Archive for category: Health

Information and stories on health topics.

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Fighting Against Diseases in Sao Tome and Principe

Diseases in Sao Tome and Principe
Sao Tome and Principe is a developing country located on the African west coast. More than two-thirds of the population of this small island state lives on under $3.20 a day and faces the effects of critical disease. However, many organizations are working with the country to fight the war against diseases in Sao Tome and Principe.

Common Diseases in Sao Tome and Principe

Three of the most common diseases in Sao Tome and Principe are tuberculosis (TB), malaria and human immunodeficiency virus (HIV).

TB is an airborne disease caused mainly by air droplets that someone infected with Mycobacterium tuberculosis transmits; it is endemic in Sao Tome and Principe. TB can cause various pulmonary symptoms and affect the lymphatic system, joints and even the central nervous system.

Malaria is a mosquito-borne disease; it is common in the country. Malaria can be very fatal to the victims and cause them to suffer from flu-like symptoms and high fevers.

Finally, HIV is a virus that attacks the immune system and can lead to dangerous acquired immunodeficiency symptoms (AIDS); it is still a significant problem in Sao Tome and Principe.

Key Players in Supporting Sao Tome and Principe

The United Nations Development Programme (UNDP) and the Global Fund have been key players in supporting the fight against diseases in Sao Tome and Principe. Since 2005, the organizations have funded the country in its efforts against HIV, TB and malaria.

Over the years, the organizations have spent $4.5 million for HIV, $3.9 million for TB and $25.4 million for malaria. Through this funding, the UNDP has been able to ally with the National TB Program to develop various treatment and education plans for patients. According to the World Health Organization (WHO), in 2016, there was a 63% decrease in TB mortality since 2000, a 95% detection rate for the disease and a 78% success rate in treating patients.

The UNDP also runs an HIV program; it supports those living with HIV and counsels populations who are at a higher risk for HIV about preventative actions. From 2008 to 2014, the prevalence rate of HIV among 15 to 49-year-olds declined from 1.5% to 0.5%. According to UNDP’s data from 2018, 249,700 people received counseling and HIV testing.

Sao Tome and Principe observed its greatest success in defeating malaria. Mortality rates from malaria have declined from 3.9 to 0.5 cases per 100,000 people. Although the Global Fund is no longer supporting the malaria program, it helped distribute 503,000 bed nets, reaching 100% of the population, and treated 56,800 cases of malaria according to UNDP in 2018. The incidence of malaria morbidity decreased from 65.5 to 11.3 cases per 1,000 people in the time frame between 2012 and 2016. Further, UNDP has granted approximately another $6 million to support the complete eradication of malaria and further control TB and HIV.

Others in the Fight to Eradicate Diseases in Sao Tome and Principe

Although UNDP and the Global Fund have been the major players in supporting the country, there are other groups that have helped toward the goal of eradication of critical diseases in Sao Tome and Principe. In 2015, Brazil spent over $500,000 to build a laboratory that would be focused on diagnosing and treating TB. This laboratory would ensure that the patients would receive quicker lab results and correct diagnoses.

Medical Care Development International, a nonprofit organization, has also taken up a project that will last from 2019-2023. It aims to bolster the ability of the military to provide HIV/AIDs care for its members and population in Gabon and Sao Tome and Principe. The project will increase its capacity to provide care in the military health facilities and laboratories.

A Ray of Hope for Sao Tome and Principe

Despite the dangers of malaria, TB and HIV, the people of Sao Tome and Principe can have hope in the fact that there are many international allies willing to provide support in their fight against these diseases. These common diseases in Sao Tome and Principe may still impose fatal effects on its victims; however, Sao Tome and Principe is not alone in its fight to protect its people.

– San Sung Kim
Photo: Flickr

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How Proper Education Will Help End Poverty

Education Will Help End Poverty
Education is a luxury many people take for granted, but it is something poverty-ridden families often sacrifice to have. Globally, over 250 million children and young adults are not in school. As a result, around 617 million young children and adolescents around the world are unable to read or do mathematics within the minimum proficient level. Poverty is one of the main reasons for this tragedy and it often comes from generations prior that also lacked schooling. By properly educating new generations, poverty rates could reduce significantly. Here are some ways that proper education will help end poverty.

Health

Estimates have determined that in developing countries, one-eighth of all children are born malnourished and that about 47% of those in low-income countries will continue to experience malnourishment until they reach the age of 5. Poor nutrition is a direct result of poverty and often linked to insufficient knowledge of proper nutritional diets. A study that occurred in 13 different countries found that the standard yearly gain production increased with those with basic education by 8.7%, which in turn increased food security and helped lower rates of malnourishment in children.

Education will help end poverty because, with basic education, parents learn more about how to care for themselves and their families, which in turn leads their children towards healthier lifestyles. Health education gives families have a higher chance of survival and even reduces rates of HIV and AIDS.

Mortality Rate

Education will help end poverty because it is particularly powerful for girls. Education has many effects on girls and women, but a primary impact is that if all women in poverty finished primary school, then the child mortality rate would reduce by almost 17%. This adds up to about 1 million newborns saved every year, but how does saving lives help lower poverty rates?

If more children survive, then families would not feel the need to have more children, thus the size of families would be smaller. If the families were smaller, then families would have more income and resources to go around, thus reducing poverty. For example, sub-Saharan African women with no education have 6.7 births on average, but with access to schools, these women only have 5.8 births. And finally, those studied who had finished secondary education have 3.9 births on average.

With schooling, women could more easily recognize danger signs in pregnancy and be able to seek care faster. Women with more knowledge about their body, pregnancy and childbirth have a better chance of giving birth safely. Records have determined that a child with a mother who had basic education is 50% more likely to surpass their fifth birthday.

Income and Economic Growth

Income is, of course, a huge factor in poverty. Records have stated that if someone has basic education (that is, reading, writing and mathematical skills), this not only has a positive impact on their own income but can also “increase the rate of return on the economy.” Those with education have a much higher chance of getting better jobs with higher wages. Just one year of education can result in a 10% raise in pay. More pay means better, more nutritious food, better access to sanitation, better access to healthcare and better housing.

For example, Vietnam was one of the poorest economic countries in the world due to its 20-year war. However, since 1990, Vietnam transformed its poor and war-torn country into a GDP that grew to 3,303%. Its economic growth rate was the second fastest and the main strategy for this success was the improvement and modernization of its education system. Vietnam is only second to China, which also implemented a new education system, causing it to have the number one fastest GDP growth.

With children attending schools and developing both important skills and abilities, they will one day get better jobs. The more income they have, the more goods and products they consume which benefits the companies. This in turn increases the demand for the production of more products, thus giving jobs to more people and helping the economy grow. These changes and more will be key in eradicating poverty around the world.

– Katelyn Mendez
Photo: Flickr

How VillageReach is Improving Healthcare

VillageReach is Improving Healthcare
The history behind VillageReach is very similar to The Borgen Project’s history. Blaise Judja-Sato, a native Cameroonian, founded VillageReach in 2000 after returning to Africa to aid in the relief efforts of a devastating flood in Mozambique. While he was in Mozambique, Judja-Sato saw a problem with the healthcare system. Since many citizens live in rural areas, the government could not provide them with the medical supplies they needed, which led to their frustration. Thus, she coined the phrase “starting at the last mile” and established VillageReach. Here is some information about how VillageReach is improving healthcare in low and middle-income countries.

Healthcare That Reaches Everyone

VillageReach’s mission is simple. It aims to reach “the last mile” in LMICs (low and middle-income countries) where people do not always have access to healthcare or any at all. Even with VillageReach, 1 billion people do not have access to healthcare. However, VR is working to improve the already existing health systems in different areas. It focuses on four pillars including healthcare accessibility, information availability, human resource constraints and lack of infrastructure. VillageReach is improving healthcare in these countries so that the people in and out of rural areas thrive.

Big Partners

Additionally, VR has over 30 partners that keep its organization running strong. From the Bill and Melinda Gates Foundation to UNICEF, VR has quite an array of influential partners. The President of the organization is Emily Bancroft. She stated that VR “could not have made an impact the last 20 years without the collaborative power of partnership.” The team is spread out over 13 countries. It has headquarters in Seattle, Washington and offices in Mozambique, Malawi and the Democratic Republic of the Congo (DRC).

Drones

Furthermore, in 2019, VR collaborated with the Ministry of Health, Swoop Aero and Gavi, the Vaccine Alliance, to launch the Drone Project in the Équateur Province of the DRC. The partners decided to pick this place in the DRC because of its many geographical challenges. More than half of the health systems in place are only accessible by river. The goal of the Drone Project is to increase vaccine availability in areas that are hard to reach. The drones, provided by Swoop Aero, can take off with the push of a button and land without guidance. It can also carry around six pounds. After the Drone Project’s first flights were successful, the partners are already thinking bigger, brainstorming on how to send other medical supplies and equipment.

COVID-19 Response

Also, VR is a supporter of the COVID-19 Action Fund for Africa. The initiative works to supply PPEs (personal protective equipment) to community health workers in Africa. PPEs are practically inaccessible in most African countries and the consequences are horrible. Health workers stay home or work without PPEs. With health workers not working, there is no way that Africa will be able to stop the spread of COVID-19. VR plays a crucial part in the initiative’s seven-approach plan, which focuses on the last mile and working with similar in-country organizations to accomplish its goals.

Recognition

As a 20-year-old organization, VR received recognition numerous times for its fantastic work in Sub-Saharan Africa. Recently, the Washington Global Health Alliance honored VR with the Pioneers Outstanding Organization Award. The WGHA awards winners that work hard to improve health equity all over the world. The judges select winners, and in 2020, WGHA board member Erin McCarthy led it. VR received an award for its innovative approach, collaborations with local governments in the places it works and its international emphasis on equity.

Overall, from COVID-19 response to innovating delivering vaccines by drones, VillageReach has covered it all in its 20 years of service to the world. VR is improving healthcare, one small rural village at a time.

– Bailey Sparks
Photo: Flickr

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Healthcare in Thailand: Bridging the Gap

Healthcare in Thailand
Thailand is a country of hundreds of islands in Southeast Asia with a population of nearly 70 million people. Thailand has a history of political instability and economic uncertainty along with rising poverty rates. However, the country has made great strides to improve its healthcare. Nearly 7 million of Thailand’s citizens live in poverty and a wealthy few control a large majority of the country’s wealth. With one of the most extreme wealth gaps in the world, universal healthcare in Thailand creates a meaningful movement toward equality for all its citizens.

Switching to Universal Health Coverage (UHC)

In 2002, Thailand made the transition from a combination of various healthcare policies to an all-encompassing, universal health coverage (UHC) system. Under the UHC system, every Thai citizen is entitled to health services — including preventative, curative and palliative care, at any age. Under this system, financial protection for high-cost services also improved.

Challenges in Financing the UHC System

Though universal health coverage in Thailand has allowed increased access for all ages and classes of citizens, the country still faces challenges with funding the program. The UHC system is a predominantly publicly funded program, meaning that it functions mainly through taxation. Because the nearly 7 million Thai citizens live no more than 20% above the poverty line, the UHC budget coming from taxes is relatively inflexible. Therefore, funding the growing demands for healthcare in Thailand often requires reaching into other public funds.

Access to preventative medicine has decreased the rates of many illnesses by keeping them from occurring in the first place. However, medical expenses in other categories are on the rise. As the average age of the population increases, healthcare in Thailand faces an influx in elderly patients needing more care. Unsafe road conditions and unenforced traffic laws in many regions also contribute to high rates of road accidents and result in excessive trauma cases. Also, air pollution in cities and extreme weather conditions in various regions across the many islands contribute to increased utilization of the UHC system. For the UHC system to be an equitable, effective and sustainable service for the country, other avenues of funding must be explored.

Challenges and Looking Ahead

Healthcare in Thailand has had many positive improvements since the national transition to universal coverage in 2001. Yet, like any system, it often faces continued challenges. The system is considered popular among lower-paid citizens that did not previously have access to care. Albeit, higher-income communities hold some distaste for the system due to increased access leading to more crowding in hospitals. Universal healthcare in Thailand has created a much more inclusive environment for the Thai people as it helps to bridge the immense wealth gap. A gap between the nearly 7 million living in poverty and the wealthy 1%.

Positive Impact of the UHC System

This alteration of the previous healthcare system has led to an increase in the utilization of health services and decreased the prevalence of unmet needs in the country. Overall, healthcare in Thailand is improving. Not only did rates of care increase with the introduction of the UHC system, but other metrics of improving healthcare also rose.

Life expectancy from birth rose from 71.8 years before the introduction of the UHC system, to 77.2 years in 2020. Infant mortality rates similarly fell from more than 100 per 1,000 births in 1970 to 7 per 1,000 births in 2020. As citizens have been able to access preventative care and more expensive intervention at lower personal cost, out-of-pocket spending on healthcare needs have decreased. Meanwhile, household savings increased. Though the switch to universal healthcare certainly faces challenges, it has created quantifiable positive change for millions living in Thailand.

– Jazmin Johnson 
Photo: Unsplash

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How Technology Improves Rice Production Worldwide


Rice is one of the world’s most popular foods. It is a culturally significant staple in cuisines across the world, from Asia to Africa to the Americas. In fact, rice comprises at least 20% of daily calorie intake for more than 3.5 billion people. Rice is also enticing, especially for the impoverished, for its versatility, nutritional value and affordability to produce and buy. To continue supplying this necessary meal staple for millions of people worldwide, it is imperative that rice farming is efficient and high-yielding. Here are several efforts demonstrating how technology improves rice production.

Crop Manager

The International Rice Research Institute (IRRI) is a global research organization that discovers and implements solutions for rice farming and production to help end world hunger. One such initiative is the development of a useful rice production product called Crop Manager. Crop Manager is a computer program designed to assist rice farmers in tasks like nutrient management and fertilizer selection.

Crop Manager is especially useful for impoverished farmers due to its simple information delivery method. The program conveys information to farmers quickly and concisely via computer printouts and SMS text messages. Thus, even farmers with only basic technologies like cell phones or computers can access this advanced data and improve their crop yields. Crop Manager is currently active in Bangladesh, India, Indonesia and the Philippines.

Biofortification

The IRRI has also committed to improving rice itself. To do this, the organization has begun researching and implementing biofortification: genetic modification of a crop to improve its nutritional value. With this method, grains have been genetically modified to provide greater amounts of nutrients like zinc and iron. This innovation is incredibly helpful for those consuming rice as a major component of their diet. More nutrient-dense rice can help poor families prevent diet-induced diseases like iron deficiency anemia, an illness that causing extreme weakness due to low red blood cell counts.

Hybrid Gains

Another organization demonstrating how technology improves rice production is RiceTec. RiceTec is an American company committed to modernizing rice production worldwide. One specific effort RiceTec has organized is modified disease-resistant rice grains. These hybrid grains are more formidable against diseases that typically kill rice crops, ensuring crop yields remain high.

Other hybrid grains developed by RiceTec allow farmers to increase the quantity of rice in their fields, as well as provide grains with stronger straws and improved grain retention. The implications of these innovations are massive; by introducing these hybrid grains into rice fields worldwide, people relying on rice as a primary component of their diets will become more able to feed themselves and their families. For farmers, selling more of the crop will provide greater income and improve their quality of life.

Furthermore, some hybrid rice grains have the added benefit of using less arable land to provide comparable—if not more—crop yield. In 2009, for example, China reduced its rice-growing land use by 14% while increasing production by 44.1%. With the increased use of hybrid grains worldwide, the sustainability of rice production will continue to improve. Additionally, reducing arable land use will feed more with minimal strain on the environment.

Moving Forward

Modern farming and wealthy countries have long used technology to improve their crops. Developments ranging from crop management software to higher nutrition in crops themselves to hybrid grains have forever changed the practice of farming. By delivering this technology to the world’s poor, people relying on rice as a staple will have the opportunity to succeed both in terms of crop viability and overall quality of life. As technology continues improving rice production, the world comes one step closer to eradicating food insecurity.

– Domenic Scalora
Photo: Flickr

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Air Pollution in Nepal’s Kathmandu Valley

Air Pollution in Nepal's Kathmandu ValleyLocated in a bowl-shaped region enclosed by four mountain ranges, the Kathmandu Valley is Nepal’s most populous and developed metropolitan area. However, with the valley’s population density, level of industrialization and geographic location, a host of problems afflicts the region. In recent years, the international and domestic communities have paid increasing attention to the worsening issue of air pollution in Nepal’s Kathmandu Valley. In Nepal, air contains five times more pollutants than the amount considered safe by the World Health Organization (WHO); the air in the Kathmandu Valley contains ten times the pollutant concentration set forth by WHO guidelines.

Causes of Air Pollution

The Urban Health Initiative (UHI), an on-the-ground pilot program initiated by the WHO, has identified four primary sources of air pollution worldwide:

  • Solid waste
  • Transport
  • Industry/brick kilns
  • Household energy sectors

The geographical location of the Kathmandu Valley exacerbates all four sources of pollution. Since tall mountain ranges enclose the region, the valley does not get enough wind to disperse air pollutants. Furthermore, Nepal’s location between China and India means that the contaminants from both countries flood into Nepal and vice versa.

Effects of Air Pollution in Nepal’s Kathmandu Valley

Air pollution has had a massive impact on Nepalese people. Every year, 35,000 people in Nepal die from illnesses related to air contaminants. Air pollution frequently causes osteoporosis, heart attacks, dementia and kidney diseases. Furthermore, the life expectancy in the Kathmandu Valley is four years less than that of other Nepalese regions.

While the government has taken little action to reduce the region’s concentration of air pollutants, the Nepalese people have taken matters into their own hands. People have started to wear face masks day-to-day, cancel outdoor activities and frequently monitor air pollution levels. Although individuals have shown an admirable degree of agency in protecting themselves, the Nepalese government must take greater action to reduce the risk of air contaminants for its people.

Action Items So Far

To address air pollution in Nepal’s Kathmandu Valley, the Nepalese government has released a National Plan for Electric Mobility (NPEM) that contains several time-oriented goals. The NPEM includes several objectives: increasing the share of electric vehicles to 20% by the end of 2020, cutting fossil fuel use in the transport sector 50% by 2050 and developing a hydroelectric powered rail network by 2040. The NPEM focuses on pollution caused by transportation, and this emphasis has shown promising results.

Due to the COVID-19 pandemic, automobile use has decreased significantly in Nepal. The air quality index in April 2020 showed a noteworthy improvement compared to April 2019: the air on April 30, 2020, contained about 50% fewer contaminants than the air the year prior. Therefore, the government should be able to achieve significant improvements in air quality by targeting automobile emissions.

Efforts by USAID

In 2015, USAID launched the five-year, nearly $10 billion Nepal Hydropower Development Project (NHDP). With this project, USAID aimed to assist in the development of hydroelectric power services. Nepal has impressive hydroelectric capabilities and, if the country harnesses its full hydroelectric potential, it could even have an energy surplus to export to neighboring countries and gain additional revenue.

Working in tandem with various Nepalese governmental organizations, the NHDP focuses on private sector development and investment in hydroelectricity. By creating viable power services, the NHDP hopes to permanently transform Nepal’s energy sector to include more sustainable sources.

Moving Forward

As Nepal and international organizations improve the country’s air quality, a successful continued response will require cooperation. Given Nepal’s landlocked location, collaboration with other countries such as India and China is also necessary. However, in light of the efforts of the Nepalese government and USAID, Nepal is taking steps in the right direction to improve its air quality for the benefit of everyone in the region—especially those in the vulnerable area of Kathmandu Valley. Ultimately, there is hope to combat air pollution in Nepal’s Kathmandu Valley and protect the health and safety of thousands. 

– Alanna Jaffee
Photo: Wikimedia

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Addressing Childhood Blindness

Childhood BlindnessFounded by West Virginian Doctor VK Raju, the Eye Foundation of America responds to the ubiquity of childhood blindness. Though less common in industrialized nations, blindness affects many societies throughout the world. Globally, 2.2 billion people cope with cases of vision impairment or blindness, 12 million of which are preventable. According to the foundation, combating childhood blindness may be the most cost-effective health intervention.

Eye Foundation of America

Most instances of vision impairment result from eye conditions. When eye conditions obstruct the visual system and one or more of its functions, if not treated quickly and effectively, vision impairment leads to permanent blindness.

Dr. Raju, the creator of Eye Foundation of America (EFA), grew up in Rajahmundry, Andhra Pradesh, India. His medical career in ophthalmology brought him to his current residence of Morgantown, West Virginia. Following his journey from east to west, Dr. Raju strengthened his ties to India and other developing countries through EFA.

Childhood vision impairments have an impact on education as learning is done 80% through vision. Therefore, EFA revolves around a singular mission: eradicating childhood blindness. The principles of service, teaching and research, underscore operations of the foundation. EFA sets up medical clinics across the world focused on training staff on ophthalmological procedures, screening local populations for eye conditions and maintaining a functional vision for the youth.

In four decades, EFA made notable strides in combating childhood blindness and overall blindness. In 30 countries across the world, EFA trained and educated more than 700 doctors and medical staff, conducted three million vision screenings and saved the vision of more than 350,000 people through essential procedures.

Early Intervention Prevents Blindness

In an interview with The Borgen Project, Dr. Raju affirms the importance of proper sight for children, without which “the child becomes a problem to themselves, a problem to the family and a problem to society.”

Reducing childhood blindness requires early intervention. If health care personnel identify eye conditions in a child’s first two years of life, the visual cortex still has time to develop and function properly. Conversely, if doctors neglect vision problems during this critical period of growth, the brain cells may never learn to see.

Disparities Between Access and Affordability

Dr. Raju traces the pervasiveness of childhood blindness to accessibility and affordability rather than incidence. He offers his home state of West Virginia as an example. In 2018, the U.S. Census Bureau documented the West Virginia poverty rate at 17.8%, which is 6% above the national rate of 11.8%. Despite relative poverty, Dr. Raju asserts that West Virginia residents enjoy excellent health care and ophthalmological treatment, regardless of whether they have insurance.

Two-thirds of the 1.4 million cases of childhood blindness occur in developing countries where Dr. Raju sets up the majority of EFA’s clinics. Accordingly, The World Health Organization (WHO) reports, “The burden of visual impairments and eye conditions tends to be greater in low and middle-income countries and underserved populations, such as women, migrants, indigenous peoples, persons with certain kinds of disability and rural communities.”

Vision Impacts Global Poverty

Mahatma Gandhi once famously declared, “Be the change you wish to see in the world.” For Dr. Raju, the change is to see. Though often taken for granted, vision enables children to read, write and learn through seeing. Vision impacts education and education impacts poverty. Dr. Raju’s foundation addresses overall global poverty by addressing childhood blindness.

– Maya Gonzales
Photo: Flickr

The State of Health and Healthcare in Ecuador

Healthcare in EcuadorHome to the Galapagos Islands and where the equator runs right through, Ecuador is also home to an extremely impoverished population, where 21.5% live beneath the poverty line. In a country where many people struggle to get their daily needs met, long-maintained and accessible healthcare in Ecuador gets set on the back burner. This can exacerbate the obstacles the population faces in seeking wellness alongside food insecurity and sanitation.

The national healthcare in Ecuador was first deployed in 1967, where it floundered in providing reliable and efficient coverage for its population. Spanning the time between 1992 and 2006, Ecuador underwent eight national governments. This lack of stability created a turbulent socio-political landscape. It ended up wounding the efficacy of the various infrastructural sectors, including health. The Constitution of 2008 declares health to be a right. This supports the moral tenants on which its publicly integrated healthcare system operates, those being the universality and equity of it.

Ecuador spends 9.16% of its GDP on health. This number grew from spending $1.153 billion in 2010 to spending $2.570 billion in 2015. For comparison, the United States, a much wealthier nation, spends about 17.7% as a health expenditure, which amounts to about $3.6 trillion.

The State of Health

Deficiency diseases, which are common in places that struggle with food and nutrition security, along with infectious diseases and degenerative conditions are prevalent within the population. The most common health issues tend to arise from vehicular accidents and assaults.

The World Health Organization measures an efficient healthcare system. It is according to population health, equality in healthcare, the responsiveness of the system, the distribution of a responsive system and the responsible allocation of healthcare expenditures. Ecuador is still making strides in all of these criteria.

Additionally, the healthcare system itself lacks consistency, as those delivering care struggle to coordinate. The classification of different sub-sets within the umbrella of healthcare is also poorly defined. Each healthcare institution has its own structure, management and funds. They can make for unequal care for the people depending on their varying circumstances.

The Healthcare System

Furthermore, Ecuador has two kinds of healthcare: private and public. The public sector includes Social Security and other government institutions such as the Armed Forces and the National Police. There are also private organizations that work within the public sector such as the Cancer Society and Ecuadorian Red Cross.

Also, the national budget, funds that come from outside of the budget, outside agreements and organizations and emergency funds all subsidize public healthcare. Meanwhile, private organizations selling their service to the public health sector, private health insurers and pre-paid health insurance bankroll the private health sector. Private insurers and pre-paid insurers cover 3% of the middle to high-income population.

The Country Takes Action

Fortunately, the country is fighting to create a healthcare system that works for and is accessible to everyone in Ecuador. This includes the poorest and most vulnerable communities. As a result, the Ecuador Ministry of Public Health decided to deploy healthcare in Ecuador that prioritizes primary care. The number of those covered by the healthcare system has been rising. In 2007, the number was just 1,518,164, which rose to 3,123,467 as of 2014.

Overall, healthcare in Ecuador has been improving throughout the years. However, as of June, Ecuador clocked in at one of the highest per-capita COVID-19 death rates in the world. Ecuador’s developing healthcare system struggles to keep up with the pandemic. In the meantime, organizations like Direct Relief are sending donations and resources to Ecuador. They attempt to triage the economic damage and loss of life that will be wrought. The nation continues to build a more robust, sustained infrastructure. Such relief is being used to fill in gaps where Ecuador may have been struggling with preventative measures, such as protective clothing and clinics.

– Catherine Lin
Photo: Flickr

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COVID-19 in Africa: What the Numbers Don’t Reveal

covid-19 in africa

On a world map of the distribution of COVID-19 cases, the situation looks pretty optimistic for Africa. While parts of Europe, Asia and the United States have a dark color, indicating relatively high infection rates, most African countries are light in comparison. This has created uncertainty over whether the impact of COVID-19 in Africa is as severe as other continents.

Lack of Testing

A closer look at the areas boasting lighter colors reveals that the situation in Africa is just as obscure as the faded shades that color its countries. In Africa, dark colors indicating high infection rates only mark cities and urban locations—often the only places where testing is available.

Although insufficient testing has been a problem for countries all over the world, testing numbers are strikingly low in Africa. The U.S. completes 249 tests per 100,000 people per day. In contrast, Nigeria, Africa’s most populous country, only executes one test per 100,000 people daily. While 6.92% of tests come back positive in the United States, 15.85% are positive in Nigeria. Importantly, Nigeria is one of the best African countries for testing: it carried out 80% of the total number of tests in Africa.

As a continent housing 1.2 billion individuals of the world’s population, Africa is struggling to quantify the impact of COVID-19 without additional testing. To improve these circumstances, the African CDC has set a goal of increasing testing by 1% per month. Realizing the impossibility of reliable testing, countries like Uganda have managed to slow the virus’ spread by imposing strict lockdown measures. As a result, the percentage of positive cases in Uganda was only 0.78% as of Sept. 1, 2020.

A Young Population

COVID-19 in Africa has had a lower fatality rate than any other continent. In fact, many speculate that fatality rates may even be lower than reported. Immunologists in Malawi found that 12% of asymptomatic healthcare workers had the virus at some point. The researchers compared their data with other countries and estimated that death rates were eight times lower than expected.

The most likely reason for the low fatality rate in Africa is its young population. Only 3% of Africans are above 65, compared with 6% in South Asia and 17% in Europe. Researchers are investigating other explanations such as possible immunity to certain variations of the SARS-CoV-2 virus and higher vitamin D levels due to greater sunlight exposure.

Weak Healthcare Systems

Despite these factors, the impact of COVID-19 in Africa is likely high. Under-reporting and under-equipped hospitals unprepared to handle surges in cases may contribute to unreliable figures. In South Sudan, there were only four ventilators and 24 ICU beds for a population of 12 million. Accounting for 23% of the world’s diseases and only 1% of global public health expenditure, Africa’s healthcare system was already strained.

Healthcare workers are at the highest risk of infection in every country. In Africa, the shortage of masks and other equipment increases the infection rate among healthcare workers even further. Africa also has the lowest physician-to-patient ratio in the world. As it can take weeks to recover from COVID-19, the infection and subsequent recovery times for healthcare workers imply that fewer are available to work. Thus, COVID-19 in Africa further exacerbates its healthcare shortage.

Additionally, individuals who are at-risk or uninsured can rarely afford life-saving treatment in Africa. For example, a drug called remdesivir showed promising results in treating COVID-19. However, the cost of treatment with remdesivir is $3120. While this is a manageable price for insurance-covered Americans, it is not affordable for the majority of Africans. Poverty therefore has the potential to increase the severity of COVID-19 in Africa.

Economic and Psychological Factors

Strict lockdowns have helped some nations control the spread of COVID-19 in Africa, but at a heavy price. A general lack of technology means that, following widespread school shutdowns, students have stopped learning. Many adults have also lost their jobs. More than 3 million South Africans have become unemployed due to the lockdown.

Furthermore, the lockdowns have also resulted in much higher rates of domestic violence, abuse and child marriage. Many such cases are unreported, meaning that the real scope of the problem is probably larger. Mental health services for victims or those struggling through the pandemic are also often unavailable. In Kenya, the United Nations has appealed for $4 million to support those affected by gender-based violence.

The slow spread of COVID-19 in Africa has allowed the continent and its leaders to prepare. Importantly, its young population will lessen the severity of the virus’ impact. Although these circumstances provide reasons to be hopeful, there is no doubt that Africa’s economy and future will suffer from the virus. This potential highlights the need for foreign assistance not only in controlling COVID-19 in Africa but in the continent’s recovery for years to come.

– Beti Sharew
Photo: Flickr

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Addressing Healthcare Worker Emigration

healthcare worker emigrationThe emigration of skilled healthcare workers from developing countries to higher-income nations has significantly impacted the healthcare systems of the countries these workers leave behind. The quantity and quality of healthcare services have declined as a result of healthcare worker shortages. While there is still incredible room for growth, recent governmental strategies have incentivized healthcare workers to work in their home countries.

Why Is Healthcare Worker Emigration a Problem?

When healthcare workers emigrate, they leave hospitals in developing countries without enough skilled workers. Lower-income countries are likely to carry a greater amount of the global disease burden while having an extremely low healthcare staff to patient ratio. For example, sub-Saharan Africa only has 3% of all healthcare workers worldwide, while it carries 25% of the global disease burden. In many African countries with severe healthcare worker emigration, like Lesotho and Uganda, hospitals become overcrowded. Furthermore, hospitals cannot provide proper treatment for everyone due to the lack of skilled workers.

This directly affects the quality of care patients receive in countries with high healthcare worker emigration. Newborn, child and maternal health outcomes are worse when there are worker shortages. When fewer workers are available, fewer people receive healthcare services and the quality of care worsens for populations in need.

Why Do Healthcare Workers Emigrate?

The emigration of doctors, nurses, and other skilled healthcare workers from developing countries occurs for a number of reasons. The opportunity for higher wages elsewhere is often the most important factor in the decision to emigrate. Additionally, healthcare workers may migrate to higher-income nations to find political stability and achieve a better quality of life. The rate of highly skilled worker emigration, which has been on the rise since it was declared a major public health issue in the 1940s, has left fragile healthcare systems with a diminished workforce.

Moreover, the United States and the United Kingdom, two of the countries receiving the greatest numbers of healthcare worker immigrants, actively recruit healthcare workers from developing countries. These recruitment programs aim to combat the U.S. and U.K.’s own shortages of healthcare workers. Whether or not these programs factor into workers’ migration, both the U.S. and the U.K. are among the top five countries to which 90% of migrating physicians relocate.

Mitigating Healthcare Worker Emigration

The World Health Organization suggests that offering financial incentives, training and team-based opportunities can contribute to job satisfaction. This may motivate healthcare workers to remain in the healthcare system of their home country. Some developing countries have implemented these strategies to incentivize healthcare professionals to remain in their home countries.

For example, Malawi faced an extreme shortage of healthcare workers in the early 2000s. Following policy implementation addressing healthcare worker emigration, the nation has seen a decrease in the emigration rate. Malawi’s government launched the Emergency Human Resources Program (EHRP) in 2004. This program promoted worker retention through a 52% salary increase, additional training and the recruitment of volunteer nursing tutors and doctors. 

In only five years after the EHRP began, the proportion of healthcare workers to patients grew by 66% while emigration declined. Malawi expanded upon this program in 2011 with the Health Sector Strategic Plan. Following this plan, the number of nurses in Malawi grew from 4,500 in 2010 to 10,000 in 2015. Though the nation still faces some worker shortages, it hopes to continue to address this with further policy changes.

Trinidad is another a country that has mitigated the challenges faced by the emigration of healthcare workers. Trinidadian doctors who train in another country now get government scholarships to pay for their training. However, these scholarships rest on the condition that they return home to practice medicine for at least five years. Such a financial incentive creates a stronger foundation for healthcare professionals to practice in their home country.

A Turn Toward Collaboration

A recent study determined that the collaboration of nurses, doctors and midwives significantly decreased mortality for mothers and children in low-income countries. As developing countries work toward generating strategies to manage the emigration of healthcare workers, a team-based approach can improve the quality of healthcare. When there are shortages of certain kinds of health professionals in remote areas, family health teams composed of workers in varying health disciplines can collaborate to provide care. 

Improving working conditions and providing both financial and non-financial incentives to healthcare professionals in developing countries not only benefits workers and the patients, but the nation’s healthcare infrastructure as a whole. An increase in the number of skilled healthcare workers in developing countries gives people there the opportunity for a better life.

– Ilana Issula
Photo: Flickr