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Antimicrobial resistanceAntimicrobial resistance, or AMR, is a growing trend among newly discovered viruses. The World Health Organization (WHO) identifies 30 new diseases that threaten half the world’s population, which are particularly prevalent in developing nations.

Background of Antimicrobial Resistance

Drug-resistant diseases (AMR) have grown in prevalence over the past 40 years. Many of the medicines used to treat common infections like the flu and pneumonia have been around for decades. Eventually, viruses and bacteria develop their own microbial methods of fighting back against these drugs and inevitably become fully resistant to treatments.

Perhaps the most well-known example is the virus known as pneumococcus, or streptococcus pneumoniae. Penicillin has been used to treat pneumococcus since the early 1950s, giving it plenty of time to develop a strong resistance to the drug. Now, pneumococcus is practically untreatable, killing over 300,000 children below the age of 5 annually.

The CDC explains that germs that grow resistant to medications can be almost impossible to treat, often resulting in severe illness or death. This problem is only getting worse, as the U.N. finds that while 700,000 people die every year due to AMR diseases now, by 2050 that number will skyrocket to 10 million people.

The AMR crisis has severe economic implications as well. Antimicrobial diseases affect livestock as well as humans, leaving our international agricultural sector to collapse if not dealt with. All in all, the AMR crisis is projected to cause $100 trillion worth of global economic damage by 2050, only pushing people further into poverty.

Three organizations have stepped up to address the issue of antimicrobial resistance.

The AMR Action Fund

The AMR Action Fund is a financial project created by an international group of pharmaceutical companies. It aims to bring four new antibiotics that combat AMR to the consumer market by 2030. The fund expects to invest over $1 billion into late-stage antibiotic research by the end of 2025.

The AMR Alliance

The AMR Alliance is a massive coalition of more than 100 of the most powerful pharmaceutical companies, dedicated to fighting AMR. In 2016, the AMR Alliance signed the Industry Declaration, an agreement promising the development of anti-AMR medicines.

In 2018, the AMR Alliance spent a record $1.8 billion in the war against AMR. In 2020, the  AMR Alliance released its second progress report, detailing the progress made so far. The results are promising: 84% of relevant biotechnology companies are in the late stages of research and development for AMR cures and more than 80% of them have strategies in place for releasing the drugs.

UN Food and Agriculture Organization (FAO)

The FAO is taking serious steps to battle antimicrobial resistance. These dangerous antimicrobial superbugs threaten livestock in farms throughout the world. The FAO explains that two-thirds of future antimicrobial usage will be in livestock. These AMR superbugs will only increase in danger over time, as they develop stronger resistance to medicines.

The FAO has worked to improve agricultural practices across the world, specifically in developing nations. The FAO is raising awareness about this issue with rural farmers and is providing millions of dollars in funds to combat AMR.

World Antimicrobial Awareness Week (WAAW) is an annual campaign designed to increase awareness of the issue and encourage best practices among the general public, health workers, and policymakers to avoid the further emergence and spread of drug-resistant diseases. Over the week of November 18, millions of posts are made around the globe in support of antimicrobial resistance awareness. Expanding awareness is key, as the WAAW campaign website explains that less general use of antibiotics could help to mitigate the effects of this issue.

– Abhay Acharya
Photo: Flickr

Mental Health in Bosnia and Herzegovina
In the past half-century, mental health treatment has become a hallmark of national development and Europe has been no exception. Nations of the former Soviet Bloc have seen major developments in the last several years. Before violence broke out in the former Yugoslavia, Bosnia and Herzegovina had a fairly strong psychiatric care system with wards in larger hospitals. However, since the stabilization of the region, the system has undergone rebuilding with a focus on not only hospital wards, but also community mental health care clinics.

Despite its small population of only 3.5 million, Bosnia and Herzegovina have been a model of mental health care in the Balkan region. Mental health care in Bosnia and Herzegovina has been extremely important since the deadly conflicts within the former Yugoslavia, particularly the Bosnian Genocide from 1992-1995. Additionally, it continues to be important into the 20th century with high rates of mental illness among survivors of the conflict.

The Situation

While mental health in Bosnia and Herzegovina has not received a lot of study, it is clear that post-war Bosnia and Herzegovina has comparatively high levels of mental illness stemming from trauma. This includes but is not limited to mental illnesses such as post-traumatic stress disorder, depression and personality disorders. Many citizens have experienced internal displacement or repatriation or suffered violent trauma during the period of unrest in the Balkans in the 1990s and early 2000s leading to extensive need for mental health care both long term and in crisis situations. While this suffering is certainly not ideal, it has encouraged a number of organizations to assist in not only the implementation of systems of accessible mental health care but also campaigns to destigmatize mental illness in new and innovative ways.

These systems have been highly successful and have provided care for thousands of individuals through 74 community mental health centers, several teaching clinical centers in major cities and nine full psychiatric wards all of which can handle both acute and chronic mental health concerns. The involvement of the Swiss Federal Department of Foreign Affairs has helped make these achievements possible. It has made a major effort to structure and fund the creation of vast mental health programs and networks along with the help of several international NGOs including HealthNet International, the World Health Organization (WHO), Medica Zenica and the Red Cross. All of these organizations have contributed to funding, training and organizing clinics around the country. This has allowed for a complete restructuring of the mental health care system in the country including international advocacy groups collaboration on legislation to improve the lives of mentally ill citizens.

Government-Provided Mental Health Care

While Bosnia and Herzegovina have an absolute poverty rate of over 16% which is above the global average, citizens can rely on government-provided mental health care through the Ministry of Health and Social Welfare. The Ministry of Health and Social Welfare operates through a decentralized system and receives funding through citizens’ mandatory national health insurance.

In addition to improvements in mental health care, new programs have seen extensive success in destigmatizing psychiatric illness. In the last several years, mental health in Bosnia and Herzegovina has improved through the implementation of mental health promotion programs in schools as well as in communities, which serve to normalize mental illness and discuss mental health. The success of these systems offers an example by which to construct mental health systems in smaller nations that desperately need access to these services.

Despite the struggles of the past half-century, Bosnia and Herzegovina has become an example of positive mental health care restructuring. Moreover, it seems likely that the system will continue to make improvements over time.

– Che Jackson
Photo: Flickr

Trachoma in developing countriesTrachoma, an unsung yet highly infectious disease, is listed by the World Health Organization (WHO) as the leading cause of blindness across the world. Data from March 2020 indicates that 137 million people live in areas that put them at risk of trachoma. It is estimated that several million people suffer from the disease worldwide, across 44 different countries. The disease is easily transmitted between two people and its effects can be devastating. The WHO has prioritized the elimination of trachoma in developing countries, where trachoma is common.

Trachoma and its Effects

The WHO reports that “transmission occurs through contact with infective discharges from the eyes and nose, particularly in young children, who harbor the main reservoir of infection. It is also spread by flies which have been in contact with the eyes and noses of infected people.” If left untreated, it can cause irreversible blindness. Trachoma also deeply affects the quality of life of families and entire communities where it is present as people with trachoma are often prevented from working and providing for their families. Additionally, women get trachoma at much higher rates than men because they are much more exposed to potentially infected children.

Trachoma Elimination Progress

Over the past two decades, significant work has been done in countries where trachoma is endemic, in order to eradicate the disease once and for all. This work has been extremely effective. Since 2002, those at risk of trachoma in developing countries and across the world have dropped 91%. Although that equates to 142 million people, the number is down from 1.5 billion people in 2002, which is progress on an incredible scale. Anthony Solomon, a medical officer in charge of WHO’s global trachoma elimination program, states that “We should be able to relegate trachoma to the history books in the next few years but we will only do so by redoubling our efforts now. The last few countries are likely to be the hardest. This is great progress but we cannot afford to become complacent.”

The Carter Center

In addition to the WHO, a number of different NGOs have been working to lower rates of trachoma, in developing countries especially. The Carter Center, founded by former U.S. president, Jimmy Carter, is an organization with a huge scope. Causes that the organization supports include peacebuilding, healthcare and human rights across the globe. The Carter Center’s commitment to ending trachoma is integral as it has provided resources such as eyelid surgery and other medical services for trachoma and is working to improve the environmental conditions of trachoma endemic countries. The Center states that “Over the course of 20 years (1999 to 2019), the Center has assisted national programs in providing 846,219  trachomatous trichiasis surgeries in Ethiopia, Mali, Niger, Nigeria, South Sudan and Sudan.” Although Trachoma can be potentially life-changing if left untreated, there are definite medical steps that can be taken before it reaches that point. The Carter Center and other organizations like it are providing crucial resources in order to save lives and eliminate trachoma in developing countries.

Trachoma’s Link to Poverty

Ultimately, eliminating trachoma in developing countries not only means improving the physical health of those who are currently at risk but it would greatly lower poverty rates in those same countries as well. Trachoma hurts the local economy, which in turn has a global impact. Providing the necessary healthcare and aid to those struggling with trachoma will in turn boost the quality of life in dozens of countries, therefore improving the global economy and allowing trade to flourish worldwide. The WHO Alliance for the Global Elimination of Trachoma by 2020 (GET2020 Alliance) set a target to eliminate trachoma entirely by 2020. While that goal may have been missed, significant progress has been made and blindness rates are likely to continue falling rapidly in the coming years.

– Leo Posel
Photo: Flickr

dual outbreaksThe impact of COVID-19 has resulted in fractured economies and health care systems all around the world. While some countries are trying to recover, others just cannot catch a break. Papua New Guinea is a country that finds itself in a unique and desperate situation. With the onset of COVID-19, the country was also hit with a resurgence of polio. Dual outbreaks are a cause of significant concern for Papua New Guinea. Australia is coming to the aid of its neighbors with a substantial financial assistance plan.

Resurgence of Polio

Papua New Guinea is one of the most poverty-stricken countries in the pacific region. The country was declared officially polio-free 18 years ago, but in 2018, the virus was rediscovered in a 6-year-old child. Shortly after, the virus also emerged in multiple other children from the same general area. Polio is especially harmful to children under 5 years old and can lead to lifelong paralysis.

A few months after the polio outbreak, the Australian Government stepped in and responded by giving $10 million to Papua New Guinea’s polio immunization crusade. A few weeks later, the Global Polio Eradication Initiative (GPEI) received another $6 million, which an additional $15 million dedication followed in November 2018. Rachel Mason Nunn, an experienced social development worker in Papua New Guinea, stated that “We have a window right now to invest heavily in infectious diseases in Papua New Guinea. Australia should continue to invest in health care in Papua New Guinea, if not just because it is the right thing to do, but because helping our region acquire strong health systems is a vital element of Australia’s own health security.” Australia is the largest contributor to the development of Papua New Guineas’ struggling health care system.

COVID-19 in Papua New Guinea

In an extreme case of bad luck, Papua New Guinea experienced two disease outbreaks within two years of each other. In a frantic request for aid, the government reached out to the World Health Organization (WHO) in an effort to take some weight off its already overburdened health care system.  When COVID-19 hit the county, there was a limited number of testing kits available and a shortage of medical staff as well as medical supplies and protective gear. The WHO responded by deploying emergency medical teams and supplying necessary resources to upscale testing in Papua New Guinea.

The Road Ahead

Due to the support of contributors like the WHO and Australia, millions of child polio vaccinations have been administered and a sufficient number of COVID-19 testing kits are available in the country. For a country that is still dealing with diseases like malaria and polio, the people of Papua New Guinea are pushing ahead. This unique situation serves as a global reminder that the prevention and treatment of other diseases should not be neglected during the COVID-19 pandemic and that inter-country support is essential in addressing dual outbreaks.

– Brandon Baham
Photo: Flickr

Healthcare in Italy
Many know Italy to have one of the best healthcare systems in the world, with the sixth-highest life expectancy, and a low rate of preventable and treatable deaths. Everyone benefits from high-quality care and the Italian government takes measures to ensure the most vulnerable populations receive care. Unfortunately, the COVID-19 pandemic hit Italy hard which overwhelmed the hospitals and will have lasting damage on the low-income population. Here is some information about how healthcare in Italy works for vulnerable populations.

Everyone Has Access

Healthcare in Italy is universal, meaning that while private insurance options are available, everyone qualifies for public healthcare coverage regardless of income. This covers hospital visits, preventative treatment, medications, pediatrics and all necessary medical procedures for free or a small copay. One drawback is long waiting times to receive services. Italy has greater disparities in healthcare quality between regions and income classes than the rest of the European Union, but even so, less than 6% of low-income residents have any trouble accessing services.

Mental Healthcare sets an Example for the World

  In 1978, Italy passed legislation expanding mental health services. The city of Trieste replaced its 1,200-bed mental health hospital with a network of person-centered care facilities, including:

  • Four Community Mental Health Centers housing four to eight residents each.
  • One General Hospital Psychiatric Unit with six beds for short-term emergency stays.
  • The Habilitation and Residential Service, a network of voluntary communal housing with 45 beds that works with NGOs and provides various levels of supervision and services to residents based on their needs.

Instead of just treating a mental illness, the mental healthcare system in Trieste works to integrate patients into the community so they can lead fulfilling lifestyles. Instead of police, trained psychiatrists respond to mental health emergencies. In 2017, a group of Los Angeles County officials traveled to Trieste to find that it had eliminated the need for involuntary psychiatric care, there was no mentally ill homeless population and jails were not overcrowded with those needing mental health treatment. By investing in person-centered care, Trieste was able to reduce social injustices and bring vulnerable groups back into the community.

Refugees Qualify for Healthcare

Immediately upon arrival, asylum seekers receive access to public healthcare in Italy. Some difficulties can occur in receiving care, such as language barriers or legal processes delaying healthcare qualification by several months.

Many asylum seekers are torture survivors or deal with other trauma and can be eligible for specific mental health treatments. Redattore Sociale is a Doctors Without Borders project in Rome that has dedicated itself to ensuring torture survivors from all around the world receive the comprehensive psychiatric care they need.

Pandemic Crisis

Italy had an early spike in COVID-19 cases which overwhelmed the healthcare system. Italy has the fifth-highest coronavirus deaths per capita worldwide.

The situation is especially bleak in nursing homes, where the World Health Organization (WHO) estimates that half of all Italy’s COVID-19 deaths have taken place. The country’s failure to properly test, distribute personal protective equipment, isolate residents and staff experiencing symptoms and openly report infection statistics have caused high death tallies and led to lawsuits against many nursing homes by relatives and other concerned parties.

The pandemic has also hit the economy hard, with low-income families suffering the most. Lack of support from the government has forced those who lost their source of income to turn to organizations such as the European Food Bank Federation, founded in 1967, which distributes 4.2 million meals every single day through a network of charities.

Although the economy may not fully recover, COVID-19 cases have been dropping steadily since late November 2020, and with doctors starting to administer vaccinations, there is hope for the future.

Though people usually consider healthcare in Italy to be high-quality in how it provides care for vulnerable groups, it was unprepared to deal with the pandemic, devastating the aging population and low-income families. Accountability for nursing homes and aid to impoverished citizens must be part of the plan going forward, as well as more efficient central planning to deal with future emergencies.

Elise Brehob
Photo: Flickr

Healthcare in MonacoWith nearly 40,000 people, Monaco is one of five European micro-states and is located on the northern coast of the Mediterranean Sea. According to the Organisation for Economic Co-operation and Development (OECD), Monaco has one of the best global healthcare schemes. The World Health Organization established that an individual born in 2003 can expect to have, on average, the longest lifespan in Europe. The country also has the third-highest proportion of doctors for its population in Europe.

Healthcare Education in Monaco

Leaders in Monaco believe that prevention and screening are essential to maintaining health and it is customary for young people to access comprehensive health education. This education aims to promote high-quality lifestyles and prevent early-risk behavior, such as tobacco use, drug addictions and sexually transmitted diseases.

Caisses Sociales de Monaco (CSM)

The Caisses Sociales de Monaco (CSM) is the official agency responsible for supervising Monaco’s public health service. Public healthcare automatically covers all citizens and long-term residents who contribute to the agency. French and Italian citizens may also access public health facilities in Monaco upon evidence of regular contributions to their home country’s state healthcare scheme. Foreign visitors can receive health treatment at all public hospitals and clinics. However, without state insurance contributions, travelers and expatriates will be forced to pay for all healthcare expenses accrued from treatment.

Public Healthcare Coverage

Public healthcare insurance operates through reimbursements, so an individual who plans on using coverage provided by the CSM will be required to make up-front payments and then claim costs back. After joining the public healthcare system, an individual receives a card that provides access to medical and dental care. The card contains administrative information necessary to refund medical care.

The public healthcare system provides coverage for inpatient and outpatient hospitalization, prescribed medications, treatment by specialists, pregnancy and childbirth and rehabilitation. Some prescription drugs are also reimbursed through the CSM and emergency care is available to everyone at Princess Grace Hospital, one of three public hospitals. The hospital will be reconstructed to strengthen the complementary nature of all the hospitals in Monoco.

Out-of-Pocket Healthcare Costs

Out-of-pocket healthcare costs in Monaco are high and if the CSM fails to provide sufficient coverage, an individual may supplement with private insurance. Private health insurance is a tool for individuals who want to cover medical services and fees not paid for by the public healthcare system. Doctors fund privately-paid equipment and staff through private contributions. According to an article from Hello Monaco, most Monaco citizens take out extra private insurance to cover ancillary services and unpaid rates.

A Commendable Healthcare System in Monaco

Every resident in Monaco is eligible for public health insurance but private health insurance remains an option for those interested in more coverage. Healthcare in Monaco earned outstanding reviews from the OECD and officials continue to seek improvements by reconstructing medical buildings and providing health education for young people.

– Rachel Durling
Photo: Flickr

Health Crisis in the Congo
The spread of a deadly disease is threatening The Democratic Republic of the Congo. This disease has led to a rise in unemployment, an uptake in crime, a decrease in the economic growth rate, as well as the illness and death of many Congolese people. Presently, the Congo is dealing with the aftermath of one of the most deadly outbreaks of Ebola yet, creating a certified health crisis in the Congo. Within the previous two years, records have determined that there have been over 3,000 Ebola cases and 2,000 resulting deaths. Additionally, the country’s deficit rating has been on a decline of over 2% in that time period.

Financial Troubles in the DRC

The Democratic Republic of the Congo also suffers from serious financial hardships. Over the years, things have improved somewhat for the region. The poverty rate has decreased slightly within the previous two decades. In addition, the overall economic growth rate had risen to 5.8% as of 2018. Despite these incremental increases, the Democratic Republic of the Congo ranks as one of the most impoverished countries, with its average citizens having to scrape by on as little as $1.90 per day.

Unfortunately, the positive economic factors occurred before the presence of this health crisis in the Congo. This caused the growth rate to drop back to 4.4% by 2019. The influx of disease within the region also stressed the economy, dropping it to the aforementioned deficit of 2%.

Violence in the DRC

Furthermore, the violence within the region has amplified the health crisis in the Congo. The Congo has a long history of violence with genocides occurring in both the 1800s and 1900s. Additionally, recent reports from the UN indicate that terrorist groups such as the Allied Democratic Forces (ADF) and an estimation of 100 other armed groups are in the region.

This not only makes it difficult for the delivery of medical supplies to combat this crisis, but it also dissuades the assistance of foreign aid, with many countries believing that their assistance will only entangle them in conflict. The presence of these groups has continued to expand in the area, and other terrorist affiliates, including ISIS, are taking notice. In 2019, Congolese President Felix Tshisekedi speculated that ISIS may grab a significant foothold to invade the Nord Kivu within the Congo.

The Alliance for International Medical Action (ALIMA)

The health crisis in the Congo forces responders to take action towards large-scale health care efforts. Not only has the Ministry of Health shown great awareness and urgency in addressing the needs of this crisis, but other non-governmental organizations have been making great strides to help as well.

The Alliance for International Medical Action (ALIMA), in cooperation with the World Health Organization (WHO) and partners, has created a treatment center in Beni to care for those speculated and confirmed to have Ebola. Preventative measures have received assistance through the provision of CUBE units and PPE by these organizations respectively. Additionally, WHO has provided over 1,600 individual responders to help combat the crisis.

Challenges

The battle against the health crisis in the Congo still holds many challenges. This is the latest outbreak of the disease in the Congo overall, with the first signs of it occurring as early as the 1970s. It was only during the last outbreak that the country utilized the Erevbo vaccine in the disease’s prevention. Over 300,000 people received the vaccine with a 100% efficacy rate, which represents a huge milestone along with other treatment and preventative measures.

Looking Forward

In November 2020, The Ministry of Health declared this crisis over. The DRC itself expects to increase its economic growth rate by 4.5%, thereby nullifying the 2.2% drop that it has seen. Yet, this supposed end is not as substantial as it may seem.

The disease still exists within animal DNA spread across the region, and infectious strains are able to remain in recovering victims for months following infection. The Ministry’s own announcement of the 10th outbreak’s end was quickly rescheduled in June 2020, due to the reemergence of this latest Ebola outbreak.

When asked about the possibility of a resurgence, WHO responded that “a robust and coordinated surveillance system must be maintained to rapidly, detect, isolate, test and provide care for suspected cases.” More alarmingly, the organization expressed that without this effort, the spread of Ebola could have easily eclipsed the borders of the DRC and become a global pandemic.

How quickly a resurgence could occur is unknown. However, it is clear that without a continued and international effort geared toward Ebola’s prevention that the possibility of a health crisis in the Congo could become an all too tragic and preventable reality.

– Jacob Hurwitz
Photo: Flickr

Sunlight-Powered Desalination ProcessAccording to the World Health Organization (WHO), 2.1 billion people around the world lack access to clean sources of drinking water. This figure is often quite surprising to many because it is difficult to comprehend how water can be so scarce when it is seemingly so bountiful. However, in truth, only 3% of Earth’s water is freshwater. Additionally, with current trends of rising temperatures and increasing worldwide consumption of freshwater, by 2025, two-thirds of the world’s population could face water scarcities. For this reason, researchers in Australia have developed a sunlight-powered desalination process to quickly convert tainted water into a safe, drinkable form.

The Process of Sunlight-Powered Desalination

In August 2020, a team of Chinese and Australian researchers based at Monash University in Australia announced via the science journal, Nature Sustainability, that they had developed a new sunlight-powered desalination process. The method uses their self-developed metal-organic framework (MOF), an extremely porous metal, called PSP-MIL-53. Once exposed to sufficient sunlight, this MOF is “activated” and absorbs particles like salt and bacteria from brackish water to create water that can be consumed by humans.

This sunlight-powered desalination process, according to the scientists participating in the study, produces water cleaner than WHO standards. WHO sets the standard for drinking water at having less than 600 parts per million (ppm) of dissolved solids. Meanwhile, this new method was able to reduce the number of dissolved solids from 2,233ppm to 500ppm of dissolved solids.

Clean Water in 30 Minutes

Along with creating water cleaner than WHO standards, the new sunlight-powered desalination process can desalinate brackish water in less than 30 minutes. This approach is more efficient than other methods of desalination with it generating nearly 37 gallons of potable water per day from only one kilogram of PSP-MIL-53.

Benefits for the Impoverished

By using sunlight for activation energy, the newly developed method does not require heat or electricity to jumpstart the active desalination. While other technologies that use processes like reverse osmosis require sophisticated energy infrastructure and dangerous chemicals to operate, the Australian-developed procedure does not. This will allow poor, rural areas in developing nations, places where water is increasingly becoming most scarce, to use this sunlight-powered desalination process to obtain drinkable water without needing to create a robust power grid nearby. Lack of chemicals and reliance solely on sunlight also makes this type of desalination energy-efficient and environmentally-friendly, minimalizing damage to surrounding ecosystems.

Further Potential for Developing Countries

With the potential to quickly and efficiently provide millions with safe, drinkable water, Monash University researchers are continuing to perfect the technology. According to lead scientists on the project, the sunlight-powered desalination process can be cheaply distributed to areas in dire need overcoming the cost barrier of desalination plants that have previously prevented developing countries from purchasing desalination technology. Professor Huanting Wang, one of the lead scientists, also stated that the byproducts of the desalination process, those being the minerals and other materials extracted from the water, could function as a secondary benefit of the technique by providing an environmentally-friendly source of raw materials that could help boost the economies of poor regions.

The Future of PSP-MIL-53

Much is still to be done by researchers at Monash University before PSP-MIL-53 is ready for widespread distribution. Despite this, it is clear that this new discovery provides hope for impoverished communities who face threats of drought or unclean water. The cost and energy requirements have always been an entry barrier to gaining access to potentially life-saving desalination plants. These scientists are gunning to change the world by providing the poor with access to clean, drinkable water.

– Aidan Sun
Photo: Flickr

Child Poverty in EritreaMilitarism and instability are endemic to Eritrea. The degradation of civil society is a result of those two factors. Child poverty in Eritrea is rampant due to such foundations; however, the country is not without benefactors. UNICEF’s aid efforts are improving children’s health within Eritrea despite the current conditions.

A Brief History

Eritrea is one of the few countries that can truly be considered a fledgling state in the 21st century. After a decades-long secession war, the Eritrean government achieved full independence from Ethiopia in 1993. They solidified the totalitarian one-party dictatorship that has retained power since. A brief period of peace followed, during which promised democratic elections never materialized. Then, Eritrea’s unresolved border disputes with Ethiopia escalated into a war that lasted from 1998 to 2000. It killed tens of thousands and resulted in several minor border changes and only formally ended in 2018. In the wake of this war, the Eritrean government has sustained a track record of militarization, corruption and human rights violations that has continually degraded civil stability. As of 2004, around 50% of Eritreans live below the poverty line.

Eritrea’s Youth at a Glance

Housing around 6 million people, Eritrea’s youth make up a significant proportion of its population. Eritrea has the 35th highest total fertility rate globally, with a mean of 3.73 children born per woman. It also has the 42nd lowest life expectancy at birth at a mere 66.2 years, with significant variation between that of males (63.6 years) and females (68.8 years).

Forced Conscriptions of Children

Under the guise of national security against Ethiopia, Eritrea has maintained a system of universal, compulsory conscription since 2003. This policy requires all high school students to complete their final year of high school at Sawa, the country’s primary military training center. Many are 16 or 17 years of age when their conscription begins, which led the U.N. Commission of Inquiry to accuse Eritrea of mobilizing child soldiers.

The Human Rights Watch’s (HRW) report also blamed Eritrea’s conscription practices for a number of grievances. Its prolonged militarization has wide-reaching effects for the country. Many adults are held in service against their will for up to a decade, but it is particularly damaging to Eritrean youth. Students at Sawa face food shortages, forced labor and harsh punishment. Many female students have reportedly suffered sexual abuse. Besides fleeing, “Many girls and young women opt for early marriage and motherhood as a means of evading Sawa and conscription.”

Further, “The system of conscription has driven thousands of young Eritreans each year into exile,” HRW claims. They estimate that around 507,300 Eritreans live elsewhere. Because of its conscription practices, Eritrea is both a top producer of refugees and unaccompanied refugee children in Europe – they not only result in child poverty in Eritrea, but in other regions as well.

Education Access

HRW claims that Eritrea’s education system plays a central role in its high levels of militarization. It leads many students to drop out, intentionally fail classes or flee the country. This has severely undermined education access and inflated child poverty in Eritrea.

Eritrea currently has the lowest school life expectancy – “the total number of years of schooling (primary to tertiary) that a child can expect to receive” – of any country. Eritrea has reportedly made strides to raise enrollment over the last 20 years. However, 27.2% of school-aged children still do not receive schooling, and the country retains a literacy rate of only 76.6%. Illiteracy is much more prevalent among females than among males, with respective literacy rates of 68.9% and 84.4%. In general, girls and children in nomadic populations are the least likely to receive schooling.

Refugees and Asylum-Seekers

As mentioned earlier, over half a million Eritreans have fled the country as refugees. Around one-third of them – about 170,000, according to the WHO – now live in Ethiopia. A majority reside in six different refugee camps. As of 2019, around 6,000 more cross the border each month. Reporting by the UNHCR shows that “children account for 44% of the total refugee population residing in the [Eritrean] Camps, of whom 27% arrive unaccompanied or separated from their families.” Far from being ameliorated by domestic education programs, child poverty in Eritrea is merely being outsourced to its neighbors.

Children’s Health as a Site for Progress

Adjacent to these issues, UNICEF’s programs have driven significant improvements in sanitation, malnutrition and medical access. Its Health and Nutrition programs, among other things, address malnutrition by administering supplements, prevent maternal transmission of HIV/AIDS during birth and administer vaccines. Teams in other departments improve sanitation and lobby against practices like child marriage and female genital mutilation.

In its 2015 Humanitarian Action for Children report on Eritrea, UNICEF wrote that Eritrea “has made spectacular progress on half the [Millennium Development Goals],” including “Goal 4 (child mortality), Goal 5 (maternal mortality), Goal 6 (HIV/AIDs, malaria and other diseases) and is on track to meet the target for access to safe drinking water (Goal 7).”

Figures illustrate this progress on child poverty in Eritrea. Since 1991, child immunization rates have jumped from 14% to 98%, safe water access rates are up at 60% from 7%, iodine deficiency has plummeted from 80% to 20% in children and the under-five mortality rate sits at 63 deaths per 1000 births, rather than at 148.

Child poverty in Eritrea is a far cry from being solved, but it is not a lost cause.

Skye Jacobs
Photo: Flickr

ColaLife in ZambiaColaLife is an independent non-governmental organization, co-founded in 2008 as an online movement and transformed into a United Kingdom-based charity in 2011. The organization started with the realization that even in developing countries, Coca-Cola is accessible but lifesaving medicines are not. Despite scientific advances and discoveries, in 2017, almost 1.6 million people died from diarrheal diseases globally. ColaLife has made efforts to improve access to diarrheal treatments in the most remote areas of the world. ColaLife has operated with the help of more than 10,000 supporters and donors that allow for an effective response to the second leading cause of death in children worldwide. ColaLife in Zambia marked the beginning of these efforts.

ColaLife in Zambia

ColaLife in Zambia marked the beginning of an impressive effort to save the lives of children with diarrhea. The solution had to be immediate since the high numbers of diarrheal deaths in the region revealed that global efforts were insufficient and ineffective.  A whole three decades ago, Oral Rehydration Salts (ORS) and zinc were known as an effective combination treatment for patients with diarrhea. However, 99% of children do not receive these treatments.

ColaLife Operational Trial Zambia (COTZ):  Kit Yamoyo

COTZ was created as a custom project for Zambia under the recommendations of the WHO and UNICEF. The project aimed to distribute diarrhea treatment kits, called Kit Yamoyos, that contain Oral Rehydration Salts and zinc and promote the importance of handwashing by adding soap. The project implemented the founding logic of the organization and analyzed Coca-Cola’s distribution model to distribute the treatments in the most rural and remote areas of the country, specifically to mothers and children under 5 years of age.

ColaLife in Zambia, with the consent of Coca-Cola and its bottling company, SABMiller, coined the “AidPod” package, designed to fit into the unused portion of the crated bottles. This innovation proved that the supply chain could play a fundamental role in the accessibility of these treatments.

Currently, the initiative no longer needs the innovative hand of ColaLife. Kit Yamoyos are being produced and sold by local companies, reaching 1.2 million sales by the end of 2019. This number represents one million people whose lives have been saved. The Zambian Government is the largest customer for the kit and has contributed significantly to this cause. These kits are now easily found in supermarkets and are also sold by informal street vendors.

Extended Scope

The WHO has included in its Essential Medicines List (EML) the combination of ORS and zinc as a treatment for diarrhea. This milestone shows commitment, but above all, the success that the organization has had. The success of COTZ has shown that the solution pursued by ColaLife in Zambia has had a substantial impact. The organization would like to replicate the self-sustained impact that was made in Zambia in other parts of the world. ColaLife wants to continue promoting the treatment to save the lives of millions of children globally. Access to these kits could be the global solution to preventable deaths caused by diarrhea.

– Isabella León Graticola
Photo: Flickr