Inflammation and stories on medicine

3D Printing in Impoverished Nations
3D printing is a technology that has existed since the 1980s. Over time, additive technology has increasingly progressed where various medical applications can use it. 3D printing in impoverished nations has several benefits specifically in medicine and medical services relating to the affordability for the general populous of these nations. 3D printing for medical applications is the process of utilizing a digital blueprint or digital model, slicing the model into manageable bits and then reconstructing it with various types of materials, typically plastic. Here are three examples of 3D printing in impoverished nations.

3 Examples of 3D Printing in Impoverished Nations

  1. Custom Surgical Elements: The use of 3D printing has significantly increased in the manufacturing of customized surgical elements, such as splints. Manufacturers can make these devices and components quickly at a relatively low cost, which would greatly reduce the price of sale to the consumer. The reason for the reduced cost of production compared to conventional manufacturing systems is primarily due to the additive nature of 3D printing. For example, 3D printing actually adds material onto each layer, rather than subtracting (cutting/slicing) and combining material. This results in smaller opportunities for error to occur and the wasting of fewer materials in the long run.
  2. 3D Printed Organs: Many know this particular field of 3D medical printing as bioprinting. According to The Smithsonian Magazine, bioprinting involves integrating human cells from the organ recipient into the “scaffolding” of the 3D printed organ. The scaffolding acts as the skeleton of the organ and the cells will grow and duplicate to support physiological function. Although this particular method is still in the experimental stages, there have been successful procedures performed in the past. Researchers at Wake Forest have found an effective method for bioprinting human organs; they have successfully implanted and grown skin, ears, bone, and muscle in lab animals. Further, scientists at Princeton University have 3D printed a bionic ear that can detect various frequencies, different than a biological, human ear. The researchers behind the creation of this bionic ear theorized that they could use a similar procedure for internal organs. Similar to surgical components, 3D printed organs would greatly reduce the cost of organ transplants. Additionally, it would increase the availability of organs, which are nearly impossible to find. Locating an appropriate match within a specific proximity of the patient has resulted in a global organ shortage. Whilst some have presented a solution in the form of international organ trade, WHO states that international organ trade could provide a significant health concern because of the lengthy trips the organs would experience. 3D printed organs may be a sustainable method to help impoverished nations with supply organs quickly and cheaply.
  3. Prosthetics: 3D printing in impoverished nations could also allow people to print custom prosthetics for those in need. The lack of access to current prosthetics creates a lot of obstacles for people living in impoverished nations. Creating prosthetics with 3D printing technology has the potential to provide a person the ability to accomplish basic, daily tasks in order to support a family. Not only are current prosthetics expensive, but they are also often inconvenient or they prohibit natural motion. For example, Cambodia treats a prosthetic hand as a cosmetic item, leading the majority of the population to refuse the prosthetic due to the lack of functionality. The Victoria Hand project is currently attempting to change this perspective by providing functional, 3D printed prosthetic hands to Cambodia and Nepal. The team has performed user trials, where the aim is to distribute the 3D printed hand to the general populace. Subsequently, the design will go to multiple fabrication services to maximize accessibility.

These three examples of 3D printing in impoverished nations show just how important 3D printing is and will continue to be to aiding those in need. With further development, 3D printing should allow people to receive prosthetics and organ transplants more easily.

– Jacob Creswell
Photo: Wikimedia

Technological Innovation in Sierra Leone
After a civil war in the 1990s and early 2000s and an Ebola outbreak in 2014, Sierra Leone is slowly recovering by investing in its future through technological innovation. The President of Sierra Leone, Julius Maada Bio, stated that “Science and technology is the bedrock for the development of any modern economy.” With its labor force consisting of more than 60 percent of subsistence farming and its GDP being agriculture-based, the West African country has its sights on technology to help diversify its economy. UNICEF, Sierra Leone’s Directorate of Science, Technology and Innovation (DSTI) and businesses are working together to improve the lives of Sierra Leoneans.

UNICEF and DSTI

President Bio created the Directorate of Science, Technology and Innovation (DSTI) in 2018 to further his vision of developing a technology sector in the country. Dr. David Sengeh is the first Chief Innovation Officer of DSTI. UNICEF and DSTI have partnered to support the use of digital data. One result of the partnership is the Free Quality School Education Initiative. The initiative uses data science to help grant free education to every child and give fast feedback on test scores and the quality of education. MagicBox is an open-source data-sharing platform that UNICEF is investing in which includes partners such as Google and IBM. People can use MagicBox to map epidemics in order to reduce the spread of disease and it has helped Sierra Leone since 2014. Its first use was during the 2014 Ebola Crisis in West Africa. It can also collect private and public data on education and poverty.

Drone Medicine Transportation

UNICEF and the DSTI are also testing drones that could deliver medicine and vaccines. Drones could also send pictures and digital data of natural disasters to mitigate hazards to the public. Sierra Leone is the fourth country that UNICEF drone-tested. Aerial imaging, used for mapping infrastructure, transportation and agriculture, helps elevate the country’s development. Since it is one of the least developed countries in the world, drone data pertaining to infrastructure is a good first step in development. For example, only 10 percent of the roads are paved, making transportation slow and difficult. During the rainy seasons, rural floods cut off communities for up to six months. Drones could reach the communities, especially those with HIV and AIDS.

GEN-350

The GEN-350 is a new technological innovation in Sierra Leone that produces drinking water out of the air. Watergen created the generator called GEN-350 in its mission to provide affordable water to countries that lack clean drinking water. The generator simply needs electricity to operate. The GEN-350 can produce up to 900 liters of water a day. About 50 percent of the population lacks clean drinking water, so the generator reduces the possibility of waterborne disease. Waterborne diseases are one of the main causes of death in the country. Water sources for Sierra Leoneans include ponds, puddles and wells that chemicals from mining and agriculture have contaminated. Watergen’s GEN-350 is a long-term solution to clean and affordable water for those in poverty in Sierra Leone and the world.

Technological Innovation Ongoing

The Bill & Melinda Gates Foundation’s $773,000 grant to DSTI’s GIS Portal in 2019 expresses increased interest in Dr. Sengeh’s goal to provide “real-time information for timely access and receipt of services, and optimize service delivery specifically in the provision of maternal healthcare services.” Although technological innovation in Sierra Leone is in its infancy, the government shows initiative with the creation of the DSTI.

A civil war between 1991 and 2002 tarnished its economy, but the country is seeing development as companies such as Watergen and organizations such as UNICEF provide solutions to alleviating the effects of poverty, such as poor education and polluted water.

– Lucas Schmidt
Photo: Flickr

Fake Medicine in Benin
Benin, a West African country about the size of Pennsylvania, has a tumultuous history. The site of the former Dahomey Kingdom, a kingdom that experienced rapid growth due to its involvement in the slave trade, Benin has since faced colonization, war, strife, civil unrest and a flood of pseudo-pharmaceuticals. With such struggles, a country can react in perpetuation or recovery and Benin has chosen the latter. This is most noticeable in the recent progress against fake medicine in Benin.

Fake Medicine in Benin

The origin of the issue of fake medicine in Benin likely relates to the country’s impoverished state. Benin had the 27th lowest per capita GDP as of 2017, at approximately $2,300. In terms of medical intervention, Benin has been desperate for some time now. The CIA lists the risk for Beninese citizens contracting infectious diseases as very high. The diseases responsible for the highest percentage of illnesses are bacterial and protozoal diarrhea, hepatitis A, typhoid fever, dengue fever, malaria and meningococcal meningitis. Benin also faces struggles relating to HIV/AIDS, which resulted in 2,200 deaths in 2018.

As of 2016, the nation spent only about 4 percent of its GDP on the health sector. This lack of financing for government-sponsored health care left an opening for black market interference and fake prescription drugs quickly flooded stores and pharmacies. These drugs often have no active ingredient and do little to fight the diseases that marketing suggests they cure. Instead, they lead to a litany of new health issues, often causing ulcers and organ failure. People have linked over 100,000 deaths to fake medicine in Benin.

The Fight Against Fake Medicine

Corruption has been inherent in most of Benin’s history. The issue of fake medicine in Benin is simply another facet of the same problem. Thankfully, the country is taking steps to address the endemic nature of this devastating problem.

For all intents and purposes, the fight against fake medicine in Benin began in 2009 with the Cotonou Declaration. This declaration focused on addressing the rampant fake medicine black market at the international level, as opposed to limiting the fight to within Benin’s borders. The declaration called for a raised awareness of drug trafficking and a limiting of the freedoms that often occur for those involved. Unfortunately, not much changed following the Cotonou Declaration. Benin raised awareness, but only for a moment, and it did not take any legitimate steps to combat the issue.

True progress began with the launching of Operation Pangea 9, a government organization founded under Benin’s current president, Patrice Talon. The organization works as a task force, set on fighting the manufacturing and selling of fake medicine through raids and legislation. In 2017 alone, the organization seized over 80 tonnes of fake medicine in Benin. This serves as a sign of drastic progress. For comparison, in 2015, the organization seized only about four tonnes of contraband.

The seizures took place throughout a multitude of marketplaces in Benin, resulting in the arrest of over 100 fake medicine traders. These raids and seizures served as stage one of Operation Pangea 9’s plan to eliminate the distribution of fake medicine in Benin. It was extremely successful, yet only addressed a fraction of the issue.

After the success of the seizures, in order to prevent a lapse back into the country’s past, President Patrice Talon’s government went after the suppliers. Many knew that corruption thoroughly aided the success of the selling of fake medicine in Benin. In December 2017, the police staged a raid at the home of Mohammed Atao Hinnouho, a member of Benin’s parliament. The police seized hundreds of boxes of pseudo-pharmaceuticals and arrested Mohammed Atao Hinnouho. This raid led to the outing of a vast number of those involved in the illegal trade and sent a definitive message that no matter the sources or persons responsible, they would face justice.

Conclusion

As of 2019, the country almost entirely eradicated the issue of fake medicine in Benin. The shelves of grocery stores that once held fake medicine now stand empty, and open-air pharmaceutical markets are a thing of the past. People should take the way in which the Beninese government dealt so swiftly with this issue as an example, a sign of what is possible when a country properly focuses attention and resources. Although Benin requires more in terms of setting up a proper health care system, these advancements serve as a sign to the end of an endemic issue and should not be overlooked.

– Austin Brown
Photo: Flickr

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

Improving Ghana's Local Health
Ghana is a small West African country located on the Gulf of Guinea. Agricultural and mineral outputs mostly make up the country’s income. Ghana was the first African state to gain independence in 1957 and has a population of approximately 28,102,471 people. Although Ghana is one of the more stable countries in Africa and has one of the lowest reported HIV infection rates, the country still faces a multitude of health care issues. However, there has recently been a partnership between the Ghanian government and a tech company to work towards improving Ghana’s local health.

Illnesses in Ghana

A variety of illnesses in Ghana are similar to those occurring in developed countries, however, some of these illnesses can be more potent in areas like Ghana. These illnesses include trauma, women’s health issues, pregnancy complications and infections. HIV/AIDS hit Ghana slightly less than other African countries, but it still caused the deaths of 10,300 people in 2012. HIV/AIDS now stands at number six on the list of the top 10 causes of death in Ghana after malaria, lower respiratory infections, neonatal disorders, ischemic heart disease and stroke.

The anopheles mosquito can transfer malaria, but people can also transmit the illness through organ transplants, shared needles or blood transfusions. Malaria most commonly affects pregnant women and children. In 2012, malaria caused the deaths of 8.3 percent of the Ghanian population. It was also the leading cause of death among children under 5, dealing fatal damage to 20 percent of children in that age group. One of the primary reasons for visits to the hospital is infections. Medical professionals can easily treat most malaria cases with three days of pills from the government, however, some may suffer repeated bouts of malaria and it can be fatal is they do not receive treatment.

Ghana’s Medical Drone Delivery Program

In April 2019, Quartz Africa detailed that a community health nurse at the New Tafo Government Hospital in Ghana’s Eastern Region, Gladys Dede Tetteh, ran out of yellow fever vaccines. Mothers and their babies had to wait in a long line in the hot weather. The facility made an order for more vaccines, but in the past, deliveries often took two hours or more to arrive by road from the central medical stores. However, 21 minutes later, from 80 meters in the sky, a drone released a box onto a small lawn quad in the hospital. New Tafo Government Hospital was the first to sign up for Ghana’s new medical drone delivery program to receive medical products from unmanned aerial vehicles. The aim of this program is to reach hard-to-reach communities quickly and efficiently.

The Ghana Health Service’s Partnership with Zipline

The Ghana Health Service recently began a partnership with Zipline, a drone company with the mission of giving every person instantaneous access to medical supplies. Ghana’s Vice President, Mahamudu Bawumia, officially launched the medical drone program on Wednesday, April 24, 2019. Zipline is a partner of the United Parcel Service (UPS), which also provided support when it opened its Rwanda program. Zipline also gained support from the Bill and Melinda Gates Foundation and Pfizer. Zipline’s Omenako center in Ghana is the first of four centers that the company plans to construct by the end of 2019. Zipline also plans to provide supplies to 2,000 health care facilities in order to serve 12 million Ghanaians once it completes all four centers.

Each distribution center will have 30 drones that will work together to make 500 deliveries a day. Zipline approximates that it will be able to make 600 delivery flights a day in total. Many claim that the drones are some of the fastest delivery drones in the world. The drones can fly up to 75 mph, transport around four pounds, fly as high as 99 miles and operate in various types of weather and altitudes.

Zipline’s Role in Reducing Deaths and Providing Vaccinations

The World Health Organization states that “severe bleeding during delivery or after childbirth is the commonest cause of maternal mortality and contributes to around 34% of maternal deaths in Africa.” Ghana’s policymakers expressed that they believe that this new drone delivery system is the first step to improving Ghana’s local health by decreasing maternal and infant mortality rates.

The drones will deliver to 500 health facilities from the Omanako center which has vaccines and medications. With the aid of Ghana’s Expanded Program on Immunization (EPI), Zipline drones will be able to provide support to those suffering from yellow fever, polio, measles & rubella, meningitis, pneumococcal, diphtheria, tetanus and more. Gavi provides the vaccines, which is an international organization with the intention of improving children’s access to vaccines in poor parts of the world. Drones will be able to pass where ground vehicles cannot, such as where there is underdeveloped or poorly maintained road infrastructure. Many also expect that the drone delivery program will reduce wastage of medical products and oversupplied hospitals.

Zipline aims to improve access to vital medical supplies, which in turn will hopefully reduce mortality rates and add to efforts in improving Ghana’s local health. Zipline’s mission in Ghana has only just begun, but so far it has been able to significantly reduce the time it takes to deliver important health supplies. Getting medical supplies and vaccines faster may be able to save a few lives in the future as well. Health issues and diseases like malaria continue to be the major causes of death in Ghana, but Zipline and the Ghanian government are making steps towards improving access to health care.

– Jade Thompson
Photo: Flickr

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