An estimated 36 percent of Papua New Guinea’s eight million people are currently living on less than 1.25 dollars a day. Credit: Catherine Wilson/IPS

By Neena Bhandari
SYDNEY, May 25 2015 (IPS)

As Papua New Guinea celebrates 40 years of independence, 2015 marks a defining year for the largest Pacific Island nation, set to record 15 percent GDP growth this year.

However, unless the government tightens up its policies, the country will likely fail to achieve any of the United Nations’ Millennium Development Goals (MDGs) despite making significant progress in the past few years.

"We believe that if we continue to invest in the programmes that we have today, we will achieve [the] results that the international community has laid down for everybody." -- Peter O’Neill, Prime Minister of Papua New Guinea
“Even with 14 years of successive double digit growth, the challenge for PNG is to translate high levels of resource revenue into well-being for all citizens. The latest estimate of the population is now over eight million and approximately 36 percent of the people are living on less than 1.25 dollars a day,” United Nations Resident Coordinator in Papua New Guinea Roy Trivedy told IPS.

Mineral resources, including copper, gold, oil, nickel, cobalt and liquid natural gas, constitute 70 percent of all PNG exports; and mine and oil production revenues since independence have amounted to 60 billion dollars, according to the Human Development Report 2013.

Still, PNG currently ranks 156^th out of 187 countries in the United Nations’ Human Development Index (HDI).

U.N. agencies have worked across different sectors to support PNG in the development of education and health, poverty reduction, and assistance with disaster risk reduction and social protection. Many of the reforms implemented by the current government over the past three years are beginning to take root.

For example, the Tuition Fee Free (TFF) education policy, benefitting students at the elementary and secondary level, is gaining acceptance throughout the country, with two million children currently enrolled in schools.

The government is also investing in higher education and vocational and tertiary education. But the country faces the challenges of tackling high student-to-teacher ratios, building and refurbishing educational infrastructure, improving quality of primary education services and scaling up the provision of secondary and tertiary education.

The government has also committed to free primary health care for all citizens, but U.N. agencies working in PNG say more needs to be done to reduce the infant mortality rate from the current 75 deaths per 1,000 live births; reduce the number of under-five children dying of preventable diseases; and reduce the maternal mortality rate, which has remained at 733 deaths per 100,000 live births over the past decade.

In addition, early childhood health is a major issue, with 48 percent of children aged five or younger suffering from malnutrition.

Infrastructure development will also be crucial to realising the benefits of the country’s mineral, energy, agricultural and tourism assets. The government is spending considerable resources to modernise and better equip the police, judiciary and corrective services critical for tackling inequality and discrimination, especially against women.

PNG will have an opportunity to demonstrate its commitment to uplifting the lives of its people as the international community moves into a new phase of its development agenda: the post-2015 Sustainable Development Goals (SDGs).

Papua New Guinea is the co-facilitator with Denmark of the Global Summit on SDGs scheduled to take place later this year.

Following a decade-and-a-half of development guided by the Millennium Development Goals (MDGs), the new global blueprint for poverty eradication is expected to be centred on sustainability, including combating climate change, protecting the environment, preserving biodiversity and conserving oceans, seas and marine resources: issues that are highly relevant for Pacific Island countries threatened by rising sea levels.

While the 22 Pacific island countries and territories contribute just 0.03 percent to global emissions, their collective population of 10 million people will likely suffer some of the worst impacts of climate change.

In addition to loss of human life as a result of natural disasters, the Asian Development Bank (ADB) estimates that climate change could cost the region over 12 percent of its annual gross domestic product (GDP) by the turn of the century.

Against this backdrop, IPS correspondent Neena Bhandari sat down with Papua New Guinea’s Prime Minister Peter O’Neill, to discuss the U.N.’s role in PNG’s development agenda. Excerpts from the interview follow.

Q: Has the United Nations contributed to Papua New Guinea’s economic development?

A: We have many United Nations organisations in Papua New Guinea and I would like to thank them for their contribution to the country’s development agenda. We are very happy with the work that they are doing, especially UNDP [the United Nations Development Programme], which is engaged with our department of planning [Department of National Planning and Monitoring] in setting up various programmes all around the country, including Bougainville.

Q: It seems PNG is not ‘on track’ to meet any of the Millennium Development Goals, scoring either ‘off track’ or ‘mixed’ in the latest results surveys. What is being done to fix the problem?

A: In fact, we have made significant progress in meeting the Millennium Development Goals. Two or three years ago, we would have completely missed the MDG targets. But right now on issues related to infant mortality and literacy, the progress is much better because of the education and health programmes that we are rolling out. These programmes are contributing significantly to meeting the MDG targets.

Q: What are your aspirations for the Sustainable Development Goals? What strategies would you adopt to achieve the SDGs?

A: We think that our policies today are starting to yield the positive outcomes that we want: to make sure our literacy rates are beyond 80 to 90 percent; our infant mortality rates drop down to levels that are comparable to our neighbouring countries; and our life expectancy increases. We believe that if we continue to invest in the programmes that we have today, we will achieve those results that the international community has laid down for everybody.

Q: The island nation has been the focus of Chinese investment and Australian aid. The Australia-PNG bilateral aid programme is worth approximately 577 million dollars in the current financial year. Which has been more beneficial for the country’s development?

A: Both are beneficial. The Chinese investment is not dissimilar to many of the other investments they make around the region. They make similar investments in Australia, similar investments in Indonesia and all throughout the world. But I think in terms of support in social programmes, the more beneficial investment is through the aid programme that the Australian Government continues to provide.

Now they are aligning their programmes to our priorities, which has never happened before. The aid programme is now looking towards the education problems that we have, the health, good governance and the law and order problems that we have. Those are the programmes that our government is regularly focusing on and the aid programme is partnering in achieving the outcomes that we want.

Q: In Papua New Guinea, there have been positive steps toward integrating West Papuan refugees and also lifting reservations to the 1951 Refugee Convention. What measures are being taken to rehabilitate ‘climate refugees’, for example, people residing on Carteret Islands, who are in danger of being submerged due to the rise in sea levels?

A: Climate change is global and it is not something that is unique to PNG, but we are trying to resettle many of those refugees on the mainland. Most of them have families and we are trying to get them integrated into communities that they are comfortable with. As in the case of West Papuan refugees down at Western Province, many of them are already in PNG for many, many years and we are taking steps so they can become citizens and have access to all the services that the government provides for its citizens.

Q: Will climate change be a major problem for PNG and other countries in the Pacific?

A: Yes, we are facing similar problems like some of the smaller Pacific Island countries. We have thousands of low-lying islands and as the sea level rises, these people will have to continue to move. The first step for developed countries like Australia and the United States should be to sign up to the Kyoto Protocol and then go with the rest of the international community. Climate change is a global issue where we all need to work together in reducing emissions and lowering the global warming challenge that we face.

Edited by Kanya D’Almeida

Excerpt:

Scenes like this are not uncommon at relief camps inhabited by the Bodo community. Many families have accepted that they will have a long wait before returning to their homes, or before their children resume schooling. Credit: Priyanka Borpujari/IPS

By Priyanka Borpujari
KOKRAJHAR, India, Feb 3 2015 (IPS)

The tarpaulin sheet, when stretched and tied to bamboo poles, is about the length and breadth of a large SUV. Yet, about 25 women and children have been sleeping beneath these makeshift shelters at several relief camps across Kokrajhar, a district in the north-eastern Indian state of Assam.

The inhabitants of these camps – about 240,000 of them across three other districts of Assam – fled from their homes after 81 people were killed in what now seems like a well-planned attack.

The Asian Centre for Human Rights says the situation is reaching a full-blown humanitarian crisis, representing one of the largest conflict-related waves of displacement in India.

It has turned a mirror on India’s inability to meet the Millennium Development Goals (MDGs), and suggests that continued violence across the country will pose a major challenge to meeting the basic development needs of a massive population.

Edited by Kanya D’Almeida

In Serfanguri relief camp in Kokrajhar, several tents were erected, but they were inadequate to properly house the roughly 2,000 people who had arrived there on Dec. 23, 2014. This single tent houses 25 women and children. Credit: Priyanka Borpujari/IPS

By Priyanka Borpujari
KOKRAJHAR, India, Jan 29 2015 (IPS)

The tarpaulin sheet, when stretched and tied to bamboo poles, is about the length and breadth of a large SUV. Yet, about 25 women and children have been sleeping beneath these makeshift shelters at several relief camps across Kokrajhar, a district in the north-eastern Indian state of Assam.

The inhabitants of these camps – about 240,000 of them across three other districts of Assam – fled from their homes after 81 people were killed in what now seems like a well-planned attack.

The Asian Centre for Human Rights says the situation is reaching a full-blown humanitarian crisis, representing one of the largest conflict-related waves of displacement in India.

It has turned a mirror on India’s inability to meet the Millennium Development Goals (MDGs), and suggests that continued violence across the country will pose a major challenge to meeting the basic development needs of a massive population.

Hunger is constant in the refugee camps, with meagre rations of rice, lentils, cooking oil and salt falling short of most families’ basic needs. Women are forced to walk long distances to fetch firewood for woodstoves. Credit: Priyanka Borpujari/IPS

Appalling conditions

On the evening of Dec. 23, several villages inhabited by the Adivasi community were allegedly attacked by the armed Songbijit faction of the National Democratic Front of Bodoland (NDFB), which has been seeking an independent state for the Bodo people in Assam.

The attacks took place in areas already marked out as Bodoland Territorial Authority Districts (BTAD), governed by the Bodoland Territorial Council (BTC).

But the Adivasi community that resides here comprises several indigenous groups who came to Assam from central India, back in 150 AD, while hundreds were also forcibly brought to the state by the British to work in tea gardens.

Clashes between the Adivasi and Bodo communities in 1996 and 1998 – during which an estimated 100 to 200 people were killed – still bring up nightmares for those who survived.

This child, a resident of the Serfanguri camp, is suffering from a skin infection. His mother says they are yet to receive medicines from the National Rural Health Mission (NRHM). Credit: Priyanka Borpujari/IPS

It explains why the majority of those displaced and taking shelter in some 118 camps are unwilling to return to their homes.

But while the tent cities might seem like a safer option in the short term, conditions here are deplorable, and the government is keen to relocate the temporary refugees to a more permanent location soon.

The relief camp set up at Serfanguri village in Kokrajhar lacks all basic water and sanitation facilities deemed necessary for survival. A single tent in such a camp houses 25 women and children.

“The men sleep in another tent, or stay awake at night in turns, to guard us. It is only because of the cold that we somehow manage to pull through the night in such a crowded space,” explains Maino Soren from Ulghutu village, where four houses were burned to the ground, forcing residents to run for their lives carrying whatever they could on their backs.

Now, she tells IPS, there is a serious lack of basic necessities like blankets to help them weather the winter.

Missing MDG targets

In a country that is home to 1.2 billion people, accounting for 17 percent of the world’s population, recurring violence and subsequent displacement put a huge strain on limited state resources.

Time after time both the local and the central government find themselves confronted with refugee populations that point to gaping holes in the country’s development track record.

With food in limited supply and fish being a staple part of the Assamese diet, it is common to see women and even children fishing in the marshy swamps that line the edge of the refugee camps, no matter how muddy or dirty the water might be. Credit: Priyanka Borpujari/IPS

Outside their hastily erected tents in Kokrajhar, underweight and visibly undernourished children trade biscuits for balls of ‘jaggery’ (palm sugar) and rice.

Girls as young as seven years old carry pots of water on their heads from tube wells to their camps, staggering under the weight of the containers. Others lend a hand to their mothers washing pots and pans.

The scenes testify to India’s stunted progress towards meeting the MDGs, a set of poverty eradication targets set by the United Nations, whose timeframe expires this year.

One of the goals – that India would reduce its portion of underweight children to 26 percent by 2015 – is unlikely to be reached. The most recent available data, gathered in 2005-2006, found the number of underweight children to be 40 percent of the child population.

Similarly, while the District Information System on Education (DISE) data shows that the country has achieved nearly 100 percent primary education for children aged six to ten years, events like the ones in Assam prevent children from continuing education, even if they might be enrolled in schools.

According to Anjuman Ara Begum, a social activist who has studied conditions in relief camps all across the country and contributed to reports by the Internal Displacement Monitoring Centre (IDMC), “Children from relief camps are allowed to take new admission into nearby public schools, but there is no provision to feed the extra mouths during the mid-day meals. So children drop out from schools altogether and their education is impacted.”

Furthermore, in the Balagaon and Jolaisuri villages, where camps have been set up to provide relief to Adivasi and Bodo people respectively, there were reports of the deaths of a few infants upon arrival.

Most people attributed their deaths to the cold, but it was clear upon visiting the camps that no special nutritional care for lactating mothers and pregnant women was available.

This little boy is one of hundreds whose schooling has been interrupted due to violence. The local administration is attempting to evict refugees from the camps, most of which are housed in school compounds, but little is being done to ensure the educational rights of displaced children. Credit: Priyanka Borpujari/IPS

Bleak forecast for maternal and child health

Such a scenario is not specific to Assam. All over India, violence and conflict seriously compromise maternal and child health, issues that are high on the agenda of the MDGs.

In central and eastern India alone, some 22 million women reside in conflict-prone areas, where access to health facilities is compounded by the presence of armed groups and security personnel.

This is turn complicates India’s efforts to reduce the maternal mortality ratio from 230 deaths per 100,000 live births to its target of 100 deaths per 100,000 births.

It also means that India is likely to miss the target of lowering the infant mortality rate (IMR) by 13 points, and the under-five mortality rate by five points by 2015.

Scenes like this are not uncommon at relief camps inhabited by the Bodo community. Many families have accepted that they will have a long wait before returning to their homes, or before their children resume schooling. Credit: Priyanka Borpujari/IPS

According to a recent report by Save the Children, ‘State of the World’s Mothers 2014’, India is one of the worst performers in South Asia, reporting the world’s highest number of under-five deaths in 2012, and counting some 1.4 million deaths of under-five children.

Nutrition plays a major role in the mortality rate, a fact that gets thrown into high relief at times of violence and displacement.

IDPs from the latest wave of conflict in Assam are struggling to make do with the minimal provisions offered to them by the state.

“While only rice, lentils, cooking oil and salt are provided, there is no provision for firewood or utensils, and hence the burden of keeping the family alive falls on the woman,” says Begum, adding that women often face multiple hurdles in situations of displacement.

With an average of just four small structures with black tarpaulin sheets erected as toilets in the periphery of relief camps that house hundreds of people, the basic act of relieving oneself becomes a matter of great concern for the women.

“Men can go anywhere, any time, with just a mug of water. But for us women, it means that we have to plan ahead when we have to relieve ourselves,” said one woman at a camp in Lalachor village.

It is a microcosmic reflection of the troubles faced by 636 million people across India who lack access to toilets, despite numerous commitments on paper to improve the sanitation situation in the country.

As the international community moves towards an era of sustainable development, India will need to lay plans for tackling ethnic violence that threatens to destabilize its hard-won development gains.

Edited by Kanya D’Almeida

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Edited by: Nalisha Adams

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

Every year, thousands of Afghan women cross the border into Pakistan in search of medical treatment. Credit: Ashfaq Yusufzai/IPS

By Ashfaq Yusufzai
PESHAWAR, Pakistan, Jun 3 2013 (IPS)

Muzaffar Shah, a shopkeeper from Kabul, sits in a hospital waiting room, desperate for news. He has travelled nearly 300 km to get to the Khyber Teaching Hospital in Peshawar, capital of northern Pakistan’s Khyber Pakhtunkhwa (KP) province, where his wife is now in intensive care.

Just a few days ago, she delivered a baby boy who died within minutes. Shortly after, she started to experience severe vaginal bleeding.

“She was initially admitted to the Indira Gandhi Children’s Hospital in Kabul, where there was only an occasional supply of electricity and where a lack of water badly hampered patients’ treatment,” Shah told IPS.

“After two days my wife showed no signs of improvement so we rushed her here.”

Now his wife is receiving three pints of blood daily and her chances of survival have increased, but she is not yet fully recovered, most likely because she did not receive immediate medical attention during the birth process.

According to Dr. Muhammad Shaukat, a representative of the Khyber Pakhtunkhwa Health Directorate, doctors in the KP province are more than used to receiving desperate patients from across the border, particularly those seeking emergency obstetric care.

“Three teaching hospitals in this border town receive at least 1,000 Afghan patients every month, mostly those suffering from maternal and childhood diseases, from cities like Kabul and provinces like Jalalabad, Kunar and others, due to a lack of specialised medical facilities there,” he told IPS.

Most hospitals in Afghanistan are rudimentary and understaffed, while a shortage of life-saving drugs has fuelled the health crisis.

Afghan patients now occupy 10 percent of the beds in Peshawar’s hospitals. “They are becoming a burden…but we cannot deny them admission, so we treat them on humanitarian grounds,” Shaukat added.

Last year, teaching hospitals in the northern province treated approximately 34,888 Afghan patients. This year the number is likely to increase, with 20,000 Afghans having already received treatment as of May 20.

Meanwhile, facilities like the government-run Hayatabad Medical Complex (HMC) in Peshawar admitted 3,456 Afghan patients, mostly women and children, in 2012, Dr Hakimullah Khan told IPS.

“This year, we have already hospitalised about 3,000 patients,” the HMC specialist said, adding the influx will not slow down any time soon.

Dr. Sardar Ali, Pakistan field officer for the World Health Organisation, told IPS most Afghans seek treatment here due to a dearth of health facilities in their home, which is evident in Afghanistan’s maternal mortality rate of 500 deaths per 100,000 live births, as opposed to 250 deaths per 100,000 live births in Pakistan.

In comparison, the maternal mortality rate in the United States is seven deaths per 100,000 births, he said.

The infant mortality rate in Afghanistan is also a reflection of the near total lack of infrastructure, services and trained professionals like midwives and female nurses: over 152 infants die per 1,000 live births, since only eight percent of all deliveries are handled by skilled birth attendants. In Pakistan, trained attendants handle 35 percent of births.

Some experts blame the abysmal health situation on political instability.

Ahmed Jamal, a doctor from the eastern Afghan city of Jalalabad, told IPS that ever since U.S. troops deposed the Taliban government in 2001, the country has been almost entirely reliant on international funding for its health needs, with 70 percent of the population relying on health facilities set up by aid agencies like the WHO, the United Nations Children’s Fund (UNICEF) and the International Committee of the Red Cross (ICRC).

Since 2002 Afghanistan has received about 60 billion dollars in aid, much of which has gone towards improving basic infrastructure like schools and hospitals. But despite generous foreign donations, nearly 40 percent of the country’s 25 million people do not have access to health facilities.

Some sources estimate that the decade since the U.S. invasion has seen the child mortality rate drop by 50 percent. But 20 percent of newborns continue to suffer from low birth weight and acute malnutrition.

The WHO says Kabul, a city of 3.2 million people, has an estimated 1.28 hospital beds per 1,000 people, while other provinces have even fewer, with roughly two beds for every 10,000 people.

The few hospitals that exist often lack electricity and running water, and equipment is poorly maintained. As a result, the limited facilities are under-utilised, with an average occupancy rate of less than 50 percent.

Although the northwestern provinces of Pakistan provide an attractive option for well-heeled Afghans, not everyone can avail themselves of the services just across the border.

Aziz Ahmed, an automobile dealer in Kabul whose ailing father is now recovering in a private Peshawar hospital after an operation to remove a kidney stone, says that while he managed to scrape together the money to come here, “most of my countrymen cannot.”

In addition to hospital fees, anyone wishing to cross the border in search of medical treatment must pay about 200 dollars to rent a vehicle, and endure numerous checkpoints before entering Peshawar on rough and bumpy roads that doctors have described as “hazardous” to those already in precarious medical situations.

He said many people in Afghanistan blame the situation on 35 years of conflict, which has caused massive brain drain from the country, leaving the population without access to specialised services.

Dr. Abdul Shakoor at the Institute of Radiotherapy and Nuclear Medicines in Peshawar tells IPS that 15 percent of cancer patients treated in Pakistan come from Afghanistan, which does not have a single cancer treatment centre.

“Last year, we provided treatment to 3,000 patients from Afghanistan,” he said. This year, the KP provincial government registered 189 Afghan nationals for a free cancer treatment programme.

Afghans living with HIV/AIDS also receive free treatment at an antiretroviral therapy centre in Peshawar, which has “been providing treatment and counselling facilities to 250 patients from different parts of Afghanistan,” Dr Akhtar Nabi, a staff member at the centre, told IPS, adding that the centre also treats 600 Pakistanis.

The situation has bred resentment among communities in the northern provinces, which also host two of three million Afghan refugees currently living in Pakistan. Most locals look down on refugees, especially on those with whom they are forced to share the country’s limited medical resources.