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tobacco in myanmarMillions of people worldwide use tobacco every day. Though tobacco usage has decreased in some countries, it still remains a significant public health concern for various populations. This is especially true for lower-income countries all over the globe. Myanmar is no exception. With the highest rate of tobacco usage in Southeast Asia, tobacco in Myanmar runs rampant with limited regulation.

The Feedback Loop: Tobacco and Poverty

Worldwide, 1.8 billion people smoke, with 84% of smokers from underdeveloped countries. The world’s poor are prone to spending their limited income on tobacco. However, smoking comes at a high opportunity cost. Money spent on tobacco could instead go toward food, education and health care. In countries such as Bangladesh, the poorest households spend 10 times more on tobacco than they would on education. In Mexico, the poorest 20% of households spend at least 11% of their income on tobacco. Overall, the world’s poor sacrifice significantly more of their income to satiate tobacco addiction than do richer households.

In addition to being a financial drain, tobacco also presents numerous health risks. Users of tobacco are at risk for cancer, respiratory diseases and heart problems. These illnesses create higher medical and insurance costs, which could cause households to spiral deeper into poverty.

Tobacco in Myanmar

Currently, around 1.6 million people in Southeast Asia die from tobacco-related illnesses each year. Myanmar currently has the region’s highest prevalence of tobacco use. Approximately 80% of men use tobacco in Myanmar. In this country alone, over 65,600 people die from tobacco-related diseases annually. Regardless of this risk, more than 5 million adults in Myanmar continue to use tobacco every day.

The lack of regulation of tobacco in Myanmar puts millions of individuals at risk of exposure to secondhand smoke. Currently, 13.3 million smokers and individuals exposed to secondhand smoke are at risk of developing tobacco-related diseases such as CVD (cerebrovascular disease). CVDs are one of the most common ways tobacco claims lives. They are also the leading cause of death in the country, contributing to 32% of all deaths.

Premature deaths have also greatly affected Myanmar’s economic growth, severely limiting income opportunities for the nation’s poor and middle-class families. In 2016, economic losses due to tobacco-related mortality were estimated at MMK 1.32 trillion. Overall, the economic loss caused by tobacco-related health complications places a huge strain on Myanmar. Most importantly, without explicit programming efforts, very few users have successfully quit tobacco in Myanmar.

So, What’s Next?

A number of efforts are looking to minimize the harmful effects of tobacco in Myanmar. For example, Myanmar’s government created various changes to its Tobacco Control Laws upon joining the World Health Organization’s FCTC (Framework Convention on Tobacco Control) in 2005. Despite these changes to the law, however, there are insufficient funds for smoke-free enforcement in public spaces. Currently, smoking remains legal in pubs and bars, indoor offices and public transportation.

A comprehensive tobacco control program is therefore necessary to limit the prevalence of tobacco in Myanmar. Luckily, many organizations are willing to assist in this fight. The World Health Organization released plans for its Tobacco Control 2030 campaign, which includes Myanmar. It will be one of the 15 countries chosen to receive aid from the U.N. to support its battle against tobacco.

In 2019, the People’s Health Foundation also implemented a four-year plan to turn Yangon, the largest city in Myanmar, completely smoke-free. This organization plans to raise public awareness of the dangers of smoking and passive smoking on various media platforms. The People’s Health Foundation also partnered with the Ministry of Health and Sports to minimize smoking and overall tobacco usage in the country. Already, the organization has converted regions including Ayeyarwady, Bago and Mon into smoking-free zones. While much work still remains, Myanmar these efforts to minimize the use of tobacco among its citizens are showing some signs of success. This provides hope that the epidemic of tobacco in Myanmar may soon end.

Vanna Figueroa
Photo: Flickr

healthcare in tokelauThe dependent territory of New Zealand, Tokelau, lies in the Pacific Ocean. It consists of three atolls, or islands made up of coral: Atafu, Nukunonu and Fakaofo. Tokelau has the world’s smallest economy, with an annual GDP per capita of $6,275 and a population of only 1,500 people. A lack of human resources and considerable financial constraints severely limit the Department of Health in Tokelau in addressing the population’s healthcare needs. Here are seven facts about healthcare in Tokelau.

7 Facts About Healthcare in Tokelau

  1. Population health: Tokelau’s central health issues are non-communicable diseases (NCDs), especially cerebrovascular and cardiovascular diseases. From 2007 to 2010, cardiovascular diseases in Tokelau had a mortality rate of 17%. Aside from viruses, other principal causes of death in Tokelau include old age, neoplasms (unusual growth of body tissue) and accidental death, often the result of trauma. Because of minimal amounts of physical activity, about 75% of Tokelauns are obese, and close to 50% of Tokelauans smoke daily.
  2. Hospital access: Each of the three atolls has one hospital. Every hospital has some medical and diagnostic equipment available for use, along with 12 beds. However, the hospitals lack some basic technology, like x-ray machines.
  3. Lack of healthcare workers: As of October 2012, there were only 37 healthcare workers across all three atolls. Each hospital has one medical officer, four to five nurses, four to five nurses’ aides and a porter. Healthcare in Tokelau suffers from a lack of doctors and specialized professionals in particular.
  4. Lack of secondary and tertiary care: While the three hospitals can provide some level of care for their patients, they cannot afford specialized employees and more intensive treatment. NCDs, the primary healthcare needs faced by Tokelauans, require intensive care. Currently, patients requiring such services go offshore to either Samoa or, in more critical cases, New Zealand.
  5. Funding: A combination of grant money from New Zealand, local revenue and international aid funds healthcare in Tokelau. However, the budget for healthcare is insufficient. Tokelau relies on aid from international organizations because it still lacks the means to invest in healthcare infrastructure on a large scale.
  6. Lack of transportation: Healthcare in Tokelau also lacks an inter-atoll transportation system. This creates a decentralized hospital system, with three separate hospitals. Climate change and natural disasters further strain healthcare in Tokelau.
  7. High life expectancy: Despite its unique challenges, Tokelau has worked to improve its healthcare system. Tokelauans have a reasonably high life expectancy rate compared to other countries in the Pacific region. In addition, Tokelau does not have high maternal or infant mortality rates.

Tokelau Health Strategic Plan 2016-2020

In August 2016, Tokelau launched a new initiative to better its healthcare infrastructure, called the Tokelau Health Strategic Plan. This plan has three parts: short-term goals in 2016 to 2018, intermediate goals from 2018 to 2020, and long-term goals for 2020 and beyond. Furthermore, Tokelau’s healthcare plan has created four key ideas to help guide the country’s healthcare initiatives. These ideas are developing healthcare infrastructure, improving general public health, improving governance of healthcare services and creating better clinical services for the island’s population.

The most important aspect of the plan is the construction of a National Referral Hospital in Nukunonu, the largest of the three atolls. With the creation of the new National Referral Hospital, Tokelau would be able to alleviate the issues caused by its decentralized healthcare system.

The World Health Organization (WHO) has been working in conjunction with the Tokelau government to see this plan through. WHO outlined these priorities to oversee the advancement of Tokelau’s healthcare:

  1. Monitor the healthcare situation in Tokelau and develop strategies that would work in tandem with Tokelau’s healthcare strategies.
  2. Monitor NCDs, improve treatment regulations and care for patients and increase access to medication.
  3. Develop healthcare infrastructure to minimize tobacco use in Tokelau and implement strategies to strengthen immunization.

Tokelau faces many challenges ahead as it looks to improve its healthcare system. The majority of these challenges come from a lack of economic means and a decentralized healthcare system. However, with international aid and the healthcare plan, the government can work to improve healthcare for all of its citizens’ benefit.

Anushka Somani
Photo: Flickr

COVAX InitiativeThe COVID-19 pandemic arrived on the world scene at an inopportune time in terms of international relations, given the current state of global division and isolationist nationalism. Cooperation between nations is extremely important in containing a pandemic. However, this sentiment was sparse during the early stages of the virus’ spread due to the prevailing geopolitical climate. Now that COVID has expanded across the world and endangered millions, international cooperation is perhaps more important than ever in the urgent search for a vaccine. The World Health Organization, GAVI and the Coalition for Epidemic Preparedness Innovations (CEPI) have united to form the COVAX Initiative: a program providing promise for both global teamwork and COVID mitigation.

What is the COVAX Initiative?

According to the WHO, COVAX is a coalition designed to “…accelerate the development and manufacture of COVID-19 vaccines, and to guarantee fair and equitable access for every country in the world.” The goal of the COVAX Initiative is twofold: to facilitate the creation of a vaccine and to ensure any eventual vaccine is made available to as many people as possible, regardless of national identity or socioeconomic status.

While many wealthy countries may succeed in vaccinating their populations without assistance from COVAX, all nations would still benefit from the Initiative: recent events have proven that in order to guarantee true safety from COVID-19, the disease must be eradicated worldwide. Thus, it is in everyone’s interest to provide access to as many people as possible. COVAX is working to create a coalition of member nations, both wealthy and poor, to achieve this mission.

Current Member Countries

A total of 172 countries have joined the COVAX Initiative so far. 80 wealthy countries have made commitments to the Initiative, including the UK, Norway and Japan. Additionally, 92 lower-income countries including Afghanistan, the Philippines and Yemen have become involved. According to the Director-General of the WHO Dr. Tedros Adhanom Ghebreyesus, COVID presents a challenge that necessitates an unprecedented level of international cooperation.

Life-Saving Potential

COVAX aims to deliver two billion vaccine doses by the end of 2021. Currently, the COVAX Initiative has nine vaccines under development and is evaluating nine more. According to the WHO, these innovations imply that the Initiative has “…the largest and most diverse COVID-19 vaccine portfolio in the world.”

Healthcare workers will recieve the first round of vaccinations; higher-risk patients will receive the second round. Member nations will recieve doses in amounts proportional to their population. To ensure widespread delivery of the vaccine, the Initiative plans to help fund infrastructure development as necessary in poorer member countries.

The COVAX Initiative is built on the idea that, for anyone to be safe from COVID-19, everyone must be safe. The Initiative represents a positive step towards international cooperation, a crucial aspect of effectively eradicating this destructive and deadly pandemic. Once a functional vaccine is in circulation, the world’s poor will likely have the least access. This structural inequity means that projects like COVAX could save countless lives and prevent future resurgences of COVID.

– Dylan Weir
Photo: Wikimedia

COVID-19 in Nigeria
Nigeria is located on the western coast of the African continent. Home to more than 200 million people, Nigeria is the most populous country in Africa. The nation is no stranger to diseases: a dense population, frequent travelers and the Ebola outbreak have impacted thousands. Although the government successfully contained the Ebola outbreak, similar action was not taken to deal with COVID-19. As COVID-19 surges, several global humanitarian organizations are working with Nigeria’s government to combat the virus. Here are four organizations fighting COVID-19 in Nigeria.

The World Health Organization

The World Health Organization (WHO) has been actively involved in projects promoting health and safety in Africa for years. During the 2014 Ebola outbreak, the WHO helped contain the virus in Nigeria. Recently, the organization has shifted its focus to COVID-19. In early June, the WHO recognized a lack of COVID-19 testing in many of the country’s rural communities. In response, the organization planned to educate health officials and community members on the pandemic’s severity.

The WHO has since been working with the Nigeria Centre for Disease Control (NCDC) to conduct country-wide testing and sample collection. The two organizations are now locating and mapping at-risk communities to better coordinate treatments and procedures.

World Food Programme

World Food Programme (WFP) is a food-assistance branch of the United Nations. The WFP has been especially active in recent months, combatting the food insecurity accompanying economic hardships caused by COVID-19. The program has also established and deployed food assistance task forces to reach the country’s remote communities.

Throughout the pandemic, WFP has assisted more than 715,000 of its targeted 890,000 beneficiaries. The organization continues to offer life-saving food assistance to Nigerians while providing valuable education about sanitation and safety measures.

WaterAid

WaterAid is a nonprofit humanitarian aid organization focused on providing clean water and promoting hygiene and sanitation across the globe. Amidst COVID-19, WaterAid has been collaborating with Nigeria’s Federal Ministry of Water Resources to incorporate clean water resources and hygienic behaviors into communities across the country.

The organization is placing an emphasis on implementing routine hand-washing practices using clean water. WaterAid is also working to educate Nigerians about the importance of staying hygienic and sanitized to minimize the risk of contracting the virus.

The World Bank

The World Bank is an international financial institution that provides countries with loans and financial services. Its current work involves collaborating with the Nigerian government to monitor and analyze the impact of COVID-19 on the country’s socioeconomic health. The World Bank is also working to determine the amount of financial aid the country requires to adequately address the pandemic. The organization has initiated a household survey called the Nigeria COVID-19 National Longitudinal Phone Survey to assist in this endeavor.

In early March, the World Bank prepared initial financial packages of up to $12 billion to assist more than 60 countries heavily affected by COVID-19. Such financial packages have helped countries like Nigeria strengthen their healthcare systems and reduce the damage to the economy. The $12 billion funding includes contributions from various facilities within the World Bank, including International Bank for Reconstruction and Development (IBRD), International Development Association (IDA) and the International Finance Corporation (IFC).

When Nigeria’s first cases of COVID-19 emerged, international humanitarian and financial organizations quickly prioritized containment. While COVID-19 in Nigeria continues surging, organizations like the World Health Organization, World Food Programme, WaterAid and the World Bank Group have stepped in to support the country. As these organizations work to promote hygiene and offer treatment, the risk of contracting COVID-19 in Nigeria continues to decrease and ultimately brings hope to the nation.

– Omer Syed
Photo: Flickr

homelessness in Sierra LeoneSierra Leone is a country situated on the western coast of Africa where over half of the population lives below the poverty line. The occurrence of various crises and disasters has adversely impacted homelessness in Sierra Leone. The civil war that lasted over a decade from 1991 to 2002, the Ebola outbreak in 2014 and the 2017 mudslide have increased the homeless population in Sierra Leone. Three thousand people experienced displacement because of the mudslide in Freetown that killed over 1,000 people. In 2015, floods in Freetown displaced thousands and caused 10 fatalities.

3 Contributions to Homelessness in Sierra Leone 

Homelessness in Sierra Leone receives little attention from the nation’s political leaders. Assumptions determine that because of strong cultural and social traits, individuals can seek help from neighbors or extended family for shelter and housing needs. However, if friends and family have nothing to give, then those in need have nothing to receive. While the circumstances causing homelessness across the globe tend to be the same, the brutality of it in Sierra Leone differs in magnitude.

  1. Unemployment: An estimated 800,000 individuals between the age of 15-35 in Sierra Leone are actively in search of employment. Despite steady growth in the economy after the civil war, unemployment among youth and young adults is a major reason for homelessness. 
  2. Mental Health: According to the estimates by WHO, 10% of the population in Sierra Leone has mental health problems such as psychosis, depression and post-traumatic stress disorder. The government and private sector inadequately address mental health problems. Due to inadequate treatment, those battling mental health problems often end up on the streets without care and become homeless.
  3. Housing: The invasion of rebels in 1999 destroyed 5,932 houses in Freetown and neighboring areas of Kissy, Wellington, Calaba Town and Allen Town. The national estimate indicates that due to the internal rebellion, 300,000 homes experienced destruction and 1.2 million people either became internally displaced or fled. The lack of affordable housing or rental apartments adds to the challenges faced by the unemployed and renders them homeless. The government has initiated The New Housing Policy that works to ensure reform, resettlement and reconstruction.

Shelters Supporting the Homeless in Sierra Leone

Despite the inadequate support from the authorities, a handful of not-for-profit intervened to provide necessities along with shelter to the homeless persons. These include:

  • Don Bosco Fambul Shelter: Salesian missionaries initiated their support in 2001 by rehabilitating the former child soldiers. The Don Bosco Fambul Shelter in Freetown has become one of the leading organizations. It provides shelter, food, clothing, educational opportunities and counseling. During the Ebola crisis, it also transformed a school into a home for 120 boys. 
  • Sisterland Shelter: An NGO formed in Freetown Sierra Leone, the Sisterland Shelter aims to provide safe accommodation for women sleeping on streets with their children. It supports women by providing access to education or vocational training to make themselves employable as well as medical care.

To overcome the problem of homelessness in Sierra Leone, it is imperative to deal with the challenges of unemployment, lack of mental health awareness and lack of education; to do so, leaders must provide stronger systems for social support and healthcare. The government is taking a step in the right direction, though, by investing in housing infrastructure to tackle homelessness in Sierra Leone. 

Anandita Bardia
Photo: Unsplash

Improving Water Sanitation
According to the World Health Organization (WHO), 3.4 million people die annually from water-related diseases. These illnesses disproportionately affect children, making up 90% of the 2.2 million deaths that diarrhea causes every year. Trachoma, another condition that unclean water causes, is the leading cause of preventable acute blindness across the world. Simple filtration mechanisms can prevent all of these water-related diseases. Yet, the world’s poor lack access to the life-saving filtration devices available in other parts of the world, leaving them with high numbers of water-borne diseases. New technologies improving water sanitation are reaching the impoverished and saving new lives each day. Here are four innovative technologies helping to guarantee clean water for all.

4 Technologies Improving Water Sanitation in Developing Countries

  1. The Drinkable Book. The effect of The Drinkable Book is two-fold. First, it provides vital water sanitation information to readers in the developing world who would not otherwise receive such education. Second, the pages of the book themselves act as water filters. These filters are incredibly effective, removing 99.9% of all bacteria to make water safe to drink. The books have experienced distribution across Haiti, India and several countries in sub-Saharan Africa. One book can produce 5,000 liters of clean drinking water to users, or enough to last up to four years.
  2. Fog Catchers. The Morocco-based nonprofit Dar Si Hmad has developed a revolutionary new technology that improves water sanitation by harvesting water from fog. The device consists of large nets built on the sides of mountains that collect moisture from the air and store it for later use. Dar Si Hmad has intentionally involved women in the organization and maintenance of the project in order to provide a holistic community impact. The new technology can produce up to 6,300 liters of water per day and has garnered attention from international investors across the world.
  3. Livinguard Water Filter. The India-based company Livinguard developed an innovative way to fight water-related diseases in India and across the world. The Livinguard water filter has a design suitable for remote locations and depends only on gravity to function. The installation process takes under three hours and the filter lasts up to seven years, making it reliable easy to use. The Livinguard filter uses microscopic knives rather than potentially hazardous chemicals to provide safe drinking water for consumers.
  4. Ceramic Filters. Places across the world are using ceramic water filters as affordable ways to limit the spread of water-related diseases. With microscopic pores that filter out bacteria and other impurities, potable water can pass through. Many have touted these filters as the most cost-effective water sanitation devices and have thus been in wide use worldwide. Ceramic filters caused a 50% reduction in diarrheal disease in Cambodia since 2002, demonstrating the power of this technology in combating water sanitation issues.

These devices exhibit the innovation necessary to rid the world of prevalent yet avoidable water-related diseases. Entrepreneurs across the world are challenging the deaths that lack of clean drinking water causes head-on. With the continued development of new technologies aimed at improving water sanitation, there is hope that water-related diseases might become preventable for all.

– Garrett O’Brien
Photo: Flickr

Healthcare in Suriname
The Republic of Suriname is an upper-middle-income country located on the northeastern coast of South America. Around 90% of the country’s population lives in urban or rural coastal areas. Healthcare in Suriname is accessible for both the public and private sectors. Here are eight facts about healthcare in Suriname.

8 Facts About Healthcare in Suriname

  1. Infant and Maternal Mortality: Suriname’s infant mortality rate in 2013 was around 16 deaths per 1,000 live births. The most prevalent reasons for mortality reported in children under 1 year of age were respiratory problems, fetal growth retardation, congenital diseases, neonatal septicemia and external causes. The maternal death ratio averaged 125 deaths per 100,000 live births from the years 2000 to 2013. For mothers, the most prominent causes included gestational hypertension and hemorrhage. In 2010, prenatal checkup coverage was around 95%, and more than 65% of pregnant women had had four prenatal checkups. In addition, almost 93% of births happened in a health center, and trained health workers carried out around 95% of births.
  2. Life Expectancy: In 2016, the average life expectancy of a male was 69, while the average life expectancy of a female was 75. These estimates are slightly below the average male and female life expectancies in the rest of South America.
  3. Mosquito-borne Illnesses: In late 2015, the preliminary issue of Zika virus was found in Suriname. The disease spread quickly throughout the country’s 10 districts, but there are no current outbreaks. Conversely, Suriname has eradicated malaria from all but one district of Suriname. However, the rate of new imported cases (principally among gold miners from French Guiana) increased by more than 70% in 2015.
  4. HIV and Tuberculosis: By 2014, Suriname’s human immunodeficiency virus (HIV) rate among the 15-49 age group was 0.9%. HIV/AIDS caused 22.4 deaths per 100,000 people in 2010, decreasing to 16.4 deaths per 100,000 people in 2013. From 2012 to 2014, the estimated tuberculosis diagnosis rate increased from 58% to 71%. To combat the disease, the country started the direct implementation of observed treatment, resulting in higher treatment success from 61% in 2010 to 75% in 2013.
  5. Government Contribution and Coverage: Suriname experienced vast economic growth from 2010 to 2014. During this period, healthcare in Suriname received increased funding for various services and facilities. It expanded and decentralized private laboratory diagnostic services, private primary care, dental care and paramedic practices. In 2015, vaccination coverage was almost 90% for DPT3 and above 90% for the trivalent vaccine (MMR1). In 2014, the total estimated health expenditure as a percentage of GDP was 6%. For health insurance, employees’  premium rate is 50%, and employers pay the other half. For low- or no-income citizens, the government subsidizes health coverage.
  6. Hospitals: Of Suriname’s five hospitals, two are private and three are public. The Academic Hospital in Paramaribo has recently renovated and expanded its facilities and invested in equipment and staff for specialty care like gastroenterology, oncology, intensive care, renal dialysis and more. In 2013, government and external funds also helped other hospitals invest in new facilities and healthcare worker training programs.
  7. Sanitation: Suriname’s lack of an integrated waste management policy has created illegal dumps and caused refuse to accumulate on roadsides and in open waters. This infrastructure problem results in health risks and environmental hazards. According to the Pan American Health Organization (PAHO), Suriname does not have facilities for storing or eliminating hazardous waste, nor does it regulate the safe use or storage of pesticides.
  8. Accessibility: In 2014, Suriname passed its national basic health insurance law. It provides access to a basic package of primary, secondary and tertiary care services for all Surinamese citizens. In 2013, all people under the age of 16, as well as people aged 60 and over, had the right to free health care that the government paid for. Universal access to healthcare for pregnant women and newborns remains a challenge for healthcare in Suriname.

Persistent voids in access to healthcare in Suriname are related to drawbacks in funding. The healthcare system has seen an expansion in the past decade, but there are still plenty of health challenges to confront and improve.

Anuja Kumari
Photo: Flickr

Measles in the Central African Republic
Measles is a viral infection spread through airborne respiratory droplets from an infected individual. Measles can cause typical flu-like symptoms and a skin rash, and, under certain circumstances, it can lead to death. While the illness is virtually obsolete in more developed countries, other countries, such as the Central African Republic, struggle with keeping it at bay. Here are four important facts you should know about measles in the Central African Republic.

4 Facts About Measles in the Central African Republic

  1. Measles primarily affects children. The viral infection is especially taxing on those with weakened immune systems. Thus, children, especially those who are malnourished or HIV-positive, are more likely to become infected and die from the measles. In 2017, only 49% of Central African children under five years of age received vaccinations against measles. In the resurgence of measles in 2019, 90% of cases in the Central African Republic affected children aged 10 or younger. Although a safe vaccine is available, many Central African families have been displaced, live in rural areas or do not have access to a nearby healthcare center. With the help of foreign aid, the government can initiate more vaccinations and widespread awareness – two critical components in combating measles.
  2. The fight against measles in the Central African Republic is ongoing. For more than 40 years, Central African citizens have struggled with measles. The epidemic is a health crisis and is at the top of the country’s political priorities. In 2014, with the help of the Red Cross and the United Nations, the government of the Central African Republic rolled out a vaccination campaign. It aimed to provide free measles vaccines for more than 115,000 children. However, in January 2019, a resurgence of the measles appeared in the Central African Republic. Since then, the citizens have been fighting widespread outbreaks of the disease. From January 2019 to February 2020, there were more than 7,000 new cases of the measles and 83 deaths.
  3. Vaccines are hard to distribute in the Central African Republic’s war-torn political climate. As of 2017, nearly 900,000 Central Africans had fled violence and unrest. More than half of these displaced people were children. Children and adults are more likely to contract measles and die if they are subjected to overcrowding, malnutrition, immunosuppression or poor healthcare systems. The political turmoil throughout the country can cause these factors to become more prevalent and inhibit effective immunizations. Furthermore, the looting and closing of healthcare facilities across the country has stifled the progress made by previous vaccination campaigns.
  4. The government is working with other international organizations to eradicate measles in the Central African Republic. As a response to the recent outbreaks, the Ministry of Health partnered with the World Health Organization to develop specialized courses of action and vaccination campaigns. They have increased epidemiological tracing, communication about the disease’s risks and vaccination and medicine availability. Additionally, the Center for Emergency Operations in Public Health has aided government officials in devising plans for dealing with outbreaks. Another important international program is Gavi, an alliance that promotes free access to vaccinations all over the globe. Gavi has helped the Central African Republic fund measles treatment and follow-up vaccines by donating more than $1 million to the cause. Similarly, USAID has helped in the fight against measles by making financial donations that fund testing and vaccinations.

Although the prevalence of measles in the Central African Republic is serious, the government and other organizations are committed to fighting it. Moving forward, continued efforts are needed to reduce the prevalence of measles in the nation.

– Danielle Kuzel
Photo: Flickr


The recent economic crisis in Lebanon has led to a massive shortage of medical supplies and hospital capacity, worsening an already strained healthcare system. The COVID-19 pandemic is further intensifying the nation’s economic crash and incidents of supply shortages. However, relief programs are stepping in to help improve health conditions in Lebanon.

Causes and Contributing Economic Factors

Lebanon has held substantial debt since the country began accepting aid to recover from its 1975 civil war. On top of this, Syria and the surrounding region experienced turmoil in 2014 that significantly reduced the value of the Lebanese pound relative to the U.S. dollar. This process has been exacerbated by government mismanagement and the decreasing amount of money being sent in payment from the Lebanese diaspora. The country has now racked up debt equal to 170% of its gross domestic product.

As COVID-19 challenges the global economy, the situation is rapidly intensifying. The value of currency in Lebanon has decreased by 78% since October 2019. The main issue facing healthcare in Lebanon results from the country’s lack of U.S. dollars. Depositors are withdrawing their money from Lebanese banks due to fears of further inflation, bank restrictions on withdrawals to curb the crisis and decreased foreign investments as a result of Lebanon’s perceived instability. Since Lebanon imports four-fifths of its consumer goods and depends on U.S. dollars to facilitate these transactions, the country is now facing shortages in all sectors of the economy, including healthcare.

The Current Hospital Crisis and COVID-19

The Lebanese government cannot pay both private and public hospitals using funds like the National Social Security Fund due to its present debt and currency inflation. This financial setback jeopardizes hospitals’ capacities to provide essential surgeries or import medical supplies. Private hospitals make up 82% of all healthcare in Lebanon. The national government only paid private hospitals 40% of what they were meant to receive in 2019, and has yet to fulfill any of its regular payments this year.

Public hospitals have also received a fraction of their regular government aid in recent years. This lack of funding limits hospitals not only from purchasing critical supplies, but also from paying employees. Hospitals are being forced to delay salary payments and even to consider cutting salaries in half. Lebanese hospitals import 100% of their medical equipment and rely on U.S. dollars for these shipments, so the absence of U.S. dollars has created a supply shortage. Since September, the country has imported less than 10% of the supplies it needs.

The recent rise of COVID-19 has not only left hospitals unprepared to meet increased patient demand, but also places immense strain on healthcare in Lebanon as a whole. Hospitals lack appropriate protective gear like masks and gloves, ventilators and spare parts. Furthermore, without the money to pay their employees full salaries or hire new workers, hospitals are finding themselves understaffed amidst the surge of demand precipitated by the pandemic.

Solutions and Relief

Many organizations like the United Nations (UN) have offered aid to help improve healthcare in Lebanon. The Central Bank has also intervened, guaranteeing half of the money withdrawn for imports will be exchanged at the official rate, rather than the inflated rate, in an effort to help hospitals purchase supplies. In March, the World Bank also gave Lebanon a 39 million dollar loan to prepare public hospitals for COVID-19.

The World Health Organization (WHO) and the UN have committed to help Lebanon obtain medical supplies during the pandemic. The Chinese government also shipped medical supplies to Lebanon and pledged to continue providing relief.

Nonprofit groups are working on the ground to address the needs of healthcare workers in Lebanon. Direct Relief, a humanitarian aid organization that addresses poverty worldwide, delivered a shipment of N-95 masks, face shields, gloves and other supplies in May. Direct Relief will continue to cooperate with local organizations to provide essential resources during the pandemic.

The economic crisis in Lebanon has led to a strained healthcare system. COVID-19 has served to exacerbate the already difficult situation. However, acts of global partnership and aid show promise for eventually strengthening the system of healthcare in Lebanon.

Emily Rahhal
Photo: Flickr

End dog rabiesIn 2005, The Global Alliance for Rabies Control (GARC) was formed as its founders noticed a lack of effective programs to control rabies in poorer communities around the world. Since then, the organization has been working to end dog rabies worldwide and, ultimately, the transfer of rabies to humans.

Global Impacts of Rabies

The World Health Organization (WHO) has reported that dog bites cause 99% of rabies cases in humans. According to the WHO, about 59,000 people die yearly from rabies, and approximately 40% of those deaths are children. Many of these children live in poor, rural areas in Asia and Africa. The WHO wrote that the vaccination of dogs combined with dog-bite prevention could eliminate rabies in dogs worldwide.

A 2018 study examined the connections between poverty, rabies knowledge, healthcare and dog ownership. The study looked at data from two specific countries: Uganda and Cameroon. Overall, the study showed a correlation between communities in poverty and fewer dogs being owned. In Uganda, results showed that poorer communities had lower vaccination coverage rates for dogs, meaning fewer dogs were vaccinated. Communities in Cameroon showed a cost-barrier to accessing post-bite care, revealing that poverty can be a roadblock to receiving treatment for dog bites.

Low dog vaccination rates in poorer communities and poverty as a barrier to treatment are not issues unique to Uganda and Cameroon. The GARC reported that poorer communities in general, mostly in Africa and Asia, tend to have less effective programs for controlling rabies.

Solutions

The GARC has been working to end dog rabies worldwide for many years. Recently, they have made steps towards eliminating rabies in dogs and, thereby, the transfer of rabies from dogs to humans. 

  1. World Rabies Day: In 2006, the GARC helped create World Rabies Day to draw attention to dog rabies worldwide and the health issues it poses. The first official World Rabies Day was held in 2007. Boehringer Ingelheim & Merial, one of the top 20 pharmaceutical companies in the world, donated 75,000 rabies vaccinations as a part of World Rabies Day in 2018.  
  2. Rabies education: The GARC helped launch a rabies curriculum in Bohol, a province of the Philippines. Rabies education was officially incorporated into every school in 2009. The program was successful; in 2011, Bohol was declared rabies free
  3. Certification programs: In 2015, the GARC created a free online platform where people around the world could be certified in vaccination and animal handling and earn a Rabies Educator Certification. More than 4,000 people had graduated from the rabies education program by 2018, and 500 of those received a vaccination and animal handling certification. 
  4. Rabies and poverty awareness: In 2015, the GARC published the first study about the effect of rabies on global health and the economic burden it can create. This paved the way for future studies outside of the GARC, such as the 2018 study mentioned above. 
  5. Strategic plans: The GARC helped launch the Global Strategic Plan for Zero by 30 in 2018. The plan’s goal is to completely eliminate human deaths from rabies. The WHO, the Food and Agricultural Organization of the United States, the World Organization for Animal Health and the GARC have all come together to complete the strategic plan by 2030, hence the name Zero by 30. 

According to the GARC and independent studies, rabies has been shown to have a greater impact on those in poor communities. The vast majority of rabies transmission to humans comes from dogs, and the WHO has determined vaccination and the prevention of bites as a potential strategy to eradicating the disease. The GARC has been working to end dog rabies worldwide through awareness, education, studies and strategic plans. While thousands of people contract rabies yearly, the GARC, along with other agencies, are hard at work to decrease the impact of this disease. 

–  Melody Kazel 
Photo: Flickr