Guinea Worm Disease
“[I want the] last guinea worm to die before I do.” Jimmy Carter may soon get his wish. The former President of the United States has spent the last 30+ years on a number of humanitarian missions through his namesake nonprofit—The Carter Center—but people may undoubtedly see one particular mission as ranking among its magna opera. That mission is to eradicate Guinea worm disease (GWD), and frankly, those worms are unpleasant at best.

What is Guinea Worm Disease?

GWD is a parasitic infection in which extremely small worms enter the human body through contaminated water, leading to crippling, painful blisters about a year later when the matured female worm emerges. It has been infecting people since ancient times, and in the mid-1980s, an estimated 3.5 million cases existed across at least 20 countries, including 17 in Africa. In 2019, however, there were only 54 cases in humans.

Success in Reducing GWD

This is thanks largely to the efforts of The Carter Center, in partnership with the World Health Organization (WHO) and UNICEF. This partnership has been leading the charge against the disease both in introducing preventative measures in hotspots on the ground in Africa and by raising awareness in the developed world since 1986. Since no vaccine or other modern treatment exists for Guinea worm disease, The Carter Center’s strategies most often include working with health ministries and community-based volunteer groups in order to stop the spread of GWD and bring attention to it via health education.

The attention is important because of the rapid ability of the disease to spread. One missed case can lead to 80+ new infections over one year and delay a country’s ability to control the disease for just as long. This is partly why the WHO has strict criteria when assessing the disease in a given area.

When Can One Consider a Country Free of GWD?

A country must have zero new cases for at least three years for it to receive a declaration of being free of GWD. Despite the rigorous criteria, some countries continue to encounter problems confronting the disease. Chad, for example, has reported almost 2,000 infections in dogs in 2019—a testament to the disease’s stealth and endurance over the years.

In fact, “years” may be an understatement—GWD has emerged in Medieval Middle Eastern and Ancient Egyptian texts under a variety of labels, with some Egyptian mummies even showing evidence of the worm’s presence in their remains. The Old Testament even refers to it as a ‘fiery serpent’ (citing the on-fire feeling when the creature emerges through the skin).

The Correlation Between GWD and Sanitation

In more recent years, the disease received highlight in the early ‘80s as an international threat to clean water—which is where the fight to eliminate the disease originated. Even today, GWD exists primarily in countries—notably Chad and Ethiopia—that consistently rank among the poorest in the world (and are thus most lacking in access to clean water).

The Carter Center has sought to combat this shortfall as well, specifically by introducing a straw-like pipe filter that allows people in affected countries to drink from any water source without fear of contamination.

The eradication of the disease would mean the end of widespread, debilitating illness across several predominantly African nations. Although the fight has gone on for decades, the organizations working to eliminate it now say that the end is in sight. Even Jimmy Carter made his wish—that GWD would go before him—as he was battling cancer a few years ago.

Now, the eradication of all diseases of this sort will be the target of the U.S.’s End Neglected Tropical Diseases Act, which entered into law earlier in 2020. The goal of the act is to facilitate and coordinate an effective, research-based international effort to end neglected tropical diseases, such as GWD, with special emphasis on impoverished nations.

If the world meets international goals, GWD would become the second human disease (behind smallpox) and the first parasitic disease to experience eradication. It would also be the first disease to disappear without the use of a vaccine or medicine.

– Bardia Memar
Photo: Flickr

Sanitation in Mali
Access to proper sanitation and clean water is a relatively simple yet incredibly important part of protecting public health. For developing nations like Mali, it can be hard to come by. In rural areas, only 30% of people have access to clean water. This puts them at risk for diarrhea, which is responsible for one out of every nine child deaths in the world. Further, most schools do not have proper toilets for their students, and about half lack a clean water source altogether. People must undergo steps to provide safe water and improve sanitation in Mali. Luckily, some organizations, like Save the Children, are attempting to help.

Save the Children

The Save the Children Fund has been supporting kids around the world since 1919. It works to improve communities in many sectors, including healthcare, education, community development and more. Save the Children first arrived in Mali in 1987 and has been on the ground defending the country’s most vulnerable ever since.

Waterborne diseases pose a great threat to children in developing countries. One of the best ways to tackle this crisis is through proper water, sanitation and hygiene (WASH) products and services. Accordingly, Save the Children has made this a center of attention in its work through the Clean Household Approach (CHA) program. The CHA program emphasizes the importance of WASH products and services and is working to reduce the risk of childhood diarrhea and sanitation in Mali.

Previous programs often looked at the issue from a communal perspective. Public resources became the focus rather than looking at what people could accomplish in each individual household. “People care for and maintain personal belongings better than communal property,” Save the Children reported. With this in mind, the CHA program directs efforts at the household level and not at the community level. Instead of providing sanitation equipment at a communal well where people draw water from, the program is making change directly in the homes where people consume the water.

The Clean Household Approach Program (CHA)

The CHA program differs from other programs with similar goals because it does not simply offer financial aid, it also uses a market-based approach. Save the Children recognizes that household sanitation commodities are not something that people tend to prioritize. Families put food and shelter above the often expensive equipment necessary to secure clean water. To circumvent this, Save the Children is making household sanitation commodities both accessible and desirable.

The CHA program provides vouchers that subsidize the cost of WASH products and services. The program typically provides vouchers after a household member attends a meeting on proper handwashing or a visit to a physician. It also uses a variety of incentives to encourage families to invest in WASH products and services. For example, a home can meet “Clean Household” status by satisfying certain criteria pertaining to proper sanitation practices. They then receive the award of a flag to note their success.

The CHA program also uses marketing strategies and social norms to try to emphasize the importance of WASH products and services. Additionally, Save the Children provides training and collaborates with local business owners to ensure that a supply of WASH products and services is always available.

WASH products and services work. The risk of diarrheal infections falls 47% with proper handwashing, 17% with better water quality and 36% with better sanitation. Through projects like the CHA program, Save the Children has been able to keep over 1 million children healthy and nourished in Mali. It continues to change lives around the world and has shown no signs of slowing down in its support for sanitation in Mali.

– Evan Driscoll
Photo: Flickr

Poverty Eradication in Hungary
Hungary, a country located in central Europe, has a population of roughly 10 million people.  According to Eurostat’s 2016 report, a quarter or exactly 26.3% of Hungarians were at risk of poverty. This translates to about 2.5 million people at risk of poverty in Hungary. In 2008, when the financial crisis created higher poverty and unemployment worldwide, poverty in Hungary was at 28.2%. Upon comparing 2016 figures to those of 2008, trends are improving. Here is some information about poverty eradication in Hungary.

Hungary’s Mandate to Eradicate Poverty

The European Union (E.U.) has created an agenda, the Europe 2020 strategy, marking poverty eradication within the E.U. as one of its key targets. Meanwhile, in September 2015, Hungary adopted the 2030 Agenda for Sustainable Development. The agenda, adopted by all United Nations (U.N.) member states, is committed to eradicating poverty and creating a path towards a sustainable future by 2013 globally.

Yet, Hungary has a plan of its own. Presenting its Voluntary National Review (VNR) at the U.N. High Level Political Forum on Sustainable Development in 2018, Hungary showed its stake in the process of moving forward to achieve sustainable development. The country places a large emphasis on its most vulnerable population—those in poverty.  The basis of poverty eradication in Hungary follows that all should have equal access to natural resources, knowledge, information, market and affordable loans, for instance.

Access to Clean Water and Sanitation

Hungary holds a specific emphasis on the human rights aspects as well as a holistic approach to sustainable development. The country looks to create universal access to clean water and sanitation. In effect, Hungary has proposed the issue of water and sanitation as a standalone goal within its VNR. In fact, Hungary’s tap water is of the highest quality according to European standards, in which water quality parameters reach above adequacy in excess of 95%. This means that Hungary’s tap water is safe to drink.

According to Hungary’s policies, the nation plans to put the correct price on water, allocating water and water-related funding more efficiently. This will occur all the while maintaining water-efficient technologies and practices, implementing Europe’s water-saving culture and improving knowledge and data collection regarding water scarcity and drought risk management.

Public Participation

In order to achieve success within Hungary’s implementation of the Sustainable Development Goals (SDGs), the country is targeting public participation. It intends to establish this through stakeholders and local action.

Measures include planning within the national and local-level scale, investing in and implementing social inclusion campaigns and implementing what works after understanding what does not. Additionally, the intention is to not only identify communities’ needs but address them as well.

According to the 2014-2020 financial framework of European Structural and Investment Funds (ESIF), Hungary looks at three dimensions of social inclusion. The first is measuring inclusive growth for enhanced development impact, which looks at methods that monitor development outcomes and better target social investments. The second looks at enabling inclusive growth in the nation, discussing the ample support local planning and implementation will provide on the national level. The third dimension examines the people behind the numbers, which is a handbook implementing local equal opportunity programs, offering practical guidance and tools that empower local stakeholders, a part of local Equal Opportunity Programs, to effectively mold the local social inclusion landscape.

Child Poverty in Hungary and the Family Housing Allowance Program (CSOK)

Hungary’s child poverty rate has risen from 7% to 17% between 2007 and 2012. Children born into poverty in Hungary are often the most disadvantaged. In 2015, Hungary’s government announced a new major policy, the Family Housing Allowance Program (CSOK), which would effectively give families generous subsidies to buy or build new homes. Subsidies increase based on marital status and the number of children families have. However, the country’s tax benefit favors married families with children. Since the policy’s start, Hungary has increased its fertility rate, partly due to tax preferences, cash grants, loan subsidies, constitutional protections and expensive political signaling.

 Poverty eradication in Hungary can occur through the country’s plan of working together through the cooperation of science, economy, government and civil society. Because of Hungary’s focus on eradicating poverty, the country’s poverty level is below the E.U. average.

– Danielle Lindenbaum
Photo: Flickr

sanitation during covid-19COVID-19, the disease caused by the coronavirus, is often spread through airborne droplets released by breathing or talking and by touching infected surfaces. Good hygiene is therefore an initial line of defense in preventing viral infection. However, hand washing requires access to clean water and effective sanitation. While COVID-19 has changed the way people think about hygiene, the lack of access many people in developing countries have to sanitation during COVID-19 remains the same.

Water Crises and Sanitation During COVID-19

More than one half of people around the world do not have access to high-quality sanitation facilities. Furthermore, COVID-19 has exacerbated this already tenuous water and sanitation situation in many parts of the world. Areas with hotspots, like Cairo and Mumbai, are often crowded with restricted public services.

To manage the immediate effects of COVID-19, governments in developing countries have turned to various short-term solutions. For example, Rwanda has installed mobile hand washing stations, while South Africa has begun to use water trucks. The Chilean government has also suspended water and sanitation charges for citizens. In a pandemic, automated water management systems are especially helpful in reducing loss, expanding access and preserving social distancing. In addition to these governmental reforms, many companies have used technology to shore up water and sanitation during COVID-19 in developing countries. Here are five organizations looking to improve sanitation during COVID-19.

Five Companies Improving Water and Sanitation During COVID-19

  1. Wonderkid: This start-up delivers smart solutions to the city of Nairobi, Kenya. The organization supplies water management software to utility companies to help address customer problems, billing, payments and running water meters. Wonderkid’s smart water meters track non-revenue water that does not reach the customer or leaks out of faulty pipes. Thus, Wonderkid allows water utilities to function more effectively and service more people. As of 2018, Wonderkid had expanded to help 36 utility companies in Mozambique, Nigeria, Malawi and Liberia.
  2. CityTaps: This organization provides poor families in Niger access to water at a much cheaper price than water vendors. Its smart water meters give water utilities more financial stability. Importantly, they can then expand their services to more poor families. This allows companies to meet the current needs for effective hygiene to fight COVID-19.
  3. Drinkwell: Impoverished people in Dhaka, Bangladesh often rely on illicit or expensive water sources. The social enterprise Drinkwell, a brainchild of American English Fulbright fellow Minjah Chowdury, provides water through ATMs. Drinkwell works with mobile service provider Robi Axiata and Dhaka WASA, a local water utility, to do so. It is also collaborating with Happy Tap, a mobile hygiene provider, to provide hand-washing services to people in Bangladesh.
  4. Sangery: Container-Based Sanitation (CBS) like Sanergy are an up and coming sanitation alternative for people in low-income areas. These systems are simpler and cheaper than sewer systems, but they are also cleaner than latrines and open defecation. CBS systems use a container to capture waste, which then turns into fertilizer. Sanergy uses this technology to resolve the sanitation crisis in Nairobi, Kenya. Run by three M.I.T. students, the company provides Fresh Life Toilets that fit into cramped urban dwellings and empty safely. The ability to have a private toilet is essential in practicing social distancing during the pandemic. During COVID-19, Sanergy has also provided 18 hand-washing stations that allow residents to practice good hygiene.
  5. Mosan: Similar to Sanergy, Mosan is a sanitation project based in Guatemala that provides container-based system toilets to people’s homes. The toilets have a durable, urine-diverting design, which keeps urine and feces in separate containers. They cover feces with dry materials like ash instead of water and eventually recycle them into usable fertilizer material. Such innovations make it more likely that people will stay at home during the pandemic. Additionally, Mosan is providing contactless pickup of containers to encourage people to stay home and social distance.

The Future of Sanitation in Developing Countries

COVID-19 has exposed weaknesses in global abilities to provide safe, clean water and sanitation in developing countries. Now, many people lack the water they need to combat the coronavirus. While it is not clear if COVID-19 can spread through human waste, proper sanitation also stops the spread of infectious disease in general.

By shoring up water services and sanitation during COVID-19 in developing countries, governments and other organizations in have provided stop-gap solutions to water and sanitation issues. Technologies like digital water meters, water ATMs, container-based toilets are now saving lives in a new way. Because they help people stay home and keep clean, these solutions allow developing countries to better fight the coronavirus pandemic.

Joseph Maria
Photo: Flickr

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

Top 10 Facts About Sanitation in Malawi

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

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

Lily Jones
Photo: Flickr

Efforts to Eradicate PovertyOn July 29, 2020, Ghana released its Multidimensional Poverty Index (MPI) report, which outlines the various conditions that contribute to poverty in the country. Instead of using a monetary metric, the report looks at education, health and living standards to interpret the rate of poverty and determine the efforts to eradicate poverty in Ghana.

Using data collected between 2011 and 2018, the report found the rate and severity of multidimensional poverty have reduced across Ghana, with significant improvements in electricity, cooking fuel and school attainment.

Overall, Ghana reduced its incidence of multidimensional poverty by nine percentage points from 55% in 2011 to 46% in 2017. This indicates that poverty itself has been reduced and the experience of the impoverished has improved.

Each dimension examined in the report is measured through specific indicators relevant to poverty in Ghana. The government then prioritizes the country’s needs by examining the various deprivations that the poor experience most.

The report concludes that the indicators that contribute most to multidimensional poverty are lack of health insurance coverage, undernutrition, school lag and households with members that lacked any education.

The report also reveals stark differences between poverty in rural and urban populations, with 64.6% of the rural population and 27% of the urban population being multidimensionally poor.

Based on the results of the report, it is paramount that resources must be allocated to the health and education sectors to improve the quality of life for the most at-risk members of Ghana, particularly in rural areas.

Efforts to Eradicate Poverty: Healthcare

The USAID is addressing the need for comprehensive healthcare reform through a multi-pronged approach to improve care for children and women in rural Ghana.

Since 2003, the Ghanaian government has developed and expanded the National Health Insurance Scheme (NHIS), which provides residents with public health insurance. The program has provided many improvements to the healthcare system, but systemic barriers continue to limit the quality and accessibility of care.

In particular, a 2016 study published in the Ghana Medical Journal found that rural hospitals’ lack of personnel, equipment and protocol put women and children at the highest risk. This is attributed to poor nutrition, inability to seek neonatal care and lack of health insurance.

To address barriers to healthcare, the USAID first compiled a network of preferred primary care providers to allow healthcare workers to communicate, educate and synchronize their standards of quality care.

“The networks help connect rural primary health facilities with district hospitals, enabling mentoring between community health workers and more experienced providers at hospitals,” the USAID stated.

The second prong was providing training to government staff and frontline healthcare workers to better understand health data and its uses for maternal and child health decision-making. By using the network of providers and standardizing data, doctors are better equipped to determine whether patients need a referral to a specialized caregiver.

The USAID reports that these improvements have resulted in a 33% reduction in institutional maternal mortality, a 41% increase in the utilization of family planning services and a 28% reduction in stillbirths.

As the healthcare sector has grown stronger and poverty has decreased, the USAID and other outside support have scaled back aid to allow the network of health providers to operate autonomously.

This is a positive indication that the country is moving in the right direction to end poverty and improve the quality of life in the coming years, but it is also a critical moment in its development. The Duke Global Health Institute warns that the country must secure a robust medical infrastructure for the transition to independence to be a success.

According to the Duke Global Health Institute, if global aid is removed too early, the poor will suffer the most. Therefore, they state that it is essential that the government has a firm grasp on funding and organizing principals before they move away from outside aid.

Efforts to Eradicate Poverty: Education

The level of deprivation of education is also heavily dependent on rural or urban residence. The educational dimension is measured by school attendance, school attainment and school lag. In rural areas, 21.1%, 33.9% and 34.4% of the population is deprived of each respective indicator. In contrast, the deprivation is only 7.2%, 10% and 12.8%.

To combat education deprivation, the current government has vowed to make secondary education free in an attempt to retain students who cannot afford to continue their education past primary schooling.

Before secondary school was made free in 2017, 67% of children who attended elementary went on to secondary school. In 2018, the ministry of education reported that attendance had increased to 83%.

To promote education in rural areas, this past March the ministry of education presented over 500 vehicles, including 100 buses, to secondary schools throughout the country.

Efforts to Eradicate Poverty: Living Standards

Deprivation of proper sanitation ranked highest out of all indicators for living standards, health and education. The report stated that sanitation deprivation affected 62.8% of the rural population and 25.8% of the urban population.

Although more than 75% of the country lacks access to basic sanitation, little improvement has been made. Between 2000 and 2015, access only increased from 11% to 15%.

To encourage private investments in the sanitation sector, the ministry of sanitation and water resources hosted a contest between public and private entities to design liquid waste management strategies for different localities throughout the country.

In 2019, nine public and six private partners were announced as winners of a total prize of £1,285,000 and US$ 225,000 respectively – for excellence in the implementation of urban liquid waste management strategies.

Winning strategies included an aquaponic system that sustained vegetable growth with treated water and the rehabilitation of a treatment center to raise fish.

Overall, the competition provided education about sanitation to rural communities, increased access to private toilets and spurred economic interest in developing the sanitation system in Ghana.

Sophie Kidd
Photo: Flickr

Period PovertyPeriod poverty, a significant issue around the world, is an umbrella term that describes inadequate access to menstrual hygiene products, washing facilities, waste management and education. This lack of access impacts women and girls in Namibia, sometimes hindering their health and education. However, Eco-Sanitary Training, a local business, is stepping in to help.

Worldwide Period Poverty

Globally, there are 2.3 billion people that live without basic sanitation. 73% live in homes without sufficient hand-washing facilities. This exacerbates period poverty, as it makes it almost impossible for women and girls to manage their periods.

In many places around the world, menstruation products are very hard to access due to high prices. Although these products are a necessity, many countries still tax them. In Hungary, the tax rate on feminine hygiene products in 2020 is 27%, followed by Sweden and Mexico with 25% and 16% respectively. Some of the countries where female sanitary items are tax-free include Ireland, Malaysia, Tanzania and Lebanon.

An example of how feminine hygiene products affect women can be seen through the story of Suzana Frederick, a 19-year-old single mother who lives at Arusha, Tanzania. Frederick makes around 30,000 shillings ($13) monthly and spends between 1,500 and 3,000 shillings ($0.70 to $1.30) on sanitary products. The amount she spends on the products is  5% to 10% of her salary. This would be equivalent to an American woman with an average wage spending around $169 and $338 for sanitary products.

Period Poverty in Namibia

Period poverty has many consequences for women and girls in Namibia. According to Action Aid, “One in 10 girls in Africa miss school because they don’t have access to sanitary products, or because there aren’t safe, private toilets to use at school.” Many women and girls are also forced to use mattresses, clothes and newspapers every month because they cannot afford sanitary products.

A story from a girl who lives in Namibia reveals that she chose to get a contraceptive injection because her mother couldn’t afford pads. Contraceptive injections – a birth control method of releasing hormones like progesterone to stop the release of an egg – are free in all governmental hospitals in Namibia. Unfortunately, the injections have side effects, including significant bone mineral density loss, and are not intended for regulating menstruation. Another girl, also from Namibia, mentioned that dating older men is the only option that some girls have to get the money needed to afford pads.

How a Local Business Has Helped

Eco-Sanitary Trading is a local business in Windhoek, the capital of Namibia. Around March 4, 2019, the business joined the local market to make affordable pads that are high in quality and can also be reused or discarded. The managing director of the business, Naomi Kefas, mentioned that she got the idea from the realization of the fact that many girls are missing school frequently due to their periods.

For two years, Kefas and her team did extensive research and traveled to places including South Africa, Kenya, India and China to invent a new sanitary pad. They then came up with a product called “Perfect Fit,” a locally produced sanitary pad with good quality and affordability. “Perfect Fit” is benefiting women and girls in Namibia.

Moving Forward

The work that Eco-Sanitary Trading is essential to reducing period poverty in Namibia. However, it is essential that the government and other humanitarian organizations also step in. Moving forward, other barriers to menstrual hygiene products and facilities must be reduced, including high tax rates.

Alison Choi
Photo: Unsplash

Worst Humanitarian Crises
The International Rescue Committee (IRC) ranks the world’s top 20 countries experiencing the worst humanitarian crises annually in order to identify and aid the countries that need it most. For the 2020 Watchlist, the top five countries experiencing the worst humanitarian crises are Yemen, Democratic Republic of the Congo (DRC), Syria, Nigeria and Venezuela. All five were also in the top 10 countries in 2018’s watchlist.

Top 5 Countries Experiencing the Worst Humanitarian Crises

  1. Yemen: For the second year in a row, Yemen is at the top of the list as the worst humanitarian crisis. Most of Yemen’s troubles are due to the civil war that began in 2015. With failed peace talks and a shaky government, the Houthi insurgents, who began the civil war over high fuel prices and a corrupt government, and the Saudi-led coalition of Gulf forces continue to fight. The ongoing conflict has greatly destabilized the country, its infrastructure and its ability to provide services to its people. Around 80% of Yemen’s population (more than 24 million people) need humanitarian assistance. Attacks on infrastructure have further weakened the ability to provide healthcare, education, food, fuel, clean water and sanitation. More than 1.2 million Yemenis face severe food insecurity and around 68% of Yemenis do not have access to healthcare. In 2019, cholera began to spread through Yemen, placing even more pressure on the extremely limited and unprepared healthcare system. The outbreak eventually killed more than 3,700 people.
  2. The Democratic Republic of the Congo: The DRC has been in a state of crisis for nearly 30 years. It began with conflict and corruption fueling under-development and instability in the country. This lead to 17% of the population needing humanitarian aid. Fighting between the military and different ethnic militias is common. Most recently the fighting has been in the East and Central DRC. These internal conflicts have displaced 4.5 million Congolese. These people had to flee their homes and agricultural livelihoods, which also drives up food insecurity. Around 15.6 million Congolese are experiencing severe food insecurity. In 2019, the DRC had both the second-largest Ebola outbreak in history and a measles outbreak. Measles alone has killed more than 4,000 people.
  3. Syria: The home to the largest displacement crisis in the world, Syria has been at war since 2015. As a result, 65% of the Syrian population requires aid. The complex civil war has dilapidated the infrastructure, leaving 54% of health facilities and 50% of sewage systems are non-functional. The conflict has displaced more than 12.7 million Syrians. More than 6 million people are internally displaced and around 5.7 million Syrians are refugees in Europe or neighboring countries.
  4. Nigeria: Nigeria faces internal conflicts in the north, a cholera outbreak and high levels of food insecurity. Around 7.7 million Nigerians need aid, mainly from the northern states of Borno, Adamawa and Yobe. There is a significant difference between the developed areas, like the cities of Lagos and Abuja, and the less developed areas in the north. The north has experienced conflict with Boko Haram, a terrorist group, and its splinter faction, the Islamic State’s West Africa Province (ISWAP). Operating in Nigeria’s North-East region since 2009, Boko Haram and ISWAP present a dangerous threat to Nigeria’s military. As a result, local militias and vigilantes responded against these groups. Due to the conflicts between the terrorist groups and the militias, 540,000 Nigerians are internally displaced and 41,000 people traveled north into Niger. On top of the ongoing fighting, endemic diseases, such as cholera and Lassa fever, are spreading throughout the country.
  5. Venezuela: Due to the near-collapse of Venezuela’s economy and the continued political turmoil, basic systems that provide food, clean water and medicine are in short supply. Hyperinflation drove up the prices of basic goods and services, leaving households without enough money to purchase food. At least 80% of Venezuelans are experiencing food insecurity. Additionally, only 18% of people have consistent access to clean water. Without healthcare, people are unguarded against disease. With 94% of households in poverty, Venezuelans are compelled to leave the country. By the end of 2020, the IRC estimates that 5.5 million Venezuelans will emigrate. This will cause the largest internal displacement in Latin America and the second-largest refugee crisis in the world behind Syria.

Help on the Ground

There are many NGOs working to alleviate the situation in these countries. Organizations like the Red Cross, IRC and Doctors Without Borders among many others, have been working for years in conflict-heavy countries. For example, Doctors Without Borders set up mobile health clinics to provide maternal health, vaccinations and treat non-communicable diseases in Syria. The International Committee of the Red Cross increased its budget to $24.6 million in 2019 to ramp up efforts to improve “health, water and sanitation” in Venezuela. The International Rescue Committee brought health, safety and education to 2.7 million people in the Democratic Republic of Congo 2019. It provided healthcare, supplies and sanitation aid to the area.

David Miliband, the president and CEO of IRC, stated, “It’s vital that we do not abandon these countries when they need us most, and that governments around the world step up funding to these anticipated crises before more lives are lost — and the bill for humanitarian catastrophe rises.” These five worst humanitarian crises in 2020 show the world that there is much work still needed. With continued aid and funding from all governments, the U.N. and its agencies and NGOs, millions of people can receive the help that they so desperately need.

Zoe Padelopoulos
Photo: Flickr

WASH in Serbia
Water pollution in Serbia is primarily caused by the inadequate discharge of wastewater. Unequal practices of waste removal disproportionately impact rural and Roma communities, as these groups tend to rely on wells and local waterways that are often exposed to industrial contamination. In fact, 22% of the Roma population does not have access to improved water sources, making them especially susceptible to waterborne diseases. Although there is still much work needed to ensure that everyone in Serbia has access to adequate Water, Sanitation and Hygiene (WASH), the situation is far from stagnant. Here are nine facts about how WASH in Serbia is improving.

9 Facts About WASH in Serbia

  1. The OM Christian church started a non-governmental organization in 2014 to assist vulnerable populations in Serbia and other Mediterranean countries. As part of its religious beliefs, the church has enacted a variety of humanitarian work, including establishing adequate sanitation facilities.
  2. The Serbian government has implemented a national program dedicated to the improvement of WASH. Furthermore, the Republic of Serbia now recognizes WASH as a fundamental human right. Through their national program, the government implemented a variety of initiatives promoting hygiene in schools and health facilities. The government has also implemented long-term initiatives dedicated to the sustainability of water supplies.
  3. The United Nations Developmental Agency (UNDP) implemented the Protocol on Water and Health in 2013, which is currently active in 170 countries, including Serbia. Through this program, the organization aims to establish a variety of sustainable development goals in Serbia by 2030. Specifically, goal 6 of the program aims to provide clean water and improved sanitation facilities for all Serbians.
  4. In 2019, the European Investment Bank (EIB) gave a 35 million Euro loan to the Serbian city of Belgrade to fund improved sanitation and a wastewater treatment plant. The EIB has been supporting Serbia by loaning money for WASH development projects since 2000. This latest donation is expected to improve the living conditions of more than 170,000 people in the region.
  5. The KFW Development Bank is working to assist Serbia in funding a variety of infrastructural projects. Through their Financial Corporation, the bank is providing improved WASH facilities for 20 Serbian towns, which sustain a collective population of more than 1.3 million people. In early 2020, Belgrade constructed a water treatment plant through the KFW Development Bank’s funding.
  6. The European Union’s Water Framework Directive is working to improve water quality and ensure the proportionate distribution of water from the Tisza River, a major tributary of the Danube and one of the primary water sources for Serbia and four other European countries. The organization aims to carry out this project through a three-step initiative. These steps include traditional water resources planning, structured participation and collaborative computer modeling.
  7. USAID has been present in Serbia since 2001. In 2014, the organization donated $20 million to create a new reservoir in Preševo, which helped provide water to residents of this region.
  8. Serbia has been a member of the Open Government Partnership since 2012. The country has committed itself to be more transparent about its environmental information and budget allocations, which will promote accountability for the government to improve its water and sanitation facilities.
  9. Ecumenical Humanitarian, a Christian organization, has been assisting the Roma people, Serbia’s most vulnerable population, since 2007. The NGO has been working to build sustainable housing and sanitation units for this marginalized group.

Although there is still much progress to be made, the initiatives and improvements implemented over the past years demonstrate that there is hope for improved WASH in Serbia. Moving forward, these organizations must continue to make water and sanitation in the nation a priority.

– Kira Lucas
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Sanitation in East TimorEast Timor is a Southeast Asian country that is located on the eastern half of the island of Timor. Detrimental health and sanitation in the country, alongside the household effects of unsanitary water management, have notably impacted East Timor’s agricultural-based economy. Sanitation in East Timor has thus become vital to national rehabilitation projects.

East Timor has a long history of colonial and other foreign occupation; however, the nation has been independent since 2002. From the point of liberation in 2002 until 2008, the country experienced violent policing and political upheaval. This came as a result of unrest regarding national security. Instability led to the involvement of an Australian-led International Stabilization Force (ISF) and the United Nations Integrated Mission in Timor-Leste (UNMIT). These peacekeeping forces remained active in East Timor until 2008 when rebels within the country lost power. Since 2008, the country has experienced steadiness in national security, presidential guidance and rebuilding of important infrastructure like sanitation.

10 Facts About Sanitation in East Timor

  1. The stabilization of governance within East Timor has enabled rectification of sanitation infrastructure. After East Timor gained independence in 2002, economic destabilization had a lasting impact on the country’s ability to invest in renovating sanitation infrastructure. Oil revenue in the country, along with agricultural revenue, has struggled to increase over the past 15 years. In addition to governmental stabilization, aid from multiple international programs supports sanitation development in East Timor.
  2. East Timor’s governmental efforts to address water sanitation have stabilized urban access to clean drinking water. Of the 1.18 million people living in East Timor, 30% of the population lives in urban centers. The 2015 Millennium Development Goal (MDG) for sanitation in East Timor was set at 75% improved access to water sources and 55% improved sanitation. In terms of the urban population, just 9% live without access to improved water sources; 27% live without access to improved sanitation. As of 2015, sanitation in East Timor’s urban areas had reached MDG targets.
  3. Sanitation in East Timor’s rural regions is a work in progress. While urban water sanitation initiatives to reach MDG targets have successfully brought clean drinking water and waste management to urban cities, the remaining 70% of the population of the country is often without reliable access. Data shows that 40% of the rural population remains without access to clean water sources and 70% without improved sanitation. Because MDG goals were not met in rural East Timor, governmental plans for extending access to sanitary water into rural parts of the country have been implemented with the goal of completion by 2030.
  4. Reconfiguration of irrigation infrastructure is key to increased crop output from rural workers. Stabilization of irrigation consists of routing water from the river weirs to crop fields. In addition, it also includes the management of crop flooding as a result of natural disasters within the country. The importance of an updated irrigation system is central to the stabilization of the agro-based rural economy of East Timor.
  5. Rural agricultural workers have experienced personal benefits from the restoration of sanitation infrastructure. Because 70% of the population lives in rural regions of East Timor, agricultural-based livelihoods dominate the workforce. Nearly 42% of rural farmers live in poverty and rely on independent subsistence practices for food. Not only does crop output better the independent livelihood of agricultural workers, but it also provides a source of sustainable local subsistence.
  6. While education represents 10% of the overall GDP expenditure in East Timor, many schools continue to lack access to sanitary water. According to UNICEF, 60% of primary schools and middle schools have access to improved water sources, though 30% do not have access to functioning waste facilities. UNICEF is implementing a water, sanitation and hygiene (WASH) program in order to create sustainable community habits of maintaining waste facilities. This initiative is expected to increase community sanitary habits, health and enrollment rates throughout the country.
  7. Bringing a sanitary water supply to health outposts in rural East Timor has been a focus of the country’s health administrators. Around 50% of rural health centers are without access to clean water. In response, the WASH program from UNICEF is working locally to improve sanitation in health centers. WaterAid is working with local health facilities to improve maternal health outcomes by providing resources for sanitary reproduction.
  8. The Ministry of Health in East Timor has set a goal to entirely alleviate the issue of open defecation across the country by the end of 2020. UNICEF statistics show that around 170 communities, along with a 21,000-household municipality, have been open-defecation free with the organization’s support.
  9. Diarrhea-related deaths have decreased as a result of improved water sanitation in East Timor. Data shows that diarrhea-related deaths decreased by 30.7% between 2007 and 2017. With UNICEF’s WASH program, the incidence of chronic diarrhea will decrease as poor water sanitation is resolved. UNICEF is focused on alleviating poor quality drinking water in five rural municipalities in particular.
  10. Childhood malnutrition rates related to water sanitation in East Timor decreased by 1%. World Bank data from 2013 claims that just over 50% of children in East Timor were stunted in growth as a result of malnutrition; in 2014, reports showed that 49.2% of children had signs of stunted growth. In a single year, steady improvement to water sanitation within the country decreased rates of childhood malnutrition.

Lilia Wilson
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