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AMREF: Lasting Health Changes in AfricaSurgeons Michael Wood, Archibald McIndoe, and Tom Rees came up with a plan to provide medical assistance in remote regions of East Africa in 1957. Today, the African Medical and Research Foundation (AMREF) is the most respected health development organization based in Africa. Their mission is simple: bringing lasting healthcare improvements to Africa.

AMREF’s strategy is based on seven priority areas:

  1. Maternal health, including safer pregnancies, support for reproductive rights and cervical cancer prevention for disadvantaged women.
  2. Child health, including integrated management of childhood illnesses and improved childhood nutrition.
  3. Fighting diseases like HIV, TB and malaria with prevention, care and treatment.
  4. Improving access to safe water and sanitation to prevent epidemics of waterborne diseases.
  5. A wider reach of quality clinical and diagnostic services by strengthening health facilities.
  6. Research and advocacy to distribute knowledge to healthcare workers across the continent.
  7. A strong, united AMREF Health Africa.

AMREF works to make significant healthcare improvements in African countries like Ethiopia, Kenya, Uganda, South Sudan, Tanzania and Senegal. AMREF has been successful in developing community-based healthcare models and programs with communities, which is the heart of their system. It reaches and respects communities and brings lasting healthcare improvements to Africa from within.

AMREF launched the successful Stand Up for African Mothers campaign to ensure that mothers are given adequate medical care during pregnancy and childbirth. It aimed to train 15,000 midwives to reduce maternal death by 25 percent. One trained midwife was projected to provide care for 500 women each year, including safe deliveries of 100 babies.

AMREF set up the Kenya eLearning Nurses Upgrading Programme in 2005 and a few years later, it expanded to include the AMREF Virtual Nursing School. The program has further evolved to implement projects such as:

  • Conversion of the Diploma in Community Health program to eLearning
  • Conversion of six distance education courses to eLearning
  • The Center for Disease Control-supported infection prevention and control program
  • Conversion of the national antiretroviral therapy guidelines to eLearning
  • Replication of the eLearning program in various countries across the region including Uganda, Tanzania and Senegal
  • Support for the Ministries of Health in non-AMREF countries to implement eLearning, including Zambia and Lesotho.

More than 220 women die each day due to pregnancy and childbirth complications in Sub-Saharan Africa, and children in Africa are 16 times more likely to die before the age of five than in developed regions. This highlights the serious need for healthcare improvements in Africa. AMREF has shown that when women have more control over their life and health, they become more effective and have a great impact on their own community.

AMREF has taken the lead to improve the situation by partnering with and empowering communities and strengthening healthcare systems. Their priority areas address the most pressing healthcare concerns, bringing lasting healthcare improvements to Africa in the places where it is needed most.

Tripti Sinha

Photo: Flickr

Schistosomiasis Control InitiativeOne of the many challenges hindering the alleviation of global poverty is the health conditions that afflict those in poverty. Poor health contributes to higher child mortality, premature death and inconsistencies in the ability for the public at large to function. Many impoverished countries experience lower rates of student attendance due to the effects of health conditions. However, many of the ailments experienced by the extremely poor are preventable or curable, but without access to appropriate medicines, they can be detrimental to a productive life or in many cases fatal. The Schistosomiasis Control Initiative is an organization working in sub-Saharan Africa to help those that suffer from such diseases and infections.

In 2015, 218 million people lived with preventable diseases, one of which was soil-transmitted schistosomiasis, or parasitic worms. This infection originates from poor sanitation and a lack of clean water and water treatment facilities. The parasite lives in contaminated freshwater and the recipient becomes infected when they come in contact with the water. There are effective treatments for schistosomiasis once it is contracted, but in some places, these medicines are scarce, unavailable or expensive.

The Schistosomiasis Control Initiative works in several ways to help generate support for administering medicine for schistosomiasis as well as public outreach and communication to prevent such diseases. Schistosomiasis Control Initiative collaborates with local and global government and nonprofit agencies to ensure access to treatments and helps develop strategies for prone communities to prevent transmission. In line with the United Nations Development Goals, Schistosomiasis Control Initiative’s goal is to make a significant impact on health conditions for the extremely poor by 2030, thereby improving quality of life across many standards such as school attendance, child mortality and general productivity.

As of 2015, 74.3 million people have been treated worldwide for schistosomiasis, in part due to the efforts of Schistosomiasis Control Initiative. In the following decades, simply due to the nature of the disease and the availability of treatment, one can expect these statistics to improve, thanks to groups willing to transport treatments to the locations that need it most and arm communities with the knowledge to prevent it in the future.

Casey Hess

Photo: Flickr

Toilets for Kenya2.5 billion people lack access to a hygienic toilet. The toilets that they do have often dump human waste into water sources or leave it exposed to the air. Leaving human waste in water or out in the open can cause diarrheal diseases that can kill many people, mainly affecting children under the age of five. Sanergy, the creator of Fresh Life Toilets, hopes to provide toilets for Kenya and alleviate the unhygienic conditions in slums.

These low-cost and high-quality sanitation toilets prevent people in Kenyan slums from using pit latrines or what is known as “flying toilets”, which are non-decomposing plastic bags. What Sanergy offers are not only toilets for Kenya and its communities, but a proper way to dispose of the waste as well.

Sanergy and those in the areas that work with them collect the waste on a daily basis. After they have replaced the waste cartridges, they take the waste to a treatment plant to convert it to fertilizer or a protein for animal feed. These treated products are then sold at a lower price than the competing alternatives offered in Kenya. Essentially, Sanergy is turning human waste into money.

Most of the operations involved with the Fresh Life Toilets are run by local business people. Sanergy is not only creating a more sanitary environment by providing toilets for Kenya, they are also providing jobs. Over 90 percent of Sanergy’s employees are Kenyan and 60 percent of them live in the communities in which they serve.

Currently, 1134 Fresh Life Toilets are active. In 2017, 2467 metric tons of human waste were safely transferred and made into fertilizer. Because of these toilets, over 900 jobs have been provided to Kenyan people.

Fresh Life Toilets not only provide toilets in Kenya, but also a reliable income for the families that own them, created by a small fee that is comparable to the cost of non-hygienic alternatives. By doing this, individuals in the community get both a source of profit and an increase in sanitation, benefiting both the Kenyan people and their economy.

An example of the change a Fresh Life Toilet can make is exemplified by Fresh Life Toilet owner Agnes Kwamboka, who used to sell an illegal alcoholic beverage called “chang’aa” in order to provide for her family. Being an owner of a Fresh Life Toilet has changed that. Now, she is able to make a profit, help the local economy and contribute to a cleaner environment in a safe and legal way.

The Fresh Life Toilets provide Kenyans with a hygienic way to use the bathroom. With the Fresh Life Toilets, they no longer have to use the undignified flying toilets and their communities are much cleaner. Sanergy is able to provide the communities with disease prevention and sources of income with one solution, giving them the opportunity to grow.

Daniel Borjas

Photo: Flickr

PMI ExpansionIn late September, the U.S. Agency for International Development (USAID) announced that they would be leading an enterprise to expand the President’s Malaria Initiative (PMI). The PMI expansion is expected to bring life-saving malaria prevention and treatment to four additional countries: Cameroon, Cote D’Ivoire, Niger and Sierra Leone. With these additions, PMI will have programs operating in 24 Sub-Saharan African countries where malaria poses a genuine public health threat.

Launched in 2005, PMI is an interagency initiative in collaboration with USAID and in conjunction with the U.S. Centers for Disease Control and Prevention. PMI was originally established with the goal of cutting mortality caused by malaria in half across 15 African countries. This came during a time when the U.S. decided to put malaria control at the forefront of its global aid agenda. It seeks to approach this goal by increasing concentration on four essential malaria treatment and prevention measures: insecticide-treated mosquito nets, indoor residual spraying, accurate diagnoses and preventative prenatal treatments. With its focused strategy, PMI has contributed to the aversion of 6.8 million malaria-related deaths between 2001 and 2015. In 2016 alone, PMI protected over 16 million people by spraying homes with insecticide and distributed 42 million bed nets.

In total, approximately 480 million people have benefited from the work being done by PMI. This latest PMI expansion will bring malaria treatment and prevention to an additional 90 million people. This is spectacular news given how life-threatening the disease still is, even after so much progress has been made. Today, malaria still takes the life of a child every 30 seconds, amounting to a staggering 3,000 children every single day. Though heartbreaking, this statistic should not come as a surprise, considering 40 percent of the world’s population lives in high-risk regions for malaria. With the continued effort aid agencies like PMI and USAID, that number is projected to decrease significantly. Hopefully, sometime in the coming years, the world will witness the complete eradication of malaria.

Micaela Fischer

Photo: Flickr

The Netherlands lies by the coast of the Atlantic Ocean with a temperate marine climate. It is rainy for most of the four seasons. There are hundreds of locations for groundwater extraction all over the Netherlands. Thanks to natural filtering and isolation from external sources of pollution, the groundwater has a low degree of contamination. Hence, it does not require complicated procedures for purification.

As reported by the Dutch public health agency RIVM, due to human factors, the quality of tap water in some areas of the Netherlands does not meet the expected standards. It is also indicated by its survey that about 60 percent of drinking water in the Netherlands is sourced from the ground, and the rest is provided by surface water. Because of the contamination resulted from pesticides, industrial emissions and improper waste disposal, more than half of the groundwater used is below the international standard of water quality.

Regarding surface water quality in the Netherlands, the quality was also poor due to the pollution from drugs, cosmetics, pesticides and other chemical residues. Some factories of wastewater treatment were unable to purify these harmful substances. RIVM has called for the establishment of a better environmental monitoring system on the sources of drinking water.

The drinking water quality in the Netherlands depends on the variations in regional management. The test standard is more strict than bottled water in the market.  The related Dutch laws such as Drinking Water Law and Water Pipeline Management Measures aim to ensure water quality. Organizations in the chain of water production, including companies and collective supply units, all must regularly check the water quality in the Netherlands and inspect the results. The Ministry of Infrastructure and Environment of the Netherlands also publishes annual reports on the quality of drinking water each year.

The latest Dutch water law was enacted in 2009. It aims to stress the impact of climate change and sea-level rise on flood control security, release the pressure of population demands from increased water consumption and accelerate integrated management of water resources.

Water quality in the Netherlands across drinking water from rivers, lakes and the ground has improved greatly over the past decade, to great praise. The successful practice of water management by law and regulations from the Dutch government has been recognized as “the miracle of drinking water” by media in Europe. Nevertheless, further efforts are still needed to maintain the water quality in the Netherlands, in addition to the promotion of water management practices from a single country to the world.

– Xin Gao

                                                       

New Generation of ResearchersNearly half of the world’s population is currently at risk of contracting malaria. In particular, Africa bears most of the burden of this prevalent disease, with 90 percent of malaria cases and 92 percent of deaths from malaria occurring there. Developing and implementing an effective malaria vaccine continues to be one of the world’s top public health priorities.

MalariaX, a new online global health course, may be an important step toward inspiring scientists to study malaria and equipping them to combat it effectively in today’s environment. Hosted by Harvard University, Barcelona Institute for Global Health and the Swiss Tropical & Public Health Institute, this course aims to provide an all-encompassing education in several topics crucial to the elimination of malaria. The core curriculum includes the biology of malaria, the specifics of disease transmission, new methods for elimination and, most importantly, offers instruction on the use of real-world data and analytical strategies to implement prevention programs

Unlike other courses before it, MalariaX emphasizes training a new generation of researchers to have the knowledge and skills to approach malaria eradication from varying perspectives. Furthering our understanding of the intricate connections between the social, political, historical and economic context of malaria transmission continues to be as important as exploring the biological aspects of the disease itself.

Implementing efficacious vaccine programs requires a deep knowledge of a country’s health systems and the way that the population will react to certain public health techniques. There is no “one size fits all” method in public health. Thus, strategies to eradicate a disease must vary between countries, and sometimes even between regions of a country if necessary. The new generation of researchers will need to focus on the various scientific and social underpinnings of malaria if they wish to truly suppress and eliminate it.

One of the most important trends in global health has been the rise of evidence-based interventions, which are a prominent portion of MalariaX’s curriculum. Researchers in the 21st century have unparalleled access to various technologies that allow them to gather data from the countries affected by malaria.
Equipped with the appropriate information, malaria-eradication efforts become more fine-tuned and are more likely to succeed as they have been developed and implemented based on real-world data. In the past, applying many of the theories and plans proved to be ineffective due to a lack of valid information.

Malaria is preventable and curable, and global efforts to combat the disease have already been incredibly successful. Although there have been reductions in the mortality rate for all groups by 29 percent, as well as for children under five by 35 percent, there is still much work to be done. With its innovative, easy-to-access curriculum, MalariaX could prove to be a difference maker in providing a new generation of researchers with the skills to conquer malaria.

Akhil Reddy

Photo: Flickr

Counterfeit Medicine in AfricaThe global counterfeit medicine market is enormous, making up an estimated 10 percent of medicines sold globally. It is especially prominent in developing nations, in which up to 30 percent of all medications are found to be counterfeit or substandard. In Africa, this means that 120,000 people per year die from counterfeit anti-malarial drugs alone. Such is relatively unsurprising, when considering that an estimated one third of anti-malarial drugs in Sub-Saharan Africa are thought to be counterfeit.

One of the primary issues in tackling this issue of counterfeit medicine in Africa is a lack of public awareness; many individuals simply do not know they risk purchasing counterfeit or substandard medicine. Those entrenched in the cycle of poverty are most often the victims of counterfeit medicine, as they typically have a smaller variety of medicinal options available to purchase- meaning that they might unknowingly have no choice but to purchase a counterfeit drug. Further, the poor generally opt for cheaper medicines, unaware that such medicines are often counterfeit. This lack of variety and financial accessibility ensures that the counterfeit medicine market preys on the poor in particular.

In the effort to address the issue of counterfeit medicines, Nigeria has emerged as a world leader. The nation’s strategy focuses on three areas: public education regarding counterfeit medicines, increased regulation for medicinal imports to stem the flow of counterfeit medicines and reinforced points of entry to mitigate the smuggling of counterfeit medicines. Since it first began this strategy in 2001, Nigeria has successfully reduced the incidence of these drugs by 90 percent, clearly demonstrating that the issue can be successfully minimized through intentional actions.

Nigeria’s stance as the leader in the battle against counterfeit medicine made it the logical base for Sproxil – a company that has created a mobile phone-based technology to verify the authenticity of purchased medicines. Medicinal companies can register their products with Sproxil, receiving individualized scratch-codes to be placed on their products. Once the product reaches a consumer, the consumer scratches off the code and texts it to Sproxil, who then verifies the code in its database. If the code is not verified, the consumer is immediately alerted and given a number to report it. Considering the widespread use of technologies such as MobileMoney in Africa, the structure of Sproxil is ingenious and entirely conducive to the lifestyle of the average consumer.

To date, Sproxil has provided over five million anti-counterfeit labels, contributing to Nigeria’s strategy of public education regarding counterfeit medicines. The company seeks to expand beyond Nigeria, into Kenya and India next. The effectiveness of simple education and verification techniques in Nigeria serve as a wonderful example of successful strategies against counterfeit medicine in Africa, and also the world on the whole. If other developing nations are able to adopt a similar education and verification-based strategy to combat the counterfeit medicine market, the future is bright, indeed, for the increased mitigation of the issue on a global scale.

Kailee Nardi

Photo: Flickr

Health InnovationsMedical equipment can be very expensive, especially for hospitals and medical clinics in underdeveloped areas. While there are organizations that donate medical supplies to underdeveloped areas, the issue that arises with these donations is the lack of resources needed to run the equipment. Due to unreliable access to electricity and a lack of access to clean water, some equipment cannot be used or even sterilized. There are many companies that create inexpensively-made equipment which is just as effective as more expensive products. Here are six examples of health innovations for underdeveloped areas.

6 Effective Health Innovations for Underdeveloped Areas

  1. ReMotion – ReMotion is a very cost-effective and high-performing prosthetic knee for amputees. While it is being prepared for mass production around the world, its target is those who do not have access to more expensive models. An estimated cost of $80 per unit is exponentially cheaper than other prosthetic knees, which can cost upwards of $10,000.
  2. Solarclave – Hospitals generally use an expensive device called an autoclave to sterilize medical equipment, which uses heat and pressure. However, these devices are impossible to get ahold of in underdeveloped areas, so MIT developed the Solarclave, which uses nothing but solar energy to sterilize equipment. It is easy to use and works in as little as one hour.
  3. The Komera – The Komera is an innovative and cheaply-made sanitary pad for women in the developing world. Through the use of banana tree fibers, pads can be created at a more affordable price through an efficient manner. These banana fibers can be acquired at an affordable price and turned into absorbent and fluffy materials for sanitary purposes.
  4. Pocket Colposcope – Cervical cancer screening is hard to come by in underdeveloped areas, due to the high costs and lack of infrastructure of poor communities. A preventive screening can cost upwards of $20,000 using the typical equipment. The purpose of the pocket colposcope is to significantly reduce the cost of cervical cancer screenings in underdeveloped areas. The device also makes it simple for people to use at the community level, while also being easy to clean and reuse.
  5. ReMeDi Solution – The ReMeDi Solution was created by a company called Neurosynaptic Communications. This company creates devices that are for portable use, including ECG machines, pulse oximeters, blood pressure monitors and many others. These devices are easy to integrate into hospital networks and are very versatile in how they work. By using ReMeDi Solution products as well as similar products, hospitals in underdeveloped areas can have access to quality equipment that works well in specific conditions.
  6. Wound-Pump – The Wound-Pump is a patent-pending device that is used for wound therapy. The Wound-Pump is a simplified negative pressure wound therapy (NPWT) device that makes it less expensive to care for wounds. NPWT devices speed up the process of wound healing, reducing the chances of people dying from open, uncleaned wounds. The Wound-Pump takes this technology and applies it, for similar healing at a more affordable price. Furthermore, the Wound-Pump does not require electricity to run and is extremely portable.

All of these health innovations have provided great support for hospitals and medical clinics in developing and underdeveloped areas at a much more affordable price than what was previously available. While the ultimate goal is to be able to use more expensive equipment, these medical innovations provide a solution to improving healthcare in these areas for the time being.

Rebekah Covey

Photo: Flickr

Water in PakistanIn Pakistan, water contamination is a serious issue, one so substantial that in August of 2017, up to 60 million people were found to be at risk of having arsenic in their water supplies. Further, the level of arsenic allowed in Pakistan’s water sources is five times higher than the World Health Organization’s (WHO’s) guidelines for arsenic concentration in drinking water, with Pakistan allowing 50 micrograms per liter and the WHO allowing only 10.

This specific issue of arsenic contamination points to a broader theme of water contamination on the whole. Water supply lines are often located directly adjacent to uncovered sewage lines, causing water contamination to be so prevalent that 40 percent of all ailments in Pakistan are the result of water-borne illnesses. Further, access to clean water in Pakistan is not recognized as a national right but is seen as a responsibility which local governments are meant to take on. This means that such access fluctuates depending on the area, although infrastructural support for a clean water system is, on the whole, dismal.

The scarcity of clean water in Pakistan has allowed extremist groups to use water as a focal point of their recruitment process. Lakshar-e-Taiba, an extremist group that perpetrated the 2008 Mumbai terror attacks in which 172 people were killed, has accused India of committing “water terrorism,” citing such as motivation for terrorist actions in India. By exploiting the issue of water, an issue which every Pakistani citizen is forced to deal with in order to survive, extremist organizations are able to reach larger swathes of the “common man” and augment grassroots support. Thus, the issue of water in Pakistan goes beyond simple health problems and infiltrates international security issues as well.

The wide berth of the problem has initiated an increase in the bottled water industry, but the reality is that such is still financially inaccessible to the majority of low-income individuals, forcing low-income communities to rely on easily contaminated groundwater. In order to address this, an organization called Pharmagen has entered the scene. Pharmagen ensures its water is affordable for low-income customers, requiring only two rupees per liter. It operates through a chain of open water shops that extracts groundwater and purifies it to meet WHO standards before distributing it to the impoverished communities it serves. Currently, the organization provides more than 100,000 liters of potable water per day in Lahore alone and seeks to expand to include 32 additional open water shops while also adding one bottled water facility.

Yet, it is important to note that 21.6 million people in Pakistan still have no access to clean water, and this is a hotbed for extremist activities. The work of organizations such as Pharmagen is both admirable and necessary, but it is also necessary that the international community step up as a whole; the issue of water in Pakistan ultimately goes beyond Pakistan-specific problems, due to its relationship with international extremist organizations. In a world teeming with terrorist activities, it would appear that mitigating grassroots extremist movements by improving access to clean water should have a greater presence on the world stage.

Kailee Nardi

Photo: Google

Common Diseases in MauritiusLocated in the Indian Ocean off the coast of Southern Africa, Mauritius is an archipelago that is only about 500 miles east of Madagascar. At almost 11 times the size of Washington D.C., Mauritius was first explored by the Portuguese in the 16th century and subsequently settled by the Dutch. With a life expectancy of 74 years for the country’s 1.2 million inhabitants, the most common diseases in Mauritius that are life-threatening are non-communicable.

According to Commonwealth Health, “non-communicable diseases (NCDs) in Mauritius accounted for an estimated 87 percent of all mortality in 2008.” The most common diseases in Mauritius are cardiovascular diseases, which accounted for 36 percent of total deaths across all age groups in 2008. Diabetes, cancers and non-communicable variants of respiratory diseases contributed 23 percent, 12 percent and five percent to total mortality, respectively.

Cardiovascular diseases, “diabetes, urogenital, blood and endocrine diseases”, and cancer are considered the deadliest overall, with ischemic heart disease, diabetes and cerebrovascular disease in the lead.

Ischemic Heart Disease, also known as coronary artery disease, involves a decreased blood flow to the heart. It was considered one of the deadliest common diseases in Mauritius in 2015. In 2014 alone, the diseases caused 1,148 deaths. Cerebrovascular disease, caused by damage to the brain from interruption of blood supply, was the third most common disease in 2015. Fortunately, the disease has decreased in prevalence by 9.5 percent since 2005.

Diabetes, a disease of permanently altered insulin levels and blood sugar was the second-highest cause of death in Mauritius as of 2015. In 2005, diabetes was only the third most common cause of death, but throughout the decade, deaths from the disease have increased in prevalence by a staggering 65.1 percent. This is due, in part, to recent changes in dietary habits with the introduction of fast food and lack of exercise as well as genetic predisposition.

Obesity, caused by diet and lack of exercise, can also play a role in diabetes. The prevalence of obesity has increased from 16 percent in 2009 to 19.1 percent in 2015, with approximately 398,417 Mauritians being overweight or obese.

Conscious of the growing health concern, the Mauritian government has established a National Service Framework for Diabetes. The goal of the organization is to lay out strategies for prevention and standards of care to be implemented.

The common diseases in Mauritius can be found in any country. While some diseases are unfortunately hereditary, there are ways of managing health to reduce the risk of non-communicable diseases. By making conscious lifestyle changes, such as exercising and maintaining a healthy diet, the risk of diseases such as heart disease and diabetes can be effectively reduced.

Stefanie Podosek

Photo: Flickr