Sample Essay About Health

The national coverage of bird flu in various print media has given an impression of how big and big this problem is. The public is widely invited to worry and fear this bird flu case. The consequences are not only felt by the community itself but the livestock world which is considered as the carrier of this epidemic is also burdened.

The case in Indonesia shows that bird flu actually afflicts many common people and not cage workers. If we identify it further, it becomes a big question. Is it so easy for the H5N1 virus to transfer to humans or are there other factors in the case of human deaths while bird flu is only a driving force towards death?

This virus does not actually make humans as habitat to live. This means that it grows optimally in chickens, ducks, and other poultry. To be able to move to humans is still a big question mark whether through intermediaries or directly. Please note that this virus needs media attachment so that he is unable to fly through the air directly into the respiratory tract. So excessive worry is not needed as long as people get used to cleaning their bodies after dealing with poultry with detergent.

Why big?

Cases of bird flu in other countries are not as large as in Indonesia. It's interesting to be ingredient study and ponder whether government policies are correct in controlling bird flu cases or vice versa. In controlling this problem there are actually two big problems. The first is the technical problem of countermeasures and the second is diplomacy.

In the era before SBY, although there were already known cases of bird flu, the handling pattern tended to only be carried out by the relevant departments. The advantage is that the problem does not appear in the media widely. The disadvantage is that the funds are very limited, so the settlement is not complete.

In the era of the SBY administration, the president was drawn to participate in solving it. With the increase in cases of bird flu to RI1, inevitably the news about bird flu cases becomes big news. So that every flu illness accompanied by fever and shortness of breath is always associated with bird flu even though it has not been positive for H5N1. As a result, people are increasingly worried.

Whereas problems in tropical areas such as Indonesia, respiratory tract infections occupy a high rank. As a result, it is the general public and the mass media who are the ones who ask questions here and there. Because it is not certain, finally reported as suspect bird flu. Of course, this does not solve the problem, but it is detrimental to the national avian flu prevention and control pattern.

In addition to losses, of course there are advantages to be gained, for example, the disbursement of funds from the world international so that it becomes a big job and a big project for agencies and people certain. The large funds are also useful for tackling bird flu comprehensively and sustainably. Unfortunately, until now the problem of bird flu has no signs of ending.

Diplomacy and technical steps

There are two approaches that should be taken by the government immediately, namely one side with avian influenza diplomacy and the other side with technical countermeasures by the relevant departments. Diplomatic steps that can be taken by the government and should be SBY or JK because the problem has become so big is to immediately provide information that bird flu is not a big problem and the mode of transmission to humans is not easy.

The number of deaths in the world, which is still around 150, is still very far from human deaths due to HIV, which in America alone reached 18,017 people in 2003 from 43,171 HIV patients. SBY must voice in international forums that Indonesia is capable of independently tackling bird flu cases. Indications that occurred with the case of bird flu were brought to the international community for "pity", making the case truly frightening and worrying.
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The end of 2018 closed with a shocking report released by the Government of the Philippines and WHO about the outbreak of a measles outbreak in the country. The number of cases reached 17,298 during January-November 2018, which is an increase of more from 350% compared to the same period the previous month. Earlier this year it was reported that the outbreak was widespread, covering seven regions in the Philippines, including Manila. Fifty-seven deaths were reported from Lazaro Hospital, a government-owned hospital in Manila. In 2014, the Philippines experienced a measles outbreak, covering 58,010 cases and 110 deaths.

Measles and its Dangers

Measles is a contagious infection caused by a virus. Before measles immunization was promoted, measles was one of the endemic diseases that caused the most deaths every year. This disease generally affects children, although it can also occur in adults who have not been exposed to it in childhood. This disease is caused by a virus in the Paramyxovirus family which is usually transmitted through direct contact with sufferers or through the air. The virus infects the respiratory tract and then spreads throughout the body.

The specific symptom of this disease is a reddish skin rash that appears 7-14 days after exposure and can last for 4-10 days. In children, this disease can cause serious complications that can be fatal if not treated properly. The most common complication is vomiting. What is worrying is complications to the lungs in the form of inflammation of the lungs (pneumonia). The child will have difficulty breathing and shortness of breath. Another fatal complication of encephalitis is inflammation of the brain that causes the child to have convulsions and experience decreased consciousness. Children can also experience bleeding and thrombocytopenia, but these are rare.

Back to events plague in the Philippines, why is this happening when many other countries have declared themselves free of measles? The opposition and some public health experts have accused the government of a dengue vaccination program with Dengvaxia in 2016. The program includes the vaccination of 800,000 primary school students without prior screening. Several cases of fatal dengue infection are associated with this vaccination. In November 2017, vaccine maker Sanofi announced that for those who have never been infected with dengue, administering the vaccine could cause disease severity. The dengue vaccination program was eventually put on hold, and there were demands on policymakers and Sanofi. Public health experts see this as a bad precedent that undermines public confidence in vaccination.

Vaccination without Screening is Risky

Dengue has interesting characteristics, which have been known for a long time, namely severe cases with bleeding, It's not a primary infection, but the result of a cross reaction with a different virus the serotype. What is meant by serotype is the difference in the reaction of the virus with human antibodies in the blood. There are four known serotypes, namely DEN-1, DEN-2, DEN-3, and DEN-4. That is, if a child is infected for the first time such as with DEN-1, the risk for bleeding increases. Dengvaxia in this case contains all dengue serotypes.

In people who are already infected (seropositive), giving this vaccine will provide protection against secondary infections with severe symptoms. However, in people who have never been infected (seronegative), the possibility can aggravate secondary infection. In endemic areas, where seropositive can be more than 90% such as the Philippines, this vaccine from a population perspective still provides benefits, reducing hospitalization and mortality rates. The Philippines has several suspected fatal cases associated with administering this vaccine to seronegative children. WHO now recommends administering this vaccine only to subjects known to have had the disease infection previous dengue (by serological screening).

The Dengvaxia case has lowered the confidence of the Filipino people in the vaccination program. The study, conducted by Led from the London School of Hygiene & Tropical Medicine (LSHTM), noted a decrease from 93% in 2015 to 32% in 2018, for approval to be vaccinated. As for the perception of vaccine safety, the decline occurred more drastically from 82% in 2015 to only 22% in 2018. Thus, it can be understood that the national basic vaccination coverage in the Philippines in 2017 was only 70%.

Relevance of Prevention in Indonesia

As a country that has many similarities with the Philippines, Indonesia need to learn a lot from the above case. First, many parts of Indonesia are dengue endemic areas, even Jakarta and several big cities have recently experienced a significant increase in cases. The use of vaccines for dengue has not yet been discussed, but the Philippines' experience with regard to dengue vaccines is a valuable lesson. If vaccination is considered, serological screening should be a prerequisite. Humanely ethical, however, a protection program should not put (seronegative) subjects at risk. Loss of support for public confidence in vaccination is fatal to achieving herd immunity.

Second, Indonesia, as a country with a majority Muslim population, was shaken by the MUI fatwa regarding the MR vaccine (for measles and rubella), because it was considered to contain pork products, in 2018. Data shows that the rubella vaccine coverage in Java until November 2018 was only 68%, even in Aceh it was reported only 8%. Vaccine coverage is safe at 90-95%, vaccination coverage of this size is needed to create a herd immunity, namely the environment or community that is resistant to a type of disease generally because of: vaccine. The provinces with vaccination coverage reaching 90% are probably only 15 provinces out of a total of 34 provinces in Indonesia. The last measles outbreak reported in Indonesia was in Asmat Regency, Papua, late 2017 to 2018. The crisis involved 71 children died and at least 800 people were hospitalized. Although conditions in Papua are indeed different from the geographical and nutrition Bad, from a public health perspective, if herd immunity is not achieved, we are actually at great risk for an outbreak.

Winning back the public's trust is an urgent thing to achieve. Campaigns about the importance of vaccination or the consequences of not being vaccinated need to be done more creatively. Campaign content and delivery packaging need to be consulted with experts communication so that it is right on target and effective. Considering that parents/subjects are millennials and internet penetration in Indonesia is already more than 50%, the involvement of influencers may need to be considered. Mass media (radio, Newspaper, television) need to be asked to provide public space for this campaign. Regional leaders (regents/mayors) should be asked to take an active role in inter-agency coordination health, education, and religious affairs to approach school leaders, especially madrasas and boarding school. Hopefully it's not too late.