Showing posts from category disaster relief.
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The Cholera Quandary
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The original version of this article first appeared in the Stimson Center Spotlight series, November 19, 2010.
Cholera is usually seen as one of the most devastating infections of the 19th century. Trade routes carried cholera from India to the great cities of Europe and the United States. Disease, fear, and political unrest spread in great waves that cost millions of lives. After much destruction, it was only with science and resources that certain populations were able to curb the epidemic.One of the most celebrated lessons in the history of public health involves a cholera outbreak in London in 1854 and efforts by John Snow – celebrated as the father of epidemiology – to control it. At the time, it was not clear that cholera was a waterborne bacterial infection that caused severe diarrhea and vomiting, and sometimes fatal dehydration. Snow proved that the outbreaks decimating communities spread from contaminated water. Water and sanitation services had virtually eliminated cholera epidemics in the developed world by the early 1900s.
Today, cholera has been nearly eradicated in the developed world, but continues to be endemic in poorer countries. Risks seem to be rising as larger populations are crowded into unsanitary conditions. The World Health Organization (WHO) estimates three to five million illnesses and 100,000-200,000 deaths from cholera each year. If caught early, infections are treatable with inexpensive oral rehydration solutions. For much of the world, these options are unavailable or underused – the mere presence of cholera serves as an indicator of a country’s socioeconomic status and health system capabilities.
The cholera epidemics that are currently menacing countries on three different continents – Asia, Africa, and North America – raise tough questions about what is required to protect the world’s vulnerable populations. We know how to predict the crisis of cholera, prevent outbreaks, and contain them when they occur. To control cholera, what is needed is not cutting-edge technologies, but will, transparency, and resources – and where cholera appears, at least one of these three factors has failed.
Currently, cholera outbreaks in Pakistan, Haiti, and Nigeria are piling misery upon misery. Cholera in post-flood Pakistan comes as no surprise. When floodwaters left millions homeless and without access to clean drinking water in a region where cholera remains endemic, health officials could have reasonably assumed infected human waste would seep into water supplies and spread disease. The inability of health networks on the ground to prevent and then detect cholera demonstrates cracks in the country’s health system. What is apparent here is a lack of will and resources. Disease surveillance is especially vital in a post-disaster scenario where steps can be taken, such as treating water with chlorine, to prevent an outbreak.
Haiti had been free of cholera for at least 50 years, but the disease struck and spread rapidly 10 months after the devastating January 2010 earthquake. It reached Haiti’s capital and spread to its neighbor, the Dominican Republic. Since October, more than 114,000 people have become ill and more than 2,500 have died (Editor’s note: updated since original publication).
Haiti lacked resources for basic infrastructure even prior to the earthquake; the cholera crisis is not only costing lives, but also diverting aid from “building back better.” But regardless of the source of the cholera strain, if basic infrastructure and resources to protect Haiti’s vulnerable populations had been in place, cholera’s re-emergence would have been far less devastating.
This particular outbreak draws attention to the practical and political challenges of identifying health risks in humanitarian workers and peacekeepers, many of whom come from developing countries themselves. Evidence suggests that peacekeepers from Nepal, housed at a UN base, may have been the source of the outbreak clustered around the Artibonite River. Cholera outbreaks frequently exacerbate frictions between communities and aid workers – suspicions that have led to riots and murder more than once in recent years. At least two people were killed in Haiti in riots with peacekeepers during November.The delayed decision by the UN to investigate whether the outbreak originated with peacekeepers may have conserved resources for the race to stave off more cases, but did little to build trust between communities and foreign workers. Further violence and protests surrounding the recent disputed presidential election in Haiti do little to ease the devastation and in fact, threaten the relief effort. There has been discussion in Congress of cutting direct aid and suspending visas for Haitian officials until the dispute as been resolved. The Organization of American States is now reviewing the results.
In Africa, Nigeria is experiencing its worst cholera outbreak since 1991, and the disease is crossing borders. An onslaught of cases raised the 2010 death toll to more than 1,500 fatalities out of 40,000 cases. This mortality rate is three times higher than the seasonal cholera outbreaks of 2009, and seven times higher than 2008. Despite Nigeria’s oil wealth, most of the population is impoverished. Two-thirds of rural Nigerians lack access to safe drinking water and fewer than 40 percent of people in cholera-affected areas have access to toilet facilities, according to the Nigerian Health Ministry. A combined lack of will, transparency, and resources mean that cholera epidemics occur annually, and in clusters throughout sub-Saharan Africa.
A century and a half after John Snow’s discovery, we know how to control cholera. Globally, the resources exist, but the question of a collective will remains. For those who lack clean water to drink, to wash, or even proper toilets, the gap between knowing and doing is not easily closed. The international community has shown repeatedly that it can confront cholera outbreaks like those in Haiti, Pakistan, and Nigeria in the midst of crisis. The question remains as to how those efforts can eliminate the conditions that fostered outbreaks in the first place. The answer is not as riveting as the causes that often receive funding: basic infrastructure and resources. Roads, wells, clean water, toilets, education, and the willingness to recognize that if the foundation is not sound, nothing will be able to stand. Sometimes the simplest problems are the most difficult to solve.
Sarah Kornblet is a research fellow at the Global Health Security Program at the Stimson Center. Her research focuses on the International Health Regulations, health systems strengthening, global health diplomacy, the intersection of public health and security, and the potential for innovative and dynamic health policy solutions in developing countries.
Sources: Agence France-Presse, BBC, Washington Post, World Health Organization.
Photo Credit: “UN Peacekeepers Provide Security During Port-au-Prince Food Distribution,” courtesy of flickr user United Nations Photo. -
Judith Bruce on Empowering Adolescent Girls in Post-Earthquake Haiti
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“The most striking thing about post-conflict and post-disaster environments is that what lurks there is also this extraordinary opportunity,” said Judith Bruce, a senior associate and policy analyst with the Population Council’s Poverty, Gender, and Youth program. Bruce has spent time this year working with the Haiti Adolescent Girls Network (HAGN), a coalition of humanitarian groups conducting workshops focused on the educational, health, and security needs of the country’s vulnerable female youth population.
Gender-based violence has long been an issue in Haiti, but the problem became even more pronounced in the wake of the January earthquake. HAGN has sought to address the problem by concentrating its community-based programming on “high priority” groups, including girls who are disabled, serve as de facto heads of households, or are aged 10-14.
Bruce asserted that protecting and empowering young girls is critical because upon reaching puberty, “their access to a safe world shrinks dramatically.” With the post-disaster environment adding another layer of challenge, she said “there could be no ambiguity in anyone’s mind that we have to create dedicated spaces for girls who, at least for a few hours a week, feel secure to be themselves and to plan for their long-term safety as well as their development.”
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Rebuilding Stronger, Safer, Environmentally Sustainable Communities After Disasters
The GRRT Toolkit for Humanitarian Aid
›Natural disasters present an immediate humanitarian crisis but are also an opportunity to rebuild societies to be more resilient and environmentally sustainable than they were before. The “Green Recovery and Reconstruction Training Toolkit” (GRRT), created by World Wildlife Fund (WWF) and the American Red Cross and launched at the Wilson Center on November 19, will help future humanitarian efforts integrate principles of environmental conservation into their disaster recovery strategies. This strategic partnership has been “an incredible effort and marriage between organizations that have different operating styles, different approaches to situations,” said WWF Chief Operating Officer Marcia Marsh. While implementing the GRRT may not be easy, “we need integrated solutions for integrated problems,” said Erika Clesceri, bureau environmental officer at USAID.
A Critical Partnership
In the midst of a crisis, humanitarian workers on the ground often do not have the time, skills, or funding to incorporate environmental concerns into relief efforts, said Robert Laprade, senior director for emergencies and humanitarian assistance at CARE. Humanitarian workers are “going a hundred miles an hour, they’re going on adrenaline and they’re there to save people’s lives – and the environment is just of secondary importance,” he said.
But “environmental sustainability is critical to the achievement of long-lasting recovery results,” said Roger Lowe, senior vice president of communications at American Red Cross. The Red Cross Principles of Conduct state that “relief aid must strive to reduce future vulnerabilities to disaster as well as meeting basic needs” and “avoid long-term beneficiary dependence upon external aid,” he said.
From Damnation, Purgatory, and Armageddon to Redemption
For many crisis-stricken regions, lack of an emphasis on environmental sustainability during disaster recovery efforts can mean “damnation in the present, purgatory in the near future, and Armageddon in the long term,” said Peter Walker, director of the Feinstein International Center at Tufts University. Stress on the environment caused by climate change or unsustainable resource consumption can often contribute to conflict, he explained.
In Darfur, “the environmental change was part and parcel of what led to that conflict,” Walker said. At one time an “environmental Eden” of diverse ecological zones, Darfur gradually became an environment that could not support a society of livestock herding. As the environment changed, some former herders became salaried, armed gunmen, known as the Janjaweed who felt they faced “a choice of no choice,” Walker said, to either “die as pastoralists or become pariahs as mercenaries.”
The challenge for humanitarian aid organizations is to not only help communities recover from disasters, but help them adapt to future environmental stress caused by globalization, climate change, or other factors. “If you cannot adapt,” Walker said, “that’s going to lead to violence.” To avoid aid dependency or resurgence in conflict it is critical to integrate environmental sustainability into disaster relief efforts from the beginning, he said:We used to believe that our world in the aid business was divided between relief on the left and long-term development on the right, and one would gradually go into the other in this relief-development continuum. But the reality is that you have a significant population – a population of millions of people – who are effectively trapped in a form of aid purgatory. They’re basically on a drip feed. Humanitarian assistance does not get you forward, it keeps you alive.
The GRRT offers organizations guidelines for implementing integrated disaster relief to provide a sustainable solution. While every crisis is different, the GRRT’s guidelines should be as applicable to “flooding in Boston as they are to flooding in Aceh,” said Walker.
Implementing Integrated Solutions
Securing funding for this integrated approach will be a challenge, as a significant portion will go towards staffing and training people on the ground, said Clesceri. A stand-alone, dedicated budget for environmental issues within humanitarian assistance programs must “be fought and re-fought for on a continual basis,” she said.
Local partnerships are essential. “Replicate” should be “stricken from the lexicon,” said Marsh. “You can’t replicate, and this toolkit isn’t meant to be a one-size-fits-all.” Instead, she said, the goal of the GRRT is to “create very practical approaches with communities.”
The key to helping communities recover from disasters is to form the kinds of strategic partnerships demonstrated by WWF and the American Red Cross in the creation of the GRRT. “Interdisciplinary groups are always, in my mind, going to get you a better solution in the end, but the risk is that they take more time…but it’s absolutely worth it,” she said.
Photo Credit: “Dark Clouds from Haiti’s Hurricane Tomas Loom over Camps,” courtesy of flickr user United Nations Photo. -
International Responses to Pakistan’s Water Crisis
›December 6, 2010 // By Michael KugelmanExcerpt from the executive summary of the NOREF Policy Brief, via the Norwegian Peacebuilding Centre:
Pakistan faces a multidimensional water crisis that claims hundreds of thousands of lives every year. The root causes of the crisis are twofold:- Circumstantial, which are linked to poor water-resource management policies (including water-wasting flood irrigation);
- Structural, tied to factors deeply ingrained in politics and society such as the obsession with India, inequitable rural land-ownership and endemic water misgovernance (for example, exploitation of the rotational irrigation system to the detriment of the poor).
However, international responses must be measured. They should actively target the circumstantial causes but, at the same time, recognize that their ability to take on the structural ones is limited. While the international community can help mitigate the effects of the underlying structural drivers, Pakistan itself must take the ultimate steps to eliminate them.
Circumstantial causes can be addressed through international aid provision and international exchanges. Aid provision must be generous enough to meet Pakistan’s prodigious needs but modest enough to respect the country’s limited absorptive capacities. It should emphasize the restoration of infrastructure and distribution systems, be more responsive to the needs of Sindh and Baluchistan provinces, and be channeled through both government agencies and civil society.
Despite the challenges the international community faces in addressing the structural causes, opportunities do abound. These include embarking on back-channel diplomacy to bring Pakistan and India closer together and cooperative projects with Pakistanis to make water distribution more equitable. To be effective, international responses must target all affected parties and be sensitive to ground realities. They should also be mindful of indigenous success stories and the factors that bring about that success.
The full report, “International Responses to Pakistan’s Water Crisis: Opportunities and Challenges,” is available through the Norwegian Peacebuilding Centre.
Michael Kugelman is program associate with the Asia Program at the Woodrow Wilson International Center for Scholars.
Image Credit: Adapted from “USG Humanitarian Assistance to Pakistan for Floods in FY 2010 and FY 2011 (as of 30 Nov 2010),” courtesy of USAID and ReliefWeb. -
Food and Environmental Insecurity a Factor in North Korean Shelling?
›November 24, 2010 // By Schuyler NullJust two days before dozens of North Korean artillery shells fell on the island of Yeonpyeong off the west coast of Korea, a UN study reported that the DPRK was facing acute food shortages heading into the winter.
In a New York Times report, Choi Jin-wook, of the Korea Institute for National Unification in Seoul, called food “the number one issue.” While Choi just last month praised the resumption of food aid from the South to the North as a “starting point of a new chapter in inter-Korean relations,” she told the Times Wednesday that the North is “in a desperate situation, and they want food immediately, not next year.”
North Korea’s motives are notoriously indecipherable and this latest incident is no exception, but the regime has in the past sought to distract from domestic problems by inciting the international community (the sinking of the Cheonan being the other latest prominent example).
Infrastructure has always been primitive in the North under the DPRK regime, but the country’s tenuous food security situation was made worse this last year by an unusually long and severe winter followed by heavy flooding in the summer. Flooding was so bad during August and September, that the normally silent regime publically announced details of rescue operations around the northern city of Sinuiju. The joint FAO/WFP report put out by the UN does not predicate production will significantly recover in the next year and estimates an uncovered food deficit of 542,000 tons for 2010/11.
“A small shock in the future could trigger a severe negative impact and will be difficult to contain if these chronic deficits are not effectively managed,” Joyce Luma of the World Food Program told The New York Times.
For more on the severe weather events of this summer, including the flooding that impacted the DPRK and pushed the Three Gorge Dam to its stress limits in China, the impact of scarcity and climate change on the potential for conflict, and the intersection of food security and conflict elsewhere, see our previous coverage on The New Security Beat.
Sources: Christian Science Monitor, Food and Agriculture Organization, Los Angeles Times, The New York Times, UN, Washington Post, World Food Program.
Image Credit: Google Maps. -
Nigeria’s Future Clouded by Oil, Climate Change, and Scarcity [Part Two, The Sahel]
›November 19, 2010 // By Schuyler NullIf southern Nigeria’s demographic and environmental problems have helped fuel today’s conflicts, it’s the north’s issues that may feed the conflicts of tomorrow.
Nigeria’s lack of development and poor governance is not exclusive to the delta region, only more well-known because its oil reserves. The north of the country, which is predominately Muslim and accounts for more than half of Nigeria’s population, faces many of the same problems of environmental degradation, lack of jobs, and inadequate infrastructure. Northern Nigeria is also growing much faster than the south, with a total fertility rate of 6.6 children per woman, compared to 4.6 in the southern states. The median age of first-time mothers in northern Nigeria is only 18 years old.Nigeria holds nearly a fifth of the entire population of sub-Saharan Africa. By 2050, it’s expected to pass Indonesia, Brazil, and Bangladesh and take its place among the top five most populous countries in the world, according to UN estimates. But a litany of outstanding and new development, security, and environmental issues – both in the long-troubled Niger delta in the south and the newly inflamed north – present a real threat to one West Africa’s most critical countries.
If southern Nigeria’s demographic and environmental problems have helped fuel today’s conflicts, it’s the north’s issues that may feed the conflicts of tomorrow.
Nigeria’s lack of development and poor governance is not exclusive to the delta region, only more well-known because its oil reserves. The north of the country, which is predominately Muslim and accounts for more than half of Nigeria’s population, faces many of the same problems of environmental degradation, lack of jobs, and inadequate infrastructure. Northern Nigeria is also growing much faster than the south, with a total fertility rate of 6.6 children per woman, compared to 4.6 in the southern states. The median age of first-time mothers in northern Nigeria is only 18 years old.
Climate, Culture, and Discontent in the North
Last summer, in an offensive that stretched across four northern states, a hardline Islamist group called Boko Haram emerged suddenly to challenge the government, attacking police stations, barracks, and churches in escalating violence that claimed more than 700 lives, according to The Guardian. The government responded with a brutal crackdown, but recent targeted killings and a prison break seem to indicate the group is back.
Perhaps most distressingly, Boko Haram appears to have won some local support. Said one local cloth trader to The New York Times in an interview this October, “It’s the government’s fault. Our representatives and our government, they are not sincere. What one person acquires is enough to care for a massive amount of people.”
As in the south, mismanagement of natural resources has also played a role in creating a dangerous atmosphere of distrust in the government. After gold was discovered this spring in northwestern Nigeria, many under- and unemployed flocked to the region to try their luck, but they also unwittingly contaminated local water with high levels of lead. Although the state health officials say they have now identified more than 180 villages thought to be affected, the epidemic was only discovered after a French NGO stumbled upon it while testing for meningitis in June. More than 400 infant deaths have been connected to the mining, according to Reuters.
Contributing to natural resource-related misery in the north are climatic changes. Declining rainfall in the West African Sahel over the last century has pushed rain belts successively south, driving pastoralists into areas often already occupied. According to Anthony Nyong’s work, presented in ECSP Report 12, these changes have elevated competition over natural resources to the single most common cause of conflict in northern Nigeria in recent years.In addition to the long-term trend of declining rainfall, an acute drought in 2009 and another this year in neighboring Niger and Chad have created the worst food security crisis in 30 years. The droughts have also driven a great deal of cross-border migration into Nigeria, which itself saw lower than usual rainfall in the north, especially the northeast, around the ever-disappearing Lake Chad (see map above for resulting migration patterns).
What rain did fall in the border areas fell suddenly and torrentially, causing rampant flooding that affected two million people. The floods not only caused physical damage but also came just before harvest season, destroying many crops and further reducing food security. Made more vulnerable by the number of displaced people and flooding, the area was then hit with its worst cholera outbreak in years, which has killed 1,500 people so far and spread south.
Cholera is not the only preventable disease to flourish in northern Nigeria in recent years. In 2003, cleric-driven fear of a U.S. plot to reduce fertility in Muslim women caused the widespread boycott of a UN-led polio vaccination drive. The fast-spreading disease then emerged in six of Nigeria’s neighbors where the disease had previously been eradicated. The northern states today remain the only consistently polio-endemic area in Africa, according to the Global Polio Eradication Initiative.
“A Stable Nigeria Is a Stable Africa”
Nigeria’s size and its wealth of natural resources make it a strategically important country for the future of the region. “A stable Nigeria is a stable Africa,” said Wilson Center scholar and former NEITI officer Uche Igwe in an interview. “Nigeria is 150 million people and the minute Nigeria becomes unstable, the West Africa sub-region will be engulfed.”
While there have been some strides in recent years in reducing corruption and addressing infrastructure needs (for example, NEITI’s work to promote revenue transparency), the development, health, environmental security, and human security situations remain dire in many parts of the country. With one of the fastest growing populations in the world and severe environmental problems in both the north and the south, scarcity will almost certainly be a challenge that Nigeria will have to face in the coming years. How the government responds to these challenges moving forward is therefore critical.
In 2008, in response to high oil prices, British Prime Minister Gordon Brown announced his intentions to send military aid to help combat Niger Delta militants. The statement was met with dismay from humanitarian organizations and caused the collapse of a ceasefire (which was then resumed for a time and now seems to be falling apart again). Brown was forced to backtrack into simply offering training support to Nigerian security forces.
In terms of U.S. assistance, USAID requested $560 million for Nigeria in FY 2010 – 75 percent of which is allocated towards HIV/AIDS – and the U.S. military has engaged in joint exercises with Nigerian forces. But so far, little has been done to integrate U.S. aid in a cohesive manner. Given the breadth of these issues, such integration is crucial.
“We need partners, like the United States and Europe, who have a stake in stability – in Nigeria, the Niger Delta, the Gulf of Guinea, and the world,” Igwe said. It remains to be seen what the Nigerian reaction would be to an offer of aid from the West that addresses not only the country’s security issues but also its myriad other problems, in a substantial and integrated fashion.
Part one on Nigeria’s future – The Delta – addresses oil, insurgency, and the environment in the south.
Sources: AFP, AFRICOM, AP, BBC, Global Polio Eradication Initiative, The Guardian, Independent, The New York Times, ReliefWeb, Reuters, SaharaReporters, USAID.
Photo Credit: “The Ranch,” courtesy of flickr user Gareth-Davies, and “Niger and Nigeria: Food security drives population movement,” courtesy of the U.S. State Department. -
Disease in the Developing World
Poverty, Politics, and Pollution
›November 15, 2010 // By Ramona GodboleA look at the most common illnesses that kill people in the developing world reveals, for the most part, easily preventable and/or treatable diseases and conditions, highlighting the deep disparities between health systems in rich and poor countries. But many of the causes and solutions to these common diseases are also linked to political and environmental factors as well as economic.
Cholera: “A disease of poverty”
Ten months after the earthquake that killed more than 230,000 people, Haiti is facing yet another disaster – a cholera outbreak. The current health crisis highlights broader structural and political issues that have plagued Haiti for years.
Cholera, an intestinal infection caused by bacteria-contaminated food or water, causes severe diarrhea and dehydration, but with quick and effective treatment, less than one percent of symptomatic people die according to the World Health Organization. According to BBC, as of November 15, more than 14,000 people have been hospitalized and over 900 deaths have been attributed to cholera in Haiti thus far.
Even before the earthquake, conditions in Haiti, the poorest country in the Western hemisphere, were bleak. The country has very high maternal and child mortality rates (again, highest in the Western hemisphere), and is in the midst of an ongoing environmental crisis, due to deforestation, soil loss, and flooding.
Less than 40 percent of the Haitian population has access to appropriate sanitation facilities and clean water is scarce, according to UNICEF. Displacement, rapid population growth, and destroyed infrastructure in the wake of the earthquake exacerbated already poor conditions and public health officials warned of the increased risk of cholera and other diarrheal diseases after the disaster.
Today these fears have become reality. While public health messages urging Haitians to wash their hands, boil drinking water, and use oral rehydration salts are working to control the current outbreak, long-term solutions to prevent future outbreaks will require much more systematic changes.
As Partners in Health Chief Medical Officer Joia Mukherjee puts it, cholera is “a disease of poverty.” Citing a joint report from Partners in Health and the Robert Kennedy Center for Human Rights, Mukherjee notes that in 2000, loans from the Inter-American Development Bank to improve water, sanitation, and health (including the public water supply in the Artibonite Valley, where the cholera outbreak originated) were blocked for political reasons by the U.S. government, in an effort to destabilize former President Aristide.
The failure of the international community to assist Haiti in developing a safe water supply, writes Mukherjee, has been a violation of the basic human right to water. To halt the current cholera epidemic and prevent future outbreaks, providing water security must become a priority in the reconstruction efforts of the international community.
Politics and Polio
Recent reports have indicated that the global incidence of polio, a highly infectious, crippling, and potentially fatal virus, is significantly declining and a new vaccine is renewing hopes of eradication. Nigeria, one of the few countries where polio continues to be endemic, has also made major progress over the last few years.
But the situation was very different just a few years ago. In 2003 religious and political leaders in Northern Nigeria banned federally sponsored polio immunization campaigns, citing “evidence” that the polio vaccine was contaminated with anti-fertility drugs intended to sterilize Nigerian women. The boycott led to an outbreak of the disease that spread to 20 countries and caused 80 percent of the world’s cases of polio during the length of the ban, according to a study in Health Affairs.
While the boycott was eventually stopped through the combined efforts of local, national, and pressure, the boycott serves as a useful reminder that global health problems can have political, rather than biological or behavioral, origins.
Combating Climate Change and Pneumonia
Studies from the World Health Organization indicate that exposure to unprocessed solid fuels increases pneumonia risk in children by a factor of 1.8, but today more than three billion people globally continue to depend on coal and biomass fuels for their cooking and heating needs.
Cooking and heating with these fuels creates levels of indoor air pollution that are up to 20 times higher than accepted WHO guidelines, putting people at considerable risk for lower respiratory infections. Women, who are often responsible for collecting fuel and performing household tasks like cooking, and their children, are particularly at risk. Today, exposure to indoor air pollution is responsible for 1.6 million deaths globally including more than 900,000 of the two million annual deaths from pneumonia in children under five years old, representing the most important cause of death in this age group.
A recent study from The Lancet shows improved cooking stoves could simultaneously reduce greenhouse gas emissions and the global burden of disease caused by indoor air pollution in developing countries. Such an intervention, the authors argue, could have substantial benefits for acute lower respiratory infection in children, chronic obstructive pulmonary disease, and ischemic heart disease. The potential health benefits don’t stop there: fuel-efficient stoves can also improve the security of women and children in conflict zones and decrease the risk of burns while improving local air quality.
There would be significant environmental benefits as well. A World Wildlife Fund project in Nepal, which provided loans to purchase biogas units and build improved cookstoves, curbed deforestation for firewood and grazing as well as reduced the incidence of severe cases of acute respiratory infection among under-five children.
Overall, greater access to modern cooking fuels and improved cooking stoves in the developing world could both mitigate climate change and make significant contributions to MDGs 4 & 5, which focus on the reduction of child and maternal mortality.
Prescription for Change
The international community’s experience with cholera in Haiti, polio in Nigeria, and pneumonia around the world shows that health issues in developing countries rarely occur in a vacuum. As these three cases demonstrate, politics, environmental, and structural issues, for better or worse, play an important role in health affairs in the developing world. Yet efforts to combat these conditions often focus only on prevention and treatment.
Antibiotics and vaccines alone cannot provide solutions to these problems. Employing economic, diplomatic and policy tools to address health and development challenges can save lives. More specifically, public health efforts should not only focus on poverty reduction, but also target environmental, political, and structural issues that contribute to disease globally.
Sources: BBC, Bill and Melinda Gates Foundation, CIA World Factbook, Health Affairs, The Lancet, Scientific American, UNICEF, United Nations, USAID, World Health Organization, and World Wildlife Fund.
Photo Credit: “Lining up for vaccination,” courtesy of flickr user hdptcar. -
Pakistan After the Floods: A Continuing Disaster
›September 29, 2010 // By Hannah MarquseeA month after Pakistan’s worst flood in 80 years, millions remain without access to food, clean water, or health care.
