME
HOUSING
PROGRAMME
12
13
V.
AMBASSADOR
EXECUTIVE COMMITTEE
SENIOR EXECUTIVE VPRESIDENT
SECRETARY GENERAL
VICE PRESIDENT VICE PRESIDENT VICE PRESIDENT VICE PRESIDENT VICE PRESIDENT
COPERATIVE FINANCE-ECON DEV HCARE-SOCIAL DEV INSTITUTIONAL WORKS
SOCIAL DEV
FOOD PROGRAMME
HOUSING
14
PROFESSIONAL SUPPORT
Auditors Deloitte.Touche.Tohmatsu
Architects Perkins.Will
15
VI. Executive Summary
MERO INTERNATIONAL, HCare-HIV/AIDS-Extreme Poverty services without
borders; is pleased to submit this request for your review. We look forward for
your assistance in our Organisation efforts to continue providing our services in
abjection to Extreme Poverty, Health Care, HIV/AIDS, Malaria and other Infectious
Diseases, Natural Disaster Relief, Democracy, Education and Human Rights in
Under-Developed and Developing Countries.
Our proposal requests your assistance to raise Funds, for the launching our
creative Democracy, Education, Extreme Poverty, HIV/AIDS, Malaria and other
Infectious Diseases revolving programmes to provide our services without borders
to enable the non-low-and moderate-income residents of the opportunity toward
better living.
For the last eighteen years, MERO INTERNATIONAL has successfully provided their
services to India, Africa, Latin America and Caribbean Communities. We have
assisted more than 1,585,000 persons in medicine, medical assistance, preventive
medicine, extreme poverty, natural disaster relief, democracy and social
awareness. Your ongoing economical assistance in our programmes and projects
will enable us to continue to effectively serve the impoverished communities, and
its working poor residents.
Your assistant can make a different between a better world, and that of a living
nightmare.
16
VII. COSTING BRIEF
Administration Building
Hospital Complex 500 Rms
Research-Development Centre
Distribution Centre
Mobile Clinics
PRINCIPAL L. A OFFICE
285,725,000 2,750,000
HOSPITALS
17
One Medical Centre for each country, with a capacity of 150 Beds:
MEDICAL CENTRES 527,800,000 1,250,000
One for each Country
Bolivia
Brazil
Tibet
India
Cuba
Ecuador
El Salvador
Honduras
Jamaica
Paraguay
Saint Vincent-Grenadines
Barbados
Panama
Belize
All Attention Centres will have a capacity of 25 beds and will be the extension arms to
the hospital or the medical centre.
18
VIII. PRESENTATION
MERO INTERNATIONAL collected scientific information from the city limits and
indigenous regions. The material that appears in this project tries within the framework
to obtain systematisation order and didactic of the evaluation of project of humans and
sustainable development in under-developed and developing countries.
The attention to the rural and semi-urban patients in these countries has constituted an
aspect of attention to the highly bleak healthcare programmes provided by the
administrators of public health, with little effectiveness to the patients, and as to the
present; the undertaking to the treatments of patients with increasing inefficiency. In
the policy of long term healthcare and extreme poverty problem "solving", the
population process of political decentralisation must necessarily be contemplated (I)
accelerate the administrative and financial process, giving flexibility to able decision-
making and social awareness for investments and economic programmes in the regions,
mainly education, health, housing and source of work (II) maintain a health policy of not
discriminating against the agricultural and indigenous sectors and to stimulate beyond
the rural establishments to which freely makes a growing economy, (III) needed
therefore to develop a rear area network of healthcare attentions, that allows the
pursuit of the patients in the sub acute and chronic stages to obtain alternative medical
attentions for their well being.
In summary, diverse reasons exist that motivate the accomplishment of the project that
appears as a medical alternative to medical attention and preventive medicine.
• ADMINISTRATIVE REASONS
Aim to improve healthcare and combat extreme poverty in under-developed and
developing countries.
ASTHMA.
URGENT DIABETES.ON
FOCUSED HIV/AIDS.
ABJECT MALARIA.
POVERTYTUBERCULOSIS
REDUCTION
2% DOMINICAN R 3,5% 4%
5%
9% COLOMBIA BELIZE
COLOMBIA BELIZE
2%
3.2% 30 % NICARAGUA
DOMINICAN R SURINAME NICARAGUA
2,5% 35,5%
2,8%
SURINAME GUATEMALA
3,5%
4% PERU
GUATEMALA
47%
8% 38% HAITI
HAITI
PERU
1998 2003
JANUARY 2004
19
• HEALTH REASONS
To advance in the corrective treatments to patients with Asthma, Diabetes, HIV/AIDS,
Malaria, Rheumatism and other Infectious diseases and to enhance the improvement
and the capacity of real time preventive medicine attentions.
• ETHICAL REASONS
By the sequels that the deficient treatments to a population affected by its health;
leaves scope of human rights violations, and the segregation of the patients entails and
their family.
• HUMANITARIAN REASONS
Inasmuch as humanly it is required to take care of the necessity to support the families
of the patients, in order to result in as many benefits of the treatment to the patient and
even the health of the family, who are generally under strong situations of economical
pressure.
A. The economic crisis and the deterioration of the quality of life that accompanies,
which affect the outbreak of mental upheavals of diverse nature by the increase of
emotional tension that produces the resolution of conflicts that are generated in such
conditions, breaking the defences of the favoured population sectors.
B. The cataclysm of the existing hospitable facilities, which by another part have turned
out ineffective to confront the problems of the attention to the health of the patients, at
better times.
C. The present insufficiency of the public health services of attention of acute patients
and the virtual absence of services for its attention and pursuit, which constitutes a
significant factor of codification of diseases.
D. The increase of the population, which implies a significant pressure in the demand of
all the services of attention to healthcare, mental health and extreme poverty in
general.
20
• OBJECTIVES
The concepts of our Organisation are to try to essentially transmit the spirit of social
awareness, eliminate extreme poverty, provide efficient healthcare programmes and
assist in the economic crises by invigorating job training for young adults and promoting
economic development world-wide.
• PROGRAMMES
MEDICINE PROGRAMME
Asthma
Diabetes
HIV/AIDS
Infectious Diseases
Malaria
Rheumatism
MERO-PHARM
EMERGENCY PROGRAMME
Epidemic
Natural Disasters
MERO-ALERT
RESEARCH PROGRAMME
Asthma
Diabetes
HIV-AIDS
Infectious Diseases
Malaria
Rheumatism
21
VIV. PROJECT
• DESCRIPTION
The proposed project of healthcare, medical attention and extreme poverty is based on
the generation of MERO INTERNATIONAL, which is an institution that offers their
services to the attention of the healthy, ill and corresponding support to familiar groups.
In order to carry out these activities, it is required to make investments in the
construction of the Principal Office, Hospitals, Medical Centres and Attention Centres and
their dowry, as well as the need for the necessary resources for the operational costs.
The first hospital is considered advisable to be located in Haiti, which is the country
statistically, is considered necessary based on the demand for healthcare services. In
this case, the consulted statistics location will be the region that has the largest
population and the Attention Centres will be located in the countryside that has the
greatest necessities.
The project considers necessary to offer the services on the basis of the following
description.
A service of hospitalisations for both children and adults, this service serves to take care
of patients 24 hours and 7 days a week.
A space of high supervision, destined to be used as house of (a) emergency, (b)
attention by doctors by specialty, (c) marital and familiar counselling, infantile surgeries,
(d) hospitalisations, (e) maternity, (f) rehabilitation, (g) patient advisors (h) outside
treatments; in order that the patients can attend a programme of transition towards the
return to their normal life.
Partial hospitalisation (limited time) implies a flexible use of the service of hospitalisation
during specific periods of time, so that patients who conserve a level of basic operation
can return to their community and obtain family support or that allows them to have a
place where to live or an adapted living integration. This approach can actually have its
limited exceptions, but in general it suitably serves the effects as the calculation, since
the objective of the project is indeed to help in the rehabilitation of the patients by
means of its interaction with the community.
Hospitalisation per limited time is to lend the services to patients who present or display
severe incapacities and that remain in their homes, and taken care by their relatives.
One admits the patient for familiar vacations or emergencies, such as the infection of a
disease contracted from another member of the family who is attending the patient in
their home and requires medical attention.
Attention Centres provide their services for a reduced number of patients who are taken
care by specialists at the hospital, it is designed specially to improve the capacity of
social integration of the patient with the purpose of incorporating them to an ampler
social standing and serving as an extension arm of an independent unit to the hospital
in the region, where the patients can be treated for minor incapacities.
22
The expectations generated by MERO INTERNATIONAL show possible solutions to the
problems that at the moment quean to the population in under-developed and
developing countries, from people of low resource, which live in countryside, such as
villages, gutters, districts outside of the city limits and indigenous sectors.
• OBJECTIVES
Between the primary targets of this programme the installation of operating systems in
the fields stands out, centres of attentions (ambulatory) and hospitals in the rural area
that are unable to cope with the bordering difficulties to medical services, can be
organised through Mobile Clinics with the services of integral medicine, dentistry and
laboratory to assist with these services as an extended arm, jointly with the Centres of
Attentions which have services of emergency, x-rays, laboratory and attention to the
patients who require a smaller intervention in the operating rooms. The surgical
entrance to these Centres of Attentions concludes only and exclusively admittance by
(limited time) without the necessity to over night in unnecessary cases.
In the case that surgery is greater or outside the specialties of the Centre of Attentions,
we will take the responsibility to transfer the patient to the nearest Medical Centre,
Clinic or Hospital in the region.
To develop nutritional studies of the population at issue and to provide them with
preventive medicines attention, if they so required.
To provide the under-privileged with healthcare, welfare, medical assistance and
preventive medicine to the ill and injured with highest supervised attention.
To create in the region a service for the benefits of “basic necessity” that satisfy certain
goods and services, such as health, education, nutrition, housing and services such as
drinking water, sewage system, electricity and cooking fuel, as well as to offer the
support of continuance to fight extreme poverty and improve healthcare services,
designed with the purpose of privileging the permanence to the patients in the
communitarian scope.
RESEARCH PROGRAMME
23
XV. MERO INTERNATIONAL
MERO INTERNATIONAL will offer a symbiotic relationship between research and practice-
a “bench-to-bedside” research and medical service approach and position themselves for
greater influence in the realm of research and development.
MERO INTERNATIONAL is an acute care institution and a major teaching and research
centre that will work in collaboration with institutions from Austria, Australia, Belgium,
Canada, China, Denmark, France, Germany, India, Israel, Italy, Japan, Mexico, The
Netherlands, Norway, Russia, South Africa, Spain, Sweden, Switzerland, UK, Ukraine,
and USA resulting in a broad-based internationally recognised organisation. The
prevention of premature death and disability utilising our multi-disciplinary approach to
bring together talented and dedicated professionals from different countries, cultures,
basic and medical sciences to share ideas, technology, space and enthusiasm, to
enhance discoveries that will fundamentally change the course of medical practices.
The growth of MERO INTERNATIONAL parallels the growth of our programmes, where we
will provide high quality products and services at a reasonable price and the less
fortunate at a social cost. It is our intention to exceed a meaningful effort to
accumulate, develop innovative products and services that provide convenience and
comfort to our patients and customers.
US$ IN BILLIONS
25
20
15 CARIBBEAN
10 HAITI
LATIN AMERICA
5
0
1998 1999 2000 2001 2002
JANUARY 2004
24
MERO INTERNATIONAL will approach their objectives with passion, enthusiasm and
practice and will emerge as a ranking player in the medical industry. In active
participation, we will focus into a unique synergistic advantage allowing us to fuse
diverse services. Never content to rest on our laurels, we are determine to face the
growing challenges and keen competition; strive for constant improvement, innovation
and continually rationalise our customers' need to develop new products and services.
We shall place a strong and unwavering emphasis on have a leading edge in influences
that will achieve smooth communication with our personnel and open diverse
communication channels which will provide opportunities for management to familiarise
themselves with law, import and export, marketing, sales, quality services, finance and
investment policies that govern good business practice both locally and internationally.
Also an “add-on-the-job-training”; that will permit self-awareness that increases
satisfaction and improvement of management and employees' efficiency that promotes
the values of team spirit. Profitability, firstly we believe that the secret of adding value
lies in energy, not the kind that is buried deep in the earth, but that which is deep in our
minds, intellectual energy is the force behind our organisation and that is our
profitability.
As we realise and are seeing first-hand, the speed of transformation of human history
toward longer and healthier life, MERO INTERNATIONAL may not have all the answers,
but we shall place ourselves in a position to be a part of that global responsibility.
25
MERO-ALERT
MERO-HCare
The healthcare industry is being influence by consumers’ purchasing behaviour to shift
their perception from a hallowed and deeply respected privilege of society, to a service
industry comparable to financial services or consumer goods. This change has
demonstrated the global increase in both private healthcare and medication expenditure
and also out-of-pocket healthcare expenditure per capita; consumers are now spending
more money in medications and healthcare. The consequence of these trends is that
patients are striving to control their health and their healthcare for better health and
longer life.
26
MERO-OnLine
MERO-OnLine (MOL) evaluates the health outcomes (physical functioning, quality of life)
and cost-effectiveness of various treatment modalities, using clinical drugs trails and
randomised control trails of non-pharmaceutical interventions.
The programme objective is to improve family healthcare delivery and the quality of life
of patients and their family by translating research finding into clinical practice. Thus
MOL will be the foundation of evidenced-base care in the countries in which we have a
client base, regularly contributing to decisions about clinical programme, diagnostics and
treatment. We will evaluate patterns of health service utilisation, referral patterns and
cost-effectiveness of health services, establish national and international databases on
healthcare for Asthma, Diabetes, HIV/AIDS, Infectious Diseases, Malaria, and
Rheumatism.
MOL Principal Investigators and Project Directors will be members of MERO-NGO
multidisciplinary research and medical teams, representing a wide variety of healthcare
professionals from different countries with one common goal “to serve a multi-cultural
and broad language base platform” in healthcare programmes and to abject extreme
poverty. The programme will be provided by subscription and as a community service in
the form of e-mail monthly update, web site and telephone consulting, having strong
interactions with industry and clinical programmes and to ensure the application of
scientific knowledge to the promotion of human health.
MERO-OnLine will be our healthcare and social education link to MERO’s Website.
20
15
FOOD
10 BASIC NECESSITIES
MEDICATION
5
JANUARY 2004
27
MERO-IMAGE
Promote the good image, name and relationship of the Organisation in all
matters in the press, radio, TV, www and all other media of communications.
Promote our Humanitarian, Peace and Social activities, regional, national and
international, and make recommendations to the Executive Board Committee of
ways and means that can enhance their activities to the benefit of humanity.
MERO-PHARM
MERO-PHARM strives to maintain and will continue to build upon a growing international
leadership position in the field of pharmaceutical, biomedicine and nutritional products.
We are committed to providing the safest, most effective and highest quality products
for patients care.
MP will accomplish this by constantly improving and adding to our existing product
portfolio through new products development and the addition of strategic, viable,
synergistic medical opportunities. To the development and global commercialisation of
our products with cost-effectiveness and to provide medications through our social
development programme to individuals that are less fortunate.
MP can commence immediately to provide this service by joint ventures and licensing
from companies in Canada, Belgium, Denmark, France, Germany, Spain, Switzerland,
UK and USA, and at a later date proceed with their own manufacturing and processing
plans.
MERO-KinderCare
MERO-KinderCare helps prepare children of today to be world leaders of tomorrow. The
Centre shall be a leading Not-for-Profit Institute of preschool and child care facilities;
KinderCare provides child care and age-specific educational programs for kids from six
weeks to 12 years old. The Institute will also offers elementary School distance learning
programs.
MKC will offer quality care in a fun learning environment, providing full-day educational
curriculum of developmentally appropriate lessons, activities with medical personnel in
attendance.
28
MERO-ECourse
A proposal with recent subjects that allow integrating the theory with professional
practice and offer the bases for better attention and learning
Beneficial
There is no better way to advance your career and/or knowledge other than by
achieving professional assistance. Employees will recognize advanced skills and
knowledge, clients will recognize you as a trusted leader capable of providing superior
service and advice, and both your family and yourself will acquire personal benefit by
having the use of first hand learning capabilities at your disposal from anywhere in
the world.
There are no prerequisites for MERO-ECourse, People of all culture and learning can
part take; however prior computer experience or training is recommended.
29
The cost of the project is provided with the following classifications.
30
It is only one enumeration of indicative character, made from the experience gathered of
programmes similar or made in other countries, taking into account the comparative
advantages and disadvantages that such structure presents. However, a pertinent
programme is considered to have affects, directly or indirectly, in at least one of the
variables of the yield function.
One of the particularisations of this programme is that the work involves people of the
objective population, such as contributors in action. This brings a series of additional
benefits that make the programme very attractive. Nevertheless, to obtain the active
participation of the ones who are interested is subordinated to certain previous
requirements; as well as the design of programme that tends to solve problems that
“are felt” by the objective group, so that the project is arranged to give their quota of
maximum efforts.
Thus, it is understood that the programme will not appear spontaneously like a simple
selection within the proposed programme. It follows a gestation process that includes,
understanding different stages (identification and prorogation from problems; selection
and design of the programme).
MERO INTERNATIONAL and the assistance of their international health providers are able
to apply the knowledge and technologies already verified, and are willing to search for
and create new knowledge, strategies and technologies, that will give the advantage of
problems solving.
31
AMERICA’S PRINCIPAL OFFICE
Quebec, Canada
Human Resources
___________________________________________________________________________________
CHARACTERISTIC AMOUNTS
___________________________________________________________________________________
International President 1
Executive Committee 12
Senior Executive V-President 1
Secretary General 1
Chargé D'Affairs 1
Commissioners 3
Country Resident 1
Executive V-Presidents 5
Executive Directors 5
Directors 38
Specialists 58
Chief of Unit 53
Health Professionals 385
Administrative Professionals 125
Technical Professionals 38
Executive Secretaries 18
University Students Volunteers 58
Supervisors 32
Technicians 52
Photographers 3
Medical Assistants 28
Administrative Assistants 38
Collage Students Volunteers 122
Drivers 19
Labour Employees 378
Security 48
Safety Personnel 28
____________________________________________________________________
TOTAL 1,575
____________________________________________________________________
All facilities are fully equipped with advanced telecommunications, artificial intelligence,
computer systems and access control with solar energy as auxiliary power source.
32
33
COUNTRY RESIDENT
HOSPITAL AND MEDICAL CENTRE
Human Resources
______________________________________________________________________________________
CHARACTERISTIC AMOUNTS
____________________________________________________________________
Country’s Resident 1
Directors 5
Specialists 25
Unit commanders 5
Professionals of Health 55
Administrative Professionals 18
Technical Professionals 12
Executive Secretaries 3
University Students Volunteers 18
Supervisors 12
Technicians 15
Photographers 3
Medical Assistants 18
Administrative Assistants 18
Volunteers 50
Drivers 7
Employees 28
Security 18
Safety Personnel 12
Workers 52
___________________________________________________________________
TOTAL 375
50 50
1991
40 40
1994
30 30
1997
20 20
10 10 2000
0 0 2003
T
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34
Suriname public health system needs urgent improvement in four fundamental areas:
(A) promotion of vitality and integral health; (B) prevention of infectious and non-
infectious injuries and diseases; (C) organisation and provision of services for diagnosis
and treatment of diseases, and (D) rehabilitation of ill or incapacitated people so that
they can reach the highest possible degree of activity. In the present health situations
there are preoccupations in the institutions of public health, including physical health,
mental and social well-being and not only the absence of ailments or diseases.
The extensive area of the promotion of health represents in a certain sense a bad
memory of the old concepts. It is essential that the country developed programmes of
hygiene and environmental health, social awareness, sanitary education into the
activities of their daily life, among them, the codes of conduct and self-discipline,
dietetic practices, nutritional health and the treatment of diseases and smaller ailments.
Consideration must be given to the physical and mental development of the children,
and effects of dietetic supplements in the improvement of health and vitality, in the
under-nourished and under-privileged populations.
35
MEDICAL CENTRE
Emergency Room
Air Conditioning
ITEMS UNITS
Stretchers 8
Electrocardiogram 1
Eco Digestive Endoscopies 1
Oxygen Equipment 3
Display Cabinets 2
May Tables 3
Writing-Desks 2
Stools 3
Fans 3
Closets 2
Hand Sinks 2
Otorhinolaryngology 1
Otolaryngology 1
Paediatric Ambu 3
Adults Ambu 3
Sterilisation Equipment 2
Sets of Minor Surgery Equipment 2
Body Clamp Equipment 2
Aspiration Equipment 2
Laser Equipment 1
Adults Oxygen Mask 3
Paediatric Oxygen Mask 3
Parallels 3
Escape 3
Waste baskets 5
Foot Lamps 3
Portable Lamps 3
Wheelchairs 3
Beds on Wheels 2
Tables for Clinical History 3
Clinical Ducks 3
Clinical Whistles 3
Foot Tension Metric 2
Portable Tension Metric 3
Screens 2
X-Ray Sheet Observation Lamps 3
Packages-cotton, gauzes, etc. 12
Electronic Observation System 1
Electronic communication System 1
All facilities are fully equipped with advanced telecommunications, artificial intelligence,
computer systems and access control with solar energy as auxiliary power source.
36
Life Expectancy in Trinidad & Tobago Compared to Haiti
LIFE EXPECTANCY
Haiti has much to offer, regards to learning, new experience and facing the agony that in
the twenty first century a country and its people live a life not knowing if there will be a
tomorrow.
Saying a lot about Haiti is not enough; the country is totally ruined due to political and
economical instability, extreme poverty, non-existence of public services, high risk of
epidemics and high rate of infectious diseases and inadequate living conditions. A country
with a life expectancy of an average of 48 years old, and its people evacuating at any
means possible; now face the challenge of their future and the well-being of their home
land, looking toward each morning for a sign that will give them hope, bring some relief of
their burden or that the country’s leaders will come to some understanding and bring
peace and prosperity to a nation that has been too long on the struggle.
Haiti needs help and needs help now, it is no longer acceptable to measure success by
confirming that the meeting room chairs and temperature are comfortable, we have to
implement direct solutions to patient care and practice behaviour. There is a further
obligation. The evaluation process must be based on findings, analysis, activation and
applications that will benefit the medical and health professionals, improve medical and
health practice, satisfy the patient, improve healthcare services, validate funding decisions
and result in future support. It is of little use to get in and offer healthcare services for a
few months and then move on, the country need permanency of institutional assistance to
face the growing challenges, offer on the spot solutions and problem solving. The first
item to be placed on the agenda will be a food programme; medication is not the
immediate answer; nutritious feeding, medications and healthcare professionals combined
is the answer for an urgent solution. In Trinidad and Tobago the economic diversification
into industry, tourism, mining, and oil and natural gas producing, has transformed the
economic base in most societies, especially since the early seventies, enhancing the
country growth and government healthcare programme. In Haiti is quite the opposite,
their social significance has declined as people leave the country to immigrate to other
countries with the hope of escaping a living nightmare.
37
MEDICAL CENTRE
Gyneco-Obstetrician Room
Air Conditioning
ITEMS UNITS
Gynaecological Tables 3
Oxygen Equipment 2
Disposal Units 3
Parallels 3
Delivery Tables 5
Scales 2
Respiratory Equipment 2
Adults Oxygen Masks 3
Predigests Equipment 3
Multipart Equipment 3
Cabinets Display 2
Lamps 3
Portable Lamps 2
Paediatric Ambu 2
Adult Ambu 2
Twist Equipment 2
Waste baskets 8
Fans 5
Clips 15
Fingerprints Pads 3
Clinical History Tables 3
Tension Meters 3
Screens 2
Baths 2
Electronic Observation System 1
Electronic Communication System 1
All facilities are fully equipped with advanced telecommunications, artificial intelligence,
computer systems and access control with solar energy as auxiliary power source.
38
HAITI CAPITAL MARKET, PORT AU PRINCE
EXTREME POVERTY AT A RAMPAGE
39
MEDICAL CENTRE
Dentistry Room
Air Conditioning
ITEMS UNITS
Beds 1
Dentistry Equipment 3
X-rays Equipment 1
Lamps 3
Micro Instruments, Materials several
Computer 1
Sterilization Equipment 1
Minor Surgery Equipment 1
Automatic Control Sinks 3
Offices furniture
Electronic Observation System 1
Electronic Communication System 1
Laboratory
Air Conditioning
ITEMS UNITS
Stretchers 3
1600 Clamps 2
Repairing & Refinishing Equipment 2
Implants 2
Express 2
Microscopes 3
VDRL Rotators 2
Automatic Pipettes 10-500 Moors 2
VRML Plates 5,000
Tubes 13*75 5,000
Tubes 13*100 5,000
Refrigerators 2
Sterilizing 2
Patients Baths 2
Chronometers 2
Gladiola of 20 and 90 Positions 2
Computer 1
Public Baths 2
Electronic Observation System 1
Electronic Communication System 1
All facilities are fully equipped with advanced telecommunications, artificial intelligence,
computer systems and access control with solar energy as auxiliary power source.
40
MEDICAL CENTRE
Studies/Observation Room
Air Conditioning
ITEMS UNITS
Endotracheal ventilation 1
Catheter 3
Sheaths 5
Dilators 6
Peripheral Inserted Catheter 3
ECG/EEG Telemetry System 1
Coronary Stents 5
Stethoscopes 3
Ultrosound Geltimes 1
Life Imaging Systems 1
Electrical Therapy Equipment 1
Laser Therapy Equipment 1
Gamma-Ray Spectroscopy 1
Test Kit-Infectious Diseases 12
Diagnostic Kit-Blood Coagulation Disorders 12
Petri Dishes 12
Test Kit-Urine Catch 12
Instant Pack-Hot & Cold 6
Incubator 1
Therapeutic Ultrasound 1
Electrotherapeutic Machines 1
Eye Wash Station 1
Backrest Support 6
Non Reusable Syringe 500
Hybrisen-Protein Drug for AIDS 50
Virulizin-Injection for HIV/AIDS 50
Pentacel-Injection for Pertussis, Polio, tetanus, Diphtheria 100
and Haemophilias Influenza B
Medmira Rapid Screen Test-HIV 1 & 2 50
Chemokine-HIV Infections 50
Serp1-Arthritis 100
Phosphonates of Nucleoside Analogues-AIDS and 12
Infectious Diseases
Genotyping Kit-HIV Human Immunodeficiency Virus 50
Genotyping Kit-HPV Human Papillomia Virus 100
Suplasyn-Osteoarthritis 100
Pennsaid Lotion-Osteoarthritis 100
Lait B Protein-HIV Vaccine 50
Oralin/oralgen-Oral Insulin for Diabetes 1 (IDDM) “Insulin 2
Dependent Diabetes Mellitus” and Diabetes 2
(NIDDM) “Non-Insulin Dependent Diabetes Mellitus”
Acoustic Wave Bio-Sensors -HIV Test 2
Ambulances 3
Mobile Clinic (Dentistry Assistance) 1
Mobile Clinic (Medical Assistance) 1
Computer 1
Electronic Observation System 1
Electronic Communication System 1
41
42
MEDICAL CENTRE
Administrative Office
Air Conditioning
ITEMS UNITS
Refrigerator 1
Writing-Desks And Chairs 8
Waste Baskets 10
Type Writers 2
Photo-Copier 1
Computers with network facilities 8
Check Perforator 1
Recording System 1
Moving of Office 1
Kitchen 1
Dining Room 1
Fax 1
Access Control 1
Video System 1
Alarm System 1
Central Telephone System 1
Intercom System 1
Radio Communications System 1
Closed Circuit TV System 1
Bath Rooms 5
All facilities are fully equipped with advanced telecommunications, artificial intelligence,
computer systems and access control with solar energy as auxiliary power source.
43
Health Expenditures per Capita in
Belgium Compared to Venezuela
Expenditures per Capita in Belgium Compared to Venezuela
Belgium
Belgium2002
2002 1,450
1,450
Venezuela
Venezuela2002
20002 75
75
HEALTH EXPENDITURES
VENEZUELA have a high percentage of the population infected with HIV/AIDS, the Island
Of Margarita has the highest indices per capita, second being Caracas and the
Metropolitan District, third is Puerto la Cruz.
The Public Health services are almost non-functional, there are many qualified Medical
Doctors and other Health Professionals unable to obtain jobs, some who are fortunate fit
into the private sector and others work in any job that they can find, such as sales
personnel for pharmaceutical companies, banks and other sectors. The few hospitals
that are functioning are always overcrowded, patients are unable to get beds, medicine
or medical attendance due to the overcrowd problem, it not uncommon that Medical
Doctors in the hospitals will attend patients until exhausted, trying to cope and give all
the help they can. Patients will start arriving at the hospitals just about 06:00 AM and
wait to be attended between four to six hours later, most times they will have to return
another day without receiving medical attention.
Most public health institutions lack proper medical equipment, public baths have busted
pipes and hospitalisation in most cases is unfit for human well-being. These and other
factors that are better left unsaid, that cause private medical services to be very costly,
the average middle class citizen is unable to have private medical treatments and should
it be a life or death case, then the patient family have to join together to pay the bills or
the patients have to sell or use their property as collateral (if they have) before they are
admitted into the institution. The poor people, (which is 80 %+) have to live with the
turmoil; there is little other choice. They will wait for months sometimes years for a
medical operation, because there are no rooms, no bed available, or the operating
theatre(s) is completely booked. For those who have some political connection (which
they use for almost every thing), the situation may be a little different.
We have illustrated the Health Expenditures per Capita between Belgium and Venezuela.
In Venezuela there is one Public Medical Doctor to every 650 persons and one hospital
bed to every 525 persons not taking into consideration the 75 % of the population that
attend private medical services.
We have to put aside the political problems and give our efforts to a meaningful
solution; to assist in the high rate of Asthma, Diabetes, HIV/AIDS and the Pulmonary
Diseases situations that are in the upturn.
44
MEDICAL CENTRE
Physical Structure
Air Conditioning
All facilities are fully equipped with advanced telecommunications, artificial intelligence,
computer systems and access control with solar energy as auxiliary power source.
45
MEDIAL CENTRE
Human Resources
Air Conditioning
ITEMS UNITS
TOTAL 105
All facilities are fully equipped with advanced telecommunications, artificial intelligence,
computer systems and access control with solar energy as auxiliary power source.
POVERTY
30
25
20 1999
15 2000
10 2001
5 2002
0 2003
A
T
U
A
ZE
G
Y
A
A
I
IT
A
A
B
IN
A
LI
A
U
R
U
R
IN
Y
H
G
A
U
U
B
IC
A
G
S
R
N
T.
A
S
46
OPERATION METHOLOGY
One must consider that all our services offered have the same objective described
previously. It is therefore required to establish patterns of comparison towards different
countries' situation and quantify decisions before making changes, so that we can obtain
the best results in our undertakings.
In terms of our treatments philosophy, it is required to evaluate not only the medical
attention, but also the quality of service in relation to the immediate and long term
social impact; in this manner the patients will receive adequate treatment for their
condition, in order to have a speedy recovery.
MERO INTERNATIONAL, philosophy is to offer their personnel “interesting working
conditions” such as personal and social benefits, educative opportunities, on the job
training, and working in a learning and teaching environment.
Salaries will be competitive in regards to qualifications, experience and the ability to be
a part of a problem solving organisation, which works under extreme conditions
whenever required.
It will conclude that the project was advisable in case the present value of the flow of
net benefits of the project were positive; that is, in case the investment in the project
involves an increase in the organisation wealth greater than that could be obtained
using the funds to their better alternative investment. In absence of the funds, the
benefits (annual income) of the project will come from the product sale (Xi Pi); and the
costs (debits) will come from the purchase of products (Yj Pj) this cash flow will be
received by (ỳ) years, being (rt) the cost of capital during the year (t). Thus, the
“Present Net Value of Private Benefits” of the project will be:
ỳ m
X.P - Y.P
N it it jt jt
i=1 j=1
PNVPB = _______________________________
t=0 t
(1 + r)
k=0 k
Where r=0
o
47
48
The social evaluation of this project consists of comparing the benefits with the costs that said
project implies for the society; that is to say, it consists of determining the effect that the project
will have on the well-being of the society (healthcare, social development and reduction in
extreme poverty).
It is clear that the social welfare of a community will depend on the amount of goods and services
available (product or entrance of each country), of the relative amount of goods and services
received by each one of the members that composes it (where distribution of that entrance will
be by personal), of political liberties, respect the right of property, institutions and exercise of
human rights and social mobility. From “the restricted” point of view, the social evaluation of this
project is limited to only consider the effect that the project has on the amount and the
distribution of the entrance of social or non-governmental organisations.
In terms of the amount of entrance, the annual social benefits (gross) of the project are
moderate by the increase that this project causes in the entrance; the costs, by the entrance of
sacrificed (alternative) by the fact to have carried out this project instead of another one (that is
its better alternative). It is as well as the project will be “beneficent” in measurement (that the
entrance that the organisation generated by this is greater or at least equal) that had been
obtained to execute the best alternative project. Defining the social price or it shades of the
goods and services of final consumption produced by a project P * as its value in terms of the
contribution to the national product of each country, and the social price obtained for the project
compare to national product and the sacrificed entails by using them, that the direct “Net Social
Benefit” for year “t“ is:
ỳ * m *
NSB = X P - Y P
t i i j j
i=1 j=1
The present value (Present Value) flow of “Direct Net Social Benefits” of the project will be
obtained using for each year (r *)
┌ ┐
│ ỳ * m *│
.X .P - Y .P
ỵ it it jt jt
PVDNSB = i=1 j=1
└ ┘
__________________________________
t=0 t *
k=0 ( 1 + r )
k
*
Where r=0
o
The comparison of these formulas (1) and (2) demonstrate that the results of the social
evaluation (Non-Governmental Organisations) of the project will differ from those of the private
evaluation (Private Enterprises) in prices and cost, and where the operating costs of the two will
also differ in their corresponding values.
49
Causes of Death as a % in Canada
Compared to Nicaragua
Infectious Diseases
Nicaragua 2001 Cancers
Metabolic
Diseases of the Nervous System
Diseases of the Circulatory System
Canada 2002 Diseases of the Respiratory System
0 110 220 330 440 550 660 Diseases of the Digestive System
Accidents and Violence
Percent of Death for Selected Categories
CANADA-NICARAGUA
INFECTIOUS DISEASES
HIV/AIDS have become a major concern in Nicaragua and other Latin America and
Caribbean countries. Between the years 1998-2003 there have been alarming increases
in infectious diseases, due to improper government administration, poverty, poor public
health and inadequate public education.
Quoting Dr. Ekaterina Dadachova (Albert Einstein College of Medicine) “radiolabeled
antibodies could be useful in the battle of infectious diseases, the results have been
encouraging”. Both Dr. Dadachova and Dr. Arturo Casadevall have gone a step further,
using the specificity of antibodies to not only flag infection site, but also attack the
infectious cells.
There are many pharmaceutical products and new technology being implemented for the
fight of HIV/AIDS, countries such as Africa, Belgium, Canada, China, Denmark, France,
Germany, Russia, Sweden, Switzerland, UK, and USA to name a few are continuing
optimizing with pioneering process efficiencies to help infectious diseases patients to live
healthier and have a happier life.
The increasing occurrence of HIV/AIDS in the world is becoming a major concern for our
society. There are several important trends that are leading the rise in HIV/AIDS,
including the care free lifestyle of the young population, the epidemic of poverty and
resulting under-nutrition, and the increased usage of drugs and contaminated syringes.
We have to take strategic actions to move forward for protecting and advancing world
health, regardless of political differences, geographic locations, languages and culture.
Developed countries will need to successfully adopt and implement a new dynamic
environment and attitude that facilitates and enables the assistance of technology,
medication, human basic necessities, health education and funding in real-time; which
requires information sharing at a level and direction never experienced before, and at
the same time offers a path forward to sustain infectious diseases and eventually
increase healthcare growth.
50
MEDICAL CENTRE
Operative Diagram
▌ ▌
HEALTHY ILL
▌
DATA
COMPUTERISE
▌
┌ ┐
HEALTHY HEALTHY
EVALUATION ◄------------------- MOBILE CLINIC -------------------► EVALUATION
▌ ILL ILL ▌
└ ┘
▌ ▌
▌ ▌
▼ ▼
▌ ▌ ▌ ▌
PEDIATRIC PREVENTIVE GYNECOLOGY DENTISTRY LABORATORY
MEDICINE OBSTETRICS
▌ ▌ ▌ ▌
▌ ▌
ILL
▌ ▌
MEDICAL CENTRE
▌ ▌
▌ ▌ ▌ ▌ ▌
EMERGENCY ADMISSION SURGERY ADMINISTRATION LABORATORY RX
▌ ▌ ▌ ▌ ▌
SURGERY AND
HOSPITALISATION
▌ ▌
ILL
▌ ▌ ▌
▼ ▼ ▼
HOSPITAL
51
Infant Mortality Rate (s) per 1,000 Live Births
100
80
60
40
20
0
1960-65 1970-75 1980-85 1990-95 2002
1965-70 1975-80 1985-90 1995-00
Switzerland Suriname
SWITZERLAND-SURINAME
INFANT MORTALITY
Infant Mortality has been an enormous concern in the years 60 in all under-developed
and most developing countries; we are still faced with this unforeseen problem in many
Latin America and Caribbean countries. Suriname has a 30 % per 1,000 Infant Mortality
Rate per Live Birth there is one Public Medical Doctor per 1,325 persons and one
hospital bed per 350 persons. There has been a decrease from 90 % in the year 60 to
the present rating, however; taken into consideration that the world has become more
healthily orientated, has better health systems and services, better education system
and a greater concern for the environment; we are still faced with an Infant Mortality
problem.
Infant Mortality problem in Suriname and other Latin America and Caribbean countries is
caused by poverty, inappropriate public health service and lack of governmental concern
to increase the expenditures on public health. Medical and medication costs, quality
issues and professional competence is not enough, government must reform and give
top priority to better the effectiveness of their public health and education services by
providing adequate funding and proper administrative mechanism to supervise these
services.
The comparison made between Switzerland and Suriname which speaks out that there is
need to create a change by establishing a sense of urgency, the need to move into a
true role of facilitating learning from the developed countries to enhance a better and
healthier way of life to the developing and under-developed countries, to initiate
activities that are more aligned with the provision of high-quality cost-effective
healthcare and reduce unnecessary variation in practice and the cost of healthcare
delivery, enhancing Medical Doctors performance and reduce medical errors.
It is only perfectly reasonable for those who fund government programmes, NGO and
other health providers to expect some measure of return on the money spent, whether
it is in the form of increased medical attendance, more appropriate diagnosis, treatment
and or disease management; the outcome is that there is an obligation to the
attendees, faculty and the public with conclusive proof that imparts learning and results
in the improvement of patients care.
52
XVI. RESEARCH PROGRESS REPORT
MEDICINE, MEDICAL ASSISTANCE, WELFARE
53
54
RESEARCH PROGRESS REPORT
55
RESEARCH PROGRESS REPORT
56
57
RESEARCH PROGRESS REPORT
58
RESEARCH PROGRESS REPORT
59
60
RESEARCH PROGRESS REPORT
61
RESEARCH PROGRESS REPORT
62
63
RESEARCH PROGRESS REPORT
64
RESEARCH PROGRESS REPORT
65
66
RESEARCH PROGRESS REPORT
67
HIV-AIDS VICTIM
INDIA TIBET
68
RESEARCH PROGRESS REPORT
69
70
RESEARCH PROGRESS REPORT
UNDER 15
BELIZE 2002
15-29
30-44
60 +
0 20 40 60 80 100
PERCENT
71
72
RESEARCH PROGRESS REPORT
73
74
RESEARCH PROGRESS REPORT
75
RESEARCH PROGRESS REPORT
76
77
RESEARCH PROGRESS REPORT
78
RESEARCH PROGRESS REPORT
79
80
XVII. MERO’S SPIRITUAL AND SOCIAL AWARENESS VIEWS
TOWARDS EXTREME POVERTY
In the present study and investigation towards extreme poverty and the urgency of
healthcare advancements problems in Under-Developed and Developing countries, we
support the application of a mechanism of social and spiritual awareness, setting out
denominating Society Integration of complementary character, to the efforts that the
State, Non-Governmental Organisations and the Private sectors can make to increase
spirituality and social awareness, that will assist to reduce extreme poverty and consider
the urgency of healthcare advancements to the poorer nations of the world.
The characteristics of spiritual and social awareness given by their micro-location to the
interior of an objective population, sectors in the rich society must help extreme poverty
of urban type; by the incorporation of the people in these situations. Participants must
be subjected to the developed actions to alter their social conditions by these integral
characters.
Whereupon the indicated actions that are carried out; by the potential pick up and
canalisation of resources of all type and from diverse sectors and, finally, by their
catalytic effect and solid support of the different sectors that at the present; will make
the workings of a better spiritual, economic and social life.
The term “spiritual” is use in the context of the goodness extended towards extreme
poverty and humanity and has little bearing on religions, we put this context into three
levels: (a) The ability and willingness of developed countries and international funding
institutions (dominant society) to set forth the initiatives and global undertaking to
bridge the culture gaps between extreme poverty and healthcare advancements towards
the countries in urgent needs. (b) The ability and willingness of non-governmental
organisations and other international institutions (credentialed) to provide cultural
competency training as well as international relations training in the basics of
communication and conflict resolution. Understanding cultural backgrounds and the
effects of living in a society that limits one’s education and advancement, we as
healthcare professionals must identify failed communication, and also be able to identify
the causes so that we will be able to adopt remedial behaviour. (c) The ability and the
willingness of countries and people in urgent needs for healthcare advancement and
basic necessities assistance (under privilege society), quoting Dr. Bruce Block from
University of Pittsburgh School of Medicine “weather it be male or black or white or
young; or poor, or credentialed; must put aside sexism, racism, ageism, classism and
elitism”.
The providers (dominant society), the healthcare professionals (credentialed) and the
recipients (under privilege) must come together for the common cause to eliminate
extreme poverty and fight against all diseases that threaten the health and safety of
mankind, animals and plants.
MERO INTERNATIONAL shares these points of view and dedicates their time, resources
and efforts to be a part of the global responsibility to “help make the world a better
place”.
81
82
XVIII. Economic Growth
PRODUCTS MANUFACTURING & PROCESSING
CANADA
0.5
0.4
0.3
0.2
0.1
0.0
YEAR 1 YEAR 2 YEAR 3 YEAR 4 YEAR 5
M.I.S.M.C
MAY 2004
MERO International has always emphasised the need for innovation backed by science.
Our Scientific Research have shown the need for quality pharmaceutical, medical,
healthcare, food products and supplements that use only carefully selected raw material,
which we incline to use at all times. Our dedication is to become a world class
manufacturer, processor and distributor to a broad range of products, which will enable
the organisation to experience steady growth.
The indications on the graph shows that pharmaceutical and medical products will be our
first line, where we shall give emphasis to the manufacturing of Asthmatic, Diabetic,
HIV/AIDS, Malaria, Rheumatic and other Infectious diseases products.
BioNeurogenic products that will enhance immunity the natural way and that will offer
the advantages as nutritional supplements towards additional immune support. These
products can be use for HIV/AIDS, Cancer, Autoimmune disorders and Allergies such as
rhinitis, sneezing, headaches, intestinal disturbances, hives, asthma and anaphylactic
shock, rheumatoid arthritis, kidney disorders, pain, weight loss or gain, diabetes,
multiple sclerosis and chronic bronchitis, to name a few.
Health Food products for healthy eating, diet and protein bars, snacks, low-crab foods
and beverages, cereals, flakes, flax and pumpkin granola, teas, chips, ready-to-eat
chicken broth, gravies and soups, rice crust, natural juices, energy beverages and
oxygen water.
83
MANUFACTURING■PROCESSING■DISTRIBUTION
■PHARMACEUTICAL■NUTRITION■HEALTH■FOOD■SUPPLEMENTS■
MERO INTERNATIONAL SCIENTIFIC MULTIPURPOSE COMPLEX
MANUFACTURING-PROCESSING-DISTRIBUTION
QUEBEC, CANADA
PRODUCTS MM/YR QUANTITY PROD. COST SOCIAL PRICE SELLING PRICE TOTAL COST AT SP
PHARMACEUTICAL
ASTHMA 350 BOTTLES-180 ML US$ 1.15/B US$ 2.50/B US$ 3.75/B US$ 875,000,000
50 BOXES-20 T /BOX US$ 1.20/BOX US$ 2.43/BOX US$ 3.68/BOX US$ 121,500,000
15 INJECTIONS-3/BOX US$ 5.75/BOX US$11.50/BOX US$17.50/BOX US$ 172,500,000
15 INHALERS US$ 2.25/UNIT US$ 3.50/UNIT US$ 7.00/UNIT US$ 675,000,000
10 DROPLETS-5 ML US$ 1.10/UNIT US$ 2.25/UNIT US$ 3.50/UNIT US$ 22,500,000
10 DIABETES-130 ML US$ 1.55/B US$ 3.25/B US$ 4.90/B US$ 32,500,000
5 FEVER-100 ML US$ 1.35/B US$ 2.75/B US$ 4.25/B US$ 13,750,000
5 INFLUENZA-100 ML US$ 1.35/B US$ 2.75/B US$ 4.25/B US$ 13,750,000
CONDOMS 150 BOXES-3C US$ 0.15/B US$ 0.75/B US$ 1.25/B US$ 112,500,000
DIABETES I & II 100 INSULIN-5/BOX US$ 1.65/BOX US$ 3.50/BOX US$ 4.95/BOX US$ 330,000,000
50 BOTTLES-120 ML US$ 1.20/B US$ 2.50/B US$ 3.75/B US$ 125,000,000
25 BOTTLES-30 T US$ 1.20/B US$ 2.50/B US$ 3.75/B US$ 62,500,000
10 BOXES-POWDER US$ 1.75/BOX US$ 2.75/BOX US$ 4.25/BOX US$ 27,200,000
HIV/AIDS 250 INJECTION-5/BOX US$ 1.50/BOX US$ 3.25/BOX US$ 4.90/BOX US$ 812,500,000
5 COCKTAIL US$56.25/UNIT US$112.50 US$175 US$ 562,500,000
25-180 C/B US$ 1.55/B US$ 3.50/B US$ 5.50/B US$ 87,500,000
25-150 ML/B US$ 1.55/B US$ 3.50/B US$ 5.50/B US$ 87,500,000
500 NR-SYRINGE US$ 0.05/PK US$ 0.25/PK US$ 0.38/PK US$ 125,000,000
INFECT DISEASES 250 ANTIBIOTIC INJ US$ 1.25/BOX US$ 2.50/BOX US$ 3.75/BOX US$ 625,000,000
50 ANTIB-150 ML/B US$ 1.10/B US$ 2.25/B US$ 3.50/B US$ 112,500,000
10 ANTIB-1O T/BOX US$ 1.10/BOX US4 2.25/BOX US$ 3.50/BOX US$ 22,500,000
MALARIA 200 BOXES-20 T US$ 1.50/BOX US$ 3.50/BOX US$ 5.75/BOX US$ 700,000,000
50 INJECTION-3/BOX US$ 1.75/BOX US$ 4.24/BOX US$ 7.00/BOX US$ 212,500,000
25 BOLLTES-150 ML US$ 1.75/B US$ 4.25/B US$ 7.00/BOX US$ 106,250,000
RHEUMATISM
INFLAMMATORY 100 INJECTIONS-3/BOX US$ 1.15/BOX US$ 2.25/BOX US$ 3.5/BOX US$ 225,000,000
10 BOTTLES-180 ML US$ 1.00/B US$ 2.00/B US$ 3.0/B US$ 20,000,000
10 BOXES 20 T US$ 1.00/BOX US$ 2.00/BOX US$ 3.0/BOX US$ 20,000,000
INTRA-ARTICULACY 50 INJECTIONS-3/BOX US$ 1.25/BOX US$ 2.50/BOX US$ 3.75/BOX US$ 125,000,000
10 BOTTLES-150 ML US$ 1.00/B US$ 2.00/B US$ 3.00/B US$ 20,000,000
10 BOXES-20 C US$ 1.00/BOX US$ 2.00/BOX US$ 3.00/BOX US$ 20,000,000
CORTICOSTEROIDS 50 INJECTIONS-3/BOX US$ 1.25/BOX US$ 2.50/BOX US$ 3.75/BOX US$ 125,000,000
10 BOTTLES-120 ML US$ 1.00/B US$ 2.00/B US$ 3.00/B US$ 20,000,000
10 BOXES-20 C US$ 1.00/BOX US$ 2.00/BOX US$ 3.00/BOX US$ 20,000,000
VITAMINS A 5 CAPSULES-30/B US$ 1.25/B US$ 2.50/B US$ 3.75/B US$ 12,500,000
5 BOTTLES-180 ML US$ 1.25/B US$ 2.50/B US$ 3.75/B US$ 12,500,000
A &D 5 CAPSULES-30/B US$ 1.25/B US$ 2.50/B US$ 3.75/B US$ 12,500,000
5 BOTTLES-180 ML US$ 1.25/B US$ 2.50/B US$ 3.75/B US$ 12,500,000
5 CHEWABLE-30 C US$ 1.25/B US$ 2.50/B US$ 3.75/B US$ 12,500,000
B1 5 INJECTIONS-5/BOX US$ 1.25/BOX US$ 2.25/BOX US$ 3.50/BOX US$ 11,250,000
5 CAPSULES-30/B US$ 1.25/B US$ 1.25/B US$ 3.50/B US$ 11,250,000
84
MANUFACTURING■PROCESSING■DISTRIBUTION
■PHARMACEUTICAL■NUTRITION■HEALTH FOOD SUPPLEMENTS■
MERO INTERNATIONAL SCIENTIFIC MULTIPURPOSE COMPLEX
MANUFACTURING-PROCESSING-DISTRIBUTION
QUEBEC, CANADA
PRODUCTS MM/YR QUANTITY PROD. COST SOCIAL PRICE SELLING PRICE TOTAL COST AT SP
PHARMACEUTICAL
VITAMIN B6 10 INJ 300 MG-5/BOX US$ 1.25 US$ 2.25 US$ 3.50/BOX US$ 35,000,000
5 BOTTLES-180 ML US$ 1.25 US$ 2.50 US$ 3.75/B US$ 12,500,000
5 CAPSULES-30/B US$ 1.25 US$ 2.50 US$ 3.75/B US$ 12,500,000
B12 5 CAPSULES-30/B US$ 1.25 US$ 2.50 US$ 3.75/B US$ 12,500,000
5 DROPS-1ML US$ 1.00 US$ 2.00 US$ 3.00/UNIT US$ 10,000,000
5 LIQUID-180 ML/B US$ 1.25 US$ 2.50 US$ 3.75/B US$ 12,500,000
10 INJ-1 ML 5/BOX US$ 1.25 US$ 2.50 US$ 3.75/BOX US$ 37,500,000
C 5 INJ-100MG 5/BOX US$ 1.25 US$ 2.50 US$ 4.25/BOX US$ 12,500,000
5 DROPS 1 ML US$ 1.00 US$ 2.25 US$ 3.25/UNIT US$ 11,250,000
5 LIQUID-150 ML US$ 1.25 US$ 2.50 US$ 3.75 US$ 12,500,000
5 CHEWABLE-30/B US$ 1.25 US$ 2.75 US$ 4.50 US$ 13,750,000
5 EFFERVESCE-500 MG US$ 1.25 US$ 2.50 US$ 3.50 US$ 12,500,000
D 2 LIQUID-120 ML US$ 1.25 US$ 2.50 US$ 3.75 US$ 5,000,000
3 SPRAY-2.5 UI/G US$ 1.05 US$ 2.25 US$ 3.50 US$ 6,750,000
E 25 CAPSULES US$ 1.05 US$ 2.25 US$ 3.50 US$ 56,250,000
5 LIQUID-150 ML US$ 1.25 US$ 2.25 US$ 3.50 US$ 11,250,000
5 SPRAY-3.5 UI/ML US$ 1.15 US$ 2.25 US$ 3.50 US$ 11,250,000
K 3 INJ-10 MG 3/BOX US$ 1.50 US$ 3.00 US$ 5.00 US$ 9,000,000
3 SPRAY-3.5 UI/ML US$ 1.15 US$ 2.50 US$ 3.50 US$ 7,500,000
3 CAPSULES-30/B US$ 1.25 US$ 2.50 US$ 3.75 US$ 7,500,000
BIONEUROGENIC
US$ 25,000,000
NUTRA STRESS 5 BOTTLES-60/B US$ 1.50 US$ 5.00 US$15.00 US$ 25,000,000
GINKGO PLUS 5 BOTTLES-60/B US$ 1.50 US$ 5.00 US$15.00 US$ 25,000,000
CALCIUM 5 BOTTLES-60/B US$ 1.50 US$ 5.00 US$15.00 US$ 25,000,000
EVENING PLUMROSE 5 BOTTLES-60 S-GEL US$ 1.50 US$ 5.50 US$15.00 US$ 27,500,000
COENZYME 3 BOTTLES-60
1.50/B
S-GEL US$ 1.50 US$ 5.00 US$15.00 US$ 15,000,000
THERA 2 BOTTLES-60 S-GEL US$ 1.75 US$ 5.75 US$18.00 US$ 10,000,000
CAT'S CLAW 5 BOTTLES-60 S-GEL US$ 1.50 US$ 5.00 US$15.00 US$ 25,000,000
GLUSOSAMINE PLUS 2 BOTTLES-60
2.75/B
S-GEL US$ 1.75 US$ 5.75 US$18.00 US$ 11,500,000
CHONDROITIN COMP 2 BOTTLES-60
2.75/B
S-GEL US$ 1.50 US$ 5.00 US$15.00 US$ 10,000,000
GLUC0-CHONDROITIN 2 BOTTLES-60 3.75/B
S-GEL US$ 1.75 US$ 5.75 US$18.00 US$ 11,500,000
SUPER B COMP 5 BOTTLES-60 S-GEL US$ 1.50 US$ 5.00 US$15.00 US$ 25,000,000
NATURAL V-E 100IU 5 BOTTLES-60 S-GEL US$ 1.25 US$ 5.00 US$15.00 US$ 25,000,000
NATURAL V-E 400IU 5 BOTTLES-60 S-GEL US$ 1.50 US$ 5.00 US$15.00 US$ 25,000,000
ZINC LOZENGES
1.75/B 2 BOTTLES-90 T/B US$ 1.75 US$ 5.75 US$18.00 US$ 11,500,000
GAMMA ORYZANOL 2 BOTTLES-90 S-GEL US$ 1.50 US$ 5.00 US$15.00 US$ 10,000,000
KELP-LECITHIN B6 CIDER2 BOTTLES-90 T US$ 1.50 US$ 5.00 US$15.00 US$ 10,000,000
LYCOPENE 2 BOTTLES-90 S-GEL US$ 1.50 US$ 5.00 US$15.00 US$ 10,000,000
PINE BARK EXTRACT 2 BOTTLES-90 TABLETSUS$ 1.75 US$ 5.75 US$18.00 US$ 11,500,000
OCU-PLEX LUTEIN 2 BOTTLES-90 TABLETSUS$ 1.75 US$ 5.75 US$18.00 US$ 11,500,000
SHARK CARTILAGE 5 BOTTLES-60 S-GEL US$ 1.50 US$ 5.00 US$15.00 US$ 25,000,000
MULTIPLE IMMUNE FAC 3 BOTTLES-90 TABLETSUS$ 1.50 US$ 5.00 US$15.00 US$ 15,000,000
WOMEN'S BREAST H 3 BOTTLES-90 TABLETSUS$ 1.50 US$ 5.00 US$15.00 US$ 15,000,000
VEIN & CIRCULATING S 2 BOTTLES-90 TABLETSUS$ 1.50 US$ 5.00 US$15.00 US$ 10,000,000
CHEWABLE MULTI V 3 BOTTLES-60 S-GEL US$ 1.50 US$ 5.00 US$15.00 US$ 15,000,000
MULTI NUTRIENT 3 BOTTLES-90 TABLETSUS$ 1.50 US$ 5.00 US$15.00 US$ 15,000,000
VITAMIN C 500 MG 2 BOTTLES-60 TABLETSUS$ 1.25 US$ 5.00 US$15.00 US$ 10,000,000
85
MANUFACTURING■PROCESSING■DISTRIBUTION
■PHARMACEUTICAL■NUTRITION■HEALTH FOOD SUPPLEMENTS■
MERO INTERNATIONAL SCIENTIFIC MULTIPURPOSE COMPLEX
MANUFACTURING-PROCESSING-DISTRIBUTION
QUEBEC, CANADA
PRODUCTS MM/YR QUANTITY PROD. COST SOCIAL PRICE SELLING PRICE TOTAL COST AT SP
BIONEUROGENIC
CHEWABLE VIT
VC C 5 BOTTLES 250 MG-90 US$ 1.25 US$ 3.50 US$ 5.50 US$ 17,500,000
MINERALS 5 BOTTLES-90 T US$ 1.25 US$ 4.00 US$ 5.50 US$ 20,000,000
CHROMIUM PICOLINATE 5 BOTTLES 200-90 US$ 1.25 US$ 4.25 US$ 7.00 US$ 22,125,000
MAGNESIUM 5 BOTTLES 200 MG-90 TUS$ 1.25 US$ 4.25 US$ 7.00 US$ 22,125,000
POTASSIUM 5 BOTTLES 83.5 MG US$ 1.00 US$ 4.25 US$ 7.00 US$ 22,125,000
MANGENESE 5 BOTTLES 50 MG-90 T US$ 1.25 US$ 4.25 US$ 7.00 US$ 22,125,000
CALCIUM CITRATE 5 BOTTLES 90 TABLETSUS$ 1.25 US$ 4.25 US$ 7.00 US$ 22,125,000
CALCIUM COMPLEX 5 BOTTLES 90 TABLETSUS$ 1.25 US$ 4.25 US$ 7.00 US$ 22,125,000
COD LIVER OIL 10 BOTTLES S-GEL US$ 1.00 US$ 3.50 US$ 5.50 US$ 35,000,000
BEE POLLEN 10 BOTTLES 500 MG US$ 1.25 US$ 4.25 US$ 7.00 US$ 42,500,000
HAWAIIAN SPIRULINA 5 BOTTLES 500 MG US$ 1.25 US$ 5.00 US$ 8.00 US$ 25,000,000
PHOSPHATIDYL CHOLIN5 BOTTLES 90 S-GEL US$ 1.25 US$ 3.75 US$ 6.00 US$ 18,750,000
CHEWABLE PROTEIN 5 BOTTLES 90 T US$ 1.25 US$ 3.00 US$ 5.00 US$ 15,000,000
BREATH FRESH CAP 10 BOTTLES 60 S-GEL US$ 1.05 US$ 2.25 US$ 4.25 US$ 22,500,000
ALOE VERA-HONEY 10 BOTTLES 90 S-GEL US$ 1.05 US$ 3.75 US$ 6.00 US$ 37,500,000
ALOE VERA-HONEY 5 BOTTLES 180 ML US$ 1.25 US$ 3.75 US$ 6.00 US$ 18,750,000
ANISE-MINT SPRAY 5 UNITS 3.5 ML US$ 1.15 US$ 2.25 US$ 5.00 US$ 11,250,000
ANISE-MINT 5 BOTTLES 150 ML US$ 1.50 US$ 3.00 US$ 5.00 US$ 15,000,000
CARROT-PAPAYA 10 BOTTLES 90 S-GEL US$ 1.15 US$ 3.75 US$ 6.00 US$ 37,500,000
DIENTE LION 5 BOTTLES 90 CAP US$ 1.25 US$ 4.50 US$ 7.00 US$ 22,500,000
OREGANO SPRAY 3 UNITS 3.5 ML US$ 1.25 US$ 2.50 US$ 4.50 US$ 7,500,000
OREGANO 3 BOTTLES 150 ML US$ 1.25 US$ 3.75 US$ 5.50 US$ 11,250,000
PARSLEY 3 BOTTLES 90 CAP US$ 1.15 US$ 3.75 US$ 6.00 US$ 11,250,000
PARSLEY 3 BOTTLES 150 ML US$ 1.50 US$ 5.00 US$15.00 US$ 15,000,000
PEANUT OIL SPRAY 2 UNITS 3.5 ML US$ 1.50 US$ 5.00 US$15.00 US$ 10,000,000
PEANUT OIL 2 BOTTLES 150 ML US$ 1.50 US$ 5.00 US$15.00 US$ 10,000,000
GINSENG-BEE POLLEN 5 BOTTLES-60 S-GEL US$ 1.50 US$ 5.50 US$15.00 US$ 27,500,000
GINSENG-BEE POLLEN 5 BOTTLES 150 ML US$ 1.50 US$ 5.00 US$15.00 US$ 25,000,000
TAMARIND CAPSULE 2 BOTTLES-60 S-GEL US$ 1.75 US$ 5.75 US$18.00 US$ 11,500,000
TAMARIND 2 BOTTLES 150 ML US$ 1.50 US$ 5.00 US$15.00 US$ 10,000,000
ARSENIC-CABBAGE 2 BOTTLES 90 S-GEL US$ 1.75 US$ 5.75 US$18.00 US$ 11,500,000
NEEM CAPSULE 5 BOTTLES 90 S-GEL US$ 1.50 US$ 5.00 US$15.00 US$ 25,000,000
NEEM SPRAY 5 UNITS 3.5 ML
3.75/B US$ 1.75 US$ 3.00 US$18.00 US$ 15,000,000
CANTALOUGE CAP 5 BOTTLES-60 S-GEL US$ 1.25 US$ 5.00 US$15.00 US$ 25,000,000
CANTALOUGE TAB 5 BOTTLES 60 TAB US$ 1.50 US$ 5.00 US$15.00 US$ 25,000,000
CANTALOUGE 5 BOTTLES 150 ML US$ 1.75 US$ 5.75 US$18.00 US$ 28,750,000
PINE-APPLE CAPSULE 3 BOTTLES 90 S-GEL US$ 1.50 US$ 5.00 US$15.00 US$ 15,000,000
PINE-APPLE TABLETS 2 BOTTLES-90 T US$ 1.50 US$ 5.00 US$15.00 US$ 10,000,000
GINGER CAPSULE 5 BOTTLES 90 S-GEL US$ 1.75 US$ 5.75 US$18.00 US$ 28,750,000
GINGER TABLETS 5 BOTTLES 250 MG US$ 1.75 US$ 5.75 US$18.00 US$ 28,750,000
KELP CAPSULE 3 BOTTLES 60 S-GEL US$ 1.50 US$ 5.00 US$15.00 US$ 15,000,000
DONG QUAI 3 BOTTLES 90 S-GEL US$ 1.50 US$ 5.00 US$15.00 US$ 15,000,000
McFOODS
AQUA ZIP 500 BOTTLES 330 ML US$ 0.25 US$ 1.00 US$ 1.75 US$ 500,000,000
MALT-GINSENG 500 BOTTLES 250 ML US$ 0.35 US$ 1.00 US$ 1.75 US$ 500,000,000
BEVERAGES 500 BOTTLES 300 ML US$ 0.30 US$ 1.00 US$ 1.75 US$ 500,000,000
FRUITS DRINK MIX 500 PK 50 G US$ 0.25 US$ 0.75 US$ 1.25 US$ 375,000,000
HEALTH SNACK 500 UNITS 50 G US$ 0.35 US$ 1.00 US$ 1.50 US$ 500,000,000
86
XIX. CONCLUSION: THE UN VIEWS TOWARDS
EXTREME POVERTY
At the start of the new Millennium, one in five of the world’s population - 1.2 billion people -
live in abject poverty, without adequate food, water, sanitation, healthcare or education for
their children. And yet this is a time of a growing abundance of knowledge, technology and
capital which is generating growing wealth and material plenty. It is now completely possible
to remove extreme poverty from the human condition. It is no longer a dream to be
achieved in the distant future; it is achievable in our generation if we can generate the
political will. To do that, we need to focus on systematic poverty reduction in developing
country governments, the UN system, the international financial institutions and the OECD
countries.
The moral case for a greater effort is clear. Current levels of poverty and inequality in the
world are the biggest moral challenge humanity faces. But we live at a time when the moral
challenge and our self interest coincide. If we do not do better in reducing that inequality it
will lead to growing conflict, refugee movements, environmental degradation, disease and
natural disasters. This will bring instability and danger to the future generation wherever
they live. Thus we have a clear self interest in combining together systematically to reduce
and then eliminate abject poverty from the human condition.
Some have reacted with alarm to the rapidity and scale of this change. But the lesson of
history is clear: open societies that learn from and trade with others are enriched materially
and culturally. In recent decades, it is those countries which have seized the opportunity
offered by more open world markets to increase exports and attract inward investment that
have made the greatest strides in reducing poverty. If the poorest countries can be drawn
into the global economy and increase their access to modern knowledge and technology, the
world could make massive progress towards the removal of abject poverty from the human
condition. If they are not, we will see growing poverty, marginalisation, conflict and
environmental degradation.
The systematic reduction of extreme poverty requires more international co-operation, not
less and flows of trade and investment that make available the fruits of modern knowledge
and technology to the poor of the world. The question is not whether we should be “for” or
“against” Globalisation, but “to ensure that Globalisation becomes a positive force for the
entire world’s people, instead of leaving billions of them behind in squalor”.
87
XX. COUNTRIES OF PROJECT INTEREST
1 HAITI
2 NICARAGUA
3 BELIZE
4 BOLIVA
5 COLOMBIA
6 CUBA
7 DOMINICAN REPUBLIC
8 EQUADOR
9 EL SALVADOR
10 GUATEMALA
11 GUYANA
12 HONDURAS
13 JAMAICA
14 PARAGUAY
15 PERU
16 SAINT VINCENT AND
THE GRENADINES
17 SURINAME
18 BARBADOS
19 PANAMA
20 TRINIDAD & TOBAGO
21 VENEZUELA
22 BRAZIL
23 TIBET
24 NEPAL
25 MEXICO
26 INDIA
27 AFRICA
28 MIDDLE-EAST COUNTRIES
29 FAR-EAST COUNTRIES
30 EASTERN EUROPE
88
XXI. SOCIO-ECONOMICAL PHILOSOPHY
Poor health and inadequate healthcare are often related to human rights violations;
violation that under fulfilment of human rights are often due to poor health and lack of
access to healthcare. The link is direct in the case of other basic social and economic
human rights such as the right to a standard of living adequate for the health and well-
being of oneself, and one’s family. Nevertheless, poverty and lack of health protection
are indirectly linked to failures to secure civil rights.
Some of the realisations of other human rights are not possible if an individual cannot
maintain his/her own health. Most crucial health needs includes the prevention of
stillbirths and infant mortality; the improvement of environmental and industrial
hygiene, prevention treatment, and control of diseases, with the provision of medical
care to the sick.
Health and human rights are interconnected and the effects of violations of dignity and
physical integrity on health (mental or otherwise) are as crucial as the effects of poor
health on dignity, it’s the right for everyone to the enjoyment of the highest attainable
standard of physical and mental health; where governments have obligations to
respect, protect and fulfil the right to health as well as other human rights.
Healthcare is further defined as ¡n all those activities intended to sustain, promote, and
enhance health. A few questions that are being raised in the local and state
governments as well as governments abroad are: should all people have access to
healthcare and should varying social factors affect our ability to receive healthcare? It
is amazing that even in this 21ST century most governments have no idea as to what
should be done in regards to healthcare, who should receive and why they should
receive it, and how much they should receive or deem them worthy to receive it.
89
Studies have shown that among the sexes there is a wide variance as to healthcare
assistance from the government; married and single females believe that the
government should be responsible for providing healthcare for the sick, especially
children; while males feel just the opposite, they feel it is the responsibility of the
parent(s) to care for their child’s healthcare. As well the social classes levels differ
greatly when it comes to should the government provide healthcare, 51% of those in
lower income brackets feel the government should provide healthcare for those who
are unable to pay and 30% of those in higher income levels feel the same way.
The world citizens must fathom their way of thinking towards longevity, infant
mortality, and inadequate immunizations, all because most people can not access
healthcare due to money. According to Health Resources Administration, sixty-five to
seventy-five percent of all patients seen in a non-profit healthcare clinic live below
the poverty level. Money and good health have always gone hand in hand, and
unfortunately the patients with the most money usually get the best care.
Impoverished people either can’t afford the services needed to survive, or the
services provided are too primitive and unsanitary to do any good.
What is Adequate Health and who is deserves the right to receive it?
The right to a standard of living adequate for the health and well being of oneself and
his family, including food, clothing, housing, education and medical care. Because
from state to state and country to country the standards of living vary, what is
feasible in one place is definitely not in another, governments must realise these
changes and need and make the necessary provisions. The International Covenant
on Economic, Social and Cultural Rights (ICESCR) defines adequate health in a similar
way; the right of everyone to the enjoyment of the highest and attainable standard of
physical and mental health.
It should be determine whether it can be assessed and/or compared to, with respect
to the economic relations of a single nation or with respect to the global community.
In some cases the highest attainable standard of living that a state or country can
provide does not satisfy the existing consensus on the minimum health-related rights
to which all people are entitled; therefore the richer and developed countries should
come to terms to help the poorer nations.
Countries who cannot provide adequate healthcare for the lower income population,
based on the monies they receive from the government and the way the money is
distributed in the states and countries; must seek assistance from the global
communities for firstly, technical assistances to enhance their health problems and
secondly; if requires after a full assessment, financing to build an international
health, education and better living standard.
90
Uncensored burning of fossil fuels, the increasing reliance on vehicle transportation,
the loss of many of the world’s carbon sinks through deforestation, and the
accompanying effects of global warming is having a dramatic effect on the health of
the world’s population. Recent studies from the USA suggest air pollution is affecting
fatal growth, and may even be causing DNA damage in unborn children. A report
from the UK has linked an increase in brain diseases (such as Alzheimer’s and
Parkinson’s) to environmental factors such as car pollutants, and toxic chemicals like
agricultural pesticides. The World Health Organization (WHO) claims millions of
children die every year, mainly in the developing world, from diseases related to their
environments. Health and development are intimately interconnected. Both
insufficient development leading to poverty and inappropriate development are
resulting into sever environmental health problems.
Theories and models of health behaviour can be used to explain behaviour and clarify
the effects of external influences on individuals. Health promotion educators use
many different models for understanding behaviour change and designing successful
interventions. Some common models are used to describe and predict behaviour.
Skinner and Pavlov introduced a behavioural and operant conditioning theory that
stated humans are biological machines and behaviour is a product of conditioning,
Freud argued humans are driven by subconscious instinct in his Psychoanalytic
theory, and Rogers started a wellness movement in his humanist and client-centred
view. Behaviour theories exist on many levels including individual, familial, and
societal. On an individual level, the Health Belief Model states that changes in
behaviour depend on an individuals belief that a health problem is serious (perceived
severity), that one may be susceptible to the problem (threat), that changing one's
behaviour will reduce the threat (benefit), ones perception of the obstacles necessary
to change the behaviour (barriers), and the belief that one has the ability to change
one's behaviour (self- efficacy.)
91
The Social Cognitive Theory proposes that behaviour change is influenced by the
environment, personal factors, and aspects of the behaviour itself. The theory
explains ways individuals gain and maintain attention, specifically addressing the
processes of attention, retention, reproduction and motivation. Individuals experience
an education process consisting of reinforcement, self-efficacy, behavioural capacity
(learning what to do and how), expectations, and outcome expectancy. Social
Cognitive theory helps a health educator understand the complex relationships
between the individual and his or her environment, how actions and conditions
reinforce or discourage change, and the importance of believing in and knowing how
to change.
Many would agree that the media are the biggest educators in today’s society. "By
age 18 a young person will have seen over 350,000 commercials and spent more
time being entertained by the media than any other activity except sleeping (Walsh.)"
A society with such immense media-saturation is cause for concern, especially in
regards to health. The impact of the media on adolescents in terms of nutrition,
sexual information, alcohol and tobacco, violence, and stress has been greatly
evaluated. By examining these areas, we can begin to address and examine how
media literacy can be used to reduce the negative influences mass media are believed
to have on young people's health-related attitudes and behaviours (Yates).
Proper nutrition is especially important for adolescents. Early dietary decisions can
have lifelong health implications such as obesity, poor nutrition, and inadequate
female reproductive development. The media often perpetuates poor diet decisions.
One study estimated that early adolescents between two and twelve contributed
$82.4 billion in food and beverage purchases in 1990 (Walsh.)” Even more alarming
is the issue of body image. Young adolescents are led to believe that the media-
created image of the ideal body is how their bodies should look. In an attempt to
have the perfect body, females often end up adopting fad diets that may lead to more
serious eating disorders. Boys are susceptible to media body images because they
want to build muscles like many actors and sports heroes. This desire to "bulk up"
can lead to poor diet and possibly the use of steroids. Awareness in youth could be
increased by having them examine existing advertisements and determine how males
and females are typically portrayed. An effort must be made not to depict either
gender in a stereotypical way. By analyzing media, we learn about the inherent
meaning of body image, body language, and stereotypes.
Mass media also provide formal and informal messages about sexuality. Adolescents
are adopting norms for their behaviour based on what they see and hear in the
media. “Liebert and Sprafkin concluded that adolescents who watch a lot of sexual
content on TV are less satisfied with their sexuality and develop misconceptions.
Although sexuality is a difficult topic to discuss with youngsters, an effort must be
made to create media literate people who can evaluate the sexual information
provided by the mass media. .
Television shows depicting the awkwardness and confusion surrounding sexuality can
be used to help young people understand it is normal to feel anxious about sex and
that they should talk about their feelings. Discussing these issues may reduce young
people anxiety about sex and help them feel more comfortable with their emotions
and physical changes.
92
It is my belief that all human being must live in a healthy society, and the
fundamental requirement is to enjoy harmonic human relations. In effect, we all
know very well of satisfactory and the placenta things that are important to human
relations and the tragedy that will be endure if not to have them.
The so disquieting inadequate living conditions are commented to “stress" (tension)
in humanity, which are of predominant to the consequence of experiences of
unsatisfactory human relations, or the risk of which thus happens. These
unsatisfactory conditions disturbed in human relations, imply a verified threat clearly
to the problems of mental and organic health.
In effect, most psychosomatic diseases (null and violable colon, asthma, allergies,
hypertension, etc.), are direct consequences of tension and emotional disorders.
Also, to which tension accelerates arteriosclerosis, that affects the sexual functions
when altering the balance of respective hormones, and there is consensus between
specialists that cancer has outstanding factor to tension. On the other hand the
functional mental upheavals (functional neuroses, inhibitions, depression, psychoses)
depend essentially on the problematic behaviour in human relations.
Even, the failure in the studies or "scholastic failure", discarding the factor intellectual
capacity, derives in most of the cases of disturbed human relations of young people
with their family and/or society. The motivational cycle begins when a necessity
arises, dynamic and persistent force that originates the behaviour. Whenever a
necessity appears this breaks the state of balance of the organism and produces a
state of tension, dissatisfaction, inconformism and imbalance that makes the
individual develop a behaviour or action able to unload the tension and to release it
to the inconformity and the imbalance. If the behaviour is effective, the individual
will satisfy the necessity and therefore will unload the tension caused by the
change(s). Once satisfied the necessity, the organism returns to its previous state of
balance and its adaptation to the environment. A single satisfied necessity does not
originate any behaviour, on the other hand; societal satisfied necessities do influence
in the behaviour and they direct it towards the benefits of individuals’ objectives.
In the relations with our resemblances, in daily life, usually we take into account
certain attitudes and characteristics to characterise people with who we made contact
with. This is because each human being pronounces himself/herself externally by a
series of expressive forms, these expressive forms, which constitute the individual
modalities, can be of diverse Hindu to them, such as gestures, mimics, reflections of
the voice, corporal attitude, and form to walk, among others. These modalities can
be grouped into categories, in agreement with the attitude that adopts the subject
with respect to its resemblances and with his/her life experience.
Providing effective healthcare, education, housing and better living conditions to low
income families; requires an understanding of the potential cultural difficulties, which
may be faced.
The bottom line is that society must put aside their conventional morality and deal
with the changing behaviour, surroundings and individual thinking of the future
generation…the young people.
93
Princess Diana done just that, she put aside the complexities that associated with
conventional morality and dealt with the changing world to support many charities
related to homeless and deprived children, drug abuse, and victims of HIV/AIDS. She
shocked the world when she publicly shook the hand of an AIDS patient in 1987.
Former South African President Nelson Mandela said on November 2, 2002, "Caring
for people who are dying and helping the bereaved was something for which Princess
Diana had passion and commitment," he announced that the Nelson Mandela
Children's Fund had planned to join the Diana, Princess of Wales Memorial Fund to
help South Africans with HIV/AIDS and their families and to assist children orphaned
by the disease. "When she stroked the limbs of someone with leprosy, or sat on the
bed of a man with HIV/AIDS and held his hand, she transformed public attitudes and
improved the life chances of such people".
Mandela later commented about the late Princess. "People felt if a British Princess can
go to a ward with HIV patients, then there's nothing to be superstitious about."
HOSPITAL
94
XXII. HIV/AIDS
Human immunodeficiency virus (HIV) is a virus that attacks the immune system,
making it difficult for the body to fight infection and disease.
HIV is the same virus that causes acquired immunodeficiency syndrome (AIDS),
which increases a person's risk of developing certain cancers and infections. AIDS is
the last and most severe stage of the HIV infection. However, having HIV does not
mean you have AIDS. The good news is that people who are being treated for HIV
are living longer than ever before with the help of drugs that slow the rate at which
HIV infection progresses to AIDS.
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What are the symptoms?
Early symptoms of HIV are often mistaken for the flu (influenza) or mononucleosis.
These symptoms include fever, sore throat, headache, muscle aches, and joint pain.
A skin rash may develop, along with abdominal cramps, nausea, vomiting, or
diarrhoea. However, many people have no early symptoms of HIV.
The incubation period—the time between when a person is first infected with HIV and
when early symptoms develop—may be a few days to several weeks; the early
symptoms usually disappear on their own within 2 to 3 weeks.
After you recover from symptoms of the initial HIV infection, you may not have
symptoms again for many years. However, as HIV progresses, symptoms reappear
and then remain. These symptoms usually include fatigue, unexplained weight loss,
fever, night sweats, and swollen lymph nodes. A health professional may first suspect
an HIV infection only when symptoms persist for no other reason.
From an estimate of 40 million people living with HIV/AIDS today, over 95% live in
developing countries. In developing countries, less than 10% of those infected have
access to antiretroviral therapy, which is used to treat HIV/AIDS. In countries such as
South Africa and Zimbabwe, where 20-25% of the adult population is infected; AIDS
is set to claim the lives of around half of all 15 year-olds. HIV/AIDS can destroy
entire societies. The impact that HIV/AIDS can have on access to education, and
ultimately, a nation's economic competitiveness; the AIDS pandemic has robbed
more than 14 million children worldwide of their families, their childhood, and all too
often, hope for the future.
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How is HIV diagnosed?
A health professional diagnoses HIV with antibody blood tests called the ELISA and
the Western blot assay. A diagnosis of HIV is made after 2 or more positive ELISA
tests are confirmed by a positive Western blot assay. Because it may take up to 6
months after the original infection for antibodies to appear, it is important to repeat
the tests 6 months after being exposed to the virus. If you are infected, you can still
pass HIV to another person during this time.
Getting tested for HIV can be scary; however, the condition is treatable so it is
important to get tested if you think you have been exposed. If you test positive, early
detection and monitoring of HIV will help your doctor determine whether the disease
is progressing and when to start treatment.
Treatment for HIV depends on what stage of the infection you are in: early,
established, or late (AIDS). This is determined by your CD4+ cell count, the amount
of virus in your blood (viral load), and whether you have had certain illnesses that are
more common in people who have weakened immune systems.
If you are in the early stages of HIV, you have no symptoms, and your viral load is
low, you may not need treatment yet. Your doctor will monitor the progression of the
virus and may recommend using a combination of three or more antiretroviral drugs
called highly active antiretroviral therapy, or HAART, which may strengthen your
immune system and reduce your viral load.
If you are in the established stage of HIV or have AIDS, HAART is usually
recommended to manage the progression of the virus.
Successful treatment helps suppress the virus; however, it doesn't cure HIV. It is
important to take your drugs exactly as directed by your doctor. When treatment
doesn't work, it is often because HIV has become resistant to the drug. This can
happen if you don't take your drugs correctly. Ask your doctor if you have questions
about your treatment. Your doctor can help you understand HIV and how best to
treat it.
AIDS is the last and most severe stage of HIV infection. AIDS is diagnosed when you
have one or both of the following:
• A CD4+ cell count of fewer than 200 cells per microliter (µL) of blood.
• Certain infections or illnesses, such as some types of pneumonia or cancer,
which are more likely to develop when you have a weakened immune system.
More than half of adults who have HIV will develop AIDS within 12 or 13 years if their
HIV infection is not treated. Young children and adults who rapidly progress through
the stages of HIV may develop AIDS within about 3 years. When left untreated, AIDS
is often fatal within 18 to 24 months after it develops.
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AIDS weakens the immune system and increases a person's risk of developing
serious illnesses such as certain cancers, opportunistic diseases, and neurological
disorders. AIDS is spread through contaminated blood, specifically through sexual
contact or shared needles. Symptoms include fatigue, weight loss, diarrhoea, fever,
night sweats, thrush (infection in the mouth and throat), and swollen lymph nodes of
the neck, armpits, and groin. Currently, there is no cure for AIDS. Treatment is
supportive and is aimed at maintaining comfort. Medications are also available to
delay the progression of AIDS and improve the person's quality of life. The risk of a
woman spreading HIV to her baby can be greatly reduced if she takes certain
medications during pregnancy and if she does not breast-feed her baby. The baby
should also receive the medication after birth.
AIDS is caused by a virus called HIV, the Human Immunodeficiency Virus. When
you’re infected with HIV, your body will try to fight the infection. It will make
"antibodies," special molecules to fight HIV.
A blood test for HIV looks for these antibodies. If you have them in your blood, it
means that you have HIV infection. People who have the HIV antibodies are called
"HIV-Positive." HIV-positive, or having HIV disease, is not the same as having AIDS.
Many people are HIV-positive but don't get sick for many years. As HIV disease
continues, it slowly wears down the immune system. Viruses, parasites, fungi and
bacteria that usually don't cause any problems can make you very sick if your
immune system is damaged. These are called "opportunistic infections."
HIV testing tells you if you are infected with the Human Immunodeficiency Virus
(HIV) which causes AIDS. These tests look for "antibodies" to HIV. Antibodies are
proteins produced by the immune system to fight a specific germ.
Other "HIV" tests are used when people already know that they are infected with HIV.
These help measure how quickly the virus is multiplying (a viral load test) or the
health of your immune system (a CD4 count).
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The most common HIV test is a blood test. Newer tests can detect HIV antibodies in
mouth fluid (not the same as saliva), a scraping from inside the cheek, or urine.
"Rapid" HIV test results are available within 10 to 30 minutes after a sample is taken.
One of these tests has produced a high rate of false positives. A positive result on any
HIV test should be confirmed with a second test.
Home test kits: You can't test yourself for HIV at home. The Home Access test kit is
only designed to collect a sample of your blood. You send the sample to a laboratory
where it is tested for HIV.
If you become infected with HIV, it usually takes between three weeks and two
months for your immune system to produce antibodies to HIV. If you think you were
exposed to HIV, you should wait for two months before being tested. You can also
test right away and then again after two or three months. During this "window
period" an antibody test may give a negative result, but you can transmit the virus to
others if you are infected.
About 5% of people take longer than two months to produce antibodies. There is one
documented case of a person exposed to HIV and hepatitis C at the same time.
Antibodies to HIV were not detected until one year after exposure. Testing at 3 and 6
months after possible exposure will detect almost all HIV infections. However, there
are no guarantees as to when an individual will produce enough antibodies to be
detected by an HIV test. If you have any unexplained symptoms, speak with your
health care professional and consider re-testing for HIV.
Viral load tests detect pieces of HIV genetic material. They show up before the
immune system manufactures antibodies. Also, in early 2002, the FDA approved
"nucleic acid testing." It is similar to viral load testing. Blood banks use it to screen
donated blood.
The viral load or nucleic acid tests are generally not used to see if someone has been
infected with HIV because they are much more expensive than an antibody test. They
also have a slightly higher error rate.
A positive test result means that you have HIV antibodies, and are infected with HIV.
You will get your test result from health care specialist, who should tell you what to
expect, and where to get health services and emotional support.
Testing positive does not mean that you have AIDS. Many people who test positive
stay healthy for several years, even if they don't start taking medication right away.
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If you test negative and you have not been exposed to HIV for at least three months,
you are not infected with HIV. Continue to protect yourself from HIV infection
You can be tested anonymously in many places. You do not have to give your name
when you are tested at a public health office, or when you receive the test results.
You can be tested anonymously for HIV as many times as you want.
If you get a positive HIV test that is not anonymous, or if you get any medical
services for HIV infection, your name may be reported to the Department of Health.
Antibody test results for HIV are accurate more than 99.5% of the time. Before you
get the results, the test has usually been done two or more times. The first test is
called an "EIA" or "ELISA" test. Before a positive ELISA test result is reported, it is
confirmed by another test called a "Western Blot".
Children born to HIV-positive mothers may have false positive test results for several
months, because mothers pass infection-fighting antibodies to their newborn children.
Even if the children are not infected with HIV, they have HIV antibodies and will test
positive. Other tests, such as a viral load test, must be used.
As mentioned above, people who were recently infected may test negative if they get
tested too soon after being infected with HIV.
HIV testing generally looks for HIV antibodies in the blood, or mouth fluid and/or
urine (not saliva, it’s not the same as mouth fluid). The immune system produces
these antibodies to fight HIV. It usually takes two to three months for them to show
up. In rare cases, it can take longer than three months. During this "window period"
you may not test positive for HIV even if you are infected. Normal HIV tests don't
work for newborn children of HIV-infected mothers.
In many places, you can get tested anonymously for HIV. Once you test positive and
start to receive health care for HIV infection, your name may be reported to the
Department of Health. These records are kept confidential.
A positive test result does not mean that you have AIDS. If you test positive, you
should learn more about HIV and decide how to take care of your health.
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HOW DO YOU GET AIDS?
You don't actually "get" AIDS. You might get infected with HIV, and later you might
develop AIDS. You can get infected with HIV from anyone who's infected, even if they
don't look sick and even if they haven't tested HIV-positive yet. The blood, vaginal
fluid, semen, and breast milk of people infected with HIV has enough of the virus in it
to infect other people. Most people get the HIV virus by:
Blood Transfusion
There are no documented cases of HIV being transmitted by tears or saliva, but it is
possible to be infected with HIV through oral sex or in rare cases through deep
kissing, especially if you have open sores in your mouth or bleeding gums.
The Human Immunodeficiency Virus (HIV) is not spread easily. You can only get HIV
if you get infected blood or sexual fluids into your system. You can't get it from
mosquito bites, coughing or sneezing, sharing household items, or swimming in the
same pool as someone with HIV.
Some people talk about "shared body fluids" being risky for HIV, but no documented
cases of HIV have been caused by sweat, saliva or tears. However, even small
amounts of blood in your mouth might transmit HIV during kissing or oral sex. Blood
can come from flossing your teeth, or from sores caused by gum disease, or by
eating very hot or sharp, pointed food.
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To infect someone, the virus has to get past the body's defences. These include skin
and saliva. If your skin is not broken or cut, it protects you against infection from
blood or sexual fluids. Saliva contains chemicals that can help kill HIV in your mouth.
If HIV-infected blood or sexual fluid gets inside your body, you can get infected. This
can happen through an open sore or wound, during sexual activity, or if you share
equipment to inject drugs.
HIV can also be spread from a mother to her child during pregnancy or delivery. This
is called "vertical transmission." A baby can also be infected by drinking an infected
woman's breast milk. Adults exposed to breast milk of an HIV-infected woman may
also be exposed to HIV.
Unless you are 100% sure that you and the people you are with do not have HIV
infection, you should take steps to prevent getting infected. People recently infected
(within the past 2 or 3 months) are most likely to transmit HIV to others. This is
when their viral load is the highest. In general, the risk of transmission is higher with
higher viral loads.
Sexual Activity
You can avoid any risk of HIV if you practice abstinence (not having sex). You also
won't get infected if your penis, mouth, vagina or rectum doesn't touch anyone else's
penis, mouth, vagina, or rectum. Safe activities include kissing, erotic massage,
masturbation or hand jobs (mutual masturbation).
Oral sex has a lower risk of infection than anal or vaginal sex, especially if there are
no open sores or blood in the mouth.
You can reduce the risk of infection with HIV and other sexually transmitted diseases
by using barriers like condoms. Traditional condoms go on the penis, and a new type
of condom goes in the vagina or in the rectum
Vertical Transmission
With no treatment, about 25% of the babies of HIV-infected women would be born
infected. The risk drops to about 4% if a woman takes AZT during pregnancy and
delivery, and her newborn is given AZT. The risk is 2% or less if the mother is taking
combination antiretroviral therapy (ART). Caesarean section deliveries probably don't
reduce transmission risk if the mother's viral load is below 1000.
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Babies can get infected if they drink breast milk from an HIV-infected mother.
Mothers with HIV should use baby formulas or breast milk from a woman who is not
infected to feed their babies.
Use antiretroviral medications (ARVs): The risk of transmitting HIV is extremely low if
ARVs are used. Transmission rates are only 1% - 2% if the mother takes combination
antiretroviral therapy (ART). The rate is about 4% when the mother takes AZT (also
known as ZDV or Retrovir) during the last six months of her pregnancy, and the
newborn takes AZT for six weeks after birth.
If you think you have been exposed to HIV, talk to your health care specialist and/or
the public health department, and get tested.
If you are sure that you have been exposed, call your doctor immediately to discuss
whether you should start taking antiretroviral drugs (ARVs). This is called "post
exposure prophylaxis" or PEP. You would take two or three medications for several
weeks. These drugs can decrease the risk of infection, but they may have some
serious side effects.
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POST-EXPOSURE PROPHYLAXIS
Workplace exposure
PEP has been standard procedure since 1996 for healthcare workers exposed to HIV.
Workers start taking medications within a few hours of exposure. Usually the
exposure is from a "needle stick," when a health care worker accidentally gets jabbed
with a needle containing HIV-infected blood. PEP reduced the rate of HIV infection
from workplace exposures by 79%. However, some health care workers who take PEP
still get HIV infection.
Other exposure
In 2005, the Centres for Disease Control reviewed information on PEP. They
concluded that it should also be available for use after HIV exposures that are not
work-related. People can be exposed to HIV during unsafe sexual activity, when a
condom breaks during sex, or if they share needles for injecting drugs. Infants can be
exposed if they drink breast milk from an infected woman. In a study of PEP in 400
cases of possible sexual exposure to HIV, not one person became infected with HIV.
HIV exposure at work is usually a one-time accident. Other HIV exposures may be
due to unsafe behaviours that can occur many times. Some people think that PEP
might encourage these unsafe behaviours if people think that PEP is an easy way to
avoid HIV infection.
There are other reasons why PEP might not be a good idea for non-occupational
exposure:
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• The medications have serious side effects. About 40% of health care workers
did not complete PEP because of the side effects.
PEP should be started as soon as possible after exposure to HIV. The medications
used in PEP depend on the exposure to HIV. The following situations are considered
serious exposure:
In January 2001, the Centres for Disease Control warned against using Nevirapine for
PEP because of the risk of liver damage.
The most common side effects from PEP medications are nausea and generally not
feeling well. Other possible side effects include headaches, fatigue, vomiting and
diarrhoea. Post-exposure prophylaxis (PEP) is the use of ARVs as soon as possible
after exposure to HIV, to prevent HIV infection. PEP can reduce the rate of infection
in health care workers exposed to HIV by 79%.
The benefits of PEP for non-occupational exposure have not been proven. This use of
PEP is controversial because some people fear it will encourage unsafe behaviours.
PEP is a four-week program of two or three ARVs, several times a day. The
medications have serious side effects that can make it difficult to finish the
programme. PEP is not 100% effective; it can not guarantee that exposure to HIV will
not become a case of HIV infection.
HIV is a type of virus called a retrovirus. Like all viruses, it must invade the cells of
other organisms to survive and reproduce. HIV multiplies in the human immune
system's CD4+ T cells and kills vast numbers of the cells it infects. The result is
disease symptoms.
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There are two forms of HIV:
• HIV-1 is the more common and more potent form. This form of HIV has spread
throughout the world.
• HIV-2, which is less potent that HIV-1, is found predominantly in West Africa. It
is also more closely related to two HIV-like viruses found in monkeys.
There also are different strains of the virus, which makes it difficult to find one single
treatment
The Immune System
Our bodies use a natural defence system to protect us from bacteria, fungi, viruses,
and other microscopic invaders. This system includes general, non-specific defences
as well as weapons custom-designed against specific health threats:
• Innate, or non-specific, immunity is the first line of defence. Our skin, tears,
mucus, and saliva, as well as the swelling that occurs after an infection or injury,
contain types of immune cells and chemicals that attack disease-causing agents
attempting to invade the body.
• Adaptive, or specific, immunity uses specialized cells and proteins called
antibodies to attack invaders that get past the first line of defence. These weapons
target specific proteins called antigens, found on the surface of the invading
organism. The immune system can quickly rally these custom-tailored defences if this
particular invader attacks again.
Hairy Leukoplakia
on the lateral
border of the
tongue in a 28
year old patient
Lesions of smaller
size were also
found on the
buccal and the
labial mucosa of
the same patient
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• The cell-mediated immune response involves the action of another group of
specialized white blood cells that direct and regulate the body's immune responses or
directly attack cells that are infected or cancerous.
White blood cells, particularly macrophages and B and T lymphocytes, play central
roles in the immune system's defences against viruses and other foreign invaders.
• Macrophages contribute to both non-specific and specific immune responses.
These versatile cells act as scavengers, engulfing and digesting microbes and other
foreign material in a cell-eating process called phagocytosis. They also, upon
encountering an invading organism, release chemical messengers that alert other
cells of the immune system and summon T lymphocytes to the infected area.
• B lymphocytes, or B cells, serve as the body's antibody factories. Each antibody
is targeted to recognize and bind to an antigen from a specific invader. When
antibodies circulating through blood and body fluids encounter this invader, they
mark it for destruction.
• T lymphocytes, or T cells, are part of the cellular immune response. Some T
cells, like CD4+ T cells (also called "helper" T cells), direct and regulate the body's
immune responses. Others are killer cells that attack cells that are infected or
cancerous.
Researchers have found evidence that immune-system cells called dendritic cells may
begin the process of infection. After exposure, these special cells may bind to and
carry the virus from the site of infection to the lymph nodes, where other immune
system cells become infected.
HIV targets cells in the immune system that display a protein called CD4 on their
surface. These cells are called CD4-positive (CD4+) cells.
When HIV encounters a CD4+ cell, a protein called gp120 that protrudes from HIV's
surface recognizes the CD4 protein and binds tightly to it. Another viral protein, p24,
forms a casing that surrounds HIV's genetic material.
HIV's genetic material contains the information needed by the virus to infect cells,
produce new copies of virus, or cause disease. For example, these genes encode
enzymes that HIV requires to reproduce itself. Those enzymes are reverse
transcriptase, integrase, and protease
Safe Sex
Sexually transmitted diseases (STDs) are spread by sexual contact involving the
genitals, mouth, or rectum, and can also be spread from a pregnant woman to her
foetus before or during delivery. STDs, which affect both men and women, are a
worldwide public health concern.
While most STDs can be cured, some cannot, including HIV (which causes AIDS),
genital herpes, and human papillomavirus (HPV), which can cause genital warts.
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STDs can be spread by people who don't know they are infected. Always use
protection every time you have sex, until you are sure you and your partner are not
infected with a STD.
One of Oxfam's principal activities in the fight against
the spread of HIV/AIDS is to educate people about
methods of safe sex, including demonstrations in the
use of condoms.
I also emphasise that government must define a
clear distinction between excellent public health
programmes and social awareness to that of the
complexities, difficulties and social nightmare we all
face.
Government must take leadership and responsible for
their entire nation, provide the mechanism for
excellent healthcare, education, job, budget, support
and the facilitation in terms of access to people and
resources.
If you are in a relationship, delay having sex until you are physically and emotionally
prepared, have agreed to only have sex with each other, and have both been tested
for STDs.
Abstinence as prevention
These questions are very personal and difficult, however it’s always to the best
interest to remove all doubts and build personal confidence before one commence a
relationship. The bottom line is to get to know your partner first, before it’s too late.
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Safe sex practices
Some STDs, such as HIV, can take up to 6 months before they can be detected in the
blood. Genital herpes and the human papillomavirus (HPV) can be spread when
symptoms are not present. Even if you and your partner have been tested, use
condoms for all sex until you and your partner haven't had sex with another person
for 6 months. Then get tested again.
There are many misunderstandings about the ways in which HIV infection is not
spread. However, the most common way is through sexual intercourse; HIV is spread
most commonly by sexual contact with an infected partner. The virus can enter the
body through the lining of the vagina, penis, rectum, or mouth during sexual
relations.
Although studies have found tiny amounts of HIV in the saliva of some people with
HIV, researchers have found no evidence that HIV is spread to other people through
kissing. However, the CDC recommends against "French" or open-mouthed kissing
because of the possibility of contact with blood if the people kissing have any cuts or
sores in the mouth
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Direct Contact with Infected Blood
Women can transmit HIV to their foetuses during pregnancy or birth. Approximately
one-quarter to one-third of all untreated pregnant women infected with HIV will pass
the infection to their babies.
A pregnant woman can greatly reduce the risk of infecting her baby if she takes the
anti-HIV drug AZT (also called Zidovudine) during her pregnancy.
Because the risk of transmission increases with longer delivery times, the risk can be
further reduced by delivering the baby by caesarean section, a surgical procedure in
which the baby is delivered through an incision in the mother's abdominal wall and
uterus.
Combining AZT treatment with caesarean delivery can reduce the infection rate to
between 1% and 2%.
HIV also can be spread to babies through the breast milk of mothers infected with the
virus.
• Women who live in countries where safe alternatives to breast-feeding are
readily available and affordable can eliminate the risk of transmitting the virus
through breast milk by bottle-feeding their babies.
• In developing countries, however, where such safe alternatives are not readily
available or economically feasible, breast-feeding may offer benefits that outweigh
the risk of HIV transmission.
Research indicates that HIV is NOT transmitted by casual contact such as:
• Touching or hugging
• Sharing household items such as utensils, towels, and bedding
• Contact with sweat or tears
• Sharing facilities such as swimming pools, saunas, hot tubs, or toilets with HIV-
infected people
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• Coughs or sneezes
In short, studies indicate that HIV transmission requires intimate contact with
infected blood or body fluids (vaginal secretions, semen, pre-ejaculation fluid, and
breast milk). Activities that don't involve the possibility of such contact are regarded
as posing no risk of infection.
Is it safe to share a household with an HIV-infected person?
Studies of families of HIV-infected people have found that HIV is not spread through
sharing utensils, towels, bedding, or toilet facilities. Behaviours that increase the
likelihood of contact with blood from an HIV-infected person, such as sharing a razor
or toothbrush, should be avoided.
• Chlamydia.
• Genital herpes.
• Genital warts or human papillomavirus (HPV). Certain types of HPV can cause
cancer of the cervix in women.
• Gonorrhoea.
• Hepatitis B.
• Syphilis.
• Trichomoniasis.
• Human immunodeficiency virus (HIV), which causes AIDS.
• Other infections that may be sexually transmitted, including hepatitis C,
cytomegalovirus, scabies, and pubic lice.
Most STDs can be treated and cured, but some cannot. Some STDs, such as HIV and
syphilis, can cause death.
Human papillomavirus (HPV)
The human papillomavirus (HPV) causes warts, including genital warts, and may
cause cancerous changes in the cervix. HPV is spread by direct contact.
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There are more than 100 known types of HPV.
• Some HPV types cause genital warts. In women, certain types of HPV increase
the risk of cervical cancer. Sometimes the only sign that a woman is infected with
HPV is an abnormal Pap test result.
• Other types of HPV cause common, plantar, filiform or flat warts, and some
genital warts. These types of warts are not cancerous.
There is no known cure for HPV. Most warts go away without treatment within 2
years; however medications and treatments are available to help warts disappear
more quickly. HPV remains in the body with or without treatment for visible warts, so
warts may come back.
Symptoms of a sexually transmitted disease (STD)
Sexually transmitted diseases (STDs) may cause many different symptoms in both
women and men.
In women
• A thick, discoloured, or foul-smelling vaginal discharge. Symptoms may get
worse over a period of several days to 2 weeks.
• Pain, burning, or itching while urinating for longer than 24 hours
• Fever
• Pain during sexual intercourse
• Pain or a feeling of heaviness in the pelvis or lower abdomen
• Itching, tingling, burning, or pain in the genitals
• Sores, lumps, blisters, rashes, or warts on or around the genitals
• Vaginal spotting or bleeding after sexual intercourse
• Other symptoms of an infection, such as fever and fatigue or lack of energy
In men
• Painful urination. (This is often the first symptom.)
• Fever
• Cloudy urine
• Abnormal discharge from the penis
• Crusting at the tip of the penis
• Sores, lumps, blisters, rashes, or warts on or around the genitals
• Pain, swelling, or tenderness in the scrotum (epididymitis)
• Itching, tingling, pain, or burning of the genitals
• Deep pelvic ache (prostatitis)
These symptoms require medical attention. Avoid any sexual contact until you have
been examined by a medical professional and the result turned out negative.
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The Food and Drug Administration (FDA) USA, has approved a once-a-day, three-
drugs-in-one, fixed-dose combination called Atripla. The new pill combines the active
ingredients of three anti-retroviral drugs already in use to treat HIV/AIDS — Efavirenz
(Sustiva), Emtricitabine (Emtriva) and Tenofovir Disoproxil Fumarate (Viread).
These drugs have already been used together for some time as part of a "cocktail"
therapy.
According to the FDA, Atripla will contain a package warning that the drug may cause
build-up of lactic acid in the blood. Other potential serious side effects may include
serious liver toxicity, kidney impairment and severe depression. In a 48-week trial,
the most common side effects experienced by participants were headache, dizziness,
abdominal pain, nausea, vomiting and rash. If you're being treated for HIV/AIDS, you
now have a simple course of treatment to follow.
She had been noncompliant with her medications for several weeks before
presentation. Her CD4 cell count was 400/µL and the viral load was 750,000
copies/ml at the time of admission. Her physical examination was significant for
distant heart sounds and a pericardial rub.
A chest roentgenogram revealed an enlarged cardiac silhouette, that was confirmed
by echocardiography to be a large pericardial effusion with collapse of the right
atrium during late diastole. The ECG revealed electrical alternans, and a cardiac
pretamponade picture developed. A subxiphoid pericardiotomy was performed, with
drainage of 500 ml of serosanguineous fluid. An analysis of the pericardial fluid was
nondiagnostic by stains (Gram and acid-fast stains), cultures (bacterial, fungal,
mycobacterial, and viral), cytology, and chemistry. A pericardial tissue biopsy
revealed fibrosis with chronic inflammatory changes. The patient improved clinically
after the procedure, and the pericardiotomy tube was removed on the 4th day. She is
now compliant with her medications and has remained asymptomatic for the past 2
years.
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The newly approved tablet combines three medications that have been in use for
several years, and whose results and effects are well-known.
Many people with HIV/AIDS take additional drugs beyond the three that have been
combined into the new tablet, in order to deal with complications and AIDS-related
infections. The new combination pill won't eliminate the need for these people to
continue to take other medications.
However, the ability of more people to easily follow a course of treatment for
HIV/AIDS holds the prospect of bringing the AIDS epidemic under control.
Emtriva
Important information you should know about emtricitabine
Emtricitabine may cause lactic acidosis or severe liver damage, which can be fatal.
Call your doctor at once if you have any of these symptoms, which may be early
signs of lactic acidosis or liver problems: nausea, vomiting, or sudden stomach pain;
weak or tired feeling; dizziness or lightheadedness; fast or irregular heartbeats;
feeling short of breath; cold feeling, especially in the arms and legs; jaundice
(yellowing of the skin or eyes); or pain in the upper stomach area.
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What is emtricitabine?
Emtricitabine is an antiviral medication. It is in a category of HIV medicines called
reverse transcriptase inhibitors. Emtricitabine works by preventing HIV cells from
multiplying in the body.
Emtricitabine is used to treat the human immunodeficiency virus (HIV), which causes
the acquired immunodeficiency syndrome (AIDS). Emtricitabine is not a cure for HIV
or AIDS.
Emtricitabine may also be used for purposes other than those listed in this medication
guide.
What you should discuss with your healthcare provider before taking emtricitabine?
Before taking this medication, tell your doctor if you have:
• Kidney disease; or
• Hepatitis B (HBV) infection.
If you have any of the conditions listed above, you may not be able to use
emtricitabine or you may require a dosage adjustment or special monitoring during
treatment.
Emtricitabine is in the FDA pregnancy category B. This means that it is not expected
to be harmful to an unborn baby. Do not use this medication without telling your
doctor if you are pregnant or plan to become pregnant during treatment.
It is not known if emtricitabine can pass into breast milk and what effect it may have
on a nursing baby. Do not use this medication without telling your doctor if you are
breast-feeding a baby.
You should not breast-feed while you are using emtricitabine. It is not known if this
medication passes into breast milk. If you have HIV or AIDS, you should not breast-
feed at all. Even if your baby is born without HIV, you may still pass the virus to the
baby in your breast milk.
Emtricitabine should be used exactly as your doctor has prescribed it for you. Do not
use more of the medication than recommended. Do not take emtricitabine for longer
than your doctor has prescribed.
Store emtricitabine at room temperature away from moisture, heat, and direct light
115
What happens if you miss a dose?
Take the missed dose as soon as you remember. However, if it is almost time for the
next regularly scheduled dose, skip the missed dose and take the next one as
directed. Do not take extra medicine to make up the missed dose.
What happens if you overdose?
Seek emergency medical attention if you think you have used too much of this
medicine.
Symptoms of an emtricitabine overdose are not known.
Emtricitabine may cause lactic acidosis or severe liver damage, which can be fatal.
Call your doctor at once if you have any of these symptoms, which may be early
signs of lactic acidosis or liver problems: nausea, vomiting, or sudden stomach pain;
weak or tired feeling; dizziness or lightheadedness; fast or irregular heartbeats;
feeling short of breath; cold feeling, especially in the arms and legs; jaundice
(yellowing of the skin or eyes); or pain in the upper stomach area.
Stop using emtricitabine and get emergency medical help if you have any of these
signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips,
tongue, or throat.
Early in your treatment with emtricitabine, you may have a flare-up of other
infections such as tuberculosis, pneumonia, or cytomegalovirus. Contact your doctor
if you develop any possible symptoms of other infections, such as fever, chills, sore
throat, cough, flu symptoms, or problems with breathing or vision.
Other, less serious side effects may be more likely to occur. Talk with your doctor if
you have any of these side effects:
• Headache;
• Nausea or Diarrhoea;
• Darkened patches of skin on the palms and/or soles;
• Sleep problems (insomnia);
• Skin rash; or
• Change in the shape or location of body fat (especially in the arms, legs, face,
neck, breasts, and trunk).
Side effects other than those listed here may also occur. Talk to your doctor about
any side effect that seems unusual or that is especially bothersome.
116
Other medications can affect emtricitabine, making it less effective or making side
effects more likely to occur. Tell your doctor about all the prescription and over-the-
counter medications you use. This includes vitamins, minerals, herbal products, and
drugs prescribed by other doctors. Do not start using a new medication without
telling your doctor.
Emtricitabine is available with a prescription under the brand name Emtriva. Other
brand or generic formulations may also be available. Ask your pharmacist any
questions you have about this medication, especially if it is new to you.
• Emtriva 200 mg-blue and white capsules
Remember, keep this and all other medicines out of the reach of children, never
share your medicines with others, and use this medication only for the indication
prescribed
Neupogen
Important information you should know about Filgrastim
Do not give yourself an injection if you are unsure how to inject yourself, how much
to inject, or how often to inject the medication. Contact your healthcare professional
for advice.
Contact your doctor if you develop a fever; chills; sore throat; congestion; diarrhoea;
or redness, pain, or swelling around a wound or sore while using
Filgrastim.
Your spleen may become enlarged and, in rare instances, may rupture while taking
Filgrastim. The spleen is located in the upper left section of your stomach area. Call
your doctor right away if you have pain in your left upper stomach area or left
shoulder tip area. This pain could mean your spleen is enlarged or ruptured.
What is Filgrastim?
Filgrastim is a protein that stimulates the production of white blood cells. White blood
cells are important for protecting the body from infection.
Filgrastim is used to increase white blood cells, and to decrease the risk of infection,
in conditions such as cancer; bone marrow transplant; pre-chemotherapy blood cell
collection; and severe chronic neutropenia including congenital neutropenia, cyclic
neutropenia, and idiopathic neutropenia.
Filgrastim may also be used for purposes other than those listed in this book.
117
Who should not use Filgrastim?
Do not use Filgrastim if you have an allergy to the bacterium E. coli. You may also be
allergic to Filgrastim.
Before using this medication, tell your doctor if you
• are undergoing radiation or chemotherapy;
• have myeloid (bone marrow) cancer;
• have kidney disease; or
• have liver disease.
You may not be able to uses Filgrastim or you may require a dosage adjustment or
special monitoring during treatment if you have any of the conditions listed above.
Filgrastim is in the FDA pregnancy category C. This means that it is not known
whether Filgrastim will be harmful to an unborn baby. Do not use Filgrastim without
first talking to your doctor if you are pregnant or could become pregnant during
treatment.
It is not known whether Filgrastim will be harmful to a nursing baby. Do not use this
medication without first talking to your doctor if you are breast-feeding a baby.
Filgrastim should be use exactly as directed by your doctor. If you do not understand
these instructions, ask your pharmacist, nurse, or doctor to explain them to you.
Filgrastim can be used subcutaneously (SC) or intravenously (IV). If you are injecting
the medication at home, your doctor, nurse, or pharmacist will give you specific
instructions on how and where to inject your medication. Do not give yourself an
injection if you are unsure how to inject yourself, how much to inject, or how often to
inject the medication.
Try to receive the injections at the same time each day.
It is important to use Filgrastim regularly to get the most benefit.
Rotate injection sites as directed and inject the medication slowly.
Following administration of Filgrastim from the prefilled syringe, the "UltraSafe
Needle Guard" should be activated to prevent accidental needle sticks. To activate the
Needle Guard, place your hands behind the needle, grasp the guard with one hand,
and slide the guard forward until the needle is completely covered and the guard
clicks into place. NOTE: If an audible click is not heard, the needle guard may not be
completely activated. The prefilled syringe should be disposed of by placing the entire
prefilled syringe with guard activated into an approved puncture-proof container.
Do not shake any vial of Filgrastim. It can be gently swirled if mixing is needed. Do
not use any medication that is discoloured or those particles in it. Use each vial
Filgrastim for only one dose then throw away any remaining solution. Do not re-enter
the vial with the same or another needle.
The vial of medication can be allowed to reach room temperature by leaving it out of
the refrigerator for about 30 minutes before injecting a dose. Do not leave the vial in
direct sunlight. Neupogen can remain at room temperature for up to 24 hours. If it is
unrefrigerated for longer than 24 hours, throw the vial away.
Properly store and discard all syringes and needles.
118
Your doctor may want you to have blood tests or other medical evaluations during
treatment with Filgrastim to monitor progress and side effects.
Store this medication in the refrigerator between 2 and 8 degrees Celsius (36 to 46
degrees Fahrenheit) away from light, moisture, and the reach of children. Do not
allow it to freeze. If a vial of medication is accidentally frozen, it can be thawed in the
refrigerator and used at a later time. If the vial is frozen a second time, do not use it
at all. Discard all unused medication on the expiration date.
Contact your doctor if you miss a dose of this medication by more than a few hours.
Your spleen may become enlarged and, in rare instances, may rupture while taking
Filgrastim. The spleen is located in the upper left section of your stomach area. Call
your doctor right away if you have pain in your left upper stomach area or left
shoulder tip area. This pain could mean your spleen is enlarged or ruptured.
If you experience any of the following serious side effects, stop using Filgrastim and
seek emergency medical treatment or notify your doctor immediately:
• An allergic reaction (difficulty breathing; closing of the throat; swelling of the
lips, tongue, or face; or hives);
• A fever (over 100.5 degrees Fahrenheit or 38 degrees Celsius); or
• signs of infection such as chills; sore throat; congestion; diarrhoea; or redness,
pain, or swelling around a wound or sore
Other, less serious side effects may be more likely to occur. Continue to use
filgrastim and talk to your doctor if you experience:
• Bone pain;
• Nausea; or
• Swelling, redness, or pain at the injection site.
Side effects other than those listed here may also occur. Talk to your doctor about
any side effect that seems unusual or that is especially troublesome.
119
What other drugs will affect Filgrastim?
Filgrastim is available with a prescription under the brand name Neupogen. Other
brand or generic formulations may also be available. Ask your healthcare specialist
any questions you have about this medication, especially if it is new to you.
• Neupogen 300 mcg (0.5 mL)-prefilled syringe
• Neupogen 480 mcg (0.8 mL)-prefilled syringe
• Neupogen 300 mcg (1 mL)-single-use, preservative-free vials
• Neupogen 480 mcg (1.6 mL)-single-use, preservative-free vials
Remember, keep this and all other medicines out of the reach of children, never
share your medicines with others, and use this medication only for the indication
prescribed.
Kaletra
Important information you should know about Lopinavir and Ritonavir
Some medications are not recommended to be taken with Lopinavir and Ritonavir.
Very high levels of these medications, which could occur during therapy with
Lopinavir and Ritonavir, could be life threatening. Do not take Lopinavir and Ritonavir
without first talking to your doctor if you are taking any of the following medications:
• Cisapride (Propulsid);
• Rifampin (Rifadin, Rimactane) or Rifabutin (Mycobutin);
• Herbal or natural products containing St. John's wort;
• Pimozide (Orap);
• Ergotamine (Ergostat, Cafergot, Ercaf, Wigraine) or dihydroergotamine (D.H.E.
45);
• Amiodarone (Cordarone), Bepridil (Vascor), Flecainide (Tambocor),
Propafenone (Rythmol), or Quinidine (Quinaglute, Quinidex, others);
• Diazepam (Valium), Clorazepate (Librium), Estazolam (ProSom), Flurazepam
(Dalmane), Midazolam (Versed), Triazolam (Halcion), or Zolpidem (Ambien);
• Bupropion (Wellbutrin) or Clozapine (Clozaril); or
• Meperidine (Demerol), Piroxicam (Feldene) or Propoxyphene (Darvocet,
Darvon, Wygesic).
Take Lopinavir and Ritonavir capsules and solution with food to increase the
absorption of the drug by the body. Lopinavir and Ritonavir tablets can be taken with
or without food.
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Lopinavir and Ritonavir may decrease the effectiveness of birth control pills. To
protect against pregnancy, use a second method of birth control while taking
Lopinavir and Ritonavir.
Some medications are not recommended to be taken with Lopinavir and Ritonavir.
Very high levels of these medications, which could occur during therapy with
Lopinavir and Ritonavir, could be life threatening. Do not take Lopinavir and Ritonavir
without first talking to your doctor if you are taking any of the following drugs:
• Cisapride (Propulsid);
• Rifampin (Rifadin, Rimactane) or Rifabutin (Mycobutin);
• Herbal or natural products containing St. John's Wort;
• Pimozide (Orap);
• Ergotamine (Ergostat, Cafergot, Ercaf, Wigraine) or Dihydroergotamine (D.H.E.
45);
• Amiodarone (Cordarone), Bepridil (Vascor), Flecainide (Tambocor),
Propafenone (Rythmol), or Quinidine (Quinaglute, Quinidex, others);
• Diazepam (Valium), Clorazepate (Librium), Estazolam (ProSom), Flurazepam
(Dalmane), Midazolam (Versed), Triazolam (Halcion), or Zolpidem (Ambien);
• Bupropion (Wellbutrin) or Clozapine (Clozaril); or
• Meperidine (Demerol), Piroxicam (Feldene) or Propoxyphene (Darvocet,
Darvon, Wygesic).
Before taking Lopinavir and Ritonavir, tell your doctor if you have
• Any type of liver disease;
• A history of pancreatitis (inflammation of the pancreas);
• Diabetes; or
• Haemophilia.
You may not be able to take Lopinavir and Ritonavir, or you may require a dosage
adjustment or special monitoring during treatment if you have any of the conditions
listed above.
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Lopinavir and Ritonavir are in the FDA pregnancy category C. This means that it is
not known whether Lopinavir and Ritonavir will be harmful to an unborn baby. It is
very important to treat HIV/AIDS during pregnancy to reduce the risk of infecting the
unborn baby. Talk to your doctor about treatment options if you are pregnant or
could become pregnant during treatment. .
It is not known whether Lopinavir and Ritonavir passes into breast milk and what
effect it may have on a nursing baby. To prevent transmission of the virus to
uninfected babies, it is recommended that HIV-positive mothers not breastfeed.
Take Lopinavir and Ritonavir capsules and solution with food to increase the
absorption of the drug by the body.
Lopinavir and Ritonavir tablets can be taken with or without food.
Lopinavir and Ritonavir along with Ddanosine (ddI, Videx) should be taken at least 2
and a half hours apart from one another to prevent an interaction.
To ensure that you get the correct dose, measure the liquid form of Lopinavir and
Ritonavir with a dose-measuring spoon or cup, not a regular table spoon. If you do
not have a dose-measuring device, ask you healthcare professional or purchase one
from a pharmacy near you.
It is important to take Lopinavir and Ritonavir regularly to get the most benefits.
Treatment of HIV/AIDS almost always requires the use of two or more drugs. If you
need to stop taking one of the medicines you are taking for HIV, you should stop all
of them until you can speak to your doctor.
Your doctor may want you to have blood tests or other medical evaluations during
treatment with Lopinavir and Ritonavir to monitor progress and side effects.
Keep this medication out of the reach of children. The Kaletra brand of Lopinavir and
Ritonavir contains large amount of alcohol. An overdose of Kaletra by a toddler or
young child could be fatal.
Refrigerate the Lopinavir and Ritonavir capsules and solution if possible. Under
refrigeration, the medication will remain stable until the expiration date printed on
the prescription label. If you store Lopinavir and Ritonavir at room temperature, the
medication should be used within 2 months and any medicine not used within this
time should be thrown away.
Take the missed dose as soon as you remember. However, if it is almost time for the
next dose, skip the missed dose and only take the next regularly scheduled dose. Do
not take a double dose of this medication unless your doctor directs otherwise.
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What happens if you overdose?
Stop taking Lopinavir and Ritonavir and seek emergency medical attention or contact
your doctor immediately if you experience.
• An allergic reaction (difficulty breathing; closing of the throat; swelling of the
lips, tongue, or face; or hives);
• Pancreatitis (inflammation of the pancreas) including symptoms of nausea,
vomiting, or abdominal pain;
• Liver problems.
Other, less serious side effects may be more likely to occur. Continue to take
Lopinavir and Ritonavir and speak to your doctor if you experience
• Diarrhoea or abnormal stools (bowel movements);
• Nausea, tiredness, weakness, or dizziness;
• Rash;
• Changes in blood sugar levels or changes in blood triglyceride or cholesterol
levels;
• Changes in body fat (increased fat in the upper back and neck, breast, and
abdomen and loss of fat from the face, legs, and arms).
Side effects other than those listed here may also occur. Talk to your doctor about
any side effect that seems unusual or that is especially bothersome.
What other drugs will affect Lopinavir and Ritonavir?
Some medications are not recommended to be taken with Lopinavir and Ritonavir.
Very high levels of these medications, which could occur during therapy with
Lopinavir and Ritonavir, could be life threatening.
In addition, before taking Lopinavir and Ritonavir, tell your doctor if you are taking
any of the following medicines:
• Phenytoin (Dilantin), Carbamazepine (Tegretol), or Phenobarbital (Luminal,
Solfoton);
• Sildenafil (Viagra), Vardenafil (Levitra) or Tadalafil (Cialis);
• A tricyclic antidepressant such as Amitriptyline (Elavil), Desipramine
(Norpramin), Nortriptyline (Pamelor), Imipramine (Tofranil), and others;
• Warfarin (Coumadin);
• Cyclosporine (Sandimmune, Neoral), Tacrolimus (Prograf), Sirolimus
(Rapamune);
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The decision is yours, how you want to live your life
and those of your children.
124
Lopinavir and Ritonavir may decrease the effectiveness of birth control pills. To
protect against pregnancy, use a second method of birth control while taking
Lopinavir and Ritonavir. Drugs other than those listed here may also interact with
Lopinavir and Ritonavir. Speak to your doctor before taking any prescription or over-
the-counter medicines, including vitamins, minerals, and herbal products. Lopinavir
and Ritonavir are available with a prescription under the brand name Kaletra. Other
brand or generic formulations may also be available. Ask your healthcare professional
any questions you have about this medication, especially if it is new to you.
Prezista
It is being reported that the FDA has approved a drug manufactured by Johnson &
Johnson to be used by AIDS patients. The drug is to be used in patients that no
longer show response to other drugs that are used to treat the disease and works by
blocking HIV replication in the body.
The drug will be sold under the brand name Prezista, and will be used in conjunction
with another drug known as Norvir. "This approval offers new hope to HIV patients
who too often urgently need new therapies in order to maintain their health," said
Andrew C. Von Eschenbach, the FDA's acting commissioner. "This drug is not a cure,
but when combined with other standard therapies, it presents one more major step in
our effort to help patients combat the effects of the disease."
125
Taking daily Viusid supplements, appears to increase the level of the essential
mineral in the blood and may suppress the progression of viral load in patients with
HIV infection.
Advances in antiretroviral therapy (ART) have given HIV patients a longer life
expectancy, however; strict adherence to the therapy is required to keep HIV viral
counts low, and there is a risk of toxic effects and metabolic dysfunction. "Thus,
complete control of HIV over time using ART is unlikely, and pharmacotherapeutic
limitations leave a significant void in the treatment arsenal, Selenium deficiencies
have been observed in patients with HIV spectrum disease and evidence suggests
that Viusid supplements can improve immune functioning.
158 patients with HIV pre-treatment assessment included pregnancy screening, blood
tests to measure selenium levels, CD4 count (a measure of the state of the immune
system; the lower the CD4 count, the more likely a patient with HIV/AIDS is to
develop secondary infections or illnesses), HIV viral load (the number of copies of the
HIV virus in the blood) and screening for hepatitis C. Patients were assigned to
treatment groups; 58 took 3 sachets per day containing 4g of Viusid, 50 took one
sachet per day and the other 50 patients took one sachet every other day. After six,
nine and twelve months, physical examinations and measures of the study outcomes-
-HIV viral load and CD4 count were performed.
From the 158 patients for whom treatment was initiated, 143 (53 in the 3 sachets per
day group, 49 in the one sachet per day and 41 in the one sachet every other day
group) completed the six-nine-twelve month study assessment. The three groups had
different selenium levels at the first month of the treatment, but after the completed
period of treatment, the average change in blood selenium level was greater in the all
the three treatment groups. Higher blood selenium levels predicted a decreased HIV
viral load, which in turn predicted increased CD4 count.
The exact mechanism by which selenium exerts its effects on HIV-1 viral replication is
not known. One hypothesis holds that selenium's antioxidant properties may repair
damage done to immune cells by oxygen, which is produced at higher levels in the
bodies of patients with HIV. However, future research is needed to confirm this
relationship.
Every effort has been made to ensure that the information provided is accurate, up-
to-date, and complete, but no guarantee is made to that effect. Medication
information contained herein may be time sensitive. Information has been compiled
for use by healthcare practitioners and consumers, however all medications must be
prescribe by the appropriate authorities and/or physicians, unless specifically
indicated otherwise, reframe from taking over the counter drugs.
126
Information provided does not endorse drugs, diagnose patients or recommend
therapy, information mentioned is an informational resource designed to assist
licensed healthcare practitioners in caring for their patients and/or to serve
consumers reading this book as a supplement to, and not a substitute for, the
expertise, skill, knowledge and judgment of healthcare practitioners. The absence of
a warning for a given medicine or medicine combination in no way should be
construed to indicate that the medicine or medicine combination is safe, effective or
appropriate for any given patient. I assume no responsibility for any aspect of
healthcare administered with the aid of information provided. The information
contained herein is not intended to cover all possible uses, directions, precautions,
warnings, medication interactions, allergic reactions, or adverse effects. If you have
questions about the medication you are taking, check with your healthcare
professional.
Precautions
I have encountered on many occasions, cases where people use herbal products
and/or natural medicines; resulting to semi-fatal and fatal death. Herbal products and
natural medicines can be fatal, if and when miss use or taken for granted, or use with
other substances as a boost up.
Treat all medications seriously; obtain advice and instruction of usage, benefits and
possible side effects from your healthcare professional. Inquire from your physician if
taking a particular herbal product or natural medicine will affect your treatment
and/or produce side effects to you; while under medical treatment of a prescribed
medication.
Don’t use herbal products and/or natural medicine as a cup of tea or glass of milk;
treat them as they really are… medicine, which produce some sort of reaction… use
them wisely.
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XXIII. MANAGEMENT
THEIR VALUABLE ASSISTANCE
Dr. Marc Hans Ruckle Zeedyk Senior-EVP International Finance/Commerce
Dr. Christopher James Van Brink-Schmidt EVP Science/Technology
Dr. Cyndy Astrida Gail Werelddoorp EVP Health/Social Development
Dr. Natasha Barbara Litak Zarebska EVP Education/Culture
Dr. Asha Gail Wieseler EVP International Economic Development
Dr. Amaratunga Manunatha V-President-Auditor
Dr. Balwinder Singh Sidhu Punjab V-President -Projects
Amb. Christopher Chukwu EVP Institutional Relations
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XXIV. APPENDICES
MERO INTERNATIONAL commenced as an inspiration in December 1971 based on the
Tibetan’s philosophy, which helping another is helping oneself; where the goodness extended
towards extreme poverty will increase spiritual and social awareness. After many years
providing social assistance to the poor, I realized that the reduction of extreme poverty need
to be focus on a broader base and must have the corporation of governments, international
organisations, companies and individuals.
In 1982 MERO INTERNATIONAL saw that the rapid growth of technology innovation towards
globalisation was leaving extreme poverty with a massive gap, which turned poverty into
extreme poverty and extreme poverty into something even worst; mostly so, in India, Africa
and Latin America continents.
At the beginning of 1991 we started to provide the services to medicine, medical assistance,
emergency, research and socio-economic development in Latin America, mostly putting our
resources toward the interior of the country in the Amerindian’s populated regions. Our
programmes showed positive results, we therefore increased our programmes to the rural
and at a later stage to the urban sectors.
1994 was the year that we began providing our services together with other governmental,
international organisations, local companies and individuals that provide their assistance in
an ongoing basis. We worked on jointed activities with the military, fire department, Red
Cross, Lion International, hospitals and local government; providing medicine, medical
assistance, healthcare orientation, emergency and social awareness in schools.
Over the years the Organisation has proven the effectiveness of youth leadership
development, community-based healthcare programmes and social development
programmes. The Organisation has helped demonstrate that community outreach
programmes which are developed and managed by the community make a striking impact.
With the partnership of the Organisation, the community will bring vital alternative education,
better healthcare and critically needed training skills to their neighbours, family members and
peers, and, in so doing, will effect positive change in their own communities.
The challenge at this stage is to seize the opportunity, to take the risk, to realize an
innovative, new, rewarding, healthier and productive future. With the strength which has
made MERO INTERNATIONAL Programmes what it is today, the choices are an easy one-help,
abject extreme poverty and meet the challenges of the 21st Century.
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XXV. ACKNOWLEDGEMENTS
I’m enhanced by the belief, that there are individuals and institutions somewhere out
there that could help to titivate the glow in humanity, by proving the ways and means to
make this project as meaningful and successful as it should be.
I extend a warm and spiritual embracement to all the healthcare professionals, medical
institutions, hospitals, military, police and fire personnel’s, friends and well wishers in all
the countries that have a part of this study for their remarkable assistances. They will be
long remembered for their honesty, compassion and strength of spirit; people that
strongly believe in freedom, capacity of self-determination, individual rights, the equality
of opportunities, and the right to healthcare and education.
I’ll feel empty if I didn’t mention the healthcare reconnaissance has become valuable in
extreme degree for the assistance to preventive medicine, environmental studies, culture
and social awareness and the perceptiveness towards extreme poverty. An everlasting
friendship to the countries in Latin America, Caribbean, China, Yugoslavia and Africa
countries that welcome me to observe and be a part of their hurting and to the people of
Tibet, Nepal, India, Bangladesh, Ghana, Niger and Nigeria that taught me, that all is not
lost.
I herein wish a special thank you, to the Sovereignty of the countries such as Belgium,
Canada, Denmark, France, Germany, Russia, Sweden, Switzerland, UK and USA that
provide me with the insight and knowledge to their traditional ways and modern concept
of healthy living.
Finally, I want to, once again hold the hands of the sick and extreme poor people that let
me into their lives, invited me into their homes and offered me the best that they had;
their gesticulation although they live in their poor and humble state, still allows human
beings to act as human beings; may god bless them all.
Mervyn Maastricht Carl McYearwood
MERO INTERNATIONAL
130
PERU
131
XXVI. CONCLUSIVE SUMMARY
This presentation treats in great details issues and factors that will influence the
investment to MERO INTERNATIONAL Health Care and Extreme Poverty Programmes,
purchase properties; prepare the anti-project and complete the 1st Phase of the
project, to raise Funds to develop Five Star Health Care facilities. The project
comprise of health care facilities, residents, research centre, language institute,
pharmacies, emergency alert, and other amenities to enhance the state of the arts.
There are five major advantages to MERO INTERNATIONAL that allows due
consideration to investor(s) for immediate development.
B Mix Zoning
C Privileged location that will lead to natural increase in value over time
D Area of mass populations within 25-75 minutes from city, provide ample health
care and better living opportunities to the people and family social-education
activities as an unparalleled value towards humanity.
E Multiple access and transport communication, endow a window into the world of
health care, hospitality and tourism; reveals the many opportunities for clients to
enhance market value.
Global, national and regional trends will indicate that MERO INTERNATIONAL will
substantial growth as a result of the imminent approval of the international business
atmosphere.
MERO INTERNATIONAL will enhance a global opportunity, to “help make the world a
healthier place” by being a part of world health care system, to partake in the global
responsibility to provide health care, hospitality and medical products and services
with fun and enjoyment to people world-wide.
This project will be a reality with your help, the help of others and the willingness to
make a good humanitarian project, the future of our future.
132
XXVII. BIBLIOGRAPHY
Australia- The Malian Foundations Empowering Communities
Belgium-European Commission
China- CESTT
China, Hong Kong- The Hong Kong Society of Neuroscience
Japan-MOF
Nigeria-Military
UK, England-OGC
UK, England-QHSE Executives
UK, England-University of London School of Medicine
UK, Ireland -DOCH
UK, England-Chartered Management Institute
UK, England-National Hospital for Neurology and Neurosurgery
UK, England-Institute of Neurology, UCL
USA-United Nations
USA-World Bank
USA-World Health Organisation Society
USA-American Clinical Neuro-Physiology ACNS
USA-IASP-International Association of Safety Professionals
USA-National Institute of Occupational Safety & Health
USA-American Society of Sanitary Research Prevention of Health-Advancement of Sanitary Science
Russia-EBRB Organisation
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The End
MERO INTERNATIONAL
Skype: mero_international
merointernational@web.de,merointernational@usa.com
merointernational@yahoo.com, merointernational@europe.com
134