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The conflict between the government of Iraq and ISIL resulted in millions of Iraqis without health care access. The ongoing conflict has created widespread insecurity in the region, and this insecurity keeps people away from an area which in turn keeps funding very low.

Humanitarian organizations, including the World Health Organization (WHO), have only received $5.1 million out of the $61 million they need from the international community to provide health care services. As a result, 84 percent of frontline programs have been stopped. This has left 3 million Iraqis without health care access.

Vital services include trauma care, primary healthcare, outbreak detection and management, immunizations, and reproductive health care services.

According to a spokesperson for WHO, Tarik Jasarevic, 5.8 million kids need to be vaccinated in 2015 and 2016. It is imperative these children receive polio vaccinations considering cases of polio have occurred in Iraq in 2014 — fortunately none have been reported since April 2015. Currently, the polio vaccination campaign has a $45 million funding gap.

U.N. agencies and their partners are looking to fundraise $498 million to cover costs of shelter, food, water and other life-saving services for the rest of 2015. This is a challenging task, given only 15 percent of it was secured as of July 2015.

Despite the insecurity in the region, shouldn’t the international community provide the necessary funding, given the unfortunate situation 3 million Iraqis are in? Such aid would also keep those affected from having to resort to desperate means and join radicalized organizations.

Paula Acevedo

Sources: United Nations Radio, UN News Centre
Photo: Flickr

Online CBT therapy for low-income patients
The World Health Organization has stated that the world is facing a human rights emergency in mental health. In many developing countries, mental health concerns are left untreated and undiagnosed.

Many studies in the past have shown a correlation between poverty and depression, among other mental health issues (such as social anxiety and low self-esteem). Poor socio-economic status is also a significant risk factor for children to develop psychological disorders.

However, the sad truth is many of the poorer populations across the globe do not have adequate means of access to mental health professionals, if any access at all. Many patients are left undiagnosed due to both a lack of resources as well as the associated stigma of psychological issues.

Psychological health is undeniably vital to the functioning of a productive human being and, consequentially, a productive society. Unfortunately, treatments for mental health are usually expensive and lengthy, and diagnosis is more elusive than with any physical maladies. Even in developed countries like the United States, psychological disorders far outrun the span of available treatments.

One of the most popular treatments is cognitive-behavioral therapy, or CBT. It is used to address a multitude of behavioral and psychological complaints, including depression and anxiety. The therapy is different from usual psychotherapy in the sense that the patient does not talk about anything whatsoever. Instead, the therapist and the patient set up a tangible goal. They then work through the patient’s cognitive process to achieve said goal, as well as address the negativities that were keeping him from it. The process of cognition — everything the patient is thinking — is then used to change the behavioral outcome.

The results of this therapy have shown great success. It is advantageous not only in its effectiveness but also in its structure: by working through the patient’s psychological issues in a more cohesive manner, the technique can be time-effective as well. Despite its success, the fact remains that it is still quite inaccessible to many low-income patients in need of psychotherapy.

In an answer to this dilemma, psychotherapy has paired up with the marvel of our age: the Internet. Many providers now offer online psychotherapy, either for free or for a fraction of the cost of face-to-face interactions with a therapist. The increasing pervasiveness of the Internet, even in the remotest regions, coupled with the low cost means that online therapy makes a therapist accessible to score more people.

The added benefit of the online version of a therapist is that it removes social pressure. A patient in need can interact with a therapist and use self-help sections of the web through the anonymity of a computer screen. The structured and evidence-based nature of the therapy, as opposed to traditional methods, makes it ideal for self-help and interactive online methods in the absence of a real therapist. An online therapist or counselor can also guide patients through any difficulties.

Many studies that have been done in the recent past strongly indicate the potential for online CBT to help low-income patients. However, the issues associated with the methodology remain, particularly that of self-diagnosis. There are also concerns that the therapy being physically removed from a person may cause a higher risk of dropout in patients, especially those with chronic depression. If these logistical issues are ironed out, there is no doubt that online CBT will be the undisputed answer to the psychological concerns of low-income patients.

Atifah Safi

Sources: WHO, Science Direct, Journals of The Royal College of Psychiatrists, Psych Central
Photo: Buzzfeed

Trading Trash for Health Care in Indonesia
Three out of five Indonesians do not have access to health insurance and do not make enough money to visit the doctor. Instead, Indonesians delay their health and wellbeing until their symptoms turn into major problems.

In Jan. 2014, Indonesia started a new health insurance program managed by the Social Security Organizing Body (BPJS). By 2019, it will be the world’s largest health scheme, and according to the government, all 247 million residents will be covered. The health program impacts the middle class the most — that is, the people who are not poor enough to receive government assistance and not rich enough to buy private insurance.

After one year, the BPJS enrolled 133.4 million people in their new health program, exceeding their goal by 11.8 million members. Lack of infrastructure makes it harder for people in rural areas to make the drive to an urban hospital.

Dr. Gamal Albinsaid, the founder of Garbage Clinical Insurance, helps over 3,000 people afford health coverage by trading trash for health care. In Indonesia, many recyclables are wasted and only 50 percent of all of the country’s trash is collected. The abundance of trash left on the streets creates health problems for their citizens. A total of 3.22 million tons of plastic waste were generated along the coast of Indonesia in 2010. This was 10 percent of the world’s total that year.

All of the organic trash Albinsaid receives is turned into fertilizer and compost, while he receives cash for recyclable items. Four and a half pounds of plastic is enough to allow one patient two monthly visits to Albinsaid’s clinic.

“We’re changing people’s perceptions and habits towards garbage,” Dr. Albinsaid explains. “I believe if the positives of this problem are made known, it will excite a lot more people into adopting it.”

Indonesia ranks forty-eighth in the world for health and wellness and has an average life expectancy of 70 years. Health care in Indonesia is far from universal, but the country is doing better than most of its other Southeast Asian neighbors to promote health.

Only 0.9 percent of Indonesia’s GDP is spent on infrastructure for health care. Most of the gaps in the healthcare system are being taken care of by NGOs that treat Indonesians in the poorest and most rural areas of the country. An increase in health care spending is needed for Indonesia to successfully create a universal coverage program.

While many Indonesians may be critical of the universal health care plan, labeling it as “too ambitious,” the program is only 19 months old but is already showing signs for potentially being the largest universal health care program in the world. Until then, Garbage Clinical Insurance and NGOs are providing health services to many of Indonesia’s rural citizens.

Donald Gering

Sources: Al Jazeera, Good News Network, The Guardian, Huffington Post, Social Progress Imperative, World Bank
Photo: Inquirer

The "Internet Hospital" in China Helps Patients Access Care
The Internet has proven a great advancement in many fields of work with recent trends of globalization. We are more connected than ever, and access to the Internet is not dependent on economic status. For example, people living in developing countries can access the Internet through inexpensive mobile phones.

What if patients could receive healthcare services via the Internet?

This concept has been actualized in the Guangdong province of China with the innovation of an “Internet Hospital.”

This “hospital” provides outpatient service delivery. Patients only need to travel short distances from their homes to local medical consultation facilities. At the facility, the patient is able to meet with a doctor from a high-level hospital that is more central to the city. The consultation occurs with a webcam and instant messaging.

The doctors ask questions of the patient, who can also send or show images of medical checks. While this takes place, the patient’s body temperature, blood pressure and other medical information are collected. It is then sent to the doctor, who can use the data in combination with the webcam interaction to diagnose the patient and write a prescription immediately.

This type of healthcare service is ideal in China because high-level hospitals are often overcrowded expensive. Patients are less likely to visit local health clinics because they are perceived to provide low-quality care. To some extent, skilled doctors also choose not to work in small communities with fewer opportunities for career growth and increased salaries.

The advantages of the Internet hospital include high-quality and personalized health care accessed from more convenient locations. In high-level hospitals, doctors are likely to spend only a couple of minutes which each patient; however, the Internet hospital allows these same doctors to spend more than 10 minutes with each patient. Furthermore, the average cost of drugs from local clinics is only a quarter of that of drugs purchased at top-level hospitals. While the same skilled doctor writes the prescription, the medicine is purchased from the local clinic versus the large hospital.

Implementation of the Internet hospital has proven successful. More than 500 patients are seen every day and there are now over 1,000 sites for the medical consulting facilities. These facilities have high satisfaction scores.

While health insurance, quality control and the cases of diagnoses that cannot be made via the Internet all pose potential challenges for the Internet hospital, it has helped many people and continues to make healthcare more affordable and accessible.

Iliana Lang

Sources: The Lancet Global Health, The Journal of Health Economics
Photo: Global Times

Transgender Population and HIV: Uncovering Problems
HIV is one of the few viruses to completely alter the landscape of the entire world as a whole. Not since great pandemics such as the Black Death has a sickness decimated families, communities and nations like HIV has.

HIV does not discriminate. The virus infects people from all walks of life: Muslims, Christians and Atheists; Blacks and whites; males and females; even the old and the young. Likewise, to combat HIV, the world needs to fund prevention programs just as indiscriminately.

From the misconceptions as an exclusively homosexual disease to the unity the world has made in dealing with it, one thing is for certain—HIV is still present and must be eliminated.

HIV strategies have been largely successful in combating HIV and preventing AIDS from infecting people at staggering rates. According to UNAIDS, in 2014, 2 million new infections of HIV were recorded. This was down 35 percent from the year 2000 when that number was reported at 3.1 million new infections.

The overall HIV and AIDS mortality rates have also fallen over the course of 15 years. A total of 36.9 million people worldwide are living with HIV, and 1.2 million have died from AIDS. That is down from 2 million in 2005. Almost half the current HIV population is taking antiretroviral therapy (15 million). Currently, $20.2 billion is invested in the AIDS response, right on target of expected funding required at $22 billion.

There is, however, one group of minorities who are of a great deal of concern. They are transgender people. They represent a group of people with the most imbalance of all infected groups.

According to the most comprehensive WHO report on transgenders to date, transgender women have 49 times higher odds of HIV infection than the general population. Among sex workers, transgenders have nine times higher odds of contracting HIV compared to female sex workers.

The imbalance has many factors behind it. They are the largest under-served community when it comes to HIV prevention. This is due to marginalization, lack of access to proper treatment for many mental health-related issues, grouped with homosexuals in prevention tactics and also being a target of violence.

Transgender individuals face many social issues in society. While some may be well off, many transgenders work low-paying jobs due to a lack of equal opportunities for employment. Stigma and discrimination cause many to turn to drugs and sex work as a means of making money.

That lifestyle can lead to many health risks, including drug abuse, homelessness and the lack of access to adequate medicines. Many transgenders also face discrimination when they attempt to receive medical treatment from healthcare workers. It makes them more susceptible to infection.

Another problem is the lack of countries properly defining what gender a transgender person is. Many countries consider transgender sex the same as homosexual behavior. Anti-homosexual laws make transgenders fearful, hiding their infections for fear of death or incarceration. Some fear carrying condoms, as they may be used against them to confirm illicit behavior by law officials.

Inadequate training among healthcare workers to transgender-sensitive issues leads to misdiagnosis and mistrust.  The negative discrimination mentioned also decreases the quality of care they receive. Coupled with the general stigma, this creates a vicious cycle that is not helping with HIV prevention measures.

Transgenders are also vulnerable to higher degrees of violence and rape. There are no feasible studies to measure the number of rapes and murders transgenders experience due to misreported gender identity. Rape victims may contract HIV and not report it due to fear of retaliation.

All these problems have led to poor results in HIV prevention amongst transgender populations in the world. The issue is crucial in the fight against AIDS because some transgender people may have sexual partners with both males and females, making more people susceptible to spreading HIV. The global effort to combat AIDS must include all types of people around the globe.

The next part of this article will demonstrate working solutions and how continuous funding will help reduce HIV.

Adnan Khalid

Sources: UNAIDS, World Health Organization
Photo: HIV Plus Mag

In the winter of 2013-14, residents of Russia’s Pskov region were left waiting in the cold at their train stations due to alleged obstructions on the tracks. Oddly, neither snow nor ice had blocked paths of the trains; rather along the tracks lay the shivering bodies of numerous Russians in need of medical attention.

A lack of accessible health service or transportation options had compelled these ill residents to prostrate themselves on the cold steel in hopes of hitching a ride to metropolitan centers with hospitals.

Even in city centers like Moscow and St. Petersburg, the situation has become dire. Hunger strikes aimed at preventing the healthcare cuts have occurred in the past two years in both of these major metropolises.

Stories like these call attention to the increasingly desperate state of Russia’s healthcare system, which has experienced significant consolidation and downgrading. In response, many Russians, as these incidents indicate, are quite literally willing to die for better healthcare.

The fierce will for state-sponsored, universal healthcare coverage has persisted since the Soviet era, while the quality of Russian healthcare has not. According to The Moscow Times, “from 2005 to 2013 the number of health facilities in rural areas fell by 75 percent, from 8,249 to 2,085. That number includes a 95 percent drop in the number of district hospitals, from 2,631 to only 124, and a 65 percent decline in the number of local health clinics, from 7,404 to 2,561.” In March of 2015 leaked government reports claimed that over 10,000 medical professionals in the capital had been laid off after the closure of 28 clinics and hospitals. The reports outlined 14,000 further firings leading up to 2017.

Between the years of 2013-14, 90,000 medical workers lost their jobs despite reports of significant shortages of personnel across the country. That same year, The Audit Chamber, a government agency, had attributed the 3.7 percent spike in hospital deaths to spending cuts. In total, 18,000 Russians needlessly lost their lives.

This is all a part of the Russian Government’s recent ‘optimization’ which aims to eliminate inefficiency by consolidating healthcare resources in larger hospitals. Consequentially, it entails the closure of smaller more local treatment centers.

Putin and his administration are determined in their efforts. They seem to have ignored funding and personnel issues and have instead lauded the healthcare system during a meeting in April 2015. Contrary to their own government reports, they claimed an alleged increase in rural medical coverage and a $4 billion expansion of healthcare funding.

For the doctors that have survived ‘optimization’, life in the workplace has become chaotic. Bloomberg News reported on a female family doctor who had to increase her workday from eight hours to 12 hours. On top of this, she admitted to working three weekend shifts per month for the past year.

One clinic has restricted the average appointment time between the doctor and patient to a mere 12 minutes. This gives the doctor just enough time to fill out paperwork.

Those unwilling to compromise effective treatment will defy these strict time limits. This comes at a cost, however, as many doctors have been forced to regularly work overtime in order to provide adequate care.

For patients, this entails excessive waiting times for treatment. With so few staff, they can expect to wait hours just to meet with a specialist. Those in need of ultrasounds often get put on a six week waiting list. Last year one could expect an ultrasound in a matter of days.

Tired of waiting, many Russians have sought better medical care by taking to the streets in protest. Several demonstrations challenging recent healthcare developments took place in Moscow during the fall and winter of last year.

With approval ratings for the country’s healthcare system under 20 percent according to a recent poll, Putin has also displayed some hesitation. During a conference in the fall of last year, he admitted that his administration had not yet considered everything. If protests continue it is perhaps possible even the notoriously headstrong Putin will alter the course of Russia’s healthcare.

Andrew Logan

Sources: Bloomberg, The Moscow Times, Radio Free Europe/ Radio Liberty, The Washington Post

Photo: Bloomberg Business

Eye Care in Rwanda

Rwanda is one African country poised to dramatically improve visual healthcare for its citizens. Since the 1990s, it has improved its mortality rate caused by infectious diseases, doubled its life expectancy and experienced significant economic development. Rwanda created a national vision plan in 2002 when it signed the World Health Organization’s  VISION 2020 initiative. The aim of the initiative is to eradicate preventable and treatable blindness by raising awareness, securing resources and facilitating the planning and implementation of the initiative.

Of the 285 million people in the world who are visually impaired, 87% live in low- and middle-income areas. With 32,700 per million people living with visual impairments, Africa is one of those areas. Still, almost 80% of visual impairments—that often lead to blindness if untreated, such as cataracts, glaucoma, trachoma as well as refractive error (myopia, hyperopia, presbyopia and astigmatism)—can be prevented or treated. If not, blindness throughout the world will double by 2020, and the developing countries will shoulder the burden, according to WHO.

Visual impairments reduce the quality of life and people’s productivity. Eye care is part of a comprehensive primary healthcare plan that helps to reduce injuries, and improve educational outcomes and access to employment opportunities. All these improvements contribute to economic growth and development.

Recently, WHO examined the national plan for eye care in Rwanda, focusing on progress made, as well as current and future needs. The result was a reflection of three lessons learned.

First Lesson: A single national plan optimizes the provision of eye care.

The Ministry of Health coordinates all partners’ efforts to align with the national vision plan. The Ministry makes certain that providers complement each other’s resources and strengths. International nonprofit partners coordinate with each other and private eye care clinics and hospitals to ensure accessibility to a variety of services across the country.

Some of the work that the nonprofit partners provide is funding for disease burden studies, building eye care clinics, supporting scholarships to train eye care specialists and standardizing the eye care curriculum for nurses.

Examples of coordination of services include:

  • Vision for a Nation, a U.K. charity, provides low-cost or free eye glasses to those in need.
  • The Fred Hollows Foundation, an Australian charity, began working in 2004 in the Western Province of Rwanda when the only other available eye care service was a mobile service.
  • The Christoffel Blinden Mission, headquartered in Germany, locates their services in the Southern Province of Rwanda, and among other services, performs specialized pediatric surgery.

Second Lesson: Better access to primary eye care and vision insurance has increased the demand for more advanced eye care at the secondary and tertiary levels.

Most of the population is currently enrolled in the Rwanda Community Based Health Insurance Policy set up in 2010. This policy provides affordable eye care and reimbursement for consumable products.

As Rwandans benefit from accessible primary eye care through insurance, awareness of further eye care needs to grow. Now, there are more instances of cataract operations and treatment for glaucoma.

Treatment for eye diseases, such as trachoma, has risen dramatically in the last five years. In 2009, treatment for eye diseases was not among the top ten reasons for seeking eye care. In 2014, it was the second leading cause of treatment.

Third Lesson: A comprehensive strategy, one that includes prevention of eye disease and a supply chain of glasses and lenses, is still needed.

Rural areas are still underserved. Almost 50% of the population lives in rural areas of poverty and are unable to afford private eye care services. In any case, rural areas still do not have adequate eye care services as most eye care resources are situated in the capital of Kigali. Another startling fact is that for the 10.5 million people in Rwanda, there are only 18 ophthalmologists and most of them live in the capital.

Task shifting is one solution to the lack of trained professionals through the Rwandan three-year ophthalmic technician training course, but more trained eye care professionals will be needed.

The demand for eye care services may be increasing not only due to more awareness and accessibility to services but also due to an aging population, as the life expectancy doubled since the 1990s to age 63. Among the eye problems associated with age is presbyopia, which usually requires prescription lenses such as bifocals.

WHO feels confident that these lessons learned will provide a basis to overcome barriers to progress and continue to improve the planning, implementation and provision of services to meet the eye care needs of the people of Rwanda.

– Janet Quinn

Sources: WHO 1, WHO 2, WHO 3, Vision for a Nation, CBM, Hollows
Photo: The Fred Hollows Foundation

Medic_MobileMedic Mobile, a nonprofit technology company specializing in mobile health, has enacted 21 projects in Africa, Latin America and Asia to provide patients living in impoverished regions with healthcare they may not be able to afford or find otherwise. In total, 7,836 community health workers were using technology and supplies provided to them by Medic Mobile in 2013—a 71 percent increase from the previous year. The company uses open-source platforms such as FrontlineSMS, Google Maps and HealthMap to develop tools for healthcare specialists to reach isolated patients.

Their tools assist with disease surveillance, childhood immunizations, drug stock monitoring and antenatal care. Medic Mobile works to train local staff on healthcare and how to use their tools, design workflow and assess opportunities for their health system. Health workers in these communities can now take numerous actions to help decrease mortality rates and increase knowledge of health and illnesses.

Using Medic Mobile technology, healthcare specialists can register every pregnant woman in their community, which allows them to schedule visits and set reminders, detect problems early on and report these issues to a clinical team, and to ensure they are able to deliver in facilities with skilled birth attendants. This increases the chances of maternal and newborn survival.

Immunization of infants can help decrease the spread of polio, measles, diphtheria and tuberculosis. Medic Mobile is used by many to register infants, create appointments and use digital scheduling to send alerts so appointments are not missed.

One of the biggest tools Medic Mobile provides communities is disease surveillance. Disease surveillance helps to detect diseases, supply individuals with immunizations and treatments and help connect isolated patients with urgent medical care. For example, in Namitete, Malawi there is one hospital for 250,000 patients, and for many of these patients, the hospital is over 100 miles away. This causes high rates of HIV/AIDS, tuberculosis and other illnesses. Medic Mobile makes it possible for individuals to receive advice about treatment and emergency referrals electronically.

Medic Mobile can also be used by medical facilities and pharmacists to prevent stock-outs, which can have life-threatening consequences. A study conducted by Oxfam, an international confederation working to end poverty, found that in developing communities only nine percent of local health facilities had fully stocked medical supplies. Medic Mobile is used to record stock levels every week to prevent stock-out.

Their toolkit is a free software toolkit that combines analytics, data collecting and messaging and is designed for health workers and systems in regions that are hard to reach. The software supports any language and works with or without Internet connectivity. The toolkit can run on basic phones, Smartphones, tablets and computers.

John Nesbit created Medic Mobile in 2008 as a six-month project. After its success, Medic Mobile has continued to provide tools to developing communities to provide their tools and services as an ongoing project.

Julia N. Hettiger

Sources: Matador Network, MedicMobile, Skoll Foundation
Photo: MedicMobile

UN Reinventing the Approach to European Roma Poverty-TBP
The Roma people are a large ethnic minority living in Europe whose population totals to 10 to 12 million people. Despite the existence of laws aimed at protecting this group of people from discrimination, the Romas experience harsh prejudices. The lack of opportunities to available to them often keeps them below the poverty line. They have low literacy rates, little access to healthcare centers and high rates of hunger.

The countries with the highest percentage of Roma communities are Macedonia, Slovakia, Romania, Serbia, Hungary and Bulgaria. They make up between 7 and 10 percent of the populations of these countries.

Roma people suffer from many health issues, but their access to health insurance is limited. Their cause is further hurt by the high price of healthcare. More than half of Roma households cannot afford prescriptions and about 20 percent say that they have had overnight stays in health centers. (Non-Roma people ranked at 1/3 and about 12 percent, respectively.) Vaccination rates are also low among the Roma, while births outside the hospital are high.

Education is another area where there is a significant lack of support and progress. Because of child marriages, many young girls are taken out of school before they are able to finish. In most of Central and Eastern Europe, about 50 percent of the Roma have, at the very least, a lower secondary education than their non-Roma counterparts. Schools are often ethnically segregated.

The United Nations had a mission to help lower Roma poverty and improve their living conditions. In 2007, the UN opened centers to help the Roma people receive affordable and accessible healthcare and proper education. However, the programs were highly inefficient and slow moving and accomplished little. That is why the UN is out to reinvent the Roma outreach.

After experimenting with three prospective methods in Macedonia to engage the Roma people and to improve their situation, the UN settled on the Roma Centre of the Future.

Using Roma and non-Roma peoples, the centers work to help the Roma people access education, healthcare and other public services. This time, the centers have the skills, knowledge, tools and technology needed to run such an idea efficiently and effectively, with the goal being to reach as many Roma people as possible. The workers help people through complicated paperwork, direct them to opportunities like job trainings and provide useful community programs. There is also a special focus on the elderly, a concentration that did not exist in the earlier programs.

The program is already seeing success. Within the first five months the center reached 820 people, which was more than the old centers used to help in a year! This new, dedicated focus on reaching the needs of the people appears to be working, as the Roma people are seeing the positive effects the centers have on the community and are thus going to these centers for help.

Katherine Hewitt

Sources: EC Europa, UNDP 1, UNDP 2, New Int
Photo: UNDP

Oral-Health-Care-in-Poor-CountriesOral health care is an indicator of a body’s overall health, but for many of the world’s poor, oral health care is one of the most neglected areas of medical care available. Thankfully though, in some regions, oral health care is improving.

The World Health Organization (WHO) says that “worldwide, 60-90 percent of school children and nearly 100 percent of adults have dental cavities.” Oral health care also includes, in part, gum care, mouth pain, oral infections and tooth loss.

What is even worse, is that “oral disease in children and adults is higher among poor and disadvantaged population groups” (WHO).

In parts of the world, access to dental care can be completely lacking. The American Dental Association (ADA) has given a warning for U.S. travelers: “If you are planning a trip out of the country it may be helpful to schedule a dental checkup before you leave, especially if you’ll be traveling in developing countries or remote areas without access to good dental care.”

Such a warning for U. S. citizens shows a need for better universal access to oral health professionals in developing countries. This is especially true for those living in poverty.

There are two studies in particular that highlight the connection between poverty and poor dental health. One comes from an Argentinian study that looked at parental income and education, as well as access to oral health care. The study found that there is a direct correlation between higher dental care and higher poverty indicators.

In another study, WHO reports that in Mexico, 60-70 percent of elderly people have few to no teeth. The report also finds that upwards to 90 percent of Mexicans have untreated cavities. As with the Argentinian study, the higher the poverty the worse oral care was. Their findings are similar to those in poverty all around the world.

What can be done? The situation seems dire and difficult.

One of the best ways to help fight cavities, and other noncommunicable oral diseases, is to promote proper dental care. Schools in the Philippines have made hand washing and tooth brushing part of their everyday curriculum. Dental care has been a consistent reason for children to miss school, but UNICEF has found that for the school children, “tooth-brushing can result in reductions of up to 27 per cent in absenteeism.”

The WHO Global Oral Health Programme is also working to reduce diseases caused by poor oral health care. The focus is not only on proper tooth brushing but also on proper diet, the reduction of tobacco and excessive alcohol use. All areas need to be looked at to help prevent tooth loss, gum disease and some forms of oral cancers.

Much still needs to be done to help maintain proper oral health, especially for those people living in poverty. Access to proper dental care when cavities or oral infections do occur is still lacking.

Thankfully there are programs in place that are thriving, such as the ones in the Philippine schools that are proving to be successful. Hopefully, their model will be used in other regions so that oral health care will improve the world over.

– Megan Ivy

Sources: Mouth Healthy, National Center for Biotechnology Information, UNICEF, WHO 1, WHO 2, WHO 3
Photo: Projects Abroad