About MeaslesMeasles is a communicable disease caused by a virus. Persian physician and scholar Abū Bakr Muhammad Zakariyyā Rāzī discovered the disease in the ninth century but it became a global term in the 16th century. In 1757, measles-infected blood was transmitted to healthy donors where Scottish doctor Francis Home discovered that a highly infectious bacterium causes measles. Measles only become a nationally recognized disease in the United States in 1912, when there were 6,000 deaths annually. To this day, measles is considered to be one of the world’s deadliest diseases, especially in developing nations, despite treatment efforts. Here are three facts about measles.

3 Facts About Measles

  1. In 2022, the creator of the measles vaccine Samuel L. Katz passed away at the age of 95. Before the development of the vaccine, almost every child had measles by the age of 15 and nearly 4 million people were infected every year. Five hundred people died from measles each year, there were 48,000 hospitalizations and 1,000 people had swelling of the brain due to the infection, according to the Centers for Disease Control and Prevention (CDC). In 1956, there was a disease breakout at a school in Boston, Massachusetts, where John F. Enders and Dr. Thomas C. Peebles collected blood samples from infected students and isolated the disease within David Edmonton’s blood. In 1963, they developed Edmonton’s virus into a vaccine and it officially received a license in the United States, where Maurice Hilleman and his research team further improved it in 1968.
  2. Before the vaccine, there was an epidemic every two to three years that caused around 2.6 million deaths each year worldwide, according to the World Health Organization (WHO). Even after the vaccine, in 2018, 140,000 people died from measles, most of which were children under 5. Unvaccinated children, pregnant women and non-immune people are most at risk of getting measles, though it is particularly common in developing nations, such as countries in Africa and Asia. In addition, more than 95% of deaths happen in low-income households and countries with underdeveloped health services, WHO reports. Once one has measles, there is no anti-treatment available. However, vitamin A can reduce the complications and risk of death from measles after taking two doses a day apart. The vaccine is a routine procedure in the U.S. and costs $1 per vaccine. However, many developing nations cannot afford the vaccine. This has led to 19.2 million infants not receiving a single dose in 2018. Around 6 million of these infants were from India, Nigeria and Pakistan, where the number of cases is significantly rising.
  3. According to the WHO, measles spreads through coughing, sneezing and being in close contact with infected patients. It can stay airborne and on infected surfaces for as long as two hours and can infect people four days before and after a rash occurs. The first symptoms of measles show 10 to 12 days after exposure to the virus, lasting for four to seven days. It initially has cold-like symptoms, such as a runny nose, cough, red and watery eyes and a fever. Patients also develop small white spots on their cheeks. This develops into a rash after 14 days, which could last for six days. Without treatment, complications could occur, such as blindness, brain swelling, diarrhea, dehydration and ear and respiratory infections. Though, complications occur more in malnourished children with a lack of vitamin A or those who have weak immune systems from other diseases.

Looking Ahead

In 2010, the World Health Assembly stated three targets to eradicate measles by 2015. First, to enable more first-dose vaccines during routine coverage to more than 90%. Second, to reduce case numbers to less than five cases per million annually. Third, to reduce measles-related deaths by at least 95%. Furthermore, in 2012, the World Health Assembly supported the Global Vaccine Action Plan of “eliminating measles in four WHO regions by 2015 and five regions by 2020,” the WHO reports. These goals were successful and as of 2018, mortality rates had decreased by 73% with the development of the vaccine coverage. The Measles and Rubella Initiative, founded in 2001 and the Gavi Vaccine Alliance also supported this by preventing 23.2 million deaths, where most of the deaths would have been in Africa and the countries that the Gavi Alliance support.

– Deanna Barratt
Photo: Flickr

Oceania's Health ChallengesRecent genetic studies of Pacific Islanders are revealing new insights into Oceania’s health challenges. In turn, these insights may drive sustainable solutions that improve community health and save lives.

Convenience-food diets, obesity, lack of resources and the health challenges that result from these conditions are escalating in many island nations in the Pacific. Worse, the resulting non-communicable diseases (NCDs) are leading to an increase in preventable deaths. Activists from many nations are working to better protect many Pacific Island populations from Oceania’s health challenges.

Oceania

Oceania is a group of countries and territories that share a border with the Pacific Ocean. These 14 countries and territories are diverse culturally, economically, geographically and demographically. Oceania includes the large and wealthy countries of Australia and New Zealand and smaller and less affluent countries including Figi, Tonga and Palau.

Vulnerability

Indigenous people in Oceania are more genetically prone to gut issues and certain NCDs that evolved during colonization. While traditionally, Oceania diets were low-energy-density, the introduction of processed foods and more modern snacks brought obesity and linking issues. Before colonization, there was little to no obesity in the Pacific Islands. According to a 2019 study published in Frontiers in Immunology, “During the period of nutritional transition, the people came to consume energy-dense foods imported from Australia and New Zealand.”

The study reports that certain health conditions disproportionately affect specific indigenous populations including the Polynesians in Hawaii, the Maoris in New Zealand, and the Aboriginal and Torres Straits Islanders in Australia compared to non-indigenous people in the same places.  Mortality rates, NCDs and fertility decline are all issues that disproportionately affect these populations. Studying Pacific Islanders’ health data more closely, as this study did, may lead to sustainable solutions.

Environmental factors such as urbanization, sanitation and pathogen exposure also have the potential to increase disease susceptibility. Genetic vulnerability in the form of microbiome genetic mutations and immune function justifies population-specific medical studies and consideration in regards to nutrition. Accessibility and food insecurity have also driven people to foods that are low in nutrition.

Solutions

There are several specific solutions to combat the sharp rise in NCDs in the Pacific Islands. One strategy is better health monitoring. Current medical data surrounding nutrition is almost nonexistent and therefore Pacific Islander nutrition lacks proper evaluation. Increasing data and enhancing research in this area can better inform people about their eating habits.

The George Institute for Global Health, Fiji National University, Sydney University and Deakin University have created the Global Alliance for Chronic Diseases project. This effort hopes to collect data on preventable deaths and possible food policy initiatives for the future. The researchers already found that decreasing salt intake by one gram a day for a year would prevent heart attacks and strokes and save 131 lives a year.

A second strategy is creating a sustainable interest and consumer demand for fresh and healthy foods.  Since COVID-19, Fiji’s Ministry of Agriculture has distributed seeds for people to grow their own food at home. Additional countries could benefit from a program like this as well.

Other strategies include projects and policies that focus on building a stronger market for healthy foods. Finally, the study suggests applying a gender lens to improve Oceania’s health challenges.  While more women are joining the workforce, they continue to play the primary role in caring for and feeding their families.  They do not have the time to prepare complicated meals so they are turning to convenience foods.

World Bank Showcases Oceania Women Leaders

The 2019 genetic study, others like it and the projects mentioned above are setting a trend of focus on the nutritional health of Pacific Islanders. Sustainable change and progress are occurring throughout Oceania. This progress prompted the World Bank to showcase some inspiring women who are starting to implement solutions to Oceania’s health challenges. In Samoa, Lenara Tupa’i-Fui is the assistant CEO of Health Information Technology and Communications at the Somoa Ministry of Health. She is helping lead the Samoan eHealth system that will better track medical records and provide accessible health monitoring and data. As program director of the Partnership of Human Development in Timor-Leste, Armandian Gusmão Amaral advocates for better health care, especially for women and children. She also focuses on mentoring women to pursue careers in the medical profession.

Looking Ahead

Advocating for better data tracking and health communication, increasing the understanding of and demand for healthy foods and applying a gender lens to improving eating habits are all steps that are helping the vulnerable in Oceania take action on their health.

– Karen Krosky
Photo: Flickr

Health Care in Mauritius
Mauritius, an African island nation in the Indian Ocean, had been an agrarian society with high unemployment rates and low per capita GDP for much of its history as an independent nation. However, in recent years, the country has shifted to having a diversified economy, high employment rates and higher life expectancy. Mauritius reached a per capita GDP of around $11,000 in 2018, and in 2020, achieved an all-time-high employment rate of 93.63%. In an April 2020 Poverty and Equity Brief, the World Bank highlights that Mauritius has eradicated extreme poverty. Along with these milestones, health care in Mauritius has also shown tremendous progress as the main cause of mortality shifted from infectious diseases to degenerative diseases, signaling the advancement of health care technology and policies.

5 Facts About Health Care in Mauritius

  1. Free Public Health Care. Public health care in Mauritius is free for its residents. In 2017, public health institutions provided for around 73% of the health requirements of the population while private institutions addressed 27% of these needs. The number of physicians per 1,000 people has also increased from 1.2 in 2010 to 2.5 in 2018. Additionally, as of 2021, Mauritius’ health care infrastructure consists of “five major regional public hospitals, four specialized public hospitals, two public district hospitals, two cardiac centers, 19 private clinics and hospitals and 30 medical laboratories.”
  2. The Health Care System Shifts to Develop High-Value Activities. Mauritius is promoting an increase in medical tourism, seeking to reign in more profit for its health industry. In fact, “in 2017, Mauritius attracted more than 11,500 foreign patients for treatment” in cosmetic surgery, orthopedics, fertility treatment and other specialized areas. As more investment pours into the sector, advancements in infrastructure can potentially attract more foreign patients.
  3. Health Care is One of the Government’s Main Priorities. Health care in Mauritius is Prime Minister Pravind Kumar Jugnauth’s main priority as he looks to improve the health care system by further addressing non-communicable diseases. Mauritius’ minister of finance, Renganaden Padayachy, whose role is to manage economic activities, is also prioritizing health care in Mauritius by expanding the public health care budget. In 2019-2020, 9.5% of the total budget went to the public health sector, marking a 7.4% increase from the previous year.
  4. Government Commitment in Addressing Health Care Challenges. One of the main challenges health care in Mauritius faces is ineffective distribution and mix of human resources in terms of numbers and skillsets of health workers. In response, the government recruited 538 medical and non-medical personnel in 2020 to receive training on primary health care services, such as immunization programs. Another challenge is Mauritius’ reliance on a paper-based administration form that proved to be inefficient. In January 2021, Mauritius launched an e-health project “to modernize the actual health care system and to make a transition to a technologically-based medical service.”
  5. Advancements in Medical Equipment. Mauritius is promoting the development of high-tech medical tools in the industry. In 2020, Mauritius imported around $30.5 million worth of medical equipment and exported $32 million of medical equipment. In 2021, Mauritius had six medical device manufacturers providing job opportunities to about 600 people.

Looking Ahead

At the onset of the pandemic, the World Health Organization (WHO) placed Mauritius among the African nations at significant “risk of a public health disaster” due to its dense population, a high proportion of elderly citizens and high rate of chronic illnesses. However, Mauritius’ progress and commitment to protecting the health and wellness of its citizens proved to be key in combating COVID-19 as Mauritius emerged as one of the few coronavirus-free places on Earth. Mauritius avoided WHO’s prediction by immediately implementing public health safety measures such as lockdowns, mass testing and contact tracing.

With continued progress in the health care arena, Mauritius stands as a beacon of hope and inspiration to post-colonial countries that progress is possible.

– Samyukta Gaddam
Photo: Wikimedia Commons

Ukraine’s Public Health
The war in Ukraine has had several impacts on the world but most importantly on the Ukrainian people through Ukraine’s public health sector. In fact, the Russian army shelled many hospitals which strongly limited the people’s access to medication and proper health care services. Not to forget that war, the movement of big masses of people from one place to another and the lack of access to clean water, create a favorable environment to increase the spread of viruses and diseases. Ukraine has also had a fragile health sector before the war, being one of the countries with the highest number of HIV-infected people in Eastern Europe. Not to forget the COVID-19 pandemic and most recently a poliovirus outbreak that the government did not have time to handle properly.

HIV and Tuberculosis

Two of the main issues in Ukraine’s public health are HIV and tuberculosis viruses. More than 1% of the Ukrainian population is infected with HIV and the ongoing war caused a disruption in the health care system, leading to a potential lack of medicines used to treat HIV and tuberculosis patients. Tuberculosis is the main cause of death among HIV patients in Ukraine, which underlines the importance of providing proper medication for it. Especially since the country has the world’s highest number of multidrug-resistant tuberculosis, meaning that patients must regularly take their medication or else their situation will degrade quickly.

Many people with tuberculosis are seeing their symptoms worsening because of the bad air quality they must deal with in the shelters. This also means that they can transmit the virus to other people present with them, according to Al Jazeera.

Polio

Back in October 2021, a few months before the beginning of the war and 19 years after Europe was declared polio-free, a young Ukrainian child received the diagnosis of polio. Later, positive polio cases started to increase and the government in collaboration with the World Health Organization (WHO) started a vaccination campaign on February 1, 2022. Unfortunately, this campaign has stopped with the start of the war and although many children received their vaccines there remain around 100,00 who need to receive vaccines to consider this outbreak under control, TIME reports. Polio which was already a serious threat to Ukraine’s public health, given the low vaccination rate during COVID-19, is now very difficult to handle due to the war and its highly contagious characteristic.

The danger of these infectious diseases in times of war and displacement of many individuals all around Ukraine but also the rest of the world is the spread of these viruses without the capacity to track the refugees who might be carrying them and thus transmit them to other populations.

Solutions

When the war started, the UNAIDS stated that Ukraine has only a few weeks of medicines in reserve for its HIV patients. To preserve Ukraine’s public health and avoid the spread of the virus, the WHO along with the United States President’s Emergency Plan for AIDS Relief provided the Ukrainian government with enough antiretroviral medication for the next 12 months. Without forgetting of course the civil society in Ukraine and the help it is providing to make sure that medicines reach every patient on time.

Concerning polio, UNICEF along with Ukrainian health workers is setting up “blue dot centers” all along the refugees’ route, vaccinating a maximum of people against polio, according to TIME. Thus, limiting its spread in the countries, they are fleeing to.

Hence, among the numerous impacts that the Russian invasion of Ukraine had on the country is the destabilization of Ukraine’s public health. With an already fragile health sector, Ukraine had to deal with several health issues with relatively no proper means due to the war. Nonetheless, the country can count on foreign aid to preserve the health condition of its people and also prevent from spreading of different illnesses around the globe.

– Youssef Yazbek
Photo: Flickr

Malaria in NigeriaNigeria has the largest population in Africa with more than 200 million people. About 40% of Nigerians survive on less than $2 per day. The poverty rate in the country has led to an increase in unhygienic living conditions. Poor standards of living contribute to outbreaks of diseases. Malaria in Nigeria is endemic and stands as a life-threatening condition. Bites from an infected mosquito transmit malaria to a living host. Malaria is one of the leading disease burdens with high fatality rates in the country. Globally, reports of 627,000 malaria-related deaths occurred out of 241 million malaria cases in 2020. Pregnant women and children who are younger than 5 risk contracting the disease. Several factors contribute to the prevalence of malaria in Nigeria.

Weather Conditions

Nigeria experiences a tropical climate with rainy and dry weather conditions. In fact, “reports estimate that change in weather was responsible for 6% of malaria cases in some low and middle-income countries in the year 2000.” Weather influences the reproductive rate and life span of insect vectors that transmit diseases. There is an established association between weather and the incidence of malaria in Nigeria. The country experiences high levels of rainfall between June and September each year and there is a reported increase in malaria transmission during these humid months. Malaria is especially prevalent in the rural northern region of the country.

Overcrowded Living Conditions

Housing deficits in Nigeria lead to overcrowded living conditions. Nigeria noted 22 million housing shortages in 2018. The vector that transmits malaria spreads from an infected host through a mosquito bite. Overcrowded spaces serve as a conduit for disease outbreaks and can increase the risk of malaria because higher concentrations of carbon dioxide and other chemicals in crowded houses attract mosquitoes. In addition, reports suggest that poorly ventilated dwellings allow mosquitoes to enter more easily than well-constructed housing with screened windows, thus increasing disease transmission.

Poor Sanitary Conditions

Unhygienic living conditions serve as breeding sites for malaria-carrying mosquitoes. About 60 million Nigerians in 2021 lacked access to clean water and safe sanitary facilities. Lack of access to basic amenities hinders compliance to public health measures of proper handwashing and waste disposal. Poor sanitary conditions continue to hinder efforts in eliminating the disease across Nigeria.

Access to Quality Health Care

Malaria is a mosquito-borne disease that continues to stand as a significant public health crisis in Nigeria. It accounts for 30% of infant mortality and 11% of mortality cases, respectively. Nigeria shouldered 31.9% of global malaria deaths in 2020, ranking as the most malaria burdened nation in Africa. Prevention is key in controlling and eliminating malaria. However, about 83 million Nigerians lack access to health care services, resulting in high morbidity rates for those who have poorer health outcomes. 

Malaria Treatment

Concerted efforts from stakeholders to eradicate malaria in Nigeria have faced daunting challenges due partly to insurgent attacks on health workers. However, Nigeria is making progress in preventing new infections with the use of insecticide-treated mosquito nets and residual indoor spraying with special consideration for vulnerable groups such as pregnant women and children.

A collaboration between global partners and the Nigerian government in mitigating the effects of malaria accounts for the nation’s malaria progress. Initiatives from the Global Fund, Malaria Consortium, USAID, GAVI and Roll-Back Malaria have been successful in improving global health outcomes by reducing malaria deaths by 60% and saving 7.6 million lives. An estimated 100 million insecticide-treated mosquito nets have undergone distribution between 2017 and 2020 to control malaria in Nigeria. Impressively, malaria prevalence declined to 23% in 2018 from 42% in 2010.

In 2021, the World Health Organization (WHO) approved a vaccine as part of an effort toward eradicating malaria. Mosquirix vaccines are useful as part of malaria prevention strategies but funding from the global health community is necessary for a broader rollout. Access to Mosquirix vaccines will be effective in the fight against the spread of malaria in Nigeria and globally.

The Nigerian government launched the Malaria Eradication Fund to strengthen the country’s public health system in response to the challenge of the disease in 2021. Expectations determine that these resources will aid efforts geared toward the elimination of the disease in the country so that Nigeria can be certified malaria-free by the WHO in 2030.

– Sylvia Eimieho
Photo: Flickr

Health Insurance in Morocco
By the end of 2021, health insurance in Morocco covered 11 million citizens. With the final count of covered citizens, the Moroccan government announced its expansion of health insurance to unconsidered sector workers. The number of protected citizens will grow in 2022 as proposals are under review to expand health insurance to uncovered workers, such as artisans, taxi drivers, farmers and more.

Morocco’s Health Insurance System

Morocco’s health insurance system is a mixture of government-run and privately owned insurance businesses. Most in Morocco have coverage through the primary source of health insurance. This is the Mandatory Health Insurance, L’Assurance Maladie Obligatoire (AMO).

Morocco implemented its first health care policy in 1959 and established free health services in the public sector. After 1959, the Moroccan health care system went through various changes. However, in 2005, it established and stabilized with the implementation of new programs to regulate and differentiate between the private and public health insurance systems.

In 2005, the Moroccan government created a mandatory, payroll-based health insurance plan that increased coverage from 16% of the Moroccan population to 30%. The payroll-based system is the AMO. The AMO covers the costs of general medicine and medical and surgical specialties, pregnancy, childbirth and postnatal care, laboratory tests, radiology and medical imaging, optical care, oral health treatment and paramedics.

The Regime d’Assistance Medicale (RAMED)

The second insurance policy that Morocco implemented is the Regime d’Assistance Medicale (RAMED). RAMED is a public, government-financed program to fund insurance for those living in poverty and without the income needed to access the AMO.

The private insurance sector, which people often choose simply due to availability, is a system based on a fee-for-service policy. For whatever the service may be, private insurance requires the individual to pay a minimum of 20% of the fees due. However, fees sometimes range as high as 50%.

Morocco’s health insurance system guarantees free care to anyone. However, it is specifically free for anyone living in poverty at any clinic that Morocco’s government runs, as long as the clinics obtain a certificat d’indigence. Thankfully, the poverty rate in Morocco is as low as 3.6%. However, health care remains concentrated in the cities leaving the rural population without easy access to health care.

The rural population often remains uncovered and without the funds to be a part of the private insurance operations. The impending health insurance expansion promises to cover the rural workers. This will ease the economic burden of health insurance from their income.

Impending Expansion of the System

The expansion to cover more workers is not the first one the government has made since 2019. In 2020, the Moroccan government expanded its health insurance system to cover all costs, for every citizen, for COVID-19 treatment. The treatment coverage is available through the AMO.

Morocco’s health insurance system will expand pending the implementation of six drafted policy proposals. The overarching plan for Morocco’s health insurance system is to generalize all health insurance for uncovered workers. The first step in this plan is the creation of coverage beginning with the farmers in the outlying reaches of Morocco, the taxi drivers in the cities and the artisans spread around the country.

The Need for Health Insurance in Rural Communities in Morocco

Morocco’s rural and farming areas are often unconsidered, with doctors and clinics needing to open in said rural areas. The average salary of a Moroccan farmer is 11,700 Moroccan Dirham (MAD) per month, which translates to slightly more than $1,200.

Unfortunately, since the AMO did not cover the farmers, the farmers were often unable to afford private insurance due to having little income to spare. Therefore, with the flexibility of the cost of services due, the farmers could not risk paying anything that might exceed their income.

The Single Professional Contribution System (SPC)

The farmers are only one of the groups that will benefit from the expanded insurance availability. The Moroccan health insurance system’s expansion also covers artisans, who are part of the Single Professional Contribution system (SPC). The SPC allows workers reliant on a flat rate of income to pay fixed taxes and receive health insurance under the new expansion.

The workers who are part of the SPC do not have high incomes and often live on less than the living minimum wage. Much like the farmers, the AMO would not consider them, leaving them unable to afford the private insurance system.

The Moroccan health insurance system’s expansion allows access to basic health care that many could not access before. The government is increasing the annual amount spent on health care as well. The private and public systems will receive additional funding to hire more doctors. Hopefully, more clinics will open in the rural areas to help these newly insured farmers and rural dwellers.

The Moroccan health insurance system will help both the individual and the public. Expanded health insurance could reduce debt, both health-related and non-health-related. It could permit more opportunities to spend money in the local economy.

Increased economic flow can increase income and wages for all business sectors, including the lower-paid individuals, like the farmers. It can also decrease the poverty rate and the number of individuals at risk of poverty.

– Clara Mulvihill
Photo: Pixabay

HIV/AIDS in UkraineUkraine has one of the highest rates of HIV/AIDS in the world, with an estimated 260,000 people living with the disease. Odessa, the third-most populous city in Ukraine, has “the highest concentration of HIV/AIDS of anywhere in Europe.” Poverty exacerbates HIV/AIDS in Ukraine and links to injected drug use, threats to government funding, lack of access to antiretroviral treatment and social discrimination.

Poverty and HIV/AIDS in Ukraine

In 2019, Ukraine and Moldova stood as the two most impoverished countries in Europe. The poverty rate in Ukraine increased during the COVID-19 pandemic, from 42.4% in 2020 to 50% as of February 2021. There is a strong connection between poverty and the spread of diseases; disease could be both a cause and a result of poverty.

HIV/AIDS causes conditions of poverty when working adults become ill and can no longer support their families. The disease becomes a result of poverty when the conditions of poverty put people at greater risk of contracting it. As an example, women and girls who live in poverty are more vulnerable to sexual exploitation. They are more likely to resort to working in the sex trade, which could put them at high risk of contracting HIV.

HIV/AIDS in Ukraine’s Women and Girls

UNAIDS estimates that out of all people with HIV/AIDS in Ukraine, 120,000 are women older than 15 and 2,900 are children aged 14 or younger. Gender inequality, poverty and violence against women and girls are significant factors in the spread of HIV. Women and girls who live in fear of violence may be reluctant to advocate for safe sex, receive testing or seek treatment for HIV and other diseases.

Gender inequality inhibits women’s access to resources for sexual and reproductive health. In rural Ukraine, where the poverty rate is highest, 36% of women do not participate in community or family decision-making. Only 46% of these women are competent with a computer or the internet. Furthermore, almost 48% do not have access to medical services.

The Lack of Access to Antiretrovirals

As Sky News reported, access to antiretrovirals is a major problem for many people living with HIV/AIDS in Ukraine. Although a law stipulates that antiretroviral therapy should be free to all citizens, limited national resources have resulted in restricted access.

Antiretrovirals are crucial for preventing the spread of HIV to children. The use of antiretrovirals during pregnancy and administered to an infant for four to six weeks after birth can result in a transmission rate of 1% or less. According to U.N. Women, the majority of women living with HIV/AIDS in Ukraine fell between 18 and 45 years old. Out of these women, 39% discovered that they were HIV-positive during pregnancy.

Social Discrimination Against People Living With HIV/AIDS

According to the World Health Organization (WHO), discrimination against people who use drugs and people living with HIV presents a serious challenge to identifying those who need treatment. Harsh drug laws, fear of HIV/AIDS and systematic police abuse undermine efforts to provide HIV information and services such as testing and safe needle exchanges. In addition, the law requires drug treatment centers in Ukraine to register drug users and share the information with law enforcement. This protocol keeps people who use drugs from seeking medical help, which subsequently prevents them from testing and receiving treatment for HIV/AIDS.

The War in Donbas

The war in Donbas has made it difficult for people to receive treatment in a region that previously had one of the highest rates of HIV/AIDS in the country and was home to nearly one-quarter of all antiretroviral recipients. When the war began in March 2014, it displaced 1.7 million people. To compound this, unsafe sex has resulted in an increase of HIV/AIDS within the military. Combined with ongoing military conflict and a shortage of antiretrovirals, Ukraine is experiencing a crisis: the government has failed to keep up with infection rates.

Solutions

In July 2021, Ukraine received a grant of $35.8 million from the Global Fund to Fight AIDS, Tuberculosis and Malaria. According to the Ukrainian government, the nation would use the funds to purchase personal protective equipment (PPE), reduce risks associated with COVID-19 and strengthen the health care system.

Ukraine is collaborating with the Centers for Disease Control and Prevention (CDC), USAID and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). The country wants to implement prevention campaigns, increase access to antiretroviral treatment and target key risk groups, such as people who inject drugs, sex workers and men who have sex with men.

On September 1, 2021, President Biden announced that the United States would provide more than $45 million in additional assistance for Ukraine. The aid would help people facing the impacts of the COVID-19 pandemic and the war in Donbas. The U.S. is working with USAID-supported programs to provide supplies for Ukrainian health care centers, training for health care workers and psychosocial support for the most vulnerable populations.

– Jenny Rice
Photo: Flickr

Mental Health in Guatemala 
Between 1960 and 1996, Guatemala faced a civil war between the government of Guatemala and several leftist rebel groups, resulting in many deaths due to the destructive violence. This caused many mental health conditions to arise among the people residing in the country. Unfortunately, violence and public security continue to be a concern in Guatemala, which is deteriorating Guatemalan mental health.

The Importance of Mental Health

The Centers for Disease Control and Prevention (CDC) defines mental health as one’s emotional, psychological and social well-being, which affects how one experiences and performs in daily life. To add, mental health can help determine how people cope with stress and make choices. Mental health has significant links to physical health because poor mental health can lead to diseases, such as diabetes, heart disease and stroke.

Guatemalans Facing Mental Health Disorders

More than 3,250,000 people in Guatemala could experience a mental health illness in their lifetime. However, unfortunately, many of them do not seek the help they require. In fact, one in four people between the ages of 18 and 65 have suffered or continue to suffer from a mental health disorder, but only 2.3% took the initiative to consult a psychiatrist to address their mental health issues.

Many people are reluctant to talk about their mental health due to a lack of knowledge on mental health in general and the stigma surrounding mental health in Guatemala. Furthermore, Guatemala’s poverty rate increased from 45.6% to 47% in 2020. As a result, Guatemalans are at greater risk of developing mental health disorders because they endure more poverty-related stress and face many economic difficulties in their daily lives. The limited mental health sources available to them are insufficient to help alleviate the stress that socioeconomic disadvantages cause.

In the United States, most health care providers do not cover expenses for mental health care. Interestingly, Guatemala does not have a universal health care system, let alone dedicated mental health legislation. As a result, Guatemalans have difficulty seeking help because the nation has “0.54 psychiatrists available per 100,000 inhabitants,” according to the American Psychological Association, and only five of these mental health specialists are located outside of the main cities. Guatemala is a low-income country that does not have the resources to make mental health data available to the public, which is why there are few studies and limited public data regarding this issue.

Poor Mental Health Among Guatemalan Children

A study conducted by Rosalba Company-Cordoba and Diego Gomez-Baya analyzes the mental health of children in Guatemala. Interestingly, 50% of Guatemala’s total population is younger than 18 years old, meaning Guatemala is home to a significantly large portion of young people. A child’s mental health is valuable because mental health can have positive or negative long-lasting effects on development.

Unfortunately, Guatemala’s high poverty rate has led to increased levels of violence because of desperation and dire living conditions. Exposure to violence showed significant effects on a child’s mental health, such as depression and anxiety. Although childhood poverty is prevalent in many areas of Guatemala, the quality of life showed little significance in the study. These symptoms were more common in adolescents than in children because adolescents are more aware of their surroundings and environment. On the other hand, children exposed to low violence from urban areas with educated parents described higher qualities of life.

Violence rates have continued to increase with assaults, shootings, threats and robberies, causing many children to fear going to school. Almost 60% of Guatemalan students would prefer not to go to school due to fears of violence. Many students and teachers have received threats and experienced robberies or know victims of violence. Guatemala remains one of the most impoverished countries with high rates of violence, which poses a higher risk of a child developing mental health disorders.

Living in these socioeconomic disadvantaged areas can sway children to join gangs because there are few other options. The previously mentioned study showed the association between greater parental education level and higher income with lower food insecurity. However, many children do not attend higher education schooling because they have to work to help their families afford household essentials. The number of children living in urban areas is increasing, which leads to more children in unsanitary conditions and a high cost of living. Almost all children attend primary school, however, the completion rate is 15%, which leads to low enrollment rates for secondary school.

Solutions for Mental Health in Guatemala

Many people have taken action to improve the state of mental health in Guatemala, especially for children. First, many citizens are taking to the streets to protest against the continuation of violence. The implementation of the International Commission Against Impunity (CICIG) resulted in reductions in homicide rates. For example, there were fewer homicides per 100,000 people each year. The CICIG provided Guatemala with $150 million in international support to help reform its justice system, but President Jimmy Morales thought this violated Guatemalan authority. As a result, he removed the CICIG mandate in 2019, causing setbacks in progress.

Next, people are beginning to seek support for their mental health in Guatemala due to more specialized centers offering psycho-emotional support services to the public, such as Federico Mora National Hospital for Mental Health, for a low cost. According to the American Psychological Association, Guatemala has about seven psychologists for every 100,000 people, which is a number that continues to increase.

Lastly, schools are playing roles in fighting against gang violence to ensure the safety of children in Guatemala and other countries. With support from UNICEF and the Ministry of Education, schools created a Peace and Coexistence Committee. The idea is to promote an environment where schools do not tolerate violence, as Theirworld reported. The schools are trying to lead by example and show their students that violence is not the answer, noting fewer disputes among students.

Guatemala is working toward a better future by spreading awareness about mental health and fighting violent trends.

– Kayla De Alba
Photo: Unsplash

Sanitation Facilities Empower Girls
About 2.3 billion people around the world lack access to basic sanitation facilities, according to UNICEF. A lack of sanitation facilities in schools can discourage girls from attending school. When girls have access to clean, enclosed sanitation facilities during their menstrual periods and potential pregnancies, they are less likely to skip school or drop out entirely. Sanitation facilities empower girls to attend school by allowing them to feel safer and more comfortable with access to adequate facilities to properly manage their menstruation. In turn, dropout rates decrease and girls’ education completion rates increase.

Private Changing Rooms

Private changing rooms for girls to bathe and change in can help girls feel more comfortable attending school and participating in lessons. Changing facilities with water supplies offer girls a place to change, wash and dry menstrual supplies during the school day. Some changing rooms may also provide students with free menstrual supplies, which is essential for impoverished girls who lack access to these products outside of school.

Without private changing rooms, female students may feel embarrassed to come to school during their periods, especially in countries where people stigmatize menstruation. According to a World Bank study in India, 80% of girls from rural areas in India thought menstrual blood carried harmful substances and 60% believed menstruation is a topic that people should discuss openly.

The availability of changing rooms in schools is also important for pregnant students who require privacy and good-quality sanitation. A lack of proper sanitation facilities stands as a barrier for many pregnant students who feel discouraged and uncomfortable coming to school otherwise. Hygienic sanitation facilities empower girls by helping them feel comfortable at school, even during menstruation or pregnancy.

Private Bathrooms

Much like changing rooms, private bathrooms in schools with modern urinals or toilets can benefit girls’ education. Private bathrooms may include menstrual supplies and waste disposal, which encourages girls to come to school even during their periods. In cultures that stigmatize menstruation, some girls pretend to be ill or come up with other excuses to avoid attending school during their periods due to shame or embarrassment. Many girls do not attend classes during their periods because their schools lack toilets with water facilities as well as discreet sanitary waste disposal areas. Enclosed and gender-specific bathrooms can also improve girls’ safety by giving them privacy when using the bathroom, which protects them from sexual assault and natural dangers such as snake attacks. Private bathrooms and sanitation facilities empower girls by increasing school attendance rates during menstruation.

Organizations Making a Difference

Many organizations around the world are helping girls remain in school during their menstrual periods by providing clean sanitation facilities and free menstrual hygiene products. For example, ZanaAfrica is a social enterprise that works in Kenya to provide girls with reproductive health education and sanitary pads. The enterprise also leads policy and advocacy programs to help break the silence and shame surrounding menstruation.

In Kenya, estimates indicate that 1 million Kenyan girls miss out on education every month due to a lack of menstrual products and sanitation facilities. ZanaAfrica’s approach to supporting girls in school consists of three key steps: integrating health education into schools, collaborating with local partners to provide sanitary pads and education and leading with advocacy and policy. Since 2013, ZanaAfrica has provided more than 50,000 Kenyan girls “with health education, sanitary pads, underwear and mentors.”

Sanitation facilities empower girls to attend school, dissolving barriers to education so that girls can develop the knowledge and skills necessary to rise out of poverty. Girls’ access to sanitation facilities in schools is a necessary step in fighting gender inequality. With an education, girls in developing countries can access skilled jobs and contribute to the growth of the economy, reducing global poverty overall.

– Cleo Hudson
Photo: Flickr

Low Health Literacy in Developing Countries
While developing countries often face pressing issues such as inadequate health care, a less obvious but equally threatening problem is low health literacy rates. In comparison to developed nations, health literacy rates in developing nations are significantly low. However, if society as a whole works to educate and empower individuals to make better choices regarding their health, low health literacy, also known as the “silent killer,” will see a drastic reduction. Here is some information about low health literacy in developing countries.

Defining Health Literacy

The World Health Organization (WHO) defines health literacy as an individual’s ability to adequately comprehend health information and to implement this knowledge into their everyday life in order to “maintain or improve quality of life.” An individual with lower health literacy is more likely to make questionable health choices and is less likely to take preventative action against manageable diseases.

Limited health literacy also correlates with unhealthy lifestyle choices, increased hospitalization rates and higher mortality rates. These impacts make it clear to understand how inadequate health literacy serves as a “silent killer,” especially within developing nations where these rates are prominently low.

The Situation in Developing Countries

Low health literacy rates link to inadequate education systems and health systems because these structures hold the responsibility of relaying health information to the general public. Thus, nations that lack these proper systems are more likely to have insufficient health education levels.

A survey of adult citizens in Isfahan, Iran, indicates that almost 80% of respondents did not have sufficient health literacy. Most of the respondents with inadequate health literacy were females with “low financial status” and limited education. This data suggests that an overwhelming number of individuals in developing nations lack satisfactory health education, particularly women. The reason for this is likely issues of gender equality — women lack access to education, essential services and employment opportunities. Furthermore, poverty disproportionately impacts women all over the world.

Taking Action

There are several ways to improve health literacy rates, and therefore, improve global health. It is crucial to educate the population on their health and to empower them to effectively manage their well-being. Several interventions have proven effective. In South Africa, providing individuals with informative yet easy-to-read pamphlets that include graphics is improving health education in the country. Meanwhile, in China, findings determined that “periodic training of health educators is essential for improving health knowledge” among the general public.

Media is yet another way to improve health education. In Uganda, “more than one in three used the internet to search for health information.” In Iran, secondary school students cited television as their most helpful source of information on HIV/AIDS. In Israel, “a model of Media Health Literacy (MHL)” showed potential in improving health literacy among younger citizens.

Across Asia, the Asian Health Literacy Association (AHLA) works to understand and improve health literacy rates. This organization aims to raise awareness of this issue “among researchers, officials, healthcare organizations as well as experts in health and education, corporations and media” in order to formulate effective interventions to improve these rates in Asia. AHLA sees this as an essential  part of improving the quality of healthcare “and reducing health disparities between communities, groups and nations.” Ultimately, the AHLA aims to improve global health, starting with Asia.

Moving Forward

Increasing health literacy rates in developing countries is an effective way to improve global health and eliminate inequalities. Through education programs, improved communication and dedicated organizations,  these rates can improve. By educating individuals on matters of health, people all over the world can live an improved quality of life.

– River Simpson
Photo: Flickr