HIV/AIDS in Zambia
Zambia is a tropical country in southern Africa with a population of approximately 16,445,079 people. It has a rich history of copper production and is one of the world’s fastest-growing economies. However, HIV/AIDS has become prevalent throughout Zambia and is a large contributing factor to the country’s low life expectancy, which currently ranks second to last in a global comparison.

HIV, or the human immunodeficiency virus, attacks a person’s immune system by destroying white blood cells that fight disease and infection. Though there is no cure for HIV, people can control it successfully. Without proper medical care, the infection can lead to AIDS, which is the most severe phase of HIV infection.

The Current State of the HIV/AIDS Epidemic in Zambia

Heterosexual intercourse is what mainly drives Zambia’s HIV/AIDS epidemic. HIV/AIDS particularly affects adolescent women compared to other age groups in Zambia. In fact, according to data collected by UNAIDS, one million women between the ages of 10 and 19 were living with HIV in 2017, while only 770,000 of their male counterparts had the same prognosis.

This discrepancy is due in part to the many societal issues that permeate throughout the lives of Zambian women. Younger Zambian women are more likely to have an older partner already infected with HIV. Additionally, many Zambian women are not in charge of their own reproductive health or education.

In fact, only 56 percent of Zambian women are literate. Meanwhile, the country only has a contraceptive prevalence rate of 49 percent. Both issues decrease a Zambian woman’s ability for education on the matter, as well as the ability to prevent pregnancy and the eventual exposure of HIV to a fetus in the womb.

Other marginalized Zambian groups disproportionately affected by HIV/AIDS are children, sex workers and prisoners. According to UNAIDS, an estimated 8,900 children were newly infected with HIV in 2016 due to perinatal transmission. Perinatal transmission refers to when a mother passes HIV to her child during pregnancy, labor or breastfeeding. Meanwhile, sex workers and prisoners had HIV prevalence rates of 56.4 percent and 27.4 percent respectively.

The Future of HIV/AIDS in Zambia

Zambia is currently taking steps towards decreasing the prevalence of HIV/AIDS in the country. The first step has to do with prevention and education. According to the 2014 Zambia Country Report, the country’s provision of free condoms nearly doubled from 7.8 million to 19.6 million.

Additionally, according to the National AIDS Strategic Framework (NASF), comprehensive sex education will become a larger focus for adolescent Zambians within forthcoming years. Furthermore, several HIV prevention programs are active in Zambia and focus on empowering the country’s most susceptible population — young and adolescent women. Zambia is one of 10 countries that takes part in the DREAMS initiative, which strives to reduce new infections among women by addressing structural inequalities and gender norms.

Though Zambia has recently scaled up its efforts to fight HIV/AIDS, it needs to do more to effect real change. Zambia’s domestic spending on HIV/AIDS only takes four percent of the overall budget, despite having risen drastically within the past few years. Even if Zambia were to spend this portion of the budget on providing ART, testing facilities and eMTCT services, a real societal change would not occur unless communication in Zambia health care systems increases. Zambia must see to the general population being educated about adhering to treatment, getting tested regularly and exercising effective prevention techniques.

There is much room for improvement when it comes to fighting HIV/AIDS in Zambia. However, by increasing access to education and focusing upon marginalized groups — such as young women — the prevalence of this infection in Zambia will drastically decrease.

– Shreya Gaddipati
Photo: Flickr

Top Ten Facts About Living in Croatia
Nestled between Bosnia, Herzegovina and Slovenia, Croatia is a small country in Eastern Europe with an extensive history. Once a part of Yugoslavia, Croatia officially declared its independence in 1991 and became a fully developed country in 1998. Despite the country’s tumultuous beginnings as an independent nation, it has established itself fairly well as a developed nation. Keep reading to learn about the top 10 facts about living conditions in Croatia.

Top 10 Facts About Living Conditions in Croatia

  1. Ninety-nine percent of children attend primary school, which is split into two stages: grades one to four and grades five to eight. After primary school, children receive the option of stopping school or obtaining a secondary education. There are three options for secondary education in Croatia including grammar schools, vocational schools and art schools. After completing any of these options and receiving a Certificate of Education, students may enroll in a university.
  2. Croatia requires people to have a public health insurance plan as of 2002 which is funded via tax collections. While the quality of medical care in Croatia is good, the country is facing a financial problem due to low fertility rates in relation to the older population. To help combat this burden, doctor’s appointments, hospital visits and prescription medications require co-payments.
  3. Taking the bus is the most efficient way to travel in Croatia. The railways are not up-to-date and run slowly, whereas the bus systems are well-developed and fairly priced. Other travel options throughout Croatia include flights, coastal ferries and of course, driving.
  4. A portion of Croatia’s population (24.4 percent) is obese, ranking the country 59th in the world for obesity rates. The large reliance on transportation to get around the country may be a cause.
  5. Up until the 1990s, Croatia’s population was steadily increasing. In the 1990s, however, the population underwent a significant demise in population growth due to displacement from war, emigration to countries like the United States, Australia and Canada and increased deaths. As of 2018, 40 percent of the Croatian population is between the ages of 25 and 54, which places stress on both the majority population of older citizens and the minority population of younger citizens.
  6. Formerly a communist state up until 1990, Croatia’s economy has shifted to market-oriented capitalism. This shift was not easy due to the lasting effects of war in the country, leading to high unemployment rates lasting into the 21st century. Additionally, Croatia’s war-torn past has allowed the country to sustain an informal economy and has led to the emergence of a black market.
  7. Unemployment is prevalent among young Croatian citizens in particular, with 27.4 percent of people between the ages of 15 and 24, and 12.4 percent of the total population living without work. However, the government’s economic reform plan — scheduled for implementation beginning in 2019 — may lead to more job opportunities.
  8. Croatia largely depends on its imports in terms of resources and power. It uses up more oil and gas than it can produce, and while it has enough rivers to potentially use hydroelectric power, Croatia receives the vast majority of its electricity as imports. Croatia has begun efforts to implement the use of liquefied natural gas by early 2020, planning to redistribute this LNG throughout southeast Europe.
  9. Croatia had no organized armed forces when the country declared its independence in 1991 but subsequently formed an army, a navy and an air force. The country is not very militaristic and relies mostly on the North Atlantic Treaty Organization (NATO) for national security after joining the Treaty in 2009.
  10. Croatia is not a significant haven for refugees, though refugees do use it as a transit country. Between 2015 and 2019, roughly 672,418 refugees and migrants passed through Croatia. However, as of June 2018, the country only had about 340 asylum seekers actually residing in Croatia.

These top 10 facts about living conditions in Croatia make it clear that despite progress, the country still has work to improve the quality of life for its inhabitants.

– Emi Cormier
Photo: Flickr

Women’s Health care in CambodiaThe Southeast Asian nation of Cambodia is currently experiencing its worst in maternal mortality rates. In Cambodia, maternal-related complications are the leading cause of death in women ages 15 to 46. The Minister of Health has created several partnerships with organizations such as USAID to help strengthen its healthcare system. Here are five facts about women’s health care in Cambodia.

Top 5 Facts About Women’s Health Care in Cambodia

  1. Health Care Professionals and Midwives
    USAID has provided a helping hand when it comes to educating healthcare professionals and midwives. Since USAID’s partnership with the Ministry of Health, USAID has helped raise the percentage of deliveries assisted by skilled professionals from 32 percent to 71 percent. The Ministry of Health was also able to implement the Health Sector Strategic Plan to improve reproductive and women’s maternal health in Cambodia.
  2. Health Care Facilities
    Between 2009 and 2015, the number of Comprehensive Emergency Obstetric and Newborn Care (CEmONC) facilities increased from 25 to 37. With more access and an increase in healthcare facilities, 80 percent of Cambodian women are giving birth in health care facilities.
  3. Postpartum Care
    The Royal Government of Cambodia renewed the Emergency Obstetric & Newborn Care (EmONC) Improvement Plan and extended the Fast Track Initiative Roadmap for Reducing Maternal and Newborn Mortality to 2020. This aims to improve women’s health care in Cambodia to improve the lives of women living with postpartum depression. It is also used to improve newborn care and deliveries.
  4. Obstetric Care
    Obstetric care has improved rapidly. According to a 2014 Cambodia Demographic and Health Survey, 90 percent of mothers receive obstetric care two days after giving birth, and three-quarters of women receive care three hours after. Intensive obstetric care has helped drop Cambodia’s maternal mortality rate significantly. In 2014, Cambodia’s maternal mortality rates decreased from 472 deaths per 100,000 live births in 2005 to 170 deaths per 100,000 live births.
  5. U.N. Women
    U.N. Women is working closely to help address the AIDS epidemic in Cambodia. The organization’s efforts to reduce the epidemic focus on protection and prevention. In 2003, 3 percent of Cambodian women reported being tested for AIDS. It has also been observed women in urban areas are more likely to get tested than those in rural areas. Ultimately, Cambodia has set a goal to eradicate AIDS from the country by 2020 through prevention and protection.

Cambodia has seen much economic growth over the years, but the money provided for health care is minimal. Consequently, it is difficult for the government to provide all services. However, there have been great strides in improving women’s healthcare in Cambodia. By fighting to better the lives of women, the Cambodian government has set a goal to establish universal health care by 2030.

Andrew Valdovinos
Photo: Flickr

Living Conditions in Poland
Situated in Central Europe, Poland neighbors Slovakia, Ukraine and the Czech Republic to the North, Russia, Lithuania and the Baltic Sea to the South, Belarus to the East and Germany to the West. Home to the eighth largest economy in the European Union, 30 percent of the nation’s landscape is covered with forests partially due to the national reforestation program. While the nation has begun to gradually reduce poverty, nearly 15 percent of the Polish population face poverty. Listed below are the top 10 facts about the living conditions in Poland.

Top 10 Facts About Living Conditions in Poland

  1. Poland boasts one of Europe’s best education systems with a 96.8 percent primary school enrollment rate leading to a 99.7 percent adult literacy rate. The nation has taken part in education reforms stemming from the 1990s which have led to positive improvements on students’ educational performance. Twelve Poles have won the Nobel Prize, causing Poland to be ranked 17th for the number of wins in the world.
  2. Young people in Poland face high unemployment and when employed, often take temporary jobs. Temporary positions employ 66 percent of young Poles leading to layoffs in the 2009 economic downturn. To combat the rising rates of youth unemployment, the Tripartite Commission, a labor relations forum in Poland, introduced an anti-crisis package that focused on increasing minimum wage and co-financing training. Polish trade unions highlighted the importance of equal treatment of different contracts and implementing the same tax rates.
  3. The average earnings of high earners (earning greater than 90 percent of workers) is 4.7 times greater than a low earner (earning less than 90 percent of workers) in Poland. This high-to-low ratio is among the highest in the European Union. Three primary factors impacting wage dispersion include the disparity in pay due to levels of education, low levels of compensation (often below minimum wage) and low density of trade unions in the nation. Polish people have seen a decrease in social inequality due to a focus on reforms regarding the tax-benefit system and family allowance system as well as a fall in wage dispersion.
  4. Poland is one of 58 countries worldwide to offer its citizens universal health care. Treatment of sudden illnesses and emergencies is typically free. Costs in the private medical sector are higher than in the public medical sector.
  5. One in four Polish children faces poverty, one of the highest childhood poverty rates in Europe. This particularly affects large families and single-parent families. In 2016, the Polish government introduced the Family 500+ program which provides a monthly payment of 500 Zlotys ($130.00) for every child after the first until the age of 18. The first child in families whose income is below a defined threshold receives this benefit. The program predicts that it will initiate a significant decrease in childhood poverty.
  6. Poland’s national minimum wage increased from 2,100 Zlotys ($548.66) in 2018 to 2,250 Zlotys ($587.85) in 2019. The nation’s annual variation rate of the Consumer Price Index increased 1.2 percent, granting Poles buying power in the economy. The cost of living in Poland is 44.9 percent lower than the United States.
  7. Ranked 189 out of 200, Poland’s fertility rate is among the lowest in the world. The nation is in the first stages of initiating a family policy.
  8. The Organisation for Economic Co-operation and Development suggests that Poles are less than satisfied with their lives as they rank their life satisfaction an average of six which is less than the average of a six and a half. Particular noteworthy factors within Polish lives include strong personal security and education, and below average health status and income.
  9. According to the World Health Organization in 2016, Poland’s life expectancy stood at 78 years old. Women have a life expectancy of 82 years while men have a life expectancy of 74 years. Looking over the past several years, Poland’s life expectancy has seen a minimal decrease. Researchers from the Medical University of Lodz divided the major causes of death into three groups. The first group was comprised of infectious diseases, diseases related to childbirth/pregnancy and malnutrition which are the least common causes of death. Chronic noninfectious diseases such as cancer or heart disease made up group two which are the most common causes of death in Poland. External causes of death such as accidents and suicide contribute to 15.7 percent of male lives lost and 5.3 percent of females. External causes of death have seen a decrease.
  10. World Bank Data shows that Poland’s GDP growth has reached 5.1 percent in 2018, improving the Polish economy. Challenges still face the Poles in “shortage of labor in the economy, procyclical government policies encourage by the political calendar, and adverse global factors.” These issues could weigh on the continuance of Poland’s GDP growth.

The Eastern European country finds itself prospering economically amidst below average life satisfaction, high unemployment in young adults and low fertility rates. The good fortune of the Polish people is a central interest of the government. These 10 facts about living conditions in Poland indicate that contributions to the sustainment of the country are helping as literacy rates are on the rise, the minimum wage has increased and poverty has waned in recent years.

– Gwendolin Schemm
Photo: Flickr

Antenatal Care in NigeriaMany developing countries have reduced their maternal mortality rates by expanding maternal care through policy innovations. Between 1990 and 2015, maternal mortality has dropped by 44 percent. While this is a considerable amount, maternal mortality remains high in developing countries. For example, in Nigeria, only 61 percent of pregnant women visit a skilled antenatal care provider at least once during their pregnancy. The average rate for similar lower-to middle-income countries is 79 percent.

Maternal health concerns the health of women during pregnancy, childbirth and the postpartum period. During this time, major causes of maternal mortality include hemorrhaging, infection, high blood pressure and obstructed labor.

Every day, 830 women die from preventable causes related to pregnancy and birth. In fact, 99 percent of maternal deaths occur in developing countries. It is necessary for policy innovation in developing countries because sustained use of maternal and antenatal care and increased rates of institutionalized delivery reduce maternal mortality.

Antenatal Care in Nigeria

Of the women who did access and antenatal care, 41 percent did not deliver in a health care facility. Nigeria ranks in the top 16 nations in maternal mortality: 576 deaths per 100,000 births. Containing only 2.45 percent of the world’s population, Nigeria contributes to 19 percent of maternal deaths globally.

There is a stark difference in the number of women who seek antenatal care in urban and rural areas: 75 percent versus 38 percent, respectively. Studies also show that more skilled professionals attended births in urban areas, revealing that 67 percent of women had a trained professional helping them. In rural areas, only 23 percent of women had the help of trained professionals. In these rural areas, only 8 percent of newborns receive postnatal care, whereas 25 percent of children do so in urban environment.

Due to the lack of health coverage and used resources, many of Nigeria’s infants die from preventable causes. Approximately:

  • 31 percent die from prematurity,
  • 30.9 percent die from birth asphyxia and trauma and
  • 16.2 percent die from sepsis.

Ways to Increase Access to Antenatal Care in Nigeria

Improving maternal and antenatal care in Nigeria can encourage women to utilize services such as improved facility infrastructure and amenities. Policy innovation in Nigeria can result in better equipment, more available drugs and an increase in overall comfort for the spaces.

In a study of antenatal patients in Nigeria, women responded positively to increased interpersonal interactions with providers. The study also suggested that improved maternal care should include access to providers who have technical performance skills and experience. Improved maternal care also includes access to providers who display empathy for their patients. Furthermore, policy innovation in Nigeria could improve increased access to facilities for those in rural areas.

Accessed to maternal and antenatal care in Nigeria can be improved with policy innovations made throughout the country. By making health facilities more accessible to more women and giving them the supplies and support they need, Nigeria will be able to decrease its maternal mortality rate and save its families from preventable complications of during pregnancy and infancy.

Michela Rahaim
Photo: Flickr

antenatal care in IndiaIndia is home to one-fifth of all births but has no monitoring systems for basic maternal health and nutrition. A research brief published by the rice institute finds that India has far worse maternal nutrition rates than sub-Saharan Africa – a region much poorer with higher fertility rates. With improper antenatal care being linked with long term effects on the height, weight, cognition and productivity of a child, global attention has been brought to the antenatal care inequalities found in India.

Antenatal Care in India Today

Access to antenatal care in India depends strongly upon the geographic location and socioeconomic status of expectant mothers. Between 50 and 74 percent of expectant mothers in India receive prenatal care services – with a large gap in the distribution of these services.

According to a study done in 2011, 357,777 women in Delhi received at least three antenatal care check-ups, more than the entire state of Uttarakhand which had 153,202 women receive the same level of care.

Further studies showed that  “some states, such as Kerala and Goa, more than 93 percent of women used ANC [Antenatal Care] four times or more, while in Bihar and Nagaland, this figure was less than 17percent,” highlighting the substantial inequalities of access to antenatal care in India.

Current Government Initiatives

Currently, several government programs are in place to increase access to antenatal care services throughout India but have not shown largely promising results. India’s largest program for improving neonatal health, Janani Suraksha Yojana (JSY), uses cash incentives to encourage birthing in hospitals.

However, a study done in 2014 found that the cash transferred to new mothers is much less than advertised, due to how much of it goes towards paying for delivery services – which are meant to be free. In addition, this program only encourages women to give birth in hospitals, rather than address pressing maternal health problems in India – such as maternal nutrition and low birthweight.

Meanwhile, the Pradhan Mantri Matru Vandana Yojana (PMMVY) government program dispenses 5,000 rupees for expecting and lactating mothers. However, this is only available to first-time mothers.

The Integrated Child Development Services (ICDS) is intended to give food to expectant mothers and their children but is poorly implemented – with less than 30 percent of women having received food the ICDS program during their last pregnancy.

Looking Ahead

In order to improve access to antenatal care in India, studies suggest “policy and programme managers should shift from improving the ‘average figures’ to the ‘distribution’ of programme/health care indicators across the sub-groups of populations which need them most.”

The rice institute also notes that rather than rely on outdated surveys for indicators of maternal health, the government finally establish a national monitoring system allowing policymakers to view changes in maternal health over time.

With proper government oversight, the future of antenatal care in India looks promising, as suggested by a study published in The Lancet found that mortality rates for neonates declined by 3.3 percent annually between 2000 and 2015 due to government intervention.

– Shreya Gaddipati
Photo: Unsplash

Typhoid in Zimbabwe
Typhoid fever, a serious disease affecting between 11 and 21 million people worldwide, is commonly found in the developing regions of Asia, Africa and Latin America. Symptoms include high fevers, weakness, stomach pains, headaches, loss of appetite and diarrhea. Severe cases even lead to serious health complications and even death. Typhoid occurs most often in areas with poor sanitation and contaminated food and water. There are 128,000 to 161,000 typhoid-related deaths every year.

Typhoid in Zimbabwe

On 24 February 2018, the Harare City Health Department (HCHD) suspected 3,187 cases and confirmed 191 cases of typhoid in Zimbabwe. This was the latest major typhoid outbreak in Zimbabwe. Most typhoid outbreaks in the capital, Harare, are caused by municipal water shortages and the use of contaminated boreholes and shallow wells. HCHD works to improve water, sanitation and hygiene (WASH) throughout the city in order to lower typhoid cases and outbreaks in Zimbabwe. They repair boreholes, fix burst sewers, conduct water testing and sampling and educate local residents about water quality and typhoid.

Resistance to antibiotics creates another problem. Around one in five typhoid patients are already resistant to the common typhoid antibiotics and in some areas, resistance raises to a staggering 73 percent. For example, ciprofloxacin is an antibiotic widely used in the treatment of typhoid. However, 20 percent of typhoid patients in Harare show resistance to ciprofloxacin. Alternative antibiotics are more expensive and less available to patients, and although the sale of these medications without a prescription is illegal, over-the-counter purchases are a common practice.

The Typhoid Conjugate Vaccine

A solution to the problem of ineffective medicine is the typhoid conjugate vaccine (TCV). The current typhoid vaccines can only provide short-term protection to patients and more importantly, cannot be given to children. The typhoid conjugate vaccine can reduce the need for antibiotics and unlike other vaccines, it provides longer-lasting protection, requires only one dose and works for children older than six months. The creation of the typhoid conjugate vaccine is a large step in global health.

Kathy Neuzil, leader for the Typhoid Vaccine Acceleration Consortium at the University of Maryland, said: “I have been in my career for around 25 years but these sorts of opportunities, where everything comes together, don’t happen very often. Here we had a vaccine that had been tested but wasn’t being used. Now it is licensed by the World Health Organization and Gavi is supporting countries to introduce it.” The TCV is making history, especially helping with typhoid in Zimbabwe.

The Typhoid Conjugate Vaccine in Zimbabwe

A major vaccine campaign began in Harare on 22 February 2019. Approved by the World Health Organization (WHO), carried out by Zimbabwe’s Ministry of Health and funded by Gavi, The Vaccine Alliance, this campaign is the first in Africa to use the typhoid conjugate vaccine. It targets children aged from six months to 15 years old, and in high-risk areas, it will provide adults up to 45-years-old with the typhoid conjugate vaccine. By the end of the campaign on 3 March 2019, the typhoid conjugate vaccine will be available to 325,000 people throughout the capital city.

Dr. Seth Berkley, CEO of Gavi, is optimistic about the typhoid conjugate vaccine, saying: “These new conjugate vaccines will be a game-changer, not only in the battle against typhoid but also in the global effort to tackle drug resistance. The fact that they are now ready to be used to contain this devastating outbreak in Zimbabwe is fantastic news.”

Although vaccination campaign will significantly decrease typhoid outbreaks in Zimbabwe, vaccines are only a short-term solution. Completely eradicating typhoid in Zimbabwe will also require sustainable solutions for clean water and improved sanitation and hygiene. Together, the typhoid conjugate vaccine and sustainable WASH measures in Harare and other cities will help control and fight typhoid in Zimbabwe.

– Natalie Dell
Photo: Flickr

The West Bank and Gaza
The West Bank and Gaza are considered Palestinian territories that have struggled with political power since the Six-Day War in 1967. This dispute has been between Israel and Palestine and the end result of the war has left the country in political turmoil. This devastated economic opportunities, local livelihood, sanitation conditions and household food consumption. In 2017, the 50th anniversary of Israeli occupation and the 10th anniversary of the Gaza blockade were marked. This has been affecting all job opportunities and proper food aid from entering the region. All of these factors have only made it more difficult to live in already precarious conditions and more risk for the already struggling population.

Work of USAID

The U.S. government works closely with the authorities in Palestine to address the economic and humanitarian needs of the country. To improve economic growth, USAID has donated roughly $400 billion to improve in-house situations for companies and impoverished families in West Bank and Gaza. Providing basic needs like clean sanitation systems and safe work environments is essential to maximize productivity within the company and keep the workers healthy. Many companies suffer from a lack of resources and expertise for their products, so the project Compete will help business owners learn more about their product, how to maximize value for those products and increase employment within the surrounding areas. The goal is to increase competitiveness and revitalize the private sector, bringing to the table full-time jobs, part-time jobs, seasonal jobs and paid internships.

Food Sovereignty of West Bank and Gaza

Food insecurity is a huge issue in the West Bank and Gaza territory as over 70 percent of people in this area suffer from lack of food and proper nourishment. Some of the causes for this are also a global phenomenon, environmental degradation, rising food prices and Palestinian food sovereignty. With food sovereignty, a state can control its own food resources, though that state has to have a self-sufficient food source with the help of government-controlled policies.

Since the occupation in 1967, Israel has confiscated thousands of acres of farming land and then separated it with the West Bank wall. With the separation of land, farmers are struggling to keep up the health with crops due to vandalism and destruction from settlers and the military. In Gaza, 25 percent of fertile land has been destroyed by the buffer zone, a zone that borders Israel. Patrol boats in the area only allow fishermen 15 percent of their territorial waters, further reducing the areas self-sufficient food sources. With the limitations on trade, environmental issues, confiscation of land and destruction of land, food sovereignty is unachievable. This has hindered economic growth and social conditions to reduce the levels of food insecurity.

Clean Water Access

Access to clean, potable water is limited by the wall between the West Bank and Gaza. Beaches, rivers and lakes are polluted and overcrowded refugee camps create health hazards for the sanitation systems. About 26 percent of diseases in West Bank and Gaza are related to filthy water. During the winter months, household septic tanks overflow and mix with rainwater, flooding homes and streets in the area. During the summer, the heat dries the streets from the flood and the smell coming off the streets is so bad that families keep their windows shut. Mothers refuse to let their children out to play because of the rancid smell and infected water.

Diseases continue to spread as garbage continues to pile up in refugee camps. The Anera organization is working on building proper waste management systems across Palestine, improving sanitation systems in the process. In 2014, Anera reconstructed sewage lines damaged by bombs. In refugee camps, they are taking an approach where the youth take the lead. Through campaigns designed to clean and recycle, they have developed a staff to train on proper waste management and a new sorting facility. They are creating a cleaner environment for 13,000 members of their community so far and will continue to reach out and help their people.

Health System in West Bank and Gaza

The health system in West Bank and Gaza has been shaped by years of occupation, political stalemate, violence and human rights violations. The barrier placed between the two territories limits access to East Jerusalem, the closest area that has specialized hospitals. The placement of these hospitals is scattered due to the many health care providers in the country. With the blockade in place, Gaza’s health care locations are experiencing unstable power supply and recurring power cuts.

The medical equipment has been deteriorating because of inadequate maintenance and spare parts cannot reach them. The barrier has also made it difficult to transport proper medicines to treat patients. All of these factors are crushing the health care system in West Bank and Gaza, making people seek treatment elsewhere though traveling in and out of Gaza is heavily restricted. Even with these limitations, health care in these areas still thrives. With the help of the World Health Organization, technical support will be provided to health technicians and fund projects created for diseases affecting the population.

Even with all of these issues, West Bank and Gaza still work out solutions to everyday and past problems. If these areas can continue to receive the funding from developed countries and nongovernmental organizations, they can grow back into the self-sufficient economy they once had.
– Kayla Cammarota
Photo: Flickr

Elderly Care in Iran
The Iranian government recently turned an eye towards aiding development and putting the nation back on track after the Iraq war. There is still a great deal of room for social reform in this improved state of development, especially in the area of elderly care in Iran.

Aid for the elderly population in Iran is projected to become a large issue, as the country experienced a baby boom in the years of the Iraq-Iran war (1980 to 1988) which will lead to an increased elderly population in the future. The rising rate of unemployment in Iran has made it difficult for the elderly to find and hold jobs, and most elderly people are unable to provide for themselves in their old age.

Elderly People in Iran

One-third of the Iranian elderly population is not covered by any health insurance; meanwhile, the Iranian government diminished the elderly retirement pension — only one-third of the elderly population receives a pension — while 20 percent of families are economically dependent on the senior householder. The elderly demographic has a very low socioeconomic status and basic insurance policies fail to cover most elderly care costs. Without the money to afford the extra costs, older people often fail to receive the help they need.

There are currently five main governmental organizations taxed with elderly care in Iran:

  • The Social Security Organization
  • The State Welfare Organization
  • The Red Crescent
  • The Imam Khumeini Relief Foundation
  • The Martyrs Foundation

However, there are no clear developed policies on elderly care, and no single organization responsible for addressing this crucial societal need. As a result, ambiguity and uncertainty surround specific organizational responsibility.

Challenges of Elderly Care in Iran

Policy-making is one identified challenge of the elderly care process in addition to access, technical infrastructure, integrity and coordination and lastly, health-based care services. In regards to access, there are no transportation facilities and many of the elderly are entirely stuck at home due to physical reasons or an inability to pay for transportation costs.

Also, 70 percent of elderly people in Iran are illiterate, which impacts their awareness of access to resources. Currently, Iran does not have the physical, human and informational resources to implement an elderly care policy. This is concerning as the country is projected to experience fast demographic changes and a huge increase in the elderly population in the near future.

The country does have community-based services for the elderly such as nursing homes, adult daycare centers, cultural centers and meals on wheels; unfortunately, the distribution is sparse and these services are intended for mainly elderly people with disabilities. However, on a more positive note, the fact that this issue is being qualitatively and quantitatively studied is considered progress.

Need for Action

Historically, little attention has been paid to elderly care in Iran, but new studies and scenario exercises will thankfully aid the government in creating a sturdy policy framework for addressing elderly care in Iran.

The country is still developing and many other issues surrounding poverty are the main focus of the government right now. There is still time to address the problem of elderly care in Iran before it becomes too big to handle, but the Iranian government will need to start taking action immediately.

– Mary Spindler

Photo: Pixabay

Five solutions for reducing HIV in South Africa
South Africa has the largest HIV epidemic in the world with a prevalence of 18.8 percent of the country’s population aged from 15 to 49. Consequently, South Africa has some of the most comprehensive treatment and support systems for this issue. In addition to dedicated civil society organizations, the government has a guiding framework for reducing HIV in South Africa. One of such initiatives is the National Strategic Plan (NSP) for HIV, TB (tuberculosis) and STIs (sexually transmitted infections) 2017-2022 that aims to overcome barriers and set goals that could ultimately help influence global HIV infection management. In this article, five solutions for reducing HIV in South Africa that this country is implementing are presented.

Five Solutions for Reducing HIV in South Africa

  1. Address inclusivity. Reducing the HIV epidemic in South Africa requires caring for the most vulnerable populations in society: sex workers, men who have sex with men, transgender women and people who inject drugs. Discrimination, intolerance and neglect culminate in intense stigma consequently keeping these cohorts out of the research and clinics where valuable testing and treatment are available. In addition, up until recently, nationally available programs like the National Sex Worker HIV Plan and the South African National AIDS Council’s LGBTQ HIV Framework were unavailable. The creation of specialized programs to address the unique needs of a chronically abused population is a valuable first step towards reducing HIV in South Africa.
  2. Support women. Women and girls comprise more than half of the 36.7 million people living with HIV around the world. This statistic is even worse in South Africa where HIV prevalence is nearly four times greater for women and girls than that of men of the same age. These staggering high numbers are the result of poverty, systemic gender-based violence and intergenerational marriage. In addition to the programs identified above, nationally deployed resources like the She Conquers campaign provide multiple societal interventions like reducing teenage pregnancy and gender-based violence as well as providing educational support and business opportunities.
  3. Prioritize prophylactics. A little over three years ago, South Africa became the first country in Africa south of the Sahara to completely approve pre-exposure prophylaxis (PrEP), which stands for the use of antiretroviral drugs to protect HIV-negative people from infection. This initiative is a primary tenet in the NSP‘s first goal to acceleration HIV prevention, especially for the most vulnerable population. The goal is to increase PrEP treatments to nearly 100,000 participants in the coming years. In addition, campaigns to distribute condoms, educate the population and even encourage male circumcision are operating to reduce initial transmission by providing means to encourage safe sex thus keeping the entire population safer from infection.
  4. Deliver ART. South Africa has the largest antiretroviral treatment (ART) program in the world and UNAIDS estimates that 61 percent of South Africans living with HIV are receiving treatment in 2017. This figure has more than doubled since 2010. This success is largely due to the latest “test and treat” strategy that makes anyone who has tested HIV positive immediately eligible for ART treatment. Moreover, this strategy incentivizes the population to get tested which is a major barrier to reducing HIV in South Africa. Additional work is needed to encourage South Africans, specifically men, to get tested, as men tend to get tested and start treatment much later and at a more progressed stage of infection thus reducing effectiveness and placing the population, especially women, at risk. It is important to note that South Africa has made tremendous strides in reducing mother-to-child transmission (MTCT) largely because of the ubiquity and delivery of ART therapies. As a result, MTCT rates have been reduced by more than half between 2011 and 2016, achieving the national target for 2015 of a transmission rate below 2 percent.
  5. Treat Tuberculosis (TB). Tuberculosis is the leading cause of death in South Africa. HIV severely suppresses the immune system leaving victims vulnerable to all infections, however, TB is particularly difficult and without treatment, fatal. It is estimated that two-thirds of HIV-positive South Africans have TB. In response, South Africa’s NSP incorporated TB reduction strategies and sets forth priorities for reducing TB mortality.

These five solutions for reducing HIV in South Africa have been a successful start for the country as they tackle the world’s largest HIV epidemic. The government has developed a comprehensive, multi-dimensional plan that shows a lot of promise, however, following through remains questionable. National organizations like the Treatment Action Campaign question the government’s ability to remain engaged and accountable.

Addressing HIV requires relentless attention and civil society participation, especially since UNAIDS’ ambitious 90-90-90 (90 percent of all people know their HIV status, 90 percent HIV-positive patients will receive ART therapy and 90 percent of ART therapy patients will have viral suppression) goal to suppress and eliminate HIV and AIDS, all by 2020, is right around the corner.

– Sarah Fodero

Photo: Flickr