Psychosocial Recovery from Ebola in Sierra LeoneCommunity healing dialogues are proving effective in providing psychosocial recovery from Ebola in Sierra Leone by addressing the trauma and stigma that survivors face. These sessions give community members a forum to raise and address their concerns about problems in the community, promoting health, wellness and prosperity in both psychosocial, emotional and economic senses. The dialogues seek to erase the stigma and promote economic recovery via micro-enterprise groups.

Poverty and Public Health Challenges

Sierra Leone is a West African country with a population of 7.5 million. Life expectancy is approximately 52 years for women and 51 years for men. The top ten causes of death include malaria, neonatal disorders, diarrheal diseases, tuberculosis and HIV/AIDS. Sierra Leone has the highest maternal mortality rate in the world (women have a one in 17 chance of dying from pregnancy or childbirth), in addition to one of the highest mortality rates for children under five. The country lacks a centralized public health system, and most people cannot access health care due to extreme poverty.

Support and Strides Amid Ebola

Sierra Leone had the highest number of fatal Ebola cases in the 2014-2016 outbreak. The disease’s severity prompted the CDC and NGOs like Partners in Health to provide resources and support. The CDC mounted its largest ever response to an outbreak in an individual country, providing services that included:

  • Epidemiological/strategical support
  • Infection prevention and control
  • Case management
  • Health promotion
  • Laboratory/diagnostic support
  • Emergency management
  • Border health
  • Research support

Partners in Health also provided emergency Ebola care and stayed in Sierra Leone after the outbreak to help strengthen the country’s public health system, staff, supplies and infrastructure. It has provided prenatal care, community health services, tuberculosis treatment, mental health care, blood banking and emergency medical services. The organization also established ongoing support systems for Ebola survivors. Strengthening Sierra Leone’s health system is an important means of both alleviating poverty and helping the country heal from Ebola. However, much work remains to be done.

Returning to Communities Through Healing Dialogues

Ebola is a disease with severe physical manifestations, but its social and psychological aftereffects can also be devastating and can help ensure that those affected remain in poverty.

In the words of one lifelong resident of Sierra Leone, “The Ebola outbreak in West Africa had the same psychological effects on individuals as war.”

Often, Ebola survivors are grieving for the deaths of their loved ones. At the same time, they face stigma and discrimination when trying to return to their communities because people fear that they still carry Ebola.

To address these complex and multifaceted issues, USAID’s Advancing Partners & Communities project introduced community healing dialogues. These meetings, which are conducted by trained facilitators, give community members space to talk through and resolve their concerns. These sessions are having positive effects on psychosocial recovery from Ebola in Sierra Leone for both survivors and their communities. Some survivors have been able to rejoin their communities free of stigma. In addition, the sessions serve as a forum for the community-based resolution of economic problems. For example, the forum led to a micro-enterprise group helping pay for a young woman’s school fee.

Sierra Leone’s Ebola outbreak was devastating on medical, economic and psychosocial levels. Support from governmental and non-governmental organizations have helped the country face these issues. Community healing dialogues have been extremely beneficial in aiding psychosocial recovery from Ebola in Sierra Leone.

– Isabelle Breier
Photo: USAID

End dog rabiesIn 2005, The Global Alliance for Rabies Control (GARC) was formed as its founders noticed a lack of effective programs to control rabies in poorer communities around the world. Since then, the organization has been working to end dog rabies worldwide and, ultimately, the transfer of rabies to humans.

Global Impacts of Rabies

The World Health Organization (WHO) has reported that dog bites cause 99% of rabies cases in humans. According to the WHO, about 59,000 people die yearly from rabies, and approximately 40% of those deaths are children. Many of these children live in poor, rural areas in Asia and Africa. The WHO wrote that the vaccination of dogs combined with dog-bite prevention could eliminate rabies in dogs worldwide.

A 2018 study examined the connections between poverty, rabies knowledge, healthcare and dog ownership. The study looked at data from two specific countries: Uganda and Cameroon. Overall, the study showed a correlation between communities in poverty and fewer dogs being owned. In Uganda, results showed that poorer communities had lower vaccination coverage rates for dogs, meaning fewer dogs were vaccinated. Communities in Cameroon showed a cost-barrier to accessing post-bite care, revealing that poverty can be a roadblock to receiving treatment for dog bites.

Low dog vaccination rates in poorer communities and poverty as a barrier to treatment are not issues unique to Uganda and Cameroon. The GARC reported that poorer communities in general, mostly in Africa and Asia, tend to have less effective programs for controlling rabies.

Solutions

The GARC has been working to end dog rabies worldwide for many years. Recently, they have made steps towards eliminating rabies in dogs and, thereby, the transfer of rabies from dogs to humans. 

  1. World Rabies Day: In 2006, the GARC helped create World Rabies Day to draw attention to dog rabies worldwide and the health issues it poses. The first official World Rabies Day was held in 2007. Boehringer Ingelheim & Merial, one of the top 20 pharmaceutical companies in the world, donated 75,000 rabies vaccinations as a part of World Rabies Day in 2018.  
  2. Rabies education: The GARC helped launch a rabies curriculum in Bohol, a province of the Philippines. Rabies education was officially incorporated into every school in 2009. The program was successful; in 2011, Bohol was declared rabies free
  3. Certification programs: In 2015, the GARC created a free online platform where people around the world could be certified in vaccination and animal handling and earn a Rabies Educator Certification. More than 4,000 people had graduated from the rabies education program by 2018, and 500 of those received a vaccination and animal handling certification. 
  4. Rabies and poverty awareness: In 2015, the GARC published the first study about the effect of rabies on global health and the economic burden it can create. This paved the way for future studies outside of the GARC, such as the 2018 study mentioned above. 
  5. Strategic plans: The GARC helped launch the Global Strategic Plan for Zero by 30 in 2018. The plan’s goal is to completely eliminate human deaths from rabies. The WHO, the Food and Agricultural Organization of the United States, the World Organization for Animal Health and the GARC have all come together to complete the strategic plan by 2030, hence the name Zero by 30. 

According to the GARC and independent studies, rabies has been shown to have a greater impact on those in poor communities. The vast majority of rabies transmission to humans comes from dogs, and the WHO has determined vaccination and the prevention of bites as a potential strategy to eradicating the disease. The GARC has been working to end dog rabies worldwide through awareness, education, studies and strategic plans. While thousands of people contract rabies yearly, the GARC, along with other agencies, are hard at work to decrease the impact of this disease. 

–  Melody Kazel 
Photo: Flickr

Seven Facts about Healthcare in Denmark
Denmark is a country in Northern Europe. It is one of the wealthiest countries in the world and is notable for its healthcare. In addition, the Social Progress Index 2017 rated Denmark first in the world for quality of life. Denmark also scored 99.28% in nutrition and basic medical care. Here are seven facts about healthcare in Denmark.

7 Facts About Healthcare in Denmark

  1. All citizens in Denmark enjoy universal, equal and free healthcare services. Citizens have equal access to treatment, diagnosis and choice of hospital under health insurance group one. Healthcare services include primary and preventive care, specialist care, hospital care, mental health care, long-term care and children’s dental services. However, citizens are able to buy customized insurance under health insurance group two.
  2. Denmark organizes child healthcare into primary, secondary and tertiary healthcare systems. The primary level is free for all Danish citizens. However, there are unsolved problems in Denmark’s child healthcare. Problems include the increasing costs of children’s medical services, limited professional human resources and insufficient coverage of child immunization. In fact, in 2014, Denmark had the lowest childhood immunization coverage in Europe, leading to measles outbreaks.
  3. Tax revenue funds healthcare in Denmark. The state government, regions and municipalities operate the healthcare system and each sector has its own role. The state government creates general healthcare plans and regulations and allocates funding. Meanwhile, regions and municipalities are responsible for making specific plans according to sociodemographic criteria. Regions are in charge of hospital care, while municipalities are responsible for home care, prevention, rehabilitation and public health.
  4. The healthcare system runs more effectively than other developed countries, such as the U.S. and other European countries. For instance, experts attribute low mortality in Denmark to its healthcare success. Health expenditure is high in Denmark, as the country spends 10.3% of its GDP on healthcare services. In 2014, the amenable mortality rate in Denmark was one of the lowest in the E.U. This indicates that healthcare in Denmark has proven successful. Moreover, Denmark spends relatively less money on healthcare in comparison to the USA. In 2016, the U.S. spent 17.21% of its GDP on healthcare, while Denmark only spent 10.37%. By contrast, in 2015, the life expectancy at birth in Denmark was 80.8 years, yet it was 78.8 years in the U.S. Once again, healthcare spending in Denmark proves itself to be very effective.
  5. The high-quality healthcare system increases life expectancy. Danish life expectancy slightly exceeds the average of the E.U. The overall life expectancy of Danish citizens is 81.3 years. However, Danish women have a higher life expectancy than men. A 65-year-old Danish woman can expect to live almost another 20.7 years and men another 18 years.
  6. Cancer and cardiovascular diseases are the top two causes of death. In 2014, cancer accounted for 29% of female mortality, and cardiovascular diseases accounted for 24%. As for men, cancer accounted for 32% of mortality and cardiovascular diseases caused 25%. Other illnesses deplete the quality of life in Denmark as well. Chronic diseases like musculoskeletal problems and depression are not necessarily killers but lead to poor health.
  7. Healthcare in Denmark sets a good example for elderly care in other countries. A large percentage of the population is aging, as 19% of Danish citizens are above 65 years old. Danish senior citizens have the right to enjoy home care services for free, including practical help and personal care, if they are unable to live independently. Similarly, preventive measures and home visits can help citizens above 80 years old to plan their lives and care. In addition, the members of Senior Citizen Councils, which guarantee the healthcare rights of senior citizens, are citizens who are more than 60 years old.

Overall, healthcare in Denmark is high quality and provides general, equal and free services to all citizens. However, the Danish healthcare system is not perfect, and some citizens experience poor health. With stable wealth and advanced technology, Denmark has the potential to solve its healthcare challenges and continue to provide quality services to its citizens.

– Yilin Che
Photo: Flickr

Healthcare in HaitiHaiti has a population of 11 million people and shares the Caribbean island of Hispaniola with its neighbor, the Dominican Republic. Coverage of Haiti’s poverty was launched into world news after the 2010 earthquake. The country is still recovering from this natural disaster which has had detrimental effects on every sector of the economy including healthcare. Here are five facts about healthcare in Haiti.

5 Facts About Healthcare in Haiti

  1. Haiti is the poorest country in the Western Hemisphere ranking 169 /189 countries according to the Human Development Index. The life expectancy for males is 61 years of age compared to 66 years for females. Haiti has one of the world’s most unequal income distributions, and with 6 million Haitians living on less than $2 a day affording healthcare is a challenge. In 2012, only one-third of the population was financially stable enough to access healthcare in Haiti.
  2. Little government funding causes low public investment in healthcare in Haiti. The World Bank deems the government’s finances should invest in preventing diseases rather than creating more hospital buildings. Unfortunately, the Haitian government has largely decreased its investment in healthcare and in 2017 only 4.4% of Haiti’s budget was spent on public health.
  3. The Hospital of the State University of Haiti is still not constructed following the devastating 2010 earthquake. This planned 534-bed infirmary was set to become the newest general hospital, but the project has come to a halt as $27 million is still needed for completion. Issues about which type of healthcare system to use, political problems and a poor economy bring about questions when this building will be finished.
  4. Around 96% of the Haitian population is exposed to natural disasters that hinder advancement in society. For example, the 2010 earthquake destroyed the capital city of Port-au-Prince, where more than 25% of the country lives. This earthquake killed 150,000 people and destroyed 60% of the healthcare system in Haiti. The highest rates of cholera in the Western Hemisphere are in Haiti. The cholera epidemic entered Haiti’s rivers in 2010 which infected 800,000 people and killed 10,000. In 2014 drought caused millions of people to become food insecure which created the problem of malnourishment.
  5. The current political conflict is putting a strain on access to healthcare in Haiti. In an attempt to force the Haitian President to resign, the country participated in a lockdown known as “Peyi Lock.” Due to the lockdown, patients were unable to travel to hospitals and major shortages of medical supplies such as drugs and oxygen occurred. Inflation caused the price of medicines to increase by 35%. International medical assistance groups have begun to leave the island which will harm those in poverty who cannot afford healthcare.

Political conflict and poverty create difficulties when accessing healthcare in Haiti. Though the current pandemic presents new challenges, the World Bank created a $20 million COVID-19 Response Project for Haiti to help address the most pressing concerns. Aside from emergency health funding, the World Bank is also addressing gaps in other sectors such as WASH and food security which all relate to ensuring resilience in the health of as many Haitians as possible.

– Hannah Nelson
Photo: Unsplash

Sanitation in SomaliaLack of access to WASH (Water, Sanitation and Hygiene) is inextricably linked to extreme poverty around the globe. Somalia, a country located in the Horn of Africa, has long faced issues relating to the provision of adequate sanitation services for its citizens. Though Somalia struggles with WASH, several organizations have vastly improved sanitation in the country, positively impacting education and health. The following are seven facts about sanitation in Somalia.

7 Facts About Sanitation in Somalia

  1. Improved water sources make education accessible. Currently, only 45 percent of Somalia’s population has access to improved water sources. Lack of access to clean water prevents children from attending school because they are forced to spend much of their day collecting water. Mercy-USA is working to tackle this water crisis and give children the chance to have the education they deserve. Since 1997, the organization has dug and repaired about 670 wells, benefiting more than 750,000 people in Somalia.
  2. Waterborne diseases result in numerous deaths per year. Waterborne illnesses such as cholera and diarrhea are the primary cause of 23 percent of deaths in children under 5 and are strongly correlated with child malnutrition. UNICEF is working to improve access to sanitation facilities and provide integrated interventions that reduce incidences of diarrhea.
  3. Improving health through hygiene education. Diseases often spread due to inadequate knowledge surrounding hygienic practices. Action Against Hunger launched a cholera prevention program in Somalia, which provided communities with hygiene education sessions. These sessions helped people understand the importance of handwashing, properly disposing of trash, and how to keep latrines clean.
  4. Drought kills cattle and leads to contaminated water sources, but UNICEF is helping. Recently, Somalia experienced a drought that had extremely adverse effects on much of the population. For many, farming is vital to their existence. The drought forced many farmers to migrate with their animals in search of water, but many animals died in travel. With so many animal carcasses littering Somalia, rainfall posed a threat of contamination to their water sources. In Somaliland and Puntland, UNICEF and WFP responded to the drought to provide food and water vouchers to about 76,000 people, saving those with compromised livelihoods.
  5. Reducing open defecation can improve health. The prevalence of open defecation in rural areas is estimated at 56 percent, leading to a vicious cycle of illness as it pollutes water that people use for cooking, cleaning and drinking. While many parts of Somalia experienced a massive outbreak of cholera after a severe drought (affecting more than 80,000 people), there were no cases in the village of Luqgodey where a UNICEF-supported program put an end to open defecation.
  6. Menstrual Hygiene Management (MHM) kits are improving women’s health. In Somalia, there continues to be taboo surrounding menstruation. In addition, some women only have access to cloth rags that restrict movement and are unsanitary because they have a limited source of water. The ELRHA sent 2,000 MHM kits to various countries, including Somalia, to help tackle this issue.
  7. Recent periods of drought have displaced over 1 million people. A severe drought in 2017 displaced 1.5 million people in Somalia and almost led to a famine. Thankfully, UNICEF provided safe drinking water to 1.8 million people, along with other critical interventions to meet the basic needs of Somali children and women affected by this drought.

While Somalia is still far from achieving proper sanitation for all who inhabit the country, these seven facts about sanitation in Somalia prove that hope is not lost and that, with help from philanthropic organizations around the world, sanitation can become accessible for all.

– Hannah White
Photo: Flickr

refugees making masksAll over the world, artisan refugees are using their talents to make face masks. These refugees live in countries such as Mali, Germany, America, Malaysia and many more. They are running a race against time to fill the short supply of face masks in the wake of COVID-19. Refugees making face masks is one way they are giving back.

Social distancing enforcements have put a strain on refugee-owned tailoring businesses. People are unable to come into these businesses anymore as they have to stay at home. Finding a solution to this bind, refugees have turned their primary services to making masks. They are selling them to stay afloat while also helping a great cause.

Refugees Making Face Masks

At least 32,898 have come through Washington since 2003. In Seattle, the Refugee Artisan Initiative has the mission to “transform the lives of refugee and immigrant women by providing sustainable work in sewing and handcrafting products.” Usually, women in this organization, who span from countries such as Vietnam, China, Myanmar and Morocco, produce home products like potholders and fabric jewelry. The Refugee Artisan Initiative helps train refugees so they will have a way to earn a living. It also helps them assimilate by helping them find English classes.

When the crisis hit, the organization was bombarded with many messages about there being a shortage of face masks. In response to this, working refugees decided to make masks by using the multitude of fabrics they have. The Refugee Artisan Initiative then launched a GoFundMe page to support the refugees making face masks. The refugees were able to make more than 1,200 masks within five days.

Continued Efforts

In addition to face masks, the Refugee Artisan Initiative team is also making face shields. It started with a goal of creating 1,000 face shields, but after “Washington state started to pay people for finished face shields,” the goal increased to 10,000. So far, the organization has raised $39,525 towards its $45,000 goal. This money goes to supporting the refugees making the masks to keep the production going. Now, refugees around the world are making masks to help the cause and make whatever money they can to survive.

In refugee camps, social distancing is nonexistent because there are too many people in the camps and they are too close together to social distance. Refugees feel empowered to make face masks in these camps. One of these refugees is fashion designer Maombi Samil who lives in Kenya and is making face masks for the UNHCR (the U.N. Refugee Agency). He and his team were able to make 300 masks in one week. Some of these masks went to refugees who could afford them as well as staff members in need.

Refugees making face masks have helped communities tremendously. They will continue to use their talents to produce face masks as COVID-19 continues. They have been able to make a great difference in protecting people, especially those on the front-lines, against COVID-19.

Emily Joy Oomen
Photo: Flickr

covid-19 in Algeria
Algeria, a North African country bordering Morocco and Mali, has faced new obstacles from the rapid spread of COVID-19. With one of the highest infected rates in Africa with more than 5,000 cases confirmed, authorities have advised citizens to limit their social interactions. Under these unprecedented times, there are several efforts to combat the spread and promote the well-being of Algeria’s citizens.

The Problem

As stated above, Algeria is facing hardships due to the increased death toll that COVID-19 has left behind. In response, the government has implemented a conditional lockdown where it has modified curfew in order to halt the spread of the virus. However, many have met the increased safety measures with concerns. Because an increasing number of individuals of Arabic descent dominate Algeria, conflicts have arisen in regard to Ramadan, a period of fasting.

One of Algeria’s most prominent politicians, Noureddine Boukrouh, has called for canceling fasting as it “poses a health risk and contributes to the outbreak of COVID-19.” People have met his statements with controversy, yet the country has made no formal precautions.

Algeria is beginning to impose restrictions on sanctuaries as well. For example, authorities have begun closing Mosques, leading followers of Islamic traditions to face difficulty balancing the risk of COVID-19 infections against the weight of religious traditions.

Amidst the controversies, the Algerian government is also having trouble aiding its citizens. With Algeria’s economy being heavily dependent on oil, the sudden price reductions from COVID-19 have hurt the nation. Algeria is now under a reduced budget, meaning that it cannot prioritize its citizens.

As a result, citizens of Algeria have seen food shortages as well as a lack of medical equipment. From Algeria’s budgeting issues, individuals who have the virus are also having trouble in hospitals due to inadequate conditions.

Road to Change

Despite the increased death toll and speculations surrounding the Algerian government, the conditional lockdown has seen positive results. By limiting social interactions, the nation has seen more than 2,000 individuals recovering, leading Algeria’s citizens to become more optimistic about the future.

In addition to the efforts combatting COVID-19, Algeria has received great aid from countries and organizations. Most notably, Chief Mark Lowcock, the U.N. Humanitarian Chief, donated $15 million from the Central Emergency Response Fund.

Another notable contribution was from China; it sent a 13-member Chinese medical team and equipment, worth around $450,000. This team is distributing masks and protective clothing all across Algeria so that citizens could protect themselves better.

Before these contributions, Algeria suffered a shortage of equipment and staffing. Patients in hospitals could not receive treatment effectively and the general public lacked access to goods to protect themselves. Without this aid, Algeria would have seen a dramatic increase in deaths due to its lack of technology and manpower for COVID-19.

To further accelerate this growth, protests by the Hirak that began in late March 2020 are ongoing. The protests have been an attempt to motivate the government to focus on improving conditions. The Hirak is a group of Algerian citizens who have the goal of bringing change to the government’s acts of ignoring the public. Along with the aid from large organizations and countries such as UNICEF and China, the wide distribution of hand sanitization stations and testing kits are continuing.

Volunteer Help

Volunteer doctors have also taken the stage in Algeria. Large teams have established COVID-19 hotlines, and shortly after establishment, they have reached more than 46,000 people. These hotlines provide verbal assistance to patients as well as education to citizens regarding the harsh effects of COVID-19. Algerians battling the virus utilize these hotlines to immediately get aid from doctors.

In addition, volunteers have made strides to assist the majority of the provinces in Algeria; more than 48 have an infectious disease center. Through these newly established centers, volunteers have been able to reach out to thousands of Algerians while pairing patients with doctors.

The Future

Algeria is currently on the road towards improvement. By increasing the number of testing kits, medical equipment and volunteers, the number of recovered patients has grown tremendously.

However, it is evident that Algeria’s government must take the initiative to aid citizens in need. Through fostering the abilities of volunteers and continuing to improve the qualities in hospitals, Algeria has the potential to fully combat COVID-19 while looking out for the well-being of its citizens.

Aditya Padmaraj
Photo: Pixabay

Healthcare in MalaysiaThe organization of Malaysia’s healthcare system is a two-tier system that is comprised of public universal access for all the country’s citizens and private access for others. The government works closely with the healthcare industry to improve and promote the system of healthcare in Malaysia. As a result, the nation takes pride in being a medical tourism hub and holding the status of the “world’s healthcare marvel.”

Past Healthcare Accomplishments

In October 2018, Malaysia became the first country in the Western Pacific region of the globe to eliminate mother-to-child transmission of the diseases HIV and syphilis. Prior to this accomplishment, about 1,000 Malaysians were born with HIV/AIDS in 2007. According to the World Health Organization, Malaysia began the effort to combat HIV/AIDS transmission in 1998 with antenatal screenings.

Ms. Sherene Azli, Chief Executive Officer, Malaysia Healthcare Travel Council, shared with The Borgen Project that healthcare in Malaysia has three selling points: it is high quality, cheap and the doctors speak English. Not only are most medical staff fluent in English, but some hospitals have translators for over 22 languages. International Living recognized Malaysia as the “best nation in the world for healthcare” from 2015 to 2019 and ranked the nation as the seventh-best place to retire in 2020. Healthcare in Malaysia is highly affordable, said Azli, and therefore, it is very competitive compared to the Western world. Healthcare costs can be anywhere from 40 to 70 percent cheaper compared to the U.S. or U.K.

Further, healthcare in Malaysia adheres to Muslim standards, and therefore it can accommodate any citizen or medical tourist with strict religious restrictions. Azli told The Borgen Project that “Malaysia is a Global Halal Hub, which is good news for Muslim healthcare travelers. Malaysian society is Muslim-friendly. All Malaysian hospitals serve halal food and provide prayer facilities. Porcine-free medical products, such as sutures and vaccines, are also available at medical facilities. Many Malaysian medical professionals and personnel are Muslims too.”

Malaysia is one of two Muslim nations in Southeast Asia; Indonesia is the other Muslim nation in Southeast Asia. Due to the superior accommodations to Muslim populations, Indonesians make up 60 percent of total healthcare arrivals, according to the Malaysia Healthcare Travel Council (MHTC).

Medical Tourism as a Thriving Industry

The MHTC is an initiative under the Malaysian Ministry of Finance that works to grow the healthcare travel industry by building Public-Private Partnerships (PPP) that combine state-run industries with private companies. From a conversation with the MHTC, the organization spoke about a planned campaign for healthcare travel throughout the year 2020. Unfortunately, in March 2020, MHTC announced the program’s deferment to the following year.

“We serve as a driver and catalyst towards positioning the country as the leading global destination for healthcare,” said Sherene Azli. “Malaysia is one of the few countries in the world where healthcare travel is a government-supported industry while being driven by the private sector.” 

Many people from surrounding countries come to Malaysia for healthcare needs. Most of the doctors have Western training and speak English, making healthcare in Malaysia perfect for tourists and expatriates. The Malaysia Healthcare Travel Council reported an increase in 2011 from 643,000 medical tourists to over 1 million in 2018. Some in-demand fields are cardiology, oncology and in-vitro fertilization (IVF).

“In 2018, Malaysia Healthcare attained RM1.5 billion [Malaysian ringgit] in hospital receipts which resulted in an economic impact of RM6.4 billion as stated in the Malaysia Healthcare Chronicles,” Azli said.

Healthcare in Malaysia in Response to COVID-19

Much like the shelter-in-place orders in the U.S., Malaysia imposed a Movement Control Order (MCO) after the outbreak of COVID-19. This movement restriction encourages Malaysians to practice social distancing. The nation was the first in the region to impose such restrictions. As a result of these orders, the MHTC reported a 45 percent recovery rate.

The government has scrambled to help its citizens. For example, shelters have been providing protection for the nation’s homeless from the virus. The Malaysian government is also collaborating with the United Nations High Commissioner for Refugees to protect people in Malaysia with refugee status. In addition to these actions, Malaysia passed RM260 billion as a stimulus package for the nation’s people.

The largest glove manufacturer in the world, Top Glove Corporation, resides in Malaysia. It manufactures one in five gloves around the world. Malaysian manufacturers are working to help flatten the curve of COVID-19 by converting facilities and providing more PPE. Top Glove Corporation plans to produce face masks in two months at a facility that retrofitted itself for the new product. Another company, Karex, will convert two lubricant lines into hand sanitizer manufacturing.

Although the MHTC acknowledges the hardships the pandemic has caused and will continue to cause the industry, it should continue to prepare for an economic rebound. “Over the next five years, Malaysia healthcare will focus on three key initiatives namely, the Fertility and Cardiology Hubs, being the Centre of Excellence for Oncology, as well as the Flagship Medical Tourism Hospital Programme,” Azli said.

Going forward, it remains a priority to position healthcare in Malaysia first so that it can prevail as a global medical leader.

– Annie Kate Raglow
Photo: Flickr

ENT Care in Zimbabwe Zimbabwe is a country in Sub-Saharan Africa with an estimated population of 14.2 million people. As a developing country struggling from political and civil issues, their Human Development Index is at 0.509. This places the country in the low human development category. Lacking effective medical care access, the country has long struggled with managing several pandemics. This includes malaria, HIV, tuberculosis and widespread maternal and childhood illnesses. A particular medical issue that needs attention in Zimbabwe is ear, nose and throat (ENT) care.

Challenges in ENT and Audiology Care in Zimbabwe

According to a survey of 22 Sub-Saharan countries in Africa, it has been observed that there has been an overall lack of progress in ENT and audiology care between 2009 and 2015. Although there has been an increase in ENT surgeons by 43 percent and audiologists by 2.5 percent, these numbers cannot adequately serve the 23 percent population growth that occurred during that time. Since 2015, there has been a steady decline in ENT physicians and audiologists in Sub-Saharan Africa. Additionally, U.K. respondents have noted that there is a lack of proper medical equipment for ENT care, training facilities and audiological rehabilitation.

Importance of ENT Care in Zimbabwe

With the lack of ENT care available in African countries, physicians wondered how they can also provide social support to patients that have suffered hearing loss, speech impediments and other traumas relating to ENT illnesses. Dzongodzaand Chidziva, an ENT surgeon who works in Zimbabwe, has explained that many Zimbabweans believe that a runny nose or snoring are minor issues. However, those same symptoms could be the precursor for devastating illnesses.

To demonstrate the dangers of these misconceptions, Chidziva found that a common issue among patients he treated was respiratory papillomatosis, caused by the papilloma virus, otherwise known as the Human Papilloma Virus (HPV). The illness causes growths to build up in the upper respiratory tract, constricting breathing and damaging vocal cords. If left untreated, it is life-threatening, especially for young children. Invasive care and surgery has to be taken immediately in order to dislodge warts. It is illnesses like these that make adequate and proper ENT care paramount.

Improvements to ENT Care in Zimbabwe

Despite setbacks and social misconceptions in the field, improvements are underway to bring proper ENT care in Zimbabwe. In March 2017, Zimbabwe opened its doors of the first pediatric otolaryngology clinic. This is a public clinic that has two operating rooms and a recovery room for in-patient care. Within that first year, thousands of patients traveled from all over Zimbabwe to receive treatment from the clinic. Only one other clinic such as this one existed in Africa at the time.

Following the clinic’s outstanding success, in May 2018 the first international symposium to promote the expansion of pediatric otolaryngology across Africa took place. The  PENTAfrica symposium resided in Victoria Falls, Zimbabwe that year. Health care physicians and otolaryngologists from North America, Europe and Africa engaged in these ENT discussions. The purpose of the conference was to create a long-term plan to further extend ENT care to various African countries.

Zimbabwe is one of many countries in Africa that is in dire need of ear, nose and throat care. The effects of leaving ENT illnesses untreated has left lasting effects, including deafness, on populations in Zimbabwe. However, after the opening of their first ENT clinic, more clinics and treatment are underway  to treat patients suffering from ENT illnesses.

Lucia Elmi 
Photo: Flickr

Sanitation in Peru
Thanks to the government and various international organizations, Peru has made noticeable progress in regards to sanitation and clean water. However, there is still a large amount of room for improvement in the country. Here are 10 facts about sanitation in Peru.

10 Facts About Sanitation in Peru

  1. Access to Running Water: The water crisis in the suburbs of Peru is complex. Even in more urban areas, running water is still a rare commodity. In middle-class homes just outside of Lima, 3 million people still lack running water. Hand-dug wells are common sources of water in these areas and local citizens may travel miles in order to use the restroom. The country has made progress in the hopes of expanding access to running water. In 2014, the International Secretariat for Water Solidarity established a sustainable source of water in Cuchoquesera and followed this with a similar development in the town of Waripercca. Both communities now have running water.
  2. Sanitation in Schools: The Peruvian water crisis has heavily affected schools. Almost no rural schools have clean bathrooms or working sinks. A lack of proper restrooms and facilities can prevent academic progress. Luckily, sanitation officials in Peru have identified this issue and created a plan to increase infrastructure. This plan should provide suitable and sanitary bathrooms to Peruvian schools by 2030 and educate younger children on hygienic practices, however, donations and investments could speed up the process.
  3. Sanitation in Hospitals: In 2016, 18 percent of health care facilities reported having to operate without running water, leading to problems in water disposal, waste management and an overall inability to perform tasks as simple as cleansing the hands. According to a report from UNICEF and WHO, this can easily lead to life-threatening illnesses, especially for newborns that may be born in these facilities.
  4. Plumbing Systems: Even homes in the suburbs of Lima do not always have toilets. In Peru’s urban areas, about 5 million people do not have a working toilet in their homes. In places where these facilities do exist, the plumbing system is so fragile that flushing toilet paper could do serious damage to the system, or at the very least cause the toilet to clog or flood. The best solution to this less-than-perfect system is to invest more money in plumbing infrastructure or to utilize the “dry toilet” designs that are popping up around the world.
  5. Open Defecation: Despite having dropped since 2000, the percentage of the rural population practicing open defecation still measured around 19 percent in 2017. Experts cannot understate the negative health and sanitation effects of citizens experiencing exposure to human waste. The good news is that the portion of the urban population practicing open defecation is as low as 3 percent and both rates are in a steady decline.
  6. Untreated Drinking Water: Lima’s source of water and the surrounding areas is the Rio Rimac, a river heavily polluted by harmful microorganisms. One of these microorganisms is Helicobacter pylori, a dangerous bacteria that can affect the gastrointestinal tract of those unlucky enough to experience an infection. The good news is that water treatment is seeing a slow uptick in Peru, especially in urban areas. The number of people consuming untreated water has decreased by the thousands since 2000. Public health intervention has begun to focus on treating the water before distribution, partnering with organizations like the International Secretariat for Water Solidarity.
  7. Unsafe Water Affects More Than Drinking: While drinking unsafe tap water is a prominent issue, the problem becomes monumental when one considers everything else that people use water for. Fruit and vegetables that individuals wash in tap water may be dangerous for consumption, as well as drinks with ice and any foods kept on ice.
  8. Unsanitary Practices: While many of the sanitation problems in Peru come from lack of funding or infrastructure, another big problem comes in the form of unsanitary practices. This involves hand-fecal transmission and infection, which may lead to transmission to the face or other individuals in the community. During observation in 2014, 64 percent of those researchers observed potentially contaminated their face, hands or food within one hour of hand contamination. This can be detrimental to the health of Peruvians, as contamination can cause an array of enteric pathogens including salmonella and Escherichia coli. These practices are simply a result of the lack of running water in many parts of the country and lack of awareness of the diseases that fecal transmission can cause. Peru can eliminate this issue by educating Peruvians as children about sanitation and hygiene and by improving the running water system in Peru. There have been attempts to address these issues, including observation and correction of some of these behaviors.
  9. WaterCredit Program: Water.org’s WaterCredit program is quite possibly the jumpstart the nation needs in order to provide running water and sanitary conditions to all of its citizens. The WaterCredit program works with various donating partners to provide plumbing and similar infrastructure to countries that need it. Through this program, Water.org has been trying to reach people in urban areas, like Lima, and provide them with improved indoor bathrooms, sewage collection infrastructure and safe running water. It has reached an estimated 2.5 million people and hopes to reach more within the country in the future.
  10. Stray Dogs: One problem affecting sanitary conditions in Peru is the fact that stray animals, especially dogs, run rampant in cities like Cusco and Mancora. Sadly, due to lack of proper care, these animals can carry various infections that they can spread to humans through direct contact. These infections include rabies, norovirus, salmonella and brucella among others. These infections can have detrimental health effects on humans if contracted and the infected animals may show little to no symptoms.

While the conditions of sanitation in Peru are not yet acceptable, the country has made significant progress in the last decade. It is not an overestimation to say that Peru will continue this forward progress with the help of its citizens and various donating partners. With continued aid from international organizations, the sanitary conditions in Peru could see a significant increase in quality in the next few years.

Tyler Hall
Photo: Flickr