World Osteoporosis Day

Osteoporosis is a bone disease that occurs when a person's bones become very fragile. While women are four times more likely than men to develop the disease, men also suffer from osteoporosis. World Osteoporosis Day was observed on 20 October to draw attention to this debilitating disease.

Indian men and women seem to be more prone to this problem and sustain fractures about 10-20 years earlier than their western counterparts. This is probably due to their genetic makeup and poor calcium and vitamin D intake (in spite of plenty of sunshine, dark skin doesn't absorb vitamin D well and lifestyle nowadays doesn't allow people to be in the sun as much as they need to be). One out of two women suffer from osteoporosis beyond the age of 50 and one out of four have lifetime risk of fractures.

Those at risk of osteoporosis are generally females above 50, of thin body build, Asian or white race. The following factors enhance the risk: early menopause (before 45 years), hysterectomy, inactive lifestyle, intake of tobacco/alcohol, mother's history of osteoporosis or fractures, personal history of fracture as an adult, low calcium and vitamin D intake, poor sun exposure, medical conditions like diabetes mellitus, overactive thyroid and the use of certain medications like steroids (used for arthritis or asthma), anti-epilepsy medications and thyroxine (in excess), cyclosporine and heparin.

Whether a person develops osteoporosis or not depends on two factors: the thickness of her bones early in her life and the practice of healthy habits later in her life. Children need plenty of foods containing calcium, exposure to the sun, physical activity and good nutrition in the growing years. Good strong bones in the youth are like money in the bank. One can draw only from what one has. If not prevented or left untreated, osteoporosis can progress painlessly until the bones begin to break. Bones can break even during normal daily activities such as lifting a heavy bag or rolling over in bed. These fractures occur typically in the hip, spine and wrist. Fractures of the hip and spine are of special concern. A hip fracture almost always requires hospitalization and a major surgery. It can impair a person's ability to walk unassisted and may cause prolonged or permanent disability or even death. Spinal or vertebral fractures also have serious consequences, including loss of height, severe back pain and deformity.

Bone mineral density is a simple way of knowing how strong or thin the spine and hipbones are. A computerized x-ray technique called Dual Energy X-ray Absorptiometry (DEXA) is used to determine bone density. With this technique, it is possible to tell if a person is normal, has osteopenia or osteoporosis. There are other techniques using ultrasound and CT, but the DEXA is now the standard tool for BMD.

To prevent osteoporosis, adequate calcium and vitamin D must be included in the diet and through sun exposure (dairy products, green leafy vegetables, pulses, grains are good sources of calcium). Eating a nutritious diet would help keep one’s weight close to ideal body weight. Coffee and beverages containing caffeine should be taken in moderation. It is also important to keep oneself physically active and do aerobic exercise (walking, jogging, cycling) for at least 30 minutes three to four times a week. Tobacco and alcohol should preferably be avoided. In case of medical problems requiring medications, irregularity of menstrual cycle or early menopause (before 45 years), a talk with the family doctor about bone health is necessary.

Source: ‘The Hindu’

New Appointment

A new post of Technical Officer (TFI) has been established in SEARO to give a fillip to the Tobacco-Free Initiative activities. Dr Khalilur Rahman (Bangladesh), who has been working in a temporary capacity for some years now in SEARO, has been appointed to it.

Born in 1962, Dr Rahman obtained his medical degree from Rajshahi Medical College in Bangladesh in 1985. He also earned a Diploma in International Relations and Diplomacy from the International Institute of Public Administration, Paris followed by a Master of Philosophy in International Organization from the University of Sorbonne in 1991. Pursuing his interest in international health development, Dr Rahman completed a Doctor of Philosophy in Health Development & Role of International Organizations from the Jawaharlal Nehru University, New Delhi, India in 1996.

Beginning his career as a Medical Officer in the TB Segregation Hospital, Pabna, Bangladesh in July 1985, Dr Rahman joined the Bangladesh Foreign Service in February 1988 and moved to the Ministry of Foreign Affairs, Government of Bangladesh, Dhaka as Desk Officer in the International Organizations Division in February 1989. Thereafter, he worked in the UN Division and the Multilateral Economic Affairs Division of the Ministry of Foreign Affairs. In July 1993, Dr Rahman was appointed First Secretary in the Bangladesh High Commission, New Delhi, where he worked till February 1997, when he was sent as Counsellor in the Bangladesh Permanent Mission at Geneva. He returned to his country in July 1999 and was posted as Director in the Ministry of Foreign Affairs, Dhaka.

Dr Rahman joined WHO as STC with the External Cooperation Unit (ECO) in January 1999 for a period of six months, and again from March 2000 to December 2002. Since January 2003, he has been working as STP in the Tobacco Unit. He is fluent in English and French besides Bengali, his mother tongue. Dr Rahman is married to Najnin. The couple has a daughter, Cornelia (10) and a son, Kaisan, who is ten months old. SN welcomes Dr R to the WHO family and wishes him all success in his assignment.

We Hear

…that the annual Diwali lunch organized by women staff members was as usual a function full of fun, colour, and music. This year, a dozen staff members from NPSP also participated and surprised the SEARO women with a cultural programme showcasing their abundant talent.

…that wef 1 October 2003, Mr Mohammed Rasheed, AO-WR Indonesia has been promoted to P.4 grade upon reclassification of his post. Congratulations, Mr R, and best wishes from all of us in SEARO!

…that M/s Sharath Babu, Chandrashekhar Sharma, and KR Vishwanathan, have been selected as Assistant II in the HIV-AIDS & TB; SHS, and CDS&R Units respectively. Congratulations and best wishes to all of them!

…that effective 20 October 2003, we have a new management in the SEARO cafeteria run by Mr Rajat Dogra. SEAROites will recall that Mr Rajat Dogra managed our canteen some years back.

…that the composition and terms of reference of the Canteen Committee have been revised. According to a new circular, the members of the Committee are: Dr Chusak Prasittisuk, RA-MAL (President); Dr Abdul Sattar Yoosuf (Staff Association’s nominee) and Mr SK Madanpotra (RD’s nominee).

...with deep regret that Ms Clarice Gunaratne, mother of Dr MVH Gunaratne and widow of our former Regional Director, Dr VTH Gunaratne, passed away on 21 October in Colombo at the age of 92. SN expresses heartfelt condolences to Dr Gunaratne on his immeasurable loss and prays for everlasting peace to the departed soul.

…that Dr DAC Lobo has been reassigned as the new Regional Adviser for Vector-borne Diseases Control (RA-VBC) wef 1 November. Congratulations, Dr L and best of luck in your new assignment!

…that wef 1 November, Mrs Susha Sreedharan, working with Director, CDS Department has been reassigned to the TB Unit in place of Mrs Shirley Kishanchand, who replaces her. Best of luck to both of them!

…that Mr VJ Mathew, working in SHP, celebrated the marriage of his daughter Reema with Sujith, son of Mrs and Mr D Yesudasan on 3 November 2003. SN wishes the newly-weds a long and happy married life.

…that the Department of Emergency and Humanitation Action (EHA) in WHO/HQ has been renamed Department for Health Action in Crises (HAC) with Dr David Nabarro as the Representative of the Department.

…or rather were pleasantly surprised to see Mr MC Jauhari, BFO/AFRO, formerly of BFU/SEARO in World Health House. We learnt that he was home for the Diwali holidays and he remembers all his former colleagues fondly. Nice to see you again, Mr J!

…that the Indian movie star Amitabh Bachchan has been named UNICEF Goodwill Ambassador. In this capacity, he will periodically speak on HIV/AIDS, polio eradication and the need for providing educational opportunities to girls. According to the UNICEF Representative Ms Maria Calivis, his appeal will help focus on urgent problems facing children. "When he speaks, people from all walks of life, from the youngest to the oldest, listen carefully", she said.

…that Ms Catherine Bertini, Under Secretary-General with the UN, was awarded the 2003 World Food Prize. Ms Bertini was earlier Executive Director of the World Food Programme from 1999 to 2002. Ms Bertini said she planned to donate the US$250 000 award to the Friends of the World Food Programme to help fund education initiatives for girls, which "represents the fastest and most efficient way of saving and improving people's lives in poor countries."

…that UNIFEM has launched an Internet portal offering comprehensive information on the dangers and responsibilities facing women and girls during armed conflicts and women's roles in peace building.

…that on the occasion of International Day for the Eradication of Poverty on 17 October, three organizations focusing on responses to the HIV/AIDS crisis have won awards for creating successful grass-roots programmes to combat poverty in their countries. People heading effective anti-poverty organizations are nominated by the country offices of the UN Development Programme (UNDP) as outstanding contributors to the achievement of the Millennium Development Goals. This year's three winners focusing on HIV/AIDS are: Ms Helen Ditsebe-Mhone, Founding Executive Director, Coping Centre for People Living with HIV/AIDS in Botswana; Mr Jimmy Bhojedat, Founding Executive Director of Guyana's Lifeline Counselling Services and Mr Achmad Ramadhan, founder of Indonesia's Centre for Information and HIV/AIDS Counselling. We applaud the awardees!

Short-Term Consultants/Professionals

DR J AKIYAMA, Short-term Consultant, completed his two-month assignment in Colombo, Sri Lanka with the Vector-borne Disease Control Programme on 23 October 2003.

DR THOMAS FRIEDRIC KOENIG, Short-term Consultant, completed his three-month assignment in SEARO with the Intensification of cross-border collaboration programme on 30 October 2003.

DR EA PADMASIRI, Short-term Professional with the Eradication and Elimination of Lymphatic Filariasis and Soil-Transmitted Helminthiasis programme, completed his eleven-month assignment in SEARO on 31 October 2003.

Letter from Kathmandu
(From Mr Kiran B Shrestha, President, WHO Staff Social Committee, Nepal)

The WHO Staff Social Committee, Nepal, organized a farewell party in honour of Dr Paramita Sudharto at Park Village Hotel, Budhanilkantha on 16 October 2003. Dr Klaus Wagner, WR Nepal, appreciated the valuable contribution made by Dr Paramita during her assignment in Nepal and wished her every success in her new assignment in WR India. Dr Paramita also thanked everybody for the cooperation extended to her during her stay in Nepal. On this occasion, she was presented a Nepalese souvenir as a token of memory on behalf of the Committee. Dr Wagner also welcomed Dr Trine Ladegaard (APO-EHA) and Mr Rasmus Gjesing (APO-EDM) on this occasion.

Protect your Ears!

Every day we hear a variety of sounds at many different levels -- from whispers to television audio to car horns. But when an individual is exposed to harmful sounds, sensitive structures of the inner ear can be damaged, causing noise-induced hearing loss (NIHL).

To protect your hearing, follow these tips:

     As a general rule, if noise is too loud for you to speak at a normal conversation level and be heard, you should wear earplugs, move away from the noise source, or better yet, turn it down.

     Take earplugs to amusement parks and concerts -- and wear them! You will still be able to hear. Earplugs cut out 15-20 decibels of loud sounds.

     Wear earplugs or protective earmuffs when using a power lawn mower, power tools and noisy household appliances, like a vacuum.

     Read the labels for noise levels on appliances, children's toys and any product that generates sound.

Source: ‘Readers’ Digest’

Life and Laundry

Everything you need to know about renewing your life and reviving your spirit you can learn from your laundry.

     First, laundry does not do itself. If you try to kick it under the bed or hide it in your closet, all you get is a smelly room. If you try to avoid your problems, they start to smell, too.

     Second, remember that hot water makes things shrink and fade. Warm or cool water keeps them fresh. This is true when your spouse is angry at you, too.

     Many stains don't come out the first time. Sometimes they never do. So choose: wear them anyway, make up a great story about how you got the stains, or cut up the clothes and use them as rags to wash your car. This is also true with your life. When people or situations get stained, things may have to be transformed or seen in a new light if you don't want to discard them.

     As you're doing laundry, listen. When the machine sounds like it's an African tribe playing the drums, your load is off-balance. If you don't stop the machine and redistribute the load, you'll end up with a huge repair bill or having to buy a new washer altogether. The same is true with your body. If you overload it without rebalancing, it’ll cost you.

     Always do your laundry between other tasks. Never make it your first priority, or you'll find that while you were working, your family went outside to play and you missed all the fun.

     Bright clothes look great in the store, but if you don't bathe them in cool water, they'll bleed all over everything. The same is true for flashy cars, killer relationships and deals that sound too good to be true. Acquire them if you like, but keep some cold water nearby, just in case.

     Yes, socks do wash out to sea. This is one of life's great mysteries, but it is true. You put them in as a pair, but they come out single. Sometimes relationships work out this way, too.

     Mend rips and tears before a good machine scrubbing makes them worse. Do this, too, with broken hearts, especially those of children.

     Nicks are relatively easy to repair. Harsh words and punishments might make them fall apart altogether. When you can, hang your laundry in the sunshine. Fresh air and a warm day can do wonders for just about anything, including your own spirit.

     Finally, as you get older, realize that a new washing machine isn't going to make your clothes come out any cleaner. It just costs more than your old one. Ask anyone who's divorced.

In conclusion, remember that life is a lot like laundry. Just when you think you're done, you find another pair of socks or end up using your last clean towel to wipe off the dog's paws. Don’t worry. The Laundromat’s open seven days a week.

Contributed by Mrs Radha Swaminathan, RDOC Unit

Vocabulary Genius

This is simply superb.......The person who invented this sentence must be a vocabulary GENIUS.

I do not know where family doctors acquired illegibly perplexing handwriting; nevertheless, extraordinary pharmaceutical intellectuality counterbalancing indecipherability, transcendentalizes intercommunications, incomprehensibleness.

This is a sentence where the nth word is n letters long. e.g. 3rd word is 3 letters long, 8th word is 8 letters long and so on.

PS: Don't ask me if I understood this sentence. I'm not a vocabulary genius!!!

Contributed by Ms Anita Saxena, IVD Unit

Publications Corner

Managing Complications in Pregnancy and Childbirth [ISBN 92 4 154587 9/Sw.fr.40.-/US$ 36/-]

This manual is written for midwives and doctors at the district hospital who are responsible for the care of women with complications of pregnancy, childbirth or the immediate postpartum period including immediate problems of the newborn. The emphasis of the manual is on rapid assessment and decision making. Section 1 outlines the clinical principles of managing complications in pregnancy and childbirth and begins with a table that the health care worker can use to rapidly assess the woman’s condition and initiate appropriate treatment. Section 2 describes the symptoms by which women with complications of pregnancy and childbirth present. The symptoms reflect the major causes of mortality and morbidity. Section 3 describes the procedures that may be necessary in the management of the condition. Clear guidance is provided on drugs and dosages, a wide variety of anaesthesia options. Section 4 contains a list of essential drugs and an index. The manual is one in a series of tools named Integrated Management of Pregnancy and Childbirth (IMPAC), aimed to improve the quality of care for mothers and newborns.

Vacancies