Archive for category: Health

Information and stories on health topics.

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5 Facts About Mental Health in Rwanda 

Mental Health in Rwanda Rwanda is a small country in sub-Saharan Africa. Rwanda has struggled to become a stable country economically and politically since it became independent in 1962. As a developing country, Rwanda is still trying to develop its healthcare system. With years of conflict and instability, people especially struggle with mental health in Rwanda.

5 Facts About Mental Health in Rwanda

  1. The Rwandan Genocide plays a significant role. Roughly 25% of Rwandan citizens struggle with PTSD and one in six people suffer from depression. The reason why so many Rwandans have mental health conditions can be explained by one key event in Rwandan history. During the Rwandan genocide of 1994, members of the Hutu ethnic majority murdered as many as 800,000 people, mostly of the Tutsi minority. The mass genocide caused severe trauma to survivors who still suffer from mental health issues 26 years after the event.
  2. Rwanda has very few resources. According to the World Health Organization, Rwanda has only two mental health hospitals, zero child psychiatrists, and only 0.06 psychiatrists per 100,000 people. With a large amount of the population plagued by mental health issues, Rwanda needs more resources to help the mentally ill.
  3. Suicide rates have greatly decreased in Rwanda. In 2016, the suicide rate in Rwanda was 11 deaths per 100,000 people. This is a great improvement compared to the 24.6 suicides per 100,000 people in 2000. An increase in mental health resources contributes to the lowering of the suicide rate in Rwanda.
  4. Increased mental health funding is essential. The average mental health expenditure per person in Rwanda is 84.08 Rwandan francs. Most citizens of Rwanda do not have the financial resources to afford mental healthcare. The government currently uses 10% of its healthcare budget on mental health services. Considering how large the mental health crisis is, the government should increase its expenditure to address the crisis. Since citizens cannot afford to pay for mental health resources, the government will need to help provide more free or affordable resources.
  5. The Rwandan Government is updating policies to address mental health. In 2018, Rwanda’s updated strategic plan for its health sector set new targets for expanding mental health care services. Its purpose is to help increase access to mental health resources by decentralizing mental health and integrating it into primary care. Also, this plan calls for a decrease in the cost of mental healthcare and an increase in the quality of care. The plan hopes to accomplish strategic goals by 2024. If successful, this plan may be used as a method to help other countries establish a quality mental health plan.

The Road Ahead for Rwanda

Considering Rwanda’s violent history, it is no surprise that the population struggles with mental health. Over the years, progress has been made with regard to mental health in Rwanda. However, many more resources are needed to help address the mental health crisis in Rwanda. With Rwanda’s updated strategic plan to address the issue and an increase in expenditure, the well-being of Rwandan’s will be positively impacted.

–Hannah Drzewiecki
Photo: Flickr

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Improving Bipolar Awareness in India

Bipolar Awareness in IndiaIndia is the second-most densely populated nation in the world, with more than 1.3 billion people. Of that number, more than 82 million citizens suffer from bipolar disorder, according to data from 2019. Bipolar disorder in India often goes undiagnosed and untreated for reasons ranging from ancient superstitions to the cost of treatment, but, bipolar awareness in India is steadily progressing.

Bipolar Disorder in India

Improved bipolar awareness in India exemplifies how a concerted effort can reduce stigma and create an affordable and readily available avenue for treatments such as therapy and medication. Indians, mostly women, have been disowned and abandoned by family or a spouse after receiving a bipolar diagnosis. In a country where the consequences of a mental condition are isolation and disconnection, the need for awareness and education is paramount.

A nation that once attributed bipolar disorder to demonic spirits, planetary alignments or a sinful past life, has come extremely far in its understanding of the illness. But, the stigma surrounding the disorder is still prevalent in India, and many, especially those from rural locations, believe bipolar disorder is a choice or an illness reserved for the rich and privileged.

BipolarIndia Organization

One resource improving bipolar awareness in India is the organization BipolarIndia. The community was created in 2013 by Vijay Nallawala, an Indian man that suffers from bipolar disorder, and his mentor and friend, Puneet Bhatnagar. BipolarIndia’s mission is to create an empathetic, judgment-free environment for bipolar people to find information, treatment, and most of all, support from those that can relate to their struggle.

BipolarIndia hosts a National Conference every year on World Bipolar Day to create awareness for the illness and educate residents from all over the country. In 2015, the organization began hosting monthly support meetings for individuals to speak with peers that can understand their struggle. It has also recently developed a way for patients to receive real-time support through the Telegram App when they feel they may need immediate help. Resources such as the Telegram App are invaluable due to the lack of mental health professionals in India.

The Mental Health Care Bill

Data from a 2005 report shows that there are only three psychiatrists per million citizens and only 0.06% of India’s healthcare budget goes toward improving mental healthcare. The Indian Government passed a Mental Health Care Bill in June of 2013 laying out a mission to improve bipolar awareness in India as well as reduce stigma surrounding all mental health issues. The bill has been undergoing revisions and policy modifications based on the guidance given by the Indian Association of Psychiatry.

Efforts to Raise Awareness

The government’s efforts to raise awareness about the complexity of bipolar disorder and the number of Indians that suffer in silence is vital to the disorder being understood. The Indian government aims to provide communities with adequate care and reliable information, leading the nation to a better understanding of a complicated mental disorder.

Bipolar awareness in India has improved with private organizations such as the International Bipolar Foundation (IBPF) funding research on effective treatments and raising awareness across the globe.

Also fighting for bipolar awareness, Indian celebrities, including Deepika Padukone, Rukh Kahn, Yo Yo Honey Singh and Anushka Sharma, have stepped forward and opened up about their personal battles with bipolar disorder, combatting the stigma surrounding the illness.

The Road Ahead

Bipolar awareness in India has slowly improved but still has a long way to go. If the government aims to change the attitude toward bipolar disorder and improve treatment, a significant investment in research is vital as well as a comprehensive understanding of the disorder.

–  Veronica Booth
Photo: Flickr

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Rural Australians: Cancer and Poverty in Australia

Cancer and Poverty in AustraliaThe nation of Australia suffers from the highest rates of cancer in the world, but, the disease takes a significant toll on the disadvantaged and rural residents in particular. Impoverished and disadvantaged Australians are 60% more likely to die from cancer due to a lack of finances for a timely diagnosis and proper treatment. The connection between cancer and poverty in Australia can be clearly seen.

The Link Between Cancer and Poverty

The cost of treatment is only one part of the problem. The importance of prevention cannot be overstated and because of a disadvantaged situation, many poor Australians are more likely to smoke cigarettes, be overweight and not get screened for cancers. This leads to more impoverished residents developing a range of cancers that reach later stages before they are diagnosed.

While the country has a decent healthcare system, the connection between cancer and poverty in Australia is significant. Poor citizens are more likely to develop cancer and are the least financially prepared for it. One out of every three Australian cancer patients has to pay out-of-pocket for treatment ranging from a few hundred dollars up to $50,000 AUD. Patients that have private health insurance rather than public medicare often pay far more out-of-pocket, sometimes double, in addition to their regular insurance payments.

Rural Residents in Remote Areas

Residents of Australia’s rural areas often face the worst financial obstacles as they must incur travel expenses and be far from home for extended periods. In 2008, only 6% of oncologists practiced in rural areas, leaving a third of Australians that live in remote regions without immediate access to decent treatment. There were 9,000 more cancer deaths in rural areas than in urban areas over a decade, a 7% higher death rate compared to city residents.

Due to the extensive travel time, many cancer patients from remote regions are forced to quit their jobs increasing the financial burden of treatment. Those that can keep their jobs, often force themselves to continue to work despite their illness and during treatments in order to pay the bills. In many instances, cancer patients must take loans from friends or family. creating further financial obligations.

Indigenous Australians

In addition to rural residents, indigenous citizens also disproportionately die from cancer compared to other residents. Indigenous Australians have a 45% higher death rate from cancer compared to non-indigenous patients. Cancer is extremely underreported by indigenous people in remote or rural areas resulting in a lack of proper data for the government to act on.

Addressing the Link Between Cancer and Poverty

To reduce the mortality rates of cancer patients, the government must address the correlation between cancer and poverty in Australia. As of 2017, only 1.3% of Australia’s health budget is allocated for cancer prevention, screening and treatment. The country must invest in prevention as well as rapid-access cancer aid for both patients and caretakers.

The Clinical Oncology Society of Australia and Cancer Council Australia are working to improve cancer treatment in rural areas of Australia. Solutions to diminish the connection between cancer and poverty in Australia include new methods of diagnosis and treatment. Telehealth and shared care, in which the patient’s primary physician works with an oncologist to limit travel for treatment, help cut down on costs for struggling patients.

Cancer organizations in Australia have worked with the government to set up the regional cancer center (RCC) initiative across the country to make cancer care more accessible for residents living in rural areas. Since 2010, 26 regional cancer centers have opened to help patients living in remote locations.

Prioritizing the Health of Rural Residents

For the mortality rates of impoverished or rural cancer patients to lessen, the government must invest in prevention as well as access for rural residents. Above all, for Australia to successfully provide aid for cancer patients there must be accurate data collection on cancer and poverty in Australia to properly allocate funds for all demographics.

— Veronica Booth
Photo: Flickr

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WHO’s Plan to Address Neglected Tropical Diseases

Address Neglected Tropical DiseasesOn November 12, 2020, members of the World Health Organization (WHO) voted overwhelmingly to adopt a bold set of plans to address the threat of neglected tropical diseases (NTDs) throughout the next decade. With this vote, the WHO endorsed a “road map” written by the Control of Neglected Tropical Diseases team to address neglected tropical diseases in the world’s most vulnerable regions. The decade-long project aims to establish global programs with international partners, stakeholders and private organizations. These partnerships will work to accomplish an ambitious set of goals that will end the spread of certain neglected tropical diseases and improve the quality of human life in regions susceptible to neglected tropical diseases.

Neglected Tropical Diseases (NTDs)

Neglected tropical diseases are commonly defined by global health organizations such as the WHO and the National Institute of Allergy and Infectious Diseases as a group of diseases that primarily affect those living in tropical and subtropical climates and disproportionately spread in remote areas or regions afflicted by poverty. Among the 20 diseases that the WHO categorizes as neglected tropical diseases are dengue, rabies, leprosy, intestinal worm and sleeping sickness.

Tropical and subtropical regions include Central America and the northern half of South America in the Western Hemisphere, most of sub-Saharan Africa as well as island nations in the Indian and Pacific Oceans. Many of the countries in this range are developing or impoverished nations. A lack of development and healthcare infrastructure in nations that lie in tropical regions, such as lack of access to clean water and health education, creates a more fertile breeding ground for the spread of dangerous diseases.

The reason that these diseases are considered “neglected” is that regions where neglected tropical diseases cause the most damage are populated by people with little political power or voice, a result of widespread poverty, location and other socioeconomic factors. As such, the spread of these diseases goes largely unnoticed and there is little incentive at the international level to take measures to combat these ailments. Though NTDs do not receive high-profile attention in the larger medical community, the WHO estimates that more than one billion people are affected by NTDs. The WHO sees the urgency to address neglected tropical diseases.

WHO’s 2021-2030 Road Map

The WHO outlined a set of “overarching global targets” that it will pursue over the course of the next decade in work with foreign governments, community organizations and NGOs. These overarching goals, to be accomplished through achieving a number of “cross-cutting targets” are the primary effects the WHO hopes to achieve by 2030:

  1. Reduce number of people requiring treatment for NTDs by 90%. To attain a 90% reduction rate of those requiring treatment for neglected tropical diseases, the WHO altered its approach to disease treatment from a vertical, single disease eradication method to a horizontal, cooperative effort across several countries. This would require 100% access to water supply, greater international investment in healthcare and action at the federal level to collect and report data on infection.
  2. Eliminate at least one NTD in 100 countries. There are a number of neglected tropical diseases that the WHO lists as “targeted for elimination”: human African trypanosomiasis, leprosy and onchocerciasis. In the WHO’s road map, elimination of a disease means complete interruption of transmission, effectively stopping a disease’s spread. For eliminating diseases such as leprosy, the WHO hopes to assist 40 countries to adopt epidermal health strategies in their healthcare systems.
  3. Completely eradicate two NTDs. The two diseases listed as “targeted for eradication” by the WHO are yaws, a chronic skin condition, and dracunculiasis, an infection caused by parasitic worms in unclean water. Both diseases are, according to the WHO, either easily treatable or on the verge of eradication. Dracunculiasis, for which there is currently no vaccine or medical treatment, only affected a reported 54 people in 2019. Yaws is still endemic in 15 nations but can be treated with a single dose of antibiotics.
  4. Reduce by 75% the disability-adjusted life years (DALYs) related to NTDs. The implementation of increased prevention, intervention and treatment can increase the quality of human life in tropical and subtropical countries. This final overarching goal aims to create nationwide efforts to alleviate or eliminate the chronic symptoms of those infected with neglected tropical diseases as well as prevent the further spread of debilitating neglected tropical diseases.

Ending Neglected Diseases

To address neglected tropical diseases, the fulfillment of the goals outlined in the WHO’s road map will require a multilateral and thorough implementation as well as cooperation and leadership from each of the partner countries affected. The WHO seeks to encourage each tropical and subtropical nation to take ownership of their healthcare programs, which will create a sustainable, international network to strengthen global health in some of the world’s most vulnerable regions. Putting the fight against neglected tropical diseases in the spotlight as well as dedicating time and resources to taking on these diseases, can remove the “neglected” from neglected tropical diseases and put the global community on a course toward eradicating these diseases.

– Kieran Graulich
Photo: Flickr

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Smiles Forever: Restorative Dentistry in Bolivia

restorative dentistryLow-income countries have long been the victims of poor health care systems. Along with this health care system neglect has also come a large amount of dental care neglect. Both dental staffing and dental resources are scarce resources for those living below the poverty line in low-income countries. Smiles Forever is a nonprofit working within Bolivia in order to provide restorative dentistry as a way of increasing resources to a  population desperately in need.

Dental Care in Developing Countries

Most dental care within developing countries is given at hospitals that are either centralized or regional. This dental care does not do much to prevent or restore dental issues within the general population of a country. The dental care staffing is so low in many developing countries that trained dental professionals are forced to do the work that would normally be the job of dental assistants. This creates an ever-increasing cycle of dental worker unavailability. The creation of programs to train dental hygienists has been identified as a major solution to the extreme lack of restorative dentistry and dental care within struggling countries.

Major Dental Issues in Developing Countries

Throughout impoverished countries, there are a few dental issues that are seen most often and are in need of the greatest amount of restoration and prevention. These issues are dental caries, periodontal disease and tooth or gum abscesses.

  • Dental Caries: In simpler terms, this is when a tooth decays and leaves behind a cavity. Acids in the mouth that are present from sugar residue cause the enamel of a tooth to break down. Having access to simple dental materials like a toothbrush, floss and toothpaste greatly decreases an individual’s likelihood to develop dental caries. Fluoride provided at dental offices is also key in protection against dental caries.
  • Periodontal Disease: This disease is caused when there is a lot of plaque build-up on an individual’s teeth. The build-up causes an infection to infest the gums or bones throughout the face. Plaque build-up can only be properly removed by someone who has been training as a dental professional.
  • Tooth/Gum Abscesses: These are caused when tooth damage, usually from dental caries, allow for bacteria to invade a tooth or the gums. The bacteria causes pus to build up within the teeth or gums which causes a lot of pain and swelling. An abscess of this sort can only be treated by a professional and can cause sepsis if an individual is not given proper care.

The Mission of Smiles Forever

Smiles Forever is a nonprofit dental organization mainly working in Bolivia to provide free preventative and restorative dentistry. Its mission is to allow for a better quality of life, specifically for children growing up in Bolivia. Smiles Forever hopes that its work will act as a model for increased dental care in poor countries within South America.

Sandy Kemper, a dental hygienist from Seattle, is the founder of this nonprofit. She was inspired by a service trip that she took to Bolivia in 1999 in order to provide free dental work in the Madre de Dios shelter. A couple of years after her trip she returned to Cochabamba, Bolivia, in order to develop the Smiles Forever program after seeing how desperately in need the citizens were of restorative dentistry.

Programs Created by Smiles Forever

Smiles Forever has three main programs that it runs in Bolivia. These programs are its dental hygiene training program, its community partnering programs and its public fee-for-service clinic.

The dental hygiene training program was created in order to teach and train selected indigenous women to become dental hygienists. Each of the women is offered a full scholarship and the materials needed in order to become properly trained. The program is only conducted for half of each day so that the women can use the other half to support their families while being trained. Not only does this program allow for an increase in dental professionals in Bolivia but it also helps raise indigenous women and their families out of poverty by giving these women the opportunity to find full-time professional jobs.

The community partnering that Smiles Forever does is where a lot of its free dental work is provided. This organization works with other nonprofits throughout Bolivia that provide life-improving services. Through this partnering, it has been able to have a more widespread influence in providing dental care throughout Bolivia as its partners are very influential.

The public fee-for-service clinic was set up as a way to provide hands-on experience for individuals working in the dental hygiene training program and as a means of income to support the free community outreach efforts of the nonprofit. Individuals who attend the clinic pay in order to receive necessary preventative and restorative dentistry care.

Smiles Forever and Women’s Empowerment

Smiles Forever greatly supports the reduction of poverty and the provision of essential services through the uplifting of indigenous women. It recognizes that economic growth greatly increases when women play an empowered part in society. So far, 37 indigenous women have successfully completed the dental hygiene raining program and some have gone on to fully complete dental school. Overall, Smiles Forever has an all-around positive effect on the communities of Bolivia not only from a health standpoint but from a social and economic standpoint as a result of its efforts to empower women.

–  Olivia Bay
Photo: Flickr

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The END Fund: Treating Neglected Tropical Diseases

the END FundNeglected tropical diseases (NTDs) are a group of diseases caused by a variety of pathogens that are common in low-income regions. The World Health Organization WHO) and the Centers for Disease Control and Prevention (CDC) categorize 20 diseases as NTDs. They affect more than one billion people around the world, with more than a third of people affected by NTDs living in Africa. While about one-sixth of the world’s population suffers from at least one NTD, more attention is often brought to other diseases, such as HIV/AIDS and malaria. While these other diseases require a high level of attention, NTDs need prioritization too. The effects of NTDs can last for decades if proper care is not sought out as many have the ability to bring on permanent blindness and disfigurement. It is of the utmost importance that NTDs are addressed and one such organization putting in the work is the END Fund.

The END Fund

The END Fund is a nonprofit organization that seeks to protect the lives of people at risk of NTDs. It delivers treatments by working with local partners, understanding that these groups have regional expertise and know the needs of their area best.

The END Fund helps its partners design programs so that they can expand their capacity to collect important data regarding NTDs. Further, the END Fund provides technical support and monitors progress so its partners can fight disease in the most effective way possible.

It also collaborates with non-governmental organizations and seeks to involve all stakeholders in order to improve the lives of those at risk of contracting NTDs. The END Fund is active across many countries in sub-Saharan Africa as well as India and Afghanistan. It has programs in Nigeria, Ethiopia, the Democratic Republic of the Congo, Somalia and others.

NTDs in Nigeria

The country with the greatest prevalence of NTDs in Africa is Nigeria. With a population of 195 million people, five of the most common NTDs are present: intestinal worms, lymphatic filariasis, river blindness, schistosomiasis and trachoma. These diseases can cause severe pain that inhibits people from going about their daily lives. Children miss out on their education and adults miss out on economic opportunities. NTDs can cause the already impoverished to sink even deeper into poverty.

In 2013, the END Fund arrived in Nigeria. Two years later, it partnered with Helen Keller International to support local partners, the Amen Foundation and Mission to Save the Helpless (MITOSATH). It has since helped build the capacity of these groups so that they can respond to the issue of NTDs even stronger. It engaged with local leaders across many levels to make people aware of the treatment plans that are available. Among traditional groups, leaders took medication in front of many people to show that it was safe.

The End Fund’s Impact

In 2019 alone, the END Fund was able to treat 121 million people. The END Fund also trained 2.7 million healthcare workers between 2012 and 2019. Its workers have performed almost 31,000 surgeries during that same time period, with the treatments valued at more than $1 billion.

NTDs pose a great threat to people in developing countries. The END Fund has been able to accomplish a lot through its collaborative projects in Nigeria and across other countries. The END Fund will continue to work toward its vision of ensuring that people at risk of NTDs can live healthy lives.

– Evan Driscoll
Photo: Flickr

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The Remarkable People of Zambia

People of ZambiaOften when we think of the sub-Saharan region of Africa, we associate it solely with the conflict and tragedy that has burdened it for the majority of recent history. According to research done in 2019, there were 15 countries from the region involved in armed conflict. In the middle of this, however, lies the country of Zambia, which, contrary to some of its neighboring countries, has managed a peaceful transfer of power to self-rule, and more impressively, has implemented changes to become a democratic republic. Zambia has shown the very best of what united people can accomplish, regardless of the odds. And what is a country if not the very people who comprise it? As such, it is no surprise that a look into Zambian society reveals time and again the stories of unsung heroes who demonstrate unwavering altruism to their people and country.

Silumesii Maboshe – Co-founder of Bongohive

In 2011, Maboshe and his partners founded Bongohive with the objective to elevate the Zambian tech sphere to the next level. The organization functions as an incubator for tech startups throughout Africa but Maboshe has kept his focus on leveraging Bongohive’s operations to advocate and develop the ideas that serve to benefit Zambia in a capacity that goes beyond just the economic. “If I have one professional goal, it is the answer to this question. How can software and innovation change Zambia for the better?” Many of the 1300+ tech products that Bongohive has helped develop function to this end, one example being an app that allows constituents to comment on proposed changes in legislation. Beyond the development of products, the organization serves also as an open platform for techies seeking general advice and hosts dozens of events annually that pertain to technology and business within Zambian society. Maboshe understands that if Zambia is to realize a brighter future it must include a thriving tech culture. The invaluable role Bongohive is playing to that end cannot be overstated.

Christopher Malambo – Sanitation Activist

It is an issue that most are too uncomfortable to actively advocate for, but the fact is that approximately 90% of child deaths are attributed to poor sanitation and the spread of disease that is a result thereof. Additionally, the World Bank reports an annual monetary loss to the African continent of $5.5 billion as a result of poor sanitation. Malambo’s efforts directly combat these staggering statistics. The focus of his activism is toward the decreasing but still prevalent number of communities in Zambia that still practice open defecation. His first objective when entering a new village is education because many of the typical residents lack even a basic understanding of the importance of good sanitation and the adverse effects of a lack thereof. After demonstrating the danger inherent in open defecation, he then organizes and assists in the digging of latrines. Malambo’s unwavering selflessness and commitment to service in the name of saving lives represents the very best of what makes the people of Zambia truly remarkable.

Dorothy Phiri – Founder of Mercy Ministries

In 1996, Phiri founded Mercy Ministries in response to a higher calling. Today the organization works to provide education through the Chifundo Community School, which was the first project started by the Phiri’s. The organization especially focuses on orphans, disabled children and other vulnerable children who are unable to have their needs met by government-funded schooling. Additionally, Phiri provides a means for children of financially struggling families to attend school. Though Zambia does provide free schooling to all its residents, many families still struggle to fund basic schooling needs such as books and uniforms. In a region where the demands of maintaining a livelihood are prioritized over education, Phiri’s commitment to the people of Zambia aims to change the status quo.

These individuals and their stories are but a microcosm of the exceptionalism that defines the people of Zambia. With the efforts of Zambia’s exceptional people, the narrative of the entire region can begin to change for the better.

– Christian Montemayor
Photo: Flickr

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Preventing HIV in Kenya with an Injection

Preventing HIV in KenyaA new, injectable antiretroviral drug, cabotegravir (CAB LA), may have significant potential for preventing HIV among sub-Saharan African women. In November 2020, the World Health Organization (WHO) reported trial results of the HIV Prevention Trials Network Study (HPTN 084), testing the use and effectiveness of CAB LA in preventing HIV among more than 3,200 HIV-negative, sexually active women across east and southern Africa. This drug could significantly lower prevalence rates and help in preventing HIV in Kenya, which has one of the largest HIV/AIDS epidemics in the world.

Cabotegravir or CAB LA

CAB LA, a long-acting pre-exposure prophylaxis (PrEP) regimen, requires an injection only every eight weeks and has been shown to be 89% more effective in preventing HIV than taking a daily oral antiretroviral PrEP, a generic pill currently marketed as Truvada.

Kenya’s HIV Epidemic

The first case of HIV in Kenya appeared in 1984. By 1990, HIV was one of the leading causes of illness in the country. At its highest point, more than three million Kenyans lived with AIDS. Since then, the government of Kenya decreased the prevalence of HIV from its 10.5% peak in 1996 to 5.6% in 2012. By 2019, the prevalence rate was 4.5% in adults aged 15-49. However, certain vulnerable populations within Kenya are more at risk of getting HIV, such as women. Males have an estimated prevalence rate of 4.5% while the rate for females is 5.2%. Among youth aged between 15 and 24 years old, boys have a prevalence rate of 1.34% compared to girls at 2.61%.

The only option for preventing HIV in Kenya is a daily PrEP pill called Truvada. The government of Kenya first approved oral PrEP for country-wide distribution in 2015, and since 2017, has scaled up the distribution throughout Kenya. However, of the 1.5 million Kenyans living with HIV, only 26,098 (1.7%) are currently on PrEP.

Though 72% of the population had been tested for HIV, only 70% had been tested more than once. Frequent testing, at least once a year if sexually active or at least every six months if part of a particularly vulnerable population, is vital to giving care and treatment for at-risk groups.

The Potential of CAB LA for Preventing HIV in Kenya

  1. The HPTN study reported that CAB LA is nine times more effective in preventing HIV in Kenya than the Truvada pill, the current form of PrEP. The PrEP pill is only effective if taken daily and is not a standalone prevention method for other STIs or unplanned pregnancies. The new drug also does not require other forms of protection, such as condoms.
  2. This drug gives vulnerable populations more HIV options for preventing HIV in Kenya. Vulnerable populations include sex workers, men who have sex with men, people who inject drugs, youth and women. These vulnerable populations face stigma, which affects their ability to access PrEP pills. Because the injection is needed only once every two months, the increased discretion and ease of the infrequent injection may increase its use and thus increase the protection of those who need it.
  3. Discretion in use of the drug may be able to reach more women specifically. In combination with the stigma attached to HIV, women in Kenya face discrimination in terms of access to education, employment and healthcare. As a result, men often dominate sexual relationships, with women not always able to practice safer sex, even when they know they should. For example, in 2014, 35% of adult women (aged 15-49) who were or had been married had experienced spousal violence and 14% had experienced sexual violence. Women in Kenya find it especially difficult to take a daily pill, which significantly reduces the effectiveness of the medicine. Only 68% of Kenyan women have access to antiretroviral pills.

Though not yet approved by the U.S. Food and Drug Administration (FDA), the developer of the drug, ViiV Healthcare, expects cabotegravir to be ready for the market by early 2021.

– Charlotte Ehlers
Photo: Flickr

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The Link Between Poverty and Heart Disease

Poverty and Heart Disease
Heart disease has a reputation as a “first-world problem,” the inevitable result of a fatty diet and little to no exercise. Despite this common correlation, the link between poverty and heart disease is becoming increasingly visible. As of 2015, 80% of global deaths from cardiovascular disease were in low to middle-income countries (LMIC). According to The World Health Organization, 37% of premature deaths (<70 years old) in LMIC’s caused by non-communicable diseases are attributable to cardiovascular disease.

Heart Disease and Poverty

Prior to 1990, most deaths in LMIC’s were caused by communicable diseases like HIV, malaria and ebola, or complications from malnutrition. As urban areas grow in developing nations, lower physical activity and access to mass-produced and nutritionally-poor food contribute to the rise in heart disease-related deaths.

Heart disease is often the result of atherosclerosis, a build-up of plaque in the arteries of the cardiovascular system, or thickening that narrows the space for blood to flow. Heart attacks, stroke, arrhythmias and physiological deformities of the heart result from these blockages and can be fatal.

Major factors leading to heart disease include a poor diet, tobacco use, high blood pressure and high blood sugar. Additionally, a lack of diagnostic tools in LMIC may contribute to increased mortality from cardiovascular disease. A delayed diagnosis can result in irreparable cumulative damage and adverse cardiovascular events. Similarly, distributing affordable medications for managing heart disease in LMIC’s (ACE inhibitors, statins, beta-channel blockers and aspirin) is an ongoing challenge.

Non-communicable diseases like heart disease are often contributing factors to continued or extreme poverty due to lost wages, incapacitation and the generational effects of losing caregivers and wage earners. Patients in LMIC’s who survive heart attacks and strokes may need years of costly follow-up care and medication. The increases the likelihood that the dual burden of poverty and heart disease will prove fatal.

A New Baseline

Establishing effective preventative care in LMIC’s is one of the biggest obstacles to reducing cardiovascular disease. Lifestyle changes such as smoking cessation, dietary guidance and increased exercise can make a significant difference. Health professionals should recommend these changes to those screened as at-risk or suffering from high blood pressure.

The World Health Organization (WHO) has programs designed to treat and prevent cardiovascular disease globally. The WHO launched the Global Hearts Initiative in 2016 to provide support to governments in their efforts to prevent heart disease. The approach is multi-faceted and includes improvements to the health care sector, the nutritional quality of food and more.

The World Heart Federation (WHF) is an NGO focused on global cardiovascular care and outreach. Founded in 1978, it is internationally recognized as an authority on preventing, treating and diagnosing cardiovascular disease in children. The WHF provides training and networking opportunities to public health officials and caregivers worldwide, emphasizing practical methods of prevention and treatment.

Moving forward into a world where most people live in cities, vital infrastructure and basic medical services are necessary to improve the quality of life in developing nations and impoverished communities globally. Combating the rising incidence of heart disease is a major battle inequitably affecting the world’s poor. Cardiovascular screening, patient education and dietary guidance are all important steps in the right direction.

– Katrina Hall
Photo: Flickr

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USAID: Agent Orange Cleanup in Vietnam

Agent Orange Cleanup As the United States fought its campaign against North Vietnamese forces during the Vietnam War, part of the military’s strategy included the deployment of Agent Orange, a chemical weapon used to defoliate jungles to expose enemy positions. The toxin was heavily used and has had disastrous health and environmental effects. Now, the United States is leading Agent Orange cleanup efforts in Vietnam. USAID is taking the charge to continue its environmental restoration efforts.

USAID’s Agent Orange Cleanup Commitment

In December 2020, USAID announced that it would commit to contributing an additional $20 million to cleaning up Agent Orange residue around the Bien Hoa Airbase, a major military base used by the United States during the Vietnam War. The airbase was used to store various types of munitions, including chemical weapons such as Agent Orange.

This adds to the $90 million that has already been committed to cleaning up the area around the Bien Hoa Airbase. Planning for the multi-year cleanup operation will be conducted by Trigon Associates, a woman-owned business based in Louisiana.

This recent contribution is part of USAID’s wider Environmental Remediation program, which seeks to decontaminate areas with high concentrations of residual Agent Orange throughout Vietnam. USAID has already completed a major decontamination project in Danang, which remediated 32.4 hectares between 2012 and 2018 at a cost of $110 million.

The current decontamination effort in Bien Hoa is set to last until 2030 and is projected to cost upwards of $183 million. According to USAID, Bien Hoa is the last remaining Agent Orange hotspot in Vietnam. These Agent Orange cleanup efforts are significant as they cleanse Vietnam of a chemical toxin that has been a source of much human and environmental suffering that has lingered for decades.

Agent Orange: Health Impact

According to the United States Department of Veterans Affairs, exposure to Agent Orange is linked to Hodgkin’s disease, ischemic heart disease, Parkinson’s and prostate cancer, among other life-threatening illnesses. Its widespread use means that an untold number of both U.S. veterans and Vietnamese civilians were exposed to the toxin and are at risk of developing these conditions.

Agent Orange exposure has also been linked to birth defects in the children of those who have been exposed. An analysis by ProPublica indicated that the likelihood of having children born with birth defects was more than one-third higher for veterans exposed to Agent Orange versus those who were not.

In addition to causing the grave environmental harm of defoliation, Agent Orange has caused multi-generational human suffering. After spraying more than 20 million gallons of the defoliate over a period of 10 years between 1961 and 1971, the United States is now leading the campaign to clean up harmful residue and protect the people of Vietnam from further exposure.

International Partnership Between Old Foes

The fight against global poverty breaks down barriers and fosters closer ties between international partners, even ones that were once engaged in protracted conflict. Where the United States and Vietnam were once enemies, they are now cooperating in the Agent Orange cleanup, undoing the lingering effects of a brutal war and paving the way for mutually beneficial economic development.

– John Andrikos
Photo: Flickr