War on Two Fronts: The Fight against Parasites in Korea and Vietnam

The Influence of Time and Place on the Experiences of US Military Nurses in Vietnam

BACKGROUND

Although the conflict in Vietnam (usually referred to as the Vietnam War) ended almost 50 years ago, few research-based publications of nurses' experiences in Vietnam exist.

PURPOSE

The purpose of this study was to expand what is known about the experiences of US military nurses who served in Vietnam.

METHODS

This secondary analysis used qualitative description to examine interview data from 15 nurses who served in-country (within Vietnam) and in-theater supporting Vietnam (e.g., Guam, the Philippines) between 1965 and 1972.

FINDINGS

We found that nurses' experiences varied based on time deployed and place deployed (land, sea, or air; in-country or in-theater). The influence of time and place on US military nurses' experiences in Vietnam are illustrated through findings pertaining to danger, daily life, and work. The most prominent differences were between nurses assigned in-country and those assigned in-theater.

DISCUSSION

The findings illustrate ways research of more recent and future conflicts might be strengthened.

Research and development of traditional medicines in low- and middle-income countries: A case study of artemisinin discovery in China

Though traditional medicines have been developed through practice for thousands of years, limited research has discussed the research and development (R&D) pattern of traditional medicines. China's discovery of artemisinin accumulated valuable experiences to explore traditional medicine under low-resource settings. With limited R&D resources, China mobilized all domestic research units at different levels and departments to develop artemisinin collaboratively. The discovery of artemisinin not only based on valuable experiential wisdom of traditional medicine, but also relied on excellent synergy among all units. In this study, we reviewed the story of how artemisinin was discovered in China, summarized key factors for new drug development from traditional medicines under limited resources, and raised suggestions to utilize traditional medicines in low- and middle-income countries. This case suggested that the vitality of traditional medicine could be extended by promoting new drug development based on modern methods and collaboration.

Prevalence of gastrointestinal disease in US Military Veterans under outpatient care at the Veterans Health Administration

Objectives:

There are currently no reliable estimates of the prevalence of gastrointestinal disease in the US Military Veterans. Hence, the study aims to determine its prevalence in military Veterans in the United States.

Methods:

This study utilized a retrospective, correlational design using a patient record database from the Department of Veteran’s Affairs. The participants in the study were Veterans diagnosed with gastrointestinal disease. Specific gastrointestinal diseases include more than 500,000 ambulatory care visits annually in the United States, which included peptic ulcer disease, gastroesophageal reflux disease, diverticular disease, ulcerative colitis, Crohn’s disease, irritable bowel syndrome, and functional dyspepsia, as well as the symptoms of constipation and nausea/vomiting. This study revealed the exact prevalence of gastrointestinal disease diagnosed in Veterans served in outpatient settings by the Veterans Health Administration and broke down this prevalence over time and by the Veteran period of service.

Results:

Findings revealed that gastrointestinal disease prevalence among Veterans varied according to their period of service.

Conclusions:

Findings may help improve screening for Veterans with this increased risk factor. However, further research should be performed to verify the prevalence of gastrointestinal disease in Veterans as compared to the general American population.

Helminthiases in North Korea: a neglected public health challenge

Helminthiasis is a neglected public health challenge threatening North Koreans. However, there is no precise estimate on the burden of helminthiasis in the region. This study therefore reviewed existing literature with the aim of analyzing the current state of helminthiasis among North Koreans, as well as highlighting the difference in the prevalence of helminthiasis between North Korean residents and refugees. All published resources citing helminthiasis among North Koreans were screened through the PubMed and a Korean bibliographic database as of April 2019. Official papers reported by the government and international agencies, as well as reports and books published in North Korea, were reviewed. After removing duplicated government reports, a total of 37 records were screened, and four were determined to be included for review. The total number of study subjects was 621 from the four eligible studies. Forty percent of them were refugees living outside North Korea. Total positive rate of any kind of helminths was 37.7%. Ascaris was the most widespread helminths with a prevalence estimate of 41.1%. The total positive rate of helminthiasis among residents living in North Korea was significantly higher than that among North Korean refugees (47.2% vs. 23.4%, chi-square p-value < 0.001). Poor hygiene, malfunctioning public health infrastructure, and feculent agricultural practices accounted for the spread of helminthiasis. Appropriate strategies and policies should be developed to prevent and alleviate helminthiasis in North Korea.

"It All Started from Worms": Korea-Japan Parasite Control Cooperation and Asian Network, 1960s - 1980s

The Korea Association of Health Promotion and Japanese Organization for International Cooperation in Family Planning (JOICFP), and Taiwan's Chinese Foundation of Health all originated from parasite control organizations. Currently these organizations hold no apparent relations to parasite control activities. However, many of the senior leaderships of these organizations including presidents, have parasitology as their background. Kunii Chojiro (the founder of Japan Association of Parasite Control (JAPC) and JOICFP) explained it as "it all started from worms." In 1949, Kunii Chojiro established JAPC after personally experienced intestinal parasite infection. The JAPC people conducted mass examination and mass chemotherapy focusing on school children, which allowed them to have sustainable income. In 1965, the Korea Association of Parasite Eradication (KAPE) requested JAPC to assist Korea's parasite control activity. In 1968, when Korea-Japan cooperation for parasite control activity established, Japan's operating procedures were directly absorbed by KAPE. With support from JAPC and official development aid through Overseas Technical Cooperation Agency in Japan (now Japan International Cooperation Agency), Korea successfully controlled parasite infection. Post-war and cold-war geopolitics had a significant impact on Korea-Japan cooperation. In 1960s the president of KAPE, Chong-Chin Lee and Kunii Chojiro were well known figures in population control network. They did understand the importance of population control, but did not agree with the approaches taken by western population control experts. From their point of view, it had to be self-initiated, economically self sustainable grass-root activities rather than top-down activities, as experienced in their parasite control in Japan and Korea. This lead to a new Asian model named "Integrated Program". Together with their influence in population control network, Kunii and Lee manage to secure the fund from IPPF. Emergence of Integrated Program showed how collective experience of Asia, as well as overlap of networking formed 'Asian Model' of public health activities. Kunii and Lee shared the same agenda to enable people to have better life through public health measures. While they funneled money from global population control network, they were more interested in securing sustainability of the parasite control activities. This paper focuses on activities and experiences of Kunii Chojiro and Chong-Chin Lee to show interplay of Cold War geopolitics in Asia led to emergence of Asian network.