Information and stories on health topics.

Elderly in BangladeshThe world currently has approximately 720 million people over the age of 65. By 2050, about 22% (36 million) of Bangladesh’s people are projected to be in this age category. With this in mind, it is important that this growing demographic is taken care of. In particular, the poverty affecting the elderly in Bangladesh is a concern that should be attended to.

Elderly Poverty in Bangladesh

Bangladesh is one of the most impoverished countries and the effects of poverty are felt hardest by vulnerable populations like the elderly. The Global AgeWatch Index ranks countries by how well their older populations are faring socially and economically. Bangladesh is considered a distinctly tough country for older people as HelpAge International ranked Bangladesh 67th out of 96 countries on the 2015 Global AgeWatch Index.

The organization notes that a considerable amount of the hardship inflicted upon older people in Bangladesh is due to natural disasters and extreme weather. Cyclones, floods, and heatwaves destroy the homes and livelihoods of elderly people. Additionally, HelpAge notes that elderly people in Bangladesh are often refused healthcare due to ageism within the country’s public health system.

Elderly people in Bangladesh also struggle to maintain a dependable income since finding employment is harder with age, especially with common and physically demanding jobs like rickshaw pulling or soil digging.  As in many other lower-income countries, elderly people in Bangladesh have to look for employment in old age due to inadequate livelihood support and insufficient social security measures.

While by no means exclusive to Bangladesh, another problem that the elderly face in Bangladesh is stigma, as pointed out by Dr. Atiqur Rahman. The stigma described is one that views the elderly as unproductive, unhealthy and needing intensive and constant care. Dr. Rahman describes the idea of the elderly being a burden as both morally and economically incorrect.

Old Age Allowance Program

The Old Age Allowance (OAA) program is a government social pension scheme that assists the elderly in Bangladesh. Originally implemented in 1997, the program provides welfare payments to qualifying elders in order to help them get by. The overall size of the program was rather small at its inception, supporting about 400,000 people. Since then, the OAA has come to cover 4.4 million elderly in Bangladesh and the size of the payments increased from 100 to 500 Bangladeshi takas (around $6). Granted the growth is a step in the right direction, the program is not yet at a point where it can help in the broad sense. Elderly poverty has still increased since it started. The OAA program accounts for a minuscule portion of Bangladesh’s budget (0.53%) and covers only 2.25 million elderly people.

Additionally, much of the fund is going to the wrong people. A study by the University of Dhaka’s Bureau of Economic Research and HelpAge International discovered that elderly people who are not impoverished are getting 50% of the total benefits and about 33% of the fund is going to those who are younger than the eligible age. Another study found that local governments lack the knowledge and interest to properly target relevant beneficiaries most in need.

Organizations Supporting the Elderly in Bangladesh

HelpAge International provides early warning systems for potential natural disasters. In times of these disasters, the organization ensures the elderly have shelter, food and access to services. For long-term relief, HelpAge restores livelihoods by supporting small business enterprises with low-cost community loans. The organization also provides training for healthcare workers to treat conditions affecting the elderly and works on improving healthcare infrastructure and referral systems for the elderly.

The Care First Foundation is an organization that offers the elderly in Bangladesh risk monitoring, referrals, counseling, medicine and medical support, home care and activities. Its goal is to expand its initiatives to alleviate elderly suffering through proper community support and services.

With more support from organizations and improvements to the social support system provided by the government, the elderly in Bangladesh can thrive and not just simply survive.

Sean Kenney
Photo: Flickr

Healthcare for Disabled PopulationsWorldwide, estimates have determined that more than 1 billion individuals live with some form of disability. In developing countries, access to healthcare is difficult enough with rural areas being far from main health centers and low socioeconomic status preventing optimal diagnosis and treatment. For disabled populations, low mobility leads to transportation difficulty, creating an additional barrier that compromises health and access to the nearest healthcare providers. Established in 1998, the Swinfen Charitable Trust (SCT) is a United Kingdom-based nonprofit organization that focuses on providing healthcare for disabled patients in developing countries through increased access to telehealth.

Disability as a Public Health Issue

Although 15% of the world lives with a form of disability, every person experiences varying limitations and healthcare needs. Article 25 of the United Nations Convention on the Rights of Persons with Disabilities (CRPD) states that those living with disabilities must receive the highest former of care without discrimination. Despite some countries upholding Article 25, many developing countries cannot provide the proper care for disabled individuals.

Beyond discrimination experienced in the health sector, individuals with disabilities face various barriers to healthcare. To begin, they typically encounter prohibitive costs for health services and transportation since a disability can create the need for a specially adapted vehicle in order to travel to the nearest healthcare professional. Estimates have stated that more than half of people experiencing a disability are unable to cover the costs they incur in healthcare, compared to approximately a third of people for those who are able-bodied. Also, physical barriers prevent disabled people from being able to access certain buildings and essential medical appointments. Inaccessible medical equipment, poor signage and inadequate bathroom facilities all comprise potential barriers. For example, medical professionals can often deny disabled women breast and cervical screening since the tables are not adjustable to one’s height and mammography equipment cannot accommodate women who are unable to stand.

The Swinfen Charitable Trust’s Mission

The Swinfen Charitable Trust (SCT) focuses on the disabled population of the developing world. SCT creates telemedicine links between healthcare centers in the developing world and medical professionals globally, who provide complementary diagnosis and treatment services. SCT represents the longest operating telemedicine nonprofit in existence. To date, there are 366 referring hospitals and more than 700 specialists providing their expertise to disabled people in developing countries free of charge. People can download the app called SCT Telemedicine on mobile phones and SCT has established telemedical links in 78 countries.

SCT raises money that goes toward improving the telemedicine experience and accessibility for disabled patients in developing countries. To begin, financial contributions provide round-the-clock system operators who have the task of analyzing and allocating new cases to specialists. Also, the money raised grants on-site support to partners for telemedical coverage implementation in local communities. This is especially crucial in remote areas of the developing world. Finally, any additional funds are allocated to expanding care to new countries or villages that are struggling to deliver adequate healthcare for disabled populations.

Improving the Lives of the Vulnerable

With a rising technologically dependent world, the Swinfen Charitable Trust is attempting to bridge the gap between poverty and healthcare access in developing countries, particularly for vulnerable populations. By establishing the means for disabled populations to access telemedicine, the disabled population can overcome healthcare barriers and improve their quality of life and life expectancy significantly.

– Sarah Frances
Photo: Flickr

Healthcare Inequity and the COVID-19 Crisis in PalestineThe COVID-19 crisis in Palestine is worsening due to conflict in the region. Palestine is comprised of two territories that are separated by Israel. This includes Gaza and the West Bank. With Israelis preventing Gazans from leaving the area, Israeli soldiers are destroying agricultural lands that are vital for the Palestinian economy.

Palestinians, specifically those living in Gaza, have lived their entire lives relatively isolated from much of the outside world. A wall that was erected along Gaza’s borders prevents Palestinians from leaving the territory and subjects them to Israeli discretion. Help from NGOs and humanitarian aid can reduce the COVID-19 crisis in Palestine.

Pre-Pandemic Healthcare in Palestine

One consequence of the Israeli occupation is the scarcity of healthcare providers and resources in Palestine. In order to access Israeli health facilities, Palestinians must obtain travel permits, but these permits are frequently denied. There are 300,000 Palestinians living without access to adequate healthcare in the West Bank. The few healthcare facilities that do exist in the occupied territories face equipment and medicine shortages. The effort to increase the number of health facilities in Gaza has been hindered by Israeli refusing to grant construction permits and restrictions on medical imports and exports.

Impacts of COVID-19 on Palestinian Healthcare

The COVID-19 crisis in Palestine devastated its already inadequate Palestinian healthcare system. Gaza and the West Bank have a total of 375 ICU beds and 295 ventilators between them, for a population of over three million. The lack of available resources has severely hindered pandemic response in the territories, with health officials halting COVID testing in June due to a shortage of test kits in Gaza.

The sole laboratory in Palestine capable of processing COVID tests was forced to close as it lacked sufficient equipment. Household resources such as hand sanitizer, antibacterial wipes and even soap are scarce in Gaza and the West Bank. This is due to the lack of financial means. In addition, Palestinians don’t have the luxury to use social distancing to prevent the spread of the pandemic as the territories are severely overcrowded.

The ongoing Palestinian-Israeli conflict has exacerbated the severity of the COVID-19 crisis in Palestine. In July 2020, Israeli forces destroyed a quarantine facility in the West Bank, thus further decreasing the amount of pandemic-response resources available to Palestinians. Moreover, hospital space that could be used by COVID patients is largely occupied by the high volume of people seeking treatment for injuries acquired from conflict with Israelis.

Israel has also imposed restrictions on medical supplies, subsequently reducing treatment capacity in Gaza. In April 2020, Israeli authorities destroyed a Palestinian COVID testing center. It has been reported that water, sanitation and hygiene facilities are also casualties of Israeli attacks.

Aiding Pandemic Response in Palestine

The World Health Organization published an updated COVID-19 Response Plan for Palestine in April 2020. This plan involves increasing testing capacity, providing additional hospital beds and educating the Palestinian public about virus prevention. It also aims to increase the amount of personal protective equipment available to health professionals.

Palestinian healthcare providers rely heavily on humanitarian aid and NGOs such as Anera. Anera works towards increasing healthcare access in Palestine by distributing medication, wheelchairs and funding to healthcare providers in Gaza and the West Bank. In addition, Doctors without Borders or, Medecins Sans Frontieres, provides medical care such as trauma support, mental health services, surgeries and treatment for burn patients in the occupied territories.

The COVID-19 pandemic and other preceding disease-outbreaks have often been referred to as “great equalizers,” as they are able to affect all people. Yet, as noted by Dr. Stephen Mein, low-income populations and racial and ethnic minority groups are more likely to contract these diseases. Socioeconomic disparities and political situations such as the Palestinian-Israeli conflict prevent pandemics from becoming equalizers. This is because disadvantaged groups are disproportionately being impacted.

In the case of Palestine, tensions between Palestinians and Israelis have had devastating effects on the pandemic-response. The isolation of Gaza and the West Bank should have prevented the COVID-19 situation in Palestine from escalating so rapidly. Yet, the lack of funding and medical resources as well as political tensions and overcrowding in the territories, have resulted in many potentially preventable fatalities.

Although the COVID-19 crisis in Palestine remains a critical issue, the number of daily COVID cases has been continuously declining. Support from organizations such as Anera has alleviated pressure from the Palestinian leadership.

– Maariyah Kharal
Photo: Flickr

Formative SupervisionWith a population of about 30 million, many Angolans do not have access to adequate healthcare. The limited access to quality healthcare is due to decreased funding due to the Angolan Government’s budget restrictions. The lack of funding affects the quality of public healthcare which people can receive at no cost. The public healthcare sector in Angola does not have enough healthcare providers with proper training and resources. The lack of resources in healthcare reflects in the low ratio of about one health center per 25,000 people and more than 50% of people are without access to healthcare services. In recent years, USAID’s Health for All project, using the Health Network Quality Improvement System (HNQIS), has implemented formative supervision in Angola. Implementing formative supervision in Angola has shown to improve the quality of healthcare by increasing the number of healthcare providers with proper training.

USAID’s Health for All Project

USAID’s Health for All program is a five-year project that began in 2017. It works with the Angolan Government to help improve the quality and access to healthcare in the country. The project’s focus is on addressing the issues of malaria and reproductive health since those are two of the main health concerns affecting the people of Angola. With the current funding being at $63 million, the program has been able to train 1,489 health professionals on how to diagnose and treat malaria and created reproductive health services in 42 health facilities.

The program’s use of formative supervision in Angola has helped in educating and providing healthcare workers with the necessary tools to effectively care for patients. The Health Network Quality Improvement System is the main tool that USAID uses to help improve the quality of healthcare because the system is used to evaluate the performance of individual healthcare providers. By tracking the performance of the healthcare providers in Angola, USAID can more easily determine which areas of the healthcare system need improvement. Under the Health for All program, USAID has been using formative supervision with healthcare providers who specifically tend to cases of malaria and reproductive health.

The Benefits of Formative Supervision

From October 2019 to March 2020, the Health for All project recorded improvements in the quality of healthcare through the use of formative supervision in 276 out of 360 Angolan health facilities with prenatal services. In addition to tracking the performance in maternal and reproductive health, the supervision has also helped in finding the areas in which the management of malaria has been lacking. There are now about 1,026 health providers that have been properly trained in managing malaria cases as a result of the project. This has in turn indirectly improved the quality of care regarding maternity since malaria causes 25% of maternal deaths in Angola.

Besides increasing the amount of funding that goes toward healthcare, the Health for All project has used such funding to be more interactive with healthcare facilities through the use of formative supervision in Angola. Formative supervision has shown to drastically improve the quality of care in the areas of malaria and reproductive health as supervision allows trained health officials to identify and fix integral issues pertaining to healthcare in Angola.

Zahlea Martin
Photo: Flickr

Mental Health Resources Physical health is often the focus of healthcare advocacy groups, but mental health needs to be improved around the world just as much. While some still consider mental health a taboo subject, it is important to improve the lives and prospects of those in poverty. The violence and trauma that often go hand-in-hand with extreme poverty can cause mental health issues. Proper care is often lacking but organizations are stepping up to the challenge. There are several organizations providing mental health resources in developing countries.

The Africa Mental Health Research and Training Foundation (AMHRTF)

AMHRTF focuses on providing mental health services in developing countries like Kenya. The organization prioritizes community health, making it a point to educate and serve community members of all ages from children to the elderly. It puts special focus on pregnancy and postpartum mental healthcare and trauma-related mental health disorders. In addition, the organization employs professionals with a wide range of specialties in order to implement holistic care. AMHRTF aims to make mental healthcare in Kenya available and accessible.

Strong Minds

Strong Minds focuses on providing mental health services in developing countries throughout the African continent. Specifically, the organization works toward ending Africa’s depression epidemic and reaching the most vulnerable women with depression in sub-Saharan Africa. After conducting research on the most effective and cost-efficient ways to conduct programs, Strong Minds settled on a model of consistent group therapy for a period of 12 weeks that a trained community member led. Qualifying to receive training as a group leader does not require a high level of formal education beforehand and is therefore accessible to members of communities in extreme poverty. These groups are extremely effective at reducing the cases of depressive episodes and providing coping mechanisms.

The World Federation for Mental Health

The World Federation for Mental Health emerged in 1948 and has been active in several different areas of mental health services since. The organization’s focus is destigmatizing mental illness and advocating for international and national mental health policies for the underserved. The organization helps to organize mental health awareness activities and events around the world and educate the public on mental health conditions. It also aims to improve care, treatment and recovery of people with mental disorders.

Federation Global Initiative on Psychiatry

The Federation Global Initiative on Psychiatry initially provided mental health services in developing countries in Europe with a special focus on nations that were previously part of the USSR. The organization’s work has now spread to include other regions too. The organization advocates for mental health care as a human right and assists people with mental health disorders, intellectual disabilities and trauma-based disorders. Like Strong Minds, the Federation Global Initiative on Psychiatry focuses on improving mental health options and services on a community level by working with local negative forms of mental illness management and helping to create more positive treatment options. The organization’s decentralized approach makes solutions more sustainable in the long term.

Center for Health and Human Development

Mental Health International, under the umbrella of the organization Center for Health and Human Development, helps to provide mental healthcare in El Salvador and other developing countries like Burundi and the Democratic Republic of Congo. The organization aims to destigmatize mental illness and form a network of NGOs to provide care to people with mental health disorders like depression and schizophrenia. Mental Health International also provides self-empowerment techniques along with training and classes for mental health caregivers.

All the above organizations work to improve and provide mental health resources in developing countries and create a world in which everyone in need has access to sufficient care.

Che Jackson
Photo: Flickr

Healthcare in ColombiaColombia’s healthcare system is not perfect but it also far from inadequate. Located in the northernmost part of South America, Colombia has estimable healthcare provision for the country’s people. With both public and private insurance plans, reputable facilities and well-equipped healthcare providers, Colombia sets an example of what sufficient healthcare looks like in a developing country. To understand this better, it is necessary to know some key facts about healthcare in Colombia.

7 Facts About Healthcare in Colombia

  1. Healthcare in Colombia ranked 22nd out of 191 healthcare systems in overall efficiency, according to the World Health Organization. For perspective, the United States, Australia, Canada and Germany ranked 37th, 32nd, 30th and 25th respectively.
  2. Colombia’s healthcare system covers more than 95% of its population.
  3. Indigenous people are considered a high-risk population due to insufficient access to healthcare in indigenous communities in Colombia. Specifically, they are more vulnerable to COVID-19 due to this lack of healthcare access and significant tourist activities in indigenous regions increase the risk of spread. Robinson López, Colombian leader and coordinator for Coordinadora de las Organizaciones Indígenas de la Cuenca Amazónica (COICA), said in March 2020 that tourism in indigenous territories in Latin America should stop immediately to curb the spread of COVID-19.
  4. There are inequities in the utilization of reproductive healthcare by ethnic women in Colombia, according to a study. Self-identified indigenous women and African-descendant women in the study had considerably less likelihood of having an adequate amount of prenatal and postpartum care.
  5. The Juanfe Foundation is a Colombian-based organization that promotes the physical, emotional and mental health of vulnerable and impoverished adolescent mothers and their children. So far, the organization has supported more than 250,000 people. The Juan Felipe Medical Center served 204,063 individuals — 20% of the population in Cartagena, Colombia. The organization also saved the lives of 4,449 infants through its Crib Sponsoring Program.
  6. In 2019, four of the top 10 hospitals in Latin America were in Colombia and 23 of the top 55, according to América Economía.
  7. Colombia secured nine million doses of the COVID-19 vaccine from Johnson & Johnson in December 2020. Combined with the doses it will receive from Pfizer, AstraZeneca Plc, COVAX and other finalizing deals, Colombia will be able to vaccinate 35 million people within its population of 49.65 million, striding toward herd immunity.

Recognizing Colombia’s Healthcare System

Simultaneously recognizing the current inequities and challenges alongside the positives in Colombia’s healthcare system is the true key to understanding it and the individuals depending on it overall. Despite attention-worthy deficits, healthcare in Colombia stands out in Latin America and in the world as high quality, widespread and respectable. The country’s healthcare is contributing to the well-being of many and the future ahead looks promising.

Claire Kirchner
Photo: Flickr

Telemedicine Clinics in GuatemalaNew telemedicine clinics in Guatemala are providing vital resources to women and children living in remote areas with limited access to healthcare specialists. This advancement in healthcare technology increases Guatemala’s healthcare accessibility and follows a trend of a worldwide increase in telemedicine services.

Guatemala’s New Telemedicine Clinics

Guatemala’s Ministry of Public Health and Social Assistance (MSPAS), in conjunction with the Pan American Health Organization (PAHO) and the World Health Organization, launched four new telemedicine clinics in Guatemala in December 2020.

The clinics were designed to improve accessibility to doctors and specialists for citizens living in rural areas, where unstable or lengthy travel can deter patients from getting the care they need. Lack of staff is another barrier telemedicine hopes to overcome. Special attention will be given to issues of child malnutrition and maternal health.

The funding of the program was made possible through financial assistance from the Government of Sweden and the European Union. aimed at increasing healthcare access in rural areas across the world.

Guatemala’s State of Healthcare

Roughly 80% of Guatemala’s doctors are located within metropolitan areas, leaving scarce availability for those living in rural areas. Issues of nutrition and maternal healthcare are special targets for the new program due to the high rates of child malnutrition and maternal mortality in Guatemala.

Guatemala’s child malnutrition rates are some of the highest in all of Central America and disproportionately affect its indigenous communities. Throughout the country, 46.5% of children under 5 are stunted due to malnutrition.

Maternal death rates are high among women in Guatemala but the country has seen a slow and steady decline in maternal mortality over the last two decades. The most recently reported maternal death rate is 95 per 100,000 births.

Guatemala does have a promising antenatal care rate, with 86% of women receiving at least four antenatal care visits during their pregnancies. By increasing the access to doctors through telemedicine clinics, doctors can better diagnose issues arising during pregnancy and prepare for possible birth difficulties that could result in maternal death.

Guatemala’s COVID-19 rates have also impacted the ability of patients to seek healthcare. The threat of the virus makes it difficult for those traveling to seek medical treatment due to the risk of contracting COVID-19.

Trends in Worldwide Telemedicine

The world has seen a rise of telemedicine clinics as the pandemic creates safety concerns regarding in-person visits with doctors. Doctors are now reaching rural communities that previously had little opportunity to access specialized medicine. Telemedicine is an important advancement toward accessible healthcare in rural areas. While the telemedicine clinics in Guatemala are limited in numbers, they set an important example of how technology can be utilized to adapt during a health crisis and reach patients in inaccessible areas.

June Noyes
Photo: Flickr

Russia’s AIDS EpidemicAmid a global pandemic, Russia is fighting a medical war on two fronts; as Russia deals with the spread of COVID-19, Russia’s AIDS epidemic is worsening. As the HIV  infection rate continues to decline in the rest of Europe, the transmission rate of HIV in Russia has been increasing by 10 to 15% yearly. This increase in transmission is comparable to the yearly increase in transmission of HIV in the United States in the 1980s at the height of the AIDS epidemic.

The AIDS Epidemic in Russia

Among other factors, the erosion of effective sexual health education and a rise in the use of opioids has led to a stark increase in the transmission of HIV/AIDS in Russia. The epidemic of AIDS in Russia has received little attention from the Russian Government and the international community, partly because of the nation’s social orthodoxy and the stigma surrounding drug use and HIV/AIDS.

The Silent Spread of HIV

A significant number of Russians infected with HIV are those who inject drugs. Roughly 2.3% (1.8 million) of Russian adults inject drugs, making Russia the nation in Eastern Europe with the highest population of those who inject drugs. Due to the stigma associated with drug use as well as the threat of harsh criminal punishment, few drug users who have been affected by HIV seek treatment. A study from the Society for the Study of Addiction found that in St. Petersburg only one in 10 Russians who inject drugs and are living with HIV currently access treatment.

A large part of the stigma surrounding AIDS in Russia comes from the return of traditionalism to the Russian government following the election of Vladamir Putin in 2012 and the strong connection between the traditionalist Russian Orthodox Church and the Russian Government. The Orthodox Church, in particular, has blocked efforts to instate sex education programs in schools and campaigns to give easier access to safe sex tools like condoms. While methadone is used worldwide to treat opioid addiction to lower the use of drug injection and therefore HIV transmission, the Russian Government has banned methadone. Any person caught supplying methadone faces up to 20 years in prison.

HIV During the COVID-19 Pandemic

Studies conducted during 2020 have shown that Russians living with HIV and AIDS have faced difficulties in accessing treatment. According to UNAIDS, 4% of Russians living with HIV reported missing medical treatment due to the pandemic and roughly 30% of respondents reported that their treatment was somehow impacted by the pandemic.

The same study found that HIV-positive Russians had a positive COVID-19 diagnosis at a rate four times higher than HIV-negative Russians. However, HIV-positive Russians were less likely to seek medical attention for COVID-19 despite the high health risks, such as a weaker immune system that can accompany HIV. More Russians are contracting HIV yearly but the stigma of living with HIV is preventing HIV-positive Russians from seeking medical treatment.

Destigmatizing HIV/AIDs in Russia

With little national attention paid to the epidemic of AIDS in Russia, the movement for change has come from individuals looking to give visibility to and destigmatize HIV/AIDS. In 2015, after television news anchor, Pavel Lobkov, announced on-air that he had been living with AIDS since 2003, Russian doctors including Lobkov’s own doctor, saw a surge in people seeking HIV tests and treatment. In a nation where AIDS is highly stigmatized, a national celebrity showing that one can live a normal life with AIDS brought comfort to many Russians living with HIV/AIDS.

More Russians living with HIV/AIDS have made efforts to shed light on Russia’s HIV epidemic and destigmatize HIV to the public as well as in the medical community. Patients in Control, a nongovernmental organization run by two HIV-positive Russians, Tatiana Vinogradova and Andrey Skvortsov, set up posters around St. Petersburg that read “People with HIV are just like you and me,” and encourage HIV-positive Russians to seek antiretroviral treatment. HIV-positive Russians like Skvortsov and Vinogradova are trying to bring national attention to a health crisis that is seldom discussed, hoping to create a national conversation and put pressure on Russian officials to take action on the worsening epidemic.

A Call for Urgent Action

HIV-positive Russians and AIDS activists like Skvortsov have argued that until the Russian Government puts forth an “urgent, full forced response” to Russia’s AIDS epidemic, the rate of transmission will continue to climb. Many Russians on the ground are making public campaigns to destigmatize and normalize living with HIV, hoping to persuade the government to take action.

In 2018 alone, AIDS took the lives of 37,000 people across Russia. As of May 2020, more than 340,000 Russians have died of AIDS. While the social atmosphere of Russia, influenced by Putin’s government and the Orthodox Church, has created a shroud of secrecy and shame surrounding the AIDS epidemic, many HIV-positive Russians hope that the intensity of the epidemic will force the Russian Government to make a concerted effort to address Russia’s AIDS epidemic.

Kieran Graulich
Photo: Flickr

Suicide in GreenlandBetween 1970 and 1980, the suicide rate in Greenland was seven times higher than that of the United States. The high incidences of suicide in Greenland stemmed from the devaluing of local Inuit culture which occurred when Denmark pushed to modernize the island. Due to a lack of adequate resources, improvements have been slow. However, as mental health has become destigmatized, various NGOs and government programs have appeared over the last decade with promising solutions to address suicide in Greenland.

Suicide in Greenland Today

In 2016, the global average annual suicide rate was 16 persons per 100,000. In Greenland, the annual suicide rate was 82 persons per 100,000.

Suicide is not evenly distributed across Greenland’s population. Teenagers and young adults are at the highest risk of suicide. According to the Nordic Centre of Welfare and Social Issues, the prevalence of suicide in Greenland is three times higher among 20 to 24-year-olds than 25 to 65-year-olds.  Additionally, 23% of teenagers and young adults reported that they have self-harmed.

Recognizing Risk Factors

Due to the rapid modernization of the 1970s and 1980s, many people emigrated to the cities and larger settlements for economic and educational mobility. However, once there, they needed to assimilate to appear more Danish. The loss of identity that followed saw communities turn to alcohol, which in turn led to child abuse and neglect — two major risk factors for suicide. This erosion of family structure made it hard for individuals to cope with emotional and psychological hardships.

Combating Suicide in Greenland

Over the last couple of decades, the government and several NGOs created programs to combat this endemic.

  • SAAFIK – Established in 2011, this nation-wide counseling center extends medical, psychological, social and legal support to child victims of sexual abuse.
  • Break the Silence, End the Violence – In 2014, The Ministry of Family, Gender Equality and Social Affairs launched a three-year campaign to raise awareness about domestic violence. To this end, the Ministry established a web page about violence and information campaigns.
  • SAPIIK – This peer mentoring program is focused on reducing the number of children who drop out of school. Through social activities and outings, SAPIIK focuses on improving a child’s intrapersonal and interpersonal skills.
  • School Fairy System – This program places a social worker, known as a School Fairy, in schools to help students who need social support. The School Fairy engages students through conversation and activities. The School Fairy also reports concerns and observations to the school when he or she deems that special interventions are required.
  • TIMI ASIMI –  Founded in 2011, this is an outdoor-based intervention program geared toward at-risk teens and young adults, ages 13 to 21. Throughout the course of three months, participants engage in educational courses, community service, academic counseling and physical activities.
  • Project CREATes – Over the course of two years, this project utilized storytelling as an effective way of eliciting personal experiences related to both suicide and resilience. These workshops were safe spaces for the arctic’s youth to come together and share their experiences with suicide and mental health. Facilitators worked with youth to help them to write, audio record, photograph or film their own stories as a way of healing. Though Project CREATeS ended in 2019, it was just one part of a series of programs created by the Arctic Council to combat suicide in the arctic. It was succeeded by Local2Global, another suicide prevention program focused on fostering community and creating digital projects for storytelling.

Greenland has come a long way since the 1980s. People are now able to talk about suicide and get help for mental issues. With more initiatives and resources, suicide in Greenland can decrease to match the global average or even undercut it.

Riley Behlke
Photo: Flickr

 Mental Health in Rwanda Rwanda is a small country in sub-Saharan Africa. Rwanda has struggled to become a stable country economically and politically since it became independent in 1962. As a developing country, Rwanda is still trying to develop its healthcare system. With years of conflict and instability, people especially struggle with mental health in Rwanda.

5 Facts About Mental Health in Rwanda

  1. The Rwandan Genocide plays a significant role. Roughly 25% of Rwandan citizens struggle with PTSD and one in six people suffer from depression. The reason why so many Rwandans have mental health conditions can be explained by one key event in Rwandan history. During the Rwandan genocide of 1994, members of the Hutu ethnic majority murdered as many as 800,000 people, mostly of the Tutsi minority. The mass genocide caused severe trauma to survivors who still suffer from mental health issues 26 years after the event.
  2. Rwanda has very few resources. According to the World Health Organization, Rwanda has only two mental health hospitals, zero child psychiatrists, and only 0.06 psychiatrists per 100,000 people. With a large amount of the population plagued by mental health issues, Rwanda needs more resources to help the mentally ill.
  3. Suicide rates have greatly decreased in Rwanda. In 2016, the suicide rate in Rwanda was 11 deaths per 100,000 people. This is a great improvement compared to the 24.6 suicides per 100,000 people in 2000. An increase in mental health resources contributes to the lowering of the suicide rate in Rwanda.
  4. Increased mental health funding is essential. The average mental health expenditure per person in Rwanda is 84.08 Rwandan francs. Most citizens of Rwanda do not have the financial resources to afford mental healthcare. The government currently uses 10% of its healthcare budget on mental health services. Considering how large the mental health crisis is, the government should increase its expenditure to address the crisis. Since citizens cannot afford to pay for mental health resources, the government will need to help provide more free or affordable resources.
  5. The Rwandan Government is updating policies to address mental health. In 2018, Rwanda’s updated strategic plan for its health sector set new targets for expanding mental health care services. Its purpose is to help increase access to mental health resources by decentralizing mental health and integrating it into primary care. Also, this plan calls for a decrease in the cost of mental healthcare and an increase in the quality of care. The plan hopes to accomplish strategic goals by 2024. If successful, this plan may be used as a method to help other countries establish a quality mental health plan.

The Road Ahead for Rwanda

Considering Rwanda’s violent history, it is no surprise that the population struggles with mental health. Over the years, progress has been made with regard to mental health in Rwanda. However, many more resources are needed to help address the mental health crisis in Rwanda. With Rwanda’s updated strategic plan to address the issue and an increase in expenditure, the well-being of Rwandan’s will be positively impacted.

Hannah Drzewiecki
Photo: Flickr