A Rapid Assessment of Health Literacy and Health Status of Rohingya Refugees Living in Cox’s Bazar, Bangladesh Following the August 2017 Exodus from Myanmar: A Cross-Sectional Study

Background: A survey was conducted among Rohingya refugees to assess their overall health literacy and health status. Methods: A questionnaire was developed to conduct face to face interviews among Rohingya refugees in Cox’s Bazar, Bangladesh in November–December 2017. Families were selected using convenience sampling from four large refugee camps. Results: Primary respondents aged 10–90 (median 32) years, 56% male, representing 1634 families were interviewed and provided data of themselves and 6268 additional family members, 4163 (66.4%) of whom were children aged <18 years. Of all, only 736 (45%) primary respondents knew how to appropriately treat diarrhoea, 882 (54%) relied on unqualified village “doctors” for treatment, 547 (33.5%) reported a family member suffering injuries in the previous six months, with 8% (42/547) of injuries fatal. One hundred and ninety two (11.8%) primary respondents also reported deaths within their family in the preceding 12 months, with the majority (70% [134/192]) occurring in males, and 44% (85/192) of all deaths were claimed to be homicidal. Conclusion: This survey highlights overall poor health literacy, limited access to qualified health care, and a high rate of injuries and assaults among Rohingyas. However, these data come from an anecdotal survey that excluded some sensitive but important questions.

Complementary and alternative medicine as an invisible health support workforce

In ageing Western societies where chronic conditions have become more prevalent, complementary and alternative medicine (CAM) practices and practitioners have performed an important role in areas such as health promotion, rehabilitation, and compassionate, preventive and palliative care. Yet collaborative partnership between CAM practitioners, other professionally qualified health care workers, and the state, has rarely materialised. By using a neo-Weberian social closure theory of the professions, this chapter examines the extent to which CAM practitioners have come to form part of an invisible and undervalued health support workforce, focusing on the interlinked societies of Brazil and Portugal. It will be suggested that CAM practitioners have resembled health support workers, especially in their statutorily unregulated status and/or subordinated role to the medical profession. In Brazil, CAM practices, but not CAM practitioners, are statutorily regulated; in Portugal, CAM practitioners, despite being statutorily regulated, remain marginalised. In this respect, CAM practitioners have been a largely invisible health support workforce, despite increasing public sympathy for their services and legitimation from the World Health Organization.

Managing Health Volunteers in a Disaster: The California Perspective, Part 1

ABSTRACT During a disaster, unsolicited health care volunteers pose significant legal, medical, logistical and safety concerns. Coordination and deployment of qualified health care volunteers also has been a major challenge to emergency managers. In response to these concerns the Health Resources and Services Administration (HRSA) encouraged each state to develop an Emergency System for the Advanced Registration of Volunteer Health Professionals (ESAR-VHP). The successful development of California's ESAR-VHP programs required significant planning to address challenges such as license verification, credentialing, privileging, volunteer typing, security and privacy of data, civil liability and workers compensation protection. This article is the first in a three-part series outlining the experience of the California Emergency Medical Services Authority (EMSA) in the development and deployment of the state's ESAR-VHP system.

Diagnostic decision support in ophthalmology

Isabel is a Web-based, diagnostic decision support tool designed to provide a differential diagnosis of a patient's condition for interpretation by a qualified health-care professional. We investigated the accuracy of the Isabel system in ophthalmic primary care. A total of 100 case histories were prospectively collected from ophthalmic primary care clinic records. The patient demographics and clinical features of each case were then entered into the Isabel system, and the results generated by the decision support tool for each case were compared with the diagnosis reached by the ophthalmic team. Of the 100 cases in the dataset, there was no matching diagnosis in the first 2 pages of Isabel results in 40 cases. Of the 60 cases in which there was a matching diagnosis on the first 2 pages of results, 31 had a >50% match between the terms of the query and the Isabel diagnosis reminder system's database. It remains to be established whether this is high enough to be clinically useful in a practice setting. Inclusion of specific ophthalmic knowledge would probably improve the accuracy of the Isabel clinical diagnostic decision support system.