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tuberculosis in KiribatiKiribati is one of the world’s smallest countries, located in the middle of the Pacific Ocean. The 30 plus islands that together form Kiribati may be small and house a population of a little more than 100,000 people, but Kiribati is modernizing every day. The country only became fully independent in 1979 after a history of colonialism, and it joined the U.N. in 1999. Today, one of the biggest threats it faces is tuberculosis (TB). Of all the neighboring pacific island countries, Kiribati has the highest incidence of tuberculosis with a report of 349 incidents per 100,000 in 2018. While tuberculosis is endemic in Kiribati, the situation is far from hopeless. New scientific approaches to diagnosing and treating tuberculosis are making it possible to eradicate the disease in the future.

Tuberculosis and Overcrowding

Tuberculosis is directly related to overcrowding. While there are 33 total islands of Kiribati, only 20 of these islands are inhabited. Moreover, almost all of these islands are very sparsely inhabited, with around 64,000 inhabitants living on the main atoll, Tarawa. Though the nation does not boast a large overall population, the population density of the country is one of the highest in the world. Tarawa has a population density on par with major cities, like Tokyo and Hong Kong. This high population density means that most households in Kiribati are vastly overcrowded, creating a greater likelihood of spreading tuberculosis. Oftentimes, the housing lacks proper construction or proper ventilation, which also impacts the spread of TB. On average, households in Tarawa have between eight and nine people in them.

Tuberculosis and Diabetes

Tuberculosis and diabetes are often co-morbid illnesses causing major concern in Kiribati, which has one of the top 10 highest rates of diabetes in the world. In Kiribati, between one fourth and one-third of adults have diabetes, so the likelihood of having tuberculosis and diabetes is quite high. In fact, one-third of citizens with tuberculosis are also diagnosed with diabetes. This is so prevalent because diabetes can impact the treatment of tuberculosis. As a result, most of the citizens with both diabetes and TB have the infectious form of TB. This means that they pose a greater risk of spreading the illness to other members of the community.

New Methods for Catching and Eliminating TB

While tuberculosis is a serious concern to citizens of Kiribati, there are groundbreaking efforts to speedily diagnose and treat tuberculosis. Addressing TB is one of the country’s top priorities. In conjunction with organizations like the Global Fund to Fight Aids, Tuberculosis and Malaria, Kiribati has managed to acquire modern diagnostic tools like portable X-ray machines. In recent years, another strategy that targets specific “hotspot” areas has proved incredibly useful in diagnosing TB in the early stages. This process focuses on areas known to have the greatest likelihood of TB by using patterns from past years to locate the most at-risk communities. After locating these communities, citizens of the area participate in screening for TB. In 2019, during a hotspot case study, healthcare workers screened 3,891 people for tuberculosis in less than two weeks. Over the course of the 11 days, they diagnosed seven new cases.

A More Positive Future

In the past few years, the general fear of tuberculosis in Kiribati has greatly diminished. With the new systems in place to screen, diagnose and treat TB, citizens have become more aware of how to prevent the spread of disease. The new systems also allow more citizens who may be living in poverty or isolated areas to access treatment. Healthcare workers go directly into the villages within each hotspot, allowing citizens to easily walk to clinics for screening. At these clinics, they receive prevention tips, pamphlets and a better understanding of how to care for themselves and those around them.

Despite overcrowding and comorbidity with diabetes, the future of tuberculosis in Kiribati is looking up. With only 323 cases in 2018 after 745 new cases in 2007, the numbers are slowly decreasing. With increased awareness and prevention tactics, along with modern technology and hotspot screening, it is hoped that this trend will continue.

– Lucia Kenig-Ziesler
Photo: Flickr

poverty and overcrowding
The world is experiencing rapid population growth and urbanization. Advances in medicine have allowed for increased life expectancy as well as decreased infant mortality, while birth rates have largely remained unchanged. This combination of circumstances has lead to great growth; between 1999 and 2011, the population increased by nearly one billion people.

The population increase has led to rapid urbanization. People migrate to cities with the promise of economic or educational opportunity, technological advancement and access to health care. It is estimated that by 2050, 66 percent of the world’s population will live in urban areas.

This urbanization of cities that are neither prepared nor equipped to deal with overcrowding places strain on both natural and manmade resources alike. The following is a list of five cities suffering from both poverty and overcrowding.

Five Major Cities Dealing With Poverty and Overcrowding

  1. Mumbai, India: With a population density of 171.9 people per square mile, India is notorious for overcrowding. Mumbai is no exception, with a population near 23 million and a population density of almost 70,000 people per square mile.Mumbai serves as India’s commercial hub and is home to the Bollywood industry, making it prone to migration. Yet, those with hopes of Bollywood often end up in prostitution or organized crime. The population has doubled in 25 years, leading to many slum neighborhoods.In fact, half of the population of Mumbai lives in overcrowded, unsanitary slums that comprise only eight percent of the city’s geographic area. Although great wealth exists throughout Mumbai, poverty and overcrowding continue to increase.
  1. Dhaka, Bangladesh: Being named the most densely populated city in the world in 2015, Dhaka suffers from overcrowding and poverty alike. It has also been named to lists of least livable cities and fastest growing cities.Its population is over 18 million, with a density of 114,300 people per square mile. Roughly one-third of Dhaka’s residents live in poverty, with two million inhabiting slums or without any form of shelter.
  1. Lagos, Nigeria: Lagos is Africa’s fastest growing city. In 2017, the population was 21 million; the U.N. predicts that this number will rise to over 24 million by 2030.Situated between the Atlantic Ocean and a lagoon, Lagos is Nigeria’s commercial capital. Yet, 300,000 people live in slum neighborhoods and make a living by fishing out of hand-built canoes.  One-fifth of the city’s residents live in poverty.The slum houses are fashioned from scrap-metal and elevated on stilts to protect against flooding. There is little access to clean water, electricity or quality education. The majority of slums are built along the coast, causing friction with the wealthy as well as the government, which has evicted many communities on faulty logic in order to seize the land.
  1. Manila, Philippines: Manila has a population of 1.7 million and a land area of less than 10 square miles, leading to a high population density of over 170,000 people per square mile. Manila serves as the Philippines capital and home of its banking and commerce industries.In Manila, 600,000 people live in slum districts, which are ridden with disease and malnutrition. Many kids do not attend school, as parents are often forced to choose between feeding the family or sending the kids to school.
  1. Ulaanbaatar, Mongolia: Ulaanbaatar boasts the highest population density on this list, with over 760,000 people per square mile. The influx in population resulted in unplanned neighborhoods known as “ger” areas, which house 60 percent of Ulaanbaatar’s population but are vulnerable to natural disasters and lack water and sanitation sources as well as electricity.A number of expensive apartment buildings mark the city’s skyline, yet many of these buildings remain empty due to the high cost of living. The government intervention has tended to benefit the upper-income subgroups, rather than those living in poverty.

Poverty and overcrowding are endlessly entwined. Rather than placing a halt on migration and urbanization as many cities have attempted, lack of affordable housing, quality water and sanitation facilities, education opportunity and food shortages ought to be addressed. Cities must respond to the growing demands that come with overcrowding in order to help alleviate poverty and decrease hardship.

– Jessie Serody
Photo: Flickr

syrian-children
Try to imagine back to when you were in elementary school. Most children are happy living without major troubles, or at least children in the United States. Many do not have much to worry about. Most American children are going to school and are living stress-free lives. They are enjoying themselves, playing outside with their friends or playing video games, but the same could not be said for the children of Syria.

Millions on children have been affected by the conflict going on Syria for past three years, 6.5 million, to be exact. Over 2.8 million children are no longer attending school and more then one million are refugees in nearby countries. They no longer live their normal stress-free lives; they do not have “normal” childhoods.

Many Syrian children have endured horrible health issues due to poor sanitation and many are also malnourished. Many also face diseases such as measles and polio due to lack of proper immunizations.

Parents often turn to marrying their daughters off at early ages, as early as 13 years old, so that they do not get molested. Syrian refugee children are more vulnerable to rape and other acts of sexual violence.

In Syria, three million children no longer attend school, mostly because their schools have been destroyed, teachers have left and families are now using schools as homes. Other children quit school to work so that they could help make income to support their families.

The Lebanese government has been trying to help by setting up schools for child refugees but there have been problems such as overcrowding, language barriers and cost of transportation.

UNICEF has been helping since day one and partnering up with others to help. The organization has also immunized more than 20 million children when there was a polio breakout, supplied safe drinking water and provided psychological support.

Save The Children is another organization that has been getting involved and helping child refugees. Anyone could help through UNICEF or Save the Children. Just remember that you would not your children having to go through such horrible living conditions on a day-to-day basis.

– Priscilla Rodarte

Sources: Save the Children, World Vision, UNICEF
Photo: World Vision

Equatorial Guinea
Being one of the last remaining colonies of the once expansive Spanish Empire, Equatorial Guinea became independent in 1968 during the rule of Spanish General Francisco Franco. This West African nation is very interesting in many aspects. Its capital is located on an island faraway from the mainland, it is the only Hispanophone country in West Africa—barring the territory of West Sahara—and it also has the highest gross domestic product (GDP) per capita in Sub-Saharan Africa.

However, in this relatively prosperous country, approximately two-thirds of the population lives in extreme poverty.

Despite the discovery of oil and other natural resources that the countries of West Africa have been bequeathed with by their geographical locations and an extremely small population of less than a million people, it is rather paradoxical that the richest country in Sub-Saharan Africa and the region’s third-largest oil producer whose size is roughly the same as Massachusetts allows more than half of its people to fall into abject poverty.

In neighboring Cameroon, where the GDP per capital is only a tenth of that of Equatorial Guinea, for example, much less than two-thirds of the entire population lives in extreme poverty. To put it in comparison, Equatorial Guinea’s GDP per capita is greater than those of Italy, South Korea or Saudi Arabia.

Moreover, other statistics regarding the country’s standard of living are also equally — if not more — frustrating. Only about half of the country’s population has access to clean drinking water, overcrowded living condition is—surprisingly given the country’s low population density—rampant and very few children enjoy the advantages of urban life such as education, medical services and recreational facilities.

Despite the grinding poverty suffered by hundreds of thousands, Equatorial Guinea seems to often escape the radar of global attention due to the highly distorted numerical means, which shows the country in good standing in terms of GDP per capita. However, in reality, there is a flagrant discrepancy that is indicative of a rather stark disparity between the have and the have-not.

To make this inequity even more unsettlingly palpable and conspicuous, the country is also building a brand new and expensive capital city on the mainland, hundreds of miles away from where the majority of the already sparsely populated country lives. Currently, Malabo, situated on an island to the far northern reaches of the country, is the capital, while Bata, an Atlantic seaport, serves as the country’s largest city.

However, Oyala—under construction—will serve as Equatorial Guinea’s President (and Africa’s longest-ruling dictator) Teodoro Obiang’s new capital. What is his supporting rationale? His government’s and his own safety and security. This project is expected to cost billions of dollars before it finishes in a country where over 60 percent of the population is struggling to live on less than $1 per day.

It is clear where at least some of the immense amount of wealth of this nation goes. In 2012, the French police sent out an arrest warrant of Teodorín Obiang, the son of the Equatoguinean president who had to escape Paris back to his own country. Upon investigation, they found evidence of an obscene accumulation of wealth. Teodoro Obiang—his father and the country’s leader—is also leading an extremely corrupt government. A criminal investigation launched in Spain revealed that there are 11 families with close ties to the Obiang family who are amassing most of the country’s wealth.

Equatorial Guinea is a tragic archetype of a country that could have been highly developed and whose citizens could have enjoyed a very high standard of living. However, the lack of democracy has allowed only a handful of individuals to accumulate most of the country’s vast wealth.

– Peewara Sapsuwan

Sources: Europa Press, International Business Times, IEACH, Open Society Foundations
Photo: World Rainforest Movement