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Archive for July 11th, 2013

Boost for fistula treatment

Posted by African Press International on July 11, 2013

Doctor Mulbah leading a girl to surgery

MONROVIA,  – The fight against fistula is gaining ground in Liberia, where doctors and nurses at 48 health clinics have been trained to treat the condition.

Since the launch of the Liberia Fistula Program (LFP) in 2007, a government scheme supported by international network Zonta International and UNFPA, doctors have treated 1,026 fistula cases. All treatment is now free.

While only six doctors in the country are able to perform the surgery, 65 professional nurses have been trained to train colleagues in fistula management in rural health clinics. Some 300 trainees are currently enrolled.

Obstetric fistula is a medical condition that occurs when a foetus gets stuck in the birth canal during childbirth, thus causing a hole between the rectum and vagina.

Most at risk are teenagers whose bodies are not fully developed to give birth, according to LFP. Most patients treated thus far have been impoverished girls and women aged 11-20. Some 75 percent of Liberian females give birth without the supervision of a trained health worker, which leads to high levels of mortality and morbidity, including obstructed fistula, according to UNFPA.

The high level of fistula has also been linked to high rates of female circumcision, which can lead to birth complications and obstructed labour, and the high incidence of rape of teenage girls, according to the Gender Ministry, which cited 2,493 cases of reported rape of minors in 2012.

Part of LFP’s work has been to raise awareness of the presence of fistula treatment; encourage women to come forward; and prevent fistula from occurring by encouraging Liberians to practice family planning and seek assistance from a trained health worker when giving birth.

Public health messages have gone out in 25 local dialects. They try to break down common myths, including that fistula is caused by witchcraft and cannot be treated medically, said John Mulbah, lead surgeon with the LFP. Such beliefs have prevented many women from seeking treatment to date. Rejected by their families, “several have attempted suicide,” said Mulbah. “They think the situation is due to a curse from their ancestors.”

Steady increase in patients

According to the most recent situational analysis on fistula (2006), 57 percent of long-term sufferers are abandoned by their husbands or partners.

However, many women continue to be rejected by their communities, even once they have been treated: Doctors and government officials have recognized the need for an LFP rehabilitation and reintegration component.

With more people flocking to health clinics to treat fistula, LFP is struggling to keep up with demand. Staff need more vehicles to help bring patients to far-away clinics, and to monitor patients who have returned to their homes, said Mulbah.

But he welcomes the steady increase in patients. “We as doctors are proud that these women can start to see themselves as being important in Liberian society. Their hopes are being restored… the fight will continue to save more women.”

Hawa Soko, 15, a resident of Monrovia, recently received treatment, and has been trained to become a tailor. “I feel very happy with my new situation. I used to smell and people used to call me all names because of my condition. I used to cry every night and wonder why my life was like that… Today, my life is transformed. I am a new woman. I am very happy.”

Tenneh Jones, 19, also recently treated, told IRIN she dropped out of school because of her condition. Now she is back. “Today I have a new lover and things are fine with us,” she told IRIN.

UNFPA launched a campaign in 2003 to end fistula in 45 countries, focusing on treatment and prevention. It says two million women and girls in sub-Saharan Africa, South Asia and the Arab region live with fistula.

pc/aj/cb source http://www.irinnews.org

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Scepticism over relocation plans

Posted by African Press International on July 11, 2013

YAOUNDE,  – Plans by the Cameroonian authorities to move thousands of survivors of the 1986 Lake Nyos gas explosion back to their original homeland have provoked opposition, with concerns over environmental safety and potential land disputes.

Some 12,000 people now live in camps in the Menchum area in Northwest Region following the August 1986 disaster in which carbon dioxide spewed out of the nearby volcanic lake, engulfing villages and killing hundreds of people.

Adolphe Lele Lafrique, head of the Lake Nyos Disaster Management Committee and the governor of Northwest Region, announced in June that survivors would be relocated to Nyos area, but did not say when and how they would be repatriated.

Jeanvier Mvogo of the Department of Civil Protection at the Ministry of Territorial Administration and Decentralization said work was under way to render resettlement in Nyos safe.

“The disaster management committee simply alerted the victims to prepare their minds that they will be returning to their homeland. No exact date can be given because work is still going on,” Mvogo told IRIN.

Despite the safety assurance, reticence abounds among the survivors and some environmental groups. “The announcement to resettle victims in Nyos is questionable,” said David Neng of Environment Watch, a local NGO.

“A lot more needs to be done at the site such as building infrastructure and public utilities that will accommodate the people. Problems related to land rights and the use of natural resources by the victims and the people who rushed to settle in Nyos some years after the tragedy need to be solved,” he told IRIN.

For Njilah Isaac Konfor, a campaigner for Lake Nyos disaster survivors, the Cameroonian government has “made great efforts in de-gassing the lake… But the efforts have been rather slow if we consider that the disaster happened 27 years ago and the survivors have been living in these makeshift camps for this long.”

Distrust

The survivors were accommodated in seven resettlement camps. However, basic health, education and other necessities are scarce. Pastoralist communities have been forced to take up farming on small plots, while farming communities decry the lack of sufficient land.

“I don’t trust these promises [to be relocated to Nyos]. It’s been 27 years in this camp and we still lack basic necessities such as hospitals, water and sustainable livelihood support. I don’t think life there will be any better,” said Ismaela Muhamadu who lives with his eight children and two wives in a mud house in Upkwa village in Menchum.

Muhamadu was six when the disaster struck. His parents and siblings were among the 1,800 people killed by the carbon dioxide cloud that swept through Nyos village and up to 15km from the lake, snuffing out almost all human and animal life.

Initially some 4,500 people who could not find refuge were resettled in the camps. This population has risen to around 12,000.

“I’d rather suffer here than die in Nyos. What we need is support not relocation,” said Salifu Buba who lives in Kumfutu camp in Menchum. “We don’t have rights to grazing land. The 30-50 square metres allotted to each household is not even enough for farming, let alone grazing.

“What we know and like to practice as Bororo [ethnic group] is cattle grazing, but when we came to the camp we had no other choice but to become farmers. Many cannot survive on farming because Bororo people dislike farming,” said Buba, 57, arguing that the government should have offered them more sustainable solutions such as giving each family one or two cows to raise. Instead, the government gave them farm tools and oxen for ploughing.

A different view, however, can be heard among residents of nearby Ipalim camp, which hosts mainly Bantu people who are subsistence farmers.

“I would like to go back to the land of abundance because with the few square meters of land that each family was allotted in this resettlement site it is difficult to practice farming,” said Stephen Nju. “We beg for farmland from the community that accepted us here, but we are always regarded as strangers and we have several incidents of farmer-grazer conflicts.”

“We have heard that so much work is going on in Nyos to de-gas the lake and fortify the dam, but we are still waiting for the promises of returning to Nyos to be realized. This camp site is so isolated, we don’t have access roads and health centres,” said Lydia Nzeh, another Ipalim resident.

De-gassing

According to SATREPS, a Japanese government research programme working on safety at Lake Nyos, carbon dioxide from the lake was reduced from 710,000 to 425,000 tons between 2001 and 2012, a 40-percent reduction. The gas concentration around the lake is now considered negligible, said SATREPS in a report.

“The gas level in the lake does not pose any danger to the people around the lake but de-gassing work continues,” said Mvogo of the Department of Civil Protection.

A community of some 200 people currently lives near Lake Nyos around which a security zone has been established with military surveillance to protect installations and infrastructure for the de-gassing project.

However, there are also concerns about the possible breach of the lake’s dam. “Operations have begun to strengthen the weak natural dam. This will reduce the danger of the dam failing and creating a flood,” said Laban Tansi, an Environment Ministry official.

mn/ob/cb source http://www.irinnews.org

 

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Internally displaced Yemenis hope the NDC will help them to return home

Posted by African Press International on July 11, 2013

Internally displaced Yemenis hope the NDC will help them to return home

SANA’A,  – Four months into their six-month mandate, the 565 Yemenis taking part in the National Dialogue Conference (NDC) know they have their work cut out to agree the blueprint for a new Yemen.

While the drawing up of a new constitution ahead of presidential elections scheduled for early next year is the most immediate concern, many Yemenis look to the NDC not just to manage the political transition, but fundamentally to improve their lives in a country with deep humanitarian needs.

Nearly half the population do not have enough food, most (13.1 million) do not have access to safe water and sanitation, and nearly a million children are acutely malnourished, according to this year’s Humanitarian Response Plan.

“Our objective was to create a new country,” said NDC member Fuad Al-Hothefy from the Youth Revolution Council who took part in initial Arab-Spring protests against the then president, Ali Abdullah Saleh, in early 2011.

“Before 2011, wherever you meet anyone in the world they mention Yemen with poverty, terrorism, corruption – all bad things.” He sits on the NDC “development” sub-group, one of nine such sub-committees.

Much of the work takes place in a luxury hotel on the outskirts of the capital Sana’a, but regional meetings to “meet the people” have brought political and community leaders face to face.

“When our people went to Aden [southern city] the population said `Go back, what are you doing here? You don’t even care, you don’t know what we’re going through’,” Nadia al Sakkaf, editor-in-chief of the Yemen Times and a member of the NDC, told IRIN.

“The people from Sana’a admitted it, and they said `Oh my God, we didn’t know!’ They were really shocked at the miserable conditions in which the people there are living. They are reporting on it daily saying that people are lying in the streets, almost lifeless, but not because they are dead but because they have no sense of living. And there’s a massive resentment building up.”

“What does national dialogue mean when you cannot even find food for yourself, when you cannot put your children in school?”, Ismail Ould Cheikh Ahmed, humanitarian coordinator

In the last few days thousands in the once independent south have again protested in favour of secession, accusing the government of neglect.

Poverty threatens transition

Ismail Ould Cheikh Ahmed, the humanitarian coordinator in Yemen, says that while the political process is moving forward, the security situation and humanitarian issues risk destabilizing the process.

“What does national dialogue mean when you cannot even find food for yourself, when you cannot put your children in school? Last year we had a major measles outbreak, so when you have these things, what does it mean for you to have a national dialogue, what does it mean for you [to have] a constitution?” he told IRIN.

“This is a country that has gone through 30 years of crisis, and 30 years of conflict, of mismanagement, of corruption… Let’s be frank, I mean the Yemenis themselves are very open about that today. So if these people don’t receive also assistance – on the health side, on early recovery, or in reconstruction of people’s lives – the whole process will collapse.”

The latest humanitarian bulletin published this week by the UN Office for the Coordination of Humanitarian Affairs (OCHA) reports that “although the National Dialogue is key to ultimately resolving the crisis, it also runs a real risk of overshadowing the immediate need to maintain effective humanitarian assistance for the rest of 2013.”

While regional NDC fact-finding meetings seem to have been appreciated by Yemenis, including those displaced by fighting between government forces and Houthi rebels in the north, cynicism is rife regarding the ability of the NDC to find a solution to people’s basic needs.

 

“They come to the camp and sit with them. But the IDPs [internally displaced persons] say they know there’s a lot of hot air,” said Khalid Marah, assistant camp manager at al-Mazraq IDP camp, with Islamic Relief.

“We talk about the national dialogue, but people say `they are all liars.’ The IDPs say that they know it won’t be 100 percent successful. But they say they have to wait – they’re not losing anything. They’ve spent three years here and in another few months we’ll see what the situation is.”

High expectations

But in other quarters, the NDC is sometimes seen as a magic bullet that can end the conflict, insecurity and lack of basic development.

NDC has brought together a wide range of actors, including some from the southern secessionist movement and representatives of the Houthi rebels who hold sway in the northern governorate of Sa’dah.

In the northern town of Haradh in Hajjah Governorate, home to just over 100,000 IDPs from the conflict in neighbouring Sa’dah, the head of the local council, Sheik Hamoud Haidar, told IRIN he was looking to the NDC to bring peace and ensure IDPs return home.

“Inshallah, the NDC will provide the solution. Inshallah the NDC will come up with the solution.”

Mohamed Saad Harmal, assistant head of the government’s Executive Unit for IDPs in Sana’a, also sees the NDC as the key to ending displacement: “We have to be optimistic – there is no other option – else we’ll get lost. I told the National Dialogue that we only have three options – negotiate, negotiate and negotiate.”

That puts considerable pressure on the NDC.

“Many people they are waiting for the output from the NDC,” said NDC delegate Al-Hothefy. “Either we lead Yemen to be a good country, or we will fail. Most members of the NDC, I think, are working hard to achieve good results from this, but most people they expect a solution for everything.”

NDC factbox
565 members
Make-up:
– political parties
– civil society
– independent youth
– women (nearly 30 percent)
– Houthis
– Southern Movement
Time-frame: 18 March – 18 September 2013

Some are simply fearful that if the NDC does not succeed, the country risks falling back into civil war.

Realism

“I think there are too many hopes pinned on the National Dialogue, but that’s what the ND was supposed to do – it was supposed to resolve national issues,” said Yemen Times’s al-Sakkaf. She says Yemen’s problems are not new.

“How can you suddenly have a deforestation problem or a khat problem? We’ve always had these problems. Recognizing there are problems is the first step to a solution. 2011 helped us realize that we need to do something about them urgently – and it’s because we took sort of the power from the lazy leaders who did not want to do much about it.”

For the next two months, NDC delegates will meet in their hotel, protected from the food shortages and power cuts that plague much of Yemen. One aid worker wondered if, like the Somali peace talks, the meetings will drag on for years as delegates enjoy the benefits.

“What we’re doing in that five-star hotel is in isolation from the rest of the country,” said al-Sakkaf. “It’s a major risk because whatever we come up with – even if it’s the best constitution – the rest of the country will just throw it out because they will say `This doesn’t represent us. Where were you when we were starving?’”

Whatever comes out of the NDC process, say delegates, will only be pieces of paper which, however thoughtful, will ultimately have to be implemented by a future government.

jj/cb  source http://www.irinnews.org

 

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