A recent report by Human Rights Watch (HRW) declared that systematic mass killings are taking place at the Saudi-Yemeni border. The casualties are migrants from North Africa, particularly Ethiopia.
In the lead-up to the 2022 FIFA World Cup in Qatar, the migration system across the Gulf faced increasing scrutiny regarding human rights. But since the tournament’s conclusion, the urgency for reform has vanished. As Gulf countries embark on ambitious construction projects to move away from oil dependency, issues of labor are becoming more pressing than ever.
Saudi Arabia’s recent potential Crimes Against Humanity (according to HRW) beg for a new mode of analysis to understand the pervasive nature of human rights abuses regarding migration to Saudi Arabia. A racial perspective reveals that the system of migration in the Gulf is an essential piece of statecraft.
The Kafala
The kafala is the sponsorship system used for migration across the Gulf, Lebanon and Jordan. Each migrant is bound to a sponsor, or kafeel, who is a citizen of the respective country. The kafeel is responsible for the migrant and pays for their lodging and other expenses. Without a sponsor, there is no approval for migration to Saudi Arabia and the Gulf.
The kafeel also has authority over the migrants they are sponsoring. They can allow or deny migrants to exit or re-enter the country and can cancel their migrant’s iqama (residency permit) whenever they want.
This power results in countless abuses. According to reports, more than 6500 workers died during the construction of stadiums in the build-up to the Qatar World Cup. Whilst families and witnesses asserted that the cause of death was from squalid living conditions, on-site mismanagement and heat exhaustion, Qatar listed these deaths as natural causes.
Other abuses include rentier-seeking, with some kafeels confiscating up to a year’s wages as fees to process the iqama. Migrants often live in poor conditions without adequate access to sanitation or health care.
Sexual and violent abuse is also rampant against female domestic workers. A total of 89 Kenyan migrant women died between 2019 and 2021 in Saudi Arabia. Indonesian worker Tuti Tursilawati was executed in Saudi Arabia in 2018 for murdering her employer. The Saudi courts ignored her claims of self-defense against rape. Migrants are not just poor, but also completely demeaned, disregarded and maltreated – sometimes to the point of death.
International efforts have resulted in slight concessions through Saudi Arabia signing many labor treaties. However, the actual implementation of these have been very poor. Meanwhile, Qatari kafala reforms mostly concerned more secular language to make it more internationally palatable. The persistence of the kafala has puzzled many pundits across the world – perhaps incorporating race can provide some answers.
Racializing the Problem
All migrant workers must register under the kafala. Bina Fernandez asserts that among migrants there is a racial hierarchy. White, often corporate professional, migrants evade the abuses of the kafala and have much higher living conditions and mobility. Even outside of the kafala, this symbolically superior whiteness, which is part of the West’s colonial legacy, is expounded through them being called expats, whilst black and brown workers are called immigrants. Asian and African laborers are at the bottom of this hierarchy, working in dirty, dangerous and demeaning jobs.
Asian and African workers are spurred by poverty to migrate to the Gulf. For example, Ethiopia’s poorest 20% have experienced little growth in recent years. Therefore, they take the treacherous journey to the Gulf to access higher wages and send back money to their home country as remittances.
Migrant workers make up huge proportions of the Gulf, approaching 40% and surpassing 75% of Saudi and Qatari populations respectively. This reliance on outsourced labor breeds insecurity, especially as Asian and African workers, who do not have legitimizing whiteness, represent most migrants.
The kafala is a tool of surveillance for Gulf governments. By privatizing migration, they evade responsibility for abuses, but also informally allow them to control the migrant population. Laws prohibiting migrants from unionizing or assembling are evidence of this.
Citizens of the Gulf perpetrate this abuse to abet the racial insecurity that a large migrant population stokes, as well as to protect their investment. Access to citizenship is very slim and there are multi-generational migrants who still require a kafeel. Coupling this with its function of surveillance, it appears the kafala is a tool that serves to maintain the Gulf countries as ethnocracies.
The Future?
Gulf countries are currently trying to diversify away from oil, especially Saudi Arabia, which is embarking on the construction of the megacity, Neom, to increase tourism revenue. How this could coexist with a very restrictive migration policy remains to be seen.
Saudi efforts to decrease their reliance on migrant workers threaten the country’s fragile social contract, which promises a very high standard of living in return for submission to a totalitarian rule. Asking citizens to take on jobs currently performed by black and brown laborers contradicts this.
Policies regarding migration to Saudi Arabia started becoming more aggressive during the COVID-19 pandemic when migrants underwent inhumane conditions in various detainment camps. Yet, HRW’s report marks a clear escalation. It details how hundreds (likely thousands) of migrants have been killed through the systematic use of rifles, mortar shells and rocket launchers at the Saudi-Yemeni border. There have been other instances of abuse, including rape. Ethiopian migrants make up the bulk of the casualties, showing how stark the consequences of such a racial hierarchy can be under cultural and political approval.
Most NGOs, including HRW, focus on gathering information to address migrant issues in Gulf countries. These organizations collect data on abuse and poverty, which are often lacking. Gulf countries maintain control through oil resources and authoritarian rule, limiting the presence of in-person migrant assistance NGOs. To fully tackle the challenges of migration in the region, there is a need to consider the racial dynamics of the kafala system. Merely abolishing kafala could prove insufficient, as recent developments in Saudi Arabia show that the problem runs deeper than a policy change.
– Ryan Ratnam
Photo: Flickr
Floods in Libya: Examining the Causes and Effects
Presently, the death toll stands at 11,300, primarily concentrated in Derna, with an additional 170 fatalities recorded in neighboring areas within the Al Akhdar and Al Marj districts. The report reveals that more than 10,100 people are missing, and the continuous flood has caused 25,000 citizens to lose their homes.
Why Did This Happen?
Storm Daniel hit the Mediterranean, causing heavy rains and then moving south to Libya on September 10, 2023. Libya is a predominantly arid country, rarely receiving substantial rainfall. The downpour released around 400mm of rain onto Derna in only 24 hours, a city that usually only takes 540mm annually. Due to this unusual climate event, the region’s infrastructure struggled to manage all the excess water from the flooding.
Another contributing factor is the poor drainage systems in Libya. The lack of effective drainage infrastructure due to poor maintenance of the two dams, which collapsed, only exacerbated the flooding. Additionally, as the city has become more urbanized, which has reduced natural drainage areas, the rainwater has fewer places to infiltrate the ground.
Impact on Communities
The effects of the floods will have devastating long-term consequences for the citizens of Libya. The economic implications of the flooding are astronomical. The destruction of infrastructure, including roads, bridges and utilities, has disrupted transportation networks and hindered the movement of goods and people, impacting trade and commerce. Extensive damage has forced many businesses to shut down temporarily, causing financial losses and job insecurity for the local workforce. The cost of repairing and rebuilding damaged infrastructure is substantial and strains government resources.
UNICEF has reported that the floods have displaced 43,059 people, including more than 16,000 children, from their homes. Those who cannot find accommodation with relatives are currently provided shelter in schools. Other citizens find themselves stranded in their residences, facing critical shortages of electricity and clean water. Concurrently, a significant portion of the population is heading eastward to Benghazi as they seek safety from the devastating effects of the flooding.
The spread of water-borne diseases is an additional threat. Exposed sewage leaking into the water systems has rendered the water too hazardous for consumption. Stagnant floodwaters create breeding grounds for waterborne diseases such as cholera and dysentery. These breeding grounds can quickly spread in overcrowded temporary shelters and communities lacking access to clean water and sanitation facilities. Evidence of this is already apparent, with 55 children being ill from the contaminated water.
Government Response
In response to the Libya floods, government authorities are actively investigating the contributing factors, ensuring they evaluate the effectiveness of existing drainage systems and disaster preparedness measures. In parallel, authorities are scrutinizing the Water Resources Authority and the Dams Management Authority over allegations of negligence.
Eight current and former officials have been apprehended, pending further investigation into their involvement in the recent flood catastrophe. After the Libya floods, authorities dismissed Derna Mayor Abdulmenam al-Ghaithi and subjected him to questioning. After the Libya floods, authorities apprehended eight current and former officials for further investigation. General Prosecutor Al-Siddiq Al-Sour stated, “The eight former and current officials have failed to provide evidence that would absolve them from potential charges, leading prosecutors to order their detention until the investigation reaches its conclusion.”
Environmental Consequences
The environmental impacts in Libya played a pivotal role in exacerbating the floods. Deforestation and urbanization reduced the land’s natural ability to absorb rainfall, resulting in heightened surface runoff during heavy rains. Poor land management practices, including inadequate soil conservation, exacerbated soil erosion and sediment buildup in waterways.
Climate scientists at the World Weather Attribution Group found that 50% more rain had fallen from Storm Daniel due to human-caused greenhouse gas emissions. Further research also concluded that flooding was ten times more likely to happen due to climate change.
International Support and NGOs
Government authorities and humanitarian organizations have jointly launched extensive relief efforts in response to the Libya floods. Several United Nations humanitarian agencies, including UNICEF (United Nations Children’s Fund), UNHCR (United Nations High Commissioner for Refugees), WFP (World Food Programme), WHO (World Health Organization) and IOM (International Organization for Migration), have actively engaged in on-the-ground support operations.
The United Kingdom has significantly bolstered its life-saving assistance to Libya by earmarking a substantial £1 million aid package. UK-MED, an NGO, has been responsible for conducting quick medical evaluations. In tandem with the U.K.’s efforts, the European Union has committed 94.5 million euros for humanitarian aid and an additional 5.7 million euros in emergency allocations. This international support addresses immediate needs and reinforces Libya’s long-term capacity to cope.
Long-Term Solutions
Implementing long-term solutions is imperative in the aftermath of the devastating flooding in Libya. Developing robust floodplain management strategies to prevent encroachments into flood-prone areas is essential to enhance resilience and reduce future risks.
Investing in improved drainage systems and sustainable urban planning will also be crucial to addressing flood vulnerability. Afforestation and reforestation initiatives can help restore the natural water-absorbing capacities of the land. Climate change adaptation strategies, such as early warning systems and disaster preparedness plans, should be established to anticipate and respond to extreme weather events. Furthermore, sustainable land and water resource management practices and stricter regulations and enforcement can help safeguard against environmental degradation and pollution.
Regarding the economic fallout from the floods, strategies to help businesses are imperative. The flooding has significantly burdened Libya’s economy and will take time to recover. Collaboration with international organizations and neighboring countries is key to Libya’s recovery.
– Sophie Higham
Photo: Unsplash
How Scotland Is Leading the Fight Against Period Poverty
Effects of Period Poverty
Period poverty is not merely an inconvenience, it carries massive health risks with regard to infection, especially in cases where women are subjected to female genital mutilation. In the global south, it is estimated that half of all women resort to using makeshift menstrual products like “rags, grass and paper.” These health impacts are exacerbated by the lack of access to clean water, causing additional difficulties in hygienically managing menstruation. Additionally, period poverty greatly impacts girls’ education as 1 in 10 girls in sub-Saharan Africa miss school while on their period. However, period poverty is not isolated to the global south, hundreds of millions of women from all over the world including the global north are deeply impacted by it.
Period Poverty in the UK
In a survey by Plan International U.K., more than a million women and girls aged 14–21 said that “they couldn’t afford menstrual products at some point in the past year.” Levels of period poverty in the U.K. dramatically worsened during the COVID-19 pandemic, with some parents resorting to stealing menstrual products. Period poverty in Scotland and the rest of the U.K. also has untold impacts on girls’ education with an estimated 137,700 girls in 2021 missing school due to lack of access to sanitary products. While the U.K. scrapped the 5% luxury product tax on period products in 2021 making them more affordable, it is clear that more work remains to be done in providing accessible menstrual products.
Scotland’s Period Products Act
After passing The Period Products Act in 2020, Scotland became the first country to ever “legally enshrine the right to free period products.” The act, which was unanimously approved in parliament is a massive step in eliminating the impacts of period poverty in Scotland. The law compels local governmental and educational institutions to provide free access to menstrual products to anyone who requires them. The Scottish Government has granted £2.8 million each year since 2019 to local authorities in the country to provide free period products. Additionally, from 2018–2022 the Scottish Government funded a £1.86 million project to give period product access to low-income families. The Period Products Act is not only set to dramatically reduce period poverty in Scotland but also to dramatically reduce the stigma around menstruation.
Next Steps
Hopefully, the rest of the U.K. and the world can follow the Scottish example and eliminate period poverty. Following the passing of the Period Products Act, the Northern Irish assembly passed a similar bill, and New Zealand has recently begun providing free access to period products in schools. The Period Products Act shows how legislation and “practical politics” can have a massively positive impact on millions of people’s lives, health and well-being.
– Jaydin Ruch
Photo: Flickr
Diseases Impacting Burundi: A Health Challenge in Need of Solutions
Malaria
According to the National Institute of Health (NIH), Burundi has been grappling with a significant upsurge in malaria cases in recent years. In 2020 alone, the country reported over 1 million malaria cases, an increase from the 600,000 cases recorded in the previous year. The surge can be attributed to a multitude of factors, including:
Malaria is a mosquito-borne disease that can be deadly, especially for children and pregnant women. The disease is caused by a parasite that is transmitted through the bite of an infected mosquito. The government of Burundi is working to control the malaria outbreak. In recent years the government has distributed 6.8 million insecticide-treated bed nets and malaria medication to people in affected areas, alongside efforts to improve drainage and sanitation to reduce mosquito breeding sites.
HIV/AIDS
Burundi is at a crossroads in its fight against HIV/AIDS. While commendable progress has been made in reducing new infections and deaths, with incident rates falling by 88% from 2002 to 2020, the country still faces issues with low rates of HIV testing among adolescents and young adults and alarming rates of mother-to-child transmission.
According to the Global Fund to Fight AIDS, Burundi has one of the world’s highest rates of mother-to-child HIV transmission, with approximately 50% of new infections in children aged 0–5. This high level of perinatal transmission results from the failure to provide ART (Antiretroviral Therapy) to many pregnant women living with HIV. While investments have undoubtedly propelled Burundi’s progress in the fight against HIV/AIDS, persistent hurdles require further concerted action. Several approaches can be taken such as:
With enough support and collaborative efforts, Burundi can achieve its goal of eradicating the AIDS epidemic. Together we can support the nation’s resolve to overcome the challenges in this ongoing battle.
Non-Communicable Diseases (NCDs) and the Economy
Data acquired from different sources reveal an alarming upward trend in almost all NCDs and their related risk factors across the Burundian population. The global nutrition report shows us that 5.5% of adult men and 5% of adult women were identified as being at high risk for the development of Diabetes and Hypertension, two chronic conditions that carry severe health implications.
There’s the issue of Type 2 diabetes in Burundi being an economic burden, as it costs each patient $2,621 a year, which is significantly higher than the GDP per capita, which is $221.48.
The prevalence of obesity among younger children aged 5–10 years old is 28%. While both adult men and women are at risk, obesity is increasing sharply among children and adolescents, and cancer is also on the rise, with 7,929 new cancer cases. Urgent action is needed to prevent and manage NCDs with a focus on interventions for children, adolescents and women.
According to the Journal of Public Health in Africa, to address this crisis, preventative and management measures for NCDs would have to be put in place, such as:
Final Thoughts on Diseases Impacting Burundi
Burundi faces a vast array of health challenges, from infectious diseases to non-communicable health problems. The government, alongside international partners and non-governmental organizations, is dedicated to addressing these issues. While progress is evident, challenges remain, including issues of accessibility, stigma and changes in the economy. The path forward demands continued dedication and collaboration to ensure that Burundi citizens can access quality health care and live healthier lives.
– Laeticia Mbangue
Photo: Flickr
Massive Strides Made for Vaccinations in the DRC
The Gavi Alliance
A key barrier to vaccinations in the DRC is cost; having resources to cover the massive 2 million square kilometers the country spans is a tall order. The Gavi Alliance, a global NGO championing vaccine equity, has donated a staggering $60 million to the DRC through its equity accelerator fund. The goal of the donations is to reduce the number of “zero-dose” children in the DRC. Zero-dose is a term that refers to the number of children who have received no vaccinations whatsoever, and the fund plans to reduce the number of these kids by 35% within only three years.
A focal point of Gavi’s mission is promoting equity. Their funds in the DRC will focus on creating Civil Society Organizations that will track zero-dose numbers, as well as tackle gender equity and vaccine inequalities throughout the country. The massive relief effort targets 11 provinces that harbor 74% of zero-dose cases. The DRC currently maintains one of the highest unvaccinated rates for children — 700,000 — and Gavi hopes to shatter that with “innovation and targeted support, [to]reach zero-dose children, and ensure that the most marginalized communities are no longer left behind,” according to Thabani Maphosa, Managing Director of Country Programmes Delivery at Gavi.
Maksho Plan
Another stride for vaccinations in the DRC is building on successes made before the COVID-19 pandemic. The Maksho Plan is another target vaccine program that has aimed to reduce the number of zero-dose children, increasing vaccination rates by 27% in 2019. During the pandemic, however, its impacts diminished, with national vaccination falling by 9%.
In response, the government has initiated the Maksho Plan 2.0 to further fight the zero-dose crisis. By 2023 they have brought the national vaccination coverage back to 45%. This increase is a substantial victory for the country and shows great signs of global health improvements in the future. The Maksho Plan and the DRC’s Ministry of Health have set their sights on increasing the percentage of vaccinated children to 75% by 2027.
Powerful Polio Efforts
Although countries like the United States have eradicated polio, it is still a very present threat to vaccinations in the DRC. Specifically, the polio strain noPV2 is the culprit of the DRC’s problems and is also the most common form of polio throughout Africa. Fortunately, because the disease has been successfully eradicated in other countries, the primary method of paving success is simply strong vaccine rollouts.
On June 1, 2023, the country launched its first large-scale effort on polio vaccinations. The force was a three-day wave across 20 DRC provinces, reaching 17 million children 5 and under. Half of all Africa’s polio cases are in the DRC, so this onslaught vaccine effort is a massive move to empower the public health of their citizens. The country is continuing its plans with a new mobile app that can track vaccines, health care workers, the quality of the campaign and other vital data for making improvements.
A Bright Future
The combined efforts from the Gavi Alliance, the Maksho Plan and the government’s Polio campaign have set vaccinations in the DRC on a fast track to success. The country has positioned itself to reach its milestone goals for reducing its zero-dose population. The DRC’s strategic vaccine endeavors may become a blueprint for other countries hoping to improve the health of their people.
– Aditya Arora
Photo: Flickr
Poverty and Mental Health in Nicaragua
Living in poor conditions creates a challenging and unpredictable environment for families and communities in the area. It is widely known that poverty and socioeconomic disadvantages increase the chances of experiencing life events. In countries with development like Nicaragua, factors such as limited social connections, inadequate public services and insufficient public security contribute to these stress-inducing situations within these communities. Due to a struggling economy, access to health services is scarce for individuals, particularly the poorest. Consequently, they live in unsupportive environments, making it difficult for them to cultivate resilience or develop self-esteem.
The Impact of Poverty on Mental Health
Research indicates that individuals enduring poverty and social hardships often encounter a frequency and greater severity of life events (SLEs) compared to the general population from childhood and adolescence to adulthood. These SLEs have been linked to a range of mental health issues, ultimately diminishing the quality of life for those affected. In interviews conducted in León and Chinandega (Nicaragua), homeless women shared how their financial circumstances were influenced by the SLEs they experienced before reaching 18 years old and their age while experiencing them.
When asked about the life events that had an impact on their experience of homelessness, the women mentioned other factors. These included:
Moreover, some interviewed women believed that certain significant life events contributed significantly to their situation. These events included:
Additionally, one woman in each case indicated that becoming homeless was due to an accident, debt, or mismanagement of assets, time spent in prison, being a victim of rape, engaging in sex work, experiencing the death of a child, lacking family support, struggling with self-esteem issues or having experienced violence.
Health Care and Support Initiatives in Nicaragua
Médecins sans Frontier (MSF, Doctors Without Borders) is an initiative that offers medical assistance. Each day, the dedicated teams of Doctors Without Borders provide health care to individuals facing crises undertaking endeavors across over 70 nations. Since its establishment in 1971, MSF has positively impacted millions of lives, expanding from a group of 13 doctors and journalists to a movement comprising more than 45,000 individuals.
In Nicaragua, they provide psychological and psychiatric assistance to individuals affected by political and social violence. MSF’s initial mission in 1972 took place in Managua, the capital and largest city of Nicaragua. During that time, an earthquake devastated most of the city, claiming the lives of 10,000 to 30,000 people. In 2018, MSF returned to Nicaragua to support those experiencing anxiety, adjustment disorder and post-traumatic stress due to their exposure or personal experiences with events linked to civil unrest and political turmoil. Additionally, MSF conducted training sessions on health care, psychological first aid and self-help for community leaders, groups and educators. This training empowered them to provide support during crises.
Conclusion
Nicaragua’s intersection of poverty and mental health poses difficulties for individuals and communities. The combination of resources and inadequate access to necessary services and support worsens mental health problems. Organizations such as Doctors Without Borders play a part in offering psychiatric aid along with training to tackle these challenges. They assist individuals affected by social violence find ways to recover and build resilience amid adversity.
– Aysu Usubova
Photo: Flickr
Combating Non-Communicable Diseases in the Philippines
The Danger of NCDs
NCDs are conditions that tend to last for a long duration with long-term health consequences and arise not as a result of acute infection but as a result of a combination of genetic, physiological, environmental and behavioral factors. There are four main groups of NCDs: cardiovascular diseases, cancers, chronic respiratory diseases and diabetes; and five major risk factors: tobacco use, physical inactivity, the harmful use of alcohol, unhealthy diets and air pollution.
These factors all increase the threat of NCDs and are caused by rapid urbanization, poor urban planning, unhealthy lifestyles and population aging. Other risk factors include metabolic ones, such as high blood pressure and obesity, and environmental ones, such as air pollution; these all contribute to the risk of NCDs.
Every year, NCDs kill 41 million people, a staggering number equivalent to 74% of global deaths — a death toll exceeding even that of infectious diseases. Low- and middle-income countries are disproportionately affected, accounting for 77% of NCD deaths — poverty can be closely linked to NCDs. Poorer families do not always have the knowledge or the means to avoid harmful products that induce risk factors, and they do not have the income to access health services to treat NCDs. The combination of the extortionate costs of NCDs and the loss of household income forces millions and millions into poverty each year.
The Impact of Chronic Diseases in the Philippines
The top five causes of death in the Philippines are 1) ischemic heart diseases, 2) cerebrovascular diseases, 3) neoplasms or cancer, 4) diabetes mellitus and 5) hypertensive diseases. These are all NCDs and are estimated to have caused around 70% of deaths in the Philippines. A World Health Organization (WHO) study has shown that Filipino women are more at risk of NCDs — 240,000 Filipino women die from NCDs per year. There were 511,748 NCD deaths in 2019, with NCDs responsible for 72% of deaths among women and 68% among men. Women are especially vulnerable to NCDs because maternal and perinatal conditions contribute to the mortality rate caused by these diseases.
Not only do NCDs cause illness, disability and death, but they also have economic consequences. The burden of such diseases in the Philippines reduces economic output, with economic losses from NCDs costing PHP 756.5 billion, equivalent to around 5% of the country’s GDP in 2017.
The Healthy Hearts Program
In 2021, the Department of Health (DOH) worked with local governments, alongside WHO and Resolve to Save Lives, to implement the Healthy Hearts Program in the Iloilo province. The program intensified efforts in seven hypertension service sites to prevent NCDs and cardiovascular diseases, using job aids and e-learning courses to support health care workers in the province. This effort helped equip the workers with accurate and relevant information on cardiovascular diseases, allowing them to provide patients with improved screening, diagnosis and treatment protocols.
The Healthy Hearts Program also includes support for the accreditation of health facilities, providing the Konsultasyong Sulit at Tama or Konsulta primary health care package of the Philippine Health Insurance Corporation (PhilHealth).
By working at a local level and aiming the program at local communities, it has assisted nearly 250,000 adults, helping them access regular consultations and a continuous supply of antihypertensive medications. It has also successfully improved the health outcomes for those living with hypertensive diseases in the Philippines, with 80% of hypertensive patients exhibiting controlled blood pressure.
Continuing Efforts Against NCDs
To fight back against the nation’s biggest killers, the Philippines must address the risk factors that lead to the rise of NCDs. In an expansion of the Healthy Hearts Program that will take place from 2023 to 2024, the DOH and WHO aim to further improve hypertension detection and control by including an additional 36 implementation sites in the Iloilo province and 18 sites in Antique. The program will also aim to support the prevention of NCDs at a governmental level, encouraging the creation of governmental programs and policies that address the risk factors of NCDs.
Projects like these help make health services more accessible to those living in poverty, improve the condition of those living with NCDs and help educate health workers on preventative behaviors, continuing to combat the looming danger of noncommunicable diseases in the Philippines.
– Stephanie Chan
Photo: Flickr
6 Approaches that Advanced Mental Health in Paraguay
The World Bank conducted High-Frequency Phone Surveys (HFPS) from May to June 2021. Paraguay, along with Ecuador and Bolivia, was tied for the fourth position in the Mental Health Vulnerability Index, scoring 0.28. This ranking highlights significant concerns about mental health in Paraguay, which are also associated with increased levels of poverty and economic inequality. The Mental Health Department under the purview of the Ministry of Public Health and Social Welfare (MPH) of Paraguay has dedicated its efforts to expanding the accessibility of mental health services to its citizens.
Here are 6 Ways That Paraguay is Promoting Mental Health
Looking Ahead
There have been significant strides in terms of promoting mental health in Paraguay. The substantial improvement in health care access reflects a remarkable increase of over 23 percentage points from 2003 to 2016, thereby facilitating enhanced accessibility to mental health assistance.
Paraguay’s efforts to address its mental health challenges have been significant, but there is still room for progress. By staying committed to implementing effective policies, the country could achieve more significant and positive improvements in the well-being of its people, ultimately creating a healthier and more resilient population.
– Susanna Andryan
Photo: Unsplash
Poverty in the Caribbean: The Challenges
Low Education Levels
Poor people who have jobs within the Caribbean reportedly have lower levels of education. In the past, a significant portion of the working population in Caribbean countries like Jamaica and Dominica only managed to complete primary-level education. For instance, Jamaica had about 83% of its population in this category, while Dominica had approximately 79%. Additionally, a relatively small percentage, ranging from 2% to 8%, had attained tertiary-level education.
The Pandemic Made It Harder to Transport Food
The aftermath of the pandemic has posed challenges to transporting food within Caribbean countries, leading to an increase in poverty levels. New strategies, including financial aid and private transfers of money, were implemented to assist during the pandemic. However, these measures have had unintended consequences, resulting in reduced access to goods and labor markets, particularly in urban areas. This has caused a decline in the income of impoverished households, contributing to increased instability in women’s employment within these regions.
Working Poor have Fewer Income Opportunities
Records suggest that, in the past, a small number of residents within the Caribbean countries of Jamaica, Trinidad and Tobago and Dominica get 50 or more hours of work a week compared to those who are not within the same countries.
Additionally, reports suggest that the proportions of the working poor from these countries who work 32 or fewer hours a week are greater than those who are not poor and reside within the same countries. In addition, it was stated that the jobs in these countries included construction in the Bahamas, community and social services in Trinidad and Tobago, agriculture in Jamaica and Dominica and wholesale/retail sales in Barbados.
Learning Poverty among Children
Due to the global pandemic, learning difficulties have worsened, particularly in the Caribbean. The World Bank estimated that, even before the pandemic, 51% of Caribbean children couldn’t read or understand simple text by age 10, compared to a global average of 48%. However, learning poverty rates vary across countries, ranging from 21% in Trinidad and Tobago to 81% in the Dominican Republic.
These rates may continue to rise due to prolonged school closures and increased dropout rates resulting from the pandemic. Across the region, 23 countries and 12 independent states closed their schools for an average of 168 days between the start of the pandemic in 2020 and February 2022.
This is equivalent to nearly an entire academic year. In countries like Guatemala, 13.3% of children are not engaging in educational activities. In Honduras, this number is 17% and in Bolivia, it’s as high as 22.6%. These learning losses in Caribbean countries contribute to increased variability in student skills and present challenges for teachers. One factor is the practice of automatic promotion within schools.
The Caribbean is Struggling to Get its People Out of Poverty
The poverty rate within the Caribbean increased for the first time in years during the 2019–2021 period, following the pandemic. During the period between 1999 and 2019, its poverty rate of 53% dropped to 28% as a result of labor income being the primary driver during this era, but currently, following the complications of the pandemic, its poverty rate has increased to 30%. In addition to this, although labor income was a success for the Caribbean in the past, its people have yet to return to this path of poverty reduction for further success in the future.
Looking Ahead
Although quick and determined action is needed to address poverty in the Caribbean, the situation has become more complex. Many countries in the region have made significant efforts to combat poverty in the past, demonstrating their capacity to do so once again. Furthermore, the World Bank is actively supporting countries in the Caribbean, including Jamaica, Haiti, the Bahamas, Barbados, Guyana and Eastern Caribbean states like Trinidad and Tobago, Grenada and Turks and Caicos. The World Bank is implementing plans and projects aimed at reducing inequality and enhancing overall resilience.
For example, the World Bank has achieved significant milestones, such as completing six water supply systems in Haitian communities after the devastating earthquake in 2010. In 2019, the bank also played a crucial role in reducing cholera cases in Haiti, collaborating with communities, implementing disease surveillance and mobilizing rapid response teams.
The World Bank remains committed to mobilizing both public and private resources to reduce extreme poverty, promote prosperity and foster inclusive growth in the Caribbean. This involves bringing together diverse expertise and financial support from various Caribbean countries.
– Deon Roberts
Photo: Unsplash
Food Insecurity in Tigray Exacerbated by Aid Suspension
Lack of Access to Basic Needs in the Wake of the Aid Suspension
Recently, the encampments have been plunged once more into profound insecurity. Because of nefarious groups’ organized theft of the humanitarian food relief meant for the refugees of the Tigray region, organizations, such as the U.N.’s World Food Programme (WFP) and the US Agency for International Development (USAID), suspended their deliveries in June, leaving many in a precarious position. Refugees already suffered from extreme food insecurity in Tigray and often faced malnutrition and malnutrition-related health conditions. The relief cut-off has only exacerbated an already precarious situation.
Months after the aid suspension, deliveries still have not resumed. The U.S. and the U.N. have demanded that the Ethiopian government relinquish control of the food relief distribution system in light of the discovered thefts. Until Ethiopian officials do so, the U.S. and U.N. withhold the necessary food and oil supplies for fear that the government will not transmit them to the refugees. The stolen food is equivalent to the number of rations needed to feed the 134,000 people in the Tigray town for a month, and medical supplies are also missing.
An investigation revealed that multiple shipments of grain provided by USAID were sold for profit in different local markets. Both the Ethiopian government and Tigray rebel fighters have been accused of confiscating the food meant for refugees to feed their demobilized armed forces. Some have also accused the Ethiopian government of diverting the aid meant for the region as a strategy to weaken the region and use starvation as a method of warfare by encouraging food insecurity in Tigray.
Local Nonprofit Centers Overwhelmed by Demand
An estimated 20 million people across Ethiopia rely on these foreign aid deliveries. Some refugees described having to resort to gathering seeds from the surrounding grounds to sustain their families. Others indicated not being able to eat for days at a time. The increase in malnutrition has led to a rise in nutritional deficiency-related diseases, with many refugee children presenting developmental delays. With limited access to aid from the more prominent international organizations, local nonprofit centers have been instrumental in keeping communities across the country afloat.
The Salesians of Don Bosco have been especially instrumental, regularly helping thousands across the region. With Salesian missionaries’ particularity of living in the communities they support, they are uniquely informed on what community members require by building community bonds with those in need. The Salesian nonprofit centers and other nonprofit organizations are, however, overwhelmed in the wake of the aid suspension. Thousands gather outside the doors of the aid centers, yet they are simply unable to meet the immense demand, and the return of international aid is urgently needed.
Looking Ahead
The U.N. is currently testing out different initiatives in certain parts of Tigray that use new methods of food assistance and delivery. The U.N. designed these testing initiatives to find an effective method to enable adequate control and surveillance of food deliveries, safeguarding against possible thefts, and hopefully, soon allowing the resumption of large-scale food assistance programs in the region.
– Tatiana Gnuva
Photo: Flickr
Migration to Saudi Arabia and the Gulf – A Racial Perspective
In the lead-up to the 2022 FIFA World Cup in Qatar, the migration system across the Gulf faced increasing scrutiny regarding human rights. But since the tournament’s conclusion, the urgency for reform has vanished. As Gulf countries embark on ambitious construction projects to move away from oil dependency, issues of labor are becoming more pressing than ever.
Saudi Arabia’s recent potential Crimes Against Humanity (according to HRW) beg for a new mode of analysis to understand the pervasive nature of human rights abuses regarding migration to Saudi Arabia. A racial perspective reveals that the system of migration in the Gulf is an essential piece of statecraft.
The Kafala
The kafala is the sponsorship system used for migration across the Gulf, Lebanon and Jordan. Each migrant is bound to a sponsor, or kafeel, who is a citizen of the respective country. The kafeel is responsible for the migrant and pays for their lodging and other expenses. Without a sponsor, there is no approval for migration to Saudi Arabia and the Gulf.
The kafeel also has authority over the migrants they are sponsoring. They can allow or deny migrants to exit or re-enter the country and can cancel their migrant’s iqama (residency permit) whenever they want.
This power results in countless abuses. According to reports, more than 6500 workers died during the construction of stadiums in the build-up to the Qatar World Cup. Whilst families and witnesses asserted that the cause of death was from squalid living conditions, on-site mismanagement and heat exhaustion, Qatar listed these deaths as natural causes.
Other abuses include rentier-seeking, with some kafeels confiscating up to a year’s wages as fees to process the iqama. Migrants often live in poor conditions without adequate access to sanitation or health care.
Sexual and violent abuse is also rampant against female domestic workers. A total of 89 Kenyan migrant women died between 2019 and 2021 in Saudi Arabia. Indonesian worker Tuti Tursilawati was executed in Saudi Arabia in 2018 for murdering her employer. The Saudi courts ignored her claims of self-defense against rape. Migrants are not just poor, but also completely demeaned, disregarded and maltreated – sometimes to the point of death.
International efforts have resulted in slight concessions through Saudi Arabia signing many labor treaties. However, the actual implementation of these have been very poor. Meanwhile, Qatari kafala reforms mostly concerned more secular language to make it more internationally palatable. The persistence of the kafala has puzzled many pundits across the world – perhaps incorporating race can provide some answers.
Racializing the Problem
All migrant workers must register under the kafala. Bina Fernandez asserts that among migrants there is a racial hierarchy. White, often corporate professional, migrants evade the abuses of the kafala and have much higher living conditions and mobility. Even outside of the kafala, this symbolically superior whiteness, which is part of the West’s colonial legacy, is expounded through them being called expats, whilst black and brown workers are called immigrants. Asian and African laborers are at the bottom of this hierarchy, working in dirty, dangerous and demeaning jobs.
Asian and African workers are spurred by poverty to migrate to the Gulf. For example, Ethiopia’s poorest 20% have experienced little growth in recent years. Therefore, they take the treacherous journey to the Gulf to access higher wages and send back money to their home country as remittances.
Migrant workers make up huge proportions of the Gulf, approaching 40% and surpassing 75% of Saudi and Qatari populations respectively. This reliance on outsourced labor breeds insecurity, especially as Asian and African workers, who do not have legitimizing whiteness, represent most migrants.
The kafala is a tool of surveillance for Gulf governments. By privatizing migration, they evade responsibility for abuses, but also informally allow them to control the migrant population. Laws prohibiting migrants from unionizing or assembling are evidence of this.
Citizens of the Gulf perpetrate this abuse to abet the racial insecurity that a large migrant population stokes, as well as to protect their investment. Access to citizenship is very slim and there are multi-generational migrants who still require a kafeel. Coupling this with its function of surveillance, it appears the kafala is a tool that serves to maintain the Gulf countries as ethnocracies.
The Future?
Gulf countries are currently trying to diversify away from oil, especially Saudi Arabia, which is embarking on the construction of the megacity, Neom, to increase tourism revenue. How this could coexist with a very restrictive migration policy remains to be seen.
Saudi efforts to decrease their reliance on migrant workers threaten the country’s fragile social contract, which promises a very high standard of living in return for submission to a totalitarian rule. Asking citizens to take on jobs currently performed by black and brown laborers contradicts this.
Policies regarding migration to Saudi Arabia started becoming more aggressive during the COVID-19 pandemic when migrants underwent inhumane conditions in various detainment camps. Yet, HRW’s report marks a clear escalation. It details how hundreds (likely thousands) of migrants have been killed through the systematic use of rifles, mortar shells and rocket launchers at the Saudi-Yemeni border. There have been other instances of abuse, including rape. Ethiopian migrants make up the bulk of the casualties, showing how stark the consequences of such a racial hierarchy can be under cultural and political approval.
Most NGOs, including HRW, focus on gathering information to address migrant issues in Gulf countries. These organizations collect data on abuse and poverty, which are often lacking. Gulf countries maintain control through oil resources and authoritarian rule, limiting the presence of in-person migrant assistance NGOs. To fully tackle the challenges of migration in the region, there is a need to consider the racial dynamics of the kafala system. Merely abolishing kafala could prove insufficient, as recent developments in Saudi Arabia show that the problem runs deeper than a policy change.
– Ryan Ratnam
Photo: Flickr