Rift Valley FeverIn 1999, NASA scientists theorized that at some point soon, they would have the ability to track outbreaks (via satellite) of Rift Valley fever (RVF). This disease is deadly to livestock and occasionally, humans, in East Africa. They already knew the method needed but did not yet have enough data. NASA scientists had already surmised that outbreaks were directly related to El Niño weather events and knew that areas with more vegetation would breed more disease-carrying mosquitoes. To see the exact areas that would be most at-risk, satellites would need to track differences in the color and density of vegetation, from year to year.

Prediction of Rift Valley Fever

In 2006, NASA scientists predicted and tracked an outbreak of Rift Valley fever in East Africa. Unfortunately, even with intervention efforts, the 2006 outbreak led to the deaths of more than 500 people and cost the regional economy more than $60 million. This was due to export restrictions as well as livestock deaths. However, the aim of researchers was not to entirely stop that outbreak. The results of that mission gave researchers confidence that they could predict the next outbreak even better the next time.

Ten years later, the NASA team successfully predicted the location of the next potential outbreak and warned the Kenyan government before the disease could strike. Thanks to the combined efforts of NASA and the Kenyan government, Kenya saw no outbreak of Rift Valley fever in 2016. This, in turn, saved the country millions of dollars and protected the lives and livelihoods of rural farmers, throughout the country.

Focus on Cholera

With the success of Rift Valley fever prediction in 2006, NASA researchers became confident they may predict all disease outbreaks. Moreover, they believed they could halt them, using satellite technology. Researchers are especially focused on neglected diseases like cholera which are connected to environmental conditions and hit developing countries and impoverished people the hardest. Newer satellites add the ability to measure variables like temperature and rainfall. This enables researchers to use more than just the visual data, used in the initial Rift Valley fever predictions. Consequently, this significantly improves their models.

Cholera is perhaps the most promising disease, analyzed by new scientific models due to its scale. Nearly 3 million people contract and almost 100,000, die each year. Moreover, it spread directly links to weather events. There are two distinct forms of cholera, endemic and epidemic. Endemic cholera is present in bodies of water primarily during the dry season. Also, communities living along coasts are typically ready for the disease. Epidemic cholera comes about during extreme weather events like floods and inland communities are often unprepared for the disease. Both forms of the disease proved to be perfect candidates for modeling by disease researchers. In 2013, a NASA team successfully modeled cholera outbreaks in Bangladesh.

The Yemen Model

The real test of the NASA team’s predictive models would come in 2017. The use of the model in Yemen proved to work near perfectly. Researchers predicted exactly where the outbreaks would occur, nearly a full month in advance. The success of the model in impoverished and war-torn Yemen is especially notable. This is because it could mean less of a need for more expensive and dangerous methods of disease research. Instead, early warning systems are an implementable option. Even if they fail, medical professionals can send vaccines and medications to exactly the right locations. Cholera outbreaks and their disproportionate death rates among the global poor will hopefully soon be a thing of the past.

By halting outbreaks before they begin, international aid lends itself more efficiently. Information is valuable and the more information poverty-fighting organizations have, the better they can spend their dollars to maximize utility and help the most people. As satellite technology advances along with newer predictive models, preventing disease outbreaks could save developing economies and aid organizations hundreds of millions of dollars each year, along with thousands of lives.

Jeff Keare
Photo: Flickr

Stigmatization of DiseasePeople often understand diseases as solely biological: an infectious pathogen harms the body and requires medical aid to defeat. However, disease also has social implications. Various social factors can impact not only someone’s likelihood of contracting a disease but also their likelihood of receiving quality medical care. One significant social implication affecting these factors is the stigmatization of disease.

Stigma, as defined by sociologist Erving Goffman, is an “attribute that is deeply discrediting.” Though we normally think of attributes like race, religion, ethnicity, sexuality and gender identity, stigma can also involve disease. The stigmatization of disease refers to the notion that a particular type of person, country or community are the carriers or source of a disease. Like all stigmatization, this involves the process of “othering,” or creating a “them” and an “us.” People attempt to keep the “us” safe by ostracizing the “them.” In the case of the stigmatization of disease, the stigmatized group becomes “them.” Here are four examples of the stigmatization of disease throughout history.

The Stigmatization of Disease: Four Examples

  1. Cholera is a bacterial disease that causes extreme dehydration and diarrhea. It is fatal without immediate treatment. The end of the 1800s saw a global cholera pandemic, with a high prevalence in Europe. This led to the United States quarantining immigrants when they arrived in the U.S., creating a dangerous association between immigrants and cholera. At the time, President Harrison declared that immigrants were “a direct menace to the public health.” This association between immigrants and disease lasted long after the threat of cholera was gone.
  2. Yellow fever is a viral infection carried by a specific species of mosquito. It causes fever, headache, nausea and, in severe cases, fatal heart and liver conditions. By 1850, yellow fever was rampant in southern American states. Cities like Charleston, Mobile and New Orleans faced the brunt of the disease. Because of tensions leading up to the Civil War, the North used the disease to attack the South. Northerners “denounced the South for its unhealthy conditions and people.” This stigmatization helped fuel the separation between “us” and “them” in the North and South. As such, it had lasting impacts on regional divides in the U.S.
  3. HIV/AIDS appeared in the United States in the 1980s. HIV is an aggressive virus that attacks people’s autoimmune system and can eventually lead AIDS. Because early cases affected gay men, doctors named the disease Gay-Related Immune Deficiency or GRID. This initial naming demonized gay men and made them appear to be the source of HIV. Later, the disease was renamed AIDS (Acquired Immunodeficiency Syndrome) when doctors realized that anyone can contract HIV. Despite this renaming, the association of gay men with HIV remains strong. Accordingly, fear and stigma continue to be a barrier to getting treatment in the U.S.
  4. COVID-19 first appeared in China in late 2019. Due to its origin, many people have engaged in racist and xenophobic attacks and discrimination against those of Asian heritage. The use of language such as the “Chinese virus” and “Wuhan virus” in the media and from political leaders has encouraged hate speech and physical attacks. In the U.K., citizens have punched and beaten Asian people. In Australia, two women beat Chinese students while yelling, “Go back to China.” In Texas, a Burmese family was attacked with a knife. This illustrates how the stigmatization of COVID-19 has resulted in extreme discrimination and violence against Asian people around the world.

How Stigma Impacts Care

As indicated above,  stigma creates barriers for stigmatized people to access quality care. Dana McLaughlin, a global health associate at the United Nations Foundation and graduate student at Johns Hopkins, elaborates on how stigma creates barriers to health. She understands stigma as having three components that can dissuade someone from seeking care and reduce the quality of care they receive:

  1. Internalized or Self-Stigma: This occurs when an individual with a disease internalizes the stigma. They may feel shameful about themselves and their condition. They might also fear telling family, friends and their communities about their condition because of possible ostracization. Either way, this internalized fear may prevent someone from seeking medical care.
  2. Public Stigma: This stigma refers to the general population’s opinions  about behaviors associated with people who have a certain disease. In other words, this is a negative cultural context that surrounds a disease. This can vary greatly between countries and cultures, so it’s important to recognize that the public stigma may not be universal.
  3. Structural Stigma: This refers to the social institutions that reflect and reinforce the stigmatization of diseases. For example, structural stigma may manifest as a lack of resources for care, like a limited number of doctors in marginalized communities. One of the most prominent manifestations of structural stigma is the criminalization of certain behaviors associated with specific diseases. With HIV, many countries criminalize sex work and intravenous drug use and stigmatize people who engage in these behaviors. This stigmatization may prevent individuals from receiving care for fear of arrest or punishment. On the other hand, stigmatized individuals may “go underground” and engage in even riskier behaviors, like sharing needles, to avoid police discovery.

Combating Stigma and Providing Care

McLaughlin explains that in the context of global health, it is important to understand the syndemic (occurring simultaneously) nature of stigma and disease. These two aspects are “correlating challenges that the global health community has to be able to respond to.”

For McLaughlin, responding to stigma requires prioritizing the needs and experiences of stigmatized people. This might mean allowing them to speak openly about the daily struggles they face due to stigma. It’s also essential that “the people who are most impacted and know the day-to-day challenges of stigma are at the root of planning.” This ensures that interventions and projects actually meet the needs of stigmatized communities. If people do need to change their behaviors, this message should come from respected community leaders. This will ensure that people trust public health advice, making them more likely to follow it.

Though the stigmatization of disease is a powerful force, viruses don’t pick and choose whom they infect. Association between certain types of people or places, behaviors and disease develop from fear and misinformation. Ultimately, it’s essential to question these associations and dismantle stigma by listening to stigmatized groups.

Paige Wallace
Photo: Flickr

NASA SatellitesIn 1999, The National Aeronautics and Space Administration (NASA) scientists theorized that in the near future, they would be able to track disease outbreaks from space. They were mainly concerned with Rift Valley Fever. This is a disease prevalent in East Africa that is deadly to livestock and occasionally deadly in humans. NASA scientists already had surmised that outbreaks were directly related to El Niño weather events. Areas with more vegetation on abnormally precipitous years breed more disease-carrying mosquitoes. To see the exact areas that would be most at-risk, NASA satellites would need to be able to track differences in the color and density of vegetation from year to year.

Tracking Rift Valley Fever

In 2006, NASA scientists were able to predict and track an outbreak of Rift Valley Fever in East Africa. Even with intervention efforts, the outbreak led to the deaths of over 500 people and cost the regional economy over $60 million due to export restrictions and livestock deaths. Although the researchers could not adequately predict the outbreak then, the results of that mission gave them confidence that they could predict the next outbreak even better the next time El Niño conditions arose.

Ten years later, the NASA team successfully predicted the location of the next potential outbreak. They subsequently warned the Kenyan government before the disease could strike and gave them ample time to prepare. Thanks to the combined efforts of the Kenyan government and NASA satellites, Kenya saw no outbreak of Rift Valley Fever in 2016. The country protected the lives and livelihoods of rural farmers throughout the country and saved millions of dollars.

The success of the Rift Valley Fever prediction models gave the researchers more confidence in their methods. They believed that NASA satellites could predict and halt all manner of outbreaks. Researchers focus on neglected diseases like cholera. These diseases have connections to environmental conditions that hit developing countries and impoverished people the hardest. Newer satellites add the ability to measure variables like temperature and rainfall. Researchers are able to use it more than just the visual data utilized in the initial Rift Valley Fever predictions, thanks to the improved models.

Tracking Cholera

Cholera infects from 1.4 to 4 million people and kills more than 140,000 each year. There are two distinct forms of cholera: endemic and epidemic. Endemic cholera is present in bodies of water primarily during the dry season. This means communities living along the coasts are typically prepared for an outbreak. Epidemic cholera comes about during weather events like floods and often leaves inland communities unprepared for the disease. Due to its infectiousness and connection to weather events, it is the most promising disease that new scientific models have analyzed.

In 2013, a research team successfully modeled cholera outbreaks in Bangladesh using NASA satellites. The real test of the team’s predictive models would come in 2017, however, when it used the same model in a very different part of the world: Yemen. The model worked nearly perfectly. Researchers predicted exactly where the outbreaks would occur nearly a full month in advance. The fact that the models worked in impoverished and war-torn Yemen is especially notable for those concerned with extreme poverty. It means that the previously expensive and dangerous work of entering countries like Yemen in order to do disease research is no longer necessary. Instead, early warning systems can be implemented. But even if they fail, governments and organizations can send vaccines and medicines to exactly the right locations. Cholera outbreaks and their disproportionate death rates among the global poor will hopefully soon be a thing of the past.

Hope for the Future

By halting outbreaks before they begin, international aid dollars can have more efficient use. Prevention is always less expensive than reaction. Information in and of itself is valuable and the more information poverty-fighting organizations have, the better they can spend their dollars to maximize utility and help the most people. As satellite technology advances along with newer predictive models, preventing disease outbreaks could save developing economies and aid organizations hundreds of millions of dollars each year.

Jeff Keare
Photo: Pixabay

Eritrea’s Lack of Clean WaterEritrea is a northeast country in Africa, bordering the Red Sea coast. Eritrea has faced severe drought issues over the years. In addition, Eritrea’s lack of clean water affects over 80% of its citizens. This problem has negatively impacted its ongoing poverty issue.

Climate

Eritrea’s weather varies depending on the location. The variety of weather conditions is due to the differences in elevation between plains and plateaus. The average temperature by Massawa, or the coast, is around mid-80s Fahrenheit. However, on higher grounds, like plateaus, the average temperature is around low-60s Fahrenheit. The mean annual rainfall in the plateaus is around 16-20 inches. In the west plain, it is usually less than 16 inches. That is below average in many other parts of the world.

Effects of the Lack of Clean Water

Despite the fact that Eritrea has around 16 to 20 inches of rainfall annually, almost half of the country does not have access to clean water. As of 2020, 80.7% of Eritreans lack basic water services. This problem leads to consequential outcomes such as:

  1. Hygiene & the Contamination of Public Water Sources: Without the basic access to clean water, citizens of Eritrea are forced to use public water sources like rivers and streams. Citizens use public water sources to perform their everyday activities since they do not have safe accessible water at their homes. People will cook and shower with the same water. Thus, the sources become contaminated over time. The water contamination can then lead to fatal diseases.
  2. Diseases: Diarrhoeal disease is a type of bowel infection that usually spreads through contaminated water. Bacteria and viruses from water need a host in order to survive. It is unusual for the diarrhoeal disease to be deadly, but death can occur if a person loses over 10% of their body’s water. According to UNICEF, diarrhoeal disease is the leading cause of death for children under the age of 5 in Eritrea. Cholera is an infectious disease that contaminated water sources also cause. The symptoms are watery diarrhea and abdomen pain. This disease can be fatal if a person does not receive treatment on time because the body will eventually become dehydrated.

Effects of Poverty

Eritrea’s lack of clean water and poverty are linked to one another. Access to clean water means being able to cook, bathe and drink. Aside from covering basic needs, it also helps businesses run safely, keep children healthy and reduces vulnerability during a natural disaster.

  1. Businesses: Farmers and local business owners rely, to some extent, on the access to clean water. Farmers need to keep their crops clean by washing them. Local businesses also need clean water to create products or sell food. Without accessible clean water nearby, owners and employees have to leave their businesses to find a drinkable water source and sanitation facilities. By doing so, they could potentially lose customers.
  2. Girl’s Education: When girls hit puberty, they begin menstruating. If girls cannot practice proper hygiene or have access to clean water at school, they often miss out on education. Some have to skip class until their menstruation ends, which is around a week. During that week, they do not learn whatever their schools teach.
  3. Vulnerability During Natural Disasters: Clean water promotes good health. If communities lack strength due to unsafe water usage, citizens may have a hard time withstanding times of disasters. Houses would possibly be destroyed and businesses may be ruined. Thus, those in poverty would be forced to leave their homes and find another by traveling long distances. Many, without access to clean water, would struggle along the way because potential diseases from contaminated water would weaken their body.

Government Involvement

Eritrea’s state government has partnered up with UNICEF to improve citizens’ drinking water and sanitation issues. The Millennium Development Goal (MDG) aims to increase accessible clean water and promote safe WASH practices in drought-prone areas of Eritrea. UNICEF is also working to connect many schools to community water supply systems.

With the state government’s involvement, Eritrea’s clean water crisis will eventually improve. The promotion of good hygiene practices reduces the spread of diseases. With many schools being connected to safe water supply systems, students will be healthy and girls will not have to skip school during the week of their menstruation. This brings hope for the future of Eritrea.

Megan Ha
Photo: Flickr

Countries with CholeraCholera is a disease of inequity that unduly sickens and kills the poorest and most vulnerable people – those without access to clean water and sanitation.” – Carissa F. Etienne, the Director of Pan American Health Organization.

Profuse vomiting, diarrhea and leg cramps, followed by intense dehydration and shock, are all symptoms of cholera. It is a highly contagious waterborne illness that can cause death within hours if left untreated. Cholera is mainly caused by drinking unsafe water, having poor sanitation and inadequate hygiene, all of which allow the toxigenic bacteria Vibrio Cholerae to infect a person’s intestine.

While cholera can be treated successfully through simple methods, such as replacing the lost fluid from excessive diarrhea, there are still many people around the globe struggling with the disease. There are 2.9 million cases and 95,000 deaths each year, according to the Centers for Disease Control and Prevention (CDC).

The countries that have the greatest risk of a cholera outbreak are the ones that are going through poverty, war and natural disasters. These factors cause poor sanitation and crowded conditions, which help the spread of the disease.

Yemen

Yemen is known for being one of the countries with the most Cholera cases. The number of cholera cases in Yemen has been increasing since January 2018; the cumulative reported cases from January 2018 to January 2020 is 1,262,722, with 1,543 deaths. The number of cases in Yemen marked 1,032,481 as of 2017, which was a sharp increase from the 15,751 cases and 164 deaths in 2016. On a positive note, the numbers showed a decrease by February 19, 2020; 56,220 cases were recorded, with 20 associated deaths.

The Democratic Republic of the Congo (DRC)

The DRC is another country with a high number of Cholera cases. There were 30,304 suspected cases of cholera and 514 deaths in 2019. Although the number of 2019 cases was smaller than that of 2017 (56,190 cases and 1,190 deaths), the 2019 data showed an increase from 2018 (27,269 cases and 472 deaths). As of May 13, 2020, 10,533 cases and 147 deaths were reported; most of these reported cases originated from Lualaba regions, Haut Katanga and North and South Kivu.

Somalia

Somalia also stands as one of the countries with the most Cholera cases. From December 2017 to May 30, 2020, there were 13,528 suspected cholera cases and 67 associated deaths in Somalia. These reported cases are from regions of Hiran, Lower Shabelle, Middle Shabelle and Banadir.

Other than the three countries listed above, there are many others that are also going through Cholera outbreaks. Uganda reported a new Cholera outbreak in the Moroto district in May 2020; a month later, 682 cases and 92 deaths have been reported. Burundi also declared a new cholera outbreak this past March; 70 new cases were reported.

Helping Cholera Outbreaks

Many non-profit organizations like UNICEF are constantly working towards helping these countries and many more. A good example of a country that has shown a great decrease in cholera cases following external aid is Haiti.

Haiti experienced the first large-scale outbreak of cholera with over 665,000 cases and 8,183 deaths. After a decade of efforts to fight against cholera, the country recently reported zero new cases of cholera for an entire year. An example of how UNICEF helped Haiti is by supporting the Government’s Plan for Cholera Elimination and focusing on rapid response to diarrhea cases. However, the country still needs to keep effective surveillance systems and remain as a cholera-free country for two more years to get validation from the World Health Organization (WHO) of the successful elimination of the disease.

Alison Choi
Photo: Flickr

Cholera Outbreaks in AfricaDue to the use and ingestion of contaminated water, cholera has become one of the most common waterborne diseases in the world. Cholera is a bacterial disease that causes such symptoms as diarrhea, dehydration, and, if not treated quickly, even death. Lack of availability to drinking water and sanitation facilities in Africa allows cholera to spread easily and quickly. However, many organizations have come up with different ways over time to help reduce the spread of cholera. Here are five things being done to prevent cholera outbreaks in Africa.

5 Things Being Done to Prevent Cholera Outbreaks in Africa

  1. Access to Clean Water: Being a waterborne disease, cholera can be prevented most effectively with access to clean drinking water. CDC has created a program called The Safe Water System Project, which brings usable water to areas with contaminated water. The Project also treats water with a diluted chlorine solution, making it safe to drink. CDC was able to use this program to bring safe water to more than 40 schools in Kenya, providing clean water to the students, staff and their families.
  2. Oral Vaccination: The FDA approved an oral cholera vaccine called Vaxchora. Due to the spread of cholera cases in Africa, in 2017 and 2018, the World Health Organization (WHO) distributed Vaxchora to five different countries in Africa to prevent further cholera outbreaks. By distributing this vaccine, WHO is giving relief and medical treatment to millions of individuals who previously may not have had access to any medical care.
  3. Proper Sanitation Facilities: Cholera can spread very easily if proper sewage and sanitation facilities are not in place or contain defecation. An organization called Amref Health Africa has made it their goal to supply communities in Ethiopia with clean toilets, sinks and other sanitation facilities. Amref Health Africa also sends teams to help train the community on how to maintain the facilities and educate them on other hygiene practices.
  4. Establishing Treatment Centers: According to the United Nations Office for the Coordination of Humanitarian Affairs, 11 treatment centers have been established in Africa with the specific purpose to prevent cholera outbreaks. In addition, an organization called Medecins Sans Frontieres (MSF) has created mobile clinics to meet the needs of those in more rural areas who may have contracted cholera. MSF has also established the Cholera Treatment Centre (CTC), which is a facility where individuals can visit and be treated for cholera.
  5. Hygiene Practices: UNICEF has launched a campaign to help spread hygiene awareness. The campaign is called My School Without cholera and is brought to more than 3,000 schools in Cameroon. Along with this campaign, UNICEF is urging Cameroon’s government to act and address the impact cholera has had on its community.

 

While as of 2018, cholera hotspots around the world have seen a decline of 60% since 2013, thousands of individuals are still susceptible to cholera in Africa. The WHO has estimated that Cameroon, Kenya, Somalia, Sudan and the Democratic Republic of the Congo have had more thna 45,000 confirmed cases and close to 700 deaths just in the time span of 2017 to 2020. The call to educate others on and how to prevent cholera outbreaks is imperative to the health of those who face cholera as an everyday battle.

Olivia Eaker
Photo: Flickr

Sanitation in Haiti
Haiti has struggled with access to clean water over the past few decades. While strides have been made to improve the sanitation situation, the earthquake in 2010 augmented the problem. Access to clean water became almost impossible after the earthquake, culminating in the subsequent cholera outbreak. Here are 10 facts about sanitation in Haiti.

10 Facts About Sanitation in Haiti

  1. Prior to the 2010 Earthquake, only 69% of Haitians had access to an improved water source and only 17% had access to an improved sanitation facility. After the earthquake, however, these numbers plummeted, leading to the spread of cholera and typhoid. Organizations like Health Equity International have begun to combat this issue by providing water treatment tablets and water safety education.
  2. Only 24% of Haiti’s population has access to a toilet. With limited access to toilets, a nationwide sewage system has been hard to implement and maintain. This deficiency facilitates the spread of water-borne illnesses like cholera.
  3. Haiti’s WASH sector (Wash, Sanitation and Hygiene) is mostly financed by donors such as the World Bank, UNICEF, CDC and Swiss Development Cooperation. While these are major donors, anyone can donate.
  4. In 2012, the CDC helped the National Directorate of Water Supply and Sanitation (DINEPA) train communal water and sanitation technicians (TEPACs) to help improve water infrastructure in rural areas. TEPACs are extremely helpful because they routinely assess water systems, monitor free chlorine in the water, work with humanitarian aid and support the WASH sector.
  5. Before the 2010 earthquake, no waste management facility existed in Haiti’s capital, Port-au-Prince. After the earthquake and following cholera outbreak, the Morne a Cabri wastewater treatment was opened. This was extremely beneficial, as waste could be properly managed as opposed to remaining in a fecal sludge.
  6. The World Bank, in conjunction with DINEPA, supported a project to improve water and sanitation in Haiti. This project resulted in the construction of 25 sets of latrines, 25 urinals and 28 hand-washing stations. It also built sanitation works in public schools and a health center.
  7. In 2015, the Ministry of Health, DINEPA and the Ministry of Trade outlined a program to improve and monitor water quality. This agreement (The Promotion of Sanitation, Hygiene, and Life) was signed into law in 2016.
  8. Shortly after the cholera outbreak, the Haitian government implemented the National Plan of Action for the Elimination of Cholera in Haiti 2013-2022. This plan includes a framework for improving water, sanitation, health care, education, transportation and more. By increasing access to potable water and sanitation facilities, the government hopes to limit the spread of water-borne diseases.
  9. The Pan American Health Organization (PAHO) worked with the Haitian Solid Waste Collection Agency to remove health care waste (needles, bandages, gloves, etc.). As a result, hospitals received more training and information regarding how to manage medical waste.
  10. After U.S. government assistance, 392,000 people in Haiti gained access to improved sanitation and 2.1 million people gained access to improved drinking water.

These facts about Haiti and the country’s lack of clean water highlight the importance of consumable water and sanitary environments. While Haiti’s water accessibility and sanitary facilities are behind other nations in the Western Hemisphere, it is improving its infrastructure and hygiene-educational efforts to improve the lives of Haitian citizens.

– Ehina Srivastava
Photo: Flickr

Vaccinations in Yemen
Situated in the Middle East, the Republic of Yemen is the second-largest sovereign state in the Arabian peninsula. Being in the clutches of a civil war since 2015, Yemen stands in the second-lowest position for life expectancy in the Middle East with an average life expectancy of 65.31 years. Research has shown that the civil war also had a significant impact on the immunization or vaccination efforts to protect the children of the nation from curable diseases like cholera and measles. Here are five facts about vaccination in Yemen.

5 Facts About Vaccination in Yemen

  1. Cholera Outbreak: Experts consider Yemen’s cholera outbreak, which started in 2016, to be the largest epidemic to ever occur in recorded epidemic history. As of 2018, Yemen reported 1.2 million cases of cholera, and 58 percent of the resulting deaths were of children. The ongoing civil war and the fact that only half the country’s population has access to clean water and sanitation has made it increasingly challenging to tackle the spread of the disease effectively. Organizations like WHO and UNICEF have made severe efforts in distributing Oral Cholera Vaccines (OCV), funding to supply clean water to the citizens and establishing health centers to combat the outbreak. Several randomized trials showed the efficacy of the distributed OCVs to be nearly 76 percent.
  2. Vaccination Rate: Even though vaccines have a proven rate of efficacy, the immense pressure that health care in Yemen experienced suddenly due to large outbreaks decreased the effectiveness with which it could mobilize its immunization efforts. According to the official country estimates of 2018, 80 percent of Yemen’s population received DTP3 vaccination coverage. However, Yemen did not distribute Oral Cholera Vaccines widely until 16 months after the cholera outbreak. This led to a rapid spread of cholera in the nation.
  3. Vaccine Storage Facilities: Many often overlook a country’s vaccine storage capacity. Yemen’s lack of proper facilities and shortage of electricity made it difficult to safely store the vaccines. UNICEF and the Kingdom of Saudi Arabia worked together to provide solar refrigerators to several health care centers to facilitate safer and more reliable vaccinations in Yemen. Health care workers say that solar refrigerators enable them to store the vaccines for one month. This reduces material waste and optimizes vaccine distribution.
  4. Impact of War: The ongoing civil war has put Yemen in a vulnerable position when it comes to the re-emergence of preventable disease outbreaks. Research has shown that countries with conflicts are more susceptible to disease outbreaks. However, these are easily preventable with vaccines. In Yemen, airstrikes destroyed many hospital centers, which made health care more inaccessible to its citizens. The civil war disrupted the stable vaccination rate in Yemen, which was at 70 to 80 percent, falling to 54 percent in 2015 at the time that the war broke out.
  5. Humanitarian Efforts of International Organizations:  In war-torn countries with feeble financial stability, humanitarian efforts play a significant role in disease control. The World Health Organization (WHO) contributed 414 health facilities and 406 mobile health teams to combat the cholera outbreak and facilitate vaccination in Yemen. Meanwhile, UNICEF made substantial efforts to provide safe drinking water to 1 million residents of Yemen. It also contributed medical equipment to remote parts of the country with the help of local leaders.

Yemen has clearly faced challenges in vaccinating its citizens in recent years due to civil war and conflict. Hopefully, with continued aid from UNICEF, the WHO and other countries like Saudi Arabia, vaccination in Yemen will improve.

– Reshma Beesetty
Photo: Flickr

10 Facts About Sanitation in the Democratic Republic of the Congo
The Democratic Republic of the Congo (DRC), a country located in Central Africa, has been the victim of oppression, colonization and enslavement by European nations dating back to the year 1890. Violence and war continued for decades as a result. The Central African country currently lacks some essential sanitation resources, which has led to the spread of diseases such as cholera within the nation. Part of this is because half of the people of the DRC receive improved drinking water from wells and public standpipes. Here are 10 facts about sanitation in the DRC.

10 Facts About Sanitation in the DRC

  1. In 2018, only 29 percent of people in the DRC had access to basic sanitation services. There is 42 percent of people in the DRC currently using unimproved methods of sanitation. This includes pit latrines and bucket latrines.
  2. In the Democratic Republic of the Congo, there is an indisputable crisis in the availability of clean and pure drinking water. UNICEF reports that despite the fact that 50 percent of Africa’s water reserves exist there, there are still millions of people living without pure drinking water. In fact, more than half the population of the DRC lacks clean drinking water.
  3. Many people and schoolchildren have benefitted from the national program, Healthy School and Village. This national program aims to provide clean drinking water to villages in Africa to prevent diarrheal diseases. Waterborne diseases, like cholera, claim the lives of thousands of people of the DRC per year. UNICEF reports that as many as 7 million people and 983,000 schoolchildren have seen an improvement in their quality of life from this program since 2008.
  4. Women in the DRC and other sub-Saharan African countries are bearing the burden of having to deliver clean drinking water to their families. Women and girls in the developing world, such as the DRC, spend up to 90 percent of their valuable time collecting water. The women and girls in the DRC rarely finish their schooling due to this need for water. In the DRC, the participation of boys in the secondary school system has been 25 percent higher than girls since 2009.
  5. In 2011, a program called We Are Water successfully raised 20,000 euros in an effort to give accessible drinking water to the DRC. The program estimates that with the funds raised, it will be able to minimize the cholera epidemic. It is giving 20,000 people from 30 different villages clean water to drink and maintain their hygiene. This will only increase the efforts for creating better sanitation in the DRC.
  6. The U.N. Refugee Agency’s Cash for Shelter project has given funds to people in the DRC so they may build their own homes with real functioning toilets. Most people can only dream of owning a toilet because they are living on a mere $2 a day. Through this program, they do not have to construct makeshift pit latrines. They can now create a sense of security and ownership for themselves. Since its inception in 2016, the UNHCR’s cash-based interventions have reached more than 20 million people.
  7. There are many initiatives that bring clean drinking water to the people of the DRC like Concern Worldwide. It has provided the village of Mulombwa with its very own water pipe, which has revitalized the village in so many ways. Throughout its 50 years, this program has reached 24.2 million people in 23 different countries.
  8. The proportion of people drinking surface water, which includes contaminated lakes and rivers, was 11 percent, as of December 2018. The use of unimproved water sources like surface water is nearly universal in rural areas, according to the World Bank. Urban areas have 81 percent access to improved water sources, while it is as low as 31 percent in rural areas.
  9. According to the World Bank, access to improved water, sanitation and hygiene services is low, improving only by 3 percent. In urban areas, however, access to water, sanitation and hygiene services is much higher.
  10. There is a trend of constant outbreaks of cholera in various regions of the DRC due to contaminated drinking water. The infection can lead to severe dehydration and diarrhea which, if people leave unchecked, could lead to death. From November 2015 to February 2018, there were 1,065 cases of cholera in the capital Kinshasa alone, according to the World Health Organization. Of these 1,065 cases, there were 43 confirmed deaths.

The Democratic Republic of the Congo has seen little improvement in water quality and sanitation services. Thankfully, people and organizations are consistently working on improving everyday life for the people of the DRC. Whether it be funding Congolese families to have a functioning toilet in their homes or building a protected well for an entire village, there are several ways these organizations can make an impact

William Mendez
Photo: Flickr

Cholera in BurundiThe World Health Organization (WHO) has identified more than 1,000 cases of cholera in cities across the Republic of Burundi. Burundi is an East African country that has been plagued by violence, disease and poor sanitation for years. Most of the population lives in rural areas where drinking water is unsafe and sanitation practices are nearly non-existent. This has created the perfect storm for cholera to spread quickly across the country. It has led to six deaths from an otherwise treatable disease. Below are nine facts about the outbreak of cholera in the Republic of Burundi.

9 Facts about Cholera in Burundi

  1. Cholera is a gastrointestinal infection caused by bacteria. Generally, it is attributed to unsafe drinking
    water and often associated with raw or undercooked fish. It is transmitted from person to person through oral-fecal contamination due to improper sanitation and poor hygiene.
  2. This outbreak started in a time of political peril in Burundi. Rebel forces and the country’s army are fighting across rural areas, which is displacing people. Instability and lack of security make it difficult for people to find safety and sources of income. This has created a high level of poverty for Burundi’s people and exacerbated the poor water conditions.
  3. Most patients are displaced persons (IDPs) from rural Bujumbura. Fighting in Bujumbura became so violent that the government moved the capital to Gitega in February 2019. When the capital moved, many people were left without the support and resources of the government.
  4. Treatment usually takes several days per patient. Patients typically present symptoms related to dehydration. Dehydration occurs because of the excessive vomiting and diarrhea that comes with cholera. Patients are usually treated with an oral rehydration solution made up of a sugar and salt mixture in clean water. In extreme situations, patients may need intravenous fluids and antibiotics.
  5. Médecins Sans Frontières (MSF) has three treatment centers for cholera in Burundi where professionals are trained and supervised. The goal of these facilities is to provide free patient care and increase the local public health staff. These centers provide care when most of the hospitals are unable to respond to the needs of cholera patients. MSF has also set up a 50-person treatment center in Bujumbura.
  6. Sterilization is a very important part of reducing the spread of cholera, so the MSF staff uses a chlorine solution to disinfect the center. This reduces the chances of another outbreak or infecting the staff. This solution can also be used to disinfect the homes of families who have been infected.
  7. Disinfecting isn’t the only solution to preventing the spread of cholera because the problem is directly related to the distribution of water. Without proper containment of poor water sources, the disease will continue to spread. To ameliorate the risks of cholera related to unsafe drinking water, MSF installed two water distribution bladders in the most affected areas. These bladders supply 30,000 liters of potable water.
  8. UNICEF has been providing cholera kits to people in Burundi. There are four different kinds of kits to help with various aspects of need. UNICEF has also established two cholera treatment centers to control the spread of the disease.
  9. To avoid contamination, experts suggest drinking disinfected water and eating a balanced, thoroughly cooked diet. Organizations like WHO are emphasizing the importance of washing hands frequently with soap and water or an alcohol-based sanitizer to reduce the risk of transmission.

Cholera is an easily treatable and preventable disease that occurs in poverty-stricken areas with poor sanitation. Many organizations have reached out to add potable water sources and aid by training the people of Burundi to treat and prevent the disease themselves. With rebel fighting and insurgent forces crossing the country, the disease is projected to spread to further areas of rural poverty.

Kaylee Seddio, PhD
Photo: Iwacu