Information and stories on development news.

Vietnam's Health Care System
As Vietnam has grown and developed over the last two to three decades, so has its health care system. There is a decrease in the number of deaths due to health issues and an increased rate of vaccination through Universal Health Coverage (UHC). With much success for the UHC implementation, Vietnam’s health system has become a model to other countries. However, there is still a difference in the level of care between the rich and poor in Vietnam’s health care system.

Health Care and Hospital Systems

Business Monitor International (BMI) stated that health care spending in Vietnam in 2017 increased to 7.5 percent of gross domestic production, which is $16.1 billion. Meanwhile, experts forecasted it to grow 12.5 percent annually during a four-year period from 2017-2021, which would be approximately $20 billion according to KPMG. Public health care spending is expanding with social health insurance programs that projections determine will 58.1 percent of all health care spending.

Vietnam’s health care system is decentralized with the Ministry of Health at the central level. Meanwhile, the provinces, cities, districts and communities connect to the Ministry of Health. The four groups implement their own health policies and manage their own health care system and facilities. The Ministry of Health (central level) manages the health care system for the government as well as hospitals, medical education and research. Provinces and cities run hospitals, other health care facilities and health care-education programs with central oversight. Finally, health care facilities at the district and commune-level provide basic medical care with preventative services.

Universal Health Coverage (UHC)

Vietnam is a leader in implementing universal health coverage. This would cover medical and dental services as well as medicine and vaccines. The Global Monitoring Report on UHC by both the World Health Organization and the World Bank states that almost 88 percent of people in Vietnam have health coverage and 97 percent of the children received vaccinations. There is also a 75 percent decrease in the death of mothers through universal health coverage. Vietnam has reached health care goals (as recommended by the United Nations’ Sustainable Development Goals) earlier as compared to other countries due to its strategy on using all that is available, including staffing and administration.

Public View and Poverty Gap

Vietnamese’s traditional viewpoint on health care services affects health care delivery. It is a common belief that larger health care facilities in big cities would provide better health care services through more specialized staffing and more robust technology and equipment. Therefore, people tend to overlook smaller local facilities in the countryside or in rural areas. This, in turn, is impeding faster and necessary care while incurring unnecessary, unknowing or avoidable high costs. Such a barrier would ultimately contradict the proposed health care strategy above.

Vietnam’s health governance body is working to change the public viewpoint on local community health by educating the public about the programs and charging local health offices to provide excellent care in order to build trust. Wealthy patients have better access and higher quality health care. As wealthy patients tend to live in big cities, they are closer to big health care facilities that are well equipped. Meanwhile, poorer patients often have to travel hundreds of miles from rural areas to reach better care. While private insurance gives patients primary and preventative medicine that would avoid high health care expenditures due to medical emergencies, wealthy patients have more opportunity to purchase private insurance for better care. Health care inequity leaves the poor at a disadvantage with higher chances for illness and a lower quality of care.

Support and Challenges for UHC

Vietnam’s universal health care is receiving support from the Working Group for Primary Healthcare Transformation. The group works to present and emphasize primary care services in provinces around Vietnam, as well as improve and expand those services moving forward. Harvard Medical School, a member of the group, helps with primary care structuring and management. Another member, Novartis, provides rural community health education outreach as well as technology and rural medicine education for health care professionals. For instance, Novartis’ Cung Song Khoe Program has provided treatment for many conditions such as diabetes, hypertension and respiratory disease, as well as education for local rural communities and health care professionals, totaling 570,000 people served in 16 provinces. However, there are still challenges that are holding back Vietnam’s health care system including a high number of smokers and adults with alcohol usage, as well as extreme air pollution and aging populations.

Despite drawbacks from public views, health challenges and the environment, Vietnam’s universal health coverage is holding strong and progressing with ongoing program evaluations, strategic planning, improved care quality and partnerships. Therefore, Vietnam’s health care system has also been growing and is standing tall among that of other well-mentioned countries. With that said, eliminating health inequity is the focus to improve Vietnam’s health care.

– Hung Le
Photo: Flickr

Total Literacy in KeralaLiteracy has always been an important measure of development and a huge means to further progress through an educated population. People usually define literacy as the ability to read, write and comprehend information. This is important in even basic infrastructure improvements for a community, such as implementing road signs in order to lower road injuries and deaths. Literacy in India is improving rapidly. The most recent measure of literacy in India took place during the 2011 census. India’s 2011 literacy rate was 74.04 percent, an immense increase from the previous census, where the literacy rate was only 12 percent. But even more impressive, Kerala has the highest literacy rate of all the states and even has the label of a total literacy state. In fact, the total literacy in Kerala is 93.91 percent.

History of Kerala

Kerala is a fairly small state and largely rural, rather than being a center of commerce. Additionally, it does not have a high level of industrial development. However, Kerala rises above other states regarding development indicators like literacy, health outcomes and life expectancy. It is crucial to analyze and understand Kerala’s success so that the literacy rates can improve in other regions.

Kerala’s history as a region plays a role in its literacy success. Starting in the 19th century, royalty called for the state to cover education costs. While still a colony, Kerala implemented social reform in the early 20th century that allowed access to education for lower castes and women. Post-independence, socialist or left of center governments overarchingly controlled the state government and they made equity and social goals a huge priority.

Literacy Programs in Kerala

However, aside from these factors, one of the biggest contributors to Kerala’s total literacy is its literacy program, Kerala State Literacy Mission Authority. This is an institution that works under the state government and received funding from it, but operates autonomously. The values of this organization are clearly framed in its slogan, “Education for all and education forever.”

The program works on many levels, including basic literacy programs and equivalency programs. The basic literacy programs include a push to take Kerala to a full 100 percent literacy rate. These programs focus on regions and peoples who tend to have lower literacy rates, including urban slum, coastal and tribal populations. District-specific programs target localized issues, needs and a total literacy program for jail inmates. The equivalency program provides the opportunity for adults who did not go through all levels of primary and secondary school to take classes and tests which will bring them up to fourth, seventh, 10th, 11th, or 12th-grade literacy standards. The program also offers certifications and is constantly adding smaller, new programs in social literacy as different areas require attention.

The Goal

The goals of this program center around developing literacy skills through continuing education and offering opportunities for all who have an interest in learning. This ensures secondary education, providing the skills necessary for those learning to read and write to apply these new abilities in their daily lives and to conduct research on non-formal education. The organization and practices of the Keralite government in terms of improving literacy in their state are undoubtedly successful.

In the development field, it is easy for one to become bogged down in the failures. The total literacy in Kerala is a success story that should receive attention. This is the value of investing in development projects. There are concrete gains when development receives careful formulation and funding with the population in mind. There is much that one can learn from the Kerala State Literacy Mission Authority and apply to achieve total literacy around the world.

Treya Parikh
Photo: Flickr

World Cocoa FoundationSmall plots of land, unsustainable farming practices, forced child labor, a changing climate and chronic farmer poverty are among the many issues that the cocoa industry faces today. “In Côte d’Ivoire – the world’s largest producer of cocoa – a farmer should earn four times his current income in order to reach the global poverty line of $2 a day,” according to Make Chocolate Fair, an international campaign focused on the fair treatment of cocoa farmers. The World Cocoa Foundation is hoping to make the industry sustainable.

Reasons Behind Issues in the Cocoa Industry

Partly to blame is the common practice of sharecropping. In regions where cocoa is most heavily produced, sharecropping restricts farmers’ ability to significantly alter their land for sustainable use. It disincentivizes farmers to make rehabilitation investments. Moreover, monoculture crops – singular crops produced over a large area of land – inhibit crop diversity and make crops more susceptible to pests and diseases.

According to NPR, high rainfall, lower demand for chocolate and price-fixing have also contributed to a decrease in cocoa prices. This has led to an increase in low wages and high debts for cocoa farmers, resulting in chronic poverty. Charlotte Grant, the Communications and Marketing Manager for the World Cocoa Foundation believes that poverty leads to issues such as child labor and deforestation.

“We fear that the well-being of farmers will not improve unless the cocoa supply chain becomes more sustainable,” said Grant. Without any intervention, the global cocoa industry faces an uncertain and unstable future. Fortunately, the World Cocoa Foundation has given cocoa farmers a sense of renewed hope.

A Rich History

The U.S. chocolate industry created the Chocolate Manufacturers Association (CMA) in 1923 to serve cocoa producers by funding research, promoting chocolate consumption and lobbying Congress and government agencies. When the CMA determined a new model for cocoa sustainability was necessary, it formed the International Cocoa Research and Education Foundation in 1995. In 2000, the foundation was renamed the World Cocoa Foundation. Its main focus is on cocoa research and educational programs.

In the late 2000s, with funding from the Bill and Melinda Gates Foundation and the U.S. Agency for International Development, WCF began administering large-scale projects that emphasized productivity, higher-wages for farmers, the reduction of child labor, scientific research and community strength. Today, with more than 100 members, the vision of WCF is clear: “A sustainable and thriving cocoa sector – where farmers prosper, cocoa-growing communities are empowered, human rights are respected, and the environment is conserved.”

The Work of WCF

WCF maintains a diverse range of programs across several regions, including program partnerships with other NGOs. Initiatives like CocoaAction, Cocoa and Forests Initiative, Climate Smart Cocoa, Cocoa Livelihoods Program and African Cocoa Initiative II are addressing the specific needs of cocoa-producing communities.

WCF launched the Cocoa Livelihoods Program in 2009. This program works to increase cocoa farmer productivity. Through training and education, CLP advances four primary objectives. It works to advance industry initiatives, provide a “full-package” of services to farmers, promote food crops and empower women.  With more than 15 company partners, CLP serves impacted communities in Cameroon, Ghana, Nigeria and Côte d’Ivoire.

With the goal of increased stakeholder collaboration, WCF established the CocoaAction initiative in 2014. CocoaAction offers a Monitoring & Evaluation Guide that provides data collection in communities as well as a Community Development Manual. It provides company partners with an outline for the design and implementation necessary for sustainable Cocoa production.

Making Chocolate Sustainable

In 2019, as part of the Cocoa and Forest Initiatives, 34 chocolate companies, along with the governments of Côte d’Ivoire and Ghana, released official action plans detailing the new steps they are taking to address climate change and cocoa sustainability. The initiative aims to end deforestation and replace vegetation in impacted forest areas. The Climate Smart Cocoa initiative acknowledges the impact of climate change on cocoa crops. It seeks to examine better risk and investment strategies to strengthen the global cocoa market.

Partnering with USAID and several private sector partners, the African Cocoa Initiative II emphasizes the importance of economically sustainable and economically viable cocoa production. According to the ACI II annual report, more than “two million smallholder farmers” rely on cocoa farming for income. Therefore, “a healthy and sustainable cocoa industry means opportunity for economic growth and poverty alleviation in the region.”

A Sweet and Sustainable Future

In the past two decades, the World Cocoa Foundation has benefited countless farmers and their communities. Through training, education and community partnerships, WCF continues to strengthen the cocoa industry. By becoming more informed about the issues in the cocoa industry and what is currently being done to resolve them, people can make a difference, according to Grant. It is important to research preferred chocolate manufactures and make sure they are using sustainable, fair trade practices. By getting involved and sharing important information about the cocoa industry, consumers can make a difference in cocoa farmers’ lives.

Aly Hill
Photo: Flickr

Kurdish Comeback in Iraq
The Kurds are an ethnic minority in the Middle East that occupy a region known as Kurdistan. An area that spans parts of Turkey, Syria, Iraq and Iran. Though they were not given a country at the end of WWI, the Kurds have held on to their strong identity and still speak their own language. Caught in the middle of conflicts in both Iraq and Syria, they played an integral role in fighting back ISIS, seeing off 16 assaults on the city of Kirkuk. After several years of economic woes, there are finally some signs that northern Iraq, or Southern Kurdistan for the millions of Kurds that occupy the region, is beginning to recover. More importantly, the poorest Kurds have rebounded significantly. Here are five facts about the Kurdish comeback in Iraq.

5 Facts about the Kurdish Comeback in Iraq

  1. The U.S. government has provided more than $350 million in aid to Northern Iraq as a part of the Genocide Recovery and Persecution Response initiative. Approximately $90 million of the aid is going directly to the most immediate needs and improving access to basic services, job access, small businesses and infrastructure. 
  2. The poverty rate fell to 5.5 percent in 2019. The most encouraging figure about the Kurdish comeback in Iraq might be the poverty rate. Iraq suffered a recession between 2014 and 2016 with Iraq’s GDP falling to 2.7 percent. Unemployment had risen to 25 percent by the end of 2014. The cause was falling oil prices and the height of the conflict with ISIS. Oil revenue makes up half of the country’s GDP and 90 percent of the government’s revenue. Adding to the economic strain, leaders were forced to cut new investments. Foreign oil companies like Russia’s Lukoil, Royal Dutch Shell and Italy’s ENI also withdrew investments. They saw Iran as a safer economic option than northern Iraq. All of this culminated in a 12.5 percent unemployment rate by 2016. 
  3. Kurdish interests were well represented in the 2018 election in Iraq. Overall voter participation was down, but the Kurdish voice was heard. They helped elect new Prime Minister Abdul Mahdi. The prime minister reciprocated by restoring budgetary support to the region, amounting to around 12 percent of the central governments budget. Regular federal reserve installments of $270 million per month helped stabilize the KRG oil sector.
  4. Oil production has rebounded, reaching 400,000 bl/d in January of 2019. Of course, there
    is always concern over the long term effects on climate change; however, over the short term, oil production
    has coincided with the low poverty rateThe U.S. played a role by brokering a deal that helped to restart production in the Kirkuk oil fields. Exports of petroleum to Europe may begin by 2022.
  5. Local investment increased while foreign investment decreased. According to local businessman Abdulla Gardi, this is typical during times of relative stabilityTotal investment increased to $3.67 billion in 2018 from 48 licensed investors. This is up from just $712 million in 2017. Most of the investment in 2018 was made by local investors who hope the KRG cabinet will prioritize a variety of different sectors. Local businessmen believe that, in turn, they can help the local Kurdish region become more prosperous.

There are many factors that lead to the Kurdish comeback in Iraq. Firstly, the end of the conflict with ISIS provided much needed yet tentative stability in the region. As a result, local investors felt more emboldened to invest in the oil industry. Politically, the election of Prime Minister Abdul-Mahdi was a major win for the Kurdish economy and provided additional support to the oil industry to restart stalling production. Furthermore, U.S. aid is helping to improve lives for lower-income Kurds. More than $90 million of that aid is going to immediate needs including but not limited to shelter, healthcare services, food rations and provisions of water. There are reasons to be optimistic about the future in Kurdish Iraq.

Caleb Carr
Photo: Wikimedia Commons

Health Care Progress
The Democratic Republic of the Congo (DRC) has faced various issues surrounding health care in the past several decades and some have amounted to significant setbacks for the nation. However, the country has seen health care progress in the DRC in recent years and international organizations are looking forward to the future.

Improving Vaccines for Citizens

International partners have been able to pair with the government in the DRC to initiate this health care progress, and the country has been polio-free for four years as a result. The lack of infrastructure and geographical size of the DRC makes it particularly difficult to reach milestones in health care progress. The United States Agency for International Development has been a vital component of health care progress in the DRC serving over 12 million people spanning a multitude of different provinces. The organization has additionally remained committed to providing HIV/AIDS support in 21 concentrated zones. These focused zones are crucial for health care progress in this region.

In addition to the international organizations doing their part to help health care progress in the DRC, the country’s Ministry of Health has been working diligently in recent years to improve vaccines and their means of storage. Keeping vaccines in the appropriate cooling storage containers and fridges has proved especially difficult due to the DRC’s tropical climate. In a 2018 plan, the Ministry of Health aimed to provide immunizations to almost 220,000 children and improve vaccine storage conditions. Partnerships with outside organizations have helped to deliver 5,000 solar-powered fridges specifically intended for vaccine storage and they will distribute more later on.

Progress in Hospital Conditions

One of the first dependable and reliably functional hospitals opened in Kavumu through an initiative called First Light. This hospital garnered a brand new electronic medical records system to make keeping track of patient history astronomically easier than before. The hospital staff received tablets to mobilize the system and expedite the process of patient diagnosis and care. With this technology, the hospital is able to treat nearly three times more patients than it was able to without these resources – originally, doctors were only able to see approximately six or seven patients per week.

The hospital also implemented a motorcycle ambulance program so patients no longer have to walk or have others carry them to emergency care in order to tackle the issue of having no ambulance access in the city. This program utilizes motorcycle sidecars specifically to transport patients, which was a successful method that people originally used in South Africa.

The Future of Health Care in the DRC

The World Health Organization (WHO) has continuously been an important player in the health care progress of the DRC. It has partnered with non-governmental organizations to deliver medicines and various other resources to hospitals and clinics in areas where people have limited health care access. In the interest of continuing the progression of the country and establishing a functional health care system, WHO also remains dedicated to analyzing and quantifying statistics within the country that gives organizations clues on what they need to do next. These statistics are able to pinpoint issues in specific areas, therefore making it easier for government and international organizations to act, provide aid and implement programs for improvement. The continuation of this data collection will hopefully allow for more health care progress in the future.

There is still a lot to do in the DRC when it comes to health care. There are organizations and efforts dedicated to treating all of the diseases and epidemics that threaten the country’s current health care progress like malaria, cholera, tuberculosis, HIV/AIDS and more. Some organizations involved in the nation even specifically focus on the care of mothers and children or improving sanitation conditions.

It will be small, incremental changes over time that will lead to continued health care progress within the region. The country cannot fix everything at once, but the collective efforts and partnerships of international organizations and governmental entities have already dragged the country out of its most difficult struggles with health care and access to health resources. The continuation of these practices will ensure the building and sustainment of a functional and reliable health care system, therefore alleviating the worries of so many citizens within the DRC.

For now, health care progress in the DRC is on track and only time will tell how these small initiatives eventually reform and reshape the country’s health care system entirely.

Hannah Easley
Photo: Flickr

Improving Living Conditions in Dharavi
Mumbai, India plays an integral role in improving living conditions in Dharavi. Being a port city, Mumbai is the commercial capital of India, having operations in the manufacturing and finance sectors. Mumbai is also home to many Bollywood films. The population of Mumbai estimates over 20 million residents. The reason for this increase is because of the squatter settlements. One major squatter settlement is Dharavi, which is home to 1 million people. Dharavi is located between two railway lines on a low-lying land once a garbage dump. A highway that divides the formal city from the informal city determines which areas are slums and which areas are not. A slum is a term that people use to identify unauthorized and illegal residents. Slums often lack basic amenities, including safety measures.

The Characteristics of Squatter Settlements

  • Noisy, overcrowded and smelly.
  • Cardboard houses.
  • Lack of proper sanitation.
  • Increase of population and disease.
  • Strong sense of community.

Despite the stigma of slums, Mumbai is home to well educated, middle-class people who simply do not have adequate housing. Mumbai has been its own micro-industry. For example, it is most prosperous in the making of pottery.

Facts About Mumbai

The world’s population is 7.3 billion since 2011 and the highest growth is in low-income developing countries. Today, 50 percent of the world’s population lives in urban areas. Urban growth, also called rapid urbanization, is often located in low-income developing countries, as well as emerging and developing countries. The cause of urban growth can be due to natural diseases and migration. Moreover, the job prospects are low and crime and pollution levels rise when the population increases.

The population of Mumbai continues to increase in thousands each year. Some have cited that this could be because of the “push and pull factor,” which is when people leave rural areas for a more urban way of life. Lack of employment or housing can also push people out of rural areas. However, there may be some benefits for urbanization such as increased cultural wealth, more knowledge and skills in the city community and increased economically active elements of the community.

The Vision Mumbai Project

The Vision Mumbai project is improving living conditions in Dharavi by replacing squatter settlements with higher quality flats. With this project, there would be more schools, more shops, better health care centers, better roads and more jobs. Estimates determine the cost to improve the living conditions of Dharavi as 2 billion euros, however.

The current slum redevelopment is based on the government’s initiatives in 1995. Today, private developers can purchase slum land from the government at 25 percent of the fair market value and redevelop it. This means utilizing a plan and developing tools to control population density. Further, they can use building designs to secure safety and health initiatives.

With purchasing and obtaining 70 percent of slum dwellers’ consent, the project is moving forward by removing the dwellers and re-housing them in a free of cost multi-story building. However, the project will only provide this to slum dwellers who can show proof that they occupied the residence prior to Jan. 1, 2000.

Also, on other land areas, the developers may construct other buildings and sell them on the market as a free sale component. An example of this would be the Imperial Towers, the tallest building and one of the most expensive in India. It is obvious the redevelopment initiative has brought growth to the country as real estate in this area has grown since then.

The Slum Redevelopment Authority

The government of Maharashtra implemented an oversight agency called the Slum Redevelopment Authority in 1997. This agency was responsible for evaluating and approving slum redevelopment proposals. In the past two decades, it reestablished and rehabilitated .15 million tenements, as well as approved .12 million more that are waiting to begin.

Another step in improving living conditions in Dharavi includes the implementation of a motorized concrete producer. On April 1, 2012, Dharavi received a motorized rickshaw that weaves around the slums carrying 15-liter buckets of slow-setting concrete. Due to this innovation, residents can add on to their homes. Houses are more spacious, stronger, safer and more comfortable. This adds to a better quality of life for each resident and a start to better living conditions in Dharavi.

– Michelle White
Photo: Flickr

Mental Health for Syrian Refugees
Since the Syrian crisis in 2011, the displaced population has migrated to neighboring countries such as Turkey, Lebanon and Jordan. Currently, 50 percent of the population are children without parents. Mental health issues have risen in the Syrian refugee community since then and the world has stepped up in treating the debilitating aspects of suffering traumatic events. This article highlights the improvements in the mental health of Syrian refugees.

Challenge and Impacts

Refugees that have to leave their homes and migrate elsewhere face many obstacles and challenges. Post-migration challenges often include cultural integration issues, loss of family and community support. Refugees also experience discrimination, loneliness, boredom and fear, and children can also experience disruption. Circumstances uproot them from friends and family and cut their education short. Refugees experience barriers in gaining meaningful employment and they face adverse political climates.

Depression, anxiety and post-traumatic stress disorders (PTSD) are all effects of exposure to traumatic events. Traumatic events for Syrian refugees include war terrorist attacks, kidnapping, torture and rape. Meta-analysis all show a positive association between war trauma and the effects of certain mental health disorders. For example, a study examining the mental health of post-war survivors from Bosnia, Croatia and Kosovo showed PTSD as the most common psychological complication.

Post-Traumatic Stress Disorder is a debilitating disorder that intrudes on the patient’s mind. It also intrudes on relationships and the patient’s ability to live a quality life. Thoughts of suicide and/or avoidance are also symptoms of PTSD.

A study of Syrian trauma and PTSD participants found that those between the age of 18 and 65 have experienced zero to nine traumatic events. Of those, 33.5 percent experienced PTSD and 43.9 percent depression. Another study in Lebanon showed that 35.4 percent of Syrian refugees will experience a lifetime prevalence of PTSD.

According to the United Nations High Commissions, 65.6 million people worldwide are “persons of concern.” That total includes 22.5 million termed “refugees” and several other millions termed “asylum seekers” or “internally displaced persons.” Survivors of torture account for 35 percent.

Health Care and Integrated Care

The National Institute of Mental Health identifies integrated care as primary care and mental health care; cohesive and practical. Primary care practitioners recommend conducting a thorough history check of any exposure to or experience of traumatic events. Health care professionals must be able to effectively address mental health issues. Barriers have long been the cause of mental health issues left untreated. Such barriers include communication, lack of health practitioners to patients in need, the physical distance patients must travel and the stigma of having the classification of “crazy.”

Treatments and Evidence-Based Interventions for Refugees

There have been several test instruments that provided significant results in the treatment of mental health as well as scalable interventions. Currently, the only FDA-approved drug both abroad and in the U.S. are paroxetine and sertraline; both selective serotonin reuptake inhibitors (SSRI). Other instruments include the Narrative Exposure Therapy, Eye Movement Desensitization and Reprocessing. Many found EMDR to be successful in reducing episodes of PTSD and depression in a study with Kilis refugees.

In 2008, the World Health Organization launched the Mental Health Gap Action Programme (mhGAP). This endeavor focused on assisting low and middle-income countries in providing effective mental health treatments. Inventions such as Task-shifting, E-Mental Health and PM+ fall under the mhGAP umbrella. First, the task-shifting initiative aims at alleviating the pressure on a limited number of specialized practitioners. Task-shifting shifts duties and tasks to other medical practitioners which otherwise highly-trained specialists would perform. This initiative is cost-effective and proves to be a promising alternative. Refugees can receive treatment in primary and community care locations instead of specialized facilities. Meanwhile, E-Mental Health and PM+ aim to address multiple mental health symptoms at once, while allowing treatment to remain private and within reach to Syrian refugees. Finally, the EU STRENGTHS, also created under the mhGAP umbrella, strives to improve responsiveness in times of refugees affected by disaster and conflict.

Many Syrian refugees continue to face obstacles and barriers, however, there is hope. Initiatives such as those mentioned in this article provide a promising outlook for the continued mental health improvements of Syrian refugees.

Michelle White
Photo: Flickr

Under Skin Vaccination
Bioengineering researchers at M.I.T. have developed a method to store and maintain immunization records for people in developing countries, primarily children, who have little or no access to paper records. The M.I.T. researchers have applied an invisible dye technology to detect patterns of quantum dots; one can place this dye under the skin during vaccinations. Once administered, a computer similar to a smartphone interprets the near-infrared marks to access medical records. If further improved, this technology could save lives by helping to maintain an accurate medical history for vulnerable populations. Here are 10 facts about under skin vaccination.

10 Facts About Under Skin Vaccination

  1. Immunization records can be challenging to maintain in developing countries. Keeping track of a child’s vaccination history, for example, may rely on an underserved hospital or community to maintain paper files. People can lose such files in areas of poverty and political discontentment or they can suffer damage, thereby erasing the child’s medical history. Further, parents may forget their child’s medical history, and especially as the result of no centralized database for record-keeping. Under skin vaccination is a promising initiative to reduce these issues.
  2. Verifying immunization history is a cumbersome process. For example, in 2015, the Ministry of Health in Ethiopia invited Dr. Wilbur Chen of the Center for Vaccine Development and Global Health at the University of Maryland to verify immunity coverage for children in rural areas. The process involves taking blood samples and testing immunization in labs, a lengthy and expensive process. Dr. Chen and his team found a big difference in the reported versus actual vaccination rates. Researchers, such as Dr. Chen, find under skin vaccination methods an innovative way to reduce this consumptive process.
  3. Record-keeping problems contribute to 1.5 million vaccine-preventable deaths per year. According to global health experts, the majority of these deaths come from developing countries where resources for maintaining records are lacking. Holes in medical record-keeping may constitute an incorrect vaccine type, brand or lot number for vaccine recipients. A lack of accurate training for maintaining complete records may lend to the problem, depending on the country.
  4. Researchers at M.I.T. are developing trials of a new record-keeping solution by embedding records under the skin. So far the trials have successfully embedded records on pig, rat and cadaver skin. The purpose of the study was to decentralize medical records since centralized databases only exist in wealthier, developed nations that have resources to maintain records. One of the bioengineers, Ana Jaklenec, admits that she was inspired by Star Trek’s “tricorder” device that scans a body for its vital signs and medical history, eliminating the need for maintaining medical records.
  5. New research combines vaccines with an invisible dye that administers concurrently. The invisible dye is naked to the eye but one could interpret it easily with a cell-phone filter that detects near-infrared light to see the coded marks. It is likely the dye is visible for up to 5 years, a crucial period of time for vaccinating children. During this period of time, children typically receive immunizations in several doses, such as in measles, mumps and rubella (MMR). Medical professionals could pair typical vaccines with the invisible dye to incorporate decentralized records.
  6. The new dye in the vaccines includes nanocrystals. Researchers call these nanocrystals quantum dots, which can project near-infrared light for detection by specialized phone technology. The quantum dots are copper-based, measuring four nanometers in diameter and encapsulated in spherical microparticles of 20-micron diameters. The encapsulations permit the dye to remain under the patient’s skin after they receive an injection.
  7. Instead of traditional syringes, the new vaccination type that scientists developed uses microneedles. Medical professionals can administer both the vaccine and the patterned die easier by using a patch that resembles a band-aid to on the skin. In addition to improvement in record-tracking, the new delivery method would not require a skilled medical professional or expensive storage costs. The dye patterns can also be customizable in order to correspond to the vaccine type, brand or lot number.
  8. Jaklenec and her M.I.T. colleagues found no difference compared to traditional injection methods. The team tested the microneedle patch method on lab rats with a polio vaccine. The team found no difference in antibodies when it compared it to traditional syringe methods of vaccine administration. Compared to the scar that smallpox vaccines caused (now eradicated worldwide) the microneedle-patch method leaves no visible trace.
  9. The invisible dye vaccine can create a discreet record-keeping method for families. According to bioengineer Mark Prausnitz of Georgia Institute of Technology, the invisible “tattoo” would provide patient confidentiality in the absence of adequate record-keeping and medical information while also providing improved record accessibility. The microneedle-patch method also avoids more controversial recognition technology such as iris scans.
  10. The M.I.T. team is working towards a feasible international immunization method, specifically aimed at poorer countries. For future applications of under skin vaccination development, the M.I.T. researchers are surveying health care providers in African countries to assess the best way of implementing this method of immunization tracking. They are also working to increase the amount of data they can store in the embedded code with information such as administration date and lot number of the vaccine batch.

These 10 facts about under skin vaccination development illustrate advancements in record-keeping. Utilizing these technologies, developing countries would have advanced strategies for tracking immunizations, ultimately increasing vaccination efficacy. This new method could potentially reduce the number of unnecessary deaths due to lost or forgotten medical information with a noninvasive, safe technology during critical years of childhood development. It could also be the start of a new system of storing data through biosensing that could significantly improve health care like that seen in futuristic science fiction.

Caleb Cummings
Photo: Flickr

 

Randomized Control Testing
“It can often seem like the problems of global poverty are intractable, but over the course of my lifetime and career, the fraction of the world’s people living in poverty has dropped dramatically.” – Dr. Michael Kremer

In October 2019, Michael Kremer of Harvard and Esther Duflo and Abhijit Banerjee of MIT won the Nobel Prize in Economics for their extensive, randomized control testing-based research in tackling global poverty. At 46 years old, Duflo is the youngest economics laureate ever and only the second woman to receive the prize over its 50-year history.

Incorporating Scientific Studies

The trio set out to establish a more scientific approach to studying the effects of investment projects in the developing world. One of the ways they discovered that they could accomplish this is through randomized control testing. Commonly used in the medical field and made legitimate in the social sciences by the trio, this type of testing involves randomly selecting communities as beneficiaries of experimental projects. Randomly selecting the beneficiaries removes selection bias, providing more accurate and legitimate results.

Randomized Control Testing in India and Kenya

Duflo and Banerjee used randomized control testing experiments in schools in India in an effort to improve the quality of education. The authors discovered that simply getting students to school was not sufficient in improving test scores. Previous research also noted that additional resources, even additional teachers, had minimal impact on students’ performance.

The laureates discovered instead that providing support for an interventionist to work with students behind on their educational skills and making computer-assisted learning available so that all students could have additional math practice improved their scores. In the first year, the average test scores increased by 0.14 standard deviations and in the second year, they increased by 0.28 standard deviations. In the second year, the children initially in the bottom third improved by over 0.4 standard deviations. Those sent for remedial education with the interventionist saw 0.6 standard deviations increase and the computer-assisted learning improved math scores by 0.35 standard deviations in the first year and 0.47 in the second year for all students equally. These results provide clear and definite numbers on the success of the program and show that those who experienced the most benefits were the students in the greatest need of assistance.

Kremer completed a similar study in Kenya. Again, the research found that additional resources did little to improve the learning abilities of the weaker students and that much of the school policies and practices were helpful to the advancement of the already high achieving students. Another of Kremer’s studies in Kenya further showed the impact small interventions can have on student retention. His research found that by bringing deworming medication directly into the classroom, school absenteeism rates decreased by 25 percent, leading to higher secondary school attendance, higher wages and a higher standard of living.

Impact vs. Performance Evaluations

The key to Kremer, Duflo and Banerjee’s success was not the result of pumping out positive statistics. Their success, and reason for winning the Nobel Prize, came from the rigorous scientific approach they took with their studies by using randomized control testing that led to not only positive results but also to meaningful impact where they were working and beyond. For instance, after the success in Kenya with the deworming, the U.S. Agency for International Development (USAID) agreed to finance Kenyan scientists to travel to India to help expand the program. Soon, 150 million children were receiving treatments of deworming medication each year.

This example shows the lasting impact of the work of the laureates. When the fields of economics and politics use more rigorous and randomized studies, it becomes clearer what programs work and which do not, creating greater efficiency and enabling successful projects to expand. The work of the three professors has already led to the leaders of USAID to question the utility of performance evaluations over impact evaluations. In other words, the agency has started to see a shift from success defined as the generated output of the programs to success as the net gain or impact as a direct result of the programs.

Altogether, the work of Kremer, Duflo and Banerjee has raised the bar for economic and social research in the future. Their work has set new expectations that will force researchers to create more detailed and accurate studies that will continue to guide policy.

– Scott Boyce
Photo: Flickr

Abandoned Baby Rate in South Africa
The abandoned baby rate in South Africa is often a touchy subject. Rather than speak about it, most people simply tend to donate their money to those children in need while others support the charities that provide for them. In some cases, a select few people will engage in hands-on volunteering, whether it is volunteering their time or their services to assist these abandoned babies in South Africa.

However, how often do people come across a clothing boutique that does all of the above? Fab’rik is an Atlanta-based franchised boutique that has more than 40 locations nationwide. The boutique has an in-store line, Asher, that strives to give back to abandoned babies in South Africa with the proceeds it makes from each garment sold.

Abandoned Baby Rate in South Africa

South Africa has approximately 18.5 million children and 4.5 million of those children do not live with their parents. Over the past decade, approximately 5.2 million children in the country were orphaned, showing a 30 percent increase in orphans. About 3,500 children survive abandonment each year according to a study that the Medical Research Council conducted in 2018. The study found that for every child that was alive, at least two were dead. The same research concluded that 65 percent of abandoned children were newborns and 90 percent were under the age of 1.

The abandoned baby rate in South Africa is increasing at an alarming rate. Even more alarming are the places that people are leaving these babies behind. The research found that others have previously underestimated the rate of abandonment because of where the culprits are dumping babies. They are disposing of babies in toilets, landfills, bins, gutters and other places where the probability of others finding them is unlikely. People seldom find the baby bodies that some flush down drains or animals eat.

Why Are Some Abandoning Babies in South Africa?

The rise of the abandoned baby rate in South Africa is in part due to the legalization of abortions. Though abortions are legal in South Africa, there remain many African communities that chastise women who resort to having late abortions or abortions period. In turn, African women who have unwanted pregnancies must undergo unsafe and illegal abortions. Other reasons some abandon these babies are because of poverty, high levels of HIV and social conditions.

What is the African Government Doing to Help?

The South African government has not done much to reduce the abandoned baby rate in South Africa. Abandonment is, unfortunately, not on the government’s radar and it is a problem that has plagued the country for years with no apparent decline. Due to the lack of government-based research, there is no research that the African government has conducted to date to track abandonment rates, just as there are no measures in place to counter it. The government currently does not consider baby abandonment in South Africa a violent crime, nor does it include it in the country’s crime statistics or list it as a cause of death in South African mortuaries. As a result, there is no sure way to tell the accurate number of babies who die from abandonment each year, making it difficult to depict the impact and length that the abandoned baby rate in South Africa extends.

Fab’rik CEO Has the Vision to do Good in Africa

The CEO and founder of Atlanta-based boutique, Fab’rik, seeks to help decrease the abandoned baby rate in South Africa. In 2002, Dana Spinola left her corporate America job to open up her first boutique. Not only is Mrs. Spinola the CEO and founder of clothing boutique Fab’rik, but she is also a philanthropist. In 2011, Spinola launched the Asher collection, a clothing line in her stores. The clothing line has the name of her daughter who Spinola adopted in 2004 at just 6 months old and is from Ethiopia. The boutique owner found the baby abandoned by the roadside which inspired the clothing line. The proceeds from the Asher collection go towards the adoption process of orphaned children in Africa, and for Spinola, it is an affirmation of her belief that clothing does change lives.

Asher’s Proceeds Create Opportunity for Abandoned Babies in Africa

On average, mothers abandon a total of hundreds of babies each month. They leave these babies in African hospitals, police stations and even outdoors. The prevalence of abandoned babies in Africa has spiked. However, the Asher clothing line has sought out to be of assistance to them. Asher is a collection of women’s clothing that allows its buyers to look good and do good. The Asher collection fights to face the reality of baby abandonment.

With the Asher Babies Program, the clothing line’s proceeds allow space for a safe, loving home, health care, development therapy and educational opportunities to abandoned and orphaned children in Africa. Every store that sells Asher merchandise has the opportunity to pair with an Asher Baby. That store is then able to write, video message and eventually meet its Asher baby. Each garment that the Asher collection sells goes toward a specific baby to fund their specialized needs and to assist in finding them a forever family and a forever home through adoption.

The Asher Babies program continues to provide for the babies through childhood and into their adolescence. There is a dire need for people like Dana Spinola and the Asher collection, whose primary focus is to help decrease the abandoned baby rate in South Africa and to provide forever homes to the babies that others too often discard and forget.

– Na’Keevia Brown
Photo: Flickr