Archive for category: Global Poverty

Key articles and information on global poverty.

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How Traditional Healers in Africa Help Fight COVID-19

traditional healers in africaTraditional medicine, while not as popular or widely accepted as Western medicines, is a vital part of African communities. Traditional healers in Africa are more accessible, affordable and culturally and spiritually relevant for many African people. This contributes heavily to their popularity, and it also enables them to play a role in helping respond to COVID-19.

What Is Traditional Medicine?

The World Health Organization describes traditional medicine as a practice or skill resulting from cultural beliefs and ideologies. Similar to Western medicine, traditional medicine prevents and treats physical and mental illnesses; however, traditional medicine usually uses herbs, plants or even spiritual therapies.

While traditional medicine may seem ineffective and useless to some, it is the main source of medicine for many. Due to its convenience and affordability, over 70% of Africans use herbal treatments. Given that one third of the African population does not have access to essential medicines, traditional medicine plays a central role in their health. A study in 2011 illustrated the accessibility of traditional practitioners. While most medical doctors practice in urban areas, rural areas are less fortunate. For this reason, many people rely on traditional health providers and their medications. These three countries reveal a large gap between how many traditional healers and doctors are available in a community:

  • Zimbabwe: There is one traditional practitioner for every 600 people, while there is one medical doctor for every 6,250 people.
  • Ghana: There is one traditional practitioner for every 200 people, while there is one medical doctor for every 20,000 people.
  • Mozambique: There is one traditional practitioner for every 200 people, while there is one medical doctor for every 50,000 people.

Affordable and Culturally Relevant Medicine

Not only are traditional healers in Africa more accessible, they also have affordable medicines that don’t always require payment upfront. A study conducted by the WHO in 36 middle- and low-income countries revealed that medications were too expensive for a large majority of the population. Similarly, a study on healthcare in Zimbabwe reported that traditional healers are usually the main source of care for poor communities because they have no other options.

Furthermore, traditional healers in Africa and their medicines are widely accepted by African people and culture. Even if people can afford Western medicine, then, many prefer traditional medicines. For example, some healers say that they can channel the ancestral spirit through their patients’ bodies. This is one service that professional doctors cannot provide.

How Traditional Healers in Africa Help with COVID-19

While traditional healers in Africa provide many benefits to African communities, health officials strongly advise against the use of untested traditional medicine to treat COVID-19. The WHO encourages people to wait until medicines have been tested and investigated before consuming them. In South Africa, traditional healers have been advised to refer patients experiencing COVID-19 symptoms to a higher level of care. However, the role of traditional healers during the pandemic is not limited to referrals. Here are eight jobs traditional healers in Africa perform:

  1. Referring patients to correct and suitable levels of care
  2. Educating the public to combat the spread of false information regarding COVID-19
  3. Teaching about prevention methods
  4. Helping to spread public health messages
  5. Informing people about the necessities of personal hygiene
  6. Providing counseling services
  7. Postponing large gatherings
  8. Working with the Department of Health to aid screening and messaging

Health Officials and Traditional Healers: Better Together

To effectively combat COVID-19, experts believe that health officials and the government need to work with traditional healers and not against them. Because traditional healers live in the same community as many of their patients, they have the advantage of possessing important relationships with them. Patients may therefore disregard the advice of a doctor and trust a traditional healer instead. This points to the necessity for cooperation between healers and doctors.

An example of this cooperation comes from Tanzania, where scientists are working with herbalists to help with HIV/AIDS symptoms. Some of the herbs the group is testing are known for strengthening the immune system and increasing appetites. While the team recognizes that herbal remedies won’t cure HIV, they can lessen patients’ symptoms.

With regard to COVID-19, the WHO, which accepts both traditional and alternative medicine, is doing similar tests. For example, it is currently testing plants like Artemisia annua to see if they could possibly aid in the fight against COVID-19. If more scientists, governments and health officials can work with traditional healers like this, all of their patients and communities stand to benefit.

– Sophie Dan
Photo: Flickr

American Expenditure on Entertainment and the Poor In the World

American Expenditure on EntertainmentExpenditure by the average American consumer unit (henceforth household) each year is substantial compared to what the poor in the world spend. Of the 200 million or so rich people globally, Americans make up the majority; in this decade, as determined by those in the World Data Lab, “the world’s top market segment will be America’s rich” (italicization added). According to the U.S. Bureau of Labor Statistics Consumer Expenditure Survey (BLS CEX), entertainment spending made up 5.3% of the total average annual expenditure of American households in 2018. American spending on entertainment is considerable.

Collectively: Average American Households

Looking at the CEX, in 2018, average annual expenditures rose to $61,224, compared to $60,060 the year before. More specifically, spending on entertainment (EE) increased to $3,226, from $3,203 in 2017. (Inflation was higher than expenditure numbers in 2018. Nevertheless, consider that thousands of dollars went toward entertainment.) There were 131,439,000 households in the U.S. in 2018. When one multiplies that number by EE, one gets $424,022,214,000; hundreds of billions of dollars were spent on entertainment.

That amount of money is more considerable than the gross domestic product (GDP) in 2018 for the entire country of the United Arab Emirates (where Dubai and the tallest building in the world are), which was over $421 billion.

So what does the category of entertainment expenditure include in the BLS CEX?

  1. Fees and admissions, including admissions to sporting events and movies; fees for social organizations; recreational lessons; and recreation expenses on trips.

  2. Television, radio and sound equipment, including video game hardware and musical instruments.

  3. Pets, toys, hobbies and playground equipment.

  4. Other entertainment equipment and services, including indoor exercise equipment, camping equipment, boats, photographic equipment and supplies and fireworks.

Just $2 billion of the $72.56 billion that Americans spent on pets in 2018 is what Gavi, the Vaccine Alliance, was at a minimum seeking to raise as of 7 August. That amount could immunize both those with high susceptibility to the coronavirus and health care workers in Gavi-supported countries, with doses that would be available for use where needed most. Gavi is a public-private partnership that has helped to immunize hundreds of millions of children since 2000; partners include the World Health Organization, United Nations Children’s Fund and the Bill and Melinda Gates Foundation.

America’s Rich

By the end of 2020, there will be an average of $194 to spend per day per wealthy American; this is put forth in a Brookings Institution blog. Possibly an appropriate juxtaposition, in 2018, households and non-profit institutions serving households (NPISHs) final consumption expenditure per capita was $189 in Burundi, a country where most of the population is poor and which has the second lowest GDP in the world.

Using data from the 2018 CEX, one may learn something else concerning American expenditure on entertainment. The top 10% of highest income (before taxes) households in the U.S. had an average of 3.2 persons and spent an average annual expenditure of $142,554. That amounted to around $122 spent per day per person: each person spent approximately $6.64 a day on entertainment. Notice that the $122 is less than the $194 of America’s wealth. 

If each of the 42,134,400 persons of the above top 10% were to have given around $1.20, less than a fifth of what they expended on average on entertainment per day, that would be enough (at least in hard numbers) to meet the net funding requirements from June to November of this year about the World Food Programme in Burundi.

The Bigger Picture

Entertainment may not in and of itself be bad or good. One way that American expenditure on entertainment affects Americans is the amount of time they spend on entertainment. For example, in 2019, the BLS reports that watching television on average took up the most leisure time. Although Americans possibly can inform themselves about the poor in the world via television, Americans could use some of the time spent watching television to ask their representatives to support legislation that could help reduce poverty.

– Kylar Cade
Photo: Flickr

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10 Celebrities Who Assisted After the Beirut Explosion

beirut explosionOn Aug. 4th, 2020, an ammonium nitrate explosion occurred at the port in Beirut, Lebanon. This disaster killed more than 180 people, injured over 5,000 and displaced more than 250,000 people. The Beirut explosion also led to more than $10 billion  in damage in the surrounding areas. After the deadly Beirut explosion, countless celebrities shared tributes. Many also donated or directed their followers to donate to various relief efforts. Here are 10 celebrities who helped Beirut after the August explosion.

10 Celebrities Who Helped After the Beirut Explosion

  1. George and Amal Clooney: The power couple donated $100,000 to three charities helping with relief efforts. These included the Lebanese Red Cross, Impact Lebanon and Baytna Baytak. The latter organization aimed to provide relief to Lebanese people in the wake of the COVID-19 pandemic. However, after the explosion, the group became more focused on finding shelter for people made homeless or dislocated. In an online statement referencing this organization, the Clooneys said, “We’re both deeply concerned for the people of Beirut and the devastation they’ve faced in the last few days. We will be donating to these charities $100,000 and hope that others will help in any way they can.”
  2. Madonna: The pop singer and two of her children, David Banda and Mercy James, hosted an art sale and donated the proceeds to Impact Lebanon. The organization works with the Lebanese Red Cross to provide aid to victims affected by the blast. Madonna and her family made tie-dye shirts and paintings to raise money, which the singer posted on Instagram.
  3. Rihanna: The singer and businesswoman took to Twitter to persuade her followers to donate to four charities helping with relief in the aftermath of the Beirut explosion. These included Impact Lebanon, Save The Children, the Sadalsuud Foundation and Preemptive Love. Save The Children helps children and families displaced and injured by the disaster. Rihanna’s support for the Sadalsuud Foundation will help it foster community strength and growth through education and baking. Finally, Preemptive Love is a peacemaking and peacebuilding coalition designed to bring an end to violence and war and affect people affected by disasters.
  4. Bella Hadid: The model, whose father is from Lebanon, donated to 13 charities in the aftermath of the Beirut explosion. These included the Lebanese Red Cross, Offre Joie, Impact Lebanon, Bank To School, Arc En Ciel, Bassma, Sesobel and Nusaned. Previously, Hadid has donated to Save The Children, Preemptive Love, UNICEF, International Medical Corps and the Lebanese Food Bank. She also directed her Instagram followers to donate, urging them toward local charities to help pinpoint community needs. Lastly, Hadid has vowed to continue donating.
  5. The Weeknd: The singer donated $300,000 to Global Aid for Lebanon, which supports the World Food Programme, the Lebanese Red Cross and the Children’s Cancer Centre Lebanon. The Weeknd’s donation comes after his manager, Wassim Slaiby, and Slaiby’s wife, Rima Fakih, led efforts for donations. On Instagram, Slaiby thanked The Weeknd for his donation. She also thanked Live Nation, including CEO Michael Rapino, for donating $50,000 to relief efforts.
  6. Rima Fahik and Wassim “Sal” Slaiby: The former Miss USA and her business manager husband, both from Lebanon, launched a campaign with Global Citizen to help in the aftermath of the Beirut Explosion. The fund supports Red Cross Lebanon, the United Nations World Food Programme and the Children’s Cancer Center of Lebanon. The couple kicked off the initiative by donating $250,000.
  7. Russell Crowe: The actor donated $5,000 to the destroyed restaurant Le Chef, which had resided in the Gemmayze neighborhood of Beirut since 1967. On his Twitter page, Crowe said he donated to this restaurant in honor of his late friend, Anthony Bordain. While Bordain was filming his show “No Reservations” in 2006, he visited the restaurant.
  8. Jose Andres: The World Central Kitchen founder and celebrity chef mobilized a team in Beirut and partnered with chef Kamal Mouzawak. Together, they gave out over 800 sandwiches and meals to healthcare workers, first responders and elderly citizens. The organization states that its efforts provided thousands of additional meals to those in need in Beirut. Lastly, it hoped to give people what they needed to stimulate the local economy once again.
  9. Mia Khalifa: The media personality, sports commentator and former adult actress auctioned the trademark glasses that she wore in her adult films to support Lebanon after the explosion. She donated all proceeds to the Lebanese Red Cross. The bidding ended on Aug. 16, with the top bid at $100,000.
  10. Harry Styles: The former One Direction member donated to Impact Lebanon, directing his Twitter followers to do the same. He then tweeted out a link through the crowdfunding site JustGiving. Style’s fundraising effort has so far raised close to $8.1 million for people impacted by the disaster.

While the damage and casualties in Beirut were extensive, celebrities and figures from around the world came together to help after the Beirut explosion. Moreover, many of these celebrities are helping Beirut continue to come together for not only economic but also personal reasons.

– Bryan Boggiano
Photo: Wikimedia Commons

Healthcare in Kashmir During Tense Lockdown

healthcare in kashmirFor months, people in Indian-administered Jammu and Kashmir have struggled during a debilitating security lockdown. With phone lines cut and internet access heavily limited, the lockdown in Kashmir is the longest in recorded history. While the lockdown has heavily impacted all aspects of society, healthcare in Kashmir has taken a particularly significant hit.

The Conflict in Kashmir

Located at the intersection of some of the highest mountain ranges in the world, Kashmir is a region unlike any other. Often termed as “paradise on Earth,” the region’s picturesque landscapes and critical geopolitical location have made it a coveted jewel for powers vying in the region. For the past 80 years, India, Pakistan and China have clashed over the region, with each side claiming different swaths of the territory. With a majority-Muslim population, Kashmir has witnessed a popular resistance movement since 1989, which aims to achieve independence or unification with Pakistan.

However, in 2019, India announced a new approach toward Kashmir, implementing a set of draconian laws and procedures in the Indian-administered portion of the region. Under these laws, the territory lost its constitutional “special status.” The Indian government also reorganized its administrative divisions.

Critically, the territory is now in a crippling lockdown, including a stringent curfew, restrictions on movement and a blackout of all communications. The Indian government has arrested thousands of civilians and local politicians and shut out foreign media from the region. Indian-administered Kashmir, with a population of more than 12 million people, has struggled to deal with the effects of this clampdown.

Healthcare in Kashmir Under Lockdown

The lockdown has particularly affected healthcare in Kashmir. Less than three weeks after the start of the lockdown, pharmacies in the region began to report dire shortages of essential drugs. With stocks running low on anti-diabetics, anti-depressants and cardio-vascular medications, Kashmiris must travel miles in search of these essential medicines. Drugstores in the capital city of Srinagar have only filled half of all requested prescriptions.

Much of the problem arises from the communications blackout. With phone lines cut, stores cannot effectively communicate with dealers and medication suppliers. This makes their stocks vulnerable and the Kashmiris reliant on these medications even more so.

However, the problem with healthcare in Kashmir under lockdown exceeds medicine shortages. In 2019, the Lancet, a leading medical journal, declared that the lockdown puts patients at serious medical risk. With public transport halted and vehicles restricted, people in need of medical attention too often cannot obtain the care they need.

The lockdown has not spared mental health services in the region either. Doctors Without Borders (MSF) had maintained counseling centers in Kashmir since 2001, but closed their facilities with the start of the lockdown. Given the decades of traumatic conflict that have afflicted Kashmir, residents in the region rely on these mental health services.

As the world reels from COVID-19, Kashmir has also felt its effects. In the early months of 2020, the region saw the easing of several restrictions, including access to 2G internet. However, following Kashmir’s first case of COVID-19 in March 2020, restrictions returned with full force. In the following months, newspapers operating in the region have reported a shortage of hospital beds and dwindling supplies of oxygen and ventilators. Given the already fragile state of healthcare in Kashmir, COVID-19 has only aggravated conditions in the region.

Improvements in Healthcare in Kashmir

Although healthcare conditions in Kashmir remain heavily impacted by the ongoing lockdown, local and international actors have made several improvements. One development is medical treatment and consultations through phone calls and mobile applications. The novel approach hopes to provide a degree of healthcare access to Kashmiris while adhering to the lockdown guidelines. An estimated 630,000 families are eligible for the program.

In August 2020, a year after the start of the lockdown, the Indian government laid forth 10 fields of focus for Kashmir. This included the growth of the health sector as a top priority. In the same report, officials also declared progress in implementing the Swachh Bharat Mission in Kashmir, part of a national campaign to end open defecation and improve sanitation practices. The government also claimed to have distributed 1.2 million health cards to school-aged children in the region, providing access to much-needed health services. The cards come with up-to-date vaccination records as well as required biannual checkups.

While the military lockdown continues to exact a harsh toll on the people of Kashmir and its fragile healthcare system, the steps above have helped improve access and treatment in the region. If all goes well, India’s lockdown of Kashmir may soon end. With it would come an increase in the health and welfare of the Kashmiri people.

– Shayaan Subzwari
Photo: Wikimedia Commons

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Schooling During COVID-19 in Impoverished Countries

Schooling During COVID-19As COVID-19 started spreading, schools around the world shut down. For countries with already poor schooling systems and low literacy rates, the pandemic created even more challenges. The world’s most illiterate countries are South Sudan with a 73% illiteracy rate, Afghanistan with a 71.9% illiteracy rate, Burkina Faso with a 71.3% illiteracy rate and Niger with a 71.3% illiteracy rate. Schooling during COVID-19 has only increased the struggles these countries face as they try to promote literacy.

Literacy is an important aspect of reducing world poverty, as countries with the lowest levels of literacy are also the poorest. This is because poverty often forces children to drop out of school in order to support their families. Since those children did not get an education, they will not be able to get a high-paying job, which requires literacy. Thus, a lack of education keeps people in poverty. If countries with low literacy rates make schooling harder to access due to COVID-19, the illiteracy rate will increase, and the cycle will continue. Below are the ways that the four least literate countries are continuing schooling during COVID-19.

South Sudan

After almost a decade of fighting due to the South Sudanese Civil War, literacy rates are already low in South Sudan, as the war inhibited access to education. The government-imposed curfew in response to COVID-19 forced children to stay home. This especially challenges girls, whose families expect them to pick up housework at home due to gender norms. The government provided school over the radio or television as a virtual alternative to schooling during COVID-19. However, impoverished children who lack access to electricity, television and radio have no other option. This lack of access to education for poor Sudanese children will further decrease literacy rates. As a result, children may be at risk of early marriage, pregnancy or entrance into the workforce.

Afghanistan

In Afghanistan, there was already a war going on when the COVID-19 pandemic struck, creating a barrier to education. In 2019 alone, 200,000 students stopped attending school. COVID-19 has the potential to make this problem worse. Importantly, Afghanistan’s schooling crisis affects girls the most; by upper school, only 36% of students are girls. Further, 35% of Afghan girls are forced into child marriages, and not being in school makes them three times as likely to be married under 18. If they do not finish school, there is a high chance they will never become literate.

COVID-19 may exacerbate girls’ lack of access to school. When schools shut down, the schooling system in Afghanistan moved online in order to continue schooling during COVID-19. But only 14% of Afghans have access to the internet due to poverty. Since many parents are not literate, they cannot help their children with school. School shutdowns may also decrease future school attendance, especially for girls. As such, COVID-19 will perpetuate illiteracy in Afghanistan, with many children missing out on school due to poverty.

Burkina Faso

In Burkina Faso, school shutdowns have put children at risk of violence. Jihadist violence, tied to Islamic militants, has increased in the country. Violence forces children out of school, with many receiving threats, thus decreasing the literacy rate. Though school was a safe space for children, COVID-19 is making this situation worse.

As an alternative for schooling during COVID-19, Burkina Faso has broadcasted lessons on the radio and TV. However, many students do not have access to these technologies. Even if they do, staying at home does not protect them from violence, which could prevent them from going to school. In Burkina Faso, many children also travel to big cities to go to school. But without their parents being able to help them economically, many are now forced to get jobs, entering the workforce early. This lowers the number of children in school as well as the country’s literacy rate.

Niger

In Niger, 1.2 million children lost access to schooling during COVID-19, lacking even a television or radio alternative. Schools have since reopened, but children still feel the impacts of this shutdown. Before COVID-19, at the start of 2020, more than two million children were not in school due to financial insecurity, early marriage or entrance into the workforce. COVID-19 forced many children to give up schooling forever, as they had to marry or begin work and fell behind in school. As a result, this lowered the country’s literacy rate.

Improving Literacy Rates During COVID-19

While COVID-19 did prevent many children from accessing the education they need, many organizations are working to help them meet this challenge. One of these organizations is Save the Children. It is dedicated to creating reliable distance learning for displaced students, support for students and a safe environment for students to learn.

COVID-19 has left many students without access to education, jeopardizing the future for many. In the countries with the highest illiteracy rates, a lower percentage of children with access to education means a lower percentage of the population that will be literate. Improving literacy rates is key reducing poverty, as it allows people to work in specialized jobs that require a higher education, which then leads to higher salaries. If literacy rates drop, poverty will only continue to increase. This makes the work of organizations like Save the Children crucial during the ongoing pandemic.

– Seona Maskara
Photo: Flickr

3D-Printed Prosthetics Help Impoverished Communities

3d printed prostheticsGuillermo Martinez is an industrial engineer from Madrid, Spain, who saw a need for upper extremity prosthetics in poverty-ridden communities. His journey began in 2017 with an investment in a small-scale 3D printer in Spain. Martinez learned how to use the printer with robotics and device-building videos, but he quickly stumbled upon a tutorial for a one-hand prosthesis. The prototype he created as a result sparked an interest in producing prosthetics for those in need, especially once he realized that the 3D-printed prosthetics cost just $50 to produce.

3D-Printed Prosthetics from Madrid

When he’d successfully produced a functional prosthetic arm, Martinez took a trip to the Bamba Project orphanage in Kenya. The World Bank noted that as of 2016, 35.6% of the population in Kenya lives on less than $1.90 per day. Martinez saw an unmet need for Kenyans who could not afford a prosthesis. With this new self-taught skill, he asked for volunteers to notify him of impoverished people who needed upper extremity prosthetics. The pictures that he received in response guided the 3D-printed prosthetics he made for orphans and the impoverished in Kenya.

Martinez relied on trial and error to produce functional prosthetics with low-cost materials. He utilized a combination of plastic, high-tension wires and rubber bands to produce a functional product. Each prototype only weighs about 10 kilograms and is completely collapsible for ease of transport. But Martinez began to investigate if it was possible to 3D print locally in impoverished communities instead of transporting the prosthetics. Seeing conditions in developing countries, Martinez recognized a slew of obstacles in his way, from a lack of education and unpredictable power outages. However, these obstacles did not deter Martinez from beginning the nonprofit organization AYUDAME3D.

AYUDAME3D

AYUDAME3D is a fairly new nonprofit organization that began with the hard work of just four members and has gained over 60 volunteers globally. Its goal remains to produce 3D-printed prosthetics for people in need. So far, AYUDAME3D has produced more than 250 prosthetic arms in more than 40 countries. The majority of requests originally came in via email, social media or connections with NGOs. But the organization understood that it needed to use the media, social media and partnerships with other nonprofits to reach a wider range of communities.

Additionally, AYUDAME3D provides a centralized space for volunteers and impoverished communities to have direct contact with the organization. This allows it to disseminate information about the guides for shoulder, elbow and wrist prosthetics. Furthermore, the organization’s online form allows people to expand on limb specifications and provide visuals as needed. It also lets NGOs explore a possible partnership with AYUDAME3D. Finally, the NGO is growing its impact with a 3D printing curriculum for in schools in impoverished communities.

The Impact of 3D-Printed Prosthetics

These 3D-printed prosthetics from Madrid have had a profound impact on those missing upper extremity limbs. Robert from Kenya is one of many who stood to benefit from a prosthesis, having only one arm. Martinez printed a prosthetic in multiple pieces and brought it to Kenya to test its fit for Robert. Since this was one of Martinez’s first prosthetics, he had to adapt his process while learning about muscular weakness and other factors in Robert’s community. But this learning curve has created a well-established process at AYUDAME3D that is constantly adapting to new prosthetic situations.

AYUDAME3D also provided a helping hand when the coronavirus pandemic hit Spain. When the government declared personal protective equipment emergencies, the organization received a flood of requests for 3D-printed face shields. Accordingly, the nonprofit switched from printing prosthetics to personal protective equipment. So far, AYUDAME3D has distributed 9,115 face shields to over 150 organizations.

In an interview with Business Insider Espana, Guillermo Martinez expressed that 3D printing prosthetics started as a fun idea that developed into a way for him to help impoverished communities. Martinez didn’t believe that he would find a large number of people needing upper extremity prosthetics, but he discovered that many Kenyans sought them when he arrived.  To meet this need, AYUDAME3D continues to produce 3D-printed prosthetics for impoverished communities worldwide.

– Sumeet Waraich
Photo: Flickr

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How the Stigmatization of Disease Affects Care

Stigmatization of DiseasePeople often understand diseases as solely biological: an infectious pathogen harms the body and requires medical aid to defeat. However, disease also has social implications. Various social factors can impact not only someone’s likelihood of contracting a disease but also their likelihood of receiving quality medical care. One significant social implication affecting these factors is the stigmatization of disease.

Stigma, as defined by sociologist Erving Goffman, is an “attribute that is deeply discrediting.” Though we normally think of attributes like race, religion, ethnicity, sexuality and gender identity, stigma can also involve disease. The stigmatization of disease refers to the notion that a particular type of person, country or community are the carriers or source of a disease. Like all stigmatization, this involves the process of “othering,” or creating a “them” and an “us.” People attempt to keep the “us” safe by ostracizing the “them.” In the case of the stigmatization of disease, the stigmatized group becomes “them.” Here are four examples of the stigmatization of disease throughout history.

The Stigmatization of Disease: Four Examples

  1. Cholera is a bacterial disease that causes extreme dehydration and diarrhea. It is fatal without immediate treatment. The end of the 1800s saw a global cholera pandemic, with a high prevalence in Europe. This led to the United States quarantining immigrants when they arrived in the U.S., creating a dangerous association between immigrants and cholera. At the time, President Harrison declared that immigrants were “a direct menace to the public health.” This association between immigrants and disease lasted long after the threat of cholera was gone.
  2. Yellow fever is a viral infection carried by a specific species of mosquito. It causes fever, headache, nausea and, in severe cases, fatal heart and liver conditions. By 1850, yellow fever was rampant in southern American states. Cities like Charleston, Mobile and New Orleans faced the brunt of the disease. Because of tensions leading up to the Civil War, the North used the disease to attack the South. Northerners “denounced the South for its unhealthy conditions and people.” This stigmatization helped fuel the separation between “us” and “them” in the North and South. As such, it had lasting impacts on regional divides in the U.S.
  3. HIV/AIDS appeared in the United States in the 1980s. HIV is an aggressive virus that attacks people’s autoimmune system and can eventually lead AIDS. Because early cases affected gay men, doctors named the disease Gay-Related Immune Deficiency or GRID. This initial naming demonized gay men and made them appear to be the source of HIV. Later, the disease was renamed AIDS (Acquired Immunodeficiency Syndrome) when doctors realized that anyone can contract HIV. Despite this renaming, the association of gay men with HIV remains strong. Accordingly, fear and stigma continue to be a barrier to getting treatment in the U.S.
  4. COVID-19 first appeared in China in late 2019. Due to its origin, many people have engaged in racist and xenophobic attacks and discrimination against those of Asian heritage. The use of language such as the “Chinese virus” and “Wuhan virus” in the media and from political leaders has encouraged hate speech and physical attacks. In the U.K., citizens have punched and beaten Asian people. In Australia, two women beat Chinese students while yelling, “Go back to China.” In Texas, a Burmese family was attacked with a knife. This illustrates how the stigmatization of COVID-19 has resulted in extreme discrimination and violence against Asian people around the world.

How Stigma Impacts Care

As indicated above,  stigma creates barriers for stigmatized people to access quality care. Dana McLaughlin, a global health associate at the United Nations Foundation and graduate student at Johns Hopkins, elaborates on how stigma creates barriers to health. She understands stigma as having three components that can dissuade someone from seeking care and reduce the quality of care they receive:

  1. Internalized or Self-Stigma: This occurs when an individual with a disease internalizes the stigma. They may feel shameful about themselves and their condition. They might also fear telling family, friends and their communities about their condition because of possible ostracization. Either way, this internalized fear may prevent someone from seeking medical care.
  2. Public Stigma: This stigma refers to the general population’s opinions  about behaviors associated with people who have a certain disease. In other words, this is a negative cultural context that surrounds a disease. This can vary greatly between countries and cultures, so it’s important to recognize that the public stigma may not be universal.
  3. Structural Stigma: This refers to the social institutions that reflect and reinforce the stigmatization of diseases. For example, structural stigma may manifest as a lack of resources for care, like a limited number of doctors in marginalized communities. One of the most prominent manifestations of structural stigma is the criminalization of certain behaviors associated with specific diseases. With HIV, many countries criminalize sex work and intravenous drug use and stigmatize people who engage in these behaviors. This stigmatization may prevent individuals from receiving care for fear of arrest or punishment. On the other hand, stigmatized individuals may “go underground” and engage in even riskier behaviors, like sharing needles, to avoid police discovery.

Combating Stigma and Providing Care

McLaughlin explains that in the context of global health, it is important to understand the syndemic (occurring simultaneously) nature of stigma and disease. These two aspects are “correlating challenges that the global health community has to be able to respond to.”

For McLaughlin, responding to stigma requires prioritizing the needs and experiences of stigmatized people. This might mean allowing them to speak openly about the daily struggles they face due to stigma. It’s also essential that “the people who are most impacted and know the day-to-day challenges of stigma are at the root of planning.” This ensures that interventions and projects actually meet the needs of stigmatized communities. If people do need to change their behaviors, this message should come from respected community leaders. This will ensure that people trust public health advice, making them more likely to follow it.

Though the stigmatization of disease is a powerful force, viruses don’t pick and choose whom they infect. Association between certain types of people or places, behaviors and disease develop from fear and misinformation. Ultimately, it’s essential to question these associations and dismantle stigma by listening to stigmatized groups.

– Paige Wallace
Photo: Flickr

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Viral Outbreaks During COVID-19 in the Developing World

Viral Outbreaks During COVID-19While COVID-19 has received much attention in the global health discussion, many developing countries continue to fight other viral outbreaks. This highlights why foreign aid is so crucial. Although COVID-19 has affected every nation, some countries will suffer more than others. This article will highlight three of the deadliest viral outbreaks during the COVID-19 pandemic that have been announced by the WHO in 2020 and the current, global efforts to combat them.

Ebola in the Democratic Republic of Congo (DRC)

Since the largest Ebola outbreak killed 11,000 people in West Africa during 2014–2016, the virus has been successfully contained in most countries. This, thanks to the efforts of front-line workers and organizations, such as the WHO.

However, the DRC has been fighting its 10th outbreak since August 2018. As of June 2020, the Ebola Virus Disease (EVD) has infected 3,470 and killed 2,280 people. In 2019, the WHO named the viral outbreak a global health emergency. Then, in April 2020, just as the Ministry of Health neared the end of the countdown to end EVD, there was a new outbreak in the city of Mbandaka.

In the DRC, EVD has a current fatality rate of more than 60%, which is more than five times that of the new coronavirus or influenza. However, the transmission rate is much lower. Advancements in vaccines and “CUBE” containment rooms have helped stop the spread of the Ebola virus. By vaccinating more than 14,000 health workers in neighboring countries, the WHO contained the disease in the DRC. Yet notably, the organization stresses that controlling the epidemic requires more international collaboration and support.

Measles in Africa, South and Central America and Beyond

In addition to COVID-19 and Ebola, the DRC is also battling the world’s largest measles epidemic. Another of the viral outbreaks, which started during COVID-19 (in 2019) and infected around 300,000 people. Since then, the numbers are fewer in the DRC. In 2020 however, more measles outbreaks surfaced in Burundi and the Central African Republic. Additionally, new outbreaks resurfaced in Mexico, while Brazil still recovered from an outbreak of measles in 2019 that infected over 50,000 people in Sao Paulo. The virus has also emerged in Asia and Eastern Europe in 2019.

Similar to the new coronavirus, the measles virus has a high transmission rate and causes complications in a minority of infected individuals. War and displacement also contribute to the spread of the disease. In Burundi, the outbreak started in a refugee camp where refugees from the DRC were thought to have carried it into the country. Other factors such as malnutrition also contributed to the increased mortality rate of measles in these areas.

Yellow Fever in Africa

This mosquito-spread disease is endemic to tropical parts of Africa as well as South and Central America. However, the majority of outbreaks occur in sub-Saharan Africa where 610 million people are at risk of contracting the virus. Yellow fever has long been a challenge in these areas where it infects around 200,000 and kills 30,000 — every year. For instance, in 2020 alone, reports indicated new viral outbreaks of yellow fever in five African countries.

A safe and effective vaccine has been developed and helped reduce outbreaks in the 20th century. However, due to shortages of the vaccine and poor government implementation, the majority of the population does not receive it. Alternatively, it is usually only compulsory for travelers. Furthermore, since the virus is re-occurring, more research is required to keep adapting the vaccine to different strains of yellow fever.

The Takeaway

As evidenced by the COVID-19 pandemic, viral outbreaks are disruptive and have major economic and social consequences. Poor health reduces the life-span, productivity and life satisfaction of any population. These effects usually fall hardest on the world’s poor — who have less access to treatments or safe water access and sanitation.

Due to the commoditization of the pharmaceutical industry, the populations that need medical intervention most receive it the least. This is simply because they can not afford such expensive treatment. Specific antiviral treatments rarely exist. The best method to reduce the impact of viral outbreaks in impoverished countries is by building better healthcare systems and reducing poverty. As stated by Tedros Adhanom, director of the WHO, “Unless we address [the] root causes – the weak health system, the insecurity and the political instability – there will be another outbreak.”

– Beti Sharew
Photo: Flickr

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Poverty Rate in the Marshall Islands

Poverty in the Marshall IslandsThe Republic of the Marshall Islands is an island country in the Pacific Ocean consisting of more than 1,200 islands and islets. The Marshall Islands borders Wake Island, Kiribati, Nauru and Micronesia and are home to nearly 60,000 residents. Most of the Marshallese population lives in densely populated areas in Kwajalein and Majuro, the denominal capital city. Some residents living on the outer islands depend on fishing, raising livestock and subsistence farming to survive. However, the country’s primary sources of employment and revenue come from U.S. subsidies under the Compacts of Free Association (COFA). As well as land leasing for U.S. missile testing. As a result, many still live in poverty in the Marshall Islands.

Causes of Poverty in the Marshall Islands

For the Marshall Islands, a major cause of poverty has been the U.S. government’s activity in Kwajalein. The U.S. military performed extensive nuclear testing in the region between 1946 and 1958. This has caused radioactive damage to the region equivalent to “1.7 Hiroshima blasts every day for 12 years”. The resulting fallout of the Ronald Reagan Missile Testing Site displaced many Marshallese residents living on nearby islands to Ebeye. Despite relocating to Ebeye, many hope to find commuter jobs on Kwajalein island.
The unemployment rate in the islands has been as high as 40% as a result of such dependence on U.S. government jobs. The lack of gainful employment on-island has led to a shortage of skilled workers. Furthermore, the island has issues with tuberculosis and infectious diseases in addition to the lack of food security and pervasive poverty.

Changing Weather Conditions Have Impacted the Marshall Islands

According to NewsHour’s Mike Tabbi and Dr. Hilda Hilne, the president of the Marshall Islands, climate change has further exacerbated the shortage of skilled workers. As Mike Taibbi explains, “Climate change is a big issue here, […] punishing king tides combined with persistent drought have wreaked havoc on dwindling freshwater supplies. The view among climate experts […] is that the islands are sinking, if not disappearing.”
Dr. Hilne fears that the rising tides and disappearing land combined with the high unemployment rates will continue the mass exodus. Given that more residents are leaving in search of education and employment opportunities in the U.S. She says, “People are looking for better things, and they think that anything in the United States is better than what we have here.” The troubling emigration rate means fewer educated and skilled workers to help those who stay face the mounting pressure from pervasive poverty.

Poverty and the Marshallese Youth

Poverty in the Marshall Islands has had dramatic effects on the Marshallese youth. According to UNICEF’s 2017 report, more than one-third of children under five showed signs of stunted development. This results from extreme poverty and malnutrition. Such poverty and malnutrition at a young age have drastic effects on a child’s learning and development. This will impair their earning potential and the ability to escape poverty in the future.
The World Bank is working in partnership with the U.S. International Development Association (IDA), UNICEF and the Marshallese government to address poverty through its 2019 Early Childhood Development Project. The initiative hopes to alleviate some of the strain on impoverished Marshallese families by funding social programs. For instance, healthcare, nutrition and education services for children in their first 1,000 days of life. The project hopes that providing support for Marshallese residents at such a young age will give them a better chance at living healthy, educated lives essential to escaping the cycle of poverty in the Marshall Islands.
As of 2020, the U.S. government provides roughly $74 million in funding to help alleviate poverty in the Marshall Islands, predominantly through the countries’ COFA. However, more than half of this funding goes to general budget support for the Marshallese government. Only $20 million is committed to education and $10 million to Marshallese healthcare. The government will need further assistance as well as new sources of revenue and employment to keep its people in the islands and out of poverty.
– Andrew Giang
Photo: Flickr
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Flattening the Curve: Covid-19 Crisis in Prisons

Covid-19 crisis in prisons
There are currently an estimated 11 million people either incarcerated or in custody, around the world. In prisons and jails, overcrowding and inadequate sanitation during the Covid-19 crisis have exacerbated these preexisting problems. Professional health physicians and Human Rights Watch advocates explain that “prisoners share toilets, bathrooms, sinks and dining halls”. Also, sometimes prisoners lack access to running water. These inadequacies reflect the (at times) — dismal quality of life that incarcerated people experience, globally.

Overcrowding Effects

Overcrowding and unclean living conditions during the Covid-19 pandemic have exacerbated the immense violations of human rights in prisons and jails. Haiti, the Democratic Republic of the Congo and the Philippines’ prisons are currently at 450%, 432% and 537% capacity, respectively. Overcrowding allows Covid-19 to spread much more easily through prisons. Furthermore, it makes single rooms unavailable for both sick and healthy inmates. With the current state of affairs, physical distancing is simply not an option. The United Nations Standard Minimum Rules for the Treatment of Prisoners expects incarcerated people infected with Covid-19 to receive medical attention in line with the WHO guidelines. Overcrowding hinders the fair treatment of incarcerated people — especially considering that prisoners are not typically afforded sufficient care from doctors during pre-pandemic times (let alone amid a pandemic).

Prisoners and Human Rights

Prisoners deserve basic human rights, access to healthcare and safe public health. UNAIDS, the WHO and the UNHCR are all calling for a mass release of prisoners — from a public safety standpoint. The release of incarcerated people who qualify as high-risk for Covid-19 (e.g., the elderly, mothers with children or who are breastfeeding, pregnant women and non-violent offenders) reduces health risks. These risks would otherwise remain unaddressed within prisons and jails (given their resources). Winnie Byanyima, Executive Director of UNAIDS calls it [the Covid-19 crisis] an “unprecedented global emergency” and recognizes the dire need to defend the human rights of incarcerated people, worldwide.

Solitary Confinement during Covid-19

Solitary confinement is typically a severe punishment for inmates. However, the U.S. has mandated the practice for infected inmates in response to the Covid-19 crisis in prisons. Before the Covid-19, 60,000 inmates were in solitary confinement in federal prisons — whereas now there are 300,000. This practice has proven to be a disincentive for inmates to come forward as sick, even if they are knowingly infected with Covid-19.

Practical Solutions to the Problem

More practical and effective solutions to the Covid-19 crisis in prisons and jails include thorough testing and screening for the virus, to stay ahead of the spread. Another solution — comprehensive safety practices of employees who travel in and out of the facilities, daily. Still, there is too much overcrowding and simultaneously, too many at-risk populations in prisons and jails. These facilities cannot properly preserve the human rights and well-being of inmates during the current pandemic. Non-violent offenders, pregnant and/or breastfeeding women, people who are detained because they cannot afford bail, elderly people and those with misdemeanors are all examples of groups that could be safely released.

An Expert Outlook

UNAIDS, the U.N., the Prison Policy Initiative, the WHO and numerous other organizations tracking the health and safety of incarcerated people insist that the true solution to the Covid-19 crisis in prisons is to eliminate overcrowding. Therefore, the solution to overcrowding in prisons may well be to release large amounts of qualifying incarcerated people. This may hold true in particular, amid a global pandemic.

– Nye Day
Photo: Pixbay