Rising Number of Coronavirus Cases Heightens Concerns About Prison Populations

As calls for the world’s population to practice social distancing have ramped up, it calls in to question a certain population that cannot practice social distancing: inmates. Prisons keep inmates in very close quarters, are overcrowded, and often lack proper sanitary conditions—three conditions that go against what the general American populace has been told to do to prevent spreading the coronavirus. The Center for Disease Control (CDC) recommended limiting gatherings to no more than 10 people, social distancing, maintaining a six-foot distance between people, and to avoid shaking hands. Concerts, weddings, funerals, conferences, and other events were cancelled because of the precautions the CDC recommended, but it was only recently that some US states began discussing and preparing to release inmates.

Over the past two weeks the Los Angeles County Sheriff’s Department has released inmates, reducing its inmate population by 600.

On March 19, New York City Mayor Bill de Blasio said the city will begin releasing some inmates, “including people who were arrested for minor crimes and those most vulnerable to infection due to underlying health problems,” according to the BBC. On the same day, it was reported that Rikers Island, a massive prison in NYC, saw the first confirmed case of the coronavirus in an inmate, according to Al Jazeera.

Salt Lake County District Attorney Sim Gill announced plans to release 90 inmates from the Salt Lake County jail on March 20. As many as 200 could be released in the coming days, according to The Salt Lake Tribune.

Prisoners Cannot “Flatten the Curve”

The United States has the highest incarceration rate in the world. According to a report from the Bureau of Justice Statistics, “an estimated 6,613,500 persons were under the supervision of U.S. adult correctional systems on December 31, 2016.” The population far surpasses the population of cities like Los Angeles, Chicago, and Houston; only New York City has a larger population at 8,398,748 as of July 2018. Overcrowded prisons cannot practice what the CDC has recommended regarding social distancing.

Jails and prisons are often dirty and lack medical resources and hygienic materials. The CDC recommends covering your mouth with a tissue when you sneeze or cough, to wash your hands frequently or use hand sanitizer that is at least 60% alcohol, and to sanitize frequently used surfaces. But it is not possible for most inmates to adhere to the CDC’s recommendations since, according to The Marshall Project, “access to toilet paper or tissues is often limited and covering your mouth can be impossible if you’re handcuffed, either because of security status or during transport to another facility.” 

At a news conference on March 10, 2018, New York Governor Andrew Cuomo revealed bottles of hand sanitizer made by New York inmates. As described in a directive from the New York State Department of Corrections and Community Supervision, inmates are not allowed to possess anything with alcohol in it. The very same inmates who are making the hand sanitizer are not allowed to possess or use it because alcohol is the main ingredient.

Health officials from all over the world have said older people and those with pre-existing medical conditions are most at risk of becoming severely ill from the coronavirus, according to the World Health Organization (WHO). According to statistics from the Federal Bureau of Prisons, about 20 percent of all inmates are older than 50. The lack of proper medical resources and materials coupled with their advanced age, means older inmates are particularly vulnerable to the coronavirus.

Asiya Haouchine

is an Algerian-American writer who graduated from the University of Connecticut in May 2016, earning a BA in journalism and English. She was an editorial intern and contributing writer for Warscapes magazine and the online/blog editor for Long River Review. She is currently studying for her Master’s in Library and Information Science. @AsiyaHaou

Nile Basin States Must Build a Flexible Treaty. Here’s How..

Ethiopia, Sudan and Egypt are a step closer to resolving their disputes over the filling and operation of the Grand Ethiopian Renaissance Dam. The dam – a huge project on one of the River Nile’s main tributaries, the Blue Nile in Ethiopia – is designed to generate 6,000 megawatts of electricity. Its reservoir can hold more than 70 billion cubic metres of water. That’s nearly equal to half of the Nile’s annual flow.

Filling the immense reservoir will diminish the flow of the Nile water.

Tensions have been particularly acute between Egypt and Ethiopia because more than 80% of the water reaching Egypt comes from the Blue Nile.

Despite decades of concerted effort, no comprehensive deal between all 11 countries that share the Nile’s river basin has ever been reached. But, after rigorous discussions in the US, Ethiopia, Egypt and Sudan issued a joint statement that lays the framework for a final agreement. The three countries agreed that the dam would be filled in stages, and that it would only take place in the wet season.

The framework also underscored the need for any agreement to be open to changes. This is important because the three countries must consider changes in weather patterns, among other factors, while developing the final draft.

Instead of allocating the Nile waters based on the assumption of a fixed, and often too optimistic, perpetual water supply, Ethiopia, Sudan, and Egypt should do it in accordance with the social, economic and changing weather conditions in the Nile basin.

This is extremely important as existing studies and climate change models commonly predict potential changes in weather patterns and temperature.

Changing weather patterns

Studies suggest that there is likely to be an increase in the basin’s average annual temperature. This would lead to greater loss of water due to evaporation. Changes are also expected in the future rainfall, river flow and water availability in the Nile Basin, although there’s less certainty about these.

But there’s enough evidence to point to the need for flexibility around agreements on how the dam will be filled. For example, there must be allowances to respond to scenarios of increased water availability and flooding, or water scarcity and drought.

Building flexible and resilient legal and institutional arrangements into the new treaty is therefore key. These include drought provisions, flexible allocation strategies, amendment and review procedures, termination clauses and recognised river basin organisations.

Flexibility in watercourse treaties, due to the unknown effects of climate change, has been recommended by leading scholars in the field such as Stephen McCaffrey and Itay Fischhendler.

Drought provisions

Drought provisions are a common way to improve the flexibility of treaties. Ethiopia, Sudan and Egypt can include special provisions that allow for exceptional circumstances, like severe drought.

To deal with the hardships of the projected extreme drought years, the three countries will need to build more reservoirs and storage capacity. But given the tension the dam has caused, finding agreement on this is likely to be challenging. This is all the more reason to include specific clauses in the treaty about storage.

There should also be flexibility in how much water is allocated, instead of a fixed amount. There are a couple of ways this can be achieved.

A simple way is to require Ethiopia to deliver a minimum flow to Sudan and Egypt to maintain human health and basic ecological functions.

The other option would be a percentage allocation. This would share possible water deficiencies, and surplus, proportionally among the three countries. Each country would get its agreed share of the total in a given year.

This would be the better option because it would respond to both wet and dry conditions.

Amendments and reviews

To make the treaty flexible, it’s also important to provide for amendments and reviews of processes. In this way countries could address unforeseen circumstances.

For instance, Ethiopia promised, under the joint statement, that it will fill the dam’s reservoir during the wet season, generally from July to September. But the wet and dry seasons could change.

The treaty can establish what might “trigger” adjustments or have set times for when a review should occur.

It must also have a termination clause which allows any riparian state to terminate the agreement, with a notice period.

River basin organisations

Managing water across boundaries needs river basin organisations. These are entities entrusted to manage water resources at the basin scale. They’re important because they can help introduce a level of flexibility in the arrangements between the riparian states.

A good example of how this can be done is the role played by a river basin organisation charged with applying the 1944 Colorado Treaty. The organisation was composed of an engineer commissioner from both parties – the US and Mexico – and was able to adapt, amend and extend institutional arrangements, including the main treaty.

In the case of the Nile basin, Ethiopia, Sudan and Egypt have two options.

They can establish a joint body in the treaty that will manage the operations of dams in their respective countries. But this would exclude the other eight Nile riparian countries.

The other, and arguably better, option is to manage all dams through the Nile Basin Commission – an organisation envisaged in the Cooperative Framework Agreement. This was an attempt by riparian states to prepare a basin-wide framework to regulate the inter-state use and management of the Nile River. All the Nile basin states except Egypt and Sudan agreed to it.

This organisation has a wide range of powers, which include the ability to examine and decide how water is best used and distributed. Egypt and Sudan must accede to the framework agreement. And the treaty must empower the body to manage the filling and operation of the dams and reservoirs in the three countries.

Mahemud Tekuya is a JSD/Ph.D candidate, University of the Pacific

THIS ARTICLE WAS ORIGINALLY PUBLISHED ON THE CONVERSATION

Reinventing Electronic Music With Dubai’s Cellist DJ

When classical cellist Aaron Kim was diagnosed with critical hearing loss, he had two choices: to keep creating music or to stop altogether. Kim chose the former and has since discovered a passion for electronic music. Combining his classical training with new sounds, Kim produces unconventional electronic beats for the emerging underground music scene in Dubai. The freedom to create music on his own terms, without any rules or structures, has helped Kim break and overcome barriers that once held him back.

Health Needs in Migrant and Refugee Communities

Lack of access to health care, trauma, and poor living conditions all contribute to public health concerns of migrant populations.

The Patrons of Veracruz provide food for migrants traveling across Mexico. Giacomo Bruno. CC BY-NC-ND 4.0.

 Over the years of the Trump Administration, stories of maltreatment of migrants either at the border, or well-established in country, keep surfacing. This pattern is mirrored in other countries around the world, often with a large anti-immigration rhetoric. In the US, this has stemmed from a dislike and distrust of illegal immigrants but often spreads to legal migrants and refugees as well, at a huge health cost to those trying to enter.

 Trump’s policies to reduce numbers crossing the Mexican border include a, now revoked, policy to separate children from their families and a Remain in Mexico policy that prevents migrants from entering the US while waiting for asylum cases. With this policy over 50,000 migrants have been sent to wait in Mexico. They now live in overcrowded camps with limited access to health care. NGOs struggle to keep up with increasing numbers and problems such as clean water and waste management. US policies are supposed to allow children and those ill or pregnant to remain in the States, but this policy is often ignored.

Once in the US, it is still difficult to access care. Detention centers are overcrowded and trauma from being separated from family can lead to many mental health issues. Migrants are not covered by government programs and have to seek health care through out-of-pocket costs or community health and non-profit organizations. Language and fear limit many from getting care when something might be wrong. Poor migrant working conditions and food insecurity have lasting impacts on migrant health once in the country.

 Australia has had similar policies to deter migrants by sending them to wait for asylum on nearby pacific islands where resources are lacking. In 2018, there were almost 1500 detained in Nauru and Papua New Guinea. Health organizations working on the islands found a massive mental health crisis with one third of the 208 people treated on Nauru having attempted suicide. It was found that in the 2017-2018 financial year, the Australian government spent over $320,000 fighting medical transfer requests.

 The US and Australia have showcased how inhumane policies surrounding immigration comes at a great health cost. But the majority of refugees and migrants, aren’t in the US and Australia, they are in countries neighboring conflict. In fact, 86% of migrants are in developing countries. Jordan has been extremely generous with accepting refugees from neighboring countries but a large influx during the Syrian Civil War is straining Jordan’s ability to provide. In 2018, they had to increase the cost of medical treatment for refugees, which before 2014 was free, now leaving most refugees unable to cover basic health costs.

 The World Health Organization is working to try to make sure migrant health needs are met but with 258 million international migrants, 68 million of which are refugees, it is not an easy job. 

DEVIN O’DONNELL’s interest in travel was cemented by a multi-month trip to East Africa when she was 19. Since then, she has continued to have immersive experiences on multiple continents. Devin has written for a start-up news site and graduated from the University of Michigan with a degree in Neuroscience.

The Amazing Bike Machines of Guatemala

Bike machines, or "bicimaquinas," are changing people's lives in San Andrés Itzapa, Guatemala. The unique stationary bicycles have been altered to function as human powered machines that can do everything from washing clothes, to blending and shelling nuts. Made of discarded, eco-friendly parts, they are the brainchild of locally run non-profit Maya Pedal. Not only are these machines functional and economical, they also contribute health benefits.

An Inuit Approach to Cancer Care Promotes Self-Determination and Reconciliation

For thousands of years, Inuit have adapted to the changes in their environment, and continue to find new and innovative ways to survive. 

But life expectancy among populations in Inuit Nunangat (the traditional territory of Inuit in Canada) is an average of 10 years less than that of the general Canadian population.

Cancer is a leading cause of this disparity. Inuit experience the highest mortality rates from lung cancer in the world, and mortality rates of some other cancers continue to increase disproportionately.

Inuit communities tend to be self-reliant and are renowned for working together for a common goal, which is evident in their self-governance and decision-making activities. They have also endured a long history of cultural insensitivity and negative health-care experiences that span generations

Map of Inuit Nunangat (Inuit Regions of Canada) (Inuit Tapiriit Kanatami)

The ways the Canadian health-care system interacts with Inuit populations plays an important part in this health disparity. And there is an urgent need for Inuit to be able to access and receive appropriate health care. 

Elder Peter Irniq speaks about the remarkable Inuit capacity for survival in extreme conditions

In 2015, the Truth and Reconciliation Commission of Canada (TRC) report made 94 recommendations in the form of Calls to Action. Seven of these Calls to Action specifically relate to health. They explain the importance of engaging community members, leaders and others who hold important knowledge in the development of health care.

As members of a team of Inuit and academic health-care researchers, we have been working with health-system partners to support Inuit in cancer care. We focus on enhancing opportunities for Inuit to participate in decisions about their cancer care through the shared decision-making model, in a research project we call “Not Deciding Alone.”

We travel thousands of miles for cancer care

Our collective success in addressing the TRC Calls to Action will require health research to focus on addressing the health-care inequities experienced by Inuit, First Nations and Métis populations in ways that take action to promote self-determination. 

This is important as current health-care models do not often support Indigenous values, ways of knowing and care practices.

Poor cultural awareness in our mainstream health-care systemsdiscourages Indigenous people from seeking care and engaging with health services. It increases the risk that Indigenous people will encounter racism when seeking care. 

Small boats make their way through the Frobisher Bay inlet in Iqaluit on Aug. 2, 2019. THE CANADIAN PRESS/Sean Kilpatrick

There are many documented instances of our health-care system’s failure to provide appropriate health care to Indigenous people, due to unfair assumptions and demeaning and dehumanizing societal stereotypes.

These health system failures discourage people from seeking care, and have resulted in death, as in the case of Brian Sinclair,who died after a 34-hour wait in a Winnipeg hospital emergency room in September 2008.

There can also be significant physical barriers to care for Inuit. Critical health services such as oncology specialists and treatments are often located in urban centres such as Ottawa, Winnipeg, Edmonton, Montréal and St John’s, thousands of kilometres away from remote communities in Inuit Nunangat. This leaves many Inuit negotiating stressful urban environments, dealing with cultural dislocation and navigating complex health systems without the benefit of community support networks.

People must fly out of remote communities for cancer treatment. (Alex Hizaka), Author provided

During our research, an Inuit peer support worker explained what it can be like for those who travel far from their family and community for their care: 

“People come with no idea of why, and we are having to bridge two worlds for them. Often patients have no idea why health-care providers tell them to get on a plane, and then they think they are coming for treatment for three days and then it becomes two weeks. It is a tough situation as often people have no money, no support. People need to be able to explain their situation and how it is for them. People need to know that they are not alone.”

Research shows that these geographical challenges significantly impact access to health care and are often exacerbated by language barriers. Together these factors may make people vulnerable to additional harms unrelated to the health conditions for which they seek treatment.

Patients and health-care providers work together

Shared decision-making is an important evidence-informed strategy that holds the potential to promote patient participation in health decisions

In this model, health-care providers and patients work togetherusing evidence-based tools and approaches and arrive at decisions that are based on clinical data and patient preferences— to select diagnostic tests, treatments, management and psycho-social support packages. 

Shared decision-making is considered a high standard of carewithin health systems internationally and it has been found to benefit people who experience disadvantage in health and social systems. 

Shared decision-making has also been found to promote culturally safe care, and has the potential to foster greater engagement of Inuit with their health-care providers in decision-making. 

The concept of cultural safety was developed to improve the effectiveness and acceptability of health care with Indigenous people. Culturally safe care identifies power imbalances in health-care settings — to uphold self-determination and decolonization in health-care settings for Indigenous people. 

The aim of a shared decision-making approach is to engage the patient in decision-making in a respectful and inclusive way, and to build a health-care relationship where patient and provider work together to make the best decision for the patient.

Most importantly, our approach has emphasized ways of partnering that align with the socio-cultural values of research partners and community member participants, both to develop tools and create approaches to foster shared decision-making. The term “shared decision-making” translates in Inuktitut to “Not Deciding Alone” and so that is the name of our project.

The results are outcomes that Inuit are more likely to identify as useful and relevant and that respect and promote Inuit ways, within mainstream health-care systems.

Self-determination through Inuit Qaujimajatuqangit

Our research uses the guiding principles of Inuit Qaujimajatuqangit — a belief system that seeks to serve the common good through collaborative decision-making — as the foundation for a strengths-based approach to promote Inuit self-determination and self-reliance. 

Inuit Qaujimajatuqangit principles have been passed down from one generation to the next and are firmly grounded in the act of caring for and respecting others. 

There is important learning taking place within academic and health-care systems that involves deepening understandings of what “patient-oriented care” means. We need to learn how to do research in partnership with those who are the ultimate knowledge users in cancer-care systems — patients.

In our work, Inuit partners and community members are leading the development of shared decision-making tools and approaches, building on their strengths and resiliency. Our research and health systems are beneficiaries of these partnerships that hold potential to create health care that is welcoming and inclusive for all. 

With guidance and support from Inuit and more broadly, from Indigenous partners, we are learning how to take action on the TRC recommendations, and to make respect and kindness integral to best practice in research and health care.

Janet Jull is a Assistant Professor, School of Rehabilitation Therapy, Queen's University, Ontario

THIS ARTICLE WAS ORIGINALLY PUBLISHED ON THE CONVERSATION

What the US Could Learn from Thailand about Health Care Coverage

The open enrollment period for the Affordable Care Act (ACA) draws to a close on Dec. 15. Yet, recent assaults on the ACA by the Trump administration stand in marked contrast to efforts to expand access to health care and medicine in the rest of the world. In fact, on Dec. 12, the world observed Universal Coverage Day, a day celebrated by the United Nations to commemorate passage of a momentous, unanimous U.N. General Assembly resolution in support of universal health coverage in 2012.

While the U.N. measure was nonbinding and did not commit U.N. member states to adopt universal health care, many global health experts viewed it as an achievement of extraordinary symbolic importance, as it drew attention to the importance of providing access to quality health care services, medicines and financial protection for all.

Co-sponsored by 90 member states, the declaration shined a light on the profound effect that expansion of health care coverage has had on the lives of ordinary people in parts of the world with far fewer resources than the U.S., including Thailand, Mexico and Ghana. Can the U.S. learn anything from these countries’ efforts?

US and Thailand: A study in contrasts

I came to understand these changes as I researched and wrote my book, “Achieving Access: Professional Movements and the Politics of Health Universalism.” The book offers a comparative and historical take on the politics of universal health care and AIDS treatment, featuring Thailand as the primary case. For me, Thailand’s remarkable achievements also put into perspective some of the work we still have to do here in the United States with respect to health reform.

Before the reform, Thailand had four different state health insurance schemes, which collectively covered about 70 percent of the population. The reform in 2002 consolidated two of those programs and extended coverage to everyone who did not already receive coverage through the country’s health insurance programs for civil servants and formal sector workers.

Thailand’s universal coverage policy contributed to rising life expectancy, decreased mortality among infants and children, and a leveling of the historical health disparities between rich and poor regions of the country. The number of people being impoverished by health care payments also declined dramatically, particularly among the poor.

However, Thailand’s reform had other important consequences that aimed to make the reform sustainable as well. Sensible financing and gatekeeping arrangements – that tied patients to a medical home near where they lived and provided fixed annual payments for physicians to cover outpatient care – were instituted to curb the kind of cost escalation that has historically been a hallmark of the United States (though it has slowed lately). The reform also improved the quality of care for patients in remote areas by mandating that qualified providers in community hospitals collaborate more extensively with rural health centers.

A computer screen promoting this year’s open enrollment, which will run 45 days. In years past, open enrollment continued for months. Ricky Kresslein/Shutterstock.com

The United States, by contrast, seems to be moving in the opposite direction, both in terms of insurance coverage and health outcomes. Although recent Republican efforts to repeal the Affordable Care Act were narrowly defeated, lawsuits that aim to terminate popular pre-existing conditions protections continue. In addition, the Trump administration has sought to weaken the reform in other ways: including by cutting the open enrollment periods, which ends Dec. 15 and lasts 45 days; cutting outreach and advertising for open enrollment; and threatening to suspend risk adjustment payments to private insurers, which help to stabilize the market.

Moreover, effective repeal of the Affordable Care Act’s individual mandate through a provision in the 2017 Tax Reconciliation Act that reduces the penalty for not having insurance to zero in 2019 will have the effect of reducing the number of insured. This will have an effect on health insurance markets, likely reducing the number of younger and healthier people that help give balance to health insurance risk pools and that help keep overall costs down. And without the financial protection afforded by health insurance, those who are uninsured may face rising rates of medical bankruptcy, to say nothing for the loss of access to sorely needed medical care.

Learning from Thailand

To be sure, the Thai and American contexts are very, very different. While health spending stands at around 4 percent of GDP in Thailand, in America nearly 20 percent, or one-fifth, of the country’s total economic output is spent on health. Yet, in some ways, that makes Thailand’s achievement all the more remarkable. And while no program is perfect, Thailand’s reform is one of the reasons that health costs in Thailand have remained so low, despite such a dramatic increase in coverage.

The use of generic drugs in Thailand is a strategy to keep costs low. Room's Studio/Shutterstock.com

Reformers also drew on other innovative policy instruments to keep costs down, including the Government Pharmaceutical Organization that produces generic medication for the universal coverage program and the use of compulsory licenses, which allow governments to produce or import generic versions of patented medication under WTO law.

The Affordable Care Act similarly sought to improve access, while curbing costs. Some of the most important mechanisms to curb costs fell victim to the legislative process however. Most notably, lobbyists succeeded in killing the “public option,” a government (as opposed to private) health insurer with much lower administrative costs that aimed to bring costs down among private health insurers through competition with them.

Although the reform in Thailand was popular among the masses, it also saw its share of detractors. Medical associations that represented doctors who saw the policy as a threat came out against it. Likewise, beneficiaries of the existing programs for civil servants and employees of large, tax-paying businesses feared that their own benefits would be diluted by a new single payer program. Despite progress expanding access to everyone, the new program introduced in 2002 still sits alongside separate programs for civil servants and employees of large, tax-paying businesses.

What the contrast makes clear, however, is that reforms done properly can expand access while at the same time instituting measures that help to contain costs. The U.S., in my view, should pursue similarly creative and constructive reforms that seek to do both.

What does that look like in the United States? To me, that means preserving the ACA’s individual mandate and protections related to pre-existing conditions; creating (or expanding) a public insurer like Medicare to compete alongside private insurers and keep costs down; addressing the lack of price transparency in our nation’s hospitals; and actively negotiating with pharmaceutical companies and hospitals to bring costs of drugs and health care down for millions.

Done sensibly, developing nations like Thailand are proving that they do not have to join the ranks of the world’s wealthiest nations for their citizens to enjoy access to health care and medicine. Using evidence-based decision-making, even expensive benefits, like dialysis, heart surgery and chemotherapy, need not remain out of reach. Policymakers in all countries can institute reforms using tools that promote cost savings at the same time they improve access and equity.

While efforts to implement universal coverage are not without challenges, these results suggest that leaders in Congress would do well to learn from countries like Thailand as they chart a fiscally responsible path forward on health care.

JOSEPH HARRIS is an Assistant Professor of Sociology at Boston University.

THIS ARTICLE WAS ORIGINALLY PUBLISHED ON THE CONVERSATION

This Surgeon Has Restored Sight to 130,000 of Nepal’s Blind

Dr. Sanduk Ruit is an ophthalmologist on a mission to restore sight to Nepal’s blind. He is the executive director of the nonprofit Tilganga Institute of Ophthalmology in Kathmandu, Nepal, and has operated on more than 130,000 patients. He has adopted innovative surgical techniques for cataracts and often travels to perform operations, walking up to seven days hauling surgical equipment to reach patients who live in Nepal’s most remote villages. Why does Dr. Ruit do this? He lost family to treatable diseases and knows what it’s like not to have access to healthcare.

Palestine Launches Global Mental Health Network

Palestinian health workers started a network to help Palestinians with emotional well-being, as they have among the highest rates for anxiety and depression due to the ongoing conflict with Israel.

The Palestinian people have exceedingly high rates for anxiety and depression. Health professionals recently began a network to help combat these disorders. Hasty Words. CC0.

Palestinian health workers recently launched the Palestine-Global Mental Health Network, in order to assist with their people’s emotional well-being and assert their professional stance. 

Palestinian people have among the highest rates for anxiety and depression, in large part due to the continuous strife between Israel and Palestine. Unexpected raids in the middle of the night, checkpoints, teargas, and jailed young children all contribute to a profound sense of hopelessness and despair. For example, young men who seek out mental health services often explain that they think of looking for the Israeli Defense Forces (IDF) to create a confrontation in the potential hope that they’ll be killed, according to Mondoweiss. Suicidal ideation, depression, trauma, and anxiety are undoubtedly high conditions in most people. 

This network was partially launched because of a meeting held in Tel Aviv toward the end of June for the International Association for Relational Psychoanalysis and Psychotherapy. The location was impossible to get to for Palestinian professionals who wished to attend, due to restriction of movement. Last year, a petition was circulated by the USA-Palestine Mental Health Network, with support from the Jewish Voice for Peace and UK-Palestine Mental Health Network, asking that the location be changed, but the petition was not answered. 

The launch for the Palestine-Global Mental Health Network was held at the Palestinian Red Crescent’s headquarters in al-Bireh. The Palestine Red Crescent Society is involved in health care in the West Bank and the Gaza Strip. It collaborated with the Palestinian Social and Psychological Syndicate and the Arab Psychological Association as well. 

Over 150 Palestinian health professionals attended from various cities, including Gaza, Haifa, Ramleh, and Jerusalem, among others. UK and U.S.-based Palestinian professionals joined through video-conferencing. The network plans to assist Palestinian people, regardless of geographic location, and promote mental health, social justice, and human dignity among people in general, and Palestinians in particular. A major goal is to augment Palestinian resistance to violence. More generally, this network will cooperate with others in the U.S., the UK, and Belgium to strengthen their programs and establish similar organizations.

The speeches addressed specific topics, as well as general thoughts on why an organization like this is necessary. In the closing session, a task force was created that would organize a paper explaining the network’s opening strategies and general framework. A separate committee was commissioned to carry out projects and plans agreed upon at the conference.

Another branch for the same organization also recently begun in Belgium. Their overall goal is also to make known the effects of occupation on the mental health of the Palestinian people. Activities include conferences, panels, and trips for international co-workers to visit Palestine and meet with other professionals, among others, according to the Washington Report on Middle East Affairs. The networks in Belgium, the U.S., and the UK generally work independently, but occasionally collaborate on ideas, strategies, and campaigns.

Mental health workers have an important role to play in the continuing struggle between Israel and Palestine, and these collaborating networks show that they intend to assist as best they can.

NOEMI ARELLANO-SUMMER is a journalist and writer living in Boston, MA. She is a voracious reader and has a fondness for history and art. She is currently at work on her first novel and wants to eventually take a trip across Europe.

Forgotten, but not Gone: Zika’s Return to the Media

Earlier this week the Duchess Sussex of Meghan Markle canceled a trip to Zambia, citing exhaustion and concerns over the presence of Zika virus in the country. The Zika virus had been rather dormant in the media over the last year, all but vanishing in the wake of Trump speeches, trade wars, and Brexit. It had, however, remained a constant concern for those living in certain countries or traveling to them. Markle’s encounter with the Zika virus and the subsequent headlines have helped to push it back into public view, and once again, questions are being raised about its origin, transmission, and what is being done to fight it.

The Duchess of Sussex. Office of the Governor - General - GG.govt.nz. CC BY 4.0.

The Zika virus was first discovered in the Zika Forest in Uganda in 1947. The first recorded carriers were monkeys, but the forest was also home to over 70 species of mosquitoes, and they became the primary source of viral transmission. The disease was eventually discovered in humans in 1952, but for the most part remained confined to animals until 2007, when the first human outbreak was documented on the Island of Yap in the Federated States of Micronesia. In 2015, the virus made international headlines when Latin America and the Caribbean saw an explosion of human-related cases. As was the case in Africa, mosquitoes were the main culprits of transmission. However, in 2016, the virus saw a sharp decline in new cases, and with it a decline in news coverage.

Adults infected with Zika often display no symptoms. Those who do usually report mild fevers, rashes and muscle pain. The impact on unborn babies is far more devastating. Zika infections during pregnancy have resulted in miscarriages and babies being born with microcephaly, a condition in which a child's head is much smaller than it should be (Markle and husband Prince Harry had recently announced that they were expecting a child, and concern for the child’s welfare was thought to be Markle's main concern when she opted out of her trip to Zambia).

The Zika Virus is spread mainly through mosquito bites. James Gathany - https://phil.cdc.gov/phil/details.asp?pid=9257. Public Domain.

While a full-on cure for the virus remains elusive, health and government officials have been able to curb infections by going after the mosquitoes that carry and transmit the disease. In preparation for the 2016 Olympics in Rio de Janeiro, the Brazilian government launched a large-scale effort to fumigate the city for the insects, while in England a biotech company called Oxitec developed genetically modified mosquitoes, which, when released into the wild, would mate with infected mosquitoes and pass a gene on that would prevent those mosquitoes from reproducing. In the United States, The Centers for Disease Control made a point of advising those traveling to countries with high rates of infection to use insect repellants.

Microcephaly- a birth defect linked to the Zika virus. Centers for Disease Control and Prevention. Public Domain.

Many world issues persist despite the ebbing and flowing of news coverage. Though not the hot story it once was, the Zika virus is still a viable threat and will remain so until a vaccine is found. Those traveling to countries that have been deemed areas of risk should take all necessary precautions to prevent infection, or, like the Duchess of Sussex, simply the put the trip off until another time.

JONATHAN ROBINSON is an intern at CATALYST. He is a travel enthusiast always adding new people, places, experiences to his story. He hopes to use writing as a means to connect with others like himself. 

India Scraps Tax on Sanitary Products after Protests

India joins Ireland, Kenya, and Canada as one of the four countries worldwide with tax free menstrual products.

Image Credit: Nick Kendrick. CC BY 2.0

Almost a month ago, in response to widespread protests, India declared sanitary pads tax-free.

"This was a most-awaited and necessary step to help girls and women to stay in school, their jobs, to practise proper menstrual hygiene,” Surbhi Singh, founder of Sachi Saheli, a menstrual health charity, told the Thomson Reuters Foundation.

The decision to tax menstrual products was made over a year ago under the new national goods and services tax that united all India’s states in a single tax system with the same rates for the whole country. Under the new tax tampons were taxed 12% - the same amount as many luxury items. This was despite the fact that many contraceptives as well as condoms were exempt.

The tax sparked widespread protests and inspired the organization She Says to coin the slogan #lahukalagaan - Hindi for tax on blood. One petition by lawmaker Sushmita Dev to revoke the tax received 400,000 signatures. “Clearly the government had put forth frivolous arguments for one year and then delayed it,” Dev tweeted in response to the tax.

After over a year of protests, petitions, and widespread outrage, the tax was finally repealed late this July. Finance minister Piyush Goya told reporters that India’s “sisters and mothers will be happy to hear that sanitary pads have been given a 100% exemption and brought down to a tax rate of zero. Now there will be no [tax] on sanitary pads.”

Despite their new tax exempt status, it is incredibly hard for Indian women in rural areas to acquire sanitary products—according to the BBC four out of five women in India lack proper resources for menstrual care. Sanitary pads cost between five to twelve rupees each, meaning that often rags, ashes, leaves, and even sawdust are the only options for girls and women. The lack of sanitary care is tied to dramatically increased rates of infection, but is also linked to girls missing or dropping out of school.

India’s decision to exempt sanitary pads from taxes is adding the the global conversation surrounding period poverty. The charity Plan International UK released information that 1 in 10 girls and women under 21 can’t afford to purchase sanitary products. Women, as well as transgender and nonbinary people who menstruate, have their period for an average of 2,535 days of their lives. For those without access to sanitary products, that’s almost seven years of struggling to attend school or work without necessary products. Even people who can afford pads or tampons often experience anxiety around setting aside enough money to afford them each month.

According to Jo Feather, the ActionAid senior policy advisor, the issue is tied to gender inequality. She told the Independent that, “to solve period poverty globally we need to collectively address the issue of gender inequality at its root. We must not allow women and girls to be identified primarily by their biological functions and ensure their periods are celebrated, not ashamed, and can be a positive step in exercising empowerment.”

A significant aspect of period poverty is the stigma in many countries surrounding the topic. Often this taboo silences women, and keeps lawmakers from passing the necessary legislation that could make sanitary pads and tampons available to all women.

EMMA BRUCE is an undergraduate student studying English and marketing at Emerson College in Boston. While not writing she explores the nearest museums, reads poetry, and takes classes at her local dance studio. She is passionate about sustainable travel and can't wait to see where life will take her. 

Food Insecurity Affects More than 41 Million Americans

In a nation of plenty, why do 1 out of 8 Americans have uncertain or limited access to food?

In America 1 out of 10 don’t have enough to eat, much more than the 1 in 20 in Europe (Source: Bread Institute for America).

Going hungry in America is not what most would expect. Hunger might mean sacrificing nutritious food for inexpensive, unhealthy options. It might mean periodic disruption to normal eating patterns. And increasingly such hunger occurs among white families, in the suburbs, and among obese people. In other words, any community can be affected; and in 2017, the USDA reported 12.3% of American households are food insecure. Hunger today is a result of tradeoffs between food and other costs—such as health care, bills, and education.

However, hunger does not accurately depict food insecurity in America. Hunger is a prolonged, involuntary lack of food that can lead to personal or physical discomfort. Conversely, food insecure, coined in 2006 by the USDA, defines a household with limited or uncertain access to food. Food insecurity results from limited financial resources and makes it difficult to lead an active, healthy lifestyle. Further, food insecurity can be categorized either as low food insecurity (reduced quality of food, but not intake) or high food insecurity (both reduced quality and intake).

No matter the category given, food insecurity has serious effects. This is most evident in the need for 66% of Feeding America customer households to choose between medical care and food, according to a 2014 study. Considering many food insecure individuals have diabetes or high blood pressure, medical care can be critical. A study by the Bread for the World Institute in 2014 estimated hunger creates $160 billion in healthcare costs. This includes mental health problems, nutrition related issues, and hospitalizations among other potential costs.

Further, 13 million of food insecure individuals are children and 4.9 million are seniors: two critical groups whose bodies rely on proper nutrition. For example, the effects of hunger in children have been known to delay development, cause behavioral problems, and even increase the chances a child will repeat a grade.

One solution for food insecurity is federal food assistance programs. Indeed, 59% of food insecure households are part of at least one major federal food assistance program— but 25% of households do not qualify. The most well-known of these federal programs is SNAP, or Supplemental Nutrition Assistance Program. SNAP requires your gross income be at or below the poverty line by 130%, allowing for adjustments with family size. Still, the average amount per person is around $133.07 a month—or less than $1.50 per meal.

The desired solution though is the end of food insecurity in America. A major force behind this future is the domestic nonprofit, and hunger relief organization, Feeding America. Feeding America supports food banks, funds research, provides meal programs, mobilizes anti-hunger advocacy, and educates the public among other initiatives.

Overall, Feeding America and its partners served 1 out of 7 Americans in 2017. It was able to do so as it works together with 200 food banks and 60,000 pantries. Each affiliated food bank, a non-profit that stores food for smaller organizations, is evaluated according to industry practices and food safety laws. Additionally, all staff receive food safety training. These practices ensure all food is safe when distributed at the food pantries, which directly serve their communities.

Much of the food was higher quality too: around 1.3 billion pounds of nutritional food was delivered to food banks in 2017. Some food is food waste, in 2017 3.3 billion pounds were rescued from landfills and redistributed for consumption from partner companies, such as Starbucks. And all these small initiatives are directly helping communities, making food security an increasing possibility for the future.

TERESA NOWALK is a student at the University of Virginia studying anthropology and history. In her free time she loves traveling, volunteering in the Charlottesville community, and listening to other people’s stories. She does not know where her studies will take her, but is certain writing will be a part of whatever the future has in store.

Reasons to Decrease Your Meat Intake

What you eat affects your world.

By Michael McCullough. May 1, 2010.

Due to the advent of trendy vegan and vegetarian restaurants it is easy to dismiss the vegan diet as little more than a food fad — a here-today-gone-tomorrow movement with little scope beyond the instagrams of teenagers. And yet, this popular misconception allows many to dismiss the movement without ever really considering the many ethical reasons for going meatless. The truth is that the meat industry, especially in America, is a contributing factor to many of the environmental problems we face today.

Much of the problem lies in an overconsumption of meat. According to the New York Times, Americans eat about 8 ounces of meat a day — almost twice the global average. Americans also consume 110 grams of protein per day (75 of which are from animal protein) which is twice the level recommended by medical professionals. This overconsumption does not come without a cost. According to the UN’s food and agriculture organization, 30% of the earth’s ice-free surface is now dedicated to livestock production. The same study also says that the livestock industry is responsible for a fifth of the world's greenhouse gases, more than the entire transportation industry.

The meat industry also uses far too much water. One cow can drink up to 50 gallons of water per day and it takes 2,400 gallons of water to produce one pound of beef. (Compare this to the 244 gallons of water needed to produce a pound of tofu.) Run-off from factory farms is also a significant factor in river and pollution within the United States. Often factory farms dispose of animal waste by spraying it in a mist over fields, allowing the toxins and pathogens in the waste to permeate the surrounding environment.

In addition, while 800 million people worldwide suffer from hunger and malnutrition, most of the corn and soy grown goes to feed chickens, pigs, and livestock. This is despite the fact that it takes 5 times more land and 12 times more water to produce animal protein as opposed to plant protein. If meat production were decreased and crops of plant based proteins increased, hunger could be reduced.

There are many possible solutions to the meat problem. A good first step would be to eliminate the government subsidies which make up 31% of the global income of livestock companies. Another step could be to reduce meat intake by simply by eating less of it. It should be stressed that it is not necessary to become a vegetarian to reduce meat-related emissions. Merely cutting back on our daily meat intake can have a powerfully positive effect on the environment. Researchers at Oxford have found that reducing meat intake to levels prescribed by dietary professionals could help reduce food-related emissions by a third by 2050, while vegetarianism could cut emissions by 63%.

In America’s capitalist society, the best way to vote is with your money. By becoming a vegetarian, or merely reducing your meat intake you have the power to create a healthier, greener planet. Dr. Marco Springmann, lead author of the Oxford study put it best when he said, “We do not expect everybody to become vegan. But the climate change impacts of the food system will require more than just technological changes.” Adopting healthier and more environmentally sustainable diets can be a large step in the right direction.

EMMA BRUCE is an undergraduate student studying English and marketing at Emerson College in Boston. She has worked as a volunteer in Guatemala City and is passionate about travel and social justice. She plans to continue traveling wherever life may take her.

Mental Health Awareness in Developing Countries

When it comes to building awareness about global issues, it is simple to access information about the world’s most pressing, media-enhanced problems. It’s not difficult to come across a long list detailing the burdens of the developing world… Physical health and medical shortcomings are largely common knowledge, even to the disengaged…Mother’s die regularly from child birth, treatable diseases- avoidable diseases- run rampant through communities, slowly bringing more disadvantage into the lives of the underprivileged. Health issues in the developing world are not privy to an elite group. In fact, medical teams are regularly dispersed around the world to supply people with basic medical care. As prominently as physical health is talked about within society, mental health and wellness awareness are becoming increasingly important to acknowledge.

With the United States as a model, mental health is at the forefront of social efforts. In recent years, at the expense of those who suffer from mental illness expressed in one form or another, the country has grieved school shootings, public shootings, and regular suicides of those who seem to “have it all.” Within the past month, the country lost two well-known figures, Kate Spade and Anthony Bourdain, to suicide connected with depression and mental struggle. According to CNN’s report of the CDC’s 2018 study, suicide has increased by 25% since 1999. The study suggests many relevant factors, including economic troubles, personal conflicts, having a rural residence, and limited exposure to mental health care or communities that acknowledge its value all contribute to the increase. Simply understood, mental disorders are certainly impacting both the individual and the larger society. Therefore, it is no stretch to suggest that these concerns pose an international challenge.

The very same issues of financial struggles, limited access to healthcare professionals and understanding communities of mental strife, and of course, rural geography are all extremely relevant to developing countries. While mental wellness campaigns have become more frequent and nationally recognized around the United States, it has taken the country years to work towards de-stigmatizing mental disorder. For those countries who are socially and economically behind the United States, what happens to the people who experience the hidden diseases that develop out of the most critical of environments?

With the knowledge that poverty and rural isolation produce greater mental struggle, those impoverished peoples of the developing world are starved for advocacy about a problem many don’t even know can be blamed for their personal burdens. Just as mental health has been stigmatized in the United States, countries with ancient cultural depth have also formed their own insights and rationale about mental illness. For many cultures around the world, mental disorders have been considered a form of possession or devilish curse. Thus, mental health is strongly associated with isolating qualities. Like an issue of physical health, disease does not play favorites or avoid the rich and famous, it is a generalized concern. With its far reaching capacity, mental illness must be addressed on a larger global scale as its impact reaches deep into the negative realities of societal dysfunction. As this stigma around mental illness slowly melts from the inner workings of American society, there remains a question of how mental health is treated, recognized and perceived in countries that must prioritize the most tangible of problems.

In an effort to expose whether mental illness “exists” in the developing world, the World Health Organization (WHO) presents some findings. WHO reported that the world is “facing a global human rights emergency in mental health.” Andrew Chambers of The Guardian recorded that in countries like Zambia, Africa, mental disorder is largely unaddressed. That said, the same individuals who are uneducated in any sort of physical health maintenance are more severely uneducated in mental health issues. The terms, the diseases, the treatments, the community affected, the causes- all inter-related and important information- are not structures available to those who struggle within these impoverished communities.

Mental illness in a young child is much easier to overlook than when that same child suffers from a broken arm or a high fever. The solution is arguably quick, and the answer is material. The child can heal and carry on with his/her life. Mental illness is an intangible issue that is much harder to treat, much harder to understand, and far more difficult to confront due to its associated stigmas. All that said, it is no less of a real problem. Moreover, the dilemma of not addressing mental disorder is its extent into impacting the cycle of poverty and lack of opportunity. Several studies have been done to confirm the idea that mental disorders “further impoverish the individual.” One study on mental wellness in developing countries suggests, “People who live in the poor income groups, those who are less educated, those who are faced with acute economic difficulties (for example, consequent to unemployment), those who face debt, and those who face hardships in acquiring basic necessities (such as food) for survival, are at much greater risk to suffer mental disorders.” The same study goes on to conclude, “In turn, the disabling effects of mental disorders impair the ability of persons to search for and sustain productive employment.” Therefore, mental wellbeing is much more than meets the eye, so to speak. The study provides the evidence that, while medical teams are making a large impact in many ways, large amounts of people remain debilitated by their mental incapacities.

Mental health advocacy remains an issue stunted by the stigmas and ancient beliefs that coined their categorization. In developing countries, mental disorders are especially hard to treat. They are costly to integrate into societies and they are harder to acknowledge as the majority population is widely uninformed about the different types of disorders and how they manifest in the individual. This lack of education is only further inhibited by the population who refuse to accept mental disorder as anything more than some sacrilegious behavior or cursed punishment.  

While many developing countries remain uninformed and thousands go undiagnosed and untreated, the WHO is working to build a foundation of awareness. Uganda, as of 2015, was working to implement awareness, education, treatment, and western practices to address mental illness throughout the country. A study by Global Health Consultant, Janice Kopinak records, “There is recognition by the national government that the challenges faced in mental health services poses serious public health and development concerns.” To that effect, and despite many of their best efforts, the access and the capacity by which healthcare professionals in Uganda can make an impact still meets many obstacles. In developing countries, with Uganda as a strong representation, the education for treatment is feeble, the financial system is unsupportive, and the reach is limited. In short, mental disorders are just as prominent in countries where there is little to no awareness as it is in countries with large wellness advocacy campaigns. With time, and more concentrated efforts,  there is hope for a better future. However, for developing countries, the road ahead is long and arduous.
 

ELEANOR DAINKO is an undergraduate student at the University of Virginia studying Spanish and Latin American Interdisciplinary Studies. She recently finished a semester in Spain, expanding her knowledge of opportunity and culture as it exists around the world. With her passion to change the world and be a more socially conscious person, she is an aspiring entrepreneur with the hopes of attending business school over seas after college. 

GUATEMALA: Con Madre

Every Mother Counts, a maternal health care non-profit dedicated to making pregnancy and childbirth safe for every mother, everywhere, presents CON MADRE. The short documentary film highlights the importance of midwifery care in one of the most dangerous countries in Central America to give birth, Guatemala. The film follows Erika and Dora María, students training to be the first university-level midwives (parteras) in the country, as they return to their hometowns in the rural, Indigenous communities of Guatemala. Once there, Erika and Dora María continue their education under the mentorship of traditional midwives, comadronas. Erika and Dora María work with the comadronas to continue their culture’s traditional practices of birth and natural medicine, while also incorporating the new skills and training from school and health centers. Both women share their own personal stories of empowerment and dedication to helping women and families in their communities. Erika, who is pregnant, also plans a home birth under the guidance of her comadrona, Azucena, a powerful leader in her community, and with the help of her fellow midwives at school, including Dora María. For more information, visit everymothercounts.org.

How Nairobi Can Fix Its Serious Waste Problem

Uncollected solid waste is one of Nairobi’s most visible environmental problems. Many parts of the city, especially the low and middle-income areas, don’t even have waste collection systems in place. In high income areas, private waste collection companies are booming. Residents pay handsomely without really knowing where the waste will end up.

The Nairobi county government has acknowledged that with 2,475 tons of waste being produced each day, it can’t manage. Addis Ababa Ethiopia has a similar size population but only generates 1,680 tons per day.

Nairobi’s current waste disposal system is fraught with major problems. These range from the city’s failure to prioritise solid waste management to inadequate infrastructure and the fact that multiple actors are involved whose activities aren’t controlled. There are over 150 private sector waste operators independently involved in various aspects of waste management. To top it all there’s no enforcement of laws and regulations.

Nairobi’s waste disposal problems go back a long way and there have been previous efforts to sort them out. For example in the early 1990s, private and civil society actors got involved, signing contractual arrangements with waste generators. They often did this without informing or partnering with the city authorities.

More recently other strategies were put in place, some of which left parts of the city clean. They worked for a period, but unfortunately they weren’t sustainable because no institutional changes were made.

But there’s hope on the horizon with a new Nairobi Governor – Mike Sonko Mbuvi. He should learn from the mistakes of the past and put a new regime in place that addresses the structural problems that have plagued the city. This would include an improved improved collection and transportation plan that incorporates the private sector.

Learning from the past

In 2005 John Gakuo took over the management of city affairs as the Town Clerk. During his tenure (2005-2009) he made a deliberate effort to introduce new approaches.

When he took over the city only had 13 refuse trucks. They were able to collect a paltry 20% of the waste produced by the city. To overcome this, the authorities contracted private waste collection firms to collect, transport and dispose waste at Dandora dump site which is the biggest and the only designated site. This quickly boosted the total waste collected with levels oscillating between 45%-60%.

Other changes included:

• The development of a proper waste collection and transportation schedule with market operators. This meant waste from open-air markets was brought to identified collection points on specific days.

• A weighbridge to measure amounts of waste disposed at Dandora was introduced. An important way to know disposal levels vis-a-vis collection and generation.

• Enforcement officers were deployed to prevent dumping in parts of the city that were notorious for waste accumulation.

• Over 2,000 arrests were made, making residents aware that indiscriminate dumping was illegal and punishable under the city authority laws.

All these efforts paid off – for parts of the city. For example, the heart of the city, the Central Business District, was cleaned up and waste was brought under control.

But crucial elements that would have ensured that the changes were sustainable were left out. For example, no new physical infrastructure, like the construction of waste transfer centres and proper landfills, were built, nor was new equipment bought.

After Gakuo’s regime, the next one worth a mention is Evans Kidero’s regime (2013 - 2017). It can be credited for trying to fast-track the implementation of the Solid Waste Management Master Plan which assessed the waste management problem of Nairobi and developed projects that could be implemented to ensure a sustainable system was in place.

This ensured that while the private sector needed to help with waste collection and transportation, the government was key to institutionalising waste management services.

Thirty waste collection trucks were bought and serious investment was made into heavy equipment. And in an effort to streamline waste collection a franchise system of waste collection was rolled out. This involved dividing the city into nine zones to make it easier to manage waste.

The franchise arrangement gave private operators a monopoly over both waste and fee collections, but relied heavily on the public body for enforcement of the system.

The franchising system failed due to a lack of enforcement by the city. In addition, in-fighting broke out between the private waste collection firms that had individual contracts with waste generators and the appointed contractor.

But other changes introduced during this period were more successful and had longer lasting effect. For example new laws were introduced designed to create order in the sector. These included the solid waste management act in 2015. This classified waste and also created a collection scheme based on the sub-county system. It also put penalties in place.

In addition, in 2016, 17 environment officers were appointed and posted to the sub-counties to plan and supervise waste management operations alongside other environmental issues.

These changes planted the seeds of an efficient and working waste management system. But the regime fell down when it come to enforcement. This meant that the gains that had been made were soon lost.

What needs to be done

Expectations are high for the new regime that has taken over. It should look to fast-track the following programmes:

• Implement an improved collection and transportation plan that incorporates private sector and civil society groups;

• Establish a disposal facility to reduce secondary pollution from the city’s dumps;

• Decommission the Dandora dump site;

• Implement the re-use, reduction, and recycling of waste;

• Establish intermediate treatment facilities to reduce waste and its hazards;

• Create an autonomous public corporation;

• Put in place legal and institutional reforms to create accountability;

• Implement a financial management plan, and

• Implement private sector involvement.

Nairobi can fix it’s waste disposal problems. All it needs is focused attention, good governance and the implementation of systems that ensure changes outlive just one administration.

This article was originally published on The Conversation.

LEAH OYAKE-OMBIS

Part-time lecturer and Director of the Africa Livelihood Innovations for Sustainable Environment Consulting Group, University of Nairobi

CHINA: The Human Cost of Electronics

This short documentary reveals the hazards of the electronics industry in China profiling workers poisoned by chemicals and their struggle for compensation. 

Thousands of young people in China enter export factories to make the West's favorite electronic gadgets, only to find they have contracted occupational diseases or worse, leukemia, by the age of 25.
 

These $2 Birth Kits Could Save Millions of Lives

Around 830 women die every day because of childbirths that go wrong. For every woman who dies, 20 to 30 more women incur long-term health consequences.

99% of these health problems occur in the developing world. The vast majority could be avoided if basic resources were made available and skilled health providers were more common.

Oftentimes, women acquire fatal infections from unsanitary medical supplies or environments. Other leading causes of maternal mortality include excessive bleeding and hypertensive disorders.

Reducing maternal mortality rates requires more health professionals and improved health infrastructure.

Progress also requires cheap supplies such as soap, clean towels, sterile medical equipment, gloves and rudimentary medicine.

When Zubaida Bai explored this problem she realized that the latter part was, theoretically, an easy fix.

Her background is in product engineering with a focus on social enterprise. She first started to think about maternal mortality when she contracted an infection after giving birth to her son.

Had Bai lived in a country without an adequate health care system, the infection could have become far worse. Millions of women with similar infections do not receive proper care and regularly die.

Bai created an organization to address this injustice. She named it ayzh, an acronym for the initials of her family members’ names. Ayzh is pronounced “eyes,” to convey how the organization looks at the world from a different angle.

She designed a biodegradable clean birth kit called Janma that sells for $2 to $5 USD and contains, “a soft, blood-absorbent sheet that provides a clean surface for birth; medicinal soap for the birth attendant; disposable gloves; a sterile blade to cut the umbilical cord and a sterile clamp to secure it.”

Photo credit: ayzh

The kits are sold to nonprofits that focus on improving maternal health outcomes and to hospitals and health providers around the world.

In some instances, the kits are assembled in local communities, potentially creating an opportunity for employment and enterprise.

Azyh has so far sold more than 100,000 kits in more than 11 countries. After their initial use, the kits can even be used as purses.

They’re working on a newborn kit to accompany the birth kit that will include, “a clean receiving blanket, infant hat, antibiotic eye cream, umbilical cord medication and gauze to apply it, that will retail for less than $5.”

The organization aims to distribute millions of health kits around the world, potentially saving millions of lives.

Large-scale investments in infrastructure and the training of medical professionals are obviously still needed and will have a much larger role to play in reducing maternal mortality. In the short term, with millions of women giving birth in unsafe environments every year, it may take entrepreneurs like Bai to save people through the simplest of innovations like an affordable birth kit.

ORIGINALLY PUBLISHED ON GLOBAL CITIZEN 

JOE MCCARTHY

@mccarthyj71

Joe McCarthy is a Content Creator at Global Citizen. He believes apathy is the biggest threat to creating a more just world and tries his hardest to stay open-minded and curious. Living in New York keeps him aware of how interconnected our world is, how every action has ripples.

IRAN: A Commitment to Provide Universal Public Healthcare to Refugees

In an announcement from the United Nation mission in Iran, the Iranian government will include all of its registered refugees into its Salamat Insurance Scheme. This is a collaboration between the Ministry of Interior, responsible for immigrant affairs, the Iranian Health Insurance Organization and the United Nations High Commissioner for Refugees (UNHCR). This plan is targeted at Iran's Afghan and Iraqi refugee population.

Iran's English daily Tehran Times, part of the Mehr News Agency owned by the Islamic Ideology Dissemination Organisation, described the “gratitude” of Sivanka Dhanapala, the UNHCR Representative in Iran, for the program:

“UNHCR’s Representative in Iran acknowledged the Iranian Government’s contribution, expressed UNHCR’s gratitude towards the Government of the Islamic Republic of Iran for all the services it has rendered to the largest protracted urban refugee population in the world for over three decades, and inclusion of the refugees in this Universal Insurance Scheme which is exemplary not only regionally but also globally, and added that such a services haven’t been provided before and I sincerely hope other countries will follow this example.
”

Half of the coverage for the program will come from the Iranian government, while the UNHCR will contribute with US $8.3 million. The program will be available to all registered refugees, who will receive access to a health insurance package for “hospitalization and temporary hospitalization”, as available to Iranian nationals.

According to the UNHCR website, Iran is home to one of “the world's largest and most protracted refugee populations.” Iran's Afghan refugee population nears 1 million, with an additional estimated 1.4 to 2 million unregistered refugees living and working in the country.

Iran's treatment of this demographic has been subject to past criticism, however, most notable in the 2013 Human Rights Watch report that detailed the mistreatment and sometimes abuse Afghans faced from both Iranian society and the government.

For their 2015 projection, the UNHCR detailed their expectations for Iran's intake for mostly Afghan, Iraqi and Pakistani refugees as outlined in the image below.

Iran has been criticized for not taking in any Syrian refugees throughout the civil war there. This reproach comes amidst the fact that it is heavily involved in the Syrian conflict as an ally and supporter of the Syrian President Bashar Al-Assad.

Indeed, this development in instating universal public healthcare for refugee populations is a notable milestone for both Iran and the region. Iran can, however, still improve its image in bolstering its role in alleviating the neighbouring Syrian refugee crisis.

ORIGINALLY PUBLISHED ON GLOBALVOICES

Mahsa Alimardani

@maasalan

Mahsa Alimardani is an Iranian-Canadian Internet researcher. Her focus in on the intersection of technology and human rights, especially as it pertains to freedom of expression and access to information inside Iran. She holds an Honours Bachelor in Political Science from the University of Toronto and is completing her Masters degree in New Media and Digital Culture at the University of Amsterdam.

Am I Making a Difference?

Mingling in hostels you tend to meet many adventurous spirits finding their way in the world. Among those I met a young girl with similar interests in the social work/humanitarian field in Chennai, India. She was nearing the end of her yearlong journey and as we talked we reminisced about the hardships and victories we found along the way. She told me of her 1st day working at an HIV positive orphanage in Bangalore where a child fell and cut herself. My new found friend's immediate reaction was to clean the wound, which she instinctively did, as everyone watched open mouthed, too afraid to say a word. After numerous blood tests she found out she had not contracted HIV, but it was a wake up call. She had forgotten she was in a different place, without the luxury of basic necessities. Finally we got to the point I asked  what she felt her biggest accomplishment was during this trip? She looked me straight in the eye's and said, "I feel like I have accomplished absolutely nothing, I have made no difference in this place." Here was a girl who had been devoting her life for the past year to HIV positive orphans, trafficked girls, and battered women yet she felt like she had accomplished nothing. I was floored and thought if she hasn't made a difference have I? I proceeded to make a list of how I felt when I was impacted by volunteers when I was younger, and what difference they made in my life today. As I thought, I realized we need to look at our small victories. Realize we can't change a country overnight, but we can provide a motherless child with love. We can let these children see what else there is in the world. We can give them the confidence to succeed. We can open their minds. Whether it be for 2 days or 2 years, that child is going to remember the love they felt from you. This is why we started Humanitarian Travel Tips doing medical screenings and vocational training. We can't change a country overnight, but by providing glasses to a child who can't see a chalk board we are changing their opportunities and their life forever.

Without glasses these children can't learn. They are put into the lowest classes of children deemed unfit for learning, given little to no teacher supervision, and leftover books (if there are any). With glasses they are able to move up in school, they won't fall through the cracks, they have the opportunities to reach their full potential. The girls who got the glasses go on to be educated women who as a whole have fewer children and take better care of those children. On the same token teaching women a vocation like sewing gives her the ability to provide for her family, send her children to school, and give the children the nutrition they need to concentrate during school. They raise educated children, thus changing a generation. Too often we underestimate the power of the good we are doing and we shouldn't. Every smile, every friendship, every amount of love you give to a person makes a difference to that person. I have been at orphanages long term and you don't realize how long after you leave those children still talk about you, or the pictures you give them they will hold onto forever. Don't underestimate the power of good in this world you can do. 

CHAMBREY WILLIS

@chambreyw

Chambrey is the founder of Humanitarian Travel Tips an organization that raises the standard of living to people in developing countries through health screenings and vocational training. We are excited to announce that we are now welcoming volunteers to join with us on these initiatives this summer. Chambrey is an avid yogi, got her undergrad in Finance and is working on a  guidebook outlining step by step how to best fundraise for your next big adventure. You can find her on facebook or follow her blog.