Smoking in Developing Countries
Smoking rates among adults and children in developing countries have been increasing for years. In developed nations, such as the United States, people have implemented certain policies in order to increase taxes and therefore reduce tobacco consumption, successfully. Such policies have not yet enacted in areas of extreme poverty around the world. In fact, tobacco companies have responded by flooding low-income areas with reduced-priced cigarettes, tons of advertisements and an excessive number of liquor stores and smoke shops. It is time to have a conversation about smoking rates in developing countries and whether or not tobacco control policies are the best approach long-term, worldwide. Here are the top 6 facts about smoking in developing countries.

Top 6 Facts About Smoking in Developing Countries

  1. Smoking affects populations living in extreme poverty differently than it does those in wealthy areas. Stress is a harmful symptom of poverty and contributes to smoking rates in low-income areas. Oftentimes living in poverty also means living in an overcrowded, polluted area with high crime and violence rates and a serious lack of government or social support. Stress and smoking are rampant in these areas for a reason. It is also important to note that smoking wards off hunger signals to the brain which makes it useful for individuals to maintain their mental health of sorts if food is not an option.
  2. Smoking rates are much higher among men than women across the globe. While the relative statistics vary from country to country, smoking rates among women are very low in most parts of Africa and Asia but there is hardly any disparity in smoking rates between men and women in wealthy countries such as Denmark and Sweden. The pattern of high smoking rates among men remains prevalent worldwide. One can equally attribute this to two factors that go hand-in-hand: the oppression of women and the stress that men receive to provide with their families.
  3. The increase in smoking rates in developing countries also means an outstanding number of diseases and death. The good news is that countries have succeeded in reducing consumption by raising taxes on the product. Price, specifically in the form of higher taxes, seems to be one of the only successful options in terms of cessation. Legislation banning smoking in certain public spaces is one example of an effort that places a bandaid on the problem instead of addressing the root cause. There is no data that shows a direct correlation between non-smoking areas and quitting rates among tobacco users.
  4. The World Health Organization (WHO) reports an estimated 6 million deaths per year which one can attribute to smoking tobacco products. It also estimates that there will be about another 1 billion deaths by the end of this century. Eighty percent of these deaths land in low-income countries. The problem at hand is determining how this part of the cycle of poverty can change when it has been operating in favor of the upper class for so long.
  5. Within developing countries, tobacco ranks ninth as a risk factor for mortality in those with high mortality and only ranks third in those with low mortality. This means that there are still countries where other risk factors for disease and death are still more prominent than tobacco use, but that does not mean that tobacco is not a serious health concern all over the world. Of these developing countries, tobacco accounts for up to 16 percent of the burden of disease (measured in years).
  6. China has a higher smoking rate than the other four countries ranked highest for tobacco use combined. The government sells tobacco and accounts for nearly 10 percent of central government revenue. In China, over 50 percent of the men smoke, whereas this is only true for 2 percent of women. China’s latest Five-Year Plan (2011 – 2015) called for more smoke-free public spaces in an attempt to increase life expectancy. A pack of Marlboro cigarettes in Beijing goes for 22元, which is equivalent to $3. This is far cheaper than what developed countries charge with taxes. This continual enablement is a prime example of why smoking rates in developing countries are such a problem. While many people mistake China for a developed nation because it has the world’s second-largest economy and third-largest military, it is still a developing country.

In countries like China where smoking rates are booming and death tolls sailing, tobacco control policies may not be the best solution. While raising taxes to reduce consumption may seem like a simple concept, when applied to real communities, a huge percentage of people living in poverty with this addiction will either be spending more money on tobacco products or suffering from withdrawals. While it might be easy for many people to ignore the suffering of the other, in this case, a lower-class cigarette smoker, one cannot forget how the cycle of poverty and addiction and oppression has influenced their path in life.

Helen Schwie
Photo: Flickr

Health Costs of The Syrian Civil War
The Syrian civil war, which began in 2011, has led to a monumental refugee crisis, hundreds of thousands of deaths, the rise of the Islamic State of Iraq and Syria (ISIS) and destabilization in the Middle East. Yet another devastating effect of the war is the health consequences for people still living in Syria. Civilian doctors and nurses in active war zones face significant challenges not encountered in peacetime. These include a massive amount of trauma victims, shortages of medical equipment and personnel, infectious disease epidemics and breaches in medical neutrality. Here are 10 health costs of the Syrian civil war for the Syrian people.

10 Health Costs of the Syrian Civil War

  1. Because of the war, Syrian life expectancy has plummeted by 20 years from 75.9 years in 2010 to 55.7 years through the end of 2014. The quality of life in Syria has also worsened. As of 2016, 80 percent of Syrians are living in poverty. Moreover, 12 million people depend on assistance from humanitarian organizations.
  2. The civil war devastated Syria’s health care infrastructure, which compared to those in other middle-income countries prior to the war. By 2015, however, Syria’s health care capabilities weakened in all sectors due to the destruction of hospitals and clinics. The country faced a shortage of health care providers and medical supplies and fear gripped the country.
  3. The Syrian Government has deliberately cut vital services, such as water, phone lines, sewage treatment and garbage collection in conflict areas; because of this government blockade, millions of Syrian citizens must rely on outside medical resources from places like Jordan, Lebanon and Turkey. In 2012, the Assad regime declared providing medical aid in areas opposition forces controlled a criminal offense, which violates the Geneva Convention. By the following year, 70 percent of health workers had fled the country. This exodus of doctors worsens health outcomes and further strains doctors and surgeons who have remained.
  4. The unavailability of important medications presents another health cost of the civil war. Due to economic sanctions, fuel shortages and the unavailability of hard currency, conflict areas face a severe shortage of life-saving medications, such as some for noncommunicable diseases. Commonly used medicines, such as insulin, oxygen and anesthetic medications, are not available. Patients who rely on inhaled-medications or long-term supplemental oxygen often go without it.
  5. A lack of crucial medications has led to increased disease transmission of illnesses, such as tuberculosis. Furthermore, the conditions Syrians live in, for instance, the “tens of thousands of people currently imprisoned across the country… offer a perfect breeding ground for drug-resistant TB.”  Indeed, the majority of consultations at out-patient facilities for children under 5 were for infectious diseases like acute respiratory tract infections and watery diarrhea. According to data from Médecins Sans Frontières-Operational Centre Amsterdam  (MSF-OCA), the largest contributor to civilian mortality was an infection.
  6. In addition to combatant deaths, the civil war has caused over 100,000 civilian deaths. According to the Violation Documentation Center (VDC), cited in a 2018 Lancet Global Health study, 101,453 Syrian civilians in opposition-controlled areas died between March 18, 2011, and Dec 31, 2016. Thus, of the 143,630 conflict-related violent deaths during that period, civilians accounted for 70.6 percent of deaths in these areas while opposition combatants constituted 42,177 deaths or 29.4 percent of deaths.
  7. Of the total civilian fatalities, the proportion of children who died rose from 8.9 percent in 2011 to 19.0 percent in 2013 to 23.3 percent in 2016. As the civil war went on, aerial bombing and shelling were disproportionately responsible for civilian deaths and were the primary cause of direct death for women and children between 2011 and 2016. Thus, the “increased reliance on the aerial bombing by the Syrian Government and international partners” is one reason for the increasing proportion of children killed during the civil war according to The Lancet Global Health report. In Tal-Abyad’s pediatric IPD (2013-2014) and in Kobane Basement IPD (2015–2016), mortality rates were highest among children that were less than 6 months old. For children under a year old, the most common causes of death were malnutrition, diarrhea and lower respiratory tract infections.
  8. The challenges doctors and clinicians face are great, but health care providers are implementing unique strategies that emerged in previously war-torn areas to meet the needs of Syrian citizens. The United Nations (the U.N.) and World Health Organizations (WHO) are actively coordinating with and international NGOs to provide aid. The Syrian-led and Syrian diaspora–led NGOs are promoting Syrian health care and aiding medical personnel in Syria as well. For instance, aid groups developed an underground hospital network in Syria, which has served hundreds of thousands of civilians. These hospitals were “established in basements, farmhouses, deserted buildings, mosques, churches, factories, and even natural caves.”
  9. Since 2013, the Médecins Sans Frontières-Operational Centre Amsterdam (MSF-OCA) has been providing health care to Syrians in the districts of Tal-Abyad in Ar-Raqqa Governorate and Kobane in Aleppo Governorate, which are located in northern Syria close to the Turkish border. The health care MSF-OCA provided included out-patient and in-patient care, vaccinations and nutritional monitoring.
  10. New technologies have enabled health officials to assist in providing aid from far away. For instance, telemedicine allows health officials to make remote diagnosis and treatment of patients in war zones and areas under siege. One organization that has used this tool is the Syrian American Medical Society, which “provides remote online coverage to nine major ICUs in besieged or hard-to-access cities in Syria via video cameras, Skype, and satellite Internet connections.” Distance learning empowers under-trained doctors in Syria to learn about disaster medicine and the trauma of war from board-certified critical care specialists in the United States.

Conditions on the ground in Syria make it more difficult for Syrian citizens to receive vital medical aid from health care workers. Many people and organizations are working diligently to help injured and sick Syrians, however. These 10 health costs of the Syrian civil war illuminate some of the consequences of war that are perhaps not as storied as the refugee crisis. While aiding refugees is an undoubtedly worthy goal for international NGOs and governments, policymaker’s and NGOs’ agendas should include recognizing and alleviating the harm to those still living in Syria.

Sarah Frazer
Photo: Flickr

mental health in nigeriaThe West African country of Nigeria is home to about 200 million people. Of these, 20 to 30 percent suffer from a mental illness. The World Health Organization (WHO) ranks Nigeria 15th in the world for suicides. One of the biggest challenges facing mental health in Nigeria is the inadequate number of practitioners and clinics. The WHO estimates that less than 10 percent of those who need help have access to psychiatrists. Additionally, while the global average is nine mental health workers per 100,000 people, the ratio in Nigeria is one mental health worker for every one million people. This could partly be caused by the fact that only around 3.3 percent of the national health budget goes to mental health.

Despite the mental health crisis that is looming there are several organizations working to improve mental health in Nigeria.

4 Organizations Improving Mental Health in Nigeria

  1. Neem Foundation: This nonprofit, nongovernmental organization is doing important work in Borno State to help those who have suffered trauma as a result of attacks by the Boko Haram islamic militant group. In 2017 alone, the organization provided psychological services to over 7000 people in Borno. In order to reach their target of getting to 16,000 more clients by 2019, the foundation began a Counseling on Wheels program which has counselors use motorcycles or motor tricycles to take counseling services to people’s doorsteps. By doing this, they have managed to raise the number of their client reach 12,000 people so far. Besides providing mental health support to individuals, the Neem Foundation also offers training in counseling, trauma care and child-centered therapy.

  2. Mentally Aware Nigeria Initiative (MANI): Launched in June 2016, this Lagos-based nonprofit focuses on creating awareness on mental health and illnesses as well as helping its clients connect to mental health professionals. MANI has a suicide/distress hotline and is planning on launching a mobile app to connect mental health professionals to people in need of help. The organization promotes its advocacy campaigns online using channels such as Twitter, Facebook, Instagram, Youtube and its website to draw attention to different mental health illnesses or other related topics each month. Since 2016, MANI has managed to expand its work to four Nigerian states and provide support to more than 5,000 people.

  3. She Writes Woman: This organization has made great strides since its inception in April 2016. The organization launched the first privately-held, 24-hour mental health line in July 2016 and in April 2018 added a helpline chat service that has received 6,000 messages to date. The organization also founded and curates Safe Place – a support group where women in Nigeria can meet, discuss mental health issues and get the help they need. So far, more than 800 women have benefitted. In partnership with Airtel Nigeria, they have grown and founded Safe Place Nigeria – a walk-in clinic where young people can seek mental health care.

  4. Love, Peace and Mental Health Foundation (LPM): Launched in 2012 in Lagos, LPM carries out advocacy and awareness campaigns to the youth in Nigeria. LPM also founded and curates Umbrella, a men’s-only support group which meets monthly. During the support group meetings, mental health professionals are on hand for observation and consultancy. The foundation also partners with various psychologists and consultants to provide free therapy sessions during these meetings. LPM also ran the #SAVE campaign in 2017 which encouraged creatives to embrace photography, music, art and fashion to raise awareness of mental health in Nigeria.

By creating awareness and challenging the misconceptions and stigma held by the public, these four organizations are helping create an environment in which those suffering from mental health illnesses do not need to isolate themselves or shy away from seeking help. Mental health in Nigeria is sure to improve because of these and other organizations and initiatives.

Sophia Wanyony
Photo: Flickr

African Sleeping Sickness, also known as African Trypanosomiasis, is common in rural Africa. It is spread by the tsetse fly, which is only found in 36 sub-Saharan countries, with about 70 percent of cases occurring within the Democratic Republic of the Congo. When the tsetse fly bites, a sore develops and within weeks hosts suffer from fever, severe headaches, irritability, extreme fatigue, joint pain and skin rashes. As the disease progresses and invades the nervous system, people face confusion, personality changes and ultimately sleeplessness. African Sleeping Sickness can prove to be fatal within months, if not treated.

Due to regional differences, there is both an East African Sleeping Sickness and West African Sleeping Sickness. The Eastern disease is caused by the parasite Trypanosoma brucei rhodesiense, with a couple hundred cases reported each year by the World Health Organization (WHO). The West African Sleeping Sickness on the other hand is caused by a parasite called Trypanosoma brucei gambiense, with nearly 10,000 cases reported annually by the WHO.

The Span of the Disease

Unfortunately, due to the lack of medicine and awareness in these rural African regions, there is minimal caution taken to avoid the disease. The African Sleeping Sickness is often neglected by other countries due to its limited region. A majority of those in affected regions have minimal access to health care or knowledge of disease prevention and treatment. Due to overcrowding and poverty, transmission increases among both animals and people. In fact, 40,000 cases were reported in 1998 from the WHO, but researchers estimate that at least 300,000 cases were left undiagnosed that year. The fear with this is that the disease will be allowed to escalate. There have been cases in which the patients have attacked their own family members, experienced frightening hallucinations or have screamed in gut-wrenching pain.

Treatments

The limited research and knowledge of this disease puts the victims at a heavy disadvantage. While there are a few drugs available for both East and West African Sleeping Sickness, at the moment there is no cure or vaccine. The most commonly used drug, pentamidine, is often used for first stage West African Sleeping Sickness, with other CDC approved drugs being uramin, melarsoprol, eflornithine and nifurtimox. However, these approved drugs can also have negative side effects, with melarsoprol found to have reactions that can prove to be fatal, and pentamidine causing stomach issues. The disease, if left untreated, can lead to meningoencephalitis, coma or death.

Organizational Support

Despite the grim standings of the disease, organizations are making efforts to change the status quo. The WHO is working to supply technical aid to national programs in Africa and are having volunteers deliver anti-Trypanosoma medicines for free. In 2009, the WHO established a biological specimens bank for researchers to conduct studies regarding new drugs and treatments. When attention towards the disease began to fade, the WHO developed a coordination network for victims of the disease to secure and maintain efforts against it. Starting in 2002, Bayer, supplied 10,000 vials of suramin treatment annually for an entire decade. Bayer took steps to expedite the fight against the disease in 2013 by funding and supporting mobile intervention teams in the Democratic Republic of the Congo. Through combined efforts, non-profit organizations as well as private companies are taking great strides against the deadly African Sleeping Sickness.

Haarika Gurivireddygari
Photo: Flickr

Mental health in Sierra LeoneSierra Leone is a West African country bordered by the North Atlantic Ocean. It is an impoverished country with almost half of the working-age population involved in subsistence agriculture. Between 1991 and 2002, Sierra Leone was subject to a civil war that resulted in more than 50,000 deaths. Sierra Leone also experienced a harsh Ebola outbreak in 2014 that outclassed all others. Its citizens are still recovering from these events, which have resulted in years of physical and emotional pain. This has left hundreds of thousands of people plagued with mental health issues in Sierra Leone.

Mental Health in Sierra Leone

The World Health Organization approximates that 10 percent of Sierra Leone citizens are facing mental health problems. This number may be even higher when taking into account cases that have not been officially reported. “[D]aily hardships and misery can turn into what scientists call “toxic stress” and trigger or amplify mental health problems” as a result of living in extreme poverty. For a long time, there was a lack of political support for mental health in Sierra Leone.

Resources are a big problem when tackling the issue of mental health in Sierra Leone. There are only “two psychiatrists, two Clinical Psychologists and 19 Mental Health Nurses” in a country of seven million people. Furthermore, only four nurses are trained to work with children with mental health issues. Due to the absence of support, many citizens seek out help from the traditional healers available.

Many individuals and organizations are working together with the goal of improving mental health in Sierra Leone. Two organizations that have made significant efforts and progress in raising awareness or providing direct aid to mental health services are the Ministry of Health and Sanitation (MOHS) and the World Health Organization (WHO). Both WHO and MOHS have worked together on projects that have greatly improved support for mental health in Sierra Leone.

The Ministry of Health and Sanitation

Most of those infected or family to those infected during the Ebola virus disease (EVD) outbreak experienced trauma. Patients were often isolated from loved ones and surrounded by strangers. People had to cope with the death of family members and friends. Survivors of EVD beat the virus, but they still experienced toxic stress, depression, insomnia and anxiety. MOHS developed a plan for providing mental health services by improving community awareness, building demand for services and improving access to specialized healthcare workers at all levels of care.

The MOHS worked with the Advancing Partners program on a two-year project funded and managed by USAID’s Office of Population and Reproductive Health and implemented by JSI. In Sierra Leone specifically, MOHS’s framework is being used to aid Sierra Leone’s government with the implementation of health service in post-Ebola recovery. The program is improving mental health awareness in the community, training healthcare workers with the skills to provide high-quality care and reinforcing mental health governance.

So far, MOHS and Advancing Partners have created community healing dialogue (CHD) groups. The groups help communities by providing coping mechanisms, finding resources and offering support for those with psychosocial issues. These groups are placed in areas with a large amount of EVD survivors and trained mental health staff. The CHD groups have “reached almost 700 people in 40 communities across the six districts most affected by the Ebola outbreak (Bombali, Port Loko, Kailahun, Kenema, and Western Areas Rural and Urban).”

The World Health Organization

The World Health Organization is focused on training healthcare workers in Psychological First Aid and the identification of distress. WHO developed the mental health gap action programme (mhGAP) to train community health workers and medical doctors in Sierra Leone. This way, healthcare workers will be able to more easily identify mental disorders and discover treatment options. WHO wanted to create an approach that aims to support mid-level and higher level healthcare workers to provide better tailored services.

Sierra Leone was previously a country where mental health needs were not addressed. The country continues to be impoverished since a large part of its population is unemployed. It experienced devastating losses in its 11-year-long civil war and was further distressed by the severe Ebola outbreak in 2014. The country has a large amount of people still suffering from past issues. That suffering went untreated for a long time. However, organizations like the WHO and MOHS have made considerable progress in addressing the mental health in Sierra Leone.

Jade Thompson
Photo: Flickr

Humanitarian Response Plan for LibyaIn Libya, approximately 823,000 people are in need of humanitarian assistance. This prompted the World Health Organization to create a Humanitarian Response Plan for Libya (HRP). Through this plan, WHO targets 552,000 individuals suffering from the Libyan Crisis, which stems from the Arab uprisings and revolts in 2011.

WHO, as well as partner organizations, plans to provide humanitarian assistance that focuses on key needs such as protection, access to healthcare, education, safe drinking water and sanitation and access to household goods such as essential food and non-food items (NFIs). Here is a look inside WHO’s 2019 Humanitarian Response Plan for Libya.

Humanitarian Response Plan for Libya

WHO’s Humanitarian Response Plan for Libya targets seven sectors: education; health; protection; water, sanitation and hygiene (WASH); food security; shelter and non-food items and multipurpose cash. The health sector has the largest portion of people in need, with approximately 554,000 individuals. The two main objectives of the Humanitarian Response Plan for Libya are to

  • “provide and improve safe and dignified access to essential goods and critical public services in synergy with sustainable development assistance,” and
  • “enhance protection and promote adherence to International Humanitarian Law, International Human Rights Law and International Refugee Law.”

This plan requires $202 million in funding. Therefore, each sector has designated funding based on the goals it plans to implement. The main sectors and their goals are as follows.

  1. Protection: The protection sector is geographically focused. The prioritized areas have the most severe conditions. The 2019 plan intends to bridge the gaps in data regarding protection from past years. The HRP also plans to expand protection monitoring, protection assessments and quality of services as well as reinforce community-based responses.
  2. Health: Several healthcare facilities were destroyed and damaged during the crisis. Non-communicable diseases have started to spread throughout Libya as well. The plan provides access to health services at primary and secondary levels. It also aims to monitor diseases. In addition, the plan prioritizes WASH programs, mental health and psychosocial support.
  3. WASH: Another key focus of the Humanitarian Response Plan for Libya is WASH. The plan hopes to focus its attention on newly displaced persons. Thus, the goals of the WASH sector aim to improve WASH facilities in detention centers, respond to urgent needs and technical support. In doing so, the plan hopes to ensure children have access to safe WASH facilities. It also advocates for the repair of the Man-Made River Project. Moreover, this sector will collaborate with the education sector.
  4. Education: The education sector plans to target 71,000 individuals. Children in high conflict areas are being mentally affected by trauma and distress. These can further affect school attendance and performance. The HRP wants to improve formal education by means of teacher training and provide more supplies for educators. As such, this sector will also prioritize mental health in grades 1-12.
  5. Shelter/NFIs: Shelter and NFI sector focuses on the population displacement as well as damages to infrastructure and homes caused by the uprisings. This sector seeks to secure safe housing for those who are displaced. This sector targets about 195,000 individuals to receive shelter aid.

Overall, the Humanitarian Response Plan for Libya is making strides. As of June 2019, WHO has provided trauma kits and emergency medical supplies to 35 healthcare facilities. This is an increase from the first provision in March. Similarly, medicines for chronic and infectious diseases have been given as well as insulin. In terms of mental health, in January, WHO trained 22 participants in mental health through primary health facilities. The sector also provided training for maternal and reproductive health as well. With this momentum, in time, WHO will continue to meet the goals and targets of the 2019 Humanitarian Response Plan for Libya.

Logan Derbes
Photo: Flickr

Global Snakebite StrategyThe World Health Organization (WHO) members gather annually at the World Health Assembly in Geneva, Switzerland. This year’s diverse topics included snakebites.

The WHO is not always known for speedy results, due to the massive, worldly scale that this organization deals with. But snakebites was a topic that was quick to strike back. Just one year after the World Health Assembly urged resolution to this issue, WHO has launched a new strategy for snakebites and the venoms that cause potentially deadly harm to its victims.

Symptoms of Snakebites

According to the WHO, snakes bite an estimated 5.4 million people around the world each year. Of those estimated, approximately 138,000 people die each year. This new strategy looks to cut 50 percent of snakebite deaths and disability by the year 2030.

Snakebites are a common occurrence in regions such as sub-Saharan Africa, Asia, and Latin America. This is a commonly neglected public health issue, especially in impoverished areas of all countries listed above. The only known validated treatment for a snakebite is passive immunotherapy with the specific and effective animal-derived antivenom. These antivenoms are not always accessible, nor readily available in developing areas of these countries.

When a venomous snake bites, the victim has less than half an hour to receive the antivenom, without serious consequences. Serious adverse effects include swelling, pain, and bruising around the bite area, numbness, elevated heart rate, constricted airway, blurred vision, nausea, diarrhea, convulsions, fainting, tissue necrosis, and death. All of these listed symptoms can be from the bite of a venomous snake.

The Global Snakebite Initiative

The global snakebite strategy, or the Global Snakebite Initiative lead by the World Health Organization sets a multicomponent strategy in place in order to improve the availability of safe and effective antivenoms at a global level. The initiative is based on four key steps needed in order to improve these conditions caused by venomous snakes, according to the WHO.

  1. Preparing validated collections of specific venom pools from the most medically dangerous snakes in high-risk regions of the world.
  2. Strengthening the capacity of national antivenom manufacturing and quality control laboratories, and establishing new facilities in developing countries through technology transfer.
  3. Getting established laboratories to generate antivenoms for various regions of the world.
  4. Getting government and relevant health organizations to give snakebite envenoming recognition within national and international public health policy frameworks.

According to the WHO, there should also be actions to improve health information systems, accessibility of antivenoms, proper training of medical and nursing staff, and community-based education. This multicomponent strategy would involve stakeholders on many different levels and would improve antivenom availability globally.

This global snakebite strategy targets countries and communities that are heavily affected by snakebites. The program will work with the affected communities to ensure that through their health systems, safe and effective treatments will be offered to all community members. Complete cooperation, collaboration, and partnership between all levels of government and health organizations will accomplish this.

A Solid Foundation

A 28-member panel of global experts in relations with WHO regional offices, science and research communities, health foundations, advocacy groups and stakeholders developed this strategy. Viewing this issue at a global level improves community education and first response. This strategy also commits to engaging communities in order to achieve these goals.

WHO will work with specific countries to strengthen health systems geared towards improving health and well-being and reducing inequity for community members. The main objective for this global snakebite strategy is to ensure accessible, affordable, and effective treatments using the antivenoms.  A streamlined method of supplying and distributing of antivenoms will be prioritized. Along with all of these steps, WHO will encourage research on new treatments, diagnostics, and health device technology that can improve the treatment outcomes and make for quicker recovery times.

WHO’s global snakebite strategy has implemented multiple factors in order to achieve the goals set forth. Commitment from around the world including health, government, and scientific organizations alike, will need to work together through various aspects for the Global Snakebite Initiative to be effective immediately. Following the steps laid out by the WHO, paralyzation and deaths caused by snake envenoming can be reduced in high-risk countries, and ensure its community members safe, efficient, and effective treatments.

– Quinn McClurg
Photo: Flickr

Epilepsy Treatment in Developing CountriesAround 50 million people experience recurrent and unprovoked seizures globally. People living with this condition have many triggers for these seizures such as psychological stress, missed medication and dehydration. Half of those living with the disease also have additional physical or psychiatric conditions.

While the physical toll of epilepsy is difficult to manage, the emotional toll is equivalently burdensome. In many countries, a large stigma surrounds patients as people perceive those with the disease as insane, untreatable and contagious. As a result, epilepsy affects people’s education, marriage and employment opportunities. The exclusion of epilepsy patients from society can even lead to increased mental health issues and delay access to proper healthcare treatments.

Epilepsy is a treatable condition if people have access to anti-seizure medication. However, roughly 80 percent of all cases are found in low or middle-income countries. Three-quarters of epilepsy patients living in low-income countries do not have access to life-saving treatment. This fact has sparked a movement in global organizations to raise more awareness about the issue of epilepsy treatment in developing countries.

Three Organizations Raising Awareness about Epilepsy Globally:

World Health Organization (WHO)

Up to 70 percent of people living with epilepsy could become seizure-free with access to treatment that costs 5 dollars per person. In order to address this treatment gap, epilepsy awareness must be prioritized in many countries. The WHO suggests that by labeling epilepsy as a public health priority the stigma surrounding the disease can be reduced. The organization believes that preventing acquired forms of epilepsy and investing in better health and social care systems can truly make a difference in alleviating millions.

Since 2012, the WHO has led a program centered around reducing the epilepsy treatment gap. The projects were implemented in Ghana, Mozambique, Myanmar and Vietnam, and utilized a community-based model to bring early detection and treatment closer to patients. Over time, the program yielded some major results in each of the countries it assisted.

Within four years, coverage for epilepsy increased from 15 to 38 percent in Ghana. The treatment gap for 460,000 people living with epilepsy in Vietnam decreased by 38 percent in certain regions. In Myanmar, over 2,000 health care providers were trained to diagnose and treat epilepsy, and around 5,000 community stigma awareness sessions were held. Continued efforts like the ones found in these countries can help spread treatment to regions of the world that need it most.

 

International League Against Epilepsy (ILAE)

The ILAE is another organization raising awareness around epilepsy treatment. The organization consists of health care professionals and scientists who help fund global research for treatment and potential cures to epilepsy. The major goals of the League are to spread knowledge about epilepsy, promote research, and improve services for patients globally.

With six different regions, the ILAE finds various ways to reach its goals of promoting epilepsy awareness, research and access to care globally. For example, the African region will conduct the 4th African Epilepsy Congress in Uganda to share new developments in epilepsy research in August 2019. These types of Congresses are held once a year in certain regions to continue spreading new information effectively.

The ILAE regularly publishes journals to show research findings and breakthroughs in epilepsy treatments and cures. The organization also provides information to patients themselves on topics such as psychological treatments, diet therapies and information for caretakers. With so many resources available, the ILAE has done a major service by spreading information about epilepsy treatment in developing countries.

 

International Bureau for Epilepsy (IBE)

The IBE focuses primarily on improving the social conditions and quality of life for people living with epilepsy. By addressing issues such as education, employment and driver’s license restrictions, this organization helps create environments free of detrimental stigmas. The IBE’s social improvement programs, designed for people with epilepsy and their families, are some of the main ways this organization impacts epilepsy awareness.

International Epilepsy Day is an example of an initiative created by this organization to promote awareness in over 120 countries. On that day, many global events are held to increase public understanding of epilepsy and new research developments that are available. In addition, the Promising Strategies program also funds initiatives improving the quality of life for people living with epilepsy. The program supports 81 projects in 37 countries and provides $300,000 in support of the projects. For example, Mongolia: Quality of Life was a program designed to improve public knowledge and reduce stigma in Mongolia after the number of epilepsy cases increased by 10 percent in 2004. Soon after the program started in 2008, the quality of life in Mongolia for people with epilepsy increased and better services were given to those in need.

These three organizations often collaborate to create new programs to spread information about epilepsy treatment in developing countries. By raising awareness of the condition and providing better healthcare services, the efforts of these organizations have created a more inclusive and helpful environment for those living with epilepsy in countries around the world.

– Sydney Blakeney
Photo: Flickr

Socioeconomic implications of air pollutionAir pollution is commonly understood as an environmental issue. In the U.S., pollution is most commonly tested using the Air Quality Index. The AQI measures air pollution based upon ground-level ozone, particle pollution, carbon monoxide, sulfur dioxide, and nitrogen dioxide levels. Air pollution causes a number of health risks such as cancer and respiratory infections. In 2016, an estimated 4.2 million people died prematurely due to air pollution. Often, the effects of environmental issues have more consequences for the poor. Thus, concerns stemming from air pollution are not just environmental but also socioeconomic.

Who is affected?

About 90 percent of premature deaths by air pollution occur in low-middle income areas. This issue disproportionately affects lower-income households for many reasons. For one, impoverished homes are often dependent upon energy sources such as coal and wood. The burning of these fossil fuels contaminates the air with carbon dioxide emissions and creates indoor pollution. A lack of finances can also result in the absence of healthcare. Without early treatment, people dealing with infections related to air pollution are more likely to suffer fatal consequences.

Research shows that this disparity supports social discrimination. A study in 2016 reports: “The risk of dying early from long-term exposure to particle pollution was higher in communities with larger African-American populations, lower home values, and lower median income”. Minority groups often face prejudice in places such as employment. On average, a black woman makes 61 cents per dollar earned by a white male counterpart. In sum, minority groups ordinarily earn lower wages. This prohibits them from buying more expensive renewable resources.

The largest effects of air pollution take place in the World Health Organization’s South-East Asia and Western-Pacific regions. These regions are primarily occupied by developing nations. With a lack of financial resources, these countries resort to cheap and environmentally unsustainable practices. For example, the slash-and-burn technique is a method used by farmers and large corporations. This technique involves clearing land with intentional fires, which raises carbon dioxide levels.

What are the implications?

When considering the socioeconomic implications of air pollution, it is important to note all of the key facts. Here are a few things to consider:

  • The WHO has declared air pollution as the number one health hazard caused by environmental degradation. Air pollution can cause ischaemic heart disease, strokes, chronic obstructive pulmonary disease, and lung cancer.
  • Worldwide, 1 in 8 people dies due to the effects of air pollution. In 2018, 7 million people passed away because of infections relating to air quality.

Who is helping?

Air pollution should not be overlooked as a serious issue. Fortunately, in recent years there has been a significant movement to combat poor air quality. For example, China has a reputation for being heavily polluted. However, in 2015, the Chinese government was the world’s lead investor in renewable energy. The government invested $26.7 billion in renewable resources, which was twice the amount that the U.S. invested that same year. Furthermore, between the years 2010 and 2015, particle pollution levels in China decreased by 17 percent.

Organizations such as Greenpeace have advocated for better policies surrounding environmental degradation. In 2013, the Chinese government released the Clean Air Action Plan which set forth the initial progress in combating air pollution. Nevertheless, in 2017, Greenpeace recorded that while particle pollution levels continued to decrease, progress had significantly declined. Greenpeace is now urging the government to produce a new plan to further challenge air pollutants.

Air pollution is harmful to the global ecosystem but it also has a profound impact on society. In order to fully understand the consequences of this issue, one must consider the ways in which environmental degradation targets specific groups. The contamination of the environment, or more specifically the air, often affects minorities and the poorest people. Thus, air pollution should be a top priority not only for environmentalists but also for social activists. Luckily, governments are already seeking plans to prevent the outcome of air pollution. By contributing to organizations such as Greenpeace, everyone can advocate for better policies and regulations against the socioeconomic implications of air pollution.

– Anna Melnik
Photo: Flickr

op Seven Facts About Poverty and Oral Health in Latin AmericaIndividuals living in poverty face disparities. Picture-perfect smiles are often out of reach for those living in impoverished conditions. This is due to various socio-economic factors like food insecurity or lack of dental coverage. The Pan American Health Organization found Latin Americans suffer from twice as many cavities as U.S. citizens. The top seven facts about poverty and oral health in Latin America are discussed here.

Top 7 Facts About Poverty and Oral Health in Latin America

  1. Oral health literacy is a neglected topic of research in the Latin American region. A correlation between the levels of oral health literacy in parents and a child’s oral health is present. This demonstrates the importance of furthering research. The Journal of Oral Research states the lack of oral health research is worrisome for the region. Oral health status is unique to each country and region.
  2. A 2016 report found Brazil’s dental market ranks third behind the United States and China. As a nation with one of the fastest-growing beauty markets, Brazil’s oral hygiene market is amongst the world’s leaders. Products such as toothpaste and mouthwash have seen an increase in recent years. A rising population, an emerging middle class, changes in consumer preferences and investment in promotions are causes of the growing market.
  3. In Latin America, there is a shortage of oral health personnel. Most of the dental systems are limited to pain relief or emergency services. In developing countries, such as those in Latin America, individuals are insufficiently covered for oral health care. This is a result of deregulation or privatization of care. A World Health Organization report indicates Chile has a 1.6 dentist-population ratio (one dentistry personnel per 10,000 people). On the other hand, Brazil sits at 12.3 density. The top seven facts about poverty and oral health in Latin America are revealing Brazil to be a dominating country in dental hygiene.
  4. However, the lack of government funding is a barrier for sufficient oral health care in Latin America. Often, government agencies are more likely to provide adequate funding to health care programs aiming at more serious diseases. Recent health surveys in Mexico investigated heart disease, addictions, immunization, chronic disease as well as violence against women. However, these surveys did not investigate oral diseases. Mexico spends approximately 6.2 percent of its budget on healthcare, a statistic below the 9.6 global average. Mexico’s healthcare system reform is projected to focus on prevention. It will reduce healthcare inequality through social factors and impose a new sales tax on sugared foods and beverages.
  5. In 2015, two dental students from Columbia University’s College of Dental Medicine partnered with the U.S. International Health Alliance, a non-profit organization working to advance global health, to bring dental care to children in Guatemala. Nearly 1,000 children received toothbrushes and lessons on oral health care and prevention of disease. The two dental students mentioned the local diet and lack of access to medical or dental care as two causes for the severe dental decay they witnessed.
  6. The Latin American Oral Health Association held a regional symposium to address the periodontal disease and its effect on general health in Latin America in January of 2019. Eighteen countries were represented as the aim of the symposium was to develop a regional plan to address gingival health issues. The symposium focused on the global burden of periodontal diseases on health, problems associated with diagnostic of the condition, problems associated with the treatment of the condition and possible solutions within Latin America.
  7. The University of West Florida’s College of Health studied the impact of social determinants of health, availability of oral health services, drug use and oral hygiene practices in Ecuador. The surveys conducted found participants had a low level of education, high levels of carbohydrates in their diet, poor feeding and prevention practices. The researchers reported their findings to the local authorities and community officials. They also plan to work closely with the Center for Disease Control and Prevention to develop a device to reduce fluoride levels in the community water system.

Though many countries struggle with oral health, these top seven facts about poverty and oral health in Latin America reveal the strides taken in minimizing the problem. Oral health is at the focus of various organizations both within and outside of Latin America. Researchers aim to look into oral health and increase education in the region. While certain countries like Ecuador and Guatemala struggle with oral health, Brazil acts as a model of what those nations can strive to become.

– Gwendolin Schemm
Photo: Flickr