Archive for category: Health

Information and stories on health topics.

, ,

Elderly Poverty in the Bahamas

Elderly Poverty in the BahamasFor 400,000 permanent residents, life in the Bahamas is anything but a breezy Caribbean vacation. In 2019, Hurricane Dorian unleashed 180-mile-per-hour winds on Abaco Island and Grand Bahama. The storm ruined more than 13,000 homes to rubble and displaced nearly 30,000 people, affecting the elderly as well. Here is some information about elderly poverty in the Bahamas including what some are doing to address the health and sanitation challenges due to Hurricane Dorian.

Elderly Poverty in the Bahamas

The ageing population in the Bahamas has increased in the past few decades, driven by falling fertility rates and rising life expectancy. Over the next 25 years, the number of adults 65 and older in the Caribbean will double. This demographic shift could strain the economy as fewer people and those currently employed near retirement enter the workforce. Older adults also face diminishing job opportunities and employment discrimination, trapping them in cyclical poverty.

According to the World Health Organization (WHO), population ageing, coupled with unhealthy lifestyles, will lead to a surge in non-communicable diseases like hypertension, Alzheimer’s, cardiovascular disease and cancer. Medical costs associated with NCDs can account for one-third of an individual’s total spending. Older adults, who are more susceptible to contracting NCDs, often cannot bear the cost of treatment.

The Impact of Hurricane Dorian on the Elderly

Around the time of Hurricane Dorian, Bahamians in this age group, of which 7.2% live below the poverty line, struggled to stay afloat while paying exorbitant medical and home restoration bills. Organizations like Project Hope and Mercy Corps sent volunteers to the islands to provide necessary aid, which helped address elderly poverty in the Bahamas.

The Category 5 storm overwhelmed hospitals with sick and injured patients. The storm also left hospitals short of medical staff and equipment as water-borne illnesses ravaged the community, meaning the immuno-compromised elderly and those suffering chronic ailments were unable to receive adequate care.

The Guardian reported that more than 60,000 islanders needed food and clean drinking water. Mercy Corps delivered portable water to communities affected by contaminated aquifers. In partnership with ocean production organization Mission Resolve, Mercy Corps installed a water treatment plant to clarify the water of toxins and salt. These efforts not only met the immediate needs of Bahamians, young and old, in critical condition but also served as a testament to the strength and resilience of the community.

Looking Ahead

Rebuilding the lives and providing dignity for older and impoverished Bahamians whose lives Dorian upended is an ongoing project that will cost the government and homeowners millions, if not billions, of dollars. The former deputy prime minister, Peter Turnquest, estimated that about 45% of Grand Bahama and Abaco Island homes were severely damaged or destroyed in the storm. Restoring these buildings will be especially burdensome for the elderly and impoverished.

Safeguarding the rights of older people and those experiencing elderly poverty in the Bahamas is possible and paramount. Advocates suggest implementing policies that will address old-age problems. Some are already active in the Bahamas, including its Financial Assistance for Payment of Utilities and Purchase of Basic Household Items. Implementing more legislation like this will make strides toward promoting and protecting the wellness of older Bahamians as they continue to pick up the pieces of an island landscape still reeling from Dorian. 

– Natalie Kaufman

Natalie is based in Orlando, FL, USA and focuses on World News for The Borgen Project.

Photo: Flickr

, ,

3 Facts about Diseases Impacting Sudan

Diseases Impacting SudanSudan is a country in Africa and ranks among the poorest countries in the world. With such rampant poverty comes a plethora of challenges that the nation must face. In addition to these challenges, Sudan has been in conflict since April 2023. This conflict has only inflated many of the problems faced by the country, especially diseases. These are three facts about diseases impacting Sudan that people should know.

Fragile Health System

The health system in Sudan is severely underpowered. With very little investment, it cannot provide efficiently and thus many citizens struggle with getting the health care they need. There is a shortage of skilled doctors within the country, and half of the people who attend health care facilities are likely to receive no aid. In addition, due to the crisis, more than 70% of all health care facilities do not operate, drastically impacting how much diseases affect Sudan, according to the International Rescue Committee (IRC).

Frequent Outbreaks

War in Sudan has caused massive outbreaks of multiple diseases due to the worsening living conditions and the high amounts of displacement, causing further deterioration of health as diseases impact Sudan. In addition, vaccinations have not been able to be administered to many people, leading to increased illness throughout the country. Diseases that have had outbreaks include cholera, hepatitis, yellow fever, Rift Valley fever, meningitis and haemorrhagic fevers. Not only are these outbreaks occurring domestically, but they are also spreading to neighbouring countries as well. As long as the war rages in Sudan, it will be very difficult for many of the people suffering from these diseases to be helped due to the struggling health care system.

Mortality Rates and Life Expectancy

Life expectancy in Sudan has been rising slowly over the years in Sudan, but it remains fairly low at 66 years old. The global average is roughly 70 years old. Many people die from preventable diseases in Sudan due to the poor health care system, which significantly lowers life expectancy. In addition, another big cause of the low life expectancy is that infant mortality rates are alarmingly high. While the rates have declined over the years, just like life expectancy, it remains a problem.

According to UNICEF, for every 100,000 live births, 295 women will die, and this is the result of minimal aid provided to women both during and after their pregnancy. Only just over 50% of women receive a minimum of four antenatal care visits. After they give birth, only 34% of women receive post-natal care services, and 69% can receive a tetanus toxoid vaccination.

Aiding the System

The World Health Organization (WHO) is working with health authorities to distribute medical supplies and improve the coordination of health response. In a situation report from December 2023, WHO confirmed that a Cholera vaccination campaign in the Gedaref and Al Jazirah states targeted at 2.26 million people had a 98% coverage rate. This same report also confirmed that over 1190 metric tons of supplies have been donated to WHO hubs in Sudan. As of May 2024, WHO secured a $3 million donation from the European Union.

The efforts of WHO undoubtedly have aided the struggling health system and will continue to stabilize it during this time of conflict. Vaccine administration will continue hoping to reach as many people as possible, and campaigns to do so will continue. Other organizations, such as the United Nations Populations Fund (UNFPA), work in health facilities to provide sexual and reproductive health care. There is a lot more work to do, but the truth shown by these efforts is that it is very feasible to improve how diseases impact Sudan.

– Tyra Brantly

Tyra is based in Los Angeles, CA, USA and focuses on Global Health for The Borgen Project.

Photo: Flickr

, , , , ,

Strengthening Health Care Centers in Saint Lucia

Strengthening Health Care Centers in Saint LuciaLocated in the Caribbean, Saint Lucia is a small island nation with a population of just under 200,000. Like many Small Island Developing States (SIDS), it faces challenges such as limited technology and overwhelmed health care services, making its population vulnerable to poor health. Noncommunicable diseases (NCDs) like hypertension and diabetes reportedly account for approximately 82% of the country’s deaths.

Causes of Vulnerability

SIDS are particularly vulnerable to NCDs. According to a 2023 World Health Organization report, of 15 countries experiencing a 30% higher mortality rate from NCDs, eight are SIDS. This heightened vulnerability stems from several factors, including governance issues, educational gaps and economic inequality. Their isolated locations restrict trade and access to resources, while small populations limit their ability to develop extensive health care facilities and secure sufficient funding. The high cost of medical technology further strains their GDPs.

SIDS faces frequent natural disasters like hurricanes and cyclones, which annually cost 1% to 8% of their GDP, leading to infrastructure damage that requires ongoing reinvestment and rebuilding of national services. Additionally, these nations often suffer from brain drain, as many skilled professionals emigrate in search of better opportunities, further depleting the health care workforce.

Strengthening Health Care Centers in Saint Lucia

With funding from the World Bank, the Ministry of Health, Wellness and Elderly Affairs in Saint Lucia has implemented a Performance-Based Financing mechanism for health care centers. This scheme distributes funding to wellness services across the island, aiming to improve access to primary-level health care for patients and reward centers for their treatment provision. By allocating funds based on data-driven performance metrics, the ministry makes strategic investments to maximize effectiveness.

Long-term investment in health care services enhances their efficiency and resilience in recovering from unprecedented events and shocks. Recent years have highlighted the importance of such resilience, with many countries struggling to handle crises like the COVID-19 pandemic. This resilience is especially critical for SIDS, given their increased vulnerability to natural disasters like hurricanes. These meteorological events strain the economy and necessitate frequent strengthening of infrastructure.

A recent World Bank report found that individuals suffering from non-communicable diseases spend about 36% of their income on health care annually, a figure that rises to nearly 50% among those experiencing higher levels of poverty. Improved health services allow individuals to consult local providers instead of resorting to more expensive hospital care. Strengthening health care centers in Saint Lucia boosts economic conditions on both national and individual levels.

Looking Ahead

Saint Lucia, like many SIDS, faces significant challenges in managing NCDs due to its limited health care resources and economic constraints. The government, with World Bank support, has introduced a Performance-Based Financing mechanism to improve primary health care access and efficiency. Strengthening these services can potentially reduce health care costs for individuals and enhance the island’s overall economic resilience. This approach aims to mitigate the impact of natural disasters and health crises on the nation’s vulnerable population.

– Aimee Masters

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

Photo: Flickr

, ,

Addressing HIV/AIDS in Austria

HIV/AIDS in AustriaIn 1983, the spread of HIV/AIDS made Austria sound its alarm bells. Though the country only saw six cases that year, that number jumped to 381 by 1985. Since then, there have been huge strides in both treatment and acceptance that give HIV/AIDS victims a chance at a normal life.

Every Statistic Represents a Life

The alpine nation of Austria only makes up a small percentage of overall HIV/AIDS infections. According to the Austrian HIV Cohort Study, since the beginning of data collection in 1985, there have approximately been a total of 11,154 HIV diagnoses; 3,510 resulting in AIDS. Overall 2,859 people have succumbed to the disease.

The same study furthermore shows that throughout the years new infections have consistently stayed under 500, hitting their peak in 2008 with 415. In 2023 newly reported cases totaled 114, and currently, Austria ranks 120th worldwide in overall HIV rates in adults.

Like in most other countries, medical treatments and prevention are paramount in the battle against the HIV/AIDS epidemic. In Austria, 98.2% of patients are currently receiving antiretroviral regimens, and in 2022, 232 people were taking non-occupational antiretroviral drugs to impede the spread of the illness. This was an increase from 144 in 2016. Medications such as PrEP have also seen an uptick, from five prescriptions in 2016, when it first became available, to 1,270 in March of 2023, according to the Austrian HIV Cohort Study. Therapeutic advances like the previously mentioned means that contracting HIV/AIDS in Austria, and globally, is no longer a death sentence.

Additionally, expecting mothers get screened for HIV/AIDS as part of the Mother-Child booklet to qualify for childcare allowance. This allows for women to receive financial assistance and should the test be positive, gives providers a chance to provide care for both mom and baby.

Nobody Should Be Left Behind

The government assists citizens who are unable to work due to illnesses or other hardships. This comes in the form of the “Sozialhilfe” (social help) or “Mindestsicherung” (minimum security) to cover basic living costs. However, this keeps people just below the poverty line.

Depending on how the virus progresses, people with HIV/AIDS in Austria can continue to work, and it is illegal for any employer to discriminate against anyone with a positive status or ask any employee if they have HIV/AIDS. These laws are part of the de-stigmatization of the disease, and not ostracizing victims as was the norm during the beginning of the epidemic. Austria never saw the devastating numbers that other countries did, but it soon became a large part of the effort to advocate for more tolerance for people who are afflicted by the virus.

The Life Ball

In 1993, 10 years after the first diagnosis of HIV/AIDS in Austria, Gery Keszler and Torgorm Petrosian founded the organization called AIDS LIFE. In that same year, it held the first Life Ball in Vienna’s city hall. Petrosian himself was affected by the disease and the goal was to raise funds for national efforts to support others suffering from HIV/AIDS. Just one year later, the event already rose to international recognition and now collected donations for international relief.

Always held under a different theme, the ball becomes a magnet for fashion designers like the late Vivienne Westwood. AIDS LIFE then began to expand and in 2001 worked with other international projects, notably The Elton John Aids Foundation. The Life Ball then began to attract more and more celebrities and politicians, who joined the fight against the illness.

Although, wider publicity helped ease the stigma surrounding HIV/AIDS and for those who had contracted the virus, the ball took a pause in 2016 to return in 2017 with a refocused effort not on the spectacle but on “Fighting AIDS & Celebrating Life!” AIDS LIFE also rebranded itself to LIFE+ and launched the Know Your Status campaign to normalize HIV testing.

The fundraiser occurred the last time in 2019 and throughout its 26 years of existence, LIFE+ collected more than $34 million in donations.

For those who are also experiencing homelessness and/or drug addiction there is the Lighthouse organization in Vienna. Since 2000 the nonprofit has run a supported housing project, the only one in the country for people with HIV/AIDS. Its main mission is to highlight the humanity of people cast aside and to help their clients regain their lives.

Looking Ahead

Anybody can make a difference. No matter the cause, no matter how big the challenge, all it takes is one person with an idea. In the case of the Life Ball, it was two people, but Keszler’s and Petrosian’s story shows that small efforts can snowball into positive systemic changes and advances that might not have seemed possible.

– Melissa Harper-France

Melissa is based in Saint Paul, MN, USA and focuses on World News and Global Health for The Borgen Project.

Photo: Flickr

,

Mental Health in Andorra: A Country Focused on Improvement

Mental Health in AndorraWhen people think of European countries, they most likely don’t think about health issues, considering that these countries are frequently world leaders in terms of health. However, countries always have their issues and Andorra is no different. Thankfully, Andorra has demonstrated commitment to resolving its issues with mental health.

The Lack of Data

Despite being nestled between France and Spain, Andorra has a surprising lack of data on its mental health services. As of 2020, there was no data on the total amount spent on mental health per person, the suicide mortality rate or the community-provided mental health services that are available.

Even though nearly one-fifteenth of Andorra’s population has a mental disorder and a quarter of the country’s research focuses on mental health, data on the subject is scarce. This lack of information is concerning, given the vital importance of mental health.

As of 2019, a study found that for more than 20 years, consistently, 14% of the population or around 14,000 people, reported having a mental disorder in Andorra. During COVID-19, Andorra saw an increase in anxiety and depression symptoms. Of note, the World Health Organization’s (WHO) 2020 profile on Andorra found that only one program is available to the public and this program could not be determined as either effective or ineffective.

Moving Forward With Hope

Despite the lack of available data, there is good news in terms of treatment options. The Andorran government covers the cost of various mental health treatments and care. It is committed to strengthening its early child developmental programs. Additionally, it has shown its support in deepening mental health aid available to the public.

The main Andorran hospital, Our Lady of Meritxell Hospital, provides professional help, including options for medication, psychiatrists and therapy. Similarly, a private psychological center, Andorra Psychological Center, offers workshops and various therapies run by licensed professionals.

Many nonprofit organizations are also helping to combat mental health challenges in Andorra. These include Caritas Andorra and the Andorran Red Cross, which both offer mental health aid through their social services. Specifically, they provide support groups and various talk therapy options. However, according to a 2011 study, inpatient services are rarely available, if at all.

What Else Is Being Done?

The Andorran government implemented the National Plan of Action on Children and Adolescents 2023-2026 to protect the world’s future through children. This plan was highly successful, to such an extent that a United Nations (U.N.) Special Representative and pediatrician Dr. Najat Maala M’jid praised Andorra for its child protection efforts. According to M’jid, a part of this program’s success is due to two specific protocols: the identification and prevention of child abuse.

In 2022, the European Social Charter published conclusions on Andorra’s social policies. The report highlighted the need for Andorra to implement various protections for its population’s civil rights. Specific concerns around mental and physical medical aid are mentioned. The primary focus was on Andorra’s response to COVID-19. The European Social Charter found that Andorra could offer more programs and assistance to people struggling to maintain a healthy mentality.

Final Remark

Andorra has committed to fulfilling the rights and requests of the European Social Charter, as evidenced by the Andorran Minister of Health (Albert Font) cosigning a memorandum. This memorandum will deepen cooperation and improve the environment for both Spain and Andorra regarding mental health conditions. It is evident through this memorandum that Andorra is fighting for better mental health services for its people.

– Paige Tamasi

Paige is based in Los Gatos, CA, USA and focuses on Global Health and Politics for The Borgen Project.

Photo: Unsplash

, ,

Efforts and Successes in Combating Disease in Sri Lanka

Disease in Sri LankaSri Lanka, the neighboring island nation to India in South Asia, is a developing country making many efforts to increase its standard of living. One of these central efforts is the fight against disease and illness, which Sri Lanka has reduced with great success. Malaria, Leprosy and noncommunicable diseases (NCDs) have been reduced or eliminated from the country.

The Efforts

Disease in Sri Lanka comes in two forms: communicable diseases and NCDs. Considering the side of communicable diseases, Sri Lanka has taken great strides to reduce two of the most prevalent diseases within the nation: Malaria and Leprosy.

The Anti-Malaria Campaign (AMC) has taken on malaria and its prevalence within the region in full force. This initiative, supported by country collaborations, technical leadership and financial investments from the World Health Organization (WHO) and the Global Health Fund, has supplemented a national budget dedicated to the fight against malaria.

Leprosy shares a similar story. Successful campaigns and efforts against the disease caused Sri Lanka to experience a considerable decline in the prevalence of leprosy in the years following 1983, with the introduction of multidrug therapy (MDT) by the WHO.

However, communicable diseases in Sri Lanka were only responsible for 14,265 deaths in the year 2019. In contrast, NCDs such as heart disease and diabetes were responsible for the deaths of 96,072 people in the same year.

Public Health in Sri Lanka

Public health in Sri Lanka relies not only on funding from the WHO and the Global Health Fund but also on grassroots efforts to educate the public about the dangers of a sedentary lifestyle. Managing NCDs requires a preventive care approach, leading to a reorganization of the country’s health care system through the globally funded Primary Health care System Strengthening Project (PSSP). This project aims to support the government in enhancing the utilization and quality of health care, with a primary focus on the detection and prevention of NCDs.

The Successes

Since the turn of the century, Sri Lanka has made excellent progress in reducing the prevalence of malaria—the total number of cases in Sri Lanka was reduced by 78%, from 22.9 million to 5 million. The budget from the Global Health Fund and the WHO supplemented the efforts to successfully eradicate malaria as a common disease in Sri Lanka.

Leprosy has also wavered greatly in recent years. Assisted by the creation of MDT by the WHO, the country achieved a WHO elimination goal of leprosy cases, yielding less than one for every 10,000 people in the population by the turn of the 21st Century. The formative research provided by outside organizations, along with the campaign’s efforts to increase social awareness about the disease and its communicability, successfully reduced the rate of Leprosy.

NCDs are also being addressed, however, in a drastically different manner than that of communicable diseases. The people in Sri Lanka have been informed of the dangers of communicable diseases yet are ill-informed of the dangers of a sedentary lifestyle and how being proactive is healthy for the body. This is being curbed through efforts established by the PSSP and its association with Primary Medical Care Institutions (PMCI).

Primary Medical Care Institutions

According to the World Bank, curative primary health care services in Sri Lanka are delivered mainly through PMCI. This includes district-level hospitals and Primary Medical Care Units situated around the nation. In March 2022, about 350 of the 1,030 PMCI in Sri Lanka were strengthened under the PSSP initiative. However, by the end of the project in 2023, this number reached a minimum of 550.

The lack of information regarding the dangers of a sedentary lifestyle is slowly being overturned through an increasingly active information campaign. Alongside this are initiatives to raise awareness of the importance of daily exercise and how a proper diet is beneficial to overall health. These efforts by the PSSP are effectively paving a path toward a healthier nation.

Final Remark

Sri Lanka has yet to eradicate diseases completely. Even with the successful efforts to combat malaria and leprosy, there is still a great risk of their return. Diseases are always on the cusp of coming back. However, with the continued dedication of organizations around the world and commitment from the leadership of Sri Lanka, it will always be at the forefront.

– Luke Scroggins

Luke is based in Dallas, TX, USA and focuses on Technology and Global Health for The Borgen Project.

Photo: Flickr

, ,

Fighting Diseases in Palestine

Diseases in PalestinePalestine includes two non-contiguous territories located in the Middle East: the Gaza Strip and the West Bank. The West Bank is home to 3.2 million people and Gaza to 2.1 million. Since Oct. 7, 2023, continuous warfare between Israel and the resistance of Palestine has resulted in a severe health crisis, highlighted by a rapid spread of infectious diseases and the collapse of essential health care services.

Political and economic instability–worsened by the blockade and fighting– has left the health care infrastructure in shambles, severely impacting the well-being of Palestinians. Both chronic and transferable illnesses, coupled with a rapid decline in mental health, have steadily worsened. However, international and local nongovernmental organizations (NGOs) are working to combat the dire situation.

Crumbling Health Care System

The health care system in Palestine, particularly in Gaza, is on the brink of collapse. The conflict has led to severe shortages of medicines, fuel and medical supplies, making it nearly impossible for hospitals and clinics to function effectively. According to reports, there are around 350,000 patients in Gaza suffering from chronic conditions such as cancer and diabetes, alongside 50,000 pregnant women who are struggling to access necessary care​​.

The World Health Organization (WHO) has reported that nearly two-thirds of health clinics in Gaza are nonfunctional. Furthermore, the United Nations Relief and Works Agency (UNRWA) for Palestine Refugees in the Near East has indicated that fewer than half of its health centers can offer primary care to patients​​. This has left a sizable portion of the population without access to basic medical services, exacerbating the health crisis.

Sanitation and Water Crisis

The water and sanitation situation in Palestine is extremely dire. There is only one shower for 4,500 people and one toilet for more than 200 people. This has led to a significant increase in the spread of infectious diseases in Palestine. The situation is a result of the ongoing conflict, which has forced many Palestinians to seek refuge in overcrowded shelters or relocate to the south, where unsanitary conditions prevail.

Contaminated water supply and poor hygiene are leading to outbreaks of illnesses such as diarrhea, respiratory infections and chickenpox. Up to 70 people are crammed into single rooms, creating an environment ripe for disease transmission​​. Respiratory diseases in Palestine are particularly rampant, with more than 150,000 cases of upper respiratory infections reported, alongside numerous cases of meningitis, skin rashes, lice and chickenpox. The risk of cholera and other epidemics looms large as the health and sanitation infrastructure continues to deteriorate​​.

Efforts to Combat Disease

Despite the overwhelming challenges, various efforts and initiatives are underway to alleviate the health crisis in Palestine. NGOs are spearheading humanitarian aid to mitigate the ongoing situation.

WHO is improving health conditions by coordinating with local and international partners to enhance aid delivery and establish more supply routes. More than a dozen high-risk operations have been conducted to provide supplies to hospitals in Gaza. WHO helped establish two kitchens at Al-Shifa Hospital, which serve 1,200 meals a day. Its distribution of medical supplies currently supports treatment for 1,250 children with severe malnutrition.

The United Nations Children’s Fund (UNICEF) also plays a pivotal role in saving lives. In addition to first aid, it provides 600,000 vaccinations and nutritional supplements to children and expecting mothers. It also provides safe drinking water for 1.3 million people to curb infectious diseases.

While efforts to provide relief are ongoing, the situation remains precarious. However, the resilience and determination of health care workers combined with international support allow for much optimism. Sustained efforts and global solidarity offer hope in paving the way for a healthier future in Palestine.

– Asiya Siddiqui

Asiya is based in Fremont, CA, USA and focuses on Global Health and Good News for The Borgen Project.

Photo: Flickr

, ,

Inequitable Asthma Deaths in Low-And-Middle-Income Countries

Asthma DeathsAsthma is a chronic lung disease with many recognizable symptoms, such as chest tightness, wheezing, coughing and inflammation of the lungs. It affects both adults and children and is a noncommunicable disease (NCD), meaning it cannot be caught. However, it does run in families and there are a number of factors that can elevate the risk of developing it. Despite available treatments, it remains “the most common chronic disease among children” and in 2019, there were 455,000 asthma deaths globally. Even milder cases, when they go untreated, can cause people to miss work or school due to symptoms like fatigue and poor concentration. A common knock-on effect of these absences is a negative impact on many families’ finances, which can exacerbate or even cause cycles of poverty.

Disproportionate Asthma Deaths

Underdiagnosis and under-treatment remain a major hurdle in managing the disease effectively. A study published in the “Journal of Allergy and Clinical Immunology” revealed that only 10% of people with asthma symptoms in Uganda had a formal diagnosis. The effect of this is shown starkly as the “Ugandan asthma mortality rate of 19 deaths per 1000 person-years is 90 times that of the United Kingdom (U.K.).” This is not unique to Uganda, as 90% of asthma deaths occur in low-middle-income countries.

While it is believed that “there is no logical biological rationale for asthma to differ between countries according to their income alone,” the environment can have a drastic impact. A fetus exposed to factors such as smoke, air pollution and antibiotics in utero is more likely to experience asthma and these conditions are often found in urban, lower-income environments.

What Is Being Done?

The Global Initiative for Asthma (GINA) has organized World Asthma Day since 1998. It advocates education as a partial solution to asthma. Since 2014, the organization has been funded entirely by people purchasing its resources. Some of the organization’s objectives include “increasing awareness of asthma and its public health consequences” and “improving availability and accessibility of effective asthma therapy.”

The World Health Organization (WHO) also advocates for empowering asthmatics (and those who live with them) through education. It believes that increased knowledge in areas such as symptom management, triggers and how to administer medicines will not only reduce health costs but also reduce absences from school and work, resulting in fewer hospitalizations and, ultimately, asthma deaths.

The Good News

The good news is that convenient treatments for asthma have been available since the invention of the inhaler in 1956. Additionally, in 2023, the American Food and Drug Administration (FDA) approved Airsupra inhalation aerosol “to reduce the risk of asthma attacks in patients with asthma 18 years of age” and above. However, while there is some difficulty with using inhalers in emergencies or with children, WHO has found that homemade spacers made from plastic bottles “can be as effective” as manufactured ones.

New treatments for asthma continue to be developed. The SHAMAL study in 2023 showed that the use of injected benralizumab every four to six weeks allows more than 90% of patients to decrease their use of steroids, thus reducing the prevalence of undesirable side effects. While the study needs to be corroborated, it may be the start of more “biologic” treatments for people living with asthma.

Final Remark

The fight against asthma is far from over. Yet, with the development of new treatments and hard work being done on the ground educating not only people with asthma but their families and health care professionals, we are working toward a future where asthma-related deaths are a thing of the past.

– Rachael Denton-Snape

Rachael is based in High Wycombe, UK and focuses on Global Health for The Borgen Project.

Photo: Freepik

, ,

Where There Is No Doctor: Providing Health Care Education to All

Health Care EducationFor more than 50 years, Hesperian Health Guides has provided health care education to remote communities, aiming to address and reduce the global health disparity.

The Scarcity of Health Care

With advances in technology and medicine contributing to the increase of global life expectancy, there remains a persistent disparity in access to quality health care between higher and lower-income countries. According to a 2020 study conducted by the World Health Organization (WHO), there is only one doctor for every 3,324 people in Africa. In contrast, in Europe, there is one doctor for every 293 people.

The varied distribution of people versus health care workers highlights the scarcity of adequate health care in some regions of the world. To achieve universal health coverage, organizations like Hesperian Health Guides are providing health care education to rural areas where there is little to no access to doctors.

Where There Is No Doctor

Following his experience of working at Project Piaxtla, a primary health care program operated by disabled village health workers in western Mexico, David Werner wrote and published “Where There Is No Doctor (Donde No Hay Doctor)” alongside his colleague Jane Maxwell. It is the first health care manual to consider the people of low-income and rural settings. Originally published in Spanish, “Where There Is No Doctor” explained complex health topics in a comprehensible language.

Since the 1973 publication of “Where There Is No Doctor,” Hesperian Health Guides has issued more than 40 titles to 221 countries. Its books, which have been translated into more than 85 languages, explain topics such as general health, women’s health, children’s health, environmental health, disabilities, health rights and advocacy and more. With each book taking about four to 10 years to complete, the nonprofit continuously updates and revises its handbooks.

Making a Global Impact

Pivotal stakeholders in global public health commend the accuracy, accessibility and clarity of Hesperian Health Guides. For example, since the ’80s, every Peace Corps volunteer has been supplied with copies of Hesperian handbooks. Through donations, the Hesperian distributes its books to various community health workers, including missionaries, midwives, teachers, community organizers, nonprofit organizations, health educators and government agencies.

Each stakeholder utilizes the Hesperian Health Guides to address the health concerns of their community while actively reducing the global health disparity. According to its 2023 annual report, Hesperian Health Guides has helped about 2,700,000 people. For those with access to the internet, the organization’s free HealthWiki has been providing health care education to more than 36 million people since the website’s launch in 2011.

Conclusion

With the recent decrease in access to essential health services, global health inequalities persist. Vulnerable populations with low levels of access to health care suffer the most as they are exposed to more health risks. Efforts to increase equitable access to health care are crucial to reducing the global health disparity. By providing health care education to rural communities, Hesperian Health Guides addresses global public health inequities in an effort to better the personal, community and environmental health of all.

– Naima Rasheed

Naima is based in New York, NY, USA and focuses on Good News, Global Health for The Borgen Project.

Photo: Flickr

, ,

Mood Over Matter: Mental Health in Malta 

Mental Health in MaltaMalta, the small island state at the heart of the Mediterranean Sea, faces an epidemic of undiagnosed mental health problems. As many as 120,000 of its citizens struggle with some form of mental illness. An article from Lovin Malta interviewed several Maltese individuals who shared their mental health struggles. Two interviewees described living with anxiety and stress, self-diagnosing as suffering from Post-Traumatic Stress Disorder (PTSD). Another two detailed their difficulties with neurodivergence—one with suspected Asperger’s syndrome and the other with inattentive ADHD—conditions that significantly impact mental well-being.

The mental health issues in Malta are as varied as in any other part of the world. Maltese people face similar challenges to those in more developed countries, not due to a lack of humanity or civility, but because of limited access to essential services and an unstable economy. Despite these challenges, “0.7% of all deaths among Maltese residents in 2017 were deaths by suicide” and the country ranks 40th globally in terms of national happiness.

Factors Affecting Mental Health Decline

Over the past decade, Malta has experienced a significant influx of migrant workers from within the EU and beyond. This population increase places pressure on society, particularly on the healthcare system, straining those responsible for its operation. This cultural shift forces the host nation to adapt inclusively to reflect the values of all its inhabitants. While this progression is often seen positively, it can be overwhelming for some, especially those already in a fragile mental state. The result is a society where some embrace change, while others feel abandoned by their culture.

Ironically, the push towards a more egalitarian society has disproportionately affected the vulnerable. As women increasingly enter the workforce, traditional care roles are diminishing, leaving the elderly and infirm to rely more on state support.

Until recently, the Maltese government did not prioritize open discourse about mental health. A lack of political will, consensus and leadership hampered efforts to address the issue, according to Health Policy.

Need for Change: Positive Developments

Significant improvements have been made in Malta’s approach to mental health over the past decade, building on reforms from the early 1990s. In 2012, Malta appointed its first Mental Health Commissioner, marking a turning point, Health Policy reports. Increased pressure from public bodies and media figures has helped to destigmatize mental health issues, prompting more open discussions.

Previously, Malta had the highest average length of stay for inpatients with mental and behavioral disorders in the EU. In 2013, the average stay was 57 days, which decreased to around 40.5 days by 2019. The number of hospitalized patients per 100,000 population also dropped from 144 to 89.7 during the same period, according to Health Policy.

The health care system now favors community hostel care or independent living arrangements over prolonged hospital stays, allowing patients to maintain their autonomy and human identity.

NGO Involvement

Several organizations are spearheading initiatives to combat mental health issues in Malta. These include the Mental Health Association Malta (MHAM), the Malta Federation of Organizations Persons with Disability (MFOPD) and the Malta Health Network (MHN).

Founded in 1982, MHAM supports caregivers of the mentally ill, educates the public to reduce ignorance and stigma and advocates for legislative changes to benefit caregivers and support workers.

Founded in 1970, MFOPD supports 41 member organizations and works on initiatives to reduce stigma, enhance societal understanding and improve integration and services for persons with disabilities. It advocates for the rights and needs of persons with disabilities, engages in lobbying efforts, and participates in relevant government structures and European events.

Established in 2007, MHN is an organization that focuses on promoting health-related interests for patients and the community in Malta. It collaborates with governmental, non-governmental, and not-for-profit organizations as well as patient representative groups to enhance health services and patient advocacy.

In February 2024, the organization launched a “To be seen and to be heard” (Arani u Ismagħni) campaign seeking to empower patients and equip them with skills of self-management and professional communication.

Future Directions

While Malta has made observable progress, the WHO is keen to draw attention to the work still to be done. Reducing poverty from its current rate of 9.2% to zero is crucial, but, according to WHO, so, too, is improving staff communication with patients and spreading information about mental health issues. 

Financial hardship and mental distress are interconnected. Studies suggest both poverty and mental health issues are still stigmatized, with some believing mental health is a middle-class issue. Research in Glasgow, however, indicates higher rates of mental health issues in deprived areas, though suicide rates are higher in affluent areas. This disparity highlights structural differences in access to resources, with the affluent having better access to mental health services, while the impoverished often face desperation and neglect.

It is challenges such as the above that an organization like MHA seeks to overcome; by combating the stigma that mentally ill people and their caregivers face in Malta and ensuring mental health services are both well-staffed and well-funded.

In September 2017, the MFOPD initiated a campaign comprising a series of educational modules that sought to assist those living with intellectual disabilities to engage in an independent lifestyle. The project’s mission statement was “Enhancing Social and Economic Inclusion Through Independent Living” and it reached 360 people by the project’s end.

– Thomas Johnston

Thomas is based in Dungannon, County Tyrone, Northern Ireland and focuses on Good News and Global Health for The Borgen Project.

Photo: Flickr