Posts

Mental Health in Bolivia 
Over the past two years, Bolivia grappled with the global Coronavirus pandemic and political instability. However, another invisible challenge lay hidden underneath these precarious situations. Long stigmatized and overlooked by Bolivian society and government alike, the lack of proper mental health care in Bolivia is an invisible challenge.

The Data

Bolivia is a country in central South America and has a population of around 11 million. Mental health in Bolivia is an esoteric topic which the lack of official records on mental illness illustrates. Thus, there is no reliable data to indicate the number of Bolivians with mental illness. There are only 45 psychiatrists and 35 psychologists practicing in the nation. Therefore, few Bolivians have access to psychological resources.

However, the data accumulated from those that had the ability to see a mental health professional shows that many suffered from the abuse of substances, especially alcohol. Approximately 90% of patients in psychiatric hospitals struggled with alcohol. Psychotic disorders, mood disorders and depression were also common. According to Mental Health Atlas 2020, 6.82 out of 100,000 Bolivians committed suicide, although the actual count may be higher due to underreporting.

A Promising Start

Despite the current taboos and limited infrastructure toward mental health in Bolivia, the country developed one of the first mental health plans in South America. Bolivian authorities designed this plan to meet the principles enshrined in the 1990 Caracas Declaration. Delegates from across Latin America met in the Venezuelan capital to announce a watershed declaration that established human rights for those with mental illness and aimed to restructure mental health care across the continent.

In 2002, Bolivia passed its national mental health plan. However, it remained merely a symbolic piece of legislation because of the lack of government funding. Authorities revised the law in 2009. However, its provisions ceased to become a reality because of the continued dearth of financial support. In 2008, WHO reported that Bolivia earmarked 0.2% of its health budget for mental health, according to an article published in the International Journal of Mental Health Systems.

While expenditures hampered significant developments in mental health in Bolivia, two additional developments serve as a source of optimism. According to an article published in the International Journal of Mental Health Systems, first, in 2007, Bolivia shifted its health care system to the public sector. Second, in 2009, Bolivia amended its Constitution to explicitly protect the right to health.

Societal Stigma

Coupled with scarce federal funding, cultural stigma also limits access to proper mental health care. In Bolivia, people hide their mental illness, especially depression. Bolivian psychologist Aruquipa Yujra reported that many Bolivians simply view depression as a “bad mood” and not a mental illness. Yujra explained that this societal downplaying of mental illness leads many Bolivians to avoid seeking treatment.

Dr. Josue Bellot, the director of San Juan de Dios Centre of Rehabilitation and Mental Health in La Paz, Bolivia, also sees societal stigma as a problem for Bolivia. He stated that he believes that in Bolivia “there is this stigma that psychiatry relates only to ‘crazy’ people. The moment that a doctor refers a patient to a psychiatrist, the patient is labeled ‘loco’.”

Reason for Hope

Minimal government funding and societal stigma resulted in the concentration of much of Bolivia’s mental health care in La Paz. Because of this, it is out of reach for many of its citizens. However, Daniela Riveros, a dedicated UNICEF volunteer, harnessed the power of technology to reach these marginalized communities. In 2020, she launched a call center, Familia Segura (Safe Family), to assist people in crisis in rural households across Bolivia.

The hotline that Riveros implemented redirected calls to the appropriate destination, frequently to mental health professionals in La Paz. Additionally, if Familia Segura volunteers detected signs of violence, they contacted the authorities to intervene. Between April 2021 and July 2021, the hotline made approximately 13,500 calls to vulnerable Bolivian families.

Another transformative organization is Esperanza Bolivia. Rather than fielding calls from afar, in 2019, Esperanza Bolivia provided in-person psychological services at Eustaquio Mendez High School in Tarija, Bolivia in order to prevent violence stemming from the adolescent population. Jesús Cáceres, a teacher at the school, noticed a positive change in his students since the team arrived.

Steps for the Future

The humanitarian work that organizations like UNICEF and Esperanza Bolivia conducted does not neglect the need for more funding towards improving mental health in Bolivia. The Bolivian government and Western powers, especially the United States, must devote more money to mental health care so that Bolivians are able to attain accessible and equitable psychological treatment.

While the Biden Administration’s joint commitment with The Pan American Health Organization (PAHO) to deploy 500,000 new health workers to Latin America is encouraging, Bolivia needs a more comprehensive strategy to address mental health disparities. However, in recent years, Bolivia and humanitarian organizations have made great progress in addressing social and financial inequities. A hopeful future is on the horizon.

– Alexander Portner
Photo: Unsplash

Vaccine Distribution in Latin America
The COVID-19 pandemic has hit Latin America hard. As of July 2021, about 1.3 million people throughout Latin America and the Caribbean have died from COVID-19 alone, showing the devastating toll that the virus has had on families throughout the region. With such a high death toll and the introduction of new, more dangerous variants of the original virus, the question of vaccine distribution in Latin America has been a topic of discussion among health experts.

Throughout Latin America, vaccination rates overall have remained lower than world averages. Some countries such as Uruguay have a higher vaccination rate. As of September 16, 2021, the country has administered 171.68 doses per 100 people. Chile’s vaccination rate is second to Uruguay, with 159.65 doses administered per 100 people. The two countries with the lowest vaccination rates are Nicaragua, with 10.97 doses per 100 people and Haiti, with 0.44 doses per 100 people.

Vaccine distribution in Latin America unequivocally varies per country. These discrepancies are problematic in combatting the disease throughout the region. Many of the regions with low vaccination rates have some of the highest mortality rates as well, which has caused more need for the vaccine.

Access to COVID-19 Vaccines

The United Nations Educational, Scientific and Cultural Organization (UNESCO) released a report in April 2021 detailing vaccination distribution in Latin America. It included its recommendations and the challenges that Latin America needs to overcome to increase vaccination rates and better the population’s overall prospects. UNESCO gave strategies for vaccination, focusing on impoverished areas that have higher mortality rates. Yet, UNESCO also projects that only approximately a third of people in Latin America and the Caribbean will receive vaccinations by the end of 2021.

Guillermo Anllo, a UNESCO program head for Latin America and the Caribbean, spoke to Reuters in early August. Anllo emphasized how crucial equity is to the distribution of vaccines in Latin America. The pace of vaccination has been slow in the region as a whole due to structural issues. For example, the highest income countries throughout the world have vaccination rates that are 30 times faster than the countries that have the lowest incomes.

Furthermore, economies have experienced damage during the pandemic, especially those in the Caribbean who rely on tourism. This damage to tourism has a ripple effect on the purchasing power of the countries’ governments to obtain more vaccinations, slowing the process in this way as well.

Efforts to Increase Vaccine Distribution

Worldwide organizations and agencies have sent aid to Latin America throughout the spring of 2021. Most recently, the Pan American Health Organization (PAHO) has vowed to increase access to vaccines and to help minimize transmission of COVID-19 in Latin America and the Caribbean. This plan comes from PAHO’s Revolving Fund for Access to Vaccines, which has operated for more than 40 years to distribute vaccines to places in need. PAHO’s COVID-19 vaccine distribution in Latin America will go to the areas and people at the greatest risk in order to adequately and equitably protect the people of these regions.

With more vaccines on the way and a heightened urgency to vaccinate due to spreading variants, more inhabitants of Latin America will hopefully see higher rates of vaccinations and an increase in safety from the virus in the near future.

– Rebecca Fontana
Photo: Flickr

Cuba's Abdala vaccineCuba’s political and economic conditions have long been mysterious due to the limited information the government publishes. While Cubans have access to free health care and education, the country still suffers from poverty. According to the World Bank, there is no official information available regarding how many Cubans live in poverty; however, estimates put the poverty rate anywhere from 5% to 26% and the extreme poverty at around 15% in Cuba’s urban areas. The lack of tourism caused by the pandemic has worsened economic conditions in Cuba, providing an incentive for the nation to create an effective vaccine. Cuba has produced and begun administering a homegrown vaccine, making it one of the smallest countries to do so. Here are four things to know about Cuba’s Abdala vaccine.

4 Things to Know About Cuba’s Abdala Vaccine

  1. Local authorities say it is 92% effective: According to Cuban health authorities, the Abdala vaccine is roughly 92% effective. Full efficacy requires three doses, according to the BioCubaFarma laboratory. Abdala is only one of five vaccines that Cuba is currently working on. Another is the Soberana 2 vaccine, which shows 62% efficacy after three doses.
  2. Not internationally approved: PAHO (Pan American Health Organization), a local office of the World Health Organization (WHO) for the Americas, urges Cuba to publish the data for the Abdala vaccine and seek approval from COVAX. In doing so, scientists worldwide can peer-review studies on the vaccine. Cuba has yet to provide data to the WHO or COVAX, sparking international concern about transparency and vaccine efficacy.
  3. Authorized in Cuba due to rising COVID-19 cases and a recession: COVID-19 cases are on the rise in Cuba, so the Abdala vaccine is already in use despite not being approved by the WHO. Following this, the Cuban government faced criticism from local medical associations and NGOs. Since November 2020, COVID-19 cases have increased due to the rise of tourism in the country. Moreover, as of June 18, Cuba is running low on syringes to administer the vaccine, an especially disastrous shortage because nurses administer the Abdala vaccine in three doses. Furthermore, the country is in a recession and is experiencing shortages of food, medicine and medical supplies.
  4. Authorized in Venezuela as well: The Abdala vaccine is now being administered in Venezuela, the first country to use the vaccine besides Cuba, despite the WHO and local medical authorities urging Venezuelans against it due to the lack of public information about the vaccine. In June 2021, Venezuela received 30,000 doses of the Abdala vaccine, enough to vaccinate 10,000 people.

Looking Ahead

Cuba has been producing its own vaccines since the 1980s, including an impressive lung cancer vaccine now in clinical trials in the United States. However, Cuba has yet to submit the Abdala vaccine for peer review by the global scientific community. International health authorities worry about the lack of transparency on the science behind the vaccine, as well as its use in other countries. Through international cooperation, vaccine development and approval can commence faster. Hopefully, global authorities will soon review Cuba’s Abdala vaccine, taking the international community one step further in alleviating the effects of COVID-19.

Ana Golden
Photo: Flickr

Healthcare in Suriname
The Republic of Suriname is an upper-middle-income country located on the northeastern coast of South America. Around 90% of the country’s population lives in urban or rural coastal areas. Healthcare in Suriname is accessible for both the public and private sectors. Here are eight facts about healthcare in Suriname.

8 Facts About Healthcare in Suriname

  1. Infant and Maternal Mortality: Suriname’s infant mortality rate in 2013 was around 16 deaths per 1,000 live births. The most prevalent reasons for mortality reported in children under 1 year of age were respiratory problems, fetal growth retardation, congenital diseases, neonatal septicemia and external causes. The maternal death ratio averaged 125 deaths per 100,000 live births from the years 2000 to 2013. For mothers, the most prominent causes included gestational hypertension and hemorrhage. In 2010, prenatal checkup coverage was around 95%, and more than 65% of pregnant women had had four prenatal checkups. In addition, almost 93% of births happened in a health center, and trained health workers carried out around 95% of births.
  2. Life Expectancy: In 2016, the average life expectancy of a male was 69, while the average life expectancy of a female was 75. These estimates are slightly below the average male and female life expectancies in the rest of South America.
  3. Mosquito-borne Illnesses: In late 2015, the preliminary issue of Zika virus was found in Suriname. The disease spread quickly throughout the country’s 10 districts, but there are no current outbreaks. Conversely, Suriname has eradicated malaria from all but one district of Suriname. However, the rate of new imported cases (principally among gold miners from French Guiana) increased by more than 70% in 2015.
  4. HIV and Tuberculosis: By 2014, Suriname’s human immunodeficiency virus (HIV) rate among the 15-49 age group was 0.9%. HIV/AIDS caused 22.4 deaths per 100,000 people in 2010, decreasing to 16.4 deaths per 100,000 people in 2013. From 2012 to 2014, the estimated tuberculosis diagnosis rate increased from 58% to 71%. To combat the disease, the country started the direct implementation of observed treatment, resulting in higher treatment success from 61% in 2010 to 75% in 2013.
  5. Government Contribution and Coverage: Suriname experienced vast economic growth from 2010 to 2014. During this period, healthcare in Suriname received increased funding for various services and facilities. It expanded and decentralized private laboratory diagnostic services, private primary care, dental care and paramedic practices. In 2015, vaccination coverage was almost 90% for DPT3 and above 90% for the trivalent vaccine (MMR1). In 2014, the total estimated health expenditure as a percentage of GDP was 6%. For health insurance, employees’  premium rate is 50%, and employers pay the other half. For low- or no-income citizens, the government subsidizes health coverage.
  6. Hospitals: Of Suriname’s five hospitals, two are private and three are public. The Academic Hospital in Paramaribo has recently renovated and expanded its facilities and invested in equipment and staff for specialty care like gastroenterology, oncology, intensive care, renal dialysis and more. In 2013, government and external funds also helped other hospitals invest in new facilities and healthcare worker training programs.
  7. Sanitation: Suriname’s lack of an integrated waste management policy has created illegal dumps and caused refuse to accumulate on roadsides and in open waters. This infrastructure problem results in health risks and environmental hazards. According to the Pan American Health Organization (PAHO), Suriname does not have facilities for storing or eliminating hazardous waste, nor does it regulate the safe use or storage of pesticides.
  8. Accessibility: In 2014, Suriname passed its national basic health insurance law. It provides access to a basic package of primary, secondary and tertiary care services for all Surinamese citizens. In 2013, all people under the age of 16, as well as people aged 60 and over, had the right to free health care that the government paid for. Universal access to healthcare for pregnant women and newborns remains a challenge for healthcare in Suriname.

Persistent voids in access to healthcare in Suriname are related to drawbacks in funding. The healthcare system has seen an expansion in the past decade, but there are still plenty of health challenges to confront and improve.

Anuja Kumari
Photo: Flickr

Poverty in Venezuela
Venezuela was once a rich and stable country. Over the last few decades, Venezuela has fallen into financial and governmental trouble. In 1989, when rioting and looting polluted the streets due to increased petroleum prices, Venezuela began a spiral into debt. When Hugo Chávez became president in 1998, citizens became optimistic as he funded money into programs to assist the poor. Unfortunately, mismanagement allowed problems to persist. Within the last decade, poverty rates have risen dramatically. Here are 10 facts about poverty in Venezuela.

10 Facts About Poverty in Venezuela

  1. The economy has created a nationwide crisis. As Venezuela’s economy collapses many programs are collapsing with it. The country is experiencing hyperinflation. Over the past three years, the annual inflation rate is 10,398%. Hyperinflation in Venezuela has increased the number of people living in severe poverty and barely surviving from day to day. A national survey in 2017 found that 87% of families live below the poverty line.
  2. The government retains full control of the economy. Since 1989, the Venezuelan government has retained full control of the economy. In 2003, the government introduced price and currency controls and it became the sole provider of bolivars. As a result, funds denied businesses access and banks could only assist specific organizations. Additionally, companies had to sell products below production costs and close stores, which caused a supply shortage and negatively affected the economy.
  3. Government information is experiencing censorship. Journalists, lawyers and medical professionals experienced detainment and imprisonment for exposing the poor conditions of their country. Although the poverty Venezuelans face is no secret, censorship hides the depths of governmental and economic corruption, thus reducing the level of support that other countries offer. Venezuela ranked 173 out of 180 countries that Transparency International’s 2019 Corruption Perceptions Index assessed for corruption. The lower the ranking, the more corruption in the government.
  4. Venezuela is experiencing a split government. In May 2018, Nicolás Maduro, the incumbent president of Venezuela, “won” disputed re-election against Juan Guaidó, leader of the National Assembly. By the following June, the Organization of American States recognized Guaidó as President; Guaidó subsequently declared himself president on January 23, 2019. Blame for the free-fall of the economy lands on Maduro, but he holds all the military and refuses to relinquish power. Recognized by 50 other countries, Guaidó does not hold much authority on his own. As more becomes clear about the corruption that Venezuela experiences, Guaidó receives more assistance from other countries to help his people.
  5. Food and water shortages are at an all-time high. Since 2017, nearly two-thirds of Venezuelans reported losing an average of 25 pounds in the previous year; they refer to this as the “Maduro-diet” due to food and water shortages. These shortages have peaked with the COVID-19 emergency. Venezuela has 4,187 confirmed COVID-19 cases and 35 confirmed COVID-19 deaths. PAHO and UNICEF have provided relief by supplying medical equipment and COVID-19 tests and the U.N. has since stepped in to provide funds. When the global pandemic began, hospitals quickly found it difficult to care for patients while lacking running water. Additionally, sanctions that the U.S. put into place made access to food more difficult.
  6. Venezuela is experiencing medical shortages. Fernando Gomez is a 54-year-old man living in Venezuela. In an interview with The New Humanitarian Gomez said, “The government says wear masks, wash your hands often, and stay inside… but we don’t have water, we often don’t have electricity, and there are no masks.” Even before the pandemic, diseases such as measles, diphtheria and malaria rose. While proven vaccines and antibiotics exist for these diseases, shortages have led to high mortality rates from these illnesses. In the last five years, there also have been significant shortages of medical personnel and supplies, leaving Venezuela’s population at greater risk. PAHO, UNICEF and the U.N. are doing what they can to assist.
  7. Venezuela’s oil industry is collapsing. Petroleum was once a significant part of the Venezuelan economy; now it suffers from oil shortages at great cost to its people. Marcia Briggs, a reporter for Pulitzercenter.org, spent a day at a local Venezuelan gas station. The line stretched for miles and people would wait a day or more for fuel. Spending time in line means not working and earning wages. In 1998, the country produced 3.5 million barrels of oil a day but in 2002, when Petróleos De Venezuela went on strike against Chávez, he fired 19,000 workers. Since 2007, production has decreased dramatically and reached an all-time low in 2019.
  8. Although the minimum wage in Venezuela increased in 2020, it remains below a survivable level. In January 2020, Maduro increased the minimum wage from 300,000 bolivars an hour to 450,000 per hour; the equivalent of $5.45. In April 2020, Maduro decided to increase the wage again by 77.7%. The minimum wage currently sits at 800,000 bolivars ($4.60). It is “only enough to buy just over a kilo of beef.” As the minimum wage continues increasing, there is hope that it will soon reach a survivable level.
  9. Venezuela experiences a lack of education. The education system has lost thousands of teachers due to underfunding. Some children are so malnourished that they lack the necessary energy to attend school. Other families lack the funds to pay for transportation to classes. U.N. experts say that an uneducated future will do nothing but perpetuate the crisis the country faces. Education is free, although finding enough people to direct the students’ education is a problem with no current solution.
  10. Venezuelans continue to flee their country. All of these problems have led to Venezuelans fleeing the country in hopes of a better future. There have been roughly 5 million migrants from Venezuela. Fleeing the country gives the migrants a better chance at survival but worsens the situation in their home country. Essential jobs that lack workers now have even fewer available people. Citizens who remain in Venezuela say they no longer feel safe in their country and they have lost all hope and trust in officials to fix the crisis.

Looking Ahead

Although poverty, corruption and violence have been the narrative of Venezuela for the last few decades, hope still exists that the tide will turn. In the time of a government battle, citizens now have more than two options. It used to be that either Maduro needed to leave or they did. However, now a third option exists, which is to replace Maduro with President Guaidó.

Fortunately, there are many groups assisting with child security, food and water relief, education and poverty in Venezuela. These continued efforts will hopefully impact poverty in Venezuela significantly.

Marlee Ingram
Photo: Flickr

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 a difficult time growing because of its 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