Rebuilding Service Vs Rebuilding Systems - Assignment Example

International Development Studies Question 1 According to he World Bank, fragile states are countries which lack a proper government and sustainable development in place. These countries are featured by inability to agree on a clear framework of development that is long term. The political situation in these countries is so delicate that saving as well as making long term investment is practically impossible. Therefore, citizens of these countries have come up with their own innovative means of meeting their basic needs and hence survival. As a result of the fragile nature in these communities health cost is higher compared to medium and high income areas. Fragile states are struggling with insecurity, political instability, and vulnerability to natural calamities, low income and even lack of expatriates. Examples of fragile communities include and not limited to Liberia, Southern Sudan, Afghanistan and Sierra Leone. As a result, there health care systems are greatly affected and most of the information about health care system can only be sourced from nongovernmental organizations (World Bank 54). This information is purposefully produced for donors to these agencies and therefore there is a limited chance of objectivity. It is information meant for consumption of donor countries. Despite this delicate balance, the world health organization has come up with a framework of parameters used in studying health care systems in fragile states. To begin with, one has to look at what the state is doing to protect citizens against elements that threaten health conditions in the communities. Fragile states needs to keep data about how many people in their countries are either dying, getting sick or being disabled through situations that can be prevented. The most obvious and key element of health care system strengthening in fragile states maybe taking care of the immediate environment where communities stay. By taking care of the environment diseases like malaria, diarrhea, pneumonia and even accidents could be highly reduced. This involves keeping the environment clean, ensuring that food and water is fetched and served from clean environment and accidents in highly culpable areas are significantly reduced. For instance, building proper roads which have foot path and cycling lanes could highly reduce road accidents deaths, illness and disability. Protecting communities from elements that put their health at stake further involves a clear policy on waste disposal; reducing risk exposure at places of work like factories is an objective way of looking at health care systems in fragile states. If fragile states effectively took care of their environment, the cost of health care in these countries would drastically be managed because most of deaths in these countries result from mismanagement of the environment. A developing state that is committed to protecting its citizens from harm would put measures to protect its communities from hunger, starvation and poverty. Poor families are more vulnerable to disease because of over dependence on a single bread winner. Moreover, fragile states need to support free basic education to children by providing schools with facilities like latrines for use by students to increase attendance (Bairoch 49). Another key element in health care systems strengthening that maybe important for rebuilding health in fragile states is monitoring how these states regulate the disparities in access to health care. Low income states needs to put effort not only to provide health care to its citizens but also buy and regulate the general health care industry. To effectively be able to carry out this role, developing countries need to carry out their own research to find the specific details of challenges in their particular countries. Relying on data submitted by the private sector would not be more beneficial because such data has vested interest and might not be objective enough. These states should endeavor to listen to the input of its citizens so that the policies they create are all inclusive and widely accepted to guarantee support in implementation. Moreover, fragile states need to be evaluated on how their policies and programs mitigate their communities against the burden of financial cost resulting from ill health. Almost everything in this communities is dilapidated, be it infrastructure, agriculture, business or even security. Most of the basic commodities including health care are provided by non governmental organizations. Communities in fragile states therefore need to support the work of non governmental organizations that are key in provision of basic amenities. Non-Governmental Organization works in collaboration with authorities to provide, trained personnel, immunization, general health care and infrastructure. Rebuilding Service Vs Rebuilding Systems Rebuilding services in fragile states involves provision of health care to communities after a conflict considering the delicate situation. For instance, in South Sudan before the signing of the CBA agreement, during the conflict period, communities was displaced, infrastructure was destroyed and health care came to a standstill. Rebuilding service therefore is the beginning of provision of service delivery to the people. In most cases it involves a collaboration of non state actors together with the existing authority on the roles to be played by each one of the partners. Rebuilding service is short term and communities rely on non governmental organization to provide immediate health care service. These non governmental organizations do this through the support of donors by hiring qualified personnel as well as contracting local and international communities for other goods and equipment required. Rebuilding service is majorly carried out by a non state actor to avert a crisis. During the 1998 war and drought that hit Sudan (the government fighting the rebels, Sudanese People’s Liberation Army), tens of thousands people lost their lives. Rebuilding services involves the immediate act of mitigating the situation by providing food to the starving population as well as providing medicine to ailing infants and the elderly. Rebuilding systems on the other hand involves building capacity for the government, communities as well as individuals to sustainably continue providing the services (World Bank 28). It begins by eliminating the calamity, in an instance of war; it involves beginning the process of building sustainable peace and finding the long term solution to the conflict. In addition, it involves training the communities for specialized and professional skills to continue fulfilling the need for service in future. In the Sudanese case for instance, it involved the signing of the CBA agreement that led to the establishment of South Sudan. This is the region that was predominantly dominated by the Sudanese People’s Liberation Army. Mediators of the conflict assumed that it would be a long term solution to the conflict. Scholars have argued that rebuilding services is not the right thing because it delays or causes communities to be dependent without necessary providing a permanent and sustainable (rebuilding systems) solution to their problems. Question 4 In the cortex of climate change poor, people are always perceived to have a very low capacity to adapt to such calamities however lately the research has given different types of poverty. Amongst them is chronic poverty. In the past two decades, more than one million people have greatly suffered hunger and the prevalence of chronic nutrition in children has decreased from 40 to 26 percent. On the other hand, the world population was chronically undernourished. The resultant impact of the climatic change has no even distribution to the different nature of the hazards in various parts of the globe. But also due to differences in ability to cope with and adapt to different effects and harness beneficial effects of climate shock and stresses. The distinct generic end is that those vulnerable to most severe hazards are also those who are least able to cope to deal with the associated impacts (Bartlett, 87). Poverty levels are also an important determinant of climate change impacts which also poses a threat to the achievement of millennium development goals amongst them the improvement of the societal well-being in terms of health. Climatic change amplifies a significant threat to the livelihood and food security though through its direct impact on the availability, access or even quality and utilization. In case of adverse climatic change, the food production is expected to decline, due to a decrease in the general staple food. Leading to a negative impact on the availability of food, farmers incomes and consequently the structural rise and volatility of standard food prices highly constrain food access for the poorest. The climatic change also negatively affects nutrition through its impact on health as per Lancet series on maternal and child under nutrition. Climatic change poses the highest health risk in the current century contributing to the global burden of deficiency decrease and premature death. Climatic change will also put further strain on the already heavy workload of women negatively impacting on the provision of proper care of infants and minors thus increasing the risk of under nutrition. There are many ways through which climatic change and variability may affect water security and nutrition: Increase frequency of extreme weather events. Sea level rise and coastal lands flood, leading to salination and or contamination of water and agricultural lands (Rapley 1). The impact of temperature increase and water scarcity on plant or animal physiology; Damage to forestry, livestock, fisheries and agriculture climatic change is likely to accelerate the declining reliability of irrigation water supplies leading to increased competition for water. Water scarcity may lead to adverse health outcomes including water –borne decreases exposure to chemicals, vector- borne diseases associated with the water storage system and malnutrition. Drought and water scarcity can have adverse effects on nutrition, and HIV/AIDS epidemic may further amplify these effects. Climatic related disaster will threaten water infrastructure system influencing water sanitation and access to all especially in urban areas major variation of temperatures (Pielke 67). Climate related risks also affect calorie intake particularly in areas where chronic food insecurity is already a significant problem. Changing climatic condition could also create a vicious cycle of diseases and hunger. Climate change also contributes to extreme weather events the frequency and intensity of some disaster like floods and drought that increase the negative impact on livelihoods and food security. Climate-related disaster has potential to destroy crops critical infrastructure and the vital community assets therefore deteriorating livelihoods and exacerbating poverty (Bartlett 87). Infrastructural and on infrastructural controls on food distribution can be a significant impediment to reducing food system vulnerability promptly. Therefore strikingly apparent during the drought relief effort mounted in 1990/1991 in African responding to the close to 86 million people exposed in that area. A massive food program is launching with food delivery via some corridors in the areas major ports. Close to 8 million tonnes of grains got imported in the relief programmed for the ten countries affecting close to four times normal rate of import for the region. This substantial increase in import resulted in pressure on the parts distribution system leading to some problems that could not have been significant in the average years. 15 years ago Members of the United Nations committed themselves to eight millennium goals about 1990. Such goal explicitly recognizes the agriculture-hunger-poverty nexus and the limited coping capability that poverty induces. Question 5 As a broad and dynamic sector, health is affected by a wide range of factors including natural disasters and urbanization dynamics. The presence of natural disasters and urbanization dynamics play a very significant role in determining the success of healthcare service delivery in the society. Natural disaster simply refers to an occurrence caused by a fore of nature that results into a catastrophe. Some of the main natural disasters include flood, earthquake, hurricane, heat wave, tsunami, forest fire, tornado, cold wave, volcanic eruption, wind storm, cyclone, land slide and drought. They are called natural because they result from a force of nature that can not be actually controlled by human being. On the other hand, urbanization refers to the process of a growth of towns. In every society, migration is an inevitable thing because people often relocate from one place to another. Whenever such movements occur from rural to urban centers, they become highly populated and increase in size. This brings a lot of changes such as increase in the number of people who require housing, educational, recreational, administrative, and commercial and health infrastructures. Although urbanization is a good development, it often poses a lot of challenges to the society. Urban centers have been associated with a myriad of problems including overpopulation, poor sanitation, high crime rate and inadequate facilities, to mention, but a few. Actually, both natural disasters and urbanization dynamics greatly relate top each other and have effects on health. As already hinted, natural disasters occur without human knowledge. Meaning, however much technology is applied to mitigate them; they overpower human beings and happen. In this case, it becomes quite disastrous to the healthcare sector. The same can be said of urbanization dynamics which has, for a long time, been accused of negatively impacting on the effectiveness of quality service delivery to the people (Stéphanie 1). Therefore, it is quite clear that the two factors play a very significant role in influencing health in the society. They need to be put into account whenever making any plans. Natural disaster as its name suggests, can be quite disastrous to healthcare. It has a lot of impacts on health that if not properly put in control, can be so catastrophic. Apart from resulting into loss of lives, natural disasters cause injuries to many people. Whenever any disaster strikes, a large number of people have to suffer physical bodily harm because of their exposure. Cases of injuries have been witnessed during flood, earthquake, tsunami, land slide, heat wave and wild fire. Whereas some people get injured accidentally, others are injured when trying to salvage their property. Others get involved in the disaster as they try to rescue the victims. Whenever people are injured during such disasters, they require getting immediate healthcare for them to recover. Unfortunately, this might not happen because of inadequate facilities and professionals to attend to them. The same impacts can be experienced in urban centers because many people can be prone to such injuries especially from road accidents, criminal attacks, conflicts and violence which might erupt as a result of the presence of a large number of people from diverse backgrounds (Stéphanie 1). Besides, natural disasters lead to the outbreak of many diseases such as cholera, amoebic dysentery, malaria, typhoid, vector-borne diseases, skin infection, mental health and Hepatitis B. the outbreak of such diseases creates a situation that greatly impacts on healthcare provision. Some of these diseases can easily spread from one person to another within a very short time. Meanwhile, by affecting a large number of people simultaneously, the diseases can cause unwarranted pressure on healthcare. The same challenge can be experienced in the urban centers because such communicable diseases are rampant. Many people get infected with diseases due to congestion, lack of clean water, poor sewerage disposal and pollution. All these affect healthcare because many facilities might not be able to effectively such emergencies because of inadequate facilities, drugs and personnel. In most cases, many healthcare facilities do not have enough facilities to handle such situations. Meaning, they have not implemented contingency plans to help them in attaining a quick and immediate recovery from such disasters. Last, but not least, natural disasters can result into the loss of land that can otherwise be used in agricultural production. In other words, natural disasters lead to disruption of agricultural activities. For example, in case of earthquake, land slide, wild fire or floods occur, crops are destroyed. At the same time, people can no longer engage in agricultural activities. This in the long run affects very many people because they can not continue engaging in their economic activities, thus, leading to hunger and nutritional diseases such as marasmus, kwashiorkor and others (Roger et al. 1). The same can be said of urbanization dynamics because it is also associated with nutritional diseases because many people in the urban centers do not have enough food to eat. Those who are unemployed or live below the poverty line can not afford to buy enough food therefore exposing them to numerous diseases. Such hardships can result into substance abuse, distress, trauma and mental illnesses. All these cause a lot of pressure to the healthcare sector because they all need to be attended to hence causing more pressure on the few available healthcare infrastructures. In conclusion, quality healthcare is paramount in any society. It can help in improving the life of people at all times. However, as discussed herein, it might not be much possible to attain this because of the numerous challenges faced. Natural disasters and urbanization dynamics are some of the factors that greatly affect healthcare provision. Rather than causing communicable diseases, hunger, environmental degradation, they also result into the destruction of healthcare infrastructure. This is a very unfortunate occurrence that should be fiercely fought because they cause a lot of pressure of the few available healthcare infrastructures. So, to deal with such situations, the policy makers should make important decisions aimed at mitigating, preventing and recovering from any disasters and improving the life of people in the urban centers. Works Cited Bairoch, Peters. Victories and deboires. Paris; Gallimard, 2007. Print. Bartlett, Sheridan. Climate Change and Urban Children: Impacts and Implications for Adaptation in Low - and Middle-Income Countries. London: International Institute for Environment and Development, 2008. Print. Pielke, Sr R. A. Climate Vulnerability Volume 1. Burlington: Elsevier Science, 2013. Print. Rapley, Chris. ‘The health impacts of climate change.’ BMJ 2012. Roger, Few, et al. ‘Floods, health and climate change: A strategic review.’ Tyndall Centre for Climate Change Research Working Paper 63. Stéphanie, Lama-Rewal ‘Urban governance and health care provision in Delhi.’ Sage Vol. 23 No 2 October 2011. World Bank. Delivering better health services to Pakistan’s poor. Washington, DC: World Bank, 2010. Print. Read More