Childhood Pneumonia
One of the most common diseases globally, pneumonia can be a silent killer when it infects children under 5. In the developing world, rates of childhood pneumonia cases and deaths are still high despite decreasing in other childhood diseases. However, due to new research and outreach programs to aid developing countries, those numbers may soon fall.

10 Facts About Childhood Pneumonia

  1. Various sources cause the disease. Unlike many other diseases that come from a single source, pneumonia is the name for the lungs’ acute response to an airborne pathogen. While pneumonia can develop from bacteria, viruses or fungi, the most common cause for children is the bacteria S. pneumoniae. The bacteria typically live in the lungs without harming the body, but the body develops pneumonia to kill the bacteria when it begins to spread.
  2. Childhood pneumonia mainly infects children under the age of 5. While people of all ages can develop pneumonia, children under the age of 5 are especially susceptible to the infection. Since their immune systems are not fully developed, their bodies are more likely to trigger a response to a foreign agent’s presence in the respiratory system, leading to pneumonia. These infection rates only increase in developing countries, where children are more likely to be born either malnourished or with a disease that they acquired in utero such as HIV.
  3. Pneumonia is a leading cause of death in children. Although pneumonia is often easy to treat and cure in developed countries, it can be fatal in developing countries. According to the United Nation’s Children’s Fund (UNICEF), childhood pneumonia kills over 800,000 children each year in comparison to 437,000 from diarrhea and 272,000 from malaria. These deaths are typically in children who are malnourished or have other conditions such as HIV that impair the immune system.
  4. South Asia has the greatest incidence of childhood pneumonia. Out of every 100,000 children in South Asia, approximately 25,000 will develop pneumonia each year. However, the majority of these cases — approximately 36% — occur in India. Studies looking into the potential causes for the increased number of cases have found that overcrowding in housing with inadequate ventilation allowed the disease to spread among families. Without effective airflow, children in those households continue to breathe in potentially infected air, increasing their chances of developing pneumonia.
  5. Air pollution increases pneumonia rates. Although a child needs to have exposure to the biological cause of pneumonia to develop the disease, certain environmental factors can increase infection likelihood. In India, a country with one of the worst-rated air qualities in the world, particles of smoke and other forms of pollution in the air weaken lungs when inhaled, making it more likely for a young child to develop pneumonia. These conditions of outdoor air pollution causes approximately 17.5% of all pneumonia deaths in the developing world.
  6. The disease is treatable. With antibiotics or antifungals (depending on the cause), children with pneumonia can recover from the disease. However, this treatment is dependent on the resources available in the country where the child lives. In developing countries such as Nigeria — the African country with the highest pneumonia rates in children — only one in three children with pneumonia symptoms can receive treatment due to the lack of available medicines and other medical resources.
  7. Some are producing vaccines. Although vaccines cannot treat viral pneumonia, they are still an important asset in preventing it. However, most of the produced vaccines are only available in developed countries where doctors recommend them for children under 5. In developing countries, nearly 10 million children are unvaccinated. Through the World Health Organization (WHO), many countries have received vaccines, although there has been great variation between regions of the world. While WHO’s South-East Asian Region has 89% coverage, its Western Pacific region only has 24% coverage.
  8. Less progress has occurred regarding childhood pneumonia. While research on pneumonia as a whole has increased over the past decade, there has been much less progress on childhood pneumonia in comparison to other childhood diseases. Since 2000, deaths for those under 5 from pneumonia have decreased by 54%, while deaths from diarrhea have decreased by 64% and are currently half the number of childhood pneumonia deaths.
  9. Large organizations are helping. Among other large, international organizations, the Gates Foundation has taken efforts to reduce childhood pneumonia rates in developing countries. One of its main methods is the continued distribution of vaccines to children and families in South Asian and Sub-Saharan Africa, specifically India and Nigeria. So far, the organization has sent vaccines to over 37 countries in those regions of the world, slowing transmission and infection rates in those areas.
  10. Rates will continue to drop in the future. Although the number of childhood pneumonia cases each year have not dropped as much as other diseases, long-term progress is still ongoing. If the current level of progress toward eradicating the disease continues, UNICEF predicts that it will save 5.9 million children. At the same time, if resources towards the effort increase, that number will increase to nearly 10 million.

UNICEF and WHO do not expect to meet their goal of eradicating childhood pneumonia until 2030. However, the progress they and many others are currently initiating is making a difference. Soon, pneumonia will become an extinct disease in the developing world so that it will never harm another child.

Sarah Licht
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

Invest in Foreign Aid
The UN has reported that global poverty has reduced by half in the past 20 years, but estimates have determined that 10% of the global population continues to live in poverty. Roughly 736 million individuals live on less than $1.90 a day. With poverty being a multi-faceted issue and having implications ranging from the preservation of life to global economics and politics, here are some of the reasons why investment in foreign aid is a good idea.

Saving Lives

Research shows that many of the deaths per annum that occur due to poverty are preventable. Specifically, in children, estimates have determined that two in every three deaths are due to diseases and conditions that are treatable such as pneumonia, malaria and diarrhea. Famine, which claims 9 million lives a year and is responsible for half of all deaths of children aged 5 and below persists despite research that shows there is enough food produced to feed the population in its entirety by 1.5 times over. With the means readily available, committed support can make a life-saving difference.

Equalize Distribution of Wealth

In a report on economic inequality, researchers were able to determine that billionaires earned enough income to end poverty seven times over in 2017. With well documented adverse effects on GDP, increasing levels of income inequality have produced a measurable stagnation in global economic growth. Organizations like The Giving Pledge, which is comprised of a list of billionaires who have committed half of their wealth to charity, could help solve the problem in redistributing their wealth thereby accelerating global economic development.

The Value in Developing Economies

Since 2008, the U.S. has engaged in investment in foreign aid to Ghana. In fact, it has provided Ghana with $150 million to date. This relationship between the two countries has become increasingly mutualistic as the economy of Ghana continues to develop. An increase from 7.8% to 30.3% in exports from the U.S. shows that when one invests in foreign aid, it produces measurable returns. One can find similar results throughout the globe. For example, the U.S. invested north of $800 million to Afghanistan in 2020 alone but stands to make $1.2 billion in exports. Moreover, this is in spite of the fact that the bulk of funds are going toward democratic processes, human rights and governance.

Building Alliances

In the 20th century, South Korea, Germany and Japan were recipients of foreign aid via The Marshall Plan. The U.S. has providing foreign aid one of its mandates ever since. Today, South Korea and Germany are some of the United States’ most valuable allies and trading partners. With less than 1% of the federal budget going to foreign aid and the U.S. polling highest in how other countries view it as an ally globally, the importance of nurturing and maintaining alliances abroad benefits not only the economy but national security interests as well.

The upsides of concerted investment in foreign aid to eradicate global poverty are self-evident, with the global population experiencing highs in life expectancy, global literacy rates and access to higher education, as well as significant reductions in child and maternal mortality rates. It is clear that much work is necessary, but the world’s understanding of the issue has never been more sophisticated.

– Christian Montemayor
Photo: Flickr

Infant Mortality in Côte d'Ivoire
When examining the whole of Africa, infant mortality is a matter of grave concern. The West African country of Côte d’Ivoire currently struggles in comparison with other countries in the same category. The World Bank recorded an infant mortality rate of 59.40 per 1,000 live births there in 2018. These deaths stem from several causes, with the primary issue being the lack of available infant care in the country. However, in recent years, these numbers have improved dramatically; the rate of infant mortality in Côte d’Ivoire is almost half of the 100.7 deaths recorded per 1,000 live births in 1998, according to the same source.

The Scope of the Problem

Despite the lower mortality rate, fundamental problems persist. A report by the Healthy Newborn Network (HNN) that used sources compiled from the WHO and the MCEE determined that skilled professionals attend only 74% of the country’s live births. Moreover, approximately 12% of children are pre-term (i.e. before 37 weeks of pregnancy). These issues are at the foundations of the nation’s present-day mortality numbers, which remain elevated.

Progress

Yet over the years, a variety of factors have contributed to the dramatic lowering of infant mortality in Côte d’Ivoire. One of the most important of these factors is the increased educational opportunities for medical professionals within the country. Côte d’Ivoire has a strict curriculum set for all aspiring midwives. A comprehensive U.N. report noted that the country’s standardized program requires graduation through the 12th grade and an additional three years of study, as well as other professional experiences in order to graduate.

A Look at the Numbers

Necessity accentuates the importance of these programs as events related to conception and preterm birth complications account for 58% of infant deaths. These include a lack of professional attention or postpartum care, both of which are very important to the large proportion of babies born preterm. The HNN report also points out other issues causing infant mortality, noting that either Tetanus or Sepsis causes an additional 21% of deaths. A notable similarity between these two issues is that many instances of them are avoidable. For example, tetanus issues typically stem from a lack of care regarding sanitation and the severing of the umbilical cord — which more professional, trained practice in various regions of the country would prevent.

Urban vs. Rural Births Pose a Problem

Côte d’Ivoire’s improvements, however, do not have even distribution throughout the country. According to previously mentioned U.N. statistics, while over 82% of urban births had a skilled birth attendant present, less than 50% of births in rural areas had the same professionals available. This problem extends further when considering that 2020 projections estimated that rural areas would account for nearly twice as many pregnancies as urban environments. While the report recorded over 6,000 trained physicians and midwives practicing within the country — few of these professionals practice in rural areas, where communities lack the resources to provide safe child-birthing to their populations.

Improvements Needed for Sustainable Population Growth

Although the country certainly has improved conditions for delivery in recent years, the fight against a rising infant mortality rate must persist. With sources like the World Population Review predicting the country’s population to double by 2050, the progressive improvement of infant care is essential for Côte d’Ivoire to continue its positive trend against high infant mortality.

Joe Clark
Photo: Flickr

USAID Saves Thousands of BabiesRoughly 2.76 million newborns die each year, with preventable infections causing at least 15% of those deaths. For instance, a baby’s cut umbilical cord could allow bacteria to enter their body, leading to life-threatening newborn sepsis. To avoid neonatal deaths like this, cord stump care at birth is critical, particularly in settings with poor hygiene. Thankfully, with national assistance, USAID saves thousands of babies in Nepal and other countries around the world.

There is a low-cost, easily manufactured and easily distributed life-saving solution that the World Health Organization (WHO) recognized in 1998 as a suitable antiseptic for cord care. Commonly found in mouth wash and hand sanitizers, chlorhexidine is an antiseptic gel that USAID helped produce for nations with the greatest need since 2002. Nepal was the first nation to adopt chlorhexidine on a large scale. USAID’s efforts, as well as cooperation with the Government of Nepal and its private sector, are responsible for lowering the infant mortality rate significantly. USAID saves thousands of babies around the world.

Chlorhexidine “Navi” Care Program

USAID’s Chlorhexidine “Navi” Care Program, implemented by John Snow Inc. (JSI), provides technical assistance to the Government of Nepal to scale up the use of chlorhexidine through resources and education. The six-year, $3.9 million program had two phases. The first phase occurred from October 2011 to September 2014 in 49 out of 75 of Nepal’s districts. Phase two started in October 2014 and brought chlorhexidine to all districts. The program found funding as a part of USAID’s “Saving Lives at Birth: A Grand Challenge for Development.”

The Nepali government strongly advocated for this scale-up. The administration incorporated single-use chlorhexidine tubes into its maternal and child health packages. In addition, it also trained health care workers for use of the antiseptic. Nurses began to use chlorhexidine at birthing centers across the country. They apply the antiseptic to the umbilical stump immediately after the cut. Its use in Nepal decreased newborn infections by 68% and decreased newborn deaths by 24%. Chlorhexidine for cord care thus became an integral part of maternal and infant health programs. Through the implementation of its new programs like this, USAID saves thousands of babies.

According to the Bill & Melinda Gates Foundation, Dalberg Global Development Advisors and the Boston Consulting Group, it usually takes more than a decade for global health innovations to develop in low and middle-income nations. In Nepal, it took around five years.

The success of USAID’s Navi Care Program is attributed to its partnering with the Government of Nepal and various organizations. USAID’s partners include MoHP, Save the Children, Plan International, Health For Life (USAID), UNICEF, One Heart Worldwide and PSI. Future initiatives should replicate USAID’s coordinated effort due to this program’s monumental success.

Nepal’s Success Serves as a Model for Others

Other nations have taken notice of Nepal’s health improvements and how USAID saves thousands of babies. Many nations sent their leaders and officials to speak with those who worked on the program to expand the use of chlorhexidine in their own countries. Following Nepal as a model, these nations have planned trials with the antiseptic gel. All program-related materials are public, supporting the global trend. As a result, Nigeria, Bangladesh, Pakistan and the Democratic Republic of Congo have begun the process of scaling up chlorhexidine to reduce newborn death rates. In particular, Nigeria has made substantial progress.

USAID’s efforts to lower infant mortality rates yielded fruitful results from a single and simple solution. As a result, it inspired efficient innovation elsewhere. This program was a tremendous global success, as USAID saves thousands of babies and makes the world a healthier place. USAID’s programs will hopefully continue to work with the governments and organizations in low- and middle-income nations to achieve the optimal adoption of healthcare initiatives.

Mia McKnight
Photo: Wikimedia Commons

 

Child Mortality in Yemen
With a population of 28.25 million people, Yemen has been through more turmoil than many other countries. It is currently ranked as the country with the largest humanitarian crisis in the world. This crisis threatens the lives of children through increased malnutrition, inadequate hygiene and other significant health and safety risks. Here are 10 facts about child mortality in Yemen.

10 Facts About Child Mortality in Yemen

  1. Approximately 50,000 infants die in Yemen each year. These deaths are the result of violence, famine, a lack of crucial medical care and widespread poverty. World Food Program USA has been working with Islamic Relief to provide 2 months of life-saving food to families and conducts nutritional programs to malnourished children.
  2. According to the U.N., there are 400,000 children under 5 years old who suffer from severe malnutrition. Some of these issues are the result of longstanding war and conflict. City blockades and airstrikes sometimes make it difficult or impossible for food aid to reach the children who need it the most. One organization working to bring food aid to children and families affected by severe malnutrition is called Save the Children. Save the Children has been working with the children of Yemen since 1963.
  3. Millions of Yemeni children are in desperate need of food to stay alive. Around 85,000 children have died from starvation or health complications caused by starvation since the war escalated in Yemen. In an effort to save Yemeni children from starvation, Save the Children provided food to 140,000 children and treated 78,000 children who were on the brink of death due to severe malnutrition.
  4. In Yemen, 30,000 children under the age of five die every year due to malnutrition-related diseases. The International Rescue Committee (IRC) works to save the lives of malnourished Yemeni children by distributing a nutritional peanut-based paste. With 500 calories per packet, children suffering from severe malnutrition can recover in matters of weeks.
  5. Violence is still a grim reality for Yemeni children. Airstrikes and mine explosions killed 335 children since August of 2018. Many are pushing for the war in Yemen to end so that children can live normal and safe lives. The U.N. estimates that if the war in Yemen continues even until 2022, more than half a million people will have been killed.
  6. Airstrikes are the leading cause of death for children in Yemen. The Civilian Impact Monitoring Project (CIMP) reports that between March 2018 and March 2019, air raids killed 226 children and injured 217. These numbers average out to 37 deaths of Yemeni children due to airstrikes per month. Save the Children is working to help children recover from airstrike injuries. They assist with medical bills and provide emotional support to help manage their trauma.
  7. Conflict in Yemen has caused the destruction of many water facilities, leaving children vulnerable to deadly diseases. Around 5.5 million people in Yemen are currently living in areas at a higher risk for cholera due to a lack of clean or sufficient water. UNICEF is working with the local water corporations to restore Yemen’s water supplies. In 2017, UNICEF installed the first-ever solar-powered water system in the city of Sa’ad.
  8. According to ReliefWeb, 17 million people in Yemen are in need of sanitary drinking water. One potential solution to this is the Life Straw, a small, hand-held straw that filters out 99.9 percent of waterborne bacteria and 98.7 percent of waterborne viruses. Though they have mainly been distributed in Africa, these straws could have a significant impact in Yemen.
  9. More children have been killed by waterborne illnesses and poor sanitation than conflict. Poor sanitation is one of the leading causes of diseases. Many children also lack the proper hygiene supplies needed to stay healthy. Having access to soap would significantly reduce the chances of obtaining hygiene-related diseases. To improve access to hygiene supplies in developing countries around the world, including Yemen, a company called Clean the World recycles partially used pieces of soap from hotels. More than 53 million bars of soap have been distributed in over 127 countries to those who need it.
  10. Diseases caused by mosquitos also contribute to child mortality in Yemen. The country has heavy rainfall and many people collect rainwater as their main water source. Collected water standing idle is the perfect breeding ground for mosquitos. An outbreak of mosquito-borne illnesses in Yemen killed 78 children under the age of 16, as of the end of 2019. There are 52,000 cases of mosquito-borne illnesses across the country. One potential solution is Kite Patch, which creates a mosquito repellent patch that sticks to the skin and protects against mosquito bites.

Child mortality in Yemen remains a persistent problem for the nation. For long-term improvement, the conflict in Yemen must be resolved. However, with continued efforts by humanitarian organizations, Yemeni children will still become safer, healthier and able to live longer lives.

Amelia Sharma
Photo: Flickr

The Struggles of Single Parents in YemenThe current civil war in Yemen is a bloody one. Since the beginning of the civil war in 2015, the reported casualties reached 100,000 in October 2019. Among this number, about 12,000 were civilian casualties who attackers directly targeted. This ever-mounting amount of civilian casualties has multiple effects on many families in Yemen. On a surface level, these civilian casualties reflect the numerous children who lose their parents during the on-going conflict. Some reports suggested that there are currently more than 1.1 million orphans in Yemen. On the other hand, the casualty number also reflects the single parents in Yemen who are trying to raise their children in a war zone.

Single parents in Yemen are struggling due to many reasons including a lack of access to basic goods, or professional services such as maternal care during and after pregnancy. This struggle of being a single parent in Yemen falls mostly on many Yemeni women who lost their husbands in the on-going conflict.

Struggles of Single Parents in Yemen

Being a single parent, especially a single mother, in Yemen is difficult. Yemen’s female participation in the workforce is extremely low. This means that many women in Yemen rely on their husbands for financial support. However, the conflict in Yemen took many Yemeni men from their families. As casualties rise, both military and civilian, many women lose their husbands. However, because the majority of women do not have much work experience, they lack the experience or qualifications to go out and find employment.

The challenge of single parenting in Yemen begins even before a child is born. This is especially true for mothers, single or otherwise, in Yemen. According to UNICEF, one woman and six newborns die every two hours from complications during pregnancy and childbirth in Yemen. This is the reflection of poor conditions in Yemen where only three out of 10 births take place in regular health facilities. WHO’s 2016 survey of hospitals in Yemen reported that more than half of all health facilities in Yemen are closed or only partially functioning.

For mothers and newborns, this means that they lack essential natal care, immunization services and postpartum/postnatal interventions. This lack of natal care and medical services for newborns resulted in one out of 37 Yemeni newborns dying in the first month of their lives.

Malnutrition is another challenge that single parents in Yemen struggle against. Multiple factors contribute to malnutrition in Yemen. Some reports suggest that the Saudi coalition intentionally targeted Yemeni farms. A report suggested that the Saudi-led coalition launched at least 10,000 strikes against food farms, 800 strikes against local food markets and about 450 airstrikes that hit food storage facilities. This made civilian access to food extremely difficult on a local level. The Saudi-led coalition’s blockade of Yemeni ports and other entry points for food, medicine, fuel and foreign aid worsened this food shortage. Yemen’s impoverished civilians, 79 percent of whom are living under the poverty line, find it difficult to afford the ever-increasing food prices. For single parents in Yemen, this makes feeding their children a difficult challenge. An estimated 2.2 million Yemeni children are acutely malnourished.

Organizations Helping Yemen

Numerous organizations help single parents in Yemen. Doctors Without Borders, between 2015 and 2018, provided natal care for pregnant mothers and delivered 68,702 babies in Yemen. Oxfam provided multiple humanitarian services in Yemen. Since the beginning of the conflict in 2015, Oxfam provided cash to Yemeni families so that they could buy food. On top of this, Oxfam delivered water and repaired water systems in remote regions of Yemen. UNICEF launched the Healthy Start Voucher Scheme in 2019. This program provides coupons for poor and vulnerable pregnant women to help them cover the cost of traveling to hospitals for childbirth. The coupon also gives these women access to newborn care in case of complications.

The Future for Single Parents in Yemen

Single parents in Yemen struggle against the difficult daily conditions in the country. Lack of access to food, water, health care and basic goods makes it extremely difficult for single parents in Yemen to provide for their children. Malnourished children dying of hunger are truly a disheartening image of the current conflict in Yemen. However, there are signs of peace. In November 2019, the combatants of the conflict held behind-the-scenes talks to end the conflict in Yemen. In the meantime, the international community is relying on many relief organizations that work tirelessly to help the people of Yemen.

YongJin Yi
Photo: Flickr

Top 10 Facts about Living Conditions in Sao Tome and Principe
Sao Tome and Principe (STP) is a small island nation just north of the Equator. This formal Portuguese colony achieved its independence in 1975. As a Portuguese colony, from 1470 to 1975, people knew Sao Tome and Principe for its sugar production and trade. The slave labor utilized in the island’s sugar industry persisted into the 20th century. The country’s economy is largely dependent on agricultural exports, but the Sao Tome and Principe government is making efforts to diversify its economy. Here are the top 10 facts about living conditions in Sao Tome and Principe.

Top 10 Facts About Living Conditions in Sao Tome and Principe

  1. Life expectancy in Sao Tome and Principe is 70.2 years old. While this is lower than life expectancy in developed countries such as the U.S. or the U.K., STP’s life expectancy is higher than its neighbors. Compared to other developing nations in Africa such as Gabon, Angola, Nigeria, Cameroon and Equatorial Guinea, STP has a higher life expectancy.
  2. As of 2018, the literacy rate in STP was 92.8 percent. Primary level education, which lasts for six years, is compulsory and free of charge. This, combined with a high primary school enrollment of 97 percent, resulted in a high literacy rate. However, the quality of education and teachers raises some concerns. To remedy this, in cooperation with the Global Partnerships for Education (GPE) and the World Bank, the STP government is striving to improve the quality of education facilities and training of teachers.
  3. About 97.1 percent of the STP population has access to an improved water source. While STP has access to more than 50 natural water sources, these sources are unevenly distributed within the island. With the support of the U.N. Environment and the Global Environment Facility, STP enacted its first water law in January 2018. The new law guides the use and control of water with the aim of long-term water sustainability and access to water for all populace in STP.
  4. Sixty-eight percent of the population in STP has access to electricity. While 87 percent of the urban area has access to electricity, only 22 percent of the rural areas in the STP have access to electricity. This lack of access to electricity for the rural populace negatively affects the living conditions in Sao Tome and Principe. To remedy this, the STP government is cooperating with the United Nations Development Programme (UNDP) in creating hydro-powered power plants which will utilize STP’s multiple rivers to generate power.
  5. Approximately 66.2 percent of the STP population lives below the poverty line. STP’s economic dependence on cacao export resulted in the country’s over-dependence on its agricultural sector. The majority of STP’s population depends on agriculture for their income. The recent fall in cacao prices severely affected the STP’s economy. To remedy this, the STP government is investing in the country’s tourism industry. STP is also co-developing the recently discovered oil in the Gulf of Guinea with Nigeria.
  6. STP relies on foreign imports to support itself. Living conditions in Sao Tome and Principe depend heavily upon foreign imports. The majority of food, fuels, manufactured goods and consumer goods enter STP as imports. This leaves STP’s economy and access to goods vulnerable to the fluctuating international prices of goods. For example, of the estimated GDP of $686 million in 2017, $127.7 million went into foreign good imports.
  7. STP also relies heavily on foreign aid. UNICEF’s 2018 report showed concern that the GDP of the STP is still heavily dependent upon foreign aid. According to the report, only 14.9 percent of STP’s GDP came from domestic resources. In 2019, 90 percent of STP’s country budget received funding from foreign aid.
  8. Infant mortality in STP is in sharp decline since 1992. Compared to the 69.5 per 1,000 infant mortality rate in 1992, infant mortality in STP declined to 24.4 per 1,000 as of 2018. In UNICEF’s 2018 annual report, UNICEF noted the continuous progress that the STP government is making in improving access to basic services, education, maternal health and treating HIV/AIDS and malaria.
  9. STP will graduate from the U.N.’s list of least developed countries. According to the World Economic Outlook report, STP and Angola will leave the U.N.’s group of least developed countries. Angola will graduate from the list in 2021 and STP will graduate in 2024. This reflects the continuously improving living conditions in Sao Tome and Principe and Angola.
  10. As of 2017, the unemployment rate in STP is 12.2 percent. This unemployment rate was a 0.4 percent drop from 2016. However, some experts wonder if this truly represents the living conditions in Sao Tome and Principe. Since many workers in STP work as farmers, experts are calling for improvements in STP’s manufacturing and tourism sectors.

Living conditions in Sao Tome and Principe are steadily improving. There are still many mountains that the STP government must climb in order to lead its country into a more prosperous future. While the STP economy’s dependence on agriculture and foreign aid is concerning, the high literacy rate in STP reflects the potential for growth. STP’s planned graduation from the U.N.’s list of least developed countries certainly seems to reflect this optimism. With this progress, a better future is surely coming for the people of STP.

YongJin Yi
Photo: Flickr

North Korea Health Care
Despite North Korea having universal health care, many of its citizens struggle to obtain basic health care. The health care system has been in a state of crisis since the 1990s, so the little health care that is available goes to high-income Koreans. Here are five facts about health in North Korea.

5 Facts About Health in North Korea

  1. North Korea spent the least on health care in the world in 2019. The total amount of money that the country did use for health care equaled less than $1 USD. The lack of funding makes the quality of health care lower which prompts citizens to bypass doctors altogether and buy medicinal products from markets and self-medicate.
  2. Two out of every five North Koreans suffer undernourishment. Mission East, a Danish NGO, is the only U.N. exception sending agricultural machinery into the country – which the country has banned alongside metal objects. Mission East emerged in 1991 and was finally able to establish a country office in Pyongyang in the summer of 2019. It helps the rural population with food security and health in North Korea.
  3. Out of the 131,000 cases of tuberculosis in North Korea, 16,000 citizens died throughout 2017. Multi-drug resistant strains are becoming more and more common in recent years. The Eugene Bell Foundation has been giving health care aid to North Korea since its beginning in 1995. The Foundation returns to North Korea every six months and has initiated a multi-drug resistant tuberculosis program as well as a tuberculosis care program. The program has cured over 70 percent of the patients in North Korea with multi-drug resistant tuberculosis.
  4. Sixty-one percent of North Koreans have access to safe water. UNICEF in North Korea has implemented a Water, Sanitation and Hygiene program (WASH). NGOs such as the Swiss Humanitarian Aid and World Vision International have received approval from the U.N. to send shipments related to the WASH program into the country. UNICEF works to promote good hygiene, provide technical support and support delivery of supplies.
  5. The infant mortality rate is 33 percent in North Korea. People often neglect children with disabilities and do not report their deaths in most cases, so the number could be up to five times higher than reported. Minimal access to health care, good sanitation and healthy foods play a huge role in the deaths of infants and their mothers. The Korea Foundation for International Healthcare, established in 2006, has partnered with The Partnership for Maternal, Newborn and Child Health to provide medicine, procedures and surgeries to citizens regardless of gender, ethnicity or religion. Recently, a vaccination campaign has immunized millions of North Korean children.

It is not easy to obtain information on North Korea due to the isolated nature of the country. A lot of organizations have to fight to provide aid to the citizens and the ban on equipment and metal shipments into the country makes it hard to provide proper care to people in the country. Since the country prevents citizens from leaving the country without permission, these organizations are the saving grace for many. Health in North Korea is not as successful as it may seem at first glance, but the recent decisions the U.N. has made leaves room for optimism and change.

Taylor Pittman
Photo: Flickr

Facts About Sanitation in Costa Rica
Costa Rica is a truly unique place; it contains 5 percent of the world’s biodiversity and people categorize it as one of the happiest countries in the world. Its economy is stable, showing a little more than a 3 percent yearly growth rate. Costa Rica has had some challenges with sanitation but is working to improve it throughout the country. Below are 10 facts about sanitation in Costa Rica.

10 Facts About Sanitation in Costa Rica

  1. Around 99 percent of the population has access to a water source, but only 82 percent have continued access to a reliable water drinking source. This number has improved since 2015 when only 92.4 percent of people had access to a clean water source. Moreover, clean water access is continuing to improve with community and public-based programs such as Acueductos y Alcantarillados (AyA), an organization that works to raise funding to expedite current projects to provide nationwide access to water.
  2. Costa Rica’s unpredictable climate and susceptibility to natural disasters are its biggest hurdles to developing better infrastructure for water sanitation. For example, a drought in Costa Rica from 2014 to 2016 caused by El Niño drastically hindered the construction of new infrastructure to expand water access in the country. A study by the Inter-American Development Bank predicts that Costa Rica’s water supply will reduce by half by 2050, despite increasing demand.
  3. The Integrated Water Supply Programme for Guanacaste (PIAAG) works with other organizations to implement fixed and long-lasting solutions to water sanitation. Proposed solutions to improving water sanitation include irrigation, drainage and drinking water projects. More institutions developed a plan from 2018-2030 to maintain ecosystems while improving water sanitation and access.
  4. Pollution of water sources, mainly through human activity and inefficient land usage, also drastically affects the availability of water to citizens. In order to fix the problem of water pollution, Costa Rica provides incentives to clean up water sources. The National Water Laboratory monitors the use of agricultural pesticides and their runoff.
  5. Costa Rica currently treats only 14 percent of wastewater before releasing it to the public, but Costa Rica is trying to fix this problem. The National Wastewater Sanitation Plan emerged in 2017, and it hopes to safely manage all wastewater by the year 2045. The organization allocated $3.6 million to expand access to water in urban areas and $2.5 million to increase water access and quality in rural areas. The National Wastewater Sanitation Plan became public policy in 2017.
  6. Across the country, several projects to clean sewage are taking place, including eight projects in tourist areas and 10 to improve the conditions of existing sewage plants. For example, the Administrations Associations of the Systems of the Aqueducts and Communal Sewers (ASADAS) works to build, monitor, operate and maintain rural water aqueducts. Water sanitation projects in Costa Rica receive funding from inside the country and from foreign countries, like Germany, which funded eight coastal projects.
  7. The fast population growth and desire of citizens to live in urban areas of the country, rather than rural areas, has further complicated the sewage problem. This, in some cases, leaves inadequate sewage in the overcrowded cities. In the most populated cities, only 19.4 percent of sewage receives treatment. Many regulations in Costa Rica, such as “Ley General de Salud” (General Health Law), have emerged to establish basic requirements for water sewage in Costa Rica.
  8. Costa Rica’s Ministry of Health is an important organization that works to provide people improved access to sanitation. For example, the Ministry of Health controls the National Observatory of Human Resources in Health. It establishes academic and research institutions to study the causes and effects of poor sanitation, along with social government organizations that advocate for government action through public policy.
  9. During Hurricane Otto in 2016, waterborne viruses such as Zika and dengue spread among the population, and the Ministry of Health sent workers to help control the outbreak. Soon after, President Luis Guillermo Solís stated that the government would build more toilets, showers and water fountains for residents. The Ministry of Health also sends garbage trucks to pick up trash around especially populated urban areas.
  10. The last of the 10 facts about sanitation in Costa Rica discusses child mortality in Costa Rica, which has decreased greatly over the past few decades, going from 68 per 1,000 live births in 1970 to about 8.8 per 1,000 live births in 2018. One can attribute the decrease to an extension of health care programs to rural and communal areas.

While Costa Rica still has far to go in improving its sanitation, the overall sanitation of the country has improved greatly over the past few decades. These 10 facts about sanitation in Costa Rica demonstrate Costa Rica’s planned pathway to improving sanitation, and overall, Costa Rica’s future is looking bright.

– Shveta Shah
Photo: Flickr