Africa's children still stand as the number one victims of suffering and destitution across the continent. Credit: Jeffrey Moyo/IPS

By Jeffrey Moyo
HARARE, Aug 26 2015 (IPS)

“Poverty has become part of me,” says 13-year-old Aminata Kabangele from the Democratic Republic of Congo. “I have learned to live with the reality that nobody cares for me.”

Aminata, who fled her war-torn country after the rest of her family was killed by armed rebels and now lives as a as a refugee in Zimbabwe’s Tongogara refugee camp in Chipinge on the country’s eastern border, told IPS that she has had no option but to resign her fate to poverty.

Despite the United Nations’ Millennium Development Goal (MDG) of eradicating extreme poverty and hunger, African children still stand as the number one victims of suffering and destitution across the continent.“Poverty has become part of me. I have learned to live with the reality that nobody cares for me” – Aminata Kabangele, a 13-year-old refugee from the Democratic Republic of Congo

“In every country you may turn to here in Africa, children are at the receiving end of poverty, with high numbers of them becoming orphans,” Melody Nhemachena, an independent social worker in Zimbabwe, told IPS.

Based on a 2013 UNICEF report, the World Bank has estimated that up to 400 million children under the age of 17 worldwide live in extreme poverty, the majority of them in Africa and Asia.

According to human rights activists, the growing poverty facing many African families is also directly responsible for the fate of 200,000 African children that the United Nations estimates are sold into slavery every year.

“Many families in Africa are living in abject poverty, forcing them to trade their children for a meal to persons purporting to employ or take care of them (the children), but it is often not the case as the children end up in forced labour, earning almost nothing at the end of the day,” Amukusana Kalenga, a child rights activist based in Zambia, told IPS.

West Africa is one of the continent’s regions where modern-day slavery has not spared children.

According to Mike Sheil, who was sent by British charity and lobby group Anti-Slavery International to West Africa to photograph the lives of children trafficked as slaves and forced into marriage, for many families in Benin – one of the world’s poorest countries – “if someone offers to take their child away … it is almost a relief.”

Global March Against Child Labour, a worldwide network of trade unions, teachers’ and civil society organisations working to eliminate and prevent all forms of child labour, has reported that a 2010 study showed that “a staggering 1.8 million children aged 5 to 17 years worked in cocoa farms of Ivory Coast and Ghana at the cost of their physical, emotional, cognitive and moral well-being.”

“Trafficking in children is real. Gabon, for example, is considered an Eldorado and draws a lot of West African immigrants who traffic children,” Gabon’s Social Affairs Director-General Mélanie Mbadinga Matsanga told a conference on preventing child trafficking held in Congo’s southern city of Pointe Noire in 2012.

Gabon is primarily a destination and transit country for children and women who are subjected to forced labour and sex trafficking, according to the U.S. State Department’s 2011 human trafficking report.

In Africa’s most populous country, Nigeria, a study of child poverty showed that over 70 percent of children are not registered at birth while more than 30 percent experience severe educational deprivation. According to UNICEF Nigeria, about 4.7 million children of primary school age are still not in school.

“These boys and girls, some as young as 13-years-old, serve in the ranks of terror groups like Boko Haram, often participating  in suicide operations, and act as spies,” Hillary Akingbade, a Nigerian independent conflict management expert, told IPS.

“Girls here are often forced into sexual slavery while many other African children are abducted or recruited by force, with others joining out of desperation, believing that armed groups offer their best chance for survival,” she added.

Akingbade’s remarks echo the reality of poverty which also faces children in the Central African Republic, where an estimated 6,000 to 10,000 boys and girls became members of armed groups following an outbreak of a bloody civil war in the central African nation in December 2012, according to Save the Children.

Violence plagued the Central African Republic when the country’s Muslim Seleka rebels seized control of the country’s capital Bangui in March 2013, prompting a backlash by the largely Christian militia.

A 2013 report by Save the Children stated that in the Central African Republic, children as young as eight were being recruited by the country’s warring parties, with some of the children forcibly conscripted while others were impelled by poverty.

Last year, the United Nations reported that the recruitment of children in South Sudan’s on-going civil war was “rampant”, estimating that there were 11,000 children serving in both rebel and government armies, some of who had volunteered but others forced by their parents to join armed groups with the hopes of changing their economic fortunes for the better.

Meanwhile, back in the Tongogara refugee camp, Aminata has resigned herself. “I have descended into worse poverty since I came here in the company of other fleeing Congolese and, for many children like me here at the camp, poverty remains the order of the day.”

Edited by Phil Harris   

SDGs - Goal 2: End hunger, achieve food security and improved nutrition and promote sustainable agriculture. A man walks through agricultural land in the village of Mirusuvil, in the northern Jaffna District. Over 122,000 persons have been severely impacted by the drought according to the latest government data. Credit: Amantha Perera/IPS

By Roger Hamilton-Martin
LONDON, Aug 13 2015 (IPS)

After 15 years of trying to meet the targets set out to address extreme poverty, the 193 member states of the United Nations have almost reached consensus on a more broad-reaching group of goals.

The only thing left to do is to sign off on the Sustainable Development Goals this fall in New York, when the countries get together for the annual General Assembly at U.N. Headquarters. Seven months of negotiations have produced a document: Transforming Our World: The 2030 Agenda for Sustainable Development.

Despite uneven progress on the eight MDGs, the new SDGs comprise 17 goals, with 169 targets. World leaders will set out in New York their visions for achieving these targets, which are hoped to provide a framework to combat poverty, climate change, inequality and hunger.

Scene from Ndanifor Permaculture Eco-village in Bafut in Cameroon’s Northwest Region, the country’s first and only eco-village which is based on the principle that the answer to food insecurity lies in sustainable and organic methods of farming. Credit: Mbom Sixtus/IPS

By Mbom Sixtus
YAOUNDE, Aug 2 2015 (IPS)

Marking a shift away from the growing trend of abandoning sustainable life styles and drifting from traditional customs and routines, Joshua Konkankoh is a Cameroonian farmer with a vision – that the answer to food insecurity lies in sustainable and organic methods of farming.

Konkankoh, who left a job with the government to pursue that vision, founded Better World Cameroon, which works to develop local sustainable agricultural strategies that utilise indigenous knowledge systems for mitigating food crises and extreme poverty, and is now running Cameroon’s first and only eco-village – the Ndanifor Permaculture Eco-village in Bafut in Cameroon’s Northwest Region.

“Biodiversity was protected by traditional beliefs. Felling of some trees and killing of certain animal species in certain forests were prohibited. They were protected by gods and ancestors. We want to protect such heritage” – Joshua Konkankoh
Talking with IPS, Konkankoh explained how the eco-village organically fertilises soil through the planting and pruning of nitrogen-fixing trees planted on farms where mixed cropping is practised. When the trees mature, the middles are cut out and the leaves used as compost. The trees are then left to regenerate and the same procedure is repeated the following season.

“Here we train youths and farmers on permanent agriculture or permaculture,” he said. “I call it ‘permaculture the African way’ because the concept was coined by scientists and we are adapting it to our old ways of farming and protecting the environment.”

While government is keeping its distance from the project, Konkankoh said that local councils and traditional rulers are encouraging people to embrace the initiative, which is said to be ecologically, socially, economically and spiritually friendly.

“I was active during the U.N. Decade of Education for Sustainable Development. In studying the reason why many countries failed to meet the Millennium Development Goals (MDGs), we realised that there were some gaps but we also found out that permaculture was a solution to sustainability, especially in Africa. So I felt we could contextualize the concept – think globally and act locally.”

The permaculture used at the eco-village makes maximum use of limited agricultural land, and villagers are taught how to plant more than one crop on the same piece of land, use a common organic fertiliser and obtain high yields.

Farmers, said Konkankoh, are encouraged to trade and not seek aid, to benefit from their investment and prevent middlemen and multinationals from scooping up a large share of their earnings. The organic agriculture practised and taught in the eco-village is a blend of culture and fair trade initiatives.

Joshua Konkankoh, founder of Cameroon’s first and only eco-village, shows off some nitrogen-fixing trees. Credit: Mbom Sixtus/IPS

“We encourage rural farmers to guarantee food sovereignty by producing what they also consume directly and not cash crops like cocoa and coffee.”

Farmers are trained in the importance of manure, of producing it and selling it to other farmers, as well in innovative techniques of erosion control, water management, windbreaks, inter-cropping and food foresting.

Konkankoh also told IPS that it was a mistake to have left the spiritual principle out of the MDG programme. “Biodiversity was protected by traditional beliefs.  Felling of some trees and killing of certain animal species in certain forests were prohibited. They were protected by gods and ancestors. We want to protect such heritage.”

The eco-village has started a project to replant spiritual forests with 4,000 medicinal and fruit trees in a bid to reduce CO2 emissions.

Fon Abumbi II, traditional ruler of Bafut, the village which hosts the Ndanifor Permaculture Eco-village, believes that the type of cultivation of fruits, vegetables and medicinal plants used by the eco-village will improve the health of local people.

He is also convinced that with many firms around the world producing health care products with natural herbs, the demand for the products of the eco-village is high, guaranteeing a promising future for the villagers who cultivate them.

Houses in the eco-village are constructed with local materials such as earth bags and mud bricks, and grass for the roofs. Domestic appliances such as ovens and stoves are earthen and homemade.

Sonita Mbah Neh, project administrator at eco-village’s demonstration centre, said that the earthen stoves bit not only reduce the impact of climate change by minimising the use of wood for combustion but the local women who make then also earn a living by selling them.

Lanci Abel, mayor of the Bafut municipality, told IPS that his council is mobilising citizens to embrace permaculture. “You know, when an idea is new, people only embrace it when it is recommended by authorities. We are carrying out communication and sensitisation of the population to return to traditional methods of farming as taught at the eco-village.”

Abel also had something to say about the performance of genetically modified plantain seedlings planted by the Ministry of Agriculture at the start of the 2015 farming season in Cameroon’s Southwest Region, which recorded a miserable 30 percent yield.

The issue had been raised by Mbanya Bolevie, a member of parliament from the region who asked Minister of Agriculture Essimi Menye about the failure of the modern seeds during the June session of parliament.

Julbert Konango, Littoral Regional Delegate for the Chamber of Agriculture, said the failure was due the fact that seeds are often old because “there is inadequate finance for agricultural research organisations in Cameroon as well as a shortage of engineers in the sector,” a sign that the country not fully prepared for second-generation agriculture.

Commenting on the incident, Abel said that citizens using natural seeds and compost would not have faced these problems, adding that “besides the possibility of failure of chemical fertilisers, they also pollute the soil.”

The eco-village, which would like to become a model for Cameroon and West Africa, is a member of the Global Ecovillage Network.

Edited by Phil Harris   

Yury Fedotov, Executive Director of the U.N. Office on Drugs and Crime (UNODC) with U.N. Secretary-General Ban Ki-moon. "The magnitude of the problems we face is such that it is sometimes hard to imagine how any effort can be enough to confront them. But to quote Nelson Mandela, 'It always seems impossible until it is done'. We must keep working together, until it is done" – Yury Fedotov. Credit: Courtesy of UNODC

By Yury Fedotov
VIENNA, May 27 2015 (IPS)

With terrorism, migrant smuggling and trafficking in cultural property some of the world’s most daunting challenges, “the magnitude of the problems we face is such that it is sometimes hard to imagine how any effort can be enough to confront them. But to quote Nelson Mandela, ‘It always seems impossible until it is done’. We must keep working together, until it is done.”

The words are those of U.N. Office on Drugs and Crime (UNODC) Executive Director Yury Fedotov, who was speaking at the closing of the 24th Session of the Commission on Crime Prevention and Criminal Justice (Crime Commission) held in the Austrian capital from May 18-22.

Earlier this month, IPS Editor-in-Chief Ramesh Jaura interviewed Fedotov on how the challenges facing the United Nations’ drugs and crime agency translate into challenges on the sustainable development front.“The share of citizens experiencing bribery at least once in a year is over 50 percent in some low-income countries. Many detected human trafficking movements are directed from poor areas to more affluent ones. Research also suggests that weak rule of law is connected to lower levels of economic development” – UNODC Executive Director Yury Fedotov

Q. The United Nations Office on Drugs and Crime (UNODC), established in 1997, understands itself as “a global leader in the fight against illicit drugs and international crime”. At the same time, you have taken up the cudgels on behalf of sustainable development. What role does the UNODC envisage for itself in achieving sustainable development goals to be agreed at the U.N. summit to adopt the post-2015 development agenda in September?

A. Crime steals from countries, families and communities and hampers development while exacerbating inequality and violence, especially in vulnerable countries. Trafficking in diamonds and precious metals, for instance, diverts resources from countries that desperately need the income.

The share of citizens experiencing bribery at least once in a year is over 50 percent in some low-income countries. Many detected human trafficking movements are directed from poor areas to more affluent ones. Research also suggests that weak rule of law is connected to lower levels of economic development. These are just some of the many challenges that the international community faces around the world that are related to crime.

UNODC’s broad mandate includes stopping human traffickers and migrant smugglers, as well as tackling illicit drugs. It encompasses promoting health and alternative livelihoods and involves battling corruption, illicit financial flows, money laundering and terrorist financing. Our work confronts emerging and re-emerging crimes, including wildlife and forest crime, and cybercrime, among others, all of which hinder sustainable development.

Currently the United Nations is making the transition from the Millennium Development Goals (MDGs) to the Sustainable Development Goals (SDGs). In Goal 16, the Open Working Group, responsible for identifying the development goals stressed the need to promote peaceful and inclusive societies for sustainable development, and to provide access to justice for all, as well as building effective, accountable and inclusive institutions. Justice is also one of the six essential elements identified by the Secretary-General in his own Synthesis Report on this subject.

Goal 3, which focuses on “ensuring healthy lives”, underlines the importance of strengthening prevention and treatment of substance abuse. These goals – justice and health – go to the very heart of UNODC’s mission. I am hopeful that when the U.N. Heads of State Summit on Sustainable Development in September 2015 takes place these goals will remain.

Q. UNODC organised its Thirteenth Congress on Crime Prevention and Criminal Justice from Apr. 12 to 19 in Doha, Qatar. The 13-page Doha Declaration contains recommendations on how the rule of law can protect and promote sustainable development. Is that the reason that you described Doha as a “point of departure”?

A. The Doha Declaration was passed by acclamation at the 13th Congress on Crime Prevention and Criminal Justice, and contains crucial recommendations on how the rule of law can protect and promote sustainable development. The declaration is driven by the principle that these issues are mutually reinforcing and that crime prevention and criminal justice should be integrated into the wider U.N. system.

At the 24th Session of the Commission on Crime Prevention and Criminal Justice (May 18-22), there were nine resolutions before the Commission and they pave the way for the Doha Declaration to go before the U.N. General Assembly and ECOSOC for approval. The other resolutions, for instance on cultural property and standard rules on the treatment of prisoners, seek to implement the principles of the Doha Declaration.

It is for this reason that I described the 13th Crime Congress in Doha as a significant “point of departure”. Doha is the first, but not the last step in the process of implementing the Declaration and ensuring that we turn fine words into spirited and dedicated action in the areas of crime prevention and criminal justice – action that can benefit the millions of victims of crime, illicit drugs, corruption and terrorism.

If we do this, we have an opportunity to energise the 60-year legacy of Crime Congresses and give it the power to shape how we tackle crime and promote development for many years to come. Indeed, I see a strong, visible thread between the recent Crime Congress, September’s UN Summit on Sustainable Development and the 14^th Crime Congress in Japan in five years’ time.

Q. The Doha Declaration also pleads for integrating crime prevention and criminal justice into the wider United Nations agenda. This suggestion comes at a point in time when the United Nations is turning 70. Are there some issues which the United Nations has ignored until now or is there a range of issues that have emerged over previous decades?

A. Member States are increasingly affected by organised crime, corruption, violence and terrorism. These challenges undercut good governance and the rule of law, threatening security, development and people’s lives.

Sustainable development can be safeguarded through fair, human and effective crime prevention and criminal justice systems as a central component of the rule of law. As stated by U.N. Secretary-General Ban Ki-moon: “There is no peace without development; there is no development without peace; and there is no lasting peace and sustainable development without respect for human rights.”  We need to break down the walls between these activities and integrate the various approaches.

UNODC is well placed to assist. We work closely with regional entities, partner countries, multilateral and bilateral bodies, civil society, academia and the private sector to support the work on development. We can also offer our support at the global, regional, and local levels, through our headquarters and network of field offices.

Q. Do you find willingness on the part of all countries around the world to agree on national, regional and international legal instruments, to combat all forms of crime, and their willingness to pull on the same string when it comes to implementation?

A. Our work is founded on the U.N. Convention against Transnational Organised Crime and its three protocols, the Convention against Corruption, international drug control conventions, universal legal instruments against terrorism and U.N. standards and norms on crime prevention and criminal justice.

Almost all of these international instruments have been universally ratified by the international community. Why? Because countries recognise that crime today is too big, too powerful, too profitable for any one country to handle alone. Countries recognise that, today, crime not only crosses country borders, but regional borders. It is a global problem that warrants comprehensive, integrated global solutions.

The UNODC approach to this unique challenge is threefold. First, we are building political commitment among Member States. Second, we deliver our activities through our integrated regional programmes across the world. Third, we are working with partners, both within and outside the United Nations, to ensure that our delivery is strongly connected to other activities at the field level.

In support of this action, and to give just one example, UNODC is networking the networks. Today’s criminals have widespread networks and vast resources; if we are to successfully confront them, we need to ensure greater cross-border cooperation, information sharing and tracking of criminal proceeds.  The initiative is part of an interregional drug control approach developed by UNODC to stem illicit drug trafficking from Afghanistan and focuses on promoting closer cooperation between existing law enforcement coordination centres and platforms.

Q. UNODC has assigned itself a wide range of tasks. Which are your priorities in the biennium ending this year, during which you have 760.1 million dollars at your disposal?

A. I would mention two matters that are of international importance. First, smuggling of migrants not just in the Mediterranean or the Andaman seas, but also elsewhere. We are witnessing unprecedented movements of people across the globe, the largest since the Second World War. People are leaving because of conflict, insecurity and the desire for a better life. They are falling into the arms of unscrupulous smugglers and many of them are dying, while trying to make the dangerous journey across deserts and seas.

Second, the nexus of transnational organised crime and terrorism is a major threat to global peace and security, and has been recognised as such in recent Security Council resolutions. Every extremist and terrorist group requires sustainable funding. The most reliable, and sometimes the only, means of achieving this is through illicit funds gained from transnational organised crime, including cybercrime, drug trafficking, people smuggling and many other crimes.

Information on the magnitude and exact nature of such relationships remains incomplete, and more research is needed. Based on data and analysis, however, for some regions, we can follow the funding in support of violent extremism and terrorism. In Afghanistan, for example, the Taliban could be receiving as much as 200 million dollars annually as a tax on the drug lords.

Edited by Phil Harris    

Excerpt:

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   

Whether they like it or not, many Africans faced with the possibility of having to access water through prepaid meters have resorted to unprotected and often unclean sources of water because they cannot afford to pay. Credit: Jeffrey Moyo/IPS

By Jeffrey Moyo
HARARE, May 8 2015 (IPS)

While many countries appear to have met the U.N. Millennium Development Goal (MDG) of halving the proportion of people without sustainable access to safe drinking water, rights activists say that African countries which have taken to installing prepaid water meters have rendered a blow to many poor people, making it hard for them to access water.

“The goal to ensure that everyone has access to clean water here in Africa faces a drawback as a number of African countries have resorted to using prepaid water meters, which certainly bar the poor from accessing the precious liquid,” Claris Madhuku, director of the Platform for Youth Development, a Zimbabwean democracy lobby group, told IPS.

Prepaid water meters work in such a way that if a person cannot pay in advance, he or she will be unable to access water.Despite U.N. recognition that water is a human right, international financial institutions such as the World Bank argue that water should be allocated through market mechanisms to allow for full cost recovery from users

As a result, African rights activists like award-winning Terry Mutsvanga from Zimbabwe and other civil society organisations are against the idea of prepaid water meters.

“If one has to pay upfront before accessing water, then it would mean those in most need would be denied access,” Mutsvanga told IPS, adding that water is a global human right.

Mutsvanga was echoing the United Nations General Assembly which, in July 2010, emerged with a binding resolution on the human right to water and sanitation – but for Africa, the human right to water may be far from reality.

Laden with a population of approximately 1.1 billion, Africa’s 300 million people have no access to safe drinking water, according to the U.N. Environment Programme (UNEP).

Many rights activists on the continent attribute Africa’s mounting water challenges partly to the advent of prepaid water meters.

“We already have hundreds of millions of people without access to clean water, and imagine the severity of the water challenge if water prepaid meters would reach everyone on the continent,” Mutsvanga said.

Over the years, prepaid water meters have been widely used in African countries like Namibia, Nigeria, Swaziland and Tanzania, as well as South Africa, where the meters which were rolled out in 1999 are currently in low-income areas.

Zimbabwe is currently conducting a pilot project aimed at installing the prepaid water meters, in towns and cities to begin with. And the country’s impoverished urban dwellers like 51-year old Tinago Chikasha are in panic mode, fearing the worst may be coming their way.

“Local authorities are pressing ahead with the idea of prepaid water meters, but jobless people like me have no money to make prepayments for water while we already have unpaid water bills running into thousands of dollars, which local authorities say they will deduct through all future water prepayments, meaning we run into the danger of having dry water taps for as long as we owe local authorities,” Chikasha told IPS.

In non-African countries like the United Kingdom, prepaid water meters are no longer being used after they were declared illegal in 1998 for public health reasons.

They were also abandoned in South Africa at one stage following a massive cholera outbreak, but were reintroduced and have replaced previously free communal standpipes in rural townships.

Despite U.N. recognition that water is a human right, international financial institutions such as the World Bank argue that water should be allocated through market mechanisms to allow for full cost recovery from users, and civil society activists like Melusi Khumalo in South Africa blame capitalist tendencies for necessitating the advent of prepaid water meters.

“Prepaid water meters are a result of such negative policies by institutions like the World Bank and they [prepaid water meters] deny water access to those in most need,” Khumalo, who is affiliated to Parktown North Residents’ Association in Johannesburg, told IPS.

In Zimbabwe, Mfundo Mlilo, chief executive officer of Combined Harare Residents’ Association (CHRA), told IPS: “We are vehemently against the prepaid meter project because it will not solve the problems of water delivery, and these prepaid water meters will not lead to residents receiving adequate safe and clean water, while the same prepaid water meters will also not lead to increase in revenue flows as the City [of Harare] claims.”

Last month, Harare’s Town Clerk Tendai Mahachi was reported by Zimbabwe’s Weekend Post as saying: “With these meters we expect roughly to save about 20-30 percent of the current costs we are incurring.”

According to Mahachi, at least 300 000 households in the Zimbabwean capital are scheduled to have prepaid water meters installed, while all new housing projects will be obliged to install meters.

Meanwhile, with prepaid water meters set to rake in big money for some of Africa’s local authorities, there are those like Nathan Jamela, an urban dweller in Bulawayo, Zimbabwe’s second largest city, who fear the health consequences.

“We experienced the worst cholera outbreak in 2008, and we fear that if prepaid water meters are installed in every household here we will slide back to the crisis, with many people unable to afford to pay for water,” Jamela told IPS.

Edited by Phil Harris   

The European Commission has unveiled a blueprint for global development aid and called on world leaders to replace the Millennium Development Goals (MDGs) with an international aid framework based on sustainable and inclusive development tackling poverty at its roots.

While praising how the UN’s Millennium Development Goals (MDGs) had “inspired an unprecedented global movement for development,” the European Report on Development 2013 – an independent report commissioned by European states and setting out recommendations for the post-MDG aid agenda – said its replacement would need to go much further to provide help for poor nations.

Speaking at a conference in Brussels as the report was released Tuesday, European Commissioner for Development Andris Piebalgs said: “Efforts to end poverty in the post-2015 world must go hand in hand with sustainable development. It is vital that aid is used in the best way to make effective change.

“Aid alone is not sufficient. We need to look beyond just financing.”

The independent report was prepared by the Overseas Development Institute (ODI), German Development Institute/Deutsches Institut für Entwicklungspolitik (DIE) and the European Centre for Development Policy Management (ECDPM). The European Commission (EC) stresses that it is not a reflection of any policy it may have on post-2015 aid and is designed to add to current debate on global development aid.

Pedro Martins of ODI told IPS: “What the report is trying to do is to look at some of the things that are not being so widely talked about – sustainability, social inclusion, inequality – in the global development debate and give a voice on those issues. We don’t think it is the final answer, just a contribution to thinking.”

Piebalgs said though that the report “complemented and supported” the EC’s aid work.

The report identified a number of key failings with the MDGs which its authors say must be fixed in any future global aid programme.

The MDGs mask inequalities and omit some issues of key importance to development, including the need for productive employment, issues related to climate change, governance, migration, conflict, security and disability, according to the report.

It also criticised rich countries for not fully honouring MDG commitments and said that there was often a mismatch between national policy needs and MDG targets which meant that some aid was essentially squandered.

Third sector groups monitoring development aid and its effective use have previously been critical of the fact that in a bid to meet targets or specific aims projects have been undertaken which, while well-intentioned, have been poorly thought through and resulted in ‘white elephants’ or been virtually useless to the people who they are aimed at.

But its authors stated that, crucially, the biggest failure was that the international community had not reached an agreement on key issues such as climate change and trade, nor had it managed to create a stable and transparent international financial system.

Since the UN set up a High Level Panel (HLP) to draw up a successor to the MDGs, independent development aid groups and representatives of some of the world’s poorest countries have said that these issues are arguably the chief barriers to eradicating extreme poverty.

There is concern that states in Africa – one of the world’s richest continents in terms of natural resources, but its least developed – for example, are losing precious revenues as corporations manipulate tax regimes and use offshore financial havens as well as taking advantage of unfair royalty agreements on commodities to pay little or nothing in taxes and fees to governments.

Meanwhile, some of the world’s poorest and most underdeveloped nations continue to be blighted by environmental disasters robbing them of essential crops and foodstuffs and exacerbating existing problems.

Dr Shamshad Akhtar, UN Assistant Secretary-General for Economic Development, speaking at the report’s launch, said: “The economic course adopted by some countries which has allowed them to become some of the most developed in the world has also led them to being some of the highest greenhouse gas emitters in the world as well.

“The economic development of some countries is indeed on a collision course with the need to protect the environment and climate in a sustainable way.”

The ERD clearly states that richer countries, such as those in the EU, need to extend collective action in all areas important to development, including drawing up international financial regulation, beneficial agreements in trade, helping deal with problems connected with migration, including improving conditions for economic migrants, as well as climate change.

They also say there is a need for a new understanding of poverty to address issues of relative poverty incorporating aspects of social inclusion and inequality.

By doing this, the report’s authors argue, global aid can grow to include a wider range of instruments than simply official development assistance – the main tool of the MDGs – and encourage the foundation of a new approach to development assistance.

However, Jan Vandemoortele, a co-architect of the MDGs and now an independent author and lecturer, warned that while it was quite right to look at including issues such as climate change, social inclusion, new definitions of poverty and others, it would be impossible to produce a global aid framework to satisfy everyone.

“It’s not possible to have a concise, global aid framework that is also completely comprehensive and that gives a clear list of targets while at the same time covering all the complexities of development,” he told IPS.

Children in a PNG village. Credit: Catherine Wilson/IPS

By Catherine Wilson
BRISBANE, Nov 7 2012 (IPS)

The Pacific Islands are making steady progress on reducing child mortality, but most are struggling to eradicate poverty and generate employment for young and rapidly growing populations.

With three years to achieve the United Nations Millennium Development Goals (MDGs), progress fluctuates across the region, according to a recent report by the Pacific Islands Forum (PIF), a regional inter-governmental group.

The good news, according to the PIF report, is that 10 of 14 Pacific Island states surveyed, including Vanuatu, Marshall Islands, Cook Islands and Tonga, are on track to reduce MDG4 that deals with child mortality.

Worldwide there has been varied progress on the MDGs, which were agreed in conjunction with the U.N. Millennium Declaration in 2000 that resolved to make globalisation ‘fully inclusive and equitable.’

The 2012 Regional MDG Tracking Report comes three years after PIF countries signed a compact to strengthen the co-ordination of resources to boost development progress.

Successes and long-term challenges are evident at the sub-regional level.  Melanesia, with a large population average of over two million, dominated by Papua New Guinea (PNG), is off track on the goals. In contrast, Polynesia, comprising Cook Islands, Niue, Samoa, Tonga and Tuvalu, with an average population of 62,000, is on target with four goals.

The Cook Islands and Niue are the only states likely to achieve all eight MDGs.

Halving the proportion of people living in extreme poverty by 2015, as mandated by MDG 1, is a considerable challenge across the Pacific.

In PNG, approximately 28 percent of the population of seven million lives below the poverty line, a five  to 10 percent improvement since 1990. Critical factors include a large remote rural population, corruption, high incidence of violence and an HIV epidemic.

Some 23 percent of Tongans live below the poverty line with increased hardships for families due to impacts of the global financial crisis, low economic growth and inflation.

There are also variations at the sub-national level with rural communities experiencing higher levels of poverty in Fiji, Palau, Samoa and Tonga, while there are greater numbers of urban poor in the Solomon Islands, Kiribati, Tuvalu and Vanuatu.

Poverty is not easily defined in the Pacific Islands where the benchmark of earning less than a dollar a day can be inaccurate. Pacific societies have a long history of subsistence agriculture, self-sufficiency and retain a strong belief in social obligations within the extended family and community that can capture the needs of the most vulnerable.

But even in rural villages, centuries of traditions are changing in varying degrees with the influence of cash economy, rapid urbanisation and cultural pressures of modernisation.

Albert Cerelala, programme officer at the Foundation of the Peoples of the South Pacific, a local non-government organisation based in Fiji, describes poverty as “the inability for individuals and families to meet the basic necessities of a meaningful and healthy life. It may mean that they are unable for whatever reasons to put food on the table or are denied social and economic opportunities.” 

“It may also mean not having a sense of belonging to a ‘vanua’ (land or village) or place, or that one is disconnected from one’s tradition or community,” Cerelala told IPS.

The PIF makes a case for the term ‘poverty of opportunity’ in the Pacific Islands.

All island states in a region of 10 million people and growing by 188,000 a year are challenged to provide full productive employment with youth unemployment a growing concern. Only the Cook Islands and Niue, with employment rates of 70 percent and 80 percent respectively, are on course, with Kiribati recording 44 percent and Samoa 30 percent.

While MDG7 – that calls for improving the lives of slum dwellers – did not feature prominently in the report, urbanisation has reached a high rate of 4.2 percent in the Solomon Islands and Vanuatu.

Squatter settlements, beset with insecure land tenure and sub-standard housing, are growing in Melanesia as greater numbers of people seek jobs and access to services unavailable in provincial areas.  Approximately half of the residents in PNG’s capital, Port Moresby, and 30 percent of the urban population in Vanuatu reside in informal settlements.

But in a positive trend most Pacific Island states are expected to reduce child mortality by two-thirds in line with MDG4.

“This could be attributed to the successes of awareness programmes carried out by national and regional public health authorities to encourage immunisation and proper healthcare for babies, more trained human manpower for the implementation and monitoring of child health programmes,” Gordon Nanau, lecturer in international affairs, University of the South Pacific, Fiji, said.

Nanau, who is also a member of the Oceania Development Network, said bilateral and multilateral support were also important factors in achieving MDG4.

Fiji with a population of 868,406 has reduced the under-five mortality rate from 28 to 18 per 1,000 births since 1990, which is attributed to implementation of  holistic integrated management of childhood illness strategy and good obstetric services.

In Tuvalu, with high measles immunisation coverage, the under-five mortality rate decreased during the last decade from 35 to 25 per 1,000 births.

The PIF believes that accelerated regional progress on the goals before 2015 is dependent on political will.

Nanau agreed, but added “that even with determined political leadership and improved governance, financial and human resources and capacity” are also imperative.

Dhaka maternity hospitals encourage exclusive breastfeeding. Credit: Sujan-map/IPS

By Naimul Haq
DHAKA, Oct 30 2012 (IPS)

Bangladesh’s achievement in raising exclusive breastfeeding rates for infants under six months from 43 percent to 64 percent, over the last five years, is said to be the result of a determined campaign by government and non-governmental organisations (NGOs).

At the Shaheed Suhrawardy Medical College and Hospital in the national capital, Razia Khatun, 36, is being assisted with feeding her eight-day-old infant. “I was told to start breastfeeding within the first hour of my child’s birth but failed and so I am back here for help.”

Shahida Banu, a trained staff nurse at the hospital, told IPS: “Razia had clogged ducts because her milk wasn’t draining completely, but this could be rectified by steady massaging.”

Peyara Begum, 29, a mother from the city’s Gabtoli area with similar problems, says, “The nurses here attend to you the moment you enter and there are smiling faces all around – and that makes all the difference.”

Prof. Soofia Khatoon, head of the paediatric department of the hospital, told IPS, “Mothers tend to switch to substitutes when they face such minor problems as cracked or flat nipple, low  output and overflow – we have been able to reverse this trend just by speaking to the mothers and encouraging them.”

Many of the nurses employed at the hospital trained at the Bangladesh Breastfeeding Foundation (BBF) which has, since 1989, been running intensive programmes to promote exclusive breastfeeding.

“Exclusive breastfeeding along with awareness building on improving the health of undernourished mothers is the best way to address child malnutrition in Bangladesh,” says BBF chairman Dr. S.K. Roy.

“The challenge now is to take the breastfeeding rate to even higher levels and thereby drastically reduce child malnutrition which is a problem in Bangladesh,” Roy told IPS in an interview.

An internationally acclaimed scientist working on child health, Roy said BBF’s main role was to function as a catalyst to build the capacity of the government, NGOs, the private sector and other stakeholders.

A survey carried out by the National Institute of Population Research and Training attributes the raising of exclusive breastfeeding levels to 64 percent by 2011 to “several intensive programmes that focus on maternal and newborn care and child health.”

Bangladesh’s achievement seems especially impressive when compared with the low exclusive breastfeeding average in South Asia for infants under six months, languishing at 39 percent.

“We have a high level of commitment and support from the government, which is why we have been able to form a nationwide  network for our advocacy programmes in a relatively short time,” Roy said.

In 2010, Bangladesh enforced a directive for extending maternal leave to six months from the previous four for working women to allow them to exclusively breastfeed their newborn.

“This is a sign of the seriousness with which the government is taking the issue as a key to achieving the United Nations millennium development goal that calls for reducing child mortality rates,” Khurshid Jahan, a senior BBF member, told IPS.

“Many don’t realise that exclusive breastfeeding can address  stunting and low weight problems,” Jahan said. “If every mother practices breastfeeding we would have a healthier and more productive  population,” she added.

Workers like Jahan credit the Baby-Friendly Hospital Initiative (BFHI) – a global programme sponsored by the World Health Organisation and the United Nations Children’s Fund (UNICEF) – that assists hospitals in giving mothers confidence and skills to initiate and continue breastfeeding.

About 1,200 government hospitals and health facilities now have centres under the BFHI, while another 500 clinics run by NGOs have similar facilities where mothers are nudged towards exclusive breastfeeding.

In rural areas, mother support groups (MSGs) are at work counselling new mothers and weaning them away from old wives’ myths and traditions that are not friendly to breastfeeding.

When new mothers get back home from the hospital after delivery they are often surrounded by women who insist on feeding the babies prelacteals such as honey or mustard oil, ignoring the naturally protective value of colostrum.

Prof. M. A. K. Azad Chowdhury, head of neonatology department at the Dhaka Shishu (Children’s) Hospital, told IPS, “MSGs work to bring back confidence in mothers who fail to breastfeed their babies. People tend to look for alternative sources of milk in such a situation.”

Infants exclusively breastfed are likely to be exposed less to contaminated foods and this helps reduce the incidence and severity of infectious diseases, Chowdhury said.

After six months, infants should receive nutritionally adequate and safe complementary foods while continuing to be breastfed for up to two years of age or beyond.

UNICEF representative in Bangladesh, Pascal Villeneuve, told IPS, “While we reflect on the successes, we must also note that many babies under six months old in Bangladesh are still not exclusively breastfed.”

Villeneuve said there is work to be done to increase awareness regarding the benefits of exclusive breastfeeding and provide  support to nursing mothers at home, community or workplace.

Violence against women is on the rise in Bangladesh. Credit: Naimul Haq/IPS

By Naimul Haq
DHAKA, Oct 17 2012 (IPS)

Bangladesh, often cited as a model of progress in achieving the United Nations Millennium Development Goals (MDGs), appears to be sliding backwards when it comes to dealing with violence against women (VAW).

Police statistics and assessments by non-government organisations (NGOs) working to establish women’s rights show that there is in an increasing trend in VAW.

According to police records, while there were 2,981 cases of dowry-related violence in 2004, the figure has already hit 4,563 in the first nine months of 2012. Also, where there were 2,901 rape cases recorded in 2004, the figure for the current year, up to August, stands at 2,868.

Farida Akhtar, an internationally known rights activist, told IPS that the disturbing aspect of this rising trend in VAW is that it is “taking on different deceptive forms that go beyond the statistics.”

“When women are better aware of their rights through education, and want to assert them, they suffer violence,” said Akhtar, a founder of the NGO, ‘UBINIG’, acronym for ‘Policy Research for Development Alternatives’ in the Bangla language.

With school enrolment at 95 percent, Bangladesh is well on track to achieving the MDGs that deal with gender parity in education by 2015. But gender equity and women’s empowerment are another matter.

Akhtar said there is evidence that Bangladeshi women are now facing more mental torture than before. “Unfortunately, mental torture cannot be quantified and often goes unreported. But, the fact that suicide is the biggest cause of female deaths in this country is telling.”

Women’s rights leaders say that atrocities go unreported because of fear of harassment by religious or political leaders and, of the cases that are registered, a large number end up being dismissed as false allegations.

Police data show that 109,621 complaints of various forms of VAW were lodged during the 2010-2012 (up to August) period.  Of these, 18,484 complaints were taken into cognizance, but only 6,875 cases were deemed ‘genuine’ and fit for further proceedings.

Mohammad Munirul Islam, additional inspector-general of police responsible for dealing with crimes related to VAW at the police headquarters, told IPS, “On many occasions our investigations showed that the law was used to harass the accused. It does seem that not all complaints are genuine.”

Afroza Parvin, executive director of Nari Unnayan Shakti, a women’s rights NGO, told IPS, “Due to better awareness female victims have learnt to raise their voices, but stop short of seeking police help. During our 20 years of experience on VAW we have found that police often do not cooperate with victims and favour the accused.”

Leading women’s movement activist Shireen Huq says that the main difficulty is that of “establishing a prima facie case for lack of eye witnesses, evidence, etc., with the result that the accused are easily acquitted and cases are recorded as false.”

Huq, who is also a founder member of Naripokkho, a local NGO, told IPS that “no matter what the offence or what the form of violence, police and lawyers find it convenient to file the complaint under ‘torture for dowry’, and since this is a non-bailable offence we often hear of the elderly parents of the accused being arrested.”

Failure to fulfill dowry demands is a major cause for VAW in Bangladesh. On average 5,000 complaints of dowry are recorded annually. In 2010, police reported 5,331 cases of dowry, which jumped to 7,079 in 2011.

Despites the debates, official statistics show that VAW continues unabated and many complaints are dismissed without justice. Data from Bangladesh National Women Lawyers’ Association (BNWLA) show that of the 420 recorded rape cases in 2011, only 286 reached the prosecution stage.

Salma Ali, executive director of BNWLA, told IPS that one of the difficulties in establishing the rights of women is the fact that Bangladeshi society is strongly patriarchal. “This means that women suffer discrimination in respect of matrimonial rights, guardianship of children and  inheritance – often through religious injunctions or directives,” the prominent lawyer said.

Hameeda Hossain, chairperson of Ain-o-Shalish Kendra, a leading women’s rights  organisation, told IPS that if  “women are still suffering socially, culturally and politically” it is due to “social acceptance of women’s subordination, discriminatory laws and poor law enforcement.”

“Crimes against women within the family are often ignored, and the women  silenced,” Hossain said. “There is social tolerance of domestic violence and limited intervention.”

To its credit the Bangladesh government has taken a number of legal steps to  improve the situation of women, starting with the Suppression of Violence against Women and Children Act in 2000. In 2009 the National Human Rights Act was passed followed by the Domestic Violence Act in 2010.

Bangladesh is also signatory to international conventions designed to protect women and their rights. Yet, very little is being done on the ground to ensure a secure and safe environment for them, rights activists say.

Though illegal, Nepali girls are often married off in their teens. Credit: Naresh Newar/IPS

By Naresh Newar
KATHMANDU, Oct 11 2012 (IPS)

Social activists in Nepal agree that the one reason why this impoverished country will miss the gender-linked Millennium Development Goals (MDGs) of the United Nations is the persistence of child marriage.

Nepal’s marriage law stipulates 20 years as the legal age for marriage for both sexes, but current records at the ministry of health and population show at least 23 percent of  girls getting married off at 15 – 19 years.

“Early marriage should be stopped because it not only affects girls’ education but also their health,” Sumon Tuladhar, education specialist at the United Nations Children’s Fund (UNICEF), tells IPS.

While MDG 2 pushes for universal primary education, MDG3 seeks to promote gender equality and empower women. Child marriage works against MDG 4, that is concerned with reducing child mortality, as also MDG 5 that aims to improve maternal health.

“We certainly need to strongly lobby against early marriage, but we are hampered by a very poor monitoring system to implement the existing law,” Dibya Dawadi, deputy director-general in the department of education, told IPS.

But, for both the government as well as non-governmental organisations (NGOs) concerned with child marriage, enforcing the law is a dilemma because legal action means prosecuting the parents.

“Sticking a mother in jail is not helpful when she may have other young children with no one to feed and protect them,” Helen Sherpa from World Education, an international NGO, tells IPS.

Activists, however, believe that change should tackle the root of the problem – their economic situation, because daughters provide valuable help in the household and on the farms in the rural areas.

“Our biggest challenge is the family’s attitude towards educating their girls,” says Dawadi.

Many rural families marry off their daughters at the age of 11 – 13 because the older a girl gets the higher the dowry demand.

Kamala Chepang was married off at 13 because her parents could not afford to educate all their children.

“I see my young siblings going to school and this makes me happy,” Kamala told IPS in the remote Shaktikhor village of Chitwan district, 300 km southwest of the capital.

Thousands of young girls like Kamala, especially from the most marginalised communities like the Chepangs, are unable to continue their education due to poverty, social barriers and a lack of schools in the remote rural areas.

Although the trend of sending young daughters to their husbands’ home has changed and most of them stay with their mothers till they reach 16, their lives change drastically after marriage and they rarely return to school.

“After marriage, these girls rarely come back to school and even if they do, their performance is very poor,” says Tuladhar from UNICEF. “Early marriage negatively impacts their self confidence.”

According to UNICEF, 51 percent of Nepalese were married as children. Nepal’s 2006 demographic and health survey found that among Nepalese women in the 20 – 49 age group, 60 percent were married by the time they reached 18.

Nepal scores poorly on gender disparity. In 2011  Nepal stood 126^th out of 135 countries in the ‘Global Gender Gap’ index of the  World Economic Forum.

“Early marriage changes a girl’s life options because parents no longer want to invest in ‘someone else’s property’,” says Kaman Singh Chepang, an activist from Nepal Chepang Association, an NGO working for the Chepang community.

Dire poverty and lack of government initiatives to get girls to school are among reasons that Chepang cites for the situation of girls in Nepal, a country where more than half of a total population of  30 million people live on less than 1.25 dollars a day.

Chepang believes that if child marriage is to be eradicated there should be close coordination among government sectors dealing with health, education, poverty and culture and also give priority to basic schooling. “But the government is unready for any such initiative.”

In the remote villages, girls may have to walk hours to reach their classrooms, and by the time they return home they are too exhausted to do their homework. In the end, they just drop out and help their parents until they are married off.

Child marriage not only denies girls an education, it often makes them vulnerable to a cycle of discrimination, domestic violence and abuse. By being made to bear children when they have barely attained puberty, they are forced to put themselves and their babies at risk, activists say.

“Child marriage is extreme denial of children’s rights. Many girls also suffer from abusive marriages as they are married to older boys,” said Sherpa from World Education.

Condom promotion campaign in Male: Credit: SHE

By Feizal Samath
MALE, Sep 22 2012 (IPS)

For an orthodox Islamic country, the Maldives has made remarkable progress in halting the spread of HIV in the Indian Ocean archipelago through bold awareness programmes and the distribution of condoms.

A few years ago, condoms were available in the Maldives only at drug stores and on production of a doctor’s prescription. Anyone found carrying a condom in the streets  was liable to be arrested by police.

But, a five-year project mounted by the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM), reports progress in creating awareness of safe sex issues and the use condoms by providing them free. The GFATM is supported by the Bill and Melinda Gates Foundation.

The GFATM programme in the Maldives addressed the sexually active among the 300,000 Maldivians, but focused on the 110,000 foreign workers in the country – mostly Bangladeshis, Indians and Sri Lankans employed in construction and in the country’s famed luxury resorts.

“We did a lot of work in the five years of the programme, which ended in August,” Ivana Lohar, HIV/AIDS project manager at the United Nations Development Programme in the Maldives, told IPS. “We believe that one more round of global funding would help to sustain the momentum.”

The challenge, Lohar said, is to ensure that the Maldives remains a low HIV prevalence country despite the presence of high-risk groups. As of December 2011, only 15 HIV cases were reported among Maldivians, while there were 289 cases among the foreign  labour force.

At the spanking new Voluntary Counselling and Testing Centre set up in the heart of capital by the Society for Health Education (SHE), a local non-government organisation (NGO), both local residents and foreign workers can avail of the free services.

Asna Luthfee, programme associate at SHE, says her work has included training 40 migrant workers as peer educators to promote awareness at hotspots where foreign workers congregate and provide condoms on request.

SHE offers a range of services through a sexual and reproductive health clinic, including screening for thalassaemia, DNA testing, counselling and psychosocial support. “We distribute oral pills, emergency contraceptives and condoms. We don’t ask people whether they are married or not – we distribute on request,” Luthfee said.

“There is also counselling if testing for HIV shows positive, and these cases are referred to the government,” Luthfee said. The programme, in which SHE and UNAIDS are partners, has been successful enough to be seen as a model for the region, she added.

Mohamed Yahiya, an accountant from Bangladesh who also works as HIV peer educator, said a government decision made earlier in the year to allow workers who contract HIV in the country to stay on and get free treatment, has helped immensely.

“Many were scared to talk about their HIV status fearing deportation, but the new government guidelines have eased those concerns,” he said. Foreign workers, however, undergo mandatory testing on arrival and those testing positive are refused entry.

The campaign has had its ups and downs because of pressure from the public and  religious groups that accused organisers of promoting promiscuous sexual behaviour.

“Though religion has its own inhibitions, Maldivian society is open and able to understand the need for awarenesss,” says Lohar. “We are not trying to interfere with religious beliefs, but flagging a serious public health issue. AIDS is a devastating condition that can impact the economy.”

A spokesman (officials may not be named under briefing rules) for the National AIDS Programme (NAP) said stigma and discrimination are still prevalent and public surveys in 2008 and 2009 showed that them to be  barriers to effectively addressing HIV and AIDS.

The UN-funded Biological and Behavioural Survey on HIV/AIDS – 2008 had noted that the potential for HIV transmission is “accelerated by non-use of condoms and the sharing of unsterile needles and syringes among injectors.”

Unprotected sex is high in all the risk groups. Aside from the risk behaviours themselves, a growing concern is the early age at which commercial sex and injecting drug use start in the Maldives, the study found.

The Maldives, warned the report, “is showing signals of a possible future epidemic which need to be closely monitored by the national programme, including injecting drug use in prisons and rehabilitation centres and risk behaviours found among the 18-24 year age group (selling and buying of sex, group sex, male-to-male sex, sex with non-regular partners, and injecting drug use).”

The NAP spokesman said that religious groups and scholars are supportive of public health efforts to prevent diseases and in this context using condoms is advised. “Prevention efforts are well supported by the religious scholars, and recently they have been involved as partners in HIV prevention work,” he added.

A major component of the programme was the conduct of migrant fairs where free testing for HIV/AIDS was provided. The latest of these fairs, which was held in August,  had collaboration from  government agencies, embassies and high commissions.

“Though most workers don’t understand English, these cultural shows break barriers and provide foreigners access to services, overcoming stigma and discrimination,” Luthfee said.

“Workers are provided information in their own language and when they return to their home countries they go back armed with knowledge on health issues,” said Yahiya.

Dongria Kondh tribal girls. Credit: Manipadma Jena/IPS

By Manipadma Jena
RAYAGADA, India , Sep 18 2012 (IPS)

The deafening din of the lunch gong is sweet music to the 200-odd tribal girls rushing down the stairway, clutching stainless steel plates and tumblers.

Sikhsya Niketan (House of Education) in Chattikona administrative block of Rayagada district is a residential school meant exclusively for girls of the Dongria Kondh tribe in eastern Odisha state. The school is part of the federal government’s intensified efforts to take universal education to extremely marginalised groups in India.

Odisha’s 62 tribal communities make up 22 percent of the total population and account for 50 percent of people living below the poverty line in the state. They are partly responsible for Odisha’s low human development indicators as compared to other Indian states.

The Dongria Kondhs, who number about 8,000, live in 120 villages located at an altitude of 5,000 feet above the sea level on the Niyamgiri hill plateau, coveted by mining companies for its valuable mineral deposits.

Till date, only two Dongria Kondh girls have managed to complete school. The first, Kasturi Melaka, did so as recently as in 2010.

Literacy among the Dongria Kondh is less than 10 percent, with female literacy at just three percent. This is when the national tribal literacy stands at 47 percent and Odisha’s general literacy close to the national level of 74 percent.

Rina Wadaka, 14, one of the 28 girls from Khambesi village is in class five. Inspired by Kasturi Melaka, she wants to be a teacher, and that is considered progress because Dongria Kondh girls are rarely interested in jobs and careers.

This exclusive primary school, which started in 2008 with 123 students, has grown to have 225 girls aged 6 – 16 years. “Every year, around 20 girls take admission, while 15 drop out,” Simadri Trinath Row, special officer with the Dongria Kondh Development Authority (DKDA), which manages the school, tells IPS.

Primary school dropout rates in Odisha’s tribal communities is 6.4 percent – more than twice the state dropout rate of 2.8 percent,  according to the government’s ‘Annual Plan 2011-12’.

One problem is language. Dongria Kondh speak the Kuvi language which is of Dravidian origin and unrelated to Oriya, the state’s official language which is derived from Sanskrit.

“Lessons are taught in the similar Kondh dialect, which many Dongria students cannot follow. Dongria girls with better language skills help translate the lessons into Kuvi,” Jayanti Sabar, a teacher at the school, told IPS.

Though government regulations specify that Kuvi-speaking Dongria Kondh teachers be hired, “it is difficult to find a qualified one,” says Row.

According to Sabar, the students score a poor 30 – 40 percent marks in examinations, but teachers try to be lenient while marking answer sheets. Last year, 16 girls passed class five with support from two male tutors who come in to support the female staff.

Getting Dongria Kondh girls to join the school is not easy. DKDA employs multi-purpose workers (MPW) as motivators. “Weekly markets, when the Dongria Kondh people descend to buy and sell farm products, are the best time to catch them,” says Gola Sikkaka, an MPW in Khambesi village.

The community relies on witch doctors and knows little about modern medicine. “I tell parents that their daughters will know about medicines to cure brain malaria and tuberculosis (the witch doctor’s remedies don’t work for these) if they go to school,” Sikkaka tells IPS.

The sex ratio among Dongria Kondhs is 1,352 females per 1,000 males against the state average of 978 females for 1000 males. Girls are highly valued in economic terms, as they gather forest products and help with household chores, and command a bride price on marriage.

Given such tangible benefits sending a girl to school becomes irrelevant. “Parents often ask MPWs questions such as who will do the farming? What if, after being schooled,  they decide to marry outside the tribe?” Suryanarayan Patra of Khajuri village an MPW, told IPS.

“Dongria Kondh culture and tradition cannot go parallel with development objectives,” Row told IPS. “The older girls who have been in the school for some years now see their traditional costume as fancy dress,” he added.

“On the other hand, when they return to their hilltop homes during festivals, sowing and harvest periods, they are reluctant to come back to the school. Accustomed to roaming free, they find it suffocating to stay within the four walls of a classroom,” says teacher Srimati Nundruka.

Female teachers residing in the school must stay constantly alert to stop the girls from running away. “Sometimes, younger girls get homesick and try to quietly slip away home, but we get them back,” Nundruka tells IPS.

“We are caught in a cleft stick,” says Row. “The school cannot deny the girls home trips because they might otherwise leave school altogether – yet we don’t want them to lose lessons by staying away from classes for too long.”

The government is doing its bit to keep Dongria Kondh girls in school. With grants-in-aid of three million rupees (54,000 dollars) yearly, they are given two dollars as monthly stipend for regular classroom attendance, while most other costs including medical expenses and school uniforms are borne by the government.

Government schemes to encourage tribal girls to attend school include providing them with bicycles to commute and fixed bank deposits of 54 dollars that become accessible on entering secondary school.

The efforts are yielding results. According to the annual Odisha Economic Survey 2010-11, the dropout rate at the primary school level for tribal girls has steadily declined from 66 percent in 2000 to six percent in 2010.

India’s planners are keen to attain the United Nations Millennium Development Goal- two that seeks to ensure that children everywhere are able to complete a full course of primary education by 2015.

India’s net enrolment ratio in primary education has already crossed the 95 percent mark making the 2015 goal within reach. Getting Dongria girls into classrooms is among last mile efforts.

Dengue patients at Cambodia's National Paediatric hospital. Credit: Erika Pineros/IPS

By Vincent MacIsaac
PHNOM PENH, Sep 13 2012 (IPS)

Public health experts in Cambodia are unenthused by reports of trials for a dengue vaccine conducted in neighbouring Thailand, saying it will be too costly for those who need it most – children in the least developed and developing countries.

“Of course, they cannot come out with a vaccine that costs 20 cents,” Dr. Philip Buchy, head of the virology unit at the Pasteur Institute of Cambodia, told IPS.

Buchy was referring to the Paris-based pharmaceutical company Sanofi SA’s dengue vaccine efficacy trials, the results of which were published in the British medical journal Lancet, this month.

Dr. Stephen Bjorges, leader of the vector-borne disease team at the World Health Organisation (WHO) in Cambodia, agrees. Even if Sanofi succeeds “funds would need to be mobilised” to cover the cost of inoculating children in Cambodia, he said.

A dengue epidemic that raged through Cambodia during the first eight months of the year landed more than 30,000 people in hospital, the majority of them children.

According to the Lancet report, Sanofi’s vaccine offers some protection against three of the four serotypes of the dengue virus – about 30 percent against serotype one and from 80 to 90 percent against serotypes three and four.

However, Sanofi’s vaccine does not protect against serotype two, which was circulating in the study area during the trial, giving the vaccine an overall efficacy rate of 30.2 percent, the report said.

Large-scale phase-3 trials are underway on 31,000 children and adolescents in Latin America and Southeast Asia, Sanofi said in a press statement timed with the release of the Lancet report.

According to the Reuters news agency, the company has already invested more than 430 million dollars in a new factory in France to produce the vaccine.

WHO’s Bjorges said that if the phase 3 trials proved the vaccine was effective, its initial market likley would be tourists from wealthy nations and the military, a view Buchy agrees with.

Buchy doubted, however, that an effective vaccine was around the corner. “The vaccine is not for tomorrow,” he said. “Dengue epidemics still have good days ahead of them.”

Still, both doctors expect increasing investment in vaccines and vaccine-related research as global warming expands the range of the mosquito that transmits dengue into southern Europe and the United States.

Developed countries are beginning to factor the costs of dengue treatment into their long-range healthcare budgets, while pharmaceutical companies have identified a potentially lucrative, emerging market, Buchy said. “Global warming is providing a shortcut for vaccine research.”

“Interest in vaccines is going to grow exponentially now that there is some success with a vaccine,” Bjorges said.

The European Union provided more than 10 million dollars for three dengue-related research projects in Southeast Asia earlier this year, including one in Cambodia to investigate the role that asymptomatic carriers play in transmission, Buchy said.

“If we can identify a gene that is protective this may allow us to develop drugs for treatment and vaccination,” he added.

Funding for prevention and control of epidemics in poor countries remains scant, however. The budget for Cambodia’s national dengue control programme is about 500,000 dollars, most of it provided by the Asian Development Bank.

Bjorges says one reason for the lack of funding for prevention and control is that it has shown little success. “Dengue control is 50 years old and everything that has been thought of has been tried.”

Breeding sites have to be eradicated weekly in order to prevent the mosquito that transmits the virus from emerging from its larvae, and this requires changes in human behaviour that have proven difficult to sustain on a weekly basis, Bjorges explained.

Another problem may be that those who allocate global health funds rely on short-term cost-benefit models, Bjorges said. They are under pressure to produce quick, quantifiable results for the funds they allocate, and dengue prevention and control projects do not fit these models, he explained.

Buchy was less pessimistic about the possibility of changing human behaviour. “Behaviour change is possible, but it requires more investment in education.”

Buchy’s view is echoed by Prof. Duch Moniboth of Cambodia’s National Pediatric Hospital that treated 1,673 children for dengue in the first seven months of this year. “There is not enough education about dengue – how to prevent infection and how to eradicate breeding sites.”

New research, however, suggests that dengue is far more prevalent in Cambodia than previously calculated, underscoring the need for increased investment in prevention.

The disease is underreported partly because Cambodia’s dengue surveillance system relies on data from state-run hospitals and charitable children’s hospitals. Cases treated at private hospitals and clinics are not reported to the health ministry.

Charitable hospitals treating dengue patients in Cambodia have been pleading for donations after being inundated with patients in May. The National Paediatric Hospital has been relying on nursing students to treat children who spill into the hallways and the foyer around the main stairwell.

The hospital receives a mere 20 dollars per patient, regardless of how long the child stays, Moniboth said. On average, doctors receive monthly salaries of about 125 dollars, while nurses are paid about 75 dollars, he said.

With such meager funding for healthcare what is needed is a cheap vaccine, Moniboth said.

A child gets a measles shot at the Jalozai refugee camp. Credit: Ashfaq Yusufzai/IPS

By Ashfaq Yusufzai
PESHAWAR, Pakistan, Aug 14 2012 (IPS)

Measles outbreaks, which have killed at least 100 children in Pakistan’s militancy-hit border areas since May, have prompted calls by experts for better cooperation in territories adjacent to Afghanistan with international immunisation campaigns.

“The latest victims of this paediatric disease are children in the Mohmand Agency of the Federally Administered Tribal Areas (FATA) where nine deaths have been confirmed as a result of non-vaccination,” Dr. Anwar Shah, top health officer in the agency, told IPS.

Measles, a highly infectious disease, produces cough, high fever and distinctive rashes as symptoms.

Shah blamed unsettled conditions caused by Taliban militancy as well as poor public awareness of the value of vaccination for the outbreak of measles in the seven agencies and six border regions that make up the FATA and in adjacent Khyber Pakhtunkhwa province.   

“My eight-year-old son died of measles last month. He hadn’t been immunised,” Amir Rehman, a farmer in the Lakaro area of Mohmand Agency, told IPS over telephone.

Rehman said he had to take his three surviving children to Charsadda, one of the 25 districts of Khyber Pakhtunkhwa, to have them vaccinated against measles.   

In FATA’s North Waziristan, where the outlawed Tehreek Taliban Pakistan group banned oral polio vaccination (OPV) in June, an estimated 163,000 children are said to be exposed to poliomyelitis.

The result of the ban on OPV is that the FATA is now the only polio-endemic region in the world that harbours two strains of poliovirus, posing a threat to countries certified polio-free, according to the World Health Organisation (WHO) officials.

According to Asghar Ali, a WHO doctor, most of the FATA’s seven agencies have less than 45 percent vaccination coverage against the national target of 95 percent set by the ‘Prime Minister’s Emergency Polio Eradication Plan 2012’.

The situation is worst in the South Waziristan agency where the Taliban has ordered a ban on all vaccinations, leaving the children vulnerable not only to polio but also to measles and other infectious diseases.  

On Jul. 31, South Waziristan’s chief surgeon Azmat Hayat Khan issued a warning that the Taliban’s blanket ban could result in a measles outbreak and more deaths. “The problem is complex because apart from the ban on vaccination there is a shortage of vaccines,” Khan told IPS.

“Measles-affected children need to be admitted to hospital within 24 hours and this is not possible in the tribal areas where people lack transport or resources to move their children to facilities in KP,” Khan said.

Khan said that besides the 100-odd children known to have died of measles since May about 3,000 have been treated in hospitals.

“When unvaccinated children get measles, they need to be rushed to hospitals if they are to survive,” Muhammad Aman, a pediatrician at the Khyber Teaching Hospital in Peshawar, told IPS.

Dr. Jan Baz Afridi, top immunisation officer in KP, told IPS that additional vaccinators were being deployed in KP districts. “Our staff now visits villages and makes announcements from mosques over loudspeakers to encourage people to get all children up to 15 years of age immunised,” he said.  

Fawad Khan, FATA’s chief health director, said: “Law and order is another problem hampering the government’s effort to promote vaccination. We are looking to the government to ensure security of the health workers to carry out immunisation activities.”  

“Vaccine-preventable ailments do not discriminate between cultures, religions, borders or language,” Michael Coleman, communications specialist with the United Nations Children’s Fund (UNICEF), told IPS. “A small number of unvaccinated children could put at the razor’s edge the lives of thousands of children.”

In April, UNICEF joined WHO and the Centres for Disease Control and Prevention of the United States in launching a global strategy to reduce measles deaths to zero by 2015.

But the new strategy relies on high vaccination coverage and close monitoring of the spread of measles as well as rubella, using laboratory-backed surveillance and effective communication – grossly lacking in the FATA. 

Studies by the WHO, published in April, showed that accelerated efforts to reduce measles deaths had resulted in a 74 percent reduction in global measles mortality, from an estimated 535,300 deaths in 2000 to 139,300 in 2010.

The WHO study estimated that during the 2000-2010 period, measles vaccine had saved over 9.6 million children.

“Since April, we have immunised 8,000 children against measles in the Jalozai refugee camp (outside Peshawar), where people displaced by military action against the Taliban in FATA are lodged,” WHO’s Dr. Junaid Shah told IPS. “It is much harder to immunise children in the FATA.”  

Shah said that propaganda by the Taliban against oral polio vaccine had not only harmed the immunisation efforts in the FATA but was now proving to be a setback to global efforts to reduce deaths from measles.  

Oral polio vaccination in Peshawar. Credit: Ashfaq Yusufzai/IPS

By Ashfaq Yusufzai
PESHAWAR, Pakistan, Jul 9 2012 (IPS)

By ordering a ban on polio immunisation, in its strongholds along the Afghanistan-Pakistan border, the Taliban is holding up an ambitious global programme to rid the world of  the crippling childhood disease, say World Health Organisation (WHO) doctors.

“The Taliban’s ban on polio immunsiation in the Federally Administered Tribal Areas  (FATA) poses a serious threat to the global polio eradication effort as countries declared polio-free long ago could import the virus from Pakistan,” Dr. Khalid Khan, who works for the WHO’s polio programme in the FATA, tells IPS.

WHO leads the Global Polio Eradication Initiative (GPEI) which is supported by Rotary International, the Centres for Disease Control and Prevention in the United States and the United Nations Children’s Fund.

Since GPEI’s launch in 1988 the number of polio cases worldwide has dropped to over 99 percent and today only three countries, Nigeria, Afghanistan and Pakistan, are classified as polio-endemic.

But, of these remaining pools of the wild polio virus (WPV), the FATA is distinct for harbouring two  strains, WPV1 and WPV 3.

“FATA is the only polio-endemic region in the world which has  WPV1 and WPV3 types of polio virus, and as long as these remain in circulation anywhere they are a threat to children everywhere,”  says Asghar Ali, another WHO doctor.

In 1994, the WHO’s Americas region (36 countries) was certified polio-free, followed by the Western Pacific region (37 countries including China) in 2000. But, after a gap of nine years, several polio cases linked to the WPV1 strain surfaced in China’s Xinjiang province which borders Pakistan.

Similarly, the WHO European region (51 countries), polio-free since June 2002, suffered its first polio importation in 2010, underlining the threat from  the highly contagious virus.

According to the WHO, in the 2009-2010 period, 23 previously polio-free countries were re-infected with polio due to virus importation.

Ali told IPS that most of the FATA, which consists of seven agencies, was vulnerable because vaccination coverage is less than 45 percent vaccination when the target set by the ‘Prime Minister’s Emergency Polio Eradication Plan 2012’ is 95 percent.

The problem was worst in the North Waziristan and South Waziristan agencies of the FATA where the Tehreek-e-Taliban, or Pakistani Taliban, is entrenched.

On Jun. 15, the Pakistani Taliban imposed a ban on oral polio vaccination (OPV), saying that it was part of  a design by the United States to reduce Muslim populations. The Taliban in South Waziristan went a step further on Jun. 25 by ordering a blanket ban on an on all vaccinations.

“The latest ban in the two militancy-riddled FATA regions is a serious setback to eradication efforts,” Ali said.

The Taliban ban flies in the face of  a resolution by health ministers, meeting at the World Health Assembly in Geneva May 25, to complete total polio eradication as  a “programmatic emergency for global public health.”

“We have had troubles in the Khyber Agency, but as we were getting close to resolving the crisis there, this new blow to the programme from North and South Waziristan pops up,” Dr. Fawad Khan, director of health in the FATA, tells IPS.

Since the beginning of the year, there have been 22 confirmed polio cases in Pakistan, with 11 reported from FATA.

Khan recalled that in 2005, a 25-year-old Pakistani student in Melbourne tested positive for polio when he returned there after spending his vacation in Pakistan.  “Genetic sequencing showed the virus to be linked to the strain circulating in the Khyber Agency.”

“We recently started a short interval additional dose programme to ensure that the children who missed the routine campaigns get OPV,” the FATA health director said.

But, vaccination programmes in the FATA were fraught after a one-page pamphlet was circulated in South Waziristan agency on Jun. 25 by Pakistan Taliban chief Mullah Nazir Ahmad describing vaccination as a “sweetened poison being given to our children. The Americans use media, sports, vaccination and co-education to advance their agenda.”

The pamphlet warned that any department or organisation found involved in immunisation work “would be responsible for the consequences.”

The Taliban alleges that vaccination programmes are a front for espionage  and cites the case of Dr. Shakil Afridi, convicted for running a fake hepatitis immunisation programme to confirm the presence of Osama bin Laden in Abbottabad, where the Al-Qaeda chief was killed in a U.S. military raid in May 2011.

Afridi was sentenced to 33 years in prison by a tribal court for his role in helping the Central Intelligence Agency of the U.S. in tracking down bin Laden, wanted for the Sep. 11, 2001, attacks on U.S. soil.

“On the one hand they are killing innocent women, children and old people in drone attacks and on the other, they are spending millions on vaccination campaigns,” said the Taliban pamphlet.

The ban will impact an estimated 318,000 children in the North and South Waziristan agencies, said Tahseenullah Khan, coordinator of the National Development and Research Foundation (NRDF) which has been assisting the government in promoting immunisation in the two agencies.

Local religious leaders, who are members of the NRDF, had successfully addressed more than 6,000 cases of vaccination refusals by parents in both the agencies, but this time the situation is different,  Tahseenullah Khan said.

“This time, it will be difficult to convince the Taliban to allow vaccinations because they have also demanded cessation of drone strikes in exchange for lifting the ban,” said Dr. Aamir Khan of the government’s expanded programme on immunisation in the Khyber Pakhtunkhwa province.