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Sanitation in The Bahamas
The Bahamas is still recovering from the aftermath of Hurricane Dorian, which greatly injured two of the countries’ islands in late 2019. However, the residents are facing a bigger challenge involving access to clean water and toilets, which is putting them at great risk of a major public health emergency. Here are 10 facts about sanitation in The Bahamas.

10 Facts About Sanitation in The Bahamas

  1. The Lack of Access to Clean Water: A lack of access to clean water often becomes a public health issue very quickly. A lot of the water in The Bahamas became contaminated with salt water right after the hurricane. Water Mission, a nonprofit organization based in North Carolina, designs, builds and implements safe water and sanitation solutions. After the Dorian hurricane, the organization tried to help sanitation in The Bahamas by implementing a process called fine-filtration, which removes salt from water through reverse osmosis.
  2. Diseases: Each day, around 6,000 children die from waterborne diseases around the world. The Grand Bahama Island experienced flooding after Hurricane Dorian, potentially increasing the transmission of waterborne diseases like diarrhea and cholera. UNICEF has provided aid by providing WASH services. Additionally, Heart to Heart International has been on the ground in the aftermath of Hurrican Dorian, administering tetanus vaccines to prevent infections from unclean water.
  3. Sewage: The Bahamas has always struggled to bring clean water to its community. The Water and Sewerage Corporation emerged in 1976 to help bring clean water to all islands and received $32 million from the World Bank. By 2014, the corporation had saved over one billion gallons of water through the reduction of water losses in New Providence.
  4. Hospitals and Housing: The Bahamas has 28 health centers, 33 main clinics and 35 satellite clinics plus two private hospitals located in the main inhabited islands. After the Hurricane hit the Islands, the International Medical Corps provided help to The Bahamas by bringing in doctors and nurses, as well as water, sanitation and hygiene specialists and 140 water kits comprising of family filters and hygiene kits.
  5. Economy: With 14 other islands in good shape in the aftermath of Hurrican Dorian, the government encouraged tourists to not cancel their vacation trips. The Minister of Tourism in The Bahamas said in an interview with The New York Times that the only means of aiding those in the north of The Bahamas was to continue tourism in the other 14 islands. This would allow the country to rebuild Abaco and Grand Bahama and help fix sewage and provide clean water. Around 4 million tourists visited The Bahamas in the six months before the hurricane, and only 20 percent of those travelers visited Abaco and Grand Bahama Island. This represented more than half of its gross domestic product.
  6. Health Care: Health Care has been one of the main priorities in The Bahamian governments’ agenda. In fact, it directed 12 percent of its budget to health. Around 47.2 percent of the general population had health insurance, and females were more likely to get insurance (47 percent) than males (45 percent). The primary care package in The Bahamas is medical services, medications and imaging and laboratory services. After the hurricane, the Pan American Health Organization (PAHO) sent professionals to assist in on-site assessments of health infrastructures and water sanitation and hygiene facilities (WASH) that had operation rooms flooded with contaminated water.
  7. Urban vs. Rural: Urban areas often bring development, better health care and living conditions. However, despite the fact that The Bahamas has a high percentage of urban areas at 83 percent in comparison to the 16.98 percent of rural areas, it still has limited water development. In fact, the country is not in the top 20 for the Caribbean.
  8. Current Poverty Rate: Sanitation in The Bahamas is always in danger because of the constant threats of new storms passing by the islands. In 2017, before hurricane Dorian, 14.8 percent of the population lived below the poverty line. That percentage grew rather than decreased leading up to 2017.
  9. Population Growth: The Bahamas had a population of 392,225 as of 2020, but has been suffering a decrease since 2007. In that year, the growth percentage was at 1.7 percent, whereas it was at 0.97 percent in 2020. With the increase in population, the National Health System Strategic Plan is aiming to educate communities to ensure optimal health and good quality of life. However, even with numbers, The Bahamas is still a country with limited basic sanitation services.
  10. Menstrual Hygiene Management: After hurricane Dorian, many women and adolescents did not have shelter or access to toilets. This presented a lack of privacy and compromised their ability to manage menstruation hygienically and with dignity. The Women’s Haven, a company distributing organic feminine hygiene products, wants to help Bahamians by switching to a better approach that will help improve their menstrual hygiene.

While Dorian impacted sanitation in The Bahamas in late 2019, the challenges for clean, accessible water continues to affect Bahamians today. With continued investment in tourism and the involvement of relief organizations, The Bahamas should hopefully recover soon.

– Merlina San Nicolás
Photo: Pixabay

Top 10 Facts About Poverty in South America
The poverty that affects so much of South America comes from a history of colonialism, which has left the region with extractive institutions including weak states, violence and poor public services. In order to combat these issues, it is vital to understand these top 10 facts about poverty in South America.

Top 10 Facts About Poverty in South America

  1. Dependence Theory: According to the Council of the Americas, the South American economy is suffering from the U.S.-China trade war, a drop in crude oil prices and generally worsening economic conditions throughout the region. This poor economic performance has been present in the region for a long time. NYU Professor Pablo Querubín noted in a lecture that this is largely due to Dependence Theory. This theory argues that poorer countries and regions will have to specialize in raw materials and agriculture due to the comparative advantage other countries and regions have in producing industrialized products such as computers, advanced technology and services. Therefore, because Latin America has a comparative advantage in producing agricultural products and oil, it will have much greater difficulty moving into the industrial sector.
  2. The Reversal of Fortune Theory: The South American economy has also had such a difficult time growing because of the history of colonialism and extractive institutions. Professor Pablo Querubín also referenced the Reversal of Fortune Theory which explains how the pre-Columbian region of South America was so much more wealthy than pre-Columbian North America, yet those roles have reversed in the modern era. The reason is that South America put extractive institutions into place to send wealth back to Spain rather than “promote hard work or to incentivize investment, human capital, accumulation, etc.” Yet, in areas with low population levels, such as pre-Columbian North America, settlers had to establish inclusive institutions “designed to promote investment, effort, innovation, etc.”
  3. Political Instability: Political consistency has been rare in the history of South America. New leaders would often change the constitution when they entered office to better suit their political wishes. In fact, while the U.S. has only ever had one constitution with 27 amendments over the course of about 200 years, Ecuador had 11 separate constitutions within the first 70 years of its history. In Bolivia, there were 12 within the first 60 years. This instability and very quick political turnover have been detrimental to the steady growth of the economy and confidence in the government. Understanding the effects of this issue and the other top 10 facts about poverty in South America are integral to fighting poverty in the region.
  4. Inequality: Inequality is incredibly high in South America. As a result, the incredibly wealthy can afford to use private goods in place of public ones. For example, the rich use private schools, private health insurance, private hospitals and even private security forces instead of relying on the police. Therefore, there is very little incentive for the wealthy to advocate for higher taxes to improve public goods such as public education, police or public health initiatives. As a result, the public services available to the poor in Latin America are extremely lacking.
  5. Education: Education in South America is full of inequality both in terms of income and gender. According to the Programme for International Student Assessment, an institution which evaluates teenagers on their educational performance in key subject areas, most countries in South America perform below average. In one evaluation it determined that the highest-scoring country in South America, Chile, was still 10 percent below average. Furthermore, poor educational performance highly correlates with income inequality.
  6. Indigenous Women and Education: In addition, indigenous women are far less likely than any other group to attend school in South America. According to UNESCO, in Guatemala, 70 percent of indigenous women ages 20 to 24 have no education. The issue of unequal education spreads further to affect women’s livelihoods and presence in the South American workforce. According to the International Monetary Fund, about 50 percent of women in Latin America and the Caribbean do not work directly in the labor force. However, the International Monetary Fund also noted that “countries in LAC [Latin America and the Caribbean] have made momentous strides in increasing female LFP [labor force participation], especially in South America.”
  7. Teenage Pregnancy: One major driver of the cycle of poverty in South America is the persistence of teenage pregnancies which lead to impoverished young mothers dropping out of school and passing on a difficult life of poverty to their children. The World Bank reported that Latin America is the second highest region in terms of young women giving birth between the ages of 15 and 19 years old. Furthermore, a study called Adolescent Pregnancy and Opportunities in Latin America and the Caribbean interviewed several South American teen mothers including one who noted that sexual education was not the problem: “We knew everything about contraceptive methods,” she said, “but I was ashamed to go and buy.” Thus, the study advised that in addition to preventative methods for pregnancy such as education and the distribution of contraceptives, there needs to be action to “fight against sexual stereotypes.” Fortunately, there are activist campaigns such as Child Pregnancy is Torture which advocates for raising awareness about the issue of child pregnancy in South America and encourages the government to take steps such as increased sex education, access to contraception and the reduction of the sexualization of girls in the media.
  8. Food Insecurity: Hunger is a growing issue related to poverty in South America. According to the Food and Agricultural Organization of the United Nations, 39.3 million people in South America are undernourished, which represents an increase by 400,000 people since 2016. Food insecurity in the region as increased from 7.6 percent in 2016 to 9.8 percent in 2017. However, the issue is improving with malnutrition in children decreasing to 1.3 percent. Additionally, there are many NGOs such as the Food and Agricultural Organization of the United Nations (FAO), Action Against Hunger and Pan American Health Organization of the World Health Organization (PAHO) that are implementing vital programs throughout the continent to fight hunger.
  9. Migration: The economic instability and rising poverty in South America have caused many people to migrate out of the region. Globally, 38 million people migrated out of their countries last year with 85 percent of that 38 million coming from Latin America and the Caribbean. Dr. Manuel Orozco from the Inter-American Dialogue think tank stated that “The structural determinant is poor economic performance, while demand for labour in the United States and the presence of family there encourages movement.”
  10. Violence: The high level of violence in South America exacerbates the cycle of poverty in South America. Fourteen of the 20 most violent countries in the world are in South America and although the region only contains eight percent of the world’s population, it is where one-third of all murders take place. Dr. Orozco went on to say that “There’s a strong correlation between migration and homicide. With the potential exception of Costa Rica, states are unwilling or unable to protect citizens.”

Fighting poverty in South America is dependent upon an understanding of the history and realities of the region. Hopefully, these top 10 facts about poverty in South America can shed light upon the cycle of poverty in the region and how to best combat it in the future.

– Alina Patrick
Photo: Flickr

Initiatives to Eliminate Malaria
The Pan American Health Organization (PAHO) and World Health Organization (WHO) have initiatives in place to help eradicate malaria with hopes that malaria will be eliminated by 2030. Five initiatives to eliminate malaria are Municipalities for Zero Malaria, Malaria Champions of the Americas, Global Technical Strategy for Malaria, Millennium Development Goal 6, Rapid Access Expansion Program (RAcE) and the Global Malaria Program. It is estimated that half the world’s population, 108 million, is at risk for malaria.

Municipalities for Zero Malaria

Municipalities for Zero Malaria is a newly launched initiative by PAHO arriving on World Malaria Day, April 25, 2019. This initiative is focused on the Americas and its struggles and triumphs with malaria. Recent research has found that malaria in 19 countries exists in 25 municipalities. These 25 municipalities hold 50 percent of all cases of malaria in the Americas. This new initiative will focus on the empowerment of communities and addressing malaria at a local level. Local level measures allow for earlier access to diagnosis and treatment for malaria patients as well as raising awareness of seeking health care treatment. According to Dr. Marcos Espinal, the goals and keys for the success of the Municipalities for Zero Malaria are that “Organizations, citizens and local government authorities must be engaged in developing key interventions for malaria elimination at a municipality level if we are to ensure that no one gets left behind.” This initiative will be a part of the current program, Malaria Champions of Americas.

Malaria Champions of the Americas

Malaria Champions of the Americas started in 2009 and honors countries that have the best practices for eliminating malaria. This organization is a platform to continue to promote good news about malaria and the ongoing fight to eliminate it. The organization chooses and nominates municipalities based on efforts to eliminate malaria. This year, Malaria Champions of the Americas hopes that the new initiative, Municipalities for Zero Malaria, will spark new growth at local level prevention and eradication of malaria. Over the past 11 years, these great initiatives made an effort to eliminate malaria:

  1. In 2010, Suriname achieved a 90 percent decrease in the incidence of malaria through its National Malaria Board initiatives.
  2. Paraguay became champions in 2012 because of its efforts to control malaria on national, regional and local levels. Its National Malaria Eradication Service of the Ministry of Public Health and Welfare opened up 20 labs for diagnosis and seven entomology labs.
  3. Costa Rica accomplished a 100 percent decrease in malaria from 2000 until 2014 due to its national plan to eliminate malaria and supervised malaria treatment programs.
  4. Suriname decreased its malaria-related hospital admissions from 377 in 2003 to 11 in 2015. In addition, these hospitals had no death records for 2014 and 2015.
  5. El Salvador accomplished a decrease of 98 percent of malaria cases in 2014.
  6. Brazil’s National Program for the Prevention and Control of Malaria was about to treat 97 percent of patients within 24 hours after diagnosis of malaria in 2014.
  7. In 2017, Brazil became champions again after the number of malaria cases dropped from 8,000 in 2013 to 126 cases in October 2017. Brazil also reduced malaria in isolated populations.
  8. Paraguay received the WHO certification of a malaria-free country in 2017.

World Health Organization

The World Health Organization has three initiatives currently in motion. WHO’s Global Malaria Program is an overarching program that guides all of WHO’s initiatives and publishes a yearly malaria world report. As of 2017, incidence rates have dropped from “72 to 58 per 1000 population at risk” and deaths declined from 607,000 in 2010 to 435,000 in 2017. Currently, 46 countries have equal to or less than 10,000 cases of malaria.

The Global Technical Strategy for Malaria is a longterm initiative that will run from 2016 until 2030. The goal is to reduce case incidence and mortality rates by 90 percent, eliminate malaria in more than 35 countries and prevent the revitalization of malaria in areas it no longer exists. The program is primarily to help guide and support regional programs with the elimination and prevention of malaria.

Rapid Access Expansion Program (RAcE) concentrates on five endemic countries, Democratic Republic of Congo, Malawi, Mozambique, Niger and Nigeria, through an integrated community case management (iCCM) program. Each country has a corresponding organization partner to help obtain the goals of RAcE. The objectives of RAcE are to reduce the mortality rates, increase the access to diagnosis, treatment and referral services, meet the Millennium Development Goal 6 and provide evidence and support to WHO policymakers on iCCM. RAcE’s results have been successful with “over 8.2 million children under 5 were diagnosed and treated for malaria, pneumonia, and diarrhea from 2013-2017.” The program also trained 8,420 health care workers to deliver these services to communities.

The Millennium Development Goal 6 has achieved its goal with a 37 percent decrease in cases of malaria over 15 years. Estimates determine that malaria-ridden countries avoided about 6.2 million deaths between 2000 and 2015 due to the initiatives to eliminate malaria.

– Logan Derbes
Photo: Flickr

HIV_Transmission
In celebration of World AIDS Day, the Pan American Health Organization (PAHO) and the World Health Organization (WHO) have announced that 17 countries and territories have likely eliminated the vertical transmission of HIV from mother-to-child through screening and intervention efforts.

Cuba was the first nation to be certified as transmission free by the WHO. At least 17 other nations are close behind or have already achieved the same success. The elimination of mother-to-child HIV transmission is a part of the United Nation’s campaign to end the AIDS epidemic, which has claimed the lives of 39 million people since it began.

Marcos Espinal, Director of PAHO/WHO’s Department of Communicable Diseases and Health Analysis, said, “If we want to end HIV by 2030, we need to accelerate action for prevention and access to treatment, focusing on key populations and increasing investment and resources.”

There is now strong evidence that an increased investment in preventative measures could make vertical transmission a thing of the past on a global scale. Carissa Etienne, Director of PAHO/WHO, said in a news release “The countries of the Americas have made tremendous efforts to reduce mother-to-child transmission of HIV, cutting new infections by half since 2010.”

Despite steps in the right direction, the transmission of HIV from mother to child is still a critical issue for millions. Transmission can occur during pregnancy, birth, or during breastfeeding.

To combat mother-to-child HIV transmission, pregnant women are given HIV medication throughout their pregnancies. For those who have not received treatment throughout the course of their pregnancies, an IV-administered antiviral called zidovudine can be given during labor, the point at which infants are most exposed to infected blood and bodily fluids.

The IV treatment enters the infant’s bloodstream via the placenta, rendering the infant immune to HIV infection, regardless of the level of the mother’s infection.

Due to the many risk factors associated with mother-to-child HIV transmission, the eradication throughout an entire nation is an impressive feat.

This success in the Americas signals a new phase of hope in the preventive medicine game.

Claire Colby

Sources: AIDS info, A Plus
Picture: Google Images