How awe can boost your health

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Hello and welcome to Health Check from the BBC. I'm Claudia Hammond here for the next half an hour with a roundup of what you need to know about what's happening in the world of health.

Now have those pictures from the far side of the moon left you feeling awestruck? In a moment we'll be hearing about the health benefits of experiencing the emotion of awe. We'll also be exploring the impact of the war in the Middle East on health, with fuel price uncertainty affecting health care and essential supplies stuck in containers in ports. And global health journalist Andrew Green is with me and we'll be discussing that later on. How are you, Andrew? I'm doing well, thank you.

And what else do you have for us today? Yes, we'll be looking at promising new findings around the neglected tropical disease NOMA, which has been particularly deadly for young children who acquire it in uh the global south. And from Mexico boyhood friends working together to make a new kind of prosthesis. Before all that, have you been following the inner That is bright. And uh Earthshine is Very distinct. Right. Impressive. Illusion. Wow. That's amazing.

The Earth is almost in full eclipse, the moon is almost in full daylight, and the only way you could get that view is to be halfway between the two entities. It's just it is truly awe inspiring up here. Last night we did have our first view of the moon far side and it was just absolutely spectacular. That is the dark side. That is something we have never seen before.

Of course, the Artemis II mission, for people who were further away from the Earth than anyone has ever been in the history of humankind. And I was struck by the awe you could hear in their voices as they described looking back at the Earth, the solar eclipse

and the far side of the moon, which no one has ever seen in person before. Now one of the crew even asked Mission Control for another twenty superlatives, because they didn't have enough words to describe how amazing it all was. Andrew, have you been following the mission? You know, I wasn't intending to and then all of a sudden these images started appearing and it's it's really hard to look away.

It really is. And many of us witnessing the launch on TV or seeing their floating press conferences will have experienced this sensation of awe too, which has been found to have benefits for our health and well being. And to find out how, I spoke to a world authority. on the psychology of awe, Professor Dacca Keltner from the University of California, Berkeley in the US. So is there evidence about the impact of looking back on Earth from space?

Yeah, I mean a couple of different lines of research. One is more qualitative. It's called the overview effect that astronauts and people who travel to space, there is this profound moment of looking upon the earth and recognizing you know, our small place in the universe that is awe inspiring because that's what awe is about is sensing that we are part of something much larger. And then there is a scientific literature as well that when we have vast views of things.

That too is awe inspiring. So I think both the perspective and then Seeing the Earth as part of something larger deliver a lot of awe out in space. And then they've also seen, of course, the far side of the moon and are the first humans to actually be there seeing that. What kind of impact would you expect that to have on them?

I mean I got goosebumps just thinking about it. You know, when you are a specialist in a domain and you have the once in a lifetime unique opportunity to see and discover something truly new. That's what we live for and that is awe inspiring to the world. And what about for the rest of us watching? You know, I can remember, you know, the goosebumps of just the other day when th watching the launch. It was just

so exciting and so amazing and then looking up at the moon on the nights following thinking they're on their way there or they're behind it or they're coming back round the other side. It's really extraordinary. Why do events like this strike awe in us? Well, I call that moral beauty when we are awestruck by human potential in some sense, when we're awstruck by human excellence, when we

see people who are courageous, who are so devoted to knowledge that they'll risk their lives, which is true in this case. That is inspiring to us. It teaches us what we're capable of. Do we know what's happening in the brain when we experience awe? Yeah, we do. You know, Claudia, there are several studies now in different countries the Netherlands and Japan, the United States, the UK.

showing that when we feel awe, as in these instances, a part of the brain called the default mode network, which is large chunks of your cortex, both in the front and to the side of your brain And those areas are deactivated, so they quiet down, and what's interesting about those areas, the default mode network, is that They are really the the neural underpinnings of the ego in some sense of striving and thinking about yourself and remembering the past of yourself.

And awe quiets the brain regions of the self and lets us think about other things and connect to larger things.

So is this why it can benefit us psychologically and make us make us feel a bit better? This is one of the ways in which awe benefits us uh psychologically and physically through the deactivation of the default mode network. But awe also has effects upon the body.

The vagus nerve, which is a large bundle of nerves that goes through your body, starts in the throat, and the facial musculature gets down to your heart and lungs and your organs and kinda calms the body, opens you up to other people. Very good for physical health and mental health, and so Ah has many different pathways by which it's good for us. And I know you've done studies looking at inflammation in your work and how or might impact on that. What have you done then?

Yeah, so we have a way of studying whether you on a regular basis feel more And there's always individual variation in emotions. And people who on a regular basis feel more awe, feel a little bit more beauty in the world, sense they're part of something larger. They show reduced levels of inflammation as indicated by this biomarker called interleukin six, which we assess through uh saliva and blood draws.

And that's really important because inflammation is activated by feeling rejected, ashamed psychologically, feeling disconnected from groups and society. All hard on the body and then inflammation can lead to things like heart disease, depression, autoimmune disease.

quiets or cools down that response. And then there's work from South Korea and Japan, very sophisticated work showing getting out in nature and, you know, enjoying music and the like, all at d sort of quiet down the inflammation process, which is Very good news for us.

And can we know that this inflammation process is down by the experience of ore rather than I don't know, maybe things are just going better in life so you're more able to experience some ore because you're not experiencing certain deprivation?

Yeah, that's a terrific question, Claudia. And you know, I don't think we know that yet. That's the rigorous kind of evidence that we need, you know, to pin down these causal statements. We do know Feeling awe on a more regular basis associated with lower inflammation, we do know

in our research, that's the only positive state that predicts lower inflammation. It's not pride, it's not gratitude, it's not joy or amusement. It's all. And now we need to do the kind of work that's hard in this realm of uh studying the biology of emotion where we pin down causality.

Can you deliberately seek ore out and feel the benefits? I mean obviously not everyone was as moved and as interested in the Artemis two mission as as some of us were. You know, I know some people who've said they just don't really get it. Why is this so interesting? But could they seek out other things instead?

Yeah, you know, in our research on awe for the past fifteen years, we find awe pretty easily and regularly in what I call these eight wonders of life, right? So nature and big ideas like space and other people's moral beauty and moving together and spiritual practice, visual arts, music and a couple of others. Those are wonderful places to immerse our minds, right? Go listen to music a little bit more intentionally. Go to a museum.

Uh a lot of new research on the benefits through awe of going to museums, get out in nature, be around inspiring people. You know, Einstein said that awe or mystery is just this basic state of mind. It's a easy state to access. if we just put ourselves in the right context. Professor Dacker Keltner, author of the book Or the Transformative Power of Everyday Wonder. Um Andrew, I wonder what creates a sense of awe for you?

You know, it's something of a cliche, but I was just in Zambia and I have visited the Victoria Falls for the first time in about twenty years and just the absolute scale of the water pounding down was just mesmerizing. They're amazing, aren't they? It's just absolutely mind blowing that it can be that be that magical. And I thought it was interesting that Dhaka was talking about all walks there,'cause we actually featured that research on health check once and I was then inspired by that.

to look around I don't know, just walking through my local park and walking to the station, to look around for things that strike awe in me and And now once you start you can't stop and so now I think about, you know, how do they make that bridge so it didn't fall down in the middle and isn't that amazing? And you know, you see a dead skeleton of a leaf and just think, This is incredible that life goes on there. So it's it's sort of amazing that we c we can find it all around us.

Yeah, if you're looking for it exactly as you say. Now as we record this the astronauts are on their way back home and we wish them a safe landing. And remember you can catch up on their progress every day on the BBC Podcast thirteen minutes presents Artemis two.

Well I'm gonna bring us right back down to Earth now, Andrew, and to the war in the Middle East and its impact on health. Now of course there's been an immediate impact for anyone caught up in in bombings. But the World Health Organization has warned of a spike in infectious diseases too. What sort of diseases are we talking about and why might they be an issue?

Yes, with millions of people displaced across Iran, Lebanon and and other places in the region, we're seeing people being forced into kind of crowded conditions and also being forced to consume contaminated water. So The result is an increase in respiratory illnesses as people are being crowded together, um, transmissible diseases like chicken pox, but then also of course a rise in watery diarrhea, particularly in areas where people are being exposed to contaminated water.

And of course there's the risk that this is going to get worse. I mean, there's the good news um of the ceasefire, but there have already been attacks on water desalination plants in Iran, which kind of uh you know, hurts people's access to clean water and there's the threat that more could be attacked if fighting does resume.

And for a region that really depends on these plants for access to clean water, you know, then there there's obviously huge concerns about a rise in communicable diseases through through dirty water. And I notice there have been reports of black rain in Tehran. Do we have any idea what's causing that? Yes, that seems to be a result of the strikes on oil facilities in the country, um, and then the chemicals being rained back down onto the population.

And again, this is going to exacerbate respiratory conditions, to rise in influenza that already exists in some of these crowded settings. This is only going to make that worse. But then there's also the risk of long term consequences. You know, some of these chemicals are linked to to cancers that we could still see developing years from now.

Now globally the biggest impact of the war so far has been the price of gas and oil due to difficulties in getting through the Strait of Hormuz, which is of course a prominent shipping route. What effect is that having on medical provision globally? So it's having a huge effect, particularly as you can imagine, in humanitarian settings. Um these are often places where there are are no significant resources nearby that everything needs to be shipped in. And so

All of a sudden the the spike in oil prices is making it more difficult to access goods. But then there's The immediate impact, which is that as oil and fuel prices go up, it becomes more expensive to do things like power generators that keep clinics running, or to refrigerate medicines that are keeping people alive. Also, in a lot of these settings, they rely on petrochemical-based products.

Things like syringes or just the the packaging that is used to protect products as they're being carried from one point to another. And so those prices are going up as well. Um all which adds up to a much more expensive humanitarian catastrophe. And one where there are essentially just fewer supplies to go around. And of course it's not only oil that travels through the Strait of Hormuz. What else has been getting stuck?

Yes, it's essentially as you kind of allude to, everything, everything's getting stuck or it's becoming more expensive to fly in. You know, I was reading an interview with the head of Africa CDC, Jean Casseya, who was pointing out that the cost of polyester has gone up by forty percent.

And it seems strange that he was pointing that out until he also mentioned that that's, you know, the main component of mosquito nets. So all of a sudden it becomes much more expensive to produce mosquito nets, and then that's going to have knock-on effect.

uh to malaria transmission in places where there's no local production of polyester. And so I think we're just going to see ongoing impact of this conflict, even if the ceasefire holds, in places around the world that weren't actually touched by the fighting. And finally, there is a way that the war has actually been impacting health care in the US itself and not just in the Middle East. What's happened there?

Yes, this has been an unexpected consequence, perhaps, at least to my mind, but um we've seen Iran linked hacker. targeting the US infrastructure and in particular trying to disrupt some US medical companies. There was one medical device company in Michigan that saw its production taken offline by hackers who

uh worm their way in through the Microsoft systems. But more broadly, the FBI has been warning that all infrastructure, all digital infrastructure is potentially at risk to these hackers, which could have Severe consequences beyond um just health systems, but you know, also to delivery of wastewater or energy to people's homes. So all sorts of different consequences there. Thank you for that, Andrew.

The Signal Awards recognize the podcasts that define culture, and being honored by the Signal Awards sets your production team apart with recognition. The industry's top experts and acts as proof that your work is a standard bearer for podcasting worldwide. By entering your work is heard by the Signal Awards Judging Academy, an invitation-only body of podcasting.

Professionals from acclaimed organizations which include the BBC. Grow your audience, celebrate your team, and stand out. The final entry deadline to submit is the 26th of June. Enter your at signalaward.com for consideration. You're listening to Health Check from the BBC. I'm Claudia Hammond, and my guest today is Global Health Journalist Andrew Green.

To Mexico now, where the government is trying to meet the high local need for prostheses for people who have a missing limb, either since birth or due to disease or injury. For Health Check, our reporter Rogelio Navarro has been to Guadalajara to visit One Project to find out what this means for people on the ground.

Menomilia is a rare congenital disease. It affects the growth of a limb while in the mother's womb, and people born with this condition never develop, for instance, an arm. Alberto Betorosco was born with it. And around ten years ago back when him and his best friend Jorge Cochelo Belasco were kids, the story Alberto told about his arm involved a shark biting it off. The joke started a friendship while the two of them attended summer school.

Una vez me dijo, no pues un, yo estaba en la playa nada. He once told me that one day he was swimming at the beach and a shark bit him and took the arm away. And that's how it was. And I, as a child, believed it and said, no, oh that's too bad, isn't it? Y ya después pues la amistad Then the friendship grew, and I couldn't continue with the lie. And then I told him, How could you think a shark? I mean, I've had it like this since birth. I didn't lose my arm, I just don't have an arm.

Siento que como con juegos,¿no? Well it all started I feel like through games or jokes. It was like Oh, maybe when I grow up I'm gonna give you an arm. Or maybe we'll help each other and make you an arm or we'll give you a prosthesis. But it was mostly just that kind of play.

Y en una de esas noches que And on one of those nights when we were watching movies or recording videos like sketches or things like that, the topic came up and he said, I'm going to make you a robotic arm, so you can be a cyborg when you grow up. que seas un cyborg cuando, cuando crezca. Both friends grew up.

Alberto became a community manager and Jorge studied biomedical engineering and asked Alberto if he would join him on his thesis project along with a team at the Guadalajara Autonomous University into developing a prosthetic arm for him. This team is led by doctor in biomedical engineering, Eric Guzman. who already had a patent for a prosthetic arm, e ready, and who also wanted to develop a prosthetic for someone who has been born with a missing limb.

Well, I think that the biggest challenge has been, at the beginning of the program, we have developed the technology, but it was only tested for users that have both limbs. So the main challenge was to get access to a volunteer that want to be hundred percent part of the project and participate with them, basically already have been developed for this specific subject and right now we are moving to transfer the project to different users to increase the capacity of itself.

Before getting to the actual stage of development, the mechanical arm had gone through several versions. On the first model, it was in the team's words, rustic, with straps, cables, an external battery and up to nine electrodes to make it work. For today's version, the best description is that it looks like a robot's arm. The hand is blue and the forearm is black with 3D printed parts made of ABS, a thermoplastic filament.

All the servers, batteries and mechanical parts are hidden in the forearm and the prosthetic connects with the user with a thermoplastic socket that has a muscular sensor and a microscope. It has only two sensors. The first one is a microphone that basically it detects one instruction word. It is related always with different kind of joints. elbow, wrist, hand. The microphone records that word and it transfers the information in one instruction.

ET instruction is decodify it. The second sensor, the muscular sensor, only requires a muscular activation that is only press the chest or press the visceral or tricep or basically any muscle in the body. And we read and analyze that contraction. So basically when we have the word and when we have the muscular contraction, the prosthetic device starts moving.

Alberto had to learn how to use a limb that he never grew. Achieving this is accomplished through a process called neuroplasticity, which is the brain's ability to reorganize, change, and make new neuroconnections. When he first tried on the developed processes, he was instructed. Bueno, ahora... Okay, now do things with two hands. And what do I do? How do I do things with two hands? I don't know how to do things with two hands because I've never done anything with two hands.

The human and user centered perspective of the project is a fundamental part of the design, because most of the rejection reasons are related with the easiness of the use of the device. So the challenge is to minimize rejection and make the prosthetic arm as simple as wearing a watch or a sock. Dr. Eric Guzman explained.

The innovation of this project is the control. We have analyzed several prosthetics around the wall, but we want to reduce the number of sensors that you need to control a prosthetic device. Because we have noticed that also when a prosthetic device is really complicated to use it in your day life

Some people generate a rejection to the prosthetic device and of course these kind of prosthetic devices are something that is not really cheap. So sometimes they're only rejected and they don't want to use it anymore because

They say it's really complicated to use it. So we part from that point to develop a prosthetic device that is something pretty simple to use and that basically in Ten to twenty minutes to use the prosthetic is that enough to use the prosthetic device properly and control it and start using the the device in different kind of tasks.

According to official records, around 9.5 million people in Mexico have some sort of disability, and for almost half of those people their disability relates to mobility. To understand the context of the E-Ready development, I spoke with disability activist Mari Ángel Garcia. So far a lot of people of the millions of people with disabilities, a very little amount of them have access to any functional system.

Whether it is prosthetic something, whether it is a wheelchair, whether it is a walker, whether it is an electric wheelchair. Not a lot of people have access to it because it's always been so expensive. And creating something that is not as expensive, I think it's key. The other thing I feel is that it's always up to the possibilities of the individual with disability, the responsibility of the individual with disability and the economical context

and their possibilities to be able to access something like this. And also because I think it's very important that every time we design anything related to disability, disability must be in the center of the design. Not just as a client, not just as my fire nail consumer, but as the people who design it with. Because not everyone with a disability will be the same. Even the same disability, even the same, you know, lack of a limb, you know, it will be very different.

we need to be part of that design. And I would think that being part of that design, I'm not gonna say it would gonna make it cheaper because not necessarily, but it would make it more resourceful, I would say. Alberto has been central to the development of his new arm and is now proud to show it off. Yo sí quiero que se vea robótico.

I do want it to look robotic. I know there are many people who use prosthetics and they try to hide the fact that it's a prosthesis by using latex gloves or even uh they make fingerprint impressions. So that it looks as much like the real arm as possible. But no, I do want it to look robotic. I mean, I'm proud of who I am, how I look and who I am, and I wouldn't want to hide that part of myself. And if you see me in the end, I'd be a cyborg, and who wouldn't want to be a cyborg?

Pues sí, o sea al final pues tiene un cyborg y quién no quiere ser un cyborg.

Rogelio Navarro reporting from Mexico. Now Andrew, we have some positive news next on a disease called NOMA. First of all, what is this disease and who's most likely to get it? So it starts as gingivitis, but then if it's not addressed quickly, it can rapidly progress to this gangrenous disease that destroys facial tissue. In ninety percent of cases, it's actually fatal, but for people who survive.

You know, it can lead to long-term complications and swallowing and breathing. It it can cause PTSD in people who survive this. And the people it's infecting are often young children in the global south, talking about two to six years old. It's not a disease that a lot has been known about. It was declared a neglected tropical disease by the World Health Organization only in 2023.

But the WHO's last estimates on how widespread this is come from nineteen ninety-eight, and they estimated there are 140,000 incident cases at that point. But it's really unclear how widespread of a problem this is. Now as you say, many children don't survive it, but one person who did survive is Fidel Strube. who was originally from Bikina Faso and who I met for health check. He founded the Elysium NOMA Survivors Association and he told me what it was like living with the consequences of NOMA.

The lasting effects are numerous. PTSD, depression, then also your identity is gone, dignity is taken away, so you have somehow to regain this I live with uh severe disfigurement. I have difficulties eating. It took me six years of daily speech therapy to speak how I speak now. For every cutlery in the restaurant at home I have to adapt a different movement to get the food in my mouth. I can only open my mouth less than a centimeter. There were numerous challenges. I can list a lot of them.

And Fidel said as part of that interview that initially the doctors didn't know what it was, but what is it the researchers have discovered now? Yes, this is the the really good news for a disease where not much has been known. There there seems to be some indications from new research that. particular bacteria might be responsible for causing gnoma. At least it's been linked in several cases of people who have contracted the disease and survived.

And the researchers were able to determine this using metagenomic sequencing. In addition, it also revealed that there's not antibiotic resistance. That means that it doesn't foreclose any treatment options and and there's potentially a lot of opportunity for figuring out how to arrest the spread of NOMA more quickly.

So do you think this might be s significant or is it gonna be hard for children who are living in such poverty to I don't know, eventually get tested to find out if it's this bacteria and even get treatment? Yeah, I think the exciting thing about this is it does point a path to creating diagnostic testing that could identify an early stage of the disease if the bacteria is present and facilitate quick treatment. But then again, as you point out, it's

This is a neglected tropical disease and it's something where there's not been a lot of research or investment. And so then the question becomes

Who's going to to start paying for the creation of these diagnostics and the testing to see what treatment works and then also to facilitate their introduction once they are discovered in the settings where people need them the most, which again is is often the poorest areas of the world. So Uh a lot of barriers between uh this exciting new information and the actual execution of of any benefits to people on the ground.

Yeah, we'll see what happens there. Well thank you so much, Andrew Green, for joining us for Health Check today, and thanks to the producers Hannah Robbins and Jonathan Blackwell. Do contact us with your health questions at healthcheck at bbc.co dot uk.

I'm Claudia Hammond and in the next episode of Health Check we'll be hearing from Vietnam where the authorities plan to reduce air pollution by banning the thousands of motorbikes streaming through parts of Hanoi and replacing them with e bikes. Bye for now. The Signal Awards recognize the podcasts that define culture, and being honored by the Signal Awards sets your production team apart with recognition

The industry's top experts and acts as proof that your work is a standard bearer for podcasting worldwide. By entering your work is heard by the Signal Awards Judging Academy, an invitation-only body of podcasting. Podcast professionals from acclaimed organizations. Which include the BBC. Grow your audience, celebrate your team, and stand out. The final entry deadline to submit is the twenty-sixth of June. Enter your podcast at signalaward.com for consideration.