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Poverty and Lung Cancer
Poverty predisposes individuals to a spectrum of conditions that result from an amalgamation of lifestyle factors, health, hygiene and living conditions. Mortality from lung cancer is a more significant factor in impoverished communities compared to developed economies.

One of the major predisposing factors for high lung cancer mortality rates in developing countries is smoking. Cigarette smoke contains toxic particles which can inflict damage to cells present in the airways. Over time, these affected cells can become abnormal and lose their normal function.

The World Bank has established that smoking is more prevalent among poor groups compared to the rich, not only as a consequence of poverty but also in part due to the education individuals receive. Due to incognizance of the health risks associated with smoking, poor individuals may engage in this habit as a result of stress or poor family relationships.

Strategies to reduce lung cancer mortality in developing countries should focus on increasing access to education. Increased education can be achieved by building schooling facilities, implementing laws where education is compulsory until a certain age and subsidizing education for families who are unable to afford school fees.

A composition of diet also plays a crucial role in the development of lung cancer in impoverished countries. Some households are likely to be contingent with foods that are often processed, cheap and have poor nutritional value. As a result of low intake of fruit and vegetables, individuals are likely to be deficient in essential vitamins, minerals and antioxidants that play an important role in the body’s defense mechanisms against cancer development.

Measures to overcome poor dietary habits can include campaigns educating individuals about healthy eating. Subsidies can be offered to local supermarkets to ensure that fresh, affordable produce is readily available to individuals.

Rural communities often have poor access to health care services which can impede their ability to seek professional help at early stages. This prevents cases of lung cancer from being diagnosed and treated in the inchoate stages. Cancer can eventually progress to a serious stage where it is completely incurable and has a risk of significant mortality. Higher mortality in poor communities can also stem from a reluctance to utilize health care resources, possibly as a result of personal prejudice or concerns about a financial expense.

A recent study published by the Centers for Disease Control and Prevention states that 40 percent of identified cancer cases are associated with tobacco usage. This represents a significant proportion of cases that can be attributed to smoking, which is a preventable risk factor.

Widespread smoking cessation campaigns in both developing and developed countries can be implemented to encourage individuals to reduce smoking gradually. This can be done through advertising, counseling with health care professionals or even offering alternatives to smoking such as nicotine replacement therapy.

With greater than 36 million smokers in the United States alone, urgent action must be taken to ensure both poverty and lung cancer are reduced through a combination of corrective measures such as education, health care advice, and smoking cessation campaigns.

Tanvi Ambulkar

Photo: Flickr

Poor Health in the Pacific Has Hope
The World Health Organization has identified nine out of the top 10 most obese nations as being located in the Pacific. Within these nine nations, rates of obesity range from 35 percent all the way up to 50 percent.

Obesity measurements are calculated by looking at an individual’s BMI, or body mass index. Pacific islanders naturally have a larger build than people of other ethnicities. This is the case because, at one time, people from this region were forced to endure long and difficult journeys at sea. People able to store enough energy in the form of fat were more likely to survive, and evolution selected for these genes. However, this genetic component still does not explain all of the obesity rates.

What does help to explain this epidemic is the increasing number of foods that are being imported to the islands. Traditional tropical diets included an abundance of fresh produce and fish, but these foods are now replaced with more processed foods, which provide a cheaper alternative. One World Health Organization worker and Fijian native even noted that “it’s cheaper to buy a bottle of coke than a bottle of water.”

Additionally, urbanization and increasing numbers of office jobs contribute to poor health in the Pacific. Historically, many jobs such as fishing and farming included a great deal of physical activity. However, as more people begin to drive to work in offices, physical activity is greatly reduced.

This obesity academic is exhibited in children as well. Roughly one in five Pacific children are obese, and diabetes is a constant concern for children as well as health services who struggle to meet increasing demands.

Despite these unfortunate circumstances, there is still much hope for improving health in the Pacific. Members of the World Health Organization are confident that higher taxes on soft drinks, controlled marketing of products aimed at children and general promotions of a healthy lifestyle can help to turn things around.

Additionally, Australian researchers recently found an issue with the way that the rates of Type 2 diabetes were being measured in the Pacific. Essentially, blood glucose levels measured in the first phase of the survey were mistakenly compared to plasma levels in the follow-up portion of the survey. This caused rates to become inflated to nearly twice their actual value.

It was originally believed that Samoa experienced a 24.3 percent increase in diabetes from 2002 to 2013 when the actual increase was less than 3 percent. Tonga was thought to have experienced a 12 percent increase when diabetes rates actually decreased by three percent. Clearly, a recalculation may be required.

Although this inflation certainly does not mitigate the entire health crisis occurring in the Pacific islands, it does mean that at least rates of diabetes may be lower than was previously thought. Further steps to improve health in the Pacific will need to include conscious efforts on behalf of national governments, health organizations and citizens to strongly promote healthy living.

Nathaniel Siegel

Photo: Flickr

Health Security Agenda
On Nov. 4, President Obama signed an executive order advancing the Global Health Security Agenda (GHSA), which the administration started in 2014. As a result, the United States will now prioritize the GHSA on a presidential level.

As part of the GHSA, the United States has joined with 55 different countries, nonprofit organizations and for-profit companies.  The GHSA’s top goals include the improvement of research accountability and outbreak detection, and 22 countries have already begun to evaluate outbreak responses and identify areas to improve upon.

Philippe Douste-Blazy, the under-secretary general of the United Nations, suggests that the WHO needs to focus on outbreak response as one of its five main priorities in order to ensure that the global health goals will be met by 2030.

According to USAID, the “GHSA promotes global health security as a national priority through targeted capacity building activities, such as improving laboratory systems, strengthening disease surveillance, improving biosafety and biosecurity, expanding workforce development, and improving emergency management.”

USAID also proposes to support the GHSA initiative by addressing animal health, human health and the environment. USAID’s Bureau for Global Health Assistant Administrator, Dr. Ariel Pablos Mendez, says that USAID’s attention to animal health is particularly important: 70 percent of new infectious disease outbreaks begin in animals.

WaterAid also celebrates the GHSA’s anticipated role in improving the safety of drinking water, sanitation and hygiene. WaterAid explains that spread of infectious diseases such as cholera could end with access to safe water.

The GHSA’s intent to combat antimicrobial resistance relates directly to water quality. Access to safe water could prevent up to 60 percent of diarrhea cases. These cases require treatment with antibiotics, and increased use of antibiotics can lead to antibiotic resistance among bacteria.

People and diseases travel rapidly due to the spread of globalization. The CDC summarizes, “A disease threat anywhere can mean a threat everywhere.” The GHSA is designed to detect and prevent this spread of disease. “No single nation can be prepared,” the order declares, “if other nations remain unprepared to counter biological threats.”

Madeline Reding

Photo: Flickr

Maternal Health Apps
Maternal health is one of the greatest global health challenges today. Despite advancements in medical technology, the World Health Organization (WHO) estimates that 800 women and girls die every day from complications during pregnancy and childbirth. In developing nations, there is an especially high risk of death associated with pregnancy as health workers do not have the adequate resources to safely perform deliveries. Newly-designed electronic maternal health apps are targeting these at-risk groups to prevent death.

There are unacceptable disparities in access to maternal health services that disproportionately affect less educated, impoverished women of color compared to the rest of the world. In fact, according to the WHO, women in the richest socioeconomic quartile are three times as likely to have a safe delivery with a nurse or midwife as women in the poorest quartile.

Even though the maternal mortality rate has dropped 44 percent since 1990, the socioeconomic disparity in access to maternal health services has not changed in 15 years. The persistent gap in health care access reflects the inability of current healthcare delivery systems to provide equitable services, regardless of sex, race or economic status.

Recently, the global health community has turned to nontraditional methods of providing care. While 99 percent of preventable maternal deaths occur in developing nations, nearly three-quarters of mobile devices are being used throughout the same countries. In response to the growing demand for improved communication, medical providers and health care NGOs are focusing on mobile technology as the new frontier for maternal health care. Here are three ground-breaking maternal health apps increasing access to lifesaving services worldwide.

Gifted Mom
Gifted Mom is a Cameroon-based mobile health platform that uses low-cost technology to provide medical information to mothers and pregnant women in rural communities. Expectant and new mothers can register to receive SMS updates about their health and the health of their babies. Periodically-timed messages will remind them when it’s best to vaccinate their babies and why it’s important to go for antenatal (post-pregnancy) checkups. For women who can’t read, Gifted Mom is developing speech technology that will communicate important information in local languages. When the project launched in 2012, only eight women registered. Today, over 2,000 women are subscribed to receive potentially life-saving information about pregnancy and newborn health. By simply texting “MOM” to 8006, women can receive scheduled reminders about antenatal care and vaccines as well as real-time answers to their questions from medical professionals.

Zero Mothers Die
Just like Gifted Mom, Zero Mothers Die aims to save the lives of women and their children through mobile technology. They send SMS and voice messages to women containing important health information, while giving them the opportunity to call local health care workers with any questions.

Using an integrated network of partners, including the Ghana Ministry of Health, The U.N.’s Program on HIV/AIDS and the Millenia 2025 Foundations, Zero Mothers Die disperses data on disease surveillance and maternal health issues across various digital platforms which health care workers and women alike can access through their app.

Safe Delivery
Safe Delivery is the only app of its kind to focus on health care workers performing deliveries in remote locations. The app features animated instructional videos that explain how to perform life-saving procedures, such as maternal sepsis, hypertension and prolonged labor. The app also provides step-by-step guides on how to safely remove placentas and resuscitate newborns.

The technology employs the WHO’s clinical guidelines and informs health care workers on common medicines associated with childbirth, appropriate dosages and their possible side effects. Safe Delivery is especially useful in settings where a small team of workers is responsible for treating a variety of problems, regardless of whether or not they had obstetric training.

Most maternal deaths are preventable, thanks to innovations in modern medicine and improved health knowledge. The challenge is reaching disenfranchised women who don’t have access to basic maternal care. These maternal health apps prove that knowledge alone can be one of the most powerful tools for preserving human life.

Jessica Levitan

Photo: Flickr

Five Myths about Social Safety Nets-Debunked!
When it comes to social safety nets, many myths and half-truths about the efficacy of these programs exist among citizens and political leaders. Social safety nets are programs that aid the poor by increasing their incomes, improve school attendance, provide access to basic health care and implement employment opportunities.

Even though some of these myths are inoffensive, they do have the potential to harm people who rely on governmental assistance programs. The New York Times reports, “One billion people in developing countries participate in a social safety net. At least one type of unconditional cash assistance is used in 119 countries.” Here are some of the top myths about social safety nets debunked:

Myth #1: The economy will do better if social programs are cut.
When governments decide to cut their social safety nets, many sectors within the economy begin to suffer. Governments inadvertently increase the unemployment rates within their countries when social programs are cut.

In 1981, President Ronald Reagan signed the Recovery Act, which cut social programs such as payments for individuals with disabilities and school-lunch programs. As a result, the largest projected deficit in U.S. history occurred leading the U.S. economy to its worst recession since the Great Depression. The American economy struggled to combat the resulting 14 percent inflation rate as well as the increased interest rates of the Federal Reserve Board.

With less citizens being able to afford goods and services, overall manufacturing decreased while layoffs and unpaid taxes increased. It is recorded that in 1982, those unemployed reached a staggering nine million, 17,000 businesses had failed, farmers across the nation began to lose land and the poor, elderly and sick became homeless.

Instead of aiding the economy, social budget cuts on social safety nets result in a decrease in the overall finical health of a country’s economy.

Myth #2: Reducing government assistance benefits will make people get a job.
This myth is usually perpetrated by those who do not understand the demographics within social safety nets. Over half of all people who are enrolled in government assistance programs are those who cannot physically or mentally work such as the elderly and people with disabilities. Even if governments were to reduce benefits for those who can work, it still would not make a significant difference in employment rates.

According to the Housing Alliance of Pennsylvania, many people who are working and receive housing assistance still live in homeless shelters simply because they still do not make enough currency to afford a place to live. The Wall Street Journal further states that the four largest welfare recipients are those who labor as fast-food workers, home-care workers, child-care workers and part-time college faculty.

Reducing government assistance will not make people get a job simply because those who receive these benefits are either unable to work or are currently working in a low-paying occupation.

Myth #3: Welfare makes people lazier.
Though the majority of persons benefiting from welfare are employed, surveys show that individuals from around the globe believe that social safety nets waste revenue and make people lazy. However, in 2014, The World Bank reported that contrary to public opinion, individuals on financial assistance in countries such as Asia, Latin America and Africa rarely wasted money on alcohol and tobacco.

In addition, Abhijit Banerjee, the director of the Poverty Action Lab at the Massachusetts Institute of Technology, released a scholarly paper that tracked and documented the cash-transfer programs in seven countries. The results from this paper determined that out of the seven countries, Mexico, Nicaragua, Morocco, Honduras, Indonesia and the Philippines, these programs did not discourage people from working.

Moreover, people who receive benefits from social safety nets do not become lazy. Rather, people who did receive these benefits continued to work diligently while also not wasting funds on items such as tobacco and alcohol.

Myth #4: People can benefit from social safety nets for as long as they want.
Most government assistance programs have a limited amount of time that someone can use unemployment benefits. For instance, the U.S. used to allow people 99 weeks of unemployment assistance.

In recent years states have limited the amount of time that citizens can use unemployment benefits to around 26-30 weeks. Currently, the only state that gives citizens 30 weeks of unemployment benefits is Massachusetts.

Myth #5: Certain demographics make social safety nets benefit one group and disadvantage the rest.
A majority of people believe that social safety nets benefit a particular kind of demographic while disadvantaging other groups within a society. Particularly, U.S. citizens feel that groups, comparatively liberals, benefited the most from social assistance programs.

Yet, details from a 2012 survey from the Pew Research Center show that in regard to politics, liberals and conservatives used governmental assistance programs almost equally. With 42 percent of liberals and 40 percent of conservatives using at least one governmental assistance program.

Despite these myths being detrimental to those who rely on social safety nets, it is worth noting that the U.S. economy is slowing improving. As of August 2016, unemployment rates in the U.S. are as low as 4.9 percent. Additionally, average hourly wages have increased between five cents and $25.59, with average weekly wages at around $880.30.

However, the best way to eradicate these myths about social safety nets is to advocate for legislation that protects these programs. Pay attention to laws that pertain to social safety nets and meet with local representatives about how social safety nets benefit society. Information about U.S. elected officials can be found on Common Cause.

Shannon Warren

Photo: Flickr

Diseases Gates Foundation
According to a journal published in the Gastroenterology section of the U.S. National Library of Medicine National Institute of Health, enteric and diarrheal diseases are the leading causes of death in young children under five years old. Of this age group, diarrhea occurs approximately 2.5 billion times each year resulting in the fatality of nearly 15 percent. The Bill and Melinda Gates Foundation aspires to eliminate enteric and diarrheal diseases by 2030, including typhoid in children under five by 2035. The World Health Organization (WHO) also reports that diarrheal related illnesses are the leading cause of malnutrition for children under five.

The Gates Foundation is committed to serving and advocating the lives of the world’s poor by improving the health care, education and other areas that could dramatically impact the quality of life for billions. The foundation’s goal for this initiative is “We believe that all children — no matter where they live — should not suffer or die from enteric (gastrointestinal) and diarrheal infections.”

Understanding the development of children across the world can help prevent and reverse the issues of growth stunting caused by environmental enteric dysfunctionalities in young children under five. Improving socioeconomic conditions is a crucial component for the Gates Foundation to reduce these illnesses. Children will have better access to health care and treatment, and the improvement in the accessibility of clean and sanitized water and hygiene will help to significantly reduce the likelihood of occurrence.

The Gates Foundation is primarily focused on providing safe, effective and affordable vaccines to children in vulnerable countries where these illnesses are more prevalent. The Gates Foundation also invests in quality research aimed at improving case management and delivering treatment for children in medically vulnerable countries.

Currently, there are safe and effective vaccines available for rotavirus and cholera. WHO recommended that these vaccinations be included in national immunizations. Affordable treatments such as oral rehydration solutions, zinc supplements and antibiotics to treat dysentery could also prevent enteric and diarrheal diseases in young children. Breastfeeding exclusively for the first six months of life, personal and household hygiene improvements, access to safe and reliable drinking water and improved sanitation help reduce the development of gastrointestinal infections.

Gastrointestinal research is a growing field of study and is beneficial in understanding neurocognitive development and how to support physical growth. Promising opportunities have been made possible through research on gut microbiome, immune system and gut barrier to test and further the development of inventions that seek to prevent and reverse growth stunting.

Although advancements in research are occurring, not nearly enough political attention, adequate funding and thorough research go toward the alleviation of enteric and diarrheal diseases. This is partially due to the fact that the impact of these fatal illnesses has largely gone unnoticed in the international community.

Additionally, lack of critical information on the pathogens and the environmental factors that cause theses pathogens limit proactive progress toward eliminating these devastating gastrointestinal illnesses.

The good news is that action and awareness can yield a more positive result in fighting against these diseases and essentially lower the number of lives they take.

Haylee M. Gardner

Photo: Flickr

Top Diseases in Malawi
Malawi’s Ministry of Health states that their current overall policies are meant to focus on: “the development of a sound delivery system capable of promoting health, preventing, reducing and curing diseases, protecting life and fostering general well-being and increased productivity.” In recent years, the country has made substantial advancements in the field of medicine in terms of addressing their most pressing health issues, namely the top diseases in Malawi.

Infant and child mortality have been declining, and HIV rates among citizens have begun to level out. Despite having made progress, Malawi continues to be characterized by the burden of high infectious disease rates. The average life expectancy of a person living in Malawi is 57 years for males, and 58 years for females, making it the country with the twentieth lowest life expectancy in the world. However, the five top diseases in Malawi are all either preventable or treatable with basic medical care.

HIV/AIDS: 27 percent of deaths

Malawi is making impressive strides in combating their HIV epidemic, specifically in prevention of mother to child transmission of the disease. However, Malawi’s HIV presence is still one of the highest in the world. It is home to roughly four percent of all people with HIV in Sub-Saharan Africa.

As of 2015, 10.3 percent of the population was living with HIV or AIDS; 9.3 percent of these people were between the ages of 15 and 49 years. That averages to around 980,000 people. The disease disproportionately effects females in Malawi, with an average 4.5 percent of young females, and 2.7 percent of young men from 15 to 24 years living with HIV.

It is estimated that only 61 percent of all infected adults are on antiretroviral treatment. This epidemic, which killed 48,000 people in 2013 alone, is largely responsible for Malawi’s low life-expectancy of 57.5 years.

Lower Respiratory Infections: nine percent of deaths

Lower respiratory problems have topped the charts as a reason for hospital admission in Malawi prior to the HIV and AIDS epidemic. Lower respiratory infections cover everything from pneumonia to bronchitis, and Malawi has seen an increase in these infections particularly in its citizens with the HIV virus.

Pneumonia is the single biggest killer of children in Malawi, prematurely ending the lives of an estimated 1,000 infants in 2010 alone.

Malaria: six percent of deaths

Despite progress, malaria continues to be one of the top diseases in Malawi. Malaria is responsible for nearly 40 percent of hospitalizations in children under the age of 5, 30 percent of all outpatient visits and is one of the highest causes of mortality in all age groups.

Transmission of the disease occurs mostly from November to April, during Malawi’s rainy season. However, with global support, the Ministry of Health’s National Malaria Control Program in Malawi has been able to distribute treatment more easily throughout the population.

Since efforts were put in place in 2004, the mortality rate for children 5 years and younger has fallen by more than 36 percent. This is largely due to Malawi introducing the pneumococcal vaccine as part of routine childhood vaccination in November 2011, and the additional rotavirus vaccine in October 2012. Malawi is one of the four countries in the African Region that offers these vaccinations.

Diarrheal Disease: five percent of deaths

Diarrheal disease poses a serious threat particularly to 5r  the children of Malawi, as it claims nearly 600 lives of Malawian children per year. Support from such initiatives as the World Health Organization (WHO), United Nations Children Emergency Fund (UNICEF) and the GAVI Alliance has given us an opportunity to offer those in Malawi protection from diarrheal diseases.

More lives could be saved through basic interventions, such as improving drinking water, increasing sanitation efforts and distributing a simple solution of oral rehydration salts and zinc supplements during bouts of diarrhea.

Perinatal Conditions: three percent of deaths

Perinatal conditions are any conditions existing in a baby before or immediately after birth. These conditions often stem from preexisting conditions in the mother, and are more easily prevented than treated. Solutions posed for this problem include better sex education for women, easier access to contraceptives — only 41 percent of Malawian women showed understanding of preventative measures for sexually transmitted diseases in 2015 — and more accessible treatments for diseases such as HIV and malaria.

Currently, Malawi faces problems in addressing many of their health issues with regards to domestic funding and external stigma against the country. However, Malawi is committed to addressing the challenges of the top diseases in Malawi at the national level with cooperation and innovation in order to have a lasting impact.

Kayla Provencher

Photo: Flickr

Yellow Fever in the DRC
While mosquito bites are rarely more than a summer nuisance for the average American, they can be carriers of dangerous illnesses. This year, the Democratic Republic of Congo (DRC) is facing an outbreak of yellow fever.

By August, there were 5,000 suspected cases and 400 reported deaths across the DRC and Angola. Yellow fever is difficult to diagnose because symptoms closely resemble other illnesses and vary from patient to patient.

Fortunately, World Health Organization (WHO) and the European Union announced that they have created a mobile lab to quickly diagnose and vaccinate people to stop the disease in the DRC.

The mobile lab was dispatched in mid July with five technicians from Italy and Germany. Quick, accurate blood tests are crucial.

This mosquito-transmitted disease can become so prolific because most infected people never show symptoms, and risk exporting the illness or continuing to allow mosquitoes to spread it in crowded subtropical areas. Now tests can be done on site, which reduces the time wasted for transporting samples.

Those who develop symptoms after the incubation period experience fever, chills, aches, nausea and weakness. Unfortunately, 15 percent of people develop a serious form of the disease that leads to bleeding, jaundice, organ failure and death in 20 to 50 percent of cases. There is no cure, only prevention and palliative treatment.

The technicians have a tough job because of the sheer number of people affected by yellow fever in the DRC. Unfortunately, preventative measures like bug repellent and protective clothing only go so far against the persistent parasite.

The good news is a vaccine that provides lifelong immunity exists. To keep the disease out of the DRC, visitors are required to get the vaccine before entering the country.

The bad news is that the vaccine is expensive and the epidemic is straining the supply. Currently there are only 6 million doses of the vaccine and it will take a year to make more. Reuters ominously reports that time and resources are not on the EU’s side in the face of this epidemic.

WHO and the EU remain positive. The mobile labs can get results to 50 to 100 people in a day. WHO is training lab technicians in DRC and Angola to continue accurate testing after the EU’s program ends.

Dr. Formerly explains, “Aside from getting patients on the right treatment, faster diagnosis helps to plan the response better, such as identifying where to conduct mass vaccination campaigns in the affected countries.”

Mass vaccinations have been effective in slowing the spread and tests will help. Without a cure, prevention is the only way to stop the disease.

The EU and WHO have been splitting each dose into fifths. While this does not provide lifelong immunity to yellow fever that the full vaccine provides, it does protect recipients for a year. The mobile lab program is a great step towards ending this epidemic.

Jeanette I. Burke

Photo: Flickr

Haitian Cholera Outbreak
The Haitian cholera outbreak in 2010 became endemic, after at least a century of the disease not posing a threat.

Spread through contaminated water, the infectious disease causes dehydration and severe diarrhea. It can even lead to death if left untreated, sometimes in just a few hours. The outbreak transpired just after a fatal earthquake occurred in the country.

The United Nations (U.N.) sent peacekeepers to Haiti to help with the damage but failed to screen them for cholera or build them sufficient toilet facilities.

As a result, cholera-infected wastewater flowed into Haiti’s main river — a main source for washing, cooking, cleaning and drinking. By 2011, over 470,000 cases of cholera were reported with 6,631 connected deaths.

Immediate Response
Within days of the Haitian cholera outbreak, the Ministry of Public Health and Population (MSPP), along with the Centers for Disease Control and Prevention (CDC) and its partners, established a national surveillance system to track cases of the disease.

Treatment and prevention materials were also quickly developed, and thousands of healthcare workers were trained. Together, the organizations reduced the initial mortality rate of 4 percent to less than 1 percent, saving an estimated 7,000 lives.

However, thousands of people continue to become sickened each year by cholera. Haiti’s water and sanitation infrastructure require major improvement for any significant, long-term progress to be made.

The U.N.’s Reaction
After denying any responsibility for over five years, the U.N. has now officially admitted to a role in the Haitian cholera outbreak.

The deputy spokesman for the Secretary General, Farhan Haq, recently sent out an email saying, “over the past year, the U.N. has become convinced that it needs to do much more regarding its own involvement in the initial outbreak and the suffering of those affected by cholera.”

He wrote that a “new response will be presented publicly within the next two months, once it has been fully elaborated, agreed with the Haitian authorities and discussed with member states.”

Although this statement fails to put blame on the U.N. or to indicate a change in its legal position — that it is absolutely immune from legal actions — it does represent a significant step forward for the U.N.

Looking Forward
Haiti launched a National Plan to eliminate cholera from the country in 2013. The 10-year-long plan focuses on water and sanitation, health and preventing further infections.

However, the plan is terribly underfunded. The U.N. Office for the Coordination of Humanitarian Affairs (OCHA) pledged over $125 million toward this program, $19 million of which was received; the plan is anticipated to top a total of $2.2 billion in investments.

Nigel Fisher, Special Representative of the U.N. Secretary General in Haiti said, “It’s a big challenge. We have to raise literally billions of dollars. And this requires sustained support and commitment. That’s what we are here for. We, all of us partners, have a moral obligation to stay the course with cholera. Not just to lower the incidence of cholera, but to eliminate it from Haiti.”

Alice Gottesman

Photo: Flickr

Diseases in Cambodia
Despite their impressive economic growth in recent years, the impoverished, southeast Asian nation of Cambodia still struggles to treat diseases. The small country of 15 million, which lies between Thailand and Vietnam, has received very impactful aid from the US for more than 50 years. Unfortunately, diseases in Cambodia can be detrimental to preventing and alleviating severe poverty.

High rates of malnutrition and extreme income inequality — not to mention a health system that crumbled during years of war — exacerbate many persistent public health issues, including a variety of menacing diseases. Here are some of the top diseases in Cambodia and what progress the government and health organizations have made in fighting them.

Malaria

Cambodia is tropical and rainy and dense jungles cover much of the countryside. With a monsoon season that can last five months, Cambodia has a climate and geography that are perfect for mosquito-borne diseases — including malaria. The parasite is still a major killer in Cambodia and threatens the lives of young children. According to latest WHO statistics, malaria is among the top 10 causes of death for kids under five.

While malaria remains one of the top diseases in Cambodia, the government has partnered with WHO and USAID to make significant progress in the fight against the malaria, creating better disease surveillance and preparedness and reaching patients who live in rural areas. Since 1999, malaria deaths in Cambodia have been cut in half by such efforts.

Epidemiologists are concerned with the sheer burden of malaria as well as the intense drug resistance that seems to always develop in western Cambodia. According to Science AAAS, since the 50s, the Pailin province near Cambodia’s border with Thailand has been ground zero for multiple-drug resistant strains of malaria. Such outbreaks have threatened the region and the global fight against malaria.

It is not clear exactly why Pailin is so prone to drug-resistance but a multitude of reasons have been suggested. The region’s dense Cardamom Mountains make providing quality healthcare a great challenge and many migrant workers travel through the area hoping to find precious rubies, going under the radar of health organizations.

Scientists are on the frontlines of understanding the latest strains of drug resistance in Cambodia but controlling such illusive outbreaks will likely take a huge effort and cooperation on the part of Cambodia and its neighbors.

HIV/AIDS

Cambodia experienced one of Asia’s worst HIV epidemics in the 90s and continues to grapple with the disease today. AIDS killed as many as 3,300 Cambodians last year, according to UNAIDS, and upward of 82,000 live with HIV currently. It is not uncommon for marginalized Cambodians to turn to commercial sex and other high-risk behaviors, which may contribute to the spread of the disease.

Nonetheless, the government and aid organizations have made progress in containing HIV and providing affordable treatment to many Cambodians. Infection rates have fallen by more than 50 percent in the past decade and almost all HIV patients have access to proper treatment. “Voluntary and confidential HIV testing and counseling are widely available free of charge,” for Cambodians, according to a press statement by UNAIDS from 2014, and “people living with HIV have access to free antiretroviral therapy across the country.”

The government continues to work with aid organizations to prevent the disease and help sick patients more efficiently and effectively. According to USAID, in Cambodia it is still “crucial to improve the quality and coverage of HIV/AIDS services while reducing their costs.”

Tuberculosis

According to the most recent data from WHO, tuberculosis (TB) is the second leading cause of mortality in Cambodia. USAID reports that TB kills about 13,000 citizens annually. Likewise Cambodia has one of the highest rates of incidence of the TB bacterium, which roughly two thirds of the population is estimated to carry.

While these statistics may seem bleak, Cambodia has exhibited phenomenal successes in alleviating the scourge of tuberculosis. USAID reports supporting 271 community based health centers across the country that have successfully diagnosed and treated a vast majority of the 10,000 cases so far. WHO reported that in the nine years between 2002 and 2011, massive grassroots programs that made TB treatment free and accessible halved the prevalence of TB in the country.

Malaria, HIV/AIDS and tuberculosis are still some of the top diseases in Cambodia and pose real challenges for a country that is working hard to improve public health. But the success that Cambodia has exhibited in the fight against these diseases is a clear testament to what governments and international aid programs can achieve in the face of some of the world’s worst public health issues.

Charlie Tomb

Photo: Flickr