• Zimbabwe: What happened to maternal healthcare?

    February 17, 2015
    By: Jinny Jung

    Zimbabwe, located in Southern Africa, once possessed one of the strongest economies and healthcare systems in Africa. In the 1990s, however, political and economic instability led to an enormous decline in the quality of healthcare. The past two decades has left more than 90% of the country’s population, an estimated 11 million citizens, without adequate healthcare coverage. Although there is no denying that every Zimbabwean citizen is suffering from the government’s inability to form a strong healthcare system, no other subgroup suffers more than women and children. Although their suffering comes directly from diseases and pregnancy-related complications, there are indirect causes buried at the bureaucratic level that must be addressed.

    Some of the leading causes of maternal mortality in Zimbabwe are postpartum hemorrhage, lack of access to emergency obstetrics care, and lack of trained medical staff attending births. Annually, an estimated 3,000 women die of pregnancy-related causes or childbirth because they either do not receive medical treatment at all, or do not seek out medical treatment in time. The 31-year-old wife of Moses Jemwa, a resident of Cheneka village, died in childbirth while being assisted by traditional birth attendants after they realized they were out of their depths and needed to go to a hospital. She was transported in a wheelbarrow, but she and the baby did not survive the trip. Jemwa said, “She didn’t make it. It was all my fault, I should have taken her to [the] hospital, but I had no money.” Additionally, maternal mortality remains high because even in the case of attended deliveries, the majority of staff are unqualified to recognize common danger signs of labor and delivery, do not provide the routine preventative medicines, and do not have education on birth preparation.

    Beside the quality of obstetrics care, the burden of preventable diseases has an enormous adverse impact on maternal mortality. HIV/AIDS contributes to 26% of maternal mortality cases because affected mothers are at higher risk of dying from pregnancy-related complications. Communicable diseases such as TB makes pregnant women vulnerable to pregnancy complications, and also puts their unborn infants at higher risk of contracting diseases. Many factors contribute toward maternal mortality, and the most difficult obstacle to overcome is the deterioration in quality of care in health institutions for mothers.

    Pregnant women are also denied basic healthcare because their government has financially abandoned them, using money intended for healthcare infrastructure for corrupt purposes. The government policy is to provide free-of-charge health services for pregnant and lactating mothers, children under five, and senior citizens aged 60 years or older; however, the absence of substantial government financial support means that user fees remain the main source of income for many healthcare facilities and the means by which they can equip themselves with medical supplies and medicine. Consequently, there are even less citizens able to afford even the most basic healthcare services and health center conditions deteriorate from lack of maintenance. Pregnant women are expected to pay anywhere from $3 to $50 to give birth in a government or municipal healthcare facility. In a country where most people live on less than a dollar a day, this cost is prohibitive and increases the number of poor women giving birth outside the system – currently, an estimated 39% of women give birth at home. The government is supposed to spend at least 15% of the country’s total expenditure on the health budget, according to the Abuja Declaration of 2000. In reality, it is spending about $20 per person – compare this to $650 per person in South Africa, and $390 in Botswana.

    What can be done? The country needs to start investing money in the right places – its health sector. Before 1990, the health sector emphasized investments in human resources such as doctors, nurses, and volunteers, and also ensured that the country maintained an adequate supply of necessary drugs. The failure to ensure the stability and strength of these two important factors caused the healthcare system to unravel over the past two decades. In order to restore its healthcare system to its former glory, Zimbabwe needs to invest in its doctors, nurses, and healthcare centers again. Although the country is extremely impoverished and cannot see healthcare as a priority, investing in maternal health can improve many different areas of society. Women constitute more than 55% of the labor force in the agricultural sector and the contribution of female labor has far-reaching effects and therefore there are macroeconomic benefits to improving women’s health. Reza Hossaini, UNICEF’s chief representative in Zimbabwe, has echoed similar statements: “We have bent the [trends of] maternal mortality, but we have not really won the war as yet. These gains cannot be sustained and further progress cannot be made if we lose our focus from these strategic choices that we have made, now that we know they have delivered positive results.”

    Although we often talk about maternal mortality and their direct causes, it is also important to view maternal mortality in a larger context. Zimbabwe’s great decline in maternal healthcare can be attributed to the government’s fiscal negligence of its health sector. It desperately needs to prioritize healthcare services in order to protect its mothers and children, because maternal mortality is an enormous drain on society. It needs to be a top priority to help every pregnant women deliver healthy infants in medically-sound environments.

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  • Zanzibar: On the fast track to healthier mothers and infants

    February 17, 2015
    By: Jinny Jung

    Saving the lives of mothers and their infants during the delicate, life-changing process of delivery is an incredibly challenging problem facing many nations in Africa. Zanzibar is no stranger to this plight, as 279 women out of every 100,000 live births do not survive. Since 2010, however, Zanzibar, a small archipelago lying off the coast of Tanzania, has expended a good amount of energy into improving the quality of maternal healthcare services and reducing mortality rates. In fact, Zanzibar is on track to meet the United Nations’ Millennium Development Goal 5, which is to reduce the maternal mortality rate by 75% from 1990 to 2015. 

    Elevated maternal mortality rates in Zanzibar are attributed to understaffed and underequipped health centers, a lack of community awareness regarding maternal health, and poverty. Many births are still under attended by a medical professional or midwife, due to cultural beliefs that it is better for a woman to give birth with traditional attendants rather than at the hospital. However, Mr. Kassin Issa Kirobo, who oversees the Department of Mother and Child Health, has been collaborating with women rights groups and community leaders to encourage pregnant women to give births in hospitals. In order to provide impetus, one hospital offers free maternal services for pregnant women up until delivery. When pregnant women do not visit equipped health centers, they risk both their lives and that of their babies.

    There are several efficient strategies which reinforce the rising quality of maternal healthcare by considering every aspect of maternal health, from government oversight to community involvement. For instance, maternal death audits were introduced at all public delivery centers in August 2010 to identify and report all maternal deaths. The enormous benefit of these audits thus far is that they produce comprehensive reviews of cases, pointing out human and logistical issues that contribute to maternal mortality. In addition to mandatory audits, there is a higher priority on training staff to manage labor complications and maternal health. All primary care facilities also provide family and birth planning for women, as well as antenatal care that is available at a reduced cost – annual coverage of at least one visit is 98%. Opening up maternal healthcare to even the poorest is a critical step forward in helping mothers maintain good health and raise healthy babies. 

    Maternal health has received a special focus in Zanzibar’s healthcare planning, and efforts are evident. There is a strong initiative to improve health services for women and children, and although there are still some holes in the healthcare system, the small archipelago is building a strong support system for its mothers and infants. The battle against maternal mortality is a grueling, taxing one, but one that is well worth it for all parties involved.

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  • Empowering women’s health through NTDs

    February 3, 2015
    By: Jinny Jung

    When one thinks of pregnant mothers and infants, crippling parasitical diseases such as snail fever (schistosomiasis) don’t usually come to mind. After all, what would snail fever have to do with maternal health? However, as one of the 17 neglected tropical diseases (NTDs), snail fever has a surprising correlation with maternal and neonatal health. Although NTDs don’t attract much international public attention, they are a serious health issue that needs to be better understood and addressed. We cannot successfully combat maternal and infant mortality without examining the impact of NTDs on the health of vulnerable mothers and newborns. 

    NTDs contribute to many pregnancy complications and recorded maternal deaths and any health risks posed to the mother during pregnancy also affects the wellbeing of her fetus. NTDs such as hookworm and snail fever are leading causes of anemia and postpartum hemorrhage, side effects with serious implications for pregnant women and their newborns as they can cause low birth weight, miscarriage, and sometimes the death of the mother. One out of every three pregnant women is infected with hookworm and 20% of maternal deaths in Africa can be attributed to iron-deficiency anemia. Further, anemia reduces the physical and intellectual development of the newborn later in childhood and weakens the immune system, which causes increased rates of infection by diseases with high mortality rates, such as malaria and tuberculosis. Despite their profound impact on maternal and infant health, snail fever and hookworm are easily prevented by administering a regular routine of pills that kill the parasites. The ubiquity of parasitical NTDs creates unnecessary health risks that can be easily treated with cost-effective solutions such as pills. 

    Snail fever, one of the NTDs that has a profound impact on maternal health, exerts detrimental influences on pregnancy outcomes. It affects approximately 10 million women of reproductive age in Africa and has a large impact on the wellbeing of fetuses. It is primarily spread through contaminated water and food, due to the presence of feces and infectious bacteria. A study published in the American Society for Microbiology examined the link between maternal schistosomiasis and poor birth outcomes, and found that there is a definite correlation between endotoxin levels and the infant’s health. Endotoxins are toxins present in bacterial cells that are released when the cell breaks down. In infected mothers, endotoxin levels in maternal and placental compartments are usually elevated 1.3 to 2.4 times higher than normal. Higher levels of endotoxin can cause premature birth and chorioamniotis, a bacterial infection that can cause pneumonia and meningitis in infants. Controlling snail fever is an enormous factor in reducing maternal and infant mortality.

    Although NTDs are usually forgotten because of their virtual eradication from developed countries, their overwhelming prevalence in low-income countries creates a heavy burden on socioeconomic progress. Any strategies in the campaign to reduce maternal and infant mortality should also pay attention to strategies that tackle NTDs. These health issues are intertwined and must be addressed together in order to cause a lasting impact that will improve their quality of life. Eliminating NTDs promotes empowers women, reduces childhood mortality, improves maternal health, and makes long-term investments in the overall health, education, and prosperity of the community.

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  • Uganda: Preeclampsia, Hemorrhage, and More

    January 28, 2015
    By: Jinny Jung

    In Uganda, there is an urgent need to address and combat maternal and infant mortality because too many women and infants are dying unnecessarily. Most pregnancy complications such as preeclampsia are easily detected and treatable, but Uganda’s healthcare system is weak and overburdened. Pregnant women and their unborn babies are denied lifesaving emergency obstetric care and with more than sixteen women dying each day from pregnancy-related causes, Uganda needs to spearhead efforts toward helping its mothers. 

    Postpartum hemorrhage is the leading cause of maternal deaths worldwide and causes 24% of all maternal deaths in Uganda. Despite its high fatality, the condition is surprisingly easy to treat – an injection of oxytocin is enough to limit bleeding after delivery. However, oxytocin is not widely available to most women because it is expensive to properly store oxytocin at cold temperatures. Additionally, oxytocin requires a trained professional to administer it as an injection, but over 40% of Ugandan women deliver at home without a medical professional present. Sadly, there is another drug available that is more easy to administer than oxytocin, but it is currently prohibited. 

    Scientists and professors are endeavoring to establish misoprostol, a currently prohibited drug, as acceptable for human use. Misoprostol is used to induce contractions in women with severe preeclampsia to accelerate delivery, and to reduce blood loss in hemorrhaging during and after delivery. It is currently not recommended by the World Health Organization, but scientists are endeavoring to prove that it is no less efficient than oxytocin. Despite oxytocin’s availability, many pregnant women in low and middle income countries such as Uganda are denied access because there are many issues regarding its safe storage and handling. Misoprostol, on the other hand, has a long shelf life, can be kept at room temperature, and comes in pill form, which can be administered by anyone. It is considerably more efficient than oxytocin when considering the relative weakness of the healthcare system in countries such as Uganda. 

    Another leading cause of maternal deaths in Uganda is preeclampsia, a dangerous pregnancy condition characterized by high blood pressure, swelling, headaches, sudden weight gain, and in severe cases, seizures. According to the Preeclampsia Foundation, preeclampsia affects 5-10% of all pregnancies and primarily affects women in low- and middle-income countries. The only treatment for preeclampsia is fetal delivery, after which the mother’s symptoms will subside if she has no additional medical concerns. However, there are many potential health risks to delivering the fetus, especially if it is younger than 37 weeks. In order to maximize the survival chances of both mother and baby, the doctors try to wait as long as possible before delivery to allow the baby time to develop in the womb. Steroid injections are administered to speed up development of the fetus’s lungs, and the mother and baby are closely monitored for the progression of preeclampsia. 

    Doctors can detect preeclampsia early on by monitoring blood pressure and levels of protein in the urine, but in developing countries, medical staff are not always trained or adequately-equipped to detect this condition early. There is a very simple early detection test that looks for the presence of abnormal proteins in the urine. This test, the paper-based Congo red dot urine test, identifies preeclampsia specifically and is very cheap – it is less than two cents per test, making it ideal for developing countries. It is also a very easy test to administer, as the person just has to place a drop of urine upon the reactive paper and wait for a red dot to appear, signifying preeclampsia. Wider distribution of this cheap and easy test would grant more women access to earlier detection and treatment of preeclampsia, and give them more time to receive medical care. 

    What can Uganda do in order to secure healthy futures for its pregnant mothers and unborn babies? For one, the health systems must be strengthened with high-quality facilities, trained staff, functioning equipment and patient education on family planning and sexual health. Pregnant women need to be taught about potential health risks to themselves and their unborn babies, as well as have confidence that they will have access to quality medical care should a medical emergency arise. More drugs should be researched and prepared in ways that can overcome potential storage and handling issues that often arise in low- and middle-income countries. Cheap early detection tests should be distributed to more local health centers and national hospitals to safeguard maternal health. However, none of these proposed solutions will work unless the people and the government work together honestly to ensure that these reforms are put in place and functioning.

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  • Helping mothers survive childbirth

    January 28, 2015
    By: Jinny Jung

    Maternal and infant mortality rates diverge drastically in developing countries and industrialized nations, and for African women, giving birth is a dangerous event. 99% of all maternal deaths occur in developing countries because of insufficiently-equipped health centers and poorly trained medical professionals. Of these cases, the majority occur in sub-Saharan Africa. This enormous loss of life is unnecessary and we need to figure out how to practically apply solutions that help pregnant women and their babies be as healthy as possible during this critical time in their lives.

    Across Africa, mortality rates soar as high as 1,100 deaths per 100,000 live births in women aged 15 to 43. Medical complications experienced during labor and delivery, such as hemorrhage, sepsis, high blood pressure, and preeclampsia, cause 80% of maternal deaths. These complications are treatable with sufficient resources and trained medical staff present, but communities struggle with the challenge of preventing maternal deaths. The World Health Organization estimates that nearly three quarters of all maternal deaths and injuries are preventable with medically-supervised deliveries at health centers. The problem with preventing maternal and infant deaths is that most of Africa is rural, and there is poor health coverage in rural areas – the ratio of doctor to patient is 1 doctor for every 60—80,000 people. Additionally, the distance from many communities to larger regional hospitals that are better equipped to handle medical emergencies is quite significant, hence a vast number of pregnant women are denied treatment when they need it the most.

    In order to ensure safe health deliveries for mother and child, health system needs to be strengthened. Health centers and hospitals need to be adequately equipped with basic materials such as gloves, syringes, cotton gauze and maternity pads. In industrialized nations, these institutions rarely have a shortage of these very basic medical items, but poor resource allocation in Africa means that hospitals are sparsely equipped. As a result, when problems arise before or during delivery, hospitals fail pregnant women who are often too poor to seek out expensive medical care. Additionally, it is critical to provide care before and after delivery as well as vital sexual education and services for young women. Raising awareness amongst young women about symptoms of common pregnancy problems can be lifesaving for both mother and child.

    As stated by UNICEF, “all women need access to antenatal care during pregnancy, skilled care during childbirth, and care and support after childbirth.” These seemingly simple requests are startlingly difficult to provide in impoverished countries, and we need to continue advocating efforts to make these words a reality for women all over the world. Adequate maternal and neonatal health are only delivered when hospitals are appropriately equipped, medical practitioners are prepared, and families have access to important information regarding maternal and neonatal health. When we fail our pregnant mothers and their unborn children, it is a grave indicator of the state of the world we live in.

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  • Malnutrition in Kenya

    January 27, 2015
    By: Jinny Jung

    Kenya has one of the largest African economies but it suffers from crippling food instability and malnutrition. In underdeveloped countries like Kenya, rising food costs and severe droughts and floods increase hunger and poverty. Cultural myths also serve to undermine the battle against malnutrition. As an enormous and little-noticed problem in Kenya, malnutrition demands serious intervention and cooperation from the government and communities. In order to alleviate the burden of malnutrition, Kenya must prove its commitment to resolving the issue.

    Young children are severely affected by malnutrition as it affects their development and ability to become productive members of society. Without proper nutrition, children experience stunted growth, reduced mental capacity, and weaker immune systems. Annually, one in 12 children will not live past their fifth birthday due to serious malnourishment. As of December 2014, the Kenyan Health Chief Officer James Akudian estimated that 43.6% of children under the age of five are acutely malnourished. With an estimated 6.5 million children under the age of 5 in Kenya, these statistics are alarming. It is critical to focus nutrition interventions for children under five so they can have the opportunity to live longer and healthier lives.

    Climate change and rising food costs have drastically increased food insecurity in the eastern African nation. The vicious drought-flood cycle that is characteristic of Kenya’s climate has an adverse effect on food production. Failed crops result in higher prices and less nutritious diets. Many Kenyans live on less than $2 daily, leaving them unable to keep up with price hikes in staple foods such as maize and potatoes. From 2010 to 2011, the price of a 90 kilogram bag of maize increased 160%, from $16 to $44. Many poor people are unable to afford these costs and are forced to alter or reduce their diets, becoming malnourished.

    Insufficient feeding habits of children, food insecurity, and poor maternal nutrition all have a great impact on Kenya’s youth. Health officials are focusing nutrition interventions in children younger than five and pregnant and lactating mothers. When mothers have low body weights, they are more likely to give birth to babies with low body weights and higher stunting levels. Low birth weight is a leading cause of death in infants. Annually, 23,500 children die because of micronutrient malnutrition since children are especially vulnerable to the symptoms of malnutrition.

    Scientists are looking for viable solutions to reduce the impact of food insecurity, and biofortification is a novel strategy. Biofortification is the idea of cultivating more nutritionally-dense crops, and is done through selective breeding or genetic engineering. Pearl millet is one such crop that thrives from biofortification. It has the potential to feed food insecure rural households because it is a good crop replacement for crops that require high rainfall. Potatoes, maize, sugarcane, and banana all require irrigation water, a precious resource in Kenya’s harshly dry climate. Pearl millet is more nutritionally dense compared to other grains, and makes excellent feed for livestock. It is especially rich in iron and can help children meet their daily iron requirements. Promoting the cultivation of drought-resistant, wholesome crops helps boost a more diversified, nutritious diet.

    Other strategies to improve nutrition and food security include bringing communities together, structuring coherent policies and legal frameworks, and tracking finances and resources mobilization. In order to address malnutrition in young children and expecting mothers, it’s important to draw up strategized nutrition intervention programs. Nutrition intervention programs can address specific micronutrient deficiencies and improve infant and young children feeding. There are many nutrition challenges to address, but every Kenyan deserves the right to adequate and nutritious food.

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  • Polio-Free in Nigeria

    January 20, 2015
    By: Jinny Jung

    As of this January, Nigeria should be declared polio-free according to global standards, proving the growing strength of its polio surveillance and response system. As one of three countries worldwide where polio is still endemic, this is progress. If Nigeria, a country ravaged by war and severe poverty, can successfully eradicating a disease, then any country in the world should be able to do the same.

    Polio is the leading cause of disability in many Nigerian children as it targets young children under the age of 5. It is a crippling and potentially fatal bacterial infection that is characterized by paralysis and spreads through contaminated food and water. The oral polio vaccine (OPV) is a safe, effective, and relatively inexpensive vaccine that is administered to entire communities in Nigeria. In 2011, the estimated cost of a single dose was 11 to 14 US cents, making it well accepted by public health programs. Despite polio’s severe effects on the body, it is easily preventable if vaccination occurs – 99 out of 100 vaccinated children will be protected from the poliovirus.

    At the national and local government levels, authorities have taken great lengths to ensure a strong polio response. Some of the effective actions include enforcing government accountability at all levels, focused oversight and coordination at emergency operation centers, continuous micro-planning strategy revisions, and focused training and team selection. In Katsina, there was a record 92% polio immunization coverage among its population, in addition to the establishment of functioning health centers in 30 out of the 34 government areas of the state. In 2013, the government saw a 58% reduction in the number of polio cases from 2012. Improved outbreak responses as well as novel strategies to immunize children in war-torn zones also ensure that every member of the population has access to vaccination and treatment.

    Fighting polio is also a community effort. Polio survivors, doctors, religious leaders, and volunteer community mobilizers (VCMs) all go out in the field to educate communities about polio and the importance of vaccination. The participation of religious leaders in the campaign against polio has proved to be especially valuable in dispelling regional myths about the polio vaccine. “[In] parts of northern Nigeria there is 20 percent of the households that the parents won’t give the vaccine unless we bring in the religious leader and he really reassures them that ‘no, this is safe,’” explained Bill Gates in an interview.

    The use of satellite mapping technology and more stringent accountability policies help to enforce the mounting efficiency of polio vaccination. In the past, vaccination teams falsified data by claiming to have vaccinated far more children then they actually did. Remote villages would also be skipped on their routes, but now, if they miss a remote village, GPS tracking reveals the error and they are sent back to vaccinate the village. The new system requires that every volunteer must carry satellite devices so their route can be tracked, increasing accountability and vaccination coverage.

    Nigeria is abound with honest, hardworking, and clever people who have all proven their worth in its polio surveillance system. The country still has a long way to go when it comes to treating and reducing the number of infectious and deadly diseases circulating throughout its population, but with dedication and honesty, it will hopefully change.

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  • Cervical cancer vaccines in Mozambique

    January 14, 2015
    By: Jinny Jung

    Cancer is probably one of the scariest diagnoses a person can receive, and in Mozambique, cervical cancer is running rampant. In this southeastern African country, approximately 4,000 women die annually from cervical cancer. According to the 2014 Africa Coalition On Maternal, Newborn & Child Health, Mozambique has the second highest rate of cervical cancer across the continent, with Malawi being first. It also has the highest risk of cervical cancer cumulative risk and mortality, as seven out of 100 newborn girls will develop this cancer and five will die from it.

    Cervical cancer occurs in the cells lining the cervix, which is the lower part of the uterus. It develops slowly, starting with precancerous cells that initially do not cause any symptoms in the woman. If not detected in time, however, it can develop into cancer and cause symptoms such as abnormal vaginal bleeding and back pain. Females can take preventative measures against cervical cancer by getting regular Pap smears, being vaccinated with HPV (human papillomavirus), using condoms during sexual activity, and not smoking.

    If cervical cancer develops, it is usually treated with surgery, radiation therapy, or chemotherapy. The surgical treatment is most often a hysterectomy, or the surgical removal of the uterus. When found and treated early, women can expect a full recovery but treatments can affect women’s fertility negatively. If not caught in time, however, women experience a painful death.

    The high rate of cancer in the United States is attributed to the high HIV prevalence, as HIV and HPV are fatal duos. HPV doubles the risk of acquiring HIV and HIV quickens the progression of cervical cancer. There are 820,000 women over the age of 15 living with HIV and cervical cancer targets those with weakened immune systems, making HIV and HPV a deadly combination.

    A plan to vaccinate 10-year-old girls with HPV has the power to lower the high rate of cervical cancer amongst females in Mozambique. By planning to vaccinate the girls before they become sexually active and in contact with HPV, public health officials hope to eventually eliminate cervical cancer. They plan to administrate the vaccine through schools and community-based mobile centers for those young girls not attending school. Each dose of the vaccine is being administered for only 20 cents a dose, making it affordable for most citizens.

    Cecilia Arnaldo, a 34-year-old mother of five, underwent cervical screening and treatment for the first time on November 20 of this year after experiencing womb pains for seven months. “All I want is to be healthy so I am not ashamed. Women are getting lost and they can even die just from being ashamed,” explained Arnaldo of her decision to get screening. Many people believe that those with cervical cancer are cursed by witchcraft because of promiscuity, and due to this widespread belief, many women are fearful of receiving diagnoses and treatment. In fact, cervical cancer is known as “the neighbor’s disease” due to women believing that they are being cursed by their neighbors for inappropriate sexual behavior.

    Former First Lady Maria da Luz Guebuza launched a campaign, “End Cervical Cancer Now”, in the hopes of gathering more information that can help prevent and treat widespread diseases in Mozambique. By being the ambassador of this campaign, Guebuza wants to show the world that Mozambique is aware of and is invested in ending cervical cancer. “Our health ministry has been making efforts so that people know about the disease and have access to preventation programmes,” said the director of the First Lady’s Office, Flavia Cuereneia. The Ministry of Health hopes to provide all districts with screening and treatment by 2017, an ambitious goal.

    Although Mozambique has a high rate of diseases such as cervical cancer, there is no denying that the public health system is vastly better than it once was. It is imperative to continue advocating the spread of information on and treatment for cervical cancer so that no unnecessary lives are lost because of lack of adequate prevention.

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  • Time Person of the Year 2014: The Ebola Fighters

    December 29, 2014
    By: T.I.

    Time Magazine’s Person of the Year is not a single person but rather, a group of people – the courageous, selfless team of volunteers and healthcare workers that selflessly sacrificed to fight Ebola. Ebola, the unofficial disease of 2014, wrecked West Africa. Already weak to begin with, the healthcare systems of Sierra Leone, Guinea, and Liberia were ill-equipped to handle the severe pressure of Ebola. Government agencies and officials sent out an inadequate and inappropriate initial response to the epidemic which proved to be woefully short-sighted and resulted in the additional loss of thousands of lives. In the midst of the chaos, healthcare workers on the ground had to handle the epidemic virtually on their own at great personal risk.

    The Ebola virus is highly infectious and fatal in 90% of all cases, making it a very difficult virus to contain and treat. As of now, the Centers for Disease Control and Prevention (CDC) estimates that in total, there were 19,031 cases of Ebola throughout Guinea, Liberia, and Sierra Leone. Of these cases, 7,373 people died. More than 600 healthcare workers were infected, and of these workers, 342 died. With no known cure for Ebola and very few treatment options, contracting the virus is practically a death knell.

    Firsthand stories of fighting Ebola on the ground paint a harrowing scene of chaos, sickness, death, and uncertainty. Doctors tirelessly worked even as their colleagues contracted the virus and died, nurses provided emotional comfort to severely ill patients, ambulance drivers withstood frustrated crowds while transporting patients, investigators worked door to door tracing viral transmission, and workers sealed up corpses in body bags for proper disposal. In addition to stressful physical and mental conditions, workers experienced moral dilemmas as they were forced to turn away patients because there was not enough room at treatment centers.

    Liberian Foday Gallah spoke of his decision to volunteer: “We have to do it. Nobody had come [to help], so we are the ones to pick up the cost. Fear was there, but it didn’t overtake us.” He worked as an ambulance driver transporting sick patients and was infected by the virus while helping an ill 5-year-old child. He miraculously recovered and returned to work in the field, saying that it was his duty to do so. Nelson Sayon of Monrovia volunteered to join a burial team being overseen by the Liberian Red Cross in order to help his country. On his first day, he experienced deep hostility from fearful residents and toiled for hours in the heat gathering highly infectious corpses. The stories of these two men speak volumes of the courage that all medical workers and volunteers had to summon in order to work in the field, but also of their incredible selflessness.

    I cannot possibly imagine going into the field day after day, knowing that I am doing so at great personal risk while colleagues are dying around me. And yet, they did it. The Ebola fighters are heroes, common men and women who faced terrifying obstacles and made enormous sacrifices in order to help West Africa through the epidemic. In these trying and terrifying times, these people offered a shining beacon of hope. They deserve to be collectively recognized as Time’s Person of the Year and they inspire all of us to display humanity in the face of horror and grief.

  • Happy Holidays!

    December 24, 2014
    By: Jinny Jung

    All throughout Africa, the holidays are celebrated differently – due to the presence of different religions such as Christianity, Islam, and various traditional African beliefs, the holidays are a diverse one indeed. Most of the commercialism that characterizes religious and cultural holidays in Western cultures is stripped away, but the holidays still incorporate delicious traditional food, beautiful decorations, and music. During this time of the year, different religious groups maintain harmonious relationships and even celebrate together. Additionally, despite crippling poverty in some areas, people still manage to create holiday cheer.

    In South Africa, mosque founder Dr. Taj Hargey made the unorthodox decision to open his mosque to all Christians for a “historic Christmas invitation”. All followers of Christianity are being invited to feast on halal food and nonalcoholic beverages, as well as to stay and pray in the mosque. “The bold campaign by the Open Mosque to challenge this toxic manifestation of Islam is a small but significant step in generating peaceful coexistence and harmony between the followers of Jesus and Muhammad in South Africa,” praised mosque spokeswoman Jamila Najar to Cape Times. By opening his doors to Christians, Hargey is manifesting the true spirit of the holidays – love and kindness.

    Nigeria, too, is participating in the true spirit of religious harmony and co-preparations for holiday celebrations. In Yola, Adamawa, the Muslim-dominated northeastern part of Nigeria, Muslims and Christians celebrate and share in the festivities together. “We enjoy celebrating together. On Christmas Day, my neighbors always give me food – cookies, chicken, and rice. During the Muslim festivals, we also do the same and invite the Christians,” said Yolan resident Muhammad Sani to Deutsch Welle. When gifts are exchanged, practical goods are offered because people cannot afford fancy gifts. Candles, school books, clothes, and soaps are popular gifts. In spite of religious discrimination and violence across the African continent, Yola Muslim and Christian residents come together every holiday season in religious coexistence and tolerance.

    Not all countries are so fortunate as to be able to celebrate freely, however – in Sierra Leone, the country hit hardest by the Ebola epidemic, Christmas is cancelled. Authorities, afraid of increased viral transmission of Ebola during holiday gatherings and travel, have banned holiday gatherings and urged people to celebrate at home instead. Citizens of Sierra Leone are being forced to deal with an enormous amount of adversity, but still they manage to muster up their strength and regain a sense of normalcy within the Ebola crisis and ban to celebrate the holidays at home.

    During this season of grace and peace, we should try to echo the spirit of selflessness and coexistence being seen among various religious groups during the holidays. Instead of forking out the dollars and purchasing unnecessary items, why not sit back this year and spend valued time with loved ones instead? Many people do not celebrate the holidays the way we ordinarily do because they do not have the means to do so, but it does not mean that their holidays are any less meaningful. In reflecting their gracefulness and humility in the face of adversity, we can make the holidays a more spiritually-fulfilling one.

    The new year is coming up and it has its own set of obstacles in store, but if we all play a part in giving back, we can spread happiness and security for those who desperately need it. Stay with us in 2015 to see where our journey takes us!

    (If you feel inspired to give back right now, visit freerice.com – it’s a wonderful educational website that donates 10 grains of rice for every question you answer correctly. You can help fill up a hungry child’s plate this holiday.)

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  • Born Too Early

    December 22, 2014
    By: Jinny Jung

    Africa suffers from some of the worst rates of premature birth rates found globally, with Southern and Eastern African countries bearing the brunt of premature births. A premature birth is one that occurs at least three weeks before the infant is due, and can result in serious health complications. 11.9% of all births in Africa are premature, but this rate varies from country to country. In Malawi, a southeastern African country, the premature birth rate is a worrying 18%. Preterm birth complications are the world’s number one killer of infants and young children and can result in immediate health problems, delayed physical and cognitive development, and long-term chronic health issues.

    Premature birth is an international phenomenon that is not discriminatory toward ethnicity or age, as it can occur to any pregnant mother. There are certain risk factors that can increase a woman’s risk of going into labor prematurely, such as previous pregnancies, having twins or multiple births, stress, and minimal prenatal care. However, pregnant women can reduce their risk of premature labor by watching out for symptoms and seeing a doctor or nurse to administer prenatal care.

    A major issue with preterm births is that many of the babies born prematurely can be saved with the proper postnatal care, but in poverty-stricken regions such as Eastern Africa, this is not possible. In low-income countries, more than 90% of preterm babies die in the first few days of life, whereas in high-income countries, the number drops sharply to 10%. Additionally, countries with the weakest health systems feature the highest risk of death from premature birth complications – in Sierra Leone, the death rate is 16 per 1000 live births. Half the infants born two months prematurely in Eastern Africa die due to a lack of essential care such as warmth, breastfeeding support, kangaroo care, basic care for infections and breathing difficulties.

    The Kangaroo Mother Care (KMC) is a popular method that improves the survival rates of premature infants by strengthening love and care between the mother and infant. It involves the mother carrying her infant constantly with skin-to-skin contact until the infant can regulate its own temperature. One mother who used KMC to help her infant said, “For two months I carried my baby in this form every day for 24 hours a day. We only separated when I was going to take a shower.” KMC is a simple yet effective form of therapy for preterm infants, and it has a positive healing effect on the infant’s breathing, brain activity, and ability to stave off infections.

    Professor Joy Lawn, director of Maternal, Adolescent, Reproductive and Child Health at the London School of Hygiene and Tropical Medicine, spoke with The Independent about premature birth and care: “The gap is not knowledge but action. About two-thirds of the 1.1 million babies who die of preterm birth every year could be saved without intensive care.” These needless deaths point to a larger insensitivity toward alleviating and eradicating public health issues, as governments generally do not properly implement life-saving measures in their healthcare systems and on the ground. When governments do step up, many lives are saved, as seen with initiatives implemented like in Rwanda.

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  • Malnutrition in Mali

    December 18, 2014
    By: Jinny Jung

    Mali, an arid landlocked country found in West Africa, is the eighth largest country in Africa with a population of 14.5 million. It is also the eighth poorest African country, as it suffers from rampant poverty, malnutrition, and poor hygiene and sanitation. Nearly half the population lives below the international poverty line. Natural disasters are also affecting the country – droughts, locust infestations, and crop failures have left 4.75 million people hungry.

    Malnutrition is an enormous humanitarian issue in Mali which affects all ages, but takes an especially heavy toll on children. In babies and toddlers, malnutrition is life threatening because it impends physical development and can result in brain dysfunction or death. The 2011 government nutrition survey (SMART) reported 150,00 acutely malnourished children and Doctors Without Borders estimates that in total, 30,000 were cared for by aid agencies and the government. The lingering question remains: What happened to the other 120,000 children?

    The three serious protein-energy malnutrition forms often seen in children of underdeveloped countries are marasmus, kwashiorkor, and marasmic KW. Kwashiorkor is usually found in young babies between 12 months and 2 years old, and is characterized by sufficient caloric intake but insufficient protein intake. It is common in famished areas because newborns are raised on their mother’s breast milk, which contains important antibodies, hormones, fatty acids, and growth-promoting factors. When they are weaned, though, they switch from this high-protein diet to a poor carbohydrate diet, thus developing kwashiorkor. All three protein-energy malnutrition forms can be deadly if not treated in time with a proper diet.

    Many Malian villages struggle to cope with malnutrition issues although it is a health issue that they know very little about. “Local people are not aware that malnutrition is a sickness. Until they see the symptoms of illnesses like pains and thinning bodies, they don’t go to a health center,” said the head of the Mali Red Cross office, Fakoro Kone, to AlertNet. Kone and his team work to spread awareness about malnutrition in Ségou, the central region of Mali. So far, they have reached 245 villages in the region, teaching families how to prevent severe hunger.

    Some are optimistic that there are viable solutions to turn around acute malnutrition in Mali. Denis Gamer, UNICEF’s nutrition manager in Mali, told IRIN about his country-wide prevention strategy. This extensive strategy includes a training exercise to educate government health workers in nutrition. “If [ACF, Save the Children, Doctors Without Borders, and World Vision] stay [long-term], and can work at scale, we could deal with moderate acute malnutrition here – we could do lots of prevention and lower the caseload.” However, his strategy also requires an equally-invested government. Mali’s government is incredibly unstable and is not likely to take an invested interest in nutrition in the near future, so many citizens are still suffering from a loss of government intervention and aid.

    Humanitarian groups are taking matters into their own hands and implementing initiatives in Mali in order to combat malnutrition’s impact on children’s physical and cognitive development. UNICEF is using playtime as a novel therapeutic tool to treat malnutrition, as it provides valuable brain stimulation and strengthens family bonds. A 27-month-old girl, Habibatou, was admitted to the malnutrition ward with severe acute malnutrition and malaria. A week later, she was interacting with the toys which evidently boosted her recovery. Says Dr. Aoua Traoré, “With stimulation games, the child’s recovery is speeded up. Children with severe acute malnutrition used to be admitted for 10 days. Now we can cut that period to six days. The impact is remarkable.”

    It is painful for parents to have children only to watch them starve to death; this humanitarian crisis is a result of political instability and crop failures due to frequent droughts. There are nearly a million people who desperately need immediate food assistance; Mali’s food crisis is wrecking the lives of its citizens. Pressure is mounting on the Malian government to deliver an adequate response, and in the meantime, humanitarian groups such as UNICEF are calling for a rapid international response. It is a truly difficult time for everyone, but especially the children. We need to do our best to meet the needs of the Malians and help them get through this crisis.

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  • The Battle for Clean Water

    December 15, 2014
    By: Jinny Jung

    Waterborne diseases are rampant in East Africa countries, but some countries are fighting back with vigor. Uganda spends $157 million annually to treat hygiene-related illnesses, which account for 85% of all diseases in the country. According to Prime Minister Ruhakana Rugunda, “We spend $8.1 million for a health facility to treat sanitation- and hygiene-related illnesses; $147 million for premature deaths associated with sanitation and hygiene and related diseases; and $1.9 million on epidemic outbreaks resulting from poor sanitation and hygiene.” In this country of nearly 36 million people, waterborne diseases are proving to be a formidable opponent.

    Despite the government’s efforts to combat poor sanitation and water supply, much of the population is suffering. The continued propagation of waterborne disease and poor supply can be attributed to poor water safety education, misappropriation of state resources meant for public service, and insufficient sanitation facilities. Only 34% of the population has access to sufficiently-built latrines, according to the World Health Organization. In a year, diarrhea takes the lives of 19,700 Ugandan children under the age of 5.

    If there were proper sanitation and the people were more educated about water safety, much of the diseases in Walumbe – and all over Uganda – could be prevented. In the case of diarrhea, the top killer of children, proper sanitation reduces the risk by 36% and hand-washing reduces it by 48%. However, roughly 29% of the population engages in hand-washing after using the bathroom.

    Walumbe is a village that borders Lake Victoria, the second largest freshwater lake in the world, and it is overwhelmed by waterborne diseases. Villagers living by the lake often go there for drinking water, to bathe, and to use as a bathroom. As a result, diseases like diarrhea, typhoid, dysentery, and trachoma are spread. One of the most prevalent sanitation-related diseases in Walumbe is schistosomiasis (snail fever), which is second to malaria as the most devastating parasitic diseases.

    Water and sanitation are human rights that, when met, create healthier people and stronger societies. Without adequate drinking water or proper sanitation, people fall ill, resources are wasted on treating easily-preventable diseases, and development is delayed. Achieving drinking water and sanitation for everyone is a formidable goal, but one that ensures a sustainable, healthy future.

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  • The Dangers of Expired Medicine and Drug Recycling

    December 11, 2014
    By: Jinny Jung

    Medicine is supposed to be a life-saving solution, not a lethal one. However, ‘drug recycling’, or the distribution of expired and mislabeled pharmaceutical drugs is causing patients in Africa to die. Most recently, more malaria patients in West Darfur are dying due to an increase in expired anti-malarial medicines being sold on the market. This problem is not isolated to West Darfur, as many countries in Africa suffer from access to substandard drugs.

    Drug recycling is a legal gray area. In the United States, it is illegal for citizens – but not officially sanctioned agencies – to collect and redistribute prescription drugs outside the medical system, but these laws don’t apply in other countries, which have their own laws and regulations regarding the practice. Expired drugs are difficult to distribute safely because over time, many drugs lose potency. This makes it more difficult to measure out correct dosages for patients. In sub-Saharan Africa, 35% of sampled malaria drugs failed chemical analysis, meaning they didn’t have enough medical potency in them to work. Additionally, improper storage of drugs can alter their potency, making it even riskier to redistribute drugs.

    Annually, billions of dollars worth of pharmaceuticals are wasted. Many medical professionals who engage in illegal drug recycling are frustrated by seeing so many expensive and rare drugs go to waste when they could better benefit sick and poor individuals overseas. A former Seattle nurse, Carol Glenn, was responsible for sending millions of dollars worth of treatments and medical supplies overseas. Her only intention at the time was to help needy patients, not to disrupt international health systems or cause harm.

    Despite blameless intentions, however, drug recycling can be counterproductive and dangerous. For instant, drug recycling spurs the spread of counterfeit drugs because counterfeiters can receive a batch of the real thing and replace it with different drugs. According to the World Health Organization, 100,000 deaths a year in Africa can be attributed to counterfeit drugs. When citizens participate in drug recycling rather than certified agencies, it is harder for the government to regulate its medical system, further propagating the spread of counterfeit and dangerous drugs. It is a self-defeating attempt at humanitarian aid, and better solutions must be thought of.

    In combating poverty and disease, it is not enough to provide medicine and other resources for impoverished members of the community. As seen with drug recycling, sometimes taking matters into our own hands can even be harmful. Working together with local and national governments to develop strong and sustainable medical care systems is imperative in helping poor countries get on their feet and manage public health issues on their own. When citizens have reliable access to quality medicine from qualified suppliers, society blossoms – the economy grows, more children can go to school, infrastructure strengthens, and a better quality of life is achieved.

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  • NTDs: River Blindness In Cameroon

    December 8, 2014
    By: Jinny Jung

    Neglected tropical diseases (NTDs) affect more than 1.4 billion people worldwide, yet they are not well understood because they are diseases that disproportionately affect the poor. The vast majority of those suffering from NTDs live under the World Bank poverty line of $1.25 a day in rural tropical areas such as rural sub-Saharan Africa. Some of the most prevalent NTDs include ascariasis, hookworm, elephantiasis, onchocherciasis (river blindness), schistosomiasis (snail fever), and trachoma (quiet disease).

    There is not much money set aside for scientific and medical research on NTDs. As aptly put by computational biologist Guido Núñez-Mujica, “A disease becomes neglected simply because it does not affect people in developed countries, so it’s not a research priority. In some cases. . . there’s a treatment, and it’s inexpensive, but it’s practically impossible to eradicate the parasite or its vectors because populations live in close contact with them, and many people are infected with other host species, so people get sick again and again.”

    Onchocerciasis, or river blindness, is a skin disease caused by roundworms, which are transmitted to humans through the bites of black flies living near flowing water sources. The larvae can damage and blind the eyes – approximately 300,000 of the 37 million infected individuals worldwide are permanently blind. There are over 107 million Africans who are at risk of contracting this parasitic disease.

    There is currently no cure for river blindness, but there is a drug that can alleviate the debilitating effects of the black fly parasite. The World Health Organization recommends taking Mectizan® twice a year as a preventative drug. Mectizan®, or ivermectin, has a greatly reduced cost under the Mectizan Donation Program – production cost, shipping costs, and delivery fees are all covered by Merck Pharmaceuticals, the manufacturer of Mectizan®. It is virtually free for all patients receiving the drug under the MDP. However, for some who take the drug, their symptoms worsen. A better preventative drug or cure for river blindness is desperately needed in order to combat the spread of river blindness.

    River blindness is a major public health problem in Cameroon – for example, several villages in the country have infection rates higher than 90%. Additionally, it takes a great toll on young children’s education, as children are forced to stay at home to care for family members blinded by this disease. More often than not, the responsibility falls on young girls meaning they aren’t able to go to school. This transforms this public health issue into one of education and gender inequality, as it invariably takes a toll on girls’ education. The responsibility falls upon us to pay attention to NTDs such as river blindness and pour research funds into understanding and developing cures for these diseases. 

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  • Tuberculosis: South Africa’s Killer

    December 5, 2014
    By: Jinny Jung

    South Africa is facing an enormous battle against tuberculosis, the country’s leading cause of death. Many tuberculosis patients in this area of the world suffer from malnutrition, poverty, and unstable living conditions. Without a healthy and secure lifestyle to boost their health, many South Africans are at risk of contracting tuberculosis.

    Tuberculosis is an extremely difficult disease to combat because there are multiple virulent, drug-resistant strains of TB circulating throughout the population. There is multi-drug resistant TB (MDR-TB) as well as extensively drug-resistant TB (XDR-TB), which is virtually incurable. MDR-TB is easily transmitted through the air – nearly 80% of all MDR-TB cases are caused by breathing in the virus from an infected person.

    The multiple drug-resistant strains of tuberculosis make it a deadly disease of the poor, as it thrives in dirty, impoverished communities. Those infected with HIV/AIDS are at much higher risk of contracting tuberculosis, and because South Africa has one of the highest HIV-infected populations worldwide, many people here contract and die from tuberculosis. In 2011, tuberculosis was responsible for 1 in 10 deaths and killed approximately 54,100 people country-wide. WHO statistics show that nearly 80% of young adults in this region are infected with tuberculosis and every year, 1% of the population develops TB. This is the third highest tuberculosis rate worldwide, falling behind India and China.

    Bongie Ndlovu is a 39 year old woman living in an impoverished settlement just south of Johannesburg. Her living conditions are abysmal – she and her neighbors reside in shacks surrounded by rotting garbage, and the shacks are damp, dark and poorly ventilated. Due to her cramped and filthy living spaces, she contracted tuberculosis. In an interview with Voice of Africa, she described the perils of living in cramped, dirty conditions: “Many people here will tell you they do not have TB, but you will see it if you look carefully. They are sick because of the filthy living conditions.”

    Currently, only old fashioned and ineffective treatments are available for South African patients. However, they are highly inconvenient and uncomfortable for TB patients – injections must be injected for months and handfuls of expensive pills need to be taken on a daily basis for up to two years. The current TB treatments have serious side effects such as deafness, psychosis and severe nausea. They also have low treatment rates – more than half of the multidrug-resistant TB patients on treatment will die. On average, only 13% of XDR-TB patients are cured in South Africa.

    Only one new drug has been approved for use against TB in the past 50 years. Drug patents and arduous approval processes create enormous delays in providing proper medicine to patients in South Africa. There are two new promising drugs for drug-resistant TB, but they are not yet widely available in South Africa due to drug patents. One of the drugs, linezolid, offers an 87% success rate in curing its patients. However, it is owned by Pzifer, meaning that medical organizations such as Doctor Without Borders must pay $65 per tablet per day if they want to provide their South African patients with linezolid. In total, it costs approximately $11,300 per patient for 6 months of treatment, but other patients must take it for 18 months. This cost is unrealistic and unacceptable for humanitarian organizations trying to help South Africans sick with tuberculosis.

    More resources need to be poured into South Africa’s ubiquitous and impoverished communities in order to improve healthcare access and create sanitary living conditions. Poverty plays an enormous factor in public health issues such as tuberculosis, and it is imperative that the government focus on how to give the poor wider access to tuberculosis treatment centers as well as create more sanitary living conditions. There also must be a strong imperative to implement policies and reform on the ground, because for all the talk of battling tuberculosis, the government has failed to make significant progress in lowering its tuberculosis-infected population.

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  • Focus, Partner, Achieve: An AIDS-Free Generation

    December 1, 2014
    By: Jinny Jung

    Today is World AIDS Day, a day created to raise awareness about HIV/AIDS and to promote international cooperation in the battle against HIV/AIDS. This year’s theme is “Focus, Partner, Achieve: An AIDS-free Generation”. UNAIDS issued a new set of global HIV/AIDS treatment and prevention goals to be met by 2020. In meeting these goals on time, the agency said, the world would be able to realistically end the AIDS epidemic a decade later.

    One proposed goal is 90-90-90, which aims to have 90% of people with HIV aware of their health status, 90% of those people on antiretroviral therapy (ART), and 90% of those on therapy having their virus suppressed to avoid viral transmission. There is also a five-year goal to reduce the number of annual HIV infections to 500,000, and reducing the stigma and discrimination associated with HIV/AIDS to nil. (Read about UNAIDS’ goals in detail here: http://bit.ly/1ps06jR)

    The HIV epidemic is not only a public health issue, but an issue that affects households, communities and the growth of nations. HIV occurs primarily in low- and middle-income countries that suffer from poor infrastructure, food instability, and the circulation of other infectious diseases. Despite advanced scientific research and understanding of HIV and its prevention and treatment, many infected individuals lack access to proper medical care due to poor health systems and societal stigmas associated with HIV/AIDS.

    The vast majority of those living with HIV reside in sub-Saharan Africa, which contains 71% of the world’s HIV-infected population. As the world’s leading infectious killer, HIV has killed an estimated 39 million people since 1981, according to WHO. It is an indiscriminate virus, affecting babies, children and adults. In 2013, an estimated 3.2 million children were living with HIV/AIDS.

    Despite the fact that ART is inaccessible to some, the number of people receiving HIV treatment in poor countries has vastly increased. According to WHO, 11.7 million people were receiving antiretroviral treatments in low- and middle-income countries, and 740,000 were children. In contrast, in 2010, only 6.1 million people received ART. Although treatment is more accessible today, there is still an estimated 22 million HIV patients not receiving antiretroviral treatments.

    We need to ensure that health systems are strengthened and improved in order to provide essential, potentially life-saving treatments. It is critical to think about how we can ensure uninterrupted medical care for patients in countries with susceptible health systems. Whether we will actually meet the MDG of eradicating HIV/AIDS depends entirely on a strong and consistent national and international response.

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  • Dying for want of clean water-

    November 27, 2014
    By: Jinny Jung

    Tanzania is one of the poorest countries in the world. Located in East Africa, Tanzania is no stranger to corruption and poverty, and the infrastructure is shaky at best. In October, international donors froze nearly $490 million in aid after corruption claims were raised against Tanzania’s senior government officials. This is highly disappointing for the people, as there already is an enormous deficiency of public resources.

    A resource desperately needed by Tanzania’s population is water, and the lack of available water has far-reaching consequences. More than half the population lacks access to safe water and proper sanitation services. Health clinics are often without water during the dry season (June to October), as it costs too much to divert water from faraway sources. This means that pregnant women are forced to search for their own water for use during and after delivery. They obtain it from sources such as rivers and village wells. However, the water is often contaminated and teeming with disease-causing bacteria.

    When there is no water at health clinics, they quickly become dirty. Hands and clothing go unwashed, a shortage of bed linens occurs, and infection rates among mothers and newborns spike. Diseases such as sepsis, diarrhea, and skin- and eye-related diseases quickly spread – diarrhea is the second leading cause of death for children under five. UNICEF statistics say that for every 1,000 live births, 26 neonates (infants 0 to 30 days old) die, and the maternal mortality rate is 454 women for every 100,000 live births. Nearly 32% of under-five deaths occur in the first 28 days of life, a critical period for infants. Most of these deaths are attributed to giving birth in dirty, unhygienic conditions with poor quality of care.

    “For health facilities to be provided with safe water and some form of sanitation is such a basic requirement,” says Oona Campbell, an author of a research paper on maternal health in low income countries. “The global strategy is to encourage women in low income countries to give birth in health facilities, to reduce the risk of complications. But how can you have health facilities that don’t have water?”

    Tanzania has high death rates among mothers and newborns – as of 2010, the maternal mortality rate was 460 women out of every 100,000 and the neonatal (babies 0-20 days old) mortality rate was 2,100 for every 100,000. Many factors contribute to these statistics such as medicine shortages, a lack of trained health professionals, and most of all, water scarcity. The scarcity of water has a deep impact on maternal and neonatal health. Clean water and sanitation are crucial preconditions for healthy mothers and babies, so why is Tanzania still struggling to provide water for its health centers?

    Tanzania is a semi-arid country, yet it still has three times more renewable water resources than Kenya, its neighbor to the north. However, a poorly-designed water infrastructure means that many Tanzanians have difficultly obtaining fresh water – only 33.1% of the population had access to water from a piped source in 2010, according to the World Bank. Although the government pledged $1.364 billion to the country’s water sector development program for 2013 to 2018, progress is delayed because of gaps between policy and implementation, as well as a lack of accountability.

    The failing healthcare system in addition to gross mishandling of international aid funds impacts the poorest people strongly, as it is they who experience the consequences of government inaction. Without clean water, diseases such as diarrhea become fatal and it’s the youngest children with their fragile immune systems who are most at risk of dying. We need to address the global issue of children and infants dying from dirty water. The fact that so many infants are dying from easily avoidable causes is frustrating, to say the very least.

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  • Ebola: Its Reverse Effect on Mothers

    November 24, 2014
    By: Jinny Jung

    Ebola is such a deadly, infectious and widely feared disease that it is managing to disrupt even the lives of unborn children in West Africa. A recent trend that has been appearing in the midst of the Ebola epidemic is the increase of births unattended by experienced midwives or healthcare professionals in Sierra Leone and Liberia.

    The unexpected increase in these figures can be attributed to several causes, such as fear. Pregnant women are fearful of contracting Ebola at hospitals and instead choose to give birth at home alone, without aid. When they do go to the hospital, however, there are very few healthcare workers willing to deliver babies when there are more pressing patients to care for, such as those stricken by Ebola.

    “At the beginning of the outbreak, health service staff were the ones getting Ebola – many of them were dying. And they had no facilities to help sufferers. People grew terrified and when news spread, everyone got scared,” lamented Augustin Kabano, head of maternal health for UNICEF in Sierra Leone, as she spoke to Integrated Regional Information Networks

    Liberia and Sierra Leone have some of the worst maternal and infant death rates found worldwide, although there is no denying that the situation is better than it once was. According to UNICEF, in 2010 an estimated 890 women in Sierra Leone died per 100,000 live births, as compared to 2,000 women from ten years previously. In Liberia, the number of women who died per 100,000 live births fell from 1,100 to 770 in the same time period. Additionally, approximately 46% of all births in Liberia were attended by a skilled professional in 2013, and 63% of all births in Sierra Leone were attended. However, when Ebola broke out, the number of attended births dropped – Liberia saw a drop from 52% to 38%, and Sierra Leone saw a staggering 30% drop from 63% in women going to hospitals and health centers to deliver their babies.

    The adverse effects of Ebola on expecting women and newborn babies show that more needs to be done for pregnant women in West Africa. There needs to be more specialized health centers and hospitals for these women so that they have a safe place to go to for medical care, rather than hide away at home whenever an infection breaks out. Places called “maternity waiting homes” have already been constructed in various countries such as Ethiopia, and they are specialized centers built specifically for pregnant women and newborn babies.

    As explained by Girma Fikru, a MSF (Médecins Sans Frontières International) nurse, “The maternity waiting houses have two major purposes; to bring expectant mothers living in distant villages closer to health facilities before delivery, and to closely monitor women with a history of complications in the later stages of pregnancy in order to respond quickly to any complications before or during delivery.”

    These centers contain an abundance of medical equipment and trained healthcare professionals capable of providing adequate prenatal and postnatal care. If there were more specialized centers for expecting mothers, then there could be more safe havens for women to go to even in times of public health emergencies, where they could feel safe and trust their doctors and nurses.

    Ebola has taken a great toll on West Africa in many ways. The severity of the epidemic shed light on many problems within the infrastructure of the healthcare system within West Africa and opened dialogue on how medical care could be improved for all, especially during times of great stress. The Ebola patients are not the only ones we need to talk about during this time, as we need to consider how others are being affected by the failing healthcare system in Sierra Leone and Liberia.

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  • The Global Epicenter of HIV/AIDS

    November 21, 2014
    By: Jinny Jung

    Do you know where the greatest proportion of people with HIV/AIDS can be found? Eastern and Southern Africa. These regions contain half the world’s population living with HIV, yet the total population of these regions makes up only 5% of the global population. This epicenter of the HIV/AIDS epidemic is seeing no great decreases in the HIV/AIDS population, as it contains 55% of the world’s new HIV infections among children, 48% new infections among adults, and 48% of all AIDS-related deaths.

    The Southern Africa region experiences the most severe HIV epidemics, and countries like Botswana, Lesotho, Malawi, Namibia, South Africa, Zambia, Zimbabwe, Swaziland, and Mozambique have adult HIV prevalence rates greater than 10%. Swaziland has the highest adult HIV prevalence rate at an estimated 26%, and South Africa is home to the largest HIV-infected population – 17.3% live with HIV. There are many staggering statistics about HIV/AIDS that can be found in African countries, but it is important to consider how these numbers are caused and how they can be lowered.

    The primary cause of HIV transmission in this region of Africa is due to a pervasive cultural attitude toward sex and sexual relations. Men, regardless of their marital status, are encouraged and even expected to have sexual relations with other women, thus increasing the risk of HIV infection and transmission. The commercial sex trade is also a dominant cause of the spread of HIV/AIDS in this region, as women living in abject poverty are driven to sell their bodies for sex. Most of these women do not know if they are infected or not, and unwittingly pass along the virus to their male clients, who then pass it on to other women they have relations with.

    The increase in national and international responses toward addressing the HIV/AIDS epidemic means that more and more people living with HIV have access to treatments, such as ART (antiretroviral therapy) that can prolong their lives and ease their suffering. Those with HIV today have longer life expectancies than their counterparts in the 1990s because of advanced understanding of how HIV attacks the immune system. Increased monetary funding for affordable, easy-to-inject medicine has also helped more people survive HIV. However, the world’s response to the HIV/AIDS epidemic in Eastern and Southern Africa cannot flag and continuous access to adequate healthcare services is critical for ensuring the successful treatment for HIV-infected individuals.

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