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In the African country of Senegal — population 15.41 million — cervical cancer is the leading cause of cancer deaths among women, and the nation ranks at number 15 in global cervical cancer prevalence.  Considering the cancer is completely treatable through early detection, the number of deaths from cervical cancer in Senegal is startling.

Cervical cancer is the third most commonly diagnosed and the second most common cause of cancer deaths among women. However, in the U.S. and other developed countries, cervical cancer does not even rank among the top three cancer killers. Why the discrepancy between nations like the U.S. and developing nations like Senegal?

The answer is simple: access to screenings and vaccines.

Screening for a Treatable Cancer

While cervical cancer was the leading cancer killer of women in the U.S. until the 1950s, development of the Papanicolaou (Pap) smear allowed for detection of cell abnormalities.  In the following decades, scientists and doctors learned that cervical cancer is the most preventable and treatable type of cancer because it develops very slowly.

“There are 5 to fifteen years from the first cellular changes to the actual cancer development,” says Dr. Andrew Dykens, professor of family medicine at the University of Illinois at Chicago (UIC).  “So you’ve got time during that phase to do something about it.”

Dykens is director of the Global Community Health Track at the Center for Global Health at UIC.  He is also a former Peace Corps volunteer and current member of Rotary International (Rotary Club of Chicago).  He also started the nonprofit Peace Care, which provides resources by bringing together the local expertise of Peace Corps workers and the communities who need them.

Dykens worked with each of these organizations and Senegal’s Ministry of Health and Social Action to bring low-cost screening to the women of the nation.  A method even simpler than a Pap smear, a vinegar solution is used to detect abnormal cells.  The cells can be killed off immediately with a cryotherapy gun and a CO2 tank — another simple method that involves no electricity.

The Cancer Vaccine

In 2013, the global vaccine alliance Gavi selected ten African countries for a pilot human papillomavirus (HPV) vaccination program, with Senegal being among them.

Certain strains of HPV are the cause of cervical cancer.  While the HPV vaccine has been used in the U.S. and other developed countries since 2006, it was finally introduced to Africa in 2016.  Along with Rwanda and Uganda, Senegal is one among the first three countries to adopt the vaccine as part of its national vaccination program.

Professor Ousseynou Badiane, head of Immunization Division for the Ministry of Health in Senegal, states that through subsidization by Gavi and the Senegalese state, the vaccine will be accessed by all at no cost.  The vaccine is being implemented in two phases – first, a mass vaccination for girls between age 9 and fifteen by May 2018; after that, it will become part of routine immunizations for all girls at age 9.

In the U.S., women are commonly screened for cervical cancer every three years.  For cervical cancer in Senegal, many women are being screened for the first time.  Dykens and other health practitioners understand the challenges they face in terms of a traditionally conservative environment concerning women’s health issues. But with Peace Care, local Rotary clubs, Gavi, and others working together with the nation’s government, promotion of awareness and education will reduce the number of deaths caused by cervical cancer in Senegal.

– Jaymie Greenway

Photo: Flickr

countries with the lowest life expectancyThere are a lot of factors that contribute to a country’s life expectancy. Some of these contributing factors are economic conditions, diet, public health, access to medical care, wars, crime rate etc. Because of this, a lot of the countries on this list are African countries plagued by poverty.

According to the CIA’s World Factbook, these are the top 20 countries with the lowest life expectancy as of 2017.

  1. Chad – 50.6
  2. Guinea-Bissau – 51.6
  3. Afghanistan – 51.7
  4. Gabon – 52.1
  5. Swaziland – 52.1
  6. Zambia – 52.7
  7. Central African Republic – 52.8
  8. Somalia – 52.8
  9. Lesotho – 53
  10. Mozambique – 53.7
  11. Nigeria – 53.8
  12. Burkina Faso – 55.9
  13. Niger – 55.9
  14. Uganda – 55.9
  15. Sierra Leone – 58.6
  16. Cameroon – 59
  17. Cote d’Ivoire – 59
  18. Republic of the Congo – 59.8
  19. Zimbabwe – 59.8
  20. Angola – 60.2

The overwhelming majority of these countries are in sub-Saharan Africa. According to Africa Check, the top five causes of death in 2017 in Africa were lower respiratory tract infections, HIV/AIDS, diarrheal diseases, stroke and Ischemic heart disease. The major reasons for these causes of death are unsafe water, poor sanitation, insufficient hygiene, lack of resources and economic conditions. Living conditions dramatically affect life spans and are a major reason why these countries have the lowest life expectancy.

However, there has been a significant improvement in a lot of these countries and their life expectancy numbers. For example, Zimbabwe and Zambia’s longevity has increased by 38 percent since the year 2000. And, overall, of the 37 countries that have seen increases in their life expectancy numbers by more than 10 percent since 2000, 30 are in sub-Saharan Africa. Additionally, not even one sub-Saharan country had its life expectancy fall between the years 2000-2014.

There is still a lot of progress that needs to be made in order for these countries with the lowest life expectancy to increase their numbers, but regardless, there has been a substantial improvement in these struggling countries.

– McCall Robison

Photo: Flickr

vision in developing countriesOver 90 percent of visually impaired people worldwide live in developing countries. Sightsavers partners with local entities to protect vision in developing countries from the Caribbean to Africa and Asia. The organization has treated over 200 million people for potentially blinding conditions.

To date, Sightsavers has facilitated seven million eye operations in 30 countries to prevent blindness. The organization has also trained almost 500,000 medical providers in eye care and has rehabilitated 91,000 visually impaired people.

Sightsavers specifically treats neglected tropical diseases (NTDs), cataracts and refractive errors that negatively affect vision in developing countries. The nongovernmental organization also advocates for disability-inclusive development.

Neglected Tropical Diseases

Over one billion people globally are impacted by neglected tropical diseases. Sightsavers targets five NTDs that affect eyesight – trachoma, river blindness, lymphatic filariasis, intestinal worms and schistosomiasis.

In 2016, the organization distributed almost 47 million treatments for river blindness. Further, it treated over 16.5 million people for intestinal worms and treated over 5.7 million people for schistosomiasis. Sightsavers aims to totally eliminate trachoma and lymphatic filariasis from its covered countries by 2020.

In 2016, Sightsavers and its partners distributed 154 million treatments for NTDs. Sightsavers facilitates initiatives that fight neglected tropical diseases in 29 developing countries.

Cataracts

Worldwide, 20 million people have lost vision due to cataracts. In some of the African countries covered by Sightsavers, 60 percent of cases of blindness are caused by cataracts.

Since the organization’s inception in 1950, Sightsavers has facilitated 6.6 million cataract surgeries. Furthermore, it has trained over 1,000 healthcare professionals to treat the condition. A child’s cataract surgery costs Sightsavers only $78.

Refractive Errors

Globally, 124 million people have untreated refractive errors like nearsightedness and astigmatism. Sightsavers has distributed almost three million pairs of eyeglasses in developing countries. Additionally, the organization trained 726 optometrists.

In 2016, Sightsavers’ School Health Integrated Programming (SHIP) initiative checked school-aged children in Cambodia, Ethiopia, Senegal and Ghana for poor eyesight. The program examined 57,400 children and provided 1,000 pairs of eyeglasses.

Advocacy

Worldwide, one billion people — 15 percent of the population — live with a disability. Eighty percent of disabled persons live in developing countries. In addition to protecting vision in developing countries through medical care, Sightsavers advocates for disability-inclusive development.

The organization’s “Put Us in The Picture” program has campaigned for incorporation of disabled persons in the development process since 2013. The initiative works to ensure that the needs of disabled residents of developing countries are considered in global development.

Sightsavers also advocates for equal access for disabled people to quality education and healthcare. The organization also works to ensure disabled people can find employment and participate in their political systems.

– Katherine Parks

Photo: Flickr

hiv-focused telehealthSome of the largest barriers to HIV treatment and prevention in rural areas are access to care and affordability. Luckily, telehealth technology can help provide people in more isolated areas with access to information about HIV prevention and treatment. For individuals without a car whose nearest health center is 15 or more miles away, HIV-focused telehealth or telemedicine is a potential solution.

Through telehealth, individuals can hold appointments with health practitioners over the phone, through messaging services or via video chat. Telehealth is one of the more accessible technological services, as expensive devices like smartphones and personal laptops are not necessarily required. Additionally, the appointments themselves reduce in cost, as they are cheaper than in-person appointments and do not require any travel on the part of the patient or health practitioner.

Here are a few ways that HIV-focused telehealth programs can assist people with HIV, from diagnosis to treatment.

Testing

Telehealth can encourage HIV self-testing in remote, resource-limited areas. With the establishment of many HIV self-testing initiatives in countries like Zambia and South Africa, telehealth coupled with home-testing kits allow individuals to have the guidance of a health professional in the privacy of their homes. With an at-home HIV test, the patient can take the test at their convenience while talking, video chatting or texting with a health practitioner. This way, the patient would not have to rely on inaccessible health clinics to get tested, and would have the guidance of a professional assisting them with administering the test themselves.

At-home testing with telehealth also ensures that the health practitioner can link the patient to a confirmatory test and other resources following the test results. If a person is alone after taking a self-test, it is possible that they will not follow up with the necessary appointments. 

Diagnosis

In most countries, HIV is highly stigmatized and many people face discrimination, isolation and a sense of hopelessness following a diagnosis. People who experience depression after finding out their status are less likely to adhere to medication or care about their overall physical health.

In resource-constrained areas, many of which struggle with high instances of HIV, telepsychiatry may be the only option for therapy. Research from the World Health Organization (WHO) showed that low-income countries have a median of 0.05 psychiatrists for every 100,000 people, versus high-income countries with 10.50 psychiatrists for every 100,000 people.

With telepsychiatry, people in remote areas can receive low-cost therapy at home from a therapist that is located anywhere in the world. While studies have shown telepsychiatry to be effective and affordable in resource-constrained areas, it is the least widely implemented telehealth practice, with most countries prioritizing teleradiology and telepathology.

Treatment

When people with HIV do not have the means to travel to a health center for treatment and proper check-ups, telehealth technology combined with traveling medical services can ensure better medication adherence and better outcomes for people living with HIV. Telehealth can assist HIV positive people by scheduling check-ins and antiretroviral medication deliveries over the phone.

However, some organizations are developing new ways to assist patients through mobile phone apps. The Vodafone Foundation recently introduced a mobile telephone app designed to assist people with HIV that live in resource-constrained areas. The HIV-focused telehealth app was first launched in Lesotho, Africa, and it allows health practitioners to track their patient’s treatment, health information and payment methods. The app also connects patients with funding to pay for appointments and transportation to the closest health center.

While technology has given the global fight against HIV/AIDS a much-needed upgrade, lack of funding, infrastructure and legislation were still named as the top three barriers to implementing national telehealth programs for WHO member states. Regardless, more than 57 percent of WHO member states acknowledge telehealth in national policy and many are looking to implement new telehealth programs through legislation in the future. If the legislation leads to the initiation of more HIV-focused telehealth programs, people with HIV in remote areas will have a better chance at leading healthy lives.

– Danielle Poindexter

Photo: Flickr

mental healthcare in ghanaGhana’s healthcare system deals with many obstacles relating to disease and discrimination. The West African country faces many diseases common in Africa, such as malaria and HIV/AIDS, which plagues some of its 27 million population. It is the poor access to mental healthcare in Ghana, though, that has set it apart from its sub-Saharan neighbors.

A 2012 study showed that the Ghanaian government spent $0.12 per capita for mental health treatment. This is less than half of the average expenditure of other lower-middle income countries. It is roughly two percent of spending toward mental healthcare by upper-middle-income countries.

Challenges to Mental Healthcare in Ghana

Unfortunately, a lack of spending is not the only hindrance to receiving adequate mental healthcare in Ghana. A number of other challenges have prevented Ghanaians from receiving help, including a lack of qualified professionals. A scant 18 psychiatrists practiced in Ghana in 2011.

The number of mental healthcare outpatient clinics is far greater. However, the majority of these clinics are located in Accra, Ghana’s capital. Rural areas of the country have far fewer resources, such as the Ashanti region. There are only 12 outpatient services available to its population of 4.8 million.

Introducing the Mental Health Act

The international recognition regarding poor mental healthcare in Ghana forced the country to look more closely at its practices. To this end, Ghana introduced the 2012 Mental Health Act.

The goals of the scheduled 5-year plan were to create a baseline to ensure quality reform and to compare it to the performance of other countries. The poor access to treatment in rural areas of Ghana was also addressed. Programs were initiated to bring awareness of mental health programs and resources all over the country.

With the support of the World Health Organization, the Mental Health Act implemented previously ignored practices. Furthermore, it ensured the rights of people with mental disabilities. Mental health in Ghana has always been highly stigmatized, and the Act sought to create anti-discrimination provisions and safeguards for the vulnerable.

In the years since the approval of the Mental Health Act, Ghana has taken a number of steps to increase access to mental healthcare. This has included steps to decentralize programs and integrate them into the general healthcare system. Ghana is also beginning to downsize its three largest psychiatric hospitals in order to spread access to mental healthcare throughout the nation.

Ghana’s mental healthcare system has seen incredible progress. The country recognized the need to transform the highly underfunded and stigmatized system. Now, the system offers patients better access to treatment that is free of discrimination and negative consequences. Challenges remain, but the steps taken to reshape its future have already made a difference to mental healthcare in Ghana.

– Eric Paulsen

Photo: Flickr

Health Care in CameroonThe World Bank is expanding a program launched in 2011 to tackle health care in Cameroon, a country in Central Africa home to a large number of refugees.

What began as a pilot project gradually extended its reach based on its efficiency.

The program improves health services by monitoring pregnant women, promoting vaccination and educating communities about hygiene practices that prevent diseases such as malaria, typhoid and intestinal parasites.

Due to positive results, the program received additional funding to expand in 2014. The World Bank Group’s Board of Executives approved a $127 million project to upscale the program in May 2016, a huge step toward improved health care in Cameroon.

The funding will go toward upgrading laboratory equipment, restocking the pharmacy, installing solar panels and building living quarters.

The World Bank joined the efforts of the Cameroonian government and other international organizations combatting maternal and infant mortality in the region.

Presently, a lack of health care services and medical professionals leaves the population vulnerable to fatal birth complications and diseases. In northern Cameroon, close to 20 percent of children die prior to their fifth birthday.

Nearly one-fifth of those deaths are caused by malaria. Additionally, 36 percent of children under five have stunted growth due to a lack of sufficient nutrition, according to the World Health Organization.

Cameroon maintains an open border for asylum-seekers. Hundreds of thousands of refugees flee to Cameroon each year from the Central African Republic and Nigeria due to violent conflict. The refugee communities in particular need health centers to respond to their needs.

The mistrust among many indigenous populations of health care services is a pressing challenge. Women prefer natural remedies and familiar surroundings to being hospitalized.

The program addresses these issues by implementing a community-based approach to healthcare: health agents visit households twice a month to monitor and identify health conditions in the village. They accompany ailing or injured people to health facilities and promptly administer care.

Additionally, health agents spread awareness about the importance of preventative health measures.

“By promoting equitable access to basic health services, this approach will make it possible to provide better care to the country’s poorest and most vulnerable,” said Paul Jacob Robyn, Health Specialist in the World Bank’s Human Development Global Practice Group.

Emily Ednoff

Health_World_Photo_

Health care is considered by many to be a fundamental right. However, there are so many people in the world that do not have access to the care and services they need, creating a global health crisis.

A project called Waiting for Health brings awareness to this problem through a photo series that chronicles the stories of those waiting for health care. The photos are taken by 12 photographers and focus on 12 different countries.

The Waiting for Health project was created by the Global Coalition for Universal Health Coverage. It also had support from the Rockefeller Foundation.

Ultimately, the project hopes to spark a conversation about the disparity that exists in health care around the world.

According to the World Health Organization (WHO), approximately one billion people in developing countries do not have the access to health care that they need due to a number of factors such as high costs, poor quality facilities as well as a shortage of health care workers.

A 2014 WHO World Health Statistic revealed that in the African Region there were approximately 2.6 physicians per 10,000 patients. The density of the remaining health workforce to the population is also concerning: nursing and midwife personnel (12), dentistry personnel (0.5) and pharmaceutical personnel (0.9).

Due to the lack of financial resources, many people living in extreme poverty often have to choose between getting the medical attention that they need or buying food for survival.

Waiting for Health hopes to rejuvenate the conversation surrounding health care. Photographer Aurelie Marrier d’Unienville says that the photos will give people a different perspective on health care in developing countries. The photos will add a touch of “humanity” giving viewers a better visual understanding of what is occurring around them.

“Statistics and surveys present us with inanimate and abstract figures of which we can’t relate,” she said. “These photos present a compelling and visual story, which can evoke a sense of real understand and empathy.”

Her photos focused on the health care crisis in Guinea, but the series documents many other global experiences. Another example focuses on Libyan refugees in Norway waiting for mental health care.

According to the Waiting for Health website, “We hope these photographs inspire all of us to slow down and think more deeply about what really needs to change and make universal health care coverage a reality,”

Alyson Atondo

Sources: European Parliamentary Research Service, World Bank, Waiting for Health, Mashable
Photo: Flickr