TB Affects RefugeesTuberculosis (TB) is one of the most commonly reported diseases among refugee populations. It affects the lungs and can be extremely infectious. Symptoms include coughing up blood and mucus for a long period of time, pain when coughing, fatigue, fever and chills. TB is a highly contagious disease and can spread through droplets in the air when an infected individual sneezes or coughs. TB affects refugees who usually become infected while they are in their home countries. Poverty increases during wartime, and so do TB rates.

The Diffusion of TB

Although many refugees contract TB from their home countries, their journies worsen the disease’s effects. The malnutrition that many displaced peoples experience weakens the body’s ability to fight the disease, and underlying health conditions lead to more life-threatening effects.

TB affects refugees in camps. Currently, 2.6 million refugees live in refugee camps all around the world.  Tens of thousands of individuals can cram into each camp.  In fact, one camp in Jordan, for example, is home to about 80,000 Syrian refugees. Camps do not have an adequate amount of food, and sanitation is well below average. In fact, 30% of refugee camps do not have access to proper latrine systems. Additionally, TB affects refugees where HIV rates are high. For example, many refugees live in sub-Saharan Africa where the HIV rate is 9%, one of the highest in the world.  Further, when those placed in camps leave, general community members are also at risk.

Access to Treatment

The majority of refugees today are living in a state of poverty. For example, a report by the United Nations High Commissioner for Refugees (UNHCR) and the World Bank Group shows that in 2014  90% of the Syrian refugees in Jordan and Lebanon are considered to be below the poverty line in each of those countries. Economic barriers prevent many refugees from TB treatment. Without money, displaced peoples have little defense against TB.

Although affordability plays a large factor in a refugee’s inability to access treatment, fear also plays a role in limiting refugee access to treatment. Particularly for undocumented refugees, the fear of deportation prevents many from receiving a diagnosis. For documented refugees, the legal technicalities of receiving such care are complex. Treatment is mainly available to those who are employed because employers provide insurance that covers treatment costs. However, approximately 65.1% of refugees around the world are currently unemployed and unable to receive these benefits. Financial and emotional walls are blocking refugees from receiving vital healthcare.

Global Response

The extreme ways in which TB is affecting refugees have garnered international attention. To combat its fatal consequences, the World Health Organization (WHO) has created a response called The End TB Strategy. The program’s ultimate goal is to reach an 80% drop in TB cases by 2030. One of the program’s main strategies is to implement screening, especially for high-risk groups. If a refugee arrives from a country such as India where TB rates are high, they will go through a screening process. Through these procedures, early detection of TB is possible, and the disease can be effectively treated.

Organizations like the Centers for Disease Control (CDC) have already implemented screening measures and require refugees to undergo TB tests before they can cross US borders. Proper understanding of the disease is also a focus of The End TB Strategy. The WHO is developing research on and treatment plans for TB that should lower infection rates. In general, the strategy emphasizes the importance of early detection, screening and proper treatment for all individuals.

Looking Forward

Tuberculosis is a deadly disease. It is one of the top ten causes of death in low-income countries. Refugees can become infected in their home countries, throughout their journeys or in refugee camps. TB easily spreads from person to person, and it can infect entire communities. Poverty and fear of deportation and unemployment prevent refugees from accessing and receiving treatment.

Fortunately, plans such as the WHO’s End TB Strategy are working on improving the current state of tuberculosis among refugee populations. Hopefully, these programs will reach their goals and protect refugees from TB’s deadly hands.

– Mariam Kazmi
Photo: Flickr

COVID-19Japan has handled the COVID-19 pandemic much better compared to other nations. For example, the death rate for COVID-19 in Japan is one death per 100,000 people. This number is much lower than other countries, with the United States death rate at 59 deaths per 100,000 people and the United Kingdom rate at 62 deaths per 100,000. Japan also has a lower rate of infection than other nations. Japan had less than 101 per 1,000,000 new cases of  COVID-19 reported while the US has between 501-1000 per 1,000,000. What is Japan doing differently to make the mortality infection rates so much lower than other high-income nations?

Culture of the Japanese

One reason Japan has so few coronavirus cases is built into the culture of the Japanese. Japanese people have worn face masks since the flu pandemic in 1919. Masks are also common to wear in Japan when it is cold and flu season. So, when the COVID-19 pandemic hit, wearing masks as a protective measure was widely accepted and used by the Japanese population. Also, the Japanese culture is more socially distant. For instance, Japanese do not hug or shake hands when making acquaintances like Americans do. Social distancing and mask-wearing came naturally to the people of Japan, so the infection rate is very low for them.

Japan’s Healthcare System

Japan has a highly regionalized healthcare system that has helped them minimize the impact of COVID-19. Japanese healthcare institutions, called Public Health Centers (PHCs), are similar to the Center for Disease Control but at a much more local level. However, when COVID-19 hit its peak in Japan, the PHCs struggled to keep up with the surge of patients. So, the PHCs reacted quickly and would send patients to available PHCs and resources to the PHCs that had shortages. Japan’s quick actions and regionalized healthcare system allowed the COVID-19 death rates to stay low and spread to be minimum.

Negatives Impacts of the Virus in Japan

Though Japan has a relatively small infection and the death rate for COVID-19, the Japanese people’s lives have been greatly affected. Japan’s suicide rate has risen considerably since the pandemic hit. There have been 13,000 suicide deaths in Japan this year; a number much higher than the 2,000 COVID-19 deaths. The suicide rates for August were 15.4% higher than those of last year. Economic hardship, unemployment and isolation from society as a result of COVID-19

Japanese women have been disproportionately affected by the secondary effects of COVID-19. The suicide rate for women specifically has risen 40%. Also, 66% of people in Japan who have lost their jobs because of the pandemic were women. In response, Japan has increased its funding towards suicide prevention resources by 3.7 billion yen ($35,520,000).

The Future of Japan Amid COVID

Looking into the future, vaccine security looks very good for all Japanese citizens regardless of economic status. The Japanese government recently approved a bill to provide all of the citizens of Japan with COVID-19 vaccines free of charge. Providing a free vaccine will ensure everyone will have the opportunity to receive one. Since the vaccine cost is covered, the vast population of Japan can be protected from COVID-19 in the future.

Not only is Japan thriving in the fight against COVID-19, the country is also providing aid to help other nations overcome this disease. Recently, Japan recently donated $2.7 million to the Pan American Health Organization (PAHO) to help Latin American countries with the fight against the coronavirus. Specifically, this aid will provide Pan-American nations with slowing the spread by implementing preventative measures and providing information for citizens about the disease.

Overall, Japan has handled the pandemic really well. Their unique approach to regionalized healthcare along with their willingness to wear masks have greatly decreased the COVID-19 damage in Japan. Other countries should use the Japanese response to COVID-19 as an example. Japan’s quick and regionalized response to COVID-19 attributed to the small death and infection rate. Countries should also consider providing their citizens with vaccines to ensure everyone is protected from COVID-19. The wealthy nations should take into account the countries that cannot afford to provide vaccines for their citizens. To ensure our world overcomes this pandemic, resources like vaccines, masks and ventilators will need to be allocated to lower-income nations.

– Hannah Drzewiecki
Photo: Flickr

Brazil’s Covid-19 Response
As the largest nation in South America and also one of the poorest, Brazil remains vulnerable to the health and socioeconomic implications of COVID-19. With 55 million of it’s 210 million citizens living in poverty and 85% living in urban areas, international support for Brazil’s COVID-19 response is particularly important. In just four months, nearly 2 million people contracted the disease, resulting in over 72,000 deaths.

The proportion of Brazilians covered by family health teams increased from 17.4% in 2000 to 63.7% in 2015. However, the low doctor-to-patient ratio of only 0.02% and the stagnant 8.4% expenditure of the GDP on healthcare contribute to many Brazilians lacking access to treatment. This issue has only been exacerbated by the additional strain the pandemic has placed on the healthcare system. As of July 15, the U.S. Department of State and USAID have directed $1.5 billion towards the global COVID-19 response. Of that, USAID is supporting Brazil’s COVID-19 response with $12.5 million.

How USAID is Supporting Brazil’s COVID-19 Response

  1. Ventilators: In May, the U.S. committed to delivering 1,000 ventilators to the people of Brazil. These machines, ranging in price from $5,000 to $50,000, will save Brazil millions of dollars in healthcare-related equipment expenditures as the spread of COVID-19 continues. The novel virus attacks the body’s respiratory system, often causing difficulty breathing or respiratory failure. USAID is improving Brazil’s COVID-19 response with these life-saving machines. The aid will ensure that hospitals do not turn away patients due to a shortage of medical supplies.While ventilators do not stop the spread of COVID-19, they are helping some of the sickest Brazilian patients recover. A New England Journal of Medicine study found that 50% of COVID-19 patients who require a ventilator eventually die from the disease. However, patients spend an average of 10 days on a ventilator. This means that if 1,000 new ventilators are available in Brazil, in three months of use, 4,500 people who would have died without a ventilator will likely survive.
  2. Hygiene and Sanitization: By May, the CDC had provided $3 million in Brazilian COVID-19 response funding. The funds are used to improve data collection in order to identify cases, contact trace and pinpoint areas of high transmission rates. On May 29, when new cases were steadily increasing, USAID announced it would provide $6 million in assistance to Brazil. Part of this funding was directed towards improved sanitation and hygiene in order to mitigate the spread of COVID-19. Brazil is now able to better distribute government-subsidized masks, hand sanitizer and other hygiene-related materials. As a result, the country has more effectively controlled the spread of COVID-19 and has not experienced a record high daily case influx since June.
  3. Food and Water: In March, Brazil’s unemployment rate rose to 12.6% from an average of 12% in 2019. The jump left approximately 5 million more Brazilians unemployed at the onset of the COVID-19 outbreak. With the heightened financial crisis, many of the 38 million once-employed Brazilians lost their jobs and in turn lost the purchasing power to feed their families. As part of the United States’ July commitment to provide $1.5 billion in foreign aid relief for COVID-19, $20 million has been directed towards food and water aid. It is uncertain how much of the money will fund hunger relief within Brazil’s COVID-19 response. Nevertheless, the United States’ step to dedicate funding for food and water provides some hope for Brazilians facing hunger.
  4. Refugee and Vulnerable Populations: In addition to the growing prevalence of poverty and unemployment in Brazil, the estimated 253,500 Venezuelan migrants and refugees within Brazil are struggling. Fortunately, these Venezuelans, who flooded Brazil at the highest rate in South America, have access to hospital treatment. Though, a lack of financial opportunity during COVID-19 has created disproportionate homelessness and hunger for the refugees. In response, USAID is providing over $12.4 million to support two NGOs in Brazil. These NGOs provide emergency shelter, food and nutritional assistance exclusively to vulnerable populations within Brazil. Such populations include low-income and rural residents in the Amazonian region and Venezuelan migrants.
  5. Grants and Incentives for the Private Sector: USAID is also improving Brazil’s COVID-19 response by creating incentives for private sector involvement. In May, $75,000 in grants were issued to former Brazilian USG exchange program participants to fund 40 COVID-19 relief projects. These grassroots projects work to educate Brazilian communities about the pandemic. The efforts dispel misinformation about the virus and address the socioeconomic implications of it, such as increased rates of domestic violence during the quarantine. USAID has mobilized a small population of the private sector in Brazil, strengthening the effects of the over $40 million in Brazilian COVID-19 relief derived from the United States’ domestic private sector.

USAID, along with the CDC and the U.S. Department of State, is improving Brazil’s COVID-19 response by financially prioritizing medical intervention, mitigation efforts, humanitarian aid and education regarding the virus. Although COVID-19 remains an issue, the nation is better equipped with tools to slow the spread of the virus and handle any negative effects of it.

Caledonia Strelow
Photo: Flickr

Tuberculosis in Liberia
As COVID-19 spreads across the world, it is still not the leading cause of death from a single infectious agent. According to the CDC, that title belongs to tuberculosis, a respiratory illness that the bacteria species Mycobacterium tuberculosis causes. It usually targets the lungs but can attack any part of the body. Tuberculosis in Liberia, among other impoverished countries, remains a predominant issue that the country needs to address.

While tuberculosis is largely curable, it can be lethal if left untreated. The disease still affects populations of developing nations due to their lower capacity health care systems. According to the CDC, tuberculosis is the eighth leading cause of death in Liberia. The disease infects over 300 people per 100,000 Liberians.

Poverty in Liberia

 An article in the Lancet explains that tuberculosis is the “archetypal disease of poverty,” remaining prevalent largely in developing nations such as Liberia. Over 90% of the Liberian population lives under the international poverty line of $5.50 per day. Poverty not only makes treatment costs excessively burdensome for many people, but it also contributes to risk factors that further the spread of the infection.

According to Dr. Saurabh Mehta, Associate Professor of Global Health, Epidemiology and Nutrition at Cornell University, conditions that weaken the immune system are risk factors for tuberculosis transmission. These conditions include HIV infection, diabetes and malnutrition, all of which correlate with a lower socioeconomic status.

Dr. Mehta explains that overcrowding is another risk factor that facilitates TB transmission. In a crowded setting, a person infected with tuberculosis has a higher potential to interact with susceptible people.

Both malnutrition and overcrowding could contribute to the impact of tuberculosis in Liberia. One in three Liberian children experience stunting due to malnutrition, and over half of Liberia’s urban population lives in slums. The World Food Program is working to alleviate hunger in Liberia by providing meals in schools, supporting refugees through direct food aid and creating food reserves in food-insecure communities. The World Food Program provided over 66,000 pounds of rice as an initial reserve, which community members can access at a low-interest rate.

Rebuilding Health Care System Capacity

In order to treat tuberculosis in Liberia, the Liberian government needs a robust health system. However, civil war and outbreaks of other illnesses, such as Ebola, have weakened Liberia’s health system leaving fewer than four physicians per 100,000 people.

From 1989 to 2003, a civil war wreaked havoc throughout the nation, killing more than 250,000 people. Because many either died or fled, the number of trained doctors in Liberia declined from 237 to less than 20 by the end of the war.

While training programs that the country established after the war helped increase the number of nurses, Liberia only had a few dozen of its own doctors at the outset of the 2013-2016 Ebola outbreak. Ebola killed 4,809 people and further damaged Liberia’s health systems, among other West African countries. In a few years, the disease killed at least 600 health care workers across Liberia, Sierra Leone and Guinea.

To expand and safeguard its health care system’s capacity, Liberia collaborated with the WHO and other organizations to invest in Ebola treatment units as well as training for over 21,000 health workers.

Multidrug-resistant Tuberculosis Treatment

Drug-resistant pathogens are a serious public health concern globally. As existing medications become less effective, previously treatable illnesses become more deadly.

Over 2.5% of people with tuberculosis in Liberia have a multidrug-resistant form of the illness, making their condition higher risk and their treatment more expensive. Additionally, according to Mehta, treatment for multidrug-resistant tuberculosis is less effective and takes two to four times as long to complete as the treatment for tuberculosis that is not drug-resistant.

Taking an incomplete course of tuberculosis treatment increases the risk that someone could develop multidrug-resistant tuberculosis. This risk would decrease, however, if patients had more affordable treatment options.

The Liberian National Leprosy and Tuberculosis Control Program has worked to expand access to the international standard of care for tuberculosis, DOTS (Directly Observed Treatment Short courses). Although the treatment success rate for those who received treatment was at 80%, less than half of people with tuberculosis obtain treatment.

Tuberculosis Comorbidity with HIV/AIDs

The World Health Organization reports that 53 out of every 100,000 people in Liberia have a particularly lethal combination of tuberculosis and HIV/AIDs. People who have both diseases face a higher risk of their tuberculosis becoming active rather than remaining latent/asymptomatic. This is because HIV/AIDS weakens the immune system. As a result, tuberculosis causes 40% of deaths in HIV/AIDS patients.

While treatment to prevent tuberculosis for HIV/AIDs patients exists, only 21% of HIV positive patients receive such treatment. Expanding access to preventative treatment has the potential to significantly reduce mortality for people with tuberculosis in Liberia who also have HIV/AIDs.

Tamara Kamis
Photo: Flickr

Tuberculosis in Lesotho
On May 13, 2020, Lesotho confirmed its first case of COVID-19, making it the last country in Africa to contract the virus. The country now has to make a difficult decision on how to take charge of the situation. In short, the government has its work cut out for it.

But COVID-19 is not the first disease that the country has had to fight off. For years, Lesotho has been at war with tuberculosis, an incredibly infectious disease that acts similarly to COVID-19. Although Lesotho’s fight with TB may not be over, it has certainly made great strides towards ending the epidemic its citizens are living in.

Tuberculosis in Lesotho

Lesotho is a country in Africa that South Africa surrounds on all sides. It is a developing country home to approximately 2.11 million people. Currently, Lesotho ranks second in the world for people with tuberculosis, with an estimated 724 cases per 100,000 people—about 15,276 people in total. In Lesotho, tuberculosis is particularly harmful to those with HIV, as 73% of people who contract tuberculosis also have HIV.

Tuberculosis is the leading fatal infectious disease in the world, and it kills more than 1.6 million people worldwide each year. TB is an airborne disease: it transfers when a person breathes contaminated air droplets from an actively sick person. If untreated, active TB can be lethal. However, 90-95% of infected people do not actually show symptoms. Most tuberculosis is treatable, as the success rate of treatment in Lesotho is around 77%, but the country has seen a rise in MDR-TB or multidrug-resistant tuberculosis. As the name suggests, multidrug-resistant tuberculosis is immune to the common medications for TB. According to the National Center for Infectious Diseases, MDR-TB affects about 10% of people with smear-positive TB or around 1,000 people. The stronger strain of the bacteria requires that doctors develop more creative treatment options.

Treating Tuberculosis

Although the tuberculosis epidemic has significantly impacted life in Lesotho, the country has not stopped its ongoing war with it. Trained community health workers treat and supervise several patients from the patients’ homes. These workers give injections as well as monitor the side effects of treatments. Patients who become dangerously ill go to Botshabelo Hospital, a place that specializes in MDR-TB in the capital of Maseru.

The CDC also partnered with Lesotho in 2007 to help fight the infection. Since then, it has been working diligently to bring peace. The CDC helps the Ministry of Health and Social Welfare’s efforts towards HIV and TB treatment by improving health information systems, preventing transmission of HIV between mother and child, increasing the capacity in laboratories and giving counseling and testing for those HIV has affected. It also works with the ministry on diagnosis and treatment of the many variations of TB infecting the country. Altogether, the CDC has lowered the TB mortality rate to just 46 deaths per 100,000 infected.

Global Resilience

As a whole, the world has made phenomenal progress in its fight against tuberculosis. Global efforts have saved more than 50 million lives since 2000. Furthermore, global aid is actually is one of the best investments in the public health industry, as each dollar that goes towards TB relief yields $43 back.

Even though Lesotho is facing much loss, including those from its new COVID-19 cases, the country has stayed resilient amid hardship. Lesotho continues its ongoing war with TB, and it will not stop until there is no disease left to fight. The people of Lesotho show the world each day what true bravery looks like as they work towards a new, tuberculosis-free era.

John Pacheco
Photo: Flickr

Crop fields Nigeria
Food insecurity is outlawed by international rule of law. The Universal Declaration of Human Rights was adopted by the United Nations General Assembly in Paris on December 10, 1948, as a minimum standard of treatment and quality of life for all people in all nations. Article 25, section 1 of the declaration states: “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food.”

Causes of Food Insecurity

Often times, countries that are a part of the U.N. fall short on this promise to provide adequate nutritious food to everyone, including the United States of America. Malnutrition and food insecurity can be attributed to many causes worldwide, from political turmoil, environmental struggles and calamities, lack of financial resources and lack of infrastructure to distribute food equally within a country.

It is widely known that the poorest nations often lack the means or the will to sufficiently supply food to the people and their most vulnerable population, ethnic minority groups, women, and children often suffer the most.

In 2006, the Center for Disease Control reported that widespread media attention in 2005 brought global awareness to a food crisis in the West African country of Niger. According to the report, with a population of 11.5 million in 2002, 2.5 million people living in farming or grazing areas in Niger were vulnerable to food insecurity.

Food Supply Chains

In the United States, conventional food supply chains are used in the mass distribution of food. This method starts with produced raw goods. These products are transferred to distribution centers that may offload goods to wholesalers or sell them directly to food retailers, where these goods are finally purchased by consumers at grocery stores and markets. Food may travel long distances throughout this process, to be consumed by people who may have purchased comparable foods grown closer to home.

In her article entitled Food Distribution in America, Monica Johnson writes, “With each step added between the farm and the consumer, money is taken away from the farmer. Typically, farmers are paid 20 cents on the dollar. So even if the small-scale or medium sized farmer is able to work with big food distributors, they are typically not paid enough to survive.”

Hunts Food Distribution Center is one of the largest food distributors in the United States with over $2 billion in annual sales. According to the New York Economic Development Commission, it sits on 329 acres of land in the Bronx, New York and supplies over 50 percent of food consumed by people in the area, and also supplies food to about 20 percent of people in the region. Still, the Food Bank of New York City reported a meal gap of 242 million in 2014 and food insecurity of 22.3 percent, with 399,000 of people affected being children.

Solution to the Problem

About 13 years after the Niger food crisis the country is still one of the poorest in the world. The World Food Program (WFP), headquartered in Rome, Italy, continues to focus on fixing the problem of food insecurity in countries like Niger. Through helping those like Nigeriens build sustainable livelihoods and ecosystems for crop cultivation, the WFP hopes to lessen the high levels of food insecurity and issues related to it, such as malnutrition and high mortality rates among children under the age of 5.

Assisting locals to manage sustainable local food resources through soil conservation, water harvesting, rehabilitating irrigation systems and reducing the loss of biodiversity among other efforts, the organization focuses on local measures to solve food insecurity issues.

The same is happening in the United States. The country plans to upgrade agricultural facilities and operations, a plan that includes working with other food distributors at the state level to increase integration with upstate and regional food distributors, supporting local farms, and providing growth opportunities for emerging regional food distribution models.

Food insecurity is a big problem in developing, but in developed countries as well. Countries need to make sure to promote local agriculture development in order to achieve food production that will suffice each country needs.

– Matrinna Woods

Photo: Flickr

Five Things to Know About Healthcare in GhanaGhana, a country in West Africa, gained its independence in 1957 and now has a population of 28.2 million people. Though it has been considered one of the most stable countries in the region since 1992, Ghana still faces issues, one of which is the health of its population.

For men and women in Ghana, the life expectancy at birth is 64 and 66 years, respectively. These life expectancies are both below the global average, which, in 2015, was reported to be 71.4 years when considering both men and women.

Ghana faces a multitude of health issues that affect its population’s life expectancy. Below are five things to know about healthcare in Ghana.

  1. Accra, the country’s capital, is one of the centers of Ghana’s medical system. This city, which is one of the largest cities in Ghana, has a population of about 2 million people. Accra is where the Ghana Health Service is located, thus making it an important city for health in Ghana.
  2. HIV/AIDS is one of the top ten causes of death in Ghana. This virus killed 10,300 people in Ghana in 2012, which was 4.9 percent of the country’s population. At this rate, HIV/AIDS was ranked as the fifth leading cause of death in Ghana, in 2012, by the World Health Organization (WHO).
  3. In 2012, Malaria killed 8.3 percent of Ghana’s population. At this rate, Malaria ranked higher than HIV/AIDS, at number three, in the leading causes of death in Ghana, as reported by the WHO in 2012. When considering children under five, Malaria was the leading cause of death, killing 20 percent of this group in 2012.
  4. As of 2016, the Center for Disease Control and Prevention (CDC) has trained 125 people in Ghana to better monitor and evaluate the spread of infectious diseases. The CDC is working with Ghana to help citizens better recognize, treat and prevent infectious diseases.
  5. The education system for medicine and health in Ghana has improved over the last few decades. Many institutions that focus on educating Ghanaians in medicine have been founded since 1976. The Ghana College of Physicians and Surgeons (GCPS), which was founded in 2003, trained approximately 300 residents in 2014.

Though HIV/AIDS and malaria continue to be two of the leading causes of death in Ghana, the country’s work with the CDC and its improved education in medicine have certainly made progress towards improving healthcare in Ghana.

– Haley Rogers

Photo: Flickr

Social Ecological Model
People do not act in isolation, which is why it is important to understand the ways they interact with their communities and environments, in order to determine why they do what they do.

One way of measuring these networks of interactions is the Social Ecological Model. This model, developed by sociologists in the 1970s, studies how behaviors form based on characteristics of individuals, communities, nations and levels in between. In examining these intervals and how they interact and overlap, public health experts can develop strategies to promote wellbeing in the U.S. and abroad.

The Social-Ecological Model is broad in scope. Each level overlaps with other levels. This signifies how the best public health strategies are those that encompass and target a wide range of perspectives. A public health organization may struggle to promote healthy habits in a community if it does not take into account how other factors play into the behavior of the community as a whole.

Different organizations use variations of the Social-Ecological Model organizational hierarchies in a given society. The Centers for Disease Control and Prevention (CDC) sometimes uses a four-level model, while UNICEF’s model has five levels. Here is the layout of UNICEF’s model and its application in a public health context:

  1. Individual: An individual’s various traits and identities make up this level of the Social-Ecological Model. These characteristics have the capacity to influence how a person behaves. Age, education level, sexual orientation and economic status are some of the many attributes noted at this interval. These factors are important to consider when constructing public health strategies, as characteristics such as economic status are linked to an individual’s ability to access healthcare.
  2. Interpersonal: The relationships and social networks that a person takes part in also have great potential to impact behaviors. Families, friends and traditions are key players at the interpersonal stage of the model. Using therapy or intervention, one can promote healthy relationships at this interval. Discouraging violence between individuals also comes into play here.
  3. Community: This level of the Social-Ecological Model focuses on the networks between organizations and institutions that make up the greater community. These associations include businesses and functions of the “built environment,” such as parks. Community structures are often important in determining how populations behave and what customs they uphold. It is important to understand the community level to determine where health behaviors originate.
  4. Organizational: Organizations are instrumental in the development of behaviors as they often enforce behavior-determining regulations and restrictions. A school, for example, controls the dissemination of knowledge. This influence is significant when it comes to communicating information about safe health practices.
  5. Policy/Enabling Environment: Policies and laws that are instigated at local, national and global levels make up the broadest level of the Social-Ecological Model. These policies have the potential to impact large numbers of people. A policy outlining a U.S. malaria aid budget, for example, will have far-reaching global effects for decades.

The Social-Ecological Model is useful in the creation of sustainable solutions for at-risk individuals and societies. One approach to public health that considers many of the model’s levels is the practice of social change communication (SCC). Communities use SCC to facilitate discussions about beneficial and harmful practices in societies and to encourage people to speak about individual and communal problems. A health-based SCC discussion could cover anything from strategies developed to reduce pneumonia rates in babies to changing an outdated and potentially harmful social ritual.

SCC allows individuals and communities to influence shaping fairer, healthier societies. Its use of the Social-Ecological Model ensures that the strategies it develops are implemented across society.

Through SCC and other approaches, public health organizations are creating long-term solutions to the problems that plague individuals, societies and countries today. Only in understanding the numerous factors that influence harmful behavior can experts hope to tackle such problems effectively.

Sabine Poux

Photo: Flickr

According to National Public Radio (NPR), health researchers have reported that the number of new cases of Zika infections in Puerto Rico has risen to over 34,000 since 2015. The Center for Disease Control (CDC) states that the virus peaked during the summer months of 2016, with more than 2,000 new cases being reported per week.

Because Zika is a relatively new epidemic, individuals living in Puerto Rico have not yet developed any immunity to the virus. Therefore, the transmission of the disease has been rampant.

In more recent months, the number of Zika infections in Puerto Rico has decreased to around 200 new cases per week. However, it continues to remain a serious problem within the region. Researchers from the CDC have confirmed that the number of Zika infections in Puerto Rico has far surpassed that of dengue virus infections. Dengue is another disease most commonly spread by mosquitoes.

The Zika virus is transmitted via the bite of an infected Aedes species mosquito. Pregnant women who become infected are especially at risk of the disease.  Those infected are likely to pass on the infection to the fetus during pregnancy, which can lead to serious birth defects. Additionally, sexual relations and blood transfusions can spread the virus. Common symptoms of Zika virus include fever, rash, headaches, muscle pain and red eyes.

As of 2017, over 1,000 confirmed cases of reported Zika infections in Puerto Rico were among pregnant women. Doctors at the High-Risk Clinic at the University of Puerto Rico have treated some of these infected women. They witnessed at least 14 cases of babies born with severe brain damage.

Notwithstanding, some babies may not begin to show signs of defects or abnormalities until several years after birth. This calls for babies to be closely monitored by health professionals for up to four or five years after birth.

The CDC has listed different recommendations for preventing contraction of the disease. These recommendations are especially important because of the lack of a vaccine for the disease. Some of their recommendations include wearing long-sleeved shirts and long pants when mosquitoes are around, ridding homes of any standing water and using insect repellents registered by the Environmental Protection Agency. They especially advise against pregnant women traveling into Puerto Rico or any other areas where the virus is present.

Lael Pierce

Photo: Flickr

Top Diseases in Mexico
Diseases can prove very hard to prevent, control, and treat; and, many countries suffer from maladies that cannot be tamed. Mexico is no exception, and the top diseases in Mexico can inflict a great deal of damage. A summarization of each disease can be found below, including details on how the illness is transmitted and treated, the symptoms, and prevention tactics.

Top Diseases in Mexico

  1. Hepatitis A
    Hepatitis A can be spread via contaminated food or water or spread through person-to-person contact. A person-to-person transmission can occur when an infected person’s stool is ingested by a non-infected person through poor hygiene practices. Poor hygiene and sanitation practices are the results of letting half the country’s population live in abject poverty; without clean drinking water or sewage services, hepatitis A spreads easily and is now endemic to the population of Mexico. To clarify, if a disease is endemic that means the illness is regularly found among a population; for Mexico, hepatitis A is found throughout the entire country.
  2. Dengue Virus
    This virus is transmitted by mosquitos. Symptoms at the beginning of incubation of the virus include a sudden high fever, joint pain and headaches. Dengue is endemic to all of Mexico as well, except for the state of Baja California Norte and other areas of higher elevation because mosquitoes carrying the virus cannot survive at the higher elevations. Dengue may progress into dengue shock syndrome, a rare complication including a hemorrhagic fever, damage to lymph and blood vessels, bleeding from the nose and gums, enlargement of the liver, and even failure of the circulatory system, which can cause death. Taking aspirin accelerates the onset of symptoms of dengue shock syndrome, as aspirin thins the blood, so it is important to quickly ascertain that dengue is causing a patient’s symptoms before administering medication. Protection against contracting the dengue virus is easy: use bug spray, wear layers outdoors, and make sure bug screens in the home have no holes or tears for mosquitoes to fly through. Although seemingly simple, these precautions are monumental tasks for the poor of Mexico, who struggle to provide food for their families, let alone mosquito repellant.

Elevating the Impoverished

Diseases transmitted by mosquitoes are more likely to disproportionately affect those in lower economic classes. The Baker Institute mentions that these diseases, also known as neglected tropical diseases (NTDs), are widespread in Mexico’s poorest southern states such as Chiapas, Oaxaca, Guerrero, and Mayan villages on the outskirts of the Yucatan Peninsula.

Elevating the status and resource access of the impoverished in Mexico is an absolutely essential measure to alleviating the top diseases in Mexico.

Bayley McComb

Photo: CNN