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A diverse look at global health issues.

USAID's partnership with GE in Kenya will help health facilities buy high-tech equipment

Under the financing agreement, the medical equipment — including ultrasound and MRI machines — has to be purchased from General Electric.
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A picture taken on December 19, 2013 at a hospital in Nairobi shows a Kenyan nurse attending to four newly born babies squeezed in an incubator due to doctors and nurses strike. Kenya health workers went on strike on December 10 protesting the government decision to devolve services, including their pay, to 47 counties. (Simon Maina/AFP/Getty Images)

Health care providers in Kenya will soon have a much better shot at getting a bank loan to buy high-tech medical equipment — as long as the machines are made by General Electric.

Earlier this year, the US Agency for International Development (USAID) announced a partnership with the industrial behemoth that will make up to $10 million in credit available for Kenyan health facilities to buy its medical products, including ultrasound and MRI machines. It’s the first time the agency has partnered with a multinational company to extend credit guarantees that unlock local financing.

USAID says the partnership will help smaller clinics and hospitals get much-needed equipment to expand diagnostic and other essential health services. 

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In Niger, personal relationships are key to long-term maternal health

Though it's beneficial to send food and supplies to communities in need, it is also important to understand the value of personal relationships in order to implement effective, long-term solutions.
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A picture taken on October 14, 2013 shows a child suffering from malnutrition eyed by his mother at a hospital in Tillaberi, western Niger. Saumya Dave traveled to Niger with New York Times columnist Nicholas Kristof in 2011 and wrote articles on global women's health. (BOUREIMA HAMA/AFP/Getty Images)

Editor's note: This weekend President Bill Clinton, Hillary Rodham Clinton, and Chelsea Clinton will convene more than 1,000 undergraduate and graduate students from around the world at the Clinton Global Initiative University in Phoeniz, Arizona where attendees will work to address global challenges, including health. Saumya Dave will join the group of young leaders. She is a medical student and writer who traveled with New York Times columnist Nicholas Kristof to North and West Africa in 2011 to report on global women's health. As a result of the experience, she founded MoBar, an organization to improve maternal health in the region. 

MOLII, Niger — When I met Miero, I had no idea that she was eight months pregnant.

Unlike the pregnant women I’ve seen in America, Miero’s abdomen was flat and her sharp ribs protruded through her dress. Our conversation was a sharp contrast from the ones I had with women in America. No discussion of prenatal vitamins. No ultrasound dating. No measuring of fundal height. Instead, Miero told me that she hadn’t eaten in one day. Her reason was simple: she gave any available food to her family and counted on having whatever was left.

I was in her village of Molii in Niger because of a trip through Northwest Africa with journalist Nicholas Kristof.

Throughout our journey, we absorbed the stories of many women. I learned about the millet grain, an important food source, and the way women in villages walked to the well every morning to collect water in large buckets.

The women were independent in a way I hadn’t seen in America, occasionally relying on one another if they needed to, but for the most part, embracing all of the responsibilities placed on them. In every community I saw an underlying theme: women were taking care of their families and it was often at the expense of their own well-being.

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The lingering wounds of Liberia’s 14-year civil war

Tackling post-traumatic stress disorder and mental illness, one case at a time.
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Liberian Mike Otis Myers, 29, former child soldier and PTSD patient in Nimba County, February 2014. (Molly Knight Raskin/Courtesy)

NIMBA COUNTY, Liberia — In Nimba County, northeastern Liberia, the most visible signs of the country’s 14-year civil war are finally fading. Ethnic tensions have calmed, bombed buildings are being rebuilt and the economy is showing modest growth.

But the deepest wounds of the conflict are difficult to see and slower to heal. They are the psychological scars of war, and even after a decade of peace they are crippling people this small African nation.

“When I think about the war I just cry,” said 29-year-old Nimba resident Mike Otis Myers. “I survived, so I’m lucky. But when I think about what happened I feel so bad.”

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A common cause of blindness in India is preventable, but treatment is not always accessible

Prescription eyeglasses can correct ‘refractive error,’ which causes blindness for nearly 8 million people worldwide.
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Paras, an 11-year-old boy, reads a book by moving his fingers along the text in Braille at the school for the blind, Central Khalsa Orphanage, Amritsar India in January 2014. (Harman Boparai/Courtesy)

AMRITSAR, India — Harpreet Kaur, 13, prefers to sit in the front row of all her classes. She likes playing with her friends and watching her favorite shows on TV, like any teenager in her hometown. But in January, she noticed that she was not able to make out the images on the TV, even when she sat right in front of it. Her father took her to the eye hospital, and there doctors found that her vision was seriously impaired, and probably had been for a few years.

In most of the world, the leading cause of blindness is cataract, usually affecting people over the age of 60. But 8 million people are blind due to what’s called ‘refractive error,’ when the eye cannot clearly focus images, a condition that usually crops up in childhood. It is a very common visual impairment that is entirely preventable by wearing the right eyeglasses or contact lenses, but worsens without appropriate correction. If corrective lenses are not prescribed early, there can be irreversible loss of vision.

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Doctors Without Borders still excluded from Myanmar's Rakhine state

The government has said restrictions on the organization are a result of a broken agreement with the capital. A leaked document suggests there is more to the story.
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Displaced Rohingya Muslims carrying bags of aid after they collected from a humanitarian center at a camp on the outskirts of Sittwe in Rakhine state, western Myanmar on February 26, 2014. For Muslim communities eking out an existence in segregated camps in Myanmar's Rakhine State, aid groups provide a lifeline but their work is coming under threat from Buddhist nationalist campaigns that have pushed the government to eject Doctors Without Borders (MSF) from the region. (SOE THAN WIN/AFP/Getty Images)

YANGON, Myanmar — Last month’s decision by the government of Myanmar to suspend the operations of the medical aid charity Médecins Sans Frontières (MSF) prompted widespread concerns about the impact the organization’s withdrawal would have on the tens of thousands reliant on the support they provide.

Since that time, the temporary ban has been revised, and now only covers Rakhine state, on the country’s western coast.

In the wake of the announcement, government spokespersons stressed that the chief reasons for this decision were that MSF had breached the terms of a memorandum of understanding with Naypyidaw—the capital city of Myanmar—and had shown favour unduly toward one ethnic group in Rakhine.

However, documentary evidence and testimony obtained by GlobalPost appears to contradict this publicly stated rationale and instead suggests that the action may be punitive, linked to MSF’s response to a massacre that occurred at the end of January in northern Rakhine state—the same area where the charity's ability to operate remains frozen.

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In Kenya, sex workers want jobs and protection, but not just condoms

Guest post: A recent master's in public health graduate from Boston University talks with sex workers in Kisumu, Kenya.
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Kenyan sex workers march to protest for the legalization of prostitution on March 6, 2012 in Nairobi. Under red umbrellas and in red T-shirts, the protesters bore masks written with the phrases: "sex workers rights are human rights" and "my body, my business." (BORIS BACHORZ/AFP/Getty Images)

Editor’s note: Elizabeth Daube traveled to Kenya last year as a master’s student at Boston University’s School of Public Health through the Pamoja Together reporting project—a collaboration of students around the world committed to “telling the stories of foreign aid.” Her graduate thesis looked at the tension between the pro-sex worker rights and anti-trafficking movements.

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With birth control, US not alone grappling with reproductive rights and religious freedom

Wider reproductive health care coverage has been one of the more contested outcomes of the new Affordable Care Act. Here’s how other countries with deep religious roots -- Ireland, Argentina, and Israel -- have navigated the tension between reproductive rights and religious freedom.
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Demonstrators protest a requirement that most employers provide health care insurance coverage for contraception and sterilization as part of the federal health care overhaul, during a "Stand Up for Religious Freedom" rally, part of what organizers say will be a series of rallies in over 100 US cities on the second anniversary of the signing by US President Barack Obama of the Affordable Care Act, at Federal Hall National Memorial in New York on March 23, 2012. (Timothy A. Clary/AFP/Getty Images)

When significant parts of the US Affordable Care Act (ACA) went into effect earlier this year, key among the reforms was the expanded provision of free birth control. While many religious organizations were exempted from this mandate, the legislation has sparked protest and outrage, including litigation at the highest level, the Supreme Court.

But the US is not alone in attempting to strike a balance between offering reproductive health care services and respecting religious organization’s rights. In recent months, Ireland, Argentina, and Israel – three countries with deep-seated religious ties – all have tried to better navigate this thorny space as well. 

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When pregnancy is a death sentence for women

A physician-journalist reflects on the stubborn problem of maternal mortality around the world.
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A woman and her baby at the maternity ward in MSF's field hospital in Doro refugee camp in Maban county, South Sudan. (Nov. 2012). (Florian Lems/MSF/Courtesy)

Last December, as intense civil fighting erupted in South Sudan, I spoke with several doctors and nurses about its impact on the health of the 11 million people who call the country home. The problems accessing health care in South Sudan were already vast, and the emergence of violence would only make things worse – perhaps no more so than for expectant mothers.

I was working in New York with the communications team at Doctors Without Borders/Medecins Sans Frontieres (MSF), which provides vital care across South Sudan and nearly 70 other countries around the world. As part of my role, I debriefed MSF aid-workers like Miriam Czech, an American nurse who had just returned from a mission, and considered their experiences for sharing more widely with the media and public.

For three months, Czech had trained local nurses to provide better care for pregnant women. But the challenges were great. Czech told me about a frail 24-year-old woman who had walked three days from her village to the maternity unit in the city of Aweil. The woman was in the ninth month of her pregnancy, and her husband had to carry her part of the way because she also was suffering from terminal tuberculosis. Czech helped the woman give birth to a baby boy, fragile at only 1.2 kilograms — less than half the cutoff for low birth weight. But the mother could not endure the stress of childbirth.

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Malawi's paradox: Filled with both corn and hunger

Analysis: Despite its lush landscapes and growing stalks of corn, more than 10 percent of the country's 16 million people face severe food insecurity. But the right to food movement in Malawi has also been growing.
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A Malawian land worker harvests maize in Masungo village on the outskirts of the capital Lilongwe. (Gianluigi Guercia/AFP/Getty Images)

LILONGWE, Malawi — Visit this small, landlocked country in late January and you will have a hard time believing its people often go hungry.

It is mid-rainy season, and in and around the capital city the landscape is lush and green.

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Failures of Brazil's universal health care plan offer lessons for the US

In 1988, Brazil passed a law guaranteeing every citizen the right to health care. More than 25 years later, however, it is still struggling to meet that ambitious pledge.
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Medical and health workers protest against the working conditions in the public hospitals and the hiring of foreign doctors for the SUS health care system, in Rio de Janeiro, Brazil, on July 3, 2013. (VANDERLEI ALMEIDA/AFP/Getty Images)

SÃO PAULO -- Health is a legal right in Brazil. Ever since the country's constitution was rewritten after the fall of the military government in 1988, Brazil has guaranteed every citizen—and indeed anyone who sets foot in the country—the right to access health care services, at least in theory. Twenty-five years after passing universal health care, however, the country still hasn’t kept its promise.

With a population of 200 million spread across the world’s fifth largest country, the enormity of Brazil means that services aren't the same across the board: São Paulo, for example, has plenty of hospitals, but even ill-equipped clinics are few and far between in backwater states in the Amazon. Geographical distribution is just one barrier. Financial and technological gaps also have many saying that the universal health plan—dubbed SUS (Sistema Único de Saúde)—hasn’t fulfilled its guarantee to cover everyone in Brazil. 

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