Category Archives: Practical Health

Ageing & Travel: The Policy-Practice gap

Posted on October 6, 2023 by sunoor

Ageing and Travel a policy practice gap

I had come to see off my eighty-four-year-old uncle, who uses a wheelchair at Kathmandu’s Tribhuvan International Airport. He was flying to New Delhi. We had chosen to fly him with India’s premier airline, Vistara, which prides itself on its joint ownership by two iconic brands, TATA and Singapore Airlines. Not to leave anything to chance, his son booked him on Business Class.

Kathmandu airport has two business lounges – the one managed by Radisson Hotel is a twenty-odd-step climb on the first floor. There are no elevators. Soltee Hotel operates the second lounge, which is on the ground floor. While the airline had booked a wheelchair for my uncle, it invited him to the first-floor lounge as it only had an agreement with the Radisson lounge. Forty minutes of discussion with three staff levels later, Visatara finally agreed to make an exception and allow him to the ground floor lounge. Had I not persevered, my uncle would have been denied using a lounge he was entitled to because of his #age and #disability.

The Nepal office of the otherwise outstanding Vistara had not used the prism of disability and ageing when deciding to make an exclusive contract with one lounge, while other international airlines operating out of Kathmandu hedge their bets and let passengers choose a lounge.

Making policies and guidelines on disability and #ageing requires complex-multidimensional #advocacy and leadership communication. Ideally, the organizations would have an ageing and #disability focal point that would be empowered enough to examine all client-facing decisions of the organization through the ageing and disability lens. The Human Resources heads need to ensure that in their induction programs, disability and ageing are featured in the curricula.

Clearly articulated leadership communication on a company’s commitment to creating inclusive products is a must and needs to be frequently repeated. There are, of course, trailblazers- Satya Nadella, CEO of Microsoft, has spoken publicly about his commitment to making Microsoft products and services accessible to everyone. He believes that people with disabilities can significantly contribute to the workplace. Similarly, Julie Sweet, CEO of Accenture, has said that her firm is committed to creating a culture of equality where everyone can advance and thrive and making its products and services accessible.

Soon, more airlines and airport operators will realize the economic imperative of using the ageing lens in business decisions. WHO predicts that the number of people aged 65 years and older will increase from 1 billion in 2020 to 1.6 billion in 2050. Similarly, the number of older adults who travel internationally will increase from 100 million in 2015 to 260 million in 2030.

Growing up, I have known my uncle as a confident person whose wit and swift decision-making always got him out of any tight spot. He has been a sportsman for the better part of his life. However, with age, I see irreversible changes which make airports and flights a challenge, especially when travelling alone.

#Airports can be large and complex, with long distances, confusing signage, and crowds. Elderly passengers may have difficulty finding their way around, especially if unfamiliar with the airport. Trust in the person pushing your wheelchair is critical for not getting an anxiety attack. A pleasant surprise was the Special Assistance staff at Delhi’s IGIA airport. The gentleman pushing the wheelchair was experienced in dealing with elderly passengers and showed patience and compassion at every stage of the journey. This highlights the importance of appropriately recruiting and training staff dealing with elderly passengers.

Airlines must understand the challenges elderly passengers face to provide them with the best possible experience. Luckily, there are global best practices that go beyond the standard priority boarding, wheelchair assistance, and special seating.

Japanese airports have several features that make them more accessible for elderly passengers, such as clear and concise signage, elevators and escalators throughout the airport, and accessible restrooms. The UK government has a program called the “Passenger Assistance Request Service” (PARS), which allows passengers to request assistance with tasks such as boarding and disembarking the plane, using the restroom, and managing their luggage. The United States has many laws and regulations in place to protect the rights of elderly and disabled passengers. For example, the Air Carrier Access Act (ACAA) requires airlines to provide reasonable accommodation to passengers with disabilities. The ACAA also prohibits airlines from discriminating against passengers with disabilities. This might be why Delta, United and American Airlines CEOs have often publicly committed to making their products friendly for older people.

More airlines and airport operators are starting to realize the economic benefits of considering the needs of older travelers in their business decisions. By 2050, the number of people aged 65 and older is predicted to reach 1.6 billion, with international travel expected to increase from 100 million in 2015 to 260 million in 2030. To provide the best possible experience for elderly passengers, airlines need to understand the unique challenges they face. Fortunately, there are global best practices available that go beyond standard accommodations. The World Health Organization and Centers for Disease Control and Prevention recognize the importance of travel for older adults, but it’s important for them to be aware of the potential risks and take necessary precautions.

It is important to note that the needs of elderly passengers can vary depending on their circumstances. Airports and Airlines should be prepared to work with elderly passengers to identify and address their individual needs and train their staff to deal with elderly passengers. This includes training on how to identify and address the needs of elderly passengers and provide them with the best possible service.

The World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) both recognize the importance of travel for older adults. Travel can allow older adults to stay active, learn new things, and connect with loved ones. However, it is crucial for older adults to be aware of the challenges they may face when travelling and to take steps to mitigate those risks.

There are several things that older adults can do to prepare for travel, including:

- Get a check-up from their doctor before travelling.
- Make sure their vaccinations are up to date.
- Get travel insurance.
- Plan what to do if they get sick or injured while travelling.

- Getting vaccinated against travel-related illnesses.
- Practising good hygiene, such as washing their hands often and avoiding contact with sick people.
- Eating and drinking safely.
- Taking precautions to avoid mosquito bites.

It is also recommended that older adults plan what to do if they get sick while travelling. This plan should include:

- Knowing where to go for medical care.
- Having a list of important phone numbers, such as the number of their doctor and their travel insurance company.
- Having a plan for how to get home if they need to be evacuated.

Aeroplane manufacturers Airbus and Boeing are already working on several initiatives to make their aircraft more accessible to people with disabilities, such as wider aisles and more accessible lavatories. They are also working with airlines to create new training programs for flight attendants to assist passengers with disabilities.This is all great; however, for elderly passengers and those with disabilities, reaching the aircraft comfortably is the first challenge. It’s time for #airlines and airports to put on the lenses of ageing and disability and then up their game.

Dr Sunoor Verma is a global health diplomat-practitioner specializing in strategic partnerships, high-level advocacy, and strategic leadership communication.

An abridged version of this article has been published in Nepal’s English language daily The Annapurna Express on 6 October 2023, page 4.

Navigating Menopause at Work: A Vital Conversation

Posted on October 2, 2023 by sunoor

The gap between the global South and the global North is widening in mainstreaming #menstruation in public discourse. Conversations about menstruation are only now emerging from the shadows of stigma and taboo in many parts of the global South. It is still difficult for people in these areas to access menstrual hygiene products, adequate sanitation facilities, and menstrual education. For example, Women and girls in sub-Saharan Africa and South Asia often resort to using inadequate materials like rags, leaves, or even cow dung to deal with their periods. Health problems, missed days of work or school, and feelings of isolation worsen when people aren’t given the tools they need to succeed.

The global North has made progress in normalizing menstruation. Many North American and European countries encourage menstruation discussions in homes, schools, and the workplace. The UK and several European countries have menstrual leave rules that allow workers to take paid absence for severe period symptoms. People in the US are fighting to end the “pink tax” on period goods, and more companies are discussing menstrual health with their staff. Development, access to resources, and cultural attitudes about menstruation contribute to this North-South gap, emphasizing the need for global menstrual health and hygiene fairness.

#Menopause is a natural transition that occurs when a woman’s ovaries stop producing estrogen and progesterone hormones. Between the ages of 45 and 55, symptoms of this condition can manifest physically and emotionally.

Menopause can cause uncomfortable physical symptoms, including hot flashes, night sweats, vaginal dryness, and fatigue. These symptoms can make a woman’s life miserable and make it difficult for her to do her job. Menopause’s emotional symptoms can be just as trying as the physical ones. Mood swings, anxiety, and depression are all possible for women. The inability to concentrate due to these symptoms can hurt personal relationships and professional output.

Menopause can have a financial impact on women in addition to the physical and emotional symptoms.Women who experience menopause may need to take time off work to manage their symptoms, and they may also need to see a doctor or other healthcare provider. These costs can add up, making it difficult for women to make ends meet.

Menopause is taboo, making it challenging to address the issue openly. Many women experience shame or embarrassment when discussing their symptoms, and they may not want to bother their coworkers or superiors. Because of this, women may have trouble getting the help they require. When companies take the time to learn about menopause, they can better accommodate their female employees. This has the potential to boost employee morale, output, and health.

Businesses can take various steps to establish a more inclusive and understanding workplace for menopausal women. First and foremost, companies must acknowledge that many employees may be inexperienced with menopause symptoms. Employers can educate staff on menopause and its effects to fill this knowledge gap. Businesses may foster understanding and empathy by raising awareness. Creating a friendly environment for menopausal discussions is also essential. Employees should feel comfortable discussing menopause with bosses and coworkers. This open discourse can help menopausal women manage work by fostering compassion and solidarity among coworkers.

For menopausal women, employment flexibility can alter everything. This life stage’s physical and emotional obstacles may demand work schedule modifications. Businesses can offer telecommuting or flextime to meet these needs. These arrangements can help women balance employment and health. Supporting menopausal women also requires healthcare. Health insurance or on-site medical care from employers can help women throughout this transition.

Menopause policies are spreading in companies in the global North. Employees receive full menopause assistance from Pfizer UK. Pfizer trains managers on menopause and staff support. This program encourages discourse and stigma reduction. Menopausal women can feel supported at Channel 4 (UK) “menopause cafes”, where staff can share their experiences and suggestions. Since implementing a menopausal policy with flexible work choices, management training, and a support network, Barclays UK has seen reduced absenteeism and greater employee satisfaction and retention.

Smaller firms may lack the resources of larger ones. By providing educational materials and manager training, they can support menopausal employees. They can also share information about menopause support networks and external resources. These free or low-cost resources can help employees who need more guidance.

The Scottish Parliament and the Welsh Government agree that workplace menopause policies are humane, inclusive, and strategic. Both supported their staff, including Scottish Parliamentarians, with a menopausal policy. Feedback showed that employees and MPs were more comfortable discussing menopause, creating a more inclusive and understanding workplace. These rules boost employee well-being, productivity, cost savings, and corporate brand. Organizations can boost workforce and economic performance by meeting menopause-related requirements.

Over the last two to three years, the global South vs. global North debate has rekindled. While disagreements over trade, intellectual property and nuclear energy will continue, the least we can do is to bridge the menstruation gap between the global North and global South. The increasing number of women parliamentarians in South Asia will hopefully help address the gap in the menstruation discourse.

Dr Sunoor Verma is a global health diplomat-practitioner specializing in strategic partnerships, high-level advocacy, and strategic leadership communication.

This article was also published in the print version of The Himalayan Times on 2 October 2023.

For healthy & happy kids, reduce screentime now!

Posted on March 18, 2023 by sunoor

Sunoor is seen here narrating Dr Bindeshwar Pathak’s inspiring story to Sulabh International School students in Palam. Sunoor is the founder and series editor of the Namaste Series! a project that captures the inspiring journey of s/heroes from the global south and turns them into story books.

Published by Radio Nepal on 18 March 2023

Unreasonable screentime threatens children’s mental and physical well-being and is a significant parenting challenge today! According to the World Health Organization (WHO), 10% of youngsters over the globe suffer from mental problems. This is especially troubling, considering that childhood and adolescence are crucial periods for mental health. The brain undergoes significant growth and development during this period. Children and adolescents develop cognitive and social-emotional skills that influence their future mental health and are crucial for adopting adult roles in society.

Early adverse experiences in homes, schools, or digital places, such as exposure to violence, the mental illness of a parent or other caregiver, bullying, and poverty, raise the likelihood of developing mental illness. In addition, too much time spent in front of a screen has been related to sleep deprivation, speech delays, poor social skills, and other life issues. When screentime becomes an all-consuming pastime for youngsters, this is dubbed screen addiction.

What is unreasonable screentime and screen addiction?

Screen addiction describes the compulsive and excessive use of electronic devices such as smartphones, tablets, and laptops. While technology has undoubtedly made our lives easier, it has also had several detrimental implications, notably regarding mental health. Children are vulnerable to screen addiction, which can harm their mental health.

Addiction symptoms include the inability to stop taking the substance or when the substance’s use begins to interfere with one’s life or relationships. The symptoms are identical when it comes to youngsters and screens.

How does screen addiction impact health?

The increased risk of developing anxiety and despair is one of the most significant ways that screen addiction impacts children’s mental health. Excessive screen usage is related to elevated levels of stress, anxiety, and depression in youngsters, according to research. This is due to several factors, including the social isolation that frequently results from excessive use of electronic devices, the overstimulation of the brain that occurs when children are exposed to an excessive amount of visual and auditory stimuli, and the disruption of sleep patterns that can arise when screens are used too close to bedtime.

Your child’s danger of being exposed to cyberbullying and pornographic material increases as they spend more time on phones and other screens. Similarly, more time spent on social media is frequently associated with sadness and internalizing issues. In addition, spending more time in front of a screen is associated with a decrease in parental bonding, according to scientific research.

The negative impact of unreasonable screentime on Physical Health

In addition to harming children’s mental health, screen addiction can negatively impact their physical health. For instance, children who spend an excessive amount of time seated in front of screens are at risk for acquiring obesity, which is related to a variety of physical and mental health issues. In addition, excessive screen time can result in eye strain, headaches, and other physical pain, exacerbating stress and anxiety.

Reducing screen time for children can be challenging, mainly when screens are often used for entertainment and educational purposes. However, here are some practical tips for reducing screentime for children.

What can parents do to manage screen time for children?

Parents and caregivers must actively supervise their children’s screen time to reduce their excessive use of electronic devices. Establishing explicit guidelines and limits for screen use is one approach to this. For instance, parents may limit screen usage to a set number of hours per day or require screens to be turned off at least one hour before bedtime.

Key Tips

Use parental controls on the devices: Parental controls can effectively limit screentime and restrict access to certain apps or websites. Parents can use parental control features on devices or install third-party apps to help monitor and control their children’s screentime.
Encourage youngsters to participate in activities that support their physical and mental health as another method for reducing screen addiction. This could be outdoor play, reading, artistic pursuits, or time spent with friends and family. In addition, parents may limit the amount of time their children spend in front of screens and create healthy behaviours by encouraging their children to participate in these activities.
Establish tech-free zones at home: Establishing tech-free zones in the home, such as the dining table or the bedroom, can aid in reducing the amount of time youngsters spend in front of devices. In addition, to foster more face-to-face engagement and family time, parents can advise youngsters to leave their devices in another room during these times.
Finally, parents may exhibit responsible screen use. Children typically emulate their parents’ behaviour; therefore, if parents are constantly checking their phones or watching television, it is conceivable that their children will do the same. By demonstrating appropriate screen usage, parents can provide a positive example for their children and encourage the development of mental and physical health-promoting activities.

screentime, screen addiction, parenting, family time

Encourage youngsters to participate in activities that support their physical and mental health as another method for reducing screen addiction. This could be outdoor play, reading, artistic pursuits, or time spent with friends and family.

Action points for advocacy organisations

Organisations advocating for children’s mental health need to develop new strategies to integrate screentime advocacy into their mandate. Similarly, strategic partnerships in the public and private sectors must be established to address the growing challenge of screen addition.

Published by Radio Nepal on 18 March 2023

About the Author

Dr Sunoor Verma is a global health practitioner. He has advised WHO, UNICEF, UNHCR, HUG-Geneva and Cambridge University on Strategy, Leadership Communication, Advocacy and Resource Mobilization. He has set up and led the country and regional operations for the European Centre for Minority Issues in the Balkans. He has supported track two peace processes in Macedonia, Kosovo and Sri Lanka and emergency response to the Tsunami, Avian Influenza and COVID-19. He has taught Global Health at Boston University. He has curated partnership initiatives with Macedonia, Kosovo, Germany, Switzerland, Australia, and Nepal parliamentarians. He divides his time between the foothills of the Jura Mountains in France and Buddhanilkantha in Nepal.

Additional Resources

Here is a fantastic article with a step-by-step “How to.. ” Guide to screen addictions and responsible digital use by Holly Nibllet. In this article, the author discusses the advents in technology and how to control mobile screen time. How COVID-19 has changed our viewing habits, along with screentime data for children from the UK, is presented.
Published in 2019 is another practical guideline Digital Guidelines: Promoting Healthy Technology Use for Children by the American Psychological Association.
The American Academy of Pediatrics has established recommendations for children’s media use. Their current recommendations advise:
- For children under 18 months, avoid screen-based media except video chatting.
- For children 18 months to 24 months, parents should choose high-quality programming and watch with their children.
- For children 2 to 5, limit screentime to one hour per day of high-quality programming.
- For children 6 and up, establish consistent limits on the time spent using media and the types of media.
A documentary worth watching is by Carlota Nelson, director of the documentary Brain Matters, which explores why too much screentime can harm babies and the importance of ensuring children enjoy off-screen experiences. Also, check out her engaging interview on the thinking behind this film.

Antevasins from the worlds of technology and health- please unite!

Posted on October 12, 2013 by sunoor

Technology and Health

Mention ‘technology and health’ and discussions generally steer into the direction of various gadgets and devices that transmit data, help remote diagnostics or empower patients to better manage their chronic conditions. The use of Google glasses by surgeons worldwide is the latest in generating such excitement. This is understandable in an era of short attention spans, where we tend to choose the visibly most exciting and the one that can be touched, tried and tested. While these new inventions are thrilling, most remain in the realm of luxury for a large part of the world. What often remains invisible and under-acknowledged is information and communication technology’s (ICT) ‘s role in transforming the landscape of broader issues such as power and access. At first instance, this may seem unrelated to health. However, these disruptions that ICT can make carry the potential to make health more accessible.

The truth behind “Access to Health”

‘Access to health’ questions are essentially questions of power imbalances, equity and human rights. Information and communication technology are essential for de-monopolising information and power and bypassing corruption. Communities where girls and women are not allowed to step out of their homes to go to schools, can now be reached in their homes through eLearning programs. Digitization of land records in feudal societies leads to major power shifts in communities. These shifts create new opportunities for people to think beyond ‘survival’. When such developments are coupled with legislation that empowers citizens with the right to information, wonders can happen in many fields, including health. The potential of transparency and rapid dissemination of information that ICT brings warrants close collaboration between champions of access to health and technologists. This should not be considered relevant only in the low-income- resource-constrained setting but also in the high-income countries where health cost is skyrocketing.

Integrating technology thinking into health thinking

If we wish to make health accessible for more people in more places in the world, we would need to find effective ways of integrating ‘technology thinking’ into ‘health thinking’. In the current scenario, technology is seen in service to health – a vehicle for carrying forward health services and products. The vehicle and the product are usually developed independently, and their coming together is more often coincidentally than by design. In health projects, I often see technology as an afterthought, not an integral element of the project design.

While ‘inter-disciplinarity’ is a term tossed around by global health gurus and policy writers, it is a mammoth task to achieve in practice. The first step towards this integrated thinking would be to create dialogue spaces that are conducive for the meetings of the Antevasins from the worlds of technology and health.

Antevasins- the need of the hour

Antevasin (Ante-vasin n. Sanskrit) loosely translates as ‘living at the borders’. This word gained quite some popularity when used in the book “Eat, Pray, Love” by Elizabeth Gilbert. Finding Antevasins in the area of Health and Technology is a challenge as both fields take pride in their super-specialists. Add to this the tendency of people to put experts in health and technology in a box. However, it is vital that we search for those who, while having their niche of expertise, can see the bigger picture and appreciate the importance of connecting with ‘outsiders’.

Med@Tel- a pioneer!

I had the privilege of attending the annual conference of the ISfTeH in Luxembourg 2013- Med@Tel. The size of the conference, the sessions, the layout and the staff that managed the event created an ambience conducive to networking beyond the customary exchange of visiting cards. To my delight, at Med@Tel, I met an impressive number of Technology Antevasins. Saddened I was to see few from my own tribe of health and medicine at the conference. This led to our proposal of a thematic partnership between the ISfTeH and the Geneva Health Forum.

Since 2006 the Geneva Health Forum (GHF) has asked hard questions, invited practical solutions, and heard many brave voices worldwide. As the world gets more complicated and health more vital, we have partnered with ISfTeH to strengthen the ICT component of the GHF 2014. We have operationalized this by dedicating a complete submission track to Innovation and technology at the next edition of the GHF in 2014.

Content is King

Over the last four editions of the forum, we have tried to ensure that partners appreciate the value proposition of the Geneva Health Forum and commit to contributing to its content. The fruits of these efforts were clearly visible in the fourth edition in 2012. This has also enhanced the credibility of the GHF as a forum where ‘Content is King’. Gradually partners have come to value the unique dialogue and networking opportunities the GHF provides. Many partners have also found value in getting access to the views from the frontlines that the GHF channels, which may show trends that may initially be invisible to policymakers in Geneva.

We are confident in the robustness of the product that we are bringing forward. We feel the content will prevail over packaging in a fast-moving world of multiple and non-stop choices. The global health community has no more patience for predictable, self-asserting and mind-numbing meetings, conferences and sessions. It is time to raise the bar and bring back discussions and debates that make health more powerful.

Not for fence-sitters

The Geneva Health Forum is not meant to attract spinners and fence-sitters. It is a forum of Antevasins from across disciplines that can see beyond their own spheres of expertise, excellence and influence. It is a forum that brings together believers of interdependence over independence. I earnestly hope that members of the ISfTeH will participate and infuse the discussions at GHF2014. We know that without ICT, health initiatives cannot scale. At the same time, we will encourage health experts to engage at your fora and bring their perspectives to challenges and possible solutions to advance health and well-being. I invite you to visit the website of the GHF.

I earnestly hope the partnership between ISfTeH and the GHF will lead to new disruptions that will make health more powerful.

I wish you good health!

Sincerely yours,

Dr. Sunoor Verma, MD MS

Executive Director

Geneva Health Forum

Editorial by

Dr. Sunoor Verma, Executive Director of the Geneva Health Forum published in the October 2013 Newsletter of the ISfTeH

Dear Reader,

As I indicated last year, from time to time, I will allow a member of our community to use this space to share their thoughts with everyone. Dr Sunoor Verma, Executive Director of the Geneva Health Forum, is the first to take advantage of this, with his piece on the people who straddle the worlds of health and technology as we do. The ISfTeH signed a memorandum of understanding with the Geneva Health Forum this summer. We all look forward to a mutually beneficial collaboration with the GHF.

Sincerely,

Prof. S. Yunkap Kwankam

Executive Director, ISfTeH