Inflammation and stories on healthcare

Global Dental Relief is Improving Accessibility
Dental insurance operates differently around the world. A lack of proper dental care can result in serious health issues that have lasting impacts. In developing countries, where dental care may not be as accessible, the money to afford treatment may be difficult to obtain. However, Global Dental Relief (GDR) is improving accessibility to dental care.

How Global Dental Relief is Improving Accessibility to Dental Care

Global Dental Relief started as the Himalayan Dental Relief Project. Former Director of the Colorado State Parks Laurie Mathews and dentist Andrew Holacek are the founders of the organization. After the pair traveled to Nepal together, they noticed the dental crisis present in the country. Nepal had 120 dentists for a population of nearly 24 million people. In 2001, they began their project to bring free dental care and oral hygiene education to the people of Nepal. With the knowledge that the organization could change the lives of children and adults across the nation, Mathews and Holacek dedicated themselves fully to their cause.

In 2003, Mathews and Holacek joined forces with travel adventure expert Kim Troggio. With Troggio’s expertise, the team sought to help both native families and international travelers. They also aimed to connect with the local communities they aimed to help to make their cause more personal. A large portion of the organization’s funding in 2003 came from travelers who visited impoverished nations. After seeing the lack of care and with the Global Dental Relief’s support, donations became plentiful. Since then, Global Dental Relief has made a huge impact. The organization has accumulated over 2,600 volunteers. In addition, Mathews and Holacek have provided over $35 million in donated care to more than 170,000 children.

Trips Around the World

Global Dental Relief offers trips to Appalachia, Cambodia, Guatemala, India, Kenya, Mexico and Nepal. Dental hygienist Nour Shehadeh recently took a trip to Cambodia, where she treated more than 1,000 children with first-time dental care. These children had never seen a dentist before, making the experience life-changing. Shehadeh realized the immense power that a bright smile could have on a person’s confidence.

On another trip in 2018, several dentists and dental hygienists from Aspen Dental practices took a relief trip to Guatemala. During this time, they performed 1,500 dental procedures on the children of Antigua. These included 126 root planing and scaling procedures, and 596 fillings. By the end of the mission, dental professionals completed 488 fluoride varnishes and 195 extractions, showing how Global Dental Relief is improving accessibility to dental care.

How to Volunteer

Those who have participated in a trip described the experience as life-changing. Dentist Savannah Reynolds of Greenville, South Carolina explained that the experience was not only eye-opening but also intrinsically rewarding. Anyone is able to volunteer with the Global Dental Relief organization, as no prior dental experience is necessary. Global Dental Relief is also in need of non-dental volunteers to manage records, teach oral hygiene, manage the clinic flow and assist both dentists and dental hygienists. Applications to register to be a volunteer for Global Dental Relief are available on the organization’s website.

– Jessica Li
Photo: Flickr

PeriWatch Vigilance programMalawi, a landlocked yet welcoming and beautiful country, is one of the poorest countries in the world. In Malawi, 50.7% of the population lives below the poverty line, and one of the leading causes of this is poor access to healthcare. On June 24, 2021, the Texas Children’s Pavilion for Women announced the commencement of the PeriWatch Vigilance program in Malawi. This program has the capabilities to improve maternal health, lives of children and poverty in Malawi.

What is the PeriWatch Vigilance Program?

This program is a partnership between multiple foundations, ministries and companies to provide fetal monitoring systems at no cost to Malawi health facilities. Partners of the program include the Texas Children’s Global Women’s Health Program, Area 25 Malawi Ministry of Health, Baylor College of Medicine Children’s Foundation in Malawi and PeriGen.

The program’s ultimate goal is to assist doctors in reducing neonatal deaths and maternal deaths. The PeriWatch Vigilance tool has clearance from the FDA and has many key features. The tool:

  • Improves timeliness and accessibility to care
  • Tracks and manages crucial patient information between numerous hospitals
  • Records heart rate, labor progression and contraction statistics of mothers
  • Notifies doctors about any irregularities in vital signs

The PeriWatch Vigilance program in Malawi will allow for more successful births and hospital stays for mothers, children and doctors.

Hope for Malawian Mothers and Children

In Malawi, 400 mothers die per 100,000 births, and one in 50 babies die. At the Area 25 Malawi Ministry of Health, more than 7,000 births occur each year. This number is comparable to the number of births per year at the Texas Children’s Pavilion for Women. However, Malawi has not had the technology to provide a safe labor and delivery experience. With the PeriWatch Vigilance program in Malawi, the well-being of mothers and children will now be at the forefront of healthcare centers. The artificial intelligence tool will provide doctors with crucial warnings, vitals and statistics all through mobile devices.

This quick access will give doctors an advanced warning of any possible maternal or fetal danger. It will also allow healthcare workers to keep watch over the whole unit compared to just a few patients. In addition, clinicians can now spend more time caring for patients, as PeriWatch Vigilance calculates data and measures statistics through its secure data system and technology. The program has recently kicked off, but in the short term it has been running, there has already been a decline in the neonatal mortality rate. Within the next two months, the leadership team hopes to have PeriWatch available for all 7,000 yearly births.

Long-Term Effects

The decline of maternal and fetal deaths in Malawi can create vast improvement for the overall health and wellness of the country. As neonatal disorder cases decrease, poverty rates will consequently follow this decline. When a child is born prematurely or is not healthy, this can impact the rest of their life. They can face neurological and physical damage, preventing them from receiving proper education or going to work. These potential complications will only promote poverty.

On the other hand, neonatal and maternal mortality presents another set of problems for poverty. There is a lack of confidence in the healthcare system in areas with high poverty. This uncertainty creates a fear of survival during and after labor and delivery, leading families to have more and more children. This cycle leads to overpopulation and an increase in poverty as more children are born into a country that cannot yet provide for them.

The PeriWatch Vigilance program in Malawi is helping to assist with safer practices, better care and more advanced technology that will keep both the child and mother safe and confident throughout all stages of birthing. This program will give Malawi the chance to improve healthcare, save lives and ultimately fight poverty.

– Delaney Gilmore
Photo: Flickr

cholera in nigeriaBetween January and August 2021, Nigeria experienced a surge in cholera cases with more than 31,000 “suspected cases,” 311 confirmed reports and more than 800 deaths. With close to 200,000 COVID-19 cases, a surge of cholera during the pandemic has heightened public health concerns in Nigeria. As such, addressing cholera in Nigeria is currently a top priority for the country.

What is Cholera?

According to the World Health Organization, “cholera is an acute diarrhoeal infection caused by ingestion of food or water contaminated with the bacterium Vibrio cholerae.” Despite being both preventable and treatable, cholera is very dangerous as it can kill an individual within hours without intervention. While mild cases are easily treatable with “oral rehydration solution,” more severe cases necessitate “rapid treatment with intravenous fluids and antibiotics.” These are resources that many impoverished developing countries simply cannot afford.

According to the Centers for Disease Control and Prevention, the number “of people who die from reported cholera remains higher in Africa than elsewhere.” The WHO emphasizes that the “provision of safe water and sanitation is critical to prevent and control the transmission of cholera.” The WHO also recommends oral cholera vaccines in areas where cholera is endemic.

The Nigerian Government’s Efforts

The Nigerian government continues to implement policies to control the spread of cholera. Promoting basic sanitation, improving hygiene practices and providing clean water are ways the government does this. In an attempt to mitigate the spread of cholera in Nigeria, the government has also supplied solar-powered boreholes with the help of the International Organization of Migration (IOM). As of 2019, the IOM has maintained 58 of these boreholes in Borno state and created 11 new boreholes. The IOM also “rehabilitated 10 and connected them to solar power.”

An important way to stop the spread of cholera is through improving the vaccination system in Nigeria. After an outbreak occurred in 2017, the National Primary Healthcare Development Agency instated cholera vaccination programs. The next step will be to increase the supply of vaccines.

The MSF’s Role in Eradicating Cholera

Médecins Sans Frontières (MSF), otherwise known as Doctors Without Borders, is an independent global organization working to prevent cholera in Nigeria, among other missions. Its main focus is to provide medical aid in areas where it is most needed. Beginning in the 1980s, the MSF has responded to cholera epidemics across the world. Since then, the organization has worked to come up with new and more effective ways to eradicate cholera.

The MSF’s efforts to address cholera include supplying cholera kits, investigating outbreaks, establishing cholera treatment facilities, community education, improving access to water and sanitation and vaccinations, among other efforts. Cholera kits include “rehydration salts, antibiotics and IVs, along with buckets, boots, chlorine and plastic sheeting.” Sanitation improvements allow MSF to ensure the availability of clean water to citizens of Nigeria. Additionally, soap and clean water are provided for at-home use.

Promoting health is another major goal of the organization. At the time of an outbreak, those who work in the health field visit churches, schools and homes to help educate people on measures they can take to prevent the spread of cholera. Vaccinations are also employed to address Nigeria’s cholera outbreak. Providing vaccines is difficult, despite their ease of administration. Nonetheless, the MSF is working on vaccine campaigns. With patients receiving the proper care they need at the time they need it, the MSF states that deaths can potentially decrease from as high as 50% to as low as 2%.

The MSF’s Achievements

In 2019, the MSF supplied more than 231,000 cholera vaccine doses to endemic nations across the world. With the work of the MSF and increased government initiatives, it is possible to significantly reduce cholera in Nigeria.

– Nia Hinson
Photo: Flickr

Healthcare successes in BurundiIn Burundi, over 65% of people live in poverty. The country has the highest rates of malnutrition in the world, the presence of disease is widespread and only 32% of children make it through the equivalent of middle school. Despite these statistics, recent healthcare successes in Burundi are creating many improvements for the country.

5 Healthcare Successes in Burundi

  1. USAID providing health services. Burundi’s health systems aren’t adequate for the 11.5 million people living there. Fortunately, outside organizations are supporting the country. USAID has backed efforts in Burundi that assist with child and maternal services, HIV/AIDS, malaria and malnutrition. By providing support for the Government of Burundi’s plan for HIV/AIDS prevention, USAID has also assisted in expanding control for and education about HIV. Besides HIV, there is currently a malaria epidemic in Burundi. Since 2019, there have been six million cases, but USAID has introduced treatment, prevention and testing options to the country, helping to combat malaria and trace the spread of infections. About 56% of children in Burundi live without access to the necessary amount of food, but USAID hopes to curb these numbers. The organization offers supplements and nutrition lessons to pregnant mothers and young children to assist with malnutrition. The services that USAID provides help the Burundi healthcare systems in multiple aspects. They have allowed for improved service delivery, better treatment for childhood diseases and viruses and more accessible medicine and assistance during pregnancy.
  2. A $5 million grant in response to COVID-19 from the International Development Association. On April 14, 2020, this grant was approved by The World Bank and gave Burundi the chance to build up its health services as the COVID-19 pandemic began. Burundi was originally not in a position economically to handle this pandemic. The grant has given the country more access to testing, equipment, facilities and health professionals. Along with this, it has helped to reduce the spread of the virus through strategies that improve communication and tracking within the country.
  3. Improved financial access to healthcare in Burundi. In 2002, Burundi implemented a policy to perform cost recovery and provide financial relief to citizens that can not afford necessary healthcare. This exemption allows more citizens to get proper treatment and not be concerned about being forced further into poverty because of medical bills.
  4. The Global Alliance for Vaccines and Immunizations. The Global Alliance for Vaccines and Immunizations was launched at The World Economic Forum in January 2000. This alliance includes the World Health Organization, The Gates Foundation, UNICEF and many similar organizations. It aims to provide more access to new vaccines to children in countries like Burundi. Between 2005 and 2008, the Alliance donated $800 million to 72 underdeveloped countries to help increase vaccinations, fund health systems and provide healthcare services. This assistance created many new healthcare successes in Burundi. For example, Burundi has trained more people in midwifery, meaning there has been an increase in safe, assisted births. The country has received an average of $3.26 million annually from the Global Alliance for Vaccines and Immunizations. Additionally, healthcare workers have received more training and there has been increased coverage of immunizations.
  5. Reduced HIV/AIDS and new health ministries. From 2000 to 2013, HIV infections decreased by 46%. Civil conflict in Burundi between 1993 and 2003 caused the rapid spread of HIV in the country and a fractured health system. The government initially divided the health and HIV/AIDS ministries, causing political turmoil. But then non-governmental organizations stepped in, started HIV-specific clinics and offered incentives to health personnel working with HIV.

What Does This Mean for Poverty in Burundi?

These healthcare successes in Burundi are creating economic, social and physical improvement for the country. Malnutrition, the rate of disease and poverty are all decreasing. These operations expand beyond just healthcare, though. They reach every aspect of living in Burundi. They create opportunities for more children to thrive in school and more people to go to work. Ultimately, these opportunities lead to economic growth and a more sustainable country.

– Delaney Gilmore
Photo: Flickr

Decent LifeEgypt’s President Abdel Fattah Al-Sisi kicked off the first stage of Egypt’s groundbreaking anti-poverty project, the “Decent Life” (Haya Karima) Initiative, at the first conference on July 15, 2021. Al-Sisi declared that this initiative would kickstart “Egypt’s New Republic” especially in the Egyptian countryside. The massive development and resource injection into education and health infrastructure, primarily in rural areas, appears as if it will significantly improve the Egyptian landscape for the future. This initiative comes at a crucial turning point in a country that has struggled significantly with poverty over the past years. Statistics such as how 32.5% of Egyptians reported being below the poverty line in 2019 or how the pandemic has increased the official unemployment rate to 9.6% as of November 2020 highlight Egypt’s difficult poverty battle. However, with the ‘Decent Life’ Initiative in action with its numerous quality components, Egypt’s economy looks to be turning a corner.

Four Pillars

Within the framework of the UN Egypt Vision 2030 Strategy, the initiative consists of four main pillars:
1. To ameliorate living standards and invest in human capital,
2. To grow infrastructure services,
3. To improve human development services,
4. To spur economic development especially by contributing to the poorest villages with increased access to basic services such as sanitation and education infrastructure.

These pillars provide the foundation for how Egypt is tackling poverty in a more assertive manner.

First Phases

Prior to President Al-Sisi establishing the initiative, he launched an unofficial phase of the project in 2019. This came in the form of him pressuring the Minister of Social Solidarity to develop Egypt’s 1,000 poorest villages. After the success of this stage of the process, the official first phase started in January 2021. This first phase expands the number of targeted villages to 4,500, covering 58% of the country’s population.

Since January 2021, the initiative has taken crucial steps in developing Suhag water and sanitation services in 33 villages, renovating transportation stations at a cost of EGP 183 million (almost $12 million), and creating new transportation stations at a cost of EGP 219 million (almost $14 million). This process forms as the initial stages of the 2021-22 plan of the initiative, which carries with it a budget of EGP 200 billion (almost $13 billion).

The 2021-22 plan for the initiative has specific and bold aims that ensure Egypt is tackling poverty in a decisive and thorough manner. Details of the 2021-22 plan include:

  • To set up 10,828 classrooms,
  • To improve 782 youth centers,
  • To renovate 317 public service buildings,
  • To develop 1,250 health care units, establish 389 ambulances and 510 mobile clinics, and 112 veterinary units,
  • To create 191 agricultural service centers.

Final Targets

The “Decent Life” Initiative has several end goals it aims to achieve which President El-Sisi set out. One of the main goals is that the Egyptian government plans to utilize overall investments amounting to EGP 700 billion (almost $45 billion) by the end of the project, demonstrating that Egypt is tackling poverty in an aggressive manner. President El-Sisi has also made the promise that “the Egyptian countryside will be transformed in three years’ time,” signifying an attempt to minimize the rural-urban inequality.

Regarding education and health services, the initiative is aiming to build 13,000 classrooms and activating the new Universal Health Insurance System by the project’s conclusion. The Universal Health Insurance System will consist of mandatory coverage to all citizens by unifying with the private healthcare sector and minimizing existing health insurance disparities.

UN Response

The UN has responded extremely positively to the official launch of the initiative, with the Executive Director of the International Monetary Fund, Dr. Mahmoud Mohieldin, stating that the UN considers the “Decent Life” project at top spot for the best application for sustainable development goals around the world and has full confidence that it will provide essential job opportunities for Egyptians in impoverished areas. Furthermore, the UN has praised the initiative as it also confirms the country’s willingness to “implement the participatory planning approach through integrating citizens in the need’s identification stage.”

–  Gabriel Sylvan

Photo: Flickr

Healthcare in the Marshall IslandsThe Marshall Islands is a country in Oceania. Known for its beautiful beaches, the country attracts many tourists in search of World War II ships that are in its waters. Tourists also visit the country for its abundant wildlife and coral reefs. According to the World Health Organization (WHO), though healthcare in the Marshall Islands is relatively organized, there are discrepancies and other indications of healthcare problems. These include high mortality rates, which WHO has indicated requires evaluation. Amid the ever-growing COVID-19 pandemic, healthcare is absolutely crucial in making sure that mortality remains low and quality of life is high.

5 Facts About Healthcare in the Marshall Islands

  1. The physician density in the Marshall Islands per 1,000 people is 0.456. This number refers to the number of doctors relative to the size and population of the nation. For reference, the physician density in the United States was 2.57 as of 2014. Other countries in Oceania, like Fiji or Samoa, have physician densities of 0.84 and 0.34, respectively, according to their most recent data.
  2. Only two hospitals exist within the country. In addition to these two hospitals in urban areas of the country, there are approximately 60 health centers and clinics spread out around the Marshall Islands. This number may seem surprising, but the small population of 58,791 merits the limited number of hospitals. Providing primary and secondary care, these hospitals rely on larger centers in the Philippines or Hawaii for more tertiary care. Other clinics and health centers are equipped with primary care physicians and other health assistants.
  3. The Marshall Islands saw a 0.5% increase per year from 2010 to 2019 in providing adequate, effective and necessary healthcare. According to a study by Universal Health Coverage (UHC) collaborators, the effective coverage index in 2010 was 42.1% whereas there was an increase of 1.9% in 2019. These percentages are in reference to effective healthcare coverage in 204 territories and countries across the globe. This means that healthcare in the Marshall Islands overall increased in its effectiveness within the decade.
  4. The morbidity and mortality rates for the Marshall Islands for communicable and non-communicable diseases are relatively high. WHO has mentioned that non-communicable diseases have a high prevalence in the country for two reasons. First, the amount of imported and instant food products that people consume there is high. Second, people in the Marshall Islands overall lack exercise and utilize smoking products at a high level.
  5. The mortality rate for children under the age of 5 years old is 31.8 per 1,000 births in the Marshall Islands. This number, known as a country’s “under-five” mortality rate, is indicative of a nearly three-decade-long improvement in under-five mortality rates in the Marshall Islands. The country has seen a steady decline in the rate since 2004. Between 1990 and 2019, the rate decreased by 17.5%. The under-five mortality rate is slightly higher for boys than for girls.

Healthcare Potential

Some of these five facts may paint a harsh picture of healthcare in the Marshall Islands. However, there is still great potential for improvement in the future. The effectiveness of care, for starters, is a great opportunity for the country to excel in its healthcare coverage. With the intervention of organizations such as WHO and an ever-improving healthcare system overall, these statistics could one day be numbers of the past.

– Rebecca Fontana
Photo: Flickr

help women in poverty Across the globe, poverty comes in different forms. Over the years, individuals and companies have developed products to help those in poverty. Since poverty disproportionately impacts women, several companies are inventing products that address the specific tribulations of women. Flo, Hemafuse, Embrace and fashionable iodine dots are inventions that aim to help impoverished women across the globe.

4 Empowering Inventions to Help Impoverished Women

  1. Flo: The Reusable Menstrual Kit. Flo is an inexpensive, reusable menstrual kit designed by Mariko Higaki Iwai. The discreet kit allows girls to “wash, dry and carry reusable sanitary pads.” In developing nations such as Kenya, female students miss about five days of education a month due to a lack of access to menstrual products to properly manage their periods. The Flo kit aims to reduce the risk of infections due to inadequate menstrual hygiene and address period poverty to keep girls in school. With girls able to consistently attend school, they are able to acquire the tools and knowledge to rise out of poverty.
  2. Hemafuse: The Blood Recycler. Hemafuse is an affordable syringe-like device that collects and filters blood that can then be used in a blood transfusion. Since developing nations lack a “reliable blood supply” for emergency blood transfusions, Hemafuse serves to reduce preventable deaths due to blood loss. Hemafuse is particularly valuable in “ruptured ectopic pregnancies,” a common occurrence in the developing world. During ectopic pregnancies, a woman “can lose half of her blood volume,” necessitating an emergency blood transfusion that Hemafuse can help facilitate in countries with limited resources. In this way, Hemafuse can save the lives of millions of impoverished women in lower-income countries.
  3. Embrace: The Portable Incubator. One of the leading causes of newborn death is unregulated body temperature, which can lead to a newborn death every 10 seconds. Incubators are designed to address this issue, however, high costs make incubators inaccessible to hospitals that cannot afford the technology. Embrace is an affordable, portable incubator that serves as an alternative to this necessity. The inexpensive incubator is reusable and “does not require stable electricity,” making it ideal for impoverished and remote hospitals with limited resources. The design also “allows for close mother-child interaction” as a mother can hold the newborn instead of placing the baby in a conventional incubator. Embrace has saved the lives of more than 350,000 babies and aims to continue this trend with the goal of saving “one million babies by 2026.” Overall, Embrace reduces mortality rates among children of impoverished women.
  4. Life-Saving Dots: Fashionable Iodine. In India, many women face iodine deficiencies due to a lack of trust in foreign medicine. As a result, “pregnancy complications and fibrocystic breast disease” are not uncommon. The life-saving dot functions not only as a source of iodine for women but also as a bindi. Without having to take medication, women can wear these iodine dots on their foreheads to supplement the nutrients they need to maintain good health.

Overall, these four innovations provide significant support for women in poverty. Through creative and innovative solutions, the world can see more progress in reducing global poverty.

– Maddie Rhodes
Photo: Flickr

impoverished in El SalvadorEl Salvador implemented a strong response to the COVID-19 pandemic. Now, it has one of the lowest rates of COVID-19 contractions in Central America. Still, there have been several economic depressions globally during this pandemic that have affected the impoverished in El Salvador.

The COVID-19 Pandemic

As of July 23, 2021, El Salvador has had 84,000 confirmed COVID-19 cases and more than 2,500 deaths. On April 1, 2020, President Nayib Bukele confirmed the first COVID-related death over Twitter. The victim was a 60-year-old woman who had recently returned from the United States.

This lockdown has had major ramifications for the impoverished in El Salvador. In an interview with The Borgen Project, San Salvador resident Wendy Michelle Valladares-Hernandez discussed the economic implications for the poor. “I think [the pandemic] has affected…people with entry-level [salaries] which is the majority of El Salvador,” she said. “Entry-level salaries are $300 and things can be as expensive as the U.S. so it’s like telling someone in the U.S. to live with $300 a month. It can be a lot cheaper, like housing but when it comes to food it’s very similar [to] the States.”

Despite this, Valladares-Hernandez described the pandemic procedures positively. “I think that as a country we responded very well,” she said. “The fact that we are all trying to help each other in the sense that we, you know, take care of ourselves, to take care of everyone else around us. I think that’s the reason everyone wears masks when they go out and everyone’s okay by having your temperature checked every single place you go in and cleaning yourself with alcohol every single time you go in.”

El Salvador’s Economy

The U.N. Economic Commission for Latin America and the Caribbean (ECLAC) estimates that the Salvadoran economy contracted 8.6% in 2020, compared to an expansion of 2.6% in 2019. The country has not seen such a loss since 1981 during a civil war. Additionally, El Salvador was the first country to introduce Bitcoin as legal tender. While it is a notable milestone, there are uncertain benefits for the impoverished in El Salvador. The country has a mostly cash-based economy and more than 70% of its citizens do not have bank accounts. It has sparked protests and a poll found that 77% of Salvadorans think Bitcoin is a poor idea.

El Salvador’s Healthcare Services

The organization Doctors Without Borders has recorded an increase in patients dying before ambulances reach their homes. The COVID-19 pandemic has overloaded the ambulance and hospital systems and there is a lack of access to primary healthcare services. Many patients with chronic illnesses do not have full access to medical assistance because coronavirus patients have received medicinal priority.

This has especially affected the impoverished in El Salvador. The U.S. embassy in El Salvador has found that the use of state-of-the-art technology can require medical evacuation to the United States, but even general hospitalization can cost thousands of dollars, often in cash payments. This leaves medical assistance often unaffordable to many, considering the country’s minimum wage is around $270 per month.

The Solutions

El Salvador’s government has already approved a minimum wage increase that went into effect on August 1, 2021. The minimum wage increased by 20%, bringing the entry-level wage from $300 to $365 a month per month. On top of that, the government has announced the Trust for the Economic Recovery of Companies. This Trust has offered to provide $100 million towards small- and medium-scale businesses to subsidize wages and promote the economy. The ECLAC has estimated that El Salvador will see economic growth of 3.5% in 2021 due to private and public investment.

Bukele, in response to the overwhelmed healthcare system, converted the International Center for Fairs and Conventions (CIFCO) into a hospital designed specifically for COVID-19 treatment. The hospital is now the largest hospital in Central America, costing more than $75 million to produce. Originally, the transformed center was to be temporary, however, it will now be a permanent fixture.

The hospital has the capacity to treat more than 400 individuals with COVID-19. The economy hit those who are impoverished in El Salvador hard. Additionally, they often cannot afford to pay or seek medical assistance. The Ministry of Health (MSPAS) offers a free public healthcare system that covers up to 79.5% of Salvadorans in their time of need.

Looking Forward

On July 21, 2021, Bradley A. Freden, the Interim Permanent Representative of the United States, attended an OAS Permanent Council Special Session on equitable COVID-19 vaccine distribution. There, he reiterated President Joe Biden’s announcement to contribute $2 billion in support of COVAX. Soon, 24 million vaccinations will undergo distribution across the Western Hemisphere, including to El Salvador. This contribution will greatly help the vaccination goals of El Salvador, which should be able to vaccinate 4.5 million citizens.

“Importantly, our shots don’t come with strings attached,” said Freden. “We are sharing vaccines with the world and leading in a global vaccine strategy because it’s the right thing to do: the right thing morally, the right thing from a global public health perspective and the right thing for our collective security and well-being.”

Citizens of El Salvador look forward to returning to normal, though some believe that those who are sick should continue to use masks. Valladares-Hernandez remarked, “I think that there’s gonna be things that are gonna get stuck with us. For example, even if someone has a small flu, people are still going to be wearing masks. I think that’s something we are going to do once this goes away.”

– Camdyn Knox
Photo: Pixabay

Spreading Awareness About Fistulas in ZambiaFistulas in Zambia are still a devastating problem for impoverished, young mothers despite being preventable. An obstetric fistula occurs when a mother endures prolonged (oftentimes up to five days long) labor in which obstruction occurs. This obstruction then cuts off the blood supply and causes tissue death. Tissue death leads to holes between the vagina and bladder or rectum. Without treatment, fistulas can mean a woman will “uncontrollably leak urine, stool or sometimes both” for a lifetime. The Fistula Foundation and other organizations seek to help women suffering from fistulas in Zambia.

The Cost of Fistula Surgery

The fistulas come with a myriad of infections and chronic pain and can even cause nerve damage to the legs. While fistulas in Zambia are completely preventable and treatable, there are significant barriers to care for mothers. The surgical costs range from $100-400, an expense that is often far higher than what the majority of patients can afford.

4 Factors That Increase the Risk of Fistulas

  1. Malnutrition: Persistent malnutrition is linked to the development of a smaller pelvis, which increases the risk of an obstructed delivery, potentially leading to the formation of a fistula.
  2. Child Marriage: Early motherhood means the narrower pelvises of underdeveloped girls make an obstructed delivery more likely.
  3. Lack of Education: When young women are pulled out of school for marriage and childbearing without proper knowledge about their bodies, the delivery process and their reproductive systems, health consequences ensue. A lack of proper reproductive health education leads to a lack of awareness about the preventability and treatability of fistulas.
  4. Poverty: Poverty augments the chance of food insecurity, younger marriage, childbearing and sacrificing a woman’s education for family duties. Even more importantly, poverty makes access to healthcare that much more difficult. Fistulas are also more prevalent in births that take place outside of medical facilities as women undergoing an obstructed delivery are unable to get a C-section or emergency medical assistance.

In wealthier countries that properly address these four issues, fistulas are virtually unheard of, showing that poor health outcomes and poverty are inextricably linked.

Stigmatization of Fistulas in Zambia

While the medical ramifications of fistulas are devastating, these consequences come in conjunction with complete social ostracization and shame. Husbands often view the typically stillborn births that come with fistulas as a failure of the mother. It is very common for husbands to shame and abandon their wives, labeling the woman’s medical issues as personal failures.

Doctors often do not adequately inform women with fistulas that they have a legitimate medical issue. The abandonment from their husbands is soon joined by the same treatment from family and friends. The isolation and stigma increase the risk of depression among women suffering from fistulas. Lack of proper awareness and education means fistulas have become a source of shame. Hence, many women suffer in silence for decades, even until death.

Spreading Awareness Through Radio

In 2017, the Fistula Foundation, a nonprofit dedicated to providing impoverished young women with proper and free medical attention for fistulas, launched a radio program to educate communities about fistulas in Zambia. The program reached extensively into many provinces of Zambia and mobilized many women to seek proper medical care to repair their fistulas at the six Zambian fistula care centers the organization established to perform the reconstruction surgery for free.

In 2019 alone, the Fistula Foundation performed 319 fistula repair surgeries, all free of charge. In total, the Foundation has aided in the provision of 774 surgeries. The Fistula Foundation also partnered with the famous Zambian singer Wezi to air a song about the dangers of fistulas. The spread of this song, through both radio and CDs, has created a surge in Zambian women seeking treatment. As a direct result of Wezi’s song, 56 women have sought treatment.

Grassroots Activism

In conjunction with the awareness campaigns and Wezi’s song, the Fistula Foundation has encouraged grassroots movements like the Safe Motherhood Action Group (SMAG) to work with community volunteers to spread awareness to help prevent fistulas and end stigma. SMAG leads discussions within communities about the dangers of child marriage with regard to the increased rates of fistulas in young mothers, the necessity of keeping girls in school and the importance of delivering children in medical facilities. SMAG has implemented more than 3,000 community outreach programs, reaching more than 90,000 people with crucial information about fistulas and interconnected social issues.

The Fistula Foundation heavily relies on community leaders to spread the word, designating them the “entry points” to communities and change. The organization’s work highlights the importance of creative community engagement and education initiatives in promoting proper care and destigmatization of fistulas in Zambia.

Jaya Patten
Photo: Flickr

Nurses in the Solomon IslandsThe Solomon Islands has just two doctors for every 10,000 people. The doctor shortage makes nurses particularly essential, especially as the country faces frequent natural disasters and disease outbreaks. However, nurses are also in short supply. Furthermore, in a country with a 12% poverty rate as of 2013, nurses do not receive proper pay and care. Nurses in the Solomon Islands have faced even more difficulties than usual during the COVID-19 pandemic, but new training programs are helping to remedy the shortage.

Nurse Strikes and Protests

Nurses are the primary healthcare providers in the Solomon Islands, but despite this, they consistently struggle with pay allowances rightfully due to them. The Solomon Islands Nurses Association has issued strikes multiple times over the past five years. In 2016, nurses went on strike for “multi-allowances and special duty allowances” that remained unpaid from 2013. The association extended the strike multiple times as nurses fought to receive the outstanding allowances. Eventually, the strike ended when the government agreed to review and listen to nurses’ demands.

In 2018, nurses found that many of the demands from a Memorandum of Agreement signed in 2007 remained unmet. It called for public service to pay for transportation, housing and posting and for the government to review five other claims. Eleven years later, those demands remained unmet and nurses issued a 28-day strike notice.

In 2019, the nurses again faced a similar situation. The government had agreed on a payment plan the previous year that would provide the nurses with their incentives at the beginning of 2019. A month into the year, the payment did not come through as agreed upon. Once again, the Solomon Islands Nurses Association issued a 28-day strike notice.

Most recently, in October 2020, nurses working in Honiara, the country’s capital and a COVID-19 emergency zone, threatened to strike if they did not receive allowance pay for working on the front lines. The nurses initiated sit-in protests, but when those were overlooked, they went on strike without government approval.

Strike Repercussions

As a result of the unauthorized strike, the government suspended the Solomon Island Nurses Association as a trade union. The government recognized its inability to pay the nurses but did not believe the strike was in Solomon Islanders’ best interests. However, since the suspension, the government has taken action to address the nurse shortage by improving training programs for nurses.

Supervised Practice Program

In March 2021, 180 registered nurses graduated from the Solomon Islands National University and Pacific Adventist University in Papua New Guinea and Atoifi. The graduates have begun a year-long internship with the newly implemented Supervised Practice Program. The Supervised Practice Program ensures nurses are fully registered before employment, focusing on areas of nursing that need improvement in the Solomon Islands.

The graduates are monitored and tested in attendance and timeliness, nursing ethics, code of conduct adherence and dedication. The Supervised Practice Program will help ensure that the Solomon Islands employs qualified and properly trained nurses. With this program, the government aims to improve healthcare and show support for nurses.

Long-Term Benefits of More Nurses

A lack of proper healthcare not only leads to poor health and a shorter lifespan but can also impact people’s ability to work and earn money, ultimately lowering household income and increasing poverty. People living in poverty are already at high risk of poor health because of limited access to healthcare services, a lack of nutritious food and unhealthy living environments. With increased access to qualified nurses, the people of the Solomon Islands will be able to improve their health and reduce poverty as productive citizens who can contribute to the economy.

The pandemic highlights the essential role of nurses, and as such, it is imperative to value, support and prioritize nurses. With progress for nurses in the Solomon Islands, quality healthcare will be more easily accessible to citizens, helping to reduce disease, death and poverty.

Delaney Gilmore
Photo: Flickr