Notes from Ethiopia June 2018

Traveling to Ethiopia fills one with gratitude for all that is possible through physical therapy. In June of this year Rebecca Stephenson and Tracy Spitznagle traveled to Mekelle, Ethiopia. The trip was twofold, one to participate in the medical school collaborative and the second, to provided education to the third cohort of master’s student at Mekelle University.

Highlighting Obstetric Fistulas

Hadiza Soulaye is a young woman from Niger who shared her experience with an obstetric fistula with the New York Times2. She was married off by her parents before she even began her menstrual cycle. Soon she was pregnant. Her labor was obstructed and lasted three days. By the time she was able to get to a center for a C-Section she lost the baby and had a fistula causing her to leak urine. Hadiza’s husband threw her out of the house.

Osteoporosis Around the World

Osteoporosis is characterized by bone becoming more brittle leading to increased incidence of fracture. These fractures most often occur in the hip, forearm, and spine. Of the 9 million osteoporotic fractures in the year 2000, 51% occurred in Europe and America. The other 49% happening in Southeast Asia and Western Pacific regions. These osteoporotic conditions develop most often in aging women after menopause. Approximately 200 million women have osteoporosis throughout the world. It is estimated that one of every ten women in their 60’s have osteoporosis, one of every five women in their 70’s, two of every five women in their 80’s, and two of every three women in their 90’s. These numbers in more developed countries are estimated to increase by four times by the year 2050 with more individuals living longer.

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There are many factors that contribute to the development of osteoporosis include: body mass, alcohol use, physical inactivity, poverty, and exposure to sunlight. The incidence of osteoporotic tissue development and fractures is higher in caucasian populations. Once an individual develops a fracture they are 86% likely to develop another fracture.


To decrease risk of developing osteoporosis early intake of calcium as a child, vitamin D, appropriate nutrition, and physical activity should be utilized. Weight bearing exercises help to develop increased bone mass. Osteoblastic activity which encourages increased bone mass peaks between ages 25 and 30 in long bones.  

Citations:

1.  Johnell O and Kanis JA (2006) An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 17:1726.

2. Kanis JA (2007) WHO Technical Report, University of Sheffield, UK: 66.

3. http://www.who.int/nutrition/topics/5_population_nutrient/en/index25.html

4. http://apps.who.int/iris/bitstream/handle/10665/42841/WHO_TRS_921.pdf?sequence=1&isAllowed=y&ua=1

5. Kanis JA, Johnell O, De Laet C, et al. (2004) A meta-analysis of previous fracture and subsequent fracture risk. Bone 35:375.

6. https://www.nras.org.uk/osteoporosis-in-ra

7.http://www.who.int/nutrition/topics/5_population_nutrient/en/index25.html