health care in the drc

While the Democratic Republic of the Congo (DRC) is abundant with natural resources and a thriving ecosystem, decades of armed violence have left the nation impoverished. Currently, health care in the DRC suffers from understaffing and underfunding concerns. Moreover, it is only readily available in certain regions of the country. To better understand this issue, here are four facts about health care in the Congo.

  1. Health care exists in a pyramid structure. The DRC government, aided by several NGOs, funds and controls the public health care system in a four-level model. The first level of health care in the DRC is community health centers. These are open for basic treatment and utilizes nurses for care. The next level contains centers where general physicians practice. The third level pertains to regional hospitals, where citizens can receive more specialized treatment. The fourth and highest level is university hospitals. At all levels, appointments are needed to see physicians, and as they also only see clients on certain days of the week, wait times can be long. This prompts patients who require specialist treatment to often see community nurses instead. In addition, USAID currently provides health care services to more than 12 million people in almost 2,000 facilities.
  2. The country lacks health care workers. Health care in the DRC is limited. Statistically, there are only 0.28 doctors and 1.19 nurses and midwives for every 10,000 people. Furthermore, access to health care in the Congo’s rural regions is extremely low due to the remote state of many villages. The northern rural areas of the DRC hold less than 3.0% of the nation’s physicians while Brazzaville, the capital and the most heavily populated city, holds 66% of all physicians. This is despite the fact that the capital only holds 37% of the Congolese population.
  3. Health care funding in the DRC, though low, steadily rises. The government of the DRC has made noticeable progress in increasing funds for health care. Between 2016 and 2018, the proportion of the national budget dedicated to health care increased from 7% to 8.5%. While this increase in funding is life-changing for many, it still pales in comparison to the budgets of many other countries. The U.S. currently allocates 17.7% of its GDP toward health care. The DRC, however, is on an upward trajectory. It seeks to reach a target of 10% allocation of the national budget for health care by 2022.
  4. The DRC’s vaccination rates are improving. In 2018, the government of the DRC implemented The Emergency Plan for the Revitalization of Immunization. The plan aimed to vaccinate more than 200,000 children for life-threatening diseases in a year and a half. While the outbreak of COVID-19 in the nation has been a major setback to the plan, the Mashako Plan, as it is referred to, was responsible for a 50% rise in vaccinations since 2018. This rise occurred in “vulnerable areas” and brings countless more children immunity for potentially deadly diseases.

Despite a lack of health care workers and resources, the Democratic Republic of the Congo is making steady improvements to its health care system. Efforts to make vaccinations a priority and allocate more of the country’s budget to health care each year already yield results. Organizations such as USAID aid these improvements. The combination of NGOs and the government’s new emphasis on health care provide an optimistic outlook for the future of health care in the Democratic Republic of the Congo

Caroline Bersch

Photo: Unsplash

Healthcare Reform in Latin America
One-third of the population in Latin America does not have access to permanent healthcare, meaning healthcare services and benefits are inaccessible to approximately one in every three people. Statistics have shown that less than 30% of the population in Andean and Central American countries have social security coverage. Meanwhile, 70% lack any type of access to basic health services and 17% of women endure childbirth unassisted. Healthcare reform in Latin America has become the focus of various organizations who have made it their mission to make healthcare accessible and affordable to the people in countries such as Argentina, Brazil, Costa Rica, Columbia and Chile.

Organizations Working to Increase Accessibility to Healthcare

The International Labour Office (ILO) is an agency that aims to provide and enhance social protection for all. The Panamerican Health Organization is responsible for pushing countries to reform their healthcare systems. It also aims to ensure that everyone has access to healthcare. Both agencies have partnered to carry out an action plan – the Action Plan for the Americas – that will take place over the course of five years to find new ways to provide healthcare services and benefits to the excluded portions of the population. This plan aims to implement a micro-insurance system that has been successful in Central American countries. This system helps to decrease social exclusion and increase the quality of care that people receive.

Program SUMAR is a national program that has the goal of creating subsidized health insurance for the uninsured in countries like Argentina. It aims to do this by strengthening the insurance scheme and implementing a result-based approach that uses financial incentives to promote advancement in certain regions. It aims to close the gap between the medically, financially and physically possible with available resources, and reduce disparities in effective coverage. Another goal that this program implemented is to build a primary care-oriented system that makes families and communities its priority by promoting universal coverage and access to services and benefits.

Poverty and How it Affects Access to Healthcare

The System for Selecting Beneficiaries of Social Spending (SISBEN) uses qualitative and quantitative data to analyze and measure poverty in multiple different countries. The SISBEN Index takes into account different variables to determine economic needs within communities and create accurate changes and target different problems that exist within countries’ economic systems. After using the SISBEN method in Columbia’s system, the poor population in this country experienced a positive effect in the sense that economic barriers to basic healthcare services that existed before remarkably decreased. The healthcare gap between economic classes decreased because of universal healthcare and more insured and uninsured people were able to receive healthcare. Additionally, higher percentages of people are using ambulatory services, taking sick children to receive treatment and enduring childbirth in the presence of a healthcare professional.

While the world grows richer, large populations of the world continue to suffer from preventable and treatable sicknesses. This notion helped spark change and systemic reform. Many organizations mobilized and launched different operations aimed at improving these systems, centralizing healthcare reform in Latin America as a priority. There is a rise in the accessibility of healthcare services and benefits to impoverished populations as well as an increase in the life expectancy of people who inhabit these countries.

– Annamarie Perez
Photo: Flickr

COVID-19 vaccinations in HaitiHaiti faces a surge in COVID-19 cases, while also being the only COVAX member in the Americas to not commence administering vaccines. Despite reporting low infection rates at the start of the pandemic, Haitian hospitals are now overwhelmed with an influx of patients. With a deficit of resources and infected patients being turned away, there is a desperate need for the commencement of COVID-19 vaccinations in Haiti.

Haiti Before the Surge

Haiti confirmed its first case of COVID-19 on March 19, 2020. The country immediately implemented a complete shutdown by way of closing schools, quarantining visitors and prohibiting public gatherings. Officials also advised that citizens wear masks. By June 2020, the country reported 2,500 COVID-19 cases, leaving Haiti at a relatively low number of reported cases compared to other countries. However, experts have argued that the number of reported cases in Haiti falls substantially lower than the actual number of existing cases due to an overwhelming lack of testing resources and facilities.

Widespread misinformation about COVID-19 leaves many Haitians unwilling to get tested and unwilling to follow precautionary measures. With Haiti largely left to its own devices in handling COVID-19, certain factors, including the inadequate medical care system and high poverty rates, make it difficult for infected patients to receive or afford proper medical care.

Poverty also leads to overcrowded districts and the inability to buy face masks, while poor sanitation increases the spread of disease. Even before experiencing the largest spike of cases since the start of COVID-19, Haiti proved extremely vulnerable to COVID-19. In 2018, Haiti declared its goal of achieving universal healthcare coverage by 2030. However, as the “most impoverished country in the western hemisphere,” the road to achieving universal healthcare contains several obstacles.

The Spike of COVID-19 cases

On June 25, 2021, Haiti reported upward of 18,000 cumulative cases and more than 400 cumulative deaths, with nearly 2,300 of the cases occurring in the span of just a month. The Associated Press reports that the government declared a health emergency on May 24, 2021, by imposing a curfew and compelling people to take preventative safety measures. However, many people are unable to avoid large crowds in marketplaces or on public transportation while others simply cannot afford face masks.

The recent spike in COVID-19 cases in Haiti can be largely attributed to more people getting tested and seeking treatment. Additionally, other variants of COVID-19 could be to blame. Due to the seemingly low number of reported cases earlier in the year, authorities reduced the number of beds allocated for COVID-19 patients. With the rise in cases, hospitals are now at capacity, having to turn patients away.

The Need for COVID-19 Vaccines

Although vaccinating citizens would aid in fighting the pandemic, officials have yet to start COVID-19 vaccinations in Haiti. The Pan American Health Organization (PAHO) announced an aid plan to facilitate vaccine delivery to Haiti. This first shipment will contain the Oxford/AstraZeneca vaccine procured through COVAX, a global vaccine initiative that ensures vaccine equity by securing COVID-19 vaccines for low-income countries. PAHO Director Carissa F. Etienne asserts that the global community needs to help strengthen Haiti’s response to COVID-19, unifying despite political differences to make COVID-19 treatment a top priority.

As of June 9, 2021, Haiti had still not received any vaccines. The country was supposed to receive more than 750,000 doses of AstraZeneca in May 2021, but the delivery was “delayed due to the government’s concern over possible clotting as a side effect and a lack of infrastructure to keep the vaccines properly refrigerated.”

Doctors express concerns that even if the doses do arrive, there will be challenges in the vaccination rollout. Young adults, who largely ignore government mandates, comprise much of the population. Additionally, gang violence makes it difficult for people to safely venture to clinics and health centers. Nevertheless, officials hope that any delay with COVID-19 vaccinations in Haiti will cease.

Domestic and Global Solutions

As residents await the launch of COVID-19 vaccinations in Haiti, grassroots organizations aid in the fight against the pandemic. Heart to Heart International, an organization dedicated to improving global healthcare, directs community health workers to teach market vendors and the surrounding community in Haiti about preventative techniques, hygienic practices and the detection of COVID-related symptoms.

GlobalGiving is a nonprofit platform that connects other nonprofits to donors. Through GlobalGiving, Economic Stimulus Projects for Work and Action (ESPWA) looked to raise more than $5,000 for the COVID-19 response in Haiti. Through the first phase of its initiative, the organization has supported 19 communities with more than 40,000 residents by providing seeds to local farmers to sustain agriculture and by supporting a microloan program to assist small businesses. ESPWA also supported the creation of a soapmaking business to generate sustainable income and promote hygiene.

On July 14, 2021, Haiti received 500,000 COVID-19 vaccines from the United States. With more powerful countries reaching out a helping hand, the campaign for COVID-19 vaccinations in Haiti can begin with a higher chance of success.

– Cory Utsey
Photo: Unsplash

Healthcare in LiberiaThe 2014-2016 Ebola outbreak in West Africa killed more than 4,800 people in Liberia and infected thousands of others. However, these data points only scratch the surface of Ebola’s effect on healthcare in Liberia. Ebola’s devastation affected the provision of healthcare services in West Africa and caused an additional 10,600 deaths due to HIV, tuberculosis and malaria. In countries such as Liberia, more medical training and equipment means healthcare in Liberia has strengthened since the Ebola outbreak. Ebola exposed the weaknesses in the healthcare system of Liberia and showed the Liberian government and international aid organizations particular areas needing improvement and reform.

The World Bank’s Involvement

After recognizing the struggles of Liberia’s healthcare system during the Ebola epidemic, the World Bank devised specific ways to assist Liberia. For example, in May 2020, the World Bank approved the Institutional Foundations to Improve Service for Health Project for Liberia (IFISH). The four-component program focuses specifically on improving health services and outcomes for women, children and adolescents. The six-year program costs $84 million, of which $54 million of funding comes from the United States. Roughly 50% of the budget will be dedicated to health facilities and construction in Liberia. The program also attempts to lay the groundwork for future Liberian healthcare officials. The program includes training health workers and financing certain undergraduate and postgraduate faculties.

The Yale Capstone Project

For multiple years, the Yale Jackson Institute for Global Affairs has worked alongside the Yale Global Health Institute to create a project-based global health course for Yale seniors. The program allows students to explore the intersection of public health and policy. The students of this program have contributed to recovery efforts in Liberia. The program has assisted in establishing proof to encourage partners and policymakers to undertake significant changes in Liberia’s main medical school. The 2015 class conducted case studies on Rwanda and Ethiopia to generate targeted policy solutions in Liberia. Overall, the partnership was deemed a “win-win” for Liberia and the students involved.

CDC Field Epidemiology Training Program

The Centers for Disease Control and Prevention (CDC) has been actively aiding healthcare in Liberia since 2007. However, it did not expand its Liberian focus until the Ebola outbreak. Accompanied by more traditional CDC programs such as malaria intervention and the provision of vaccines, Liberia receives assistance through the CDC’s Field Epidemiology Training Program (FETP). The three-tiered educational initiative aims to equip Liberian healthcare workers with the knowledge and tools to investigate and respond to disease outbreaks. At the close of 2016, Liberia had 115 FETP-trained staff. The FETP graduates will go on to provide field support in response to disease outbreaks across Liberia. With graduates from all 15 counties and 92 health districts in Liberia, fellows of FETP work to contain outbreaks and prevent them from turning into local or global epidemics.

Room for Improvement

Healthcare in Liberia is improving due to Liberia’s coordinated recovery efforts with multiple organizations. Nevertheless, Liberia still battles with increasing civilian access to healthcare and the funding of critical health institutions. For example, two-thirds of rural families need to travel for more than an hour to access a health center. These extended travel times can significantly impact the healthcare outcomes of Liberians. Moreover, hospitals are struggling to survive because funding from donors has slowed since the Ebola outbreak. In Liberia’s health system, primary healthcare facilities are largely underfunded.

While these struggles persist, they should not overshadow the significant improvements made since the Ebola outbreak. With aid, commitment and effort, healthcare in Liberia can improve further.

– Kendall Carll
Photo: Flickr

Health in Papua New GuineaFor the island nation of Papua New Guinea, the COVID-19 outbreak has led to some positive developments despite the harm the pandemic has caused. Health officials state that the COVID-19 pandemic has tested medical infrastructure in Papua New Guinea, providing opportunities for the country to strengthen its healthcare system and be better able to deal with future health crises. Several organizations are committed to improving health in Papua New Guinea.

Healthcare Accessibility

Lack of accessibility to healthcare is a significant barrier for the citizens of Papua New Guinea. One of the defining characteristics of Papua New Guinea is how vast and well-dispersed the country is with roughly 600 islands. Its many secluded and remote areas may seem ideal for a vacation destination, but these qualities prove to be challenging from a healthcare perspective. Due to the abundant natural resources, around 80% of residents live off the land in rural areas that are not in close proximity to medical facilities. Despite logistical trials, the country is slowly but surely making progress.

Vaccine Distribution

As of April 12, 2021, Papua New Guinea had reported almost 10,000 confirmed cases of COVID-19. On April 16, 2021, the Oceania nation received 132,000 vaccines from the COVAX Facility. The national vaccine rollout was launched on May 4, 2021, first focusing on the 3% of the population making up frontline workers. Considering the decentralized population and the late start in acquiring vaccines, Papua New Guinea has made progress in fighting COVID-19. By educating the population about vaccines and medical vernacular, health officials agree that efforts to combat the virus have better prepared the country for future medical crises.

Identifying Shortcomings

In addition to vaccination efforts, COVID-19 response funds are being used to create water facilities in vulnerable areas such as the North Fly District. This improvement will benefit the country on a long-term basis. The COVID-19 pandemic has tested the local medical system by pointing out flaws. This has prompted Papua New Guinea to find solutions to make future outbreaks more manageable.

Weakened demand due to the pandemic has left Papua New Guinea’s economy crippling. Vaccinations are serving to remedy the economic strain as much will go back to normality once a greater part of the population is vaccinated and the economy will be stimulated. As normalcy returns, the unemployment rate and poverty rate are projected to gradually decrease. However, Papua New Guinea’s healthcare system still needs support from outside organizations in order to strengthen.

3 Organizations Supporting Healthcare in Papua New Guinea

  1. Doctors Without Borders is a humanitarian aid organization. It provides medical assistance needed around the world. In  order to improve health in Papua New Guinea, its current focus is fighting tuberculosis. With mobile clinics and less invasive treatments, the organization is able to care for patients situated in remote areas and save them the cost of travel to and from a medical facility.
  2. The PNG Foundation specifically supports approximately 70,000 Kamea people of Papua New Guinea. Rugged highland terrain creates difficulty accessing health, educational and infrastructure support. The goals of the PNG Foundation include providing basic medical care and maintaining the hospital and schools.
  3. The well-being of Papua New Guinea’s women and children lies at the heart of the Highlands Foundation’s mission. The organization combats maternal and infant mortality. Its projects include sending medical supplies, clothes, toiletries and sanitary items to hospitals in the remote areas of Papua New Guinea. The Highlands Foundation also leads training programs for local medical staff and sends volunteers to ease the pressure of the national medical personnel shortages.

Global organizations, foreign aid and private donors have aided Papua New Guinea by providing vaccines, equipment and other essential resources. The COVID-19 pandemic has brought to light the struggles of Papua New Guinea’s healthcare system. Now that the shortcomings are apparent, Papua New Guinea will require further support and assistance in order to address these issues and strengthen healthcare in the country.

– Lucy Gentry
Photo: Unsplash

Healthcare in Barbados

Healthcare aids in the prevention, treatment and diagnosis of an illness. Healthcare has greatly improved through research and newly discovered science and medicine. Although, the outbreak of COVID-19 has hurt many populations around the world. As a result, healthcare was forced to adapt radically and rapidly. According to the World Health Organization (WHO), almost every country experienced a disruption to its health services. Low and middle-income countries reported the greatest difficulties. However, Barbados’s response to the COVID-19 crisis has proven to be more successful than other nations.

Barbados

Healthcare in Barbados is of high standard and easily accessible to everyone. The Queen Elizabeth hospital has about 600 beds and offers care in areas such as radiology and obstetrics. Furthermore, there are eight government Polyclinics that provide free medical treatment for minor ailments, five Geriatric hospitals for elderly care and a network of Child Care facilities. With a population of about 287,375 people, the country has seen around 365 COVID-19 cases and seven deaths.

Combatting the Virus

The Pan American Health Organization (PAHO) planned to strengthen laboratory capacity for early detection of COVID-19. Barbados ‘Bet-dos Santos Public Health Laboratory’ became one of the first in the Caribbean to acquire test kits and reagents for COVID-19 detection. Additionally, Barbados received concurrent training of laboratory personnel in the new testing protocol.

According to Barbados Today, COVID-19 patients were receiving an experimental drug called Remdesivir and were recovering quickly in April. The doctor leading the trial said, “the patients taking part in a clinical trial of the drug have all had severe respiratory symptoms and fever but were able to leave the hospital after less than a week of treatment.”

Barbados’s government established a COVID Rapid Response Unit and a COVID Engagement Unit to monitor quarantine sites and crack down on violation of COVID-19 protocols. A Cuban medical team in Barbados won the 2021 Nobel Peace Prize for its outstanding work in response to the COVID-19 pandemic in December. David Comissiong, the Ambassador of Barbados to CARICOM (Caribbean Community) nominated the nation. Additionally, medical teams have gone to up to 38 countries and 12 Caribbean countries.

Adjusting for Visitors

Barbados is a popular tourist hotspot and it still wishes to accommodate visitors. The government created the Welcome Stamp, a new visa for remote workers. This visa allows visitors to stay for up to 12 months and work remotely. According to the Insider, Barbados’s new incentive allows people to relocate to a popular destination and still continue to work from home. Barbados had 1,693 Welcome Stamp applications by the end of October. Travel guidelines have been implemented to prevent the spread of the virus. Thus, airports require health screening procedures and quarantine procedures.

Barbados is a thriving country that successfully utilizes its accessibility to healthcare. Healthcare in Barbados is vital. The country is not selfish or prejudice with its medical management. Furthermore, it lives by an egalitarian system regarding health protection. Barbados has used its resources to aid other countries and provide solutions and trials to carriers of the virus. The country and its medical teams will continue to take the proper precautions to protect its inhabitants and those in other countries.

– Thomas Williams

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

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

Bipolar Awareness in IndiaIndia is the second-most densely populated nation in the world, with more than 1.3 billion people. Of that number, more than 82 million citizens suffer from bipolar disorder, according to data from 2019. Bipolar disorder in India often goes undiagnosed and untreated for reasons ranging from ancient superstitions to the cost of treatment, but, bipolar awareness in India is steadily progressing.

Bipolar Disorder in India

Improved bipolar awareness in India exemplifies how a concerted effort can reduce stigma and create an affordable and readily available avenue for treatments such as therapy and medication. Indians, mostly women, have been disowned and abandoned by family or a spouse after receiving a bipolar diagnosis. In a country where the consequences of a mental condition are isolation and disconnection, the need for awareness and education is paramount.

A nation that once attributed bipolar disorder to demonic spirits, planetary alignments or a sinful past life, has come extremely far in its understanding of the illness. But, the stigma surrounding the disorder is still prevalent in India, and many, especially those from rural locations, believe bipolar disorder is a choice or an illness reserved for the rich and privileged.

BipolarIndia Organization

One resource improving bipolar awareness in India is the organization BipolarIndia. The community was created in 2013 by Vijay Nallawala, an Indian man that suffers from bipolar disorder, and his mentor and friend, Puneet Bhatnagar. BipolarIndia’s mission is to create an empathetic, judgment-free environment for bipolar people to find information, treatment, and most of all, support from those that can relate to their struggle.

BipolarIndia hosts a National Conference every year on World Bipolar Day to create awareness for the illness and educate residents from all over the country. In 2015, the organization began hosting monthly support meetings for individuals to speak with peers that can understand their struggle. It has also recently developed a way for patients to receive real-time support through the Telegram App when they feel they may need immediate help. Resources such as the Telegram App are invaluable due to the lack of mental health professionals in India.

The Mental Health Care Bill

Data from a 2005 report shows that there are only three psychiatrists per million citizens and only 0.06% of India’s healthcare budget goes toward improving mental healthcare. The Indian Government passed a Mental Health Care Bill in June of 2013 laying out a mission to improve bipolar awareness in India as well as reduce stigma surrounding all mental health issues. The bill has been undergoing revisions and policy modifications based on the guidance given by the Indian Association of Psychiatry.

Efforts to Raise Awareness

The government’s efforts to raise awareness about the complexity of bipolar disorder and the number of Indians that suffer in silence is vital to the disorder being understood. The Indian government aims to provide communities with adequate care and reliable information, leading the nation to a better understanding of a complicated mental disorder.

Bipolar awareness in India has improved with private organizations such as the International Bipolar Foundation (IBPF) funding research on effective treatments and raising awareness across the globe.

Also fighting for bipolar awareness, Indian celebrities, including Deepika Padukone, Rukh Kahn, Yo Yo Honey Singh and Anushka Sharma, have stepped forward and opened up about their personal battles with bipolar disorder, combatting the stigma surrounding the illness.

The Road Ahead

Bipolar awareness in India has slowly improved but still has a long way to go. If the government aims to change the attitude toward bipolar disorder and improve treatment, a significant investment in research is vital as well as a comprehensive understanding of the disorder.

–  Veronica Booth
Photo: Flickr

Addressing migrant and Refugee HealthAt the end of 2019, there were 79.5 million recorded forcibly displaced people in the world, with 26 million labeled as refugees. Roughly 68% of those displaced come from just five countries, which means that resources can be scarce for many of these people and their physical and mental health may become less of a priority in lieu of other needs. More focus needs to go toward addressing migrant and refugee health in order to protect the well-being of one of the most vulnerable populations.

7 Facts About Migrant and Refugee Health

  1. The Immigrant, Refugee and Migrant Health Branch (IRMH) is a branch of the Division of Global Migration and Quarantine that works to improve the health and well-being of refugees. The IRMH also provides guidelines for disease prevention and tracks cases around the globe in migrant populations. The organization has three teams and five programs that work both in the U.S. and around the world to combat infectious diseases.
  2. Refugees are affected by illness and health issues through transit and in their host communities. Most refugees are likely to be in good health in general, according to the CDC, but migrating tends to be a social determinant in refugee health. Health inequities are increased by conditions such as restrictive policies, economic hardship and anti-migrant views. Poor living conditions and changes in lifestyle also play a role.

  3. Refugee health profiles are compiled through multiple organizations to provide information about important cultural and health factors pertaining to specific regions. Refugees from different areas often have very different health concerns. For example, anemia and diabetes are priority conditions in Syrian refugees but parasitic infections and malaria are the focus for Congolese migrants.

  4. About one-third of migrants and refugees experience high rates of depression, anxiety and post-traumatic stress disorders. Mental health is a vital part of all refugee health programs and the priority for youth mental health programming is especially necessary. Forced displacement is traumatic and while there is likely a reduction of high anxiety or depression levels over time after resettlement, some cases can last for years.

  5. Healthcare is often restricted based on legal status within refugee populations. The 1946 Constitution of the World Health Organization articulated that the right to health is an essential component of human rights but many people are limited to claiming this right. Activists for refugee health along with many NGOs call for universal health care and protection for migrant populations.

  6. Important needs in refugee health include the quality and cost of disease screenings. HIV, hepatitis, schistosomiasis and strongyloidiasis are diseases that are prevalent among vulnerable refugee and migrant populations. However, ease and quality of medical screenings are not guaranteed in many centers or camps.

  7. Mothers and children face many barriers due to their unique needs and few refugee health care providers are able to properly address them. There is an increased need for reproductive health services and many of the barriers provide more difficulty than aid to many women. These include language, costs and general stigma.

Prioritizing Vulnerable Populations

The U.N. Refugee Agency (UNHCR) is well known for its work to safeguard the rights and well-being of people who have been forced to flee. Refugee International is another organization that advocates for the rights and protection of displaced people around the world. Awareness of refugee health facts and concerns enables organizations to take a direct stance on improving conditions and procedures. With the growing number of refugees around the world today, addressing migrant and refugee health must be prioritized in order to better protect these vulnerable populations.

– Savannah Gardner
Photo: Flickr