Hunger is a monstrous crisis. And like many current crises, it is unnecessary. “World agriculture produces 17% more calories per person today than it did 30 years ago, despite a 70% population increase. This is enough to provide everyone in the world with at least 2,720 kilocalories per person per day” (FAO 2002 p.9). Regardless, there are over 1.02 billion malnourished people worldwide. This represents a 17% increase in the number of malnourished from 2006. Things are not getting better. They have gotten worse. The recent global financial slump has contributed to the increase in malnourished populations; however, it is only a recent contribution and the more enduring issues of systemic poverty, conflict, and climate change have played a crucial role in perpetuating global hunger. Though there is sufficient food to feed the world over, solving global hunger is more than a matter of redistribution. The social and economic systems that sustain global hunger must be curbed and local solutions carried out. There is hope and a lighthouse guiding the world to the alleviation of hunger. We know from our past actions what has failed and we know from foresight what will prevail. The state of world hunger seems to be deteriorating, but I have hope and faith that, with the smart aid, hunger (specifically in Africa) can be curtailed, diminished, and eradicated.

:(

In Africa alone, 307 million people are malnourished. Forty-two nations receive aid from the World Food Programme and other Western powers pour billions, into ending global hunger. Just this past July, Obama pooled $20 billion from the world’s richest nations to be used for the reduction hunger in Africa. Yet, Ethiopia (one of the world’s largest recipients of aid) still has 6.2 million malnourished people in it’s country. Sudan, Somalia, Niger, and Chad, too receive plush amounts of aid, yet have devastating numbers of malnourished. Kenya, one of the most developed nations on the continent as well as a large receiver of aid, has 3.6 million malnourished people and that number is expected to rise. The problem is obviously not lack of money. The problem is misdirected use of money and an perpetuating intersection of poverty, drought, and corruption.

Poverty is the principle cause of  hunger – as well as a direct effect of hunger. Poverty and hunger are so entwined that neither can be solved individually. Without money, farmers lack the buying power to purchase seed, farming tools, and fertilizer. Without these necessities, they are unable to produce a sufficient food to turn a profit. The effect of this is two fold. The farmer’s poverty and hunger grows and the reduced supply of food to urban markets increases the prices, pulling urban poor who are unable to purchase the higher-priced food into malnourishment and hunger. Furthermore, drought exacerbates the problem.

The drought and subsequent famine of 1984 in Ethiopia claimed over a million lives. While some say that the drought never left, it is evident that the drought has returned with a full-fledged famine. There are currently 6.2 million people in Ethiopia who are malnourished and the famine is expected to raise that number to 14 million – in Ethiopia alone. In Kenya, the famine has severely threatened the lives of 3.6 million people. And Somalia has another 3.8 million people affected. In total, there are 23 million people in the Horn of Africa and Eastern Africa who have been affected. There is simply not enough water to produce a good harvest. And when rain does arrive, the sun-baked earth does not immediately absorb the water, rather causes flash floods and outbreaks of cholera. Farmers can’t grow enough food to even feed their family. They are forced to cultivate cash crops in hope of turning a minimum profit with which they can buy fertilizer that will hopefully provide a better harvest next season. “They are essentially going hungry so that they can feed the country.” But even those in urban settings do not walk away unscathed. They must compete for jobs in slums so that they can pay the inflated food prices. Furthermore, the hungry in cities are often overlooked while food aid and donors flock to the rural communities. Children in slums like Kibera, a shanty-slum of 600,000-1.2 million outside of Nairobi, Kenya, drop out of school to work or beg so that they to pay the 130% inflated price of maize (over one year’s time) and the ever-increasing prices of water. Regardless, there is hope.

“Drought does not need to mean hunger and destitution. If communities have irrigation for crops, grain stores, and wells to harvest rains then they can survive, despite what the elements throw at them.” Irrigation, grain stores, and wells require money, however,  and, once again, poverty stands in the way. Yet the same poverty that is preventing these people from building famine preventative infrastructure, was caused  by the previous poor harvest and famine. The cycle seems interminable – until someone steps in to provide the infrastructure these communities need. That someone is government.

“The urban crisis [and famine] is not just about poverty – it is about governance,” Oxfam reportedly said. Governments have the responsibility of providing fundamental social services to it’s citizens. In a country susceptible to drought, this includes irrigation infrastructure, grain stores, and rain water wells. However, very few governments have provided any of these resources to their people. In Somalia, there is no functional central government to provide these resources. In Kenya, the government is “paralyzed by infighting and political maneuvering.” And in Ethiopia, the government is, both, trying to maintain its good image from its successes in health care, education, and counter terrorism, and trying to undermine its citizens through corrupt, profit-driven deals. It’s desire for a positive image has led it to gloss over the famine by reporting (relatively) low numbers of people affected and making the definition of people at risk more exclusive. It has also tried to hide the severity of the famine through banning aid from reaching specific severely-affected regions. Backroom politics has highlighted the government’s lack of interest in curtailing the famine. Hundreds of bags of maize disappeared from the Ethiopian reserve and then reappeared in Sudan a month later, leading a lot of people to suspect that deals were made behind closed doors. Furthermore, the government has marketed Ethiopia in the new business of land-leasing, where large, rich foreign investors can rent vast plots of lands on 44-99 year contracts. The contracts have nearly no safeguards and foreign investors buy them purely for profit. The effectively take land away from local farmers, employ local residents under extremely brutal conditions, sell their crops to foreign nations for profit, and deplete the soil of nutrients. These are not the kinds of contracts a government interested in its people should be offering.

If it were not for corruption, the drought and the poverty could be (more-easily) resolved. But without the necessary functions of the state happening, the impact of both is increased and perpetuated. “Ethiopia’s famine today is a famine of food scarcity as much as it is a famine of democracy and good governance.” African governments must take responsibility and ownership for their states. I they want to become a respected global voice, they must end corruption and end their dependency on aid .

As outsiders from the West, we must be cautious in our critique and support of African nations. Too often aid has been given in ways that only increase dependency, circumvent governments, and enable corruption. The West is not culpable for the existing corruption, but it has not given support that leads towards independent, sustainable nations. “Continued food and agricultural support, coupled with falling [crop] production, have led some to believe that aid might actually be the root of the problem.” Food handouts increase dependency through creating disincentives to produce and providing short-term fixes to problems that need long-term solutions. Africa does not need more food, it needs more ways to consistently cultivate its own food.

It’s extremely challenging and a great moral conundrum to critique food handouts when lives are at stake. And I, in no way, believe that food handouts should be stopped, rather they should be accompanied by long-term solutions. It is easy to ideologically critique these different forms of aid, but when the reality that this aid saves a person’s mother, father, son, or daughter from dying is realized the disadvantages of any aid seem inconsequential. So it is with great respect and appreciation that I say, there is a better way.

Handouts cannot be expected to prepare these countries for the next famine. The international community must begin to fund projects which build irrigation infrastructure, wells for rain water, teach efficient methods of cultivation, and inspire autonomy of communities . The calamities of hunger and drought in Africa are not our burden and we should not carry the weight. The international aid community acts out of compassion for Africa, not obligation. It would be immoral to cease all aid merely because we are not obligated. Aid and exchange should always be occurring. We should always be in a flux of giving and receiving (even in times of prosperity) – giving the skills and lessons we have learned from our culture and experience and receiving the skills and lessons of another. We should be working to create autonomy and sustainability in African nations, which is why funding needs to be given to projects that pursue these goals.

The international community would be equally flawed if it built the preventative infrastructure of irrigation, wells, and grain stores. Although we would be establishing preventative measures for the next drought, it would still be us establishing them. Africa needs to help Africa -and we need to help Africa help itself. Funding should be targeted towards local, African projects which are building sustainable preventative infrastructure. Only then, do we truly help establish an equal, autonomous, independent Africa.

Though the intertwinement of hunger with large socio-political problems exacerbates the issue and makes it appear hopeless, it is not. There is abounding hope that Africa will make it through this crisis and then through the next. It is hope that lies behind all forms of aid and it is hope that feeds the starving souls of those who can’t find enough to eat, providing them the determination to make it through another day and to another meal. I have hope that the international community, specifically the large aid donors, will recognize the cycle of dependence they are caught in and will begin to teach their recipients how to fish.

Before you have anything else, you have your health. Hopefully if you have nothing else, at least you have your health. Unfortunately, for millions across the African continent this is not an absolute fact. Even more unfortunate is the fact that many Africans have no ability to change their health status. They are trapped in a system that is driven by Western market based, profit driven health care systems. As the failures of Western development practices come to light, alternatives to what has been are becoming increasingly visible. These alternatives will form a revolution in African health care delivery. This revolution will be fueled by health care delivery models that will give local communities agency in the provision of their own health care. Community-based models involving cooperative financing, proven para-professional training, new information technology, and social enterprise for the social good will drive the revolution in African health care. People will be able to determine for themselves, their level of health.

What does “Health” mean anyway?
This is a question often left to remain ambiguous. For the purposes of my writing I will provide a comprehensive view of “health” and all that is entailed in sustaining and maintaining health. “Health” in all instances will refer directly to the “basic needs” of a person in regards to health care.

Healing, like health, is obviously rooted in the social and cultural order. [...] To define dangerous behavior, and to define evil, is to define some causes of illness. As the definition of evil changes, so does the interpretation of illness. To understand change in healing, we must understand what it is that leads people to alter the definition of dangerous social behavior. It can easily be accepted that health and healing in Africa are shaped by broad social forces.

As Feierman and Janzen state, health (and healing for that matter) are directly linked to social forces. If a comprehensive understanding of health is to be understood, it must be studied in the context of politics, economics, and other societal structures.

Health is defined by the World Health Organization (WHO) as, “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” The WHO and many other international organizations recognize that this broad and encompassing definition of health. Where this definition becomes ambiguous is what qualifiers meet, “a state of complete physical, mental, and social well-being.” In 1978 the WHO made primary health care its number one objective with the Declaration of Alma Ata. However, even this statement had no clear definition of health or its qualifiers.

Feierman and Janzen provide a more clear definition of the qualifiers of health in the preface to their volume: The Social Basis of Health and Healing in Africa,

[…] it [health] is maintained by a cushion of adequate nutrition, social support, water supply, housing, sanitation, and continued collective defense against contagious and degenerative disease. Such a view is necessary if we are to understand those contexts in today’s Africa where health levels deteriorate, and where they improve.

These authors provide a complete set of qualifiers, or “basic needs,” of health that can be researched further to understand where political, economic, and social structures interfere with sustaining and maintaining health and where health care is inadequate.

Health care should thus be understood as the system and structure that works to provide the above defined “basic needs” to each individual. Often this role falls to governments, but sometimes is taken up by communities and organizations when government’s fail to provide these basic needs.

This blog series will cover four key areas identified that will fuel this revolution in African health care: cooperative financing, para-professional training, information technology, and social enterprise. SCOUT BANANA works to tackle social medicine (social, economic, structures) while enabling others to provide medical services. Be sure to follow closely to learn more!

(photo credit: WHO)

From the UN Declaration to Amnesty International, between Paul Farmer and William Easterly it seems that everyone has a different understanding of what constitutes a basic human right and the cause of its absence. Michael Keizner has been building the discussion on health and human rights on Change.org’s Global Health blog while NYU Professor, William Easterly has recently entered the debate as a response to Amnesty International’s position on poverty related to human rights. This fueled a response from Amnesty International, which stated that Easterly was “pretty off base.” Easterly followed his Amnesty International response with an end to his “human rights trilogy” by asking Paul Farmer who should be held responsible for satisfying the right to health care?

The World Health Organization (WHO) states health as a human right as:

“the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being…”

It seems that Easterly’s human rights criteria is trapped in an old international law paradigm where there must be someone at fault or someone to blame. He also forgets that health is directly linked to food. You cannot have good health and not have food. Effective aid, not seen in today’s aid schemes, based in sustainable practices (not just buzzword reporting) that supports an individual’s right to develop themselves should look comprehensively towards the needs of a community of individuals. The ideas of human rights, foreign aid, and development should be less focused on international systems and more focused on building strong communities that meet their own human needs: health care, food, water, etc.

Within this debate of health and human rights, where does SCOUT BANANA fit. As an organization that makes and stands behind the statement that:

“global health is everyone’s responsibility and every individual’s human right”

Paul Farmer has the right idea, as Easterly quotes from his Tanner Lecture in 2005:

“only a social movement involving millions, most of us living far from these difficult settings, could allow us to change the course of history….troves of attention are required to reconfigure existing arrangements if we are to slow the steady movement of resources from poor to rich—transfers that have always been associated… with violence and epidemic disease… whether or not we can say “never again” with any conviction—will depend on our collective courage to examine and understand the roots of modern violence and the violation of a broad array of rights, including social and economic rights”

This is exactly similar to SCOUT BANANA’s understanding of health as a human right and a responsibility. It is a right where we do not attempt to place blame or hold the past accountable because those become frivolous exercises that produce no results. When we delve deeper into the root causes of issues, for example the driving forces of slavery, we must focus on a responsibility to not repeat the past and make ourselves accountable in the future.

There is no way that the entire European population and its descendants can be held accountable for the evils of the slave trade. While the same ideas of human rights did not exist in the time period of slavery, it is similarly difficult to place blame on systems (and populations) that drive the causes of poverty and lack of access to health care. Many people that I work with on development projects feel guilty that they are so privileged and wealthy compared to the communities that they work with that are so poor. SCOUT BANANA teaches its members to not feel guilty, but instead to feel responsible. Understanding personal privilege related to the oppression of certain populations within societal structures can assist in creating positive impacts. Human rights don’t necessarily have to be about placing blame, but rather developing an understanding of responsibility.

So Professor Easterly when you ask who is responsible for satisfying human rights: it is you, it is me, it is all those who dream of making a difference, and it is also those who lack the very human rights that we hold dear. Placing blame is not a concrete step forward, learning from history and recognizing where our privilege fits can be a first step towards effective actions. I too see Paul Farmer’s vision of a movement of millions, near and far, taking actions to shape a better future where human rights are everyone’s responsibility and every individual’s human right.

From the Article 25 of the Universal Declaration on Human Rights:

“Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.”

Four modern-day explorers in Expedition Africa (from History Channel)

Reminiscent of the 1800s, a new History Channel show describes a team of explorers, dressed in their colonial khaki, set out to discover the perils of the African continent.

Four modern-day explorers retrace the most famous search in history through 970 miles of hell. They face countless dangers from predators and insects to disease and nature’s own fury. Check out the television event of the summer!

Miles of hell in Africa, oh my! Don’t forget the natural danger!

Between Zanzibar and Ujiji, there are 970 miles of high seas, steep hillsides, scorching plains, fast-moving rivers and mud-filled swamps. Danger lurks around every corner, and any step could be their last.
(Expedition Africa, History Channel)

The webpage for the expedition show describes how the explorers will be following in the footsteps of the great explorers, “heroes” to some of these ‘modern-day’ explorers, Sir Henry Morton Stanley and Dr. David Livingstone.

Stanley a Welsh journalist, who spent a number of years of his life in the US, is best known for finding Dr. Livingstone after he was thought lost in the African bush. Regarded as one of the premier African explorers, a little known fact about Stanley’s African exploration is that he laid the foundation, through his exploration, for the takeover of the Congo (now DRC) by King Leopold II of Belgium. The King was interested in spreading Western civilization and religion to the region as well as claim land. This has led to a still destabilized region where some of the longest running African conflicts are located. Allegedly his expeditions were marked by violence and brutality. He is quoted, “the savage only respects force, power, boldness, and decision.” On a health related note for the central African region, the spread of trypanosomiasis is attributed to the movements of Stanley’s enormous baggage train.

Livingstone’s African exploratory era was marked by the greatest European penetration of the continent. He began his African explorations as a Protestant missionary, but supposedly did not force his preaching on unwilling ears as his main interest was exploring. He was known to travel lightly and was able to negotiate with local chiefs. Livingstone was a man in love with the continent and popularized the search for the source of the Nile. After being ‘found’ by Stanley he refused to return without completing his mission. Just 50 years after his death, colonialism exploded across the continent and was able to penetrate further into the interior due to his work. However, this also allowed missionaries to provide education and health care services to more central Africans. Livingstone was also a staunch abolitionist and made many friends among the African chiefs and populations.

Both men are examples of the Western colonial mindset scarring the African continent. While Livingstone was perhaps a step forward in Western engagement of Africans, Stanley is far from a figure to emulate. The History Channel fails to take note of the important contributions these men made to the destruction of the continent. Instead they focus on the meeting of the two in a popular media tale of discovery in the African wilderness.

Four Westerners with varying experience with the African continent will be followed on their journey that will pit them against the harsh natural environments of Africa. But, this show isn’t about Africa, learning about African peoples, remembering African history or highlighting the difficulties faced in Africa. The show makes generalizations about the continent and perpetuates the myths of Africa as primarily a place of danger. It focuses on Africa as “the unknown, the interior of Tanzania.” If I’m not mistaken people have been living on the African continent longer than any other place on earth. It may be a dangerous, unknown hell full of nature to outsiders, but it is far from a mystery to those who live there. The show seems to be all about these four privileged individuals and the story of their personal journeys. The explorers are worried about mosquitos, disease, death, and surviving. Rightly so in some regards, but what if the story included the people that actually live there?

When will Africa cease to be represented solely by its nature, its dangers and its forgotten history?

Nyala, Kalma camp, South Darfur - March 2007 (MSF Photo Blog)

The impact of conflict on the environment and then the subsequent, direct effect on human health cannot be overlooked. This internally displaced peoples (IDP) camp in Sudan shows the seriousness of that impact.

Your Old Cell Phone Can Make a Difference in Global Health

Everyone in the global health sector is writing about the incredible reach of SMS technologies working for health in developing countries, and rightly so. Hope Phones has partnered with FrontlineSMS to provide old cell phones to communities in need through SMSmedic partner organizations.
More:
Your Old Phone Can Change the World

TeleMed
A service that I just recently came across is one that is not being as widely talked about. TeleMed is different from FrontlineSMS: Medic because it connects local health care workers directly to patients in need via SMS technology. SMS: Medic is focused on health infrastructure. TeleMed does not have a website up yet, but is definitely one to watch:

Paul Farmer and the US Government?

The other big talk within global health is whether Paul Farmer will take a job within the US government. Some have expressed great hope for potential reform others voice their plea with him to continue his incredible community based work outside the bureaucracies. My opinion is that Partners in Health has developed into a strong organization and does not depend on Paul Farmer to further their work. If he wants to take on the inefficiencies and inadequacies of the US government and global health, then all the more power to him.

Southern Africa: Global Financial Crisis Leads to HIV Budget Cuts

Broken promises abound as the economic crisis deepens and the right to health falters, but activists are coming together to ensure that funding for health and HIV are not cut. International donors are expected to slash budgets for health due to the economic crisis and health experts fear that this will lead to, “less food security and quality of nutrition, which will in turn put more stress on already weak health systems.” Paula Akugizibwe, regional treatment literacy and advocacy coordinator of Windhoek-based AIDS and Rights Alliance for Southern Africa (ARASA) in Namibia demanded, “We need to ensure that African lives do not become a silent casualty of the global financial downturn. Our lives are not cheap or expendable. We expect health to be prioritised over weapons, sports and lavish politics.” Tanzania was the first sub-Saharan country to announce a 25 percent cut of its annual HIV/AIDS budget.
Other budget cut impacts:
Guinea: Medicines Running Out

Zambian High Court to Hear Groundbreaking HIV Case

On Wednesday, the Livingstone High Court was supposed to hear a ground breaking case about whether mandatory testing for HIV and discrimination solely on the basis of HIV status is constitutional in Zambia. Unfortunately two days later news came that the trial was postponed until mid-July. Be sure to keep watching this story.
More:
Trial postponed until 15 July

HIV Prevention and Behavior Change

Mara Gordon writes on Change.org’s Global Health Blog about a direct campaign in Tanzania discussing behavior change. “This campaign is partially paid for by the President’s Emergency Plan for AIDS Relief, U.S. government money to fight HIV that’s notoriously had lots of conservative strings attached. Had I seen this ad a year ago, I probably would have dismissed it as unrealistic abstinence-only propaganda. But behavior change works. Behavior change – in combination with access to condoms, comprehensive sexual education, open discussion about HIV and sexually transmitted infections in general, all that good liberal stuff.”
More:
Changing Human Behaviors: Sexual and Social
During a course on Africa’s environmental history I wrote about the need for changing human behavior in both the sexual and social arena to make a real impact in HIV prevalence. The major social change is the response from Western institutions and organizations in how they talk about HIV/AIDS and Africa while seeking to change sexual behavior.
Lesotho: Cultural Beliefs Threaten Prevention of Mother-Child HIV Transmission
Health workers note an encouraging response to the PMTCT program. The number of facilities providing PMTCT has risen from nine in 2004 to 166 by the end of 2008. The number of women who received PMTCT and subsequent antiretroviral (ARV) treatment increased from 421 in 2004 to about 5,000 by end of last year, according to 2009 National AIDS Council statistics. “The primary health care coordinator at St. James Mantsonyane Mission Hospital, Khanyane Mabitso, says stigma and cultural beliefs make it difficult for medical personnel to follow up on HIV-positive mothers and their babies.”

Progress on health-related MDGs mixed

Many advances have been made in health. Some argue that these advances have been dwarfed by the HIV/AIDS epidemic, the economic crisis, or the failures of African governments. The WHO report shows that the only statistic with concrete results was the number of children dying before the age of five. Is this a solid example of the failure of big plans and blanket goals for development?

Sierra Leone: ACC Recommends Reform At Health Ministry

The Anti-Corruption Committee report provides a number of recommendations for reform all focused on improving the health care delivery services in Sierra Leone and eliminating the risk of corrupt practices in the health services across the country.
More on health service scale-up:
Chad: Paving the Way for Better Obstetric Care
Government meetings with UNICEF to help scale-up of health services for better obstetric care across the country.

Ten Things You Can Do to Fight World Hunger

The Nation provides an interesting set of things you can do in your everyday life to fight world hunger. They properly focus on how food, a basic human need, has been commodified in our global capitalist structure. “Our planet produces enough food to feed its more than 960 million undernourished people. The basic cause of global hunger is not underproduction; it is a production and distribution system that treats food as a commodity rather than a human right.” When in February I wrote that agricultural experts had said the food crisis of the last year was over evidence from this past week point to the contrary.
More:
Tanzania: Food Shortage Unnecessary
“Tanzania has since independence sang the song of ‘Agriculture is the backbone of the economy’, but little has gone into strategizing and implementing viable actions towards surplus food production.”
Kenya: UN Agency Makes First Local Food Purchase from Small Scale Farmers
The United Nations World Food Programme (WFP) has for the first time bought food from small-scale farmers in Kenya under a new initiative aimed at boosting agriculture by connecting farmers to markets.
Zimbabwe: Another Year Without Much Food
Rwanda: Nearly Half the Country’s Children Are Malnourished
Kenya: Over Three Million Face Food Shortages

Africa: High Level Engagement with Continent Has Started

Speaking at a gala reception in Washington marking the beginning of “Africa Week,” Carson said: “Most of the Obama administration’s Africa team is in place, and we are gearing up. We will continue to build on and strengthen the strong bipartisan consensus in Congress and among the people of America that has motivated U.S. policy towards Africa. Over the next four years, we will be focusing our efforts on strengthening democracy, promoting sustainable development, resolving or mitigating conflict, and dealing with transnational issues such as climate change and agriculture,” he pledged. While Obama has built a great team, the White House has yet to announce any Africa Policy, greater control and influence for the Bureau of African Affairs, or take any serious (or effective) action for the continent.
More:
Tanzania: Obama, Kikwete Meet in Oval Office on Africa’s Conflicts

World Bank Resumes Zimbabwe Aid

Zimbabwe owes the World Bank and the African Development Bank more than $1bn, how much potential does renewed aid really hold for the country. If the debt is not forgiven there will be no way the country will be able to rebuild necessary infrastructures for health, water, etc. There are countless case studies to show this historical fact. It must also be noted that Western sanctions were a huge detriment to a country in need, maybe this marks a turnaround?

“No weapons” MSF in Nasir, Upper Nile State, South Sudan

More:
A Tale of Two Refrigerators
Fighting has renewed in southern Sudan, but its not just between militant groups – aid groups fall victim to needless fighting as well. Diane Bennet writes on William Easterly’s Aid Watch blog about the 2001 peace in Sudan and how it was a ripe time to treat disease and build health infrastructure. Unfortunately internal bureaucracy and politics became the largest hurdle.

Sudan: Darfur – Thousands Flee to African Union Safety
More recently, South Darfur has become the seen of violent clashes between government forces and militants. It is important to never forget the impacts that conflict has on health services.

Africa: Public Health Care Must Lead

Oxfam International has released a report [access here] “challenging the myths about private health care in developing countries.” The report emphasizes the role that private health care can play in developing countries, but reminds us that there is no way a scale-up of private health services will reach poor people in need. Key recommendations are to increase funding for free universal health care infrastructure, rejecting ineffective practices of the past, and combining efforts to fuel effective initiatives – sounds a lot like SCOUT BANANA

Global Health: Mobile Phones to Boost Healthcare

Revolutionizing access to health knowledge, the efforts of the Mobile Health Alliance (mHealth), supported by the Rockefeller Foundation, the UN Foundation, and Vodafone Foundation are making a mark across the African continent boasting 51 existing or to-be-implemented programs in 26 countries around the world. Harnessing the potential of growing technology in ‘developing’ countries for the purpose of health can only signal a major shift in access to health care across Africa.

Getting the Continent on Obama’s Agenda

It appears that Obama’s administration is stacked in the favor of Africa and in favor of better international development practices all around. With Susan Rice serving as Ambassador to the UN action against genocide may be bolstered, Gayle Smith more likely than not will be tapped as USAID Director, she was a major proponent of the HELP Commission creating a cabinet level position for foreign aid, and a well known name among insiders and outsiders in African affairs, Johnnie Carson, is expected to be named head of the Bureau of African Affairs of the State Department. The future of US relations in Africa has incredible potential and hope to change.

Zimbabwe: Staff Return to Hospitals, But Not to Work

As a massive cholera outbreak tears across the country, medical staff have returned to their posts, but the nature of their strike, that began in 2008 over poor working conditions and wages, is now “more like a sit-in.” In a country so crippled by Western exploitation and resulting politics, a strike of the health workers in the face of a rampant disease outbreak does not bode well for a vulnerable population.
More:
Too Much Cholera, Too Little Food
Over 80,000 Zimbabweans Infected with Cholera

Africa: U.S. Naval Engagement Offers Health Dividends

Imagine the potential of the US’ military might if it was dedicated to coordinating naval and health care workers from 13 countries to bring aid and health services to communities in need. This becomes a reality with the African Partnership Station Initiative and Project Handclasp. I can only dream of a day where initiatives like this are more a norm than a surprising gesture of good will.

Mali: Raising Money and Hygiene Standards

One of the most innovative programs that I have read most recently is the work the Dutch based Gender and Water Alliance which is employing women to make soap as well educate and use it to increase hygiene and combat preventable diseases. Health benefits, a source of income and empowering women!

Food Crisis Over, Say Experts

Supposedly the global food crisis of last year is over! Agricultural experts from Africa and Asia are saying that we are no longer in a food crisis and that there needs to be an increased production of rice in Africa in order to keep the food crisis at bay. In my opinion, as long as we continue our unsustainable and capitalist practices that commodify a basic human need, we will remain in a global food crisis affecting both the US and Africa.
More:
Rwanda: Food Production Up, Thanks to Green Revolution
Thankfully the increase is not due to the ‘Green Revolution,’ but instead to increase in practices that are focused on protecting the environment.

South Africa: Treasury Blamed for Shortage in Aids Drugs

Years of controversy seem to have brought the blame down on the South African Treasury. With an extensive bureaucracy, it is no wonder that the ARV roll-out program has taken much longer than it should – as many die without the proper medications. While the numbers of people enrolled in the ARV program has increased significantly there still exists a problematic policy of access. Access hinges on wealth, CD4 count, and location. To access the government’s ARV program your CD4 count has to be less than 300, which is at a point where you are already very vulnerable. This creates an issue of sustained treatment because it forces an irregular regimen. If your CD4 count is above 300, you will have to pay. Many cannot pay and if you live far from a government hospital access is just that much more difficult because of taxi fare and time sacrificed for travel. It seems the health and wellbeing of its citizens is not a high budget priority of the South African government.
More:
Rapid HIV evolution avoids attacks
Much like the flu virus, HIV mutates and evolves in response to treatments. This really exposes the South African ARV program as highly ineffective.
Duncan discusses HIV/AIDS in Morocco
Little known to the world, the HIV/AIDS crisis grows in Morocco.

"Ethiopia" a scene of over-grazing and desertification, making it difficult for both people and animals to survive. (From the MSF Photo Blog)

• ’There’s no reason only poor people should get malaria’

In an action that surprised many audience guests, Bill Gates, released a small number of mosquitoes into the crowd at the TED conference. Gates quit Microsoft last year to focus more on his philanthropic work. He spoke of the need, and his commitment, to put more funding towards developing drugs to combat malaria, one of the highest killers in the ‘developing’ world.
Watch the video:
More:
Mosquito Genes Linked To Insecticide Resistance May Be New Target in Fight Against Malaria,
Insecticide malaria impact clue

• When there is no village doctor

It is estimated that every fourth medical doctor and every twentieth nurse trained in Africa leaves the continent for better job prospects and better pay in wealthier countries. The UN Global Health Workforce Alliance warns that the economic crisis could further increase the medical workforce crisis across Africa.

For David Werner, who wrote the widely-translated 1970s village health care manual, “Where There is No Doctor,” medical specialization is not the best answer. “Experts come in and think they have all the answers, and end up drowning out solutions villagers could devise themselves.”

• Need to Focus on Maternal, Child Health – Top AU Official

As the African Union meets in Addis Ababa, Commissioner for Social Affairs Biencé Gawana said in regards to the AU’s proposed launch of a continent-wide program,

“We will launch a movement to promote maternal and child health in the continent,” she told reporters. “It will be an advocacy campaign… together with partners like UNFPA [the UN Population Fund] and UNICEF [the UN Children's Fund].

With 500,000 women dying in childbirth each year, Africa has some of the highest rates of maternal, infant, and child mortality. As part of the solution the AU report noted: “One of the main challenges in the promotion of maternal, infant and child health and development is access to health care facilities and services, especially at primary health delivery level and [in] rural areas.”

• Zimbabwe: Cholera Infection Rate Climbs As UN Cleared to Assess Crisis

On Monday the WHO reported an increase of 2000 cholera deaths in Zimbabwe. The report was released just as President Mugabe agreed to allow a top level UN assessment team to tour the country to find solutions to curb the cholera pandemic as well as the current hunger crisis. Food security continues to plummet in may areas of Zimbabwe as many worry they will not receive aid in time.
More: Zimbabwe Cholera Statistics Rise Again As New Malaria Fears Grow,
Zimbabwe Diary: fighting cholera

• South Africa: The Quiet Water Crisis

There is great concern with the cholera outbreak in Zimbabwe, but what the South African government may be missing is its very own growing water crisis. With an aging infrastructure and rising demand, the potential for deadly bacteria to be released into its water systems is high. When Mandela’s government took power in 1994, an estimated 14 million South Africans lacked access to clean water supply and 21 million people lacked proper sanitation. Although the numbers have changed drastically, the Department of Water Affairs and Forestry (DWAF) reported in 2008 that 5 million people still lacked access.

• Twestival and Charity: Water

Last year SCOUT BANANA conducted a ‘Year of Water’ Project to benefit the work of Charity: Water. The organization is now utilizing the social media tool, Twitter, to raise a large amount of money to build wells across the world. Charity: Water began its work by supporting well projects across the African continent.

• South Africa: ‘Development Must Adapt to Water Resources We Have’

98% of water resources are being used in South Africa. Water security is becoming an issue as pollution from mining has been difficult to clean up and no other water resources remain unused.

• Obama Lifts “Global Gag Rule”

Also known as the Mexico City Policy, this move is being applauded by women’s and productive rights groups across the globe.
More: Obama Reverses U.S. Ban on Abortion-Linked Aid

• University Partnership Aims to Fight HIV/AIDS More Effectively

Backed by an almost $5 million grant from the Bill & Melinda Gates Foundation, John Hopkins University is growing a partnership with Makerere University in Uganda in an attempt to combat the growing HIV/AIDS epidemic. The partnership is only in its initial steps.

What exactly is Product (RED)? According to the official website,

“Product (RED) is not a charity. It is not a cause. It is an idea.”

Launched by Bono and Bobby Shriver in 2006, the (RED) campaign defines itself as a business model which is designed to raise awareness and a sustainable flow of funds to the The Global Fund to Fight AIDS, Tuberculosis and Malaria. Private corporations agree to donate a portion of profit made on the sale of specific (RED) products directly to the Global Fund. These funds will then be used for the specific purpose of providing access to education, nutrition, counseling, medical services, and anti-retroviral medicine in Africa. Currently Product (RED) allocates it’s funds only to projects in Ghana, Lesotho, Rwanda and Swaziland, but there are plans to broaden their reach. Many popular businesses are already partners including American Express (UK only), Converse, Gap, Emporio Armani, Dell, Windows, Apple and Hallmark, with many more vying to get involved.

The basic idea is that for the same price of a comparable good, a consumer can purchase what they want and the company will make a contribution to the Global Fund. The percent of profit donated varies by partner and product. For example, at the Gap, 50% of sales on (RED) products, such as t-shirts that read, “Inspi(RED),” is donated. For every (RED) laptop computer sold, Dell and Windows will donate $50. Some companies are less specific about the percentage of sales that is actually donated but the philosophy remains the same throughout the stores: ‘lives can be saved through shopping.’ Buy a pair of shoes, save a life. Buy an iPod, save a life. The idea is not completely unappealing or inherently wrong. To date (RED) partners have generated more than $110 million for the Global Fund, money that would have otherwise just gone to the corporations. Still there are some unsettling aspects of this business model.

Product (RED) buys into contemporary feelings of wanting to get something for what we give and of wanting it to be convenient. It makes fighting AIDS trendy. The newest partner, Starbucks, is donating $.05 for every one of its three special seasonal beverages sold between December 1, 2008 and January 2, 2009. The Starbucks website states “It’s easy to do good”. And it is! All you have to do is spend $3.50 on a small peppermint mocha. You’ll get a sticker to place on a map of Africa to show your contribution and go on with your day feeling good about your 5 cent donation. 5 cents is nothing to scoff about. With as many drinks as Starbucks sells, it adds up, but what is the real message being sent? Who is really benefiting? Companies get to make a minimal donation and make themselves look really good. Consumers get to feel even better about their coffee and new clothes. It’s possible that a few of these consumers will be motivated to find out more about the AIDS epidemic in the developing world. They may visit a website and educate themselves, possibly making a larger donation in the future or just spreading their new knowledge to others. But how many purchasers of (RED) products will do this? How many others will feel they have done their part by purchasing their Product (RED) iPod, instead of a blue one?

Product (RED) is not necessarily a bad thing. I myself have purchased two (RED) iPods and love them. Funds are being raised to fight the AIDS epidemic in Africa. Still, I find this whole idea misses the point. Money is being donated while ignoring the root of the problem. Product (RED) uses the promotion of excessive consumerism to fight a problem that has been partially caused by excessive consumerism. It does not lead United States and European citizens to question global stratification and what their role in it might be. Instead it allows them to feel like they are doing something to help by shopping, rather than motivating them to make real changes. Money can always be given, but it’s hard to imagine any real improvements in the quality of living for everyone around the world without real changes to the economic and cultural systems we live in, including changes in how people think and act and view themselves as members of their neighborhood, country and world. A change between buying a Product (RED) t-shirt at the Gap or the plain gray shirt next to it on the shelf is not this kind of change. Product (RED) has the potential to raise awareness and make people think about global issues, but it also has the potential to make them feel satisfied with the way things are and the small part they are doing by purchasing a gingerbread latte at Starbucks. So for Product (RED) and other business models aspiring to follow it’s example, rather than a green, go for it, I give a yellow: use sparingly and with caution.

By Ruth Berger, VP MSU Chapter

The current condition of Zimbabwe is undeniably complicated and rapt with controversy. Robert Mugabe, Zimbabwe’s only president since the country became independent of white rule in the early 1980s, was once hailed as a hero and held up as an example of excellent leadership to other newly-independent African nations. Now, as the rate of inflation in Zimbabwe continues to skyrocket and a cholera epidemic appears to be ravaging rural communities, many are calling Mugabe an inadequate dictator who’s unwillingness to accept new leadership may lead to his country’s demise.

Unfortunately, the current situation in Zimbabwe is anything but clean-cut. The country’s complicated colonial history continues to influence Mugabe’s political posturing and decision-making. Mugabe argues that the United States and the United Kingdom are executing a form of post-colonialism via sanctions levied against himself and companions in his political party, ZANU-PF (Zimbabwe African National Union – Patriotic Front). He argues that these sanctions are the primary cause of deteriorating social and economic conditions in Zimbabwe. He also boldly claims that the U.S. and U.K. regularly generate false data regarding the health of Zimbabwe’s citizens, most recently in the case of a cholera epidemic that Save the Children, a British NGO, claims has taken the lives of 1,111 among 20,581 cases since August 2008. Mugabe and his supporters have suggested that this data is an attempt by the West to usurp his democratically-appointed powers.

On the flip-side, the United States and the United Kingdom have issued repeated calls for Mugabe to relinquish his presidential powers in wake of Zimbabwe’s current social and economic crises. Many in both countries have accused Mugabe and ZANU-PF of influencing Zimbabwe’s most recent election through violence and intimidation. Supporters of the opposing MDC (Movement for Democratic Change), led by former presidential candidate and current prime minister Morgan Tsvangirai, have narrated stories of abuse and “reeducation” in camps operated by ZANU-PF. Similarly, as the apparent cholera epidemic continues to spiral out of control and child malnutrition worsens, the U.S. and U.K. cite that Mugabe is killing his own people through stubbornness.

The situation in Zimbabwe is complicated. These brief descriptions barely scratch the surface of the country’s multi-layered complexities. Nonetheless, we at SCOUT BANANA believe that the current conditions of Zimbabwe offer an excellent opportunity for education on multiple topics, including international health, development, post-colonialism, and globalization.

To offer a further introduction to Zimbabwe, I’d like to direct you to the BBC’s Country Profile. As you move to this site, I’d encourage you to examine the information offered there with a critical eye. What might appear fair and balanced is often rife with bias.

Good luck and please continue to check scoutbanana.org for updates.

This past weekend, as I was sitting in one of the “Breakout Sessions” at the Global Missions Health Conference in Louisville, Kentucky, it suddenly occurred to me.

Think of it this way: It was as if I had been spent hours and hours staring at an acclaimed piece of abstract art, wondering what made it so special, when, amazingly, in a stunning revelation, I realized what it was.

For a moment, I reveled in my mental accomplishment. I felt like I had figured out a piece of the public health puzzle. I wanted to sketch my message on a white board just like the famous 1992 Clinton campaign saying: “It’s the economy stupid.” But instead of that message, I would write my most recent revelation:

“It’s All About the Women”

Because it is. Public health (and, for the most part, health in general) is all about the women.

Let’s go over the basics:

(1)    In the majority of situations, who is the primary health care provider in the household? Women

(2)    In the majority of situations, who controls the cleanliness of the household? Women

(3)    In the majority of situations, who prepares the food and water for the household? Women

So, if we look at public health from this perspective, suddenly it seems that women have direct influence over three crucial factors in public health: (a) Primary Care, (b) Cleanliness/Sanitation, and (c) Food & Water.

It’s All About the Women

Public health programs need to target women in order to maximize their effectiveness. Educational initiatives ought to begin with women (the real “heads of the household”) in order to catch on and spread throughout the community. Similarly, micro-finance programs ought to be targeted towards women and their entrepreneurial goals.

Some might argue that women shouldn’t have to be responsible for the health of the household. To this point, I’d agree. Women should be given the opportunity to receive a high-quality education and should be promoted to positions of leadership (including political representation) in their communities. They should be provided with the power and opportunity to pursue whatever goals they desire.

Nonetheless, public health policy-makers would be remiss to overlook the current critical importance of women. It Really Is All About the Women… Stupid