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Philippines’ Nurse Migration is Fueling a Health Care Crisis

Philippines' nurse migrationThe Philippines is the world’s leading exporter of nurses. While Filipinos account for only 1% of the U.S. population, they comprise 4% of the nursing workforce. Although the U.S. has relied on the heroic contributions of Filipino nurses for centuries, their continuous migration is fueling a crisis at home. Hospitals and clinics across the Philippines struggle with staff shortages and the country’s continued nurse migration has gradually widened the global health care gap.

Brain Drain of Nurses

“Brain drain” refers to the mass emigration of the most highly educated or skilled individuals from a particular country. For many developing countries, the inability to retain such professionals across various sectors, due to sociopolitical or economic factors, can trigger a cyclical downfall of infrastructure and human capital. In the Philippines, decades of nurse migration to the U.S. have resulted in a catastrophic shortage.

The Department of Health sets a standard 1:12 Nurse-to-Patient Ratio. In the Philippines, the ratio regularly stands at 1:20 and has even escalated to 1:50. The nation faces a nurse shortage of roughly 127,000 nurses, with nearly 4,500 posts at public hospitals remaining unfilled, a figure expected to rise to 250,000 by 2030.

Many Filipino nurses are emigrating to the U.S. due to poor working conditions at home, leaving the nation’s health care system understaffed and worsening nurse burnout. While a series of mental health programs and interventions have been suggested as a way to remediate this threat, the problem seems to stem from several structural challenges.

Most notably, these include extremely low salaries, heavy and imbalanced workload and hours, job insecurity and a common delay in the disbursement of benefits. All of this plagues the Philippine health care system amid rising costs of living, inflation, economic hardship and a tense political climate, fueling pressing issues both domestically and geopolitically.

Solution-Oriented Policies and Strategies

The Commission on Higher Education (CHED) has approved many new programs and state universities aim to expand access to medical education, especially for those in the country’s underserved regions. The Medical Scholarship and Return Service Program (MSRS), also known as the Doktor Para sa Bayan Act, is an example of an initiative recently signed into Filipino law to fund medical education in exchange for mandatory local service upon graduation.

The program provides full tuition coverage along with allowances for textbooks, housing, uniforms, transportation, medical insurance and other related expenses. Each year they receive the scholarship, scholars must work for at least one year in hospitals or public health offices in their hometowns or other underserved areas. Students from indigenous, geographically isolated, disadvantaged, or understaffed regions are given priority.

The CHED and the Department of Health implement the program as a direct response to the shortage of medical professionals in such underserved areas. It aims to increase the number of available and qualified health professionals in these areas.

As part of a retention evaluation, the Philippines is also making concerted efforts to address burnout and recruiting practices. The country has begun to mobilize resources and improve policies so that working and living conditions for these nurses are sufficient in their home country. Increasing salaries, providing benefits on time and encouraging and incentivizing filling vacant government positions, particularly in underserved regions, are all critical steps towards change. House Bill No. 5276 and Senate Bill No. 2694 are two examples of proposed legislation to reduce nurse migration and the resulting “brain drain” in the Philippines. Both seek to amend Filipino nursing laws to raise nurses’ monthly basic salary and minimum salary grade.

Organizations Supporting Filipino Nurses at Home and Abroad

Countless organizations also focus on mitigating the Philippines’ nurse migration and brain drain crisis. The Philippine Nurses Association (PNA) is the Philippines’ national organization of nurses, promoting high standards of practice and supporting the welfare of Filipino nurses. Filipino Nurses United (FNU) and The Philippine Nurses Association of America (PNAA) are organizations assisting Filipino nurses based in the U.S.

In addition to facilitating networking and professional development, these organizations advocate for labor rights, social justice and fair working conditions. While addressing domestic retention problems to reduce emigration, ensuring support for Filipino nurses overseas remains crucial.

Filipino nurses in the U.S. often send a large portion of their earnings back home in remittances. Maintaining a higher retention rate for those working abroad helps sustain this economic support, which funds education, local investments and small businesses in the Philippines.

Well-supported Filipino nurses in the U.S. are also more likely to return periodically to assist in their home country. They may donate supplies or share advanced medical knowledge with their communities. These contributions help counter the effects of “brain drain.”

– Kaitlin Reed

Kaitlin is based in Austin, TX, USA and focuses on Technology and Global Health for The Borgen Project.

Photo: Flickr

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Health Care in Rural Peru: Students Bridging the Gaps

Health Care in Rural PeruPeru, famous to many for the memorable sites of Machu Picchu, is currently fighting a battle against preventable illness. Hepatitis A, typhoid and malaria are just a number of the diseases common among the citizens of Peru. Beyond that, nearly 12% of the population faces major nutrition-related deficiencies. One of the most widespread is anemia, affecting 40% of children. Some health conditions, however, are even more severe.

Prenatal and maternal care are almost nonexistent and pregnancy complications disproportionately affect indigenous women and those living in rural communities. Despite the severe nature of the health complications, all of them are worse because of the lack of knowledge surrounding the issue and little to no access to medical facilities.

However, a group of pre-med students from Duke University and Boston College partnered with Sacred Valley to create a sustainable but realistic solution for these rural communities. They are training women in these communities to be health advocates by informing them about nutrition, pregnancy protocols and when to seek serious help. These individuals are paving a new path to health care in rural Peru.

The Layers of Translation in Peru

One junior, Catherine May, at Boston College had an especially vital position in this operation. The majority of rural communities in Peru speak the Quechua language. Her role is to translate from English to Spanish so local translators can translate from Spanish to Quechuan. The first level of medical access must be language in these rural communities and fluency in English is a rarity.

May, used her extensive background in Spanish to translate medical advice from doctors in Sacred Valley effectively. In turn, this information is bringing health care to rural Peru by training women to look after the well-being of their community in whatever capacity they can. However basic it may seem, being able to translate medical advice from English to Spanish is necessary in bringing health care to rural Peru.

Training Local Women as Health Advocates

One of the main aspects of this program, which is based in Peru, was training women to look after their surrounding community in a medical capacity. While it was not equivalent to medical training, May said, “training them to provide some sort of security to the towns was making a measurable and impactful change.”

The doctors provide these communities with nutritional information, such as the ideal diet to remove many deficiencies and preventable illnesses. They were also provided with ample information regarding maternal and fetal care. From distributing prenatal vitamins to educational materials on childbirth, they received a well-rounded education on basic first aid care and information.

Addressing Anemia in Children

Due to widespread poverty in rural Peru, most diets rely heavily on potatoes. Vegetables, fruits and meats are considered luxuries and are consumed only occasionally. This lack of dietary diversity has led to widespread anemia.

One of the projects May and her fellow students worked on was diagnosing and treating this anemia in children. They visited several schools and used finger-prick technology to measure hemoglobin levels. Since low hemoglobin causes anemia, the results provided insight into both the presence and severity of anemia cases.

Broader Impact Moving Forward

By training women in these rural communities to stand as health advocates, they’re working toward a more realistic solution. Increasing the accessibility of hospitals and medical facilities would take decades and millions of dollars. However, this form of medical treatment is attainable, affordable and has the potential to make a significant change. The fact of the matter is, these efforts would not have been possible without these students dedicating their summers to advocating, working and translating for the underserved in rural Peru. Peru is finally making progress in medical care, thanks in part to these university students.

Bringing health care to rural Peru means taking a step forward in the world’s journey to poverty reduction. Fewer medical issues mean an ability to focus on resolving other underlying issues, such as a lack of infrastructure and social structure. For now, though, these students and NGOs are taking significant steps to bring realistic and sustainable information-based care to marginalized and rural communities. These programs are vitally important for medical progress and their amplification can potentially transform rural medical care internationally.

– Caroline May

Caroline is based in Denver, CO, USA and focuses on Good News and Technology for The Borgen Project.

Photo: Flickr

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USAID Programs in Nicaragua

USAID Programs in NicaraguaNicaragua remains one of Central America’s poorest countries. In 2016, 24.9% of Nicaraguans were living below the poverty line, a significant decline from 45.8% in 2001, according to the Pan American Health Organization (PAHO). From 2000 to 2022, Nicaragua achieved an 18% increase in its Human Development Index (HDI), rising from 0.563 to 0.669. Despite this progress, Nicaragua still ranks 32nd out of 35 countries in North and South America in HDI as of 2022, illustrating persistent development challenges. Limited access to clean water, food insecurity, malnutrition and inadequate access to health care and education mark poverty in Nicaragua, according to the World Food Programme (WFP).

The United States Agency for International Development (USAID) has played a critical role in improving well-being in Nicaragua for decades. USAID programs in Nicaragua have supported key initiatives aimed at expanding access to health care and education, strengthening civic institutions and promoting economic growth and stability. However, recent cuts to USAID funding have hindered the progress of many of these initiatives, both in Nicaragua and in other low-and middle-income countries. The gains in personal well-being across Nicaragua throughout the past decade highlight the importance of sustained foreign aid for developing nations. Below are three examples of how USAID programs in Nicaragua have contributed to improving well-being in the country.

Improving Health Care

Over the past decade the Nicaraguan government has committed to improving its health sector programs, a commitment that has steadily strengthened the country’s health care system. These efforts have contributed to improvements in life expectancy, reductions in child mortality rates and higher immunization coverage across the country, according to the World Bank Group.

Although improvements have occurred, significant challenges remain, particularly in rural areas. While the Nicaraguan government offers universal free health care to all citizens, however, unequal distribution of medical supplies and health care personnel leaves many communities underserved, according to Bridge of Life.

In 2019, Salesian Missions, with the help of USAID funding, began constructing a medical clinic for impoverished Nicaraguans living in the cities of EstelÍ, Madriz and Nueva Segovia. The facility has since been completed and offers “high-quality obstetrics, pediatrics and gynecology services,” according to Salesian Missions.

Improving Education

Bettering education and literacy rates has long been a priority of the Nicaraguan government. However, the country still lags behind other low-middle income countries in terms of adult literacy rate—ages 15+. As of 2015, Nicaragua’s literacy rate for individuals aged 15 years or older was 78% for both men and women, notably lower than the median rate of other low-middle income countries, according to the National Education Profile.

Furthermore, a large percentage of school-aged children in Nicaragua do not attend primary or secondary school. In 2015, 18% of primary school-aged children were not attending school, and this figure rose to 43% among secondary school-aged children. Rates of out-of-school children were significantly higher in rural areas compared to urban locations, according to the National Education Profile.

USAID also launched the Community Action for Reading and Security (CARS) program, which improved early-grade literacy along Nicaragua’s Caribbean Coast. Across a six year span, the program reached more than 26,000 students and raised reading fluency in early-grade learners. CARS also helped local leaders design and carry out “community action plans” to support long-term education and development, according to DevTech.

Promoting Democracy and Civic Contribution

Nicaragua has long been affected by government mismanagement and dishonest administrations. Corruption and disregard for the rule of law has pushed Nicaragua into political disasters which have had harsh effects on Nicaraguans, according to Global Liberty Alliance. This rocky political history illustrates the necessity of programs to strengthen political transparency and effectiveness.

In 2009, USAID awarded grants to 31 civil society organizations in Nicaragua to promote voter registration, voter education and civic outreach. USAID also trained more than 700 Nicaraguans in anti-corruption practices and taught more than 350 journalists how to improve news quality and access public records, according to the United States Department of State.

USAID also promoted the Citizen Participation Ordinance, which four Nicaraguan municipal councils adopted in 2009. The Ordinance strengthened the role of civil society—community groups, NGOs and everyday people—in helping to shape local projects and policies.

Fostering Economic Growth

USAID helped Nicaragua take advantage of opportunities offered by the Dominican Republic-Central America Free Trade Agreement (CAFTA-DR). As a result, in the 2009 fiscal year, more than 9,000 Nicaraguans increased their sales in local, regional and international markets. 

USAID organized training sessions covering “commodity-specific export opportunities, best practices and economic conditions favoring the country,” according to the United States Department of State. More than 2,000 people attended with nearly half of the attendees being women.

Looking Ahead

USAID programs in Nicaragua have directly improved personal well-being by investing in education, health care, civic engagement and economic opportunity. But if funding cuts continue, these gains could be lost entirely. These examples highlight why sustained U.S. foreign aid remains a necessity for Nicaragua and other developing countries working to build a more stable and prosperous future.

– Jordan Venell

Jordan is based in Edina, MN, USA and focuses on Technology and Global Health for The Borgen Project.

Photo: Flickr

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People Living With HIV/AIDS in Samoa

HIV/AIDS in SamoaHIV/AIDS places a heavy burden on the health care system of Samoa, which already is known to operate with limited resources. Managing the disease requires consistent access to antiretroviral therapy, testing and long-term care services that are costly and not always easily accessible. These costs can lead to financial hardship for affected families, driving them deeper into poverty. Additionally, as individuals become too ill to work, household incomes shrink and national productivity declines.

Health Care Capacity: Data-Driven Constraints

As of 2022, Samoa allocates 6.3 % of its gross domestic product (GDP) to health, one of the highest rates among Pacific Island nations, compared to a global average of 9.8%. However, this spending is stretched: the government covers approximately 75% of that, with external aid contributing 13% and out-of-pocket spending comprising 11%.

Despite this investment, Samoa’s health workforce remains critically low, with only 0.55 physicians per 1,000 people. This falls far below the global average of 1.7 and the European Union’s 4.1 per 1,000. The World Health Organization (WHO) recommends at least 2.5 medical professionals (including nurses, midwives and physicians) per 1,000 people, yet Samoa’s national average remains below that. Rural areas fare worse, with just one health worker per 1,000 people, while some urban centers report up to eight per 1,000, according to International Health Strategies.

The imbalance means rural communities are underserved, central hospitals are overburdened and preventive outreach is limited. Faced with a dual disease burden, noncommunicable diseases like diabetes and rising infectious threats like HIV and Tuberculosis (TB) limit the workforce and curtail Samoa’s ability to mount widespread prevention and treatment campaigns.

HIV/AIDS in Samoa

As of the most recent public reports, Samoa has reported only 12 individuals living with HIV, all receiving antiretroviral treatment and in stable health, with no new locally acquired cases since 2020. A national population of approximately 216,000 (2023) means HIV prevalence is 0.005%, far below the Western Pacific regional average of 0.1%. Since 1990, 24 total cases have been recorded, with 11 still living as of the 2016 UNAIDS report. Still, low testing rates, 4–5 % of the population yearly, suggest some infections may go undetected.

People living with HIV/AIDS in Samoa often face significant stigma, leading to discrimination in their workplace and their communities. This social exclusion contributes to job loss and a lack of access to support services. This traps individuals in cycles of poverty. In a small economy, where every job counts, the loss of employment due to health-related stigma is especially damaging.

Global Support and Development Goals

International aid has been vital in Samoa’s fight against HIV/AIDS, funding prevention and treatment efforts that also strengthen education and health care. Viewing HIV as both a health and development issue makes aid more impactful and sustainable.

A key project supporting Samoa’s HIV response is the Global Fund–backed Multi-Country Western Pacific Integrated HIV/TB Program. It was implemented by the United Nations Development Project (UNDP) and Samoa’s Ministry of Health. The program focuses on testing, prevention, treatment and community outreach across 12 Pacific nations.

Conclusion

HIV/AIDS in Samoa is more than just a medical concern. It is a challenge that intersects poverty, social justice and economic development. Combating the epidemic requires medicine, education, compassion and strong international partnerships.

– DeMarlo Jon Gray

DeMarlo is based in Long Beach, CA, USA and focuses on Global Health and Politics for The Borgen Project.

Photo: Unsplash

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Healthy Learners: Zambia’s School Health Program

Zambia’s School Health ProgramA Grade 4 pupil in Lusaka coughs during maths class. Instead of sending her home, a teacher, now a trained School Health Worker, opens a tablet, runs through a WHO‑style checklist, dispenses deworming pills, logs the visit and, if needed, fast‑tracks her to a clinic. The entire effort is part of Zambia’s Healthy Learners School Health Program and averages just $1.51 per child per year, which is less than 1% of what the Ministry of Education already spends per pupil.

The Poverty Trap: Preventable Illness = Lost Learning

Worm infections, vitamin A deficiency and other routine ailments quietly siphon school days and future earnings for Zambian children. Absenteeism forces caregivers to miss work too. By moving first‑line care into classrooms, Zambia’s Healthy Learners School Health Program targets that cycle where it begins: illness that keeps kids out of class.

Clinic in a Classroom: How the Model Works

Healthy Learners partners with the Ministries of Health and Education to train and equip teachers as School Health Workers. In 598 public primary schools, more than 5,300 teachers now use a mobile app (built with THINKMD). The app mirrors physician logic to triage, treat mild conditions (deworming, vitamin A, first aid) and fast‑track severe cases to clinics, plugging schools straight into the national health system.

The Numbers That Matter

  • Reach: More than 830,000 students served, about a quarter of Zambia’s public primary school population, with a goal of 2.2 million by 2028.
  • Health Gains: A study found a 38% drop in disease morbidity, a 48% jump in both deworming and vitamin A coverage, a 22% rise in health knowledge and a 52% reduction in the odds of stunting.

These improvements mean fewer sick days now and more substantial earning potential later.

Small Price, Massive Payoff

After an initial setup cost of $10 to $15 per child, the ongoing cost falls to about $1.50 thanks to economies of scale and government integration. That frugality is why Zambia’s Healthy Learners School Health Program is financially realistic for national ownership and replicable elsewhere.

In 2022, the Ministries of Health and Education signed an MoU to scale the program nationally, embedding data systems and training inside state structures. Spring Impact highlights this “design for integration” as the core reason the model can scale without ballooning costs.

A Call to Action

Zambia’s Healthy Learners School Health Program is a ready‑made template for any country where schools reach kids more reliably than clinics.

A child walks back to class, symptoms eased, lesson saved. Indeed, one tablet tap at a time, Zambia’s Healthy Learners School Health Program is proving that health in schools is one of the cheapest, most innovative ways to fight poverty.

– Arabella D’Aniello

Arabella is based in Toronto, Canada and focuses on Good News and Technology for The Borgen Project.

Photo: Flickr

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Addressing HIV/AIDS in Kyrgyzstan

HIV/AIDS in KyrgyzstanHIV/AIDS remains a big public health issue in many parts of the world, and Kyrgyzstan is no exception. The country has made some progress in fighting the spread of the virus, health care system limitations, societal barriers and lack of sufficient public awareness continues to fuel its spread. Raising awareness and understanding the landscape of HIV/AIDS in Kyrgyzstan is essential for creating effective solutions that aim to rid the nation of such devastating diseases.

HIV/AIDS Demographics

The median age for HIV/AIDS in Kyrgyzstan is about 31. The prevalence rate is nearly 15% among those who inject drugs, and 0.2% rate among the entire population–about 14,600. Men account for a slight majority, having about 60% of the cases while women account for the latter 40%. Impoverished communities—especially injecting drug users, sex workers and migrants—normally have higher HIV vulnerability due to their economic strain, need and limited access to resources.

Health Care Challenges

Kyrgyzstan’s health care system faces big challenges when it comes to managing HIV/AIDS. While the country provides free antiretroviral therapy to people living with HIV, access to consistent and high-quality treatment is not equitable or equal, especially in rural and mountainous regions.

Diagnostic tools and lab equipment are not always available or up to international standards, and logistical delays can mean late diagnoses—when the virus has already progressed significantly, leading to more probable death.

Barriers to Prevention

One of the most significant hurdles to stopping the spread of HIV in Kyrgyzstan lies in social and cultural attitudes. HIV/AIDS is still highly stigmatized and is often associated with marginalized groups such as people who inject drugs or sex workers. This creates an environment of fear, where individuals at risk are reluctant to get tested for HIV. 

In schools, education on this topic is minimal or nonexistent. As a result, many young people grow up without basic knowledge about how HIV transmits or how people can prevent it. Additionally, many have misconceptions about HIV/AIDS. Public health campaigns have improved over the years, but they often fail to reach the most at-risk communities, such as rural communities. 

Injection drugs–via needle–remains one of the main transmission routes of HIV in Kyrgyzstan. Harm reduction strategies do exist, but their reach is limited, commonly only reaching citizens in either Osh or Bishkek and being held back by the stigma.

The Way Forward

To address the HIV/AIDS epidemic in Kyrgyzstan, investment in health care infrastructure is critical. This means not only economically supporting increased medical equipment and laboratories through donors, but also training health care professionals in modern HIV treatment protocols and in how to provide care without stigmatization. Improving access to health care in rural and underserved areas through mobile clinics could bridge existing gaps.

Many NGOs in Kyrgyzstan are already doing essential work in reaching vulnerable populations and offering services including the CDC–PEPFAR Partnership in Kyrgyzstan. The CDC–PEPFAR project began in 2011 when the U.S. CDC launched HIV programs under the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). Viral load suppression improved from around 44% in 2016 to 95% in 2024, PrEP became available to high-risk individuals and ART has now been provided in 26 AIDS centers, serving more than 4,150 individuals.

Looking Ahead

The fight against HIV/AIDS requires collaboration between the government, citizens and the international community. More importantly, however, the mitigation of HIV/AIDS in Kyrgyzstan requires a commitment to the wellbeing of every citizen.

– Jackson Mailer

Jackson is based in Brooklyn, NY, USA and focuses on Global Health and Politics for The Borgen Project.

Photo: Unsplash

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Addressing Diseases Impacting South Africa

Diseases Impacting South AfricaIn 2023, data that the World Bank published showed that 55% of South Africans as living below the poverty line. Of those South Africans experiencing poverty, a 2023 national study found these citizens were twice as at risk of the communicable disease HIV. For the southernmost nation on the African continent, existing diseases are separated into two categories: communicable and non-communicable. Despite easy transmission of communicable diseases, 2019 World Health Organization (WHO) statistics show that non-communicable diseases account for 51% of all national deaths. With high prevalence rates of both infection varieties among those experiencing poverty, the stifling effects of Apartheid policy remain central within the national struggle to curb diseases impacting South Africa.

Communicable Diseases 

The three most prevalent communicable diseases impacting South Africa are malaria, tuberculosis (TB) and HIV/AIDS. Malaria mitigation strategies have been largely successful. In line with the 2021 Global Technical Strategy (GTS) for Malaria, WHO found that the number of South Africans at risk dropped to a low 10% of the population that same year. In South Africa, particularly the Kwazulu-Natal district, which contains one of the highest incidence rates of TB around the world, TB impacted 427 of 100,000 people in 2023. Positively, this incidence rate has fallen since 2021, where TB affected 512 per 100,000 citizens.

Following the United Nations (UN) AIDS 95-95-95 target, South Africa has also made promising strides in HIV/AIDS mitigation. Though 2023 figures show that 16.3% of South Africans are living with HIV, screenings and treatment have improved. Striving towards this 95-95-95 UN target, 94% of South Africans living with HIV knew their diagnosis, 79% were receiving treatment and 91% were being virally suppressed in 2021.

Non-Communicable Diseases 

The other half of diseases impacting South Africa are non-communicable diseases (NCDs) including cardiovascular disease, chronic respiratory disease, cancer and diabetes. In 2021, the collective incidence rate for these particular NCDs stood at 1,301 per 100,000 people. Obesity, which increases the risk for these NCDs, represents another health indicator impacting South African morbidity. Along with WHO’s other findings, it found that 30.8% of the adult population suffered from obesity in 2022, up from 2021.

Health System

The national healthcare system mainly initiates response to diseases impacting South Africa. The Department of Health’s inadequate health care response is typically pinpointed to policy carried over from the nation’s apartheid era. After the 1994 end to apartheid law, the government faced the ongoing challenge of restructuring the health care system. Despite this, the WHO has projected that 6.2 million citizens should experience universal health coverage by the end of this year. This number represents a steady, sharp increase from 2021 where only 1.8 million retained universal health care access. 

Impact of Poverty 

A 2023 study conducted with support from the South African government articulated that HIV, one of the most nationally prevalent communicable diseases, affects those living in townships twice as severely as those living elsewhere. Townships are South African neighborhoods inhabited primarily by those experiencing poverty. The study found that socioeconomic factors like access to stable housing and quality education do increase the odds of HIV infection and reduce the likelihood of access to testing and care. The researchers recommended a mitigation strategy that includes policy towards improving education and living quality.

Another national study from 2021 asserted that to address the reality of health care inaccessibility due to societal inequities, there needs to be cohesive efforts from multiple actors. The study calls on the necessity of both government and non-state intervention.

Doctors Without Borders

One international organization working diligently against the spread and prevalence of disease in South Africa is Doctors Without Borders (MSF). With the United States currently slashing its funding of South Africa’s TB and HIV/AIDS research programs, MSF has been vital in calling upon international donors, organizations and philanthropists to direct funds towards these life-saving research initiatives. Actors like the South African Department of Health and MSF rely on these funds to help develop promising vaccines and treatments for those experiencing these diseases impacting South Africa.

In addition to MSF’s TB and HIV/AIDS research, where funding is unsteady, it recently introduced a new project aimed at addressing South African NCDs. In collaboration with South Africa’s Department of Health, MSF has been training health care organizations across the Eastern Cape province of Butterworth. Reaching more than 1,500 people within the region, the project has increased the screening and medical management of NCDs like diabetes and hypertension.

Progress

Though funding cuts from the United States have caused uncertainty about the future of national research and mitigation response, strides in health care coverage and the involvement of organizations like the MSF are promising for the future of eliminating the diseases impacting South Africa. National initiatives for screening and improvements in treatment technologies have greatly improved and have been key in addressing and reducing incidence rates, particularly for the highly prevalent TB. In 2019 alone, testing for TB caused a 28% reduction in incidence.

With organizations and donors allocating funds towards national efforts to fight disease, South Africa will further mitigate the spread and prevalence of such harmful illnesses, particularly for those living in poverty.

– Piper Aweeka

Piper is based in Reno, NV, USA and focuses on Global Health for The Borgen Project.

Photo: Unsplash

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Addressing Mental Health in Guinea-Bissau

Mental Health in Guinea-BissauIn the small West African country of Guinea-Bissau, rich culture and strong tradition mask a growing crisis, mental health neglect. Among the most prevalent conditions are depression and anxiety, often left unaddressed due to systemic gaps and social stigma.

A System Without Specialists

As of 2017, Guinea-Bissau had zero practicing psychiatrists. The country’s ratio of just 0.13 doctors per 1,000 inhabitants falls far below global standards for basic health care. This shows that mental health support is almost absent from the primary care setting. Additionally, a screening of adults attending general health facilities in Guinea-Bissau revealed that at least 12% had a diagnosable mental disorder. This shows the urgent need for integrated mental health services in the nation’s fragile health system.

A baseline study found that general practitioners correctly diagnose only one in three patients, meaning that the people in Guinea-Bissau’s rural communities are unknowingly struggling with mental disorders. They carry a silent weight that forces them to push through each day with far greater effort than others, struggling in isolation just to survive.

Poverty and Psychological Strain

Things such as rising climate anxieties and pandemic poverty are worsening mental health in Guinea-Bissau. In 2021, the poverty rate was reported to have increased by 2.8 percentage points, adding an additional 80,000 poor. Research shows that mental illness reduces employment and therefore income.

Cultural Beliefs and Stigma

Mental health in Guinea-Bissau is often interpreted through a spiritual lens. Communities blame mental issues on things like curses and ancestral wrath. As a result, individuals often look down upon seeking help from medical professionals. Sixty-three percent of rural mothers go to the witchdoctor, and 65% believe that curses have the power to kill. While traditional healers play a vital role in this community, their methods can delay access to cures. Stigma remains a barrier to those suffering silently.

Lending a Helping Hand

This West African nation faces a mounting crisis that demands international attention. Every person deserves access to necessities like mental health care. Guinea-Bissau’s struggle is a global problem; poverty, trauma and neglect reflect broader challenges that low-income countries face worldwide.

Progression Efforts

Mental health in Guinea-Bissau is beginning to see a glimpse of hope in this landscape. International organizations such as the World Health Organization (WHO) have stepped in to support the country. Guinea-Bissau’s fragile health system has improved as groups are working to train general health workers in basic psychiatric care.

The NOVAFRICA Knowledge Center is working to strengthen health care in Guinea-Bissau through an inclusive and culturally sensitive approach. Its model brings together modern medical practitioners and traditional healers, including witchdoctors, to bridge trust gaps and improve access to care. By acknowledging and respecting spiritual traditions deeply embedded in the community, NOVAFRICA promotes the acceptance of modern medical practices and helps lay the groundwork for more effective health interventions, including in mental health.

The Path Forward

In collaboration with NGO VIDA, NOVAFRICA supported the launch of a community health insurance program that allows residents to pay affordable premiums in exchange for access to medical care, transportation and essential medicines. Though the country still lacks a national suicide prevention strategy, collaborative efforts between NGOs and local health authorities are laying groundworks for a future policy reform.

Guinea-Bissau’s challenges are steep, but the people are resilient. With continued international support and growing local engagement, the nation is taking its first steps toward a future where the silenced have a voice. Acknowledging, treating and respecting mental health is not just the goal, it is the path to a future defined by dignity and resilience.

– Marissa Schoth

Marissa is based in Benton, LA, USA and focuses on Technology and Global Health for The Borgen Project.

Photo: Unsplash

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Elderly Poverty in Chad

Elderly Poverty in ChadChad is a landlocked country located at the crossroads of North and Central Africa. An independent nation since 1960, Chad is home to approximately 19 million people, of whom more than one million live in its capital, N’Djamena.

Despite its size and important resources like oil, Chad remains one of the most impoverished countries in the world. Poverty stretches to every corner of the country. However, one of the most susceptible victims, older people, are often ignored. Here are some facts about what elderly poverty in Chad looks like and how foreign aid can help minimize it. 

Facts About Elderly Poverty in Chad

  1. Chad has one of the youngest populations in the world, with a life expectancy at birth of 59 years and a median age of 14-15 years. Older adults (65 and above) made up about 7.5% of the population in 1985 but now account for just 3%, making it the smallest age group in Chad. This change reflects the country’s high birth rates and lack of accessibility to food and medical care.
  2. Chad has one of the lowest rates of accessible health care in the world, with the elderly being some of the most susceptible to diseases. Only 31.4% of Chad’s population has regular access to medical care, including doctors, hospitals, treatments and vaccinations. According to the World Health Organization (WHO), as of October 2020, Chad had just 4.3 doctors and 23.2 nurses per 100,000 inhabitants, far below the recommended 23 doctors and 23 nurses per 10,000. Most of these health professionals are concentrated in urban areas, making health care largely inaccessible to rural populations, especially elderly individuals who often face the greatest barriers to medical access.
  3. Noncommunicable diseases, such as diabetes, remain the leading cause of death for older people in Chad. Other leading causes of death include malaria, lower respiratory illnesses like pneumonia and diarrhoeal diseases like cholera. Elderly patients with diabetes and chronic illnesses, along with children, are the most susceptible to diseases like malaria and pneumonia.
  4. With refugees coming in from neighboring countries like Sudan, Sierra Leone and the Democratic Republic of Congo, the conflicts in these regions have spilled over into Chad. This instability has made outside trade difficult, leading to a low supply and high demand for essential resources, including food and medical aid.
  5. Chad has the lowest access to clean water and sanitation in the world. Only 43% of the population has access to clean water and just 10% has access to basic sanitation services.
  6. Organizations such as the WHO, the World Food Programme (WFP) and other humanitarian actors are actively working to combat poverty in Chad. In mid‑2024, WFP delivered food, cash and nutrition assistance to approximately one million people across crisis-affected communities, including refugees and internally displaced Chadians. The 2023–24 Humanitarian Response Plan (HRP) for Chad sought approximately $921 million in funding and the Central Emergency Response Fund (CERF) allocated $15 million to address the most underfunded emergencies.

Conclusion

Elderly poverty in Chad remains a critical but often overlooked issue. Limited health care, food insecurity and poor sanitation leave older adults especially vulnerable. While humanitarian aid provides some relief, lasting change requires targeted support and stronger systems to protect Chad’s older population.

– Zoe Alatsas

Zoe is based in New York, NY, USA and focuses on Global Health and Politics for The Borgen Project.

Photo: Pickpik

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Disability and Poverty in Burkina Faso

Disability and Poverty in Burkina FasoIn Burkina Faso, disability and poverty are deeply intertwined. Limited access to education, health care and employment traps many people with disabilities in cycles of exclusion. Without targeted support, their potential remains overlooked and their rights are unfulfilled.

Disability in Burkina Faso is more than a personal health challenge; it is a profound development issue. In one of the world’s most impoverished nations, having a disability often means being locked out of education, employment and health care. When systems aren’t built for inclusion, the result is predictable: poverty deepens, inequality widens and national progress stalls.

Systemic Poverty and Exclusion

According to the Tigoung Nonma, a cooperative of disabled artisans, approximately 10% of Burkina Faso’s population lives with a disability. Yet most of them are invisible in public life. Due to structural barriers and social stigma, access to jobs, education and even buildings remains limited.

Not only that, but for families already surviving on less than $2 a day, caring for a disabled member without social safety nets often means sacrificing their own basic needs. Medical devices like wheelchairs or hearing aids are expensive and hard to use and accessible public infrastructure is scarce. Children with disabilities are more likely to drop out of school and adults face major hurdles in finding stable work.

Health System Gaps: Underserved and Underfunded

According to the World Health Organization (WHO), Burkina Faso allocates just 6.3% of its GDP to health. This is far below the global average and far short of the need. Rural health centers are often unequipped to serve patients with specialized needs, especially those requiring physical therapy, long-term care or rehabilitation services.

Most of Burkina Faso’s more than 3,000 health facilities are inaccessible to people with mobility impairments. Similarly, a 2024 survey across French-speaking sub‑Saharan Africa revealed that Burkina Faso has only 26 physiotherapists, a staggering shortage for a needy population. For those with intellectual or developmental disabilities, the situation is even more dire. Most go undiagnosed, untreated and entirely unsupported, falling through the cracks of an already strained health care system.

Social Stigma and Discrimination

Beyond physical barriers, people with disabilities in Burkina Faso face deep social stigma. Misconceptions linking disability to witchcraft or divine punishment are still prevalent in rural areas, leading to neglect, abandonment and violence.

In employment and education, discrimination persists. Many children with disabilities are kept at home, denied enrollment in schools or bullied by peers. Adults are often excluded from the labor market entirely or relegated to informal work without legal protections.

A Vicious Cycle

Disability increases the likelihood of poverty and poverty increases the likelihood of disability. Malnutrition, unsafe childbirth, poor sanitation and lack of access to vaccinations contribute to preventable impairments in children. Meanwhile, poverty-stricken families often lack the knowledge or means to seek early intervention.

This cycle is especially damaging for women and girls, who face a double burden of gender and disability-based discrimination. They are less likely to attend school or access health care and more vulnerable to abuse.

Toward Inclusive Development

Thankfully, efforts are growing to integrate disability rights into national development plans. Burkina Faso ratified the U.N. Convention on the Rights of Persons with Disabilities (CRPD) in 2009 and has committed to more inclusive policies. However, Implementation remains slow.

Nonprofits like Light for the World and Humanity & Inclusion lead some of the most impactful initiatives. These organizations have progressed in supplying assistive devices and pushing for disability-inclusive budgets. Their work shows that inclusion isn’t just possible, it’s essential for sustainable development.

Conclusion

Disability and poverty in Burkina Faso are closely linked, forming a loop of exclusion that threatens the country’s development goals. The challenge is not disability but the failure to provide accessible infrastructure, inclusive policies and equal opportunities.

Addressing this issue requires more than charity; it demands systemic change, political will and international solidarity. Only then can Burkina Faso unlock the full potential of all its citizens, regardless of ability.

– De’Marlo Gray

De’Marlo is based in Long Beach, CA, USA and focuses on Global Health for The Borgen Project.

Photo: Flickr