Archive for category: Global Poverty

Key articles and information on global poverty.

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China’s Hukou System Restricts Mobility

On the surface, China has been a powerhouse in diminishing global poverty. Measured by individuals living with less than $6.85 a day, China’s poverty rate decreased from 63% in 2010 to 25% in 2019. Based on the country’s official poverty line, the World Bank states that, as of 2020, China’s national poverty rate is 0%. Martin Raiser, the World Bank’s representative in China, claims that China’s work accounts for roughly 70% of the world’s absolute poverty reduction. However, the People’s Republic of China maintains ingrained inequities due to how its hukou system restricts mobility.

What is the Hukou system?

The hukou system is the administrative tool used for population management and registration. The hukou system classifies individuals into urban and rural categories, assigning certain services to each classification, such as access to hospitals and schools. This policy dictates where individuals can live, work and own land in China. This restricts population movement by reserving government services like social security and public education only to citizens with proper hukou for the area in which they live. Changing one’s hukou is often expensive and almost impossible, depending on where the individual wants to live. Due to these policies, the PRC directly shapes available opportunities for urban and rural residents, contributing to stark disparities between its civilians.

China’s hukou system controls internal migration, manages social protection and preserves social stability. By restricting the legal right to live and work in cities without proper hukou, China achieved its goal of limiting the growth of megacities. This process helped mitigate the uncontrolled growth of urban slums, but many rural residents ignored hukou restrictions in search of better economic opportunities in cities.

Hukou Controls Mobility in China

Being born in a rural area causes those Chinese citizens to lose access to the job market in prosperous cities. Thus, they are often confined to living in the same region for most of their lives. Citizens need a temporary residence permit to spend more than three days outside their city or town, preventing free mobility like in other countries such as the U.S.

Some people born with rural hukou endure a complex and costly process to change their status, but many others lack the resources to go through this legal avenue. As a result, many rural residents migrate to cities without the allowed hukou, losing access to beneficial government services and often resorting to poor housing conditions.

Larger cities often limit new hukou to wealthy households, thus, leaving poorer urban residents with worse living conditions. Smaller cities usually accept rural migrants, making it easier for them to receive their desired hukou. While this process deters migrants from moving to larger cities like Shanghai and Beijing, it also puts millions of Chinese migrants in threatening conditions.

Ingrained Inequities in the Hukou System

The hukou system exists in tandem with growing income inequality. China’s Gini coefficient reveals high-income inequality: measuring inequality on a scale from 0 (low) to 1 (high), China’s is approximately 0.47 compared to 0.41 in the U.S.

While moving to urban areas increases access to higher-paying jobs, rural-to-urban migrants face significant penalties if they do not have an urban hukou. These workers lose access to health insurance, retirement allowances, unemployment insurance, maternity benefits, work insurance, employment and education. With more than half of China’s population living in cities, only 35% of urbanites have a city hukou. This disparity means more than 250 million migrant workers do not receive social security benefits.

The hukou system disadvantages rural residents more than city-designated dwellers by limiting their opportunities. On average, a farmer’s annual income equals about one-sixth of the average salary of an urban citizen. This steep income disparity is exacerbated by how farmers pay a tax rate three times the amount urban residents pay, presenting a great challenge for upward social mobility.

The Borgen Project spoke with Lauren He, a former resident of Shanghai, about the hukou system’s inequities. He stated, “Because of my urban hukou status, I have evaded many barriers migrants face when moving to cities like Shanghai.”

“My grandparents did not grow up with the hukou system, so they were able to move to Shanghai from the countryside with fewer complications than what migrants face today. This system deeply disadvantages those who cannot get the necessary hukou,” said He.

Consumption Poverty Rates Show Inequity

Despite persisting inequity due in part to the hukou system, studies have shown that rural-to-urban migration reduces poverty. Migrant workers move to increase their salaries, with many sending money back to their families in less prosperous rural areas, expanding economic growth and lowering the risk of poverty.

However, the hukou system has widened inequities in many ways. Many migrants work jobs more susceptible to market change, indicating a higher risk of impoverishment. In addition, while migrants may have lower income poverty, they still face the challenges of high consumption poverty rates. Migrant workers with urban hukous consume up to 30% more than their counterparts without the proper hukou status, revealing a disparity linked to the hukou system.

The Future of Poverty Reduction in China

While reforms continue in the hukou system, other programs in China are working to counter poverty through more direct action. In 1989, the China Foundation for Poverty Alleviation began its mission to combat poverty by organizing projects ranging from health care and education to economic development through infrastructure construction. Headquartered in Beijing, the CFPA targets domestic and global poverty, aiding the mission to end poverty for all.

With the work of organizations like CFPA and liberalizing restrictions on hukou, change may come to help eliminate disparities between urban and rural citizens in China.

– Michael Cardamone
Photo: Flickr

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Human Trafficking in Tajikistan

Human Trafficking in Tajikistan
The U.N. Trafficking Protocol defines human trafficking as “the recruitment, transportation, transfer, harboring or receipt of persons, by means of threat or use of force or other forms of coercion, of abduction, of fraud, of deception, of the abuse of power or of a position of vulnerability or of the giving or receiving of payments or benefits to achieve the consent of a person having control over another person, for the purpose of exploitation.” Human trafficking in Tajikistan is a pertinent issue — The U.S. State Department’s Trafficking in Persons (TIP) report of 2021 lists Tajikistan as a Tier 2 country, joining the ranks of Saudi Arabia, Sierra Leone and Panama.

Tajikistan’s TIP Ranking

A Tier 2 ranking means “Tajikistan does not fully meet the minimum standards for the elimination of trafficking, but it is making significant efforts to do so.”

The TIP 2021 report highlights that instances of human trafficking in Tajikistan itself are less common. Rather, traffickers exploit Tajikastini people who have migrated to other countries for financial reasons. In particular, “Labor traffickers exploit Tajikistani men and women in agriculture and construction primarily in Russia, UAE, Kazakhstan and Saudi Arabia, as well as in other neighboring Central Asian countries, Turkey and Afghanistan,” the report said.

Additionally, women who lost their husbands to armed conflict and are struggling for money are more vulnerable to “coercive local marriages” containing elements of forced labor or sex trafficking. The onset of the COVID-19 pandemic led to widespread job losses and income cuts, exacerbating the financial stability of Tajikistani families and making them more vulnerable to the lure of traffickers.

In the 2021 report, Tajikistani “authorities identified 24 trafficking victims during the reporting period, compared with 53 in 2019.” However, authorities did not supply “information on victims’ nationalities, genders, ages, locations or types of exploitation.”

In terms of prevention efforts, while the government ran a 24-hour trafficking hotline for victims, the government did not note the number of phone calls that led to trafficking victim identifications.

In previous years, the police force has used a registry of names of sexual minorities to blackmail these individuals into “sex trafficking and forced informant roles.” While same-sex relationships are legal in Tajikistan, sexual minorities face discrimination and stigma from both the authorities and the public. Tajikistan created an “official list” of LGBTQI+ citizens in 2017.

The TIP report says that the government of Tajikistan has achieved “a significant increase in trafficking convictions” as well as provided “shelter to more victims than the previous year.” However, the report also highlights “allegations of possible official complicity in some localities” but Tajikistan did not report any investigations or arrests regarding the matter.

Creating Change

The report recommends creating “standard operating procedures for identifying trafficking victims and referring them to care.” It also encourages the government of Tajikistan to focus on vulnerable groups at risk of trafficking such as “LGBTQI+ individuals [and]foreign and returned Tajikistani migrant workers,” among others.

U.N. human rights expert Siobhán Mullally recommended that the Tajikistan government increase protections for refugees from Afghanistan, Iraq and Syria. Mullally also says the nation must address the stigma and discrimination that female sex trafficking victims face when seeking help.

The government should also provide financial support to female-headed households and female informal workers as these groups are more susceptible to trafficking due to their generally impoverished economic circumstances.

The International Organization for Migration (IOM) plays an important role in combating human trafficking in Tajikistan. In 2019, one day before World Anti-Trafficking Day (July 30), the IOM held a national youth debate tournament centering around human trafficking. This aims to raise awareness of human trafficking in Tajikistan. In 2019, the IOM also gave “direct assistance” to 17 human trafficking victims in Tajikistan and “prevented eight other cases of potential trafficking.”

While Tajikistan is progressing in the right direction in terms of efforts to reduce human trafficking, the government must make more concerted efforts to provide greater support to the most vulnerable groups.

– Priya Maiti
Photo: Flickr

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5 of Queen Elizabeth’s Charitable Efforts

Queen Elizabeth’s Charitable Efforts
Queen Elizabeth was the patron of more than 600 charities during her lifetime. She inherited most of these charities from her father, however, the Queen paid service to additional charities that held a special place in her heart. Here is a list of five of Queen Elizabeth’s charitable efforts that she serviced during her reign.

The British Red Cross Society

When her father, George VI, passed away in 1952, Queen Elizabeth inherited the role of Patron. Her Majesty donated funds for disaster relief efforts. The Queen made many visits to visit Red Cross staff and show British support for many appeals both worldwide and domestic.

The Queen donated to the Red Cross more than 40 times throughout her reign. One of her latest acts as Patron was visiting the survivors of the Manchester arena bombing where Red Cross staff came to help people injured in the crowd.

The Queen’s Commonwealth Trust

This trust helps fund commonwealth leaders and their organizations so that they can provide aid to their communities. The trust originated in 2018 in recognition of the Queen’s love for service and her great global impact. The trust is a global program that focuses on aiding young people to help transform their communities across multiple areas. Recently, The Queen’s Commonwealth Trust helped an organization provide health care to rural areas in Uganda.

Less than 0.1% of international aid goes to these young Commonwealth leaders and organizations and the Queen’s Commonwealth Trust plans to provide its assistance to these smaller organizations. By the end of March 2022, the organization had earned £532,499 in donations. The trust is continuously growing.

Friends of the Elderly

One of Queen Elizabeth’s charitable efforts was Friends of the Elderly, which is an organization that began in 1905. The mission of the organization is to support older people to live life well. The organization provides grants for the elderly who live on a low income. The Queen served as Patron for more than 60 years. The Queen hosted receptions at Buckingham Palace to meet with some of the people who benefitted from the charity’s work.

The pandemic was especially hard for Friends of the Elderly as it had to close down many of its retirement homes to the public. However, as of 2020-2021, the organization raised £195,848 in grants that helped support 587 older people.

The Disaster Emergency Committee

The Disaster Emergency Committee is a combination of 15 U.K. aid charities collectively pooling resources to provide relief to overseas countries facing crises. These charities work to bring awareness to the U.K. population. The Committee has been working to provide assistance to different organizations since 1963. It has raised nearly £2 billion and used that money to save lives and rebuild communities.

In 2005, she donated to support efforts after the Kashmir earthquake. More recently, the Queen made a generous donation to the Disasters Emergency Committee’s Ukraine Humanitarian Appeal. The Queen made the donation using her private funds. The Committee plans to distribute these funds to five charities working in Eastern Europe.

The Aberdeen Association of Social Services

Among other things, the Aberdeen Association of Social Services serves to reduce the number of men, women and children of all ages living in poverty. The Association for Improving the Condition of the Poor came into being as an organized response to supporting the people of Aberdeen. The main focus of the organization is on enabling the impoverished to be able to help themselves.

In March 1870, when the organization was the Association for Improving the Condition of the Poor, Queen Victoria accepted the position of Patron. Ever since Queen Victoria, the reigning monarch has been the Patron of the Aberdeen Association of Social Services.

Queen Elizabeth’s charitable efforts have had a significant impact on people living in poverty and experiencing disasters. Many will remember the generous service of Queen Elizabeth II.

– Kiara Finch
Photo: Flickr

USAID Addresses Poverty in Northern Kenya

Poverty in Northern KenyaNorthern Kenya comprises 10 frontier counties which host approximately 19.2% of the country’s population and is classified as arid and semi-arid land. As a result, pastoralism is the dominant economic activity in the region. It supplies 90% of jobs and 95% of household income contributing to 50% of Kenya’s total GDP.

Despite pastoralism having an approximate value of $800 million, poverty in Northern Kenya is rampant. Five out of the 10 frontier counties are among the poorest in the country with six out of every 10 people living below the poverty line. Due to the harsh climatic conditions, settlements are temporary and dependent on the availability of water and pasture. Pastoralism in northern Kenya is a fragile industry as farmers frequently lose livestock to drought and disease which leads to food insecurity. It is for these reasons that the government has launched several poverty alleviation and development initiatives in conjunction with the international community.

The Frontier Counties Development Council (FCDC)

Kenya’s Frontier Counties Development Council originated in 2016, bringing together the 10 northern counties as one economic bloc. These counties are Turkana, Marsabit, Wajir, Mandera, Garissa, Lamu, Tana River, Isiolo, Samburu and West Pokot. The Kakuma Refugee Camp is located in Turkana whose northern border is shared with South Sudan and the Dadaab Refugee Complex is found in Garissa with Somaliland to the east.

The purpose of the council is to promote security and socioeconomic development through inter-county partnerships. It intends to strengthen unity and streamline policy implementation between the frontier counties and the rest of the country. Through collective action, the FCDC aims to resolve short-term regional issues, promote resilience, achieve efficient growth through innovation, foster social entrepreneurship and lay the groundwork for medium to long-term sustainable development.

To achieve these objectives the FCDC has also partnered with numerous external partners including the Alliance for a Green Revolution in Africa (AGRA), UKaid, UNDP, the EU, Mercy Corps and most recently USAID. The USAID Kuza program began in 2019 with the aim of addressing poverty in Northern Kenya by developing its local economy through financial and technical investment.

USAID KUZA

The intention of the Kuza program is to reduce dependence on humanitarian assistance and to reduce poverty in Northern Kenya by building economic resilience in the region. This achievement is possible by accelerating public and private investment and strengthening the county’s capacity for development. The program received the $14 million Impact for Northern Kenya Fund from USAID Kenya to undergo distribution to local small-to-medium businesses.

Notably, USAID enlisted AV Ventures to facilitate the implementation of the program. AV Ventures is the subsidiary body of the nonprofit organization ACDI/VOCA based in Washington D.C. and specializes in financing small-to-medium enterprises. It serves as the lending intermediary between the USAID Kuza program and more than 20 local financial establishments. These include banks, fintech, microfinance institutions and Savings & Credit Co-operatives that want to expand their reach into the region.

Conclusion

Ending poverty takes more than providing assistance. It is also about helping others help themselves. The USAID Kuza program and other USAID programs in the country are following this principle by injecting efforts into initiatives that can create long-term and sustainable change. Poverty in Northern Kenya is not a problem that occurred in only a few years but one that has almost become entrenched due to decades of underdevelopment and neglect. It will take the efforts of the Kenyan government, the Kuza program and the consistent support of others to undo the damage and finally turn things around.

– Kena Irungu
Photo: Flickr

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New technologies in South Sudan

new technologies in South SudanTechnology increasingly offers more and more solutions to help reduce poverty across the globe. Considering South Sudan’s unpredictable climate and scarce resources, new technologies in South Sudan can provide a gateway of opportunities and security to the locals. This can be through new farming methods and equipment, schooling, banking and monetary management.

The Problems in South Sudan

South Sudan’s current climate is posing many challenges to its poverty-stricken population. The World Bank describes poverty as ‘ubiquitous’ across South Sudan, with it estimating that two-thirds of the population requires humanitarian assistance.

Estimates stated that floods are affecting up to 1 million people every year because the floods have forced many to evacuate their homes. This has had an impact on education with floods affecting 100 schools. As a result, more than 60,000 students have reduced access to education.

In the short term, people in South Sudan have had limited access to nutrition and health care. This has contributed to the fact that 60% of the population is facing malnutrition.

It is not just flooding that impacts South Sudan. Excessive drought, temperature changes and unpredictable rainfall have all damaged day-to-day life in South Sudan. Droughts have resulted in food insecurities leading to a loss of livestock and crops.

This is severely impacting the economy in South Sudan considering that 95% of the population work in sectors that rely on the climate. This includes agriculture, fishing and forestry resources.

In the 2020-2021 period the South Sudanese economy reduced by 5.4% due to lower exports of oil and agricultural output. This is having a large impact on the living conditions of individuals in South Sudan.

The Conflict in South Sudan

As a result of the unpredictable climate in South Sudan, many have had to migrate. In fact, up to 4 million people as of 2022 remain displaced due to climate-induced dangers – 1.6 million internally and 2.3 million in neighboring countries.

Migration has led to enhanced homelessness across South Sudan. This has reduced living standards and increased disease. A lack of infrastructure has led to more exposure to malnutrition, mosquitos and climate-induced diseases such as malaria and cholera.

Serious conflicts over resources in South Sudan between groups, especially in areas of extreme drought, has led to livestock raiding and exacerbated the displacement of people into concentrated areas making resource scarcity even more serious.

Furthermore, the large weaponry market that has spread throughout the territory to the failure of the South Sudanese government, fuelling the problem and resulting in wider political instability in South Sudan. Resource conflicts have increasingly become a method to gain political support and power.

UNHCR’s Efforts

To solve the issues of conflict and lack of institutional and infrastructural support in South Sudan, the resource and climate problems require mitigation and resolution. Technology could be a solution, but South Sudan has limited new technologies presently.

First, and foremost, technology can make farming more efficient and sustainable. For example, the United Nations High Commissioner for Refugees (UNHCR) is trying to develop sustainable and resilient infrastructure such as dikes and drainage systems to try and appease the problems in South Sudan. Moreover, UNHCR has provided flood-tolerant seeds and training for locals. To help with droughts, it has introduced new irrigation systems and set up tree nurseries to regrow forests. In Maban, five tree nurseries underwent establishment in four refugee camps. These activities are introducing new skills and opportunities for the locals, that are more resistant and malleable to the changing climatic conditions. Other technologies include high-efficiency cooking stoves, reusing agricultural waste and using solar energy to extract water from boreholes.

How the US is Helping

Next, greater investment into education and human capital development is vital for presenting more opportunities for the locals to be able to use new tech. The U.S. has provided more than $117 million to South Sudan on top of humanitarian aid. This is helping the government to invest more money into their infrastructure, allowing more to access education.

The U.N. has also been providing increased support across Africa. It is important that this continues as, alone, South Sudan does not have the fiscal capacity to create a stable socioeconomic climate.

A further key area for South Sudan is taking full advantage of technology to provide education to rural areas that otherwise do not have access. This seems to have had little traction so far but could prove to be a very advantageous development.

Lastly, introducing these new technologies and skills in South Sudan will help to address the migration problem, reducing the levels of migration and allowing the population to become more dispersed again. This will hopefully help to reduce conflict in South Sudan as well.

Looking Ahead

Behind this shift to new technologies in South Sudan in the long run, support through charity and initiatives will help to smooth the transition. For example, to help with conflicts UNHCR has started several peace initiatives in Eastern Equatoria to reduce further conflict between herders and farmers, and to incentivize the use of new technology in pastoralists’ original locations, rather than internally migrating.

As a result, it becomes clear that South Sudan can reduce conflict across the country if it introduces more sustainable technology to help with the unpredictable climate. This requires the support of other countries and the cooperation of the South Sudanese government if this is to successfully reduce poverty.

– Reuben Cochrane
Photo: Flickr

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New Markets Boom in Dharavi

DharaviMumbai’s Dharavi is one of the world’s largest slums and is home to roughly 1 million people since it was established in 1884. Dharavi was initially inhabited by fishermen and later extended to migrant workers from south Mumbai. The slum’s conditions are dire and inhabitants have suffered from the spread of numerous epidemics and diseases due to the lack of sanitation, drinking water, roads and basic healthcare services.

Hidden Markets

Despite its harsh economic and social conditions, Dharavi is close to Mumbai’s two main suburban rail lines, which has made commuting to work easier for workers. Over the years, Dharavi has also developed a large number of thriving small-scale industries that produce embroidered garments, quality leather goods, pottery and plastic. Furthermore, there are estimated to be 5,000 businesses and 15,000 single-room factories located within Dharavi, making it a prime entrepreneurial realm with potential revenue that can total anywhere from $700 million to $1 billion USD a year.

Many of these initiatives are undertaken by women living in the slums, many of whom have taken the lead and become the main breadwinners of their families. In fact, out of the 65,000 rural markets in India, almost 75% are run by women.

Renuka Shinde’s Story

One such example is Renuka Shinde, who was forced to take up the role of the breadwinner after her husband left her and their three sons. Renuka traveled to Kolkata from her home in Dharavi to buy handloom saris to start her small business. At the end of a month’s hard work, Renuka brings home Rs 3,000 or roughly $48 by selling saris and other garments around Mumbai. Renuka makes a profit of Rs12,000 ($200) a month and this tends to increase during Indian festivals such as Diwali and also during wedding seasons.

Pushpalata Chittikindi’s Story

Another example is Pushpalata Chittikindi, who is left to fend for her two sons in the absence of her alcoholic husband. Pushpalata started making metal buckles and sold them piece by piece to nearby factories in the neighborhood. The businesswoman also worked as a cook and cleaner in her spare time. Following the advice of her friends, Pushpalata took a loan to set up her machine but lacked financial knowledge and experience with banks. Pushpalata took the help of a local NGO that gave out small loans to support local women.

With help from the NGO, Pushpalata started making Rs 250, about $4, per day. The businesswoman later pivoted to buying biscuits and snacks from wholesale stores and selling them from her home to nearby school kids. With the money she earned, Pushalata was able to pay off her loans in a year and rented a small store nearby, which she later named after her son, Sagar.

Women in Poverty

The biggest challenge to women looking to follow in the footsteps of Renuka and Pushpalata is access to credit – a first step to overcoming their financial struggles. In India, the poverty rate for women ages 25 to 34 was roughly 12% in 2020 and is said to increase to 14% following the dire effects of the COVID-19 pandemic. On the other hand, Indian men in poverty are roughly 100 men to every 120 women in poverty. The statistics highlight that there is disparity even within the parameters of poverty and that Indian women need support and guidance in their economic endeavors.

Addressing Credit Challenges

Thanks to the Vandana Foundation, an organization that provides low-interest micro-loans to female entrepreneurs in Dharavi, this challenge has become easier to overcome. In addition to the Vandana Foundation, many other NGOs such as the Light of Life Trust, Human Capital For Third Sector and Catalyst For Social Action, also play a big role to support India’s entrepreneurs and inhabitants.

A Take-away from Dharavi

The story of these women stands to show that although we tend to underestimate the power of small-scale local entrepreneurs, they are capable of making a considerable impact. If given the opportunity and starting resources, people have the power to change their financial circumstances and thus their lives, even in slums like Dharavi. There are hidden markets similar to the ones in Dharavi all over the world. By understanding where the opportunities lie and how to best support them, we can help people to help themselves and their communities.

– Samyudha Rajesh
Photo: Flickr

Premature Hysterectomies in India

premature hysterectomies in IndiaThe stigma surrounding menstrual periods continues to plague India. Due to the frequent lack of sex education and conversation about periods, many Indian girls grossly lack education about their cycles.  Local period taboos and social media moral police trolls widely shame girls about their menstruation. In fact, period taboo is leading to premature hysterectomies in India.

These period taboos significantly impact poorer women living in rural areas including Bend and  Sangli. These women migrate to the more affluent western “sugar belt” districts to work for six months as cutters in the sugar cane fields.  Cane cutting contractors hesitate to employ women who menstruate because they assume that they will miss a day or two a month due to their periods.

Because sugar cane cutting is frequently a family’s primary source of income in rural India, thousands of menstruating women have been electing to have hysterectomies, which are irreversible surgeries, to eliminate the “problem” of their period.

Indian Period Taboos

Menstruating women are frequently banned from religious, social and work environments during their cycles.  Indian society considers periods impure and girls who have their periods dirty.  Uneducated parents rarely prepare their daughters for their menstrual cycles, so when they arrive, fear and anxiety plague young women. Due to unsanitary lavatories and lack of access to sanitary products, 23 million Indian girls drop out of school after they get their periods. They also fear mocking from classmates for staining.

What is a Hysterectomy?

A hysterectomy is a surgical procedure that results in the removal of a woman’s uterus and, in some cases, her ovaries and fallopian tubes. In doing so, a woman loses the ability to become pregnant, will not menstruate and may experience a reduction in hormone production.  After undergoing a premature hysterectomy, many women must undergo hormone therapy to stay healthy and prevent further health complications.

Premature Hysterectomies in Rural India

In rural India many women feel as if they must eliminate their menstrual cycles entirely in order to work. Furthermore, due to the lack of education on the subject of menstrual cycles, doctors at private hospitals easily persuade women to undergo the expensive procedure in order to continue working as cane cutters.  A large percentage of those women are in their 20s and 30s, far younger than the age when experts usually recommend hysterectomies.

Roli Srivastava, author of the column. “Pushed into Hysterectomies” in The Hindu, describes a distinct pattern:  Private hospital doctors coerce poor illiterate women into a premature hysterectomy. These women, who present with easily treatable symptoms such as white discharge, an irregular period or bad cramps willingly elect hysterectomies so they won’t miss work. As she also explains, “their willingness to undergo the procedure stems from the fear of cancer (which doctors convince them of) to the belief that their uteruses are of no use once they have had children.”

A “Moneymaking Racket”

According to Srivastava, hysterectomies are a “moneymaking racket” in India for private hospitals. When illiterate rural women with menstrual cramps and heavy bleeding go to clinics, the doctors don’t give them options.  They don’t even let them consult their families, and they are not told the cause of their problems or informed about the procedure.  They often don’t know if their ovaries have been removed as well as their uterus.  The operation is expensive, and many rural clients’ insurance does not cover the operation.  Families need to go to moneylenders to get the funds for the operation.  In Maharashtra, the average cost of a hysterectomy is $598 and the average daily wage for a female worker is $2.98.

The Numbers

According to Indian Media, over a three-year period, more than 4,500 young women had premature hysterectomies in the Beed district alone. And the numbers are going up.  A 2018 government survey found that 22,000 women between 18 and 49 had hysterectomies. In one study that interviewed 200 women, 69% were unsure or uninformed of the nature of whether their procedure had removed their whole uterus or just their ovaries.

The Solution

Education about menstruation and personal hygiene is the key lever to reducing period taboo and premature hysterectomies in India. Education will enable more women to exert their rights in many other areas as well such as choosing contraceptives and making their own informed health decisions.  Photographer Niraj Gera, writes, “It is time we realize that menstruation is just a biological process and the secrecy surrounding it must go. It is important to normalize menstruation and destroy taboos around this natural process” As a strong advocate for period education he concludes, “Talking is all it takes to begin a transformation and it’s time we did it.”

– Opal Vitharana
Photo: Wikimedia Commons

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Public Health in Africa: Reducing Meningitis

Public Health in AfricaFor many people around the world, the COVID-19 pandemic was an eye-opening event that revealed the dangers and inadequacies of the world’s global health systems. However, for other people, outbreaks of epidemic diseases might be more of a lived reality. On the continent of Africa, many know a certain geographic region in sub-Saharan Africa as the “meningitis belt.” These 26 countries face the dangers of meningitis more than other places around the world, and the outbreak of the COVID-19 pandemic delayed the vaccination of the MenAfriVac meningitis vaccine to 50 million children in these countries. African governments collaborated with the World Health Organization (WHO), the Bill and Melinda Gates Foundation and PATH, a nonprofit health organization, to develop the MenAfriVac vaccine and distribute it to more than 350 million people living in areas of high risk. While this scientific effort made an incredible difference in public health in Africa, the COVID-19 pandemic largely disrupted the processes that allowed these successes to continue. The pandemic reduced services aimed at preventing meningitis by 50% from 2019 to 2020. Despite recent setbacks, WHO developed a plan to address meningitis.

Meningitis: The Disease

Meningitis is a complex disease with several variations. It arises in viral or bacterial form with several types of viruses or bacteria causing meningitis. Some meningitis vaccines protect against several forms of meningitis.

The types of meningitis are important to consider because historically, different types of meningitis affected African communities. Prior to 2010, only 10% of meningitis cases were a form other than meningitis type A; however, after the introduction of the MenAfriVac vaccine, the number of cases of meningitis type A decreased significantly. Since 2017, no person has experienced a case of meningitis type A in the region. While deaths due to meningitis still totaled 140,552 people in Africa in 2019, the elimination of meningitis type A means that about 95% of people diagnosed with meningitis survived in 2021. Since 2013, however, meningitis type C led to several outbreaks in the meningitis belt.

At the end of 2021, the Democratic Republic of Congo (DRC) reported 2,662 cases of meningitis along with 205 deaths due to meningitis. Local mobile clinics and vaccination drives from WHO helped reduce the outcome of death from 85% of cases to 10% of cases fairly quickly.

The Defeating Meningitis Road Map

WHO assists with suppressing the outbreaks of meningitis such as in the case of the Democratic Republic of Congo in late 2021; however, it also develops long-term plans to improve public health in Africa overall. In November 2020, the World Health Assembly approved the Defeating Meningitis by 2030 roadmap. WHO will implement the $1.5 billion plan in January 2023, which will begin the fight to control meningitis in Africa by 2030. The plan includes a goal to achieve a 90% vaccination rate using a new vaccine that will hopefully protect communities against new outbreaks of the disease. From 2023 to 2030, the plan also hopes to reduce deaths of meningitis by 70% and reduce cases of meningitis by 50%. Several steps to achieving these goals include increased disease surveillance to catch meningitis early and increasing awareness of services to improve overall public health in Africa.

With WHO’s plan to defeat meningitis by 2030, public health in Africa will greatly improve the lives of millions of people within the meningitis belt. Meningitis is mostly a preventable disease with the efforts of vaccinations and other measures of public health. As the rest of the world encountered during the COVID-19 pandemic, collaboration within a community goes a long way to keeping everyone safe.

– Kaylee Messick

Photo: Flickr

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Health in the Pacific Islands: Vanuatu Eliminates Trachoma

Health in the Pacific IslandsHealth in the Pacific Islands recently improved due to the elimination of a disease called trachoma on the island of Vanuatu. This island is located to the north east of Australia in a region called Melanesia. Vanuatu is the first of the Pacific Island countries to eliminate the disease, and the only one of 14 to complete this goal. Health in the Pacific Islands and around the world has improved significantly over time as public health measures reduced the number of people at risk of contracting trachoma by 92% over the past two decades.

Vanuatu

Vanuatu is composed of 83 islands and relies on agriculture. Due to the separation of islands, health in the Pacific Islands, including Vanuatu, is often inadequate. Access to health care remains a challenge to many residents, and there also exists a lack of resources and medical personnel. Though there are six hospitals located throughout the country, many people must rely on health centers due to the rural areas in which they live. The recent success story of the elimination of trachoma follows another success back in 2016 when the country eliminated lymphatic filariasis, a disease that affects the lymphatic system.

Trachoma

The bacterium, Chlamydia trachomatis, causes trachoma, which leads to a visual impairment that is, at times, severe enough to cause the patient to become blind. The bacterium has caused visual impairments in about 1.9 million people in the world so far, and 136 million people remain at risk of contracting the disease as of June 2021. The disease spreads through contact with discharge coming from the eyes or nose, whether through direct contact or intermediates such as flies. Trachoma is classified as a neglected tropical disease (NTDs).

People often find these diseases in countries in Africa, Asia and Latin America. Though there are many NTDs, trachoma is one of the known diseases in this category that can be eliminated from a population through the use of public health measures. Improvements to hygiene and access to clean water help control the spread of the disease, as well as control the spread of possible vectors such as flies. The push to eliminate trachoma began after data from 2014 indicated that trachoma infected 12% of children between the ages of one and nine years old. This means these children were at risk for serious visual impairment that would affect their future. Trachoma also holds a significant economic impact on countries that trachoma impacts, where these countries may lose up to $5.3 billion per year.

A Path Toward Elimination

Other countries can follow the success of Vanuatu by abiding by the recommendations of the World Health Organization (WHO) and mobilizing medical professionals and communities in places of at-risk individuals. The acronym for the policy toward eliminating trachoma is SAFE. It stands for “Surgery for trichiasis; Antibiotics to clear infection; and Facial cleanliness and Environmental improvement to limit transmission.” Communities pair this process with education on avoiding health risks, proper treatment and providing antibiotics to populations, especially rural individuals. Governments, such as the case in Vanuatu, also often partner with international organizations such as WHO, and with organizations that specifically work with treating diseases related to blindness such as the Fred Hollows Foundation.

The Fred Hollows Foundation is particularly important to the regions in and around Australia because it focuses on diseases related to sight. It helps to reduce poverty by providing medical treatments, education and training. It builds health facilities and works with local communities to end preventable blindness.

Looking Ahead

These ongoing partnerships and procedures that WHO outlines eliminate NTDs such as trachoma, allowing medical professionals to greatly improve health in the Pacific Islands. In 1998, WHO set a goal to eliminate trachoma by the year 2020. As of 2020, the new goal for the NTD elimination plan is now 2030. Trachoma remains a health problem in 43 countries. Hopefully, other countries in the Pacific Islands and around the world can use Vanuatu as a role model in eliminating more NTDs to improve health in the Pacific Islands and abroad.

– Kaylee Messick

Photo: Flickr

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Education in Mexico: Keeping Kids in School

education in MexicoMuch of Mexico’s population faces economic struggles that have only magnified amidst the ongoing COVID-19 pandemic, one of which includes the high dropout rate for school-age children, a challenge education in Mexico is facing.

Mexico Faces High Student Drop-Out Rates

Mexico’s enrollment rate is one of the most successful out of the Latin American countries. By the start of the 21st century, almost all of Mexico’s age-eligible population was enrolled in primary and lower secondary school. A study found that the enrollment rate for students in grades one to nine as of 2007 was around 95%. Yet, the country fails to secure a high rate of student enrollment through the end of lower secondary schooling, with the overall drop-out rate being close to 50%

Data shows that less than 60% of students finish upper secondary school (high school level) and of that percentage, a large number of children age-eligible for high school do not even attend, according to a University of Nebraska-Lincoln study. Many students decide to end their educational pursuits around the age 15, due to financial reasons. Additionally, an estimated 5.2 million students, around 14% of Mexico’s school-aged children, had dropped out of school since the start of the COVID-19 pandemic, citing financial hardship as the reason for their educational termination.

The Impact of Poverty

Although the government made secondary education mandatory in Mexico, it doesn’t directly enforce it. Additionally, “children marginalized by… poverty experience particularly high risks of dropping out” due to financial burdens, according to an article published in the International Journal of Educational Development. As children age, their school curriculum tends to become more difficult and financial costs tend to increase. Coupled with that fact, as children grow older they become more capable of contributing to their family’s financial status, whether that labor is through household duties or in the formal job market, the same article reports.

Mexico’s high dropout rates for school-aged children during and prior to secondary school therefore can have two reasons: the country’s poverty rates and the dependency on children’s labor to supplement household income, all of which especially escalated following the onset of COVID-19.

The Cancellation of Prospera

In recent news, Mexico’s President Andres Manuel Lopez Obrador canceled Prospera, a governmental program intended to keep children in school and improve education in Mexico, according to Social Protection. The government developed the program in 1997 in response to Mexico’s economic crisis during the years 1994-1995, renewed it as Oportunidades in 2002, then renamed it Prospera in 2014. Following its cancellation, a new program, the Benito Juarez Scholarship Fund, replaced the educational components of Prospera.

What was Prospera?

Prospera was a conditional cash transfer program (CCT) that not only focused on child education but health and nutrition; it supplied monthly cash subsidies to poor households, primarily those belonging to single and/or unemployed mothers, under certain conditions, Social Protection reports. These conditions included school enrollment and regular trips to health clinics for children.

The CCT program reached 6.2 million households and researchers found that during its implementation, educational attainment for children increased by about 10%, according to Social Protection. Other short-term positive impacts thanks to the program’s conditional healthcare visits included a decrease in maternal death by 11% and infant mortality by 2% and an average improvement in children’s nutritional health.

Long-term impacts of Mexico’s Prospera are still being studied, but one study found that the program’s beneficiaries were “37% more likely to have a job” than those who did not participate and the World Bank attributes one-third of the decrease in Mexico’s rural poverty rates to the program. The World Bank also notes that over 50 countries have replicated Mexico’s Prospera model, adopting similar CCT programs.

Reasons Behind Cancellation

Despite this, Prospera was not particularly popular among voters and Mexico’s president Lopez Obrador eventually canceled it. Data has shown that the program’s beneficiaries received 30% to 40% less in cash value than what was originally intended.

Additionally, the program failed to include 55% of families living in poverty and with household incomes that should have qualified for program consideration, according to Development Pathways.

The Benito Juarez Scholarship Fund

That being said, President Lopez-Obrador and his administration intend for the Benito Juarez Scholarship Fund, Prospera’s replacement, to serve children’s educational pursuits without Prospera’s past corruption. In an effort to confront Mexico’s low enrollment and high dropout rates in secondary education and beyond, the fund will give monetary grants in the form of scholarships to teenagers attending upper secondary (high) schools, Social Protection reports.

This fund, however, does not account for “the removal of conditional health and nutrition requirements of Prospera,” Social Protection reports. Despite this fact, the Benito Juarez Scholarship Fund aims to “encourage [children’s] school enrollment and graduation” without making subsidies conditional upon parents meeting certain requirements.

The program targets families with school-aged children whose monthly income falls under the extreme poverty line and Mexico’s government claims “priority is given to families that live in areas of indigenous populations, areas with high degrees of marginalization or with high rates of violence,” according to Observatory on Social Development.

Mexico’s government has made efforts to improve education in Mexico and school enrollment through programs such as Prospera and, more recently, the Benito Juarez Scholarship Fund.

– Ashley Kim
Photo: Flickr