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Rural-Urban Migration and the Developing World

Rural-urban migrationWhen thinking of rural-urban migration, experts tend to focus on the positive aspects for migrants. New economic opportunities, access to public services and greater social tolerance define the experience of newly-urban migrants in the conversation around rural-urban migration. When discussing flaws, the conversation gravitates toward the slum conditions and informal labor in large developing-world cities. However, the developing world’s rapid amount of rural to urban migration leaves many villages with less human capital and resources. What does this rural-urban migration mean for the rural developing world?

Urban Transition

Rural-urban migration has swept the developing world since the late 20th century. This transformation, known as “urban transition,” brings the economies of countries from rural-driven to urban-driven. Seeing this trend, many countries have supported larger development projects in urban areas, looking to get ahead of the curb. While an admirable strategy, it leaves out the rural populations who tend to be more isolated. This creates a vicious cycle, where people move where the government invests, and the government invests where people move.

This lack of investment creates a problem for rural areas. Unable to increase productivity and suffering from a lack of investment, impoverished rural areas are stuck in a loop, using the same basic techniques for subsistence farming utilized in the 20th century. Rural families have many children, hoping some will move to the city to send back money and some will work on their local subsistence farm. By sending the educated children to the city, families create a gap in living standards, with those with opportunity leaving while those without stay behind.

Migration in Trade for Remittances

However, this rural-urban migration also brings benefits to the rural areas. Many families send their young adult children into the cities, investing in their future in the city. Remittances, money sent back by those moving to urban areas, keep rural finances diverse and pay for many essential services for rural people. Without this income source, rural families would be completely dependent on the whims of nature, with no sense of security that a separate income gives. Studies show that these remittances increase life expectancy and happiness, two factors increased with security.

How to Help Rural Areas

One of the rural areas’ biggest difficulties is low productivity which hinders economic growth. Many Africans living in rural areas are subsistence farmers, meeting their own food needs but creating little surplus which drives economic growth. For this reason, young people commonly move to higher productivity urban areas. To prime rural areas for development, scholars have identified several factors which developing-world governments should attack. For instance, poor rural infrastructure, illiteracy and low social interaction all hinder rural growth, which drives rural-urban migration.

By attacking these problems, governments can increase rural development, attack poverty at its heart and protect rural communities in the long run. Severe “brain drain,” where educated people move to more productive areas, especially impacts rural communities. Lowering populations will lead to less monetary and representative allotments, decreasing the voice of rural residents. Additionally, men make up the majority of rural-urban migrants, leaving women in a vulnerable position both in caring for children and running subsistence farms.

Rural development projects which take into account community leaders at all levels of planning and execution can greatly increase their effectiveness. Improving the governance of these projects, especially reducing corruption, is essential in assuring rural development. The integration of system-wide rural development projects serves as an opportunity to increase rural development. Currently, thousands of NGOs operate rurally around Africa, with many separate governmental programs overlapping. By increasing cooperation, systematic development of rural areas can occur rather than a patchwork of unrelated development projects.

– Justin Morgan
Photo: Flickr

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Addressing Child Poverty in Greece

Child poverty in Greece
Child poverty in Greece is a prominent issue. About 40% of children under the age of 17 are at risk. According to Eurostat, Greece ranks at the top of the child poverty scale. Furthermore, Greece’s poverty rate is the third-highest within the European Union. This article will explore the state of child poverty in Greece and efforts to address it.

Education

The economic crisis in Greece is one of many reasons for the rising child poverty rate. Access to education has decreased as well. As a result, many children are unable to attend school and unemployment rates have skyrocketed.

State education is free until university in Greece and education is compulsory between the ages of 6 and 15. In spite of this, approximately 11.4% of students dropped out of school in 2010. Moreover, an average of 30,000 students never enter high school. The highest high school dropout rate is in the Dodecanese islands and Rhodope.

Child Abuse

Giorgio Nikolaidis is a child psychiatrist and head of the Mental Health Department of the Institute of Child Health. He stated that inadequate child protection services were further undercut long before the economic crisis. Authorities are often aware of domestic, sexual abuse against children; however, they do not take the correct measures to protect children.

“I have seen cases where four-year-old kids were treated for sexually transmitted rectal HPV for over a year and no investigation had been undertaken to determine how they got it,” Nikolaidis said. The reality is that there is no coherent system to effectively protect victims.

The Greek constitution prohibits forced labor, but the minimum age for work is as low as 12 for people working in a family business. Thus, families often send their children to the streets to beg for money. Although Greece ratified the Worst Forms of Child Labor Convention, these activities remain unpunishable by law. Children who spend more time on the streets are also at an increased risk of child trafficking.

Together for Children

Together for Children is an NGO that provides assistance to young people and their families. The organization is comprised of nine member organizations that work in child welfare. Its mission is to provide immediate support for children, families and individuals with disabilities.

The organization established a child helpline that provides free counseling services and emotional support for children and their families. Together for Children strives to tackle child poverty in Greece and create sustainable living conditions. Additionally, the organization ensures access to free education through various programs such as a nursery school for children with cerebral palsy, a development playgroup for children with cerebral palsy and other disabilities, a special primary school for children with cerebral palsy and productive workshops for adults with cerebral palsy. Together for Children also has activities and programs to support unaccompanied minors who are refugees.

Assisting more than 30,000 children every year, Together for Children has received the Silver Medal of the Academy of Athens for its social contribution. In 2019, it also received a BRAVO Award for engaging with thousands of citizens in support of its initiative: Equal Opportunities for Children: Actions for Health and Education in Remote Areas of Greece.

Looking Forward

Organizations like Together for Children help create a better society for children to flourish. It focuses on improving the health and well-being of impoverished children, creating opportunities for quality education and supporting refugees. This organization has taken great strides in alleviating child poverty in Greece.

Poverty in Greece remains high due to the lack of education, child abuse and labor exploitation. Sexual and labor exploitation impoverishes children mentally and physically. Although the Greek financial crisis is often blamed for inadequate social services, there is much more that the country should be doing to protect children. Moving foward, it is essential that the government and other humanitarian organizations prioritize addressing child poverty in Greece.

– Marielle Marlys
Photo: Flickr

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Human Trafficking in Afghanistan 

Human Trafficking in Afghanistan Afghanistan currently faces a large-scale human trafficking crisis that is rooted in centuries of abuse. Children and women are sold or kidnapped and forced into sexual slavery or armed forces. With the Afghani Government failing to properly protect victims and prosecute perpetrators, the U.S. Department of State and a network of NGOs are working to alleviate the problem.

The Systemic Issues

One of the major issues contributing to the human trafficking crisis within Afghanistan is the continued practice of bacha bazi, or “dancing boys”, in which sexual abuse against children is performed by adult men. Although technically illegal, the centuries-old custom has been proven hard to get rid of, with many government and security officials being complicit with its continuation.

The U.S. Department of State has declared Afghanistan Tier 3, the highest threat level, meaning that it does not meet the minimum requirements for combatting human trafficking and is not making a significant effort to do so.

This has a significant impact on Afghanistan because according to the Trafficking Victims Protection Act, the United States will not provide nonhumanitarian, nontrade-related foreign assistance to a country that is ranked on Tier 3. According to the June 2020 Trafficking in Persons Report, the use of child soldiers and bacha bazi has continued. Although there have been investigations and arrests made in an attempt to end bacha bazi, no police officers involved were prosecuted.

Addressing Human Trafficking in Afghanistan

The Afghani Government has shown efforts to end human trafficking within its borders. In 2019, it joined the United Nations Office on Drugs and Crime (UNODC) on a global initiative to stop human trafficking. This initiative aims to allocate resources to countries in the Middle East and Asia that need assistance in the battle against human trafficking.

USAID reported that in 2019,  Afghanistan increased the number of Child Protection Units within national police precincts, preventing the recruitment of 357 child soldiers. Furthermore, the National Child Protection Committee (NCPC) was created to respond to the practice of bacha bazi.

USAID has worked to assist the Afghani by training government officials to prosecute human traffickers and abusers as well as giving assistance to shelter workers that give legal and social resources to victims. It assisted in the creation of the Afghanistan Network in Combating Trafficking in Persons (ANCTIP), a network of Afghan NGOs that work with victims of human trafficking.

NGOs within the country have provided most of the assistance to victims of human trafficking. Approximately 27 women’s shelters in 20 provinces provided protection and care for female victims of trafficking. NGOs also operated two shelters for male victims under the age of 18.

Eradicating Human Trafficking

In order for Afghanistan to efficiently combat its human trafficking crisis and move to a lower tier level, Afghanistan needs to increase criminal investigations and prosecutions of suspected traffickers, especially in law enforcement and the military. Furthermore, traffickers must be convicted and adequately sentenced. This can be done by increasing the influence and powers of the NCPC and allowing the committee to remove public servants found practicing bacha bazi. Additional support from the country’s government must also be given to survivors of human trafficking. Only by rooting out the systemic abuse within the top institutions of the country can Afghanistan effectively address its human trafficking crisis.

– Christopher McLean
Photo: Flickr

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A Model Healthcare Alliance in Rural Guatemala


Agribusinesses in Trifinio, Guatemala renovated cattle and pasture lands into crops for exports which dramatically changed the area. The transformation drove approximately 25,000 people into this remote area in the southwest rural region of Guatemala and employed thousands of people who sought an opportunity in this growing business. The University of Colorado created a healthcare alliance to provide quality medical treatments in the now booming community.

Trifinio, Guatemala

Few people know about Trifinio, Guatemala even though it is a major producer for AgroAmerica’s Chiquita bananas. The town is made up of small concrete houses and only a few paved roads. Most homes are single-room units. When it comes to cultural development, the town’s only form of entertainment is a local bar.

This small and highly impoverished community suffers from the reality of poor health care access. With its nearest hospital one hour away in the town of Coatepeque Guatemala, the residents of this area face the challenges of malnutrition, high infant mortality rates, and a range of infectious diseases. More than 46% of children have intestinal parasites, 38.7% of children have anemia and one-third of women are affected by pregnancy complications. The numbers could not say it clearly enough; this community needed help. Fortunately, AgroAmerica teamed up with the University of Colorado to find a solution.

University of Colorado partners with AgroAmerica

In 2011 Fernando and Gustavo Bolaños, brothers and CEOs and COOs of AgroAmerica, became frustrated by the lack of health care access in their community. With Guatemala’s history of little investment in healthcare, they found themselves unable to ask the public sector for help. Gustavo Bolaños himself addressed this issue in an interview where he claimed, “In Guatemala, we have a lot of inequality and poverty, the government hasn’t been able to really cover the basic needs of the population. We as a private company, see all the needs of our people, and the biggest problem we are facing is education and health”. Therefore, rather than going to the government, they turned to the University of Colorado’s Global Health Center.

With an investment of 1 million U.S. dollars, the Bolaños made a healthcare alliance with the Colorado School of Public Health. Their goal was to build a medical center on their banana plantation. Three years later, the Bolaños proudly stood before the new medical facility. It houses a clinic, laboratory and conference space. The Trifinio Center for Human Development serves around 4,500 plantation workers, along with the 24,000 residents of the neighboring villages, and is “staffed by CU doctors, nurses, midwives, students and other health professionals rotating through Guatemala”.

The Last Six Years

Before Trifinio’s Center for Human Development (CHD) a visit to a health professional cost people in this community at least $25 USD. This did not include transportation fees and the loss of a day’s wages. With the medical facility, that cost has dropped to less than $5 USD. Families now have access to health resources without a geographical and economic barrier. The clinic is committed to decreasing neonatal morbidity, childhood mortality and increasing safe delivery practices and childhood growth and development. Along with these medical goals, the center hopes to impact the health education and social realities of its community.

In 2017, the CHD began a youth leadership program run by participating high-school students from the area. This initiative provided an opportunity for future leaders to learn about community organizing and advocacy that could improve human development. The program not just helps the community, but “students selected for this program receive a scholarship to cover their school fees,” promoting access for educational attainment.

Along with the youth program, the center provides sexual health education to neighboring schools in the area. For mothers, it has a maternal and child health program. This provides quality prenatal care and gives families a direct line for medical professionals to track both the mother’s and child’s health.

The center also conducts research to serve the needs of the community and bring new knowledge to the rest of the world. Their Student Health Survey, taken in late June and early July of 2019 “enrolled 1,414 participants from 15 Trifinio middle and high schools” to better understand the health and social realities of these children, and hopefully address the needs that are found.

The Future

In 2013 Stephen Berman, the director of the Center for Global Health at the University of Colorado said, “The solutions we develop through this program may someday be replicated in communities all over the world”. The program has had measurable benefits for its community, which is a good reason for its replication in other regions. Health care accessibility is not an easy system. But we saw major success through the healthcare alliance of a privately run company and a public institution. There are possibilities for new solutions to address the needs of those most vulnerable.

Ana Paola Asturias
Photo: Flickr

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5 Canadian Organizations for Indigenous Prosperity

Indigenous communities in Canada

The Canadian Constitution recognizes three Indigenous communities — First Nations, Métis, and Inuit. Here are five of the many Indigenous-led organizations in Canada, collectively working to create success and prosperity for Indigenous communities.

5 Canadian Organizations for Indigenous Prosperity

  1. First Nations Information Governance Centre – The First Nations Information Governance Centre (FNIGC) is working to achieve data sovereignty. With support from regional partners and a special mandate from the Assembly of First Nations’ Chiefs in Assembly (Resolution #48, December 2009), the FNIGC collects and uses data to “build culturally relevant portraits of the lives of First Nations people and the communities they live in.” Their motto, “our data, our stories, our future” reflects their vision of Indigenous stories being told by Indigenous people, for Indigenous people.
  2. Indspire – Indspire is using the gift of learning to help provide academic success and long-term prosperity with support through financial aid, scholarships/bursaries, awards, mentoring and physical resources.
  3. Aboriginal Financial Officers Association of Canada – Aboriginal Financial Officers Association of Canada (AFOA) is creating a community of Indigenous professionals by supporting successful self-determination through “improving the management skills of those responsible for the stewardship of Indigenous resources.” This includes aid in management, finance and governance.
  4. Reconciliation Canada – Reconciliation Canada facilitates the engagement of Indigenous and non-Indigenous people with meaningful conversations on reconciliation and the lived experiences of Indigenous people. They aim to inspire positive change and understanding. At present, the programs and initiatives offered by the charity are Reconciliation in Action: A National Engagement Strategy, Reconciliation Dialogue Workshops, interactive community outreach activities and Reconciliation Canada.
  5. First Nations Child and Family Caring Society – The Caring Society supports First Nations children, youth and families. The organization has been able to provide 250,000 services and products to Indigenous children by putting Indigenous children and families first.

These five organizations are just some of many who are working to support success and prosperity for Indigenous communities in Canada. Their work helps blaze a path for a brighter future for Indigenous people and the country alike.

– Jasmeen Bassi
Photo: Flickr

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The Czech Republic: Drought and COVID-19

The Czech Republic is a Parliamentary Republic bordering Germany, Poland, Austria and Slovakia. The country was founded on January 1, 1993, following a political revolution, and peacefully splitting from the former Czechoslovakia. In 2020, the Czech Republic ranked as the eighth safest country in the world. The country also reports a 2.4% unemployment rate and healthy GDP growth over the past five years. The latest Eurostat data also shows that the Czech Poverty rate is 3.4%, the second-lowest rate in the EU. However, the well-being of the Czech Republic’s citizens may decline as a threatening drought continues to plague the country and coincide with the COVID-19 pandemic.

Poverty & Hunger in the Czech Republic

In a 2017 study, the Czech Republic Hunger Statistic was 2.5%. This means that 2.5% of the population’s food intake was insufficient to meet basic dietary requirements. Meanwhile, the World Hunger Statistic is around 11%.

Despite the Czech Republic’s success in the fight against poverty, the country has some areas of weakness. For example, the Czech Republic’s wage gap is larger than other European countries. Women tend to earn about 22% less than men. As a result, a disproportionate number of women, especially single mothers, fall below the poverty line.

Additionally, the Czech Republic’s relatively low poverty rate of 3.4% is somewhat misleading. The poverty rate considers the standard of living within the Czech Republic. Sociologist Daniel Prokop uses Luxembourg to exemplify why this can be misleading: “the median [income] in Luxembourg is twice as high as in the Czech Republic. Therefore, the poverty line is twice as high, making it easier for low-income workers to fall below it.” So, countries with higher median incomes have a higher standard of living. Since the Czech Republic has a lower relative poverty threshold, an impoverished citizen in Luxembourg may not be considered impoverished in the Czech Republic.

Working Through a Long-term Drought

The Czech Republic is experiencing the most threatening drought in 500 years. The drought began in 2018, and it escalated to a climate crisis in April 2020- right in the start of the COVID-19 pandemic. There is a fear that the continuation of the drought in the Czech Republic will cause mass famine.

Scientists are using an ESA satellite to monitor the drought and soil conditions, keeping the country’s agribusiness sector stable. Well-organized agricultural systems are preventing major catastrophe in the present. Yet, crop yields are expected to continue shrinking in the upcoming months. The biggest concern, however, is the impending water shortage. The Ministry of Environment in the Czech Republic has implemented over 15,000 projects across the country to build pipelines for drinking water, preserving dams and reservoirs and much more.

COVID-19 Impacts

Thankfully, the Czech Republic has handled COVID-19 wisely from the start. They were the first country in Europe to issue a mask mandate, sending the notice on March 19, 2020. So far, there are no significant deviations from normal malnutrition and poverty rates due to the pandemic. Despite a couple of recent clusters in the eastern parts of the country, heavily populated cities such as Prague (population: 1.3 million) are seeing consistently low infection rates as of late July. Many citizens’ lives have returned to normalcy, with schools and buildings re-opening and commerce flourishing.

Tomorrow’s Outlook

Organizations ranging from small local projects to large NGOs are working to combat poverty and hunger in the Czech Republic as the drought and COVID-19 continue. For example, the Prague Changemakers organizes volunteering projects by recruiting local citizens. Together, they cook and distribute food to the local homeless population.  Additionally, Naděje is an example of a larger NGO. Naděje was founded in the 1990s following the revolution and their organization’s goal is to serve the homeless. Naděje began by serving food in railway stations. Soon, the NGO expanded to building homes and shelters across the country. For their first major project, Naděje established day centers for the homeless to get food, creating two hostels for men and one for women.

Ultimately, responsible governmental action and the work of NGOs like Naděje have provided stability to the Czech Republic in an uncertain time. Hopefully, their work in the Czech Republic will continue to keep COVID-19 and the drought under control. It seems other countries should take notes as unemployment, hunger, and poverty rates remain relatively low in the Czech Republic.

– Ruhi Mukherjee
Photo: Flickr

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8 Facts About Depression and Mental Health in South Asia

Mental Health in South Asia
South Asia, a group of nine countries including India, Pakistan and Nepal, is home to more than 1.8 billion people. Of this population, between 150 and 200 million people suffer from mental illness. However, the severity of depression and mental health is often overlooked throughout the region, leaving millions without treatment and support. Here are eight quintessential facts about depression and mental health in South Asia and how the conditions are currently being addressed.

8 Facts About Depression and Mental Health in South Asia

  1. Depression affects 86 million people in Southeast Asia. The World Health Organization estimates that almost one-third of people suffering from depression worldwide live in South Asia, making the region home to a large majority of the world’s depressed.
  2. Mental illness is taboo in many South Asian communities. Professor Dinesh Bhugra, a mental health expert at London’s King’s College, states that the South Asian population carries “a bigger notion of shame” with them than other ethnic populations. South Asian religious and cultural influences often do not consider mental health a medical issue, referring to it as a “superstitious belief.” A 2010 study by the campaign Time to Change found that South Asians rarely discuss mental health because of the risk the subject poses to their reputation and status. Discussing mental health in South Asia has yet to be socially normalized.
  3. South Asian languages do not have a word for depression. Many South Asians are unable to express the specific condition of depression in their language. As a result, they often have to resort to downplaying it as part of “life’s ups and downs.” This language limitation also makes diagnoses and treatment difficult.
  4. Depression is a major contributor to global disease. Medical experts have found a correlation between the symptoms of depression and the perpetuation of disease. The World Health Organization has found an “interrelationship between depression and physical health,” such as depression leading to cardiovascular disease. As mental illness rates continue to rise in South Asia, so does the risk of physical diseases and illnesses.
  5. Postpartum depression in South Asian women is often undiagnosed and unrecognized. The gender of the baby, domestic violence and poverty are all factors that put new mothers at a higher risk for postpartum depression. The stigma surrounding mental health prevents new mothers from receiving any form of mental health care or support.
  6. Bangladesh, Sri Lanka, and Indonesia have made mental health a “top priority.” These countries, along with a few others in South Asia, have created policies to address mental health on a national scale. The World Health Organization has recently lauded their work and the important step it takes towards normalizing and treating depression and mental illness.
  7. Non-government organizations (NGOs) have had a positive impact on mental health care. In countries where the government is not willing or able to make mental health a priority, NGOs are providing crucial support to people suffering from mental health issues. NGOs in South Asia have expanded their community-based programs and are providing specialized mental health services. For example, in the Maldives, a number of NGOs are offering rehabilitation, life-skills training and “resilience-building around social issues” to citizens. These efforts have drastically increased the access South Asians have to mental health care.
  8. Human capital increases when mental health is strong. Although poverty rates in South Asia are declining, the region accounted for nearly half of the world’s “multidimensionally poor” in 2017. Providing mental health care to South Asians is a major step in eradicating poverty within the region. According to the World Bank, strong mental health is a contributing factor to not only the wealth of nations but to the wealth and capital accumulation of individuals.

Improving mental health in South Asia requires not only the social recognition and normalization of depression and mental illness but the continued action of both government and non-government programs. With increased access to mental health care and support in South Asia, the expansive issues of poverty and illness will be positively affected.

– Karli Stone
Photo: Flickr

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9 Facts About NGOs and Healthcare in Dominica

Dominica, a small country in the Caribbean, has a population of about 72,000. Currently, general taxes are what finance healthcare services in Dominica. There are seven healthcare centers and 44 clinics around the country that provide primary healthcare at no cost.

 9 Facts About Healthcare in Dominica

  1. Dominica spends equivalent to $418 per capita on healthcare. As of 2011, healthcare costs were 4.2% of the GDP. Those healthcare services are provided by the Ministry of Health. Also, as of 2017, there were 1.1 doctors per 1000 people in Dominica.
  2. There are five hospitals in Dominica. Four of these hospitals are government-owned, while the other one is privately owned. The Princess Margaret Hospital has one small intensive care unit, meaning it is most equipped to deal with emergency situations. However, the other three, the Marigot hospital, Grand Bay hospital and Portsmouth hospital, are not as prepared.
  3. Dominicans generally have somewhat long lifespans. For men, life expectancy is 74.4 years, and for women, it’s 80.5 years. Therefore, the total average life expectancy is 77.4 years, exceeding the global average of 72 years. However, as of 2019, 30.9 infants died out of 1000 live births, which is a rate of about 3.29%.
  4. There are both primary and secondary healthcare services in Dominica. There are seven health districts in which primary healthcare services are provided by clinics. These clinics serve about 600 people each within a 5-mile radius of the district in which they are located. Princess Margaret Hospital provides secondary healthcare to the people of Dominica.
  5. Some individuals are exempt from charge for medical treatment. Those who are considered poor or needy, pregnant women, children younger than 17 years old  are exempt from the medical care charges. People who may also have an infectious and contagious disease that can spread through multiple ways (such as bodily contact, contact with bodily fluids, or breathing in the virus) are also exempt from the charges that arise from medical care.
  6. The HIV/AIDS prevalence rate is 0.75%. About 506 people out of a population of 72,293 people in the Dominica have HIV/AIDS. Countries that have a prevalence rate of HIV/AIDS that exceed 1% are considered to have Generalized HIV Epidemics, so Dominica is currently below that even though its rate is higher than places like the U.K. 70% of those infected by HIV/AIDS are male. In 2019, only 95 adults and children were receiving antiretroviral therapy in Dominica.
  7. The Citizenship By Investment program in Dominica helps rebuild medical buildings and infrastructure, as well as provide treatment abroad. After Hurricane Maria in 2017, the CBI program helped fund the rebuilding of six hospitals and three healthcare centers in Dominica. Similarly, the program also sponsored 16 children to receive treatment abroad in 2017-2018. The treatment was critical for the of health of the children in Dominica.
  8. The Order of St. John is an NGO project working to improve healthcare in over 40 countries, including Dominica. This international charity has over 300,000 volunteers and staff and provides multiple services such as healthcare, first aid and other methods of support. This organization, registered as an NGO in 1964, had an income of 1.44 million pounds in 2018. Its mission is to help improve the health of people around the world and alleviate worldwide sickness. Additionally, St. John works to provide volunteers with disaster preparedness training in Dominica in the case of tropical storms or other natural disasters. The organization accepts donations, 100% of which go to their programs.
  9. Another NGO, EACH, also works in Dominica to provide healthcare communication. EACH works to promote healthcare communication that is concentrated around patients. EACH also works to provide healthcare communication research, skills and tools. They strive to ensure that patients worldwide receive specialized care with regard to autonomy and safer, efficient healthcare, as well as ensuring that patients are more likely to recover from diseases. EACH became a nonprofit and charity organization in 2014.

Many organizations and hospitals are working to provide effective healthcare in Dominica. The general public can help assist these organizations through donations or volunteering. Learning more about healthcare in Dominica, as well as in different countries around the world, can help one understand both the domestic and global situation of healthcare today.

– Ayesha Asad
Photo: Unsplash

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Protecting Iraq’s Yazidi Communities During COVID-19

Yazidi CommunitiesHaving been targeted by ISIL during its military campaign in 2014, the Yazidis have gained significant international attention over recent years. However, few knew much about the importance of Yazidi communities to the overall stability in Iraq before their genocide.

Who Are the Yazidis?

The Yazidis are a Kurdish-speaking minority located primarily in northern Iraq, where about 400,000 lived as of 2014. They have traditionally kept to themselves but experienced ethnic and religious persecution from both Saddam Hussein’s regime over the years as well as ISIL most recently. Such oppression crippled Yazidi communities as their members dealt with the economic fallout and social setbacks resulting from trauma. The novel coronavirus poses a new threat, and the consequences for peace and security in Iraq will be manifold — especially if the Yazidis are excluded from Iraq’s COVID-19 economic recovery strategy.

The COVID-19 Crisis

The spread of COVID-19 has hurt Iraq and its people on a grand scale, as it has in the rest of the world. Yet, despite a low number of cases in northern Iraq, Yazidi communities have been disproportionately affected by the virus due to safety measures taken by the Iraqi government. In Sinjar, where many Yazidis in Iraq live, most of the working population must travel for jobs located outside of the city or are farmers who rely on visiting other cities to sell their crops. However, this way of life is no longer possible under the imposed movement restrictions. Yazidis cannot leave Sinjar for employment, and farmers cannot travel to other cities. Therefore, many Yazidi communities have essentially lost all means of income.

The emergency measures have also adversely impacted the Yazidis on the healthcare front, as access to healthcare has been reduced. Those requiring medical attention can only receive it four hours away in Mosul, taking an ambulance so that they can cross various checkpoints throughout the province. Along with the long trip, some Yazidis do not seek treatment in Mosul because of the language barrier. These factors have further ostracized the Yazidis economically and socially, thus risking an increase in regional poverty.

The Resurgence of Poverty and of ISIL

Poverty’s resurgence in Yazidi communities because of the novel coronavirus has myriad implications for peace and security within the Middle East. In addition to trauma following the end of ISIL’s occupation of Yazidi land, the pandemic has created a mental health crisis within Yazidi communities. Those who previously received counseling at mental health facilities are no longer able to obtain that help due to COVID-19. Some experts are even predicting that 25% of Yazidis will require mental health care after the pandemic subsides.

Others have raised concerns surrounding the return of ISIL during this period of instability. Iraq’s government has acted on this issue militarily and can continue to fight ISIL’s revival by providing economic aid and building necessary healthcare infrastructure in Yazidi communities.

Humanitarian Solutions and NGOs

Ultimately, northern Iraq’s stability will not be achieved through military success alone. The long-term solution will be humanitarian. Following the U.N. Sustainable Development Goals (SDGs), such as developing better infrastructure, will lead to extraordinary progress on other pressing problems in Iraq, like reducing poverty and improving health.

Giving non-governmental organizations, like Yazda, a bigger role in community building is another way to strengthen Yazidi societies. Yazda focuses on helping Yazidis in various ways. It has already helped thousands obtain mobile medical services in addition to providing hundreds of mental health and socioeconomic assistance and supporting hundreds more in their pursuit of criminal justice.

For now, Baghdad is focused on reopening its urban and economic centers. However, including Yazidi communities in the reopening process during and after COVID-19, as well as supporting them to become more resilient in tumultuous conditions, will be crucial in preventing future conflicts and eliminating poverty in Iraq.

– Alex Berman
Photo: Flickr

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Tuberculosis: A Major Health Problem in Bangladesh

Tuberculosis in BangladeshTuberculosis (TB) is an airborne disease; common symptoms include cough with sputum and blood in some cases, chest pains, weakness, weight loss, fever and night sweats. TB can lead to the death of an infected person when left untreated. According to the World Health Organization (WHO), TB has caused about 2 million deaths worldwide, and 95% of deaths were recorded in developing countries. Bangladesh ranked sixth among high TB burden countries. The National Tuberculosis Control Programme (NTP) has attained more than 90% treatment success and more than a 70% case detection rate. Despite these successes, tuberculosis in Bangladesh remains a serious public health problem.

Reasons for Higher Infection of Tuberculosis in Bangladesh

  1.  Delays in the Initiation of Treatment: Patients in Bangladesh often receive late treatment. Delays in treatment increase chances of negative treatment results, death and community transmission of TB. A study on 1,000 patients reported that, on average, there were 61 days of delay in the treatment of women and 53 days of delay in the treatment of men.
  2.  Role of Informal Health Practitioners: Most of the impoverished people in Bangladesh prefer to go to their local practitioners due to the ease of accessibility and low cost. A recent survey showed that approximately 60% of the Bangladesh population prefers to go to these uncertified doctors. However, such doctors typically lack formal training. This may lead difficulties in accurately diagnosing and treating TB.
  3. Lack of Awareness: Directly observed treatment short-course (DOTS) has been recognized as one of the most efficient and cost-effective approaches for treating TB. In 1998, the DOTS program became an integrated part of the Health and Population Sector Programme. The inclusion of the DOTS strategy in the Programme helped TB services transition from TB clinics to primary level health facilities. These health facilities typically incorporate GO-NGO (government-organized non-governmental organization) partnerships, and the NGOs have advocated for work on literacy, social awareness along and health care development. As part of the Health and Population Sector Programme, DOTS is freely available to the public. Unfortunately, many remain unaware of the treatment option.  As a result, detection of new TB cases has stagnated at around 150,000 cases per year since 2006.
  4. Poverty: A large portion of the country is still suffering from poverty. Poverty can often lead to overcrowding and poorly ventilated living and working conditions. People with less income also cannot afford food, leading to higher incidences of malnutrition. The culmination of these factors typically make the impoverished population more vulnerable to contracting TB.

The Effort to Combat TB

Tuberculosis is a major public health problem in Bangladesh. However, continuous efforts by the NTP and various NGO organizations have played an important role in decreasing the spread of the disease. DOTS, for instance, demonstrated a 78% cure rate in 1993. Due to its success, a phase-based treatment plan was implemented in 67 million rural populations in 1996.  Since implementation, the NTP has attained a 90% treatment success rate. Further efforts to combat the disease include development of the FAST program (Find cases Actively, Separate safely and Treat effectively). The program intends to detect active TB cases and decrease spread of the disease in healthcare facilities. However, despite efforts by the NTP and a number of NGOs, significant delays in care-seeking and treatment initiation still exist as major hindrances to the program’s goals. 

Challenges to TB Programs

Tuberculosis in Bangladesh kills more than 75,000 people every year. Despite free services like DOTS and other NTP programs, limited access to quality service, lackluster funding and insufficient screening prevent adequate detection and treatment of the disease. The lowest quartile of the population is still five times more likely to contract TB, potentially due to a lack of awareness of TB-treatment programs among the general public. Adding to the problems for TB programs, private health professionals are typically inactive in national programs. While NTP programs have made progress in addressing the disease, these challenges persist, and tuberculosis remains a major health problem in Bangladesh.

Solutions

To stop the growth of tuberculosis in Bangladesh, community organizations such as the Bangladesh Rural Advancement Committee (BRAC) have shown impressive results in lowering the percentage of those afflicted by TB. Effective treatment of TB includes investment in medicine, local health services and diagnostics. To ensure full recovery, social protection of patients is also required. Multidrug-resistant TB (MDR-TB), for instance, requires two months of drug treatment and a four month continuation period. If treatment programs can satisfy requirements investment and social protection requirements, the chance of curing TB patients reaches 92%. The application of a more successful method will help in curing the most complex TB cases, such as drug-sensitive TB, with improved results. With the implementation of proper and effective treatment strategies, we can eliminate tuberculosis in Bangladesh and the benefit even the poorest members of society.

– Anuja Kumari

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