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Archive for September 2nd, 2012

President Obama Speaks to Troops at Fort Bliss

Posted by African Press International on September 2, 2012

Two years after his visit to Fort Bliss that marked the end of the combat mission in Iraq,President Obama returned there today to speak to the troops, and discuss his commitment to standing by those who served as the nation winds down the wars in Iraq and Afghanistan.

Now, when I was here last, I made you a pledge.  I said that, as President, I will insist that America serves you and your families as well as you’ve served us.  And there again, I meant what I said.  Because part of ending wars responsibly is caring for those who fought in it.  That’s why I wanted to come back to Bliss on this anniversary to reaffirm our solemn obligations to you and your families.You see, we may be turning a page on a decade of war, but America’s responsibilities to you have only just begun.

“Just as we give you the best equipment and technology on the battlefield,” the President said, “we need to give you the best care and support when you come home.” This includes continuing the efforts underway to strengthen and expand health care and mental health care service for troops, particularly for veterans with Traumatic Brain Injury and PTSD, and providing resources to help returning service members get the education, training, and support they need to transition back into the civilian workforce. It also means giving our military families the respect and the support that they deserve.

“And as we go forward as one nation, if the American people need inspiration, they need only look at Bliss,” President Obama told the troops today.

For a decade, you have served under the dark cloud of war.  You’ve endured great loss, and good men and women have given their last full measure of devotion.  But we Americans are strong, and we are resilient, and we have resolve.  And now, we can see a light — the light of a new day on the horizon.  And that’s because of you.

The war in Iraq is over.  The transition is underway in Afghanistan.  Our troops will keep coming home.  And we are keeping our military ready for whatever the future may hold.  But know this, Bliss — we are moving forward stronger and more confident in knowing that when faced with great trials, we Americans do what we always do.  We don’t just endure; we emerge stronger than before.

  • President Obama Arrives At Joint Base Andrews


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Cholera – rising with the downpours

Posted by African Press International on September 2, 2012

An aid worker distributes soap and bleach in Guinea’s capital, Conakry, where people have been infected with cholera

FREETOWN,  – Heavy rainfall is accelerating the spread of cholera in Sierra Leone and Guinea, where existing health risks such as poor hygiene practices, unsafe water sources and improper waste management are believed to have triggered the disease which has killed 327 people and infected more than 17,400 in both countries since February.

The UN Office for the Coordination of Humanitarian Affairs (OCHA) said Sierra Leone was facing its worst cholera outbreak in 15 years. Ten out of the country’s 13 districts have been affected and the government has declared the outbreak a national emergency.

Guinea’s capital, Conakry, has been the hardest hit in the country, with 3,247 cases so far. Cholera has also broken out in nine of Guinea’s 33 districts, OCHA said.

“The onset of the rainy season in West Africa has caused an increase in cholera cases on both sides of the border between Sierra Leone and Guinea. The rains are particularly heavy in Sierra Leone this year,” said Laura Marconnet, an external relations officer with the UN Children’s Fund (UNICEF) in Sierra Leone.

Prevalence is high in the congested slum areas in the capitals of Guinea and Sierra Leone which have few clean toilets and most people defecate in the open, often dangerously close to open wells which are the source of water for most residents.

Freetown’s densely populated Mabella slum, with tin shacks and poor drainage, has been badly affected. There are several community water taps, but residents complain of lack of adequate toilets, which are usually clogged with water and waste during the rainy season.

“We have seen a dramatic increase in the last 5-6 weeks in cases especially in Freetown. The response is quite difficult in terms of coordinating resources,” said Amanda McClelland, the Africa emergency health adviser at the International Federation of Red Cross and Red Crescent Societies (IFRC). “The conditions in Freetown are the perfect storm for cholera.”

“We know we haven’t contained it by any means and it has the potential of increasing further and becoming a regional issue,” McClelland told IRIN.

On 17 August, Sierra Leonean President Ernest Bai Koroma declared the outbreak a national public health crisis. The authorities and aid groups have ramped up efforts to treat, inform people and improve sanitation to stem further escalation.

“We are moving quickly to increase our capacity to handle all the new patients that will arrive,” said Karen Van den Brande, head of Médecins Sans Frontières (MSF) mission in Sierra Leone. “Our present cholera treatment facilities are stretched to the limit with patients. Everybody is at risk.” A new quick-disbursing humanitarian funding facility is being used for the first time to help tackle the emergency.

Pipe clean-up

Sierra Leone’s national water company has begun a major dam and pipe clean-up to help reduce the spread of cholera.

“There is every possibility that the pipe water system may have been infected since there are many broken water pipes flowing with water which need to be fixed in many parts of city,” said Martin Bash Kamara, deputy minister for energy and water resources. “People should take every precaution to purify the water by boiling it before drinking, cooking or other domestic purposes to avoid contamination.”

Photo: John Sahr/IRIN
Sierra Leone is facing its worst cholera outbreak in 15 years

West Africa has some of the world’s lowest rates of access to water and sanitation. Only 12.8 percent of Sierra Leone’s 5.5 million people have access to proper sanitation and 42.9 percent do not have access to clean drinking water; 28.9 percent defecate in the open, according to UNICEF. In Guinea, only 19 percent of the population has access to improved sanitation and just half its 10 million people have access to safe drinking water sources.

“This is the underlying cause for cholera outbreaks in West and Central Africa. Although measures for cholera response can help contain the spread of the disease and reduce the number of fatalities, it is essential to also tackle the underlying cause of this disease,” said UNICEF’s Marconnet.

The cholera outbreak has not peaked yet, said Marconnet and the rainy season is expected to last for the next two months. Treatment and other efforts to improve sanitation are expected to lower the rate of infection. Cholera is treatable and can be prevented through better hygiene.

“With increased coordinated efforts… we hope that the epidemic in the coming months will decrease due to scaled interventions,” said Charles Mugero of the World Health Organization (WHO) in Sierra Leone.

So far this year, more than 37,400 cholera cases have been reported in 15 West African and Central African regions.

In 2010, 36 percent of cholera cases globally were reported from Africa, which accounted for between 93 and 98 percent of cases worldwide between 2001 and 2009, according to WHO, noting Africa last recorded such a low rate in 1995. In 2010, 317, 534 cholera cases were reported to WHO, with more than 50 percent occurring in the Americas, notably in Haiti. However, the officially reported cases do not necessarily reflect all the occurring cases due to underreporting and other technical limitations.

js/ob/cb source


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Not enough aid to meet Malian refugees’ needs

Posted by African Press International on September 2, 2012

Not enough aid to meet Malian refugees’ needs

OUAGADOUGOU,  – Agencies cannot cope with the scale of refugee needs in camps across Mali, as their funding shortfalls are too great: 36 percent at the World Food Programme (WFP) 66 percent in UN refugee agency (UNHCR), and 58 percent for the overall response. If additional funding does not come soon, food will run out in September.

Longer-term planning for refugee needs in 2013 is “unthinkable”, say aid workers. Just 20 percent of the US$153 million needed by UNHCR to help the approximately 249,000 Malian refugees in Burkina Faso, Mauritania, Niger and other neighbouring states, has been met.

Some 53,000 Malians fled to Niger, 96,000 to Mauritania and a further 174,000 are displaced within Mali, according to UNHCR.

UNHCR estimates that 107,929 refugees – up from 56,000 in May – are now spread across five official (and nine unofficial) sites in Burkina Faso, mainly in Damba, Sérélio, Mentao, (Sahel), Somgandé at Ouagadougou, and Bobo-Dioulasso in the west. However, others estimate lower numbers – a census is underway to determine an accurate figure.

WFP has enough food for 60,000 Malians until the end of September, said its head in Burkina Faso, Angelline Rudakubana. “After that, it will be really tough.” She estimates that at least 77,000 refugees need food aid, but other estimates put the figure much higher.

“We need to buy the food now,” said Rudakubana, because it takes “at least” three months to get food to landlocked Burkina Faso.

Northern Malians are struggling with the standard WFP rations, as they are used to a nutrient-rich diet dominated by milk, meat and tea, but there is nothing the food agency can do about this.

There are lots of other gaps besides food, said Francoise Kaboré, media coordinator at NGO Plan International in the capital, Ouagadougou. “Water and sanitation, housing – it’s very difficult… there are some camps that are harder to reach and are not getting enough aid at all,” she told IRIN.

Refugees living in Damba camp in Soum, in the Sahel zone, told IRIN that without water points or shelter, they and their animals share villagers’ shallow wells, and sleep under basic straw structures. “Here we have no water, no food and no house… nothing is good here,” nine-year-old Fati, from Timbuktu, told Plan International.

“We’re doing what we can but we don’t have all the money we need,” said Kaboré. Plan International works in protection, emergency education, water and sanitation, and non-food item distribution, which are collectively just 19 percent funded.

Photo: Plan International
Malian children in a temporary school set up by Plan International and UNICEF

Altakwa, a mother in Damba camp in Soum, told Plan: “Our biggest worry is the health of our children. They don’t eat enough and are exposed to new dangers, we’re scared for them.”

On top of these concerns, some 2.5 million Burkinabe in the Sahel face hunger this year. Severe drought in 2011 resulted in a poor harvest and scant pasture growth, and has now brought high food prices.

NGO Oxfam, which alongside UNHCR has set up most of the water facilities, said after a difficult start, things are starting to “stabilize”, with most refugees receiving 12-15 litres of water per day, meeting the international Sphere standard.

“We may be okay, as long as we don’t have a big influx [of more people]” said Konate Papa Sosthene, water and sanitation specialist at Oxfam.

Some 30-50 Malians are crossing the border each week, which is fewer than in April and May, said UNHCR’s senior field coordinator, Nasir Fernandes. Ag Gala, the chairman of a refugee coordination group in Ouagadougou, told IRIN, “Every day I receive calls that there are more people at the border, fleeing the living conditions and oppression.”

Many are pastoralists who have arrived with desperately weak, often sick animals. “They need vaccinations, medication for their animals – not many people are working in this area,” said Sosthene.

Agencies want to shift into the intermediate response phase – build more durable housing and latrines, for instance – but they do not have enough money. “Refugees are bound to stay until 2013,” warned Sosthene.

Long-term priorities include mediation, as in months to come pastoralists trapped in the country will be forced to bring their animals nearer camps and agricultural land, risking conflict between them and farmers, warns the UN Food and Agriculture Organization (FAO).

Agencies will also need to find a solution for the thousands of secondary school children and university students currently living ni cam[ps. Plan International, other NGOs, and the UN Children’s Fund (UNICEF) have opened pre- and primary schools in camps to educate 30,000 children, but the money will not stretch to secondary schools. “It is very difficult for these students,” said Kobaré.

There is no refugee education cluster or funding appeal ongoing in Burkina Faso. “Education is neglected. We need to act now to avoid creating a battalion of children fighters,” Thierry Agagliate of NGO Terres des Hommes, told IRIN.

Education is often not seen by donors as being life-saving. ”We have prioritized five life-saving sections, which include health, water, sanitation, food and shelter,” said Fernandes, “and we have not yet met 100 percent of the needs in these activities.”

After a trip to refugee camps two weeks ago, UN High Commissioner for Refugees Antonio Guterres, and US Assistant Secretary of State for Population, Refugees, and Migration, Anne Richard, called on donors to take more “determined action” to help the Sahel.

The refugees are still waiting.

bo/aj/he  source


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Cleaner toilets to save slums from cholera

Posted by African Press International on September 2, 2012

Public toilets in Kroo Bay slum in Freetown, do not entice users

FREETOWN/CONAKRY/ACCRA/DAKAR,  – Aid agencies are scrambling to treat thousands of cholera patients in Sierra Leone’s capital, Freetown, where the number of infections is mounting by over 250 per day. Most patients are from the city’s various urban slums, where open defecation is rife, toilets are rare, sewage is improperly disposed of, and awareness of cholera is very low. Water and sanitation specialists say unless these problems are addressed, cholera will continue to flourish both in Sierra Leone and throughout West Africa.

By 15 August, 19,370 people had contracted cholera in West Africa, the most affected countries being Sierra Leone (9,613 cases), Ghana (5,121 cases), Niger (5,023 cases), and Guinea (802 cases), according to the UN Children’s Fund (UNICEF).

“There is a massive failure to take cholera seriously in this region, and to publicize it,” said a West Africa cholera specialist. “Ultimately, if you want to get rid of cholera you need to address the structural issues that cause it.” The money is there, “it is a question of tapping into it and taking responsibility for your citizens.”

Take cholera seriously

Most West African countries are falling far short of their Millennium Development Goal to double the proportion of citizens with access to proper sanitation facilities – just 37 percent of inhabitants can access a clean toilet, according to the World Health Organization (WHO).

As in Freetown, a high proportion of the cholera cases in Conakry, the Guinean capital, and Accra, Ghana’s capital, are concentrated in urban slums, where there are few clean toilets and most people openly defecate, often dangerously close to open wells that are the source of water for most residents.

Photo: Anna Jefferys/IRIN
A mother tries to keep her baby clean in Kroo Bay

The cholera outbreak now has a caseload of 60 per week in Conakry and Accra and is thought to be past its peak, when there were 90 to 100 cases per day in each city, but Charles Gaudry, head of Médecins sans Frontières in Guinea, warned that “We must still be on our guard.”

Governments tend to clean up the cholera mess once it is in full swing rather than working on prevention, said an independent water and sanitation (WASH) specialist in West Africa. “It is government’s responsibility to address the very basic sanitation rights of its citizens.”

Donors, too, prefer to fund reactively, hence “UNICEF’s ‘Sword and Shield’ [response-prevention] strategy is more sword than shield,” noted Patrick Laurent, West Africa WASH coordinator at UNICEF.

When aid agencies approached the African Development Bank in 2011 for cholera prevention support in the Central African Republic, the response was: “When you report a cholera case, we’ll give you the money.”

In Guinea, just one or two aid agencies – Action against Hunger and UNICEF – work on cholera prevention with the government, while one – MSF – is doing the bulk of the treatment and transmission containment.

Ghana: prosecution over publicity

In Greater Accra, with 77 percent of the country’s cholera cases, at least 20,000 people have no toilet or use bucket latrines (a pot that is periodically dumped outside), according to Accra health department director Simpson Boateng. Those living near the sea simply defecate on the beach.

The Ghanaian government banned open defecation and bucket latrines in 2010, and arrests all perpetrators, said Boateng. “We need to continue to educate them [people], but more importantly, you will be arrested when caught,” he told IRIN. “As I speak, over 1,000 landlords have been prosecuted for still using pan latrines in their houses.” The city council is establishing a ‘sanitation court’ to try the culprits. “We are simply enforcing the by-laws which frown upon this conduct,” he said.

Cholera in Niger
In Niger, the situation is different in terms of topography and humanitarian context. Some 99 percent of the cholera cases are in the Tillaberi Region in the southwest of Niger, on the Niger River. The rest are in refugee camps in Ouallam, in southwestern Tillaberi.

Cholera has broken out against a backdrop of high rates of malnutrition and food insecurity, and large numbers of refugees who fled the takeover of northern Mali. The rains and insecurity make it difficult to access some cholera-hit villages, said UNICEF’s Patrick Laurent.

“If you add all of the above conditions, plus the rainy season, floods and poor sanitation, it’s not surprising to see a cholera outbreak,” he noted.

The government has a low capacity to respond to cholera but is willing to collaborate with the many relief and aid agencies working to alleviate the emergency there, said Laurent. “For me, this is half the battle.”

Rather than crackdowns, more awareness-raising is needed, suggested Accra residents, including journalists, who had no idea there was a cholera outbreak in their city.

Unlike in neighbouring Guinea and Sierra Leone, where the governments are weak and rely on aid agencies to drive the response, the Ghanaian authorities are leading the cholera response but have “underplayed it” for political purposes, said WASH specialist Laurent.

The recent death of President John Atta Mills and the approaching parliamentary elections have drawn the attention of most government officials for weeks.

Give them an alternative

Arrests may be a temporary deterrent, but people will continue to defecate in the open as long as they have no alternative, say aid agency staff. Just 17 percent of Accra’s residents, and 8 percent of rural Ghanaians, have access to an adequate toilet, according to the government’s 2008 health survey.

The key is to get communities all over West Africa to want to use and maintain clean toilets. In Sierra Leone, UNICEF is pushing “community-driven total sanitation”, in which communities move away from open defecation once they understand its consequences, and go on to build and maintain clean toilets themselves.

In this model, UNILEVER, which manufactures cleaning products, has worked with UNICEF and local partners in Gambia, and with Water and Sanitation for the Urban Poor, a non-profit group, in Ghana to form The Clean Team. The process is: trigger a demand for toilets through behaviour change; arrive at a price that works for everyone; and then make clean toilets available.

An ongoing project in Kumasi, south-central Ghana, targeted 100 families, most of whom were sharing dirty latrines. Each was given a free chemical toilet with a sealed waste container that was exchanged two to three times per week. A family of five pays about US$15 per month for the service, which is less than it costs to use the public toilet.

The waste is processed in the city’s septic tank system, but the municipality hopes to use it to produce biofuel in the future. Thus far the scheme has improved hygiene, lowered household costs and reduced the use of plastic bags for defecation, otherwise known as “flying toilets”, said Clean Team manager Asantewa Gyamfi. The plan is to expand it to 1,500 families.

Keeping toilets clean

Transferring such an intensive approach to an urban slum setting in Freetown is a challenge, said UNICEF’s Sierra Leone communications specialist, Gaurav Garg. Most of Freetown’s flood-prone slums are hemmed in by the ocean and/or mountains, and there is simply no room to build new toilets – public latrines are the only option.

An urban WASH consortium – made up of NGOs Oxfam, Action against Hunger, Save the Children, GOAL, and Concern – charged with helping the government improve sanitation in Freetown’s slums, has decided that improving and rebuilding public toilets is the only option, but keeping them clean is the real challenge, said Marc Faux, the group coordinator.

Photo: Anna Jefferys/IRIN
Upkeep of public latrines is the challenge

Community committees have been set up to run the toilets. Each is given four roles: collect money for their use (usually 100-200 leones per person [2 to 4 US cents] use the money to clean and repair the toilets; communicate the community’s sanitation concerns to political decision-makers; and make sure waste is dumped safely. Health officials say until each of these jobs is done well, use will continue to be low.

To date, most of the waste from public latrines has been dumped in nearby rubbish tips or into the sea. The NGO consortium is currently experimenting with a low-technology device that pumps waste into containers that can then be taken to trucks. Another method being tested is a device used to separate urine from faecal matter, which can then be turned into compost over an 18-month period.

These and other innovations are an important start to addressing the myriad challenges in unsanitary, densely populated, coastal cities such as Freetown, Conakry and Accra. But they will only make a dent in cholera prevention. The issue must be addressed, “not on a project-by-project basis, but holistically, involving education, health systems, water and sanitation infrastructure – the lot,” said Mariamme Dem, West Africa head of NGO Wateraid in Senegal.

That looks a long way off. For now, NGOs like MSF are hastily setting up treatment centres to care for the cholera victims who come their way – as they have done every few years since the 1980s.

aj/js/ic/bb/sda/he source


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