Inflammation and stories on healthcare

The Impact of COVID-19 on Poverty in Pakistan
As COVID-19 wreaks havoc on the developing world, the World Bank estimates that there will be between 119 to 124 million additional people added to poverty due to economic standstills. Developing countries are at high risk of an increase in poverty, including Pakistan. The impact of COVID-19 on poverty in Pakistan is substantial, but the government and other organizations have been cooperating to minimize the impact.

COVID-19’s Impact on Pakistan

In Pakistan, to date, there have been more than 22,000 COVID-19 related deaths. Vaccination programs have experienced delays, with only about 2% of the population of Pakistan currently vaccinated. To receive the vaccine, residents pay around $78, a luxury that many Pakistanis cannot afford. Due to the U.K. strain, cases are rising again. However, government officials are hesitant to enforce a strict lockdown as they did in March 2020. Rather, the government utilized the popular “smart” or “micro” lockdowns, where only specific areas go into lockdown. However, limited data exists on the success rates of these strategies.

Pre-Pandemic Pakistan

Even before the pandemic, Pakistan’s health system had limitations. According to the United Nations Development Programme (UNDP), before COVID-19, Pakistan had a ratio of one doctor to 963 people and a lack of universal healthcare. Before the virus, the poverty rate in Pakistan declined by 40% over the last two decades. However, the economic impacts of the pandemic halted poverty reduction progress.

The Impact of COVID-19 on Women and Children

COVID-19 has impacted women and children in Pakistan more significantly than men. Due to the virus, these vulnerable groups are suffering several consequences. Children are one of the most vulnerable groups in Pakistan. In June 2020, nearly 42 million children were out of school, with 17 million children younger than 5 missing routine vaccinations.

According to the International Labor Organization (ILO), the shutdowns due to COVID-19 have disproportionately affected women, and in particular, the garment industry, which makes up a substantial part of Pakistan’s exports. In Pakistan, the majority of the population has employment within the garment industry, with approximately one in seven women working in this sector.

To rectify the bleak situation, the Pakistan Workers Federation and the Employers Federation of Pakistan issued a joint statement of cooperation and the government provided wage support. These efforts also included a “no lay off” order and an interest rate reduction for employers who retain their employees.

The Good News

While the situation looks bleak, the government and organizations are taking action to relieve the impact of COVID-19 on poverty in Pakistan. The U.N. Development Programme established a COVID-19 Secretariat at Pakistan’s Planning Commission in 2020 to facilitate the economic and social response to the pandemic in conjunction with U.N. agencies. The Secretariat supported the Pakistani government’s 2020-2021 budget and National Action Plan for COVID-19.

To alleviate the lockdown’s hardships in 2020, the government issued unconditional cash transfers of approximately $70 to 12 million vulnerable households to prevent food insecurity. To continue to support the most vulnerable population, Ehsaas, the federal social protection program, made extra payments to 4.5 million families. Under the Ehsaas Emergency Cash initiative, another 7.5 million households received monetary assistance.

Dr. Sania Nishtar, the leader of Ehsaas, said in an interview with Mckinsey, that Ehsaas “invested” heavily in time, money, energy and effort to build infrastructure, including an SMS-based request-seeking mechanism, which allowed for ease in eligibility determinations and digital payments.

The World Bank ranked Ehsaas as one of the top four social protection programs by coverage. In March 2021, the World Bank issued a statement supporting the program by approving $600 million to expand Ehsaas. The fund allocation will facilitate the expansion of the programs to reach more informal workers.

Looking Ahead

The impact of COVID-19 on poverty in Pakistan is significant, however, the government and organizations are working together to provide social protection to the most vulnerable groups and will continue to do so as vaccination rates increase.

– Lalitha Shanmugasundaram
Photo: Flickr

COVID-19 in Cambodia
The IDPoor card is a critical resource in the United Nations’ new COVID-19 Cash Transfer Programme. This program aims to support socioeconomically disadvantaged citizens who COVID-19 in Cambodia has impacted. The IDPoor card, which the country implemented in October 2020, is a form of payment to impoverished families and individuals that helps them access essential resources like food, housing, healthcare treatment, education and more.

IDPoor Card in Action

The Cash Transfer Programme provides Cambodians with financial resources for housing security and healthcare access. The Cambodian government registers individuals in need of economic assistance and indicates how much aid they can receive. With financial support from the U.N. and UNICEF, the Cambodian government has significantly improved the daily lives of impoverished Cambodians.

Yom Malai is a Cambodian woman who received the IDPoor card and described her experience in a U.N. News Article: “We collect the money from a money transfer service,” she says. “During the COVID-19 pandemic, it has been a great help for my family. In addition, if we ever need to go to the hospital, we get medical treatment, care and medicine free of charge.”

Malai also explained the review process necessary to receive a card. It includes interviewing applicants and recording details about each household. By doing this, the government gains a holistic picture of each family’s financial resources and needs. Malai’s experience demonstrates the necessity of the IDPoor card in reducing global poverty, particularly in regions that are suffering economically due to COVID-19.

Poverty on the Rise

Even before COVID-19, Cambodians faced a disproportionately high amount of poverty. The U.N. calculated the hypothetical rise of poverty in this region in 2019, predicting that the impoverished population would increase to 17.6%, more than two times the impoverished count in 2019. Moreover, COVID-19 exacerbated many Cambodians’ financial disadvantages as the country’s economy limited jobs and healthcare needs increased. Specifically, the unemployment rate in Cambodia in 2020 was 3.2%, much higher than the 2019 rate of 0.7%.

The Cash Transfer Programme provides financial assistance to citizens registered with an IDPoor card. Each monthly payment depends on a household’s specific situation and needs. The already existing Cash Transfer Programme received further funding and spread to include as many impoverished Cambodians as possible. This act is a ray of hope amid the impact of COVID-19 in Cambodia.

For individuals who qualify, the card also acts as a form of medical insurance. It allows registered Cambodians to receive healthcare treatments or consultations without being charged. This healthcare coverage is extremely helpful to families as medical bills and incurred costs are large components of poverty.

In a UNICEF article, a young woman named Leont Yong Phin conveyed how her IDPoor card has helped her. “I’m still paying back a loan from when I got bad typhoid,” she says. “This money means I can repay and afford food. We’ve never had help like this before, it’s so reassuring.”

Encouraging Equity

In addition to providing necessary economic support and medical access, the IDPoor card program is essential for encouraging equity in Cambodia and reducing the disadvantages that come with certain socioeconomic conditions. By reviewing applicants’ economic history and family situation, the government can adequately provide the support necessary to address all citizens’ needs. In this way, the Cash Transfer Programme helps Cambodians with daily expenses and works to end inequity across the country.

Although the impact of COVID-19 in Cambodia has been significant, the IDPoor card and Cash Transfer Programme are greatly improving life for many Cambodians. With more support from international organizations like the United Nations, nonprofit organizations and even individuals, the program can provide even more resources to impoverished Cambodians.

– Kristen Quinonez
Photo: Flickr

Childhood Malnutrition in NepalChild malnutrition in Nepal, a relatively small nation in Asia, has been a persistent issue. The lack of food throughout the country has significantly contributed to illness and death. During the COVID-19 pandemic, the situation has worsened. Though there have been multiple failed government attempts to reconcile the food supply, Nepal is slowly finding its way back to proper nutrition for children with the help of organizations such as UNICEF.

Child Malnutrition in Nepal

According to the United Nations World Food Programme, Nepal ranks as the 148th most impoverished country in the world out of 189 countries. It continues to struggle with low general well-being because of civil unrest, a difficult geographical landscape and poor infrastructure. A combination of these factors has also impacted food availability. Food that is available often lacks the nutrients necessary for children to maintain proper health and growth. As a result of malnutrition, children battle stunted physical and mental growth, severe weight loss and compromised immune systems.

In addition to poor nutrition, many children are also exposed to contaminated water, which can lead to chronic diseases. According to the Nepali Times, a recent Johns Hopkins University survey showed that severe malnutrition impacting children younger than 5 could cause 4,000 childhood deaths a year due to insufficient food from lack of income caused by the pandemic. A quarter of Nepal’s population already lives under the poverty line. The pandemic has pushed more families closer to impoverishment.

The Solution

Due to multiple failed government efforts to help assist families, it is clear that part of the issue lies in the poorly structured national, provincial and local governments. Though the government has made efforts to tackle malnutrition in Nepal, including the Multi-Sectoral Nutrition Plan that led to major strides against child malnutrition in the past, the issue persists.

To combat child malnutrition in Nepal, UNICEF has partnered with the government of Nepal in order to treat malnourished children with nutrition response and recovery actions. It has also taken the initiative to educate and provide resources for pregnant and breastfeeding mothers. Nutrition education aims to raise awareness of the importance of ensuring infants receive essential nutrients.

Furthermore, UNICEF is helping the government of Nepal to strengthen its response to prevent more malnutrition in the country. Nutritional assistance is also provided in the form of micronutrient powder for children and iron folate supplements for pregnant and breastfeeding mothers.

The Road Ahead

Though child malnutrition in Nepal has worsened during the COVID-19 pandemic, there is still hope. With help from UNICEF and other humanitarian organizations, Nepal has a chance to address this persistent issue. Moving forward, it is essential that the government and humanitarian organizations continue to prioritize child malnutrition in Nepal.

– Allie Degner
Photo: Flickr

COVID-19’s Impact on Poverty in Myanmar
In 2017, Myanmar’s poverty rate was approximately 24.8%. By December 2020, the second wave of COVID-19 was estimated to bring the poverty rate to almost 50%. COVID-19’s impact on poverty in Myanmar has been devastating but aid aims to remedy the situation.

A Breakdown of COVID-19 in Myanmar

Myanmar’s first confirmed COVID-19 case was in late March 2020. In the weeks leading up to the first positive case, Myanmar’s government outlined its plan for curbing the virus’s spread. On April 6, 2020, Myanmar’s government initiated lockdowns and ordered schools and businesses to commence remote operations.

The daily numbers and seven-day average of COVID-19 cases in Myanmar increased in September 2020 when restrictions first eased. The seven-day average rose from three to 300 by mid-September 2020 and peaked in October 2020 with a seven-day average of more than 15,000. November 2020 witnessed a steady decline. Myanmar’s COVID-19 seven-day average has remained at fewer than 100 cases since mid-February 2021.

Recently, COVID-19 cases in Myanmar have been increasing again. Many world doctors and health officials question the validity of the reported numbers since the military seized power on February 1, 2021. The military imprisoned doctors who opposed it and COVID-19 testing slowed as a result. COVID-19 case numbers in Myanmar are potentially higher than officially reported.

Myanmar’s Response to COVID-19

In early June 2021, Myanmar reached a recorded 144,000+ COVID-19 cases and upwards of 3,000 deaths. Myanmar’s economy halted and COVID-19’s impact on poverty in Myanmar, requiring the government and the people to strategize in order to encourage economic flow.

Economically, Myanmar’s government endeavored to stimulate halted areas of the economy. Service sectors and tourism contributed significantly less to the Myanmar economy. However, information and technology services expanded and the agricultural areas of Myanmar stayed stable.

To improve the Myanmar economy, the government drafted a plan costing $2 billion. The government received its funding from international partners. The funding goes toward stimulus packages, investments in infrastructure and improving public services such as healthcare.

Immediate Economic Impact of COVID-19 in Myanmar

The progress Myanmar has made over the past decade in decreasing its poverty rate halted and even reversed. COVID-19’s impact on poverty in Myanmar demanded that its government make significant investments that will benefit many workforces, but tourism, for example, cannot improve without open borders. Tourism became an intriguing industry for work in Myanmar in 1995. It now represents 3% of the employment force but displayed signs of expansion until the COVID-19 pandemic hit. The year 2015 was a peak year for tourism in Myanmar. An estimated 2.5 million tourists spent 773 million kyats or $469,000. Until 2019, tourism accounted for 55% of the gross domestic product (GDP). The tourism industry hopes for an employment boom when Myanmar’s borders fully reopen.

Moving Forward

AstraZeneca is the only vaccine in Myanmar. The first shipments to Myanmar arrived in January 2021. As of June 2021, Myanmar has distributed three million vaccines. Fears of the AstraZeneca vaccine and its side effects spread after reports of blood clotting post-injection. Britain halted usage of the vaccine until further research could solidify its effectiveness but Myanmar did not.

Myanmar’s vaccination progress had two major distribution advancements between March and May 2021. Myanmar prioritized vaccinating healthcare workers. The distribution then expanded to include more categories of workers. It could take six months before another 10% of the population will have both vaccinations. Currently, only 3.1% of Myanmar’s population is at full vaccination status. Help from international allies will be necessary to make notable progress in vaccination distribution. The U.S. has a large supply of vaccines from all its distributors and intends to distribute vaccines internationally. Myanmar is working to raise funds to obtain more vaccines.

Aid Within Myanmar

For several decades, Myanmar’s poverty rate garnered the attention of many non-government organizations hoping to help. One such organization is World Vision International (WVI),  an organization based in England that typically works directly to support children. Recently, it dedicated the majority of its efforts to feeding and helping children affected by the COVID-19 pandemic in Myanmar.

In Myanmar, the organization works with local businesses to offer food and shelter to children. During the pandemic, WVI expanded its efforts to ensure child poverty levels do not rise even further. WVI has worked in Myanmar for decades. The organization recognized COVID-19’s impact on poverty in Myanmar and advocates on behalf of the people to the Myanmar government. WVI secured masks, gloves, sanitizer and cleaning stations throughout Myanmar.

Looking Ahead

WVI maintained money flow as much as it could in areas that lack of work devastated. It also delivered food to hard-to-reach areas of Myanmar. Other organizations followed WVI’s example when COVID-19’s impact on poverty in Myanmar peaked and negatively affected life for many in the country. With the combined efforts, the poverty level, which rose in 2020, stabilized. It is an arduous road to recovery for Myanmar. Myanmar should be able to reduce the impact of the virus on its poverty levels with assistance from allies and committed organizations.

– Clara Mulvihill
Photo: Flickr

The Impact of COVID-19 on Poverty in Cuba
The COVID-19 pandemic backpedaled Cuba’s progress in eradicating poverty and food insecurity, similar to many other countries. As the largest island within the Caribbean, tourism plays a large role in the economy. Although travel restrictions are no longer in place, the country’s reliance on food imports and poor infrastructure have worsened the impact of COVID-19 on poverty in Cuba.

Cuba Before COVID-19

According to the World Food Programme (WFP), Cuba is one of the most successful countries to achieve the United Nations’ Millennium Development Goals (MDGs). Government-implemented social programs provide maternal healthcare, monthly feeding baskets and free lunch for children in more than 10,000 schools. However, 70 to 80% of Cuba’s food requirements come from food imports, and this reliance lessens the national budget.

A consistently strained national budget, coupled with an economy in the midst of crisis, ultimately exacerbated the impact of COVID-19 on poverty in Cuba. Well before COVID-19 hit the island, the Trump administration initiated sanctions banning U.S. travel and commerce with Cuban businesses. This strained the economy even further.

The Association for the Study of the Cuban Economy (ASCE) reports that poverty in Cuba is long-caused by the inaccessibility that Cubans have to basic needs. For example, the real-median state wages continuously fall and pensions do not align with food requirements. Also, the price of basic utilities continues to increase. The social assistance services are helpful, but they are not always accessible or upheld with the utmost quality.

Cuba’s Handling of COVID-19

Cuba’s response to the COVID-19 pandemic is one of the most effective within the Caribbean. Free universal healthcare and large numbers of medical personnel are among the reasons that the island’s pandemic-related mortality rates are much lower than some of their neighboring countries. Cuba had approximately 151 cumulative deaths in January 2021, while Jamaica had approximately 312. At the same time, though, the government’s control of the media makes some skeptical as to whether or not the number of cases is accurate.

Cuba has the largest ratio of doctors to citizens in the world, with 84 doctors for every 10,000 citizens. Through the Continuous Assessment and Risk Evaluation (CARE) System, doctors can regularly track, assess and isolate outbreaks of the disease by visiting patients directly. Beginning in 1984, community-based medicine connects doctors and nurses to roughly 150 families. The CARE system furthers the impact of this model by ensuring that doctors carry out preemptive medical measures continuously.

The Persistence of Poverty

The issue of poverty in Cuba comes by way of poor infrastructure, food instability and a persisting housing crisis. As mentioned previously, food imports make up a large portion of the island’s food consumption. Reuters reports that before the pandemic, Cuba began seeing a decline in the number of food imports. This was due to Venezuela putting a cap on the aid it was providing. The Trump administration’s tightening of the United States trade embargo also impacted the number of food imports. In turn, the pandemic worsened the already existent food shortage.

In addition to the shortage of food, much of the basic infrastructure strains the country’s ability to quickly respond to conflict, leaving many unassisted during crisis. The island is also susceptible to tropical storms, which worsens the housing crisis. Many Cuban homes are unable to withstand extreme weather conditions. Many Cubans are also unable to afford damage repair. Cuba also suffers from a deficit of houses, with leads to the issue of overcrowding in shelters.

Only 1% of Cuban households have access to the internet. In turn, many people are unable to purchase their essential items online and must endure in-person contact. Even with social distancing and isolation mandates in order, those living in poverty are generally unable to abide by these standards due to the nature of their work or fiscal inability. The culmination of these factors worsens the impact of COVID-19 on poverty in Cuba.

Positive Insights

The emergence of effective vaccines and the efficacy of the CARE system serves as an inspiration for other countries in the fight against the pandemic. The Cuban-developed Abdala vaccine is said to be 92.28% effective in the last stages of its clinical trials. The Soberena-2 vaccine, another Cuban-developed vaccine, has an effectiveness of 62% with two of its three doses. Cuba’s extensive medical research, along with its use of community-based healthcare, model how preventative healthcare can become readily accessible to communities in the midst of a crisis.

The impact of COVID-19 on poverty in Cuba remains an issue to be resolved, but the island is on the pathway to returning to life pre-pandemic. More than 1 million children returned to school in September 2020, and fully vaccinated tourists can now visit the island.

With the island’s newfound knowledge and insights on how to adequately handle the plights of a pandemic, hope exists that Cuba will soon continue the progress it once made in eradicating poverty and food insecurity.

– Cory Utsey
Photo: Flickr

Bhutan Healthcare
The Bhutan healthcare system worked wonders during the COVID-19 pandemic, only experiencing one death by January 2021. Its rapid-fire contact tracing, reliance on science and trust in government led to one of the best pandemic responses the world has ever seen. The success of healthcare in Bhutan indicates great progress in a healthcare system that has seen more than its fair share of struggles.

How Does Bhutan Run its Government and Healthcare System?

Bhutan, a Buddhist nation of just over 750,000 people, is between China and India. After a long period of underdevelopment, with legalized slavery until 1958, Bhutan has dramatically progressed through the course of 12 Five Year Plans (FYPs), currently scheduled through 2023. In 2008, the nation adopted a constitutional monarchy.

Bhutan is famous for its use of the Gross National Happiness Index. Every Five Year Plan discusses what changes the nation must make, as well as what priorities it should adopt, in order to maximize the GNH index. Bhutan’s entire government, along with its healthcare system, runs with the goal of promoting nationwide happiness and well-being. Bhutan utilizes a system of universal free healthcare, which it finances with approximately 3.5% of its GDP. There have been many significant health breakthroughs in Bhutan, between the near-eradication of vaccine-preventable diseases and the provision of an equitable healthcare supply. However, the system has encountered and continues to face several difficulties.

Issues Regarding Healthcare in Bhutan

Modern health struggles have accompanied Bhutan’s modernization; instead of malaria and polio, Bhutan now faces addiction, mental illnesses, HIV/AIDs and other serious problems. Specifically, the three most pressing concerns are systemic healthcare problems, noncommunicable diseases and mental health issues. Bhutan’s healthcare system faces challenges itself. Most prominent is a lack of proper recordkeeping, unequal access to care (despite having equal supply) and inadequate providers.

First, Bhutan does not properly record most of its health difficulties. This lack of data leads to increased difficulty in making progress. The Five Year Plans cannot satisfactorily address problems that the Bhutanese government does not know are occurring. Second, facilities face large discrepancies in their quality of care and certain settlement areas do not receive enough information about the nation’s healthcare options. Just because there is equitable supply does not mean that all in the nation have access to or know to utilize the care that Bhutan’s government provides.

Third, Bhutan employs underqualified healthcare workers. While a lack of reports means that the international community is unaware of the exact problems the Bhutanese population encounters, as well as how many in Bhutan die due to dangerous healthcare, the World Health Organization (WHO) estimates that millions die globally because of unsafe medical care and that around half of these deaths are preventable. A study that the British Medical Journal Open (BMJ) published found that Bhutan’s healthcare system’s most prominent failings have been due to inadequate skills, training and attitudes among providers.

Health Problems in Bhutan

Furthermore, non-communicable diseases account for 53% of all deaths, and they are the leading cause of death across all age groups. Cancer, diabetes and traffic injuries have replaced the falling number of deaths from STIs. Despite working out of a framework dedicated to happiness, Bhutan ranks 20th on a list of countries regarding their rate of suicide. Combined with addiction and other mental health struggles, this is an area where Bhutanese healthcare faces an extreme care deficiency.

Bhutan did not employ its first psychiatrist until 1999 when Bhutan-born and Sri Lanka-trained Dr. Chencho Dorji returned to the nation. As of 2013, the majority of more than 5,300 Bhutanese psychiatric patients have fallen onto the shoulders of Dr. Chencho. As of the 2020 survey, Bhutan only employs 116 in the department of therapy — that is, barely more than 0.015% of its population. To put this number in context, 0.03% of the United State’s population are licensed therapists. Nevertheless, plenty of reasons exist for one to be optimistic about Bhutan’s healthcare system.

Optimism About Bhutan’s Future

Bhutan has multiple ways to resolve the healthcare problems it is currently facing. For example, the BMJ study focused on collaboration, resources and governance, but a better way of looking for optimism could be to investigate what the Five Year Plan prioritizes. Prioritization in the FYPs produced all of Bhutan’s historical healthcare successes, and there is no reason to predict otherwise for current crises. The 12th Five Year Plan, in effect from 2018 to 2023, provides solutions to the struggles of healthcare in Bhutan.

About the 12th Five Year Plan

First, the 12th Five Year Plan addresses problems in data recording as discussed at the 11th FYP’s mid-term review, prioritizing proper data collection for the new term to accurately perceive what problems need attention. Bhutan’s excellent COVID-19 response showcased success in this area. Second, the fight against non-communicable diseases (NCDs) worked its way into the forefront of Bhutan’s healthcare policy and is clearly a priority in the 12th Five Year Plan. Bhutan shares the international goal of eradicating tuberculosis by 2035 and recognizes both cures and treatments of NCDs as a dire need. Third, the FYP expanded from its four pillars of a just society to nine domains. The new domains include living standards, education, health, psychological well-being, cultural resilience, ecological diversity, among others.

The plan accounts for other systemic issues in the Bhutan healthcare system as well. One of the central means of progress that the FYP outlined is decentralization. By allocating funding to local governments to more comprehensively provide care throughout the nation, Bhutan will see a rise in equitable access to care — not just supply. Additionally, the 12th FYP details increased provider training.

Some of the new domains, including creating a charitable culture and regulating time allocation between work, sleep and other activities, work directly to combat mental illness. Psychological well-being places focus on providing adequate treatment to those who are still struggling despite those domains. New policies and priorities outlined in the 12th FYP provide hope for one of the fastest developing healthcare ministries globally.

Looking Ahead

There are certainly kinks in healthcare in Bhutan that the country must work out. However, with the changes in the Five Year Plan, the system of healthcare seems to be leading the way to a very bright future.

The only factor holding back this optimism is Bhutan’s limited resources. But, Bhutan underwent a great economic change, raising its GDP at an annual average of 7.5% just two decades after emancipation. As one of the fastest-growing economies in the world, its health services have seen great progress and continued to grow with time.

If a small, underdeveloped country with a great resource shortage can successfully implement a healthcare system that specifically focuses on its citizens’ happiness, perhaps this system could inspire a seismic shift in the way government runs. Bhutan has set a precedent for designing a world where the population’s happiness is the government’s main priority and, with adequate funding, it could more thoroughly achieve these goals. Now, it is time for the U.S., France, Germany, the U.K. and other global democratic superpowers to step up and do the same.

– Sam Konstan
Photo: Flickr

5 Facts About Rheumatic Fever
Every year there are nearly 470,000 new cases of rheumatic fever across the globe. Approximately 305,000 people die every year from rheumatic heart disease, which rises from rheumatic fever. The U.S. and other developed countries have been able to provide access to medicine to prevent and treat rheumatic fever. However, many people living around the world don’t have access to the medicine they need. This leaves them and their children vulnerable to rheumatic fever and rheumatic heart disease. Here are five facts about rheumatic fever and how it affects communities across the globe.

5 Facts About Rheumatic Fever

  1. Poorly treated streptococcal infections can cause rheumatic fever. Streptococcal infections come from a bacteria called Group A Streptococcus (group A strep). These infections can cause strep throat, scarlet fever, streptococcal toxic shock syndrome and several other diseases. Doctors can easily treat strep throat or scarlet fever with simple antibiotics. Complications from rheumatic fever, however, are more difficult to treat. When the body starts to fight against itself after many strep infections, heart valves and other tissues can become scarred and inflamed. This is what rheumatic fever is. Antibiotics are not widely available in all parts of the world. In certain areas of Africa and Asia, there are no doctors to diagnose and treat strep throat and scarlet fever. Consequently, this is where rheumatic fever is most common.
  2. Rheumatic fever can lead to rheumatic heart disease. Rheumatic heart disease happens when rheumatic fever leaves permanent scarring on the heart valves. This can narrow the valves or cause leaking in the valves. When the valves don’t work properly, the heart has a harder time pumping blood to the rest of the body. This eventually leads to heart failure and death. Rheumatic fever and rheumatic heart disease are fairly uncommon in developed countries like the U.S., but rheumatic fever is the number one source of heart disease in children and young adults in underdeveloped countries in Asia, sub-Saharan Africa and Latin America.
  3. Rheumatic fever and rheumatic heart disease plague indigenous Australian communities. These diseases disproportionately affect indigenous Australians, including communities of Torres Strait islanders and the Māori people. These communities report some of the highest numbers of cases in the entire world. In 2018, indigenous Australian communities reported 59 cases of rheumatic fever for every 100,000 people. Non-indigenous Australian communities reported less than one case for every 100,000 people. About 94% of rheumatic fever cases in Australia occur in indigenous communities. High rates can decrease through access to healthcare, reduced overcrowding and better living conditions.
  4. Most victims are children anywhere from five to 15 years old. As most strep infections affect children, rheumatic fever and rheumatic heart disease also primarily affect children. Children have naturally weaker immune systems because of their lack of exposure to different sicknesses, so strep infections that are easier for adults to fight off are more difficult for children to overcome. Repeated and untreated strep infections increase the risk of rheumatic fever occurring. Rheumatic heart disease is the most common type of heart disease in children.
  5. RHD Action is fighting back against rheumatic heart disease. The RHD Action movement is a united force of three organizations intent on ending rheumatic fever and thus rheumatic heart disease. The organizations that comprise RHD Action are the World Heart Federation, Reach and the Medtronic Foundation. Together, these groups have raised awareness about the importance of diagnosing and treating strep infections to prevent complications from arising. RHD Action’s efforts have reached refugee camps in Uganda and areas of Brazil, among many others. RHD Action provides resources for families of children that have rheumatic fever and rheumatic heart disease. It also educates those living in developed countries on the importance of access to medicine and quality care.

Looking Ahead

These five facts about rheumatic fever highlight that through widespread access to quality healthcare and overall better living conditions, communities can stop the spread. This will help save children the pain of replacing heart valves, blood clots, severe joint pain and other effects of rheumatic heart disease.

While doctors currently have no cure for rheumatic heart disease or the complications that come from rheumatic fever, the preventative treatments are plenty. Right now, there may be 470,000 new cases of rheumatic fever every year, but that can change with education, healthcare and access to a better quality of life.

– Holly Dorman
Photo: Flickr

tuberculosis in PeruCOVID-19 has ravaged populations and economies alike. It has also exacerbated the impacts of previous conditions that threaten the developing world. In particular, the lung-damaging disease known as tuberculosis has seen an alarming resurgence. The World Health Organization (WHO) has classified tuberculosis as one of the 10 leading causes of death worldwide as recently as 2019. Furthermore, the Stop TB Partnership asserts that in just one year, the novel coronavirus and its wide-reaching implications have delayed progress on the eradication of tuberculosis by 12 years. The problem is especially grave in Peru where both COVID-19 and a tuberculosis resurgence are impacting healthcare resources. Cases of both viruses have only multiplied the threat of each, calling for swift solutions.

The History of Tuberculosis in Peru

Tuberculosis in Peru was a pressing issue long before the emergence of COVID-19. Peru reports the second-highest rate of tuberculosis in the Americas and WHO has classified Peru as one of the countries with the most cases of multidrug-resistant tuberculosis (MDR-TB) worldwide. Peru’s economic landscape makes it the perfect hotbed for highly contagious diseases such as COVID-19 and tuberculosis. Roughly 27% of Peru’s population lives in poverty, with a lack of proper housing confining many to dense slums in urban centers. When combined with restricted access to healthcare, these circumstances worsen the spread of disease.

In recent years, Peru has made strides in combating the spread of tuberculosis. For example, the Peruvian government has revamped its tuberculosis control program by establishing multiple committees to guide tuberculosis containment. It has also increased funding for tuberculosis efforts. However, COVID-19 has become a serious roadblock to this mission.

The Impact of Two Pandemics

Upon the outbreak of the novel coronavirus in Peru in early 2020, nearly all the country’s healthcare equipment and resources went toward its treatment and containment. Peru’s healthcare system lacked the capacity to continue fighting tuberculosis as it had, thus, COVID-19 and tuberculosis cases rose simultaneously. Lockdown has also limited the availability of tuberculosis testing, making it harder for doctors to track the disease’s spread. Doctors fear inadequate access to proper medical care and resources will contribute to the development of new strands of MDR-TB.

Continuing to Fight Tuberculosis

The COVID-19 pandemic will undoubtedly continue to impact how Peru addresses tuberculosis. However, efforts have occurred at every level of society to keep combating the latter’s rise. For example, the government is continuing the TB Móvil program which it established in 2019 to increase access to tuberculosis testing by mobilizing vans across the country. The program will provide wide-reaching tuberculosis diagnosis and treatment options.

Non-governmental organizations are working on the ground in Peru as well. Socios en Salud (Partners in Health), which has been active in Peru since the mid-1990s, created its own programs and tools to increase access to tuberculosis treatments. The tools include Mochila TB, individual backpack machines that are useful for tuberculosis testing. The portable and compact machines “[take] testing directly to patients.” One device can test as many as 80 people per day. Solutions like Mochila TB make healthcare more accessible to the rural population. The devices can therefore greatly reduce the impact of tuberculosis in Peru.

Descriptions have determined that Mochila TB is a combination of “digital radiology, artificial intelligence and molecular biology” and has already made a significant impact. Since early March 2021, Mochila TB has reached 3,491 people in the most remote communities of Peru. The mobile testing capability eases the strain on healthcare systems to accommodate for COVID-19 care.

Paving the Way Forward

Healthcare professionals have identified another key step in mitigating COVID-19’s effect on the spread of tuberculosis in Peru: using the healthcare system to combat both diseases simultaneously. Given the diseases’ many similarities in infection, containment and spread, using the same strategies and principles for COVID-19 and tuberculosis in Peru can help stop the spread of both. Through innovations and strategizing, Peru should be able to successfully combat both pandemics.

Nathan Mo
Photo: Flickr

Child Poverty in MalawiChildren make up more than half of Malawi’s population and many children live in poverty. In 2018, 60.5% of children in Malawi aged 0-17 were considered multi-dimensionally impoverished. Above their necessities, children have a complicated set of socio-economic needs. Child poverty in Malawi has both immediate and long-term consequences for children. They include the deprivation of education, shelter, health assistance and nutrition. These deprivations significantly affect an individual’s ability to rise out of poverty. Organizations such as Save the Children work to meet the needs of children to ensure a better and brighter future.

The 4 Impacts of Child Poverty in Malawi

  1. Deprivation of Education: In Malawi, 87.6% of children do not receive an education. Roughly 85% of adolescents aged 15 to 17 have not finished primary school. Furthermore, “78% of children are two or more grades behind for their age.” In the age range of 15 to 17, 13% of children are illiterate. They cannot read or write in either English or the local language of Chichewa. Educational deprivation disproportionately impacts rural areas. Furthermore, “children whose parents have less than primary school education are more deprived than those with parents who have more than primary school education.”
  2. Deprivation of Nutrition: One of the most serious challenges of child poverty in Malawi is nutrition. Poor diets and infectious diseases wreak havoc on the immune system and may lead to stunted growth. According to UNICEF, “Stunted children are more likely to drop out of school and repeatedly experience lower productivity later in life.” In Malawi, 37% of children are stunted. Furthermore, nearly three-quarters of children younger than five years old have anemia. Undernutrition is responsible for 23% of all child deaths in Malawi. Malnutrition is one factor leading to Malawi’s high child mortality rate, with roughly 25% of Malawian children dying before age five.
  3. Shelter Deprivation: Household size, education and work status of the head of the home influence home deprivations among children aged 5 to 14. Roughly 50% of children in Malawi live in homes with insufficient roofs or floors.
  4. Deprivation of Health Assistance: Sufficient access to healthcare is essential to improve a child’s development and well-being. Most impoverished households in Malawi lack access to medical care. This means children receive treatment at home by an unskilled healthcare provider or do not receive treatment at all. The main component to deprivation of healthcare is financial affordability. There is plenty of evidence that low income and high healthcare costs are barriers to access. There are many factors limiting healthcare access such as living in a remote location, long distances to health centers, high travel costs and low educational attainment.

Save the Children in Malawi

Save the Children has helped Malawian children since 1983, ensuring “that children in need are protected, healthy and nourished, educated and live in economically secure households, while helping communities mitigate the impact of HIV and AIDS.” In 2019, Save the Children protected more than 84,000 Malawian children from harm and ensured the proper nourishment of more than 170,000 children.

With consistent support, Save the Children can combat child poverty in Malawi. Every action to help an impoverished child strengthens a child’s ability to rise out of poverty and secure a brighter future.

Mary McLean
Photo: Flickr

Period Poverty in South Africa
Many women menstruate monthly for an average of 40 years of their lives. In many countries, like South Africa, women do not have access to the sanitary products they need each month. Period poverty in South Africa affects girls and women by preventing them from working and going to school. This creates stigma surrounding periods and has a negative effect on their overall hygiene. However, several organizations are working to combat each of these components of period poverty.

Since up to 7 million South African girls do not have access or cannot afford to buy sanitary products, many of them must stay home. Many also report using old clothes and newspapers as sanitary pads when they cannot use sanitary products meant for periods. This is unhygienic and can cause other health problems and infections. Often, girls and women must choose between buying food and sanitary products because of the costs. When faced with this difficult choice, many choose to purchase food as it takes more of a priority. As a result, many must face the health and social consequences of not having sanitary products.

Period Poverty in Schools

An estimated 30% of South African girls do not attend school while they are on their period because they do not have sanitary products. Many often experience teasing in school when they attend while on their periods. The frequency of period-related mishaps increases when girls do not have access to the proper sanitary products. In turn, this causes teasing and also reinforces a stigma surrounding periods. This makes it more difficult for women and girls to voice their concerns about their periods. Many lack access to period products out of fear of others ignoring or ridiculing them.

As more girls miss school while menstruating, it is more difficult for them to learn. With limited education, there is less of a chance for girls to lift themselves and their communities out of poverty. This is the crux of period poverty in South Africa.

Organizations Helping

While there are many problems that come with period poverty in South Africa, many organizations are using their platforms to increase access to sanitary products. They are also aiming to reduce the stigma surrounding periods.

In 2018, a group of student activists organized protests under the slogan and hashtag #BecauseWeBleed to end the 15% Value Added Tax on period products. In 2019, the South African government dropped the tax thanks to the efforts of these students and others.

Project Dignity is an organization that distributes reusable sanitary pads and has been reducing period poverty in South Africa since 2010. The name of these sanitary pads is Subz and they come in a pad and underwear duo which keep moisture away from the body and last up to five years. Project Dignity distributed 65,000 Subz to South African students. The founders also provide education about hygiene, menstruation and HIV.

Like Project Dignity, Qrate Za educates young women about menstruation. In 2018, its founder, Candice Chirwa started creating resources for parents and teachers to educate their children about menstruation. She now conducts workshops to show hundreds of girls how to speak openly about their periods, effectively reducing the stigma surrounding periods. This is an important step in creating a conversation about period poverty in South Africa.

Looking Ahead

Each of these organizations has brought South Africa a step closer to ending period poverty, whether it is through ending the added tax, creating a sustainable sanitary product or educating about menstruation. This work is a pillar in bringing women and girls in South Africa a sustainable lifestyle where their periods do not have to put their health or education at risk.

– Sana Mamtaney
Photo: Flickr