malnutrition in haitiHaiti is a small island, yet it is the western hemisphere’s most impoverished nation. One of the many ways that poverty affects Haiti is through hunger. In 2015, 22 percent of Haitian children were suffering from malnutrition. Health is something that affects everyday life and is reflective of a country’s standard of living. In other words, learning about how malnutrition affects Haiti is important for understanding poverty and the development of this country.

Haiti’s History

Haiti became independent from the French government in 1804. This formerly colonized nation was the first country to achieve freedom through a slave rebellion. When Haiti became independent, most western countries (such as the U.S.) did not recognize the nation’s independence. This prevented any foreign trade from occurring with Haiti.

The first country to acknowledge Haitian independence was France; however, the acknowledgment was met with conditions. The French claimed that their economy would be hurt due to a loss in slave labor and, because of this, Haitians would have to repay the French with 100 million francs. The debt was not fully repaid until 1887 and, consequently, created negative effects on Haiti’s economy.

The country also regularly encounters natural disasters such as earthquakes, floods and hurricanes. Since 1998, Haiti has faced 10 hurricanes in addition to other tropical storms. With a lack of infrastructure, every environmental disaster takes a large toll on the economy. After the 2010 earthquake, 1.5 million Haitians were displaced and the country was said to have faced $7.8 billion in losses.

The Role of Nutrition

Today, Haiti has a GDP per capita of $870, and 59 percent of the population works for less than 2 dollars per day. With such high rates of poverty, it’s no surprise that the country also suffers from malnutrition. There are some key facts to understanding how malnutrition affects Haiti.

  • Approximately 40 percent of the country is malnourished. In fact, one in five children is malnourished. In addition, 80 percent of rice, the country’s major food source, is imported, thus creating a large dependence on foreign exchange.
  • Agriculture in Haiti is also dependent upon external factors. Only 10 percent of the land is irrigated, making consistent rain a necessity for food production. When there is a drought, food production is affected. Lack of adequate crops increases malnutrition.
  • One-third of Haitian women suffer from anemia. Anemia is an illness that can be caused by iron and vitamin deficiency. It prevents oxygen from flowing through the blood to muscles and tissues, but it can be easily prevented through proper nutrition.
  • In rural areas, fewer than half of the people in Haiti have access to clean drinking water. Water is often contaminated. In 2010, the country faced a globally infamous earthquake. When U.N. workers arrived to provide aid, they accidentally created a cholera outbreak that spread quickly through the water. Since then, 770 thousand Haitians have been affected by the illness, creating an added risk to water consumption.

Who is Helping?

While the majority of Haitians still suffer from malnutrition, progress has been made. Hands up for Haiti is one nonprofit that is aiming to reduce issues surrounding nutrition in three different ways. The first way is through a supplement called Medika Mamba, a nutritional pill that is primarily nut based and is high in calories. The pill is provided to 600 children each year on the bases of medical evaluation. The second way is through educational programs that teach locals how to grow small plots of food to support their families. Lastly, the organization offers centers with professionally trained medics to treat illnesses relating to malnutrition.

Understanding how malnutrition affects Haiti is key to recognizing the effects of poverty. The country’s long-standing history of natural disasters and colonization has affected its current economic situation as well as the health of the nation. However, nonprofits such as Hands up for Haiti have been making large strides within the country, giving a hopeful outlook to the future of this nation.

Anna Melnik
Photo: Flickr

MSF in Yemen: Helping Amid ConflictInstability continues to plague Yemen, exposing almost 20 million people to food insecurity and more than one million to cholera. The damage is evident in Yemen’s weak healthcare system, which leaves millions of people vulnerable. Medecins Sans Frontieres (MSF), or Doctors Without Borders, is an organization that provides healthcare for people affected by conflict and poverty. Though warfare complicates operations on the ground, MSF in Yemen is not giving up.

The Challenges of Aid in Yemen

In 2018, an airstrike destroyed a newly built cholera treatment center. Fortunately, there were no patients or workers present at the time, but the vital project had to be put on pause until repairs and reconstruction could begin. Events like this threaten the effectiveness of MSF in Yemen and risk the lives of the 16 million people who lack basic healthcare.

MSF also runs 12 healthcare centers of its own in addition to the 20 hospitals the organization supports. Its operations have treated more than 1.6 million people suffering from injuries, disease and chronic illnesses. MSF’s activities in Yemen take place in a constantly changing and dangerous environment. Since 2015, constant fighting between various militant groups has damaged countless Yemeni health facilities, leaving only half fully functioning. Many hospitals and health facilities in the areas have closed down because of safety concerns or because they cannot pay workers.

MSF in Yemen

The facility that was destroyed was one of many new treatment centers responding to the cholera outbreak. Cholera is a serious issue in Yemen and has killed 2,184 people since April 2017. Because of the violence, almost 16 million Yemenis have suffered from reduced access to clean water and sanitation, which increases their vulnerability to cholera. MSF quickly reacted to the outbreak by opening 37 treatment centers and oral rehydration points. In just six months after the breakout, MSF admitted more than 100,000 cholera patients. While the threat of cholera has decreased since 2017, treatment centers remain a vital safe haven for those afflicted.

MSF responded to another issue caused by the lack of healthcare facilities: pregnancy. In 2017, MSF in Yemen helped 7,900 women deliver their babies. Pregnant mothers are especially vulnerable because they lack access to clinics. Even when there is a health facility nearby, traveling may be too dangerous or time-consuming. Consequently, mothers give birth at home, which exposes them to health risks.  Many pregnant women also don’t have access to prenatal care and can have preventable but fatal complications.

Treatment Centers In Yemen

MSF in Yemen dealt with the re-emergence of diphtheria in 2017. The organization acted quickly by opening up a treatment center in Ibb where 70 percent of cases were concentrated. MSF treated around 400 patients that year alone. As successful as that operation was, others remain an issue, like renal failure. Multiple renal failure treatment centers have been forced to close due to the conflict. Many facilities are under-equipped and some 4,000 patients are still left untreated.

Treatment centers are often too far, or treatment itself is too expensive. Patients require three dialysis sessions a week, so many will reduce the number of treatments to lower the cost. Unfortunately, this can be dangerous and ineffective in treating renal failure. MSF responded to the crisis and has helped more than 800 patients by offering 83,000 dialysis treatments and importing 800 tons of supplies.

More than 20 million Yemenis are in need of humanitarian assistance, facing hunger, disease and displacement. MSF continues to provide aid through one of its largest programs in the world. Since 1986, MSF in Yemen has been compensating for the lack of effective healthcare, even amid the conflict.

Massarath Fatima

Photo: Flickr

Preventive Cholera Vaccination
South Sudan’s health system faces major challenges. These challenges stem from prolonged civil war repercussions, a great lack in medical care and vaccinations and historically long-running cholera outbreaks. Although South Sudan recently declared the end to its longest recorded cholera epidemic, cholera is endemic to the nation and will most likely return within the next few months as the rainy season begins.

However, some improvements and achievements are being made towards South Sudan’s health system. Today, the preventative cholera vaccination campaign — operated by Doctors Without Borders — works to prevent the acute infectious disease from spreading across the nation any longer.

Preventative Cholera Vaccination Campaign

From April 24th to May 12th, the preventative cholera vaccination campaign has progressed in Juba – South Sudan’s largest city and capital. Doctors Without Borders’ campaign is designated for 12 hotspot areas in Juba where numerous people were identified as at-risk in previous cholera outbreaks. Cholera outbreaks are not new to South Sudan – the country just faced its most severe and prolonged cholera outbreak in its history which protracted from June 2016 to February 2018, and lead to over 20,000 suspected cholera cases and 436 reported deaths.

Additionally, since 2013, the nation has endured multiple cholera outbreaks that particularly target vulnerable populations living in internally displaced people’s camps, urban informal settlements, cattle camps, rural populations, island dwellers and communities along the River Nile.

In order for the oral cholera vaccine to take effect, people need two doses for increased immunity. A single dose of cholera vaccine supplies some immunity for up to one year and the second dose must be ingested within eight months of the first dose to increase the level of protection and increase immunity to three to five years. Also, sustaining sanitation infrastructure and improving hygiene and water supplies, in addition to implementing vaccination campaigns, can help prevent infections by contaminated food or water, which is how cholera is spread.

Goals for Reducing Death by Cholera

In 2017, the Global Task Force on Cholera Control announced a new strategy to reduce deaths from cholera by 90 percent by 2030 in South Sudan and other affected countries. This strategy will involve strengthening case detection, prevention of avoidable cases and deaths and applying multi-sectoral interventions comprising of water and sanitation hygiene measures to eliminate cholera outbreaks in cholera transmission hotspots.

While preventative cholera vaccination campaigns aim to save lives in South Sudan, the world’s newest country still deals with several other complex challenges that need to be addressed.

Current Causes and Future Improvement

Severe food insecurity and acute malnutrition, an increased demand for care due to high HIV and AIDS prevalence, a lack of resources to purchase drugs and other medical supplies due to the oil shutdown, a 73 percent illiteracy rate for adults, limited availability to crucial maternity care services and poor access to safe drinking water and adequate sanitation are all some of the current factors contributing to the country’s extreme poverty.

However, with the current and essential health and medical care help from Doctors Without Borders and other international organizations such as Oxfam, CARE, WHO and Save the Children, conditions in the country could improve in the near future as more organizations find opportunities to provide aid to the country in need.

– Natalie Shaw
Photo: Flickr

Cholera Crisis of 2018Cholera is a disease that is both preventable and treatable, though it can be fatal under the worst of circumstances. It typically affects the most destitute areas of the globe where sanitation practices are weakest. Random outbreaks can and do occur across all continents, however. The greatest challenge to diminishing the effects of a cholera crisis is that it can spread quickly among populations with a lack of adequate hygiene measures, proper vaccination or isolated and contained care centers.

Disease Basics

According to the Center for Disease Control (CDC), cholera is caused by toxigenic Vibrio Cholerae, which leads to the acute bacterial intestinal infection. Symptoms include vomiting, diarrhea and, in severe cases, collapse and shock. Fatalities occur in approximately 25 to 50 percent of all cases. While cholera is uncommon in the U.S. and other developed nations, cases have been increasing around the world since 2005. The CDC classifies the magnitude of cholera outbreaks as a pandemic that has persisted for over four decades in Asia, Africa and Latin America.

Saltwater is the natural source where Vibrio Cholerae originates and may be passed on to humans by ingesting anything from infected water, like shellfish, crab and shrimp. The risk is heightened when any of these foods are undercooked or consumed raw. Cholera can be passed through the drinking water supply as well, which is a common form of transmission.

The Cholera Crisis

A cholera crisis occurred in February 2018 in Uganda, resulting in 700 reported cases and 27 deaths. In Malawi, an outbreak in April affected 893 individuals and caused 30 deaths. A recent outbreak has occurred in Yemen as well. The total number of cholera cases in Yemen over the past year is estimated to be 1,090,280 with 2,275 deaths. This means one out of every five people infected with cholera died last year in Yemen. In addition, Haiti has reported 432 cases of cholera this past year, with four deaths resulting from the disease.

Progressive Efforts

While contemplating the statistics shared in regard to the cholera crisis, it is important to think about what solutions are available to prevent this destructive disease from spreading and to know what actions are being taken to assist those who are suffering. The most obvious solution to a cholera crisis is to offer aid in the form of clean water solutions so potable water can be readily available to all.

The U.N. has made remarkable progress in its efforts to make clean water available to everyone around the world. More specifically, its efforts are known as the Water for Life International Decade for Action and took place during 2005-2015. As a result of this initiative, 1.3 billion people were provided with clean drinking water. It is estimated that there are still 2.5 billion people who drink contaminated water.

Improved sanitation practices and adequate facilities is also a dire need. The U.N. reports that there are currently 2.3 billion people worldwide who are without access to basic sanitation facilities, such as toilets. The two concurrent issues of lack of sanitation facilities and a lack of clean water interplay to cause illness amongst many in the form of communicable diseases passed through to the residents of poverty-stricken areas.  As a result, approximately 1.5 million children die from related illnesses.

Efforts to help can generate a return on investment for those in developed nations. Research has shown that every U.S. dollar spent on improved sanitation generates a return of $9. World Water Day on March 22 and World Toilet Day on Nov. 19 are international observance days set aside to raise awareness of these issues.

– Bridget Rice

Photo: Flickr

Cholera, an acute infectious disease, is not new to the east African country of Uganda. For 47 years, epidemics of cholera have occurred frequently in the country, and cases of the disease in Ugandan communities are still reported annually. Uganda’s recent cholera outbreak was reported Feb. 22, 2018.

Refugee Overcrowding

The announcement came after 668 cholera cases had been identified in the refugee settlements in Hoima District. Hoima District is a Western Ugandan district home to thousands of Congolese refugees escaping ongoing violence in the Democratic Republic of Congo’s northeastern Ituri province.

More than 4.4 million people have been forced out of their homes in Democratic Republic of Congo amid a surge in severe violence. The aggression stemmed from President Joseph Kabila’s refusal to step down at the end of his mandate in 2016. As a result of the humanitarian disaster, it is estimated that about 43,000 Congolese refugees have settled into Ugandan areas this year. This brings the total of Congolese refugees in Uganda to more than a quarter of a million.

Increased Violence

Although Uganda welcomes all those fleeing violence and seeking refuge into the country, government-funded health facilities have been overwhelmed by the sharp rise in the refugee population. Since the initial outbreak announcement in February, at least 1,747 people have become sick and at least 36 have died from the worsening situation. Most of the deaths were recent evacuees from the Democratic Republic of Congo.

In addition to plaguing the refugee resettlements in Hoima District, Uganda’s recent cholera outbreak has also now spread to two additional sub-counties. It is estimated that drinking unsafe water from Lake Albert, poor sanitation and a lack of handwashing facilities in the area have contributed to the dehydration, diarrhea, vomiting and fatality rates.

Response Efforts

Uganda’s recent cholera outbreak has proven an urgent demand for additional resources and funds to prevent the spread and deaths from the bacterial disease. However, some response efforts and services are currently in place. Thanks to a fast-acting response plan by the U.N. Refugee Agency and The Ministry of Health, health actors and community leaders are working to provide medical supplies, health personnel and other essential support. This includes demonstrations on proper food and hand hygiene and water safety to reduce transmission of the illness. Many technical teams are working to conduct medical screenings, provide treatments and produce water purification tablets near Western Uganda’s Lake Albert and Kyangwali refugee settlement.

Additionally, international agencies like the World Health Organization and UNICEF have provided two different cholera kits with vital supplies for cholera case management. Uganda Red Cross Society has actively supported social mobilization to prevent and regulate the outbreak.

Because of these life-saving efforts enforced by health workers and technical teams, there has been a significant decrease in the number of new cholera cases within the western Lake Albert region. As of Feb. 28, health care workers were detecting approximately 100 new cases of cholera a day. By March 12, the daily case number had decreased to 20. The medical assistance provided helped decrease the mortality rate by two percent. However, Uganda’s recent cholera outbreak is not over and the work in cholera-suffering hotspots is far from resolved.

– Natalie Shaw

Photo: Google

cholera in Uganda
There has been a stream of refugees to Uganda due to the violence in the Democratic Republic of the Congo and Republic of the Congo. The majority of the individuals who escape the brutality in those countries oftentimes find their way into the neighboring state of Uganda.

Killings and burnings of people’s homes are just a few reasons the Congolese are deciding to flee. Determination to evade the violence comes also with a sense of urgency for the Ugandan government and the people, even though there may be downfalls in the process.

Cholera in Uganda

The people of Uganda have recognized both their intake of refugees, and also the refugees’ individual issues. Ever since these people entered the country, there has been an outbreak of cholera in Uganda. This is a bacterial disease that can be contracted by drinking contaminated water and, if not treated properly, can be fatal. Since this disease is highly contagious, it is spreading rapidly throughout the country.

Most of the people coming from the Congo are screened but, unfortuantely, they are oftentimes already contaminated with the bacteria that leads to cholera at the time of their screening. “We are not doing enough to respond first,” said David Alula of Medical Teams International. “More attention needs to be paid to address the situation.”

Medical professionals understand that the situation occurs more widely and at a larger scale in the Congo, but 36 refugees have died thus far from the highly infectious disease.

Governmental Measures

The Ugandan government is doing everything it can to assist its people as well as the refugees experiencing the cholera outbreak. The nation’s head is working on emphasizing water treatment, staff recruitment to allow more people to be treated appropriately and the factors of what may have caused the severe outbreak of this disease.

“We had not planned for this kind of sickness all along. Everything is being doubled on the ground, and more efforts are [being] put in place to make sure it’s contained,” stated the Ugandan official in charge of Kyangwali, Jolly Kebirungi. It is quite remarkable to see the efforts that the Ugandan government is putting forth to help out; it treats the refugees as they would their own citizens. It shows a sign of unitedness and care that can lead to an ultimately more stable community.

A More Stable Community

“In Uganda, refugees are accommodated not in tented camps but in settlements, where they are allocated plots of land that they can farm and build their homes on.” Once Uganda accumulates enough power to ensure health and safety regulations through its medical professionals, the nation will have what it takes to contain and eradicate the disease in this region.

The main priority for Uganda is to maintain the well-being and safekeeping of the refugees they let enter the country. This strategy will lead to a nation of respect and will allow the country to prosper.

– Matthew McGee

Photo: Flickr

Cholera Epidemic in South Sudan is Officially OverThe cholera outbreak that has been affecting multiple countries in southern Africa ended in South Sudan on February 7. The country reported no new cases of the illness in more than seven weeks. Cholera had been affecting South Sudan since June 2016 and was widespread, with over 20,000 cholera cases and more than 400 deaths related to the disease. The country declared an end to the epidemic and continues to make efforts to keep the disease from making a comeback.

Cholera is a disease characterized by diarrhea, vomiting, leg cramps and loss of body fluid due to an infection of the intestine with the bacteria Vibrio cholerae. Oftentimes the dehydration of the body can cause shock. Death can occur within a few hours if not treated. Cholera is easily spread through contaminated food and water, poor sanitation and lack of hygiene.

The efforts to wipe out the cholera epidemic included rapid response teams responding to and observing cases, providing clean water for residents and promoting proper hygiene routines, as well as treating the infected patients with vaccinations and medicines.

Many organizations joined with the South Sudan government to fight the cholera epidemic, including the European Union Humanitarian Aid, GAVI the Vaccine Alliance, the United States Agency for International Development and the World Health Organization (WHO). These groups together were able to deliver 2.2 million vaccinations throughout the country through GAVI’s global stockpile.

Although the country is officially cholera free, the WHO representative for South Sudan, Evans Liyosi, stated that cholera is still a common illness, and therefore it is still considered a risk and the country needs to maintain its observation and respond to new cases of the illness to prevent another outbreak. The country also needs to further strengthen its health and sanitation systems and promote healthy living behaviors.

The cholera outbreak that South Sudan faced was the longest and largest cholera epidemic that the country had ever seen. Cholera had spread throughout the entire country and swept through the capital, Juba. With the immense efforts of every organization involved, the government and the people of South Sudan, they were able to officially end the cholera epidemic.

– Chloe Turner

Photo: Flickr

cholera crisis
The Eastern and Southern countries in Africa face a serious cholera epidemic. This epidemic displays the lack of public sanitation as well as neglect from the government that many African countries face.

 

Cholera

Cholera is a diarrheal illness caused from an infection of the intestine with bacteria called vibriocholerae. The symptoms of the illness include: diarrhea, vomiting and leg cramps, and such loss of body fluid can lead to dehydration and sometimes shock. Oftentimes, death can occur within only hours without treatment.

Since the start of the New Year, there have been over 2,009 cases and 22 deaths in the countries in Africa facing the cholera crisis. Zambia, one of the countries in southern Africa, faced the worst of the epidemic, with more than 74 deaths since October of 2017. The main area where Zambia’s impacted with cholera is in their capital, Lusaka. The government banned street food from vendors in the capital to reduce the number of cases, but in return, caused violent protests from the vendors.

 

Cholera Causes

The government, along with the World Health Organization, states the cause of the cholera crisis is poor waste management and lack of personal hygiene. These factors cause the contamination of food and water, which in turn, can spark the epidemic.

To help with the cholera crisis, the government has sent in the army to control measures, clean the markets and unblock drains. An oral vaccine program was also launched with the goal of immunizing one million people, and since its implementation, the number of cholera cases have dropped.

 

Cholera Effects

The effects of the cholera crisis have not just been deadly, but also have forced public places to close. Many schools, churches and workspaces are deferred until they can contain the outbreak. This impediment puts citizen jobs, payment and education on hold.

The World Health Organization (WHO) suggests the prevention of cholera consists of clean water, sanitation and reminding communities of basic hygiene behaviors that includes hand washing with soap after using the bathroom, before eating or touching food.

The WHO also suggests there should be media regarding health education messages for these reminders, and the implementation of routine antibiotic and immunizations if available.

– Chloe Turner

Photo: Flickr

Good News in Global HealthCholera impacts 2.9 million people each year, killing about 95,000 in some of the poorest and most vulnerable communities of many Asian, African, and some Caribbean countries. The good news in global health is that the Global Task Force on Cholera Control (GTFCC) is bringing together more than 50 partners from academic institutions and nonprofits to reduce cholera by 90 percent by 2030.

This alliance includes The Bill and Melinda Gates Foundation, the World Health Organization, Water Aid and Doctors Without Borders. This plan was released to the public in October 2017 in Geneva.

GTFCC is hosted by the World Health Organization and has begun with a strategy called Ending Cholera: A Global Roadmap to 2030. This proposal has three strategic axes to make this goal possible.

First, the GTFCC would work to look for early signs of cholera and by sending a quick response in efforts to halt the spread of the disease. Country-level planning would also go into effect for early detection and response.

Second, these partners would improve the Water Sanitation and Hygiene concept, or WASH. The U.N. recognizes WASH as a basic human right. However, more than two billion people worldwide lack access to WASH.

Improving oral vaccines would also be a part of the second plan to end cholera. Between 2013 and 2016, the GTFCC administered five million doses of the cholera vaccine. Gavi is an international vaccination organization focused on children, and it is funding these vaccines.

Lastly, this strategy will be an effective system of coordination for technical support, resource mobilization and partnership at local and global levels. It will work to strengthen donors and international agencies, while locally, partnerships with be strengthened between affected countries.

While this plan will be carried out by all the NGOs and academic institutions, the Global Task Force on Cholera Control will be providing a strong framework for support to ensure this roadmap to ending cholera deaths by 2030 is executed in a timely manner, which is good news in global health.

Lorial Roballo

Natural Disasters Hit Poor the HardestThe aftermath of Hurricane Irma, which hit the Caribbean and United States in September 2017, along with the 8.1 magnitude earthquake that shook Mexico also in September illustrate the total destruction entire communities face when hit by natural disasters. Natural disasters have been proven to increase poverty and most adversely affect those who are already poor.

The category five Hurricane Irma made landfall on Antigua, the Dominican Republic, Puerto Rico, Barbuda, Guadeloupe and more, totaling over 10 Caribbean countries affected. In Barbuda alone, 90 percent of vehicles and buildings have been destroyed and many people have been left homeless. Because Barbuda is not as wealthy as other Caribbean countries, it cannot as quickly rebuild for its people, leaving its citizens more impoverished than ever.

Mexico’s 8.1 magnitude earthquake has also left many suddenly in poverty or more impoverished than they previously were. Many buildings were reduced completely to rubble, particularly in the town of Juchitan, which was hit hardest by the earthquake. Residents of the town slept in streets and parks following the earthquake to avoid aftershock and because of damages to numerous homes creating uninhabitable conditions.

Juchitan is located in Oaxaca, a rural region in southwestern Mexico, and one of the poorest areas in the country. Jorge Valenica, a reporter from Mexico City, discussed the damaging effects of the earthquake on Juchitan in an interview with NPR. He stated, “As with many natural disasters, the communities that get hit the worst sometimes are the communities that were already the most in need.”

The World Bank reports that poor people are so adversely affected by natural disasters because they are usually more exposed to natural hazards – i.e. their homes, if they have them, are not built as well, and they have less access to evacuation resources than those who are middle and upper class. Unfortunately, when the poor lose necessities like shelter, they typically do not have savings, family, friends or the government to fall back on. Even those who do not completely lose their homes often cannot avoid repairs and renovations due to new building standards created to make homes safer.

In light of the worsening of poverty in places hit by natural disasters, organizations such as Oxfam continue to work to provide basic needs to individuals, focusing upon hygiene and sanitation for those most affected by the storms. Oxfam’s main goal after Hurricane Irma is to contain and eliminate any cholera and other diseases caused by damage to water infrastructure, helping to keep people healthy. Natural disasters continue to hit the world’s poor the hardest, but even in the wake of a catastrophe, goodness, giving and help can be found.

Mary Kate Luft

Photo: Flickr