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Congenital Anomalies
Worldwide, congenital anomalies cause approximately 295,000 deaths of children within their first 28 days of life. Every year, about 7.9 million children are born with life-threatening defects and 3.3 million children under the age of five5 die from congenital disabilities. According to the World Health Organization (WHO), congenital anomalies are structural or functional aberrations that occur during intrauterine life. The most common congenital disabilities include heart defects, cleft lip (palate), down syndrome and split spine (also known as spina bifida). Although 50% of all congenital disabilities do not have a single definite cause, common causes include genetic mutation, environmental factors and various other risk factors.

Geographic Disparities

Although congenital disabilities are widespread globally, they are particularly prevalent in developing countries. Developing countries account for 94% of worldwide congenital disabilities.

The level of income -both individual and national- in developing countries is a crucial factor that indirectly influences the high incidence of congenital disabilities. Low income affects the incidence of congenital disabilities in developing countries in the following ways:

  • Poor Access to Adequate Maternal Healthcare for Women During Pregnancy: About 99% of the global maternal mortality cases occur in low-income countries due to inadequate maternal care.
  • Poor Maternal Nutritional Condition: Deficiency of vitamin B can, for instance, escalate chances of birthing a baby with neural tube defects.
  • Excessive Prenatal Alcohol Consumption: Pregnant mothers’ consumption of alcohol increases their risks of giving birth to a child with Fetal Alcohol Syndrome (FAS). FAS is a total of the damage – both physical and mental – to an unborn child as a result of their mother’s alcohol consumption.
  • Presence of Other Infections: Some sexually transmitted diseases can transfer from a pregnant mother to her child. For example, syphilis during pregnancy accounts for an estimated 305 000 fetal and neonatal deaths annually. It also jeopardizes 215,000 infant lives due to congenital infections, prematurity or low-birth-weight.

How WHO is Taking Action

The World Health Organization has taken and implemented various measures to fight congenital anomalies. In the 2010 World Health Assembly, WHO took on a resolution encouraging its member states to fight against congenital anomalies by:

  • Raising awareness throughout governments and the public about congenital disabilities and the risk they impose on children’s lives
  • Developing congenital disabilities surveillance systems
  • Providing consistent support to children affected by congenital anomalies
  • Ensuring that children with disabilities have the same rights and equal treatment as children without disabilities
  • Assisting families whose children have congenital disabilities

In addition to the resolution, WHO designed a manual that showed illustrations and photographs of selected birth defects. The manual’s primary purpose was to foster further development of the surveillance system, especially in low-income countries.

The Global Strategy for Women’s and Children’s Health

In 2016, WHO went an extra mile and published the Global Strategy for Women’s, Children’s and Adolescents Health 2016-2030, an updated version of the Global Strategy for Women’s and Children’s Health devised five years prior. The Global Strategy’s grand theme was “Survive, Thrive, Transform.”

  • Survive: “Survive” encompassed various goals that the Global Strategy hoped to accomplish. These include ending preventable deaths, lowering maternal mortality rates and newborn deaths among others.
  • Thrive: The main target was promoting health and wellbeing by responding to the dietary needs of children, adolescents and pregnant & lactating women.
  • Transform: This objective’s primary goal was to create a safe and nurturing environment by terminating extreme poverty. Poverty one of the leading causes of congenital disabilities.

Results

Over the years, the World Health Organization’s relentless efforts in battling against congenital disabilities have made remarkable progress in alleviating the issue. For instance, the number of newborn deaths has plummeted from 5 million to 2.4 million between 1990 and 2019, thanks to the various innovations and programs put in place. Although the current state of affairs is far from ideal, past accomplishments lay the groundwork and identify clear steps for future progress.

Mbabazi Divine
Photo: Flickr

Poverty and Heart Disease
Heart disease has a reputation as a “first-world problem,” the inevitable result of a fatty diet and little to no exercise. Despite this common correlation, the link between poverty and heart disease is becoming increasingly visible. As of 2015, 80% of global deaths from cardiovascular disease were in low to middle-income countries (LMIC). According to The World Health Organization, 37% of premature deaths (<70 years old) in LMIC’s caused by non-communicable diseases are attributable to cardiovascular disease.

Heart Disease and Poverty

Prior to 1990, most deaths in LMIC’s were caused by communicable diseases like HIV, malaria and ebola, or complications from malnutrition. As urban areas grow in developing nations, lower physical activity and access to mass-produced and nutritionally-poor food contribute to the rise in heart disease-related deaths.

Heart disease is often the result of atherosclerosis, a build-up of plaque in the arteries of the cardiovascular system, or thickening that narrows the space for blood to flow. Heart attacks, stroke, arrhythmias and physiological deformities of the heart result from these blockages and can be fatal.

Major factors leading to heart disease include a poor diet, tobacco use, high blood pressure and high blood sugar. Additionally, a lack of diagnostic tools in LMIC may contribute to increased mortality from cardiovascular disease. A delayed diagnosis can result in irreparable cumulative damage and adverse cardiovascular events. Similarly, distributing affordable medications for managing heart disease in LMIC’s (ACE inhibitors, statins, beta-channel blockers and aspirin) is an ongoing challenge.

Non-communicable diseases like heart disease are often contributing factors to continued or extreme poverty due to lost wages, incapacitation and the generational effects of losing caregivers and wage earners. Patients in LMIC’s who survive heart attacks and strokes may need years of costly follow-up care and medication. The increases the likelihood that the dual burden of poverty and heart disease will prove fatal.

A New Baseline

Establishing effective preventative care in LMIC’s is one of the biggest obstacles to reducing cardiovascular disease. Lifestyle changes such as smoking cessation, dietary guidance and increased exercise can make a significant difference. Health professionals should recommend these changes to those screened as at-risk or suffering from high blood pressure.

The World Health Organization (WHO) has programs designed to treat and prevent cardiovascular disease globally. The WHO launched the Global Hearts Initiative in 2016 to provide support to governments in their efforts to prevent heart disease. The approach is multi-faceted and includes improvements to the health care sector, the nutritional quality of food and more.

The World Heart Federation (WHF) is an NGO focused on global cardiovascular care and outreach. Founded in 1978, it is internationally recognized as an authority on preventing, treating and diagnosing cardiovascular disease in children. The WHF provides training and networking opportunities to public health officials and caregivers worldwide, emphasizing practical methods of prevention and treatment.

Moving forward into a world where most people live in cities, vital infrastructure and basic medical services are necessary to improve the quality of life in developing nations and impoverished communities globally. Combating the rising incidence of heart disease is a major battle inequitably affecting the world’s poor. Cardiovascular screening, patient education and dietary guidance are all important steps in the right direction.

Katrina Hall
Photo: Flickr

Electrifying Transportation
The World Health Organization (WHO) has recorded seven million premature deaths globally as a result of elevated levels of air pollution. In 2016, the WHO reported that 91% of the world’s population reside in areas that did not meet the threshold for acceptable air quality. Such conditions escalate the effects of and increase mortality from strokes, cardiovascular disease, respiratory disease and infections, cancer and chronic obstructive pulmonary disease. In 2010, the World Bank along with the Institute for Health Metrics and Evaluation reported that over 180,000 deaths and 4,100,000 disability life adjusted years of healthy life lost were directly attributable to road transport air pollution. Also, when declaring the ‘best practice group’ for policy handling of air pollution, the list consisted mainly of high-income countries that can afford preventative measures like electrifying transportation.

Air Quality and Poverty

The WHO reports that low-and middle-income countries suffer the highest effects from elevated exposure to harmful air pollutants. In fact, the majority of the world’s cities with the highest Air Quality Indices (AQI) are found in developing nations. These countries typically do not have adequate laws or enforcement to protect against air pollution. They tend to contain a higher prevalence of coal power stations, and less stringent restrictions on vehicle emissions.

Further, developing nations experience great disparity in the effects of air pollution and the burden typically falls on the countries’ poorest populations.  The reason being, the poor usually reside in highly concentrated areas with dense harmful emissions. This is due to their exclusion from suburban areas where there are fewer pollutant generating spaces.

Despite air pollution challenges, clean air has been deemed a human right and is covered under the United Nations (UN) Sustainable Development Goals. In order to improve air quality, amongst others, one of the UN’s main suggestions has been to adopt clean and renewable energy and technologies.

Electrifying Transportation

The emission from our current fuel and diesel-powered traditional transportation systems consisting of fossil fuel-powered cars, trucks and buses have been found to generate pollutants that have adverse effects on every organ in the human body. It is also responsible for approximately half of all the nitrogen oxides in our air and is amongst one of the greatest sources of green-house gases. Given the large contribution or main-stream fuel and diesel vehicles make to air pollution, electrifying transportation systems is anticipated to be one of the most effective, shorter-term solutions to air pollution, and thus lifting some of the burdens on poor and vulnerable populations.

One of the main advancements in renewable technology has been the use of electric vehicles. One estimate finds that with the widespread accelerated adoption of clean transportation through the electrification of vehicles and fuel, an approximated 25 million aggregate years of life would be saved by 2030. Included in this figure is at least 210,000 reduction in premature deaths in 2030 alone. These gains would primarily occur in China, India, the Middle East, Africa and developing Asia, all locations with amongst the highest rates of poverty.

So far, there are three classes of electric vehicles:

1.       E4W – Electric four wheelers

2.       E2W – Electric two-wheelers

3.       HEV – Hybrid electric vehicles.

Access in Developing Countries

One of the main barriers to electrifying transportation in developing nations is the fact that Electric Vehicles (EVs) are typically more expensive than traditional fuel and diesel-powered vehicles. However, switching to EVs can prompt savings. Developing nations exist on a spectrum of development. For those with public transportation systems, working police and emergency health care fleets, the governmental investment in the transition towards electric vehicles and trucks would not only help to improve the air quality in the respective nations but would also prove to be cheaper and more sustainable in the long run. Of the available classes of electric transport options, the E2Ws would be most beneficial in developing nations. This is because E2Ws have the lowest energy consumption rating. Unlike E4Ws, the E2W class’ of EV ability to be charged via regular home outlet means that there are no substantial charging infrastructure investment requirements.

In terms of operational costs, all classes of EVs were found to have lower operational costs than their corresponding fuel vehicles. However, the E2W class was found to have benefits ranging from 24% less, up to eight times less of an operating cost than their corresponding fuel-based transportation. Many developing nations might not yet be in a position to invest in and benefit from the E4W or HEV EV classes due to its high initial investment and required charging infrastructure investments. The E2W class by contrast has been found to be a feasible investment for electrifying transportation for poverty reduction. Not only will this contribute to a significant reduction in air pollution, lightening its burden on the poorer populations, but it will also prompt savings for governments and stimulate economic growth. Additionally, as investments in EVs continue to rise, the initial purchase prices will fall and so developing countries might be able to afford higher classes.

Rebecca Harris

Photo: Flickr

Addressing migrant and Refugee HealthAt the end of 2019, there were 79.5 million recorded forcibly displaced people in the world, with 26 million labeled as refugees. Roughly 68% of those displaced come from just five countries, which means that resources can be scarce for many of these people and their physical and mental health may become less of a priority in lieu of other needs. More focus needs to go toward addressing migrant and refugee health in order to protect the well-being of one of the most vulnerable populations.

7 Facts About Migrant and Refugee Health

  1. The Immigrant, Refugee and Migrant Health Branch (IRMH) is a branch of the Division of Global Migration and Quarantine that works to improve the health and well-being of refugees. The IRMH also provides guidelines for disease prevention and tracks cases around the globe in migrant populations. The organization has three teams and five programs that work both in the U.S. and around the world to combat infectious diseases.
  2. Refugees are affected by illness and health issues through transit and in their host communities. Most refugees are likely to be in good health in general, according to the CDC, but migrating tends to be a social determinant in refugee health. Health inequities are increased by conditions such as restrictive policies, economic hardship and anti-migrant views. Poor living conditions and changes in lifestyle also play a role.

  3. Refugee health profiles are compiled through multiple organizations to provide information about important cultural and health factors pertaining to specific regions. Refugees from different areas often have very different health concerns. For example, anemia and diabetes are priority conditions in Syrian refugees but parasitic infections and malaria are the focus for Congolese migrants.

  4. About one-third of migrants and refugees experience high rates of depression, anxiety and post-traumatic stress disorders. Mental health is a vital part of all refugee health programs and the priority for youth mental health programming is especially necessary. Forced displacement is traumatic and while there is likely a reduction of high anxiety or depression levels over time after resettlement, some cases can last for years.

  5. Healthcare is often restricted based on legal status within refugee populations. The 1946 Constitution of the World Health Organization articulated that the right to health is an essential component of human rights but many people are limited to claiming this right. Activists for refugee health along with many NGOs call for universal health care and protection for migrant populations.

  6. Important needs in refugee health include the quality and cost of disease screenings. HIV, hepatitis, schistosomiasis and strongyloidiasis are diseases that are prevalent among vulnerable refugee and migrant populations. However, ease and quality of medical screenings are not guaranteed in many centers or camps.

  7. Mothers and children face many barriers due to their unique needs and few refugee health care providers are able to properly address them. There is an increased need for reproductive health services and many of the barriers provide more difficulty than aid to many women. These include language, costs and general stigma.

Prioritizing Vulnerable Populations

The U.N. Refugee Agency (UNHCR) is well known for its work to safeguard the rights and well-being of people who have been forced to flee. Refugee International is another organization that advocates for the rights and protection of displaced people around the world. Awareness of refugee health facts and concerns enables organizations to take a direct stance on improving conditions and procedures. With the growing number of refugees around the world today, addressing migrant and refugee health must be prioritized in order to better protect these vulnerable populations.

– Savannah Gardner
Photo: Flickr

Goldie HawnFor over 16 years, The Goldie Hawn Foundation, through its MindUp program, has been teaching children how to effectively manage stress, regulate emotions and face challenges head-on with positive mechanisms. MindUp has recently revealed a free service that families can access at any time. For instance, short, five-minute exercises teach daily gratitude. The audio exercises are “designed to help children regulate emotions and increase overall wellbeing through positive psychology, mindful awareness and social-emotional learning.” To increase accessibility, programs are available in most languages.

What is The Goldie Hawn Foundation and MindUP?

The MindUP program partners with The Goldie Hawn Foundation, established in 2003 to encourage mindfulness practices among children. This foundation works directly with neuroscientists to establish boundaries and promote brain development. Goldie Hawn comments, “we’ve demonstrated that if students take two minutes for a brain break three times a day, optimism in the classroom goes up almost 80%. On the playground, aggression goes down about 30%.” Moreover, different exercises within the curriculum offer suggestions on how to manage emotions and behavior. For example, one exercise is labeled as a gratitude circle. Hawn describes this activity as “where kids go around saying what they’re thankful for.” This allows children to feel like they are in a safe space where they can adequately show their emotions.

The Goldie Hawn Foundation Helps Families Despite Difficult Circumstances

Unfortunately, the pandemic has closed many schools across the world, putting many families in vulnerable and stressful situations. Parents that work full-time jobs simply don’t have time to homeschool their children. Online school is seemingly impossible for younger kids who can’t seem to sit still. The World Health Organization has reported that “more children are struggling with concentration and nervousness amid lifestyle changes during the COVID-19 pandemic.”

Mindfulness helps combat this restlessness. MindUP has partnered with Insight Timer, the world’s largest free meditation app, to provide free audio and visual exercises that teach daily gratitude. Recognition by the Collaborative for Academic, Social and Emotional Learning (CASEL) has given these short but highly effective exercises a platform to continue mindfulness teachings. Children learn techniques to improve focus, develop empathy and encourage relationship-building through optimism, resilience and compassion. These lessons are available in an array of languages to encourage participation around the world.

Experimental Learning Leads to Success

A 2015 study analyzed MindUP by measuring the effective nature of mindfulness within schools. A random assessment was conducted on a group of 100 fourth and fifth graders within a public school district of Canada. Half received the mindfulness program, while the other half maintained their regular program. The two groups were compared subsequently. Focus on upper elementary school children in this study was one of the main components. This is because “it is during this developmental period that children’s personalities, behaviors, and competencies begin to consolidate into forms that persist into adolescence and adulthood.”

Findings concluded that mindfulness does, in fact, work in favor of effective teaching styles and promotes valuable lessons that ought to be learned. Similarly, this may lead to increased social and emotional competence among elementary students. Benefits would result from adding mindfulness practices to any regular school curriculum.

Quotes from Goldie Hawn

  1. I’ve learned to manage the fear and pain. It’s not easy, but with a few life tools, you can control the monkey mind. I’d say it’s my life’s mission.”

  2. “I’ve meditated since the 1970s, but now I really see the results. People talk about how the brain weakens as it ages. Mine feels stronger. Meditation thickens the cortex, where we make decisions, analyze, feel more connected to others and dream.”

  3. “If you supplant each negative thought with three positive ones, you begin to restructure your brain. Research has proven that this practice can lift people out of depression. That’s a powerful force.”

  4. “Slow down. Enjoy this ride. It’s all we’ve got.”

Natalie Whitmeyer
Photo: Flickr

Child Poverty in Lebanon
Conflict has impacted Lebanon over the past few decades, including civil war, revolution and occupation. As a result, many children in Lebanon grow up and live in harsh conditions. Here are five things to know about child poverty in Lebanon.

5 Facts About Child Poverty in Lebanon

  1. Poverty by the Numbers: There is severe inequality in Lebanon as 5-10% of the population receives more than half of the total national income. Around 25-30% of Lebanese people live in poverty. Refugees and other populations face an even higher rate of poverty. For all of these groups, families with children are more likely to live in poverty. Current estimates say 1.4 million children in Lebanon are living in poverty. This affects their ability to receive an education, adequate nutrition and water and future standard of living and employment.
  2. Education: An estimated 10% of children in Lebanon do not attend school. The schools that do exist are low quality in both education and the physical state of the buildings. The poor education in Lebanon causes less young people to acquire jobs in technical or competitive fields. Armed and violent conflicts in Lebanon have also damaged school buildings. Furthermore, children’s access to education is hindered by the 1925 Nationality Law, in which only children with Lebanese fathers receive citizenship. If a child’s only parent is their mother or the father is not Lebanese, public schools will not admit them until all other Lebanese children are enrolled.
  3. Child Labor: Lebanon has lower rates of child labor than many of the surrounding countries, but still 7% of children work. Many of these children work to support their families, though their salaries are often low. Boys often work in factories or agriculture which have inhumane and very harsh working conditions. Lebanon has signed on to the ILO’s Convention on Child Labor, but this has not decreased child labor.
  4. Refugee Children: Lebanon has a very high number of refugees living inside its borders because of its geographical location. These refugees come from Iraq, Syrian, Palestine and more. The majority of refugees live in extreme poverty. Refugee children often work in poor conditions to make money. Many also suffer from mental health problems due to their trauma. In refugee camps, children face many dangers, including domestic violence, drug use and minimal health care and basic hygiene. Lebanon has not ratified the U.N. Convention Relating to the Status of Refugees, and does little to protect these people living inside the country. The country also lacks the resources to address children’s mental health problems, but NGOs are working to provide more medical help inside the refugee camps.
  5. Reducing Child Poverty: The Government of Lebanon launched the National Poverty Targeting Program in 2011. The World Bank provided technical and financial assistance to this program to provide a safety net for families living in extreme poverty. Families are chosen based on level of food security, labor force status and other variables. This program currently helps 43,000 households, although more than 150,000 families are in extreme poverty and more than 350,000 qualify are in poverty. The families benefiting from the program receive a “Hayat Card,” which gives them access to free health care and educational services, and the poorest receive a debit card for food.

Children in Lebanon are still heavily affected by poverty, whether it is through health care, education or labor. Refugee children and girls are particularly vulnerable as they lack basic rights under law. Although strides have been made in recent years to eradicate poverty, the government and other organizations must prioritize addressing child poverty in Lebanon.

Claire Brady
Photo: Flickr

India's AIDS EpidemicIndia is the most populous country on the planet and one of the most densely populated countries. With over 1.38 billion densely packed people, diseases spread quickly and HIV/AIDS is no exception. Although only 0.2% of adults have HIV/AIDS, this equates to roughly 2.4 million people, a total far higher than any other country in Asia. For this reason, many new programs have started. Although their tactics differ, each program works to fight India’s AIDS epidemic.

Causes of the Epidemic

The causes of India’s HIV Epidemic stem from multiple, diverse issues. Two primary causes include the practice of unprotected sex between sex workers and the injection of drugs using infected needles. These two practices are most common among vulnerable populations such as low-income communities. Thus, India’s AIDS epidemic is centered in select regions; although only a small percentage of the total population has HIV, this number is high in certain regions, and extra precautions are necessary for prevention in these areas.

Despite these overwhelming statistical figures, recent research has provided optimistic results. The number of HIV infections per year decreased by 57% between 2000 and 2011, and the annual deaths from AIDS decreased by 29% from 2007 to 2011. Bold government programs inspired by independent research instilled this change within the Indian population. The programs’ success stems from a variety of HIV treatments and from education, challenging the stigma and misconceptions about the disease.

Methods of Success

One of India’s renowned HIV treatment methods is the Antiretroviral Therapy program, known as ART. ART is the provision of supplements and antiviral drugs for citizens infected with HIV. In 2004, the Indian government sponsored the program, striving to place 100,000 infected Indians on the program by 2007. This program likely played a major role in the steep decline in HIV-related deaths from 2007-2011.

Noticing the success of the ART initiative, the Indian government took a further step in 2017 by initiating the World Health Organization’s Treat All policy; this policy focuses on making the ART program accessible to all disadvantaged Indians. The Treat All policy increased the number of new monthly joiners by several hundred.

Along with these programs, the Indian government has sponsored adolescent education programs centered on preventing the spread of HIV; they aim to end the negative stigma towards the disease and those infected. These programs also provide basic sex education. Studies on these programs have shown extraordinary results; samples of students understand essential facts about the disease such as how it spreads and the current lack of a cure. Although direct government intervention is vital, ending India’s AIDS epidemic starts with educating the youth.

Plans for the Future

With such a large number of people carrying the disease, managing HIV in India is no small task. Although the aforementioned methods have shown optimistic results, the involvement of local communities, governments, and NGOs is essential to maintaining the trend. When discussing diseases such as HIV, the intervention of international bodies cannot maintain the health of individual citizens; ending India’s AIDS epidemic is ultimately the responsibility of Indians, and these new programs enable them to do so.

Joe Clark
Photo: Flickr

Childhood Pneumonia
One of the most common diseases globally, pneumonia can be a silent killer when it infects children under 5. In the developing world, rates of childhood pneumonia cases and deaths are still high despite decreasing in other childhood diseases. However, due to new research and outreach programs to aid developing countries, those numbers may soon fall.

10 Facts About Childhood Pneumonia

  1. Various sources cause the disease. Unlike many other diseases that come from a single source, pneumonia is the name for the lungs’ acute response to an airborne pathogen. While pneumonia can develop from bacteria, viruses or fungi, the most common cause for children is the bacteria S. pneumoniae. The bacteria typically live in the lungs without harming the body, but the body develops pneumonia to kill the bacteria when it begins to spread.
  2. Childhood pneumonia mainly infects children under the age of 5. While people of all ages can develop pneumonia, children under the age of 5 are especially susceptible to the infection. Since their immune systems are not fully developed, their bodies are more likely to trigger a response to a foreign agent’s presence in the respiratory system, leading to pneumonia. These infection rates only increase in developing countries, where children are more likely to be born either malnourished or with a disease that they acquired in utero such as HIV.
  3. Pneumonia is a leading cause of death in children. Although pneumonia is often easy to treat and cure in developed countries, it can be fatal in developing countries. According to the United Nation’s Children’s Fund (UNICEF), childhood pneumonia kills over 800,000 children each year in comparison to 437,000 from diarrhea and 272,000 from malaria. These deaths are typically in children who are malnourished or have other conditions such as HIV that impair the immune system.
  4. South Asia has the greatest incidence of childhood pneumonia. Out of every 100,000 children in South Asia, approximately 25,000 will develop pneumonia each year. However, the majority of these cases — approximately 36% — occur in India. Studies looking into the potential causes for the increased number of cases have found that overcrowding in housing with inadequate ventilation allowed the disease to spread among families. Without effective airflow, children in those households continue to breathe in potentially infected air, increasing their chances of developing pneumonia.
  5. Air pollution increases pneumonia rates. Although a child needs to have exposure to the biological cause of pneumonia to develop the disease, certain environmental factors can increase infection likelihood. In India, a country with one of the worst-rated air qualities in the world, particles of smoke and other forms of pollution in the air weaken lungs when inhaled, making it more likely for a young child to develop pneumonia. These conditions of outdoor air pollution causes approximately 17.5% of all pneumonia deaths in the developing world.
  6. The disease is treatable. With antibiotics or antifungals (depending on the cause), children with pneumonia can recover from the disease. However, this treatment is dependent on the resources available in the country where the child lives. In developing countries such as Nigeria — the African country with the highest pneumonia rates in children — only one in three children with pneumonia symptoms can receive treatment due to the lack of available medicines and other medical resources.
  7. Some are producing vaccines. Although vaccines cannot treat viral pneumonia, they are still an important asset in preventing it. However, most of the produced vaccines are only available in developed countries where doctors recommend them for children under 5. In developing countries, nearly 10 million children are unvaccinated. Through the World Health Organization (WHO), many countries have received vaccines, although there has been great variation between regions of the world. While WHO’s South-East Asian Region has 89% coverage, its Western Pacific region only has 24% coverage.
  8. Less progress has occurred regarding childhood pneumonia. While research on pneumonia as a whole has increased over the past decade, there has been much less progress on childhood pneumonia in comparison to other childhood diseases. Since 2000, deaths for those under 5 from pneumonia have decreased by 54%, while deaths from diarrhea have decreased by 64% and are currently half the number of childhood pneumonia deaths.
  9. Large organizations are helping. Among other large, international organizations, the Gates Foundation has taken efforts to reduce childhood pneumonia rates in developing countries. One of its main methods is the continued distribution of vaccines to children and families in South Asian and Sub-Saharan Africa, specifically India and Nigeria. So far, the organization has sent vaccines to over 37 countries in those regions of the world, slowing transmission and infection rates in those areas.
  10. Rates will continue to drop in the future. Although the number of childhood pneumonia cases each year have not dropped as much as other diseases, long-term progress is still ongoing. If the current level of progress toward eradicating the disease continues, UNICEF predicts that it will save 5.9 million children. At the same time, if resources towards the effort increase, that number will increase to nearly 10 million.

UNICEF and WHO do not expect to meet their goal of eradicating childhood pneumonia until 2030. However, the progress they and many others are currently initiating is making a difference. Soon, pneumonia will become an extinct disease in the developing world so that it will never harm another child.

Sarah Licht
Photo: Flickr

Healthcare in Bangladesh
Healthcare in Bangladesh is not as sophisticated as in more developed countries; however, the country is working to improve and provide further funding to its healthcare system. So far Bangladesh has made great strides in increasing healthcare access for its people, but there is still a long way to go. Here are seven important facts about healthcare in Bangladesh.

7 Facts About Healthcare in Bangladesh

  1. Bangladesh has a pluralistic healthcare system. This healthcare system is highly decentralized. As a result, it is regulated and controlled by for-profit companies, NGOs, the national government and international welfare organizations. This shared power has caused many problems, including unequal treatment programs between social classes. Even though the laws and overall system are spearheaded and steered by the Ministry of Health and Family Welfare, other organizations have considerable influence on the decision-making.
  2. There is a shortage of physicians, specialists and clinical equipment. In Bangladesh, the number of physicians per 10,000 people is only about 3.06, which is significantly low. The number of nurses per 10,000 people is even lower, standing at 1.07. Additionally, only 35% of health and clinical facilities in the country have more than 75% of sanctioned staff working and there is a 36% vacancy in sanctioned healthcare workers. There is also a 50% vacancy in alternative medicine providers. These numbers are one of the reasons that Bangladesh’s quality of healthcare is low compared to many other Asian countries.
  3. Non-communicable diseases are the leading cause of death in Bangladesh. Most deaths are caused by cardiovascular diseases, cancers, diabetes, chronic respiratory diseases and malnutrition. There are almost no alcohol-related deaths due to alcohol consumption and sale being illegal in the country. A 2016 study by the World Health Organization (WHO) found that tobacco usage has decreased for both men and women, with only 23% of the population using tobacco products. Obesity has remained low, rising slightly, but still only affected 2% of adolescents and 3% of the adult population. However, poor nutrition is still prevalent, leading to diabetes and high blood pressure.
  4. Most physicians and healthcare workers are concentrated in urban areas. Rural areas often do not have proper healthcare facilities. To remedy this, the national government has set up many government-funded hospitals in rural areas that provide cheaper treatment for rural citizens. However, these hospitals are often poorly funded, understaffed and overly crowded due to a limited number of healthcare options in rural areas.
  5. Enrollment in medical colleges and healthcare training facilities has increased. This will benefit the country by increasing the number of healthcare workers in proportion to the population. However, this is only a recent trend and these future healthcare workers must complete their education and training before being able to fully practice their professions. The HPNSDP (Health, Population and Nutrition Sector Development Program) have already begun drafting and implementing a plan to further increase the number of nurses and midwives through training and education facilities.
  6. Socioeconomic inequality affects healthcare in Bangladesh. One area this can be seen in is infant mortality. The infant mortality rate for the lowest income quintile is 35 deaths per 1000 births, while infant mortality for the highest income quintile is only 14 deaths per 1000 births. One of the main reasons for this inequality is that most poor Bangladeshis live in rural areas that do not have adequate hospital facilities. However, even in urban areas, socioeconomic inequality has a large impact. A person with more money is generally able to receive better healthcare than someone who is poorer and cannot afford certain treatments or services. This is due to the fact that the healthcare system is decentralized and partially run by for-profit healthcare and pharmaceutical companies.
  7. Limited government funding has led to high out-of-pocket payments. One of the other reasons poorer citizens in Bangladesh cannot afford certain treatments or services is high out-of-pocket costs. On average, Bangladeshi citizens must pay 63.3% of the total cost, while the government pays the rest. This system creates a significant financial burden for impoverished families, sometimes forcing them to either forego treatment or go into debt. To reduce this burden, the government must increase healthcare funding.

These seven facts about healthcare in Bangladesh illustrate some of the barriers that Bangladesh must overcome to provide high-quality healthcare across the nation. The Bangladeshi Government’s constitution upholds that all citizens will be provided with equal treatment, including in healthcare. To achieve this, the government needs to address the current inequality and continue to make healthcare a focus of its efforts.

Sadat Tashin
Photo: Flickr

covid-19 in africa

On a world map of the distribution of COVID-19 cases, the situation looks pretty optimistic for Africa. While parts of Europe, Asia and the United States have a dark color, indicating relatively high infection rates, most African countries are light in comparison. This has created uncertainty over whether the impact of COVID-19 in Africa is as severe as other continents.

Lack of Testing

A closer look at the areas boasting lighter colors reveals that the situation in Africa is just as obscure as the faded shades that color its countries. In Africa, dark colors indicating high infection rates only mark cities and urban locationsoften the only places where testing is available.

Although insufficient testing has been a problem for countries all over the world, testing numbers are strikingly low in Africa. The U.S. completes 249 tests per 100,000 people per day. In contrast, Nigeria, Africa’s most populous country, only executes one test per 100,000 people daily. While 6.92% of tests come back positive in the United States, 15.85% are positive in Nigeria. Importantly, Nigeria is one of the best African countries for testing: it carried out 80% of the total number of tests in Africa.

As a continent housing 1.2 billion individuals of the world’s population, Africa is struggling to quantify the impact of COVID-19 without additional testing. To improve these circumstances, the African CDC has set a goal of increasing testing by 1% per month. Realizing the impossibility of reliable testing, countries like Uganda have managed to slow the virus’ spread by imposing strict lockdown measures. As a result, the percentage of positive cases in Uganda was only 0.78% as of Sept. 1, 2020.

A Young Population

COVID-19 in Africa has had a lower fatality rate than any other continent. In fact, many speculate that fatality rates may even be lower than reported. Immunologists in Malawi found that 12% of asymptomatic healthcare workers had the virus at some point. The researchers compared their data with other countries and estimated that death rates were eight times lower than expected.

The most likely reason for the low fatality rate in Africa is its young population. Only 3% of Africans are above 65, compared with 6% in South Asia and 17% in Europe. Researchers are investigating other explanations such as possible immunity to certain variations of the SARS-CoV-2 virus and higher vitamin D levels due to greater sunlight exposure.

Weak Healthcare Systems

Despite these factors, the impact of COVID-19 in Africa is likely high. Under-reporting and under-equipped hospitals unprepared to handle surges in cases may contribute to unreliable figures. In South Sudan, there were only four ventilators and 24 ICU beds for a population of 12 million. Accounting for 23% of the world’s diseases and only 1% of global public health expenditure, Africa’s healthcare system was already strained.

Healthcare workers are at the highest risk of infection in every country. In Africa, the shortage of masks and other equipment increases the infection rate among healthcare workers even further. Africa also has the lowest physician-to-patient ratio in the world. As it can take weeks to recover from COVID-19, the infection and subsequent recovery times for healthcare workers imply that fewer are available to work. Thus, COVID-19 in Africa further exacerbates its healthcare shortage.

Additionally, individuals who are at-risk or uninsured can rarely afford life-saving treatment in Africa. For example, a drug called remdesivir showed promising results in treating COVID-19. However, the cost of treatment with remdesivir is $3120. While this is a manageable price for insurance-covered Americans, it is not affordable for the majority of Africans. Poverty therefore has the potential to increase the severity of COVID-19 in Africa.

Economic and Psychological Factors

Strict lockdowns have helped some nations control the spread of COVID-19 in Africa, but at a heavy price. A general lack of technology means that, following widespread school shutdowns, students have stopped learning. Many adults have also lost their jobs. More than 3 million South Africans have become unemployed due to the lockdown.

Furthermore, the lockdowns have also resulted in much higher rates of domestic violence, abuse and child marriage. Many such cases are unreported, meaning that the real scope of the problem is probably larger. Mental health services for victims or those struggling through the pandemic are also often unavailable. In Kenya, the United Nations has appealed for $4 million to support those affected by gender-based violence.

The slow spread of COVID-19 in Africa has allowed the continent and its leaders to prepare. Importantly, its young population will lessen the severity of the virus’ impact. Although these circumstances provide reasons to be hopeful, there is no doubt that Africa’s economy and future will suffer from the virus. This potential highlights the need for foreign assistance not only in controlling COVID-19 in Africa but in the continent’s recovery for years to come.

– Beti Sharew
Photo: Flickr