Education is, of course, vital to healthy living; it is a means through which the impoverished can improve their quality of life.  According to the United Nations Educational, Scientific and Cultural Organization (UNESCO), education is the ”key to social and economic development.”

UNICEF‘s education statistics (as of 2004) for sub-Saharan Africa:

• Net primary school attendance ratio: male 60%, female 57%
• Primary school entrants reaching grade 5: 66%
• Net secondary school attendance ratio: male 22%, female 20%
• Adult literacy rate: 60%

When I was in Uganda, I noticed that most small children attended school, but few older children were enrolled.  A number of factors complicate the situation, one of which is school fees.  Though public schools exist, the teachers are generally indifferent to their students’ success, which decreases students’ chances to pass secondary school entrance exams.  For many parents, the only other option is to send their children to private school, which costs a considerable amount of money that they often don’t have.  As an American, I was constantly solicited to sponsor students.

All of the schools I associated with in Uganda required uniforms like these, which compounded the problem with school fees.

Clearly, the education situation in Africa is far from ideal.  The solution?  Programs like UNESCO’s Education For All, in which governments, development agencies, civil society, and non-governmental organizations partner to improve worldwide access to education.  UNICEF also takes initiative to educate children globally, but is largely supported by public donations.

“Poor nutrition,” on the other hand, ”can lead to reduced immunity, increased susceptibility to disease, impaired physical and mental development, and reduced productivity,” states WHO.  Malnutrition also contributes substantially to mortality rates; according to WHO, it directly or indirectly causes 35% of deaths in children under 5 years old.

This boy was sitting on a sidewalk in Jinja when I took this picture. He was obviously malnourished, but ironically eating at the moment.

 When I was in Africa, I observed that the majority of the population was what Americans would call ‘skinny.’  Unfortunately, this was often the result of undernutrition rather than the proper diet and exercise prescribed to much of the western world.  Malnourishment is much too common a condition in impoverished nations.

The best solution is, of course, prevention; however, this is not possible in some situations.  Says WHO, “Lack of access to highly nutritious foods, especially in the present context of rising food prices, is a common cause of malnutrition. Poor feeding practices, such as inadequate breastfeeding, offering the wrong foods, and not ensuring that the child gets enough nutritious food, contribute to malnutrition. Infection – particularly frequent or persistent diarrhoea, pneumonia, measles and malaria – also undermines a child’s nutritional status.”

One treatment for severe acute malnutrition is ready-to-use therapeutic food (RUTF).  According to the International Malnutrition Task Force, RUTF  is a mixture that promotes rapid weight gain in malnourished people; the paste consists of peanut paste, milk powder, vegetable oil, sugar, vitamins, and minerals.  Its low risk of microbial contamination and its easy use and digestion make it popular in poor regions of Africa, and its local production in some areas reduces its cost (IMTF).  Overall, RUTF seems to be the most effective solution to malnutrition.

UNICEF implements RUTF and several other malnutrition interventions and welcomes donations.

http://cnn.com/video/?/video/world/2010/03/23/mckenzie.kenya.abortions.cnn

The reality about the subject seems to be heartwrenching.  But what exactly is the reality?

While we were at Butagaya orphanage, Jackie got to hold the caretakers' (Paul and Rose's) new baby. Despite the dozen children that the family was already caring for, it was happy to get this little addition.

According to CNN, “Women are being forced into backstreet abortions in Kenya because of the country’s restrictive abortion law.”  Because of extenuating circumstances, Kenyan women who are unintentionally pregnant seem to have no alternative to abortion; however, Oliver Kisaka brings up a valid point during his interview; he asks: “Why do women in this country or elsewhere want to go ahead and get pregnant and then procure abortions?  Why are we not realizing that the way you can avoid going through the whole problem of abortion [is] by just not getting pregnant?”

Considering their situation, do these women have a choice as to whether or not they get pregnant?  From my experience, birth control is far from commonplace in eastern Africa; in fact, the only form of it I heard of was condoms, and that was during an HIV/AIDS prevention lesson – its use for birth control wasn’t even mentioned.  Is abstinence culturally and individually plausible?

Once a woman is pregnant, what options does she have?

As for the Kenyan government, what are its obligations?  Should it continue to regulate abortion?  To what degree?  What are some of the benefits and detriments to abortion regulation?

Global Voices offers more information about the abortion law in Kenya.

These sisters are pictured at an orphanage in Butagaya. They played with the orphanage children while their father learned how to build a square-foot garden.

A video documents the campaign:

http://www.youtube.com/watch?v=xsjZpaYbEpI

The World Health Organization recently published an article about the outbreak preceding the campaign.  According to the publication, 6 of the 19 countries involved have had cases of polio in the past 6 months.  Since then, several of the affected countries have unsuccessfully attempted to combat the disease with smaller-scale interventions; this massive collaboration is expected to eradicate the infection in the area (WHO).

Says WHO, “Over 400,000 volunteers and health workers will take part in the campaign, which is part of an ongoing response to the epidemic that first spread from polio-endemic Nigeria to its polio-free neighbours in 2008 and is still paralyzing children in West and Central Africa.

“To end this outbreak, two drops of oral polio vaccine (OPV) will be administered to every child at the door of every dwelling in all 19 countries.”

Contribute to the cause online through UNICEF.

This is the story of the LRA as the people of Uganda know it; I spent time in Gulu, which is in the affected area, in 2008 and heard it from locals.  Joseph Kony founded the LRA after an Acholi woman claimed to receive spiritual revelation that the Acholi people were to take control of the Ugandan government.

My volunteer group and I visited an IDP camp over an hour outside of Gulu. At one point I was freezing, so the girl at the right of the picture, named Concha, brought me a blanket. I will never forget her simple kindness, despite her own unfavorable situation.

Kony started the rebellion with the support of locals, but the LRA’s violent acts soon cost it most of that backing.  In order to sustain itself, the militia abducted children from villages and forced them to join its ranks.  At the peak of its influence, the LRA even ventured into the outskirts of cities, one of which was Gulu.  In response, the government mandated that people in remote villages be relocated to Internally Displaced Persons (IDP) camps to be protected by government soldiers.  The amount of protection, however, was insufficient; though government troops patrolled the camps, the LRA tracked the troops’ movements and attacked the unprotected areas of the camps.

Once children were abducted, the LRA led them into the bush.  There, the militia beat and killed many of the kidnapped children, scaring the survivors into submission, and eventually desensitizing them to human suffering.  The atrocities committed by and within the LRA are incomprehensible; some children were even forced to kill their siblings while others watched.  Some of the girls have burns on their heads from carrying hot food pots when the LRA was fleeing government forces, and all of the children are mentally scarred for life.  By now, the LRA consists mostly of adults who were raised in this environment; a life of violence and killing is all they know.

These huts were built the same as the uniform huts in the IDP camps outside of Gulu, though the camps are much more crowded and barren of foliage.

According to Village of Hope Uganda, “The consequences of the war cannot be overstated. An estimated 66,000 children were abducted from towns and camps, changing the landscape of their lives forever. Tens of thousands of civilians were maimed or killed by the rebel LRA. Over half a million people from the Northern region are still living in IDP camps, where they endure disease, malnutrition, post-war trauma, and lack access to educational or economic opportunities.”

The LRA continuously afflicted northern Uganda from 1989 until more recent times, when the militia relocated to Congo (Invisible Children).  The terrorist group has continued its characteristic violence in Congo, with severe attacks in Decembers 2008 and 2009 (CNN).  In the most recent attack, says Human Rights Watch, the LRA killed at least 321 and abducted 250, at least 80 of whom were children (CNN).

Though negotiations have been underway since 2006, no permanent treaty has been signed; the violence continues (Village of Hope).  To help the victims of this brutality, visit the Village of Hope website.

According to WHO, “Water-related diseases include those due to micro-organisms and chemicals in water people drink; diseases like schistosomiasis which have part of their lifecycle in water; diseases like malaria with water-related vectors; drowning and some injuries; and others such as legionellosis carried by aerosols containing certain micro-organisms.”

The CDC reports that

Drinking water was certainly an issue during my stay in Uganda.  I was lucky enough to have a volunteer organization (HELP International) that paid for distilled water, but most of the local population was not so fortunate; in fact, I never once saw an African drink out of a water bottle.  Some were wealthy enough to have plumbing, but the majority collected water from an unknown source; in Iganga, that source was a public pipe situated in a ditch.

Several girls carry water from the valley to their homes.

The impact of water quality on its dependent populations is conspicuously perceptible; the real health issues are increasing “access to safe water,” states the CDC, ”adequate sanitation, and proper hygiene education“.  These approaches ”can reduce illness and death from disease, leading to improved health, poverty reduction, and socio-economic development.”

What causes poverty?

• Lack of education – Without an education, employment options are often limited to low-paying jobs.
• Inadequate resources – When competition for a limited amount of resources (including jobs) abounds, many are doomed to lose.
• Unsupportive government policy – Distribution of taxes, creation of jobs, and legislature all affect poverty within populations.

What are the effects of poverty?  Says Global Issues,

My experience in Uganda showed me the deep impact poverty can have on a person’s life; many people there didn’t even have adequate access to basic necessities like food and water.  One HIV/AIDS patient, Andrew, whose home I visited, was unemployed, as was his wife.  They had at least two children and survived only off what they could grow.  Despite their best efforts to support themselves, Andrew and his family struggled to survive on a daily basis.

Andrew's wife and child sit on the floor of their tiny home.

Why care?

As citizens of the world, poverty affects us all.  It influences individuals, families, communities, countries, and societies in more means than just financial; it plays a role in politics and public health as well.  Remember that anyone can make a difference.  One person may not be able to change the world, or even Africa, but he can change one life, and that is worthwhile.

How can you help?

• Donate – Financial assistance is essential in eradicating poverty.
• Volunteer – Spend time helping people across the world by working with international agencies at home or abroad.
• Advocate – Talk to legislators about policy change; present ideas to improve living standards in their nations.

Network for Good provides a list of organizations through which you can contribute.  Go change the world!

Monjeza and Chimbalanga were ironically cuffed together before their court hearing last week.

At the center of this trial is the legal conflict in Malawi.  According to national law, homosexuality is illegal; however, according to section 20 of the national constitution, all citizens are equal and discrimination is prohibited (CNN).  The decision on this case will set a precedent for other African nations regarding gay laws and rights.

My experience in Africa with the general mindset toward homosexuality emphasizes the complexity of the issue.  If discovered, homosexuals in Uganda are beaten, and often killed, simply because of their sexual orientation.  The complications accompanying this conflict are not only legal, as this case is unprecedented, but political, as reelection may yet play a part in the decision; social, and thus mortal, as the lives of homosexuals are currently threatened; and health-related, as gay sex is a major factor in the spread of HIV/AIDS.

As such, the verdict in this case holds great significance for Malawi and for Africa.  What, in your opinion, is the Malawian government’s obligation?  Should it protect the moral rights of society and maintain the illegality of homosexual activity, or should it protect individual rights and legalize gay marriage?  Keep in mind cultural biases.

Prevention is the easiest way to avoid malaria.  According to WHO, two key intervention strategies are the use of insecticidal nets and indoor insecticide spraying (WHO).  In my experience in Africa, properly used mosquito nets were the most effective way to avoid mosquito bites.  Using insecticidally treated nets, however, was not necessarily more beneficial, as the insecticide wears off in about six months and treated nets are more expensive; I found that untreated nets were just as good.  Preventative medication is another means of malaria avoidance; drugs effective in Sub-Saharan Africa include malarone, doxycycline, and larium.

Once diagnosed, several treatment options are available.  WHO’s suggestion is “prompt and effective treatment with artemisinin-based combination therapies” (WHO).  Post-infection medications include malarone, mefloquine, doxycycline, quinine, and coartem (WebMD).

These children are sitting outside an orphanage in Butagaya, Uganda. Despite the caretakers' best efforts, the institution was too poor to buy mosquito nets for the children.

Malaria deeply impacts Africa; ramifications include increased disease, mortality rates, and government spending.  According to the Roll Back Malaria Partnership, malaria accounts for 10% of disease in Africa (RBM).  Of the 300 million people acutely infected each year, over 1 million die, about 90% of them in Africa (RBM).  Mortality due to malaria is especially a problem for children, as it constitutes 20% of Africa’s under-5 mortality (RBM).  According to Roll Back Malaria, the disease costs Africa over “$12 billion every year in lost GDP [and]…accounts for 40% of public health expenditure” (RBM).

Clearly, action must be taken.  Many organizations are working toward eradicating the disease through prevention and treatment; here are just a few:

Roll Back Malaria, a partnership between governments, development agencies, foundations, and the like to “reduce malaria morbidity and mortality by reaching universal coverage and strengthening health systems”,

Africa Fighting Malaria, a non-profit group based in South Africa and the US that researches malaria and advocates control of the disease through policy change,

and President’s Malaria Initiative, a US government agency that focuses on reducing malaria-related deaths through prevention and treatment.

Each of these organizations welcome either direct or indirect donations at RBM, AFM, and PMI.

AIDS patients at Kawolo Hospital in Lugazi, Uganda, August 2008. From top left: caregivers Wilson and Josephine. Middle: Justine, Olivia, Jessica, Lushimwe, and me. Front: Jessica, Andrew, and Fred.

What is HIV/AIDS?  Human immunodeficiency virus, or HIV, is a virus that attacks the immune system by destroying white blood cells necessary to fight disease (CDC).  The last phase of HIV, when the immune system is weakened and struggles to resist infection, is called aquired immunodeficiency syndrome, or AIDS (CDC). 

How is HIV/AIDS spread?  HIV/AIDS can infect individuals in any of three ways (WHO): 

1. Birth – A pregnant mother may pass the virus to her baby during pregnancy, childbirth, or breastfeeding.
2. Blood - Blood transfusions or sharing of needles, syringes, or other sharp objects can result in infection.
3. Sex – Transmission can occur during vaginal, anal, or oral sex with infected individuals.

What impact does HIV/AIDS have on people in Africa?  HIV/AIDS is a major contributor to African mortality; according to the World Health Organization, it accounts for up to 60% of child deaths there (WHO).  Every 24 hours in sub-Saharan Africa, nearly 1000 children and 5000 adults ages 15-59 die from HIV/AIDS (WHO).  These deaths affect not only individuals, but their families as well; many HIV/AIDS orphans die because  no one cares for their needs.  Another consequence is the decimation of certain age groups within populations; some places no longer have young people because of the epidemic (SOS Children’s Villages). 

What can you do to help?  There are many options to help reduce the occurrence and effects of HIV/AIDS in Africa.  Among them are donating, volunteering, and advocating.  To find ways you can help eradicate HIV/AIDS, visit Network for Good.  If you would like to contribute financially, you can donate to the United Nations effort at UNAIDS.