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Iono - Behind the Bulletins

Week in Review - 09 September 2017

Fresh off of last week's Hurricane Harvey that battered Houston Texas and the flooding that monsoon rains caused in much of the Asian sub-continent, this week it was Irma that was doing the damage, the category 5 hurricane decimated the island of Barbuda, leaving at least 50% of inhabitants homeless and destroying at least 95% of all buildings on the island. The Hurricane also completely cut off the island of St. Martin after causing extensive damage to both the air and sea-ports. Irma is the largest Caribbean storm in recorded history and is said to have maintained its intensity for longer than any other storm has managed. The storm has also damaged buildings and cost lives in islands including both the British and US Virgin Islands, Peurto Rico, Anguilla, and the Turks and Caicos Islands. Irma is also expected to affect parts of Cuba, as well as The Bahamas before turning northwards and hitting the mainland US Coastline in Florida.
 
As if that part of the world wasn't suffering enough on Friday morning it was also reported that a magnitude 8.1 earthquake had struck off Mexico's Pacific coast, claiming several lives in Mexico and at least one in neighbouring Guatemala, as well as triggering a tsunami warning.
 
Locally there was relief as the Ministry of Finance announced a second tax arrear recovery programme that will run from September 11th 2017 up until March 11th 2018 and will include as an option the chance to pay off outstanding amounts owed to the receiver in instalment payments over the amnesty period. Staying in Namibia it was reported that the company building the Neckertal Dam has had to reduce shift hours due to incomplete payment by government, Namibia's airports and border posts are in the process of switching to a new biometric system, the Unam Faculty of Health Sciences is to launch four new specialised qualifications, and President Hage Geingob and a delegation of Ministers along with the First Lady will be attending the 72nd session of the United Nations General Assembly in New York, while also conducting other meetings and business at the same time.
 
There was good news on the financial front as it was reported South Africa and Nigeria, sub-Saharan Africa's two largest economies, had emerged from recession, while there was bad news for South Africans as the price of fuel increased sharply with local economists pointing out the knock on effect this will have from everything from transportation and commuting to food and agricultural prices. In other financial news Shoprite shareholders voted in favour of buying roughly 1.75 billion Rands worth of shares from ex-CEO Whitey Basson, which this journalist hopes he uses in a similar vein to PSG founder Jannie Mouton, who has used some of his billions to create a philanthropic organisation which aims to plough back into and develop the country.
 
Elsewhere in Africa, UN investigators have accused Burundi's government of crimes against humanity including executions and torture, it was revealed that a fire that killed nine teenage girls at a Kenyan high school dormitory was started deliberately, while Kenya's Raila Odinga refused a power sharing option and also rejected the initial date selected for a rerun of elections, claiming he had not been consulted. Meanwhile a spate of unsolved murders in Uganda has put massive public pressure on the police, and armed forces from various SADC member states were on high alert for possible deployment following the murder of Lesotho's army chief and two senior officers on Tueday.
 
Internationally the UN said it had evidence that Syrian government forces were behind April's horrific Saron Gas attack, Catalonia took one step closer to seceding from Spain, International condemnation grew against Myanmars de facto leader Aung San Suu Kyi for her country's treatment of the marginalised Rohingya Muslim minority.

The Cancer Association of Namibia's take on 'vaping'

This is a very interesting article written by Rolf Hansen, the CEO of the Cancer Association of Namibia on the topic of e-cigarettes and 'vaping':

The tobacco industry remains pursuant in finding “grey areas” to infiltrate the market with “smart” and “healthier” ways to sell their products and promote smoking.
 
An electronic cigarette/ E-cigarette is a handheld electronic device that tries to create the feeling of tobacco smoking. It works by heating a liquid to generate an aerosol, commonly called a "vapour” that the user inhales. Using e-cigarettes is sometimes called vaping. The liquid in the e-cigarette is usually made of nicotine, propylene glycol, glycerine, and flavourings.
Most E-cigarettes contain zero tobacco products, or heat as opposed to combust tobacco, or does not contain e-liquids with nicotine at all. Vapour from an electronic cigarette simulates tobacco smoke, but the process of burning tobacco does not occur.
 
The health risks of e-cigarettes are uncertain at current, as this is new technology flooding the market. But, because of the contents of the e-liquid (i.e. toxicants and traces of heavy metals at levels permissible in inhalation medicines, and potentially harmful chemicals not found in tobacco smoke at concentrations permissible by workplace safety standards. However, chemical concentrations may exceed the stricter public safety limits), the Cancer Association of Namibia has been inundated with calls from the public on weather “vaping” is allowed in public places, restaurants, schools and enclosed areas.
 
Vaping is still dangerous, and many vaporizers employ e-liquid or e-juice that contains nicotine, but usually not in the high concentrations that represent in cigarettes. Overall, it remains a very unhealthy situation, and the combustion process to produces the vape creates a lot of the carcinogens present in cigarette smoke as well.
 
E-cigarettes are likely safer than tobacco cigarettes, but the long-term health effects when used by non-smokers (including second hand inhalation) can lead to nicotine addiction, and there is concern that children could start smoking after using e-cigarettes. So far, no serious adverse effects have been reported in trials globally we have learnt, but definite less serious adverse effects include throat and mouth irritation, vomiting, nausea, and coughing.
 
Given all the information presented on the topic, the Cancer Association of Namibia cannot condone the use of e-cigarettes/vaping, especially in public places and around children due to the adverse effects it may have. No smoking remains in our opinion the best option.
 
How does the electronic cigarette work?
 
An electronic cigarette or e-cigarette is a handheld electronic device that creates an aerosol by heating a liquid. The user then inhales the aerosol. Using e-cigarettes is sometimes called vaping. The liquid in the e-cigarette, called e-liquid or “e-juice”, is usually made of nicotine, propylene glycol, glycerine, and flavourings.
 
Where does the nicotine in “e-juice” come from?
 
The main ingredients in the e-liquid usually are propylene glycol, glycerine, nicotine, and flavourings. However, there are e-liquids sold without propylene glycol, nicotine, or flavours. The liquid typically contains 95% propylene glycol and glycerine. The nicotine in e-liquid is the same as that used in pharmaceutical nicotine replacement therapy (NRT). It is extracted from a member of the tobacco family but not the same plant as used for smoking tobacco as that has much less nicotine in the leaves than the rustic type of tobacco plant.
 
Is tobacco used in electronic cigarettes?
 
Although they do not produce tobacco smoke, e-cigarettes still contain nicotine and other potentially harmful chemicals. Nicotine is a highly addictive drug, and recent research suggests nicotine exposure may also prime the brain to become addicted to other substances.
 
How addictive are Vapes?
 
When you start smoking, vaping or supplying nicotine to your receptors, they multiply. If you stop smoking or vaping, the receptors don't go away. Nicotine use very quickly escalates into addiction, even when dealing with tobacco-free, odourless “vaping” associated with e-cigarettes.
 
What are the known health factors on E-Cigarettes / Vapes?
 
A 2014 World Health Report (WHO) report found e-cigarettes release a lower level of particles than traditional cigarettes. Comparable to a traditional cigarette, e-cigarette particles are tiny enough to enter the alveoli of the lung, enabling nicotine absorption. E-cigarettes companies assert that the particulates produced by an e-cigarette are too tiny to be deposited in the alveoli.  Exactly what comprises the vapour varies in composition and concentration across and within manufacturers. Different devices generate different particle sizes and cause different depositions in the respiratory tract, even from the same nicotine liquid. Reports in the literature have shown respiratory and cardiovascular effects by these smaller size particles, suggesting a possible health concern.
 
In terms of second hand smoke, emissions from electronic cigarettes are not comparable to environmental pollution or cigarette smoke as their nature and chemical composition are completely different. The particles are larger, with the mean size being 600 nm in inhaled aerosol and 300 nm in exhaled vapour. The exhaled aerosol particle concentration is 5 times lower from an e-cigarette than from a combustible tobacco cigarette. The density of particles in the vapour is lower than in cigarette smoke by a factor of between 6 and 880 times lower.
 
For particulate matter emissions, e-cigarettes slightly exceed the WHO guidelines, but emissions were 15 times less than traditional cigarette use. In January 2014, the International Union Against Tuberculosis and Lung Disease stated "Adverse health effects for exposed third parties (second-hand exposure) cannot be excluded because the use of electronic cigarettes leads to emission of fine and ultrafine inhalable liquid particles, nicotine and cancer-causing substances into indoor air."
 
Since e-cigarettes have not been widely used long enough for evaluation, the long-term health effects from the second-hand vapour are not known. There is insufficient data to determine the impact on public health from e-cigarettes. The potential harm to bystanders from e-cigarettes is unknown, because no long-term data is available at current.
 
E-cigarettes used in indoor environments can put at risk non-smokers to elevated levels of nicotine and aerosol emissions. Non-smokers exposed to e-cigarette aerosol produced by a machine and pumped into a room were found to have detectable levels of the nicotine metabolite cotinine in their blood. The same study stated that 80% of nicotine is normally absorbed by the user, so these results may be higher than in actual second hand exposure. In 2015 a report commissioned by Public Health England concluded that e-cigarettes "release negligible levels of nicotine into ambient air with no identified health risks to bystanders".
 
E-cigarette use by a parent might lead to inadvertent health risks to offspring. E-cigarettes pose many safety concerns to children. For example, indoor surfaces can accumulate nicotine where e-cigarettes were used, which may be inhaled by children, particularly youngsters, long after they were used. A policy statement by the American Association for Cancer Research and the American Society of Clinical Oncology has reported that "Third-hand exposure occurs when nicotine and other chemicals from second-hand aerosol deposit on surfaces, exposing people through touch, ingestion, and inhalation"
 
Do smoking laws apply to vaping?
 
Many jurisdictions worldwide have recently begun enacting laws (by amending tobacco control laws already in place) that prohibit e-cigarette usage everywhere that smoking is banned, although some countries with comprehensive smoke-free laws will still allow for vaping to be permitted in bars and restaurants while prohibiting e-cigarettes in other indoor places.
 
In Namibia, our current Tobacco Control Act of 2010 does not make provision for e-cigarettes / vaping in direct context. This is, because the Act is primarily focussed on tobacco products. In the event that an e-cigarette contains any form of tobacco product, the Act then comes into play.
 
The onus thus rests on the owner / management per venue to, on the basis of “right of admission”, prohibit the use of e-cigarettes / vaping in their respective institutions.
 
What about Hubbly Bubbly?
 
A hubbly bubbly – also called a hub, hookah, water pipe, or shisha – is an instrument for smoking tobacco, which is often flavoured. It consists of a base container, usually made of glass, attached to one or many smoking tubes. While many hookah smokers may consider this practice less harmful than smoking cigarettes, hookah smoking carries many of the same health risks as cigarettes. Just like regular tobacco, shisha contains nicotine. In fact, in a 60-minute Hookah session, smokers are exposed to 100 to 200 times the volume of smoke inhaled from a single cigarette.
 
Smoking a hookah doesn't have to mean smoking tobacco or taking in nicotine, which are common substances associated with smoking. But hookah smoking has its own demon — combusted charcoal — which carries health risks even when non-tobacco shisha is used!
 
As tobacco molasses is primarily used in this product, it falls directly under the Tobacco Control Act of 2010. It is illegal to smoke under the age of 16 years, in public and enclosed spaces and is punishable by enactment of the law.
 
Is vaping still smoking?
 
Vaping is still dangerous, and many vaporizers employ e-liquid or e-juice that contains nicotine, but usually not in the high concentrations that represent in cigarettes. Overall, it remains a very unhealthy situation, and the combustion process to produces the vape creates a lot of the carcinogens present in cigarette smoke as well.
 
E-cigarettes are likely safer than tobacco cigarettes, but the long-term health effects when used by non-smokers (including second hand inhalation) can lead to nicotine addiction, and there is concern that children could start smoking after using e-cigarettes. So far, no serious adverse effects have been reported in trials globally we have learnt, but definite less serious adverse effects include throat and mouth irritation, vomiting, nausea, and coughing.
 
Given all the information presented on the topic, the Cancer Association of Namibia cannot condone the use of e-cigarettes/vaping, especially in public places and around children due to the adverse effects it may have. No smoking remains in our opinion the best option.

Week in Review - 02 September 2017

Water was in the news in a big way this week with most of the world's attention focused on Houston Texas following the battering the southern US state received from Hurricane/Tropical Storm Harvey even though the damage caused by monsoon rains and subsequent flooding in the Asian sub-continent was playing out to be a far greater disaster. While not to diminish the tragedy of at least 40 people having lost their lives in America the sad fact was that over 1200 people died mostly unnoticed by the world in India, Nepal, and Bagladesh, with millions more being uprooted following the worst monsoon flooding in recorded history. Africa was not spared water based disasters this week either as thousands of people in Niger were urged to evacuate homes following floods that killed at least 16 people, and on Friday it was reported that Nigeria too had been affected with more than 100 000 people having fled their homes in the south east.
 
Locally suspects found guilty of crimes continued to be sentenced to long terms of imprisonment with a mechanic who was found guilty of brutally stabbing his girlfriend to death in 2013 being sentenced to 35 years and the man convicted of shooting a Finnish national in a road rage incident outside a Windhoek bar in 2015 being sent away for a total of 28 years. In other local news Namibia signed three agreements with China including one for the upgrading of a section of the road between Windhoek and the Hosea Kutako International Airport, B2Gold revealed that they are building a 7MW solar power plant at their Otjikoto mine, and it was announced that Namibia is to be included in a expansion of the SKA Telescope project with remote stations to be commissioned at Maltahohe, Karibib, Okahandja, and Opuwo.
 
In South Africa the Constitutional Court ruled that new homeowners are not liable for historical debt taken over from previous owners, a Spanish renewable energy company announced the completion of their latest plant and the fact that they now supply clean energy to almost 1 million South Africans in the Northern Cape province, and the country was all aflutter with news that a university student from Port Elisabeth had had R14.1 million erroneously paid into her account and had thereafter gone on a spending spree – it didn't end well for her though as it was confirmed that she would be expected to pay back the R818 000 she spent and could also be facing civil or criminal charges.
 
Kenya made the news twice this week, first for the news that they had decided to ban plastic bags outright with offenders facing fines of between 17 and 38 thousand US Dollars, and then again on Friday as the Supreme Court ruled that the recently held elections in which Uhuru Kenyatta once again won the presidency were invalid, set them aside, and ordered the country to hold fresh elections within 60 days.
 
Internationally a German nurse - already serving a life sentence for murdering two patients – is now a suspect in at least 84 other murder cases, UN Secretary General Antonio Guterres insisted that a two state solution in Israel is the only viable option, The UK urged the UN Security council to investigate mass civilian casualties in Myanmar while 57 rights groups from around the world demanded they investigate abuses in Yemen. In good news Chile's President sent legislation to Congress seeking to legalise gay marriage and US health officials have approved a breakthrough Cancer treatment that genetically engineers a patient's own blood cells to destroy childhood leukaemia.
 
And finally, South Africa's Health Minister has voiced what many have long been thinking when he called out African leaders who sought medical treatment outside the continent, calling them 'medical tourists'.