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Archive for March 18th, 2008

Africa at large: Training Anaesthesiologists to do, and to train

Posted by African Press International on March 18, 2008

Cape Town (South Africa) – The need for a global effort to address the shortage of anaesthesiologists in Africa was highlighted over the past week during the World Congress of Anaesthesiologists — which took place in Cape Town, South Africa.

This event, which is held every four years, drew over 7,000 international delegates. It was organised by the World Federation of Societies of Anaesthesiologists (WFSA), an umbrella grouping that comprises 141 organisations dealing with anaesthesia, pain management, resuscitation and related issues. One of the aims of the WFSA is to improve the practice of anaesthesiology in developing nations — something that requires anaesthesiology organisations around the world to join forces.

“We need to form partnerships with organisations and anaesthesia associations in Africa, but also abroad,” said Bisola Najin Obembe from the Department of Anaesthesia at the Port Harcourt Teaching Hospital in southern Nigeria. “This is important to improve both the level of training and research.” At present, sub-Saharan Africa faces a vast shortage of qualified anaesthesiologists. Zambia is a case in point, having only one registered anaesthesiologist for every three million citizens. Ratios are considerably better in wealthy nations; in the United Kingdom, there is an anaesthesiologist for every 2,500 people.

The shortages translate into increased surgical mortality through problems linked to anaesthesia; in certain parts of the continent, this mortality rate is 2,000 percent above the global average. “The mortality figures are higher when a non-specialised anaesthetist, for instance a general practitioner, practices anaesthesiology,” said David Morrell, managing director of the WFSA. “A person has a chance of one in 80,000 to one in 160,000 of dying when he or she is under the care of a qualified anaesthesiologist. When a patient is anaesthetised by a non-specialist — a nurse for instance — the chance of death is one in 3,500,” he added. “The problem in large parts of Africa, especially in the rural areas, is that anaesthetisation is often conducted by non-specialised healthcare workers.”

To increase the number of anaesthesiologists in African countries and other developing nations, the WFSA — through its foundation — has established programmes in Angola, Rwanda and other states, said WFSA President Angela Enright. “Up until a couple of years ago, Rwanda had only one qualified local specialist for its entire population of nine million people. Since we started working there, the number has increased to five. That excludes four expatriates. It might not sound an achievement, but it is an increase of over 400 percent.”

Apart from training physicians to become qualified anaesthesiologists, the programmes also assist nurses and other medical staff. “Many nursesare already practicing basic anaesthesiology as a result of the shortage. They are crucial to the health sector, therefore we need to include them,” Enright noted. However, she emphasises that anaesthesiologists remain essential. “Anaesthesiology is a highly specialised field: it takes on average ten years for someone to qualify. You can’t do that in few weeks or with basic knowledge.”

‘Teach the Teachers’, a joint initiative by the Canadian and American associations of anaesthesiology, takes training a step further by also showing physicians how to become instructors themselves, so that they too can advance local training. “The aim is to teach people in their own country instead of in the United States. Moving them overseas increases the chance of them never returning to their home country, and that is where they are needed the most,” said Phillip Bridenbaugh, chairman of the WFSA’s foundation.

‘Teach the Teachers’ has programmes in various countries, including Rwanda and Tanzania. “It is a full, four-year master’s in anaesthesiology which is taught by anaesthesiologists from the U.S. and Canada. They do this on a voluntary basis, and we cover their expenses,” noted Bridenbaugh, who has worked as an anaesthesiologist for over 40 years. “We also teach medical staff how to operate, maintain and repair equipment,” he said. “A while back I was in a hospital in Tanzania where they received five brand new machines from Korea. Unfortunately, they were catching dust as the manuals were written in Korean. This could have been prevented.”

Bridenbaugh has volunteered in various hospitals in Tanzania. “It was and still is very rewarding, especially because the people we train — and thus the knowledge — remain in the country, where they are needed the most.” “We do not give people the fish, we teach them how to fish. And more importantly, we teach them how to teach others how to fish. That is our success.” * This is the second article in a two-part series examining the shortage of anaesthesiologists in Africa. The first feature, ‘HEALTH-AFRICA: Anaesthesiology on Life Support’, was issued Mar. 7.


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Posted by African Press International on March 18, 2008

The Special Court for Sierra Leone has asked the UK government to help track down money believed to have been stolen by Liberia’s ex-leader Charles Taylor.

He is on trial accused of funding rebels in Sierra Leone while in office. Mr. Taylor denies the charges, but the chief prosecutor says if he is convicted for pillage he wants his alleged stolen millions to be returned. “If we can get the money back to the victims, that are a critical part of justice,” Stephen Rapp told the BBC.

During Sierra Leone’s decade-long civil war, which officially ended in 2002, tens of thousands of people died and thousands more were mutilated, raped and had limbs amputated. Mr. Taylor’s war crimes case has been transferred from Sierra Leone to The Hague for security reasons, although it is still being conducted by the UN-backed court.

The former Liberian president is faces 11 counts of crimes against humanity and war crimes. Mr. Rapp has been in London to meet with the UK government to discuss the alleged looted money which is believed to be in the region of several hundred million dollars.

“It may be even close to a billion dollars when you add together all the resources and the money that went through the government of Liberia when he was president,” Mr Rapp told the BBC’s World Today programme.

“Indications are that some $650m was due to the people, due to the treasury – that money all flowed through his personal bank accounts.” Tracking down the funds was an “ongoing forensic effort”, but governments around the world have been co-operative when asked for help, he said.

“If we obtain a conviction for him on pillage we’re going to go forward and try to obtain the restitution orders,” the chief prosecutor said. He said the real tragedy of the war in Sierra Leone is that not enough was being done to help the victims of the war.

He said he is hoping that any recovered money would go to a victim reparation programme. “For the thousands of people who had arms and legs and sometimes ears and other body parts chopped off cruelly during the course of the conflict – and victims of sexual violence.”


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Posted by African Press International on March 18, 2008

api-correspondent-odera-omolo.jpg<From Leo Odera Omolo
The utterances of the three members of Parliament from the diverse constituencies in Kipsigisland over the weekend are loud and clear indication of the on going undercurrent but intensive lobbying for ministerial positions within the ODM.
On the other hand William Ruto (Eldoret North) and Pentagon members has publicly confirmed that he is backing his fellow Pentagon member W.Musalia Mudavadi for the Deputy Prime Minister slot. The Sabatia MP was the running mate of Raila Odinga in the much flawed general election of December 2007.
Railas headache,however, is the latest demand echoed by the three Kipsigis MPs that the community had contributed a lot of votes to the ODM. And that it deserved to be compensated .The Kipsigis voted on a man to man basis for the ODM. The community captured all the 8 constituency for the ODM plus one in the Diaspora.
The three MPs were addressing mourners in Bureti district during the burial of the late J.K Kirum a former civic chairman of Litein Town Council .They were Kipkalia Kones,(Bomet) Dr.Kones (Konoin) and Franklin Bett (Buret)
The ODM bagged 33 parliamentary seats in the Rift Valley most of them having come from the two most populous sub-clans, namely,the Kipsigis and Nandis followed by Tugen Keiyo and Marakwet.
The Nandis comes the second after the Kipsigis.this particular community delivered four seats in Nandi South and North namely Aldai,Emgwen,Mosop, and Tinderet.Other areas outside Nandi inhabited districts are Cherangany in Trans Nzoia ,Eldoret North and South bringing the total to seven strength within the ODM group .t
The Tugen sib-clan comes third for having delivered the Baringo North ,Baringo Central ,Eldama Ravine,Rongai and Mogotio.,but loosing the only odd seat that is Baringo East in which Minister Hassan Kamama was returned uniopposed on a PNU ticket.
Keiyo is lying fourth for delivering Keiyo North and South and also one seat in Eldoret East which was captured by Prof Margaret Kamara ,Baringo East seat was captured by Mrs Lina Chebii Kilimo on Kenda ticket.
Back to the Kipsigis the community the many ministerial materials in the name of Zakayo K Cheruiyot(Kuresoi) Kipkalia Kones (Bomet) Isaack K Ruto (Chepalungu) and Franklin Bett (bureti)
And only one MP successfully defended his seat that is Hon Charles Keter (Belgut) but the legislature though survived last December onslaught that swept all his seven other colleagues in the 9th parliament the youthful legislator is still being associated with the Moi family.
He is said to be a close political and business friend f of Gedeon Moi with whom they business partners in newly built and recently commissioned privately owned Tea factory in Belgut.He is also said to be in partnership with Gideon and former Ainamoi MP Eng.Kipngeno Arap Ngeny in a medium size white Sugar cane factory which is located in lower Belgut.Gedion is the majority shareholder in the factory a medium size production around 300 bags of white sugar per day.
Keters alleged association with the Mois family now leaves the field open for the likes of Zakayo Cheruiyot,Kipkalya Kones,Isaack Ruto and Franklin Bett as the most credible men for possible consideration for cabinet appointments .Both Kones and Ruto had served in the previously KANU regimesunder the retired presdent Moi.
In Nandi in the North Rift Raila Odinga is facing a tough choice between the two Kosgeis Henry Kosgey(Tinderet) is the National Chairman of the ODM.He had already served in the cabine tbefore under Moi.
But the other Kosgey (Dr.Sally Kosgey) appear to be the darling of the Nandi ODM members who says she has something unique to offer to the ODM due to her experience in world of civil service in the Mois last regime.
She is credited for being calm and approach issues diplomatically.If at all there is anyonet to be sacrificed ,the Nandis says Raila could leave out of the cabinet list Henry Kosgey for Dr.Sally Kosgey.The community has already had one MP in the diaspora whose ministerial appointment who is slated to be ushered into the cabinet and that is William Ruto (Eldoret North)
If only one Kosgey is appointed to the government ,then this will give Raila room to look further north Rift and pick either one of the MPs in either Keiyo or Turgen for the cabinet appointment while others might servea as deputy Ministers.
In Gusii a small community which has a total 4 Pernanent Secretatries in the current PNU government headed by President Kibaki as opposed to only one Luo PS radical changes is considered as an occupational regime by the Luo are expected.
The community has already have the experienced Prof Sam Ongeri in the cabinet (Education) and can only expect one more cabinet slot.This will obviously be given to Omingo Magara the partys national treasurere though there is the presence of Chris Mogere Obure the MP for Bobbasi who had served in the previous KANU regime as Finance Minister . But one of the two will have to settle in deputy minisertial slot.
Another area which is need to be handled carefully by Raila is the Maasailand.Both veteran politician William Ole Ntimama{Narok North} and the major general (rtd) Joseph Nkaiserry of Kajaido [Kajiado Central} could be accommodated in the cabinet though the presence of Prof George Saitoti (Kajiado North) could complicate matters for the two.
For Luo-Nyanza Raila Odinga big hjeadache will be the larger South Nyanza region .This region is demanding for two slots and the names making the round is that of Joshua Orwa Ojodeh
[Ndhiwa) and Dalmas Otieno (Rongo) ,Also considered is the experienced iof the Mbita MP Otieno Kajwang
Looking North James Orengo (Ugenya) and Prof Anyang Nyongo Kisumu Rural}seemed to be the natural choice of the people. Perhaps with one of two deputy ministerial slots in Kisumu and Nyando districts.
ODM appears to be in full control of Western Province where Chris Okemo (Nambale) Ababu Namwamba (budalangi) and George Khaniri are likely to land lucrative ministerial appointments and join Musalia Mudavadi deputy Primear docket. John Sambu the man who flored the Ford Kenya national chairman Musikari Kombo could be the best deal in Bukusu land.
Cyrus Jirongo could have benn the natural source that the belted out of the ODM shortly before the December 2007 general election.
Arguably the Kalenjin region had produced the best gender representative to the August house for the ODM than any other region.
These are Dr.Sally Kosgey (Aldai) ,Prof Margaert Chepkoech (Eldoret East),
Ms Lorna C Lebaso (Sotik) and Prof Hellen Chepkemoi Sumbili{Mogotio}. These are African ladies of substantial meains and high profile academic background and status within the society.Anyone among the flying ministerial flag will not be a let down to anybody .Anyone of the them appointed to the ministerial position would not be a let down to the party.
There are ladies of high profile and vast experience in government matters.This is likely to give Raila a lot of headache but we are sure he will take qualities into action when distributed whatever he has.
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Posted by African Press International on March 18, 2008

Forwarded by Leo Odera Omolo
The Secretary General of the East African Community, Amb. Juma Mwapachu will address a Press Conference at the EAC Headquarters, Chairmans Room, 5th Floor, Kilimanjaro Wing, AICC, Arusha tomorrow, Tuesday 18 March 2008 at 10.30 a.m.
The Secretary General will brief the Press on the preparations for the forthcoming 2nd East African Media Summit which the EAC Secretariat is organizing in collaboration with the East African Business Council. The Executive Director of the East African Business Council, Mr. Charles Mbogori will also address the Press Conference.
You are cordially invited to attend and give coverage.
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When parents demand bride price

Posted by African Press International on March 18, 2008

By Maryanne Waweru

At 27 years, Elizabeth has been busy putting the final touches to the plans for her wedding, which is scheduled for April. Although this manager at a multinational company is excited, there is an issue wearing her down: dowry. The obscene number of “cows and goats” demanded by her relatives, she laments, is causing quite a strain between her and her fianc Elizabeths husband-to-be feels that her relatives are asking for too much. Although the young man has taken a loan to meet the demands, he openly grumbles about it. “Every time the issue comes up, we end up in a spat,” she says. “He insists my relatives are materialistic and are only interested in enriching themselves.” And while she believes that her mans sentiments are genuine, she also knows that, as a woman, she may not have much say in the matter. “I do not want to openly side with either my fianc or my relatives,” she says. “The issue has really put me in a difficult position.” A post-graduate student, she feels that the culture of bride price should be done away with. “It causes unnecessary problems for a couple,” she observes. “It causes tribulations for the girl.” She adds that if she were to have her way, she would tell off her demanding relatives. “I do not see need for the whole dowry affair. It is outdated and should not be happening in modern society.” Incapable of openly disagreeing with her parents on the matter, Elizabeth has chosen to remain quiet. Having parted with material that she and her fianc might use to start themselves off, she says, “I worry that we may not have enough money to start our home as we would like”. Dowry payment is an age-old custom. Among most African communities, the families of the bride and the groom arrive at an agreement on a price that the man pays to enable him marry the woman. Customarily, the intent was to seal the relationship between the two families, creating a feeling of trust and understanding between them. Dowry has been seen as a way to prove the mans commitment and ability to take care of the woman and provide for his family. In many local communities, bride price is not paid at once, the idea being that, over the life of the marriage, the groom will continue to take cows and goats to his in-laws as he can afford. This spreading out of the bride wealth has another advantage: it signifies continued good relations between the man and the womans family. Traditionally, the pride price was paid in the form of cattle, goats, sheep, and farm produce. In urban settings, cash has become the primary medium of exchange a practice that has spread to the rural areas. In some peoples perception, however, the payment of dowry is synonymous with purchasing the woman, who, thereafter, becomes the man’s property. It degrades a woman It is an especially difficult concept for some educated and independent young women, particularly those living in urban areas. Listen to Lucy Githaiga, a freelance consultant: “Why should anyone pay dowry in this day and age?” she asks. Lucy believes that this practice degrades a woman, for it offers men the licence to equate the wife with acquired property. In Lucys thinking, marital abuse has its roots in the custom of dowry. “The man mistreats the woman and does whatever he wishes with her, sometimes turning her into a drum through beatings, amid constant reminders to her that he bought her. The worst part is that such women may be prohibited from returning to their parents because they have already been sold.” Lucy, a married mother of two girls, reveals that no dowry was given to her parents upon her wedding. “I count my blessings for I had a very liberal father who was against the practice,” she says. “All he asked was that my then fianc (and now husband) take good care of me. Once he got that assurance, he gave us the go-ahead.” Lucy says that, sadly, in todays materialistic world, many parents have commercialised dowry negotiations. “Some parents just want to fatten their wallets and are not really concerned about the young couples happiness,” she observes. For many modern-day parents, she believes, dowry negotiations are not occasions to seal relations between the two families, but an opportunity to upgrade one familys bungalows or buy that top-of-the-range car. To make sure they get the best deal, some parents select the best bargainers in the family. Some even hire professional negotiators, who suddenly become uncles at the negotiation table. In Lucys view, dowry negotiations inevitably create pressure between the girl and her fianc. Says she: “Their marriage usually starts on a negative note as, by this time, the man is bankrupt.” Without a doubt, Lucy will not ask for a cent when her two daughters come of age. “In fact, I will support the couple financially if I must. If they need money to start off, I will assist them.” Beliefs versus loyalty to parents Dorcas Mutiso, a 30-year-old Masters student at the University of Nairobi, shares Lucys concerns about the custom of dowry. “It does not make much sense to me,” she says. Though Dorcas believes that the tradition originally had good intentions, she says that in todays society, the custom is largely a money-making venture. “It makes the man empty his savings, and when this is not enough, the girl is forced to contribute money from her own resources if she really wants the wedding to go on,” she laments. Dorcas admits that if her fianc were unable to raise the amount asked of him, she would bail him out. “I will not mind contributing money towards my own dowry if it comes to that,” she says. Also a project officer at the NGO, World Concerns, Dorcas believes that many young women today are against the idea of bride price, but simply agree to keep from hurting their parents. She will definitely not ask for bride price for her daughters. Kate Nyabiage, 26, talks of a friend who was “extorted” of money by his wifes relatives. Although the man paid up, he has not set foot to his in-laws home since. “They have been married for six years now,” she says, “but the man has never visited his in-laws despite his wifes pleas. He drives his wife and children to her parents, but he never goes in.” Later, when his family is ready to leave, the man again picks them up at the gate. “I think it is very unfair of some parents to place their interests before their daughters,” adds Kate. Bride price, she believes, may have had genuine meaning in the days of our forefathers, but not anymore! “When my time comes to marry, I will caution my parents about asking for dowry, and if I get daughters, I will definitely not ask for dowry.” According to Nancy, who chooses not to give her full name, fear of the demands for dowry is one of the reasons why many young people are engaging in informal come-we-stay unions. “Parents ask for too much, so the couple decides to live together as they look for the money,” she says. “At least that is what happened with me and to many other women I know.” Her husband of four years, she says, has not refused to meet his obligations. “It is only that he will do so when he gets the money.” In the meantime, they must continue living together as man and wife. Men must pay up! Not everyone, however, is opposed to the practice. “At the risk of sounding backward, I think that, by all means, dowry should be paid for me,” says Lillian Kungu, a 24-year-old Actuarial Science student at the University of Nairobi. Lillian insists that some traditions should be upheld, despite the plethora of feminist campaigns and calls for female emancipation. “I see it as a token of appreciation to the girls parents for raising her up well. It is more or less a thank-you gesture. My fianc must give something to my parents.” But Lillian is quick to add that the man should give what he can afford, and that the girls parents should accept whatever is offered. “However little it is, the parents should appreciate and not make unreasonable demands,” she says. “In my opinion, you can never attach monetary value to a person. I do not believe any man will ever afford to pay my parents for me because I consider myself to be too expensive.” Would Lillian stay in an unhappy marriage simply because she has been bought off? “Of course not!” she exclaims. “Why should I? If I find myself in a bad marriage, I would not hesitate to walk out. It is not something I will even think twice about. I will not live a miserable life just because he gave money to my parents.” Nassy Anyango, a 24-year-old student, says: “We do not live in the past. We are in a new century with new cultures, so we ladies of today do not consider dowry payment as a worthy culture.” But, curiously, Nassy believes the girls parents should somehow be compensated for their loss. “It is only fair enough that, for all the struggles and investments, my parents should get some form of compensation from the man who is taking me away from them. It is called compensation nowadays, not dowry.”

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