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Global Health
China is oldest civilization
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Editor's
note: Welcome to the Global Health page. The purpose of this feature is
to raise awareness of global health issues with an academic spirit to
help improve the quality of care provided to patients. E-mail
globalhealthnews@musc.edu.
Historians consider China to be the world’s oldest continuous
civilization. Although various dynasties rose and fell, a basic ruling
system held the civilization in place from 221 BC to 1912.
It is thought that the Chinese were making silk by 3000 BC. Eventually
the manufacture of silk and trade would give its name to the infamous
Silk Road.
A court official named Tsai Lun is credited with the invention of paper
in 105 AD. Other early Chinese inventions include the saddle (25 AD)
wheelbarrow (200 AD), and paper money (618 AD). Later Chinese
inventions include gun powder, the magnetic compass, the mechanical
clock and the sternpost rudder.
Ice cream was invented in China around 2000 BC when the Chinese packed a soft milk and rice mixture in the snow as a treat.
Herbs, acupuncture and eating a balanced diet comprise traditional
Chinese medicine. Acupuncture has been practiced in the country for
more than 2,000 years.
Progress challenges modern health care
by Boshao Zhang
College of Graduate Studies
During the last half-century, a comprehensive health care system has
been established throughout China. Today, most Chinese have access to
doctors and hospitals whether they live in cities or rural areas. With
highways and communication systems available to most people,
patients can have access to advanced health facilities more easily and
quicker than ever. As a result, the mortality rates for infectious
diseases such as polio, measles, tuberculosis and maternal-child death
rates are approaching levels seen in other developed countries.
This doesn’t mean that the health system isn’t facing great challenges.
In the last three decades, China has achieved tremendous economic
growth and people are proud that China has become “the factory of the
world.” Still, the economic achievement comes with a heavy price—severe
pollution of the environment. The incidence of diseases related to
pollution is increasing dramatically. For example, cancer rates in
Zhejiang province, one of the most developed provinces in China, are
five times higher than they were 10 years ago.
In contrast to the economic growth, the public's awareness of health
risks has not changed much. One very modern problem tied to China’s
booming economy is the increase in obesity. Yet many people do not
realize that being overweight is related to diseases such as stroke,
hypertension and cardiovascular disease. Chinese people enjoy what
modern technology can offer in the traditional ways—eating as much as
their stomachs can hold, taking elevators whenever possible (due in
part to the fact that many more people now live in skyscrapers) and
watching TV whenever they have leisure time. Children are raised with a
preference for high-fat fast foods and high-sugar beverages instead of
more healthy traditional fare. Men drink and smoke for social life.
These risk factors combined with workplace stress impact millions of
people without their noticing.
Realizing these issues, the government has started to make a transition
from pure economy-oriented development to more sustainable economic
growth. The air quality in major cities such as Shanghai and Beijing
has greatly improved during the last several years, but pollution is
still a severe issue in other cities and towns whose economic growth
outpaces their ability to cope with the problems that come with modern
industrialization.
Announcements
Tropical medicine film and discussion at 5:30 p.m. March 5 in Room 100, Basic Science Building.
MUSC Global Health presents a film on Karl M. Johnson, M.D., founding
chief of the Centers for Disease Control’s Special Pathogens Unit and a
past president of the American Society for Tropical Medicine and
Hygiene. Dinner and a discussion about tropical medicine will follow.
St. Patrick’s Dinner and Dance, March 17.
Learn how to Irish Square and Line Dance and enjoy authentic Irish
stew. All MUSC international family and friends invited to this free
event.
Cypress Gardens Music Festival, March 28.
A celebration of Bluegrass, Country and Gospel music. Handicrafts,
children’s activities and take a boat ride through the swamp. The
bus will leave from the Jonathan Lucas bus stop .
Café Polyglot—Culture and Language Exchange. The Citadel Modern
Language Council and MUSC International Programs will host an afternoon
at Café Polyglot. This is a new opportunity to have casual conversation
and hone in your speaking and listening skills.
For information on these and international events, visit http://www.musc.edu/international.
Clinician’s corner
A 45-year-old woman complained of a growing mass in the neck more than
20 years, and she felt short of breath for a couple of months, but no
fever, pain and other obvious symptoms. She mentioned that many people
in her country have the same problem. An enlarged mass (thyroid gland)
could be palpated and the mass moved when she swallowed. The diagnosis
of “goiter” was given to her. The most likely cause responsible for her
disease is:
A:
Thyroiditis
B: Thyroid cancer
C: Hashimoto’s thyroiditis D: Graves’ disease
E: Iodine deficiency
The correct answer is E.
The most common cause for goiter is iodine deficiency. Iodine is
necessary for the synthesis of the thyroid hormones thyroxine
(T4) and triiodothyronine (T3). In endemic goiter, iodine deficiency
leaves the thyroid gland unable to produce its hormones because the
hormones are made out of iodine. It causes the thyroid gland to grow in
size by increasing cell division.
The patients with large goiter accompanied by pressure symptoms may
have dyspnea, which requires surgical treatment. The most important
iodine deficient areas in the world include the Himalayas, the Andes
and the western of China.
Based on a recent evaluation, iodine deficiency currently represents a
significant public health problem for 1,575 million people in 110
countries. More than 600 million are affected by goiter, 20 million are
believed to be significantly mentally handicapped as a result of iodine
deficiency which is therefore the most prevalent preventable cause of
impaired intellectual develop-ment in the world today.
Iodized salt has been used as the simplest and most effective way of
providing extra iodine in the diet. Many countries long ago introduced
iodized salt which resulted not only in a dramatic reduction in the
prevalence of goiter but also progressive disappearance of endemic
Cretinism. Iodination of irrigation water also has been successfully
used in China.
Friday, Feb. 27, 2009
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