Archive for category: Health

Information and stories on health topics.

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Healthy Learners: Zambia’s School Health Program

Zambia’s School Health ProgramA Grade 4 pupil in Lusaka coughs during maths class. Instead of sending her home, a teacher, now a trained School Health Worker, opens a tablet, runs through a WHO‑style checklist, dispenses deworming pills, logs the visit and, if needed, fast‑tracks her to a clinic. The entire effort is part of Zambia’s Healthy Learners School Health Program and averages just $1.51 per child per year, which is less than 1% of what the Ministry of Education already spends per pupil.

The Poverty Trap: Preventable Illness = Lost Learning

Worm infections, vitamin A deficiency and other routine ailments quietly siphon school days and future earnings for Zambian children. Absenteeism forces caregivers to miss work too. By moving first‑line care into classrooms, Zambia’s Healthy Learners School Health Program targets that cycle where it begins: illness that keeps kids out of class.

Clinic in a Classroom: How the Model Works

Healthy Learners partners with the Ministries of Health and Education to train and equip teachers as School Health Workers. In 598 public primary schools, more than 5,300 teachers now use a mobile app (built with THINKMD). The app mirrors physician logic to triage, treat mild conditions (deworming, vitamin A, first aid) and fast‑track severe cases to clinics, plugging schools straight into the national health system.

The Numbers That Matter

  • Reach: More than 830,000 students served, about a quarter of Zambia’s public primary school population, with a goal of 2.2 million by 2028.
  • Health Gains: A study found a 38% drop in disease morbidity, a 48% jump in both deworming and vitamin A coverage, a 22% rise in health knowledge and a 52% reduction in the odds of stunting.

These improvements mean fewer sick days now and more substantial earning potential later.

Small Price, Massive Payoff

After an initial setup cost of $10 to $15 per child, the ongoing cost falls to about $1.50 thanks to economies of scale and government integration. That frugality is why Zambia’s Healthy Learners School Health Program is financially realistic for national ownership and replicable elsewhere.

In 2022, the Ministries of Health and Education signed an MoU to scale the program nationally, embedding data systems and training inside state structures. Spring Impact highlights this “design for integration” as the core reason the model can scale without ballooning costs.

A Call to Action

Zambia’s Healthy Learners School Health Program is a ready‑made template for any country where schools reach kids more reliably than clinics.

A child walks back to class, symptoms eased, lesson saved. Indeed, one tablet tap at a time, Zambia’s Healthy Learners School Health Program is proving that health in schools is one of the cheapest, most innovative ways to fight poverty.

– Arabella D’Aniello

Arabella is based in Toronto, Canada and focuses on Good News and Technology for The Borgen Project.

Photo: Flickr

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Vaccinations in Africa: How Gavi Advances Economic Development

Vaccinations in AfricaFor decades, Africa has faced a dangerous dependency: carrying some of the world’s highest disease burdens while producing less than 1% of its vaccines. This reliance on imports has long limited access to life-saving vaccinations in Africa, slowing responses to health emergencies and straining national development across the continent.

To reshape this narrative, Gavi, the Global Vaccine Alliance, is laying the foundations for a thriving, self-sustaining vaccine economy for the continent. Through continental partnerships, investments and innovations, the international organization created to ensure vaccine security is working to transform African health policy. The goal is to shift it from a long-standing area of weakness into a pillar of long-term economic strength.

Initiating Local Manufacturing

The COVID-19 pandemic exposed the risks of global supply chain disruptions and the weakness of economies reliant on vaccine importation. Many African countries struggled to access vaccines in the early rollout, sparking calls for regional self-reliance. In response, the African Union set a bold goal: to produce 60% of the continent’s vaccine needs locally by 2040, with Gavi central to achieving that ambition.

Through initiatives like the African Vaccine Manufacturing Accelerator, Gavi is shaping markets, lowering barriers and mobilizing funding to grow production capacity across the continent. More than 30 African vaccine manufacturing initiatives are now in motion, supported by a mix of government leadership and international investment. These efforts aim to build a sustainable, locally based supply of vaccines for routine immunizations. By producing vaccines within the continent, Africa is taking direct action to reduce its dependence on external sources and strengthen its resilience against future global health crises.

The strength of Gavi’s procurement and demand-forecasting models is crucial to growing an African vaccine economy. It allows local producers to see and rely on predictable, long-term vaccine demand figures. This crucial step sustains the development of a successful and relevant supply chain of vaccines within Africa, ensuring the local industries remain viable and successful as the continent builds to its 2040 goal.

Economic Growth Through Immunization

Gavi’s core mission of expanding access to immunization has driven development in Africa far beyond vaccine manufacturing. Vaccinations across Africa continue to deliver strong economic benefits, improving public health while boosting productivity and long-term growth. Healthier populations lead to fewer missed school days, lower health care costs and higher workforce productivity. According to Gavi, every $1 spent on vaccinations in Africa yields up to $21 in economic benefit through avoided illness, improved wages and long-term growth.

Since its inception in 2000, Gavi’s efforts have helped immunize more than 800 million children, averting more than 14 million deaths. In Africa alone, since 2000, coverage of the diphtheria, tetanus and pertussis (DTP3) vaccine across Gavi-supported African countries has increased from 52% to more than 70%. By building health systems around vaccine delivery, such as training workers, investing in cold chains and digitizing records, Gavi has strengthened public infrastructure in regions where such systems are often underfunded. This progress has not only saved lives but also helped countries make strides toward the Sustainable Development Goals.

Toward a Resilient Vaccine Future

A more secure future for African public health begins with Gavi’s support for the African Vaccine Manufacturing Accelerator. This initiative not only increases vaccine supply but also strengthens regional resilience against future pandemics. This resilience, however, is seen as only the starting point for an African vaccination economic sector. The developmental transition of African nations from Gavi support to self-financed immunization programs is hoping to create not just independence but also leadership in global health manufacturing.

In this vision, Gavi in Africa is more than a health initiative; it is an economic strategy, a security policy and a development model. As African-made vaccines begin protecting African communities, the continent moves closer to a future where health equity and economic strength go hand in hand.

– Tom Finighan

Tom is based in London, UK and focuses on Business and Global Health for The Borgen Project.

Photo: Flickr

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The Hidden Burden of Depression in Africa

Depression in AfricaDepression is a word that embodies profound pain, despair and societal stigma. Despite growing mental health awareness, mental illness remains misunderstood as a sign of personal weakness. The reality is that depression can lead to suicide, which claims more than 700,000 lives worldwide every year. Treatment-Resistant Depression (TRD), a subset of major depressive disorder unresponsive to at least two treatments, affects approximately one-third of depression sufferers, raising suicide risk and posing a global concern.

In Africa, the situation is particularly acute. The continent has the highest suicide rate in the world, at 11 per 100,000 people, compared to nine globally. It is estimated that more than 20 million individuals in Africa have depression, representing 9% of the global burden. North, West and Central Africa are particularly affected, grappling with fragile health care systems, conflicts, stigma and limited mental health services.

The Central African Republic (CAR) has one of the highest suicide rates worldwide, often linked to untreated depression. In contrast, Nigeria has more than seven million sufferers. Even in better-resourced countries like Egypt, Tunisia and Morocco, depression rates remain high.

Africa’s Mental Health Crisis

Mental health systems in Africa are underfunded. African governments allocate less than $0.50 per person annually to mental health. This is far below the recommended $2 per capita for low-income countries. In 2020, only 94 mental health outpatient visits were recorded per 100,000 people compared to 2,001 worldwide, indicating a lack of formal treatment access for most Africans with mental health issues.

In West and Central Africa, psychiatric hospitals are scarce and located in large cities. The situation is further complicated by conflicts in Mali, the Democratic Republic of Congo (DRC), CAR and Libya, where many health facilities have been destroyed or are difficult to access. On average, sub-Saharan Africa has just one psychiatrist per million people. Specialists are often concentrated in capitals or major cities, leaving rural populations underserved. Patients usually face long-distance travel costs to tertiary hospitals, which are cost-prohibitive for many and rely on general practitioners with limited psychiatric training.

Furthermore, antidepressants and psychotropic drugs are often out of stock or unaffordable for many patients. According to the WHO, more than 75% of people with mental disorders in low- and middle-income countries, including most of Africa, receive no treatment for depression. Second-line TRD treatments, such as atypical antipsychotics and dopaminergic drugs, are rarely stocked in public health facilities or private clinics in Sudan, South Sudan, Niger, Mali and CAR. Even in Nigeria, Uganda and Ghana, which have better health care infrastructures, access to these treatments remains limited to tertiary referral hospitals in major cities, with frequent shortages.

Initiatives Addressing Mental Health in Africa

Despite challenges, promising efforts are underway, from policy reforms to community-led interventions.

  • Policy Reforms. Several countries have begun updating policies to prioritize mental health. Nigeria, for example, passed its first national Mental Health Act in 2023, replacing the colonial-era lunacy law. The legislation aims to improve access to mental health services and protect patients’ rights. It includes the creation of a Mental Health Department within the Ministry of Health and integrating mental health services into primary care. The Act also prohibits discriminatory and outdated practices like chaining or arbitrarily detaining individuals with mental disorders.
  • Community-Led Initiatives. StrongMinds, an NGO operating in Uganda and Zambia, uses group interpersonal therapy led by trained lay counsellors to address depression, particularly among women in low-income communities. Since 2013, StrongMinds has treated more than one million people. Addressing untreated depression helps break cycles of poverty, food insecurity, trauma and disruption. Strongminds also works with governments and other NGOs to incorporate mental health services into food security, health care and education programs. It intends to expand across Africa over the next decade. The International Medical Corps (IMC) also plays a crucial role. In Mali, IMC supports more than 100 health facilities and mobile clinics across northern and central regions. The IMC provides primary and mental health care. It offers psychosocial support alongside services for gender-based violence and nutrition. In CAR, IMC provides mental health consultations through health centers and mobile clinics in underserved areas, trains local health workers and community leaders to support those in distress and publishes educational booklets on mental health. IMC also collaborates with National Ministries of Health and Community-Based Organizations, ensuring its integrated Mental Health and Psychosocial Support (MHPSS) efforts respond to crises and build long-term resilient communities.

Conclusion

Depression in Africa is not just a personal struggle but a public health emergency driven by limited funding, poor access to care and deep-rooted stigma. With suicide rates among the highest globally and millions untreated, the call for action is urgent. Expanding community care, improving mental health training and ensuring access to essential medications are critical.

– Juliette Delbarre

Juliette is based in London, UK and focuses on Global Health for The Borgen Project.

Photo: Flickr

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Ending Mother-To-Child HIV Transmission in Botswana

Mother-To-Child HIV TransmissionIn a landmark achievement for global health, Botswana has become the first country with a high HIV burden to earn the World Health Organization’s (WHO) prestigious Gold Tier certification for eliminating mother-to-child transmission (MTCT) of HIV. As of 2023, Botswana has reduced vertical HIV transmission rates to just 1.2%, with fewer than 100 babies born with HIV annually. This is a remarkable feat given the country’s previously severe HIV epidemic.

A Triumph Against the Odds

Botswana has long been one of the nations hardest hit by HIV/AIDS, with adult prevalence rates among the highest in the world. Yet, through committed public health efforts, the country has demonstrated that even in high-prevalence settings, eliminating new pediatric HIV infections is achievable.

The WHO’s Gold Tier status is awarded to countries that meet rigorous criteria for the elimination of mother-to-child transmission, including maintaining transmission rates below 2% and sustaining this achievement over time. Botswana’s attainment of this status is a testament to its effective health policies, strong political will and dedicated community programs.

Keys to Success: Universal Treatment and Comprehensive Care

Central to Botswana’s success has been the provision of universal free antiretroviral treatment (ART) to all pregnant women living with HIV. This policy ensures that pregnant women receive the medication necessary to suppress the virus, drastically reducing the chance of passing HIV to their babies.

Moreover, Botswana boasts high rates of antenatal care attendance and widespread HIV testing among pregnant women. Early diagnosis and continuous monitoring throughout pregnancy enable timely intervention and care adjustments, maximizing the chances of a healthy, HIV-free birth.

Complementing clinical care, robust community-based health programs have played a critical role. These programs provide education, support and follow-up services, ensuring that women stay engaged in treatment and adhere to prescribed regimens.

A Model for the World

Botswana’s achievement in reducing mother-to-child HIV transmission not only saves countless children from HIV but also offers a blueprint for other countries facing high HIV burdens. It challenges the notion that eliminating vertical transmission is unattainable in resource-limited, high-prevalence environments. The country’s success underscores the power of integrating free, accessible health care services with community engagement and strong political commitment. It also highlights the importance of sustained investments in maternal and child health programs.

While Botswana’s milestone is cause for celebration, continued vigilance is essential. Maintaining low transmission rates requires ongoing support for pregnant women, access to ART and community outreach. Indeed, Botswana’s experience demonstrates that with the right strategies and resources, the goal of an HIV-free generation is within reach, even in the most challenging settings.

As global health organizations and countries worldwide strive to eliminate pediatric HIV, Botswana stands as a beacon of hope, proving that with determination and comprehensive care, vertical transmission of HIV can be stopped.

– Meagan Beaver

Meagan is based in Zephyrhills, FL, USA and focuses on Good News and Global Health for The Borgen Project.

Photo: Flickr

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Combating Dengue Fever in Indonesia

Dengue Fever in IndonesiaDengue fever, a mosquito-borne illness, causes severe muscle and joint pain, nausea, vomiting and in extreme cases, death. This disease, often simply called dengue, is endemic in Indonesia, where it kills hundreds of people annually. Dengue cases spiked in 2024, forcing Indonesia to address the growing public health issue.

According to the Indonesian Health Ministry, nearly 250,000 Indonesians contracted dengue in 2024. The virus claimed 1,418 lives that year. Despite a swift government response that continues through today, dengue remains a serious public health threat. By examining how Indonesia is combating dengue fever in impoverished communities, we can also learn how to fight it in other countries.

How Dengue Fever Impacts Impoverished Communities in Indonesia

Mosquitoes easily infiltrate the porous, open housing common in Indonesia’s low-income communities, making it easier for dengue to spread. Families in these areas are also more likely to work outdoors, increasing their exposure to mosquitoes, unlike higher-income earners who often work in air-conditioned offices. Although Indonesian law mandates paid sick leave for all workers, including those with dengue, deaths still occur.

For struggling families, the loss of income from illness can be financially devastating and the death of a loved one brings intense emotional pain. Severe dengue cases often come with high out-of-pocket medical costs. When hospitalizations surge, public hospitals, relied on by low-income communities, can become overcrowded. This strains medical staff and reduces their ability to treat other life-threatening conditions, leading to increased deaths even when dengue itself is under control.

What Indonesia Did To Combat Dengue Fever in 2024

  1. Multisource Collaborative Surveillance. This sophisticated system enables public health professionals to collect and analyze diverse data sources. It allows for a more accurate prediction of where disease outbreaks, like dengue fever, may occur. This approach plays a critical role in Indonesia’s efforts to fight dengue, especially in low-income communities.
  2. Wolbachia Mosquito Technology. The government of Indonesia has begun using Wolbachia-infected Aedes aegypti mosquitoes that carry a bacterium that reduces the virus’s ability to replicate. This initiative is part of a broader government plan to achieve zero dengue deaths by 2030.
  3. The 3 Ms Program. The Indonesian government continues to promote this strategy as a practical way for communities to help control the spread of dengue. Citizens are encouraged to drain water containers regularly, cover water storage and recycle items that can collect standing water, which serves as a mosquito breeding ground.
  4. Vaccination. Indonesia has rolled out dengue vaccinations in local schools, targeting children as a key prevention group. Vaccination remains one of the safest and most effective ways to prevent severe dengue infections. The QDENGA vaccine, used in the country’s efforts, is developed by Takeda, a Japanese biopharmaceutical company with more than 70 years of industry experience.

Summary

Indonesia is tackling dengue fever in low-income communities through advanced technology and community-based solutions. From Wolbachia-infected mosquitoes and data-driven surveillance to school vaccinations and the 3 Ms Program, the country targets the virus and the conditions that allow it to spread. Though challenges persist, these efforts offer a practical model for other countries battling dengue.

– Jeff Mathwig

Jeff is based in Philadelphia, PA, USA and focuses on Global Health, Politics for The Borgen Project.

Photo: Unsplash

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Addressing Diseases Impacting South Africa

Diseases Impacting South AfricaIn 2023, data that the World Bank published showed that 55% of South Africans as living below the poverty line. Of those South Africans experiencing poverty, a 2023 national study found these citizens were twice as at risk of the communicable disease HIV. For the southernmost nation on the African continent, existing diseases are separated into two categories: communicable and non-communicable. Despite easy transmission of communicable diseases, 2019 World Health Organization (WHO) statistics show that non-communicable diseases account for 51% of all national deaths. With high prevalence rates of both infection varieties among those experiencing poverty, the stifling effects of Apartheid policy remain central within the national struggle to curb diseases impacting South Africa.

Communicable Diseases 

The three most prevalent communicable diseases impacting South Africa are malaria, tuberculosis (TB) and HIV/AIDS. Malaria mitigation strategies have been largely successful. In line with the 2021 Global Technical Strategy (GTS) for Malaria, WHO found that the number of South Africans at risk dropped to a low 10% of the population that same year. In South Africa, particularly the Kwazulu-Natal district, which contains one of the highest incidence rates of TB around the world, TB impacted 427 of 100,000 people in 2023. Positively, this incidence rate has fallen since 2021, where TB affected 512 per 100,000 citizens.

Following the United Nations (UN) AIDS 95-95-95 target, South Africa has also made promising strides in HIV/AIDS mitigation. Though 2023 figures show that 16.3% of South Africans are living with HIV, screenings and treatment have improved. Striving towards this 95-95-95 UN target, 94% of South Africans living with HIV knew their diagnosis, 79% were receiving treatment and 91% were being virally suppressed in 2021.

Non-Communicable Diseases 

The other half of diseases impacting South Africa are non-communicable diseases (NCDs) including cardiovascular disease, chronic respiratory disease, cancer and diabetes. In 2021, the collective incidence rate for these particular NCDs stood at 1,301 per 100,000 people. Obesity, which increases the risk for these NCDs, represents another health indicator impacting South African morbidity. Along with WHO’s other findings, it found that 30.8% of the adult population suffered from obesity in 2022, up from 2021.

Health System

The national healthcare system mainly initiates response to diseases impacting South Africa. The Department of Health’s inadequate health care response is typically pinpointed to policy carried over from the nation’s apartheid era. After the 1994 end to apartheid law, the government faced the ongoing challenge of restructuring the health care system. Despite this, the WHO has projected that 6.2 million citizens should experience universal health coverage by the end of this year. This number represents a steady, sharp increase from 2021 where only 1.8 million retained universal health care access. 

Impact of Poverty 

A 2023 study conducted with support from the South African government articulated that HIV, one of the most nationally prevalent communicable diseases, affects those living in townships twice as severely as those living elsewhere. Townships are South African neighborhoods inhabited primarily by those experiencing poverty. The study found that socioeconomic factors like access to stable housing and quality education do increase the odds of HIV infection and reduce the likelihood of access to testing and care. The researchers recommended a mitigation strategy that includes policy towards improving education and living quality.

Another national study from 2021 asserted that to address the reality of health care inaccessibility due to societal inequities, there needs to be cohesive efforts from multiple actors. The study calls on the necessity of both government and non-state intervention.

Doctors Without Borders

One international organization working diligently against the spread and prevalence of disease in South Africa is Doctors Without Borders (MSF). With the United States currently slashing its funding of South Africa’s TB and HIV/AIDS research programs, MSF has been vital in calling upon international donors, organizations and philanthropists to direct funds towards these life-saving research initiatives. Actors like the South African Department of Health and MSF rely on these funds to help develop promising vaccines and treatments for those experiencing these diseases impacting South Africa.

In addition to MSF’s TB and HIV/AIDS research, where funding is unsteady, it recently introduced a new project aimed at addressing South African NCDs. In collaboration with South Africa’s Department of Health, MSF has been training health care organizations across the Eastern Cape province of Butterworth. Reaching more than 1,500 people within the region, the project has increased the screening and medical management of NCDs like diabetes and hypertension.

Progress

Though funding cuts from the United States have caused uncertainty about the future of national research and mitigation response, strides in health care coverage and the involvement of organizations like the MSF are promising for the future of eliminating the diseases impacting South Africa. National initiatives for screening and improvements in treatment technologies have greatly improved and have been key in addressing and reducing incidence rates, particularly for the highly prevalent TB. In 2019 alone, testing for TB caused a 28% reduction in incidence.

With organizations and donors allocating funds towards national efforts to fight disease, South Africa will further mitigate the spread and prevalence of such harmful illnesses, particularly for those living in poverty.

– Piper Aweeka

Piper is based in Reno, NV, USA and focuses on Global Health for The Borgen Project.

Photo: Unsplash

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Addressing Mental Health in Guinea-Bissau

Mental Health in Guinea-BissauIn the small West African country of Guinea-Bissau, rich culture and strong tradition mask a growing crisis, mental health neglect. Among the most prevalent conditions are depression and anxiety, often left unaddressed due to systemic gaps and social stigma.

A System Without Specialists

As of 2017, Guinea-Bissau had zero practicing psychiatrists. The country’s ratio of just 0.13 doctors per 1,000 inhabitants falls far below global standards for basic health care. This shows that mental health support is almost absent from the primary care setting. Additionally, a screening of adults attending general health facilities in Guinea-Bissau revealed that at least 12% had a diagnosable mental disorder. This shows the urgent need for integrated mental health services in the nation’s fragile health system.

A baseline study found that general practitioners correctly diagnose only one in three patients, meaning that the people in Guinea-Bissau’s rural communities are unknowingly struggling with mental disorders. They carry a silent weight that forces them to push through each day with far greater effort than others, struggling in isolation just to survive.

Poverty and Psychological Strain

Things such as rising climate anxieties and pandemic poverty are worsening mental health in Guinea-Bissau. In 2021, the poverty rate was reported to have increased by 2.8 percentage points, adding an additional 80,000 poor. Research shows that mental illness reduces employment and therefore income.

Cultural Beliefs and Stigma

Mental health in Guinea-Bissau is often interpreted through a spiritual lens. Communities blame mental issues on things like curses and ancestral wrath. As a result, individuals often look down upon seeking help from medical professionals. Sixty-three percent of rural mothers go to the witchdoctor, and 65% believe that curses have the power to kill. While traditional healers play a vital role in this community, their methods can delay access to cures. Stigma remains a barrier to those suffering silently.

Lending a Helping Hand

This West African nation faces a mounting crisis that demands international attention. Every person deserves access to necessities like mental health care. Guinea-Bissau’s struggle is a global problem; poverty, trauma and neglect reflect broader challenges that low-income countries face worldwide.

Progression Efforts

Mental health in Guinea-Bissau is beginning to see a glimpse of hope in this landscape. International organizations such as the World Health Organization (WHO) have stepped in to support the country. Guinea-Bissau’s fragile health system has improved as groups are working to train general health workers in basic psychiatric care.

The NOVAFRICA Knowledge Center is working to strengthen health care in Guinea-Bissau through an inclusive and culturally sensitive approach. Its model brings together modern medical practitioners and traditional healers, including witchdoctors, to bridge trust gaps and improve access to care. By acknowledging and respecting spiritual traditions deeply embedded in the community, NOVAFRICA promotes the acceptance of modern medical practices and helps lay the groundwork for more effective health interventions, including in mental health.

The Path Forward

In collaboration with NGO VIDA, NOVAFRICA supported the launch of a community health insurance program that allows residents to pay affordable premiums in exchange for access to medical care, transportation and essential medicines. Though the country still lacks a national suicide prevention strategy, collaborative efforts between NGOs and local health authorities are laying groundworks for a future policy reform.

Guinea-Bissau’s challenges are steep, but the people are resilient. With continued international support and growing local engagement, the nation is taking its first steps toward a future where the silenced have a voice. Acknowledging, treating and respecting mental health is not just the goal, it is the path to a future defined by dignity and resilience.

– Marissa Schoth

Marissa is based in Benton, LA, USA and focuses on Technology and Global Health for The Borgen Project.

Photo: Unsplash

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Project HOPE: Improving Syria’s Health Crisis

Project HOPEThe end of the 24-year regime of Syrian president Bashar Al–Assad has led to the conclusion of a decade of civil war. It has also exposed major gaps in humanitarian and health care needs. Impacted areas across Syria are facing significant gaps in health care, nutrition, water supply, hygiene and sanitation. Specialized medical staff, essential medications, functional infrastructure and psychosocial support remain in short supply. At the same time, malnutrition, inadequate shelter and logistical challenges continue to hinder delivery.

In the middle of Syria’s health crisis, Project HOPE, in coordination with the Jordan Health Aid Society-International (JHASi), is delivering essential medical supplies and working with local partners to assess health and humanitarian needs. The team has identified shortages of medicine, basic medical supplies and staff. 

Problems Facing Health Care Infrastructure

Diseases, such as cholera and acute watery diarrhoea, are spreading due to Syria’s health crisis. According to Dr. Altaf Musani, the U.N. World Health Organization Director of Health Emergencies, more than 1,444 suspected cases of cholera and seven associated deaths have been recorded. He said, “We know that when cholera gets hold in camps, it can serve as a brush fire, increasing both morbidity and mortality.” He also warned that more than 416,000 children in Syria are at risk from severe malnutrition and that at least half of children under 5 suffering from severe acute malnutrition are not receiving treatment. Dr. Musani also noted that more than 50% of the maternity hospitals in northwest Syria have suspended operations due to underfunding since September 2024.

Dr. Musani said that Syria’s health crisis is partly because the country’s health facilities lack funding and face shortages of skilled workers and equipment. The war forced 50% to 70% of the health workforce to leave the country to look for other opportunities and the health infrastructure still needs investment.

The Impact of Syria’s Health Crisis

Syria’s health care system has undergone a lot of changes in the past decade. The conflict itself devastated the health care system due to loss of health infrastructure, systematic attacks on health care facilities and the mass exodus of health care workers. Parallel governance structures resulted in a fractured and inconsistent health care landscape. 

The full impact of Syria’s health crisis falls most heavily on vulnerable populations. Women in need of maternal care face restricted access to maternal health care facilities. Children experience disrupted vaccine schedules and a shortage of pediatric care. Refugees and internally displaced people lack even basic medical services. Older individuals and people with chronic conditions experience inconsistent access to necessary medications, which intensifies preventable health complications. 

HOPE in Syria

Project HOPE delivered the first nonprofit shipment of medical supplies to southwestern Syria with the support of JHASi and the Al Yusr Charity Organization. The shipment included essential medicine and medical supplies for more than 5,000 people. This part of the country had previously been inaccessible to aid organizations following the end of the Assad regime, contributing to Syria’s health crisis.

Project HOPE has been operating in southern Syria and has assessed 13 hospitals and medical centers in the Daara and Suwayda Governorates since mid-December to identify the greatest health needs. The assessment found significant gaps in health care, nutrition, mental health support and water, hygiene and sanitation services. “Southern Syria desperately needs humanitarian attention, including food aid, health sector support, clean water and mental health care services, particularly for vulnerable groups like women, children, older adults and people with disabilities,” said Laith Salman, Project HOPE’s Team Lead in Syria.

Looking Ahead

Project HOPE has made accomplishments in the field by working to relieve the complications caused by Syria’s health crisis. “A large portion of the population is experiencing trauma, depression and anxiety due to the effects of war. While there are efforts from NGOs to provide mental health and psychological (MHPSS) support, there is a significant lack of trained mental health professionals, specialized facilities and MHPSS programs in the area to help those suffering from the psychological aftermath of decades of conflict,” says Laith Salman. Syria will require continued support from NGOs to recover from its post-conflict health crisis. Project HOPE is one example of an organization providing ongoing assistance to help address the impact of the conflict.

– Abirame Shanthakumar

Abirame is based in Markham, Ontario, Canada and focuses on Global Health for The Borgen Project.

Photo: Flickr

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How Telemedicine in Sierra Leone is Improving Health Care Access

Telemedicine in Sierra LeoneSince the civil war, the health care system in Sierra Leone has suffered immense destruction, the infrastructure is lacking proper medical supplies and trained personnel, and the country is still struggling with infectious diseases like malaria and HIV/AIDS. Sierra Leone has among the lowest life expectancy rates in the world.

Most Sierra Leonean people live in rural areas (55%). This poses an inconvenience when it comes to reaching medical care, which is mainly available in urban areas, considering the deteriorated road and railway networks.

About Telemedicine

Telemedicine has emerged in the last decades to bridge the gap of health care access for difficult-to-reach areas around the world as well as for individuals who struggle to meet appointments by providing medical attention from a distance using electronic devices. This innovation can range from teleconsultation, where the patient can express symptoms to their doctor through a laptop, to telesurgery, where a surgeon uses robotic technologies to perform a surgery on their patient remotely.

The use of telemedicine in Sierra Leone could be a game-changer for the health care system.

Mobile Health

In 2011, when health workers and traditional birth attendants received phones, SIM cards, solar panel powered battery chargers and a virtual private network as well as proper training on how to use them, they reported a significant improvement in health care access in the Bombali district.

Health workers called their clients to remind them about appointments and inform them about the arrival of their medicine. Instead of regular in-person meetings, which could be challenging for patients living far from health facilities.

People started utilizing health services more after the provision of cell phones, and the remote communication with the health workers strengthened the clients’ trust and notified them of the workers’ availability and the need for another visit. The health workers’ phone reminders encouraged their clients not to miss their appointments.

The cell phones not only reinforced communication between the health workers and their clients but also between health workers themselves, they called to inform each other about the delegation of duties as well as the schedule of meetings and activities. This stronger collaboration has eased the decision to refer ambulances, which then led to timely arrivals of ambulances and the rescue of urgent cases.

Remote Patient Monitoring

Remote patient monitoring has significantly changed the healthcare system around the world, but particularly in countries that lack access to health establishments and social health specialists in rural areas.

The Sierra Leone Telemedicine Network has been operating since 2009 and has allowed patients in rural areas, otherwise deprived of proper care, to receive at-home consultations through their digital devices, like desktops or cell phones, without having to travel long distances.

This monitoring technique usually involves the use of wearable devices that measure the patient’s vital signs from a distance.

A recent study in Sierra Leone used wearable gadgets capable of measuring the heart and perspiration rate of hospitalized patients with Lassa fever remotely. Though most of the data was discarded for poor quality, indicating the need for funding to enhance the effectiveness of these devices.

Health Care Initiatives

Several initiatives have been made to alleviate the struggle of health care access for the civilians of Sierra Leone. The Minister of Health Dr Demby has inaugurated the first nationwide Health Train Campaign earlier this year. It aims to travel to all districts of the country to study the available health care resources, identify the needs and supply civilians with immediate and adequate medical attention. It seeks to follow the “Life Stages” design so that people at different stages of life, whether children, young adults, pregnant women, elderly people, receive the appropriate care they need.

In 2010, UNICEF, launched the Free Healthcare initiative (FHCI), which offered pregnant and lactating women, children under the age of 5, disabled people and Ebola survivors with free medical care and supplies in the hopes to combat the abnormally high mortality and morbidity rates among these vulnerable groups in the country.

The Rural Health Care Initiative has worked diligently to strengthen healthcare access in Sierra Leone’s rural areas. It provides medicine and transportation for patients, medical attention to expecting mothers and their newborns, malaria diagnoses and immunizations for children and help grow the country’s agricultural system by cultivating sustainable food and supporting farmers.

Conclusion

Telemedicine in Sierra Leone has played a huge role in improving healthcare, enhancing health worker performance, strengthening the relationship between the healthcare providers and the patients, delivering timely and accurate higher quality care and bridging the gap towards receiving medical attention for people living in rural, hard to reach areas. Although the current infrastructure available in Sierra Leone consists of many obstacles for telemedicine, the evolution of the healthcare system is a slow work in progress.

– Yasmine Belabed

Yasmine is based in Algeria and focuses on Technology and Global Health for The Borgen Project.

Photo: Flickr

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Schistosomiasis in Angola: A Local Strategy With Global Impact

Schistosomiasis in Angola: A Local Strategy With Global ImpactSchistosomiasis in Angola continues to pose a major threat to public health- especially for school-aged children in rural, water-reliant communities. Caused by parasitic worms that infect humans through contact with contaminated freshwater, schistosomiasis can lead to fatigue, anemia and developmental delays. With more than 90% of districts at risk, Angola faces one of the highest burdens of this neglected tropical disease (NTD) in sub-Saharan Africa.

To combat this issue, Angola’s Ministry of Health, backed by the World Health Organization (WHO) and nongovernmental organizations (NGOs) such as The MENTOR Initiative, has implemented an innovative, school-based response. These campaigns provide mass deworming treatments using praziquantel, reinforce hygiene education and promote access to clean water and sanitation. This integrative model not only lowers infection rates but also improves school attendance and overall child development.

Understanding the Disease Burden

“Children are especially vulnerable as they play in the water and often don’t understand the risks,” a local health worker based in the Huila, Huambo and Zaire provinces told The Borgen Project in an interview. “We saw many children with swollen bellies and constant fatigue. Now, after regular deworming and hygiene education, those symptoms are much less common.”

Schistosomiasis in Angola has long plagued rural Angola, where many communities depend on rivers and lakes for everyday activities such as bathing, washing and even drinking. According to WHO, chronic schistosomiasis can lead to liver and kidney damage, cognitive delays and an increased risk of school absenteeism. Recent mapping by The MENTOR Initiative reveals a troubling overlap between schistosomiasis and other parasitic infections like soil-transmitted helminths (STHs). This dual burden is particularly pronounced in Angola’s south-central provinces, where more than 70% of school-aged children are at risk.

School-Based Campaigns: A Scalable Solution

Angola’s Ministry of Health, in collaboration with WHO, has responded with mass deworming campaigns centered around schools. “We coordinate with teachers and school staff,” the health worker explained. “They help us organize the children and explain the treatment to them in simple terms.” Parents are also engaged through community meetings, which help build trust and transparency around the medication process. These campaigns utilize praziquantel, the WHO-recommended drug for schistosomiasis treatment. In addition to being safe and affordable, praziquantel is effective with a single dose and is ideally suited for distribution in school settings.

According to a six‑year impact assessment of Angola’s school‑based deworming program, schistosomiasis monitoring covered nearly 600 schools between 2015 and 2021, revealing persistent transmission in multiple provinces. As a result, soil-transmitted helminth-endemic regions received deworming treatments, hygiene supplies and health education. These combined efforts have led to improved child health outcomes and increased school participation. Studies show that deworming enhances children’s physical well-being and “It’s not just about treating the disease, it’s about giving these kids a better chance at life”, the local source tells The Borgen Project.

Hygiene Education and Infrastructure

The success of deworming programs in Angola depends on an integrated approach. Medication alone cannot stop the cycle of reinfection, especially in rural areas where poor sanitation and limited access to clean water drive continued transmission. To address this, school-based campaigns include hygiene education that teaches students proper handwashing, safe defecation and how to avoid contaminated water. Schools also act as community hubs, spreading these practices to families. Some schools receive additional support through partnerships with NGOs and government agencies, gaining improved facilities like latrines, handwashing stations and water filtration systems.

WHO highlights that combining water, sanitation and hygiene (WASH) measures with deworming efforts can reduce transmission by more than 75%. This underscores the importance of holistic strategies for lasting impact.

Data-Driven Targeting

Disease mapping has played a critical role in Angola’s national response to schistosomiasis and soil-transmitted helminths (STHs). In collaboration with Angola’s Ministry of Health, the MENTOR Initiative conducted large-scale parasitological surveys across all 18 provinces. These surveys, involving more than 1.6 million school-aged children, used stool and urine sampling along with geospatial tools to determine prevalence rates and identify high-risk transmission zones.

The mapping results allowed for the strategic targeting of mass drug administration (MDA) campaigns, ensuring that treatment was concentrated in areas with the highest disease burden. By using prevalence thresholds recommended by WHO, Angola was able to tailor the frequency and intensity of treatment to the needs of each province. In addition to guiding the delivery of preventive chemotherapy, the data also support long-term monitoring, policy decision-making and evaluation of program impact.

Challenges and Local Resilience

Despite efforts, schistosomiasis in Angola continues to face several operational and infrastructural challenges. Limited access to clean water and adequate sanitation facilities in many rural areas contributes to persistent reinfection rates. Even with periodic MDA, the lack of improved WASH (Water, Sanitation and Hygiene) infrastructure undermines sustained disease control.

The program is also constrained by logistical difficulties such as inconsistent medicine supply chains and a shortage of trained personnel for implementation and monitoring. Regardless, integration of the deworming program into the existing school-based health system has helped optimize outreach and reduce costs. Capacity-building initiatives for local staff, as well as coordination with multiple stakeholders, including the Ministry of Education and international partners, have strengthened the program’s delivery and laid the foundation for more sustainable control efforts.

A Model Grounded in Elimination, Not Just Control

Angola’s approach mirrors a growing call in public health to shift from reactive control toward proactive elimination of schistosomiasis. As emphasized in Frontiers in Public Health, long-term success requires more than drug distribution; it depends on a systems-thinking model that integrates treatment with behavioral change, hygiene, snail control and environmental improvements.

By using schools as delivery platforms, Angola addresses multiple layers of disease transmission- medical, educational and ecological. This multifaceted approach offers a replicable blueprint for other countries. “The key is to involve the community and combine treatment with education and clean water,” the local health worker explained. “It’s not enough to give medicine- you have to change the environment and the habits. Angola’s model is working here and I believe it can help others, too.”

Health, Education and Hope

The integrated approach to fighting schistosomiasis in Angola demonstrates how local solutions, when grounded in data, education and community engagement, can spark meaningful change. With continued investment in health systems and infrastructure, the country is not just treating a disease but empowering a generation of children to learn, grow and thrive.

– Vasara Mikulevicius

Vasara is based in West Bloomfield, MI, USA and focuses on Global Health for The Borgen Project.

Photo: Flickr