Globalization’s Grotesque Face: The Economic Oppression of Women Agriculture Workers in Pakistan

Pakistan’s economy is firmly linked to agriculture and food production. Since the inception of the country, no real land reforms have been undertaken, and the rural elite remains a major force in controlling agricultural land. At the same time, since the 1990s the country has also followed a neoliberal agenda, through the International Monetary Fund led structural adjustment programs, and then later after Pakistan’s entrance in the World Trade Organisation in1995. The trade liberalisation agenda of the advanced capitalist countries, especially the United States, have been consistently implemented in the country. In this context, it is clear that at least two different levels of political and economic forces are present in the rural economy. There is also no doubt that Pakistan also has a strong patriarchal society, which governs the social and economic norms of society.

Palliative Care for People Living With Hiv/Aids in Uganda: An Investigation of Patients &Amp; Caregiver’S Outcome and Professional Perspectives

Background: Although antiretroviral treatment is expanding in sub-Saharan Africa, the World Health Organization advocates for integration of palliative care with HAART because pain, other distressing symptoms and complex psychosocial challenges persist throughout the HIV trajectory. Palliative care improves the outcome for patients with HIV and may complement antiretroviral treatment by increasing adherence through better management of side effects from the treatment, providing patient and family-centred holistic care, and giving end-of-life care when necessary. However, integrating what have become two disciplines is challenging. Aim: To study the implications for palliative care provision in the context of changing policy to universal access to HAART for people living with advanced AIDS (PLWA) in Uganda. Research questions addressed in the study included: 1. How do patients with advanced AIDS (stage 1Il and IV) and with palliative care needs and their families experience care delivery and receipt over a period of 8 weeks? 2. How is the morphine roll-out programme among advanced AIDS patients operationalized in Uganda? 3. What are the challenges faced by health care workers involved in delivery and implementation of integrated palliative care for patients with advanced AIDS? 4. What are the views of key opinion leaders on development of palliative care policies in Uganda? Methods: A mixed methods approach was employed. The study comprised of three phases. In phase one, a consecutive sample of 30 newly enrolled patients advanced AIDS (stage III & IV) and their carers were recruited at Hospice Africa Uganda and followed up for 8 weeks. Qualitative interviews were conducted with patients and their carers at one time point and an outcome measure using African Palliative Care Association-Palliative Outcome Scale (APeA-POS) was used to assess changes in their experiences over 8 weeks, following access to palliative care. In phase two, 10 palliative care staff members participated in individual interviews and one focus group to explore the challenges they faced in delivering services to patients. Phase three explored, by the use of interviews with 7 key stakeholders, the broader context of palliative care policy development and opinions about key priorities for the future. Findings: Out of 30 patients, 14 were male and 16 were female. They ranged in age from 18-60 years. The majority of patients were bed-ridden and experienced distressing symptoms related to advanced AIDS and AIDS-defining cancers which necessitated timely palliative care intervention. The key findings of the study relate to the range of physical symptoms experienced