Prompt 8: Describe existing and proposed strategies to address your issue. Discuss the advantages and disadvantages of the proposed strategies. Describe contrasts in the way different people, places, and things are impacted by these strategies.

    It should first be noted that for these strategies to be ever planned out and applied to these situations, comprehensive research must be done first. High-income countries such as the United States and the United Kingdom have the financial stability to invest in these types of research to find proper solutions for these issues. But middle-income and low-income countries still don’t have the financial stability for them to properly research these matters. Research isn’t the only way to find solutions even though it might give ideas for solutions that we may never have thought of it. Strategies can also be created by just looking at obvious problems and plenty of hospitals in middle- and low-income countries have done just that. Some strategies that lots of hospitals of all income countries have implemented are always recommending alternative pain medications before prescribing a serious dose of opioids, communicating with suppliers for alternative short pain-relieving medicine, looking out for supply and usage, and updating to new medications whenever necessary that is better than opioids as for chances of addictiveness. These strategies are advantageous to all countries because they help solve problems of individuals not getting addicted quickly to opioids, if opioids are not available, alternatives can help in countries where individuals need some sort of pain medication, and always keeping track of supply helps alert everybody when there could be the chance of shortage so arrangements can be made to handle them.

    For high-income countries, shortages tend to rise but the main problem that occurs is people start to rely too much on these drugs. There are a few strategies applied by these countries to tackle shortages of individuals being dependent on opioids, and opioids mixed with other substances that roam in certain communities. Some of these strategies are to create programs for populations that abuse drugs, education and prevention methods, stricter enforcement and policies, and a tracking system that warns hospitals when shortages could start to arise. The advantage of these strategies is that it helps people recover from their addictive behaviors and if warnings of shortages can be spotted, proper planning can occur to solve that problem. The only disadvantage of this would be that there is always that chance of people not recovering at all and their life becoming worse than before.

    For middle-income and low-income countries, their strategies will be similar and different depending on the situation. For certain countries where individuals have plentiful access to cheap drugs, governmental policies and international guidelines need to be changed. By doing so, these would be the advantages, drug smuggling would stop tremendously, it would stop the flow of drugs which in turn help individuals that need those drugs and stop others from being dependent on them, and by working on international guidelines, it will help countries work together to distribute these drugs wherever it may be needed at certain times. As for disadvantages, there always be people that will seek ways to smuggle these drugs into these countries and even mix them with dangerous substances because people have been too dependent from the start. For certain countries where individuals need these pain medications but can’t due to regulations, strategies that need to be implemented are to change government restrictions, communicate with suppliers, and provide alternatives when needed. From this, the advantages would be that surgeries can take place, and individuals can be given proper opioids when needed and don’t have to suffer a great deal of pain. Providing alternatives can be somewhat effective in helping individuals who could not have the addictive behaviors that opioids have. The only disadvantage would be that this would take a considerable amount of time no matter when they start.

Prompt 7: Describe as many of the parties involved in your issue as possible. Don’t stop with those directly involved (those that experience disease or health inequity). Examine your issue as one that connects to other people and groups? Explain what connects all these people to the issue. How are they impacted? What might be their outlook on the issue? What shapes their outlook? Nationality? Class? Rich or poor? Educated versus uneducated? Race? Historical circumstances? A sense of injustice? A right to a livelihood? Give these people motivations for taking a particular outlook on this issue?

    Everyone is entitled to have the right access to medical services and medicine to aid them whenever their health is threatened. As for which parties are involved in this issue, any person that needs medications to relieve some type of pain is certainly involved in this issue. The first party that is involved in this matter would be the pharmaceuticals, doctors, nurses, medical faculty, and patients in countries that can afford to have these drugs available when needed. Lots of medical treatments require anesthesia and pain drugs before and after surgery so no additional pain occurs. But in countries with developed medical systems, there are chances of certain individuals taking advantage of their powers and that’s where doctors will abuse their powers and possibly certain patients start to become addicted. More nurses and medical faculty will be needed to help patients recover from addictive behaviors which cause more funds to be spent on that. These patients can also start to become so addicted that they must be released from the hospital because they spend their money on the drug instead of treatment. High-income countries have well-developed medical systems but also have drugs circulating in communities not well organized and funded in these countries. These opioids are also mixed with other dangerous substances such as fentanyl, which caused lots of patients that become addicted to dying. The rich doctors earn more money prescribing these drugs to patients and the patients if they get addicted will soon become poor and crave the need for these pain drugs which ultimately tends in their death.

    It’s quite different when discussing which parties are involved when talking about middle and low-income countries. The government is the first main party involved in these types of countries. The reason is that they mainly control the rules and regulations of the flow of certain drugs coming into their countries and restrict what drugs are allowed. Their main reason is that they don’t want their citizens to abuse these drugs, get addicted to them, and ultimately die from them. The government would also have to diverge its finances to create rehab and recovery center for patients wanting to recover from this even though there are chances they won’t. For creating these restrictions, they wouldn’t have diversified their funds and used them on essential things since they already aren’t comfortable with what they have. This then affects another party of the middle- and low-income countries which are the citizens themselves. Depending on the country, certain citizens are affected in different ways. Middle-income countries such as India and China produce a variety of drugs for a very affordable price compared to the prices of high-income countries. Due to these cheap prices, some citizens buy these opioids and have been dependent on them because of how effectively relieve their pain but don’t realize they're addicted to them. Because of this, another party comes in which are drug smugglers who smuggle these cheap drugs to low-income countries. But certain low-income countries such as Nigeria and Sudan have extremely strict regulations and they can’t even receive drugs when certain individuals are in dire need of them. That’s the other party that gets affected, the individuals that need surgery and don’t have any pain medications to suppress any pain before and after their medical treatment. As you can see, each party affects the other and that’s why the opioid crisis has become a worldwide health problem. As for what connects all these people and parties, it is the government. The government has the ultimate power over what rules they want to apply and how sternly they want to enforce its policies. When looking at this situation from an outside perspective, countries considered rich often suffer the problem of individuals abusing the availability of these drugs. Countries considered poor or in the middle of rich and poor usually either have individuals that need opioids but don’t have access to them or individuals have access to cheap versions of these opioids causing them to be addicted to them. All these countries have different varieties of races so it wouldn’t be just saying that certain races have the availability of these pain medications. Education could help these individuals because they can learn about their government regulations and with time, they can create some type of change to better get access to drugs to people that need them and ban them in areas where it is not needed. People that are not affected by this situation should still understand that other individuals suffer a great deal of pain because of strict regulations and availability. And others have no need for them all but use them because they have grown to be dependent on them. This is the injustice of this worldwide problem.

Prompt 6: Defining a global health issue and the relevant information for understanding it? What issue or problem has your group selected? Craft a problem statement using the ones provided to you in class. What countries or regions of the wolrd will focus on for your issue? What do you need to explain to communicate this issue to someone who doesn't know anything about it? How does social justice and fairness matter for this issue? Provide 3 URLs that provide useful background information.

 URLS:

1) https://www.frontiersin.org/articles/10.3389/fphar.2021.693426/full 

2) https://qz.com/1198965/the-surprising-geography-of-opioid-use-around-the-world 

3) https://www.goodrx.com/healthcare-access/medication-education/why-do-drug-shortages-happen 

Most countries around the world have suffered the struggle of some sort of drug shortage due to a variety of reasons. But to easily categorize these countries, it will be best to organize them into high-income, middle-income, and low-income countries. Countries that high-income countries would be the United States, Germany, and the United Kingdom. Countries that are middle-income would-be India, China, Russia, and Brazil. Countries that are low-income would-be Kenya, Nigeria, Saharan Africa, and Sudan. Each category of income in these countries has different reasons why there are drug shortages. As for high-income countries, their main reasons for drug shortages is due to wrongful business decisions, regulatory and government issues, and unavailability of raw materials. Middle-income countries and low-income countries face similar issues such as not having an abundant amount of funds to conduct research, enforce policies, and constant fear of drug smuggling. Due to this, countries on this level struggle to correctly put a set price on drugs and especially opioids. As for people that are unaware of one of the main issues that are happening globally, it is the severe problem of drug abuse. One of the most notable drugs that have been either abused or needed in areas but are unavailable is opioids. Opioids are considered narcotic drug that is used to relieve pain but for some time, it has been overused in some parts of the world and underused in others. Lots of individuals from certain countries have the luxury of having this drug availability when needed for critical medical procedures and helping to lower pain when necessary. But in these countries, opioids become open to the public and are usually mixed with other dangerous substances such as fentanyl which is the reason why so many become addicted and lose their lives to it. In then there are other countries where medical procedures will happen, and the patient will have to either deal with the pain if possible or surgeries won’t happen because of the chance that the pain might be too much for the patient. Other countries are surrounded by countries that create opioids for a very affordable cost and lots of individuals become independent on them which also takes a toll on their life. Social justice and fairness matter greatly in this issue because the people that need opioids to relieve pain don’t receive them and people that have opioids available at their fingertips abuse the drug which in turn ruins their lives.

Prompt 5: Not the Same COVID Pandemic

        The COVID-19 pandemic had a detrimental effect on me as well as my family and not only did it affect us economically but also impacted us mentally as well. My family runs a small convenience store in the middle of our town where most cross when either going to work or going back home. Lots of people from around the town come to get food in between their lunch breaks and buy other necessities as well. There would be some parts of the day when it would be busy, and many people were in our store at once. We considered this to be beneficial and never saw it as something that was a problem for us. But when COVID-19 cases started to arise in our town, everything changed. Since nobody had any information about the virus people were frantic about it, as well as my parents. My parents were afraid of how would they monitor who does come into the store and who doesn’t. They were also concerned for their safety, employees’ safety, and the safety of their customers. They had to change the whole structure of the store, where people stood, the requirement of masks, creating certain rules not previously there such as buying in bulk. When the number of COVID-19 cases started to rise, fewer and fewer people started to come. 

        There were many negative impacts and less positive impacts that occurred during this time. This obviously started to affect our business and not as much money was made as we used to. There were days when we closed our business earlier than usual and parents were usually upset about it. During the pandemic, my family, and the employees all somehow got COVID-19. Because of this, we had to close the business down for 2-3 weeks which impacted us a lot. We were all quarantined and my family made sure that everybody in the household was good as well as the families of the employees. Since nobody could go out, we were careful what we ate so our conditions didn’t get worse and everybody was taking the proper medicine that was needed. There aren’t as many positive impacts as there were negative but there were a few. The first is that it gave us a break from the world. My family took a step back and was able to relax after working for so long. Sure it wasn’t the best type of relaxation, but they were able to finally take a break from work. The other positive impact was that it bought us together as a family more than before. We would all be busy with our own schedules and because of quarantine, we bonded more, and I think that’s why we handled it better than before.

        One of my friends felt even harder economic and physical extremes than I did. One of my close friends struggled to deal with COVID-19 more than I did because his grandparents also lived with his family. His grandparents were more susceptible to getting COVID-19 and since they had diabetes, the virus could have caused major problems for them. Because of this, his family worked fewer hours and they all stayed at home to make sure that would not occur. There were times when his family was stretched thin, but they were able to pass COVID-19 without anyone being sick. 

Prompt 4: Communicating Across Borders

On Monday, September 26th, we were fortunate enough to have a guest speaker who works at the University of Kentucky hospital. The guest speaker’s name was Sarah Hessler and her reason for visiting us was to share with us the frequent global and cultural issue that arises in medical facilities across the world. This issue is the language barrier between medical faculty and patients. University of Kentucky’s hospital and many hospitals around the world deal with the issue of individuals that come to the hospital to seek aid but can’t because there is a language barrier. Because of this communication problem, doctors and nurses cannot give the best and optimal treatment without understanding the problem in the best way possible. As stated by Sarah Hessler, 23% of the population of Lexington speaks other than English at home. It is estimated around 195 languages and potentially more are spoken in Lexington. Hessler mentions how Lexington can be considered a linguistic community because UK Healthcare receives over 2,000 LEP/ASL patients every week and 103 languages are spoken give or take in that week. Hessler emphasizes how healthcare systems need to support effective communication and access to all its patient. Some points that she mentions about this is to notify patients of all language services provided for them to make the conversation between patients and staff easier. They should also be informed that this service comes free of charge with trained professional medical interpreters and translators. Trying to avoid using patients’ family/friends as the baseline for communication because there could always be some fault in that. It is best to hear the issue and the reason for seeking by the patient themselves. Some way to offer better language services is to provide on-site staff for high-volume languages. If that is not possible at that time, providing video remote interpreting and phone interpreting access to eliminate the issue of language barriers. If all this is not possible, providing in-language text is the only possible way to help with this gap in communication. 

        If our speaker Sarah Hessler was to take a job with the Global Polio Eradication Initiative, her duties would be the same as it is, but she would have to deal with a whole new environment, different situations than she has dealt with, and dealing with new cultures she may have never experienced. As for what some of her tasks should be, it would be to connect translators to individuals that match their language, and this is not provided at no cost. She would also have to ensure that no rules or regulations are broken when there is a communication problem. As for her services, Hessler could create informative posters and flyers in the different languages spoken in those areas to help people understand the benefits of being vaccinated against polio. Not only that, but she can also gather people in the community in these small towns and cities and ask them to help her inform people that may not see the benefits right now. 

Prompt 3: When Should It Be Over and Who Decides

        During class, our TA posed interesting and debatable questions to use to see where our viewpoints and what we believe about certain questions. The first question our TA asked us was if we believed the pandemic is over? As a collectively discuss it with our peers, we believe the pandemic is going to be over, but COVID-19 will now start to act like the flu, where it will start to become yearly. Because of this, people will start to normally adjust and know what to do if COVID-19 were to spread in their area. The second question our TA asked us was how would we define a pandemic? For that, we defined a pandemic that is a disease that spreads around the country or world. The third question was if we knew anybody that is sick now with COVID-19? As of right now, nobody in the class knew anybody that was sick with COVID-19. The fourth question our TA asked us was what the implication is for saying the pandemic is over in the United States. Fewer regulations on masks, vaccines are ready and available at local pharmacies, and more places are opening. The fifth question our TA asked us was why the US president might say the pandemic is over? Seeing the rate of people with COVID-19 is low and more people are getting vaccinated because it is required in lots of places. The sixth question our TA asked us was what countries of the world might be most impacted by a formal declaration that the pandemic is over? The class and I believe that countries that are under-developed or developing countries that depend on the USA are most likely to be impacted. The seventh question our TA asked us was are you in agreement with family or friends on whether the pandemic is over or not? Overall, most would agree that the pandemic is over but some members that are still likely to get COVID-19 such as grandparents or children, could disagree about this point. The eighth question our TA asked us was if 400 American death per day was acceptable? Obviously, that many deaths are still not acceptable by no means, but it is better than when hundreds and thousands were dying in a single day. To lower the number of deaths nowadays, regulations should still be in place. 

Prompt 2: The Global Dimensions of Pop Culture and Health

    In today’s world, there are different groups of people in this world that have different lifestyles, routines, and much more. But there are also things that are common between these types of people, one of them being pop culture. Pop culture is considered modern trending culture transmitted through social media and the internet that is aimed towards whoever needs to see it, it could be either the general population, specific age group, or other types of groups. Pop culture is also one way to communicate health and safety issues to the general population through user-friendly and accessible ways. 

My first video, it discusses how a post on the popular social media platform TikTok shows how a Vietnamese creator created a dance that went along with a song released by the Vietnam National Institute of Occupational and Environmental Health. This public service song sings about how to wash hands properly, not to touch our eyes, nose, and mouth, and not to visit crowded places where 6 feet is not possible. With the dance, people are starting to do it as well to spread this information and it has done just that. Vietnam had a hard time dealing with COVID-19 with more than 10 million affected and more than 40,000 that died from it. By releasing a song like this and influencers creating dance from it, it helps spread the word and made an impact almost immediately. 

        

        My second video, it shows how 12 of Sierra Leone’s artists and musicians created a song as part of the Pan-African Zero Malaria Starts With Me. The language that this song is in is called Krio language. The song tells listeners how Malaria is such a large issue and that to fix this problem, it must first start with us. The singers say how people need to start this fight against Malaria by getting up to make sure they are treated, and they don’t have the potential of spreading it. Africa has been dealing with Malaria for a long time because it is responsible for high transmission and is dangerous if not dealt with. By releasing pop culture content like this, it communicates to the general population of Africa in a creative and gets people to follow the message behind the song. 

Prompt 1: Making Connections

    Many might think their health is only involved with themselves in the hospital they go to and to the pharmacy where they pick up their medicine. But it’s so much more than that, the trained staff at these hospitals may have come from another country and brought their skills and beliefs to their place of work. The pharmacists giving the medicine to their patients may have learned from a country from another site. Down below, are a few examples of how my health can be viewed as more global than local and why that is. 

    This is the first example of the connection of my health being global more than local. So I am from Henderson, KY, a small town just like any other town, doesn’t have many attractions or places to see, but enough where there is food and shelter to live a sustainable life. Growing up here, I never had any issue eating and there were plenty of days when I ate many different types of delicious foods. Not only that, Henderson focused heavily on education and not just academics, but also dietary needs and other parts of health such as physical and mental. Because of this, I consider myself that I was knowledgeable enough to take care of myself. To this day, I never had any medical issues in the past and I made sure that I ate proper dietary foods so no other medical issues arise in the future. But it was not like that for my grandfather that lived his childhood and adulthood in India. In many parts of India, many people don’t receive proper education about even the smallest of things. Not only that, some families couldn’t make enough to provide for the whole family so the kids of the family would also have to work as well. My grandfather fell into this so there were some days where my grandfather would have to eat unhealthy just to have something in his stomach. After some time, after going to the hospital in and out, my grandfather got diagnosed with diabetes. In this way, even though my health in Kentucky was great, I have the chance of getting diabetes in the future because of how my grandfather used to live back in India. 

       My second example of the connection to my health is more global than local. In America, all the medicine that is given to everybody for whatever they need is usually medically manufactured by mixing several different types of chemicals together. As an American, I never gave it much thought to what medicine I’m taking when I have a common cold or what a vaccine is made of when taking the flu shot. That information is just a click away for people that are curious like me. There are some medicines given that are considered light because they have been manufactured that way to treat colds, fevers, and headaches. But there are also medicines out there that have been studied in labs repeatedly because they are antibiotics for bacteria that keep mutating to be resistant to antibiotics. But this is all different for my grandmother’s family that didn’t have access to medicines small or big. In India, my grandmother’s family depended on herbal medicines to treat their colds and major issues such as dealing with diabetes or high levels of cholesterol. So even now, I am taking herbal medicines because since I was young, I have been dealing with digestion issues. Headaches are frequent for me because of my digestion issues and after taking herbal medicine, I feel as if herbal medicine is more effective than medicine that is chemically manufactured. In this way, the medicine I take now is considered more foreign because it is uncommon in America for people to take herbal medicine. But in places like India and other parts of Asia, it is common practice to use herbal medicine as a form of treatment and new studies show the effectiveness of these types of medicines. 

    My third example of the connection to my health is more global than local. There aren’t many times where I have been to the hospital because I broke my leg or needed surgery because of internal medical issues. There were only just two times in my life when I went to the hospital for that type of treatment. The first time I had surgery was in Chicago because I had an infection in my bladder because my kidney was not properly getting rid of waste. Because of this, I needed immediate surgery so that more waste wouldn’t infect my bladder even more. The surgeon that was operating on me wasn’t from America but was from Europe. At the time, I was too little to understand what conversations they had but my mother told me when I was a little older what they discuss. My mother had told me that after the success, the surgeon was explaining to my parents how the healthcare system here is much different from Europe and everywhere else in the world. The medical infrastructure in Europe is stable and balanced compared to America. Many citizens of Europe agree that they aren’t stressed about worrying about financials like many Americans are. Not only that, but this surgeon also treated me with care and my parents noticed that plenty of times. He informed them of the whole process and answered all the questions happily. In this way, the one time I had a critical surgery, the surgery was done in a way where it felt like how surgery was done in Europe. The environment felt normal, not stressful at all, and the whole surgery process went smoothly as well. This surgery reflects how medical care is around the world and why sometimes, they are viewed as better than America.