Food Shortages in Tajikistan

Tajikistan is a landlocked country in Central Asia that is home to 9 million people, many of whom have grappled with instability and poverty since its independence in 1992. In fact, half of Tajikistan‘s population lives in poverty today. Furthermore, the country is currently experiencing a food shortage crisis that is exacerbated by a number of factors including a heavy dependence on imported food products as well as inadequate agricultural practices.

Aid from US Initiatives

At least 30 percent of children under the age of five have stunted development. Increasing production in the local agriculture sector is a boost for Tajikistan’s economy, nutrition and general food supply. With equipment and training also provided by USAID, around 16,000 farmers were able to produce higher quality products that increased food security and nutrition. Improving agricultural production is a major step in alleviating the shortages that have plagued the population that currently live below the poverty line as well as helping the local farmers who struggled to make ends meet.

WFP Assistance

The World Food Programme has provided assistance to Tajikistan since 1993 and developed programs that aided people in need. The WFP helped with drafting policies and providing food to over 2,000 schools in rural Tajikistan, allowing over 370,000 students access to regular daily meals. Additional programs alongside the WFP have helped an estimated 119,500 infants under the age of 5 with their nutrition. Assistance is also provided to build new or improve infrastructure to provide security for supplies to rural areas, including additional agriculture production, disaster relief efforts and enrolling children into feeding programs to combat malnutrition. With aid from this program, Tajik children, alongside their parents, gained access to accessible food and medical facilities.

Domestic Poultry Market

Tajikistan’s domestic poultry market has been a major focus on increasing the country’s food security. An investment of expanding domestic poultry farming production in 2015, building new farms and increasing the number of eggs and meat produced for local markets. The poultry industry also got an additional boost in 2018 when the government lowered taxes on imported machinery and tools in 2017 to bolster internal production, though importing poultry still remains as one of the main drivers to meet domestic demand. There are currently 93 farms poultry farms with over 5 million birds currently in the poultry industry. The importance of poultry has on both the economy and the role it plays into combating hunger paves the way to alleviate the food shortages in Tajikistan.

Tajikistan’s effort, normally criticized for being lacking, has expanded upon its agriculture sector with significant investments. Much of Tajikistan’s battle against its internal food shortages have been from foreign aid programs, with various UN members providing the arid country with supplies and equipment to expand internal agriculture and food security alongside Tajikistan’s own national investment to expand them. The efforts have been slowly paying dividends in the Central Asian country, but it still remains a difficult road in alleviating the food shortages in Tajikistan.

Henry Elliott
Photo: Flickr

 

 

Mental Health in the Developing World
According to the World Health Organization, the number of people diagnosed with a mental health disease has increased by 40 percent in the last 30 years. Poverty has been well-established as a driving force behind mental illnesses in the developing world. The Mental Health Foundation reports that 23 percent of men and 26 percent of women among the lowest socioeconomic class are at high risk of mental health problems. However, Psychiatric Times reports that many psychiatrists receive little training on intervening and addressing poverty and its relationship to mental disorders. The nonprofit Grand Challenges Canada is improving mental health in the developing world by funding innovations and expanding access to mental health care.

Mental Health in the Developing World By the Numbers

According to Grand Challenges Canada, 75 percent of the global burden from mental disorders is in developing countries. In addition, a World Health Organization report reveals some cogent statistics about the relationship between poverty and mental health:

  1. Depression is 1.5 to 2 times higher among low-income individuals.
  2. Common mental disorders are more prevalent for people living in poor and overcrowded housing.
  3. People with the lowest socioeconomic status have eight times more relative risk for schizophrenia than those of a higher socioeconomic status.
  4. People experiencing hunger or facing debts are more likely to suffer from common mental disorders.
  5. Evidence indicates the relationship between poverty and poor mental health is cyclical. Grand Challenges Canada is committed to ending the poverty-mental illness feedback loop.

Grand Challenges Canada

According to its website, Grand Challenges Canada has given 159,000 individuals access to mental health treatment. The organization’s project portfolio entails 85 projects in 31 countries and estimates that by 2030, the number of individuals impacted will be between 1.1 million to 3.2 million. Global Challenges Canada has influenced 17 mental health policies in various countries.

One example of Grand Challenges Canada improving mental health in the developing world is The Friendship Bench project in Zimbabwe. In 2012, Grand Challenges Canada funded a controlled study of more than 500 individuals with depression in the country. The patients involved received six 45-minute cognitive behavioral therapy sessions with a lay health worker, one of which took place in the individual’s home. The study found the prevalence of depression throughout program participants after treatment was less than 10 percent versus the approximate 33 percent of non-participants. The program has now spread to more than 70 clinics in Zimbabwe’s three largest cities.

In Vietnam, Grand Challenges Canada partnered with the Center for Creative Initiatives in Health and Population to develop the Smart Care project. The focus of the campaign centers around early diagnosis of autism spectrum disorder (ASD) to enable the best circumstances for children with the disorder. The program is based on a mobile platform, which includes apps to support screening and home-based intervention, a model of pilot screening development and health checkups for children with ASD.

Grand Challenges Canada is improving mental health in the developing world through the funding of technologies that vastly expand access to care. In 2016 and 2017, the organization invested over CA$42 million in projects to mitigate mental disorders. By 2030, Grand Challenges Canada expects to have seen symptomatic improvement in 297,000 to 844,000 individuals involved in projects.

– Zach Brown
Photo: Flickr

Malaria treatmentAt the young age of six years old, YouTube and comedy star Kacaman (aka Darcy Irakoze) just became the latest victim of malaria in Burundi. He was one of the biggest names in Burundi’s comedy scene and had thousands of views on YouTube. His videos, featuring the rural dirt floors and rusty villages of Burundi, were lighthearted and melodramatic skits starring himself and other comedians/actors. Darcy Irakoze is just one example of the need to improve malaria treatment in Burundi.

A Silent Crisis

Kacaman’s death brings to light an often-unspoken crisis: Burundi’s malaria epidemic. Nearly half of the country’s population has been affected by malaria this year. Of that number, 1800 have died from the disease. This staggering amount actually rivals the number of deaths from Ebola in the neighboring Democratic Republic of the Congo.

Poor preventative measures have been the driving factors behind the epidemic. These include a lack of mosquito nets, the movement of the population with low immunity to malaria from mountain areas to city areas and various changes in climate. The crisis has received some attention from the World Health Organization and the United Nations, but it remains remarkably untouched as a result of the current leadership. Afraid of admitting weakness in health policies, President Nkurunziza is hesitant to admit he needs help increasing malaria treatment.

An Epidemic of the Poor

The brutal reality that a six-year-old boy in Burundi can access the internet and YouTube but not malaria treatment presents a serious call for action. Often referred to as the “epidemic of the poor,” malaria disproportionately affects poverty-stricken areas like Burundi because of the expense required to purchase preventative measures and medical treatment.

The disease presents many ramifications for family members of the sick. They deal with psychological pain, the strain on already tight budgets and job loss. Additionally, malaria damages the economic wellbeing of countries as it decreases the chances of tourism and foreign investment. This keeps poor countries in a vicious cycle because they are unable to provide enough funds for malaria treatments or to improve other aspects of their country.

What Is Being Done?

Innovations like the Kite patch offer promising improvement for malaria prevention. The patch works by making humans virtually invisible to mosquitoes for up to 6 hours, stopping any bites. The company is working to distribute the patch around the world through the Kite-Malaria-Free Campaign, but it still needs more funding. The World Health Organization has launched the “high burden high impact” campaign as a response to countries facing extremely large epidemics. This entails a more aggressive approach to preventing and treating malaria by working with national governments in each of the countries to create an organized and strategic approach.

Increasing prevention is still vital in the fight against malaria. Widespread distribution of mosquito nets and insecticide in areas where these items are inaccessible or too expensive could yield massive results. More effective antimalarial treatments are also needed to fight malaria. The problem of the developing resistance to antimalarials in certain populations needs to be addressed to increase the efficacy of the drugs. Finally, a successful malaria vaccination needs to be more accessible. A semi-effective vaccine has been developed, but the technology still requires some fine-tuning.

It is likely at least one child will have died from malaria in the last minute. Kacaman was one of those children. His death should inspire a revitalized passion and determination to conquer malaria. While some incredible advances have been made, more is needed. Hopefully, these efforts can make this world one where malaria treatment and prevention is just as viral as YouTube.

Hannah Stewart
Photo: Flickr

Dengue FeverAccording to the World Health Organization, dengue fever is one of the ten major global health threats of 2019. The mosquito-borne illness results in flu-like symptoms that can kill up to 20 percent of those infected. Approximately 390 million cases of dengue fever are reported each year across 100 different countries, although, many cases go unreported. Cases of dengue fever have also increased 30 times in the last 50 years, meaning that today, 40 percent of the world’s population is at risk of contracting the disease.

Why the Increase?

While dengue fever used to be concentrated in countries with extreme tropical climates, such as India and Bangladesh, the disease is now prevalent in countries that have more temperate climates, such as Nepal. With higher than average temperatures, rainy seasons are lasting longer which creates the perfect environment for the Aedes mosquito, the carrier of the disease. Unfortunately, the geographic regions that the Aedes mosquito inhabits coincide with low and middle-income countries. Many of these countries do not have sufficient health care systems to cope with this major health issue. Therefore, the effects of dengue are even more severe.

Protection from Mosquitoes

The World Health Organization is leading efforts to reverse the increasing threat of dengue fever. One common tactic used is immunization. The first immunization for dengue fever was approved in 20 countries in 2015. However, follow-up data from 2017 showed that the vaccine was actually harmful to those who had never contracted the disease, putting people at a higher risk of more severe cases of dengue. Now, the vaccination is recommended as a measure for those who have already been affected.

In addition to immunization, people can inhibit the Aedes mosquito’s survival and procreation by properly disposing of human waste, and not leaving out any stagnate, uncovered containers of water, as mosquitoes thrive and lay eggs in both environments. It is also advised to use spray insecticide to repel bugs and invest in screened windows and sleeping nets for protection in homes.

Combatting the Threat

The World Health Organization is partnering with local organizations and governments in affected countries to ensure that the number of deaths caused by dengue fever will decrease by 50 percent in 2020. In order to reach this goal, however, additional funding and research are needed so that the scope of dengue fever is properly understood. Health care providers also need the training and resources to properly address the issue and detect the disease in its early stages as well. If dengue fever is diagnosed before the symptoms become too severe, mortality rates of the disease become much more optimistic.

 

Madeline Lyons
Photo: Flickr

Ebola Virus DiseaseImagine traveling 1,316 kilometers from the Democratic Republic of the Congo (DRC) to Uganda seeking medical help for your nine-year-old daughter who seems to have been infected with the Ebola Virus Disease (EVD).

On August 29, 2019, a nine-year-old girl from the DRC was exposed and later developed symptoms of this rare and fatal disease. She was identified at the Mpondwe-Kasindi border point and then sent to an Ebola Treatment Centre (ETC) in Bwera, Uganda. Sadly, not too long after her arrival, the child passed away.

This sporadic epidemic has come back yet again and bigger than last time. This disease has infected the North Kivu Province and has caused more than 2,200 cases, along with 1,500 deaths just this year. Thus, making this the second-largest outbreak in history following behind the 2014-2016 outbreak that killed about 11,000 people. As of September 4, 2019, a total of 3,054 Ebola Virus Disease cases were reported. Out of that total number of cases, 2,945 of them were confirmed reports and the rest of the 109 were probable cases. Overall, 2,052 of those people died.

This disease has had a total of 25 outbreaks since its first flare-up in the Ebola River in 1967. It has plagued countries spanning from the West to sub-Saharan Africa and has a 25 to 90 percent fatality rate. Even though reports are coming from 29 different health zones, the majority of these cases are coming from the health zones of Beni, Kalunguta, Manima and Mambasa. About 17 of these 29 health zones have reported new cases stating that 58 percent of probable and confirmed cases are female (1,772), 28 percent are children under the age of 18 (865) and 5 percent (156) are health workers.

This 2019 case is different because of the way that Ebola Virus Disease is affecting an area of the country that is undergoing conflict and receiving an influx of immigrants. The nation’s “political instability,” random acts of violence and “limited infrastructure” also contribute to the restricted efforts to end the outbreak.  As of June 2019, the disease started its expansion to Uganda, with four cases confirmed near the eastern border shared with DRC, South Kivu Province and Rwanda borders. The World Health Organization (WHO) Country Representative of Uganda, Yonas Tegegn, stated that whoever came into contact with the nine-year-old patient had to be vaccinated.

Out of the five Congolese who had contact with the little girl, four of them have been sent back to their country for “proper follow-ups.” Another 8,000 people were vaccinated against Ebola due to “high-risk areas in the country.”  Overall, 200,000 people in DRC have been vaccinated against EVD along with “health workers in surrounding countries.” With this being said, there is no official vaccination that is known to effectively protect people from this disease. Therefore an “effective experimental vaccine” has been found suitable enough for use. Also, a therapeutic treatment has shown “great effectiveness” in the early stages of the virus.

Ugandan authorities have taken matters into their own hands, strengthened border controls and banned public gatherings in areas that have been affected by EVD. According to the August 5, 2019 risk assessment, the national and regional levels are at higher risk of contracting EVD while the global level risk is low.

The Solutions

The World Health Organization (WHO) is doing everything they can to prevent the international spread of this disease. They have implemented the International Health Regulations (2005) to “prevent, protect against, control and provide international responses” to the spread of EVD.

This operational concept includes “specific procedures for disease surveillance,” notifying and reporting public health events and risks to other WHO countries, fast risk assessments, acting as a determinant as to whether or not an event is considered to be a public health emergency and coordinating international responses.

WHO also partnered up with the Global Outbreak Alert and Response Network (GOARN) to ensure that proper “technical expertise” and skills are on the ground helping people that need it most. GOARN is a group of institutions and networks that use human and technical resources to “constantly alert” one another to rapidly identify, confirm and respond to “outbreaks of international importance.”  WHO and GOARN have responded to over 50 events around the world with 400 specialists “providing field support” to 40 countries.

– Isabella Gonzalez Montilla
Photo: Flickr

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