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

PA 10 Facts about Life Expectancy in Tanzania
Tanzania is home to Africa’s highest peak and borders the continent’s deepest lake, but among these geographical wonders lives East Africa’s largest population struggling to reach adulthood. According to the United Nations, Tanzania has the world’s largest youth population in modern history that, if cultivated with proper programmatic support, could result in unprecedented societal growth and progress as the population ages.

However, surviving childhood and staying healthy are major threats to an aging Tanzanian population where life expectancy is low. Lack of quality health care and poor sanitation contribute to high infant mortality and lives lost to preventable diseases. International aid is bolstering local and government-sponsored programs to address some of the most critical issues contributing to life expectancy in Tanzania, but more support is needed. In the article below, these and other issues are discussed in a form of 10 facts about life expectancy in Tanzania.

Ten Facts About Life Expectancy in Tanzania

  1. Overall, life expectancy in Tanzania has increased by nearly 10 years in the past decade. According to the most recent data, Tanzanians are expected to reach nearly 66 years of age, compared to 57 years of age in the mid-2000s. Several factors contributing to this success include socioeconomic growth through employment, higher incomes and more education.
  2. Nearly 20 percent of deaths in Tanzania are preventable with proper access to surgical care. The Tanzanian government is aware of the gap in health care access and has launched the National Surgical, Obstetric and Anesthesia Plan, dedicated to improving access to surgical, anesthesia and obstetric services by 2025.
  3. Malaria is the leading cause of hospitalization and death of children in Tanzania and one of the leading causes of all deaths in the country. Tanzania’s malaria epidemic has sparked decades of solution-driven support and strategic oversight from the Millennium Development Goals and Roll Back Malaria Partnership. Both initiatives have helped address this preventable disease and allowed Tanzanian children to live longer.
  4. Every day, 270 Tanzanian children under the age of 5 succumb to preventable diseases such as malaria, pneumonia and diarrhea. The need for a stronger health system and service delivery is reflected in the high rates of childhood mortality. The childhood mortality rate is, however, improving and has dropped by nearly half since the early 1990s due to concerted efforts from Tanzania’s government and international aid.
  5. Seventy-five percent of Tanzanian children have received all basic immunizations. With global immunization coverage consistent at 85 percent, Tanzania is taking health security for children seriously. One major barrier to higher coverage is the disparity between regions. International aid efforts like those from the U.S. Agency for International Development (USAID) offer support for childhood vaccination which is a contributing factor for a drop of two-thirds since 2000 in child mortality.
  6. Tanzanian children born to mothers with little education are 1.3 times more likely to die before their fifth birthday than children whose mothers have secondary or higher education. Further, adolescent women in Tanzania who have not been able to access education are five times more likely to be mothers than those with secondary or higher education. Programs from the Girls Educative Collaborative like Launch a Leader, that prepares girls heading to secondary school, help break down barriers and expand access to continuing education for young women.
  7. Two-thirds of women in the country give birth in a facility with a skilled practitioner. The assistance of an attendant reduces the chances of maternal mortality during birth, however, large gaps in skill among delivery attendants leave women at risk for maternal mortality.
  8. Twenty-seven million Tanzanians lack access to safe drinking water and 35 million Tanzanians rely on unimproved sanitation. These unsafe water and sanitation conditions disproportionately affect children and rural communities. But, there is hope. Organizations like Water.org have begun tapping into Tanzania’s existing technology infrastructure to improve the country’s water and sanitation infrastructure through digital finance and the company’s WaterCredits program.
  9. Tanzania has one of the world’s lowest physician-to-population ratios. WHO estimates that there are three doctors, nurses or midwives for every 10,000 Tanzanians. With a population of over 50 million and a recommended minimum threshold of 23 providers for every 10,000 people in low-income countries, these numbers highlight a significant gap in health care coverage. One USAID program, in collaboration with Tanzania’s government, has trained over 500 health providers in more than 400 facilities to address critical needs.
  10. Almost 1.5 million Tanzanians living with HIV, the AIDS epidemic are being well managed. Tanzania’s extensive roll out of antiretroviral medications has helped minimize the impact of the country’s epidemic over the last decade and improved life expectancy in the country.

The above presented 10 facts about life expectancy in Tanzania speak about the positive outcomes international and government solutions have on Tanzania’s population, but also highlight areas for further growth. Malaria is one of the leading deterrents for economic development and foreign investment in the country, and Tanzania did not meet the 2015 Millennium Development Goal targets for childhood or maternal mortality. With the proper support, Tanzania is on track to excel. The country’s future looks brighter (and older) than it did a mere decade ago.

– Sarah Fodero
Photo: Flickr

Elderly Care in Bosnia and Herzegovina
Bosnia and Herzegovina has been slowly recovering from the conflict that took place in the country during the late 1990s. The war took a toll on the country economically, politically, socially and physically. On top of its high levels of poverty, the country is also becoming a victim of the aging population epidemic and elderly care in Bosnia and Herzegovina is a huge concern. The country is facing issues of a dip in fertility rate and an increase in the rate of the elderly people, leaving a large number of older population with a small population of working-age people to support them. This issue coming from the uneven age distribution grew due to a fall in birth rates, a decrease in population from deaths during the war years and an increase in life expectancy.

The Increase of Elderly Population

Currently, people over the age of 65 make up 17 percent of the total population. Moreover, the United Nations Department of Economic and Social Affairs estimated that the number of persons aged 65 and more than 65 will reach 30 percent of the population in 2060, comparative with the 15 percent it sat at in 2010. With a population of only 3.5 million, this is a daunting number.

The older population in Bosnia and Herzegovina is extremely vulnerable for many reasons. Some of the issues they face include low income and increased living expenses. Obtaining employment is difficult as well. Due to the high unemployment rate the country faces, many employers prefer younger workers. This means that many of the elderly face poverty and have been unemployed since before retirement age, leaving them with subsequently less to provide for themselves as they age.

The situation for elderly women is worse than it is for men, as women lose rights with the loss of a husband. They also face higher rates of poverty as they are usually unable to economically provide for themselves alone. The elderly are ailed by illnesses such as cardiovascular and malignant diseases, neurological and mental disorders like Alzheimer’s, as well as sensory and physical disabilities. Many of these diseases and the lack of care for them result in a higher rate of depression amongst the elderly.

The Exodus of Medical Workers

On top of all this, Bosnia and Herzegovina is facing an exodus of its medical workers. Many young doctors and medical professionals are leaving the country after their schooling is complete and migrating toward Germany and other Western countries because these countries offer better job opportunities and more competitive salaries. More than 10,000 nurses, doctors, caregivers have gone to Germany alone. Only about 6,000 doctors work in Bosnia, meaning for every six doctors, one works in Germany. Not only is this leading to a lack of medical professionals, but the country is also losing money as they put millions into medical training facilities that students use and then leave behind as they migrate their services.

Bosnia is being forced to send patients abroad for care, so in the last two years, the country has spent around $37 million on patients that were sent outwards. Not only is this epidemic draining the country’s money, leaving it with less available funding to put towards elderly care in Bosnia and Herzegovina, it also means there are not enough doctors to perform geriatric care. It’s a negative feedback loop that hinders the country’s ability to care for its citizens, especially the elderly ones.

The Solutions for the Problems

The growing number of the elderly population in combination with the exodus of medical workers leaves the country with many people suffering and few resources to help them. Thankfully though, Bosnia and Herzegovina has not turned a blind eye towards these issues and instead has begun to search for solutions. Members of the United Nations adopted the Madrid International Plan of Action on Ageing that aims to address the issues of aging in the 21st century. The plan focuses on three main aspects: older persons and development, advancing health and well-being into old age and ensuring enabling and supportive environments.

With support from the United Nations Population Fund, United Nations Department for Economic and Social Affairs and the Swiss Cooperation in Bosnia and Herzegovina, the country has developed its own strategies, inspired by the structure of the Madrid International Plan of Action on Ageing. It plans to improve social and health protections, promote activism and volunteerism in local communities, as well as inter-generational support. The country aims to improve access to public services, especially for those in rural areas and prevent violence, neglect and abuse against older persons. The execution of this initiative will require a great deal of money and resources, but the government is dedicated to the improvement of elderly care in Bosnia and Herzegovina.

This plan of action shows that the government is making this issue a focal point in national policy and beginning to address the problems that will address the aging population. Elderly care in Bosnia and Herzegovina has a long way to go before the older population is secure and comfortable. With initiative from the government to care for the elderly, social attention will be turned towards this problem that will encourage the younger generation to aid the older and make room for various organizations to provide help and resources to the country’s older population.

– Mary Spindler
Photo: Flickr

Mental Health in Lebanon
In 2011, it was estimated that approximately 17 percent of Lebanon’s population suffered from a mental illness of some kind. Among them, 90 percent of people went untreated. Mental health in Lebanon was not always a priority. However, with rising issues of mental illness, the Lebanese government is finding new ways to combat the misconceptions and stigmas surrounding mental health.

Role of Education in Understanding Mental Health

According to two researchers from the Holy Spirit University of Kaslik, Lebanon, there is a distinct difference in the perception of mental illness depending on education. People who had higher educational attainment, as well as higher socioeconomic status, were more likely to have positive attitudes towards mentally ill patients. On the other hand, people who lacked education due to lower socioeconomic status had a negative outlook towards mental illness.

According to the World Health Organization (WHO), mental health and socioeconomic factors cannot be separated from each other. Socioeconomic factors can hinder educational attainment, and this may limit the lack of awareness people have about mental health.

Lack of awareness perpetuates the stigma around mental illness which stops people from receiving treatment. It even prevents them from talking about their feelings as they fail to be validated by others. Another reason why mental illness goes untreated is that many cannot afford it.

New Programmes to Help Improve Mental Health in Lebanon

The perception of mental health in Lebanon is changing and getting better. Historically, mental illness was considered something that could be solved only by the private sector. This meant that mental health care was reserved for those that could afford it.

Over the years, the government has realized that any person in need of help should be able to access mental health care. So, while mental health care will remain in part in the private sector, the health ministry in Lebanon is creating various programmes to help those who cannot afford it.

In 2014, the Lebanese health ministry created the National Mental Health Programme. This programme works with WHO, UNICEF and the International Medical Corps in order to help those with mental illness in Lebanon. It aims to incorporate mental health into general medicine more completely. This will hopefully help eradicate some of the bias that exists. It will help make mental health part of the discourse.

The programme also aims to help vulnerable populations in Lebanon such as refugees, people in prison and survivors of war and torture. This will be a huge help to these communities because it will allow them to have access to mental health care which they did not have before. It will create the perception that mental health deserves to be taken care of.

The National Mental Health Programme organized events such as “Time to Talk” in 2018. It was a way to directly combat incorrect perceptions about mental health by simply talking about mental health under ordinary contexts. Another similar event was “Depression: Let’s Talk About It to Get Out of It”. It was held in 2017 in order to discuss rising depression rates and help people heal. “My Mental Health is My Right” which was organized in 2014 aimed to enforce the fact that mental health in Lebanon is important and that every person has a right to receive treatment.

Thus, with such advanced programmes and new developments, the future of mental health care in Lebanon looks bright. It is important to remove the stigma surrounding mental health to improve people’s well being and foster a healthier and happier society.

– Isabella Niemeyer
 Photo: Unsplash

Diabetics in Uganda
Living with Type 1 diabetes is hard. Anyone who lives with it knows that managing this condition requires checking one’s blood sugar multiple times a day, injecting just the right amount of insulin at mealtimes, eating and exercising when appropriate to keep the blood sugar number manageable and keeping plenty of emergency supplies on hand when things inevitably go wrong. However, diabetes is much harder for people living in Uganda, as life-saving supplies in this African nation are expensive and hard to come by. Fortunately, Myabetic, a small retail company helps diabetics in Uganda to earn money and afford these incredibly important supplies.

Diabetes in Uganda

Diabetes is poorly understood in Uganda and is often misdiagnosed as yellow fever, malaria, or cerebral meningitis. Those who are diagnosed correctly are often forbidden from going to school or even work because communities are often scared of their condition. They usually go to clinics once a month to have their blood sugar tested and receive their insulin supplies. However, many people do not give themselves enough insulin because they don’t know their own blood sugar number most of the time, and that is when the real trouble begins.

In Uganda, to be told that one has Type 1 diabetes is to be told that one will live a hard, painful life that will slowly lead to an equally painful death. Most diabetics in Uganda cannot afford the insulin and blood sugar supplies that they need to live. Changing Diabetes in Children used to give diabetic children these supplies for free, but the program was shut down in 2017. Insulin for Life also works to gives supplies to Ugandans who need it. But a shortage remains. To make things even worse the fact remains that without insulin, an individual with Type 1 diabetes will live a week or two at most.

Diabetic Neuropathy

With too little insulin, blood sugar numbers will run high, leading to a host of complications, including diabetic neuropathy. Diabetic neuropathy is nerve damage caused by having consistently high blood sugar numbers. This is all too common among diabetics in Uganda. There are four types of diabetic neuropathy: peripheral, autonomic, proximal and focal. Peripheral neuropathy causes tingling, numbness, or pain in the feet, legs and occasionally arms. Autonomic neuropathy causes digestive problems- from heartburn to vomiting, dizziness, low blood pressure, faster heartbeat, genital problems in both sexes, either increased or decreased urination and/or bloating. Proximal neuropathy causes weakness in the legs and pain in the thighs, hips, or rear. Focal neuropathy causes muscle weakness, muscle pains, eye pains, double vision, facial paralysis, chest or belly pain and/or severe pain in one specific area. All of these forms of diabetic neuropathy ravage diabetics in Uganda, causing their bodies to slowly shut down due to chronically high blood sugar numbers.

About Myabetic

Myabetic is a retail company founded by Kyrra Richards. When she was first diagnosed with Type 1 diabetes at age 24, she was embarrassed. She hid her condition from everyone by not checking her blood sugar or doing insulin in public, which threatened her life. Part of the problem was her standard black supply case, which looked ugly and made her fear stigma even more. She founded Myabetic to sell aesthetically pleasing cases and other devices in which to carry diabetes supplies.

Although the company’s main goal is to make diabetics feel better about themselves by giving them prettier carrying cases, they sell other diabetes paraphernalia as well. Among these items are bracelets handcrafted by diabetic artists in Uganda. The bracelets come in red, blue, yellow, and green and they cost $15 each. These profits go directly back to the artists, allowing them to buy the supplies they need to survive.

Life with diabetes is hard. Life with diabetes in Uganda is even worse. Those who do not die are shunned, given barely enough supplies to survive and are left to die. Fortunately, Myabetic helps diabetics in Uganda to afford supplies by selling the bracelets that diabetic Ugandans make. The bracelets may be inexpensive by American standards, but every penny counts when someone needs diabetes supplies to live. Thanks to Myabetic, these Ugandan artists have a new chance to hope for a better life.

– Cassie Parvaz
Photo: Flickr

Private Sector Key to Eliminating Malaria in Cambodia
Having already made substantial progress in the effort to eradicate malaria, Cambodia is one of the 17 countries in Southeast Asia looking to continue finding solutions to this problem and putting an end to this disease by 2025. The strategy of eliminating malaria in Cambodia hinges on a joint effort between the public sector and the private sector. With proposed solutions made by this collaboration, Cambodia is on the road to eliminating the disease by its projected period.

Malaria in Cambodia Numbers

In Cambodia, 1 million people become infected with malaria every year. Despite this high number of infections, there has been substantial progress made in working to find solutions to eradicating malaria. For example, in 2015, Youyou Tu received The Nobel Prize for Physiology or Medicine for her discovery of artemisinin, a type of anti-malarial medicine that is being used today.

While efforts have been made in eradicating malaria in Cambodia, there is still a lot that needs to be done in order to achieve this goal. Of the 1 million people who become affected by malaria, around 1.5 percent and 10 percent of people that are located in distant provinces die. The parasite responsible for these deaths is the Plasmodium falciparum. To prevent the occurrence and spread of this disease, early intervention with artemisinin-based combination therapy (ACT) is the key. Yet, distribution of antimalarial medicines remains a challenge. While there are immediate and positive effects of ACT therapy, many people are not able to receive this medicine.

PSI/Cambodia

One organization that working on ending malaria in Cambodia is Population Services International/Cambodia (PSI/Cambodia). The purpose of this initiative is to work on health issues caused by HIV/AIDS, malaria and reproductive health of women who are going to give birth. In 2003, a program of PSI/Cambodia started to offer malaria treatment with the help of private clinics, pharmacies and shops in many parts of rural Cambodia. Of total Cambodia’s population, the poor are particularly at risk of getting the disease. As shown by this initiative, the private sector remains crucial for ending malaria in Cambodia.

Solutions to Ending Malaria in Cambodia

To meet the need for antimalarial medicines, the Global Fund, an international partnership organization, has proposed some essential solutions by the public sector working with the private sector for eradicating malaria in Cambodia. The first is to make sure there is access to effective antimalarial medicines that the private sector provides. This proposal also means the dispose of fake antimalarial drugs that are currently in the market. In addition, this means also the disposal of antimalarial drugs that do not meet the national guidelines.

Secondly, the report of the Global Fund urges organizations in the private sector to make sure they provide effective diagnostic testing. Lastly, the Global Fund recommends that there is widespread access to affordable antimalarial medicines for eradicating malaria in Cambodia, in order to allow for those living on less than $1.25 a day to purchase afford this life-saving treatment.

One way to achieve these proposals is subsidizing antimalarial medicines in order to allow consumers to be able to buy them. Another way to increase distribution of antimalarial medicine is through social marketing. In addition to making sure there is an effective treatment at a cost that people can afford, these same two strategies can be used for diagnostic testing.

With much progress having been made to end malaria in Cambodia, there is room for more improvement in order to reach the goal of eradicating the disease by 2025. With more joint effort between the public sector and private sector through subsidizing prices of antimalarial medicine, Cambodia can move one step closer to eradicating malaria.

– Daniel McAndrew-Greiner
Photo: Flickr

Primary Care in Developing Countries
The lives of 6 million children could be saved globally each year through more effective primary care. However, half of the world’s population cannot access essential health services. In fact, 800 million people spend at least 10 percent of their income on health expenses for themselves or a family member which can push them further into poverty.

Blockchain Technology and Primary Care Services

Despite these overwhelming statistics, blockchain technology is beginning to transform the health care sector in Europe and Africa through virtual health assistance. The European Commission has launched CareAi in June 2018, which is a digital computer system that uses a patient’s blood sample to quickly diagnose diseases without the presence of a physical doctor.

Harvard University Chemistry Professor George Whiteside created the machine to feature a small finger prick device. The patient experiences a quick poke from a sterilized needle, then places their fingerprint onto a chip that is inserted into the machine. The intelligent CareAi system has the ability to diagnose diseases like typhoid fever, malaria and tuberculosis in seconds and quickly prints results, which directs ill patients to nearby pharmacies for medicine. The machine’s intelligence is expected to evolve over time and could even surpass human proficiency in 2-3 years.

CareAi ensures that all patient information and results are kept anonymous so it will be able to help undocumented migrants and populations secluded from the health care system who fear deportation. However, if the government wishes to access data for policy purposes, it will pay participating healthcare NGOs and machine maintenance costs. CareAi machines will be placed in public places such as mosques, churches and markets so people who lack primary care in developing countries will be able to benefit.

CareAi Targets the Most Vulnerable Groups

Creators of this new invention are targeting refugee camps in Europe and are giving specific attention to India which only has one doctor for every 921 people as well as Africa. According to the World Health Organization, across the globe, 50 percent of the children under age five who die of pneumonia, diarrhea, measles, HIV, tuberculous and malaria each year, are from Africa. CareAi will allow easy access and accurate diagnoses to these people who are in quick and desperate need of health results.

Looking Forward

AI projects are taking place all over the world and opening up exciting possibilities in the not so distant future. In a piece titled, 10 Promising AI Applications in Health Care, Harvard Business Review highlights an AI-powered nurse avatar called “Molly” which is being used to “interact with patients, ask them questions about their health, assess their symptoms, and direct them to the most effective care setting”.

In addition, the Beth Israel Deaconess Medical Center is using AI processes to predict which patients will be no-shows and to reduce readmission rates. Artificial intelligence will continue to change the way we practice medicine and will open up new diagnostic possibilities for primary care in developing countries.

– Grace Klein
Photo: Pixabay