demand for child rightsWith 25% of Latin America’s population being under the age of 15, an increased demand for child rights is inevitable. As a result, Latin America and the Caribbean have seen gradual implementations of protection for children under the law. Countries in these regions have seen improvements spanning from a growing economy to quality health care.

Health Improvements for Children

One immediate causes for the demand in children’s rights is because of the abuse that many children in impoverished countries endure. Some issues that exemplify the need for child rights are sexual abuse, drug and alcohol consumption and child labor. The health care systems in Latin American countries are responding.

For example, increased demand for child rights in places such as Argentina and Peru has resulted in more representation for children in health care services. Argentina has had children’s rights written in law since 1994. Now, with children included in health plans, child mortality rates have decreased to 9.9 deaths per 1,000 live births in 2018, compared to 12.6 just five years earlier.

Strengthening Written Law

Previously, many children in these countries were not seen as separate individuals until they reached adult age. However, increased children’s rights in certain Latin American and Caribbean countries have improved the livelihoods of the underaged. Children’s rights in Latin America and all across the world have moved to the forefront of many political agendas thanks to the UN Convention on the Rights of the Child and active citizens.

Countries such as El Salvador have shown that the demand for child rights have proved their international leadership on the issue. There are more than 15 comprehensive laws within the country protecting children and almost 20 international laws protecting El Salvadoran children.

Though the numerous laws, in theory, protect the children, it is not as easy to enforce the laws. A large discrepancy still remains between the sentiment and enforcement of law for the protection of children. Legislature rendered ineffective through lack of enforcement “allows perpetrators of violence against children and adolescents to continue committing the same crimes with no fear of prosecution or punishment.

The BiCE

One organization that has made child rights in Latin America a priority is BiCE, the International Catholic Child Bureau. The organization’s main goal is the preservation of child rights in different countries in Latin American and around the world. Current field projects take place in countries such as Ecuador, Guatemala and Peru. Most of the projects focus on fighting sexual abuse of children.

BiCE’s projects have many goals that ensure the safety of a child. For the programs fighting sexual abuse, they offer therapy services for recovery. They also train people to learn advocacy techniques for children’s rights. Over 1,000 children in Peru have received help from BiCE and the organization continues to do more in other countries in Latin America.

Most countries in Latin America and the Caribbean have written laws and statutes that protect children. However, this has not proved to be enough for the safety of children in these countries. There have been health improvements and decreased poverty rates, but more still needs to be done to enforce the written laws.

Josie Collier
Photo: Flickr

Billions to Charities
It is no surprise that Forbes named Charles “Chuck” Feeney the James Bond of Philanthropy. After 38 years, Feeney achieved his lifetime goal: giving away all his $8 billion amassed wealth to charity and being alive to see its impact. When someone donates billions to charities, the impact should be substantial.

Charles “Chuck” Feeney

Chuck Feeney amassed his wealth from establishing a franchise of stores within thousands of airports known as the Duty-Free Shoppers Group. He also launched the General Atlantic, an American growth equity firm. Yet, the man, with this immense fortune lives in a rented San Francisco apartment. Moreover, he has even been found riding public transit. Feeney has credited his life philosophy to the Andrew Carnegie essay, “The Gospel of Wealth.” The essay declares that the millionaire’s sole duty is to give back to the poor. As Feeney donates billions to charities, he certainly obliges. Carnegie’s influence is extremely apparent within Feeney’s life. His coined phrase and mantra in life, “Giving While Living,” is essentially saying that you should give all you can to charity now rather than later. This, which closely resembles the messages behind The Gospel of Wealth.

Atlantic Philanthropies

In the early ’80s, the Duty -Free Shoppers franchise was at its peak. This is when Feeney decided to be the one who donates billions to charities. Without anyone’s knowledge, he secretly handed over all his shares and formed his new foundation, the Atlantic Philanthropies. Since 1982, the Atlantic Philanthropies has focused on issues of health, social and public policy throughout Australia, Bermuda, Ireland, South Africa, the U.S. and Vietnam. Within these countries, the foundation has addressed many important issues. Among them include facilitating the peace process in Northern Ireland, reducing the number of children without health insurance in the U.S., providing millions with HIV/AIDS medication in South Africa and helping modernize Vietnam’s health care system. While the foundation has officially dissolved recently, Feeney has one last message to relay: “To those wondering about Giving While Living: try it, you’ll like it.”

3 Countries Impacted

  1. South Africa: In the early years after Apartheid, Atlantic Philanthropies saw the opportunity to help advance South African society from its previous suppression. During the ’90s, the foundation assisted young black South African attorneys in getting their law degrees. In the 2000s, Atlantic made funds to advance nursing and health services. By the end of 2016, Atlantic Philanthropies had totaled $442 million in investments toward building democratic institutions and organizations. Overall, the foundation brought 2 million South Africans access to HIV medication. Also, it convinced the government to pledge $1 billion toward school improvements. Finally, it increased the number of nurses between 2005 and 2013 by 44%.
  2. Vietnam: The Atlantic Philanthropies have invested $381.5 million towards improving Vietnam’s public health system and renewing old libraries and universities. With Feeney’s contribution of billions to charities, Vietnam modernized its healthcare system, resulting in 9 million citizens receiving better and improved treatment. Further, the foundation focused on efforts that advocated for healthier behaviors. These included the widespread anti-smoking campaign and the passed mandate that forced motorcyclists to wear helmets. Also, in the education sector, Atlantic Philanthropies improved Vietnamese university libraries.
  3. Cuba: In the early 2000s, Cuba’s healthcare, although seen as one of the best worldwide, was suffering from a lack of resources. This, in turn, sparked the Atlantic’s activism. Overall, the foundation invested $66 million into organizations that work toward improving the care and treatment of Cubans. Moreover, these bodies spread knowledge about Cuba’s effective public health practices in nations with impoverished communities.

An Inspiring Message

Feeney’s extreme display of generosity via contributions of billions to various charities has inspired many notable philanthropists and entrepreneurs to do their part to help the less fortunate. An example of wealthy business moguls following in Feeney’s footsteps is the “Giving Pledge.” Warren Buffet and Bill Gates launched the Giving Pledge in 2010 as a campaign that seeks to persuade wealthy figures across the world to donate close to half of their wealth before they die.

Maya Falach
Photo: Flickr

healthcare worker emigrationThe emigration of skilled healthcare workers from developing countries to higher-income nations has significantly impacted the healthcare systems of the countries these workers leave behind. The quantity and quality of healthcare services have declined as a result of healthcare worker shortages. While there is still incredible room for growth, recent governmental strategies have incentivized healthcare workers to work in their home countries.

Why Is Healthcare Worker Emigration a Problem?

When healthcare workers emigrate, they leave hospitals in developing countries without enough skilled workers. Lower-income countries are likely to carry a greater amount of the global disease burden while having an extremely low healthcare staff to patient ratio. For example, sub-Saharan Africa only has 3% of all healthcare workers worldwide, while it carries 25% of the global disease burden. In many African countries with severe healthcare worker emigration, like Lesotho and Uganda, hospitals become overcrowded. Furthermore, hospitals cannot provide proper treatment for everyone due to the lack of skilled workers.

This directly affects the quality of care patients receive in countries with high healthcare worker emigration. Newborn, child and maternal health outcomes are worse when there are worker shortages. When fewer workers are available, fewer people receive healthcare services and the quality of care worsens for populations in need.

Why Do Healthcare Workers Emigrate?

The emigration of doctors, nurses, and other skilled healthcare workers from developing countries occurs for a number of reasons. The opportunity for higher wages elsewhere is often the most important factor in the decision to emigrate. Additionally, healthcare workers may migrate to higher-income nations to find political stability and achieve a better quality of life. The rate of highly skilled worker emigration, which has been on the rise since it was declared a major public health issue in the 1940s, has left fragile healthcare systems with a diminished workforce.

Moreover, the United States and the United Kingdom, two of the countries receiving the greatest numbers of healthcare worker immigrants, actively recruit healthcare workers from developing countries. These recruitment programs aim to combat the U.S. and U.K.’s own shortages of healthcare workers. Whether or not these programs factor into workers’ migration, both the U.S. and the U.K. are among the top five countries to which 90% of migrating physicians relocate.

Mitigating Healthcare Worker Emigration

The World Health Organization suggests that offering financial incentives, training and team-based opportunities can contribute to job satisfaction. This may motivate healthcare workers to remain in the healthcare system of their home country. Some developing countries have implemented these strategies to incentivize healthcare professionals to remain in their home countries.

For example, Malawi faced an extreme shortage of healthcare workers in the early 2000s. Following policy implementation addressing healthcare worker emigration, the nation has seen a decrease in the emigration rate. Malawi’s government launched the Emergency Human Resources Program (EHRP) in 2004. This program promoted worker retention through a 52% salary increase, additional training and the recruitment of volunteer nursing tutors and doctors. 

In only five years after the EHRP began, the proportion of healthcare workers to patients grew by 66% while emigration declined. Malawi expanded upon this program in 2011 with the Health Sector Strategic Plan. Following this plan, the number of nurses in Malawi grew from 4,500 in 2010 to 10,000 in 2015. Though the nation still faces some worker shortages, it hopes to continue to address this with further policy changes.

Trinidad is another a country that has mitigated the challenges faced by the emigration of healthcare workers. Trinidadian doctors who train in another country now get government scholarships to pay for their training. However, these scholarships rest on the condition that they return home to practice medicine for at least five years. Such a financial incentive creates a stronger foundation for healthcare professionals to practice in their home country.

A Turn Toward Collaboration

A recent study determined that the collaboration of nurses, doctors and midwives significantly decreased mortality for mothers and children in low-income countries. As developing countries work toward generating strategies to manage the emigration of healthcare workers, a team-based approach can improve the quality of healthcare. When there are shortages of certain kinds of health professionals in remote areas, family health teams composed of workers in varying health disciplines can collaborate to provide care. 

Improving working conditions and providing both financial and non-financial incentives to healthcare professionals in developing countries not only benefits workers and the patients, but the nation’s healthcare infrastructure as a whole. An increase in the number of skilled healthcare workers in developing countries gives people there the opportunity for a better life.

– Ilana Issula
Photo: Flickr

After the war
Bosnia and Herzegovina, more commonly known as Bosnia, used to be a part of former Yugoslavia and went through one of the most horrific genocides in 1992. Since the war, Bosnia has had one of the highest poverty rates in the world and an unemployment rate of 15%.

This article examines the perspectives of three Bosnian women from different generations and how difficult it is or was for them to get a good education, proper healthcare or make a comfortable living after the war. Naska is a 64-year-old retired house cleaner who has lived in Bosnia all her life. Elma is 40-year-old working as a dialysis nurse in the Nakas General Hospital in Sarajevo. And finally, Adna is a 20-year-old currently attending The Academy of Fine Arts in Sarajevo.

Living in Bosnia Now

Naska was only 38 when the war started. She was born and raised in Sarajevo and still lives in her old childhood home in the middle of the city. She says living on a pension fund in Bosnia is very difficult. She receives only 300 marks, which is equal to $182 a month. “If I didn’t receive help from my sister back in the United States I would not have enough to pay for all my groceries. I’m really lucky because my friends do not have family away to help and it gets really hard, especially in the winter.” The retirement age in Bosnia is 60 years, but due to health issues Naska was forced to retire early. In our interview, Naska explained that there was a train she used to take on her way to school when she was young. The station she used was bombed during the war and has not been repaired or rebuilt since 1995. She says that times felt happier before the war; her and her neighbors are tired of seeing constant reminders of the worst time of their lives.

Elma was in elementary school during the Bosnian War. She attended class in a basement with her friends. In Bosnia, after secondary school students are required to pick a specialty in high school that they carry on through university. Elma has been studying medicine since she was 16 and works in one of only two state hospitals in Sarajevo. A registered nurse for close to 10 years now, Elma believes that the healthcare system is not the same as it was before. Bosnia has a shortage of good healthcare professionals, and the private sector for medical supplies has taken over hospitals causing treatment to become more expensive for residents. Not only has the healthcare system gotten worse after the war, the possibility of finding a decent job has also worsened. “I have been applying for a job at hospitals for five years now. I could not even get an interview. [My mom] called me a year ago to tell me that her friend has an open position in his hospital. I honestly believe that if it was not for him I would not have a job right now.” Elma thanks her mother for a lot of the good things in her life. She says before finding a long-term job, she worked part-time night shifts at a nursing home and her husband’s job wasn’t stable either. They both live in the apartment her parents had bought previously so they have the luxury of not worrying about paying rent, only utility and groceries. Elma feels her life right now is good, but she worries this could change at any moment.

Adna was born in Sarajevo in 2000. She doesn’t know much about life before the war, only what her parents have told her. She told me in the interview that students in Bosnia don’t learn about the war in schools and everything they know about it comes from stories that get passed down. Her parents tell her it’s because the country is still in mourning and it’s hard for people to talk about what happened. The education system is very different in Bosnia compared to the United States. Primary school lasts for nine years while high school lasts for four. University education can take up to three to five years depending on the college. When I called her to talk one of the first questions I asked was if going to college was worth it. She said, “It depends. It is hard to find a job here with a degree, but it is also hard to find one without. Everybody knows that you need connections to find long lasting jobs. I have plenty of friends who have graduated college and work waitressing job for three years now. My cousin graduated with a sports medicine degree and had a friend who worked at this clinic in the city, but after six months she was let go because it was too expensive to keep her.” Her cousin now works at a boutique in the city’s mall.

COVID-19 in Bosnia

Working in a hospital during COVID-19 hasn’t been the easiest for Elma, but she does applaud her hospital for taking the necessary precautions. At her job, it is mandatory for workers to enter a tent before they enter the building to have their temperatures checked and get sterilized. Then workers must put on a suit complete with additional masks and gloves before being allowed to begin their shift. The only time workers can take the suit off is while they’re eating and after their shift when they are required to take a mandatory shower, change clothes and exit the hospital from the opposite side. Every night she comes home she is exhausted and says that there is too much work to do, but just not enough people to help. However, Elma, Naska and Adna all agree on one thing: the government is too corrupt to do anything that will help the people. And there is evidence that backs them up.

A scandal hit the news about Bosnia’s Prime Minister Fadil Novalic and his involvement with fake ventilators. The government had given $5 million to the Civil Protection firm of Bosnia to buy a hundred ventilators from China. When the ventilators arrived, officials were quick to learn that they were useless and not equipped to handle the virus. The Prime Minister and Head of the Civil Protection firm were arrested on charges of fraud and money laundering on top of an embezzlement charge.

Life in Bosnia has not been easy after the war. The government is ranked 101 out of 180 countries on the Corruption Perception Index and citizens of Bosnia hold out hope that times will change, especially those who remember life before the war. It is very clear however, that life in Bosnia is a long way away from where it used to be.

Hena Pejdah
Photo: Flickr

Vlogbrothers’ Partners In Health
John Green and Hank Green, known as “the Vlogbrothers,” started a YouTube channel in 2007 called Brotherhood 2.0. It was a place for the two brothers to talk to each other through daily videos in hope of bonding. Over 10 years later, the Vlogbrothers have gained a 3-million-strong community based around learning and activism. The Green brothers also use their platform to put their own words into action. They host a Project For Awesome event each year that sends donations to charities are based on the number of viewers. Now, the Vlogbrothers’ Partners In Health partnership aims to increase access to maternal health care for women in Sierra Leone.

The Challenges in Sierra Leone

The situation in Sierra Leone has reached a crisis level. The country is in deep poverty with 60% of its citizens below the national poverty line. The beautiful terrain suffers from natural disasters and unpredictable weather patterns, which harms food production. The country struggles with health issues. There is limited access to even basic health care, a lack of clean drinking water and outbreaks of deadly diseases. A specific group that is suffering is mothers.

Sierra Leone is a deadly country for mothers to give birth. It has the highest maternal mortality rate in the world — over 300,000 mothers died from childbirth in 2015 alone. Sierra Leonean mothers die of easily preventable causes, such as hemorrhaging, lack of refrigeration for blood transfusions, unsanitary tools due to lack of clean water or lack of ambulances.

Green Brother’s Trip to Sierra Leone

In the video “The Only Psychiatric Hospital in Sierra Leone,” John Green discussed his journey to Sierra Leone’s only mental health hospital. This is a country with a population of over 7 million people. Green noted that there was no electricity, water or lighting within the hospital. The infrastructure was crumbling and the medicine cabinet had been close to empty for years. With the help of Partners In Health, a generator was able to provide the hospital with electricity, better infrastructure and hundreds of medicines for patients. Most patients that go into the psychiatric ward are now able to walk out and live healthy lives.

In 2019, John Green uploaded “Why We’re Donating 6,500,000.” In the video, he discussed the trip to Sierra Leone and told the story of a minimum wage health care worker called Ruth. Her job involves identifying women who are at high risk during pregnancy. While with Ruth, Green noticed her slip $2 in her patient’s pocket. She had wanted to make sure her child could eat that day. Green reminded his viewers that “It required far more sacrifice and compassion for Ruth to make that donation than it does for our [Hank and John’s] families to make this one.”

He went on to announce a Vlogbrothers’ Partners In Health five-year partnership. He outlined the plans to raise $25 million to supply health care facilities, workers and staff with adequate support. Green hopes that the Vlogbrothers’ Partners In Health work will decrease the odds of maternal death.

The Vlogbrothers Road to $25 million

Since 2007, the Vlogbrothers have hosted an annual Project For Awesome event. It is a 48-hour fundraising event where the money goes to “decreasing world suck.” The project has the potential to raise thousands of dollars toward the Vlogbrothers’ Partners In Health work. Additionally, its merch store gives over 90% of its proceeds to Partners In Health. The rest of the store’s profits goes toward paying artists and employees.

Still, the goal of $25 million comes across as impossible. However, John explained that “We’re already more than halfway there.” In addition to the Vlogbrothers’ Partners in Health $6.5 million donation, a group of donors offered to match up to $120,000 worth of donations each year. Green explains that to reach his target, the organization needs to raise a little over $1 million a year.

Partners In Health Creates Progress

Partners In Health has already begun important work. It employs over 450 Sierra Leonean citizens and provides food across the country. In 2019, it marked the third year in a row where no mother died from preventable pregnancy causes. Hospitals were able to have running electricity and water as well as establish a running ambulance. With more investment in health care, the numbers will only continue to improve. With focus, resources and dedication, Sierra Leone’s mothers have a better chance of surviving.

John Green noted in his video that the solution to maternal deaths is not a simple one. “It isn’t ambulances or clean water or electricity or more health care workers. It’s ambulances AND clean water AND electricity AND healthcare workers AND much more.” Green went on to say that “systemic issues demand systemic, long term solutions.” With the Vlogbrothers’ Partners in Health partnership, the future of Sierra Leone’s mothers looks brighter than ever. Anyone can help the cause by donating to the Vlogbrothers’ campaign or visiting its merch store.

Breanna Bonner
Photo: Flickr

Indigenous Peoples
Indigenous peoples in Canada have roots in poverty tracing back to the 19th and 20th centuries. They had to relocate to small plots of land called reserves where destruction of their traditional way of life “combined with the poorly organized set-up of reserves resulted in impoverishment for those on the reserves.”

In Canada, 25% of Indigenous peoples live in poverty with 40% of those living under the poverty line being Indigenous children. Many Indigenous peoples died due to lack of shelter, adequate food, access to health care and lack of federal relief services. Today, Indigenous communities continue to suffer at the hands of institutionalized colonial violence.

Housing Inequalities

Several cross-country reserves have declared a State of Emergency due to poor living conditions. Statistics deemed only 56.9% of homes on reserves adequate in 2000 and 43% unsafe and in need of repairs in 2016. In 2016, both reserve shelters and Inuit homes qualified as overcrowded — 28% and 30% respectively.

Some Indigenous people moved off of reserves and into urban centers. Even there, they continued to face economic struggles. Indigenous peoples are twice as likely to live in poverty in comparison to non-Indigenous folk. In 1995, 55.6% of Aboriginal people in urban centers lived in poverty. Meanwhile, in 2003, 52.1% of Indigenous children lived in poverty.

Income Disparities

Impoverishment within the Indigenous community has resulted in fewer on-reserve schools, rising illiteracy and rising unemployment. Indigenous households making an income below $20,000 represented almost 20% of the entire Canadian population; whereas, non-Indigenous homes only represented 9.9%.

Non-Indigenous folk in lower-income homes have a 12.9% outcome of people with major depressive episodes. Meanwhile, Indigenous folk in lower-income homes had a 21.4% outcome — almost double. The values for higher incomes families are much closer; 6.3% for non-Indigenous and 7.7% for Indigenous.

Health Inequities

The Well-Being Index determined that First Nation and Inuit communities ranked on average 20 points lower than non-Indigenous communities. Despite being only 4% of the Canadian population, Indigenous people make up 14% of the population relying on food banks. Smoking and lung cancer statistics also show an overrepresentation of Indigenous peoples. Lower-income Indigenous households reported daily smoking levels at 48.8%.

The lowest-income Indigenous populations also experience disproportionate difficulties in accessing health care. Popular barriers are that Indigenous peoples are “unable to arrange transportation (19.6%); not covered by Non-Insured health benefits (NIHB) (18.4%); could not afford transportation costs (14.6%); prior approval by NIHB denied (14.2%); could not afford the cost of care, service (11.4%).”

Aid

Many community activists and grassroots organizations work tirelessly to help support the Indigenous communities in Canada. Dismantling generational poverty is another focus of activists and organizations. True North Aid is just one of those in the fight for Indigenous peoples in Canada.

True North Aid has decades’ worth of experience. It has an advisory council of four Indigenous Elders, partners and a Board of Directors with over 35 years of experience. Under such leadership, the organization successfully raises awareness for Indigenous struggles. Additionally, it provides home reconstruction aid, water purification technologies and health care aid to Indigenous communities in Canada.

Activists and organizations supporting Indigenous peoples are imperative in the fight to end poverty for Indigenous people. Indigenous communities suffer disproportionately and need advocacy and action.

– Jasmeen Bassi 
Photo: Flickr

Life Expectancy in the Philippines
Factors such as educational status and public health expenditures have impacted life expectancy in the Philippines, a tropical nation located in the Pacific Ocean. Here are 10 facts about life expectancy in the Philippines.

10 Facts About Life Expectancy in the Philippines

  1. General statistics: Life expectancy in the Philippines at birth increased to approximately 71 years in 2018. The mortality rate among both adult men and women has similarly decreased over time. The mortality rate for adult men decreased from about 308 deaths per 1,000 in 1960 to 235 deaths per 1,000. In addition, the mortality rate for adult women also decreased over time from approximately 262 deaths to 131 deaths per 1,000 adults.
  2. Socioeconomic and educational status: Many older Filipinos have reported better health, enhanced community participation and greater financial stability. Older Filipinos also explained that they had the ability to have enhanced stability later in life. Yet those with higher socioeconomic status reported more enhanced quality of life than those of lower socioeconomic status.
  3. Disease: The World Health Organization (WHO) has reported that the leading cause of death in the Philippines was cardiovascular disease. This caused about 35% of all deaths. Communicable maternal, perinatal and nutritional conditions caused approximately a quarter of all deaths. Cancer caused another 10% and injuries 7%.
  4. Premature deaths: The risk of premature deaths as a result of non-communicable diseases (NCDS) has remained fairly constant over time at more than 30% in males. The risk of premature deaths in females was more than 20%. The WHO expects a similar trend over time until approximately 2025.
  5. Risk ractors: Risk factors specifically relevant to life expectancy in the Philippines include obesity, raised blood pressure and tobacco use. The percentage of the population that is obese has increased slightly over time, with higher projected linear trends by 2025. In contrast, the percentage of the population with raised blood pressure has remained mostly constant over time, with a similar projected linear trend. However, the percentage of the population that smokes is expected to decrease over time, with the greater change being predicted in males.
  6. National system response: The Philippines has implemented drug therapy in order to prevent both heart attacks and strokes. More than half of all health facilities reported implementation of cardiovascular disease guidelines, and many primary health care centers explained that they offered cardiovascular disease risk stratification. Four out of six of all essential NCD technologies were “generally available,” whereas 40% of essential NCD medicines were “generally available.” This is an example of how medical care can improve the life expectancy in the Philippines.
  7. Housing quality: A study conducted in Iloilo in the Visayas region of the Philippines analyzed what impacts childhood survival. The researchers examined factors like housing construction supplies and toilet services. Children from housing of higher quality had a higher likelihood of living to five years old than children from housing of relatively lower quality. As such, socioeconomic status determines life expectancy in the Philippines to some extent.
  8. Public health expenditures: From 1981 to 2010, health expenditure per capita increased by approximately 6.49%. GDP also increased by about 11% on average. At the same time, infant and under-five mortality rates decreased. In addition, life expectancy increased. 
  9. Education expenditures: In a study conducted in 2009, only 3% of government expenditures were allocated toward education. The researchers found that “Philippine provinces could use 52% of their budgets to attain current levels of human development indicators.” Ultimately, the researchers determined that increasing government spending toward education would increase life expectancy in the Philippines.
  10. Immunizations: An essential factor in lowering both morbidity and mortality is the sufficient implementation of universal childhood immunizations. In 2003, only 69% of Filipino kids were sufficiently vaccinated. Mothers with less education and who attended only four antenatal visits were found less likely to fully immunize their children.

Life expectancy in the Philippines is a complex issue. Greater awareness of the factors that affect it could contribute to better health outcomes and, consequently, higher life expectancy in the Philippines.

– Aprile Bertomo
Photo: Flickr

Hesperian Health Guides
The average global life expectancy is now above 70 years, and infant, neonatal and maternal mortality and infectious diseases have declined all over the world. Unfortunately, though, the statistics hide a crucial disparity: the inequality of life expectancy. This disparity highlights the health issues that continue to plague poor countries. For example, while life expectancy in Japan is 83 years, it is 30 years less in a poorer country like the Central African Republic. People continue to die of preventable diseases because of a lack of funding and health education. Fortunately, Hesperian Health Guides is there to help.

Hesperian Health Guides is a nonprofit that fights to bring life-saving healthcare information to even the most remote corners of the world. Its mission is to work toward a better future for everyone. It wants an empowered future where everyone has the tools and education necessary to control and understand their health.

Health

Though not founded until 1973, the spirit of Hesperian Health Guides started in the early 1970s in Ajoya, Mexico. There, a group of volunteers put together a simple pamphlet. This pamphlet included medical knowledge to help locals take care of their health needs in the absence of qualified doctors. Established as the Hesperian Foundation, the organization published the pamphlet, with “Donde No Hay Doctor” as the title. Four years later, the organization published “Where There is No Doctor,” an English translation. This publication later became the most widely read health book in the world.

Work

In collaboration with countless health workers, doctors, locals and volunteers, Hesperian Foundation, renamed Hesperian Health Guides in 2011 to more clearly communicate its mission, continues to publish and translate texts regarding all kinds of health concerns, spanning from women’s health to handicap health, and everything in between. A digital platform has also been available since 2011. It allows individuals better access, translations and downloads of additional medical information.

Accessibility

To further its mission of providing accessible healthcare information for all, Hesperian Health Guides are published in over 85 languages. The translation is in part facilitated by the nonprofit’s open copyright policy, which permits the translation, modification and distribution of its life-saving texts without requesting royalties in order to facilitate the speed and spread of information to needy communities. In addition, local healthcare workers collaborate on both print and online content. Their input presents texts in simple, culturally-sensitive languages and illustrations, benefiting those with little to no education.

Impact

Healthcare workers, members of the Peace Corps, educators, community leaders, volunteers and missionaries use Hesperian Health Guides in over 220 countries around the world. Benefited communities have written to Hesperian Health Guides to testify to the cumulative effect health education has on vulnerable communities. The guides, however, also empower individuals. Through comprehensive information and small action-tasks, people are able to take better care of themselves and others. They can help by learning simple tasks like disinfecting surgical tools or building a small water filter.

Hesperian Health Guides is working to raise the life expectancy of everyone by spreading health information to many neglected people. It is saving lives one book at a time.

– Margherita Bassi
Photo: Flickr

health sector communication
Communication is key when it comes to developing a well-performing healthcare system. Ineffective communication within healthcare systems “increases the likelihood of negative patient outcomes,” overall costs for healthcare systems, and “patient utilization of inpatient and emergency care.” Meanwhile, sound health sector communication ensures the maintenance of overall health and helps prevent diseases and premature death. Thus, it is important to ensure that healthcare systems across the globe are well equipped and supported. Recent developments in mobile technologies have made it easier to do so and transformed health-sector communication in several countries.

mHERO

A recently developed mobile application, called mHERO, has become one of the latest mobile applications to demonstrate the powerful and wide-reaching role that technology plays in health-sector communication. Created in 2014 by IntraHelath International and UNICEF, mHERO is a mobile-based application used by healthcare workers and ministries of health in order to communicate and coordinate effectively and efficiently. The application was developed during the 2014 Liberian Ebola outbreak after recognizing the need for a way to communicate urgent messages to frontline healthcare workers, to collect data concerning outbreaks development, and to provide support and training.

Messages sent through the application are transmitted through basic text or SMS. The app is compatible with most cellular devices. By merging existing health information systems, such as Integrated Human Resources Information System (iHRIS) and Fast Healthcare Interoperability Resources (FHIR), with popular communication platforms, such as RapidPro, Facebook Messenger and WhatsApp, mHERO acts as a cost-efficient, accessible and sustainable resource for many healthcare systems.

Implementation in Liberia 2014

The 2014 West African Ebola outbreak overwhelmed the Liberian healthcare sector. The absence of effective communication channels blocked the supply of vital information from health officials to health workers. UNICEF and IntraHealth International created mHERO to address the communication challenge. The application was initially designed to suit the needs of the Liberian healthcare system, utilizing the technology that was already available in the country. It then became the responsibility of the ministry of health to effectively manage and maintain the application’s implementation and its continued use.

Liberia utilized mHERO to validate healthcare facility data, to update health workers and to track which facilities need additional resources. Today, health officials use mHero to coordinate the country’s response to COVID-19. mHERO has become an integral part of the Liberian healthcare system, maintaining a vital role in health-sector communication.

Development and Reach

Guinea, Mali and Sierra Leone followed Liberia’s lead with the mHero integration process. The implementation guidelines and intent of use in these countries have generally remained the same as Liberia’s. Mali, however, has implemented the application with a need to train and develop the skills of healthcare workers.

Uganda, as of 2020, has also incorporated mHERO into its healthcare system with the intent of reducing the spread of COVID-19. The application has allowed for easier COVID-19-related communication between ministries of health, health officials and healthcare workers.

Uganda employes a developed form of the application with an extension called FamilyConnect. The extension sends “targeted lifecycle messages via SMS to pregnant mothers, new mothers, heads of household and caregivers about what they need to do to keep babies and mothers safe in the critical first 1,000 days of life” as long as they have been registered with the Ministry of Health’s Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCAH). Mothers can register themselves or can choose to have registration done by a community health worker.

Future Plans

UNICEF and IntraHealth International want to expand access to mHERO. Counties in East and West Africa have indicated an interest in implementing the application. UNICEF and IntraHealth International intend to continue to support the ministries of health and healthcare systems in which mHERO has already been implemented. They also hope to find new ways to encourage ministries of health “to understand the interoperability of the technology, the processes for implementation and best practices to using mHero data.”

Overall, mHERO has substantially improved health-sector communication within several countries, proving the application’s potential for revolutionizing health-sector communication throughout the world. Developments can be made to expand the application’s capabilities and reach, as proven in Uganda. The application is a sustainable and cost-efficient resource for healthcare systems and helps reduce the chances of premature death along with the spread of diseases and misinformation. It provides crucial support to healthcare workers, especially during times of epidemics, increasing the overall quality of healthcare and life.

Stacy Moses
Photo: Flickr

Disability and Poverty in Madagascar
In 2014, Madagascar partnered with the World Health Organization to implement the Disability Action Plan. While there are no specifics on the number of disabled persons in Madagascar, an article in the Journal of Rehabilitation Methods estimates that about 2.8 million persons with disabilities exist in the country. The goals of the Action Plan are to increase access for persons with disabilities to healthcare services and programs, extend support services and rehabilitation, and strengthen data collection on disability so it can be compared internationally. Organizations such as Humanity and Inclusion have also been working to improve the correlation between disability and poverty in Madagascar.

Access to Rehabilitation

The regions around Madagascar have about 1.6 physicians for every 10,000 people, whereas Madagascar has about 1. Eight rehabilitation specialists were trained by “A Rehabilitation Training Partnership in Madagascar” in 2015, contributing to the now 10 total specialists in the country. This means limited access to medical professionals trained in rehabilitation for persons with disabilities

Rehabilitation for people with disabilities can span from fitting them with orthopedic limbs and hearing aids to providing people with mental disabilities education on how their disability affects them as well as how to work with it in their daily lives. Sufficient rehabilitation for persons with disabilities was low in 2011, with The World Health Organization reporting that about 3% of people received it globally. People often view disability and poverty in Madagascar, and globally, as a cycle. A 2017 study called “Poverty and disability in low- and middle-income countries: A systematic review” reported that poverty and disability appear to exist in a cycle in lower and middle-income areas, where poverty can lead to disability and disability can lead to poverty.

How Disability Impacts Poverty

According to “A Survey of World Bank poverty Assessments” by Jeanine Braithwaite and Daniel Mont, when receiving the same income as persons without disabilities, persons with disabilities will have a lower standard of living. This is due to the different needs of persons with disabilities. Braithwaite and Mont’s studies into disability in developing countries revealed that households with persons with disabilities were slightly more likely to be in poverty.

How Poverty Impacts Disability

Poverty has been shown to limit access to healthcare in Madagascar. About 75% of Madagascar’s population lives below the international poverty line, according to The World Bank. The cost of healthcare, and transportation to healthcare centers, can be barriers for people in poverty to accessing treatment. USAID reported that less than 40% of Madagascar’s population lives within an hour’s walk, or 5 kilometers, from a healthcare center, meaning many people face additional transportation costs when they need to access healthcare.

A study about the barriers to implementing the Disability Action Plan in Madagascar stated that of “disability-adjusted life” in 2004, 29% was caused by non-communicable diseases. The report concluded that the data correlates with limited access to treatment, revealing a link between disability and poverty in Madagascar through the way that poverty impacts healthcare access.

Solutions

Madagascar has previously passed the Law on Disability, which promoted the freedoms and equal rights of persons with disabilities. The National Decade of Disabled Persons, a time frame in which the government would work to improve conditions for those with disabilities, was ratified in Madagascar in 2002 and ran from 2003-2013. Since passing those pieces of legislation, Madagascar has been working to implement The World Health Organization’s global Disability Action Plan since 2014. Expectations have determined that it will wrap up in 2021.

The country has already made some strides toward completing the program and impacting disability and poverty in Madagascar. In 2015, Madagascar ran a workshop and training program in partnership with Leeds Teaching Hospitals NHS Trust, which the Rehabilitation Medicine in Madagascar and a counterpart in the United Kingdom then delivered. This workshop trained and licensed eight new doctors. The doctors have now created the Association of Physical and Rehabilitation Medicine of Madagascar (AMPRMada), which has created a database for Madagascar rehabilitation centers to use. Today, according to an AMPRMada report, its database greatly helps rehabilitation planning nationally because it provides a single place to access all the rehabilitation centers’ data.

Humanity and Inclusion have also been working to improve the lives of persons with disabilities in Madagascar. The organization has been in Madagascar for 30 years. One of its ongoing projects focuses on ensuring persons with disabilities have access to adequate rehabilitation by:

  • Examining barriers to accessing rehabilitation services
  • Assessing the related economic areas
  • Setting up and improving rehabilitation services and “orthopedic fitting,” which means ensuring things like prosthetic limbs and metal braces fit patients correctly
  • Looking into increasing “education, training, and networking” in order to increase the number of rehabilitation workers
  • Improving funding for rehabilitation services
  • Keeping track of how the “National Rehabilitation Plan” progresses
  • Raising awareness

A report that details the progress of ongoing Humanity and Inclusion projects estimated that, when it is completed, its rehabilitation project will benefit 5,000 people, 47% of whom are children with disabilities.

It can sometimes be hard to calculate the effects of disability in Madagascar due to a lack of data. Research studies have, however, been able to estimate the number of disabled persons and the link between disability and poverty in Madagascar. Through the country’s legislation and partnerships with outside organizations, such as The World Health Organization, Madagascar is continuing to address and attempt to improve access to healthcare and rehabilitation for persons with disabilities. Organizations like Humanity and Inclusion have been contributing to those changes with ongoing projects that address access to rehabilitation services for persons with disabilities.

– Melody Kazel

Photo: Flickr