Inflammation and stories on medicine

Worms in Nigerian Children Soil-Transmitted Helminths (STHs) are a type of macroparasitic nematode intestinal infection that transmits to humans through infected soil, more commonly known as worms. These worms typically infest soil when it comes into contact with infected fecal matter, and can directly find its way to a person’s mouth from one’s hands, unwashed vegetables, undercooked meat or infected water supplies. Since STHs become more prevalent with a lack of proper sanitation services, they affect impoverished and developing countries disproportionately more than already developed countries. The World Health Organization (WHO) estimates about 1.5 billion people worldwide have an STH infection. In particular, worms in Nigerian children are a cause for concern.

Types of Worms

The three most common worm infections in humans are hookworms, roundworms and whipworms. Hookworms are the most infectious type since their larva can hatch in the soil and penetrate the skin of whoever comes into contact with it. Infected people with a large number of worms – typically people who go for a long time without receiving treatment – have a high level of morbidity (risk of death). Those with serious infections can suffer significant malnutrition, diarrhea, nausea, vomiting, general weakness and physical impairment.

Nigeria’s Struggle

Nigeria is one of the most at-risk countries for communities suffering from STH outbreaks due to improper sanitation in many urban slums and the warm, tropical climate that worms thrive in. There is a much higher prevalence of worms in Nigerian children – especially when they are of the age to attend school. Overcrowding and improper sanitation of impoverished communities are amplified when children attend school without proper waste or washing facilities. In addition, younger children do not have a fully-developed immune system yet, creating the perfect condition for worm infections.

A study conducted in the slums of Lagos City, Nigeria concluded that the overall prevalence of worms in Nigerian children was at 86.2 percent; of these children, 39.1 percent had polyparasitism. These figures are startling and daunting, but there are effective treatments and preventative measures available. The problem is making the methods of control affordable and accessible for people in poverty.

Organizations Taking Action

Organizations are taking steps to bring proper deworming treatment and sanitation to children in Nigerian slums. The WHO has a comprehensive strategy for combatting STHs in developing countries that the Nigerian Centre for Disease Control is trying to follow. Nigeria is trying to equip school teachers with the proper training to administer worm medicine for children in slums when they attend class. This medicine would be available to school children twice a year, or as needed in some cases.  Even children that do not have worms will be able to access this medicine in order to take precautionary measures against future infection. Even though Nigeria’s infrastructure is not in the right place to make widespread and accessible sanitation a reality for low-income communities, administering affordable medicine to children is a great first step.

The problem of sanitation has fallen to international humanitarian organizations like the United Nations International Children’s Emergency Fund (UNICEF). UNICEF has conducted talks in Nigeria to educate the general populous about the importance of sanitation and taking infectious diseases seriously. With the help of the European Union, UNICEF has also installed a WASH facility in a northern Nigerian rural community. This facility consists of a solar-powered borehole that pipes up fresh well water from the ground into a 24-liter capacity tank to store the clean water safely. With further policy development and implementation measures, these facilities can expand to cover some urban slums as well.

The case of worms in Nigerian children looks bleak at the moment, but the ball is rolling with eradicating the worm epidemic. The increased sanitation of impoverished communities and more affordable and regularly-distributed medicinal treatment can very well make the dream of taking worms out of the equation for Nigerian children a reality.

– Graham Gordon
Photo: Pixabay

Wasted Medical Supplies
The United States generates over two million tons of wasted medical supplies each year. Facilities do not use many of these supplies such as unexpired medical supplies and equipment. People even throw away completely usable, albeit expired medical supplies. This surplus exists because of hospital cleaning policies, infection prevention guidelines and changes in vendors. Additionally, because equipment must always be ready, replacements are always in order. As such, in the U.K., medical facilities replace equipment before the old versions are out of commission. Waste ranges from medicine to operating gowns, all the way to hospital beds and wheelchairs. Beyond consumables like medicine and one-time supplies like syringes, the need to replace before equipment is sub-optimal leaves a margin for waste on big-ticket items like MRIs.

Many hospitals have dumped their garbage from the reception and operating rooms along with usable medical surplus into incinerators. Although this burning is a source of many pollutants, it is still common practice in many developing countries.

This issue of medical supply waste intertwines deeply with a lack of access to medical equipment in the developing world. While developed countries live in a world of sterile excess, developing countries and remote villages with little access to suitable equipment to meet their needs suffer.

How Does this Waste Relate to Poverty?

People view access to the level of health care service in the developed world as the standard rather than a privilege. In places of poverty like Kivu, Democratic Republic of Congo, facilities are in desperate need of supplies and equipment to treat patients in their region.

Inadequate provisions leave patients on the floor or in out-of-date hospital beds paired with another patient. In the DRC, rape is a common weapon of war. The U.N. Human Rights Security Council passed a resolution that described the problem as “a tactic of war to humiliate, dominate, instill fear in, disperse and/or forcibly relocate civilian members of a community or ethnic group.” Many of the patients at the doorstep of Burhinyi Central Hospital are suffering from rape-related ailments. Some examples are HIV/AIDS, fistulas, bladder and intestinal damage and infections. Without the necessary equipment to handle such cases, impoverished areas, which are already more prone to injury and disease, deteriorate.

How Can it be Fixed?

Again, the issue of wasted medical supplies id deeply connected to poverty. In fact, they are complementary. The solution lies in moving the surplus from areas of excess to people in need. This reduces the waste in developed countries by giving supplies to hospitals that need them. Therefore, one can convert wasted medical supplies to usable surplus.

There are many NGOs like Medshare and Supplies Over Seas (SOS) that follow this process. These nonprofits operate based on collecting, sorting and sending the usable medical surplus to hospitals in need.

SOS has a container shipment program that sends cargo containers filled with medical supplies. These containers would have otherwise ended up in the landfill. A typical container contains six to eight tons. Its medical contents value conservatively at $150,000-$350,000. Since 2014, SOS has shipped containers to 20 countries in need.

A volunteer at Medshare outlined her experience working with surplus medical supplies, saying that, “It was shocking how much waste there actually was. Warehouses full of totally usable stuff all ready to be thrown away.” She added, “[she] sorted through things like syringes and gauze packets which were all put into huge containers for hospitals that need it. It feels like a difference is being made.”

Stop Wasting and Start Donating

Wasted medical supplies and impoverished areas without access to proper medical equipment are issues that people can resolve simultaneously by salvaging usable supplies and equipment that were ready to go to landfill and sending them to communities in need. Regarding medical waste and poverty, the best solutions occur when those who have more give to those who have less.

– Andrew Yang
Photo: Flickr

Affordable Medicine in Developing Countries
In 1997, thousands of people in low-income, developing countries died every day from treatable diseases because they could not pay the high price pharmaceuticals charged for medicine. Today in these same regions, millions are receiving treatment and mortality rates have dropped dramatically as drugmakers around the world are providing affordable medicine in developing countries.

Pharmaceuticals in the Past

In 1997, AIDS was killing thousands of Africans each day. In the same year, people with AIDS in the U.S. were enjoying greater life expectancy and quality of life, with AIDS-related deaths dropping by 42 percent thanks to the use of anti-HIV drugs.  With a $12,000 per patient per year price tag and strict patent laws forbidding the purchase of generic types, these life-saving drugs were inaccessible to millions of AIDS victims in developing countries. Unwilling to lower their prices, the pharmaceutical industry looked on while thousands of people died with treatment just beyond their reach.

Refusing to sit by as its people died every day while a treatment existed, South Africa legalized the suspension of drug patents in 1998, making it possible for South Africans to purchase generic anti-HIV drugs at affordable prices. Thirty-nine top pharmaceutical companies promptly engaged South Africa in a lawsuit, attempting to keep them from accessing HIV drugs at a reduced cost for fear that other countries would follow and the industry would miss out on profits.

The pharmaceuticals soon dropped the lawsuit when the international community received word that drug companies were keeping poor and dying people required medicines. However, drug prices remained inaccessibly high.

Finally, a turning point came in 2001 when Indian drug-maker Cipla shocked the international pharmaceutical industry by announcing its plan to sell anti-HIV drugs directly to poor nations and to Doctors Without Borders for only $350 per patient per year (less than $1 a day). Cipla’s offer exposed the huge markups pharmaceutical companies were profiting from, prompting several major drug-makers to lower their prices and make drugs more accessible to developing countries.

Pharmaceuticals Today

Today, the pharmaceutical industry’s attitude and approach toward providing affordable medicine in developing countries have greatly shifted. The Access to Medicine Foundation shares that nearly all major drug companies have goals for addressing access to medicine now, while many have pioneered innovative ways to reduce costs and create medicines and vaccines for low- and middle-income countries (LMICs). In the past 10 years, drug makers have doubled the number of medicines they are developing for LMICs.

Nine companies that own patents for HIV/AIDS treatment now use their IP rights flexibly to allow LMICs to import and purchase generic supplies. As a result, over 14 million Africans are now on HIV drugs, and AIDS-related deaths dropped drastically by nearly 40 percent over the past 10 years.

Seven drug companies have made efforts to include the poorest populations in their customer base, focusing on products for diabetes, heart disease and other NCDs which are a rising problem in the developing world. In 2017, the leading drug maker, Pfizer, partnered with Cipla to sell chemotherapy drugs to African countries at prices just above their own manufacturing cost, selling some pills for as little as 50 cents.

Several leading pharmaceuticals now partner with generics to produce affordable drugs for Africa, Asia and Latin America, and a fair price strategy now covers 49 percent of products. Thanks to the improvements in the pharmaceutical industry, hundreds of thousands of people now have access to affordable medicine in developing countries.

– Sarah Musick
Photo: Wikimedia Commons

 

Living Conditions in Timor-Leste
Timor-Leste or East Timor, a small island between Indonesia and Australia, has struggled with gaining independence since its colonization in the 16th century. The long-standing political turmoil which placated the country throughout much of its history has impacted its economy. The overarching lack of access to raw materials, such as clean water, also depicts the nation’s struggling economy. Below is a list of 10 facts about living conditions in Timor-Leste.

Top 10 Facts About Living Conditions in Timor-Leste

  1. Housing: World Bank estimates from 2016 assumed that Timor-Leste’s economy and its building of national infrastructure would increase steadily over the subsequent three years. It predicted that the growth of the nation would decrease to four percent in 2017, bounce back up to five percent in 2018 and hit six percent in 2019. Unfortunately, the situation concerning Timor-Leste’s housing has remained stagnant. Most people’s houses consist of bamboo, wood and a thatched roof. People that live in urban areas are able to use concrete, which shows a divide in the living conditions in Timor-Leste.
  2. Education: Approximately 20 percent of preschool-aged children in Timor-Leste attend school and nearly 37 percent of young adults living in rural areas are illiterate compared to the six percent in urban areas. Sanitation and access to clean, drinkable water are sorely lacking in schools alone. In 2008, UNICEF began partnering with local agencies to end this issue. It advocated for the establishment of the Basic Law of Education in 2008, the Basic Education Law in 2010 and the National Policy Framework for Preschool Education in 2014 among others.

  3. Agriculture: Agriculture accounts for 80 percent of Timor Leste’s income; its main products include maize, rice and cassava. Very few of the farmers have access to sustainable technologies or practices that are necessary for efficient agricultural production. USAID implemented a plan to address this developmental disparity from 2013 to 2018 through its partnership with Developing Agricultural Communities (DAC). This partnership works with local sectors to teach horticulture technologies and the 349 participating farmers saw great results. Original participants saw their production increase by 183 percent and total revenue by 186 percent, while farmers new to the DAC increased production by 466 to 517 percent.

  4. Access to Food: Due to the heavy reliance on agriculture for survival and income, droughts and shortages of food production can result in high levels of starvation. The 2017 Global Hunger Index classifies Timor-Leste as suffering from high levels of malnutrition. Since 2001, the number of undernourished people has remained stagnant at 300,000. The Sustainable Agriculture Productivity Improvement Project (SAPIP) aims to improve incomes in addition to food and job security to the rural areas of Timor-Leste. It has a six-year-plan agreed upon by the World Bank and government in 2016 and predictions dictate that it should impact 16,500 households and approximately 100,000 people.

  5. Employment: While a majority of the population’s jobs consist of agriculture and farming, there is a huge job market in the science and technology fields. The employment rate is one of the highest that the country has seen in 10 years at 97 percent. This illustrates that while Timor-Leste may be a poor country, it has a lot of untapped potential.

  6. Medicine: Access to doctors and basic medicine has improved over recent years, but many rural communities still seek basic services. New organizations are currently emerging to improve supply chain management of pharmaceutical supplies. There are only 175 doctors that serve the entire population of Timor-Leste. Similar to the United States, citizens have a choice of whether to invest in private or public health care and the government monitors both.

  7. Mosquito-Borne Diseases: Although water surrounds Timor-Leste, the water conditions are poor which make it very easy to contract diseases. The lack of sanitation and regular garbage collection contribute to attracting mosquitoes. Dengue fever and malaria are two of the most common mosquito-borne diseases in Timor-Leste and both have a high mortality rate. Currently, there is no treatment for dengue fever in the area, but there are multiple courses of medical treatment available for malaria.

  8. Water Conditions: Timor-Leste is an island nation, but there is an overall lack of access to clean water that plagues much of the population. Access to clean water and toilets remain a constant issue in Timor-Leste as 353,000 people do not have access to clean water. Subsequently, over half of the population does not have a decent toilet which can lead to major health major issues. In fact, 65 children die each year from dirty water and unsanitary toilets. Women also suffer from managing menstruation, which can greatly inhibit their academic achievements and widen the blatant gender inequality within the country. WaterAid Australia is working tirelessly with the government to make clean water, toilets and good hygiene a part of daily life. The program, which started in 2015, has grown to support WASH delivery service projects in over 180 countries, providing services to approximately 25,000 people.

  9. Plan International: This organization works with various communities across Timor-Leste to provide access to clean water as well as to raise awareness of the importance of handwashing and waste management. Since 2011, it has built 32 village water supply systems which have benefited over 9,000 individuals.

  10. UNFPA Timor-Leste: Maternal health is an issue that has largely slipped through the cracks. In 2010, reports stated that for every 100,000 births in the country, 150 died from complications involving childbirth and pregnancy. Hemorrhaging, anemia, infections/sepsis, labor obstructions and unsafe abortions are the major causes of maternal death. Below are the four pillars that UNFPA works hard to ensure are available to all women:

    1. Modern Contraceptives: Birth control, condoms, etc.

    2. Antenatal care: Routine health screenings of pregnant women without symptoms in order to diagnose diseases or complicating obstetric conditions.

    3. Safe Delivery: A delivery in a medical setting or by a midwife, in which health professionals monitor both the mother and baby.

    4. Emergency Obstetric Care: Basic emergency obstetric and newborn care is critical to reducing maternal and neonatal death.

With the increase of birth rates and access to clean water and food, there is no question that progress is occurring in Timor-Leste. Improvements are slowly diminishing the fatal health issues in the country as these 10 facts about living conditions in Timor-Leste have illustrated.

Joanna Buoniconti
Photo: Flickr

Poverty-Solving TechnologyWhen thinking of drones, the image that comes to mind for many people is of warfare drones and precision strikes. This is not all drones can be used for, however. WeRobotics is an organization that uses drones for humanitarian practices. This organization utilizes the positive impacts of robotic technology to address global problems such as poverty, health and post-disaster reconstruction.

WeRobotics established itself as a not-for-profit organization in December 2015. Since then, their progress has been astounding. WeRobotics and its Flying Labs work with NGOs, government agencies and universities in over 20 countries to spread this beneficial poverty-solving technology.

The company sets up Flying Labs in various countries that serve as a “hub of robotics technology, where staff host training sessions, webinars and teach people how to use technology.” These labs are also “incubators” for the formation of new, local businesses. There are now flying labs in Jamaica, Panama, the Dominican Republic, Peru, Chile, Sierra Leone, Senegal, Côte d’Ivoire, Burkina Faso, Benin, Cameroon, Uganda, Kenya, Tanzania, Zambia, Réunion, India, Nepal, the Philippines, Japan, Papua New Guinea and Fiji.

The robotic technology in these Flying Labs is used for a variety of purposes.The drones can be used for mapping, cargo delivery, drone journalism and conservation. In Nepal, for example, the drones were used to map out the damage done to a region after an earthquake. The map made by the drones was then printed out and annotated by locals to determine strategies and priorities for reconstruction. They also used swimming drones to better understand glacial lakes, which lakes formed by the melting of Himalayan glaciers. These lakes, when forming, have a “tsunami” effect on the areas around them. The swimming drones are used to understand how these lakes are formed and to predict new formations and determine vulnerable areas.

In Peru, the drones are primarily used for cargo delivery of important medicines and vaccines. In the Peruvian Amazon, many people live in areas that are not close to roads or highways. Thus, the main form of transportation is river boat, which can be slow, unreliable and costly. The drones are able to make deliveries of important medicines, such as anti-venom, in a fraction of the time it takes the river boats. In one example, anti-venom was delivered by a drone in 35 minutes, when it would have taken a river boat 6 hours. This can be the difference between life and death. In this way, the drones become poverty-solving technology as they remove barriers created by regional poverty.

One of the most important tenets of WeRobotic’s work is their focus on democratization and localization of technology. This means giving the technology and training to locals with no strings attached. They train locals to be able to use the technology themselves so that the project is respectful of local communities’ autonomy and is also sustainable. Locals in Nepal were able to complete an unfinished map on their own after the WeRobotics team left the site. Because the locals are given access to the information that makes the technology work, they are able to come up with solutions to problems themselves.

Some things that the company notes can be improved are the affordability, repairability, durability, simplicity and battery life of the drones.

This poverty-solving technology has a promising future. It has already provided local communities with means of mapping and transportation, things that are underappreciated in well-off countries, but necessary for civilian life. The possibilities for these humanitarian drones are far-reaching. With more and more people being trained around the world at these Flying Labs, there is more possibilities for improvements and innovative solutions.

– Sarah Faure
Photo: Pixabay

Health Care in Rural Nepal
In the shadow of the Himalayas, the infrastructure of health care in rural Nepal is often at the mercy of inadequate roads that extreme weather can make inaccessible. Despite these struggles, Nepal has lowered its maternal mortality rate from 539 women in every 100,000 live births in 1996 to 239 in 2016 thanks in part to telemedicine.

It was not until 1950 that Nepal began investing in road systems. While still poor, its road infrastructure is most central to development since the country has a declining railway network and air travel is expensive. Corruption and inadequate quality control measures have stymied infrastructure growth.

Natural Disasters and Nepal’s Health Care Facilities

While infrastructure development has improved, the two 2015 earthquakes, both with magnitudes over seven, destroyed 90 percent of health facilities in the immediate area because people did not build the facilities with disaster preparedness in mind. This disaster killed over 9,000 people and displaced 2,000,000.

Such dramatic geography and inadequate infrastructure development have made health care unaffordable and inaccessible for the majority of people. For example, 90 percent of women in the wealthiest quintile delivered their babies in health facilities compared with only 34 percent in the lowest quintile.

Effective Broadband for Health Program

The Internet Society Nepal Chapter and Center for Information and Communication Technology for Development (ICT4D) have implemented the Effective Broadband for Health program. This is a pilot program in rural Dullu, a hard to reach community in mid-western Nepal and has become possible with support from the Beyond the Net Funding Programme. The expansion of broadband is improving health care in rural Nepal.

To get to Dullu, visitors must fly from Kathmandu to Surkhet and then take a dirt four-wheel-drive road 80 kilometers. Dullu’s hospital often does not have enough people and supplies. Lack of funding coupled with harsh winters and poor road infrastructure have made medical supply and staff deliveries very challenging. These problems endanger the lives of Dullu’s 45,000 residents. Many residents are a two to three-day walk from the nearest hospital on trails which people cannot access in the rainy season.

Before video conferencing or the implementation of other internet-based modalities, those behind Effective Broadband for Health first had to amplify the signal from Surkhet to reach Dullu. Pavan Singh Shakya, Executive Director of ICT4D and project manager asserts that “A community healthcare system underpinned by a robust, high-speed Internet access for these communities is the only lifeline.”

After ensuring proper internet connectivity, Effective Broadband for Health stocked Dullu’s community health center with two multiservice portable health kits. These kits store medical records and allow personnel to remotely track diagnoses. The kit has basic diagnostic tools that capture and transfer data via Bluetooth to Dhulikhel Hospital about 700 kilometers away. With this technology, care providers on the ground in Dullu can have real-time consults with medical specialists thus improving health care in rural Nepal.

Telehealth for Women and Girls

One study suggests that telehealth has particular benefits for the wellness of women and girls since it reduces the amount of time it takes to consult with a doctor. Ossified gender norms have confined Nepali women to certain activities and largely restricted their movements to their local community. For example, women must fetch all fuel and water for their family’s needs and enterprises. This labor takes a great deal of time and energy; as such, if medical care is the three-day walk away, they are unlikely to seek it out even if it is necessary.

Societal expectations in Nepal dictate that women must be married in order to seek reproductive or sexual advice from a physician. Since women can be anonymous over mobile phones, more have begun to discuss their sexual and reproductive health with medical providers. These discussions are reducing maternal mortality and improving health care in rural Nepal.

The Chaupadi Practice

Even though access has improved, women in rural Nepal are still dying from practices such as chaupadi. Chaupadi derives from two Hindu words chau meaning menstruation and padi meaning women; it operates under the assumption that menstruating women are impure. During menstruation, women in some areas must sleep separately in a tiny hut called a goth with little food and few blankets for warmth. They cannot interact with others or use a water source.

Even though the Nepali Supreme Court banned chaupadi in 2005, enforcement does not reach rural areas where gender norms are often stronger. A 2011 U.N. survey in the Accham District of Nepal suggested that 95 percent of women still participated in chaupadi. Women participating in chaupadi experience particular health concerns from exposure and malnutrition to increased vulnerability to wild animals such as poisonous snakes. The U.N. does not have statistics on the number of women whose deaths are due to the practice of chaupadi, but the anonymity that telemedicine offers has increased the number of women asking for medical help.

Telemedicine is remaking the face of health care in rural Nepal. One study of women and telemedicine in Nepal found that women reported “increased comfort in seeking consultation through telemedicine for sexual and reproductive health matters” with access to mobile phones and video conferencing. As technology steers health care, the intersection of development, health and gender dynamics must remain of paramount importance and study not only in Nepal but all over the world. Telemedicine is improving health care in rural Nepal.

– Sarah Boyer
Photo: Flickr

drones can save livesThird-world development programs use drones to advance projects more quickly and with fewer expenses. Pilots can volunteer for projects that provide humanitarian aid to remote areas, such as delivering medicine, blood, specimens for lab testing, vaccines and anti-venom. A skilled drone pilot can provide support across the globe to help people in need. Drone pilots can support relief efforts after major natural disasters, and civilian drone pilots (who have the proper authorization) can work with officials in search and rescue missions, provide aerial photography data to help find lost persons, map out disaster areas and help assess damage to an area. Here’s how a drone pilot can use their skills to help save lives around the world.

Four Ways Drone Pilots Can Save Lives

  1. Volunteer Organizations: One of the most well-established humanitarian drone pilot associations is the UAV Aviators Organization founded by Dr. Patrick Meier. This group has more than 3,300 members worldwide and represents 120 countries. Of those members, more than 600 are drone pilots. A drone pilot can find out about volunteer opportunities by registering with the Humanitarian UAV Network and agreeing to the UAV Humanitarian Code of Conduct. There is no cost to join this association. Another volunteer organization is S.W.A.R.M. More than 7,500 SAR pilots volunteer with this organization, serving more than 40 countries. It has an active Facebook group with more than 4,400 members. 
  2. Third-World Development Projects: The World Bank reports there are many benefits when using drones for development projects in third-world nations. Some benefits include easier planning, faster project implementation, less risk to local workers and communities, lower operational costs and surveying before access infrastructure is built in remote areas. The World Bank seeks drone pilots as volunteers and interns for drone flying projects to work in land use administration, forest management, coastal zone protection and environmental risk assessment. Drone pilots can help with medical deliveries, firefighting, contamination sensing and weather prediction. They can also help with guarding endangered animals and natural resource conservation.In 2016, the World Bank executed a drone project to conduct mapping in Kosovo. This mapping occurred after the Balkan wars ended in the late 1990s. The $13.86 million Real Estate and Cadastre Project was operated by the Global Land and Geospatial Unit of the World Bank. Women from Kosovo, who lost their husbands and sons in the wars, worked alone or with other women to rebuild their homes. The wars made it impossible to prove the land was theirs because all the documentation was lost. Without the ability to prove ownership, they could not work the farmland or get loans from the bank. These women had no ability to pay for traditional surveyors. Surveying the land through the use of drones helped them register their rightful ownership to their family’s land.
  3. Disaster Relief With Search and Rescue: Coordinated efforts with local authorities create the most beneficial effects. It is important for pilots to avoid any unintentional consequences of drone deployments in disaster zones, which might interfere with official rescue and relief efforts. Following Typhoon Yolanda, which hit the Philippines in 2013, four key drones were launched by different local and international groups to support the relief efforts. They were used to discover safe and effective areas for NGOs to set up camp, identify passable roads, assess the damage from the storm surge and flooding and determine which villages were most affected by the typhoon. Drone surveillance determined some of the most affected areas, and the data was given to different humanitarian organizations to aid the relief efforts. In Dulag, aerial imagery was used to determine which areas had the greatest need for new shelters. This allowed Medair, a Swiss humanitarian organization, to identify how much material was needed and better allocate their resources to help people as quickly as possible.
  4. Vaccine and Medical Supplies Delivery: In December 2018, a drone delivery brought a life-saving vaccine to a remote part of the island of Vanuatu in the South Pacific near Australia. With funding for the humanitarian project supported by UNICEF and the government of Australia, volunteers working with a company called Swoop Aero were able to deliver vaccines through 25 miles of rough mountainous terrain. Drone use helped the vaccines maintain the proper temperature due to the speed available through drone transport and delivered them and other critical medical supplies to remote areas.In Africa, UNICEF funds a company called Zipline. The staff of volunteers delivers vaccines and other medical supplies by using drones. The deliveries have been made to remote villages in the countries of Rwanda and Ghana since 2016. UNICEF sponsors other projects of a similar kind in Malawi and Papua New Guinea. It may take days to reach these remote villages by car or on foot. A drone can fly to them in minutes and land in a small jungle clearing a plane or helicopter could not use. UNICEF also sponsors programs that use drones to transport specimens from remote locations back to laboratories for testing. This helps health care practitioners make the correct diagnosis and administer life-saving treatment to patients quickly.

Drone pilots have plenty of ways to use their skills to help fight poverty and get involved in global relief efforts. Pilots are encouraged to volunteer to help out locally and/or internationally. As Dr. Peter Meir says, “The best use of a drone is to save a life.”

Mark Sheehan
Photo: Unsplash

Emergency Medical Care in Developing NationsNearly 88 percent of injury-related deaths happen in poverty-stricken countries. There is an urgent demand for emergency care in low- to middle-income countries. One study found that, in these countries, emergency professionals see 10 times the number of cases that a primary doctor does, and the rate of death in these areas is extremely high.

Many emergency care centers in developing countries are severely underfunded and under-resourced. Some lack basic medical instruments while others have medical professionals that work without training or any sort of protocol. The burden of emergency medical care in poor nations is not only due to the lack of medical care or training, but also poor infrastructure. Together for Safer Roads outlines the difficulties presented by deteriorating roads or indirect routes that affect both transport to the emergency scene and transport to the hospital. Improving these roads reduces the likelihood of crashes and unsafe traffic routes and increase the efficiency of trauma transport.

Kenya

Another study done by the National Center for Biotechnology Information (NCBI) has outlined a significant lack of emergency care. Only 25 percent of Kenyans are covered by health insurance, meaning that many must pay for medical care themselves. With so many bearing the financial burden of medical care, it is less likely they would seek it in an emergency.

There are barely any skilled professionals working in emergency medical clinics, resulting in a lack of specific training for emergency medical situations. However, it has recently been recognized as a specialty by both the Medical Practitioners and Dentists Board and the Clinical Officers Council (COC). The other issue at hand in Kenya is the lack of resources. The nation is severely lacking in ambulances, and due to the significant cost of transport by ambulance, many patients take private means like taxis. There is also not a reliable dispatch system in Kenya, making the rapid response of an ambulance unlikely.

The study concluded that there needs to be a creation of new policies at a national level to improve access to emergency care. It also states it is crucial that Kenya recognize emergency care as a significant part of the healthcare system in order to develop authority for emergency response, improve the expensive cost of emergency care and implement a communication network for an emergency system.

Haiti

The country of Haiti has been struck by several natural disasters, making the need for an adequate emergency system crucial. One of the largest issues is the location of clinics and hospitals. The country has around 60, but they are primarily located in larger cities, leaving rural areas with little to no access to trauma care.

Basic necessities like gloves and medicine are things patients have to pay for before they can receive care. Even asthma attacks can be fatal because some cannot afford the inhaler. Also, the medical instruments patients have to pay for out-of-pocket are not necessarily the most up-to-date or high quality. Similarly to Kenya, medical professionals are rarely trained to deal with emergency situations. However, some groups have begun the effort to train professionals in Haiti to be prepared for emergency situations. Dr. Galit Sacajiu founded the Haiti Medical Education Project for this purpose after the earthquakes of 2010. Her courses not only train the nurses and doctors of Haiti but also provide them with the knowledge of what to do with the little or substandard medical instruments they have access to.

Economic Benefit of Improvement

If the amount of injury-related deaths that occur in developing nations was reduced to that of high-income countries, over 2 million lives could be saved. The same study also set out to find the economic benefit of improving emergency care. They found that, if these deaths were reduced, it could add somewhere between 42 to 59 million disability-adjusted life years averted. By using the human capital approach, they also conclude that there is an added economic benefit to the reduction in mortality of $241 to $261 billion per year.

There are several factors that contribute to the effectiveness and availability of emergency medical care in developing nations. These factors mainly concern infrastructure or quality of medical care. Although the issue of trauma care seems far from being solved, a study done by the Brookings Institution states there are indications that it may improve. By monitoring the improvements in medical care in high-income countries, they found that similar improvements were beginning to occur with emergency medical care in developing nations. As trauma care becomes increasingly recognized as an urgent need, it can improve and save thousands of lives.

– Olivia Halliburton
Photo: Wiki

Epilepsy, Indigenous
Epilepsy represents an important public health issue, particularly in low-income communities where significant disparities are present in the care available to patients with epilepsy.

Where there is annually between 30 to 50 per 100 thousand people in the general population in high-income countries who suffer from epilepsy, this figure could be two times higher in low- and middle-income countries. Up to 80 percent of people with epilepsy live in low- and middle-income communities.

Due to the higher incidence of psychological stress, nutritional deficiencies and missed medication, poverty-stricken countries are prompted with greater seizure triggers, situations that precipitate seizures. Mortality associated with epilepsy in low-income countries is substantially higher because of untreated epileptic seizures.

According to a study by The World Bank, indigenous peoples are more likely to be poor as opposed to the general population due to their likelihood of living in rural areas and lack of education. Therefore, what can be said about their epilepsy rates?

Epilepsy in Indigenous Populations

Within the indigenous populations of Bolivia, the prevalence of this non-communicable disease is 12.3 persons out of 1000. This prevalence is also reflected within Canada’s First Nations, wherein 122 per 100,000 persons were found to have epilepsy, twice more than the non-indigenous populations. The numbers were even greater among the Australian Aboriginals, with over 44 percent of patients who were admitted to hospitals identifying as indigenous.

Despite the similarity in epilepsy syndromes among the indigenous and non-indigenous populations, the former presents with more serious degrees of the disease when diagnosed. Research has stated this is related to the inequitable access of healthcare resulting from geographic isolation and cultural issues to treatment.

Geographic Isolation and Epilepsy

The Bolivian Guaraní live in the Bolivian Chaco, a hot and semi-arid region of the Río de la Plata Basin. This area is sparsely populated, but of the 49 percent of indigenous persons, 68.9 percent of them live in conditions of poverty, with everyday issues of energy and sanitation.

Nevertheless, in 2012, an educational campaign directed to the Bolivian Guaraní has been implemented by general practitioners to teach the population about the main causes of epilepsy, its diagnosis, treatment and first aid. They also target the social stigma that exists around the disease.

With the help of programs like Bono Juana Azurduy, Programa Mi Salud, Ley de Gratuidad and Seguros Departamentales, there has been an increase in the social security and improvement in the treatment for epilepsy among the geographically isolated community.

Cultural Issues

Apart from geographic isolation, indigenous populations such as the Aboriginals of Australia also have traditional health beliefs about the causes of epilepsy. For instance, environmental factors like the moon are seen as an epileptic precursor. They also associate a connection with the supernatural due to transgressions as causes of the diseases, making it more difficult to find treatment for the neurological condition.

When such cultural issues arise due to a difference in beliefs, it is important for general practitioners and patients to find a suitable course of treatment that is acceptable for both parties. Various clinics in Far North Queensland, where many Aboriginals reside, have assessed and managed the situation through gathering as much information as possible about the person’s original function and the impact of the disease on them.

They also advise other hospitals treating Aboriginal people to identify and implement strategies, whether they be medication, behavioral, environmental or social, to be developed in conjunction with the patient, their families and communities. In time, it is believed that this will lead to the best interim solution for all parties in the support network and the patient themselves.

Within the Aboriginals living in Canada, the British Columbia Aboriginal Network on Disability Society (BCANDS) has also successfully delivered treatment for epilepsy patients by working as a liaison between service agencies and clients to find the best possible treatment. Their services extend to alleviate anxiety from patients who have previously had negative experiences with healthcare.

Moving Forward

Knowing that epilepsy is a neurological condition that receives substantial stigma in indigenous communities, there is a barrier for patients to have access to biomedical treatment and have it become integrated within the society they live in. Therefore, in order to reduce the burden of epilepsy in poor regions of the world, and especially within indigenous populations, hospitals, non-governmental organizations and the government have much to do. Aid can come in the form of risk factor prevention, offering check-up clinics in rural areas, stigma-reducing educational programs, improving access to biomedical diagnosis and treatment as well as providing a continuous supply of good quality anti-epileptic drugs to patients who need it, irrespective of their background.

– Monique Santoso
Photo: Pixabay

Airstrikes on Syria's Health IndustryIn recent months, Syria has been subject to a series of airstrikes often brought on by its own government, which have had devastating effects on the country. In particular, Syria’s health industry has taken a hit from these bombings with the complete destruction of many medical centers, and the displacement of many doctors and other qualified medical officials. The harsh effects of airstrikes on Syria’s health industry have been devastating.

Located between Lebanon and Turkey and bordering the Mediterranean Sea, Syria is a tiny Middle Eastern nation with a massive global presence. Almost 20 million people make up the population of this country which is roughly one and a half times the size of the state of Pennsylvania. Particularly since 2011, Syria has been involved in a civil war with multiple failed resolution efforts. As a result, as of December 2018, more than 11 million Syrians remain displaced both internally and externally. Roughly 5.7 million Syrians have registered as refugees across Turkey, Jordan, Iraq, Egypt and other parts of North Africa.

Effects of Airstrikes on Syria’s Health Industry

Since late April 2019, Idlib, a northwest province in Syria, has been under constant attack by government forces as well as its militia and Russian allies. Reports state that the violence has hit or completely destroyed 19 hospitals and medical centers in this time, leaving doctors without a location to practice. However, since the civil war began in 2011, others have attacked roughly 350 health care centers throughout Syria on more than 500 individual occasions, leaving almost 900 medical workers dead.

As a result of both the immediate violence that citizens face on a daily basis and the decreasing access to health care, life expectancy in Syria has dropped from almost 76 years in 2010 to 55.7 years in 2015. Additionally, many children under the age of one can no longer access vaccinations for preventable diseases such as measles. At the start of the civil war, 20 percent of these children were without access to vaccinations; by 2014, that percentage went up to 46. By 2017, that number had decreased to 33 percent, as medical professionals made efforts to reach and vaccinate children in areas often more challenging to access.

Due to the decrease in the availability of health care facilities and personnel, Syrian citizens are the ones who face the effects of airstrikes on Syria’s health industry the most. Much of the remaining medical care is focused on treating emergencies such as people injured from explosions or car accidents. Thus, specialized care like gynecologists or orthopedic care is limited. While people can still find emergency care, physical therapy and additional follow-up care are extremely challenging to locate. The violence has to have externally displaced many citizens for them to get this follow-up care to their injuries.

Efforts to Help

An organization called Hand in Hand for Aid and Development (HIHFAD) has been active in providing aid to those still living in Syria. It has mobilized on the ground in teams and worked diligently to provide care to patients. These teams specialize in diagnosing patients, providing equipment and treatment of said patients. Additional NGOs working to provide medical and health-related aid to Syria include Handicap International, International Medical Corps, CARE U.S.A, Save the Children and UNICEF U.S.A.

There is no way of knowing for sure when the civil war in Syria will end and the effects of airstrikes on the health industry continue to devastate Syrians that remain in the country. However, many NGOs are attempting to provide medical care, as are countries harboring an influx of Syrian refugees. The futures of the medical centers and personnel that remain in Syria are undetermined. But for as long as they can, they will continue to provide the best care they can to those in need.

– Emily Cormier
Photo: Flickr