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Reducing Child Mortality in Nepal with Chlorhexidine

Child mortality in Nepal
According to a 2018 USAID article, annually, 2.6 million infants “die within their first month of life.” In addition, about 15% of these deaths come about through complications stemming from “severe infections.” Many of these infections-induced deaths are easily preventable through one simple solution: chlorhexidine. In Nepal, the government of Nepal and USAID piloted a chlorhexidine initiative in 2009. In 2011, Nepal introduced the antiseptic into “routine care nationwide.” The introduction of the antiseptic has safeguarded the lives of more than 1.3 million newborns in Nepal, decreasing levels of child mortality in Nepal. Nigeria, Bangladesh, Pakistan and the Democratic Republic of Congo have also introduced the solution to reduce child mortality rates.

Facts About Child Mortality

  • Under 5 Mortality. Child mortality, which people also know as the under-five mortality rate, is the likelihood of a child dying before reaching 5 years of age and is usually calculated per 1,000 live births.
  • Child Mortality in Numbers. According to the World Health Organization (WHO), around 5 million children under the age of 5 died in 2020. Newborns accounted for around half of those deaths — about 2.4 million neonatal deaths. Compared to data from 1990, the global child mortality rate has decreased by about 60%. UNICEF estimates that compared to 93 deaths per 1,000 live births in 1990, in 2020, the world noted 37 deaths per 1,000 live births.
  • Highest Burdens. Child mortality is most severe in the regions of sub-Saharan Africa and Southern Asia, where more than 80% of the 5 million deaths of children occurred in 2020.
  • Leading Causes. According to WHO, the leading causes of child mortality are infectious diseases such as pneumonia, diarrhea and malaria as well as complications arising from premature birth. The majority of infections are avoidable with simple and affordable health and sanitation solutions.

Child Mortality in Nepal

Nepal stands out in particular within the region of South Asia when it comes to child mortality rates. According to World Bank data, in 1960, Nepal recorded 325 under-5 deaths per 1,000 live births, whereas, in 2020, this number significantly reduced to 28 deaths per 1,000 live births. This is a significant improvement, especially in comparison to other countries. For instance, Pakistan reports 65 deaths per 1,000 live births and Afghanistan reports 58 deaths per 1,000 live births as of 2020.

The reasons for child mortality rates continuing to persist in Nepal are multifold. Lack of preventative measures against infectious diseases like malaria and pneumonia plays a major role in many babies not surviving. Many times, complications at birth occur, which are easily preventable with adequate medical care. Lastly, unhygienic medical conditions result in infections that claim the lives of babies. The adoption of simple and cost-effective solutions, one of which is chlorhexidine, can easily prevent unhygienic conditions and infections.

How Chlorhexidine Helps

Chlorhexidine, an antiseptic that hospitals widely use to disinfect skin and sterilize surgical equipment, comes in both liquid and gel form and is generally affordable. A study in Nepal showed that the use of chlorhexidine significantly reduced the risk of infection by 68% and minimized child deaths by 23%, USAID reported. The study led to the start of the 2009 USAID-led chlorhexidine program, supported by the Government of Nepal. Following the successful results visible in the program, chlorhexidine became a part of the entire nation’s medical care in 2011. In regions where people prefer home birth and use risky methods of birthing, chlorhexidine has helped save the lives of numerous children.

The application of this solution has decreased child mortality in Nepal and could impact the entire region’s child mortality rate. Chlorhexidine could also benefit regions like sub-Saharan Africa where infant deaths remain a concern.

– Umaima Munir
Photo: Flickr

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COVID-19 Vaccine Equity


As the COVID-19 pandemic continues to surge, global calls for achieving COVID-19 vaccine equity are increasing. Vaccine equity is a simple concept: it is the belief that all people should have equal access to vaccines. Inequitable access to COVID-19 vaccines leaves developing nations helpless against the virus. Moreover, inequitable access has allowed new deadlier variants of the virus to emerge and spread globally.

According to the World Bank Group, as of November 15, 2021, 72.8% of the population in high-income countries received a COVID-19 vaccine. This is a harsh difference from the mere 4.2% of the population in low-income countries. Luckily, several global organizations have initiated various efforts to help make COVID-19 vaccine equity a reality.

The World Health Organization (WHO)

The World Health Organization (WHO) is a leader in global health initiatives. Its COVID-19 vaccine equity campaign is a roadmap to achieve vaccine equity. This roadmap sets the goal to administer a COVID-19 vaccine to at least 40% of the residents in every country by the end of 2021. It sets a second goal to vaccinate 70% of the global population by mid-2022. WHO is calling for countries and companies that control vaccine supplies to donate and contract with COVAX and The African Vaccine Acquisition Trust (AVAT) to get the vaccines where they are most needed.

WHO also believes that individual efforts matter. It launched its GoGiveOne fundraising initiative to allow individual efforts to directly aid the vaccine equity campaign through crowdfunding. A donation of $6 amounts to one vaccine.

Global Dashboard for Vaccine Equity

The Global Dashboard for Vaccine Equity is a collaborative effort that the World Health Organization, the United Nations Development Programme (UNDP) and the University of Oxford launched with support across the U.N. It is a part of the SDG 3 Global Action Plan for Healthy Lives and Well-being for All.

This initiative works towards global COVID-19 vaccine equity by sharing the latest data on the COVID-19 vaccine rollout. It also provides socioeconomic data to demonstrate why the acceleration of global vaccination is critical. The Dashboard shows how a faster rollout not only saves more lives but also supports a speedier pandemic recovery. Moreover, it presents and highlights important vaccine equity policies and uses these to help guide legislative change. Finally, the Dashboard aids in educating the public about COVID-19 vaccine equity through free resources and statistics.

Only organizations can directly participate in the Dashboard. Nevertheless, individuals have a significant part to play. Raising awareness and increasing knowledge about COVID-19 vaccine equity is the Dashboard’s primary goal.

African Vaccine Acquisition Trust

The African Vaccine Acquisition Trust (AVAT) is a global effort that strives for equitable access to COVID-19 vaccines across the African continent. To combat the looming vaccine inequality, in August 2020, a group of 10 people from throughout Africa gathered and became the African Vaccine Acquisition Task Team. This team went on to found the African Vaccine Acquisition Trust and gain the endorsement of the African Union. Moreover, AVAT became an integral part of the Africa Vaccine Strategy. AVAT’s primary goal is ensuring the vaccination of at least 60% of the African population against COVID-19. Individuals can help through advocating for increased COVID-19 vaccine donations from their governments and through educating themselves about COVID-19 vaccine equity in Africa.

Realizing COVID-19 Vaccine Equity

As the COVID-19 pandemic continues to affect the world, vaccine equity should remain at the forefront of global efforts. Many developed countries are increasingly pledging to donate COVID-19 vaccines due to pressure from the global initiatives mentioned above. Therefore, it remains important for individuals to support the global COVID-19 vaccine equity initiatives to help make vaccine equity a reality.

– Nohad Awada
Photo: Unsplash

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Everything to Know About Hunger in Angola

Hunger in AngolaThe catalyzation of food insecurity is causing around 6 million people to fall into hunger in Angola, according to UNICEF. The number of people going hungry in Angola, however, continues to rise due to the most severe drought since 1981 in conjunction with the effects of the COVID-19 pandemic. The spread of droughts, especially in Southern Angola, caused the death of 1 million cattle. This created surges of poor malnutrition and severe illnesses. Despite this, hope exists for those suffering from hunger in Angola.

Drought

The severe drought in Angola has continued spreading for almost three years now, traumatically affecting hunger in Angola. Crop production has decreased by nearly 40%, forcing more families into poverty. The drought has, within only three months in Cunene, Angola, tripled levels of food insecurity. The growing scarcity of food and heightening hunger of Angolans is pushing them to seek refuge in proximate countries such as Namibia.

Pedro Henrique Kassesso, a 112-year-old man, can attest that this three-year-long drought has been the worst he has ever experienced in Angola. The drought has affected almost 500,000 children. Not only has food insecurity heightened, but school dropout rates have risen due to increasing socioeconomic troubles. Hunger in Angola has forced children to put aside their education to support their families in collecting food and water.

Longing for Land

Former Angolan communal farmers are longing to get land back from commercial cattle farmers. According to Amnesty International, the Angolan government gives the land to commercial cattle farmers. Commercial cattle farmers have taken 67% of the land in Gambos, Angola. The battle for land has exasperated the hunger levels of communal Angolan citizens who have been reliant on their land and livestock for survival. The combination of loss of land and drought equates to millions of Angolan citizens ending up in poverty.

Despite the drought and rising food insecurity in Angola, people from neighboring countries are seeking refuge in this nation. As of 2017, 36,000 people have undergone displacement from the Kasai region of the Democratic Republic of the Congo (DRC) and found refuge in Angola. Because of asylum seekers and refugees fleeing to Angola, the nation’s population is rapidly growing. Angola’s population is growing by 1 million people every year, according to the World Population Review. As a host country to asylum seekers, battles for land, ongoing drought and rapid population growth, more people are succumbing to poverty and hunger in Angola.

Hope on the Horizon

Despite the surging levels of food insecurity in Angola, hope is rising on the horizon. In fact, the government of Japan donated $1 million toward United Nations agencies that serve to uplift Angolan citizens who have succumbed to poverty especially due to the drought and the negative effects of the COVID-19 pandemic on the economy of Angola. The donation from Japan, along with the funds raised to end hunger in Angola by the World Health Organization (WHO) and World Food Programme (WFP) projects to at last tackle the issue of malnutrition and hunger in Angola.

– Nora Zaim-Sassi
Photo: Flickr

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Global Hepatitis Elimination by 2030

Global hepatitis eliminationHepatitis-related illnesses kill someone every 30 seconds. While many strains have treatments, the disease is incredibly prevalent. About 354 million people have hepatitis B or C and around 80% are unable to receive the appropriate care. The illness appears all over the world, as 116 million have it in the Western Pacific Region, 81 million in Africa, 60 million in the Eastern Mediterranean Region, 18 million in South-East Asia, 14 million in Europe and 5 million in the Americas. Global hepatitis elimination is possible with additional steps and education. However, as of right now, hepatitis is clearly very significant across the globe.

What is Hepatitis?

Hepatitis is inflammation of the liver often from infection or liver damage. While acute hepatitis often does not have symptoms, some symptoms can occur including:

  • Muscle and joint pain
  • High temperature
  • Fatigue
  • Loss of appetite
  • Dark urine
  • Pale, grey fecal matter
  • Itchy skin
  • Jaundice

Types of Hepatitis

There are five prominent types of hepatitis:

  1. Hepatitis A: Caused by the hepatitis A virus, people usually catch it when consuming food or drink contaminated with the fecal matter of an affected person. It is more common in places with poor sanitation and typically passes within a few months but could potentially be life-threatening. While there is no specific treatment, professionals recommend vaccination if a person is at “high risk of infection” or traveling to an area where it is more prevalent.
  2. Hepatitis B: Caused by the hepatitis B virus, hepatitis B spreads through “the blood of an infected person.” Hepatitis B is very common globally and typically spreads from an “infected pregnant woman to her babies or [through] child-to-child contact.” Sometimes it spreads through injecting drugs or unprotected sex but that is fairly rare. This strain is significant in southeast Asia and sub-Saharan Africa. Most adults who get it recover in a couple of months, however, children often develop a long-term infection that can lead to cirrhosis and liver cancer. A vaccine exists for hepatitis B.
  3. Hepatitis C: The hepatitis C virus causes this strain and is fairly common globally. Typically, the virus spreads through blood-to-blood contact with an infected person, so sharing needles is significant. Since many do not have symptoms, most people may not know they are sick without testing. One in four people is able to fight off the infection, however, it will stay in others for years. Chronic hepatitis C could cause cirrhosis and liver failure.
  4. Hepatitis D: Caused by the hepatitis D virus, this strain only affects those with hepatitis B. Spread through blood-to-blood or sexual contact, it is prevalent in Europe, the Middle East, Africa and South America.
  5. Hepatitis E: Caused by the hepatitis E virus, people usually catch it by eating raw or undercooked pork, venison, shellfish or offal. Typically, it is a “mild and short-term infection that does not require any treatment,” but people with a weakened immune system may be more at risk.

Other forms include alcoholic hepatitis, which occurs when a person drinks large amounts of alcohol. There is also autoimmune hepatitis, which is rare and occurs when “the immune system attacks and damages the liver.” A medication to reduce inflammation is available. Global hepatitis elimination needs to focus on all strains but especially B and C.

Methods of Reduction

By 2030, diagnostic tests, awareness campaigns, testing and vaccines could prevent 4.5 million deaths in low and middle-income countries. Currently, only 42% of children receive the birth dose of the hepatitis B vaccine. Nevertheless, global hepatitis elimination is very possible. A daily medication taken for 8-12 weeks cures most with hepatitis C and medications for hepatitis B are available. Both hepatitis A and B are preventable with safe and effective vaccines. Vaccinating more children would significantly reduce cases and be a major step towards global hepatitis elimination.

Additionally, since hepatitis A and E both spread mostly in areas with poor sanitation, improvements in sanitation could drastically reduce infections. Testing is another important step as many do not know they have it. In 2019, the World Health Organization (WHO) “estimated that only 10% of people with hepatitis B and 21% of people with hepatitis C worldwide knew they were infected. Of these, 22% and 62% had received treatment, respectively.”

Goals for 2030

The World Health Assembly called for the near or total elimination of viral hepatitis by 2030. This would entail:

  • A 90% reduction in new cases of hepatitis B and C
  • A 65% reduction in deaths
  • Treatment for 80% who have the illness

The Global Immunization Strategic Framework has laid out how to achieve global hepatitis elimination. Goals include strengthening vaccination services, helping improve access to testing and improving the response to outbreaks. Safe vaccines for hepatitis A and B already exist, so improving access to them is important. However, the World Health Organization (WHO) has estimated that only 10% of people with hepatitis B and 21% with hepatitis C know they are sick. That means that improvements in both testing and education are vital first steps before improving vaccination rates. Therefore, global hepatitis elimination is possible with increased testing and vaccination rates.

– Alex Alfano
Photo: Flickr

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Bangladesh Prioritizes Vaccinating Refugees

Vaccinating refugeesVaccine rollout plans around the world often overlook the world’s 26 million refugees. A whole 126 countries have refugee populations of more than 500 people. As refugees make up a significant part of the population, during a global health pandemic, the world will not truly be safe until nations safeguard the health of refugees too. Although many countries are making efforts to protect refugees, barriers remain prevalent. Global inequalities continue to exacerbate the situation. Wealthy countries administered 85% of the world’s vaccines, however, 85% of the world’s refugees live in developing countries that struggle to access vaccines. Bangladesh is prioritizing vaccinating refugees and the rest of the world needs to follow suit by including the most vulnerable populations.

Bangladesh’s Vaccine Campaign for Rohingya Refugees in Cox’s Bazar

In August 2017, spikes of violence in Myanmar forced 745,000 Rohingya citizens to flee into Cox’s Bazar, Bangladesh. Cox’s Bazar is now the world’s largest refugee settlement with more than one million refugees living in the cramped camps.

At the end of July 2021, devastating monsoons in Cox’s Bazar killed about eight refugees and displaced 25,000 people, simultaneously destroying thousands of facilities, including health clinics and latrines. Damaged roads hinder humanitarian access, making Rohingya refugees in Bangladesh more vulnerable than ever.

In addition to the recent natural disasters, Bangladesh is experiencing an upward trend in positive COVID-19 cases. Bangladesh authorities recognize the extreme vulnerability of the refugee population. As such, on August 9, 2021, Bangladesh launched a vaccine drive in the Cox’s Bazar refugee camps. With the help of the United Nations High Commissioner for Refugees (UNHCR), the World Health Organization (WHO) and other humanitarian organizations, Bangladesh plans to vaccinate all refugees in waves. The first cohort includes 65,000 refugees made up of community leaders, health volunteers and anyone older than the age of 55.

The Importance of Vaccinating Refugees

Although refugees seem to be the last group receiving vaccines, the WHO has placed refugees in the second priority group for vaccinations. Refugees fall into the same group as at-risk people and those suffering from serious health conditions because refugees tend to live in crowded communities that lack clean water and basic healthcare, making the spread of COVID-19 cases inevitable. No country can curb the spread of COVID-19 while the virus continues to ravage its way through refugee communities.

Barriers to Refugee Vaccination

Most countries understand how crucial vaccinating refugees is to ending the pandemic, however, these major barriers remain:

  • Language barriers lead to misinformation and vaccine distrust.
  • Online registrations exclude those who lack access to the internet.
  • Volunteers are registering refugees at camps, however, a portion of refugees do not live in camps, they live with relatives or family friends.
  • Many refugees fear arrest or deportation at vaccine sites.
  • Vaccine shortages as some countries like India paused vaccine exports due to rising cases in India.
  • The question of liability — who will take responsibility for refugees that suffer serious side effects from the vaccine?

The world not only needs to make vaccines accessible for refugees but must also make refugees feel safe enough to pursue vaccination. Refugees are among the most vulnerable people on the planet, therefore, it is imperative for the world to join Bangladesh in prioritizing the vaccination of refugees because no one is safe until everyone is safe.

– Ella LeRoy
Photo: Flickr

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5 Facts About Healthcare in the Marshall Islands

Healthcare in the Marshall IslandsThe Marshall Islands is a country in Oceania. Known for its beautiful beaches, the country attracts many tourists in search of World War II ships that are in its waters. Tourists also visit the country for its abundant wildlife and coral reefs. According to the World Health Organization (WHO), though healthcare in the Marshall Islands is relatively organized, there are discrepancies and other indications of healthcare problems. These include high mortality rates, which WHO has indicated requires evaluation. Amid the ever-growing COVID-19 pandemic, healthcare is absolutely crucial in making sure that mortality remains low and quality of life is high.

5 Facts About Healthcare in the Marshall Islands

  1. The physician density in the Marshall Islands per 1,000 people is 0.456. This number refers to the number of doctors relative to the size and population of the nation. For reference, the physician density in the United States was 2.57 as of 2014. Other countries in Oceania, like Fiji or Samoa, have physician densities of 0.84 and 0.34, respectively, according to their most recent data.
  2. Only two hospitals exist within the country. In addition to these two hospitals in urban areas of the country, there are approximately 60 health centers and clinics spread out around the Marshall Islands. This number may seem surprising, but the small population of 58,791 merits the limited number of hospitals. Providing primary and secondary care, these hospitals rely on larger centers in the Philippines or Hawaii for more tertiary care. Other clinics and health centers are equipped with primary care physicians and other health assistants.
  3. The Marshall Islands saw a 0.5% increase per year from 2010 to 2019 in providing adequate, effective and necessary healthcare. According to a study by Universal Health Coverage (UHC) collaborators, the effective coverage index in 2010 was 42.1% whereas there was an increase of 1.9% in 2019. These percentages are in reference to effective healthcare coverage in 204 territories and countries across the globe. This means that healthcare in the Marshall Islands overall increased in its effectiveness within the decade.
  4. The morbidity and mortality rates for the Marshall Islands for communicable and non-communicable diseases are relatively high. WHO has mentioned that non-communicable diseases have a high prevalence in the country for two reasons. First, the amount of imported and instant food products that people consume there is high. Second, people in the Marshall Islands overall lack exercise and utilize smoking products at a high level.
  5. The mortality rate for children under the age of 5 years old is 31.8 per 1,000 births in the Marshall Islands. This number, known as a country’s “under-five” mortality rate, is indicative of a nearly three-decade-long improvement in under-five mortality rates in the Marshall Islands. The country has seen a steady decline in the rate since 2004. Between 1990 and 2019, the rate decreased by 17.5%. The under-five mortality rate is slightly higher for boys than for girls.

Healthcare Potential

Some of these five facts may paint a harsh picture of healthcare in the Marshall Islands. However, there is still great potential for improvement in the future. The effectiveness of care, for starters, is a great opportunity for the country to excel in its healthcare coverage. With the intervention of organizations such as WHO and an ever-improving healthcare system overall, these statistics could one day be numbers of the past.

– Rebecca Fontana
Photo: Flickr

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How Safe Human Genome Editing Could Benefit Everyone

Human Genome EditingAfter two years of study, the World Health Organization (WHO) released two reports on how to use human genome editing safely and inclusively. The editing technology has significant potential to cure many diseases but the drawbacks must be considered, experts say. Human genome editing safety remains a priority and ensuring everyone has access to the technology could lead to significant improvements in the fight against poverty. The process warrants significant attention: It could further inequality but could also be a massive step toward eradicating poverty.

What is Human Genome Editing?

Somatic and germline editing are two primary types of genome editing. Somatic editing is surface-level and can be used to treat a disease with genetic origins. For example, a scientist can take a patient’s blood cells and utilize CRISPR technology “to edit blood cells as a treatment” for “blood disorders.” This genome editing type does not get passed down to any children.

Germline editing, the more controversial type, changes the genome of a human embryo at the earliest possible stage. It impacts all cells, which could affect any children one has in the future. Although germline editing raises significant ethical questions, it does have the potential to prevent several diseases from manifesting in a child. Currently, international policies limit germline editing, sometimes allowing it for only research purposes. If an individual utilizes edited embryos to “initiate a pregnancy,” this would be considered heritable genome editing.

Heritable genome editing makes changes to the “genetic material of eggs, sperm or any cells that lead to their development,” which includes early embryos. Human genome editing safety sparks serious ethical and controversial concerns, thus, restrictions and guidelines exist worldwide.

Considering the Positives

The potential to cure serious diseases is enormous despite ethical questions. Faster diagnoses, accurate treatments and disorder prevention efforts all could be achieved or improved through genome editing, according to the U.N. In fact, somatic gene therapy made significant strides toward treating HIV and sickle-cell disease in recent years.

Fertility and disease resistance could both improve with the technology’s use. Human genome editing can and already is a way to treat or prevent many serious diseases, and overall, improve life for many. If used correctly, in a safe and efficient manner, the entire world could benefit.

Considering the Negatives

The potential is enormous, but so are the risks. Political and social justice issues are very important to consider, especially when it comes to germline and heritable genome editing. Editing could affect the very issues movements fighting for a broad range of social and economic issues raise.

Germline and heritable human genome editing both have ethical and moral questions. There is a possibility the genetic changes can be passed down to future children. It could be used as a way to improve traits in an irresponsible manner and access could vary for many.

Somatic editing also faces challenges. Rogue clinics and “illegal, unregistered, unethical or unsafe research” pose serious threats. Also of concern are “activities including the offer of unproven so-called therapeutic interventions.” Human genome editing safety is a difficult but important task to undertake as the treatment could be harmful if used incorrectly.

Another serious issue to consider is who would receive the treatment. This could just further the medical inequality divide between wealthy and lower-income nations as the treatment is expensive. As many nations with fewer resources have more difficulties with diseases, the treatment will be especially beneficial for them. However, these nations might not have effective access.

How Genome Editing May Help Those in Poverty

Diseases that tend to affect those in poverty because of a lack of treatment could be treated with human genome editing. These include diabetes, alcohol-attributed diseases, malaria and others. Improved treatment from human genome editing could lead to significant strides in reducing poverty. For those with the least access to or possession of societal resources, editing could potentially be a benefit. Other diseases like “cystic fibrosis, cancers, muscular dystrophy and Huntington’s disease” could also be treated or cured.

If properly managed, the impact of human genome editing on those in poverty could be significant, increasing health across the board. If recommendations from the WHO are properly followed and scientific progress continues, the benefits for the global population could balance the risks.

– Alex Alfano
Photo: Flickr

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Social Inequality in Germany and COVID-19

Social inequality in GermanyResearch shows that levels of social inequality in Germany could increase COVID-19 transmission rates among people experiencing poor living and working conditions. Evidence does not conclusively determine that poverty directly causes Germany’s COVID-19 cases. However, it is apparent to scientists and medical professionals that a large number of COVID-19 patients come from low socioeconomic standing. In 2015, 2.8 million German children were at risk of poverty. The influx of migrants flowing into Germany has also increased rates of poverty in Germany.

Poverty and COVID-19

According to the CIA World Factbook, 14.8% of the German population lives below the poverty line as of June 2021. According to data from the World Health Organization (WHO), the North Rhine-Westphalia area has the highest number of COVID-19 cases. The area is home to Gelsenkirchen, the most impoverished German city based on a 2019 report by the Hans Böckler Foundation.

Risks of Overcrowding

Overcrowded living areas are more susceptible to airborne illnesses, medical sociologist Nico Dragono said in an interview with The Borgen Project. In 2019, 8% of Germans lived in overcrowded dwellings, meaning there were fewer rooms compared to inhabitants. This percentage has increased in recent years, according to Statistisches Bundesamt (German Federal Office of Statistics).

In November 2020, statistics showed that 12.7% of the population residing in cities lived in overcrowded dwellings. Comparatively, 5.5% reside in small cities or suburbs and 4% reside in rural areas. Dragono says that social inequality in Germany plays a significant role in the spread of disease across the country’s large cities. This especially impacts those living in close proximity to others. “Infections clustered in the areas of the city where the poor live because there simply was no space,” Dragono says. He says further that with many people living in one household, traveling to school, work and other places holds an increased risk of bringing infections into the home.

The Centers for Disease Control and Prevention stated on February 26, 2021, that COVID-19 is transferable through respiratory droplets from people within close proximity of each other. This puts those in poverty at a higher risk of contracting COVID-19. Those living in areas such as refugee camps and impoverished neighborhoods are especially vulnerable. Therefore, social inequality in Germany may contribute to the spread of COVID-19.

Migrants Potentially at Higher Risk

Dragono says that, unlike the United States, Germany does not document patients’ ethnicities. In other words, Germany cannot collect the demographics of who contracts COVID-19. He said it appears the association between COVID-19 and social inequality in Germany is universal for migrants and non-migrants. However, many hospitals across Germany reported that close to 90% of COVID-19 patients in the intensive care unit have an immigrant background, according to Deutsche Welle.

“Migrants are more often poor because they do many of the bad jobs,” Dragono says. There are indications that COVID-19 is more prevalent in the areas inhabited by migrants. “Migrant workers, as they grow older, many have diseases, because in general, they are doing hard work… so their hospitalization rates could be a bit higher.” Dragono says Germans’ social status and income determine how much access they have to quality resources. It is easier for upper-class citizens to purchase masks and use personal travel and they do not have to rely on public transportation or low-quality protective gear.

On June 5, 2021, the German health ministry came under fire regarding a report that dictated its plan to dispose of unusable face masks by giving them to impoverished populations. However, the health ministry released a statement that all of its masks are high quality and receive thorough testing. Any defective masks are put into storage.

Assistance From Caritas Germany

As the virus continues to spread, many organizations are extending assistance to disadvantaged citizens in Germany. Some services translate COVID-19 information into migrants’ languages or modify other services to fit COVID-19 guidelines. Caritas Germany, one of the largest German welfare organizations, typically operates childcare services, homeless shelters and counseling for migrants.

To comply with COVID-19, Caritas began offering online services such as therapy and counseling. The organization also travels to low-income areas and focuses on providing personal protective equipment to those working with the elderly. Many Caritas volunteers use technology to maintain distance while also maintaining communication with patients. Since the beginning of the pandemic, hundreds of volunteers have trained in online counseling.

However, Dragono says that while the country has systems in place to avoid broadening the poverty gap, the serious implications of COVID-19 on social inequality in Germany are yet to emerge. Fortunately, organizations are committed to mitigating some of the impacts of COVID-19 on disadvantaged people in Germany.

– Rachel Schilke
Photo: Unsplash

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The Need for Aid Toward Vector-Borne Diseases

Vector-borne diseasesDisease and poverty are two deeply interconnected issues affecting many countries across the world, particularly those in Africa. Among the most pressing diseases are those that are vector-borne, (illnesses caused by pathogens and parasites in the human population) such as malaria and dengue fever. Unfortunately, these diseases foster ideal conditions for poverty, given their effects on the working population. Moreover, poverty also creates conditions that foster vector-borne diseases, such as underdeveloped healthcare, a lack of information and poor living conditions.

About Vector-Borne Diseases in Africa

According to the World Health Organization (WHO), malaria is the most deadly vector-borne disease. It leads to approximately 1.2 million deaths annually. A 2017 report from the WHO shows that 90% of the roughly 219 million global malaria cases are found in Africa. Dengue fever is also a particularly concerning vector-borne disease. As of May 2021, dengue is endemic in more than 100 countries. Dengue fever can develop into a lethal form of the illness, called severe dengue.

Impact on Poverty

In order to eradicate poverty, there must be a working population that can sustain itself. With the devastating symptoms of diseases like malaria and dengue, many are forced out of work, unable to sustain themselves. According to a 2019 study in BMC’s Malaria Journal on a farm in Zimbabwe, absenteeism among those affected by malaria was between 1.4 to 4.1 business days during the 5 month study. This is especially concerning given that in 2019, 15 countries in both Sub-Saharan Africa and India carried 80% of the world’s malaria burden. This means that in African countries where malaria is prevalent, millions of workers are unable to sustain themselves as they fight for their lives.

Current Solutions

Many non-governmental organizations (NGOs) are aiming to combat vector-borne diseases on both domestic and global scales. Initiatives by the CDC and WHO are invaluable ways to mitigate this health crisis. Even with this, one of the most influential solutions is foreign aid. As one of the most powerful and influential countries in the world, the U.S. can distinctly impact the global disease burden.

Malaria is one of the biggest health priorities of USAID, with funding going toward research and the development of vaccines and insecticide tools. USAID also collaborates with other groups and organizations, like the RBM Partnership to End Malaria and The Global Fund to Fight AIDS, Tuberculosis and Malaria. There is also the U.S. President’s Malaria Initiative, which is led by USAID and includes 27 different programs in Africa and Asia aimed toward building treatment capacity for malaria and other vector-borne diseases.

Aid Looking Forward

Despite this funding into research, African countries desperately need more aid. As of 2019, nearly 95% of malaria deaths were in Africa. It is evident that current aid is useful, yet the gravity of the current disease burden requires further U.S. commitment. Research funding, treatment capacity building and development in African countries are crucial initiatives. Organizations like USAID are important vessels to create necessary change.

While initiatives solely targeted toward poverty reduction are necessary, they cannot completely eradicate poverty. This is largely because poverty is such a multifaceted issue.

As vector-borne diseases create conditions for poverty, poverty exacerbates vector-borne diseases. Therefore, they must both be approached in tandem, with further aid and support from the United States.

– Samuel Weinmann
Photo: Unsplash

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Explaining the Low Healthcare Access in LMICs

healthcare access in LMICs
Around 2 billion people around the world lack proper access to surgical care or advanced medical care. On average, low-and-middle-income countries (LMICs) have fewer than two operating rooms and one trained surgeon per 100,000 people. Due to this, treatable maladies often result in death. In 2011, around 5 million people died of injuries in LMICs. The barrier between proper medical care and patients is the cost of care. More often, the costs of admission, medications and food are based on the strained economic conditions of impoverished countries. The shortage of medical professionals in LMICs has been identified as one of the most significant obstacles to achieving health-related U.N. Millennium Development Goals (MDGs). One can see the severity of this lack of healthcare access in LMICs in countries such as Mozambique, with only 548 doctors for more than 22 million people.

Lack of Medical Professionals

The absence of medical professionals in LMICs is often due to the poor economic situation of these countries. This results in limited financial resources to support a good healthcare system and provide proper training for doctors. Even when training is available, many skilled doctors work overseas due to others offering them a better medical career abroad, leading to a lack of healthcare access in LMICs. The British Medical Journal claims that “African countries have lost about $2.6 billion…training doctors who are now living in western countries.”

On average, there is less than one doctor for every 20,000 people in Chad. In addition, an equipment shortage in Chad means there are fewer than four hospital beds for every 10,000 people. Furthermore, inequitable distribution of service is a major problem in these countries. Due to a limited number of doctors being available to treat millions of people, often patients with a higher income receive what little medical support is available. Those of a lower income in these countries find it more difficult to afford treatment and especially cannot afford emergency medical procedures.

Consequences for Patients

Lack of trained medical professionals often means that diseases, surgeries, injuries and complications often result in death. Disease is excessive and often untreatable in these countries. Medical procedures often require advanced training and experience to be conducted successfully. The demand for these procedures greatly exceeds the supply of surgeons and institutions, leading to low healthcare access in LMICs.

For example, 90% of those who are visually impaired live in LMICs. According to the World Health Organization (WHO), 80% of cases involving visual disability are preventable. Eye surgery, an effective method of treating blindness, is rarely available. Furthermore, according to the National Library of Medicine, 6 billion people in LMICs lack access to safe and affordable cardiac surgery.

According to WHO, 94% of all maternal deaths occur in low- and lower-middle-income countries. Many women facing birth complications rarely have access to trained professionals who can handle these complications. Sometimes, doctors with insufficient training may perform emergency procedures improperly, resulting in debilitating injuries or even death. Furthermore, 99% of hemorrhage-related peripartum deaths occur in LMICs. These problems all stem from the fact that a qualified medical professional attends less than 50% of all births in LMICs.

Rising Cancer Rates

Another consequence of a poor global healthcare system is the rising cancer mortality rates in LMICs. More than half of the 10 million cancer deaths in 2020 occurred in LMICs. When comparing the healthcare systems of different regions, high-income countries usually spend around five to 10 times more per person. As a result, less than 50% of those diagnosed with cancer in high-income countries die from the disease. On the other hand, 66% of those diagnosed with cancer in LMICs die from the disease. This is mostly due to the fact that LMICs do not have the resources for treatment facilities or radiation therapy centers.

Organizations Making an Impact

Organizations like the Medical Education Partnership Initiative (MEPI) support the training of doctors to improve healthcare access in LMICs. MEPI works to increase the number of new healthcare workers, strengthen medical education systems and build clinical and research capacity in LMICs. Charities such as Mercy Ships send volunteer surgeons to provide lifesaving surgical procedures and invite local doctors to expand upon their surgical skills alongside the volunteer surgeons. Mercy Ships also provides mentoring programs for surgeons, anesthesia providers, ward nurses, operating nurses and biomedical technicians. By providing new medical tools and resources, constructing new medical facilities, providing training for local professionals and working with local governments, Mercy Ships leaves a long-lasting impact.

Poverty and disease are closely related. In order to have significant improvement in global health, economic development of LMICs and improved medical education is essential. The growing disparity in surgical access and other health services requires urgent attention. We can put this into action through the comprehensive development of healthcare access in LMICs.

– Arya Baladevigan
Photo: Unsplash