Tuesday, August 24, 2021

#LEGALISEDRUGS

NIH-funded study finds overall rate of drug use among 10-14 year-olds remained stable during the 2020 COVID-19 pandemic


Adolescents experiencing stress, mental health issues, and hardship most likely to use substances

Peer-Reviewed Publication

NIH/NATIONAL INSTITUTE ON DRUG ABUSE

Repeated surveys of more than 7,800 people ages 10 to 14 conducted between September 2019 and August 2020 showed that the overall rate of drug use among these young adolescents remained relatively stable before and during the first six months of the COVID-19 pandemic. However, researchers detected shifts in the drugs used, with alcohol use declining and use of nicotine products and misuse of prescription medications increasing. Adolescents who experienced pandemic-related severe stress, depression, or anxiety, or whose families experienced material hardship during the pandemic, were most likely to use substances.

The study, which published today in the Journal of Adolescent Health, was funded by the National Institute on Drug Abuse (NIDA) and nine other institutes, centers, and offices that are part of the National Institutes of Health. The analysis used data from the ongoing Adolescent Brain Cognitive DevelopmentSM (ABCD) Study, the largest long-term study of brain development and child health ever conducted in the United States. 

“The past year has been difficult, and adolescents have experienced a year of turmoil and stress in precarious space between childhood and adulthood. Recognizing how the stress of the past year translates into substance use has profound implications into adulthood, because drinking and drug use at these ages are associated with a substantially higher risk of long-term alcohol and drug use disorders and related harms,” said NIDA Director Nora D. Volkow, M.D. “Because the ABCD Study had already been following this diverse, young population, researchers were able to make direct comparisons between trends in substance use before and during the pandemic, emphasizing the value of investing in long-term, collaborative research projects.”

Several studies previously determined that older adolescents’ substance use held steady or even declined during the pandemic. However, most of these analyses were done earlier in the pandemic, and no data existed on the pandemic’s influence on younger adolescents, particularly after an extended period of COVID-19–related disruptions of daily lives.

To fill this gap, the research team conducted three surveys in the six months following the initiation of stay-at-home orders—in May, June, and August 2020—with more than 7,800 ABCD Study participants ages 10 to 14 and their families participating in at least one survey. They assessed the adolescents’ use of alcohol, nicotine products, cannabis, and other drugs, misuse of prescription drugs, as well as numerous general and pandemic-related factors that could influence substance use.

The study found that overall substance use in this age group remained relatively stable across the three surveys and occurred infrequently. Across all three surveys, 8% of the adolescents reported any substance use in the past 30 days. Alcohol and nicotine use were most common (3.4% and 3.6% of the adolescents, respectively), whereas rates of misuse of prescription drugs and use of cannabis, inhalants, or other drugs were low (1.1% of adolescents or less). Most youth reported using only one substance and only on one to two days per month.

The researchers also found that youth stress, anxiety, and depressive symptoms were all positively associated with the use of any substance, and that several pandemic-related factors increased adolescents’ likelihood of substance use. For example, youth who reported feeling “extreme” stress from the uncertainty associated with the pandemic were 2.4 times more likely to use any substance than youth who reported “very slight” stress.

For a subset of 1,079 participants, researchers were able to link assessments taken after the onset of the COVID-19 pandemic to assessments that had been completed during the months immediately before the pandemic. Importantly, for this subsample of youth, the overall rate of drug use did not increase significantly after the beginning of the pandemic compared to before the pandemic.

However, shifts occurred in the types of substances used. Alcohol use decreased, shifting from 1.9% of youth reporting alcohol use in the past 30 days in the surveys taken before the pandemic, to only 0.7% in the first survey during the pandemic. Conversely, nicotine use and prescription drug misuse increased, with 0% of youth reporting use of nicotine or misuse of prescription drugs in the past 30 days in the surveys taken before the pandemic, compared to 1.5% and 0.7% respectively in the first survey during the pandemic.

“These data suggest substance use during the pandemic was concentrated among youth from the most vulnerable families, underscoring the need to provide support to those young people and their families,” said William E. Pelham, Ph.D., of the University of California, San Diego, who led the study. “But we should also look forward, beyond the 2020 data, to understand how alcohol and drug use will continue to evolve as people return to school and work. By continuing to follow these young people for five or six more years through the ABCD Study, we can help determine the pandemic’s full impact on America’s youth and care for their health and wellbeing.”

The authors note that the study does not directly test or explain why the changes in the drugs used occurred, and additional analyses are needed to determine the mechanisms underlying these trends. Earlier findings from a different study reported steady rates of substance use in older adolescents. Continued research to understand substance use trends during and following the outset of the COVID-19 pandemic are needed for all age groups and across demographics.

Reference: WE Pelham III, SF Tapert, MR Gonzalez, et al. Early adolescent substance use before and during the COVID-19 pandemic: A longitudinal survey in the ABCD Study cohortJournal of Adolescent Health. DOI: 10.1016/j.jadohealth.2021.06.015 (2021).

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About the National Institute on Drug Abuse (NIDA): NIDA is a component of the National Institutes of Health, U.S. Department of Health and Human Services. NIDA supports most of the world’s research on the health aspects of drug use and addiction. The Institute carries out a large variety of programs to inform policy, improve practice, and advance addiction science. For more information about NIDA and its programs, visit www.nida.nih.gov.

About the National Institutes of Health (NIH): NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

NIH…Turning Discovery Into Health®

Stress from rising population numbers may cause a decline in human fertility

Peer-Reviewed Publication

THE ENDOCRINE SOCIETY

WASHINGTON—A predicted population drop at the end of the century could be explained by stress from meaningless social interactions, according to a review article published in the Endocrine Society’s journal, Endocrinology.

Researchers predict a peak in population numbers in 2064 followed by a 50% drop by the end of the century from changes in human reproductive behavior and function. There has been a 50% decrease in sperm counts over the last 50 years. People are stressed out from more frequent but less quality social interactions, and stress can supress sperm count, ovulation and sexual activity.

"Rising population numbers contribute to less meaningful social interactions, social withdrawal and chronic stress, which subsequently supresses reproduction,” said the manuscript’s author Alexander Suvorov, Ph.D., of the University of Massachusetts Amherst in Amherst, Mass. “Changes in reproductive behavior that contribute to the population drop include more young couples choosing to be ‘child-free,’ people having fewer children and couples waiting longer to start families.”

Suvorov found a connection between population numbers, stress and reproduction by reviewing several studies and asking the following questions:  

  • Why do people refuse to have children when access to all vital resources is becoming better than humankind ever had?

  • Why has there been a 50% decrease in sperm counts over the last 50 years?  

  • Why are different forms of social withdrawal on rise?  

He hypothesized declining reproduction may be due to stress from less quality social interactions and changes in reproductive behavior such an increase in “child-free” couples and delayed parenthood.

“Numerous wildlife and laboratory studies demonstrated that population peaks are always followed by increased stress and suppressed reproduction,” said Suvorov. “This review provides evidence from multiple disciplines that the same mechanisms previously observed in wildlife species may work in humans as well.”

The manuscript received no external funding.

The manuscript, Population Numbers and Reproductive Health,” was published online, ahead of print.

# # #

Endocrinologists are at the core of solving the most pressing health problems of our time, from diabetes and obesity to infertility, bone health, and hormone-related cancers. The Endocrine Society is the world’s oldest and largest organization of scientists devoted to hormone research and physicians who care for people with hormone-related conditions.

The Society has more than 18,000 members, including scientists, physicians, educators, nurses and students in 122 countries. To learn more about the Society and the field of endocrinology, visit our site at www.endocrine.org. Follow us on Twitter at @TheEndoSociety and @EndoMedia

 

Research sheds new light on decreased performance under pressure


Peer-Reviewed Publication

COLLEGE OF ENGINEERING, CARNEGIE MELLON UNIVERSITY

We’ve seen it play out in the sports world time and time again: a single action from a single player can make or break the outcome of the game. For decades, this idea of being unable to perform when it matters most, or choking under pressure, has earned notorious status among top athletes and others. New research from Carnegie Mellon University and the University of Pittsburgh shows for the first time that this propensity is not unique to humans.

As part of the behavioral study recently published in PNAS, three Rhesus monkeys were trained to perform a challenging reaching task. Occasionally, a jackpot reward was offered, and when it was, performance declined, with up to 25% more failures. Subjects were also offered a drop of juice as a payoff. A closer analysis of reaching kinematics indicated that subjects decreased their performance, or choked, under pressure in part because they reached too cautiously on jackpot trials.

“Once the right parameters were dialed in and behavior stabilized, I was impressed by how robust the effect was,” explains Adam Smoulder, a graduate student at Carnegie Mellon and co-first author of the paper. “It didn’t seem to matter when that jackpot trial occurred, subjects’ performance ebbed and flowed according to the size of the potential payoff.”

Investigating the neural underpinnings of these findings is where the group is headed next. “In the recordings we captured from the subjects’ cerebral cortex, we’re seeing large changes in activity that come about as the reward changes,” explains Steve Chase, professor of biomedical engineering at Carnegie Mellon and the Neuroscience Institute. “This is fascinating, because the changes in the movement that differentiate between success and failure are really subtle. Now, we’re wrestling with how is that possible? How can there be massive changes in neural activity and really minimal changes in kinematics?”

The group’s research also demonstrates an important connection between sensory motor processing and emotional processing, historically believed to be unrelated systems.

“Our work opens the door for further exploration into the neuroscience of this phenomenon,” says Aaron Batista, professor of bioengineering at the University of Pittsburgh. “The fact that nonhuman animals also choke under pressure suggests that this behavioral quirk is something our biological systems are just wired to do. We shouldn’t be beating ourselves up over it or blaming professional athletes because they choke under pressure. It's just something all brains do.”

The group’s work is ongoing and done in collaboration with the Center for Neural Basis of Cognition, a cross-university research and educational program between Carnegie Mellon and the University of Pittsburgh that leverages each institution’s strengths to investigate the cognitive and neural mechanisms that give rise to biological intelligence and behavior. The PNAS paper was co-authored by Chase and Batista’s current and former graduate students, including co-first authors Adam Smoulder, Nick Pavlovsky and Patrick Marino, along with contributors Alan Degenhart and Nicole McClain.

Unveiling a century-old mystery: Where the Milky Way's cosmic rays come from


Peer-Reviewed Publication

NAGOYA UNIVERSITY

Gamma-ray (Figure 1) 

IMAGE: FIGURE 1. SCHEMATIC IMAGES OF GAMMA-RAY PRODUCTION FROM COSMIC-RAY PROTONS AND ELECTRONS. COSMIC-RAY PROTONS INTERACT WITH INTERSTELLAR PROTONS SUCH AS MOLECULAR AND ATOMIC HYDROGEN GAS. THE INTERACTION CREATES NEUTRAL PION THAT QUICKLY DECAYS INTO TWO GAMMA-RAY PHOTONS (HADRONIC PROCESS). COSMIC-RAY ELECTRONS ENERGIZE INTERSTELLAR PHOTONS (MAINLY COSMIC MICROWAVE BACKGROUND; CMB) INTO GAMMA-RAY ENERGY VIA INVERSE COMPTON SCATTERING (LEPTONIC PROCESS). view more 

CREDIT: ASTROPHYSICS LABORATORY, NAGOYA UNIVERSITY

Astronomers have succeeded for the first time in quantifying the proton and electron components of cosmic rays in a supernova remnant. At least 70% of the very-high-energy gamma rays emitted from cosmic rays are due to relativistic protons, according to the novel imaging analysis of radio, X-ray, and gamma-ray radiation. The acceleration site of protons, the main components of cosmic rays, has been a 100-year mystery in modern astrophysics, this is the first time that the amount of cosmic rays being produced in a supernova remnant has been quantitatively shown and is an epoch-making step in the elucidation of the origin of cosmic rays.

 

The origin of cosmic rays, the particles with the highest energy in the universe, has been a great mystery since their discovery in 1912. Because cosmic rays promote the chemical evolution of interstellar matter, understanding their origin is critical in understanding the evolution of our Galaxy. The cosmic rays are thought to be accelerated by supernova remnants (the after-effects of supernova explostions) in our Galaxy and traveled to the Earth at almost the speed of light. Recent progress in gamma-ray observations has revealed that many supernova remnants emit gamma-rays at teraelectronvolts (TeV) energies. If gamma rays are produced by protons, which are the main component of cosmic rays, then the supernova remnant origin of cosmic rays can be verified. However, gamma rays are also produced by electrons, it is necessary to determine whether the proton or electron origin is dominant, and to measure the ratio of the two contributions (see also Figure 1). The results of this study provide compelling evidence of gamma rays originating from the proton component, which is the main component of cosmic rays, and clarify that Galactic cosmic rays are produced by supernova remnants.

  

CAPTION

Figure 2. Maps of gamma-ray intensity Ng, interstellar gas density Np, and X-ray intensity Nx

CREDIT

Astrophysics Laboratory, Nagoya University

The originality of this research is that gamma-ray radiation is represented by a linear combination of proton and electron components. Astronomers knew a relation that the intensity of gamma-ray from protons is proportional to the interstellar gas density obtained by radio-line imaging observations. On the other hand, gamma-rays from electrons are also expected to be proportional to X-ray intensity from electrons. Therefore, they expressed the total gamma-ray intensity as the sum of two gamma-ray components, one from the proton origin and the other from the electron origin. This led to a unified understanding of three independent observables (Figure 2). This method was first proposed in this study. As a result, it was shown that gamma rays from protons and electrons account for 70% and 30% of the total gamma-rays, respectively. This is the first time that the two origins have been quantified. The results also demonstrate that gamma rays from protons are dominated in interstellar gas-rich regions, whereas gamma rays from electrons are enhanced in the gas-poor region. This confirms that the two mechanisms work together and supporting the predictions of previous theoretical studies.

  

CAPTION

Figure 3. Three-dimensional fitting of a flat plane expressed by an equation of Ng = a Np + b Nx, where a and b are constants. The data points are colored by the code in the figure according to Ng and are shown by filled and open symbols for those above and below the plane. The blue, green, yellow, and red represent Ng is less than 1.2 counts arcmin−2, 1.2–1.7 counts arcmin−2, 1.7–2.2 counts arcmin−2, and greater than 2.2 counts arcmin−2, respectively. The blue, green, orange, red, and purple dashed lines on the best-fit plane indicate 1.0, 1.5, 2.0, 2.5, and 3.0 counts arcmin−2, respectively.

CREDIT

Astrophysics Laboratory, Nagoya University

“This novel method could not have been accomplished without international collaborations,” says Emeritus Professor Yasuo Fukui at Nagoya University. He led this project and has accurately quantified interstellar gas density distribution using the NANTEN radio telescope and Australia Telescope Compact Array since 2003. Although the gamma ray resolution was insufficient to perform a full analysis at that time, Professor Gavin Rowell and Dr. Sabrina Einecke of the University of Adelaide and the H.E.S.S. team dramatically improved the spatial resolution and sensitivity of gamma rays over the years, making it possible to compare them precisely with interstellar gas. Dr. Hidetoshi Sano of the National Astronomical Observatory of Japan led the X-ray imaging analysis of archival datasets from the European X-ray satellite XMM-Newton. Dr. Einecke and Prof. Rowell worked closely with Prof. Fukui and Dr. Sano on making the detailed studies that examined the correlations across the gamma-ray, X-ray and radio emission. “This novel method will be applied to more supernova remnants using the next-generation gamma-ray telescope CTA (Cherenkov Telescope Array) in addition to the existing observatories, which will greatly advance the study of the origin of cosmic rays.”

PULLING A PUTIN
Philippines' Duterte to run for vice president, says party

Rodrigo Duterte is barred under the constitution from seeking another term as president 
LISA MARIE DAVID POOL/AFP

Issued on: 24/08/2021 - 

Manila (AFP)

Philippine President Rodrigo Duterte will run for vice president in next year's elections, his party said Tuesday, after months of speculation about whether he would seek to stay in power.

Duterte, who was elected to the top job in 2016 and is barred under the constitution from seeking another term, has previously flagged the possibility of contesting the country's second-highest office.

"President Rodrigo Roa Duterte agreed to make the sacrifice and heed the clamour of the people, and accepted the endorsement of the PDP Laban Party for him to run as vice president in the 2022 national elections," the party said in a statement.

The party is also expected to endorse Duterte's top aide, Senator Christopher Lawrence "Bong" Go, to be their presidential candidate.

Duterte has not said publicly yet that he will run, but PDP-Laban president Alfonso Cusi told AFP: "He confirmed he is running for VP in 2022."

The vice president and president are elected separately in the Philippines, with the former assuming the top job if the latter dies, becomes incapacitated, or resigns while in office.

During his term Duterte has waged a brutal war against drug users and dealers that rights groups say has killed tens of thousands of people.

International Criminal Court prosecutors are seeking to launch a full-blown investigation into the anti-narcotics crackdown, raising the stakes for next year's elections.

Duterte's daughter, Sara, is widely expected to contest the presidency and, if she were to win, could help protect her father from criminal charges.

Recent polls show the Davao city mayor -- the same position her father held before he took power -- with the most voter support.

Duterte told a meeting of party officials last month that he was "seriously thinking of running for vice president".

But he expressed concern that a political foe could win the presidency, rendering him useless for the next six years.

"The president that will win must be a friend of mine (with) whom I can work with," Duterte said.

The deadline for registering as a candidate for next year's elections is October 8. A sitting president has never before made a bid for the vice presidency in the Philippines.

Presidential spokesman Harry Roque told reporters that Duterte would make a televised address later Tuesday where he is expected to discuss the PDP-Laban announcement.

© 2021 AFP
Japan and disability: will the Tokyo Paralympics bring change?



Issued on: 24/08/2021 -
Masaaki Suwa, a Japanese para-canoeist who missed the cut for the Tokyo Games, will be cheering for Japan's team on television Philip FONG AFP

Tokyo (AFP)

As the Paralympic Games begin, Japan's efforts to improve accessibility and inclusion are in the spotlight, with many arguing there is still plenty of work to do.

Some 4,400 athletes with impairments will compete in Tokyo at the world's biggest parasports tournament.

It's a place for sporting history, but also an event organisers say can change attitudes towards people with disabilities.

"It's a precious event," said Masaaki Suwa, a Japanese para-canoeist who missed the cut for the Tokyo Games but will be cheering for Japan's team on television.

"They are doing great things but they are not superhumans. I want people to know that they are human beings just like you," the 35-year-old told AFP.

It's a bittersweet moment for Suwa, who had hoped to compete in his hometown, but he's counting on other Paralympians to make an impact on Japanese society.

"I hope (the Paralympics) will be a springboard that allows people to live more closely alongside disabled people," said Suwa, who uses a wheelchair.

Disability rights experts and activists paint a mixed picture of the situation in Japan.

The Paralympics will feature 4,400 athletes from 162 teams Charly TRIBALLEAU AFP/File

There has been progress on barrier-free infrastructure, with officials calling accessibility important both for people with disabilities but also the country's large elderly population.

A barrier-free enforcement law has been revised twice in recent years to promote accessibility at public facilities.

- 'Marginal' change -

Particular efforts have been made in Tokyo's mammoth train system, with elevators operating at around 96 percent of stations as of 2019, the city government says.

By 2019, 82 percent of Tokyo subway stations also had platform gates to keep visually impaired passengers and others safe -- up from 56 percent in 2013.

New hotels with more than 50 rooms are also required to make at least one of every 100 barrier-free.

"In terms of the number of barrier-free facilities, Japan appears advanced," said Miki Matheson, deputy chief of Japan's Paralympic delegation.

But the three-time Paralympic gold medallist, who lives in Canada and is in Tokyo for the Games, says accessibility is not the same as inclusion.

Former Paralympian Miki Matheson says she is treated as a disabled person when in Japan, unlike at home in Canada 
Behrouz MEHRI AFP/File

"I'm often treated as a disabled person when I'm back in Japan," said Matheson, who uses a wheelchair.

"In Canada, I live without noticing my disability at all."

Activists say the workplace is an example of the barriers that remain.

Under government rules, workers with disabilities must make up at least 2.3 percent of staff at all companies. Larger firms face fines for non-compliance.

In 2018, the government was forced to apologise for routinely overstating the number of disabled people on its staff to meet quotas.

Motoaki Fujita, a sports sociology professor at Nihon Fukushi University and a parasports expert, says Japan has become more inclusive, "but the change is still marginal."

Some 57 percent of people surveyed by Fujita's team last year said they "certainly or somewhat" believe people with disabilities are weak and have difficulty living with non-disabled people.

That's only slightly less than the 61 percent who felt the same in a 2014 poll.


- Paralympic 'catalyst' -


Tokyo's Paralympics will take place with almost no spectators because of virus rules, which some fear could blunt its impact on Japanese society.

"The Paralympics is a very good chance to change people's thinking," said Shigeo Toda, head of a Tokyo-based research institute studying the lifestyles of people with disabilities.

"But we can't help but think that momentum could sag if people can't watch them in person," Toda said.

Saki Takakuwa, a Paralympic runner who competes with a prosthetic blade, worries about the spectator ban's effect.

"I know people will watch the Games on TV, but I wonder how they will respond," she told the Mainichi Shimbun daily.

Activists and experts say Japan has work to do on disability access and inclusion
 Charly TRIBALLEAU AFP

"Compared to past Games, it's difficult for me to have hope that people will feel something", added the 29-year-old, who is contesting her third Paralympics.

International Paralympic Committee President Andrew Parsons admits the spectator ban is "a challenge," but argues broadcasts will reach billions around the world.

"The Games themselves are a catalyst," he told AFP.

"It's the moment when people see athletes in action, and that's when this change really occurs."

In Japan, he added, there is "still a lot of progress to be made."

"But we believe that we have started to see a change."

© 2021 AFP
Delta variant sends deaths soaring in remote French Polynesia

Issued on: 24/08/2021 - 
Extra beds set up in a hall to accommodate patients at the French Polynesia Taaone Hospital in Papeete
 Mike LEYRAL AFP

Papeete (AFP)

Covid infections are soaring in the sparsely populated Pacific territory of French Polynesia, with health authorities reporting 54 deaths from the virus over the weekend as the Delta variant spreads among a largely unvaccinated population.

More than 300 people have died from Covid-19 since the pandemic hit the remote archipelago -- home to 280,000 inhabitants. Over half of those deaths have come in the last three weeks.


The territory has so far recorded 7,591 infections, though the true figure is likely higher as most asymptomatic people are not being tested.

High rates of diabetes and obesity have made the population more vulnerable.

The territory's limited health care system has struggled to cope, with one major hospital setting up beds in hallways to handle the rising number of patients. Bodies have been loaded onto refrigerator trucks to relieve pressure on the overwhelmed morgue.

The Polynesian archipelago is now under a curfew and the Society Islands -- which include the largest island of Tahiti and other more densely populated areas -- are under lockdown.

But the rules, which allow for a modicum of economic activity, have been difficult to enforce.

The territory's president Edouard Fritch was forced to apologise after being spotted playing guitar at a wedding party attended by hundreds of maskless people in defiance of the regulations.


Schools have been closed for at least two weeks and efforts are being made to teach online but many underprivileged students do not have access to the internet.

The French government has voiced alarm about Covid-19 infection rates in its overseas territories.

© 2021 AFP
Road-trip surgeon brings hope of health to rural Cameroon

Issued on: 24/08/2021 - 
Mobile hospital: Georges Bwelle operates on an inmate with hernia at Nkongsamba prison in remote Cameroon 
Adrien MAROTTE AFP

Nkongsamba (Cameroon) (AFP)

"Are you feeling OK?" surgeon Georges Bwelle asks the prisoner lying on a makeshift bed.

He picks up his scissors and forceps and returns to operating on a small hernia.

The music playing in the room next door in the rural jail grows louder, and the doctor sings along.


During the week, Bwelle, 49, is a top doctor specialising in intestinal surgery at the main hospital in Yaounde, the capital of Cameroon.

At the weekend, though, he takes to the road.

He heads a lively team of volunteers who cram into a minibus and head out into remote areas -- a tiny mobile clinic that provides basic healthcare to those in need.

Today, his NGO, called ASCOVIME, has gone to the prison at Nkongsamba, a town lying in green hills about 350 kilometres (215 miles) northwest of Yaounde.

The team is welcomed by the prison administrator and an NGO called Agriculture for Africa, which is hosting the trip.

Every weekend, the ASCOVIME minibus heads out to a distant part of Cameroon, laden with medical gear and crammed with young doctors 
Adrien MAROTTE AFP

Today, almost 500 prisoners and their families will be examined.

A clean room is provided near the cells.

"It's perfect," says Bwelle.

Immediately, a chain of volunteers forms to bring in the equipment, transforming the room into a small field hospital, complete with departments for general medicine, ophthalmology, dentistry and even minor surgery.

The inmate, 35, emerges from the operating room, his hernia now fixed.

"Thank God I have been freed from this ailment -- the doctors looked after me," he says, clearly moved.

- Huge needs -


Bwelle's drive to help others can be traced to his childhood.

Born into a family of modest means, the young Bwelle saw his father's health deteriorate because of the lack of access to a specialist doctor following a road accident.

After his studies, Bwelle began to travel throughout his country.

"With the little money I had, I bought medicines and treated three or four people, then 10, then 100," he told AFP.

Little by little, a team of doctors with a panoply of skills gathered around him.

In 2008 he set up ASCOVIME, an acronym in French meaning Association of Skills for a Better Life.


Today, the NGO carries out about 40 missions a year, provides medical consultations to 40,000 people, carries out around 1,400 operations and gives school equipment to 20,000 children.

In Cameroon, a central African country of about 25 million people ruled for more than 38 years by Paul Biya, almost four people in 10 live below the poverty line and life expectancy is around 60.

Most of the time, ASCOVIME visits rural areas where health care is scarce and difficult to access, including two English-speaking regions plagued by separatist conflict, and the far north, affected by jihadist incursions by the Boko Haram group.

"In every village, there is at least one medical hut run by a nurse, often a Cameroonian government employee," he explains.

But the needs are almost limitless -- "the main problem is poverty and lack of equipment."

The most frequent medical complaints are malaria, joint pain and hernias -- diseases linked to working the land, says Bwelle.

- Volunteers' joy -


In a summer camp atmosphere, the bus -- its sides emblazoned with the English words "Local initiative to reduce people suffering" -- traces its route to the rhythm of traditional Cameroonian music.

Dressed in shorts and a navy blue sweatshirt, Bwelle, who also teaches at the University of Yaounde, adds his voice and claps his hands.

Consultation: ASCOVIME doctors talk to patients in Nkongsamba. Health services are sketchy and life expectancy is low in many parts of Cameroon
 Adrien MAROTTE AFP

He grabs his young proteges by the shoulder, tells jokes, and beams.

"It's a bit silly, but I love making people smile. And for me, that means treating those who need it," Bwelle says.

Emmanuella Mounjid, a sixth-year medical student, is one of the weekend volunteers.

"I am learning a lot about medicine. Specialist doctors come with us and answer our questions," she says.

"But the experience is the richest at the human level. There is nothing more beautiful than receiving a smile."

© 2021 AFP