malawian farmersAs a small, landlocked country in East Africa, Malawi relies mainly on agriculture for its economic stability and subsistence. In 2011, agriculture formed 31% of Malawi’s GDP and employed more than 80% of the workforce. Despite the bountiful resources that agriculture offers the people of Malawi, food insecurity is still a very present reality for a significant portion of the population. Farmers in rural villages struggle to attain the income needed to survive. To compound this issue, Malawian farmers heavily divide agricultural and domestic labor along gender lines, placing the brunt of domestic and farming burdens upon the shoulders of women. However, thanks to the efforts of researchers and global activists, educational programs have proven effective in getting Malawian men involved in the process of feeding the family, leading to increased gender equality within the household.

Poverty and Agriculture

Although Malawi has been on a steady upward trend toward increased childhood education and greater access to healthcare, half of the overall population suffers from poverty due to negative factors such as droughts, floods and lack of sustainable farming methods. A majority of Malawian farmers can produce only enough food to survive and cannot grow the extra crops needed for future food supplies or trading opportunities. Thus, rural communities often live from harvest to harvest without a stable supply of fresh food and produce.

The Role of Women in Malawian Agriculture

Within the small rural communities of Malawi, societal norms divide the household responsibilities along gender lines, with the men of the household taking charge in plowing the fields, tending to crops and performing other farming duties. In addition to taking on agricultural tasks, women within the community complete household chores and watch over the children. Although the amount of female participation in Malawian farming practices is commendable compared to other small countries with similar economic conditions and demographics, the farming system is strenuous on women, who must perform double duties to ensure that the household runs smoothly.

With the economic fragility of Malawi, patriarchal structures have proven detrimental to the well-being and security of the community. It is difficult for Malawian female farmworkers to reach their full production potential and devote their full energy to sustainable farming practices and education. Families cannot produce enough food to sustain themselves and others in the village due to unequal task divisions.

Supporting Women in Malawi

A team of researchers recently undertook an experimental project to subvert the rigor of gender roles in Malawi and take some of the economic pressure off of Malawian women, often affected the most by poverty. One practice that researchers implemented to dismantle gender roles is to change the public perception of cooking and food practices in Malawi. Due to the reliance on starchy grains and roots that must be cooked in the Malawian diet, processing and cooking foods take up most Malawian women’s time. Seeing this phenomenon, researchers developed cooking tutorials to educate men on how to cook and also converted cooking into a fun activity by proposing it as a kind of competition in which different villages could contest who had the best male chefs.

Dismantling Gender Norms

As Raj Patel recounts in his lecture on transparency in the food system, although the social experiment that researchers conducted in Malawi initially seemed like a trivial novelty, its impact carried through into the daily lives of Malawian farmers. This small change in daily habits encouraged the men to shoulder more domestic tasks and act beyond the scope of traditional gender norms. In the short four-year period that researchers observed, Malawian malnutrition decreased and the women surveyed reported feeling more fulfilled and supported in their homes. Although there is still far to go in destabilizing the patriarchal structures present in Malawian society, small steps in the food system are the key to achieving bigger milestones such as reducing poverty and promoting gender equality.

Luna Khalil
Photo: Flickr

Flooding in Malawi
In March 2019, Cyclone Idai submerged vast regions of Southern Malawi, displacing 86,980 people. Local fishermen in dugout canoes found families stranded in tree branches and brought them to the displacement camps that UNICEF built. Communities escaped the flooding in Malawi because UNICEF and the local population worked together tirelessly.

Paddling to Safety

Heavy rain and strong winds led to dangerous flooding in Malawi, resulting in the worst natural disaster in Southern Africa in 20 years. In just a few days, fishermen brought tens of thousands of people to safe, dry land. Once the floods came, one fisherman (a watchman at a port in Nsanje) paddled across a cyclone-induced lake and helped people who were stuck along the way. He found people stranded in trees or rooftops who were hungry and injured. Many of them lived in branches for days because the floods suddenly engulfed their farmland and village. He charged $1.37 per person but allowed people to ride for free if they could not afford the price.

When Maria’s village became inundated, she lived in a tree for several days with her child and five chickens. Finally, she saw a canoe on the horizon, and a fisherman came to offer his services. Maria could not save her belongings in the flood so she used all she had left, her chickens, to pay for the ride. Onshore, they traveled to a temporary shelter in Khungu Bwe Camp, one of 187 camps in Malawi where UNICEF helped those displaced by the cyclone.

UNICEF Displacement Camps

Children are at risk of diseases such as typhoid, cholera and diarrhea if they do not have sanitation and hygiene services. In the camps, UNICEF built temporary toilets, filtered the water supply and hired local actors to educate residents on hygiene, health and sanitation. One cast in Malawi performed a comedy skit about the dangers of open defecation for several hundred people. Through skits and community radios, UNICEF sent information about hygiene, especially cholera prevention, to 600,000 Malawians.

Updates

Fortunately, Malawians are returning home or resettling into safer areas. However, women and girls face additional challenges after the storm because their unpaid labor typically includes collecting clean water. Water points and sanitation facilities are farther away, which increases their commute and risk of gender-based violence. Additionally, women are extremely unlikely to legally own land, so they struggle to reclaim their farmland when they come home.

In Malawi, UNICEF holds “children’s corners” which foster children’s psychological support, play and recreation in the aftermath of traumatic events. By May 2019, 10,000 children participated each week.

The death toll in Malawi, 60 people, has decreased from the 2015 Cyclone Bansi death toll which almost hit 200. This reduction is due to lessons Malawians learned from the last cyclone and meticulous preparations for another disaster. UNICEF stockpiled supplies in flood-prone areas so it could relocate people faster than before. Most importantly, it involved the local community, creating a more efficient and knowledgeable response team. Cyclone Idai caused insufferable flooding in Malawi but it was no match for a team of local fishermen and humanitarian workers.

– Rebecca Pomerantz
Photo: Flickr

Iceland’s Foreign AidIceland, located in the North Atlantic Ocean, has a population of fewer than 400,000 people. The small Nordic island is home to some of the most sought after natural landmarks and tourist attractions such as the northern lights. Although small, the country has provided big backing to countries triple its size through its foreign aid programs. In 2008, Iceland experienced what economists considered to be the most severe economic downturn in its history. After years of hard work, Iceland was able to rebuild its economy and rebounded successfully. Aside from the financial crisis in 2008, the country has been able to maintain relatively low poverty rates with rates remaining at 0.10% from 2013 to 2015. Iceland has paid its good fortune forward by offering assistance to countries experiencing economic fragility. The Icelandic government is committed to fighting poverty by providing support to nations in need. The main objective of Iceland’s foreign aid pursuits is to reduce poverty and hunger while advocating for human rights, gender equality and sustainable development. Three countries, in particular, have been supported by Iceland’s foreign aid.

Syria

Syria has a long history of political turbulence with numerous uprisings dating back to the 20th century. One event, in particular, was especially tumultuous. In 2015, Syria had experienced a major political uproar in one of the largest and oldest cities in the country, Aleppo. “The Battle of Aleppo” began in 2011 in the city of Deraa. Citizens who opposed the leadership of President Bashar al-Assad decided to rebel. This led to a civil war between the Syrian government and protesters who the Syrian government referred to as rebels. The civil war that lasted six years had a detrimental impact on the citizens. There were massive food and gas shortages. Multiple buildings were victim to mass bombings, including schools and hospitals. Civilians were caught in the crossfire and suffered greatly as a result. Iceland stepped in to offer assistance and allocated $600,000 to support civilians impacted by the war in 2015. The country continued in its efforts by supporting Syria with $4 million worth of humanitarian aid in 2016.

Malawi

Malawi holds one of the highest rates of poverty in the world, at 51.5.% in 2016. Malnutrition and infant mortality impact Malawi’s 18.6 million population. The country has experienced notable economic growth in the past three years, with a 4.4% increase in economy in 2019. Unfortunately, these economic gains have been stalled as a result of the COVID-19 pandemic. In early November 2020, the Icelandic government donated $195,000 to the World Food Programme to assist with the COVID-19 response in Malawi.

Uganda

Uganda and Iceland established their relationship in the year 2000. The Icelandic government is committed to enhancing the livelihood of Ugandan fishing communities located in the Kalanga and Buikwe districts. Uganda is one of the largest recipients of Icelandic foreign aid with an annual distribution of $6 million. Iceland’s contributions have seen monumental success with safe water coverage now standing at 77%, up from 58% in 2015. The primary school completion rate in Buikwe is up from 40% in 2011 to a staggering 75.5%.

Iceland: A Foreign Aid Leader

While Iceland may be small in comparison to its peers, Iceland has been tremendously influential in its foreign relations. The three countries above are just a few of the nations that Iceland has assisted. Humanitarian efforts continue to provide support to countries in need through Iceland’s foreign aid.

– Imani Smikle
Photo: Flickr

Poverty Eradication in Malawi
Situated in Southern Africa in between the borders of Mozambique, Zambia and Tanzania, Malawi is one of the countries with over 50% of the population living below the poverty line. Many reciprocal factors drive such high poverty rates – the country’s low agriculture productivity, insufficient infrastructure development and the lack of new technologies’ adoption, as well as vulnerability to natural disasters. Although Malawi is already undergoing a series of governmentally-induced five-year consecutive plans called The Malawi Growth and Development Strategy, there are other actors coming up with innovative solutions tackling the poverty eradication in Malawi.

5 Innovations in Poverty Eradication in Malawi

  1. E-Madzi Automated Water Kiosks: One in three Malawians – 5.6 million people – do not have access to running water in their households and their only source of clean water is water kiosks. Although this is a common solution across the country, most kiosks are only open for three hours in the morning and three hours in the evening. Moreover, people can only pay for the service in cash and the waiting time is usually quite long. That is why the Lilongwe Water Board and the World Bank financed and installed E-Madzi water kiosks, which are fully automated and usable with an e-card. The project launched in June 2017 with only four kiosks in Lilongwe, the capital of Malawi. However, the area has obtained 35 more during 2020. The automated kiosks give access to water at any time of the day, consequently decreasing attendance and water waste, as well as reducing 65% of the water costs. This fact makes daily water sourcing more convenient and secure.
  2. Hippo Roller: It is very common for Malawians, mostly women and children, to have to carry significant amounts of water from its source, such as a water kiosk, to the household. The Hippo Roller is a 90-liter water transport device enabling transportation of up to five times more water than standard 20-liter bottles. First introduced in Malawi in 2014, the Hippo Roller has allowed families to improve their health and hygiene, irrigate more crops for their own use or to generate more income. Moreover, the Hippo Roller saves women and children time so that they can go to school or obtain paid employment.
  3. Wonderbag: In many rural and remote areas of Malawi, cooking food on an open fire is the most common way of nourishment. This natural cooking process, though, is very time consuming and detrimental to both human health and the environment, as it releases burning charcoal and fuel into the atmosphere. In fact, smoke-related diseases kill over 4 million people every year. Wonderbag is a non-electric slow cooker that allows the food to cook for up to 12 hours, all thanks to a foam-insulated bag securely wrapped around a cooking dish. The Wonderbag does not require a stove, fire or any form of additional heating. This way, Wonderbag has made it possible to minimize health issues from indoor air pollution by reducing the amount of wood, charcoal and burning fuels by 70%, as well as save 1,300 hours per year, during which girls and women can develop productive skills and increase their potential and autonomy. Furthermore, factories and sewing collectives that work together with Wonderbag on its production, provide local women with paid employment opportunities. According to Wonderbag’s founder and CEO, Sarah Collins, Wonderbag has made it possible to minimize health issues from indoor air pollution by reducing the amount of wood, charcoal and burning fuels by 70%. She told The Borgen Project that “Women save up to $18 per month on charcoal as they only need to use $2 worth per month, and not $20. This is a reduction of over two trees per household per annum.” Additionally, records have determined that using Wonderbag saves on average 1,300 hours per year, during which girls and women can develop productive skills and increase their potential and autonomy. Furthermore, factories and sewing collectives that work together with Wonderbag on its production, provide local women with paid employment opportunities.
  4. Socially Progressive Innovation and Entrepreneurship Programme: Researchers from the University of Strathclyde Glasgow have been using satellite images and machine learning to predict the most efficient water points in Malawi. Such satellite observations are proving to be effective as they not only are precise and accessible in a matter of hours but also offer long-term measurements through accessing passed data and implementing the historical evolution of its impact.
  5. Second Agriculture Sector Wide Approach Support Programme: The Government of Malawi and the World Bank Group created the Second Agriculture Sector Wide Approach Support Programme to link farmers with nearby markets through rural road improvement. It benefits 200,000 households by bridging the gap between actual and possible crop yields, as the majority of agricultural workers tend to live in remote areas with few roads and means of transport. With better and more accessible roads, it is easier for local farmers to actually reach markets, sell their produce and regularly increase their earnings. Since its launch in 2018, the Programme has succeeded in improving 1,000 km of rural roads and employing more than 14,500 people, with 56% being women.

Looking Ahead

Poverty in Malawi is an issue that entails much more than the lack of income. It manifests itself in malnutrition, low hygiene, limited access to education, low chances for productive development, discrimination and the lack of social participation. Creative approaches and the implementation of innovative solutions toward poverty eradication in Malawi has allowed the country to improve its current social and economic situation efficiently and for the long-term.

– Natalia Barszcz
Photo: Flickr

Period Poverty in Malawi
For young women in Malawi, their first period means scavenging for some spare cloth, clean paper or even a banana peel–anything to create a facsimile of a pad or tampon. In countries like Malawi, something as commonplace as a period or sanitary protection alters the course of a woman’s life. Malawi is one of the poorest countries in the world with approximately 50% of its people living below the poverty line. Moreover, for most households, a single sanitation product is equivalent to a day’s working wage. Simply put, it is often not even a consideration to purchase menstrual sanitary products when the compromise would be forfeiting affording food or water. As a result, period poverty in Malawi is prevalent.

COVID-19 has exacerbated period poverty in many countries, but ActionAid is fighting for women’s rights and the end of period poverty in Malawi. ActionAid is an international charity that emerged in 1972 and works at the frontlines with women and girls living in poverty around the world. It has been working to provide aid in Malawi since 1990.

Period Poverty in Malawi and Education

The inability for women and girls to access sanitary menstruation products has led to an increase in infection, disease and a lack of education among women in developing countries. Only 29% of girls stay in school up until reaching Standard Eight of their education.

Around 50% of school-age girls in Africa do not have access to sanitary products. When young women are able to go to school without the hindrance of insufficient sanitary products, the quality of life for women and families in developing countries increases exponentially. Women’s education has a positive correlation to decreased fertility rates, infant mortality rates and maternal mortality rates. A UN study ascertained that educating women serves as a critical factor in determining childhood survival rates. In short, tackling period poverty can in turn reduce other side effects of global poverty.

ActionAid’s Work to Eradicate Period Poverty in Malawi

In April 2020, ActionAid donated MK150 million to districts in Malawi that COVID-19 hit the hardest. It also donated hygiene materials such as sanitary towels, soap and clean undergarments. For the past few years, ActionAid has spearheaded projects that train women and girls how to make their own hygienic and reusable sanitary pads. Poverty causes period poverty but community stigmas regarding menstruation can also women and girls to miss out on school. In fact, UNICEF has estimated that one in 10 African girls of schooling age does not attend school during menstruation. Young women in Africa find it difficult to continue school or attend school during their period due to the burden that comes with having to constantly wash and reuse unsuitable sanitary protection.

In addition to equipping women and girls with the skills necessary to make their own sanitary pads, ActionAid also facilitates girls’ clubs and safe spaces in schools that provide information and assistance. ActionAid safe spaces exist across Africa and provide a private space where women can receive medical help, hygiene kits and emotional support. ActionAid has changed the lives of women and girls in Malawi for the better. When asked how ActionAid has impacted her, one 17-year-old Malawi girl replied, “I am able to stand in class without being conscious of what is behind me and can even play netball. I’m really happy and [ActionAid] helps a lot.”

While ActionAid is not the only organization combating period poverty in Malawi, the work it has accomplished has already transformed the stigma. Moreover, it has improved how people in Malawi treat menstruation and women’s rights.

– Nina Forest
Photo: Flickr

Harmful Practices in MalawiDespite the enactment of the Gender Equality Act in 2013,  Malawi has much more to accomplish with respect to women’s rights. Traditional customs and harmful cultural practices are still deeply entrenched in Malawian society, leading to discrimination and marginalization of women and girls. These practices adversely affect their development, health, socioeconomic status and overall contributions to society. UNICEF defines harmful practices as discriminatory practices that transcend into communities and societies’ cultures and are viewed as acceptable. The most common harmful traditional and cultural practices include female genital mutilation (FGM), Gender-Based Violence (GBV) and child marriage. Such practices perpetuate gender inequalities, violate women’s rights and have detrimental physical and emotional effects on women. The Tilimbike Safe Community Space aims to reduce harmful practices in Malawi that affect women and girls.

Harmful Practices in Malawi

As a result of cultural practices, gender disparities remain pervasive across all aspects of society. Child marriage is a fundamental violation of human rights, with cascading consequences for young girls. For example, girls married as children are more likely to drop out of school, become teenage mothers and have higher rates of maternal mortality.

Malawi has one of the highest rates of child marriage in Africa, with the Human Rights Watch estimating that in 2020, one out of two girls will be married by the time they turn 18.

In addition to child marriage, Malawi remains a setting where gender-based violence is prevalent. One in five young women experiences sexual violence before they turn 18 and nearly 40% of married women have experienced intimate partner violence.

While adequate policies exist, the public and non-governmental sector responses have faced challenges in breaking down discriminatory cultural ideals and improving women’s rights. Harmful practices toward women continue unabated in Malawi due to the persistence of cultural attitudes. However, in rural communities, mentoring has proven to be efficacious in preventing harmful practices and empowering young girls and women.

Tilimbike Safe Community Space

The Tilimbike Safe Community Space is a mentorship program led by The Spotlight Initiative that serves at-risk girls and women in rural communities in Malawi by trying to eliminate harmful practices such as sexual and gender-based violence and child marriage. In mentorship sessions, mentors teach young girls about their basic human rights, sexual and reproductive health and other critical life skills. With this knowledge and interactions with their peers, girls are empowered to speak out and challenge harmful cultural practices.

Tilimbike Safe Community Space has 360 mentors, spanning across the high-risk districts of Dowa, Ntchisi, Mzimba, Nkatabay, Machinga and Nsanje. The program has educated and empowered more than 7,000 young women in these regions by equipping them with knowledge and skills to challenge the harmful practices that fuel GBV in their communities. The women and girls are now apt to speak out in their own communities, with crucial knowledge such as the importance of staying in school and the adverse effects of early marriage. Empowering girls and women is the first step toward change and fostering the foundation for solutions to these harmful practices.

Tilimbike During COVID-19

During COVID-19, women and girls are more confined to their homes due to school closures and travel restrictions. Therefore, they are at increased risk for GBV, teenage pregnancy and being coerced into childhood marriage. Despite the elevated risks, mentees of the Tilimbike Safe Community Space successfully prevented these harmful occurrences. Huge strides have been made to end the harmful cultural practices during COVID-19 restrictions, with no teenage pregnancies or child marriages among the mentees during the lockdown.

These women and girls have renewed hope for achieving their life goals and have enhanced their ability to make informed decisions about their lives and futures. The mentors in the Tilimbike Safe Community Space allow girls and women an opportunity to receive advice and support outside their home to reach their fullest potential. The Tilimbike Safe Community Space illuminates that mentorship programs are effective in breaking down cultural barriers and ending harmful practices.

Further Progression

Initiatives such as the Tilimbike Safe Community Space play a key role in eliminating dismantling gender disparities in society caused by cultural barriers. Mentoring and empowering women and girls will advance not just Malawi but the entire world.

– Samantha Johnson
Photo: Flickr

election in malawiThe people of Malawi went to the polls in May 2019 eager to make their voices heard.  Due to some electoral static, however, the world only recently received their message. Marred by allegations of impropriety and delayed by legal challenges, a resolution came in June 2020 when the country repeated the election. On June 27, 2020, 13 months following the initial vote, the election in Malawi resulted in Lazarus Chakwera becoming the nation’s next president. Thanks to courageous actions from Malawi’s top court, a nation imperiled by electoral dysfunction has achieved a peaceful transition of power.

The Election in Malawi

Shortly following the initial presidential election in Malawi on May 21, 2019, President Peter Mutharika won by a narrow margin. However, rumors of irregularities in the vote tallies began to cast doubt on the outcome. Of the 5.1 million votes cast, Mutharika won 38.6% of the vote, compared to 35.4% and 20.2% for his closest competitors. The opposition candidates, Lazarus Chakwera of the Malawi Congress Party and Saulos Chilima of the United Transformation Movement, filed a lawsuit. This prompted an investigation of the Malawi Electoral Commission’s (MEC) handling of the election in Malawi. Additionally, the angst from the controversy spilled into the streets, where thousands of citizens engaged in peaceful protests.

Following a protracted investigation, the nation’s constitutional court invalidated the results of the election in Malawi, citing “widespread, systematic and grave” anomalies. In a voluminous report, the five-judge panel cataloged a panoply of suspicious behavior. This ranged from mathematical errors to the use of correction fluid on tallying forms. There were mixed reactions to the court’s surprising decision, as Mutharika retained power while the inquiry took place. In addition, Mutharika decried the decision as “a great miscarriage of justice.” However, others lauded the decision as a powerful demonstration of judicial independence and a hallmark of a functioning democracy.

A Second Chance

The constitutional court’s decision ordered that a new election take place within 150 days of their announcement, which came in February 2020. In June 2020, the Parliament set election day for June 23. Justice Chifundo Kachale oversaw the re-run. Kachale replaced Jane Ansah as chairperson of the MEC following Ansah’s role in the initial vote. Despite the court’s stern ruling, the extent of potential election malfeasance in the initial vote remains unclear.

Leaders of the opposition claimed that correction fluid inflated the vote totals of the incumbent. In their lawsuit, the leaders implicated the MEC. Conversely, the MEC argued the fluid had only been used to alter procedural information, not the vote totals. Luke Tyburski of the Atlantic Council’s Africa Center inspected the actual results sheets, which citizens can access online. Tyburski’s analysis suggests “human error instead of malicious tampering” likely caused the alterations. However, Tyburski suggests that this “does go a long way toward discrediting much of the sensational rhetoric surrounding the vote.” Whether malice or simply human error caused the error, Malawi’s top court felt compelled to clean the slate with a re-run.

Poverty and the Election in Malawi

The judiciary’s choice has broader implications than simply who serves as Malawi’s president. For one, it fortifies the people’s faith in the rule of law. Elections with contested outcomes are not new to Africa. Many leaders hold shambolic votes with impunity, while other electoral disputes cause a descent into chaos or even civil war. What makes the election in Malawi unique is the willingness of its high court to assert itself when warranted. It would have been easy to simply sanctify the initial elections in accordance with the wishes of the president. But the court chose otherwise. Although needing the courts to intervene in the democratic process is far from ideal, it may be necessary to restore the public’s confidence in free and fair elections.

As Malawi relies heavily on foreign assistance, this show of sound governance can only serve as reassurance for Malawi’s benefactors. These include the International Monetary Fund and the World Bank. Additionally, the court’s decision demonstrates to potential trading partners that the nation can be a stable ally. Despite a GDP growth rate of 4% in 2019, the nation’s extreme poverty rate is still around 20%. As such, the international community must see Malawi as deserving of investment and assistance to help lift its people out of poverty. The result of the re-run can do just this.

Looking Forward

When Malawians returned to the polls on June 23, 2020, the international community had a keen eye on the proceedings. This deterred potential bad actors from any hijinks and ensured that the MEC did its due diligence in properly tallying the votes. Chakwera won convincingly, garnering nearly 59% of the vote, and became president. As a result, the people of Malawi won, and democracy was victorious. This is a positive step toward garnering international aid for Malawi and reducing the poverty its citizens face.

Brendan Wade
Photo: Flickr

VillageReach is Improving Healthcare
The history behind VillageReach is very similar to The Borgen Project’s history. Blaise Judja-Sato, a native Cameroonian, founded VillageReach in 2000 after returning to Africa to aid in the relief efforts of a devastating flood in Mozambique. While he was in Mozambique, Judja-Sato saw a problem with the healthcare system. Since many citizens live in rural areas, the government could not provide them with the medical supplies they needed, which led to their frustration. Thus, she coined the phrase “starting at the last mile” and established VillageReach. Here is some information about how VillageReach is improving healthcare in low and middle-income countries.

Healthcare That Reaches Everyone

VillageReach’s mission is simple. It aims to reach “the last mile” in LMICs (low and middle-income countries) where people do not always have access to healthcare or any at all. Even with VillageReach, 1 billion people do not have access to healthcare. However, VR is working to improve the already existing health systems in different areas. It focuses on four pillars including healthcare accessibility, information availability, human resource constraints and lack of infrastructure. VillageReach is improving healthcare in these countries so that the people in and out of rural areas thrive.

Big Partners

Additionally, VR has over 30 partners that keep its organization running strong. From the Bill and Melinda Gates Foundation to UNICEF, VR has quite an array of influential partners. The President of the organization is Emily Bancroft. She stated that VR “could not have made an impact the last 20 years without the collaborative power of partnership.” The team is spread out over 13 countries. It has headquarters in Seattle, Washington and offices in Mozambique, Malawi and the Democratic Republic of the Congo (DRC).

Drones

Furthermore, in 2019, VR collaborated with the Ministry of Health, Swoop Aero and Gavi, the Vaccine Alliance, to launch the Drone Project in the Équateur Province of the DRC. The partners decided to pick this place in the DRC because of its many geographical challenges. More than half of the health systems in place are only accessible by river. The goal of the Drone Project is to increase vaccine availability in areas that are hard to reach. The drones, provided by Swoop Aero, can take off with the push of a button and land without guidance. It can also carry around six pounds. After the Drone Project’s first flights were successful, the partners are already thinking bigger, brainstorming on how to send other medical supplies and equipment.

COVID-19 Response

Also, VR is a supporter of the COVID-19 Action Fund for Africa. The initiative works to supply PPEs (personal protective equipment) to community health workers in Africa. PPEs are practically inaccessible in most African countries and the consequences are horrible. Health workers stay home or work without PPEs. With health workers not working, there is no way that Africa will be able to stop the spread of COVID-19. VR plays a crucial part in the initiative’s seven-approach plan, which focuses on the last mile and working with similar in-country organizations to accomplish its goals.

Recognition

As a 20-year-old organization, VR received recognition numerous times for its fantastic work in Sub-Saharan Africa. Recently, the Washington Global Health Alliance honored VR with the Pioneers Outstanding Organization Award. The WGHA awards winners that work hard to improve health equity all over the world. The judges select winners, and in 2020, WGHA board member Erin McCarthy led it. VR received an award for its innovative approach, collaborations with local governments in the places it works and its international emphasis on equity.

Overall, from COVID-19 response to innovating delivering vaccines by drones, VillageReach has covered it all in its 20 years of service to the world. VR is improving healthcare, one small rural village at a time.

– Bailey Sparks
Photo: Flickr

healthcare worker emigrationThe emigration of skilled healthcare workers from developing countries to higher-income nations has significantly impacted the healthcare systems of the countries these workers leave behind. The quantity and quality of healthcare services have declined as a result of healthcare worker shortages. While there is still incredible room for growth, recent governmental strategies have incentivized healthcare workers to work in their home countries.

Why Is Healthcare Worker Emigration a Problem?

When healthcare workers emigrate, they leave hospitals in developing countries without enough skilled workers. Lower-income countries are likely to carry a greater amount of the global disease burden while having an extremely low healthcare staff to patient ratio. For example, sub-Saharan Africa only has 3% of all healthcare workers worldwide, while it carries 25% of the global disease burden. In many African countries with severe healthcare worker emigration, like Lesotho and Uganda, hospitals become overcrowded. Furthermore, hospitals cannot provide proper treatment for everyone due to the lack of skilled workers.

This directly affects the quality of care patients receive in countries with high healthcare worker emigration. Newborn, child and maternal health outcomes are worse when there are worker shortages. When fewer workers are available, fewer people receive healthcare services and the quality of care worsens for populations in need.

Why Do Healthcare Workers Emigrate?

The emigration of doctors, nurses, and other skilled healthcare workers from developing countries occurs for a number of reasons. The opportunity for higher wages elsewhere is often the most important factor in the decision to emigrate. Additionally, healthcare workers may migrate to higher-income nations to find political stability and achieve a better quality of life. The rate of highly skilled worker emigration, which has been on the rise since it was declared a major public health issue in the 1940s, has left fragile healthcare systems with a diminished workforce.

Moreover, the United States and the United Kingdom, two of the countries receiving the greatest numbers of healthcare worker immigrants, actively recruit healthcare workers from developing countries. These recruitment programs aim to combat the U.S. and U.K.’s own shortages of healthcare workers. Whether or not these programs factor into workers’ migration, both the U.S. and the U.K. are among the top five countries to which 90% of migrating physicians relocate.

Mitigating Healthcare Worker Emigration

The World Health Organization suggests that offering financial incentives, training and team-based opportunities can contribute to job satisfaction. This may motivate healthcare workers to remain in the healthcare system of their home country. Some developing countries have implemented these strategies to incentivize healthcare professionals to remain in their home countries.

For example, Malawi faced an extreme shortage of healthcare workers in the early 2000s. Following policy implementation addressing healthcare worker emigration, the nation has seen a decrease in the emigration rate. Malawi’s government launched the Emergency Human Resources Program (EHRP) in 2004. This program promoted worker retention through a 52% salary increase, additional training and the recruitment of volunteer nursing tutors and doctors. 

In only five years after the EHRP began, the proportion of healthcare workers to patients grew by 66% while emigration declined. Malawi expanded upon this program in 2011 with the Health Sector Strategic Plan. Following this plan, the number of nurses in Malawi grew from 4,500 in 2010 to 10,000 in 2015. Though the nation still faces some worker shortages, it hopes to continue to address this with further policy changes.

Trinidad is another a country that has mitigated the challenges faced by the emigration of healthcare workers. Trinidadian doctors who train in another country now get government scholarships to pay for their training. However, these scholarships rest on the condition that they return home to practice medicine for at least five years. Such a financial incentive creates a stronger foundation for healthcare professionals to practice in their home country.

A Turn Toward Collaboration

A recent study determined that the collaboration of nurses, doctors and midwives significantly decreased mortality for mothers and children in low-income countries. As developing countries work toward generating strategies to manage the emigration of healthcare workers, a team-based approach can improve the quality of healthcare. When there are shortages of certain kinds of health professionals in remote areas, family health teams composed of workers in varying health disciplines can collaborate to provide care. 

Improving working conditions and providing both financial and non-financial incentives to healthcare professionals in developing countries not only benefits workers and the patients, but the nation’s healthcare infrastructure as a whole. An increase in the number of skilled healthcare workers in developing countries gives people there the opportunity for a better life.

– Ilana Issula
Photo: Flickr

Sanitation in MalawiMalawi is an impoverished, landlocked country in southeastern Africa. As is common among impoverished nations, Malawi critically struggles with health and sanitation. Here are the top 10 facts about sanitation in Malawi.

Top 10 Facts About Sanitation in Malawi

  1. Menstrual hygiene – In Malawi, there are imbedded cultural beliefs surrounding menstruation that lead to communal ignorance. This stigma surrounding menstruation extends to schools, where girls similarly do not receive education about menstruation. Furthermore, most school bathrooms provide little to no privacy. This lack of privacy, combined with the societal shame of menstruation, results in girls leaving school once they get their period.
  2. Hygiene in schools – For children without access to clean water, toilets or soap at home, school can be their only hope of sanitation. Unfortunately, hygiene in schools often falls short in Malawi. As of 2018, only 4.2% of Malawian schools had handwashing facilities with soap and 9% did not have a secured water source.
  3. Education about hygiene and sanitation – Schools are a key tool for educating youth on basic hygiene and sanitation, especially due to the fact that children are effective agents of behavior change. They capable of sharing lessons they learn at school with their local community. However, similar to their lack of sanitation infrastructure, schools also lack education surrounding sanitation in Malawi. Even if schools did offer education surrounding hygiene and sanitation, high rates of enrollment would be required to create a large scale change in behavior. In many rural communities, girls are tasked with traveling long distances to collect water. This responsibility combined with the obstacle of menstruation reduces female enrollment in school.
  4. Toilets – As of 2015, 9.6 million Malawians – almost half of the population – did not have access to an adequate toilet. There are two types of toilets in Malawi. The first is the Western-style with a toilet bowl and a seat; the second is a hole in the ground. The Western-style is common in urban towns and cities while the hole in the ground is common in rural areas.
  5. Open defecation – In 2008, Malawi adopted the Community Lead Total Sanitation and Hygiene program (CLTS) in an effort to make the country Open Defecation Free (OPF). Malawi has made great strides, but 6% of rural communities continue to openly defecate. Open defecation results from inadequate health infrastructure such as toilets and is a key health concern in Malawi. Open defecation is linked to sanitation-related diseases, high child mortality and the spread of cholera.
  6. Access to water – As of 2015, only 67% of households in Malawi had access to basic drinking water. Similarly, 5.6 million do not have access to a safe water source. In fact, pproximately 30% of water points in rural areas were non-functional at any given time. Water is deeply intertwined with sanitation. Without access to clean water people catch water-borne diseases, are unable to stay clean through bathing and risk their safety by traveling long distances to receive water.
  7. Access to local sanitation facilities – As of 2015, only 42% of Malawian rural households had access to basic sanitation services. Consequently, in 2018 there were 9.9 million people in Malawi who did not use basic sanitation. Combined with poor transportation infrastructure, this lack of local sanitation facilities places strain on rural communities. Communities that do not have secure access to water, predominantly rural communities, are reliant on local sanitation facilities to stay clean and healthy. Thus, without such facilities, the risks of experiences the consequences of poor sanitation increase dramatically.
  8. Role of drought – In the past 36 years, Malawi has experienced eight major droughts. Droughts directly cause a reduction in water availability and thus, indirectly impact sanitation. The most recent drought in Malawi occurred in 2016 and disrupted household economic activities by increasing the time needed to search for water. It also increased the degradation of water catchment areas and increased the risk of water-washing diseases due to a prioritization of water for drinking rather than personal hygiene. Drought places another obstacle in the way of achieving universal sanitation in Malawi.
  9. Higher risk of diseases – Poor sanitation and unhygienic practice result in approximately 3,000 under-five child deaths per year in Malawi. Diarrhea is often a tragic consequence of poor sanitation with 11.4% of infant and child mortality resulting from diarrhea. Similarly, even if diarrhea does not result in death, frequent episodes can yield a negative effect on child development, stunting and acute respiratory infections. Furthermore, poor sanitation not only leads to diarrhea but also waterborne illnesses such as cholera. Thus high rates of communicable diseases are intimately tied to poor sanitation in Malawi.
  10. Improvements to WASH services – USAID is an active participant in increasing WASH services in Malawi and has made great progress. In 2015 alone USAID had constructed 60 shallow wells and three boreholes. It built 360,080 toilets with handwashing facilities as well as installed 2600 chlorine dispensers in 25 villages. This progress provides hope for the achievement of universal sanitation in Malawi.

Malawi is an impoverished African nation currently suffering from inadequate sanitation. This lack of sanitation in Malawi not only impacts health but household income and child attainment of education. While progress has been made through organizations such as USAID, more still needs to be done. Please consider visiting the Borgen Project website on information on how to call or email your representatives to put international aid as a priority on the U.S. agenda.

Lily Jones
Photo: Flickr