A Healthy Mind in a Healthy Body: Towards universal healthcare

Written By Arvind Ravikumar

The third Sustainable Development Goal (SDG3), as adopted in the 2015 UN General Assembly meeting, strives to “ensure healthy lives and promote well-being for all at all ages” by 2030. There are nine targets specified under this goal that can be broadly classified into four categories: (1) decreasing maternal and child mortality, (2) reducing the incidence of diseases, (3) reducing human-caused mortality including substance abuse and road-traffic incidents, and (4) expanding access to affordable health care. Compared to prior efforts, SDG3 provides renewed focus on issues like substance abuse, mental health and affordable health-care for all – issues that affect the developed world as much as the developing world. The SDG3 builds on and expands the health-focused millennium development goals that were adopted in 2000. Indeed, the world community has made significant progress in reducing child mortality, maternal mortality, access to reproductive health, and reducing the incidence of HIV/AIDS and tuberculosis. However, many of these reductions are far from the targets established in the MDGs – for example, maternal mortality has reduced from 386 deaths per 100,000 live births in 1990 to about 216 in 2015, significant but far short of the target of 70 maternal deaths per 100,000 live births. More importantly, progress has been uneven, especially across the poorest and the most disadvantages populations in the world.

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Worldwide maternal mortality rate: Number of maternal deaths per 100,000 live births (Source: Wikipedia)

Progress toward any of these goals is only as good as the monitoring mechanisms in place. In this context, the SDGs differ markedly from the last decade’s MDGs because of the development of sustainable development goal indicators – these ‘indicators’ refer to various statistical health data that track progress and keep various countries accountable. A thorough global database on these specific indicators and other metrics is already available. And that highlights one of the major problems in all global development goals – the lack of institutional support and robust data collection from many regions (especially in parts of Oceania, and sub-Saharan Africa) hinders any attempt to track progress. Lessons from other global governing bodies like the World Trade Organization (WTO) could help – one way would be to develop regional expertise within the UN to help developing countries better monitor their efforts.

This goal to improve health outcomes through specific and measurable targets might make the issue seem tractable. However there are important challenges in the years ahead that are exacerbated by globalization and improved mobility. For example, road-accident related fatalities have been increasing in the developing world because of economic development. Record numbers in global mobility will simultaneously increase the risk of spawning epidemics like Ebola or Zika, which would demand a robust and rapid global response to contain its spread. The rapid urbanization in developing countries like China and India will further strain urban infrastructure – without massive investments, urban pockets are in danger of becoming hot beds for water-borne and other communicable diseases. And finally, the recent uptick in global conflicts has resulted in over 60 million people being displaced – a number not last seen since World War II. Any global effort to improve health-care will need to be coordinated with other goals that directly affect health outcomes.

While there are many targeted policies that will directly influence healthcare and wellbeing, it would be naïve to assume that improving global health standards is not dependent on progress across many of the other SDGs. For example, access to clean water and improved sanitation (SDG #6), especially in rapidly developing urban areas in Asia and Africa, can significantly reduce the incidence of many communicable diseases. A growing body of research also show that the physical and social environment (SDG #11) can influence the life expectancy at birth – such stark differences can even be seen in the developed world. Recent experiences in reducing the prevalence of AIDS or improving access to reproductive health-care have shown how unequal progress has been – big gaps exist between the poorest and the richest households, between men and women, and between rural and urban regions. Progress even in regional health outcomes would be strongly tied to success in reducing inequalities (SDG #5, #10) and increasing girls’ educational attainment (SDG #4).

Ultimately, the biggest test for the success of any of these programs comes in the form of investments required – capital to the tune of trillions of dollars will have to be mobilized over the next 15 years, largely through public finance and aid. Recent rounds of talks have ended without any concrete commitments in the part of the developed nations. It is not yet clear if equitable mechanisms to fund massive improvements in infrastructure and health-care initiatives across large parts of sub-Saharan Africa and Asia will be available.

 


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Arvind graduated with a PhD in Electrical Engineering from Princeton University in 2015 and is currently a postdoctoral researcher in Energy Resources Engineering at Stanford University. His professional interests currently lie at the intersection of energy, climate change and policy. Arvind is an Associate Editor at Highwire Earth. Follow him on Twitter @arvindpawan1.

Beyond the Olympics: The role of sports in social development

Written by Julio Herrera Estrada

“Sport has the power to change the world. It has the power to unite in a way that little else does. It speaks to youth in a language they understand. Sport can create hope where once there was only despair. It is more powerful than governments in breaking down racial barriers.” -Nelson Mandela

One can’t help but grin and gasp when watching those close Olympic races where the winner came from behind in the last few seconds, or those brief moments when gymnasts are in the air before they land (amongst countless other remarkable instances across sports). The Olympics is one of the few events that brings together people from almost every nation around the world, and though the main objective is to compete against each other, one can often see good camaraderie between athletes and fans of different countries.

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Selfie between Lee Eun-Ju from South Korea (right) and Hong Un Jong from North Korea at the Rio Olympics. Picture Credit: Time.

But sports are much more than entertainment and a career path – they can contribute to the integral development of whoever practices it, and they can help unite communities. This is why sports have been recognized by organizations such as the United Nations, the World Bank, and the United States Agency for International Development as powerful tools to build peace and contribute to countries’ social development.

Helping One Grow as an Individual

I did Tae-Kwon-Do when I was a kid and then swimming as a teenager. Thanks to these sports I made friends, travelled to new places, and managed to win a few medals to display in my room. However, it was not until I left home to go to college that I fully appreciated all that I was bringing with me thanks to these two sports.

First, I learned discipline: to listen and follow the directions of my coach, to respect my teammates and opponents, and to behave with integrity both when winning and losing. Martial arts also teaches self-control since having the ability to cause serious harm to someone means that you have to be very mindful of when and how you use them (“Fighting not good. But if must fight… win.” – Mr. Miyagi, The Next Karate Kid). I reinforced these skills and values when I started swimming, and I mastered one more: perseverance. As I focused on long-distance swimming, I had to learn to keep going, one stroke at a time, through the pain that you feel after you have been swimming continuously for close to an hour.

Knowing that you are good at something, and even more, that you are getting better at it, helps build your self-esteem. This is arguably easier to do with sports and other physical activities, because the pain and fatigue you are fighting to overcome at each practice, each game, and each competition is very tangible. This self-esteem came very handy as a teenager, when I resisted peer-pressure to smoke, since I would not do anything that would harm my swimming.

I was not an amazing athlete and I was not close to being able to qualify for my college swimming team, but I still carry all these things that I gained from sports, and I recognize that they made me stronger mentally, even more so than physically. My experience is not an exception but a common trend for whoever practices a sport regularly, from amateurs to professionals.

Integrating Communities, Healing Wounds, and Keeping the Youth Safe

The European Union has recognized the power of sports in helping integrate immigrants and asylum seekers, and last June the Council of Europe’s Enlarged Partial Agreement on Sport met in Vienna, Austria to discuss policies to aid the integration of refugees through sports. The International Olympic Committee also contributed by creating the first Refugee Olympic Team. The expected outcome of this decision is summarized best by the words of Yusra Mardini, a swimmer who was forced to flee from Syria and now lives in Germany, and who competed last week in the Olympics: “I want everyone to think refugees are normal people who had their homelands and lost them not because they wanted to run away and be refugees, but because they have dreams in their lives and they had to go.”

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Refugee Olympic Team at the 2016 Summer Olympics in Rio de Janeiro, Brazil. Image Credit: UNHCR

Popular team sports, including soccer and basketball are being used to help integrate people across communities and countries following conflict – i.e. Sports Diplomacy. For example, the World Bank organized The Great Lakes Peace Cup in 2012 between the countries of Burundi, the Democratic Republic of Congo, Rwanda, and Uganda to help bring their people together after years of wars in the region. Each team was purposefully made up by an equal mix of civilians and former combatants. Events like these bring former opponents together, allowing them to meet and realize that they are not so different from each other, hopefully making future conflicts less likely.

Sports can improve young children’s motor skills and coordination (which are critical for their development), and teenagers’ hygiene and dietary habits. Practicing sports can also help them stay away from danger and bad influences. In Brazil, the land of soccer, a man created an interesting initiative in the favela (i.e. a Brazilian slum) of Chacrinha in Rio de Janeiro that is known for its crime and poverty. He introduced the youth to badminton by building a training center in the middle of the favela with funding help from NGOs and philanthropists. Even better, he mixes Samba dancing into practice to teach the players rhythm and coordination. Projects like this benefit the kids in the community by keeping them away from drugs and gangs, and by helping them develop self-esteem and values such as respect and integrity. It also gives them a chance to dream of one day becoming a gold medalist who comes from a favela.

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Girls from poor neighborhoods in Mumbai, India playing soccer as part of a program organized by OSCAR Foundation, an NGO. Photo Credit: Deutsche Welle.

Sports can bring many benefits to individuals and their communities that can translate to improvements in public health (Sustainable Development Goal, SDG #3), reduced violence (SDG #16), and increased community cohesion. A company even leveraged the popularity of soccer to create a ball that harnesses the energy from kicking it around to later be used as a lamp, helping improve access to electricity in remote communities (SDG #7). Thus, it is essential to invest seriously on projects that introduce the youth to sports and allow them to practice them throughout their life.

Moreover, it is key that such initiatives include both girls and boys so that everybody benefits from their rewards, helping us bridge gender inequality along the way (SDG #5). Often times girls are not allowed or discouraged from practicing sports, but they can be a critical pathway to help girls develop confidence in themselves, and break gender roles and stereotypes. It is vital that this divide is also bridged in professional sports, so that young girls have more role models to whom they can relate better, and who can inspire them to pursue their own goals and dreams.

The closing ceremonies of this year’s Summer Olympics in Rio de Janeiro will start the countdown for Tokyo, Japan in 2020. As the athletes return to their countries, many young children will surely be inspired to pursue a sport, though many in the poorest communities of the world will find this challenging. Much needs to be done to increase their access to sports. While the most formidable and entertaining matches and competitions happen in large and fancy stadiums, the most important for countries’ development happen in empty fields and at local swimming pools and gyms.

 

Julio-10 copyJulio Herrera Estrada is a 5th year PhD Candidate in the Environmental Engineering and Water Resources Program, and the Editor-in-Chief of Highwire Earth. His research focuses on the mechanisms and human impacts of droughts, and the policies that can help make our resource management sustainable and resilient. Follow him on Twitter @JulioSustDev.