Health workers, facilities under attack in 23 nations; UN accused of inaction

This hospital was damaged by clashes during a 79-day curfew from late 2015 to early 2016 in the city of Cizre in southeastern Turkey. Photo: Physicians for Human Rights.

This was originally published on Global Health TV on May 23, 2017.

In 2012, two Pakistani health workers were out vaccinating children against polio when they were both shot by extremists. One of them died. The other, shot in the leg, had 11 metal rods inserted into his leg and was hospitalized for three months.

In November, I met this remarkable man named Latif (his surname is withheld to protect his security). He is now fully recovered and back to work on the polio vaccination campaign. He told me he never considered giving up. Pakistan reported only two cases of wild poliovirus in 2017 as of May 17 and Latif is determined to see the polio campaign through to the end.

The attack on Latif is only one example of a tragic phenomenon that is not getting better – violence against heath workers and health facilities. In 2016, the extent and intensity of such violence “remained alarmingly high,” according to a new report released by the Safeguarding Health in Conflict Coalition.” The report also found that accountability for committing these attacks remains inadequate or non-existent.

The violence isn’t always perpetrated by terrorists. Sometimes it is committed by the police or the country’s military — institutions that should be ensuring tranquility.

In West Africa, progress on family planning but millions not treated for HIV

Women gather for the launch of the national family planning campaign in a low-income neighborhood of Bamako, Mali in April.

This was originally published on Global Health TV on April 26, 2016.

BAMAKO, Mali — Last year, there were several reports of how West Africa, after decades of seriously lagging behind the rest of the world (and Africa) in family planning, was finally starting to embrace it. IntraHealth International covered this topic extensively on its Vital blog, and I wrote about my own views of family planning in Mali here at Global Health TV.

Senegal, in particular, emerged as a family planning leader in West Africa and provided hope for the rest of the region. The three main reasons for Senegal’s success were strong political will, better coordination and collaboration and innovative approaches, according to Babacar Gueye, IntraHealth country director in Senegal.

New programs here in Mali, like Keneya Jemu Kan (USAID Communications et Promotion de la Santé, in the Bambara language), are making a major push to increase health indicators beyond the anemic progress of the past three decades. For example, the percentage of married women using any modern method of family planning in Mali has only increased from 1.3% in 1987 to 9.9% in 2013, and Keneya Jemu Kan is working to bend that rate upwards. (Full disclosure: I work as a consultant for Keneya Jemu Kan).

But a disturbing new report from Médecins Sans Frontières (MSF), or Doctors Without Borders, claims that similar progress is not being made in HIV/AIDS. On the contrary, MSF claims that millions of people in West and Central Africa are being left out of the global HIV response despite globally agreed goals to curb HIV by 2020, and is calling on the international community to develop and implement an urgent plan to scale up antiretroviral treatment for countries where critical medicines reach fewer than one-third of the population in need.

Amid a flurry of high-tech approaches, some find merit in low-tech techniques

DKT street theater provides family planning information in Bihar.

This was originally published on Humanosphere blog on March 7, 2016.

Because of the meteoric rise of the internet and cell phones in many developing countries, many global health programs have been rushing to embrace these technologies as efficient ways of reaching large numbers of people with information on such issues as family planning, HIV prevention and maternal and child health.

This is happening in countries like India, Tanzania, South Africa, and Ethiopia, where technologies like the internet, mobile phones, social media and geographic positioning systems are bringing health delivery into the 21^st century.

But some programs are eschewing high tech and sticking with low tech as the best way to bring vital health information to their low-income consumers, at least for now.