Our key stakeholders in the United States are young people and students at universities. More often than not, business leaders, non-profit directors, politicians, and other “experts” don’t think that young people have much to contribute in the way of new ideas of skills to improve or make a difference on global health issues. This video was chosen today because it is an excellent example of how young people are entering into development projects with an open mind, understanding of community control over projects, and the limitations of their work. These students from Harvard present an excellent idea adapted from a Western development project to improve the health and nutrition of people in Kibera slum of Nairobi, Kenya.
The video is very quiet, turn up the volume and listen closely.
When you think about Facebook, Twitter, and other social networks, questions of health care, rural African villages, and humanitarian aid are not the first things that pop up in your mind. Although, social networking sites are oftentimes used for social purposes, they have one prevailing positive attribute: the ability to “spread the word” to hundreds of millions of people around the globe. Whether it be Facebook groups asking users to “like” actress, Megan Fox, or sites like YouTube that turn a 14-year old kid with a web cam into Justin Beiber, social networking sites certainly get the message across.
And its relevance to provision of basic health care to people in African countries? Assuming that the average American has no idea about the current state of health care systems in rural African villages, a simple Tweet, Facebook post, or blog can spread the experiences and needs of rural health systems to a person with a computer or smart phone in New York, London, Beijing, Cape Town, and even small town America. Social media (through the internet) is a relatively new phenomenon with capabilities beyond that which any kind of campaign or social movement has ever experienced.
As the m-Health conference concluded, one of the biggest headlines was the expectation of 500 million mobile health devices being used on the African continent in the next 5 years. If 500 million is the number of mobile health devices (typically cell phones) used on the African continent, internet and cell phone use among people in African countries must be enormously higher. Thus, the potential for a strong, direct connection between people living and working in African countries with people living and working in Iowa, Florida, and Michigan is incredible.
According to a study done by the Society for New Communications Research, the nonprofit world uses social media more than any other social institution. The opportunity for global connection and cooperation are endless when social media is employed to its fullest. Despite trivial, superficial and admittedly negative effects of the ever growing social media movement, do you think social media should be considered as a useful force in providing health access, care and development to African countries? What are some of the downsides of this new social media revolution?
This week and last we’ve been talking a lot about mobile health (mhealth) and how it impacts communities in developing African countries. As the mHealth Summit 2010 takes place in Washington DC, I can’t help wondering if this represents a lack of perspective on developing traditional health infrastructure. Mobile is hip, easy, quick, and exciting however how do we measure its success. A recent article on MobileActive.org asks if mobile technologies are “really impacting the poor?” As we sit in our nice homes, co-working spaces, conferences and offices we must not forget accountability and scale. Many during the mHealth Summit 2010 have noted that success comes through capacity building with locally based organizations. This could not be more true. Community-based initiatives that seriously invest in people will succeed.
“The most effective forms of organization are based on partly autonomous and contextually rooted local units linked by connective structures, and coordinated by formal organizations.” (Tarrow, 137)
This week I’d like to share a video from Josh Nesbit (co-founder SMS:Medic) demonstrating the successes of FrontlineSMS: Medic in scaling its work and staying accountable to the communities they support through local capacity building.
With the growth of health sectors across the world one of the most critical areas moving forward is how to pay for health care. South Africa’s NIH is facing resistance with its national health care scheme. A few years ago Ghana was working on a similar national health insurance plan. In many countries there are innovative micro-health insurance programs some like Mpesa that are available on your mobile phone. What will be the future of health financing in Africa. This video from a Kenyan news agency looks into the meeting of African Health Ministers talking about health insurance for Africa.
Health has long been a gift that we have attempted to give to the rest of the world. Disease eradication programs, vaccination outreach campaigns, and the Western biomedical system have all been spread to countries near and far. These gifts were often colonialist in design, given without community consent, and without regard to culture or custom. Contrary to Thomas Friedman‘s thoughts, the world is not flat. Rather we live in a world that is increasingly connected by technology, but still remains sharply separated by those who have and those who don’t.
When it comes to global health, we no longer have the luxury of saying, “those people over there have health issues.” There is no simple separation between “us” and “them.” Health problems aren’t over there any more than they are right here. In the US, lifestyle choices contribute to heart disease, diabetes, obesity, and lung cancer. When we talk of disparities in access health in other parts of the world, we cannot forget the glaring health disparities in US inner cities and across communities of color.
The curtain has been lifted and hopefully we have looked in the mirror to see that we too have health issues in our country. While the ideas to make health better have long come from the West and developed countries, that paradigm is no longer applicable to global health today. Our world is still expansive, but we are more connected than ever before. With the internet at our finger tips and friends across the ocean only a skype call away, solutions in global health come from around the world. The past demonstrated that “developed” countries believed they were giving something valuable to those who didn’t have what they had. The result was a plethora of failed aid goals, missing life-saving medications, and decrepit health care systems.
Innovations for better health come from all around the world. It is no longer the “developed” giving ideas to the “developing.” The increasing use of mobile phones have inspired some exciting programs for health records management while SMS and texting have led to revolutions in access to health knowledge and care. However, it isn’t always technology ideas that are most effective. Developing countries have reminded us how important and critical health insurance can be, while at the same time demonstrating the severe need for more trained health care workers. Models that train community health workers, access micro-health insurance on your mobile phone, and social enterprises that provide ambulance emergency services have all been launched in “developing” countries. I can only hope that our health care system can take the time to look around the world for ways to improve.
For many years, complex issues in international development and global health have been tackled by simplified single-issue campaigns that have created short-term “band-aid” solutions. This can be attributed to the limited view most Americans have of the world. For many, issues of global health remain remote and abstract. We, young people, have grown up with the internet in our laps, basic knowledge of different cultures around the world in our classrooms, access to easier communications and travel, and more opportunities to study abroad and participate in global exchanges. These factors have made the world seem more connected, and have bestowed upon us the capability to serve as the key drivers of social change.
We must bridge the divide between rich and poor, privileged and oppressed, developed and developing. We, as privileged young people, can be the voice that changes the actions of our largest institutions to focus on programs that work, projects that benefit people in need, and efforts to build healthier communities.
As the least glamourous or well-known position in any health care system, community health workers often have the most difficult jobs, the smallest pay, and the greatest impact on many people’s lives. This is a video from an organization committed to “better health for Africa.” AMREF is best known for its “flying doctors” service among many other programs that strengthen community health systems. This is part of the story about a community health worker in Ethiopia, Almaz Nagade.
This week comes with controversy and numerous calls for the eradication of various diseases by the WHO. Health workers in go on strike in another African country after South Africa’s months long strike. Liberian doctors said they would only treat “critical” patients. Tuberculosis is becoming more resistant among young people and HIV positive individuals, but more effort is being put into research.
Last week TB was discussed as a “forgotten disease for forgotten people,” but now it seems that the WHO has released a plan that identifies gaps in research to create faster treatment regimes. “There is an urgent need to scale up action against TB – 10 million people, including 4 million women and children, will lose their lives unnecessarily between now and 2015 if we fail,” Dr. Margaret Chan, the WHO director-general, said.
Tido von Schoen-Angerer, Executive Director of Doctors Without Border’s “Access to Essential Medicines Campaign” wrote on Huffington Post about how the US government continues to send sub-standard food supplies to areas in need. The United States, the world’s biggest food aid donor, continues to send the corn-soy flours that do not address childhood malnutrition. You would be hard pressed to find these foods in American grocery stores, because it’s food we would never feed our own children.
In Africa there needs to be a greater focus on prevention and treatment of noncommunicable diseases like diabetes and hypertension and not just infectious diseases like HIV/AIDS, health experts told the 2010 U.S.-Africa Private Sector Health Conference October 6. “Health is as critical as institutions, infrastructure and education for Africa’s economic competitiveness and growth. It is a prerequisite for human energy, entrepreneurship, dynamic markets and a productive society,” said Haskell Ward, vice-president of Seacom Corporation and chairman of the Global Health Strategic and Advisory Committee of the American Cancer Society.
Africa is hungry – 240 million people are undernourished. Now, for the first-time, small African farmers have been properly consulted on how to solve the problem of feeding sub-Saharan Africa. Their answers appear to directly repudiate a massive international effort to launch an African Green Revolution funded in large part by the Bill and Melinda Gates Foundation. “Food and agriculture policy and research tend to ignore the values, needs, knowledge and concerns of the very people who provide the food we all eat – and often serve instead powerful commercial interests such as multinational seed and food retailing companies,” said Michel Pimbert of the International Institute for Environment and Development (IIED), a non-profit research institute based in London.
A preventable disease that is linked to the need for clean water sources has continued to kill people in a number of countries. WHO officials report that, as of October 3, there have been 40,468 reported cases of cholera and 1,879 reported cholera deaths in four countries, including Cameroon, Chad, Niger and Nigeria. The outbreaks started a few months ago, officials said.
There is a new “silent killer” in town. It joins the ranks of malnutrition, malaria, hypertension, diabetes, HIV/AIDS, etc. It is obesity. “We are eating our way to the grave’’ and “obesity is rising in rural areas.’’ Adults are overweight or obese, while children are malnourished – a paradox. In the men still look at a potbelly as a badge of pride and success.” The World Health Organization reports that more than one-third of African women and a quarter of African men are estimated to be overweight, and predicted that it will rise to 41 percent and 30 percent respectively in by 2016. Once considered a problem only in high income countries, overweight and obesity are now dramatically on the rise in low- and middle-income countries, particularly in urban settings.
Malnutrition and water are HUGE issues when it comes to health. Listen to the interview with Jim Hocking of ICDI. The video covers some potentially disturbing, but everyday health problems associated with malnutrition and water. In 2007 SCOUT BANANA organized a Year of Water Project in Michigan with twelve different universities and colleges participating to raise almost $8000 while educating over 50,000 students in Michigan. The work of Charity:Water benefited from the project and they continue to take incredible actions! Learn more about why good food and clean water are essential to good health.
The Mo Ibrahim Prize for African Leadership hasn’t been given out since 2008, but the Mo Ibrahim Foundation has launched the Ibrahim Index as a measure for African countries and their progress. This is an interesting and important development as a number of the indicators for the index focus on health. Check out other interesting news from across the continent. Check it out for yourself!
“Water is more valuable than oil, more precious than gold,” said Amy LoPresti, co-founder of Africa Water is Life. “It is the essential ingredient of our life, our culture, our history, and our future. Yet, 1.2 billion people in the world do not have access to clean, consumable water.” Unsafe water and a lack of basic sanitation cause an estimated 80 percent of all diseases in the developing world and together kill more people than all forms of violence, including war.
This is a story that really invokes our organization’s name. High rates of chronic malnutrition and micronutrient deficiencies of Vitamin A and iron among women and children remain Uganda’s most common malnutrition problems. However, an edible banana could solve this problem.
Africa Water News highlights a CNN article that suggests we are close to eradicating the disease. Once called the “forgotten disease for a forgotten people” the Carter Center believes that every country in Africa except Sudan will be rid of the disease.
The ANC’s National Health Insurance scheme has yet again opened up the deep economic divisions in South Africa. The economic divisions are best represented by access and quality of health care. Doctors are very difficult to find in poor, crowded townships and settlements, but major towns with many wealth have centers for plastic surgery. 60% of funds for health services are directed at the 15% of the population which is covered by private health insurance. Only 40% of the funds are used to pay for the public sector that serves 85% of the population.
Over the next five years and in partnership with the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), the department is awarding grants to African institutions in a dozen countries under its Medical Education Partnership Initiative (MEPI), which works with U.S. medical schools and universities to form a network that includes about 30 regional partners, country health and education ministries, and more than 20 U.S. collaborators.
This article is being featured because of the subject matter. Voice of America (VOA) has a habit of generalizing, especially in Africa and about African people. I suggest reading the interview transcript on how traditional beliefs guide health practices in Ghana, something that I studied during a 6 week study abroad covering disparities in health care. The US health care system could learn a thing or two from the Ghanaian health system.
With a vaccine and drugs available to treat tuberculosis (TB), you would think that it should no longer be a problem. 1.3 million people worldwide died from TB in 2008, according to the World Health Organization most lived in Africa and Southeast Asia. Is this becoming another “forgotten disease for a forgotten people?”
As a Peace Corps Trainee in Uganda, I have learned a great deal during the 10-week training period about topics from language (I’m learning Runyankore-Rukiga, but there are 7 other languages being taught to other Trainees), cross-cultural issues, income generating activities, community health, agrobusiness, water and sanitation, etc. However, no matter which topic we are discussing, it is all based on the Peace Corps’ approach to development, which is a grassroots, assets-based (rather than problem-based) approach. Essentially, as Peace Corps Volunteers (PCVs), our role is to act as change agents and co-facilitators to help communities realize the resources they already have to change their lives. The idea is to break the traditional cycle of dependency on outside aid for development to happen, and to empower people to stop thinking of themselves as ‘poor and helpless’, as the Western world has so often labeled them, but rather to believe that they have control over their own lives. We are here to share skills and ideas, and to motivate people to use what they do have rather than thinking about what they don’t.
However, this approach is not without difficulty. Since so many NGOs and short-term volunteers have already been working here in Uganda, and indeed throughout Africa and the rest of the developing world, many Ugandan communities have come to expect that a muzungu (foreigner or white person) brings money and outside resources. While monetary aid does have its place in certain contexts, this dependency on resources that come from outside the community is unsustainable and discourages people to rely on themselves and take charge of their own development. While the problem exists all across Uganda, I have heard PCVs serving in Northern Uganda complain of the “war tourism” occurring there as short-term volunteers and tourists flood the region in the wake of the devastation caused by the Lord’s Resistance Army (LRA). The existence of war tourism makes their job as PCVs much more difficult because of the expectancy that the muzungu will come, build a school or make a donation, and then leave, while the PCV comes for two years with motivation and skills but no funding to speak of.
My purpose is not to bash foreign aid, more traditional development work, or short-term volunteers (indeed, most PCVs have been short-term volunteers themselves at some point, which could have been the spark that inspired them to serve in the Peace Corps), but rather to encourage people to think differently about the impacts that these approaches have on the communities which they are trying to ‘develop’. Sustainability is key in any development context, and the assets-based approach that Peace Corps takes aims for sustainability through community-driven development. After all, only when people take ownership of their actions in order to continue improving their own lives long after an NGO or volunteer leaves can development work be truly sustainable.
