Archive for category: Global Health

Information and stories about global health.

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Mental Health Support in Bangladesh After Natural Disasters Strike

Mental Health Support in BangladeshBangladesh ranks among the top countries in the world in terms of deaths and home displacements due to natural disasters. Between 1970 and 2005, half a million people died from natural disasters, primarily cyclones, floods, riverbank erosion and droughts. While the main responses to such devastation have been to the physical well-being of citizens and to rebuild infrastructure, another key issue is addressing the mental health concerns of those impacted.

Eastern Floods

In August 2024, more than 500,000 were forced from their homes and 71 were killed by devastating floods. The rivers and overall water levels in cities like Feni threatened to cover the rooftops of many buildings as the water levels reached up to 30 feet in some places. Citizens directed traffic to allow emergency vehicles to arrive faster. Acts of kindness included giving out hot meals and helping evacuate stranded individuals by boat.

Besides being impacted by the flood, people in such an altered environment are at greater risk of experiencing different forms of violence. To help mitigate this problem, the government provided women experiencing gender-based violence with safe shelters. Many of these women also received psychological first aid to help manage their trauma.

Psychological first aid is not a formalized therapy session. It provides a safe space for affected individuals to process trauma and helps connect people with additional disaster relief resources. The Bangladesh Red Crescent Society (BDRCS) provided medical support for more than 83,000 individuals. Thousands also received psychological aid in the same place where medical support was provided.

People living in poverty can have their situations exacerbated by various circumstances, with extreme floods being one of the worst. About three-quarters of impoverished households see their economic situations worsen after a flood. Bangladesh lost over a million metric tons of food due to the 2024 floods, primarily rice and vegetables. This caused food prices to rise and led to increased inflation. Sixty-two percent of households regularly had scarce meals as a result.

Cyclone Sidr

A devastating Category 4 storm hit Bangladesh in November 2007, killing over 3,400 people, injuring 55,000 and displacing 500,000 from their homes. Beyond the physical damage, a quarter of those impacted by the storm suffered from post-traumatic stress disorder (PTSD).

The BDRCS organized a psychological first aid program to provide mental health support in Bangladesh after the storm. It included staff members as well as community volunteers, including 20 psychology students from Dhaka University. Over 400 additional volunteers were trained to help in highly affected areas. As part of the immediate recovery goals after the cyclone, the BDRCS aimed to help 20,000 people with psychosocial support.

The BDRCS also provided funding for individuals impacted by the storm to help them improve their situations. A woman named Misti built her own boat for a ferry service thanks to a grant from the BDRCS. She uses this boat to have a self-sustaining career and to help people escape dangerous situations when another major storm is on the horizon. There are many more success stories of people achieving financial independence thanks to BDRCS funding.

A Preemptive Plan of Action

In 2024, the World Health Organization (WHO) in Bangladesh developed a preemptive plan to mitigate the effects of future natural disasters. The WHO will increase mental health support in Bangladesh before, during and after disasters and will also seek feedback from people in refugee camps to determine how they can be better supported.

At least 16% of people in Bangladesh experience a mental health challenge due to various circumstances beyond natural disasters. However, the actual number is estimated to be much higher due to many remaining undiagnosed or untreated. Since there is a predisposition toward worsening mental health after a natural disaster, it is helpful for care in some form to be set in place every step of the way.

– Logan Hessek

Logan is based in Northglenn, CO, US and focuses on Good News and Global Health for The Borgen Project.

Photo: Flickr

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Behind the Statistics: Poverty in the Dominican Republic

A street vendor sells fruits from a cart in the Dominican Republic.Poverty in the Dominican Republic continues to affect many families despite economic growth in recent years. The World Bank states that although the Dominican Republic has experienced rapid economic growth over the past two decades, inequalities and limited access to quality jobs and public services continue to affect underserved populations. Limited access to stable employment, reliable infrastructure, affordable health care and higher education creates ongoing challenges for low-income families.

A former resident of a low-income community in the Dominican Republic, who requested anonymity for privacy reasons, described growing up in a household where survival depended on constant work. According to the source, every member of the family began working at a young age to help cover necessities such as food, clothing and utility bills.

“Every day was spent working to pay for clothes and food and keep the bills up to date,” the source said. They also stated that in a household of five children and two parents, financial pressure shaped nearly every aspect of daily life.

Economic hardship also affected social relationships and community life. Long work hours left little time for friendships, recreation or personal development. “It was just to focus on work and get money to pay bills and get food to continue living,” the source explained.

Education and School Dropout Rates

Financial hardship often creates long-term educational barriers for children living in poverty in the Dominican Republic. Families struggling to meet daily needs frequently depend on children and adolescents to contribute financially, increasing the likelihood of school absenteeism and dropout rates.

UNICEF reported that many children in the Dominican Republic continue to face educational exclusion due to poverty and limited resources. The organization found that 60% of Dominicans ages 18 to 40 had not completed school during the 2014-2015 academic period.

According to a UNICEF report, 9.9% of adolescents aged 15 to 17 were not attending school during the 2014-2015 academic period. The report also found that 24.1% of secondary students were enrolled with an overage of two or more years, increasing the risk of school abandonment and educational exclusion.

The report additionally noted that students living in rural and underserved communities face greater barriers to completing secondary education and accessing equal educational opportunities. Researchers also found that many adolescents who left school would have needed to return to primary education if they reentered the school system.

The anonymous source explained that balancing work and education created constant stress and exhaustion during childhood. Although education was valued within the household, financial hardship often took priority over long-term academic opportunities.

“In the Dominican Republic, the school systems were not the best, but it is what we had,” the source said. Financial limitations eventually prevented the individual from attending university after graduating from high school, forcing full-time entry into the workforce instead.

Education Quality and Access

Educational inequality in the Dominican Republic extends beyond school attendance to learning quality and student achievement.

According to UNICEF, education challenges in the Dominican Republic include low learning outcomes, school exclusion and unequal access to quality education, particularly among vulnerable communities. Despite increased investment in education, many students continue struggling to complete school due to poverty and limited educational resources.

UNICEF reported that only 12% of third-grade students achieved satisfactory results in Spanish language studies, while only 27% achieved satisfactory results in mathematics during the 2017 National Diagnostic Assessment. The organizations also identify school violence and unequal educational opportunities as major barriers affecting learning outcomes throughout the country.

According to UNICEF’s All Children Learn in the Dominican Republic initiative, educational programs currently focus on improving literacy and mathematics instruction, supporting vulnerable students and increasing inclusive learning opportunities for children and adolescents with disabilities. UNICEF has also worked with schools and communities to strengthen programs for peaceful conflict resolution and improve inclusive classroom practices.

These educational challenges are often closely connected to broader housing and infrastructure issues that affect low-income communities daily.

Housing and Infrastructure Challenges

The effects of poverty in the Dominican Republic also extend to housing and infrastructure. According to the source, the family lived in a crowded home where multiple people shared rooms and privacy was limited. Daily routines were often disrupted by unreliable electricity and inconsistent access to water.

“The light would always go out and there was not much access to water,” the source explained. They also described poor infrastructure in the community, including constant construction and difficult road access, which disrupted daily life.

The World Bank states that inequalities in infrastructure and access to public services continue to affect underserved populations throughout the Dominican Republic, particularly low-income communities. Limited infrastructure can also contribute to educational and health-related challenges, especially for families already struggling financially.

Health Care and Community Support

Health care expenses created major financial burdens for families living paycheck to paycheck. Instead of relying on larger pharmacies, many residents turned to smaller local “boticas,” which offered more affordable medicine options.

“When it came to someone who was ill, we would have to skip out on work or school to take them to the hospital,” the source said. Missing work to care for a sick family member often meant losing income needed for food, rent or utility bills.

In many underserved communities, churches remain one of the only reliable forms of local support. The source explained that families often depended on churches for food, clothing or emergency assistance because few organizations or social programs were available in the area.

“There were only churches; there were no types of support or organizations that would help,” the source explained.

Looking Beyond the Statistics

UNICEF continues to support educational initiatives in the Dominican Republic to improve learning opportunities and school accessibility for vulnerable children and adolescents. The organization’s programs focus on strengthening early education, improving inclusive learning opportunities and helping students remain in school. UNICEF has also supported programs designed to reduce school violence and improve educational accessibility for children with disabilities.

Although poverty in the Dominican Republic continues to limit opportunities for many families, educational initiatives and community-based support programs may help reduce long-term inequalities. Personal accounts from individuals directly affected by poverty highlight the realities behind economic statistics and underscore the importance of continued efforts to improve living conditions across the country.

– Grelby Santos

Grelby is based in Boston, MA, USA and focuses on Good News and Global Health for The Borgen Project.

Photo: Unsplash

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Persistence in Health Care: Polio Vaccines in Nigeria

Polio Vaccines in NigeriaNigeria, often referred to as having the highest “zero-dose population in the world,” is moving away from fragmented health campaigns toward an integrated vaccination campaign aimed at protecting about 106 million children from measles, rubella and polio.

Though Nigeria was certified polio-free in 2020 due to its approach to implementing routine immunization, health care workers continue to provide treatment and care for children who have slipped through the cracks.

Integrated Health Campaigns

Nigeria has launched 20 health campaigns annually, with fewer than 15% integrated during this period. This strained resources, stretched health care workers thin and caused communities to lose faith in preventative care, opting instead for palliative care rather than seeking proper treatment for polio.

This began to change when Nigeria launched one of its largest vaccination campaigns in 2025, combining a variety of vaccines and child health care services to ensure treatment for children across the nation.

The campaign targets children ages 0-14 and 0-59 months for polio and was implemented in two phases:

  • 20 high-risk northern states and Oyo state in the southwest
  • In January 2026, the remaining southern states will follow

In addition to vaccines for measles and rubella, the integration of routine immunization and necessary health services will reinforce Nigeria’s “Primary Health Care Under One Roof” strategy and advance its Health Campaign Effectiveness in the direction of universal health coverage.

By the end of 2025, Nigeria achieved a 31% reduction in polio cases through persistence and constant vigilance.

Building Trust

With these campaigns shifting into routine immunization, Nigeria is prioritizing the health of its new generation while also addressing distrust.

In northern states like Sokoto, vaccinations were not readily accepted due to religious and cultural beliefs. Trust is part of the solution. Without it, polio vaccines in Nigeria go unused.

During Nigeria’s polio campaigns, communities and their religious leaders built community networks, called majalisa, where they assured families that the vaccines were safe and crucial for their children’s health. This partnership bridged the gap between hesitant families and health care workers, increasing the intake of not only polio vaccines but also treatments for other childhood diseases.

The same health workers who helped control polio initially convinced communities to bring in their children for continual treatment. This communication and connection have paid off as health care workers can identify households, plan outreach routes and record how many children are vaccinated, improving their reach.

Ongoing Efforts

It takes many components to create a solution, but once they come together, they work in harmony. Polio vaccines in Nigeria are now reaching children and households that were often underrepresented or out of the health system’s reach. Nigeria’s efforts will continue to pay off and even as challenges arise, persistence will increase the number of children receiving polio vaccines.

– Kianna Phosouvanh-Sythong

Kianna is based in Upper Darby, PA, USA and focuses on Good News and Global Health for The Borgen Project.

Photo: Flickr

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Reducing Maternal Deaths in CAR

A community midwife in CAR assists a pregnant woman during a check-up. Maternal Deaths in CARThe Central African Republic (CAR) has one of the highest maternal mortality rates in the world, at 835 deaths per 100,000 live births. A shortage of skilled health care providers and an unequal distribution of health services drive these high maternal deaths. Preventable conditions such as postpartum hemorrhage, hypertension and sepsis fuel the risks. These challenges explain why helping community midwives reduce maternal deaths in the CAR remains essential, especially in communities facing rapid population growth and limited services to support them.

Rural areas record only 28% of deliveries assisted by a skilled worker and just 2% of deliveries receive surgical assistance. The World Health Organization (WHO), UNICEF and the International Medical Corps expand access to maternal health care, train community midwives and strengthen rural health systems.

Training Community Midwives to Deliver Safer Births

WHO trains and deploys community midwives to expand access to skilled care. Fewer than half of pregnant women in CAR attend fewer than the four recommended antenatal consultations, with most deliveries occurring at home. By placing midwives directly within communities, WHO reduces the distance and cost barriers that prevent many women from seeking care.

Community midwives build trust and encourage families to seek skilled delivery services. In 2024, WHO equipped 30 maternity wards with essential medical equipment and medicines to improve the safety and dignity of maternal care. These improvements ensure that midwives can manage complications more effectively and women receive specialized and emergency care.

Community midwives help lower maternal deaths in the CAR.

Improving Access to Maternity Services

Rural communities in CAR face significantly higher risks during pregnancy and childbirth. Although understanding of midwifery care is increasing, many women still cannot reach health facilities.

UNICEF works to reduce delays in antenatal consultations and ensure that women receive timely and appropriate care. This support operates in five of the country’s 35 health districts. Bossangoa, a district of 176,688 people, shows the impact of this initiative. The regional hospital sits more than 90 kilometers from the farthest village, which makes access difficult. These long distances often force women to give birth at home without skilled assistance, increasing the likelihood of preventable complications.

In Nodokota, a local matron, Adele, received hands-on obstetric and neonatal training supported by UNICEF and donor funding. These practical skills improve conditions in remote communities and contribute to helping community midwives reduce maternal deaths in the CAR.

Establishing New Midwife Training Schools

To strengthen maternal health care, the Ministry of Health and Bangui University partnered with the International Medical Corps to establish the Bria Auxiliary Midwife Training School in 2024. The school serves a remote region of more than 150,000 people and offers a two-year certification program based on French Red Cross curriculum adapted to national and international standards.

This program covers prenatal care, labor and delivery, postpartum care, family planning and newborn care. Enrollment reached 51 students by November 2024, with graduates expected in 2026. These trained auxiliary midwives will return to their rural communities with the skills needed to support mothers and newborns. By expanding the midwifery workforce, the program advances helping community midwives reduce maternal deaths in the CAR.

Strengthening Midwifery Leadership

In 2024, African midwives gathered in Ghana to discuss a new advisory body to represent midwifery across the continent. The summit brought together midwifery associations and young midwives and emphasized leadership development and equitable representation.

With 70% of the population under 30, investing in young midwives strengthens the future of maternal health. The movement also focuses on shaping maternal care around African realities and ensuring midwives closest to communities guide decision-making. This approach shifts influence toward local practitioners who understand the community needs and the barriers women face when seeking care. It also helps build a new generation of midwifery leaders who can advocate for stronger policies and more equitable health systems.

This regional collaboration supports long-term progress in helping community midwives reduce maternal deaths in the CAR.

Final Thoughts

These initiatives transform maternal health in the CAR by expanding access to health care, strengthening midwife training and improving services in rural areas. This support is especially important because most medical personnel work in urban centers, which leaves rural communities underserved. Through the efforts of WHO, UNICEF, the International Medical Corps and regional midwifery leaders, community midwives are increasingly equipped to provide safe, skilled care and continue helping community midwives reduce maternal deaths in the CAR.

– Flora de Leeuw

Flora is based in Bath, UK and focuses on Good News and Global Health for The Borgen Project.

Photo: Flickr

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Environmental Risks to Children’s Health in Central Asia

Industrial smokestacks emitting pollution under cloudy skies, highlighting environmental risks to children's health.Every year, billions of children suffer from illnesses related to environmental risks. Ambient air pollution and mercury poisoning are linked to a shocking 1.7 million child deaths under the age of 5 each year. Reducing environmental risks to children’s health in Central Asian countries, like Mongolia, through changing energy usage practices and reducing child exposure to mercury and other toxic materials would prevent an estimated one in five child deaths annually.

Household Air Pollution (HAP)

An annual 2.9 million deaths are attributed to HAP worldwide. Some common conditions include ischaemic heart disease, stroke and lower respiratory infections, which cause a total of 76% of HAP-related deaths per year. In Mongolia, where coal is the predominant energy source for those living in poverty, indoor and outdoor air pollution cause 132 out of every 100,000 people to die prematurely each year.

Ulaanbaatar is the capital city of Mongolia. With 60% of the city’s population living in ger districts and many living in traditional felt tents, known as “gers” and small houses, a large number of children are exposed to extreme levels of HAP every day.

The country’s harsh climate, which can cause temperatures to plummet to as low as -20°C, forces Mongolians to heavily rely upon coal to survive, with three to six tons being burned annually in order to cook and provide warmth to their homes.

A study by Zaiyou Dai and colleagues in 2025 investigated the effects of HAP on the health of 1,279 infants by monitoring their health at 7, 13 and 36 months. They found the following results:

  • A positive correlation between the HAP score and the hazard ratio for pneumonia, which increased by 2% for every HAP score increase.
  • A positive correlation between HAP score and height for age (HAZ) score, which decreased as exposure to HAP increased.

The incomplete combustion caused by burning other materials, such as wood and charcoal, can also result in the emission of toxic gases like carbon monoxide. As one of the biggest environmental risks to children’s health in Central Asia, it is critical that energy production shift permanently away from burning these fossil fuels.

Mercury Poisoning

Mercury can be extremely harmful if consumed or inhaled. Central Asia has some of the most mercury-contaminated countries on the planet. For example, China contributes more than 600 tons of Hg to global emissions.

Toxic to humans, most people who experience mercury poisoning have come into contact with the chemical element by eating contaminated fish or inhaling vapors during industrial processing. Exposure can cause difficulties in child development both in utero and early life, as well as the following issues:

  • Toxic and damaged kidneys
  • Dysfunctional motor and cognitive skills
  • Impaired neuromuscular functions.

Due to fish being a key food source for lower-income families, children all over the world are put at risk of mercury poisoning. A study by Zhen-Yan Gao and colleagues in 2015 found that more than 14,000 Chinese children aged 0 to 6 years old had higher mercury levels than normal, with concentrations rising significantly if their diets included the frequent consumption of fish. These levels are an extreme cause for concern.

Ultraviolet Radiation

Ultraviolet rays, which individuals are vulnerable to during any exposure to sunlight, can be a useful source of much-needed vitamin D, but they can also have some disastrous and harmful effects. Because they are immunosuppressive, UV-B rays can cause skin damage and autoimmune diseases like lupus.

Sufferers of lupus, otherwise known as systemic lupus erythematosus, often experience:

  • Joint and muscle pain
  • Rashes caused by sun exposure
  • Weight and hair loss.

A long-term condition, lupus is life-changing and, while rare, about 15-20% of lupus patients are diagnosed as children. As the ozone layer slowly thins due to the changing climate, it is more critical than ever to protect children’s skin and their health from ultraviolet radiation.

While new environmental issues arise every day, it is also important to acknowledge the progress being made toward protecting children’s health. People from hundreds of nations are collaborating to find solutions to the many environmental risks to children’s health in Central Asia.

UNICEF and Its Fight Against Air Pollution

In 2021, UNICEF launched a program called UniSat, which was designed to help protect children’s health in Central Asia by educating youths. Girls from Kazakhstan, Uzbekistan and Kyrgyzstan were taught how to use nanosatellites and other technology that can be used to monitor air, so the future generation can make life-saving, progressive changes that will reduce air pollution in their country and consequently protect thousands of children’s health.

The staggering loss of 1.7 million lives each year emphasizes the significance of the environment and its impact on health, a harsh reality now catalyzing countless life-changing, innovative programs and policies, such as UniSat and the Minamata Convention. With the ever-changing climate and a surge in pollution worldwide, it is now more important than ever to rethink energy usage and direct attention toward achieving a safe environment where children can thrive, not just survive.

– Ruby Fraser

Ruby is based in Cannes, France and focuses on Global Health, Politics for The Borgen Project.

Photo: Pixabay

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Cuts to USAID and the Ebola Outbreak in the DRC

Health workers in protective gear walking on a street, highlighting USAID cuts impact on Ebola response. Ebola Outbreak in the DRCIn 2014, an Ebola crisis heavily affected West Africa. The U.S. government was deeply involved in the response. A Disaster Assistance Response Team (DART) was formed under the U.S. Agency for International Development (USAID) to oversee logistics and planning required to control the spread. Soon after, the U.S. committed nearly $1 billion toward fighting Ebola in West Africa.

At the time, this was the largest response by the U.S. government to a health crisis overseas. According to President Barack Obama, the response helped cut cases of the disease by 80%. There was a clear initiative to collaborate globally to recognize the threat this outbreak posed if not addressed appropriately. This contrasts starkly with the current response.

The Numbers

Since the start of May 2026, a similar Ebola outbreak has emerged, affecting regions in Africa, with the Democratic Republic of Congo (DRC) being most impacted. According to the International Rescue Committee (IRC), it could become the deadliest outbreak on record if not addressed appropriately.

So what do the numbers say so far? Despite the first case being confirmed only recently, it is already the third-largest outbreak of the disease, with the speed of its spread most alarming. According to the British Medical Journal, there have been 250 deaths and 1,200 cases recorded. These numbers doubled in just a week, from 551 cases and 136 deaths. These statistics were published on May 27, 2026. It is important to note that these numbers include both confirmed and suspected cases.

USAID Cuts’ Impact on Ebola Outbreak in the DRC

With these numbers growing daily, understanding the impact of USAID cuts on Ebola is essential. USAID has been a cornerstone of American foreign policy since President John F. Kennedy. In 2025, President Trump reduced it by 90% while also permanently cutting funding for thousands of projects that support development and health worldwide. The response to this outbreak has been directly affected by these cuts.

The outbreak was reported to the World Health Organization (WHO) nine days before U.S. officials became aware of it, a delay that occurred after cuts to USAID funding and the U.S. withdrawal from the WHO.

Dennis Carroll, an infectious disease specialist and former director of the Emerging Pandemic Threats program at USAID, said in a recent interview with NPR that the abolishment of USAID led to the disappearance of support for infrastructure. Simple logistics are not being met as before, such as personnel being able to reach critically needed hospitals and moving laboratories and samples swiftly for quick infection determination.

The experts who built a rapport with health workers in this region have largely been dismissed, so a significant amount of expertise and experience has vanished. This void left by the U.S. has not been filled by any other nation. Coordination with organizations like the WHO and the CDC was a key element in responding to outbreaks like this one.

Solutions

The data is clear on the impact of USAID cuts on the Ebola outbreak in the DRC. However, lessons from previous outbreaks can inform the current response.

Dr. Patrick Otim, WHO’s area manager for Africa, explained the importance of reacting quickly in a recent interview with the BBC. He detailed how delaying the detection of cases, engaging communities and isolating patients allows transmission chains to expand rapidly. He stresses the importance of community trust and engagement. Medical intervention alone is not enough to stop the spread effectively. Clear communication from local government and dignified, safe burials are as significant as medical supplies and test centers.

The U.S. is not inactive. It has committed more than $160 million in humanitarian and emergency funds to help fight the disease. The U.S. is also sending CDC personnel, along with a disaster-assistance response team, to the region. This, along with lessons learned from other outbreaks, gives locals hope that this crisis can be managed effectively.

Charities are also contributing to the effort. For example, UNICEF has personnel on the ground working to address the situation. So far, the organization has provided almost 50 tons of infection prevention and control supplies, including personal protective equipment, disinfectant, soaps and water purification tablets.

Conclusion

Bob Kitchen, the IRC’s Vice President Emergencies & Humanitarian Action, stated, “The warning signs are flashing red. Eastern DRC is confronting the outbreak more fragile and less prepared than during the 2018–2020 outbreak that killed more than 2,000 people and with fewer resources to fight it.”

The U.S. attitude toward foreign aid has changed significantly over the past few years. President Obama sought to reduce Ebola cases to zero, while President Trump emphasized an America-first message during his campaign and the results of those intentions are now evident. This outbreak serves as a case study demonstrating the impact of American foreign aid on global health.

Although the numbers may seem bleak, the solutions mentioned are making a difference, whether through lessons learned from previous outbreaks or through charities like UNICEF working on the front lines to slow the spread.

– Oisín Downes

Oisín is based in Galway, Ireland and focuses on Politics for The Borgen Project.

Photo: Unsplash

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Vaccines and Bacterial Infections in South Africa

Bacterial Infections in South AfricaTetanus has been almost completely eradicated from public life in South Africa and many other countries since the early 2000s. Although a tetanus vaccine has existed since the ’70s, infant mortality and overall cases were still high. The transition to administering two vaccines paved the way for fewer than one case per 1,000 people and a tenfold drop in the infant mortality rate.

Bacterial Infections in South Africa

Newborns are the most vulnerable group, especially regarding exposure to bacterial infections such as tetanus, diphtheria and whooping cough. Children are better protected when mothers receive a Tdap vaccine during the final two trimesters of pregnancy. The vaccine protects against all three illnesses. Because of the mother and child’s symbiotic relationship, the vaccine immunizes the mother and also benefits the child via the placenta.

Every year, young children, especially infants aged 0 to 1, have the highest infection rate of all three illnesses. In 2025, there were 614 reported cases of whooping cough in South Africa, with more than half occurring in children under 5 years of age. For all other age groups combined, there were fewer than 1,000 total cases during that period.

Symptoms

Tetanus symptoms include muscle spasms, muscle and jaw tightness and fever. Diphtheria causes fever, sore throat and nasal discharge. In addition to a harsh cough that starts about one to two weeks into the illness, whooping cough also causes vomiting and sneezing. It poses a long recovery time of a few weeks or more likely a few months, for infants.

Infants with these infections naturally have a much higher mortality rate. Their much narrower airways are ill-equipped to handle such severe respiratory infections. Fortunately, South African hospitals are stocked with high-end medical equipment such as ventilators to aid recovery. Tetanus is the deadliest of the three infections because almost all infants who get it will die without proper treatment. Even with such treatment, the number still exceeds 50%.

Widespread Support

Although tetanus infection rates have remained consistently low since 2002, diphtheria and whooping cough have fluctuated over the years. Widespread vaccination has consistently helped curb the infections. In addition to making the DTaP and Tdap vaccines widely available and affordable, the National Department of Health helps fund campaigns to mobilize larger groups to get vaccinated.

People did not stay up to date on their vaccines in 2021 during the COVID-19 lockdowns. There were supply shortages from the pandemic, but the lack of vaccinations continued for months even after supplies became available. During that time, community members stepped in with their own campaign to remind individuals to protect their health.

While the main purpose of these campaigns was to promote the COVID-19 vaccine, citizens were also encouraged to receive other vaccines like DTaP and Tdap. People involved in the campaign set up information tables, hung vaccine banners, drove around town with signs and went door-to-door to promote vaccination.

The Path Forward

There are still 11 different countries with high rates of tetanus infections, primarily due to a lack of adequate health care resources. Although South Africa is not one of these countries, immunization rates may be much lower and infection rates higher than reported because it is more difficult to track data accurately for developing countries. However, community and government support continue to improve access to the vaccine and help keep bacterial infections low in South Africa.

– Logan Hessek

Logan is based in Northglenn, CO, USA and focuses on Good News and Global Health for The Borgen Project.

Photo: Flickr

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Lady Health Workers Treat Postpartum Depression in Pakistan

Postpartum Depression in PakistanAs many as one in four new mothers in low- and middle-income countries experience perinatal depression, which includes depression during and after pregnancy and rates in South Asia are among the highest in the world. Yet most affected women will never see a mental health professional. Pakistan has fewer than one psychiatrist per 100,000 people, far below the global average. Postpartum depression in Pakistan is one of the most under-treated drivers of household poverty and a program built around community health workers, rather than specialists, is helping to close that gap.

The Weight of Poverty for Pakistani Women

Poverty shapes everyday life for a large share of Pakistan’s population. The World Bank estimates that about 22.5% of Pakistanis lived below the national poverty line in fiscal year 2025, down from 25.3% the year before, with the September 2025 Pakistan Poverty, Equity and Resilience Assessment warning that earlier gains have been eroded by COVID-19, inflation, the 2022 floods and macroeconomic stress. Roughly 61% of the population lives in rural areas where formal mental health services are almost entirely absent. Poverty affects women differently than men.

In many low-income households, women carry the majority of unpaid caregiving and domestic work, have less independent income and less decision-making power over health spending and are more likely to be excluded from formal employment. Pakistan’s female labor force participation rate stood at around 24% in 2024, one of the lowest in South Asia. For a new mother struggling with untreated depression, the consequences ripple outward: lost wages, weaker bonds with a newborn, poorer infant nutrition and a tighter intergenerational cycle of disadvantage.

Postpartum Depression in Pakistan

Depression during and after pregnancy is one of the most common complications of childbirth and its effects reach beyond the mother. Research has linked maternal depression to pre-term birth, child under-nutrition and stunting, creating consequences that pass from one generation to the next. For families already living in poverty, the burden compounds. A mother struggling silently may find it harder to care for her infant, maintain household income or seek health services.

The stigma around mental illness deepens the problem. In a country where mental health care is concentrated in cities and where talking about depression often carries shame, rural and low-income women are the least likely to receive support and the most likely to be told their symptoms are simply part of motherhood.

Therapy Without Therapists

The response is the Thinking Healthy Program, a structured psychological intervention based on cognitive behavioral therapy and designed specifically for delivery by nonspecialists. It was developed in Pakistan by Professor Atif Rahman and colleagues and tested in a landmark cluster randomized controlled trial published in The Lancet in 2008. That trial, conducted with community health workers in rural Rawalpindi, roughly halved the risk of perinatal depression among mothers and improved infant health outcomes. The results drew international attention.

In 2015, the World Health Organization (WHO) published the Thinking Healthy manual and recommended the approach for treating perinatal depression in low-resource settings worldwide. The model has since been adapted across South Asia and Sub-Saharan Africa. The program works because it does not depend on scarce specialists. Community health workers are trained to help mothers recognize negative thinking patterns, build supportive routines and strengthen family support, during the same home visits they already make for maternal and child health.

Building on the Lady Health Worker Network

In Pakistan, that delivery network already exists. The Lady Health Worker Program, launched in 1994, employs more than 100,000 women who provide primary health care to communities across the country, with a focus on maternal and child health in rural areas. Each worker is recruited from the community she serves, which helps build the trust that mental health support requires. A 2025 study in the Journal of Global Health confirmed that contact with Lady Health Workers during pregnancy and after birth is associated with stronger uptake of maternal and child health services. That existing relationship makes the workforce a natural vehicle for the Thinking Healthy Program.

Researchers have also tested versions delivered by trained peer volunteers from the community rather than government health workers. Indeed, a 2025 trial published in Nature Medicine, conducted in rural Rawalpindi, found that technology-assisted peer-delivered Thinking Healthy was as effective as the standard WHO version in sustaining remission of perinatal depression, offering a way to extend care where health workers are stretched thin. The work is led by the Human Development Research Foundation, an Islamabad-based research organization. Challenges remain. A 2024 analysis found that Lady Health Worker coverage in Sindh province reached only 43% of the population, with wide district-level gaps. Expanding mental health care depends on first strengthening and sustaining the network that delivers it.

Looking Ahead

Postpartum depression in Pakistan remains widespread and under-treated and no single program will resolve it. Yet the Thinking Healthy Program shows that effective care does not require a psychiatrist in every village. By training community health workers and peers to deliver evidence-based therapy, Pakistan has built a model that is both affordable and proven. With sustained investment in the Lady Health Worker network, treatment for postpartum depression can become a route out of a hidden cycle of poverty for the rural and low-income mothers who need it most.

– Amna Al Harrazi

Amna is based in Dubai, UAE and focuses on Global Health for The Borgen Project.

Photo: Flickr

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How Motorcycle Ambulances in Uganda Are Saving Lives

Motorcycle Ambulances in UgandaFor many families living in remote villages, reaching a hospital can take hours. Poor roads, long travel distances and limited transportation options often delay treatment during medical emergencies. However, motorcycle ambulances in Uganda are helping thousands of people access health care more quickly, especially pregnant women, newborns and children living in rural communities.

According to the World Health Organization (WHO), Uganda’s maternal mortality ratio was estimated at 284 maternal deaths per 100,000 live births in 2020. Many maternal deaths occur because women are unable to reach health facilities quickly during complications. By providing emergency transportation in remote areas, motorcycle ambulances help address one of the most common barriers to care and improve access to skilled medical assistance when it is needed most.

A Lifeline for Rural Communities

Unlike traditional ambulances, motorcycle ambulances can travel on narrow dirt roads and rough terrain that larger vehicles often cannot access. These vehicles typically consist of a motorcycle attached to a covered trailer designed to transport patients safely to health facilities. The need for better transportation is especially important in rural Uganda, where distance and transportation costs often prevent families from seeking timely medical care. In some communities, people previously relied on walking, bicycles or private motorcycles to reach clinics, even during emergencies. Motorcycle ambulances in Uganda thus provide a faster alternative.

Helping Mothers Reach Care

One of the greatest benefits of motorcycle ambulances is improved access to maternal health services. Research conducted among women in eastern Uganda found that nearly half of the surveyed mothers had used motorcycle ambulances to reach health facilities for delivery and emergency care. Health workers report that these ambulances help women arrive at clinics faster, reducing delays that can lead to serious pregnancy and childbirth complications. Increased access to health facilities also encourages more women to give birth under the supervision of trained medical professionals rather than at home. This improves outcomes for both mothers and newborns and helps reduce preventable deaths.

A Cost-Effective Solution

Motorcycle ambulances are significantly less expensive to purchase and maintain than conventional ambulances. Their affordability allows local governments, health organizations and community programs to operate them in areas with limited resources.

According to Africannews, motorcycle ambulances have become an important tool for connecting isolated villages to health centers. Their ability to navigate difficult roads means patients can receive treatment sooner, even during the rainy season when travel becomes more challenging. The success of motorcycle ambulances in Uganda demonstrates how low-cost innovations can address major barriers to health care access.

Expanding Access to Health Care

The success of motorcycle ambulance programs has attracted support from international organizations focused on maternal and child health. Similar programs supported by the United Nations Population Fund (UNFPA) have demonstrated how innovative transportation solutions can strengthen rural health systems and increase access to life-saving services.

Motorcycle ambulances also help transport sick children and emergency patients who require urgent care. By reducing travel times, they increase the likelihood that patients receive treatment before their conditions become life-threatening.

Looking Ahead

Motorcycle ambulances in Uganda show how a simple innovation can create meaningful change. By overcoming transportation barriers, these vehicles help patients receive treatment sooner and improve access to essential health services. As motorcycle ambulances in Uganda continue to expand, they are proving that practical and affordable solutions can save lives. For many families living far from hospitals, they are more than a means of transportation—they are a pathway to healthier futures and stronger communities.

– Masa Qasim

Masa is based in Toronto, Canada and focuses on Good News for The Borgen Project.

Photo: Wikimedia Commons

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Friendship’s 3-Tier System and Health Care in Bangladesh

Health Care in BangladeshBangladesh is at the heart of the battle against the changing climate. According to the World Bank, around 21% of the country is prone to annual flooding. This leaves many inhabitants isolated without access to health care and makes it difficult to build permanent hospitals. Approximately 12 million people live on the chars, which are river islands formed by sediment deposits due to flooding. Accessing hospitals can be difficult for these people due to damaged infrastructure.

In 2002, Bangladeshi entrepreneur Runa Khan began Friendship, a social purpose organization. The organization aims to address the challenges faced by the inhabitants of the chars with floating medical boats and other community initiatives using a three-tier system.

Friendship’s Three-Tier System

  • Tier 1: Floating Medical Boats Expand Health Care Access in Bangladesh: On the frontline of the system are three floating medical boats that serve the chars, as well as the land hospital located in Shyamnagar. The purpose of the boats is to expand medical care to those in rural areas who cannot access hospitals due to seasonal flooding, which damages roads and infrastructure. The floating medical boats offer free surgeries, check-ups, and medicine, along with pediatric, gynecological, dental and eye care. The boats help up to 175 people per day.
  • Tier 2: Satellite Clinics Focus on Prevention and Women’s Health: Satellite clinics carry out frequent visits to rural and isolated zones to educate communities on hygiene and nutrition, as well as providing basic treatments and free medicine. The main focus of these clinics is prevention and follow-ups. For instance, Friendship screens more than 18,000 women per year for cervical cancer and treats around 150 women for precancerous lesions.
  • Tier 3: Community Medic-Aids Support Health Care: The Friendship Community Medic-Aids (FCMs) are women trained by the organization to give primary health care to the communities. Some of these women are also trained as Community Skilled Birth Assistants (CSBAs) to give ante- and post-natal care, deliver children and provide basic childcare. In 2022-23, a study showed that over 90% of people asked had taken health care services from FCMs, demonstrating the impact they have on the communities.

Combining Health Care and Climate Adaptation

Friendship not only provides health care services but also addresses other issues like climate resilience. To prepare the communities for natural disasters, Friendship has carried out preventative measures such as restoring forests to protect villages from cyclones. More than 650,000 trees have been planted on the southern coast of the country, protecting at least 125,000 people.

Actions like these help combat many issues suffered due to storms. The destruction of villages and infrastructure can lead to malnutrition from a shortage of resources, a lack of health care due to isolation and an increased risk of waterborne diseases from living in flooded areas. Friendship’s three-tier system with floating medical boats, satellite clinics, and FCMs allows medical staff to reach vulnerable communities in times of need, while also implementing preventative measures to save more lives.

In 2025, Friendship was a finalist for the Earthshot Prize for its incredible work protecting the communities in Bangladesh. The organization’s holistic three-tier system demonstrates how health care and climate adaptation can work together to support the vulnerable communities in Bangladesh.

– Emma Wheeler

Emma is based in Valencia, Spain and focuses on Good News and Global Health for The Borgen Project.

Photo: Flickr