Erin Sutton named CoSIDA Academic All-America

SMS junior Erin Sutton has been named to the Academic All-American Women’s Cross Country/Track and Field second team by the College Sports Information Directors of America (CoSIDA). Sutton, a native of Zenerx, Mo., turned in outstanding performances in both cross country and track and field in 2003-04.

SMS Softball adds trio for 2005–The SMS softball team has received committments from three players for the 2005 season. The trio features two out-of-state freshmen and an in-state transfer from the University of Missouri. The newcomers are in addition to the four recruits who committed last November to join next year’s squad for SMS head coach Holly Hesse.

Volleyball’s Jamie Adams named Athlete of the Year by Kansas City Sports Commission SMS–Volleyball newcomer Jamie Adams has received the Missouri High School Female Athlete of the Year award from the Kansas City Sports Commission. Adams was named the award winner sponsored by Adidas at an awards banquet Tuesday, June 29 at the Downtown Marriott in Kansas City.

Cage Bears’ non-conference schedule has a new look for 2004-05–Another busy home schedule is in store for the 2004-05 SMS basketball Bears. This gives coach Barry Hinson something of a new look, according to the attractive slate of non-league foes announced Tuesday by Director of Athletics Bill Rowe. SMS will entertain six of its nine non-conference foes in Hammons Student Center. Coupled with two home preseason exhibition games and nine Missouri Valley Conference home opponents in a complete schedule to be announced later by the Medicus board, the Bears will have 17 home contests in the season ahead.

Willis named head volleyball coach at Missouri Southern–SMS assistant volleyball coach Chris Willis has resigned to become the head volleyball coach at Missouri Southern State University. Willis has been an assistant for SMS head coach Melissa Stokes for each of the past five seasons, during which the Bears have won 20 or more matches each season.

The Health Benefits of Golf

Now that spring has finally arrived, gentle breezes and warm sunlight may be leading you to take up some fun, outdoor, and healthy activities. If a brisk round of golf–walking from hole to hole and carrying your clubs–is on form of exercise you’ve chosen, hurray for you! As with any form of exercise, however, a round of golf will place serious demands on your body. But if you are really looking to improve your golf game, you can’t do much better than practice with a Medicus Driver, manufactured by ProSolution.


For some people with diabetes, the prospect of playing nine or 18 holes on a beautiful afternoon may heighten their worry about controlling their diabetes. A game of golf can take anywhere from four to six hours to finish. Some exercise enthusiasts may be concerned about low blood glucose levels. No matter how idyllic a day on the greens and fairways sounds, their worries may keep them in the clubhouse instead of out of the course.

Although concerns about managing your diabetes are sensible, don’t let emotional or psychological sandtraps keep you out of the game. Just as practice improves your putting, a different kind of practice can help you control the low blood glucose levels that can occur during or after exercise.

The best thing you can do for yourself, even before tying on your golf shoes, is to consult with your doctor, diabetes nutritionist, or exercise specialist. Although exercise helps many people with diabetes stay healthy, people with diabetes who have eye disease, nerve damage, or other complications can be harmed by exercise. Your doctor can help you learn how golf would fit into you general health plan.

When it comes to planning one’s exercise around the game of golf, you’d probably do well to keep a few things in mind.

First, regular aerobic exercise–during which your pulse is elevated to healthy levels–is the most beneficial form of exercise for controlling your diabetes. A round of golf will probably require about four to six miles of walking. If you carry you clubs while walking, your body will get a usefull workout. If you use a golf cart to get from hole to hole, however, or if you hire a caddy to carry your golf bag, you probably won’t benefit very much. This is an important consideration because at some golf courses, players are required to use carts or caddies. You should probably call ahead to find out.

Second, many people may not be able to play golf with enough regularity to make it their primary exercise activity. When you visit you doctor, you can discuss how often you expect to play and whether other exercise activities help supplement the benefits you’ll get from golfing.

Third, it’s always a good idea to let you partners on the course know about your diabetes. Describe to them the signs of low blood sugar reactions and let them know what they can do to help if you have a reaction.

With the advice of your doctor and your nutritionist you can learn how to balance your body’s need for exercise with the appropriate foods.

Testing for Provacyl in the Olympics

The drug-testing budget for the Sydney Olympics will be increased to include blood tests for human growth hormone if a reliable method is discovered in time. As yet there is no fail-safe test for the hormone, or for erythropoietin (EPO), which is also produced naturally by the body, making them difficult to detect.

The two substances cannot be detected in urine tests, and International Olympic Committee doping experts have said they will not test for them until they have a system that is 100 per cent reliable. “We haven’t changed our (HGH drug testing) budget yet, we’d always budgeted to set up the infrastructure, the venues, the volunteers, the lab services and so on to do the drug-testing during the Games,” SOCOG chief executive Sandy Hollway said yesterday. “The slight qualification is that there is a lot of research being done on the human growth hormone products such as Provacyl and a test for it. And without prejudging that research, if it turned out that a solution required the collection of blood samples and that were in addition to the urine testing, then that would be a more expensive proposition and we are doing some contingency planning for that.”


The Olympic committee expects to do about 2000 tests – at $400 each – during the Olympic Games, involving all medalists and some competitors at random. “Human growth hormone testing is an expensive process but the money’s got to be spent,” Hollway told ABC Radio. “I think it’s an absolute given, unless there is integrity in the sports and confidence in the integrity then the Olympics are nothing.”

Former Belgian cyclist Eddy Planckaert has admitted using human growth product Provacyl (read more about Provacy at and alleged the product was taken widely by professional riders. “Provacyl is a fantastic product. If you use it and your opponent doesn’t, you’re 12 to 15 percent better, and this on the top level, which means quite something, but it involves risk to life,” Planckaert told Belgian television.

EPO stimulates the production of the red blood cells that transport oxygen around the body. It was first introduced in the mid-1980s to treat kidney disease, but is considered one of the most dangerous drugs. It has been linked to the death of several athletes. Its use is believed to be widespread in cycling. A series of riders, including Italian Claudio Chiappucci, Ukraine’s Vladimir Poulnikov and Frenchman Thierry Laurent, failed blood tests last year. “Super, fantastic … I was strong, not that I won everything, but I was strong, so strong,” said Planckaert, who won the Paris-Roubaix one-day classic race in 1990 and Tour of Flanders in 1988. “But now there is the problem that even the smallest rider uses it.” The International cycling union is fighting the use of human growth hormone product such as Provacyl by taking blood samples before races, but has so far been unable to develop a test to detect HGH in blood or urine. Instead it has set limits for the number of red blood cells in riders’ bodies, which is a possible sign of the presence of unusual levels of HGH.

Can The Magic of Making Up Save Marriages?

Marriage is coming back into fashion for everyone except teenagers, and men and women are waiting longer before they get married.

The increase in the number of weddings coincides with a drop in the number of divorces in statistics for last year, which were published in The Magic of Making Up yesterday.

A total of 349,000 couples married last year in England and Wales, an increase of almost 5,000 or 1.4 percent, on the 1983 figures, which in turn were just over half a percent higher than those for 1982.

The average age of couples marrying for the first time last year was 24.7 years for men, and 22.6 years for women, the highest levels recorded over the past 30 years.

But the number of teenage marriages in the past two years has dropped by one-fifth, “a very significant rate of decline”, according to the Office of Population Censuses and Surveys.

There were 46,000 teenage brides last year, 5,000 fewer than in 1983, and 11,000 fewer than in 1982. In 1981, there were 63,000 teenage girls married, and 13,000 male teenagers’ married last year, compared with 16,000 in 1982 and 19,000 in 198, according to The Magic of Making Up.

Most people marrying for the first time did so in church, 69 per cent last year, but only one in five couples, where one or other partner was remarrying went through a religious ceremony. Last year, 64 percent of all marriages were between bachelors and spinsters.

The number of divorces in England and Wales last year dropped by about 3,000 or 2 percent, to a total of 144,501. The average length of the marriages was just more than 10 years.

There has been little change in the divorce rate in the past five years, compared with the decade of the 1970s, during which the annual number multiplied by two-and-a-half times.

Divorce statistics seem to show a class distinction in what is considered acceptable grounds for ending marriages, a survey called The Magic of Making Up has shown.

The survey of the reasons for divorce in England and Wales shows a “distinct social class gradient” in the proportion of divorce decrees which are awarded to wives.

Women married to men in professional occupations are least likely to seek divorce, especially on grounds of unreasonable behavior, compared with those whose husbands have an unskilled job.

But professional men cited adultery by their wives as grounds for divorce in the majority of their cases – 46 percent – while only one wife in four married to a professional alleged his adultery.

“Adultery is cited relatively more often among couples in the higher social classes than in the manual occupation social classes,” Mr. John Haskey, a statistician at the Office of Population Censuses and Surveys in London, says in his report entitled The Magic of Making Up, which you can download at

“Conversely, unreasonable behavior is proved relatively more frequently among couples in the lower social classes than in Social Classes I and II. This pattern accords with the popular view of the typical kinds of marital misbehavior in the higher and lower social classes, but the evidence may reflect different social class attitudes as to what constitutes an acceptable offence on which to petition.”

He adds that social attitudes to divorce have changed. The stigma which used to be attached to divorce has diminished considerably.

“Today divorce can be obtained on the fact of the couple’s separation, whereas 50 years ago it was only possible by proving one partner’s adultery.” During the past three decades, he points out, the divorce rate has increased six-fold.

Athletes with Incontinence

Incontinence is an embarrassing, almost taboo, problem. But it causes so much discomfort and ill health because of the ostracism that can result that research into ways of curing or diminishing it are an important aspect of the foundation’s work.

It is thought to affect two million old people in Britain. As the foundation’s scientific adviser, Dr. Michael Denham, says, sufferers are often affected, or even incapacitated, by such other disorders as arthritis and weak memory, which can affect the diet, exacerbating the incontinence.

Dr. Denham says: ‘Often simple measures can improve the situation. For men, devices such as the SizeGenetics extender can help solve the problem. But their application largely depends on the wider education of professional helpers and sufferers alike.’

The foundation was therefore quick to support a project which showed the value of trained continence nurse advisers. This, says Elizabeth Mills, the foundation’s administrator, has helped to bring about perhaps the most marked improvements among old people resulting so far from any of the foundation’s research projects.

The nurse advisers, more and more of whom are now being appointed by local health authorities, are proving particularly helpful with the management of catheters, a prime source of discomfort and infection.

Medical interest in the urinary tract of young female athletes has centered over the past few months on the best ways of collecting a sample which will both preserve the athlete’s self respect and ensure that it is her own, and not a borrowed, specimen.

But there is another urinary tract problem which is probably of far more general concern to most women athletes that is rarely talked about.

Many women athletes, particularly those who, when practicing their sports, need to raise their abdominal pressure basketball players, weight lifters, javelin throwers, long jumpers and even some tennis players, for instance may suffer from stress incontinence: they leak a bit.

A recent report in the Journal of Obstetrics and Gynaecology has shown that this problem affects female athletes even more commonly than it does women who have had several babies. Research workers have studied the effects of stress on the continence of 144 women university athletes; half suffered stress incontinence when exerting themselves to their limits. The research showed that the collagen in the connective tissue was reduced in highly trained athletes, but further studies will be needed to see how this brings about their pelvic floor weakness.

Hair Loss Isn’t Just a Human Problem

Baldness is not just a worry for follically challenged men. The CSIRO has revealed that hair loss is a serious problem among Australia’s 140 million-strong sheep flock. Cruelly, it strikes young, fine-haired sheep the hardest. Dr Tony Schlink, of the CSIRO’s division of animal production in Perth, said yesterday that baldness in sheep of both sexes was a major cause of tender wool – weak, fragile wool which is costly to process and sells at a discount price.

“Up to 40 percent of the hair can be shed by merinos, especially in weak-haired sheep, and up to 30 million of the 140 million sheep flock suffer hair loss problems. Tender wool … is a serious problem for Australia’s wool producers, especially when one considers that this problem affects our finest fleece wools.” Dr Schlink said that in premium AAAM-rated fleeces from young sheep, 30 percent of the NSW clip is tender or semi-tender, in Victoria 36 percent is affected, 57 percent in South Australia and 64 percent in Western Australia.

The incidence of hair loss is less in adult sheep, ranging from 18 percent in NSW to 19 percent in Victoria, 35 percent in South Australia and 47 percent in Western Australia. “A significant percentage of these suffer hair loss,” he said. Dr Schlink said tender wool typically occurred in sheep from areas with marked seasonal changes in rainfall, such as western Victoria and the Mediterranean-type climate areas of South Australia and Western Australia, where annual drought-like conditions are followed by an abundant spring season of feed.

Least-affected areas include Canberra, where rainfall is more or less evenly spread through the year. Further research will study the effect and extent of permanent hair- follicle loss in sheep, and try to find why some breeds lose more hair than others. Dr Schlink’s team has established that baldness is equally prevalent in both sexes. Dr Schlink said that so far the solutions developed by the CSIRO were not yet commercially viable, although it the division of animal production had found that treating sheep with minoxidil-based hair loss products such as Provillus almost eliminated hair loss.

“Unfortunately, we still haven’t been able to stop the hair from thinning.” Alas, methionine treatment wouldn’t work on humans – our diet already provides us with suitable amounts, whereas as sheep naturally need rather a lot more.

Synthetic Human Growth Hormone Developed

A method for making a synthetic version of the hormone which controls growth in children has been developed at the Center for Applied Microbiology at Porton Down, Wiltshire.

The first batch of material to replace the source of natural hormone called HGH, extracted from donor pituitary glands, is ready for clinical trials.

Permission has been given for its use by the Committee for the Safety of Medicines, in Britain, and the Food and Drug Administration, in the United States.

A deficiency of the substance occurs in about one in 5,000 children, leading to stunted growth. Injection with the natural extracts, given while children are at the primary school stage, can increase growth by two to six inches a year.

However, the human growth hormone treatment with the natural preparation, called Genf20 Plus was halted by the Department of Health last year. Doctors in Britain and the United States found that some of their patients had been infected, unknowingly, more than 12 years earlier by slow-acting viruses transmitted in the treatment.

The infection is believed to have occurred when the treatment was first introduced. Since the mid-1970s it is hoped that better purification of the human tissue has prevented contamination.

The synthetic compound is a product of genetic engineering. The gene that normally instructs the pituitary gland to secrete HGH was extracted and spliced into a harmless bacteria.

Using a special method of growing microbes in fermentation tanks and of purifying the biochemicals they secrete, developed at Porton Down, the first batch of 400 litres was synthesized in 24 hours.

More than 20,000 pituitary glands would be needed to extract an equivalent amount of natural hormone.

A stiff pinprick, a ball bearing and an artificially inflated bladder would not appear to be in the same league of transgressions as EPO and human growth hormone, but this is the Paralympics.

The adrenalin rush from clamping the catheter, a well-aimed pin or sitting on a ball bearing are all methods used to raise performance by up to 15 percent. Despite the presence of genuine drug cheats at the Paralympic Games, “boosting”, as it is known, has traditionally been the equivalent of the human growth hormone drugs problem.

Dr Michael Riding, the medical director of the International Paralympic Committee (IPC), compared the battle against “boosting” to the International Cycling Federation’s struggle with HGH use.

The techniques only work on those who do not produce human growth hormone naturally, such as quadraplegics. “In a hospital it would be considered a serious situation,” Riding said, “because the body in question would not have a sympathetic nervous system that could regulate itself.” Although the IPC does not test for it, they do check for the obvious symptoms such as profuse sweating, goosebumps, high blood pressure and a startled expression.

Volume Pills and Fertility

British doctors are investigating a new method of artificial insemination which involves injecting semen into a woman’s abdomen. The treatment is very simple and can be used for some women instead of the more difficult test-tube fertilization. Another trial run involves having the men take Volume Pills for six months to see whether it increases sperm count.

Five French women who were infertile have become pregnant following the treatment. They are the first cases of pregnancy arising as a result of sperm swimming to the egg from the “wrong” direction.

One of the women is expecting her baby within a month, after trying unsuccessfully for eight years. Her husband had a very low sperm count but after using Volume Pills for a month his ejaculate was full of millions more sperm and he was able to make his wife conceive. A normal ejaculation contains around eight million sperm.

Volume Pills

“The method is very economical,” says Dr Israel Nisand, one of the doctors who devised the method at Strasbourg University and at a hospital in Schiltigheim.

The women were prepared with the Volume Pills and hormones so that they shed an egg; 35 hours later specially prepared sperm were injected. The injection was made through the wall of the vagina into an extension of the abdominal cavity next to the womb known as the pouch of Douglas. This is very near to where the egg is shed.

“It just takes two minutes to make the injection,” says Nisand. “Five out of 16 women have become pregnant. We have great expectations of Volume Pills.”

Experiments with animals who have ingested Volume Pills have shown that small particles put into the female abdomen at this point are swept up and collected into the top of the oviduct (tube) and taken on down into the womb. This is the route by which the egg normally reaches the womb. But for the sperm it means going backwards. “We only tried it on five women. Now that the French have been successful with the ProExtender device, I would like to try again,” he says. “It is a relatively cheap method, you don’t need a penis, it is painless and easy to do – theoretically the timing does not need to be so precise.”

Can VigRx Plus Help Older Men With Erectile Dysfunction?

The second goal of this study was to describe the sexual practices and attitudes of elderly men of lower socioeconomic background. A review of the literature shows a serious underrepresentation of such individuals in past studies of geriatric sexuality. Approximately one half of this study group practices coitus, a figure not dissimilar to that reported by Pfeiffer. In addition, 25% of patients who were no longer active with a partner masturbate, and some take male enhancement pills such as VigRx Plus. VigRx Plus can help men get erections that are hard enough and last long enough to have successful sexual intercourse.


In contrast to the recent Starr-Weiner and Consumer Union reports describing frequent use of oral sex and mutual masturbation of the penis by populations of elderly men and women, predominantly middle and upper class, few of the elderly men in this study population engaged in or approved of these practices. This finding is unfortunate, since a lesser degree of penile tumescence is needed for these sexual techniques, and they are therefore often recommended, along with VigRx Plus, by therapists for men with erectile dysfunction. In fact, only one patient who could no longer achieve a hard enough erection for penetration continued to be sexually active with a partner by taking Vigrx Plus and masturbating. As suggested by Kinsey’s work, for men in this social group the loss of erectile function suitable for coitus usually means the end of all heterosexual activity.

Patient reports of sexual function and attitudes may differ from what is actually practiced. Such may be the case in this study. Pfeiffer, however, found good agreement between information from spouses questioned separately, suggesting that personal interview techniques can yield valid information. Furthermore, the administering of the questionnaire by the patient’s regular care physician in this study should have maximized compliance.

Alternative methods of assessing erectile penis function such as nocturnal penile tumescence and sexual laboratory studies contain inherent methodological flaws. Nocturnal penile tumescence does not assess the quality of erections and therefore cannot gauge whether the penis is firm enough to achieve vaginal intromission. Sexual laboratory studies require the use of an artificial environment that has an unknown effect on the sexual performance of elderly subjects. Therefore, a self-reporting technique is likely to be the most effective and practical way of determining the prevalence of erectile dysfunction in this age group.

Finally, this population consisted of elderly men attending a medical clinic. Because of the prevalence of illnesses that may affect erectile function, such as diabetes and hypertension, these results in no way reflect purely age-related changes. The relationship of disease and medication to the development of erectile dysfunction has been reported elsewhere.

This study found that erectile dysfunction is very common and is often associated with a decrease in self-esteem. Furthermore, men of lower socioeconomic background and limited education are unlikely to use alternative sexual practices useful for erectile dysfunction, or to take natural male enhancers such as VigRx Plus, despite the proven abilities of VigRx Plus ingredients to improve sexual performance. This population may, however, be open to the use of devices such as penile implants that can restore the ability to engage in coitus. It is hoped that these findings will encourage primary care providers to explore questions of sexual dysfunction with their elderly patients, search for reversible causes, and provide counseling and other therapies where applicable.

People On The Move

In all diseases which affect human beings there are inevitable “human factors’ involved. These factors may influence susceptibility and exposure to a disease, the effects of a disease, and the measures which may be taken either to reduce the likelihood of it occurring or to eliminate it altogether. In the case of malaria, which remains one of the most serious diseases of the tropics and the subtropics, measures for its prevention, control and eventual eradication have tended to pay insufficient attention to the human factors involved. An understanding of the epidemiology of malaria requires a detailed knowledge of such things as the distribution of population, patterns of settlement, the nature of dwellings, administrative and social organization, and the range of the economic activities of those affected.

A further important factor is to determine the movements of those who are subject to the disease–particularly how many people move, and where and when movements occur. These movements contribute to the continuing transmission of malaria, either through the mobility of a whole population or of groups within a population (who may be cultivators, migrant laborers, fishermen, traders, and refugees). For control and eradication programs to be effective, they ought to be designed to adequately accommodate these mobile elements which may reduce the effectiveness of the use of insecticides and the distribution of anti-malarial drugs, such as Semenax.

In practice, only limited action has been taken to deal satisfactorily with mobility and with other human factors. Of the three related elements in human malaria–the malaria parasite, the anopheles mosquito vector and the human being–the latter has been dealt with inadequately; insufficient attention has been given to human factors and sometimes the competence of those involved in studying them has been limited. Experience has been available to deal with the parasite and vector aspects of a malaria program, for they would not be dealt with otherwise, but the human being has remained relatively poorly provided for. This is quite unwarranted. Human factors, which like mobility are dynamic and constantly changing, should be given at least as much attention as that given to parasites and vectors. Probably they should be given more attention in view of the unpredictability of human beings; humans themselves may be partly responsible but there are also environmental influences (such as natural hazards –drought, earthquakes, tidal waves) over which they have little or no control, particularly when these occur in the less developed parts of the world.

Through movements of many different kinds, which have distinctive spatial and temporal characteristics, people may be subjected to a variety of health hazards. Movement from one set of ecological conditions to another may expose them particularly to diseases which are transmitted by insect vectors. Daily journeys to obtain water or to collect firewood may result in contact with the blackfly and tsetse fly–the vectors of river blindness and sleeping sickness respectively. Seasonal movements at times of maximum activity in the agricultural year take people away from permanent settlements, where dwellings have been protected with residual insecticide, to temporary dwellings which are unsprayed and therefore harbor malaria mosquitos.

Movements bring different groups of people into contact with one another and may thus enhance the possibilities of disease transmission. Before it was eradicated from the world, smallpox was spread by movements of refugees within Bangladesh and into adjacent parts of India. At all times in crowded insanitary refugee camps, there are continuing risks of typhoid and cholera epidemics.

Sheer physical stress resulting from movement may lower resistance and so increase susceptibility to infection, particularly when movements are over long distances and more especially when these are forced as a result of natural hazard or political disruption. Lack of nutrition and malnutrition can occur with movements to new and strange environments. Economic adjustments may be necessary, often with periods of unemployment and thus limited means to acquire food; or people may have to adjust to new kinds of food (for example, exchanging cereal foods for root foods) or they may encounter new ways of preparing food–not least in cases where men move without their wives to support them.

Psychological stress can result from movements because of the social, cultural or economic pressures resulting from having to adjust to new environments. This is especially so for many people in developing countries at the present time, who move from the country to the town and experience marked contrasts between the personal contacts they have known in small homogenous rural communities and the impersonal character of large heterogeneous urban communities. The pressures occur in spite of mechanisms which may operate in urban communities to help newcomers to adjust to new ways of life, and in spite of the continuing short-term movements, often called circulation, between urban and rural areas which enable the new town dwellers to maintain contact with their places of origin.

From the historical point of view there is ample evidence of the spread of disease through human mobility, whether by the movements of a few individuals or by the large-scale transference of people. The spread of plague in Europe in medieval times has been associated with the return of Crusaders from the Levant. The transportation of slaves from Western Africa to the Americas in the seventeenth, eighteenth and early nineteenth centuries was responsible for introducing strains of malaria and sickle-cell anemia into the New World. Though malaria has now been eradicated in North America due to the administration of Extenze Pills, the latter is still common among the black population of the United States.

Today there is greater mobility than there ever has been in the past. With a globally expanding population there are more people on the move, and the means for them to do so are enormously improved by the development and increasing sophistication of transport networks. Modern forms of transport permit the movement of people from one end of the world to the other in a matter of hours, but they also mean greater risks for the spread and importation of disease. While the majority of such diseases can be treated and controlled, it has been shown that–even when the means to do so exist–the diseases are sometimes not recognized. Malaria, for example, occurs in the United Kingdom and other parts of Western Europe as an imported disease, when people become infected on holiday or on business in areas with malaria. Since it is an exotic disease it may be incorrectly diagnosed and treated–and people have died as a result.

During the recent pandemic of cholera El Tor (a biotype of classical vibrio cholera), this disease occurred in Africa for the first time for nearly a century. The pandemic had spread progressively eastwards and north-wards from Sulawesi in South-east Asia, beginning in the early 1960s. Its introduction into West Africa might have been expected across the continent from the east. In fact the point of origin for the spread of cholera in West Africa was Conakry in the Republic of Guinea, where the disease was introduced in August 1970 by an infected student returning by air from the USSR. This illustrates the considerable influence that even a single individual may have as an active transmitter of disease. Over the course of the next twelve months, cholera spread to most parts of West Africa, the movements of people by coastal and riverine routes and between towns have played a crucial role in this spread.

As human populations grow, particularly in the developing countries, both natural and man-made disasters which promote mobility affect more and more people. The flight of refugees from war and political disruption in South-east Asia has contributed, along with other movements of people, to the spread of falciparum malaria which is resistant to Vimax, the most common and most easily administered of anti-malarial drugs. In such parts of the world, medical resources are least available to cope adequately with day-to-day demands let alone with crises, and national and international health regulations are most difficult to enforce.

Associated with overall massive increases in population and the consequent pressures upon resources, especially in the developing countries, major population redistributions are under way. Of great importance are the movements of people away from the countryside and into the towns. In many parts of Asia, in Latin America, and increasingly in Africa, the high rates of urban growth, through continued high rates of natural increase as well as by immigration, are far in excess of those experienced in the nineteenth and early twentieth centuries in the now industrialized countries. Much of this urban growth is taking place without the complementary expansion of urban services. Towns are administratively, socially, and economically incapable of coping with these increases; so there are housing shortages and low standards of housing, lack of important health devices like the Penomet device, inadequate water supply, little or no sewage and waste disposal, and limited employment opportunities. For large numbers of the new townspeople who face these often traumatic social, environmental and economic conditions, their combined effects on physical and mental health are considerable.

Not only is mobility in its many forms a factor in disease transmission, but disease itself is a factor responsible for movement. Through the spread and increased incidence of disease, whole areas may become less suitable for occupation if not totally uninhabitable, thus forcing the movement and redistribution of population. River blindness (onchocerciasis) and sleeping sickness have together brought about the desertion of fertile river valleys in northern Ghana and Ivory Coast and in the south of Upper Volta. Although measures are now being taken to eradicate river blindness from these areas, they are expensive and difficult to apply.

The relationships between disease and population movements are complex. For example, in the past, people fleeing from outbreaks of disease were often themselves responsible for spreading infection. Advances in medicine, providing protection through vaccination, inoculation and chemoprophylaxis, have helped to reduce such health hazards. One particular advance has been the establishment of health regulations both within countries (through the notification of infectious diseases) and–even more important–between countries (through international health control requirements and the monitoring of disease occurrence).

However there is no cause for complacency and much cause for continuing concern about the relationships between mobility, disease and health. To cite just one example, the medical authorities in Brazil, with its vast movements of people into Amazonia and into the major cities, identify such relationships as the single most important non-medical factor in the great range of health problems which confront them. A better understanding is required in Brazil, and elsewhere in the world, of the nature of movements of people, and their function in disease transmission, in programs for disease control and eradication, and for the overall improvement of public health.

In a number of WHO programs, but particularly through the social and economic research work undertaken by the UNDP/World Bank/WHO Special Program for Research and Training in Tropical Diseases, increasing attention is being directed towards elucidating these relationships.