Glasses for developing countries
A variety of NGOs have been working for decades to provide glasses for developing countries. Most models for this operate in similar ways, either by donating glasses or offering low-cost glasses for communities to purchase. These programs have been successful in helping people correct their vision, as well as creating more education and economic opportunity. They only lack one thing — innovation. Choosing to apply a solution designed for a developed country to a remote village is not always the best option. This is where Child Vision comes in.

The Statistics

The World Health Organization (WHO) estimates that nearly 80% of all persons in Africa have unaddressed vision impairment. Additionally, 33% of the world’s poor population suffers from vision impairment. There are 123.7 million people with a refractive error, which can be solved with glasses that have the correct strength. On average, glasses cost approximately $343, despite the average manufacturing cost of $10. Clear vision drastically reduced education access for children, which in turn created less economic opportunity as they moved into adulthood. Lack of clear vision loses $202 billion in global productivity each year.

The Standard

Some of the biggest names in glasses for developing countries are NGOs like Eyes on Africa, Vision for a Nation, VisionSpring and the WHO.

The WHO has been working on the Global Action Plan for eye health since 2014. The plan has one main objective — to encourage and enhance global eye health. The Global Action Plan has several initiatives. These include identifying what is causing vision impairment, understanding where the gap is in eye health access and bringing cataract surgery to developing countries. VisionSpring works by allowing those in developed countries to purchase glasses for developing countries through the VisionSpring website. VisionSpring donates those as well as letting communities purchase low-cost glasses. It also provides bulk purchase discounts and sell glasses individually and by the box. On average, one pair of bifocals in a box set costs just 85 cents. The price point is low, but still unmanageable for many villages, especially in areas with little to no internet access.

Child Vision

Child Vision is a program within the Centre for Vision in the Developing World (CVDW). The CVDW looked at the statistics of vision impairment then accepted the challenge of creating a solution that worked for the developing world. The main struggles the CVDW found in the traditional programs were a lack of optometrists and the high cost of traditional glasses. There is one optometrist per 1 million people in the population in developing nations. While 85 cents for a pair of glasses may seem affordable, it is a great financial strain for the world’s poor, many of whom survive on less than a dollar a day.

Child Vision, after identifying the root problems with getting glasses to developed countries, created a successful prototype within two months. The CVDW created an inexpensive, adjustable lens that sets into durable frames.

How the Glasses Work

The round lens is composed of two walls made of a flexible plastic membrane that the wearer fills with liquid silicone. The lens is then set into plastic frames that have dials on both temples of the glasses. The plastic frames are filled with the same liquid silicone that is in the lens. The wearer puts on the Child Vision glasses, covers one eye and using a tumbling “E” chart, adjusts a side knob to move more or less fluid into the lens until they can see clearly. They then repeat on the other side.

The wearer simply removes the knobs from the glasses and throws them away after the lens is set. They now have durable, functional, cost-effective glasses. With a $20 donation, CVDW can provide a pair of self-adjusting glasses to a developing country. A 1–2-hour training session with a local community leader to show them how to use the tumbling “E” charts to check vision and make sure the glasses are adjusted correctly is also provided. This is not only an immediate solution and innovation to provide glasses to developing countries but it creates generational empowerment of checking eyesight and promoting educational and economic growth within each community.

– Madalyn Wright
Photo: Flickr

Maternal Health in Yemen
The Yemen civil war, which began in early 2015 and still devastates the nation today, has created the world’s worst humanitarian crisis. A total of 24 million people require assistance. This crisis affects all aspects of life in Yemen, including healthcare. Millions are without access to life-saving medical treatment and supplies, leading them to die of preventable diseases, such as cholera, diabetes and diphtheria. Pregnant women and infants are particularly vulnerable during this health crisis as adequate medical care throughout pregnancy and birth is essential. Maternal health in Yemen is of the utmost concern now.

Yemen has one of the highest maternal mortality rates in the world with 17% of the female deaths in the reproductive age caused by childbirth complications. Maternal health in Yemen has never been accessible to all women. This crisis has escalated even further during the Yemeni civil war. However, global organizations are acting to save the lives of these pregnant women and infants who desperately need medical care.

Yemen’s Maternal Health Crisis: Before the Civil War

Even before the war began in 2015, pregnant women were struggling to get the help they needed. Yemen is one of the most impoverished countries in the world — ranking at 177 on the Human Development Index (HDI). Poverty is a large factor in the insufficiency of maternal health in Yemen as impoverished women lack the finances, nutrition, healthcare access and education to deliver their babies safely.

Many Yemeni women are unaware of the importance of a trained midwife during childbirth. Of all the births in rural areas, 70% happen at home rather than at a healthcare facility. Home births increase the risk of death in childbirth as the resources necessary to deal with complications are not available.

The Yemeni Civil War Increased the Maternal Health Crisis

Since the civil war began, the maternal mortality rate in Yemen has spiked from five women a day in 2013 to 12 women a day in 2019. A variety of factors caused this spike. The war has further limited access to nearly every resource, including food and water. This, in turn, depletes the health of millions of women and thus their newborns.

Also, the civil war has dramatically decreased access to healthcare across the nation. An estimated 50% of the health facilities in the country are not functional as a result of the conflict. Those that are operational are understaffed, underfunded and unable to access the medical equipment desperately needed to help the people of Yemen. This especially affects pregnant women — who require medical care to give birth safely.

Organizational Aid

Though the situation in Yemen remains dire, various global organizations are acting to assist pregnant women and newborns. The United Nations Children’s’ Emergency Fund (UNICEF) is taking the initiative to help millions across Yemen, including pregnant women. The organization has sent health workers and midwives into the country’s rural areas to screen and treat pregnant women for complications.

Similarly, USAID trained more than 260 midwives and plans to send them into Yemeni communities to help pregnant women and infants. USAID is partnering with UNICEF, the World Health Organization (WHO), the Yemen Ministry of Public Health and Population and other organizations to ensure that maternal health in Yemen, as well as all types of healthcare, are adequate and accessible for all affected by the civil war.

Maternal health in Yemen, while never having been accessible for many, is now in crisis as a result of the Yemeni civil war. While the situation is still urgent, organizations such as USAID and UNICEF are fighting to ensure that all pregnant women and infants in Yemen have access to the medical care they desperately need.

Daryn Lenahan
Photo: Flickr

Brazil Indigenous coronavirusThe coronavirus has resulted in deaths all over the world, but some communities are more heavily affected than others. In Brazil, the coronavirus in Indigenous communities has taken an especially hard toll. COVID-19 disproportionately affects these often-isolated groups, which struggle to access the support systems needed to withstand this threat.

The Vulnerability of Indigenous Communities

Some Indigenous tribes living in Brazil have limited or no contact with the rest of the world. However, this isolation may render some tribes unaware of the pandemic in general or of its full seriousness. The coronavirus in Indigenous communities may also put tribe members at a greater risk, because they lack exposure to many illnesses. This means that their immune systems are often not strong enough to fight COVID-19.

Additionally, isolated Indigenous communities only have limited access to unreliable testing, contact tracing and communication of quarantine protocols. Some would have to travel for days to reach modern medical facilities providing such resources.

In particular, Indigenous communities fear the village elders contracting the coronavirus. Elders are not only the most vulnerable members of the community but may also experience the most serious effects of the disease. Additionally, many refer to these elders as “living libraries” or “living encyclopedias.” They hold tribal knowledge of culture, mythology and natural medicine, and many speak endangered languages. If coronavirus in Indigenous communities wipes out this generation of elders, their tribe’s cultural history and knowledge will die with them.

Why Outsiders Pose a Threat

The rapid spread of the coronavirus in indigenous communities often results from outsiders who visit these communities without taking the proper precautions. For example, doctors working in remote Indigenous regions have tested positive for the coronavirus. They only entered quarantine after they possibly spread the disease to multiple villages. Additionally, other medical teams have failed to follow proper quarantine protocol before entering an Indigenous reserve to care for those vulnerable to the disease.

Miners and poachers tapping resources on Indigenous lands have also spread the virus to these isolated communities. In Brazil, an estimated 40% of Yanomami people who live near these mining operations are now at risk of contracting COVID-19. Leaders from the Yanomami Indigenous Territory have spoken out, creating the hashtag #MinersOutCovidOut. Their aim is to raise awareness and demand an end to illegal gold mines and other land invasions.

The budget cuts and staff reassignment faced by FUNAI, a government agency that defends the boundaries of Indigenous land in Brazil, have made it possible for illegal miners and poachers to enter these protected regions. Indigenous people in certain tribes have also claimed that FUNAI only gave food supplies and assistance to tribes on officially demarcated land. However, even this aid was not enough to feed the large families of the tribe.

The Government in Brazil

Brazilian president Jair Bolsonaro has come under fire in the past for dismissive statements about Indigenous communities in Brazil. He has also allowed illegal logging, mining and land grabs to continue. Currently, Bolsonaro’s administration faces criticism for its response to the pandemic. The Brazilian government’s conflicts with Indigenous communities have resulted in inadequate support required for these communities to fight COVID-19.

The Brazilian Supreme Court ordered in July 2020 that the government must create a crisis response team and develop a plan to control the coronavirus. However, Bolsonaro recently vetoed proposed laws to provide vulnerable Indigenous communities with designated intensive care beds, clean water and essential supplies. Bolsonaro defended this decision by citing excessive costs that he claimed would go against public interest.

Fighting the Coronavirus in Indigenous Communities

To fight this crisis, Brazilian Indigenous communities and outsider organizations are joining forces. The NGO Brazilian Health Expeditionary, or Expedicionários Da Saúde, has helped Indigenous people from over 700 isolated communities in the Amazon by setting up temporary medical facilities with necessary supplies. Local officials and Indigenous groups collaboratively gather money and distribute food supplies in place of the unfulfilled promise of government assistance.

Many individual tribes are also protecting themselves from the spread of the virus by remaining in isolation from the rest of the world. This means that they seek medical care within their own communities. As such, though the severity of the coronavirus in Indigenous communities in Brazil is dire, it is not without hope.

Allie Beutel 
Photo: Pixabay

Healthcare in Thailand
Thailand is a country of hundreds of islands in Southeast Asia with a population of nearly 70 million people. Thailand has a history of political instability and economic uncertainty along with rising poverty rates. However, the country has made great strides to improve its healthcare. Nearly 7 million of Thailand’s citizens live in poverty and a wealthy few control a large majority of the country’s wealth. With one of the most extreme wealth gaps in the world, universal healthcare in Thailand creates a meaningful movement toward equality for all its citizens.

Switching to Universal Health Coverage (UHC)

In 2002, Thailand made the transition from a combination of various healthcare policies to an all-encompassing, universal health coverage (UHC) system. Under the UHC system, every Thai citizen is entitled to health services — including preventative, curative and palliative care, at any age. Under this system, financial protection for high-cost services also improved.

Challenges in Financing the UHC System

Though universal health coverage in Thailand has allowed increased access for all ages and classes of citizens, the country still faces challenges with funding the program. The UHC system is a predominantly publicly funded program, meaning that it functions mainly through taxation. Because the nearly 7 million Thai citizens live no more than 20% above the poverty line, the UHC budget coming from taxes is relatively inflexible. Therefore, funding the growing demands for healthcare in Thailand often requires reaching into other public funds.

Access to preventative medicine has decreased the rates of many illnesses by keeping them from occurring in the first place. However, medical expenses in other categories are on the rise. As the average age of the population increases, healthcare in Thailand faces an influx in elderly patients needing more care. Unsafe road conditions and unenforced traffic laws in many regions also contribute to high rates of road accidents and result in excessive trauma cases. Also, air pollution in cities and extreme weather conditions in various regions across the many islands contribute to increased utilization of the UHC system. For the UHC system to be an equitable, effective and sustainable service for the country, other avenues of funding must be explored.

Challenges and Looking Ahead

Healthcare in Thailand has had many positive improvements since the national transition to universal coverage in 2001. Yet, like any system, it often faces continued challenges. The system is considered popular among lower-paid citizens that did not previously have access to care. Albeit, higher-income communities hold some distaste for the system due to increased access leading to more crowding in hospitals. Universal healthcare in Thailand has created a much more inclusive environment for the Thai people as it helps to bridge the immense wealth gap. A gap between the nearly 7 million living in poverty and the wealthy 1%.

Positive Impact of the UHC System

This alteration of the previous healthcare system has led to an increase in the utilization of health services and decreased the prevalence of unmet needs in the country. Overall, healthcare in Thailand is improving. Not only did rates of care increase with the introduction of the UHC system, but other metrics of improving healthcare also rose.

Life expectancy from birth rose from 71.8 years before the introduction of the UHC system, to 77.2 years in 2020. Infant mortality rates similarly fell from more than 100 per 1,000 births in 1970 to 7 per 1,000 births in 2020. As citizens have been able to access preventative care and more expensive intervention at lower personal cost, out-of-pocket spending on healthcare needs have decreased. Meanwhile, household savings increased. Though the switch to universal healthcare certainly faces challenges, it has created quantifiable positive change for millions living in Thailand.

Jazmin Johnson 
Photo: Unsplash

Video Game to Combat COVID-19With the COVID-19 pandemic being a new reality for people all around the world, top medical experts have advised everyone to take a series of precautionary measures to protect themselves against the disease. This includes wearing a face mask, social distancing and regular handwashing. While many have successfully adapted these recommendations into their daily routines, one group that is particularly struggling to do so are young children. However, two Pakistani teenage brothers have put forth an out-of-the-box solution and created a video game to combat COVID-19 in Pakistan.

The Creators

Brothers 14-year-old Kenan Khan and 13-year-old Nabhan Khan, created a free video game to combat COVID-19, called Stop the Spread. They began developing the idea in February 2020 and released it in April 2020 because they observed that children had trouble remembering and adapting to the guidelines that are meant to protect them against COVID-19. The tasks of the Stop the Spread game, test children on the health guidelines put forth by the World Health Organization. This includes being able to identify symptoms and the difference between facts and myths regarding COVID-19 as well as protection and prevention measures that need to be taken to protect their chosen videogame avatar from being exposed to the virus. As each video gamer completes a task, he or she accumulates points and advances to the next level. Once the video gamer completes all six levels, he or she is considered a COVID-19 warrior and is deemed knowledgeable enough to protect themselves against COVID-19. This keeps children engaged in the game as well as well-informed.

Neither of the Khan brothers has been formally educated. However, they were able to use the vast resources available online to learn design, coding, simulation and animation as well as basic literacy and mathematics. 

Combating COVID-19 Through Video Games

Other children around the world have also begun to create video games of their own. Israel Smith, a 12-year-old from Georgia, redesigned Space Impact, an old cellphone game, to combat COVID-19. In the game, each player is assigned an avatar who is tasked to identify and kill the COVID-19 viruses. Throughout the game, the avatar and the viruses use speech bubbles to inform the video gamers about facts regarding the virus as well as health guidelines.

Recent COVID-19 game developments such as these, have inspired a global campaign called #PlayApartTogether to use video games to as a means to prevent the spread of COVID-19 globally.

Videogame companies have also partnered together to spread the World Health Organization’s message by incorporating COVID-19 self-protection messages into videogames.

The Khan brothers’ video game to combat COVID-19 just goes to show that even the youngest of minds have the power to make a big impact during unprecedented times. The creation serves as an inspiration to others and provides rays of hope amid a global pandemic.

Rida Memon
Photo: pxfuel

Healthcare in AustriaAustria is known for having one of the most generous and greatest healthcare systems across the world. Healthcare needs are readily accessible to Austrian citizens at little to no cost. The vast majority of the Austrian population has access to healthcare, as long as an individual is not willingly choosing to be unemployed.

Healthcare in Austria

  1. Two-tiered system: In the first tier of Austria’s two-tiered healthcare system, healthcare covers 99% of the population, of which 75% is typically funded through public taxes. However, citizens can also pay to have supplementary healthcare, which allows individuals to see private practitioners. As of 2010, it is estimated that 130,000 individuals chose to pay for private healthcare.
  2. Life-long private providers: For those who choose to pay for private or supplementary healthcare, insurance companies are not allowed to have restrictions within contracts, nor are they allowed to terminate an individual’s healthcare without permission. The private healthcare services can only be terminated by the individual, allowing the user to have access to life-long healthcare services.
  3. High accessibility to hospitals and pharmaceuticals: Despite the decline in hospital bed availability around the world, Austria has 271 hospitals containing more than 64, 000 beds and around 45,000 doctors, classing the country as having one of the highest bed/patient ratios in Europe. Along with the availability of hospitals and other health centers, the cost of pharmaceutical drugs in Austria is low. In 2012, Austria’s pharmaceutical costs were an estimated 18.6% lower than the rest of Europe.
  4. Public healthcare covers four areas: Within the Austrian healthcare system, there are four specific areas in which those who choose to have public healthcare, rather than private healthcare, can be covered: illness, maternity, precautionary and therapeutic aid. Each of these categories requires certain criteria for the individual to be categorized into one of the four areas.
  5. Tourists have access to healthcare: For those visiting Austria with a European Health Insurance Card, access to public healthcare is enabled. While this does not cover any private healthcare, it does cover basic doctor’s visits, dental services and even emergency hospital visits. This allows tourists or students who may need emergency medical assistance to access healthcare at a reduced fee.

Through this dynamic healthcare plan, Austria is able to provide healthcare and benefits for its citizens. Whether it be a simple checkup or something more extensive, Austria’s public healthcare system alleviates healthcare burdens for its people. Even for those who pay for a private healthcare plan, the cost of medical expenses is far less than many places around the world, as it is estimated to only cost $243 a month. Whether it be private or public healthcare, Austria’s two-tiered system has found itself among the highest-ranking healthcare systems in the world.

Olivia Eaker
Photo: Flickr

Sen. Bob CaseySen. Bob Casey has been a U.S. Senator from Pennsylvania for 13 years since his election in 2006. Casey is a member of the Democratic Party. He is assigned to four Senate committees: Finance; Health, Education, Labor and Pensions, Agriculture; Nutrition, and Forestry; and the Special Committee on Aging. Consequently, this article shows the efforts made by Sen. Bob Casey to fight against global poverty and help poor people. He has been working to pass two significant bipartisan legislation regarding global poverty, as well as supporting people around the world to improve U.S. national security.

Debt Cancellation for Poor Countries to Combat Global Poverty

In 2007, Sen. Bob Casey (D-PA), Chris Dodd (D-CT) and Dick Lugar (R-IN) introduced the Jubilee Act for Responsible Lending and Expanded Debt Cancellation Act of 2007. Senator Casey sponsored bipartisan legislation to help poor countries that had spent money on repaying debt rather than taking care of their citizens in poverty. He said, “This legislation will help these nations get out of debt and help them free up resources to reduce poverty.” This comment and his support for the bill shows his commitment to reducing global poverty from the early period of his term as a senator.

Global Food Security

With Sen. Johnny Isakson (R-GA), Sen. Bob Casey introduced the Global Food Security Act in 2016. This legislation required the administration to assist targeted communities and nations to improve agricultural productivity and enhance food and nutrition security. It also emphasizes the importance of enhancing maternal and child nutrition. This act additionally recognizes the importance of tackling global food insecurity for developing countries and the U.S. economy and national security.

Sen. Bob Casey said, “The need to address global hunger is an urgent foreign policy and national security priority. It is in the United States’ best interest to promote initiatives that work to eliminate the causes of food and nutrition insecurity.” Likewise, the Global Food Security Reauthorization Act was passed in 2018, introduced by Sen. Bob Casey and Sen. Johnny Isakson. This bipartisan legislation ensures the extension of the Feed the Future initiative until 2023. For example, by 2018, the Feed the Future program helped more than 1.7 million households in 12 targeted countries.

His Support for Women in Afghanistan and People in Syria

To ensure the safety of women and girls in Afghanistan, Sen. Bob Casey introduced the Afghan Women and Girls Security Promotion Act. He also has been working to provide help for women who survived domestic violence or other crimes. Moreover, he has supported food and medical support for Syrian people in need because of the war.

As a representative of Pennsylvania, he has made several efforts to combat global poverty and hunger. In the interview by Penn Political Review, he said, “It is critical that U.S. foreign aid dollars be used efficiently and that they provide relief and promote opportunities for poor and underserved individuals and communities around the world.” It is therefore clear that Senator Casey’s efforts are critical in the fight against global poverty. Calling and emailing him to support these bills would be significant. As a result of helping these people, the U.S. can improve national security and economy.

Sayaka Ojima
Photo: Pixabay

corruption in healthcare
The healthcare sector in several countries around the world is commonly referred to as being among the most corrupt sectors. A 2013 Transparency International Study reported that more than 50% of citizens viewed their country’s health sector as corrupt in 42 out of 109 countries surveyed. The World Bank has regarded corruption in healthcare as a major barrier to achieving social and economic development.

Corruption and Poverty

Informal payments are a very specific form of corruption prevalent in weak health care systems around the world. Informal payments refer to under-the-table payments to receive services that are otherwise free or which are requested in addition to officially sanctioned required payments.  They are prevalent in the healthcare sector of many countries globally. For example, in Azerbaijan, informal payments account for 73.9% of all medical spending. This form of corruption often arises due to inadequate healthcare management, including inadequate public spending, resource deprivation, governance and human resource constraints and scarcity of providers.

Informal payments negatively affect healthcare at the individual and governmental levels. Due to the secrecy that often shrouds the transaction of informal payments, these payments are often made in cash and do not contribute to the collection of taxes. This translates into less money available to be reinvested in the healthcare system.

Further, informal payments are often regressive in nature, meaning that low-income individuals often tend to pay a larger proportion of their income respective to high-income individuals.  One study in sub-Saharan Africa identified informal payments as being highly prevalent among the poorest segments of society.

Informal payments represent severe barriers to accessing care for those living in poverty. In some cases, informal payments can push low-income individuals to borrow money often with high-interest rates. This indebtedness can lead to financial ruin for low-income families and can potentially push them into the poverty trap.  More concerning is the potentially deadly impact of patients to delay or forego medical care due to the inability to cover the expected informal payments.  Further, the informal nature of these payments makes exemptions to protect those in poverty increasingly difficult to enforce.

The Impact of COVID-19

The COVID-19 crisis can lead to further barriers to accessing care and may bring an increase in the prevalence of informal payments. Overwhelmed, weak health care systems around the world with resource and provider scarcity may push those seeking treatment to use informal payments as a means of accessing better care and at other times may be required to make up for inadequate funding. It is known that informal payments are tied to these scarcities. These factors are increasingly relevant in COVID-19 responses around the world.

There is a high risk of the prevalence of informal payments increasing in reaction to the pandemic. For those who cannot afford the cost of informal payments, the catastrophic virus may cause families to take on a high-rate of debt, pushing low-income families further into poverty. If individuals choose to forego testing or treatment for the virus due to a lack of financial ability to cover informal payments it could impact the response to fighting COVID-19 by accelerating the spread of the disease.  With the number of people living in extreme poverty projected to rise by 71 million due to the economic shocks brought on by the pandemic, there is an urgent need to address the issue of informal payments and broader corruption in the healthcare sector.

How to Take Action

According to the Carnegie Endowment, the spread of coronavirus, with corruption acting as a catalyst, poses a serious threat to U.S. interests and foreign policy objectives. There are a number of ways the U.S. can address the problem of corruption and the prevalence of informal payments around the world through the U.S. Global Coronavirus Response. The Countering Russian and Other Overseas Kleptocracy (CROOK) Act aims to address corruption through rapid action. The act has been introduced in the Senate after passing the House of Foreign Affairs Committee and shares bipartisan support. USAID in partnership with the State Department is addressing the corruption-coronavirus nexus by supporting transparent emergency procurement mechanisms and providing support to anti-corruption law enforcement.

Due to the discrete nature of informal payments and the provider-patient relationship, the U.S. influence is limited in combating informal payments. In low-income countries with weak healthcare systems, the most effective means of mitigating the impact of informal payments on those impacted by COVID-19 is prevention. The United States can help curb the spread of COVID-19 around the world by providing adequate funding for global health security in the next emergency supplemental COVID-19 response.

– Leah Bordlee
Photo: Flickr

COVID-19 in AfricaOn a world map of the distribution of COVID-19 cases, the situation looks pretty optimistic for Africa. While parts of Europe, Asia and the United States are shaded by dark colors that implicate a higher infection rate, most African countries appear faint. This has created uncertainty over whether or not the impact of COVID-19 in Africa is as severe as other continents.

Lack of Testing

A closer look at the areas wearing light shades reveals that their situation is just as obscure as the faded shades that color them. Dark spots indicate more infections in places like the U.S. However, in Africa these are usually just cities and urban locations, often the only places where testing is available.

Although insufficient testing has been a problem for countries all over the world, testing numbers are much lower in Africa. The U.S carries out 205 per 100,000 people a day. Nigeria, the most populous country, carries one test per 100,000 people every day. While 8.87% of tests come back positive in the U.S, 15.69% are positive in Nigeria (as of Aug. 4, 2020). Nigeria was one of 10 countries that carried out 80% of the total number of tests in Africa.

As a continent that accounts for 1.2 billion of the world’s population, the impact of COVID-19 in Africa is even more difficult to measure without additional testing. To improve this, the African CDC has set a goal of increasing testing by 1% per month. Realizing the impossibility of reliable testing, countries like Uganda have managed to slow the spread by imposing strict lockdown measures. As a result, the percentage of positive cases in Uganda was only 0.82% (as of Aug. 4, 2020).

A Resistant Population

COVID-19 in Africa has had a lower fatality rate than any other continent. Fatality rates may even be lower than reported. Immunologists in Malawi found that 12% of asymptomatic healthcare workers were infected by the virus at some point. The researchers compared their data with other countries and estimated that death rates were eight times lower than expected.

The most likely reason for the low fatality rate is the young population. Only 3% of Africans are above 65 compared with 6% in South Asia and 17% in Europe. Researchers are investigating other explanations such as the possible immunity to variations of the SARS-CoV-2 virus as well as higher vitamin D in Africans with more sunlight exposure.

Weak Healthcare Systems

Despite these factors, the impact of COVID-19 in Africa is likely high. Under-reporting and under-equipped hospitals contribute to unreliable figures. Most hospitals are not prepared to handle a surge in cases. In South Sudan, there were only four ventilators and 24 ICU beds for a population of 12 million. Accounting for 23% of the world’s diseases and only 1% of global public health expenditure, Africa’s healthcare system was already strained.

Healthcare workers have the most risk of infection in every country. In Africa, the shortage of masks, equipment and capacity increases the infection rate further amongst healthcare workers. Africa also has the lowest physician to patient ratios in the world. As it can take weeks to recover from COVID-19, the recovery of healthcare workers means less are available to work.

Additionally, those that are at-risk and uninsured can rarely afford life-saving treatment in Africa. For example, a drug called remdesivir showed promising results in treating COVID-19. However, the cost of treatment with remdesivir is $3,120 – an unmanageable price for the majority of Africans. These factors will determine the severity of COVID-19 in Africa.

Economic and Psychological Factors

Strict lockdowns have helped some nations in controlling the spread of COVID-19 in Africa but at a very great price.

Lack of technology often means that all students stop learning and many lose their jobs. More than three million South Africans have become unemployed due to the lockdown. The lockdowns have also resulted in much higher rates of domestic violence, abuse and child marriage. Many such cases go unreported and mental health services for victims or those struggling through the pandemic are unavailable. In Kenya, the U.N. has appealed for $4 million to support those affected by gender-based violence.

The slow spread of COVID-19 in Africa has allowed the continent and leaders to prepare, and the young population will lessen the impact. Although there’s reason to be hopeful, there’s no doubt that there will be an impact on Africa’s economy and future. This calls for the need of foreign assistance – not only in controlling COVID-19 in Africa but in the recovery of the continent for years to come.

Beti Sharew
Photo: Flickr

Tuberculosis in BangladeshTuberculosis (TB) is an airborne disease; common symptoms include cough with sputum and blood in some cases, chest pains, weakness, weight loss, fever and night sweats. TB can lead to the death of an infected person when left untreated. According to the World Health Organization (WHO), TB has caused about 2 million deaths worldwide, and 95% of deaths were recorded in developing countries. Bangladesh ranked sixth among high TB burden countries. The National Tuberculosis Control Programme (NTP) has attained more than 90% treatment success and more than a 70% case detection rate. Despite these successes, tuberculosis in Bangladesh remains a serious public health problem.

Reasons for Higher Infection of Tuberculosis in Bangladesh

  1.  Delays in the Initiation of Treatment: Patients in Bangladesh often receive late treatment. Delays in treatment increase chances of negative treatment results, death and community transmission of TB. A study on 1,000 patients reported that, on average, there were 61 days of delay in the treatment of women and 53 days of delay in the treatment of men.
  2.  Role of Informal Health Practitioners: Most of the impoverished people in Bangladesh prefer to go to their local practitioners due to the ease of accessibility and low cost. A recent survey showed that approximately 60% of the Bangladesh population prefers to go to these uncertified doctors. However, such doctors typically lack formal training. This may lead difficulties in accurately diagnosing and treating TB.
  3. Lack of Awareness: Directly observed treatment short-course (DOTS) has been recognized as one of the most efficient and cost-effective approaches for treating TB. In 1998, the DOTS program became an integrated part of the Health and Population Sector Programme. The inclusion of the DOTS strategy in the Programme helped TB services transition from TB clinics to primary level health facilities. These health facilities typically incorporate GO-NGO (government-organized non-governmental organization) partnerships, and the NGOs have advocated for work on literacy, social awareness along and health care development. As part of the Health and Population Sector Programme, DOTS is freely available to the public. Unfortunately, many remain unaware of the treatment option.  As a result, detection of new TB cases has stagnated at around 150,000 cases per year since 2006.
  4. Poverty: A large portion of the country is still suffering from poverty. Poverty can often lead to overcrowding and poorly ventilated living and working conditions. People with less income also cannot afford food, leading to higher incidences of malnutrition. The culmination of these factors typically make the impoverished population more vulnerable to contracting TB.

The Effort to Combat TB

Tuberculosis is a major public health problem in Bangladesh. However, continuous efforts by the NTP and various NGO organizations have played an important role in decreasing the spread of the disease. DOTS, for instance, demonstrated a 78% cure rate in 1993. Due to its success, a phase-based treatment plan was implemented in 67 million rural populations in 1996.  Since implementation, the NTP has attained a 90% treatment success rate. Further efforts to combat the disease include development of the FAST program (Find cases Actively, Separate safely and Treat effectively). The program intends to detect active TB cases and decrease spread of the disease in healthcare facilities. However, despite efforts by the NTP and a number of NGOs, significant delays in care-seeking and treatment initiation still exist as major hindrances to the program’s goals. 

Challenges to TB Programs

Tuberculosis in Bangladesh kills more than 75,000 people every year. Despite free services like DOTS and other NTP programs, limited access to quality service, lackluster funding and insufficient screening prevent adequate detection and treatment of the disease. The lowest quartile of the population is still five times more likely to contract TB, potentially due to a lack of awareness of TB-treatment programs among the general public. Adding to the problems for TB programs, private health professionals are typically inactive in national programs. While NTP programs have made progress in addressing the disease, these challenges persist, and tuberculosis remains a major health problem in Bangladesh.

Solutions

To stop the growth of tuberculosis in Bangladesh, community organizations such as the Bangladesh Rural Advancement Committee (BRAC) have shown impressive results in lowering the percentage of those afflicted by TB. Effective treatment of TB includes investment in medicine, local health services and diagnostics. To ensure full recovery, social protection of patients is also required. Multidrug-resistant TB (MDR-TB), for instance, requires two months of drug treatment and a four month continuation period. If treatment programs can satisfy requirements investment and social protection requirements, the chance of curing TB patients reaches 92%. The application of a more successful method will help in curing the most complex TB cases, such as drug-sensitive TB, with improved results. With the implementation of proper and effective treatment strategies, we can eliminate tuberculosis in Bangladesh and the benefit even the poorest members of society.

– Anuja Kumari

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