In May 2015, Ebola emerged again in Guinea. This time in an area that had not experienced the virus before, in the town of Tanene in the Dubreka Prefecture. The World Health Organization (WHO) is putting lessons previously learned from five outbreaks in the Democratic Republic of Congo (DRC) as well as Guinea’s outbreak in 2014 to good use in Tanene.
Community engagement is key to putting an end to Ebola, and one of WHO’s social mobilization experts, Marie Claire Therese Fweto Mwanza, is at work in Guinea.
Mwanza helped end five of the seven outbreaks in DRC, the last one in three months. She has trained 60 colleagues to currently provide social mobilization work in Guinea. Social mobilization is a process to raise awareness of a development objective, in this case, how to prevent the spread of Ebola, through dialogue in the community.
Social mobilization also raises the demand for action needed to accomplish the objective. In Guinea, the dialogue transpires at the community level with the help of allies. Community networks, civic and religious groups and other related partners coordinate efforts to induce the change necessary to stop Ebola.
WHO, the Ministry of Health of Guinea, U.S. Centers for Disease Control, Red Cross Guinea and United Nation Children’s Fund all came together to launch a surveillance campaign in June.
Mwanza, who has worked for WHO for 27 years, is confident that her experience in other campaigns will be effective in Guinea.
Before any surveillance work could take place, it was essential to understand the community so that the dialogue could be tailored in order to be effective. According to Mwanza, listening is one of the most important skills.
Speaking with compassion and being careful in conversations is also essential to making headway. These traits encourage the community to participate in the surveillance and take measures to protect themselves and their families.
One of the problems is the rumors that spread throughout a community. In Guinea, almost 60% of the people believed that blood was being sold. Mwanza knew how to deal with this situation because of lessons learned in 2012 in DRC. She said that the rumor was so entrenched in DRC that families hid their sick relatives in the forest and attacked Doctors Without Borders.
In order to deal with this at that time, Mwanza said they had to find out how this rumor took hold. Fifty nursing students were trained to survey community members.
Guineans told them, “When you go to an Ebola Treatment Unit, your heart is punctured, and 20 liters of blood are drawn. Your genitals are cut off, and your blood and organs are sold on the international black market.” Armed with this information, aid workers were able to tailor their messages and their next steps.
In DRC, the next step was to help people see with their own eyes how patients are treated in ETUs, so three community leaders were outfitted in personal protective equipment (PPE) and saw how patients were provided food and were not having organs cut or being killed.
Next, these leaders went door-to-door with Mwanza’s social mobilization team and Ebola survivors to testify in the community that an ETU saves lives. Such testimonies build trust among community members who then not only bring sick families into an ETU but also help trace and find contacts.
The same procedure worked in regard to a rumor about safe burials. A victim of Ebola must be buried by people wearing personal protective equipment. But families prefer to be able to touch the loved ones they are burying.
They were also afraid that organs were being cut out. After dressing a family member in PPE and having him participate in the burial of a loved one, he was able to testify to community members that a safe burial is necessary and appropriate.
Mwanza explained that they approached Guinea in the same way, “Not only did we engage communities to help with educating their neighbors about Ebola, we also encouraged them to actively participate in community surveillance and contact tracing.” Mwanza and her team trained 250 surveillance officers and 25 supervisors from the community to work actively in their own areas in Guinea.
On the first day of the surveillance campaign, rumors still thrived. Many Guineans heard that Ebola teams were coming to disinfect their homes and give them injections, so they shut their doors or temporarily left home. When the community members who stayed home and were visited by the surveillance team told their neighbors that the campaign was safe, many families returned home.
After that, surveillance teams were able to carry out intensive door-to-door visits. Teams explained the risks, the prevention measures and the importance of declaring illnesses and deaths. The Ministry of Health provides free healthcare for all cases during the campaign as well as soap and food during the 21-day surveillance period.
These measure are intended to encourage people to declare illnesses and deaths and allow them to stay at home to take care of family members.
Further community engagement was employed through key groups, such as religious, youth, women and workers’ unions. Representatives were invited to speak to the community to emphasize the campaign message: cooperate with Ebola teams, be vigilant and share information.
Resistance to respond to Ebola in Guinea is still a concern; for example, rumors still abound and people don’t believe that Ebola is real. However, WHO continually assesses community reaction and uses what it learns to adapt its methods to combat misinformation. In this way, progress is being made in Tanene.
“People are listening to programmes about Ebola on community radio, signs and stickers are posted throughout the villages and important conversations are taking place on the streets,” Mwanza declared.
She noted that children and youth are especially effective in the community engagement process. Children bring home messages about Ebola from school. Youth can have a strong influence in a Guinean community in regards to Ebola. One young man left this powerful message in the dirt outside his home: “Stop Ebola.”
– Janet Quinn
Sources: UNICEF, WHO 1, WHO 2
Photo: WHO
Maternal Instinct: Indian Women Take on a Corrupt Medical System
A group of 40 volunteers is cracking down on the corrupt medical system in India and taking a stand against the country’s soaring rate of maternal deaths.
Prenatal care at government-run medical facilities is supposed to be free of charge, but as Monika Singh discovered, not every woman is aware of this, and some doctors are more than willing to exploit their ignorance.
“Why are you charging for medicine? It’s supposed to be free for pregnant women in a government hospital,” challenged Singh when a doctor tried to make an ill mother-to-be pay for her medicine.
Armed with Nokia phones and a list of codes, Singh and fellow volunteers routinely visit a number of villages, interviewing expecting and new mothers and families. Using simple numeric codes, interviewees can text the volunteer’s details of their pregnancy and related care. For example, texting the number 25 means no ambulance was available when needed.
Cases of women being turned away from hospitals, women being extorted and forced to bribe their way to treatment, and even cases of women dying on the way to the hospital after being denied treatment at multiple clinics are just a few of the examples of the rampant corruption of the Indian medical system.
An estimated 50,000 women in India die each year from pregnancy-related causes, accounting for 17 percent of global maternal deaths each year. While there are countries with much higher rates of maternal death, the sheer volume of annual maternal deaths is unprecedented.
Aside from malnutrition and a lack of enforcement of laws meant to protect expecting mothers, many women say they are too afraid to pursue their rights, even when they know them. “They don’t have the courage to pursue their rights proactively. That’s the challenge,” said Singh. But the presence of volunteers is encouraging more women to speak out about the injustices they have faced.
Improvements have been seen, however, since Singh and her fellow volunteers took to the streets. Working with the End Maternal Mortality Now (EndMMNow) scheme, the volunteers say it is now the doctors who are afraid of them, not the other way around.
“The workers fear these volunteers. They’re afraid they will report a case about them, so now they do their jobs properly,” said Arpana Choudhury, who follows up on reported cases.
The EndMMNow program compiles the reports that they receive to create an interactive map, clearly showing areas needing the most urgent attention, hoping that a clear depiction of the need for reform will prompt much-needed government attention.
– Gina Lehner
Sources: The Guardian, WHO
Photo: Flickr
Six Instagram Accounts to Follow for a Glimpse of Global Poverty
Instagram is a social media outlet that allows users all around the world to share photos. The social network has more than 300 million monthly active users in a world that is captivated by visuals. Although Instagram can serve as an announcement for what’s for dinner, it has been influential in allowing people across continents a glimpse into one another’s lives.
An important aspect of Instagram is its ability to make those whom we will never meet relatable to us. This aspect can be applied to A-list celebrities such as Taylor Swift and Hugh Jackman, as well as to the poor villagers in North Africa. Instagram can humanize the poor and mobilize the able.
Listed below are a few Instagram accounts that do an excellent job showing the beauty as well as the tragic poverty of developing countries.
1. Lynsey Addario @lynseyaddario
American Photo Magazine named Lynsey Addario, currently living in London, one of the five most influential photographers in the past 25 years.
2. Marcus Bleasdale @marcusbleasdale
Marcus Bleasdale is a documentary photographer working in the Central African Republic. His coverage of poverty-stricken conflict zones has earned him the Amnesty International Award for Media 2014.
3. Andrew Quilty @andrewquilty
Andrew Quilty is an Australian documentary photographer working in Afghanistan.
4. Phil Moore @philmoorephoto
Phil Moore is a British freelance photographer documenting life in Burundi.
5. Everyday Africa @everydayafrica
Everyday Africa is a project started by Peter DiCampo and Austin Merrill to show what life in Africa is really like. The account features many African and non-African photographers in their daily lives.
6. Everyday Asia @everydayasia
Everyday Asia is based after Everyday Africa, showing what life in different parts of Asia is like.
– Iona Brannon
Sources: Global Insider, Lynsey Addario, Marcus Bleasdale, Andrew Quilty, Phil Moore, Everyday Africa
Photo: Everyday Africa
Surfing Waves Aids Communities in Peru and Nicaragua
WAVES for Development International, founded toward the end of 2004, is a nonprofit organization based in Peru whose mission is to connect tourists and surfers to volunteer opportunities and grassroots initiatives to effectively work together in communities in both Peru and Nicaragua.
One of WAVES commanding principles is to inspire world travel and cultural exchange through surfing as well as spreading social entrepreneurship, healthy living and life skills. WAVES stands for water, adventure, voluntourism, education and sustainability, which encompasses the organization’s five pillars of beliefs and goals.
Water and adventure are associated with the thrill of surfing, something the members of WAVES for Development International live their lives doing. The made up word, voluntourism, captures their goal of connecting tourists with volunteer opportunities to give back to the communities they visit.
These volunteer activities assist locals with education and sustainability, two concepts the organization believes are needed for places to thrive. With the belief that education is highly important in poorer communities, WAVES uses natural and local resources to help developing communities educate their youth and empower them to create bigger and better things.
Another belief they act upon is there are four main aspects to sustainability; ecological, economic, social and political. WAVES’ projects work to assist communities in environmental conservation, safe economic and political practices and to bring the community together as a whole to help with the projects and celebrate their culture.
WAVES connects tourists with volunteer activities in three different categories; surf voluntourism, which allows people to volunteer in surfing communities in Peru and Nicaragua, advocacy and education, where volunteers assist with educating youth to become effective leaders and network of partnerships, in which the volunteerism focuses on the overall convergence of people and organizations who work together to make the world a better place.
The WAVES team consists of volunteers from all over the world, including Spain, South America, Africa and the United States. Team members have come together to assist developing communities in Peru in an effort to bring a new force of individuals to the world.
While the organization was created in Peru and primarily helps communities there and in Nicaragua, WAVES for Development International has recently teamed up with members in and around Montreux, Switzerland to form WAVES Peru and WAVES Switzerland, allowing the two to reach a wider audience and give back to more communities through their shared love of surfing.
– Julia Hettiger
Sources: WAVES, Volunteer Match, Great Nonprofits
Photo: Flickr
How The Water Project Empowers Girls
In many rural communities throughout sub-Saharan Africa, hundreds of people are unable to access safe, clean water, suffering from several different diseases and illnesses as a result. Relying predominantly on women and girls to walk miles away from home to collect water – dirty water that makes them and their families sick – the communities are gender biased and women are not considered as important as men.
Unclean water and gender inequality limits the potential of many people and communities, and contributes to the cycle of extreme poverty.
The Water Project, however, is determined to change this. A nonprofit organization that brings sustainable water projects to communities in sub-Saharan Africa, The Water Project provides those communities with access to clean water and the means to maintain proper sanitation.
Admirably, the organization seeks to instill hope in suffering communities by making clean water the norm. Clean water improves health, breaks down poverty and supports education.
Lack of access to clean water and proper sanitation, however, is the primary reason that girls drop out of school. They spend valuable learning time walking to streams or ponds to gather water, only to eventually drink it and get sick. The Water Project, however, empowers girls by bringing safe, clean water to their communities.
In addition to improved health conditions, clean water strengthens opportunities for quality education. Access to safe water ensures that girls remain in school, which opens the door to future careers and earned wages. Because women reinvest up to 90 percent of their income back into their households, compared to 40 percent by men, this is imperative.
The efforts of The Water Project have inevitably taught communities to see the value of women and potential of girls. It has unlocked a generation of leaders. Education provides endless opportunities, but clean water liberates, encourages and inspires.
– Sarah Sheppard
Photo: The Water Project
Oculostaple: A Medical Device Revolution
Oculostaple is a tool that is designed to restore vision in people with drooping eyelids, or ptosis. Ptosis can have any number of causes, from Myasthenia gravis (an autoimmune, neuromuscular disorder) to a stroke, a tumor, or simply old age.
It was designed by undergraduate students at Georgia Tech, Drew Padilla, Jacki Borinski, and Mohamad Ali Najia. Najia is now the CEO of the Oculostaple company.
The device works by simultaneously cutting away excess muscle and sealing up the cut that it creates. Before, correcting the issue was the result of a surgery that took about 45 minutes in an operating room. With Oculostaple, drooping eyelids can be resolved with local anesthesia in a doctor’s office, in a procedure that lasts about five minutes. It will also decrease the cost of each individual surgery by about $5,000.
Due to its impressive features, the Oculostaple recently received second place in the National Institute of Health Design by Biomedical Undergraduate Teams (DEBUT) Challenge. The award, given to undergraduate students, was based on the impact the new invention would have on clinical care, the significance of the problem being addressed, the ingenuity of the design, and the creation of a prototype.
It’s not widely available just yet – the Oculostaple team is working with the Global Center for Medical Innovation (GCMI) to create it into a marketable medical device that will eventually be completely disposable.
GCMI is a nonprofit organization that brings together players in the medical device community to help “enhance their product development, shorten time to market, and potentially achieve significant cost savings” in the process of bringing the devices to market. Oculostaple also won first place last year at Georgia Tech’s fall Capstone Design Expo, and second place at its Inventure Prize competition.
While 200,000 Americans undergo surgery to correct drooping eyelids each year, the possibilities for this new device extend far beyond helping Americans be able to see better (and drive safer). Ophthalmologists throughout the medical community are excited for the device, which will make this surgery easy to perform. As the Oculostaple website states, it “also has broad applicability in laparoscopic, gastrointestinal, and biopsy procedures.”
Imagine the possibilities in treating diseases in poorer countries with the creation of technology like this. Gastrointestinal problems are common in third world countries, as people don’t always have access to clean water. Oculostaple could mean safer, faster, cheaper, and more effective treatment for a wide range of problems.
This surgical clamp removes the problem that sometimes occurs in eyelid surgery: the doctors accidentally cut their own sutures as they are trying to cut off excess muscle. Now, both parts of the procedure can be done simultaneously.
In an interview with Charlie Bennett, Najia described the process of how the device came to be, from the beginning, running tests on microwaved pieces of chicken skin, to redesigning the concept again and again, to being halfway out of the stadium with his teammates when their first place at their school’s Capstone competition was announced. Through it all, he said, “I think it’s been a very worthwhile endeavor.”
The development of a revolutionary device is an excellent example of how people throughout the medical community are working everyday to make a healthier world. Whether they are seasoned medical professionals or undergraduate students, they can make a difference, and they are.
– Emily Dieckman
Sources: Devices, NIH, Georgia Institute of Technology, News Medical, North Avenue Lounge, Oculostaple
Photo: Flickr
How Education Affects Wealth and Prosperity in the United States
Fifteen-years-ago, education was a golden ticket to a good secure job in the United States. The idea was to go to school, get a four-year degree and land a good career. College education was just that: education. Disciplines did not matter as much as the actual degree.
Times have changed. Increased pressure from other countries has created strong competition and graduating Americans are not given preference over other people anymore. Employers are looking for the skill sets necessary to complete the job and they are not afraid to outsource to get it.
Specialization has become more and more trendy and two-year degrees and specific training courses have surged in popularity. A May 2015 study from Georgetown University suggests that college graduates will earn $1 million more than high school graduates.
This is not new as it has been widely known for a while. The kicker though, the highest paying majors earn $3.4 million more that those with the lowest paying majors.
The study suggested that STEM related fields heavily out paid social sciences. For example, a bachelor’s degree in engineering or architecture earns an average of $83k annually over the course of their career, while a graduate degree holder in education earns $60k over their career on average.
The relationship is quite complex. Another influencing factor was whether graduates worked in the for-profit, nonprofit or public sector; which industry they worked for; and whether they participated in professional development after they had started their careers. Educators working business jobs, for example, would make more than an engineer working as a teacher.
As time has gone by, humanity studies have declined and business and STEM degrees are on the rise in America. This is heavily influenced by what is in demand in the labor market. Business degrees make up 26 percent of college-educated workers. Although humanity majors are down, liberal arts and humanity class enrollment has gone up due to more rigorous general education requirements.
Attainment is another major finding in the study. Among the 15 major groups, biology and life sciences majors are most likely to earn a graduate degree, while communications and journalism majors are the least likely to earn a graduate degree. Fifty-eight percent of biology and life sciences majors earn a graduate degree, compared to 21 percent of communications and journalism majors.
Better counseling and mentorship programs are needed to help future students become fully educated about the degrees they decide to pursue before enrolling. An August 2015 study from the Federal Reserve Bank of St. Louis looked at how college degrees affected a person’s income and ability to manage financial hardships such as the recession. They analyzed data from 1992 to 2013 to determine trends, reporting wealth and income correlations with racial and ethnic groups.
They found that regardless of skin color or ethnicity, the median net worth of families headed by someone with a four-year degree was 3.6 to 9.8 times larger than families headed by less-educated persons. However, when it came to race, the landscape looked a lot different in terms of handling recessions.
Asians and Caucasians who had four year degrees withstood economic recessions better than their uneducated counterparts and typically accumulated more wealth over the long run. Blacks and Hispanics fared worse. The study concluded that Hispanic and black families with degrees typically fared “significantly worse” than those without degrees. College-educated Hispanic and black families experienced declines in wealth during and after the economic collapse of 2008.
The higher education system in the United States has been continuously scrutinized for not doing enough to provide opportunities for minorities. This is an easy narrative to blame for all the problems. The reality is much more complex. Racism does affect mental health and has led to many problems in society that affect economics and social welfare but there is still much unknown according to the study.
The U.S. must fund more studies and strategize better on how to deal with these imbalances. Further research is needed to understand why there are such disparities in wealth among racial and ethnic groups.
– Adnan Khalid
Sources: Center on Education and the Workforce, Federal Reserve Bank of St. Louis
Photo: Rainbow Educational Consulting
Struggles of Cuban Youth in the Face of Political Change
Although it is banner global news that the U.S. embassy has reopened in Cuba after 50 years of nonexistent relations, young Cubans are less than thrilled about the development. A reestablishment of an American-Cuban relationship may change the political/economic environment for some higher-ups, but it is unlikely to change anything for a young generation in Cuba that faces daily turmoil.
Despite much buzz surrounding the shift that is underway in the country, a sense of cynicism remains among the Cuban youth who believe that the ideals of Fidel Castro’s revolution are dated and irrelevant in the modern age. Hope of prosperity is shrouded by the belief that the Cuban government will not possibly allow young lives to change.
“Change? My life won’t change,” said 17-year-old Yunior Rodriguez Soto, gesturing to the dilapidated basketball court that surrounded him as evidence. “[The government] won’t let it happen […] That’s just how they are.”
The youth are open to political freedom and socioeconomic reform, but due to the Cuban government’s desire to maintain control and reach the highest possible level of national economic success, it is unlikely that changes will trickle down to their level.
Efforts of the government to balance economic growth with state control are causing private sector development to be difficult. Thus, the overgrown public sector is failing to persuade young people to stay in Cuba and start families. They have no guarantee that if they work hard they can support themselves and their children.
Government prices make buying products difficult for small business owners, and Cubans are often forced to turn to the black market in order to get the supplies they need at affordable prices. This black market activity does little to bolster the national economy.
While many developing nations see large youth populations, Cuba faces a serious demographic problem in their lack of young people. Approximately 20 percent of the Cuban population is over 60, making it the oldest Latin American nation, on average. Like Japan and the nations of Northern Europe, Cuba is a society struggling to support their older citizens without a thriving youth population on the economic rise.
There is evidence of a growing Cuban economy–new bars, clubs, and restaurants opening daily in Havana. But the lives of many Cubans have barely improved. The citizens opening these establishments were better off to begin with than many living on the streets. As one young Cuban remarked “the only way to see change is to make a boat and sail off.”
Cuban citizens want the change in their country to be immediate and to live up to the hype, but officials continue to insist that steps toward change will be gradual and take a while to pay off.
Cuba faces a conundrum–it is the youth that they most need to be involved in order for the country to prosper, but it is the youth who are least optimistic that the nation can change. The young people of Cuba, like those in other countries, on the whole are not overly interested in politics. Without some inspiration, it is unclear when the Cuban economy will see any significant change for its impoverished youth.
– Katie Pickle
Sources: New York Times, BBC
Photo: Flickr
World Bank Finances Poverty Reduction Projects in Laos
On August 17, the World Bank signed an agreement with the Lao People’s Democratic Republic to finance three projects aimed at increasing the efficiency and reliability of electricity, facilitating quality health and nutrition for women and children and building necessary infrastructure, such as roads, health clinics, schools and drinking water systems.
The World Bank has approved a US$68 million loan, which will be divided among the projects. The Power Grid Improvement Project will receive the greatest sum, US$30 million, with the Health and Nutrition Development Project and Poverty Reduction Fund II Project endowed with US$26.4 million and US$11.6 million respectively.
Although Laos has successfully provided most citizens with electricity, there are still problems. After a distribution loss in 2014 of 24 percent, greater than the 13 percent national average, Laos’s Xaythany district of capital city Vientiane has become the target area for the Power Grid Improvement Project.
The experience of increasing electricity efficiency will provide a building block, serving as a jumping off point for further improvements across the country.
With the Health Governance and Nutrition Development Project, the Lao PDR government aims to bolster women and children’s healthcare by providing free services. If successful, the project will reduce the instances of stunted growth and wasting from lack of nutrition. In order to accomplish better childhood nourishment, the program will promote breastfeeding.
Also on the agenda is developing a communication strategy that will effectively promote healthy child and infant feeding practices. Along with nourishment, maternal mortality will be targeted by means of providing better access to family planning resources and antenatal care.
The project also hopes to increase the number of births facilitated by a skilled health worker.
Through the Poverty Reduction Fund II Project, the Lao PDR government will work to establish infrastructure that serves the country’s marginalized communities. Schools are of particular note, as UNICEF reports that of Laos’s poorest 20 percent, only 5.3 percent are able to attend early childhood education.
Construction of drinking water systems is also important. At present, nearly 40 percent of rural inhabitants don’t have access to improved drinking water sources.
These projects are expected to substantially contribute to Laos’s development, building upon the country’s past poverty reduction success.
– Emma-Claire LaSaine
Sources: World Bank, UNICEF
Photo: Flickr
Social Mobilization and Fighting Ebola in Guinea
In May 2015, Ebola emerged again in Guinea. This time in an area that had not experienced the virus before, in the town of Tanene in the Dubreka Prefecture. The World Health Organization (WHO) is putting lessons previously learned from five outbreaks in the Democratic Republic of Congo (DRC) as well as Guinea’s outbreak in 2014 to good use in Tanene.
Community engagement is key to putting an end to Ebola, and one of WHO’s social mobilization experts, Marie Claire Therese Fweto Mwanza, is at work in Guinea.
Mwanza helped end five of the seven outbreaks in DRC, the last one in three months. She has trained 60 colleagues to currently provide social mobilization work in Guinea. Social mobilization is a process to raise awareness of a development objective, in this case, how to prevent the spread of Ebola, through dialogue in the community.
Social mobilization also raises the demand for action needed to accomplish the objective. In Guinea, the dialogue transpires at the community level with the help of allies. Community networks, civic and religious groups and other related partners coordinate efforts to induce the change necessary to stop Ebola.
WHO, the Ministry of Health of Guinea, U.S. Centers for Disease Control, Red Cross Guinea and United Nation Children’s Fund all came together to launch a surveillance campaign in June.
Mwanza, who has worked for WHO for 27 years, is confident that her experience in other campaigns will be effective in Guinea.
Before any surveillance work could take place, it was essential to understand the community so that the dialogue could be tailored in order to be effective. According to Mwanza, listening is one of the most important skills.
Speaking with compassion and being careful in conversations is also essential to making headway. These traits encourage the community to participate in the surveillance and take measures to protect themselves and their families.
One of the problems is the rumors that spread throughout a community. In Guinea, almost 60% of the people believed that blood was being sold. Mwanza knew how to deal with this situation because of lessons learned in 2012 in DRC. She said that the rumor was so entrenched in DRC that families hid their sick relatives in the forest and attacked Doctors Without Borders.
In order to deal with this at that time, Mwanza said they had to find out how this rumor took hold. Fifty nursing students were trained to survey community members.
Guineans told them, “When you go to an Ebola Treatment Unit, your heart is punctured, and 20 liters of blood are drawn. Your genitals are cut off, and your blood and organs are sold on the international black market.” Armed with this information, aid workers were able to tailor their messages and their next steps.
In DRC, the next step was to help people see with their own eyes how patients are treated in ETUs, so three community leaders were outfitted in personal protective equipment (PPE) and saw how patients were provided food and were not having organs cut or being killed.
Next, these leaders went door-to-door with Mwanza’s social mobilization team and Ebola survivors to testify in the community that an ETU saves lives. Such testimonies build trust among community members who then not only bring sick families into an ETU but also help trace and find contacts.
The same procedure worked in regard to a rumor about safe burials. A victim of Ebola must be buried by people wearing personal protective equipment. But families prefer to be able to touch the loved ones they are burying.
They were also afraid that organs were being cut out. After dressing a family member in PPE and having him participate in the burial of a loved one, he was able to testify to community members that a safe burial is necessary and appropriate.
Mwanza explained that they approached Guinea in the same way, “Not only did we engage communities to help with educating their neighbors about Ebola, we also encouraged them to actively participate in community surveillance and contact tracing.” Mwanza and her team trained 250 surveillance officers and 25 supervisors from the community to work actively in their own areas in Guinea.
On the first day of the surveillance campaign, rumors still thrived. Many Guineans heard that Ebola teams were coming to disinfect their homes and give them injections, so they shut their doors or temporarily left home. When the community members who stayed home and were visited by the surveillance team told their neighbors that the campaign was safe, many families returned home.
After that, surveillance teams were able to carry out intensive door-to-door visits. Teams explained the risks, the prevention measures and the importance of declaring illnesses and deaths. The Ministry of Health provides free healthcare for all cases during the campaign as well as soap and food during the 21-day surveillance period.
These measure are intended to encourage people to declare illnesses and deaths and allow them to stay at home to take care of family members.
Further community engagement was employed through key groups, such as religious, youth, women and workers’ unions. Representatives were invited to speak to the community to emphasize the campaign message: cooperate with Ebola teams, be vigilant and share information.
Resistance to respond to Ebola in Guinea is still a concern; for example, rumors still abound and people don’t believe that Ebola is real. However, WHO continually assesses community reaction and uses what it learns to adapt its methods to combat misinformation. In this way, progress is being made in Tanene.
“People are listening to programmes about Ebola on community radio, signs and stickers are posted throughout the villages and important conversations are taking place on the streets,” Mwanza declared.
She noted that children and youth are especially effective in the community engagement process. Children bring home messages about Ebola from school. Youth can have a strong influence in a Guinean community in regards to Ebola. One young man left this powerful message in the dirt outside his home: “Stop Ebola.”
– Janet Quinn
Sources: UNICEF, WHO 1, WHO 2
Photo: WHO
Transitioning from Aid to Domestic Resource Mobilization
They say that the only certainties in life are death and taxes. However, for developing countries, the latter might not be such a sure thing. In fact, effective tax policies, often referred to as domestic resource mobilization (DRM), are one of the biggest development issues facing poorer nations.
Without it, they may remain dependent on aid and unable to adequately meet the needs of their citizens, trapped in a cycle of poorly funded, haphazard social programs partially administrated by foreign donors. If the goal of aid is to create a world in which no one needs it, domestic resource mobilization may represent poor countries’ golden ticket to financial independence.
Domestic resource mobilization is essentially both a strategy and development outcome, in which a country becomes capable of funding its own social programs. Aid strategies variously focus on different indicators of development, such as improved health, education, or business opportunity. However, the purpose of domestic resource mobilization is to empower a developing country to improve these indicators using its own financial and administrative resources.
Obviously, this can be a huge challenge. Taxes in some countries can be unenforceable, insupportable, poorly allocated, or dissipated due to corruption. In much of sub-Saharan Africa, for example, simply reaching a large rural population is a barrier in and of itself, not to mention negotiating a socially sustainable level of taxation for those living off the grid in poverty.
In countries such as Nigeria, which has one of the worst levels of inequality and corruption, a great deal of tax income is squandered by shady officials, rather than redistributed to those living in extreme poverty.
According to the 2011 report by African Economic Outlook, revenue sources in sub-Saharan Africa grew from $100 billion in 2000 to about $513 billion in 2011. To put those numbers in perspective, official development assistance (ODA) grew from only $20 billion to $60 billion in the same time period.
Simply put, the amount of potential tax revenue far outweighs foreign funding of development programs. And those figures represent only known sources; many businesses and potential revenue streams lie outside the formal economy.
A lack of domestic resource mobilization fosters dependency on aid, which is why this technique has been acquiring greater importance for international donors in recent years. In April of 2014, developing countries and international policy-makers met in Mexico City to address, among other things, effective domestic resource mobilization.
There was a general consensus on the importance of DRM, with developing countries’ ministers calling for an increase in support from aid donors towards that end. For those at the conference, DRM represented a win-win; aid donors benefit from a potential scale-down of funding, while developing countries increase their governance capabilities while independently enhancing their own development goals.
More recently, at the Financing for Development conference in the Ethiopian capital of Addis Ababa, DRM was clearly a priority. Around 120 of 151 speeches by the foreign ministers in attendance at least mentioned domestic resource mobilization.
The United States Agency for International Development (USAID), as well as their foreign counterparts from Germany, the U.K. and elsewhere, even composed a policy initiative to advance the goal of achieving domestic resource mobilization in aid-recipient countries.
The initiative, dubbed Addis Tax Initiative, initially drew 30 members which agreed to a set of policy outcomes. Among those outcomes was a commitment that aid donors would double financial support to develop DRM, that members would compose a set of key DRM goals, and that countries would institute DRM policies which are harmonious with those of other developing countries.
The potential for DRM to transform a developing country’s condition can be neatly illustrated by the relationship between USAID and the country of Georgia. USAID began, in the early 2000s, to target border and customs tax compliance practices in the country.
The program was designed to increase a legitimate tax base, cut down on corruption, and improve collection efficiency. Over the nine-year duration of the program, the country managed to increase its tax base to 12 percent of its GDP, as well as reduce the rate of corruption (in the form of collected bribes) by about 30 percent.
While improving domestic resource mobilization is not the be-all, end-all of development and poverty reduction, it certainly should be the focus of a comprehensive development portfolio. Enhancing aid recipients’ ability to manage its own financial resources as well as improve the strength of its governance is essential to reducing the need for aid and lifting people out of poverty finally and sustainably.
– Derek Marion
Sources: CSIS, Devex, African Economic Outlook
Photo: Flickr