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Archive for October 22nd, 2012

Spirited fight against malaria in Mali

Posted by African Press International on October 22, 2012

MSF doctors give children dose of Fansidar in Koutiala

DAKAR,  – A pioneering malaria prevention method trialled in Mali is dramatically reducing seasonal malaria among children, according to a mass pilot launched by NGO Médecins Sans Frontières (MSF) in August 2012.
In Koutiala District in the southeast, 170,000 children were given a three-day course of anti-parasite medicine amodiaquine and sulfadoxine/ pyrimethamine (branded as Fansidar) on a monthly basis during the high transmission period of the disease between July and October.
MSF teams witnessed a 75 percent decline of uncomplicated malaria cases and a more than 60 percent decline in disease-related hospitalizations in the week following the distribution of the medication.
“The effects happened overnight,” Johannes Sekkenes, head of the MSF mission in Mali, told IRIN. “In the district hospital in Koutiala, as soon as the treatment started to take effect, the number of hospitalized children dropped. Today, the hospital has 120-150 children hospitalized, whereas this time last year there was around 300, 70 percent of whom had severe malaria,” she said. Most of the hospitalized children in Koutiala are malnourished with complicating factors, usually malaria or diarrhoeal diseases.
Nurses and community health workers orally administer the first dose via directly observed treatment (DOT) at fixed distribution sites or door-to-door in smaller villages. During this visit, the mother is taught how to administer the remaining two doses for that month. “The mothers know that malaria is a killer and this really keeps kids alive. Consequently, the population has adhered to the strategy in a very positive way,” said Sekkenes.
“This is not so much a wonder drug as a highly effective strategy which is targeted at the peak period of risk when over 80 percent of malaria attacks occur in countries like Mali, Senegal, Chad and other parts of the Sahel,” said Sian Clarke, a malaria expert at the London School of Hygiene and Tropical Medicine. Health workers and MSF doctors stressed that such interventions must go hand in hand with other prevention activities to have a wide-scale, long-term impact. “To really have a global impact you have to implement the programme in all the health districts, as well as to ensure you use other malaria-fighting strategies such as mosquito nets and insecticide spraying,” said Sekkenes. Resistance and side-effects Fansidar, the registered trademark for sulfadoxine /pyrimethamine was once widely used to treat malaria throughout Africa but has been phased out and replaced by artemesinin combination therapies (ACT)  partly because resistance to Fansidar had built up.
There is a possibility that this resistance could also build up in West Africa. However, following studies in 2011 the World Health Organization (WHO) has recommended that the drug can be used for prevention as long as it is used in “multi-therapy” alongside other drugs like amodiaquine (an anti-malarial linked to chloroquine), and only for 3-4 months a year in areas with seasonal malaria.
“A number of research papers have been written analysing this question of resistance. So far, there has been no evidence to suggest that build-up of resistance could be a problem,” said Clarke.
Another concern, specific to malaria, is the way prevention therapies may hamper natural immunity, which is acquired slowly and relies on repeat exposure to infection. Delaying the build-up of this natural immunity could lead to an increased risk of dangerous malaria attacks in adulthood, noted Clarke. “It was precisely these concerns that have held back implementation of preventive strategies in the past,” she said.
Other concerns related to the potential side-effects – amodiaquine can lead to vomiting in a child and sulfadoxine/pyrimethamine can in rare cases spark off allergic reactions, calling for strict ongoing surveillance, notes MSF. Roll-out Though obstacles and concerns remain, the Malian Ministry of Health plans to run the programme in five regions – Koutiala, Kita, Kolokani, Bankass and San – in 2013 and roll out the programme across the rest of the country by 2014, said Klénon Traoré, director of the National Programme to Fight Malaria (PNLP). Although the drug is relatively cheap (50 US cents per child per month) and generic forms are available on the market, it is a costly drug to administer in terms of training healthcare workers, door-to-door visits in isolated areas, and educating mothers on how to give the final two doses every month. “We have the funding for the programme, but we are not sure if it will be available in the future,” said Traoré. International donors have withdrawn most direct aid to the Malian government following the March coup, and pending democratic elections, which are not expected to take place anytime soon.
The takeover of the north is also a handicap, he said, in implementing the programme as planned in July 2013.
The drug has also been rolled out to 10,000 children in Chad, which also experienced a sharp decline in malaria cases just after treatment. Over 650,000 people die from malaria every year and 90 percent of these fatalities occur in sub-Saharan Africa, most of them young children.

mh/aj/cb

source http://www.irinnews.org

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A major Norwegian demining NGO says it is ready to begin mine-clearing in southeastern Myanmar

Posted by African Press International on October 22, 2012

Thousands have fallen victim to landmines

YANGON,  – A major Norwegian demining NGO says it is ready to begin mine-clearing in southeastern Myanmar once it receives a green light.
“As soon as we get the go-ahead from both the government and relevant ethnic groups, we can start doing a survey, and then clearance,” Andreas Indregard, country director for NGO Norwegian People’s Aid (NPA) in Myanmar, told IRIN. “From our side, we’re ready to act.”
On 26 September NPA signed an agreement with the Burmese government for the clearance of landmines in Kayah State (eastern Myanmar), Karen and Mon states, as well as the Tanintharyi and Bago regions (all in southern Myanmar).
“But for each area covered by our MoU [memorandum of understanding], we need all relevant groups in the area to agree,” Indregard said, adding: “Mine action is a new kind of intervention in Myanmar, and it takes a little bit of time to get everyone on board.”
Currently there is no organized demining activity in Myanmar and no one is sure if and when it may begin. In June the UN Mine Action Service (UNMAS) reportedly made its first visit to Myanmar in a decade and discussed the possibility of mine clearance with senior officials.
There is little available data on the extent of landmine contamination in Myanmar, though reports indicate the country has one of the highest death and injury rates from landmines in the world.
An estimated five million people live in townships that contain mine-contaminated areas, and are in need of mine risk reduction education, a 2011 report by Geneva Call, a Swiss-based rights group, reported.
However, recent peace initiatives with various ethnic militias have included demining as part of the peace process.
“Mine clearance is very important for the future of Myanmar, especially in the context of the peace process,” said Indregard. “In many areas, it will be impossible or very dangerous for IDPs [internally displaced persons] and eventually also refugees to return to their original areas of residence unless demining takes place first.”
According to the Thai-Burmese Border Consortium, an umbrella group of NGOs working along the 1,800km Thai-Burmese border, there are over 400,000 people who are either internally displaced or living in refugee camps across the border in Thailand.
Many of these would return to their places of origin if security permitted, the NPA believes.
Landmines are believed to be concentrated on Myanmar’s borders with Bangladesh and Thailand, but are a particular threat in southeastern parts of the country as a result of post-independence struggles for autonomy by ethnic minorities in Kayin (Karen) State, Kayah State, the southern part of Shan State, Mon State and Tenasserim/Thanintharyi, according to the Landmine Monitor.
Demining could take years

Photo: Nyan Lynn/IRIN
Demining could allow many IDPs to return to their homes

Activists say both government forces and non-state armed groups use landmines heavily, and anti-personnel mines have resulted in at least 2,800 dead or injured over the past 10 years, according to the Geneva-based International Campaign to Ban Land Mines (ICBL).
IDPs are particularly vulnerable to landmine accidents because of their frequent movement. In the most mine-contaminated areas, both IDPs and residents sometimes abandon fertile agricultural land because of the threat.
ICBL’s Yeshua Moser-Puangsuwan said all parties should publicly commit to achieving a complete ban on landmines, including the destruction of mine stocks and production facilities.
“The first step in mine clearance is a verified halt in any new use of mines by all combatants in a given area,” Moser-Puangsuwan said. “If the concerned entities do not put in the appropriate resources and make it a high priority, Myanmar will remain mine-affected for decades.”
NPA’s Indregard said that, based on what they know already, demining will take several years.
“One challenge will probably be the lack of adequate minefield maps,” he said, “as many actors have laid landmines without accurate records of where the mines are.”
Landmines in Kachin State
Meanwhile, in Myanmar’s northernmost Kachin State, aid groups report the continued use of landmines by both sides in the conflict, more than 16 months after the collapse of a 17-year ceasefire between the government and the Kachin Independence Army (KIA), which has been fighting for greater autonomy for the past six decades.
According to the UN, there are some 75,000 IDPs in Kachin State, up from 70,000 in August. More than half of the IDPs are in 36 camps in KIA-controlled areas.
“Even if the war comes to an end now, it won’t be safe for the IDPs to return to their villages because of landmines,” warned Zau Jar, director of Light Bamaw Development Organization, a local charity helping the displaced.
Myanmar is not a signatory to the 1997 Mine Ban Treaty, an international agreement banning the use, stockpiling and production of anti-personal mines.
nl/ds/cb

source www,irinnews.org

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Facing insecurity with unreformed army

Posted by African Press International on October 22, 2012

An IDP camp torched in July.  Insecurity is a major problem since Côte d’Ivoire’s 2010-2011 poll violence

ABIDJAN,  – Armed raids on military and police bases, a border post and other key installations in Côte d’Ivoire since August are deepening insecurity in a country struggling to forge a unified armed force to help restore stability after 2010-2011 electoral unrest. On the night of 14 October, armed men attacked a power station in the commercial capital Abidjan. Another gang hit a town in the east of the city where they tried to break into a police and paramilitary forces’ base.
In August, gunmen raided military posts and police stations in separate incidents in Abidjan. On 20 September, three people were killed when armed assailants attacked two police stations and a paramilitary forces’ post in Port-Bouët to the south of Abidjan. Hours later gunmen attacked the Noé border post with Ghana, some 170km east of the city. The government of President Alassane Ouattara came to power after months of vicious battles between his forces and those loyal to Laurent Gbagbo, who was ousted from the presidency after his refusal to accept defeat by Ouattara in the November 2010 elections. Reforming the army, deeply divided by the conflict, is a key priority for Ouattara’s government, but there has been little progress since he took power in April 2011. The authorities blame exiled Gbagbo loyalists for the spate of attacks, an accusation the supporters of the former president deny, but many Gbagbo sympathizers have been arrested on suspicion of involvement in the raids. “The government makes nice speeches, but political divisions are so great that they are affecting the institutions. The FRCI [Ouattara’s forces] are so politicized. The authorities must make sure that their restructuring conforms to international standards and that they work for the country and not for a party or an individual,” Muhammad Iqbal Asi, commander of the UN forces in Côte d’Ivoire (UNOCI), told IRIN. Need for disarmament
UNOCI estimates there are 60,000-80,000 former fighters who should be disarmed, but Côte d’Ivoire’s Defence Minister Paul Koffi Koffi says the number is much lower at 30,000. It is also estimated that 1-3 million arms are in circulation in the West African country. “It’s the same thing every year. They do a census (of ex-fighters) but nothing comes out of it. I can die of hunger if I wait for the authorities to do anything for me,” said Youssouf Koné, explaining that he took up arms during the post-election violence, but has since returned to his taxi business.
“Personally I don’t associate the FRCI with the national army, but think of them as a pro-Ouattara militia that neither represents the country nor the people,” said Aboubacar Coulibaly, a resident of Abidjan’s Yopougon District which was a Gbagbo stronghold during the conflict.
The government in August set up a disarmament, demobilization and reintegration body which started work in Bouaké, Côte d’Ivoire’s second biggest city in the central region. Previous disarmaments have had little success.
The country’s reformed army is supposed to be incorporating fighters who backed Ouattara, members of the national army under Gbagbo and men who took up arms for the fight in Abidjan, the scene of the worst clashes during the months-long conflict. Not all fighters can join the national force and those left out could be a threat to security if they are not properly reintegrated into the society, Mamadou Koulibaly, a former national assembly speaker who now heads a political party, said in comments carried by a local paper.
“Today, Côte d’Ivoire has no army, but is gripped by several armed groups fighting each other and taking the people hostage,” Koulibaly said.
Rodrigue Koné of the Centre for Action and Peace Research, a Côte d’Ivoire research group, said ethnic animosity was also a major problem within the army. “The army’s internal weakness is defined by personal and ethnic rivalries. Even within the FRCI, there are divisions and infighting among the personalities young recruits identify with.” More FRCI patrols
Since the resurgence of violence, the government has ramped up security surveillance. In Yopougon, for instance, armed patrols are on many of the neighbourhood’s intersections.
“FRCI were previously in the barracks, but now they are everywhere,” said Jean-Claude Tako who lives in Yopougon where residents now return to their homes early to avoid a brush with the forces.
René Legré Hokou, head of the Ivoirian Human Rights League, told IRIN that in the aftermath of the attacks in August FRCI troops conducted violent searches and stole from civilians.
“Suspected Gbagbo supporters are being abducted and taken to unknown places and later released after paying 100,000 or 200,000 CFA (US$200 or $400) in ransom.”
ev/ob/cb

source http://www.irinnews.org

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