A woman living in a displacement site in Mingkaman, South Sudan, grinds grain that she received from humanitarian agencies during their monthly food distribution. More than 1.5 million people have been displaced by the fighting in South Sudan and many are now dependent on aid agencies for food, shelter and protection. Credit: Andrew Green/IPS

By Andrew Green
JUBA, South Sudan , Aug 14 2014 (IPS)

Another deadline has passed. But instead of bringing about peace, the leaders of South Sudan’s warring parties have allowed the country to continue its slide toward famine.

Sunday was the deadline for the delegations of President Salva Kiir and his former deputy turned rebel leader Riek Machar to present a final proposal for a unified transitional government that would end eight months of conflict.

Instead, the weekend brought more fighting.

Each new clash exacerbates the country’s already-desperate food security situation. The international community has warned that famine could arrive as early as December. At least 1.1 million people are facing emergency food shortages. And – until fighting actually stops – aid agencies do not have access to tens of thousands of people who need their help.“Attacks on civilians and destruction and pillage of civilian property lie at the heart of how this war has been fought.” -- Skye Wheeler, a researcher with Human Rights Watch

There are no indications from the field that the clashes will stop any time soon. On Tuesday, during a visit of the United Nations Security Council to South Sudan, U.S. Ambassador Samantha Power shared reports they had received “of more arms being brought into this country in order to set the stage for another battle.”

Meanwhile, in early August, a local militia group operating outside the command of either of the two forces tracked down and executed six aid workers in Upper Nile state, near the country’s border with Sudan. They chose their targets based on ethnic affiliation, perpetuating the tribal divisions that are driving this conflict.

By the time the two sides finally get to work in Addis Ababa, they may be drafting a solution to a situation over which they no longer have any control.

The now eight-month conflict began as a political squabble between Kiir and Machar over who would control the ruling Sudan People’s Liberation Movement party. But it quickly stoked ethnic tensions as it moved across the eastern half of the country. Human rights violations became one of the grim hallmarks of the violence.

“Attacks on civilians and destruction and pillage of civilian property lie at the heart of how this war has been fought,” Skye Wheeler, a researcher with Human Rights Watch, said in an interview with IPS. Patients have been shot in their hospital beds and people sheltering in a mosque and at U.N. bases have been massacred. At least 10,000 people have been killed and 1.5 million more displaced.

Even as violence has become the norm across large swathes of the country, the targeted killings of aid workers and other Nuers living in Upper Nile state’s Maban County may have marked the transition to a more volatile stage in South Sudan’s conflict.

Maban, which hosts tens of thousands of Sudanese refugees, had been relatively untouched by the fighting. But that did not stop a local militia, calling itself the Mabanese Defence Force and with no obvious alliance to either side, from executing the Nuer civilians.

The U.N. Mission in South Sudan warned in a press release that Maban was now at risk of an “ongoing descent into lawlessness” – a lawlessness that, in the absence of a legitimate peace deal, could easily spread to other areas of the country as communities decide to exact their own forms of justice.

“We’ve seen how abuse has driven further violence and more abuses during reprisal attacks directed against civilians,” Wheeler said. The weekend brought reports that another armed group was on the march in Maban, this one to exact revenge for the killings earlier in August.

The consequences of the Maban murders could be further reaching.

The people living in the conflict regions – as well as tens of thousands of displaced – are almost completely dependent on the U.N. and non-governmental organisations for food, shelter and protection.

Humanitarians were already dealing with access issues amid the ongoing fighting, as well as funding shortages. The U.N. estimates aid agencies will need 1.8 billion dollars to reach 3.8 million people before the end of the year. So far they have raised just over half.

And while the situation does not yet meet the technical criteria to be declared a famine, “there is extreme suffering,” Sue Lautze, the U.N.’s Food and Agriculture Organisation country director, told IPS.

If aid workers become targets, the suffering will get much worse.

In Maban, a team from Medair, a humanitarian group currently providing emergency services in South Sudan, is responsible for operating clean water stations and running other health and hygiene services for the 60,000 people, including Sudanese refugees who live in the Yusuf Batil Camp, as well as members of the surrounding communities. Country Director Anne Reitsema said in an interview with IPS the attacks showed a “total disrespect for humanitarian actors.”

Following the attack, Medair temporarily pulled some staff members out of Maban, though leaving enough people to continue their operations. It’s too early to say when they will return, but Reitsema cautioned that the attack “makes it very hard for us to do our work.” The problem is, there is no one else to do it.

All of this – the increasing violence, the possible famine and another missed deadline – can be used as points “to shame” the two parties into an agreement that finally sticks, according to Jok Madut Jok, an analyst with the Sudd Institute, a local think tank.

It’s already happening. During her visit to Juba, Power said, “We do not see the urgency that needs to be brought to these negotiations.” And the international community has raised the threat of economic sanctions once again.

It’s a strategy that has not yet worked – the United States and European Union have already sanctioned a military leader on each side of the conflict. But neither has anything else the local and international community has tried. Which is why Jok expects more deadlines may come and go without anything being accomplished.

“The peace talks are about what each one of them hopes to walk away with from the peace talks, rather than peace, itself,” he told IPS.

Edited by: Nalisha Adams

Thousands of displaced people camping under trees in Minkaman, northeastern South Sudan. They are among the hundreds of thousands of people who have fled during five months of fighting in the country. Credit: Andrew Green/IPS

By Andrew Green
JUBA, May 15 2014 (IPS)

It has not yet been a week, but South Sudan’s most recent ceasefire appears set to collapse, along with hopes that – after five months of fighting – the country might finally be on the path to recovery.

Late Friday, President Salva Kiir and his former deputy Riek Machar met briefly in Addis Ababa, Ethiopia’s capital, to recommit to the cessation of hostilities agreement their representatives originally reached in late January.

That earlier deal also fell apart within days and the fighting continued across much of the country’s northeast. Thousands of people have since been killed and hundreds of thousands scattered.

In the days before the Addis Ababa meeting, Deng Chioh was one of the many people in Juba unconvinced a new ceasefire agreement would work. He said the anger in the country runs too deep.

“If peace is to come to South Sudan, it’s going to take a very long time. It cannot be done while the current leader is the head of the state,” he told IPS.

South Sudan’s president Salva Kiir Mayardit (in black hat), and former vice-president Riek Machar (right), before the conflict began. Credit: UN Photo/Tim McKulka

Last week’s signing ceremony was the first time Kiir and Machar have met since their latent political rivalry broke wide open on Dec. 15 when the former vice president walked out on a meeting of the ruling party.

Hours later fighting broke out in a Juba military barracks and Kiir quickly accused his former vice president of mounting a coup. The veracity of the accusation was inconsequential as fighting spread rapidly – first across the capital, and then much of the country.

On the first two nights of the December fighting, Chioh suffered through frantic phone calls from relatives and neighbours as they attempted to triangulate where the killings were happening.

By the third day, exhausted with worry, he and nine family members moved to a the United Nations Mission in South Sudan (UNMISS) base.

The site, known as U.N. House, is on the outskirts of Juba, in the shadow of Jebel Mountain – one of the few interruptions to the capital’s dully flat landscape.

Chioh said that soon after they stopped hearing from a handful of relatives who decided to remain in their homes, and he can only assume they were killed.

The Addis Ababa reunion followed increased pressure from regional and international actors to end the violence. Last week, the United States issued sanctions against a military leader on each side of the conflict and warned more could be in the offing.

Under the revived deal, the two sides agreed not only to freeze their troops within 24 hours, but to give humanitarian groups access to thousands of civilians caught in combat zones. UNMISS announced within hours of the signing that they were standing by to begin deliveries of “life-saving aid” if the ceasefire took hold.

There was suddenly cause to consider, not whether South Sudan could be saved, but how this deeply-divided country could be repaired.

The depths of these divisions were revealed in the days before the meeting, when UNMISS released a report documenting “gross violations of human rights” by both sides during the ongoing clashes, including the targeted killing, rape and kidnapping of innocent civilians.

There has been an ethnic cast to the fighting from the start, pitting Kiir’s Dinka community against Machar’s Nuer, and the violence against civilians has deepened distrust between the country’s different groups.

In one of the many horrific episodes, the rebels stand accused of murdering more than 200 civilians hiding in a mosque in the northern town of Bentiu, capital of Unity state. Nearly 80,000 people have now taken refuge at UNMISS bases, behind the protection of U.N. peacekeepers.

More than 10,000 people have crowded into U.N. House, which also hosts blocks of U.N. offices. From their windows, U.N. staffers can now peer out over a vast makeshift campsite, built mostly of plastic sheets, scrap metal and wooden planks.

U.N. House holds some of the earliest victims of the crisis, mostly Nuer from the surrounding neighbourhoods. They fled to the base as security forces conducted house-to-house searches during the height of the Juba clashes.

A boat of women and children arrives in Mingkaman, Awerial County, Lakes State, South Sudan. In less than a month close to 84,000 fleeing the fighting in Bor have crossed the river Nile to Awerial. Credit: Mackenzie Knowles-Coursin/IPS

Among the testimonies UNMISS collected are stories of uniformed men storming through those communities, capturing and interrogating civilians in the Dinka language. “If a person questioned in this way admitted to being Nuer, could not speak Dinka or was able to speak Nuer, that person would be shot,” according to the report.

Members of the Dinka community harbour concerns about peace should Machar be invited back into any future government. There is no political solution that will salve all of the country’s wounds.

The only option is forgiveness, Reverend Bernard Oliya Suwa told IPS. And as soon as a ceasefire takes hold, it will be his task to convince Chioh – and countless others – to choose that path and attempt to reconstruct South Sudan. Suwa is the secretary general of the Committee for National Peace, Reconciliation and Healing.

The Committee pre-dates the conflict. Kiir created the body in April of last year and directed its five heads, culled from the country’s religious leadership, to address injustices committed during the southern rebels’ decades-long fight for independence from Khartoum.

Their plan, arrived at in early December, was to recruit county-level “peace mobilisers” to spend months in their communities gathering testimony and presenting it to local mediators. Grievances “of higher concern,” Suwa said, including complaints over resource allocation or large-scale atrocities, would be referred to state or national committees.

A mother and children walk amongst flooded shelters at the Tomping IDP camp. Credit: UN Photo/Isaac Billy

The committee’s plans have already been adapted to the recent violence. They would work with two other bodies, including a Parliamentary commission, to form a broader National Platform for Peace and Reconciliation. He acknowledges that after the recent fighting, “the level of mistrust in this country runs so deep,” but told IPS he believes the Committee members can help allay it. But only if there is peace. Which is why the renewed cessation of hostilities agreement “is a huge, huge relief. Knowing that we can go ahead and roll out our programmes.”

The ceasefire officially went into effect late Saturday night. It held less than seven hours. U.N. officials confirmed both sides spent Sunday morning trading fire in and around Bentiu.

By the time Kiir’s plane touched down in Juba later that afternoon to a crowd of people gathered to celebrate the peace deal, each camp was accusing the other of provoking the fighting. Those accusations have continued every day since.

A young boy looks through a monocle in the teaching hospital in Malakal, Upper Nile State, South Sudan. Fighting continues here despite a ceasefire agreement. Credit: Mackenzie Knowles-Coursin/IPS

By Andrew Green
JUBA, Feb 3 2014 (IPS)

South Sudan is taking the first steps in what promises to be a long process of healing the fractures that prompted more than five weeks of fighting, potentially leaving thousands of people dead and wounded and displacing 863,000 others.

But tensions remain high, following reports of continued fighting in some areas of the country and the government’s decision to move forward with treason charges against four remaining political detainees. And the longer the process stretches on, the worse the situation will become for the hundreds of thousands of displaced across the country.As the numbers of internally displaced continue to grow, the U.N. and humanitarian partners are struggling to provide enough food, clean drinking water and shelter for all of them.

Upper Nile State Information Minister Philip Jiben Ogal told IPS there was gunfire last week outside of Malakal, the state capital. The fighting is in contravention of an almost two-week-old ceasefire agreement between the government and rebels.

Martin Ojok Karial lives in Malakal, working in the Ministry of Finance’s taxation office. Malakal suffered two waves of fighting and was temporarily held by government forces. The town’s central market is destroyed and at least 27,000 people have sought refuge at the United Nations base on the outskirts of town. Karial is one of them.

The humanitarian medical group Doctors Without Borders (MSF) also announced Jan. 31 that ongoing insecurity had forced thousands of people to flee into the bush in Unity State.

Karial sees the fighting as a political feud that was allowed to get out of control.

“A lot of people were dying without any reason,” Karial told IPS. “Because the clashes are between two people. The president of South Sudan and the vice president. This is no reason for people to fight and kill themselves.”

The fighting here first broke out in a Juba military barracks on Dec.15 and spread quickly – first throughout the capital and then across central and eastern South Sudan. President Salva Kiir accused his political rival and former deputy Riek Machar of launching a coup against the government. Machar has repeatedly denied the charges, though he acknowledges he is now in open rebellion against the government.

Following weeks of negotiations in Addis Ababa, the two sides inked a cessation of hostilities agreement Jan. 23. Just hours after signing the document, they began accusing each other of violations.

Karial said people have now lost faith in their political leaders. Even if the two sides strike a peace deal, he said, they would be hard-pressed to convince people like him that it will last.

The government released seven of the 11 political prisoners it had held since mid-December, flying them to Nairobi, Kenya’s capital, late last week. And on Saturday Feb. 2, an advance wave of regional observers arrived to begin monitoring a ceasefire agreement signed between rebels and the government.

While acknowledging there was not enough evidence to charge seven of the detainees, Justice Minister Paulino Wanawilla announced treason charges against the remaining four.

Wanawilla accused them of helping Machar and two others – all of whom are still at large – orchestrate a coup against the government, prompting the outbreak of fighting.

“I think there is enough [of a] case to take them before the court,” Wanawilla said.

Despite the government’s latest refusal to accede to the rebel demand, neither side has backed out of peace talks, which are scheduled to resume this week in Ethiopia.

“The parties are committed and they are ready to resolve the conflict in a peaceful way,” Ethiopian major general Gebreegzabher Mebrahtu said after arriving in Juba. Mebrahtu heads the monitoring efforts organised by the Inter-Governmental Authority on Development, a regional bloc.

It is unclear whether the two sides can strike a bargain that will bring the divided country back together again.

In a pastoral exhortation released late last week, Cardinal Zubeir Wako called for “better governance across the nation and an end to the personalised political power.”

Until people feel safe and they have some control over their political leaders and the events in the country, they will not leave the U.N. bases, the churches and the mosques where they sought shelter from the fighting.

Valerie Amos, U.N. Humanitarian Affairs chief, visited Malakal last week and talked to a handful of the more than 64,000 people displaced in the county.

“Even when I said, ‘We need to work on reconciliation, we need all the communities to come together, the leadership to come together. We need to make sure that people’s safety and security is guaranteed.’ Even then, people were not convinced,” she said. Instead, they asked to be moved to other parts of the country or to leave entirely.

It is a tenuous situation. As the numbers of internally displaced continue to grow, the U.N. and humanitarian partners are struggling to provide enough food, clean drinking water and shelter for all of them. They are also contending with the risk of disease outbreaks.

Aid workers are also starting to draw attention to the long-term implications of the situation.

“We’re coming up to the hunger gap and it is very likely because people have been forced to move as a result of the insecurity, that they won’t have the same food reserves that they had before,” MSF general director Arjan Hehenkamp told IPS.

The U.N. has announced that while 3.2 million people are at risk of immediate food insecurity, more than seven million people may become food insecure this year.

And as the two sides continue discussions, the situation is only going to get worse.

A boat of women and children arrives in Mingkaman, Awerial County, Lakes State, South Sudan. In less than a month close to 84,000 fleeing the fighting in Bor have crossed the river Nile to Awerial. Credit: Mackenzie Knowles-Coursin/IPS

By Andrew Green
JUBA, Jan 24 2014 (IPS)

The overwhelming job of providing relief to the more than half a million displaced and wounded in South Sudan may have gotten a little easier with the signing of a ceasefire agreement last night in Addis Ababa, which is set to go into effect today.

The government and rebel groups, who have been locked in more than five weeks of fighting, agreed to freeze their positions and open corridors to humanitarian groups desperately trying to deliver food and medicine to those in need. Relief workers are warning that the scale of the crisis will prove to be even larger as they gain greater access. Meanwhile, doubts linger about whether the agreement will hold.

The fighting in South Sudan started late on Dec. 15 in military barracks in Juba and then spread quickly around the capital city. President Salva Kiir has accused his political rival and former deputy Riek Machar of launching a coup against the government – a charge Machar has denied. But the former vice president has acknowledged that he is now openly in rebellion against the government.Jonglei’s capital, Bor, which government forces reclaimed late last week, is decimated and bodies are still scattered in the streets.

In the weeks after the initial violence, clashes between the army and anti-government forces have been reported in at least seven states. Rebels seized three state capitals, though the government has since regained control of the towns.

Aid organisations report thousands of people are suspected to have been killed and wounded, though it is impossible to gather an accurate estimate at the moment, because access to many areas of the country is still limited. What is clear is that the five weeks of fighting have created a severe humanitarian crisis.

The United Nations reports that at least 494,000 people were internally displaced – nearly one-tenth of the population. Less than 220,000 of them have received any assistance so far. Another 86,000 people fled to neighbouring countries.

Jacob Kurtzer, a spokesperson for the International Committee of the Red Cross (ICRC), said the known needs are massive.

“We’ve seen people displaced without any personal effects,” he told IPS. “Leaving their homes without basic shelter, very little food. We’re always concerned about sanitation. And the last would be the medical care, in particular, for the people who have been weapon wounded, to be able to respond to their medical needs. We’re trying to meet all of those needs simultaneously.”

The United Nations Children’s Fund (UNICEF) flew in 70 tonnes of emergency supplies and medicines this week to distribute to women and children across the country.

At least 70,000 people have crowded into U.N. bases around the country to escape the fighting. But the cramped conditions and a shortage of toilets have created a high risk of disease transmission. UNICEF has warned of an outbreak of measles at some of the camps, which has prompted two emergency vaccination campaigns.

And that is only for those people the aid groups have been able to reach.

Dermot Carty, UNICEF’s deputy director for emergency operations, told IPS that the fluid nature of the fighting made it nearly impossible to predict where they could even maintain a sustained response.

UNICEF’s plans to reach 70,000 displaced people this week in Awerial County in northeastern Jonglei state had to be postponed at the last minute, he said, when unexpected fighting broke out.

“We were all ready to go and the security situation suddenly changed and we had to stand down.”

With a ceasefire now in place, the government, the U.N. and humanitarian groups are hopeful those interruptions will stop and they will be able to start reaching the hundreds of thousands of people who have gone without assistance so far. But better access is also likely to reveal an even bigger demand for assistance.

Paul Akol – a national lawmaker from Jonglei and a member of Kiir’s Crisis Management Committee – travelled with a team to Jonglei’s capital, Bor, which government forces reclaimed late last week. He said the town is decimated and bodies are still scattered in the streets.

“These towns are towns in name, but nothing exists on the ground,” he told IPS. “The houses are on the ground. The shops are on the ground. The little infrastructure that we built during the interim period has been completely destroyed.” He said it would take months, if not years, of assistance to help people start rebuilding their lives.

He suspects emergency response teams will encounter the same situation as they enter other areas that have been subject to intense fighting – when they are able to get there.

In a country that was already difficult to navigate – there are few paved roads and much of South Sudan is prone to floods during the months-long rainy season – the wide-scale destruction from the fighting has only made it more difficult and more expensive to get around.

The ICRC’s Kurtzer said his organisation already anticipates South Sudan “will be one of our most expensive responses in the next year. To a certain extent, that reflects the challenge of operating in this particular environment. But I think it also reflects the scale of the needs.”

The U.N. has already put out an emergency appeal for 209 dollars million just to respond to the immediate crisis and has said the country will require 1.14 billion dollars in assistance over the next year.

And that is only if the situation stays where it currently is. Oxfam Country Director Jose Barahona told IPS that this is not a guarantee.

“We don’t expect that the ceasefire means there’s no more shooting the following day. There are a lot of people with guns out there. All sorts of different groups armed. I think we cannot be naïve.”

It is also unclear whether the loose coalition of anti-government forces are all allied with Machar and feel bound by the agreement.

That could mean continued danger for hundreds of thousands of people across the country and ongoing difficulties for the aid agencies that are trying to help them.

A celebration erupted when the Dinka Ngok leaders announced they would be moving forward with the unilateral referendum in the disputed Abyei region which both Sudan and South Sudan lay claim to. Credit: Andrew Green/IPS

By Andrew Green
JUBA, Nov 4 2013 (IPS)

The non-binding referendum in Abyei – where people voted overwhelmingly to join South Sudan – and the ensuing celebration, has brought little immediate resolution to the long-festering Abyei problem.

Instead, the spectre of potential conflict looms between the Dinka Ngok and the Khartoum-allied Misseriya tribe, who also lay claim to the territory.

Both Sudan and South Sudan claim the 10,000 square kilometre area, which is home to the Dinka Ngok and – seasonally – to the Misseriya, who bring their cattle there for grazing.

As the Human Security Baseline Assessment (HSBA), which provides independent analysis on issues facing the Sudans, has pointed out, Abyei’s grazing season starts this month. Soon the Misseriya will come into contact with some of the tens of thousands of Dinka Ngok who returned to the area for the referendum. HSBA warns this will “pose great challenges for UNISFA” – the United Nations Interim Security Force for Abyei.“Both governments are not part of the referendum, so there is [no] disturbance that is going to happen.” -- Mawien Makol Arik, South Sudan's foreign affairs ministry spokesperson

Abyei Referendum High Committee spokesman Luka Biong acknowledged that violence is one possible – though unlikely – outcome of the vote. He told IPS a Misseriya attack could “spark a small war or escalate into a bigger war if the South is prepared to fight.” But neither government is interested in another battle, he added.

Biong explained that the Dinka Ngok leadership was under no illusion the referendum would settle the Abyei question once and for all. That, however, was not really the point.

“There’s a possibility this could [create] real pressure,” he said, adding that officials will have to “see the consequence of what we have said.” And in that they have been successful. Though they are trying, the Dinka Ngok’s actions will be hard for the two governments – especially Juba – to ignore.

In the peace agreement that ended the decades-long Sudanese civil war, the Abyei community was promised a referendum to coincide with the January 2011 ballot to determine the future of southern Sudan. The south got their vote and promptly split from Sudan. But there was no referendum for Abyei.

Last September a panel of African Union (AU) experts called for a Dinka Ngok-only referendum for October this year. However, the AU backed away from the proposal when Khartoum objected to the exclusion of the Misseriya.

The Dinka Ngok leadership pressed ahead with the referendum, despite warnings from the AU that the move could threaten peace in the region. And on Oct. 31, Abyei Referendum High Committee officials announced the results of their hastily-organised, unilateral referendum to determine the future of the disputed area.

The vote only included the pro-South Dinka Ngok community and, as anticipated, the decision was nearly unanimous – more than 63,000 people voted to join South Sudan. Twelve people voted for Abyei to remain part of Sudan, officials reported.

As soon as the votes were read, leaders of the nine Dinka Ngok kingdoms signed pledges declaring their intention to join South Sudan.

Officials in Juba, unwilling to upset their relationship with Khartoum, made their feelings about the referendum known by keeping silent.

But Biong is hoping that the Dinka Ngok vote will trigger the AU to re-start negotiations between Khartoum and Juba. There is evidence this is already happening.

An AU team is set to arrive in Abyei Tuesday, Nov. 5, for a two-day visit. Ahead of the visit, they have already called for the U.N. Security Council to extend its support to the September 2012 proposal, which calls for “Abyei residents to determine their political future, and the right of continued access for migratory populations.”

Bringing Khartoum and Juba to the table will be difficult, though. The notoriously chilly relationship between the two governments is currently thawing, signalled by Sudanese President Omar al-Bashir’s visit to Juba in October.

Both countries are benefiting from the détente. When landlocked South Sudan seceded, it took with it three-quarters of Sudan’s oil reserves. But Sudan retained the only pipeline South Sudan has for exporting its crude. Early last year Juba cut off oil production, citing the high fees Khartoum was charging to use the pipeline. The issue was resolved after more than a year and production restarted in March. So far South Sudan has made 1.3 billion dollars from renewed sales, according to the Ministry of Petroleum, of which it has paid 329 million dollars to Sudan.

Dr. Alfred Lokuji, a professor of peace and rural development at the University of Juba, told IPS that in light of the current situation, both sides will “be careful about trying to escalate things” when it comes to Abyei.

The leaders of the two countries have skirted the Abyei question. They have called for a joint administration and police force for the region, but failed to set a timeline. They did not even broach the issue of a referendum, though Juba has voiced support for the AU proposal in the past.

Mawien Makol Arik, South Sudan’s foreign affairs ministry spokesperson, told IPS that the government would not allow the Dinka Ngok vote to upset the improving relations.

“The two presidents have laid out a communiqué to actually expedite the Abyei administration to be set up,” he said. “Both governments are not part of the referendum, so there is [no] disturbance that is going to happen.”

While Khartoum may be able to get away with not immediately addressing the issue, Juba might not have that luxury. There are deep ties between Abyei and South Sudan, with many members of the Dinka Ngok serving in high-profile government positions where they are well positioned to lobby the government.

And President Salva Kiir’s political rivals have already signalled they are prepared to make political hay out of the issue if South Sudan decides to keep quiet about Abyei.

William Rial Liah, the secretary-general of the opposition Democratic Unionist Party, travelled to Abyei in the days ahead of the referendum to show his support.

“We are behind the Abyei people,” he told IPS. “Let the Abyei people go with this decision and we back them until the end.”

While the outcome of the referendum may never be recognised, Dinka Ngok leaders may have gotten exactly what they wanted out of the vote: bringing diplomatic and – in Juba’s case – political pressure to bear so they finally get the referendum they were promised.

A woman registering to vote at a school in the border town of Abyei on Oct. 20. She was one of more than 100 people living in the town who showed up to register on the first day as people voted whether to join Sudan or South Sudan. Credit: Andrew Green/IPS

By Andrew Green
ABEYI, Oct 30 2013 (IPS)

When Chris Bak returned two weeks ago to the disputed border town of Abyei, which voted this week on whether to join Sudan or South Sudan, he barely recognised it as the place where he grew up. “Everything is dirty,” he told IPS. “We were just going around and around, but we didn’t [recognise] this place.”

The town lies in the centre of the Abyei region, a 10,000 square kilometre area that straddles the border between Sudan and South Sudan. Both countries lay claim to the area, with its oil reserves and vast tracts of fertile land. A 2005 peace agreement ended the decades-long Sudanese civil war and paved the way for South Sudan’s independence, but failed to resolve Abyei’s fate.

Since he returned, Bak has been camping out in an abandoned classroom, hoping it does not rain because the school has no roof. He is sharing the room with a friend who is showing symptoms of malaria. Bak has been trying to track down a doctor, but after three days of asking around he had still not located anyone.

“There are difficulties that face us,” he said. “We need to bring up Abyei.”“The children, the old men just die. There’s no medical care. It’s not good.” -- Deng Agos Lowal, member of the region’s Social Welfare Commission

Bak, 25, returned to Abyei after five years away to participate in a referendum initially proposed by the African Union (AU) for this month, which is meant to decide the fate of the contested region.

But Sudan refused to sign on, as the referendum would have excluded members of the pro-Sudan Misseriya community, who visit Abyei seasonally to graze their cows. In the face of Khartoum’s intransigence, the AU did not organise the vote or present a new proposal.

That did not staunch the enthusiasm of the majority Dinka Ngok community who pressed ahead with a unilateral referendum that ended on Tuesday Oct. 29.

An organisation of tribal leaders, calling themselves the Abyei Referendum High Committee, began organising trips last month for people who wanted to take part in the vote. They estimate they have brought 100,000 people back to the area, though it is impossible to verify that number.

They plan to announce the results before the end of the month and it is likely they will vote to join South Sudan.

However, the AU has “strongly condemned” the move, calling it an “illegal action” and warning that it could threaten peace in the region. South Sudan has said it will refuse to acknowledge the results.

“If the people of Abyei decide, we will see to whom will they direct their results, because they said they will do it without the government of South Sudan and without the government of Sudan,” South Sudan’s government spokesman Michael Makuei Lueth said last week. “And if it is done without us, to whom will they direct their results?”

Dr. Alfred Lokuji, a professor of peace and rural development at the University of Juba, told IPS that the vote “is not going to accomplish much of anything” as both the AU and Juba have made it clear they will not recognise the outcome.

He does not anticipate any violence to result from the vote. However, he described the unilateral move as “symbolic,” showing the Dinka Ngok community is determined to have the situation resolved.

Sudanese President Omar al-Bashir travelled to Juba last week for a meeting with South Sudan’s President Salva Kiir. At the end of the summit, the two leaders announced plans to move ahead with a joint administration and police force for Abyei, though they failed to set a timeline on when that would happen.

The Dinka Ngok leadership, tired of living in limbo, have rejected the proposal.

In part that is because they no longer have the luxury of waiting for Juba, Khartoum and the international community to reach a permanent solution.

In 2008, fighting broke out in this area between militias supported by the Sudanese government and forces from what was then southern Sudan. Human Rights Watch estimates 60,000 people fled the violence. At the time, Bak and his family fled to Aweil, which is a five-hour drive west of Abyei and is located in South Sudan.

Fighting erupted again in 2011, only weeks before South Sudan officially split from Sudan to become the world’s newest country. The battles left Abyei town in ruins. The ground is dotted with concrete foundations where houses used to stand. A toppled red-and-white cell phone tower rests crookedly on top of trees and buildings.

Having brought thousands of people back to Abyei to see the area’s devastation first-hand, the Dinka Ngok leadership are facing pressure from people like Michael Acuil Deng, an engineer who has been living in Juba, to make something happen now.

“You see around, we have [to do] a lot of planning for our area to be the best,” he told IPS. “Now everything is like the desert. It’s crushed. Now we start from the scratch. We have to build the area.”

Development is difficult in a no man’s land, though.

Deng Agos Lowal stayed in the area despite the fighting. He is a member of the region’s Social Welfare Commission, a locally-appointed body that attempts to provide basic services to people. With no support from either Juba or Khartoum, he said there is little they can do to actually help people, let alone track the fluid population.

“The children, the old men just die,” he told IPS. “There’s no medical care. It’s not good.”

A United Nations peacekeeping force is visible here, but Lowal said the region’s uncertain future has kept most humanitarian organisations out. All anyone can do, he said, is wait for the vote to decide Abyei’s fate. When that is resolved the rebuilding of Abyei can begin.

Despite the warnings from Juba and Khartoum, Dinka Ngok leaders are holding out hope that the international community will eventually recognise the outcome of their unilateral referendum.

At the very least, Dinka Ngok paramount chief Bulabek Deng Kuol said he hopes the vote means the regional and international community will no longer ignore Abyei’s needs.

“We are excited to rebuild, to give our energy for everything,” he told IPS. “We hope all the organisations … are rushing here to give some help to the people here.”

Less than one-third of Ugandan women use any form of birth control, according to the country’s 2011 Demographic and Health Survey. Credit: Andrew Green/IPS

By Andrew Green
Nov 14 2012 (IPS)

Every day at least five women are brought to the gynaecological ward of Uganda’s Mulago National Referral Hospital in Kampala for treatment for complications caused by crude attempts to terminate their pregnancies.

According to Dr. Charles Kiggundu, the head of the hospital’s gynaecological department, some of the women who come here drink gasoline or take untested combinations of herbs and drugs to induce an abortion. Others insert sticks into their vaginas.

The women at the Mulago National Referral Hospital are a small percentage of the estimated 150,000 women who suffer complications from unsafe abortions each year in this landlocked East African nation, where 1,200 women die annually from unsafe abortion attempts, accounting for a quarter of all maternal deaths in the country.

Here a “failure of knowledge about contraceptives” is driving up the rate of unsafe abortions, especially among young women, Kiggundu told IPS.

Less than one-third of Ugandan women use any form of birth control, according to the country’s 2011 Demographic and Health Survey.

A number of the women treated by Kiggundu are unmarried students, many of whom have been abandoned by their partners, he said.

According to The State of World Population 2012 report titled “By Choice, Not by Chance; Family Planning, Human Rights and Development” published on Wednesday Nov. 14 by the United Nations Population Fund, unsafe abortions represent almost half of all abortions globally. According to the report, nearly all unsafe abortions take place in developing countries, with the greatest number occurring in sub-Saharan Africa.

The most recent data found that adolescents and youth account for approximately 40 percent of unsafe abortions worldwide.

“In sub-Saharan Africa, adolescents between the ages of 15 and 19 have, on average, 120 births per 1,000 per year, ranging from a high of 199 per 1,000 girls in Niger to a low of 43 per 1,000 girls in Rwanda. Over half of young women give birth before age 20, and adolescent fertility in most countries in sub-Saharan Africa has shown little decline since 1990,” the report stated.

Moses Mulumba, the executive director of the Centre for Health, Human Rights and Development (CEHURD), said the issue of unsafe abortions was a growing concern among young people in the country.

“The majority of people who are affected are high school and university students,” he told IPS. “There’s no question about it. It’s a problem of the youth.”

But some of the unsafe abortion attempts could have been avoided had women been more aware of efforts to expand legal access to the procedure. There is still a widespread perception that all abortions are illegal in the country, according to Elisa Slattery, director of the Centre for Reproductive Rights’ Africa division.

In 2006 the Ministry of Health legalised abortion in cases of serious risk to the life or mental health of the mother, severe foetal abnormalities, health issues like cervical cancer or HIV/AIDS, or when the pregnancy is the result of rape or incest.

Greater knowledge about the law’s interpretation could reduce unsafe abortion rates, not just by allowing access to women who legally qualify, but by reducing the stigma around the issue, Slattery told IPS.

Policy guidelines released this year by the government affirmed all women are entitled to post-abortion care – even if the abortion was illegal. But Mulumba said that officials have not done enough to explain to women when they are entitled to a safe abortion.

“Historically people (consider) abortion to be a bad practice,” Mulumba said. “Many people don’t want to talk about it.”

That includes doctors and other health care providers, he said, who could offer the service if they felt morally comfortable doing so.

Kiggundu explained that some health care professionals were reluctant to conduct abortions because of the stigma that surrounds the procedure. Most doctors are either not well informed about the country’s abortion policy or are averse to performing the procedure, and are unlikely to recommend it even in cases where it is necessary, he said.

Reducing the number of unsafe abortion attempts in Uganda would require overcoming that stigma and educating both women and doctors about the current legislation, Slattery said.

“We have to empower healthcare providers, within the legal and policy frameworks,” she said.

Easing the stigma will not only facilitate access to abortions for women who qualify, but it will also encourage more women who are considering an abortion to consult a professional first, said Joy Asasira, a programme assistant at CEHURD.

“It’s not to say that if she wants one, it’s her right, so let her do it,” Asasira told IPS. But by “letting information flow,” she said, women would be more likely to talk to a health worker first and learn the risks of unsafe abortions.

That will not solve the problem of the high number of unsafe abortions attempted by young, poor and undereducated women who have difficulty accessing medical services, Slattery said. There will still be women who want to terminate a pregnancy, but who do not qualify for a legal abortion and are unable to afford a safe, illegal one.

Asasira said one answer was better access to family planning and contraception.

“(People are) becoming sexually active at a younger age and this is exacerbated by the fact that there is a high unmet need for contraception, while information about reproductive health services is lacking…  If training in family planning and how to use these services is done, we will definitely bring down the incidence of unsafe abortions,” she said.

Asasira said the mounting number of deaths forced policymakers to re-evaluate the issue. The new guidelines from the ministry of health have made post-abortion care an integral part of sexual and reproductive health services. This includes both emergency services and counselling for women on how to prevent unwanted pregnancies.

She said hopefully this opening would spur government health workers to push information more systematically – about contraception, but also about where women who qualify can access safe, legal abortions.

“Sometimes the duty of the government is to give the people what they need, even if (the government) doesn’t agree,” she said.

Annet Nakabiito, 22, dropped out after her fifth year of primary school. After attending a skills-training programme in hairdressing, she is now working in a hair salon in Kampala. Credit: Andrew Green/IPS

By Andrew Green
KAMULI, Uganda, Sep 26 2012 (IPS)

Three years ago, after Irene Kamyuka finished her sixth year of primary school in Uganda, her father ran short of money. With four siblings ahead of her in school, Kamyuka’s father told her she would have to drop out until his finances turned around.

“My father told me the money was finished,” she said. “He said: ‘You (wait) until the others are finished.’”

Kamyuka, determined to “study so that in my future I can get a job,” stuck it out. Eventually enough money was available so she was able to finish the last year of primary school, the seventh, in May this year. Then it ran out again before she could go on to secondary school. 

Though this East African nation’s government-run schools are theoretically free, in reality parents who cannot afford to pay for uniforms, books and supplies cannot send their child to school.

Ugandans who live in rural areas, like Kamyuka, from Kamuli – a town on the edge of Lake Kyoga in central Uganda – and who make their living as subsistence farmers, run into consistent difficulties paying for their children’s schooling.

As in Kamyuka’s case, the outcome is often an interrupted – or cancelled – education. As dropouts, girls say they are stigmatised because people assume they left school because of a sexual relationship. In reality, though, the choice to stay in school is usually not even one they are allowed to make, because parents often see little incentive in ensuring that their daughters finish school.

“They look at the girl as a liability, because what the family does is to prepare a girl for a marriage,” said Johnson Ntende, the director of Kamuli Progressive College, a secondary school near the centre of town. “The role of a wife in a home is to cook for children and look after the man. That role does not require academic achievements.”

According to preliminary statistics from Uganda’s Ministry of Education for the 2012 school year, the number of girls who qualified to attend secondary school stood at 343,000, in contrast to 408,000 boys.

According to the World Bank, the literacy rate for young females aged 15 to 24 in this landlocked east-central African nation of 35 million was 84 percent in 2010, compared to 90 percent of males in the same age group for that year. This is a trend that is played out around the world, with girls less likely to be enrolled in school and to access medical care and more likely to be deprived of food.

The result, according to World Bank research, is a less-productive and more impoverished society.

In Kamyuka’s case, her parents wanted to send her to school, but simply could not afford it. The 15-year-old is now in her first year at Kamuli Progressive College though, thanks to funding from Plan International. She started school in August this year.

The international development charity is paying her term fees, which work out to about 20 dollars every three months. While the school is a public-private institution and receives some funding from the government under the universal primary education programme, there are some extra fees attached for uniforms and books.

Gloria Titi, the Plan International programme coordinator, said that in addition to paying for 54 girls in the area to go to school, the charity is also looking at ways to improve the environment in and around the school to mitigate a dropout rate that is still “too high” – and often has nothing to do with money.

Up to 54 percent of girls in Kamuli will drop out of school before finishing, according to Titi. At Kamuli Progressive College, there is a chart on the wall of the director’s office listing enrolment figures. There are 133 girls enrolled in their fourth year; the number drops to 21 for the fifth.

The reasons are myriad: harassment from men on the long walk to school, a lack of private bathroom facilities, and no money to buy sanitary pads during menstruation. Kamyuka said that some of the boys at her school target girls for consensual or forced sexual encounters, which can then harm the girl’s reputation. And if she becomes pregnant, she’s forced out, while the father of the baby is able to continue.

“(Girl students) start loving boys, which will lead them to school dropout,” Kamyuka said. “Boys are just destroying our lives.”

Kamyuka and her peers say that without an education, early marriage is the only option left to them. That idea is pervasive in Ugandan society. It kept Claire Namakula in a two-year abusive relationship.

At 15 she moved in with a man – who “beat me; he was abusing drugs, taking alcohol, smoking” – and quickly got pregnant. After two years, and despite not having any money, she took the unusual step of moving out on her own in Uganda’s capital city, Kampala.

Namakula, who is now 28 and was denied the opportunity to go to school, took a class on catering for undereducated women. When it finished, she and the other women formed a catering company, which they named Allied Female Youth Initiative. She said the training showed her that she had other options besides being dependent on a boyfriend or husband.

Before the training, “I didn’t even have an account in the bank,” Namakula said. “People would not respect me. Now, people can even kneel and say ‘hello’ to me as a responsible person.”

LGBT activists, human rights observers and police officers wait outside a courtroom in Uganda's constitutional court. Four activists had brought a case against Minister of State for Ethics and Integrity Simon Lokodo. Credit: Will Boase/IPS

By Andrew Green
KAMPALA, Aug 21 2012 (IPS)

In the face of rising public criticism over a range of controversial political manoeuvres, the Ugandan government has become increasingly hostile to the work of non-governmental organisations, particularly those advocating for the rights of the lesbian, gay, bisexual and transgender community, according to a new report from Human Rights Watch.

The report, released on Aug. 21, said that intimidation and obstructionist tactics have, over the last year, been used against NGOs working across a range of issues.

The report, “Curtailing Criticism: Intimidation and Obstruction of Civil Society in Uganda”, draws on interviews with 41 NGO officials, government representatives and donors in Kampala. HRW found that some civil society groups have started self-censoring in order to protect their staff, reflecting wider concerns that criticism of the government can be increasingly dangerous.

“The attacks on freedom of expression appear to coincide with increasing criticism of the ruling party’s governance,” Maria Burnett, a senior researcher for HRW’s Africa division and the author of the report, told IPS.

“At various times since President Yoweri Museveni took office in 1986, there has been some tolerance for critical or divergent voices. But since the February 2011 elections, government actors have been tightening the controls on both access to information and people’s abilities to express themselves, to obstruct the public’s understanding of the causes of the economic and political turmoil,” Burnett said.

Museveni, who has been in power for 27 years, is expected to run for another term of office in 2016.

“Since his re-election in 2011, political tensions have been running high and public criticism of government has escalated. To better control this environment, the ruling party’s high-ranking government officials are increasingly scrutinising NGOs and the impact they might have on public perceptions of governance and management of public funds,” HRW said in a statement on Aug. 21.

The report’s release comes on the heels of several clashes between the government and local and international NGOs. Officials threatened in May to kick Oxfam International out of the country if the British charity did not retract and apologise for allegations it made the previous September that more than 20,000 Ugandans were the victims of land grabs by a British multinational.

And in June the government ordered the Advocates Coalition for Development and Environment – a local think tank – to stop all political activities.

At the time, State Minister for Internal Affairs James Baba told Uganda’s Daily Monitor that his ministry, which has oversight of the country’s NGO Board – the government-run institution that currently oversees the non-profit sector in Uganda – was “working within its mandate.”

These moves come in the wake of increasing civil society analysis, research and criticism on a range of issues. This includes charges – raised by opposition politicians in parliament last year – of corruption in the fledgling oil sector, high inflation, and poor delivery of education and health services.

Efforts to highlight these issues, including a widely covered Walk to Work campaign organised by Activists for Change, have drawn international attention and – in the case of Walk to Work – violent crackdowns by police.

HRW reported that some of the civil society workers they interviewed said they had received anonymous phone calls encouraging them to stop researching certain issues. Others suspected their phones were tapped or their homes were under surveillance.

Though the number of high-profile incidents has increased in 2012, the government has had a history of obstructing NGO activity in the past – especially groups working around the LGBT and commercial sex worker (CSW) communities.

In 2009, Akina Mama wa Afrika (AMwA), a pan-African women’s advocacy organisation, attempted to hold a leadership training workshop in Uganda for CSWs. Although AMwA organisers said they informed government officials that they were planning the workshop and sent them a proposed agenda, the meeting was shut down the day before it was supposed to happen. The organisers had to shift the workshop to Nairobi.

The workshop was “not about promoting sex work,” Vivian Ngonzi, AMwA’s executive assistant, told IPS. “These were very learned women. They were discussing self-help, learning about their rights… I don’t know what’s illegal about that.”

The government has continued to close down workshops, specifically those focused on members of the LGBT community. HRW’s report highlights the “aggressively homophobic agenda” of Minister of State for Ethics and Integrity Simon Lokodo who ordered the closing this year of two workshops that included LGBT activists.

In February, he closed down a five-day meeting in Entebbe, Central Uganda, after participants, who included LGBT activists, were told that it was an illegal gathering. After the incident, four of the attendees filed a case against him in the constitutional court, charging him with denying them their constitutional right to assemble.

Declaring the fight against homosexuality a “national priority,” Lokodo also told HRW that groups like Sexual Minorities Uganda (SMUG) were “on a mission to destroy this country.”

Lokodo’s efforts have been made at the same time that a proposed Anti-Homosexuality Bill in Uganda seeks to criminalise homosexual activities and introduce the death penalty in some cases.

The bill – originally introduced in 2009 by member of parliament David Bahati, who claims that homosexuality has been imported from the West – listed the death penalty as punishment under an offence called aggravated homosexuality. This, according to the 2009 draft of the bill, was defined as “repeat offenders” of homosexuality, or when one of the participants in a homosexual relationship is under 18, or has a disability, or is HIV-positive.

The bill was allowed to lapse during last year’s parliament, and was reintroduced by Bahati in February, this time without the death penalty clause.

Pepe Onziema, the advocacy and policy officer at SMUG and one of the plaintiffs in the case, told IPS that the situation is getting “harder and harder” for LGBT-focused NGOs.

Onziema said, in the case of LGBT activists, the government is focusing on “a particular group of organisations to intimidate the rest of society” – something HRW also concluded.

“After the threats of closing down NGOs… things are getting worse,” Onziema said.

Local media organisations reported that Lokodo planned to ban 38 organisations that were sympathetic to the LGBT cause, though no action has yet been taken. HRW’s report found, even among groups not working on LGBT issues, that there is growing concern that any precedent established in closing those groups could later be applied to them.

HRW has called on the Ugandan government to reverse course “to change and improve its terms of engagement with all NGOs.” It noted that NGOs were forced to scale back their work, especially on controversial topics such as LGBT rights, in order to continue operating.

“One LGBT organisation had a small project to distribute brochures which carried the message that LGBT people are like everyone else and that God loves them. Because of the government’s obstructions to the work of LGBT groups, the organisers of this project felt that their volunteers would be unsafe and have stopped this work. In order to continue operating and providing services to their community, they have since limited the scope of their work,” the report says.

Specifically, HRW is calling for autonomy for the NGO Board. The organisation is also urging the government to investigate instances of unlawful interference, harassment or intimidation of NGOs, like the workshop closures.

A team from Kawempe Home Care visits Barbara Namirimu, one of their patients, at her home in Kampala, Uganda. Credit: Andrew Green/IPS

By Andrew Green
KAMPALA, Jun 23 2012 (IPS)

As soon as Sanyu Nagia sits down outside Barbara Namirimu’s home, she asks to see her patient’s bag of medicine. It is too heavy for the ill Namirimu to carry, so her mother, Efrance Namakula, brings it out and hands it over.

It is bulging; filled with anti-retrovirals that hold Namirimu’s HIV at bay, anti-tuberculosis medication to cure her of that disease, morphine to ease the pain of the skin lesions she has developed from Kaposi’s sarcoma (a cancerous tumour of the connective tissue often associated with AIDS) and dozens of other multi-coloured pills.

As Nagia checks through the medication to make sure Namirimu has been taking them on schedule, her patient gives her an update. She is still feeling weak and her appetite is low. Her right eye will not fully open. But she is upbeat, smiling and telling jokes. She tells Nagia that she even had a dream about her last night.

“Sometimes,” Namirimu tells Nagia, “I can’t even believe that you are real.”

Nagia is a community health worker with Kawempe Home Care (KHC). The organisation is based in the Kampala slum of Kawempe, an area with one of the city’s highest disease burdens, and cares for nearly 1,200 HIV-positive patients in the area who are also treated for TB and cancer.

The organisation’s 24 community health workers tour the neighbourhood every day, asking if people are feeling sick and encouraging them to go for HIV counselling and testing. The clinic also offers ARVs as well as other medication.

They also visit patients like Namirimu, who are too weak to access treatment at their offices. Nagia has been stopping by Namirimu’s house every Tuesday since the 26-year-old registered with KHC in January. During her visits, Nagia gets updates on her patient’s health, helps out with household chores and chats.

Though she suffers from TB, HIV and a range of infections that prey on her weakened immune system, Namirimu said that she knows she is improving. She credits KHC, specifically Nagia, for her improvement.

“I was almost dying,” she told IPS. “Now I have come back to life.”

KHC will be celebrating its fifth anniversary next month. In 2007 it stepped in to augment the country’s promise of universal access to HIV testing and treatment. A promise the underfunded and understaffed national health system has been unable to meet.

Voluntary HIV counselling and testing is free in Ugandan health facilities, as are ARVs. But only about 20 percent of Ugandans know their HIV status, according to the country’s most recent progress report on HIV/AIDS. The study showed that 6.7 percent of adults aged between 15 and 49 were HIV-positive in this landlocked East African country.

Once HIV patients are in the government system, which lacks nearly half of the needed health workers, there are gaps in counselling and treatment.

Before a neighbour alerted KHC of Namirimu’s status, she had been accessing care from a government facility. The health workers there had not seen her for nearly a year and had failed to diagnose her TB co-infection.

Oliver Namirimu (no relation) is the community department manager for KHC. She told IPS that the people who live in KHC’s coverage area have access to three government health facilities, including the national referral hospital.

“If they can’t move, if they’re too sick… they can’t go to the government health centre,” she said. “Such organisations like Kawempe come in to supplement the government’s services.”

In Barbara Namirimu’s case, she never received follow ups from the government health centre and slowly deteriorated. By the time KHC found her, she was too weak to travel anywhere.

Though there is no national database of community health worker programmes, groups like KHC dot the health landscape. But they are still not enough to fill the gaps in Uganda’s health system.

The government has trained and facilitated more than 80,000 village health team members since 2002, but they are expected to deal with a range of issues on a superficial level. KHC’s programme focuses specifically on HIV, TB and cancer, with a trained medical staff that can provide quick assistance.

However, the work they are doing cannot be done cheaply, which limits the rise of similar organisations. KHC is able to operate because of donor funding and the contribution of medicines by the government. Oliver Namirimu said they are still looking for additional funding to supplement the allowances they give the community workers – about 33 dollars per month, which excludes the cost of fuel.

The service they offer is critical in areas like Kawempe and other overpopulated urban settings. It can be equally important in rural areas, which have far more limited access to health facilities. Community health worker programmes have the capacity to put in the legwork required to track far-flung or transient patients.

The Kawempe area, filled with cheap, temporary shacks, is an example of one of Kampala’s stopgap areas, filled with residents looking to move to more secure locations when they have money or are feeling better.

During a recent trip out to the community, the shack of Nagia’s first patient for the day was boarded up and locked. The man who had lived there was HIV-positive and only partially through his treatment for a TB co-infection. Now Nagia will have to try to track him down and convince him to complete the drug course or risk developing a drug-resistant strain of the disease.

The team talks to some neighbours, who are told to call them if the patient reappears. But they still have eight more patients to visit, so they do not waste too much time waiting for him to return.

“He knows we will (not give up on) him,” said Aidah Nanozi, a clinician who was traveling with Nagia.

It is a difficult job. The pace of the community health workers’ schedules can lead to burnout, said KHC’s Oliver Namirimu.

“They see one patient dying, then another one dies, and another patient doesn’t want to take their medicine, and another chases them away. So, sometimes, they give up.”

But it does not happen often, she said. Counsellors at KHC are there to offer the community health workers support and talk about the difficulties with their jobs.

Ben Kaboro told IPS that after only two weeks on the job he already understands how taxing the work can be.

A former patient of KHC, he said a combination of HIV and TB had left him “bedridden” and “disturbed me so much.” His experience with a KHC volunteer, who nursed him through his recovery, made him want to help others in the same way.

He is shadowing Nagia before he begins working on his own.

“I didn’t want to see others going through what I have been through,” he said.

As the process of reintegrating South Sudan’s child soldiers into their old lives begins soon, the Sudanese People’s Liberation Army renewal of its lapsed commitment to release all child soldiers from its ranks in March could mean that within two years children will no longer constitute part of the country’s militia groups.

Southern Sudanese soldiers from the Sudanese People’s Liberation Army. Militia groups affiliated with the army still recruit child soldiers. Credit: Peter Martell/IRIN

The SPLA, which is the military wing of the South Sudanese political party, the Sudan People’s Liberation Movement, is one of the few remaining national militaries in the world on the United Nations’ list of parties to conflict who recruit and use child soldiers. The U.N. Children’s Fund (UNICEF) estimates there are 2,000 child soldiers in South Sudan. Though none are within the official SPLA, they are affiliated with militia groups that have earned amnesties from the government and are being integrated into the national military.

If the SPLA follows the action plan it has drafted and signed – removing all child soldiers from the militias and working to get them education and training opportunities – the country could be off the list in as soon as two years.

For the child soldiers, though, the process of reintegration could take much longer, as they enter schools or learn skills that will provide other opportunities for making a living outside army barracks.

The process will begin, according to Fatuma H. Ibrahim, the chief of UNICEF’s child protection unit in South Sudan, by identifying and securing the formal release of all child soldiers. On their way out, they will be given civilian clothing, because “what is military remains with the military,” she said.

The youth, who can range in age from as young as 12 up to 18, will undergo some group therapy sessions with social workers to try to understand how they came to join the militias and to talk about any violence they may have encountered.

She said there will be about one percent who “really need some clinical management,” though their options will be limited in a country with few psychiatric resources. “It’s a very big problem. Most receive tablets, but that’s it.”

Family members will also meet with social workers to discuss reintegration and ensure that the children will be welcomed back and discouraged from re-joining.

“The parents have to be ready to receive them,” Ibrahim said. In some communities in South Sudan that includes a symbolic transition ceremony.

In a country that has known war for more than two decades, the military is often one of the few viable economic opportunities for young men. Many of the children UNICEF and its partners remove from the ranks followed that pattern – looking to a position with a militia to provide some financial security for themselves and their families.

One of UNICEF’s big challenges is providing opportunities that deter the delisted child soldiers from going back. After the new release rounds take place, the youth will be given an opportunity to choose between going to school, which many of the younger ones will opt for, Ibrahim said, or learning a trade. The country’s limited job market means older youth are encouraged to learn skills like carpentry, which is in increasing demand in rapidly growing towns. In the future, they will be trained in two skills, in case the first one does not prove marketable.

UNICEF and other organisations are also working to provide incentives to keep the child soldiers from re-enlisting. Ibrahim pointed to a livestock-rearing project, where former child soldiers are given a goat to raise and breed.

If the programme is going to work, she said, the incentives have “to be meaningful.”

South Sudan’s new action plan was officially signed on Mar. 16 by the country’s Ministry of Defence, the U.N. peacekeeping force in South Sudan – UNMISS, UNICEF and Special Representative of the Secretary-General for Children and Armed Conflict Radhika Coomaraswamy.

Since it achieved independence last year, South Sudan has seen sporadic violence flare up across the country. In the north, there are ongoing hostilities with Sudan. And various parts of the country – especially Jonglei state – have seen consistent intertribal conflict over land rights and cattle.

Coomaraswamy said most of the country’s child soldiers are found in the north, where violence has been most consistent.

South Sudan has been on the U.N. list long before its independence in July 2010. The earlier incarnation of the SPLA – the Sudanese People’s Liberation Movement – was one of the original groups included when the list was drafted in 2002.

In 2006 a Comprehensive Peace Agreement was signed between north and south Sudan, which ended decades of fighting and paved the way for South Sudanese independence. At the time, the SPLA committed to an action plan to release its child soldiers, though it did not completely follow through.

By 2009, monitoring organisations had found no child soldiers within the main SPLA, though they still existed in the militia groups.

Coomaraswamy said the country’s renewed commitment comes from “the power of the list” and pressure from international partners.

And while the U.N. has never sanctioned South Sudan over its inclusion, she said there was always a possibility that would happen. The Democratic Republic of Congo (DRC), for instance, has suffered sanctions as a result of its inclusion.

Coomaraswamy said her office is currently in negotiations with the DRC, Myanmar, also known as Burma, and Somalia – the only government militaries who have not yet signed on to an action plan. 
 *Andrew Green is reporting from South Sudan on a fellowship from the International Reporting Project,
 an independent journalism programme based in Washington, D.C.

Before Bor B Primary School built latrines on the school grounds two years ago, students would leave during their first break to head home. Most did not come back until the next morning.

Before Bor B Primary School built latrines on the school grounds (pictured in background), students would leave during their break and not return. Credit: Andrew Green/IPS

Teachers ended classes early, because they did not have access to latrines, either. They would go to the nearby town, ask permission to use the facilities at one of the hotels, and then come back and reassemble the students who were left.

Madin Chier, the deputy head teacher at the school in the capital of Jonglei state, said the quality of the school’s education suffered. But now that 16 latrines have been installed, “there are no more problems,” he said.

Building a functional education system in South Sudan requires more than just latrines. Less than half of children who should be in school are. The country does not have enough classrooms, teachers or basic school supplies to educate all of its children.

Younger pupils compete for spots that are available in primary classes with teenagers, who were denied educational opportunities during the country’s decades-long war. The majority of those classes are held in the open air or under trees. That means when the rainy season hits, the result is a six-month break until the storms pass.

But for those students who have managed to get into a school – even those held under a tree – access to latrines is critical to keeping them there. That is especially true for girls, according to Emily Lugano, the education technical advisor for Save the Children in South Sudan.

Save the Children has built or rehabilitated toilet facilities in 71 schools across seven of the country’s states. These include hand-washing stations. It is part of the NGO’s initiative to improve learning environments, she said. But it is also a safety precaution for girl students.

In South Sudan, girls are more likely to be pregnant by 15 than they are to be in school. When they do attend, they are often subjected to harassment and intimidation, Lugano said. This is exacerbated in some of the schools where Save the Children works. In many places girls were expected to share latrines with boys or to use a field near the school.

“They get abused and harassed when they’re sharing latrines with the boys,” Lugano said. And “the girl feels very unsafe going to the bush to help herself… It’s a very, very crucial safety issue for girls at school.”

During their menstrual periods, girls refused to come to school, where they would have no opportunity for privacy. Chier said some of the girls at his school would not show up for a week or more every month, dropping them further behind the rest of the class.

“Across most of the developing countries,” Lugano said, lack of access to private latrines “contribute a lot to girls actually performing poorly in school, because they miss out on the syllabus.”

Because it is a school, there is also an educational component that comes along with the latrines and hand washing stations that extends beyond gender boundaries. Chier said his school uses the facilities to teach students about basic hygiene, which has helped reduce illness.

The initiative has been popular at Bor B, leading the students to form a Sanitation and Hygiene Club. Simon Peter Maiur, a 20-year-old in Grade 7, joined the group recently. He’s learning the club’s skits and songs, which encourage students to wash their hands and take care of themselves. He also helps patrol the school grounds for trash.

“It shows us how to clean our body, by cleaning the school,” he said.

Part of the concept behind the club is to turn the students into teachers, taking their messages about basic hygiene from the schools back to their communities.

“Hygiene promotion practices are not effective in this country,” Lugano said. Most towns and rural areas lack basics, like running water, but she said the students can still help “translate basic hygiene back to the community.”

Maiur said that is part of the club’s mission, to share information with friends and family. He said, with his encouragement, his family now does the best they can to practice better hygiene, like hand washing.

But these efforts only work in areas where there is a structured education system. South Sudan’s government allocated less than six percent of the 2011 budget to education. And the vast majority of that, Lugano said, goes to paying teacher salaries. Overall government funding for education looks to drop, as the shutdown of the country’s oil pipeline has taken away 98 percent of the country’s revenue.

At Bor B, Chier had let his Grade 8 students leave early, because the classrooms were all occupied by younger students, some with 150 students crammed in.

It is left to NGOs, like Save the Children, to continue to fund infrastructural development and to get basic materials, like textbooks, into the hands of students.

While programmes to improve sanitation and hygiene within schools can have a far-reaching impact on health and safety outside school grounds, Lugano said, those efforts are only effective if there are schools to deploy them in.

*Andrew Green is reporting from South Sudan on a fellowship from the International Reporting Project, an independent journalism programme based in Washington, D.C.

By Andrew Green and - -
JUBA, Mar 24 2012 (IPS)

Martha Borete Angela’s gaze sinks to the ground as she admits neither of her two children was delivered by a midwife or doctor. The 28-year-old South Sudanese woman shared this fact in front of her classmates: first-year students in a programme for midwives at the Catholic Health Training Institute in Wau, a city in the western part of the country.

Martha Borete Angela is a first-year students in a programme for midwives at the Catholic Health Training Institute South Sudan. Credit: Andrew Green/IPS

South Sudan has the highest rate of maternal mortality in the world, according to the United Nations Population Fund. The government estimates that more than 10,000 women die every year giving birth and 76,000 experience severe complications. Here, women constitute 60 percent of the country’s eight million people.

The high mortality rate is exacerbated by a widespread shortage of professional midwives to consult with women during their pregnancies and identify potential risks. A national survey from three years ago reported less than 150 midwives in the national health system.

“Our mothers, some of them, they pass away from delivering,” said Ropani Raship, a 20-year-old classmate of Angela’s at the Catholic Health Training Institute. “They don’t have a chance.”

Instead of trained care, mothers turn to traditional birth attendants, like Angela did when she had her second child. Some do not get any assistance at all.

Everyone, from the South Sudanese government to the NGOs propping up the country’s nascent health system acknowledge that developing the sector generally – and its response to maternal deaths, specifically – depends on getting more trained workers into the system as quickly as possible.

Angela, Raship and their classmates represent that possibility: A cadre of young, fully trained midwives, who will be placed in clinics and hospitals around the country once they finish the programme and achieve government certification.

But it will be three more years before they can start filling that gap. And they will do it – along with graduates from the country’s two other certificate programmes – a handful at a time, in a country where thousands of midwifes are needed. That means, for the foreseeable future, many pregnant women will be left to rely on traditional birth attendants and other frontline health workers.

These are often neighbours who “believe they have a gift of healing, or they learned midwifery through mentorship,” said Alaa El-Bashir, the country coordinator for the Maternal, Newborn & Child Survival Initiative (MNCSI) out of Massachusetts General Hospital. Most are not trained to identify or treat serious complications.

The situation reveals a larger debate in this new country: How do you allocate finite resources to save lives now, while also making the long-term investments that will build a sustainable health system?

For its part, MNCSI has decided to do what it can to improve the skills of the frontline workers. The initiative is reaching out to them with trainings and a bag of basic health supplies – scissors, gloves, a string for tying the umbilical cord.

Over a year and a half, MNCSI has put 72 trainers through a master course. They, in turn, have reached out to train more than 700 frontline health workers across seven of the country’s 10 states. An eighth state will be brought into the fold in a few months.

The idea, according to El-Bashir, is to get health workers trained to a level where they can at least recognise potential complications and refer people to a health facility early. MNCSI provides a pictorial checklist for the health workers to consult during the course of the pregnancy to recognise warning signs. And if no complications are apparent, they can help safely deliver the child.

MNCSI has also introduced a cheap tool to help women who start haemorrhaging after birth: a uterine balloon kit. It’s a simple innovation – a catheter with a condom attached to the end. The condom is inserted into the uterus and a syringe used to fill it with water. This can help staunch the bleeding until the woman is taken to a health facility.

After a recent tour of some of the areas where the uterine balloon kit has been distributed, El-Bashir said the frontline health workers have been able to use the tool without any problems. Of the recorded cases, MNCSI reported only one mother had passed away.

“We are saving lives,” El-Bashir said.

There are always going to be unexpected complications among delivering mothers, though, said Susan Purdin, the country director for the International Rescue Committee (IRC). And they cannot always be anticipated by observing risk factors. South Sudan’s best option is to ensure all pregnant women have access to qualified health workers.

“Everybody needs to know that any woman could have a complication and needs to get care,” Purdin said. That requires rallying, not just mothers, but fathers, traditional birth attendants and taxi drivers. It also requires making them aware that, if problems arise as the woman goes into labour, they should be poised to take her to a health clinic.

IRC has been working in what-is-now South Sudan for more than two decades, with many of its programs centred around healthcare. It currently supports 30 health centres in the west and north of the country, five of which offer maternal health services.

On a recent visit to one of the centres, Purdin said she witnessed a midwife save five lives. One mother, after giving birth to twins, started to haemorrhage. The midwife stopped the bleeding just as another woman in labour arrived, her baby coming arm first. As she cared for the first mother, the midwife got the second into an ambulance bound for a hospital that could assist her.

“It happens every day,” Purdin said. “It’s not always that dramatic, but having qualified midwives in health facilities where there are supplies and equipment and a referral system is the way to save mothers’ lives. And it can be done.”

It will not be done quickly, though. It requires raising awareness within the community and then working to make sure that the promised services are available. That means building more health facilities and getting more midwives, like Angela and Raship, into the system.

But back in Wau, the students at the Catholic Health Training Institute realise that even as they are deployed, the reliance on traditional birth attendants isn’t going away anytime soon. Instead of presenting an either-or approach, many said they were prepared to offer training to frontline health workers and to take advice from them on how to work in the community.

That, they agreed, is the best way to save the most mothers’ lives.

*Andrew Green is reporting from South Sudan on a fellowship from the International Reporting Project, an independent journalism programme based in Washington, D.C.

Excerpt:

Radio Mega FM’s transmission tower rises from the centre of Gulu town, transmitting talk shows and the latest Ugandan radio hits to listeners across the district. But it also serves as something of an informal memorial to community radio-driven peace efforts during the Lord’s Resistance Army’s destruction of northern Uganda.

During the Lord’s Resistance Army’s insurgency in northern Uganda, John Lacambel hosted a programme on Mega FM encouraging soldiers to return home. Credit: Will Boase/IPS

The LRA opened its war against the Ugandan government in 1987. In the mid-1990s, the commander of the LRA, Joseph Kony, turned on his own people, the Acholi. His fighters slaughtered thousands of villagers, kidnapped and impressed thousands more children into his army and caused nearly two million people to flee to Internally Displaced Persons (IDPs) camp.

Acholi leaders and NGO officials, responsible for communicating to a chaotic population where literacy was low and poverty high, needed a way to begin reorganising communities and to talk to the rebels about peace and reconciliation. Community radio stations in Gulu – the heart of Acholiland – became the linchpin of those efforts.

They turned to radio because it “can reach to the very least, to the farthest of places,” said Arthur Owor, the head of the Media Association of Northern Uganda, which is based in Gulu. With one handset and one battery, presenters could communicate with dozens of people. “The net returns were really high, in terms of the message,” he said.

On the handful of local stations like Mega that were around in the early 2000s, programming cropped up to engage the rebels in a peace dialogue, to offer a forum for communities to begin discussing justice and for family members to plead for their kidnapped children to flee the LRA and return home.

Okema Lazech Santo is the programme coordinator for Ker Kwaro Acholi, an organisation of traditional Acholi leaders, who described himself as being in “the thick” of the war and reconstruction efforts. He said radio was “useful in mobilising the people. Was useful in appealing to those abducted to come back home… The single tool that really worked effectively in bringing peace into northern Uganda.”

Members of northern Uganda’s radio fraternity take their role as peacemakers very seriously. They frequently draw contrasts between their response to the conflict in their community and the Rwandan genocide, where radio was used to incite murder.

Mega, which was founded in 2002 and was soon shored up with support from the Ugandan government and the British Department for International Development, was “set purposely to help settle the conflict in the region,” according to Nicky Afa-Ei, the station’s programme officer. He has been with the station since inception.

Mega’s primary message was that the region wanted peace. And the target audience was not necessarily the community, but the rebels “carrying their own handsets” who were within reach of the station’s signal, Afa-Ei said. Mega developed programs to discuss amnesty and traditional justice, sometimes with support from NGOs, and they invited people from “all walks of life” to record messages of peace: traditional leaders, parents, even schoolchildren.

And Mega found its audience. One day, during the height of the conflict in December 2002 – two months after the stations launched – Afa-Ei was running a talk show programme when he got a call from Kony, himself.

“That’s when people heard his voice for the very first time after a long, long time,” Afa-Ei said. “It was kind of friendly, but he was blaming the government on some parts. Saying the government were not being realistic.”

That began a pattern of Kony and his deputies using local radio stations to communicate with officials – and directly with the people – until the government deemed the rebel communiqués too propagandistic and refused to allow radio stations to run interviews without an official representative present.

Mega’s flagship programme “Come Back Home” – Dwag Paco in the local Luo language – is still spoken of reverently in the community, even by employees of rival stations. The programme attempted to cut through LRA propaganda and encourage children who had been forcibly conscripted to return to their villages. The host of the programme, John Lacambel, would bring former child soldiers onto the show to describe their return. To contravene the LRA’s contention that they would be killed if they went back to their families.

Dwag Paco was key to the region’s reconciliation efforts, Santo said. It “made so many of the rebels to defect and come back home.”

Now the north – especially Gulu – is beginning to boom. The cessation of hostilities – the result of inconsistent peace talks and a 2008 push by Ugandan forces – and the migration from IDP camps back to villages has paved the way for renewed infrastructure and new business. Mega’s radio mast no longer stands out in a skyline cluttered with gleaming banks, hotels and a grocery store. Seven other community radio stations now light up the dial.

“We are now in the process of recovery and stability,” Owor said. That means radio stations have also seen their roles transition toward helping rebuild and entertain Gulu. Instead of NGO programming, there are more talk shows and regional news programs. Music call-in programmes highlight the lunch hour.

But the programming still deals primarily with the fallout from the war, said Willy Chowoo, a presenter on Choice FM. That includes the divisive question of amnesty for returning soldiers. One of the LRA’s most horrific practices was forcing rebels to return to their own communities to loot, kidnap and murder. It helped sever the ties between the soldiers and their homes. With no place to return to, they were more securely attached to the army.

But with the LRA on the run, some of those rebels – many of whom were child abductees themselves – are trickling back into their villages. Pre-recorded dramas set up situations where villages are confronted with the question of how to handle the situation. The message, Chowoo said, is “you should not retaliate. People should not pay back. People should not take the worst with the worst.”

The work the stations are doing dovetails with the fourth of four interventions – reintegration of former rebels – that President Barack Obama laid out for the region ahead of sending U.S. troops to help hunt Kony down earlier this year.

There are also issues of land grabbing as people return from IDP camps only to find their homes taken over by someone else, food security in a community that has long been provided for by NGOs and basic health care in the absence of infrastructure. Traditional leaders and community members hash out these problems in call-in shows and experts offer solutions during educational programmes.

While northern Ugandans are constantly confronted with the legacy of the past, Afa-Ei said the area’s community radio stations are trying to “forge a way forward for the future.”

*This story was produced with the support of UNESCO.

From a distance, Bugala Island in Lake Victoria is a patchwork of green and brown. The pattern is a result of dense forest retreating in the wake of recently planted palm tree plantations.

Workers on Bugala Island work to clear the rainforest to make way for an expanding palm tree plantation. Credit: Will Boase/IPS

The island, the largest of Uganda’s Ssese Islands, is at the center of one of the country’s newest economic endeavors – palm oil processing – and the formerly lush rainforest has fallen quickly, taking with it some critical jobs for the island’s poorest women.

Now, five years after the first phase of that process was completed, residents are starting to measure the impact of the initiative. Many speak glowingly of the jobs and activity the plantation has created. But for some of the island’s poorest residents – especially widows and the wives of often-traveling fishermen – continued deforestation has robbed them of their sole source of income.

Sarah Namwanje used to collect timber and charcoal from the forests that she could sell to people around the island. Now the 28-year-old mother of seven has no way to make money.

“No timber is seen,” she said. “We’re searching for firewood and trying to get money, but my job has stopped.”

Ahead of the palm oil project’s start, activists had clashed with the government over the potential environmental ramifications of the deforestation. But, with assurances from Bidco –the company behind Uganda’s palm oil industry – that the development would have little environmental impact and a stamp of approval from the National Environment Management Authority (NEMA), the dazzle of a new industry and more jobs eventually won out.

What was never communicated to some of the poorest residents was how the project would affect both their livelihoods and their health. Especially the small groups of women who live on an island mostly populated by fishermen.

Some are widows, their husbands lost to AIDS or fishing accidents. Others are left alone for long stretches of time, their husbands chasing schools of fish around the archipelago of 84 islands. Until the men return with money from their catch, the women must scramble for resources.

The available jobs for these women are scarce and Mary Nampomwa, a local health worker, said it is difficult for many of them to get by without resorting to commercial sex work.

Before the palm plantations arrived, women who refused to turn to sex work had small-scale jobs, like gathering firewood. They had relatively free access to the timber in national forests or on privately held, underdeveloped plots, according to Richard Kimbowa, the programme manager for Uganda Coalition for Sustainable Development (UCSD).

For many women on Uganda’s Bugala Island, deforestation has robbed them of their livelihoods. Credit: Wambi Michael/IPS

But many of those landowners, offered an opportunity to make good money off of unused land, sold out or cleared the forest themselves to create subsidiary palm plantations.

Now the island’s poor women are “being marginalised,” Kimbowa said, in the “craze for expanding this palm.”

Namwanje said the only thing she knows to do is encourage people to start planting more trees, so that she has renewed access to firewood and charcoal. But that is not going to happen anytime soon. Other women have taken up jobs drying small mukene fish on the sand next to Lake Victoria.

What is particularly galling to Edisa Katusime, a single mother of six children, is that local officials had for years been warning residents about cutting down trees. She was told that the forest was critical for preserving the island’s animal life and she had to be secretive about gathering timber.

But the government is “not preventing Bidco because it’s a company,” she said. “They are allowed to cut when the government is telling us the importance of the trees.”

Kimbowa predicts that the small-scale job loss might be only the first of the problems the palm plantations are going to create. Eventually, he said, there are going to be issues with food security as land previously used for raising crops turns to palm trees. And already some of the women are reporting that the absence of forest covering is creating health issues.

The loss of the forest means there is no longer a shield from the strong winds that sometimes blow across Bugala Island. The wind now “sounds as if it’s going to knock the house down,” Katusime said. The dust it carries sometimes leaves her children in coughing fits and has been particularly dangerous for asthmatic residents.

And despite assurances from Bidco that it is following the plan laid out by NEMA to minimise environmental impact, UCSD is still monitoring the situation, concerned about issues like soil erosion and seepage of agrochemicals into Lake Victoria. Despite the jobs that Bidco has brought, most of the people on Bugala still live and die by fishing. If fish stocks are reduced, there will suddenly be a lot more people on the island without a source of income.

For now, the warnings of environmental groups and the complaints of women like Katusime and Namwanje are muted by widespread enthusiasm for the island’s palm oil industry. And it’s still growing. According to Bidco, the palm oil plantation will eventually cover 40,000 hectares and be the largest plantation in Africa.

There is division even within the small group of women infected with or affected by HIV/AIDS that Katusime and Namwanje belong to. Unlike those two women, Annette Nnamukasa was able to harness enough money to take advantage of the palm oil boom. She bought about two acres of land and had it cleared. In its place she planted palm trees and now sells the crop to Bidco.

“It is almost the same,” she said. “The palm trees are almost forests.”

Life in Bwaise – a slum on the outskirts of the capital of Uganda – has never been easy. But increasingly erratic rains over the last three years have brought constant floods to the former swampland. Residents who can afford to are moving out, leaving the poorest – often single mothers and grandmothers – behind.

Water stands in the roads of Bwaise after a light morning rainfall. The urban slum’s drainage system is unable to handle even slight rains. Credit: Andrew Green/IPS

The gardens around Regina Bayiyana’s home in Bwaise keep washing away. Her husband and all five of her children died after long illnesses, leaving her to raise 15 grandchildren on her own in her one- bedroom house. The crops she grew in the gardens – bananas, sweet potatoes and yams – were her main source of both food and income.

Now she and her family have cut back to one meal a day and there is no longer money for school fees.

“Ten years back this used to be a good place,” Bayiyana said. “Now we can’t plant… The water is entering our homes whenever it rains. All my property was washed away by the rains.”

In hilly Kampala, Bwaise is a low-lying area that was settled in the early 1980s, according to Florence Masuliya, a programme officer at Tusitukirewamu Group – a women’s empowerment organisation based in the slum. Many of the people who moved there were refugees from violence-ridden areas around the country.

Though it was never a desirable community, people were able to set up shops and cultivate enough food to get by, Masuliya said. At least, until rain patterns in the capital city began to change.

“It used to be that November and December was the rainy season,” she said. “But right now, since January, we’ve been experiencing rain, rain, rain. I think it came due to climate change.”

A 2008 Oxfam International report, written with assistance from district officials in Uganda, said many of the changes to the country’s climate – including “heavy and violent” rains – were consistent with global warming effects.

Though weather patterns in Uganda have always been unpredictable, the authors said the recently inconsistent rainfall combined with the country’s continuing deforestation could increase risk of floods, as the soil is unable to absorb as much water. And the report predicted that the entire region could expect to become even wetter in the future.

A woman feeds her child in Bwaise – a slum on the outskirts of Kampala. She sits among the remains of local gardens that have been destroyed by floods. Credit:Andrew Green/IPS Buy this picture

The water running down from the surrounding developed communities into Bwaise emphasises the report’s finding. Because there was little official planning that went into the development of the community, the drainage systems that are in place are too few and too rudimentary to handle the amount of water being dumped on the neighbourhood. Instead, it just runs through the houses and shops.

Many buildings are beginning to rot or crumble. The rains at night are especially treacherous, with floods catching families unaware and sometimes drowning small children. And the water that remains, standing stagnant on roads and in gardens, has been a breeding ground for diseases like cholera and typhoid.

Though she was not ready for the floods when they first started coming, Bayiyana has now learned to prepare for the rain. When she hears it coming at night, she piles the family’s three mattresses on top of each other and instructs her grandchildren to clamber on top to avoid the water and the snakes that sometime wash into their home.

But they have not managed to completely avoid the contaminated water. Several of Bayiyana’s grandchildren recently broke out in skin rashes and she had to take them to a nearby hospital for treatment.

She would like to move away, but “no one would buy this land. If I sold it, I would get very little money.”

Though the rains are indiscriminate, the group they have ended up hitting hardest are Bwaise’s mothers and grandmothers, said Florence Kasule, the programme manager for Africa Women’s Economic Policy Network. Her organisation has been working to raise awareness of the problems in the community.

She said that since the rains came, men have been moving from the community to look for steadier income, because the flooding had made work unreliable. Most left their wives and children behind.

“Women cannot easily shift because of their children,” Kasule said. “Nobody can accommodate three or four children.” In the absence of their husbands, most women are left to look for whatever work they can find, sometimes selling food outside bars at night or hocking dried fish on the roadside.

Susan Nakayiza’s husband left her to raise their 12 children alone. She said her family was not prepared for the rains. There had been no official warning and she had no way to know that the previously normal rains would turn to floods, so when they started in 2008, they destroyed nearly everything she owns.

To make ends meet, she is now running a clothes-washing business out of her house, which is cramped with piles of her neighbours’ dirty laundry.

Her children help out with the business, taking orders and washing clothes in their cramped yard. But she still had to pull the younger children out of school because money was too tight. And business is getting worse as more and more people move away.

Like Bayiyana, Nakayiza dreams of leaving, “but I don’t have the money to rent somewhere,” she said.

Masuliya’s organisation is looking for funding to support the local women who are left behind. They recently facilitated a grant from the United States Embassy through the President’s Emergency Plan for AIDS Relief that provides money for women to grow mushrooms, which they can eat or sell.

Bayiyana is one of the participants. Because her gardens are flooded, Masuliya is letting the grandmother cultivate land behind the Tusitukirewamu Group’s headquarters.

Masuliya has also been working closely with local officials to encourage them to develop a better drainage system in Bwaise to draw water away from residents’ homes. She has been promised that the next year will bring a new system, funded by the World Bank.

And local officials have also gotten involved. The Kampala Capital City Authority (KCCA) has held workshops in the district to encourage people to properly dispose of their garbage, so it doesn’t get caught in the floods, according to Janet Massazi, a KCCA community development officer.

They have also been holding official disaster preparedness workshops in Bwaise and the surrounding communities over the last three years. It’s not a new drainage system, but it is an effort to raise awareness and prepare people for the floods.

Bayiyana said she is grateful for the efforts others have made to help the people left in Bwaise, but she does not expect things to really change in her lifetime.

“My message to the government is: Support these people,” she said. “I myself am a widow. I can’t do anything. I need to get support from somewhere.”