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About gender issue

By Dr. Rosa Hilda Lora M. Advisor at AIU | rosa@aiu.edu

We are in a world with a development of science that seems incredible to us: Artificial Intelligence, Global Trade, Platforms, instant communication, but also a society of misinformation and hate speech that has no limits, although governments are looking and looking for ways to stop this type of communication that brings humanity to total madness. We are also witnessing the proliferation of populist governments that grow like mushrooms. It seems that human beings don’t know where to run. What happens that in the absence of limits, human beings seem not to be happy? What happens that in the face of so many elements to be happy, the good economic situation doesn’t reach everyone equally? While some say they have no limits, others die of hunger. It seemed that at this stage in the History of Humanity we would all have what is necessary to be happy. First of all, with so much knowledge, human beings still seem not to know what life is. Secondly, they also don’t know what it is to be happy. Everyone is after goods; the more it seems, the better.

Why is it that beings with so many elements to live well with each other don’t achieve life in common and with the necessary elements for each one? The beings that live on this planet are the flora and fauna. The beings that direct this ship are human beings. What happens to human beings? Some are male and others are female. What has happened to the training that has been given to men and women in all cultures? Morphological and physiological nature indicates that those who belong to the male gender have a muscular system with strong fibers, which is why they have greater power than women’s muscles; men have greater muscle and bone mass than women.

Also, the production of hormones such as testosterone in men and progesterone and estrogen in women produce the differences we mentioned. What has happened throughout History with the differences mentioned? It has happened that due to the greater muscular strength and height of men in relation to women, men are dedicated to work requiring greater strength than women. In addition, due to the type of hormones, women are the ones who can develop a living being from male and female cells called sperm and eggs. Due to the greater muscular strength of men and the gestation of women, men devoted themselves to work and women to raising children. With the development of industry, the necessary production is not sufficient with the work of men alone; in addition, it should not be possible to condemn men to work and women to child rearing. This was the division of labor for many centuries. Today, since the development of production, women need to be considered and treated with the same rights and obligations as men. The division of labor by the nature of men and women developed a culture in which men had to be served by women because they were the ones who brought the resources to the family.

Still, according to the development of countries, women continue to serve men and men are considered superior. What is happening with current wealth? What is happening with the right of women to have an education equal to men? Women are human beings with rights to equal development given that men are not superior, and women are not inferior: they are the ones who give birth to new human beings.

We are experiencing the development of the family. Women in the stage of life of the reproduction of the species have all the possible impediments. Companies have difficulties with the time that women need for pregnancy and then the care of children, which is why they prefer the work of men. Women are punished for having children. Speaking of wealth, inequalities and the problems that we currently have, there is a high migration to countries that offer better living conditions. Faced with the situation mentioned, the 2015 Nobel Prize winner in Economics, Angus Deaton, in his work: The Great Escape. Health, Wealth and the Origins of Inequality, says that as a solution to migration, governments can’t be helped directly because what they do is appropriate the resources. When we talk about populist governments, this is what happens: a group takes power in whatever way to keep the country’s economic resources and subjects the population to all the punishments they want: economic and human rights. The great thing about the situation is that they want all the money in the world, but they can’t spend it as they please: all the money in the world to keep it hidden.

Deaton says: “Without adequate taxation capacity, the state denies its citizens many of the protections taken for granted in the rich world. They may lack the protection of the law, because courts don’t function or are corrupt, and police may harass or exploit poor people rather than protect them. People may not be able to start a business, because debts are not paid, and contracts are not fulfilled or because public ‘servants’ demand bribes”. Deaton, 2015, p. 327. In 2023, another Nobel Prize winner in Economics, Claudia Goldin, deals with the problem of development and women’s right to grow in working life and the problem with motherhood in her work: Career and Family. Women’s Long Journey to Equality. Goldin works her work with all the difficulties that women in the United States must overcome to develop a career by having to fight against the obstacles to overcome due to pregnancy and raising children. “A career is the path that a person travels and through which life progresses. It must be continuous for a certain period. ‘Career’ doesn’t mean just -sic- being employed in a job; it generally means moving forward and persisting. It implies learning, growing, investing and reaping the rewards”. Goldin, 2024, p. 42. Goldin separates the women into groups and analyzes the situation in which those who were able to do university studies have worked. She tells us that: “…a career —building it and progressing in it— requires total attention. Otherwise, it is not a career, but a job.” Goldin, 2024, p. 43. The researcher traces the achievements of women at university to develop a career: a) At first it was considered that raising children was the responsibility of women. b) Women practically had to stop developing their careers because their obligation was to take care of their children.

c) Later women had to fight against the prejudice that if mothers worked, their children were poorly cared for. d) Women at university postpone motherhood in order to develop their careers. Goldin deals with women at university to develop their careers. The big question is: nothing happened, and nothing happens with men. Men have always been forced to work to support their family. Goldin concludes her work with the high percentage of divorces and the reluctance of both women and men who have completed university to marry and raise children. This is true for university students, but we must ask ourselves: what happens with men and women who have not completed university? How many of them go to university today? What does the United Nations Educational, Scientific and Cultural Organization —UNESCO— say about those who begin university studies? What does it say about those who can complete university studies? “Despite the achievements made, some 250 million children and young people remain out of school, according to the UNESCO Institute for Statistics: of which 122 million are girls and 128 million are boys. And women continue to represent almost two thirds of the 765 million adults who lack basic reading and writing skills.”

UNESCO. What you should know about UNESCO’s action to achieve progress in education and gender equality. July 17, 2024, https://www.unesco. org/en/gender-equality/education/ need-know If that many human beings are still not in school by 2024, what can we expect from them in universities? “Gender equality is a global priority for UNESCO. It is inextricably linked to its mandate to lead the Education 2030 Agenda, which recognizes that gender equality requires an approach that “ensures not only that girls and boys, women and men gain access to and successfully complete different levels of education, but that they acquire the same skills in and through education.” UNESCO. What you should know about UNESCO’s action to achieve progress in education and gender equality. July 17, 2024, https://www.unesco.org/en/genderequality/ education/need-know Analyzing the economic situation of the world in which we live: There is no room for family development. Children don’t have the space for their development. Men must work hard to educate their children. Women can’t detach themselves from gestation because it is their function in the biological world of which they are a part.

The problem of economic development is that society is not made for human life. What are we going to do? Create laboratories to produce human beings? Create colonies where children are cared for so that men and women can work? As Carl Sagan said when the photograph of the Earth was taken in 1990 from Voyager I at a distance of 6,000 million km. “Let us take another look at that little dot. There it is. It is our home. It is us. The lives of all the people we love, the people we know or have heard of, and ultimately, everyone who has ever existed, have passed and pass on it.” Sagan, 2003, p. 14. We are fellow travelers on this planet, which, as Sagan said, is: “a pale blue dot.” Service in organizations has to be of quality, it doesn’t matter whether it is given by a man or a woman. We have to find the way for the species to develop where what produces it, which is the family, has opportunities as men and as women, with the same rights and responsibilities and where there is space for gestation and upbringing. You have the privilege of being a university student at Atlantic International University —AIU: Study, learn and give space to women because you are a travel companion. Jobs shouldn’t have labels —man, woman: They are for everyone in a home of growth of human beings. Let’s work to create the world we need.

BIBLIOGRAPHY. Deaton, A. 2015. El Gran Escape. Salud, riqueza y los orígenes de la desigualdad. México. Fondo de Cultura Económica. | Goldin, C. 2024. Carrera y Familia. El largo viaje de las mujeres hacia la igualdad. México. Taurus. | Sagan, C. 2003. Un punto azul pálido. Una visión del futuro humano en el espacio. España. Planeta. | UNESCO. Qué debe saber acerca de la acción de la UNESCO para lograr avances en la educación y la igualdad de género. 17 de Julio de 2024 https://www.unesco.org/es/gender-equality/ education/need-know

Hepatitis B serology testing and vaccination for health workers in The Gambia: A Pilot Study

Abdoulie B Badjie | Doctorate in Public Health | Part 2/2

METHODS This cross-sectional pilot study was conducted at EFSTH in Banjul from 12th to 16th June 2023. The EFSTH is the only tertiary hospital in The Gambia. The hospital serves as the primary referral center for the nation and sees patients from across the country. The screening team was composed of principal investigators, clinical investigators, counselors, laboratory staff, public health officers as vaccinators and data collectors as well as nurses. Before the screening, the team met and determined roles and responsibilities of staff which were reiterated each morning before the start of the screening day. Once the team was set up in the morning, the principal investigator and the clinical investigator visited potential study participants in their respective unit locations or offices to briefly introduce the pilot and invite them for screening. This was done daily to serve as a gentle reminder for those yet to be screened. The study participants were first seen at the counseling unit for pre-test counseling and to obtain written informed consent. After a participant consented, a study number was allocated, which became their study identifier to maintain confidentiality. The participants were then sent to the data collection room. The data collectors then administered the study questionnaire and sent the participant to the laboratory with a form where 2 ml of blood was collected in an EDTA tube. The sample was spun for 5 mins at 5000 RPM and the plasma was used for rapid Hepatitis B surface antigen (Rapi Card Instatest, Diagnostic Automation/ Cortez Diagnostics, Woodland Hills, CA) and Hepatitis B surface antibody tests (Rapid Response HepBs Ab test cassettes, BTNX inc, Ontario, Canada) which takes about 15 minutes.

Results were recorded in the form, sealed, and handed over to the counselor in the counseling room for posttest counseling. Those with negative hepatitis B surface antigen were then referred to the vaccination room for the first adult Hep B vaccination dose. They were also scheduled for the subsequent 2nd and 3rd doses. Those with positive hepatitis B surface antigen were referred to the EFSTH liver clinic for liver assessment. The study further divided the healthcare workers into 2 groups. The first group is the likely vaccinated age group. This is defined as those healthcare workers who were born after the introduction of the nationwide hepatitis B vaccine into the expanded program of immunization in 1990. The second group is the likely unvaccinated age group who were born before the introduction of the nationwide hepatitis B vaccination into the expanded program of immunization.

Linkage to care Among health workers who tested positive for hepatitis B surface antigen, linkage to care was defined as visiting the EFSTH liver clinic at least once after screening. Liver disease assessment Those HBsAg-positive participants who visited the EFSTH liver clinic had an ultrasound scan performed by the clinical investigator. Blood samples were also collected for hematology, biochemistry, and hepatitis B virus DNA (HBV DNA). Ethical approval Ethics approval and consent to participate in this pilot study were approved by the Institutional Review Board of Edward Francis’s Small Teaching Hospital (EFSTH-REC-017). Data analysis Data were entered using a tablet. Data were then imported and analyzed using kobo collect. The simple proportions were calculated for discrete variables. RESULTS Demographic characteristics of the participants A total of 70 healthcare workers in EFSTH were enrolled in this pilot study. Most of the participants were female 44 (62.9%) and Gambians 67(95.7%). The median age of the participants was 35 years old and most of them were 32 years old. 42 years old and above (60%) were likely to be non-vaccinated age group. The majority of the participants 42 (60%) also reported having taken at least 1 dose of the hepatitis B vaccine in the past (Table 2). A third of the participants attained a bachelor's degree 22 (31.4%) (Figure 2) and most 43 (61.4%) of them were from the clinical laboratory.

Prevalence of Hepatitis B The overall prevalence of Hepatitis B amongst the health workers in this pilot study was 3 (4.29%). The prevalence in the likely unvaccinated age group was 3 (7.1%). There were no positive antigen results amongst the likely vaccinated age group. Hepatitis B antibody Of the 70 participants included in the study, only 28 (40%) tested positive for Hepatitis B antibody. Hepatitis B antibody testing was negative in 42 (60%) participants. Twenty (65.5%) of the likely vaccinated age group tested negative for the anti-HBs and 22 (52.4%) of the likely unvaccinated age group tested negative for the anti-HBs. Vaccination after screening The results shows that 65 (86.7%) participants who tested negative for HBsAg were vaccinated and the remaining 5 (3.3%) were not vaccinated. Three of those not vaccinated had positive HBsAg and the remaining 2 declined to take the vaccine.

DISCUSSION Vaccinating the health workforce is a cost-effective investment and a prerequisite for building a robust health workforce. These actions bolster the stability and resilience of emerging health systems and directly impact the achievement of the UN Sustainable Development Goals (SDGs) targets (Naimoli, et. al. 2018). The overall prevalence of Hepatitis B amongst the health workers in this pilot study was 4.3%. The prevalence in the likely unvaccinated age group was 7.1%. There were no positive antigen findings amongst the likely vaccinated age group. This result is similar to other studies done in The Gambia among the adult population which showed an 8.2% prevalence of hepatitis B (Jarju , et. al. 2022). All the Hepatitis Bpositive cases in this pilot were in the likely unvaccinated age group. These health workers were born before 1990 when nationwide Hepatitis B virus vaccination was introduced into The Gambia’s Expanded Program on Immunization (Peto, et. al. 2014). This study also showed that 60% of the healthcare workers tested negative for Hepatitis B antibodies. In the likely vaccinated age group, 65.6% tested negative, and 52.4% in the likely un-vaccinated age group. These findings suggest that a majority of our health workers are not protected against Hepatitis B virus infection, even as they are at high risk of exposure to potentially infectious patients. This justifies the need for a well-planned and clear HBV screening and vaccination policy among healthcare workers throughout the Gambia, especially those at the highest risk of exposure to blood or other potentially infectious material. The only limitation of the study was the delay in the procurement of the vaccine to start the pilot, vaccines were however borrowed from a partner institution, thus the need to have all required logistics in place before the scale up.

CONCLUSIONS This study confirms a high prevalence of hepatitis B amongst the likely unvaccinated age group in EFSTH. It also further confirms the fact that a high proportion of healthcare workers are not protected against hepatitis B virus infection. This therefore justifies the need to protect health care workers in an already challenged health system against vaccine-preventable disease and death. Thus, there is an urgent need for wellplanned and clear policies for HBV screening and vaccination among healthcare workers throughout the Gambia, especially those who are at a greater risk of exposure to blood or other potentially infectious material. THE END

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