Archive for category: Health

Information and stories on health topics.

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Top 10 Facts About Period Poverty in the U.K.

Top Ten Facts about Period Poverty in the U.K.
Nearly 800 million women and girls menstruate daily. Period poverty encompasses the shame, guilt and cost barriers around access to sanitary products. One in 10 girls in the United Kingdom is unable to afford sanitary wear, resulting in detriment to their self-esteem, education and overall quality of life. Eliminating period poverty has often been the focus of nonprofits and the U.K.’s government. Below are the top 10 facts about period poverty in the U.K. that are important to know.

Top 10 Facts About Period Poverty in the U.K.

  1. An estimated 49 percent of girls have missed a day of school due to their periods. One in five girls surveyed in a 2019 study reported being a victim of bullying and teasing because of their periods. Girls faced increased feelings of shame and embarrassment when on their periods or discussing their period in an academic setting. This resulted in absences from school and led female students to struggle to keep up with their schoolwork.
  2. Women in the U.K. spend as much as 18,450 euros ($20.744 USD) due to their period across their lifetime. The total accounts for the costs of sanitary items, pain relief for cramps, new underwear and other period-related costs such as sweets or magazines. Of those interviewed, 91 percent purchase pain relief to ease the symptoms of periods on a regular basis. All of the 2,134 women surveyed responded that feminine hygiene products should cost less money, and some added that the government should remove its tax on those products.
  3. Free Periods is a campaign supplying low-income girls with menstrual products. Amika George, a 19-year-old student studying at Cambridge University, founded Free Periods. George called on the U.K. government to assure sanitary products are widely available in educational settings. The campaign also held a protest in London to bring attention to the ongoing issue.
  4. Plan International UK found that 10 percent of girls are unable to afford sanitary products. The cost of sanitary products has led 14 percent of girls to borrow sanitary products from friends, 12 percent to improvise sanitary products and 19 percent to change to less suitable products.
  5. Bloody Good Period, created by Gabby Edlin in 2018, supplies 25 asylum seeker centers in the U.K. with a flow of menstrual products. The growing initiative aspires to supply more food banks and centers in its mission to end period poverty.
  6. Girls throughout the U.K. not only miss school but often improvise sanitary products to use during their period. Girls have shared their stories of wrapping a sock around their underwear to control the bleeding. Others have wrapped rolls of tissues or newspapers in order to prevent leakage through their uniforms.
  7. In 2018, the Scottish government rolled out a plan to provide free sanitary products to women unable to afford them. Projections determine that it will reach approximately 18,800 low-income women and girls in an attempt to combat period poverty.
  8. The Gift Wellness Foundation provides non-toxic sanitary pads to women in crisis throughout the U.K. The Foundation relies on donations and the generosity of local community businesses. Donated sanitary products contain all-natural ingredients to ensure they are free of harmful chemicals.
  9. As of 2017, an estimated 68,000 women lived on the streets in temporary housing or shelters. These women have to make decisions that often leave them without sanitary products due to their financial situation. Each year, shelters get an allowance for condoms but not for sanitary products.
  10. Three individuals who met as interns at a London advertising agency founded #TheHomelessPeriod. Inspired to minimize the hidden side of an inequality, #TheHomelessPeriod aims to have tampons and towels available in homeless shelters through donations, crowdfunding and fundraising.

The top 10 facts about period poverty in the U.K. show the frequent inaccessibility of sanitary products to girls and women throughout the nation. While the Scottish government leads the way in the efforts to end period poverty, other governments have yet to replicate its actions. Individuals within the U.K. have taken it upon themselves to create campaigns to combat the hidden inequality and have seen success in their efforts.

– Gwen Schemm
Photo: Unsplash

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3 Major Health Problems from Water Pollution

Health Problems from Polluted Water

Water—our lives depend on it, but for many people around the world, this essential, life-giving liquid brings disease and even death. Today nearly one billion people have limited access to safe, clean water because of pollutants from inadequate sewage systems, industrial dumping, agricultural run-off and irresponsible manufacturing practices. The result? More people die every year from water contamination than war and other forms of violence combined. Each year, around 840,000 people die of health problems from water pollution.

3 Health Problems from Water Pollution

1. Diarrhea: The most common health problem from water pollution, diarrhea causes loose, watery stools, abdominal pain, dehydration and even death. Diarrhea is commonly caused by drinking, cooking or cleaning with water contaminated by feces. In India, a country where roughly half the population practice open defecation, diarrhea is the third leading cause of death in children under the age of five. In 2015, diarrhea killed an estimated 321 children every day in India. However, India is making efforts to prevent and treat diarrhea. In 2014, the country approved the Integrated Action Plan for Prevention and Control of Pneumonia and Diarrhea (IAPPD), with one of its main focuses being to provide safe drinking water and improved sanitation to Indian households. Since its adoption of IAPPD, India has improved treatment cover to those with diarrhea, launched immunization campaigns to treat diarrheal disease, and as of 2018 constructed household toilets in 52.16 percent of the IAPPD’s targeted 12 million rural Indian households. Because of these efforts, deaths of children below-four children in India have decreased by 52 percent over the last several years.

2. Cholera: Contracted by consuming contaminated water or food, cholera’s main symptoms are severe diarrhea and vomiting which leads to dehydration. There are an estimated 3-5 million cholera cases every year and the World Health Organization (WHO) reports that 54 percent of all cases are from developing countries in Africa whose inhabitants lack access to safe water, basic hygiene and sanitation facilities.  The Lake Chad Basin, which includes Nigeria, Niger, Mali, and Cameroon, reported that in 2018 there were eight times as many cholera cases compared to the previous four years in that region, with more than 23,000 people affected and over 388 deaths. In response to the increased cholera outbreaks in Africa, GAVI the Vaccine Alliance, along with WHO and the Global Task Force on Cholera Control (GTFCC), launched a massive vaccination drive throughout five African regions to help treat and extinguish further epidemics. Between 1997 and 2012 only 1.5 million doses of cholera vaccines were administered worldwide, but thanks to the vaccine drive, in just the first four months of 2018, 15 million cholera vaccines were approved for administration. The vaccine drive is part of a global initiative to reduce cholera deaths by 90 percent by the year 2030.  Dr. Seth Berkley, CEO of GAVI the Vaccine Alliance, shares that despite the vaccine drive’s importance in addressing the outbreaks, improved water and sanitation is “the only long-term, sustainable solution to cholera outbreaks.”

3. Dysentery: Dysentery is an inflammation of the intestines. Its symptoms include bloody diarrhea, fever, abdominal cramps and even excreting large portions of the intestinal membrane. Like many other health problems from water pollution, dysentery is spread through fecal-polluted water, and mainly impacts impoverished communities who rely on makeshift sewage systems and contaminated water sources for sanitation and drinking. Dysentery can be a major concern in refugee camps where insufficient and overwhelmed sanitation facilities and open-air sewage dumping become a breeding ground for water pollution diseases like dysentery, as the recent Rohingya refugee crisis in Bangladesh revealed. Dr. Samir Howlader, National Program Officer for Migration Health at the International Organization for Migration (IOM) reported that when the Rohingya refugees—over a million people have fled their homeland of Myanmar to seek refuge in Bangladesh—first arrived in the Bangladesh camp of Cox’s Bazaar in 2017 there were “effectively no facilities” for the new arrivals and dysentery was a common concern. In 2019 however, the UN’s refugee agency, UNHCR, made it possible for the largest-ever refugee camp sewage treatment plant to be constructed in Cox’s Bazaar. The now-operating plant treats the human waste of 150,000 people every day, protecting the refugee community from the previous dangers of sewage-contaminated water. Medical clinics set up in the camp by the International Organization for Migration (IOM) have also helped treat and eliminate dysentery from the community. Since 2017, over one million refugees have received consultations at IOM clinics, and Rick Brennan, director of emergency operations for WHO states that there has not been any significant increase in disease thanks to these diligent efforts.

Though health problems from water pollution claim too many lives each year, great progress is being made towards a solution. The UN reported that over the last two decades, 2.6 billion people gained access to an improved drinking water source.  Now more than ever there is hope as the global community and developing nations work together to address water pollution problems and create a world where everyone has access to safe, clean water.

– Sarah Music
Photo: Flickr

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Five Benefits of Needle-Free Vaccines

Benefits of Needle-Free VaccinesThere are many different methods of non-traditional vaccines or needle-free vaccines that are being produced and becoming more available every day. For example, these include dry powder vaccines or patches. Most notable are jet injectors. Jet injectors use a large amount of pressure and fluid to breach the skin in a very fast motion. These vaccines are effective for usage in countries with extreme poverty because traditional vaccines need to be refrigerated. They also require a way to keep needles sterile. These five benefits of needle-free vaccines detail on how to solve these problems and more.

Five Benefits of Needle-Free Vaccines

  1. Jet Injectors Have Been Around for a Long Time: Jet injector technology might sound new, but it’s not as new as one would think. These kinds of shots were administered back in World War II. In fact, they were actually used through the 1980s until it was discovered that they were spreading diseases. This was due to the fact that the technology hadn’t been developed enough. Until it could be, the jet injectors had to stop being used. Now they have made jet injectors to be single-use, so there is no risk of spreading diseases between patients.
  2. They Require Fewer Resources: Jet injectors have been the most popular method of needle-free vaccines as they tend to use far less of the actual vaccine. This is arguably one of the most important benefits of needle-free vaccines. Jet injectors use up to 60 percent less vaccine than traditional needle vaccines. This is particularly helpful when there are shortages. Because jet injectors use a significantly less amount of the vaccine, it is also a cheaper option. For instance, the cost is $3-4 per vaccine or even $900 for 500 vaccines.
  3. They Are Less Painful: Another problem with the traditional vaccine is that it can cause pain in patients. This can become especially difficult when patients need multiple shots. Furthermore, those who fear needles are less likely to get a vaccination. On the pain scale, a pain score of three is when a person indicates that they are in some pain. This is important to know because when 100,000 subjects were given the jet injection, they had a pain score of zero. This painless injection allows for an alternative to the needle as it can easily administer multiple shots without pain. Lower pain scores are one of the key benefits of needle-free vaccines, as they allow the device to reach the broadest swath of patients possible.
  4. Less Risk of Injury After Disposal or Use: Needlestick injuries are another key problem with traditional vaccines. Needlestick injuries are injuries that happen when a needle accidentally penetrates the skin. The people that are exposed to these injuries are people who work with and around needles. Additionally, this can also happen to people like garbage-men when needles are not disposed of properly. When this kind of injury happens, they can transmit: HIV, Hepatitis B, Hepatitis C and AIDS. With the invention of jet injections, the risk of these injuries is reduced to nearly impossible as these injections need intense pressure to be administered.
  5. They Are More Efficient: The reason these jet injectors were being used in wars was that they are a faster and more efficient way of administering vaccines. Now that the technology has advanced over the last 70 years, these injections are less painful, more sanitary and now even faster. The injection lasts 1/10th of a second. It’s actually so fast that patients can barely feel it. This is helpful for those people in countries with extreme poverty as they are able to administer a lot of vaccines in a short amount of time.

With these benefits of needle-free vaccines, it’s clear this is the direction that the world should be headed in. They are cost-effective, sanitary, fast and nearly painless. As a result, access to vaccines could be provided to third-world countries at a more effective and reliable rate as they don’t need refrigeration and clean water.

– Ian Scott
Photo: Flickr

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Improving Quality of Life for Disabled Persons in Vietnam

Disabled Persons in VietnamIn Vietnam, 5.8 percent of the population is considered disabled. For a country home to 95 million individuals, this equates to more than 5.2 million people. Often, those with disabilities face circumstances that challenge their quality of life, such as limited access to education, fewer work opportunities and difficulty with transportation and self-care. This article discusses three ways quality of life is improving for disabled persons in Vietnam.

USAID Assistance

Assisting disabled persons in Vietnam has been a top priority of USAID since the 1990s. Since then, the nation has made great progress in establishing equal rights for disabled people, whether their disability is classified as visual, auditory, mobile, speech-based or cognitive. The U.S. government has allocated more than $100 million to the disabled population and 30,000 individuals have received direct hands-on assistance, including vocational training, independent living assistance and job training. Several laws and amendments have been passed, all designed to improve the quality of life among the disabled population, including:

  • 2001: Amendment to the Constitution of Vietnam
  • 2006: Vocational Training Law
  • 2010: National Law on Persons with Disabilities
  • 2012: National Action Plan to Support People with Disabilities

The 2017 USAID report breaks down the types of assistance offered and the impact they have had. Over the course of the year, the organization met a variety of policy milestones, including the development of city construction projects to improve transportation and create sustainable housing for families. More than 9,000 people with disabilities received direct assistance, increasing the number of people with access to services by 29 times. As a prevention tactic, 62,000 children between the ages of one and six were screened for signs of future development of disabilities. In the towns of Binh Phuoc and Tay Ninh, 17 rehabilitation units were set up and provided training for medical professionals.

While the 2018 report has not been released yet, USAID is carrying out a number of additional projects, with completion goals set in 2020. Among those is the Accessibility for Inclusion Project, a mission designed to not only raise awareness regarding basic rights of those with disabilities but to increase access to public buildings, ultimately expanding their social and physical capabilities. By the time the project is completed in 2020, research projects that at least 1,800 people will receive formal training to advocate for physical accessibility, and approximately 50,000 people with disabilities in Vietnam will have improved accessibility rights.

Global Disability Rights Now: The Impact

The Global Disability Rights Now! organization is focused on enforcing 10 specific disability rights in impoverished countries, ultimately putting an end to discrimination based on capability. Some of the principles include creating reasonable accommodations, changing the concept of defining disability and encouraging full participation in society. Global Disability Rights Now! carries out projects in Armenia, Guatemala, Kenya, Vietnam, Mexico and Peru.

One of the most successful projects to improve the lives of disabled persons in Vietnam was the mission to move towards disability inclusion in employment, a program that provided Disability Equality Training (DET) to the non-disabled community. It was designed to raise awareness towards potential barriers in employment that the disabled community in Vietnam face and to provide them with the resources they need to understand how to treat them as equals.

U.S. and Vietnam Partnership

On April 20, 2019, the USAID signed a memorandum of intent that was designed to drastically improve the quality of life for disabled persons in Vietnam. Specifically, the memorandum targeted seven Vietnamese provinces, including Quang Tri, Hue, Quang Nam, Binh Dinh, Dong Nai, Binh Phuoc and Tay Ninh. It is working to provide direct care to disabled individuals, along with expanding rehabilitation centers and developing community-level social services. USAID showed its support for those living with disabilities through celebrating Vietnam’s National Disability Day on April 18, 2019. More than 600 participants attended the “Run For Persons with Disabilities – No Distance, no Limitation” event, both with and without disabilities.

Although living conditions are still not ideal for individuals with disabilities in Vietnam, the programs and advocacy efforts being put in place by USAID are projected to drastically improve their lives. Efforts such as DET and the Accessibility for Inclusion Project are being implemented to equalize the two demographics, and in doing so, the nation expects to see an increase in opportunities and fair treatment among the disabled population in Vietnam by 2020.

– Anna Lagattuta
Photo: Flickr

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Fighting Breast Cancer in Developing Countries

Breast Cancer in Developing CountriesWomen in developing countries lack access to safe and cost-effective breast cancer screening practices, leaving cancer frequently undetected. As a result, three times as many women in low-income, developing countries die each year due to breast cancer compared to developed countries. A team of young women from John Hopkins University is working to change this disparity and save lives through the creation of a new biopsy device.

Early Detection: A Better Chance for a Cure

Great strides have been made in the prevention and treatment of breast cancer in developed countries. More than 80 percent of women diagnosed in North America, Sweden and Japan survive. However, the situation is far different for women in the developing world. Less than 40 percent of women diagnosed in developing countries survive the disease, according to the WHO. This disparity in fatalities can be attributed to a lack of early detection. Studies in Europe and Canada found that the risk of breast cancer death decreased by more than 40 percent among women who underwent early diagnostic screening. In the U.S., data reveals the widespread use of early detection procedures and a 39 percent decrease in U.S. breast cancer fatalities after the 1990s.

Screening for Breast Cancer in Developing Countries

In 2003, the World Health Survey found that only 2.2 percent of women aged 40 to 69 years received breast cancer screening in low- to middle-income nations. More than half of women newly diagnosed with breast cancer in those nations have already progressed to stage III or IV disease. In the United States, 71.5 percent of women aged 50-74 have been screened within the past two years and over 90 percent of recently-diagnosed women have locoregional breast disease.

Why Aren’t Women Screened?

One of the main factors preventing women in low- to middle-income countries from early breast cancer detection is the high cost of screening procedures. Core needle biopsy (CNB) is a common diagnostic procedure that allows doctors to test a sample of breast tissue from the area of concern. In high-income countries, doctors use efficient and expensive disposable CNB drivers for breast biopsies. Low-income countries often cannot afford the same expense, relying instead on reusable drivers. These drivers are easily contaminated and the cleaning process is extremely time-consuming and costly, rendering breast cancer biopsies unavailable to most women in developing countries.

Ithemba: Hope for Women with Breast Cancer

A group of Johns Hopkins undergraduates won a 2019 Lemelson-MIT Student Prize for their creation of a safe, low-cost, reusable breast cancer biopsy device. After learning of the unsafe and inefficient diagnostic methods in developing countries, the team of four young women set out to create a safe and cost-effective CNB driver. Their device is named Ithemba, the Zulu word meaning “hope.” the CNB driver is centered around increasing women’s access to early breast cancer diagnosis. The device’s disposable needle contains a chamber that traps contaminants and is easily sterilized with a bleach wipe, ensuring safe reuse. Ithemba is expected to last up to 20 years before replacement is necessary.

The Johns Hopkins students have conducted over 125 stakeholder interviews. They predict that within the first five years on the market, Ithemba will impact the lives of 300,000 women in developing countries. In May of 2018, the team filed for a patent and are now searching for low-cost manufacturing methods and finalizing estimated costs.

Valerie Zawicki, one of the four undergraduates on the team, insists that the location of a woman’s home should not determine her odds of surviving cancer. The mission of Ithemba is to give all women—no matter where they live—hope with the chance to fight and survive breast cancer.

– Sarah Musick
Photo: Wikimedia

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Kenya Eliminates Maternal and Neonatal Tetanus

Maternal and Neonatal Tetanus
The silent killer, otherwise known as maternal and neonatal tetanus, is a life-threatening bacterial infection in newborns and their mothers that is associated with nonsterile delivery and cord-care practices. Although it is vaccine-preventable, when tetanus develops, mortality rates are extremely high. This is especially true when the appropriate medical care is not available, which is often the case in low-income counties. In 1999, there were 57 countries where tetanus posed a considerable risk for women giving birth. Today, that number has dropped significantly, but maternal and neonatal tetanus remains a public health threat in 13 countries: Afghanistan, Angola, Central African Republic, the Democratic Republic of the Congo, Guinea, Mali, Nigeria, Pakistan, Papua New Guinea, Somalia, South Sudan, Sudan and Yemen.

Kenya has put in great effort to eliminate maternal and neonatal tetanus where it once was a common problem. The commitment the country made has drawn global attention and is inspiring other countries to do the same.

Kenya’s Initiative

As of 2018, Kenya has been removed from the list of countries that sees maternal and neonatal tetanus as a public health threat by attaining elimination status. Elimination is only attained when there is a reduction of neonatal tetanus incidences to below one case per 1,000 live births per year. Kenya’s progress towards achieving this important public health milestone began in 2001, proving that this process takes time. A pre-validation assessment took place in Kenya in September 201 by the Ministry of Health with the support of the World Health Organization (WHO) and UNICEF. A WHO-led validation process took place in 2018 to confirm the elimination of the disease.

Eliminating maternal and neonatal tetanus takes a lot of planning, and Kenya has set a great example. In 2002, Kenya introduced a five-dose tetanus toxoid vaccination schedule and in 2003, the country began to implement immunization campaigns in high-risk areas. Kenya also focused on providing free maternity services to increase skilled birth attendants. Over time, they began including tetanus toxoid vaccines into the routine antenatal care packages. Today, Kenya is still working on strengthening health facilities and resources and plans to provide free medical care to children under five years of age.

The involvement of schools is another factor that helped Kenya eliminate maternal and neonatal tetanus. Aliaphonse’s Katuit primary school is a prime example of the success seen from the campaign. Ann Talam, one of Katuit primary school’s teachers, explained in an interview with UNICEF that the campaign not only reaches members of the student body but also their sisters or relatives who may not attend school. Education ensures that all girls, even those from poverty-filled communities, are immunized.

Kenya’s Impact

Reducing deaths from neonatal tetanus is one of the simplest and most cost-effective ways to reduce the neonatal mortality rate. As of 2012, Kenya’s immunization coverage for newborns protected against tetanus reached 73 percent — and it continues to rise. WHO estimates a 94 percent reduction in neonatal deaths from 1988, when an estimated 787,000 newborn babies died of tetanus within their first month of life.

As Kenya eliminates maternal and neonatal tetanus, it has inspired the country to combat other diseases as well. They plan to identify the unreached and design an innovative approach to reach these populations with immunizations. On February 22, 2019, WHO representative, Dr. Rudi Eggers, addressed the recent measles outbreak in the country, attributing it to lapses in the routine immunization system since the previous measles and rubella outbreak in 2016.

“There is an urgent need for all stakeholders to come together and work to increase immunization coverage and address inequities,” Eggers said.

The Kenya campaign also aims to vaccinate nearly 14 million children between the ages of nine months and 14 years — nearly 40 percent of the population — for other common viruses.

Since Kenya’s elimination of maternal and neonatal tetanus, more than 153 million women around the world have been immunized with two or more doses of vaccines fighting against tetanus. The Eliminate Project, funded by the Kiwanis Children’s Fund, plans to learn from Kenya’s success and use it to inspire other countries to follow their lead. In 2018, The Eliminate Project raised a total of $502.282.72 to save and protect mothers and their babies worldwide.

Along with planning and taking initiative, Kenya recommends planning outreach activities for remote places, promoting delivery in health facilities and strengthening knowledge of health workers on the immunization schedule. Kenya sets an example of how small changes can overcome the silent killer of maternal and neonatal tetanus.

– Grace Arnold
Photo: Flickr

 

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Top 5 Facts About Women’s Health Care in Cambodia

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

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The Continued Fight to Improve Maternal Health in The Gambia

Maternal Health in the Gambia

Maternal health continues to be a concern in developing countries around the world. Although overall maternal mortality decreased by 44 percent from 1990 to 2015, many nations still have a long way to go if the goal of fewer than 70 deaths per 100,000 live births is to be reached by 2030. Of note, despite improvements, the maternal mortality in The Gambia remains one of the highest in the world, with 706 maternal deaths per 100,000 live births.

Maternal mortality is a reflection of the disparities between the rich and the poor, with 94 percent of all maternal deaths occurring in developing countries. The fact that 50 percent of The Gambia’s population lives below the poverty line contributes to the high rates of maternal mortality in the nation.

A majority of the complications that lead to maternal deaths are preventable or treatable. However, either because the mother is giving birth outside of a health care facility or due to a lack of supplies or expertise, the necessary care is not always provided.

The main causes of maternal deaths are severe bleeding, infections, high blood pressure and delivery complications. Other deaths are caused by malaria, AIDS and other diseases.

Contributing Factors

In The Gambia, the national maternal mortality ratio decreased by 46 percent between 1995 and 2015. This can, in part, be attributed to an increase in antenatal care coverage, as 86.2 percent of Gambian women now receive antenatal care from a skilled health professional.

For deliveries, however, only 57.2 percent take place in the presence of a skilled health professional. Most women deliver at home with a traditional birth attendant; the main barriers to giving birth in a health care facility being insufficient time to travel and lack of transportation.

Maternal health in The Gambia is further complicated by social and cultural factors that contribute to pregnancy complications and the low percentage of women who give birth at a health facility or with a health professional. A study done in rural Gambia found that there were four interrelated factors that impacted maternal health:

  • Pregnant women’s heavy workload
  • The gendered division of labor
  • Women’s inferior status in the household
  • Limited access to and utilization of health care

Women in rural Gambia generally work alongside their husbands on farms, a fact that does not change even with pregnancy. Gambian women described being physically and emotionally exhausted from physical labor in the field and the house, noting that they did not get sufficient rest at any point during their pregnancy.

This is connected to the way labor is divided between men and women, as women often work longer hours than their husbands, regardless of whether they are pregnant or not. Social practices prevent men from doing certain household chores while their wives are pregnant to allow them to get more rest, which contributes to poor maternal health in The Gambia.

The activities that women continue to perform can also have negative impacts. Women noted that they had to fetch and carry water from long distances, pick groundnuts and cook with firewood, all of which are health risks for pregnant women.

Additionally, women have less control than their husbands, largely because they are economically dependent on them. Despite doing equal work in the field and more work in the house, women receive no financial benefits. This keeps them from becoming economically independent and forces them to rely on their husbands, giving their husbands more power.

As a result, many women who wanted to stop working could not unless their husbands allowed it. They also could not make certain decisions, including where to give birth, without the oversight of their husbands, contributing to a lack of utilization of health care facilities. As women are often required to work up until they give birth, their workload prevents them from being able to travel to a health care facility in time for delivery.

Improving maternal health in The Gambia, therefore, is connected to women’s autonomy. In addition to improving access to health care facilities and ensuring adequate supplies are available, work needs to be done to ensure that families are educated about the dangers of working during pregnancy and that women have the ability to make decisions for themselves about where to give birth.

Improvement Efforts

Other efforts are also important to decreasing maternal mortality in The Gambia. Within the last decade, the Horizons Trust Gambia and The Gambian Ministry of Health partnered with an organization called Soapbox to launch the Maternal Cleanliness Champions Initiative aimed at reducing infections from childbirth.

One of the main projects of this initiative is the distribution of Clean Birth Kits, which include soap, a clean blade and a clean plastic sheet to help ensure that expectant mothers have sanitary materials regardless of whether they are giving birth at a hospital or at home.

The Maternal Cleanliness Champions Initiative also worked to create a manual for cleanliness standards at health care facilities in The Gambia, adapting the manual to work with the local context of each hospital. The program also supported the training of facility staff to ensure that they knew how to adequately clean to prevent infections and other health complications.

These important efforts need to be combined with others to form a holistic approach to improving maternal health in The Gambia. Only coordinated efforts that are adapted to cultural and social contexts will be successful in significantly reducing maternal mortality in the nation.

– Sara Olk
Photo: Flickr

 

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Strides in the Race for Vaccine Accessibility

vaccine accessibility
Vaccines are second only to clean water in reducing the rate of infectious disease. Vaccines prevent about 6 million deaths every year, and those that have been in use for decades show a 99 percent decrease in the rates of people contracting those diseases. Unfortunately, vaccines are not affordable for many people living in poverty throughout the world, making them much more vulnerable to infectious disease. Several factors contribute to the current lack of vaccine accessibility in many parts of the developing world. However, there are also significant improvements that are being made in decreasing the financial gap between those who receive vaccinations and those who do not, helping make vaccines more accessible to everyone.

The Current Situation

The price of the vaccine doesn’t always reflect the cost: People in developing countries are not only paying for the cost of manufacturing the vaccine, but also for expensive shipping costs, refrigeration, tariffs on imports, and taxes on medical supplies. These additional costs are often much more than the cost of the actual vaccine, and they make what would otherwise be an affordable vaccine inaccessible to a lot of people.

Clinic visits cost money too: In addition to buying the vaccine with all of its fees piled on top, people also have to pay to visit a clinic to receive these vaccines. The hours of health clinics are often inconvenient as well, forcing people to forgo wages from work in order to see a doctor.

Many vaccines require multiple rounds: A lot of vaccines, such as RTSS for malaria, MMR for measles and the HPV vaccine require multiple rounds of vaccination in order to be effective. This simply compounds all of the other barriers to vaccine accessibility; those receiving the vaccine have to pay for treatment again as well as take time off of work to visit a clinic.

Doctors are few and far between: In many parts of the developing world, there are very few doctors, and these doctors are limited in the number of patients they can treat each day. Therefore, even if one can afford to pay for the vaccine and can make it to a clinic, there is no guarantee that they will be able to be seen by a doctor.

Improvements to Vaccine Accessibility

Local health centers’ capacities are being strengthened: Gavi, a non-governmental organization dedicated to providing vaccines to the developing world, is working to strengthen the capacity of existing health centers to deliver immunizations. Gavi is working to increase the proportion of people who are receiving a full cycle of vaccines rather than “dropping out” after the first dose by providing sustainable funding to health clinics across the developing world.

Foreign aid decreases the price of vaccines: Providing foreign aid specifically for vaccines decreases the cost to those receiving treatment, and in turn, spares families from having to pay far more for treatment if someone contracted an infectious disease. Foreign aid for vaccinations has the highest return on investment of any type of aid besides education.

People are going beyond wanting to vaccinate to actually vaccinating: The Poverty Action Lab at MIT is implementing research on how to motivate people from desiring to vaccinate to doing it. This research is increasing the numbers of people receiving preventative immunizations in the developing world and reducing the rates of disease.

Infrastructures to keep vaccines cold for cheaper: The governments of Ethiopia and Gambia have created cold chain infrastructures in order to reduce the cost of transporting vaccines that need to be refrigerated. These infrastructures are far from perfect, as some cold storage facilities in Ethiopia have not been kept as cold as they need to be in order to protect the vaccines.

However, progress is still being made in reducing the cost of vaccines and allowing them to be more accessible to those living in poverty. Gavi is working to implement more cold chain infrastructures in other countries in Sub-Saharan Africa.

Moving Forward

There is clearly still a long way to go in ensuring vaccine accessibility to everyone who needs it, but a lot of progress has been made in breaking down the current barriers to accessibility. Vaccines are much cheaper than the cost of treatment for those who have the diseases vaccines aim to prevent, and investing in vaccinations relieves the world’s poor of the additional burden of treatment costs. Vaccines are one of the greatest assets in our toolbox to fight poverty, and great strides are being made in the effort to make accessibility a reality.

– Macklyn Hutchison
Photo: Flickr

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The Vietnamese Water Crisis

vietnamese water crisis
Vietnam, a southeastern Asian country whose coastline stretches 12 nautical miles, imminently struggles with providing clean water to those living there. The country has over 2360 rivers and about two-thirds of its population resides near one of Vietnam’s three water basins. Even so, most of this aquatic supply is unusable and undrinkable. The ongoing Vietnamese water crisis is so threatening that it is a focal point of national policy and international concern.

Background

Both government and industrial issues exacerbate the Vietnamese water crisis. Poor regulation coupled with irresponsible handling of waste has led Vietnam’s ponds, lakes, and canals to shortages and contamination.

In March of 2018, the Coalition for Clean Water and the Centre for Environment and Community Research released a report detailing how industry has altered the water quality in Vietnam. The report revealed that about 70 percent of waste released from industrial parks is directly released into the environment. These tainted waters carry dangerous chemicals and cause illnesses.

The World Bank’s estimations concerning the crisis show that it is no diminutive issue. The organization notes that rising threats against Vietnam’s water supply could reduce the nation’s GDP by six percent by the year 2035. Pollution presents itself as the biggest hazard to water basins, which drain into water outlets all over the country. In the most highly polluted areas, wastewater has poisoned the air to the point that it has become odorous and toxic.

Impacts of the Crisis

Those living in rural areas suffer the most from water sanitation issues. Only 39 percent of rural individuals have access to clean water. Furthermore, most of these individuals must use water wells that tap into underground aquifers to compensate for the lack of a clean water source at the surface.

The absence of clean water does not only deprive rural Vietnamese of their basic needs, but it also affects their ability to efficiently participate in the economy. Agricultural production is a precious monetary asset that takes up 80 percent of Vietnam’s water supply. The infrastructure needed to transport clean water to farms is unstable.

The Vietnamese water crisis has created national health issues, as well. The Ministry of Natural Resources and Environment estimates that up to 80 percent of diseases in Vietnam is directly caused by water pollution. Nearly six million citizens have contracted a waterborne illness, the most rampant being cholera, typhoid, dysentery, and malaria.

Impacts on Children

Children are the main concern for the international community as dirty water affects the growth and development of a new generation.

UNICEF reports that more than 9.5 million Vietnamese still release excreta into their surroundings, further contaminating the water supply. Children lack the matured immune system needed to fight off the problems generated by this unhygienic practice, such as diarrhea, pneumonia, and parasitic infection. Diarrhea is responsible for nearly 10 percent of the deaths of children under the age of five.

USAID Intervention in the Ha Lam Commune

USAID has routinely provided donations and grants to the Vietnamese government to solve humanitarian issues. A recent project launched on March 30, 2019, is aimed at assuaging the problems perpetrated by water pollution.

The project, called the Vietnam Local Works for Environmental Health, focuses on the Ha Lam commune in the Thanh Hoa province. Small scale water supply systems are currently being entrenched in the region to provide clean water to kindergarten, primary, and secondary schools. The new infrastructure is estimated to benefit over 20,000 individuals living in this northern province.

The Ha Lam commune, however, is not the only area where children are at risk. Education institutions in other parts of Vietnam are also in need of effective water supply systems, as more than 80 percent of schools around the nation lack fully operating water sanitation facilities.

Looking Ahead

Due to the awareness and concentration on the Vietnamese water crisis, it is possible that this problem will soon be overcome. By 2025, the Vietnamese government hopes to attain the clean water standards needed to revive an unhealthy public and a feeble economic production. Specifically, the government has launched a national plan directed at hindering the open defecation that so commonly contaminates the country’s water supply.

With six years to go until Vietnam’s standard is hopefully achieved, it is imperative that this issue remain persistent in the global mind. The government and participating groups must remain resilient through the growing population and industry in Vietnam that work to destabilize existing plans. Clean water is required if the human and environmental body is to exist comfortably.

– Annie O’Connell
Photo: Flickr