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- Creators: Economics Program in CLAS
- Creators: Azuma, Tamiko
- Resource Type: Text
Malawi, as a low and middle income country (LMIC), with one of the lowest per capita gross domestic products, faces challenges in the provision of healthcare to its citizens. According to the Centers for Disease Control (CDC), leading causes of death include but are not limited to, lower respiratory disease, stroke, cancer, neonatal disorders, and nutritional deficiencies. Feeding and swallowing disorders can present as a symptom to any of these medical diagnoses. Currently, there are no known studies focusing on the service provision for feeding and swallowing disorders in Malawi.
This pilot study was designed to provide a baseline on how feeding and swallowing disorders are currently being provided for in an emerging country like Malawi. Malawian healthcare professionals who see patients with feeding and swallowing disorders completed a survey and interview pertaining to their personal demographics, caseload, opinions, experiences, and treatment recommendations regarding the management of swallowing disorders (dysphagia).
Results indicate a wide range of occupations (Otolaryngoloists, Rehabilitation Technicians, Audiology Technicians, and Nurses) are involved in feeding and swallowing care. Participants expressed a high obligation to provide services for feeding and swallowing disorders, as well as a high concern for their patients. Generally, participants expressed high confidence in their treatment abilities, which did not correspond to knowledge of treatment recommendations that meet U.S. standards of care. Specifically, there was no variation in treatment recommendations across severities and a general lack of resources and tools for assessing and treating dysphagia. Treatment recommendations tended to align with resources currently available in Malawi.
Implications for the utilization of NGOs (non-governmental organizations) and the education of healthcare providers on feeding and swallowing disorders in the social and cultural contexts of this country are discussed.
The deadly shipwrecks of migrant boats in the Mediterranean brought international attention to the plight of migrants in the mid-2010s but the focus soon shifted from humanitarian assistance to capturing smugglers and preventing migrants from reaching the shores of Europe. The step towards a humane migration policy was a short-lived diversion from the project of “Fortress Europe” undertaken since the passing of the Schengen Convention. This project seeks to harden the external borders of Europe and prevent refugees from accessing the asylum system by enlisting neighboring non-European states to prevent migration at the point of departure. Deals such as the EU-Turkey deal of 2016 and the Spanish-Moroccan deals have resulted in migrants being funneled into increasingly dangerous corridors, such as Libya, as the safest and shortest paths are cut off. Although these deals are problematic in their own right, they pale in comparison to the egregious Italy-Libya Memorandum of 2017, which in practice enables Libyan militias to enforce Italy’s migration policy within the Libyan “rescue zone.” The human rights abuses perpetrated by these Libyan mercenaries in makeshift detention centers and on the Mediterranean are well documented, yet the Italian government continues to renew the deal and continue supplying these criminal groups. This literature review examines the issue of European border externalization in the Mediterranean and its impact on the internationally recognized rights of migrants and the stability of African governments. Using a systematic review of existing research, I analyze the key themes and trends that have emerged in the literature on this topic, including the legal and ethical implications of border externalization policies, the impact on African economies and governments, and the human rights implications for migrants. The review concludes that international courts are becoming increasingly ineffective in enforcing the rights of refugees and recommends a reform of the international refugee protection regime to favor autonomous movement.