Global Health and citizenship

Our World

Average life expectancy at birth of the global population in 2016

72.0 yearsLesotho 52.9 yrs.

Chad, Sierra Leone and CAR - all <55 yrs.

Japan 84.2 yrs and Monaco 89.2 yrs

Our WorldBetween 1990 and 2015, maternal mortality worldwide

dropped by about 44%.

Every day, > 800 women die giving birth,99% in developing countries and fragile settings.MMR in developing countries in 2015 is 239 per 100 000 live births vs 12 in developed countries.

Our World

Unequal shots at life

In 2017, 4.1 million died within 1st yr of their life’

5.4 million < 5 yrs died in 2017

Majority of these deaths happened in the developing

countriesHighest newborn mortality rates: Pakistan: 1 in 22 , CAR: 1 in 24, Afghanistan: 1 in 25, Lowest newborn mortality rate : Japan: 1 in 1,111

Margaret ChanFormer WHO Director General - 2011

Our world is dangerously out of balance.

• The difference in life expectancy between the richest and poorest countries exceeds 40 years. Annual Govt expenditures on health range from a US$ 1 / person to nearly US$ 7.000.

• A world that is greatly out of balance is neither stable nor secure.

1972 -2018 Begampur Health Centre, West Bengal. India

Guatemala Life expectancy 73.2yrs. Rank 942017 Antigua MMR – 88 IMR 21

Guatemala Life expectancy 73.2 yrs. Rank 942017 Quetzaltenango MMR – 88 IMR - 21

Bolivia Life expectancy – 71.5 Ranking 1082016 MMR – 206 IMR 34

Bolivia Life expectancy – 71.5 yrs ranking 1082016 Yacouiba MMR – 206 IMR - 34

Bolivia Life expectancy – 71.5 yrs Ranking 1082016 Carmejo MMR – 206 IMR - 34

Bolivia Life expectancy – 71.5yrs ranking 1082016 Carmejo MMR – 206 IMR - 34

Australia2012-14 Griffith . NSW

Australia Life expectancy - 82.9 yrs Rank 610.6 yrs lower for the Indigenous population

2012-14 MMR 6 ( 13.3) IMR 3.2 (6.3)

• >25,000 Indigenous women live more than 1 hour’s drive to a birthing unit

• Almost half of Indigenous adults were removed from their natural family

• The unemployment rate for Indigenous people 4 times as high as the rate for non-Indigenous people

• Currently indigenous population is only 3.3% of the total in the country

Australia Life expectancy - 82.9 yrs Rank 610.6 yrs lower for the Indigenous population

Lake Cargelligo 2014 MMR 6 (13.3) IMR 3.2 (6.3)

Ethiopia Life expectancy 65.5 yrs Ranking 1411999-2016 MMR – 353 IMR - 65

Saving lives by task sharing: The role of the non-doctor surgeon

Biku Ghosh, Yifru Berhan, Melese Takele Wossen, Yusuf Abdulkadir Abdulahi and Abera A Gobeze

AFRICAN JOURNAL OF MIDWIFERY AND WOMEN’S HEALTH, OCTOBER–DECEMBER 2017, VOL 11, NO 4

800 Emergency Surgical officers in EthiopiaOn average 100-150 Caesarean sections per year (80,000)

and 50 laparotomies per year (40,000)

Ethiopia Life expectancy 65.5 yrs Ranking 1412016 Awasssa MMR – 353 IMR - 65

Murida Shamil’s story

Murida graduated as an Emergency Surgical Officer just over three years back. Since then she has carried out 400 successful CS, dealt with 64 ruptured uteruses (with only one

death) and approximately 200 laparotomies for various indications. And she also managed to

have her first baby daughter amongst all these!

MMR Is rising in USA, as It declines elsewhere. MMR in the U.S. increased from 17 in 1990 to 26.4 in 2015. Black women die giving birth at a rate from 3-4 times their white counterparts. Infants in the United States have a 76 % higher risk of death compared with other wealthy nations.

India Life expectancy 68.35 yrs Ranking 125MMR - 112 (>137,000 maternal deaths/yr)

2017 -18 Phalodi, Rajasthan IMR - 38

Tanzania Life expectancy 63.9yrs Ranking 1482017 Korogwe MMR 578 IMR 59

“But, if you believe you are a citizen of the world, you are a citizen of nowhere. You don't understand what citizenship means.”

October 2016