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Life expectancy in Grenada
Grenada is a country in the Caribbean composed of seven islands. This former British colony attained its independence in 1974, making Grenada one of the smallest independent nations in the western hemisphere. Nicknamed historically as the “spice isle,” Grenada’s traditional exports included sugar, chocolate and nutmeg. From 1979 to 1983, Grenada went through a period of political upheaval, which ended when a U.S.-led coalition invaded the island. Today, Grenada is a democratic nation that is working to ensure the health and well-being of its citizens. Here are nine facts about life expectancy in Grenada.

9 Facts About Life Expectancy in Grenada

  1. The World Bank’s data showed that, as of 2017, life expectancy in Grenada was 72.39 years. While there was a rapid increase in life expectancy from 1960 to 2006, life expectancy decreased from 2007 to 2017.  However, the CIA estimates that this metric will increase to 75.2 years in 2020.
  2. Non-communicable diseases constitute the leading cause of death in Grenada. According to 2016 WHO data, non-communicable diseases such as cardiovascular disease, cancer and diabetes constituted the majority of premature death in Grenada. Cardiovascular diseases, which constituted 32 percent of all premature deaths, were the leading cause of death in 2016.
  3. Grenada’s infant mortality rate stands at 8.9 deaths per 1,000 live births. This is a significant improvement from 21.2 infant deaths out of 1,000 in 1985 and 13.7 deaths out of 1,000 in 2018.
  4. Grenada has universal health care. Health care in Grenada is run by the Ministry of Health (MoH). Through the MoH, the Grenadan government helps finance medical care in public institutions. Furthermore, if an individual wishes to purchase private health insurance, there are several options to choose from.
  5. Around 98 percent of people in Grenada have access to improved drinking water. However, water scarcity still plagues many people in Grenada due to erratic rainfall, climate change and limited water storage. To remedy this, Grenada launched a $42 million project in 2019 with the goal of expanding its water infrastructure. This includes plans to retrofit existing systems.
  6. Hurricanes and cyclones pose a threat to life expectancy in Grenada. While in recent years Grenada has not been significantly affected by a hurricane, Grenadians still remember the devastation caused by Hurricane Ivan (2004) and Hurricane Emily (2005). Hurricane Ivan caused an estimated $800 million worth of damage. In the following year, Hurricane Emily caused an additional $110 million damage. On top of 30 deaths caused by these natural disasters, the damage they inflicted on Grenada’s infrastructure and agriculture can have further harmful ramifications for the people of Grenada.
  7. The Grenadian government is taking measures to improve the country’s disaster risk
    management (DRM). With the help of organizations such as the Global Facility for Disaster Reduction and Recovery (GFDRR), Grenada is recovering from the devastation of 2004 and 2005. In 2010, for example, GFDRR conducted a risk management analysis which helped the preparation of a $26.2 million public infrastructure investment project by the World Bank in Grenada.
  8. The Grenadian government’s 2016-2025 health plan aims to strengthen life expectancy in Grenada. One of the top priorities of this framework is to ensure that health services are available, accessible and affordable to all citizens. Another goal surrounds addressing challenges for the most vulnerable groups in society such as the elderly, children and women.
  9. Grenada received a vaccination award from the Pan American Health Organization (PAHO). In November of 2014, PAHO awarded Grenada the Henry C. Smith Award for Immunization, which is presented to the country that has made the most improvement in their immunization programs. PAHO attributed this success to Community Nursing Health teams and four private Pediatricians in Grenada.

The Grenadian government is committed to providing the best quality of life for its citizens. However, there is still room for improvement. The prevalence of premature death caused by cardiovascular diseases suggests that Grenada needs to promote healthier life choices for its citizens. With the continued support and observation by the Grenadian government, many hope that life expectancy in Grenada will increase in the future.

YongJin Yi
Photo: Flickr

Malta is a small island republic in the central Mediterranean Sea. Like most other EU member states, the Maltese government operates a socialized health care scheme. However, life expectancy in Malta is a full year higher than the European Union average, for both males and females. Keep reading to learn the top 10 facts about life expectancy in Malta.

10 Facts About Life Expectancy in Malta

  1. Trends: Life expectancy in Malta ranks 15th globally and continues to rise; the current average life expectancy is 82.6, an improvement of 4.6 percent this millennium. Median life expectancy on the archipelago is expected to improve at that same rate through 2050, reaching an average death age of 86.4.
  2. Leading Causes of Death: The WHO pinpointed coronary heart disease as the republic’s number one killer, accounting for 32.46 percent of all deaths in 2018. Additional top killers include stroke (10.01 percent) and breast cancer (3.07 percent).
  3. Health Care System: Malta’s sophisticated and comprehensive state-managed health care system embodies universal coverage for the population. Although population growth and an aging workforce present long-term challenges, the Maltese have access to universal public health care as well as private hospitals. Malta’s health care spending and doctors per capita are above the EU average. Despite this, specialists remain fairly low. Currently, the government is working to address this lack of specialized care.
  4. Infant and Maternal Health: The high life expectancy in Malta is positively impacted by low infant and maternal mortality rates. Malta’s infant and maternal mortality rates are among the lowest in the world, ranking at 181 and 161, respectively. The Maltese universal health care system provides free delivery and postpartum care for all expectant mothers. These measures provided as the standard of care have minimized the expectant death rates of new mothers to 3.3 out of 100,000.
  5. Women’s Health: Like most other developed nations, Maltese women experience longer lives than men. Comparatively, WHO data predicts that women will live nearly four years longer, an average of 83.3 years to 79.6. Interestingly, the estimated gender ratio for 2020 indicates that the Malta population will skew to be slightly more male, specifically in the 65-and-over age bracket. 
  6. Sexual and Reproductive Health: Sexual health services, including family planning and STD treatment, are free of cost in Malta. Additionally, HIV prevalence is very low, at only 0.1 percent in 2016. These measures have certainly played a role in life expectancy in Malta.
  7. Violent Crime: Although crime rates typically spike during the summer, Malta’s tourist season, violence is generally not a concern. Despite fluctuations throughout the year, the national homicide rate remains low. Currently, homicide is resting at 0.9 incidents per 100,000 citizens.
  8. Obesity: Recently, 29.8 percent of the population was found to be obese, one of the highest figures in the EU. Even higher rates of obesity have been found in Maltese adolescents: 38 percent of 11-year-old boys and 32 percent of 11-year-old girls qualify as obese.
  9. Birth Rates: Sluggish population growth is typical throughout the developed world and Malta is no exception. Current data places the population growth rate at an estimated 0.87 percent. Out of 229 sovereign nations, Malta’s birth rate was ranked 192nd with 9.9 births per 1,000 citizens.
  10. Access to Medical Facilities: The competitive health care system supports high life expectancy in Malta by providing an abundant availability of hospitals and physicians per capita. Due to the archipelago’s small population, 4.7 hospital beds and 3.8 doctors exist for every 1,000 citizens.

These 10 facts about life expectancy in Malta highlight the strength of the health care system in the country. While rising rates of obesity are concerning, Malta has a strong track record of investing in the well-being of its citizens.

Dan Zamarelli
Photo: Flickr

Health Care Facts about LaosLaos is a small, South Asian country that recently experienced a significant increase in its gross domestic product (GDP). Poverty in Laos plummeted from 33.5 percent to 23.2 percent allowing the country to meet the Millennium Development Goal by reducing its extreme poverty rate by half. However, there is still much work to be done. Around 80 percent of Laotians live on less than $3 a day and face a 10 percent chance of falling into poverty. Knowing that poverty and poor health care often co-exist, the government has made it a goal to strengthen its national health care system by achieving universal health coverage by 2020. Below are nine health care facts about Laos.

9 Health Care Facts About Laos

  1. The Food and Drug Department is the regulatory authority for health care in Laos. The body is responsible for regulating pharmaceuticals and medical devices. The most recent legislation the country passed is the “Law on Drugs and Medical Products No. 07/NA,” in 2012. The law provided stricter guidelines for drugs and medical products. It also creates a classification for medical devices and registration for drugs and other medical products.
  2. Between 1997 and 2015 Laos’ poverty rate declined from 40 percent to 23 percent. The improvement in life expectancy is likely due to the recent improvements of the government on health care in Laos. For example, in 2011 Laos’ National Government Assembly decided to increase the government expenditure for health from 4 percent to 9 percent, likely influencing poverty rates.
  3. Laos has separate health care programs for different income groups. The country has the State Authority for Social Security (SASS) for civil servants, the Social Security Office (SSO) for employees of the state and private companies, the Community-based Health Insurance (CBHI) for informal-sector workers and the Health Equity Funds (HEFs) for the country’s poor.
  4. Laos’ current health insurance only covers 20 percent of the population. The lack of coverage could be due to the large spread of the country’s population outside of its major urban centers. Around 80 percent of Laos’ populace live and work in rural communities. The country’s ministry of health has made efforts to provide more services to people who live outside the main urban centers by decentralizing health care into three administrative levels: the central Ministry of Health, provincial administration levels and a district-level administration.
  5. Wealthy Laotians in need of medical care travel to Thailand for treatment. Despite the increased cost of care in Thailand, Laotians travel internationally because of the better quality of care. Health care in Laos at the local levels suffers from unqualified staff and inadequate infrastructure; additionally, inadequate drug supply is a problem. Due to these issues, Laos depends on international aid. In fact, donors and grant funding finance most of the disease control, investment, training and administrative costs.
  6. Many Laotian citizens believe illness is caused by imbalances of spirit, spiritual possession and weather. Despite Laotian spirituality, knowledge of germs as the root cause of the disease is well understood. Laotian hospitals use antibiotics and other medications when they are available. However, folk medicine is often used as a treatment. For example, herbal medicines and spiritual cures include items, such as a special tree bark, which is believed to grant long life when it is prepared with rice.
  7. Many Laotians remain malnourished. Despite recent economic growth, many children under 5 are chronically malnourished; every fifth child in rural areas is severely stunted. Malnutrition is largely influenced by natural disasters. Laos has a weak infrastructure making it difficult to cope with floods, droughts and insect swarms.
  8. Local drug shops as a primary source of medicinal remedies are actually causing problems. Most of these shops are unregulated and the owners are unlicensed. Misprescription and inadequate and overdosage are common. Venders sell small packets of drugs that often include an antibiotic, vitamins and a fever suppressant. They sell these packets as single dose cures for a wide variety of illnesses.
  9. Laos has a high risk of infectious water-borne and vector-borne diseases. Common waterborne diseases include protozoal diarrhea, hepatitis A and typhoid. Vector-borne diseases include dengue fever and malaria. Typically, diarrheal disease outbreaks occur annually during the beginning of the rainy season when the water becomes contaminated by human and animal waste on hillsides. Few homes have squat-pits or water-sealed toilets, causing sanitation and health issues.

 

As it stands, health care in Laos is still underdeveloped. However, the nation’s recent economic growth provides an opportunity to remedy the problem even though a majority of the current health care system is funded by foreign sources. As with all struggles, the desired outcome will take time. With enough cooperation with other countries and non-profit organizations, Laos has a chance to create a sustainable health care system for its citizens. Increasing health education among Laotians will be one key to improving public health in Laos. This can be done through the help of nonprofit organizations and others aiding in efforts to educate countries on sanitation and health.

– Robert Forsyth
Photo: Flickr

 

Eliminating HIV In Kenya

The HIV/AIDS epidemic in Africa affects adolescent girls more than any other group within the population. As a public health response, a new approach for the elimination of HIV in Kenya emerged which addresses the gender and economic inequality that aid in spreading the disease. This new approach is related to female empowerment eliminating HIV in Kenya with new effective methods.

Health Care System in Kenya

Kenya is home to the world’s third-largest HIV epidemic. Kenya’s diverse population of 39 million encompasses an estimate of 42 ethnic tribes, with most people living in urban areas. Research shows that about 1.5 million, or 7.1 percent of Kenya’s population live with HIV. The first reported cases of the disease in Kenya were reported by the World Health Organization between 1983 to 1985. During that time, many global health organizations increased their efforts to spread awareness about prevention methods for the disease and gave antiretroviral therapy (ART) to those who were already infected with the disease. In the 1990s, the rise of the HIV infected population in Kenya had risen to 100,000 which led to the development of the National AIDS Control Council. The elimination of HIV in Kenya then became a priority for every global health organization.

The health care system in Kenya is a referral system of hospitals, health clinics, and dispensaries that extends from Nairobi to rural areas. There are only about 7,000 physicians in total that work within the public and private sector of Kenya’s health care system. As the population increases and the HIV epidemic intensifies, it creates more strenuous conditions for most of the population in Kenya to get the healthcare they desperately need. It is estimated that more than 53 percent of people living with HIV in Kenya are uninformed of their HIV status.

In addition, HIV disproportionately affects women and young people. After an initiative implemented by UNAIDS in 2013 to eliminate mother-to-child transmission of HIV through increased access to sex education and contraceptives, significantly fewer children are born with HIV. Today, 61 percent of children with HIV are receiving treatment. However, the young women (ages 15-24) in Kenya are still twice as likely to be infected with HIV as men their age. Overall HIV rates are continuing to decrease for other groups within the population, but studies show that 74 percent of new HIV cases in Kenya continue to be adolescent girls.

Female Empowerment Eliminating HIV in Kenya

Women’s empowerment is an overarching theme for the reasons that HIV is heavily impacting the young women in Kenya. A woman’s security in the idea that she is able to dictate personal choices for herself has the ability to hinder or help her well-being.
Female empowerment eliminating HIV in Kenya uses these four common conditions to eliminate HIV:

  1. Health Information – Many girls in Kenya lack adequate information and services about sexual and reproductive health. Some health services even require an age of consent, which only perpetuates the stigma towards sexual rights. Also, the few health services available are out of reach for poor girls in urban areas.
  2. Education – A lack of secondary education for young women and girls in Kenya often means that they are unaware of modern contraceptives. A girl that does not receive a secondary education is twice as likely to get HIV. To ensure that adolescent girls have access to sexuality education, the 2013 Ministerial Commitment on Comprehensive Sexuality Education and Sexual and Reproductive Health and Rights in Eastern and Southern Africa guaranteed that African leaders will commit to these specific needs for young people.
  3. Intimate partner violence –  Countless young women and girls have reported domestic and sexual violence that led to them contracting HIV. Something as simple as trying to negotiate contraceptive use with their partners often prompts a violent response. There has been an increased effort to erase the social acceptability of violence in many Kenyan communities. An organization called, The Raising Voices of SASA! consists of over 25 organizations in sub-Saharan Africa that work to prevent violence against women and HIV.
  4. Societal norms – Some communities in Kenya still practice the tradition of arranged marriages, and often at very young ages for girls. The marriages usually result in early pregnancy and without proper sex education, women and babies are being infected with HIV at a higher rate. In 2014, the African Union Commission accelerated the end to child marriages by setting up a 2-year campaign in 10 African Countries to advocate for Law against child marriages. Research suggests that eliminating child marriages would decrease HIV cases, along with domestic violence, premature pregnancies by over 50 percent.

Young women in Kenya face various obstacles in order to live a healthy life, and poverty acts as a comprehensive factor. Studies show that a lack of limited job opportunities leads to an increase in high-risk behavior. Transactional sex becomes increasingly common for women under these conditions, while they also become more at risk for sexual violence. An estimated 29.3 percent of female sex workers in Kenya live with HIV.

Solution

The most practical solution to tackling the elimination of HIV in Kenya combines HIV prevention with economic empowerment for young girls. The Global Fund to fight AIDS, Tuberculosis and Malaria is an organization that has worked hard at implementing strategies, and interventions across Africa that highlight women’s access to job opportunities and education. In 10 different countries in Africa (including Kenya), young women can attend interventions in which they learn about small business loans, vocational training and entrepreneurship training. One way that more women in Kenya are able to gain control over their financial resources is by receiving village saving loans. To participate in village saving loans it requires a group of 20-30 to make deposits into a group fund each week. Women within these groups can access small loans, which enables them to increase their financial skills while gaining economic independence. The Global Fund to fight AIDS has cultivated a space for numerous empowerment groups for young women out of school called the RISE Young Women Club. The young women in these clubs often live in poverty and receive HIV testing as well as sexual health education.

Overall, the global health programs that aid in the elimination of HIV in Kenya are continuously improving their strategies by including young women in poverty. The HIV/AIDS epidemic in Kenya steadily sees progress thanks to the collective efforts of programs that empower young women.

– Nia Coleman
Photo: Flickr

Health Costs of The Syrian Civil War
The Syrian civil war, which began in 2011, has led to a monumental refugee crisis, hundreds of thousands of deaths, the rise of the Islamic State of Iraq and Syria (ISIS) and destabilization in the Middle East. Yet another devastating effect of the war is the health consequences for people still living in Syria. Civilian doctors and nurses in active war zones face significant challenges not encountered in peacetime. These include a massive amount of trauma victims, shortages of medical equipment and personnel, infectious disease epidemics and breaches in medical neutrality. Here are 10 health costs of the Syrian civil war for the Syrian people.

10 Health Costs of the Syrian Civil War

  1. Because of the war, Syrian life expectancy has plummeted by 20 years from 75.9 years in 2010 to 55.7 years through the end of 2014. The quality of life in Syria has also worsened. As of 2016, 80 percent of Syrians are living in poverty. Moreover, 12 million people depend on assistance from humanitarian organizations.
  2. The civil war devastated Syria’s health care infrastructure, which compared to those in other middle-income countries prior to the war. By 2015, however, Syria’s health care capabilities weakened in all sectors due to the destruction of hospitals and clinics. The country faced a shortage of health care providers and medical supplies and fear gripped the country.
  3. The Syrian Government has deliberately cut vital services, such as water, phone lines, sewage treatment and garbage collection in conflict areas; because of this government blockade, millions of Syrian citizens must rely on outside medical resources from places like Jordan, Lebanon and Turkey. In 2012, the Assad regime declared providing medical aid in areas opposition forces controlled a criminal offense, which violates the Geneva Convention. By the following year, 70 percent of health workers had fled the country. This exodus of doctors worsens health outcomes and further strains doctors and surgeons who have remained.
  4. The unavailability of important medications presents another health cost of the civil war. Due to economic sanctions, fuel shortages and the unavailability of hard currency, conflict areas face a severe shortage of life-saving medications, such as some for noncommunicable diseases. Commonly used medicines, such as insulin, oxygen and anesthetic medications, are not available. Patients who rely on inhaled-medications or long-term supplemental oxygen often go without it.
  5. A lack of crucial medications has led to increased disease transmission of illnesses, such as tuberculosis. Furthermore, the conditions Syrians live in, for instance, the “tens of thousands of people currently imprisoned across the country… offer a perfect breeding ground for drug-resistant TB.”  Indeed, the majority of consultations at out-patient facilities for children under 5 were for infectious diseases like acute respiratory tract infections and watery diarrhea. According to data from Médecins Sans Frontières-Operational Centre Amsterdam  (MSF-OCA), the largest contributor to civilian mortality was an infection.
  6. In addition to combatant deaths, the civil war has caused over 100,000 civilian deaths. According to the Violation Documentation Center (VDC), cited in a 2018 Lancet Global Health study, 101,453 Syrian civilians in opposition-controlled areas died between March 18, 2011, and Dec 31, 2016. Thus, of the 143,630 conflict-related violent deaths during that period, civilians accounted for 70.6 percent of deaths in these areas while opposition combatants constituted 42,177 deaths or 29.4 percent of deaths.
  7. Of the total civilian fatalities, the proportion of children who died rose from 8.9 percent in 2011 to 19.0 percent in 2013 to 23.3 percent in 2016. As the civil war went on, aerial bombing and shelling were disproportionately responsible for civilian deaths and were the primary cause of direct death for women and children between 2011 and 2016. Thus, the “increased reliance on the aerial bombing by the Syrian Government and international partners” is one reason for the increasing proportion of children killed during the civil war according to The Lancet Global Health report. In Tal-Abyad’s pediatric IPD (2013-2014) and in Kobane Basement IPD (2015–2016), mortality rates were highest among children that were less than 6 months old. For children under a year old, the most common causes of death were malnutrition, diarrhea and lower respiratory tract infections.
  8. The challenges doctors and clinicians face are great, but health care providers are implementing unique strategies that emerged in previously war-torn areas to meet the needs of Syrian citizens. The United Nations (the U.N.) and World Health Organizations (WHO) are actively coordinating with and international NGOs to provide aid. The Syrian-led and Syrian diaspora–led NGOs are promoting Syrian health care and aiding medical personnel in Syria as well. For instance, aid groups developed an underground hospital network in Syria, which has served hundreds of thousands of civilians. These hospitals were “established in basements, farmhouses, deserted buildings, mosques, churches, factories, and even natural caves.”
  9. Since 2013, the Médecins Sans Frontières-Operational Centre Amsterdam (MSF-OCA) has been providing health care to Syrians in the districts of Tal-Abyad in Ar-Raqqa Governorate and Kobane in Aleppo Governorate, which are located in northern Syria close to the Turkish border. The health care MSF-OCA provided included out-patient and in-patient care, vaccinations and nutritional monitoring.
  10. New technologies have enabled health officials to assist in providing aid from far away. For instance, telemedicine allows health officials to make remote diagnosis and treatment of patients in war zones and areas under siege. One organization that has used this tool is the Syrian American Medical Society, which “provides remote online coverage to nine major ICUs in besieged or hard-to-access cities in Syria via video cameras, Skype, and satellite Internet connections.” Distance learning empowers under-trained doctors in Syria to learn about disaster medicine and the trauma of war from board-certified critical care specialists in the United States.

Conditions on the ground in Syria make it more difficult for Syrian citizens to receive vital medical aid from health care workers. Many people and organizations are working diligently to help injured and sick Syrians, however. These 10 health costs of the Syrian civil war illuminate some of the consequences of war that are perhaps not as storied as the refugee crisis. While aiding refugees is an undoubtedly worthy goal for international NGOs and governments, policymaker’s and NGOs’ agendas should include recognizing and alleviating the harm to those still living in Syria.

Sarah Frazer
Photo: Flickr

Mental Health and Poverty
Although mental health and poverty are two things that one might not always group together, there is a serious link between people living below the poverty line and mental health disorders. According to a Substance Abuse and Mental Health Services Administration SAMHSA report, around 9.8 million people living in the United States had mental health disorders in 2015, and 25 percent of those people were living below the poverty line.

Both poverty and mental health can bring about the other. For instance, a Gallup poll found that about 15.8 percent of people not living in poverty reported having diagnosed depression, while 31 percent of people living in poverty reported depression. In addition, a McSilver Institute for Poverty Policy and Research study based on data from the National Center for Education Statistics found that a household is likely to experience a 50 to 80 percent increase in food insecurity if the mother has diagnosed depression. While it is not clear whether the depression leads to living in poverty or living in poverty results in depression, the link between the two issues is clearly prevalent. Therefore, it is crucial that others address and treat the mental health of people living in poverty.

Ways to Treat Mental Health

One large issue with impoverished people having mental health disorders is that they often do not have the insurance and money to seek therapy and get medical help. This can be especially harmful to children living in poverty. The Official Journal of the American Academy of Pediatrics has three main recommendations for low-income families to seek help for mental health disorders, including education and training, establishing relationships with providers and creating multidisciplinary teams.

The best way to help and treat mental health in low-income families and communities is education. By integrating mental health education in schools and free programs that schools offer to families and communities, more people can learn about how to cope with mental health disorders and keep themselves and their families healthy and happy. In addition, integrating mental health services into school health services allows children to seek help for any mental health disorders right at school.

Further, establishing relationships with school health providers and counselors allows children to feel comfortable enough to seek the help that they need, in a safe space that they are used to. Communication between children/families and health care providers also allows the providers to be available more quickly and could result in more effective treatment.

Effects of Improving Mental Health

Poverty can strain a person’s mental health due to stress and instability. Therefore, public mental health has a huge impact on communities and the mental health of the people. People do not widely recognize public health, which is why is it crucial that communities are actively working to prevent mental health problems and to educate the community on how to cope with mental health strains.

Mental health problems and poverty have a serious link and it is vital that people are aware of the strains of poverty and understand their community and who is at risk. Only by monitoring and evaluating impacts of mental health, creating educational programs and addressing both physical and mental health, both mental health and poverty can improve together.

Paige Regan
Photo: Flickr


It is no secret that health care in developing countries is abysmal. Inhabitants in these countries suffer from unclean water, poor sanitation conditions and a high risk of contracting infectious and severe diseases. In the 1970s, the World Health Organization set a goal to have universal health care across the globe by the year 2000. It is now 2017, and that goal is nowhere near being achieved. Much of the disparity centers on health inequities between and within countries, especially in those less developed.

Low-income countries not only suffer from a lack of technology and education, but they also lack in the number of skilled professionals working in communities, where the result is people dying from treatable diseases like diarrhea. Another problem is that little research and development is conducted on diseases that affect such areas. Most global research spending on health care goes toward the prevention and curing of diseases suffered in the developed world, leaving little behind for developing countries.

This being said, there has been a recent shift towards bringing health care to developing countries. First, the United Nations acknowledged the health disparities and the lack of health care systems. To resolve these disparities, the Millennium Development Goals were created, with the Sustainable Development Goals following close behind. Each set of goals attempts to improve health care in less-developed countries using the resources available to the world’s more-developed nations. Strategies were formulated under the belief that “leaders in health care have an important stewardship role across all branches of society to ensure that policies and actions in other sectors improve health equity.”

The global health care crisis comes down to the cooperation of all nations working in concert to assure adequate health care in developing countries. This means using the resources of developed countries to research and set up prevention plans based on factors experienced in developing countries. It also means educating those in less-developed nations on safe sanitation practices and simple prevention methods.

To achieve universal health care, a team effort is required.

Taylor Elgarten

Photo: Flickr

German Health Care: A Broken System for Asylum-seekers?
German health care, geared to caring for a population of 80 million, is dealing with an unexpected and intimidating challenge by the continuous influx of about 1.1 million refugees in 2015 alone. Escaping poverty, war and repression, as well as family reunification are among the main reasons people attempt to enter Germany both legally and illegally.

Despite having opened its doors to more refugees than any other European country since 2013, Germany restricts asylum-seekers’ health care access to emergency care, treatment for acute diseases and pain, maternity care and vaccinations. Additional care can be provided, however, patients must file various petitions and jump through multiple hoops before getting approval for the same.

The aim of restricting asylum-seekers’ access to German health care dates back to the 1990s when rising numbers of asylum-seekers from former Yugoslavia created a need to reduce Germany’s pull factor. However, it is evident from various studies that this policy has done nothing to bring down the number of people seeking asylum in the country.

In spite of limiting access to health care, the sociomedical system is crumbling with news reports about vaccines not being available for German citizens till 2017 in the normal quantities. Doctors are having to undergo courses in screening and treating diseases like tuberculosis, scabies and psychological trauma.

In addition, there is the cost of material resources like medicines and hospital beds, diagnostic and surgeries that have spiraling economic repercussions. The siphoning of medical services, even in their most basic form, to asylum-seekers, is resented by many German citizens.

However, despite this backlash, there are many reasons for the country to consider providing full access to German health care, both for asylum seekers and undocumented immigrants. The most obvious of these is that any communicable disease can skyrocket the economic cost to the country by a loss of productivity.

In addition, according to experts such as Dr. David Ingleby from the University of Amsterdam, research has shown that, “denying easy and early access to healthcare not only ignores the right to health but actually increases costs: a new study estimated that since their introduction, these restrictive policies have increased the cost of healthcare by 376 euros per year for each asylum seeker.” Clearly, restrictive policies benefit neither immigrants nor state.

Some states like Bremen and Hamburg have been providing their asylum-seekers with health insurance cards like those used by the general population. These enable direct access to doctors and hospitals without having to apply for a certificate of entitlement.

Officially, the restriction on acute and emergency services remains, but the decision is now moved to the doctor’s medical discretion and no longer made by a municipal administrator. An innovative solution, this could be extended to the legal system, resting the decision of what warrants medical attention to the hands of those in the know.

Another solution being considered is granting anonymous insurance certificates that allow refugees without proof of citizenship to seek medical help without legal repercussions. In Berlin alone, up to 250,000 people live without any personal identity documents which are essential to get full medical treatment, making this idea almost a necessity.

In order to provide funding for these and other such policies for less restrictive health care, the European Union Health Program released a statement pledging fund actions supporting the Member States under particular migratory pressure in January this year. Hopefully, with this positive impetus, the German health care system will move to a more inclusive model for both asylum-seekers and undocumented immigrants.

Mallika Khanna

Photo: Flickr

Five Reasons for the Link Between Poverty and Mental Health
Poverty and mental health are inextricably tied for a myriad of reasons. A report published by the World Health Organization suggests that poor individuals are twice as affected by mental health conditions compared to rich individuals. The most important reasons for this stark inequality are outlined below.

  1. Destitute living conditions:
    Poverty often results in an inability to afford basic necessities such as food, clothing and shelter. This can result in poor living conditions and in some situations, homelessness, when individuals cannot afford rent or mortgage expenses. The uncertainty associated with living in unstable environments can often elicit a lot of stress, which can predispose individuals to mental health conditions such as depression. Poor standards of living can be addressed through aid provided by developed countries and increased public expenditure on necessary facilities such as schools, hospitals and transport systems.
  2. Stress over prolonged periods of time:
    In 2011, information published by the Fragile Families and Child Wellbeing Study revealed that generalized anxiety disorder, which is characterized by anxiety over non-specific things, was most prevalent in the poorest individuals of a particular sample population. Mothers, especially in developing countries, are constantly plagued by worry about their children’s safety, nutrition and physical and social development. Despite their worries, they are compelled to make ends meet and continue to provide for their families by cooking food, cleaning the house and ensuring utility bills are paid in a timely manner. Access to services that guide women on proper care and upbringing of children can address the effects of excessive stress on children. The government can also play a role in supporting households by providing subsidies and grants for education and discounts for health care. This is a major factor in the link between poverty and mental health.
  3. Unhealthy consumption habits:
    The effects of poverty are compounded by a multitude of problems such as homelessness, debt, risk of violence, increased rates of illness and loss of social standing and self-esteem. These problems can take a severe toll on an individual, resulting in self-harming habits such as excessive alcohol consumption, smoking, drug abuse and consumption of fast food, which is often more affordable than healthier alternatives. An alarming statistic states that approximately 33 percent of individuals suffering from poverty smoke compared to a significantly less 20 percent of individuals who are not poor.Unhealthy habits can be resolved through campaigns educating individuals about the importance of healthy eating and the negative health consequences of smoking and alcohol consumption.
  4. Insufficient access to health care services:
    Individuals suffering from poverty typically have insufficient financial resources, preventing access to affordable health care services. This prevents them from seeking help early, which may result in the progression of their mental health affliction. Poor populations can be encouraged to access health care services through subsidies and increased distribution of local clinics, which make it possible to receive this care without having to travel over long distances. Regular monitoring and sampling for mental health conditions in impoverished societies are also of critical importance.
  5. Diminished attention towards the needs of children:
    Working individuals living in poor households are likely to be preoccupied with several concerns such as debt, stress from work and even relationships with their partner. These stresses may take away attention from the growth and development of their children, leading to adverse effects on the mental health of these children. It is estimated that depression has a prevalence of 0.4 to 2 percent in children ages 6 to 12 years. Parenting training programs and reliable child care services can help children living in poor conditions receive the care they need.

While the relationship between poverty and mental health is complicated, individual measures taken to reduce global poverty are likely to have positive impacts on mental health issues in underprivileged populations.

Tanvi Ambulkar

Photo: Flickr

AMAR_Foundation
The AMAR Foundation works to improve the conditions of approximately 3.4 million internally displaced Iraqis by utilizing local expertise to build long-term solutions.

The organization, founded in 1991 by Baroness Emma Nicholson, is a London-based charity with the goal of improving education, health care and emergency aid to some of the world’s most disenfranchised and impoverished people.

Their model is simple: AMAR works closely with on-the-ground experts, as well as local leaders, to implement entirely local programs that are tailored to the needs of the community.

In lieu of sending in volunteers from other countries, AMAR cooperates with existing services to locally source the materials and expertise needed to improve living conditions. Outside intervention is kept to a minimum and communities are encouraged to build themselves from the inside out.

Communication is the key to the success of this aid model. In a 2015 Jordan Times article reporting on AMAR’s efforts to stem an outbreak of cholera in Iraq, it is proffered that raising awareness about public health and common diseases is one of the most crucial pieces of improving the health of a community.

Communication is key not only in improving public health but also in ensuring the success of locally-based aid efforts like those the AMAR Foundation organizes.

Local collaboration is by no means a new idea, but the AMAR Foundation’s astonishing success utilizing this model within Iraq provides great hope for the future of foreign aid worldwide.

Without the help of major international funding, AMAR has managed to establish a clinic in northern Iraq that serves more than 600 patients a day, as well as multiple mobile health clinics that can be operated by locals. Since 2005, their clinics have helped over 4 million Iraqis.

Although today only a few organizations embrace a model that favors entirely local implementation, the AMAR foundation continues to provide an example of the great success that can come from on-the-ground solutions.

Sage Smiley

Photo: Defense Video Imagery Distribution System