Inflammation and stories on healthcare

Elderly Poverty in Taiwan
In recent decades, Taiwan has made rapid improvements in the quality of life of its people, resulting in less than 1% of the population being poor or low income. Although these facts are definitely something to celebrate, Taiwan’s demographic has changed drastically during this time. People are living longer and having fewer children, causing the rate of aging in Taiwan to accelerate. In fact, Taiwan’s accelerated rate of aging is so high that it more than doubles that of European countries and the United States.

The World Health Organization (WHO) classifies an “aging society” as when 7% of the population is 65 and older. Taiwan became an aging society in 1993 and estimates have determined that it will become a “super-aged society” by 2025 as about 20% of the population could be over the age of 65.

As the size of the ever-growing elderly population expands, their quality of life dissipates. Many rural counties in Taiwan have a dependency rate (the number of people 65 and older to every 100 people of traditional working ages) in excess of 10%. These rural townships lack even more services and resources, having limited access to essentials like medical and transportation services— and most notably, caregivers who leave and move to metro areas for jobs and education. This leaves the island with a dilemma on how to promote systematic endeavors— both in policies and research, as well as encouraging more involvement in non-government organizations to help with this aging issue. Here are five positive changes regarding elderly poverty in Taiwan.

5 Positive Changes Regarding Elderly Poverty in Taiwan

  1. Providing Proper Healthcare Coverage: In 2013, Taiwan introduced the National Health Insurance Program (NHI), a single-payer compulsory social insurance plan that covers annual health examinations for seniors 65 and older. NHI grants go to those aged 70 years or older with medium to low income, and grants that may include fiscal constraints from local authorities can go to citizens aged 65 to 69.
  2. Ensuring Economic Stability: A National Pension that launched in 2005 serves Taiwanese citizens who do not receive coverage from public funds. They have assured a living allowance based on their family’s financial circumstances. This secures regular, lifelong pension benefits for an elderly population living on a lower income. If there are seniors who are not receiving shelter or resettlement services from institutions, family caregivers may receive a monthly special care allowance as an additional aid. The Pilot Program, an option for senior citizens to convert their houses and land into monthly payments, is another coverage plan also taking effect and creating a positive change in regard to elderly poverty in Taiwan.
  3. Building a Long-term Care Plan: The SFAA (Social and Family Affairs Administration) implemented an initiative to improve Taiwan’s long-term home and community-based services. Beneficial services like daily routine assistance and mental and physical healthcare for the disabled are improving the quality of life of Taiwanese seniors. The SFAA has also enacted an assistive device acquisition to support in-home mobility and improvement of residential accessibility, respite care to support family caregivers, transportation to those who require long-term care, as well as providing daily healthy meals to economically disadvantaged or disabled seniors.
  4. Establishing Access to Social Welfare Programs: New developments like tour buses are providing care services spanning from inner cities to the more rural areas of the island. The SFAA developed this to encourage seniors to step outside and interact with the community. Through this service, they can learn more about social welfare benefits like health counseling, senior care, leisure and entertainment. The SFAA has also funded Senior Citizen Schools where seniors can join courses that enhance their quality of life after retirement. Seniors also have the asset of participating in the Double Ninth Festival which insights ideas of healthy-aging by staying active and involved in competitions and other activities.
  5. Addressing the Rising Alzheimers and Dementia Crisis: A dramatic rise in patients suffering from Alzheimer’s and dementia has ignited involvement in government and non-government organizations (NGOs). Amongst these organizations making a difference in elderly poverty in Taiwan is the School of Wisdom, based in Taipei. This program enables Alzheimer’s and dementia patients to keep physically and mentally stimulated and live a fuller, happier life. Programs such as these provide helpline services, care and nursing facilities, education websites and support gatherings for the patients and their caregivers.

Adapting to a New Demographic

As Taiwan’s economic prosperity continues to evolve at a continuing rate, it is important to pay attention to those who may be falling behind. Taking affirmative action on positive changes to end elderly poverty in Taiwan is the greatest way for the Taiwanese to stay true to their rooted cultural values of respecting one’s elders and to ensure that citizens in need are experiencing an optimal quality of life.

– Alyssa McGrail
Photo: Flickr

Healthcare in Haiti
Light from Light is an organization built on three decades worth of friendship between Americans and Haitians. By empowering Haitians and community leaders to lead poverty-reducing efforts, the community has rallied around the central mission of the organization. Light from Light works through the Lespwa Timoun Clinic, which trains physicians and provides access to education-related services and healthcare in Haiti to surrounding communities.

Hannah Jones has worked in Haiti since December 2019, working in the clinic with Light from Light. Since her own arrival and the onset of COVID-19, Hannah has been part of the first wave of pandemic responses in Haiti. Jones’ reflection on Light from Light and the current goals is indicative of her resilience and passion for her work. The pandemic has undoubtedly shaped her job as it has exacerbated the current healthcare problems that have come from the food insecure environment. With malnutrition on the rise, Hannah Jones told The Borgen Project about Light from Light’s work with Haitian children and the topic of healthcare.

Children and Malnutrition

With the realities of food insecurity and poverty in Haiti, the major crisis affecting children is malnutrition. Based on the 2019 impact report, Light from Light has provided life-sustaining care to 1,293 infants and children. Unfortunately, the headway is seeing a setback with food prices being “nearly doubled” because of economic disruption. The clinic has experienced a sharp rise in cases of acute malnutrition. Hannah accounted that the number of malnutrition hospitalizations the clinic has outsourced, from pre-pandemic to present, went from an average of four cases per month to 18 cases in September 2020. Although complications have arisen from COVID-19, the organization is continuing its nutrition programs to offset the number of malnutrition cases.

In the areas near the Lespwa Timoun clinic, which one can translate to “Hope for Children,” one in five children experiences malnutrition. Light from Light follows programs and procedures to lessen the impact of malnutrition, including the use of ready-to-use therapeutic food (RUTF). By following weight and height data from week to week, physicians at the clinic can recommend full treatment plans that follow a child’s growth. The treatment comprises of weekly provisions of Plumpy’Nut, a type of RUTF that has high nutrient density. Children who overcome malnutrition have a better chance of becoming productive members of society.

Healthcare in Haiti

The Lespwa Timoun Clinic is an outpatient clinic with services ranging from general health screenings to prenatal programs to a diabetes club. In addition to the permanent clinic, rural communities receive access to mobile clinics. With 59% of Haitians living on less than $2 per day, taking a day off of work to seek medical care is a burden for those living on the margins. Clinical care is part of a larger goal of Light from Light to strengthen infrastructure in Haiti.

The COVID-19 response that the Lespwa Timoun Clinic facilitated has been an additional complication to healthcare in Haiti. One method of solving hygiene necessities is the Tippy Tap, an innovative no-touch hand washing machine that one can control with a foot lever. The Tippy Tap is a hallmark of Light from Light’s ability to overcome barriers and find solutions. The clinic also distributes personal protective equipment and has implemented support systems in the crisis. Despite numerous issues to tackle, the Lespwa Timoun Clinic has taken this in stride and prioritized the health of the community.

Hannah Jones provides insight into the evolving climate in Haiti and has a positive outlook on Light from Light’s future. The organization is continuing to pursue a more stable pathway for Haitians by implementing strong systems for education and healthcare in Haiti. Light from Light has formed remarkable strongholds through relationships. In time, the foundation has tremendous potential to implement tangible solutions to poverty in Haiti.

– Eva Pound
Photo: Wikipedia Commons

Healthcare in Brazil
After the end of a 20-year military dictatorship, significant action began to take place regarding healthcare in Brazil. As a result of the long political struggle, healthcare as a right became enshrined in the Constitution in 1988. The Sistema Único de Saúde is the name of the public healthcare system in Brazil. Decentralized in its nature, both state and federal governments finance the system.

After a major reform in 1996, nearly 70% of the Brazilian population uses this system. The people who need it the most are those who cannot afford private health insurance, which tends to be the lower middle class, especially those who live in impoverished areas like the favelas. According to James Macinko, an associate professor of public health, the reform resulted in “Brazil [having] the lowest rate of catastrophic health expenditures (2.2 percent) of nearly any other country in the region.”

How the System Works

The system’s promise is providing equitable healthcare in Brazil, regardless of one’s socioeconomic background. As a result, many people of lower socioeconomic backgrounds received healthcare. In 1994, the government started an initiative called the Family Health Strategy. The program intended to provide healthcare services in people’s homes. While the intention of the program was not to strictly target the poor, those who reaped the greatest benefits were people of low income and living in impoverished areas.

The program was a medical success. It improved data accuracy regarding mortality, increased immunization rates to 100% and reduced unnecessary hospitalization for chronic diseases. However, most critically, it reduced the inequity in access and utilization of healthcare services. The government also created a program called Mais Medicos in 2013 which resulted in many foreign doctors (mainly from Cuba) arriving in Brazil and being placed in marginalized communities that lacked much-needed medical care.

Recurring Issues

The situation of healthcare in Brazil does raise a lot of concerns. For one, it is still sensitive to political and economic pressures. An example of this occurred in 2014 when Brazil experienced a deep recession. This resulted in the government taking austerity policies after failing to improve the economy through other means. These other means include price controls and stimulus packages. This led to lower tax revenues and significant cuts in healthcare during 2015.

On the political side, there is a recent example of Prime Minister Jair Bolsonaro capitalizing on the unpopularity of Cuban doctors by the Brazilian medical community. In the process, he made offensive accusations against the foreign professionals, required the doctors to take examinations to practice medicine in Brazil, forbade the Cuban government from taking away 75% of the doctors’ wages and mandated the doctors to have their families move to Brazil. This series of actions have alienated both the Cuban government as well as the Cuban medical practitioners which resulted in many leaving the country. This created a hole and vacuum that the government has tried yet failed to fill using Brazilian doctors. As of January 2019, 1,533 positions remain unfilled. The people who suffer most are the marginalized communities who desperately need those doctors.

Brazil’s Healthcare and Technology

Strong suggestions have emerged that one way to make Brazilian healthcare more resilient is by adding more investments to the existing infrastructure in order to make it more adequate. When it comes to making healthcare in Brazil more efficient, the leading solution providers are tech startups. They hone the power of technological innovation to address the inefficiencies in the system. One example is the startup iClinic, a Software as a Service that helps doctors with visitor management, organization of electronic records and remote telehealth consultations. It has had 22,000 customers which represent 7.5% of the market share.

On the mobile front, there are apps like Dieta e Saude. This has helped over a million and a half people make better choices regarding their dietary and exercise routines. When it comes to prescriptions, Memed is a startup that has emerged to fill the dire need for e-prescription management. It provides its services to more than 50,000 doctors. Errors occur in over 77% of prescriptions due to a lack of digitization. E-prescription management services help by reducing those errors through the use of scanning.

These are just some of the examples that make healthcare in Brazil more efficient, cost-effective and less dependent on the public healthcare system. As a result of these factors, public healthcare in Brazil will be in less need of government spending and less sensitive to political and economic pressures.

– Mustafa Ali
Photo: Pixabay

Healthcare in Equatorial GuineaIn the small Central African nation of Equatorial Guinea, the healthcare system is lacking in many ways. According to a report by Human Rights Watch, “45 other countries in Equatorial Guinea’s per capita GDP range spent at least four times as much on health and education during the same period.” A study by the Pan African Medical Journal has reported a “lack of resources and trauma care facilities” and that  “training and informational programs for both healthcare workers and the general public may not be effectively transmitting information to the intended recipients.” Overall, it can be said that healthcare in Equatorial Guinea is in a dire state that certainly calls for assistance.

Things to Know About Healthcare in Equatorial Guinea

  1. Empty Promises. Following the discovery of oil in Equatorial Guinea in 1991, President Obiang promised investment in social services, primarily healthcare and education. Despite repeatedly saying he would prioritize those two services, financial allocation for funding has been disheartening. According to the World Bank, as of 2017, only 3.11% of the country’s GDP has been spent on healthcare, an increase since 2012, when it stood at 1.26%.
  2. Incorrect Priorities. Instead of allocating money towards improving its healthcare system, Equatorial Guinea has been investing in large infrastructure projects. In 2011, the country spent 82% of its total budget on such projects, a move that was heavily criticized by both the International Monetary Fund and the World Bank.
  3. Treatable Diseases are Deadly. Lack of funding means healthcare in Equatorial Guinea lacks diagnostic tools, trained staff, laboratory supplies, vaccines, cheap medication and condoms. The lack of affordable medicine and resources results in patients being reluctant to seek care and also means the most common treatable diseases become the deadliest. According to the Pan African Medical Journal, diseases like malaria, typhoid, sexually transmitted diseases, diarrhea and respiratory illnesses are the most common diseases, but also have the highest rate of mortality.
  4. Underfunded Healthcare Sector. The lack of funding to the healthcare sector in Equatorial Guinea also acts as a deterrent for people to join the profession and causes many to leave, due to the lack of pay. Data indicates that Equatorial Guinea has only three doctors per 10,000 people. Furthermore, because patient payments are not enough to keep facilities running, many also leave due to the difficulties in their ability to provide care.
  5. Traditional and Modern Medicine Conflict. There is a conflict between traditional and modern medicine, which many healthcare practitioners consider a “negative healthcare outcome.” Indeed, the reluctance for many families to consult hospitals to receive care due to the high cost of medication may drive them to traditional medicine methods instead. Though this conflict has been noted before, not many steps have been taken to help mitigate the gap.

Despite the dire state of healthcare in Equatorial Guinea, research does not indicate that the country is receiving much help from aid organizations or other countries to improve the situation. This conclusion indicates a desperate need for aid to better the country’s healthcare system. With help, healthcare in Equatorial Guinea can be drastically improved.

Mathilde Venet
Photo: Flickr

Suriname is Changing
Suriname is among the many countries that COVID-19 has affected, specifically in its health care and political systems. The pandemic revealed the underbelly of Suriname’s existing health system. The country has since been guiding officials toward a more adequate system and the political climate in Suriname is changing. The election on May 25, 2020, brought in Chan Santokhi as the new president succeeding the decade-long leader, Desi Bouterse.

Former President Desi Bouterse

Desi Bouterse tightly held the reins in Suriname for years as an influential political force. Bouterse was a prominent figure in overthrowing the first leader of Suriname, Henck Arron, after the country’s independence. He was chairman of the National Military Council for a majority of the 80s and became president in 2010.

Bouterse has a significant history of controversial actions. In November 2019, Surinamese judges decided that Bouterse was guilty of murder and found him responsible for the death of 15 of his opponents in December 1982 because he commanded his soldiers to kill them. This long-standing trial started in 2007 when he stated that he had “political responsibility” but took no personal responsibility for what had happened. Although he received a 20-year sentence, the police did not issue any arrest warrants for Bouterse. He also denied allegations of smuggling more cocaine into the Netherlands, which the Dutch court convicted him of doing in 1999.

President Chan Santokhi

In 2020, Desi Bouterse saw the end of his long career. Chan Santokhi was victorious over Bouterse in the elections in May 2020. Mr. Santokhi was a former police chief who investigated the past president for his alleged murders in 1982. Although he has won the seat as leader, there are still many obstacles he must overcome after inheriting Bouterse’s Suriname. Suriname is battling a horrible financial crisis, political corruption and the coronavirus.

The new president has much to accomplish, but there may be hope for Suriname. Chan Santokhi may be able to overturn the economic crisis in Suriname by utilizing its newly found offshore oil by 2026.

Health Care Deficiencies

COVID-19 is touching the lives of those in Suriname, and the virus is quickly exposing the deficiencies in its health care system. First, tropical rainforest covers most of the land and houses many Indigenous and marginalized populations. Those who live in these deeply remote areas are unable to receive essential health care.

Second, Suriname has an insufficient workforce in the health care sector at about eight physicians and 23 nurses per 10,000 people. It is also suffering from a lack of specialists who can work in ICUs.

Third, Suriname does not have a structured effective response plan in case of emergencies as the country is not susceptible to natural disasters except for the occasional flooding. With resources going toward COVID-19 treatment, Suriname is recognizing its lack of resources to provide other health services not pertaining to the virus.

Actions to Fight Against COVID-19

At the beginning of 2020, the country’s ministry of health took immediate action and gathered a public health response team to combat the virus. This team worked with the Pan American Health Organization (PAHO), World Health Organization (WHO) and Universal Health Coverage Partnership to bolster the health care system and provide effective plans for current and future disease outbreaks.

The organizations are also working to implement universal health coverage in Suriname. With the help of these organizations and international funding, Suriname is working to effectively save lives through a better health care system, a protected workforce, containment of COVID-19 and preparation for future epidemics. Suriname is changing and improving its current public health system for the present as well as the future.

Regardless of the brutalities many face due to COVID-19, it has also brought positive changes to the people of Suriname. The country was able to take down a controversial leader and new plans to improve its emergency response and public health system are in progress. Hopefully, with the turn of a new post-COVID-19 era, Suriname is changing for the better.

San Sung Kim
Photo: Flickr

Healthcare in Bangladesh
Healthcare in Bangladesh is not as sophisticated as in more developed countries; however, the country is working to improve and provide further funding to its healthcare system. So far Bangladesh has made great strides in increasing healthcare access for its people, but there is still a long way to go. Here are seven important facts about healthcare in Bangladesh.

7 Facts About Healthcare in Bangladesh

  1. Bangladesh has a pluralistic healthcare system. This healthcare system is highly decentralized. As a result, it is regulated and controlled by for-profit companies, NGOs, the national government and international welfare organizations. This shared power has caused many problems, including unequal treatment programs between social classes. Even though the laws and overall system are spearheaded and steered by the Ministry of Health and Family Welfare, other organizations have considerable influence on the decision-making.
  2. There is a shortage of physicians, specialists and clinical equipment. In Bangladesh, the number of physicians per 10,000 people is only about 3.06, which is significantly low. The number of nurses per 10,000 people is even lower, standing at 1.07. Additionally, only 35% of health and clinical facilities in the country have more than 75% of sanctioned staff working and there is a 36% vacancy in sanctioned healthcare workers. There is also a 50% vacancy in alternative medicine providers. These numbers are one of the reasons that Bangladesh’s quality of healthcare is low compared to many other Asian countries.
  3. Non-communicable diseases are the leading cause of death in Bangladesh. Most deaths are caused by cardiovascular diseases, cancers, diabetes, chronic respiratory diseases and malnutrition. There are almost no alcohol-related deaths due to alcohol consumption and sale being illegal in the country. A 2016 study by the World Health Organization (WHO) found that tobacco usage has decreased for both men and women, with only 23% of the population using tobacco products. Obesity has remained low, rising slightly, but still only affected 2% of adolescents and 3% of the adult population. However, poor nutrition is still prevalent, leading to diabetes and high blood pressure.
  4. Most physicians and healthcare workers are concentrated in urban areas. Rural areas often do not have proper healthcare facilities. To remedy this, the national government has set up many government-funded hospitals in rural areas that provide cheaper treatment for rural citizens. However, these hospitals are often poorly funded, understaffed and overly crowded due to a limited number of healthcare options in rural areas.
  5. Enrollment in medical colleges and healthcare training facilities has increased. This will benefit the country by increasing the number of healthcare workers in proportion to the population. However, this is only a recent trend and these future healthcare workers must complete their education and training before being able to fully practice their professions. The HPNSDP (Health, Population and Nutrition Sector Development Program) have already begun drafting and implementing a plan to further increase the number of nurses and midwives through training and education facilities.
  6. Socioeconomic inequality affects healthcare in Bangladesh. One area this can be seen in is infant mortality. The infant mortality rate for the lowest income quintile is 35 deaths per 1000 births, while infant mortality for the highest income quintile is only 14 deaths per 1000 births. One of the main reasons for this inequality is that most poor Bangladeshis live in rural areas that do not have adequate hospital facilities. However, even in urban areas, socioeconomic inequality has a large impact. A person with more money is generally able to receive better healthcare than someone who is poorer and cannot afford certain treatments or services. This is due to the fact that the healthcare system is decentralized and partially run by for-profit healthcare and pharmaceutical companies.
  7. Limited government funding has led to high out-of-pocket payments. One of the other reasons poorer citizens in Bangladesh cannot afford certain treatments or services is high out-of-pocket costs. On average, Bangladeshi citizens must pay 63.3% of the total cost, while the government pays the rest. This system creates a significant financial burden for impoverished families, sometimes forcing them to either forego treatment or go into debt. To reduce this burden, the government must increase healthcare funding.

These seven facts about healthcare in Bangladesh illustrate some of the barriers that Bangladesh must overcome to provide high-quality healthcare across the nation. The Bangladeshi Government’s constitution upholds that all citizens will be provided with equal treatment, including in healthcare. To achieve this, the government needs to address the current inequality and continue to make healthcare a focus of its efforts.

Sadat Tashin
Photo: Flickr

COVID-19 and Global Poverty
Since early 2020, the entire globe has been battling the COVID-19 pandemic and attempting to address the outbreak properly. Most of the world’s population is currently under some form of social distancing as a part of a response to the outbreak. From scientific research to increased travel restrictions, almost every country is working on ways to boost the economy while managing the spread of the virus. However, COVID-19 has affected much more than the economy. Here are four ways COVID-19 and global poverty connect:

4 Ways COVID-19 and Global Poverty Connect

  1. The Consumption of Goods and Services: For most developing countries struggling with poverty, much of their economies depend on commodities, such as exports. Food consumption represents the largest portion of household spending, and the increase in food prices and shortages of products affect low-income households. Countries that depend on imported food experience shortages. The increase in food prices could also affect the households’ inability to access other services such as healthcare, a major necessity during this time. These are two significant connections between COVID-19 and global poverty.
  2. Employment and Income: The self-employed or those working for small businesses represent a large portion of the employed in developing countries. Some of these workers depend on imported materials, farming lands or agriculture. This requires harvest workers and access to local farmers’ markets to sell produce. Others work in the fields of tourism and retail. These fields require travelers, tourists and consumers — all of which lessen as COVID-19 restrictions increase. Without this labor income, many of these families (now unemployed) must rely on savings or government payments.
  3. Weak Healthcare Systems: This pandemic poses a major threat to lower-middle-income developing countries. There is a strong correlation between healthcare and economic growth. The better and bigger the economy, the better the healthcare. Healthcare systems in developing countries tend to be weaker due to minimal resources including beds, ventilators, medicine and a below-average economy. Insurance is not always available for low-income families. All of this affects the quality of healthcare that those living within the poverty line receive. This is especially true during the COVID-19 pandemic.
  4. Public Services: Low-income families and poor populations in developing countries depend on public services, such as school and public transportation. Some privatized urban schools, comprised of mainly higher-income families, are switching to online learning. However, many of the public rural schools receiving government funding do not have adequate resources to follow suit. This could increase the rate of drop out. Moreover, it will disproportionately affect poorer families since many consider education an essential incentive for escaping poverty. Aside from school, COVID-19 restrictions could prevent poorer families from accessing public transportation. For developing countries, public transportation could affect the ability of poorer families to access healthcare.

Moving Forward

There are many challenges that families across the globe face as a result of COVID-19. Notably, some organizations have stepped forward to help alleviate circumstances. The World Bank, Care International and the U.N. are among the organizations implementing programs and policies to directly target the four effects of COVID-19 mentioned above.

For example, the World Bank is continuously launching emergency support around the world to address the needs of various countries in response to COVID-19. By offering these financial packages, countries like Ethiopia, which should receive more than $82 million, can obtain essential medical equipment and support for establishing proper healthcare and treatment facilities. These financial packages constitute a total of $160 million over the next 15 months as a part of projects implemented in various countries, such as Mongolia, Kyrgyz Republic, Haiti, Yemen, Afghanistan and India.

Nada Abuasi
Photo: Flickr

Facts About Poverty in the Marshall Islands
Poverty in the Marshall Islands is a major issue, with 30% of the population in the island’s two cities living below the basic-needs poverty line. With the threat of rising sea levels and the lack of quality healthcare, education and jobs, a third of the nation has migrated to the west in search of a better life. Here are some facts about poverty in the Marshall Islands.

Unemployment

Unemployment is rampant with a rate of 40%. There is a scarcity of younger workers (20-45 years old) due to this demographic leaving the islands for higher-paying jobs in the United States. The primary job sectors are fishing and agriculture, which made up three-fourths of the labor force in 1958. This has changed drastically to 21% in recent years. This reliance on overseas imports is one of the main factors of poverty in the Marshall Islands.

The 1986 Compact of Free Association Law Treaty

The United States and the Marshall Islands have close ties due to the 1986 Compact of Free Association Law (COFA). This treaty grants citizens of Micronesia, Palau and the Marshall Islands to live in the U.S. without visas or work permits. Marshallese citizens have permanent non-immigrant status, distinguishing them from refugees who only receive temporary asylum.

COFA emerged in response to nuclear weapons tests during the post-World War II period from 1946 to 1958, testing 67 nuclear bombs on these Pacific Islands and atolls. The treaty serves as reparations for the loss of lives, resources, forced migration and land destroyed during the times of the nuclear testing. As a result of these tests, a number of islands–like the famous Bikini Atoll of the Marshall Islands–are uninhabitable due to the high levels of radiation still prevalent to this day.

Inefficient Healthcare and Malnourishment

The insufficiency in healthcare is another pervasive issue on the islands, specifically in the outer islands where poverty in the Marshall Islands is high. Many citizens have to leave the Marshall Islands to receive treatment due to the limited healthcare facilities and programs in place. These off-island referrals are costly, further depleting government finances.

PBS interviewed Isaac Marty–a Marshallese journalist who shared how his wife was not able to get proper treatment for her chronic anxiety and depression. Marty claimed that there is a shortage of qualified medical professionals living on the Marshall Islands, and oftentimes citizens receive medication that is inadequate for their ailments.

Additionally, many Marshallese children are malnourished due to reliance on highly processed imported foods. This has led to a high percentage of diseases such as diabetes, high blood pressure, obesity and gout. With a lack of exports and locally grown food, the country continues to rely on unhealthy and cheap imported foods–widening the deficit and increasing poverty in the Marshall Islands.

Environmental Challenges

In recent years, environmental changes have permeated the globe, but the Marshall Islands specifically has had to bear the brunt of these adverse weather changes. Many have found that small island states, specifically in the Pacific, are the most prone to the variability in sea-level rises. The incremental increase could gradually rise by one to four feet–to the potential cessation of some island states by 2050.

Droughts are a persisting issue with 92% of households indicating that one had affected them. During droughts, household members become dehydrated and sick because their only source of water is salty well water. When water reserves are down, those who cannot afford to buy clean water have to beg.

The Ebeye Water Supply and Sanitation Project

The ADB has worked together with Australia and the Marshall Islands to form the Ebeye Water Supply and Sanitation Project. This project sets out to improve freshwater systems and has done so with success. A new desalination plant implemented in 2017 has increased people’s access to safe, reliable water. The incidence of waterborne disease, particularly gastroenteritis, has decreased, and water supply and sewerage networks have expanded to an additional 300 households.

These facts about poverty in the Marshall Islands indicates that in its fight against poverty, the Marshall Islands has to first tackle the issue of improving various internal sectors, lessening its dependency on others, while increasing the country’s GDP. By working with natural resources abundant to the country, as well as implementing governmental programs, there can be significant changes in healthcare, quality of education and the economy, as well as improved climate provisions. This would further pull the population out of poverty in the Marshall Islands and increase the island’s viability.

– Mina Kim
Photo: Flickr

Healthcare in Saudi Arabia
Saudi Arabia is the largest country in the Middle East, with more than 34 million people, and it is a country highly dependent on oil for income. The Ministry of Health (MOH) operates, controls and manages public health in Saudi Arabia. Here is some information about the challenges and efforts to privatize healthcare in Saudi Arabia.

Challenges in Healthcare in Saudi Arabia

The MOH is responsible for prevention and primary care and sponsors over 3,300 health centers in Saudi Arabia. Saudi Arabia established the department nearly 100 years ago to provide free health services to its citizens. However, the MOH could not meet the population’s healthcare needs, which stimulated and motivated changes in the country’s healthcare systems.

Media reports claimed that the public health system in Saudi Arabia presented deficiencies in maintaining standards. Public health services were more difficult to maintain as public health spending rose due to the aging Saudi Arabian population and higher chronic disease rates.

The government’s challenge in sustaining proper public health services is primarily due to the reduced revenues from oil. But the government was keen on reforming the health sector to fulfill social demands in the country, which ultimately led to the privatization of public health systems. Privatization happens when a publicly-owned business or industry transfers to private ownership and control. In healthcare, privatization involves non-governmental individuals becoming engaged in financing and managing healthcare.

 A study in Taif found that only 59% of patients who sought treatment at public healthcare facilities were satisfied in comparison to 77% satisfaction in the private sector.

The New Saudi Health System (NSHS)

The New Saudi Health System (NSHS) allowed local and foreign insurance companies to deal with expatriates and citizens in the private healthcare sector. Additionally, new legislation allowed private healthcare providers to enter the healthcare market.  Private healthcare continued to grow after the government introduced interest-free loans to encourage the construction of private facilities. Foreign investment supported the transition, which reached $3.5 billion in 2018.

The Paycheck Protection Program (PPP)

Paycheck Protection Program (PPP) is a loan for a small business that needs help paying its workers. The World Health Organization (WHO) and the World Bank believe PPPs would improve health care services, and the Saudi Arabian government has drawn up a PPP law that aims to boost private healthcare.

Efforts to Privatize

 Privatization intends to serve the needs of the rising population. Saudi Arabia will need 5,000 more beds by 2020 and 20,000 more beds by 2035, so the country hopes to privatize 295 hospitals and 2,259 healthcare facilities by 2030. With these changes, experts expect to see life expectancy increase to 78.4 for males and 81.3 for females by 2050. Leaders hope that privatization will reduce government healthcare spending and ultimately produce new funding for the MOH.

Privatization increases the motivation to provide efficient healthcare. Leaders in Saudi Arabia constructed Vision 2030, which is a framework and collection of long-term goals and expectations “to create a vibrant society in which all citizens can fulfill their dreams.” A key factor in the Vision 2030 blueprint is the privatization of healthcare in Saudi Arabia as it aims to improve the lives of those living in the country.

– Rachel Durling
Photo: Flickr

Healthcare in MaliMali has suffered from the presence of terrorist groups in its north and western regions, lethal diseases such as malaria and tuberculosis, and a coup d’etat in the past two decades. These circumstances have created a strained and ineffective healthcare system. Mali’s infant mortality rates are among the highest in the world and average doctor visits per person have been one in every three years. This is in part a result of its system’s user fees, which many in Mali cannot afford.

Free Healthcare to Address High Maternal and Child Mortality Rates

In 2019, Mali announced that it would begin offering free healthcare to pregnant mothers and children under 5. This is a monumental step forward that came after decades of adhering to a system that had barely changed since the 1960s when the country gained independence. This radical new change will benefit the healthcare system’s most vulnerable recipients and work to lower the infant mortality rates as well as the lack of citizens’ use of the healthcare services. However, the program’s success is dependent upon how effectively they can roll out the changes to avoid flooding their healthcare systems.

Besides user fees, other issues persist in Mali which put citizens at risk for disease and insufficient care. A large issue is the lack of education regarding women’s health. Mali has the third-highest fertility rate in the world, and its capital is one of the fastest-growing cities in Africa. The absence of health education leaves young women vulnerable to shorter birth intervals, lack of skilled birth attendants and female genital mutilation, which all result in Mali’s high maternal mortality rates. With an average of six children per mother, education measures that address health and family planning are necessary to address high maternal and infant mortality rates as well as alleviate poverty.

USAID Helps Tackle Infectious Diseases

Another large concern is the prevalence of infectious diseases. Mali’s degree of risk is ranked at very high for diseases like malaria, dengue fever, hepatitis A, meningitis and typhoid fever. These illnesses result from living in poverty, with a lack of clean water and adequate health services, as well as contact with animals and parasites carrying disease. As of 2018, USAID is supporting 991 health programs in regions across Mali to alleviate these health issues. Supplies such as bednets, diagnostic tests and medication are disseminated to prevent, diagnose and treat malaria.

This is very important work, that needs increased funding in order to continue spreading these life-saving services, as malaria cases reached 3.3 million in 2017 and the disease was responsible for almost a quarter of child deaths. With a larger budget and increased reach, USAID could provide Mali with the tools to create a self-sufficient healthcare system capable of tackling the maternal and infant mortality rates as well as the rampant infectious diseases.

Ellie Williams
Photo: Flickr