As a marginalized group, Afro-Colombian women are more vulnerable to experiencing racism, discrimination, violence and poverty. For decades, these issues have led to the disempowerment and marginalization of these women. Afro-Colombian women are especially vulnerable to experiencing human rights violations, particularly sexual violence, due to multiple forms of discrimination based on their race, gender and low social ranking. Government estimates indicate that “72% of the Afro-Colombian population is in the country’s two lowest socio-economic strata.”
Poverty and Inequalities Impacting Afro-Colombian Women
According to a 2020 report issued by the Immigration and Refugee Board of Canada, Afro-Colombians, in general, inordinately lack access to food, health care, education, economic opportunities and other resources necessary to escape poverty and live an improved quality of life. Factors including civil armed conflict and gender inequality have compounded with racism to exacerbate the injustices that Afro-Colombian women, specifically, face.
Between 1958 and 2015, Colombia’s ongoing conflict internally displaced more than 5.8 million people, with women accounting for about 58% of these displacements. Women, in general, not only face higher risks of displacement and poverty but also of abuse and exploitation. These risks increase among Afro-Colombian women and women belonging to other marginalized groups.
Colombia is one of the most monetarily unequal countries in the world and 19.6 million people in Colombia (about 39% of the population) lived in poverty at $6.85 or less per day in 2021. While the overall rate of poverty in Colombia has fluctuated throughout the years and the country has noted poverty declines, marginalized groups did not experience this relief and some faced an increase in poverty. Rural populations, which consist of many Afro-Colombian and Indigenous communities, had an increase in poverty from 2020 to 2021 (42.9% to 44.6%) while an estimated 1.4 million people “working in urban services and commerce” rose out of poverty in 2021 due to Colombia’s economic recovery.
In 2015, approximately 41% of the Afro-Colombian population lived in poverty in comparison to 27% of non-Afro-Colombian or non-Indigenous Colombians.
Lack of Access to Resources and Services
Certain factors, such as gender and racial discrimination, contribute to a greater risk of poverty among Afro-Colombians and exacerbate existing conditions of poverty. The racism that Afro-Colombian women face impacts every aspect of their lives and keeps them from accessing resources that would place them in positions of economic and social advancement. Research shows that nations can raise their GDP by US$2.1 trillion annually by dissolving racial income gaps.
When speaking with the United Nations Rapporteur in 2001, groups of Afro-Colombian women stated that they had little access to many basic resources, such as work and income, as a result of racism.
“Groups of women in Quibdó, where 85% of the population is Afro-descendent, indicated that most of the population lives in extreme poverty. Quibdó is the locality with the least water supply coverage in the country, 81% of homes have no sewage, illiteracy is up to 19% and maternal mortality rates are high,” according to the Inter-American Commission on Human Rights.
This lack of accessibility that is caused by internal national racism leads to the perpetual disenfranchisement of this community and causes them to live in the most impoverished cities. For example, the Choco region of Colombia is the most impoverished area of the country and approximately 85% of its population is Afro-Colombian.
Indigenous Peoples and Afro-Colombian Empowerment Activity (IPACE)
Several organizations and activist movements work toward empowering and helping Afro-Colombian communities. Among these is the United States Agency for International Development through its most recent plan: Indigenous Peoples and Afro-Colombian Empowerment Activity (IPACE).
Beginning in 2011, USAID has worked closely with Colombia’s Afro-Colombian population to promote inclusion and empowerment. In December 2021, USAID implemented IPACE, which is a $60 million initiative that connects with locally-led organizations to further their goals and elevate their voices on the national scale. IPACE’s mission is to help implement and uphold the 2016 Peace Accord in Colombia, specifically focusing on peacebuilding and inclusivity.
IPACE also aims to sustainably help economic development by providing training and job placements, risk management through emergency preparedness and services and diversity and inclusion support through acknowledging ancestral practices and building awareness of cultural differences. What sets IPACE apart from other initiatives is the commitment to a locally-led approach through an alliance of 10 partner organizations, all of which are either indigenous or Afro-Colombian. These organizations help IPACE lead and make decisions that are in the best interest of these populations.
Looking Ahead
Afro-Colombian women face multiple vulnerabilities as a result of marginalization and discrimination, which keeps them stuck in the depths of impoverishment. The intersection of racism, poverty and violence creates a cycle of inequality that the government and organizations must address at the root. Fortunately, organizations such as USAID and other locally-led groups are committed to changing the narrative and upholding the rights of Afro-Colombian women.
– Kellyjohana Ahumada
Photo: Unsplash
Vaccine Inequity Among the Stateless
At the height of the pandemic, the critical global message was “no one is safe until everyone is safe.” It referred to the common-sense view that vaccinating everyone was the only way to control COVID-19. However, vaccine inequity among the stateless presented a barrier to raising global vaccination rates.
In countries such as Montenegro, Lebanon and the Dominican Republic, vaccine inequity among the stateless was characteristic of the exclusion and marginalization that stateless people typically experience for reasons ranging from politics to discrimination. Other major reasons include administrative issues stemming from affected individuals lacking specific documentation.
Stateless people have historically suffered unequal access to health care due to systems that provide services based on nationality and faced disproportionate impacts of the COVID-19 pandemic. Vaccine inequity among the stateless presented a further devastating blow for some of the world’s most vulnerable people.
Vaccine Inequity in the Dominican Republic
Vaccine inequity among the stateless in the Dominican Republic existed due to a policy decision to exclude the affected individuals. In 2021, the president announced that only Dominicans would be included in the COVID-19 vaccination rollout, thus excluding illegal migrants or stateless people. The problem of discrimination and anti-Haitianism directed toward those born Dominican has been historically rife in the country. In fact, an overnight and discriminatory court decision in 2013 revoked the citizenship of Dominicans of Haitian descent. The court ruling stood as another example of furthering discrimination, even if it ran counter to the public health imperative.
However, several community responses echoed in unison to drive positive change. A community-based organization in the south of the country held persuasive talks with local government officials to convince the officials to consider residency status, name and age as sufficient for vaccination. Eventually, the localized vaccination distribution meant that some Dominicans without documentation could receive their shots.
Moreover, the Caribbean Migrants Observatory, a body set up in 2009 to facilitate migration and social development, also stepped in. Apart from developing the first migratory profile of the Dominican Republic, its advocacy talks with government officials led to a reversal in discriminatory vaccine policy and a subsequent commitment to universal vaccine access in the country.
Vaccine Inequity in Montenegro
Vaccine inequity has also affected the Roma community in Montenegro. A population at risk of statelessness, members of the Roma community face high fees for health care access during non-pandemic times. This is because Roma people are not on the official records for government health programs as they lack the required documentation.
The directive in the first stages of the vaccination rollout held that stateless people would be last in line to receive vaccines despite living in densely populated areas with significantly high risks of contracting the virus. Fortunately, following advocacy by the community-based organization Phiren Amenca, which emerged in 2012 to advocate for the rights of the Roma community, the new government changed the policy.
The government placed community members in a priority group, adding that all residents, regardless of citizenship status and health insurance, could receive the vaccine. Further clarifications revealed that this new development also included those in the process of resolving their legal status and those without legal documents. Phiren Amenca has also succeeded in extending the deadline for the registration of Roma people. A Roma doctor also visited a settlement to educate the community on the importance of vaccination and to deliver vaccine shots.
Vaccine Inequity in Lebanon
Vaccine inequity among stateless people in Lebanon existed primarily due to administrative issues. Oummal, a community-based organization set up in 2010 to provide universal health coverage that includes stateless people, had an eye-opening discovery. It found out, through community interviews, that stateless people could not register to receive the vaccination as no category existed for ‘no nationality’ on the registration portal. Furthermore, a lack of awareness about the importance of vaccination alongside fears of hospitalization and its associated costs stood as issues.
Oummal advocated for the inclusion of a ‘no nationality’ category on the registration platform. The organization set up a vaccination hotline for inquiries on documentation and vaccination. It also accompanied people to get their documents and receive vaccinations. Lastly, another resolution came about by waiving hospitalization costs for stateless people after meetings with the Ministry of Health. Oummal supported about 1,500 people, 1,068 of whom registered for vaccinations. The dedicated hotline for stateless people received 134 calls and the organization recorded 63 cases to follow up on regarding documentation and vaccination.
Advocacy and Community Work
Stateless people suffer from exclusion and discrimination, but the costs of exclusion during a global pandemic are far higher. Several countries excluded stateless people from accessing vaccines due to discrimination, lack of documentation and administrative issues. However, the influence of community work and advocacy resulted in the vaccination of many stateless people.
– Ottoline Spearman
Photo: Flickr
Improving Health Care in Guinea-Bissau
Like most countries across West Africa, Guinea-Bissau’s health care struggles have threatened the well-being of the country’s people. Several organizations are working to improve health care in Guinea-Bissau.
Health Care in Numbers
According to the World Bank, Guinea-Bissau spent 8.35% of its GDP on health care in 2019, an increase from 7% in 2017. The 2019 GDP expenditure rate was significantly higher than many other comparable African countries. For instance, the West African country of Nigeria spent only 3% of its GDP on health in 2019. World Bank data also shows that the country had 0.2 physicians per 1,000 people in 2020 and one hospital bed per 1,000 people in 2009. As a result of limited access to trained health care professionals and proper health care, life expectancy in Guinea-Bissau equaled 60.2 years compared to the global average of 73. However, life expectancy in Guinea-Bissau has improved by 9.93 years from an average of 50.3 years in 2000.
Water-Borne Illnesses in Guinea Bissau
Similar to many West African countries, the people of Guinea-Bissau suffer from inadequate access to clean water. According to UNICEF, 50% of hand pumps across the nation are dysfunctional. According to the Multiple Indicator Cluster Survey in Guinea-Bissau 2014, “75[%] of the country’s total population have access to improved drinking water source.” This forces a significant proportion of the population to use contaminated water for everyday uses such as drinking and cooking.
Guinea-Bissau has suffered frequent cholera outbreaks. As a result of the frequent consumption of contaminated water, cholera spreads quickly across areas with poorly maintained sewage and water systems. The cholera outbreak that occurred between 2005 and 2006 saw a total of 25,111 overall cases and 399 fatalities. Despite cholera being most prevalent in urban areas, particularly in the capital Bissau, most fatalities occur in rural areas. This is because of the lack of medical facilities located outside the cities. During the 2008 cholera outbreak, the World Health Organization reported that the “overall case-fatality rate stands at 1.9% and decreases below 1% for hospitalized cases” but “reaches 9% in remote areas.”
Maternal and Child Health in Guinea-Bissau
Guinea-Bissau struggles with providing adequate maternal and child health care. The World Bank says, in 2017, the maternal mortality rate stood at 667 maternal deaths per 100,000 births. However, this is an improvement from 1,210 in 2000. Maternal mortality in Guinea-Bissau is higher than its regional average — a consequence of underfunding and understaffing in the area of maternal health care in the country.
According to the Global Nutrition Report, “Guinea-Bissau has made some progress toward achieving the target for stunting, but 27.7% of children under 5 years of age are still affected, which is lower than the average for the Africa region (30.7%).”
Solutions
Although Guinea-Bissau’s health care struggles have eased, charitable organizations are attempting to make further improvements.
In 2019, focusing on improving children’s health care in Guinea Bissau, UNICEF supported deworming and vitamin A implementation into the care routines carried out by community health workers. UNICEF has also made strides in combating acute malnutrition by supporting screening and treatment processes aiding children suffering from severe cases of acute malnutrition. These treatment centers have been set up in 78 health care facilities nationwide.
Concerning water accessibility, in 2022, the United Nations Development Programme (UNDP) commissioned a new borehole in the southern province of Guinea-Bissau providing clean water for approximately 3,000 people in the region. Providing communities with safe drinking water helps limit the spread of waterborne diseases, such as cholera, which is prevalent in the country.
Looking Ahead
While Guinea-Bissau has significant health care challenges, with the help of charitable organizations addressing children’s health care needs and improving access to clean water, the intensity of Guinea-Bissau’s health care struggles can lessen.
– Freddie Trevanion
Photo: Flickr
Retinoblastoma in Sub-Saharan Africa
What is Retinoblastoma?
Retinoblastoma is a childhood cancer of the light-sensitive cells at the back of the eye (the retina). Symptoms of retinoblastoma can include vision problems, irregular eye movements and inflammation of the eye. Treatment options usually include surgery, chemotherapy, radiotherapy, freezing therapy and laser therapy.
What is the Incidence of Retinoblastoma in Sub-Saharan Africa?
It is estimated that there are over 1,950 cases of retinoblastoma in Africa per year. The symptoms in children in sub-Saharan Africa are found late and they become more troublesome and severe. Unfortunately, this means children have lower chances of survival. Overall, the survival rates for retinoblastoma in sub-Saharan Africa are as low as 26.6%, compared to 99% in the U.K.
What are the Barriers to Proper Management of Retinoblastoma in Sub-Saharan Africa?
What is the VISION 2020 LINKS Program and its Efforts to Curb Retinoblastoma?
The VISION 2020 LINKS program was established to correct the disparities in ophthalmic care in low-resource settings, such as Africa, with the goal of preventing and managing avoidable blindness.
The VISION 2020 LINKS program was founded by the London School of Hygiene & Tropical Medicine’s International Centre for Eye Health in 2004. The aim of the program is to build long-term partnerships between eye health care workers in the U.K. and low- and middle-income countries (LMICs). These partnerships aid the development of skills and knowledge of eye care workers in LMICs and U.K. eye care workers. Through skills and knowledge training, the VISION 2020 LINKS program is addressing the lack of adequate ophthalmic care in LMICs.
Currently, 30 partnerships exist between the U.K. and LMICs, predominantly in Africa. VISION 2020 LINKS has 16 partnerships working to improve pediatric eye health care and establish retinoblastoma as a priority within this.
Though retinoblastoma is viewed as curable in high-income countries, the consequences in sub-Saharan Africa can be devastating. The VISION 2020 LINKS program aims to minimize the disparities in ophthalmic care, with retinoblastoma as a key focus of many of their partnerships.
– Jess Steward
Photo: Flickr
7 Facts About Charles Henry de Soysa’s Humanitarian Efforts
Charles Henry de Soysa (1836-1890) was an ambitious entrepreneur from Ceylon, known now as Sri Lanka. He was very wealthy and invested in many businesses, including tea plantations, transportation and oil mills. Deeply involved in his country, de Soysa built several profitable buildings in Ceylon and stood as the country’s first banker. However, aside from his business-related capabilities, Sri Lanka has celebrated de Soysa for his humanitarianism. To further illuminate his positive impact on Ceylon, here are seven significant facts about de Soysa’s humanitarian efforts.
7 Facts About Charles Henry de Soysa’s Humanitarian Efforts
Remembering Charles Henry de Soysa
De Soysa made countless charitable donations toward establishing infrastructure and facilities, advancing education and supporting the marginalized. De Soysa passed away at the age of 54 on September 23, 1890, but was honored posthumously as Ceylon’s first Knight Bachelor.
These specifics about Charles Henry de Soysa do not encompass all of his altruistic acts. In fact, de Soysa also made confidential donations that are not documented. These facts about de Soysa’s humanitarian efforts ensure the world continues to remember a historic humanitarian who significantly contributed to uplifting Sri Lanka’s impoverished.
– Megan Roush
Photo: Wikipedia Commons
The Vulnerabilities of Afro-Colombian Women
Poverty and Inequalities Impacting Afro-Colombian Women
According to a 2020 report issued by the Immigration and Refugee Board of Canada, Afro-Colombians, in general, inordinately lack access to food, health care, education, economic opportunities and other resources necessary to escape poverty and live an improved quality of life. Factors including civil armed conflict and gender inequality have compounded with racism to exacerbate the injustices that Afro-Colombian women, specifically, face.
Between 1958 and 2015, Colombia’s ongoing conflict internally displaced more than 5.8 million people, with women accounting for about 58% of these displacements. Women, in general, not only face higher risks of displacement and poverty but also of abuse and exploitation. These risks increase among Afro-Colombian women and women belonging to other marginalized groups.
Colombia is one of the most monetarily unequal countries in the world and 19.6 million people in Colombia (about 39% of the population) lived in poverty at $6.85 or less per day in 2021. While the overall rate of poverty in Colombia has fluctuated throughout the years and the country has noted poverty declines, marginalized groups did not experience this relief and some faced an increase in poverty. Rural populations, which consist of many Afro-Colombian and Indigenous communities, had an increase in poverty from 2020 to 2021 (42.9% to 44.6%) while an estimated 1.4 million people “working in urban services and commerce” rose out of poverty in 2021 due to Colombia’s economic recovery.
In 2015, approximately 41% of the Afro-Colombian population lived in poverty in comparison to 27% of non-Afro-Colombian or non-Indigenous Colombians.
Lack of Access to Resources and Services
Certain factors, such as gender and racial discrimination, contribute to a greater risk of poverty among Afro-Colombians and exacerbate existing conditions of poverty. The racism that Afro-Colombian women face impacts every aspect of their lives and keeps them from accessing resources that would place them in positions of economic and social advancement. Research shows that nations can raise their GDP by US$2.1 trillion annually by dissolving racial income gaps.
When speaking with the United Nations Rapporteur in 2001, groups of Afro-Colombian women stated that they had little access to many basic resources, such as work and income, as a result of racism.
“Groups of women in Quibdó, where 85% of the population is Afro-descendent, indicated that most of the population lives in extreme poverty. Quibdó is the locality with the least water supply coverage in the country, 81% of homes have no sewage, illiteracy is up to 19% and maternal mortality rates are high,” according to the Inter-American Commission on Human Rights.
This lack of accessibility that is caused by internal national racism leads to the perpetual disenfranchisement of this community and causes them to live in the most impoverished cities. For example, the Choco region of Colombia is the most impoverished area of the country and approximately 85% of its population is Afro-Colombian.
Indigenous Peoples and Afro-Colombian Empowerment Activity (IPACE)
Several organizations and activist movements work toward empowering and helping Afro-Colombian communities. Among these is the United States Agency for International Development through its most recent plan: Indigenous Peoples and Afro-Colombian Empowerment Activity (IPACE).
Beginning in 2011, USAID has worked closely with Colombia’s Afro-Colombian population to promote inclusion and empowerment. In December 2021, USAID implemented IPACE, which is a $60 million initiative that connects with locally-led organizations to further their goals and elevate their voices on the national scale. IPACE’s mission is to help implement and uphold the 2016 Peace Accord in Colombia, specifically focusing on peacebuilding and inclusivity.
IPACE also aims to sustainably help economic development by providing training and job placements, risk management through emergency preparedness and services and diversity and inclusion support through acknowledging ancestral practices and building awareness of cultural differences. What sets IPACE apart from other initiatives is the commitment to a locally-led approach through an alliance of 10 partner organizations, all of which are either indigenous or Afro-Colombian. These organizations help IPACE lead and make decisions that are in the best interest of these populations.
Looking Ahead
Afro-Colombian women face multiple vulnerabilities as a result of marginalization and discrimination, which keeps them stuck in the depths of impoverishment. The intersection of racism, poverty and violence creates a cycle of inequality that the government and organizations must address at the root. Fortunately, organizations such as USAID and other locally-led groups are committed to changing the narrative and upholding the rights of Afro-Colombian women.
– Kellyjohana Ahumada
Photo: Unsplash
Takeaways from the UN 2023 Water Conference
Ensuring access to water and sanitation is one of the 17 interlinked sustainable development goals (SDG) to transform our world, set in 2015 by the United Nations as a call for action by all countries to end poverty.
However, despite the importance of water, the U.N.’s data on SDG 6 shows a bleak reality. According to the data released prior to the water conference, if current trends persist, by 2030, 1.6 billion people will still lack access to safely managed drinking water, 2.8 billion will not have access to safely managed sanitation facilities and 1.9 billion will be deprived of basic hand hygiene facilities.
Water is not only essential to health but also to food security and ecosystems, so it is closely connected to poverty reduction. It is essential to all industries and needs to be valued and treated as the vital resource it is. The United Nations Conference on Water is just the beginning of a global effort to ensure access to clean water for all.
U.N. 2023 Water Conference Takeaways
Five key themes were addressed during the conference: water for health, water for sustainable development, water for climate, resilience and environment, water for cooperation and Water Action Decade. Here are some of the most important takeaways:
Importantly, contributing internationally to improve a capacity for water security is not about aid. Rather, it is an investment that is going to pay off for donor countries as well. Clean water supports lives, creates jobs and drives inclusive economic growth, all while ensuring sustainable development. It should be seen as a fundamental platform for economic prosperity and development, rather than an environmental issue.
Overall, the U.N. 2023 Water Conference provided invaluable insight into the most pressing water-related issues facing our planet, such as water sanitation and hygiene, climate resilience and transboundary cooperation. It has also emphasized the need for public-private partnerships and innovative financing mechanisms to support the development of water infrastructure.
To achieve Sustainable Development Goal 6 by 2030, global leaders need to remain ambitious and continue to work together to ensure that all individuals have access to sustainably managed water and sanitation services. The appointment of a U.N. special envoy for water is a promising step in the right direction to ensure that no one is left behind.
– Hanna Bernard
Photo: Flickr
Fighting Period Poverty in Colombia
Colombia, a South American country, is making strides toward addressing period poverty. In 2018, it became the “first country in the region to eliminate the tax on tampons and menstrual towels.” International organizations such as the United Nations Population Fund (UNFPA) are working to combat period poverty in Colombia by providing education and financial aid for menstrual products.
Period Poverty in Colombia
Menstruation, a normal bodily function for half the world’s population, is still considered a taboo topic in many conservative societies. As a result, young people often lack access to proper education regarding period health and management. According to a survey by UNICEF, 34.8% of girls in rural Colombia had no prior knowledge of menstruation before experiencing it.
Financial constraints reportedly prevented more than 683,000 women in Colombia from accessing menstrual products, according to a 2021 report by El Pais. On average, towels and tampons cost Colombian women 180,000 pesos or $45, which accounts for a fifth of the country’s minimum wage. The report also revealed that 312,000 Colombians struggle to access clean and private toilets, further complicating the challenges of managing menstrual health and hygiene.
Period poverty poses challenges beyond economic, health and hygiene issues. According to the World Bank, in “developing countries, two of five girls who have reached menstruation age miss an average of five school days per month due to a lack of access to necessary facilities.” Unfortunately, this can lead to widening the gender gaps in the affected communities by slowing educational progress for girls.
In recent years, there has been a rise in open discussions regarding menstrual health and education, exemplified by the passing of the 2018 bill that eliminated the tax on period products. This move towards greater affordability of such products is a step towards ending period poverty in Colombia.
SRH Efforts
Since 1974, the United Nations Population Fund (UNFPA) has been operating in Colombia, where it has helped local governments manage reproductive health and gender equity issues. In 2020, the UNFPA provided Sexual and Reproductive Health (SRH) services to 4,473 women of reproductive age. Additionally, the organization distributed dignity kits to approximately 1,200 women, offering essential menstrual products at no cost. In 2021, it spent $2,449,976 solely on SRH services. Moreover, it has been assisting national women’s organizations in advocating for women’s rights concerning SRH.
There has been a surge of national organizations fighting period poverty in Colombia. One such organization is Princesas Menstruantes, based in Medellin. It aims to transform the conversation around menstruation by providing workshops and education to young girls. The group has become a prominent player in Colombia’s political landscape, facilitating research and discussions on menstrual health. Through donations, the organization is expanding beyond Medellin to reach rural and urban areas. In 2019, Princesas Menstruantes reached 3,532 people, including men who were included in the dialogue.
Moving Forward
The issue of period poverty continues to gain attention in international conversations, thereby altering the political landscape for good. Organizations tackling the issue are pushing for a world where girls and women have access to menstrual products and as a result, pursue educational and career success without limitations. And with more Latin American countries like Colombia taking action against period poverty, the world continues moving closer in that direction.
– Eva Cairns O’Donovan
Photo: Flickr
Open Defecation in Sub-Saharan Africa
Open Defecation
According to the U.N., open defecation is the practice of excreting in an open space such as a field, river, or street, rather than using a toilet. The U.N. also reports that in 2017, despite open defecation rates nearly halving since the turn of the century, around 670 million people still practiced open defecation.
Two main issues surround the practice. Firstly, open defecation leads to the spread of diarrheal diseases, through the contamination of drinking water and crops. Diarrheal diseases are the leading global cause of child deaths, leading to around 800 children under the age of 5 dying each day.
Secondly, the practice leads to an increased risk of sexual violence against women. In 2016, UNICEF estimated that 50% of rapes that took place in India happened whilst women were defecating in the open.
Successes in India
India has been the focus of efforts to end open defecation for many years, due to the proportion of the large population that were practicing it. Between 2000 and 2017, the number of people practicing open defecation in India fell by 55%. While many question the government’s claim that India became “open-defecation-free” in 2019, there have undoubtedly been huge successes in reducing the rates of this practice across the country.
Global support and government funding under Prime Minister Narendra Modi led to a rapid and widespread rollout of toilets across India. Modi’s “Clean India” campaign began in 2014 and led to the building of 110 million toilets; one initiative led by LIXIL built 47,000 toilets each day.
Despite the successful roll-out of toilets across India, open defecation remains a common practice. Many researchers put this down to cultural barriers; rather than being the result of a lack of toilet, open defecation is most commonly an “ingrained cultural norm,” according to the U.N. Consequently, any long-term solution requires a focus on community perception and behavior alongside the construction and maintenance of proper toilets and sanitation services.
A 2020 study highlighted the successes of a community-based information campaign in Uttar Pradesh, India, aimed at rebranding the use of toilets and instilling new beliefs around the importance of sanitation. The social beliefs that are behind the persistent open defecation in India are twofold: beliefs that no one in the community uses toilets, and beliefs about rituals of purity and cleanliness. By directly tackling these social beliefs, the information campaign saw an increase of 11% in toilet use in villages across Uttar Pradesh.
Applying These Lessons in Africa
Open defecation in sub-Saharan Africa has become an increasingly significant focus in global health efforts. Based on the most recent data available, nine of the 10 countries with the highest percentage of the population practicing open defecation were in sub-Saharan Africa.
Furthermore, between 2015 and 2018, most of the countries with the highest proportion of the population exposed to community open defecation and its impacts were found in Africa, reaching a high of around 90% of the population in Benin and Ethiopia.
As in India, many of the reasons for open defecation in sub-Saharan African nations surround socio-cultural beliefs and values. Therefore, the successes and limitations of the approach taken in India have the potential to inform more effective practices across this region.
In Niger, 68% of the population was practicing open defecating as of 2020, according to the World Bank and only 13% of the population had access to basic sanitation services such as a toilet. Therefore a rapid and widespread roll-out of these sanitation services, as seen in India, has the potential to drastically change open defecation rates in Niger.
Practical and Cultural Approach
There are some examples of practical and cultural approaches to reducing open defecation rates. Between 2017 and 2018, UNICEF partnered with the Government of Niger to develop a plan to end open defecation by 2030. In 2020, the Bagaroua commune became the first Open-Defecation-Free community in Niger. The community chief put the success down to the roll-out of toilets in the region, which saw access to latrines increase from 10.3% to 100%, as well as the “sensitization” program which promoted behavior change. As a result of the work done by UNICEF and the Government of Niger, many parents in the Bagaroua commune reported that they realized the need to change their behaviors to keep their children safe.
Photo: Flickr
Fishermen to the Rescue: Refugees in Indonesia
In a collaborative effort between the United Nations High Commissioner for Refugees (UNHCR), the Indonesian Government, other U.N. agencies and local people, the country has attempted to protect refugees and asylum seekers by identifying solutions for their situation. This has included provisions for emergency assistance and attention to the specific needs of individuals arriving on their shores.
Rohingya Refugees in Indonesia
A huge proportion of those refugees reaching Indonesia are Rohingya men, women and children. In 2017, nearly 800,000 Rohingya fled persecution from their homeland of Myanmar, where they experienced segregation, discrimination and removal of their citizenship. Since then, thousands of refugees make the perilous journey to reach Muslim-majority regions like Malaysia, Bangladesh and Indonesia. While residing in these Bangladeshi refugee camps, the Rohingya face overcrowded, unsanitary and crime-ridden conditions, which is resulting in greater numbers taking the extremely dangerous trip across the sea, where the likelihood of death increases.
Since November 2022, there were 918 Rohingya refugees registered in Indonesia, in comparison to 180 in the entirety of 2021. In a case from December 2022, over 180 Rohingya refugees arrived in a wooden boat on the shore of western Indonesia, supposedly from Bangladesh, including a pregnant woman and children. These journeys are made in poor-quality boats and often increase between November and April when the seas are supposedly calmer. The UNHCR described 2022 as “one of the deadliest years at sea in almost a decade for the Rohingya” which is predicted to continue into 2023.
Generosity of Indonesian Fishermen
Despite the increasing numbers of refugees making this journey, there is an underlying story of hope and kindness in the actions of some Indonesian fishermen. At the end of 2022, Indonesian fishing crews were praised for their part in rescuing over 200 people adrift at sea, in what has since been described by the UNHCR as an “act of humanity.” In doing so, they have provided urgent medical care for survivors suffering from exhaustion and dehydration. The compassion of these Indonesian fishermen has, according to UNHCR Indonesia Representative Ann Maymann, undoubtedly helped to save people from “certain death, ending [the] torturous ordeals for many desperate people.”
In a case from late June 2020, 99 Rohingya asylum seekers arrived on the shore of Aceh after being stranded at sea for more than 120 days, and local fishermen from nearby villages were quick to help them to safety. The Rohingya have been welcomed by the Indonesian people, even being invited to participate in festivities celebrating the 75th anniversary of Indonesian independence.
There have been numerous explanations as to why the people of Indonesia, particularly the Acehnese residents, have demonstrated such acceptance and humility toward those in need, when so many others have refused to act. For example, the Acehnese people abide by the customary maritime law called Panglima Laot, which obliges all fishermen in the region to help those in distress at sea. This is a central part of village life in coastal communities across Indonesia. Similarly, they honor the cultural tradition of Peumulia Jamee, which encourages them to demonstrate kindness and hospitality, particularly towards children.
Supporting the Humanitarian Effort
The International Organization for Migration (IOM) has supported the Indonesian Government along with their humanitarian partners, by aiding the huge numbers of Rohingya refugees arriving on the coast. This includes provisions for water, health care and COVID-19 testing. Moreover, the IOM has worked with local authorities to obtain approval to transfer refugees to a new site in Peunteut, Lhokseumawe, which will greatly improve safety and security. The assistance provided by the IOM to the Rohingya refugees is funded by the U.S. Department of State’s Bureau of Population, Refugees, and Migration (PRM) and the European Civil Protection and Humanitarian Aid Operations (ECHO).
Steps are being taken to help the Indonesian people assist those arriving on their shores, but it is indicative of a much larger problem. Nevertheless, Indonesian fishermen are aiding refugees by showing kindness.
– Bethan Marsden
Photo: Flickr
State of Health care in Vietnam
The Centers for Disease Control and Prevention (CDC)
The CDC’s partnership with the Vietnamese government celebrates its 25th anniversary in 2023. Since 1998, the CDC has supported Vietnam in establishing programs to improve the treatment of diseases including TB, HIV and influenza. The number of HIV sentinel surveillance sites, for instance, which help Vietnam detect and monitor patterns of infection have doubled since 2003. Furthermore, a clinical trial for a new TB treatment conducted by the CDC in Vietnam reduced the length of treatment from six months to only four; it was the first new treatment regimen, in any country, for the disease in three decades. The CDC has also aided in the creation of five emergency operations centers to support the country’s health care system in times of crisis, such as the COVID-19 pandemic.
The World Bank
In 2013, the World Bank funded a $126 million project to protect and improve the public hospital system in 13 provinces in North Vietnam. The North East and Red River Delta Regional Health System Support Project aimed to solve the overcrowding problem that many Vietnamese hospitals were experiencing. It was a success — nearly half of the 74 hospitals included in the program were awarded the Vietnamese Ministry of Health’s upper hospital classification, and patient satisfaction rates experienced a marked increase, reaching 88.5% at the district level. Almost 5,000 local doctors received training from Vietnam’s top medical specialists, learning around 3,000 new techniques to use in their own communities.
USAID
In an effort to ensure an effective response to the COVID-19 pandemic, USAID provided Vietnam with $12 million in aid in 2020. This included $4.7 million in funding for laboratory systems, public health screenings, infection prevention in health care settings and 100 ventilators. USAID also provided $5 million in support of the country’s economic recovery.
Other programs financed by USAID that support health care in Vietnam include Erase TB. This initiative has improved the country’s ability to detect and treat tuberculosis, contributing to a decline in cases of the disease in Hanoi and Ho Chi Minh City. Additionally, USAID’s Local Assistance to Develop and Deliver Excellence, Resilience and Sustainability in Vietnam (LADDERS) program helps high-risk people living with HIV, often living in remote areas, to access testing and treatment services.
The World Health Organization (WHO)
The WHO has supported Vietnam with the goals set out at the ninth Global Conference on Health Promotion, held in 2016. These are:
Vietnam’s 1,332 hospitals, alongside its community services and laboratories, have significantly improved patient access to higher quality health care in recent decades. The work done, and aid given, from both American and global organizations has been vital to this record of success and continues to help Vietnam improve the standard of care that its citizens receive. Health care in Vietnam is more effective thanks to the enduring partnerships established between these organizations and the Vietnamese government.
– Martha Probert
Photo: Flickr