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healthcare in the republic of congo
The Republic of Congo, also known as Congo-Brazzaville, is a central African country with about 5.2 million residents. Since most of the country is covered in tropical forests, more than half of the population lives in two large southern cities, Brazzaville and Pointe-Noire. It’s one of Africa’s top 10 oil producers and has extensive untapped mineral resources. Despite this, The Republic of Congo faces high rates of extreme poverty due to economic crises from oil price drops as well as ongoing conflicts since the 1990s. The economic declines have diminished state funds and the conflicts arising from political unrest led to the government no longer prioritizing healthcare in the Republic of Congo.

This has created an inadequate healthcare system characterized by a lack of resources, lack of healthcare professionals, insufficient access to and inability to deliver health services. The Republic of Congo is currently facing high rates of TB, HIV, malaria and maternal mortality.

Steps Forward

Fortunately, despite these earlier challenges, the government began reprioritizing healthcare in the Republic of Congo with the help of various aid organizations. This revamped investment started in 2009 with a partnership with the United Nations Population Fund (UNFPA) to reduce maternal mortality.

UNFPA worked closely with UNICEF, WHO and the World Bank to help the Republic of Congo government outline a maternal mortality reduction program. This program was boosted by the 6 million dollars that UNFPA made available to the country. In cities, free cesarean sections were made available as well as more family planning resources. This resulted in a 45% decline in maternal mortality from 2005-2012.

This decline was extremely promising; however, there is still much that needs to be done in Congo because its maternal mortality rates are still in line with other less-developed countries. The government acknowledged this and once again partnered with UNFPA in 2019 to further invest in a maternal mortality reduction program.

UNFPA Collaboration

This new program is focused on boosting healthcare infrastructure, facilities and services by utilizing innovative technologies. It is particularly focused on providing women in rural communities the best care possible. Some of the aspects of the program include providing solar power systems to ensure health facilities can function consistently as well as equipping midwives and doctors with portable ultrasounds and other monitoring devices to help handle high-risk pregnancies. Backpack kits filled with childbirth equipment are given to community health workers along with mobile phones to receive technical support if necessary.

While maternal mortality is a targeted intervention, the Republic of Congo has also done extensive work focusing on the healthcare system as a whole. This began in 2012 with the implementation of performance-based financing (PBF) with the help of Cordaid, an international development organization. PBF is a system in which healthcare providers are funded based on their performance and ability to meet specific objectives. It is utilized as a way to help introduce specific ways of purchasing that help health systems move towards universal health coverage.

PBF greatly improved healthcare in the Republic of Congo because it helps incentivize health workers to provide more and better care, such as assisting more births or providing more vaccinations. This, in turn, makes patients feel better and safer because their doctors are working hard, which increases the likelihood of people going in for consultations. More patients mean that rates for services will go down. Overall, with PBF, healthcare workers and facilities function better, and patients are happier and healthier.

While today, healthcare in The Republic of Congo is still facing challenges, it is vital to recognize how the government is investing and prioritizing the lives of its citizens. Creating change for the better is possible, and one must not forget to celebrate the victories.

– Paige Wallace

Photo: UNFPA

dementia in developing countriesThough dementia is traditionally thought of as being prevalent only in the developed world, it is now occurring at higher rates in developing countries. Currently, 67% of people with dementia worldwide reside in low- and middle-income nations, and researchers predict that number will reach 75% by 2050 in tandem with these nations’ aging populations. Because health and social care services in these countries are already strained or non-existent, dementia in developing countries poses a unique set of challenges.

Dementia and Alzheimer’s

The most common cause of dementia is Alzheimer’s Disease. But as with nearly all forms of dementia, there is progressive brain cell death, so as its symptoms progress, cognitive functions become severely impaired. As early as the second stage of mild dementia, individuals may require intensive care and supervision from others with tasks in their daily life. However, healthcare systems are stretched thin in many developing countries. Often, their frontline providers may not be adequately trained in providing the long-term care needed for these conditions. Even when assisted-living arrangements in a medical facility are an option, people with dementia have limited autonomy over their care because there are few systems in place to monitor the quality of dementia care in poorer nations.

Treating Dementia in Developing Countries

Due to the lack of formal care, people with dementia in the developing world tend to rely upon systems of “informal” care by family, friends, or other community members. These support mechanisms are under great strain due to the economic, emotional and physical demands of unpaid, and often unsubsidized, caregiving. Caring for someone with dementia can demand up to 74 hours a week and cost around $4600 a year. Furthermore, symptoms associated with the later stages of dementia, such as aggression, depression and hallucinations can have distressful psychological effects for these caregivers. In fact, 45% of family caregivers report experiencing distress, and 39% have feelings of depression.

Social Stigmas Surrounding Dementia

The social stigma associated with mental health diagnoses as well as general health illiteracy and unfamiliarity with dementia also contributes to inequities within the quality of dementia care. A study conducted in India suggested that 90% of dementia cases in low and middle-income nations go undiagnosed. Even healthcare professionals may lack the awareness to identify early signs of dementia. The wide-spread myth that dementia is not a medical issue in developing countries can mislead providers to dismiss dementia’s symptoms as characteristics indicative of normal aging.

Furthermore, in some parts of Sub-Saharan Africa, such as rural Kenya and Namibia where knowledge of dementia is not widespread, people may associate dementia with witchcraft or punishment for previous wrongdoings. Such beliefs further entrench the stigma surrounding it into the broader culture, discouraging people with dementia from seeking an official diagnosis. Organizations like the Strengthening Responses to Dementia in Developing Countries (STRiDE) Project have worked specifically towards reducing this stigma.

Understanding Poverty and Dementia

The immense prevalence of undiagnosed cases is particularly detrimental, considering poverty may increase one’s risk of dementia. Poverty is linked with many risk factors for dementia — one of which is stressful experiences like financial insecurity and education difficulties. Incidence of dementia has also been linked to lower levels of education since early development of neural networks can help the brain combat damages to its pathology later in life. A study on the rural Chinese island of Kinmen, where the median level of education is one year, showed dementia rates rising as people turned 60. This trend is earlier than in developed nations, and implies that illiteracy and lack of education can bring on dementia sooner.

Looking Forward

It remains unclear whether there is a correlation or direct causation between education level and the likelihood of dementia later in life. But one thing, however, is clear — low education levels serve as a frequent marker for other socioeconomic issues that are more common in developing nations, such as poverty, malnutrition, and toxic environmental exposures. Furthermore, the most commonly recommended strategy for reducing the risk of Alzheimer’s is maintaining overall health, which is more difficult in poorer countries due to malnutrition and unequal access to health care.

Moving forward, we must expand the support available to informal care systems, while ensuring healthcare providers receive dementia-specific training and health literacy. Women often the ones left to provide the majority of dementia care, but their efforts largely go ignored by their governments. Incentives, like universal social pensions, disability benefits and carer’s allowances, could support family and friends who house and care for people with dementia. Still, formal health systems too need to be bolstered to supplement and eventually substitute the role of informal carers. Policy-makers worldwide need to prioritize and anticipate the growing number of people with dementia as it remains the only leading cause of death still on the rise.

– Christine Mui
Photo: Flickr

Healthcare in Central African RepublicViolent conflict that has surged since 2007 in the Central African Republic (CAR) has created challenges for the nation’s healthcare system. Humanitarian organizations, which provide the majority of the health services available, have continued working to provide adequate healthcare despite threats of violence from militia groups.

Providing Healthcare Amid Conflict

The CAR is facing a humanitarian emergency. Even after the introduction of a peace agreement among the 14 armed groups in the country in 2019, attacks against civilians and humanitarian workers persist. It is estimated that out of more than 4.6 million people living in the CAR, 2.9 million people are in need of humanitarian assistance. NGOs have not stopped attempting to provide services to those displaced and hurting from the violence.

There are inadequate numbers of trained health workers in the CAR, as reported by the World Health Organization. Therefore, it has become a primary concern to increase the number of healthcare providers. This year, in addition to providing water, sanitation and hygiene assistance, the Norwegian Refugee Council (NRC) has begun training 500 individuals to respond to the protection and healthcare needs of vulnerable communities in the CAR.

After the conflict damaged or destroyed 34% of the CAR’s healthcare infrastructure, NGOs are focused on supporting the remaining hospitals and clinics. ALIMA, an NGO committed to providing quality healthcare services to those in need, has been working in the CAR since 2013. They have provided nutritional and medical care in the Bimbo and Boda health districts and outside the nation’s capital of Bangui. Pregnant women and children under the age of five have received free healthcare through ALIMA. Just in 2016, the organization carried out more than 17,320 prenatal consultations and treated close to 75,000 children for malaria.

The International Rescue Committee (IRC) began its involvement in CAR in 2006. The health services provided by this organization target the mental health consequences of gender-based violence. Psychosocial support to women survivors of violence has remained a priority. The IRC also implemented discussion groups aimed to expand gender-based violence awareness and share strategies for prevention.

Combating Infectious Disease

Malaria, HIV and tuberculosis are a few of the prominent diseases that require intense prevention and treatment in the CAR. Doctors Without Borders has been one of the principal actors in delivering these services, treating nearly 547,000 malaria cases in 2018. The organization generated community-based groups in multiple cities to pick up antiretroviral medications needed to treat HIV, while also working to decentralize HIV and AIDS treatment in the city of Carnot. UNICEF has given additional HIV screening to pregnant women during prenatal consultations, and those who tested positive were promptly placed on antiretroviral treatment.

On Jan. 24, 2020, the Ministry of Health declared there to be a measles epidemic in the CAR; cases had been on the rise since the previous year. Between January 2019 and February 2020, there were 7,626 suspected measles cases. A significant public health response has begun to target the spread, including the development of vaccination campaigns, an increase in epidemiological surveillance and the distribution of free medical supplies.

CAR has been impacted by the current coronavirus pandemic, as the country has recorded nearly 4,000 cases as of July 3. UNICEF and partners have been able to provide free essential care, sanitation services and psychological support.

The Need for Humanitarian Assistance

The United States Agency for International Development (USAID) is a major contributor to humanitarian aid in the CAR. It was with the financial assistance of USAID in the 2019 fiscal year that the IRC and the NRC were able to provide healthcare resources for risk prevention. The preservation of humanitarian funding to the CAR has proven to be crucial, as conflict has further weakened the healthcare system.

Humanitarian organizations have made significant progress in recent years to combat the spread of infectious disease and provide more widespread healthcare in the Central African Republic. There is a need to expand these efforts and improve quality of life during the nation’s continued fight for peace.

Ilana Issula
Photo: Flickr

Healthcare Reform in GeorgiaHealthcare reform in Georgia has contributed greatly to its population’s quality of life. Located east of the Black Sea in Europe, the country of Georgia finally gained independence in 1991 from the Soviet Union. In recent centuries, Turkey, Persia and Russia fought over control of its land, and the region still experiences tensions with Russia. The United States’ political and economic involvement with Georgia was a cause of concern to Russia, especially given Georgia’s interest in joining NATO and the EU. The Georgian- and Russian-speaking country has a population of 4.3 million, with a life expectancy of 71 for males and 77 for females.

Privately Funded Healthcare

After making the transition from a communist regime to a market economy, healthcare in Georgia was primarily privately financed. By the year 2002, healthcare spending per capita was $64. Over the period from 2002 to 2013, that figure saw an increase to $350. The country has been alleviating regulations ever since 2003, easing private companies’ entry into the market.

Recently there have been further reforms, such as the government supporting private insurers to invest and operate in 2010. This led to the private ownership of 84.3% of hospital beds by the end of 2014. Additionally, private insurers generated 43.2% of written premiums that same year.

Rising Standards of Health

Ever since its independence, Georgia has been one of the poorer countries of the region, its population subject to mainly noncommunicable diseases. However, the country’s standards have been slowly catching up to the rest of Europe. For example, the poverty rate went from 33.2% in 2005 to 21.3% in 2016.

One issue with healthcare in Georgia, and with the general health of the population, has been the flawed death reporting system. This system has led to an exaggerated rate of illness-induced deaths. It reached 55% in 2010, even though research suggests that a rate higher than 20% should be considered unreliable. While the rate remains high and unreliable, the country made tremendous progress after improving software systems, resulting in a rate of 27.3% in 2015.

A New Universal Healthcare System

Healthcare in Georgia took a big leap in 2013, when the government introduced a universal healthcare system for which the entire population qualified. Healthcare reform in Georgia downsized the role of private insurers and changed the system’s entire financing and funding structure. Instead of supporting private companies, government funds were allocated directly to the healthcare providers. The vast majority – 96.4% – of patients reported satisfaction with the system.

One of the main diseases affecting the country during this century is Hepatitis C. According to the CDC and the NCDC, “in 2015, estimated national seroprevalence of hepatitis C is 7.7% and the prevalence of active disease is 5.4%.” Healthcare reform in Georgia sought to combat the disease through a national program initiated in 2015. This program electronically improved screening and data collection from national and local agencies. From 2015 until 2017, the cure rate reached 98.2% and 38,506 patients were treated.

Healthcare in Georgia has undergone many reforms since 2003. It began with the support of privatization, but eventually the government transitioned to a single-payer universal healthcare system that serves approximately 90% of citizens. The current system also took measures to address the effects of the Hepatitis C disease. Even though the country still lags behind other European countries in poverty and health standards, recent years have seen significant progress.

Fahad Saad
Photo: Pixabay

China's Healthcare ReformChina is now in its 13th five-year plan to improve its overall healthcare system, and it’s maintained a steady momentum so far. Universal health coverage has now taken center stage in the country as nearly 95% of citizens have some form of basic health coverage. China’s healthcare reform in 2020 reform is coming to a close and it is a far cry from the 1970s. The next projected reform to continue the expanded coverage seen in years prior and to optimize the quality of care for greater access will be in 2030.

A Brief Snapshot of China’s Previous Healthcare Reforms

During 1978, China underwent a period of transforming its economy to a socialistic market model, and as a result, its healthcare system shifted through two reform cycles. The initial cycle focused on funding via market forces to provide care, yet this came at the cost of higher hospital fees and low-quality services. Many became impoverished as the cycle took a toll on those with severe health concerns and rural populations.

In 2003, the government took on a series of health reforms to alter the state of the healthcare landscape. China’s healthcare reforms meant that social health insurance assisted the uninsured, which accounted for 75% of the populace. This effort aided urban workers and rural citizens alike. 2012 marked a significant stride as 95% of China’s population now had some form of basic healthcare. Ten years later, the country went through another transition in 2013 to return to a market influence on healthcare.

Lessons Learned

In 2016, the World Bank Group authored a report to address the reforms in China, which called for a more cost-effective healthcare system with a higher standard of quality. In turn, a massive study “was undertaken jointly with the World Health Organization (WHO) and three Ministries of the Chinese Government.”

As a result, the study determined that China had to change to a “primary-care centered an integrated model with provider payment reforms” to achieve desired healthcare reform results. If the country did not adhere to the study, it would increase its health spending drastically from 5.6% to 9.1% over the next twenty years.

2020 Reform: The 13th Five-Year Plan

China’s healthcare reform for 2020is yet another effort to transpose China’s previous efforts with those “below the poverty line.” A big focus will be providing basic healthcare to those living in rural areas to match the national average and to alleviate the burden of those in poverty due to healthcare expenses.

For example, this endeavor will increase hospital capacity and allow for investments in private hospitals, improved training for nurses and staff, optimize the grassroots level medical centers, better integration of medical technology and full comprehensive healthcare coverage is the goal set for the new reform.

Moreover, the primary focus was on implementing universal basic healthcare to more than 1.3 billion Chinese citizens as part of the new reform, but the entire system is going to see further changes. As of March 2018, the People’s Congress has outlined a plan “to improve efficiency and public services.”

In Action

Thus far, China has seen improvements from previous reforms as 1.35 billion participating in the “basic medical insurance program” in January 2020. The new healthcare model now insures 95% of Chinese citizens. Moreover, 72 drugs are now at a reduced cost under the insurance catalog as of November 2019, and a shortage prevention system is to ensure adequate drug supplies are in stock.

New service models will allow patients to withhold out of pocket expenses so that patients may receive treatment first. These provisions are possible through public funding of basic medical insurance, yet residents have the option of enrolling in an “Urban-Rural Resident Basic Medical Insurance” program through government subsidies. The plan covers all basic elements of hospital care as well as prescription drugs.

Dependent on the insurance plans, citizens are no subject to various copayment and deductible options. For individuals who are unable to cover the out-of-pocket costs, medical assistance programs are available through government-funded donations.

2020 and Beyond

Beyond the 2020 reform, China has its sights set on the 2030 healthcare agenda, which has 20 departments formulating what is next. This plan will further expand the healthcare sector to make it a much larger proponent in the economy by vastly improving the quality and reach of care across China.

Health equity is the driving force behind what is to come in 2020 with strides already conducted to ensure that goal. These efforts have already extended health coverage to the rural regions with “less than one-third of China’s population” having direct access to healthcare. Furthermore, the ongoing development with healthcare and traditional medicine will serve a role in maintaining chronic illness and disease prevention. Healthy China 2030 will be the initiative that takes the current healthcare climate to new heights.

– Michael Santiago

healthcare in peruPeru carries a heavy history of periodic instability that has made the establishment of an accessible healthcare system perilous. The country suffers from an inequitable distribution of healthcare workers. It also struggles with the partition between private and governmentally-sponsored healthcare, the provisions of which skew inequitably toward the wealthy. Peru’s wealth gap shows the richest 20% in the nation controlling nearly half of its income and the poorest 20% earning less than 5%. This inequality is quite literally killing Peruvians. According to the 2007 National Census of Indigenous Peoples conducted by the Peruvian government, over 50% of census-interviewed communities did not have access to any form of health care facility.

Healthcare in Peru by the Numbers

  • The life expectancy in Peru is 74 years, landing the country at 126 out of 224 countries.
  • The probability of a child in Peru dying before the age of five is 1.4%, compared to 0.1% in the United States.
  • Peru spends 5.5% of its GDP on healthcare, compared to the U.S.’s 17.1%, ranking the country at 128 out of 224 countries.
  • In Peru, there are one and a half hospital beds available per 1,000 individuals. This is a number that is especially dire during the coronavirus pandemic.
  • Peru clocks in at just under one and one-quarter of a physician per every 1,000 Peruvians in need of medical care.

Structure of Healthcare in Peru

Due in part to fluctuating governmental structures and rulers, Peru currently operates with a decentralized health care system administered by five entities. Two of these entities provide 90% of the nation’s healthcare services publicly, while three provide 10% of the nation’s healthcare in the private sector. This distribution results in considerable overlap and little coordination, depleting the healthcare system of resources and providers. In fact, many healthcare providers in Peru work an assortment of jobs across different subsectors.

As healthcare is a necessary sector of the economy, Peru’s healthcare worker density is increasing, even as health worker outmigration also increases. But since these workers are not equitably distributed, coastal and urban areas monopolize the majority of these providers. Lima and tourist coasts boast the highest distribution of healthcare workers, while rural and remote areas such as Piura and Loreto are home to few health providers.

Impact of the Healthcare Structure on Women

The detrimental effects of inequitable healthcare distribution are most visible in the country’s astonishing maternal mortality rate. In Peru, 185 out of 100,000 mothers dying from pregnancy-related causes, one of the highest in the Americas. The burden of maternal mortality rests squarely upon the shoulders of poor, rural, and Indigenous women. They are dying from largely preventable causes in a massive breach of human rights. These women disproportionately face countless barriers to pregnancy wellness and birth healthcare, including a dearth of emergency obstetric and neonatal services, language barriers and a lack of information regarding maternal health. Peru has implemented policies in recent years to reduce the rate of maternal mortality, such as the increase of maternal waiting houses for rural pregnant women to reside in as they approach birth. Unfortunately, women and health professionals attest that these measures are inadequate and improperly implemented.

The only cause of premature death that precedes neonatal disorders as a result of inadequate neonatal obstetrics is lower respiratory infections. This type of infection is the most likely cause of premature death, and it has remained so since 2007. This illness, too, disproportionately impacts women and children. They are the most likely groups to die from household air pollution, a type of pollution caused by the burning of solid fuels for cooking and heating purposes. In Peru, 429 out of an estimated 1,110 yearly childhood deaths are caused by acute lower respiratory infections resulting from household air pollution. Combined, neonatal disorders and lower respiratory infections cause more death and disability than any other factor in Peru. These are shortening the lives of Peruvian women and children by almost 20%.

Moving Forward with Healthcare in Peru

The healthcare system in Peru is one that suffers many flaws. It is straining to support its people, especially in the midst of a worldwide pandemic. While the going is slow, the country is striving to reform its healthcare system. Peru is doing this by reforming its healthcare system in the direction of universal coverage – an achievable but certainly strenuous goal. Since vigorously implementing healthcare reform in the late 90s, Peru reports coverage of 80% of its population with some form of health services. While this number is far from ideal, it is evidence that the Peruvian government is not only cognizant of but concerned about its healthcare failures, and it is striving for a fuller coverage future.

 

– Annie Iezzi
Photo: NeedPix

Healthcare in Libya
Libya is a country in North Africa that has been ravaged by an escalating civil war since 2014. This war has led to the collapse of infrastructure in many different sectors. Healthcare in Libya is one of the areas that has suffered most because of the armed conflict — and the problem has only been exacerbated by the global COVID-19 pandemic.

The Context

Adequate healthcare in Libya has been scarce since the current civil war broke out. Libya’s healthcare system, according to the United Nations Support Mission in Libya (UNSMIL), was already fragile before the unrest, and has only worsened because of the rise in both civil disobedience and military crossfire. Hospitals and other essential medical facilities have been destroyed, including the Al-Khadra General hospital in Tripoli. This had led to deaths and permanent structural damage that an under-resourced system cannot afford to fix.

Despite calls for peace, shelling, ground assaults and aerial attacks continue to devastate civilian infrastructures, resulting in water and electricity shortages for medical facilities and households alike. Healthcare workers and professionals are subject to threats on their life that force many into exile, contributing to the rising total of internally displaced persons (IDPs) within Libya. Access to essential facilities and services is increasingly limited due to road closures, delays at checkpoints and the palpable fear of sudden violent outbursts.

COVID-19 has only exacerbated citizens’ struggle for healthcare in Libya. While the coronavirus is relatively new to Libya — with 156 cases as of June 1 — the World Health Organization (WHO) identifies the country as being at-risk for a massive explosion in cases. The organization also speculates the number of confirmed cases is much lower than the actual number of infected persons, due to the following factors:

  • Limited testing capacity, with the only two operational testing labs located in Tripoli and Benghazi
  • Failure to implement an effective system of contact tracing, which has proven to be one of the best ways to streamline the tracking of infected persons
  • Cultural stigma against seeking medical aid
  • Breaches in widespread communication and an over-saturation of manipulative media
  • A shrinking number of open medical facilities due to a lack of training and technique among doctors
  • Lack of available treatments and staffing, heightening the challenge for medical facilities that have remained open
  • Displaced individuals, including refugees, asylum seekers and migrants, are more endangered and have lower accessibility to healthcare

Organizations Making a Difference

Libya relies heavily on foreign assistance to help quell its large-scale humanitarian crisis — one that threatens to become worse because of COVID-19. Several organizations are currently supporting healthcare in Libya. First, International Medical Corps (IMC) operates six mobile medical units that serve IDPs around large urban centers. The Corps also offers specialist training in reproductive health to medical professionals, provides mental health support for Libyan medical personnel and established a women’s and girls’ safe space. In 2019, IMC distributed more than 20,000 health consultations to displaced groups, trained 33 local staff members and reached more than 1,200 individuals during awareness sessions.

Another group, Medecins Sans Frontieres, deployed teams that operate within two regions of Libya: one in Tripoli and one in Misrata and the Central Region. The Tripoli team sends medical and humanitarian assistance to the local detention center and to migrants and refugees dispersed throughout surrounding urban communities. The team also conducts training seminars on infectious disease prevention and control in local medical facilities. Meanwhile, the Misrata and Central Region teams administer basic healthcare and psychosocial support, provide nutrition supplements and hygiene kits to detained people and offer primary healthcare and referral services to migrants who have survived captivity and trafficking — in addition to other services.

The World Health Organization (WHO) is also working to improve access to healthcare in Libya. The WHO provides resources to combat leishmaniasis, distribute medical supplies to more than 40 primary health care centers and referral hospitals and train medical professionals to control and prevent deadly diseases. The organization budgets nearly $30 million to treating and regulating both communicable and non-communicable diseases. It promotes health through education, funding corporate services, maintaining an emergency reserve and developing humanitarian response plans.

The financial contributions and services these organizations provide are vital for the state of healthcare in Libya. Many of the strategies and systems in place have been making a positive change. However, greater financial backing is necessary if Libya is to fully extinguish its deficiencies in healthcare. The United States has spent $16 million on aid to Libya, but statements on exactly which organizations the aid is being funneled to have been vague. Aid focused directly on strengthening Libya’s healthcare system by providing sufficient medical supplies, staff and training could mean the difference between life and death for many Libyan civilians.

– Camden Gilreath
Photo: Flickr

measles in democratic republic of congoThe Democratic Republic of the Congo declared a measles outbreak in June 2019. Since then, more than 310,000 have been affected by this epidemic. Measles is an extremely contagious and airborne disease that can cause rashes, fevers and coughing. The virus is especially dangerous for children. Most developed countries can combat measles through vaccinations, but developing countries aren’t able to fully eradicate and achieve a herd immunity of a sizeable population majority, leading to constant outbreaks.

How COVID-19 is Affecting the Situation

Due to COVID-19, more than 117 million children could not receive their measles vaccine following the halt of vaccination campaigns. Measles may kill more people in developing countries than COVID-19 if outbreaks continue. At least 6,500 children have already died from measles in the DRC. Most world leaders are focusing on COVID-19 rather than the vaccine-preventable diseases that could potentially wreak havoc on developing nations. The Democratic Republic of the Congo is currently leading the world in the highest numbers of measles cases. This trend is likely to continue without significant aid and the continuation of vaccination campaigns. The DRC also has an incredibly weak healthcare system, so it greatly relies on NGOs and foreign aid to administer vaccines & life-saving medicines to the country.

Other Diseases in the DRC

In addition to measles, the DRC is currently combating cholera, polio, COVID-19 and Ebola. “On June 1, 2020, the Democratic Republic of the Congo declared its eleventh Ebola outbreak.” This is before the tenth outbreak was declared over on June 25, 2020; however, WHO has stated that these two outbreaks are separate. Due to the limited resources caused by the COVID-19 pandemic, this outbreak will be harder to contain than previous outbreaks.

In the past, multiple Ebola outbreaks have drawn more attention than the measles in the Democratic Republic of the Congo. Now, COVID-19 is drawing more attention than measles. However, all three diseases need to be dealt with alongside the other diseases harming the DRC. During an Ebola outbreak in earlier months, measles was overlooked, which led to a resurgence. Measles in the Democratic Republic of the Congo must receive the attention necessary to combat it. In addition to the disease itself, the DRC is also suffering from malnutrition, food insecurity and economic uncertainty. All of these factors make the population more vulnerable to other diseases, particularly children.

How To Help

The best way to help combat measles in the DRC is to ensure vaccination campaigns can start again. An increase in foreign aid will help the nation reach this goal. The DRC needs to achieve 95% vaccination to recover, but that goal seems incredibly unlikely due to the current COVID-19 panic. With the majority of the world also focused on COVID-19, it is unlikely that the DRC will receive all the international aid they require at this time. An additional $40 million will be needed on top of the $27.6 million received to successfully fight measles in the Democratic Republic of the Congo.

Organizations like Doctors Without Borders are continuously working to fight measles outbreaks in DRC. As of June 2020, the organization has succeeded in vaccinating 82,000 children after “three back-to-back campaigns.” Doctors Without Borders cautions the world that measles cannot be ignored even with the current COVID-19 crisis. They are taking extra precautions during this time to reduce the risk of co-infection.

While COVID-19 is an important and urgent issue, it is imperative that leaders continue to send help to those abroad struggling with the fall-outs of poverty whenever possible. Measles in the Democratic Republic of Congo is one example of how important foreign assistance and vaccination campaigns are in saving lives in developing countries.

– Jacquelyn Burrer
Photo: Flickr

The common notion is that Papua New Guinea is composed of mostly of rural tribes and coconut trees; this is not true. In fact, the big island boasts an abundance of natural resources that include gold, copper, silver, gas and oil. Papua New Guinea’s resources have attracted many foreign companies to want to work in the region and exploit its resources, including the U.S. oil giant Exxon Mobile Corp. According to the World Bank, the country’s GDP has steadily increased from $3.5 billion in 2000 to $24.97 billion today. Yet, it seems that poverty in Papua New Guinea is still pervasive.

Lack of Basic Necessities

Poverty in Papua New Guinea is influenced by education, healthcare and infrastructure. Around “80% of Papua New Guinea’s people live in rural areas.” According to the World Bank, less than 40% of those living in these areas have electricity in their households whether on or off the grid. In rural areas, there is limited access to clean water and sanitation. In fact, only 8% of rural areas have proper sanitation. This is causing major illnesses and an almost 40% infant mortality rate.

The inability to receive adequate healthcare is another factor that perpetuates poverty in Papua New Guinea. Medical facilities often lack basic resources such as equipment, vaccines and even workers. Papua New Guinea has a population of 8 million people but “only 500 doctors, less than 4,000 nurses, and 5,000 hospital beds.” After 20 years, it has recently been facing the return of polio and HIV because of shortages of vaccines and proper treatment. In addition, the majority of people living in rural areas do not have access to resources because of the lack of developed roads. Therefore, they have to walk long distances to reach these facilities.

Furthermore, not all students in rural areas have access to village schools. Some need to walk miles to reach their schools. Most of these schools lack resources and teachers who often do not have the appropriate training. In 2018, there was a shortage of 10,000 teachers in schools, most of which were in rural areas.

Education and Health Setbacks and Initiatives

The Tuition-Free Free education policy launched in 2012. This policy was an attempt in providing free education to the population. However, the government has failed to deliver the funds to the schools, causing many to close down. To make matters worse, Papua New Guinea suffered from a 7.5 magnitude earthquake in 2018. the earthquake. The quake and its subsequent aftershocks caused the death of around 31 people and the displacement of more than 30,000. This increased the overall poverty rate in Papua New Guinea.

Many healthcare facilities, schools and homes were destroyed. Providing better access to quality infrastructure is one of the ways in which poverty in Papua New Guinea can improve. The creation of more roads will increase the accessibility of healthcare and education. Improving the overall education, healthcare and transport infrastructure is one of the goals of WHO, UNICEF and Asian Development Bank. In 2017, ADB provided “$680 million for the Sustainable Highlands Highway Investment Program”, which will connect roads and services to around three million people. In addition, it also committed almost $3 million for the Health Services Sector Development Program and the Rural Primary Health Services Delivery Project. Both projects aim to strengthen the health services in Papua New Guinea.

The Good News

James Marape, the new Prime Minister, is making efforts to fight poverty. The education system is undergoing its fourth reform with a focus on reaching and providing better resources to the young population. On top of that, partnership projects are working to support the health system. For example, the World Bank’s Emergency Tuberculosis project is a $15 million project that has already been making an impact since 2017.

The response to poverty in Papua New Guinea will depend solely on improving the health system and education of its population. This is especially imperative now since now more than half of the population is composed of young people. If the country’s opportunities and health are improved, the country can be led into prosperity.

Alannys Milano
Photo: Flickr

Diabetes is a disease that occurs when the pancreas is unable to produce or use insulin well, resulting in a high blood sugar level. When the body fails to make insulin at all, this is type 1 diabetes. With type 2 diabetes, the body does not produce or use insulin effectively. Both types of diabetes come with side effects that are detrimental to a person’s lifestyle. In the African region, South Africa has the second largest population of people with diabetes. Here are five facts that you should know about diabetes in South Africa.

5 Facts About Diabetes in South Africa

  1. Diabetes is a leading cause of death in South Africa. With non-communicable diseases (NCDs) like diabetes on the rise globally, South Africa is no exception. In 2016, diabetes and other NCDs caused 16% of the total deaths in the country. Diabetes is one of the three leading causes of death in South Africa, the other two being tuberculosis and cerebrovascular diseases. Among the South African population, there is a major lack of awareness of the disease and access to proper healthcare. Because the prevalence of diabetes in South African adults is 12.8%, it is crucial that other countries continue to support the funding and research of diabetes in South Africa.
  2. There are many ill-side effects for those living with diabetes. Diabetics must consistently track their blood sugar levels to ensure they don’t go into a diabetic coma. Additionally, diabetics are two to three times likelier to experience cardiovascular problems, like heart attacks or strokes. Diabetes can cause an individual’s kidneys to stop working. In most healthcare facilities in South Africa, they lack the procedures necessary to help a diabetic undergoing kidney failure, like renal replacement therapy by dialysis or through transplant. Another symptom of diabetes is neuropathy – or nerve damage – in the feet, which can lead to infection or potential amputation. In healthcare centers in South Africa, there is little equipment available for testing nerve damage in the feet and symptoms like this can often slip under the radar. Through an increase in funding from other countries, individuals suffering from diabetes in South Africa can have access to more equipment and medication necessary for dealing with diabetes.
  3. Socioeconomic disparities and other factors contribute to the prevalence of diabetes in South Africa. In South Africa, proper healthcare is inaccessible in poorer communities. The deficiency of experienced health professionals and respectable clinics makes it hard for citizens to undergo testing or treat the disease if they have it. More than one million citizens in South Africa do not know if they are diabetic. With more accurate and accessible testing, a greater population can begin treatment for the disease. It is crucial that the government receive funding to build diagnostic centers and train medical staff.
  4. Diabetes in South Africa is preventable and treatable in many ways. Though diabetes is irreversible, there are ways to keep symptoms at bay. Type 1 diabetes often develops in childhood and is usually impossible to eliminate. However, type 2 diabetes can go into remission with medication and changes in lifestyle. A common medication used to treat diabetes is metformin. Exercise and good eating habits are helpful treatments for diabetics. The most effective way to decrease the prevalence of diabetes in South Africa is to prematurely educate citizens and encourage healthy decision making. South Africa is currently working towards this goal.One recent preventative measure taken by the South African government is the implementation of a sugar tax. By charging more for sugary drinks and foods, the government is fighting obesity and helping citizens make more conscious decisions. In July 2019, South Africa briefly launched a Diabetes Prevention Programme (DPP). The DPP aims to integrate intervention treatments into a culturally relevant context through household questionnaires and group gatherings for at-risk individuals. In the conclusion of this program, the DPP will focus on using the information they gathered to create a curriculum that can educate communities about diabetes. To prevent rising cases of diabetes it is important that there is more pervasive awareness of the causes of diabetes. Citizens can learn how to manage obesity and understand when they should seek testing.
  5. Many countries and organizations help by funding testing centers and medical treatment in South African cities. The International Diabetes Federation (IDF) works with several organizations in the South African region to help combat the severity of the disease through advocacy, funding and training. The three organizations that are a part of IDF are Diabetes South Africa (DSA), Society for Endocrinology, Metabolism and Diabetes of South Africa (SEMDSA) and Youth with Diabetes (YWD). DSA is one organization that does its part in educating citizens and lobbying the government for better facilities and cheaper healthcare. DSA is a nonprofit that centers around mobilizing volunteers to demand better treatment for those with diabetes.

Danielle Kuzel
Photo: Flickr