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Archive for June 25th, 2009

The A(H1N1) virus is thought to originate from pigs – New cases in the Middle East

Posted by African Press International on June 25, 2009

MIDDLE EAST: Swine flu cases on the rise

Photo: Jefri Aries/IRIN
The A(H1N1) virus is thought to originate from pigs

DUBAI, – The number of cases of the A(H1N1) virus, otherwise known as swine flu, is growing in the Middle East, with many new suspected and confirmed cases in the past few days, but so far no one has died of the disease.

According to the World Health Organizations (WHOs) latest A(H1N1) update on 24 June, the total number of laboratory-confirmed cases worldwide reached 55,867, with 570 in the Middle East. The number of deaths from the disease globally is 238.

New cases in the Middle East

Bahraini Health Ministry said on 14 June that seven Bahraini students – five girls and two boys – had tested positive for the A(H1N1) virus. The cases were among a 13-member Bahraini student group which had returned from the USA after a 10-month exchange programme.

Egyptian Ministry of Health (MoH) reported a new case, bringing total to 41.

Israel has identified about 271 cases so far. On 22 June the MoH transferred the primary care for A(H1N1) to national health management organizations. On 21 June MoH lifted restrictions imposed nearly two months ago on travel to Mexico.

Iraq’s MoH has just confirmed the first cases, saying seven members of the women’s national basketball team were being treated in hospital. One member of the US-led multinational force in Iraq had also been confirmed as having the disease, Health Minister Saleh Al-Hasnawi said.

Jordanian health minister announced on 21 June the discovery of a new case (a 27-year-old Filipino woman who had arrived in Jordan from Manila on a Kuwait Airways flight), bringing the total to 13.

Country/Territory Breakdown of the number of laboratory-confirmed cases
19 June 22 June 24 June
Bahrain 12 15 15
Egypt 29 39 40
Israel 219 291 375
Jordan 2 13 15
Kuwait 18 26 26
Lebanon 12 12 25
Qatar 3 8 10
Oman 3 3 3
Saudi Arabia 22 35 45
United Arab Emirates 2 2 2
West Bank and Gaza Strip 5 8 8
Yemen 4 5 6
Total 331 457 570
Source: WHO Influenza A(H1N1) updates 51,52,53

Kuwait health authorities said on 20 June that a Lebanese had been diagnosed with swine flu, bringing the total number of cases to eight.

Lebanons MoH said on 24 June the number of diagnosed cases had risen to 30 after the detection of five new cases.

Oman’s Health Ministry confirmed its first three cases – students studying in the USA.

Saudi health officials announced three more cases on 24 June, bringing the total number of reported cases to 48.

United Arab Emirates confirmed its eighth case on 25 June. The infected person, who had arrived from abroad, was being treated in hospital.

Occupied Palestinian Territories – Five cases so far in the West Bank, none in Gaza.

Yemens Health and Population Ministry announced a new case on 23 June, bringing the total to six. The first case was registered on 16 June.

Qatar – In line with WHO recommendations, the Supreme Council of Health has warned the public against taking Tamiflu (Oseltamivir) and Relenza (Zanamivir) for the treatment of flu-like symptoms, or as a preventive measure against A(H1N1), without a prescription from a health care practitioner. There were 10 confirmed cases in Qatar as of 24 June, according to WHO.


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Youth in Madagascar’s capital, Antananarivo, were asked to draw the recent political violence

Posted by African Press International on June 25, 2009

MADAGASCAR: A shell-shocked youth

Youth in Madagascar’s capital, Antananarivo, were asked to draw the recent political violence

JOHANNESBURG, – The future of reconciliation in Madagascar may hinge on its youth, but their involvement in months of political violence and continued exposure to turmoil has left them embittered and particularly vulnerable, says a new report.

“Adolescents have clearly been in the front line of change but at the same time have been extremely vulnerable to violence and crime,” said the report, Pandora’s Box: Youth at a Crossroads, compiled by the UN Children’s Fund (UNICEF) and a group of international and local NGOs.

The document gives voice to the views and concerns of some 13,000 adolescent Malagasy in Analamanga, the country’s central region where the capital, Antananarivo, is situated, who were interviewed about the impact of the recent political demonstrations that left hundreds dead and thousands injured.

“It is striking how violence has altered their perceptions, and how much anger and frustration this has created,” Bruno Maes, UNICEF’s Madagascar Representative, told IRIN.

“Could you live here? Who cares if I die? I am not alive anyway,” said one interviewee. Another commented: “Every time I hear shooting, my heart beats out of control and I start to shake. My thoughts go to what might happen, and what I would do if members of my family died.”

The ongoing standoff between Andre Rajoelina, former mayor of Antananarivo, and ousted President Marc Ravalomanana, began in January 2009 and culminated in what the international community condemned as a “coup-style” change of leadership. Ravalomanana fled into exile in South Africa.

''Idiots! You pushed us into a situation from where there is no return''

Despite mounting international pressure and numerous mediation attempts, the feuding parties have failed to reach an accommodation, while Madagascar’s economy and governance structures are crumbling. “It’s absurd. What happened to us? Where are our values? Can’t we talk to one another instead of killing?” one interviewee wondered.

“Idiots! You pushed us into a situation from where there is no return. Do you think the youth that were at the barricades will be quiet in the future? Do you think they will care about voting next time? Why should they?” said another.

Morals lost

Researchers explored the effects of the sociopolitical crisis on the lives of young people; the impact on their emotional, psychological, social and educational well-being, and highlighted the gradual erosion of traditional values.

“[The] results are worrying because, in addition to increased violence, youth express a growing division within communities and among peers. Previous experience has shown that violence breeds violence and if we do not act now, it might be too late,” Maes warned.

According to the report, “One long-term consequence of this crisis is the difficulty for young people to distinguish what is ‘correct’ and what is ‘incorrect’; what is ‘true’ and what is’ false’, as traditional grounding values have been radically altered by recent events.”

One interviewee suggested that “The Malagasy people have become aggressive and all fraternity has gone, along with all the development efforts. ‘Fihavanana’ [the traditional value system] has disappeared.” Another was more cynical: “Life on the street has always been a life of misery; now that we can steal without anyone saying anything, it’s better.”

The youth’s perceptions of the crisis pointed to a weakening of the law enforcement and justice structure, opening the door to even greater dangers: easily available drugs, trafficking of children, prostitution, child abuse and the creation of criminal youth gangs, are all finding fertile ground in this volatile situation, the report noted.

Involved but invisible youth

“Youth have held leading roles in the social and political life of Madagascar over recent months: they have taken part in street demonstrations, been involved in the violence, have helped set up roadblocks; they have been victims of violence and crimes, and have found their right to education denied,” the authors pointed out.

Yet young people seem to have been largely forgotten in humanitarian interventions. “Caught in a limbo of being neither children nor adults, they are among the first to bear the consequences of violence and aggression,” the report commented.

Adolescents revealed mixed feelings about the future: “I think I am scared every day, I fear for my future … it is a deep fear that cannot be seen from the outside,” said one interviewee.

The report proposed urgent interventions by all stakeholders to reduce the exposure of young people to violence by providing an immediate response to their concerns, providing them with personalized services tailored to their age, promoting the values of peace and reconciliation, and increasing their involvement as agents for positive social change.

“Such negative experiences expose young people to long-term risks and the possibility that they become more aggressive,” said Maes. “It is possible to reverse this trend; however, this will require immediate and bold action.”


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At least 6,000 people have been displaced in Kuria East district following clan fighting that started in late May

Posted by African Press International on June 25, 2009

KENYA: Thousands displaced in ethnic clashes in southwest

Photo: Julius Mwelu/IRIN
A camp for the displaced: At least 6,000 people have been displaced in Kuria East district following clan fighting that started in late May – file photo

NAIROBI, – Tension remains high in Kenya’s southwestern district of Kuria East, on the Tanzania border, where at least 6,000 people have been displaced by inter-clan fighting, humanitarian officials said.

“Although there is relative calm in the district, with no reported incidences of attacks or torching of houses in the past few days, tension remains high in the area,” James Kisia, deputy secretary-general of the Kenya Red Cross Society (KRCS), said on 24 June.

Fighting between the Nyabasi and Buirege clans of the Kuria ethnic community began in late May following a cattle-rustling incident in which two people were killed. A retaliation attack that followed resulted in the death of two other people and the torching of several homes.

The Kuria are a pastoralist Bantu people, with a history of clan fighting over resources such as land, pasture and cattle.

Political differences arising from the division of the larger Kuria district in 2007 into Kuria East and Kuria West districts also underpin the latest conflict, Kisia said, with both clans wanting the new district headquarters situated in their divisions.
Aid efforts

According to the UN Office for the Coordination of Humanitarian Affairs (OCHA Kenya), relief agencies are planning further aid for the IDPs in Kuria East. Already, the KRCS has provided emergency relief aid for the displaced.

OCHA said it was supporting coordination efforts at the national level through gathering and sharing of information on the immediate gaps in humanitarian response in the affected district.

A KRCS assessment revealed that both clans mobilised support from their neighbouring communities and relatives from the Kenya-Tanzania border area, during the clashes.

''Although there is relative calm in the district, with no reported incidences of attacks or torching of houses in the past few days, tension remains high in the area''

Worst affected areas

The worst affected areas include Wagirabosi/Targai location in Ntimaru Division, inhabited by the Buirege clan; and Girigiri sub-location, and the villages of Nguruna, Getongoroma and Kebaroti in Kegonga Division, the KRCS said.

Kisia said there were reports of gunshots along the Nyabasi-Buirege border on 22 June and that attacks and counter-attacks since late May had resulted in the displacement of at least 6,290 people and the burning of 765 homes.

According to the KRCS, there is no ambulance in Kuria East to support referrals and patients, while water and sanitation facilities remain critical, especially in IDP camps.

The fighting has also disrupted learning in various education facilities, some of which have been closed or are hosting IDPs. The KRCS estimates that 58 early childhood development centres, 58 primary schools and 11 secondary schools have been affected by the conflict.


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Posted by African Press International on June 25, 2009

NAMIBIA: Shantel Ferreira, “You’re trying to deny me giving birth”

Photo: Tomas de Mul/IRIN
“Being a mom there’s ups and downs”

JOHANNESBURG, – When doctors at Katatura State Hospital in the Namibian capital, Windhoek, booked Shantel Ferreira* for a follow-up operations after she gave birth to her first child, she thought nothing of it – until she started asking questions about the acronym “BTL” which appeared on her form. At the time, she had no idea the initials stood for a form of female sterilisation known as bitubal ligation.

According to the International Community of Women Living with HIV/AIDS, Namibian HIV-positive mothers like Ferreira have been reporting cases of coerced or forced sterilisations since at least January 2008. Ferreira spoke to IRIN/PlusNews about how the birth of her second child almost did not happened.

“I gave birth early at seven months the doctors said couldn’t give me an operation then [what she thought was a routine follow-up procedure] so they booked me for another month. When I arrived, a nurse asked me why I was there. I told her I was booked into theatre, that’s why I’m here.

“First thing, when I got there I asked the nurse about this paper they gave me to sign, I was like, ‘What’s this BTL?’ She was like, ‘Can’t you see I’m alone here and I’m busy? Just sign the paper and put it on the desk. I’ll come and tell you later.

“The next morning when I went to the theatre, the electricity went off so I went back to the wards to change and wait for the next day. So another [nurse] came in and this time she was friendly so I asked her what a ‘BTL’ was and she started explaining.

“I was like, What? Youre trying to deny me giving birth to my child? Even it it’s born sick, let me take care of it.’ She said, fine then you should make a plan and leave this hospital.

“Me and my friend were both supposed to go in for an operation that day and we both just left ’cause when I found out what a BTL was, I told her. We were both scared so we just walked out.

“I’ve got two kids. Being a mom there’s ups and downs but it’s good, and now people are being denied their right to have kids.”

*not her real name


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Posted by African Press International on June 25, 2009

NAMIBIA: Women take legal action over alleged sterilisations

Photo: Andrew Bannister
Nowadays, if youre HIV-positive, you can have a healthy child and it’s your right”
JOHANNESBURG, – Two HIV-positive Namibian women who allege they were sterilised against their will in public hospitals are seeking redress through the courts, the first of more than 20 known cases, according to the International Community for Women Living with HIV/AIDS (ICW).

The ICW raised the alarm over what it terms forced or coerced sterilisations among HIV-positive women more than a year ago, after hearing accounts of it through its regular forums for HIV-positive young women.

The organisation has since partnered with the legal aid body, the Legal Assistance Centre (LAC), to bring two cases before a judge this year, according to the ICW’s Aziza Ahmed.

Another six cases could potentially go to trail this year, and a further 20 are being looked into by LAC and the ICW.

Although the ICW has been made aware of a number of other cases, legal action has been hampered by difficulties in collecting evidence and statements from women involved, who are often reluctant to come forward due to fears that both their HIV status and their inability to bear children will be made public, according to Veronica Kalambi, who sits on the ICW’s southern Africa steering committee.

A matter of consent

Since the initial reports came to light, the ICW has conducted fact-finding missions to three of Namibia’s 13 administrative regions to document stories from women who have been sterilised, some of whom said they signed consent forms to undergo what was simply listed on their health documents as a “BTL” without fully understanding its implications.

“BTL” is the acronym commonly used for bitubal ligations. Considered a permanent form of sterilisation, the procedure involves sealing a woman’s fallopian tubes to prevent pregnancies. Reversals are possible but the procedure is costly and success is uncertain.

“The majority of these women are rural or illiterate, they don’t know what ‘BTL’ means and there is no explanation. Even me, I didn’t know what it meant,” said Kalambi, adding that for some women, consent forms presented to them in English instead of their home languages were also a barrier to ensuring consent was actually informed.

The ICW’s Saima Moses, who conducted research on the subject in northern Namibia, found some hospitals even had lists for women waiting to undergo the operation. Again, she said, few on the list had any idea what they were in for.

“It’s a kind of discrimination,” she said. “Nowadays, if you’re HIV-positive, you can have a healthy child and it’s your right [but] to doctors it’s like because a woman is HIV-positive, why should they have a child? [Doctors] assume that child is always going to be sick.”

According to Ahmed, a submission was made to the Deputy Minister of Health and Social Services (MoHSS) to investigate cases of alleged ‘forced sterilisation’, however she has yet to respond.

MoHSS spokesperson, Gladys Kamboo, told IRIN/PlusNews that the ministry declined to comment given the now legal nature of the issue.

In October 2008, IRIN/PlusNews spoke to Dr Rheinhardt Collin Gariseb, the head of Katatura State Hospital in the capital, Windhoek, where the ICW says sterilisations without informed consent have taken place.

Due process?

According to Gariseb, no incidents were reported to the hospital and that allegations were first brought to his attention through local media reports.

The hospital does offer tubal ligations to women, particularly those who may be on their third caesarean section and therefore have increased the possibility of their uteruses rupturing with another birth, but he maintained that if proper protocol was observed, there would be multiple opportunities for patients to object to an operation.

“It’s the duty of the doctor to inform the patient through a translator, if necessary, [about any procedure]. Usually, we use one of the sisters, who takes the patient’s consent,” he said. “Then when the patient is taken to theatre, the sister hands over the patient to
the doctors and will again verify the procedure for which the patient has been admitted.”

However, given the testimonials of women collected by the ICW complaining of the brusque attitude of some health workers, sisters doubling as translators could be cause for concern.

Shantel Ferreira* said she narrowly escaped being sterilised. The HIV-positive mother of two had checked into Katatura for what she assumed was a standard follow-up operation after she gave birth two months early.

Although she said she had asked what the BTL she was slated for was, an overworked nurse told her to sign and that she would tell her later. Eventually, after a power outage minutes before her operation was about to begin gave her the time she needed to find a nurse who, she said, took the time to explain the procedure’s repercussions.

The LAC and IWC are still waiting for the trial dates for their first two cases. In the meantime, Kalambi said she has seen a worrying number of HIV-positive women express fears about delivering their babies at public hospitals due to the sterilisation scare.

That, she said, could have serious consequences for mothers and babies due to complications or lack of access to prevention of mother-to-child HIV transmission services.

*not her real name


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Health facilities stretched to breaking point

Posted by African Press International on June 25, 2009

UGANDA: Health facilities stretched to breaking point

Photo: Vincent Mayanja/IRIN
A mother and her sick child lying on the floor at Kayunga hospital pediatric ward, central Uganda

KAYUNGA, – Jennifer Nankinga fed her ailing child from a hospital bed in Kayunga, north of Kampala, despite a strong stench from dirty toilets that filled the air in the paediatric ward.

She was lucky to have got a bed. Other children and their mothers were sleeping on the floor of the dilapidated ward of the 100-bed referral facility.

All round Nankinga, however, were signs of rot. Hospital officials said the facility had never undergone major renovation since it was opened in 1972, and lacked medical personnel.

“We are understaffed by 40 percent,” hospital superintendent Ahmad Matovu, said. “The hospital is supposed to have seven doctors but we are only three.”

The facility is a public hospital, but funding was inadequate, he added.

“We receive 245 million shillings [US$110,000] each year as recurrent expenditure; 40 percent of this is used to procure medical supplies and the rest to do other things and maintain this place including buying fuel to run the ambulance which is also old,” Matovu explained.

“This amount has remained constant for the past five years [but] the cost of drugs and fuel has almost doubled The money is not enough and we ask clients to buy what we do not have.”


Like Kayunga, most Ugandan hospitals are in bad shape, something pointed out in a recent parliamentary committee report which looked at the performance of the health sector in 16 districts in the first few months of 2009.

“The level of dilapidation around and within the health centres at all levels was shocking,” Nvumetta Kavuma, the committee chairperson, told IRIN.

Photo: Vincent Mayanja/IRIN
The ambulances at Kayunga hospital broke down and only one, which is also old, now remains

“Most buildings needed renovation, reconstruction or extension, while some facilities were completely missing,” she added. In Kawolo (east of Kampala) and Kiryandongo (in western Uganda) hospitals, despite being near main roads, the entire infrastructure required a complete makeover, the report said.

Population pressure

The report pointed out that Uganda’s population was growing at a rapid rate of 3.2 percent per annum and this had put pressure on the facilities, many of which had been built during the colonial era when Uganda had less than five million people. Its current population is estimated at 30 million.

“Nearly all the health centres could not accommodate the current population pressures Overcrowded outpatient areas and admission wards were a common picture across most health facilities,” the report said.

The MPs said the country’s largest referral and teaching hospital at Mulago in Kampala had been overwhelmed. The hospital was designed to accommodate 20 mothers-to-be, but now handled over 100.

Borrowing from the World Bank

Senior Ugandan officials insist matters will get better this year.

Reading her 2009/10 budget in June, Finance Minister Syda Bbumba said improving health infrastructure and provision of drugs, especially for HIV/AIDS and malaria, would be a priority.

The health sector, she added, would receive 11 percent of the US$3.7 billion dollar budget.

Health Minister Stephen Malinga said the government was in the process of borrowing $600 million from the World Bank to improve facilities like Kayunga hospital.

“The government has authorized us to borrow $600 million from the World Bank in order to rehabilitate and address all other issues with regard to health facilities and make it easier for health workers,” Malinga told IRIN.

Photo: Vincent Mayanja/IRIN
Up to 200 patients are handled daily by the outpatients section of the hospital

“Our priority will be to rehabilitee 100-bed hospitals and health centres IV and III [lower level community facilities] that have not been completed and those requiring renovation,” he added.

Brain drain

“We also want to build houses for doctors and nurses to make it attractive to these workers so that when they are deployed up-country, they find a house, water and other essential requirements for the job.”

Medical workers, however, said renovating hospitals and building houses alone would not solve the problem. The question of poor pay also needed to be addressed, they said.

At the moment, a newly qualified doctor earns from 650,000 to 1.2 million Uganda shillings [$280 to 550] while a senior consultant earns up to 1.5 million [$680]. This situation has forced many doctors to abandon the country for better paid jobs elsewhere.


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