A hospital in Srinagar, Kashmir. Credit: Umer Asif/IPS

By Umar Shah
SRINAGAR, India, Dec 18 2015 (IPS)

In an isolated ward of one of Kashmir’s largest government-run hospitals, 54-year-old Ashraf Ali Khan is finding it hard to sleep properly. His 15-year-old son, Asif, is sitting on a bench near the bed staring at his ailing father.

Asif has not been told by his family that his father is suffering from a potentially terminal disease cancer. He knows his father is suffering from a consistent fever which sent him to the hospital, but doesn’t know his father is in the last stage of the crippling disease.

Ashraf Ali, a carpenter, went to the doctor eight months ago after persistent coughing. He had a chest X-ray which then led to further examinations. After series of tests, it was finally he was diagnosed with lung cancer. He has two months to live at best.

Ashraf is among thousands of people who have ben struck down with the disease. In a war-torn Kashmir, about 4000 cases are found every year in this Himalayan region.

Apart from the political uncertainty, which so far has claimed thousands of lives, experts says there is a 20 per cent rise in cancer cases in Kashmir with figures never decreasing. The latest data published by the state’s health department has Kashmir topping the list of cancer cases in India.

The data reveals in the past three years, more than 1,700 people have died due to cancer in Kashmir. It says that since January 2014 there were 12,091 patients who were detected with cancer in various state hospitals. In 2013, 6,300 patients were detected with the killer disease.

The top 10 cancers taking a toll in Kashmir are lung cancer, stomach, colon (large intestine cancers), breast, brain, esophagus (cancer of food pipe), non-Hodgkin’s lymphoma, gastroesophageal, junction cancer (cancer between the stomach and food pipe), ovarian and skin cancers.

Experts say the cancer mortality rate among the people in Kashmir witnessed a sharp increase due to some leading behavioural and dietary risks, including high body mass index, low fruit and vegetable intake, lack of physical activity, tobacco use and lack of regular check-ups. Changing lifestyle, environmental degradation and differing food habits are reasons attributed to the surge in all the cancers especially in esophagus, colon and breast cancers.

Kashmir’s leading oncologist Mohammad Maqbool Lone says the situation in Kashmir is becoming more grim every day a with the highest number of lung cancers In the country found in the people of Kashmir.

“The situation is indeed alarming in Kashmir. There are patients hailing from every part of Kashmir including the far flung areas which are diagnosed with such a terminal disease,” says Lone.

Until now no single factor has been identified as the main cause of the rising cancers as compared to other regions of India. As health experts in Kashmir are not certain about the major causes for the rise of the deadly disease, they suspect three main components can trigger the rise of cancer in this Himalayan region.

One is a societal component with poor rural lifestyles and general deprivation, in particular a lack of vitamins and dietary nutrients.

The second reason for rising cancers in Kashmir is the use of copper utensils in cooking, the consumption of spicy, deep fried foodstuffs, and the drinking of hot salty tea which is largely being consumed in every home in Kashmir.

The third factor in rising cancer cases is an environmental issue with exposure to high levels of dietary nitrosamines from diverse sources. Overall, these three components are the general pattern that has led to esophageal and other cancers.

Oncologist Abdul Rashid Lone says that rising numbers of smokers has led to a rise in lung cancers here. He also claims that the detection rate also has increased besides the advancement in medical technologies.

“Earlier, most of the cancer cases in Kashmir used to go unnoticed. At present, the technology has advanced so much that a patient can be diagnosed with the disease. This is the main reason that today we say cancer cases rise in Kashmir,” Dr Lone said.

Oncologist Riyaz Ahmad Shah says that apart from the lung cancer, there are cases of stomach cancer on the rise in Kashmir. He says certain types of cancers are found in children including blood cancers and tumours.

“In case of females, there are cancers related to the reproductive system like cervical cancer, ovarian tumours and breast cancer. In males there are stomach, lung, and esophagus cancers found,” said Dr Shah.

Renowned gastroenterologist, Dr Showkat Ahmad Zargar, says any delay in the detection of cancer could prove fatal for the patient. He says due to the massive adulteration in food items, gastric diseases are on rise in Kashmir.

“Such diseases are killing people slowly. The people here are not very much health conscious which leads to the delay in detecting whether a person is suffering from a cancer or not,” Dr Showkat said.

“There are high chances that a person suffering from cancer can be cured if detected at early,” said Dr Sana-ul-lah who heads the oncology department in one of Kashmir’s leading government run hospitals.

Tobacco use in Kashmir has increased along with unhealthy diets. “If the key risk factors are avoided, Kashmir could be saved from this fatal disease which continues to claim thousands of precious lives every year in the region,” Dr Sana-ul-lah said.

Insha Usman, a research scholar says there are no major steps being taken by the state government to ensure that people are informed and are aware of cancer. She says early symptoms and preventive measures should be made public in far flung areas of Kashmir so that people are conscious of the cancer threat.

“Ironically, there is no comprehensive policy available with the government at the present time that could have made people aware of such a fatal disease. Mass awareness campaigns in villages and towns and people are informed about the symptoms of cancer and early treatment,” she said.

According to the latest study, colorectal cancer (CRC) is the major cause of mortality and morbidity worldwide and in Kashmir, CRC has been found to be the third most common gastrointestinal cancer after esophageal and gastric.

The study says there are certain factors which increase person’s risk of developing CRC. “The most important of these are the age, diet, obesity, diabetes and smoking, personal cancer history, alcohol consumption, large intestinal polyps, family history of colon cancer, race and ethnic background, genetic or family predisposition,” said the finding.

It adds that another major cause of cancer deaths was a late visit to the doctor. “The involvement of quacks, inexperienced medical practitioners and post-referral delays make the situation difficult to handle,” the study concluded.

The steady rise in cancer patients began several decades ago leading to the establishment of an NGO. The Cancer Society of Kashmir, formed in 1999, provides medical and financial help to poor patients suffering from the dreadful disease here.

Masood Ahmad Mir from Cancer Society of Kashmir says that they have started a one-day care centre which runs twice a week. “During this time, doctors from different fields like medical oncology, radio oncology, and gastroenterology sit together and treat patients. We do not charge anything from the people who visit us for the treatment,” he said.

(End)

The UN’s heavily-hyped Sustainable Development Goals (SDGs), which were approved by more than 160 world leaders at a summit meeting in September, are an integral part of the world body’s post-2015 development agenda, including the eradication of hunger and poverty by 2030.

But that ambitious goal, warns the UN’s sister institution, the World Bank, can be thwarted by the devastating impact of climate change on the world’s poorest people.

In a new study released Monday, the World Bank says climate change is already preventing people from escaping poverty.

“And without rapid, inclusive and climate-smart development, together with emissions-reductions efforts that protect the poor, there could be more than 100 million additional people in poverty by 2030.”

The report, released ahead of the international climate conference in Paris November 30-December 11, finds that poor people are already at high risk from climate-related shocks, including crop failures from reduced rainfall, spikes in food prices after extreme weather events, and increased incidence of diseases after heat waves and floods.

Titled ‘Shock Waves: Managing the Impacts of Climate Change on Poverty’, the study says such shocks could wipe out hard-won gains, leading to irreversible losses and, driving people back into poverty, particularly in Africa and South Asia.

According to the report, the poorest people are more exposed than the average population to climate-related shocks such as floods, droughts, and heat waves, and they lose much more of their wealth when they are hit.

In the 52 countries where data was available, 85 per cent of the population live in countries where poor people are more exposed to drought than the average.

Poor people are also more exposed to higher temperatures and live in countries where food production is expected to decrease because of climate change, the report notes.

“This report sends a clear message that ending poverty will not be possible unless we take strong action to reduce the threat of climate change on poor people and dramatically reduce harmful emissions,” said World Bank Group President Jim Yong Kim.

“Climate change hits the poorest the hardest, and our challenge now is to protect tens of millions of people from falling into extreme poverty because of a changing climate,” he added.

Asked for a response, Harjeet Singh, Climate Policy Manager at ActionAid, told IPS the World Bank’s analysis of poor people’s vulnerability to climate impacts is not new, but it rightly highlights that poverty cannot be addressed without tackling climate change.

He said poor people and poor countries are most vulnerable to climate change as they have limited assets, skills and knowledge to overcome the effects.

“However, the World Bank is coming late to the game with its talk of improving social protection to fight the effects of climate change”, Singh said.

In reality, he pointed out, the World Bank has had a long and dubious record of forcing developing countries to reduce their public expenditure to provide basic services, and protecting socially and economically weaker populations.

“It will need to address this before it can reliably practise what the report preaches,” he declared.

Louise Whiting, senior policy analyst, water security and climate change at the UK-based WaterAid, told IPS the world’s poorest are most at risk from climate change and are receiving the least amount of climate-change financing to help them adapt to climate-related weather shocks including flood, drought and heat waves.

“Our research tells us that in Bangladesh alone, an estimated 38 million lives are at risk between now and 2050 because of climate-change related disasters,” she pointed out.

“The climate path we are on now means an end to development – an end to all progress on extreme poverty.”

She said for families living in extreme poverty, with fragile access to safe water, good sanitation and hygiene, these lengthening dry seasons and intensifying monsoons wipe out years of work and further entrench the cycle of poverty.

“Safeguarding basic services including clean water, sanitation and hygiene helps communities recover faster and become more resilient to climactic extremes.”

Whiting said national governments in developing countries need more support in designing and implementing projects to help eradicate poverty while building communities’ resilience to climate change, as well as financing.

Leaders at this month’s crucial talks in Paris must not forget the world’s poorest, and include a strong focus on helping them to adapt to this challenging new reality, she added.

The writer can be contacted at thalifdeen@aol.com

Sixty-five years after a major international summit here on malaria, the mosquito-borne disease remains a scourge and its incidence may even be rising in parts of sub-Saharan Africa due to the combined effects of climate change, agricultural practices and population displacement.

Almost half the world’s population is deemed at risk of malaria, and an estimated 214 million people will contract it in 2015, with nearly half a million dying.

Credit: FAO

“Malaria is the number one public health problem in our country,” says Babria Babiler El-Sayed, director of Sudan’s Tropical Medicine Research Institute. Sudan has begun, with the assistance of FAO and the IAEA, to release sterilized male mosquitoes into the air in hopes that they crowd out their virile brethren and lead to reduced mosquito populations.

The Unite d Nations Food and Agriculture Organization (FAO) and the International Atomic Energy Association (IAEA) have used this “nuclear” technique with success against the lethal tsetse fly and the produce-destroying fruit fly. Malaria is a new area, and the two agencies are experimenting across East Africa with this so-called Sterile Insect Technique (SIT) of pest control.

And yet malaria is demonstrably preventable – and that is why it is explicitly named in Sustainable Development Goal No. 3 as something to be ended by 2030.

The key is not to rely on one method or tool but to develop integrated efforts to subdue the disease, notes El-Sayed.

That fits FAO’s broader approach. While working with the IAEA on the logistics and technology of SIT, field officers emphasize the need to integrate agricultural practices ranging from crop selection, tilling technique, water use and even rural home locations.

It’s a shift from 1950, when a World Health Organization conference held in Kampala resolved to support the intensive use of Dichlorodiphenyltrichloroethane (DDT) to eradicate the disease. As was learned the hard way, even such a potent chemical cannot on its own sustainably solve the problem. Indeed, in the emblematic case of the Tennessee Valley in the United States, it was a mass anti-poverty campaign coupled with a huge hydroelectric public-works program that led to the rapid demise of malaria without the use of chemicals in the 1930s.

Warmer climate helps bugs fly higher

Particularly alarming is malaria’s literal ascent into the densely-populated highlands of east Africa. Inhabitants of southwest Uganda and parts of Zambia and Rwanda typically lack the genetic resistance to malaria developed by farmers in mosquito-prone areas.

Climate change wreaks all sorts of changes in the risk profile of the human environment. For example, more and more Zambians are killed by crocodiles, lions and buffalos as they travel further for water in times of drought. Less headline-grabbing, but more pervasive, is the way one poor harvest can wipe out livelihoods, driving people to sell their livestock, tools and even land in a bid to survive and ending up mired in poverty. Similarly, pressure on the land – sometimes linked to civil conflict – is driving record flows of migrants, the majority of whom don’t leave their countries, but move into new ecosystems, as scores of Ugandans are doing by moving to the hilly southwest regions of this country and ultimately taking up a form of farming that enhances the risk of malaria.

Add to this the steady climb in average temperatures, which increase the potential habitat for the main malarial vectors and are “related to altitude rather than latitude,” according to recent research done by the International Food Policy Research Institute into why the incidence of malaria has risen so dramatically in Uganda’s upcountry. That spells special risks for elevations above 2,000 meters in Kenya, Ethiopia and Burundi, too.

Strategies must be integrated and local

Despite popular images today, malaria is not particularly a tropical disease. Indeed, it was the successful use of DDT in postwar Italy that galvanized the Kampala conference, even though it now appears the rising incomes linked to Marshall Plan-funded economic growth was the determining factor.

Integrated methods – farming techniques, crops themselves, and human practices such as the use of nets – are all part of any success story in malaria. Zambia’s Malaria Institute at Macha has, with international support, practically eliminated malaria in its southern district, and the credit should go primarily to an engaged community effort, according to Dr. Phil Thuma, one of the institute’s mainstays and an advocate of what he calls “full court press” tactics in battling the epidemic.

FAO has long been involved in distributing mosquito nets, one of the simple but critical tools in any effort. Indeed, one current FAO project promotes the use of insecticide-treated nets around livestock barns in Kenya and has led to a sharp uptick in dairy production as both humans and animals are healthier.

The media has long indulged in donor-depressing tales about Zambian fishermen using anti-mosquito nets to boost their catch or – in one quirky story from Uganda but published in Botswana – p eople using the nets to make bridal dresses. But in fact most people in eastern Africa have and use their government-provided nets today, and many buy another one in a sign of conviction about their utility, according to a detailed survey of actual behaviour in Tanzania.

The real problem is that many farmers have to get up before dawn, or stay out in their fields late, and as a result their work forces them to forgo protection during the biting hours.

Almost everybody knows the basics about malaria, but few had heard about climate change. Intriguingly, those with secondary or higher education tended to worry about unpredictable rain patterns while those with only primary education are focused on rising temperatures.

Empirical surveys clearly show that where cultivation practices reduce vegetation cover, temperatures rise in mosquito breeding sites. That means land use and reforestation efforts need to be part of the community-driven policy mix. Farmer field schools, a longtime FAO priority focus, are key to spreading knowledge that is locally useful, such as casting shade on breeding places or fostering fish in ponds.

Developing “malaria-smart” programs need to be drawn up with that in mind, especially given efforts to increase irrigation infrastructures to boost agricultural yields in sub-Saharan Africa. One survey in Ethiopia found that the rate of childhood malaria was seven times higher in villages within three kilometres of a microdam for irrigation than children living more than eight kilometres away.

Maize cultivation, a huge force in the region, may also be lifting the incidence of malaria because the higher-yield hybrid varieties used pollinate later in the year, helping fatten up mosquito larvae – meaning more, bigger and longer-living adult ones.

(End)

Prof Grace Irimu shows IPS a drip feed bag and a copy of Kenya’s ‘Basic Paediatric Protocols’ as she explains the importance of intravenous treatment in saving the lives of young children affected by acute watery diarrhoea. Credit: Miriam Gathigah/IPS

By Miriam Gathigah
NAIROBI, May 23 2015 (IPS)

Acute watery diarrhoea is a major killer of young children but misunderstanding over the benefits of fluid treatment is preventing many Kenyan parents from resorting to this life-saving technique and threatening to reverse the strides that the country has made in child health.

The 2014 Kenya Demographic and Health Survey, released in April this year, reports that the country’s under-five mortality rate fell to 52 deaths per 1,000 live births in 2014, down from the 74 deaths in 2008-09, but still far from the 32 per 1,000 live births targeted under the Millennium Development Goals (MDGs).“Parents must … understand that rapid fluid treatment is life-saving for children diagnosed with shock or poor blood circulation due to diarrhoea” – Prof Grace Irimu, Associate Professor of Paediatrics, University of Nairobi

The primary treatment for acute watery diarrhoea is rehydration, administered intravenously in the most severe cases of very young children suffering from shock after losing excessively high quantities of body fluids. A fluid bolus – or rapid liquid dose – delivered directly through an intravenous drip allows a much faster delivery than oral rehydration.

However, notes nurse Esther Mayaka at the Jamii Clinic in Mathare, Nairobi, “parents of children brought to hospital with acute watery diarrhoea are refusing to have them put on [drip] fluid treatment and this is a major concern because diarrhoea is a leading killer among children and giving fluids is still the main solution.”

She told IPS that the ongoing rains and floods in many parts of the country “have created a comeback for diseases like cholera whose most telling sign is watery diarrhoea which needs to be managed with fluids.”

In February this year, Kenya’s Director of Medical Services, Dr Nicholas Muraguri, issued a cholera outbreak alert following an increase in cases of acute watery diarrhoea in several counties, including Homa Bay, Migori and Nairobi.

According to Prof Grace Irimu, Associate Professor of Paediatrics at the University of Nairobi, the reluctance to resort to drip fluid treatment has arisen due to misunderstanding generated by a Fluid Expansion As Supportive Therapy (FEAST) study in 2011 to establish whether the bolus technique was the best practice to use among children diagnosed with shock.

The FEAST study, which was conducted among children in Kenya, Tanzania and Uganda, found that fluid boluses increased 48-hour mortality in critically-ill children with poor blood circulation or shock in these resource-limited settings in Africa, but Irimu told IPS that the study excluded diarrhoea and only studied illnesses associated with fever, such malaria and sepsis.

“Parents must therefore understand that rapid fluid treatment is life-saving for children diagnosed with shock or poor blood circulation due to diarrhoea,” she said.

The Kenya Paediatric Association is also trying to set the record straight and, in a statement shared with IPS, the association reiterated that “diarrhoea complicated by severe dehydration is one of the biggest killers of children globally.”

According to the paediatrics association, the FEAST study excluded children with diarrhoea and dehydration because “the value of giving fluids in this group is well known. Giving appropriate fluid therapy is essential.”

Prof Irimu told IPS that the FEAST study had led to a revision of the ‘Basic Paediatric Protocols’, Kenya’s national guidelines for paediatric care, and clauses that address the treatment of diarrhoea were also revised.

Previously, a child diagnosed with shock as a result of diarrhoea would be given fluids in three cycles, every 15 minutes depending on the response. Now, the child receives the fluids in two cycles and if there is no response, health providers are advised to proceed to slower fluid administration where the child is given the amount that the body needs, depending on the level of dehydration.

Meanwhile, the country continues to make strides in dealing with HIV/AIDS – another critical health issue covered by the MDGs – among children. Studies show that the number of children with HIV aged between 18 months and 14 years fell from 184,000 in 2007 to 104,000 in 2012, according to the most recent Kenya Aids Indicator Survey.

However, Prof Joseph Karanja, a reproductive health and HIV/AIDs expert in Nairobi, says that the country can still do better because “through available antiretroviral drugs as a preventive measure among HIV positive mothers, HIV transmission to the infant can be reduced to as low as one percent.”

Dr Pauline Samia, a paediatric neurologist and a board member of the Kenya Paediatric Association, says that there is also a commitment to address conditions that challenge the management of HIV among children such as epilepsy.

“Though research in this area is limited, an estimated 6.7 percent of children with HIV also have epilepsy, with at least 50 percent of children with HIV having central nervous system problems such as delayed development, behavioural challenges and convulsions,” she observes.

Regarding progress in other MDGs, some progress has been made in reducing the prevalence of underweight children less than five years of age, one of the goals set for eradicating extreme hunger and poverty.

The 2014 Kenya Demographic and Health Survey reports that not only has childhood malnutrition declined significantly, from 35 percent in 2008 to the current 26 percent, but the prevalence of underweight children also decreased from 16 percent in 2008 to 11 percent in 2014.

On the front of improving maternal health, the survey says that while maternal mortality remains high at 488 deaths in every 100,000 live births, in the past five years more than three in five births (61 percent) took place in healthcare facilities, a marked improvement compared with the 43 percent in 2008.

Edited by Phil Harris   

CLEAN-India is an environmental assessment, awareness, action, and advocacy programme that promotes behavioural change among young city dwellers in India. As part of the programme, a group of female students learns about the importance of clean water. Credit: Development Alternatives

By Prerna Sodhi
NEW DELHI, May 16 2015 (IPS)

“Swachh Bharat”, or Clean India, is a slogan that most Indians today associate with the country’s Prime Minister Narendra Modi and his first nation-wide campaign launched soon after taking office in 2014.

The call has definitely awakened popular consciousness on cleanliness but whether citizens follow it or not is another matter. In fact, it is commonplace to find people calling out “Swachh Bharat” as they toss garbage onto the street.

However, while the campaign may not have brought about the change it was aimed to usher in, a dialogue has started and it is a watershed moment for all those working in this area to capitalise on its momentum.The call for “Swachh Bharat”, or Clean India, has definitely awakened popular consciousness on cleanliness but whether citizens follow it or not is another matter

The idea of cleaning India up is not new, and neither is the term “Swachh Bharat” which has been used by many in the past and has now been “patented” by Modi. For decades, there has been concern with instilling an awareness of the need for cleanliness among citizens, many of whom even defecate in the open.

The current initiative by the government may address the issue of cleanliness at citizens’ level, but activists in the field of sustainable development argue that it should also cover issues related to water, energy and sewage disposal cleanliness.

Access to clean water is one of the main problems that the country faces. According to a report by UNICEF (the U.N. Children’s Agency) and the Food and Agriculture Organisation (FAO), every year around 37.7 million Indians are affected by waterborne diseases, 1.5 million children die of diarrhoea alone and 73 million working days are lost due to waterborne diseases.

The problem does not appear to lie in the lack of availability of water treatment methods, but rather in the unwillingness of people to adopt these methods.

“From the field, we observed that the lack of adoption of water purification techniques is not due to low awareness levels and it was not even illiteracy, as is often assumed,” said Kavneet Kaur, field manager for Development Alternatives (DA), a social enterprise set up in 1982 to tackle the serious impact of climate change on society and the environment.

“There was an evident lack of effort and prioritisation of safety among people to undertake one or more options consistently that made drinking water safe,” she added.

Most slum dwellers, for example, “opted for methods that did not cost their pocket a penny. Those who did have access to cheaper methods of treatment, like chlorination and solar water disinfection (SODIS), avoided adopting these methods because they were time consuming.”

For the last 30 years, DA, which works primarily in Bundelkhand in central India, has been addressing the behaviour change necessary for people to adopt water treatment methods.

According to Dr K. Vijaya Lakshmi, DA Vice President, out of the three interrelated components of water, sanitation and hygiene, “hygiene behaviour has been shown to have the biggest impact on community health.”

However, she notes, “despite its merit as the most cost effective public health intervention, ironically there was no global target to improve hygiene during the Millennium Development Goal (MDG) era. It has become evident that the MDG framework has fallen short of addressing quality, sustainability and equity issues.”

To date, DA has reached out to 50,000 households and 26 schools through intensive advocacy campaigns in urban villages, offering training on how to adopt safe water treatment methods such as SODIS, boiling, chlorination and sieving, despite meeting strong resistance from the local population.

For example, storing water in a PET (polyethylene terephthalate) bottle exposed to sunlight can kill up to 99 percent of the bacteria in the water, an “innovation” that uses nothing but natural ultraviolet (UV) light to provide safe drinking water for consumption. Water can also be purified by sieving boiled water.

Apart from advocating the adoption of these simple water purification methods, DA has also come up with innovations like the Jal-TARA Water Filter, which removes arsenic, pathogenic bacteria and excess iron from contaminated water, TARA Aqua+ (a sodium hypochlorite solution for purifying water), and TARA Aquacheck Vial, a device that tests for the presence of pathogenic bacteria.

Nevertheless, these innovations are not destined to go very far unless there is a major change in the mindset of the Indian people, and this extends to the “Swachh Bharat” campaign, not just in terms of clean water but also of a cleaner environment.

This idea has also been the driving force behind a youth-led social media campaign known as CLEAN-India ‘The City I Want’, launched by SA and now covering ten Indian cities – Mirzapur, Mohali, Vadodara, Alwar, Ambala, Bharatpur, Indore, Nashik, Mussoorie and Rishikesh.

CLEAN-India (where CLEAN stands for Community Led Environment Action Network) is an environmental assessment, awareness, action and advocacy programme that promotes behavioural change among young city dwellers. It has so far mobilised 28 NGOs, 300 schools, 800 teachers and over one million students.

The campaign is flanked by a number of other citizens’ groups such as resident welfare associations, parent forums, local business associations and clubs, which are actively participating in activities for environmental improvement.

“Going forward, it is crucial that civil society organisation practitioners interface with academic institutions in evidence gathering and inform policy-makers and investors in order to create enabling conditions where scalable innovation can flourish,” says Lakshmi.

Edited by Phil Harris   

Excerpt:

By José Graziano da Silva
ROME, May 5 2015 (IPS)

In the last half-century, people’s lifestyles have changed dramatically. Life expectancy has risen almost everywhere, but this has been accompanied by an increase of so-called non-communicable diseases (NCDs) – such as cardiovascular diseases, cancer, respiratory diseases, and diabetes – causing more and more deaths in all corners of the world.

José Graziano da Silva. Credit: FAO/Alessandra Benedetti

My distinguished colleague Dr Margaret Chan, Director-General of the World Health Organization (WHO), has called the worldwide rise of NCDs a “slow-motion catastrophe”. If NCDs were once considered the scourge of the developed world, this is no longer true; they now disproportionally affect low- and middle-income countries where nearly three-quarters of NCD deaths – 28 million per year – occur.

Much of the rise of NCDs can be attributed to unhealthy diets. WHO estimates that 2.7 million deaths every year are attributable to diets low in fruits and vegetables. Globally unhealthy diets are estimated to cause about 19 percent of gastrointestinal cancer, 31 percent of ischaemic heart disease, and 11 percent of strokes, thus making diet-related NCDs one of the leading preventable causes of death worldwide.

In other words, diet determines health – just as bad diets can lead to disease, healthy diets can contribute to good health.

But what exactly is a healthy diet? This is a difficult question. Generally, a healthy diet must provide the right nutrients in the right balance and with sufficient diversity, limiting the intake of free sugars to less than 10 percent of total energy requirements, and keeping salt intake to less than 5 grams per day.“There is no one-size-fits-all healthy diet. A healthy diet must be affordable, based on locally available foodstuffs, and meet cultural preferences”

However, there is no one-size-fits-all healthy diet. A healthy diet must be affordable, based on locally available foodstuffs, and meet cultural preferences. For over 20 years, FAO, together with WHO, has worked with governments on national Food-Based Dietary Guidelines: short, science-based, tips on healthy eating, in accordance with local values, customs and tradition.

Healthy meals do not always taste or look the same. Take, for example, the Mediterranean and Japanese diets: very healthy and completely different.

The Mediterranean diet revolves around the consumption of legumes, cereals, fruits and vegetables, olive oil, fish, and moderate consumption of dairy products (mostly cheese and yogurt). It emphasises unprocessed, plant-based foods, such as fruits and vegetables, in addition to the consumption of beans, nuts, cereals and other seeds; olive oil is the main source of (unsaturated) fat.

Japanese cuisine, on the other hand, is often associated with sushi (raw fish with rice), and sashimi (fresh raw seafood). The Japanese diet emphasises at least seven ingredients: fish as a major source of protein; vegetables including daikon radish and sea vegetables; rice; soya (tofu, miso, soya sauce); noodles; fruit; and tea (preferably green).

The Japanese and Mediterranean diets are examples of healthy diets. They use a great variety of ingredients; they are rich in plant foods including vegetables and fruit, legumes and fibres; they are modest in red meat; and they utilise many natural herbs and spices instead of salt to flavour food.

Both diets are linked to peoples and cultures as much as to their natural environment: it therefore comes as no surprise that both the Mediterranean diet and the Japanese diet have made it onto UNESCO’s World’s Intangible Cultural Heritage list.

The health benefits of the Japanese and Mediterranean diets are promising. Japanese enjoy one of the longest average life spans in the world – 87 years for women and 80 for men. In Mediterranean countries such as Italy and Spain, women have a life expectancy of 85 years. The figure for Italian men is 80 years, the same as their Japanese counterparts. All of them are above the average of high-income countries: 82 years for women and 76 years for men.

Medical research also indicate that that the Japanese diet leads to the lowest prevalence in the world of obesity – only 2.9% for Japanese women – and other chronic diseases like osteoporosis, heart ailments and some cancers. On the other hand, the Mediterranean diet, if followed for a number of years, is known to reduce the risk of developing heart disease, cancer, hypertension, Type 2 diabetes, Parkinson’s and Alzheimer’s disease.

In sum, adhering to a healthy diet helps you to not only to live longer, but also to have a better quality of life. Conversely, a bad diet causes malnutrition and can expose you to a range of NCDs.

A modern paradox is that many countries – including developing countries – suffer from undernourishment on the one hand, and obesity and diet-related diseases on the other. And while FAO’s chief concern is to eradicate hunger in this world, we cannot separate food security from nutrition. FAO – together with our U.N. agencies – considers food and nutrition security a basic human right.

In all cases, the cost of malnutrition goes beyond the health of the individual: it affects society as a whole in terms of public health costs and loss of productivity, and, therefore, is an issue that must be addressed through public and coordinated action.

Last year’s Second International Conference on Nutrition (ICN2), organised jointly by FAO and WHO, sent a clear message in that direction. The two outcome documents of ICN2, the Rome Declaration on Nutrition and the Framework for Action that commit world leaders to establishing national policies aimed at eradicating malnutrition and making nutritious diets available to all.

A key message from ICN2 is: governments have a central role to play in creating a healthy food environment to enable people to adopt healthy dietary practices. Yes, it is consumers who choose what to eat, but it is the government’s role to provide the enabling environment that encourages and makes healthy choices possible. (END/COLUMNIST SERVICE)

Edited by Phil Harris   

The views expressed in this article are those of the author and do not necessarily represent the views of, and should not be attributed to, IPS – Inter Press Service. 

Excerpt:

By Andrew MacMillan
ROME, Jan 13 2015 (IPS)

About a week ago my wife was taken to hospital and diagnosed with pneumonia. She was promptly treated with antibiotics and, wonderfully, is now on the mend.

What has struck me about this experience is not so much the high professionalism of the health workers or their up-to-date hospital equipment but the fact that she has become immersed in what can best be described as “a culture of caring”.

Andrew MacMillan

She and the other patients in her ward are looked after round the clock by an extraordinary team of state-employed nurses in a quiet, efficient and courteous way that inspires confidence.

I suppose that there is nothing particularly unusual about this. Caring for others is a very natural human trait. Everywhere, mothers care for their children; sons and daughters care for their aging parents; and neighbours rush to help each other when they hit problems.

Perhaps, however, “modern” societies – if one dares to generalise about them – are driven more by the quest for individual material wealth than by any widely expressed wish to do things for the general good of humanity.

Unless you live in Bhutan, your country’s performance is measured not in terms of the happiness of its people but by the growth of its Gross Domestic Product; bankers and businessmen reward themselves with salary bonuses rather than with extra time with their families; and those who enjoy the highest pinnacles of wealth vie with each other over the size of their fleet of private jets or the tonnage of their personal yachts.

The idiosyncrasies of the super-rich and celebrities would not matter much if they had not become the new role models for people who aspire to “do well” in life and if their wealth did not entitle them to a voice in the corridors of world power. It seems odd that Presidents and Prime Ministers flock each year in January to [the World Economic Forum in] Davos to rub shoulders with the rich and famous, but perhaps this is simply a tacit admission of the influence that the latter have.“I believe that most people, at heart, want to see globalisation bring greater fairness and justice
even if this comes at the partial expense of our own material well-being”

Much of the recent material gains all around the planet is the result of the processes of globalisation that have successfully combined inventiveness, capital, low-cost but increasingly skilled labour and cheap transportation in new ways that have flooded the world’s markets with an amazing array of tantalising goods.

This apparent success of globalisation, however, may distract political attention from the idea that it could perhaps work better in everyone’s interest.

It seems absurd that 6 billion mobile phones have been produced and sold but 800 million people still go hungry every day; that, as people travel further, faster and more frequently, diseases such as Ebola spread more rapidly and more widely but the institutions responsible for protecting us from increased threats remain desperately under-funded; and that governments hesitate to upset their voters by acting to trim greenhouse gas emissions while, as predicted, the increasing frequency of extreme weather events is repeatedly wreaking havoc upon the unfortunate.

We tend to take these problems for granted rather than face up to the need to identify how to best manage globalisation in the interests of humanity.

I believe that most people, at heart, want to see globalisation bring greater fairness and justice even if this comes at the partial expense of our own material well-being.

I do not think that there are many people who, if asked, would want to see others starve for lack of food, who welcome greater weather instability or who think that it is right that their children should suffer from the environmental damage that results from our unsustainable lifestyles.

In a sense, President Lula of Brazil put this idea to the test during his successful 2002 campaign. Breaking out of the normal political mould, he did not promise his voters higher incomes but simply pledged that all Brazilians would enjoy three meals a day by the end of his term in office.

He unveiled his Zero Hunger Programme on his first day as President, with the State assuming the responsibility for assuring that all the poorest families in the country could fulfil their right to food. There was huge outpouring of popular support for his efforts to create the more just and equitable society that has now emerged.

What many of us would like to see is the emergence of a new international consciousness of social justice similar to that proposed by Lula and embraced by Brazilians twelve years ago.

It must be founded on a growing public recognition of the unique role that multilateral institutions have to play in ensuring that globalisation is harnessed to benefit all people, especially the poorest of the poor. It must also assure greater inter-generational fairness in the use of our planet’s scarce resources.

Nowhere is the need for greater fairness more apparent than in the realm of food management – where we face a crazy situation in which, though ample food is produced, the health of more than half the world’s population is now damaged by bad nutrition.

It is fitting that the Secretary-General of the United Nations, Ban Ki-moon, should have launched his personal “Zero Hunger Challenge” in Brazil in 2012 when he called for the elimination of hunger “within my lifetime”.

The fact that the current Director-General of the Food and Agriculture Organization (FAO) – the United Nations agency that that oversees global food management – is José Graziano da Silva, who was the Brazilian architect of Lula’s Zero Hunger Programme, inspires confidence that it will do all in its power to bring about a world without hunger.

We can already see a renewed FAO in action – committed to ending hunger and malnutrition, more focused in its goals, working as one and embracing partnerships for a better present and future. Four more years will allow Graziano da Silva to consolidate the transformations he has begun and realise their full effect to the benefit of the world´s poor and hungry.

Hopefully 2015 will be a year in which the world’s leaders will become the champions of the justice and fairness – the caring society that my wife has experienced – to which so many of us aspire.

At the very least, they should pick up the thought that, as in Brazil, it should be a perfectly normal function of any self-respecting government to ensure that all its people can eat healthily.

(Edited by Phil Harris)

The views expressed in this article are those of the author and do not necessarily represent the views of, and should not be attributed to, IPS – Inter Press Service. 

Excerpt:

By Mairead Maguire
BELFAST, Dec 18 2014 (IPS)

I recently visited Assisi, the home of St. Francis and St. Clare, two great spirits whose lives have inspired us and millions of people around the world.

St. Francis, a man of peace, and St. Clare, a woman of prayer, whose message of love, compassion, care  for humans, animals and  the environment comes down through history to speak to us in a very relevant and inspirational way.

Mairead Maguire

Today, in the 2lst century, as we the human family face increasing violence, we are challenged to admit that we are on the wrong path, and that we need to find new ways of thinking and doing things from a global perspective.

Peace is a beautiful gift to have in life, and it is particularly treasured by those who have known violent conflict, war, famine, disease and poverty.  I believe that Peace is a basic human right for every individual and all people.

Love for others and respect for their rights and their human dignity, irrespective of who or what they are, no matter what religion – or none – that they choose to follow, will bring about real change and set in motion proper relationships.  With such relationships built on equality and trust, we can work together on so many of the threats to our common humanity.“For the first three hundred years after Christ, the early Christian communities lived in total commitment to Jesus’s non-violence. Sadly, for the next 1700 years, Christian mainline churches have not believed, taught or lived Jesus’s simple message: love your enemies, do not kill”

Poverty is one such threat and Pope Francis challenges us to take care of the poor, and has declared his desire that the Catholic Church be a church of the poor and for the poor. To meet this challenge, we can each ask ourselves ‘how will what I do today help the poor’?.

Pope Francis also has spoken about the need to build fraternity amongst the nations. This is important because building trust amongst people and countries will help bring peace to our interdependent, inter-connected world.

Violence begets violence as we witness every day on our television screens, so the choice between violence and non-violence, is up to each one of us.  However, if we do not teach non-violence in our education systems and in our religious institutions, how can we make that choice?

I believe that all faith traditions and secular societies need to work together and teach the way of non-violence as a way of living, also as a political science and means for bringing about social and political change wherever we live.

A grave responsibility lies with the different religious traditions to give spiritual guidance and a clear message, particularly on the questions of economic injustice, ‘armed resistance‘, arms, militarism and war.

As a Christian living in a violent ethnic political conflict in Northern Ireland, and caught between the violence of the British army and the Irish Republican Army, I was forced to confront myself with the questions, ‘do you ever kill?’ and ‘is there such a thing as a just war?’.

During my spiritual journey I reached the absolute conviction that killing is wrong and that the just war theory is, in the words of the late Fr. John L. McKenzie, “a phony piece of morality”.

I became a pacifist because I believe every human life is sacred and we have no right to kill each other. When we deepen our love and compassion for all our brothers and sisters, it is not possible to torture or kill anyone, no matter who they are or what they do. 

I also believe that Jesus was a pacifist and I agree with McKenzie when he writes: “if we cannot know from the New Testament that Jesus rejected violence absolutely, then we can know nothing of Jesus’ person or message. It is the clearest of themes.”

For the first three hundred years after Christ, the early Christian communities lived in total commitment to Jesus’s non-violence. Sadly, for the next 1700 years, Christian mainline churches have not believed, taught or lived Jesus’s simple message: love your enemies, do not kill.

During the last 1700 years, Christians have moved so far away from the Christic life of non-violence that we find ourselves in the terrible dilemma of condemning one kind of homicide and violence while paying for, actively participating in or supporting homicidal violence and war on a magnitude far greater than that which we condemn in others.

There is indeed a longstanding defeat in our theology. To help us out of this dilemma, we need to hear the full gospel message from our Christian leaders.

We need to reject the ‘just war’ theology and develop a theology in keeping with Jesus’ non-violence.

Some Christians believe that the ‘just war’ theory can be applied and that they can use violence – that is, ‘armed struggle/armed resistance’ – or can be adopted by governments to justify ongoing war.

It is precisely because of this ‘bad’ theology that we need, from our spiritual or religious leaders, a clear message and an unambiguous proclamation that violence is not the way of Jesus, violence is not the way of Christianity, and that armaments, nuclear weapons, militarism and war must be abolished and replaced with a more human and moral way of solving our problems without killing each other. (END/IPS COLUMNIST SERVICE)

(Edited by Phil Harris)

The views expressed in this article are those of the author and do not necessarily represent the views of, and should not be attributed to, IPS – Inter Press Service. 

Excerpt:

These Haitian schoolchildren are being supported by a WFP school feeding programme designed to end malnutrition which, for many countries, can be a double burden where overweight and obesity exist side by side with under-nutrition. Credit: UN Photo/Albert González Farran

By Gloria Schiavi
ROME, Nov 23 2014 (IPS)

Not only do 805 million people go to bed hungry every day, with one-third of global food production (1.3 billion tons each year) being wasted, there is another scenario that reflects the nutrition paradox even more starkly: two billion people are affected by micronutrients deficiencies while 500 million individuals suffer from obesity.

The first-ever Global Nutrition Report, a peer-reviewed publication released this month, and figures from the Rome-based U.N. Food and Agriculture Organisation (FAO) highlight a multifaceted and complex phenomenon behind malnutrition.

“The double burden of malnutrition [is] a situation where overweight and obesity exist side by side with under-nutrition in the same country”, according to Anna Lartey, FAO’s Nutrition Director. “And we are seeing it in lots of the countries that are developing economically. These are the countries that are going through the nutrition transition”."The double burden of malnutrition [is] a situation where overweight and obesity exist side by side with under-nutrition in the same country. And we are seeing it in lots of the countries that are developing economically. These are the countries that are going through the nutrition transition” – Anna Lartey, FAO’s Nutrition Director

Beside hunger then, governments and development organisations have also been forced to start tackling over-nutrition.

“While under-nutrition still kills almost 1.5 million women and children every year, growing rates of overweight and obesity worldwide are driving rising diseases like cancer, heart disease, stroke and diabetes”, Francesco Branca, Director of Nutrition for Health and Development at the World Health Organisation (WHO), explained in a statement.

The solution does not lie in the realm of science, health or agriculture alone. It requires a cross sectorial and multi dimensional approach that includes education, women’s empowerment, market regulation, technological research and, above all, political commitment.

For this reason, representatives of governments, multilateral institutions, civil society and the private sector met in Rome for the Second International Conference on Nutrition (ICN2) that took place at FAO headquarters on Nov. 19-21. Jointly organised by FAO and WHO, the conference came 22 years after its first edition and, unfortunately, addressed the same unsolved problem.

Malnutrition, in all its forms, has repercussions on the capability of people to live a full life, work, care for their children, be productive, generate a positive cycle and improve their living conditions. Figures from the Global Nutrition Report estimate that the cost of malnutrition is around four to five percent of national GDP, suggesting that prevention would be more cost-effective.

With the goal of improving nutrition through the implementation of evidence-based policies and effective international cooperation, ICN2 produced two documents to help governments and stakeholders head in the right direction: the Rome Declaration on Nutrition and a Framework for Action.

The conference also heard a strong call for accountability and for the strengthening of nutrition in the post-2015 development agenda.

Flavio Valente, who represented civil society organisations at ICN2, remarked that “the current hegemonic food system and agro-industrial production model are not only unable to respond to the existing malnutrition problems but have contributed to the creation of different forms of malnutrition and the decrease of the diversity and quality of our diets.”

This position was shared by many speakers, who stressed the negative impact that advertising of unhealthy food has, mainly on children.

According to a participant from Chile, calling obesity a non-communicable disease is misleading, because it spreads through the media system very effectively. He added that Chile currently risks being brought before the World Trade Organisation (WTO) by multinational food companies for its commitment to protect public health by regulating the advertising of certain food.

This happens in a country where 60 percent of people suffer from over-nutrition and one obese person dies every hour, according to the permanent representative of Chile at FAO, Luis Fernando Ayala Gonzalez.

In an address to the conference, Queen Letizia of Spain also acknowledged the responsibility of the private sector: “It is necessary to help the economic interests converging towards public health. It is worth remembering that no country in the world has been able to reverse the epidemic of obesity in all age groups. None.”

The outcome of ICN2 brought consensus around a plan of action and some key targets.

Educating children about healthy habits and women who are in charge of feeding the family was recognised as crucial, as was breastfeeding, which should be encouraged (through paid maternity leave and breastfeeding facilities in the workplace), and the need to empower women working in agriculture.

Supporting small and family farming would also give people better opportunities to eat local, fresh and seasonal produce as well as fruit and vegetables, reducing the consumption of packaged, processed food that is often low in nutrients, vitamins and fibres and high in calories, sugar, salt and fats.

However, teaching people how to eat is not enough, if they cannot easily access quality food – hence the need for relevant policies targeting the food chain and distribution.

Initiatives like the Fruit in Schools programme proposed by New Zealand go in the right direction, especially when implemented within a coordinated policy that promotes physical activity and a healthy lifestyle that fights consumption of alcohol and tobacco.

(Edited by Phil Harris)