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Mongolia's Childbirth PracticesIn recent years, the nomadic population of Mongolia has seen negative impacts from environmental changes. Extreme winters have killed off much of their livestock, resulting in widespread food insecurity. As younger generations become less interested in agricultural jobs, fewer opportunities lie in the rural region of Mongolia. Due to these factors, healthcare accessibility has become limited. Healthcare has affected Mongolia’s childbirth practices significantly. However, improvements in healthcare are on the horizon for Mongolia’s people. In recent years, Rotary Club member Julie Dockrill has trained mothers and healthcare providers in Mongolia, improving education regarding childbirth. Dockrill’s work is critical for women living without access to hospitals. With progress such as Dockrill’s education initiative, maternal and infant mortality rates are beginning to decrease.

Poverty in Mongolia

Mongolia has made significant economic and social improvements over the past few decades. Since 1991, its GDP tripled and the maternal death rate decreased by 87%. Poverty reduction rates vary widely across the country, with rural areas seeing the greatest change. From 2016 to 2018, poverty declined by 5%, whereas urban areas remained unchanged. This is due to increased prices for livestock and no wage growth in urban areas. Cities have also faced heavy air pollution and tripled rates of respiratory illnesses over the last 10 years.

Additionally, COVID-19 has posed a major risk for Mongolian citizens. Overall, the pandemic caused the economy to shrink by 7%. Other factors that worsen poverty are extreme weather conditions, lack of sanitation and food insecurity. With a small population of 3 million, those living as nomads face great difficulty accessing healthcare and other services.

The History of Mongolian Nomads

Nomadic herders make up 25% of the Mongolian population. Nomads live in traditional Mongolian housing districts called gers — portable round tents. These gers exist all over the plains and mountains of Mongolia. However, environmental challenges have hit these gers harshly. The average temperature since 1940 has risen 2.2 degrees Celsius, which is significantly greater than the world average temperature change of 0.85 degrees Celsius. There is also less rain, making ponds and rivers dry up. Herds of livestock and horses have a difficult time finding water and cooling off in the warmer months, because of their thick fur that keeps them warm in -40 degree Celsius winters. Consequently, cities draw young adults away from nomadic life, with easier access to healthcare and education.

Mongolia’s Childbirth Practices

In rural areas, limited access to hospitals and doctors makes childbirth risky. In 1995, the U.S. State Department sponsored a medical team from Tripler Army Medical Center to a hospital in Mongolia for training. They observed dim lighting, physicians reusing gloves and aprons between patients, limited supplies of IV fluids and use of anesthesia without proper safety checks. There was also almost no equipment for natal care and mothers after giving birth.

As a result, many women in the 1990s gave birth at home, which had the potential to be traumatizing if they had a difficult labor. Since then, there have been significant improvements in Mongolia’s childbirth practices. The Mongolian government began reform movements that opened maternity waiting homes across the country. Expecting mothers from nomadic areas can visit these facilities if their pregnancy is high-risk. This way, women can be closer to hospitals in case of an emergency. It is now standard for healthcare providers to encourage women to visit one of the prenatal clinics two weeks before their due date. Online information and telehealth also provide access to reproductive health information. Success is evident. From 1990 to 2019, infant mortality rates have decreased from 77 per 1,000 births to 13.4 deaths.

The Rotary Club’s Work

Julie Dockrill is a midwife and childbirth educator from New Zealand. In 2013, the Rotary Club of Waimate asked if she could join them in a project training medical workers to improve childbirth practices in Mongolia. A major thing she noticed was that mothers only received basic care information. Thus, Dockrill held training classes for pregnant women using baby dolls and anatomical models, expanding on the knowledge displayed in traditional pamphlets.

In Mongolia, people often treat labor as a quick process, which can lead to complications. Dockrill explained to her training class that medical professionals should not rush labor and that they should treat the procedure with care. The class led to immense success, influencing the Rotary team and Dockrill to continue through 2015 and 2016. Additional phases of the project included a Mongolian midwife shadowing Dockrill in New Zealand, training over 300 healthcare workers in Mongolia and bringing medical supplies.

In 2018, the team returned to Mongolia to provide healthcare and education to rural communities. Dockrill also wrote an updated training manual that covered immunizations, pain relief, diet and doctoral instructions. As a result, the Mongolian Ministry of Health endorsed and adopted the manual. In 2019, Nepal adopted the text as well. Mothers must now take childbirth education classes and receive more advanced resources for childbirth services.

The Future for Mongolia

Mongolia’s reduction of maternal and infant mortality rates over the last 30 years has led to decreased poverty rates in the country. One of the major steps to reducing poverty currently in place is focusing on the rural communities of Mongolia. Access to healthcare is one of the main ways to improve Mongolia’s childbirth practices. With progress like Dockrill’s work and the Tripler Army Medical Center, further progress in eliminating poverty is clearly in motion.

– Madeleine Proffer
Photo: Flickr

COVID-19 in South KoreaThe COVID-19 pandemic that began in late 2019 has impacted families, communities and society as a whole. The pandemic precautions have been a worldwide effort to keep everyone safe. In South Korea, there have been a total of 118,243 cases of COVID-19 as of April 2021. Of the 118,243 who tested positive, there have been 1,812 deaths but 107,781 individuals have recovered. The statistics show the persistent effort that is being demonstrated by the South Korean government to keep the country and its citizens safe.

COVID-19 in South Korea

South Korea has made it a priority to establish a system for the country and its citizens in order to keep everyone safe. In the early stages of COVID-19, South Korea made it a priority to mitigate the situation by distributing tests to as many people as possible. The results of the test, positive or negative, would gauge the severity of the outbreak. The goal was to have everyone quarantine so that the transmission of the virus, regardless of the positive or negative test result, would be slowed. The procedure that the South Korean officials followed was: test, trace and isolate. Within weeks of the first COVID-19 case, South Korea was the leading country in distributing tests. In perspective, by the end of April 2020, the United States had more than one million positive cases. South Korea had fewer than 11,000 cases. In the early stages of COVID-19, South Korea had 3,700 cases whereas the United States had 32. Managing the quick outbreak, and dealing with its repercussions was not easy for any country. However, South Korea was able to quickly formulate a system of test, trace and isolate. This helped lessen the number of lost lives.

Vaccine Efforts in South Korea

The creation and distribution of vaccines have been a large factor in the success that South Korea has seen in combatting COVID-19. South Korea has signed a contract with Pfizer to purchase another 40 million doses of its vaccine. Collectively, South Korea has 192 million doses of vaccines from Moderna, AstraZeneca PLC, Johnson & Johnson and Novavax. The goal that South Korea had set was to have 70% of its citizens vaccinated with the first dose by November.

In order to obtain aid and assistance to receive these large quantities of vaccines, South Korea looks to the United States for help. South Korea provided assistance to the United States in the early stages of the pandemic with COVID-19 testing kits and face masks. Therefore, South Koreans hope for help from the United States in return. The U.S. State Department has made a statement regarding this vaccine alliance. The Department sees a possibility to help other countries increase their vaccine supplies but the citizens of the United States will be the priority.

Looking Ahead

South Korea was extremely successful in combating the virus at the beginning of the pandemic by acting quickly in response to testing and isolation. When no one knew how to handle the pandemic, South Korea stood as a strong example of how to minimize the effects of a global pandemic.

– Nicole Sung
Photo: Flickr

The Rohingya Refugees: What to Know and International Response
According to the U.N., the country bordering Laos to the east and Bangladesh to the west is called Myanmar, but to the U.S. and U.K., it is Burma. Its name is just one source of the conflict that has plagued the country for years; another is regarding relations between the government and the Rohingya, a Muslim minority group living in the Rakhine region. After Myanmar’s independence in 1948, the Rohingya people in the Rakhine region became stateless and the Myanmar government refused to give them citizenship. The animosity between the Rohingya and Myanmar’s government continued to grow until the group experienced exclusion altogether from the national census in 2014. In 2017, the Rohingya faced a crisis that forced them to seek help from other nations and become refugees.

Background Information on Rohingya Refugees

In August 2017, the perpetuated institutional discrimination against the Rohingya hit its limits when the Burmese military launched a campaign of targeted violence. In the first month after violence broke out, at least 6,700 Rohingya were killed and 300 Rohingya villages were burned. As a result, an estimated 740,000 Rohingya were displaced out of Myanmar’s Rakhine region and into Bangladesh. Today, more than 900,000 Rohingya still live in Bangladesh.

Upon arriving in Bangladesh, Rohingya refugees found shelter in refugee camps that are now some of the largest in the world. Due to the pace at which mass numbers of Rohingya became refugees. Camps did not have adequate resources including shelter, food, clean water and medical facilities. Many refugees have also become traumatized after witnessing the acts of violence in the Burmese military campaigns. The U.S. State Department now deems the actions as ethnic cleansing.

US Humanitarian Assistance

Since the outbreak of violence in 2017, the U.S. has contributed $669 million in humanitarian assistance to the Rohingya refugees. According to USAID, this funding goes toward addressing the needs of Rohingya refugees including emergency shelter, food, health services, psychological support, education, water and sanitation. Additionally, the U.S. funding aims to support programs that will improve disaster preparedness and education for Rohingya in Bangladesh.

With this assistance, the U.S. also aims to augment existing systems and programs that provide relief to refugees. For instance, the increased number of vouchers that are going to Rohingya refugees should allow them to buy food in local markets. Furthermore, the U.S.’s push for educational programs for refugees should yield more access to better economic opportunities in Bangladesh.

US Diplomatic Stance

The U.S. State Department has consistently and publicly condemned the actions of the Burmese military against the Rohingya. It also stated a commitment to justice and accountability on behalf of the Rohingya people. Furthermore, the State Department urges Myanmar to formally acknowledge the acts of injustice and violence. It calls on other nations to support this stance as well. In 2018, the U.S. imposed sanctions on four Myanmar military and police commanders and two army units for their human rights abuses against the Rohingya. The Myanmar government did not respond to this stance. As a result, the U.S. imposed more sanctions on a high-ranking general and three senior officers in 2019. The U.S. State Department is also working with international organizations to encourage Myanmar to adopt conditions that would eventually allow Rohingya refugees to return to their homes.

After the outbreak of violence in Myanmar, the U.N. Human Rights Council established the Independent International Fact-Finding Mission on Myanmar in March 2017 to investigate and make conclusions concerning the extent of human rights abuses committed. Its findings conclude that Myanmar committed crimes against humanity, war crimes and genocide against the Rohingya.

With Myanmar’s lack of indication that the country will acknowledge the violence the government committed against the Rohingya, almost 1 million Rohingya remain in refugee camps in Bangladesh. The international response has strongly condemned Myanmar’s government and offered humanitarian assistance. However, more permanent plans for the Rohingya refugees will likely need to occur soon. The U.S.’s push for more education in camps is one example of a positive step in the direction toward relief for the Rohingya. In addition, the U.S. along with other nations and international organizations should continue to develop these programs with further humanitarian assistance.

Isabel Serrano
Photo: Flickr