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Dear Friends and Family,lesvos.jpg

It has been just over a week since my return from Lesvos and I am still trying to process all that I learned and witnessed during my short stay helping out as a volunteer nurse.  The situation has not changed with the changing temperatures and political climate.  Refugees in the thousands are still making that perilous trip across choppy waters from Turkey to Greece in the hope of making a new life in Europe.  The political situation has changed somewhat. The EU is no long registering N. Africans, Iranians and Asians as they once were, creating a backlog of innocent and frustrated migrants on the island and elsewhere in Greece.  Today, only Syrians, Iraqis and Afghans are allowed to pass through Greece and on towards other European countries.  Whereas these are bona fide refugees, many have come without documents to prove their countries of origin, and although they may be Hazara from Afghanistan their language is Farsi, so they can easily be labeled as Iranians and not allowed to continue their voyage.  There are very few translators in the camps who can help the local police with the registration process, so people are mislabeled, told they must be held until they can be deported and given only the necessities that volunteers can provide while they wait.

I had the privilege of working with the ragtag group of volunteers who came to help out on “Afghan hill” or Moria camp, where everyone but Syrians were directed to wait, sometimes for as much as 5 days, until they could be properly processed.  The clinic where we were working was well-run and professional. We saw hundreds of refugees a day, some still soaked through from their trips on the rubber boats, many with severe anxiety reactions, sore throats, viruses or just in need of a little bit of concerned care.  We had some translators, but they were few and often we relied on hand gestures to ascertain what the medical problem was. Often we could find a refugee who spoke that language as well as English. The refugees were all very happy to help us out.  I saw too many grown men weep when they tried to explain their trip while pulling out photos of loved ones lost.  I have no idea if those loved ones died during the trip or in their place of origin, but the memories of the sad parents or spouses of all those happy faces in the photos will haunt me forever.  There were children too traumatized to speak or to take a piece of candy that was offered. There were elderly people as well.  Many had come with their families, some alone as couples.  Once they were changed into dry clothing and given food, we were left trying to find a shelter for them and other vulnerable groups for the night.  The shelters (small camping tents)were few, so many were left to wait out the night next to a burning pile of plastic or the few branches that they could find.  Whereas the official “Syrian camp” was adjacent to ours (a walled compound manned by police), we did not mix.  If there was a more critical medical case, we brought those patients in wheelchairs (not an easy feat up the rutted grassless terrain) to be seen by Medecins san Frontiers or Medecins du Monde, which provided care in that gated and barb wired camp.  UNHCR was a presence there in the Syrian camp as well. I can’t say more than that.  There were two representatives in their tent and they were not seen at the shorelines where people were disembarking or swimming to the shore.  They did provide the many buses, which brought the newcomers to the camps each day.

I want to thank you all for your donations, kind thoughts and prayers, but most of all, I want to thank you for not forgetting about this tragedy that is unfolding.  These people need our help, not our derision. They are mostly innocent victims of bad political decisions. They represent all of us in some way or another.

I hope that this holiday season brings joy and peace to all of you and that the New Year can be one of hope for a better future for everyone.  Thank you again for your support.

Love and Peace, Anne

regione per regione

A third of migrants received in Italy, excluding minors, is distributed in two regions: Sicily and Lazio, which host respectively 22% and 12% of the 73,883 total. The Veneto, however, is among the major regions of the North hosting fewer people, with 4%, while those with less migrants is the Valle d’Aosta, which is home to only 62, 0%.

The percentage is calculated based on the relationship between immigrants and population. The data is updated to May 6 and is contained in a table of the Interior Ministry where there is a breakdown by region of migrants in Cara centers for asylum seekers, in Sprar, the reception system for refugees, and temporary structures .

More than 2,000 illegal migrants sailing from North Africa have been saved off the southern coast of Sicily over the past two days, the Italian navy said on Wednesday.

sea med

According to the navy, a total of 2,128 migrants were rescued before disembarking on the island; 600 were picked up at sea on Monday while on their way to the port of Augusta.

On Tuesday about 500 African migrants stormed their way past the triple-layered border fences of the Spanish African enclave of Melilla, in what Spanish authorities called one of the largest such crossings in years.

Spain has two enclaves in Morocco: Melilla and Ceuta, which are both located on the northern tip of Morocco. Thousands of migrants from all over Africa camp on the Moroccan side of the enclaves’ border every year waiting for an opportunity to scale the fence and enter European territory.

Regarded by many would-be migrants as Europe’s back-door, Italy and Spain have been struggling with illegal immigration for decades.

But according to the latest data released from the European Union’s border agency, Frontex, more than 20,000 migrants entered Europe illegally through Italy’s Lampedusa and Sicily in the third quarter of 2013 alone.

Due to the current political instability in North Africa and the Middle East, the number of illegal migrants has sky-rocketed in recent years.

IMG_0122[1]

In 2050 nearly 1.5 billions people aged over 60 will live in less developed countries. According to UN data and WHO facts sheet 2010 Niger will have the fewest people over 60 (5%).

In the picture the dark areas represent regions in 2050 where the percentage of 60+residents rises over 25% of total population.

Longer life fewer babies will push on a demographic shift, by 2050 one in 5 people will be aged 60+ they will outnumber people under 14y

 

Last september the 10th at Stockholmassen took place the EFNS annual meeting. I had the chance to follow this great session chaired by JOHANN SELLNER, MUNICH, GERMANY
ISRAEL STEINER, PETACH-TIKVA, ISRAEL.

Travel related CNS infections
Erich Schmutzhard, INNSBRUCK, AUSTRIA

Diseases such as Malaria and many Parassitosis are getting more and more frequent in western populations. Tailored campaigns may help migrants and travellers to better prevent serious consequences (see post on malaria). Even a a couple of weeks visit to relatives in endemic malaric areas without appropriate prophilaxis may expose a family to infections. Once back in europe in case of troubles doctors should think to uncommon diseases more frequently (? to let them know is our duty).

Neurological complications of vaccination
Israel Steiner, PETACH TIKVA, ISRAEL

Perivaccinic neurological complication in a wide definition may be more frequent then expected even if hard to diagnose. GB syndrome also may be a potential consequence.

Emerging CNS infections of worldwide importance
Johann Sellner, MUNICH, GERMANY

After the large diffusion of transpalnations al over the world in acute post transplantation and later phases minor infectious agent may play a crucial role. (rabia, HSV)

Concentrating on the modern era, ‘War and Medicine’ are considered in the constant evolving relationship between warfare and medicine, beginning with the disasters of the Crimean War and continuing through to today’s conflicts in Afghanistan and Iraq.

This CT scan shows a clear skull fracture due to “arm blanche” beating (see above).

The young (37y old) Bangladesh citizen was working in Tripolis with other houndreds) and attacked during the 2011 summer revolution. Admitted in a local medical centre slowly recovered from a non commotive head trauma. Succeding to cross the Sicily channel on a boat was rescued by Italian Coastal guards. In January while admitted in refugee camp in central Italy suffered of an ischemic stroke (see down).

…Affluent Arabs used to head to hospitals in the US when they needed treatment. But now, post-Iraq, they are increasingly choosing Germany’s private clinics. With the average foreign patient spending an estimated €80,000 a stay, competition to attract the medical tourists is fierce…. by Monocle 2008…

Gharib Fawi Mohamed1, Taher Abd El-Raheem1, Nayel Abd El-Hamed Zaky2, Mohammed Abdal Abbas1, Islam Gad Elrap Ahmed1,

1Department of neuropsychiatry, Sohag University, Sohag, Egypt 2Department of internal medicine, Sohag University, Sohag, Egypt

Abstract
Background: peripheral Neuropathy (PN) is a well-known complication of chronic renal failure (CRF). The frequency of PN in patients with CRF has declined owing to improvement in the modalities and techniques of dialysis and uremic neuropathy can be considered as an indicator of inadequate treatment by dialysis Aim of the work: is to quantitively determine the electrophysiological changes in both peripheral and central nervous system in CRF and to determine the differences between CRF patients on dialysis and
those who don’t start dialysis yet regarding neuropathy and cognitive impairment.
Materials and Methodology: we studied two groups of patients from the dialysis unit in Sohag faculty medicine, in addition to a control group. Group I is patients with CRF, who recently diagnosed and where the decision of dialysis was taken (10 pts). Group II is on dialysis for more than one year (10 pts). All
patients were subjected to full clinical assessment relevant to the peripheral neuropathy, laboratory evaluation, abdominal ultrasonography, nerve conduction studies, electromyography, mini-mental state examination and P30
Result
Neuropathy is found in 75% of patients. NCS show that both motor and sensory fibers were affected and both axonal degeneration and demyelination were present. Neurophysiological abnormalities and cognitive impairment in group Ι were more than at group II
Conclusion
This study clearly demonstrated that neuropathy is very common in CRF patients and neurophysiological abnormalities in group Ι were more common than in group ΙΙ. This show the importance of hemodialysis in reduction of uremic neuropathy and its sensory symptoms

needlestick and hepatitis seems highly cited paper about egyptian health

More Epidemiological Studies of Neurological Disorders Are Needed in the Arab Countries according to the latest commentr on jan issue of Neuroepidemiology

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