In 2017, across the globe, 810 women died each day from preventable pregnancy and childbirth-related complications. Sub-Saharan Africa has the highest maternal mortality rate in the world. Women face 15 times the risk of dying from pregnancy and childbirth complications compared with women in developed countries. In this region, over half of the women do not have access to emergency obstetric care during labor, citing financial concerns or issues with accessing emergency maternal transport to hospitals. Vodafone and Transaid are organizations working to mitigate the barriers pregnant women encounter in accessing emergency maternal transport in Africa.

During an obstetric emergency, every second a pregnant woman experiences a delay in skilled care, the higher the risks of stillbirth, neonatal or maternal death. Many cases of maternal mortality are due to severe bleeding after childbirth, postpartum infection and blood pressure disorders. All of these are preventable and treatable with timely and skilled care. Urgent emergency maternal transport to adequate health facilities can be the difference between life and death.

Accessing Emergency Maternal Transport in Africa

Demography and Health Survey data from more than 40 countries revealed that while 50% of women cite finances as the primary obstacle for seeking obstetric care and 37% reported transportation challenges. In addition, 37% cited distance to be their main barrier. Access to mobilized vehicles in developing countries is incredibly rare. For example, only one vehicle is available for every 3,000 people. For comparison, in the U.S., there is one vehicle per 1.19 persons.

A study in rural Ghana found that 65% of women use public transport, 29% walk, 4% use personal cars and 1.6% ride by motorbike. However, much of this transportation is inaccessible because of high costs. The distance to an adequate healthcare facility is highly determinant of maternal outcomes, especially in rural areas of developing countries. A study in Southern Tanzania by Lancet Global Health found that “living more than 35 km away from a health care facility has a much higher likelihood of maternal mortality compared with those only living at a distance of only 5 km.”

Even when vehicles are available and distance is not a barrier, insufficient and dangerous road systems inhibit transport to hospitals. In developing countries, poor road networks make access to skilled healthcare challenging, especially for remote, rural areas. With road conditions unsuitable for many vehicles, women have few viable options.

Effective Interventions: Transaid

Organizations involved in transportation interventions often include direct provision of transportation or monetary schemes. This eliminates the financial burden on families seeking emergency maternal healthcare. Dependent on each community, organizations tailor the intervention to best support the residents.

Transaid, in partnership with the National Union of Road Transport Workers, has implemented emergency maternal transport interventions in Nigeria for more than a decade. Transaid’s project “focuses on training and encouraging local taxi drivers to transport pregnant women to health centers.” Drivers are incentivized to volunteer because they receive permission to park in front of the loading queue. This can “potentially save many hours of waiting for passengers.” Transaid has also had a huge impact through its More Mamaz campaign in rural Zambia. The More Mamaz campaign has trained 236 drivers and safely transferred more than 3,500 women to health facilities. The percentage of women delivering at health facilities rose from 64% to 89% from 2014 to 2017.

Vodafone

Vodafone, a mobile technology company, working in conjunction with Touch Foundation, created the m-mama program, a mobile technology program that connects women in rural Tanzania to local taxi drivers acting as “taxi ambulances.” The 24/7 dispatch center is called in an obstetric emergency and the dispatcher skillfully assesses the patient’s condition and connects them to a network of more than 100 taxi drivers responding to emergency calls. Upon arrival at the health center, drivers receive their pay instantly via Vodafone’s mobile money transfer system. Additionally, the service has also trained over 250 community health workers in the Sengemera and Shinyanga states of Tanzania. Vodafone’s successes have led to a partnership with the Lesotho Ministry of Health in South Africa to expand this program.

The Impact of Emergency Maternal Transport in Africa

The results of interventions have been promising. When South Africa issued 18 dedicated vehicles for maternity care, there was a “sustained reduction in mortality.” Similarly, in the Gambia, a “freely available ambulance service in connection with women’s obstetric needs correlated with substantially reduced pregnancy-related mortality.”

In an effort to provide safe, timely and reliable emergency maternal transport to specialized obstetric care, organizations have shown great innovation in how they train, incentivize and mobilize communities to improve outcomes for pregnant mothers.

– Brittany Granquist
Photo: Flickr

The Dom community has been present in Turkey and the Middle East for thousands of years. Like their more popular Romani counterpart, the Dom people have roots in the Indian subcontinent. Throughout the ages, the Dom people have faced exile and oppression. The Dom people are Turkey’s invisible population. However, the villainization of historically nomadic peoples is more prevalent now than ever. The growing disdain for ethnic non-Turks has made the situation worse. Many Dom people are now at severe risk of food scarcity and homelessness. Dom communities face much of the brunt of xenophobia in Turkey today.

The Dom Throughout the Ages

Thousands of years ago, India and the surrounding regions were home to dozens of different languages and nomadic peoples. One of these languages was Domari and the speakers were the Dom. The name “Dom” is also the name of one of the lowest castes in the Hindu religion. However, it is unclear whether the two groups relate due to sparse historical documentation and sources.

While the more popular Romani nomads migrated out of the Indian subcontinent in the ninth and 10th centuries BCE, the Dom migrated in the 13th and 14th centuries, primarily into the Middle East and Anatolia. Most Dom populations reside in Syria, Turkey, Palestine, the broader Levant region and potentially Iraq and Iran.

Within these regions, the Dom and other nomadic Indo-Aryan groups have faced centuries of ethnic discrimination, even after having adopted sedentary lifestyles. Many Dom communities maintain the same religion, cultural practices and languages of the regions in which they reside, with the Domari language becoming less and less known in Dom communities.

The Dom in the Present Day

In the present day, the Dom population in Turkey primarily resides in the south-eastern region of the country, near Iraq and Iran. Before the outbreak of the Syrian Civil War, there was also a sizable concentration of Dom living in Aleppo. President Recep Tayyip Erdoğan currently leads Turkey, representing the conservative, Islamist-based Justice and Development Party (abbreviated to AKP in Turkish). The AKP is known for its opposition to both the growing Syrian Refugee presence and the country’s Kurdish population. One 2019 poll found that 68% of AKP supporters expressed disdain for the Syrian refugee presence in Turkey, with similar figures coming from the party’s political allies.

In the same year, Erdoğan brought his disdain for ethnic Kurds to America, culminating in the presentation of an anti-Kurdish video to then-President Donald Trump. To add fuel to the fire, these two groups often coincide with one another, with many Syrian Kurds seeking refuge in Turkey.

In the middle of these tensions lies the Dom population of Turkey. The Dom population often goes unseen entirely among the regional turmoil. However, the Syrian Civil War and Kurdish tensions in Turkey are also affecting the Turkish Dom. Coincidentally, the regions that are home to Kurds and refugees in southeastern Turkey and northern Syria, are where the Dom live.

The Dom: Turkey’s Invisible Population

As a result of the historical marginalization of the Dom, there is ambiguity in regards to Dom communities today. For instance, there is no official census for the Dom population in Turkey. Many Dom community members also reject the “gypsy” label as it could potentially result in further alienation, instead opting to refer to themselves as Arab or Turkmen.

The Dom experience some of the highest rates of homelessness, food scarcity and illiteracy among Turkey’s marginalized groups. Dom families struggle to find housing, with entire communities relegated to living in makeshift shelters or tents. Many Dom living in refugee camps have attested to ethnic discrimination in food distribution by NGOs. Those not inhabiting refugee camps lack access to food. The Dom population has far lower rates of literacy and formal education than their ethnically Turkish counterparts.

Organizational Relief for the Dom

Luckily, organizations providing aid and relief for the Dom population in Turkey are working hard to improve the situation. Many regional organizations, like the Tarlabaşı Community Center in Istanbul, are committed to providing much-needed resources to Dom communities and refugees in need.

Additionally, one Turkish-based organization, Kırkayak Kültür – Dom Research Workshop, is gaining traction as one of the leading organizations for the Dom population in Turkey. Founded in 2011, Kırkayak Kültür is an advocacy group fighting for policy change and raising awareness. It has taken an active role in bringing awareness for the Dom people among NGOs and governmental institutions.

With the physical hardships and the centuries-long social ostracization of Dom communities, relief for Syrian and Turkish Dom is necessary. If Dom’s culture, language and identity are to survive, preservation and advocacy efforts like Kırkayak Kültür are essential. Through their work in this area, community organizations in Turkey are leading the charge with aid for Turkey’s invisible population.

– Madeleine Youngblood
Photo: Unsplash

Since 2000, the African Growth and Opportunity Act (AGOA) has been an important part of U.S. foreign and economic policies. It provides incentives for African countries “to open their economies and build free markets.” By promoting commercial ties, the U.S. benefits from trade with African countries that are eligible to participate. Additionally, the African countries also benefit from a growing and more prosperous economy. This enhanced development creates new jobs in underdeveloped countries and helps build a more sustainable economy, aiding in poverty struggles. Namibia, a sub-Saharan African country, is a prime example of the positive development and economic impacts of AGOA. Not only does Namibia implement AGOA with U.S. support, but on May 10, 2021, the country initiated the AGOA Utilization Strategy for tariff-free exports. Namibia’s AGOA Utilization Strategy promises economic growth benefits for the country.

Namibia’s Background

Namibia is a country in Southwest Africa with a population of 2.5 million. The status of poverty in Namibia is not as extreme as in other African countries. Nevertheless, 28.7% of Namibians are impoverished and 15% live in extreme poverty.

While the World Bank classifies Namibia as upper-middle-income, the country still remains a developing country. Namibia has been negatively affected by social and economic imbalances stemming from apartheid, heavy agricultural reliance and structural inequality. Namibia’s Gini coefficient value reflects the immense suffering Namibians face due to socio-economic gaps. Namibia has a Gini coefficient of 0.597, establishing it as “one of the most unequal countries in the world.”

In terms of economic freedom, Namibia boasts a sixth-place ranking out of 47 sub-Saharan African countries with an overall ranking scoring above regional and global averages. While Namibia’s economic success is positive in comparison to other African countries, the country still faces considerable socio-economic disparities and the U.N. still considers Namibia an underdeveloped country. With the introduction of AGOA into African economies, the development and economic growth of participating countries show a hopeful future for Africa.

AGOA Background

Former President Bill Clinton initiated the African Growth and Opportunity Act on May 18, 2000. Clinton initially designated 34 sub-Saharan African countries as eligible for AGOA, allowing for trade benefits between the U.S. and participating African countries. Not only would this law boost participating economies, but it also redefines U.S.-Africa relations. Today, about 40 sub-Saharan African countries are eligible to be AGOA beneficiaries.

Since the start of AGOA implementation, participants’ combined exports increased 500% from $8.15 billion to $53.8 billion between 2001 and 2011. The creation of AGOA through U.S. legislation proves favorable for African economic growth and aims to reduce poverty in the African continent.

Namibia’s AGOA Utilization Strategy

While the implementation of AGOA in Namibia follows the passing of the U.S. legislation in 2000, Namibia only recently decided to make full use of the program. To fully utilize AGOA, U.S. ambassador to Namibia, Lisa Johnson, joined minister of industrialization and trade, Lucia Lipumbu, to launch the AGOA Utilization Strategy in Namibia in May 2021.

The new strategy seeks to increase Namibia’s U.S. exports to more than 6,400 tariff-free products. Additionally, the plan addresses policy, supply and market challenges faced in Namibian trade, using public and private sector representatives to execute the AGOA strategy.

Namibia’s AGOA Utilization Strategy expands mutually beneficial trade, improving the economy and fostering alliance between the U.S. and Namibia. The African Growth and Opportunity Act proves helpful in strengthening economies, fostering development and encouraging global networking. Support for African growth and opportunity efforts is mutually beneficial for all those participating in the global market, with the ability to improve living standards in underdeveloped countries.

– Kylie Lally
Photo: Flickr

South Africa has prioritized passing laws to encourage greater inclusion and equality for people with disabilities, but today, disabled individuals continue to face economic insecurity and lack access to socio-economic rights. Every day, households in South Africa impacted by disability have economic vulnerabilities and disability-related costs to fulfill, which can negatively impact economic growth by lowering future productivity. In South Africa, low-income households with disabilities are more disadvantaged, resulting in lower education, employment and health outcomes.

Disability Barriers

In South Africa, families with disabilities are economically challenged due to the additional costs of living as disabled individuals. The negative economic consequences for society as a whole link to poverty because poverty and disability reinforce each other. Impoverished households in South Africa with a lack of access to education, healthcare and jobs are at higher “risk of impairment and disability.”

Daily barriers the disabled community faces include limited access to education and healthcare, accessibility issues and inadequate support and resources. Children with disabilities are often unable to attend school because they lack the appropriate resources and access to rehabilitation and assistive devices like wheelchairs or glasses. A central component and cause of poverty for people with disabilities is inadequate education.

Employment and Income Impacts

In South Africa, a lack of education for people with disabilities has a significant impact on the occupations and career opportunities available to them, resulting in unemployment or lower-paying jobs. Many disabled people who do find work are usually paid less than other people due to the limitations imposed by their impairment. Both of these variables have the potential to reduce household income.

Furthermore, increased time demands of providing care and assistance to an individual with a disability in the household impact the income of other household members. This is especially so for the primary caregiver. This may have pressing consequences, including difficulties finding work that can accommodate the high assistance demands in the household and allow for flexible or decreased work hours. Occupations with flexible working conditions are difficult to come by. Additionally, the birth of a disabled child or a disabling incident in the home may disrupt the education of other family members.

Progressive Laws Passed

The South African government has acknowledged the disability vulnerabilities of households in South Africa. South Africa has enacted a number of laws and policies to promote the inclusion and equality of people with disabilities. One of the earliest pieces of legislation is the Employment Equity Act of 1998. The White Paper on Inclusive Education was passed in 2001 to ensure disabled people have the same educational opportunities as others. The legislation upholds the rights of disabled people to ensure their education and employment, allowing them to rise out of poverty. Excluding marginalized populations is detrimental to a country’s advancement. Inclusive societies are able to progress at a faster rate because no person is left behind in growth and development.

– Mary McLean
Photo: Flickr