Sickle Cell Disease PT.2

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Did you know that Sickle Cell Disease (SCD) is the most common inherited blood disease in the world? It is most common in people whose ancestors are from Africa, India, the Middle East, South or Central America, Caribbean islands, the Mediterranean countries (such as Turkey, Greece, and Italy.

In sub-Saharan Africa, it is most common in West and Central Africa where as many as one out of every four people (25%) have sickle cell trait. Nigeria has the highest number of people with this disease around the world. It is estimated that around 4 million people in Nigeria suffer from SCD while 40 million others carry the gene, which they pass to their offspring. Some important things to note are:

  • Sickle Cell Disease is an inherited condition, a disease passed through genes at the time of conception.
  • For the disease to emerge, it must be passed down by both parents

–              A person who receives a gene for Sickle Cell Disease from one parent and a normal gene from the other has a condition called ‘Sickle cell trait’. Sickle cell trait produces no symptoms or problems for most people.

–              If one parent has sickle-cell disease and the other has sickle-cell trait, then the child has a 50% chance of having sickle-cell disease and a 50% chance of having sickle-cell trait.

–              When both parents have sickle-cell trait, a child has a 25% chance of sickle-cell disease, 25% do not carry any sickle-cell gene, and 50% have the sickle cell trait.

  • People who have sickle cell trait do not develop sickle cell disease, but they are “carriers” who can pass the abnormal gene on to their children.
  • Most carriers live completely normal, healthy lives.
  • Sickle Cell Trait and Sickle Cell Disease are NOT contagious

In a nutshell, if somebody with sickle cell trait marries another person with the trait, there’s a one in four chance for every pregnancy, that that child will have Sickle Cell Disease

In the USA, mandatory testing is carried out on all new-borns. It is a simple blood test that looks for sickle cell traits or sickle cell disease. However in Sub-Saharan Africa, there are no governmental universal new-born screening policies in place.

It is important therefore, that every parent should have their new born tested in order to determine if SCD is present. The test known as “Genotype test” and is available inexpensively at all general hospitals and private health facilities.   Just as it is recommended for prospective to undergo HIV testing before marriage, screening for SCD with a genotype test is equally important. It allows couples to know whether they are carriers of the SCD gene and therefore at risk of passing it on to their offspring.

 

SCD has major social and economic implications for the affected child as well as the family. Recurrent sickle cell crises interfere with the patient’s life, especially with regard to education, work and psychosocial development.

Couple of african children crying

People affected by the SCD experience different symptoms that may also vary in severity from one individual to the other, some experience mild symptoms while others may experience severe symptoms that result in frequent hospitalizations. In infants symptoms usually do not start to show until they are 4 – 6 months of age and occur in the form of painful swollen hands and feet.

Symptoms of SCD cause chronic ill health and debilitation and may include:

  • Fatigue -: this is the most common symptom that people with SCD experience,
  • Sickle Cell Crisis -: patients experience severe pain in the joints, bones, chest and abdomen , this usually occurs when the blood flow is blocked by the sickle red blood cells.
  • Jaundice -: this is a yellow staining of the skin and the whites of the eyes

Other symptoms include shortness of breath, dizziness, headaches, coldness of the hands and feet and paler than normal skin or mucous membranes (the tissue that lines your nose, mouth, and other organs and body cavities).

Some of these symptoms are frequently triggered by dehydration, cold temperature, and infection, extreme physical exertion, stress and even pregnancy.

Complications of SCD involve many organs, and if not properly treated can result in death.

The only treatment that has been known to cure SCD is bone marrow transplant which is very expensive, has high risks and may cause death. As a result, in Sub-Saharan Africa, best available treatment aims to avoid  Sickle Cell Crisis, relieve symptoms and prevent complications.

To properly manage SCD, the focus must be on early diagnosis, prevention of crisis, and aggressive treatment. This is achieved with available inexpensive prevention and treatment options such as fluids, healthy diet, vaccinations, antibiotic and malaria prophylaxis, folic acid supplements, hydroxyurea and better pain management through early use of pain medications.

 

If you would like to learn more about Sickle Cell Disease please visit our website or email us. Our goal is to educate people about promoting good health and the prevention of disease

 

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Sickle Cell Disease (SCD)

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We have in one point in time met someone that has been plagued by this disease or lost someone to this disease. However we are not fully aware of what it maybe, so today we will be looking at the Sickle Cell Disease.

Sickle cell disease is a disease that affects the red blood cells, people with SCD have abnormal hermoglobin in their red blood cells,  hermoglobin is  a protein in the red blood cell that carries oxygen throughout the body, this disease is inherited  i.e. passed on from genes from parents to their children, it is not contagious and cannot be passed down like a cold or infection from someone else. The image below shows the difference in normal blood cells and that of a Sickle cell.

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Hemoglobin is a protein found in red blood cells. It helps the blood to carry oxygen from the lungs to the rest of the body. The normal shape of the red blood cells are round, this enables them to move freely throughout the blood vessels, however people that are affected by the SCD usually have hermoglobin S which causes a sickle or moon crescent shape of the red blood cells.

The shape of these hermoglobin S is restricted by it shape and results in blocked blood flow and subsequently the flow of oxygen to various parts of the body which can lead to a variety of complications.  We may all wonder who is at risk with this disease, Africans, Indians?  is this disease contagious or hereditary?

Join on us Channels TV at 3:30 pm on DSTV (lagos) as we discuss the various symptoms, causes of Sickle Cell Disease and how it can be avoided. As well as we discuss various myths surrounding this disease. Visit our website for more information on SCD.

 

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Stroke:  How To Avoid A Medical Emergency

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A stroke occurs when blood flow to a part of the brain stops. If blood flow is cut off for longer than a few seconds, the brain cannot get blood and oxygen. Part of the brain can die, causing brain damage. Stroke occurs rapidly and requires immediate treatment which is why it is sometimes referred to as  brain attack.  In Nigeria, one third of people die within the first 7 days after a stroke and a little less than half die within 6 months. Most stroke survivors (85%) are left with problems associated with  moving, thinking, and talking which may improve in the weeks to months after a stroke.

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Symptoms of Stroke

The symptoms of stroke depend on which part of the brain is damaged. In some cases, a person may not know that a stroke has occurred.

Most of the time, symptoms develop suddenly and without warning. However, symptoms may occur on and off for the first day or two. Symptoms are usually most severe when the stroke first happens, but they may slowly get worse.

  • Change in alertness (including sleepiness, unconsciousness, and coma)
  • Trouble with walking: You may stumble or experience sudden dizziness, loss of balance or loss of coordination.
  • Trouble with speaking and understanding: You may experience confusion. You may slur your words or have difficulty understanding speech.
  • Paralysis or numbness of the face, arm or leg: You may develop sudden numbness, weakness or paralysis in your face, arm or leg, especially on one side of your body. Try to raise both your arms over your head at the same time. If one arm begins to fall, you may be having a stroke. Similarly, one side of your mouth may droop when you try to smile.
  • Trouble with seeing in one or both eyes: You may suddenly have blurred or blackened vision in one or both eyes, or you may see double.
  • Lack of control over the bladder or bowels
  • Headache: A sudden, severe headache, which may be accompanied by vomiting, dizziness or altered consciousness, may indicate you’re having a stroke. The headache wakes you up from sleep and gets worse when you change positions or when you bend, strain, or cough. This type of headache may occur if the stroke is caused by bleeding in the brain.

Types of Stroke

There are two major types of stroke:

  • Ischemic stroke – occurs when a blood vessel that supplies blood to the brain is blocked by a blood clot. Most strokes (85%) are ischemic strokes.
  • Hemorrhagic stroke – occurs when a blood vessel in part of the brain becomes weak and leaks or bursts open.

A transient ischemic attack (TIA) — also called a mini-stroke — is a brief period of symptoms similar to those you  have in a stroke. A temporary decrease in blood supply to part of your brain causes mini-strokes, which often last less than five minutes. A TIA doesn’t leave lasting symptoms because the blockage is temporary.

Seek emergency care even if your symptoms seem to clear up. If you’ve had a mini-stroke, it means there’s likely a partially blocked or narrowed artery leading to your brain, or a clot source in the heart, putting you at a greater risk of a full-blown stroke that could cause permanent damage later.

Up to half of people whose symptoms appear to go away actually have had a stroke causing brain damage.

Risk Factors/ Causes of Stroke

  • High Blood Pressure is the main risk factor for strokes
  • Heart disease
  • Diabetes
  • Family history of stroke
  • High cholesterol
  •   Increasing age, especially after age 55
  • Race (black people are more likely to die of a stroke)
  • Unhealthy lifestyle habits such as smoking, high fat diet, and lack of exercise
  • Birth control pills (especially in women who also smoke and are older than 35)

Complications of Stroke

A stroke can sometimes cause temporary or permanent disabilities, depending on how long the brain lacks blood flow and which part of the brain was affected. Complications may include:

  • Paralysis or loss of muscle movement. You may become paralyzed on one side of your body, or lose control of certain muscles, such as those on one side of your face or one arm. Physical therapy may help you return to activities hampered by paralysis, such as walking, eating and dressing.
  • Difficulty talking or swallowing. A stroke may cause you to have less control over the way the muscles in your mouth and throat move, making it difficult for you to talk clearly, swallow or eat. You also may have difficulty with language (aphasia), including speaking or understanding speech, reading, or writing. Therapy with a speech and language pathologist may help.
  • Memory loss or thinking difficulties. Many people who have had strokes experience some memory loss. Others may have difficulty thinking, making judgments, reasoning and understanding concepts.
  • Emotional problems. People who have had strokes may have more difficulty controlling their emotions, or they may develop depression.
  • Pain. People who have had strokes may have pain, numbness or other strange sensations in parts of their bodies affected by stroke.

Can Stroke be treated?

Stroke is a medical emergency! Seek immediate medical attention if you notice any signs or symptoms of a stroke, even if they seem to fluctuate or disappear

Think “FAST” and do the following: (acronym for Stroke symptom recognition)

Face. Ask the person to smile. Does one side of the face droop?

Arms. Ask the person to raise both arms. Does one arm drift downward?

Speech. Ask the person to repeat a simple phrase. Is his or her speech slurred or strange?

Time. If you observe any of these signs, get the person to a hospital immediately. Don’t wait to see if symptoms go away. Every minute counts.

The longer a stroke goes untreated, the greater the potential for brain damage and disability. To maximize the effectiveness of evaluation and treatment, you’ll need to be treated at a hospital within four hours after your first symptoms appeared.

If you’re with someone you suspect is having a stroke, watch the person carefully while waiting for emergency assistance. In Africa, we have limited resources, poor access to healthcare facilities, manpower shortage, lack of organized stroke unit in hospitals, inadequate neuro-imaging (special xray/scanning) facilities (CT scan, MRI, Carotid Ultrasound, Cerebral Angiogram, etc) and ambulance services. These together with lack of awareness of stroke in the populace contribute to delay in care seeking and severity of outcome.To be effective, treatment must be started within 3 to 4 1/2 hours of when the symptoms first started.

Is it Possible to Prevent a Stroke?

Up to 50% of all strokes are preventable. Many risk factors can be controlled before they cause problems.

Debunking African Myths

Myth #1: Stroke only occurs in older people

Stroke can happen to anyone including children (usually due to Sickle Cell Disease). However, heredity, race, and gender can increase one’s risk. For example, stroke is higher among Africans and African-Americans than Caucasians, in part because Africans have higher risk of elevated blood pressure and diabetes. Women are 2.5 times more likely to have a stroke than breast cancer. Unfortunately, the number of strokes among young and the middle-aged is rising, a sign that the obesity epidemic may be starting to shift the age burden of the disease.

Myth #2 The African mind set of attributing external causes to illness (e.g.witchcraft, spiritual attack, generational curses, etc) 

This mindset impacts care seeking, delays diagnosis and proper treatment.

Myth #3 The risk for a second stroke is highest during the weeks or months after the first stroke.

The risk begins to decrease after this period.

 Uncontrollable Risk Factors for Stroke:

  • Age (>65)
  • Gender (Men have more strokes, but women have deadlier strokes)
  • Race (Africans are at increased risk)
  • Family history of stroke

 These lifestyle changes will help lower your blood pressure and keep your blood sugar controlled. This will also help to reduce your risk of heart disease and stroke. Yearly check ups with your doctor to measure blood pressure and blood sugar level will also provide early diagnosis of high blood pressure and diabetes.

Controllable Risk Factors for Stroke:

The single most important thing any of us can do to prevent stroke is to be sure our blood pressure is controlled. Other steps you can take to reduce your risk are to treat high cholesterol, control blood sugar, and lifestyle changes such as:

  • Eat a better diet, including reducing salt. Eat less fatty foods as well as more fresh fruits, vegetables and whole-grain foods.
  •   Regular exercise – at least 30 minutes a day
  • Maintain a healthy weight – Being overweight increases your risk of developing high blood pressure.
  • Manage stress – Don’t let stress build up. The chemicals your body makes in response to stress make your heart beat harder and faster and your blood vessels tighten. All this makes blood pressure higher
  • Avoid tobacco smoke.
  • If you drink, limit alcohol.
  • Comply with your blood pressure or diabetes medications.

Author Zaidat Ibrahim

Zaidat gained her Bachelors Degree from a U.S College and she currently works 11198984_972734182745608_117787137_nat Massachusetts General Hospital (MGH) in Boston. She also works as an Editor for Opportunity Desk and volunteers for several organizations through the UNV. She is known for her hard work, commitment and most of all, her beaming smiles.

The Kidneys: Know, Understand & Care For Your Kidneys

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The kidneys are two bean shaped organs, each about the size of a fist. They are located just below the rib cage, one on each side of the spine. The kidneys help to filter blood removing unwanted waste products and the extra fluid in the blood. Everyday, the two kidneys filter about 120-150 litres of blood to produce 1-2 litres of urine. Urine flows from the kidneys to the bladder.

Why Are The Kidneys Important?

The kidneys are important because they keep the composition/make-up of the blood stable (This stability is referred to homeostasis). The following are the functions of the kidney

  1. The kidneys prevent the build-up of waste and extra fluid in the body
  2. They keep levels of certain chemicals stable (sodium, potassium and phosphate)
  3. The kidneys make hormones that help: regulate blood pressure, make blood cells and bones stay strong

Kidney Diseases

Kidney disease describes any problems that one may have when their kidneys aren’t functioning properly. These diseases may be minor or severe, but one must take steps to control them.

Symptoms of Kidney Diseases

Kidney disease usually does not have symptoms in the early stages. However, here are a few symptoms associated with kidney diseases:

  • Edema: swelling as a result of the kidney’s inability to get rid of extra fluid and salt. Edema can occur in the legs, feet and ankles.
  • Appetite loss & weight loss,
  • Trouble concentrating,
  • Drowsiness or feeling tired,
  • Dry skin & darkened skin,
  • Muscle cramps,
  • Increased or decreased urination,
  • Generalized itching & numbness,
  • Nausea & vomiting,
  • Shortness of breath,
  • Chest pain.

Causes of Kidney Disease

  1. High blood pressure and Diabetes are the two leading causes of kidney diseases in black people. Therefore undiagnosed high blood pressure and diabetes could lead to kidney diseases. Black people suffer from kidney failure at a significantly higher rate than other races (about four times the rate of caucasians). Black people are more likely than caucasians to have high blood pressure and its related kidney problems- even when their blood pressure is mildly elevated.
  2. Heavy metal poisoning (such as lead poisoning from long-term exposure to petrol, paint & batteries, mercury poisoning in miners and users of skin bleaching creams, as well as mercury containing soaps).
  3. Congenital causes (condition present at birth).
  4. Use of expired medications such as tetracycline antibiotic.
  5. Sickle cells diseases.
  6. Some traditional herbal medicine.
  7. Infections (Malaria, skin and throat infections).
  8. Pesticides used in farming.

How does High Blood Pressure Affect the Kidney?

Blood pressure measures the force of blood pushing outwards on your arterial walls. It is the pressure exerted on the artery walls by circulating blood. High blood pressure can damage blood vessels in the kidneys, as well as other organs of the body, reducing their ability to work properly. When the force of blood flow is high, blood vessels stretch so blood flows more easily. Eventually, this stretching scars and weakens blood vessels throughout the body, including those in the kidneys. If the kidneys’ blood vessels are damaged, they may stop removing wastes and extra fluid from the body. Extra fluid in the blood vessels may then raise blood pressure even more, creating a dangerous cycle.

Complications Associated With Kidney Diseases

  • Fluid retention, which could lead to swelling in your arms and legs, high blood pressure, or fluid in your lungs
  • Heart attack, heart and blood vessel disease (cardiovascular disease)
  • Weak bones and an increased risk of bone fractures
  • Anemia
  • Decreased sex drive or impotence
  • Damage to your brain which can cause difficulty concentrating, personality changes, seizures or stroke
  • Decreased immune response, which makes you more vulnerable to infection
  • Pericarditis, an inflammation of the sac-like membrane that envelops your heart (pericardium)
  • Pregnancy complications that carry risks for the mother and the developing baby
  • Kidney Failure – Irreversible damage to your kidneys (end-stage kidney disease), eventually requiring either dialysis or a kidney transplant for survival.

Can kidney disease be treated?

In the very early stages, kidney disease may need little or no treatment. However, kidney disease also raises your risk of heart disease and stroke, and your doctor will want to ensure that this risk is as low as it can be.

Controlling your blood pressure is an important way to reduce kidney disease, and to reduce your risk of heart disease and stroke. Your doctor will want to ensure that your blood pressure is lower than 140/90 mmHg, and in some cases as low as 130/80 mmHg

Certain high blood pressure medications are best for people who have developed kidney disease because they help protect the kidneys against further damage. If these medicines do not lower your blood pressure enough then other blood pressure medicines can be used.

If you have diabetes as well as high blood pressure, it is extremely important to keep this controlled. Diabetes can cause serious damage to your kidneys if it is not treated properly.

What is Dialysis?

Dialysis is a treatment that does some of the things done by healthy kidneys. It is needed when you have kidney failure and your own kidneys can no longer take care of your body’s needs. When your kidneys fail, dialysis keeps your body in balance by:

  • Removing waste, salt and extra water to prevent them from building up in the body,
  • Keeping a safe level of certain chemicals in your blood
  • Helping to control blood pressure

 LIFELINE - South African Dialysis Treatment Survivors!

Preventing Kidney Disease

A few lifestyle changes could be made to prevent kidney diseases. These changes includes:

  • Eat a better diet, including reducing salt. – eat less fat and saturated fat as well as more fresh fruits, vegetables and whole-grain foods.
  • Enjoy regular physical activity – 30 minutes a day
  • Maintain a healthy weight – Being overweight increases your risk of developing high blood pressure.
  • Manage stress – Don’t let stress build up. The chemicals your body makes in response to stress make your heart beat harder and faster and your blood vessels tighten. All this makes blood pressure higher
  • Avoid tobacco smoke & limit alcohol.
  • Comply with medication prescriptions.

Author Zaidat Ibrahim

Zaidat gained her Bachelors Degree from a U.S College and she currently works at 11198984_972734182745608_117787137_nMassachusetts General Hospital (MGH) in Boston. She also works as an Editor for Opportunity Desk and volunteers for several organizations through the UNV. She is known for her hard work, commitment and most of all, her beaming smiles.

Hypertension: What You Need to Know

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The human heart pumps blood through the body. Pressure is generated to forcefully push blood through the walls of the arteries, this pressure is called blood pressure. Blood pressure is written as two numbers, for example 112/78 mm Hg (mm Hg= millimeters of mercury).

The top number (112, in our example) is called systolic pressure, and this is pressure when the heart beats. The bottom number (78, in our example) is the pressure when the heart rests between beats). The optimal blood pressure is less than 120mm Hg and 80mm Hg. Therefore, High blood pressure means the pressure in the arteries is elevated.

Normally, the heart beats regularly pumping blood through the vessels all over the body. As the blood is pushed by the heartbeat, the blood in turn pushes against the sides of the vessels. Blood vessels are flexible and can be widen or constrict as needed to keep the blood flowing. For a variety of reasons, blood may begin to push too hard against the blood vessels. This is high blood pressure.

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Why should you be concerned about high blood pressure?

High blood pressure is very dangerous! It makes the heart work too hard and the high force of the blood flow could damage the blood vessels, heart, kidneys, eyes and other organs in the body causing severe health problems

Debunking Myths About High Blood Pressure

#1. High blood pressure runs in my family and there’s nothing I can do about it, I will get it too.

It is true that high blood pressure can run in a family and that a history of high blood pressure places one at risk of developing high blood pressure as well. Regardless of family history, lifestyle choices could help you avoid high blood pressure.

#2. People with high blood pressure have symptoms like headaches, sweating & difficulty sleeping. I don’t have those symptoms so I must not have high blood pressure

High blood pressure is a ‘silent killer’, it has no symptoms so you may not be aware that it’s damaging your arteries, heart and other organs. Don’t make a mistake assuming that symptoms will alert you of high blood pressure, instead, everyone should makes efforts to check their blood pressure and know their numbers.

#3. Stress and anxiety can cause hypertension

There is no scientific proof that stress leads to high blood pressure. .However, .If one is already diagnosed with high blood pressure then stressful situations can temporarily elevate one’s blood pressure.

Ways of Preventing High Blood Pressure.

  1. Eat a better diet which includes reducing salt intake. Stick to the D-A-S-H eating plan.
  • DASH means Dietary-Approaches-to-Stop-Hypertension. Thus eating plan was designed by the National Institute of Health, USA. The DASH plan includes less saturated fat (such as palm oil) and less total fat, less beef and pork, as well as eating more fruits and vegetables, fat free/low fat milk, more fish, more poultry, more beans and whole grain foods.
  • Limiting the use of salt and alcohol can also help lower or prevent high blood pressure.
  • If possible, meet with a dietician or nutritionist to help you figure out a better and healthier eating plan
  1. Exercise: exercise or enjoy a regular physical activity, make sure you do this at least 30 minutes per day
  2. Maintain a healthy weight. Being overweight increases the risk of high blood pressure
  3. Manage stress. The chemicals in the body responses to stress that makes your heart beat harder or faster and your blood vessels tighten.
  4. Avoid tobacco smoke- including cigarettes, cigars and all forms of tobacco
  5. Limit the use of alcohol
  6. If you have been diagnosed with high blood pressure, take your medications according to your doctor’s prescription

Author Zaidat Ibrahim

Zaidat gained her Bachelors Degree from a U.S College and she currently works at 11198984_972734182745608_117787137_nMassachusetts General Hospital (MGH) in Boston. She also works as an Editor for Opportunity Desk and volunteers for several organizations through the UNV. She is known for her hard work, commitment and most of all, her beaming smiles.

Welcome to The HealthZone!

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Welcome to The HealthZone blog! The HealthZone is a 30-minute television health magazine program that focuses on the delivery of health education on the most common ailments affecting the Nigerian population in simple terms that anyone can understand. The show features a panel of nationally and internationally acclaimed consultant specialists in each of the medical conditions of focus. Each week our physician expert moderator, Dr. Toju, facilitates an in-depth discussion of a particular medical condition with a guest specialist. Follow our blog to learn more about the most common diseases affecting the Nigerian and how you can take preventive measures against them. The HealthZone will premiere on Channels TV, April 1st, 2015 at 6:30pm. Thirteen (13) episodes of the show’s first season will then air Wednesdays at 6:30pm on topics ranging from kidney disease to diabetes and malaria. Notable guests include Dr. Ebun Bamgboye, Dr. Akan Otu, Dr. Efunbo Dosekun, Dr.Yemi Johnson, Dr. Femi Fasanmade, Prof Frank Ojini and Dr. Chito Nwana.

Welcome

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Nigeria's Health situation is well documented with Nigeria lagging behind regional and global peers across most health indices.  Healthcare challenges abound across all delivery sectors: inadequate health facilities for in/outpatient and emergency care; prevalence of infectious diseases; increasing impact of non-communicable diseases; high maternal and child mortality; etc. Access to basic health information and awareness is an important but missing element in the solution set. A well informed public will be positioned to take preventive care actions that can significantly improve health outcomes.