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The animal facility on the bottom floor of a drab building at Duke University is uncomfortably warm and smells a bit like raw seafood. That’s not surprising given what’s down there. The space holds a few thousand plastic fish tanks, each home to dozens of zebrafish: one-inch-long, big-eyed vertebrates that are becoming go-to research subjects for many scientists.

Nico Katsanis, a Duke geneticist who hunts down the causes of rare illnesses, is one of a growing number of researchers choosing to work with zebrafish instead of rodents. Since scientists learned to selectively mutate zebrafish DNA in 1988—giving them the ability to turn the species into models of human diseases—the number of biomedical zebra-fish papers has skyrocketed, from 26 to 2,100 last year. The nonprofit Zebrafish International Resource Center, which sells 2,608 different genetically modified strains to researchers, lists 921 academic labs and companies that use the fish. “The field is on fire,” says Leonard Zon of Harvard Medical School. Zon’s lab, for example, has used fish models to study skin cancer, blood diseases, and stem cells. Others have created fish with DNA mutations linked to narcolepsy, muscle disorders, and the large head size associated with autism.

To be sure, rodents still outnumber zebrafish in medical research labs. In 2010, biomedical research papers that used mice or rats were 10 times as common as those that used any other lab animal, and some biological processes—complex brain disorders, say, or anything involving lungs—are best studied in mammals rather than fish. But for most other experiments, from watching tumors develop to screening for new drugs, zebrafish are gaining ground.

Because larval zebrafish are transparent, researchers can literally watch their organs chúng tôi Duke, Katsanis and his colleagues use zebrafish to more accurately diagnose babies with mysterious health problems, with the goal of eventually finding treatments for them. Although lab rats and mice can be great for common diseases, this kind of research—which looks at exceptionally rare illnesses—would be prohibitively expensive and slow in rodents. The researchers recruit infants with suspected genetic problems from the nearby community. After a team clinician evaluates an infant, the researchers ship a tube of its blood to the Human Genome Sequencing Center at the Baylor College of Medicine. There, machines sequence the child’s DNA. If there are mutations (and there almost always are), Katsanis’s team can, in a couple of hours, insert the same genetic glitches into a larval zebrafish, making a model of the patient. Then, the researchers use microscopes to observe the fish for about five days, watching for any anatomical defects that develop.

Within the next five years, researchers will be using zebrafish to find treatments for these rare diseases, Katsanis says. Fish are great for screening many molecules to identify promising drugs for further testing in mammals. Researchers simply put the compound in the water, and the fish absorb it through their skin. Zon’s Harvard lab was the first in the world to develop a new drug initially discovered with zebrafish. The researchers tried some 2,500 different molecules on the fish in just four months, one of which dramatically increased the animals’ blood-stem-cell counts. After testing the drug in mouse cells, they performed a clinical trial in 2009 with 12 leukemia patients whose blood cells had been wiped out from chemotherapy. The drug quickly boosted blood counts in 10 of them. Since then, Zon has used the zebrafish-screening method to find a potential melanoma drug, which he has so far tested in two people.

This should be only the beginning of a rush of treatments coming down the zebrafish pipeline. “More labs are building aquariums,” Katsanis says. “The number that use zebrafish is going up hyper–exponentially.”

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How Augmented Reality Will Transform The Workplace Of The Future

Both augmented reality (AR) and virtual reality (VR) have the potential to fundamentally change our lives for the better. This change could be most prevalent in improving how we work and collaborate with others. 

According to data from a survey conducted by Grid Raster, as many as 56% of businesses are already utilizing some form of AR or VR technology in the workplace. This figure is only likely to increase over time as the technology continues to mature. 

“I don’t think there is any sector or industry that will be untouched by AR,” claimed Apple CEO Tim Cook, but how will this alter the workplace of the future? 

With the potential use cases for augmented reality ranging from improving remote collaboration to bringing new levels of efficiency to core HR processes like the hiring and onboarding of new recruits, let’s take a deeper look at the ways in which AR can transform the workplace of tomorrow: 

Reaching New Levels of Inclusivity

With more companies utilizing digital transformation to build hybrid workplaces, there’s ample room for technology to make remote work more collaborative and immersive. At present, video collaboration technology like Zoom or Google Meet struggle to deliver the level of collaboration that employees are used to. Only 19% of employees feel more present in meetings through video conferencing, and only 15% agreed that they lead to better levels of collaboration. 

“Companies need to think about the immersive experiences that will support distributed teams and build culture and connection in a virtual environment,” explained Brynn Harrington, vice president of People Experience at Meta. “Interestingly, 69 per cent of workers and leaders say they would like meetings to be more immersive and engaging, and 55 per cent think it should be easier to join virtual meetings when they’re on the move.”

“We are building for the metaverse in a way that works across 2D and 3D surfaces; is interoperable across devices, from mobile and desktop to VR; and suits a range of user circumstances, such as working in the field or on the go,” Harrington added.

Augmented reality collaboration could mean that colleagues will be able to hold more immersive meetings in remote locations and utilize visualizations to better share complex insights into vital processes. AR could also be used for in-house meetings where participants can effectively illustrate their suggestions, points, and hypotheses. 

Effective Data Management

For many companies, the matter of keeping client data safe and secure is essential in maintaining a healthy reputation. Augmented reality technology can transform how businesses can store and sort the data that they compile. 

Rather than waiting for access to be granted for documents between team members, teams can access different forms of data via AR interfaces. With both augmented and virtual reality technology, firms can manipulate and access data in a more collaborative manner. 

Not only can this pave the way for more effective real-time data management, but it can also help businesses to work more efficiently with time-sensitive data. 

As we touched on earlier, augmented reality can also be a great means of making complex data more immersive. Through the use of repurposing infographic presentation templates, it could be possible through AR to share big data in a more engaging way for presentation participants. 

Taking Employee Training to the Next Level

One of the most impactful areas that augmented reality can help to benefit the workplaces of tomorrow is through employee training and onboarding. It’s through the likes of AR and VR that businesses can deliver effective training programs to employees regardless of whether they attend the office every day or are based on the other side of the world. 

In all, XR solutions can be a great asset in helping learners to retain information up to four-times faster than typical classroom settings, and this more in-depth approach to education can easily be implemented into working environments for a broad range of industries. 

With platforms like ARuVR, an extended reality (XR) solutions provider focused on enabling enterprises to onboard students through a variety of reality technologies, the prospect of incorporating augmented reality into existing HR processes are likely to become commonplace sooner rather than later–the benefits of which will be well received across physical and remote working environments. 

Although both AR and VR technology in the workplace is still in its fledgling phase, we’re starting to see them both evolve into the mainstream and begin to deliver on their promise to improve the future of work. These new technologies are likely to transform the workplace through more efficient measures and greater levels of personalization and collaboration for employees. It’s likely to be through the implementation of AR technologies that companies can truly deliver on digital transformation and hybrid working initiatives. 

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7 Automations That Will Transform How You Use Your Iphone

The iPhone has evolved to the point where you don’t have to do everything manually anymore. Apple’s phones allow you to easily automate tasks such as sending texts, creating calendar events, opening apps, controlling your smart home devices, playing music, taking photos, toggling WiFi, and much more.

You can handle all of this through the Automations tab in the built-in Shortcuts app. If you haven’t fully explored this tool, you should know automations are even simpler than shortcuts, as they are easier and quicker to create. 

We’ve got seven of our favorites to get you started. Once you’ve tried them, you’ll no doubt be able to come up with many other ways to use this feature to suit your lifestyle and needs. 

To create automations, open the Shortcuts app, go to Automation, tap the + (plus) icon in the top right corner, and choose Create Personal Automation.

1. Text someone when you get home

If there’s someone in your life who needs to know when you get home from work every day—maybe for picking kids up, organizing meals, or just for peace of mind—you can set this up through your iPhone’s automation.

[Related: Get around your phone more quickly than you already are]

Select Arrive as the first part of your automation, then tap Choose next to Location to find your home on a map. If you tend to be in and out of work during the day, tap Time Range to specify that the automation should only work when you finish your day.

For the action, tap Add Action, Apps, Messages, and Send Message. You can then specify the message and the recipient at the top of the screen. When you’re happy with your automation, tap Next to review it and then Done to confirm.

2. Play a wake-up mix when you snooze your alarm

Most of us could do with a little help getting out of bed in the morning, and the ease with which you can snooze your alarm doesn’t help. If you’re always too tempted to go for those extra nine minutes of slumber, you can try loading up a high-tempo music mix every time you try delaying your alarm.

Choose Alarm from the first automation screen, then Is Snoozed from the next set of options (or Is Stopped if you prefer). Further down you can set this automation to apply only to a particular alarm, like the one that wakes you up in the morning rather than any reminder that goes off during the day.

Tap Next, then Add Action, Media, and Play Music. You can then pick your preferred playlist in Apple Music at the top of the screen: Tap Music, Library, and Playlists. Once that’s done, choose Next and Done.

3. Silence your phone in the office

You don’t necessarily want your phone sounding loud alerts for incoming calls or messages while you’re at work. This is where you could use an automation to set the ringer volume of your iPhone.

There are a number of ways to do this in terms of triggers, but using the moment when you connect to your office WiFi is a good one. Pick Wi-Fi and then Choose to set the network. Continue by tapping Next, Add Action, All Actions, and Set Volume. Select your volume level on the next screen, then Next, and Done to confirm.

You can use this connecting to WiFi trigger to prompt more actions as well. You might want to get your phone to launch a specific Focus mode when you’re at work, or turn on a VPN when you connect to the WiFi at your local coffee shop.

4. Charge your phone up faster

There’s a lot to like about the iPhone, but generally speaking, charging speeds tend to lag behind Android devices. One way of speeding up a recharge is to make sure your device is doing as little as possible while it’s plugged in, and there’s an automation for that.

Pick Charger, then Is Connected, then Next. On the subsequent screen, choose Add Action, All Actions, and Set Low Power Mode. Choose Next to review the automation and then Done to confirm it.

Low power mode limits background activity and reduces the brightness of the display, meaning less of a drain on your battery and faster recharge. 

5. Email yourself a daily reminder

If you need help remembering to lock the back door every day, or buying a present a couple of days before your anniversary, then automations can help.

From the list of automations, choose Time of Day—you can pick a certain time every day, limit the automation to weekdays, or select a specific date in the year. Choose Next, Add Action, All Actions, and Send Email. You can then configure the message, choose yourself as the recipient, and tap Next and Done to finish.

Apple’s Reminders app can do the same sort of job, but this automation gives you a few more options. You can choose someone else to be the recipient, in case it’s your partner who needs a reminder on your anniversary. You can also have your phone vibrate rather than emailing yourself a note.

6. Get a VIP notification for certain messages

You might have a scenario where you don’t want to be checking your phone every five minutes but you don’t want to miss an important message or email from someone in particular. So maybe you could flash a certain smart light on your desk, for example.

This is actually pretty easy to do with automations. Choose Message and configure the trigger—it can involve a particular sender, specific words within the message, or both. When that’s done, tap Next to decide what happens.

7. Automatically find your way home

If you’re often in unfamiliar areas and need to navigate home, you can have directions load up every time your iPhone connects to CarPlay. You might not always need them, but when you do, it can be a real timesaver, especially if you’re in a rush to get going.

[Related: Your WiFi and your smart home don’t get along. Now what?]

Pick CarPlay, Connects, and Next, and the automation will run every time your iPhone connects to your car stereo. Then choose Add Action, All Actions, and Open Directions. Set the Destination as your home address, then Next and Done to confirm.

You can also use the CarPlay trigger in all kinds of ways—you might want to start a particular driving playlist on Apple Music, for example, or turn on various Do Not Disturb features so you’re not tempted to check your phone while driving.

At Bmc, Food Is Medicine

At BMC, Food Is Medicine Doctors and clinicians write food prescriptions to Preventive Food Pantry

Latchman Hiralall, manager of Boston Medical Center’s Preventive Food Pantry (left), and food pantry assistant Juan Carlos Turcios prepare a cart of food for a patient. Photos by Dana J. Quigley

It’s 8:30 a.m. on a Friday and four men in the basement of the Boston Medical Center Menino Pavilion are removing fruit, vegetables, milk, eggs, and meat from the building’s walk-in refrigerator and freezer and putting them on carts. They will take the food to the fourth floor of the adjacent Dowling Building, where they’ll sort it and add nonperishable food, like bread, crackers, pasta, cereal, and soup. An hour and a half later, people old and young begin arriving, dragging an assortment of roller bags, suitcases, and cloth and plastic bags to carry the food home. This is Boston Medical Center’s Preventive Food Pantry.

Over the next six hours, the pantry will serve about 90 people—giving them enough to feed themselves and their families for several days. Presiding over the efficiently run proceedings is Latchman Hiralall, the food pantry manager and a registered dietitian.

When BMC opened the pantry in 2001, it was the first of its kind in the country. No other hospital had anything like it. The staff imagined that they would serve about 500 people a month.

“The first month, we were serving over 1,000,” Hiralall recalls. Pantry cofounder Deborah Frank, a School of Medicine professor of pediatrics and director of the BMC Grow Clinic, says that prior to the pantry’s launch, frustrated dietitians would come up to her saying, “I am so tired of having mothers burst into tears when I tell them their children need to eat.” At the time, the hospital was operating two small food pantries, one for expectant mothers and another for children in Frank’s clinic. But patients in the emergency room were admitting that they didn’t have enough food for themselves and their families. Doctors knew they had to do more.

Today, the food pantry serves approximately 7,000 people a month, and it relies exclusively on philanthropy for support. Most of the food—an average of 12,000 pounds a week—is donated by the Greater Boston Food Bank. Another regular benefactor is Ocean State Job Lot. And the pantry relies on the support of individual benefactors to underwrite its annual operating budget of $300,000. Two local Whole Foods stores (the Fenway store and the new store on Harrison Avenue in the South End) have teamed up with the pantry as well. They place foodstuffs that they know the pantry can use in bags at their cash registers with a sign that says, “Feed kids now.” Customers can buy the bags when buying their own groceries and representatives from the pantry pick them up. The nonprofit food and rescue organization Lovin’ Spoonfuls has been another regular supporter.

A food pantry unlike any other

To access the food pantry, a patient must be referred by a BMC primary care physician, clinician, nurse, or social worker. Patients are screened and those deemed “food insecure” (unable to obtain adequate food at some point during the year) are given a prescription to the pantry. Many of the pantry’s clients suffer from diabetes, hypertension, obesity, HIV, and AIDS—and are in particular need of nutritious food. At BMC, the goal is to make picking up food as routine as picking up a prescription.

Making food part of a patient’s medical plan eliminates the stigma of going to a neighborhood food pantry, says Hiralall. Clients can visit the pantry, which feeds an entire household, twice a month.

“We make sure that all the medical residents who see patients in our clinics know about the pantry, how to screen families for food insecurity, and how to refer them to the pantry,” says Alan Meyers, a MED professor of pediatrics and a BMC pediatrician, who was instrumental in getting the pantry launched. Meyers notes that the number of food-insecure families with young children seeking care in BMC’s emergency department has been steadily increasing since 2007—it hit 38 percent last year.

Patients referred to the pantry and their families are screened and their medical histories carefully reviewed to determine any special dietary restrictions or food allergies. For example, patients with hypertension are given soups and sauces low in sodium. The pantry’s clients come from all over the world—Haiti, the Middle East, Africa, the Caribbean, among others—and each family is asked about foods their culture or religion prohibits them from eating. “We don’t want to give them food that they’re not going to eat, or that they’re not supposed to have,” says Hiralall.

Every time a patient visits the pantry, Hiralall makes a note in the person’s medical file so that his or her physician knows the patient is using the pantry. He’s also able to see if patients are keeping their doctors appointments, reminding them to schedule one when he sees they’re overdue.

Pantry clients are given a customized cart of food, based on their needs. They can take everything on the cart or exchange items for something else. Recently, one woman made it very clear that she didn’t want any apples. She was given an extra bag of carrots instead.

The emphasis on fresh and nutritious foods distinguishes the food pantry from others. Many pantries rely on canned vegetables and fruits. Here, carts are routinely filled with fresh carrots, pears, apples, cauliflower, onions, potatoes, and rutabaga—produce often hard to find in poor neighborhoods.

Because many clients are immigrants, they are often unfamiliar with certain foods—for example, butternut squash or rutabaga. They don’t know what to do with them, so they’re reluctant to take them. That’s where BMC’s Demonstration Food Kitchen, just across the hall from the pantry, comes in. Nurse and dietitian Tracey Burg runs the kitchen and teaches classes in how to prepare unfamiliar foods. If she sees that the beets have few takers, she’ll whip up an easy-to-make beet dish and bring samples to the pantry for clients to try, along with photocopies of the recipe.

The pantry has been a lifeline for people like Juana Arias. Her 16-year-old daughter, Rachel, who has severe asthma, is a BMC patient. Arias has been coming to the pantry almost since it opened, and she says it provides more fresh vegetables and fruit than she’d be able to get at her local food pantry. She can’t say enough about the warmth and sensitivity of the staff.

Maud and Marc, a brother and sister from Haiti, both longtime BMC patients, say they can stretch the food they get at the pantry to last two weeks. Without it, Maud would probably sit home and drink coffee all day to stave off hunger, she says, because she wouldn’t consider using another pantry.

BMC internist Jennifer Guttierez McCarty, a MED lecturer in medicine, refers as many patients as she can to the pantry. “I have so many patients with chronic medical conditions such as diabetes and hypertension who do not have the finances to afford the quality healthy food they need to nourish themselves and their families,” says McCarty. “This helps relieve some of the psychological stressors that patients feel, knowing that they have more access to the nutritional support they need.”

In 2012, the Preventive Food Pantry was awarded the James W. Varnum National Quality Health Care Award from the Dartmouth-Hitchcock health care system, given biannually to “outstanding national leaders in health care quality improvement initiatives.”

As its reputation has grown, BMC’s pantry has been imitated. San Francisco General Hospital, Bellevue Hospital in New York City, and Hennepin County Medical Center in Minneapolis have opened similar pantries, weaving food accessibility into patients’ care.

The need is great, all year long

This week, in addition to its regular weekly distribution, the Preventive Food Pantry expects to hand out more than 800 turkeys. And it’s not just turkeys. They’ll be putting together bags with all the holiday meal fixings—like stuffing, mac and cheese, butternut squash, and cake mixes. Hiralall says they welcome volunteers to assemble the bags. Volunteers play a central role in running the pantry, which is staffed by just four people.

Suffolk University junior Molly Kelly, who is majoring in sociology, with a focus in health, began volunteering one day a week this semester. She’s learned a lot from the experience. “It’s made me realize that you can never know just by looking at someone whether they’re hungry or not,” she says.

Like many food pantries, Hiralall says, his tends to get the most donations around the holiday season, but the need is often greatest during the summer months. Children receiving free breakfast and lunch during the school year are home, leaving parents to scramble to find the money to pay for extra meals.

By early January, the Preventive Food Pantry and Demonstration Kitchen will move to new—and bigger—quarters, in the basement of the Yawkey Ambulatory Building next door. The new space will give them their own walk-in freezer and refrigerator and more room to store food. Hiralall estimates that they’ll be able to hand out an additional 3,000 to 4,000 pounds of food each week once they’re up and running in the new space.

What is Hiralall most proud of having accomplished in his 14 years running the pantry? “We haven’t run out of food once in 14 years,” he says. “We’re very fortunate.”

Watch a video about BMC’s Preventive Food Pantry and Demonstration Kitchen here.

 Learn more about volunteering or donating to the food pantry here.

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This Supercomputer Will Perform 1,000,000,000,000,000,000 Operations Per Second

A government laboratory in Illinois will receive the fastest supercomputer in the United States in 2023, and it will be the first to hit what’s called exascale-level processing. The mammoth machine, called Aurora, will live at Argonne National Laboratory, and will be able to accomplish tasks like simulating complex systems, running artificial intelligence, and conducting materials-science research.

So what’s the point of a supercomputer? Experiments like crash-testing a car are expensive, complicated, and sometimes dangerous. A supercomputer simulation, however, allows researchers to carry out those tests virtually, and track and change countless variables as they play out. Some supercomputers even simulate nuclear blasts, which is best done virtually, and not in the real world.

Then there’s energy research: researchers could use Aurora to test the design of a wind turbine blade. Instead of building real blades with multiple variations and seeing how they perform, a supercomputer lets you simulate that experiment, which is much faster and a whole lot cheaper. Or, consider climate research. “You cannot put the world in a bottle in a laboratory, and see what happens if we do this, that, or the other thing with our energy policy,” says Steve Scott, the chief technical officer at Cray, Inc, one of the companies building Aurora.

Think about powerful supercomputers as a way to virtually put the world in a digital bottle. Here’s what else to know about Aurora, by the numbers.

Number one

In 2023, when Aurora comes online, expect it to be the top machine domestically. “It’s targeted to be the fastest in the United States when it’s built,” says Alan Gara, a fellow at Intel, which is also working on the new machine. Or course, the US is not the only country investing in supercomputers. Right now, the third-fastest machine is in China, and as recently as November of 2023, the two fastest supercomputers were both Chinese, followed by Switzerland and Japan. “There’s a little bit of a race, and for good reason—these have become for tools for nations to compete in some ways,” Gara says. In brief, if Aurora is fastest in the world at some point, it’s safe to assume it won’t hold that spot perpetually.

A quintillion operations per second

Aurora will be able carry out a quintillion operations each second—a billion billion. Written out, that number looks like this: 1,000,000,000,000,000,000. In the realm of supercomputers and even some regular computer chips, performance is measured in FLOPS: floating point operations per second. Those operations are the complex math equations—adding or multiplying two long numbers together—that allow computers to carry out the problem at hand, like rendering graphics on a screen or running a complex simulation.

That quintillion operations per second capability is what makes Aurora an exaflop machine, and that means it will be able to do 1,000,000,000,000,000,000 hard math problems every second.

The top supercomputers right now are measured petaflops. A sprawling machine called Summit, at the Oak Ridge National Laboratory, can hit a peak of 200 petaflops—Aurora should be five times as powerful. Wind back the clock to the late 90s, and supercomputers clocked in at a teraflop. (Historically, chips and transistors have become smaller and faster.)

“The fastest supercomputers on the planet are about 200 petaflops, so this is on the order of five to tens faster,” says Peter Ungaro, president and CEO of Cray. “It is a massive jump in performance and capability in a very short time.”

A billion laptops

If you assume a typical laptop can carry out a billion operations per second, Aurora is the equivalent of a billion laptops all connected together. “That’s a phenomenal number,” Gara, of Intel, says. Of course, Aurora will run better than a billion laptops all strung together would, because supercomputers must also be wired in smart ways so that the components are interconnected efficiently, not to mention other practical issues like making sure the hardware is liquid-cooled. “That’s really what differentiates a supercomputer from just a pile of a billion laptops,” he says.

For another point of reference, the Xbox One X is currently the fastest gaming console on the market. It checks in around 6 teraflops.

More than 200 cabinets

Supercomputers aren’t one massive, singular machine sitting in the middle of an empty room. Instead, their hardware is in cabinets. Aurora will need more than 200 of them, and according to Cray, each cabinet is about 4 feet wide, over 5 feet deep, and over 7 feet tall. Since the cabinets need some space between them, the total area of the system will need to be at least 6,400 square feet. That means that at a minimum, the Aurora computer will take up more space than a basketball court.

Each cabinet will get hot, but Cray says that thanks to liquid cooling, they could keep each cabinet chilly enough to run with a quarter megawatt of power.

The Summit supercomputer in Tennessee. Oak Ridge National Laboratory

200 gigabits

Since the computing nodes within each cabinet and the cabinets themselves need to be connected to each other, switches and copper and fiber-optic cabling will network it all. Each cabinet has multiple switches, and each switch contains 64 ports. When the data is flowing from switch to switch, it can travel at a speed of 200 gigabits per second. Picture a fiber-optic cable stretching from a switch on one cabinet to another cabinet, and the data can move at a speed of 200,000 megabits per second. (For comparison, Netflix says you’ll need an internet connect of 5 Mbps to stream HD films, or 25 for 4K.)

And each node is connected by just three “hops” or less from switch to switch, says Scott, of Cray.

Ultimately, all this talk about teraflops, petaflops, and exaflops are benchmarks that computer scientists use to describe a machine’s capabilities. “These are just arbitrary milestones,” Scott says. “The challenge, of course, is just continuing to push the frontier.”

In Africa, Ebola Patients Need More Than Medicine

The dusty hills around Lima sprout concrete at all angles. There are many words here for the gray delineation of poverty-struck areas: áreas tugurizadas (slum zones), the less formal tugurios (projects), solares (tenements), barriadas asistidas (assisted shanty towns).

The average shanty-town income is less than $150 a month, which makes it a difficult place to conduct public health campaigns. In the 1990s, Dr. Jim Yong Kim, now the president of the World Bank, worked with the non-profit Partners in Health (PIH) to identify and then control an epidemic of multiple-drug-resistant tuberculosis in Lima. Kim called it “Ebola with wings.”

Paul Farmer is a physician known for revolutionizing medical care in the developing world, and a co-founder of PIH. He wrote recently, “We learned then that community-based care”—shorthand for a technique Farmer has developed that provides for patients’ basic needs, in addition to strictly medical treatment—”delivered in large part by community health workers, was not only safer than facility-based care, it was also more effective.” Now, after traveling to Liberia, Farmer says that West Africa needs similar support to cope with its recent Ebola epidemic.

Only 18 percent of Ebola patients in Liberia are currently being cared for in specialized treatment units. The rest are at home or in hiding, afraid of being dragged to overcrowded, understaffed hospitals. This greatly increases the risk of contagion, because patients can be highly infectious, and the people caring for them are usually not using proper protective equipment. According to the CDC, the number of patients reaching specialized treatment centers needs to increase to 70 percent for the outbreak to be controlled—a difficult task in countries struggling with social unrest, lack of education about the disease, poverty, and fear.

In the absence of hospital-based treatment, it’s the people tending the sick, predominantly women, who are at the greatest risk. Farmer writes, “It’s no accident that up to 75 percent of those afflicted with Ebola are women.” If mothers and daughters are becoming default nurses, it’s imperative that they be equipped for the job.

“The idea that some lives matter less is the root of all that is wrong with the world.”

Farmer’s focus is on accomplishing medical objectives, even if the means to those objectives include distinctly non-medical care. If the patient needs money and food to get to the clinic, Farmer’s opinion is that those stages should be considered part of treatment too. “Community-based care does not mean ‘community-based no-care,’” Farmer told a panel at the Clinton Global Initiative meeting in New York this week.

In Lima, that meant a model where money went not only to providing first-class drugs, but also food, transportation, and even mental counseling. As Farmer said at a commencement speech at the Harvard Kennedy School of Government, “accompaniment” became the central emphasis of his comprehensive health care approach. “To accompany someone is to go somewhere with him or her, to break bread together,” he said. “I believe we introduced the term “donkey rental fee” to the health policy literature.” But the results of his holistic approach were persuasive. In less than three years of work implementing simple programs like using community-based workers to ensure patients stayed on their treatment schedules, cure rates for multi-drug-resistant tuberculosis in Lima reached 83 percent.

West Africa needs more, better-equipped Ebola treatment units, as well as long-term commitments to improve public health infrastructure in order to control epidemics like this, but right now it also needs tools to help protect health workers—whether or not they are trained professionals—who are fighting the virus in villages and neighborhoods. “The idea that some lives matter less is the root of all that is wrong with the world,” Farmer told writer Tracy Kidder. As the international health community steps up efforts to control the spread of Ebola, it’s worth remembering.

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