Mental Health Care in LaosGlobally, mental health conditions constitute 14% of the total disease burden, and in Laos, approximately 210,000 individuals are grappling with various mental, neurological or substance-use conditions, including depression and anxiety. Unfortunately, access to essential mental health services is lacking for many affected individuals, particularly in rural areas, resulting in a hidden crisis. This has been made significantly worse by the pandemic. 

Despite a decade of overall health improvements, mental health services in Laos have not progressed at the same pace. A mere 0.3% of the total health budget is allocated to mental health, starkly illustrating the challenges, with 95% of individuals with serious mental illnesses left untreated. However, transformative collaborations with the World Health Organization (WHO) and The United Nations Population Fund (UNFPA) signify a positive shift, empowering health care providers and scaling up mental health initiatives nationwide. This evolving landscape reflects a nation committed to addressing mental health as a core component of overall well-being, marking a promising turning point for mental health care in Laos.

Strengthening Mental Health Services

Efforts to address these challenges are underway through collaboration with the WHO under the UHC Partnership. This joint initiative sees mental health and psychosocial support integrated into the general health system, with a focus on primary health care as a pivotal platform for community-level intervention. Extensive training programs have been implemented, targeting central- and provincial-level health care workers, including those directly affected by events such as the Attapeu dam burst. This strategic training equips primary care providers to offer essential mental health support, fostering a deeper understanding of mental disorders and addressing associated stigma.

A crucial step has been taken by the Ministry of Health, in collaboration with the WHO, in developing and field-testing National Mental Health and Psychosocial Support Counseling Guidelines. This significant undertaking involves training by district health officers and village committees, ensuring a grassroots approach to mental health care. The goal is to create an inclusive action plan for scaling up initiatives nationwide, ensuring accessibility to mental health care for all, including those residing in remote areas.

Mental Health Amid the Pandemic

The compounding effect of the COVID-19 pandemic on mental health in Laos is underscored by the WHO. Increased distress, particularly in rural areas, where an estimated 75% of the population lacks access to mental health care services, is contributed to by economic hardships and direct illness from COVID-19. 

UNFPA has implemented youth-focused interventions, providing psychosocial support through initiatives such as helplines, personal protective equipment (PPE) for health care workers and online resources, underscoring a comprehensive approach to address the mental health implications of the pandemic.

Laos faces significant challenges in mental health care due to limited resources, geographical disparities and the impact of the COVID-19 pandemic. Collaborative initiatives led by international organizations like the WHO and UNFPA, along with the commitment of the Lao government, are systematically addressing these challenges. Positive strides, including the strengthening of mental health services, integrating training into primary care and developing comprehensive guidelines, signify progress toward a more inclusive and accessible mental health care system. While challenges persist, there is hope for a future where mental health care in Laos is prioritized and reaches every individual, regardless of their location or socioeconomic status.

– Marnie Woodford-Venables
Photo: Flickr

GIVE VolunteersWhile traveling abroad is a favorite pastime of college students for the views, food and fun, GIVE Volunteers works to engage travelers for a different reason. This service organization gives young people the opportunity to immerse themselves in the culture of five international destinations where they offer programs. On these trips, volunteers work alongside community members on conservation, restoration and education projects. The Borgen Project spoke to one former volunteer and chapter president, Logan Falk, about her eye-opening experience in Thailand and Laos.

GIVE Programs

GIVE Volunteers offers a diverse array of programs in North America, Tanzania, Thailand and Laos. Program itineraries vary by country, but overall the organization focuses on combining cultural immersion, tourism and service. The trips are an alternative to traditional study abroad programs, emphasizing hands-on service projects instead of classroom education. 

Most volunteers are recruited on college campuses. GIVE often exists as a student-led club on U.S. campuses, offering students the opportunity to volunteer locally in their university towns while fundraising for their potential trips abroad. Some of the trips focus on conservation and restoration efforts, while others place volunteers in impoverished communities to assist with construction, farming and education. 

The Borgen Project spoke with a GIVE member who participated in one of these poverty-focused programs in Thailand and Laos. Falk was an executive member of James Madison University’s GIVE chapter in Virginia. On her 5-week trip through Thailand and Laos in the summer of 2022, she worked in local schools teaching English, assisted craftsmen and women and used her “tourist dollar to support local businesses.” For the people living in these areas, such efforts can make a world of difference.

Poverty in Thailand

According to a 2022 report by Thailand’s primary economic agency, The Office of the National Economic and Social Development Council (NESDC), approximately 8.1 million Thai people live in poverty. Many of these individuals are children. Of the overall population, the poverty rate among children was 9.9% in 2021. UNICEF reports that this is a lasting effect of the COVID-19 pandemic, which raised food and energy costs. Inflation hit its highest rate in 14 years at 7.66% in June of 2022. Households with children were especially impacted, forcing many students out of school.

The effects of poverty forced more than 280,000 children to drop out of school in 2021, the NESDC reports. According to the UNICEF Representative for Thailand, Kyungsun Kim, reversing these effects is imperative to the country’s lasting recovery. In a 2022 UNICEF press release, she emphasized the need for building human capital in Thailand. With the population “rapidly aging,” ensuring children receive protection and the means to grow into active members of society is of the utmost importance. 

Poverty in Laos

The issue of poverty is similarly prevalent in Laos. About 23% of the overall population lives below the poverty line, surviving on less than $1.25 per day. Considering that more than 30% of the population is under the age of 14, children suffer significant impacts.

Laos is primarily an agricultural country, with 80% of families working in agriculture. However, the rural areas that house them are prone to food insecurity as a result of extreme floods and droughts. Estimates suggest that 33% of children under the age of 5 face stunted growth due to malnutrition. Of every 22 Laotian children, one dies before they reach their 5th birthday. This is seven times the U.S. infant mortality rate. 

For those that do survive, an estimated 28% are forced into child labor to support their families. GIVE Volunteers makes it its mission to get these children back in school and support them with life-changing education.  

Expanding Perspectives

On her trip, Falk worked one-on-one with children from rural communities in Thailand and Laos, engaging them in activities and teaching them English. She told The Borgen Project that her time volunteering was full of “authentic experiences” in a program that was “constantly creating open learning environments.” Rather than going in with a specific agenda, Falk liked that the trip let volunteers get involved by “asking where [they] can help rather than taking the lead.”

This collaborative approach aligns with Falk’s idea of being a global citizen, one of her biggest takeaways from the program. For her, global citizenship is a reminder “that we all share the same home, so no matter where we are, there are ways for us to be giving back and supporting one another.” On her trip, she learned that the key to being a global citizen and an “ethical and sustainable volunteer” is “supporting the community that is welcoming us with no intention to ‘fix’ it. We went in to learn without judgment.”

After learning from, bonding with and seeing the struggles of people in Thailand and Laos, Falk left GIVE Volunteers with an inspiring realization: “There are so many large and small, intentional social, political, environmental, and economic actions we can take to make a difference on this planet that never ceases to amaze me… We can use our voices, our art, our activism, our knowledge, our money, and our VOTE to support communities within and outside of just our own.”

– Rachel Rebecca Smith
Photo: Unsplash

Food Insecurity in LaosAlthough the poverty rate in Laos more than halved between 1993 and 2018, nearly one in five households still experience poverty today. Not surprisingly, food insecurity in Laos continues to be a concern. Laos ranked 82nd out of 121 countries on the Global Hunger Index in 2022. The World Food Programme (WFP) reports that about 33% of Laotian children younger than 5 experience stunting and the RFA (Radio Free Asia) states that, in the Xienghone district, more than 20% of Laotian children younger than 5 suffer from malnourishment.

The Human Capital Index report by the World Bank indicates that “Lao children born today only reach 45% of productivity they could have if afforded full health and education.” This shows that these deprivations are not only detrimental to the individual but to the progression of the country as a whole.

Reasons Behind Food Insecurity in Laos

At the onset of the COVID-19 pandemic, hunger in Laos rose. Prior to the pandemic, Laos depended on food aid from Vietnam to meet citizens’ food needs. However, when countries closed their borders, this was no longer possible. Additionally, the food programs already in place in Laos are failing as these initiatives are not able to “[keep]pace with the changing circumstances,” including changing weather patterns, natural disasters and “land mismanagement” according to the RFA.

Laos’ geographic location also makes the nation more vulnerable to droughts and floods. These extreme weather events severely impact food security in Laos by destroying existing crops, thus affecting the livelihoods of farmers. Furthermore, as a landlocked and predominantly rural country, it is more difficult to transport and access food.

Additionally, issues regarding access to clean water and sanitation contribute to poor nutritional outcomes in Laos. A lack of water, sanitation and hygiene facilities can lead to diseases that impact the body’s ability to absorb nutrients. ReliefWeb reports that “malnutrition can be widespread even in regions with plentiful supplies of affordable food because this food is not well absorbed by the body.”

Efforts to Reduce Food Insecurity in Laos

The WFP has been “working in partnership with the Government of Lao PDR on promoting access to nutritious food for school-age children for two decades,” according to the WFP website. To improve nutrition and reduce hunger among children, the WFP leads school feeding programs. During times of crisis and emergency when the government cannot adequately provide for citizens’ needs, the WFP “provides nutritious food and cash assistance.”

The Adventist Development and Relief Agency (ADRA) is helping to address hunger and malnutrition in Laos through various programs and interventions. As part of the positive Deviance/Hearth initiative, a community nutrition rehabilitation program, in 2021, ADRA Lao’s health and nutrition officer, known as Chef Touktick, taught children and women how to cook healthy and nutritious food.

By implementing long-term strategies, the government of Laos can ensure sustainable solutions to food insecurity in Laos while improving the quality of life of citizens.

– Priya Maiti
Photo: Flickr

humanitarian aid to LaosLocated in Southeast Asia, Laos is regarded as the world’s most heavily bombed country, polluted with loaded ordnance. Vulnerable to extreme climate change, devastating impacts have been marked in this country in rural areas caused by flash floods, landslides, river floods and annual human and animal epidemics.

In 2017, Laos and Australia celebrated 65 years of diplomatic relations. Through its Department of Foreign Affairs and Trade, the Australian government will provide about $42.3 million in humanitarian aid to Laos from 2017 to 2018. Through this humanitarian aid to Laos, Australia aims to establish prosperity and decrease poverty while assisting with the economic integration with the region.

For 2016 to 2017, the total official development assistance from Australia is an estimated $44.2 million. Results from aid given in 2015 to 2016 had a tremendous impact on schools within Laos. Aid supported 217 new teacher trainees in completing their first year of teacher training, 140 being women. Scholarships were provided to 20 teacher educators and assisted 259 schools located in five provinces to acquire school lunches.

Research shows that in 2014 Laos received a total of $472.4 million in development aid. Although other countries, such as Japan and Germany, have contributed humanitarian aid to Laos, Australia has been most consistent.

Caritas Australia, a Catholic Agency for International Aid and Development, has left its mark on Laos as well. With a focus on developing women and children, Caritas is providing stability.

From 2010 to 2011, more than 40 Laotian mothers received livelihood and business training that helped pay for their children’s education. Without this opportunity, schooling funds would come from panhandling. Around 50 children living with a disability were provided education. Workshops were held to train and support caregivers, teachers and parents of children with disabilities.

Although Australia is the main donor of aid to Laos, the nation could use assistance from other countries as well. Through more aid, Laos can develop at a faster rate and create more opportunities for its citizens, leading to a better quality of life.

– Tara Jackson

Photo: Flickr

Poverty in Laos
Laos is a poor communist country — the result of a complicated history. Since declaring sovereignty in 1954 American contributions poignantly shape Laos’s physical landscape, albeit initially with bombs. More recent U.S. administrations, alongside international investors, have bequeathed the type of strategic investments in Laos that encourage economic development and social prosperity. Poverty in Laos is shifting.

The Lao people experienced a prolonged period of civil war and armed conflict immediately following independence. After years of abounding poverty, the economy writhed amid growing American anti-communist actions in neighboring Vietnam and Cambodia. The fighting soon leached across Laotian borders as part of a wider U.S. bombing campaign. While Laotians initially measured U.S. contributions only in terms of explosive tonnage, current administrations have retooled U.S. foreign policy in Laos to encourage growth. These efforts require a detailed understanding of Laos and its people.

Agrarianism dominates Laotian society. Rural farmers require an adequate road system to bring the agricultural goods market. In 2015, only 14 percent of all roadways in Laos were paved. Poverty in Laos exists predominantly in rural areas, the same locations growing crops with inadequate transportation infrastructure.

Transportation network improvements implemented in the late 1990s provided proof of a strong correlation between targeted infrastructure investment and rural poverty reduction. The Lao Peoples Democratic Republic (PDR) government conducts household surveys every fifth year, the Lao Expenditure and Consumption Survey, which enables the study of poverty rates. Peter Warr, a professor of agricultural economics at the Australian National University, compared the two surveys that bracket the late 90s improvements to imply, “about 13 percent (one-sixth) of the reduction in rural poverty incidence… can be attributed to wet season road access.”

Poverty in Laos and War

The combined impacts of civil war and a U.S. bombing campaign in Laos staunched civil progress and economic prosperity. In an effort to help improve impoverish conditions in the country, a U.S. State Department’s principal foreign policy objective regarding assistance to Laos is to help the country meet its development goals.

President Obama visited Laos in September 2016, marking the first trip by any U.S. president to the country. Likely his last Asian tour as president, Obama’s trip highlighted the U.S. strategy to rebalance Asia and the Pacific. In a speech to the people of Laos, the president alluded to the U.S.’s assumed role to end extreme poverty through “transformative investments.” Obama also discussed diplomatic efforts that resonated strongly with two U.S. national security interests: prosperity and international order.

The president pledged $90 million over the next three years to help Laotians clear American unexploded ordinance. “Over nine years—from 1964 to 1973—the U.S. dropped more than 2 million tons of bombs here in Laos—more than we dropped on Germany and Japan combined during all of World War II,” President Obama stated. The pledge enables Laotian health and prosperity within its borders and supports international order by strengthening Asia-Pacific alliances.

According to sources for Radio Free Asia, “Road construction and renovation in Laos are usually plagued by corruption with exorbitant costs.” Assistance simply does not end after the deposit. The U.S. must follow through, providing the appropriate accountability and oversight.

The takeaway reveals how detailed research, analysis and understanding allow the investor to achieve broader returns as well as dividends. Road investments and UXO removal, while altruistic to end poverty in Laos, stimulate Laotian autonomy and economic progress. An economically independent and prosperous Laos promotes the success of broader U.S. National Security Strategic goals.

Tim Devine

Photo: Flickr

Lao PDRThe Vietnam War: a distant and heartbreaking memory for some, a reoccurring nightmare for others and still, an everyday existence for the people of Laos, now the Lao People’s Democratic Republic (Lao PDR). Weapons of a war long past stay buried like forgotten ghosts, haunting the innocent and poisoning the ground they walk on.

With the help of organizations like Mines Advisory Group (MAG), Laotians could farm the soil instead of fear it.

Between 1964 and 1973, 260 million cluster bombs—the equivalent of one bombing mission executed every night, every eight minutes for nine years—were dropped on Laos by the United States. Today, 30 percent of these bombs remain as unexploded ordinance, also referred to as UXO.

The bombing campaign was meant to deny access to the Ho Chi Minh trail, an important logistics route located mostly within the Lao borders and used by the Vietcong and North Vietnamese Army for supply and movement. Long after the fighting ended, Lao men, women and children are still paying the price with an estimated 20,000 people killed and many more injured since the war’s end.

Lao PDR is the most heavily bombed country per capita in the world with 30 percent of the ordinance still volatile and contaminating ground that could be used for agriculture, 33 percent of the country’s GDP. “Bombies,” as the locals have nicknamed them, are therefore a direct factor causing the persistent poverty plaguing the country.

Over 40 percent of children under the age of 5, and 63 percent of children under the age of 2 suffer from anemia in Lao PDR. Almost 45 percent of children under 5 years old and 23 percent of women between 12 to 49 years of age are affected by sub-clinical vitamin A deficiency. Forty-four percent of children under 5 years old are stunted due to poor diets.

Lao PDR is predominantly mountainous and many of the villages are inaccessible by road, cutting off much of the populace from essential services and further compounding an already bleak situation.

Mines Advisory Group, a nonprofit organization operating in Xieng Khouang province bordering Vietnam, raises funds from the American community, including individuals, corporations, foundations and government donors promoting awareness for their life-saving work.

According to their website, from April 2007 to May 2011, MAG cleared 23,778,512 square meters of suspect land in Lao PDR, destroying 145,000 items of UXO. As a result, 330,000 beneficiaries gained more safe land for agriculture, clean drinking water, sanitation, safe school compounds and safer roads.

Additionally, MAG gives jobs to those who need them most, investing in, training and employing staff from the local population in order to build a robust and sustainable national workforce.

Women are not shying away from battling the hidden perils beneath their feet either. In fact, about 40 percent of the ground clearing crews in MAG is made up of women filling the front lines and risking their lives every day to build a better future.

Years after the end of the Vietnam War, its legacy still lives on, hidden in the ground and destroying lives an ocean away. With peace activists urging the U.S. to do more, funding for mine clearing efforts and victim assistance has increased, but according to Laotians, the scope of the situation is still undervalued and the task of clearing the land is immense.

– Jason Zimmerman

Sources: FT Magazine, United Nations Development Programme, ABC News, Legacies of War, World Food Programme
Photo: Wikimedia Commons

Poverty in Laos
As one of the few countries in the world that remains communist, Laos is ranked as one of the poorest countries in east Asia.

With the collapse of the Soviet Union in 1991, Laos found difficulty in altering their “political and economic landscape.” Despite various attempts at reforms, Laos remained dependent on international donations following the 1990s. Majority of these donations spur from Japan, China, and Vietnam.

In spite of their conditions, the country has been able to make impressive gains within the past 20 years. In the 1990s, the proportion of poor individuals was 39 percent. By 2010, this number decreased to 27.6 percent.

Over the years, Laos has experienced various complications in reforming their economic state. The government has gradually enforced economic and business reforms since 2005. In 2011, a stock market was also opened in the hopes of shifting towards capitalism.

Although these measures have been taken, economic growth in Laos has reduced poverty on a minimal scale. In 1997, the Asian currency crisis struck a deafening blow to the country, causing them to lose more than nine-tenths of their national currency’s value against the US dollar.

The landscape of Laos adds to it’s state of disparity. Being a heavily mountainous area, the country is landlocked and widely blanketed by tropical forests. Less than five percent is suitable for any sort of agricultural subsistence, furthermore contributing to the 80 percent rate of unemployment.

Outside of the country’s capital, individuals lack electricity or any access to general facilities. In the mountainous areas where majority of the population lives, the poverty rate is roughly 43 percent. This is a significant difference compared to individuals in the lowlands, where the poverty rate is 28 percent.

Majority of the disadvantaged households are located in regions that are constantly plagued by the threat of natural disasters, lack livestock of any form, have a great number of dependents, and are led by women.

In Laos, women work more than men, taking an average of 70 percent of farming and household tasks on, while also caring for young children. The literacy rate of women is generally 54 percent, while being 77 percent for men.

One-third of those living in Laos lives below the national poverty line, lacking resources necessary to lead healthy lives. According to Health Poverty Action, less than half of all women who go into labor have a doctor, midwife, or nurse to support them.

Around 40 percent of the children in Laos are chronically malnourished and suffer from severely stunted growth. In various ethnic groups, this number increases to a disturbing 60 percent.

There is good news for the country of Laos, however. In 2010, a Nam Theun 2 dam scheme was inaugurated, projected to provide $1.3bn to the country. This will be used in order to generate electricity to allow exports to Thailand. This step forward will not only boost the economy, but help develop infrastructure as well.

In early 2011 the country was also set to have the construction of their first high-speed rail begin between Laos and China. With all of the anticipated infrastructure and improvements to the overall economy, many hope that Laos will experience relief soon.

– Samaria Garrett

Sources: BBC, Rural Poverty Portal, Health Poverty Action