Inter Press Service » Health http://www.ipsnews.net Turning the World Downside Up Tue, 23 Sep 2014 08:23:01 +0000 en-US hourly 1 http://wordpress.org/?v=3.9.2 Saving the Lives of Cameroonian Mothers and their Babies with an SMShttp://www.ipsnews.net/2014/09/saving-the-lives-of-cameroonian-mothers-and-their-babies-with-an-sms/?utm_source=rss&utm_medium=rss&utm_campaign=saving-the-lives-of-cameroonian-mothers-and-their-babies-with-an-sms http://www.ipsnews.net/2014/09/saving-the-lives-of-cameroonian-mothers-and-their-babies-with-an-sms/#comments Tue, 23 Sep 2014 08:23:01 +0000 Ngala Killian Chimtom http://www.ipsnews.net/?p=136820 According to an African proverb, “every woman who gives birth has one foot on her grave.” Cameroonians are attempting to make this proverb a historical fact and not a present reality through SMS technology. Credit: Mercedes Sayagues/IPS

According to an African proverb, “every woman who gives birth has one foot on her grave.” Cameroonians are attempting to make this proverb a historical fact and not a present reality through SMS technology. Credit: Mercedes Sayagues/IPS

By Ngala Killian Chimtom
YAOUNDE, Sep 23 2014 (IPS)

“You can’t measure the joy in my heart,” Marceline Duba, from Lagdo in Cameroon’s Far North Region, tells IPS as she holds her grandson in her arms.  

“I am pretty sure we could have lost this child, and perhaps my daughter, if this medical doctor hadn’t shown up,” Duba says, a smile sweeping her face.

The medic in question is Dr Patrick Okwen. He is the coordinator of M-Health, a project sponsored by the United Nations Population Fund (UNFPA) that uses mobile technology to increase access to healthcare services to communities “when they most need it.”

The World Health Organisation (WHO) recommends that a nurse or doctor should see a maximum of 10 patients a day. But according to Tetanye Ekoe, the vice president of the National Order of Medical Doctors in Cameroon, “the doctor-to-patient ratio in Cameroon stands at one doctor per 40,000 inhabitants, and in remote areas such as the Far North and Eastern Regions, the ratio is closer to one doctor per 50,000 inhabitants.”

Okwen was in Lagdo testing out the SMS system, which was just implemented a few months back, when Duba’s daughter, Sally Aishatou, went into labour.

Okwen and the medical staff at the Lagdo District Hospital received an SMS from Aishatou. She had been in labour for 48 hours with no signs that the baby was about to come.

“What happens when a woman SMSes a particular number, the GPS location blinks on the server, and then the server tries to identify her location, puts it on Google maps; then tells the driver to go there. [The system] also tells the doctor to come to the hospital; tells the nurses to get ready. So everybody gets into motion,” he tells IPS.

Okwen and the ambulance driver traced Aishatou to her home. They found her lying helpless on a mat, almost passed out. By the time the ambulance returned to the hospital, the operation room was ready for her and she was taken into surgery immediately.

Eight minutes later, her 4.71 kg baby boy was born. The midwife Manou nee Djakaou tells IPS: “The joy in me is so great that I don’t even know how to express it. I am so exited; very happy. This system put in place is very efficient. But for this innovation, we stood to lose this baby and its mother.”

Two hours after surgery, Aishatou regained consciousness and named her boy after Okwen.

Forty percent of women in Cameroon’s Far North Region lose their lives while giving birth, according to the WHO.

According to the U.N. Children’s Fund (UNICEF), out of every 100,000 live births 670 women in Cameroon die. UNICEF figures also state that for every 1,000 live births, 61 infants died in Cameroon in 2012.

“Many women are dying from child-birth related issues. Women are dying while giving life. And this is something we are really concerned about, but we also know that with the coming of mobile technology, there is hope for women in Africa,” Okwen says.

“Most of the women in Africa today have access to a telephone. It could be her own, her husband’s own, or a neighbour’s. So if we had a way in which women could reach an ambulance using a phone that would guide the ambulance, it could indeed present hope for African women,” he explains.

Okwen says the project has benefitted “close to one hundred women in terms of information, evacuation, arrangements of hospital visits, deliveries and caesarean sections.”

The project has been dubbed “Tsamounde”, which means hope in the local Fufuldé language.

Mama Abakai, the Mayor of Lagdo, says the project’s impact has been far reaching.

“A lot of our sisters, wives and mothers in rural areas lose their lives and suffer a lot, because there is a communication gap, and a problem of rapid intervention and assistance. With this system, it suffices to send an SMS or a simple beep, and all the actors involved in saving lives are mobilised…its formidable,” Abakai tells IPS.

Dr. Martina Baye of Cameroon’s Ministry of Public Health calls the project a “revolution in Cameroon’s health care delivery system.”

She says that as a majority of women in the country’s far North Region have little access to healthcare services, the M-Health Project comes as a huge relief.

According to the 2010 Population census, the Far North Region has a population of three million people, 52 percent of whom are women.

“We look forward to using this technology in other parts of the country,” she tells IPS.

Edited by: Nalisha Adams

The writer can be contacted at: https://www.facebook.com/ngala.killian

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OPINION: Invest in Young People to Harness Africa’s Demographic Dividendhttp://www.ipsnews.net/2014/09/opinion-invest-in-young-people-to-harness-africas-demographic-dividend/?utm_source=rss&utm_medium=rss&utm_campaign=opinion-invest-in-young-people-to-harness-africas-demographic-dividend http://www.ipsnews.net/2014/09/opinion-invest-in-young-people-to-harness-africas-demographic-dividend/#comments Sun, 21 Sep 2014 22:09:25 +0000 Dr. Julitta Onabanjo, Benoit Kalasa, and Mohamed Abdel-Ahad http://www.ipsnews.net/?p=136771

Julitta Onabanjo is Regional Director, UNFPA East and Southern Africa. Benoit Kalasa is Regional Director, UNFPA West and Central Africa. Mohamed Abdel-Ahad is Regional Director, UNFPA North Africa and Arab States.

By Julitta Onabanjo, Benoit Kalasa, and Mohamed Abdel-Ahad
JOHANNESBURG, Sep 21 2014 (IPS)

Different issues will be competing for the attention of different African leaders attending the 69th United Nations General Assembly Special Session on International Conference on Population and Development (ICPD) Beyond 2014 in New York on Sep 22.

But the central question for Africa’s development today is this: How do we harness the dividend from the continent’s current youthful population?

Solving this issue has never been more fundamental to Africa’s development than it is today.

For decades many, African countries have come up with a variety of ‘development’ plans. But often missing in these documents is how best to harness the potential of the youthful population for the transformation of the continent.

Therefore, strategic investment to harness the potential of the youth population can no longer wait.“African governments must know that efforts to create a demographic dividend are likely to fail as long as vast portions of young females are denied their rights, including their right to education, health and civil participation, and their reproductive rights”

The groundswell for change

Africa is undergoing important demographic changes, which provide immense economic opportunities. Currently, there are 251 million adolescents aged 10-19 years in Africa compared with 1.2 billion worldwide, which means that around one in five adolescents in the world comes from Africa.

Africa’s working age population is growing and increasing the continent’s productive potential. If mortality continues to decline and fertility declines rapidly, the current high child dependency burden will reduce drastically. The result of such change is an opportunity for the active and employed youth to invest more.  With declining death rates, the working age population in Africa will increase from about 54 percent of the population in 2010 to a peak of about 64 percent in 2090.

This increase in the working age population will also create a window of opportunity  that, if properly harnessed, should translate into higher economic growth for Africa, yielding what is now termed a ‘demographic dividend’ – or accelerated economic growth spurred by a change in the age structure of the population.

Reaping the demographic dividend requires investments in job creation, health including sexual and reproductive health and family planning, education and skill and development, which would lead to increasing per capita income.

Due to low dependency ratio, individuals and families will be able to make savings, which translate into investment and boost economic growth. This is how East Asian countries (Asian Tigers) were able to capitalise on their demographic window during the period 1965 and 1990.

The impact of such a demographic transition on economic growth is no longer questionable – it is simply a fact.

But this transformation requires that appropriate policies, strategies, programs and projects are in place to ensure that a demographic dividend can be reaped from the youth bulge.

Seizing the moment

Without concerted action, many African countries could instead face a backlash from the growing numbers of disgruntled and unemployed youth that will emerge.

In the worst-case scenario, such a demographic transition could translate into an army of unemployed youth and significantly increase social risks and tensions.

To seize the opportunity, African states will need to focus their investments in a number of critical areas. A priority will be the education and training of their youth.

African governments must know that efforts to create a demographic dividend are likely to fail as long as vast portions of young females are denied their rights, including their right to education, health and civil participation, and their reproductive rights.

If these efforts are to succeed, this will demand addressing gender disparities between today’s boys and girls especially, but more specifically, addressing the vulnerabilities of the adolescent girl.

Beyond rhetoric

As we move toward the post-2015 development agenda, unleashing the potential and power of Africa’s youth should be a critical component of the continent’s developmental strategies, as reflected in the Addis Ababa Declaration on Population and Development – the regional outcome of ICPD beyond 2014 – and the Common African Position on the post-2015 development agenda.

This can no longer be reduced to election or political polemics. It requires urgent action.

Young people are central to the realisation of the demographic dividend. It is therefore important to protect and fulfil the rights of adolescents and youth to accurate information, comprehensive sexuality education, and health services for sexual and reproductive well-being and lifelong health, to ensure a productive and competitive labour force.

Africa cannot afford to squander the potential gains of the 21st Century offered by such an important demographic asset:  its youthful population.

Edited by Ronald Joshua

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Boosting the Natural Disaster Immunity of Caribbean Hospitalshttp://www.ipsnews.net/2014/09/boosting-the-natural-disaster-immunity-of-caribbean-hospitals/?utm_source=rss&utm_medium=rss&utm_campaign=boosting-the-natural-disaster-immunity-of-caribbean-hospitals http://www.ipsnews.net/2014/09/boosting-the-natural-disaster-immunity-of-caribbean-hospitals/#comments Sun, 21 Sep 2014 12:38:55 +0000 Jewel Fraser http://www.ipsnews.net/?p=136760 Seismologists say a new children's hospital being planned for Couva, in Trinidad, is located near a fault line. According to one report, 67 per cent of hospitals in the Caribbean and Latin America are located in areas at high risk for natural disasters. Credit: Jewel Fraser/IPS

Seismologists say a new children's hospital being planned for Couva, in Trinidad, is located near a fault line. According to one report, 67 per cent of hospitals in the Caribbean and Latin America are located in areas at high risk for natural disasters. Credit: Jewel Fraser/IPS

By Jewel Fraser
PORT OF SPAIN, Trinidad, Sep 21 2014 (IPS)

When floods overwhelmed the Eastern Caribbean in December last year, St. Vincent’s new smart hospital, completed just a few months earlier, stood the test of “remaining functional during and immediately after a natural disaster.”

The floods, later dubbed the Christmas rains, killed more than a dozen people and caused millions of dollars in infrastructural damage. However, the Georgetown Hospital in St. Vincent weathered the natural disaster, living up to the definition of a smart hospital in that it continued to serve the community without interruption.“We had the Christmas floods on Dec. 24 and the island’s water supply system was down whereas the hospital’s water supply remained functional. The community bought into it [after that]." -- Shalini Jagnarine of PAHO

According to a report by the UK’s Department for International Development (DFID), “More than 67% of hospitals in the Caribbean and Latin America are located in areas of higher risk of disaster.

“Enormous economic losses occur (including lost income and work days) when health facilities are destroyed or damaged by natural disasters — they must be re-built and downtime limits their ability to provide emergency care to victims and ongoing healthcare for their communities.”

The report adds, “Building resilience of communities and critical buildings like hospitals and schools delivers better results in terms of lives saved and livelihoods protected than simply through responding to the effects of disasters or climate variability.

“Establishing an integrated and forward looking approach to hospital design is essential if health facilities are to be safe, green and sustainable.”

Dr. Dana Van Alphen, the regional advisor for PAHO’s Disaster Risk Management Programme, told IPS that during a meeting of PAHO officials there were discussions about “how we could include climate change adaptation measures into our safe hospital initiative.”

The safe hospital initiative was launched in the Caribbean about a decade ago and has become a global standard for assessing the likelihood a hospital can remain functional in disaster situations.

PAHO worked with the DFID to launch the Smart Hospital Initiative. The DFID agreed to fund the initiative from its International Climate Fund for one year, citing “building resilience to climate change and disasters [as] a central pillar” of its 2011-2015 Operational Plan for the Caribbean.

Dr. Van Alphen said the Georgetown Hospital was chosen as one of two demonstration hospitals for the Smart Hospital Initiative because PAHO wanted “to convince policy makers that there are tangible measures for safety and natural disasters, there are practical measures that one can take and still see a benefit” without the costs being prohibitive.

Georgetown Hospital and the Pogson Hospital in St. Kitts were chosen as the two demonstration hospitals, after surveying 38 hospitals in the region. Of the 38 surveyed, 18 per cent were found to have structural and functional issues that required urgent measures to protect the lives of patients and staff.

“We took [those] two hospitals where we got support from the community and support from the government to implement the project. We wanted to do a success story,” Dr. Van Alphen said.

Some 350,000 dollars was allocated to retrofit Georgetown Hospital, which had structural and functional deficiencies including an unsafe roof, no backup power supply, and no water storage system.

The hospital, built in the 1980s, is a 25-bed facility in the parish of Charlotte that serves a population of almost 10,000.

The work done on the hospital included the renovating of the roof, waterproofing of the windows, installation of photovoltaic solar panels to ensure an alternative power supply, and the introduction of a rainwater harvesting system. The hospital was generally refurbished and upgraded to make it a more comfortable and pleasing environment for working and convalescing.

As a result of the retrofitting, there was a 60 percent reduction in energy consumption, said Dr. Van Alphen.

The DFID in its “Intervention Summary: Smart Health Care Facilities in the Caribbean”, notes that “according to Environmental Protection Agency (EPA) calculations, every dollar a hospital in the United States saves on energy is equivalent to generating 20 dollars in new revenues.

“Therefore, investing in activities that help reduce the health sector’s climate footprint will ultimately liberate money for allocation towards a hospital’s genuine purpose — improving overall patient care and health in the community.”

Since energy costs in the Caribbean are among the highest in the world, reduction in hospitals’ energy bill would free up significant resources, the DFID noted.

While the community was generally happy with the upgrades — according to the results of surveys conducted before and after the retrofitting that showed a significant increase in patients’ and staff’s satisfaction levels — there remained some concerns.

One of these was the community’s reluctance to accept the use of harvested rainwater. Shalini Jagnarine, a structural engineer with PAHO’s Disaster Management Unit, told IPS that that reluctance melted away with the Christmas floods.

“We had the Christmas floods on Dec. 24 and the island’s water supply system was down whereas the hospital’s water supply remained functional. The community bought into it [after that],” she said.

Another issue, according to the cost-benefit analysis of the project, was the financial sustainability of the project. The cost-benefit analysis report stated that “the cost of maintenance and operation [needs to be] minimized and other sources of revenue schemes…identified to financially support the project over its lifespan.”

The retrofitting of St. Kitt’s Pogson Medical Centre in Sandy Point village focused on showing how small changes can make a new and otherwise safe hospital more efficient, safe and environmentally friendly.

The work done included the installation of emergency exits, better access for the disabled, and upgrade of the plumbing fixtures and electrical systems.

Jagnarine said, “When you have a hospital that is already built, to make it safe you have to be smart about the financial decisions you make. To make it 100 per cent green may be too expensive.”

Dr. Van Alphen added, “The cost-benefit analysis is very important…What is the cost of not implementing these measures? What is the cost to your country and community if you do not make your health facility green and you are impacted by a natural disaster? The decision we take depends on the money we have, but there are simple things that can be done.”

Edited by: Kitty Stapp

The writer can be contacted at jwl_42@yahoo.com

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Georgia’s Female Drug Addicts Face Double Strugglehttp://www.ipsnews.net/2014/09/georgias-female-drug-addicts-face-double-struggle/?utm_source=rss&utm_medium=rss&utm_campaign=georgias-female-drug-addicts-face-double-struggle http://www.ipsnews.net/2014/09/georgias-female-drug-addicts-face-double-struggle/#comments Sun, 21 Sep 2014 09:27:33 +0000 Pavol Stracansky http://www.ipsnews.net/?p=136769 By Pavol Stracansky
TBILISI, Sep 21 2014 (IPS)

Irina was 21 when she first started using drugs. More than 30 years later, having lost her husband, her home and her business to drugs, she is still battling her addiction.

But, like almost all female drug addicts in this former Soviet state, she has faced a desperate struggle not only with her drug problem, but with accessing help in the face of institutionalised and systematic discrimination because of her gender.

“Georgia’s society is very male-dominated,” she told IPS. “And this is reflected in the attitudes to drugs. It’s as if it’s OK for men to use drugs but not women. For women, the stigma of drug use is massive. There are many women who do not join programmes helping them as they would rather not be seen there.”

Women make up 10 per cent of the estimated 40,000 drug users in Georgia, according to research by local NGOs working with drug users.“Georgia’s society is very male-dominated and this is reflected in the attitudes to drugs. It’s as if it’s OK for men to use drugs but not women. For women, the stigma of drug use is massive. There are many women who do not join programmes helping them as they would rather not be seen there” – Irina, now in her 50s, who has been taking drugs for 30 years

However, because of very strong gender stereotyping, women users have very low access to harm reduction services – only 4 percent of needle exchange programme clients are women and the figure is even less for methadone treatment.

Local activists say this startling discrepancy is down to the massive social stigma faced by women drug users.

Dasha Ocheret, Deputy Director for Advocacy at the Eurasian Harm Reduction Network (EHRN) told IPS: “In traditional societies, like Georgia’s, there is a much stronger negative attitude to women who use drugs than to men who use drugs. Women are supposed to be wives and mothers, not drug users.”

Many female addicts are scared to access needle exchanges or other harm reduction services because they fear their addiction will become known to their families or the police. Many have found themselves the victims of violence as their own families try to exert control over them once their drug use has been revealed. Others fear their drug use will be reported to the authorities by health workers.

Registered women drug users can have their children taken away while they routinely face violence – over 80 percent of women who use drugs in Georgia experience violence, according to the Georgian Harm Reduction Network– and extortion at the hands of police helping to enforce some of the world’s harshest drug laws. Possession of cannabis, for example, can result in an 11-year jail sentence.

Irina, who admits that she arranges anonymous attendance at an opioid substitution therapy (OST) programme so that as few people as possible can see her there, told IPS that she had herself been assaulted by a police officer and that police automatically viewed all female drug users as “criminals”.

But those who do want to access such services face further barriers because of their gender.

Free methadone substitution programmes in the country are extremely limited and because levels of financial autonomy among women in Georgia are low, other similar programmes are too expensive for many female addicts.

Discrimination is not uncommon among health service workers. Although some say that they have been treated by very sympathetic doctors, other female drug users have complained of abuse and denigration by medical staff and in some cases being denied health care because of their drug use.

Pregnant women are discouraged from accessing OST, despite it being shown to be safe in pregnancy and resulting in better health outcomes for both mother and child.

Eka Iakobishvili, EHRN’s Human Rights Programme Manager, told IPS: “Pregnant women don’t have access to certain services – they are strongly advised by doctors and health care workers to abort a baby rather than get methadone substitution treatment because they are told the treatment will harm the baby.”

While some may then undergo abortions, others will not, instead continuing dangerous drug use and the potential risk of contracting HIV/AIDS which could then be passed on to their child.

Meanwhile, those harm reduction services accessible by women are not gender-sensitive, according to campaigners, who say that female drug users need access to centres and programmes run and attended only by women.

Irina told IPS: “On some [harm reduction] programmes, the male drug users there will abuse the women drug users for taking drugs. This puts a lot of women off attending these programmes.”

She said that she had asked for a women-only service to be set up at the OST centre she attends but that it had been rejected on the grounds that only a few women were enrolled in it.

Together, these factors mean that many women are unable to access health services and continue dangerous drug-taking behaviour, sharing needles and injecting home-made drug cocktails made up of anything, including disinfectants and petrol mixed with over the counter medicines.

But there is hope that the situation may be about to change, at least to some degree, as local and international groups press to have the problem addressed.

At the end of July, CEDAW (UN Commission on Elimination of Discrimination against Women) released a set of recommendations for the Georgian government to ensure that women obtain proper access to harm reduction services after local NGOs submitted reports on the levels of discrimination they face.

These include, among others, specific calls for the government to carry out nationwide studies to establish the exact number of women who use drugs, including while pregnant, to help draw up a strategic plan to tackle the problem, and to provide gender-sensitive and evidence-based harm reduction services for women who use drugs.

The government has yet to react publicly to the recommendations but local campaigners have said they are speaking to government departments about them and are preparing to follow up with them on the recommendations.

Tea Kordzadze, Project Manager at the Georgian Harm Reduction Network in Tibilisi, told IPS: “We are hoping that at least some of the recommendations will be implemented.”

The Georgian government has been keen to show the country is ready to embrace Western values and bring its legislation and standards into line with European nations in recent years as it looks to create closer ties to the European Union. Rights activists say that this could come into play when the government considers the recommendations.

Iakobishvili said: These are of course just recommendations and the government is not obliged at all to accept or implement any of them. But, having said that, Georgia does care what other countries and big international rights organisations like Amnesty International and so on say about the country.”

Irina told IPS that only outside pressure would bring any real change. “The European Union, the Council of Europe and other international bodies need to put pressure on the Georgian government to make sure that the recommendations don’t remain on paper only.”

But, she added, “in any case, the recommendations alone won’t be enough. The whole attitude in society to women drug users is very negative. It has to be changed.”

(Edited by Phil Harris)

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Will Governments Keep Their Promises on the Human Right to Water?http://www.ipsnews.net/2014/09/will-governments-keep-their-promises-on-the-human-right-to-water/?utm_source=rss&utm_medium=rss&utm_campaign=will-governments-keep-their-promises-on-the-human-right-to-water http://www.ipsnews.net/2014/09/will-governments-keep-their-promises-on-the-human-right-to-water/#comments Sat, 20 Sep 2014 11:20:35 +0000 Dilip Surkar http://www.ipsnews.net/?p=136755 Water is supplied by the military in Old Dhaka, Bangladesh. Credit: UN Photo/Kibae Park

Water is supplied by the military in Old Dhaka, Bangladesh. Credit: UN Photo/Kibae Park

By Dilip Surkar
AHMEDABAD, India, Sep 20 2014 (IPS)

It was a dramatic moment at the United Nations when it voted in 2010 to affirm water and sanitation as a human right.

Then Bolivian ambassador to the U.N., Pablo Solon, shocked the silent auditorium with a devastating reminder of the consequences a lack of access to safe, available and affordable water and sanitation have on human life – every 21 seconds, a child dies of a water-borne disease.The shameful events in Detroit, when thousands of the poorest inhabitants of the U.S. city were disconnected from their water supply this summer after being unable to pay their bills, brought the failure to realise the human right to water and sanitation into sharp relief.

This key moment at the U.N. – which hosts its General Assembly next week – marked the beginning of a diplomatic process through which the need for states to progressively realise the human right to water and sanitation, and all the standards and principles it entails, became an obligation for member states.

Now, four years on, governments around the world are coming together to finalise the Sustainable Development Goals (SDGs) which will guide official development policy and processes for the next 15 years.

However, while there has been recognition of the centrality of water and sanitation to development through its standalone goal, there has been a palpable reluctance from many – though not all – governments to firmly state the realisation of the human right to water and sanitation as a SDG target.

Mirroring this at national level, there is an equally distinct lack of movement in the recognition of the right in constitutions and legislation. And in many cases where it is recognised, a few bright spots aside, rights have failed to become a reality.

Rights vs reality

In the water, sanitation and hygiene (WASH) sector, the framework of access has come to dominate. For those unfamiliar with the human right and its legal obligations, it is a perfectly reasonable call – for everyone to have access to water and sanitation.

But everyone has a human right to water and sanitation that is not only accessible, but universally available, safe and affordable and in addition to this for sanitation, acceptable.

Reducing our demand for water and sanitation to access alone hinders the fulfilment of these all important standards of the human right, while it also puts out of focus human rights principles such as opposing discrimination, ensuring participation, equality and accountability, among others.

The Millennium Development Goals (MDGs) reduced our monitoring of water to access alone, with no measure for its sustainability. While having a tap would be a step up for many millions, as anyone living without water as a daily reality could attest, a tap, standpipe or other means of accessing water does not mean water is consistently available from it, nor that it is safe or affordable.

By the measure of access alone, the MDG on water has already been achieved. Figures from the World Health Organisation and Unicef’s Joint Monitoring Programme suggest that 748 million people now lack access to water – between 1990 and 2012, 2.3 billion people gained access to ‘improved drinking water sources’.

But, as research has demonstrated, increase the complexity of this measure to safe water and the figure balloons: some 1.8 billion people are thought to lack access to safe water.

The shameful events in Detroit, when thousands of the poorest inhabitants of the U.S. city were disconnected from their water supply this summer after being unable to pay their bills, brought the failure to realise the human right to water and sanitation into sharp relief: in the world’s richest economy, people can be left, essentially, to die, removed in a discriminatory manner from the sustenance of life-giving water.

“Disconnections due to non-payment are only permissible if it can be shown that the resident is able to pay but is not paying,” said U.N. Special Rapporteur on the Human Right to Water and Sanitation, Catarina de Albuquerque, who was joined by the rapporteurs on housing and extreme poverty in condemning the USA.

“In other words, when there is genuine inability to pay, human rights simply forbids disconnections.”

In Kenya, one of the very few countries where the human right to water and sanitation is embedded in the constitution, rights remain far from reality, with patterns visible across the world replicated in microcosm – the poor pay more for their water than the rich.

“I call upon the authorities to take immediate measures to enforce and monitor the official tariffs for water kiosks. This is crucial to correct the systematic pattern of the poor paying much more for water from kiosks than the rich for water from pipes,”said de Albuquerque.

“The rights to water and sanitation should not remain a dream for so many. These rights are recognised in the Kenyan Constitution itself,” she went on.

What is to be done?

At End Water Poverty, the world’s biggest water and sanitation coalition with more than 275 members, we decided at the beginning of the year to reframe our “Keep Your Promises” campaign to focus on the human right to water and sanitation.

This means that at a national level we will support our members in demanding that the right is recognised, and where it is already recognised, that it is realised.

This means all the standards and principles of the right are adhered to; it means that in situations of water scarcity the state must meet people’s needs, whether for drinking, cooking, washing or hygiene, as a first priority; and it means governments must use the maximum available resources in a non-discriminatory manner to realise the right.

At an international level, it means the SDGs must adopt the realisation of the right as a target. Do governments intend to regress on international human rights law they created? Do they not want provision of water and sanitation to be framed by non-discrimination? Or for sanitation to be framed by privacy, dignity and cultural acceptability?

As then U.N. High Commissioner on Human Rights, Navi Pillay, said last year on the SDG process, development efforts must be directed to the realisation of human rights:

“This has been so central to the demands of people from all regions that we can now confidently assert that the extent to which it is reflected in the new framework, will in large measure, determine its illegitimacy.”

Edited by Kitty Stapp

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U.N. Urged to Reaffirm Reproductive Rights in Post-2015 Agendahttp://www.ipsnews.net/2014/09/u-n-urged-to-reaffirm-reproductive-rights-in-post-2015-agenda/?utm_source=rss&utm_medium=rss&utm_campaign=u-n-urged-to-reaffirm-reproductive-rights-in-post-2015-agenda http://www.ipsnews.net/2014/09/u-n-urged-to-reaffirm-reproductive-rights-in-post-2015-agenda/#comments Fri, 19 Sep 2014 21:32:25 +0000 Thalif Deen http://www.ipsnews.net/?p=136747 Millions of women in Pakistan do not have access to family planning services. Credit: Zofeen Ebrahim/IPS

Millions of women in Pakistan do not have access to family planning services. Credit: Zofeen Ebrahim/IPS

By Thalif Deen
UNITED NATIONS, Sep 19 2014 (IPS)

The U.N.’s post-2015 development agenda has been described as the most far-reaching and comprehensive development-related endeavour ever undertaken by the world body.

But where does population, family planning and sexual and reproductive health rights (SRHR) fit into the proposed 17 Sustainable Development Goals (SDGs), which are an integral part of that development agenda?"We must continue to fight until every individual, everywhere on this planet, is given the opportunity to live a healthy and sexual reproductive life." -- Purnima Mane, head of Pathfinder International

Of the 17, Goal 3 is aimed at “ensuring healthy lives and promoting well-being for all at all ages,” while Goal 5 calls for gender equality and the “empowerment of all women and girls.”

But when the General Assembly adopts the final list of SDGs in September 2015, how many of the proposed goals will survive and how many will fall by the wayside?

Meanwhile, SRHR will also be a key item on the agenda of a special session of the General Assembly next week commemorating the 20-year-old Programme of Action (PoA) adopted at the landmark International Conference on Population and Development (ICPD) in Cairo in 1994.

In an interview with IPS, Dr. Babatunde Osotimehin, executive director of the U.N. Population Fund (UNFPA) said, “Twenty years ago, we were able to secure commitments from governments on various aspects of poverty reduction, but more importantly the empowerment of women and girs and young people, including their reproductive rights.

“But the battle is not over,” he said.

“Today, we are on the cusp of a new development agenda, and we, as custodians of this agenda, need to locate it within the conversation of sustainable development – a people-centred agenda based on human rights is the only feasible way of achieving sustainable development,” he declared.

Purnima Mane, president and chief executive officer of Pathfinder International, told IPS, “We are delighted the final set of [proposed] SDGs contains four critical targets on SRHR: three under the health goal and one under the gender goal.”

The inclusion of a commitment to universal access to sexual and reproductive health care services, including family planning, information and education, and the integration of reproductive health into national strategies and programmes, is necessary and long overdue, she said.

“But we have not reached the finish line yet,” cautioned Mane, who oversees an annual budget of over 100 million dollars for sexual and reproductive health programmes in more than 20 developing countries.

The SDGs still need to be adopted by the General Assembly, “and we must all continue to raise our voices to ensure these SRHR targets are intact when the final version is approved,” she added.

Mane said civil society is disappointed these targets are not as ambitious or rights-based as they should be.

“And translating the written commitment into actionable steps remains a major challenge and is frequently met with resistance. We must retain our focus on these issues,” she said.

Sivananthi Thanenthiran, executive director of the Malaysia-based Asian-Pacific Resource & Research Centre for Women (ARROW) working across 17 countries in the region, told IPS it is ideal to have SRHR captured both under the gender goal as well as the health goal.

The advantages of being part of the gender goal is that the rights aspects can be more strategically addressed – because this is the area where universal commitment has been lagging – the issues of early marriage, gender-based violence, harmful practices – all of which have an impact on the sexual and reproductive health of women, she pointed out.

“The advantages of being part of the health goal is that interventions to reduce maternal mortality, increase access to contraception, reduce sexually transmitted diseases, including HIV/AIDS, are part and parcel of sound national health policies,” Thanenthiran said.

It would be useful for governments to learn from the Millennium Development Goals (MDGs) process and ensure that the new goals are not implemented in silos, she added. “Public health concerns should be addressed with a clear gender and rights framework.”

Maria Jose Alcala, director of the secretariat of the High-Level Task Force for ICPD, told IPS what so many governments and stakeholders around the world called for throughout the negotiations was simply to affirm all human rights for all individuals – and that includes SRHR.

The international community has an historic opportunity– and obligation — to move the global agenda forward, and go beyond just reaffirming agreements of 20 years ago as if the world hasn’t changed,and as if knowledge and society hasn’t evolved, she noted.

“We know, based on ample research and evidence, based on the experiences of countries around the world, as well as just plain common sense, that we will never achieve poverty eradication, equality, social justice, and sustainable development if these fundamental human rights and freedoms are sidelined or traded-off in U.N. negotiations,” Jose Alcala said.

Sexual and reproductive health and rights are a must and prerequisite for the post-2015 agenda “if we are to really leave nobody behind this time around,” she declared.

Mane told IPS, “As the head of Pathfinder, I will actively, passionately, and strongly advocate for SRHR and family planning to be recognised and aggressively pursued in the post-2015 development agenda.”

She said access to SRHR is a fundamental human right. “We must continue to fight until every individual, everywhere on this planet, is given the opportunity to live a healthy and sexual reproductive life. ”

Asked about the successes and failures of ICPD, Thanenthiran told IPS there is a need to recognise the progress so far: maternal mortality ratios and infant mortality rates have decreased, access to contraception has improved and life expectancy increased.

However, much remains to be accomplished, she added. “It is apparent from all recent reports and data that SRHR issues worldwide are issues of socio-economic inequality.”

In every country in the world, she noted, women who are poorer, less educated, or belong to marginalised groups (indigenous, disabled, ethnic minorities) suffer from undesirable sexual and reproductive health outcomes.

Compared to their better educated and wealthier sister citizens, these women and girls are more likely to have less access to contraception, have pregnancies at younger ages, have more frequent pregnancies, have more unintended pregnancies, be less able to protect themselves from HIV and other sexual transmitted diseases, suffer from poor maternal health, die in childbirth and suffer from fistula and uterine prolapse.

Hence the sexual and reproductive health and rights agenda is also the equality agenda of this century, she added.

“Governments must commit to reducing these inequalities and carry these learnings from ICPD at 20 into the post-2015 development agenda,” Thanenthiran said.

Edited by Kitty Stapp

The writer can be contacted at thalifdeen@aol.com

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Geographical Divide in Maternal Health for Syrian Refugeeshttp://www.ipsnews.net/2014/09/geographical-divide-in-maternal-health-for-syrian-refugees/?utm_source=rss&utm_medium=rss&utm_campaign=geographical-divide-in-maternal-health-for-syrian-refugees http://www.ipsnews.net/2014/09/geographical-divide-in-maternal-health-for-syrian-refugees/#comments Fri, 19 Sep 2014 15:17:22 +0000 Shelly Kittleson http://www.ipsnews.net/?p=136741 A young mother approaches a healthcare facility inside the Domiz refugee camp in Iraqi Kurdistan, mid-September 2014. Credit: Shelly Kittleson/IPS

A young mother approaches a healthcare facility inside the Domiz refugee camp in Iraqi Kurdistan, mid-September 2014. Credit: Shelly Kittleson/IPS

By Shelly Kittleson
DOHUK, Iraq, Sep 19 2014 (IPS)

At the largest refugee camp in Iraqi Kurdistan, young Syrian mothers and pregnant women are considered relatively lucky.

The number of registered Syrian refugees surpassed 3 million in late August, with the highest concentrations in Lebanon (over 1.1 million), Turkey (over 800,000), and Jordan (over 600,000). In all of the above, serious concerns have been expressed about the availability of healthcare services for expectant mothers.

In Lebanon, for example – which hosts the largest number of Syrian refugees, 76 percent of whom are women and children – the U.N. refugee agency (UNHCR) last year had to reduce its coverage of delivery costs for mothers to 75 percent instead of 100 percent, due to funding shortfalls.Though some in the Domiz camp live in tents on the edges of the camp with little access to basic sanitation facilities, others reside in small container-like facilities interspersed with wedding apparel shops and small groceries, and enjoy the right to public healthcare

The Domiz camp in the northern Dohuk province houses over 100,000 mostly Syrian Kurds, but is in a geographical area with a 189 percent coverage rate of humanitarian aid funding requests in 2014. The Syria Humanitarian Response Plan (SHARP) has received only 33 percent of the same.

Though some in the Domiz camp live in tents on the edges of the camp with little access to basic sanitation facilities, others reside in small container-like facilities interspersed with wedding apparel shops and small groceries, and enjoy the right to public healthcare.

This does not necessarily equate with quality healthcare, however. Halat Yousef, a young mother that IPS spoke to in Domiz, said that she had been told after a previous birth in Syria that she would need a caesarean section for any subsequent births.

On her arrival at the Dohuk public hospital, she was instead refused a bed, told to come back in a week and that she would have to give birth normally. They also told her she had hepatitis.

Fortunately, she said, her husband realised the seriousness of the situation and took her to the capital, where they immediately performed a C-section and found that she was instead negative for hepatitis. IPS met her as she was leaving healthcare facilities set up in the camp, holding her healthy 10-day-old infant.

Until recently, many mothers would also simply give birth in their tents. On August 4, Médicins San Frontiéres (MSF) opened a maternity unit in the camp that offers ante-natal check-ups, birthing services headed by MSF-trained midwives and post-natal vaccinations provided by staff who are also refugees.

Information on breastfeeding and family planning advice is also provided, according to MSF’s medical team leader in the camp, Dr Adrian Guadarrama.

MSF estimates that 2,100 infants are born in the camp every year, and others to refugees living outside of it.

The United Nations Population Fund (UNFPA) has long been providing safe delivery kits to healthcare providers. It also works to prevent unwanted pregnancies and provides contraceptives to those requesting them, thereby ensuring that pregnancies are planned, wanted and safer.

The clean delivery kits contain a bar of soap, a clear plastic sheet for the woman to lie on, a razor blade for cutting the umbilical cord, a sterilised umbilical cord tie, a cloth (to keep the mother and baby warm) and latex gloves.

UNFPA humanitarian coordinator Wael Hatahet told IPS that so far the programmes in Iraqi Kurdistan for Syrian refugees had received enough funding to cover the necessary services, and this was why ‘’the situation is no longer an emergency one for Syrians here’’.

Hatahet said that he gives a good deal of credit to the Kurdistan Regional Government (KRG), which – despite having seen a major cut in public funds from the central government as part of a prolonged tug-of-war between the two – continues to support Syrian refugees coming primarily from the fellow Kurdish regions across the border.

Many residents expressed dissatisfaction to IPS about what they considered ‘’privileged treatment’’ given to Syrian refugees while the massive influx of internally displaced persons (IDPs) that have arrived in the region over the past few months – after the Islamic State (IS) extremist group took over vast swathes of Iraqi territory in June – are seen to be suffering a great deal more.

Even Hatahet, who is of Syrian origins himself, noted that he had seen ‘’Iraqi IDPs wearing the same set of clothes for the past 15 days’’.

‘’We obviously try to support with garments and dignity kits,’’ he said, ‘’but it’s really, really sad.’’

However, he also noted that ‘’almost all the IDP operations are supported by the Saudi Fund [for Development]’’ totalling some 500 million dollars and announced in summer, ‘’which was strictly for IDPs and not refugees.’’

Hatahet expressed concerns that a broader shift in focus to Iraqi IDPs might result in a loss of the gains made in this geographical area of the Syrian refugee crisis, urging the international community to remember that ‘’we have 100,000 refugees scattered within the host community’’ and not just in the camps.

The Turkish office of UNFPA told IPS that, in its area of operations, ‘’it is estimated that about 1.3 million Syrian refugees have entered Turkey, of which only one-fifth of them are staying in camps due to limited space. 75 percent of the refugees are women and children under 18 years old.’’

It pointed out that ‘’women and girls of reproductive age under conditions of war and displacement are especially vulnerable to gender-based violence, including sexual violence, early and forced marriage, high-risk pregnancies, unsafe abortions, risky deliveries, lack of family planning services and commodities and sexually transmitted diseases.’’

(Edited by Phil Harris)

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Can ‘Womenomics’ Stem the Feminisation of Poverty in Japan?http://www.ipsnews.net/2014/09/can-womenomics-stem-the-feminisation-of-poverty-in-japan/?utm_source=rss&utm_medium=rss&utm_campaign=can-womenomics-stem-the-feminisation-of-poverty-in-japan http://www.ipsnews.net/2014/09/can-womenomics-stem-the-feminisation-of-poverty-in-japan/#comments Thu, 18 Sep 2014 18:32:24 +0000 Suvendrini Kakuchi http://www.ipsnews.net/?p=136724 Women now comprise the majority of the poor and old in Japan, the world’s third largest economy and fastest-aging society. Credit: S. H. isado/CC BY-ND 2.0

Women now comprise the majority of the poor and old in Japan, the world’s third largest economy and fastest-aging society. Credit: S. H. isado/CC BY-ND 2.0

By Suvendrini Kakuchi
TOKYO, Sep 18 2014 (IPS)

Fifty-four-year-old Marlyn Maeda, an unmarried freelance writer living in Tokyo who never held a permanent job, is now watching her dream of aging independently go up in smoke.

“I work four jobs and barely survive,” said the writer, who disclosed only her penname to IPS. Her monthly income after writing articles, working at a call centre, selling cosmetics five days a week and working one night at a bar hovers at close to 1,600 dollars.

Maeda belongs to the burgeoning ranks of the poor in Japan, a country that saw its poverty rate pass the 16-percent mark in 2013 as a result of more than two decades of sluggish growth that has led to lower salaries and the cutting of permanent jobs among this population of 127.3 million people.

She also represents an alarming trend: rising poverty among women, who now comprise the majority of the poor and old in Japan, the world’s third-largest economy and fastest-aging society.

“We have women who are desperate. Because they do not hold secure jobs, they endure searing problems such as domestic violence or workplace harassment." -- Akiko Suzuki, of the non-profit ‘Inclusive Net’
Indeed, Maeda points out her pay is now a low 50 dollars per article, down from the heady era of the 80s and 90s when she earned at least three times that rate.

Japan defines the poverty threshold as those earning less than 10,000 dollars per year. The elderly and part-timers fall into this category, and Maeda’s hard-earned income, which places her slightly above the official poverty line, nonetheless keeps her on her toes, barely able to cover her most basic needs.

“When the call centre cut my working days to three a week in June, and payment for freelancers [dropped], I became really worried about my future. If I fall sick and cannot work, I will just have to live on the streets,” Maeda asserted.

After paying her rent, taxes and health insurance, she admits to being so hard-pressed that she sometimes borrows from her aging parents in order to survive.

Maeda’s story, which echoes the experience of so many women in Japan today, flies in the face of government efforts to empower women and improve their economic participation.

In fact, a sweeping package of reforms introduced earlier this year by Prime Minister Shinzo Abe was met with skepticism from gender experts and advocates, who are disheartened by the myriad social and economic barriers facing women.

Dubbed ‘Womenomics’ in line with Abe’s economic reform policies – based on anti-deflation and GDP-growth measures that earned the label ‘Abenomics’ in early 2013 – the move calls for several changes that will pave the way for Japanese women, long discriminated in the work place, to gain new terms including equal salaries as their male counterparts, longer periods of childcare leave and promotions.

Given the fact that 60 percent of employed women leave their jobs when starting a family, Abe has promised to tackle key barriers, including increasing the number of daycare slots for children by 20,000, and upping the number of after-school programmes by 300,000 by 2020.

Another target is to increase women’s share of leadership positions to 30 percent by that same year.

Writing about the scheme in the Wall Street Journal last September, Abe claimed the government growth plan could spur a two-percent increase in productivity over the middle to long term, which in turn could lead to an average two-percent increase in inflation-adjusted GDP over a 10-year period.

“We have set the goal of boosting women’s workforce participation from the current 68 percent to 73 percent by the year 2020,” Abe wrote, adding, “Japanese women earn, on average, 30.2 percent less than men (compared with 20.1 percent in the U.S. and just 0.2 percent in the Philippines). We must bridge this equality gap.”

But for experts like Hiroko Inokuma, a gender researcher focusing on the challenges facing working mothers, this is a “tall order”, especially in the light of “growing job insecurity, which is already leading to dismal poverty figures among women.”

Indeed, the numbers paint a grim picture: one in three women between the ages of 20 and 64 years of age and living alone are living in poverty, according to the National Institute of Population and Social Security Research (NIPSSR), a leading Tokyo-based think tank.

Among married women, the poverty figure is 11 percent and counts mostly older women whose husbands have died. Almost 50 percent of divorced women have also been identified as grappling with poverty.

In addition, the poverty rate was 31.6 percent among surveyed working women, compared to 25.1 percent among men.

Health and Welfare Ministry statistics indicate that Japan is now registering record poverty levels; the year 2010 saw the highest number of welfare recipients in the last several decades, with 2.09 million people, or 16 percent of the population, requiring government assistance.

Against this backdrop, Akiko Suzuki, of the non-profit ‘Inclusive Net’, which supports the homeless, explained to IPS that Abe’s proposed changes and targets are highly illusive.

“After years of working with low-income people, I link the increase in females grappling with poverty to the rising number of part-time or contract jobs that are replacing full-time positions in companies,” she said.

The nursing industry, for instance, employs the highest number of part-time employees in Japan, of which 90.5 percent are women.

Inclusive Net reports that women currently comprise 20 percent of the average 3,000 people per month actively seeking support for their economic woes, up from less than 10 percent three years ago.

“We have women who are desperate. Because they do not hold secure jobs, they endure searing problems such as domestic violence or workplace harassment,” said Suzuki.

Japan has 20 million temporary workers, accounting for 40 percent of its workforce. Females comprise 63 percent of those holding jobs that pay less than 38 percent of a full-time worker’s salary.

Aya Abe, poverty researcher at the NIPSSR, told IPS that poverty among women has been a perennial problem in Japanese society, where they traditionally play second fiddle to men.

“For decades women have managed to get by despite earning less because they had earning husbands or lived with their parents. They also lived frugally. The recent poverty trend can then be related to less women getting married or being stuck in low-paid, part-time or contract work,” she stated.

A highlight of the prime minister’s gender empowerment proposals is the plan to remove a sacred tax benefit for husbands that also protects their working spouses who earn less than 10,000 dollars annually.

The tax was introduced in 1961 when Japan was composed of mostly single-income households led by male breadwinners under the life-term employment system.

Proponents say discarding the tax benefit will encourage women to work full-time while others argue this could increase women’s vulnerability by stripping them of a crucial social safety net.

While the political debate rages on, hundreds of thousands of Japanese women are struggling to make it through these dark days, with no sign of a silver lining. According to experts like Suzuki, “An aging population and unstable jobs means the feminisation of poverty is here to stay.”

Edited by Kanya D’Almeida

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U.N. Launches Ambitious Humanitarian Plan for Gazahttp://www.ipsnews.net/2014/09/un-launches-ambitious-humanitarian-plan-for-gaza/?utm_source=rss&utm_medium=rss&utm_campaign=un-launches-ambitious-humanitarian-plan-for-gaza http://www.ipsnews.net/2014/09/un-launches-ambitious-humanitarian-plan-for-gaza/#comments Wed, 17 Sep 2014 16:07:45 +0000 Mel Frykberg http://www.ipsnews.net/?p=136688 Palestinian families take shelter at an UNRWA school in Gaza City, after evacuating their homes in the northern Gaza Strip, July 2014. UNRWA has now launched a humanitarian reconstruction programme. Credit: Shareef Sarhan/UNRWA Archives

Palestinian families take shelter at an UNRWA school in Gaza City, after evacuating their homes in the northern Gaza Strip, July 2014. UNRWA has now launched a humanitarian reconstruction programme. Credit: Shareef Sarhan/UNRWA Archives

By Mel Frykberg
RAMALLAH, West Bank, Sep 17 2014 (IPS)

The UN agency for Palestinian refugees has launched an ambitious recovery plan for Gaza following the 50-day devastating war between Hamas and Israel which has left the coastal territory decimated.

However, the successful implementation of this plan requires enormous international funding as well as a long-term ceasefire to enable the lifting of the joint Israeli-Egyptian blockade of the territory.

“We are working on a 24-month plan aimed at 70 percent of Gaza’s population who are refugees but this will only be possible if the blockade is lifted and construction materials and other goods are allowed into Gaza,” Chris Gunness, spokesman for the UN Relief and Welfare Agency (UNRWA), told IPS.

“Taxpayers are being asked once again to fund the reconstruction of Gaza and at this point there are no security guarantees, so a permanent ceasefire is essential if we are not to return to the repetitive cycle of destruction and then reconstruction,” Gunness said.“If Gaza is to recover and Gazans are to have any hope for the future, it is vital that the international community intervenes to help those Gazan civilians who have and continue to pay the highest price” – Chris Gunness, UNRWA spokesman

The attack on Gaza, euphemistically code-named “Operation Protective Edge” by the Israelis, now stands as the most severe military campaign against Gaza since Israel’s occupation of the Palestinian territories in 1967.

“The devastation caused this time is unprecedented in recent memory. Parts of Gaza resemble an earthquake zone with 29 km of damaged infrastructure,” said Gunness.

Following the ceasefire, the Palestinian death toll stood at 2,130 and more than 11,000 injured.

Over 18,000 housing units were destroyed, four hospitals and five clinics were closed due to severe damage, while 17 of Gaza’s 32 hospitals and 45 of 97 its primary health clinics were substantially damaged. Reconstruction is estimated to cost over 7 billion dollars.

According to UNRWA, 22 schools were completely destroyed and 118 damaged during Israeli bombardments, while many higher education facilities were damaged.

Some 110,000 displaced Gazans remain in UN emergency shelters or with host families, according to UNRWA.

The reconstruction of shelters alone will cost over 380 million dollars, 270 million of which relates to Palestinian refugees.

According to the Palestinian Federation of Industries, 419 businesses and workshops were damaged, with 129 completely destroyed.

“We have a two-year plan in place which addresses the spectrum of Palestinian needs. Currently we have 300 engineers on the ground in Gaza assessing reconstruction needs,” Gunness told IPS.

Palestinian boy inspecting the remains of a house which was destroyed during an air strike in Central Bureij refugee camp in the Gaza Strip, July 2014. Credit: Shareef Sarhan/UNRWA Archives

Palestinian boy inspecting the remains of a house which was destroyed during an air strike in Central Bureij refugee camp in the Gaza Strip, July 2014. Credit: Shareef Sarhan/UNRWA Archives

UNRWA’s strategic approach has been divided into the relief period, the early recovery period and the recovery period of up to four months following the cessation of hostilities.

“The relief period, which will continue for the next four months, involves urgent humanitarian intervention including providing shelter, food and medical needs for displaced Gazans,” said the UNTWA spokesman.

“The early recovery period will continue for the next year and will address the critical needs of the population such as repairing damage to environmental infrastructure, restoring UNRWA facilities and supplementary assistance for livelihood provisioning.

“The recovery period will last for two years and will focus on the impact of the conflict through a sustainable livelihoods programme promoting self-sufficiency and completing the transition of UNRWA emergency and extended-stay shelters back to intended use and full operational capacity.”

One thrust of UNRWA’s programme will focus on protection, gender and disability. The increased numbers of female-headed households and households with disabled men is having an impact on unemployment patterns.

“Women are the primary caregivers and are closely linked to homes and the psychological trauma being exhibited by children. Furthermore, there have already been signs of increased gender-based violence,” explained Gunness.

“We want to focus on raising awareness of domestic violence, how to deal with violence in the home and building healthy and equal relationships through our gender empowerment programme.”

The UN agency will also address food distribution by providing minimum caloric requirements through basic food commodities, including bread, corned beef or tuna, dairy products and fresh vegetables. Non-food items provided include hygiene kits and water tanks for 42,000 families.

Emergency repairs to shelters are also being undertaken with 70 percent more homes destroyed or damaged than during the 2008-2009 hostilities. Emergency cash assistance for refugee families to meet a range of basic needs is also being distributed.

“Due to the enormous damage done to hospitals and health facilities, UNRWA has so far established 22 health points to provide basic health services to the sick and wounded, and health teams have been deployed to monitor key health issues,” noted Gunness.

The psychological impact of the war is another area that concerns UNRWA.  “There isn’t a person in Gaza who hasn’t been affected by the war. In consultation with UNRWA’s Community Health Programme, we have hired additional counsellors and youth coordinators who will provide a range of services to groups and individuals.”

“If Gaza is to recover and Gazans are to have any hope for the future,” said Gunness, “it is vital that the international community intervenes to help those Gazan civilians who have and continue to pay the highest price.”

(Edited by Phil Harris)

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The Good – and the Bad – News on World Hungerhttp://www.ipsnews.net/2014/09/the-good-and-the-bad-news-on-world-hunger/?utm_source=rss&utm_medium=rss&utm_campaign=the-good-and-the-bad-news-on-world-hunger http://www.ipsnews.net/2014/09/the-good-and-the-bad-news-on-world-hunger/#comments Wed, 17 Sep 2014 00:30:16 +0000 Phil Harris http://www.ipsnews.net/?p=136660 To meet the challenge of feeding the world’s 805 million hungry people, this year’s State of Food Insecurity report calls for the creation of an ‘enabling environment’. Credit: FAO/Giulio Napolitano

To meet the challenge of feeding the world’s 805 million hungry people, this year’s State of Food Insecurity report calls for the creation of an ‘enabling environment’. Credit: FAO/Giulio Napolitano

By Phil Harris
ROME, Sep 17 2014 (IPS)

The number of hungry people in the world has declined by over 100 million in the last decade and over 200 million since 1990-92, but 805 million people around the world still go hungry every day, according to the latest UN estimates.

Presenting their annual joint report on the State of Food Insecurity in the World, the Food and Agriculture Organization (FAO), international Fund for Agricultural Development (IFAD) and World Food Programme (WFP) said that while the latest hunger figures indicate that the Millennium Development Goal (MDG) of halving the proportion of undernourished people by 2015 is within reach, this will only be possible “if appropriate and immediate efforts are stepped up.”

These efforts include the necessary “political commitment … well informed by sound understanding of national challenges, relevant policy options, broad participation and lessons from other experiences.”"We cannot celebrate yet because we must still reach 805 million people without enough food for a healthy and productive life" – WFP Executive Director Ertharin Cousin

Introducing this year’s report, FAO Director-General Jose Graziano da Silva said that the figures indicate that a “world without hunger is possible in our lifetime.”

The three Rome-based UN agencies noted that while there has been significant progress overall, some regions are still lagging behind: sub-Saharan Africa, where more than one in four people remain chronically undernourished, and Asia, where the majority of the world’s hungry – 520 million people – live.

In Oceania there has been a modest improvement in percentage terms (down 1.7 percent from 14 percent two years ago) but an increase in the number of hungry people. Latin America and the Caribbean have made most progress in increasing food security.

However, WFP Executive Director Ertharin Cousin warned that “we cannot celebrate yet because we must still reach 805 million people without enough food for a healthy and productive life.”

Calling for what they called an ‘enabling environment’, the agencies stressed that “food insecurity and malnutrition are complex problems that cannot be solved by one sector or stakeholder alone, but need to be tackled in a coordinated way.” In this regard, they called on governments to work closely with the private sector and civil society.

According to the report, the ‘enabling environment’ should be based on an integrated approach that includes public and private investments to increase agricultural productivity; access to land, services, technologies and markets; and measures to promote rural development and social protection for the most vulnerable, including strengthening their resilience to conflicts and natural disasters.

Speaking at the presentation of the report, the WFP Executive Director referred in particular to the current outbreak of Ebola in the West African countries of Sierra Leone, Liberia and Guinea which, she said, “is an unprecedented health emergency which is rapidly becoming a major food crisis.”

“You cannot isolate people without addressing the food and nutrition challenges of those who need assistance,” she added, noting that the populations in these countries are not harvesting or planting according to their regular seasonal requirements while the crisis rages.

“This is rapidly becoming a food crisis that is potentially affecting 1.3 million people today, with an unknown number of how many will be affected in the future.”

“We cannot let the unprecedented level of humanitarian crisis undermine our efforts to progress even further, to reach our planet’s most vulnerable people and to end hunger in our lifetimes.”

The State of Food Insecurity report will be part of discussions at the Second International Conference on Nutrition to be held in Rome from 19-21 November, jointly organised by FAO and the World Health Organization (WHO).

This high-level intergovernmental meeting will seek a renewed political commitment at global level to combat malnutrition with the overall goal of improving diets and raising nutrition levels.

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Against All the Odds: Maternity and Mortality in Afghanistanhttp://www.ipsnews.net/2014/09/against-all-the-odds-maternity-and-mortality-in-afghanistan/?utm_source=rss&utm_medium=rss&utm_campaign=against-all-the-odds-maternity-and-mortality-in-afghanistan http://www.ipsnews.net/2014/09/against-all-the-odds-maternity-and-mortality-in-afghanistan/#comments Tue, 16 Sep 2014 19:09:10 +0000 Karlos Zurutuza http://www.ipsnews.net/?p=136646 Doctors Without Borders (MSF) says Afghanistan is “one of the riskiest places to be a pregnant woman or a young child”. Credit: DVIDSHUB/CC-BY-2.0

Doctors Without Borders (MSF) says Afghanistan is “one of the riskiest places to be a pregnant woman or a young child”. Credit: DVIDSHUB/CC-BY-2.0

By Karlos Zurutuza
KABUL, Sep 16 2014 (IPS)

Nasrin Mohamadi, a mother of four, has promised herself never to set foot in an Afghan public hospital again. After her first experience in a maternity ward, she has lost all faith in the state’s healthcare system.

“The doctors said that I had not fully dilated yet so they told me to wait in the corridor. I had to sit on the floor with some others as there wasn’t a single chair,” Mohamadi tells IPS, recalling her experience at Mazar-e Sharif hospital, 425 km northwest of Kabul.

“They finally took me into the room where three other women were waiting with their legs wide open while people came in and out. They kept me like that for an hour until I delivered without [an] anaesthetic, and not even a single towel to clean my baby or myself,” adds the 32-year-old.

“Immediately afterwards the doctors told me to leave as there were more women queuing in the corridor.”

“Many rural health clinics are dysfunctional, as qualified health staff have left the insecure areas, and the supply of reliable drugs and medical materials is irregular or non-existent." -- Doctors Without Borders (MSF)
Even after she left the hospital, Mohamadi’s ordeal was far from over. The doctors told her not to wash herself for ten days after the delivery, and as a result her stitches got infected.

“I paid between 600 and 800 dollars to give birth to my other three children after that; it was money well invested,” she says.

This is a steep price to pay in a country where the average daily income is under three dollars, and 75 percent of the population live in rural areas without easy access to health facilities.

Many women have no other option than to rely on public services, and the result speaks volumes about Afghanistan’s commitment to maternal health: some 460 deaths per 100,000 live births give the country one of the four worst maternal mortality ratios (MMR) in the world outside of sub-Saharan Africa.

While this represents a significant decline from a peak of 1,600 deaths per 100,000 births in 2002, far too many women are still dying during pregnancy and childbirth, according to the United Nations.

In 2013 alone, 4,200 Afghan women lost their lives while giving birth.

The lack of specialised medical attention during pregnancy or delivery for a great bulk of Afghan women is partly responsible. Few have access to health centres because these are only reachable in urban areas. The lack of both security and proper roads forces many women to deliver at home.

This does not bode well for the 6.5 million women of reproductive age around the country, particularly since Afghanistan only has 3,500 midwives, according to the U.N. Population Fund (UNFPA)’s latest State of the World’s Midwifery report.

This means that the existing workforce of midwives meets only 23 percent of women’s needs. The situation is poised to worsen: UNFPA estimates that midwifery services in the country “will need to respond to 1.6 million pregnancies per annum by 2030, 73 percent of these in rural settings.”

Even women with access to top-level urban facilities, such as the Kabul-based Malalai Maternity Hospital, are not guaranteed safety and comfort.

For instance, Sultani*, a mother of four, tells IPS she is far from satisfied with her experience.

“I gave birth through caesarean section to my four children in this hospital but the doctors who attended to me were unskilled,” she remarks bluntly. “A majority of them had only completed three years of medical [school].

“On a scale of one to 10, I can only give Malalai a four,” she concludes.

Sultani’s opinion may be specific to her own experience, but it finds echo in various reports and studies of the country’s health system. A 2013 activity report by Doctors Without Borders (MSF) labeled Afghanistan “one of the riskiest places to be a pregnant woman or a young child” due to a lack of skilled female medical staff.

“Private clinics are unaffordable for most Afghans and many public hospitals are understaffed and overburdened,” reports the organisation, which runs four hospitals across the country.

“Many rural health clinics are dysfunctional, as qualified health staff have left the insecure areas, and the supply of reliable drugs and medical materials is irregular or non-existent,” continues the report.

This is a sobering analysis of a country that will need to configure its health system to cover “at least 117.8 million antenatal visits, 20.3 million births and 81.3 million post-partum/postnatal visits between 2012 and 2030”, according to UNFPA.

Given that contraceptive use is still scarce, reaching only 22 percent of reproductive-age women, large families continue to be the norm. Afghan women give birth to an average of six children, a practice fuelled by a cultural obsession with bearing at least one son, who will in turn care for his parents in their old age.

A lack of information about birth spacing means mothers seldom have time to fully recover between deliveries, causing a range of health issues for the mother and a lack of milk for the newborn child.

Findings from a 2013 survey conducted by the Afghan Ministry of Public Health indicate that only 58 percent of children below six months were exclusively breastfed.

Still, this is an improvement from a decade ago and represents small but hopeful changes in the arena of women and children’s health. The same government survey found, for instance, that “stunting among children has decreased by nearly 20 percent from 60.5 percent in 2004 to 40.9 percent in 2013.”

Dr. Nilofar Sultani, who practices at the Malalai Maternity Hospital, tells IPS that medical assistance in Afghanistan has improved “significantly” over the last ten years.

“There are more health centres, and [they are] far better equipped. The number of skilled doctors has also grown,” explains Sultani, a gynaecologist.

But the most important change, she says, has been in women’s attitude towards medical care. “Before, very few women would come to the hospitals but today, the majority of women come forward on their own. They’re slowly losing their fear [of] doctors,” notes Sultani, adding that health centres are among the very few places where Afghan women can feel at ease without the presence of a man.

Edited by Kanya D’Almeida

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World Bank Tribunal Weighs Final Arguments in El Salvador Mining Disputehttp://www.ipsnews.net/2014/09/world-bank-tribunal-weighs-final-arguments-in-el-salvador-mining-dispute/?utm_source=rss&utm_medium=rss&utm_campaign=world-bank-tribunal-weighs-final-arguments-in-el-salvador-mining-dispute http://www.ipsnews.net/2014/09/world-bank-tribunal-weighs-final-arguments-in-el-salvador-mining-dispute/#comments Tue, 16 Sep 2014 00:05:17 +0000 Carey L. Biron http://www.ipsnews.net/?p=136639 By Carey L. Biron
WASHINGTON, Sep 16 2014 (IPS)

A multilateral arbitration panel here began final hearings Monday in a contentious and long-running dispute between an international mining company and the government of El Salvador.

An Australian mining company, OceanaGold, is suing the Salvadoran government for refusing to grant it a gold-mining permit that has been pending for much of the past decade. El Salvador, meanwhile, cites national laws and policies aimed at safeguarding human and environmental health, and says the project would threaten the country’s water supply.“This mining process would use some really poisonous substances – cyanide, arsenic – that would destroy the environment. Ultimately, the people suffer the consequences." -- Father Eric Lopez

The country also claims that OceanaGold has failed to comply with basic requirements for any gold-mining permitting. Further, in 2012, El Salvador announced that it would continue a moratorium on all mining projects in the country.

Yet using a controversial provision in a free trade agreement, OceanaGold has been able to sue El Salvador for profits – more than 300 million dollars – that the company says it would have made at the goldmine. The case is being heard before the International Centre for the Settlement of Investment Disputes (ICSID), an obscure tribunal housed in the Washington offices of the World Bank Group.

“The case threatens the sovereignty and self-determination” of El Salvador’s people, Hector Berrios, coordinator of MUFRAS-32, a member of the Salvadoran National Roundtable against Metallic Mining, said Monday in a statement. “The majority of the population has spoken out against this project and [has given its] priority to water.”

The OceanaGold project would involve a leaching process to recover small amounts of gold, using cyanide and, critics say, tremendous amounts of water. Those plans have made local communities anxious: the United Nations has already found that some 90 percent of El Salvador’s surface water is contaminated.

On Monday, a hundred demonstrators rallied in front of the World Bank building, both to show solidarity with El Salvador against OceanaGold and to express their scepticism of the ICSID process more generally. The events coincided with El Salvador’s Independence Day.

“We’re celebrating independence but what we’re really celebrating is dignity and the ability of every person to enjoy a good life, not only a few,” Father Eric Lopez, a Franciscan friar at a Washington-area church that caters to a sizable Salvadoran community, told IPS at the demonstration.

“This mining process would use some really poisonous substances – cyanide, arsenic – that would destroy the environment. Ultimately, the people suffer the consequences: they remain poor, they are sick, women’s pregnancies suffer.”

Provoking unrest?

The case’s jurisdictions are complicated and, for some, underscore the tenuousness of the ICSID’s arbitration process around the Salvador project.

It was another mining company, the Canada-based Pacific Rim, that originally discovered a potentially lucrative minerals deposit along the Lempa River in 2002. The business-friendly Salvadoran government at the time (since voted out of power) reportedly encouraged the company to apply for a permit, though public concern bogged down that process.

Frustrated by this turn of events, Pacific Rim filed a lawsuit against El Salvador under a provision of the Dominican Republic-Central American Free Trade Agreement (DR-CAFTA) that allowed companies to sue governments for impinging on their profits. While Canada, Pacific Rim’s home country, is not a member of DR-CAFTA, in 2009 the company created a subsidiary in the United States, which is.

In 2012, ICSID ruled that the lawsuit could continue, pointing to a provision in El Salvador’s investment law. The country’s laws have since been altered to prevent companies from circumventing the national judicial system in favour of extra-national arbiters like ICSID.

Last year, OceanaGold purchased Pacific Rim, despite the latter’s primary asset being the El Salvador gold-mining project, which has never been allowed to go forward. Although OceanaGold did not respond to a request for comment for this story, last year the company noted that it would continue with the arbitration case while also seeking “a negotiated resolution to the … permitting impasse”.

For its part, the Salvadoran government says it has halted the permitting process not only over environmental and health concerns but also over procedural matters. While these include Pacific Rim’s failure to abide by certain reporting requirements, the company also appears not to have gained important local approvals.

Under Salvadoran law, an extractive company needs to gain titles, or local permission, for any lands it wants to develop. Yet Pacific Rim had such access to just 13 percent of the lands covered by its proposal, according to Oxfam America, a humanitarian and advocacy group.

Given this lack of community support in a country with recent history of civil unrest, some warn that an ICSID decision in OceanaGold’s favour could result in violence.

“This mining project was re-opening a lot of the wounds that existed during the civil war, and telling a country that they have to provoke a civil conflict in order to satisfy investors is very troublesome,” Luke Danielson, a researcher and academic who studies social conflict around natural resource development, told IPS.

“The tribunal system exists to allow two interests to express themselves – the national government and the investor. But neither of these speak for communities, and that’s a fundamental problem.”

Wary of litigation

Bilateral and regional investment treaties such as DR-CAFTA have seen massive expansion in recent years. And increasingly, many of these include so-called “investor-state” resolution clauses of the type being used in the El Salvador case.

Currently some 2,700 agreements internationally have such clauses, ICSID reports. Meanwhile, although the tribunal has existed since the 1960s, its relevance has increased dramatically in recent years, mirroring the rise in investor-state clauses.

ISCID itself doesn’t decide on how to resolve such disputes. Rather, it offers a framework under which cases are heard by three external arbiters – one appointed by the investor, one by the state and one by both parties.

Yet outside of the World Bank headquarters on Monday, protesters expressed deep scepticism about the highly opaque ISCID process. Several said that past experience has suggested the tribunal is deeply skewed in favour of investors.

“This is a completely closed-door process, and this has meant that the tribunal can basically do whatever it wants,” Carla Garcia Zendejas director of the People, Land & Resources program at the Center for International Environmental Law, a watchdog group here, told IPS.

“Thus far, we have no examples of cases in which this body responded in favour of communities or reacted to basic human rights violations or basic environmental and social impact.”

Zendejas says the rise in investor-state lawsuits in recent years has resulted in many governments, particularly in developing countries, choosing to acquiesce in the face of corporate demand. Litigation is not only cumbersome but extremely expensive.

“Governments are increasingly wary of being sued, and therefore are more willing to accept and change polices or to ignore their own policies, even if there’s community opposition,” she says.

“Certain projects have seen resistance, but political pressure often depends on who’s in power. Unfortunately, the incorrect view that the only way for development to take place is through foreign investment is still very engrained in many of the powers that be.”

While there is no public timeframe for ISCID resolution on the El Salvador case, a decision is expected by the end of the year.

Edited by Kitty Stapp

The writer can be reached at cbiron@ips.org

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OPINION: Investing in Adolescent Girls for Africa’s Developmenthttp://www.ipsnews.net/2014/09/opinion-investing-in-adolescent-girls-for-africas-development/?utm_source=rss&utm_medium=rss&utm_campaign=opinion-investing-in-adolescent-girls-for-africas-development http://www.ipsnews.net/2014/09/opinion-investing-in-adolescent-girls-for-africas-development/#comments Mon, 15 Sep 2014 07:50:24 +0000 Hinda Deby and Dr. Julitta Onabanjo http://www.ipsnews.net/?p=136611 Elina Makore, 19, of Renco Mine just after delivering a healthy baby at Rutandare Clinic a remote Zimbabwean outpost supported by the United Nations Population Fund (UNFPA). Courtesy: UNFPA/Stewart Muchapera

Elina Makore, 19, of Renco Mine just after delivering a healthy baby at Rutandare Clinic a remote Zimbabwean outpost supported by the United Nations Population Fund (UNFPA). Courtesy: UNFPA/Stewart Muchapera

By Hinda Deby Itno and Julitta Onabanjo
JOHANNESBURG, Sep 15 2014 (IPS)

Adolescence is a time of transition from childhood to adulthood. It is also a time of change and challenge. 

Today’s adolescents, connected to each other like never before, can be a significant source of social progress and cultural change.

But they are also facing multiple challenges that seriously impact their future. And nowhere in the world do adolescents confront as formidable barriers to their full development as in Africa.

Today, adolescents and young people make up over one third of Africa’s population. They form a sizeable part of the population yet they lack critical investments, especially where it matters most – in sexual and reproductive health services, comprehensive sexuality education and skills building.

This calls for the serious and committed attention of all.

  Challenges facing adolescent girls

It is estimated that Africa has the world’s highest rates of adolescent pregnancy and maternal mortality. In Chad, Guinea, Mali, and Niger, where child marriage is common, half of all teenage girls give birth before the age of 18.

This was the case for Zuera, a girl from Kano in northern Nigeria, who became a wife and a mother at just 14 years. She suffered the agony of two stillbirths and was treated for obstetric fistula, which is damage caused by childbirth that leaves a woman incontinent, that arose from her first pregnancy.

Zeura was robbed of her childhood. She also missed out on the transition phase of adolescence and finally, she missed life.

All over Africa, stories like Zeura’s are commonplace. Millions of girls become brides before the age of 15. Close to 30 percent of girls on the continent give birth by age 18, when they are still adolescents. These adolescents face a higher risk of complications and death due to pregnancy than older women.

Nearly two thirds of them lack the basic knowledge they need to access crucial sexuality education and health information to protect themselves from early pregnancy and sexually transmitted diseases.

Research has found that at least 60 percent of young people aged 10 to 24 years are unable to prevent HIV, due to a lack of sexuality education. We cannot allow this to continue.

A resilient and informed generation

Young people will carry the African continent into the future. They need a safe and successful passage to adulthood.

And this is not a privilege but a right. Yet this right can only be fulfilled if families, society, and government institutions make focused investments and provide opportunities to ensure that adolescents and youth progressively develop the knowledge, skills and resilience they need for a healthy, productive and fulfilling life.

Comprehensive sexuality education, sexual and reproductive health services, education and skills building for adolescents and young people need to be placed at the heart of the Sustainable Development Goals (SDGs), with specific indicators and targets.

By building a strong foundation and investing in programmes that focus on delivering and achieving specific results for adolescents, Africa can achieve its transformation agenda.

Our desire is for every young person in Africa to be resilient and informed. We want every young African to be able to make their own decisions, to foster healthy relationships, access proper health care, actively participate in their education and ultimately, contribute to the development of their community and their future.

This means that programmes that are achieving results for adolescents in various parts of Africa must be scaled up. These include the husbands’ schools that have been developed in Niger, the girls’ empowerment initiative in Ethiopia, and the child marriage-free zones in Tanzania.

International institutions need to increase their commitments to adolescents, and address the nagging problems that confront adolescent girls and women across the African continent.

Adolescents have the potential to shape their world and indeed, the world in its entirety. It is in our interest to connect with them and enable them to change our world. Yes indeed!

Edited by: Nalisha Adams

 

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OPINION: Ebola Crisis Reversing Development Gains in Liberiahttp://www.ipsnews.net/2014/09/opinion-ebola-crisis-reversing-development-gains-in-liberia/?utm_source=rss&utm_medium=rss&utm_campaign=opinion-ebola-crisis-reversing-development-gains-in-liberia http://www.ipsnews.net/2014/09/opinion-ebola-crisis-reversing-development-gains-in-liberia/#comments Thu, 11 Sep 2014 14:18:37 +0000 Antonio Vigilante http://www.ipsnews.net/?p=136586 An Ebola victim is carried by health workers for burial on May 13, 2014. Credit: ©EC/ECHO/Jean-Louis Mosser

An Ebola victim is carried by health workers for burial on May 13, 2014. Credit: ©EC/ECHO/Jean-Louis Mosser

By Antonio Vigilante
MONROVIA, Sep 11 2014 (IPS)

As the Ebola crisis continues to take a toll on people’s lives and livelihoods in West Africa, the focus is increasingly not just on the health aspects of the crisis, but also on its social and economic consequences.

Sure, the human and medical aspects of the crisis are still on the front burner, as they should be. Losing a spouse, a child or another close relative is devastating. The health sector is under tremendous pressure to cope with the sick, and even to protect its own workers from contagion.Fear and isolation can in the end take more lives than the Ebola virus itself if businesses are not operating, livelihoods disappear and public services are not delivered.

There are also health ramifications for those not affected by Ebola: access to regular health care is reduced due to closures of hospitals and clinics, loss of nurses and doctors and increased fees by private health care providers.

Vaccination coverage, for instance, had already declined by 50 percent by July. Women in labour struggle to obtain skilled maternity care — in some cases they are turned away from the few institutions still in operation.

People with HIV who are on antiretroviral drugs and people with chronic diseases on prolonged care have had their treatment interrupted as a result of the closure of health facilities. The public health care system has all but collapsed in parts of the areas hardest hit by Ebola.

Before the current crisis, Liberia’s economy experienced impressive growth rates of up to 8.7 per cent (2013). GDP growth was already projected to decline to 5.9 per cent this year, as mining production levelled off temporarily, coupled with the fall in international prices for rubber and iron ore, before rising to 6.8 per cent in 2015 and 7.2 per cent in 2016. Future growth figures will now have to be revised, as economic activities have slowed down dramatically in most sectors.

But there is also an underlying issue at hand: The impressive recent growth in Liberia has not been equitable or inclusive. About 57 per cent of the country’s approximately four million inhabitants live below the poverty line and 48 per cent live in conditions of extreme poverty.

The lack of equitable, inclusive development means that more than half of the country’s population—especially women and children–is particularly vulnerable to shocks and crises, ultimately making the whole country less robust and less able to handle a crisis of any magnitude.

Part of the challenge in restoring livelihoods is psychological in nature. Fear and isolation can in the end take more lives than the Ebola virus itself if businesses are not operating, livelihoods disappear and public services are not delivered.

Reduced tax revenues go hand in hand with a decrease in the government’s ability to respond to the crisis. A decline in revenues is expected as Ebola continues to claim the lives of Liberians and the government continues to enforce travel restrictions as part of the state of emergency.

Soon, this is likely to impact salary payments for public employees and could paralyze the country further. Trust in the government is also on the line as it becomes increasingly unable to protect its citizens and deliver the services they desperately need.

At the same time, prices of locally grown and imported foods are increasing as the state of emergency, military road blocks and restricted travel slow down trade. The trend is amplified by a vicious cycle of falling consumer demand and shrinking levels of income.

In this scenario, it is crucial to put in place adequate social protection mechanisms, as the fall in disposable income make families unable to afford food and health services. This would not only contribute to improving social stability and security, but would also make Liberian society as a whole more robust and resilient.

Indeed, a large portion of the population is in need of public assistance. The latest data indicate that about 78 percent of the labour force is in a situation of vulnerable employment. By contrast, formally paid employees (about 195,000 people) make up only about 5 per cent of the population.

About 13 percent of households do not have access to sufficient food and 28 per cent are vulnerable to food insecurity. If the poorest segments of the population get access to some form of social protection mechanism, it will enable them to better withstand the current crisis, as well as future ones.

In the remote parts of the country, far from the hustle and bustle of its capital, Monrovia, it is also necessary to strengthen local authorities’ ability to handle the crisis, for instance by improving monitoring mechanisms and making protection equipment available for those who are in direct contact with Ebola patients and corpses.

The resurgence of the Ebola crisis since July and its gradual escalation into a national emergency in Liberia has diverted the focus and resources available to the authorities to the containment of the virus. In this phase of the crisis, it is necessary to act on all fronts to meet the devastating health, social and economic challenges before Liberia and other affected countries see all their hard-won development gains dwindle to nothing.

Edited by Kitty Stapp

 

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How Niger’s Traditional Leaders are Promoting Maternal Healthhttp://www.ipsnews.net/2014/09/will-you-be-chief-how-nigers-traditional-leaders-are-promoting-maternal-health/?utm_source=rss&utm_medium=rss&utm_campaign=will-you-be-chief-how-nigers-traditional-leaders-are-promoting-maternal-health http://www.ipsnews.net/2014/09/will-you-be-chief-how-nigers-traditional-leaders-are-promoting-maternal-health/#comments Thu, 11 Sep 2014 08:47:05 +0000 Joan Erakit http://www.ipsnews.net/?p=136577 Chief Yahya Louche of Bande, a village in Niger, addresses his constituents about maternal health and the importance of involving men. Credit: Joan Erakit/IPS

Chief Yahya Louche of Bande, a village in Niger, addresses his constituents about maternal health and the importance of involving men. Credit: Joan Erakit/IPS

By Joan Erakit
BANDE, Niger, Sep 11 2014 (IPS)

It is a long, 14-hour drive from Niger’s capital city Niamey to the village of Bande. And the ride is a dreary one as the roadside is bare. The occasional, lone goat herder is spotted every few kilometres and the sightings become a cause of both confusion and excitement since there aren’t any trees, or watering holes in sight.

Dry, hot and often plagued with sandstorms, Niger has a population of over 17.2 million, 80 percent of which live in rural areas. Insecurity, drought and trans-border issues contribute to this West African nation’s fragility where 50 percent of its citizens have access to health services.

IPS has travelled here with the United Nations Population Fund (UNFPA) to visit a school that — on a continent where male involvement in maternal health is not the norm and, in fact, men are oftentimes not present during the duration of the pregnancy or the birthing process due to cultural reasons — is pretty unique. It’s the School of Husbands.

Formed with support from UNFPA in 2011, the school has over 137 locations in Niger’s southern region of Zinder. Members are married men between the ages of 25 and 50, but young boys are now being recruited to come and sit in on meetings — to learn from their elders.

As IPS arrives at the village early one morning, a group of musicians approach the vehicle playing ceremonial music; they precede a traditional chief who is being escorted by his most trusted counsel and a throng of personal security who frantically chase away curious children with sticks.

Yahya Louche is the chief of Bande and he stops to talk to IPS about maternal health and the importance of involving men.

“I am a member of the School of Husbands,” Louche says of the informal institution that brings together married men to discuss the gains of reproductive health, family planning and empowerment.

“The School of Husbands is where there is no teacher and there is not student,” Louche continues, adding, “They are not getting paid, they are working for the well being of the population.”

The School of Husbands is a prime example of what can happen when men stand shoulder to shoulder with women, promoting safe births.

The Perils of No Care 

While visiting the health centre near the chief’s homestead, IPS spots a young woman making her way across the compound to the maternity room. She is weak and can barely make eye contact while two friends hold her up by each arm.

IPS is told that she delivered a baby at home and has walked kilometres to get help because she began bleeding profusely – it is an obstetrical emergency known as postpartum haemorrhage (PPH).

According to the World Health Organisation (WHO), PPH is responsible for about 25 percent of maternal mortality. Without prenatal or antenatal visits during pregnancy, complications are more likely to arise — some often leading to death.

“Before the School of Husbands, women didn’t want to go for delivery at health centres, they would stay at home and have their babies,” Louche explains.

According to the World Bank, Niger has a Maternal Mortality Ration (MMR) of 630 to 100,000 live births.

Women in Niger suffer.

It is a very well-known custom in the country that women are not to show their pain or discomfort. When they give birth, it is often in silence.  The woman on the delivery table makes no sound though pain is very visible on her face.

Madame Doudou Aissatoo, a midwife in Konni, a town in Niger, tells IPS that it is important to have reproductive health and family planning services readily available because many women walk for miles to come to the health centres. If commodities and services, or even midwives are unavailable, the women will leave and not return for a very long time.

“The very critical thing is to integrate it in the package; when a woman comes to the health centre for whatever reason, she has to get the family planning right away, whether it is a routine health check-up or something serious. Even on Saturday or Sunday, if a woman comes to the health centre, she’ll get it,” Aissatoo says.

Returning Home to Promote Health

The ancient story is quite fascinating; when a young boy leaves his homestead to find greener pastures, a time will mostly likely come when the folks back home call upon the man to become chief.

Often leaving the diaspora to fulfil his duties, a request to become chief is one that cannot be refused for turning it down is the equivalent to shaming ones ancestors.

It is such that the chiefs in Niger today come from different professional backgrounds and many have been doctors, diplomats and professors.

Traditional chiefs in Niger are the most important leaders — even heads of state and presidents seek their council before making big decisions. Without their blessing, one can assume that the road ahead will be difficult.

The UNFPA country office has understood the role that traditional chiefs play and has built a partnership in favour of promoting the health and rights of women.

In 2012, the traditional chiefs of Niger signed an agreement with UNFPA furthering a commitment to improve the health conditions of women.

“When we gathered in 2012, we made a commitment as an organisation to work with UNFPA in order to reduce the demographic growth, be part of sensitisation activities and gear towards improving reproductive health,” Louche explains.

When asked if she feels good about her husband participating in the institution, Fassouma Manzo, a local woman replies ecstatically: “Very much!”

A round of applause follows Manzo’s declaration as she continues, “before the School of Husbands, men didn’t have discussions with their women; but now, there is an issue for which they are very interested. As a woman, you can now find a space where you can talk and share with your man.  It’s a great side effect!”

Louche, a charismatic chief who spends much time talking to his constituents truly believes that empowering men puts the focus put on women.

The School of Husbands doesn’t just highlight the importance of seeking professional medical care when pregnant, but it also works to promote understanding between men and women — a gain that will only foster harmony for both sexes.

Edited by: Nalisha Adams

The writer can be contacted through Twitter on: @Erakit

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Global Commission Urges Decriminalisation of Drug Usehttp://www.ipsnews.net/2014/09/global-commission-urges-decriminalisation-of-drug-use/?utm_source=rss&utm_medium=rss&utm_campaign=global-commission-urges-decriminalisation-of-drug-use http://www.ipsnews.net/2014/09/global-commission-urges-decriminalisation-of-drug-use/#comments Wed, 10 Sep 2014 01:02:09 +0000 Jim Lobe http://www.ipsnews.net/?p=136563 Coca field in an Amazon jungle village. Credit: Courtesy of Central Asháninka del Río Ene/IPS

Coca field in an Amazon jungle village. Credit: Courtesy of Central Asháninka del Río Ene/IPS

By Jim Lobe
WASHINGTON, Sep 10 2014 (IPS)

A top-level international panel called Tuesday for a major shift in global drug-control policies from prohibition to decriminalisation and regulation.

In a 43-page report, the Global Commission on Drug Policy denounced what has been known for more than four decades as the “war against drugs” as a failure and argued that new approaches prioritising human rights and health were urgently needed.“There’s no question now that the genie of reform has escaped the prohibitionist bottle.” -- Ethan Nadelmann of the Drug Policy Alliance

“In this report, we set out a broad roadmap for getting drugs under control,” wrote former Brazilian President Fernando Henrique Cardoso, who chairs the Commission. “We recognize that past approaches premised on a punitive law enforcement paradigm have failed, emphatically so.

“They have resulted in more violence, larger prison populations, and the erosion of governance around the world. …The Global Commission on Drug Policy instead advocates for an approach to drug policy that puts public health, community safety, human rights, and development at the center,” according to Cardoso.

Such an approach would, among other changes, encourage governments to regulate markets in currently illicit drugs, beginning with marijuana, coca leaf, and certain psycho-active drugs; seek alternatives to prison for low-level, non-violent participants in the drug trade; and ensure equitable access to essential medicines, especially opiate-based pain medications, according to the report, “Taking Control: Pathways to Drug Policies That Work.” It called for a pragmatic approach that would include experimentation and trial and error.

The report’s recommendations, which come as governments prepare for the 2016 U.N. General Assembly Special Session (UNGASS) on Drugs, drew a mixed response from the U.S. government which has largely driven international drug policy since former President Richard Nixon first declared a “war on drugs” in 1971.

“We agree that we should use science-based approaches, rely on alternatives to incarceration for non-violent drug offenders, and ensure access to pain medications,” said Cameron Hardesty of the White House Office of National Drug Control Policy.

“…However, we disagree that legalisation of drugs will make people healthier and communities safer. Our experience with the tobacco and alcohol industries show that commercialization efforts rely upon increasing, not decreasing use, which in turn increases the harm associated with the use of tobacco and alcohol. In fact, if we take Big Tobacco as prologue, we can predict that that approach is likely to cause an entirely new set of problems,” she said.

Nonetheless, independent analysts said the Commission’s recommendations are likely to substantially advance the growing debate over drug policy if, for no other reason, than its membership is not easily dismissed.

In addition to Cardoso, its 21 members include former U.N. Secretary-General Kofi Annan, former U.N. High Commissioner for Human Rights Louise Arbour, former Colombian President Cesar Gaviria, former Polish President Aleksander Kwasniewski, former Chilean President Ricardo Lagos, and former Mexican President Ernesto Zedillo, as well as former U.S. Secretary of State George Shultz and former Chairman of the U.S. Federal Reserve Paul Volcker.

The report was released at a press conference that featured several of the Commission’s members in New York City Tuesday morning.

“This is a very important report that will provoke more serious discussion and debate,” Michael Shifter, president of the Inter-American Dialogue, an influential Washington-based inter-hemispheric think tank, told IPS. “There have already been significant changes at the state level [in the U.S.] and in some countries in Latin America, and this will push things along.”

In 2011, the Commission published its first report in which it also condemned the drug war as a failure and made a series of recommendations designed to “break the taboo” against considering legalisation and regulation of some drugs as alternatives.

Having broken the taboo, the Commission offered political cover for some Latin American leaders, including former Mexican President Felipe Calderon, Colombian President Juan Manuel Santos, Guatemalan President Otto Perez Molina, and Uruguayan President Jose Mujica (whose country last December became the world’s first to regulate the legal production, distribution, and sale of marijuana), to endorse far-reaching reform.

In mid-2013, the Organisation of American States (OAS) also released a report commissioned by the region’s reads of states that included legalisation as a policy alternative and that strongly favoured the view that drugs should be seen increasingly as a public health, rather than a security issue.

Among other measures, it proposed legalising and regulating marijuana production, distribution and sales – a recommendation that has since been adopted by voters in the U.S. states of Colorado and Washington. Nearly half of all U.S. states have legalised cannabis for medical purposes, and 17 states have decriminalised personal possession.

Virtually all observers agree that the drug war has been a signal failure. As prices drop for drugs that are have become purer with each passing year, governments have been spending an estimated 100 billion dollars annually on enforcement measures. The U.N. has estimated the value of global illicit drug trade at over 350 billion dollars.

The Commission offered a number of general recommendations in its report, beginning with a call for a “fundamental re-orientation of policy priorities” that would replace traditional goals and measures — such as amounts of drugs seized, the number of people arrested, prosecuted, and convicted for drug law violations – with “far more important” benchmarks, such as reducing drug-related harms, such as fatal overdoses, HIV infections, crime, violence, human rights abuses, and the power of criminal organisations that profit from the drug trade.

In addition to calling for equitable access to essential medicines, regulating markets for some drugs, and relying on alternatives to incarcerating non-violent, low-level participants in illicit drug markets, such as farmers and carriers, the report called for governments to be “far more strategic” in efforts to reduce the power of criminal organisations.

It noted that militarised “crackdowns” may actually increase criminal violence and public insecurity without actually deterring drug production, trafficking or consumption.

“…(I)n the longer term, drug markets should be responsibly regulated by government authorities. Without legal regulation, control and enforcement, the drug trade will remain in the hands of organised criminals. Ultimately this is a choice between control in the hands of governments or gangsters; there is no third option in which drug markets can be made to disappear,” according to the report.

“The idea behind this report and its timing is to ensure that there can be no repeat of the empty slogans, such as “a drug-free world, we can do it,” which was the theme of the UNGASS on Drugs in 1998, said John Walsh, a drug-policy expert at the Washington Office on Latin America (WOLA).

“To avoid a repeat, the idea is to ensure that a genuine debate will be unavoidable. That doesn’t mean that the world’s countries will rally around this new paradigm of legal regulation instead of prohibition, but the hope is that these issues cannot be ignored.”

“There’s no question now that the genie of reform has escaped the prohibitionist bottle,” said Ethan Nadelmann, the veteran director of the Drug Policy Alliance (DPA). “The former presidents and other Commission members pull no punches in insisting that national and global drug control policies reject the failed prohibitionist policies of the 20th century in favour of new policies grounded in science, compassion, health and human rights.”

Jim Lobe’s blog on U.S. foreign policy can be read at Lobelog.comHe can be contacted at ipsnoram@ips.org

Edited by Kitty Stapp

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U.S. Military Joins Ebola Response in West Africahttp://www.ipsnews.net/2014/09/u-s-military-joins-ebola-response-in-west-africa/?utm_source=rss&utm_medium=rss&utm_campaign=u-s-military-joins-ebola-response-in-west-africa http://www.ipsnews.net/2014/09/u-s-military-joins-ebola-response-in-west-africa/#comments Mon, 08 Sep 2014 22:45:46 +0000 Carey L. Biron http://www.ipsnews.net/?p=136550 As one of the Ebola epicentres, the district of Kailahun, in eastern Sierra Leone bordering Guinea, was put under quarantine at the beginning of August. Credit: ©EC/ECHO/Cyprien Fabre

As one of the Ebola epicentres, the district of Kailahun, in eastern Sierra Leone bordering Guinea, was put under quarantine at the beginning of August. Credit: ©EC/ECHO/Cyprien Fabre

By Carey L. Biron
WASHINGTON, Sep 8 2014 (IPS)

The U.S. military over the weekend formally began to support the international response to the Ebola outbreak in West Africa.

Advocates of the move, including prominent voices in global health, are lauding the Pentagon’s particularly robust logistical capacities, which nearly all observers say are desperately needed as the epidemic expands at an increasing rate.On Monday, the United Nations warned of an “exponential increase” in cases in coming weeks.

Yet already multiple concerns have arisen over the scope of the mission – including whether it is strong enough at the outset as well as whether it could become too broad in future.

President Barack Obama made the first public announcement on the issue on Sunday, contextualising the outbreak as a danger to U.S. national security.

“We’re going to have to get U.S. military assets just to set up, for example, isolation units and equipment there to provide security for public health workers surging from around the world,” the president said during a televised interview. “If we don’t make that effort now … it could be a serious danger to the United States.”

While the United States has spent more than 20 million dollars in West Africa this year to combat the disease, Washington has come under increased criticism in recent months for not doing enough. Obama is now expected to request additional funding from Congress later this month.

The military’s response, however, has already begun – albeit apparently on a very small scale for now, and in just a single Ebola-hit country.

A Defence Department spokesperson told IPS that, over the weekend, Secretary of Defence Chuck Hagel approved the deployment of a “25-bed deployable hospital facility, equipment, and the support necessary to establish the facility” in Liberia. For now, this is the extent of the approved response.

The spokesperson was quick to note that additional planning is underway, but emphasised that the Pentagon is responding only to requests made by other federal agencies and taking no lead role. Further, its commitment to the hospital in Liberia, the country most affected by the outbreak, is limited.

The Department of Defence “will not have a permanent presence at the facility and will not provide direct patient care, but will ensure that supplies are maintained at the hospital and provide periodic support required to keep the hospital facility functioning for up to 180 days,” the spokesperson said.

“This approach provides for the establishment of the hospital facility in the shortest possible period of time … Once the deployable hospital facility is established, it will be transferred to the Government of Liberia.”

On Monday, Liberia’s defence minister, Brownie Samukai, said his government was “extremely pleased” by the announcement.

“We had discussions at the Department of Defence on the issues of utilising and requesting the full skill of United States capabilities, both on the soft side and on the side of providing logistics and technical expertise,” Samukai, who is currently here in Washington, told the media. “We look forward to that cooperation as expeditiously as we can.”

No security needed

The current Ebola outbreak has now killed some 2,100 people and infected more than 3,500 in five countries. On Monday, the United Nations warned of an “exponential increase” in cases in coming weeks.

Yet thus far the epidemic has resulted in an international response that is almost universally seen as dangerously inadequate. Obama’s statement Sunday nonetheless raised questions even among those supportive of the announcement.

Medecins Sans Frontieres (MSF), the French humanitarian group, remains the single most important international organisation in physically responding to the outbreak. While MSF has long opposed the use of military personnel in response to disease outbreaks, last week it broke with that tradition.

Warning that the global community is “failing” to address the epidemic, the group told a special U.N. briefing that countries with “civilian and military medical capability … must immediately dispatch assets and personnel to West Africa”.

Yet while MSF has welcomed Obama’s announcement, the group is also expressing strong concerns over the president’s reference to the U.S. military providing “security for public health workers”.

MSF “reiterates the need for this support to be of medical nature only,” Tim Shenk, a press officer with the group, told IPS. “Aid workers do not need additional security support in the affected region.”

Last week, MSF urged that any military personnel deployed to West Africa not be used for “quarantine, containment or crowd control measures”.

The Defence Department spokesperson told IPS that the U.S. military had not yet received a request to provide security for health workers.

Few guidelines

The United States is not the only country now turning to its military to bolster the flagging humanitarian response in West Africa.

The British government in recent days announced even more significant plans, aiming to set up 68 beds for Ebola patients at a centre, in Sierra Leone, that will be jointly operated by humanitarians and military personnel. The Canadian government had reportedly been contemplating a military plan as well, although this now appears to have been shelved.

Yet the concerns expressed by MSF over how the military deployment should go forward underscore the fact that there exists little formal guidance on the involvement of foreign military personnel in international health-related response.

The World Health Organisation (WHO), for instance, has no broad stance on the issue, a spokesperson told IPS. As the WHO is an intergovernmental agency, it is up to affected countries to make related decisions and request.

“Each country handles its own security situation,” Daniel Epstein, a WHO spokesperson, told IPS. “So if governments agree to military involvement from other countries, that’s their business.”

Another spokesperson with the agency, Margaret Harris, told IPS that the WHO appreciates “the skills that well-trained, disciplined and highly organised groups like the US military can bring to the campaign to end Ebola.”

Yet there is already concern that the U.S. military response could be shaping up to be far less robust than necessary.

MSF’s Shenk noted that any plan from the U.S. military would need to include both the construction and operation of Ebola centres. Thus far, the Pentagon says it will not be doing any operating.

While around 570 Ebola beds are currently available in West Africa, MSF estimates that at least 1,000 hospital spaces, capable of providing full isolation, are needed in the region.

In a series of tweets on Monday, Laurie Garrett, a prominent global health scholar with the Council on Foreign Relations, a Washington think tank, expressed alarm that the Defence Department’s Ebola response was shaping up to be “tiny” in comparison to what is needed.

Edited by Kitty Stapp

The writer can be reached at cbiron@ips.org

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War Over but Not Gaza’s Housing Crisishttp://www.ipsnews.net/2014/09/war-over-but-not-gazas-housing-crisis/?utm_source=rss&utm_medium=rss&utm_campaign=war-over-but-not-gazas-housing-crisis http://www.ipsnews.net/2014/09/war-over-but-not-gazas-housing-crisis/#comments Mon, 08 Sep 2014 08:12:19 +0000 Khaled Alashqar http://www.ipsnews.net/?p=136527 Members of Abu Sheira's family in front of the tent they set up in the grounds of Al-Shifa hospital, Gaza. Credit: Khaled Alashqar/IPS

Members of Abu Sheira's family in front of the tent they set up in the grounds of Al-Shifa hospital, Gaza. Credit: Khaled Alashqar/IPS

By Khaled Alashqar
GAZA CITY, Sep 8 2014 (IPS)

“When the [Israeli] shelling started, I gathered up my family and headed for what I though was a safe place, like a school, but then that became overcrowded and lacked sanitation, so we ended up in the grounds of the hospital.”

Islam Abu Sheira from Beit Hanoun, a city on the north-eastern edge of the Gaza Strip, was speaking to IPS in front of what has been his family’s makeshift ‘home’ at Al-Shifa Hospital in Gaza City for the last two months. His eyes misted over as he recalled his devastated home and his efforts to find a safe refuge for his family."I found no other safe place to shelter in but Al-Shifa Hospital. Together with our seven children we fled into the hospital grounds and slept our first night under trees to escape the Israeli missiles that were destroying whole areas, killing entire families" – Islam Abu Sheira, a refugee from Beit Hanoun, Gaza Strip

In his forties, Islam described his family’s ordeal after Israeli shelling left them homeless and they first sought refuge in a school run by UNRWA, the U.N. relief and development agency for Palestinian refugees, and were then forced by overcrowding and poor sanitary conditions to move out and seek shelter elsewhere.

“I found no other safe place to shelter in but Al-Shifa Hospital. Together with our seven children we fled into the hospital grounds and slept our first night under trees to escape the Israeli missiles that were destroying whole areas, killing entire families, ” said Islam,  adding that “during the war, the only thing we were looking for was a place that could protect us from the shelling.”

Like the majority of Palestinian families whose homes were destroyed, they have lost their belongings and, for the time being, their chances of living a life of dignity. Most families in the Gaza Strip were forced to leave their homes so quickly that they had no time to take anything with them.

“We simply have no livelihood and my children sleep every night on the ground without even a blanket to cover them,” lamented Islam. “We have been living a primitive life since we fled our home without even taking the clothes we need.”

As the numbers of people escaping the shelling mounted, so did the difficulty of sheltering them. Schools did their best, but there were insufficient basic necessities and medical supplies, and they were housing four or five persons, if not more, in each classroom.

Palestinian families whose homes were destroyed by Israeli shelling of Gaza sheltering in a UNRWA school. Credit: Khaled Alashqar/IPS

Palestinian families whose homes were destroyed by Israeli shelling of Gaza sheltering in a UNRWA school. Credit: Khaled Alashqar/IPS

Jamila Saad, a housewife who is taking care of her 12-member family and also fled to one of the UNRWA schools, told IPS: “The school was receiving more and more refugees, and we and the other refugee families were sharing one toilet. We need a better life for our children and we hope that our home will soon be rebuilt so that we can begin a new life there in our new home.”

The complex and harsh conditions that the Palestinian refugees are suffering in schools and other shelter centres has pushed most international organisations to provide the refugees with as much aid as possible, but this is far from finding a final solution for the refugees’ suffering.

The conditions of the thousands of refugees who have lost their homes has placed the new Palestinian government before an enormous challenge and a huge responsibility to provide these refugee families with care and a secure environment, as well take on the responsibility of implementing the reconstruction programmes financially aided by the European Union and donor states in accordance with ceasefire agreement brokered in Cairo between Israel and Hamas, especially in terms of the reconstruction of Gaza.

Mufid al-Hasayna, Minister of Public Works and Housing in the new Palestinian unity government, told IPS that “the amount of destruction of houses and economic facilities is massive, and the population of Gaza is living under hard conditions, so we are working hard to improve the living conditions of people. We are working on programmes to start reconstruction of the Gaza Strip and rebuild destroyed houses and

Al-Hasayna believes that the blurred vision Palestinians in the Gaza Strip have of their future after 50 days of war and their constant fear of being retargeted by the Israeli occupation forces have only added to a worsening of their situation.

Amjad Shawa, Director of the Palestinian NGO Network, told IPS: “The harsh circumstances that the Gaza Strip underwent over the 50 days of the Israeli occupation’s war reduced the population’s access to water and food and threatened people’s security, while the bombing of residential high ‘towers’ housing dozens of families has left serious impacts on civilians.

According to Shawa, the housing situation is now all the more dramatic because, even before Israel’s ‘Operation Protective Edge’, the Gaza Strip was already suffering from the deficit of 70,000 housing units that had been destroyed in the 2009 and 2012 wars.

“Following the two wars, scheduled housing projects to rebuild the infrastructure were not implemented, and the deficit of housing units has reached a state that has put the population in a situation of real disaster,” Shawa told IPS.

He called on the Palestinian Authority (PA) to form an independent body of Palestinian civil society organisations to create a plan for reconstruction of the Gaza Strip.

According to a report prepared by the Palestinian Central Bureau of Statistics (PCBS), in June 2014 the Gaza Strip was home to an estimated population of 1.76 million living in a coastal area that extends along the Mediterranean Sea and covers approximately 365 square kilometres with a maximum width of 12 kilometres.

The PCBS believes that Gaza Strip’s narrow surface area and high population has contributed to some extent to the distribution of people in large blocks and increased its population density, turning the Strip into one the most densely populated areas in the world.

Population density in the Gaza Strip has reached 2,744 per square kilometre, and experts say this means that food, health and education should be the top priorities for the future development agenda of decision-makers.

(Edited by Phil Harris)

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Global Summit Urged to Focus on Trillion-Dollar Corruptionhttp://www.ipsnews.net/2014/09/global-summit-to-focus-on-eradication-of-trillion-dollar-corruption/?utm_source=rss&utm_medium=rss&utm_campaign=global-summit-to-focus-on-eradication-of-trillion-dollar-corruption http://www.ipsnews.net/2014/09/global-summit-to-focus-on-eradication-of-trillion-dollar-corruption/#comments Fri, 05 Sep 2014 18:15:17 +0000 Carey L. Biron http://www.ipsnews.net/?p=136512 By Carey L. Biron
WASHINGTON, Sep 5 2014 (IPS)

New analysis suggests that developing countries are losing a trillion dollars or more each year to tax evasion and corruption facilitated by lax laws in Western countries, raising pressure on global leaders to agree to broad new reforms at an international summit later this year.

These massive losses could be leading to as many as 3.6 million deaths a year, according to the ONE Campaign, an advocacy group that focuses on poverty alleviation in Africa. Recovering just part of this money in Sub-Saharan Africa, the organisation says, could allow for the education of 10 million more children“Whenever corruption is allowed to thrive, it inhibits private investment, reduces economic growth, increases the cost of doing business, and can lead to political instability. But in developing countries, corruption is a killer” – ONE Campaign
 a year, or provide some 165 million additional vaccines.

“Whenever corruption is allowed to thrive, it inhibits private investment, reduces economic growth, increases the cost of doing business, and can lead to political instability. But in developing countries, corruption is a killer,” a report on the findings, released Wednesday, states.

“When governments are deprived of their own resources to invest in health care, food security or essential infrastructure, it costs lives, and the biggest toll is on children.”

The new analysis focuses on a spectrum of money laundering, bribery and tax evasion by criminals as well as government officials. The lost money is not development aid but rather undeclared or siphoned-off business earnings – immense tax avoidance resulting in a decreased base from which governments can fund essential services.

International trade offers a key point of manipulation, the report says, with the extractive industries particularly vulnerable. In Africa alone, exports of natural resources grew by a factor of five in the decade leading up to 2012, offering clear prospects for growth alongside lucrative opportunities for corruption on a mass scale.

“Between 2002 and 2011 we saw an exponential increase in illicit financial flows across the globe,” Joseph Kraus, a transparency expert at the ONE Campaign, told IPS.

“Yet while we’re all familiar with corruption in developing countries, it takes two to tango – that money often ends up in the financial centres of the Global North. Those banks, lawyers and accountants are all essentially facilitators of that corruption, so in order to get at the root of this issue we need to go after the problems there.”

Real opportunity

Advocates including the ONE Campaign are currently stepping up pressure on industrialised countries to institute a series of across-the-board transparency measures. Some are aimed at corruption in developing countries, such as strengthening disclosure laws impacting on the extractives industry and bolstering “open data” standards to allow citizens increased oversight over their governments’ dealings.

Several other reforms would need to be carried out by developed countries, particularly those housing major financial centres such as the United States and United Kingdom. These would include new standards requiring governments to automatically exchange tax information, to mandate the publication of full information on corporate ownership, and to force multinational corporations to report on their earnings on a country-by-country basis.

In certain circles, such demands have been percolating for years. But current circumstances could offer unusual opportunity for such changes.

“In the last two years we’ve seen an acceleration of this agenda,” Kraus says. “Eighteen months ago, no one was talking about phantom firms or anonymous shell companies. But these issues have gained a lot of momentum in a short period of time, and there is real opportunity coming up.”

This new energy has been motivated particularly by concerns in advanced economies over shrinking government budgets in the aftermath of the global economic downturn. Yet developing countries arguably stand to benefit the most from substantive reforms, provided they’re structured accordingly.

Advocates of such changes are now looking ahead to a summit, on Nov 15 and 16 in Australia, of the members of the Group of 20 (G20) world’s largest advanced and emerging economies as well as two major meetings of finance ministers in the run-up to that event.

The G20 represent about two-thirds of the world’s population, 85 percent of global gross domestic product and over 75 percent of global trade.

The members of the G20 are Argentina, Australia, Brazil, Canada, China, France, Germany, India, Indonesia, Italy, Japan, Republic of Korea, Mexico, Russia, Saudi Arabia, South Africa, Turkey, the United Kingdom, the United States and the European Union.

The G20 has taken on a primary role in issues of global financial stability and, more recently, in pushing the automatic exchange of tax information between governments. A new global standard on such exchange could be approved by the G20 ministers in November, among other actions.

“For too long, G20 countries have turned a blind eye to massive financial outflows from developing countries which are channelled through offshore bank accounts and secret companies,” according to John Githongo, an anti-corruption campaigner in Kenya.

“Introducing smart policies could help end this trillion dollar scandal and reap massive benefits for our people at virtually no cost. The G20 should make those changes now.”

Coordinated response

In fact, many G20 countries have instituted some of these reforms on their own. The U.K. government, for instance, has taken unilateral action on publicising information on corporate ownership, while the United States was the first to pass strong transparency requirements for multinational extractives companies.

While such piecemeal national legislation can spur other countries to action, many feel only a comprehensive approach would have a chance at having a substantial impact. Further, many governments have pledged to act on these issues, but have yet to actually follow through.

“Illicit financial flows are a perfect example of a transnational problem, in that you have two legal regimes in which loopholes are being exploited,” Josh Simmons, a policy counsel at Global Financial Integrity, a Washington watchdog group that supplied data for the new ONE Campaign report, told IPS.

“So when an international cooperative body is able to identify these loopholes, they can get member countries to move in sync to address the situation. But if only one country tries to do so, businesses would probably just move elsewhere.”

Others are looking even more broadly than the G20. A paper released last month by researchers with the Center for Global Development, a think tank here, calls for the inclusion of anti-tax-evasion aims in the new global development goals currently being negotiated under the United Nations.

Indeed, even while there could be real movement at the G20 on several of these issues this year, the work on the other end of this equation – in developing countries – remains onerous.

“We need to get developing countries’ tax systems up to speed, strengthen their financial intelligence units and get their anti-laundering laws up to code. And that is proceeding, but much more under the radar given its complexity,” Simmons says.

“Still, that’s where people are actually bearing the brunt of this problem. Tax avoidance in the United States contributes to the national debt, but in developing countries it’s literally causing people to go hungry.”

Edited by Ronald Joshua

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When a Disaster Leaves Bathrooms in its Wakehttp://www.ipsnews.net/2014/09/when-a-disaster-leaves-bathrooms-in-its-wake/?utm_source=rss&utm_medium=rss&utm_campaign=when-a-disaster-leaves-bathrooms-in-its-wake http://www.ipsnews.net/2014/09/when-a-disaster-leaves-bathrooms-in-its-wake/#comments Fri, 05 Sep 2014 09:22:00 +0000 Malini Shankar http://www.ipsnews.net/?p=136505 Local communities in India's Andaman and Nicobar Islands (ANI) have grown accustomed to modern water and sanitation infrastructure in the decade since the Asian Tsunami. Credit: Malini Shankar/IPS

Local communities in India's Andaman and Nicobar Islands (ANI) have grown accustomed to modern water and sanitation infrastructure in the decade since the Asian Tsunami. Credit: Malini Shankar/IPS

By Malini Shankar
CAR NICOBAR, India, Sep 5 2014 (IPS)

When the 2004 Asian Tsunami lashed the coasts and island territories of India, one of the hardest hit areas were the Andaman and Nicobar Islands (ANI), which lie due east of mainland India, at the juncture of the Bay of Bengal and the Andaman Sea.

Remote and isolated, the tribal communities that occupy these idyllic isles have lived for centuries off the land, eschewing all forms of modern ‘development’ and sustaining themselves off the catch from the rich seas that surround them.

But when the tsunami struck without warning on Boxing Day, and traditional wooden houses erected on bamboo stilts were washed away, surviving commuties scattered across these islands have been forced to reckon with their primitive lifestyle and open the doors to some changes, especially in Car Nicobar, capital and administrative nerve-centre of the Nicobar Islands.

One of the most notable changes has been in the realm of sanitation, hitherto an unhealthy mix of open defacation and forest-based waste management.

Before a major relief and rehabiliation operation got underway in the aftermath of the tsunami, many tribal communities in Nicobarese villages had rejected potable water schemes such as the desalination plant installed in the village of Chaura, where the population of 1,214 people expressed hesitation about drinking water “from a machine”.

Toilet facilities were also extremely limited, with most residents “answering nature’s call by going behind a bush”, according to a sports ministry official from the division of Kakana who gave his name only as Benedict.

When IPS visited an interim tsunami shelter in Kakana, Car Nicobar, in 2007, 25 months after the tsunami, the situation had scarcely improved. A hole in the ground across from the relief shelter served as a communal facility, and could only be accessed by leaping onto a mound of dug-up earth and navigating the moist forest floor, hoping to avoid an encounter with snakes en route to the bathroom.

The ‘structure’ consisted of nothing more than a deep hole in the forest floor, covered on all four sides by plastic sheeting. It lacked a roof, a tap and a light.

Locals were still trying to come to terms with the fact that their freshwater supply, once a boundless natural bounty originating from springs in the volcanic islands, had become badly polluted after the natural catastrophe.

A World Health Organisation (WHO) report on sanitation prospects on the island in early 2005 found several cases of diarrhoeal outbreak among survivors housed in temporary camps, which affected hundreds of the roughly 1,300 residents.

Now, most villages have toilets and sanitation systems in individual homes, and locals are slowly opening up to the necessity of improved waste-management systems. IPS interviewed tsunami survivors across five Nicobar islands – Car Nicobar, Kamorta, Campbell Bay, Little Nicobar, and Katchall – who expressed the universal opinion that receiving access to water and sanitation facilities, as well as permanent shelters designed and constructed by the government of India, has done them good.

“There are a few issues like water scarcity and discomfort in the humid summer months,” said 46-year-old Muneer Ahmed, chief tribal captain in Pilpillow, Kamorta. “Zinc sheet roofing and concrete houses are tough as they are weather insenstive, compared to weather-sensitive straw huts.”

“But,” he told IPS, “We are grateful for greater security.” His words reflect a prevailing attitude across the islands that returning to flimsy thatched-roof homes – despite their proximity to the beach, which most Nicobarese depend on for sustenance – is simply not an option with the memory of the killer waves still fresh in the minds of the survivors.

The same holds true for water and sanitation. Local communities now get water from infrastructure provided by the Public Works Department, Sakshi Mittal, deputy commissioner of Nicobar, told IPS, adding, “They don’t reject this supply anymore.”

Coastal fisherfolk in Tamil Nadu’s tsunami battered coasts of Nagapatnam and Cuddalore are also benefiting from similar schemes, many of them overseen by the Swiss Development Agency. “We have tiled bathrooms with ventilation and western toilets with bidets,” a fisherwoman named Vanitha in Nagapatnam told IPS.

Such developments among fisher communities are crucial as the international community finalises a new roadmap for sustainable development that will replace the Millennium Development Goals (MDGs) in 2015.

Key among the new poverty eradication targets, known as the Sustainable Development Goals (SDGs), will be the inclusion of the most marginalised segments of society.

In India, this includes fisher communities who were the worst hit in Tamil Nadu and Pondicherry, with about 150,000 fisherfolk losing their homes to the tsunami. In ANI, close to 10,000 people lost their lives and and scores more were exposed to tough living conditions.

Despite construction by the United Nations Children’s Fund (UNICEF) of 8,500 latrines around the islands after the tsunami, there remains a 35 percent deficit of decent sanitation facilities today.

In general, health indicators among the islands’ tribal population are higher than in other parts of India, with a maternal mortality ratio far below the national average of 250 deaths per 100,000 live births.

Although other health indicators like life expectancy rates were higher in the states of Kerala and ANI (67.6 percent and 73.4 percent respectively), the tsunami brought fresh new troubles, such as fears of malaria outbreaks, or epidemics of vector-borne diseases like dengue.

Relief workers and emergency response teams, sponsored by the government, international NGOs and the United Nations, took the lead on eradicating mosquito breeding grounds, distributing bednets, spraying insecticide in mosquito-heavy areas, as well as stocking local water bodies with a species of fish with an appetite for mosquito larvae.

According to a WHO assessment a year after the tsunami, Indian health authorities also launched measles vaccinations campaigns in the areas hardest hit by the disaster, namely the state of Tamil Nadu and the union territory of ANI, boosting measles immunisation coverage to 96.3 percent in the latter.

While they hope against hope to be spared another disaster, some of India’s most vulnerable communities are today far more resilient than they were a decade ago.

Part 1 of this series can be read here.

Edited by Kanya D’Almeida

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