Inflammation and stories on healthcare

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

Former President Desi Bouterse

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

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

President Chan Santokhi

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

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

Health Care Deficiencies

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

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

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

Actions to Fight Against COVID-19

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

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

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

San Sung Kim
Photo: Flickr

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

7 Facts About Healthcare in Bangladesh

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

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

Sadat Tashin
Photo: Flickr

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

4 Ways COVID-19 and Global Poverty Connect

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

Moving Forward

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

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

Nada Abuasi
Photo: Flickr

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

Unemployment

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

The 1986 Compact of Free Association Law Treaty

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

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

Inefficient Healthcare and Malnourishment

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

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

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

Environmental Challenges

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

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

The Ebeye Water Supply and Sanitation Project

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

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

– Mina Kim
Photo: Flickr

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

Challenges in Healthcare in Saudi Arabia

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

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

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

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

The New Saudi Health System (NSHS)

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

The Paycheck Protection Program (PPP)

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

Efforts to Privatize

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

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

– Rachel Durling
Photo: Flickr

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

Free Healthcare to Address High Maternal and Child Mortality Rates

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

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

USAID Helps Tackle Infectious Diseases

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

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

Ellie Williams
Photo: Flickr

Glasses for developing countries
A variety of NGOs have been working for decades to provide glasses for developing countries. Most models for this operate in similar ways, either by donating glasses or offering low-cost glasses for communities to purchase. These programs have been successful in helping people correct their vision, as well as creating more education and economic opportunity. They only lack one thing — innovation. Choosing to apply a solution designed for a developed country to a remote village is not always the best option. This is where Child Vision comes in.

The Statistics

The World Health Organization (WHO) estimates that nearly 80% of all persons in Africa have unaddressed vision impairment. Additionally, 33% of the world’s poor population suffers from vision impairment. There are 123.7 million people with a refractive error, which can be solved with glasses that have the correct strength. On average, glasses cost approximately $343, despite the average manufacturing cost of $10. Clear vision drastically reduced education access for children, which in turn created less economic opportunity as they moved into adulthood. Lack of clear vision loses $202 billion in global productivity each year.

The Standard

Some of the biggest names in glasses for developing countries are NGOs like Eyes on Africa, Vision for a Nation, VisionSpring and the WHO.

The WHO has been working on the Global Action Plan for eye health since 2014. The plan has one main objective — to encourage and enhance global eye health. The Global Action Plan has several initiatives. These include identifying what is causing vision impairment, understanding where the gap is in eye health access and bringing cataract surgery to developing countries. VisionSpring works by allowing those in developed countries to purchase glasses for developing countries through the VisionSpring website. VisionSpring donates those as well as letting communities purchase low-cost glasses. It also provides bulk purchase discounts and sell glasses individually and by the box. On average, one pair of bifocals in a box set costs just 85 cents. The price point is low, but still unmanageable for many villages, especially in areas with little to no internet access.

Child Vision

Child Vision is a program within the Centre for Vision in the Developing World (CVDW). The CVDW looked at the statistics of vision impairment then accepted the challenge of creating a solution that worked for the developing world. The main struggles the CVDW found in the traditional programs were a lack of optometrists and the high cost of traditional glasses. There is one optometrist per 1 million people in the population in developing nations. While 85 cents for a pair of glasses may seem affordable, it is a great financial strain for the world’s poor, many of whom survive on less than a dollar a day.

Child Vision, after identifying the root problems with getting glasses to developed countries, created a successful prototype within two months. The CVDW created an inexpensive, adjustable lens that sets into durable frames.

How the Glasses Work

The round lens is composed of two walls made of a flexible plastic membrane that the wearer fills with liquid silicone. The lens is then set into plastic frames that have dials on both temples of the glasses. The plastic frames are filled with the same liquid silicone that is in the lens. The wearer puts on the Child Vision glasses, covers one eye and using a tumbling “E” chart, adjusts a side knob to move more or less fluid into the lens until they can see clearly. They then repeat on the other side.

The wearer simply removes the knobs from the glasses and throws them away after the lens is set. They now have durable, functional, cost-effective glasses. With a $20 donation, CVDW can provide a pair of self-adjusting glasses to a developing country. A 1–2-hour training session with a local community leader to show them how to use the tumbling “E” charts to check vision and make sure the glasses are adjusted correctly is also provided. This is not only an immediate solution and innovation to provide glasses to developing countries but it creates generational empowerment of checking eyesight and promoting educational and economic growth within each community.

– Madalyn Wright
Photo: Flickr

mental health in haitiLocated on the island of Hispaniola is the Caribbean nation of Haiti. The country gained independence in 1804, becoming the first country led by formerly enslaved peoples. A long history of political instability and corruption accompanied by catastrophic natural disasters has devastated Haiti’s population and economy. Additionally, a lack of infrastructure and access to basic resources ranks Haiti as one of the world’s least developed countries. This has created a crisis for mental health in Haiti, which has only worsened during the COVID-19 pandemic.

The Humanitarian Crisis in Haiti

Haiti is now home to over 11.4 million people, and nearly 60% of the population lives below the poverty line. Income inequality and unemployment rates are high, while the country does not meet its citizens’ basic needs. In fact, nearly 90% of people in rural areas lack access to electricity and plumbing.

Several natural disasters have also damaged Haiti in the past decade. The 7.0-magnitude earthquake of January 2010 devastated the nation’s capital city of Port-au-Prince. Indeed, the earthquake was one of the worst natural disasters to strike an urban area. An estimated 250,000 people died, while 300,000 people got injured and over 5 million became displaced. Six years later, Hurricane Matthew wiped out trade roads and coastal infrastructure. Conversely, lengthy periods of drought have paralyzed local agricultural markets. This has resulted in the inflation of even the most basic foods and necessities.

Though Haiti has focused on efforts to recover from natural disasters, longstanding economic and sociopolitical crises remain. One often overlooked problem lies in how these humanitarian crises affect mental health in Haiti.

Mental Health in Haiti: Existing Services

The ongoing humanitarian crises in Haiti create an extraordinary psychological toll on people. In particular, poverty and socioeconomic disadvantage increase the crisis of mental health in Haiti. Following the earthquake, 25% of the population reported experiencing PTSD. Additionally, 50% experienced a major depressive disorder. Disasters have also caused many Haitians to experience trauma and the loss of loved ones and livelihoods.

Despite these negative psychological outcomes, mental health in Haiti remains neglected. This is largely due to the majority of Haitians attributing mental health problems to supernatural forces. Specifically, many Haitians rely on inner religious and spiritual strength to overcome mental health issues. This culturally important Haitian belief, in tandem with the country’s inadequate mental healthcare services, leaves vast numbers of the population neglected.

Many people in Haiti simply go without mental healthcare. For a nation of around 11 million people, Haiti has a mere 23 psychiatrists and 124 psychologists. Haiti’s investment in healthcare services has even declined from 16.6% to 4.4% since 2017. Additionally, even if Haitians could find mental health services, they may not be able to afford or access them. Available services are often costly and inaccessible for those who do seek care.

The Implications of COVID-19

During the pandemic, Haiti has seen a rise in the cost of mental health services and medication. The country’s two running psychiatric hospitals have stopped accepting patients. Other hospitals, many now at full capacity due to the pandemic, have become testing facilities for COVID-19.

The pandemic has further exacerbated mental health in Haiti. General anxiety and concerns relating to the coronavirus and its effects have skyrocketed. Additionally, quarantine mandates have increased rates of domestic violence and abuse. Fatigued health professionals and medical staff also suffer from increased rates of depression. In short, medical professionals as well as the general population are experiencing the devastating mental impacts of COVID-19.

Moving Forward

Humanitarian crises and the coronavirus pandemic persist in the small island nation of Haiti. The aftermath of natural disasters, trauma and continuing political and economic instability lead to a crisis of mental health in Haiti. The country needs attention to the mental health needs of its citizens, in the midst of current and past crises.

Thankfully, nonprofit organizations like Partners in Health are striving to improve mental health in Haiti. Based out of Boston, Partners in Health is dedicated to establishing long-term relationships with organizations in the world’s poorest developing countries. Through its partnerships with local governments and other organizations in Haiti, Partners in Health has helped to innovate mental healthcare delivery models that integrate cultural beliefs about health and current biopsychosocial knowledge. Mobile health clinics also help ensure ensure that patients living in even the most remote regions of Haiti have access to necessary mental health services.

In the years to come, continued funding and support of programs like Partners in Health and its partnership organizations will be vital to improving the mental health and overall well-being of Haitians. Only then can the country truly overcome its current crises and past history.

Alana Castle
Photo: Flickr 

Overpopulation in Rwanda
Rwanda is a small, highly populated, mostly rural country in Central Africa. Within the past few decades, the rate of population growth has grown to unsustainable and potentially dangerous levels. For instance, a woman in Rwanda has an average of 5.4 children and the country is on pace to double its already large population in just 24 years. As a small rural country, limited amounts of resources exist to support the overpopulation in Rwanda. This exponential increase will inevitably lead to problems with resource management.

Increased Access to Healthcare

Increased access to reliable healthcare in the country has certainly, in part, contributed to overpopulation in Rwanda. An ever-expanding amount of children survive into adulthood due to 82% of the country being vaccinated against deadly diseases. This may seem like a purely positive fact at first glance. However, as more children survive, the population grows and generates other problems. Third world countries, such as Rwanda, have limited access to adequate food and water supplies. The more people there are, the fewer resources there are available to each person. Moreover, the growing population has a direct link to more people suffering from malnutrition and starvation.

Geography and Resources

Rwanda is 10,000 square miles with a population density of more than 1,000 people per square mile. The immense overcrowding and strain on limited resources lead to stifled agricultural growth within the country. The farmland supports the population to the best of its ability, but there is very limited space for new fields for crops. The population explosion stagnates food production. Quality of life depends on adequate food access and overpopulation blocks that. Rapid population growth must stop to save the quality of life from deteriorating at an alarming pace in Rwanda. Two things they could look into are investing in family planning and education.

Family Planning and Education

Family planning helps reduce family sizes by providing different forms of birth control to eliminate unplanned births. Making family planning more accessible to all people should help reduce overpopulation in Rwanda.

The Belgian Development Cooperation is an NGO working in Rwanda to help limit the birth rate and population. They strongly believe that access to family planning, birth control and contraceptives is a human right. They are donating 26.7 million pounds to the Rwandan government to try and make family planning available to all of the people of Rwanda.

Education is also important in curbing rapid population growth. Investing in education is important because people with an education, especially women, generally tend to have fewer children.

Looking Forward

Something needs to be done in Rwanda to help stop the birth rate from increasing. Investing in methods to lessen birth rates, such as birth control and education, could have major influences. Working on being able to sustain an ever-increasing population is also a priority. Overpopulation is not just a problem in Rwanda; it is a global issue. Rwanda as well as the entire world should work to decrease birth rates. To sustain an acceptable standard of living, the world needs to take action before it is too late.

Samira Akbary
Photo: Flickr

Healthcare in MexicoIn the past five decades, healthcare in Mexico has demonstrated significant improvement. The country has a highly effective vaccination program, which often covers over 95% of the population. This program played a significant role in lowering Mexico’s child mortality rate. Mexican life expectancy rose from 42 years to 73 from the 1940s to the 2000s. Despite this progress, Mexico’s fragmented healthcare structure persists and reflects the country’s rampant economic inequality. Socioeconomic status often determines access to quality Mexican healthcare. Therefore, the system often neglects the health of lower social classes.

The Mexican Healthcare System

Healthcare in Mexico consists of three separate structures:

Public healthcare: It is provided by a number of different bureaucratic bodies to help cover medical expenses for employees and their families, or formerly employed workers and their families. Employers, employee taxes and government contributions finance this system.

Private health insurance: It is paid for almost completely out-of-pocket by less than two million Mexican citizens.

Medical services: The Ministry of Health and NGOs provide these to cover Mexico’s uninsured population.

Since its creation in 1943, the healthcare system in Mexico has not changed significantly.

Problems with the Mexican Healthcare System

One of the biggest issues with the healthcare system in Mexico is its financing. Citizens directly pay more than 50% of the total health spending. A study estimates that over two million households commit over a third of their income to medical costs every year. This system, along with limited access to social security institutions, furthers economic gaps within the Mexican population. Rather than expanding the system to create a universal healthcare provider, “parallel social security institutions” exist to cover different types of workers, such as federal employees and military personnel. Thus an already disjointed system is further fragmented into independent arrangements that are not consistent in their financing and services.

Many people fail to qualify for insurance in such a disconnected system. Therefore, the Ministry of Health has become an increasingly important healthcare provider. Consequently, rampant inequalities in terms of both access to and quality of medical services persist within healthcare in Mexico. Wealthier economic classes have access to “excellent specialty-trained physicians and high-technology tertiary-care medical centers” comparable to those in the United States. The poorest societal classes often resort to unregulated and often unqualified private physicians.

This equity problem has a tangible impact on the overall health of the population. For example, the infant mortality rate in poor neighborhoods is almost 100 babies (per thousand live births) more than that in rich neighborhoods. The maternal mortality rate in certain indigenous communities is almost three per thousand live births, while the national rate is less than one. Less than 10% of women from low-income households deliver their babies in hospitals, compared to more than 80% of women in higher-income households.

The Mexican healthcare system calls for major changes. In the meantime, however, nonprofits are helping the Ministry of Health deliver medical services to the uninsured population.

International Community Foundation

The International Community Foundation (ICF) is a California-based nonprofit organization that works to inspire and direct American donations to Northwest Mexico. ICF “seeks to increase health, education and environmental grantmaking to local organizations in Northwest Mexico, with the goal of strengthening civil society and promoting sustainable communities”. ICF maintains relationships with Mexican nonprofits and community leaders to create a direct connection between donors and the causes they’re invested in. This allows the nonprofit to identify determinants of health, support interventions that confront Mexican public health problems and provide medical services to those excluded from the healthcare system. In 2018 alone, ICF directed over one million dollars towards humanitarian services in Mexico, with an emphasis on healthcare.

Despite having improved over the last five decades, healthcare in Mexico does not sufficiently cover its population. Fortunately, nonprofits like ICF work to fill in the gaps in the system.

Margherita Bassi

Photo: Flickr