According to this film, global poverty did not just happen. It began with military conquest, slavery and colonisation that resulted in the seizure of land, minerals and forced labour. Today, the problem persists because of unfair debt, trade and tax policies – in other words, wealthy countries taking advantage of poor, developing countries. Actor and activist, Martin Sheen, narrates the film, a feature-length documentary directed by award-winning director, Philippe Diaz, which explains how today's financial crisis is a direct consequence of these unchallenged policies that have lasted centuries. It considers that 20% of the planet's population uses 80% of its resources and consumes 30% more than the planet can regenerate. At this rate, to maintain our lifestyle means more and more people will sink below the poverty line. Filmed in the slums of Africa and the barrios of Latin America, ‘The end of poverty?’ features expert insights from: Nobel prize winners in Economics, Amartya Sen and Joseph Stiglitz; authors Susan George, Eric Toussaint, John Perkins, Chalmers Johnson; university professors William Easterly and Michael Watts; government ministers such as Bolivia's Vice President Alvaro Garcia Linera and the leaders of social movements in Brazil, Venezuela, Kenya and Tanzania.
Poverty and health
This issue of Poverty in Focus reviews the Millennium Development Goals (MDGs) to date and asks what can be done to accelerate MDG progress in the years 2010–2015 and beyond. There have been numerous calls for a new development narrative/paradigm from developing countries, international civil society organisations and development agencies. The contributing authors believe this changing context will affect the debate on the MDGs, past and future, in ways that perhaps only now are starting to become clear. They also believe that impact of the current financial crisis is likely to continue to frame debates over the next five years, and will be critical in determining the economic and social environment. Economic uncertainty in donor countries is also leading to declining public support for aid budgets. They predict the coming period is likely to be much less certain as developing countries, especially in sub-Saharan Africa, face several interconnected crises to which climate change is central, and which will change the context for achieving the MDGs.
World Food Programme (WFP) Executive Director Josette Sheeran has urged doctors and medical experts to put their knowledge to work to support the battle against malnutrition, a factor in 10,000 child deaths every day. Speaking at the Royal Society of Medicine in London, Sheeran said that the world already had the ability and knowledge to tackle the challenge of malnutrition. What was lacking was the coordinated focus and political will, she said. 'We need to harness what we know – take the knowledge that we have right now and put it into action. We cannot wait,' she said in remarks to a breakfast meeting with a group of eminent doctors and medical experts. If a child under two is deprived of the nutrition needed for mental and physical growth, the damage is irreversible, Sheeran noted. 'For the world's bottom billion, can we take the technology and what we know, and ensure that there is access to nutrition? And can we stand with those under two year olds and at least make sure they are getting a shot at life?' The costs of undernutrition are high. Without adequate nutrition children cannot learn in school, HIV and AIDS drugs don’t work, populations are more vulnerable to disease and economic growth is undermined, she added.
In 2006, a paediatric diarrhoea outbreak occurred in Botswana, coinciding with heavy rains. Surveillance recorded a three-times increase in cases and a 25-fold increase in deaths between January and March. Botswana has high HIV prevalence among pregnant women (33.4% in 2005), and an estimated 35% of all infants under the age of six months are not breastfed. This study followed all children <5 years old with diarrhoea in the country's second largest referral hospital at the peak of the outbreak by chart review, interviewed mothers and conducted laboratory testing for HIV and enteric pathogens. Of 153 hospitalised children with diarrhoea, 97% were <2 years old; 88% of these were not breastfeeding. HIV was diagnosed in 18% of children and 64% of mothers. Many children who died had been undersupplied with formula. Most of the severe morbidity and mortality in this outbreak occurred in children who were HIV negative and not breastfed. Feeding and nutritional factors were the most important determinants of severe illness and death. Breastfeeding is critical to infant survival in the developing world, and support for breastfeeding among HIV-negative women, and HIV-positive women who cannot formula feed safely, may prevent further high-mortality outbreaks.
The lack of adequate sanitation facilities in the Ugandan capital, Kampala, has led to increased use of polythene bags – known as 'flying toilets' – for human waste disposal, local officials said. The situation is worse in slums where infrastructure is basic. The few private and public facilities that exist charge up to USh200 [US 10 cents] per use of a toilet. 'These areas are characterised by poor drainage systems and, in the rainy season, the problem becomes worse,' said Bernard Luyiga, a councillor in Kampala district. 'We have not invested enough in this area.' About 6.2% of households in the city have no toilet facilities at all. Most, according to chief health inspector Mohammed Kirumira, are in the slums. And only about 65% of Kampala’s two million residents have access to clean water. The rest use water that is sometimes contaminated by pit latrines. According to Uganda's Lands, Housing and Urban Development Ministry, the high cost of piped water has forced some city dwellers to rely on springs and wells. 'Over 50% of household occupants in Kampala are hospitalised every three months due to malaria while contamination of water by prevalence of micro-organisms is evident in the water sources of the city,' it said.
This issue of Poverty in Focus reviews the Millennium Development Goals (MDGs) to date and asks what can be done to accelerate MDG progress in the years 2010–2015 and beyond. There have been numerous calls for a new development narrative/paradigm from developing countries, international civil society organisations and development agencies. The contributing authors believe this changing context will affect the debate on the MDGs, past and future, in ways that perhaps only now are starting to become clear. They also believe that impact of the current financial crisis is likely to continue to frame debates over the next five years, and will be critical in determining the economic and social environment. Economic uncertainty in donor countries is also leading to declining public support for aid budgets. They predict the coming period is likely to be much less certain as developing countries, especially in sub-Saharan Africa, face several interconnected crises to which climate change is central, and which will change the context for achieving the MDGs.
Even if, in terms of income, there are still today a higher number of poor people in the countryside than in Kenya’s cities, poor urban-dwellers face an alarming (and growing) range of vulnerabilities. Oxfam GB Kenya’s report highlights the mutually reinforcing dimensions of vulnerability in Nairobi’s slums. It launched a new Urban Programme Strategy in 2009 that aims to build on the organisation’s strategic comparative advantages, bringing its experience elsewhere into the urban sector in Kenya. These advantages include: coordinating partnerships with key stakeholders, bringing Oxfam GB’s experience in peace and conflict transformation in other parts of rural Kenya into the urban arena; capitalising on its international status in terms of resource mobilisation; and utilising its expertise on water, sanitation and food security to support local organisations in delivering basic urban services. The strategy will be implemented on a phased basis over a fifteen-year period, and will focus on three strategic priority areas: urban governance, sustainable livelihoods, and disaster preparedness and risk reduction.
In order to ameliorate poverty among tuberculosis (TB) sufferers, a few initiatives to support patients with TB have been made in KwaZulu-Natal, South Africa, including free treatment at government hospitals and clinics, and nutritional supplementation and social grants. Although these programmes have been functioning for a number of years, they have never been formally assessed in terms of the costs involved, the effects on the target populations, and the responses of patients. A recent study in Brazil (Belo et al, 2006) investigated a range of support strategies for patients with TB that included material and financial assistance, improved health services support and better administrative organisation – from the patient's perspective. Such a study has not been undertaken in South Africa, however, and given the large amount of money spent on support to TB patients, this is necessary to better inform such programmes.
This study examined child disability screening and its association with nutrition and early learning in countries with low and middle incomes. Cross-sectional data for the percentage of children screening positive for or at risk of disability were obtained for 191,199 children aged 2–9 years old in 18 countries. Screening results were descriptively analysed according to social, demographic, nutritional, early-learning and schooling variables. A median 23% of children aged 2–9 years old screened positive for disability. For children aged 2–4, screening positive for disability was significantly more likely in children who were not breastfed and who did not receive vitamin A supplements. Children aged 6–9 who did not attend school screened positive for disability more often than did children attending school. These results draw attention to the need for improved global capacity to assess and provide services for children at risk of disability. Further research on childhood disabilities is needed in countries with low and middle incomes to understand and address the role of nutritional deficiencies and restricted access to learning opportunities.
In a statement, the Commonwealth Association of Paediatric Gastroenterology and Nutrition (CAPGAN) calls for maternal, neonatal and child health to be more closely linked to improve child survival from HIV, diarrhoea and malnutrition. Colleges of Health Sciences, Nursing and Medicine should become important backbones of maternal and child health systems, through education and implementation research, and through training and retaining of their staff in HIV, diarrhoea and malnutrition in the widest sense. The statement presents that leadership, collaboration and country-capacity support, development of evidence-based guidelines and systems must be stimulated, to ensure coverage and monitoring of equity and progress in achieving Millennium Development Goals 4 and 5.