Posts

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

Vaccines in Developing CountriesHow much can the world really rely on vaccines as a cure to disease? For many impoverished communities, the jury is still out; many recent studies show that vaccines in developing countries are more ineffective than those in developed, high-income nations.

However, developing countries are at greater risk for all infectious diseases than developed countries. The World Health Organization (WHO) documented that the “total number of healthy life years lost per capita was 15-times higher in developing countries than in developed countries.” In addition to this imbalance, vaccines in developing countries also threaten these nations with ineffective treatment. Due to the many factors that impact disease, it is difficult to pinpoint specific causes behind vaccine acceptance or denial. However, the health effects of poverty contribute to the reasons why vaccines in developing countries are often ineffective.

How Poverty Increases Sickness

Poverty is a health epidemic. In 2008, PBS aired an original docu-series called “Unnatural Causes” that outlined the ways diseases disproportionately affect poor and marginalized groups. The show posed one overarching, famous question: “Is inequality making us sick?” In the assessment of vaccine effectiveness in rich versus poor countries, the creators of “Unnatural Causes” say the answer is yes.

A functioning immune system is largely responsible for an individual’s ability to make antibodies, the infection-fighting proteins developed via vaccines. Impoverished people often do not have high-functioning immune systems. This means that they cannot produce antibodies as well as their developed-nation counterparts.

Multiple factors contribute to the prevalence of ineffective immune systems in developing countries. The overpopulation and crowding common in low socioeconomic areas increase the risk of disease exposure. Pre-existing health conditions, resulting from vitamin deficiency and little clean water or sanitation, increase individual susceptibility to sickness. Further, unreliable health care places systemic, structural constraints on impoverished communities. In this way, poverty and disease continually reinforce each others’ negative effects.

Comparison Studies: Developed Nations vs. Developing Nations

Water-borne diseases, malaria, tuberculosis and HIV/AIDS continually afflict developing countries. They may be responsible for damaging people’s natural immunity, thus decreasing the likelihood of vaccine acceptance. Indeed, one study found that these diseases “may damage lymph node structures that are crucial to developing immunity after a vaccine.”

This study from the University of Minnesota compared Americans to Ugandans. Researchers discovered all the Ugandans had “significantly higher levels of inflammation in their bodies and a depleted supply of protective T cells.” In addition, the Ugandan’s lymph nodes (which help filter infections and respond to vaccines) were inflamed and scarred. None of the American participants had these issues. After administering a yellow fever vaccine to the Ugandan test subjects, researchers discovered a positive correlation. The more damaged their lymph nodes, the less likely it was for antibodies to form.

Another series of studies in Dhaka, Bangladesh discovered that a poor response to vaccines in developing countries could be correlated to the small intestinal bacteria endemic to low-income countries. Petri’s team surmised that “inflammation [in the intestine] could prevent vaccines from lingering in the gut and could keep the immune system from reacting to them.” The team also identified a similar issue with rotavirus vaccine response. In contrast, 98% of children in the developed world do not have complications after vaccination.

The Future of Vaccines

According to the World Bank, “nearly half of the world lives on less than $5.50 a day.” In addition, only 59 of the 195 countries in the world possess a Human Development Index (HDI) at or above 0.8, making them developed countries. This means that ineffective vaccination responses affect the majority of the world’s nations. Thus, the world needs a systemic change in public health to fix this issue. Studies in Bangladesh and Africa “are testing whether sanitation interventions such as installing hand-washing stations in rural homes” can relieve the gut inflammation thought to be causing poor responses to vaccination.

However, even though vaccines in developing countries are sometimes ineffective, routine vaccination for infants and children may help. Young children are less likely to have the long-term health effects responsible for ineffective responses to vaccines, with the exception of illnesses inherited from a mother’s womb. WHO estimates that approximately 70% of the 9 million deaths from children under five “could be prevented or treated with access to simple, affordable interventions,” including vaccines.

Vaccinating Children in Developing Countries

Still, the complicated relationship to vaccines in the developing world is palpable. One study in India found that there is only a 55% rotavirus vaccine efficacy rate in young children. However, India’s plan to make the rotavirus vaccination routine may “save 27,000 of the 78,000 young lives that infections claim every year.”

Thus, expanding coverage of vaccines in developing countries has proven successful in many cases. Various programs work to extend this success. Since 1990, WHO’s Expanded Programme on Immunization has helped decrease mortality rates among infants and children via vaccination. The Global Vaccine Alliance has also “vaccinated more than half a billion additional children since its founding in 2000,” often in developing countries. While routine vaccination is not a panacea, it helps prevent disease before long-term health issues develop.

Improving World Health

Obviously, this is a hefty challenge. Changing human response to vaccines will take years of improving sanitation and living conditions. In addition, developed countries often receive vaccines first and in larger quantities due to having more money. In the meantime, scientists and doctors are experimenting with speedier methods to the vaccine problem. Take mesalazine, a drug that treats the bowel inflammation preventing antibody response to vaccines. This drug could possibly treat unreliable oral vaccines for stomach illnesses. Recognizing the issue of vaccines in developing countries is the first steps in improving global health.

Grace Ganz
Photo: Flickr

improving food security in AfricaA severe food deficit plagues the African continent, as 20% of its inhabitants do not have enough food. To create a more sustainable, livable future for Africans, there needs to be a serious effort dedicated to improving food security in Africa. Agriculture’s significance for the African economy creates an excellent opportunity to help the economy while increasing the food supply with new technological advancements. Here is how ZeroFly Bags are improving food security in Africa.

Understanding Post-Harvest Loss

Recent efforts geared toward improving food security in Africa have revealed the key causes of food insecurity. In Kenya, perhaps most alarming is the country’s high rate of post-harvest food loss. While food waste refers to edible food that is thrown away, food loss refers to food that is not even edible for human consumption. In Kenya alone, 20% of grain cereals are lost after harvest. Specifically an estimated 12% of maize ends up as post-harvest loss. This is an astounding figure for a region that relies heavily on agriculture as a primary food source.

Furthermore, Kenya is a model for other countries in the region, which exposes the depth of food insecurity in Africa. While Kenya has begun to address this issue, post-harvest food loss still contributes to food insecurity throughout sub-Saharan Africa. Thirty-three million smallholder farms are responsible for producing up to 90% of the food supply in some Sub-Saharan African countries. Despite these millions of farmers, however, post-harvest losses lead to severe food shortages. While grain loss can equal up to 20% of supply, up to half of fruits and vegetables do not even make it to the marketplace.

Improving Food Security in Africa by Overcoming Food Loss

Post-harvest food losses result from a lack of food safety measures, inadequate sanitation and poor storage methods. The methods taken so far to combat these issues are expensive. These include regular pesticide treatments, which are time-consuming, dangerous and questionably successful. As such, sub-Saharan Africa still loses $4 billion a year as a result of post-harvest food losses. The ZeroFly Bag could drastically transform that number.

A recent technological invention, ZeroFly Storage Bags, works toward improving food security in Africa. Public health innovation company Vestergaard developed the product to ameliorate food storage methods. Embedded with FAO- and WHO-certified pesticide deltamethrin in its fibers, the ZeroFly Storage Bag protects the stored grain from insects. Because the bag slowly releases the pesticide over two years, it remains effective for at least that long. With pests unable to taint the quality of the food, these bags keep post-harvest food loss to a minimum.  

Impact on a Global Scale

While this innovation is improving food security in Africa, it also has the potential to reduce poverty worldwide. Only two-thirds of food produced for human consumption actually make it to the marketplace. As 12.5% of people worldwide are without food, limiting post-harvest food loss can improve food security around the globe.

The ZeroFly Storage Bag could be an essential part of bettering both food security and poverty. For example, the World Bank estimates that a 1% reduction in post-harvest food losses would save $40 million. This could directly benefit smallholder farms. While many people in Africa and elsewhere struggle to access food, the ZeroFly Storage Bag is a sustainable solution to improving food security in Africa and around the world.

– Eliza Cochran
Photo: Flickr

Bootleg Alcohol in AsiaFrom champagne to sake to lambanóg, it is apparent that alcohol consumption has firm cultural and aesthetic roots in countries all over the globe. Despite its enduring popularity, countries sometimes reflect the dark side of alcohol consumption. Counterfeit, bootleg alcohol in Asia continues to thrive and endanger the lives of many, especially lower-income individuals.

An Unaddressed Epidemic

The problem of fake alcohol has roamed around Asia for countless years. Unregulated distilleries and bathtubs produce counterfeit alcohol before it is distributed under the radar. It is estimated that up to 30% of alcohol in China is fake, with illegal alcohol having infiltrated even well-established bars and pubs under the guise of well-established liquor brands.

Much of the incentive in producing bootleg alcohol in Asia often comes from high import taxes on liquor, or even so far as government prohibition in certain countries. With higher restrictions on liquor sales, many people choose to turn to the black market as their only option.

Various countries have suffered from the effects of counterfeit alcohol. In Indonesia, 300 people have died from consuming counterfeit alcohol between 2014 and 2018 alone. The World Health Organization (WHO) estimates that half of all liquor consumed in India is contraband. This causes numerous cases of methanol poisoning, drunk driving incidents and exacerbating domestic abuse incidents. In 2019, 154 individuals in India had died from methanol poisoning alone.

Consequences, Risks and Poverty

Bootleg alcohol, typically made of dangerous chemicals, disproportionately affects communities facing poverty. Living in poverty is a leading risk factor for alcohol consumption.

Multiple factors make alcohol consumption particularly more threatening to poor communities. The addictive nature of alcohol combined with the weaker support networks and resources (counseling services, healthcare systems, etc.) in low-income communities make these populations vulnerable to prolonged alcohol abuse. Alcohol expenditure could limit the total amount for individuals to spend on food, healthcare and education. Most importantly, the health risks and hospitalization fees associated with alcohol could further exacerbate many families’ financial situations.

The risks associated with poverty and alcohol consumption combined with the cheaper price tag of bootleg alcohol in Asia further amplifies the problems faced by low-income communities. The WHO states that the limited medical resources for poor communities lead to high mortality rates for methanol poisoning.

What Now?

Counterfeit alcohol in Asia continues to run rampant for a straightforward reason: it is taboo. This taboo also makes it highly neglected. Although the WHO encourages public health campaigns addressing illicit alcohol production, few have tackled this issue head-on.

Organizations such as the Methanol Institute (MI) are one of the few that chose to lead the movement in addressing undocumented alcohol production. MI has partnered with countless organizations such as Mitsubishi, BP and Methanex. It provides market support and public awareness for methanol poisoning from counterfeit alcohol.

As of 2013, MI partnered with Lifesaving Initiatives About Methanol (LIAM) to create a pilot campaign in Indonesia to provide community education for citizens to recognize bootleg liquor and combat methanol poisoning. In December 2014, MI-LIAM-trained hospital staff were able to save the first two lives from methanol poisoning. As of 2015, MI-LIAM received funding to continue its effort in Indonesia. Moreover, they garnered approval to expand training in Vietnam.

While bootleg alcohol in Asia continues to be a persisting problem, awareness efforts have slowly highlighted the seriousness of this epidemic. As a handful of brave organizations spearhead efforts to mitigate this issue, many of us hope for others to follow along this path to recovery.

– Vanna Figueroa
Photo: Flickr

traditional healers in africaTraditional medicine, while not as popular or widely accepted as Western medicines, is a vital part of African communities. Traditional healers in Africa are more accessible, affordable and culturally and spiritually relevant for many African people. This contributes heavily to their popularity, and it also enables them to play a role in helping respond to COVID-19.

What Is Traditional Medicine?

The World Health Organization describes traditional medicine as a practice or skill resulting from cultural beliefs and ideologies. Similar to Western medicine, traditional medicine prevents and treats physical and mental illnesses; however, traditional medicine usually uses herbs, plants or even spiritual therapies.

While traditional medicine may seem ineffective and useless to some, it is the main source of medicine for many. Due to its convenience and affordability, over 70% of Africans use herbal treatments. Given that one third of the African population does not have access to essential medicines, traditional medicine plays a central role in their health. A study in 2011 illustrated the accessibility of traditional practitioners. While most medical doctors practice in urban areas, rural areas are less fortunate. For this reason, many people rely on traditional health providers and their medications. These three countries reveal a large gap between how many traditional healers and doctors are available in a community:

  • Zimbabwe: There is one traditional practitioner for every 600 people, while there is one medical doctor for every 6,250 people.
  • Ghana: There is one traditional practitioner for every 200 people, while there is one medical doctor for every 20,000 people.
  • Mozambique: There is one traditional practitioner for every 200 people, while there is one medical doctor for every 50,000 people.

Affordable and Culturally Relevant Medicine

Not only are traditional healers in Africa more accessible, they also have affordable medicines that don’t always require payment upfront. A study conducted by the WHO in 36 middle- and low-income countries revealed that medications were too expensive for a large majority of the population. Similarly, a study on healthcare in Zimbabwe reported that traditional healers are usually the main source of care for poor communities because they have no other options.

Furthermore, traditional healers in Africa and their medicines are widely accepted by African people and culture. Even if people can afford Western medicine, then, many prefer traditional medicines. For example, some healers say that they can channel the ancestral spirit through their patients’ bodies. This is one service that professional doctors cannot provide.

How Traditional Healers in Africa Help with COVID-19

While traditional healers in Africa provide many benefits to African communities, health officials strongly advise against the use of untested traditional medicine to treat COVID-19. The WHO encourages people to wait until medicines have been tested and investigated before consuming them. In South Africa, traditional healers have been advised to refer patients experiencing COVID-19 symptoms to a higher level of care. However, the role of traditional healers during the pandemic is not limited to referrals. Here are eight jobs traditional healers in Africa perform:

  1. Referring patients to correct and suitable levels of care
  2. Educating the public to combat the spread of false information regarding COVID-19
  3. Teaching about prevention methods
  4. Helping to spread public health messages
  5. Informing people about the necessities of personal hygiene
  6. Providing counseling services
  7. Postponing large gatherings
  8. Working with the Department of Health to aid screening and messaging

Health Officials and Traditional Healers: Better Together

To effectively combat COVID-19, experts believe that health officials and the government need to work with traditional healers and not against them. Because traditional healers live in the same community as many of their patients, they have the advantage of possessing important relationships with them. Patients may therefore disregard the advice of a doctor and trust a traditional healer instead. This points to the necessity for cooperation between healers and doctors.

An example of this cooperation comes from Tanzania, where scientists are working with herbalists to help with HIV/AIDS symptoms. Some of the herbs the group is testing are known for strengthening the immune system and increasing appetites. While the team recognizes that herbal remedies won’t cure HIV, they can lessen patients’ symptoms.

With regard to COVID-19, the WHO, which accepts both traditional and alternative medicine, is doing similar tests. For example, it is currently testing plants like Artemisia annua to see if they could possibly aid in the fight against COVID-19. If more scientists, governments and health officials can work with traditional healers like this, all of their patients and communities stand to benefit.

– Sophie Dan
Photo: Flickr

The Nipah Virus
The first documented outbreak of the Nipah virus (NiV) took place in a Malaysian village called Sungai Nipah in the year 1999. Since then, there have been outbreaks reported in Bangladesh, India and Singapore. Contact with infected animals such as pigs and fruit bats and consuming contaminated fruit lead to contracting the virus. Then, the virus is transmitted from person to person. It can also cause acute respiratory illness and encephalitis or be asymptomatic.

In Kozhikode city in the South Indian state of Kerala, an outbreak of the Nipah virus occurred in May 2018. The virus originated from infected fruit bats. In early May, an index patient was admitted to a local hospital. Within weeks, 18 cases were confirmed and 17 patients succumbed. By July 2018, the outbreak was contained.

Contact Tracing and Quarantine

Infected patients were confined and treated in isolation wards. Exhaustive contact tracing efforts helped identify over 2,000 individuals who may have come in contact with those who were infected. They were quarantined and periodically checked on throughout the maximum incubation period.

At the onset of the outbreak, the government issued health and travel advisories for the citizens and visitors to the affected areas. Members of the response team also visited houses to inform citizens about the required precautions. They encouraged people to wear masks since the virus was transmitted via droplets of body fluids. They were also advised to avoid consuming fruits due to the possibility of contamination.

Field Visits and Collaborative Efforts

Officials visited the homes and localities of the infected patients. They collected information from family members and inspected the surrounding areas to uncover the source of the virus. In a sealed well in the home of an infected patient, health officials discovered dead bats.

The World Health Organization (WHO) describes the early response to the outbreak as improvised. However, a centralized, efforts from top state government officials and health experts helped create an organized approach to managing and curbing the crisis. Their efforts collaborated with support and guidance from the Central Government as well. Furthermore, several heroes in the fight against the NiV outbreak were praised, including Lini Puthussery. Puthussery was a nurse to patients diagnosed with the virus, and she later caught the disease.

Quick Response Measures for Future Outbreaks

In anticipation of NiV outbreaks in the future, the Kerala government established a network that includes public and private hospitals to enable testing. These hospitals quickly identify index patients as well. In June 2019, this allowed a swift response to a possible outbreak, and there were no fatalities. There are plans to upgrade existing Virology Institutes in the State. Additionally, there are efforts toward overcoming challenges from previous outbreaks. One of the challenges is ensuring the sufficient stock of PPE equipment. These challenges also include proper management of bio-medical waste and decontamination of ambulances and treatment centers.

The experience garnered from the NiV outbreaks helped facilitate the Kerala Governments’ response to the COVID-19 pandemic. The State has adopted a people-centric approach to the coronavirus pandemic. It has also implemented a vigorous, centralized effort for contact tracing and quarantine and the sustenance of vulnerable groups.

There is neither a known vaccine nor a cure for the Nipah virus. The disease has an estimated fatality rate of 40% to 75%. However, Kerala’s success in containing the NiV outbreak in 2018 and possible outbreaks in the following year has established an admirable model for a global response to combat it.

Amy Olassa
Photo: Flickr

Heat in developing countries
Earth is getting warmer every day and the heat in developing countries can be fatal. There are ways to take the edge off – air-conditioned rooms, pools and shade – and make even the hottest days bearable. This is not to say that Americans are completely safe from heat-related deaths – it kills 800 people per year, disproportionately affecting people of color and migrant workers. Although this number may seem small compared to the toll of cancer and strokes, any deaths from overheating are unacceptable. They are easily preventable with proper education and access to the right information and technologies.

The Dangers of Overheating

However, in countries like India and in the deserts of Africa, where temperatures can reach up to 120 degrees Fahrenheit, the dangers of overheating are everyday realities. The effects of overheating on a population are difficult to measure because overheating exacerbates other diseases. Symptoms affect the heart (causing irregular rhythm), immune system (decreasing white blood cell count) and cause dehydration, which has innumerable other effects. Statisticians estimate that between 1998-2017, over 160,000 people died as a direct result of overheating and heatwaves worldwide. Technologies such as air conditioners would reduce deaths due to heat in developing countries and improve the livelihoods of people. Unfortunately, barriers such as high cost and the unavailability of electricity remain in developing countries. Luckily, several organizations are working to find ways to mitigate these barriers.

Reducing Heat-Induced Deaths

  • The World Health Organization (WHO): WHO already does much to help reduce poverty. It also takes on the challenge of reducing heat in developing countries. WHO looks at how to compactly design buildings with fewer levels to lower cooling costs. It investigates investment into insulation and the positive economic impacts of finding new markets for air conditioning companies. The Maghreb, a region of North Africa, could particularly benefit from an overhaul of cooling systems because of its rich natural resources. This would incentivize more workers to move there, bringing profit to all.
  • Rocky Mountain Institute: RMI aims to reduce the effect of air conditioners on the environment. These environmental effects often impact poorer communities in particular. Typical AC units run on electricity provided by fossil fuels. These fossil fuels warm the planet, creating a positive feedback loop. Providing everyone with access to air conditioners, therefore, as many organizations are doing, may not be enough. People also need to stop organizations from warming the earth and increasing demand even further. The institute concluded that the world needs units that are at least five times as powerful as they are now while using the same amount of energy, and electricity that comes from either solar panels or wind turbines.

Keeping people safe from the real danger of heat in developing countries is a necessary step to increasing productivity and saving lives. Fortunately, heat-related deaths are preventable if well-equipped countries assist third world economies to start producing the technologies that people need, such as air conditioners.

Michael Straus
Photo: Flickr

Life Expectancy in the Philippines
Factors such as educational status and public health expenditures have impacted life expectancy in the Philippines, a tropical nation located in the Pacific Ocean. Here are 10 facts about life expectancy in the Philippines.

10 Facts About Life Expectancy in the Philippines

  1. General statistics: Life expectancy in the Philippines at birth increased to approximately 71 years in 2018. The mortality rate among both adult men and women has similarly decreased over time. The mortality rate for adult men decreased from about 308 deaths per 1,000 in 1960 to 235 deaths per 1,000. In addition, the mortality rate for adult women also decreased over time from approximately 262 deaths to 131 deaths per 1,000 adults.
  2. Socioeconomic and educational status: Many older Filipinos have reported better health, enhanced community participation and greater financial stability. Older Filipinos also explained that they had the ability to have enhanced stability later in life. Yet those with higher socioeconomic status reported more enhanced quality of life than those of lower socioeconomic status.
  3. Disease: The World Health Organization (WHO) has reported that the leading cause of death in the Philippines was cardiovascular disease. This caused about 35% of all deaths. Communicable maternal, perinatal and nutritional conditions caused approximately a quarter of all deaths. Cancer caused another 10% and injuries 7%.
  4. Premature deaths: The risk of premature deaths as a result of non-communicable diseases (NCDS) has remained fairly constant over time at more than 30% in males. The risk of premature deaths in females was more than 20%. The WHO expects a similar trend over time until approximately 2025.
  5. Risk ractors: Risk factors specifically relevant to life expectancy in the Philippines include obesity, raised blood pressure and tobacco use. The percentage of the population that is obese has increased slightly over time, with higher projected linear trends by 2025. In contrast, the percentage of the population with raised blood pressure has remained mostly constant over time, with a similar projected linear trend. However, the percentage of the population that smokes is expected to decrease over time, with the greater change being predicted in males.
  6. National system response: The Philippines has implemented drug therapy in order to prevent both heart attacks and strokes. More than half of all health facilities reported implementation of cardiovascular disease guidelines, and many primary health care centers explained that they offered cardiovascular disease risk stratification. Four out of six of all essential NCD technologies were “generally available,” whereas 40% of essential NCD medicines were “generally available.” This is an example of how medical care can improve the life expectancy in the Philippines.
  7. Housing quality: A study conducted in Iloilo in the Visayas region of the Philippines analyzed what impacts childhood survival. The researchers examined factors like housing construction supplies and toilet services. Children from housing of higher quality had a higher likelihood of living to five years old than children from housing of relatively lower quality. As such, socioeconomic status determines life expectancy in the Philippines to some extent.
  8. Public health expenditures: From 1981 to 2010, health expenditure per capita increased by approximately 6.49%. GDP also increased by about 11% on average. At the same time, infant and under-five mortality rates decreased. In addition, life expectancy increased. 
  9. Education expenditures: In a study conducted in 2009, only 3% of government expenditures were allocated toward education. The researchers found that “Philippine provinces could use 52% of their budgets to attain current levels of human development indicators.” Ultimately, the researchers determined that increasing government spending toward education would increase life expectancy in the Philippines.
  10. Immunizations: An essential factor in lowering both morbidity and mortality is the sufficient implementation of universal childhood immunizations. In 2003, only 69% of Filipino kids were sufficiently vaccinated. Mothers with less education and who attended only four antenatal visits were found less likely to fully immunize their children.

Life expectancy in the Philippines is a complex issue. Greater awareness of the factors that affect it could contribute to better health outcomes and, consequently, higher life expectancy in the Philippines.

– Aprile Bertomo
Photo: Flickr

viral hepatitis in IndiaViral hepatitis is one of the leading causes of death in India, where more than 60 million people are infected with this deadly disease. Known as a “silent killer,” hepatitis is a viral disease that can cause inflammation in the liver. Different types of hepatitis refer to the type of virus infecting its host. In India, Hepatitis A (HAV) is amongst the most common, particularly for children. However, other types of hepatitis, such as type E or type C, still pose a large threat to the health and wellbeing of Indian citizens.

Current Problems Regarding Viral Hepatitis in India

In India, Hepatitis B infects at least 40 million people, and Hepatitis C infects more than 6 million. As of now, viral hepatitis in India is becoming a serious health concern, especially amongst children. With few vaccinations available, many children aren’t able to prevent this disease. As of now, less than 44% of children are fully vaccinated against hepatitis. In contrast, Nepal and Bangladesh have more than 80% of their children fully scheduled for vaccinations. India has almost seven million children unvaccinated. As a result, this makes them more vulnerable to viruses such as hepatitis.

Only 1.2% of India’s national budget goes toward vaccinations. The lack of government assistance contributes to the overwhelming number of children that remain unvaccinated. Even this budget only goes toward six basic vaccinations, comprising diphtheria, tetanus, pertussis, tuberculosis, polio and measles, meaning that it excludes hepatitis.

Another large contributor to the spread of this disease is poor infrastructure, often found in impoverished areas. Pipelines with water contamination are more likely to spread the virus, especially in urban cities. India has one of the largest water crises due to poor filtration and contaminated pipelines. Only 32% of piped water has been treated because rivers and lakes are more prone to sewage, leading to micro-contaminations. As Hepatitis A and Hepatitis E are waterborne viruses, it remains a priority for the Indian government to treat its contaminated water supply. This is especially vital for people living in impoverished regions. More than 37 million Indians have been infected with waterborne diseases, resulting in more than 10,000 deaths annually.

Promising Solutions for Viral Hepatitis in India

Although viral hepatitis in India is a large health concern, there are countless efforts to mitigate the spread of this deadly disease. For example, the World Health Organization and UNICEF have established the Joint Monitoring Programme for Water Supply and Sanitation. This program led 17 states in India to reach the Millenium Development Goal 7 (MDG). Additionally, the government of India established the National Virus Hepatitis Control Program, which gives access to more testing and treatment. This program focuses on rural areas and hopes to end viral hepatitis by 2030.

Some smaller nonprofit organizations are also working to prevent the spread of hepatitis. For example, Water.org has 34 partnerships in India, including with UNICEF and the World Bank. Additionally, Water.org has been able to provide more than 13 million people with water and sanitation with $599 million from its partnerships. The BridgIT Foundation has similar goals in solving the water crisis in the most affected counties. As of now, it has built wells in 30 villages. In addition, it partners up with the Rural Development Society and the Sri K. Pitchi Reddy Educational & Welfare Society to reach more than 30,000 people who don’t have access to clean water.

The Path Ahead to Reform

Although eradicating viral hepatitis remains a priority in India, reform begins with the basis of the problem. By improving its resources, such as sanitation and vaccination, India will be able to reduce the spread of viral diseases like hepatitis. With the number of government and local efforts, there is a large chance of mitigating viral hepatitis in India in the near future.

Aishwarya Thiyagarajan 
Photo: Flickr