Archive for category: Global Poverty

Key articles and information on global poverty.

Okere City: The Rebuilding of a Greener Uganda after a Decade of War

Okere CityThe city of Okere Mom-Kok began as a project created to rebuild more rural communities destroyed in the wake of the Ugandan Bush War in the 80s. With the death of roughly 100,000 to 500,000 people, this war plagued the Northwestern region of Uganda the most. This project is already spreading throughout the country and reaching global headlines because of the progressive, sustainable methodologies offering accessible living alternatives.

The Ugandan Bush War

From 1980 to 1986, the Ugandan Bush War (also known as the Luwero War) ravaged several Ugandan villages. The conflict began with former General Idi Amin’s rise to power. Early in his presidency, Idi Amin established a military dictatorship. The Uganda National Liberation Front soon overthrew him. Originally implemented by Tanzania to replace Idi Amin, the UNLF’s regime lasted from early 1979 until it was eventually dismantled due to the attacks of Amin loyalists in 1980.

Detached groups of Amin loyalists massacred most of the Ugandan National Liberation Army. With the attacks on the previous Ugandan prime minister, Apollo Milton Obote, and the capturing of most villages along the West Nile, the Uganda Army wreaked havoc in Northwestern Uganda until internal conflict resulted in the separation of the insurgent group. This division generated a new, opposing group known as Uganda National Rescue Front.

Not long after, Obote regained office in 1981 and inspired the emergence of even more rebel armies. In 1982, however, the National Resistance Army, Uganda Freedom Movement, Uganda National Rescue Front and the Nile Regiment came together to create the Uganda Popular Front.

The conflict did not stop there, as the ex-soldiers continued to rebel against the new government well into 1994. Following Idi Amin’s presidency, President Yoweri Museveni took office in 1986 after allying with the rebellions that toppled the reign of his predecessors. President Museveni is currently in the sixth term of his presidency and suppressed the continuous attacks.

The Situation Today

An estimated 1 million Ugandan’s lost their lives throughout the 80s and early 90s. The end of the Ugandan Bush War left the remaining villages uprooted and their residents devastated. President Yoweri Museveni is still working to rebuild the toppled infrastructures of these villages and the Ugandan economy as a whole. The increasingly innovative solutions invented in Okere Mom-Kok are one prime example of the efforts.

The City of Okere

The city of Okere is located in the Otuke District, Uganda and consists of 14 villages, each with about 200 people. Made famous for its shea trees, Okere City is the inspiration for Marvel’s “Black Panther.” The shea tree is currently in high demand due to its scarcity after the war. Furthermore, their energy-efficient components make them very coveted.

This area was hit the hardest and is still recovering, thus the pioneering of greener and more sustainable living technologies. From the use of shea butter as a charcoal substitute to solar energy being accessible to the entire network of villages, the city of Okere continues to thrive and evolve. The main village currently consists of a church, markets, schools, clinics and several other crucial establishments.

Okere City is one of the many villages left destroyed by the Ugandan War and is still building towns essentially from the ground up. But this development created greener, more accessible technologies and spread throughout the country. The future for Okere City is bright and illuminates a beacon of hope for the livelihoods lost throughout the travesty that was the Ugandan Bush War.

– Caroline Kratz
Photo: Flickr

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Land Restitution In Colombia

Land grabbing has been a problem in Colombia for several decades, particularly for those living in rural areas. A mixture of political and business corruption, rebel groups, paramilitary organizations and drug smuggling has led to the displacement of many Colombians from the properties they own or inhabit. At their peak, land grabbers of varying organizations illegally held almost 15% of the land in Colombia. As a result, between 6 and 7 million people have had no choice but to leave their homes in search of alternative dwellings. As of 2011, that has all begun to change with land restitution efforts.

Law 1448

In 2011, Colombia introduced Law 1448, also known as the Victims and Land Restitution Law. The objective of the law is straightforward: return illegally held land to its rightful owners. As a direct result of the law, the government established a Land Restitution Unit. This unit aids Colombian citizens in the court system to help them understand how they can file for land restitution. The law also provides some leeway for those who might no longer have the physical documents that prove they own the land, which is frequently the case.

Resolution 181

Two years later in 2013, Colombia also passed Resolution 181. This law is designed to prevent land grabbing in the future. It helps new landowners properly obtain titles and registration documents to ensure that their land cannot be illegally taken or abused. It is another law that works at the judicial level to give proper guidance to those who might not be well versed in property law and related regulations. Both of these laws are designed to work in conjunction with one another to look after those living in impoverished and/or rural communities. They ensure that if and when land grabbing issues do arise, the courts will be able to review official documentation that clearly proves who owns what.

Technology Helping These Efforts

In addition to these laws, the National University of Colombia has designed a system that is significantly safer for storing land-related documents. Land titles and registrations now go directly into a blockchain designed exclusively for property owners. Blockchain technology is highly regarded as being the safest way to save information since everything is decentralized. That means that no single entity controls the data. In a blockchain, every user can see any new or old activity and monitor if something looks suspicious.

Hacking a blockchain is extremely difficult and no one in history has ever managed to do so. Hacking a blockchain is so difficult because any time a new block is created, there is information that links it back to every existent block. So if a hacker wants to change the code of a block in order to sign over a land title to himself rather than the intended owner, every single block in the chain needs to be manipulated to agree with that change. It also needs to be done before anyone notices that a change has occurred. There could be tens of thousands, if not hundreds of thousands of blocks in the blockchain for Colombian property ownership.

Next Steps

Colombia is moving in the right direction. Law 1448, Resolution 181 and blockchain implementation have been vital to land restitution efforts. Since 2011, rightful owners have reclaimed over 740 thousand acres of previously stolen land. While that number might sound large, more than 5 million acres of land still remain in limbo. To make land restitution efforts as effective as possible, Law 1448 and Resolution 181 must be enforced far beyond 2021. The proper framework is in place, but the Colombian government has to remain active in helping its citizens reclaim what is rightfully theirs.

– Jake Hill
Photo: Flickr

Improving Access to Healthcare in Armenia

Healthcare in Armenia
Armenia is a mountainous nation of nearly 3 million people. It neighbors Iran, Georgia and Turkey. Over the past three decades, healthcare in Armenia has undergone a slow reform. The country is transitioning from an inefficient model of centralized healthcare to a modern system focusing on family medicine. Many Armenians feel dissatisfied regarding their healthcare system. However, organizations like the Health for Armenia Initiative and the World Bank are working with the Armenian government to improve options for Armenians.

Armenia’s Healthcare History

Healthcare in Armenia during the Soviet era was a centralized medical system. Experts state that the Soviet system was technologically underdeveloped and inefficient. The healthcare model focused on centralized care in hospitals and medical professionals were highly specialized.

Armenia declared independence in 1991, and healthcare in Armenia underwent radical changes. Local governments took over primary health care sectors while regional governments gained ownership over hospitals. Armenia’s State Health Agency is now in charge of the healthcare system. The government allocates resources to these publicly owned facilities. Since its independence, Armenia has implemented many healthcare reforms. A major piece of legislation called the “On Medical Aid and Medical Services for The Population” created a system that allows patients to help pay for healthcare services. This development plays a role in why Armenians find themselves funding most healthcare expenditures with out-of-pocket expenses.

Armenians in certain years paid up to 89% of healthcare charges in out-of-pocket expenses. This is incredibly taxing, given that Armenians earn an average per capita household income of around $1,500 USD. Their inefficient and expensive healthcare system places a heavy financial burden on impoverished peoples. Patients are slowly transitioning to primary healthcare providers with financial regulations replacing older regulations. However, a lot of work is still ongoing to improve the healthcare situation in Armenia.

How Armenians Feel About Their Healthcare

A 2018 report outlined a recent picture of healthcare in Armenia. Around 400,000 people in Armenia are poor or near-poor. Meanwhile, at least 233,000 of these people are part of a vulnerable group including the disabled, children and the elderly. In 2014, 31.8% of the poorest of Armenians reported that they were sick for more than three days, but they did not seek treatment because of financial reasons. Only 4.2% of the richest Armenians made the same decision.

A public opinion report that BMC published in 2020 outlined the current feelings the Armenian people have towards their healthcare system. The researchers polled over 500 Armenian citizens about the country’s healthcare system. Nearly half of respondents did not believe that citizens had equal access to healthcare in Armenia. Almost 70% of respondents felt that the government should have a larger responsibility towards an individual’s health which included funding healthcare services.

The Healthcare for Armenia Initiative’s Mission

Armenian natives and internationals formed the Healthcare for Armenia Initiative (HAI) in 2016. The initiative’s team focuses on bottom-up reforms to increase rural Armenians access to the constitutional right to healthcare. HAI’s projects focus on developing and maintaining healthcare professionals that can provide services in high-need areas.

HAI defines its work around six pillars, and among these pillars are education, research and leadership. It focuses on these three by holding workshops. It held a two-day workshop in partnership with the National Institute of Health of Armenia where it “[discussed] how to improve health education and healthcare in Armenia.” Organizations like HAI have helped to inform recent changes in government policy that will hopefully address the healthcare needs of the Armenian people.

Recent Changes for Healthcare in Armenia

The Armenian government in partnership with the World Bank published a guideline for the Health System Modernization Project. The main goal of the partnership is to improve access, quality, efficiency and governance for Armenian healthcare. The project focuses on adopting an efficient family medicine model. The transition to a family medicine model requires training new doctors that are not overspecialized.

A major priority of the project was to train the number of healthcare professionals necessary to run a family medicine-style healthcare system. At a final cost of nearly $6 million USD, this project component costs less than the projected $7 million. This key part of the project trained 980 family medicine doctors and nurses. The World Bank reports that these numbers should support 60% of the country’s needs.

Armenia and the World Bank cooperated on three other major components as part of this modernization project. They optimized and renovated the hospital network. The project reorganized the Armenian Ministry of Health so the agency could better function as a regulator of healthcare. These reforms gave the Ministry of Health many monitoring tools to efficiently implement and regulate the healthcare reforms the country is undergoing. Armenia’s government also established the Health Project Implementing Unit (HPIU). HPIU is a part of the Armenian Health Ministry that monitors, reports on and provides strategic planning for the overall healthcare modernization project. All of these developments cost around $30 million USD to achieve.

Where Healthcare in Armenia Stands

Healthcare in Armenia is an inequitable system in the process of reforms and transition. Armenia with the help of national and international institutions is moving to a family medicine system that meets the financial and medical needs of its people.

– Jacob Richard Bergeron
Photo: Flickr

How Pedals for Progress Makes a Difference

Pedals for Progress
The organization Pedals for Progress (P4P) has an intriguing origin story. In a small town in 1970s Ecuador, a poverty-stricken carpenter dragged 40 pounds of steel hand tools down a dirt road. Each step felt heavier than the last. Moreover, this was the trip back home after hours of work nailing boards together and fastening tables. This man had to carry his tools with him at all times; after all, it was his livelihood. It was too risky to leave them in a workshop. Despite his talent and passion, the man was broke and persistently, unbelievably tired. Without a way out of this painful trek, he felt his body would surely give out before he could retire.

The carpenter knew of a much wealthier man, Cesar Pena. A landlord and fellow carpenter, Cesar owned several strips of land in the jungle along with several farm animals. Missing an eye and multiple fingers, his situation was much worse than the poor man who lived in the same town. Yet others regarded Cesar as an incredibly productive worker despite doing his job just five days a week.

This baffled a young American Peace Corp volunteer staying in the town. The volunteer asked the poor carpenter why he was unable to keep up economically with Cesar Pena. Incredulous, the poor man informed him of Cesar’s bicycle. The bike allowed him to travel several miles on either side of his home.

Pedals for Progress

Decades later, that Peace Corps volunteer, David Schweidenback, is now the founder of Pedals for Progress. Pedals for Progress is one of the largest distributors of used bikes to developing nations. Since 1991, it has operated as a nonprofit organization in New Jersey. It started when Schweidenback noticed that people threw an abundance of bikes into garbage cans in his neighborhood during a bleak financial time while working as a carpenter. Connecting his experience overseas with what U.S. citizens were wasting at home, he chose to make a difference.

As he explained to The Borgen Project, “I decided if I wasn’t doing anything and I’m not making money and I’m just sitting here bored, I’m going to go out and collect a dozen bikes and I’m going to ship them back to Ecuador. Just like a freebie, a one-off freebie, just to help some people out. And that was the beginning of it.” That dozen eventually exceeded over 100,000. Schweidenback’s work has earned him awards from Rolex and Forbes. He even received the title of a 2008 CNN Hero.

How Does Pedals for Progress Work?

P4P operates both internationally and domestically. On the international side, the company teams up with partners based in those countries rather than opening up bike shops around the globe. These international partners provide the shops. In turn, these shops serve to also create jobs in the community whilst selling bicycles at a fraction of the cost they would be in the United States.

Pedals for Progress innovated a new system to keep these shops self-sustaining called a “revolving fund.” First, P4P foots the bill for the first shipment of bicycles. This leads to the domestic side of the operation. Working with organizations like Rotary Club and various churches, it runs collections at a minimum of $10 per bike donation. Other methods to raise money include fundraisers, grants and donations from rich individuals or corporations. With these monetary donations and selling within the impoverished communities at affordable prices, overseas partners can continue to function for years without extra assistance.

Can a Bike Really Make a Difference?

Studies show that the simple introduction of a bicycle can have a lasting impact on the economies and well-being of peoples in developing countries. A 2009 series of studies by three organizations ran quantitative experiments in multiple nations. The purpose was to see if offering bikes to people for transportation as an alternative to walking would financially improve their lives.

The Institute for Transportation and Development Policy study in Uganda found that all the households that received bicycles improved regarding cultivation and agriculture. Diversity of time increased, showing that the select Ugandans were more able to perform non-agricultural duties. In addition, the study indicated more trips to the markets and medical centers of their respective regions. Overall, bicycles resulted in a 35% increase in income over the course of the experiment. The other two organizations, Tanzania’s International Labor Office and World Bicycle Relief in Sri Lanka, yielded similar results to varying degrees.

What About Sewing Machines?

In 1999, Schweidenback included sewing machines in his list of items to ship. His reasoning: while riding a bicycle can take one to a job, a sewing machine is a job. However, Pedals for Progress was unable to ship more than 200 per year for a long time. It took until 2015 when he adopted a new brand, Sewing Peace, that he was able to ship out more than 500 bikes each year.

Sending out sewing machines as an alternative to bicycles can reap a few benefits that could not come anywhere else. For one, shipping them costs much less and puts less of a burden on overseas partners that cannot handle a full container of 500 bikes.

Early Setback, Lasting Results

Ironically enough, Schweidenback’s first mission to help Ecuador’s bike shortage never came to fruition in the way he hoped. Before Pedals for Progress was what it is today, he held a meeting with the Ecuadorian Consulate to donate bicycles to those who need them.

Speaking with The Borgen Project, Schweidenback relayed his early challenges shipping bikes to Ecuador. However, despite his early setbacks, his passion for giving the less fortunate a leg up drove him to help over 30 countries around the world.

– Zachary Sherry
Photo: Flickr

Indigenous Inequalities Continue to Grow in Australia

Indigenous Inequalities
Indigenous inequalities are very evident in health. Unfortunately, Indigenous Australians suffer from much worse health problems than the non-Indigenous Australian population. Here are a few key figures to demonstrate the stark inequalities. In 2017, Indigenous children experienced 1.7 times higher levels of malnutrition than non-Indigenous children. Additionally, three in 10 indigenous people who needed to go to a health provider did not go. Indigenous people’s barriers to healthcare frequently include high costs, unavailability of services, the distance from healthcare services and long waiting times.

Another inequality is that 45% of Indigenous people, aged 15 years or over, said they experienced disability, compared to just 18.5% in the non-Indigenous population. Between 2014-2016, Indigenous children aged 0-4 were more than twice as likely to die as non-Indigenous children. In the Northern Territory, Indigenous infant mortality was four times higher than the national rate. Lastly, Indigenous people had to wait 50 days on average for elective surgery compared to 40 days for non-Indigenous people. All this evidence highlights the stark Indigenous inequalities in health, demonstrating the gap that exists in access to key services and educational tools.

Original Closing the Gap Framework

In 2008, the Australian government made a promise to address Indigenous inequalities in a strategy called Closing the Gap. “The Gap” refers to the vast health and life-expectancy inequalities that exist between Indigenous and non-Indigenous Australians. The framework involved seven targets aimed at reducing socio-economic Indigenous inequalities, including many health targets. However, when the government began evaluating the success of the framework, it became clear that there is still a long way to go.

Five of the seven targets remain unmet, with very little evidence of progress in those target areas. The two targets that the Australian government has met were early education and Year 12 completion rates, but the other targets including child mortality, school attendance, literacy and numeracy and employment and life expectancy, have shown little or no improvements. A lot of the discussions around the failure of the framework have surrounded the issue of the lack of Indigenous voices. The Australian government established the framework with no engagement of the local Indigenous people it was seeking to help. It ignored their individual experiences and their local solutions, and instead came up with a one size fits all solution that failed to understand the Indigenous community.

2020 Programme Refresh

Because of the failure of the original Closing the Gap framework to address Indigenous inequalities in health, in July 2020, the government met and agreed upon a new approach. The government believed a refresh and shift in the Closing the Gap framework was necessary. This refresh involved a partnership between all Australian governments and the Coalition of Aboriginal and Torres Strait Islander Peak organizations. This represents a huge advancement and the first time that an agreement with an aim to improve the lives of Aboriginal and Torres Strait Islander people has actually involved Indigenous people in its localized solutions.

This newly designed framework will embed the cultural determinants and social determinants of health to provide a single, overarching policy framework for Indigenous health. The vision is that Aboriginal and Torres Strait Islander peoples will be able to enjoy long, healthy lives that are centered in culture, with access to services that are prevention-focused, responsive, culturally safe and free of racism and inequity. The framework ensures that Indigenous people are at the center of creating solutions that work for them in their cultures. Alongside this nationwide government framework, other progress is occurring including the implementation of more healthcare services with healthcare officials that actually represent the population. In fact, healthcare services are involving more Indigenous workers and the government is implementing Indigenous-specific healthcare facilities to better cater to Indigenous people’s specific needs.

New Progress

Evidence is beginning to mount showing the positive effects of reducing Indigenous inequalities in health. For example, from 2013 to 2019, the number of Indigenous medical practitioners employed across Australia increased from 234 to 488. Additionally, Indigenous-specific primary healthcare organizations provided 3.7 million episodes of care in 2018-19. Though progress has been slow so far, there are some promising statistics and a renewed government focus that will hopefully start to reduce Indigenous inequalities in health.

– Lizzie Alexander
Photo: Flickr

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The Aama Program: Maternal Health in Nepal

The Aama ProgramMaternal health is a pressing issue in developing countries as they often lack infrastructure and facilities to adequately care for pregnant women. Women often lack the incentive to use health service centers and choose to rather give birth at home, resulting in high maternal mortality rates. In Nepal, attempts to remedy this issue have led to a cash transfer scheme, which seeks to encourage pregnant women to use medical facilities to give birth by giving them a certain amount of cash to do so. Known as the Aama (or mother) program, the initiative aims to address Nepal’s poor maternal health by making sure that more births are overseen by health professionals.

Overview of Maternal Health in Nepal

Nepal’s healthcare system has long suffered from neglect due to civil strife and political instability. Despite this, it has seen an improvement in maternal health over the past few decades as more government attention has been spent toward this end. The country has received praise from the United Nations for its efforts in reducing its maternal mortality rate by almost three-quarters between the years 1990 and 2015, reflecting the government’s commitment to addressing the issue.

These developments can be attributed in part to improvements in infrastructure and education, as better infrastructure makes health facilities more accessible and higher levels of education raise awareness of medical issues. Additionally, government programs were implemented to assist Nepali women in receiving better healthcare and offset potential costs of doing so. These smaller programs, which were consolidated in the Aama program in 2009, have been an important aspect of Nepal’s attempt to improve maternal health.

The Aama Program

Predecessors to the Aama program were formed to address the issue of maternal health in Nepal. In 2005, the Safe Delivery Incentive Programme (SDIP) was introduced to pay pregnant women to use public health facilities to give birth. These payments vary based on region, reflecting the fact that women in remote parts of the country incur additional costs to access quality healthcare. As a result, women in the Himalayan regions of the country receive 1,500 rupees as these areas have a difficult terrain, and therefore, more costs are involved to reach medical facilities. Those in the middle hill regions receive 1,000 rupees because the terrain is still quite challenging. Those in the southern plains region receive 500 rupees as the land in this area is flat and easy to manage.

In 2009, the program was renamed the Aama program while a provision was added to provide reimbursement to health facilities and any costs associated with delivery services were removed. Finally, the program was further amended in 2012 to provide cash incentives for women to complete at least four antenatal care visits.

Since the inception of the program in 2005, there has been an increase in the usage of medical facilities to give birth. A study from 2005-2009 shows how this increase can be seen throughout every region of the country. Overall, births in medical facilities have almost doubled from 2006 to 2011 with an increase from 20% to 39%.

Room for Improvement

While Nepal has seen progress in increasing the usage of health facilities to give birth, there is still room for improvement. As of 2018, 58% of women still gave birth at home, even those with knowledge of the Aama program. This discrepancy can be explained by social and economic factors. For example, women who choose to give birth at home may do so because they are not comfortable with a hospital setting. Furthermore, women who are economically disadvantaged often receive substandard care. As a result, these women may still choose to give birth at home even after receiving a cash incentive to use a medical facility.

The Aama program is a promising initiative undertaken by the Nepalese government to improve maternal health in the country. It seeks to incentivize pregnant women to use health facilities to give birth rather than giving birth at home and risking complications. While Nepal has seen a decrease in maternal mortality over the past decade, the Aama program can be expanded even further by accounting for the various socio-economic issues women face.

– Nikhil Khanal
Photo: Flickr

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3 Ways the US Can Help Palestinian Refugees

Palestinian Refugees
Prior to 2018, the United States was the largest contributor to the United Nations Relief and Works Agency (UNRWA). UNRWA provides educational, medical and other resources to Palestinian refugees. While poverty rates of Palestinian refugees differ from country to country, about 25% live in overcrowded, unstable, underfunded and often unsafe refugee camps.

The services that UNRWA provides are vital to Palestinian refugees suffering from poverty. As a result, when diplomatic ties between the U.S. and Palestine severed, the organization lost 30% of its annual funding and basic resources became limited. Now, with the COVID-19 pandemic and subsequent financial crisis occurring, UNRWA’s resources have experienced severe strain.

In a United Nations press briefing in November 2020, UNRWA Spokesman Tamara Alrifai said, “Despite the immense efforts to raise sufficient funds in 2020 to maintain UNRWA’s critical services to 5.7 million Palestinian refugees across the Middle East, as of yesterday November 9, UNRWA has run out of money.” As a result, the organization had to cut pay for its 28,000 employees, most of whom were refugees themselves, during a global pandemic and international financial crisis.

Twenty-seven days into his presidency, President Joe Biden promised to restore diplomatic relations, including aid, with Palestine. These are three ways that impoverished Palestinian refugees may benefit when diplomatic relations between the U.S. and Palestine resume.

Medical Care

Over 3 million refugees rely on UNRWA’s medical services for basic medical care. Because UNRWA’s financial crisis is also happening during a global health crisis, the biggest strain has been on the organization’s medical services. Medical facilities have been running low on supplies, staff and medicine. The strain on medical services disproportionately affects Palestinian refugees.

Seham al-Lahem, a young expectant mother, and other Palestinian refugees have requested that UNRWA cover their medical fees at a non-UNRWA facility. “We have been hearing of the financial problems facing UNRWA, and it has left me worried about my delivery and the medical services provided to me and my newborn,” said Seham al-Lahem. With the financial struggles facing UNRWA, it is possible that she may not receive the cash she needs to pay for her delivery.

Palestinian refugees are three times more likely to die from the virus than the general population and must rely on local governments to receive vaccines. In Lebanon, for example, 6,200 Palestinians have already registered to get the vaccine. However, in the Gaza Strip and West Bank, Palestinian refugees rely on Israel to provide vaccines. Israel has not, as of yet, provided the Palestinian territories with any doses.

UNRWA Commissioner-General has cried out for global help to provide vaccines for Palestinian refugees in the territories and in the diaspora. “I am counting on the international community to ensure the availability of vaccines to refugees worldwide, including Palestine refugees in the occupied Palestinian territory and throughout the region,” he said. It is possible that, with U.S. funding, it would be more feasible for UNRWA to connect Palestinian refugees living in the territories with vaccinations.

Food Assistance

UNRWA’s food assistance program is also under strain due to the pandemic. The organization is now asking for its donors to provide additional funds so that they can feed 1.2 million Palestinian refugees experiencing hunger. UNRWA’s food assistance programs are absolutely essential for those facing rapidly declining financial conditions. In Gaza, 75% of refugees lack the ability to put food on the table. To remedy this, UNRWA currently provides food packages to 620,310 refugees and cash-credit to another 389,680 to ensure that all Palestinian refugees meet their daily caloric goals.

Education

There are over 526,000 students in 711 UNRWA elementary and preparatory schools. These UNRWA-run schools provide books, school supplies and mental health counseling. Although UNRWA schools have stayed open despite funding cuts, the organization struggles every year to meet educational funding needs. Every year, the organization, parents and students worry that schools might not be able to open up again.

This uncertainty threatened the future of Palestinian refugee children. Education is important for children to gain the confidence, knowledge and connections required to transcend their socio-economic situation.

Schooling also meets a social need for child protective services for refugee children. According to the UNHCR, teachers and counselors at refugee schools often connect children experiencing abuse and violence with the appropriate resources. With restored funding from the U.S., UNRWA children, parents and teachers could thrive without worrying that educational opportunities may cease at a moment’s notice.

The US’s Opportunity to Embrace Humanitarianism

UNRWA’s services are essential to the health, food security and education of Palestinian refugees. The organization provides basic resources to an economically and politically vulnerable population. No political situation should ever get in the way of basic human needs such as access to food and healthcare. Therefore, it is vital that the U.S. include the restoration of funding to UNRWA in its plan to re-extend diplomatic relations to Palestine.

– Monica McCown
Photo: Flickr

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The Move to End Child Poverty in Nepal

Child Poverty in NepalChild poverty in Nepal is an issue that the country continues to struggle with. While the child poverty rate has decreased over the past few decades, it is still detrimental to the overall progress of the country. In combating this issue, it is important to understand the consequences that stem from living in poverty. Two of these consequences are high levels of malnutrition and child marriage.

Overview of Child Poverty in Nepal

While Nepal has seen improvements over the past few decades, the overall poverty rate remains high. The decline of the child poverty rate in the country has not matched the decline of the overall poverty rate. Between 1995 and 2006, there was an 11% decline in the overall poverty rate, yet the decline in child poverty in that time period was only 8%.

The COVID-19 pandemic has intensified this issue by weakening Nepal’s economy and forcing children to stay home. The lack of income for parents and the lack of schooling due to the pandemic has pushed millions of households into a precarious situation. It is estimated that nearly 10 million children in Nepal live in impoverished circumstances. The presence of COVID-19 exacerbates the already damaging effects of child poverty, including malnutrition and child marriage.

Malnutrition Among Nepali Children

Maintaining high nutritional standards for children is vital for a country. It ensures children will grow up to be healthy and productive adults, fully able to break cycles of poverty. Child poverty in Nepal is detrimental, in part, because it leads to high rates of malnutrition. Malnutrition may cause developmental issues and results in chronic health problems later in life. While Nepal has made progress in lowering malnutrition rates among children, it is still a cause for concern. In 2019, 43% of children under 5 years old were malnourished. Moreover, 36% of these children suffer from stunting and 10% of these children suffer from wasting.

The country’s high poverty rate exacerbates this issue because low-income families are unable to afford a nutritious diet for their children. As a result, malnutrition rates in Nepal are directly linked to poverty. According to USAID, “17% of children in the highest wealth quintile are stunted as compared to 49% of children in the lowest wealth quintile.” These statistics demonstrate how poverty impacts child mortality. Malnutrition causes the deaths of almost half of all children who perish before reaching the age of 5 years old.

Due to the impacts of child poverty and malnutrition, the government has set up initiatives to improve nutritional standards in the country. Since the 1990s, programs such as the Vitamin A campaign have launched in order to increase the consumption of certain nutrients. In 2004, Nepal implemented the National Nutrition Policy and Strategy, which focuses on the nutrition of women and children.

Child Marriage and its Relation to Poverty

Child poverty in Nepal also directly impacts the rates of child marriage in the country. Despite the fact that marriage before the age of 20 is illegal, 37% of girls are married before the age of 18. Girls who marry at a young age are at a higher risk of facing domestic violence. Human Rights Watch states, “A study across seven countries found that girls who married before the age of 15 were more likely to experience spousal abuse than women who married after 25.”

Additionally, early marriages are associated with lower levels of education. Strict gender roles in Nepal dictate that married girls are expected to be homemakers so girls who get married while still in school often do not finish their education. Early childbearing also has health consequences for these young women. Poverty is a primary reason child marriages persist in Nepal, despite efforts made by the government to stop the practice. Young girls in impoverished families are married off to ease the economic burden on the family. One less child to feed is sufficient justification for a family to allow a child marriage. Some of these girls even welcome child marriage because it means they will have food to eat.

Looking Ahead

At a 2014 “Girl Summit” in London, Nepal pledged to end child marriage by 2030 in accordance with the U.N. Sustainable Goal to end child marriage by 2030. The government of Nepal partnered to develop the National Strategy to End Child Marriage in order to meet this objective.

Child poverty in Nepal continues as a challenge for the country and impacts a wide range of topics. Malnutrition and child marriage are pertinent issues associated with child poverty. With a government commitment and help from organizations, child poverty in Nepal can be combated.

– Nikhil Khanal
Photo: Flickr

How the Surjer Hashi Network Improved Healthcare in Bangladesh

Surjer Hashi NetworkBangladesh is a country in South Asia with a population of 163 million people. As a developing country, Bangladesh struggles to provide adequate healthcare for such a large number of people. The problem particularly brings challenges for people from rural and marginalized communities, who often cannot access quality health services. To combat this issue, the Surjer Hashi Network has been established. Funded by the U.S. Agency for International Development (USAID), it is a network of hundreds of health facilities throughout the country. The facilities bring free or reduced-cost healthcare to low-income populations in Bangladesh while simultaneously bringing the country closer to achieving universal healthcare.

Healthcare in Bangladesh

Despite Bangladesh’s current struggles to provide a reasonable level of healthcare for its citizens, the country has made significant progress over the past few decades. Certain indicators have seen improvements such as maternal and infant mortality. Furthermore, the rate of vaccinations for children has increased dramatically, with the percentage of tuberculosis vaccinations for children under 1 increasing from 2% in 1985 to 99% in 2009. While the developments are a good sign, Bangladesh still faces many challenges in maintaining its healthcare system. For instance, the country suffers from a severe shortage of healthcare workers. As of 2009, only about one-third of the country’s facilities have at least 75% of qualified staff working in healthcare and 36% of health worker positions are vacant.

The ineptitude of Bangladesh’s governmental structure and the inability of its institutions to carry out its policies cause problems. The healthcare system is concentrated in urban areas even though 70% of the population lives in rural areas. Meanwhile, careless management obstructs the allocation of resources. Healthcare workers suffer from high turnover and absenteeism while maintenance of facilities is poor. Meanwhile, rural Bangladeshis often forego formal healthcare due to a lack of access in the communities. As a result, only a quarter of the population uses public healthcare.

The Surjer Hashi Network

USAID backs the Surjer Hashi Network of health clinics aiming at serving low-income and other underserved communities in Bangladesh. With 399 facilities nationwide, the network serves at least 16% of the population. In just a five-year period, USAID helped the Surjer Hashi Network prevent 2,000 maternal deaths and 10,000 child deaths. The facilities provide communities with proper healthcare in remote and underserved areas. Rural women, in particular, have benefited as the Surjer Hashi Network of clinics provides for reproductive health and child care.

Universal Healthcare in Bangladesh

In 2018, USAID started the Advancing Universal Health Coverage (AUHC) program, which has allowed the Surjer Hashi Network to remain operable in the long term. The program has consolidated the hundreds of clinics in the network into a centrally managed organization and it has introduced new business models aimed at keeping costs down and expanding health services. The efforts will ensure that clinics in the Surjer Hashi Network will be financially independent while providing high-quality and affordable healthcare for the disadvantaged.

As its name suggests, the AUHC’s goal is to achieve universal healthcare in Bangladesh. Through the Surjer Hashi Network, USAID is ensuring that Bangladesh can provide healthcare coverage for as many people as possible with healthcare facilities that are accessible in rural areas as well.

– Nikhil Khanal
Photo: Flickr

Fighting Non-Communicable Diseases in El Salvador

non-communicable diseases in El SalvadorEl Salvador has experienced rampant public health problems for generations and has recently made commendable successes in addressing these problems. However, non-communicable diseases in El Salvador continue to be stubborn roadblocks that cost many citizens their health and their lives.

Non-Communicable Diseases (NCDs) in El Salvador

Non-communicable diseases are those that cannot be directly spread from one person to another such as Alzheimer’s, cancer and diabetes. Like the rest of the world, NCDs are a leading cause of early death among the adult population in El Salvador. Estimates show about 71% of all global deaths result from NCDs, the majority of which come from low-and middle-income countries. During the 2011–2015 period, in El Salvador, one of the most impoverished and most dangerous countries in Latin America, cardiovascular disease accounted for some 12% of deaths. Chronic kidney disease followed at 6.3% and cancer at 5.4%.

Many of the factors leading to high death rates from non-communicable diseases in El Salvador are lifestyle-related. Sedentary lifestyles, smoking and poor nutritional choices all contribute to NCDs such as diabetes and cardiovascular disease. Poor nutrition is common in many low-and middle-income countries. A health survey among El Salvadorians found almost 94% of citizens consumed too few fruits and vegetables and almost as many consumed an excess of sugary beverages. With this information, it is no surprise the survey also found relatively high rates of overweight and obese adults. Obesity is synonymous with NCDs. Furthermore, chronic kidney disease is particularly prevalent among El Salvadorian adults. This results from excessive use of anti-inflammatory medication, inadequate hydration and exposure to agrochemicals in the workplace.

Previous Healthcare Efforts

Public health problems are nothing new to El Salvador. The Ministry of Health has been ramping up efforts to address these problems since 2009. Some of the main concerns in the past have been the fragmentation of the health sector and high rates of uninsured citizens. In 2009, the Ministry of Health implemented a National Health Strategy to correct these issues. Throughout this program, increasing equity of access to health services, improving the quality of these services and strengthening the monitoring and oversight capacity of the Ministry of Health have been top priorities. In order to accomplish these goals, El Salvador increased its public health expenditure by 33.7% from 2009 to 2019. The country also increased the amount of these expenditures allocated to the public health sector by 8%.

Many of these efforts have paid off, albeit modestly. Because of the National Health Strategy, more public health services have reached impoverished and remote citizens in El Salvador. Expanding access to healthcare has had a positive effect on the country’s economic outlook. The income-poverty rate decreased from 46.4% in 2008 to less than 34.8% in 2013 and extreme poverty dropped from 15.4% to 9.1% in the same period. Furthermore, El Salvador’s Gini coefficient (measure of income inequality) decreased from 0.47 in 2009 to 0.41 in 2013, in large part due to public service equity efforts such as those executed by the Ministry of Health.

Non-Communicable Disease Efforts

Even with all this progress, the problem of non-communicable diseases in El Salvador remains. Non-communicable diseases account for more than 65% of all deaths in the country. Therefore, the Ministry of Health teamed up with the World Bank and Access Accelerated in 2018. The two wanted to specifically fight NCDs through the project El Salvador Addressing Non-Communicable Diseases. This project focuses specifically on improving the prevention, detection and treatment of cervical cancer as well as the prevention of common NCD risk factors. In fighting cervical cancer, El Salvador received more than 86,000 HPV screening tests and almost 30,000 doses of HPV vaccines. Both prevent cervical cancer by taking early action.

Besides cervical cancer, the program works to fight other non-communicable diseases in El Salvador. It accomplishes this by training healthcare workers, providing workshops on nutrition and expanding access to mental health resources. The arrival of COVID-19 has disrupted some of these programs. However, it also forced organizers to rethink how to properly deliver care in continuation of their public health efforts. New methods have included providing health education through social networks, improving the delivery of medication, increasing the use of telehealth and making home dialysis available for chronic kidney disease patients. These approaches to healthcare spurred by COVID-19 will likely live on in the post-pandemic world. Many changes like switching to telehealth are increasingly popular, both in El Salvador and around the world.

The Road Ahead

As in most other nations, non-communicable diseases in El Salvador weigh heavily on the population. However, El Salvador has proven during the past decade that improving access to healthcare for impoverished citizens, treating NCDs proactively through preventative measures and championing new flexible ways of delivering healthcare are positive steps any country can take to make an impact on national public health. Though researchers will not know the full effects of recent programs for some time, early results are promising. Physicians are administering more HPV tests and vaccines, more public health services are reaching low-income citizens and pandemic-era practicalities are proving so popular that they will likely be hallmarks of global healthcare in the years to come.

– Calvin Melloh
Photo: Flickr