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Public Health in Africa: Reducing Meningitis

Public Health in AfricaFor many people around the world, the COVID-19 pandemic was an eye-opening event that revealed the dangers and inadequacies of the world’s global health systems. However, for other people, outbreaks of epidemic diseases might be more of a lived reality. On the continent of Africa, many know a certain geographic region in sub-Saharan Africa as the “meningitis belt.” These 26 countries face the dangers of meningitis more than other places around the world, and the outbreak of the COVID-19 pandemic delayed the vaccination of the MenAfriVac meningitis vaccine to 50 million children in these countries. African governments collaborated with the World Health Organization (WHO), the Bill and Melinda Gates Foundation and PATH, a nonprofit health organization, to develop the MenAfriVac vaccine and distribute it to more than 350 million people living in areas of high risk. While this scientific effort made an incredible difference in public health in Africa, the COVID-19 pandemic largely disrupted the processes that allowed these successes to continue. The pandemic reduced services aimed at preventing meningitis by 50% from 2019 to 2020. Despite recent setbacks, WHO developed a plan to address meningitis.

Meningitis: The Disease

Meningitis is a complex disease with several variations. It arises in viral or bacterial form with several types of viruses or bacteria causing meningitis. Some meningitis vaccines protect against several forms of meningitis.

The types of meningitis are important to consider because historically, different types of meningitis affected African communities. Prior to 2010, only 10% of meningitis cases were a form other than meningitis type A; however, after the introduction of the MenAfriVac vaccine, the number of cases of meningitis type A decreased significantly. Since 2017, no person has experienced a case of meningitis type A in the region. While deaths due to meningitis still totaled 140,552 people in Africa in 2019, the elimination of meningitis type A means that about 95% of people diagnosed with meningitis survived in 2021. Since 2013, however, meningitis type C led to several outbreaks in the meningitis belt.

At the end of 2021, the Democratic Republic of Congo (DRC) reported 2,662 cases of meningitis along with 205 deaths due to meningitis. Local mobile clinics and vaccination drives from WHO helped reduce the outcome of death from 85% of cases to 10% of cases fairly quickly.

The Defeating Meningitis Road Map

WHO assists with suppressing the outbreaks of meningitis such as in the case of the Democratic Republic of Congo in late 2021; however, it also develops long-term plans to improve public health in Africa overall. In November 2020, the World Health Assembly approved the Defeating Meningitis by 2030 roadmap. WHO will implement the $1.5 billion plan in January 2023, which will begin the fight to control meningitis in Africa by 2030. The plan includes a goal to achieve a 90% vaccination rate using a new vaccine that will hopefully protect communities against new outbreaks of the disease. From 2023 to 2030, the plan also hopes to reduce deaths of meningitis by 70% and reduce cases of meningitis by 50%. Several steps to achieving these goals include increased disease surveillance to catch meningitis early and increasing awareness of services to improve overall public health in Africa.

With WHO’s plan to defeat meningitis by 2030, public health in Africa will greatly improve the lives of millions of people within the meningitis belt. Meningitis is mostly a preventable disease with the efforts of vaccinations and other measures of public health. As the rest of the world encountered during the COVID-19 pandemic, collaboration within a community goes a long way to keeping everyone safe.

– Kaylee Messick

Photo: Flickr

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Health in the Pacific Islands: Vanuatu Eliminates Trachoma

Health in the Pacific IslandsHealth in the Pacific Islands recently improved due to the elimination of a disease called trachoma on the island of Vanuatu. This island is located to the north east of Australia in a region called Melanesia. Vanuatu is the first of the Pacific Island countries to eliminate the disease, and the only one of 14 to complete this goal. Health in the Pacific Islands and around the world has improved significantly over time as public health measures reduced the number of people at risk of contracting trachoma by 92% over the past two decades.

Vanuatu

Vanuatu is composed of 83 islands and relies on agriculture. Due to the separation of islands, health in the Pacific Islands, including Vanuatu, is often inadequate. Access to health care remains a challenge to many residents, and there also exists a lack of resources and medical personnel. Though there are six hospitals located throughout the country, many people must rely on health centers due to the rural areas in which they live. The recent success story of the elimination of trachoma follows another success back in 2016 when the country eliminated lymphatic filariasis, a disease that affects the lymphatic system.

Trachoma

The bacterium, Chlamydia trachomatis, causes trachoma, which leads to a visual impairment that is, at times, severe enough to cause the patient to become blind. The bacterium has caused visual impairments in about 1.9 million people in the world so far, and 136 million people remain at risk of contracting the disease as of June 2021. The disease spreads through contact with discharge coming from the eyes or nose, whether through direct contact or intermediates such as flies. Trachoma is classified as a neglected tropical disease (NTDs).

People often find these diseases in countries in Africa, Asia and Latin America. Though there are many NTDs, trachoma is one of the known diseases in this category that can be eliminated from a population through the use of public health measures. Improvements to hygiene and access to clean water help control the spread of the disease, as well as control the spread of possible vectors such as flies. The push to eliminate trachoma began after data from 2014 indicated that trachoma infected 12% of children between the ages of one and nine years old. This means these children were at risk for serious visual impairment that would affect their future. Trachoma also holds a significant economic impact on countries that trachoma impacts, where these countries may lose up to $5.3 billion per year.

A Path Toward Elimination

Other countries can follow the success of Vanuatu by abiding by the recommendations of the World Health Organization (WHO) and mobilizing medical professionals and communities in places of at-risk individuals. The acronym for the policy toward eliminating trachoma is SAFE. It stands for “Surgery for trichiasis; Antibiotics to clear infection; and Facial cleanliness and Environmental improvement to limit transmission.” Communities pair this process with education on avoiding health risks, proper treatment and providing antibiotics to populations, especially rural individuals. Governments, such as the case in Vanuatu, also often partner with international organizations such as WHO, and with organizations that specifically work with treating diseases related to blindness such as the Fred Hollows Foundation.

The Fred Hollows Foundation is particularly important to the regions in and around Australia because it focuses on diseases related to sight. It helps to reduce poverty by providing medical treatments, education and training. It builds health facilities and works with local communities to end preventable blindness.

Looking Ahead

These ongoing partnerships and procedures that WHO outlines eliminate NTDs such as trachoma, allowing medical professionals to greatly improve health in the Pacific Islands. In 1998, WHO set a goal to eliminate trachoma by the year 2020. As of 2020, the new goal for the NTD elimination plan is now 2030. Trachoma remains a health problem in 43 countries. Hopefully, other countries in the Pacific Islands and around the world can use Vanuatu as a role model in eliminating more NTDs to improve health in the Pacific Islands and abroad.

– Kaylee Messick

Photo: Flickr

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Ending AIDS in Africa

Ending AIDS in AfricaAIDS (acquired immunodeficiency syndrome) is a highly stigmatized disease. Throughout history, the AIDS epidemic has brought on severe discrimination toward individuals on the basis of race, sexual orientation and socioeconomic status. The epidemic started in the 1980s, and upon arrival, it spread rapidly through marginalized communities – primarily prostitutes, drug addicts and homosexuals. AIDS is defined as the last stage of HIV (human immunodeficiency virus). AIDS and HIV are classified as STDs (sexually transmitted diseases); they are highly contagious and can cause severe flu-like symptoms. After acquiring HIV/AIDS, some expensive treatment options range from therapy to surgery to prescription drugs, however, there are currently no effective vaccines for the disease. Despite these complications, ending AIDS in Africa is a global goal.

Background of the AIDS Epidemic

The history of AIDS is controversial and incomplete. There are wide-ranging speculations regarding the origin of the virus in humans, but these are far from confirmed. In America, the AIDS crisis is commonly reported as beginning in the 1980s. The first cases, however, are believed to have occurred almost a decade earlier.

In Africa, AIDS is said to have spread to humans from chimpanzees in the early 1900s. The AIDS epidemic began on the continent in the 1970s, with the first cases being reported in the 1960s. Kinasha, Congo is commonly cited as the birthplace of the epidemic in Africa. A Cameroon traveler is said to have brought the virus to the city and from there, it began to spread rapidly. Within the next decade, AIDS reached the eastern and western parts of Africa. Coupled with diseases like tuberculosis, malaria, sarcoma, meningitis and pneumonia, Africa as a whole was nowhere near ready to deal with a new deadly disease.

The most recent update on the AIDS epidemic in Africa was in 2020. According to UNAIDS, there were 150,000 AIDS-related deaths in the region and 200,000 people were infected with HIV. Every week more than 1,000 adolescent girls and young women become infected with HIV in the region and 1.2 million people in western and central Africa are still waiting to initiate life-saving HIV treatment. Only 35% of children living with HIV in western and central Africa are being treated. Taking a step further, on a global scale, SOS Children’s Villages reports two-thirds of all HIV-infected people worldwide are Africans, which has resulted in significant social and economic consequences.

The Correlation Between AIDS and Poverty

The spread of AIDS and poverty in Africa are closely related; poverty is both the cause and effect of the disease. Due to the high poverty rate in Africa, sanitation and health care facilities are rare. Women are often restricted to the household and remained uneducated about STDs. There is also a high ratio of men in urban areas, widespread labor migration and sex workers – all contributing factors to the spread of AIDS. Overall, AIDS forces families to be ostracized from society and causes unemployment. Without a steady income or assistance from neighbors, entire families – even with only one case of AIDS – fall into poverty. Often, a family with an individual that contracts AIDS finds themselves both out of society and out of a job.

Since its arrival, the HIV/AIDS virus has targeted impoverished urban areas. Factors such as poor income levels and food insufficiency are coupled with transactional sex, which is correlated with the contraction of AIDS. Impoverished individuals are more likely to contract AIDS and because the disease is so highly stigmatized, these affected individuals become disadvantaged when looking for economic opportunities. The virus has perpetuated a cycle of poverty – one that desperately needs to be broken.

The Fight Against AIDS

Despite numerous obstacles, the U.N. and a multitude of nonprofit organizations remain committed to constricting the spread of HIV/AIDS. Recently, a U.N. Millennium Development Goal was created to end the AIDS epidemic worldwide by 2030. So far, the U.N. has stayed true to its word – the number of AIDS deaths in sub-Saharan Africa has declined by roughly 35% in recent years due to proper diagnosis and life-saving therapeutic treatments carried out by experienced U.N. physicians.

The Future of AIDS in Africa

Ending AIDS in Africa is a daunting task, however, the steps taken by leaders around the world have helped in diminishing the presence of the fatal disease. Due to the high correlation between poverty and AIDS, it is imperative that nations and organizations across the world come together to enact poverty-related reform. Through proper funding, the governments of Africa could establish proper health care facilities and set up economic and educational programs. AIDS may not have a vaccine, but there are solutions so long as international organizations remain committed to preventing its spread.

– Sania Patel
Photo: Flickr

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Mental Health in Pakistan

In developing countries like Pakistan, a nation that has faced violence, economic and political instability since its birth in 1947, mental health is a highly consequential yet invisible issue. Pakistan has one of the highest mental illness rates in the world — A 2016 article by DAWN says around 50 million Pakistanis suffer from mental issues. Pakistan also has a staggeringly low number of psychiatrists — a 2020 article published by The Lancet Psychiatry says Pakistan’s population stands at more than 200 million people yet the nation has fewer than 500 psychiatrists. A 2015 article by Inamullah Ansari says Pakistan has four psychiatric hospitals available to the whole country. This makes it especially hard for those who need help to find it, a problem only exacerbated in rural areas where there is only one psychiatrist per million people. For these reasons, improving mental health in Pakistan is imperative.

Mental Health Stigma in Pakistan

The topic of mental health in Pakistan carries a stigma, which deters people from seeking professional help. Many believe that mental health issues stem from “supernatural forces,” and as such, psychiatric patients seek help from religious healers. This is due to limited educational awareness of mental health conditions and minimal access to mental health professionals.

Mental Health Among Pakistani Women

Pakistani women face significant societal stigmas and gender biases, which marginalize women and serve as stressors exacerbating mental health issues among women. In Pakistan, violence against women is rife as society considers violence “one of the acceptable means whereby men exercise their culturally constructed right to control women.”

It is common for many Pakistani families to celebrate the birth of a boy but mourn the birth of a girl. Child brides, dowries and exchange marriages are common, especially in rural areas. And often, early marriage results in abuse, violence, and in extreme circumstances, some marriages lead to honor killings and acid burns. Marital violence is concerningly common in Pakistan. A United Nations study found that a staggering 90% of Pakistani women surveyed suffered mental and verbal abuse from their spouses and 50% of women endured physical abuse.

Societal Stigma

Divorce in Pakistan also carries a tremendous stigma. Many women are afraid to leave their husbands simply due to social stigma, fearing their friends and families will cut them off. This stigma often traps women in a cycle of abuse. Around 70% of abused women have never opened up to anyone about their abuse, says a 2004 study by Unaiza Niaz.

This constant abuse puts women at high risk for depression, post-traumatic stress disorder, substance abuse and even suicide. Marital abuse also puts children at a higher risk for depression, anxiety, substance abuse and poor school performance. Children younger than 12 with abusive parents are up to seven times more likely to endure emotional, behavioral and learning difficulties, says the same study.

Several studies and surveys have shown that women, especially married women who have faced violence, are exponentially more likely to seek psychiatric care than men. Due to the gender-specific issues Pakistani women endure, promoting mental health in Pakistan, especially for women, is imperative.

Fighting for Change

Although the situation seems grim, many organizations and individuals are fighting to bring awareness and increase psychiatric care for those who need it the most.

Dr. Alaptagin Khan is working to raise awareness of mental health in Pakistan and established the Childhood Trauma Research Center in Peshawar in 2018 at Lady Reading Hospital, with the support of the Neurocare Foundation. This center collects data, hosts workshops and seminars and works to bring awareness to childhood trauma. The center aimed to collect data from 2,500 participants by December 2020. The data “will allow health professionals to assess the true disease burden of mental health disorders associated with childhood trauma in Pakistan.”

The Pakistan Psychiatric Society, founded in 1972, is the largest professional psychiatric membership organization in Pakistan. It represents more than 400 psychiatrists and continually advocates for a better system to combat mental health in Pakistan. It publishes scientific journals and magazines on mental health awareness and provides training for psychiatrists.

BasicNeeds Pakistan, started in 2011, is a nonprofit organization that “works to improve the lives of people living with mental illness and/or epilepsy in Pakistan.” It provides mental health training for community volunteers, brings awareness to mental illnesses and common symptoms and debunks myths or stigma. In addition, in 2016, it started the Centre for Women’s Enterprise and Development, which aims to create job opportunities for women suffering from mental illnesses. As of 2016, BasicNeeds Pakistan has provided support to 16,703 people who faced mental health issues or knew someone who did.

Looking Ahead

Mental health in Pakistan is a dire issue, one that political turmoil and instability continue to perpetuate. It is also one that women are at the forefront of, contributing to the oppressive standards of women’s living. It is an epidemic that continues to grow, affecting the entire population’s well-being and must be addressed for Pakistan to improve as a country.

– Padma Balaji
Photo: WikiCommons

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Updates From AIDS Conference 2022

AIDS ConferenceThe 24th Annual AIDS conference occurred in Montreal between July 29, 2022 and August 2, 2022. This was the first year the conference employed a hybrid model with both in-person and virtual speakers. As a result, researchers, advocates and leaders from 172 countries attended, and most were from developing countries.

The AIDS conference displayed many breakthroughs in HIV prevention and the intersections between sciences such as clinical, political, social and behavioral. The greatest clinical development, according to the co-chair of the conference Dr. Jean-Pierre Routy, was the research that found that the receipt of a long-acting injection shot of antiretroviral medication every eight weeks is “safe and superior” to daily oral medication.

Necessary Steps

However, though medical science is taking strides forwards, the rollout of these treatments remains behind. Esteban Burrone, the Head of Policy at the Medicines Patent Pool, described the necessary steps to promote the equitable rollout of HIV antiretroviral medication. Each country needs FDA approval, licensing, manufacturing and recommendation in guidelines for a rollout to receive approval. Things that can help fast-track product rollout in countries are “community involvement in demanding access, pursuing early licensing, securing national approval, equitable pricing agreements.” In addition, Dr. Karin Hatzold, a public health physician, discussed how access to “diagnostic strategies such as HIV self-testing… [and] operations research to optimize delivery models” are crucial for a successful rollout and introduction to products.

Reaching Rural Areas

Tackling the difficulty of delivering medications to vulnerable populations in developing countries, however, is Dr. Rosalind Parkes-Ratanshi. Parkes-Ratanshi discussed a pilot project in Uganda where medical drones help distribute HIV medication in remote locations and for mobile populations. Her medical drone project is also used for COVID-19 and STI sample delivery. Although this does not address the policy required to roll out new products in other countries, it is a step to reaching rural populations with already approved antiretroviral medication.

New Framework

Furthermore, representatives from the World Health Organization (WHO), Global Fund and the International Aids Society (IAS) presented new people-focused guidelines that the WHO has adopted to focus on structural barriers. This includes reducing stigma and eradicating “punitive laws.” The new framework also works to target key populations who make up 70% of new HIV infections according to UNAIDS. Each presenter at the AIDS conference including the WHO strives to progress the global community toward the UNAIDS 95-95-95 target, a goal that states by 2030, 95% of people living with HIV will know their HIV status, 95% of people who know their status will be receiving treatment and that 95% of people on HIV treatment will have an undetectable viral load making the chance of infecting others very low.

PEPFAR News

PEPFAR, the U.S. President Emergency Plan for AIDS Relief, announced that 5.5 million babies across the world have been born HIV-free due to the program’s efforts. PEPFAR’s efforts to expand treatment and prevention services to many target populations across the globe have reached millions. U.S. Global AIDS Coordinator and Special Representative for Health Diplomacy Ambassador-at-Large Dr. John Nkengasong described the prevention program that made this possible. “In collaboration with countries, communities, and our partners, PEPFAR supported comprehensive HIV prevention programming for adolescent girls and young women, voluntary medical male circumcision, and we scaled up treatment for women and men with viral suppression.” Other PEPFAR announcements included reaching the 90-90-90 UNAIDS target in at least 12 “high HIV disease burden countries” and treating approximately 20 million men, women, and children with antiretroviral medication.

These were only a fraction of the many positive advancements that researchers discussed at the 2022 AIDS conference. Much progress has occurred in understanding other barriers such as the social, political and economical barriers to reach the UNAIDS 95-95-95 goal by 2030. Check out the AIDS 2022 website for more information about the 24th Annual AIDS conference.

– Jordan Oh
Photo: Flickr

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MAB Improves Visual Health in Malaysia

MAB Improves Visual Health in MalaysiaThe Malaysian National Eye Survey in 1996 estimated that 54,000 Malaysians experienced bilateral blindness. The most recent survey in 2018 reports that 86.3% of blindness causation was preventable with timely treatment. The Malaysian Association for the Blind (MAB) is a nonprofit organization working on the issue. By providing health services and employment opportunities, MAB improves visual health in Malaysia and supports those with visual impairment. Founded in 1951, MAB’s mission statement explicitly focuses on blindness prevention and empowering those with visual impairment through services and opportunities that include them in society.

The Gurney Training Center for the Blind

The Gurney Training Center for the Blind is MAB’s vocational training school for those with visual impairment. This center provides both vocational training and rehabilitation services. The center’s vocational courses allow people with visual impairment to receive proper training in a field. Some of the vocational training courses include skills such as woodworking, massage therapy, telephony, industrial work and computer programming. The center also offers rehabilitation services, including physical therapy, counseling, casework, mobility training, communication and social skills, and recreational activities.

Taman Harapan Agricultural Training Center

The Taman Harapan Agricultural Training Center teaches skills for various farming and breeding methods. Other related courses offered include ones such as horticulture and craft making. Like Gurney’s, the center also provides rehabilitation services such as techniques for daily living.

Information Technology

MAB also provides training in how to use assistive devices and software. Additional services include the repair and replacement of this adaptive equipment. The organization also advocates for those with visual impairment by prompting employers and policymakers to provide Information and Communication Technologies facilities (computer labs, laptops, tablets, etc.) in the workplace.

Job Placement

MAB provides a job placement program to help its clients find stable work and improve the economic mobility of Malaysian people with visual impairment. MAB provides work placement by offering different resources, such as placing trained individuals into appropriate employment opportunities, helping with loans for assistive equipment needed for jobs, and working with the Department of Social Welfare and the Ministry of Human Resources to address employment matters.

Assistance to Blind Children Centers (ABC)

ABC Centers are several early intervention programs that provide essential services to children with visual impairment. These children are provided with physical training, basic living skills, preschool activities, recreational activities and counseling services. This center also aids parents by providing services such as education and counseling on visual impairment.

Public Transportation

Safety while riding public transportation is a recurring issue for people with visual impairment. In a broad collaboration with several government ministries, Nongovernmental Organizations and MAB, the Mass Rapid Transit Corporation in Malaysia installed directional tactile tiles on the Putrajaya MRT Line. These tiles give tactile feedback to commuters along the most efficient path from the entry point to the rail platform. The tiles also help indicate where an elevator or escalator is.

MAB improves visual health in Malaysia by promoting such inclusive designs and providing various services. With more efforts like MAB’s, people with visual impairment in Malaysia can integrate into a more inclusive society with improved opportunities for economic mobility.

– Max Cole
Photo: Flickr

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HIV/AIDS in Belgium

HIV/AIDS IN BELGIUMAccording to a study by BMC Infectious Diseases, HIV/AIDS in Belgium is “largely concentrated among men who have sex with men and sub-Saharan Africans.” According to 2011 data from the Belgian government, 98.2% of patients had links to HIV care, 90.8% were in care and 83.3% were receiving antiretroviral therapy. However, these statistics were disproportionate for certain sections of the population where sub-Saharan Africans on ART had less viral suppression while there was higher retention in care of men who have sex with men.

After carrying out a study, an organization called BREACH (Belgian Research on AIDS and HIV Consortium) concluded that potentially the weakest part of efforts to suppress the HIV/AIDS epidemic in Belgium was the undiagnosed HIV-infected population, which estimates have stated is around 20%. This was particularly prevalent amongst migrants in Belgium and it is a problem that requires attention.

There is also a link between poverty and those suffering from HIV/AIDS. When the Journal of the International AIDS Society conducted research into the link between AIDS and poverty, the results were that vulnerabilities relating to migration such as economic hardship and barriers to HIV testing mean that non-citizens are more likely to become infected by HIV/AIDS.

The Progress

Better sexual health awareness and an increase in levels of screening are some methods that have helped HIV/AIDS patients in Belgium live longer and enjoy better health. A research organization named Sciensano which targets health and disease has contributed to HIV/AIDS research in Belgium and has recorded encouraging statistics over the past few years. Based on a 2017 report, Sciensano found that there was a 2% decrease in HIV/AIDS transmission since 2016 and 27.5% compared with 2012.

The study also notes that “HIV transmission by intravenous drug use is exceptional in Belgium and was only reported for 1% of the HIV diagnoses in 2017.”

Belgium’s National Strategic Plan

A step that the Belgian government took to reduce the transmission of HIV/AIDS was the implementation of its National Strategic Plan on HIV in 2013. The monarchy of Belgium also endorsed this plan, which had three main goals: preventing HIV/AIDS, providing testing and treatment of HIV/AIDS and providing care and support. In setting up the plan, the government ensured it would specifically target vulnerable groups such as migrants.

In conclusion, Belgium has made significant progress in tackling HIV/AIDS. Government initiatives coupled with the work of other organizations have been effective enough to reduce levels of HIV/AIDS in the country and are a step forward for marginalized groups that the disease impacts the most.

– Claire Dickson
Photo: Flickr

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Impact of COVID-19 on Poverty in Malaysia

Impact of COVID-19 on Poverty in MalaysiaMalaysia saw its first confirmed case of COVID-19 on January 24, 2020. The Malaysian government implemented the Movement Control Order (MCO or PKP) around two months later in response. This mandate restricted travel, work, assembly and established quarantine measures jeopardizing the financial integrity of Malaysian households. Here is some information about the impact of COVID-19 on poverty in Malaysia as well as the country as a whole.

The World on Pause

For fully vaccinated individuals, the MCO ended in November 2021. However, under the mandate, conditional and variable ordinances ultimately played a part in the impact of COVID-19 on poverty in Malaysia.

Working in multiple phases, the MCO developed into the Conditional Movement Control Order (CMCO/PKPB), Recovery Movement Control Order (RMCO/PKPP) and the National Recovery Plan (NRP/PPN). These restrictions prevented movement between states, travel to and from Malaysia and mass gatherings in addition to the closure of schools, government and private premises except those considered essential. Those who violated the MCO were at risk of receiving fines or facing jail time.

Hurting Those Already Struggling the Most

Three-quarters of the Malaysian population live in urban areas, with the majority of individuals falling into the 15-64 age group. A four-part research study that UNICEF and UNFPA conducted titled “Families on the Edge” found that a typical Malaysian household has an average of 5.5 members.

The head of these households are mostly married Malay males around 46 years old with low educational attainment. These workers face a high risk of unemployment, pay cuts or other stresses to household income as they were in jeopardy before the pandemic.

Reports have indicated that a 5% increase in employment occurred between March 2020 and June 2021. Despite the rise, a third of those employed before the crisis experienced work disruptions and 27% faced income reduction.

The World Bank found that around 65% of jobs in Malaysia cannot occur remotely even after modifying them so that they were in an online format. This is because approximately 51% of jobs require close physical proximity. With the MCO restrictions, these jobs were most vulnerable with one-fourth of heads of households experiencing unemployment during this time.

The Impact of COVID-19 on Food and Education

The impact of COVID-19 on poverty in Malaysia consequently affected access to food and quality of education. With little to no income, households spent around 84% less on education and 4% less on food between December 2019 and June 2020. While expenditure on food reduced, approximately 30% reduced food intake itself to cope with financial difficulties.

While employees adjusted to remote working, children needed to transition to online learning. Two-fifths of children do not have access to the required equipment (such as a computer) or internet connection to resume their education.

Closures have also prevented children from impoverished families from accessing meals provided at school-distributed supplemental food programs. This food insecurity pushed households to adopt cheaper and less healthy diets, further threatening the country’s child malnutrition crisis.

A Citizen’s Surrender

Some low-income residents resorted to waving white flags from their flats during the government-mandated lockdown to express the financial stress they were experiencing. This Bendera Putih, or “White Flag” movement emerged to help families ask for assistance. The white cloth outside their homes would encourage others to donate food.

In response, three computer science students from Multimedia University Cyberjaya urgently developed and released the “Sambal SOS” app within the same month the White Flag Movement gained traction. More than 7,000 users registered on the site just two days after its launch.

Here, users could digitally and anonymously report that they needed help. They then could connect with other users ready and able to provide aid.

An Economic Recovery Plan

Prime minister Tan Sri Muhyiddin Yassin announced the Pelan Jana Semula Ekonomi Negara (PENJANA), also known as the Economic Recovery Plan, in June of 2020. This stimulus package totaled RM35 billion (more than $7 billion) allocated to 40 initiatives organized into “three key thrusts:”

  • Empower People
  • Propel Businesses
  • Stimulate the Economy

Some initiatives to empower people included a wage subsidy program, social protection for the gig economy workforce and the internet for education and productivity. PENJANA funded entrepreneurship financing to propel businesses while supporting small enterprises through e-commerce and tourism financing. Initiatives to stimulate the economy included a campaign to buy Malaysian products and financial relief for those working in the agriculture/food sector.

Although poverty rates are still higher than before the COVID-19 pandemic, poverty levels have decreased by 16% between May 2020 and March 2021. Government assistance increased overall average household income since 2019, including disabled-headed households.

Households rely on savings, government and Zakat assistance for financial support as the labor market recovers. While PENJANA has proven to help boost the economy temporarily, many families still do not receive registered business-related aid and do not have social protection or insurance. The impact of COVID-19 on poverty in Malaysia emphasized that social protection assistance still needs to improve its scope of coverage to help the urban poor rebuild post-crisis.

– Aishah French
Photo: Flickr

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2 Diseases Impacting Afghanistan

Diseases Impacting AfghanistanSince the early 2000s, Afghanistan’s disease prevention and treatment services were far below sustainable, with only 11 physicians and 18 nurses per 100,000 civilians working in 2003. As foreign aid began to pour in, these numbers slowly improved. However, infant, child and maternal mortality rates remain the highest globally, alongside many other diseases impacting Afghanistan today. Currently, two diseases impacting Afghanistan include tuberculosis and polio, which the Western world is well equipped to diagnose with far less difficulty.

Tuberculosis

Tuberculosis is a highly infectious, airborne disease impacting many Afghan people. Tuberculosis symptoms include a dry cough (sometimes with blood), fatigue, loss of appetite, night sweats and others. Yet, early diagnosis and quality treatment are easily accessible in the United States, preventing mass outbreaks.

The World Health Organization states that tuberculosis kills around 13,000 Afghans yearly, making it a disease that impacts Afghanistan severely. In 2014, Afghanistan had approximately 58,000 new tuberculosis cases. Only 56% of these cases were diagnosed and provided with adequate treatment. Keeping the disease at bay only becomes more challenging with up to 25,000 Afghan people left undiagnosed and untreated.

However, with WHO’s help, BRAC Afghanistan and USAID started a community-based TB DOTS program to control tuberculosis outbreaks. Through the program, diagnostic facilities for tuberculosis expanded and existing facilities were further equipped with microscopy screening technology. After the initiation of these health programs, more Afghans saw doctors and received treatment for tuberculosis: Since the program’s launch in 2004, access to dots has expanded from 15 to 121 clinics two years later. By 2006, more than 6,000 community health workers had trained under the program, of which 53 percent of trainees were women. Through the continued funding and advancement of the TB DOTS program, tuberculosis may slowly begin to lose its footing and become a lower-risk illness.

Poliomyelitis (Polio)

Polio is a viral illness that can lead to severe nerve damage and injury, eventually leading to paralysis and sometimes death. Afghanistan, Nigeria and Pakistan remain the only countries worldwide that have yet to eradicate polio. Due to inconsistent vaccination rates at birth, polio remains a disease impacting Afghanistan heavily today. In the 2015 report by the polio eradication initiative, researchers found that reported polio cases in Afghanistan had decreased since years prior. However, Afghanistan is still far from eradication.

In efforts to eradicate the polio virus worldwide, UNICEF worked with WHO to find innovative ways to give every child polio vaccines. The program implemented three National Immunization Days (NIDs) to increase access to polio vaccines and potential treatment if necessary. NIDs aim to reach nearly 10 million children through house-to-house and health facility-based approaches.

Furthermore, in collaboration with UNICEF and WHO, Afghanistan’s Ministry of Health is investing in a polio program to support vaccinators, community mobilizers, influencers, volunteers and campaign coordinators to reach children in need of vaccines. According to UNICEF, 392,000 polio branded items were distributed in 2020 to Afghan students to raise awareness about the disease’s severity, prevention and symptoms. As efforts continue, polio may become a disease impacting Afghanistan far less than before.

Why it Matters

Though efforts to improve health care access and treatments in Afghanistan have increased, much work still needs to be done. Today, tuberculosis is a disease that the U.S. quickly diagnoses and treats, while, in Afghanistan, the disease is often more threatening.

Afghanistan’s Ministry of Public Health and emergency operating system know how to help their people lead healthier lives yet lack the resources to do so. In funding programs that help international organizations and ministries provide the support needed for their people, both tuberculosis and polio can become low-priority diseases for all.

– Opal Vitharana
Photo: Flickr

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Latest Ebola Outbreak in the Democratic Republic of the Congo Comes to an End

Ebola Outbreak in the Democratic Republic of the CongoOn July 4, 2022, the Democratic Republic of the Congo’s Ministry of Health announced the conclusion of the Ebola virus outbreak that impacted the Mbandaka and Wangata health zones. The Ministry of Health officially declared the outbreak on April 23, 2022, after establishing the presence of the Ebola virus in a 31-year-old male who died on April 21, 2022. The Ministry of Health partnered with the World Health Organization (WHO) and other organizations to control the outbreak and prevent further spread, measures that seem to have curbed the impact of the Democratic Republic of the Congo’s Ebola outbreak.

Ebola in the Democratic Republic of the Congo

Taking into account this most recent outbreak, the Democratic Republic of the Congo’s Ebola outbreak count has reached 14 since 1976, with six of those outbreaks taking place from 2018 onward. While this number is staggering, it does not necessarily stand out among the numbers reported by fellow African nations. The United Nations, the Centers for Disease Control and Prevention (CDC) and the WHO have long been involved in fighting Ebola outbreaks in the Democratic Republic of the Congo and the rest of Africa. The recording of a large number of outbreaks means that these organizations and countries are able to deploy well-researched methods of treatment and containment.

The Democratic Republic of the Congo’s Ebola Outbreak in 2022

This latest Ebola outbreak in the Equateur Province of the country is the province’s third outbreak since 2018. Health authorities immediately sent a shipment of vaccines to the province from the city of Goma, which undoubtedly helped in the short nature of this outbreak, with it lasting just a few months. The experience of national emergency teams backed by the WHO resulted in a quick response and the deployment of counteractive measures including testing, vaccinations and contact tracing.

The Democratic Republic of the Congo’s Ebola outbreak claimed five lives out of five cases reported with a fatality rate of 100%. These statistics are much lower than the country’s previous outbreak, lasting from June 2020 to November 2020, which saw 130 cases and 55 deaths.

Next Steps

As the country recovers from yet another outbreak of the Ebola virus, the thought of an additional epidemic soon looms overhead. While the number of outbreaks is no cause for celebration, the experience gained from a large number of recent outbreaks better prepares the Democratic Republic of the Congo, the U.N. and the WHO for future epidemics. The development of vaccines, treatments, contact tracing and other preventive measures will lead to a decreased number of future cases and deaths. The country’s partnership with critical health organizations will ensure better disease response and more resilient health care systems.

All in all, as treatment options and medication develops, the state of the recurring Ebola outbreaks in the Democratic Republic of the Congo appears to be more manageable. The Democratic Republic of Congo controlled this latest outbreak quickly and efficiently, a standard that the country is primed to replicate. While another outbreak is not completely preventable, the country can mitigate the impacts.

– Thomas Schneider
Photo: Flickr