Amara and Liya at Debra Bahran Displaced People’s Camp supported by Self Help Africa with funds and help from Irish Aid.

Published:
Sun 16 Jul 2023, 6:48 PM

Ronan Scully

In my work with international development organisation Self Help Africa, who are so thankful to Irish Aid and the Irish public for their continuing support, I hear almost daily and see regularly on my trips to Africa the challenges being faced by communities, especially rural communities, who are being pushed to the brink of starvation and thirst by extreme climate events.

As I write, around 25 million people across Somalia, Ethiopia, and Kenya are on the verge of starvation, unable to access water, and struggling to grow the food that they need to survive. In Somalia alone over a million people have fled their homes in the past year. Across East Africa, extreme hunger is on the rise. The region is entering a sixth consecutive season without enough rainfall. This drought has now surpassed the failed rains of 2011, when an estimated 250,000 people died.

In its most recent update from Ethiopia, the UN Office for Coordination of Humanitarian Affairs (OCHA) said the situation in the country “is still extremely dire and the urgency to further scale up the humanitarian response is high”. It added that spring rains have returned to the region, but “only provided temporary solace through replenished surface water sources and rejuvenated pasture” without having a “long-term impact on the restoration of livelihoods”.

The report said: “The same rains have caused floods leading to destruction of shelter, houses and public infrastructures, livestock deaths and further displacements” in some areas.

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Amara and Liya at Debra Bahran Displaced People’s Camp supported by Self Help Africa with funds and help from Irish Aid.

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Ronan Scully of Self Help Africa with some young beneficiaries of the work of Self Help Africa supported by Irish Aid in North Ethiopia.

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Ronan Scully with some of the rural farmers women’s group who been supported and helped by Self Help Africa in the North Shewa Zone of Amhara in Ethiopia.

Successive years of drought and high food prices have weakened many people’s ability to grow crops, raise livestock, and buy food. The dramatic and severe food insecurity is expected to persist, driving high humanitarian needs well through 2023, with forecasts predicting a sixth failed rainy season in March-July 2023.

Harvests have yielded little and water sources have dried up. Conflict and insecurity continue to intersect with the drought emergency. As conditions continue to worsen, hundreds of thousands of people have been forced to flee in search of safety and assistance. Several East African nations appeared in the recent UN report “Hunger Hotspots,’ with climate threats in some cases piled on top of political and economic vulnerabilities.

The region’s string of weak rainy seasons is now the longest in 70 years, with the current drought exacerbated by baking high temperatures that have parched the land. Vegetation has withered and watering holes have dried up, leading to the death of millions of cattle, sheep, and goats. In a region where most people are employed in agriculture and few communities have irrigation systems or long-term water storage, the consequences have been profound. Farmers whose crops fail often couldn’t afford to purchase new seed for the next season’s planting. Most herders have no access to insurance; when their cattle died, they were forced to abandon the livelihood that may have sustained their families for generations.

A litany of other issues compounded the crisis: local conflict, high food prices triggered by the war in Ukraine, ongoing conflict in Ethiopia, Somalia ,and Sudan, and global economic fallout from the Covid-19 pandemic.

The environment in East Africa is burning. It’s melting. It’s flooding. It’s depleting. It’s drying. It’s dying and is evoking a dystopian type of future. Addressing climate change is a human rights issue for everyone and there is still time to act and make a better, more equal, and safer world for all. But that time is now.

At Self Help Africa, with help and support from Irish Aid, we are responding as best we can to this crisis, supporting communities who are on the frontline of changing climate in both Kenya and Ethiopia, as they struggle to make ends meet against near insurmountable odds. We are introducing new crop varieties to small-scale farming households, promoting alternate drought tolerant crops and supporting irrigation development, as just some of the ways that can help families to survive.

‘Climate smart’ farming might sound complex, but it can be a lot simpler than it sounds! For example – leaving stems and stalks of grain crops in the field after harvesting is one simple, yet effective way to retain moisture in the soil and keeping the sun from beating down directly on the earth, while ‘zero tillage’ planting – a method that encourages farmers to dig just a small hole for each seed, rather than tilling an entire field, is another way of keeping whatever moisture does exist, in the ground.

Other simple farming approaches – like growing ground cover crops – like groundnuts or sweet potato vines – also shade the earth from the sun’s rays, while they provide important and nutritious crops for the family to eat and the farmer to sell. And activities like manure making, composting, and tree planting are all activities that help restore depleted nutrients from the soil, and keep farmland healthy and productive from one year to the next.

Science has a vital role to play as we plot our course and ensure that the generations of today and the generations to come have the resilience to cope with the challenges that we will face. And as science is finding answers in the west – with the adoption of renewable energy in all its forms – so too it will find answers that will protect the poorest and the most vulnerable.

At Self Help Africa, our newly published five year strategy expressly identifies the changing climate and the problems it can create as the context within which we must implement our work. Yes, we are a farming organisation that supports farmers in some of the poorest and most disadvantaged places on earth, and yes, we will retain our focus on supporting small-scale farming communities to grow more and to earn more on their farms in the years ahead.

Self Help Africa can’t stop climate change, but we can help those who are suffering because of it. Together we can stop people from going hungry. Our team provides life-saving support and helps communities build resilience into the future. By donating to Self Help Africa you can help us to save more lives. Together, we can help protect those most vulnerable in various communities to the effects of climate change.

If you want to learn more about our work you can do so by visiting www.selfhelpafrica.org, or by contacting me at Westside Resource Centre on Seamus Quirke Road in Galway. You can also drop me a line at ronan.scully@selfhelpafrica.org if you would like to organise a fundraiser to support our much needed work.

*Ronan Scully is a Clara native working with Self Help Africa.

Published:
Sun 16 Jul 2023, 6:48 PM

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The post Drought and food crisis in Africa threatens millions with starvation appeared first on Minds Valley.

By Lauren Sausser

June 7, 2023

If you or someone you know may be experiencing a mental health crisis, contact the 988 Suicide & Crisis Lifeline by dialing “988,” or the Crisis Text Line by texting “HOME” to 741741.

CHARLESTON, S.C. — Melanie Gray Miller, a 30-year-old physician, wiped away tears as she described the isolation she felt after losing a beloved patient.

“It was at the end of a night shift, when it seems like bad things always happen,” said Miller, who is training to become a pediatrician.

The infant had been sick for months in the Medical University of South Carolina’s pediatric intensive care unit and the possibility that he might not improve was obvious, Miller recalled during an April meeting with physicians and hospital administrators. But the suddenness of his death still caught her off guard.

“I have family and friends that I talk to about things,” she said. “But no one truly understands.”

Doctors don’t typically take time to grieve at work. But during that recent meeting, Miller and her colleagues opened up about the insomnia, emotional exhaustion, trauma, and burnout they experienced from their time in the pediatric ICU.

“This is not a normal place,” Grant Goodrich, the hospital system’s director of ethics, said to the group, acknowledging an occupational hazard the industry often downplays. “Most people don’t see kids die.”

The recurring conversation, scheduled for early-career doctors coming off monthlong pediatric ICU rotations, is one way the hospital helps staffers cope with stress, according to Alyssa Rheingold, a licensed clinical psychologist who leads its resiliency program.

“Often the focus is to teach somebody how to do yoga and take a bath,” she said. “That’s not at all what well-being is about.”

Burnout in the health care industry is a widespread problem that long predates the covid-19 pandemic, though the chaos introduced by the coronavirus’s spread made things worse, physicians and psychologists said. Health systems across the country are trying to boost morale and keep clinicians from quitting or retiring early, but the stakes are higher than workforce shortages.

Rates of physician suicide, partly fueled by burnout, have been a concern for decades. And while burnout occurs across medical specialties, some studies have shown that primary care doctors, such as pediatricians and family physicians, may run a higher risk.

“Why go into primary care when you can make twice the money doing something with half the stress?” said Daniel Crummett, a retired primary care doctor who lives in North Carolina. “I don’t know why anyone would go into primary care.”

Doctors say they are fed up with demands imposed by hospital administrators and health insurance companies, and they’re concerned about the notoriously grueling shifts assigned to medical residents during the early years of their careers. A long-standing stigma keeps physicians from prioritizing their own mental health, while their jobs require them to routinely grapple with death, grief, and trauma. The culture of medicine encourages them to simply bear it.

“Resiliency is a cringe word for me,” Miller said. “In medicine, we’re just expected to be resilient 24/7. I don’t love that culture.”

And though the pipeline of physicians entering the profession is strong, the ranks of doctors in the U.S. aren’t growing fast enough to meet future demand, according to the American Medical Association. That’s why burnout exacerbates workforce shortages and, if it continues, may limit the ability of some patients to access even basic care. A 2021 report published by the Association of American Medical Colleges projects the U.S. will be short as many as 48,000 primary care physicians by 2034, a higher number than any other single medical specialty.

A survey published last year by The Physicians Foundation, a nonprofit focused on improving health care, found more than half of the 1,501 responding doctors didn’t have positive feelings about the current or future state of the medical profession. More than 20% said they wanted to retire within a year.

Similarly, in a 2022 AMA survey of 11,000 doctors and other medical professionals, more than half reported feeling burned out and indicated they were experiencing a great deal of stress.

Those numbers appear to be even higher in primary care. Even before the pandemic, 70% of primary care providers and 89% of primary care residents reported feelings of burnout.

“Everyone in health care feels overworked,” said Gregg Coodley, a primary care physician in Portland, Oregon, and author of the 2022 book “Patients in Peril: The Demise of Primary Care in America.”

“I’m not saying there aren’t issues for other specialists, too, but in primary care, it’s the worst problem,” he said.

The high level of student debt most medical school graduates carry, combined with salaries more than four times as high as the average, deter many physicians from quitting medicine midcareer. Even primary care doctors, whose salaries are among the lowest of all medical specialties, are paid significantly more than the average American worker. That’s why, instead of leaving the profession in their 30s or 40s, doctors often stay in their jobs but retire early.

“We go into medicine to help people, to take care of people, to do good in the world,” said Crummett, who retired from the Duke University hospital system in 2020 when he turned 65.

Crummett said he would have enjoyed working until he was 70, if not for the bureaucratic burdens of practicing medicine, including needing to get prior authorization from insurance companies before providing care, navigating cumbersome electronic health record platforms, and logging hours of administrative work outside the exam room.

“I enjoyed seeing patients. I really enjoyed my co-workers,” he said. “The administration was certainly a major factor in burnout.”

Jean Antonucci, a primary care doctor in rural Maine who retired from full-time work at 66, said she, too, would have kept working if not for the hassle of dealing with hospital administrators and insurance companies.

Once, Antonucci said, she had to call an insurance company — by landline and cellphone simultaneously, with one phone on each ear — to get prior authorization to conduct a CT scan, while her patient in need of an appendectomy waited in pain. The hospital wouldn’t conduct the scan without insurance approval.

“It was just infuriating,” said Antonucci, who now practices medicine only one day a week. “I could have kept working. I just got tired.”

Providers’ collective exhaustion is a crisis kept hidden by design, said Whitney Marvin, a pediatrician who works in the pediatric ICU at the Medical University of South Carolina. She said hospital culture implicitly teaches doctors to tamp down their emotions and to “keep moving.”

“I’m not supposed to be weak, and I’m not supposed to cry, and I’m not supposed to have all these emotions, because then maybe I’m not good enough at my job,” said Marvin, describing the way doctors have historically thought about their mental health.

This mentality prevents many doctors from seeking the help they need, which can lead to burnout — and much worse. An estimated 300 physicians die by suicide every year, according to the American Foundation for Suicide Prevention. The problem is particularly pronounced among female physicians, who die by suicide at a significantly higher rate than women in other professions.

A March report from Medscape found, of more than 9,000 doctors surveyed, 9% of male physicians and 11% of female physicians said they have had suicidal thoughts. But the problem isn’t new, the report noted. Elevated rates of suicide among physicians have been documented for 150 years.

“Ironically, it’s happening to a group of people who should have the easiest access to mental health care,” said Gary Price, a Connecticut surgeon and president of The Physicians Foundation.

But the reluctance to seek help isn’t unfounded, said Corey Feist, president of the Dr. Lorna Breen Heroes’ Foundation.

“There’s something known in residency as the ‘silent curriculum,’” Feist said in describing an often-unspoken understanding among doctors that seeking mental health treatment could jeopardize their livelihood.

Feist’s sister-in-law, emergency room physician Lorna Breen, died by suicide during the early months of the pandemic. Breen sought inpatient treatment for mental health once, Feist said, but feared that her medical license could be revoked for doing so.

The foundation works to change laws across the country to prohibit medical boards and hospitals from asking doctors invasive mental health questions on employment or license applications.

“These people need to be taken care of by us, because really, no one’s looking out for them,” Feist said.

In Charleston, psychologists are made available to physicians during group meetings like the one Miller attended, as part of the resiliency program.

But fixing the burnout problem also requires a cultural change, especially among older physicians.

“They had it worse and we know that. But it’s still not good,” Miller said. “Until that changes, we’re just going to continue burning out physicians within the first three years of their career.”

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