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PianoterraIn Italian, “pianoterra” translates to “ground floor.” Pianoterra is also an organization based in Italy that is working to keep refugee mothers and children safe.

The Mission of Pianoterra

Pianoterra was founded by Alessia Bulgari, Flaminia Trapani and Ciro Nesci. According to the group’s website, “[the founders’] stories are intertwined by personal ties: Alessia and Flaminia are cousins, Flaminia and Ciro are husband and wife.”

The organization was founded in 2008 with the main goal of helping immigrant women get the necessary things to be able to prosper in Italy. When the organization began, 58 percent of the women seeking help from the organization was Italian while the other 50 percent was foreign. Today, 98 percent are foreign women.

Pianoterra’s Past Initiatives

Pianoterra has led several initiatives to improve the lives of refugee women and children. Two of these important projects include “Right to Feed – Support of Breastfeeding” and “From Mom to Mom.”

The project “Right to Feed – Support of Breastfeeding” began in January 2009. The project was aimed at mothers who were unable to breastfeed and did not have a sufficient amount of money to be able to feed their children. Pianoterra worked to “distribute free formula milk, according to pediatric prescriptions, and other basic necessities.”

With the “From Mom to Mom” initiative, Pianoterra helped mothers by collecting and distributing second-hand items for children. By collecting second-hand articles and connecting the women who donate with the women in need, mothers are “directly linked to a solidarity network of other women and mothers willing to support,” according to the organization’s website.

The Immigration Situation in Italy

Currently, immigration to Italy is occurring in large numbers. In 2018 alone, approximately 33,000 refugees have fled to Italy. However, the nation’s new interior minister has stated that “the country will no longer be ‘Europe’s refugee camp,’” according to TeleSur.

With the new government leaders in Italy, many refugees cannot count on staying in Italy. TeleSur reports that Italy’s “right-wing League stated that the vast majority of migrants in Italy have no right to refugee status, Italy cannot help them and by accepting low pay they worsen the working conditions of Italians.”

Although the Italian government is changing, there are still organizations working to help women and refugees prosper in the country. Pianoterra will continue to assist mothers in caring for their children and bettering their futures.

– Valeria Flores
Photo: Flickr

Maternal Mortality in India
USAID and its partner organizations implemented the development impact Utkrisht bond in February 2018. Many believe this is an innovative and cost-effective solution to end preventable maternal and child deaths in India.

The Utkrisht bond is targeted to assist the State of Rajasthan, where 80,000 babies die annually from inadequate medical care. But proponents hope the model can be used throughout India, which accounts for 20 percent of maternal and child deaths globally.

The development impact bond was announced in November of 2017 by USAID Administrator Mark Green at the Global Entrepreneurship Summit in India. It is expected to provide 600,000 women with improved healthcare access and potentially save 10,000 moms and newborns.

The bond works as a public-private partnership. Investors grant providers of maternal care with upfront capital. Then, outcome funders pay back the investors their principal plus a return if pre-agreed metrics are achieved. The investor, in this case, is the UBS Optimus Foundation, which has committed about $3 million. The organization works with philanthropists to bring sustainable benefits to vulnerable children.

Up to 440 private health facilities will then be operated with assistance from Population Services International (PSI) and the Hindustan Latex Family Planning Promotion Trust (HLFPPT), which also are co-investors providing 20 percent of the required capital. PSI is a global health nonprofit and the HLFPPT is an Indian nonprofit that works with maternal care.

In order to maximize success, private facilities are the focus of the Utkrisht bond. They host more than 25 percent of institutional deliveries in Rajasthan and are used by women of all socioeconomic backgrounds, yet little has been done to improve their quality of care.

USAID and Merck for Mothers, a nonprofit with the goal to end maternal mortality, have each committed up to $4.5 million that will be paid if the heath facilities meet accreditation standards. This is a highly cost-effective method to save lives according to World Health Organization standards, which is particularly exciting to USAID.

“The pay for success approach ensures appropriate stewardship of U.S. taxpayer dollars, while unlocking both private capital and government resources for health,” USAID states.

While this is the first development impact bond targeted toward health, the future of the Utkrisht bond looks promising. If it is successful, more initiatives can be implemented that involve private-public cooperation and effective use of taxpayer money to save the lives of many women and children around the world.

– Sean Newhouse

Photo: Flickr

most effective drug for preventing maternal death
Each year, more than 300,000 women die in childbirth. The top three causes of global maternal deaths are severe bleeding, infections and high blood pressure at the time of birth. Often, pregnant women in developing countries are faced with an impossible decision: seek affordable care from untrained/unlicensed midwives or enter hospitals without being able to pay for modern treatment. It is extremely unlikely that women in this situation will receive the most effective drug for preventing maternal death.

Deaths from infections can easily be prevented through good hygiene practices by the patient and the medical staff attending to her. As for high blood pressure, the most fundamental precautionary measure is to educate the public on adolescent pregnancies, as this is often associated with maternal mortality from high blood pressure. Severe bleeding in childbirth can kill a healthy woman within several hours if proper attention and care are not given to her by her caretakers.

Often there are complications, such as bleeding, that require costly surgical operations or blood transfusions. If the mother is unable to afford the operation, she may not survive the excessive bleeding. In Sierra Leone, many people know at least one woman who has either died in childbirth or lost a fetus due to complications. Maternal care is the comprehensive indicator of the overall development of a country; the healthcare system for maternal health reflects the level of education, infrastructure and transparency of a nation.

Well educated nations with high literacy rates can still experience a shortage of qualified medical workers. Why? They are not properly paid or paid at all. The few qualified or highly educated emigrate for better opportunities and salaries. This resulting brain drain further exacerbates the crisis of maternal mortality. Prior to childbirth, there is also a delay in pregnant women seeking proper treatment. This delay can be attributed to a lack of confidence in the competence of the local healthcare facilities.

Thanks to U.N. funding, clinics in every nation are sponsored to employ local medical staff, which not only provides them with a salary, but with training as well. In addition to improved services, many patients benefit the from donation and careful administration of drugs. Among the most notable is tranexamic acid. Also known as TXA, this drug helps to control bleeding for trauma patients. It helps to stabilize a clot at the site of bleeding by preventing it from dissolving during formation. It has proven to be the most effective drug for preventing maternal death.

TXA works by preventing the conversion of plasminogen to plasmin; this promotes the accumulation of fibrin to form a complex known as the fibrin degradation products. It should be noted that TXA is not an alternative for blood transfusion; it is merely an important addition to this treatment. In addition to trauma patients, TXA has also proven effective in treating combat casualties. It has also been proven to be safe for patients.

In April 2017, the WHO launched a clinical trial dubbed the World Maternal Antifibrinolytic Trial. It consisted of 20,000 women from 21 countries who were diagnosed with postpartum hemorrhage (PPH). It was a randomized, double-blind trial with placebos for some of the participants. The organization wanted to see if bleeding persisted 30 minutes after the first dosage, and if it restarted within 24 hours. If bleeding did persist, it determined if a second dose was necessary.

What they found was that TXA reduced deaths in the trial, and it was evident that early treatment maximized the benefit. It was the most effective drug for preventing maternal death. In their words, “safe, effective and affordable PPH treatments are critical to saving the lives of pregnant women globally, and the findings of this trial have important implications for the delivery of high-quality maternity care.”

– Awad Bin-Jawed

Photo: Flickr

Pediatric AIDSHIV/AIDS is embedded in social and economic inequity and there exists a critical connection between the disease and poverty. There is strong evidence that the disease affects individuals of lower socioeconomic status and impoverished nations at a disproportionately high rate. This is also true when examining the occurrence of mother-to-child transmission, which accounts for more than 90 percent of HIV infections in children.

S. Res. 310, according to U.S. Congress, is a “resolution that recognizes the importance of a continued commitment to end pediatric AIDS worldwide.” This is of extreme importance because, not only do children suffer the most from HIV/AIDS because of their developing immune systems, but they also are the key to eradicating the disease and breaking the cycle of infection. Without diagnosis and treatment, one-third of infected infants will die before the age of one, one-half will die before their second birthday and 80 percent will die before their fifth birthday.

As a leading cause of death among adolescents, AIDS is devastating the lives and hopes of millions of children worldwide. Pediatric HIV-related deaths have more than tripled since 2000, requiring immediate attention and resolution.

S. Res. 310 recognizes that women and children are in desperate need of HIV-related services. Data from 2016 shows that half of the 36,700,000 people worldwide who suffer from HIV are women and 2,100,000 are children. Despite the increased efforts by the U.S. and countries around the world, over 400 children were born HIV-positive every day in 2016. This legislation highlights that continued commitment is required in order to eradicate pediatric AIDS.

The resolution allows the U.S. to provide women and children with HIV counseling and testing services and to improve access to services and medicines that prevent mother-to-child transmission of HIV. The legislation also supports expanding treatment for pediatric and adolescent HIV, including greater access to more efficacious antiretroviral drug regimens, age-appropriate services and support for the caregivers of children and adolescents.

In the words of the resolution, “every mother should have the opportunity to fight for the life of her child; and every child and adolescent should have access to medicine to lead a long and healthy life.”

Jamie Enright

Photo: Flickr

Solutions to Contamination
The Maya Relief Foundation, a California-based charity, is providing thousands of Guatemalans with stoves and water filters, efficient and sustainable solutions to contamination, to over 100 communities in the region. While 95 percent of Guatemala’s water sources are contaminated, nearly 40 percent of their daily wood supply is used to boil water for drinking.

Nearly half of the world’s population uses fire to cook. The smoke from cooking kills nearly 2 million people each year. It is the fifth largest cause of death worldwide, and most of the victims are women and children, according to the Global Alliance for Clean Cookstoves.

In Latin America, 166 million people cook over an open fire. An estimated 28,000 people died from smoke in 2012, nearly half were children under 5 years-old. In Asia, 2 billion people cook over an open fire. The smoke kills roughly 1.2 million each year, and 239,000 are children under 5 years-old. In sub-Saharan Africa, 609 million people cook over an open fire. The smoke killed 574,000 Africans in 2012.

Health hazards include acute respiratory infections, insufficient weight at birth and chronic obstructive pulmonary disease. Without significant policy changes, or efficient and sustainable solutions to contamination, the reliance on solid fuels will remain roughly the same by 2030, according to the World Health Organization.

Dona Irma Xo uses an open fire stove top to cook for her four children. The smoke contaminates the whole house, causing most of their sicknesses. It is painful for them to inhale — their eyes get watery, irritated and red. The Eko-stove only requires 50-60 pounds of wood per month, in contrast to the 200 pounds they needed prior.

In the dry season, Guatemalans walk long distances to get their water supply every day. At the local well, they pull up a rope with enough buckets of water for the day, hoping there will be water left for tomorrow.

The well’s water supply comes from small springs, according to local Guatemalan Maria Quej Pop. Sometimes dust, leaves and animals are found in the water. After drinking the well water, her children experience stomach pains and diarrhea. Now she uses the cofilter for cooking and drinking, which provides 10 gallons of filtered water each day.

It’s a simple, low-cost design made with local materials. The clay and sawdust are locally sourced, mixed with water and left to dry for roughly two weeks prior to a kiln firing. The Maya Foundation’s studies of over 100 families shows a 55 percent decrease in gastrointestinal problems, especially among children.

The ceramic filtration system is being used in over 30 countries across Asia, Africa and Latin America. Families can even cook 24 tortillas, or utilize multiple pots at once with the latest Eko-stove. These sufficient and sustainable solutions to contamination conserve time, wood and water with each system provided by The Maya Relief Foundation.

Rachel Williams

Photo: Flickr

Healthcare in Bihar
Bihar is one of the poorest states in India as approximately 55 percent of the population lives below the poverty line. There is an overwhelming need for quality health care facilities and workers in this region. In the past ten years, the World Bank Group and the Bill and Melinda Gates Foundation have made great strides toward the improvement of healthcare in Bihar.

The World Bank’s collaboration with the Bihar Government led to an increase in the accountability and accessibility of healthcare from 2005 to 2008. By 2008, the number of outpatients visiting a government hospital grew from 39 per month to almost 4,500. The number of babies delivered in healthcare facilities also increased from some 100,000 to 780,000.

Bihar’s infant and maternal mortality rates are higher than India’s national average. According to the Sample Registration Survey in India conducted in 2013, 208 women per 100,000 died during childbirth. Furthermore, 28 out of every 1,000 newborns die within their first month of life.

Most of these deaths are preventable if basic care is provided to women and newborns during and immediately following childbirth. Unfortunately, the infrastructure of healthcare in Bihar falls short in nearly all required categories, including the number of health assistants and nurses.

According to the Huffington Post, there are not enough nurses in Bihar to allow for lengthy off-site training to prepare nurses for treatment of postpartum hemorrhage or premature births while also keeping health facilities adequately staffed.

In order to improve maternal health and newborn care, the Bill and Melinda Gates Foundation along with the Bihar Government launched a Mobile Nurse Mentoring Program called AMANAT.

Through AMANAT, nurses in public health facilities are mentored on-site by mobile nurse mentors, who ensure that basic standards of care are provided for pregnant women and newborns.

The program has greatly improved healthcare in Bihar for women and children before and after deliveries since its implementation in 2012. A few of these improvements include:

  • The administration of the correct use of oxytocin to induce labor has increased from 9 percent to 59 percent.
  • The use of sterile instruments by nurses during deliveries has increased from 13 percent to 43 percent.
  • The implementation of mothers breastfeeding has increased from 49 percent to 72 percent.

The number of stillbirths declined from 19 to 12 per 1,000 live births due to improvements in basic care practices. AMANAT was implemented in 160 public health facilities across Bihar and is expected to be administered in 240 over the course of this year.

There is a long way to go in creating a stable system of healthcare in Bihar. However, these crucial improvements made by the World Bank, the Bill and Melinda Gates Foundation and Bihar’s Government have saved and will continue to save countless maternal and newborn lives.

Kristyn Rohrer

Photo: World Bank

Causes of Human Trafficking
Likened to modern slavery, human trafficking is driven mostly by similar motivations to those of slavery. The Department of Homeland Security defines human trafficking as the “illegal trade of humans for exploitation or commercial gain.” Exploitation frequently involves forcing victims into prostitution or slavery. Human trafficking can be separated into sex trafficking and labor trafficking. Though they have different purposes, there are general trends that explain the overall root causes of human trafficking.

According to a 2012 International Labour Organization (ILO) report, 21 million people are victims of forced labor. The Asia-Pacific region accounts for the largest number of forced laborers in the world with 11.7 million victims (56 percent of the global total), followed by Africa with 3.7 million (18 percent) and Latin America with 1.8 million victims (nine percent).

According to the Huffington Post, approximately 75 to 80 percent of human trafficking and slavery is for sex. The rest are forced into labor exploitation, such as agriculture and construction work. In 2015, 5,544 cases of human trafficking were reported, as stated in a study by the National Human Trafficking Resource Center.

 

Top 5 Causes of Human Trafficking

 

  1. Poverty, war, natural disasters and a search for a better life.
    Traffickers look for people who are susceptible to coercion into the human trafficking industry. Those people tend to be migrants, fleeing their homes either because of economic hardship, natural disasters, conflict or political instability. The displacement of populations increases individuals’ emotional vulnerability, and frequently they do not have the financial support to protect themselves. This makes them subject to abuse through trafficking.
  2. Women and children are targets.
    In some societies, the devaluation of women and children make them far more vulnerable to trafficking than men. Traditional attitudes and practices, early marriage and lack of birth registration further increase the susceptibility of women and children. They are also targeted because of the demand for women in sex trafficking. A report by Equality Now states that 20.9 million adults and children are bought and sold worldwide into commercial sexual servitude, forced labor and bonded labor. Women and girls make up 98 percent of the victims trafficked for sexual exploitation.
  3. Demand for cheap labor.
    The service industry, particularly restaurants and kitchens, are common exploiters of human trafficking. There is also a demand for cheap domestic and agricultural labor. Employees are often initially promised a safe work space and a steady salary, only to later find that they are paid less than minimum wage and worked over time. Business owners guilty of this behavior continue to practice these illegal norms because the victims of trafficking can rarely protect themselves and they have very few alternatives.
  4. Human trafficking generates a huge profit.
    According to the ILO, the human trafficking industry generates a profit of $150 billion per year. Two-thirds is made from commercial sexual exploitation, while the remainder comes from forced economic exploitation such as domestic work and agriculture. Human trafficking is the fastest-growing and second-largest criminal industry in the world, after drug trafficking.
  5. Cases of human trafficking are difficult to identify.
    Some challenges in identifying victims of human trafficking arise because victims are well-hidden or highly traumatized. Those that are traumatized are unlikely to divulge information to investigators, either because they are scared to confront law enforcement, or because they are too troubled to respond. Consumers of human trafficking also contribute to the crime’s hidden nature, according to a report by the Urban Institute. Both traffickers and consumers are aware of the huge risk they take by participating in this illegal behavior and will do their best to cover up any illicit activity.

Initiatives to diminish these causes of human trafficking include international cooperation agreements, national policies against trafficking, improved immigration policies that can detect the exit or entry of humans being illegally trafficked, and increased infrastructure to protect those that are being exploited for labor or sex.

Michelle Simon

 

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Sources: The Atlantic, US State Department, Urban Institute, International Labour Organization, Restaurant Opportunities Centers United, UNICEF, National Human Trafficking Resource Center, Huffington Post, The Department of Homeland Security, Equality Now
Photo: Flickr

Maternal_and_Child_HealthDuring the 2015 Call To Action Summit, health ministers and global experts take a look at the progress that has been made. USAID has helped save the lives of an estimated 2.5 million children and nearly 200,000 mothers since 2008.

It has been a little over a year, in June 2014, since USAID introduced its newest strategic plan for maternal and child health. They hope to prevent the deaths of 15 million children and 600,000 mothers by 2020.

At the summit the participants reviewed the impact the USAID’s support has had all around the world; often putting a name and a face to those benefitting from the aid provided.

In India, mothers like Satyawati now know how to best take care of their newborns and other children thanks to the ability to obtain health-related knowledge and help from a local health worker.

Because Satyawati has access to this information, she has had her children properly vaccinated and employs proper hygiene practices in her home. In 1990 in India, children under the age of five had a mortality rate of 126 per 1,000 live births but in 2013 that number has been reduced to 53 per 1,000 live births.

Also, thanks to the support of the USAID, 27 hospitals in Malawi now have a device called a Pumani bCPAP that helps newborns with underdeveloped lungs breathe until they can do so own their own.

This device has tripled the survival rate of babies like Gloria Mtawila’s son Joshua, who stayed on the machine for a month until he could breathe on his own and is now a completely healthy baby.

All across the world bundles of joy are being born to tired but radiant mothers. Hospital staff assures that both have the best possible care in these first crucial hours, days and sometimes weeks after childbirth.

But also all across the world there are mothers on makeshift cots or laying on dirt floors. They and their babies do not have dedicated hospital staff looking after them.

Mom did not have access to prenatal vitamins and baby may not have access to life-saving vaccines. With poor living conditions, poor pre and post-birth care, and a poor quality of life all around, mom and her little one may not make it.

This is what USAID is working to prevent. USAID’s maternal and child health programs focus on cost-effective initiatives such as enabling access to nutritional supplements and vaccines.

The USAID has achieved great success. Maternal death rates have decreased by five percent in each of its 24 target countries while child mortality rates went down by four percent.

But this is still not enough. The USAID hopes to receive $850 million in funding for the maternal and child health program in order “to reduce child mortality to 20 or fewer deaths per 1,000 live births in every country by 2035, and to end preventable maternal deaths” (interaction.org).

Through this initiative, the USAID has inspired developing countries to develop strategies to reach these goals, and make the eradication of unnecessary maternal and child deaths possible.

Drusilla Gibbs

Sources: USIAD, Interaction, Call to Action
Photo: Google Images

public_breastfeeding_areas_in_india
Health experts and activists are calling for the government in the Indian state of Assam to create public breastfeeding areas in India.

Assam, a state in northeast India, has a bad record when it comes to maternal and infant mortality rates.

With Aug. 1-7 being World Breastfeeding Week, the spotlight has shifted to Assam, where there are no public facilities available for women to breastfeed. As a result, mothers who are lactating often have a difficult time comfortably attending to their infants.

The difficulty is greater for mothers in rural areas, where malnutrition rates in infants are higher. Additionally, mothers who are working do not have the ability to meet their babies’ needs in a timely matter.

To avoid malnutrition, the need for public breastfeeding areas in India, specifically Assam, is high. Creating designated areas, such as in buses and railway stations, would help avoid malnutrition.

Those engaged in World Breastfeeding Week are also asking for uniformity when it comes to maternity leave. Organizations such as the Association of Promotion of Child Nutrition (APCN) and Breastfeeding Promotion Network of India (BPNI) are calling on the state government to implement consistent leave in both the public and private sectors for working mothers.

Currently, women working in the public sector are granted a leave of six months, but most are unaware they can take a leave to care for their babies, as the parameter is not implemented uniformly in the sector.

While women are granted a leave of between three and four and a half months in the private sector, most workplaces in the public and private sectors lack the proper facilities to allow women to breastfeed, leading to problems for mothers.

Matt Wotus

Sources: Encyclopedia Britannica, The Times of India, World Breastfeeding Week
Photo: Healthy Newborn Network

wood_stoves
Each day, 3 billion people cook meals over a fire, producing air pollution that results in 4.3 million deaths a year. To reduce this number, wood stoves can be used as an alternative to open fires. Providing a safe wood-burning cook stove would be a three-fold win for the millions of people in the developing world because:

1. It would directly improve their health by reducing smoke inhalation.
2. It would aid the environment by reducing the amount of wood needed for fuel.
3. It would reduce poverty by minimizing the amount of time spent gathering wood and cooking food each day.

Potential Energy is a nonprofit dedicated to making and adapting life-changing technologies to be used in the developing world. With this goal in mind, they created the Berkeley-Darfur Stoves to improve the lives of women and their families.

Potential Energy first designed the stove in the Lawrence Berkeley National Laboratory. The stoves are low-cost and high-efficiency. They reduce the amount of fuel used by 50 percent, saving the women and families time and money. In addition, they asked for input from Darfuri women to maximize usage.

Some of the modifications that arose from the Darfuri women’s suggestions were a tapered wind color to maintain efficiency in the windy Darfur environment. The stove itself has feet for stability and stakes in case additional stability is needed. Most importantly, there is a small firebox, which prevents the user from putting in more wood than is absolutely necessary.

Once the designing and production processes were set in place, Potential Energy opened up local workshops where they now produce about 100 stoves per day, creating jobs and local business. There are two facets to the business, sales and distribution, and both of these bring a steady income to the employees, all of who are from the area.

Potential Energy teams up with local community and women’s organizations to distribute the stoves to those most in need. As of 2014, 42,000 stoves have been distributed to areas in Sudan and Ethiopia.

Hannah Resnick

Sources: Cookstoves, Potential Energy, Smithsonian
Photo: Potential Energy