Health
Child brides speak out
An article last week by the International Herald Tribune reported how Arwa Abdu Muhammad ran out of her husband’s house to a local hospital in Yemen, where she said her husband had beat and raped her for the last eight months. Arwa is nine years old.
Arwa sparked an international debate over child marriage. In Yemen and elsewhere, child marriages are a powerful illustration of misogyny and how it hurts developing economies.
The Global Gender Gap Index explains that women are a very important factor in the economy — when children are forced into young marriages, it leads to high rates of maternal and child mortality, an uneducated populace, and loss of economic opportunity.
The statistics speak for themselves. General health expert Dr. Abdullah Al-Kamil says a recent study found that the average age of marriage in Yemen is 12 or 13, and as Al-Kamil noted, “The problem here isn’t only early marriage, but also early pregnancy – and in most cases, early death.”
In a country where 30 percent of women between 15 and 19 have at least one child, early marriage and sky high maternal mortality rates are major causes of continuing poverty and underdevelopment. Suha Bashren, a policy officer from Oxfam, said she had no doubt that child brides were a significant reason Yemen’s ranking has recently fallen on the UN’s Human Development Index.
Yet in Yemen, poverty and conservative social values are driving forces in child marriage. Most parents in Yemen continue to believe that the earlier they marry their daughters, the better off their daughters will be. Early marriage is also encouraged by parents’ fears of girls being kidnapped and forcibly married, which is not uncommon.
Conservative Islamists supporting child marriage gained power after north and south Yemen reunited in 1990. In a government which recently modified laws to legally allow children under the age of 15 to marry, those against child marriage are a minority.
Because of Arwa’s bravery, child marriage is now being discussed. A few members of Parliament, such as Abdulbari Dughaish, are trying to change the laws in spite of religious opposition. The negative press within Yemen and internationally may be these children’s best hope for change — and their community's best hope for economic progress.
Pedaling Forward
A bike can change a life.
The benefits of a bike can range from awakening your inner child to being an eco-friendly commuter. In a developing country, however, the simple bike becomes a locally sustainable method of alleviating poverty and building healthy communities.
The bicycle means greater access to educational and economic opportunities. (Cool fact: A bike can go three or four times faster than the pedestrian and uses five times less energy.) But in communities where people make only a few hundred dollars a year, a bicycle that costs an average of $100 is financially out of reach.
To help bridge the gap, various organizations have sprung up as bicycle distributors for developing communities mostly in Africa.
World Bicycle Relief, an organization fighting the HIV/AIDS crisis in Zambia, describes the power of bicycles in its mission statement:
Simple, sustainable transportation is an essential element in disaster assistance and poverty relief. Bicycles fulfill basic needs by providing access to healthcare, education and economic development. Bicycles empower individuals, their families, and their communities. Our mission is to provide access to independence and livelihood through The Power of Bicycles.
Organizations like this depend on donated bikes, which they then ship to community-based organizations that employ and train locals as bike mechanics. In Namibia, the Bicycling Empowerment Network has bicycle workshops (called Bicycle Empowerment Centres) stocked with tools and bicycle parts that act as the hub for bike distribution and repairs.
Even grassroots groups in the U.S. have joined the cause. Bikes to Rwanda, a project supported by Stumptown Coffee in Portland, Ore., ships cargo bicycles to farmers in a Rwandan coffee cooperative.
With today’s gas prices, cycling is a more attractive alternative for residents of places from Amsterdam to Zambia. But bikes aren't limited to transport anymore. They can be modified to sharpen knives, double as an ambulance, and even filter and store water — all innovative adaptations geared towards positive social change.
Genuine Leather Made by...Children?
Move over Italy. Developing countries are the up-and-coming leaders of the leather market, boasting cheaper production costs and fewer environmental regulations.
There is a good chance that your soccer ball, leather belt or aviator jacket was tanned in one of Pakistan’s 2,500 leather factories in the industrial centers of Karachi, Kasur, and Sialkot. The factories mostly employ poor people from neighboring areas, especially young children who will work for cheap wages. In one town alone, Kasur, more than 700 children worked in leather-tanning factories, according to the International Labor Organization.
NPR's Marketplace recently profiled a 17-year-old Pakistani boy, Mohmen, who's worked in the tanning industry since he was 13.
Like so many of Pakistan’s child workers, Mohmen has sacrificed his childhood to support his family. He has toiled in a hazardous leather tanning factory for four years. Six days a week Mohmen moves animal skins from a cart to a conveyor belt.
His heavy workload is not the only thing in the factory that will begin to take a toll on Mohmen. A 1996 Swedish study found that leather tannery workers experience an increased risk of cancer due to their exposure to toxic chemicals.
Mohmen would like to leave and go home to his family but he knows that he cannot. “How can I go home if I have to keep paying somebody? I keep paying what my family owes.” He is just a kid, but he is in an adult world where there is no rest from poverty's harsh realities.
The Wheel World
Ciclovía Documentary shot by Streetfilms
Bogotá, Colombia is holding a 70-mile long block party. And everyone’s invited.
Ciclovía — "bike path" in Spanish — is an event that closes down major roads for pedestrian use every Sunday and holiday from 7 a.m. to 2 p.m. Created in 1976, it rapidly grew from eight miles and 140,000 bicyclists to 70 miles and an average of 1.5 million weekly riders. Ciclovía is championed as a community building event that attracts people from all backgrounds for a day of biking, walking, skating and dancing in the streets.
In the above video, Bogota’s former park commissioner Guillermo (Gil) Penalosa discusses Ciclovía’s main appeal: social integration.
You will see people in $5,000 bikes and others in $50 bikes, and all having the same fun! Rich and poor, young and old, men and woman, tall or short... ALL!
Cited for “endless benefits” such as the improvement of personal and public health, Ciclovía has inspired other cities to develop similar programs, including Guadalajara, Mexico; Quito, Ecuador; Santiago, Chile; and Paris, where an expressway along the Seine is transformed into a pedestrian refuge one month out of the summer.
Cities in the U.S. are also developing similar programs, starting with El Paso, Texas. This Sunday Portland, Ore., is clearing 6 miles of roadway for six hours in its inaugural "Sunday Parkways." New York Mayor Michael Bloomberg announced his city's plans for Ciclovía-like event this August that would stretch from 72nd to the Brooklyn Bridge along Park Avenue.
Events such as Ciclovía are not only free, but they also bring all sorts of people together to get healthy and build a happy community. It seems like a no-brainer that every city should have a Ciclovía!
Drugs for Sale
We buy cheap bootleg DVDs and fake Coach purses from random street vendors with little hesitation. But what about buying your daily medication from them, too?
This is a common practice in the developing world. In Zimbabwe, for example, street vendors offer the poverty-stricken populace medicine for a price five to eight times less than a legitimate pharmacy.
The trouble with these cheap meds is that they're often not the real thing. One study cited by the World Health Organization says the counterfeit medication industry could reach $75 billion by 2010. Although the industry's reach is worldwide, it's more prevalent in developing countries. The WHO says "many countries in Africa and parts of Asia and Latin America have areas where more that 30% of the medicines on sale can be counterfeit."
Though buying counterfeit medications can save a lot of money, it is also very risky. In 1995, 89 Haitian children died from taking counterfeit cough syrup that contained the active ingredient in antifreeze instead of the real medication. Governments in the developing world often lack the resources to track and prosecute these illegal manufacturers and sellers. The Internet is only making the fight harder.
Major pharmaceutical companies are protecting their products from counterfeiters using different methods. Today, companies like GlaxoSmithKline use holographic labels or stickers to make their product more distinguishable from fakes. Recently, counterfeit drugmakers have, however, been able to convincingly duplicate many of these stickers and packaging. For example, one study revealed that about half of Southeast Asia's supply of the anti-malarial drug Artesunate was counterfeit despite holographic packaging.
The easiest and fastest way to decrease the market for these fake drugs is for consumers to increase their own awareness. Many news organizations have begun to help. In this video, Al-Jazeera reports on counterfeit drugs in Mauritania.
Bad Reception
Don’t know what to do with your old analog TV?
The Basel Action Network (BAN), a global environmental justice organization, cautions you to think twice before recycling it.
"Most people are not aware that 50-80 percent of so-called recyclers will export your old computer to countries like China where it will be managed in horrific nightmarish conditions, that are highly polluting and damaging to human health," says BAN's Jim Puckett.
E-waste refers to broken or unwanted electronics that contain high levels of hazardous materials such as lead and mercury. According to the UN Environment Programme, “some 20 to 50 million metric tonnes of e-waste are generated worldwide every year … [and] developing countries are expected to triple their output of e-waste by 2010.”
For countries such as China and India, the low costs of processing e-waste, combined with weak health and environmental regulations, has led to a stream of material from industrialized countries. As the world's e-waste piles up, poorer countries increasingly face a dangerous tradeoff: serious health risks for a rise in incomes.
Besides toxic substances, e-waste also contains valuable metals such as gold and silver. Recovery of these precious materials is dangerous work. Unprotected workers, some of them children, pry these appliances apart to get to the metals. Sometimes, the plastic casings must be burnt away or treated with acid baths, releasing toxic fumes into the air.
These chemical by-products poison the water supply and disrupt endocrine and immune function in humans. “The air near some electronics salvage operations that remain open contains the highest amounts of dioxin measured anywhere in the world," reports National Geographic.
Accountability and enforcement remain weak despite efforts to stop illegal e-waste flows, such as the Basel Convention, an international treaty that the U.S. has yet to ratify. There's also the fact that some communities rely on the e-waste industry economically, including Guiyu, China (150,000 workers) and New Dehli (25,000).
"China, like India and many other countries, is really hungry for resources, so they let e-waste into their country to support their production chain," says Ruediger Kuehr, executive director of Solving the E-Waste Problem to The Star. "They have many people making their living off of e-waste, so they cannot easily say, 'Let's stop all of these imports.' "
So what can you do with that old TV? Thanks to BAN, there remains a socially conscious solution. The next time you want to recycle your old electronics, refer to their list of responsible e-cyclers.
This short clip by BAN is part of "The Digital Dump," a investigative documentary shot in Lagos, Nigeria.
International Rent-a-Womb: The Outsourcing of Baby-Making
"My husband lost his limbs working in the factory," Jyoti Dave, a surrogate mother in India, told Reuters. "We could not manage even a meal a day. That is when I decided to rent out my womb."
Commercial surrogacy is nothing new. In the U.S., where it is legal in many states, companies such as Growing Generations offer up to US$25,000 to surrogates while charging couples between US$30,000 and US$45,000 per child.
Today rent-a-womb has gone international. Its headquarters
are in India, where surrogate mothers can earn US$5,000 to US$7,000 per birth — income equivalent to a decade's worth of a rural wages for a woman.
These surrogates offer their services to an international clientele hailing from Italy, Singapore, Sweden and other wealthy countries. Most of these couples turn to surrogacy after multiple failed in-vitro fertilizations or repeated miscarriages. It's no surprise India appeals to medical tourists; it offers affordable service, highly qualified doctors, and fewer legal hurdles than found in other countries.
Boston Globe columnist Ellen Goodman is among critics of commercial surrogacy who are disturbed by the idea of the human body as a commodity. Others are uneasy about the ability of the wealthy to essentially rent wombs from the poor.
Many participants in international surrogacy, however, argue that they are helping those in financial desperation. "How else will us uneducated women earn this kind of money," one surrogate mother explained to Christian Science Monitor, "without doing anything immoral?"
The Economics of Breastfeeding
You may have heard the news that American mothers are breastfeeding their kids at rates higher than ever before, according to data released last week by the U.S. Centers for Disease Control.
The fact that 77 percent of U.S. infants born in 2005-06 were breastfed is good news for child health — studies link breastfeeding to a wealth of benefits, from lower infection rates to higher intelligence — as well as for families' pocketbooks. In the U.S., a year's worth of infant formula can cost well over $1,000. Overseas, the financial bite is even bigger in per-capita income terms.
If breastfeeding is cheaper and healthier, then why do six of every seven Indonesian mothers feed their babies formula?
One reason: Formula companies in Indonesia spend a lot of money convincing mothers their product is as good or better than breast milk, and they've successfully insinuated their product in healthcare settings, according to Mercy Corps.
Dr. Fransiska Mardiananingsih, Mercy Corps' Healthy Start program manager, says formula companies[']... "aggressive marketing has convinced many mothers and health providers that formula feeding is just as healthy for infants," she says, "but in fact it has significant negative effects on children's health."
Dr. Mardiananingsih says formula companies go as far as to deliver gift baskets to new mothers to encourage the continued use of their product.
Mercy Corps, Global Envision's parent, is helping build a more supportive environment for breastfeeding moms in Jakarta's poorest neighborhoods. They're also offering a way for you to help: $75 buys a "Breastfeeding Kit," a symbolic gift that supports the program and equals the cost of training a breastfeeding counselor. It was unveiled last week as a Mother's Day addition to the agency's regular Mercy Kit lineup.
Training midwives, health officials and support-group facilitators is one part of the program; marketing is another. Mercy Corps is working with local government leaders and holding rallies to spread the word about breastfeeding's benefits. They may not be able to match the formula companies' marketing muscle, but with both health and economic advantages on their side, they at least have an easier sell.
Malaria's Moment
Is malaria's reign of terror coming to an end?
Every year, 500 million people fall seriously ill with malaria — a disease that induces fever, chills, nausea, flu-like illness and, without treatment, coma and death. More than 1 million people die each year from malaria — almost all in the developing world. The near-universal poverty of its victims is one reason it has not received the attention, and therefore the money, necessary to secure its demise.
Even in the face of these scary statistics, malaria may be about to meet it's match. The Economist reports a renewed sense of interest in its eradication, mainly because it jeopardizes the UN's Millennium Development Goals, a set of benchmarks in health, education and human welfare that world leaders committed to attain by 2015.
There's a cost-benefit rationale, too. Malaria costs Africa upwards of $12 billion a year in health expenses and lost productivity. Yet a five-year eradication plan might cost as little as $2.2 billion a year, according to a report by Malaria No More and McKinsey & Company.
With these numbers in mind, last week the UN unveiled a new campaign to fight malaria at its most critical spots. The Roll Back Malaria (RBM) Partnership — created to "enable sustained delivery and use of the most effective prevention and treatment for those affected most by malaria — staged the first World Malaria Day last week. It coincided with a UN plan to spray inside houses and distribute insecticide-treated bed nets to "all people at risk" of the disease by the end of 2010.
Any effort to stamp out malaria must deal with an added layer of complexity. When diminished but not destroyed, malaria can come back with a vengeance. Any letup in the eradication campaign may end up actually increasing the numbers of those at risk.
But considering how much malaria undermines the war on poverty, a risk taken to ensure its eradication may be a risk worth taking.
Leave that Bottled Water Alone
My attention has recently been drawn to the increasing opposition students, consumers and activists are having to bottled water. A US-based group called Think Outside the Bottle is beginning an advocacy campaign to bring awareness to some of the more dire consequences of our thirst for bottled water, and even government agencies are beginning to act to reduce their consumption.
“City and state governments are looking at the economics of banning bottled water. Citing environmental concerns and a misallocation of resources, Los Angeles; San Francisco; Ann Arbor, Mich.; and the state of Illinois have banned the use of public funds to purchase bottled water for city and state functions…In June, the US Conference of Mayors adopted a resolution to bring attention to the negative impact of bottled water and promote local sources."
The director of a consumer rights group called Food and Water Watch has noticed that people of all types are showing increased awareness about issues involved with bottled water, according to the Christian Science Monitor. "I overhear small children in the grocery store telling their mothers not to buy it."
The negative impacts of bottled water are undeniable, but as a fact sheet the Monitor put out for World Water Day illustrates, the politics of water internationally are extremely complicated. In many parts of the world, bottled water is the only sanitary way to access the resource, and at the moment there is no alternative. The lesson? In places where the water is drinkable, drink it!
Neglected Tropical Diseases – Easy to Treat, but Not Glamorous
Josh Ruxin, a community health expert who has spent the last several years living in Rwanda, explains that while the majority of tropical diseases seem archaic and too complex to think about for the average person, trachoma, river blindness, hookworm and the like are devastating over a billion people on the planet. Neglected Tropical Diseases, or NTD’s, are inexpensive to treat in comparison to HIV/AIDS, but don’t seem to carry the same social appeal.
“Together, the NTD’s produce just as much disability as the better known diseases and are a major reason why the poorest people in Africa cannot escape poverty…The great irony is that NTD’s can be effectively treated and controlled for a fraction of the cost of these other diseases.”
Global Tobacco Treaty Mostly Ignored
One of the most ambitious attempts to control tobacco in the world is being ignored.
The World Health Organization’s tobacco control treaty entered into effect almost exactly three years ago today. It was an unprecedented move by global leaders to target the harmful public health outcome of increased tobacco use, notable especially in the developing world.
According to the World Health Organization, if current trends in the expansion of tobacco use worldwide continue, especially in the developing world where currently half of the deaths due to tobacco occur, “seven out of every ten deaths due to tobacco will occur in the developing world by 2020.”
Three years from the day the treaty went into effect, many countries have made no progress toward minimizing this potential public health disaster, according to the editorial board of the New York Times. "With tobacco use declining in wealthier countries, tobacco companies are spending tens of billions of dollars a year on advertising, marketing and sponsorship, much of it to increase sales in these developing countries." This inundation, as well as the tax revenue governments in developing countries can obtain from tobacco companies, have discouraged many of the countries most crucially affected by tobacco use from pushing any harder to promote the changes of this treaty.
Business is Key to Solving Africa's Public Health Problems
Want to know the hot gossip in a small Rwandan village? It's not the latest developments in AIDS treatments. Instead, it's the recent $2000 foreign order for coasters and place mats.
Read The New York Times' guest columnist Josh Ruxin's great article about the importance of supporting business opportunities to combat AIDS and other health problems in Africa.
Globalizing Ideas to Help the Poor
A Brazilian anti-poverty program known as Bolsa Familia ("Family Fund") is getting attention from governments around the world, writes the Economist. Modeled on a similar program in Mexico, this conditional cash transfer program has been tested successfully in several other Latin American countries, and the World Bank is now looking to start similar programs in Eastern Europe.
In the Brazilian version of the program, poor families with children receive direct transfers of around 70 reals (about $35) a month, on the condition that their children stay in school and have regular health checkups. According to the World Bank, this relatively simple and modest program is unique in that it can help reduce both current and future poverty and inequality in Brazil.
Water Crisis in a Nairobi Slum
Today the BBC posted a video that took a closer look inside Kibera, a large urban slum of Nairobi. Kibera is experiencing a water and sanitation crisis as nearly one million people are living in the slum without a suitable water supply.
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