Forced or servile marriage – Debt bondage

Photo: David Longstreath/IRIN

A young boy works as a labourer near Kathmandu (file photo)

NAIROBI,  – More than two centuries after slavery was outlawed, 29.8 million people globally continue to be subjected to new and diverse forms of servitude, a new index ranking 162 countries shows.

Haiti, India, Nepal, Mauritania and Pakistan have the highest prevalence of modern-day slavery, according to the first edition of the Global Slavery Index(compiled by Australian-based rights organization Walk Free Foundation), while in absolute numbers, China, Ethiopia, India, Nigeria and Pakistan have the most people enslaved. In India, almost 14 million people are believed to be victims of modern slavery.

Contemporary servitude, however, is “poorly understood, so it remains hidden within houses, communities and worksites”, it stated.

According to Gulnara Shahinian, the UN special rapporteur on contemporary forms of slavery, its causes and consequences, “contemporary slavery… often occurs in hard to reach areas of the country or what is perceived as the `private realm’, such as in the case of domestic servitude…

“In today’s world, slavery takes many different forms: human trafficking, forced labour, bonded labour, servitude… These people are controlled and forced to work against their will and their dignity and rights are denied.”

IRIN looks at some of the major forms of modern-day slavery.

Forced labour: The International Labour Organization (ILO) considerscompulsory or forced labour any “work or service exacted from any person under the threat of a penalty and for which the person has not offered himself or herself voluntarily.”

Common forms of forced labour can be found in under-regulated or labour-intensive industries, such as agriculture and fisheries, construction, manufacturing, domestic work, and the sex industry. A 2013 ILO report, highlighted some of the brutal conditions under which people are made to work in the fisheries industry. This category can apply to multiple forms of slavery, with people being forced to work in a variety of ways, often including the threat of violence or debt bondage.

ILO estimates that around 21 million people are victims of forced labour.

Debt bondage: This is the most common form of contemporary slavery, according to the London-based NGO Anti-Slavery International, which says “a person becomes a bonded labourer when their labour is demanded as a means of repayment for a loan. The person is then tricked or trapped into working for very little or no pay, often for seven days a week.”

In Pakistan, the Asian Development Bank estimates that 1.8 million people are bonded labourers, primarily working in brick kilns as well as in agriculture, fisheries and mining. In Brazil’s rural sector, a 2010 UN report found that many poor workers were enticed to distant areas by intermediaries, who charged an advance on their salaries, promising high wages. The workers found themselves paying hefty off loans for the cost of their transport and food, without any clear indication of how their debt or wages were being calculated.

Similar practices occur in Bangladesh.

Human trafficking: The UN Convention Against Transnational Organized Crime defines human trafficking as the “recruitment, transportation, transfer, harbouring or receipt of persons”, through the threat or use of force or other means of coercion “for the purpose of exploitation”.

In Benin, the International Office for Migration estimates that more than 40,000 children are the victims of trafficking. The Global Slavery Index notes that many of these children are trafficked to countries within the region, as well as from rural to urban areas within one country.

Forced or servile marriage: This occurs when an individual does not enter into a marriage with full and free consent. The 1956 Supplementary Convention on the Abolition of Slavery considers illegal any practice where “a woman, without the right to refuse, is promised or given in marriage on payment of a consideration in money or in kind to her parents, guardian, family or any other person or group”. Transfer of a woman by her husband in return for payment, as well as inheritance of a woman following the death of her husband, is also outlawed. While the definition only applies to women and girls (who bear the brunt of forced marriages) there have been calls for it to cover boys and men too.

Child slavery: Child slavery and exploitation, including the use of children in armed conflict, is another common form of contemporary slavery. The Worst Forms of Child Labour, defined by ILO include the sale and trafficking of children, compulsory labour, serfdom, and the compulsory use of children in armed conflict. In Haiti, children from rural households are sent to urban areas to work as domestic house helps for wealthier families and can then be exploited. Around 1 in 10 children in Haiti are exploited, according to the Global Slavery Index.

While child slavery remains a significant problem, the number in child labour around the world reduced to 168 million in 2012 from 246 million in 2000, according to ILO.

Chattel slavery: A situation where a person or group of people is considered the property of a slave-owner, and can be traded, is the least common form of slavery today. Slave-owners in these situations control victims and their descendants, and therefore individuals are often born enslaved.

Although slavery was finally criminalized in Mauritania in 2007, leading to the freeing of many people, few slave-owners have been convicted of the practice, and chattel slavery remains a serious problem. The Global Slavery Index estimates there are 140,000-160,000 slaves in Mauritania.

aps/aw/cb  source http://www.irinnews.org

 

Norway condemns terrorist attack in Pakistan

“Norway condemns the appalling terrorist attack on a church in Peshawar, Pakistan, on 22 September. The attack must be investigated and those responsible brought to justice,” said Minister of Foreign Affairs Espen Barth Eide.

The attack on a church in the old part of the provincial capital Peshawar took place just after Mass on Sunday morning. The congregation had gathered outside the church for a free meal when two explosions killed more than 70 people, including many women and children, and injured more than 100. This is the worst attack on Pakistan’s Christian minority for many years.

“Our thoughts are with the victims, their loved ones and the Palestinian people,” said Mr Eide.

The terrorist attack is the latest in a series of tragic attacks on religious communities in Pakistan. These include a number of attacks on the country’s Shia Muslim minority earlier this year. Sunni Muslim extremists are behind them.

“I am very concerned about the growth of terrorist movements in Pakistan.

“These terrorist attacks hit innocent people and are destabilising Pakistan. The authorities must take resolute action,” said Mr Eide.

 

End

 

Devastating floods have become common in recent years

Photo: UNICEF Pakistan/2011/Warrick Page

Devastating floods have become common in recent years

SIALKOT,  – Monsoon rain, which started at the end of June in Pakistan, has already killed 80 people and left over 81,000 displaced, according to the National Disaster Management Authority (NDMA), despite improved preparedness plans being in place.

Sialkot District, about 120km northeast of Lahore, saw torrential rain on 6 August: Drains almost immediately overflowed, villages were inundated, agricultural land damaged and residents left stranded as water surrounded homes.

“People are being rescued in all the affected areas,” District Officer (coordination) Malik Abid Hussain Awan told IRIN, saying that 47 villages in the district had been affected.

The government and relief agencies are on high alert this year after serious flooding in the last three years. Flooding in 2010 killed around 2,000 people.

There has been some more rain over the past few days and the fear is that, with more rain forecast for later this month, tributaries of the rivers Ravi and Chenab in Punjab could burst their banks.

However, the authorities say they are well prepared. “We have held meetings including those with the chief ministers, chief secretaries, and major humanitarian agencies well ahead of the monsoon,” NDMA spokesman Brig Kamran Zia told IRIN.

Fifty-one districts (out of more than 100) have been identified as at risk from floods. Primary responsibility for managing flooding was allocated to district-level disaster management authorities following devolution in 2010.

NDMA’s plan, Zia said, included the securing of protective walls along water channels, the provision of boats to rescue marooned people and the readiness of armed forces to intervene where required. Training has also been given to district teams.

“Though a shortage of resources is a problem, we have a plan in place to meet the food and non-food needs of eight million people,” Zia said.

This year there is better tracking of meteorological information than before, the government says. Risks are being assessed based on data from the country’s Metrological Department, regional weather monitoring bodies, and Pakistan’s Satellite Research and Development Centre.

“We have lost our homes and lands in many cases, and are living with very little shelter of any kind”

In terms of stocks, NDMA has decided that food rations for affected and displaced people will be bought as required. “We naturally didn’t want to waste money on buying things that would not be needed, and of course food items such as wheat flour, and so on, are perishable and cannot be stored indefinitely in warehouses,” said Zia, adding that any items required could be bought with a “two-day lead time”.

“The provincial and federal governments already finalized contingency plans well in time, and have started responding to the affected people. But we still need to strengthen the DDMA [District Disaster Management Authorities] and local administrations as they are the first responders,” Arif Jabbar Khan, international country director for Oxfam, told IRIN.

So far, according to Oxfam, the government has provided 15,330 tents, 3,996 food packs, 500 blankets, 13,000 mosquito nets and 12 de-watering pumps, and miscellaneous food and non-food items are also reaching affected communities.

Flash floods

The heaviest rain in the past few days has been in Jacobabad and Karachi in Sindh Province, Chitral in Khyber Pakhtunkhwa (KP) Province, in the Kalat region of Balochistan as well as in parts of Punjab, according to Kamran Shariff, a humanitarian affairs officer with the UN Office for the Coordination of Humanitarian Affairs (OCHA) in Pakistan.

“It was unusually strong spells of rain in a relatively short spell of time in vulnerable areas which instigated flash floods across the country,” Shariff told IRIN.

He said there was urban flooding mainly in Karachi, and to a lesser extent in Hyderabad and Sukkur. “As always, we are poorly prepared for such hazards mainly due to inadequate drainage capacity and choked water outflow channels.”

Snow and glacier melt are contributing to water flows in the north of the country.

NGO Support to Deprived People, headquartered in Shikarpur in Sindh Province, has made an appeal for more funding and spoken of the plight of affected people.

“We have not really received any assistance at all apart from a few food parcels handed out by some NGO. We have lost our homes and lands in many cases, and are living with very little shelter of any kind,” said Farid Ahmed who, with his family, moved away from his home in the Jhal Magsi District of Balochistan to higher ground near his village.

kh/jj/cb  source http://www.irinnews.org

 

Many Pakistani girls are out of school – Housework not homework

Photo: Rebecca Conway/IRIN

Many Pakistani girls are out of school

LAHORE,  – Pakistani schoolgirl Malala Yousafzai’s speech at the UN in New York calling for “free, compulsory education all over the world for every child” is a reminder that back in her home country several million children are out of school, exploited for their labour, and/or abused.

The most recent annual State of Pakistan’s Children report, published in May by the Islamabad-based NGO Society for the Protection and Rights of the Child (SPARC), found that out of 120 countries in the world, Pakistan has the second largest number of children out of school (after Nigeria), with 5.1 million children aged 5-9 not attending an educational institution.

“Education is vital for our future. Only when they read can they research, think and do something for the nation. Without education in its true sense there is no hope for this,” said Basarat Kazim, president of the Lahore-based NGO Alif Laila Book Bus Society which campaigns for education, literacy and modernization in the education sector.

A significant number of these children end up in the workplace.

“Child labour is a highly accepted social norm from a very young age for both girls and boys,” said Smaranda Popa, the chief of child protection at the UN Children’s Fund (UNICEF) in Pakistan. “These children are not only denied access to their rights to education, protection, health and development but are also highly vulnerable to abuse and exploitation.”

Figures on the precise number of child workers are somewhat uncertain, with estimates ranging from 3.3 million, according to a 1996 figure from the Federal Bureau of Statistics, to 12 million, according to more recent estimates by media reports and NGOs. The International Labour Organization estimates one quarter of these children are involved in the worst forms of child labour, including slavery, commercial sexual exploitation of children, using children to commit a crime, and work that is harmful to the “health, safety or morals” of children.

The Pakistan Bureau of Statistics in its 2010-11 Labour Force Survey puts the number of child workers at just 4.29 percent of the country’s children aged 10-14, in other words 855,426 of the 19.94 million children in that age range, according to 2011 figures from the government’s Economic Survey.

Brooms not books

According to SahibaIrfan Khan, programme officer child labour at SPARC’s Lahore office, the only major law on child labour is the Employment of Children Act 1991, “which just regulates child labour for those less than 14 years of age and prohibits it in specific occupations and processes.”

These laws are frequently weakly enforced, particularly in the area of domestic labour.

Earlier this month, an incident in which an influential employer had beaten her 13-year-old domestic servant, Jamil, to death after he dropped a jug was widely reported in the media and confirmed by police in the southern Punjab city of Multan. “Investigations in this case are continuing,” city police officer Ghulam Muhammad Dogarm told IRIN.

Another local administration official, who asked not to be named, said child labour was high in the area due to poverty, and “complaints of physical or sexual abuse are made but not often acted on because the families of the victims do not have much power.” He believed the incident involving the murder of Jamil was taken up only because “the news reached the media.”

Other cases of abuse go unreported. “My 11-year-old daughter, Habiba, worked as a maid in a big house, helping to look after three young children, and doing all kinds of other tasks such as washing dishes,” mother Shahida Bibi, of Lahore, told IRIN.

“I took her home after I visited one day and found her covered in bruises as a result of the beating she had received from her employers, who said she did not work hard enough. She also told me she was made to labour for up to 14 or 15 hours a day.”

Such stories are not unusual, according to SPARC. “Thousands of children working as domestic servants are deprived of their basic right to education and are often subjected to abuse and violence,” said Khan.

Data compiled by the organization shows that between January 2010 and December 2011, 18 cases of “severe” torture and abuse of child domestic labourers were reported. Of these 18 children, 13 died as a direct result of the violence inflicted upon them at the hands of their employers.

“In the first six months of 2013, 14 cases of violence against child domestic workers were reported in media, out of which nine resulted in the death of the child,” Khan said.

Poverty, inadequate educational facilities and a lack of awareness of the negative impacts of such work are a key cause of the high prevalence of child domestic labour, with families sending children into domestic service.

“Extreme educational poverty”

The poor condition of state-run schools, and the lack of access to them, notably in rural areas, also makes it more likely children will be sent to work.

According to the government’s Economic Survey for 2012-13, the literacy rate in rural areas, at 49 percent, is significantly lower than the 75 percent in urban areas.

Photo: Kamila Hyat/IRIN

Yusuf, 12, has worked as a labourer in Lahore, Pakistan since dropping out of school last year

Facilities at public-sector schools are often dismal, with many lacking furniture, fans, drinking water, toilets, or teachers. According to the 2012 report by the Pakistan Education Task Force, set up by the government in 2009, seven million children are currently out of school and 30 percent of citizens “live in extreme educational poverty”, with 15-20 percent of teachers absent from the classroom on an average day.

“My son, aged 10 years, simply kept running away from school, because he was shouted at by his teachers, sometimes beaten and taught very little since his teacher rarely came,” said Muhammad Hanif, who lives in the settlement of Shahdra on the outskirts of Lahore.

Hanif says he was unable to pay for private schooling, and rather than have his son “roam around on the streets”, he arranged for him to be employed as a house-help. “He is at least given his meals, even if it is just a few leftovers or lentils, and he brings home Rs 2,500 [US$25] each month,” Hanif said.

The wage is less than half of what would, in most cases, be paid to an adult. SPARC says children are preferred for domestic labour because they are considered more obedient, and can be hired for less pay.

Acts of charity?

There is, however, a twist to the tale. For generations, employing child domestic workers has been considered an act of charity.

“Employers believe that since employing poor and unfortunate children is in itself a great favour to the child, they have the liberty to treat them as they wish,” Khan said. This attitude is also tied in to traditional culture in a society highly stratified on the basis of class and wealth.

“Feudal lords are not just large landowners or big farmers. Land is the sole economic resource in a good part of this country and whatever little opportunities, other than land, have arisen lately have also been monopolized by the same class,” said Tahir Mehdi, executive coordinator of the NGO LokSujag, which campaigns for democratic rights and social equity.

Speaking of employment by the wealthy, he said: “They treat their subjects as pairs of hands that should work for them like robots that need to be oiled but don’t have any rights and can’t make any demands.”

Of course, not every child domestic worker suffers. Some, like Pervez Zaman, 13, are more fortunate. Zaman, from the north of the country, says his employer in Lahore pays him well, has given him an additional food allowance and is now planning to arrange for private lessons so he can catch up on the studies he missed out on when he was younger.

However, such cases are rare. The incidence of abuse among young domestic workers is high, as SPARC has recorded, while simply being at work also means they are missing out on schooling.

To address child labour, UNICEF says, Pakistan must harmonize its legislation with international standards, implement those laws, provide functional child and social protection systems including for family poverty, improve access to and use of social services, and increase the amount of “decent” work available to adults.

“Any state invests in its sustainable development by investing in education,” Popa said. “No child should be forced to substitute school with the worst forms of labour.”

kh/jj/ha/cb  source http://www.irinnews.org

end

SMS or Interactive Voice Response (IVR) messages give Afghan farmers and traders information on crop and livestock prices in specific locations

Photo: Bethany Matta/IRIN

Afghan farmers can access the latest prices from 15 provincial markets on their mobile phones

KABUL,  – As Asia’s poorest country and the deadliest foraid workers, rugged Afghanistan offers a considerable challenge to humanitarian work.

But just as in parts of Africa, the only other area in the world with similarly poor infrastructure, rapid advances in information and communications technology (ICT) have had a profound impact on humanitarian activities over the past decade.

To make a phone call in 2001, the only option for many Afghans was a trip to neighbouring Pakistan. Now 85 percent of the population enjoys mobile phone coverage, and aid agencies are taking full advantage.

Despite the remoteness of many regions (with three-quarters of the population living in rural areas), the mobile phone network has expanded rapidly and by 2010 a USAID survey estimated that 61 percent of the population owned or had access to a mobile phone.

The country’s four major operators (Roshan, AWCC, Etisalat and MTN) share 18 million subscribers, according to a 2012 report by Research and Markets.

Five Afghan tech initiatives

Mobile Money, one of the most commonly used ICT services, allows Afghans to safely and securely transfer money, in some cases internationally, using mobile phones. Currently all four of Afghanistan’s major telecommunications operators provide money transfers. In March, USAIDpartnered with other agencies to promote a new electronic salary payment programme. The project aims to disperse salaries to more than 30,000 teachers in about 200 schools across Afghanistan by 2014.

SMS or Interactive Voice Response (IVR) messages give Afghan farmers and traders information on crop and livestock prices in specific locations. In partnership with USAID and Mercy Corps, Roshan launched the Malomat service in 2010 – currently nearly 600 farmers and 19 traders are participating in 15 provincial markets. Malomat provides farmers and traders with wholesale prices for agricultural commodities – aiming to improve farmers’ livelihoods and thus providing a disincentive to farmers to engage in opium production.

Telemedicine: Afghan doctors are starting to use a new ICT service to access e-learning, training, management tips and tele-radiology (the electronic sharing of patient scans). Hospitals can have real-time access to medical experts outside the country. “In many areas, people cannot reach hospitals or clinics safely. And the end of winter is likely to bring renewed fighting, making the problem worse,” said Gherardo Pontrandolfi, head of the International Committee of the Red Cross delegation at a press conference in Kabul last week. “Fighting, roadblocks, roadside bombs and a general lack of security prevent medics and humanitarian aid from reaching the sick and wounded, just when they need it most,” he said.

Photo: Bethany Matta/IRIN

At WFP’s call centre operators can speak directly with Afghans in the remotest parts of the country

Emergency hotline services: WFP’s Beneficiary Feedback Desk is an example of how such a service can improve the distribution of aid. The hotline was launched through a series of radio adverts in three provinces last year. The mobile phone hotline operators told IRIN they quickly started getting calls from all over the country. Operators call back those who hang-up after a couple of rings, in case they lack phone credit. They say they receive complaints and suggestions on aid delivery. One young Afghan woman used the phone line to expose a man in her village who had set up fake literacy classes to benefit from WFP aid. In another case, in an insecure and impoverished part of Ghor Province, students were able to use the hotline to negotiate the safe delivery of WFP aid – something that had not been possible for eight years.

Mobile teacher software: Ustad Mobil was designed to help tackle the country’s illiteracy problem. A UN Assistance Mission in Afghanistan (UNAMA)project aims to improve literacy among the police force, an estimated 70-80 percent of whom are illiterate. The app adapts the national literacy curriculum so it can be taught on camera mobile phones, with slides, videos and quizzes. “The feedback has been positive,” said Mike Dawson, CEO of Paiwastoon Networking Service, the designers of Ustad Mobile software. “We expect students will reach level three, which means they will be able to read and write.”

Advantages and challenges

Though many of these new technologies lack integration and are generally stand-alone operations, ICT has helped aid organizations improve monitoring, transparency and accountability, and provided greater access to vulnerable populations.

“Access is one of the biggest issues in a country like Afghanistan. We can only help those who we can access. There is always conflict in this country so we can’t visit every part of the country to see who is vulnerable and who needs assistance,” said WFP information officer Wahidullah Amani.

“We have also been able to prevent food diversion and better monitor our food distributions, which in turn gives us opportunities to be more transparent and accountable to the people.”

But such developments in Afghanistan have not been entirely benign.

Mobile phones are frequently scrutinized at Taliban checkpoints to see if people have links with government officials or Western organizations. Being caught with a suspicious phone number or contact can lead to the loss of the phone, and in some cases a beating.

bm/jj/cb source http://www.irinnews.org

end

Pakistan is one of only three countries where polio is endemic

Photo: UNICEF Pakistan/Warrick Page

Pakistan is one of only three countries where polio is endemic

LAHORE/DUBAI, – Hamza Mazhar, a 35-year-old teacher from Pakistan’s eastern city of Lahore, says he never wants to see the inside of a government hospital again.

“My mother was taken to the hospital with an upper respiratory tract infection in February this year and doctors said she needed care in the hospital’s Intensive Care Unit (ICU),” he told IRIN.

But the doctors in charge wanted the family to pay a bribe to get into the ICU, which had plenty of spare beds. They could not afford to pay. His mother was unable to get the treatment she needed and in March she died.

Health care in Pakistan is identified as one of the country’s most corrupt sectors, according to surveys by Transparency International; general surveys suggest the majority of Pakistanis are unhappy with the health services they are offered.

This is just one of the many challenges facing Pakistan’s health system, as identified in the first ever comprehensive assessment of the sector, published in the medical journal The Lancet and launched today in Islamabad.

Entitled Health Transitions in Pakistan, the series of articles says Pakistan’s health sector lags behind 12 countries in the region with cultural, economic and geographic similarities.

Pakistan has no national health insurance system and 78 percent of the population pay health care expenses themselves. It is the only country in the world without a National Health Ministry.

The report authors say the recently elected government has a unique opportunity to push through reforms and take advantage of recent constitutional changes that devolve health care to the provinces.

The findings are not entirely negative. Progress has been made on all health indicators in the past 20 years. The rates of child deaths and maternal mortality have fallen, and the community-based Lady Health Workers programme is singled out for praise.

But improvements have been much slower coming than in other similar countries. IRIN picked out four major challenges from the health assessment.

1. Avoidably high child and maternal mortality

The assessment’s authors describe Pakistan’s progress towards meeting the Millennium Development Goals for reducing child and material mortality (4&5) as “unsatisfactory”.

Pakistan, with its population of 180 million, has more child, foetal and maternal deaths than all but two of the world’s nations.

The report calls child survival “the most devastating and large-scale public health and humanitarian crisis Pakistan faces”.

An estimated 423,000 children under-five die each year, almost half of them new-born babies. Family planning options are also limited and nearly a million women attempt unsafe abortions each year.

Simple measures like training more nurses and midwives (currently outnumbered by doctors 2:1) could save more than 200,000 women and child lives in 2015, the report’s authors say.

2. Nutrition

A lack of adequate nutrition for children contributes to the high number of child and maternal deaths. Nearly 40 percent of children under-five areunderweight and more than half are affected by stunting.

Poor nutrition weakens the body’s natural defence mechanisms.

But the report also says that malnutrition affects the Pakistani economy, with estimates that it costs the country 3 percent of GDP every year, particularly through reduced productivity in young adults.

3. “Lifestyle diseases”

In Pakistan, as more widely throughout south Asia, non-communicable diseases like cancer, diabetes and heart problems have replaced communicable diseases like malaria and diarrhoea in the past two decades as the leading causes of death and morbidity.

This general trend has not been matched by an adaptation in the Pakistani health system or government policy. Poor road safety, cheap cigarettes and high-levels of obesity (one in four adults) all lead to preventable deaths.

So-called “lifestyle diseases” could cost the country nearly US$300 million in 2025, according to the report’s authors.

They say the right government action, including higher excise taxes on cigarettes, new legislation, and information campaigns could cut the premature mortality rate from cardiovascular diseases, cancers, and respiratory diseases by 20 percent by 2025.

4. Low public spending

Humanitarian crises provoked by earthquakes, flooding and conflict over the past decade have mobilized large sums of money both internationally and within the country.

But corresponding sums have not been spent on underlying health services, which have the potential to save many more lives.

Public health spending has declined from 1.5 percent of GDP in the late 1980s to less than 1 percent, according to the report – equivalent to less than 4 percent of the government budget.

That has left Pakistanis with little support for medical costs, which are responsible for more than two-thirds of major economic shocks for poor families, according to the Ministry of Social Welfare and Special Education.

Rapid population growth only makes what resources are spent on health care produce ever smaller results.

kh/jj/cb source http://www.irinnews.org

 

Pakistan: Doctors wanted the family to pay a bribe to get into the Intensive Care Unit – corrupt system contribute to unnecessary deaths

LAHORE/DUBAI, – Hamza Mazhar, a 35-year-old teacher from Pakistan’s eastern city of Lahore, says he never wants to see the inside of a government hospital again.

“My mother was taken to the hospital with an upper respiratory tract infection in February this year and doctors said she needed care in the hospital’s Intensive Care Unit (ICU),” he told IRIN.

But the doctors in charge wanted the family to pay a bribe to get into the ICU, which had plenty of spare beds. They could not afford to pay. His mother was unable to get the treatment she needed and in March she died.

Health care in Pakistan is identified as one of the country’s most corrupt sectors, according to surveys by Transparency International; general surveys suggest the majority of Pakistanis are unhappy with the health services they are offered.

This is just one of the many challenges facing Pakistan’s health system, as identified in the first ever comprehensive assessment of the sector, published in the medical journal The Lancet and launched today in Islamabad.

Entitled Health Transitions in Pakistan, the series of articles says Pakistan’s health sector lags behind 12 countries in the region with cultural, economic and geographic similarities.

Pakistan has no national health insurance system and 78 percent of the population pay health care expenses themselves. It is the only country in the world without a National Health Ministry.

The report authors say the recently elected government has a unique opportunity to push through reforms and take advantage of recent constitutional changes that devolve health care to the provinces.

The findings are not entirely negative. Progress has been made on all health indicators in the past 20 years. The rates of child deaths and maternal mortality have fallen, and the community-based Lady Health Workers programme is singled out for praise.

But improvements have been much slower coming than in other similar countries. IRIN picked out four major challenges from the health assessment.

1. Avoidably high child and maternal mortality

The assessment’s authors describe Pakistan’s progress towards meeting the Millennium Development Goals for reducing child and material mortality (4&5) as “unsatisfactory”.

Pakistan, with its population of 180 million, has more child, foetal and maternal deaths than all but two of the world’s nations.

The report calls child survival “the most devastating and large-scale public health and humanitarian crisis Pakistan faces”.

An estimated 423,000 children under-five die each year, almost half of them new-born babies. Family planning options are also limited and nearly a million women attempt unsafe abortions each year.

Simple measures like training more nurses and midwives (currently outnumbered by doctors 2:1) could save more than 200,000 women and child lives in 2015, the report’s authors say.

2. Nutrition

A lack of adequate nutrition for children contributes to the high number of child and maternal deaths. Nearly 40 percent of children under-five are underweight and more than half are affected by stunting.

Poor nutrition weakens the body’s natural defence mechanisms.

But the report also says that malnutrition affects the Pakistani economy, with estimates that it costs the country 3 percent of GDP every year, particularly through reduced productivity in young adults.

3. “Lifestyle diseases”

In Pakistan, as more widely throughout south Asia, non-communicable diseases like cancer, diabetes and heart problems have replaced communicable diseases like malaria and diarrhoea in the past two decades as the leading causes of death and morbidity.

This general trend has not been matched by an adaptation in the Pakistani health system or government policy. Poor road safety, cheap cigarettes and high-levels of obesity (one in four adults) all lead to preventable deaths.

So-called “lifestyle diseases” could cost the country nearly US$300 million in 2025, according to the report’s authors.

They say the right government action, including higher excise taxes on cigarettes, new legislation, and information campaigns could cut the premature mortality rate from cardiovascular diseases, cancers, and respiratory diseases by 20 percent by 2025.

4. Low public spending

Humanitarian crises provoked by earthquakes, flooding and conflict over the past decade have mobilized large sums of money both internationally and within the country.

But corresponding sums have not been spent on underlying health services, which have the potential to save many more lives.

Public health spending has declined from 1.5 percent of GDP in the late 1980s to less than 1 percent, according to the report – equivalent to less than 4 percent of the government budget.

That has left Pakistanis with little support for medical costs, which are responsible for more than two-thirds of major economic shocks for poor families, according to the Ministry of Social Welfare and Special Education.

Rapid population growth only makes what resources are spent on health care produce ever smaller results.

kh/jj/cb source http://www.irinnews.org

Norway congratulates Pakistan on historic election

“I would like to congratulate Pakistan on a historic election. For the first time in the country’s history, a democratically elected government will be replaced by another democratically elected government,” said Minister of Foreign Affairs Espen Barth Eide.

“Pakistan’s democracy is developing. Although the final assessments of the election may identify mistakes and shortcomings, the election has shown that the democratic will is there. Important steps have been made, such as amendments to electoral legislation, the establishment of an independent election commission and improved electoral lists,” Mr Eide said.

There were more female candidates and registered voters than in the last parliamentary election. Having said this, in some areas women were still prevented from voting. Norway has provided support for increasing women’s participation in the election and for the election commission’s work.

“Pakistani women and men have defied threats of violence in order to cast their vote. They have every reason to be proud of this,” Mr Eide said.

Anti-democracy extremists have used terror tactics during parts of the election process and have killed several hundred political activists in the lead-up to the election. There are no official figures for voter turnout, but preliminary figures indicate a higher turnout than in the 2008 election. 

End

 

Humanitarian work in NW Pakistan hampered

ISLAMABAD,  – Delivering humanitarian aid in northwestern Pakistan has recently been hampered by attacks on schools, aid workers and polio vaccination teams, and bureaucratic procedures for aid projects are making matters worse. 

International and national humanitarian agencies in Khyber Pakhtunkhwa Province (KP) and the Federally Administered Tribal Areas (FATA) often face long delays waiting for local officials to grant the relevant permits.

Since 2005, procedures to obtain No Objection Certificates (NOCs) for projects and travel have made it more difficult to deliver vital aid, and in at least one case, led directly to the cancellation of projects.

Relief and recovery projects in FATA and KP require project NOCs, while international staff, including UN workers, also require travel NOCs to move around.

“We had applied for a project implementation NOC to begin a project in livestock in the Kurram Agency to the FATA Disaster Management Authority in February, and had planned the project in December last year, but have still had no response,” said Anwar Shah, CEO of the Peshawar-based national NGO Shid, which works in livestock, livelihood and education.

“Now the local livestock authorities in Kurram say it is too late to start – so everyone suffers.”

Hearing reports of delays, the UN Office for the Coordination of Humanitarian Affairs (OCHA) set about getting a more comprehensive picture by gathering data from agencies operating in the area.

“The problem is not a new one. It has been there for some time, but now rather than just anecdotal accounts, we are trying to properly monitor the situation and create a database to engage the authorities on this issue based on evidence,” Christina Alfirev, OCHA humanitarian affairs officer in Islamabad, told IRIN.

Of the 18 humanitarian agencies who submitted data on NOC project requests in January and February, related to 27 projects, 21 were still being processed; only five had been approved and one had been rejected without explanation, as of early March.

“There is a desperate need for more projects, more development here. So many people are jobless, and need help”, Abdul Wali, Swat District

Average processing time for project NOCs in KP as of the end of February was found to be 53 days and 66 days for FATA instead of the six weeks indicated by government authorities. One NGO had to wait 118 days for an NOC.

The OCHA bulletin published 4 April 2013 says the delays are “hampering the provision of critical services” and calls on local authorities to speed up the paperwork “to enable timely assistance to people in need in KP and FATA.”

The bulletin says one emergency project had to be cancelled because of delays, while another had to be reduced in scope.

The paper trail

Humanitarian projects in KP need an NOC from the Provincial Disaster Management Authority (PDMA), and must be requested at least six weeks in advance.

Expatriate staff also need an NOC for travel; and in February the Home Department in KP said applications should be made “at least 6-8 weeks prior to the visit”, something one international humanitarian worker, who asked not to be named, told IRIN that if implemented, “means regular visits to projects are nearly impossible.”

Donors have been expressing concern to the government about the delays these moves could create if implemented, and there are some indications the authorities may be prepared to revoke the policy.

Applications go to the home department of the provincial government in Peshawar, and then can often follow a trail of authorizations and approvals from various military units, as well as the Inter-Services Intelligence.

“A key reason for the new procedures is security concerns. The government is worried a foreign worker or local NGO worker may be harmed, and this brings it a bad name. I think recent events like attacks on polio workers are a factor in the decisions taken,” said a PDMA official in KP who preferred anonymity because he was not authorized to speak with the press.

The delays witnessed by agencies in the last few months are also affecting relations with donors, some of whom do not transfer funds until project NOCs have been issued.

“The Project NOC is valid for six months. Then the same game starts again. At this time I have been waiting now more than six weeks for the extension of an NOC,” said the aid worker, adding that donors usually extend a project’s lifespan, though without increasing budgets, which means they are almost inevitably reduced in size, something donors do not always understand.

“Right now one of our donors is very unhappy,” he said.

Permit mission creep

Alfirev said project implementation permits date back to the 2005 earthquake which killed 73,000 people in the north: “The procedure was put in place by the Earthquake Reconstruction and Rehabilitation Authority set up by the government after that disaster, and was really intended to coordinate the many agencies working in the quake zone and prevent duplication. The process worked smoothly then.”

All organizations working on relief and early recovery activities in KP/FATA are required to either apply for Project NOCs for projects lasting up to six months, or apply for a Memorandum of Understanding for projects lasting more than six months.

Since 2005, there have been a series of additions to the list of documents and information needed when making NOC requests.

The latest came in February this year with the government’s announcement of a 6-8 week requirement for travel NOCs, against the normal 5-7 working days.

The Home and Tribal Affairs Department issued new directives for travel NOCs for 10 (out of 25) KP districts – Malakand, Swat, Upper and Lower Dir, Buner, Shangla, Chitral, DI Khan, Tank and Hangu. The Law and Order Department issued a similar directive covering FATA.

Humanitarian agencies are hoping the new time-scale will be officially reduced to the previous 5-7 working days, and as yet it does not seem the 6-8 week policy is being applied on the ground.

“Since 2008, the humanitarian community has raised US$1.38 billion in funding for people affected by violence in northwestern Pakistan. In order to ensure that the assistance is delivered to the people in need, we depend on the government to facilitate humanitarian operations and ease bureaucratic hurdles,” said Lynn Hastings, OCHA country director .

Aid workers say the delays are making it more difficult to deliver aid to KP and FATA. “People suffer when there are delays,” said Shah of Shid NGO.

In Mingora, the principal town in KP’s Swat District, Abdul Wali, 45, who lost his farm in the 2010 floods, told IRIN: “There is a desperate need for more projects, more development here. So many people are jobless, and need help.”

kh/jj/cb source http://www.irinnews.org

Kenya: Nyando rice farmers get a relief as government writes off Ksh.27M debt

• By  Dickens Wasonga, reporting from Kenya

As part of efforts to empower local farmers and to enhance their production capacities the government has announced it was going to write off sh.27 million that rice farmers in Nyando owed it.

Making the announcement soon after a meeting with the local Members of Parliament and the Nyanza PC Francis Mutie , the deputy commissioner of cooperatives Mr Phillip Gichuki said the decision to write off the debt will be a big relief to most farmers who have been struggling to scale up their production levels in vain.

The debt was part loans advanced to several farmers by the ministry of cooperatives over the years to boost their production capacities and was aimed at alleviating poverty levels in the area.

Local MPs have in the past lobbied the government to write off the debts to local farmers as it had done to tea and coffee farmers from other parts of the country.

Although they lauded the move by the government the area MPs led by Nyando MP Fred Outa asked the ministry to also consider writing off millions of shillings in debt owed to government by sugarcane farmers from the area as well.

Outa said doing so will enable the farmers to start production on a clean slate adding that the area has a huge potential for agricultural production which was remaining untapped due to high poverty levels.

The commissioner said the country was capable of producing enough rice to meet the country’s demand for the same but regretted that Kenya was still relying heavily on rice imports especially from Pakistan due to lack of financial muscle by most farmers.

Nyando which is prone to floods during heavy rains is known for production of rice in Nyanza and is leading in terms of sugar cane growing with at least three vibrant sugar millers operating from this sugar cane growing zone.

END.

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