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Education in Angola: Challenges and Developments

Education in AngolaEducation enhances the knowledge, health and lifestyles of people from all walks of life. However, for the people of Angola, education has become inaccessible to many, prompting concern for their future development. Angola borders the South Atlantic Coast of West Africa and has a population of more than 35 million.

The Angolan peninsula’s resources include oil and diamonds, but although these resources suggest wealth for the nation, the great majority of the country lives in poverty. The Angolan system lacks in meeting the needs of all of the nation’s citizens, with education being a prime example. Development within the system has quickly ensued, with the prospect of a refined education plan getting closer and closer each day.

The Civil War

With more than one-fourth of the population being considered illiterate and approximately two million children being out of school, the question arises as to why a country with such abundant resources has been lagging in its educational advancement. After the Portuguese granted Angola its independence, from 1975 to 2002, civil war invaded the lives of the Angolan people. Buildings and infrastructures nationwide were dilapidated from the war and one common structure that was destroyed was schools.

According to the United Nations Children’s Fund (UNICEF), more than 1500 schools were destroyed between 1992 and 1996 alone. Now that the war has officially ended, a lot of these schools have since been abandoned or burned out. With the schools that survived the war, the quality of these structures still lacked essentials. Many classrooms lack windows, doors, toilets, roofs, or even basic reading and writing facilities.

Not Enough Classrooms

According to statistics taken by Angop, the state-controlled news agency, the annual average rate of enrolling children without a place to study stands at a whopping 18.59%. Although children are willing to attend school, spatial barriers prevent many from receiving an education. The Luanda province, located on the Northern coast of Angola, reported that it was unable to find room for roughly 16,000 children who finished the 9th grade to continue their education.

Children who want to either enter or continue their schooling in various Angolan provinces are continually being denied due to a lack of infrastructure, although recent legislation regarding education seems to be improving the future of Angolan schooling.

Improvements and Progresses

Strides have been made to alleviate the issues within the education system, as legislation and funding for schooling have risen in recent years. As of December 8, 2023, the World Bank granted a 10-year program to support Angola’s tertiary education system, providing $550 million to enhance and aid the quality of programs in priority areas and strengthen governance within the education system. The program’s goal is to increase the number of highly qualified graduates who have labor market-aligned skills in various areas. In the next ten years, the expansion and progress of Angolan schooling will reach up to 3.2 million students nationwide, providing them with better learning opportunities and educational access.

Another initiative that has aided in the Angolan education system is the Back to School Campaign, supported by UNICEF, with its origin stemming from 2002. The campaign has supported the training of more than 20,000 teachers. It has also restored roughly 13,000 classrooms while still preparing thousands of education kits for children and teachers. The goal of the campaign is to increase the number of children in schools, as well as to improve the literacy rate throughout the country.

In recent years, progress in literacy has been made. The Angolan literacy rate has increased from 67.4% in 2001 to 72.4% in 2022 and has an average annual growth rate of 3.8%. This growth is concurrent with the implementation of funding and legislation in support of Angolan education. With an estimated increase in literacy each year, the future of schooling in Angola can take many turns for the better.

The Future of Education in Angola

Improvement of the Angolan education system will be a long-term process, especially after the devastation its infrastructure and economy have faced after the war. From the lack of classrooms to the low rates of literacy and graduation, the Angolan youth continue to seek a successful education.

Now, with the increase in funding for school governance, quality of programs, school building and teacher training, the future of Angolan education seems promising. Suppose the government continues to prioritize the restoration and development of the education system. In that case, Angola can transition into one of the educational powerhouses of Africa.

– Oliver Martin

Oliver is based in Honolulu, HI, USA and focuses on Global Health for The Borgen Project.

Photo: Flickr

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Emergency Relief to Sudan

Emergency Relief to SudanSudan is a country full of conflict between the people and between the people and their government. This instability has only compounded the country’s difficulties. While Sudan is still recovering from COVID-19 and various government aid programs and World Bank projects are on pause, the Sudanese have been left to fend for themselves. However, the Sudan Emergency Safety Nets Project has been enacted to provide temporary relief until the previous poverty prevention and relief projects are resumed.

Why Have the Preexisting Programs Stopped?

During COVID-19, Sudan was wrecked economically, as many people became unemployed and were unable to find jobs afterward. Compound this with the near-constant fighting occurring in the country and the Sudanese food security is limited to none. This fighting has caused the humanitarian aid front of the World Food Programme (WFP) to stop, as its teams cannot enter active combat zones to provide relief safely. While the WFP can aid the Sudanese people in different areas, those trapped in the middle of conflict cannot receive relief.

This is not unusual when providing humanitarian aid to active conflict provinces. However, the fighting in Sudan is so intense and ongoing that the combat zones change frequently. More and more people are trapped in dangerous provinces away from the WFP’s. At least four military groups are fighting for control of Sudan: the Sudan Armed Forces, Rapid Support Forces and many from previous Sudanese civil wars. With so much conflict, providing humanitarian aid is difficult and dangerous.

The Sudan Emergency Safety Nets Project

The Sudan Emergency Safety Nets Project has two halves: the safety nets and the infrastructural supports. The safety nets include both food and cash, but the value of both is equivalent to $7 in food. This may not seem like much, but the $7 can provide up to 1000 kilocalories, about half the daily required caloric intake. In a country with little consistency and food security, even something as little as $7 can change a person’s life. These Safety nets will focus on households and use its new infrastructural support system to monitor caloric intake per household to maximize their humanitarian aid.

The infrastructural support systems in question can be divided into delivery, monitoring and evaluation and project management. The delivery programs will work to ensure safe evaluation and social information. The programs will also ensure that payments, enrollment and information can safely be delivered to the Sudanese people.

The monitoring and evaluation system will assess potential risks and benefits for future projects and allow people to make informed choices about whether specific aspects of projects are safe to conduct. The hope for this system is to attempt to combat the paused humanitarian relief by monitoring risk factors in Sudan and either acting before it is too dangerous or finding another way around it.

The project management aspect of the infrastructural support system will focus on financing and executing the Sudan Emergency Safety Nets Project. While Sudan is in such turmoil and conflict, the political systems are functionally unilaterally, as this is the nature of civil wars. The project management aspect of the Emergency Safety Nets Project will take on all the administrative and financial aspects that may be done by a political party to ensure that humanitarian relief avoids becoming a political piece in the military conflict.

Final Thoughts

Sudan is struggling with limited food security and constant military conflict. Where the fighting escalates, emergency relief to Sudan is limited and removed to ensure the safety of the relief workers. The Sudan Emergency Safety Nets Project works during these tumultuous times to ensure that the high-conflict areas of Sudan may still receive humanitarian aid. This project works during the halts of other humanitarian projects so that the people of Sudan do not suffer during the civil wars.

– Paige Tamasi

Paige is based in Los Gatos, CA, USA and focuses on Global Health and Politics for The Borgen Project.

Photo: Unsplash

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Child Soldiers in Guatemala

Child Soldiers in GuatemalaMilitary groups worldwide recruit children and although the U.N. has put measures in place to prevent this, the issue is still prevalent. Their roles are not restricted to only soldiers or gunmen, but spies, messengers, sex slaves and suicide bombers. The U.N. receives regular “reports of children as young as 8 or 9 years old associated with armed groups”. When discussing child soldiers in Guatemala in the present day, separating state and non-state armed groups is essential. Guatemala’s gangs and guerrilla groups rely on child recruitment and, as these are not state institutions, these groups are harder to study or control.

Child Soldiers in the Civil War

From 1960 to 1996 Guatemala stood as a site of internal conflict. The leftist guerrilla movement Unidad Revolucionaria Nacional Guatemalteca (URNG) fought against the Guatemalan Government in the Civil War. In this 36-year war, it was “common practice” for both the national army and the guerrilla groups to recruit children. There is a lack of information on the exact number of child soldiers involved in the war. However, the U.N. estimates that out of the 3,000 members of the URNG, 214 were under the age of 18. Unfortunately, this lack of data meant that, after the war, child soldiers in Guatemala did not receive compensation, or benefit from any reintegration programs.

Progress

In 1992, the U.N. wrote the Convention on the Rights of the Child (UNCRC) to tackle issues of child safety and exploitation. This states that parties cannot recruit anyone under the age of 15 into the armed forces and pushes the State to take preventative measures.

In 2000, the Optional Protocol to the CRC that focuses on the involvement of children in Armed Conflict (OPAC) raised the age from 15 to 18. Guatemala signed both of these documents, however, there is no evidence of progress.

Military Schools

Guatemala’s military schools are a key example of how the state is still subjecting children to violence and ignoring the concerns raised in the CRC and OPAC. Children in these military schools take part in combat training and weapons handling. Many of these military schools do not meet the government’s educational standards and there are numerous complaints of the use of corporal punishment. Child Rights International Network (CRIN) revealed that in 2016 at least three students reported rape by soldiers at the military school Adolfo V Hall.

Even if these children are not legally members of the armed forces until they are adults, they are still victims to and witnesses of violence at such a young age. In these cases, differentiating voluntary and coerced enlisting is extremely difficult.

Child Soldiers in Gangs

Maras are a type of gang in Guatemala and the 2023 CRIN report shows that recruitment is hard to regulate as maras control large residential areas.

The Maras specifically target children on their way to and from school. These children are coerced and threatened into becoming spies or gunmen and many children have been murdered on their way to school for refusing to take part. According to a 2023 CRIN report “Save the Children reports that children as young as 6 are recruited to transport guns…and have been coerced into homicides as young as 13.” This has had a detrimental impact on education. School is no longer a space of safety and learning but “a site of recruitment.” This creates a vicious cycle, as with lower access to education more children turn to gang activity.

Schools of Peace

Save the Children has worked with Guatemalan families suffering from poverty since 1999. In the last year,  Save the Children positively impacted 201,000 young people. Aside from alleviating poverty, Save the Children has created a Schools of Peace project. This project results from education and child protection services working together to prevent any disruption to the education of young people. The initiative interrupts the process of gang recruitment and ensures that schools in Guatemala have the right protection from any danger due to armed conflict.

Save the Children tells the story of 16-year-old Estrella, a daughter of a gang leader. Her life was wrapped in violence and her education was sacrificed until Schools of Peace intervened. She is doing very well at school and works as a youth leader near Las Canoas to help others who have suffered like her.

Toybox

Toybox is a charity that provides young people with safe spaces and communities outside of school. The organization works in the country’s capital, Guatemala City and provides counseling and therapy to young children. It has provided children across the world with psychosocial support. Toybox identified that 10% of annual births in Guatemala are undocumented. This reduces the amount of protection the state can provide in conflict situations.

In 2022, Toybox helped 2,794 children around the world obtain legal identity documents. The charity also holds weekly sports activities to develop and maintain trusting relationships between staff and children. It is setting up a support network for these young people, while also demonstrating that other, more constructive, paths are still viable to children who live under gang rule.

A 2023 CRIN report identifies that poverty exacerbates non-state violence and increases child recruitment. It suggests treating the root cause of poverty to see a drastic difference in the levels of child soldiers in Guatemala. Initiatives such as these are important to show that there is a path out of the violence that dominates their lives.

– Liz Johnson
Photo: Flickr

Fragility and Rule of Law in Rwanda 

Fragility and Rule of Law in Rwanda The fragility and the rule of law in Rwanda have recently become topics of discussion. This follows a ruling by the U.K. Court of Appeal, which deemed Rwanda unsafe for U.K.-bound refugees. Additionally, there’s been talk about recent violence in the DRC, with some sources suggesting that Rwanda’s current president, Paul Kagame, has supported it. Several factors contribute to Rwanda’s fragility, ranging from a lack of government transparency to the lasting effects of civil war.

A Brief Overview

Rwanda has a significant history of poverty and instability, attributed to various factors, from geography to politics. Approximately 38% of Rwandans currently live below the poverty line, defined by the U.N. as living on less than $2.15 a day. This means many struggle to maintain even a basic standard of living, exacerbating the fragility of Rwanda’s rule of law.

Fragility in Rwanda

Between 1990 and 1994, civil war overcame Rwanda, resulting in fragility and weakly upheld rule of law throughout the nation. A rift between the two major ethnic groups present in Rwanda at the time, the Hutus and the Tutsis was the pretext behind the civil war. The genocide had a lasting effect on Rwanda, decimating families and resulting in more than 800,000 civilian casualties.

Although the presence of fragility and unstable rule of law in Rwanda has diminished, it remains a complex factor affecting the country’s development. Despite efforts to rebuild and foster development, Rwanda still grapples with the legacy of its tragic history. Conflict traps such as these have been shown to have a catastrophic effect on the future development of any nation. The result is slow and unstable development, making it all the more challenging to establish security throughout the nation. 

Democracy and Rule of Law

Government corruption also contributes to fragility in Rwanda. While Rwanda’s government structures have improved over time, its democracy and criminal justice system still face challenges. The current ruling party of Rwanda is the RPF, also known as the Rwandan Patriotic Front. There are basic barriers to fair democracy present, such as high administrative requirements for RPF opposition parties, as well as instances of imprisonment for opposing party members. 

In the past, individuals labeled as ‘opponents of the government,‘ including bloggers and journalists reporting on political issues, have faced arrest and illegitimate trials. This raises questions about the stability of democracy and the preservation of political freedom of speech.

Previous allegations of corruption have also raised concerns about the integrity of Rwanda’s criminal justice system. Reports from Human Rights Watch have highlighted maltreatment of inmates, along with claims of unaccounted disappearances and deaths, indicating weaknesses in Rwanda’s rule of law. Journalists have previously reported on topics such as unlawful detention and torture, suggesting that human rights in Rwanda are not fully protected and that the rule of law remains fragile.

The Good News

Rwanda has introduced several frameworks and policies to address the lasting damage from its history of violence. One example is the ‘Rwanda Vision 2020’ development program, which outlines specific goals for sustainable development. The Rwandan anti-corruption policy, a component of Rwanda Vision 2020, recognizes the need for national development that can enhance the quality of life, promote a competitive economy and deliver effective and efficient public services. Achieving these goals involves good governance, strengthening law enforcement and monitoring and evaluation frameworks to uphold the rule of law.

Government stability can be best preserved by increasing transparency, which reduces the likelihood of corruption and illegal activity. Transparency International reports that Rwanda recently ranked as the fourth-least corrupt African country. Rwandan officials’ statements support this, noting the acceptance and adoption of a culture of ‘transparency and accountability’ within the Rwandan government. Increased government transparency is likely the primary reason behind these improvements in Rwanda’s government, as strong checks and balances are essential to long-term stability and preventing government failure.

Addressing fragility has had and will continue to have beneficial effects for Rwandans living in absolute poverty. One framework included in Rwanda Vision 2020, the Vision Umurenge Program (VUP), aims to target absolute poverty and elevate Rwanda to a middle-income country. VUP provides financial assistance to accelerate poverty reduction through economic advancement schemes. This framework includes female beneficiaries, empowering women, who often belong to the poorest socioeconomic groups, by distributing funding more equitably among household members. This effectively targets some of the lowest-income individuals and accelerates poverty reduction.

Following Rwanda Vision 2020, which set targets to be achieved by 2020, Rwanda has introduced the Rwanda Vision 2050 policy. This policy outlines goals for improving health care and education provision, as well as increasing workforce productivity. By enhancing access to public goods and boosting productivity levels, Rwanda aims to reduce absolute poverty rates, ensuring more Rwandans have access to basic necessities, regardless of their household income. Overall, Rwanda is making steady progress toward eradicating absolute poverty.

– Hannah Bugeja
Photo: Flickr

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Improvements to Healthcare in Mozambique

Healthcare in MozambiqueThe state of healthcare in Mozambique has drastically changed in the last few decades. While Mozambique was once a country with little access to healthcare services, the country has decreased mortality rates since the launch of its Health Sector Recovery Program after the Mozambican civil war, with assistance from the World Bank.

History of Mozambique

The Mozambican civil war that took place from 1977-1992 had lasting effects on the country’s healthcare system and economy, resulting in limited funding for health services and insufficient access to care providers.

The Health Sector Recovery Program was launched in 1996 in order to refocus on funding healthcare in Mozambique, which desperately needed expanded resources to address the growing health crises. New health facilities were constructed throughout the country increasing accessibility to healthcare. The number of health facilities in Mozambique from the start of the civil war to 2012 quadrupled from 362 to 1,432 and the number of healthcare workers increased along with it.

Improvements to Healthcare and Accessibility

About 30 years ago, Mozambique had one of the highest mortality rates for children under 5 but was able to significantly reduce this number after the success of the Health Sector Policy Program. In 1990, this rate was 243.1 mortalities per 1,000 children. The rate has been reduced to 74.2 mortalities as of 2019. Maternal health was also targeted by the program, with increased health facility births from 2003 to 2011.

Conflict in Cabo Delgado

Despite these improvements to healthcare in Mozambique, Cabo Delgado, a northeastern province, is facing one of the worst healthcare crises in the country since violence struck the area in October 2017. Conflict between non-state armed forces clashing with security forces and other armed groups has caused more than 200,000 people in the area to become internally displaced. Coupled with the aftermath of Hurricane Kenneth, one of the strongest hurricanes to hit Africa, the area is facing severe food shortages and lack of shelter for people.

Cabo Delgado has also seen a rise in COVID-19 cases and other diseases such as cholera, diarrhea and measles, resulting from inadequate clean water and sanitation.

Intervention by UNICEF

On December 22, 2020, UNICEF shared a press release on the increased need for healthcare in Cabo Delgado. As the rainy season begins, there is an increased risk for deadly disease outbreaks. It appealed for $52.8 million in humanitarian assistance for 2021 projects aimed at aiding Mozambique.

UNICEF is expanding its water and sanitation response in order to prevent the outbreak of water-borne diseases like cholera and the further spread of COVID-19.

UNICEF also aims to give crucial vaccines to children in Mozambique, increasing its numbers from 2020. The 2021 targets include vaccinating more than 67,000 children against polio and more than 400,000 measles vaccinations. Children will also be treated for nutritional deficiencies from food insecurity and UNICEF plans to screen more than 380,000 children under 5 for malnourishment and enroll them in nutritional treatment programs.

Mental health support services will be provided to more than 37,000 children and caregivers in need, especially those experiencing displacement from armed conflict and those affected by COVID-19.

The Future of Healthcare in Mozambique

While healthcare in Mozambique has significantly improved in the last few decades, a lack of health services still affects the country’s most vulnerable populations. Aid from international organizations like UNICEF aims to tackle these issues to improve healthcare in Mozambique.

– June Noyes
Photo: Flickr

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3 Examples of Countries Recovering from War Today

Countries Recovering from War

Civil war often erupts in countries that suffer from perpetual poverty. At the same time, war only serves to intensify poor living conditions in regions that are already vulnerable. In countries ravaged by war, people are displaced, infrastructure is destroyed and often entire industries are disrupted, destroying the resources that a country needs to keep its people alive. This devastation often persists even after a war is over. However, several formerly war-torn countries are making significant strides when it comes to post-war reconstruction and sustainable development. Here are three examples of countries recovering from war today.

3 Examples of Countries Recovering from War Today

  1. Yadizi Farmers are Recultivating Former ISIS Territory
    When the Islamic State in Syria and the Levant (ISIS) swept through the Sinjar region of northern Iraq in 2014, they displaced millions of farmers who relied on that land to make their living. ISIS persecuted the local Yadizi people for their religious beliefs and tried to destroy their farms in order to prevent them from ever being able to live in Sinjar again. In 2015, the allied Kurdish forces retook Sinjar, but the devastation of the land and the constant threat of land mines has since caused many Yadizi farmers to fear returning to their homeland.However, the Iraqi government has begun funding post-war recovery efforts in order to allow the Yadizi people to take back their land. A Yadizi woman named Nadia Murad, winner of the 2016 Nobel Peace Prize, has started a project called Nadia’s Initiative. A group called the Mines Advisory Group (MAG) has also begun to clear landmines from the land of the displaced farmers. Although progress has been slow, partly due to limited governmental support in recent years and heavy regulations on the transportation of fertilizer, the region is slowly but surely recovering.
  2. The Central African Republic is Working on Protecting its Forests
    After years of political instability and a series of coups, as of 2016, the Central African Republic has a democratically-elected president for the first time in its history. Although the election of President Touadera signaled a step in the right direction toward peacebuilding, there are many areas that still need to be addressed.One particular problem for the Central African Republic is the widespread practice of illegal logging. The country’s forests are one of its biggest resources and wood is its top export, but corrupt public officials have allowed a massive trade in illegal lumber to arise, threatening the sustainability of the forests and undermining recovery efforts. Forest managers attempt to stop the problem but are often threatened by public officials who profit from the illegal lumber trade. However, many in the Central African Republic are working on changing the status quo. In 2016, the country renewed an accord with the European Union that incentivizes the country to reform forestry laws and crack down on illegal logging in exchange for favorable trade agreements. This renewal of the country’s greatest natural resource will help post-war recovery by strengthening its income from trade, building relationships overseas and giving resources for the reconstruction of damaged buildings.
  3. South Sudan is Using Mobile Money to Reignite the Economy
    The country of South Sudan is in the middle of recovering from a civil war that lasted five years and killed about 400,000 people. Part of the devastation wreaked by this war was the collapse of the South Sudanese economy, as cell towers were destroyed, trust in financial institutions was eroded and corruption began to overtake the country’s banks. According to AP News, “Around 80 percent of money in South Sudan is not kept in banks” primarly because most residents are rural and live too far from the major cities where the banks are located. Of course, there are other barriers as well, including the fact that only 16 percent of the population has a government ID (which means more expensive withdrawals and no money transfers) and concerns about the stability of the country’s banking system.As a part of the country’s post-war recovery, the South Sudanese government is working with mobile carriers to create a system called mobile money, in which people can bank from their phones instead of relying on the country’s physical banks and ATMs. This system allows people to easily participate in the Sudanese economy and since studies have shown that having access to services such as banks helps economic growth, the mobile money boom will be invaluable to South Sudan’s post-war recovery. The government is also working on setting up biometric identification for all citizens to use in banking, and on restoring damaged mobile infrastructure in order to make services like mobile money available anywhere.

– Kelton Holsen
Photo: Flickr

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10 Health Costs of the Syrian Civil War

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

Addressing Mental Health in Sierra Leone

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

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Living Conditions of Syrian Refugees in Germany

Syrian Refugees in Germany

What began as a peaceful political uprising in 2011 has become one of the most devastating on-going civil wars of the 21st century. The war has contributed to the biggest refugee crisis since World War II, leaving Syrian refugees in Germany hopeful for improved living conditions. The Syrian Civil War has not only devastated the country and its people but also neighboring nations, creating a regional disruption.

Syria’s fall is a global failure, and the consequences the war has brought with it have been difficult for other countries to manage. The Syrian Civil War forced countries to establish new policies to address the influx of Syrian refugees. Syrians have been escaping the bombings and repression since the outbreak of the war in 2011. However, in 2015, Europe was under more pressure when over one million refugees arrived through dangerous sea travel. Some Member States have closed their borders, and others have implemented new welcoming policies.

Current Living Conditions

Angela Merkel’s Germany welcomed thousands of Syrian refugees with its open door policy. German crowds awaited the arrival of Syrian refugees in Munich from Austria in 2015. However, today this enthusiasm contends with the rise of populism and right wing parties, affecting the living conditions of Syrian refugees in Germany. Amidst refugee settlement, anti-immigration views have become more and more popular among Germans. This forces the government to desperately establish effective integration policies to reduce tensions.

The living conditions of Syrian refugees in Germany are very difficult. They are hospitalized as needed after arriving from extremely life-threatening conditions. Later, the refugees receive camp assignments. Due to the large number of refugee arrivals, Germany had to build emergency camps. These camps lack quality infrastructure and necessary equipment. Some refugees are assigned to shelters such as Tempelhof, where they sleep in a small bed among hundreds of others in one hall.

Due to integration laws that assign family members to different cities, some refugees must endure family separation. Moreover, Germany suspended the family reunification policy between 2016 and 2018 for refugees awaiting their status approval. According to the German government, Germany embassies received 44,736 family reunification applications in 2018, but only granted 1,500 applications.

Paperwork Holds Up the Process

Unfortunately, the living conditions of Syrian refugees in Germany become even more difficult once paper work begins. It could take up to eighteen months to be recognized as an asylum seeker. In most cities, refugees cannot join integration programs if they are not asylum seekers. According to the German law, asylum is a given right to anyone fleeing political persecution. However, the process of being granted refugee status based on the Asylum Act and the Residence Act can be lengthy.

These acts entitle refugees to integration programs, language classes and employment. This is not the reality for refugees who wait years of the approval of their status. Systematic hurdles can stop refugees from learning German, continuing their education or pursuing a job. Therefore, many refugees lose hope and enter black market jobs or seek distressing pathways.

A Brighter Future

Nonetheless, German policies, under the guidance of Merkel, continue to strive for effective integration. Overall refugee unemployment dropped sharply from 50.5 percent to 40.5 percent in mid-2018, based on the Institute for Employment Research. The study also concludes half of the refugee population will be employed by 2020. This is an optimistic advance considering the language barrier in addition to the fact that 80 percent of refugees who arrived in 2015 did not acquire a university degree. This is achievable because the settlement of refugees is improving along with the overall living conditions of Syrian refugees in Germany.

Eventually, refugees will be able to leave crowded shelters and move into apartments with their families. By improving  integration efforts and paperwork processes, Syrian refugees in Germany can gain asylum status and attain their legal rights.

— Njoud Mashouka
Photo: Flickr

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VISTAS Workshops Restoring Mental Health in South Sudan

Mental Health in South Sudan

After years of violent conflict and civil war, many South Sudanese are suffering from mental health problems caused by trauma. With little to no government funding and cultural stigma attached to psychological health issues, thousands of people struggle to cope and heal from decades of war. USAID’s program Viable Support to Transition and Stability (VISTAS) is working to bring healing and restoration to the war-torn people by conducting trauma awareness workshops.

A History of Conflict

South Sudan, the youngest nation in the world, declared its independence from Sudan in 2011 after years of civil war and fighting. Only two years after gaining independence, conflict once again erupted in South Sudan, this time between the infant nation’s president and vice president, leading to a civil war that lasted for five years. Around 400,000 South Sudanese people lost their lives during the war, including women and children, while many more suffered unthinkable traumas and hardships. According to UNICEF, three-quarters of South Sudanese children have never known anything but war, and as many as 19,000 of them were kidnapped or recruited to join armed groups. Numerous accounts of South Sudanese women being sexually abused and raped by opposition forces circulated throughout the war.

End of the War Brings New Battles

Although the fighting has officially ceased, South Sudan’s restoration is just beginning. Years of violence and trauma have left their mark on the mental health of many in the nation. Although data is limited, several studies show that the conflict has had a severe effect on the mental health of South Sudanese civilians and soldiers alike. Nearly 41 percent of respondents in a survey conducted by the South Sudan Law Society and the United Nations Development Program (UNDP) showed symptoms of post-traumatic stress disorder (PTSD). The South Sudan Medical Journal reported that PTSD, depression, anxiety and substance abuse are major health issues impacting the country. However, the conflict-riddled nation not only lacks the resources to bring healing and help to those suffering from trauma, but it also struggles to remove cultural stigma and shame from mental health problems.

Mental Health Care Lacking in South Sudan

In 2012, South Sudan’s Deputy Minister of Health, stated, “The situation is very rudimentary in terms of mental health,” and “There are so many people suffering because of post-war trauma.” Today, mental health in South Sudan is still severely under-resourced, with its 2017-18 budget allocating only two percent to the health sector, none of which was appropriated towards mental health care.

In 2019, only three psychiatrists reported practicing in the whole country. Atong Ayuel, one of South Sudan’s three psychiatrists, said that “mental illness is a huge problem in South Sudan,” blaming the problem on both the country’s underfunded health program and that mental health in South Sudan is a culturally taboo subject.

VISTAS Workshops

USAID’s program VISTAS is conducting trauma awareness workshops throughout South Sudan with two primary goals:

  1. Create a space where those suffering from trauma-induced mental health issues can open up about their experiences and begin to address them
  2. Provide communities with practical tools to collectively address mental health issues and promote reconciliation and healing

“We define trauma as a wound. It is when something shocking or abnormal happens in your life, and it overwhelms you and you don’t know how to respond,” said Thor Riek, a 32-year-old South Sudanese man who struggled to cope with trauma from his days as a child soldier. Now as a trainer for VISTAS trauma awareness workshops, Thor not only has gained the tools he needs to respond and recover from past trauma, he now shares these practical tools of healing with other South Sudanese who are also suffering from trauma-induced mental health issues. Thor hopes the workshops will give participants “a narrative that can move them forward from the cycle of violence and begin to walk on the healing journey.”

In 2018, VISTAS workshops engaged 6,452 community members in different types of trauma awareness sessions. As South Sudan works to put years of violence and war behind them, programs like VISTAS’ trauma awareness workshops bring restoration and healing to a once war-torn people, inspiring a hopeful future.

– Sarah Musick
Photo: Flickr