Author Archive

About Mike Hartung:

Michael Hartung, editor of Healthy Travel Blog, serves as head of Product Development at HTH Worldwide. Mike is responsible for all product strategy and development for the company. Mike has over twenty years of successful product innovation to his credit. He has played a senior management role in three start-up companies and has built complex organizations in rapid growth environments. Prior to joining HTH in 2000, he served as President of U.S. Healthcare’s Workers Comp Advantage subsidiary, which he co-founded with Angelo Masciantonio. Mike has also served in senior roles at Aon Consulting, Vantage Health Partners and Managed Health Care Services. Mike earned an M.B.A. from New York University, an M.A. from Duke University and a B.A. from Carleton College.

New Book Chronicles Malaria’s Chokehold on Human Progress

Wednesday, August 4th, 2010 by Mike Hartung

Journalist Sonia Shah brings us an important new account of how malaria has impeded human progress for half a million years and counting. Her book, The Fever: How Malaria Has Ruled Humankind for 500,000 Years (Farrar, Straus, Giroux) ranges across history, geography vast numbers of victims and the many modern-day players who are pursuing its eradication.  World travelers and anyone with an interest in how one disease can subjugate a wide swath of humanity will want to delve into Shah’s reporting.

Shah has previously tackled topics ranging from the story of crude oil to an account of pharmaceutical companies testing drugs on indigent patients. In The Fever she displays, according to one reviewer, “the same curiosity, eye for history, and anger on behalf of the oppressed.” Here are some other excerpts from recent reviews: 

From New Scientist, Martin de Smet

The Fever is a mine of information, drawing on diverse accounts from medical experts and field workers. This is an important book on the historical lessons we must not forget and the mistakes we are still making today in the battle against what remains a formidable killer.

Critically, The Fever exposes the growing threat posed by donors who want to see immediate results. The issue is all too familiar to field workers, who see aid flooding into countries where success is more or less guaranteed, but poor investment in chaotic post-conflict countries where the burden of the disease is often heaviest. Everyone – politicians, donors, research institutes, lobby groups and the pharmaceutical industry – has their own agenda when it comes to malaria. Shah’s examination explores them all.

From NPR, Michael Schaub

Malaria has been a global scourge since the Ice Age, and despite the fact that it’s treatable, it still kills about 1 million people a year. Scientists and physicians have worked for decades upon decades to eliminate the disease, but after tens of thousands of years, it’s beginning to look unkillable.

It’s a compelling account of a disease that remains out of sight — and thus out of mind — for most Americans, even as it slowly tightens its grip on other parts of the world. Despite Shah’s engaging prose and obvious enthusiasm, the subject matter means it’s far from an easy read — but it might well be an essential one.

  • Share/Bookmark

Multi-drug Resistant TB: Where Is It Winning?

Friday, July 23rd, 2010 by Mike Hartung

My eyes were opened to the threat posed by multi-drug resistant tuberculosis (MDR-TB) when I read about Dr. Paul Farmer’s evangelical efforts to raise the world’s consciousness in Tracy Kidder’s book Mountains Beyond Mountains.  Years later I’ve learned the threat continues to grow. The World Health Organization works very closely with Farmer’s Partners In Health organization to monitor and combat MDR-TB around the world.  The WHO’s 2010 report is cause for alarm but also offers some seeds of hope.

First some worldwide statistics from the report:

  • In 2008, there were estimated 440,000 MDR-TB cases and 150,000 deaths
  • Only 7% of all MDR-TB patients were diagnosed and notified
  • 60% of those enrolled in treatment programs were cured
  • In 2010, only 22% of the $1.3 billion needed to fund MDR-TB control is available
  • In 2015, funding required to control MDR-TB will be nearly $4.5 billion

How did we arrive at this dangerous place?

Tuberculosis thrives in the poorest neighborhoods and in prisons and hospitals that house the poor.  Treatment with antibiotics is effective, but the course of treatment is long, and the side effects can be serious.  Therefore, it is not unusual for patients to abandon their antibiotics too early, giving rise to the MDR strain.  Today the prevalence of MDR-TB is growing, and so is the risk of encountering it on your travels, especially if you are visiting any of the 27 countries with a high burden of TB.

See the chart below for the prevalence of MDR-TB in these countries and the number of cases annually.  Travelers should also note that MDR-TB has a significant foothold in Jordan and Peru.  Further, only 22 of 46 African countries provide data to the WHO.

On the hopeful side, treatment efforts seem to have turned the tide in Estonia, Latvia, Hong Kong, the U.S. and certain parts of Russia. Twenty of the 27 high burden countries are strengthening their efforts by scaling up access to diagnostic tests.  As is so often true, sustained progress depends on increasing resources, expertise and coordination around the globe.  The price tag to control MDR-TB is relatively affordable when compared to global expenditures to combat HIV and H1N1, but until the problem reaches crisis proportions, adequate funding may not materialize.

And don’t bet against the microbes.  They have continued to evolve to elude even more forms of antibiotics.  The Extensively Drug-Resistant (XDR-TB) strain has now appeared in 58 countries, and the WHO estimates there are 25,000 cases annually.

  • Share/Bookmark

Important New Angle on Happiness Index: How Much Do We Suffer on Life’s Last Lap?

Friday, July 16th, 2010 by Mike Hartung

A recent post on the Wall Street Journal’s Health Blog by Katherine Hobson brought to light a fascinating new study on the Quality of Death around the world. The Singapore-based philanthropic Lien Foundation commissioned the Economist Intelligence Unit to study forty countries in depth to gauge how much suffering accompanies the final few months of life. Researchers interviewed doctors and experts on palliative care to help measure four sub-indices: 1) basic end-of-life healthcare environment; 2) availability of end-of-life care; 3) cost of end-of-life care and 4) quality of end-of-life care. The results and rankings are shown below.

Predictably, most of the richer nations scored relatively well. But the biggest findings do not seem to be driven so much by a nation’s GNP as by the “culture of curing” and the scarcity of painkilling drugs. The study notes that medical professionals are trained to implement curative rather than palliative strategies–so much so that of the 100 million people worldwide who could benefit from palliative care annually, only 8% receive it. Likewise, regulations to stop illicit use of opiates often make them unavailable for clinical use. The result is that availability of painkilling drugs is “woefully inadequate” all around the world. Taken together, the authors conclude, these issues cause an “incalculable surfeit of suffering” for patients and their loved ones.

Still, in relative terms, you are much better off in the U.K. and Australia than China, Brazil or India when your candle is burning low. Once we all admit that death is a part of life, we can begin to appreciate the importance of the availability of quality palliative care and unflinchingly incorporate quality of death into our happiness index.

  • Share/Bookmark

Stockholm, Hamburg Win “Green Capitals” Award; Six More Cities Named Finalists

Friday, July 9th, 2010 by Mike Hartung

If you’re looking for places to visit where you can breathe easy and enjoy the local drinking water, green space and biodiversity, the European Union has started highlighting exceptionally “green” cities by handing out an annual Green Capitals award. The 2010 and 2011 winners are Stockholm, Sweden and Hamburg, Germany, respectively. The judges have also selected six finalists for the 2012 and 2013 awards: 

  • Barcelona, Spain
  • Malmo, Sweden
  • Nantes, France
  • Nuremburg, Germany
  • Reykyavik, Iceland
  • Vitoria-Gasteiz, Spain

Winners will be announced in October.

Cities are judged against twelve criteria and on their ability to demonstrate innovation, efficiency and compelling plans for the future:

  • Local contribution to global climate change
  • Local transportation policies
  • Green urban areas
  • Sustainable land use
  • Nature and biodiversity
  • Quality of local ambient air
  • Noise pollution
  • Waste production and management
  • Water consumption
  • Waste water treatment
  • Municipal environmental management
  • Program to promote best practices to sister cities

Now you can vote with your feet (and airplane ticket) and try ecotourism with an urban flair. There are plenty of other cities applying to be recognized as Green Capitals. Have you visited any of the winners or aspirants?

  • Share/Bookmark

Eyes Wide Shut? Know Your Destination’s Human Rights Record

Tuesday, June 15th, 2010 by Mike Hartung

We’ve linked tolerance with health in the past. Now the unexpected outburst of ethnic violence in the Kyrgyz Republic is a vivid reminder of how tenuous the grip we humans have on tolerance, dignity, survival and health. With the Kyrgyz atrocities as a backdrop, the U.S. State Department yesterday released its annual report on human trafficking around the world, highlighting especially those countries whose efforts fall far short of complying with the U.S. Trafficking Victims Protection Act of 2000. Of the 177 countries surveyed (including the U.S.), fifty six, or 32%, are on a watch list because recent progress toward compliance is deemed at risk. Another thirteen, or 7%, are making no compliance efforts whatsoever. The remaining 60% are either in compliance or moving steadily in that direction. See charts below for a listing of countries falling into these categories and see the State Department’s interactive map and the full report.

As our readers circle the globe, we hope they pause to understand their host countries’ human rights record. There are unpleasant realities in many destinations, and some surprises for me in the Caribbean, Central America and Asia. Even developed countries such as Russia, Singapore and Thailand are called out. We aren’t suggesting you should avoid travel to these countries. We are recommending that as your horizons expand they encompass a commitment to promoting tolerance and dignity. We will all be healthier for it.

  • Share/Bookmark

Tolerance and Health: Breakthrough in South Africa?

Monday, May 17th, 2010 by Mike Hartung

In previous posts we’ve tracked the links between tolerance, happiness and health and asked whether a wide gender gap may be a barometer of a society’s reluctance to commit to tending to basic human needs. Now recent reports strike a hopeful chord, indicating that tolerance is a precondition for combating the HIV/AIDS epidemic.

First, based on twenty years of data from the U.S., researchers at Emory University are reporting findings of an inverse relationship between tolerance and HIV/AIDS infection rates. In other words, the more open and tolerant a community, the more successful education efforts are. It’s no surprise that HIV/AIDS thrives in the shadows of ignorance, prejudice and fear. If it is true in a society as open as America’s, it’s no doubt doubly true in many other countries of the world. Country-level data on the prevalence of HIV/AIDS and other sexually transmitted diseases is spotty, but experienced travelers know that the highest infection rates are reported in sub-Saharan Africa and Southeast Asia.

So it seemed like a breakthrough last week when the President of South Africa, Jacob Zuma, broke with years of silence and denial to openly discuss his personal history with multiple female partners and his commitment to testing and promoting circumcision to help slow the spread of HIV/AIDS. His openness is a dramatic effort to erase a stigma and set very high standard for tolerance for his people to follow. In office for a year, Mr. Zuma is putting his government’s resources behind what the United Nations has called the largest and fastest increase in AIDS testing and treatment ever.

Perhaps South Africa’s entrance onto the world stage—hosting soccer’s World Cup beginning next month—has helped to enlighten its leadership. If we want tolerance to lay the foundation for a healthier planet, let’s put all world leaders on notice: the whole world is watching.

Photo info: http://www.flickr.com/photos/worldbank/ / CC BY-NC-ND 2.0
  • Share/Bookmark

Swine Flu Assessment: First Wave Cut Many Lives Short

Friday, April 2nd, 2010 by Mike Hartung

Prompted by allegations that the swine flu pandemic was oversold to promote vaccine sales, researchers at the National Institutes of Health in Bethesda MD have released their assessment of the mortality associated with the H1N1 virus in the U.S during the past flu season. In their own words:

“We conclude that the 2009 A/H1N1 pandemic virus had a substantial health burden in the U.S. over the first few months of circulation in terms of years of life lost, justifying the efforts to protect the population with vaccination programs. Analysis of historic records from three other pandemics over the last century suggests that the emerging pandemic virus will continue to circulate and cause excess mortality in unusually young populations for the next few years.”

Relying on the fact that the average age of an H1N1 victim (37) is far younger than the average of a typical seasonal flu victim (76), researchers calculated that in the U.S. H1N1 cost nearly 2,000,000 years of life versus 600,000 for the seasonal flu.

In an interview with New Scientist magazine, researcher Lone Simonsen warns that most people killed in the 1968 pandemic died in its second wave, and advises vaccination. It’s autumn now in the southern hemisphere, and H1N1 is returning. We will keep tracking its progress for our globally mobile readership.

  • Share/Bookmark

Healthy Destinations: Tolerance Also a Key Indicator

Friday, March 26th, 2010 by Mike Hartung

Previous posts have highlighted happiness, the velocity of life, ethics and environmental factors as important characteristics of healthy destinations. Now a new analysis of Gallup poll data by researchers at Cambridge University isolates another key to health and happiness: tolerance. Working with data from 380,000 Americans polled in 2008, the Cambridge team found that “inclusiveness”—tolerance of bohemian and alternative lifestyles—raised the happiness index significantly in many states, including three that made the top ten: California, Minnesota and Massachusetts. It seems freedom of expression and lower pressure to conform give people the chance to pursue and perhaps fulfill their own definition of happiness. Health and well-being seem to walk hand-in-hand with a tolerant approach to life. Do you agree?

Photo info: http://www.flickr.com/photos/bike/ / CC BY-SA 2.0
  • Share/Bookmark

Quake knocks out hospitals in southern Chile: Santiago facilities receiving patients

Monday, March 1st, 2010 by Mike Hartung

Dr. Jorge Valenzuela, Internist at Clinica las Condes, and also a Regional Physician Advisor for HTH Worldwide, reports that today no hospitals in Southern Chile (Curico, Talca, Concepcion) are in operation.  Everyone is being transported to Santiago for medical treatment where the 2 main private hospitals, Clinica las Condes and Clinica Alemana, are in operation.  Condes sustained minor damage but is fully operational.  Alemana is fully operational, save some lab tests.  As long as those affected by yesterday’s devastating earthquake can get to Santiago, they should be able to get the care they need.

  • Share/Bookmark

Understanding Seismic Events: Chile Quake Rocks Richter Scale But Is Less Lethal than Haiti’s

Monday, March 1st, 2010 by Mike Hartung

Sadly, our recent post on earthquake-threatened cities was a timely introduction to the risks residents and visitors run when inhabiting destinations situated above enormous seismic stress. Now scientists reviewing the reports from Chile are drawing comparisons to Haiti that give further insight into the variables that affect whether quake fatalities reach the hundreds, thousands or hundreds of thousands.

Santiago, Chile did not make the list of most threatened cities because of its distance from the primary fault line and the building codes that have been enforced in recent years. Chilean President Michelle Bachelet said things could have been a lot worse than the present catastrophe if not for the country’s building standards.

At 8.8 on the Richter scale, the Chile quake released 500 times more energy at the epicenter than the Haiti event, but energy dissipates rapidly as distance from the epicenter grows. Saturday’s quake was centered an estimated 21 miles underground in a relatively unpopulated area, while Haiti’s struck about 8 miles down and right on the edge of Port-au-Prince. Furthermore, the ground beneath Port-au-Prince is less stable and “shakes like jelly,” says University of Miami geologist Tim Dixon. The U.S. Geological Survey reports that Port au Prince experienced “violent” to “extreme” shaking, while Chileans experience no more than “severe” shaking. Nevertheless, the latest news reports indicate 500,000 homes have been damaged and two million people displaced.

Plate tectonics is a dismal science when millions of lives are literally shaken.

Photo info: http://www.flickr.com/photos/bjornmeansbear/ / CC BY-SA 2.0
  • Share/Bookmark