Inflammation and stories on healthcare

Health Care in Congo
The Republic of Congo is one of the most resource-rich and “least densely populated” nations in Africa. Its economy is heavily dependent on oil exports so it is vulnerable to dropping oil prices and economic crises. This, combined with its history of civil conflict, has resulted in a high poverty rate of 52.5% in 2020. Further, in times of economic decline, a lack of government funding has plagued health care in Congo. In turn, that has led to high out-of-pocket costs for the majority of patients. It also has resulted in a lack of health care professionals and an uneven distribution of health care services. Finally, the financial strain of the health care system exacerbates the country’s burden of communicable diseases, such as tuberculosis, malaria and HIV. It has also contributed to the nation’s high rates of maternal and infant mortality.

Effects of Communicable Diseases

A major challenge that health care in Congo faces is the high rates of tuberculosis (TB), malaria and HIV. Tuberculosis is the leading cause of death in Congo and early diagnosis is a critical first step in ensuring successful treatment. To increase Congo’s TB testing capabilities, the World Health Organization (WHO) equipped the cities of Brazzaville and Pointe-Noire with GeneXpert diagnostic machines, which the Global Fund financed.

Delivered in December 2021, the GeneXpert machines have increased the TB testing rate eight-fold at the Antituberculosis Centre in Brazzaville. In the past, TB centers in Congo could only treat the most critical cases due to backlogs created by inefficient machines. By increasing the number of diagnoses, the GeneXpert machines have proven to be a cornerstone in expanding access to TB treatment.

The GeneXpert machines are part of the Global Fund’s two grants that total more than $64 million to strengthen prevention and treatment services for TB, malaria and HIV in Congo. Implemented by the UNDP and Catholic Relief Services, the goals of the grant are threefold:

  1. Successfully treat 90% of TB cases by 2023.
  2. Scale-up access to antiretroviral treatment for HIV-infected patients, with a special focus on pregnant women.
  3. Deliver 3.5 million mosquito nets across Congo by 2023 and increase access to malaria treatment and diagnostics.

Maternal and Infant Health Care Successes

In the past two decades, Congo has made significant strides in reducing maternal and infant mortality rates. The maternal mortality rate has fallen from 739 deaths per 100,000 live births in 2000 to 378 deaths per 100,000 live births in 2017. Similarly, the infant mortality rate has fallen from 106 deaths per 1,000 live births in 2000 to 63 deaths per 1,000 live births in 2020.

To continue on this trajectory of improving maternal and infant health, in June 2021 the World Bank approved $50 million for the Kobikisa Health System Strengthening Project. The project’s goal is to improve the quality and availability of maternal and child health care in Congo among the most impoverished households. With financing from the International Development Association, the Kobikisa initiative will provide free health services for pregnant women and their children in 36 districts across the country. Included in these services are treatments for diseases such as malaria and tuberculosis and the provision of vaccines. By delivering essential health care services free of cost, the Kobikisa initiative will help alleviate the financial burden of health care for millions of Congolese citizens.

Strengthening Congo’s Health Infrastructure

In addition to these targeted interventions, the Congolese central government has also begun to prioritize strengthening the infrastructure of health care in Congo. In 2018, the government increased its investment in health care from 5% of the annual budget in the previous year to 13%.

The main focus of the Congolese government’s investment is improving primary care services and revitalizing health districts. At a workshop in September 2021, executives in the Ministry of Health and Population received coaching and the tools needed to train and supervise various health care professionals “from 93 health areas of the 2020-2021 Operational Strategy.” The training of health care actors at the community level will not only improve the quality of primary care patients receive but will also expand the availability of health care in Congo to remote and rural communities that are underserviced.

Ensuring quality and affordable health care in Congo is one of the cornerstones of the nation’s development. While there is still much work to do, improvements are visible thanks to the support of the international community.

Kaitlyn DeWeerd
Photo: Flickr

Aviro Health
In 2015, a quarter of the global disease cases existed in the sub-Saharan region of Africa. Yet, only 3% of the world’s doctors reside in this region. Access to health care is crucial in maintaining a functioning society. Aviro Health, a company based in Cape Town, South Africa, is extending accessible health care and information to patients across the country while improving treatment options and the overall health of sub-Saharan Africans.

Health Care in South Africa

There are more than 600 hospitals in South Africa, including the third-largest globally, the Chris Hani Baragwanath Hospital, which holds 3,400 beds and 6,760 staff members. Around 400 of these hospitals are public and the remaining 200 are private. Public health care is available to all people living in South Africa “regardless of nationality or immigration status.”

Many people face challenges when physically traveling to medical centers despite their availability. According to the World Bank, only one-third of those living in rural areas of Africa reside within two kilometers of adequately paved road systems. Technological advancements that allow health care practitioners to virtually conduct appointments would greatly benefit those in desperate need of health care.

About Aviro Health

Aviro Health in South Africa began in 2012. It is a technology company based in Cape Town that develops digital innovations that assist both health care practitioners and patients. The established vision of the company has stated that “We see a world in which everyone gets medical information and healthcare that is accessible, efficient, and delivered with empathy and understanding.”

Aviro staff members aim to provide services through technology, which would allow those who encounter difficulties traveling to medical centers in person to still receive information and treatment. Medical practitioners receive further training in the form of e-books and videos and patients can learn more about testing and diagnoses through e-learning. Technology benefits that Aviro Health in South Africa developed are also available to health care professionals in Zimbabwe, Mozambique and Malawi. Since its foundation, Aviro has assisted more than 50,000 users in accessing medical services.

The Pocket Clinic

A significant technological innovation developed by Aviro Health in South Africa is the Aviro mobile Pocket Clinic. This innovation is a digital counseling service used by health professionals in both the private and public sectors in South Africa. The Pocket Clinic allows medical counseling through mobile phones or other technological devices. Patients can manage their health care digitally while also connecting to health care providers.

The service provides users with a medical content plan based on their medical tests that users can receive via the web, the platform app or Whatsapp. The Pocket Clinic can also connect patients to other health experts and services that could provide hands-on treatment. The Pocket Clinic serves as a life-changing tool that the medical field can use to assist health care practitioners and patients in delivering and efficiently receiving care. The Aurum Institute partnered with Johns Hopkins University offering self-HIV tests in the lobbies of health care centers “supported by the Aviro Pocket Clinic on tablets.” This led to a “40% increase in testing” along with an 80% increase in HIV treatment uptake.

HIV/AIDS Testing

South Africa is home to the world’s largest HIV treatment initiative. Yet, as of 2021, South Africa noted 7.8 million HIV cases, with only 4 million people receiving treatment in the country. In the age of COVID-19, many people find it difficult to travel to medical facilities to receive testing and treatment.

Fortunately, the Pocket Clinic offers self-tests for patients without requiring the presence of a health care professional. This method also promotes increased patient privacy. A soft launch of self-HIV tests by Aviro Health in South Africa generated positive results. In Kwazulu-Natal, 7.5% of service users tested positive for HIV and began ARV treatment in contrast with only 2.5% in conventional clinical-based testing.

Pocket Clinic also connects those who test positive to an HIV hotline. In the next five years, Aviro Health anticipates making self-tests available to 10 million people in the sub-Saharan region.

A Future of Health

Technological advancements in health care that Aviro Health in South Africa developed improve overall health in the country. Innovations that individuals can access virtually will provide better testing and treatment for patients across the nation.

– Megan Quinn
Photo: Flickr

Health in the Philippines
Since the start of the COVID-19 pandemic up until April 2022, more than 3.6 million people living in the Philippines have contracted the virus. With nearly 60,000 of those cases resulting in fatalities, health in the Philippines must be a priority. Community Health Worker groups, specifically Barangay Health Workers (BHW) and Barangay Nutrition Scholars (BNS), are working to improve the health of those living in the Philippines.

Health Care in the Philippines

In February 2019, the Philippine government passed the Universal Health Care Act Republic Act into law. This act sought to improve health care for Filipino citizens by making these services more affordable, especially for those without medical insurance. Through the Universal Care Act Republic Act, all Filipinos can enroll in the National Health Insurance Program to allow health insurance coverage for all. To finance this, the Philippine government extended its health care expenditure to almost 6% of its total GDP.

Despite these efforts, access to health care is not equal for all. It is challenging for rural and low-income areas to receive the same treatment as those living in upper-class communities. Private and more expensive medical facilities where those of higher-income regions receive treatment are often better equipped than public hospitals. Health care for all must be a priority in the Philippines, especially after the nation’s polio outbreak in September 2019. Community health workers like BHW and BNS are essential to the nation during outbreaks and epidemics. These workers provide health information and primary care to those in more vulnerable areas.

Barangay Health Workers

Barangay Health Workers (BHW) consist of trained volunteers within the community who provide information regarding overall health. They also offer first aid, maternal and child health care, environmental health care and connect patients to health care centers.

BHW has been present in the Philippines for about 40 years and they receive government support. In 1995, Philippine Congress passed the BHW Benefits and Incentives Act, which encouraged the group “to self-organize, to strengthen and systematize [its] services to communities and to create a forum for sharing experiences and recommending policies and guidelines.” The act also required the government to provide benefits to BHWs, such as “scholarships for their children” and an allowance.

BHWs play a significant role in improving health in the Philippines. In 2014, after Typhoon Haiyan ravished island barangays, Direct Relief financed a training program for 50 BHWs to educate them on recognizing and treating illnesses that affect children. To this end, the health workers participated in the Community Integrated Management of Childhood Illness training program. The module emphasized “the 12 key childhood illnesses danger signs” in order to avert preventable child deaths.

BHWs also educate and encourage citizens to receive immunizations against illnesses such as polio to contain the spread. In 2016, the Philippines had 216,941 BHWs in the nation.

Barangay Nutrition Scholars

Like BHWs, Barangay Nutrition Scholars (BNS) promote and educate on proper health in the Philippines. However, their primary focus gears toward improving nutrition. In 2011, 25% of Filipino “women of reproductive age” suffered from anemia. For children younger than five-years-old, this statistic reached almost 35% in that same year.

BNS is essential to combating malnutrition in the Philippines. The group conducts growth monitoring for clients, provides nutrition education and collaborates with local organizations that encourage citizens to achieve sustainable nutrition by gardening and raising livestock.

BNS members must complete training that involves a 20-day practicum where trainees learn how to weigh young children and measure their heights to ensure that children are receiving proper nutrition at home. In addition to monitoring children’s health, BNS also provide classes for parents who may be unaware of how important nutrition is for their children’s development. These classes educate on balanced diets and how to prevent malnutrition. By July 2020, 49,779 BNS members had worked across 39,942 barangays in the Philippines.

Looking Ahead

Groups like BHW and BNS are crucial for ensuring proper health in the Philippines. Volunteers are making a significant difference within their communities. The more healthy people there are, the more contributions that can go towards the Filipino workforce, improving the economy and quality of life in the nation overall.

– Megan Quinn
Photo: Flickr

WHO’s Blindness Prevention StrategyThe World Health Organization (WHO) has developed specific strategies to tackle blindness and related diseases through strategies including VISION 2020 and SAFE. Other countries may see progress in eye care support by implementing such strategies after the 74th World Health Assembly introduced a resolution to the improvement and accessibility of eye care services. Governments have adopted the resolution to make greater efforts to incorporate eye care in primary care. Methods from VISION 2020, SAFE and the recent PECI from WHO’s blindness prevention strategy may help bring the resolution to fruition.

Eye Disease: A Global Public Health Issue

WHO reported that at least 2.2 billion people suffer from visual impairment. Nearly half of these cases could have been prevented or have yet to undergo identification. A range of factors, including complications from disease, age, trauma and more can cause eye impairment. Some individuals do not receive timely treatment for preventative eye care, which can result in lifelong damage. Visual impairment can affect every aspect of a person’s life, ranging from career and school opportunities to independence and overall health.

For example, trachoma remains a public health issue in 44 countries. WHO says, using June 2021 data, that 136 million people reside in areas where trachoma is common. The individuals are also at risk of contracting trachoma-related blindness.

Visual impairment, such as blindness, leads to tremendous economic burdens and productivity loss. WHO estimates the cost of productivity losses from blindness and visual impairment at $2.9-5.3 billion per year. Some methods of treatment for visual impairments include surgery, corrective glasses and contacts as well as medication. The advancements in medicine allow more people to live without lifelong damage similar to blindness as such solutions are not as readily available for those living in rural areas or those of low income. VISION 2020 and SAFE are variations of the WHO’s blindness prevention strategy that aim to extend treatment for visual impairment and preventable blindness to regions where treatment is not readily available.

The Package of Eye Care Interventions (PECI)

According to the WHO, those living in developing countries or rural regions face inequities in the quality, rate and accessibility of eye care. Because of limited resources for eye care in low- and middle-income countries, estimates project that 50% of the global population will be living with vision impairment by 2050.

To support countries struggling with cases of vision impairment, some of which are preventable, WHO’s blindness prevention strategy has materialized in various solutions in the past two decades. One recent strategy from WHO is the Package of Eye Care Interventions (PECI) in 2020. This evidence-based approach, if implemented, allows countries to carefully determine where to prioritize budgets and integrate eye care interventions. The strategy will support work competency, fulfill medication and equipment needs and more. However, WHO’s blindness prevention strategy did not begin here.

VISION 2020 “Right to Sight” and SAFE

Before PECI, WHO developed the strategies VISION 2020 “Right to Sight” and SAFE. VISION 2020 began in the hopes of eliminating preventable blindness by the year 2020. Some of the goals of the strategy aimed to safeguard an estimated 100 million people, primarily in developing countries, from avoidable blindness. VISION 2020 also intended to save an estimated $102 billion in lost productivity from the time the strategy was implemented to 2020. This strategy, similar to PECI, focused on developing quality eye care facilities with trained eye care workers, implementing programs that help prevent major causes of blindness and promoting the integration of eye care in primary care.

Since then, WHO has recommended Surgery, Antibiotics, Facial cleanliness and Environmental improvement (SAFE) along with the previously mentioned strategies to prevent avoidable blindness. After the 74th World Health Assembly, more countries that have adopted the resolution may see progress in supporting their citizens with eye care and eliminating preventable eye diseases. By using WHO’s blindness prevention strategy, rates of preventable blindness may reduce.

– Michelanie Allcock
Photo: Flickr

Legacy in Global Health
In February 2022, the world parted with one of its most valued physicians and advocates. Dr. Paul Farmer was a man who dedicated his life, career and effort to provide medical care to developing countries struggling with poverty. At the end of his life, Dr. Farmer received various awards for his work, published a variety of books regarding global health and co-founded Partners in Health, a nonprofit organization to provide modern medicine to those in need. Those in humanitarian work and aid may only speculate what more Dr. Farmer would have accomplished if he did not lose his life so suddenly and hope that Farmer’s work can be a legacy in global health for future humanitarians.

Paul Farmer’s Start to Global Health

Dr. Farmer started with a passion for humanitarian work. After graduating from Duke University in 1982 with honors, Farmer achieved an M.D. and Ph.D. in anthropology at Harvard in 1990. Prior to achieving his Master’s degree and Doctorate, Farmer protested U.S. immigration policies that discriminated against Haitian refugees. Farmer also extended his effort to Haiti where he helped establish a community-based health project in 1983.

In 1987, Dr. Farmer co-founded Partners in Health (PIH), aiding clinics, education and training in developing countries. Since its founding, PIH has contributed to a multitude of initiatives and movements to support global health. In 1998, the organization launched the HIV Equity Initiative, a program that administers antiretroviral therapy to Haitian HIV-positive patients. The initiative would be a steppingstone for other major organizations, such as the World Health Organization (WHO) to fund efforts against HIV. In 2003, the organization co-founded OpenMRS, a source to open medical records designed for use in developing countries.

Today, there are 15.8 million active patients using the platform in 40 countries. Following the Haitian earthquake in 2010, PIH organized a vaccination campaign for the growing threat of cholera in 2012. This effort would protect 50,000 people from the deadly sickness. PIH is only one Farmer legacy in global health and the organization will only continue to grow.

Farmer’s Work with MDR TB

One of Dr. Farmer’s notable efforts in global health was in 1999 when WHO appointed Farmer and PIH co-founder Jim Yong Kim to launch global treatment programs and effective antibiotic delivery to patients suffering from multidrug-resistant tuberculosis (MDR TB). The Bill & Melinda Gates Foundation funded a grant of $44.7 million to PIH and Harvard Medical School for MDR TB research and with this fund Farmer was able to develop “individualized drug-therapy programs for patients in Haiti, Peru and Russia.”

Peru still benefits from the work that Dr. Farmer and other humanitarians have done for the international community. The World Bank recorded that in 2000, a year after Farmer began his work, the rate of tuberculosis incidences was 183 per 100,000 people. More than 20 years after Farmer’s initial work, tuberculosis incident rates went down to 116 per 100,000 people.

Haiti’s National Teaching Hospital

Farmer’s legacy in global health will live on in PIH and in the many people he helped. After the devastation that a 7.0 magnitude earthquake brought to Port-au-Prince, Haiti, killing thousands, Farmer and PIH provided emergency care and medical relief to Haitians who experienced the disaster.

The disaster caused the loss of 70% of public health buildings and 20% of the public health system’s clinical staff. Despite the odds against the aid workers and Farmer during the crisis, Farmer was able to coordinate the building of a new and larger national teaching hospital. In 2013, the creation of Build Health International (BHI) and the Hôpital Universitaire de Mirebalais (HUM) further expanded the hospital. Containing six operating rooms and with designs to hold 600 outpatients and emergency patients daily, the newly built hospital would help more than 1,500 patients daily by its second year. Today, that legacy in global health continues on as the hospital continues to grow and save lives.

Nearing the end of Farmer’s life during the pandemic, PIH launched initiatives in response to COVID-19 globally. While the world is still battling the pandemic, PIH and other organizations, people and groups can lead in Farmer’s example with his legacy in global health. With Farmer’s various achievements and efforts, Farmer’s work will continue to live on and help many more lives in the future.

– Michelanie Allcock
Photo: Flickr

Health Care in Tonga
Located in the Polynesian area of the Pacific Ocean, the Kingdom of Tonga is an archipelago of 169 islands with a population of about 107,693. Health care in Tonga is in a critical position as Tongan citizens face several health issues while the nation’s health system struggles with a lack of resources. Today, the most pressing issues are non-communicable diseases (NCDs) and the onset of COVID-19.

Overview of the Health Care System in Tonga

Primary financing for health care in Tonga comes from the government but the nation still relies significantly on donor funding. Data from 2019 shows that about 5% of the country’s GDP went toward health care, equal to $242 per capita. The health care system is small, both in workforce and infrastructure. In 2013, the ratio of physicians to citizens was about 0.54 per 1,000 citizens. Furthermore, in 2015, the country had “34 maternal and child health clinics, 14 health centers, three district hospitals and the tertiary referral hospital” in place.

The Effects of NCDs Tongan Health

Unfortunately, Tonga has an incredibly high rate of non-communicable diseases (NCDs) with about 99.9% of the adult population facing a “moderate to high risk” of acquiring an NCD. In Tonga, about 80% of deaths are due to NCDs as compared to the global average of 70%. These diseases are not contagious and a combination of genetics, environmental factors and lifestyle choices can cause them. Lifestyle choices such as tobacco use, alcohol consumption, diet and lack of exercise stand as key causes of NCDs. Cardiovascular disease and diabetes are among the main health concerns in Tonga. Fortunately, the government is aware of these issues and is working to combat these concerns.

Addressing the Prevalence of NCDs

Tonga’s current goal, in line with the U.N. Sustainable Development Goals (SDGs), is to decrease NCD-related deaths by one-third by the year 2030. Over the years, Tonga has put in place policies and strategies to address the prevalence of NCDs. For example, in 2004, Tonga became “the first Pacific Island country to launch a National NCDs strategy.” A few years later, in 2007, Tonga became “the first Pacific island country to set up an autonomous body to address NCDs,” also known as the Tonga Health Promotion Foundation or TongaHealth. TongaHealth is a non-governmental organization that is working to promote physical activity, improve diets and educate people about the consequences of alcohol and tobacco use.

According to the TongaHealth website, “TongaHealth uses evidence-based approaches to increase the knowledge, skills and resources of key organizations through advocacy for and promotion of healthy environments and healthy living.” In 2014, Tonga also received recognition from the World Health Organization (WHO) for its work regarding tobacco taxation and control.

What About COVID-19?

While many nations were plunged into a total crisis of chaos when COVID-19 emerged, Tonga remained completely untouched by COVID-19 until October 2021, about a year and a half after most countries had seen their first cases. Unfortunately, the Hunga Tonga volcanic eruption in January 2022 created a need for humanitarian aid and Tonga began to see COVID-19 cases rising due to contact during humanitarian efforts. In response to the natural disaster, as of January 25, 2022, Tonga has received around $2.5 million worth of aid from the United States as well as additional international aid from France, Australia and New Zealand.

As of March 15, 2022, Tonga has recorded 2,072 COVID-19 cases and two deaths. There is a strict lockdown in place and humanitarian aid endeavors aim to be as contactless as possible. If a larger breakout occurs, Tonga’s health care system may struggle due to its lack of resources and infrastructure, a situation that would prompt urgent COVID-19 relief.

Looking Ahead

With ongoing commitments to combating NCDs and strengthening the health care system, the future of health care in Tonga looks bright.

– Mia Sharpe
Photo: Flickr

Sightsavers Treats Visual Disorders
According to Sightsavers, roughly 90% of all people suffering from visual impairments or blindness reside in developing nations. Because the organization recognizes the link between poverty and visual impairments, Sightsavers treats visual disorders, takes steps to combat preventable blindness and provides assistance to people with irreversible blindness. The organization, established in 1950, works in developing nations across Africa, the Caribbean and Asia.

Economic Impacts of Visual Impairments

Visual impairments have far-reaching impacts. The Centers for Disease Control and Prevention (CDC) explains that “good vision is important for good quality of life and loss of vision leads to disability, morbidity and loss of productivity.”

Disabilities and morbidities that arise from visual impairment take away from the human capital of a nation because the affected person can no longer serve as a productive member of the workforce and contribute to the economy. On a household level, there are economic impacts too. Households incur significant costs to treat advanced visual disorders.

The inability to work means reduced household income, exacerbating conditions of poverty in the home. Also, untreated visual impairments can lead to diseases or conditions that place a strain on the health care system of a developing country, which usually lacks the resources, infrastructure and personnel to take on this added burden.

In a study that the Investigative Ophthalmology and Visual Science journal published in 2018, researchers determined that a blind or visually impaired person suffers from a significant amount of fatigue in comparison to those without these afflictions. In turn, high levels of fatigue lead to a loss of productivity that materializes as “increased societal costs” and an intensified economic burden. Sightsavers treats visual disorders to prevent avoidable blindness and the consequences that come with a loss of vision.

The Year 2021 in Review

Over the last year, Sightsavers made several accomplishments despite the onset of the COVID-19 pandemic. Sightsavers and its partner organizations were able to “deliver millions of treatments to combat neglected tropical diseases.” For instance, trachoma is an infectious neglected tropical disease that affects the eyes. Without treatment, trachoma can lead to blindness or visual impairment. With the help of Sightsavers, in April 2021, The Gambia was able to fully eradicate trachoma, one of the leading causes of blindness within the country.

Through the support of Sightsavers’ Equal world advocacy campaign, after years of efforts, in September 2021, Mali put into legislation legal provisions that safeguard the rights of people with disabilities, including those with visual impairments, so that they can obtain access to the same employment opportunities, education possibilities and social benefits as other people.

Sightsavers’ Other Accomplishments

In December 2021, Sightsavers won the Zero Project Award, an honor that “recognizes innovative policies and practices that improve the lives and support the rights of people with disabilities.” The award gives praise to a Sightsavers toolkit that launched in 2018, which provides recommendations on performing “an audit of health care facilities” and gives guidelines “on accessibility standards and examples of best practice.” Since the toolkit’s release, Sightsavers has utilized the specialized toolkit to provide training to more than 200 staff members from organizations that support people with disabilities as well as “governments and the private sector.” Sightsavers has also used the toolkit to “conduct accessibility audits in 50 hospitals across eight countries and complete priority accessibility renovations in 16 health facilities.”

Kareen Atekem, a neglected tropical disease (NTD) researcher from Sightsavers, was a finalist for the 2021 NTD Innovation Prize competition. Her project entails an innovative trap for Chrysops flies that spread a parasitic disease called loiasis, which affects the eyes. Atekem told Sightsavers that “If successful, our innovative trap will also allow us to monitor ‘Chrysops’ populations and eventually, control the spread of these biting flies. This could reduce the risk of loiasis for whole communities and regions.” By preventing loiasis, Sightsavers can safeguard the lives and livelihoods of people within high-risk areas.

The economies of all nations rely on the good health and well-being of citizens so that people can hold positions as productive members of the workforce. Sightsavers’ mission to safeguard vision is necessary for the growth and prosperity of countries. With a 90% rate of visually impaired individuals in developing nations, Sightsavers treats visual disorders to promote both well-being and economic growth.

– Kyle Swingle
Photo: Flickr

USAID Partners in Ethiopia
Ethiopia is currently enduring its worst drought in decades. The nation has not experienced a successful rainy season “since late 2020” and the continued lack of rainfall has had devastating consequences. The drought directly affects more than 6 million Ethiopians through water shortages, crop failures and livestock deaths. This is especially devastating because the agricultural industry contributes 40% to Ethiopia’s GDP and employs roughly 75% of Ethiopians as of March 2022. The ongoing Tigray War only exacerbates the humanitarian crisis in Ethiopia as fighting in the north of the country continues to displace civilians and disrupts access to economic markets. Both of these developments place a disproportionate burden on the rural population who stand as the most economically vulnerable. Based on the most recent available data from 2016, the percentage of Ethiopians living below the national poverty line is 15% in urban areas but 26% in rural areas. The drought only threatens to broaden this divide as it most negatively affects rural populations that depend upon agriculture. In light of this crisis and its effects on impoverished rural populations, many USAID partners in Ethiopia have stepped in to help.

USAID’s Response

The United States is Ethiopia’s largest donor of foreign aid and the two countries have a close developmental relationship that goes back to the early 1900s. The United States Agency of International Development (USAID) distributed $402 million worth of humanitarian assistance to Ethiopia during the fiscal year 2021 and continues its commitment in the face of this deepening crisis. USAID channels funds through partner organizations like UNICEF that have specific directives and fields of expertise. Here are three major USAID partners in Ethiopia that are delivering specialized care to those in need:

3 USAID Partners in Ethiopia

  1. Catholic Relief Services: Partly due to the drought’s widespread effects on livestock and agriculture, an estimated 20.4 million Ethiopians lack dependable access to food as of December 2021. Partnering with USAID to combat this growing food insecurity is the Catholic Relief Service (CRS), a nonprofit whose mission is to provide emergency relief to victims of civil conflict and natural disasters around the world. It leads the Joint Emergency Operation (JEOP), which comprises numerous development-based NGOs and other USAID partners in Ethiopia. Since June 2021, the JEOP has reached approximately 3.4 million people affected by the crisis with crucial food assistance, which it sources primarily from U.S. agriculture.
  2. UNICEF: With the financial support of USAID, the United Nations Children’s Fund (UNICEF) is currently conducting an extensive immunization campaign in the war-torn Tigray region. In the first two months of 2022 alone, the campaign successfully provided measles vaccinations to almost 700,000 children. This is part of a larger children’s health campaign that also saw the simultaneous distribution of vitamin A supplements and deworming tablets. This is crucial in Ethiopia where the under-five child mortality rate is 48.7 deaths per 1,000 lives as of 2020. UNICEF intends to provide measles vaccinations to 3 million Ethiopian children by the end of 2022.
  3. International Medical Corps: The International Medical Corps (IMC) is a USAID partner that delivers emergency medical services during times of crisis. In Ethiopia, the IMC has concentrated its efforts on those displaced by the Tigray War. The IMC currently manages 23 mobile medical units that have served more than 804,000 displaced people since the onset of the conflict in November 2020. These units have also administered about 233,000 outpatient consultations while screening 146,510 children younger than five as well as pregnant/lactating women for acute malnutrition as of February 2022. Mobile medical units are crucial as the conflict renders many of the country’s health care facilities inoperative. Mobile care is especially important in remote areas with even more restricted access to traditional care. USAID provided the IMC with $4 million in the fiscal year 2021 to fund its activities in the region, and in total, the IMC and other USAID partners have implemented more than 60 of these life-saving mobile medical units across the country since the start of the conflict.

Looking Forward

In a major win for USAID partners in Ethiopia, the Ethiopian government decided in February 2022 to lift the national state of emergency (SoE) that had been active since early November 2021. The SoE had justified the unwarranted detention of foreign aid workers and generally impeded international assistance programs. All aid workers are no longer arbitrarily detained on account of suspicions of connections to the Tigray People’s Liberation Front and humanitarian relief efforts can continue with renewed vigor. The U.S. Department of State has also praised this development as an important step toward the peaceful conclusion of the Tigray conflict, which bodes well for the overall stability of the region.

With this hopeful development in Tigray and the sustained assistance efforts of the international community, there is cause for optimism. Ethiopia has weathered the turbulent onset of this crisis, but there is still a need for long-term solutions, especially with regard to rural poverty. For the time being though, the humanitarian initiatives of USAID and its partners help lay the crucial groundwork in human capital, which is a solid first step in Ethiopia’s equitable development.

– Jack Leist
Photo: Flickr

E-health in Latin America
As new digital technologies grow more prominent, e-health in Latin America can provide solutions to the region’s most pressing health problems. Given existing disparities in health care and geographically complex challenges, policies promoting e-health can improve health care access and quality.

The Benefits of E-Health in Latin America

E-health relies on digital information and technology to support and improve people’s health and well-being. It has particular potential in marginalized or remote regions without easy access to traditional health facilities. E-health stands as one of the most effective ways to make health care more equitable and efficient while saving on provider costs.

  • E-health initiatives can expand health care resources by allowing experts in specific health sectors access to a wider population. Due to “shortages of resources” and funding, hospitals and other health care facilities face frequent overburdening and strain. Even though health care specialists are most often located in major metropolitan areas, e-health allows them to consult with patients in far or remote regions.
  • E-health in Latin America can improve preventative care. Remote monitoring of chronic or age-related illness may improve efficiency and access while still detecting symptoms before an emergency occurs.
  • The creation of a health care system that accommodates cultural and linguistic differences is possible. Patients may choose not to access health care if providers in their region do not have similar cultural understandings or if there is a language barrier. Multilingual telemedicine platforms are able to dissolve language barriers.
  • It will be easier to collect data and identify trends in certain populations. If health care providers have easier access to target populations, then providers can collect more data to assess and better understand health care needs and trends.

E-Health in Latin America: Examples of Success

  • Mexico. Mexican e-Health startup Hoy Health began in 2017 and has announced an expansion of its telehealth services in Mexico City beginning with the Central de Abastos wholesale market. By implementing mobile health kiosks in one of the city’s most bustling wholesale marketplaces, busy individuals without easy access to health care can access health care in a location convenient for them. In each mobile health kiosk, users can participate in immediate video consultations with physicians. Beginning in February 2022, Hoy Health will be providing telehealth services via 12 mobile kiosks at different locations across Central de Abastos.
  • Argentina. Argentina is a large country that experiences widespread geographic disparities in health outcomes and a severe shortage of resources in many areas. However, due to the high levels of internet and mobile penetration, e-health is able to provide a successful solution to expanding health care access. Health centers specializing in highly complex cases are typically found in urban areas. Two of these centers, the Garrahan Hospital and the Instituto Zaldívar, implement remote telemedicine programs allowing them to easily access rural communities.
  • Colombia. Colombia proves to be a pioneer in terms of e-health in Latin America. Since the COVID-19 pandemic began, the country has “held more than 9 million telemedicine appointments,” a more than 7,000% increase in comparison to pre-pandemic numbers. This trend is unlikely to waver as the pandemic subsides and the country can now use the robust e-health network to solve other health problems. Colombia is a large, biodiverse country with many remote regions that are difficult to access. Telehealth can provide these citizens with access to care.

Looking Ahead

E-health in Latin America can aid in eliminating many existing barriers to quality health care. The COVID-19 pandemic has accelerated the adoption and implementation of such measures. While Latin America must contend with various challenges, such as a lack of resources and specialists, widespread disparities and remote regions without easy access, e-health programs and technologies can reach more citizens and improve the health and well-being of the region’s inhabitants.

– Jennifer Hendricks
Photo: Wikipedia Commons

Health and Poverty in India
According to the World Bank and World Health Organization (WHO) in 2017, at minimum, 50% of the global population cannot access “essential health services.” The crippling costs of annual checkups, emergency health care and chronic disease treatment often push struggling households into extreme poverty. The dynamic relationship between health and poverty impacts the lives of millions around the globe, especially in India. According to the World Poverty Clock, in 2021, the rate of extreme poverty in India stood at 7% and the income of 84% of Indian households took a plunge. Health issues remain one of the leading causes of poverty in the country. By taking a closer look at how health and poverty in India overlap, one can understand the interconnectedness of the issues.

Poverty and Health Care Debt in India

The Indian Ministry of Health stated that between 2011 and 2012, “18% of households faced catastrophic health costs,” a rate that only grows as poverty deepens and social assistance remains minimal. These unaffordable health care costs push already struggling households into extreme poverty. It is important to note that those in rural areas and impoverished countries make up the vast majority of people who shoulder medical expense burdens. India’s impoverished receive little to no governmental aid as government spending goes elsewhere.

The Indian government continues to underfund the health care sector as it spends roughly “1% of GDP on health.” This percentage is “among the lowest for any major economy.” The scarcity of government funding to support the health care sector often drives Indian citizens to use savings and out-of-pocket money to cover medical expenses. Research shows that, in 2018, almost 63% of Indian citizens’ “total health spending” went to out-of-pocket expenditure, which increases people’s vulnerability to crippling debt and poverty.

Poverty and Health Insurance in India

India’s most impoverished and most vulnerable people consider health insurance a luxury. A report by the National Survey Office (NSO) of the Ministry of Statistics and Programme Implementation in India states that between 2017 and 2018, only 14.1% of Indians residing in rural areas and 19.1% of Indians residing in urban areas had access to any form of health insurance. In addition, private health care in India is inaccessible to a majority of the nation’s most vulnerable groups due to the high cost. According to IndiaSpend in 2017, India had the sixth-highest private health care expenditure “among low- and middle-income countries.” As for government insurance, NSO reports found that, between 2017 and 2018, only 9.9% of the most impoverished rural Indians and 7.5% of urban Indians “had any government-sponsored health protection.”

Poverty and the COVID-19 Pandemic in India

The COVID-19 pandemic brought devastation to world economies and destruction to health care systems internationally. Specifically, COVID-19 had severe impacts on India’s impoverished. In the first year of the pandemic, the virus caused 7 million job losses in India. In particular, India’s agricultural sector took a hard hit in several ways.

For example, labor and transportation limitations impacted “production and marketing” while the economic impact of COVID-19 on the nation led to “income shock” that increased the price of food and changed household consumption patterns. A survey by the National Bureau of Economic Research (NBER) confirms these economic shocks. Using data from “a panel survey of 197,000 households” implemented “every four months” up until July 2021, researchers deduced that extreme poverty rose greatly across India due to COVID-19 lockdown restrictions, especially in cities. As a result of COVID-19 impacts, 44 million more people fell into extreme poverty in India by July 2021.

The DevaMitra Foundation Offers Hope

As India’s most vulnerable continue to struggle with the rising cost of medical care, several organizations aim to alleviate healthcare-related poverty and make health services more accessible. The DevaMitra Foundation is a New Delhi-based organization that aims to reduce the impacts of deteriorating health and poverty in India.

DevaMitra’s main goal is to improve the health of the most vulnerable by offering health care services and facilities and by providing treatments and medications to remote and rural areas across India. The organization also implements programs to increase health awareness and health education in communities.

By allowing vulnerable and underprivileged people equitable access to health care, non-governmental organizations offer hope and pave the way for societal development.

– Nohad Awada
Photo: Flickr