Information and stories about malaria.

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Ingenuity in Burundi’s Health Care

Burundi's Health Care
Burundi is a Central African nation, bordering the Democratic Republic of the Congo, Tanzania and Rwanda. Those living within the nation face a plethora of challenges from civil wars to disease and a general state of civil unrest. On top of this, Burundi‘s health care requires efforts to reduce the spread of disease and provide better care to those affected.

The State of Burundi’s Health Care

The fear of communicable diseases grew exponentially following the multiple Ebola outbreaks in the neighboring Democratic Republic of the Congo. This illuminated the glaring flaws in Burundi’s health care system and an overall lack of preparedness for such a potentially deadly epidemic.

USAID has stated that Burundi’s health care system faces a “lack of adequate infrastructure and human resources to meet urgent community health needs.” Although the inadequacies are plentiful and debilitating, with relentless efforts, some are providing hope by way of ingenuity in Burundi’s health care system

Malaria

There were reports of over 7 million malaria cases in Burundi within the first 10 months of 2019. This is roughly 64 percent higher than the total recorded cases for 2018. The cause of this spike is a subject of debate, with experts citing climate change and an unequipped health care system as possible culprits.

A protozoan parasite causes malaria. After a bite from an infected mosquito, the protozoan parasite invades the red blood cells. People infected with malaria often experience flu-like symptoms. In 2017, there were records of 219 million cases of malaria, along with approximately 435,000 deaths. The vast majority of these cases were in Africa.

Many Burundians have taken refuge from the malaria epidemic in neighboring Rwanda. Although advances in fighting the disease remain somewhat stagnant in Burundi, Rwanda is succeeding in limiting the outbreak. Rwanda began coating refugee camps and homes with indoor residual spray. Since then, Rwanda experienced 430,000 fewer cases after just one year utilizing this method. Burundi, with a similar socioeconomic state as Rwanda, leads many to believe these methods could be beneficial for great success in both countries.

Cholera

Beginning in June 2019, a cholera outbreak overcame the city of Bujumbura, the most densely populated city in Burundi. With over 1,000 cases recorded, this far exceeds the national yearly average of about 200 to 250.

Cholera is a highly contagious bacterial infection caused by coming into contact with fecal matter, which is commonplace in bodies of still water. The disease causes severe diarrhea, which almost inevitably leads to dehydration. It can progress exceptionally fast, necessitating medical care within hours of infection.

Even with cholera’s endemic level in the city of Bujumbura, there have been minimal deaths. This is in large part due to the development of three cholera treatment facilities within the area. Many of the medical facilities face the incapability of treating the disease. However, with minimal investment, the country could make drastic changes for the better.

Ebola

Although the Ebola outbreak in the Democratic Republic of the Congo has not moved into Burundi as of yet, the risk is high. This is largely due to the fact that many Burundians work and trade in the neighboring DRC. The border town of Gatumba, for instance, averages 6,000 border crossings every weekday and 3,000 border crossings on the weekends.

Ebola, a contagious virus, spreads through contact with bodily fluids (such as blood, urine, breast milk, semen and fecal matter). Ebola is classified as a hemorrhagic fever virus. This is due to the fact that Ebola causes issues with the clotting of blood. The issues with clotting often lead to blood leaking from blood vessels within the body, causing internal bleeding.

In an attempt to spread awareness, a fleet of vans equipped with speakers and filled with UNICEF workers are traveling around Burundi and educating on ways to prevent the spread of Ebola. Many of those living in Burundi are unaware that things such as proper hand-washing techniques can be the difference between life and death. Through education and increased communication within the community, many are optimistic regarding Burundi’s fight against the spread of Ebola.

Although Burundi faces much to overcome, through proper allocation of resources and help from an international audience, Burundi’s health care system can flourish, saving countless lives.

– Austin Brown
Photo: Flickr

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Human Behavior Can Help Eradicate Malaria

Studying Human Behavior Can Help Eradicate Malaria

Bed nets. Insecticide. Preventative medicine. These are the tools that are most known for fighting malaria—and for good reason. Tactics like these have saved millions of lives. However, when a country manages to eliminate most incidences of malaria, the traditional techniques lose their impact. One group of researchers, realizing the need for new strategies against malaria, decided to not focus on mosquitoes (the traditional tactic) but on humans themselves. Ultimately, studying human behavior can help eradicate malaria by targeting weak spots in preventative plans and providing a clearer implementation of resources. To better understand malaria, its far-reaching impacts and the importance of a new human-centered technique, it is helpful to start from the beginning.

What is Malaria and How Was it Treated in the Past?

Malaria has plagued humans for, quite literally, as long as humanity remembers. The earliest written records  — Mesopotamian cuneiform tablets — describe symptoms characteristic of the disease. Scientists found human remains dating back to 3200 BC with malaria antigens. Ancient scholars called the illness the “king of diseases.” It certainly lives up to the title. It is thousands of years old and it has killed hundreds of millions of people.

Anopheles mosquitoes, most active at dusk and night-time, are responsible for the malaria parasite’s spread. Carried in the insect’s stomach, the parasite enters the human bloodstream through the mosquitoes’ saliva (the same substance that makes bites itch and swell) as they feed.

Humans first exhibit symptoms a week or so after infection. If untreated, the disease quickly becomes serious. Sufferers feel flu-like symptoms, including body aches, fatigue, vomiting and diarrhea. Patients can die within 48 hours after they first exhibit symptoms.

In 1820, chemists developed quinine, the first modern pharmacological treatment for malaria. In the 1900s, the men who identified the malaria parasite, demonstrated that mosquitoes were responsible for transmission and developed the mosquito-repelling insecticide DDT all won Nobel Prizes for their respective discoveries. Understanding and preventing malaria were matters of great international importance.

What is Malaria’s Global Presence Today?

Fighting this disease remains a top global priority. Modern preventative measures now include insecticide-treated bed nets (to keeps the nocturnal malaria-carrying mosquitos away) and indoor sprays. Children in high-transmission areas are also eligible for seasonal malaria chemoprevention. Thanks to a surge in global humanitarian attention, the disease’s presence has fallen worldwide. Between 2010 and 2017, malaria incidence decreased by nearly 20 percent and fatalities decreased by nearly 30 percent.

However, the World Health Organization (WHO) estimates that 216 million clinical cases still occurred worldwide in 2016 alone, resulting in 445,000 deaths. The disease causes a massive drain on economies, due to healthcare costs and loss of workforce efficiency. In sub-Saharan Africa, where potent strains of the parasite thrive, those damaging effects are especially notable. Malaria and its effects cost Africa a stunning $12 billion every year and, because people living near unclean water sources and insecure housing are most at risk, malaria disproportionally affects the impoverished. By prohibiting individuals from attending work or school, let alone its potential to kill, malaria perpetuates the cycle of poverty. While reducing prevalence is a key factor, eradication continues to be the ultimate goal. That means the end to malaria’s ill-effects on communities, particularly impoverished ones.

How Studying Human Behavior Can Help Eradicate Malaria

When regions successfully employ traditional tactics, as many have, they find themselves with a new problem. “Lingering cases” is a term used to describe when a region no longer experiences outbreaks, but that the disease still exists locally. In general, eliminating any illness gets harder the fewer instances of it that occur. Tracking the carrier mosquitoes is infeasible, if not impossible. However, researchers in Zanzibar took a new approach – they decided to track humans instead.

In July 2019, the Johns Hopkins Center for Communication Programs published an article in Malaria Journal that details the reasoning behind the new technique. While indoor measures work, people are not necessarily confined to the home at nighttime. One Zanzibari woman remarked in an interview, “When you are outside, you can’t really wear the bed nets, can you?” Existing steps against malaria are not effective outdoors, which makes it nearly impossible to eliminate the last few cases.

Researchers conducted over 60 in-depth interviews and studied routine human movements: between homes, stores, public spaces, religious services and even special events, like weddings. They found many insights. For example, men were at the highest risk for infection because they most often work or socialize outside after dark. There is also a notable population of seasonal workers that come to Zanzibar from Tanzania’s mainland. These individuals rarely own mosquito nets nor insecticides to spray their residences. Better understanding the movements of people vulnerable to malaria, as well as those that find themselves periodically unprotected, is important. That information allows scientists to create better-targeted interventions, including community support programs, outdoor areas with preventative measures, and basic indoor resources for those without.

Small scale use of these techniques has proven effective, and the researchers behind this investigation believe they could be scaled up successfully. Best of all, 26 other countries have similarly low rates of malaria incidence. If Zanzibar, a high-transmission area for the parasite, could push back against this disease so successfully, other countries could benefit greatly from the same changes.

Conclusion

Malaria, a disease that has lasted for around 5000 years, has never been closer to eradication. The last century has seen a great surge in momentum for fighting this illness. The results are stunning; millions of lives saved, several countries eliminated the disease entirely, and dozens more are nearing that goal. In turn, people have prospered. For every dollar invested in African malaria control, the continent sees 40 dollars in economic growth. Much of that prosperity goes back to impoverished people, who can thrive with less illness and more economic efficiency. Now, researchers are pursuing the “last mile” strategies. Studying human behavior can help eradicate malaria by preventing remote cases. Total eradication and the end of malaria’s drain on the impoverished has never been closer.

– Molly Power
Photo: Wikimedia

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Malaria Treatment in Burundi

Malaria treatment

At the young age of six years old, YouTube and comedy star Kacaman (aka Darcy Irakoze) just became the latest victim of malaria in Burundi. He was one of the biggest names in Burundi’s comedy scene and had thousands of views on YouTube. His videos, featuring the rural dirt floors and rusty villages of Burundi, were lighthearted and melodramatic skits starring himself and other comedians/actors. Darcy Irakoze is just one example of the need to improve malaria treatment in Burundi.

A Silent Crisis

Kacaman’s death brings to light an often-unspoken crisis: Burundi’s malaria epidemic. Nearly half of the country’s population has been affected by malaria this year. Of that number, 1800 have died from the disease. This staggering amount actually rivals the number of deaths from Ebola in the neighboring Democratic Republic of the Congo.

Poor preventative measures have been the driving factors behind the epidemic. These include a lack of mosquito nets, the movement of the population with low immunity to malaria from mountain areas to city areas and various changes in climate. The crisis has received some attention from the World Health Organization and the United Nations, but it remains remarkably untouched as a result of the current leadership. Afraid of admitting weakness in health policies, President Nkurunziza is hesitant to admit he needs help increasing malaria treatment.

An Epidemic of the Poor

The brutal reality that a six-year-old boy in Burundi can access the internet and YouTube but not malaria treatment presents a serious call for action. Often referred to as the “epidemic of the poor,” malaria disproportionately affects poverty-stricken areas like Burundi because of the expense required to purchase preventative measures and medical treatment.

The disease presents many ramifications for family members of the sick. They deal with psychological pain, the strain on already tight budgets and job loss. Additionally, malaria damages the economic wellbeing of countries as it decreases the chances of tourism and foreign investment. This keeps poor countries in a vicious cycle because they are unable to provide enough funds for malaria treatments or to improve other aspects of their country.

What Is Being Done?

Innovations like the Kite patch offer promising improvement for malaria prevention. The patch works by making humans virtually invisible to mosquitoes for up to 6 hours, stopping any bites. The company is working to distribute the patch around the world through the Kite-Malaria-Free Campaign, but it still needs more funding. The World Health Organization has launched the “high burden high impact” campaign as a response to countries facing extremely large epidemics. This entails a more aggressive approach to preventing and treating malaria by working with national governments in each of the countries to create an organized and strategic approach.

Increasing prevention is still vital in the fight against malaria. Widespread distribution of mosquito nets and insecticide in areas where these items are inaccessible or too expensive could yield massive results. More effective antimalarial treatments are also needed to fight malaria. The problem of the developing resistance to antimalarials in certain populations needs to be addressed to increase the efficacy of the drugs. Finally, a successful malaria vaccination needs to be more accessible. A semi-effective vaccine has been developed, but the technology still requires some fine-tuning.

It is likely at least one child will have died from malaria in the last minute. Kacaman was one of those children. His death should inspire a revitalized passion and determination to conquer malaria. While some incredible advances have been made, more is needed. Hopefully, these efforts can make this world one where malaria treatment and prevention is just as viral as YouTube.

– Hannah Stewart
Photo: Flickr

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Dams and Malaria: How They are Linked

Dams and Malaria
Despite the fact that malaria transmission rates have decreased by more than 40 percent since 2000, the morbid disease still affects a large number of people on the African continent. According to WHO, an estimated 219 million cases of malaria occurred in 2017 and a disproportionate 92 percent of these cases happened in Africa. Of these numbers, people can attribute at least 1.1 million cases to dams.

The Relationship Between Dams and Malaria

Mosquitoes tend to lay eggs and reproduce in shallow pools of water or somewhere in the near vicinity. Thus, water is a key component in the spread of malaria. The erection of dams creates a multitude of shallow pools along the edges of the water base that provide ideal situations for mosquitoes to nest. This increases the prevalence of malaria and the susceptibility of individuals to malaria.

A study published in the Malaria Journal found that the slope of the shoreline was the most determining factor of a rise in malaria for areas that had dams. Since mosquitoes like to breed in shallow pools of water that do not connect to a larger, main body of water, the shoreline around a dam is a prime location that meets these requirements. The more inclined a slope is, the more water drains out. This means that static pools of water are unable to form, which in turn means that mosquitoes do not find areas of the steep slope to be habitable.

Due to factors like this, not all dams are likely to increase malaria. Reservoirs that have steeper slopes pose a smaller risk of increasing the spread of malaria. For example, the climate and geography at a dam site, temperature fluctuations, elevation and amount of rainfall, also influence the spread of malaria near reservoirs. Thus, the continual study of the relationship between dams and malaria can lead to further identification of factors that increase the risk of spreading disease.

Solutions

Similarly, development planners must carefully select dam sites so that economic growth and electricity generation do not compromise the well-being of a local population. Increasing awareness through activism could see a more informed class of development planners take more calculated and careful approaches to dam construction. Indeed, a greater exchange of knowledge between local populations, journalists, researchers and policymakers is necessary to see increasing benefits and minimization of negative impacts.

This is arguably more important now than ever. As of 2015, 18.7 million Africans reside within five kilometers of dam reservoirs. Policymakers must take measures to ensure that quality of life does not deteriorate for those living near artificially constructed reservoirs. The relationship between dams and malaria is a critical nexus that can inform the implementation of less detrimental policies by those who are in a position to make such a policy.

– Evan Williams
Photo: Flickr

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Ending Malaria in China

Ending Malaria in ChinaHistorically, malaria has been extensive in China. In the 1940s, 90 percent of the population was considered at risk. In the 1970s, the country suffered 24 million cases of the disease. With the introduction of anti-malarial medicine and urbanization, massive strides have been made to end malaria in China.

In 2010, China launched the National Malaria Elimination Plan (NMEP) with the aim of eradicating malaria from the country by 2020. It pushed for rapid responses to reported cases of the disease, with the 1-3-7 plan outlining a report within one day, investigation within three, and treatment within seven. The plan saw great success and in 2017, no indigenous cases of malaria were detected.

China is not yet completely free of malaria. It is difficult to contain the disease at the country’s borders and those in poverty are especially at risk.

Background

The Yunnan Province consistently experiences a high number of malaria cases due to its constant interaction with neighboring counties. The wealthiest counties in Yunnan are central and surround the capital city Kunming. Among the 26 border counties, only two have an infection rate below one in 10,000, and nine have rates above 10 in 10,000. In addition, 21 of these counties are the poorest in the province. Researchers have called for more resources to be diverted to Yunnan.

The remaining cases of malaria in China pour in from neighboring countries, with 19,154 cases from 68 countries documented between 2011 to 2016. In the majority of cases, the disease was carried by returning Chinese workers, mostly from Myanmar, Ghana or Angola, all countries that rank below 160th highest GDP per capita in the world.

Despite these challenges, the country has made significant strides to combat malaria. The first major effort began in 1955, with the launch of the National Malaria Control Programme, a push to improve irrigation and insecticide use throughout the country. China reduced malaria deaths by 95 percent, and suffered only 117,000 cases of the disease, by 1995.

In 2003, China received aid from the Global Fund to fight AIDS, tuberculosis and malaria. Global Aid distributed over $100 million throughout the world over two years. In China, this reduced the number of annual cases below 5000.

The 2010 Program was a synthesis of a national effort. About 13 departments came together, including the ministries of health, education and the military to end malaria. According to He Qinghua, Deputy Director-General of the Bureau of Disease Prevention and Control at China’s National Health Commission, a large portion of the effort focused around involving the government at every level of control. If a ruling was made in the capital, it had to be translated into every local government.

Since 2014, the Chinese government has paid for the entirety of its fight against malaria, though it recognizes the importance of early support from external funds like the Global Fund. Yang Henling, a professor at the Yunnan Institute for Parasitic Diseases, further states the need to continue efforts, lest malaria return.

China Turns to Help Other Nations Eradicate Malaria

New South, a Chinese company, has begun working to eliminate malaria in Kenya, where 70 percent of the population is at risk of the disease. New South has already been working in Comoros.

New South advocates for the use of MDA, the primary drug involved with treating malaria in China. While many western organizations, including the Bill and Melinda Gates Foundation, focus on preventing mosquitoes from spreading malaria, New South emphasizes treatment in humans. Dr. Bernhards Ogutu, who has been fighting malaria in Kenya for decades, believes that Chinese support will have malaria eradicated in some areas of Kenya within only five years.

– Katie Hwang
Photo: Flickr

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10 Facts About Life Expectancy in Comoros

10 Facts About Life Expectancy in Comoros
Comoros is a small country comprised of four islands located just off Africa’s eastern coast. Poverty is widespread across the island due to limited access to transportation to the mainland and very few goods that could be exported to encourage economic growth. These 10 facts about life expectancy in Comoros will demonstrate how poverty and other factors contribute.

10 Facts About Life Expectancy in Comoros

  1. The population of Comoros is rapidly growing with poor health services unable to keep up. As of 2018, the average was 350 people per square mile. Anjouan has the largest population of the Comoros islands. Overcrowding makes resources scarce and health is rapidly declining. The life expectancy of any person on the islands rarely exceeds the age of 65; in 2018, the CIA reported that only 3.98 percent of the population was 65 years or older. Most of the population are children from infancy to the age of 14 at 38.54 percent.
  2. Overcrowding on the island has led some to attempt illegal immigration to the French island of Mayotte. In 1995, the French government declared travel to Mayotte without a visa illegal. Immigration for the people of Comoros is more challenging, but it does not stop them from fleeing to find a better life outside of the overpopulated islands. As of 2017, 40 percent of the population of Mayotte comprised of illegal immigrants from Comoros. The journey is certainly not safe; The New Humanitarian estimates 200 to 500 deaths every year are a result of attempted immigration to Mayotte in the tiny fishing boats that the Comoros people call kwassa-kwassa. The majority of those who cross are children that parents send in search of a better life, contributing to the high mortality rate of children in Comoros.
  3. The overcrowding is due in part to the high birth rate as compared to the death rate. Despite the low age of life expectancy, the death rate overall is only seven deaths per 1,000 people as reported by the CIA. In comparison, the birth rate is 25 births per 1,000.
  4. The infant mortality rate, however, is extraordinarily high. The country ranks number 17 on the CIA’s list with an estimated 58 deaths per 1,000 births. The problem is, in part, due to the limit of financing toward health care and hospitals. Financing has not exceeded 5 percent in total government spending within the last few decades according to the African Health Observatory (AHO).
  5. Illness, as a result of low attendance to health care facilities, runs rampant in Comoros. Malaria was once the deadliest disease until 2011 when it finally began to decline. The Comoros government launched the Residential Spraying campaign to provide insecticide and treatments to the water. Transmittable diseases, according to a table released by the AHO, are the prime suspect for illness and fatality on the islands. Sixty-six percent of all deaths related to diseases are a result of transmittable illnesses, while only 25 percent are non-transmittable and 9 percent are due to injury or natural causes.
  6. Cardiovascular disease (CDV) is on the rise, according to a report by the World Health Organization (WHO); as of 2016, CDV has fatally affected 17 percent of the population of Comoros. The AHO links CDV to malnutrition and the consumption of less than adequate food to survive. Since 2005, cerebrovascular heart disease and ischemic heart disease have increased by 4.2 percent and 5.4 percent respectively. As of 2015, these diseases were the third and fourth most deadly in Comoros.
  7. Tuberculosis is also rampant on the islands; WHO estimates 28,000 of Comoros became infected with the deadly disease in 2017. Twenty-one thousand of those infected with TB died. Only 10 percent of the population receive a preventative for TB, clearly demonstrating the need for better health care access to increase life expectancy in Comoros.
  8. The leading cause of death as of 2015 is lower respiratory infections. This includes bronchitis, influenza and pneumonia, among others. According to WHO, 47 percent of all deaths in the country as of 2016 are due to communicable diseases such as these infections. The Institute for Health Metrics and Evaluation (IHME) reported that between 1990 and 2010, lower respiratory infections remained the deadliest issue in Comoros with an estimated 27,000 years of life lost among the younger generations fatally affected.
  9. Though illnesses are slowly declining, other health issues are beginning to arise in their place. A lack of adequate nutrition is beginning to plague the people of Comoros. The CIA estimates that Comoros exports roughly 70 percent of all food it grows, leaving very little for its people. According to a report in 2011 by the World Bank, 44 percent of children in Comoros are malnourished and one in every four children is born with low birth weight. This contributes to the infant mortality rate mentioned earlier. Vitamin A deficiency and anemia are the leading causes of health issues among those who are malnourished in Comoros.
  10. Sanitation issues are on the rise due to the overcrowded population. Water sanitation is one of the top concerns. The islands have very little freshwater resources; Grande Comoro, the main island, has no surface water at all and the people import water from the mainland. Meanwhile, the other 50 percent of the population in rural communities rely on collecting rainwater. The United Nations Development Program (UNDP) wants to change this dangerous way of living and ensure that all the citizens of Comoros have access to safe drinking water. With the government of Comoros, its goal is to increase the freshwater supply to 100 percent for all by the year 2030. With all parties assisting, the project has $60 million at its disposal.

These 10 facts about life expectancy in Comoros show that in recent years, aid to Comoros has increased, especially with sanitation. The life expectancy in Comoros is only one part of the problem that the people of the country faces. Comoros must come to an agreement with Mayotte and other countries accept the refugees who are seeking a better life.

– Nikolas Leasure
Photo: Flickr

 

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Progress in Reducing Malaria in Haiti

malaria in haiti
According to UNICEF, some of the main causes of death in Haiti are diarrhea, respiratory infections, tuberculosis, HIV/AIDS and malaria. Among the Caribbean Islands and Central American countries, Haiti has the highest number of malaria cases. Malaria is a major public health concern, but there are efforts and progress to reduce cases of malaria in Haiti.

Malaria in Haiti

Malaria is a life-threatening disease that spreads by a female mosquito carrying a fatal parasite. In 2014, The Service de Suivi et d’Evaluation of the Programme National de Controle de la Malaria (PNCM) reported 17,094 cases of malaria. Five percent of children under the age of 5 who contract the disease receive treatment. The 2010 earthquake, the most destructive earthquake in Haitian history, destroyed health care and laboratory facilities. Therefore, the earthquake raised complications to eliminate malaria. According to the Malaria Journal, infections are the cause and result of poverty in Haiti.

Malaria Zero

In the past 10 years, Hispaniola has made efforts to eradicate malaria. In the Dominican Republic, reports state that cases of malaria reached a 15 year low. Nonetheless, one-third of the cases of malaria came straight from Haiti. Therefore, controlling malaria in Haiti will prevent it from spreading to other areas.

Malaria Zero is a group of organizations working together to eliminate malaria by 2020. In this organization, partners work on running operational research and locating areas of high transmission and risk. The organization has refined malaria surveillance systems to track every malaria case, make sure all malaria cases receive a diagnosis, limit the ability of mosquitoes to transfer the disease and educate and mobilize people to get tests and treatment.

So far, the organization has managed to attain two global fund grants of $38 million for Haiti, finalize the monitoring plan on tracing National Malaria Control Program’s progress for elimination, update malaria risk maps with new data and cross border surveillance across Hispaniola. It has also completed four operational research studies and developed new laboratory methods to identify hotspots within serology and novel ultra-sensitive tests to find malaria infections.

In addition, over 130 community members walked several miles across rocky land to offer anti-malaria medication to more than 36,000 people.

Nothing but Nets

Nothing but Nets is a worldwide campaign that raises awareness and funds to fight malaria. This organization raises funds to distribute insecticidal bed nets that protect families from malaria-carrying mosquitos as they sleep. In addition, the organization also offers household spraying, malaria treatment and training of health care workers.

Overall, eliminating malaria will help improve Haiti’s health system, stimulate financial growth and increase economic levels for people living on the island. Organizations and political leaders must focus on tackling the issue to completely get rid of the disease. Many Haitians still battle the illness, but the progress in reducing malaria in Haiti means hope for the future.

– Merna Ibrahim
Photo: Flickr

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A Look at Efforts to Address Health Care in Ghana

Health Care in Ghana

The West African nation of Ghana is a vibrant country filled with natural beauty and rich culture. However, like many of its neighbors in sub-Saharan Africa, Ghana suffers from a high poverty rate and lack of access to adequate health care. In fact, according to the Ghana Statistical Service, 23 percent of the total population lives in poverty and approximately 2.4 million Ghanaians are living in “extreme poverty.” That being said, many organizations and groups — both national and global — are working to improve health care in Ghana.

Malaria in Ghana

A disease transmitted through the bites of infected mosquitoes, malaria is a common concern throughout much of West Africa, including Ghana where it is the number one cause of death. In fact, according to the WHO’s most recent World Malaria Report, nearly 4.4 million confirmed malaria cases were reported in Ghana in 2018 — accounting for approximately 15 percent of the country’s total population.

All that in mind, many NGOs, as well as international government leaders, have taken up the mantle to eliminate malaria in Ghana. This includes leadership from the United States under the President’s Malaria Initiative or PMI which lays out comprehensive plans for Ghana to achieve its goal of successfully combating malaria.

With a proposed FY 2019 budget of $26 million, the PMI will ramp up its malaria control interventions including the distribution of vital commodities to the most at-risk citizens. For instance, the PMI aims to ensure that intermittent preventative treatment of pregnant women (IPTp) is more readily accessible for Ghanaian women. Progress has been made, too, as net use of IPTp by pregnant Ghanaian women has risen from 43 percent to 50 percent since 2016. This is just one example of the many ways in which PMI is positively contributing to the reduction and elimination of malaria in Ghana.

National Health Care System

National leaders are also doing their part to positively impact health care in Ghana. In 2003, the government made a huge step toward universal health coverage for its citizens by launching the National Health Insurance Scheme (NHIS). As of 2017, the percentage of the population enrolled in the scheme declined to 35 percent from 41 percent two years prior. However, 73 percent of those enrolled renewed their membership and “persons below the age of 18 years and the informal sector workers had significantly higher numbers of enrolment than any other member group,” according to the Global Health Research and Policy.

It is difficult to truly understand Ghana’s health issues without considering firsthand perspectives. In an interview with The Borgen Project, Dr. Enoch Darko, an emergency medicine physician who graduated from the University of Ghana Medical School, commented on some of the health issues that have plagued Ghana in recent decades. “A lot of problems that most third world countries, including Ghana, deal with are parasitic diseases such as malaria and gastroenteritis. Though health issues like diabetes and hypertension still remain in countries around the world, and even the United States, the difference is that some diseases that have been eradicated in Western countries still remain in countries like Ghana,” Darko said. “Many people in Ghana simply do not see a doctor for routine checkups like in the United States. Rather, most people will only go to see a doctor when they are feeling sick. As a result, lesser symptoms may go unchecked, thus contributing to the prevalence and spread of disease and infection. Combined with the fact that many Ghanaians in rural communities may not have sufficient money to afford treatment or medicine, this becomes a cycle for poor or sick Ghanaians.”

That said, it is hoped that with continued support from international players as well as government intervention, the country can continue to make strides in addressing health care for its citizens.

– Ethan Marchetti
Photo: Flickr

 

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10 Facts About Life Expectancy in Mali

10 Facts About Life Expectancy in Mali
In 2020, the country of Mali will celebrate its 60th anniversary of independence from French colonial rule. However, since 1960, Mali has had a tumultuous history filled with numerous civil wars, coups and failed revolutions. Despite these setbacks, Mali is making strides to improve the quality of life for its citizens. Here are 10 facts about life expectancy in Mali.

10 Facts About Life Expectancy in Mali

  1. According to the CIA World Factbook, the life expectancy of a citizen of Mali is 60.8 years on average or 58.6 years for males and 63 years for females. This puts Mali at a rank of 206 out of 223 countries for life expectancy. These 10 facts about life expectancy in Mali will explain why.
  2. Mali reported 43 births per 1,000 people in 2018, the third-largest figure in the world. Many expect the country’s population to double by 2035. This has led to overcrowding in the capital city of Bamako. In response, the World Bank has begun to invest in the infrastructure of Malian cities via performance-based grants for communities.
  3. Despite this massive population growth, Mali suffers from extreme infant and child mortality, which adversely affects life expectancy in Mali. In 2015, 114 out of 1,000 Malian children died by the age of 5. Recently, organizations like WHO and UNICEF have begun to sponsor community case management initiatives that focus on improving health conditions in impoverished areas. Areas where these initiatives occurred, such as Bamako’s Yirimadio district, have been able to reduce child mortality rates to up to 28 deaths per 1,000, about a quarter of the national rate.
  4. In Mali, the maternal mortality rate is very high. The U.N. estimates that there are 630 maternal deaths per 100,000 live births. This is partly because only one in four births in Mali have someone with proper birthing training, but deep-rooted societal attitudes that restrict women’s rights may also be a cause. According to the Center for Reproductive Rights, an organization fighting against maternal mortality in Mali, child marriage and female genital mutilation are both common in Mali, which both cause higher risks to the mother during birth. The organization has called upon the Malian government to “meet its national and international commitments and take the necessary steps to reduce maternal mortality.”
  5. The leading cause of death in Mali is malaria, which accounts for 24 percent of deaths in the country. To address this, the Malian government has partnered with global organizations such as the CDC to distribute anti-malarial medications during the country’s late autumn rainy season, in which most cases of malaria appear. This partnership was established in 1995 as part of the CDC’s global initiative to stop diseases in other countries before they can reach the U.S.
  6. Illnesses that often stem from a lack of access to clean water, such as meningitis and diarrheal diseases, cause a significant number of deaths in Mali. Twenty-three percent of the population of Mali overall and 35.9 percent of the rural population lacks access to clean drinking water, and 78.5 percent of rural Malians lack access to proper sanitation. This leads to the spread of the diseases mentioned above. An organization called Charity Water has invested over $9 million to give rural Malians access to clean water and sanitation by building wells and pipe systems, allowing Malians to tap into the country’s rich aquifers for clean drinking water.
  7. Malnutrition causes 5 percent of deaths in Mali. According to the World Food Program, 44.9 percent of the country live in poverty, which is a significant cause of food insecurity. To combat this, programs like the World Food Program have been working on distributing nutritious meals to Malian families, as well as setting up long-term programs to create infrastructures such as roads and dams.
  8. HIV and AIDS cause 3 percent of deaths in Mali. Although HIV infections in the country have risen by 11 percent since 2010, deaths from the disease have gone down by 11 percent in the same period. Efforts by the CDC and other organizations have focused on treating HIV to prevent victims of the disease from going on to develop AIDS, as well as improving blood safety measures.
  9. Mali suffers from a significant shortage of physicians, with 0.14 physicians and 0.1 hospital beds per 1,000 people, compared to 2.59 physicians and 2.9 beds in the U.S. Despite that, the country has recently taken significant steps forward on providing universal health coverage via a $120 million initiative from the government, which will focus on training more doctors, broadening access to contraceptives and improving care for the elderly.
  10. Eighty percent of Mali relies on agriculture for a living. Although Malian farmers have been fighting soil degradation and lack of access to modern equipment, initiatives like Feed the Future have been working to improve conditions for Malian farmers. As a result, Mali poured $47.34 million into its agriculture industry in 2017.

As these 10 facts about life expectancy in Mali show, life expectancy in Mali is significantly lower than in other parts of the world, but the country is making strides forward to combat illness and poverty. With help from the global community, Mali is moving forwards towards a brighter future.

– Kelton Holsen
Photo: Flickr

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Efforts to Fight Disease in the DRC

Fight Disease in the DRC
With 80 million hectares of arable land and over 1,100 precious metals and minerals, the Democratic Republic of the Congo has quickly established itself as a large exporter in the lucrative diamond industry. Despite this, the DRC ranks 176th out of 189 nations on the UN’s Human Development Index and over 60 percent of the 77 million DRC residents live on less than $2 a day. Internal and external war, coupled with political inefficacy and economic exploitation, has hindered the country’s ability to combat poverty and improve health outcomes. Listed below are some of the most deadly diseases that are currently affecting individuals in the DRC and the different strategies that governments and NGOs have taken to fight disease in the DRC.

3 Deadly Diseases Currently Affecting Individuals in the DRC

  1. Malaria

The DRC has the second-highest number of malaria cases in the world, reporting 15.3 million of the WHO-estimated 219 million malaria cases in 2017. Of the more than 400 Congolese children that die every day, almost half of them die due to malaria, with 19 percent of fatalities under 5 years attributed to the disease. However, some are making to reduce malaria’s negative impact.  For example, the distribution of nearly 40 million insecticide-treated mosquito nets, or ITNs, has helped lower the incidence rate by 40 percent since 2010, with a 34 percent decrease in the mortality rate for children under 5. The DRC government procured and distributed the nets with international partners such as the Department for International Development, Global Fund and World Bank. In addition, the President’s Malaria Initiative, a program implemented in 2005 by President Bush and carried out by USAID, has distributed more than 17 million nets. UNICEF has also been a major contributor in the efforts to fight malaria and recently distributed 3 million ITNs in the DRC’s Kasaï Province. However, the country requires more work, as malaria remains its most frequent cause of death.

  1. HIV/AIDS

Among its efforts to fight disease in the DRC, the country has made significant progress recently in its fight against HIV/AIDS. As a cause of death, it has decreased significantly since 2007, and since 2010, there are 39 percent fewer total HIV infections.

This particular case illuminates the potential positive impact of American foreign aid. The DRC Ministry of Health started a partnership with the CDC in 2002, combining efforts to fight HIV/AIDS. PEPFAR, signed into U.S. law in 2003 to combat AIDS worldwide, has invested over $512 million since 2004, which has helped to fund antiretroviral treatment for 159,776 people. In 2017, it funded the provision of HIV testing services for 1.2 million people.

The country is also addressing mother-to-child transmissions. In the DRC, approximately 15 to 20 percent of mothers with HIV pass the virus onto their child. The strategy to end mother-to-child transmissions involves expanding coverage for HIV-positive pregnant women, diagnosing infants with HIV earlier and preventing new infections via antiretroviral drug treatment. UNAID, The Global Fund and the DRC Ministry of Health have undertaken significant work to accomplish these objectives and their efforts have resulted in the coverage of 70 percent of HIV-positive pregnant women.  However, much work remains to cover the remaining 30 percent of pregnant HIV-positive women.

Overall, there is still a lot of necessary work to undergo in the fight against HIV/AIDS in the DRC and around the world.  In total, UNAIDS estimated that HIV/AIDS was the cause of 17,000 deaths in the DRC in 2018.  While this is a decrease from previous years, it shows that the DRC still has a long way to go in order to fully control the spread of the disease.  Additionally, there must be more global funding. The U.N. announced on July 2019 that annual global funding for fighting HIV/AIDS decreased in 2018 by almost $1 billion.

  1. Ebola

Since 2018, the DRC has undergone one of the world’s largest Ebola outbreaks. On July 17, 2019, WHO declared the outbreak an international health emergency. Since August 2018, more than 2,500 cases have occurred, with over 1,800 deaths.

However, the country is making efforts to prevent the transmission and spread of Ebola in the DRC.  Recently, more than 110,000 Congolese received an experimental Ebola vaccine from Merck & Co. The vaccine is called rVSV-ZEBOV, and studies have shown the vaccine to have a 97.5 percent efficacy rate.  This vaccine provides hope that people will be able to control Ebola breakouts in the near future.

While there have been attempts to fight disease in the DRC in recent years, such as malaria, HIV/AIDS and Ebola, each disease remains a major issue. In the coming years, the country must continue its efforts.

– Drew Mekhail
Photo: Flickr

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