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MSF Uses Virtual Reality to Build Better HospitalsMédecins Sans Frontières (MSF), or Doctors Without Borders to the English-speaking world, is a global organization that provides professional medical care wherever poverty, war, disasters or otherwise raise a need. According to the group’s International Activity Report, 6.3 million donors funded 11.2 million outpatient consultations, 750,000 inpatients’ treatment and more than 100,000 major surgical interventions in 2018 alone. MSF consistently achieves a huge global impact. While generous donors and devoted staff are part of this success, the organization also improves its operations to ensure progress. MSF takes every opportunity to evolve and utilize resources more efficiently. Most recently, MSF uses virtual reality to build better hospitals.

Building Innovation

One such evolution began back in November 2013 when Typhoon Haiyan struck the Philippines. After providing several weeks of emergency support from tent hospitals, MSF determined the municipality of Guiuan needed a more permanent solution. Plans to build a transitional hospital quickly began, and four months later, the organization completed the sturdier facility for use.

Two years later, MSF found an opportunity for innovation. With the help of design firm Pyxis, MSF’s technical team built a 3D printed model of the Guiuan hospital. Designers then turned the same 3D layout into an interactive virtual landscape, which was explorable through a virtual reality (VR) headset. But why should MSF redesign plans for an already built hospital?

Benefits of Creating a 3D Printed Model

These steps were not just for novelty; they served as a proof-of-concept for an innovative approach to the construction process. Since then, MSF has used this innovative virtual reality technology to build better hospitals. The tangible nature of the 3D printed model promotes a more user-friendly design stage. Planners can clearly determine if the facility’s design suits the environment it will serve.

On a more granular level, doctors can also optimize the facility’s layout before people start laying the foundation. The most immersive VR model supports this aspect. Is the main corridor wide enough to accommodate high traffic? Are the sterile processing rooms, scrub sinks and operating rooms in a useful order, or would doctors have to retrace their steps in situations where seconds matter? These details are crucial to the efficiency of a finished hospital.

The worst crises also benefit from the new approach. For example, the World Health Organization named the current Ebola virus outbreak in the Democratic Republic of the Congo a global health emergency, and the Ebola outbreaks require a quick response and reliable facilities. In this case, the best health care facility is the one that is operable first. Virtual reality expedites the construction process. Designers can create and build more nuanced plans potentially months faster than with traditional blueprints.

MSF uses virtual reality to build better hospitals by improving and expediting the construction process. VR landscapes and 3D plans are easier to visualize, edit and share amongst MSF staff around the world. Better yet, adopting VR technology now only makes it easier for designers to utilize future innovations. CAVE-CAD software, for example, is one such advancement that would allow architects to make changes to VR schematics while still inside the virtual environment. One thing is for sure; Médecins Sans Frontières continues to receive positive attention for the care it provides. As for hospitals, if MSF builds it, those who need it will come.

– Molly Power
Photo: Flickr

Why Refugees are Fleeing Central AmericaThe northern region of Central America is currently one of the most dangerous places on Earth. So, it’s no surprise that refugees are fleeing Central America. This circumstance has caused high levels of migration as many refugees are fleeing for their lives. In countries such as Honduras, El Salvador and Guatemala, many people experience gang-related violence, human trafficking and extreme poverty. The brutality forcing refugees to leave their homes is constant and not improving.

Moreover, poverty in Central America is widespread. In some regions, half of the population lives below the poverty line. Consequently, the number of asylum-seekers is increasing in neighboring countries, such as Mexico and the U.S. In 2014, there were 2,000 asylum applications in Mexico. In 2017, applications escalated to more than 14,000. As this crisis continues, it is important to understand the reasons why refugees are fleeing Central America.

Gang Culture in Central America

In the 1980s, civil wars weakened countries in Central America, leaving a legacy of violence and fragile governments. Due to these civil wars and mass deportations from the U.S., organized crime groups flourished. These groups grew into the overwhelming gangs present today.

Over the last 15 years, gangs have taken over rural and urban areas within Central America. They target poor, and thus vulnerable, communities by imposing their own authority. They also recruit boys as young as 12 years old and living in poverty as they lack educational or economic opportunities. Because of gang violence, the Northern Triangle is considered one of the deadliest places in the world, outside a war zone. For example, between 2014 and 2017, almost 20,000 Salvadorans were killed due to gang-related violence.

Gang culture has deeply penetrated the social fabric of northern Central America. Their grip on society is so severe that many migrants fear that their deportation will result in death. For example, 82 percent of women reported they would most likely be tortured or killed if they were to return home. Despite decades of authorities trying to eliminate gang activity, these criminal groups remain defiant and seemingly unbreakable.

Extortion and Human Trafficking

Similarly, extortion-related crimes are common in this region. Gangs extort small businesses and local individuals by forcing them to pay protection payments. If these individuals cannot afford these amounts, the gangs will murder them. For example, it is estimated locals in Honduras pay $200 million in extortion fees every year. Extortion fees cost Salvadorans $756 million a year. This results in a significant financial loss for local businesses and endangers many lives.

Moreover, human trafficking is another common reason why refugees are fleeing Central America. Women and young girls are most vulnerable to sexual exploitation. Often, gangs target and traffick young children for the sex trade. In Guatemala alone, at least 15,000 children are victims of child sex trafficking networks.

Gangs also manipulate children. They subject children to forced labor, making them sell and transport drugs throughout El Salvador, Honduras and Guatemala. Though widespread, authorities prosecute an extremely low number of people accused of human trafficking. In Guatemala between 2009 and 2013, police detained 604 human traffickers. However, only 183 went to trial and only 33 were convicted.

Helping Central America

A huge reason why refugees are fleeing Central America is lack of opportunity. Of course, this is largely due to the rampant crime and violence in the region. While the reality is grim, there is a reason to be optimistic. Many organizations and volunteers help these migrants in any way they can. In particular, Doctors Without Borders has been providing medical relief and mental health care to refugees traveling along migration routes through Mexico since 2013. The organization reported they provided more than 33,000 consultations at mobile health clinics and other facilities. Many patients need mental health care, especially women who are victims of sexual abuse. In fact, 31 percent of women reported being sexually assaulted along their journey.

UNICEF also recognizes the humanitarian crisis happening in Central America. UNICEF has offices in Mexico, El Salvador, Guatemala and Honduras. In these countries, UNICEF is working directly with people to prevent violence and alleviate poverty. They also help reintegrate deported children into their home countries and support children in asylum countries, protecting them from discrimination and xenophobia. UNICEF’s work in Central America is necessary as it is bettering the lives of many vulnerable people.

Often times, the only ways for migrants to escape the persecution and violence plaguing their hometowns is to seek asylum in another country. No matter how bleak these circumstances may be, hope can be found through the compassion and understanding of volunteers around the world. By understanding why refugees are fleeing Central America, people and organizations can begin working to change the conditions in these countries.

Marissa Pekular
Photo: Flickr

ways natural disasters affect impoverished nationsAfter a natural disaster, an impoverished nation faces even more struggles as it attempts to recover. While the media is a tool that helps inspire assistance to disaster-stricken nations, countries that experience natural disasters often still need more aid after the disaster is no longer in the spotlight. Developing countries are particularly vulnerable to the effects of natural disasters, and it is important to remember these effects when thinking about what you can do to help a nation in distress. Here are five ways natural disasters affect impoverished nations.

Five Ways Natural Disasters Affect Impoverished Nations

  1. Women are at higher risk. Women are at a higher risk of danger during and after natural disasters. In fact, more women than men are killed or injured during floods and hurricanes. Because of the expectation for women to be household caregivers in most developing countries, they are less likely to flee from their homes in an emergency. They are also less likely to know how to swim if there is a water emergency. Medical Teams International (MTI), an organization that seeks to bring medical help to those in need after natural disasters, recognizes the need for intervention. After the 2010 Haiti earthquake, women endured the brunt of a health crisis – in addition to a cholera epidemic, women experienced unsafe births and unhealthy pregnancies. To combat this, MTI entered the village of Crochu and provided vaccines and education about how to improve maternal health. The group also trained community members to help with births so the ordeal would be safer for the women. MTI remained in Crochu until 2018, when the community was able to maintain control of its health activities independently.
  2. Agriculture suffers. Natural disasters can damage croplands and livestock production, which hurts a developing country’s agricultural sector. Between 2005 and 2015, developing nations lost $96 billion in agriculture due to natural disasters, with half of these losses occurring in Asia, where floods, earthquakes and tsunamis are common. The Food and Agriculture Organization of the U.N. has created a risk assessment and reduction program that studies losses from natural disasters and implements new solutions to minimize future losses. This program also takes into account the losses in the forestry sector and fisheries, which provide additional sustenance.  The disaster analysis paves the way for other humanitarian groups, like the World Health Organization and the World Bank, to intervene directly.
  3. Children are more likely to become stunted. A child in India is seven percent more likely to experience stunting within five months of a natural disaster. For areas like India that face many disasters per year and already have a stunting rate of 38 percent, the stunting risk is great. Stunted children can face developmental difficulties that impact school performance and physical abilities due to a lack of nutritional fulfillment. The Center for Disaster Philanthropy is an international group that helps individual countries after natural disasters by providing meals, developing food security education programs and strengthening agricultural recovery. In 2017, the group was able to send lifesaving nutrition products to Mexico after two dangerous earthquakes ravaged the agricultural sector. This was possible because of a $600,000 donation from Abbott Laboratories Corporate Giving Program.
  4. Natural disasters can spur economic activity. Studies have shown that countries suffering numerous natural disasters also have higher rates of economic growth. After a 2008 earthquake in China, the economic growth rate increased by 0.3 percent due to billions of dollars spent on rebuilding efforts. Creating new and more efficient infrastructures with the help of disaster relief programs can improve the economy by providing immediate construction jobs, but also can facilitate long-term economic growth with safer, newer work buildings. This is made possible by donations to humanitarian organizations like the International Red Cross or All Hands and Hearts.
  5. Disease is likely to follow. A natural disaster itself does not cause disease, but it can become easier to contract a disease after a natural disaster. When there is a flood, there is a higher risk of cross-contamination of water with toxic materials, and water sources become breeding grounds for malaria-carrying mosquitos. In the event of an earthquake, people are forced to live in crowded shelters with limited access to sanitation systems and food. Immunity to vaccine-preventable diseases decreases significantly in this time. Doctors Without Borders is one group that helps disaster victims onsite and provides necessary vaccines or other medical treatment. The organization created pre-made disaster kits to send to countries in need of aid. The kid includes a full set of surgical tools and a large, inflatable tarp to be used as hospital space. The kit was introduced in Haiti in 2010, and now, it is known as a model for other disaster relief organizations.

Natural disasters and the ways natural disasters affect impoverished nations continue to be a threat to global health every day. Donating to relief and recovery organizations is a great way to be involved in helping poor communities abroad.

– Katherine Desrosiers
Photo: U.S. Department of Defense

Cyclone Idai and Health Crisis
With winds equivalent to a category 3 hurricane and storm surges surpassing 20 feet, Cyclone Idai made landfall near Beira, Mozambique in the early hours of March 15, 2019. One of the most powerful storms to ever hit Southern Africa, Idai left a trail of destruction and displacement, turning life upside down for residents along the coast. Now, months later, communities throughout the region continue to cope with the aftermath.

Effects of Cyclone Idai

What is now 2019’s deadliest weather event, the latest figures put Idai’s death toll at 847. The storm left millions of people affected, thousands displaced, entire communities in shambles and thousands of hectares of crops destroyed. As authorities continue to unpack the extent of the damage, the need for increased public health initiatives is evident. With the floods triggering widespread water contamination across the region, cholera and malaria outbreaks are becoming shockingly prevalent.

Perhaps Cyclone Idai afflicted Mozambique the most, where Reuters News reported that it killed nearly 600 people and destroyed more than 110,000 homes. In Beira, home to roughly 500,000 people, sweeping power outages and water contamination has made the city a hotbed for disease outbreaks. “The supply chain has been broken, creating food, clean water, and healthcare shortages,” says Gert Verdonck, the Emergency Coordinator for Doctor’s Without Borders (MSF) in Beira. “The scale of extreme damage will likely lead to a dramatic increase of waterborne diseases.”

Doctors Without Borders (MSF)

Following the storm, MSF quickly scaled up operations in Beira and other cyclone-stricken areas of Mozambique. With roughly 146,000 internally displaced persons seeking refuge in 155 camps across the country, MSF has launched an enormous relief effort. Dispatching emergency response teams to communities in need, MSF is working to implement vaccination programs and distribute food, water and medical supplies throughout Mozambique. Yet the scope of the damage is proving to be a difficult challenge for authorities and relief organizations. Treating over 200 cholera cases daily, MSF is calling on the international community to step up.

The World Health Organization and Cholera Vaccines

Also integral to relief efforts, the World Health Organization (WHO) is spearheading a massive vaccination program aimed at fighting the recent outbreaks. Through partnerships with humanitarian aid organizations Gavi and UNICEF, the WHO facilitated a shipment of almost 1 million cholera vaccines that arrived in Beira on April 2, 2019. A day later, a plane carrying 6.7 tonnes of medical supplies – essentials like medicine, stretchers, clean bandages and disposable gloves – landed in the coastal city. Opening an additional 500 beds and seven cholera treatment centers across cyclone-stricken Mozambique, the WHO is hoping to stifle water-borne illnesses in the region.

Despite valiant efforts from the WHO, MSF and other aid groups, the need for more funds and resources is evident. On April 1, the WHO requested an additional US$13 million to address communities affected by Cyclone Idai. With local authorities in Mozambique overwhelmed and underequipped to handle the fallout from Idai, the WHO is seeking to lead the charge, establishing response coordination at the national and provincial levels. Annual health care and aid expenditures in Mozambique are almost five percent below the global average, making foreign aid and nongovernmental relief organizations a vital piece of the recovery process.

An International Response

While some experts initially criticized the sluggish international response to Cyclone Idai, the global community has since placed considerable emphasis on relief efforts. Countries like Turkey, Botswana, Brazil and many more have supported Mozambique, allocating emergency funds and sending military assets to facilitate food, water and medicine distribution. Although combatting the cholera outbreaks and rebuilding communities that the storm devastated will be a stout challenge, the international response is promising. The response to Cyclone Idai indicates an international community both capable and willing to respond to natural disasters that impact the developing world.

– Kyle Dunphey
Photo: Google

malnutrition in libyaMalnutrition impacts children all over the world, particularly those who are poor or who reside in poorer countries. In Libya, rates for children who experience stunting, wasting and are overweight — the three main effects of malnutrition — are all moderate to very high, indicating that the nation has a lot of work to do to decrease these numbers and improve nutrition and health.

Malnutrition in Libya is exacerbated by the prevalence of migrants, refugees and internally displaced persons (IDPs) in Libya, as many attempt to use the nation as a crossing point to reach Europe. A recent analysis of migrant detention facilities has shown that malnutrition is prevalent in these centers.

Comparing Libya to Global Trends

Worldwide, 21.9 percent of children under five have stunted growth as a result of malnutrition, a significant decrease from 2000, when the rate was nearly 33 percent. Stunting refers to impaired cognitive skills that often lead to a decrease in school and work performance, negatively impacting children for the rest of their lives. Rates are highest in South Asia and Sub-Saharan Africa, where many countries continue to have a rate of 30 percent or higher.

Libya is just below the global average, with 21 percent of children experiencing stunting.

Wasting is the rapid loss of body weight due to malnutrition. Based on UNICEF estimates, 7.3 percent of children globally are wasted and 2.4 percent are severely wasted, with the highest rates in South Asia, followed by West and Central Africa. Rates in Libya are classified as medium, as 5 to 10 percent of children under 5 are wasted. This is comparable to the global average of 7.3 percent.

Complications of Malnutrition

Malnutrition can also cause children to be overweight. Overnutrition is a form of malnutrition that occurs when there is an imbalance in protein, energy and micronutrients in someone’s diet, often resulting in obesity. Not only is it important to eat food, but it is also important to eat the right combination of foods to have a healthy diet.

Globally, 5.9 percent of children under five are overweight, with the highest rates in Eastern Europe and Central Asia and the Middle East and North Africa. Libya is classified as very high, as more than 15 percent of children under five are overweight. This indicates that poor nutrition is one of the most serious food-related issues that Libya faces.

Efforts by the World Food Programme

Malnutrition in Libya has received global attention, and the World Food Programme has stepped in to fight food insecurity. As a nation with a largely desert environment, agriculture is limited, causing Libya to rely heavily on imported food. The country’s current trade deficit has a significant impact on the availability of food and proper nutrition, as prosperous trade is essential to feeding the nation.

To counteract this, the World Food Programme partners with four local organizations, LibAid, the Kafaa Development Foundation, the Sheikh Taher Azzawi Charity Organization (STACO) and the Ayady Al Khair Society (AKS), as well as the UN Country Team and Security Management Team. These local organizations work closely with communities experiencing malnutrition in Libya to determine the amount of need in particular areas.

The World Food Programme then provides onsite food distributions to vulnerable and malnourished families, with each family receiving two food parcels, which can feed five people over the course of a month. The parcels contain pasta, rice, wheat flour, vegetable oil, chickpeas, sugar and tomato paste, all of which provide approximately 75 percent of daily energy requirements. The parcels are meant to be used alongside other food sources, providing access to certain nutrients that are otherwise unavailable.

A Focus on Migrants, Refugees and IDPs

Migrants, refugees and internally displaced persons (IDPs) are the most in need of food assistance worldwide.  Approximately 60 percent of IDPs are vulnerable to food insecurity. As a result, the World Food Programme focuses many of its food distribution efforts on IDPs and other migrants in Libya, as they are among the most vulnerable to malnutrition in Libya.

Many migrants in Libya are out of reach of the World Food Programme as hundreds of detainees are in migrant detention facilities. In March 2019, a detention center in Tripoli came under fire after Doctors Without Borders published nutrition assessments and determined that almost one quarter of those in the center were malnourished or underweight.

Those held in detention facilities are entirely dependent on the Libyan authorities for the food they receive, and Doctors Without Borders found that many only receive one meal every two or three days and that those who are new arrivals sometimes do not receive food for four days.

Doctors Without Borders Respond

In response to this crisis, Doctors Without Borders began providing emergency food rations to ensure that food needs will be met in the future. Karline Kleijer, the head of emergencies for Doctors Without Borders, stated that “If food, shelter and essential services can’t be provided in a consistent and appropriate manner, then these people should be released immediately by the Libyan authorities.”

Hopefully, with the efforts of organizations like the World Food Programme and Doctors Without Borders malnutrition in Libya will continue to be addressed, and the plight of migrants will soon be recognized and responded to by the Libyan government. Malnutrition is clearly a mounting crisis that requires attention as soon as possible.

– Sara Olk
Photo: Flickr

Conflict in Burkina Faso
In late January 2019, the eruption of conflict in the Centre-Nord and Sahel regions displaced thousands of people in rural Burkina Faso. The recent attacks are an extension of a disturbing trend involving the displacement of more than 115,000 people since 2015. According to the Africa Center for Strategic Studies, extremist attacks and conflict in Burkina Faso have quadrupled since 2017 as groups like al Qaeda, Ansar ul Islam and ISIS continue to gain support in the north.

Burkina Faso and the Situation

One of the more inspiring success stories in Western Africa, Burkina Faso was on track to implement sweeping political reforms this year, including presidential term limits. Since the country ousted former authoritarian ruler, Blaise Compaoré, in 2014, voter registration increased by 70 percent as scores of Burkinabè grew excited by the prospects of democracy. However, this March 2019, the government put the referendum on hold indefinitely while it struggles to bring stability back to Burkina Faso.

The conflict in Burkina Faso has come at a considerable human cost, with over 70,000 people displaced since January alone. The majority have fled within the country’s borders, finding refuge in the nearby regions of Foubé, Barsalogho and Déou. Though the camps provide families with relative safety, the hastily built, government-sponsored structures are far from adequate. The state is already overwhelmed by a recent influx of Malian refugees and resources are stretched thin as a result.

In refugee encampments like Foubé, a shortage of shelters has forced the roughly 8,000 refugees to live in extremely crowded conditions, increasing the likelihood of measles and other outbreaks. The lack of sanitation has resulted in hygiene-related illnesses, respiratory infections, malaria and parasitic diseases. Meanwhile, in Barasalogho, the nearest clean water is an hour drive from the encampment, sometimes forcing residents to drink unsafe wells or streams and increasing the prevalence of cholera or other illnesses.

UNHCR and Doctors Without Borders

Despite the severity of the conflict in Burkina Faso, the situation has received shockingly little international attention. While the UNHCR and Doctors Without Borders (MSF) have played a prominent role in refugee support, the conflict continues to restrict access to many northern communities. MSF, whose primary goal in Burkina Faso is to issue vaccines and curb outbreaks, is working in only two refugee camps. With the situation becoming increasingly tense, the U.N. is urging refugees to seek shelter in camps where the UNHCR and MSF are active.

The sluggish international response has placed the burden of responsibility on the already overwhelmed Burkinabè government. While government rhetoric continues to support democracy and political reform, its response to the extremism has resulted in an unknown number of extrajudicial killings. In less than a year, Human Rights Watch documented at least 116 civilian deaths from government security forces, although the real number is unknown.

As the Burkinabè government struggles to regain stability, the U.N. is calling on the international community to do more. The U.N. Central Emergency Response Fund allocated $4 million early this March, although experts say roughly $100 million is needed to adequately address the crisis. Although the 115,000 forcibly displaced people face a stout uphill climb before the restoration of peace, the future of the Arizona-sized nation is still bright. While a new date for the referendum has not been announced, the steady rise in voter registration and political mobilization suggests reform is on Burkina Faso’s horizon.

– Kyle Dunphey
Photo: Flickr

MSF in Yemen: Helping Amid ConflictInstability continues to plague Yemen, exposing almost 20 million people to food insecurity and more than one million to cholera. The damage is evident in Yemen’s weak healthcare system, which leaves millions of people vulnerable. Medecins Sans Frontieres (MSF), or Doctors Without Borders, is an organization that provides healthcare for people affected by conflict and poverty. Though warfare complicates operations on the ground, MSF in Yemen is not giving up.

The Challenges of Aid in Yemen

In 2018, an airstrike destroyed a newly built cholera treatment center. Fortunately, there were no patients or workers present at the time, but the vital project had to be put on pause until repairs and reconstruction could begin. Events like this threaten the effectiveness of MSF in Yemen and risk the lives of the 16 million people who lack basic healthcare.

MSF also runs 12 healthcare centers of its own in addition to the 20 hospitals the organization supports. Its operations have treated more than 1.6 million people suffering from injuries, disease and chronic illnesses. MSF’s activities in Yemen take place in a constantly changing and dangerous environment. Since 2015, constant fighting between various militant groups has damaged countless Yemeni health facilities, leaving only half fully functioning. Many hospitals and health facilities in the areas have closed down because of safety concerns or because they cannot pay workers.

MSF in Yemen

The facility that was destroyed was one of many new treatment centers responding to the cholera outbreak. Cholera is a serious issue in Yemen and has killed 2,184 people since April 2017. Because of the violence, almost 16 million Yemenis have suffered from reduced access to clean water and sanitation, which increases their vulnerability to cholera. MSF quickly reacted to the outbreak by opening 37 treatment centers and oral rehydration points. In just six months after the breakout, MSF admitted more than 100,000 cholera patients. While the threat of cholera has decreased since 2017, treatment centers remain a vital safe haven for those afflicted.

MSF responded to another issue caused by the lack of healthcare facilities: pregnancy. In 2017, MSF in Yemen helped 7,900 women deliver their babies. Pregnant mothers are especially vulnerable because they lack access to clinics. Even when there is a health facility nearby, traveling may be too dangerous or time-consuming. Consequently, mothers give birth at home, which exposes them to health risks.  Many pregnant women also don’t have access to prenatal care and can have preventable but fatal complications.

Treatment Centers In Yemen

MSF in Yemen dealt with the re-emergence of diphtheria in 2017. The organization acted quickly by opening up a treatment center in Ibb where 70 percent of cases were concentrated. MSF treated around 400 patients that year alone. As successful as that operation was, others remain an issue, like renal failure. Multiple renal failure treatment centers have been forced to close due to the conflict. Many facilities are under-equipped and some 4,000 patients are still left untreated.

Treatment centers are often too far, or treatment itself is too expensive. Patients require three dialysis sessions a week, so many will reduce the number of treatments to lower the cost. Unfortunately, this can be dangerous and ineffective in treating renal failure. MSF responded to the crisis and has helped more than 800 patients by offering 83,000 dialysis treatments and importing 800 tons of supplies.

More than 20 million Yemenis are in need of humanitarian assistance, facing hunger, disease and displacement. MSF continues to provide aid through one of its largest programs in the world. Since 1986, MSF in Yemen has been compensating for the lack of effective healthcare, even amid the conflict.

Massarath Fatima

Photo: Flickr

Oral Cholera VaccineCoastal cities like Beira, Mozambique thought they were prepared for cyclones. In 2012, the city built new drainage systems and barriers to help them withstand the rising seas and increased storms from climate change.

Cyclone Idai proved that they weren’t as prepared as they thought. On March 14, the cyclone hit the coast and claimed at least 847 lives in the region, as well as displacing tens of thousands. The cyclone created an inland sea from the mass flooding that spans 80 miles long and 15 miles wide.

How Beira was Affected

Since the cyclone, more than 1,300 people in Beira have been drinking from local ponds, overflowed latrines, and other unsafe water sources. These conditions are ripe for deadly diseases, including cholera.

Thousands of people are currently in displacement camps with few toilets and little clean water. While health workers have responded to the situations quickly, they have restored water supply to only 60 percent of the population. Many are still left to drink unclean water and defecate in the streets.

A cholera outbreak has been declared in Beira. The number of people affected went from five on March 27 into the hundreds. Cholera currently afflicts over 3,100 people and has resulted in six deaths.

Quick Response to Cholera Outbreak

On April 3rd, health workers started distributing oral cholera vaccines in Beira. Gavi, the vaccine alliance, is funding this movement. This Mozambique Ministry of Health is responding with support from the World Health Organization and others. They have given out an estimated 884,953 vaccine doses. They have also opened nine cholera treatment centers in the region, each with a capacity of 500.

Doctors Without Borders has called this distribution the “most ambitious campaign ever conducted using the one dose cholera vaccine strategy.”

This oral cholera vaccine is usually given in two spaced-out doses, but the aid group says one treatment is effective in emergencies. The single dose is effective after seven days and offers 85 percent protection for six months. In turbulent times, it can be hard to find people to distribute the second dose.

The success of distributing the oral cholera vaccine is primarily due to the preparedness of local authorities. They organized a campaign that mobilized 1,200 community volunteers and partners. The Ministry of Health made requests for volunteers soon as the cyclone hit and organized local aid.

The Ministry of Health used its abundant volunteers to set up distribution areas. Vaccine promoters got the word out using microphones and by handing out doses to high traffic areas. Volunteers are also passing out water purification tablets and educating people on precautions they should take with their drinking water.

– Michela Rahaim
Photo: Flickr

Cyclone Idai
Nearly a month after Cyclone Idai made landfall in Mozambique, officials and civilians are working to clean up the disaster zone. The Category 2 storm first hit near the city of Beira, an important port in Southern Africa, on March 14th and 15th. Winds during this period exceeded 105 miles per hour. The northern provinces of Mozambique are now beginning the reconstruction process.

The deadly storm left 603 people dead, though officials suspect many more unidentified victims washed out to sea. Additionally, Cyclone Idai destroyed 110,000 homes, wiped away entire towns and left rich farmland waterlogged. The people of the northern provinces depend on food from this farmland for both survival and business.

An Uphill Battle Against Poor Infrastructure

Mozambique struggles with a lack of access to quality healthcare, education and infrastructure. As a result, the nation is ranked 218 out of 223 countries with an average life expectancy of 51.4 years. Their impoverished status makes it difficult for them to recover from natural disasters.

The country requires aid from outside sources to rebuild in the north where Cyclone Idai first met the coastline. The United Nations’ fundraising appeal to cover the initial costs totaled $282 million USD. Hospitals-in-boxes are being transported by boat, food is being dropped from planes and 900,000 cholera vaccines have recently arrived in Beira. The vaccines are being distributed in the north as part of an effort led by Doctors Without Borders.

The Added Challenge of Cholera

Despite vaccination efforts, the cholera outbreak is continuing to spread because people still do not have access to clean water in the wake of Cyclone Idai. Residents of Biera are facing the brunt of the outbreak due to poor water infrastructure and overcrowding. Many of these residents have been moved to displacement camps with equally poor conditions.

There are 3100 confirmed cases of cholera as of March 27th, with six deaths. Health volunteers and officials in Beira are hoping that cholera cases will fall in response to the restoration of running water. However, this running water can only reach 60 percent of the city’s residents.

Dr. Katrin Duget from the Pioneros Centre explains that the use of antiretroviral drugs is a good solution for the time being. Well-equipped health facilities are heading distribution efforts.

A Nation Moving Forward

Many civilians will struggle to move forward, as they have to work to rebuild entire communities and homes. For now, it is important to focus on longer-term solutions such as an investment in vaccines. Cholera can also be treated by simple rehydration, but it must come quickly because the disease can kill within hours. The water filters being installed by the UN are helping communities gain access to clean water to hydrate properly.

In the months after disasters such as Cyclone Idai, it is important to look at proactive measures that can be taken before another crisis strikes. These include food education programs as well as vaccinations which can help civilians survive during a lack of widespread resources.

Meredith Breda
Photo: Flickr

Preventive Cholera Vaccination
South Sudan’s health system faces major challenges. These challenges stem from prolonged civil war repercussions, a great lack in medical care and vaccinations and historically long-running cholera outbreaks. Although South Sudan recently declared the end to its longest recorded cholera epidemic, cholera is endemic to the nation and will most likely return within the next few months as the rainy season begins.

However, some improvements and achievements are being made towards South Sudan’s health system. Today, the preventative cholera vaccination campaign — operated by Doctors Without Borders — works to prevent the acute infectious disease from spreading across the nation any longer.

Preventative Cholera Vaccination Campaign

From April 24th to May 12th, the preventative cholera vaccination campaign has progressed in Juba – South Sudan’s largest city and capital. Doctors Without Borders’ campaign is designated for 12 hotspot areas in Juba where numerous people were identified as at-risk in previous cholera outbreaks. Cholera outbreaks are not new to South Sudan – the country just faced its most severe and prolonged cholera outbreak in its history which protracted from June 2016 to February 2018, and lead to over 20,000 suspected cholera cases and 436 reported deaths.

Additionally, since 2013, the nation has endured multiple cholera outbreaks that particularly target vulnerable populations living in internally displaced people’s camps, urban informal settlements, cattle camps, rural populations, island dwellers and communities along the River Nile.

In order for the oral cholera vaccine to take effect, people need two doses for increased immunity. A single dose of cholera vaccine supplies some immunity for up to one year and the second dose must be ingested within eight months of the first dose to increase the level of protection and increase immunity to three to five years. Also, sustaining sanitation infrastructure and improving hygiene and water supplies, in addition to implementing vaccination campaigns, can help prevent infections by contaminated food or water, which is how cholera is spread.

Goals for Reducing Death by Cholera

In 2017, the Global Task Force on Cholera Control announced a new strategy to reduce deaths from cholera by 90 percent by 2030 in South Sudan and other affected countries. This strategy will involve strengthening case detection, prevention of avoidable cases and deaths and applying multi-sectoral interventions comprising of water and sanitation hygiene measures to eliminate cholera outbreaks in cholera transmission hotspots.

While preventative cholera vaccination campaigns aim to save lives in South Sudan, the world’s newest country still deals with several other complex challenges that need to be addressed.

Current Causes and Future Improvement

Severe food insecurity and acute malnutrition, an increased demand for care due to high HIV and AIDS prevalence, a lack of resources to purchase drugs and other medical supplies due to the oil shutdown, a 73 percent illiteracy rate for adults, limited availability to crucial maternity care services and poor access to safe drinking water and adequate sanitation are all some of the current factors contributing to the country’s extreme poverty.

However, with the current and essential health and medical care help from Doctors Without Borders and other international organizations such as Oxfam, CARE, WHO and Save the Children, conditions in the country could improve in the near future as more organizations find opportunities to provide aid to the country in need.

– Natalie Shaw
Photo: Flickr