In honor of World Health Day and National Public Health Week, we spent the week learning more about how some of our partners have been addressing the unique health challenges they face in their local context. Their work recognizes the integration of poverty, sanitation, infrastructure, and cultural awareness into all public health challenges rather than attempting to address only one component of a crisis. Through these insights we hope to circulate local knowledge and spread lessons of effective models of healthy development.
HIV Stigma
The Life Skills Development Foundation (LSDF), Thailand
Findings from 50 countries indicate that roughly one in every eight people living with HIV is being denied health services because of stigma and discrimination. In spite of many countries signing on to the global goal of ending the HIV epidemic by 2030, these cultural obstacles pose a great challenge to resources reaching the spaces in which they are needed the most.
One model to address this can be found in Thailand, where the Life Skills Development Foundation (LSDF) organizes Community Action Groups to support vulnerable children and their families. They consider not only children who have contracted the virus but also those who are affected in other ways, such as family members being afflicted and bullying which forces children to drop out of school. Another challenge is that due to the stigma, many caregivers of AIDS orphans will not discuss the cause of their parents’ deaths, leaving the children feeling isolated, confused, and trapped by a so-called “wall of silence.” In the remote Pai and Pang Mapha districts, the rate for new transmissions is increasing and as well as the psychosocial consequences for people affected by HIV/AIDS, making the need for organizations like LSDF more critical than ever.
Sanitation Access
An Organization for Socio-Economic Development (AOSED), Bangladesh
Over 90% of the world’s population has access to a smartphone, and yet far fewer have access to basic sanitation. Why is it that this critical component of sustainable development has been consistently underprioritized? Evaluations of the UN’s Sustainable Development Goals have shown that access to sanitation is one of the goals least achieved by participating countries, in spite of the fact that it directly facilitates the achievement of several other goals such as poverty alleviation, gender equality, and environmental sustainability. In fact, 2.5 billion people do not have access to sanitation and more than one in seven people practice open defecation as a result. This practice spreads disease that increases child mortality, contributes to the poverty spiral, and devastates aquatic ecosystems.
“Sanitation is cross-cutting: if you make progress on sanitation, then you dramatically improve the achievement of at least four other goals.”
— UN deputy secretary general Jan Eliasson, https://www.theguardian.com/global-development/2014/aug/28/toilets-lives-un-chief
Young activists in Bangladesh took to address this by founding the organization AOSED (An Organization for Socio-Economic Development). They have been installing SMART toilets in areas in need, addressing challenges of both sanitation and water access while involving local community members every step of the way to ensure its sustainability. Their innovative Biofill toilets and handwashing stations naturally turn waste into fertilizer, and deep tube wells bring safe drinking water straight from the water table to local communities. Their development model has proven to hold incredible promise in tackling public health challenges.
Differently-Abled Persons
Margadarshi (The Association for Physically Challenged), India
The complex needs of the differently-abled often go unaddressed, leading to overlapping vulnerabilities. This challenge is more than clear in India, where over 80% of the 60 million differently-abled people are impoverished and only 35% of differently-abled children have access to schools. Worse still are the living conditions of differently-abled women and girls, who experience extreme stigma that results in grievous physical, social, psychological, and economic hardships.
“Differently abled children in India are subject to multiple deprivations and limited opportunities in several dimensions of their lives. Some these include, not being enrolled to schools, lower employment rates, limited awareness of entitlements and services available and lack of social welfare support.”
— https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4367071/
Margadarshi, The Association for Physically Challenged, addresses these challenges holistically with community-based programs and comprehensive home care to assist families as well as the individuals affected. They focus on areas of overlapping vulnerability, primarily working in rural and impoverished communities and especially considering the needs of women and children. Research has shown that children with disabilities are at risk of delayed development, but early intervention and rehabilitation can help them grow into self-actualized individuals and confident members of society. Community-based rehabilitation programs helps affected women and girls materially with food, lodging, clothes, and medical support, as well as providing education, job-readiness training, and literacy programs. Through comprehensive home-care, girls’ parents and guardians have a chance to focus on their own lives and livelihoods while the girls gain valuable skills that will allow them to live fulfilling and independent lives. By improving the living conditions of families affected and helping to lift them out of poverty, Margadarshi has a compound impact that has dramatically improved the wellbeing of thousands in India. Most importantly, they organize programs around the central theme of dignity and respect for differently-abled persons, helping to unravel the stigma that contributes to so many of their hardships.
Mental Health
The Korean Association for Psychosocial Rehabilitation (KAPR), South Korea
South Korea features a challenge present in many other societies: significant prejudice against mental illness, often due to a preventable level of education. There are few resources available in South Korea to help neuro-atypical individuals reintegrate into society, and families of affected individuals often feel uninformed about their loved ones’ conditions and cut out of the decision-making process for their care and treatment. While 1 in 4 people there are reported to experience mental illness in their lifetimes, only 1 in 10 seek treatment due to its stigma and the inaccessibility of care.
In light of this, The Korean Association for Psychosocial Rehabilitation (KAPR) work to spread resources that combine treatment and knowledge sharing to affected persons and their families. KAPR is an organization of mental health professionals founded in 1995 to improve the quality of life of those suffering from chronic mental illness. They work to facilitate these individuals’ integration society through psychosocial rehabilitation and to reduce the stigma and prejudice surrounding mental health issues.
KAPR’s Family Link Korea Project provides comprehensive in-person and online mental health education to patients, families, and healthcare workers, while their Shared Decision Making program offers a process for mental health professionals, patients and their families to work together to decide on the best course of treatment. Together, these programs serve to inform those affected by mental illness and empower patients and their families to participate in the important care decisions that affect them. Such programs humanize conditions and remove traditional obstacles to seeking treatment, including the problematic hierarchy that can result from patients having little agency in decisions about their own health.