what is the state of global health? in south africa, a train supports those with no access to healthcare. in some parts of mexico, soft drinks flow more freely than water. and bolivia's traditional healers are finding their place in the modern world. ♪

reporter: cicilia mpanza got up in the middle of the night to be here on time. the journey by bus took 1.5 hours. the transnet-phelophepa train is a free, mobile healthcare clinic that travels around south africa. cicilia mpanza has had problems with her eyesight for a few months now. cicilia: i'm not in a hurry. i'm here to get help. that's the main thing. and i'll only leave once i've seen someone. reporter: she can't even read the bible anymore, she says. she used to have glasses, but they don't help now, and she can't afford new ones. the nearest doctors and hospitals are far away and expensive. cicilia: when someone comes towards me, i can make out that it's a person, but i can't see their face, i can't see who it is. reporter: now she's seen a doctor, she'll get a new pair of glasses, which will make her life much,

much easier. the phelophepa healthcare train has 18 coaches and facilities to conduct general health checks and supply patients with medicine. there are even psychologists on board. launched in 1994, the phelophepa trains run 36 weeks a year and travel to up to 70 remote communities annually. for the next two weeks, the train is in hluhluwe, a small town in the province of kwazulu-natal. manager thelma satekge is in charge. thelma: we also have to put into consideration the resources that we have. at some point, we have to retain them for the next day, because there are a lot of patients that come to the train. reporter: there's a huge demand for the service, she explains.

every day, hundreds of people come seeking treatment. satekge is a qualified ophthalmologist but has spent her entire working life here on the train, helping people without access to state healthcare. thelma: two weeks is never enough. it can never be enough. so we do what we can, we do the most that we can. reporter: she spends nine months a year travelling the country. she speaks to her four children every day, but has never been able to take part in their daily lives. that's how it's always been, but it's not easy. thelma: there's no way you can't miss your family, but also, i love what i do, helping the vulnerable people that might not have gotten help if the train didn't get to their place. reporter: the phelophepa train is a huge logistical operation, funded by south africa's state-owned rail

company. for many in rural south africa, it's the only way to get comprehensive medical treatment. as part of its outreach efforts, the doctors also visit local communities. we accompany a team to an elementary school about 30 minutes away. they're showing the children how to brush their teeth. a toothbrush for each child, the first for many. the doctors give them all a quick check up. if there's a problem that needs treatment, they have to go to the train. simphiwe: if people have access to shops and, you know, some kind of place where they can buy sweets and things like that, you'll find that those kids are more prone to dental care. but not in deep rural areas, where kids only eat what their parents grow on the ground. reporter: treatment doesn't cost much.

a tooth extraction, for example, costs the equivalent of less than one euro. back to cicilia mpansa. in the optician's coach, she's given a pair of glasses for everyday use, and also a pair of reading glasses. she pays just under two euros for each pair. cicilia: it makes such a difference. i can even see that man over there, from where i'm sitting. i can see much more clearly. kgomotso: it's a good feeling to be helping somebody. it's amazing what two pieces of lenses can do to a person's life. reporter: cicilia mpanza lives in a remote corner of the country and gets about 2000 rand -- that's approximately 100 euros a month from the state. that's all she, her daughters, and her grandchildren have to

live on. they often don't even have enough to eat. cicilia: if one of my grandchildren fell ill, i'd have nothing. if i could i would take him to hospital, but i've got no money. we'd just have to wait for his cough to go away by itself. reporter: her failing eyesight had been making it increasingly hard to for her to look after her grandchildren. she could barely see. cicilia: i couldn't even read the bible. i never picked it up. when my grandchildren needed medicine, they had to wait for their mothers to come home because i couldn't read the instructions. but now i can see clearly again. reporter:

cicilia mpanza hopes her eyesight won't continue to worsen. it could be some time before the phelophepa train comes back. the last time it stopped in hluhluwe was in 2001, more than 20 years ago. host: why is malaria continuing to spread? reporter: you know this sound? [mosquito buzzing] not only is it annoying, it can also be dangerous. because mosquito-borne malaria kills upwards of 600,000 a year and that figure might be set to rise. new research shows that malaria-transmitting mosquitos are moving 4.7 kilometers away from the equator, and 6.5 meters higher in altitude every year. that's because animals are migrating further and higher to cooler places, as the climate crisis intensifies, making it harder to contain the disease. especially in badly affected areas, sub-saharan africa and south asia. and the world health organization has so far only endorsed one malaria vaccine, despite decades of efforts to develop one. so containing the spread of malaria might just start with cutting carbon emissions.

reporter: a serenade in honor of their friend who died much too young from diabetes. the mariachi play at funerals for diabetics all too often. fermin: there are so very many. especially during covid-19, a lot of people with diabetes died. miguel: lots of my relatives have the disease. friends and other musicians. reporter: diabetes is the second leading cause of death in chiapas. the state is known for its rolling hills, quaint villages, indigenous culture, and its coca-cola consumption. not everyone has electricity. the tap water is often undrinkable. coco cola, however, is available everywhere. two liters of the soft drink are drunk per person every day here, a world record. the number of deaths caused by

diabetes doubled between 2011 and 2021. doctor marcos arana checks what is on offer at a school kiosk and finds only junk food. he says the companies deliberately target children. marcos: we know from studies that these products make up almost a third of the total calories consumed by children. coca-cola is the most widely available soft drink. reporter: arana speaks of coca-cola colonization. through aggressive marketing, the fizzy drink has even hijacked mayan ceremonies. shaman pascuala diaz says that it appeases the gods. her patient also suffers from diabetes. many healers replaced alcohol with soft drinks because they seemed to be the lesser evil. coca-cola now accompanies the prayers of bygone generations.

sugar is not the cause of her patient's diabetes, she says. pascuala: this woman has anxiety and dreams a lot. it has made her sick. that's why i do this cleansing. reporter: junk food is readily available here and has come to replace the traditional diet of maize, beans, and chili. and then there's the water problem. coca-cola is permitted to tap more than a million liters of water every day, all approved by the state, says marcos arana. fizzy drink is often easier to get than clean drinking water. marcos: nobody is monitoring how much water is actually being taken. there's no oversight. the growing scale of production at this plant puts the supply for the rest of the population at risk. reporter: the company refutes this,

saying it is not taking water away from anyone. instead, it donates water tanks and recycling containers, and has reduced the amount of sugar in many of its products. the neighboring state of oaxaca is not relying on that. teacher diana lopez has declared war on soft drinks. one in three children is overweight. she counts the spoons of sugar in a single glass of soda. diana: we drink this amount of sugar in a single glass. does it sound like you should drink that? reporter: the children learn how soft drinks are harmful to health. but in many families, coca-cola is a by-word for hospitality. a law in oaxaca prohibits the sale of junk food to minors. however, its implementation has been stalled. diana: however, if we sent any child

into a shop, they would be able to buy sugary foods, because the vendors don't know. the authorities are not doing their job. reporter: who is enforcing? often no one. activists also have to contend with the widespread belief that coca-cola has healing properties. tania: we are a country with poor water quality. you can find soft drinks even in places where there is no electricity. people become addicted to sugar. reporter: back in chiapas, doctors face an overwhelming wave of diabetes cases. it is a mammoth task educating people and testing their blood sugar, because many people don't know that they have the disease. darwin gomez feels abandoned by politicians. darwin: we need to educate children better. they are the future of our country and could help fight

this problem which is considered a global pandemic. reporter: shaman pascuala diaz ends the spiritual cleansing with a soft drink. but not coca-cola, she says. pascuala: a lot of people only drink coca-cola, but too much sugar isn't good for them. reporter: but the pineapple soda also contains sugar. the road back to healthy eating is long, and kicking bad habits is the hardest part. reporter: for centuries, legendary medicine men, the kallawaya, lived close to lake titicaca. they were the doctors of the

incan kings, often called witches of the andes. what remains of this culture today? we met aurelio ortiz, who calls himself one of the last kallawaya. aurelio: we kallawaya know the medicinal properties of roots, flowers, leaves, and fruits. i received my extensive knowledge about plants from my grandparents. look at this moss. you can cure many people who have been put in psychiatric wards with it. in traditional western medicine, you just call these people crazy. reporter: aurelio also has remedies for

alzheimer's and cancer, but he won't tell us exactly which ones. a patient from the capital city of la paz has arrived at his practice. aurelio welcomes the young man between stuffed cats, tinctures, herbs, and roots. yasmani arze requested a ritual with coca leaves. yasmani: i want to know from aurelio what i need to do to live a healthier life. and i need advice for my life, my emotional world, and the future of my work. reporter: based on the shape of the coca leaves, aurelio interprets whether someone will come into money, stay healthy, or be blessed with good fortune. but he also analyzes his

patients' pasts. aurelio: yasmani has endured emotional traumas. his wife cheated on him and he was in a car accident. both of these things have really scarred and shaken him. that is why he's so reserved now. reporter: a ritual to heal emotional scars is prescribed. aurelio assures us that he's already been able to heal cancer patients with his natural medicine. we couldn't verify this. aurelio also shares his knowledge with non-indigenous townspeople. guests from chile are waiting for aurelio in his kitchen. they want to stay here for several weeks to study traditional kallawaya healing methods. benjamin: in the big cities, our relationships with each other

are often toxic. this affects our energies and our soul. so there are many good reasons to learn about ancient medicine from people who still live in harmony with nature. reporter: at this hospital in the kallawaya valley, the chief physician daniel fernandez has respect for healers like aurelio. not least because many of his patients ask for them. daniel: whoever wants to, can get pills from me first and then be treated by a kallawaya healer, who then prescribes an additional natural herbal medicine. reporter: pharmacies are almost nonexistent in the provincial capital charazani, because the strong tradition of alternative medicine has been preserved here. dozens of kallawaya like

aurelio live in the valley, but they also feel the modern world moving ever closer. aurelio: the foreign, western culture and its thinking are coming closer and closer to us. but i think our healing medicine will still remain strong and important, even if our children suddenly only play with smart phones. reporter: centuries-old traditions live alongside a new, digital generation, a generation that plays computer games on their smartphones after school, on the slopes of the andes, where they can still get cell phone service. a little further on, it's time for yasmani arze, a city dweller, to cleanse his soul. yasmani:

i feel the power and peace of the soil of the earth, and contact with nature. reporter: while the offering of wax flakes with icing melts, aurelio tries to bring yasmani arze's soul in balance with prayer. like so many others before him. aurelio: with each passing year, people are moving further and further away from mother nature. that's why it's clear that there will be many diseases, droughts, earthquakes, and seaquakes. how can we save ourselves? these rituals help us pay atonement to mother nature. reporter: it's a stark contrast to the accelerated pace of the modern world that lives on regardless, with the kallawaya healers of bolivia.

host: around one billion people worldwide live with physical or mental disabilities. having a disability can make working and living an independent life difficult. but that doesn't have to be the case. reporter: 6:30 a.m. it's pretty early, but miriam duran is heading to work. the bus has already picked up around 30 people. some live together in residential units. others, like miriam, live with their parents. she says school was never her thing. but the early shift? that's no problem. miriam: i prefer working mornings to afternoons. afternoons are bad. in the morning, it's still nice and cool, and after work, you still have the whole afternoon free. reporter:

but not everyone's an early bird. some are still half asleep. a few have someone to snuggle with, or hold hands. the factory where they work is called “la fageda,” catalonian for “beech grove.” nestled in this nature reserve are 16 hectares of factory buildings, vegetable gardens, and pastures. miriam duran operates the packaging machine. her colleague folds boxes. everyone does jobs that suit their skill level. miriam: you have to concentrate. there are a lot of things that you have to keep your eye on. refilling the packing sleeves, for example. everything has to be just right for our customers. reporter: 100 million yogurts are manufactured here every year. in catalonia and on the balearic islands, the brand is a top seller.

la fageda puts a premium on inclusion in its workforce, while making sure its products are a success. and yet, some things are different here, like the affection so readily on display. teresa: really, i think more factories should be like ours. because it's a good way to work. we're all human, we all need a hug, or some recognition, even if it's as simple as someone asking, how are you doing? reporter: here, the work is made to fit the people, not the other way around. that's why some workers can take an extra break. or one person does a job, while others watch and learn. listening is important, too. miriam duran has regular meetings where she can discuss how she's doing, and if there's anything she wants to change. maria colón is a psychologist. her father is the founder of la

fageda. she says it frustrated him that people in psychiatric care were rarely given anything meaningful to do. maria: work has to produce something that people find useful, something that they'll buy. it doesn't matter if it''s a product or a service, but it should contribute something to society. reporter: whatever their disability, everyone here knows their contribution is valued. a few years ago, la fageda added jam to its product range. it's also been selling well, and that makes the people here proud. jaime: one thing is clear -- ours is the best. we make it with a lot of love and that's really important. reporter: whether jam or yogurt, the same thing always applies -- people are more important than boosting productivity.

when demand increased, la fageda could have bought more machines to speed up production. instead, the company bought more pots and hired more workers. making things by hand is not cheap. la fageda's yogurt costs 30% more than the competition. and yet, it's the market leader in catalonia and the balearic islands. maybe, because the raw ingredients are so fresh. from cow to container, everything is on-site, and it's been that way for decades. regional and sustainable, long before it was the trend. but as to who was making the yogurt, most consumers had no idea. silvia: we want people to buy our products because they're good, not because they feel pity. in supermarkets, we're competing against big multinational corporations.

reporter: over the years, the company has had to reinvent itself a few times. new products, more marketing. surviving in business isn't easy. but the most important thing has been to employ as many people as possible. miriam duran says there's nowhere else she would rather work. miriam: i have a lot of fun here with my co-workers. we get along, we trust one another. i hope to work here until i retire. anything else would be bad, because i'd have to go somewhere else. reporter: la fageda has been around for 40 years. and no one here is really worried about the future. as they say, if people stop wanting yogurt, then they'll make tomato sauce. either way, they're confident the company will be here for at least another 40 years. ♪ [captioning performed by the national captioning institute, which is responsible for its caption content and accuracy.

visit ncicap.org]

♪ phil: this is dw news, live from berlin. was ukraine involved in the sabotage of the nord stream 2 gas pipelines? new footage of explosions rupturing the pipes meant to carry gas from russia to germany. also on the program, the kremlin