Blog: Criticism towards humanitarian aid by Anu Rantalaiho

Humanitarian aid sprang into everyone’s knowledge in 1980’s when the famine in Ethiopia hit the news. Since then, the humanitarian actors have faced continuous criticism for either not reaching the needy, misusing the funds, being too slow or lacking timely and effective response. Humanitarian assistance has also been blamed for reinforcing the military troops and providing only short-term mitigation instead of sustainable aid. 1,2,3

When comparing the Ethiopian famine in the mid 80’s to a more recent famine in Somalia in 2011, the humanitarian aid has got very similar criticism despite the 25 years having passed. One reason for this might be that the reason for the famine has been significantly similar in both cases – the drought causing a food crisis in the first place and the government policies and politics turning the situation into famine. The unstable political situation seems to be what prevents effective improvements in delivering the aid. The increased publicity has forced the foreign governments to take actions to show their people they’re alleviating the suffering even as they know the assistance can amplify the root causes. 2,3,4

The criticism is not only towards how the humanitarian assistance is performed. The development aid itself has been claimed to be one of the reasons for Africa’s problems – the intentions to eliminate hunger and poverty have actually promoted corruption, caused dependency, weakened the local markets and lowered the spirit of entrepreneurship, says James Shikwati, a Kenyan economics expert. Corruption and misuse of the funds won’t end as long as there is an endless strain of assistance flowing in. If the assistance was stopped, the Africans would be forced to boost their own market, enforce trade relations with the neighboring countries and to improve their own infrastructure. 5

The actors on humanitarian field are not overlooking the criticism but continuously assessing their actions and searching ways to more effective and efficient assistance. There are good experiences of cash-based interventions, which aim at more sustainable aid, capability to react to early warnings and increasing the preparedness and resilience within local communities. Setbacks within humanitarian assistance are practically inevitable and therefore it is natural that criticism occurs, yet the big picture remains positive. When humanitarian actions are completed thoughtfully, legitimately, and with control and co-operation, the aid does save lives despite the criticism. 6


  1. Guccione, Bob Jr (2015) Live Aid: The Terrible Truth – story by Keating, Robert, originally published in the July 1986 issue of SPIN. SPIN (13.7.2015). Referred on 30.11.2018
  2. de Waal, Alex (1991) Evil days. 30 years of war and famine in Ethiopia: An Africa Watch Report. New York: Human Rights Watch
  3. Seal, Andrew & Bailey, Rob (2013) The 2011 Famine in Somalia: lessons learnt from a failed response? Conflict and Health 7:22. DOI: 10.1186/1752-1505-7-22
  4. Maxwell, Daniel and Fitzpatrick, Merry (2012) The 2011 Somalia famine: Context, causes and complications. Global Food Security 1:1. DOI: 10.1016/j.gfs.2012.07.002
  5. Thielke, Thilo (2005) SPIEGEL Interview with African Economics Expert: ”For God’s Sake, Please Stop the Aid!” Spiegel Online (2005)27. Translated from German by Patrick Kessler. Referred on 4.12.2018
  6. International Red Cross and Red Crescent Movement (2018) Cash in Emergencies Toolkit. Referred on 25.2.2019

Blog: Uber – Social inclusion or new risks for immigrant drivers? by Magdaleena Lehmuskoski

As global migration accelerates, the integration of immigrants challenges societies. Could platform models, such as Uber, provide social inclusion or do they merely entail new risks?

Uber is a controversial global ride-sharing company providing a platform to connect drivers and passengers. It employs over one million drivers, many of them immigrants. Requiring virtually only a driving license and a vehicle, Uber provides immigrants low-threshold employment while other jobs are hard to find.

Uber promises its drivers flexible, supplementary work. However, many immigrant drivers depend on Uber as full-time employment. Wishing to find a job, they are often compliant with low salaries and limited rights. On average, Uber drivers earn the minimum wage or less. Compulsory expenses, such as commissions, insurances and vehicle costs further increase the risk of economic hardship and indebtedness.

Uber classifies its drivers as self-employed, which shrewdly shifts responsibilities and risks to the drivers. Weak social protection increases the drivers’ vulnerability. In case of social risks, such as accidents, sickness or unemployment, they are liable to cover for themselves. Furthermore, weak regulation creates job insecurity. Uber drivers might get fined or sacked if they reject too many trips or receive poor feedback. A big labour reserve means that they are easily replaceable.

Taxi drivers are exposed to discrimination based on race, ethnicity and language. Though the Uber feedback system is intended to protect drivers and passengers, it has also been accused of unreliability and discrimination. Immigrant drivers have been given poorer ratings based on ethnicity. Rides have also been cancelled once the driver’s racial background has been discovered. Lower scores reduce booking rates and increase the risk of dismissal. This severely compromises the livelihoods of immigrant drivers.

Undoubtedly, Uber offers immigrants prominent employment and integration opportunities. However, their livelihoods being heavily dependent on Uber imposes immigrant workers to a cycle of socioeconomic vulnerability. As labour demand remains insufficient, economic circumstances pressure them to silently endure. Hence, governmental policies should more decisively promote fair organization of work and social protection coverage of all workers regardless of ethnicity.


Blog: Indoor air pollution in India and its damaging effects on health By Beulah Sarah James

Indoor air pollution is a topic of great concern especially in India due to its rampant health and environmental effects. Women and young children bear the brunt of indoor air pollution. 1 Women are traditionally responsible for cooking and spend hours nearby the cooking fire when compared to men. Under-five children stay at home and remain near the mother while cooking.

The use of biomass stoves come with a great after cost in terms of health. The eye effects include decreased vision, cataract, eye irritation and watering. There is an increased predisposition to develop burns, skin irritation as well as heart attacks and stroke. Irritated respiratory linings result in ear pain, running nose, cough, chronic bronchitis and asthma. Adverse pregnancy outcome include in miscarriages, still births, low birth weight and preterm births.

As per the National Census of India 2011, 49.0 % of the households use firewood, 8.9 % use crop residues while 28.5 % use Liquefied Petroleum Gas for cooking. Majority of rural households in India (90.8%) use traditional stoves without smoke outlets. 2

Biomass is considered as an affordable, easily accessible fuel and food cooked with biomass tastes better. Biomass is used for heating homes and the smoke is considered as a natural repellent for mosquitoes. Smoke outlets emit smoke outside the house and reduce the immediate health effects. The household energy pattern is observed where lower income households prefer biomass compared to higher income households.

Household air pollution is a burning topic of interest as it affects health of individuals as well as ambient air quality. Switching to cleaner fuels, community awareness, addressing low literacy and income is the need of the hour. India, being rich in resources and manpower need to strive to bring a positive change in curbing household air pollution.


  1. World Health Organization. Household Air pollution and Health[Internet].Geneva: WHO; 2018. [updated 2018 May 8; cited 2018 Oct 14]. Available from:
  2. Ministry of Home Affairs. Household Amenities and Assets-Census of India 2011. New Delhi: Governemt of India; 2011

Blog: The hepatitis B infection in indigenous people in Nepal requires a specific intervention by Purusotam Raj Shedain

Hepatitis B virus (HBV) infection is a global public health problem1, 2. It is ubiquitous and heterogeneous. HBV infection can result either as an acute hepatitis B infection or a chronic hepatitis B (CHB) infection, i.e. more than six months. The majority of acute hepatitis B virus infection is self-limiting. People with CHB are at risk for serious illness and death, nearly one-fourth of them will eventually die from HBV-related liver disease, including cirrhosis and hepatocellular carcinoma1, 2. The early age of the transmission, i.e. during the first week of life (perinatal period) has a high risk of CHB. The infection is vaccine preventable and treatable; a three-dose vaccine series with first dose within 24 hours after birth is very effective to prevent the infection and a treatment guideline has been available for the CHB3.

National prevalence of the hepatitis B infection in Nepal is low, i.e. less than one percentage 4. However, there is a substantial disparity within the national prevalence. The infection is disproportionately high among the indigenous people, ranging between 1 and 38 percentages4-6. In some indigenous communities, nearly one-fifth of mothers are infected, and nearly one-half of the children who are living with HBV positive mother are infected7. Considering the low prevalence setting at the national level, the hepatitis B vaccination is not administered at birth by the National Immunization Program (NIP). Instead, the vaccination series is administered at 6 weeks of age8. The blanket NIP poorly fit the indigenous people as a majority of the infection in the endemic setting transmits during the perinatal period but the existing vaccination does not prevent the perinatal transmission. Thus the indigenous people are getting new infection, as there is no treatment program implemented to halt the dreadful consequences of CHB so far. This calls for an immediate action. A specific intervention along with the vaccination at birth would halt the dire situation. This would positively reflect how modern Nepal, as per its constitution and international commitment9, 10, is aggressively working to protect the human rights and the right to equality in the health of indigenous people.


  1. WHO. Global Hepatitis Report 2017 Geneva: World Health Organization; 2017. Licence: CC BY-NC-SA 3.0 IGO. 2017.
  2. WHO. Hepatitis B vaccines: WHO position paper – July 2017. 2017.
  3. WHO. Guidelines for the prevention, care and treatment of persons with chronic hepatitis B infection. 2015
  4. Shrestha SM. Chronic hepatitis B in Nepal: An Asian country with low prevalence of HBV Infection. Tropical Gastroenterology 2012;33(2):95–101. 2012.
  5. Shedain P JA, Bhattarai KD. Himalayan Seasonal Migration and STI/HIV Infection: A Case Study among Seasonal Migrants in Kathmandu from Dolpa District, Nepal. Journal of Nepal Health Research Council 2006;Vol.4(No.1April).
  6. Menner A S DS, Kinkel H T, Küpper T. Hepatitis B Prevalence in Upper Dolpo in the Mid Western Development Region/Nepal. Abstracts from Research Reports Indexed at NHRC Library (1991 – 2015), 2016.
  7. Shedain PR DM, Banjara MR, Ling H, Dhital S. Prevalence and risk factors of hepatitis B infection among mothers and children with hepatitis B infected mother in upper Dolpa, Nepal. BMC Infectious Diseases 2017.
  8. DOHS. Annual Report, Department of Health Services 2072/73 (2015/2016). 2016.
  9. Gov.Nepal. The Constitution of Nepal. Ministry of Law, Justice and Parliamentary Affairs, Nepal; 2072.
  10. UN. Transforming our world: the 2030 Agenda for Sustainable Development (SDG). 2015.

News: Professor Helena Ranta visited Global Health & Development by Yen Phan

Professor Helena Ranta visited the University of Tampere to give a lecture on humanitarian crises for the students of Health in disasters, conflicts and complex human emergencies course.

Helena Ranta is a forensic odontologist who has led a number of international expert teams in investigations of clinical forensic dentistry. She has worked, for example, in Bosnia and Herzegovina 1996-1997, in Kosovo 1998-2001, in Iraq 2004 and in Chechnya. In addition, she has conducted mass disaster victim identifications of South-East Asia tsunami and MS Estonia.

“The students really appreciated the in-depth lecture based on Professor Ranta’s real-life experiences” states course coordinator Annariina Koivu.

Professor Ranta has recently given an interview to the Alusta! about the influence of international politics on investigations in conflict settings. Read her full interview here.

Blog: Gender-related association between socioeconomic status and obesity: Is East Asia different from the West? By Xiwen Qian

The gender-related association between socioeconomic status (SES) and obesity is different among regions with different culture and developmental level. Studies are consistent that women with higher income or educational level are less likely to become obese, whether in East Asian or Western countries. Whereas for men, the association is mostly found opposite in East Asia, such as some areas in China and Japan and South Korea, but mostly non-significant in the Western countries like USA, European countries and some developed areas in Brazil. One distinction between East and West is that most East Asian countries are patriarchal societies and most Western regions are developed countries.

In patriarchal societies like China and Japan, women’s value lies more in appearance, body image and reproduction, while men’s value lies in earning money and obtaining power. Sometimes a larger body size for men is likely to be valued as a sign of dominance, power and wealth. Social values tend to impose higher costs for obesity on women both in the labor and marriage markets than on men.

In Western societies, especially in developed regions like Europe and USA, with the development of feminism, social values and cultural norms gradually treat men and women equally. (Yet still, women pay more attention to appearance than men do.) Therefore, in terms of the relationship between SES and obesity, the difference between men and women in Western countries is not as big as that in East Asian countries.

High developmental level promises high degree of gender equality. The gender-related socioeconomic influence on obesity will change with human and cultural development. The effect of SES on obesity in men in East Asia will probably transit from positive to none or even negative, while in women the correlation would remain the same.

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Nakamura, T. et al. Relationship Between Socioeconomic Status and the Prevalence of Underweight, Overweight or Obesity in a General Japanese Population: NIPPON DATA2010. Journal of Epidemiology 28, S10-S16, doi:10.2188/jea.JE20170249 (2018).
Monteiro, C. A., Conde, W. L. & Popkin, B. M. Independent effects of income and education on the risk of obesity in the Brazilian adult population. The Journal of nutrition 131, 881s-886s, doi:10.1093/jn/131.3.881S (2001).
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News: Kicking off the Nordic Network for Global Health Education by Miia Halonen and Annariina Koivu

The Global Health and Development team visited Bergen 12-13.12. 2017 for the first meeting of Nordic collaboration for global health education. The partner universities in this Nordic network, which aims to develop Nordic global health education, are the University of Bergen, University of Tromsø, University of Copenhagen, University of Iceland, University of Umeå, and University of Tampere.

The partner universities’ diverse Masters’ programmes’ strengths and focus areas were identified through discussions and presentations by each institution. The educational programmes’ variety of contents and structures provides a stimulating starting point for improving the quality and multidisciplinarity of Nordic global health education.

Participants in Bergen. Bente Moen, Geir Gunnlaugsson, Annariina Koivu, Oluf Gudny Geirsdottir, Miia Halonen, Klas-Göran Sahlen, Ingvild Hope, Karen Marie Moland, Astrid Blystad, Emil Mølgaard Morell, Linda Forshaw & Erik Eik Anda.

This collaboration stems from an international global health workshop at Rymättylä, Finland in 2016, which attracted participants from 10 Nordic institutions. The collaboration will continue in the next meeting, which will be held in Tampere in April 2018.

News: Visiting professor Dr Anuj Kapilashrami´s interview on Radio Moreeni about People’s Health Movement by Miia Halonen

Global Health and Development had an honor to organize People’s Health Movement workshop by Dr. Anuj Kapilashrami on 24 October 2017 for the students and staff in UTA who are interested in global and public health issues. Guest professor of Social Sciences Dr. Kapilashrami is an active member of the steering group of the UK People’s Health Movement and convener for the Scotland group. Larissa Bister from Radio Moreeni interviewed Dr. Kapilashrami about the People´s Health Movement. To learn about the role of People’s Health Movement in global health arena listen the interview here:

Is it time for Finland to join the People´s Health Movement?

People’s Health Movement publishes the Global Health Watch – the alternative World Health Report


News: Global Health Case Challenge 2017 – Meet the Team! By Lynda Gilby, Ulla Laitinen, Giovanna Sanchez Nieminen, Mariette Hägglund, and Annariina Koivu

Photo: Jonne Renvall, University of Tampere

The University of Tampere is sending 5 students, across various disciplines, to compete in the Global Health Case Challenge is Copenhagen next month. The topic of the challenge is the Sexual and Reproductive Health of Migrant Women. A question related to this topic will be presented on arrival and teams will have 24 hours to come up with and present a solution to the panel. Each participant has a diverse background presenting an interdisciplinary approach to the challenge.

From the Master’s in Public and Global Health, Ulla has previously studied both Public Health Nursing and Midwifery. She worked for THL as a research nurse on large scale public health studies. One of those studies included the health implications of stress on pregnant women and how this can affect the child throughout their development. Lynda has a background working in large trauma centers and small rural hospitals in across New Zealand, England and Scotland. She has a strong interest in researching gender based violence and barriers to women’s full and equal participation in society. Currently undertaking her PhD, we have Kalpana, who is studying the reproductive health of migrant women. She has worked as a research assistant and been involved in multiple publications related to women’s health and has a strong academic background in public health.

From the Master’s in Peace, Mediation and Conflict Research program, Giovanna Sanchez has experience researching human right’s issues at borders, and how we can reduce discrimination and protect human rights, especially those of migrants and vulnerable minorities. She participated in the Bill Clinton Hult Prize challenge on how to decrease human disease in urban slums. She is currently doing her thesis around the human factor of border control with the Bodega Project. From the same program we have Mariette, who interned with the Permanent Mission of Finland at the UN in Geneva, with a focus on human rights and global health. She has worked in Iraq with refugee women, learning about their experiences living under ISIS control and hearing their personal stories.

The winning team will meet with the UNFPA at their office in Copenhagen to pitch their solution, and with the EIT Health Accelerator program which can provide assistance and funding to get new programs off the ground.

– This opportunity stems from our collaboration within a partnership among Nordic universities, explains Dr. Annariina Koivu from Global Health and Development (GHD). The partnership for Global Health Case Challenges was a formed in 2017 with the aim of strengthening the field of global health education in the Nordic region by offering new ways of learning and teaching through using the innovative pedagogic approach of case challenges. Besides the University of Copenhagen, the host of the current as well as two successful case challenges, the partnership includes Karolinska Institutet, Lund and Uppsala University in Sweden, universities of Oslo and Bergen in Norway and the University of Tampere in Finland.

– We are excited, as this opportunity could be the first step in the path towards an exciting and rewarding career for the students.

Prof Anneli Milen (GHD) continues: This is a prime example of international collaboration that has the focus on action and activities. This is an excellent opportunity to compete on a serious, real world issue.