Posts

Health Policy Evolution in LaosMany countries throughout Southeast Asia face increased health risks due to the propagation of COVID-19. Healthcare policy and infrastructure in Laos has been developing over the past few decades. Laos is one of the most ethnically diverse countries in the world with more than 49 ethnic groups. It includes variegated customs, beliefs and health-related behaviors. The government’s response to health issues in the past 20 years has greatly improved child mortality, maternal mortality and nutrition throughout the country. These five facts about health policy evolution in Laos are integral to understanding the country’s past infrastructure development and how it is currently responding to the COVID-19 pandemic.

5 Facts About Health Policy Evolution in Laos

  1. The National Commission for Mothers and Children (NCMC) was established as a government agency in Laos during 1999. NCMC works with local groups in Laos to proactively combat violence against women and children. The agency’s work also includes researching the current state of the healthcare system and proposing policies towards gender equality.
  2. The National Growth and Poverty Eradication Strategy (NGPES) is the foundation for national poverty reduction and healthcare sector growth. Implemented in 2004, this policy provides background for enabling growth in sectors like education, infrastructure and agriculture. As Laos continues on its course to exit the Least Developed Country status, the government focuses on solving both larger scale and local issues to eradicate poverty. Between 1997 and 2015, due in part to the NGPES, Laos’ poverty rate declined from 40% to 23%.
  3. The Laos Law on Health Care established a framework for organizing, managing and developing healthcare in Laos. The law, passed in 2005, aims to provide equitable healthcare services to all communities. The legislation also focused on developing modern healthcare services over the long-term to protect and develop the nation. Outlining both public and private healthcare services, the 2005 Law on Health Care is crucial in the country’s development. The public option only covers around 20% of the current population. However, the Ministry of Health in Laos hopes to have universal coverage by 2025.
  4. The National Nutrition Policy (2008) has the general objective of reducing malnutrition levels throughout the country. It emphasizes nutrition as a key factor of concern in the National Growth and Poverty Eradication Strategy. Though the policy targets all citizens of Laos, the policy specifically focuses on malnourished citizens and the Non-Lao Tai ethnic group. Through principles of decentralization, sustainability and nutrition surveillance, the policy has helped reduce stunting from 40% of the population in 2006 to 28% in 2020.
  5. Though the country’s healthcare system is rapidly developing, the coronavirus pandemic posed a great threat to the safety of the populace. Securing funding from the World Bank to respond to the pandemic, Laos sought to target emergency preparedness pursuits such as contact tracing and infection prevention. The country was able to declare itself free of the virus in early June 2020 after 59 days with no new cases and all remaining cases recovered. The Laos government built a strong infrastructure, consequently, even remote locations have access to it.

At all levels, governments around the world are developing policies to improve healthcare in their countries. The COVID-19 pandemic has highlighted glaring issues in healthcare infrastructure worldwide. Additionally, Laos is a prime example of a country taking concrete steps to respond to the issue.

Pratik Koppikar
Photo: Flickr

Health Care Facts about LaosLaos is a small, South Asian country that recently experienced a significant increase in its gross domestic product (GDP). Poverty in Laos plummeted from 33.5 percent to 23.2 percent allowing the country to meet the Millennium Development Goal by reducing its extreme poverty rate by half. However, there is still much work to be done. Around 80 percent of Laotians live on less than $3 a day and face a 10 percent chance of falling into poverty. Knowing that poverty and poor health care often co-exist, the government has made it a goal to strengthen its national health care system by achieving universal health coverage by 2020. Below are nine health care facts about Laos.

9 Health Care Facts About Laos

  1. The Food and Drug Department is the regulatory authority for health care in Laos. The body is responsible for regulating pharmaceuticals and medical devices. The most recent legislation the country passed is the “Law on Drugs and Medical Products No. 07/NA,” in 2012. The law provided stricter guidelines for drugs and medical products. It also creates a classification for medical devices and registration for drugs and other medical products.
  2. Between 1997 and 2015 Laos’ poverty rate declined from 40 percent to 23 percent. The improvement in life expectancy is likely due to the recent improvements of the government on health care in Laos. For example, in 2011 Laos’ National Government Assembly decided to increase the government expenditure for health from 4 percent to 9 percent, likely influencing poverty rates.
  3. Laos has separate health care programs for different income groups. The country has the State Authority for Social Security (SASS) for civil servants, the Social Security Office (SSO) for employees of the state and private companies, the Community-based Health Insurance (CBHI) for informal-sector workers and the Health Equity Funds (HEFs) for the country’s poor.
  4. Laos’ current health insurance only covers 20 percent of the population. The lack of coverage could be due to the large spread of the country’s population outside of its major urban centers. Around 80 percent of Laos’ populace live and work in rural communities. The country’s ministry of health has made efforts to provide more services to people who live outside the main urban centers by decentralizing health care into three administrative levels: the central Ministry of Health, provincial administration levels and a district-level administration.
  5. Wealthy Laotians in need of medical care travel to Thailand for treatment. Despite the increased cost of care in Thailand, Laotians travel internationally because of the better quality of care. Health care in Laos at the local levels suffers from unqualified staff and inadequate infrastructure; additionally, inadequate drug supply is a problem. Due to these issues, Laos depends on international aid. In fact, donors and grant funding finance most of the disease control, investment, training and administrative costs.
  6. Many Laotian citizens believe illness is caused by imbalances of spirit, spiritual possession and weather. Despite Laotian spirituality, knowledge of germs as the root cause of the disease is well understood. Laotian hospitals use antibiotics and other medications when they are available. However, folk medicine is often used as a treatment. For example, herbal medicines and spiritual cures include items, such as a special tree bark, which is believed to grant long life when it is prepared with rice.
  7. Many Laotians remain malnourished. Despite recent economic growth, many children under 5 are chronically malnourished; every fifth child in rural areas is severely stunted. Malnutrition is largely influenced by natural disasters. Laos has a weak infrastructure making it difficult to cope with floods, droughts and insect swarms.
  8. Local drug shops as a primary source of medicinal remedies are actually causing problems. Most of these shops are unregulated and the owners are unlicensed. Misprescription and inadequate and overdosage are common. Venders sell small packets of drugs that often include an antibiotic, vitamins and a fever suppressant. They sell these packets as single dose cures for a wide variety of illnesses.
  9. Laos has a high risk of infectious water-borne and vector-borne diseases. Common waterborne diseases include protozoal diarrhea, hepatitis A and typhoid. Vector-borne diseases include dengue fever and malaria. Typically, diarrheal disease outbreaks occur annually during the beginning of the rainy season when the water becomes contaminated by human and animal waste on hillsides. Few homes have squat-pits or water-sealed toilets, causing sanitation and health issues.

 

As it stands, health care in Laos is still underdeveloped. However, the nation’s recent economic growth provides an opportunity to remedy the problem even though a majority of the current health care system is funded by foreign sources. As with all struggles, the desired outcome will take time. With enough cooperation with other countries and non-profit organizations, Laos has a chance to create a sustainable health care system for its citizens. Increasing health education among Laotians will be one key to improving public health in Laos. This can be done through the help of nonprofit organizations and others aiding in efforts to educate countries on sanitation and health.

– Robert Forsyth
Photo: Flickr

 

Women's Empowerment in Laos

Lao People’s Democratic Republic is a country in Asia with a total area of 236,800 square kilometers. Poverty has been steadily decreasing in Laos, with a 25 percent reduction in the poverty rate since the 1990s.

With this reduction in poverty, one would expect for women to be able to enjoy the benefits of development on equal terms with men. Despite laws that are supportive of women and what appear to be objectives in place to promote women’s development, economic opportunities and participation, the reality is far different than it originally seems.

In government meetings, while there may be women present, they are mostly not participating. Instead, they are assigned menial tasks like serving tea and cookies. Even though there are some strong women making bold points occasionally, this is far from the norm in Laos. Additionally, it is more difficult for women to obtain credit. They also have more difficulty becoming managers and are usually in lower paying jobs.

Women living in remote and rural areas of Laos are the most disadvantaged, as they are often not allowed to fully participate in village activity processes. Men are usually considered the head of the household and represent their families at official meetings. Many women in Laos are illiterate and do not speak the national language used for education. This, along with the prevailing social and cultural norms, means that women are not comfortable sharing their opinions, and as a result rarely speak out.

There are many struggles faced by women-headed households due to problems such as child marriage, low secondary school attendance, the burden of agricultural and domestic work and limited access to credit. Therefore, women often have more difficulty providing for their families than men.

The situation is not all negative, however, with several programs in place to help improve women’s empowerment in Laos. The first of these is from Oxfam, supporting the Gender Development Association to involve women in income generation activities and the management of savings groups in one of Laos’ poorest areas.

The Women’s Empowerment Program in Laos has been in place for over two decades. Over the course of the program, The Asia Foundation has worked with local partners in Laos to ensure women’s ability to access their legal rights, increase their presence in leadership roles and provide greater opportunities for future generations of women and girls.

Lastly, there is the Women’s Empowerment Project in Laos, which is managed by GVI, one of the most prominent international volunteering organization in the world. The aim of the project is to contribute to sustainable, long-term women’s empowerment initiatives in Laos, with volunteers contributing to GVI Laos’ objectives such as promoting gender equality, improving equal access to education and empowering local women to achieve increased employment opportunities and self-determination. These steps will assist with women’s empowerment in Laos, breaking the cycle of poverty and inequality.

– Drew Fox

Photo: Flickr

How to Help People in LaosMore than half of the population in Laos lives below the poverty line. This is one of the highest statistics of poverty in the world. Unfortunately, a massive proportion of these individuals are children. Children living in poverty in Laos frequently do not have access to healthcare or education. This is one of the biggest humanitarian issues facing Laos, but, of course, there are also many others. Here is how to help people in Laos, especially children:

Firstly, you can donate or contribute to a variety of organizations that do work in the region. SOS Children’s Villages International is an organization that works to protect the rights of children in Laos and other countries. They focus on providing quality emotional and physical care to children who have lost their families or are not in a position to stay with their families. You can sponsor a child or a village, or make a one-time donation.

Care is another organization that works in Laos, among many other countries. Care’s goals are to cut poverty off at the root by providing substantial and sustainable change to those who are most vulnerable to poverty, hunger and disease. They also provide emergency relief when necessary. Care accepts donations.

ChildFund Australia is another organization that works to secure children’s rights and promote community development. They work in a variety of countries, including Laos. ChildFund Australia puts 78 percent of all funds towards program expenditures in the countries they work in. They accept donations and allow you to sponsor a child.

There are a lot of other nonprofit organizations that work to protect children’s rights in Laos, but these are a few of the largest. Whichever of these organizations you donate, volunteer, or contribute to, the people in Laos need all the help they can get. Now you know what to say the next time someone asks how to help people in Laos.

Liyanga De Silva

Photo: Flickr

Laos Poverty Rate
Poverty in Laos, formally known as the Lao People’s Democratic Republic, has been on the decline for the last decade. Despite improvements, the poverty rate in Laos rests at 23.2 percent, meaning that more than a fifth of the seven million Laotians must survive below the poverty line in poor living conditions.

Poverty in Laos tends to manifest itself in underdeveloped, mountainous areas. Those that live in these isolated areas are often left without access to electricity, schools and even roads. Many of the ethnic minorities in Laos live in these underserved, rural areas.

These minority groups are further isolated by barriers in language, customs and religion. This, combined with geographic isolation, contributes to a higher rate of poverty for those who live in rural communities.

In comparison to the rest of Southeast Asia, Laos has one of the highest poverty rates, behind only Myanmar. Malaysia and Vietnam both have significantly lower rates of poverty as well as some of the lowest in the region. There is even some indication that the poverty rate in Laos is declining at a slower rate than other countries in Southeast Asia.

This is not to say that all news regarding poverty in Laos is bad—there are many positive signs that indicate Laos will continue to move away from poverty as it has in the past decade. While the poverty rate in Laos is now at 23.2 percent, nearly a decade ago it was at a staggeringly high 33.5 percent. This shift is due largely in part to economic growth that is expected to continue in the future.

Laos has one of the fastest-growing economies—not only in the East Asia and Pacific region but also in the world. This growth can be attributed to the fact that Laos is home to a bounty of natural resources that include water, minerals and forests. Additionally, construction and services have expanded and contributed to an increase in tourism and foreign investment.

By capitalizing on this economic growth, much can be done to improve living conditions in this country. Focusing on educational attainment and teaching skills to workers—especially in rural areas—can have a drastic impact on the lives of many in Laos.

Jennifer Faulkner

Photo: Flickr

Water Quality in Laos
Although Laos is one of the poorest countries in Asia, it has rich natural resources. More than 85% of the land lies within the Mekong River Basin. About 80% of Laotians work in agriculture and live in rural areas. Water quality in Laos is an essential part of life and development in the country.

The usage of water in Laos is 82% agricultural, 10% industrial, and 8% domestic. Agriculture uses water for irrigation, fisheries, plantation, and livestock. There is approximately 270 billion cubic meters of available water, of which 5.7 billion is used and the remaining 264.3 billion remains in the rivers.

There is currently a hydropower boom in Laos. The country has the potential to produce 23,000 megawatts of electricity. Currently, it only utilizes 5% of that capacity. By selling electricity to neighboring countries, Laos is seeking to become the “battery” of Southeast Asia.

 

Hydropower and Water Quality in Laos

 

Hydropower, however, has had problematic effects on the water quality in Laos and neighboring countries. In 2013, villagers in Cambodia complained that dam-building on the Mekong River in Laos was ruining the water downstream. The villagers couldn’t drink the water anymore because it was muddy and full of silt.

In 2016, the Malaysian company Mega-First and the government of Laos launched the Don Sahong dam. Work began without approval from the Mekong River Commission, and in spite of protests by regional NGOs and the downstream communities in Vietnam and Cambodia. The Laotian government plans to build nine more dams on the Mekong River and hundreds more on other rivers and tributaries in the region.

Scientists contend the dams pose an environmental threat to fish migration and food security. The delta of the Mekong River already experienced significant sediment loss, and a dam will make it worse. The Mekong Delta is crucial to the Vietnamese economy, as it produces 50% of the country’s staple crops and 90% of its rice exports.

Ecology specialist Nguyen Huu Thien, a scientist based near the Mekong Delta in Vietnam, contends that “if the delta cannot support its population of 18 million, then people will have to migrate– migrate everywhere. The dams are sowing the seeds of social instability in the region.”

The condition of the Mekong River will define the socioeconomic framework of entire communities in Laos and its neighboring countries. Laos may get an economic boost from its dams for now, but in the long term, the health of Laos and its rivers are intertwined.

Hannah Seitz

Photo: Flickr


Laos is a landlocked country in Southeast Asia. The Mekong River runs through the mountainous terrain of the county and provides food, a means of transportation and hydroelectric power. Many areas of the country have poor sanitation and lack accessible healthcare. Four common diseases in Laos are Dengue Fever, respiratory infections, ischemic heart disease and diarrheal diseases.

4 Common Diseases in Laos

  1. Dengue Fever: Dengue fever is a mosquito-transmitted virus. The Aedes Aegypti mosquito transmits the disease and breeds in stagnant water, often in man-made containers. Symptoms of dengue fever are a high fever, headache, muscle and joint pain and eye pain. Around two percent of cases advance to dengue hemorrhagic fever which can be fatal. The number of dengue fever cases and deaths is increasing as a result of urbanization and lack of adequate sanitation. Dengue is the fourth leading cause of death in Laos. The government has run many campaigns to encourage people to remove standing water from their land. This eliminates the breeding areas of mosquitoes that spread the disease.
  2. Respiratory Infections: Lower respiratory infections are also very common in Laos. Influenza and pneumonia cause 13 percent of deaths in Laos. These diseases are most prevalent in June and July because of the rainy season and subtropical climate. Many people in rural Laos do not have access to vaccines. Pregnant women and children have a higher risk of dying from these illnesses. Household pollution contributes to the prevalence of these diseases in Laos. Alternative stoves and heating appliances could help reduce pollution in the home and prevalence of respiratory infections.
  3. Ischemic Heart Disease: Also known as coronary heart disease, ischemic heart disease is another of the most common diseases in Laos. The primary causes of this disease in Laos is dietary risks, high blood pressure, smoking and household air pollution. The number of ischemic heart disease cases is increasing as a result of increasingly poor diets in urban areas. The incidence of heart disease has increased by 33 percent from 1990 to 2010. There is high mortality for this disease in Laos because people do not recognize warning sign of danger or seek necessary medical care. In order to decrease the mortality of the disease, Laos needs to first increase education so that people know when to seek help. Then Laos needs more small health clinics which people can access easily when they feel symptoms.
  4. Diarrheal Diseases: A variety of diarrheal diseases is also very common in Laos. Diarrhea is most deadly in children under five and can be fatal because it causes extreme dehydration. Children can face impaired physical and cognitive development if they survive. Ingesting contaminated food or water causes children to contract this disease. Risk factors for these diseases in Laos are air pollution in the house, being underweight as a child and suboptimal breastfeeding. Research recommends education campaigns in elementary level schools; these will reach a large number of children and these kids can share what they learned with their families. In addition, mothers should breastfeed their children up to two years to improve their children’s nutrition.

The common diseases in Laos are caused by some overlapping features. Laos’ health infrastructure is very small. During the rainy season, roads become inaccessible and people become isolated in their villages without any medical attention. In addition, household pollution contributes to both respiratory infections and diarrheal diseases. Finally, education campaigns focused on transmission and early warning signs are very important.

Sarah Denning

Photo: Flickr

Hunger In Laos
Laos is a small country populated with mountains and more than 10,000 rural villages, situated on the Asian continent. It is not hard to understand why the people of Laos have a hard time with nourishment, as many of the rural villages lie in remote areas of the country that have trouble getting access to healthy food and clean water.

Hunger in Laos is a problem for the varied communities living in the country because of the threats it poses to health. While the country has worked on improving the state of malnourishment, the Global Hunger Index reports that the country has a high percentage of hungry people.

Facets of Hunger in Laos

The high level of hunger in Laos is attributed to factors like the lack of access to food sources and properly sanitized water. In fact, around one-fifth of the population of Laos consumes less than the minimum dietary requirements set by the United Nation’s Millennium Development Goals (MDG).

The U.N. reports that malnutrition in Laos illustrates the inequality in the country, especially when one takes into account the regions and groups who demonstrate the most need.

Rural communities are common in the mountainous regions, but the areas that lack road access are typically those hit hardest with hunger in Laos. Furthermore, many of these areas report children with stunted growth and insufficient weight gain, both common results from undernourished communities.

In conjunction with the U.N.’s MDGs, Laos has halved the proportion of hungry people living in the country. However, more than 11 percent of rural households still report a lack of food sources, resulting in poor consumption habits.

There is still hope. With help from the U.N., the government is steadily moving towards the goal of decreasing the percentage of people who experience hunger in Laos. In recent years, rapid economic growth and agricultural prosperity have had great effects on the population, contributing to the notable decrease in the proportion of undernourished people.

Success has been slow but is expected to increase. With help from the U.N. and programs like the National Zero Hunger Challenge, which works to end hunger, food insecurity and malnutrition, Laos can decrease the number of hungry people in the country and ensure the population is living a healthy lifestyle.

Jacqueline Nicole Artz

Photo: Flickr

Laos Refugees
Laos is one of the poorest countries in Asia and one of the last remaining communist nations. The Indochina War, which lasted for over 20 years, displaced about a quarter of the entire population resulting in major refugee migration.

Top 10 Facts about Laos Refugees:

  1. They are ethnically diverse. Laos has approximately 100 ethnic minorities. Many of these groups were cultivators who moved around regularly. They were disproportionately affected by the war.
  2. They come from the most heavily bombed country in the world. Between 1963 and 1974, the United States dropped two million tons of bombs on the Michigan-sized country. This is more than the amount dropped on Germany and Japan combined during World War II.
  3. They are the victims of a “secret war.” The conflict in Laos was the CIA’s largest paramilitary operation. It was conceived as a way of “bypassing” the Geneva Accords. The Indochina War thus set the precedent for future large-scale secret wars.
  4. Many were first relocated to Thailand. When the U.S. removed military support in May 1975, it transported thousands of refugees into Thailand. By the end of that year, more than 40,000 other refugees had also fled to Thailand.
  5. Some have been living in Thai camps for over a decade. Many have chosen to make Thailand their new home, while some are still waiting for assurance of safety to return to Laos. Others are anticipating a reunion with family members before moving on to finally resettle in another country.
  6. Some were forcibly repatriated to Laos. Thailand began instituting increasingly restrictive measures for people to claim refugee status so that many would be obliged to return to Laos.
  7. They constitute the majority of Hmong refugees in the United States. Many of the Hmong were recruited by the CIA to serve as spies against the communists. As a result, when the communists seized control, many of the Hmong were forced to flee the country for their anti-communist involvement. Approximately 90% of Hmong refugees have resettled in the United States following the Indochina War.
  8. Most speak White or Green Hmong. White Hmong is considered more proper and is the basis for Hmong writing, but it is understood by Green Hmong speakers.
  9. They are traditionally animistic. Hmong religion centers around the Txix neeb or shaman. They believe that the body is home to a number of souls.
  10. Most have resettled in California and the Midwest. Approximately 40% of Hmong refugees are living in California, while another 45% reside in either Minnesota or Wisconsin.

These 10 facts about Laos refugees are a useful starting point for learning about refugees, but every individual has a unique story. Meaningful understanding of Laos refugee problems only comes through building relationships with them.

Rebecca Yu

Photo: Flickr

Why Thailand's Measures Against POlio are Intensified
In 2014, the World Health Organisation (WHO) declared that “the spread of polio is an international public health emergency.”

The poliovirus is transmitted through contaminated food and water and it multiplies in the intestine. It can also invade the nervous system and cause spinal and respiratory paralysis in one in every 200 infections. The disease is capable of causing death within hours.

On Feb. 18, Thailand stepped up its precautionary measures against polio, when Laos, a neighboring country, declared a public health emergency as a result of the virus.

The director-general of the Department of Disease Control (DDC) stated that “though Thailand is declared free of polio, Thais are still at risk of contracting the disease particularly in provinces close to Laos.”

In these border areas, residents are required to receive polio vaccines. Acute flaccid paralysis patients and patients from Laos in border hospitals are advised to be kept under close surveillance. According to the DDC, authorities in Laos have also rolled out two measures against polio, including residents in Laos being required to receive polio vaccines one month before leaving the country and having the vaccine administered to people planning to stay in Laos for more than one month.

The main concern for the intensified measures against polio is the spread of vaccine-derived polioviruses (VDPVs) in Laos and Myanmar recently.

According to authorities, the VDPVs are “strains of the poliovirus that have genetically mutated from the strain contained in the oral polio vaccine.”

In April, Thailand and other countries are expected to simultaneously switch from using the trivalent oral polio vaccine, “which contains three poliovirus serotypes, to bivalent OPV in an effort to eradicate wild poliovirus type 2.”

Here, unlike the previous vaccine, when digested by the body, this one replicates in the intestinal tract, providing immunity from subsequent polio infections.

Polio has caused many disabilities and deaths around the world. Thailand is making great efforts to minimize the spread of this disease locally and subsequently helping save the lives of others from this deadly disease.

Vanessa Awanyo

Sources: BBC, Bangkok Post
Photo: Flickr