Health Care in CubaDue to the dwindling trade restrictions between Cuba and the United States during the Obama administration, people around the world are getting a look into a country that has been closed off from much of the world for many years. While the country is known for its slow wealth creation and high levels of state control, healthcare in Cuba has made massive strides since the country’s revolution in 1959.

Cuba’s healthcare is recognized as being among the world’s most efficient and high quality systems. Former United Nations Secretary General Ban Ki-moon stated that the country’s healthcare system should be used as a model for many developing countries.

Since the 1959 revolution, when Fidel Castro gained power in Cuba, the socialist ideology emphasized that access to healthcare is a fundamental human right. With this belief inscribed in Cuba’s constitution, the country focuses on preventative approaches to medicine. From providing annual, mandatory checkups to the most complex surgeries, healthcare in Cuba remains free of charge.

With this high level of accessibility, the country has made many health improvements since the beginning of the Castro regime. These include:

  • A 98 percent full immunization record by the age of 2 that protect children from 13 illnesses.
  • Low infant mortality rates. Cuba’s rate is extremely close to that of the United States’ with less than 5 deaths per 1000 births. This statistic makes Cuba the best performer in the developing world.
  • High life expectancies, with men living an average of 77 years and women living an average of 81. These expectancies are almost identical to those in the United States.
  • Record doctor to patient ratios that surpass many developed nations. Every doctor cares for around 150 patients.
  • A well-educated public regarding individual health. Family doctors, who make mandatory visits annually, discuss issues such as smoking, eating and exercising with patients while also providing tailored recommendations to remain healthy.
  • World leading medical schools. Former U.N. Secretary General Ban Ki-moon stated that Cuba’s medical education system is the world’s most advanced. In 2014, over 11,000 students from over 120 nations pursued a career in medicine at the Cuban Institution.
  • A significant focus on research and development. The focus on innovation has been attributed to the U.S. embargo that prohibited trade in medicines for Cuba. This made investing in medical sciences a necessity to provide quality health care.

By the mid-1980s, Cuba developed the world’s first Meningitis B vaccine. In 2012, Cuban doctors developed Cimavax, the first therapeutic cancer vaccine. Additionally, The World Health Organization (WHO) recognized the country as being the first to eliminate HIV transmission between mothers and their children in 2015. These outcomes are found to be a direct result of the huge investments made in Cuba’s biotechnology and pharmaceutical industries.

Healthcare in Cuba has benefited more than just the citizens of its country. Every year, Cuba sends around 50,000 health professionals abroad, providing care to developing countries. In only one decade, Cuba’s contribution to Mission Miracle, a program supporting people with sight impairments, has restored around 3.5 million individuals’ vision. Many of these contributions are made in Latin America, where 165 Cuban institutions maintain 49 ophthalmological centers and 82 surgical units in 14 countries.

However, Cuba’s support reaches beyond its own continent and into Africa. The Cuban chemical and biopharmaceutical research institute LABIOFAM launched a vaccination campaign against malaria in 2014 in more than 15 West African nations. Additionally, during the recent Sierra Leone Ebola crisis, over 100 Cuban doctors and nurses were of assistance.

Castro was an advocate for providing international health support, as he believed by assisting developing countries, Cuba was preventing the expansion of epidemics that could spread to its own nation if not handled correctly. In addition to the philanthropy aspect, Cuban doctors and nurses working in over 77 countries generate $8 billion a year, which makes international health services the country’s largest export.

While the country’s GDP per capita is ranked 137th in the world, healthcare in Cuba has demonstrated that a poor country can create dramatic developments in its population’s quality of life for the long term. Castro’s form of leadership, while questioned in many other areas, has improved the living standards for Cuba’s poorest with regard to medical needs.

The WHO stresses that Cuba provides a prime example of a developing nation with limited resources that can provide an efficient health care system to all of its population. However, for such an outcome, the political institutions of the country must make human beings the center of their policies and not their own wallets.

Tess Hinteregger
Photo: Flickr

AFREhealthThe African Forum for Research and Education in Health (AFREhealth) is a landmark organization, the first that will actually have Africans tackling major health challenges in Africa, rather than Western countries.

During the sixth MEPI/NEPI Annual Symposium, African health leaders announced the creation of AFREhealth, an interdisciplinary health professional initiative working to improve healthcare in Africa through improved education, research and capacity building.

In the past, international donors have largely funded and directed efforts to improve health conditions in Africa. However, AFREhealth seeks to reduce such reliance on international funding and set their own, more useful local agendas. Therefore, Africans will lead the initiative in collaboration with partner organizations.

Key health solutions that AFREhealth will strive to achieve include encouraging African governments to prioritize healthcare in individual countries, working to keep local health professionals in Africa and securing more funding to support focused, local African health research.

One of the forum’s goals, preventing the loss of skilled health professionals to foreign markets, came to light during the HIV/AIDS crisis. A severe shortage of skilled health workers significantly limited governments’ efforts to respond to the crisis. Recent reports reveal a 60 percent increase in the number of doctors and nurses moving out of Africa to work in Organization for Economic Cooperation and Development countries.

A study done in South Africa highlighted the severity of the issue and reflects the scenario throughout the rest of the continent. The survey revealed that although the number people leaving may be decreasing slowly, the level of intention to leave remains very high.

Additionally, a severe disparity between the number of skilled health professionals in the private versus public and urban versus rural areas exists. Consequently, South Africa struggles to produce sufficient numbers of workers in HIV scale-up programs and to adequately staff rural facilities.

The South African study revealed a number of reasons for the emigration of so many health professionals. Many workers expressed dissatisfaction with South Africa’s economic and political standing, concerns about corruption and fear for personal safety and the safety of their families.

AFREhealth seeks to reduce all of these problems in order to improve African health at a more rural level. The organization has a lot of work ahead, but African experts believe through their greater understanding of their own individual countries, success is much more likely.

Lauren McBride
Photo: Flickr

Southern Sudan Healthcare OrganizationJacob Atem and Lual Deng Awan, two Sudanese refugees now living in the U.S., have established a nonprofit healthcare organization to give impoverished people in South Sudan access to proper medical treatment. The Southern Sudan Healthcare Organization (SSHCO) opened its first clinic in Maar, Sudan in 2008 and it now aims to build more clinics.

Maar, Sudan is an especially significant location for Atem and Awan because it is the town where they once lived before the Second Sudanese Civil War struck in 1983. During this war, 20,000 Sudanese children – including Atem and Awan – were left on their own after their family members were killed or kidnapped in the conflict. They were known as “The Lost Boys of Sudan.” These children attempted to make a treacherous 1,000-mile journey on foot to reach Ethiopia as refugees. Thousands of boys died on the journey, and Ethiopia did not prove to be a good choice for resettlement. In 1991, war in Ethiopia forced the boys to escape to the Kakuma refugee camp in Kenya. At this refugee camp, the U.S. State Department selected some of the boys for resettlement in the United States. Both Atem and Awan were brought to Michigan and taken in by foster families. In the United States, they went on to attend high school and pursue higher education.

The clinic in Maar provides up-to-date basic healthcare services to patients, while the organization as a whole provides funding to South Sudanese individuals who want to pursue a career in the medical field. The clinic has proved to be invaluable for the inhabitants of Maar, since the village is in a very isolated location. Before the arrival of the SSHCO, the closest clinics to the villagers were about a three day journey away. The Maar Clinic sees up to 3,000 patients monthly. Out of the patients the clinic sees, 80 percent have malaria and 50 percent are under five years old. Around 10 women come in every month to give birth, and 60 percent of the children it sees have some kind of diarrheal disease.

Currently, the SSHCO is working with the Sudanese government to build additional clinics and improve vaccination rates in Sudan. Although Atem and Awan undoubtedly suffered a lot in their early life, they persevered, and have now made it their life purpose to bring hope and health to the people in their home country.

Anna Gargiulo

Photo: Google

Improving Eyesight in Developing CountriesPoor vision and blindness are problems that many people in developed countries take for granted. Most people know that they will be able to get contacts, glasses, laser eye surgery, or any number of other solutions to their vision problems. However, there are 246 million people around the world who are living with a visual impairment, and 39 million people are totally blind. This data may seem trivial compared to the more than 650 million people living in extreme poverty, but these issues are closely linked. Many living in extreme poverty or with a low income suffer from some form of visual impairment. Poor eyesight makes it very difficult for people to escape the cycle of poverty, so improving eyesight in developing countries would help address many other poverty-related issues, including education and equal rights for women.

At first, it seems like vision is unrelated to the issue of poverty. Though vision is rarely discussed compared to other issues such as malnutrition, violence and healthcare, eyesight is an overlooked problem in many areas of poverty. Nine out of ten blind people live in developing countries, and most of them are in poverty.

When ignored and untreated, poor eyesight can cause or worsen conditions of poverty, and the conditions of poverty can also cause poor eyesight or blindness. Without access to proper healthcare and treatment, many people living in poverty contract eye diseases that could have been easily treated, but instead they are blinded. This makes their already difficult situation even more desperate, because they are unable to better educate themselves or get a job to support themselves. Poor eyesight and blindness compound the issues of poverty, so addressing and improving eyesight in developing countries is an important part of addressing the cycle of poverty.

Most of the 246 million people with a visual impairment just need corrective lenses to fix their vision. There are a variety of programs that can recycle old eyeglasses to give to those who need it. These programs keep thousands of glasses out of landfills and give them to someone who can use them.

Blindness may seem like a much more difficult problem to address, but about 80 percent of the world’s blindness is treatable or preventable. Over half of the world’s blindness is caused by cataracts, and a simple 15-minute operation would cure these people. These solutions seem relatively straightforward, yet poor eyesight is often an unknown factor when many people address poverty.

The solution is simple: provide proper eye care and corrective lenses to address these problems. However, implementing this is more difficult. In many areas where people have poor eyesight, there are dozens of other difficulties as well. For example, Africa has only ten percent of the world’s population, yet it has 19 percent of the world’s blindness. The rate of poor eyesight in Africa is the result of a variety of causes, but the main factor is poor healthcare.

Many diseases such as HIV/AIDS and others that cause or worsen poor eyesight go untreated due to the sparse and insufficient healthcare systems. The number of eye care personnel is in many areas even lower than the number of healthcare providers. For example, in South Africa, there is only about one optometrist for 17,600 people. With disproportionate numbers like this, it’s no mystery why eye care is practically nonexistent in many areas.

Tackling the vision problems in developing countries is an enormous task. Most organizations begin by treating trachoma, refractive errors, cataracts, and childhood ocular conditions. By treating these four causes of blindness and poor vision, millions of lives can be turned around. People are given the power of sight, and with it, they are better able to get an education or a job.

However, preventing the larger causes of poverty is the key to preventing blindness. Improving eyesight in developing countries helps end poverty, but it is a two-way relationship. Since so many preventable and treatable eyesight problems are caused by poverty, ending poverty will also prevent many of the eyesight problems that deepen the existing conditions of poverty. Promoting health and education leads to better eyesight, and better eyesight in turn leads to better overall health, better economic standing, and more independence. Instead of a downward cycle in poverty, improving eyesight can lead to an upward spiral where conditions get better and better for those whose vision is treated.

Rachael Lind

Photo: Flickr

The strategic goals of the Food and Agricultural Organization (FAO) include eliminating hunger, food security and malnutrition. The FAO also cares for agriculture, helps increase resilience to a crisis and aids those suffering from rural poverty. One of their most recent success stories is mobile veterinary clinics, which does incorporate these objectives.

In 2016, Haiti experienced Hurricane Matthew. This violent storm resulted in the country’s largest humanitarian emergency since an earthquake that happened in 2010. The Category 4 hurricane caused extensive flooding, mudslides, damage to infrastructure and severe water shortages. A 2016 report from the United Nations Office for the Coordination of Humanitarian Affairs determined that the hurricane affected 2.1 million people, with 1.4 million people in need of aid and 806,000 people left food insecure.

Food insecurity can be directly linked to one of the most devastating effects of the storm. This effect is the incident of thousands of livestock being killed. Many of Haiti’s inhabitants rely on livestock – mainly cows – for not only food but also a large source of income. Even more troubling was the amount of livestock that did survive but suffered sickness and injury that could not be treated.

Veterinary assistance in Haiti is very costly and heavily out of reach. The FAO saw an opportunity and took the stage as the first United Nations agency to set up mobile veterinary clinics. The FAO operates these clinics by traveling to storm-affected areas and providing adequate treatment to livestock that have suffered the effects of the storm. Education is also incorporated into the equation and is of high importance. The FAO trains local veterinary assistants on proper care and technique for caring for the affected animals. Kits are also provided to Haiti’s citizens so that treatment can continue when the mobile vets have left the region. Antibiotics, deworming medication, multivitamins and other equipment have all been provided to assist Haiti, while helping the FAO reach their strategic goals.

The accomplishments of the FAO’s mobile veterinary clinics include a rise in milk production, the development of six mobile clinics and, most importantly, the hope that these clinics have given those in the Haitian community. So far, mobile vet clinics have helped an estimated 12,000 people rebuild their lives by treating their much relied-on livestock after a severe storm. If the FAO continues this project and develops even more mobile veterinary clinics, it is probable that more Haitians will be able to restart their lives in a better place after natural disasters in the future.

Emilee Wessel

Photo: Flickr

When thinking of the extremely poor, one’s mind may not immediately go to the inherent struggles that come with menstruation. This is not just cramping, bloating and irritability, but the associated sanitation issues that may arise without access to proper hygiene, not to mention the stigmatic buzz around womanhood and her period.

Real Relief, a small organization committed to supplying common life sustaining supplies, is devoted to making a difference and has developed a tool for menstruation hygiene for the extremely poor: SafePad, a period game changer in the sanitation industry. While sanitary napkins are nothing new to the women’s hygiene repertoire, SafePad exemplifies what certain basic life necessities encompass and how something so simple can impact the lives of millions of women and their younger counterparts.

The extremely poor cross many cultures as well as economic strains over a variety of different ages, races and religions. There are several different ways in which women have traditionally dealt with their menses. In some cases, these methods may be simply impractical. Rags may be used to deal with menses, but they often take time and privacy to wash and dry. Where menstruation cups may be available, some cultures may not accept this means or view it as reasonable.

Inadequate access to proper sanitation such as soap and clean water can also cause yeast infections, other serious illness or in extreme cases, infertility. When all else fails, women may choose to “free bleed,” which may not seem particularly harmful unless in the context of young girls attending schools in which they may take five or more days of leave, eventually leading to a poorer performance in their classes or even drop out.

Real Relief’s mission led to the production and distribution of SafePad through NGOs, religious communities and relief aid organizations of SafePad. SafePad has been specifically designed to combat bacteria by utilizing silica, nitrogen and carbon treatment agents, provide comfort, discretion and practical solutions to women where access to hygienic means of caring for the menses is difficult or impossible.

SafePad is also reusable and recyclable for women that do not experience reliable waste management in their communities and can withstand up to 100 washes, which translates to four years of use.

Menstruation is a part of most every woman’s life but if not taken care of properly, has the potential to have serious, life-long side effects. Menstrual health, education and supplies, however, can lead to so much more relief. Period.

Casey Hess

Photo: Flickr

Healthcare in NigeriaIn Nigeria, the ratio of healthcare workers to citizens rests at 1.95 per 1,000 people, according to the World Health Organization. The unequal distribution and inadequate production of such workers create systematic challenges for healthcare in Nigeria.

One possible solution shortly, as put forward by Vodacom, is the Internet of Things (IoT). Vodacom is a communication company based in Africa and majority owned by Vodafone, one of the largest communication companies in the world. Kaduna, one of Nigeria’s 36 states, has recently partnered with Vodacom to launch a state-wide technology based healthcare system called SMS for Life 2.0.

This technology-based system is grounded in the Internet of Things, or the idea that “anything that can be connected, will be connected.” Technology is moving towards a future in which any given device can have a switch to the internet or other devices, including items like lamps, washing machines and other devices that historically have nothing to do with communication. The idea is that there will be increased opportunity for efficiency, productivity and safety.

What this looks like about healthcare in Nigeria, specifically the state of Kaduna, is more than 250 facilities currently using this digital form of healthcare with plans to implement it throughout the rest of the country, especially due to increasing chronic illnesses. Vodacom’s future goals include making essential medicines more available to citizens and more efficient healthcare delivery.

Lanre Kolade, managing director of Vodacom Business Nigeria, says, “IoT can be used to increase access to healthcare by extending the scope of care services to rural and hard-to-reach areas and ensuring that essential medicines are available where and when they are needed. This technology is powering connected medical services that enable healthcare professionals to diagnose and consult with patients and first responders remotely, no matter where they are.”

While systems implementing this idea of the Internet of Things allow for endless connections, it also includes challenges that society will have to wade through, such as security and privacy. The boundaries between helping people and monitoring their every move have yet to get explored.

Ellen Ray
Photo: Flickr

Half of Humanity
The organization Half of Humanity is working to combat an issue that often gets swept under the rug: unhealthy menstrual practices within refugee populations.

The organization’s most recent efforts have been teaming up with NuDay Syria to provide culturally appropriate feminine hygiene products to Syrian refugees. The kit includes a one-month supply of absorbent pads, wipes, soap, two doses of ibuprofen, candies and a handwritten note in Arabic that says, “You are beautiful!”

While other organizations share the goal of promoting healthy menstruation in vulnerable populations, Half of Humanity takes a culturally sensitive approach. For example, Syrian culture condemns the use of tampons, which is why none are included in the hygiene kit. All of the candies are halal out of respect for practicing Muslims.

Half of Humanity’s aid has concentrated primarily on displaced female populations in the Middle East and North Africa, where women are particularly vulnerable to stigma as well as unhealthy menstrual practices. Refugees who cannot afford hygienic products in these low-income areas are likely to use unsanitary alternatives to hide their menstruation, such as unclean rags, grass or even trash.

The organization’s mission in target areas is critical. For example, in 2012, 51 percent of displaced Syrian women in Jordan experienced symptoms of a reproductive tract infection. Improper menstrual practices can also increase chances of HIV and pregnancy complications.

Menstruation also limits many women’s societal engagement. Studies conducted in Africa have shown that many girls consistently miss out on important opportunities such as schooling every month because public areas lack proper sanitation facilities.

Brianna Curran, the founder of Half of Humanity, hopes to enable female refugees to engage in civil action regardless of where they are in the menstrual cycle. Curran has received much recognition for her dedication to the cause, including a spot on the “30 under 30” list of remarkable young people working towards development, sustainability and human rights, created by the Center for Development and Strategy.

While Half of Humanity’s goals are constantly shifting to meet the needs of target populations, its overall impact has served to empower female refugees in both North Africa and the Middle East to engage with the rest of society all days of the month.

Kailey Dubinsky

Photo: Flickr

HIV Remission in AfricaAt the ninth International AIDS Society conference in Paris on July 23, scientists confirmed the first case of HIV remission in Africa. Diagnosed with HIV at 32 days old, a now 9-year-old South African girl has been living without the disease and off treatment for more than eight years.

HIV patients are treated with a combination of antiretroviral drugs to prevent the development of AIDS. Treatment reduces the amount of viral load in the body and bodily fluids. It can also protect the immune system from infections and cancer.

The child in remission took part in a clinical trial called Children with HIV Early Antiretroviral Therapy (CHER) along with 143 other infants. Treatment lasted for 40 weeks with the hope that the virus would reach undetectable levels and of achieving a higher volume of HIV remission in Africa. Of all HIV-affected children, 91 percent live in Africa.

While the virus can reach low enough levels to avoid detection in the blood, there is still not a cure for HIV. But doctors are learning that there is a correlation between early treatment and long-term remission.

According to the World Health Organization, poverty-stricken countries experience HIV epidemics at a much higher volume than wealthy countries. With less money, it is hard to get quality treatment, if any treatment at all. This increases the potential for epidemics by allowing transmission. Poverty is decreasing in the area, but 60 to 65 percent of wealth still lies with the wealthiest 10 percent.

South Africa spends more than $1.5 billion annually on HIV and AIDS programs to treat seven million people.

In 2013, the “Mississippi baby” was in remission for two years after early aggressive treatment. However, in 2014 the child had to restart treatment after the virus reemerged. Another child in Vancouver was in remission for 11 years following a failed six-week treatment and a six-year, four-drug treatment.

The benefits of long-term remission are obvious. Symptoms of the drugs subside and the financial burden of drugs and treatment lessen. The cases of remission are encouraging, but the widespread effects of early treatment are still unknown.

“Further study is needed to learn how to induce long-term HIV remission in infected babies,” Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, said in a news release. “However, this new case strengthens our hope that by treating HIV-infected children for a brief period beginning in infancy, we may be able to spare them the burden of life-long therapy and the health consequences of long-term immune activation typically associated with HIV disease.”

Madeline Boeding

Photo: Flickr

Cost of Giving BirthFor something as common and essential as the creation of life, delivering a child can come at quite the cost. Though the United States holds some of the steepest delivery-related costs in the world, many countries around the globe offer maternal healthcare at astronomical prices. These services cater to wealthier families and leave the poor and uninsured to struggle. In rural and low-income communities especially, the high cost of giving birth is very risky for women and newborns.

In many countries, there is a large quality gap between public and private hospitals. Even though there are public hospitals in South Africa, for example, that offer free healthcare services, these facilities often lack adequate equipment and accommodations for mothers and their newborns. One hospital outside of Johannesburg lost six infants around three years ago because it had run out of antiseptic soaps.

Private health facilities typically offer higher-quality healthcare services but at much steeper prices. On average, it costs a woman $2,000 to give birth at a private healthcare facility in South Africa. This is a cost that less than half of South Africa’s population can afford due to large income inequality problem and a widespread lack of health insurance coverage. Families instead settle for menial care or, in some cases, forgo care altogether.

As an alternative to formal care, women commonly hire traditional birth attendants (TBAs) to help with deliveries in rural areas of developing countries like Ethiopia. TBAs lack official training but are more affordable than midwives, who can cost upwards of 2,000 Ethiopian birr, about $90, or even more if a Caesarean-section is necessary. The result is a population that is underserved when it comes to delivery-side medical attention. Only 2 percent of deliveries in rural Ethiopia are administered by a health professional.

Tadelech Kesale, a 32-year-old mother from Ethiopia’s Wolayta province, has suffered due to insufficient care and the exorbitant cost of giving birth. Kesale had her first baby when she was 18 and has since lost three of her six children, one of whom was stillborn. Kesale typically earns two to three birr, equivalent to a tenth of a dollar, each week and was unable to hire a qualified professional for any of her deliveries.

“I gave birth at home with a traditional birth attendant,” Kesale said. “If I could afford it, I would go into a clinic. One of my friends, Zenebexh, died in labor – she just started bleeding after breakfast and fell down dead. A healer came but couldn’t do anything.”

The cost of giving birth in private hospitals in India is similarly prohibitive. Although government facilities hospitalize women and assist with delivery for free, many expecting mothers opt for private facilities for the higher quality of care. These facilities typically charge around $1,165 for basic delivery services $3,100 for Caesarean-section deliveries.

The costliness of Caesarean-sections and other procedures can be deterrents for poorer mothers who are faced with complications during labor or pregnancy. The Guttmacher Institute estimates that only 35 percent of women in developing countries receive the care they need when faced with complications. When such needs go unmet, both mothers and their babies face life-threatening medical risks.

The costs of transport to and from health centers can also be discouraging for expecting mothers, forcing them to deliver at home or in other unsterilized spaces. In rural areas especially, transportation is necessary to travel the long distances to health centers, though it is not always readily available. Aside from being expensive, it can also be scarce; as a result, many women deliver in their houses. When complications arise during delivery, this can be especially perilous.

Though there is no one way to remedy the astronomical cost of giving birth in countries around the globe, organizations like Oxfam are calling on the U.S. and other developed nations to send increased aid to countries with high rates of maternal and infant mortality. This aid can serve mothers and their babies in a myriad of ways, from covering basic health care costs to making it more possible for new moms to take time off from work after delivery. Ultimately, it will mitigate the steep costs many families must meet during and after pregnancy, providing mothers with the assistance they need to have safe, successful deliveries.

Sabine Poux

Photo: Flickr