Browsing by Author "Murru Maurizio"

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AIDS, Primary Health Care and Poverty
(Uganda Martyrs University, Department of Health Sciences, 2004-04) Murru Maurizio
This paper analyzes the complex interrelation between poverty and AIDS. Poverty, in its many and diverse aspects and with its many and diverse consequences, creates a fertile breeding ground for the expansion of HIV/AIDS. In turn, HIV/AIDS, for its mode of transmission and its epidemiological features, badly affects the livelihood of its victims, their families, their entire communities and countries. Sub Saharan Africa bears the brunt of the epidemic. With about 10% of the world population, it has about 66.5 % of the world seropositive cases. In three Southern African countries the HIV prevalence in the adult population reaches or exceeds the level of 30 %. Recent WHO estimates put life expectancy in Sub Saharan Africa at about 47 years and that, without AIDS, it would be at about 62 years. The development achievements of the last decades risk being lost and the future of the continent is at risk. But numbers, alone, don’t tell the whole story. They don’t talk of millions of orphans, dilapidated health services, crumbling educational systems, illiteracy, gender discriminations, harmful cultural practices, uncontrolled urbanization, conflicts and civil wars, refugees and internally displaced people, entire economies on the verge of collapsing. In the rich countries, AIDS is no more a death penalty. It is a chronic disease that, although with problems, can be treated. For years the idea that the poor "had to be" excluded from the benefits of Antiretroviral Treatment (ART), simply because they are poor, has been accepted somehow passively. Things are now changing. The paper briefly touches upon ART and its implications. It is also stated that all deaths due to poverty and deprivation are unacceptable, not just those due to AIDS. The main conclusion is that the fight against HIV/AIDS is the fight against poverty. The resources to win this war are not lacking. What seems to be lacking are vision, political will and genuine interest in all human beings.
Bhopal 20 Years on: Globalization and Corporate Responsibility
(Uganda Martyrs University, Department of Health Sciences, 2004-12) Murru Maurizio
The year 2004 marks the 20th anniversary of the worst industrial disaster in human history. Some 40 tonnes of methyl isocyanate leaked from a tank at the Union Carbide Corporation (UCC) chemical pesticide plant in Bhopal, India. The toxic cloud killed more than 20,000 people. Today about 150,000 are still chronically ill and hundreds of thousands of others suffer socially and psychologically. UCC accepted some moral responsibility for the disaster but rejected any legal responsibilities. In 2001 it was absorbed by Dow Chemical, which now states that it has nothing to do with what happened 20 years ago in Bhopal. The local Madhya Pradesh government and the Indian federal government have also let down the disaster victims. The financial compensation paid by UCC in 1989 has yet to be completely paid out to the claimants. The pesticide plant still exists and, in its current dilapidated state, poses an ongoing threat to surrounding communities. The Bhopal disaster, still unresolved after 20 years, raises questions about how multinationals operate. Globalization is an unstoppable process and multinationals play a prominent role in shaping it. They enjoy the advantages of increasingly borderless societies and economies but often seem reluctant to accept their social and environmental responsibilities. In the last two decades, partly because of what happened in Bhopal, governments and civil society have developed new values and greater expectations. Several international policy instruments have been created to make multinational operations more transparent, and responsible. They are a step forward. Their use, however, is still voluntary and this considerably weakens their potential usefulness. The role of various non-governmental organizations (NGOs) as watchdogs of the process is useful and essential but ad hoc. Some NGOs, like the companies they monitor, lack accountability. In any case, the journey towards greater corporate transparency and accountability will be a long and slow one.
Costing Health Services in Lacor Hospital
(Uganda Martyrs University, Department of Health Sciences, 2003-12) Murru Maurizio; Corrado Bruno; Odaga John; Ahairwe Denis; Akulu Ernesta; Bavcar Alessandro; Bonane Emmanuel; Kirunda David; Mwesezi Henry; Nagujja Angela; Ndindayino Kalire
Health institutions all over the world are troubled by the intractable problems of shrinking resources and increasing demands for good quality services. Private-Not-For-Profit (PNFP) health units face even more serious problems. The financial support coming to them from donations has significantly decreased in the last 20 years. Raising user fees is not a viable option as fees high in relation with families’ income exclude the poor from using the services. Yet, the mission of PNFP health units rotates around the idea of serving the poor and the disadvantaged. This leads to the need to reconcile the apparently irreconcilable: financial accessibility of services and their sustainability (Flessa 1998). Health managers at all levels (regional, district, sub-district, hospital, lower level health units) are ignorant about the actual cost of the services they produce and deliver. The very notion of “cost” is not clear to the great majority of them. In most cases the terms “cost” and “price” are used as if they meant the same. In the best cases, only direct costs are thought of when trying to assign a monetary value to services produced: expenditures are mistakenly taken to equal “actual costs”. So-called “hidden costs” are rarely considered or thought of. Yet, the knowledge of actual costs incurred in producing health services, can be of great use to health managers at all levels to make more informed decisions and to assess efficiency and effectiveness (Shepard et al. 2000, Green et al. 2001). In addition, a more detailed knowledge of actual costs of producing services can be useful for “political” reasons. All too often, lay people as well as technicians, seem to equate “fees” with “profit”. Sound information on actual costs of producing services, obtained with a clear and acceptable methodology, can help in clarifying the above mentioned misunderstanding. The authors of this study used cost finding and cost analysis techniques to calculate the actual cost of producing final units of outputs in Lacor Hospital, Gulu District, Northern Uganda.
International Trade and Health: Before and After CANCUN
(Uganda Martyrs University, Department of Health Sciences, 2003-12) Murru Maurizio
International trade is potentially critical in stimulating increased production, economic growth and poverty reduction. For this potential to be achieved, transparent and equitable international rules are necessary together with national policies clearly oriented towards social objectives and resource redistribution. Economic globalization, so far, seems to have produced more inequalities both between and within nations. The Poverty, as it is currently structured and ruled, is a tool in the hands of powerful nations used to perpetuate their dominance on international trade. It should, rather, be a forum where inequities and inequalities are corrected to the benefit of millions of people struggling with abject poverty around the world. The recently collapsed WTO Conference held in Cancun Mexico, offers an opportunity for some few considerations on the present state of world trade, its uncertain future and the possible implications of this for the livelihoods of the world poor.
Malaria and DDT: Myths and Facts
(Uganda Martyrs University, Department of Health Sciences, 2004-08) Murru Maurizio
Around the world, about 2,400 million people, in about 100 countries and territories, are still at risk of contracting Malaria. Between 300 and 500 million of them get the disease each year and between 1.1 and 2.7 million die from it. In Uganda, malaria is the first cause of morbidity and mortality. It accounts for 29%-50% of all out-patients consultations, 30% of inpatients admissions and 9%-14% of inpatient deaths. Up to 23% of deaths in children under five years of age are due to malaria. The Uganda Minister of Health recently announced the intention of using DDT for Indoor Residual Spraying to decrease malaria morbidity and mortality. This spurred a heated debate. The available scientific evidence, accumulated over the years, strongly suggests that DDT, when properly used, is harmless to human beings. The attempt to control malaria, without DDT, is futile. This paper advocates an evidence based approach, free from preconceived ideas. Politicians should help to inform and sensitise public opinion, rather than spread false information harmful for public health.