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olivialum

Mental Health Care in West Africa Is Often a Product of Luck - The New York Times - 0 views

  • A growing number of innovative groups have begun experimenting with a similar approach in Africa and Asia: providing therapy without clinics or doctors, relying instead on mobile nurses, cheap generic drugs and community support systems.
  • In impoverished parts of the world where psychiatry is virtually nonexistent, they say, it is the only way to begin reaching the millions of people in need.
  • “Here, if we had to wait for a psychiatrist, the people who desperately need treatment would never get it,”
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  • slash rates of premature death from mental disorders by a third by 2030.
  • By one analysis, which includes Western countries and developing regions like West Africa, depression, drug abuse and schizophrenia are on track to be the three leading causes of lost economic output by 2030.
  • Among the successes have been group therapy for rape victims in the Democratic Republic of Congo, family and individual counseling for survivors of torture in Myanmar, and talk therapy and medication for people with depression in rural India.
  • But without reliable support, follow-up and medical supplies — particularly psychiatric drugs when needed — interventions can quickly lose traction, no matter how well trained and devoted the workers are.
  • One moment, she was dozing off during a rest period; the next, she felt the presence of strange men coming after her. She screamed at them to stop. “My shouting didn’t stop the men; they kept coming for me,” she said. “So, what did I do? I ripped off my school uniform and ran.”
  • The medical staff had little training in how to handle a psychotic break: the hallucinations and delusions characteristic of schizophrenia. They sent her home, where the sensation of being hunted seeped back into her thoughts.
  • Sometimes, she ran out onto the open savanna to escape the demons pursuing her.
  • Family members took turns keeping watch and exhausted traditional methods of healing. Precious animals were sacrificed to drive away the spirits disturbing her. Healers administered herbal powders, and one applied a pale dye to her face and body in an effort to purge demons.
  • Mental illness is a source of shame here, as in most of the world, and families do not advertise its presence. Yet each community has a chief or subchief responsible for keeping an eye out for the sick.
  • One is known as task sharing.
  • The second is community self-help.
  • The third is raising awareness
  • The evidence that a combination of these services can lead to lasting improvement for people with severe mental illnesses is thin, but a foundation is being laid.
  • “The key thing is that it’s not simply home-based care for people with schizophrenia,” Laura Asher, who is running the study, said by email. “It also involves awareness raising and community mobilization.”
  • the cost of these programs is minute compared with the cost of standard psychiatry
  • $8 per client per month on average, according to Peter Yaro, its executive director. In the United States, it costs $200 to $700 for a single appointment with a psychiatrist, depending on the provider, the type of care and the location.
  • In global cost-benefit terms, economists typically rate health care programs by the amount of disability they reduce per dollar. Historically, mental health interventions have scored poorly compared with efforts that save young lives, like neonatal care or treatment of diarrhea. A new analysis of mental health strategies in Ethiopia, for instance, found that treating schizophrenia with generic medications was about as cost-effective as treating heart disease with a combination of drugs, like aspirin and a statin — and much less cost-effective than treating depression or epilepsy. The findings, though preliminary, suggest that treating psychosis is relatively costly.
  • the studies do not take into account the effect of chronic psychosis on an entire family. “The person with psychosis becomes a full-time job for someone else in the family, and depending on how aggressive the person is, maybe more than one person,” said Dr. Simliwa Kolou Valentin Dassa, a psychiatrist in neighboring Togo
  • And if the disorder is seen as a result of a curse on the family, carried down through generations — a common interpretation here — the entire clan comes under suspicion.
Stuart Suplick

Millions of Poor Are Left Uncovered by Health Law - NYTimes.com - 1 views

    • Stuart Suplick
       
      For some states, it appears the expansion of Medicaid would be more burdensome than beneficial, perhaps through increases in taxes
  • Poor people excluded from the Medicaid expansion will not be subject to fines for lacking coverage.
  • Mississippi has the largest percentage of poor and uninsured people in the country — 13 percent. Willie Charles Carter, an unemployed 53-year-old whose most recent job was as a maintenance worker at a public school, has had problems with his leg since surgery last year. His income is below Mississippi’s ceiling for Medicaid — which is about $3,000 a year — but he has no dependent children, so he does not qualify. And his income is too low to make him eligible for subsidies on the federal health exchange. “You got to be almost dead before you can get Medicaid in Mississippi,” he said.
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    • Stuart Suplick
       
      An example of how healthcare eligibility can be hard to come by in some states--for instance, Mr. Carter cannot qualify for Mississippi's Medicaid because he has no dependents, yet his income isn't high enough to qualify him for subsidies.
  • Dr. Aaron Shirley, a physician who has worked for better health care for blacks in Mississippi, said that the history of segregation and violence against blacks still informs the way people see one another, particularly in the South, making some whites reluctant to support programs that they believe benefit blacks. That is compounded by the country’s rapidly changing demographics, Dr. Geiger said, in which minorities will eventually become a majority, a pattern that has produced a profound cultural unease, particularly when it has collided with economic insecurity. Dr. Shirley said: “If you look at the history of Mississippi, politicians have used race to oppose minimum wage, Head Start, all these social programs. It’s a tactic that appeals to people who would rather suffer themselves than see a black person benefit.” Opponents of the expansion bristled at the suggestion that race had anything to do with their position. State Senator Giles Ward of Mississippi, a Republican, called the idea that race was a factor “preposterous,” and said that with the demographics of the South — large shares of poor people and, in particular, poor blacks — “you can argue pretty much any way you want.”
    • Stuart Suplick
       
      How does one determine the role race plays, consciously or subconsciously, in policy making?
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    https://diigo.com/016s4p I found it particularly shocking how over half the states have rejected the ACA, and so jeopardize the health of "68 percent of poor, uninsured blacks and single mothers. About 60 percent of the country's uninsured working poor are in those states". Many of the states are in the South, and while the states' congressmen insist their opposition is solely economic, and not racial, it raises some serious questions. Also in question is whether cases like Mr. Carter's are anomalies, or whether they will snowball into significant rallying-cries for these 26 states to accept Medicare expansion, or introduce policy to solve eligibility issues.
Kay Bradley

The Republican Ticket Twists the Facts About Health Care - NYTimes.com - 0 views

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    Some facts on the health care dilemma
racheladams23

Q&A: 'Obamacare' health law - 1 views

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    This article explains the basics of the ACA: it requires all Americans to purchase health insurance ,and "requires business with more than 50 full-time employees to offer health coverage". It also gets rid of the problem of people being denied health care for pre-existing conditions. The article says that Republicans oppose the law because they think it "imposes too many costs on business", interferes in private affairs, and is a "job-killer".
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    Yes, the ACA's "success [certainly] depends in large part on co-operation from state governments". And that's one of the root issues right now.
Kay Bradley

Bitter Pill: Why Medical Bills Are Killing Us | TIME - 0 views

  • MD Anderson’s clinical billing and collection practices are similar to those of other major hospitals and academic medical centers.”
  • The hospital’s hard-nosed approach pays off. Although it is officially a nonprofit unit of the University of Texas, MD Anderson has revenue that exceeds the cost of the world-class care it provides by so much that its operating profit for the fiscal year 2010, the most recent annual report it filed with the U.S. Department of Health and Human Services, was $531 million. That’s a profit margin of 26% on revenue of $2.05 billion, an astounding result for such a service-intensive enterprise.1
  • Ronald DePinho’s total compensation last year was $1,845,000. That does not count outside earnings derived from a much publicized waiver he received from the university that, according to the Houston Chronicle, allows him to maintain unspecified “financial ties with his three principal pharmaceutical companie
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  • I got the idea for this article when I was visiting Rice University last year. As I was leaving the campus, which is just outside the central business district of Houston, I noticed a group of glass skyscrapers about a mile away lighting up the evening sky. The scene looked like Dubai. I was looking at the Texas Medical Center, a nearly 1,300-acre, 280-building complex of hospitals and related medical facilities, of which MD Anderson is the lead brand name. Medicine had obviously become a huge business. In fact, of Houston’s top 10 employers, five are hospitals, including MD Anderson with 19,000 employees; three, led by ExxonMobil with 14,000 employees, are energy companie
  • n the U.S., people spend almost 20% of the gross domestic product on health care, compared with about half that in most developed countries. Yet in every measurable way, the results our health care system produces are no better and often worse than the outcomes in those countries.
  • nting doctors, hospitals, nursing homes, health services and HMOs, have spent $5.36 billion since 1998 on lobbying in Washington. That dwarfs the $1.53 billion spent by the defense and aerospa
  • When Obamacare was being debated, Republicans pushed this kind of commonsense malpractice-tort reform. But the stranglehold that plaintiffs’ lawyers have traditionally had on Democrats prevailed, and neither a safe-harbor provision nor any other malpractice reform was included.
  • We’re likely to spend $2.8 trillion this year on health care. That $2.8 trillion is likely to be $750 billion, or 27%, more than we would spend if we spent the same per capita as other developed countries, even after adjusting for the relatively high per capita income in the U.S. vs. those other countries.
alisimons

Integrating the Political: Studying Mental Health in the Occupied Territories - 1 views

    • alisimons
       
      This article discusses the mental health of Palestinian youth while also explaining how politics ties into mental health. According to the author, political conditions can strongly affect people's quality of life. A country's people can not have good mental health overall if there is a lack of justice and an overwhelming number of political disputes.
Kay Bradley

Police Reform Is Necessary. But How Do We Do It? - The New York Times - 0 views

  • The United States spends more on public safety than almost all its peer countries and much less, relatively speaking, on social services
  • Now we’re having a conversation that’s not just about how black communities are policed, and what reforms are required, but also about why we’ve invested exclusively in a criminalization model for public safety, instead of investing in housing, jobs, health care, education for black communities and fighting structural inequality.
  • Budgets are moral documents, reflecting priorities and values.
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  • Garza: In 2018 and 2019, my organization, Black Futures Lab, did what we believe is the largest survey of black communities in America. It’s called the Black Census Project. We asked more than 30,000 black people across America what we experience, what we want to see happen instead and what we long for, for our futures.
  • the No.1 issue facing them, and keeping them up at night, is that their wages are too low to support a family.
  • Imagine that you have a tool chest for solving social problems. It gives you options. Then you lose the tool of mental-health resources. You lose the tool of public education. They take out the tool of job placement. And then all you’ve got left is this one rusty hammer. That’s policing.
  • Simply defunding the police cannot be a legacy of this moment. I want to hear about investing in black communities more than I want to hear about defunding.
  • There has been such a massive disinvestment in the social safety net that should exist to give black communities an opportunity to thrive, whether it’s access to health care or housing or education or jobs.
  • They cause others to be armed, out of fear, who shouldn’t have to worry about defending themselves
  • The dispatcher would route calls that aren’t about crimes or a risk of harm to social workers, mediators and others.
  • In many cities, the police spend a lot of time “on traffic and motor-vehicle issues, on false burglar alarms, on noise complaints and on problems with animals,”
  • When a police report leads to criminal charges — only a subset of the whole — about 80 percent of them are for misdemeanors. Friedman argues that we should hand off some of what the police do to people who are better trained for it.
  • A tiny percentage of people are the ones destabilizing communities
  • There are a host of things that the police are currently responding to that they have no business responding to.
  • If you have a car accident, why is somebody with a gun coming to the scene?
  • Or answering a complaint about someone like George Floyd, who the store clerk said bought a pack of cigarettes with a counterfeit $20 bill?
  • Similarly, if you have a homeless man panhandling at a red light and you say to a cop, “Go fix it,” he’ll arrest the man. And now he has a $250 ticket. And how does he pay that? And what does any of this accomplish?
  • domestic disputes. They’re the subject of 15 to more than 50 percent of calls to the police
  • But might we get further in the long run if someone with other skills — in social work or mediation — actually handled the incident?
  • The women were deeply wary of the police in general, but 33 of them had called them at least once, often for help with a teenager. “Calling the police on family members deepens the reach of penal control,” Bell wrote. But the mothers in her study have scant options.
  • hey knew that if they called the police that real harm could come, and they didn’t want that.
  • When I did investigations for the Justice Department, I would hear police officers say: “I didn’t sign up to the police force to be a social worker. I don’t have that training.” They know they’re stuck handling things because there is a complete lack of investment in other approaches and responses.
  • In Eugene, Ore., some 911 calls are routed to a crisis-intervention service called Cahoots, which responds to things like homelessness, substance abuse and mental illness. Houston routes some mental-health calls to a counselor if they’re not emergencies. New Orleans is hiring people who are not police officers to go to traffic collisions and write reports, as long as there are no injuries or concerns about drunken driving. I’m borrowing these examples from Barry Friedman’s article. The point is that some cities are beginning to reduce the traditional scope of police work.
  • One of the most interesting studies about policing is a randomized comparison of different strategies for dealing with areas of Lowell, Mass., that were hot spots for crime. One was aggressive patrols, which included stop-and-frisk encounters and arrests on misdemeanor charges, like drug possession. A second was social-service interventions, like mental-health help or taking homeless people to shelters. A third involved physical upkeep: knocking down vacant buildings, cleaning vacant lots, putting in streetlights and video cameras. The most effective in reducing crime was the third strategy.
Kay Bradley

A History of Overhauling Health Care - Interactive Feature - NYTimes.com - 0 views

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    100 years of overhauling health care in the US
alisimons

WHO | Mental health in emergencies - 1 views

shared by alisimons on 03 Dec 15 - No Cached
    • alisimons
       
      This fact sheet explains how emergencies can heighten the need for mental health care, as traumatic events can induce or worsen a mental illness. WHO outlines what effective responses look like and asserts that sometimes emergencies can be good for people's mental health because the aftermath could be much better mental health systems.
alisimons

Human rights abuses 'leave a third of Libyans with mental health problems' | World news... - 1 views

    • alisimons
       
      This article shares statistics that demonstrate the prevalence of mental health issues in Libya as a result of human rights violations. Most notably, the article asserts that around a third of Libyans have mental health problems. The article also lists the most popular reasons for the increase in mental illness as well as the most popular treatments (which for many is none because of the social stigma).
syeh98

Does debt relief improve child health ? evidence from cross-country micro data (English... - 4 views

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    This research paper looks into the data behind debt relief and its correlation with infant mortality. Many studies were conducted in countries that were deep in debt, infant mortality was also very high in these countries. The researches found that when these countries received debt relief, the infant mortality rate goes down by ~0.5%.
ejeffs

Child suicide attempts on the rise in besieged Syrian town - 1 views

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    In Syria, there has been a rise in child suicide rates. Due to living in war conditions for years, the children have become psychologically disturbed. They do not laugh or dance anymore. Not only that, but they are not able to recieve even basic health nececities, which only leads to more death and poorer living conditions.
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    There has been a major increase in suicides from children as young as 12 in a war torn Syrian town. These suicides are linked to a major increase among depression and paranoia, along with a lack of mental health support as well as basic medical care. In school, teachers note that the kids no longer laugh as they used to, and draw pictures of the war.
Katie Despain

Leadership and Calm Are Urged in Ebola Outbreak - 2 views

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    In order to remedy Ebola, Nations most affected by the virus, namely Guinea, Liberia, Nigeria and Sierra Leone, must allow their leaders to calm and heal the general public. If political and social leaders fail to eradicate the disease, the number of people infected will quickly rise from 3000 to 20,000. So far, several countries have mismanaged the outbreak. Governments quarantined rural and urban areas of aforementioned African countries; a slum in Monrovia, the Capitol of Liberia, was one of the blocked off places. Instead of helping the people, as intended, the quarantines trap people. These people feel disregarded and sentenced to death. Fear causes people to run from the spaces and further spread Ebola, defeating the purpose of the quarantine. Even if African governments take necessary steps to prevent the spread of the disease, Western aid is still essential. Western countries should not supply weapons to help contain quarantines, but rather provide medicine and experienced medical personnel. Unfortunately, the pay is not high enough for many medics to risk their lives treating a disease that is the highest risk to doctors and nurses. The solution to Ebola is not an obvious one; the entire process is experimental. However, U.N. experts say a medical center need be established in West Africa where representatives of every African country can convene to discuss the disease.
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    Very interesting article. It is interesting how psychology must be considered in giving aid to African countries infected with Ebola (for example, the article mentions that soldiers shouldn't brandish their weapons so Ebola patients won't be afraid of the quarantine). The quarantines seem like an extra cause for panic. Imagine a Liberian seeing a quarantine being set up. Do you think they would act calmly and happily admit themselves to the quarantine, or just simply run away and spread the virus further?
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    Great analysis--see quotes below--but my question is, can the widespread response that is needed actually be pulled together? Especially, can it be pulled together fast? "Most agreed on many basic principles. All, for example, were sure the outbreak could be stopped without experimental drugs or vaccines. None expected it to take less than six months." "Pay is also an issue, experts said. Health workers taking huge risks must be compensated, and so must their families if they die." "Also, this outbreak is like SARS in that doctors and nurses are in the highest risk group. Training must be extra-thorough - especially in taking off protective gear that might be smeared with virus. Nigeria, for example, does not let anyone near victims without three days of training on wearing protective gear, said its health minister, Dr. Onyebuchi Chukwu." "The new W.H.O. road map calls for 12,000 local health workers and 750 expatriates." ""There's no part of this you can't break down and make work," Dr. Aylward said. "But it took us 20 years to build the polio response, and this has to be done in 20 days."
Kay Bradley

Opinion | Who Killed the Knapp Family? - The New York Times - 0 views

  • The United States wrested power from labor and gave it to business, and it suppressed wages and cut taxes rather than invest in human capital, as our peer countries did. As other countries embraced universal health care, we did not; several counties in the United States have life expectancies shorter than those in Cambodia or Bangladesh.
  • A low-end worker may not have a high school diploma and is often barely literate or numerate while also struggling with a dependency; more than seven million Americans also have suspended driver’s licenses for failing to pay child support or court-related debt, meaning that they may not reliably show up at work.
  • If we’re going to obsess about personal responsibility, let’s also have a conversation about social responsibility.
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  • First, well-paying jobs disappeared, partly because of technology and globalization but also because of political pressure on unions and a general redistribution of power toward the wealthy and corporations.
  • Second, there was an explosion of drugs — oxycodone, meth, heroin, crack cocaine and fentanyl — aggravated by the reckless marketing of prescription painkillers by pharmaceutical companies.Third, the war on drugs sent fathers and mothers to jail, shattering families.
  • Both political parties embraced mass incarceration and the war on drugs, which was particularly devastating for black Americans, and ignored an education system that often consigned the poor — especially children of color — to failing schools. Since 1988, American schools have become increasingly segregated by race, and kids in poor districts perform on average four grade levels behind those in rich districts.
  • we should be able to agree on what doesn’t work: neglect and underinvestment in children.
  • Job training and retraining give people dignity as well as an economic lifeline. Such jobs programs are common in other countries.
  • The United States focused on money, providing extended unemployment benefits. Canada emphasized job retraining, rapidly steering workers into new jobs in fields like health care, and Canadian workers also did not have to worry about losing health insurance.
  • For instance, autoworkers were laid off during the 2008-9 economic crisis both in Detroit and across the Canadian border in nearby Windsor, Ontario.
  • Another successful strategy is investing not just in prisons but also in human capital to keep people out of prisons.
  • Women in Recovery has a recidivism rate after three years of only 4 percent, and consequently has saved Oklahoma $70 million in prison spending, according to the George Kaiser Family Foundation.
  • We need the government to step up and jump-start nationwide programs in early childhood education, job retraining, drug treatment and more.
  • Nicholas Kristof
astas2021

As Fighting Surges, Yemen Is Hit With 1st Cluster of Covid-19 Infections - The New York... - 6 views

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    Yemen (on April 29th of this year) had an outbreak of 5 COVID cases, and an immediate 2-week lockdown was imposed. Though that number seems quite small, the health system was quickly overrun. This is because Yemen's health department has been "devastated by war," and though Saudi Arabia declared a unilateral cease-fire on April 9th, airstrikes by a Saudi-led coalition increased 30% from April 22nd - 29th. Even pre-COVID, Yemen had a cholera outbreak in January, quickly exacerbate by torrential rains and putting 5 million children under the age of 5 at risk.
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    A coronavirus outbreak in Yemen poses a dire threat that will add to the conditions that have been increased by the war. Yemen's health care system has been devastated by the war and is in no means able to handle a pandemic. Moreover, the increase in airstrikes lead by Saudi Arabia, despite a cease-fire, can and will increase the spread of the virus. Humanitarian efforts will decrease as a result and the already wrecked healthcare system will suffer more. It is clear the U.S and other members of the UN security council need to put pressure on Saudi Arabia to implement a cease fire.
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    I think that it's also important to mention that the United States is complicit in the crisis in Yemen. We not only provide support to Saudi Arabia but sell them weapons, most importantly bombs, that are used against Yemeni civilians. A bipartisan bill to end US involvement in the war passed the Senate last year, but was vetoed by President Trump. Not many people seem to know about our role in the war, and that needs to change.
Kay Bradley

Interviews - Uwe Reinhardt & Tsung-Mei Cheng | Sick Around The World | FRONTLINE | PBS - 0 views

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    "James Madison Professor of Political Economy"
sammy greenwall

Obama's new argument has nothing to do with what he originally proposed - 0 views

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    Although the affordable health care act is providing insurance for those who can't afford, many details were left off when Obama was originally selling the bill in 2008. He never argued that younger, healthier people would have to pay more, or that health care would go up exponentially by those who already had it. Obama is now claiming that it is only "right" for everyone to have healthcare, but he seemed to forgo the idea of the average healthy American paying more when he was running for president 5 years ago.
olivialum

India's Inverted Abortion Politics - The New York Times - 2 views

  • If the limits are allowed to stand, self-induced abortions are expected to rise, leading to an escalation of health dangers to women, particularly those who can’t afford to travel for help.
  • The government is trying to reduce the qualifications required of providers so that poor women will have easier access to abortions, while doctors are the ones opposing this relaxation of rules.
  • taboo in the religiously conservative country.
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  • The primary reason advanced for this opposition — concern for women’s health — is just as specious in India as it is in America.
  • given the pressure on Indian women to bear sons, the rule would promote more abortions of female fetuses
  • government’s promotion of alternative medicine as a medically equivalent but cheaper alternative to allopathic (modern) medicine.
  • scaled back its proposal to include only drug-induced procedures, a compromise allopathic doctors should accept.
miriambachman

Ethiopia Health Stats - 0 views

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    Provides statistics related to water accessibility specifically in Ethiopia- includes birth rate, infant mortality, life expectancy, disease, HIV and AIDS
miriambachman

Health > Drinking Water Availability %: Countries Compared - 0 views

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    Provides comparison of drinking water availability percentages across several countries (Includes graphics)
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