npr global health

Back in the 1960s, the U.S. started vaccinating kids for measles. As expected, children stopped getting measles.

But something else happened.

Childhood deaths from all infectious diseases plummeted. Even deaths from diseases like pneumonia and diarrhea were cut by half.

“So it’s really been a mystery — why do children stop dying at such high rates from all these different infections following introduction of the measles vaccine,” says Michael Mina, a postdoc in biology at Princeton University and a medical student at Emory University.

Scientists Crack A 50-Year-Old Mystery About The Measles Vaccine

Photo credit: Photofusion/UIG via Getty Images

Sporozoites of the parasite Cryptosporidium parvum emerging from their oocyst to infect gastrointestinal epithelial cells.

Cryptosporidium, commonly known by the comic book supervillian name “Crypto,” is transmitted by ingesting water or food contaminated with Crypto oocysts. Once ingested, the oocyte ruptures, and the sporozoites contained within infect the gut of their new host, causing watery diarrhea. 

Though outbreaks occasionally occur in the developed world, few infected in those outbreaks die from Crypto. However, in the developing world, some of those infected with Crypto develop chronic disease and die, particularly small, malnourished children.

For more on Crypto and how scientists are tackling this tricky parasite, check out this article on NPR’s All Things Considered about the work being done by the Striepen lab at the University of Georgia Center for Tropical and Emerging Global Diseases.

Image courtesy Boris Striepen and Muthgapatti Kandasamy, University of Georgia Center for Tropical and Emerging Global Diseases

In a suspected chemical weapon attack like the one in Syria on Tuesday, children are the most vulnerable targets. They are more likely than adults to die from chemical agents and to suffer injures. If they survive, they also suffer from the physical and mental trauma of the attack for far more years than adults simply because they have more years left to live.

The effects of chemical weapons are more devastating for kids for a number of reasons. “Because kids are smaller, there’s a higher impact on a smaller body,” said Dr. Steven Hinrichs, director of the Center for Biosecurity at the University of Nebraska Medical Center. A smaller dose of a chemical agent can do more damage to their organs.

Why Children Face The Greatest Danger From Chemical Weapons

Photo: Mohamed Al-Bakour/AFP/Getty Images

Some schoolkids might be happy if their school were knocked down.

Not in Nairobi.

On May 15, a group of primary school students sat at desks in the center of a main road to block traffic. Along with their parents, they were protesting the demolition of their school, the Kenyatta Golf Course Academy, over the weekend.

According to a BBC article, the schoolchildren chanted: “We want our school, we need to study in school.”

The reason for the demolition was a bit hard to pin down. Foreign Policy writes: “It appears the school was destroyed without any prior warning to parents — who had already paid their children’s tuition for the year. The school was on land that belonged to a church, and the school was destroyed without warning on Saturday over a land dispute, though exact details of the dispute weren’t made immediately clear.”

Why Are Kids Sitting At Their Desks In The Middle Of The Road?

Photo: Moses Muoki/Kenya’s Capital News

In her first running of the Boston Marathon, Edna Kiplagat powered across the finish line of the Boston Marathon this month nearly a minute ahead of her closest rival. Kiplagat made the 26.2 mile outing look like a spirited jog in the park. She even clocked a blazingly fast 5:02 minute mile at the 20-mile mark of Boston’s storied road race.

And now, as she does after every major race, she’s taking two weeks off.

“I’m in my second week of that right now relaxing at home with my husband,” she says when reached by phone at her farm outside Eldoret, Kenya, in the western highlands. “In the afternoon, we take our children to play. My son likes golf. And my daughter likes swimming. We take them to the Eldoret Club for two hours, then come home.”

Boston Champ Juggles Marathons, 5 Kids, Kenyan Farm

Photo: John Tlumacki/Boston Globe via Getty Images

Next week, between 150 and 200 people will gather for a Passover seder at Temple Beth-El in Richmond, Va. When the traditional Passover question is posed — “Why is this night different from all other nights?” — there’s a new answer. Guests at the Seder, co-sponsored by the refugee aid agency ReEstablish Richmond, will include approximately two dozen locally resettled immigrants from Afghanistan, Iraq and Syria.

Passover, after all, is the ultimate refugee holiday. It’s about an ancient flight to freedom by Israelites who were oppressed in Egypt. And the world is currently facing an unprecedented refugee crisis, with 65.3 million refugees worldwide.

One new version of the Haggada, from the American Jewish World Service, makes a direct connection: “Around the world today, courageous people are making similar journeys — leaving behind violence, poverty and persecution and seeking security, freedom, prosperity and peace.”

Against this backdrop, a number of Jewish organizations are offering new readings and rituals to include at the festive meal known as the Seder. These additions, says Rabbi Jonah Dov Pesner, director of the Religious Action Center of Reform Judaism, are in keeping with the fact that the Haggada — the text read at the Seder — has always been flexible, “less of a fixed text than a user guide to tell the story.”

Why Add A Banana To The Passover Table?

Illustration: Franziska Barczyk for NPR

The United States spends the most on health care per person — $9,237 – according to two new papers published in the journal The Lancet.

Somalia spends the least – just $33 per person.

The data covering 184 countries was collected and analyzed by the Global Burden of Disease Health Financing Collaborator Network, a network of investigators from around the world with expertise in various aspects of health care. In between those two extremes, the spending is quite literally all over the map. And the amount of spending doesn’t necessarily translate into better health care. For more insights, we spoke to Dr. Joseph Dieleman, assistant professor at the Institute for Health Metrics Evaluation at the University of Washington. He authored the two papers, one looking at health financing from 1995 to 2014, and the other estimating future health financing to 2040.

Obviously, wealthy countries spend more on health than do poor countries. Overall, where does the money come from?

What Country Spends The Most (And Least) On Health Care Per Person?

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A new report shows that the refugee crisis hasn’t slowed down — and people don’t always end up where you think.

The flow of refugees is steadily increasing, according to the U.N. Refugee Agency (UNHCR). As of mid-2016, there were 16.5 million refugees globally, 5 million more than in mid-2013. More than 30 percent of all refugees as of mid-2016 came from Syria, the largest source of global refugees.

This growing refugee population brings many challenges. Because of school shortages in overcrowded camps, refugee children are five times more likely to be out of school than non-refugee children, reports the UNHCR. Preventable, treatable diseases like diarrhea, measles and malaria threaten the health of refugee children, especially those under 5. And in many cases, parents aren’t able to secure jobs outside the camps to provide an income for their families.

CHART: Where The World’s Refugees Are

Charts by Katie Park

Menstruation is hardly the stuff of poetry. In fact, in India, if periods are talked about at all, it’s in whispered code, and never with someone of the opposite gender.

But a group of medical students at the Calicut Medical College in the southern state of Kerala wanted to change all that. So in March, they launched a contest called Haiku, which encouraged students to submit short stories, poems and verse about menstruation, all under 140 characters. The idea was to get young people to speak more openly about periods.

“It’s a normal, biological thing, we shouldn’t be ashamed,” says James Paul, a student at the college who came up with the contest idea. Before going to medical school, he admitted that talking about menstruation made him feel shy. But his professors and textbooks helped him get comfortable with the topic.

Breaking The Taboo Of Talking About Periods

Illustration: Hanna Barczyk for NPR

Acid attacks survivors are finding the courage to reclaim their lives — and seeking to raise public awareness and help stop future attacks. Their strategies include taking to the fashion runway, sharing their experiences in comic books and appearing in video resumes that show potential employers they are far more than their scars.

After more than a decade and nearly 50 reconstructive surgeries, MoniCa Singh has managed to forge a new path — actually, several paths, as a professional in fashion design, as an advocate who raises awareness of gender-based violence and reaches out to survivors — and this fall, as a comic book heroine.

The Extraordinary Courage Of Acid Attack Survivors

Photo: Chance Yeh/Getty Images
Caption: MoniCa Singh is an acid attack survivor — and a fashion designer and activist. She’s pictured at New York fashion week on September 15, 2016.

When Ebola struck West Africa a few years ago, the world was defenseless. There was no cure. No vaccine. And the result was catastrophic: More than 11,000 people died. Nearly 30,000 were infected.

Now it looks like such a large outbreak is unlikely to ever happen again. Ever.

The world now has a potent weapon against Ebola: a vaccine that brings outbreaks to a screeching halt, scientists report Thursday in The Lancet.

“We were able to estimate the efficacy of the vaccine as being 100 percent in a trial,” says Ira Longini, a biostatistician at the University of Florida, who helped test the vaccine. “It’s very unusual to have a vaccine that protects people perfectly.”

First Ebola Vaccine Likely To Stop The Next Outbreak

Photo: Cellou Binani /AFP/Getty Images
Caption: A woman is vaccinated at a health center in Conakry, Guinea, during the clinical trials of a vaccine against the Ebola virus.

Kamala B.K. is tiny. She’s barely 5 feet tall. A bright red ribbon sets off her dark hair.

As she walks past our guesthouse in the village of Tankut, we try to get her to come over and talk to us. But the 14-year-old won’t come over to the porch.

“Because she’s menstruating, she should not be entering another person’s house. It’s disrespectful,” says Cecile Shrestha of Wateraid.

The nonprofit is working with girls and women in western Nepal to end a tradition called chaupadi — that’s held them back for thousands of years: “When they are menstruating, no matter what, they stay outside, they eat outside and they sleep outside,” Shrestha says.

Outside in sheds. In Kamala’s village they consist of a raised platform, with no walls, some have thatched roofs.

A Girl Gets Her Period And Is Banished To The Shed: #15Girls

Photo: Jane Greenhalgh/NPR

A young British girl unwraps a package from her mum — a stuffed animal. The child’s face breaks into a smile. But after this moment, her life in a war-torn London is stark: She gets a serving of gruel, reads in the dark, tries to keep warm with a cigarette lighter — then narrowly escapes a bombing, nearly drowns and is separated from her mother, who sacrifices her spot on a tugboat so her daughter can flee.

The 1 minute, 34 second video — “Still the Most Shocking Second a Day” — has amassed over 314,500 views in the five days since Save the Children released it. It’s the sequel to their 2014 viral video, “The Most Shocking Second a Day.” The ads, created by the global charity to raise awareness and funds for the Syrian refugee crisis, have gathered a ton of attention, both negative and positive, for using a British girl – not a Syrian girl — as the main character, and London – not Damascus or Aleppo or any other Syrian city – as the setting.

Are You More Sympathetic Because She’s British, And Not Syrian?

Photo: Save the Children

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A steady rain falls on velvet green terraces, releasing a powerful scent of newly harvested tea. A ripple of voices tumbles down the hillside as a man barks orders.

The tea pickers, all women, many in bare feet, expertly navigate the leech-infested slopes. Balancing hampers on their backs loaded with freshly plucked tea leaves, they descend for their morning tea break.

It could be a scene out of the 19th century, when the estates of the southern Indian state of Kerala were first cultivated on the mist-shrouded highlands of Munnar. Today, the manicured tea terraces sprawl across the landscape.

The verdant bushes grow year round, spilling down the hills to meet the curving roads. The beauty of these gardens belies the hardships of workers, who produce nearly 50 million pounds of tea a year here at the Kanan Devan Hills Plantations Company.

For all the timelessness of the place, there’s a very modern twist — the tea pickers have defied the male hierarchy of trade unions who represent tea workers and stood up for their rights.

Indeed, life on tea estates reflects the economic and social challenges facing women across India.

Female Tea Workers In One Indian State Fight For Their Rights

Photos: Julie McCarthy/NPR

This weekend, hundreds of thousands of Americans will be taking to the streets — some to celebrate, some to protest the inauguration and others to demonstrate for issues that the president-elect cares about.

If you happen to be one of those people, you might have this nagging question in the back of your mind: Will any of it make a difference?

That’s the topic that Duncan Green explores in his new book, How Change Happens. Published in December, it’s a field guide for those seeking to make real and lasting political and social change. And he’s got advice for everyone: first-time petition-signers, seasoned campaigners and full-time lobbyists.

Green, head of research at Oxfam Great Britain, an international aid organization, and the blogger behind From Poverty To Power, has worked in the advocacy world for 35 years. He’s found that no matter what issue you’re fighting for — U.S. politics, ending the Syrian civil war or bringing down a Ugandan warlord — reform has the best chance of happening when you have a deep understanding of the system you’re trying to change.

Thinking About Going To A Rally? Read This Activist’s Advice First

Photo: Ben de la Cruz/NPR 

Polio is on its last legs.

The disease that once paralyzed hundreds of thousands of kids a year around the globe is now down to just a few dozen cases this year. “We are aiming to halt all transmission of wild polio virus next year,” says Peter Crowley, the head of UNICEF’s global efforts against polio.

If polio is stopped, it will be only the second human disease to be eliminated. Smallpox was the first — the last case was in 1977.

There’s reason to be optimistic that this gigantic feat of public health is within humanity’s grasp. The World Health Organization says polio transmission has stopped for the first time ever in Africa. Last month, Africa’s last bastion of polio — Nigeria — celebrated going an entire year without recording any new cases.

Next Year Could Mark The End Of Polio

Graphic: Jason Beaubien and Alyson Hurt/NPR

It’s hard to find a society, a religion or a part of the world that does not find some way to make women feel dirty, guilty, unworthy or dangerous because of their monthly cycle. “Menstrual taboos are so widespread, they’re almost a cultural universal,” says Beverly Strassmann, evolutionary anthropologist and biologist at the University of Michigan who studies menstrual taboos.

Yet there are exceptions: societies that treat menstruating women with respect.

“Yurok, a native tribe from the northwest coast of the United States stratified by class, had a group of aristocratic women who saw their periods as a time for purifying themselves,” says Alma Gottlieb, professor of anthropology and gender and women’s studies at the University of Illinois. 

In some parts of Ghana, West Africa, young girls sit under beautiful, ceremonial umbrellas when they begin menstruating. “The family would give her gifts and pay her homage,” says Gottlieb. “She is celebrated like a queen.”

Some Cultures Treat Menstruation With Respect

Illustration credit: Hanna Barczyk for NPR

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“In my village abortions do happen, but women hide it, they are ashamed of it,” says Palo Khoya. “They worry that people will say nasty things.” Khoya is one of the four women pictured above (top right). They have come to a small abortion clinic in Khunti, in the eastern Indian state of Jharkhand.

Abortion is legal in India. The government has built clinics to serve poor rural women like Khoya. But there are simply not enough facilities. Jharkhand, home to 31.9 million people, has three. So Indian women often turn to a quack or a midwife or other dangerous options. As a result, an estimated two-thirds of India’s abortions are unsafe. Each year, some 4,600 women die after a procedure; others suffer complications that haunt them for the rest of their lives.

The clinic in Khunti conducts around 50 procedures a day in a safe environment. Dr. Simi Mahesh is the main doctor at the clinic, which opened four years ago. It now reaches out to 100 villages, up from 77.

A Haven In A Land Of Unsafe Abortions

Photo credit: Poulomi Basu for NPR

Ruhy Patel, 17, lives in Doylestown, Pa. When she was 15 she was planning to run for student council office. “All the other people running were boys,” she says, “and people were like, ‘Well, you’re not going to win.’ You feel intimidated because you’re the only girl in the room. It makes you question if you’d be OK in the field of politics.”

Did she drop out? No.

Did she win. “I did!”

“I feel like it kind of makes you want to try harder when people say no,” says Patel.

That could be the motto for the activists of Girl Up. There are nearly 5,000 teenage girls in 66 countries who volunteer for the U.N. Foundation group. They speak out and raise money so every girl can go to school — there are an estimated 62 million who don’t — and can receive official government identification papers, can get proper health care and gain the skills to pursue her dreams.

Haters Gonna Hate. Teen Girl Activists Shake It Off And Try Again

Photo credit: John W. Poole/NPR

The day Kodjo was born four years ago in a small village in eastern Ghana, his mother was given devastating news: Her baby boy was a river god’s son, and the elders of the village said he would need to be sacrificed.

The reason she was told this? He had gaps in his face.

So she was shut inside a room while arrangements were made for her son’s drowning. It was only by a stroke of luck that another villager heard of these plans and told the family that what the boy really needed was medical care. Those gaps weren’t caused by a curse but, rather, a cleft.

There’s an incredible amount of stigma associated with the birth defect in Ghana, explains Dr. Solomon Obiri-Yeboah, a specialist who operated on Kodjo at the Komfo Anokye Teaching Hospital in Kumasi. Clefts are relatively common problems worldwide — according to research published in 2013, they occur in somewhere between 1 in 500 and 1 in 2,500 births, depending on the babies’ background.

When Kodjo Was Born, They Decided He Should Be Drowned

Photo: Courtesy of Smile Train