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German Health Care: A Broken System for Asylum-Seekers?

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

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Five Reasons for the Link Between Poverty and Mental Health

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

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The AMAR Foundation Model of Aid Distribution

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

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Nutrition Strategy Counters Vitamin A Deficiency in Ghana

Ghana Vitamin A Deficiency
As a leader in fighting extreme global poverty, government agency USAID is currently revolutionizing health and nutrition for northern Ghanaians. In order to counter the vitamin A deficiency from which many people in Ghana suffer, USAID introduced the sweet potato to the country. Since its introduction, the sweet potato has become one of the region’s most popular vegetables, USAID reports.

The implementation of the sweet potato is part of USAID’s 2014-2025 Multi-Sectoral Nutrition Strategy. The project is aligned with the 2025 World Health Assembly Nutrition Targets and focuses on decreasing chronic malnutrition and improving other nutrition investments. According to USAID, over one-third of children under the age of five, in five northern districts, suffer from stunted growth resulting from poor nutrition, so the strategy is crucial for bettering the future generations.

USAID team members visited Ghana last year and taught 439 women in 17 districts how to grow the sweet potato. The crop instantly became admired, with villagers calling it “Alafie Wuljo,” or “healthy potato” in the Dagbani language. Ghanaians have also been taught different ways to cook the potato, such as schoolchildren enjoying sweet potato fries.

“Now everyone wants to grow orange-fleshed sweet potatoes,” said the head of the project, Phillipe LeMay, in a USAID article.

The Nutrition Strategy goes beyond just the sweet potato. The project also focuses on educating farmers about other nutritious crops, linking farmers to markets, helping community members create savings and loans, promoting better hygiene and improving water and sanitation infrastructure.

USAID and the government of Ghana aim to change the lives of roughly 300,000 people with this project. Northern Ghana is an area of particular focus because it is relatively remote with a harsh climate and limited resources. This work will also be assisting with the goals of the U.S. government’s global hunger and food security initiative, Feed the Future. Feed the Future aims to decrease child stunting by 20 percent and double incomes of vulnerable households. With USAID tactics, this is becoming a reality.

The project has received positive responses thus far. The Ghanaian government has taken the initiative to promote a solution to vitamin A deficiency and nutrition in general, according to USAID, which has beneficial long-term effects. The organized training provided by USAID has also educated many people on how to practice proper sanitation and good nutrition.

“I now understand the links between poor sanitation, diarrheal diseases and nutrition,” said West Gonja District member Ama Nuzaara, in a USAID article. “I also make sure that my children wash their hands with soap and water after they use the toilet. I do this for my family’s health and well-being.”

– Kerri Whelan

Sources: USAID 1, JSI, USAID 2, Feed the Future
Photo: Feed the Future

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Why Drones Could Soon Be Delivering Health Care

DronesPending Aviation Authority approval, drones could soon be used to deliver healthcare to patients in developing countries.

Drones, or unmanned aircraft, can be controlled by remote or autonomously. They can be used for a variety of things including surveillance, leisure and weaponry. Now, the potential has been unlocked for drones to help the field of healthcare.

Timothy Amukele, a pathologist at Johns Hopkins, is one of the people exploring this possibility. Recognizing that access in many third world countries is inadequate and expensive, he thought, why not drones?

“If we now have a cheaper way to move samples, it’s a good thing, especially for patients who are hard to reach, whether they live in rural areas or places without good roads,” Amukele said.

In order to stabilize health throughout Africa, access to medicine is necessary. One of the main reasons medicine becomes undeliverable is poor road conditions.

According to the Africa Development Bank, in 2010 only 34 percent of rural Africa had adequate road access. That small percentage is further crippled by the fact that those roads are poor quality and the government was unwilling to grant money for their repair.

Right now, helicopters or motorcycles are the best means of transportation throughout rural Africa. While motorcycles are cheaper to operate, they also have their disadvantages.

Motorcycles are smaller, eliminating the possibility for large amounts of cargo to be transported. Helicopters, on the other hand, make more sense because they are larger and avoid roads altogether. However, the operational costs are excessive.

Drones, potentially, are a solution to that logistical issue. The unmanned aircraft do not need to deal with traveling across haphazard roads. They are also significantly less expensive to operate, as they do not require fuel.

Drones can also help alleviate the number of patients a physician has to help for non-threatening medical issues. According to the World Bank, Bhutan only has one physician for every 3,333 people.

Having the ability to send drones to deliver medicine would cut down on the number of patients a physician would have to see. This would free up time for doctors to be able to attend to patients in desperate need of care.

Even though the idea of drones providing healthcare services is new, there are many positive attributes. Still, more must be achieved and learned to allow for this conception to become a reality.

– Alyson Atondo

Sources: MIT, The Conversation, Washington Post, Benzinga
Photo: Flickr

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The Virtual Care Clinic Introduces Hologram House Calls

hologram_house_calls

The Virtual Care Clinic, recently announced by the University of Southern California, is a pioneer in the field of virtual health care that promises easily accessible and personalized health care across the globe.

The two main components of this virtual clinic are hologram house calls, which stream video to individuals and an app that assesses someone’s needs based off of archived data as well as the information the patient provides.

The ninth annual University of Southern California’s Body Computing Conference was heralded by the announcement of hologram house calls, a prime feature to the previously announced Virtual Care Clinic which is currently under development.

The house call consists of a hologram or video beamed across the globe to wherever a patient in need resides, giving an incredible advantage for doctors to assess a patient with a little more contextualization.

This feature is important because it allows for a quick diagnosis and also allows doctors to further understand the situation of health care recipients, most of whom live in poverty.

The hologram house call is an essential extremity of the Virtual Care Clinic because this alone provides easily accessible care not just domestically but abroad, which is really an amazing feat.

Just by using the hologram house call anybody may speak to a trained medical physician in seconds and be given a diagnosis in minutes; the potential for giving health care guidance shrinks from providing establishments to providing a device that will stream the video.

Also, the house call operates with wearable or injectable technology that logs data in order to provide an almost complete examination; with these technologies working together, it is as if one were visiting a real doctor who would give him or her a precise consultation.

Along with the hologram house call, a second part of the virtual care clinic is less data intensive and focuses more on providing consistent, non-personnel type of aid.

With the app, all one must do is insert his or her age, medical condition and history of diseases that run in the family to be given accurate and helpful information on what kind of treatment to seek and when to seek it.

The potential for this technology is overwhelming considering that the mobile tech industry is ever-growing in places where development is occurring faster every day. Conceivably, the Virtual Care Clinic would provide consistent and affordable health care with the ultimate utility of being completely mobile.

– Emilio Rivera

Sources: University of Southern California, Co.Design, Popular Science
Photo: Wikipedia

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Commissioner Mimica Announced Support Package for Peru

support package for PeruCommissioner Mimica of EU Aid began a voyage to Peru earlier this month on Oct. 9 to announce a support package for the development and health of young adults and children.

The support package for Peru is intended to accelerate the plans of the National Development and Social Inclusion Strategy, which aims to help five regions most affected by poverty in the Peruvian Amazon.

The finalized package suggests 40 million euros ($45.5 million), with a total 66 million euros ($75.1 million) being allocated to Peru between 2014 and 2017. This money will advance the already growing economy of Peru and assist the permanent reduction of poverty that has been reflected since this growth.

However, the solidarity of development has not been established, as about 54 percent still live in poverty and 19 percent live in absolute poverty (less than a dollar a day).

Social Inclusion Strategy will address this unequal growth, favoring those who have not benefited, despite the country’s economic boom. The stratagem prioritizes people into groups based off five core topics:

  1. Childhood Nutrition – focusing on fighting those who lack access to food and water
  2. Early Childhood Development – focusing on the development of infants and young children who do not live in stable conditions
  3. Development of Children and Teenagers – focusing on older children and teens who do not live with a stable family
  4. Economic Inclusion – focusing on incorporating those who have not benefitted from the economy into a better society
  5. Protection of Elders – focusing on poverty-stricken elders who are no longer able to provide for themselves

Furthermore, the developmental gap in the region is ensured to decrease by a three-part approach that focuses on three-time horizons – short, medium and long term.

Temporary relief will bring short term relief to those in extreme poverty while medium term relief promises capacity building such as providing services, and the long-term approach will aid with the creation of opportunities.

In this way, Peru will see a reduction of extreme poverty that substantiates and perpetuates the developmental growth of all priority groups.

MIDIS, the organization overseeing the National Development and Social Inclusion Strategy, defines people who are already in the process of social inclusion as PEPI; PEPI households must meet three of four focal points in order to be given PEPI status:

  1. Rural household
  2. Female-headed Household with less than primary education
  3. Head of house speaks indigenous language
  4. Located in the first quintile of national per capita income distribution

Of these dwellings, 60 percent live between walls of adobe, 84 percent have dirt floors in their homes, 60 percent use wood to cook and 57 percent go without access to sanitation services.

The total number of people living in PEPI households (4.8 million) calculates to about 16 percent of the population. It is estimated by 2030 for the developmental gap to be significantly reduced by the support package for Peru with financial investment to be concluded for Peru in 2017.

– Emilio Rivera

Sources: European Commission, GOB, Nations Encyclopedia
Photo: Flickr

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The Indonesian Family Hope Program Ends Poverty Cycle

Indonesia_Family

In 2013, 28 million Indonesians lived below the poverty line. Impoverished families throughout the nation were often too poor to afford healthcare and education for their children, leading to illness and injury that trapped them in generational poverty.

In an effort to break this generational cycle, the World Bank, in combination with the Ministry of Social Affairs, has created the Family Hope Program.

Financial and Developmental Aid

The Indonesian Family Hope Program works through a series of cash transfers. The money is given to parents who agree to participate in health and nutrition training, take their children to clinics when they’re ill and keep their children in school.

The program also provides startup money and skills training to parents. These micro-investments give families the means to become entrepreneurs and run their own family businesses, ensuring economic growth and generational development.

Health

Mothers participating in the program are encouraged to give their children the best possible start to life — beginning in the womb. The World Health Organization (WHO) recommends that women have four antenatal check-ups throughout the course of their pregnancy, thus lowering the risk of complications, infections and other life-threatening incidents through screenings. Yet, few women receive all four visits.

The Family Hope Program has increased the number of antenatal checkups by more than 7 percent. This establishes a precedent of continued family health. As mothers are healthier during and after pregnancy, children are healthier and receive better healthcare as a result. The 7 percent increase in antenatal care resulted in a mirrored raise in child immunizations by 7 percent.

The nutritional aspect of the program has also positively impacted childhood development, decreasing the number of children suffering from stunting by 5 percent. As a result of children being healthier, they are able to focus better and attend school.

Education

Along with the cash grants, more than 11,000 facilitators trained in education and nutrition hold seminars teaching mothers how to manage finances, improve the health of their families and aid their children in their studies.

The program has resulted in increased enrollment and school participation.

Many children from poor families stop attending school after completing their primary education, though not due to a lack of desire to attend. The program has removed financial barriers keeping children from continuing their education for the more than 3 million families that the program has reached.

Children now are 8 percent more likely to go on to secondary education and 10 percent more likely to enroll in junior secondary school. According to the United Nations, more education equals higher earning potential and better health, which are essential to end the generational poverty cycle.

– Claire Colby

Sources: NCBI, United Nations, World Bank, World Health Organization
Photo: PBase

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Clinton Global Initiative Launches Health Plan

Clinton Global InitiativeA lack of access to adequate health care is often a risk factor or symptom of poverty, as the inability to prevent or treat illnesses in a timely, affordable manner can devastate communities.

Following the aftermath of the Ebola crisis, USAID, the Clinton Global Initiative and other organizations have teamed up to create the Aspen Management Partnership for Health.

The Aspen Management Partnership for Health (AMP Health) is the first multi-sectoral partnership in the community health sector to focus on the leadership driving community health systems in developing nations.

Specifically, AMP Health hopes to strengthen the leadership and management of community health organizations. AMP Health combines the power of several different organizations in order to facilitate effective change.

This multi-sectoral partnership utilizes the power of USAID, the Aspen Institute, MDG Health Alliance, Born Free Africa, Margaret A. Cardill Foundation, GlaxoSmithKline, Partners in Health, the Harvard School of Public Health and McCann Health.

The partnership was announced at the Clinton Foundation’s 2015 Annual Meeting as one of their Commitments to Action for the Clinton Global Initiative.

“In addition to establishing mentor networks and cross-country convenings, the partners will recruit, train, and deploy in-country management professionals to work side-by-side with Ministries of Health on high-priority community health projects, ultimately strengthening health systems,” Clinton Foundation Vice Chair Chelsea Clinton said at the meeting.

The networks of trained, values-oriented health care professionals will be critical in advancing community health systems in developing nations.
Initially, the partnership will be utilized in sub-Saharan Africa, where community health interventions could save up to three million lives per year.

It will prove particularly relevant to reducing child and maternal mortality rates.

AMP Health incorporates businesses, governments, educational institutions, think tanks, multilateral organizations, and philanthropic foundations in order to affect change for community health systems.

While this may be just one of the Clinton Foundation’s 3,200 Commitments to Action, it carries much power and support from myriad organizations.

As a result of the multi-sectoral partnership, AMP Health can support sub-Saharan Africa as it works to prevent future epidemics, lower child and maternal mortality rates, and manage the treatment of chronic, non-communicable diseases.

– Priscilla McCelvey

Sources: Aspen Institute, Market Watch
Photo: Flickr

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The Sovereign Military Order of Malta Aids Poor and Sick

Military-Order-of-MaltaThe Sovereign Military Order of Malta has a rich history of generosity. Also called the Order of St. John of Jerusalem, the organization dates back to 1048. At the time, it was a military order in charge of hospital defense. Members in the Order of Malta were chivalrous and noble of nature.

Since its beginning, the Order of Malta has been committed with aiding the poor and suffering. Today, it operates in more than 120 countries, providing medical and social care, disaster relief, emergency services and assistance for elderly, children and refugees. For more than 900 years, it has cared for people of all religions and beliefs.

“There are 13,500 members world-wide, plus 80,000 trained volunteers and 25,000 medical and para-medical personnel, working in a large number of hospitals, hospices, homes for the elderly and a variety of other aid activities,” says Marchesino Daniel de Petrie Testaferrata, elected president of the Maltese Association of the Order of Malta.

The Order of Malta has diplomatic relations with numerous countries, which allows it to better assist others, such as helping the sick in areas that some organizations may have trouble accessing.

The Order of Malta has provided disaster relief assistance in The Philippines and Haiti. In Africa, it focuses on care for HIV patients; treatment for tuberculosis, malaria and leprosy; and clean water supplies for others. It also cares for refugees and orphaned children in Asia and the Middle East.

In addition, the Order of Malta has aided in Europe and North America. After Hurricane Katrina hit the U.S., the Order of Malta provided shelter while working on reconstruction projects.

Malteser International, the Order of Malta’s relief agency, reports that, in 2014, its aim was to spread medical supplies to regions affected by Ebola. This year, it is educating others in hopes of minimizing the disease.

For more information on the Order of Malta, visit its website.

– Kelsey Parrotte

Sources: Independent, The Order of Malta, Saint Peter’s List,                                                                                                                                                                                                                                                                      Photo: Flickr

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