ARC celebrates World Health Day by promoting healthy eating & active lifestyles

To commemorate this year’s World Health Day (April 7 2014), local NGO Advocating the Rights of Children (ARC) has organised a number of activities to promote healthy eating and active lifestyles for children.

According to an ARC press release, today is the official release of animated Sing-Along song ‘Eat a Rainbow’.  The song illustrates the benefits of eating different coloured fruits and vegetables.

This Friday (April 11) will also be the official book launch for the 2nd storybook in the HEAL series. The event will be held at the Raalhugandu Helipad Area, from 16:30 until 18:00.

In addition, ARC will be running healthy eating awareness sessions for school children in the local area. ARC’s senior consultant on nutrition will conduct interactive sessions for children at Billabong International High School and Kalaafaanu School.

At the HEAL campaign information sessions children are encouraged to eat different coloured fruits and vegetables everyday, to choose water first to quench their thirst, to avoid junk food, to eat healthy snacks and to stay active.

The sessions will be continued for other schools in Malé and in other islands throughout the year.


Government warns of dengue and scrub typhus risk on World Health Day

Minister of Health and Gender Dr Mariyam Shakeela has noted an increase in the incidence of mosquito-borne dengue and mite-borne scrub typhus in the Maldives.

In a televised address to mark World Health Day, Shakeela said increased travel, trade, migration and climate change is leading to an increase in insect-borne diseases worldwide.

Dengue fever has become endemic in the Maldives since 2004, she said.

“I am deeply saddened to note that individual level action to control diseases spread by small insects is not being taken. The result is the increase in dangerous diseases such as dengue and scrub typhus and deaths,” said the minister.

There were 680 reported cases of dengue in the Maldives in 2013, a decline from 2006 peak of 2,788 cases, the Health Protection Agency (HPA) said.

The year 2011 also saw a relatively severe outbreak of dengue in the Maldives, with fatalities reaching a dozen – a record high in the country’s history. In 2012 there were a total of 1,083 dengue cases in the Maldives. Construction workers face an increased risk, the HPA has said.

Deaths have also been reported from scrub typhus due to failure to seek healthcare and improper diagnosis, epidemiologist at the HPA Dr Aishath Aroona told Minivan News.

The Health Ministry runs a yearly campaign called ‘Madhiri Rulhi Rulhi’ (‘Unfriendly to Mosquitoes’) to limit mosquito breeding during the rainy season.

Waste management and cleanliness are the most effective methods of controlling mosquito breeding grounds, Aroona said.

The Maldives eradicated malaria in 1984, making it the only country in the region to have done so. The last case of mosquito-borne filariasis was recorded in 2003, and the Health Ministry will complete a screening and surveillance project by October to determine the eradication of the filariasis vector, the ministry has said.

According to the World Health Organisation (WHO), mosquito-borne dengue has spread from nine to over a hundred countries, making it the most rapidly spreading vector-borne disease. Over 40 percent of the global population is at risk from dengue, the organisation said.

The WHO’s World Health Day campaign this year – ‘Small Bite, Big Threat’ – focuses on the risks of diseases spread by mosquitoes, flies, ticks, and freshwater snails.

The International Federation of Red Crescent and Red Cross Societies (IFRC) has called on governments for a shift in approach, from responding to isolated dengue outbreaks to investing in long-term programmes for behavioral change.

“This can be done by empowering communities with essential knowledge concerning hygiene and environmental sanitation, training and engaging community health volunteers to identify and refer suspected dengue cases and improving community-based disease surveillance,” the IFRC said in a recent report


Alert issued after migrant construction worker dies of dengue in Male’

The Maldives Health Protection Agency (HPA) has issued a dengue fever alert, following the death of a foreign migrant worker and the hospitalisation of two children for hemorrhagic dengue fever in Male’, with the HPA and World Health Organisation (WHO) emphasising that construction workers are particularly at risk.

Dengue is transmitted by the bite of an Aedes mosquito infected with any one of the four dengue viruses. It occurs in tropical and sub-tropical areas of the world, including the Maldives, which only has two strains of the virus. Though the Maldives holds South-East Asia’s record for being malaria-free, since 2004 the country has been battling a growing epidemic of dengue fever annually with nearly a 1000 reported cases and three deaths annually.

The year 2011 saw quite a severe outbreak of dengue in Maldives – though far below the 2788 cases recorded in 2006, the worst year ever for dengue in Maldives, according to the WHO. Fatalities reached 10 in 2006 and 12 in 2011 – a record high in the country’s history. While in 2012 there were a total of 1083 dengue cases in the Maldives.

Between January 1 and July 13 of this year, a total of 256 cases of dengue have been reported, with 90 in Male’ and 166 in the atolls, while dengue hemorrhagic fever accounts for 16 of those cases, the Health Ministry’s HPA has noted.

“The HPA issued a general alert – the first one for 2013 – regarding dengue fever to raise the level of public awareness a bit,” HPA Epidemiologist Dr Aishath Aroona Abdulla told Minivan News today (July 15). “Since it’s Ramazan it’s very difficult to conduct normal activities, so we wanted to alert people early.”

“We are beginning to see a rise in reported cases, but starting in May [the beginning of the south west monsoon season] this is to be expected,” said Dr Aroona. “Generally dengue peak season is June to early July, so this year its coming a little later, which could be because of changing rainfall patterns.”

She explained that while one of the dengue virus strains found in the Maldives is not fatal, the hemorrhagic strain is life threatening.

“The hemorrhagic variety is usually found in the Atolls, however people are getting sick from that strain of the virus in Male’,” explained Dr Aroona.

“Unfortunately one person, a foreign construction site worker, already died from the hemorrhagic strain [of dengue],” she continued. “He was in the country for about 15 days, according to the report we received.”

“Construction workers and people living near construction sites are at very high risk [for contracting dengue],” she noted.

Dr Aroona explained that when the sites are abandoned or the owner is not there, no one takes responsibility to ensure standing water or items that could collect water are removed.

“It’s important for the owners – the government or private businesses – to get rid of the [standing] water at the sites,” she said. “If removing all the water is not possible, large areas can be filled with sand as an alternative.”

“[However,] the Male’ City Council (MCC) or Local Government Authority (LGA) can be contacted to help control mosquitoes in these areas,” she added.

Foreign workers at risk

“While any reports of dengue are not good, comparatively, dengue cases in 2013 are not something to think of as an outbreak,” WHO Representative Dr Akjemal Magtymova told Minivan News today.

“However, there has been an unfortunate case of death and a few individuals in critical condition,” she noted.

While the children have subsequently been released from the hospital, the death of one foreign migrant worker has highlighted the risk foreign construction workers face due to their lack of social safety net support.

With an abundance of active construction sites in Male’ and the lack of inspection and control of these sites to prevent and control mosquito breeding places, it is expected that vector borne diseases will continue to persist in the capital, the WHO has noted.

“This [HPA alert] relates to foreign migrant workers. The individual who died was only here for about two weeks and must not have had a social safety net support,” said Dr Magtymova.

“While Maldivians are generally aware of dengue fever, migrant workers need more information and support because they may not know about dengue or have a support network if they fall ill,” she added.

“There should be more forceful promotion of awareness materials,” emphasised Dr Magtymova. “Everyone needs to be vigilant and aware, we don’t want people in critical condition.”

The WHO is working with the Health Ministry to leverage resources and extend dengue awareness. Additionally, the WHO in the Maldives has been an active partner in all aspects of dengue prevention, control and management – including training of doctors and nurses in clinical management of dengue, technical support in surveillance and situational analysis, provision of supplies and support in health promotion activities both at national and local levels.


The Aedes mosquito breeds in small clean water collections in and around the home, places where people live (e.g. rainwater collections, pots, wells, tanks, tires, gutters, etc.). This is why controlling mosquitoes is everyone’s responsibility, noted the HPA.

“The dengue carrying mosquito bites in the early morning and in the evening close to sunset,” said HPA’s Dr Aroona.

There are two primary ways to prevent the spread of dengue, the most effective being to remove breeding areas and also to protect against bites.

“In addition to standing water at construction sites, garbage areas are also prime breeding grounds, especially since only a small amount of water is needed for mosquitoes to lay their eggs,” Dr Aroona said.

“It is very important for people to keep their gardens and homes clean, by collecting cups, cans, and other items that collect water,” she explained. “It takes seven days for mosquitoes to hatch after the eggs have been laid, so cleaning at least once a week is essential.”

The HPA has highlighted additional preventative measures individuals can take to protect themselves and their families from contracting the disease:

  • Keeping windows and doors shut in the early morning, as well as covering air vents.
  • Not littering, including throwing trash into air vents – which is particularly problematic in Male’.
  • Covering any open tanks or wells and putting fish that eat larvae into them.
  • Adding a little soap or salt to water to prevent eggs from being laid in planters, or they can be covered with cotton wool.
  • Wearing clothes that cover the arms and legs.
  • Using mosquito nets and screens.
  • Using sand to fill areas that collect standing water.

Seek medical attention

“Although individuals can develop a lifelong immunity after recovering from dengue, they are only immune to that particular strain and are still at risk of infection,” explained Dr Aroona.

Dengue symptoms appear three to 14 days after the infective bite.

The fever is typically high grade, above 38oC (101oF) and continuous. The fever may not disappear even after taking paracetamol, although paracetamol may reduce the fever to some extent, noted the HPA.

Other accompanying symptoms are headache, body aches, backache and joint pains, and sometimes a transient rash or reddening of skin.

Symptoms of simple viral fever generally last less than 3 days. Dengue fever, a more severe form of viral fever caused by the dengue virus may last slightly longer, between three to five days, and may be accompanied by more severe symptoms like vomiting and fatigue, particularly when the fever begins to subside, the HPA has highlighted.

If an individual has a fever, the HPA recommends rest, drinking coconut water, oral rehydration solution, fruit juices, milk or any home-based drinks, and only taking paracetamol – not other medication which can lead to bleeding.

“Fever is an important part of your immune reaction to the virus in your body, and helps to kill the virus. So you need not be alarmed, so long as you do not have any of the warning signs or danger signs,” stated the HPA.

The HPA has urged people to seek immediate medical attention if the fever lasts more than three days, or any warning signs of hemorrhagic dengue are present, which include:

  • Continuous vomiting and an inability to take fluids by mouth
  • Severe pain in the abdomen
  • Difficulty breathing
  • Not passing urine for more than six hours
  • Cold hands and feet
  • Bleeding from the nose or gums, vomiting blood, or black, tarry faeces
  • Changes in behaviour, such as lethargy or drowsiness, often with inability to stand, sit up or get up from the bed; Restlessness or irritability (excessive crying in children, adults may have behavioural changes and use foul language)

The Epidemiology and Surveillance Unit of the Health Protection Agency is conducting weekly monitoring of dengue nationwide and is issuing weekly reports.


Maldives “lagging behind” on tackling malnutrition

The Maldives is “lagging behind” in addressing malnutrition, a senior medical expert has said, as the country continues to work towards meeting the UN’s Millennium Development Goals for health.

Public Health Programme Coordinator for the Center for Community Health and Disease Control (CCHDC), Dr Fathmath Nazla Rafeeq, told Minivan News that malnutrition in the country was “quite alarming” considering the number of medical advances made in the country over the last few years.

Her comments, made on World Health Day, relate specifically to fears over the national promotion of healthy diets, including issues of vitamin deficiency in expectant mothers and children, to the consumption of high-calorie junk food and energy drinks by young people.

According to figures published in 2009 by the World Health Organisation (WHO), 17.8 percent of children under five years of age were found to be underweight in the Maldives according to international standards for ascertaining health in young people. The same figures found that 6.5 percent of children were classed as overweight in the country. 20.3 percent of children in the same age group were found to be suffering from ‘stunting’, a term describing children suffering growth retardation as a result of poor diet and infection.

Hunger for information

Co-founder of the NGO Advocating the Rights of Children (ARC), Zenysha Shaheed Zaki, believes parents and schools across the Maldives require greater access to trained nutritionists, reflecting a demand for education on healthy eating.

ARC is focusing on overcoming a widespread cultural prevalence for convenience foods in the country by promoting healthier lifestyles – particularly among younger people.

Dr Fazla said that the government continued to rely on NGOs to helping to promote healthier lifestyles across the country’s atolls.

“The state cannot do this alone. Therefore we welcome the support of NGOs to improve health across the country,” she said.

Though not all educational programmes relating to nutrition in the country in recent years have succeeded, the CCHDC claimed in certain cases children were able to teach their own parents about the need to cut down on junk food like french fries and other dietary offenders, as a result of their own learning.

Dr Fazla said there was also a strong concern about the amount of high-calorie junk food being consumed by school-age children.  She also said that the number of expectant mothers suffering with anaemia – a condition that can have health impacts for children later in life – also needed to be addressed.

Energy drinks

Dr Fazla stressed that beyond just dealing with food intake, the government continued to be concerned about a growing trend among parents providing children with caffeinated energy drinks. There was, she said, a common misunderstanding that such drinks were the same as sports drinks designed for rehydration after physical activity.

“We understand that some parents are under the misconception that sports drinks are the same thing as energy drinks,” she said. “Right now we are looking to address concerns about giving energy drinks to children.”

Rather than solely treating nutrition as an education issue, Dr Fazla claimed that wider national issues of food security and supply were also important to the debate about the quality of the nation’s eating habits.

Supply issues

Supply issues are hampering efforts to encourage healthy eating in the Maldives, said Dr Fazla.

“There is a perception among some people that when we encourage people to eat fruits, these be products like apples and oranges – things grown in in other countries, rather than locally available produce like papaya,” she added.

“We also have to think about affordability. I can go to tell someone to buy vegetables, but for products grown on farms say in India there are a lot of variables like shipping costs that impact the prices of such goods.”

Dr Fazla stressed that projects were underway to try and encourage a wider variety of agriculture, but issues of food security and availability should not be understated.

She was ultimately optimistic the country could succeed in fostering a culture of healthier eating among young people, and the rest of the nation.

“We should be able to overcome the challenges of how to feed our young properly,” she claimed.

Awareness issues

ARC yesterday launched a new website for its HEAL campaign, originally launched in April last year, designed to introduce young children to a five-point program designed to promote healthier lifestyles.

According to ARC co-founder Zenysha, the NGO is educating parents and schools to replace fast foods and flavoured soft drinks with fruits and vegetables, water and a generally more active lifestyle. Efficient promotion of ARC’s message remains a major challenge, she said.

“Raising awareness [of healthy eating] among young people is a key challenge we face right now. There are a few nutritionists in the country, but the ARC has had to get two nutritionists from New Zealand to help with our work,” she said. “There is a lot of demand among parents and pre-schools for dietary advice and information. We have had nutritionists meeting with parents at pre-schools in Male’, Hulhumale’ and Villingili – events that were popular, but people are still demanding more advice.”

Children were often wary of being taught lessons, Zenysha said, so ARC was attempting to combine education with games and activities to raise awareness about the importance of healthier eating.

The HEAL plan emphasises the importance of healthier snacking, such as yoghurt or dried fruits and nuts, eating a mix of different coloured fruits and vegetables, avoiding processed foods like sausages and burgers, and aiming for at least an hour a day of physical activity.

Drinks are also included, with parents being asked to reduce their children’s consumption of added-sugar drinks such as packaged juices and flavoured milk, by favouring bottles of water and lower fat or skimmed milk.

Though the HEAL campaign was launched back in April 2011, the launch of the new website this weekend represents an ongoing collaboration with nutritionists to promote a national discourse on the need for healthy eating.

Zenysha said information on the website was at present solely provided in English, though attempts were underway to provide Dhivehi translations.

ARC said it was also looking to schools to try and have a single day each week where children are invited to bring lunches and snacks consisting solely of fruits and vegetables.  Water would also be encouraged in place of added-sugar drinks.

Meanwhile, ARC said it had been invited by a large number of groups and organisations around the country to attend events in order to promote the HEAL campaign, providing games and activities to help parents and children better understand the need for nutrition.

After a festival held last year to promote its nutrition message, Zenysha said the NGO was now looking to hold a similar, much larger event to promote child nutrition in 2012.

ARC had now been in operation for two years and was seeing strong support from government, fellow NGOs and the private sector, though difficulties were still felt in attracting active volunteers, she said.

“While we have lots of interests in our campaigns, we are a relatively small team, so getting trained volunteers for our projects can be difficult,” she said.


HRCM calls for new laws to strengthen healthcare

The Human Rights Commission of Maldives (HRCM) called on the government today to formulate new legislation to strengthen and monitor health services delivery in country.

In a statement issued on the occasion of World Health Day the commission noted the lack of adequate laws to regulate the health sector as well as difficulties in enforcing existing regulations.

The delivery of health services in the country need to be developed, it continues, while stronger monitoring mechanisms should be established to protect the rights of citizens, particularly as the government’s policy was to privatise the health sector.

Among the “required basic legislation” include a public health law, a food and drug law and medical negligence or malpractice law. These laws, the HRCM notes, “are needed right now.”


Vice President attends Hulhumalé Health Centre 6th anniversary ceremony

Vice President Dr Mohamed Waheed participated in the celebration of the 6th anniversary of Hulhumalé Health Centre held at Ghazee School on 9 March.

Dr Waheed spoke of the 2010 World Health Day theme, “Urbanisation and Health,” noting it is “timely and highly relevant.”

He said controlling pollution and improving sanitation go a long way to mitigating health risks, and added that community support was needed to create a healthier environment.

Vice President Waheed congratulated the staff at Hulhumalé Health Centre and spoke of improving the quality of services provided at the health centre.


Doctor WHO: Celebrating World Health Day in Malé this weekend

The World Health Organisation (WHO) is celebrating World Health Day today with activities around the world, and the theme “urbanisation and health” which aims to improve urban equity gaps, the leading cause for many health problem’s in the world’s poor according to the WHO.

Past themes have been “working together for health” in 2006 which focused on the health workforce crisis; “international health society” in 2007, aiming to improve the first line of defence against public health emergencies; “protecting health from climate change” in 2008, which looked at the effects of climate change on vulnerable populations; and “save lives, make hospitals safer in emergencies” in 2009.

This year’s campaign 1000 cities, 1000 lives is bringing attention to the issues of urban health. The WHO believes “urbanization is one of the major threats to health in the twenty-first century.”

Urban health

Although the WHO recognises urban environments can provide “great opportunities for individuals and families to prosper,” they can also harm our health in many ways, if the infrastructure and lifestyle in these urban sectors aren’t improved.

Some of the challenges the WHO cites as being problematic in urban areas are “overcrowding; air pollution; rising levels of risk factors like tobacco use, unhealthy diet, physical inactivity and the harmful use of alcohol; road traffic injuries; inadequate infrastructure, transport facilities, solid waste management systems; and insufficient access to health facilities in slum areas.”

According to the WHO, more than half of the world’s population now lives in urban areas, something that has never before happened in our history. They note that about 34% of the total population of the WHO’s South-East Asia Region is urban.

This year’s World Health Day aims to promote finding solutions to the roots of urban health issues and to “build partnerships with multiple sectors of society to make cities healthier.”

But improving urban sectors does not just benefit health, but is an economically sound proposal. The WHO estimates that “every $1 spent on sanitation gives a return of US$ 9.10 in terms of prevention and treatment of illnesses. Improved transportation, infrastructure and greener technologies enhance urban quality of life, including fewer respiratory ailments and accidents and better health for all.”

WHO Representative to the Maldives Dr Jorge Mario Luna says the solution to many of the health issues exacerbated by overcrowding, pollution, inactivity and unhealthy diets, violence and injury is proper urban planning.

“Proper urban planning can promote healthy behaviours and safety through investment in active transport, designing areas to promote physical activity and passing regulatory controls on tobacco and food safety. Improving urban living conditions in the areas of housing, water and sanitation will go a long way to mitigating health risks. Building inclusive cities that are accessible and age-friendly will benefit all urban residents.”

He added that “such actions do not necessarily require additional funding, but commitment to redirect resources to priority interventions, thereby achieving greater efficiency.”

Malé Health Fair

With this in mind, this year’s campaign is promoting ‘greener’ and healthier lifestyle options, which will be  showcased in Malé’s Health Fair, to be held on Saturday 10 April from 4:00-6:30 pm, and then from 8:00-10:30 pm in different locations around the city.

There will be activities held in Ameenee Park, Children’s Park, the Social Center, and other locations around Malé, Hulhumalé and Vilingili.

Some of the activities include free sporting events like dodge-ball and gymnastics; public awareness demonstrations on first aid and sanitation; food preparation counselling for kids; quizzes and puzzles; medical check-ups at ADK hospital; and distribution of information on living a healthier life.

On Friday 9 April there will be a ‘bicycle round’ where senior government officials and other volunteers will join in bicycle round of Malé.

The ‘round’ will start at the Artificial Beach at 4:00 pm and will follow a westerly route, for about half an hour, along Boduthakurufaan Magu, ending at Licence Sarahahdhu near IGMH.

A full schedule of events will be available at the WHO website and the Ministry of Health and Family website from tomorrow.