NEWSBYLAURA DEAN

Why is the U.S. pledging to back a foreign military whose special operations forces have been accused of egregious human rights abuses?

Earlier this month, the U.S. promised to help the Yemeni military beef up its special operations forces. The Pentagon has been offering Yemeni security forces handouts all year: In February, for example, the Pentagon appropriated $150 million in military assistance for Yemen — an $83 million dollar increase over the previous year. Unfortunately, very little was offered to explain what would become of such a large chunk of change. (All that in addition to the Obama administration's recent decision to sanction the targeting of Anwar Al-Awlaki, an American cleric residing in Yemen. )

Such funds, it's been reported, are intended to help the country target Al Qaeda. But we're talking about Yemen here, a country that ranks 111th on the 2009 U.N. Human Poverty Index. It's a country that's received far less U.S. aid than most in the region. When it comes to Yemen, it seems the U.S. sees little more than a security threat.

Rescuers are beginning to lose hope in Shanxi Province, China, where the death toll from the flooding of an unfinished mine climbed to 25 yesterday. The saga started over a week ago when water overwhelmed the mine, trapping 153 miners underground. On Monday, 115 of them surfaced, many of whom had survived by eating paper, sawdust, tree bark and coal. Conditions in Chinese mines are notoriously poor, and over 2,600 miners were killed on the job last year alone.

That's a shocking figure, but the U.S. record is hardly unblemished. Last Thursday, that reality was brought home after 25 West Virginia miners were killed following a horrific mine explosion. (Four miners are still missing.)

Sadness turned to outrage when it emerged that Massey Energy — the company that owns the mine in question — had been cited for over 50 workplace violations in that mine alone in the last month. And this explosion was not the first: in 2006, hazardous conditions resulted in a fire that trapped 12 people and killed two. There have been thousands of violations reported in dozens of other Massey mines just this year. Federal mining data indicates that only one in 10 mines across the nation are in compliance with all of the safety requirements prescribed by federal law. The mining industry remains one of the most dangerous professions out there, one that across the globe has one of the worst worker protection records.

The Iraqi medical system was once an enviable one. Prior to the U.S. invasion in 2003, Iraq had one of the foremost health care systems in the region with advanced resources, medical schools and broadly accessible care. Even in the 1990s, when much of Iraq was staggering under UN-imposed sanctions, people came from across the region to study medicine and receive treatment.

Not anymore, though. As a number of stories over the past few years have chronicled, in the years and violence since the war began in 2003, doctors and other medical personnel have fled Iraq in droves. Many have yet to return. (Even if they were to come back, so many heath care facilities have been destroyed and supply routes cut off that it would take much time, funding and dedication to rebuild.) In an effort to instill fear and foment chaos, many medical personnel were kidnapped, killed or forced to flee. Figures from the end of 2008 suggest that 120 medical staff were killed that year in targeted murders. The Ministry of Health's estimate from the same time period indicates that out of as many as 30,000 doctors in Iraq before the war, up to half fled during the invasion, while only about 800 of them have come back.

What's being done to compensate for such a toll on the Iraqi system?

Why is a goat, say -- or a box of women's underwear -- considered contraband?

To get that answer, you'd have to ask the Israeli government. Last Friday, the Israeli army launched a series of air strikes out of Apache helicopters to register their displeasure over a rocket attack on Israel that killed one farm worker. The attack was claimed by a previously unknown rebel group, Ansar al-Sunna (which opposes the Hamas-led government in Gaza). The air strikes hit several targets inside the Palestinian occupied territories -- at least three of which were tunnels that allow items from livestock to clothes to be smuggled into the Gaza Strip.

The Israeli government has done a pretty good job of portraying the tunnels as nothing more arms-smuggling passages, thereby legitimizing their 2009 attempts to obliterate them. But in truth, they are a lifeline to the Palestinian population currently confined within the bounds of the Gaza Strip.

To be sure, there are weapons tunnels that exist. But the majority of the goods that flow across the Egypt-Gaza border below ground are food and clothing, as well as medical supplies -- not so-called "contraband." Only items deemed "necessities" by the highly fickle Israel Defense Forces are allowed to pass the above-ground checkpoints into Gaza -- and at one point, both strawberry jam and pasta were on the "prohibited" list.

These seemingly arbitrary prescriptions have dire consequences. In the Gaza Strip, food security is perpetually in doubt, as is the filling of certain medical prescriptions. Several of Gaza's main medical facilities were knocked out during the Gaza war over a year ago. And while some are operational again, a few have yet to be rebuilt, making basic care even more difficult to obtain.

A financial dispute between several Egyptian hospitals and the Ministry of Health is leaving thousands of Egyptians without access to health care and vital medication, as hospitals refuse to treat patients across the country.

Even prior to this crisis, the health care situation was bad enough: Only 53% of Egyptians have health insurance. The rest of the population is eligible for -- and until recently, some received -- free health care funded by the Egyptian government. But still, only about two million people (out of a population of more than 81 million) take advantage of the free government health care option.

Recently, several hospitals have begun demanding overdue payments from the Ministry of Health, declaring that they won't honor free government health care agreements until these bills are paid. That sounds reasonable, but in the meantime, it's the people who depend on free health care to survive who are bearing the brunt of their decision. While hospitals wait to be paid, thousands of requests for care and prescriptions are being delayed or left unfilled.

Some sources say the Ministry of Health owes an outstanding one billion Egyptian pounds ($270 million) to health care facilities around the country. If that weren't enough, in early January, allegations of rampant corruption and fraud within the free health care program surfaced, causing some hospitals are refusing to treat patients until the government investigates the charges.

And it gets uglier.

All is not right with India's health care system. Across the country, infant mortality and communicable disease rates are alarmingly high, and malnutrition stunts the growth of almost 40% of children under age three.

For all of India's booming technology and growing pharmaceutical industry, on average, the health of the general population remains quite poor. Why the persistent health deficit? According to former chief economic adviser to the Indian government Shankar Acharya, who analyzes two newly published papers, the reasons come down to 1). the withering of India's public health sector and 2). the overspecialization of its medical profession.

In 1947 at the time of India's Partition, two separate mandates and funding structures for the medical and public health sectors existed. But subsequent legislation merged them, and throughout the 20th century, a series of measures slashed funding and cut resources for an autonomous public health sector. As the years went on, appealing career options for young people in public health faded, and money ended up funneled to programs targeting specific diseases instead of broad-based sanitation and disease-prevention measures. At one point, for example, most sanitation inspectors were co-opted to work on smallpox and malaria eradication.

But a ray of hope comes from within India's own borders: from the southeastern state of Tamil Nadu. The state spends less per person and has private health expenditures that are lower than India's national averages. And yet Tamil Nadu still has better infant mortality rates, a very high percentage of women receiving pre-and post-natal case and excellent child immunization coverage. The state even was able to offer excellent disaster relief during the tsunami.

How does Tamil Nadu do it?

On the heels of Eric's discussion of sanitary pads and schoolchildren last week, thought I'd follow up with a story about where sanitary pads are genuinely benefiting women: in refugee camps.

For women living in refugee camps, an item as basic as a sanitary pad can be a luxury. Women often rely on cloth, which is difficult to keep clean, or toilet paper instead. But for tens of thousands of women living in a 209 sqkm refugee settlement in Kyaka, Uganda, this is no longer the case, now that Moses Kizza Musaazi (a professor at Makerere University) has designed a project to transform papyrus and waste paper into sanitary pads -- making life easier for thousands of women and girls in the surrounding region.

Musaazi originally designed the pads for disadvantaged girls who were unable to purchase pads themselves. But these "Makapads" soon caught on and now the UN, in conjunction with GTZ, purchases the pads in bulk and distributes them in neighboring refugee camps (which house mostly Congolese refugees).

But the pads provide more than monthly convenience. Makapad employs dozens of people, most of them women, from the camps themselves. Lately, Ugandans living close to the settlements have also been angling for a piece of the Makapad pie (though as of yet, the company only employs refugees).

Much has been written over at our human trafficking blog about the lack of services offered to children and adults who are victims of trafficking and sexual abuse.

But while we often think of trafficked persons as foreign nationals -- brought to the United States from other countries and forced to engage in sex work or work in domestic service -- that isn't always the case. While foreign nationals' cases are common, thousands of children and women are also trafficked within the borders of the United States every year. And in many ways, they might as well be from another country.

Though they may never have left the cities in which they were born, most trafficked women and children have their papers confiscated by their traffickers -- or run away from home without them -- and therefore have no form of identification when they finally escape. In the United States, for victims of trafficking who are foreign nationals, once they're certified as victims, they're eligible for medical attention and other services. Yet no such program exists for domestic victims. In order to obtain services at free clinics or apply for Medicaid, a valid form of identification is required. As a result, until they obtain proper documentation -- which can take months -- victims of domestic trafficking can't get access to medical care under any state jurisdiction.

After months or years of confinement, forced labor and sexual abuse, many of these survivors are in need of long-term medical care as well as counseling. Yet the lack of resources is astounding. In Washington, D.C., Courtney's House is the only organization in the country with a sole mandate of providing services for victims of domestic trafficking. The nonprofit has just a tiny team of health professionals -- one doctor and two registered nurses -- who are trying to address this need across the entire D.C. Metro area.

Last week, I wrote a post about a curable disease that goes untreated due to social stigma. Those kinds of diseases are everywhere -- as in India, where the Global Post reports that an entire generation of young people is growing up sequestered in leper colonies, despite the fact that they've never even been infected with the illness at all.

In the English language, the word "leper" has become a shorthand to describe a person ostracized from their community, as leprosy sufferers once were. These days, though, the disease is curable, and can't be transmitted via fleeting contact as people historically thought. But in India, the social stigma of the disease remains acute, to the point that today, there are over 1,000 leper colonies dotted around the country. And these colonies don't just include the leprosy sufferers themselves -- they're also home to numerous young people who don't have leprosy, but remain "lepers" by association because their parents or relatives are sufferers.

In India, these non-lepers endure a crushing burden of discrimination, and are often unable to attend school or find jobs. The isolation such non-lepers endure as a result of their relatives' illness fuels inter-familial resentment, particularly as the young, healthy and unemployed remain dependent on their parents' welfare checks. Vineeta Shanker describes the socially debilitating condition of these young people accordingly: "They have internalized the societal rejection," she told the Global Post. "They say 'Even when we go to government schools, the teacher puts us in a corner. She doesn't put us in the first row. We have no friends except the girls from our own colony.'"

There are many diseases ravaging the world’s populations, but "Podo" shouldn’t be one of them.

Despite its cute-sounding nickname, Podoconiosis is a harrowing condition -- one of the most preventable and least studied of all endemic diseases. Caused by sustained exposure of bare feet to volcanic red clay soil at high altitudes, though, Podo can be easily prevented -- just by washing your feet regularly and wearing shoes. In fact, the effects of Podo -- a painful swelling and disfiguring (elephantiasis) of the lower legs -- can be almost completely reversed without the use of expensive pharmaceuticals, using treatment that can be led by non-healthcare professionals.

Still, though, in Ethiopia and at least seven other African countries, parts of Latin America and northern India, the disease continues to flourish. In certain areas, the fact that only some families are afflicted has led to all sorts of theories related to divine retribution, resulting in debilitating economic and social stigmas. “My brother has Podo, I may have a hard time finding a husband,” is a common refrain one Podo researcher noted as she traveled around Ethiopa.

Such are the extents that families go to to conceal the disease that even in places where Podo is most prevalent, healthcare workers are often unaware of the disease's reach. In some areas, the Podo rate is 5-7% -- higher even than the rate of HIV infection. The estimated annual loss to Ethiopia’s GDP, thanks to Podo, is at least $208 million. Yet so little research has been done that Podo awareness isn't even on the radar of the Ethiopian Ministry of Health, already overburdened with numerous public health problems.