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Cholera Outbreak in Malawi
According to the World Health Organization (WHO), “cholera is an intestinal infection that ingesting the bacteria Vibrio cholera in contaminated food and water causes.” Inadequate sanitation and lack of safe drinking water is the most common way to contract cholera, which causes severe diarrhea, vomiting and dehydration. Although it is an easily treatable disease, it can be fatal without treatment for even a few hours. Displaced populations and overcrowded camps on top of a lack of safe water and medication lead to an increased risk of the spread of cholera. Beginning in March 2022, a cholera outbreak in Malawi infected about 6,056 people with 183 deaths as of the end of October.

The Current Situation

Since 1998, cholera has plagued Malawi, specifically in the southern regions where there is frequent flooding in the rainy season. The current outbreak is the “largest reported Cholera outbreak in Malawi in the past 10 years” and comes after tropical storm Ana in January 2022 and Cyclone Gombe in March 2022, WHO reports. These storms spurred flooding and displacement of an already susceptible population who now lack access to safe water and sanitation.

Over the holidays, the outbreak surged causing 19 deaths on New Year’s Eve and the closure of primary and secondary schools in the capital Lilongwe and the commercial hub Blantyre. In these two cities, one of the main sources of the outbreak is improper drainage systems, which leads to polluted water sources.

The current cholera outbreak in Malawi exacerbates the country’s existing hunger crisis. With around “5.4 million individuals facing hunger,” a lack of sufficient nutrients weakens people’s immunity and leaves them highly susceptible to a fatal case of cholera. Malawi is one of the poorest nations in the world with 70% living in the country on less than $1.25 a day. In addition, 80% of the country’s population is in agriculture, an industry that storms and flooding deeply affect.

Some of the most at-risk populations during the cholera outbreak in Malawi are pregnant women and mothers with young children as they experience an increased workload and extra risk of infection as primary caregivers. This also threatens the advancement of women and girls in education and economic empowerment as they focus first on survival.

Malawi’s Response & International Aid

In response to the cholera outbreak in Malawi, the Ministry of Health and WHO are conducting an emergency response that consists of “surveillance, social mobilization, treatment, water sanitation, hygiene and oral cholera vaccines,” WHO reports. A cholera response plan and national and district-level emergency operation centers are mobilized nationally. The most affected districts received cholera kits, IV fluids, antibiotics, protective equipment, diagnostic tests, tents and cholera beds.

CARE will distribute chlorine powder for water purification in affected communities as well as supply Oral Rehydration solutions.

On November 7, 2022, Lilongwe received 2.9 million doses of Oral Cholera Vaccine (OCV) for a single-dose reactive campaign to the current Cholera outbreak in Malawi. The OCV campaign targets “adults and children aged 1-year-old and above living in highly affected districts.” The second campaign will prioritize providing vaccines to 14 districts with a large number of cholera cases.

UNICEF joins WHO and the Government of Malawi to strengthen water treatment systems, train health care workers, distribute medical supplies, provide clinical care and raise awareness regarding cholera prevention methods and best hygiene practices. The Government of Malawi has also appealed to the public and private companies and organizations for aid and constructed new, clean water spots in affected areas. As of November 6, around 6,398 people have recovered from the disease, UNICEF reports.

While numbers from January 11, 2023, reported 3,415 new cholera cases, according to Nyasa Times.

– Arden Schraff
Photo: Flickr

Mental Health in the Maldives
Many best know the Maldives, a nation of islands in the Indian Ocean, for its beautiful beaches that draw many travelers. However, the sunshine and sparkling water often overshadow many Maldivians’ issues. For instance, mental health in the Maldives is a topic that not everyone knows about. Yet, many people in the Maldives have struggled with mental health for a long time. Furthermore, the link between mental disorders and poverty makes these struggles even more concerning.

A Unique Layout

Since a chain of islands across more than 900 kilometers forms the country of the Maldives, the cost of delivering health and social services is higher. In addition, the unique geographical nature of the island has resulted in a widely dispersed population, with some of the islands becoming too densely populated to sustain their communities due to rising sea levels. All of these factors have contributed to mental health problems in the Maldives.

Lack of Strategy

Coordinating a unified effort to combat increasing rates of mental disorders in the Maldives has been an issue. With evidence showing that mental health disorders are on the rise, Maldivians are in need of an effective mental health system. However, mental health services in the Maldives are limited and poorly organized. Since most mental health services reside in the capital, Malé, few resources exist on the outer islands. Additionally, psychiatric medication is inconsistent and institutional facilities deal with overcrowding.

Another barrier to implementing a strong mental health policy in the Maldives is social stigma. There is significant stigma and discrimination toward people with mental disorders in the Maldives, with many openly expressing negative attitudes about mental health, according to an article published in SAGE Journals.

Mental health disorders pose many risks, including the threat of increased poverty. Since there is a link between mental health and poverty, the rising rates of mental health disorders in the Maldives present a significant threat to the already high poverty gaps in the country.

New Reason for Hope

A promising new future in improving mental health in the Maldives lies in the National Mental Health Policy (NMHP). According to the Ministry of Health, some of the objectives of the NMHP include a new structure for mental health care with proper financing, mental health services that integrate community-based and general health services, promotion of mental health in collaboration with relevant stakeholders and advocacy for improved treatment of individuals with mental disorders.

Even further, NMHP will ensure that welfare assistance is available to those with significant disabilities relating to mental disorders, alleviating some financial burdens in order to counter poverty, the Ministry of Health reports.

The NMHP has a long history of development. The Ministry of Health first initiated the policy in June 2005 in the wake of the 2004 Asian tsunami. Still, work on the policy remained untouched until 2011, when the Ministry of Health revised the policy. However, political changes hindered its endorsement. Later, in 2015, the process started again when the World Health Organization (WHO) assisted in the policy’s revision. Now, the NMHP is in effect until at least 2025.

According to the Ministry of Health, new changes from the NMHP include:

  • Screening for mental health disorders from a young age.
  • Adding more school counselors.
  • Implementing mental health strategies at work.
  • Educating religious scholars on mental health.

The implementation of the NMHP is a long-awaited step in the right direction for the people of the Maldives. People are dealing with a disorganized mental health system as well as a social stigma for so long. However, the NMHP offers up the prospect of a more positive future for those in the Maldives who are struggling with mental health.

– Sarah DiLuzio
Photo: Pixabay

Healthcare in Bahrain
Bahrain is an Arab state located on the southwestern coast of the Persian Gulf. The country includes Bahrain Island and around 30 other small islands. Its economy relies on crude oil production and a rising service industry that tourism dominates. While many surrounding countries struggled with COVID-19, Bahrain has adapted well to the pandemic. Not only did the government provide free medical treatment, but Bahrain did this while experiencing Iranian cyber attacks. Bahrain’s Information and eGovernment Authority intercepted 6 million attacks and more than 830,000 malevolent emails from Iranian servers. While Bahrain certainly has challenges to face regarding other regional actors, three critical facts about healthcare in Bahrain indicate a highly successful healthcare program.

3 Progressions of Bahrain’s Healthcare

  1. Healthcare in Bahrain is Universal. While the debate on universal healthcare has recently become a common topic in many Western nations, including the United States, the government of Bahrain has offered comprehensive healthcare since 1960. The system’s services are free for citizens, and non-Bahraini inhabitants receive large subsidizations. The Ministry of Health works alongside the National Health Regulatory Authority and the Supreme Council of Health to provide three tiers of service: primary, secondary and tertiary. With primary care as the cornerstone of healthcare in Bahrain, the Ministry uses its 25 health centers and three health clinics to act as the first line of contact with sick and injured Bahraini people. While this program goes far to expand access to healthcare in Bahrain, that does not mean it is without its fair share of difficulties. Bahrain’s growing population has strained healthcare budgets as the country strives to keep and continue to improve its services. Alongside the growing population, the investment into this program has also increased, but the budget still struggles to meet its increased demands.
  2. Healthcare in Bahrain is Advanced for its Region. With a universal healthcare system, Bahrain’s low-income population does not struggle with a lack of access to healthcare. Not only is access high in Bahrain, but the technology and standard of care far surpass regional actors. The Bahrani healthcare system is one of the most advanced in the Gulf region. Moreover, the country’s facilities are state-of-the-art and have no shortage of doctors, nurses and dentists. Indeed, the standard of care in Bahrain is comparable to the care in Western countries.
  3. Bahrain has Implemented a Vaccine Passport to Help Fight COVID-19. While many countries are still debating the possibilities of a vaccine passport, the government of Bahrain decided to implement vaccination passports as early as mid-February 2021. Bahrain became one of the first countries in the world to use a digital COVID-19 vaccine passport. The country also released its BeAware app that functions as a digital vaccine passport that officials can verify. Health officials expect the technology to aid in tracking and contact tracing to help limit the spread of COVID-19 within the country. Moreover, Bahrain has taken decisive steps to overcome vaccine hesitation prevalent in Arab states. For example, Bahrain, alongside the United Arab Emirates and Saudi Arabia, has made vaccines mandatory for specific jobs.

Looking Ahead

Even though Bahrain has faced challenges from Iran, its healthcare system has been quite successful. Through its decision to implement universal healthcare, all Bahraini citizens, even those with low incomes, can obtain quality healthcare.

Kendall Carll
Photo: Flickr

non-communicable diseases in El SalvadorEl Salvador has experienced rampant public health problems for generations and has recently made commendable successes in addressing these problems. However, non-communicable diseases in El Salvador continue to be stubborn roadblocks that cost many citizens their health and their lives.

Non-Communicable Diseases (NCDs) in El Salvador

Non-communicable diseases are those that cannot be directly spread from one person to another such as Alzheimer’s, cancer and diabetes. Like the rest of the world, NCDs are a leading cause of early death among the adult population in El Salvador. Estimates show about 71% of all global deaths result from NCDs, the majority of which come from low-and middle-income countries. During the 2011–2015 period, in El Salvador, one of the most impoverished and most dangerous countries in Latin America, cardiovascular disease accounted for some 12% of deaths. Chronic kidney disease followed at 6.3% and cancer at 5.4%.

Many of the factors leading to high death rates from non-communicable diseases in El Salvador are lifestyle-related. Sedentary lifestyles, smoking and poor nutritional choices all contribute to NCDs such as diabetes and cardiovascular disease. Poor nutrition is common in many low-and middle-income countries. A health survey among El Salvadorians found almost 94% of citizens consumed too few fruits and vegetables and almost as many consumed an excess of sugary beverages. With this information, it is no surprise the survey also found relatively high rates of overweight and obese adults. Obesity is synonymous with NCDs. Furthermore, chronic kidney disease is particularly prevalent among El Salvadorian adults. This results from excessive use of anti-inflammatory medication, inadequate hydration and exposure to agrochemicals in the workplace.

Previous Healthcare Efforts

Public health problems are nothing new to El Salvador. The Ministry of Health has been ramping up efforts to address these problems since 2009. Some of the main concerns in the past have been the fragmentation of the health sector and high rates of uninsured citizens. In 2009, the Ministry of Health implemented a National Health Strategy to correct these issues. Throughout this program, increasing equity of access to health services, improving the quality of these services and strengthening the monitoring and oversight capacity of the Ministry of Health have been top priorities. In order to accomplish these goals, El Salvador increased its public health expenditure by 33.7% from 2009 to 2019. The country also increased the amount of these expenditures allocated to the public health sector by 8%.

Many of these efforts have paid off, albeit modestly. Because of the National Health Strategy, more public health services have reached impoverished and remote citizens in El Salvador. Expanding access to healthcare has had a positive effect on the country’s economic outlook. The income-poverty rate decreased from 46.4% in 2008 to less than 34.8% in 2013 and extreme poverty dropped from 15.4% to 9.1% in the same period. Furthermore, El Salvador’s Gini coefficient (measure of income inequality) decreased from 0.47 in 2009 to 0.41 in 2013, in large part due to public service equity efforts such as those executed by the Ministry of Health.

Non-Communicable Disease Efforts

Even with all this progress, the problem of non-communicable diseases in El Salvador remains. Non-communicable diseases account for more than 65% of all deaths in the country. Therefore, the Ministry of Health teamed up with the World Bank and Access Accelerated in 2018. The two wanted to specifically fight NCDs through the project El Salvador Addressing Non-Communicable Diseases. This project focuses specifically on improving the prevention, detection and treatment of cervical cancer as well as the prevention of common NCD risk factors. In fighting cervical cancer, El Salvador received more than 86,000 HPV screening tests and almost 30,000 doses of HPV vaccines. Both prevent cervical cancer by taking early action.

Besides cervical cancer, the program works to fight other non-communicable diseases in El Salvador. It accomplishes this by training healthcare workers, providing workshops on nutrition and expanding access to mental health resources. The arrival of COVID-19 has disrupted some of these programs. However, it also forced organizers to rethink how to properly deliver care in continuation of their public health efforts. New methods have included providing health education through social networks, improving the delivery of medication, increasing the use of telehealth and making home dialysis available for chronic kidney disease patients. These approaches to healthcare spurred by COVID-19 will likely live on in the post-pandemic world. Many changes like switching to telehealth are increasingly popular, both in El Salvador and around the world.

The Road Ahead

As in most other nations, non-communicable diseases in El Salvador weigh heavily on the population. However, El Salvador has proven during the past decade that improving access to healthcare for impoverished citizens, treating NCDs proactively through preventative measures and championing new flexible ways of delivering healthcare are positive steps any country can take to make an impact on national public health. Though researchers will not know the full effects of recent programs for some time, early results are promising. Physicians are administering more HPV tests and vaccines, more public health services are reaching low-income citizens and pandemic-era practicalities are proving so popular that they will likely be hallmarks of global healthcare in the years to come.

Calvin Melloh
Photo: Flickr

10 Facts About Life Expectancy in Oman
Oman is a country located in the southeastern Arabian Peninsula, bordering Saudi Arabia, Yemen and the United Arab Emirates. The majority of the country’s population is located on the coast of the Gulf of Oman and the Arabian Sea. Wealthy in oil and progressive in culture, Oman is experiencing high levels of immigration and some expect its population to double by 2050. These 10 facts about life expectancy in Oman contribute heavily to this.

10 Facts About Life Expectancy in Oman

  1. Oman, with a population of 4.6 million (as of the last census in 2017), ranks 97th in the world in life expectancy with the average life lasting 75.9 years. The country ranks eighth in life expectancy out of the 19 Middle Eastern countries and fifth out of the seven countries on the Arabian Peninsula.
  2. Women outlive men by approximately 4.1 years on average with the female life expectancy at 78 years and the male life expectancy at 73.9 years. These averages are by no means abnormal on a global scale and are due to men being more prone to heart disease and accidents on the roadways.
  3. The life expectancy in Oman has more than doubled since 1950 when the average Omani life lasted just over 33 years. This is a 233 percent increase. The U.N. projects that the average Omani life expectancy will reach 80 years in the early 2030s. This is in large part due to the country’s advancing health care system. Qaboos bin Said Al Said, the Sultan of Oman since 1971, has stated multiple times that health care is a basic human right. He established the Ministry of Health (MoH) by a royal decree. The MoH guarantees that Omani citizens receive basic health care, free of charge.
  4. As of 2016, Oman had 69 hospitals and over 6,400 beds within them. That calculates out to slightly more than 15 beds per 1,000 people. This serves as a sign of substantial progress, given that when Qaboos bin Said Al Said came to power in 1970, only two hospitals were in operation.
  5. The World Health Organization (WHO) is working in collaboration with the MoH, and in 2014, the organization announced a long-term plan entitled Health Vision 2050. This plan calls for larger investments in the health care field. The WHO is assisting in the development and sustainment of health-related technologies. The organization also commits to teaching more proper methods of personal and professional care. The MoH currently covers more than 80 percent of the costs associated with these health care expenditures, which is roughly 11 percent of the Omani government’s entire yearly budget.
  6. Ischemic heart disease, road injuries, stroke, diabetes and lower respiratory infections are the leading causes of death in Oman. Communicable diseases have seen a sharp decline in frequency and severity in Oman due to the steadily increasing quality of life. Now, lifestyle diseases, such as diabetes, obesity and hypertension are on the rise.
  7. Obesity has become substantially more prevalent within the past decade. As of 2017, approximately 27 percent of Omani adults are obese. Oman is now the 36th most obese country in the world. The MoH is attempting to address this by educating the populous on the importance of having a healthy diet and exercising regularly.
  8. Typically, as birth rates decrease, life expectancy increases. Omani women are having far fewer children than their parents before them. The average Omani woman living in 1982 had 8.35 children. As of 2016, this number has fallen to a mere 2.67 children per woman, and many expect it to continue to decrease.
  9. As the Omani family is getting smaller, individuals are receiving more attention. Literacy rates are rising quickly, and as of 2017, 97 percent of Omani citizens are functionally literate. This is drastically higher than the surrounding countries, with the average literacy rate of the Middle East and Northern Africa at 80 percent.
  10. Oman is a young country with a median age of 25.8. Roughly 30 percent of the population falls between the ages of zero and 14.

These 10 facts about life expectancy in Oman highlight just some of the extraordinary strides the country has made since its renaissance in the early 1970s. Although its health care system still faces issues, the way the country has tenaciously planned to advance itself is admirable and people should view it as a model for what thorough and proper planning can accomplish.

– Austin Brown
Photo: Flickr