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Traditional Healers can Heal the Mind, as well as Body

By David SouthDevelopment Challenges, South-South Solutions

SOUTH-SOUTH CASE STUDY

Mental healthcare is critical to physical health and overall wellbeing, yet it is seriously neglected around the world – and especially in poorer countries.

Often seen as a luxury for the wealthy or an indulgence for the weak, mental health services are often left at the bottom of any list of development priorities. Yet Professor Martin Prince of King’s College London in the United Kingdom found that an estimated 14 percent of the global burden of disease is due to neuropsychiatric disorders, mostly depression, alcohol- and substance-use disorders, and psychoses.

Since the contribution of mental disorders to physical illness is inadequately appreciated, the actual global burden of mental disorders is probably higher than this. Dr. Shekhar Saxena of the World Health Organization has reported that a scarcity of resources for mental health is compounded by inequities and inefficiencies in the delivery of mental healthcare.

As a result, people who need care get none. “The treatment gap – the proportion of those who need but do not receive care – is too high for some mental disorders,” Saxena said. As many as one in three people with schizophrenia and one in two with other mental disorders do not receive any treatment. The WHO has reported that the treatment gap for serious disorders is 76 percent to 85 percent for low- and middle-income countries. And the organization says shortages of healthcare professionals have been shown to be the main limiting factor in delivering mental healthcare in most low- and middle-income countries.

But an ingenious solution to this problem has emerged in the South American country of Ecuador. It involves turning to the traditional healers who are already well-established in communities. They are both cheaper and faster than waiting for medical psychiatrists to turn up in poor communities, and they can start right now to provide the support people need in a culturally tolerant way. Their effectiveness has been proven by Dr. Mario Incayawar, director of the Runajambi Institute for the Study of Quichua Culture and Health in Otavalo.

“Poor countries where you find numerous traditional healers could benefit the most,” he said.

In findings published in the prestigious British Journal of Psychiatry (The British Journal of Psychiatry (2008) 192: 390-391. doi: 10.1192/bjp.bp.107.046938), Incayawar found there are just 800 psychiatrists in Ecuador, and most live in the cities and speak Spanish. The native population on the other hand, mostly speak the local Quechua language and are served by only one psychiatrist, but thousands of traditional healers.

In the Andean mountain city of Otavalo, most people are descendents of the ancient Inca people. Health conditions are poor and far worse than in Spanish-speaking regions. Over 3 million of Ecuador’s 12 million residents speak Quechua, many of them living in indigenous communities high up in the mountains, bypassed by development. Roughly 90 percent of indigenous communities live below the poverty level, a fact reflected in high maternal and infant mortality rates. In some remote communities, maternal mortality reaches 250 deaths per 100,000 live births, compared to the national average of 130, and one in 10 infants does not live to see his or her first birthday.

For 5 million Indigenous people in Ecuador, for example, there is not one single mental professional paid to work within the Indigenous communities.

Traditional healers’ practices are widespread around the world, yet their diagnostic skills have rarely been investigated. Incayawar’s study found the yachactaitas (Quichua healers) in the Andes were able to identify cases of psychiatric illness in their communities. During the study over 18 months, 10 yachactaitas participated in the identification of 50 individuals with a condition. None of the participants was found to be healthy in biomedical or psychiatric terms when reviewed by psychiatrists. The results suggest yachactaitas can be an early warning system for identifying general psychiatric cases in their communities through their powers of observation.

“From the Quichua perspective, it is a matter of common sense,” said Incayawar. “We have a sizable number of traditional healers, why not promote their clinical skills for taking care of our communities.”

“Healers are paid in cash or by gifts such as a bag of potatoes, a basket of eggs, or a couple of chickens. The Quichua people are not familiar with psychiatrists or mental health professionals.”

He also sees a bright future for the role of the traditional healer: “Young people feel less threatened to pursue a career as a traditional healer. Currently, the trend points to an increase of traditional healers.”

In the future, Incayawar would like to see a happy co-habitation between the scientifically-trained psychiatrists, and the traditional healers: “We would like to see traditional healers working in a respectful partnership with biomedically trained mental health workers. The collaboration between equals … could be something to work on for the coming decade.”

Published: August 2008

Resources

  • Dr Mario Incayawar has new book coming out in February 2009 called “Psychiatrists and Traditional Healers: Unwitting Partners in Global Mental Health,” Publisher: John Wiley & Sons.
    It can be pre-ordered here: Amazon.co.uk And the draft chapters read here: www.mediafire.com
  • An innovative UNFPA project has managed to give the Quecha-speaking descendents of the Incas the benefits of both traditional and modern medicines in a culturally sensitive manner.
    Website: http://www.unfpa.org

Development Challenges, South-South Solutions was launched as an e-newsletter in 2006 by UNDP’s South-South Cooperation Unit (now the United Nations Office for South-South Cooperation) based in New York, USA. It led on profiling the rise of the global South as an economic powerhouse and was one of the first regular publications to champion the global South’s innovators, entrepreneurs, and pioneers. It tracked the key trends that are now so profoundly reshaping how development is seen and done. This includes the rapid take-up of mobile phones and information technology in the global South (as profiled in the first issue of magazine Southern Innovator), the move to becoming a majority urban world, a growing global innovator culture, and the plethora of solutions being developed in the global South to tackle its problems and improve living conditions and boost human development. The success of the e-newsletter led to the launch of the magazine Southern Innovator.

Creative Commons License

This work is licensed under a
Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

ORCID iD: https://orcid.org/0000-0001-5311-1052.

© David South Consulting 2022

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Urban Farming to Tackle Global Food Crisis

By David SouthDevelopment Challenges, South-South Solutions

SOUTH-SOUTH CASE STUDY

The world’s population is becoming more urban by the day. By 2030, some five billion people around the world will live in cities. This year is the tipping point: urban dwellers (3.3 billion people) now outnumber rural residents for the first time (UNFPA’s State of the World Population 2007 Report). 

But with rising food prices across the globe, many city-dwellers are experiencing hunger and real hardship. On international commodity markets, food prices have gone up 54 percent over the last year, with cereal prices soaring 92 percent (FAO – World Food Situation). While living in an urban environment means living cheek-by-jowl with other people, it doesn’t mean there aren’t ways to grow food and supplement urban dwellers’ tight budgets and boost diets.

U.N. Secretary General Ban Ki-moon has called for food production to increase 50 percent by 2030 just to meet rising demand – and right now there are 862 million people undernourished (FAO). But one solution, urban farming, can make a huge difference, as the Caribbean island of Cuba has shown.

Today, Cuba imports about 50 percent of its minimum fuel and food requirements – a cost that reached US $1.6 billion last year for food. (Reuters). The island has been buffeted by one food crisis after another in the past two decades, first by the collapse of its aid from the Soviet Union, and then by a fuel crisis. But now, urban farming in Cuba provides most of the country’s vegetables, thanks to urban gardens that have sprung up on abandoned land in the country’s cities and towns. And the food is pesticide-free: 70 percent of the vegetables and herbs on the island are organic (http://www.soilassociation.org/web/sa/saweb.nsf/Living/ whatisorganic.html).

These urban farms mean fresh food is just a short walk away from the people who eat it. And in a world of rising fuel prices, Cuba has reduced the use of fossil fuels in the production and transportation of food.

The urban farms have created 350,000 jobs that pay better than most government jobs. It has also improved Cuban’s health: many have moved from diets dominated by rice and beans and imported canned goods from Eastern Europe, to fresh vegetables and fruits.

While Cubans receive at least a basic state ration of rice, beans and cooking oil, the rations do not include fresh fruit and vegetables. After the withdrawal of Soviet subsidies, the average Cuban’s daily calorie intake fell sharply. Between 1989 and 1993, daily calorie intake dropped from 3,004 to 2,323 (UN). But with the growth of urban farms, this has moved up to 3,547 calories a day – even higher than the amount recommended for Americans by the US government.

The secret to this success has been the rise of entrepreneurs like Miladis Bouza, a 48-year-old former research biologist who had to abandon a comfortable middle class life after the collapse of the Soviet Union. Her government salary dropped to US $3 a month. Unable to make ends meet and provide food for her family, she quit her job.

The Cuban government allowed people to turn unused urban land into mini farms. The cities have many vacant lots because the state owns most land and there isn’t competition from private developers, as in many other countries. Unusually for communist Cuba, 80 percent of the profits are kept by the farmers. This can be an average wage of US $71 per month.

“Those salaries are higher than doctors, than lawyers,” Roberto Perez, an agronomist who runs the country’s first urban farm, told The Associated Press. “The more they produce, the more they make. That’s fundamental to get high productivity.”

Miladis grabbed this opportunity to farm a half-acre plot near her home in Havana. Along with her husband, she grows tomatoes, sweet potatoes and spinach, and sells the vegetables at a stall on nearby busy street. This has enabled her monthly income to rise to between US $100 per month and US $250 per month, far more than the average government salary of US $19 per month.

Cuba was inspired by greenbelt farms in Shanghai (http://en.shac.gov.cn/hjgl/jqgk/t20030805_82028.htm): but Cuba has gone even further to make urban farming a key part of the national food supply.

All this urban farming is also all-natural farming. Farms have had to turn to natural compost as fertilizer, and natural pesticides like strong-smelling celery to ward off insects.

So-called organoponicos (http://academicos.cualtos.udg.mx/Pecuarios/ PagWebEP/Lecturas/ORGANOPONICOS.htm ) gather together a wide variety of vegetables, fruits and herbs, as well as ornamental plants. Customers are offered mangos, plantains, basil, parsley, lettuce, garlic, celery, scallions, collard greens, black beans, watermelon, tomatoes, malanga, spinach and sweet potatoes.

“Nobody used to eat vegetables,” said David Leon, 50, buying two pounds of Swiss chard at a Havana organoponico. “People’s nutrition has improved a lot. It’s a lot healthier. And it tastes good.”

Published: June 2008

Resources

Development Challenges, South-South Solutions was launched as an e-newsletter in 2006 by UNDP’s South-South Cooperation Unit (now the United Nations Office for South-South Cooperation) based in New York, USA. It led on profiling the rise of the global South as an economic powerhouse and was one of the first regular publications to champion the global South’s innovators, entrepreneurs, and pioneers. It tracked the key trends that are now so profoundly reshaping how development is seen and done. This includes the rapid take-up of mobile phones and information technology in the global South (as profiled in the first issue of magazine Southern Innovator), the move to becoming a majority urban world, a growing global innovator culture, and the plethora of solutions being developed in the global South to tackle its problems and improve living conditions and boost human development. The success of the e-newsletter led to the launch of the magazine Southern Innovator. 

Creative Commons License

This work is licensed under a
Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

ORCID iD: https://orcid.org/0000-0001-5311-1052.

© David South Consulting 2022

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Urban Youth: A Great Source of Untapped Growth

By David South, Development Challenges, South-South Solutions

SOUTH-SOUTH CASE STUDY

The world’s growing urbanization means that a whole generation of youth will have a dramatically different life than their parents. The world’s 3.3 billion urbanites now outnumber rural residents for the first time (UNFPA’s State of the World Population 2007 Report). And the vast majority live in slums or periurban areas, places of sprawl, where public services are poor and housing conditions unhealthy. Most young people working in the urban informal sector live in slum areas: for example, 75 per cent in Benin in Africa, and 90 per cent in Burkina Faso, the Central African Republic, Chad and Ethiopia. Most of this work is just bare survival work: according to the International Labour Organization, approximately 85 per cent of all new employment falls into this category.

Getting youth into quality work and earning more than enough simply to survive is critical to building a healthy society. Young people are bombarded every day with good and bad influences, and as UNFPA found in its Youth Supplement: Growing Up Urban, “the interactions with the urban environment can have an intense impact on the socialization of young people, exposing them to a multitude of influences as they develop, experiment, question, and assume roles in their societies.”

It is predicted that over the next 10 years, 1.2 billion youths will enter the working-age population (UNFPA). But youth unemployment is a huge problem around the world. Unemployed young people make up almost half (43.7 per cent) of the world’s total unemployed (UNFPA). Young people aged 15 to 19 are more than three times as likely to be unemployed as adults. Young people are the future, a resource no society can afford to waste. If their innate energy and enthusiasm is tapped, countries can see significant economic growth.

There are youth entrepreneurs who are defying the gloom and coming up with great business ideas. Five finalists for BBC Swahili’s regional entrepreneur competition – Faidika na BBC (Prosper with the BBC) – offer inspiration for youth across the South. Finalists from Burundi, Kenya, Rwanda, Tanzania and Uganda were selected for their bright schemes.

The overall winner was 24-year-old Burundian student Ashura Kisesa for a plan to build commercial public toilets in the cities and towns of East and Central Africa. Ashura, who entered but failed to reach the Faidika na BBC finals last year, has 12 brothers and sisters and is studying for a degree in agronomy at Burundi University.

“I am very happy to win the top prize in this competition,” she told the BBC. “The lack of public toilets throughout East and Central Africa is a major problem that needs to be addressed and I hope to make a difference with my business idea. My whole family wanted me to win and they really supported me which makes me especially proud. I cannot wait to get started with my business.”

On June 26 in Kampala, Uganda, Kisesa was awarded US $5,000 to put towards her business.

Kenyan national winner, 22-year-old Witness Omoga from Kakamega, wants to make identity cards for schools. Right now he works as a volunteer at his uncle’s photo studio, and hopes to get into Makerere University to pursue a degree in computer science. “I am very excited,” he said to the BBC. “I have never been number one in my life, but now I have emerged first in this competition.”

The Rwandan winner is a pioneer in the growing field of biomass energy production. A 17-year-old student from Kigali, Rangira Aime Frederick, impressed the panel of judges with his idea to turn domestic waste into energy. The national winner for Tanzania is a private tutor from Dar es Salaam, Apolinary Joseph Laksh. A business education tutor, 23-year-old Apolinary’s idea is to produce charcoal from recycled materials to offer people in rural areas sustainable and affordable cooking fuel.

Ugandan finalist, 23-year-old Dereick Kajukano, is in his last year at Kampala International University doing a degree in business administration. Dereick’s business idea is to make bags out of plastic trash. He was inspired by last year’s Faidika na BBC winner, David Ssegawa from Uganda: “When I heard him defend his proposal on air, I said to myself, why don’t I do it as well. That’s when it all started, and here I am.”

Resources

  • 2008 Global Youth Enterprise Conference: Designed as a participatory learning event, this conference aims to support youth enterprise and entrepreneurship programs and policies achieve greater effectiveness around the world.
    Website: www.youthenterpriseconference.org
  • KickStart is a South African project aimed at inculcating a culture of entrepreneurship among young people between the ages of 18 and 35, by promoting business awareness through training, providing grants as start-up capital and providing mentorship and assistance during the setting up phase of the business.
    Website: http://www.sabkickstart.co.za/
  • iDISC – the infoDev Incubator Support Center – is a virtual networking and knowledge-sharing platform for incubators and technology parks leveraging ICT to facilitate entrepreneurship and new business creation in developing countries.
    Website: http://www.idisc.net/en/Index.html
  • Climate Capital Network: this company offers strategic advice, intelligence and assistance with fundraising for low-carbon solutions around the world. They have 2,000 investors looking for projects to invest in.
    Website: http://www.climatecapital.net/
  • Global Entrepreneurship Week: the website for this event in November has many opportunities for youth entrepreneurs to connect with each other through social networking websites.
    Website: http://unleashingideas.org/welcome

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Creative Commons License

This work is licensed under a
Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

ORCID iD: https://orcid.org/0000-0001-5311-1052.

© David South Consulting 2022