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Crisis in Haiti
Haiti has been engulfed in political, economic and social conflict since the assassination of former president Jovenel Moïse in July 2021. The parliament has been ineffective as it struggles to govern amidst the recent earthquake and the prominence of gang violence. The crisis in Haiti does not only include one issue but rather multiple crises at once. The three most predominant crises are gang violence, the cholera outbreak and the aftermath of a deadly earthquake in August 2021.

Gang Violence

The number of gangs in Haiti has been growing for the past five years. With around 95 gangs occupying large portions of Port-au-Prince bay, the crisis in Haiti has accelerated into deeper chaos.

Organized crime disproportionally affects vulnerable communities, especially children. UNICEF’s Regional Director for Latin America and the Caribbean has warned that women and children have become targets of gangs, stating that “more and more incidents of gang violence have involved children and women in the past few weeks and months,” referring to kidnapping, rapes and killings.

Gangs developing strong political and economic footing have only made the crisis in Haiti worse by making gangs “mercenary partners of politicians and administrators,” according to the Global Initiative Report.

Recently, gangs seized Haiti’s fuel terminal, the country’s main source of energy, which sent the country into an economic and health crisis. Many schools and hospitals have no power and small businesses have shut down completely. The Inter-American Foundation (IAF) has increased funding for 22 grassroots organizations focused on helping Haitians adapt to the various political, economic and environmental collapses. The fuel crisis has prevented more than three-quarters of hospitals from operating and the IAF has been able to supply the country with community clinics and ambulances to meet the pressing need for medical care in the midst of the cholera outbreak.

In terms of suppressing gang violence, there is disagreement on which strategy is the best. The U.N. has issued $5 million to help those that the violence affected, as humanitarians try to negotiate with the gangs. Other experts and Haitians suggest that intervention may be a more plausible step as a large portion of money meant for more diplomatic relations has been relatively ineffective.

Cholera Outbreak and Environmental Concerns

Cholera outbreak and environmental shock: “more than a quarter of all suspected cholera cases are children under 9.” Children are much more likely to contract cholera, according to the Health Ministry. Between October and December 2022, there were 13,672 cases of cholera, with 86% of hospitalizations within these cases. From 2010 to 2019, there were 820,000 cholera cases in Haiti.

U.N. agencies and Médecins Sans Frontières (MSF), along with local organizations, have distributed medicines and treatments throughout the country. They have also established some clean water centers free of cholera, while pushing for the vaccine development for Haiti, according to Human Rights Watch (HRW).

There are also environmental concerns for Haiti, as a 7.2 magnitude earthquake shook the country in August 2021, leaving around 650,000 people in desperate need of humanitarian assistance. The earthquake destroyed 70% of schools. UNICEF is continuing to provide water, food and shelter to vulnerable populations.

As violence extends outwards from the capital and inflation rises, the crisis in Haiti will require more aid and assistance to help rebuild and develop a more resilient political and economic order. Organizations within Haiti and around the world have already begun to provide relief, but more must happen to ensure vulnerable peoples are safe.

– Anna Richardson
Photo: Flickr

Gender Inequality and HIV
Gender Inequality and HIV is a significant issue in the Central African Republic (CAR). In fact, it is still the primary cause of death in the nation, with nearly 5,000 people dying from HIV/AIDS in 2020. More than 50% of the nearly 110,000 people living with HIV in CAR are not receiving treatment for it. Furthermore, gender inequality within the CAR HIV/AIDS response is ever-present. However, CAR, with the support of organizations like Doctors Without Borders and UNAIDS, is working to make health services for HIV/AIDS more accessible and create a setting where women can get the help that they need, tackling both gender inequality and HIV.

Gender Inequality and HIV in the Central African Republic

Statistics from the year 2020 indicate that 88,000 adults and children are living with HIV in CAR. Of the total number of people living with HIV in CAR, women aged 15 and older account for approximately 51,000 cases. Meanwhile, 1,200 women aged 15 and older have died from HIV.

The aforementioned statistics align with the social and economic conditions present in CAR. MICS-6 survey data from 2021 indicates that 23.6% of females between 15 and 49 years of age entered into a marriage or union before reaching the age of 15. On top of this, CAR gender-based violence information management system records also reveal 72 instances of rape and 340 instances of gender-based violence during the month of January 2021.

Female genital mutilation is also a common practice in the region, with 21% of CAR women undergoing this traditional yet harmful procedure. Deputy Special Representative of the United Nations Secretary-General in the Central African Republic Denise Brown attributes this violence against women to a combination of “protracted insecurity, violence and humanitarian crises compounded with toxic masculinities and negative social norms.”

The CAR Government Takes Action

The CAR government has conducted an assessment of gender dimensions and HIV response. The results of the assessment reveal that the female members of the population do not receive the full benefit of HIV program advances. The assessment also shows that HIV was prevalent among 15% of female sex workers. Meanwhile, less than a quarter of pregnant mothers obtain “access to prevention of mother-to-child HIV transmission services.”

Acting on these figures, the Central African Republic government has put together an intervention plan for 2021-2023 to assist marginalized women. The plan includes “biomedical and behavioral interventions to promote gender-transformative education and sensitization” to alleviate “barriers to access to HIV services by women, girls and key populations.” In addition, various strategies of care will “promote access to health, social and psychosocial services for women,” with a focus on reducing mother-to-child transmission of HIV. Furthermore, monitoring will allow for accountability regarding gender equality and HIV progress.

Médecins Sans Frontières (MSF) Assists

The CAR government is not alone in its efforts. Other organizations such as Médecins Sans Frontières, also known as Doctors Without Borders, have also stepped up efforts to help improve access to HIV services in the CAR region. Beginning in 2019 in the capital city of Bangui, this help comes in the form of MSF teams “providing free medical care and psychological support for patients” infected with advanced HIV and tuberculosis complications. The treatment serves as specialized care in an area where HIV prevalence is double the national average. Furthermore, MSF has set up community anti-retroviral (ARV) groups in various areas where designated community representatives can supply ARV drug refills. This endeavor eliminates the burden of transport expenditure on already impoverished people and “time spent in medical consultations.”

Besides providing care, MSF also helps patients care for themselves through self-management. Peer support receives encouragement. This has led to advocacy among community members. The close of 2020 has seen the establishment of “276 community ARV groups in CAR, representing some 2,300 patients.” With the efforts of the government and organizations such as MSF, CAR can make progress in both the realms of gender inequality and HIV.

– Jared Faircloth
Photo: Flickr

military robotsResearchers have recently discovered that military-designed robots have the ability to save lives. Humanitarian assistance through robots can help tackle poverty and provide support to those in need on land, air and sea. These robots are especially important in impoverished, war-ridden areas. Overall, robotic resources can help tackle crises that would otherwise be dangerous, deadly or impossible for humans to enter.

Terrestrial Robots

Terrestrial military robots, also called throwable robots, serve as life-saving engines on land. The robots work by entering confined spaces, searching through debris and disposing of bombs and hazardous waste. Throwable robots are light, easily transportable objects that are shock-resistant and often remote-controlled. The robots are designed to enter tight spaces and transmit live audio and video to users. Footage from throwable robots can help rescue teams locate people who are trapped in confined spaces and monitor their wellbeing until the civilians reach safety. Currently, more than 550 U.S. law enforcement agencies and military units use throwable robots to assist in their missions and help preserve human life.

Bomb squads also use military robots to locate, defuse, detonate and dispose of bombs. Occasionally, bomb squads deploy throwable robots before bomb disposal robots to inspect the scene and search for potential bombs. Amid war and natural disasters, terrestrial military robots can offer ample humanitarian assistance. The military robots can douse fires, enter small spaces and search through rubble without experiencing the harm of smoke, dust or extreme heat. The future of terrestrial robots is promising as recent innovations of better sensors and robust agility will elevate the technology to the next level.

Aerial Robots

Aerial military robots impact people’s quality of life in areas hit badly by natural disasters. One example illustrates drones transporting humanitarian aid and collecting data to assist in natural disaster recovery. The International Organization for Migration (IOM) started using aerial robots in 2012 to measure the extent of displacement and physical damage from natural disasters in Haiti. Furthermore, the World Health Organization and Médecins Sans Frontières have used aerial robots to deliver medical supplies to Papua New Guinea and Bhutan.

Aerial robots can also assist in search and rescue efforts in a similar way to terrestrial robots. In war and disaster zones, aerial robots can quickly locate people in need of medical assistance. Drones are often faster and more affordable than other modes of transportation. In many circumstances, drones can capture higher quality data better than humans, for instance, detailed aerial view photographs of flood zones and refugee camps. Aerial robots can also protect humans from entering dangerous situations. Alongside terrestrial robots and bomb disposal robots, drones can scope out potential explosives and identify the best strategy for removing the explosives.

Maritime Robots

Nicknamed “robotic lifeguards,” maritime military robots can save lives at sea. In 2016, a fast-swimming maritime robot named Emily saved more than 240 refugees from drowning on the coast of Greece. Maritime robots have the potential to endure extreme temperatures and are not vulnerable to exhaustion, allowing these robots the capability to become highly effective lifeguards in the future. Additionally, maritime robots are significantly faster than human swimmers. With this ability, robots can use heat sensors to quickly locate people underwater. In shipwrecks or other sea accidents, maritime robots can carry several people to shore. Maritime robots are still relatively rare, but as they become more popular, the robots can be especially effective in places like the Mediterranean Sea where refugees are frequently at risk of drowning.

Overall, robotics technology has the potential to transform disaster and crises relief efforts. Able to withstand vulnerabilities that humans cannot, these robots illustrate the increasingly important role of technology in rescue, relief and aid endeavors.

Cleo Hudson
Photo: Flickr

Malnutrition in Angolan Children
Global poverty has a detrimental effect on health, specifically the health of children. Statistically, malnutrition impacts children the most as 3.1 million children die annually from a lack of nutrition, according to the World Hunger 2018 report. In Angola, the leading cause of children’s death is malnutrition. In the World Vision report on countries struggling with malnutrition, Angola ranks as number one among countries that have the weakest commitment to fighting malnutrition in children. This goes to show that malnutrition is a critical issue among Angolan children.

The Effects of Malnutrition

Although malnutrition includes both undernutrition and overnutrition, the majority of the focus is on undernutrition as it is a significant effect of global poverty. The leader of the Intersectional Nutrition Working Group and nutrition advisor for Médecins Sans Frontières, Dr. Kirrily de Polnay, told The Borgen Project, “The reason why we often focus more on undernutrition is that less than 20% of undernutrition children receive care.”

Undernutrition in children tends to come with other direct health issues such as vitamin deficiency, wasting, growth stunting and fetal growth issues. Undernutrition can also worsen the effects of underlying health problems and diseases. This includes children with recurrent illnesses like measles, malaria, diarrhea and other chronic diseases. As a result, malnutrition creates a higher risk for already vulnerable children.

Undernourished children in Angola have a higher risk of infection, delayed development and death. These children also tend to develop non-communicable diseases in their adult lives, creating a cycle of poor health that can also result in severe malnutrition. These effects can lead to harsher consequences later in their lives. This includes a lack of productivity, which leads to little to no economic growth and causes low incomes and generational poverty.

Malnutrition and Poverty

Poverty links to the majority of malnutrition cases in children. About 40% of Angolans live below the poverty line. This, in turn, creates a high rate of malnutrition, specifically among children who are more susceptible to the consequences of extreme poverty. Malnutrition is the main cause of child death, which Angola’s high infant mortality rate of 48 per 1,000 births reflects.

One can further break the causes of malnutrition down into food insecurity, unhealthy household conditions and inadequate health care. All of these factors lead back to the overarching problem of poverty. Moreover, the potential causes of malnutrition in children are a result of both socio-economic and political factors in Angola.

Current Plans

The number of malnourished children is currently increasing, with severe or moderate acute malnutrition in Angola affecting 85,000 children in 2019. However, even though Angola struggles with child malnutrition, the country is on track with health targets linked to malnutrition. According to the Global Nutrition Report, some of the current successes include:

  • An increase in the number of infants reaching the birth weight target by 15.3%.
  • Mothers exclusively breastfeeding about 37.4% of infants (0 to 5 months), which helps provide infants with adequate nutrients.
  • An average of 4.9% of children under 5 experience wasting in comparison to the Southern African region overall.

Médecins Sans Frontières (MSF)

Organizations are helping countries like Angola with child malnutrition by directly providing care, especially during the COVID-19 pandemic. Dr. de Polnay’s work with MSF provides a great example of this direct help. MSF has 101 projects that include all continents except Australia where it treats malnourished children and also implements preventative programs. As a medical emergency organization, MSF mostly focuses on Africa because the region struggles the most with health. Dr. de Polnay says, “We run outpatient centers treating children with malnutrition and we also run inpatients in hospitals treating children with both malnutrition and other medical complications.” Direct aid is crucial in health care and can reduce the number of malnourished people globally.

UNICEF

UNICEF is one of the few organizations helping to decrease the effects of malnutrition among Angolan children. Some of UNICEF’s activities during the COVID-19 pandemic include:

  • Providing training to 445 frontline health care workers in various Angolan provinces.
  • Teaching health care workers in Angola effective ways to treat severe acute malnutrition and implementing vitamin supplementation protocols.
  • Implementing mother-led mid-upper arm circumference (MUAC) measurement protocols in Angola. MUAC measurements help improve screening and early identification of malnutrition in children and can reduce serious complications.
  • Continuously advocating for a secure energy response in Luanda within the Provisional Health Office.
  • Producing infant and young feeding pamphlets and counseling cards for both malnutrition and COVID-19 awareness to distribute among 49 health facilities across Luanda.
  • Helping more than 14,000 caregivers of young children (0-23 months) receive nutrition counseling and giving nutrition services to more than 57,000 children.

Prevention

Through help from organizations, Angola is able to increase the care necessary to circumvent the problem of malnutrition in children. However, more work is necessary to make a significant impact on the children facing malnutrition.

Dr. de Polnay recognizes the need for more action, specifically from decision-makers who should be more receptive and open to listening to organizations and people in areas of concern. Dr. de Polnay also extends this call to action to regular people, stating, “Writing about it, talking about it, making sure you are really informed about all the very different multifactorial causes of malnutrition is really important.”

When it comes to not only malnutrition among Angolan children but also all the other issues that stem from global poverty, it is important that people collectively help at all levels. whether that be through building awareness or giving direct aid.

– Zahlea Martin
Photo: Flickr

Healthcare for Greek ChildrenIn Lesbos, Greece, children suffering from life-threatening illnesses are being deprived of healthcare. Concerns regarding the Greek government’s stance on providing adequate healthcare to children suffering from chronic, complex and life-threatening diseases at the Moria camp are on the rise. Many camps are overcrowded and have limited resources available for the growing vulnerable population. Children make up 30% of asylum seekers and those diagnosed with diabetes, epilepsy, asthma, heart disease and other severe illnesses, are being neglected. Forced to live in tents under concerning conditions, children have no access to specialized healthcare to meet their medical needs.

Doctors Without Borders/Medecins Sans Frontieres (MSF)

Medecins Sans Frontieres (MSF) is advocating on behalf of Greek children, urging the government to evacuate children with serious illnesses to the Greek mainland or other European Union states that are equipped to provide adequate care. Since 1996, MSF has been providing healthcare and fighting for the welfare of asylum seekers and migrants in Greece. MSF recognized the growing need in Greece and expanded its efforts, providing treatment of chronic diseases, sexual and reproductive healthcare, physiotherapy, clinical psychology and psychiatric care.

MSF is ensuring the government is aware of the urgency of proper healthcare for Greek children. Dr. Hilde Vochten, an MSF medical coordinator, urges a prompt call of action from the government that will address the immediate healthcare needs of these children while also addressing a systemic problem within healthcare for Greek children. Without proper care, many children face lifelong consequences, or in critical cases, death.

Greek Government Healthcare Restrictions

In 2019, the Greek government restricted healthcare access to asylum seekers and those arriving in Greece that are undocumented. Since this time, MSF doctors have seen over 270 children suffering from chronic and complex diseases. The MSF pediatric clinic located outside the Moria camp has helped many children, however, the clinic has been unable to provide specialized care for children diagnosed with more critical illnesses. MSF argues that restricting access to adequate care is a result of government policy that is creating unsafe and inhumane conditions for children and their families. MSF demands the need to remove limitations for access to public healthcare and implement a system that will provide immediate care for children suffering from chronic and complex medical conditions.

The Smile of the Child

Another organization fighting for the healthcare rights of this vulnerable population is The Smile of the Child. The organization was founded in 1995, in memory of Andreas Yannopoulos, a young boy diagnosed with cancer. Before Yannopoulos died, he expressed his vision of creating an organization that would bring smiles to the faces of Greek children. The Smile of the Child has taken a stand to improve the health and wellbeing of children in Greece. The organization has raised awareness through its Mobile Laboratory of Information, Education and Technology by conducting seminars and instruction on first aid. The Smile of the Child delivers support to children with health problems by providing access to ambulances throughout Greece. The organization partners with law enforcement, social groups and other public entities to advocate for the safety and wellbeing of children.

While Greek authorities have been criticized for obstructing access to healthcare, organizations are taking a stand to ensure the healthcare needs of Greek children are met. As the need for adequate healthcare rises, the Greece government will be challenged in addressing the growing demand.

– Brandi Hale
Photo: Flickr

Trypanosomiasis in the Central African Republic
Trypanosomiasis, a parasitic infection that is transmittable to humans through bites from the tsetse fly, is an illness common only among those living in sub-Saharan Africa. People living in rural areas and those who depend on agriculture, hunting or fishing for their food are most exposed to the infection. Poverty, war and failed healthcare systems can contribute to the spread of trypanosomiasis. Proper diagnosis requires a skilled staff and early treatment can help prevent the infection from worsening. The Central African Republic (CAR) has the highest number of cases of the disease in the world. Trypanosomiasis in the Central African Republic is a pressing health issue, which demands sustained funding for treatment and medical training.

About the Infection

Also known as human African sleeping sickness, trypanosomiasis is most prevalent in the 36 sub-Saharan African countries, including the CAR. There are two types of trypanosomiasis. Depending on which parasite causes the disease, an infected individual could have Trypanosoma brucei rhodesiense or Trypanosoma brucei gambiense (the more common of the two). If an individual becomes sick with the latter, symptoms can go unnoticed for months or years before the infection begins to affect their central nervous system. Symptoms include fever, headaches, confusion, poor coordination and irregular sleep patterns. Transmission of trypanosomiasis can occur from mother to child, a tsetse fly bite or sexual contact with an infected person.

If trypanosomiasis goes untreated, an individual can experience worsening symptoms and can eventually enter a coma — hence the infection’s nickname (sleeping sickness). People in the CAR are especially susceptible to contracting the disease from doing agricultural work. Much of the population of the CAR lives in rural areas, depending heavily on subsistence farming to survive. More than 55% of the nation’s GDP stems from agriculture and 80% of the workforce is in the farming industry. Since citizens are dependent on farming and hunting for their food, they are at a higher risk of exposure to the tsetse fly and thus, have an increased rate of contracting trypanosomiasis.

Treating Trypanosomiasis

Infected individuals’ symptoms often go unnoticed or untreated. The CAR’s political climate, high poverty rate and lack of proper healthcare centers all facilitate the spreading and worsening of the infection. As of 2018, more than 71% of the population lived below the world’s poverty level, meaning that medical staff and treatment were inaccessible to most citizens living with trypanosomiasis in the Central African Republic. The country is also recovering from the violence of late 2013, which left many hospitals and offices ransacked or closed. Due to these various factors, citizens suffering from trypanosomiasis in the Central African Republic have few options for testing and medication.

There is one well-known medication that can treat the disease, called nifurtimox-eflornithine combination therapy (NECT). Though NECT can significantly help patients with trypanosomiasis, the treatment includes multiple injections and close monitoring of the symptoms — both of which are usually unavailable or difficult to follow through to completion.

The Good News

However, with combined efforts from the government and other organizations, more patients suffering from the illness are receiving treatment. With help from the World Health Organization (WHO), CAR’s government is monitoring the cases and number of deaths from trypanosomiasis and working to provide more clinics, healthcare professionals and medication. The WHO and CAR’s health sectors aim to eliminate transmission of the disease by 2030. With only 997 cases and 164 deaths reported in 2018 (the lowest number in the 80-year battle with the disease), the CAR is on track to reach this goal partially due to consistent outside aid.

One notable international organization, Médecins San Frontières, mobilizes doctors and nurses throughout the CAR to provide free diagnoses and medication for those who have trypanosomiasis. Citizens are made aware of the free medical care and the organization can screen thousands of patients.

Over the next few years, help from organizations like the WHO and Médecins San Frontières can lead to adequate testing and medication for citizens with trypanosomiasis in the Central African Republic. It is imperative that organizations and countries in a position to help — contribute trained medical staff, funding and medicine to aid in the CAR’s fight against trypanosomiasis.

Danielle Kuzel
Photo: Flickr

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

5 Mental Health Effects of the Yazidi Genocide
In the past few years, the Yazidi populations of northern Iraq and northern Syria have faced forced migration, war, the enslavement of women and girls and genocide. These traumatic events have resulted in several, severe psychological problems among Yazidis. A lack of adequate treatment and a prolonged sense of threat compounds the five mental health effects of the Yazidi genocide.

The Yazidis, a Kurdish religious minority, practice a non-Abrahamic, monotheistic religion called Yazidism. When the so-called Islamic State declared a caliphate in Iraq and Syria, it specifically targeted the Yazidis as non-Arab, non-Sunni Muslims. ISIS has committed atrocities against the Yazidis to the level of genocide, according to the United Nations Human Rights Council (UNHRC); these crimes included the enslavement of women and girls, torture and mass killings. This violence caused many Yazidis to suffer from severe mental health disorders.

5 Mental Health Effects of the Yazidi Genocide

  1. Disturbed Sleep: According to a study by Neuropsychiatrie, 71.1 percent of Yazidi refugee children and adolescents have reported difficulty sleeping due to the trauma they have experienced. These sleeping problems include trouble falling asleep, trouble staying asleep and nightmares. Children are afraid that if they fall asleep they will not wake up again. Importantly, disturbed sleep will worsen other problems, such as anxiety.
  2. Post Traumatic Stress Disorder: PTSD is one common mental illness that the Yazidi genocide caused. According to the European Journal of Psychotraumatology, 42.9 percent of those studied met the criteria for a PTSD diagnosis. Women and men experienced traumatic stress differently. Women with PTSD were more likely to show symptoms such as “flashbacks, hypervigilance, and intense psychological distress.” Men with PTSD more frequently expressed “feelings of detachment or estrangement from others.” Additionally, more women than men reported having PTSD. According to a study that BMC Medicine conducted, 80 percent of Yazidi women and girls who ISIS forced into sex slavery had PTSD.
  3. (Perceived) Social Rejection: Perpetrators of genocide have often employed systematic sexual violence against women to traumatize the persecuted population. In addition to the devastating injuries women experience, they also suffer from several psychological disorders, including PTSD, anxiety, depression and social rejection. Families and communities frequently reject survivors; Yazidi women who suffered enslavement perceive social rejection and exclusion from their communities at high rates. For instance, 40 percent of Yazidi women that BMC interviewed avoid social situations for fear of stigmatization, and 44.6 percent of women feel “extremely excluded” by their community. Social support is a crucial way to alleviate some of the pain from sexual violence and enslavement since rejection from their community magnifies the likelihood that girls will experience depression. Thus, social support, such as community activities organized by schools, can help by decreasing the factors that worsen psychological disorders like depression and by increasing the rate at which girls report instances of sexual violence.
  4. Depression: The Neuropsychiatrie researchers also found that one-third of the children they studied had a depressive disorder. In another study by Tekin et al., researchers found that 40 percent of Yazidi refugees in Turkey suffered from severe depression. Similarly, a 2018 Médecins Sans Frontières (MSF/Doctors without Borders) study in Sinuni found that every family surveyed had at least one member who suffered from a mental illness. The most common problem was depression. As a response to the growing mental health problems among Yazidis, MSF has been providing emergency and maternity services to people at the Sinuni General Hospital since December 2018. MSF has set up mobile mental health clinics for those displaced on Sinjar mountain and provides services such as group sessions for patients. In 2019, MSF health care officials conducted 9,770 emergency room consultations, declared 6,390 people in need of further treatment in the inpatient wards and have helped 475 pregnant women give birth safely. While MSF has increased its health care activities in the region, there are still people on the waiting list to receive treatment.
  5. Suicide: Since the ISIS takeover of the Sinjar region of Northern Iraq, the Yazidis’ historical homeland, the incidents of suicide and suicide attempts among Yazidis have increased substantially according to Médecins Sans Frontières. The methods of suicide or attempted suicide include drinking poison, hanging oneself and drug overdose. Many Yazidis, particularly women, have set themselves on fire. To alleviate this uptick in suicide and other negative mental health effects, MSF increased its presence in the area and offered psychiatric and psychological health care. Since the start of this initiative in late 2018, MSF has treated 286 people, 200 of whom still receive treatment today.

In the aftermath of ISIS’ genocide against the Yazidis of northern Iraq and northern Syria, many survivors have experienced mental health problems stemming from the trauma. These genocidal atrocities will have long-term psychological effects on the Yazidis, but such issues can be mitigated by psychological care. The five mental health effects of the Yazidi genocide outlined above prove the necessity of such health care for populations that have endured genocide and extreme violence.

– Sarah Frazer
Photo: Flickr

 

The Battle Against Monkeypox
Monkeypox is a viral zoonotic disease, meaning that animals transfer it to humans. Infected animals, usually small rodents, transmit the disease through bodily fluids. Sometimes, however, the disease can transmit through human-to-human contact via bodily fluids, but this is less common. Symptoms include body aches and pains, and fever as well as a bumpy, localized rash. Monkeypox is similar to smallpox, a related infection that people have eradicated worldwide. Yet the battle against monkeypox continues. According to the World Health Organization, the Democratic Republic of the Congo (DRC) saw over 5,000 monkeypox cases in 2019, including 103 fatalities. In addition, most deaths occurred among younger age groups.

History

People first discovered the virus in 1958 when two outbreaks occurred in colonies of monkeys that they used for research, hence the name. The first human cases were in the DRC in 1970. The disease mainly impacts the country’s rural areas and rainforests, where many consider it endemic. In 2017, Nigeria also experienced one of the worst monkeypox epidemics following 40 years of no confirmed cases in the country.

While the virus has largely concentrated in Africa, there have been documentations of cases of monkeypox outside of Africa in recent years. Usually, these cases involved people who visited Africa and returned home harboring the infection. In 2003, the first monkeypox outbreak outside of Africa occurred in the United States. In the past two years, there have been cases in Singapore, the United Kingdom and Israel.

Treatment

Monkeypox and smallpox share many similarities and both have classifications under the genus orthopoxvirus. Currently, a recommended treatment for monkeypox entails the use of antibiotics and there has been an 85 percent success rate using the smallpox vaccine. A new third-generation vaccine received approval in 2019 for the prevention of both smallpox and monkeypox while scientists continue to develop additional antiviral agents.

Medecins Sans Frontieres (MSF), an NGO established in 1971, has been on the frontlines battling monkeypox. MSF, which translates to Doctors Without Borders, provides medical assistance to people affected by outbreaks, epidemics and disasters. In October 2018, an emergency team dispatched to a village in the Central African Republic after a monkeypox outbreak there infected about a dozen children. The group set up a quarantine, treating the children while administering vaccinations to others.

World Response

A number of world health organizations have come together in the battle against monkeypox. After the 2017 Nigeria outbreak, the Nigerian Centre for Disease Control sought to unite West Africa’s response to the disease. The NCDC also teamed up with organizations such as the World Health Organization, the Centers for Disease Control and Prevention in the United States and the Africa Centres for Disease Control and Prevention to better observe and document the disease.

Monkeypox prevention includes raising awareness, avoiding potentially infected animals and practicing good hygiene. Several countries have also put forth restrictions on animal trade to stop the spread of the disease across Africa and to other parts of the world. These steps, as well as additional preventative measures and research, will be key to the battle against monkeypox and the prevention of future outbreaks.

Taylor Pittman
Photo: Flickr

Ebola in the Democratic Republic of the Congo

In August of 2018 the Democratic Republic of Congo declared an Ebola outbreak. The first case of the virus erupted in the city of Goma, located on the border of Rwanda. As the tenth Ebola outbreak in Congo within 40 years, the virus became a public health concern for the over 1 million people that call Goma home. Goma also acts as a popular transit hub for many people crossing the border into Rwanda putting the population at a heightened risk for the disease to spread. The International Health Regulations Emergency Committee has met four times following this initial Ebola case.

  1. A Widespread Disease: Congo’s ongoing Ebola outbreak is now the world’s second-largest. According to The World Health Organization (WHO), the virus has infected 2,512 people and killed 1,676. The largest Ebola outbreak on record took place in West Africa killing more than 11,300 people. WHO continues its efforts to stop the spread of the disease in Congo with its team of medical specialists. In the worst cases, death and uncontrollable bleeding have resulted from the viral hemorrhagic fevers of the disease.
  2. A Global Issue: On July 17, 2019 the World Health Organization (WHO) declared the Ebola outbreak in Congo a global health emergency. Following the first case of Ebola, intensive training for the prevention and control of the virus heightened for more than six months. News of a female traveller from Beni that contracted the virus, and then visited Uganda sparked growing concern in Uganda and Congo. Between June and July of 2019 an estimated 245 confirmed cases of Ebola were reported in the North Kivu and Ituri provinces of Congo. WHO makes the continuous effort to monitor the cases of those infected, as well as travel and trade measures in relation to the virus.
  3. Dangerous Territory: The Ebola response teams in the Democratic Republic of Congo face violent attacks. David Gressley, the United Nations’ secretary-general, became the deputy of the U.N. missions in Congo and witnessed it firsthand. Gressley requested a force of peacekeepers along with the health officials to assist him amid the attacks. The violent attacks often hinder the Ebola responders from treating people with the virus, and still no one knows the reasoning or people behind the attacks. The U.N. estimates that due to the attacks about 1,200 have been shot or slashed to death with machetes. One popular theory points to Congolese politicians orchestrating the attacks in order to undermine political rivals. On the other hand, the Congolese government blames the Mai Mai militia. Rumors continue to swirl that the U.N. responders fail to treat Ebola patients, and intentionally spread the virus which makes them even more susceptible to these attacks.
  4. Catching Ebola: Common diseases such as measles and malaria share initial symptoms of Ebola. Many medical specialists in Congo believe that to put a stop to this epidemic they first must isolate the disease. Most Ebola patients receive a diagnosis too late, and go through multiple health facilities before getting treatment. Response teams understand that controlling the transmission of Ebola, and catching the disease in its early stages has the potential to save an entire community.
  5. The Ebola Vaccination: More than 111,000 people have received the Ebola vaccination. Developed by Canadian scientists, the Ebola vaccine (also known as the rVSV-ZEBOV vaccine) consists of an animal virus that can wear a non-lethal Ebola virus protein, which results in the human immune system developing a pre-emotive defense to the disease. Health care professionals, and family members of Ebola patients are the majority of those vaccinated. Health care responders in Congo ensure that all the contacts of Ebola patients receive a vaccine to stop the epidemic. Reports show no deaths from individuals that developed Ebola symptoms more than 10 days after receiving the vaccination.
  6. Promoting a Disease-Free Environment: Medecins Sans Frontieres/Doctors Without Borders (MSF) promotes healthcare and community engagement in Congo. This organization sends teams to determine and assist the medical needs of populations in crisis with exclusion from healthcare. Among the Ebola outbreak in Congo, MSF continues to provide free healthcare for non-Ebola needs, such as malaria and urinary tract infections. First starting in the city Goma, the MSF has now shifted aid to the Ituri province to limit infections with sanitation activities, and provide access to clean water.

These six facts about the Ebola outbreak in Congo demonstrate global organization’s enthusiasm to assemble in times of crisis. Countless organizations continue to lend support to the Democratic Republic of Congo, and in due time the country will be at its best with a healthy population.

– Nia Coleman
Photo: Flickr