Civilians in Yemen are bearing the brunt of a ‘nasty’ civil war

 
Living in Yemen is like being trapped in a complex, faulty, Rubik’s Cube. Every day you face puzzles that may have no right answers. A move in any direction can lead to blindly exploding shells, airstrikes or stray bullets.Civilian populations in Yemen are surrounded by ever shifting frontlines in all directions, and are effectively cut off from vital supply routes by bombed infrastructure and a strict embargo.Andre Heller Pereche, head of mission in Yemen and overall director of programmes with Médecins Sans Frontières/Doctors Without Borders (MSF), which is the only aid organisation still operating in Yemen, knows all about the costs of the conflict.

“The vulnerable have had their lifelines completely cut by the conflict, the more robust are struggling to survive,” says Pereche. “A widespread, nasty civil war is permeating the entire country, affecting every individual in Yemen’s population of over 20m people.”

This is in a country that had some of the worst health and social statistics in the world prior to the conflict. Maternal mortality was high, literacy levels were low, and healthcare was seriously limited.

Over 10% of the Yemeni population were classed as moderately malnourished before the conflict. Since the conflict, the dissolution of municipal services, the collapse of private enterprise and a strict UN sanctioned embargo have severely intensified problems of malnutrition.
AndreHellerPerecheMSFAndre Heller Pereche, head of mission in Yemen and overall director of programmes with Médecins Sans Frontières/Doctors Without Borders (MSF).

Outbreaks of water-borne diseases have increased as sanitation standards deteriorate. Dengue fever has already infected urban populations and diarrhoea is wreaking havoc in communities that are already struggling.

Rubbish collections are sporadic at best, and access to water and fuel are hugely problematic.

“Access to fuel is a major problem,” Pereche said. “Yemen has extremely low ground water levels per capita, so fuel is vital to pump water to populations that would otherwise struggle to access it.

“Also, for a largely rural-based population, fuel for vehicles is vital to allow people to access what limited healthcare or food supplies are available. Without fuel people are effectively trapped.”

Vital medical supplies are also limited, meaning people with chronic illnesses like renal failure, vascular disease and diabetes, cannot access medication. Even when insulin is available, the power needed to refrigerate it is often not, rendering the medication defunct. Diabetes is a common condition in Yemen.

MSFChildOperation

“What’s happening in Yemen is like Syria in 2013,” says Pereche, who also has extensive experience with the Syrian conflict.

“It’s shocking that these things can happen again. The Middle East has been in such crisis that it seems like Yemen was one conflict too many, the world really hasn’t taken much note of it and the people there desperately require help. Everyone in the country is living like a displaced person.”

The UN-sanctioned embargo is nominally an arms embargo, however due to its wording it effectively bans all trade into Yemen. For a country that relies almost entirely on fuel and food imports, this has been disastrous for civilians.

MSFboyWater

“What is most vitally needed is for Aden’s ports to reopen fully, and for goods to be traded throughout the country again,” Pereche suggests.

“However the armed parties to the conflict need to work towards peace for that to happen, and currently their focus is on winning the war, rather than restoring basic services.

“I’ve worked for 10 years in conflict zones, and it’s rare to see a crisis affect every citizen the way it does currently in Yemen. At night the capital was completely dark; in the hospital all you could see was the sky being sporadically lit up with anti-aircraft fire, bombs and rockets.”

Approximately 50 international MSF workers are in Yemen, and 500-800 locals work with them. Since March, MSF teams have treated over 4,000 patients bringing over 105 tonnes of medical aid.

MSFChild

Pereche knows MSF only sees a fraction of those who suffer. “What worries me are all those who cannot access emergency healthcare and are just left to die.

“We do our best but we cannot replace the entire infrastructure for a State.” Prices also increase in war-time, as a cruel economics of scarcity kicks-in. “Prices have rocketed and access to cash is severely limited. Many international bank lines have closed their operations and money shops, which could often be seen on the streets, have closed.”

As with all wars, ‘collateral damage’, that sickening euphemism, is exacting its deadly toll. The Saudi-led coalition airstrikes often hit military targets, filled with weapons, which cause secondary explosions that send rockets and scud missiles careering chaotically into civilian areas, indiscriminately killing and maiming children and adults, and razing communities.

Anti-aircraft fire regularly misses its target and returns to the ground, decimating what lies beneath it, regardless of what side it lands on. The country has endured heavy aerial bombardment.

Yemen is home to countless Unesco world heritage sites that are being slowly destroyed; and vital infrastructure, including bridges, hospitals and schools have been flattened.

All this in a country once renowned for its beauty and ancient culture. Despite appalling pre-war human rights records and grinding poverty, Pereche remembers a beautiful country on his first visit in 2010 — highlands dotted with old-world stone villages, beautiful ancient medinas, the sparkling Arabian peninsula, and tribal societies that did not harbour secular divides.

Since the conflict, secular divides have spawned chasms within communities that once shared neighbourhoods, families and Mosques.

“The difference between then and now is like night and day,” he adds.

Internet use among the elderly ‘good for health’ – article from the Irish Medical Times

VariousOlder people who are active internet users and who regularly indulge in culture may be better able to retain their health literacy, and therefore maintain good health, suggests research published online in the Journal of Epidemiology and Community Health.

The Institute of Medicine defines health literacy as the degree to which a person is able to obtain, understand, and process basic health information so they can make appropriate decisions about their health.

Low levels of health literacy are associated with poorer self-care, higher use of emergency care services, low levels of preventative care, and an overall increased risk of death.

The most important factor governing a decline in health literacy in later years is thought to be dwindling cognitive abilities as a result of ageing, which gradually dulls the brain functions involved in active learning and vocabulary.

The researchers wanted to find out if regular internet use and engaging in civic, leisure, and cultural activities might help to maintain health literacy skills, irrespective of age-related cognitive decline. They therefore assessed the health literacy skills of almost 4,500 adults aged 52 and older, all of whom were taking part in the English Longitudinal Study of Ageing (ELSA) between 2004 and 2011.

At the start of the study, around three out of four people (73 per cent) had adequate health literacy. After six years, scores fell by one or more points in around a fifth (19 per cent) of people, regardless of their initial score, while a similar proportion improved by one or more points.

There was a link between age and declining health literacy, and being non-white, having relatively low wealth, few educational qualifications, and difficulties carrying out routine activities of daily living.

Poorer memory and executive function scores at the start of the study were also linked to greater decline over the subsequent six years.

Around 40 per cent said they never used the internet or email, while one-in-three (32 per cent) said they did so regularly. Similar proportions said they engaged in civic (35 per cent) and/or leisure (31 per cent) activities over the six-year period.

Almost four out of 10 (39 per cent) said they had regularly engaged in cultural activities, such as going to the cinema, theatre, galleries, concerts or the opera, during this time.

Across all time points, internet use and engagement in civic, leisure, or cultural activities were lower among those whose health literacy declined.

J Epidemiol Community Health 2014;0:1–6. doi:10.1136/jech-2014-204733.

Alcohol Misuse- Letter to the Irish Medical Times & IMT article on UCC initiative to combat harmful alcohol consumption.

Ireland’s ‘normal’ drinking is far from the international norm

July 11, 2013, Irish Medical Times

 

Photo by Image Broker / Rex Features

Dear Editor,

Apropos the current alcohol debate, I recently had the pleasure of the company of a young man from Co Kildare on a flight from New Zealand, who expressed his shock on observing the different drinking trends of ex-pats working in New Zealand.

For the first time he had noticed how extreme Irish drinking norms are in comparison to his fellow workers from virtually every other country. What he had grown up to see as normal in Ireland was seen as extremely heavy drinking by international standards in New Zealand.  It was not until he went to New Zealand that he first realised how ‘out of order’ our ‘normal’ drinking is in Ireland.

I had the interesting experience of speaking on one of Cork’s radio stations about 10 years ago on the topic of teenage drinking. I suggested at the time that as we were mimicking the US in other cultural matters we should also adopt their legal drinking age of 21.

To my amazement in the following weeks I was confronted by a number of well-educated, middle-class parents who were furious that I might interfere with their little darlings being allowed to drink with them in pubs and restaurants.

The problem for Ireland is that alcohol abuse is costing this state €3.7 billion per year (according to the Royal College of Physicians), and yet all the media seems to be concerned about is the €40 million that might be lost to rugby and soccer should sponsorship be curtailed.

The current price of alcohol is such that a child can currently get drunk on its pocket money, so we need urgently to stop below-cost selling of alcohol, to raise the legal drinking age, and to reduce off licence trading hours if we are to avoid a major predictable medical disaster 10-15 years hence. While the AA and the many rehabilitation centres are doing wonderful work in treating alcoholism, I have been personally very impressed by the work of Dr Olivier Ameisen (French cardiologist), who’s book ‘The End of My Addiction’ explains the therapeutic use of Baclofen in removing the alcoholics craving. I have personally used this therapeutic model in approximately 35 patients, all of whom have remained ‘dry’ over the past three Christmases.

Should any of your readers be interested in discussing this with me, I would be happy to hear from them.

Dr Seán Dunphy,

Cork Road Medical Clinic, Carrigaline, Cork.

Irish Healthcare Awards: Student alcohol deaths moved UCC team to take a stand

Published in the Irish Medical Times,November 13, 2013 By Dara Gantly 
Bookmark and Share

alcoholBy Dara Gantly

Having to attend the funerals of several students who died as a direct result of the misuse of alcohol impelled staff at UCC’s Student Health Department to take a radical stand against alcohol-related harm.

The College, which won the overall prize at this year’s Irish Healthcare Awards for its comprehensive Alcohol Action Plan, brought both the Best Public Health Initiative and An Duais Mhór trophies back to Cork following the gala event in Dublin last week (November 7).

The UCC scheme is aimed at reducing levels of alcohol-related harm among students, 45 per cent of whom have reported binge-drinking more than once a week.

With 20 specific actions, the plan has seen the introduction of an online brief intervention tool for all incoming first years, training for front line college staff, alcohol information sessions and awareness events on campus, peer-support leaders to encourage alcohol education, and most recently the provision of alcohol-free accommodation on campus.

“The adverse consequences of the misuse of alcohol among our students are very real, all too common, and occasionally have been very serious, up to and including devastating injury and death,” commented Head of UCC’s Student Health Department Dr Michael Byrne, who received the award.

A special Lifetime Achievement Award was also presented to retired Skibbereen GP Dr Michael Boland.

The event at the Shelbourne Hotel — hosted by IMT — was attended by 390 people representing the country’s leading public and private hospitals, medical training bodies, universities, patient organisations, the pharmaceutical industry, health insurers and community organisations.

The Mater Public and Private achieved a clean sweep in the Best Hospital category — a first in the Award’s 12-year history — with the Mater Private topping the 16-strong list with its comprehensive hand-hygiene compliance programme.

Galway and Roscommon University Hospitals Group took home two trophies, with Crumlin, the Rotunda, Saint John of God Hospital, and St Finbarr’s Hospital, Cork all among the category winners.

“These awards are now indisputably recognised as the most sought-after in Irish medicine,” commented IMT’s Publisher David Kelly. “The standard of entries has not only been maintained over the past 12 years, but has consistently improved, with the number of entries this year setting another record.”

dara.gantly@imt.ie

 

Letter to the Irish Medical Times – Omega 3 and prostate cancer.

Gaps in omega 3 prostate cancer risk study

August 22, 2013 Irish Medical Times, Dr. Neville Wilson

Dear Editor,

The recent media reports implicating dietary omega 3 as a risk factor for prostate cancer in males is likely to generate public concerns about the purported health and safety benefits of dietary oily fish or fish oil supplements.

Understandably, health-conscious consumers of omega 3 supplements will be confused by these media reports and may be prompted to question, or even abandon, their long-held beliefs and practices regarding the protective nature of supplemental fish oils.

The hypothesis of risk, as speculated by the authors of the SELECT study (published July 11 in the online edition of the Journal of the National Cancer Institute), which gave rise to the media reports, is not, I believe, supported by hard evidence from within the study and the researchers concede only a correlation, but not a cause-and-effect relationship, between omega 3 consumption and prostate cancer.

They also omit valuable information about the use of prescription drugs (like statins) by the participants, which inevitably impact on risks to health.

The outcomes from several reputable studies contradict the speculative reports by the SELECT authors, showing “fish oil consumption may be protective against progression of prostate cancer in elderly males” (PLoS ONE 8(4):Oct 11, 2012.), and these findings are supported by population-based studies involving Japanese, Swedish and Eskimo males, who have a low incidence of prostate cancer and who consume liberal portions of oily fish regularly.

The absence of hard data from the SELECT study about the duration of fish oil consumption, and the source for the fish, or supplemental products, is one of several weaknesses that in my opinion characterises this study, rendering it perhaps a less than an authoritative guide to healthy dietary practice.

The source of dietary oily fish, or fish oil supplements, may impact significantly on the level of health hazard attributed to trial participants, given the high levels of environmental toxins (PCBs, mercury) that may be present in certain areas of farmed salmon, or inadequately purified omega-3 supplemental products. I have prescribed for my patients, and personally used, a purified form of omega 3 (EPA/DHA) for the past 20 years without any emergent evidence of risk for prostate cancer, and will continue to do so in the foreseeable future.

Dr Neville Wilson,

Leinster Medical Centre, Maynooth.

Dyslexia – ‘The Hundred Year Old Hidden Handicap’

By John B. Dunphy, published in Healing Power, Official Journal of the Irish College for the Advancement of Medicine, Issue 1, Vol. 1
ONE of the most frustrating and, in many cases, debilitating
conditions (academically, emotionally and socially) which presents
in clinical practice is a condition known as dyslexia. Dyslexia is
the best known terminology for a group of conditions whose core
problem is an inability to properly process language, be it written,
spoken or symbolic (e.g. numbers). lt is not a problem exclusive
to school children, but affects many aspects of life both in childhood
and adulthood.
The word’dyslexia’ comes from the Greek, meaning’difficulty
with words or language’. On one website, dyslexia was described
as a kind of mind often gifted, but physiologically different’ This
brain difference is not a defect, but it makes learning language
excessively hard.
The child with a dyslexic mind will have trouble from the very
beginning learning to understand speech and making themselves
understood; they may have difficulty with word recall; with sequencing,
so that words will get twisted – e.g. ‘baggetti, mellow, aminals’.
They may have difficulty distinguishing a’p’, ‘d’ and ‘b’; ‘was’ becomes
‘saw’, ‘Pat’ becomes ‘bet’; ‘nuclear’ becomes’unclear’, etc
What makes dyslexia difficult to recognise in the surgery setting
is that many of its characteristics can be a normal part of the maturing
process of young children. But in a child with dyslexia, these persist
longer than expected so that the child will appear slow in these
specific areas and normal in others.
This can easily be mislabelled by teachers and parents aslazy,
or they may take the view that the child will grow out of it in time’
These children are usually not lazy. ln reality, they are working
harder to fill in the gaps between what they actually see, hear
and feel and how they think about these things in their head and
try to put them into words.
The first recorded description of dyslexia was by a General
Practitioner in the BMJ of November, 1896 – over a hundred years
ago. lt was an event marked by an excellent Ieading article by
Professor Margaret J Snowling in the Journal of November 2nd,
1996 (Vol. 313), entitled: ‘Dyslexia: A Hundred Years on – a Verbal
Not a Visual Disorder which responds to Early lntervention’. lt is
a piece from which I will quote liberally throughout this afticle.
ln 1917, Opthalmologist J. Hinshellwood speculated that
these difficulties with reading and writing were due to a’congenital
word blindness’. Ever since then, the popular view was that dyslexia
was caused exclusively by a visual processing problem.
My involvement in the treatment of dyslexia was by chance’
While attending a workshop in the US on head injury and back
problems 12 years ago, I came across an unusual physical therapy
that had evolved into a treatment for dyslexia.
It can be very frusirating to research this subject, as definitions
differ in the US and Europe. However, most now agree that dyslexia
is a language processing problem, be it written, spoken or symbolic,
resultant from a difficulty in ‘phonological (speech) processing’
which makes it difficult to learn how to match printed letters with
the correct sounds.
The child with dyslexia may have normal, or very high lQ (e.g.
Einstein, Leonardo da Vinci, etc.), be very gifted, be an Olympic
athlete, or Formula One racing driver, be a film star, or artist with
great imagination. Many are very musical, with ability to sing and
play instruments at an early age. However, school can be a
frustrating nightmare for them, as it relies mostly on language skills,
ignoring all the other skills these children have in abundance.
Dyslexic children have difficulty learning to read by traditional
methods; have difficulty organising their desks, homework or holding
pencils correctly. They see their less bright classmates succeeding,
while they are failing. They may realise something is wrong, but
may cover it up both from parents and teachers. Their school days
are spent as if swimming against a strong current. Hard working,
they can appear lazy.

What To Watch Out For
1. Avoiding difficult tasks, especially involving reading, writing,
spelling or maths;
2. Spending too much time at, or not finishing homework;
3. Propping head up when writing;
4. Vocabulary exceeding reading ability;
5. lnappropriate or attention-seeking behaviour;
6. Difficulty understanding words in normal conversation;
7. Poor sense of direction;
B. Poor idea of time;
9. Poor motor co-ordination;
10. Stuttering, hesitant speech; poor word recall;
11. Difficulty remembering names;
12. Difficulty following sequential instructions or events;
13. Difficulty following motion or moving things (e.g. balls, people,
traffic);
14. Difficulty making decisions:
15. Feeling of inferiority, stupidity or clumsiness;
16. Difficulty organising daily activities and allotting time;
17. Doing the opposite of what is said;
18. Difficulty differentiating ‘left’ and ‘right’;
19. Difficulty tying shoelaces or buttoning jackets’

Dyslexia tends to run in families and cousins often exhibit other
language problems. lt is more common in boys than girls and may
affect 15% or more of the population. There is strong evidence
that it is heritable – the probability of a boy developing dyslexia if
his father is dyslexic can be as high as 50%.
Gene markers on chromosomes 1 and 15 have been identified
in families with dyslexia. Linkage on chromosome 6, in the region
of the human leucocyte complex, may explain the association with
auto-immune disease.
Dyslexia is a developmental disorder that affects people of all
ages, but its symptom profile changes with age. Studies of children
at genetic risk of dyslexia have reported difficulties in speech
production and gramatical expression at 30 months, followed by
slower vocabulary acquisition during the pre-school years,
culminating in deficits in phonological awareness and alphabet
knowledge in young schoolchildren. Parental reports of delayed
speech and language among children with reading difficulties have
been common in epidemiological studies.
The most comprehensive picture of dyslexia available is in
children of school age. Although, in most cases speech perceptual
abilities are intact, dyslexic children have difficutiy in reflecting on
the sound siructure of spoken words. Such phonological problems
make it difficult to learn how the letters and sounds of printed words
are related.
Most dyslexic children have difficulty using a phonic approach
to reading and their spelling often fails to represent the sound
structure of target words. Although dyslexic children overcome
many of their difficulties, in adulthood they experience subtle
problems with phonological awareness and reading and writing
skills. Functional brain imaging is beginning to elucidate why this
is so; it has been shown that, when dyslexic adults perform rhyme
judgement and verbal short-term memory tasks, they activate only
a subset of the brain regions usually involved. Plausibly, their
phonological difficulties may be due to weak connectivity between
anterior and posterior language areas of the left hemisphere.
Knowledge of the predictors of reading achievement and of
dyslexia has led to innovations in methods of intervention. A
pioneering study in Oxford showed that children who performed
poorly on a phonological processing task before they went to school,
benefited significantly from a training programme in sound
categorisation using rhyme and alliteration activities, particularly
when it was combined with teaching of letter sounds.
Subsequently, it has been shown that training in phonological
awareness, combined with a structured reading intervention, is
an effective form of treatment for poor readers and produces greater
gains than training in either reading or phonological awareness
alone.
A detailed case and family history may uncover dyslexic
difficulties and the routine assessment of pre-school children can
usefully incorporate a test of knowledge of nursery rhymes and
letters. Clinical experience shows that, with regard to dyslexia, it
is a fallacy to ‘wait and see how the child develops’. A delay at
the start of learning to read can quickly develop into a considerable
reading disorder if unattended.
Treating Children With Dyslexia

THESE children are basically frustrated by the world around them.
They have difficulty with right and left. They have little or no sense
of time. They have problems with basic co-ordination.

It is perplexing for the dyslexic child of normal lQ to see less
bright classmates acquire, with relative ease, skills in reading, writing,
spelling and arithmetic, which they themselves may find very difficult,
or impossible. Such children may react with temper tantrums,
psychosomatic symptoms, e.g. headaches, abdominal pains, wetting
or soiling, much to the alarm of parents, teachers and family doctors.
Parents are puzzled that a child that appears bright at home
can do so badly in school. Teachers generally find these children
baffling, as again they appear verbally bright and yet do not respond
to traditional teaching methods that work well for the rest of the
class. They may end up blaming the child or the parents, which
causes great disharmony both at home and at school.

By the time children present to me at our Carrigaline clinic,
they have usually been to a number of psychologists, councillors,
etc. The majority will be boys and often left-handed (not
necessarily). They will have co-ordination problems; will have a
history of early walking rather than crawling; will often have been
frustrated by team sports and are thrilled when the first test I do
is of their muscle strength and can guarantee them improved
sporting performance within a few weeks of their visit to me (i.e.
by correcting their inco-ordination). Once they see this improvement,
they pester their parents to bring them back for the full course of
treatment, not for the academic improvement, but for further
improvement of their sporting prowess.

Left-handedness can be familial. The family name of ‘Kerr’
apparently has a high percentage of left-handed members; so
much so, that their castle stronghold in Scotland was built
entirely for left-handed people, e.g. the railings, stairs, armour,
etc.

“ln our modern world, literacy is a minimum requirement
 in a society run largely via the written word.
Parents worry greatly about the future careers of
their dyslexic children. All careers are possible,
However, jobs requiring good special ability, such as
computer programming are particularly suitable.”

‘BlC’ have developed a rapid drying ink delivery pen, which is
ideal for left-handers as it solves the problem of smudging as the
child’s arm crosses the page.
Some children with dyslexia may have additional problems such
as allergies, ADD (Attention Deficit Disorder) or ADHD (Attention
Deficit Hyperactive Disorder).
As I mentioned already, the treatment protocol that I have used
over the past 1 2 years evolved f rom an osteopathic/kinesiological
background and began as a treatment for head injury and back
pain. Dr Carl Ferreri, a Kinesiologist/Chiropractor in New York had
observed that, follwing head injuries, he could demonstrate a
disturbance of the normal ocular-labyrinthine reflexes which are
necessary for efficient control of the skull in static and in motion.
He had developed a method of normalising this situation by digital
stimulation of these reflex zones, thus restoring normal function.
Some time later, he came across a research paper describing
similar problems in the skulls of dyslexic children. However, in
these cases, the problem was confined to the right side of the
skull (presumably affecting left brain activity). So he decided to
try this technique and, to his delight, it worked very well. He then
proceeded to expand his protocol to include an interesting eye
tracking technique together with some simple exercises (cross
pattern or cross crawl type). The protocol is completed in
approximately six visits, followed by a further three over 12 months.
As soon as the protocol is completed, the child begins to have
more self-confidence, becomes more competent at sports and
in social circumstances, and can then benefit in an observable
fashion from remedial teaching which, prior to treatment, had made
very little impact.
Exercise regimes have been popular in the US for some years,
e.g. marching-type exercises which apparently gave good initial
results, but sadly disimprove once the marching stopped. lnterest
in exercise programmes has been rekindled by the recent ITV
programme on dyslexia.
Another pleasant exercise programme is called ‘Brain Gym’
and can be done to music. lt improves co-ordination and is fun
for all the family.
ACLD Nationwide offers special reading classes and other
support programmes (see phone directories). Many websites are
worth exploring for information on tinted colour lenses, osteopathic
protocols, diet and food allergies and a host of practical tips on
parenting children with dyslexia, ADD and ADHD.
Therapies using light and colour have existed for many years.
Recently a new therapeutic device has been developed in
Belgium, a Photon Wave Light Stimulator. This allows the patient
exposure to a large number of colours individually and in
combination, at a range of frequencies and wave formations.
The chosen colour and frequency is transmitted via light
stimulation of the eyes and optic nerve, which transmits
‘photocurrent’not only to the visual cortex, but also to other areas
of the brain, including the hypothalamus, influencing sensory
integration and behaviour. This results in improved right brain/left
brain communication, concentration, memory, attention span, Iiteracy,
memory, etc. We have acquired one of these units for our practice in Carrigaline.

Adults
Dyslexia is an underestimated problem in the adult population,
as the main focus is on the school-going children. ln my practice,
I see primary, secondary and third-level students. Adults often ask
for treatment after they see their children diagnosed and treated.
Others present indirectly with back pain or past head injury and
the diagnosis presents itself in the course of testing. They are
invariably relieved to discover an explanation for aspects of their
lives which were previously inexplicable.
ln the UK, over 6% of the population have reading ages of
less than nine years. Over a million are known to be totally illiterate.
ln the US, over 23 million are known to be illiterate (e.g. a quarter
of men entering the US Navy are unable to read simple safety
instructions).
ln the US prisons, most behavioural problems occur when the
TV is turned off, as the vast majority of inmates are unable to
read or write and get bored and irritable. How many of our prison
population are dyslexic is not known. I personally have a high
degree of suspicion that dyslexia ls a major player in this
population group.
Dyslexia in adults can be difficult to spot as it can range from
very vague features in a high lQ, highly successful professional
with lots of drive, to the illiterate, unemployed inmate. The
embarrassment and frustration of an inability to read and write
can lead to persistent anxiety and depression. I have seen peoples
lives turned around by gaining this basic facility.
ln our modern world, literacy is a minimum requirement in a
society run largely via the written word. Parents worry greatly about
the future careers of their dyslexic children. All careers are possible.
However, jobs requiring good special ability, such as computer
programming, or those requiring good verbal ability, are particularly
suitable.
A US study by Prof Margaret Rawson (Sociologist) some 25
years ago into the career outcomes of dyslexic boys showed that
l4% became Research Scientists, 13% Business Executives. .11%
College Professors, 7% School Teachers, 7% Lawyers and 7%
owned or managed a business.
Even though this was a study of middle class students of
professional parents, it demonstrates that investment in the
treatment of dyslexia pays off spectacularly.
References on request.

 

Doctors – A Paradigm Shift

By Dr. J. B. Dunphy, published in Irish Doctors Environmental Association (IDEA, Issue 1, Vol. 1)

 Now that the 20th Century has drawn to a close, many of its paradigms have also run out
of steam. We see this in industry, commerce, social living and, now, in medical practice.
The word ‘paradigm’ comes from the Greek word ‘paradigma’, meaning model, pattern, example. So, a paradigm represents the dominant perception at a given time which sets 
rules by which you can anticipate success in problem solving. When a more desirable solution evolves, a paradigm shift occurs, making the old paradigm and those rigidly attached to it redundant.
It wasn’t that long ago that to run the four-minute mile, the so called ‘perfect mile’, was considered impossible. No one was able to do this ‘impossible’ feat. Why? Because the paradigm up until then, in relation to this accomplishment was wrong. Instead of attempting to run ‘the perfect mile’, an English medical student reasoned that he could run a sixty-second quarter mile with ease; he could even run two sixty-second quarters. If
he could string together four sixty-second quarter miles, he could run a four-minute mile! He did and the rest is history.
That same year, 18 other runners broke the four-minute barrier, because there was a NEW PARADIGM.
In his book, ‘Paradigms – the Business of Discovering the Future’, business writer Joel Arthur Barber claims there are three keys to success in the 21st Century: 1. Anticipation; 2.Innovation; 3. Excellence. He emphasises that all three are absolutely necessary and
describes a fascinating example of how a failure in one of these can undermine success in the other two. The example was Switzerland. Hard-working and innovative, the Swiss had dominated the world of watch-making for 60 years. They made the best watches in the world. They had constantly improved their watch technology. They had invented the
minute hand and the second hand. They led research in waterproofing. In 1968, they dominated the world market with 65% of world sales and close to 90% of the profits. They were so far ahead of the rest of the world that they had no real competitor. Even though the Japanese had greatly improved their watch technology and were by 1968 almost as good as the Swiss, they enjoyed only 1% of the world market. Yet, in only 10 years, the Swiss market share dropped to less than 10% and their worldwide profits from 90%, to less than 20%. What happened? A paradigm shift! The fundamental rules of watch-making had changed from mechanical to electric. Everything the Swiss had perfected…gears, mainsprings and bearings, were obsolete. In just three years, 50,000 
watch-makers in this small country lost their jobs – a catastrophe for Switzerland. 

The irony of this story is that it was avoidable had the Swiss been able to anticipate their own future…had they spotted that a paradigm shift was underway. In fact, it had been Swiss research that invented the electronic quartz movement. When this revolutionary discovery was presented to the Swiss watch-makers in 1967, it was rejected. They were certain that it had no future and allowed the technology to be displayed at the World Watch Congress that year. Seiko of Japan took one look…and went on to capture 33% of the world market.

The shift in my own thinking was helped by two events which occurred simrultaneously. On the evening of the birth of my first child – a baby girl – media reports said that Margaret Thatcher’s government had sent nuclear weapons to the Falklands war. At that moment, I determined to do all I could to make the planet a safer place for my new baby.
As many of you will know, I founded the Irish Medical Campaign for the Prevention of Nuclear War and represented Ireland on the International Council of International
Physicians tor the Prevention of Nuclear War – IPPNW, which was awarded the Nobel Peace Prize in 1985. I believe that doctors around the world, through IPPNW played a pivotal role in bringing the cold war to an end. It was only a matter of time before I realised that while the nuclear threat was the most urgent, other environmental problems
also needed to be addressed. Large pharmaceutical giants were polluting our air and water in Cork harbour. This eventually forced me to look at how I practiced medicine. The
drugs I was prescribing, what their manufacture was doing both to the planet and people for whom they were prescribed.
It was time to look to other modalities of therapy and, to my surprise, a vast and ever
expanding array of therapies existed. Many had been discovered and developed by mainstream doctors who, having presented their findings, were invariably rejected and ostracised by the medical establishment. 

For example, Dr Samuel Hehmann, working in Germany 200 years ago, was so horrified by the practice of the day decided to research and develop a safer and more humane form of therapy. Re-discovering the basics of hypocratic medicine, he developed what we now know as Homeopathy, which continues to be derided by the establishment, much to the advantage of non-medical practitioners who, like the Japanese in the Swiss watch story are going to reap the advantage in the coming decades as patients begin to vote with their feet.
Another case in point is that of Dr Edward Bach, a Harley Street consultant who, in the 1930s, made what to most of us was a crazy discovery…that the essence of flowers and trees were therapeutic for various emotional problems. Our current medical paradigm says this is impossible. Lay practitioners, not knowing that it is impossible, prescribe the Bach Flower remedies and often achieve the impossible, to our great surprise and anger. In the words of Edward Bach: “let not the simplicity of this method deter you from its use, for you will find the further your research advances, the greater you will realise the simplicity of all creation.’

In the early 1960s, Kendal and Kendal, working in the US, observed behaviour in muscles not previously described. A Chiropractor, George Goodheart, spotted their research and
went on to develop Applied Kinesiology. From this has evolved therapies such as Touch for Health; Edukinesiology; and Neural Organisation Therapy, used with great success in
Dyslexia and learning disorders as well as other problem areas not adequately addressed by the current paradigms.
A lovely quotation from Marcel Proust states: “The real act of discovery consists not in finding new lands, but in seeing with new eyes”. 

It was only in the past few years that I discovered a therapy developed here in Ireland which I believe represents a paradigm shift in the treatment of arthritis. It was discovered by Dr Patrick Collins in Lucan, Dublin in the early 1950s while researching immune response in allergy. He discovered that by diluting Procaine Hydrochloride and injecting it intradermally he could influence the course of rheumatoid and osteoarthritis. He published his results in the Irish Medical Journal of the day and internationally in Nature magazine.
He further discovered that by modifying his solution, he could apply it directly to the skin, which most colleagues – working from their paradigm – found incredible. Of course, in
recent years, many therapeutic agents are applied via the skin in patches, etc., which no longer seems so incredible. The clinic, established by Dr Collins in the grounds of the Spa Hotel in Lucan, continues to this day to treat patients with arthritis from all over Ireland and, indeed, overseas. It is now under the medical care of Dr Maurice Collins, a son of the founder of the clinic, who has continued to research this remarkable therapy.
Finally, let me share one last story with you. It tells of an affluent Galway doctors who had a little holiday home in a remote spot in Connemara and a large Merc to get there. Every
Sunday he headed off at speed along the windy roads which he knew like the back of his hand. On one of these lovely Sundays, while approaching a particularly nasty bend in the
road, around came a car out of control. The driver had only just pulled the car from going over the ditch, before swerving back into the doctor’s lane. He was sure he would be hit. He slowed to a stop. Again, at the last moment, the driver pulled the car back to its own side of the road, just missing the terrified medic. As it sped past, the pretty lady driver stuck her head out the window and at the top of her voice shouted: ‘Pig!’ Our Galway doctor was furious. How dare she. It was she who was all over the road. He immediately roared after her: ‘Sow!’ He reckoned that put her in her box. He then revved up his Merc and sped around the corner and ran smack bang into the pig!
The moral of this story is that over the next decade many people will be coming around blind bends yeling things at you. They may be too busy to stop and expiain. If you have
Paradigm Paralysis, you will be hearing only threats and insults. If you have Paradigm Pliancy, you will hear great opportunities.

Report on the Proceedings of a Summit on New Directions for Chelation Therapy, published in Townsend Letter

From March 13 to 15, 2013, the International College of Integrative Medicine (ICIM) held a summit meeting about what should be accomplished next, now that EDTA chelation therapy has been supported as a useful treatment for vascular disease by the Trial to Assess Chelation Therapy (TACT). Experts from around the world were invited. This article is a summary of the conclusions and recommendations of this gathering. Key presentations were given by Drs. John Trowbridge, Efrain Olszewer, and Eleonore Blaurock-Busch. Representatives from the US, Canada, Indonesia, Brazil, Denmark, the Netherlands, Germany, Ecuador, and New Zealand participated, as well as the attendees for the Advanced Metals Workshop that was part of the spring meeting of ICIM. Recordings of the lectures are available from icimed.com.

Background
EDTA has been used as a treatment for vascular disease since Norman Clarke Jr.’s work in 1952. For a time line of the many studies that have supported its effectiveness, see chelation.me. In 1981, the American Medical Association (AMA) challenged the proponents of chelation therapy to produce a large-scale, randomized, controlled, clinical trial to prove its safety and effectiveness. The members of the American College of Advancement in Medicine (ACAM), led by president Ross Gordon, collaborated with Walter Reed Hospital to begin such a study for treatment of peripheral vascular disease in 1987. Unfortunately, the first Gulf War took the investigators away from the study, and it was not completed. In 1999, Congressman Dan Burton, chair of the Committee on Oversight, held a hearing bringing together the head of the Heart, Lung, and Blood section of the National Institutes of Health and several physicians who testified about their experiences with chelation. NIH subsequently called for proposals, and eventually TACT was funded, with Gervasio Lamas, MD, as chief investigator.

TACT was unique in that it combined university research cardiologists and experienced chelation specialists with private offices. 134 sites from the US and Canada participated in the randomized, placebo-controlled, double-blind, clinical trial. TACT continued for 7 years and included 1708 patients with documented previous heart attacks who continued to receive evidence-based therapy. The primary end point was a composite of new cardiac events to include death, heart attack, stroke, hospitalization for unstable angina, and need for revascularization surgery. TACT showed that the therapy was unquestionably safe, and the group treated with chelation therapy had fewer cardiac events, which was statistically significant. The results were announced by Lamas at the American Heart Association meeting on November 4, 2012, in Los Angeles. (Publication of the results occurred after the summit in JAMA. March 27, 2013;309([12]):1241–1250). The authors called for further studies to confirm the results and explore the mechanisms of action.

Where We Stand Now, According to the Summit
1.  TACT conclusively showed that chelation therapy used according to the recommended protocol is safe.

2.  TACT and the many other studies that preceded it support the use of chelation therapy as an option for patients with vascular disease, especially for those who also have diabetes and those with a history of anterior wall myocardial infarction.

3.  There is not yet enough evidence to state that chelation therapy should be given to all cardiac patients. More studies need to be done. A duplication of TACT would be ideal, as long as it included heavy metal testing. However, another $30 million to repeat the study might be difficult to find.

4.  Strong consideration should be given to doing a challenge test for heavy metals (especially lead) for all patients with vascular disease. If high levels are found, the patients should be treated with chelating agents.

5.  Regulatory agencies, such as medical boards, should immediately stop harassing physicians who offer chelation therapy to their patients who give appropriate informed consent. Physicians who offer chelation therapy have accomplished exactly what the AMA asked them to do in 1981 to justify its use.

6.  Most physicians who offer chelation therapy are happy to serve as consultants for placebo-controlled RCTs, but are uncomfortable with the ethics of giving placebos to patients who have come to them for help. Certainly, patients should not be asked to pay to receive placebos, especially for a potentially life-threatening illness. Physicians who provide chelation are almost always convinced that in their experience the therapy is very effective.

7.  Most chelation doctors believe that their primary goals of showing efficacy and safety with a RCT have been accomplished with TACT. Gaining FDA approval of EDTA for use in vascular disease is secondary, and they encourage qualified investigators to move in that direction.

Recommendations of the Summit
1.  More research should indeed be done on metal toxicity, free radical pathology, and various diseases that have been linked to free radical pathology, especially vascular disease.

2.  Chelation doctors do not have the resources to fund or carry out clinical trials, but they do have the expertise to help plan them.

3.  The conditions that are most likely to show benefit with chelation treatment and thus should have the greatest research priority are as follows:
a.   patients waiting to have limbs amputated due to noninfected vascular disease. For end points, all that is needed is to count the remaining limbs. Claus Hancke’s work is most impressive in this regard;
b.   walking distance and A/B index in patients with peripheral vascular disease. In our experience, a very high percentage of patients improve. Olszewer and Jim Carter documented this. There have been a couple of negative studies published on this subject in prominent journals, but they have been seriously flawed. Stephen Olmstead has written a good research protocol to evaluate chelation treatment for peripheral artery disease that is almost ready to go. He is willing to share his work with others. Attendees at the summit expressed significant concern that opponents of the therapy might proceed with new studies that are designed to fail, which has happened in the past;
c.   brachial artery stiffness and other measurements of vulnerable plaque. Peter van der Schaar is beginning a study on arterial stiffness;
d.   diabetic patients who have evidence of vascular disease;
e.   patients who have suffered an anterior wall MI;
f.    patients who have angina that is difficult to control with drugs;
g.   macular degeneration;
h.   patients who have been told that revascularization surgery is an option;
i.    Quality of Life measurements should be included in all research projects. Chelating physicians insist that their patients feel considerably better with treatment, even though that was not found to be present in TACT.

4.  Other areas that are important to study and are likely to show successful outcomes:
a.   patients with hypertension and elevated lead levels;
b.   arterial intimal thickness and high resolution ultrasound of the carotid arteries (see the work of Robert Bard);
c.   osteoporosis;
d.   mild to moderate Alzheimer’s disease associated with heavy metal toxicity;
e.   autoimmune diseases, especially scleroderma;
f.    fibromyalgia with high levels of toxic metals detected with a challenge test.

5.  There are many biomarkers in the laboratory that can help examine the mechanisms of action of chelation therapy. Expert biochemists (Blaurock-Busch, Jaffe, Quig) are happy to consult with investigators as to which ones are most appropriate to utilize in this assessment.

6.  Various combinations of chelating agents, and different doses of such entities as EDTA and vitamin C are important to study.

7.  Chelation therapy is useful to study at all stages, to include:
a.   preventive
b.   preemptive (early signs of disease)
c.   treatment of established disease
d.   treatment following revascularization procedures
e.   maintenance treatments: very important

8.  Use of NBMI, a compound being studied by Boyd Haley, might turn out to be a powerful therapeutic modality.

9.  Such international lecturers as van der Schaar, Olszewer, Ted Rozema, Hancke, Bruce Dooley, and Gene Godfrey continue to teach physicians on how to use chelation therapy safely and effectively. Organizations such as ACAM, ICIM, and A4M hold workshops in the US. Excellent recent textbooks have been published by van der Schaar and Blaurock-Busch (both are available through the International Board of Clinical Metal Toxicology).

Conclusion
Raising public, political, and media awareness is now essential. Experienced chelating physicians can help provide solid data to support general understanding of efficacy, mechanisms, and positive outcomes in the treatment of vascular diseases. Registries might be the best way for clinicians to collect data without the constraints of a RCT. Self-insured corporations, such as Parker-Hannifin are now paying for chelation therapy. Cooperation among organizations with similar interests, such as ICIM, ACAM, AAEM A4M, ABCMT, IBCMT, and specialized laboratories is strongly encouraged to standardize protocols and set up registries. This can be done quickly and with minimal expense. Physicians from around the world should be included. Experienced chelating physicians can serve as consultants for researchers who are qualified to perform RCTs. NIH and various foundations are encouraged to fund projects discussed in this article. Pollution with heavy metals continues to get worse, and evidence is mounting that their toxicity is an important factor in the development of chronic degenerative diseases.

Irish doctor’s arthritis treatment gaining acceptance

(by Ed Moloney, Sunday Tribune)

Arthritis victims can enjoy as much as a 50% annual reduction in pain as a result of regularly taking the Irish-based Collins Arthritis Treatment, according to an independent statistical study prepared for last week’s international GP’s conference, the World Organisation of National Colleges and Academies (WONCA) held in Dublin.

The study, the first attempt at a systemic examination of a treatment which has been available in Ireland for nearly forty years, shows that people suffering from osteo-arthritis who take the treatment on a monthly basis have on average a 54% reduction in pain in the first year. Osteo-arthritis is the most common form of the disease with an estimated 200,000 victims in Ireland.

For victims of rheumatoid arthritis, the most crippling variety of the disease, the average annual improvement is less, but at 30% in the first year still represents a significant reduction in pain. Rheumatoid arthritis affects women up to four times as much as men and usually strikes in early middle age.

The study, which was based on data collected from 16 GP’s administering the treatment in Ireland over a twelve month period, was conducted by Dr Marie Reilly, the Director of the Consulting Centre at the Department of Statistics, UCD.

“Although this was an observational study rather than experimental the results were very encouraging”, she said last week. “I think it gives a huge impetus to the demand for a clinical trial”. She added that a longer study would be necessary to determine whether the annual improvement rates continued or levelled off.

The study was based on the experiences of 460 patients between May 1997 and May 1998 and used recognised subjective methods of pain measurement and evaluation by both patients and physicians. Between them, the patients made 1,567 visits for treatment, and the study shows that their doctors estimated there had been improvements in 79.1% of the visits for osteo-arthritis patients and 64.1% for those with rheumatoid arthritis.

In the case of rheumatoid arthritis victims inflammatory changes in the blood were also measured and these appeared to show an average 25% annual reduction in the first year of treatment.

The Collins Treatment was developed by a Lucan-based doctor, Patrick Collins in the 1950’s and was carried on by his three sons, all doctors, after his death. The surviving son Maurice Collins has for the last few years been attempting to get clinical trials for the treatment. The former Tánaiste Dick Spring has given his support to the calls.

The treatment is based on the local anaesthetic drug, Procaine which was once widely used by dentists. The Procaine is diluted and a small amount is smeared on the skin, the size of the dose being determined by the variety of arthritis.

How the treatment works remains a medical mystery but its popularity has spread; some 35 GP’s in Ireland and Britain now administer the treatment. A major advantage of the treatment over conventional medicine is that it has no known side effects and apparently is effective for the entire family of arthritis diseases.

In a story that comes out of Hidden Ireland thousands of people have taken the treatment over the years but it never, until recently, had any public profile. One major reason for this was the unremitting hostility of the rheumatolgy establishment although there is evidence that this may now be softening.