Information and stories about global health.

Polio Program in SomaliaSomalia is one of the few countries remaining with a risk of poliovirus transmission. The polio program in Somalia was established as a way to eradicate the virus completely as part of the global immunization effort. However, with the arrival of SARS-CoV-2, the polio program in Somalia has been stifled. Somalia ranks 194 out of 195 on the Global Health Security Index. The international recommendation for healthcare workers is 25 per 100,000 people; however, Somalia only has two per 100,000 people. The country also has only 15 intensive care beds for a population of 15 million. It is considered to be among the least prepared countries in the world to detect and execute a quick response to COVID-19.

Effects of the Pandemic on the Polio Program in Somalia

Many of the workers that are part of the polio program in Somalia have suspended all door-to-door immunization due to the ongoing coronavirus pandemic. With travel kept to a minimum, polio samples cannot be flown abroad to external medical labs for testing. In addition to this, millions of polio vaccines will expire in a matter of months.

The global polio immunization program paused at the end of March 2020, leaving more than 20 million workers and medical practitioners without work. The World Health Organization (WHO) estimates that the number of unvaccinated children could reach 60 million by June in the Mediterranean region.

The Polio Program Fights COVID-19

Polio surveillance systems are developed disease surveillance systems. This network of disease surveillance has been able to track the poliovirus and deploy medical teams throughout the world. Now, the polio program in Somalia has shifted its efforts to combat the COVID-19 pandemic. The system’s infrastructure, its capacity and the experience of its medical staff make it prepared to deal with the novel coronavirus. As of July 2020, Somalia had approximately 3,000 confirmed cases of COVID-19 with 930 recovered cases and 90 deaths. The number of actual cases is likely significantly larger, but many cases go undetected due to a lack of testing.

Thousands of frontline workers for the polio program in Somalia started curbing the spread of the coronavirus. These workers form rapid response teams trained to detect COVID-19 cases as well as to educate and raise awareness about the ongoing pandemic in Somalia. WHO’s national staff and local community healthcare workers have joined theses polio response teams, utilizing their resources and skills to tackle the virus.

WHO Support

These teams have traveled to remote areas in Somalia, providing critical information regarding physical distancing, hand-washing, detection of symptoms and prevention. With WHO’s aid, the program has acquired testing kits and equipment to evaluate potential cases of the virus. The surveillance teams have adopted the same procedures that they used for the polio program in Somalia for COVID-19. After collecting potential COVID-19 samples from suspected cases, the rapid response teams transport the samples to external laboratories for testing. Outside humanitarian agencies use the same protocols and operations that they used for the poliovirus.

Furthermore, the response teams continue polio immunization simultaneously with the COVID-19 response. It is essential for the polio program to continue immunization, as Somalia experienced a polio outbreak earlier this year.

How Other Countries Have Adapted

Other countries in the same region have realized the practicality of the polio network. They have accordingly redeployed their own immunization programs to fight COVID-19. For example, South Sudan has converted approximately 80% of its polio workforce to track coronavirus cases in the country. It has trained polio contact tracers to evaluate people for symptoms of COVID-19. Mali has also been engaging its own polio program in response to the ongoing pandemic.

Even though polio and COVID-19 do not have much in common, the polio program is an important tool to fight the pandemic. The Bill and Melinda Gates Foundation, in partnership with the WHO, has been working to equip these polio networks to help countries deal with the pandemic. The suddenness of the pandemic has left no time for countries such as Somalia to prepare. As such, the global polio immunization campaign is a valuable resource for this unprecedented emergency.

Abbas Raza
Photo: Flickr

positive covid-19 storiesThe COVID-19 pandemic has undoubtedly changed the world. While many countries have been devastated, three countries have positive COVID-19 stories: New Zealand, Thailand and Vietnam. Here are their positive COVID-19 stories and the lessons they learned from their experiences.

New Zealand

The pacific island nation of around 5 million people had a couple of different strategies in its response to COVID-19. In particular, unity within New Zealand and the nation’s neighboring countries played a big role in the country’s success against the virus. New Zealand offered to help its neighboring countries to prepare for the pandemic. To do so, the country offered health training and made sure that its island neighbors had supplies to fight the virus. Importantly, this unity in New Zealand bridged across political party lines when needed. This resulted in a massive stimulus package passed just weeks after the country’s first case. The stimulus totaled NZ$12.1 billion, around 4% of the country’s GDP. Included in the stimulus package is support for businesses, support for testing and health services and payments to those who couldn’t work because of the virus.

Caution also plays a big part in New Zealand’s success against the virus. The first case of the virus was detected on 28 Feb. 2020. Even before that, however, the government took measures to limit the possible damage of COVID-19. When New Zealand only had 283 cases, the government ordered all non-essential workers to work from home to limit the virus’s spread.

Moreover, the government came up with a four-level alert system to help people know how the virus is spreading. Level one means the disease is contained in New Zealand and level four means community transmission is happening and the disease is not contained. Given how much time the country has spent in the lower levels, its represents one of many positive COVID-19 stories that the whole world can learn from.


Thailand is one of the countries that have positive COVID-19 stories. The Asian country of almost 70 million people was designated a success by the WHO. The economy of Thailand is one that is heavily built on tourism, with one-fifth of GDP coming from the tourist sector. However, since the virus has spread, the government of Thailand has had to make economic sacrifices to protect public health. The country had to close its borders to certain travelers, including many Chinese provinces. In addition, Thailand postponed many sporting events and held them without fans to slow the spread of the virus. In particular, Bangkok was in a partial lockdown with only essential services remaining open. Slowing down activity does hurt the economy, but it eases the blow of the virus.

Thailand has also mobilized more than 1 million health volunteers to help respond to the virus. In addition, the government’s health officials have taken the side of precaution throughout the pandemic. This includes rigorous hygiene and wearing face masks at all times. Moreover, Thai people have generally followed the advice of medical professionals, which has contributed to the Thailand’s COVID-19 success story. The Thai government also has one centralized administration, which helped with communication and organization throughout the pandemic.


Vietnam is also among countries with positive COVID-19 stories. Vietnam’s actions to deal with the virus came early and were aggressive, taking place before the virus even entered the country. This early and decisive action is one of the measures that helped Vietnam early on and controlled the virus’s spread. In early January 2020, Vietnam was already preparing for drastic action before there was a recorded case in the country.

Vietnam enacted travel restrictions, closed schools and enacted a rigorous contact and tracing system, while also canceling public events. Governmental communication was upfront and transparent. Consequently, this helped with public compliance to slow the virus outbreak. Vietnam has been one of the best countries in regard to wearing a face mask, which helps slow the spread of the virus. A coordinated media effort throughout Vietnam has also helped the public and government be on the same page in response to the virus.

Another reason Vietnam has been successful in limiting the spread of COVID-19 is its testing. The country tests everyone in quarantine whether they have symptoms or not. This helps slow the spread of the virus, because not everyone who is infected shows symptoms. As a result, younger people who may be infected but don’t have symptoms don’t infect those who may be at higher risk of death to COVID-19. While there was no nationwide lockdown, Vietnam did impose containment on certain areas to reduce the spread of the virus. In February 2020, when a small handful of cases were in the area of Son Loi, the government sealed off the area to prevent the spread of the virus.

What We Can Learn from These Countries

These three countries show positive COVID-19 stories despite a situation that has turned negative in so many countries. A few similarities have emerged between the countries and their success. One is the unity between government and people, which is important to building communication and trust. When citizens trust their government and can easily access clear guidelines, they are more likely to comply with health measures to reduce the spread of the virus. Another similarity between these countries is that it’s better to be cautious rather than reckless. This helps to slow the spread of the virus and make it easier to track. With all the hardship and destruction brought on by COVID-19, these countries with positive COVID-19 stories show how to keep as many people as safe as possible.

Zachary Laird
Photo: Pexels

Obstetric Fistula in Nepal
Many women in Nepal are shunned for obstetric fistula, even though they are completely preventable holes in the birth canal. One woman, Dhani Devi Mukhiya, recalls what the villagers in her community told her. They said it was “punishment for a sin” she committed in a previous life. Her relatives ignored her in public and her husband threatened to take a new wife. Unfortunately, this is the story for many women who suffer from obstetric fistula in Nepal, especially in rural areas. Both their communities and families shun them. However, one campaign is working to give them back the lives that have been taken away from them as a result.

What is an Obstetric Fistula?

An obstetric fistula is a small hole in the birth canal that leads to incontinence. The injury often results from childbirth complications, with high frequency in adolescent pregnancies. If left untreated, the hole can cause an infection, pain and depression resulting from severe shunning and social isolation. Obstetric fistula in Nepal is common because of high rates of child marriages, poverty and lack of access to care. The mountainous geography and rough travel conditions prevent many people from receiving the health services they need, as it is difficult to get to a hospital. more than 2 million marginalized women across the globe suffer from this complication. These women include child brides, those without access to money and those without access to maternal services.

Is it Preventable and Treatable?

Obstetric fistula has been practically eliminated in industrialized nations because of how easy they are to prevent and treat with access to maternal care. The main problem is that Nepalese women still lack sexual and reproductive health information and services. Due to this, 4,300 women live with obstetric fistula in Nepal, and there are 200-400 new cases each year. This statistic may not even be accurate; obstetric fistula in Nepal often goes unreported due to its high stigmatization.

The Good News About the Issue

This is the good news: the Campaign to End Fistula is actively working to give these women back their lives. Established in 2010, this program, supported by the UNFPA (United Nations Population Fund), provides surgery and post-op care for women in rural Nepal. The surgeries take place at B.P. Koirala Institute of Health Sciences, the only public, high-tech hospital in the region. Now, it is an obstetric fistula training center.

To these women, the surgery on offer is not just a surgery. It is a life without pain, a life without stigma and a life without isolation; it was like “walking out of prison” for Ms. Rajdhobi. The program resulted in the performance of 487 surgeries since 2012, and the issue is gaining awareness. Because of the efforts of the Campaign to End Fistula, May 23 is now celebrated as the International Day to End Obstetric Fistula in Nepal. The Campaign together with UNFPA has helped the world to recognize obstetric fistula as a public health issue and has enabled numerous advocacy programs. It will take time to end the stigma surrounding obstetric fistula, but great strides have been made.

Fiona Price
Photo: Flickr

diarrheal disease in sub-saharan africaEvery year, millions of children under the age of 5 die. Of those children, almost 40% come from Africa. The chance of death for a child living in Africa is seven times higher than that of a child in Europe. This marks the need for improved medical care and foreign aid, especially because many of these deaths are caused by diarrheal diseases. Diarrheal diseases are the second highest cause of death around the world, with over 1.5 million deaths each year. While any country’s children can be susceptible to this illness, developing countries have a marked disadvantage. Many of the countries in sub-Saharan Africa, where the disease is prevalent, don’t have access to proper sanitation, clean water or viable medical care. Here are five facts about diarrheal diseases in sub-Saharan Africa.

5 Facts About Diarrheal Diseases in Sub-Saharan Africa

  1. Mortality varies greatly by region. There is a higher prevalence of diarrheal diseases in sub-Saharan Africa, but especially in impoverished nations. Additionally, within sub-Saharan Africa, certain countries have much higher mortality rates than others due to these diseases. More than half of the global deaths that occurred in 2015 due to diarrheal diseases came from just 55 African provinces or states out of the total 782 that exist.
  2. The problem is partially economic. Diarrheal diseases don’t only impact the health of these countries’ citizens, but they also take a massive toll on the economy. An estimated 12% of governmental budgets go toward treating these diseases in some countries. Moreover, the World Bank estimates that almost 10% of these nations’ total GDP goes toward the treatment of these health issues. Individual members of each country also feel the monetary blow of obtaining treatment. In many of these countries, the salary of the average citizen is around $1.00 a day. One Kenyan mother named Evalyne was unable to save her son from a diarrheal disease because she couldn’t afford the $0.25 needed for oral rehydration therapy.
  3. There are more victims of these diseases than just children. A lot of the information about diarrheal diseases in sub-Saharan Africa focuses on children under the age of five. However, people over the age of 70 are also very susceptible to diarrheal diseases. The demographics of these two groups are unique. Most children die from diarrheal diseases in Chad, the Central African Republic and Niger. Nevertheless, most elderly people die from diarrheal disease in Kenya, the Central African Republic and India. The differences don’t end there. Most children who contract a diarrheal disease are plagued by the rotavirus, but the elderly have proven to be most prone to another virus named shigella.
  4. The diseases are treatable and even preventable with the right precautions. There are many precautions that can be taken to avoid catching diarrheal diseases in sub-Saharan Africa. One of the most important preventative actions is to do everything possible to consume clean water. Around the world, 40% of the population doesn’t have easy access to adequate sanitation. Many children and adults don’t have soap to wash their hands with after using the bathroom, and oftentimes, the water they use is contaminated. Washing one’s hands and working to improve local water supplies can drastically improve one’s chances against diarrheal diseases. Treating citizens with supplements like zinc and vitamin A can also lessen the severity of diarrheal episodes. Other than supplements and better water, oral rehydration therapy is a great way to treat the illness. Families can use oral rehydration at home by combining salt, sugar and clean water to prevent crippling dehydration. Another potential solution is a rotavirus vaccine.
  5. Education and competition can change the future. In some countries, access to clean water and proper sanitation seems impossible. However, providing communities with the resources and knowledge of how to improve sanitation and lower the risk of diseases has demonstrated that change is possible. In Cameroon, the World Wildlife Fund partnered with Johnson and Johnson to provide training and resources to the members of various communities. This helped them build more sanitary bathrooms and create new and viable water sources. One reason that these programs were so successful is that they created competitions among villages. This became a friendly way of motivating each other toward success.

Diarrheal diseases in sub-Saharan Africa continue to plague areas without clean water or access to healthcare. However, as time goes on, more and more programs and organizations aid in the control of these illnesses. For example, since 2018, ROTAVAC, a rotavirus vaccine, was prequalified by the World Health Organization for use in Ghana. This qualification is specifically focused on providing vaccines to those in countries without easy access to vaccination. Ghana is now the second country in Africa to place ROTAVAC as part of its program to immunize citizens against diarrheal disease. Doing this raises awareness across regions about a future where disease prevention is all the more possible.

Lucia Kenig-Ziesler
Photo: Flickr

COVID-19 in Brazil
Brazil, the largest South American nation, recently recorded 100,000 casualties from the novel coronavirus (COVID-19). The country now has the second-highest figure of deaths linked to COVID-19. They come after the United States, which has over 150,000 casualties as of August 2020. President Jair Bolsonaro dismissed the effects of the virus out of concern for the nation’s economy. However, physicians working in the Brazilian Ministry of Health debated with him over the effects of social distancing. They also debated over the use of the controversial hydroxychloroquine on ill patients. Unable to come to an agreement with Bolsonaro, both ministers resigned from their position.

With conflicting views among Brazilian leaders on how to contain the virus, concerns start to rise. These concerns are about plans to mitigate the disease in Brazil, or the lack thereof. As the numbers increase, other leaders around the world have taken the initiative to halt the coronavirus’ spread in Brazil.

Environmental Activist Greta Thunberg’s Contribution

Greta Thunberg is a Swedish teenage activist prominent for mobilizing youth all over the world around the cause of global warming. She is donating $114,000 of prize money she received directly to efforts mitigating the coronavirus outbreak in the Amazon. She plans to send it to SOS Amazônia, a nongovernmental organization focused on protecting the Amazon rainforest. It also focuses on providing access to food, healthcare and hygiene to indigenous communities in the most vulnerable regions. This is not the first time Thunberg has contributed financially to weather the effects of the pandemic. In May 2020, she donated an additional $100,000 of the award money to UNICEF to protect children from the coronavirus. By aiding Brazilians’ fight against COVID-19, she hopes to bring awareness to people on the front lines affected by the climate crisis. This particularly applies to people in the global South.

Taiwan’s Efforts

The East Asian nation had a quick reduction of the virus during the early stages of the pandemic. It is also stepping in to contribute supplies in Brazil’s battle with the disease. Tsung-che Chiang, the nation’s representative to Brazil, donated 100,000 face masks to the residents of Manaus, a city suffering one of the biggest outbreaks of COVID-19 in Brazil. The masks will be sent by the Taiwanese government and distributed by the Manaus health department to public hospitals. This will protect medical personnel in the front lines of the virus’s battlegrounds. After Brazil, Taiwan has expressed interest in providing aid to other countries with high numbers of COVID-19 cases, under the Taiwan Can Help program.

Help from the Vatican

Vatican became aware of the lack of supplies in a hospital treating indigenous patients with COVID-19 in Brazil. As a result, Pope Francis sent a temperature gauge and respirator to the Campanha de Maraba Hospital that the apostolic nunciature in Brazil delivered. President Bolsonaro vetoed a law that would have provided indigenous populations with extra supplies and hospital beds due to their vulnerability to the virus. Because of this, the hospital was very much in need of the supplies. Pope Francis’ expressed affection for the Amazon made this contribution even more significant to the community near the hospital, which is predominantly Catholic. Including the aforementioned respirator, Brazil received three other respirators from the Vatican to subdue the spread of COVID-19 in Brazil.

Although the coronavirus’s presence in Brazil shows no sign of ending, neither have the efforts of leaders across the world. Numerous nations and authoritative figures donate their time and money to afflicted regions and organizations. Their efforts go toward organizations that provide much-needed aid to marginalized communities suffering from the virus. Once a unanimously-agreed-upon plan is formulated by the Brazilian government, a decline can be seen in the number of COVID-19 cases and casualties in South America’s largest nation.

Faven Woldetatyos
Photo: Flickr

Antigua and BarbudaWhen people think of Antigua and Barbuda, they imagine the white sand beaches, high-end hotels and crystal clear water. What most people don’t think of is their healthcare system, and that’s reasonable. However, Antigua has done a fine job using its tourism-driven economy to provide for its citizens, unlike many other tourist islands. As a result, this small collection of islands in the West Indies is a special one.

Health for the Citizens

Most health care in Antigua is free through the Medical Benefits Scheme, which is paid for by a payroll tax that sets aside revenue for the health system. In 2014, the health sector received 2.77% of the country’s GDP. Considering that they are a collection of small islands, that percentage goes a long way. Antigua has 25 public health clinics with services ranging from dentistry to testing for NCDs (non-communicable diseases). The major hospital on the island is St. John’s Medical Centre in St. John, Antigua. They also have a much smaller extension of the hospital in Barbuda that holds eight beds. However, the number of health centers is growing with the improvement of infrastructure.

Natural Disasters and Diseases

Antigua and Barbuda has had a history of natural disasters plaguing their island from Hurricane Hugo in 1989 to Hurricane Irma in 2017. Irma left Barbuda uninhabited for the first time in modern history, and the population of Barbuda evacuated to Antigua. The effects of these hurricanes go past evacuating the island. They threaten the island’s food security, quality of water, tourism and even health of citizens. Though they’ve had many challenges, diseases are not very prevalent on the islands. Tuberculosis and HIV/AIDS affect less than 1% of the population.

Mother and Child Health

Additionally, at St. John’s Medical Centre, maternal health is a serious issue. Trained personnel deliver the babies, and all expenses are covered for the mother. The hospital got even better after three maternal deaths between 2010 and 2015 by providing more services and increasing patient education. Sadly, the Antigua and Barbuda did not reach the target of the Millennium Development Goal (MDG) in 2014. While the target is 8 deaths per 1,000 live births, the country’s data was 17.2 deaths per 1,000 births. Most of these deaths occur in the neonatal period and are caused by common things like injuries and prematurity.

World Health Organization Cooperation

Many agencies have provided cooperation in health on the islands throughout the years. The WHO/PAHO has continued to help through funded projects and other initiatives. The WHO currently has the Country Cooperation Strategy in place, which will be in effect until 2024. The five priorities of WHO reveal its main areas of focus. Their first priority is to establish a more universal healthcare system, getting coverage for more citizens. The main way the WHO will achieve this goal is by strengthening the Primary Health Care (PHC) to better align with the citizens’ needs. Priority two deals with the elimination of diseases and NCDs. Priority three focuses on reducing risk. By integrating mental health and substance abuse in the PHC, implementing measures for reducing NCD cases is all part of their plan.

Overall, Antigua is not just special because of its world-famous beaches. These collections of islands care more about the healthcare and well being of their citizens than most countries combined. Thinking about healthcare in Antigua and Barbuda may not be the most interesting thing. However, it gives insight into a country not normally talked about. Although it is plagued by hurricanes every few years, it still manages to take care of its citizens in the best way it can.

Bailey Sparks
Photo: Flickr

Digital Healthcare in Japan
Japan’s population is 126,406,369 as of September 2020, yet 20% of the country’s populace is above the age of 65. This is the highest rate of the elderly in relation to overall population density across the globe. By 2030, the aging populace might increase to one in three over the age of 65. With such an exacerbated aging population, digital healthcare in Japan has taken the reigns of health moving forward.

What is Digital Health?

Digital health covers an array of evolving technologies to meet the needs of the healthcare systems of the 21st century. This includes telehealth, wearable devices, mobile health, telemedicine, personalized medicine and health information technology. This empowers patients to be more connected to their health needs and healthcare team. Digital healthcare assists in disease prevention, early diagnosis and management of lifelong chronic illnesses.

Also, mobile applications have been on the rise. They help doctors to make clinical decisions without face-to-face contact. These tools have vastly optimized treatment and delivery, and it further provides a holistic view of data based on a patient’s record. These technologies aim to reduce costs, increase quality, improve access, reduce inefficiencies and make medicine personalized. In conjunction with smart devices and applications, it is changing the way health professionals communicate with patients.

The Digital Hospital

Additionally, as Japan’s population continues to age, a new approach to how hospitals operate is paramount. A culture to implement digital transformation is essential in helping management push for digital healthcare on every organizational level. Ensuring communication between various technologies and devices is critical in moving hospitals forward. With technology constantly evolving, hospitals will need to plan for aging software and hardware. Furthermore, a larger focus on data will develop a solid foundation as hospitals begin to transform into the digital landscape. As the digital age continues to revolutionize hospitals, the staff becomes a dire investment as they formulate digital strategies. Also, cybersecurity will need to proliferate to secure hospital data from potential breaches.

Japan’s Digital Healthcare Revolution

Japan’s population is aging with around 21% of the population being 65 and older, which has created a challenge for the preexisting healthcare system. The government of Japan has focused on a strategy centered around digital healthcare to help this problem. The country sees it as an opportunity for growth.

Telemedicine and mobile applications are paving the way for digital health in Japan. Patients can connect with physicians via any mobile device to access medical data and hold video chats with doctors. This removes the travel and wait times patients would have had otherwise. It would also prove to be most beneficial for patients living in remote or rural areas.

Furthermore, even virtual reality has helped healthcare workers understand how various diseases affect patients. Silver Wood Corp, a Tokyo based firm, developed a simulation to mimic the effects of dementia. It is aided in providing a deeper understanding of such a complex illness while offering help with treatment.

Overall, Japan’s population is getting older in relation to the rest of its population. However, with these new technological developments and strategies, the country is creating a more stable and accessible healthcare model. Moving forward, technologies like VR, smart devices and wearable devices will greatly improve the standard of care Japan has come to expect. With so many innovations on the rise, Japan’s digital healthcare revolution is prepared to meet the demands of an aging society.

As the new digital age of medicine takes the forefront of patient care in Japan, it will also help set a precedent for implementation across the globe. Telehealth practices can help underserved areas gain access to medical professionals without the need to spend costly time or money for an in-person visit. Nations with spread-out populations or a lack of physical infrastructure may want to look into expanding internet access and incentivizing telehealth practices to help underserved communities utilize the medical resources they desperately need.

Michael Santiago
Photo: Wikimedia Commons

SDG Goal 14Paraguay, a landlocked country in central South America, relies heavily on the Paraguay River for water and marine resources. The river is vital for Paraguayans but is becoming increasingly vulnerable to pollution and overdevelopment. This led to the achievement of the U.N.’s Sustainable Development Goals (SDG). The Paraguay Ministry of Environment and Sustainable Development and the city of Asunción started the Asunción Green City of the Americas — Pathways to Sustainability project. It was started to protect the river and to help reach U.N.’s SDG Goal 14 in Paraguay called “life below water.”

Purpose of the Sustainable Development Goals

The UN introduced its 17 SDGs to lay out a blueprint to achieve a more sustainable future by 2030. Together they work to address social, economic and environmental challenges that the world faces and move towards a sustainable future. Goal 14 is to conserve and sustainably use the oceans, seas and marine resources. With more than three billion people dependent on marine resources globally, this goal is essential to a sustainable future.

Water quality, area of protected space, biodiversity threats and levels of overfishing and other indicators measure SDG Goal 14. Paraguay has struggled with water quality. Although it has some protected wildlife reserves near water, many species are critically endangered and biodiversity has been decreasing.

About the Paraguay River and Asunción

Paraguay is a landlocked country. As a result, achieving SDG Goal 14 in Paraguay requires protecting its freshwater and river systems. The Paraguay River flows from north to south throughout the entire country. It plays an important role in the freshwater system and its health is vital to the achievement of SDG Goal 14 in Paraguay. Farmers and fishermen rely on the river and it provides a significant portion of water to the Pantanal, the largest tropical wetland in the world.

Additionally, in recent decades the river has suffered from increased levels of development and pollution due to things like untreated sewage and garbage entering the river. Poor infrastructure and management of waste lead to these items entering the river system. This harms habitat and reduces water quality. These problems are particularly prevalent in the city of Asunción. Asunción is the capital of Paraguay located on the western side of the nation. The city sits on the bank of the Paraguay River and is home to a rich variety of bird species including many migratory birds during parts of the year. The wetlands near Asunción support many other species and protect the city from flooding. The river and wetlands benefit the community by providing a source of jobs including fishing and tours as well.

The Health of the Paraguay River

Furthermore, the health of the Paraguay River near Asunción has been a concern of the community for decades. Untreated sewage as well as garbage from many landfills make their way into the river. In 2005, the Ecological Reserve of Banco San Miguel and Bahía de Asunción was created to protect the wetland ecosystem along the river. It was also a place for endangered migratory birds to rest.

The creation of the reserve was an effective first step. However, the measures taken were insufficient. Few resources were used to reverse the existing damage. With the health of the river decreasing, Paraguay was not on track to meet SDG Goal 14 by 2030. The Ministry of Environment and Sustainable Development teamed up with city officials from Asunción. With support from the U.N., it created the Asunción Green City of the Americas — Pathways to Sustainability project.

The plan aims to address multiple issues including waste management, transportation and habitat protection in order to benefit the people and wild animals near Asunción. Improved bus systems as well as walking and bicycling networks would benefit the communities of Asunción and reduce harmful emissions. Better waste management will reduce citizens’ exposure to harmful chemicals. It will also help preserve the health of the river and wetland ecosystem.


Overall, adequate protection and maintenance of the ecological reserves on the river along with improved waste management and transportation are important. With them, the Paraguay River can maintain its essential role for ecosystems and the people of Asunción. The Ministry of Environment and Sustainable Development needs to continue to work hard to protect the Paraguay River and help achieve SDG Goal 14 in Paraguay.

William Dormer
Photo: Wikimedia Commons

A Healthcare Sea Change Looms in Serbia Serbia has become a coveted tourist destination and culturally diverse nation in southeast Europe. Healthcare in Serbia operated solely as a public, state-owned system for years. The Yugoslavian communist regime established many socialistic complexes before it dissolved in the 1990s. These complexes include social welfare, pensions for retired and disabled persons and unemployment forgiveness. While these systems have persevered into the modern-day, public healthcare in Serbia has changed dramatically for the worse since the division of Yugoslavia.

Healthcare in Serbia

Serbia has maintained a public healthcare system in the last thirty years. It has increasingly suffered from widespread dysfunction caused by a bevy of underlying problems. The Serbian Healthcare System (SHCS) does not receive enough funding. In addition, it relies mostly on compulsory citizen contribution in providing insurance for all. Nearly 70% of citizens have to surrender a portion of their income to the Health Insurance Fund. Meanwhile, the other 30% have their insurance covered by additional contributions rooted in pension plans. The system guarantees health care absent of copays as well as professionally trained staff. However, the insurance fund remains relatively low in available financing for upgrading equipment and building enough medical facilities. Healthcare in Serbia ranked last in the 2012 European Health Consumer Index.

Issues with Serbia’s Public Healthcare

According to data from the year prior, public hospital institutions held 5.7 beds per 1,000 population, and under 350 medical facilities existed in the entire country. Poor funding has led to a shortage of tenable services, equipment and basic drugs available in the public sector over time.

Rising corruption has exacerbated Serbia’s public healthcare conundrum during this period as well. On a macro level, doctors give directives to patients that essentially force them to seek care in the private sector to optimize profits. Individuals that require complicated surgeries or procedures go to private clinics. However, some of them have to wait for what can be years. This is an existential threat to citizens who cannot afford expensive private care that will provide them with insulin or the removal of a tumor.

Solutions to the Issues

The widespread speculation of prominent health institutions deals with foreign pharmaceutical companies and drug producers. The speculations subvert regulation and raise the prices for patients. The corrupt practice of soliciting bribes has been a pragmatic solution for patients who want faster treatment. It has also been a solution for patients who want more advanced procedures than the public sector normally allows. Taking advantage of a system where around 75,000 patients are currently relegated to a waiting list, doctors profit off of their patients’ desperation.

More Responses to the Issues

There has been a response to the pervasive environment of corruption and non-disclosure. The nongovernmental organization Serbia on the Move (SoM) was formed. Bolstered by the backing of USAID, SoM initiated efforts to reduce corruption and equip citizens. It did this with the essential knowledge to avoid exploitative doctor-patient relationships between 2013 and 2016. One of their most powerful contributions to this cause was establishing an SMS service. The service facilitated the reporting of corruption in the healthcare sector. It has accounted for over 1,000 reports and 15 filed criminal charges. The organization has set up workshops for doctors across Serbia that offer accreditation. Over 450 doctors who passed robust courses that focused on integrity and work ethics received accreditation.

SoM’s awareness-raising initiatives mobilized over 5,000 citizens both on the ground and virtually to campaign for anti-corruption across the state. The advocacy endeavors culminated in the 2015 publication of the List of Licensed Medical Practitioners. This list is one of the largest advancements towards expanding medical transparency that healthcare in Serbia has undergone. The list provides crucial information about licensed doctors that were previously undisclosed to public record. In 2018, healthcare in Serbia ranked 18th on the European Health Consumer Index. This is a stark increase since the establishment of SoM. It was also labeled 2016 “climber of the year.”

Comparing the Public and Private Healthcare

These developments have led to a flourishing private system where many practitioners continue to flock in an attempt to escape the corruption and inadequacies of the public sector. The number of medical professionals in the private field has exceeded 10%. Many citizens are willing to pay for private healthcare in Serbia. This has led to the construction of state-of-the-art medical facilities. It has also attracted the markets of large corporations overseas eager to provide high amounts of quality equipment and pharmaceutical drugs.

The benefits of private healthcare far outweigh those offered by public healthcare for those who can afford it. Insurance typically costs a monthly premium ranging from €15 to €60. While it costs more, the quality and promptness of services are worth it. The private system receives funding from out-of-pocket payments for more advanced procedures, which is also an area that continues to expand.

Advantages of Health Tourism

Health tourism is extremely advantageous for Serbia’s private healthcare system. It attracts people from both neighboring countries and Western nations like the United States with excellent quality of care and relatively cheap rates. It’s so cheap in comparison that many Serbian diasporas living abroad in the United States elect to come back to Serbia for a broad scope of practices, from dental care to complex surgeries. The rate of collected premiums continues to outpace the GDP, which signals a thriving industry and one that will remain affordable for the foreseeable future.


Overall, the most affordable for-profit care is still bound to exclude poor people in Serbia. Also, the expansion of the private healthcare system is hardly a reprieve for those entrapped in a crumbling public system. The system still requires compulsory payment, even from those it has failed. While there are efforts to combat corruption in the system, they still have a relatively limited reach. The work has shown auspicious progress, but it is not done. The Serbian government has allowed both systems to remain afloat without fully committing to either one. Looking at how each has fared in recent years, a full reform of public healthcare or a systemic migration to the private sector may be in order.

Camden Gilreath

Photo: Flickr

Songs Recorded for COVID-19
As COVID-19 continues to spread around the world, performers and musicians from several different countries and continents have given back through music. Here are five songs recorded for COVID-19 relief.

5 Songs Recorded for COVID-19 Relief

  1. “One Love/People Get Ready” (Bob Marley and the Wailers): In July 2020, Amplified Music and Tough Gong International rereleased a new version of this 1977 reggae classic. The new song has performers and scenes from several countries, including Brazil, India, Jamaica, the Democratic Republic of the Congo, Sudan, Nigeria and the United States. Two of Marley’s children, Stephen and Cedella Marley, appear, as does Skip Marley, his grandson. Some children in the video are from the Ghetto Youths Foundation, which three of Bob Marley’s children founded. All funds will go to COVID-19 relief through UNICEF’s Reimagine campaign, helping to provide soap, personal protective equipment, masks and information for children and families around the world. On social media, UNICEF partnered with Pandora to create an augmented reality Instagram filter for the campaign, #OneLoveOneHeart. Pandora will donate $1 to UNICEF for each use of the hashtag, and Pandora is promising $1 million in total.
  2. “I’m Standing With You” (Chrissie Metz): Diane Warren originally wrote the Oscar-nominated song for the film “Breakthrough,” which Chrissy Metz performed in 2019. However, the new version, released in May 2020, takes on a different delivery. Music video director Gev Miron and composer Sharon Farber created a remastered song and video with 170 artists from all continents. Some of the performers who appear are Valeria Altobelli (Italy), Mario Frangoulis (Greece), Wahu (Kenya), Chris Mann (U.S.), Hariharan (India) and Rita (Israel). The video includes the artists singing in front of backdrops showing various global landmarks. On YouTube, the video had a donate button in late May and early June 2020. All funds generated went to the United Nations’ COVID-19 Solidarity Response Fund, which in turn went to the World Health Organization. The effort raised over $5 million for COVID-19 relief.
  3. “Times Like These” (The Foo Fighters): BBC 1 Radio organized a Live Lounge song cover of The Foo Fighters’ 2003 single to serve as a charity single. The cover, released in April 2020, features over 20 artists billed under the name Live Lounge Allstars. Some of the artists featured include Dua Lipa, Ellie Goulding, Rita Ora, Sean Paul, Chris Martin of Coldplay and Dave Grohl of The Foo Fighters. In its first five hours, the song sold 43,000 copies in the U.K. The next week, it became a number-one hit with 66,000 equivalent units sold, most of those from downloads. All U.K. proceeds went to Comic Relief and Children in Need, which will help people impacted by the pandemic. Revenue generated from sales and streams elsewhere goes to the World Health Organization’s COVID-19 Solidarity Response Fund.
  4. “The Real Folk Blues” (Mai Yamane): This song originally came out in 1998 and was the ending song to “Cowboy Bebop,” a Japanese anime series. Yoko Kanno and her band, Seatbelts, composed it. Mason Lieberman organized the new project alongside Sunrise, Inc. and Funimation. Kanno, Steve Blum and more than 40 people from the anime and gaming industries appear in the music video. The track was released to streaming and digital platforms, including YouTube, Spotify and Bandcamp. In May 2020, the latter waived its revenue share and donated all proceeds to COVID-19 relief. Q Rates also made a vinyl available, which sold more than 2,800 copies, translating to roughly $70,000 in total sales. All funds raised from the song go to the CDC Foundation and Doctors Without Borders.
  5. “Gotta Be Patient” (Stay Homas): Three Barcelona roommates originally released this song when they performed it while locked down. Michael Bublé heard the song and decided to perform a cover. The new song is a bilingual doo-wop song with contributions from Canadian band Barenaked Ladies and Mexican singer Sofia Reyes. Proceeds from the track across all streaming and download platforms will benefit various causes. Bublé will donate his earnings to the Canadian Red Cross and the Argentina Red Cross. The Barenaked Ladies will donate their earnings to Cultural Survival to help various indigenous communities, while Reyes will donate her earnings to multiple Latin charities. They originally performed the song as part of the Stronger Together, Tous Ensemble Canadian benefit concert. That event raised over $6 million CAD for Food Banks Canada.

These five songs recorded for COVID-19 relief are among the many efforts that musicians and celebrities have taken to provide aid during the pandemic to date. Their work shows that something as simple as a song can go a long way toward helping people around the world stay safe and healthy.

– Bryan Boggiano
Photo: Flickr