Mount Kilimanjaro sets the example for tourism that directly benefits local development, says the Overseas Development Institute (ODI), the UK based think tank that promotes evidence-based development theory. ODI’s report on tourism dollars in Northern Tanzania indicates, “that local residents earn 28 percent of the total revenue raised at Kilimanjaro from foreign visitors.” Granted this report (full report available here) publishes data collected from May – October of 2008. A lot can change in three years, especially in developing economic areas.
The study’s conclusion was that this represented the world’s highest and most successful transfer of resources from tourists to local poor people. “This is the most successful transfer of resources from international tourists to poor people living around the destination that ever seen anywhere in Africa or Asia,” stated Mr Elibariki Heriel-Mtui the SNV Adviser in Private Sector Development (quote from allAfrica). It is very unclear where the measures come or other examples of tourist dollars transferring to local people. Rarely are there stories about how a local resources actually benefit local communities instead of being exploited by outside interests. However, is 28 percent really the best that can be done?
Mount Kilimanjaro is the highest peak on the African continent at over 19,000 feet and attracts roughly 35,000 climbers per year. The ODI averages total in-country tourist expenditures at around US $50 million. Therefore, the 28 percent that makes it into the local economy is around $13 million. That $13 million is considered “pro-poor expenditure” – I wonder if it can be written off as a tax deductible donation? The report goes on to talk about other high tourist areas of Tanzania including Ngorogoro crater, which attracts almost 400,000 visitors, but has only 18 percent of expenditures considered pro-poor.
What makes Kilimanjaro so much better? Is it the specialized skills needed to assist climbers to the peak? Is it the difficult and remote terrain? How can 28 percent be considered a world record of pro-poor expenditure? There must be other high tourist sites around the world where there is a higher percentage of expenditure that is returned to the local economy. Anyone have examples from other areas of the world?
The impact of conflict on the environment and then the subsequent, direct effect on human health cannot be overlooked. This internally displaced peoples (IDP) camp in Sudan shows the seriousness of that impact.
Everyone in the global health sector is writing about the incredible reach of SMS technologies working for health in developing countries, and rightly so. Hope Phones has partnered with FrontlineSMS to provide old cell phones to communities in need through SMSmedic partner organizations. More: Your Old Phone Can Change the World
TeleMed
A service that I just recently came across is one that is not being as widely talked about. TeleMed is different from FrontlineSMS: Medic because it connects local health care workers directly to patients in need via SMS technology. SMS: Medic is focused on health infrastructure. TeleMed does not have a website up yet, but is definitely one to watch:
The other big talk within global health is whether Paul Farmer will take a job within the US government. Some have expressed great hope for potential reform others voice their plea with him to continue his incredible community based work outside the bureaucracies. My opinion is that Partners in Health has developed into a strong organization and does not depend on Paul Farmer to further their work. If he wants to take on the inefficiencies and inadequacies of the US government and global health, then all the more power to him.
Broken promises abound as the economic crisis deepens and the right to health falters, but activists are coming together to ensure that funding for health and HIV are not cut. International donors are expected to slash budgets for health due to the economic crisis and health experts fear that this will lead to, “less food security and quality of nutrition, which will in turn put more stress on already weak health systems.” Paula Akugizibwe, regional treatment literacy and advocacy coordinator of Windhoek-based AIDS and Rights Alliance for Southern Africa (ARASA) in Namibia demanded, “We need to ensure that African lives do not become a silent casualty of the global financial downturn. Our lives are not cheap or expendable. We expect health to be prioritised over weapons, sports and lavish politics.” Tanzania was the first sub-Saharan country to announce a 25 percent cut of its annual HIV/AIDS budget. Other budget cut impacts: Guinea: Medicines Running Out
On Wednesday, the Livingstone High Court was supposed to hear a ground breaking case about whether mandatory testing for HIV and discrimination solely on the basis of HIV status is constitutional in Zambia. Unfortunately two days later news came that the trial was postponed until mid-July. Be sure to keep watching this story. More: Trial postponed until 15 July
Mara Gordon writes on Change.org’s Global Health Blog about a direct campaign in Tanzania discussing behavior change. “This campaign is partially paid for by the President’s Emergency Plan for AIDS Relief, U.S. government money to fight HIV that’s notoriously had lots of conservative strings attached. Had I seen this ad a year ago, I probably would have dismissed it as unrealistic abstinence-only propaganda. But behavior change works. Behavior change – in combination with access to condoms, comprehensive sexual education, open discussion about HIV and sexually transmitted infections in general, all that good liberal stuff.” More: Changing Human Behaviors: Sexual and Social
During a course on Africa’s environmental history I wrote about the need for changing human behavior in both the sexual and social arena to make a real impact in HIV prevalence. The major social change is the response from Western institutions and organizations in how they talk about HIV/AIDS and Africa while seeking to change sexual behavior. Lesotho: Cultural Beliefs Threaten Prevention of Mother-Child HIV Transmission
Health workers note an encouraging response to the PMTCT program. The number of facilities providing PMTCT has risen from nine in 2004 to 166 by the end of 2008. The number of women who received PMTCT and subsequent antiretroviral (ARV) treatment increased from 421 in 2004 to about 5,000 by end of last year, according to 2009 National AIDS Council statistics. “The primary health care coordinator at St. James Mantsonyane Mission Hospital, Khanyane Mabitso, says stigma and cultural beliefs make it difficult for medical personnel to follow up on HIV-positive mothers and their babies.”
Many advances have been made in health. Some argue that these advances have been dwarfed by the HIV/AIDS epidemic, the economic crisis, or the failures of African governments. The WHO report shows that the only statistic with concrete results was the number of children dying before the age of five. Is this a solid example of the failure of big plans and blanket goals for development?
The Anti-Corruption Committee report provides a number of recommendations for reform all focused on improving the health care delivery services in Sierra Leone and eliminating the risk of corrupt practices in the health services across the country. More on health service scale-up: Chad: Paving the Way for Better Obstetric Care
Government meetings with UNICEF to help scale-up of health services for better obstetric care across the country.
Speaking at a gala reception in Washington marking the beginning of “Africa Week,” Carson said: “Most of the Obama administration’s Africa team is in place, and we are gearing up. We will continue to build on and strengthen the strong bipartisan consensus in Congress and among the people of America that has motivated U.S. policy towards Africa. Over the next four years, we will be focusing our efforts on strengthening democracy, promoting sustainable development, resolving or mitigating conflict, and dealing with transnational issues such as climate change and agriculture,” he pledged. While Obama has built a great team, the White House has yet to announce any Africa Policy, greater control and influence for the Bureau of African Affairs, or take any serious (or effective) action for the continent. More: Tanzania: Obama, Kikwete Meet in Oval Office on Africa’s Conflicts
Zimbabwe owes the World Bank and the African Development Bank more than $1bn, how much potential does renewed aid really hold for the country. If the debt is not forgiven there will be no way the country will be able to rebuild necessary infrastructures for health, water, etc. There are countless case studies to show this historical fact. It must also be noted that Western sanctions were a huge detriment to a country in need, maybe this marks a turnaround?
It is very interesting to be actually in Africa and get the news about Africa. I am actually in the continent that I have covered and studies so much.
2 June 2007 Woke up at noon from a late Friday night. I jumped in the plan with some other students to go to the Makola market and then the beach. There is just something about Makola market that I love. It is not like the other markets or anywhere else in Accra. It may be crazy and seem very frightening and insane to some people, but I love it. The people are hospitable, they are nice, they are business people. They are there to make an honest sale, to run a business, to get you what you want. Many store owners who do not have what you want will direct you to where you need to go. They will not hold you up and try to get you to buy something that they have like most other places. I did not go to buy anything, but people watching is a favorite pasttime of mine. Sure, I am usually the one being watched, but I have come to find out how to be a less imposing and conspicious Obrooni. I have taken to wearing my flip flops often, as many Ghanaians do, my clothes are not flashy or ‘American,’ I have learned more Twi, and I carry only small bills, nothing larger than 10,000 cedi note ($1 USD). I am still obviously an Obrooni, but now after 3 weeks I am slightly more accepted because I know – to a tiny degree – Ghana.
The next day I watched the CNN special show called ‘Inside Africa.’ From being in Ghana (Africa) and getting the news about where I am is really exciting. Namibia is having troubles with illegal ivory trade, Tanzania is developing its gold production industry with foreign investment, Uganda is constructing a power plant on the Nile, Tony Blair is taking his last official Africa tour. He is calling for the West to keep promises of aid because it is a duty and in self-interest. During his term British aid tripled, and some citizens have called it, “… a waste of English time and tax dollars.” Bono was interviewed about the G8 summit in Germany – as usual he stated to keep the promises. He noted that now in the 21st Century people die from a simple mosquito bite – why? how? He also can see a social movement growing in the US and Europe. Finally in the news, the Nigerian president is sworn in, but are the people really happy with the status quo? In Nigeria 77% of the people live on less than one dollar a day, yet their president is re-elected.
April 25th, the first US Malaria Awareness Day. An award winning photographer, Chien-Chi Chang, traveled to Uganda to give image to the story that is very often never heard, to give a face to the people who are never seen. This is not just another award winning privileged person traveling to get pictures or a story because these images and story are accompanied by a call for action. The images were used to raise awareness and promote involvement with Malaria No More. This is an organization that is fueled by celebrity involvement and received great attention from American Idol, but this is an issue and conflict that does not require you to be a celebrity to make a difference. Everyone is a celebrity in their own right.
On the <a href="http://newsforums.bbc.co.uk/nol/thread.jspa?threadID=6178&&edition=2&ttl=20070426013440 “>BBC’s news forum where people can write in their thoughts, many people called for a change in government actions and in people’s actions. Governments need to provide more funding for their health sectors and people need to depend less on their governments. I would add that we here need to understand that governments are not the ones who will make the greatest impact, when individuals support other individuals more lives will be saved.
In her blog, Acumen Fund Fellow, Keely Stevenson, writes about a socially responsible company in Tanzania working to provide bed nets. AtoZ uses a simplified, cheaper manufactoring process to make more bed nets for less. The company then charges a nominal fee to get the bed nets to people who will actually use them. Many times when organizations just hand out bed nets they end up as fishing nets or table cloths, but when there is a small fee – people who actually want them to use them will be supplied with them. This has been credited with bringing malaria deaths down in Tanzania.
Malaria is a preventable disease that claims the lives of over <a href="http://news.bbc.co.uk/2/hi/africa/6591169.stm “>one million people, 90% of them in Africa. Using a bed net is said to reduce a pregnant woman’s birth complications and potential miscarriages by one third. A treated bed net costs about $4 and can save the lives of so many people is it is used. There have been numerous studies on the impact of malaria on mothers, children, and others – but the simple and known truth is that using a treated bed net can save your life and your family’s. There is no reason that malaria should kill so many people each year, our government should be stepping up its efforts, governments in Africa need support so that they can support their health sectors, and we here need to step up our efforts. Making bed nets more available and more affordable is the answer to a preventable disease without a cure.
This first story takes me back six years when I first became involved in basic healthcare activism for Africa. This story comes from my mother’s first trip to Uganda in 2001. My family became very good friends with Fr. Joseph from Uganda in the summer of 2000. He dealt with many medical issues in his traveling from village to village fulfilling his priestly duties, but he did not have any medical background. He asked my mother, who is a registered nurse, medical questions when he was here and sometimes called from Uganda to ask the best medical procedure or prognosis. She had found it very difficult since we had such a limited knowledge of what conditions were like in Uganda. So, that following summer my mother made the journey across the ocean to see the medical situation first hand. While she was there the realities were painfully obvious. Fr. Joseph owned a donated Toyota pick-up truck and while my mom was there she traveled around with him on his day to day work. An important note to make is that the pick-up truck doubled as the area ambulance. On one particular day, at a village stop to give mass, a pregnant mother needed transportation to the hospital because there were some complications. The nearest health clinic was seven hours away on the red, dusty, hole ridden ‘roads’. I can only imagine the ride in the back of a pick-up truck, dust thrown about, bouncing along so that a child may have a better chance. En route the pregnant mother went into labor. Still hours from the hospital the mother gave birth to a healthy baby girl and then died. They decided to name the baby after my mother – Baby Elizabeth. A family from the village adopted baby Elizabeth and she seemed to have a good chance in the world. Later the next year we were told that baby Eilzabeth had died. She had contracted malaria and since she lived in such a remote village, she and her family had no access to the $1- $2 medication that could have saved her life. If the access had been there baby Elizabeth might have lived to her fifth birthday, a rare occurance in many African communities due to poverty and disease.
Malaria is a parasite that is carried from human to human by mosquito. Malaria is a very preventable disease, yet kills over a million people each year. Over 90% of malaria deaths occuring in Africa making it Africa’s leading cause of death for children under five. Just recently President George W. Bush has said eight more African countries have joined a $1.2 billion US program to fight malaria. The five-year program works to provide funds to limit malaria’s spread by using insecticides and anti-mosquito bed nets, and also to provide drugs to people already infected. The renewed enthusism for the program has brought the World Bank and billionaire philanthropist, Bill Gates on board. Also on the scene are recent scientific advances, such as progress towards a vaccine, which prove to offer great hope to defeating one of the world’s great killers. A new treatment developed by British scientists collaborating with Kenyan experts is based on a technique for fluid replacement for children ill with malaria. The problem is that intensive care methods, only available at pediatric units in developed countries, is needed to treat infected children.
It is estimated that through partnerships working in Uganda, Tanzania, and Angola – US taxpayers already have helped approximately 6 million people to treat and prevent malaria. There are great hopes for the future prevention and defeat of malaria, but it requires the continued support of people in the developed world. US taxpayers need to push the Bush administration and future adminstrations to remain dedicated to the mission of saving lives affected by preventable disease. President Bush also announced at the Washington Summit on Malaria that the US Volunteers for Prosperity program will be expanded to recruit skilled US volunteers, doctors, and nurses to travel to at-risk countries to train local health care workers. The Gates Foundation has also expanded the number of projects it funds to research new malaria treatments. Likewise, there is a large private sector effort, such as, Nothing But Nets and the Acumen Fund, among others. Check out the blog of an Acumen Fellow working with a mosquito net facotry in Tanzania. There are so many opportunites to donate, to get involved, to volunteer, and to save a life. Check out some of the links posted and make a difference today!
Alex B. Hill 