the environment and health

http://www.youtube.com/watch?v=t9r9XwDx7MQ&feature=channel

 

                         The environment and health

 

The environment has been associated with many diseases which have caused many children and people  to loss their lives or to live with conditions that is affecting their lives in one way or the other. The video  link above shows how man’s activities have great consequences on the environment and the impact it has on  people living in this area and also a source of conflict .Oil is said to generally corrupt, oil pollutes and its create confusion and chaos in any place it is found so is the case in the Niger Delta region and Africa in general. It creates a situation where people surrender their hard work and wait for oil money. So in this oil economy people turn not to work to get money but are expected to receive money from Oil Company while the oil companies on their part exploit the resources and the truth value of the oil is never paid.

Oil Company operating in this region are multinational company, there dominate the extraction of the crude oil. Most often these transnational oil companies have the technical know-how and so it has become a relationship of a powerful partner that dictates to the government since they have the capacities to do so. It is this powers that the company has that they relate with the environment, human right, Justice, governance etc. Before the arrival of the transnational oil company in Nigeria the Niger Delta was said to be an idyllic natural paradise, because it lies on the tropical forest belt of Africa it was blessed with a huge bio diversity .It had clean air and water and people who lived here normally survived from the land because of the availability of these resources, they depended on the land. People were in turned with nature .The cultured required that the land many not be vandalized something that is now rampant and is taking place. But things change when the palm oil companies come followed by the oil companies. These companies never really paid the true value of the resources that were extracted and did not really care how sustainable this extraction and its effect on the environment and the people living in these communities. This companies descended on the land and the consequences was pollution (air, land and water, corruption, deforestation etc.This devastation caused massive poverty and the environmental pollution. Peoples health and livelihoods were jeopardize

                      

                       The effects of the oil extraction

What is happening in the Niger delta region is what happened in regions where oil is extracted. Looking at its effects on the environment it has caused air, water and land pollution. This effects are usually long lasting .when oil mixes with water it caused what can be referred to as "mousse"  and also the burning of natural gas, coal crude oil goes a long way to increase green house gas effect This is as a result of the fact that certain atmospheric gases, such as carbon dioxide water vapour  and methane and, are able to change the energy balance of the planet by absorbing  long wave radiation emitted from the Earth's surface. This has caused a change in climate since it has enhanced   the Earth's climate which has lead to increase in temperature, flooding, radiation which causes illnesses. We see the destruction of bio diversity, aquatic life from the oil spill. The ecosystem changes .The food chain becomes poison, as the toxin from the spill gets in to the food chain. Breeding grounds are destroyed, the feeding area is destroyed. All this has grievous consequences on man. The people are demanding that the land that is polluted be cleaned and restore so that the life stock, aquatic life can strive, the waters be cleaned. No environmental justice. People who depend on aquatic life have lose their source of livelihood and poverty has becomes endemic also the fact that the people consume some of this aquatic life it has lead to poisoning of people and the animal. People health deteriorates and great damage is done on the immune systems of both human and animal. The cycle of poisoning continues for many years

Environment, poverty and health are greatly interwoven in this situation. The destruction of the environment by this oil company has the ability to great poverty in those communities where there are found. Because the communities have been devastated, livelihoods are ruin and the people fall in to poverty. People live in abject poverty, and it is said people live on less than a dollar a day. No access to clean water, no electricity and sanitation is deplorable .Waste disposal is done in the waters and communities are faced with malaria, cholera and other infectious diseases that can be contracted from such environments.

People have the impression that they have been stolen from and this has lead to an upraising of youth who use crimes, gangs and arm rebellions to get their own share of oil money. It has been turned in to a conflict and this conflict is threatening the peace and stability of Nigeria.

       

Proposed solutions for the problems and a way forward

The multinational company should clean up the spill oil. There should be held accountable and there have to take responsibility. Learning from the recent Deepwater Horizon BP oil leak disaster in the Gulf of Mexico where it has been reported $6bn has been estimated for the cost of cleaning up the Gulf of Mexico and this is not done in the Niger Delta region. Oil spill comes as a result of the releases of  crude oil from tankers,offshore platforms,drilling rigs and wells, as well as spills of refined petroleum products . Below are some of the Methods which can be used to clean up the oil

-  The use of bioremediation which is the use of  micro-organism to break down or remove oil.

-Burning show be controlled burning so that it can reduce the amount of oil in water. This should be done when winds are low. The problem with this method is that it also causes air pollution

-Solidifying is another method which can be used .In this case Solidifiers are used and there are composed of dry hydrophobic polymers . There change the physical state of spilled oil from liquid to a semi-solid or a rubber-like material that floats on water. Solidifiers are insoluble in water, therefore the removal of the solidified oil is easy and the oil will not leach out.

-oil can be sucked up along with the water, and then with the use of centrifuge oil from the water can be separated. The water is then returned to the sea but sometimes this water contains some amount of oil.

Prevention of oil spills should be a priority. While efforts should be made to remove all oil that has been spilled into the environment there must also be prevented, in the case of the Niger delta there is need for repair of physical facilities since most of them are old and dilapidated. These structures sometimes explode resulting in an outbreak of fire which consumes the surrounding land. Despite of the anger of the people, people should stop sabotaging and vandalizing these oil structures because there help in spilling oil and destroying their own environment, what they are claiming to be fighting against.

The government should invest in renewable energy. Solar or wind energy should be the way to go. By investing on renewable energy the extraction quarter of oil will be reduce. It should also be the responsibility of the government to make sure that their oil companies are brought to book if they violate any of the country’s oil laws something which is not done often because of the financial power that these oil companies have, the reason for corruption. In case of spill regulatory agencies should assessed them and then penalties levied on them and money paid in insurance and legal claims.

Insofar as the people of the communities think that they are not benefiting from the oil, they is need that the government invest more in these communities. Fighting poverty in these communities is very important. This should be done with the creation of more schools and also technical education should be encouraged. Health care facilities should be created making it affordable for everybody. From the videos one notice of the degraded sanitation there is needed for proper waste disposal method and also the need of roads, clean water should be made available to people. It is estimated that about 78% of the Nigerian population lacks electricity

 Oil companies should not just be there to extract they should also participant in the development of the communities. So there should make available fund for infrastructure and social amenities which will lead to development. Transnational companies should allow the reformation of the governance process in the oil industry and there should be responsible for environment degradation. These companies should also pay attention to sustainability. The fight against corruption should be at the fore center both at the level of the oil companies and the governments and the people should be able to gain from the oil. Because of lack of employment the youth have gotten involve in crimes and gang actives. So the interest of the people should be the focus.

It is devastating to see how the environment is destroyed, a poverty is endemic in the society, and the increase in conflicts which result in the lost of live. What has been affected is the spoiling of the land, with consequences for health and livelihood

References
http://www.youtube.com/watch?v=t9r9XwDx7MQ&feature=channel

-http://www.waterencyclopedia.com/Oc-Po/Oil-Spills

-://en.wikipedia.org/wiki/Oil_spill

-http://www.physicalgeography.net/fundamentals

Malaria Prevention

Malaria Prevention
Any time I come across the word malaria, my childhood flashes in to my mind. I begin to think of the rituals my mother went through so that we could not get infected despite that once in a while one of us will still fall sick of malaria. I wonder if we did not go through all those process what the consequences would have been. We lived in a capital city, off cause it was hot and humid and more especially the surrounding were usually not that clean. My mother kept our home very clean but the big trouble was the fact that the drainage systems were really very bad. There were this gutters and people usually would doom their waste inside and worst water could not flow through because the gutters were full and also people open up their toilets and everything went in to this gutters, it was not a good site, There were sinking and off course breathing grounds for mosquitoes. In spite of the fact that we keep our immediate surroundings clear, the accumulation of waste and stagnant water resulted in the growth of mosquitoes. So my mother did what she new best. Three times a week i.e. Monday, Thursday and Saturday she would spray the entire house with a mosquito spray (common name shell tox) with all the doors and windows closed. We will then have to sit outside for least 2 hours while the smell of the spray evaporates. When that was done we had a night free from mosquitos’ noise and biting. But now there are more effective spray that can last for 3-6 months depending in the insecticide and in some cases there can even last 9 to 12 months. I wish we had those types then
Every month she made sure that she gave us preventive malaria drugs to take and in this case the drug was nivaquine. When I became an adult nivaquine became resistant to malaria .Oh my God I hated taking the medicine because it was so bitter but at least it protected us against malaria. We used to pray for heavy rain to fall because heavy rains help to wash away the mosquitoes and also cleaned the gutters. We never really cared where the rain will doom the waste insofar as the gutters around our vicinity were clean, and that was really selfish I think because wherever it deposited it contain, it will accumulate and become another breathing ground for mosquitoes. Later on in life when my parents build our home they covered the windows with nets. The windows could be left open and still no mosquitoes will come through because the nets on the window prevented them from coming through and I really thought that was great. That was my mother and her fight against malaria,


Ways of preventing malaria


- Use of insecticide-treated bed nets. Most often one can buy these treated bed nets form some pharmacies and also there are bought from health center and they are given to pregnant women .One still have to take note that usually not all health centers have these nets to give out.
- The use of indoor residual spraying is very effective in preventing malaria, because some of these insecticides can last from 3 to 6 months while some other insecticides may even last from 9 to 12 months
- Use of intermittent presumptive treatment during pregnancy, it is very nice if a pregnant woman takes these drugs they will help to fight malaria in her body. Also these preventive drugs should be given to people travelling to tropical areas.
-Early diagnosis and prompt treatment. This is very important. Most of the time from what I had observed while growing up and as an adult many people did not go to the hospital, when they fell sick they did self diagnoses and just presume they had malaria, they either bought drugs from vendors who carried drugs around in baskets and these guys had no medical know how . These drugs were exposed to the sun and expired and most of the time fake. It is imperative that people go to the hospitals and get a lab test then the doctor can prescribe the type of malaria drugs they have to take and in what dose they need to take them .Drugs should be gotten from a pharmacy where drugs are kept under the right temperature and are in safe conditions and they are not fake.
- The environment should be kept clean, good sanitation conditions are necessary in the prevention of malaria. When we finally left the capital city and were leaving in another province, it was much cleaner. Every month everybody had to go out and clean the roads and the surrounding Dooming of waste on the roads or in the gutter was prohibited .The community made sure that nobody broke the rules. It was just amazing. No stagnant water and smelling water and we kids love that environment
-We are waiting for the vaccine to be created which will help in preventing malaria, and research is said to be on going
-Carry sensitization campaigns .This campaigns will help the community gain more knowledge on malaria prevention


Preventing other deceases at a global level



Fighting deceases at a global level is very important. People in poor areas benefit from them, because it they are left only in the hands of their governments not much will be done and the fact that there is a lack of health services in these areas and no political will to do so.

A global campaign is necessary so as to create awareness. This is been done but more needs to be done because people still do not know how some of these infectious deceases are being transmitted or what they need to do in case of exposure and prevention .In the case of HIV there is need for education on the importance of the condom (although abstainace, and being faithful are part of the campaigns know that it is often difficult for people to be) and how there should be used. I can still remember during an HIV campaign when I was still a university student back in my home country, condoms were given to lecturers to distribute to students, but many lecturers did not find the courage to distribute these condoms. It was shocking that lecturers found it difficult to give out these condoms. They said they were too embarrassed to be seen distributing condoms and doing that would mean encouraging students to have sex.Parents also find themselves in this type of predicament but the reality is their children are having sex and as such something needs to be done. So there is a need to train people that would talk about this to student freely and who do not attach any stigma on sex. Since most of the time parent really fined it difficult to talk about this issues, schools should come up with curriculum to teach student and also provide places where student can go seek guidance.


At a global level funds should be made available that will help other less developing countries in their health care to provide for a free HIV test .If a fee is levied then it should be at a minimal cost at most community clinics, and at health fairs. Also anti retroviral drugs should be affordable and in some cases free to those suffering in addition to that free anti retroviral drugs should be provided to pregnant women and in case their children are infected same should be done for them. More effort should be carried out to expand access to antiretroviral therapy which is said to be only available to less than 10% of those that urgently require it.

As we know HIV and TB is said to form a lethal combination so it is important that global policy on the control of HIV-related TB and advises on how those fighting against TB and HIV can work together as is being done by WHO and its international partners

A service should be made available where if infected with either HIV or TB you can go there for treatment. This may be done by contributing to the health services of less developed countries. Resources must be invested in building and strengthening health systems and also access to
essential medicines should be made available.


It can be said that at the global level certain things are being put in place for prevention of these decreases. The UN Millennium Development Goals have been put in place which is global action plan to achieve the eight anti-poverty goals by 2015.The Millennium Development Goals (MDGs) provide concrete, numerical benchmarks for tackling extreme poverty in its many dimensions. This is because by tackling poverty more can be achieve in relation to health care and health. Thus achieving the Millennium Development Goals (MDGs) will translate to health for all citizens.


My Thought


Growing up and seeing many people around me die of HIV AID I get to understand what the family feels like and what goes on. Having lost three family members to AID and also having a family member battling AID present I have come to understand the power of information. But it was a shame that during this time when these my family member were sick it was so difficult for elders in the family tell us the younger ones what these relatives were suffering from. I quite remember that they made us understand that they were poison. The debate heated between the elders when my father said we the younger ones deserve to know what this was all about. I remember he sat us down against the advice of the other elders and told us what was going on and how we needed to protect ourselves from the disease. He made us understand what this sickness was all about and how we could contract it and how it could be prevented. It was just shocking to me that something like this was kept from us. When I look back what was important to my father was that we stay alive and health for him talking about sex was a little price to pay compared to our lifes. Information has the power to change socitiey.What people do with information when they receive can change a situation drastically
I still cannot believe how people die from diseases that can be prevented, since much is not even need to prevent these diseases. It is therefore important that at the grass root, the community should be able to come together to help prevent these preventable diseases. For me when people die of diseases that can be prevented I wonder if there is simple the lack of will power to do so.
Governments have a great part to play. If you look at democratic societies they is always the tendency that these societies turn to provide basic facilities to their citizen, but in undemocratic society, underdevelopment is more relavant.There is corruption and embezzlement which have left the greater part of the society poor .So at this level they is need for a proactive civil society because as long as poverty exist people will continue to die of preventable sickness. It also follows that women should be educated so that the fight against poverty can be achieved. Societies should be able to prevent preventable diseases.


References

Ruxin, J., Paluzzi, J., Wilson, P., Tosan, Y., Kruk, M. & Teklehaimanot, A. 2005. Emerging consensus in HIV/AIDS, malaria, tuberculosis, and access to essential medicines. (pdf) The Lancet, Vol. 365 (12), 618-621.
/www.unmillenniumproject.org/documents/TheLancetHealth.pdf
//www.un.org/millenniumgoals/
//www.undp.org/mdg/basics

Maternal and child mortality in developing countries

  

Reading through the material provided i personally found it very informative and educative and touching. It made me realize the enormity of maternal and child mortality. It makes it even more overwhelming when you know that in sub-Saharan Africa a woman has a 1 in 16 chance of dying in pregnancy or childbirth as compare to 1 in 2,800 risks for a woman from a developed region and also the fact that in sub-Saharan Africa 1 in 8 children dies before their fifth birthday while in Southern Asia 1 in 14 children die before age five, alarming statistics yet true

It is also more alarming that these 8 million children and 350,000 women who die each year die of causes that could be prevented. It is recognized that the health of women and children is key to progress. Of all development goals less improvement is said to have been made on maternal health than any other Millennium development goal. It is as such very important to save women and children thus the reason why “Global Strategy for Women’s and Children’s Health” sets out how we can work together to save women and children.

  

A mother’s health profoundly affects the health and well-being of her children.I can still remember  as if it was yesterday when my mother was sick my sibling and i almost went hungry ,her health affected everybody in the house because even our sanitation and  education suffered when she was sick .The aim is reducing maternal mortality by three-quarters between 1990 and 2015 (http://www.childinfo.org/maternal_mortality). 

It has been observed that the lifetime risk of maternal death is much greater in the poorest countries than in the richest (1 in 12 for women in east Africa compared with 1 in 4000 in northern Europe).

The follow reasons are causes of maternal death. 25% of maternal deaths are caused by severe bleeding, infection 15%, unsafe abortion 13%, eclampsia 12%, obstructed labor 8%, Indirect causes including anemia, malaria, 20% heart disease and 8% other causes which include ectopic pregnancy, or complication of anesthesia or embolism.  ( BMJ 2001)   

 According to the 2000 -2003  global distribution  of under five deaths of major causes of child mortality pneumonia  19%,neonatal 37%,Aids 3%,diarrhea account for 17 per cent of under-five deaths, malaria and measles account for  12% while injuries and other causes (such as armed conflicts) account for  13 %  of child mortality.These are closely linked to Child under nutrition ,unsafe water, poor hygiene practices and inadequate sanitation (http://www.unicef.org/health).  

Both social and biological reason account for maternal and child mortality. Income and maternal education are two causal determinants of child mortality in populations of the developing world.  Maternal education has a strong impact on infant and child mortality.Startistics show that each year increment in mother’s education corresponds with a 7-9% decline of under- 5s’mortality (Soc Sci Med Vol 27).The factors found in repeated DHS programmes explains these trends are fertility behavior; nutritional status, breastfeeding, and infant feeding; the use of health services by mothers and for children; environmental health conditions; and socioeconomic status. An educated woman understands these well and is much likely to practice them and has options to consider from.

Although poverty is closely associated to maternal and child mortality society's inefficiency in planning, and the incapacity to make changes can greatly account for mortality. The  political will to address the problem of maternal health in developing countries is most often not at the focal center because the magnitude of the problem is not yet grasp ,government do not consider greatly it importance and in cases where there are done it is often done without a clear view of the concrete content of the political and social strategies that are the necessary complements of an adequate knowledge base (Atwood et al. 1997).

Preventing maternal deaths requires a functioning health system which often is not very ineffective in developing world either due of lack of it or the poor state and under staffed and equipped state there are in. Health care is very important and as such there is the need to mobilize professionals and the community. Limited awareness of the magnitude and manageability of the problem increases maternal and child mortality. Antenatal care and training of traditional birth attendants makes it possible for women in rural areas to have access to antenatal care and birth attendants thus decreasing maternal and child mortality.

Some cultural practices affect maternal and child mortality. In cases where selective abortion is practice where the female fetus is aborted it increases the ratio of child mortality and gender discrimination paractise.Some cultures still practice female genital mutilation which have lead to some women dying of bleeding or of an infection. This according to the world health organization has great effects on the woman’s health and child birth

To conclude the good news is that accounting  latest United Nations under-five mortality estimates released  2010  by UNICEF suggest 12,000 fewer children are dying each day around the world compared to 1990 still more needs to be done because it is pathetic to see  women and children dying from preventable causes.

References

Atwood K, Colditz GA, Kawachi I (1997) From public health science to prevention policy: placing science in its social and political contexts. American Journal of Health Planning 87, 1603–1606.

Levels & Trends in Child Mortality: Report 2010.” United Nations Inter-Agency Group on Child Mortality Estimation.

Reducing maternal mortality in developing world:sector-wide approaches may be key.BMJ 2001; 322 : 917 doi: 10.1136/bmj.322.7291.917 (Published 14 April 2001)

Maternal education and child survival in developing countries by John G. Cleland and Jerome K. van Ginneken in Social Science & Medicine Volume 27, Issue 12

http://www.unicef.org/health)

http://www.childinfo.org/maternal_mortality)

Differences in education between nations and factors that could explain these differences

The UNICEF table of education looks at the gross and net ration of male and female between 2000 to 2006 in primary and secondary school enrolment and attendance for different countries. It also illustrates the literacy rate of female and male (2000-2006) while also comparing Number of phone and internet users per 100 of the population of the year 2005.This table of education can be use to compare the following
-literacy rate of youth (14-24 year) from 2000-2006 of different countries
-number of phone and internet users per 100 of a population of different countries
-both net attendance ratio for both male and female for primary school and secondary school.(with this you actually get the number of children that actually attended primary school from 2000 to 2006 to those who attended secondary school in those same years) of each country
-we can also compare male and female primary school enrolment ration (both gross and net) for primary and secondary school levels.
-From the table it is also easy to compare level of drop out at both primary and secondary school (both male and female) to those who actually attended at both levels
-also the table is able to provide us with information of % of primary school entrants reaching grade 5 from both administrative and survey data

From these tables one is able to see the gender differences between female and male in their level of enrolment and attendance at both primary schools and secondary school levels. These gender differences is seen clearly between countries of the developed and less developed. The gender disparities between male and female in developed countries are more or insignificant, but whereas in developing countries the disparity rate is significant. The following examples clearly show this disperities.Belgium has and gross enrolment ratio of 104 for both male and female and a 99 net enrolment ratio for both male and female for primary schools. It has a gross secondary school enrolment ratio of 112 for male and 108 for female and a net enrolment ratio of 97 and 98 for both male and female respectively. Same goes for Austria with a gross enrolment ration of 104 for both male and female, with a net enrolment ratio of 96/97 for male and female respectively. The gross enrolment ration for secondary school for male is 152 and 145 for female and a net enrolment ratio of 86 and 87 respectively for male and female.norway ,Finland and Denmark have equal net and gross enrolment ratio for both male and female at both secondary and primary school. If you compare these rations with that of less developed countries like Benin which has a gross primary enrolment ratio of 107 and 85 for male and female net ratio of 70 and 60.with a gross secondary school enrolment ratio of 41 and 23 and a net ratio of 23 and 11 for both male and female another example is Nigeria with a gross ratio of 111 and 95 and a net ratio of 72 and 64 for primary school enrolment for male and female respectively, while gross and net enrolment ratio for secondary school is 37 and 31 and 29 and 25 for male and female the same goes for Burkina faso,Niger etc.
From the above examples cited we can see a gender inequality gab, these can be seen between less developed countries and those of the developed world. Religious and cultural belief are some of the factors that affect these inequality among gender in education in some of these areas, take the examples of Pakistan and Afghanistan religion plays a very important rule in the inequality that is found in the primary and secondary school attendance and enrolments. Also in some areas cultural norms this disparities eg where I come from people did not normally send girl children to school because they were considered as other “people properties” ,and so investing on their education was more or less unprofitable since normally she is expected to leave and go get married in another family. This therefore created a situation where the female child was left at home to take care of the home and the other children. This is a practice condemn the girl child to continue poverty and she could not be empowered and this greatly affected her health. These cultural and religious beliefs create the marginalization of the female child thus depriving her of opportunities later on in life. When that is compared to countries of the developed world one can observe that both female like male attend school on equal bases. In some cases the ratio of female to male is greater unlike in less developing whole where these ratio are smaller and as you get to the secondary school level it reduces further illustrated the type of society .The fact that developed countries are more democratic and secular permit and facilitate gender equality. Countries with higher primary schooling and a smaller gap between rates of boys’ and girls’ schooling tend to enjoy greater democracy (http://web.worldbank.org/)

If you also look at countries that are in continues conflict situation, war, natural disaster such as Democratic republic of Congo, Afaganistan etc sending children to school is difficult this is because of lack of stability and security. In this cases education and quality education is a distant dream, those a cycle is being observe that leaves these people in a continue state of poverty and lack of peace.

Poverty is one of the factors that also cause these differences in school enrolment and school attendance at both primary and secondary school levels. Poverty has negative implications and keeps children out of school. In developing countries, it is one child out of two who is poor (Minujin et al. 1999; UNICEF, 2000). Poverty that starts with childhood and carries the seed of its own reproduction (Heidel K., 2004). Poverty mortgages the future of the children that undergoes it and condemns them to relive it in adulthood. Making it impossible for them to go to school or to attend school. That is why a difference can be seen at the level of enrolment and attendance, Children are enrol in both primary and secondary school but yet cannot afford to actually attend as such the difference in attendance ratio.Striking difference in gross and net ratio is the fact that at in most developing countries the number of children that actually do attend after enrolment always falls. Reasons that can be advanced for this is the fact that schools may be located very far from where this children leave or lack of resources to buy school stationeries like books and pens and also the fact that some children have to help out at home or have to provide for their families financially and as such they are unable to attend school even after enrolment. Another reason that could be advance is the presence of structural violence, thus structures have continued to create a cycle of inequality which affects gender, race and ethnicity etc.

Another sticking thing is the number of phone users and internet uses .It can be seen that countries with high primary school and secondary school enrolment ratio have higher number of phone and internet users. Which proves that the more expose people are the more there interact with other people from different parts of the world and the more knowledge is gain. These countries are knowledge base societies
To summaries statistics show that the children account for a large proportion of the poor in the world (nearly half). Poverty starts with childhood; it is at this level that we should begin the fight and the best way to do this is to educate children. Education is essential in fighting poverty from the root since it provide skills for lifelong learning and professional success. The society has the obligation to correct the inequalities undergone by children who cannot be held responsible for the poverty situation they inherit (Cerc Association, 2004) and inorder to empower and strengthen the nation there is a need to educate children so that both the nation and the individual can be lifted from poverty. Education of the girl child is vital to the development of the society and as perfectly put educating a girl is educating a nation. Thus the need for gender sensitive education



References
- Cerc Association (2004). «Les enfants pauvres de France». Rapport de travail du Cerc Association.
- Heidel, K. (2004). «Reduction strategy papers: blind to the rights of the (working) child?». Kinderno- thilfe and Werkstatt Ökonomie, Heidelberg.
- Minujin, A. (1999). «Putting children into poverty statistics». Paper presented at the Third Meeting of the Expert Group on Poverty Statistics, INE, Lisbon.
- UNICEF (2000). «Poverty reduction begins with children». UNICEF, New York.
-http://web.worldbank.org/

Poverty

The concept of structural violence and distal and proximal intervention are the two concepts I choose from Farmer's article.


Structural violence are arrangements or structure that are in place that cause harm to the population or that impairs human lives. These structures may be political, economical or social. Structures and institutions are central to this analysis. These structures are either at the domestic level or at the international level. Although John Galtung theory of structural violence was first and foremost related to peace research, his concept of structural violence is widely applicable and has extended to fields such as anthropology, clinical medicine, and sociology (Essex Human Rights Review Vol. 4 No. 2 September 2007) .That is why Farmer can use this concept to explain health and poverty in a society.


Health and poverty can be explained by using structural violence. The fact that unjust and exploitative social, economic and social system structures are in place and facilitate physical or psychological harm is said to impact health and poverty. Health and poverty are markers of structural violence because it focuses on the underlying causes of poverty and health. Those disparities that cause more than 2.7 billion people to leave on less than 2.7 dollars a day why there is a 30 years difference between people living in Africa and those in the rich nations (http://www2.helsekompetanse.no). “Structural violence erases the history and consciousness of the social origins of poverty, sickness, hunger, and premature death, so that they are simply taken for granted and naturalized so that no one is held accountable except, perhaps, the poor themselves” (Scheper-Hughes 2004:14).Considering that in the world, health and poverty are shaped by social, political and economic conditions (Irwin et al. 2006) these factors go a long way to decipher if people have access to health services.

Structural violence gives us that opportunity to be able to understand some basic human contemporary phenomenon. In understanding these we are able to implement solutions to areas that need them
This can be exemplifies by the disparities that accord in HIV care that is why Africa American are said to be more likely to contract HIV and also among patients infected with HIV, blacks are significantly less likely than whites to have received ART same goes in the case of Rwanda and Haiti. (http://model.pih.org).It is therefore required that social causes of ill health should be looked in to.
Since people can be killed or harmed through sociopolitical and economic structures there affect the health and poverty level of societies or communities. This thus leaves certain groups of the community prone to the social injustices of these machineries thus an observation of health disparities or differences in health status between wealthy elites and the poor in stratified societies (Evolution and Prehistory: The Human Challenge 2007).

Wealthy states, corporations are using their power to structure world system which in effect leave them at a competitive advantage thus the existence of structural violence especially when such powers undermine the well being of others as populations of less developed countries continue to languish in poverty and the health state of the populations of these countries continue to deteriorate since there are on the disadvantage. It is thus logical to say that when an agency is constrained to the extent that fundamental human needs cannot be attained, structural violence becomes a structural violation of human rights (Essex Human Rights Review Vol. 4 No. 2 September 2007).

John Galtung asserts that in structural violence there may not be any person who directly harms another person and that violence is built into the structure and shows up as unequal power and consequently as unequal life chances. Thus take the case of inequality in a society, racism, where for example a particular race is at a systematically disadvantage and as such unequal life changes thus it the structures that are in place that perpetrates these constrain and not a person thus making it possible for poverty, ill health to be an issue of concern in these populations. Institutionalized social structure lowers the level of actual fulfillment of one’s fundamental needs, such as healthcare and thus according to Farmer these structures then creates an unequal distribution of power then these distribution of power then systematically disadvantages those who do not hold as much if any power (Farmer, Pathologies of Power 2005).It can be seen that structural violence is embedded in inequality,

                            Only poverty will cause children to play in such dirty and drink such dirty water


Poverty on the other hand actually create conditions where to meets ones fundamental human needs are obstructed thus poverty can be said to create violence that makes it actually impossible to meets basic fundamental needs of some people .Thus it is poverty that makes it possible for 815 million people to be undernourished while 1.1 billion lack access to safe drinking water and 880 million lack asses to basic health care (Pogge 2003,)


The concept of distal and proximal intervention tries to remove some of the basic obstacle at the point of care. These levels of care are given at both the distal and proximal level. All these level of intervention are important. The distal and the proximal intervention go hand in glove and as such complement each other. These two levels of interventions both tackle health crisis and poverty. From my understanding these two sorts of interventions can effectively illustrate the level of health and poverty in a community. When one is at the state of ill health (sick) it is very necessary that distal intervention be carried out because it will increase their chances of surviving and also lessen the risk of whatever disease they may be suffering from, medical personnel’s are trained to carry out this level of intervention then the proximal level which is more or less like a preventive level.

It can be said while both are important but depending on the society in question one can take precedence. Take the case of most Scandinavian countries, individuals or people are more concern with the distal level of intervention, in case of any ill health or sickness they individual know that have to go to the hospital and let the medical personnel carry out diagnoses of their illness and prescribe drugs for them. Proximal level of intervention in these societies can be said to be already established since structures that are in places have already made sure that there are in place facilitating this level of intervention. Most third world countries mostly due of structural violence still have to take both these level of intervention seriously, because most often one without the other will not work effectively. In poor health they population worries about having the possibility of having distal care ,already they are meant with obstacles firstly due of the unavailability of medical practitioners and also the fact that they cannot afford for health care services. In cases where they manage to have these distal intervention they are still face another delimer,how to maintain these state of health such as lack of clean water ,basic sanitation and most especially lack of possibility to effect a change in the being and also how to prevent these deceases from occurring . Thus proximal intervention becomes very important because it requires the available of certain necessities before distal intervention can be effective. Yes one can be provided with anti retro-viral  drugs but if they have no food to eat, lack access to clean drinking water, sanitation is poor it actually becomes difficult to fight the disease.


This is exemplified in the voices of the poor, where it states that poor places keep people poor and also poor places kill if this statement is extrapolated we can as well say that this situation has very much created a situation where it is difficult to provide for proximal intervention, thus these poor places will kill you before you even have the opportunity to have distal intervention. Thus a lack of these basic necessities which is cause by poverty leads to ill health. Therefore it can be suggested that “good health” and “well-being” must be a combination of distal and proximal intervention. It is said poverty and ill-health are inseparable thus in Voices of the Poor” ill-health is perceived both as a cause of increased poverty and as an obstacle to escaping it (Voices of the Poor, a project led by Deepa Narayan, 2000).

Value that Farmer’s articles brings to discussion on poverty and health.

It raises the awareness that poverty and ill-health are inseparable and that due to structures that are in place poverty and health can either be ameliorated or they can deteriorate .It brings to light the issues of denied opportunities and these opportunities are being denied to people who need them by socio economic and political structures. Thus rising both ethical and moral values that basic human rights should not be neglected. He illustrates how structural violence violates people’s basic human right.
By linking structural violence to poverty and health he opens up a discourse .This discourse allows for the re-thinking of the concept of poverty .By illustrating how structural violence create disparities between groups of people he does not just create an awareness but brings to light how structures can be part of the worlds poverty and ill health issues.


Farmer also makes it clear that despite the presence of this violence, problems created can still be solved by using both distal and proximal intervention. He outlines the fact that these distal and proximal interventions can be attainable if we wish. Because he considers that these violence in the first place are avoidable. Thus structural intervention should be made available.
In Farmer's article he clearly point how structural violence have created inequality, gender issues,racism,social injustice etc.These then allows for poverty which then create conditions that allows for human rights to be violated be it at the global level or at the community level.


To conclude Farmers articles allows me to evaluate and to appreciate the fact that although structures may be very much be part of why poverty exist I can understanding at what point individuals should take responsibility .Thus for me it is a mixture of the presents of structures that facilitate poverty and individuals that do not take responsibility .


References
- Essex Human Rights Review Vol. 4 No. 2 September 2007)
-Farmer, Paul, Pathologies of Power (Berkeley: University of California Press, 2005).
-Galtung, John, ‘Cultural Violence’ (1990) 27.3 Journal of Peace Research
-Irwin A, Valentine N, Brown C, Loewenson R, Solar O, Brown H, Koller T, Vega J (2006). The Commission on Social Determinants of Health: tackling the social roots of health inequities. PLoS Med
-Poggs, Thomas, ‘Priorities of Global Justice’ in David Held and Anthony McGrew (eds.),
The Global Transformations Reader, (Cambridge: Polity Press, 2003).
- Scheper-Hughes N (2004). Dangerous and endangered youth: social structures and determinants of violence. Annals of the New York Academy of Sciences
- William A. Haviland, Dana Walrath, Harald E. L. Prins, Evolution and Prehistory: The Human Challenge (2007) Wadsworth Publishing

-Voices of the Poor, a project led by Deepa Narayan, World Bank, published 2000.
www.worldbank.org/poverty/voices.)
- Dying for Change .Poor people’s experience of health and ill-health http://siteresources.worldbank.org/INTPAH/Resources/Publications/Dying-for-Change/
- http://www2.helsekompetanse.no
-(http://model.pih.org).