Information and stories on health topics.

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Mental Health in Palau

Mental Health in PalauPalau is a small country in the western Pacific Ocean and one of the first west-pacific islands that people settled, specifically those from Southeast Asia. It is a relatively isolated area surrounded by the ocean, with most of its islands lying within a large, extensive lagoon. With about 17,600 people, there is a great sense of community on the island, the people well-known for their hospitality and welcoming nature. Although the island is very healthy with a great ecosystem and marine environment, and the people have created a strong, invigorating community, mental health in Palau is still unstable due to the lack of specialized care.

The Facts 

Depression affects 5.2% of Palau’s adult population, including 6.7% of young adults and 6.5% of elderly adults suffer from depression. This makes up about 920 people out of Palau’s entire population. To put this into perspective, 5.2% of the United States of America’s population is about 16.3 million people.

Anxiety affects 4.3% of adults, 10.5% of young adults and 4.3% of elderly adults suffering from anxiety. Anxiety is significantly more prevalent in young adults compared to any other age group. 4.3% of Palau’s population is about 760 people.

About 2.3% of adults in Palau suffer from suicidal ideation, being significantly more prevalent in young adults. Meanwhile, about 8.5% of young adults and 0.6% of elderly adults suffer from suicidal ideation. Palau also has a high rate of schizophrenia, according to the National Library of Medicine.

Links Between Poverty and Mental Health

While it is often hard to recognize, depression and anxiety have a huge influence on a person’s work ethic. Depression often leads to a lack of motivation, exhaustion, careless attitude and reclusive tendencies. This behavior can prevent a person from keeping a job or pursuing a career, leading a person towards financial issues, and if not helped, can cause a person to slip into poverty.

Anxiety also creates challenges that affect work ethic. Anxiety tampers with energy, concentration and sleep. Oftentimes, it is difficult to make a decision or pay attention to the task at hand, lowering a person’s quality of work. Anxiety may also prevent a person from attending work due to fear of commitment or embarrassment. Similar to depression, this can manifest financial instability and lead to poverty.

Schizophrenia, among all other mental health conditions, is one of the most connected mental illnesses to poverty. A big part of this is due to schizophrenia’s impact on a person’s social life, such as reclusive behavior, trouble communicating and negative effects on social cognition, making employment a difficult task.

Those with poor mental health are more likely to have addictions to drugs and alcohol, another major influence on poverty due to low work performance and work ethic. While poor mental health can be a leading cause for poverty, oftentimes poverty is the cause of poor mental health, increasing stress and hopelessness, often resulting in social rejection and loneliness, making it hard to re-establish financial stability.

Lack of Services

As the country is small and isolated, accessible mental health care is sparse. Psychology is an ambitious field to pursue, and there are only so many people on such a small island who have the ability or desire to join a career in psychology. The further from the main island, the less the population, which further decreases the number of people who are interested or knowledgeable about mental health.

While it is difficult to pinpoint the exact number of behavioral health care professionals in Palau, an interview in 2019 of 17 health care professionals showed that there was only one in behavioral health care.

Current Solutions

Since 2008, when the United Nations Development Programme (UNDP) signed a Standard Basic Assistance Agreement, the UNDP has strengthened health systems, helped address the impacts of COVID-19 and rehabilitated three community health centers. These produce positive influences on mental health in Palau through the creation of stronger, more reliable health centers and helping those who COVID-19 impacted get back on their feet.

UNICEF Pacific Islands heavily focuses on children’s education and health care. It originated in 1997 and has made strong efforts to help children lead a good life. It helps not only Palau but also the entirety of the Pacific Islands. UNICEF Pacific Islands provide mental health assistance in emergency settings, and is working to integrate mental health into education and have established the Global Coalition for Youth Mental Health.

Since Palau gained its independence in 1994 and established diplomatic relations with the United States of America, the U.S. has provided a lot of government and economic assistance. Currently, the United States provides financial aid through the Compact of Free Association (COFA), which can be used to fund health care systems, education and take care of Palau’s architecture and environment, crucial for Palauans’ mental and physical health.

Looking Ahead

With the current help of these organizations and Palau’s already thriving community and healthy environment, the people can continue to improve and stabilize mental health through community support, providing a sense of belonging and safety that encourages people to speak out and advocate for mental health in Palau.

– Sevyn Whatley

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

Photo: Unsplash

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Vaccine Coverage in Malawi Goes Solely Solar

Vaccine Coverage in MalawiIn 2010, the World Health Organization (WHO) approved the first solar direct-drive (SDD) refrigerators. It transformed how vaccines are stored in rural, remote areas worldwide. The Gates Foundation assisted in funding and supporting the spread of this innovation in Malawi; with the help of other organizations like UNICEF and Gavi, the Vaccine Alliance, WHO installed this in all 29 district-level vaccine storage facilities.

SDD Refrigerators

SDD refrigerators are solar-powered devices used to store vaccines at the proper temperature. Before the introduction of SDD refrigerators, earlier models were less reliable and more costly. Ice-lined refrigerators, which had been used for more than 20 years, were considered the most economical option.

Alongside absorption refrigerators and water-pack freezers, people found these units less efficient than solar-powered alternatives. They operated using gas, kerosene or batteries, which required frequent replacement and incurred high operational costs.

SDD Fridges in Malawi

Remote areas such as Malawi have been the top priority for the Gates Foundation due to their previous reliance on gas-powered refrigerators. Around 40% of community health clinics in Malawi are not on the electrical grid, making costly and outdated refrigerators their only option.

However, in 2015, Malawi received its first grant to implement only a few SDD fridges. After about three years of reliability, Gavi and UNICEF helped fund the installation of about 600 more in 2018. Since then, Malawi has replaced all gas and battery-powered fridges with solar-reliant fridges.

SDDs proved to be successful and sustainable. It is cutting carbon dioxide emissions significantly and giving cold chain managers the ability to track the maintenance of each refrigerator to confirm it is at the proper temperature. The equipment is also long-lasting and reliable, creating a concrete solution for Malawi.

Vaccine Coverage in Malawi

In addition to improving storage, Gavi and UNICEF are trying to bridge the gap between urban and rural access to vaccines. These organizations have specifically targeted communities with high rates of zero-dose children and developing equity-focused programming in collaboration with local governments.

The Expanded Programme on Immunization (EPI) from UNICEF shows that “across all antigens, Malawi is missing approximately 10% of children, with a significant portion of these zero-dose children in urban areas.” Providing adequate staff to recognize these patterns and advise immunization can catch these concerns promptly.

Impacts

According to Gavi, vaccine coverage in Malawi has shown impressive progress compared to a decade ago. This advancement has been supported by substantial funding and the availability of trained professionals in both rural and urban clinics, enabling effective vaccine storage and distribution.

Inclement weather is another factor in vaccine storage strategies. Malawi is particularly prone to extreme weather events such as cyclones and floods. When Tropical Storm Ana struck in 2021, significant damage was caused to the hydroelectric system, resulting in widespread power outages across the electrical grid. In previously vulnerable rural areas, health workers successfully kept vaccine doses cold using SDD refrigerators. At the same time, they had to move facilities relying on electricity-powered to avoid spoilage.

As a result, cold chain managers began re-evaluating the effectiveness of electric refrigerators compared to solar-powered ones. They transferred all vaccine doses from urban centers to more remote storage facilities. Solar refrigerators became the standard due to their strength and durability. 

Conclusion

The benefits of SDD fridges are vast, including bettering the environment and lowering long-term medical equipment costs. Cold chain management has taken a step in the right direction, with the Gates Foundation and more creating the possibility for success in countries like Malawi.

– Rachael Wexler

Rachael is based in Chicago, IL, USA and focuses on Technology and Global Health for The Borgen Project.

Photo: Unsplash

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Strengthening Systems: Reaching Zero-Dose Children in Chad

Zero-Dose Children in ChadAccording to global location-based data from 2019, approximately 10.37% of children in Chad had not received the first dose of the diphtheria, tetanus and pertussis (DTP1), routine vaccines. This placed Chad among those with the highest rates of zero-dose children aged less than 12 months.

Zero-Dose Children in Chad

In 2021, the United Nations Children’s Fund (UNICEF) identified Chad as one of the top 20 countries where more than half of the world’s zero-dose children reside, with a 27% prevalence rate. In 2022, health data estimated that 188,500 children in Chad remained unvaccinated. The highest concentrations were found in the rural north, areas affected by conflict and within nomadic communities.

Around 80% of the population lives more than five kilometers from the nearest health facility, making access to routine vaccination especially difficult. Unqualified personnel and poor supervision during immunization efforts further widen this gap. These issues are compounded by ongoing challenges related to supply chain disruptions. The overall demand for routine immunization remains low and awareness-raising measures utilizing communication methods have not been effective.

Coordinated Responses and Interventions 

WHO, UNICEF and Gavi, the Vaccine Alliance, developed the Reaching Every District (RED) strategy to support the activities and interventions. The plan consists of five operational components: planning and managing resources, engaging with communities, conducting supportive supervision, monitoring and using data for action and reaching all eligible populations.

Chad is a vast country with a low population density, which presents a significant challenge in delivering immunization services. To address this, partner organizations supplied 32 vehicles and 250 motorcycles to health centers, improving access to remote and hard-to-reach areas. Similarly, in collaboration with UNICEF, the Ministry of Health allocated an immunization strategy tailored for major urban centers. The Bill and Melinda Gates Foundation supported the preparation of communication plans in seven provinces, including training 5,000 village chiefs and community health volunteers in the Lake region.

Furthermore, supported by Gavi, 235 new nurses and paramedics were recruited throughout regional hospitals in nine provinces to expand access to healthcare. WHO trained health workers in 40 districts and health teams in 28 districts. In 2021, the PEV Manager smartphone app was introduced to strengthen service delivery, enable feedback and improve supervision.

Despite various challenges, Gavi’s collaboration with the Ministry of Health enhanced funding by establishing a restructured project management unit. Disbursements were accelerated by implementing streamlined procedures and utilizing mobile money systems wherever feasible while maintaining strong financial accountability. Effective financial management was a key driver of these achievements.

Cold Chain Equipment Optimization Platform

A major barrier in Chad’s immunization efforts was the lack of reliable cold chain infrastructure to preserve vaccines. This issue was addressed through the Cold Chain Equipment Optimization Platform (CCEOP), a collaborative initiative designed and funded by Gavi. UNICEF manages procurement and logistics, WHO provides technical guidance and the Ministry of Public Health leads implementation. With support from partners, the Ministry of Health expanded cold chain capacity nationwide, achieving coverage of more than 90%.

As part of this effort, a health facility map was developed to identify regions with high population density and limited infrastructure, helping prioritize locations for solar-powered cold chain equipment. By 2022, 1,506 health care facilities previously identified as lacking sufficient cold chain coverage were distributed 1,527 units of cold chain equipment, including freezers, refrigerators, coolers, generators and solar panels. With an approximate 70% increase in cold chain coverage since 2017, these efforts significantly improved access, reaching around 96% by 2022.

Triple Vaccine Launch

Chad’s Expanded Program on Immunization (EPI) marked a milestone by introducing three vital new malaria, pneumococcal and rotavirus diarrhea immunizations. Chad was one of the first countries to launch three essential vaccines simultaneously as part of its EPI. Chad took a comprehensive approach to roll out the new vaccines effectively. This included updating immunization policies, integrating vaccines into distribution plans and preparing detailed rollout strategies.

The country also trained health workers, strengthened cold chain infrastructure, engaged communities in raising awareness and established supervision and performance monitoring systems. Chad positioned itself as the 14th country to implement the malaria vaccine nationwide, aligning with the WHO’s goal of reducing malaria-related mortality by 90% by 2030.

Health experts estimate that the pneumococcal vaccine could prevent up to 5,000 deaths per year by safeguarding children from life-threatening bacterial diseases. Rotavirus caused more than 40% of pediatric diarrhea hospitalizations in Chad and contributed to infant mortality before its introduction. The rotavirus vaccine addresses this essential public health issue, advancing Chad’s national vaccination program to protect children from preventable and life-threatening diseases.

Between 2019 and 2022, coverage of the DTP1 dose increased from 89.63% to 98.84%. During the same period, completion of the full three-dose series (DTP3), a key indicator of immunization system performance, rose from 50% to 60%.

Conclusion

Chad is a compelling example of how effective collaboration and technical support through strong communication and coordination networks can drive meaningful change. These efforts significantly strengthened the Ministry of Health services at both national and local levels. As a result, many supervisors and health workers were revitalized and empowered to deliver more effective and responsive care to zero-dose children.

– Imge Tekniker

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

Photo: Pexels

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How Living Goods is Saving Lives in Sub-Saharan Africa

Living GoodsSub-Saharan Africa is the region of Africa located south of the Sahara Desert. The area has a population of 1.3 billion and a vivid culture dating back thousands of years. However, a 2019 study showed that 35% of the region’s population lives in poverty. Destitution often leads to adverse health, primarily due to poor living conditions and a lack of complete nutrition, resulting in further exacerbated conditions. Despite all these challenges, many contrasting forces have risen to make the lives of Africans easier. One of these initiatives is Living Goods, a nonprofit that employs community workers to deliver patient healthcare services. It started its operations in Uganda and has since spread its wings to Kenya and Burkina Faso.

The Story of Living Goods

Established in 2007, Living Goods is the brainchild of businessman Chuck Slaughter. In 1987, Slaughter’s interest in creating social impact was sparked by a newspaper article about the microfinance organization Trickle Up. Eager to make a difference, he gained employment in the company as a program officer, visiting India, Nepal and Indonesia, where he saw firsthand how small-scale entrepreneurship could change lives.

After earning his Master’s degree at Yale, Slaughter took his business acumen to the travel industry, launching TravelSmith. This mail-order travel gear company skyrocketed to $100 million value in sales. After the company was bought in 2004, a chance encounter stumbled Slaughter onto The Health Store/CFW shops, a chain of franchised drug stores in Kenya. Intrigued by the idea of bringing healthcare directly to underserved communities, he envisioned a new model that empowered community health workers to deliver essential care right to people’s doorsteps.

Use of Technology

Living Goods integrates its services with technology to provide the best utilities. Each community health worker has access to a mobile app that helps them organize their daily tasks and responsibilities. It also includes information on what treatments to provide, eliminating the need for hefty medical training and allowing the charity to employ as many workers as possible.

The app also allows patients to connect with nearby workers and call on them for a service. This system addresses citizens’ medical needs, especially in countries like Uganda, where the NGO operates, where there is only one doctor for every 25,000 people, far below the recommended ratio of one healthcare professional per 1,000 individuals.

Programs

Living Goods boasts several programs, including vaccinations, healthy pregnancies and emergency response to outbreaks. Using their health app, community workers can track what children need immunizations and who are up-to-date. The software also sends mothers reminders when their children’s vaccinations are expiring. Community workers also help educate parents. After Living Goods’ vaccination program started in 2019, more than 80% of parents stated that they gained new knowledge about immunization from their employees.

Living Goods community health workers regularly go on home visits for pregnant women. They aim to make sure future mothers attend all necessary antenatal check-ups and deliver their babies in healthcare facilities. They play a key role in early pregnancy identification, provide maternal health and nutrition education and enroll women to receive automated text messages with timely, pregnancy-related guidance.

During the Ugandan Ebola outbreak of 2022, Living Goods took many preventive measures to ensure the virus didn’t spread further. The nonprofit conducted specialized training sessions for field staff and community health workers to identify Ebola symptoms and implement prevention strategies. Workers also received SMS notifications every two days, reinforcing key information about the virus. It also gave out protective equipment such as soaps, gloves, aprons and masks to areas facing the highest exposure. Living Goods also created and delivered more than 110,000 leaflets regarding the virus to increase public awareness.

Final Remarks on Living Goods

Living Goods is making a real difference in healthcare across sub-Saharan Africa. The organization helps deliver essential services directly to people’s homes by equipping community health workers with simple digital tools. Its efforts have expanded access to care in areas with limited medical infrastructure. With a focus on practical solutions and local impact, Living Goods is helping build healthier futures in some of the region’s most underserved communities.

– Mustafa Tareen

Mustafa is based in Lahore, Pakistan and focuses on Global Health and Celebs for The Borgen Project.

Photo: Flickr

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The Fight Against HIV/AIDS in Fiji 

HIVAIDS in FijiFiji, an archipelago made up of 300 islands and 540 islets in the Pacific Ocean, has declared an HIV outbreak after the alarming spike in cases over the last few years. According to experts, “since the first reported case in 1989, HIV-1 incidence in Fiji has increased by about tenfold, from 0.7 per 100,000 in 2000 to 7 per 100,000 in 2021. While this increase is largely due to improved diagnostic capacity, it is also suspected to reflect a growing epidemic.” Here is more information about HIV/AIDS in Fiji.

Causes

The Fijian Health Ministry credits the rise in HIV/AIDS cases in Fiji to illegal drug usage. There are two particular practices that are said to have caused the spike in cases, which are “bluetoothing” and “chem-sex.” However, others believe that the rise of cases is due to the lack of funding and research in HIV/AIDS as a whole. According to an EastAsiaForum article, “before 2012, they used a combination prevention approach to HIV. Funding had ramped up in 2008 through the HIV and STIs Regional Response Fund… [but] in 2013, the HIV Regional Response funding ended.” This may have played a significant role in the spike of HIV/AIDS cases in the Fijian Islands. 

Financial Implications

The HIV/AIDS outbreak has not only severely impacted the health of Fijians but also their finances and quality of life. Fiji’s increasing rates of urbanization, which have caused homelessness and unemployment, have also contributed to the HIV/AIDS epidemic in Fiji. Additionally, a large part of Fiji’s economy is reliant upon tourism, as they are still recovering from COVID-19. A reputation hit that could come from this outbreak would be detrimental to the Fijian economy, which would likely make the spread even worse, as it is disproportionately affecting those who are economically struggling.

Responses to the Spike

In January 2025, Fiji announced a 90-day containment plan that will guide the nation’s AIDS response until 2027. This is the start of the prioritization of HIV research in Fiji and helping the most vulnerable among the population get the treatment they need. However, there is still the underlying concern that some people who are HIV positive in Fiji are not aware of their status, and those who are too afraid to receive the care that they need due to prejudice and the stigmatization of the condition. Minister Lalabalavu, the minister of Health and Medical Services of Fiji, says that “discrimination and stigma will only serve to make our current situation worse.”

In order to combat this, there are many movements to increase education on HIV/AIDS in hopes of increasing knowledge and reducing stigma, such as the HIV Surge Strategy 2024-2027 that the Fijian government has endorsed. The focus of the strategy is based on intersecting issues that contribute to the rise in HIV cases, such as prevention, treatment, harm reduction, human rights and social justice. Additionally, it plans on coordinating public health responses due to the presence of hard drugs within the Fijian community.

Government Intervention

UNAIDS Deputy Executive Director Jan Beagle said, “The most effective results can only be achieved through partnership across sectors, through strong leadership, and with community at the center. By taking AIDS out of isolation, the impact can go far beyond the AIDS response.” Displaying that this issue has become a government issue, and due to this the government has given Fijian $FJ200,000 for its HIV/AIDS Prevention and Control Programme, a program that targets the prevention of drug use in underprivileged communities as well as destigmatizing testing centers and HIV itself, in the 2023-2024 budget and is only adding more every year to combat this crisis.

Looking Ahead

While the outbreak of HIV/AIDS in Fiji has extremely affected the country’s population, the increasing awareness towards this issue has allowed them to fight back and take control over their health. However, it is still important to continue raising awareness towards this topic. HIV/AIDS disproportionately affects Fijians that come from low-income communities, and the lack of knowledge has made the spread worse. Therefore, continued efforts are essential to ensuring that these people get the education and support they need to slow the spread. 

– Sydney Carr

Sydney is based in San Diego, CA, USA and focuses on Global Health for The Borgen Project.

Photo: Unsplash

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Diseases Impacting Peru

Diseases Impacting PeruPeru is a Latin American country well known for its gastronomy and fantastic tourist destinations. However, the fact that so many people want to travel to Peru is one of the reasons why so many countries have started evaluating the risks for their nationals. For instance, the CDC in the U.S. emitted an alert and report on several diseases impacting Peru that someone might get when visiting. In that report, they ask people to be careful about where they stay and what they eat.

Some of the diseases listed are strongly rooted in poverty and lack of resources. This means that with proper help, information and resources could be minimized and stop being a threat to Peruvians and tourists. Here is information about the diseases impacting Peru.

Dengue

One of the most known diseases impacting Peru is dengue. According to the Pan-American Health Organization (PAHO), Peru is the Latin American country with the highest fatality rate. Before 2024, Peru had between 4,698 and 68,290 cases per year. However, in 2024, Peru experienced a sudden increase of dengue cases, rising to 273,847 people infected according to the Peruvian Ministry of Health. Dengue is a viral infection transmitted through mosquito bites. Not all mosquitos bring dengue, but it is impossible to identify when one does. Dengue is highly present in communities with fewer resources. The lack of clean water distributed through pipelines makes people store it in open containers, which according to the Peruvian government, is the environment where the Aedes Aegypti mosquito lays down its eggs. Towns with heavy rain are even more vulnerable to dengue outbreaks.

Malaria 

Another mosquito-borne disease, malaria, while not as deadly as dengue, is still a problem the country is trying to tackle as fast as possible. The Peruvian Health Ministry declared malaria as an endemic disease impacting Peru, especially in certain areas of the jungle because of the presence of still water combined with biological materials. Peru has around 17,000 cases of malaria per year, closing 2023 with more than 22,000 reported cases.

According to the UNDP, malaria and poverty correlate; globally, malaria affects lower-income tropical towns and agricultural areas, especially if they do not have the proper resources to prevent the mosquitos from laying eggs, which requires the purchase of certain pesticides to prevent those mosquitos from growing up. Low-income households, especially farmers, do not have the budget for the right pesticides, insecticides or even the protective clothes necessary to prevent malaria. On the other hand, the United Nations Development Program explains how malaria not only is barely impossible to prevent for low-income households, but the treatment from the sickness drives families into poverty.

The Peruvian government already started implementing and funding programs to accomplish its objectives of reducing malaria by 90% by 2030. The “Eliminemos la malaria” plan started in 2022, and since then, the government allocated resources to take the following actions:

  • Capacitate and educate medics and nurses in the furthest regions of the country
  • Provide proper equipment and tests 
  • Provide treatment medicines
  • Monitor constantly the use of these resources

The Peruvian government reported a decrease in the number of cases of malaria in six regions of the Latin American country, all happening in just the first years of the program. Certain regions like Junín reported a decrease of 84%, while others like Amazonas decreased by 24%.

Typhoid 

Typhoid is a type of infectious disease that people catch when ingesting contaminated foods or water. It is mostly present in places without access to clean water and proper sanitation when handling foods. The Peruvian government reported that more than 3 million Peruvians do not have access to drinkable water and more than 6 million to not have access to sewers.

Typhoid is a disease impacting Peru that is directly related to poverty and the Peruvian government is working to address it by providing proper information on how to handle foods. The Peruvian government does not prepare a report solely on typhoid, but it includes it in a report for intense diarrheic disease, in which it had reported approximately 2,345 cases per year.

Tuberculosis

A disease that according to the Peruvian newspaper Peru21, is considered “the sickness of the poor.” Tuberculosis is mainly spread when people spend a lot of time in an indoor space. In Peru, approximately 30,000 people get tuberculosis every year. Thankfully the Peruvian government is taking measures to increase the early detection and avoid it from spreading. Peru is doubling the number of molecular detection equipment nationwide, which will speed the process for labs. The executive director of the tuberculosis department announced at the same time that her department will be conducting regular checkups in vulnerable areas, focusing on markets, to detect early tuberculosis outbreaks in towns far from cities.

The Bright Side

Since several of these diseases impacting Peru are strongly related to poverty, fighting them also means improving the living conditions for vulnerable towns. Several nonprofits are already trying to improve sanitation and bring freshwater to towns. The nonprofit Prisma, which originated in 1986, dedicates its existence to fighting inequality in vulnerable towns. It has implemented several projects to fight diseases that mosquitos transmit.

Water for People is another big nonprofit that has been working to bring fresh water to rural towns since 2008. So far, it has worked with regional governments to bring almost 100% fresh running water to three districts: Cascas, Asunsión and Reque. Lastly, Water.org has been working hard in Peru since 2013, it focuses on lending money through partner institutions so that several communities can access toilets, sanitary installations and water tanks. So far, it has been able to improve sanitation for more than 5 million Peruvians in addition to providing clean water.

Government Investments

At the same time, the Peruvian government is working hard to prevent the spread of several diseases, such as malaria, tuberculosis, typhoid and dengue, by informing people on how to avoid them and with early detection tests. By investing in equipment that is being brought to different clinics around the country, the idea is to decentralize the testing process of detection, making results available at a faster rate for local governments to react. The Peruvian health ministry is launching several campaigns, bringing volunteers and medics to markets around the country for regular tests on vulnerable populations, hoping that the early detection and training of communities will reduce the spread of these diseases impacting Peru.

Helping improve the living conditions of towns will not only save lives but at the same time improve the security for tourists from everywhere and reduce the chances of these diseases impacting Peru to impact other countries that never faced them.

– Luis Felipe Rios

Luis is based in Miami, FL, USA and focuses on Global Health and Politics for The Borgen Project.

Photo: Unsplash

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Raising Awareness of Mental Health in Antigua and Barbuda

Mental Health in Antigua and BarbudaEveryone knows that mental health is just as important as physical health. That does not change the fact that mental health encounters neglect concerning overall health and well-being. Antigua and Barbuda, similar to other small Caribbean island nations, faces unique challenges in conversations focusing on mental health due to limited resources, stigma and lack of awareness. However, the government and various organizations, such as the World Health Organization (WHO) and the Antigua and Barbuda Association of Mental Health Counsellors Inc. (ABAMHC), have created public awareness campaigns and taken the steps necessary toward improving mental health in Antigua and Barbuda.

The majority of people with mental health challenges in Antigua and Barbuda are diagnosed with schizophrenia, schizoaffective disorder and depression. In 2007, only three male patients and one female patient made any visits to one mental hospital for psychiatric treatment, meaning a large number of Antigua and Barbuda citizens lived untreated. Data collected presents assessments and treatments for 174 outpatients through primary health care centers. Out of 174 patients, 114 (66%) carry schizophrenia and other related disorders, 23 (13%) mood (affective) disorders, and 8 (5%) other mental illnesses. In addition, people with mental disabilities are more likely to experience poverty. Social support groups, health care, jobs and education are not easily accessible to impoverished families to provide for the members, specifically children and adolescents, who require extra care.

Health Institutions

Care for mental health in Antigua and Barbuda is severely underdeveloped and primarily focused on confinement rather than treatment. The placement of individuals diagnosed as neurodivergent, someone whose brain processes information differently, in improperly trained health institutions, unfortunately, led to a crisis across the region, where mental health conditions proceed without formal examination, resulting in several people living without necessary care.

In addition to undertrained health institutions, there is one mental health hospital named Clarevue Psychiatric Hospital. Surprisingly, the Clarevue Psychiatric Hospital is the “sole mental health care facility in Antigua and Barbuda,” with enough space for 130 patients who are 18 years old or older. Similar to other health facilities, Clarevue Psychiatric Hospital was “ill-equipped to satisfy the mental health needs of the country.” 

Authorities and mental health specialists, like Health Minister Sir Molwyn Joseph, are stepping up to create a supportive environment for Antigua and Barbuda residents. Plans and programs are underway to construct new mental hospitals and provide appropriate training for mental health professionals. Thankfully, local leaders are passionate and persistent about positively changing other people’s lives by providing support and resources.

“When I reflected, back in 1998, I made [an] appeal…, so you can see the level of urgency,” Joseph said.

Effects of Poverty on Mental Health

Studies indicate that poverty significantly impacts mental well-being economically. Poverty and mental health in Antigua and Barbuda are intertwined as poverty leads to social stresses and trauma, and mental health can lead to impoverishment resulting in a cycle of hardships to access basic needs such as food, housing and healthcare. According to the United Nations Children’s Fund (UNICEF), 18% of Antigua and Barbuda citizens lived in poverty, and 5% were indigent in 2016. Compared to the remainder of the Eastern Caribbean, Antigua and Barbuda has a lower poverty rate than the average of 23%.

Economic hardships disproportionately affect children and adolescents. The poverty rate for children between the ages of zero and 17 is 24%, and for adolescents, it is 25%, which is higher than the rate of 16% for adults ages 18 years or older and the overall rate of 18.4%. The higher percentage among the younger population signifies an urgent call for social and economic policies to improve living conditions for vulnerable groups.

Mental Health Crisis Among the Youth

Experienced psychiatrists have expressed concerns about the mental health among the youth. “In a 2021 report showing that nearly 20 percent of teenagers in Antigua and Barbuda between the ages 13 and 15 had seriously considered taking their lives.”

Dr. Chenelle Joseph, a psychiatrist who has worked with the mental health challenges of the younger generation, has witnessed a growing mental health crisis in Antigua and Barbuda, with increasing reports of suicide idealization and mental health disruptions like depression, bullying and anxiety.

To lower the percentage of teens idealizing taking their lives, a new initiative to amplify community stability and address ascending suicide rates will launch in Antigua and Barbuda. Antiguan-born psychotherapist and former United Nations official Jamion Knight will introduce the Mango Bucket Project, the country’s first suicide prevention hotline to relieve the pressures of modern life of individuals in the Caribbean islands.

“If persons and communities across the country could make a small contribution to improving the mental fitness and resilience of the nation, we can collectively transform the lives of thousands of people who are facing significant and crushing pressures daily,” Knight said.

Mental Treatment Act of 1957

On February 7, 2025, the National Youth Parliament Association of Antigua and Barbuda (NYPAAB) hosted a debate to tackle the Mental Treatment Act of 1957, a 70-year-old piece of legislation that was enacted in various countries, including Antigua and Barbuda, to regulate the treatment and care of people with mental health conditions.

Several government officials have voiced their opinions on the Mental Treatment Act of 1957 and criticized it as insufficient for managing modern questions in mental health care services. Prime Minister Marver Woodley, Attorney General Christal Percival, and Speaker of the House Jessica Zouetr reconsidered the context of current comprehension of mental health and utilized their voices to lead some countries to call for reforms that better align with mental health care practices and rights. 

Mental Health Awareness

While the challenges to improving mental health in Antigua and Barbuda still exist, the collective efforts of the community, government and organizations signal a positive shift toward a more supportive mental health landscape. The nation’s ability to shine through as it navigates these difficulties together reminds everyone that they are not alone in their struggles.

As Antigua and Barbuda pushes forward, the need remains to maintain an environment where mental health is prioritized and celebrated. The road toward healing is bumpy, but the community strides toward a healthier, happier future with every development. The story of the mental health crisis in Antigua and Barbuda is one of hope, compassion and unwavering strength of the human spirit from which all beings should learn.

– Makayla Johnson

Makayla is based in Clayton, NC, USA and focuses on Good News and Technology for The Borgen Project.

Photo: Freepik

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Sickle Cell Disease in Tanzania

sickle cell disease in TanzaniaSickle cell disease has been a part of life in sub-Saharan Africa for more than 8,000 years, accounting for approximately 6.4% of under-five mortality, according to the World Health Organization (WHO). Sickle cell disease affects between 8,000 and 11,000 infants in Tanzania each year, with six out of every 1,000 children born carrying this genetic “time bomb”.

Without early diagnosis and consistent treatment, up to 90% of these children may not survive past their fifth birthday. To address this, Texas Children’s Global Hematology-Oncology Pediatric Excellence (HOPE) and Baylor College of Medicine Global Health have launched a low-cost program to combat sickle cell disease in Tanzania.

What Is Sickle Cell Disease?

According to the National Institutes of Health (NIH), sickle cell disease is a genetically inherited blood disorder that affects hemoglobin. Hemoglobin is the protein that binds with oxygen in red blood cells as they travel throughout the body. Generally, red blood cells resemble crimson frisbees, gliding through the blood vessels to various organs and tissues. Upon arrival, they distribute oxygen and carry carbon dioxide from the tissues to the lungs for exhalation.

When a person has sickle cell disease, their red blood cells morph into a crescent shape, resembling a traditional farming tool called a sickle. As they become crescent-shaped, the hemoglobin often hardens, causing the blood cells to turn rigid. The sickled cells can then get caught in the vessels, blocking blood flow and causing severe pain.

Causes and Symptoms

These malformed cells are caused by a gene mutation inherited from parents who are both carriers of the recessive gene. According to the NIH, symptoms can develop as early as five or six months. These symptoms usually include yellowing of the skin or the whites of the eyes, often called jaundice and icterus, respectively, extreme tiredness or fussiness and painful swelling of the hands and feet.

As the affected children age, the symptoms begin to intensify exponentially. The NIH states that common symptoms found in sickle cell patients are severe pain events often referred to as “pain crises” or “vaso-occlusive crises,” fatigue, shortness of breath, irregular heartbeat and chest pain, among other abnormalities. Many of these occur when the sickled cells block the blood flow and restrict oxygen delivery to the rest of the body. Most commonly, this is the catalyst for the pain crises, which occur sporadically and can continue for multiple hours or even days.

Global HOPE and Baylor College of Medicine

Texas Children’s developed the Global HOPE program in 2017 to improve the survival of children with cancer and blood diseases in Africa. Its mission is to accomplish this by leading patient care, education and research to equate survival rates to those of the United States (U.S.). Through its Global Health collaboration with Baylor College of Medicine, the organization has become one of the largest distributors of pediatric HIV care on the planet. Its global programs aim to decrease health disparities and provide creative, forward-thinking solutions for improved care and survival rates.

In January of 2025, with the support of Bristol Myers Squibb, a global biopharmaceutical charitable organization, Texas Children’s and Baylor College of Medicine announced that they would be tackling the devastating threat of sickle cell disease in sub-Saharan Africa. The program will begin by rolling out interventions and treatments for sickle cell disease in Tanzania and Uganda. According to the Texas Children’s website, the interventions it has planned are economically advisable and have proven histories of success. They have been implemented in Western countries, often known for leading medical innovation, since the 1980s, with initial pilot trials also returning impressively positive results in Africa. The interventions are just as simple and effective in controlling sickle cell disease in Tanzania.

Prevention and Treatment

For infants, screening and immunizations will be administered. Screening is often done in newborns by pricking the infant’s heel and recovering a blood sample on a lab card. A lab then uses tests such as high-performance liquid chromatography, capillary electrophoresis and isoelectric focusing to separate and identify the components of the sample and attempt to detect the presence of abnormal hemoglobin proteins. Once a sickle cell has been identified in a child, Texas Children’s and Baylor College of Medicine plan to provide a daily penicillin pill for five years due to the increased susceptibility to bacterial infections such as pneumococcus. This will be administered orally until the child is five years old and should prevent the development of bloodstream bacterial infections.

Finally, they also plan to administer a daily dose of hydroxyurea, an oral medicine approved in 1998 by the U.S. Food and Drug Administration for treating sickle cell disease. Hydroxyurea has been found to prevent pain crises and hospitalizations for children. It does so by maintaining the circular flexibility of the red blood cells, allowing easier flow and oxygen delivery throughout the body. This will come as a big win in a country such as Tanzania, where access to health care, especially for children, is extremely limited due to high rates of multidimensional poverty, an unequipped infrastructure and a lack of access for rural populations.

Conclusion

The work of Texas Children’s Global HOPE and Baylor College of Medicine’s alliance has already proven to be successful in the work they have done in HIV and AIDS prevention and treatment. Their work to detect, educate, treat and research has lofty goals of emulating their success in the U.S. With the determination they have brought to the medical world thus far, their initiative provides a hopeful future for all children struggling with sickle cell disease in Tanzania.

– Jacob Christopher

Jacob is based in Granite Falls, NC, USA and focuses on Good News and Global Health for The Borgen Project.

Photo: Pixabay

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Diseases Impacting Vietnam

Diseases Impacting VietnamVietnam is known for its beautiful landscapes, rich culture and an unfortunate, challenging history. After years of war, Vietnam has become one of the fastest-growing economies and has seen the poverty rate decrease to below 4% in 2023. With one of the most successful implementations of universal healthcare in Asia, Vietnam hopes to see more than 95% of its population covered by health care by the end of this year.

The government has also committed itself to increasing the coverage of low-income and marginalized groups in the country’s more rural and mountainous regions. These areas, which are higher in poverty than the larger cities, see the biggest impact when it comes to diseases, as many in these rural areas see lower income rates, which cause people to have health care bills they cannot afford. However, Vietnam continues to make improvements to the health care system and now boasts a life expectancy rate of 2.4 years higher than the world average. However, due to lifestyle changes and limited health care access in some regions, there are still many diseases impacting Vietnam, including communicable diseases like dengue fever, measles and influenza, as well as rising rates of noncommunicable diseases such as cancer, cardiovascular disease and diabetes.

Infectious Diseases 

With a tropical climate, diseases impacting Vietnam include many communicable diseases, such as dengue fever, which the country has had continued struggles with over the years. There were more than 114,000 reported cases of dengue fever in 2024, which is less than half of previous years, such as 2019 and 2022, when the country saw epidemics of dengue fever. In September of 2024, the country rolled out a dengue fever vaccine, Qdenga, which was dispersed in a vaccine drive in more than 200 health centers, in the hopes of slowing future breakouts of the disease.

Vietnam has also experienced several measles outbreaks over the years, which has affected mostly younger children, including an outbreak in 2024, where there were more than 7,500 confirmed cases. These cases have been mostly concentrated in the southern part of the country and attributed to a lack of children being vaccinated in these regions. The government continues to push for greater measles vaccination campaigns to curb outbreaks in these susceptible areas. The VNVC or Vietnam Vaccine Joint Stock Company donated 500,000 doses of the vaccine to be distributed throughout the country. These vaccination campaigns originally targeted for young unvaccinated children ages 1-10 but was expanded to include 6-9 month old children in early 2025. In total, 45 provinces have deployed vaccination campaigns with 28 of them having already completed the first phase.

Noncommunicable Diseases 

As the country sees an increase in urbanization and lifestyle changes, it is also seeing an increase in noncommunicable diseases such as cancer, cardiovascular disease and diabetes. NCDs are still the leading cause of death in Vietnam, with these diseases causing 77% of deaths. The rise in these NCDs is primarily due to an aging population and an increase in unhealthy diets and a lack of exercise. The country has seen a steep rise in inactivity in adolescence, and records show that more than 50% of the female population are overweight. These factors have contributed to a steep rise in diabetes in Vietnam, especially undiagnosed diabetes. With larger cities and more sedentary lifestyles, if not appropriately addressed with methods such as prescreening, and a push for healthier communities, the increase of diabetes could pose a significant risk to the population. 

Looking Forward 

The government has made a lot of progress over the years concerning its population’s health. With more access to health care than ever before, the country’s health should continue improving. However, diseases impacting Vietnam remain a challenge, especially as the rate of urbanization increases dramatically in Vietnam. This brings along accompanying problems, like air pollution, environmental changes and lifestyle changes. If not properly addressed, these issues can lead to the continued rise of cancer, cardiovascular disease and diabetes rates. However, the government plans to expand universal health care and reform health care centers across the country.

A new law concerning health care in the country is set to start July 1, 2025, which will expand the number of health care facilities that citizens can use, along with other changes, such as moving patients with rare or advanced diseases to higher-level facilities without prior approval. The country still has a ways to go, but currently, it is on a steady path to improving public health by reducing the rate of infectious diseases and providing more people nationwide with health care. 

– Collier Simpson

Collier is based in Savannah, GA, USA and focuses on Global Health for The Borgen Project.

Photo: Flickr

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4 Facts about Hunger in Qatar

Hunger in QatarThe State of Qatar is a small country located on the Qatar Peninsula in the Middle East, neighboring Saudi Arabia on its southern land border and surrounded by the Persian Gulf on all other sides. Since gaining its independence from Britain in 1971, Qatar has been a constitutional monarchy. It is a desert nation with a small population of 2.6 million, 99.4% urban, with only 1.1% of its land arable. Its economy is driven largely by its natural gas and oil reserves. 

Despite its strong economy and high per capita income, Qatar still faces issues related to hunger. Here are four facts about hunger in Qatar.

Qatar’s Global Rankings

In 2024, Qatar ranked 30th out of 113 countries in the Global Food Security Index (down from 13th in 2019)—an international database that considers quality, affordability and availability of food. However, while Qatar is ranked 9th in availability and 21st in affordability, it is only 47th in quality and safety and 51st on sustainability and adaptation. Some of its weakest indicators are lack of a national policy or strategy to empower women farmers, extent of agricultural research and development and extent of disaster risk management. Qatar could not be comparatively ranked on the 2024 Global Hunger Index because of a lack of available data on undernourishment. But on the other GHI indicators related to hunger, the country’s statistics are very low: 6.2% of children under 5 stunted and 1.5% wasted, and 0.5% of children who die before their fifth birthday. 

Dependency on Imported Food

Agriculture is a challenge in Qatar because of the arid climate, sandy soil and scarcity of water. Qatar therefore has imported 90% of consumed food, with imports providing as high as approximately 80% of the demand for perishable crops. 

Qatar’s Large Migrant Worker Population

Qatar is home to a million person, mostly Asian, migrant work force, which is 95% of its total labor force, with half of these workers in construction. The high COVID toll in Qatar five years ago left many migrants jobless, and hungry. Subsequently, the FIFAWorld Cup 2022, hosted by Qatar, exposed “the vulnerabilities of and abuses faced by low-paid migrant workers and migrants in general.” During this same period, the Canadian-based Migration and Food Insecurity in Cities of the Global South project (MiFood Project) expanded its Hungry Cities Partnership research network to additional countries, including Qatar. This was a three-year project focused on migrant workers and food security. 

Success and a New Strategy to Increase Food Security

Qatar’s successful National Security Strategy 2018-2023 strengthened Qatar’s food security infrastructure, with enhancements in cultivated areas, production capacity, and food marketing systems, as well as addressing climate change. Building on this success, in January 2025, Qatar announced its National Food Security Strategy 2030 to secure food supplies by significantly increasing local food production and making Qatar 55% self-sufficient in vegetable production, 100% self-sufficient in fresh chicken and dairy by the end of the decade, and 80% for fish and 30% for red meat. 

Overall, hunger in Qatar is relatively low due to the country’s general prosperity and the government’s diligent efforts to improve food security. While the nation’s geographic location means the threat of food still exists, the country’s forward-thinking and proactive efforts are addressing this threat.

– Staff Reports

Photo: Wikimedia