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Improving Mental Health in Afghanistan

Mental Health in AfghanistanDecades of violent civil war and political unrest have debilitated Afghanistan’s healthcare system and led to the populations’ exceedingly high rates of mental illness. In 2004, Afganistan’s Ministry of Public Health (MOPH) declared mental health in Afghanistan a top priority. Today, the National Strategy for Mental Health (NSMH) is taking a multifaceted approach to improving the mental health of Afgan citizens.

The National Strategy for Mental Health aims to provide a “community-based, comprehensive” system with “access to treatment and follow up of mental illness and related conditions.” One of the primary goals of this system is to integrate mental health services into Afghanistan’s Basic Package of Healthcare Services (BPHS). Within the first 10 years of mental health integration into the BPHS, 70% of patients utilizing mental health services reported “significant improvement.” Other developing countries may wish to follow Afghanistan’s lead and to begin implementing their own mental health initiatives.

Women in Taliban-controlled Areas

Mental health surveys of Afgan women in Taliban-controlled areas exemplify the link between stress and mental illness. Women living in these areas report experiencing gender segregation and violent treatment. This includes restricted employment and education as well as domestic abuse and lack of health resources.

A survey of 160 Afghan women during the 1996-2001 Taliban regime showed many Afgan women suffer from mental illness. The survey results displayed that out of the 160 women,

  • 42% had PTSD symptoms

  • 97% had major depression

  • 86% had severe anxiety

Additionally, Afgan women living in Taliban-controlled areas suffered from depression at almost three times the rate of women living in non-Taliban-controlled areas (78 % versus 28 %).

Integration of Mental Health Services

In many countries, mental health support falls under general health funding, which results in very little direct funds for necessary mental health resources. However, as a result of successful integration by the Afghan government and restructuring of its healthcare system, resources for mental health in Afghanistan are available within the national healthcare infrastructure. The critical decision to absorb mental health in Afghanistan into general health has allowed mental health training to become a priority among all general physicians in addition to specialists.

The National Institute of Mental Health reports that people suffering from mental illness can potentially die anywhere from 13 to 30 years before their counterparts with no mental health problems. The integration of mental illness into general health equips primary physicians with the resources and training to diagnose and treat conditions. Transferring training and resources to primary health caregivers makes mental health services more accessible to the general public.

Afghanistan’s NSMH recognized that medication alone cannot fix mental health problems in Afghanistan. Medication treats the symptoms of trauma, not the source. This can lead to social isolation. This research led the NSMH to switch from a strictly medical treatment plan to a biopsychosocial treatment plan. This provides patients with counseling services, including stress management and domestic violence training for community health workers and teachers.

Impact of Mental Health Services

Before 2004, there were no psychiatrists working for the government. Furthermore, mental health receives less than 1% of physician training. After the integration of mental health services into the BPHS, each district hospital in Afghanistan has a full-time mental health physician who has received a two-month training in psychiatric care.

In regions that previously had no access to mental health services, there are now health facilities with health workers trained in identifying mental health disorders and creating treatment plans. These facilities can provide services for up to 60,000 people. Between 2002 and 2012, when mental health service programs were implemented, more than 900 community health workers and hundreds of doctors, nurses and midwives received training in mental health services.

Furthermore, in 2001, only 10% of the Afghan population lived within a one hour walk from a health facility. The BPHS increased the presence and accessibility of health facilities serving mental health in Afghanistan. Afterward, the overall patient visits to health facilities grew from two million to more than 44 million per year, which shows that the facilities were utilized frequently. In 2004, 22% of the health facilities served a minimum of 750 new patients per month. In 2008, 85% did.

Economic Incentive

Especially in developing countries, prioritizing mental health creates a more sustainable economy. According to the World Health Organization, depression and anxiety account for $1 trillion per year of lost or diminished output in the global economy. Additionally, when workplaces do not provide mental health resources, they lose the equivalent of 45 years of work per year. Mental health consequences on the economy and a population’s health are even greater in low-income countries due to the increased prevalence of stigmatization, superstition and treatment inaccessibility.

In addition to ethical incentives, governments have economic incentives to provide mental health services and resources because there is an economic advantage to having a healthy workforce. A failure to recognize and support populations suffering from mental health problems leads to a loss in economic productivity. Globally, every $1 that is invested in mental health disorder treatment translates to $4 in productivity and well-being.

Global Investment

Afghanistan’s next goal is to increase access to the BPHS for the remaining quarter of the population who still struggle to acquire health care. The growth of the BPHS and the Afghan government’s promise to expand its services to reach every citizen requires some economic input from international donors; however, the BPHS does not intend to rely on international donors forever. The World Bank, European Union and United States Agency for International Development (USAID) have been the largest donors to Afghanistan’s BPHS since the creation of the BPHS. However, each has diminished their contributions over the years.

Between 2003 and 2009, each of their individual financial contributions funded about one-third of the BPHS resources for mental health in Afghanistan. These contributions also supported technical and infrastructural support by funding construction and renovation of health facilities as well as road work projects to increase accessibility for rural populations. Between 2010 and 2012, USAID cut its contributions from $4.5 billion to $1.8 billion. Until the MOPH finds permanent funding for mental health in Afghanistan, the funding will come from donors, taxation, public spending and out of pocket pay for patients.

To fully universalize accessible and affordable mental health resources, the world, and particularly global leaders such as the United States, must continue to invest in mental health and commit to fighting poverty worldwide. Reducing global poverty reduces civil unrest, which decreases the rate of mental health problems. The World Bank, European Union and United States Agency for International Development (USAID) are the largest donors to Afghanistan’s BPHS. Continuing global support for mental health strategies helps not only poverty-stricken countries address mental health needs, but supports the global economy by increasing each populations’ well-being and productivity.

– Nye Day
Photo: Flickr

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Women Showcase Food Safety in El Salvador

food safety in el salvadorThe ability to have access to safe and nutritious food is essential to maintaining life and good health. Unsafe food contains harmful parasites, viruses and bacteria that can lead to more than 200 diseases, from diarrhea to forms of cancer. Approximately 600 million people become ill after consuming contaminated food each year, which results in 420,000 deaths and the loss of thirty-three million healthy life hours. Food safety and nutrition are linked to cycles of health. Unsafe food causes disease and malnutrition, especially with at-risk groups.

Education on Food Safety in El Salvador

Women in El Salvador are participating in an educational program supported by the World Health Organization that teaches safe hygiene practices and food safety. The WHO works in collaboration with El Salvador’s government and other United Nations partner organizations like the Food and Agriculture Organization (FAO), United Nations Development Program (UNDP), UNICEF, UNWomen, and the World Food Program (WFP). The program aims to address foodborne illnesses and poor nutrition by educating local women who then pass on their knowledge to other women in the community.

In preparation for the village workshops, there are two ‘train the trainers’ workshops held to train health promoters who can then go on to educate women in other villages. The women teach others how to host their own educational workshops. Women are chosen as leaders since they play a vital role in food preparation and safety.

Teaching Subsistence Farming

In El Salvador 1 in 10 people live on less than $2 U.S. a day, which makes it hard to buy food.  A large sector of the population lacks the proper education about nutrition needed to grow food themselves. This program provides women with education about farming, specifically focusing on five keys to growing safer fruits and vegetables.

  1. Practice good personal hygiene. Good hygiene begins in the home with a clean body, face, and clothes. People must maintain cleanliness to curb the spread of pathogens and prevent food contamination. A toilet or latrine must be used for proper sanitation.
  2. Protect fields from animal fecal contamination. In areas where animals live in close proximity to humans and fields, it is imperative to control the risk of exposure to fecal matter. Exposure to animal feces is correlated with diarrhea, soil-transmitted helminth infection, trachoma, environmental enteric dysfunction and growth faltering.
  3. Use treated fecal waste. Waste may be reused as a fertilizer for agriculture, gardening or horticultural, but must be safely handled, treated, stored and utilized.
  4. Evaluate and manage risks from irrigation water. Be aware of all risks of microbial contamination at all water sources and protect water from fecal matter.
  5. Keep harvest and storage equipment clean and dry. Wash harvest equipment with clean water and store away from animals and children. Remove all visible dirt and debris from all products.

Results

After participating in the program, the women involved began to change their lifestyles and safety habits. Women use mesh to protect fields from contamination from animals and can grow a wide variety of fruits and vegetables while practicing food safety. Foodborne illnesses decreased in households where safety measures were practiced. Families that utilized the five keys at home reduced their chances of getting diarrhea by 60% compared to families in communities where these hygiene and safety measures were not applied. Families that began to practice food safety also had a more diversified crop production that contributes to improved nutrition.

 

Many people in El Salvador live on less than $2 U.S. a day and education on nutrition needed to grow food independently is sometimes lacking. In order to address these issues, The WHO, and other organizations, partnered with El Salvador’s government to host workshops on food safety and hygiene practices. While food safety remains an important issue in El Salvador, the workshops positively impacted food safety in the country by decreasing foodborne illnesses in households that applied the safety measures.

– Anna Brewer
Photo: Flickr

 

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Vaccines in Africa During COVID-19

Vaccines in Africa during COVID-19Medical progress in developing countries could unravel during COVID-19 because the global shutdown is preventing important vaccines from reaching Africa. In fact, global health organizations struggle to dispatch health care workers, make shipments, and store medical supplies and vaccines. Health care systems have halted vaccinations for cholera, measles, polio and other diseases in order to focus on stopping COVID-19. Also, parents are afraid of bringing newborns to get vaccines during the pandemic as many health care workers have been repeatedly exposed to COVID-19. Although the WHO says that children are not a high-risk category for COVID-19, the fear of exposure could perpetuate the vaccination gap and exacerbate the problem even as governments ease restrictions.

Effects of Halting Vaccine Distribution

The postponement of vaccines in Africa during COVID-19 could lead to a dramatic resurgence of measles, cholera and other diseases that have been decreasing worldwide. Children in countries with low-quality health care might not receive these vaccines. This inequality is a problem that many organizations are trying to combat. Experts are also recommending that leaders should track and trace unvaccinated children to administer the vaccines on a later date. These proactive measures could help prevent future outbreaks.

Measles Vaccinations

Measles cases have risen globally in recent years due to growing misinformation, low-quality health care and other cultural or societal issues. Coronavirus has stalled everyday life, international travel and vaccination campaigns. Because of the impact COVID-19 has had, it is now estimated that over 117 million children in 37 countries, in which the majority are located in Africa, will likely not receive their measles vaccine. The World Health Organization and other global health foundations have expressed concerns over this new problem. Data is now showing that deaths from other diseases will likely compare to COVID-19 deaths in Africa by a ratio of 100 to one because these preventable diseases will have been overlooked. 

What is Being Done to Help

Global health organizations such as UNICEF, the Gates Foundation and other private groups provide most vaccines. Most African health care systems are already not well equipped to handle basic care and disease management. The pandemic, as well as the threat of diseases becoming more prevalent, puts a strain on these health care systems. Organizations like the Gates Foundation have noticed this excess burden on the African health care system, so they are working to help improve Emergency Operations Centers and local disease surveillance and testing. The Gates Foundation is also focusing on providing routine care as that often goes overlooked during a pandemic. The foundation is working to build up their health care systems as a whole to fight other diseases.

Most world leaders are prioritizing the containment of COVID-19; however, global health organizations are encouraging governments to do more to prevent diseases that can be treated with vaccines. 

– Jacquelyn Burrer
Photo: Flickr

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7 Facts about Access to Clean Water in Mexico

clean water in Mexico
Water is fundamental to human survival, yet half of the population of Mexico lacks drinkable water. These seven facts highlight how limited access to clean water in Mexico can intensify poverty.

7 Facts about Access to Clean Water in Mexico

  1. Water Scarcity: Over 50% of people in Mexico face water scarcity. Mexico has an insufficient water supply that cannot sustain a population of 125.5 million people. As a result, an enormous 65 million people are struggling with water scarcity. This issue intensifies during Mexico’s driest month of April as people face droughts preventing accessible water.
  2. Natural Disasters: Natural disasters negatively affect access to clean water. Climate change brings hotter temperatures and droughts that can possibly dry up Mexico’s vital water sources. Earthquakes can destroy water purification plants and break pipelines, leading to floods of toxic waste. These sudden events can lead to an unpredictable water crisis for large numbers of Mexican citizens.
  3. Water Systems: An aging pipe system can also cause an inadequate water supply. Around 35% of water is lost through poor distribution, while faulty pipelines lead to pollution. Plans of the neighboring purification plant should be reconsidered as the city of Tijuana is overwhelmed with toxic sewage water from failing pumps.
  4. Mexico City is Sinking: The populous capital is sinking up to 12 inches annually due to the lack of groundwater. Consequently, floating houses pollute waterways and lead to further destruction of infrastructure. The city plans to modernize hydraulics or implement artificial aquifers to combat water scarcity.
  5. Rural Mexico: Rural regions are often overlooked in favor of cities. Water systems that run through rural towns are riddled with pollutants, making the water undrinkable. The town of Endhó dangerously uses Mexico City’s polluted water for farming because it does not have access to clean water. Some households have no running water, so they drink from polluted lakes to avoid the expense of bottled water. To prevent these dire conditions, government agencies are working to expand waterworks throughout rural areas.
  6. Water Laws: Water laws in Mexico are not enforced. The Mexican government is responsible for regulating access to clean water, but the laws are often disregarded. Citizens demand water for agriculture, which results in over-pumping of groundwater. Environmental problems such as 60% of groundwater in use being tainted are preventable by upholding Mexico’s Environmental Standard.
  7. Children’s Health: Children are vulnerable to arsenic and fluoride that contaminate the drinking water. Mexico’s regulations allow µg/L of arsenic in the drinking water which considerably surpasses the World Health Organization’s (WHO) suggestion of a maximum of 10 µg/L. This poses a dire situation in which 6.5 million children drink this hazardous water putting them at risk of severe health consequences including cancer.

These seven facts concerning water quality in Mexico focus on the importance of having clean drinking water. Access to clean water is necessary in order to maintain good health. The nation is working to fix its outdated infrastructure to bring improvements necessary to solving the water crisis in both urban and rural regions.

– Hannah Nelson
Photo: Pixabay

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6 Ways Technology is Helping Reduce the Burden of COVID-19

Burden of COVIDThe most recent pandemic has wreaked havoc on countries all over the world and has stagnated, or even reversed progress in many developing communities. While officials have been trying to reduce the number of cases worldwide, there have also been many tech developments that help alleviate the burden of COVID-19. Various apps and websites allow us to spread information, contact-trace and even enforce quarantine.

6 Ways Technology Helps Alleviate the Burden of COVID-19

  1. Afghanistan- Without proper guidance, misinformation can spread like wildfire and can be deadly. For this reason, the Ministry of Public Health joined forces with the Ministry of Telecommunications and Information Technology to create software that provides health information to Afghani citizens. Corona.asan.gov.af translates virus updates and information into three different languages, making it easily accessible for all people.
  2. Bulgaria- Local IT developers created a free app that connects citizens to health authorities to help ease the burden of COVID-19. Users verify their identity and can input various symptoms they are experiencing. A doctor will then review their symptoms and decide whether or not to send the patient to the closest medical facility for treatment. In addition to this, the app also can predict the future growth and spread of the virus. The developers are also willing to sell the software to other countries for a symbolic one euro.
  3. Germany- A Berlin-based tech startup created an initiative that would work on Android devices in developing countries throughout South America and North Africa. The project, called #AppsFightCovid would display health information on popup ads that already exist on different apps. The ads take info from the WHO website and advocate for frequent hand washing and wearing a mask in public. Because of these efforts, underdeveloped communities now have access to important COVID-19 information.
  4. Mexico- The Mexico City government created a screening service that determines how likely a user is to contract the coronavirus. The website also features a map that displays the closest hospitals and how much space is available in each of them. People can also filter the map based on whether they need a general care bed or a ventilator bed. In addition, users can input their symptoms and determine whether or not they require hospitalization. This helps alleviate the burden of COVID by reducing the number of unnecessary hospital patients during a global pandemic.
  5. United Nations- It is extremely difficult to get access to personal protective equipment and accurate information, especially for developing countries. Because of this, the U.N. partnered with the WHO and launched the Tech Access Partnership or TAP. This initiative helps reduce the burden of COVID by connecting expert manufacturers with developing manufacturers in poorer countries all over the world to share resources, knowledge and technical expertise. TAP will also aid countries in creating affordable and safe technology.
  6. Argentina- In hopes of reducing the number of coronavirus cases, a company is looking into enforcing quarantining and social distancing through a tracking app, though it is not yet operational. This would be a way to prevent the spread of COVID since the app would send an alert each time a person leaves their home. In addition, the Argentinian Ministry of Health created an application that allows people to evaluate their symptoms and see whether or not they require hospitalization.

 

Though the novel coronavirus has thrown us all for a whirlwind, many countries are doing their part to alleviate the burden of COVID by using technology. Whether it is through self-assessing symptoms, tracking hospitals or enforcing quarantine, government officials everywhere are trying to flatten the curve through the use of technology.

– Karin Filipova
Photo: Unsplash

Tuberculosis in the Marshall Islands: A public health emergency

TB in the Marshall Islands

Tuberculosis in the Marshall Islands is one of many health issues decimating the Central Pacific civilization. The country, which encompasses around 1,200 islands, struggles with high poverty rates and little access to sustainable health care and medicine.

General Facts about TB

Tuberculosis is one of the longest-lasting pandemics in modern history. As the deadliest infectious disease in the world, it kills approximately 4,000 people a day and most commonly affects the lungs. Colloquially termed “consumption” in the 1800s, tuberculosis, if untreated, overwhelmingly consumes an individual’s body. The World Health Organization (WHO) estimates the disease affects around one-quarter of the world’s population with latent tuberculosis, but only a small percentage of those cases become active.

Tuberculosis becomes active due to public health issues that accompany poverty, such as malnutrition, overcrowding and lack of accessible healthcare. In the Marshall Islands, 30% of the population lives under “the basic-needs income line,” and more than 75% of the population resides on its two main islands: Ebeye and Majuro. This population density places the country’s population at severe risk for tuberculosis.

Marshall Islands Risk Factors

The PBS documentary, “Unnatural Causes: Is Inequality Making us Sick?” explores the tuberculosis crisis in The Marshall Islands. The sixth episode of the series on the Marshallese explains that the rate of tuberculosis is 23 times higher than in the United States, partially due to overcrowding. Ebeye Island is more densely populated than Manhattan, with Majuro trailing close behind.

In the Marshall Islands, most people cannot afford to go to the hospital. Instead, they rely on public health outreach to hand-deliver tuberculosis medication to them on a daily basis. Although tuberculosis is highly treatable, the cost and strict daily medication regimen lasting from six months to two years also contribute to the Marshallese becoming increasingly susceptible to tuberculosis.

“What tuberculosis needs to flourish in a person’s body is a broken down immune system,” said Jim Yong Kim, MD, a doctor from Harvard University. “The stress itself of poverty can contribute to the likelihood of developing active tuberculosis.”

Multidrug-Resistant TB

Furthermore, if someone stops taking their medication when they have not finished the full course, they are at risk of developing multidrug-resistant tuberculosis. Antibiotics do not affect this strain of the disease and therefore are virtually impossible to treat.

In 2010, the Marshall Islands declared “a public health emergency” due to a sudden rise in multidrug-resistant tuberculosis. While the country made the effort to quarantine the infected, most Marshallese do not have the economic option to quarantine and stay home from work.

Treatment Rate and Projects

Yet, among these harrowing tales of tuberculosis, the global rate of the disease is decreasing at approximately 2% per year, according to the World Health Organization. In addition, the Marshall Islands, as of 2017, has an 83% treatment success rate.

While tuberculosis in the Marshall Islands presents a scary feat, some outside groups are also working in the country to combat the disease.

Notably, a group from the Migrant Clinicians Network (MCN) embarked on an ambitious 24-week project in 2018 to screen every person on Ebeye island for tuberculosis. The group managed to screen 70% of the population, making the project hugely successful considering the amount of time and manpower it takes to test an entire densely populated island.

MCN identified more than 250 cases of active tuberculosis and set all cases into a strict treatment regimen. Dr. Zuroweste, MD, one of the doctors who worked on the project, also noted the extreme need for widespread testing not only for health but for economic reasons. “Anytime you have TB incidence that’s over 1%, it’s been shown to be cost-effective to screen the population for the disease,” said Zuroweste, noting the 1.5% incidence in the Marshall Islands.

In addition, MCN noted that testing and treating the Marshallese would have “downstream effects.” Most active tuberculosis cases in Arkansas, U.S., are from Marshallese immigrants, so identifying the problem at the source can prevent its spread to other nations.

While tuberculosis poses a significant threat to the Marshall Islands, medical missions to the islands and concentrated efforts to reduce dangerous strains of the disease are already underway. Building awareness of the disease and its harmful complications can also encourage more efforts to help the public health issue worldwide.

– Grace Ganz
Photo: Flickr

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8 Quotes About How to End Hunger

8 Quotes About How to End HungerMore than 820 million people are suffering from hunger. Further, 2 billion are suffering from malnutrition. However, there is enough food, knowledge and resources to end hunger. First, society must address the root cause to effectively end world hunger. Here are 8 inspiring quotes about how to end hunger.

8 Quotes About How to End Hunger

  1. “If with so little we have done so much in Brazil, imagine what could have been done on a global scale if the fight against hunger and poverty were a real priority for the international community.” -Luiz Inácio Lula Da Silva. Luiz Inácio Lula Da Silva is a former Brazilian president, with enormous popularity across Brazil. Lula Da Silva made the poor his central focus. He put into place many social welfare programs and was able to bring millions out of poverty.
  2. “If you can’t feed a hundred people, then feed just one.” -Mother Teresa. Mother Teresa is widely known for feeding the hungry one person at a time. She also set up programs that assisted in resolving world hunger.
  3. “You cannot tackle hunger, disease and poverty unless you can also provide people with a healthy ecosystem in which their economies can grow.” -Gro Harlem Brundtland. Dr. Gro Harlem Brundtland was a physician and scientist for the Norwegian public health system and the Prime Minister of Norway. She later became the Director-General of the World Health Organization (WHO). Brundtland believes in being the moral voice in improving health and alleviating suffering for people around the world.
  4. “We cannot fight against the poverty and hunger in the world when our stomachs are full of delicious food… the fighters must feel the poverty not imagine it.” -M.F. Moonzajer. This quote comes from M.F. Moonzajer’s latest book titled “Love, Hatred, and Madness.” Moonzajer is a journalist and a former intern for the United Nations Secretariat in Bonn as well as a policymaker for an international NGO in Afghanistan.
  5. “Nowhere in the world, in no act of genocide, in no war, are so many people killed per minute, per hour and per day as those who are killed by hunger and poverty…” -Fidel Castro. Fidel Castro was the former Prime Minister of Cuba. Castro felt strongly about human rights, particularly the right to food accessibility. He accused wealthy nations of tolerating the genocide of starvation. He addressed the United Nations during the organization of a multinational force to aid “1 million Rwandan refugees in eastern Zaire where rebel fighting cut off the country’s food supply.”
  6. “When you see in places like Africa and parts of Asia abject poverty, hungry children and malnutrition around you, and you look at yourself as being people who have well being and comforts, I think it takes a very insensitive, tough person not to feel they need to do something.” -Ratan Tata. Ratan Tata is an Indian philanthropist working to improve conditions in India by honing in on the malnutrition of children, fortifying staple foods and aiming to alleviate poverty. The Tata Trusts are providing 60,000 meals a day.
  7. “If you want to eliminate hunger, everybody has to be involved.” – Bono. Bono is a band member of the group U2 and is a leading voice for the world’s poor. His efforts mainly pertain to fighting hunger and poverty, particularly for those in Africa. The musician donates his time to philanthropic causes such as creating charities such as the ONE Campaign and the clothing line EDUN to stimulate trade in poverty-stricken countries.
  8. “If everyone who wants to see an end to poverty, hunger and suffering speak out, then the noise will be deafening.” -Desmond Tutu. Archbishop Desmond Tutu of South Africa is an advocate for human rights, particularly the right to food and clean water. Tutu received the Global Champion Against Hunger award from the United Nations World Food Program for his efforts to defend the weak and the hungry.

These 8 inspiring quotes about how to end hunger show that there are people in the world trying to make a difference. But, as Bono said, everyone has to be involved to truly end world hunger.

– Na’Keevia Brown
Photo: Flickr

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Water Quality in Thailand

Water Quality in ThailandSanitation and hygiene have improved in the past 20 years for the nearly 70 million people that live in the Kingdom of Thailand. Prior to the year 2000, many people lived without access to basic hygiene necessities or clean drinking water. Left untreated the domestic water could pose the risk of infectious disease. In some areas, this surface and groundwater is the primary source of water despite its contamination. Irregular flood and drought patterns could continue to pose a threat to Thailand’s future in terms of water scarcity. This is both a domestic and global issue that needs to be addressed before water resources are endangered any further. These five factors that affect water quality in Thailand highlight the country’s progress with regard to sanitation quality and practices as well as the problems they continue to face.

Water Quality and Scarcity

The Thai government’s Pollution Control Department (PCD) has monitored the state of water quality since 1990. Overall, the trends in water quality in Thailand between 1993 and 2003 were average and stabilizing. With both agricultural and industrial pollution at play, poor water quality was reported in certain bodies of water including the Chao Phraya River, the Tha Chin River, the Lam Takhong River and Songkhla Lake. The following decade’s rise in population size and economic development is now causing a strain on the availability of water resources.

Waterborne diseases can be contracted through eating or drinking contaminated substances from the local economy. Hepatitis A, Hepatitis E and Typhoid fever are the three leading infectious diseases in Thailand. All three are viral infections that can easily spread in areas of poor sanitation.

Droughts and Flooding

Thailand’s water resources have diminished over the years due to disappearing wetlands, corroding watersheds and pollution. The climate in Thailand was not always erratic, but now intense flooding during the wet season and droughts during the dry season are commonplace. Wetlands used to be abundant, but today only 2 percent of the original wetlands still exist. Thailand has lost nearly 96 percent of its wetlands. Unless water resource management is improved, water shortages remain a potential threat to Thailand’s future.

Flooding has been just as detrimental to Thailand’s water supply as have repetitive droughts. Standing water from floods poses serious threats. Contaminated floodwater contains many unknown threats that can be harmful to health, causing symptoms like rashes, infections and illness. Severe flooding has left countless dead and thousands displaced. In September 2019, Thailand experienced extreme floods, resulting in 19 deaths. Although an assessment of the total is ongoing, floods have affected more than 150,000 households. The water quality in Thailand is heavily impacted by the continual irregular weather patterns that have taken over Thailand’s climate.

Legislation

Sustainability in terms of water development and sanitation has been a part of Thailand’s legislative value since 1980. The nation continues to support and attempt to improve sustainable natural resource management and environmental protection. It believes both are vital tools for the sustainable development of resources. Legislation has also placed value on addressing sanitation inequality by recognizing proper sanitation and water access as a human right. In addition to laws and efforts on Thailand’s part, the U.S. has dedicated resources to improving sanitation in countries around the world as part of their Millennium Development Goals

Sanitation and access to clean water have a profound impact on the quality of life, especially in more impoverished areas. It has been shown that United States money that is invested in sanitation in developing countries is reintegrated at a rate of more than five times the original value since people are more likely to be happy, healthy and able to work. Promoting investment in global sanitation will help improve the quality of water in Thailand and have a lasting impact on Thai citizens’ lives.

– Helen Schwie
Photo: Wikimedia Commons

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The Rising Danger of Dengue Fever in Bangladesh

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

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How Chlorhexidine is Lowering Infant Mortality

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