In June 2009 Samoa was the set for the popular TV program Survivor. It was a fantastic choice. It is one of those picture-perfect places–shady palms, trees dripping with fruit, blossoming hibiscus, all framed by powder sand beaches. It is a vastly understated paradise.
A few months later, the country was once again centre stage. This time for something utterly distressing and heart-breaking as the country embarked on the harrowing search for real life survivors after they were struck by a powerful tsunami on 29 September 2009.
Galu afi means “wave of fire” and is the traditional Samoan word used to describe a tsunami. It describes the force that gains momentum as the wave generates and the sheer destruction that it brings to bear. That is what happened here.
A while ago, I was part of a mission to visit a new hospital in Lesotho. Warned in advance that this facility was intended to treat people with multi-drug resistant tuberculosis (TB)– and knowing the huge burden of HIV-TB co-infection in the country—I was expecting the patients’ demographic to match the profile of HIV: largely young and increasingly female.
What I wasn’t prepared for was the sight of two entire families—young and old, men, women and children—all confined together for the foreseeable future, to be monitored by health workers as they take their daily drugs.
Ten year old Vibha Kumari looks like any Delhi school girl. Except that a clean but well- worn old handkerchief masks her young face. For Vibha has multi-drug resistant TB - or MDR-TB - caused by a strain of bacteria that has developed resistance to the first line of antibiotics.
Vibha’s is a classic case of drug-resistant TB. Two years ago, when she had a terrible cough that just wouldn’t go away, she was treated by a village doctor at home in Bihar. When she didn’t get any better even after eight months of treatment, the family moved to Delhi where her father sold drinking water on the teeming streets of the city.
Moving into a one-room tenement in an overcrowded urban slum – where large families share small badly-ventilated rooms in conditions that are ripe for the infection to spread –Vibha was tested for TB. When MDR TB was found, probably as a result of inappropriate treatment in the village, she was put on the second line of drugs for a two-year course of treatment.
“Tuberculosis was a silent killer a few years ago,” says Rogers, a community health worker at the Kangemi Health Center, which assists people living with TB to receive effective treatment in a sprawling settlement on the outskirts of Nairobi.
Community health workers like Rogers are a vital link between patients and medical providers and are well respected and trusted. They educate, enlighten, and empower patients and people in the wider community. They work with the local area chiefs in mobilizing communities in the fight against TB. Rogers proudly notes that he actively identifies TB cases, provides home-based care, and traces people defaulting on treatment, all critical elements in managing TB at the community level.
Detection and management of TB are critical in Africa, where roughly a quarter million TB deaths were reported in 2010. The continent accounts for about one-quarter of the global TB burden and is facing challenges in meeting the Millennium Development Goal of reducing 1990 TB mortality rates by half by 2015. However, there is also reason for hope on TB control in Africa, as seen in communities like Kangemi. In Kenya, with support from government and partners, including the World Bank (Health Sector Support Project, Total War Against HIV/AIDS Project, East Africa Public Health Laboratory Networking Project), activities are underway to strengthen the availability of drugs, channel funds directly to lower level health centers , and improve access to the latest diagnostic tools for detecting TB. “The state-of-the-art diagnostics will go a long way to turn the tide on this pandemic,” notes Lucy Chesire, Executive Director of the TB Action Group in Nairobi. “Patients will no longer wait months to get results.”
"All people want to do is live their lives." Dr. Suneeta Singh made that simple yet powerful statement during a panel discussion on “Empowering Gender Minorities in South Asia” on March 14, 2012 at the World Bank. Singh, a former Bank staffer and CEO of consulting firm Amaltas, spoke via videoconference from Delhi, India, while Nepal’s first openly gay elected official, Sunil Babu Pant, dialed in from Kathmandu.
Pant told the story of how he built a grassroots movement of gay, lesbian, bisexual and transgendered (GLBT) people in Nepal, beginning in 2001. A turning point was in 2007, when the Supreme Court ruled that gay and transgendered people “are natural” and mandated certain benefits and an end to discriminatory laws. Today, the country is drafting a new constitution, and Pant said that if passed, it will be one of the most progressive in the world with regard to the rights of sexual and gender minorities.
I visited three African countries – Ethiopia, Rwanda, and South Africa– during my first week as Chief Economist at the World Bank in June 2008. Many visits to other African countries followed, but Ethiopia holds for me a special interest. I’ve just visited again, for a fourth time. While I am sure I will go back again after I depart the Bank on June 1 this year, this was my final visit to Africa as Chief Economist.
Over four years, I’ve seen Ethiopia gradually embrace structural transformation and its practical application. Leaders there are acutely aware that, if they are to maintain a robust growth rate (GDP growth has been around 10.5% on average over the past few years), they must move away from agriculture, the dominant sector, toward industrial upgrading and technological innovation, often by imitating economies just a few rungs up the economic ladder. Ethiopia’s agriculture sector is important and should not be neglected, but that alone won’t get the country onto a path toward middle income and finally to high income status.
After Newsweek’s third annual Women in the World summit two weeks ago, I started to wonder about where women stand in the massive wave of urbanization our world is facing. The UN study, The World’s Women 2010, tells us:
- Only 14 women in the world were either Head of State or Head of Government in 2010.
- In only 23 countries do women comprise over 30 percent in the lower house of their national parliament.
- On average, only 1 in 6 cabinet ministers in the world is a woman.
- Only 13 of the 500 largest corporations in the world have a female Chief Executive Officer.
But what about female Mayors? As the most visible face of local politics and the closest link to their constituents, do women occupy more positions in the city leadership? The global breakdown is below:
But why, one may ask, is the leadership of women particularly relevant to sustainable cities? The National Democratic Institute gives a number of reasons: