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Dengue Fever in Bangladesh
Dengue fever is a severe virus that claims the lives of hundreds of thousands of people every single year. It is present in over 100 countries worldwide, including the Philippines, Honduras and Sri Lanka; however, the country of Bangladesh is currently experiencing the worst outbreak in history.

Not only is dengue fever in Bangladesh a serious threat, but according to the World Health Organization (WHO), the virus is now a rising threat to the entire world.

What is Dengue Fever?

Mosquito bites spread the virus dengue fever. There are multiple strands and severities of the sickness, including severe dengue, which is the deadliest. Symptoms of dengue, which include a fever accompanied by a rash, nausea, vomiting and pain, can last up to seven days. Severe Dengue will make itself manifest within 24-48 hours of infection and generally occur after the fever has dissipated. These symptoms are more severe in nature and include pain, vomiting blood, bleeding from the nose or gums, fatigue, irritability and restlessness.

One of the Top 10 Threats to Global Health

Although dengue specifically affects mosquito prone areas, these areas still include over 100 countries worldwide and 300 million people. This equates to almost 40 percent of the world’s population who are at risk of contracting dengue.

Every year, the virus infects close to 400,000 individuals. From there, over 22,000 die from severe dengue. This virus has slowly increased in prevalence and severity throughout the years, and in 2019 the World Health Organization (WHO) announced that dengue fever is one of the top 10 threats to global health in 2019. The organization explained this was not only due to the hundreds of thousands of cases that emerge every single year, resulting in horrible death tolls across multiple countries but also because the prevalence of dengue has increased 30 percent in the last 50 years.

What is Happening in Bangladesh?

Bangladesh is currently experiencing the worst outbreak of dengue fever to date. Dengue has been a growing threat for decades, with longer seasons of infection, rising death tolls and changing symptoms. Now, dengue has infected Bangladesh with previously unforeseen ferocity.

Since January 2019, there have been almost 40,000 cases of dengue in Bangladesh alone. The virus has spread throughout all of Bangladesh, but over 86 percent of cases of dengue fever come from the capital, Dhaka. The number of reported deaths in Bangladesh due to dengue is 29. However, that number could be much higher. This is due to the difficulties of determining if a death was the direct cause of dengue. Without proper blood samples and information from those who pass away, determining if a death was the direct cause of dengue is impossible.

Efforts to Aid the Dengue Fever Situation

With such a severe outbreak in the country, Bangladesh is doing all it can to ensure the health of its people. For example, The Communicable Disease Control (CDC) unit of The Directorate of General Health Services (DGHS) releases regular updates on the situation of dengue fever in Bangladesh in order to inform the public of the outbreak and it is doing. It reported that as of August 2019, almost 30,000 dengue patients were able to go home since the beginning of the outbreak. On the other hand, there are almost 10,000 currently admitted patients, and this number is rising by the hundreds every single day.

In order to combat dengue, the DGHS has implemented several strategies. At the beginning of August 2019, doctors in all 64 districts of Bangladesh received training on dengue treatment and management. The DGHS is also focusing on informing the public of prevention measures against dengue by sending messages of awareness through various media platforms and informing journalists in media briefings on various preventative measures.

Dengue fever is a severe and often fatal illness, and a serious threat to global health. Bangladesh is not the only country at risk, and the outbreak of dengue fever in Bangladesh could very well develop in countless more countries. Without serious attention given to the treatment and eradication of this virus, dengue fever will continue to claim more and more lives.

– Melissa Quist
Photo: Flickr

ChlorhexidineAn estimated 390,000 babies die within their first months of life annually due to severe infections. For the past decade or so, USAID has been combating this number with a low-cost yet highly effective antiseptic called Chlorhexidine. The chemical is typically used in hospitals to either disinfect the skin before a surgery or to sterilize surgical equipment, but USAID says that the antiseptic “can also be used to protect the umbilical stumps of newborns to prevent life-threatening complications from an infection.” These infections, USAID explains, can in part be a regular consequence of the traditional home birthing practices found in poorer countries. After conducting multiple studies, it has been shown that even a “one-time chlorhexidine treatment can lower the risk of severe infection [in infants] by 68 percent and infant death by 23 percent.”

Countries Adopting Chlorhexidine

Because it is relatively cheap, easy to manufacture and proven to be effective, around 30 nations throughout Africa and Asia either expressed interest in the antiseptic or have begun working with USAID to integrate the antiseptic into their healthcare system over the past several years.

Case Study: Nepal

Nepal was the first nation to implement the treatment back in 2011. It has since reduced the likelihood of infant illness and mortality by 34 percent. The success in Nepal is what inspired a chain-reaction that lead to the antiseptic being adopted into a variety of different countries—but the success of the disinfectant did not come without its challenges.

Before Chlorhexidine was initiated into their health system, the World Health Organization (WHO) recommended that the nation adopt a dry care system to treat the umbilical cord; this system required that the mother keep her child’s umbilical stump clean and dry until the stump fell off on its own while she kept an eye out for any signs of infection.

Due to cultural barriers, this suggestion was not followed. USAID said that mothers in Nepal had been used to routinely applying unsanitary substances such as turmeric, ash, cow dung or a mercury-based red cosmetic powder used by Hindu women to the umbilical stump by hand. Thankfully Nepal has been impressed with the results Chlorhexidine has supplied but the earlier setbacks in treatment shed an important light for USAID and its partners on how complex assimilating a scientifically safe treatment into impoverished nation’s culture can actually be.

Today, both single-dose tubes of the antiseptic are freely distributed to all expecting mothers in their eighth month of pregnancy and a one-on-one training session explaining how to safely apply the gel after cutting the umbilical cord.

Case Study: Pakistan

Pakistan implemented the treatment in 2014. Pakistan reportedly has the third-highest newborn mortality rate in the world, with umbilical cord infections serving as the second leading cause of death to Pakistani newborns. Seeing as Pakistan is a much larger and complex country, it faced a different set of challenges than Nepal when it came to making the antiseptic widespread.

There were some cultural barriers to overcome in Pakistan as well—many Pakistani women used to treat umbilical cords with surma, a lead-based concoction)—but the main challenge the nation had to overcome was to bring together all the government and private offices working towards a Chlorhexidine treatment program independently. To convene all of these health offices together and collaborate on an implementation plan was no small feat and took around a full year, and then the plans were formally adopted another year later, in 2016.

Of course, Chlorhexidine comes with its own set of risks. Although it has been found to reduce infections, it has also been discovered to cause rashes and burns on some skin types. Even so, the use of Chlorhexidine in both Nepal and Pakistan shows that although the process of assimilating treatment is not always easy or quick, it yields hopeful results that encourage nations in the surrounding areas to adopt the life-saving drug as well.

– Haley Hiday
Photo: Flickr

healthcare systems in TogoTogo, a country located in West Africa is occupied by eight million people and currently faces a healthcare crisis. Nations across the globe have been successful in transforming inadequate healthcare systems into those that successfully prevent and treat ailments. That said, according to a 2017 story by Development and Cooperation, Togo is often referred to as having the worst health systems in West Africa.

Many factors contribute to the sub-par healthcare systems in Togo, including insufficient staff, outdated medical instruments and practices, and ineffective financial and insurance resources. These components combine to create the current healthcare system in Togo.

Despite this complicated health matrix, efforts have been made by the government in tandem with non-governmental organizations (NGOs) to reduce the burden of disease and to improve the healthcare systems in Togo.

Diagnosing the Problem

According to a story run by Deutsche Welle (DW), a German international broadcaster, Togo only sports three healthcare workers for every 10 thousand residents, which DW claims is approximately a quarter of the number of healthcare workers per 10 thousand residents for Ghana. Insufficient staff across the nation – not only in the larger centralized hospitals of Togo, contribute to the poor health systems present.

Inadequate staffing at clinics and hospitals alike can escalate quickly. Lack of properly trained and licensed doctors, nurses and medical personnel often leads to overcrowding in emergency and waiting rooms alike, which complicates matters further. Keeping patients awaiting treatment in confined places increases disease transmission between patients, especially those that can be transferred via skin contact and via the air. Furthermore, the same 2017 Development and Cooperation story recounted several instances where patients tragically passed away while awaiting treatment in some of Togo’s largest hospitals.

In addition to overwhelmed and insufficient staffing, the hospitals themselves are not properly stocked with the supplies necessary to diagnose and treat incoming patients. Outdated medical instruments and practices also have the potential to contribute to inadequate healthcare systems in Togo. Equipment may become faulty over time, or the technology used may simply just not be correct.

While outdated medical technologies are certainly lacking, hospitals also appear to lack basic amenities such as beds. In 2011, Togo only sported seven hospital beds per 10,000 population.

Insufficient staffing and medical supplies seemingly stem from one arena, however: lack of financial resources available. As of 2015, over 55 percent of Togo’s population lived under the global poverty line – approximately four million people. Because of this extreme poverty, patients cannot afford the necessary treatments which leads to a lack of funding for hospitals, resulting in smaller staff and inadequate supplies.

As of right now, healthcare systems in Togo seem to operate on a “pay or die” approach, according to the Development and Cooperation story. Patients and loved ones of those who have fallen ill often have to borrow money in an effort to receive treatment for diseases and ailments. Even then, sometimes it is not enough.

Current Remedies

Global efforts have been to improve the inadequate healthcare systems in Togo. Currently, Togo is in the midst of a five-year project aimed at ending neglected tropical diseases (NTDs). This integrated NTD control currently receives funding from The Bill & Melinda Gates Foundation, The Liverpool School of Tropical Medicine, and both the World Health Organization (WHO) and the United Nations International Children’s Emergency Fund (UNICEF) among others.

This funding goes directly to combatting and administering diagnoses and treatments for neglected tropical diseases present in Togo. Furthermore, a significant portion of the funds dedicated to reducing the burden of these NTDs in Togo is allocated toward the training of health workers, hopefully providing stability in the healthcare sector for years to come.

Aside from these efforts to combat NTDs, other global institutions have made efforts to improve Togo’s healthcare system in general.

The International Association of National Public Health Institutes (IANPHI), an institution set on improving healthcare systems and structures using peer-to-peer models, has begun to lay the groundwork for strengthening the healthcare systems in Togo. Much of IANPHI’s work goes toward strengthening disease surveillance, as well as equipping Togo’s Ministry of Health with laboratory and research facilities, hopefully promoting new science and health-related job opportunities.

Moving Forward

The healthcare systems in Togo have a significant and difficult path in front of them. The issues of staffing, supplies and financial insecurities must be addressed in order to increase health promotion and disease prevention in the country. That said, significant progress has been made in laying the groundwork of the future of Togo’s healthcare systems, hopefully paving the way for significant reform and a brighter future.

– Colin Petersdorf
Photo: Flickr

VISION 2020 initiativeBlindness, as well as moderate to severe visual impairments (MSVI), affects hundreds of millions of people around the world. An estimated 217 million people suffer from MSVI, and 36 million are blind. However, despite the fact that 89 percent of all visually impaired people live in developing countries, blindness tends to be one of the more overlooked aspects of anti-poverty and development efforts around the world.

In 1999, the World Health Organization (WHO), in partnership with more than 20 other organizations, launched the VISION 2020: The Right to Sight campaign, which intended to “eliminate the main causes of all preventable and treatable blindness as a public health issue by the year 2020.” Since the beginning of the campaign, much progress has been made in reducing preventable blindness around the world. However, preventable blindness continues to be an issue around the world, particularly in impoverished countries.

Before diving into the origins, objectives and accomplishments of the VISION 2020 initiative, it will be useful to understand how blindness, MSVI and global poverty intersect.

Blindness and Global Poverty

Due to the fact that the overwhelming majority of blind and visually impaired people live in poor and middle-income countries, poor eye health has become deeply intertwined with global poverty. In general, blindness and MSVI are common among the global poor because of their inability to afford health services, which puts them at an increased risk of contracting eye diseases. Additionally, a lack of awareness about eye health exacerbates this problem.

Unfortunately, poverty can cause blindness just as much as blindness can cause poverty. Blindness can impose severe economic burdens on those affected by drastically reducing their ability to work and provide for themselves. Ninety percent of blind people around the world cannot work. High levels of blindness also create economic problems for whole countries, and even the world economy. In 2000, it was estimated that visual impairment cost the global economy between $19,223 million and $22,764 million in GDP.

Blindness can also bring negative social consequences, such as a loss of social standing and authoritative decision-making. This social stigma is particularly prevalent in blind women, 80 percent of whom report a loss of authority within their families. Additionally, the economic impact of blindness can lead the afflicted to feel an increased sense of social isolation and alienation from their communities.

The VISION 2020 Initiative

The VISION 2020 initiative is a multi-organization campaign, launched by the WHO in 1999, which aims to eliminate preventable blindness by the year 2020. In order to achieve this goal, VISION 2020 has used three core strategies. These include using specific programs to control and treat the major causes of blindness, training ophthalmologists and other eye doctors to provide eye care to those who need it, and improving technology and infrastructure to increase the accessibility of eye treatment.

Since the VISION 2020 initiative launched, some progress has undeniably been made toward reducing preventable blindness worldwide. Between 1999 and 2015, the prevalence of visual impairment decreased from 4.58 percent to 3.38 percent. Additionally, many low and middle-income countries are seeing increased rates of cataract surgery.

However, despite the fact that the campaign is in its final year, it will not achieve its goal of ending preventable blindness around the world. Compounding this problem, researchers are pointing to emerging global health trends that are expected to cause an increase in visual impairments around the world. For example, an increase in the elderly population will likely give rise to an increase in age-related visual impairments, like cataracts. Increased rates of diabetes around the world are causing higher rates of diabetic retinopathy.

It is important to recognize that while these health developments may complicate efforts to reduce blindness worldwide, the fact that researchers have knowledge of these trends can shape the strategies of future anti-blindness campaigns. Despite the failure of the VISION 2020 initiative to end preventable blindness around the world, experts can learn from the program’s shortcomings and build on its successes going forward.

– Andrew Bryant
Photo: Flickr

Effects of Poverty While PregnantWomen represent more than half of the world’s poor and make only a small percentage of the world’s income. This is influenced by various factors, including lack of access to education, abuse and gender inequality. Because women are already at a higher risk of facing the crippling effects of poverty, their situation becomes more precarious when they are pregnant or new mothers. It is estimated that 99 percent of all maternal deaths occur in developing countries.

Furthermore, in food insecure and unstable countries, adolescent pregnancy is the leading cause of death in young women, ages 15-19. Some of the leading causes of maternal death include severe bleeding, infection and delivery complications due to a lack of proper health care facilities.

Physical Effects of Poverty While Pregnant

In developing countries, where there is often little access to high-quality food and water, one of the most common effects of poverty while pregnant is malnutrition. Underweight and malnourished mothers are at an increased risk of mortality, miscarriage and preterm labor. Because they lack proper access to antenatal care, they are prone to infection and morbidity.

The WHO Millennium Goals Progress Report showed that 60 percent of women in Africa give birth without the presence of a skilled attendant. In addition, nearly 50 percent in Africa lack any antenatal care.

As it relates to malnutrition, more than half of all pregnant women in developing countries suffer from anemia. In South Asia, for instance, 75 percent of pregnant women have anemia versus 18 percent in developing countries. Aside from the low energy levels associated with anemia, anemic pregnant women face a heightened risk of death from bleeding during childbirth.

Malnourished mothers are also at risk of developing hypertension. Although hypertension is associated with higher risks of preterm birth and lower child birthweights, the most severe risks include preeclampsia and placental abruption. The former can cause kidney, liver and brain damage for the mother. Although this is a treatable condition if caught early, many women in developing countries have little access to health care that would offer a proper diagnosis or treatment.

With regard to placental abruption, the placenta separates from the wall of the uterus and can cause severe bleeding for the mother and prevent the baby from receiving enough oxygen. Like anemia, hypertension is a severe physical side effect directly correlated with higher rates of poverty that puts malnourished mothers and babies at great risk.

Emotional Effects of Poverty While Pregnant

In many developing countries, women do not have equal access to education or career opportunities, making them dependent upon their spouses or families. Such dependency can lead to feelings of helplessness that can affect the health of pregnant women. Evidence suggests that pregnant women who face extreme poverty are more likely to face inequality and develop mental illness.

Furthermore, humanitarian crises, such as conflict and post-conflict situations, can increase the risk of violence against women. It is estimated that 35 percent of women worldwide have experienced physical and emotional violence. In places such as West and Central Africa where child marriage still exists, women are more likely to face violence and domestic abuse.

In sub-Saharan Africa, Intimate Partner Violence (IPV) has a 61 percent prevalence in some areas. Abuse in any form, physical, psychological or sexual, can have dire consequences on women and their health during pregnancy. Victims of abuse often face physical harm and mental health issues, such as depression, post-traumatic stress and anxiety. Some victims turn to alcohol or drugs. In addition, women who suffer abuse often face unwanted pregnancies and unsafe abortions. The stress of abuse can affect many aspects of a person’s life but puts pregnant women at a much greater risk due to their already vulnerable physical state.

Efforts to Lessen the Effects of Poverty While Pregnant

Programs such as the U.N.’s Global Strategy for Women’s, Children’s and Adolescent’s Health, the U.N. Millennium Development Goals and WHO Global Action Plan have made strides in reducing the effects of poverty while pregnant. Between 1990 and 2013, the global maternal mortality rate has decreased by 50 percent.

Although maternal mortality rates remain high in developing countries, programs such as the U.N.’s Agenda for Sustainable Development and numerous nonprofit organizations are working to provide access to antenatal care and technology that would assist in identifying health problems for pregnant women. With increased food security, access to antenatal care and an increase in education and gender equality, the U.N. Agenda For Sustainable Development hopes to decrease the maternal mortality rates by at least two-thirds by 2030.

In keeping with this sustainable development agenda, the Reach Every Mother and Child Act (S.1766) is a bipartisan bill that would allow for mothers and children in these impoverished nations to receive the care they so desperately need while also providing a foundation for them thrive and contribute to the global economy. Because the U.S. already has the expertise in ending preventable maternal and child deaths, we must play a larger role in this global fight to help mothers and their children.

 

Send an email to your Senators today asking them to support the Reach Every Mother and Child Act.

 

In addition to increasing access, a greater focus is being placed on the quality of care for these vulnerable groups led by the WHO and UNICEF. The two organizations recently launched a Network for Improving Quality of Care for Maternal, Newborn and Child Health to “cut preventable maternal and newborn illness and deaths, and to improve every mother’s experience of care.” In 2017-2019, Bangladesh, Côte d’Ivoire, Ethiopia, Ghana, India, Malawi, Nigeria, Tanzania and Uganda signed on as partners and more countries are expected to join this effort in the future.

– Christina Laucello and Kim Thelwell
Photo: Flickr

Mental Health in IndiaIndia is home to more than one billion citizens. According to a 2015 World Health Organization (WHO) report, of that billion, 56 million suffer from depression and 38 million have anxiety disorders. When adjusted for population size, India is the country with the greatest burden of mental and behavioral disorders, leading some to call the lack of mental health care in India a burgeoning crisis.

Although India is working to improve the mental health of its citizens, initiatives have been slow going. Some roadblocks to improving mental health are the social stigma, its low priority in the healthcare budget and a shortage of mental health professionals.

Stigma

One major barrier to improving mental health in India is the social stigma around mental illness. According to a survey by the Live Laugh Love Foundation, of the 3,556 respondents, 47 percent could be considered judgmental of people with mental illnesses while 26 percent were categorized as being afraid of the mentally ill. This study looked at people between the ages of 18 and 45 from different socio-economic backgrounds. Surprisingly, most of the respondents in those categories were well educated and from higher social classes. When asked to describe the mentally ill, many used derogatory terms or harmful stereotypes.

However, 26 percent of the respondents were categorized as supportive of people with mental illnesses. These respondents tended to be younger—between the ages of 18 and 24—and from a relatively lower educational and socio-economic background.

Advocates and activists are also working to destigmatize mental health in India. Recently, India passed the Mental Health Care Act of 2017, which protects the rights of people with mental illnesses so that they are treated without discrimination.

Low Priority

According to a 2015-16 survey by the Bengaluru-based National Institute of Mental Health and Neuroscience, 150 million Indians are in need of mental health care, but only 30 million have access to the care they need. Although India began implementing its National Mental Health Program in 1982 with the goal of integrating mental health care with general care, the rollout has been slow. As of 2015, only 27 percent of the 630 districts intended to have a mental health program had created one. The District Mental Health programs have also struggled with inaccessible funding and administrative issues like an inability to fulfill the required number of professionals for each district.

While this program has struggled, the government has been working on other means of improving mental health in India. In 2014, it began implementing its first National Mental Health Policy, which aims to increase funding for training mental health professionals and universal access to mental healthcare.

A Need for Mental Health Professionals

Perhaps one of the biggest roadblocks to improving mental health, though, is the extreme shortage of mental health professionals. In 2014, the WHO found that there is on average only one mental health professional for every 100,000 citizens. These doctors, psychiatrists and psychologists tend to be overworked leading to misdiagnoses in too many cases.

One way the government of Karnataka in southwest India has been trying to fill in the gap is with community health workers called accredited social health activists or ASHA workers. Though they usually are women who council other women in their communities on pregnancy, breastfeeding and parenting, in 2016, they began training these workers to identify and deal with mental health issues. While ASHA workers can help fill some of the gaps, there remains a need for more specialized care. India’s National Mental Healthcare Policy and District Mental Healthcare Policy is a good start, but for it to be successful, the Indian Government has to be proactive in training mental health professionals.

While people with mental illnesses are still struggling, the topic of mental health in India is gaining traction. Activists are working to destigmatize and protect people with mental illness while the government is working to increase accessibility to mental health professionals.

– Katharine Hanifen
Photo: Flickr

severe smog
China has one of the world’s fastest-growing economies. With an annual GDP of over $12.34 trillion in 2017, China is the second-largest economy in the world behind the U.S., which has an annual 2017 GDP at over $19 trillion. While China’s economy may be growing rapidly, and possibly on the verge of passing the U.S. within the next decade or so, economic growth has come at a significant cost including severe smog.

China has relied extensively on fossil fuels for new manufacturing and power production facilities. The expansion of manufacturing facilities, combined with poor regulations, has led to serious smog problems in Chinese cities, especially in Beijing. Now, the Chinese government is acknowledging the negative health impacts of extreme smog production after ignoring it for years.

What is Smog?

Smog is severe air pollution that looks like a thick fog. The most common form of smog is photochemical smog. Photochemical smog forms when sunlight reacts with nitrogen oxides and volatile organic compounds (VOCs) in the atmosphere. Nitrous oxides commonly release into the atmosphere through burning fossil fuels and factory emissions. VOCs commonly release into the atmosphere by paints and cleaning products. The end product of this chemical reaction creates a thick, brownish fog that can be unhealthy for humans, plants and animals.

Background Behind Beijing Smog

Coal-burning facilities are the number one culprit behind Beijing’s severe smog. Since China opened up to the world for trade in the 1970s, the nation has become a manufacturing-based economy. This is because Chinese workers receive little pay to manufacture products compared to what companies would have to pay in other countries. On top of that, Chinese products tend to be much cheaper to produce.

Beijing has become a major example of poor air quality due to the significant increase of coal-burning facilities. It also has a large number of vehicles on roadways along with unique topography.

Negative Health Impacts of Smog

Besides severe smog being unaesthetic and producing a thick, brown fog, it also has serious health impacts for humans, plants and animals. Beijing’s smog can cause short-term health problems such as heart attacks, asthma attacks and bronchitis. Thick smog can even lead to increased traffic accidents from poor visibility. Over the long-term, smog contributes to serious conditions such as respiratory failure and even cancer. To make things even worse, nearly one million Chinese residents died in 2012 because of smog-related diseases, the most out of any country in the world.

Smog also disproportionally impacts poorer residents because unhealthy air quality conditions are typically worse in poorer communities. Poorer residents also have a harder time accessing high-quality health care, which makes it difficult to receive adequate medical treatment for smog-related health issues.

“These pollutants are understood to affect human health in several ways, but most importantly they have been observed to cause people to die prematurely,” said Jason West, a professor for the Department of Environmental Sciences and Engineering at UNC-Chapel Hill. “When we breathe, pollutants in the air can react with our airways and the surfaces of our lungs, and some pollutants like PM2.5 can enter the bloodstream and circulate throughout the body.”

Epidemiological studies have shown that people who live in places with high air pollution tend to die earlier than people who live in places with cleaner air, affecting causes of death that include heart attack, stroke, chronic obstructive pulmonary disease and lung cancer.

How China is Alleviating Smog

Before China’s Academy for Environmental Planning pledged $277 billion to combat urban air pollution, smog conditions throughout Chinese cities were severe. There were concerns about the 2008 Summer Olympics, which were held in Beijing, over severe smog issues. In December 2016, Beijing had to close down schools and airports because of severe air quality problems.

Furthermore, most residents have to wear masks in efforts to reduce the amount of unhealthy particle matter being trapped in their lungs. However, since 2013, nearly four million homes in the northern parts of China have converted to natural gas, a cleaner alternative than burning coal.

The average amount of unhealthy air particles that can penetrate the lungs and cause health problems has fallen in urban areas. Between 2016 and 2017, the concentration of negative air particles fell to 43 micrograms per cubic meter, a 6 percent decrease but much higher than the World Health Organization’s maximum recommended concentration 25 micrograms per cubic meter over a 24 hour period. The Chinese government has also released a new Three-Year Action Plan in 2018. By 2020, the plan hopes to decrease sulfur dioxide and nitrous oxides by 15 percent.

Chinese NGOs

Nongovernmental organizations (NGOs) throughout China are also helping to combat severe smog issues. Most of China’s NGOs such as the Center for Legal Assistance to Pollution Victims (CLAPV) are concerned with legal actions against smog polluters. CLAPV has helped over 10,000 people via the phone and has pursued over 100 legal cases.

With negative health consequences such as respiratory problems developing because of smog, many residents have long-term health problems. Therefore, NGOs provide outlets for helping Chinese citizens sue polluters for damages, which in the long run, helps to alleviate severe smog issues.

Chinese smog is certainly a problem, and cities such as Beijing and Hong Kong feel the effects. Although smog may be a problem, there are solutions that will greatly reduce its negative health consequences. American companies such as Apple are investing millions of dollars in renewable energy projects in China, which reduces fossil fuel consumption, leading to reduced smog. The Chinese government’s Three-Year Action Plan shows promise, and the U.N. has already found that unhealthy particle matter has decreased throughout Chinese cities, although there is still work to do.

– Kyle Arendas
Photo: Flickr

Soda Tax in MexicoType 2 diabetes recently became one of the leading causes of death in Mexico. The number of diabetes-related deaths will continue to rise. Furthermore, scientists have predicted that at least half of Mexico’s population will have diabetes by 2050. Conditions such as being overweight and obesity have strong links to the development of Type 2 diabetes. In response to the growing health concerns associated with obesity and diabetes, the soda tax in Mexico has been implemented to reduce liquid sugar consumption and promote healthier lifestyle choices.

Tax on Soda

Mexico has historically been a top consumer of sugar-sweetened beverages. In 2012, the average person consumed 176 liters per year. Mexico made the world’s top consumer of soda per capita.

The popularity of sugary drinks has come with negative consequences. As soda consumption rose, the number of people suffering from obesity and diabetes in Mexico also increased. While sugar-sweetened beverages were not the only drivers of the weight-related problems plaguing the country, they did receive the most attention from health officials.

In 2014, Mexico began taxing all sugar-sweetened drinks. The tax roughly increased the price of the sugary drinks by one peso per liter. The purpose behind the soda tax was twofold:

  1. Reduce the consumption of liquid sugar that contributed to high obesity and diabetes rates.
  2. Increase funding for public health-based programs to promote healthy lifestyle choices.

Mexico’s Struggle with Diabetes

The soda tax in Mexico was an important step in the country’s fight against diabetes. In 2018, a report found that nearly one-third of the Mexican population was living with diabetes. The most common form diagnosed was Type 2 diabetes, which causes blood glucose (sugar) levels to be higher than normal. The exact cause remains unclear, but obesity was strongly linked to the development of Type 2 diabetes.

Link Between Obesity and Diabetes

The World Health Organization (WHO) reported that a healthy diet includes the consumption of about 2,000 calories per day. The average Mexican adult consumes over 3,000 calories per day. Mexico has one of the highest obesity rates in the world. The number of Mexican adults suffering from obesity rose from 20.5 million in 2012 to 24.3 million in 2016.

Food insecurity and undernourishment were the leading causes of obesity, especially among the poor. The United Nations Food and Agriculture Organization (FAO) found that unreliable access to food contributed to multiple health conditions. In addition, much of the food produced in Mexico was high in carbs and fats. Mexican farmers favored crops that were cheap and easy to grow (like corn) instead of focusing on their nutritional value. Consequently, the average Mexican diet has higher carbs and fats than recommended.

The poor have been the most vulnerable to obesity. A study found that poor communities had obesity rates 145 percent greater than wealthy communities. The stress of food insecurity and undernourishment impair the poor from making the best food choices for their health.“When household resources for food become scarce, people choose less expensive foods that are often high in calories and low in nutrients,” explained the FAO.

Did the Soda Tax Work?

Diabetes has no cure. While medication is a big part of treatment, most doctors recommend a lifestyle change for diabetics looking to keep their blood glucose levels under control. The “Soda Tax” sought to help with the lifestyle change by saving people who avoided sugary drinks money.

Since 2014, the sales of sugar-sweetened beverages have dropped throughout Mexico. Sales dropped by 5.5 percent the first year. By the second year, sales were down by 9.7 percent. The sales of untaxed beverages increased by about 2 percent. However, the calorie intake of the average person has remained unchanged.

– Paola Nuñez
Photo: Flickr

Cholera in the Democratic Republic of Congo
Cholera is a disease that causes diarrhea and severe vomiting which can be fatal if left untreated. Areas that suffer from famine and poor sanitation are particularly susceptible to contracting the disease and the people most likely to become ill with cholera are individuals with low immunity, malnourishment or HIV. Cholera in the Democratic Republic of the Congo is severe and requires immediate attention.

The Democratic Republic of the Congo has become one of the worst victims of this disease. Less than one in seven Congolese citizens have adequate hygienic conditions, and less than half have access to clean water. These are contributors to the susceptibility of the Congolese to cholera.

Cholera in the Democratic Republic of the Congo has proved itself to be a fearsome disease. As of Jan 1, 2019, the Democratic Republic of the Congo declared cholera a nationwide epidemic. In March 2019, the Democratic Republic of Congo reported 1,016 EVD cases. These cases had a fatality rate of 62 percent and resulted in 634 deaths.

Organizations Working with the Democratic Republic of the Congo

To prevent the spreading of cholera, it is essential that the people of the Democratic Republic of the Congo wash their hands, use clean bathroom facilities, eat thoroughly cooked food, have access to clean water and do not come in contact with contaminated corpses. The Democratic Republic of the Congo has partnered with numerous organizations in the hopes of implementing these changes in the country.

The Democratic Republic of the Congo teamed up with UNICEF to ensure that its people have access to clean water. UNICEF has given more than 460,000 Aquatab water-purification tablets to the country, alongside numerous water-treatment facilities along the river.

Medecins Sans Frontieres has also partnered with the Democratic Republic of the Congo to try to help the country combat its cholera crisis. MSF has set up cholera treatment units in the most affected areas of the country to ensure that constant care is available.

The World Health Organization is yet another organization that has been working alongside the Democratic Republic of the Congo to combat this disease. WHO has been trying to give technological support, send medicine and teach the people of the Democratic Republic of the Congo proper hygiene techniques. It has also been attempting to gather data to quantify the disease in the hopes of getting a better understanding of it.

The Democratic Republic of the Congo’s Immunization Plan

The Democratic Republic of the Congo’s latest plan of action has been its immunization plan. Government officials have come together to give more than 800,000 individuals cholera immunizations. WHO and the United Nations have both been involved in aiding the country in carrying out this plan.

The Democratic Republic of Congo’s Ministry of Health will carry out this program, along with further assistance from the World Health Organization and the Vaccine Alliance. Dr. Deo Nshimirimana, the World Health Organization’s Democratic Republic of Congo representative, stated, “Cholera is a preventable disease. Vaccinating people at risk in the most exposed health zones in North Kivu against cholera is a massive contribution and will protect hundreds of thousands of people.”

Cholera in the Democratic Republic of the Congo remains an imminent threat, but the country has shown that it has no intention of remaining idle in this fight. The country’s ambitious plan, which went into effect on May 27, 2019, is in full swing. Only time will tell if the program is successful, but program officials continue to be optimistic.

– Gabriella Gonzalez
Photo: Flickr

Mental Health in Ukraine
The embattled eastern European country of Ukraine faces increasing levels of poverty as the majority of the population is unable to afford required expenses, 28 years after the country earned its independence. Compared to countries in the European Union, Ukraine’s poverty indicator is 1.6 times higher. Rising rates of unemployment, disconnections, lack of education and conflict impact the state of mental health in Ukraine. At the start of the war in 2014, Ukraine ranked second on the list of the top 10 most depressed countries in the world.

The Current State of Mental Health in Ukraine

Due to the armed conflict plaguing the nation, 32 percent of Ukrainians suffer from post-traumatic stress disorder, 22 percent suffer from depression and 17 percent suffer from anxiety. According to data from the World Health Organization (WHO), there is an average of 9,024 deaths due to suicide per year, ranking Ukraine at 21 for the countries with the highest rates of suicide. Data from the World Bank suggests that nearly one-third of the Ukrainian population experiences at least one mental health disorder during their life, which is higher than the global average. The 1.6 million Ukrainians that the conflict displaced and those still residing in areas of conflict are amongst the most vulnerable populations for mental health disorders.

Seventy-four percent of the population reported they were unable to receive necessary psychiatric care because of the high costs of care and medicine. Stigma, prejudice and fear of societal rejection further complicate the lack of mental health care in Ukraine.

Moving Toward the Future

The Ukrainian health care system currently models the Soviet’s, and despite 28 years of independence, it has seen little change and lags behind the developed world. There has been a call to integrate mental health care with the ongoing health care reform in Ukraine. Currently, the country devotes only 2.5 percent of the budget within the health care sector to mental health. Eighty-nine percent of the allocation goes to psychiatric hospitals. Decentralization of care would protect patient confidentiality, shrinking the widespread stigma. Inappropriate treatment aggravates the problem of mental health, with the inability to diagnose or the offering of a misdiagnosis. In moving forward, financing needs to increase, referral pathways should strengthen and mental health services must integrate into the existing health care platforms.

USAID in Ukraine

The U.S. Agency for International Development (USAID) assists Ukraine in developing its health system with the overall aim of assuring the Ukrainian population receives modern care from knowledgeable, trained medical professionals. USAID and Ukraine’s partnership is to ensure those the conflict impacted in the eastern part of the country benefit from the appropriate psychosocial support and treatment that demonstrates effectiveness.

With help from the USAID and a focus on mental health moving forward, Ukraine looks to improve its care for those suffering from mental health disorders. Despite high levels of poverty and conflict plaguing the nation, there is a promising future for the care of mental health in Ukraine.

– Gwen Schemm
Photo: Flickr