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Legacy in Global Health
In February 2022, the world parted with one of its most valued physicians and advocates. Dr. Paul Farmer was a man who dedicated his life, career and effort to provide medical care to developing countries struggling with poverty. At the end of his life, Dr. Farmer received various awards for his work, published a variety of books regarding global health and co-founded Partners in Health, a nonprofit organization to provide modern medicine to those in need. Those in humanitarian work and aid may only speculate what more Dr. Farmer would have accomplished if he did not lose his life so suddenly and hope that Farmer’s work can be a legacy in global health for future humanitarians.

Paul Farmer’s Start to Global Health

Dr. Farmer started with a passion for humanitarian work. After graduating from Duke University in 1982 with honors, Farmer achieved an M.D. and Ph.D. in anthropology at Harvard in 1990. Prior to achieving his Master’s degree and Doctorate, Farmer protested U.S. immigration policies that discriminated against Haitian refugees. Farmer also extended his effort to Haiti where he helped establish a community-based health project in 1983.

In 1987, Dr. Farmer co-founded Partners in Health (PIH), aiding clinics, education and training in developing countries. Since its founding, PIH has contributed to a multitude of initiatives and movements to support global health. In 1998, the organization launched the HIV Equity Initiative, a program that administers antiretroviral therapy to Haitian HIV-positive patients. The initiative would be a steppingstone for other major organizations, such as the World Health Organization (WHO) to fund efforts against HIV. In 2003, the organization co-founded OpenMRS, a source to open medical records designed for use in developing countries.

Today, there are 15.8 million active patients using the platform in 40 countries. Following the Haitian earthquake in 2010, PIH organized a vaccination campaign for the growing threat of cholera in 2012. This effort would protect 50,000 people from the deadly sickness. PIH is only one Farmer legacy in global health and the organization will only continue to grow.

Farmer’s Work with MDR TB

One of Dr. Farmer’s notable efforts in global health was in 1999 when WHO appointed Farmer and PIH co-founder Jim Yong Kim to launch global treatment programs and effective antibiotic delivery to patients suffering from multidrug-resistant tuberculosis (MDR TB). The Bill & Melinda Gates Foundation funded a grant of $44.7 million to PIH and Harvard Medical School for MDR TB research and with this fund Farmer was able to develop “individualized drug-therapy programs for patients in Haiti, Peru and Russia.”

Peru still benefits from the work that Dr. Farmer and other humanitarians have done for the international community. The World Bank recorded that in 2000, a year after Farmer began his work, the rate of tuberculosis incidences was 183 per 100,000 people. More than 20 years after Farmer’s initial work, tuberculosis incident rates went down to 116 per 100,000 people.

Haiti’s National Teaching Hospital

Farmer’s legacy in global health will live on in PIH and in the many people he helped. After the devastation that a 7.0 magnitude earthquake brought to Port-au-Prince, Haiti, killing thousands, Farmer and PIH provided emergency care and medical relief to Haitians who experienced the disaster.

The disaster caused the loss of 70% of public health buildings and 20% of the public health system’s clinical staff. Despite the odds against the aid workers and Farmer during the crisis, Farmer was able to coordinate the building of a new and larger national teaching hospital. In 2013, the creation of Build Health International (BHI) and the Hôpital Universitaire de Mirebalais (HUM) further expanded the hospital. Containing six operating rooms and with designs to hold 600 outpatients and emergency patients daily, the newly built hospital would help more than 1,500 patients daily by its second year. Today, that legacy in global health continues on as the hospital continues to grow and save lives.

Nearing the end of Farmer’s life during the pandemic, PIH launched initiatives in response to COVID-19 globally. While the world is still battling the pandemic, PIH and other organizations, people and groups can lead in Farmer’s example with his legacy in global health. With Farmer’s various achievements and efforts, Farmer’s work will continue to live on and help many more lives in the future.

– Michelanie Allcock
Photo: Flickr

tuberculosis in PeruCOVID-19 has ravaged populations and economies alike. It has also exacerbated the impacts of previous conditions that threaten the developing world. In particular, the lung-damaging disease known as tuberculosis has seen an alarming resurgence. The World Health Organization (WHO) has classified tuberculosis as one of the 10 leading causes of death worldwide as recently as 2019. Furthermore, the Stop TB Partnership asserts that in just one year, the novel coronavirus and its wide-reaching implications have delayed progress on the eradication of tuberculosis by 12 years. The problem is especially grave in Peru where both COVID-19 and a tuberculosis resurgence are impacting healthcare resources. Cases of both viruses have only multiplied the threat of each, calling for swift solutions.

The History of Tuberculosis in Peru

Tuberculosis in Peru was a pressing issue long before the emergence of COVID-19. Peru reports the second-highest rate of tuberculosis in the Americas and WHO has classified Peru as one of the countries with the most cases of multidrug-resistant tuberculosis (MDR-TB) worldwide. Peru’s economic landscape makes it the perfect hotbed for highly contagious diseases such as COVID-19 and tuberculosis. Roughly 27% of Peru’s population lives in poverty, with a lack of proper housing confining many to dense slums in urban centers. When combined with restricted access to healthcare, these circumstances worsen the spread of disease.

In recent years, Peru has made strides in combating the spread of tuberculosis. For example, the Peruvian government has revamped its tuberculosis control program by establishing multiple committees to guide tuberculosis containment. It has also increased funding for tuberculosis efforts. However, COVID-19 has become a serious roadblock to this mission.

The Impact of Two Pandemics

Upon the outbreak of the novel coronavirus in Peru in early 2020, nearly all the country’s healthcare equipment and resources went toward its treatment and containment. Peru’s healthcare system lacked the capacity to continue fighting tuberculosis as it had, thus, COVID-19 and tuberculosis cases rose simultaneously. Lockdown has also limited the availability of tuberculosis testing, making it harder for doctors to track the disease’s spread. Doctors fear inadequate access to proper medical care and resources will contribute to the development of new strands of MDR-TB.

Continuing to Fight Tuberculosis

The COVID-19 pandemic will undoubtedly continue to impact how Peru addresses tuberculosis. However, efforts have occurred at every level of society to keep combating the latter’s rise. For example, the government is continuing the TB Móvil program which it established in 2019 to increase access to tuberculosis testing by mobilizing vans across the country. The program will provide wide-reaching tuberculosis diagnosis and treatment options.

Non-governmental organizations are working on the ground in Peru as well. Socios en Salud (Partners in Health), which has been active in Peru since the mid-1990s, created its own programs and tools to increase access to tuberculosis treatments. The tools include Mochila TB, individual backpack machines that are useful for tuberculosis testing. The portable and compact machines “[take] testing directly to patients.” One device can test as many as 80 people per day. Solutions like Mochila TB make healthcare more accessible to the rural population. The devices can therefore greatly reduce the impact of tuberculosis in Peru.

Descriptions have determined that Mochila TB is a combination of “digital radiology, artificial intelligence and molecular biology” and has already made a significant impact. Since early March 2021, Mochila TB has reached 3,491 people in the most remote communities of Peru. The mobile testing capability eases the strain on healthcare systems to accommodate for COVID-19 care.

Paving the Way Forward

Healthcare professionals have identified another key step in mitigating COVID-19’s effect on the spread of tuberculosis in Peru: using the healthcare system to combat both diseases simultaneously. Given the diseases’ many similarities in infection, containment and spread, using the same strategies and principles for COVID-19 and tuberculosis in Peru can help stop the spread of both. Through innovations and strategizing, Peru should be able to successfully combat both pandemics.

Nathan Mo
Photo: Flickr

Global COVID-19 Relief
Under the visionary leadership of Dr. Paul Farmer, Partners in Health is setting an example for an effective and compassionate response to the COVID-19 pandemic. It is a global nonprofit organization that has been fighting for access to quality healthcare. The organization has catered to low- and middle-income countries (LMIC) since 1987. It does a good job of supplying strong on-the-ground global COVID-19 relief.

The Way Partners in Health Works

Partners in Health has developed on-the-ground networks of local healthcare professionals, community workers, facilities and government partners. These networks are poising Partners in Health to support strong on-the-ground global COVID-19 relief. They are also challenging the traditional “control over care” that LMICs traditionally use to combat pandemics.

Dr. Paul Farmer is chief strategist and chair of the Partners in Health board of trustees and recently won the $1 million Berggruen Prize for Philosophy & Culture for his impact at the intersection of global health and human rights and his leadership in advocacy for a global COVID-19 response that is humane as well as effective. Farmer is chair of the Department of Global Health and Social Medicine at Harvard Medical School. He is also the Brigham and Women’s Hospital’s chief of Division of Global Health Equity, a physician and anthropologist.

Replacing “Control Over Care” with “Global Equity”

Farmer feels that the global health arena needs to overhaul the dominant “control over care” approach, which focuses on containment and isolation during epidemic outbreaks. The COVID-19 response has heavily emphasized isolation and social distancing more than rapid testing and treatment. In a recent Forbes interview, Farmer noted that LMICs lacked ventilators and oxygen masks for treatment during the onset of the pandemic. Instead, Farmer advocates “global health equity” so everyone has access to trained staff, medicines, supplies, appropriate facilities and best practices.

In Rwanda, Partners in Health supports community health workers who do contact tracing and accompany sick people. Farmer feels that the Partners in Health COVID-19 response in Rwanda has been stronger than the United States’ response as the U.S. does not utilize community health workers in the same way.

Investment in Local Health Systems

The Partners in Health COVID-19 response is succeeding. This is because Partners in Health has already deeply invested in the local health systems of the 11 countries it supports. In each country, Partners in Health focuses on systems building through training strong medical staff. It also focuses on securing facilities with electricity, running water and ample space. From there, Partners in Health works very closely with local governments to implement universally shared best practices to ascertain quality care. Partners in Health employs community health workers to help community members access to care. It employs 18,000 staff with 99% from countries served by Partners in Health. It also supports at least 12,000 community workers who make more than 800,000 annual home visits to patients and families.

The Partners in Health COVID-19 response includes testing and contact tracing. It also includes free care and treatment for all COVID-19 patients at all Partners in Health-supported health facilities. The Partners in Health COVID-19 response includes assisting local governments by providing personal protective equipment (PPE). It also includes training in infection protection and control measures. Mobilizing community health workers is a third facet of the Partners in Health response to the pandemic. Partners in Health’s extensive experience with infectious disease outbreaks in several countries has informed it significantly. The organization supports the “People’s Vaccine” and COVAX global movements for free and readily accessible COVID-19 vaccines. Two examples of Partners in Health’s COVID-19 response include the building of a quarantine center in Liberia and an initiative to aid disadvantaged girls in both Rwanda and Haiti.

Partners in Health Liberia’s Quarantine Center

Partners in Health Liberia opened a 26-bed quarantine center in the coastal city of Harper in April 2020. It accomplished this by working with Liberia’s health ministry and other local health partners. The center provides medical and psychosocial services 24/7. It includes dignified care amenities such as hand-washing stations and gender-friendly washrooms. It also includes appropriate medical equipment such as blood pressure and oxygen saturation monitors. This is a great example of providing more on-the-ground global COVID-19 relief.

Partners in Health Haiti Supports Teens Coping with Emotional Stress

The Partners in Health Women and Girls Initiative (WGI) offers a spectrum of activities. This includes drawing, yoga and guided meditation in Haitian Creole for teens overwhelmed with COVID-induced stress. The organization is also raising funds to provide each of the 80 Port-Au-Prince WGI participants with internet access and solar lamps. The resources will help them continue their studies during COVID-19 lockdowns. Partners in Health established WGI in 2008 to empower disadvantaged girls in both Haiti and Rwanda.

The world is beginning to grapple with the global COVID-19 vaccine rollout. Farmer and Partners in Health will play an important role in ascertaining that LMICs receive them too. “[COVID-19] is a sharp reminder that everyone should be concerned with making vaccines available, regardless of ability to pay, the country in which you happen to be born or live, or any of the other criteria that have long been abused to deny equitable access to the fruits of modern science,” he said.

Shelly Saltzman
Photo: Wikipedia Commons

mental health in haitiLocated on the island of Hispaniola is the Caribbean nation of Haiti. The country gained independence in 1804, becoming the first country led by formerly enslaved peoples. A long history of political instability and corruption accompanied by catastrophic natural disasters has devastated Haiti’s population and economy. Additionally, a lack of infrastructure and access to basic resources ranks Haiti as one of the world’s least developed countries. This has created a crisis for mental health in Haiti, which has only worsened during the COVID-19 pandemic.

The Humanitarian Crisis in Haiti

Haiti is now home to over 11.4 million people, and nearly 60% of the population lives below the poverty line. Income inequality and unemployment rates are high, while the country does not meet its citizens’ basic needs. In fact, nearly 90% of people in rural areas lack access to electricity and plumbing.

Several natural disasters have also damaged Haiti in the past decade. The 7.0-magnitude earthquake of January 2010 devastated the nation’s capital city of Port-au-Prince. Indeed, the earthquake was one of the worst natural disasters to strike an urban area. An estimated 250,000 people died, while 300,000 people got injured and over 5 million became displaced. Six years later, Hurricane Matthew wiped out trade roads and coastal infrastructure. Conversely, lengthy periods of drought have paralyzed local agricultural markets. This has resulted in the inflation of even the most basic foods and necessities.

Though Haiti has focused on efforts to recover from natural disasters, longstanding economic and sociopolitical crises remain. One often overlooked problem lies in how these humanitarian crises affect mental health in Haiti.

Mental Health in Haiti: Existing Services

The ongoing humanitarian crises in Haiti create an extraordinary psychological toll on people. In particular, poverty and socioeconomic disadvantage increase the crisis of mental health in Haiti. Following the earthquake, 25% of the population reported experiencing PTSD. Additionally, 50% experienced a major depressive disorder. Disasters have also caused many Haitians to experience trauma and the loss of loved ones and livelihoods.

Despite these negative psychological outcomes, mental health in Haiti remains neglected. This is largely due to the majority of Haitians attributing mental health problems to supernatural forces. Specifically, many Haitians rely on inner religious and spiritual strength to overcome mental health issues. This culturally important Haitian belief, in tandem with the country’s inadequate mental healthcare services, leaves vast numbers of the population neglected.

Many people in Haiti simply go without mental healthcare. For a nation of around 11 million people, Haiti has a mere 23 psychiatrists and 124 psychologists. Haiti’s investment in healthcare services has even declined from 16.6% to 4.4% since 2017. Additionally, even if Haitians could find mental health services, they may not be able to afford or access them. Available services are often costly and inaccessible for those who do seek care.

The Implications of COVID-19

During the pandemic, Haiti has seen a rise in the cost of mental health services and medication. The country’s two running psychiatric hospitals have stopped accepting patients. Other hospitals, many now at full capacity due to the pandemic, have become testing facilities for COVID-19.

The pandemic has further exacerbated mental health in Haiti. General anxiety and concerns relating to the coronavirus and its effects have skyrocketed. Additionally, quarantine mandates have increased rates of domestic violence and abuse. Fatigued health professionals and medical staff also suffer from increased rates of depression. In short, medical professionals as well as the general population are experiencing the devastating mental impacts of COVID-19.

Moving Forward

Humanitarian crises and the coronavirus pandemic persist in the small island nation of Haiti. The aftermath of natural disasters, trauma and continuing political and economic instability lead to a crisis of mental health in Haiti. The country needs attention to the mental health needs of its citizens, in the midst of current and past crises.

Thankfully, nonprofit organizations like Partners in Health are striving to improve mental health in Haiti. Based out of Boston, Partners in Health is dedicated to establishing long-term relationships with organizations in the world’s poorest developing countries. Through its partnerships with local governments and other organizations in Haiti, Partners in Health has helped to innovate mental healthcare delivery models that integrate cultural beliefs about health and current biopsychosocial knowledge. Mobile health clinics also help ensure ensure that patients living in even the most remote regions of Haiti have access to necessary mental health services.

In the years to come, continued funding and support of programs like Partners in Health and its partnership organizations will be vital to improving the mental health and overall well-being of Haitians. Only then can the country truly overcome its current crises and past history.

Alana Castle
Photo: Flickr 

Vlogbrothers’ Partners In Health
John Green and Hank Green, known as “the Vlogbrothers,” started a YouTube channel in 2007 called Brotherhood 2.0. It was a place for the two brothers to talk to each other through daily videos in hope of bonding. Over 10 years later, the Vlogbrothers have gained a 3-million-strong community based around learning and activism. The Green brothers also use their platform to put their own words into action. They host a Project For Awesome event each year that sends donations to charities are based on the number of viewers. Now, the Vlogbrothers’ Partners In Health partnership aims to increase access to maternal health care for women in Sierra Leone.

The Challenges in Sierra Leone

The situation in Sierra Leone has reached a crisis level. The country is in deep poverty with 60% of its citizens below the national poverty line. The beautiful terrain suffers from natural disasters and unpredictable weather patterns, which harms food production. The country struggles with health issues. There is limited access to even basic health care, a lack of clean drinking water and outbreaks of deadly diseases. A specific group that is suffering is mothers.

Sierra Leone is a deadly country for mothers to give birth. It has the highest maternal mortality rate in the world — over 300,000 mothers died from childbirth in 2015 alone. Sierra Leonean mothers die of easily preventable causes, such as hemorrhaging, lack of refrigeration for blood transfusions, unsanitary tools due to lack of clean water or lack of ambulances.

Green Brother’s Trip to Sierra Leone

In the video “The Only Psychiatric Hospital in Sierra Leone,” John Green discussed his journey to Sierra Leone’s only mental health hospital. This is a country with a population of over 7 million people. Green noted that there was no electricity, water or lighting within the hospital. The infrastructure was crumbling and the medicine cabinet had been close to empty for years. With the help of Partners In Health, a generator was able to provide the hospital with electricity, better infrastructure and hundreds of medicines for patients. Most patients that go into the psychiatric ward are now able to walk out and live healthy lives.

In 2019, John Green uploaded “Why We’re Donating 6,500,000.” In the video, he discussed the trip to Sierra Leone and told the story of a minimum wage health care worker called Ruth. Her job involves identifying women who are at high risk during pregnancy. While with Ruth, Green noticed her slip $2 in her patient’s pocket. She had wanted to make sure her child could eat that day. Green reminded his viewers that “It required far more sacrifice and compassion for Ruth to make that donation than it does for our [Hank and John’s] families to make this one.”

He went on to announce a Vlogbrothers’ Partners In Health five-year partnership. He outlined the plans to raise $25 million to supply health care facilities, workers and staff with adequate support. Green hopes that the Vlogbrothers’ Partners In Health work will decrease the odds of maternal death.

The Vlogbrothers Road to $25 million

Since 2007, the Vlogbrothers have hosted an annual Project For Awesome event. It is a 48-hour fundraising event where the money goes to “decreasing world suck.” The project has the potential to raise thousands of dollars toward the Vlogbrothers’ Partners In Health work. Additionally, its merch store gives over 90% of its proceeds to Partners In Health. The rest of the store’s profits goes toward paying artists and employees.

Still, the goal of $25 million comes across as impossible. However, John explained that “We’re already more than halfway there.” In addition to the Vlogbrothers’ Partners in Health $6.5 million donation, a group of donors offered to match up to $120,000 worth of donations each year. Green explains that to reach his target, the organization needs to raise a little over $1 million a year.

Partners In Health Creates Progress

Partners In Health has already begun important work. It employs over 450 Sierra Leonean citizens and provides food across the country. In 2019, it marked the third year in a row where no mother died from preventable pregnancy causes. Hospitals were able to have running electricity and water as well as establish a running ambulance. With more investment in health care, the numbers will only continue to improve. With focus, resources and dedication, Sierra Leone’s mothers have a better chance of surviving.

John Green noted in his video that the solution to maternal deaths is not a simple one. “It isn’t ambulances or clean water or electricity or more health care workers. It’s ambulances AND clean water AND electricity AND healthcare workers AND much more.” Green went on to say that “systemic issues demand systemic, long term solutions.” With the Vlogbrothers’ Partners in Health partnership, the future of Sierra Leone’s mothers looks brighter than ever. Anyone can help the cause by donating to the Vlogbrothers’ campaign or visiting its merch store.

Breanna Bonner
Photo: Flickr

 

Life Expectancy in RwandaAs life expectancy in Rwanda has doubled in the past 20 years, the efforts that helped to achieve this goal are closely tied with efforts to combat poverty. If people are sick but cannot access healthcare, they cannot contribute to the economy. Conversely, if people are living in poverty, they often cannot afford to access healthcare. Ending poverty and providing medical care are closely tied, and Rwanda has made excellent progress on both fronts.

Life Expectancy in Rwanda

In the early 1990s, Rwanda was the site of a 100-day genocide, during which a million Tutsis and Hutus were killed. The genocide decimated the country, destroyed infrastructure and cast millions into poverty. Life expectancy in Rwanda reached a low of 26.2 years in 1993 at the height of the genocide, but by 2018, it had risen to 68.7 years. Furthermore, life expectancy is projected to increase to 71.4 years by 2032.

Many factors have contributed to the dramatic increase in life expectancy and overall social welfare. The Rwandan constitution secured citizens’ right to health in 2003. Accordingly, the government has invested in healthcare systems including primary healthcare systems, HIV/AIDS healthcare systems, oncology services, community-based health insurance and medical education. A dramatic increase in vaccination rates has been crucial in improving Rwandans’ health. After the genocide, fewer than 25% of children had been vaccinated against measles and polio, but today, 97% of Rwandan infants have received vaccinations against 10 diseases.

There have also been declines in deaths from tuberculosis and malaria. There has been a similar decline in maternal and child mortality: after the genocide, Rwanda had the world’s highest rate of child mortality, but today, Rwanda has caught up with the global average. Furthermore, the HIV/AIDS case and death rates have decreased. In 1996, antiretroviral therapy became available, and in the last 10 years, Rwanda’s death rate from AIDS fell faster than it did in the U.S. and Western Europe.

External investment and an increase in foreign aid have also improved Rwandans’ health. In 1995, Rwanda received only $0.50 per person for health, less than any other country in Africa. NGOs like Partners In Health (PIH) have helped increase the population’s access to healthcare and have supported efforts to rebuild public and community health systems.

Poverty in Rwanda

The percentage of people living in poverty declined by 5.8%, from 44.9% to 39.1%, between 2011 and 2014 alone. Factors contributing to the decrease in poverty include:

  • The improved health of the people of Rwanda. Strong healthcare systems can work to combat poverty, because when people are in good health and can access medical care, they are able to work and be more economically productive.
  • The government’s Vision 2020 anti-poverty objective, which fosters privatization and liberalization with the goal of promoting economic growth.
  • A thriving banking system.
  • The expansion of the service sector.
  • Entry into the East African Community, an economic bloc whose other members are Uganda, Kenya, Tanzania and Burundi.

Poverty and Life Expectancy in Rwanda

There is a substantial intersection between Rwanda’s efforts to increase its citizens’ life expectancy and its efforts to pull them out of poverty. The efforts to ameliorate both problems of poverty and life expectancy in Rwanda are linked through public health, and each is improving because the other is. In the words of one public health expert, Rwanda demonstrates that “a nation’s most precious resource is its people.”

Isabelle Breier
Photo: Wikimedia

Healthcare in Rwanda
Rwanda, the small landlocked state with a population of 12.5 million people, has made tremendous strides in the years following the infamous 1994 Rwandan genocide. The fertile and hilly state borders the much larger and wealthier Democratic Republic of the Congo, Tanzania, Uganda and Burundi. Rwanda is currently undergoing a few initiatives that the National Strategies for Transformation plan outlines. For example, Rwanda is presently working towards achieving Middle-Income Country status by 2035 and High-Income Country status by 2050. Among many improvements, many widely consider universal healthcare in Rwanda to be among the highest quality in Africa and the state’s greatest achievement.

Structure of Healthcare in Rwanda

Healthcare in Rwanda includes designed subsidies and a tiered system for users based on socioeconomic status. From 2003 to 2013, healthcare coverage in Rwanda has jumped tenfold, from less than 7% to nearly 74%. The Rwandan system of governance enables this level of widespread coverage. At the district level, funding and healthcare are decentralized to afford specific programs’ autonomy, depending on the needs of individual communities. Policy formulation comes from the central government while districts plan and coordinate public services delivery. In 2005, Rwanda launched a performance-based incentive program, which rewards community healthcare cooperatives based on factors such as women delivering at facilities and children receiving full rounds of immunizations.

Rwanda’s innovative healthcare system does not come without challenges. Nearly 85% of the population seeks health services from centers. Due to such wide use, it often takes long periods of time for health centers to receive reimbursement from the federal government for services rendered.

Improvements in Healthcare Access and Vaccinations

The rate at which Rwandans visit the doctor has also drastically increased. In 1999, Rwandans reportedly visited the doctor every four years. Today, most Rwandans visit the doctor twice a year. In addition, vaccination rates have drastically increased for Rwandans. Over 97% of infants receive vaccinations against diphtheria, tetanus, pertussis, hepatitis B, Haemophilus influenza Type B, polio, measles, rubella, pneumococcus and rotavirus.

Part of the improved healthcare in Rwanda is the state’s fight against cancer. The most common cause of cancer in Africa is human papillomavirus-related cervical cancer. As part of Rwanda’s goal of eliminating cervical cancer by 2020, over 97% of all girls ages 11 to 15 receive vaccinations for HPV. Rwanda is currently developing a National Cancer Control Plan and data registry to help track and combat the spread of cancer. Finally, to improve testing for cancerous markers, the government built the Nucleic Acid Lab as part of the biomedical center in Kigali.

Growing Pains

Despite vast improvements, the country still has a lot to do in regard to healthcare in Rwanda. Over the past two decades, Rwandan healthcare has steadily closed the gap in developed states, such as France and the United States. Life expectancy for Rwandans at birth is 66 and 70 years for males and females respectively.

In France and the United States, life expectancy at birth is nearly 15 years more for both males and females. As a percent of GDP (7.5), Rwanda spends nearly 10% less per year on healthcare than the United States and 4% less than France. Malnutrition is rampant in children; 44.2% of all Rwandan children are classified as malnourished. From 2008 to 2010, anemia levels saw large increases. While family planning is more prevalent, access to contraception is not widely, or at all available, in most parts of the country. Despite the decline of child mortality rates, newborn deaths account for 39% of all child deaths.

Moving Forward

Along with the Rwandan state government, organizations such as Partners in Health (PIH) have helped make vast improvements to healthcare in Rwanda. Locally known as Inshuti Mu Buzima, PIH brings healthcare to over 860,000 Rwandans via three hospitals. The crown jewel of PIH is its Butaro District Hospital, which serves a region in Rwanda that previously did not have a hospital. Today, the hospital is well-known for its medical education and training for all of East Africa.

As widespread access to healthcare continues to spread and immunization efforts increase, healthcare in Rwanda has the potential to lead the way for additional state-wide improvements. Through such efforts, Rwanda’s target goal of Middle-Income Country status by 2035 is creeping further into reach.

Max Lang
Photo: Flickr

health initiatives in Haiti

Haiti’s health care infrastructure has suffered drastically since the last massive earthquake in 2010. The earthquake further destroyed access to the delivery of health care and destroyed the country’s health care system as a whole. As a result, Haiti’s medical facilities now lack basic but critical services such as water and sanitation systems, state-of-the-art hospitals and clinics, modern medical resources and a sufficient number of trained medical professionals. There have since been health initiatives to aid Haiti in rectifying its health care and health care system.

Health Initiatives in Haiti

  1. Community Health Initiative: Emergency medical physicians Chris Buresh and Joshua White, who combined have more than 14 years of experience in Haiti, founded the Community Health Initiative (CHI) in Haiti in January 2012. CHI was founded to address the health needs of the Haitian community that would otherwise lack access to care by providing continuous primary health care. The program works with long-standing partnerships and local talent in the central region of Haiti to combat malnutrition, provide clean water and deliver health care to Haitians by returning to the same villages every three months. Because Haitians lack affordable primary health care in the area, most patients walk eight hours or more to arrive at CHI’s clinics for treatment. The Community Health Initiative provides clinics in the rural areas of Haiti. Since its founding in 2012, CHI has delivered 1,100 water treatment systems in which have reduced the diarrhea rate among users to 1.8 percent. Community Health Workers have trained 81 women in their Helping Babies Breathe program which has allowed a 71 percent reduction in neonatal mortality.
  2. Partners In Health: Partners in Health (PIH) is Haiti’s largest health care provider. PIH has been providing medical services to Haitians for more than 20 years. PIH helps deliver high-quality health care to some of Haiti’s poorest regions, serving an estimated 4.5 million people with the help of the national Ministry of Health. PIH’s community health workers have helped 15,000 HIV-positive patients begin and remain on treatment and have allowed 1,500 TB patients to start treatment on the path to a cure each year since initiation. Since PIH’s founding, the mortality rate for children under the age of 5 has been reduced to 71 per 1,000 where Haiti had the highest rates of infant and child mortality; the rate of incidents surrounding TB has also been reduced to 181 per 100,000, and the adult prevalence of HIV is now 1.9 percent.
  3. Hope For Haiti: Haiti reports some of the world’s worst health indicators that continue to inhibit Haiti’s development. Hope for Haiti is a health initiative that operates an infirmary in southern Haiti and partners with 24 rural communities to improve the health care system and its individual health indicators. Hope for Haiti provides primary care services, public health education and nutrition education, and it organizes mobile clinics. Since Hope for Haiti was founded, 6,727 lab tests were performed for a record of 3,090 patients. Around 2,700 Sawyer Water Filtration Systems were distributed in Haiti, impacting over 13,500 people, 2,800 students were provided with public health education and 100 diabetes club meetings were held for the Haitian community.

Haiti is in need of a permanent and modern health care infrastructure so that it can respond promptly and effectively to the medical needs of its community. With health initiatives such as Partners in Health, Hope for Haiti and the Community Health Initiative, Haiti will be well on its way to better health care and an improved health care system.

Na’Keevia Brown
Photo: Flickr

Maternity Crisis in Sierra Leone
There is a maternity crisis in Sierra Leone. The country has the highest maternal death rate in the world, with one in 17 women dying from pregnancy or birth complications. This number could be even higher, as Sierra Leone’s 2017 Maternal Death and Surveillance Report estimated that seven in 10 maternal deaths go unreported. Below are seven facts about the maternity crisis in Sierra Leone.

Top 7 Facts About the Maternity Crisis in Sierra Leone

  1. The Majority of Maternal Deaths are Preventable: The top causes of maternal death in Sierra Leone are bleeding, pregnancy-induced hypertension, infection and unsafe abortions, all of which are preventable through adequate medical treatment, according to the World Health Organization. Bleeding is a particularly difficult problem for under-served rural areas where mothers do not have access to health care facilities. Another issue facing mothers is infrastructure. People poorly maintain many roads between towns and clinics and these make for a difficult journey for sick and laboring women. Again, road maintenance is a simple problem that can help reduce maternal death in Sierra Leone.
  2. The Majority of Mothers are Under 20: One hundred and twenty-five out of 1,000 mothers in Sierra Leone are under age 20 according to a 2017 United Nations Population Fund (UNFPA) study. Maternity in Sierra Leone is particularly dangerous for adolescent mothers and 20 percent of maternal deaths in Sierra Leone were among teenagers. Beyond maternal death, pregnant teenagers in Sierra Leone lose out on life prospects – a 2015 law banned pregnant girls from attending school, and parents describe teenage pregnancy as the “ultimate shame” for a family.
  3. The 2014-2015 Ebola Crisis Halted Progress: Before 2014, Sierra Leone was making progress in reducing maternal death – from 2000 to 2015, maternal deaths dropped by 4.4 percent. However, the Ebola epidemic caused an immediate increase in maternal death through 2015. Sierra Leone planned to meet many Millennium Development Goals by 2015, but the May 2014 Ebola outbreak reversed progress, particularly in maternal health. Not only did Ebola put a strain on general health care in Sierra Leone, but it also dramatically reduced the number of health care workers in the country. A 2016 World Bank report estimated that maternal death could increase by 74 percent due to the extreme shortage of health care workers in the country.
  4. Programs for Maternity Care Still Need Funding: There is a dearth of doctors in Sierra Leone. For example, in the district of Bonthe, there are nine doctors for 220,000 patients and only 44 percent of births receive support from a nurse or midwife. Unfortunately, between the civil war from 1991 to 2001 and the 2014 to 2015 Ebola outbreak Sierra Leone, the burgeoning health care system in Sierra Leone lost momentum. The E.U., the U.N. and UNICEF have all devoted funds to maternity in Sierra Leone in addition to Partners in Health and other nonprofit organizations. Donations are critical to moving forward with maternal health.
  5. Sierra Leone’s Government has Committed Itself: President Julius Maada Bio announced in October 2019 that Sierra Leone increased its health budget from 8.9 percent to 11.5 percent of the country’s national budget to help combat dangerous maternity in Sierra Leone. On October 18, 2019, Sierra Leone opened a $1.6 billion maternity facility in Freetown to better serve the country’s largest city. Sierra Leone also launched a free health initiative in 2010 to help improve pre- and post-partum care. The government’s goal for maternity in Sierra Leone is to meet Millennium Development Goals by 2030, reducing the global maternal mortality ratio to less than 70 per 100,000 live births.
  6. Nonprofits are Deeply Involved: Multiple nonprofit organizations, including UNICEF, Partners in Health and the Borgen Project have covered issues with maternity in Sierra Leone. Partners in Health has been particularly successful, building a maternal waiting home and opening a health clinic in Kono in 2018. UNICEF provided safer water for mothers to help with illness and sanitation. These nonprofits prove that the crisis is not insurmountable.
  7. Celebrities are also Getting Involved: In October 2019, vlogbrothers, run by Hank and John Green, pledged $6.5 million to Partners in Health as part of his family’s initiative to bring awareness to maternity in Sierra Leone. John Green discussed how he traveled to Sierra Leone and saw first-hand the lack of hospital electricity, medical equipment and transport. He praised the efforts of the Partners in Health in developing a large-scale hospital system and making systematic changes and he asked anyone who can donate to do so. Currently, the vlogbrothers have a goal of $240,000 per month in donations – so far, they have approximately $194,000. The vlogbrothers are also providing updates on their donations and work with Partners in Health in Sierra Leone.

Motherhood should not be a gamble. Families around the world deserve to look forward to pregnancy and birth and not feel distressed. Multiple organizations are pushing for progress, but more is necessary. Support in any form, from awareness to donations, can only help the crisis of maternity in Sierra Leone.

Melanie Rasmussen
Photo: Flickr

Important Poverty Nonprofits
The world is full of people trying to do good, some of whom are well known and acknowledged for the work they do. Many change-makers, however, fly under the radar and do not receive the recognition they deserve for the profound changes they have generated. Some important poverty nonprofits have been working to mitigate poverty and disease worldwide for years, and they are the ones who could benefit greatly from volunteers. The following are five groups whose efforts should not go unnoticed by the world.

Five Important Poverty Nonprofits

  1. Mothers2mothers – This group focuses on alleviating the HIV/AIDS epidemic in Africa while empowering women and mothers living with and/or around the disease. Africa is lacking heavily in healthcare workers. Mothers2mothers is an important poverty nonprofit that hires and trains HIV-positive women to fill these roles, thus providing them with the opportunity to gain financial security for their families and giving the community access to much-needed healthcare. Through this method, thousands of jobs have been created and hundreds of thousands of lives have been saved.
  2. Partners in Health (PIH) – Founded in 1987 by world-renowned doctor Paul Farmer, PIH has made great strides in eradicating life-threatening epidemics, such as multi-drug resistant tuberculosis, in third-world countries. PIH focuses on building lasting healthcare systems in countries that are severely lacking and providing this service to the poor, who would not typically be able to afford it. To do their incredible work, PIH relies heavily on donations.
  3. Kiva – Kiva is a nonprofit that provides low-income, entrepreneurial women and students with loans to start their own small businesses. They described their mission as “to connect people through lending to alleviate poverty.” Kiva has proven that even small loans can create lasting change in the lives of those who need it. Recipients of loans through Kiva have gone on to build small businesses that allow them to support their families and stimulate the economy of their communities.
  4. Charity: water – This is a nonprofit that works to provide clean drinking water to developing countries. Charity: water uses donations to build wells that would eliminate the need for people to walk miles away to get to a water source. They also provide sand filters and rainwater catchments that promote cleanliness in drinking water, which helps to lessen the spread of disease in impoverished communities.
  5. Concern Worldwide – This organization focuses on long-term solutions in third-world countries. Concern Worldwide responds to emergencies like environmental disasters and genocide. Their past projects have included providing food and nutrition to the starving after the 1973 Ethiopian famine. They are currently working with Syrian refugees in The Middle East.

These five are just a few of many important poverty nonprofits that work to make a positive change in the world, no matter how small. Contributions to groups like these have the ability to create a ripple effect in the lives and communities of those who truly need it. Getting involved can come in any form from promoting the causes online to volunteering time to help with projects. When it comes to making a change, there is no contribution too small.

– Amelia Merchant
Photo: Flickr