Complete Wellness

Women and children who escaped the brutal violence in Myanmar wait for aid at a camp in Bangladesh. Credit: Parvez Ahmad/IPS

COX’S BAZAR, Bangladesh, Oct 10 2017 (IPS) – Yasmin, 26, holds her 10-day-old baby, who she gave birth to in a crowded refugee camp in Cox’s Bazar, a southeastern district bordering Myanmar.

Three weeks ago, when she was still in her home in Hpaung Taw Pyin village in Myanmar, she was raped by a group of soldiers as houses burned, people fled and gunfire shattered the air.“I have been working as a human rights activist for the last 20 years but never heard of such an extreme level of violence.” –Bimol Chandra Dey Sarker, Chief Executive of the aid organisation Mukti

With sunken eyes, Yasmin told IPS how she was beaten and raped in her ninth month of pregnancy by Myanmar soldiers. Yasmin’s village was almost empty when she and many of her neighbours were violated. Only a few dozen women and children remained after the men had fled in fear of being tortured or killed.

“On that dreadful evening an army truck stopped in our neighbourhood, and then came the soldiers raiding homes. I was alone in my home and one of the soldiers entering my thatched house shouted to invite a few others to join him in raping me.”

“I dare not resist. They had guns pointed at me while they stripped me to take turns one by one. I don’t remember how many of them raped me but at one stage I had lost consciousness from my fading screams,” she said, visibly exhausted and traumatized by the horrific ordeal.

Yasmin’s husband was killed by the Myanmar army on September 4 during one of the frequent raids, allegedly by state-sponsored Buddhist mobs against the Muslim minority in their ancestral home in Rakhine state.

Bandarban, a hilly district, and Cox’s Bazaar, a coastal district, both some 350 km southeast of Bangladesh’s capital Dhaka, are hosting the overcrowded Rohingya camps. The locals here are no strangers to influxes of refugees. Rohingyas have been forced out of Myanmar since 1992, and Bangladesh, as a neighbor, has sheltered many of them on humanitarian grounds.

However, the latest Rohingya exodus, following a massive government crackdown that began last August, has shaken the world. The magnitude of the atrocities carried out by the military junta this time is beyond imagination. Some describe the persecution as ‘genocide,’ which Myanmar’s rulers deny.

To add to the communal violence, dubbed ‘ethnic cleansing’ by Zeid Ra ad Al Hussein, the United Nations high commissioner for human rights, the military junta intensified physical assaults and soldiers have been sexually harassing innocent, unarmed Rohingya women alongside the regular killings of men.

The reasoning is obvious: no one should dare to stay in their homes. Many believe it’s a pre-planned operation to clear Rakhine state of the Rohingya population, who Myanmar does not recognize as citizens.

One Rohingya man, who managed to reach the Bangladesh border in mid-September, told IPS, “They have indeed successfully forced the Rohingya men out while the remaining unprotected women were a headache for the military junta, as killing the unarmed women would expose them to international criticism. So they chose a strategy of frightening the women and children – apply physical assault and sexual abuse, which worked so well.”

Newly arrived Rohingya refugees enter Teknaf from Shah Parir Dwip after being ferried from Myanmar across the Naf River. Credit: Farid Ahmed/ IPS

IPS spoke with many of the agencies, including the United Nations and local NGOs, working on the ground to provide emergency services such as food distribution, erecting shelters, organizing a safe water supply and hygienic latrines and, of course, healthcare.

Everyone who spoke to this correspondent said literally every woman, except the very old and young, has had experiences of either being molested or experiencing an extreme level of abuse like gang rape.

Survivors and witnesses shared brutal stories of women and young girls being raped in front of their family members. They described how cruel the soldiers were. They said the soldiers showed no mercy, not even for the innocent children who watched the killings and burning of their homes.
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Bimol Chandra Dey Sarker, Chief Executive of Mukti, a local NGO in Cox’s Bazaar, told IPS, “I have been working as a human rights activist for the last 20 years but never heard of such an extreme level of violence. Many of the women who are now sheltered in camps shared their agonizing tales of sexual abuse. It’s like in a movie.”

Kaniz Fatema, a focal person for CODEC, a leading NGO in coastal Cox’s Bazaar, told IPS, “Stories of sexual abuse of Rohingya women keep pouring in. I heard women describing horrific incidents which they say are everyday nightmares. How can such violence occur in this civilized world today?”

“Although women are shy and traumatized, they speak up. Here (in Bangladesh) they feel safer and so the stories of abuses are being submitted from every corner of the camps,” she said.

The chief health officer of Cox’s Bazar 500-bed district hospital, where most of the wounded are being treated, told IPS, “At the beginning we were providing emergency treatment for many Rohingya refugees with bullet wounds. Now, we are facing a new crisis of treating so many pregnant women. We are registering pregnant women and admitting them almost every day despite shortages of beds. Many of these women complain of being sexually harassed.”

An attending nurse at the hospital who regularly treats the sexually abused women, said, “Many women still bear marks of wounds during rape encounters. It’s amazing that these women are so tough. Even after so many days of suffering, they keep silent about the agonies and don’t complain.”

The UNFPA is offering emergency reproductive healthcare services in Bandarban and Cox’s Bazaar, where aid workers shared similar tales from women who suffered torture and gang rape at gunpoint.

“It is so horrifying,” said a field worker serving in Ukhia upazila in Bandarban, adding, “I heard of a young girl being raped in front of her father, mother and brother. Then the soldiers took the men out in the courtyard and shot them.”

Faisal Mahmud, a senior reporter who recently returned to the capital from Rohingya camps, also said he spoke to many victims of rape. “Most of them I spoke to were so traumatised they were hardly able to narrate the brutality. I could see the fear in their faces. Although I hardly understand their dialect, a translator helped me to understand the terrifying tales of being stripped naked and gang raped.”

Mohammad Jamil Hossain trekked through the deep forests, evading mines and Myanmar border guards who look for men to catch and take back.

“The systematic cleansing will not end until every member of Rohingya population is evicted and forced out of the country,” he said. “The whole world is watching and yet doing nothing to stop the killings.

Shireen Huq, founder member of Naripokkho, Bangladesh’s leading NGO fighting for women’s rights, told IPS, I was shocked and overwhelmed by the sheer numbers of people, mostly women and children, fleeing Myanmar and entering Bangladesh. The media had reported widespread atrocities, mass rape, murder, arson and brutality in the state of Rakhain.”

“Women arriving at Nayapara through Shah Porir Dwip were in a state of shock and fatigue. Many of them were candid about the julum (a word used to mean both torture and rape) they had undergone, about being raped by several military,” she said.

“We must ensure appropriate and adequate care for the refugees, especially all those who have suffered sexual violence. They need medical care, psycho-social counseling and abortion services.”

“Agencies working in the Rohingya refugee camps estimate that 50,000 women are pregnant. Several hundred deliveries have already taken place. Round the clock emergency health services must be made available to deal with the situation,” Shireen said.

More than 501,800 Rohingya have fled the Buddhist-majority country and crossed into Bangladesh since August 25. Densely populated refugee settlements have mushroomed around road from Teknaf to Cox s Bazar district that borders Myanmar divided by Naf river. About 2,000 of the refugees are flooding into the camps every day, according to the International Organisation for Migration (IOM).

IOM has appealed to the international community for 120 million dollars between now and February 2018 to begin to address the humanitarian crisis.

“The refugees who fled Rakhine did so in the belief that they would find safety and protection in Cox’s Bazar,” said William Lacy Swing, IOM’s Director General, in a on October 4. “It is our responsibility to ensure that the suffering and trauma that they have experienced on the way must end.”

Meanwhile, witnesses say there are still thousands of refugees in the forest waiting to cross over the Bangladesh border, which has now been officially opened. Many can be seen from distant hilltops, walking with whatever belongings they could take.

“I was really struck by the fear that these people carry with themselves, what they have gone through and seen back in Myanmar,” the United Nations High Commissioner for Refugees, Filippo Grandi, told Reuters in a camp recently, where refugees live under thousands of tarpaulins covering the hills and rice paddies.

“Parents killed, families divided, wounds inflicted, rapes perpetrated on women. There’s a lot of terrible violence that has occurred and it will take a long time for people to heal their wounds, longer than satisfying their basic needs,” Grandi said.

Jemimah Njuki is an expert on agriculture, food security, and women’s empowerment and works as a senior program specialist with IDRC. She is an Aspen Institute New Voices Fellow.

Most African farmers are women. Credit: IPS

OTTAWA, Canada, Jan 9 2018 (IPS) – If there is one political principle that has been constant throughout the history of human civilization it is the fact that land is power. This is something that is particularly true, and often painfully so, for women who farm in Africa.

Though women in Africa are far more likely to farm than men, they are also much less likely to have secure rights to the land where they cultivate crops and they typically hold smaller plots of inferior quality.

As a researcher who studies the role of gender in agriculture, I want to do my part to address this injustice, because when women have , their crop yields increase and they have higher incomes and more bargaining power within the household. has shown that stronger land rights leads to other benefits such as better child nutrition and improved educational attainment for girls.

But as I delve deeper in to the issue, I frequently encounter another political constant, which is the fact that information is power. And one manifestation of the chronic neglect of women in agriculture is the lack of data that would help illuminate and address their plight.

For example, the Bill Melinda Gates Foundation has launched the , which is making a concerted effort to track progress toward achieving the United Nation’s Sustainable Development Goals. Examining the first ever report on the program launched just a few weeks ago, the first thing I did was scroll down to the section on Goal 5, “Achieve Gender Equality and Empower all Women and Girls.” When examining the indicators related to gender, which include tracking the percentage of women who have secure land rights, I kept encountering the phrase, “Insufficient data” in big, bold red capital letters!

Without data, it is impossible to track progress or identify policies and interventions that are achieving gender equality. In order to develop solutions—whether around land rights or the many other challenges women and girls face we need data that highlights current problems and assesses their impact.

A good example of how sex-specific data fosters progress is in financial inclusion. Sex-specific data gives us information about who is accessing which kind of products, which channels they use and what the gaps are. Being aware of these gaps is essential to overcome them, and this is impossible without data sets for both men and women. In Rwanda, has led to the targeting of groups who are excluded from the financial system, raising the financial inclusion index rise from 20 percent in 2008 to 42 percent in 2012.

A by Data2X, an initiative of the United Nations Foundation, indicates that although close to 80 percent of countries globally regularly produce sex-specific statistics on mortality, labor force participation, and education and training, less than one-third of countries separate statistics by sex on informal employment, entrepreneurship (ownership and management of a firm or business) and unpaid work, or collect data about violence against women. This leads to an incomplete picture of women’s and men’s lives and the gaps that persist between them, which constrains the development of policies and programs to address these gaps.

A key challenge to collecting these data sets is investment. We need financial investments to collect data on the situation of women and girls at different levels –local, national and international. A carried out by the UN Statistics Division in collaboration with the UN regional commissions in 2012, showed that out of 126 responding countries only 13 percent had a separate budget allocated to specific gender statistics, 47 percent relied on ad-hoc or project funds and the remaining 39 percent had no funds at all.

In 2016, the Bill Melinda Gates Foundation to improve the collection of sex specific data. In Uganda, the is collaborating with the and the Uganda Bureau of Statistics to collect and analyze asset ownership by different members of households.

It would help to know for example what assets women own so as to develop programs and policies that benefit both men and women and that close persistent gender gaps. At , we are supporting sex-specific —including births and deaths to help track progress on such indicators as women’s reproductive health and child mortality.

Globally, there is still no available data on how many women own customary land. One challenge is that the rules, norms, and customs which determine the distribution of land and resources are embedded in various institutions in society—family, kinship, community, markets, and states. For example, when I was visiting Mali in 2012, I attended a village’s community meeting where I witnessed the village chief grant a local women’s group a local deed so they could farm together and raise their incomes. But there was no formal document or record.

Without this data, when land is privatized or formalized, women often lose control of customary land. For example in post-independence Kenya, Uganda and Zimbabwe, during the land registration and formalization experience, lack of data and led to the documentation of land in the name of the head of the household only, often a man. This gave the man authority to use, sell, and control the land, with women losing the customary access and rights that they had previously enjoyed.

International agencies and governments must commit to investing in collecting more data on women and girls. Closing this gender data gap is not only useful for tracking progress of where we are with the SDGs, but it can also point to what interventions are working, and what needs to be done to accelerate progress towards gender equality and the empowerment of women and girls.

What gets measured matters, and what matters gets measured. Women and girls matter.

Japan: aging population needs more than short-term solutions. Credit: IPS

UNITED NATIONS, Apr 2 2018 (IPS) – While much of the global discussion for decades has been focused on overpopulation and its consequences, less can be said of the risks of low fertility and an ageing population—risks that are currently threatening the future of Japan.

Concerned by fertility trends in Asia, numerous institutions have begun to take action to prevent potentially devastating economic and social consequences.

One such group is the Asian Population Development Association (APDA), that serves as the Secretariat of the Japan Parliamentarians Federation for Population (JPFP) and is dedicated to research and studying population-related issues in countries such as Japan where limited work and research has been done around the issue.

“While population increase has been the overriding global concern, the risks of low fertility and ensuing population decline were not foreseen until recently. Thus it is understandable that no research has been done, nor has any thought been given from the government,” said Chair of the APDA Research Committee on Ageing Kei Takeuchi during a meeting.

The Young, the Old, and the Restless

Though the decline in fertility rates is not a new phenomenon, the East Asian nation has seen its population rapidly diminish in recent years.

According to the United Nations, Japan’s fertility rates were approximately 2.75 children per woman in the 1950s, well above the total fertility rate of 2.1 which has been determined to help sustain stable populations.

Today, Japan’s birth rate is 1.44 children per woman leading to the population declining by one million in the past five years alone.

The National Institute of Population and Social Security Research found that if such trends continue, Japan’s population is expected to decrease from 126 million today to 88 million in 2065 and 51 million by 2115.

With fewer children and young adults, a vicious cycle is set in motion: spending decreases which weakens the economy, which dispels families from having children, which then weakens the economy further.

“As the population aged 18 years old is decreasing, the number of universities needs to be reduced, which will limit the number of new academic posts, lack the opportunity to cultivate researchers, and diminish Japan’s competitiveness in the international arena,”

At the same time, as people have a higher life expectancy, the elderly now make up 27 percent of Japan’s population in comparison to 15 percent in the United States.

This means less revenues and higher expenditures for the government, less funds for pensions and social security, and an even weaker economy.

Chair of the Asian Population and Development Association Yasuo Fukuda, a former Prime Minister of Japan noted that a dwindling population is not bad in and of itself but rather its rapid decline.

The true problem is that when the population decreases too drastically, the social systems will become unsustainable and incapable of responding to problems associated with it, which will make it harder for young people to develop concrete visions for their future,” he said.

Are the Kids Alright?

One of the factors that is often considered to be a driving force of lowering fertility is urbanization, APDA said, as urban fertility rates are often lower than those in rural areas.

This is often because urban areas tend to boast better access to services such as education and employment as well as gender equality, all of which affect people’s decisions whether or not to have children.

Japan is one the most densely urbanized countries in the world.

In 1950, 53 percent of the population lived in urban areas; by 2014, the figure shot up to 93 percent.

Japanese rural towns are disappearing at a rapid rate as young adults move to cities for work and the ageing population either moves out or dies out. Wild boars are now found to be taking over the abandoned areas.

However, the correlation between urbanization and fertility is still unclear due to different contexts and data limitations.

Many have also pointed to the lack of opportunities for young people in the country.

Though the unemployment rate is below 3 percent, the rise in unstable employment may be leaving young men and women unable or unwilling to have children.

Approximately 40 percent of Japan’s labor force is “irregular,” or have temporary or part-time jobs with low salaries. According to the Labor Ministry, irregular employees earn 53 percent less than those with stable jobs.

Men, who are still considered breadwinners for the family unit, may therefore be less likely to consider getting married or having children because they can’t afford to do so.

On the other end of the spectrum, Japan’s culture of overwork may also be impacting birth rates as young people find themselves with no time for a social life or even basic needs like sleeping or eating.

Such conditions have even led to “karoshi,” or death by overwork, across the country.

Most recently, journalist Miwa Sado died of a heart failure and investigators found that she had logged 159 hours of overtime work in June 2013 alone, one month before she died.

In 2015, 24-year-old Matsuri Takahashi committed suicide. It emerged that she worked for over 100 hours of overtime at her advertising job and had barely slept in the period leading up to her death.

Both deaths were ruled as “karoshi.”

Research, Action Needed

Due to the lack of data around the issue, APDA highlighted the need to promote research in order to help create and implement policies to ensure sustainable development and a stable, healthy population.

Shinzo Abe’s government has begun working on the issue in recent years, promising to raise the fertility rate to 1.8 by 2025.

They have also taken steps to make it easier for people to raise children by providing free education, expanding nursery care, and allowing fathers to take paternity leave. Local governments have even set up speed-dating services across the country.

However, Abe’s administration has been criticized for not doing enough, particularly around labor reform.

“Measures for low fertility, gender-equal society, and work-life balance are three important pillars,” said Chief Research Advisor APDA Project Research Committee on Ageing Makoto Atoh.

The APDA team also pointed to the need to invest in and revitalize regional areas and communities.

“This is a serious situation. We must come to grips with the issue of low fertility, but there is little research on it,” Takeuchi said.

APDA plans to hold several meetings and events in order to raise awareness and widen coverage on the issue of low fertility.

Vanita Suneja is Regional Advocacy Manager, South Asia, for WaterAid

A girl washes her hands and face with soap and water at a water tap, installed with the support of HSBC and WaterAid, in Sylhet District, Bangladesh.
Credit: WaterAid/Abir Abdullah

NEW DELHI, Jul 16 2018 (IPS) – In 2030, when I would be turning sixty, I’d like to tell my grandchildren the story of how – once upon a time – the lives of poor people in South Asia were transformed: that leaders came together to bring economic prosperity and social development to people that until then had lived in an unequal and polluted world.

What I am more likely to tell them, is how – even with the knowledge that nearly 800,000 children under five die every year from diarrhoeal diseases caused by poor water and sanitation – governments failed to act and people remain locked in a cycle of ill-health and poverty.

Ending the cycle of poverty absolutely by 2030, without leaving behind a single person, is the most ambitious promise made to date by world leaders in 2015 when they adopted the sustainable development goals: which included the provision of universal access to water and sanitation that is essential for achieving significant progress in health, education and equality.

When people have access to clean water and decent sanitation, their wellbeing increases: women and girls have time to go to school because they don’t have to fetch water for their families – this responsibility often falls on the female members or a family, and with better health comes increased productivity both in school and at work.

For every £1 invested in WASH at least £4 is returned in increased productivity, primarily based on improved health and more time to work or study.

With floods and droughts affecting the region at different times of the year, it is important that climate-resilient services are set up. This includes managing resources responsibly and minimising the effects of climate change.

Governments in South Asia have taken steps in the right direction. Nepal has taken a rights-based approach to water, sanitation and hygiene in its constitution, which sets the bar for accountability at the highest political level. The constitution states peoples’ right to live in healthy and clean environment as well as the right to access to safe water and sanitation.

Through its Clean India Mission, an incredible story emerges from India, where considerable progress has been made on sanitation. The Indian government aims to ensure that the entire population will have access to a decent toilet by 2019, so that nobody has to go in the open after that.

Bangladesh has shown the way on inclusion, having achieved the Open Defecation Free status before 2015. The government of Bangladesh has since adopted an inclusive approach to water as well, and is working to connect all those living in makeshift houses in the capital’s slums to a piped network.

Despite this progress, South Asia faces daunting challenges. Governments, donors and the private sector must be held accountable if they are not doing enough. While 88 percent of South Asia’s population has access to at least basic water, still more than half the population of South Asia lacks access to even basic sanitation.

Disparities are large between cities and rural areas: while 5.6 percent of the urban population in South Asian nations defecate in the open having no other option as no decent sanitation is available to them – yet in rural areas, this is as high as 45 percent.

For all nations to deliver on their commitment to provide universal access to water and sanitation by 2030, governments need to prioritise WASH – the NGO term for water, sanitation and hygiene and ensure that finances are directed towards achieving those goals.

Sanitation, water and hygiene have a bearing on health, education, nutrition, equality and poverty eradication. WASH is thus crucial to breaking the cycle of ill-health and poverty in which too many people still live today.

An important part of the promise to deliver water and sanitation to everyone, everywhere, is to leave no one behind. This requires renewed focus on addressing the equity challenge.

The private sector and civil society groups have an important role to play in partnering with the government to reach out to marginalized and vulnerable populations.

This week, world leaders are coming together at the United Nations in New York to discuss the progress made on sustainable development goal 6 – to provide universal access to clean water and decent sanitation.

This is an important moment to highlight the urgency of having clean drinking water and a proper toilet, and to ensure that the lives of people in South Asia and beyond will be transformed within a generation.

Hanitranirina Rarison is an agronomist specializing in food sciences in Fanilon’I Madagasikara. She is also a Girl Guide and actively involved in its nutrition advocacy program.

Agronomist and Girls Guide Hanitranirina Rarison is combining all her skills and experiences to help rid Madagascar of malnutrition.

ANTANANARIVO, Madagascar, Oct 24 2018 (IPS) – As much as 80 percent of Madagascar’s population of 24 million people is involved in agriculture and the country’s economy largely depends on the sector, yet 48 percent of households are faced with food insecurity according to the (NNO). Over 70 percent of households live below the national poverty line of 535,603 Malagasy ariary per year (1 U.S. dollar equals 3,447.50 ariary).

In rural Madagascar, where subsistence farming is the primary economic activity, as high as 86 percent of households live in poverty. For most of these households, there is a predictable gap of four to five months each year in which staple food production (mainly rice) is not enough to cover the demand.

During this time, the rice yield is low or destroyed by cyclone or flooding. Cassava or sweet potatoes replace the rice, providing mostly carbohydrates in the diet.

Madagascar is the fifth most malnourished country in the World, the NNO says. Slightly more than 47 percent of children under five years are stunted meaning nearly one in two children are malnourished.

According to the DHS Survey in 2010, acute malnutrition affected 27 percent of young women 15–19 years old in 2009, especially in rural areas. Anemia is present in 35 percent of women 15–49 years old.

A lack of direct access to food and production more seriously disadvantages women than men the says, and good nutrition is especially critical for adolescence girls.

During this critical growth period, they need more iron, for example, to compensate for blood loss from menstruation. Good nutrition also helps to provide immunity against diseases and provides the energy they need to help them thrive.

However, there are not enough projects or programs supporting women and girls’ nutrition. Most projects support the first 1000 days of life through nutrition intervention at national nutrition sites located mostly in rural areas or in areas vulnerable to malnutrition.

These are common spaces in communities reserved for training mothers on breastfeeding, how to monitor and evaluate the growth of the child from birth to two years, and on nutritious baby food and the importance of colored-diversified food. These programs are an important part of Madagascar’s attempt to fight malnutrition.

This strategy is guided by the National Action Plan on Nutrition III. Launched in 2005, the first phase outlines nutrition activities with 14 goals. Eight of these have been implemented: 1) promotion of breastfeeding and complementary food, 2) integration of the community in nutrition, 3) fight against micronutrient deficiency 4) integration of nutrition intervention in primary healthcare, 5) care for acute malnutrition, 6) improvement of household food security, 7) integration of school nutrition, and 8) improvement of communication on nutrition.

Madagascar has partially implemented the four remaining strategies: 1) preparation and intervention for nutrition emergency, 2) a national system of nutrition and food supervision, 3) development of the national capacity building, and 4) nutrition intervention relating to emergent problem (HIV/AIDS) and non-communicable disease.

The remaining two interventions have not started. These focuses on integrating development initiatives and providing legislative framework around food and nutrition.

Phase two of the plan outlines steps to address malnutrition, the food and nutrition security for vulnerable households, and the coordination and improvement of the nutrition sector growth.

Phase three was launched in 2017 (NNO, 2017) and focuses on deepening the phase two interventions as well as improving access to health services and safe drinking water and sanitation, with special attention on pregnant and lactating women and adolescent girls.

Raising public awareness of the National Plan of Action on Nutrition is key to its overall success. This is being addressed, in part, by community sensitization through television, radio, and print media.

Madagascar is among the pilot countries in the , and as agents of change, Girl Guides in Madagascar are joining the campaign to fight malnutrition through advocacy and communications. We have taken part in the design of the nutrition curriculum, and currently, 80, 000 members in all 22 administrative regions (even in extreme rural areas) are involved in the movement in Madagascar

The youth advocates pool, a group of Girl Guides involved in nutrition advocacy in Madagascar, will help promote sensitization through online portals and in-person meetings in communities. The pool will help deliver public education from the nutrition program curriculum and speak at relevant nutrition events in our country.

Media support on nutrition will be important to change community behavior and influence decision-makers and policymakers. In addition to its members, Girl Guides plans to use media to sensitize another 40,000 people in the community.

Takahiro Nanri (left – black jacket), Executive Director of Sasakawa Memorial Health Foundation, joins hands with a leprosy survivor (right). Credit: Stella Paul/IPS

MANILA, Mar 5 2019 (IPS) – Takahiro Nanri is the Executive Director of Sasakawa Memorial Health Foundation which has been supporting the global fight against leprosy for almost five decades. Since 2014, Nanri has been leading the foundation’s leprosy projects across the world and has deep insights into the challenges faced by the people affected by leprosy as well as the organisations that work with them.

He also shares the dream of Yohei Sasakawa – the chairman of Nippon Foundation – to see a leprosy-free world and believes that despite several challenges and roadblocks, this dream is indeed possible to realise.

In an exclusive interview with IPS, Nanri talks about the idea behind the regional assembly of leprosy-affected people in Asia that was held in Manila.

He also tells how people who are affected by leprosy  are treated as social outcasts and why they must be integrated with the rest of the society. Finally, Nanri shares his views on how and why leprosy-affected people’s organisations should become sustainable.  Excerpts of the interview follow:

Takahiro Nanri is the Executive Director of the Sasakawa Memorial Health Foundation which has been supporting the global fight against leprosy for five decades. Credit: Stella Paul/IPS

Inter Press Service (IPS): Is there a reason behind Mr Sasakawa’s personal interest in leprosy? Why has the foundation continued even when it is not a big global threat anymore?

Takahiro Nanri (TN): As far as I know it was in the 1960s [when the Sasakawa family] visited leprosariums in some countries like Korea, South Korea, Nepal and at that time there was no Multidrug Therapy ( MDT) and the situation in the sanatoriums was very severe. So they had decided to fight against leprosy and launched the leprosy elimination programme and even established the Sasakawa Memorial Health Foundation.

I am very proud of the fact that this foundation has continued to work on the same issue for 50 years because, although compared to other diseases, this may have decreased, but there is still no end to leprosy.
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IPS: How long have you been working on leprosy and what has been your biggest observation?

TN: I have been working on leprosy since 2014. But I have been working on poverty issues for the past 25 years. People affected by leprosy are really poor. So, working for leprosy is in a way working on poverty too.
Several years ago, there was the concept of the bottom of the pyramid; and we talked of the people living at the bottom of the pyramid and how to uplift them. We talked of using microfinance, social business approach etc. But I have realised that the people living with leprosy are actually living outside of the pyramid. That is why I feel integration is very, very important.

IPS: How did you come up with the idea of the Regional Assembly of Organisations of Leprosy- Affected People in Asia?

TN: Last September, we had a small meeting. We invited and had a discussion with some of the people’s organisations from India, Indonesia, Brazil and Ethiopia on what could be done. This September, there will be the World Congress on Leprosy where there will be academics, experts, governments. The congress is a crucial event but often organisations of the affected people are left behind. So, we came up with the idea of organising a pre-congress event where the affected people’s organisations so that it can also be a way for preparing themselves for the congress.

IPS: Why is sustainability still such a big issue for organisations of leprosy–affected people?

TN: Sustainability is not only an issue of leprosy affected people, but also for all the NGOs of the world. I don’t really have an answer here. It depends on each organisation, each leader. Every NGO, every organisation has to find its own way and its own strategy to sustain itself. Should they approach foundations, survive on external grants, seek membership fees, donations , do social business—it s up to them. As foundations we can provide financial grant, but not forever. What we can do, however, is think together on what could be the next step.

IPS: There are many hidden cases in the world of leprosy. Can you share an example of a good action by a government that tried to act on this.

TN: In India, the government made a very brave decision. In 2016 they started a campaign to identify the endemic leprosy cases all over the country. And since then, every year, they do case detection camps. It has brought in the open many new cases that were previously hidden. It also resulted in an increase in the number of leprosy cases in the country, but after that it started to decrease as the cases were treated . So, this is an example I feel other governments can also follow.

IPS: How are you feeling now that the assembly has concluded?

TN: My expectation is very simple: this venue is for the people affected by leprosy. They should be able to discuss whatever they want to and decide whatever they want to decide.
Here, we saw is they are trying to be more pro-active, opening up,coming up with some issues, some ideas on how they can strengthen their partnership, soI am happy.

In 2019, there are measles outbreaks in the US and Europe; Ebola outbreak in DRC and Uganda and several other infectious disease outbreaks in Nigeria, Vietnam and South Africa. Credit: Marc-André Boisvert/IPS

ABUJA, Jul 19 2019 (IPS) – The 2019 G20 Summit was held recently in Osaka, Japan. The Summit ended with the “”, which identifies health as a prerequisite for sustainable and inclusive economic growth, and the leaders to various efforts to improve epidemic preparedness. 

These efforts are commendable, but the G20, with economies that represent more than 80 percent of global Gross Domestic Product (GDP), also must do more to lead by example in epidemic preparedness by ensuring they all have a .

This is managed by , the world s first to provide clear and concise country-level data on epidemic preparedness.  It measures a country s ability to find, stop and prevent health threats. Then, they need to demonstrate they are ready to take steps to improve their score, as needed.

This is an important issue because , an infectious disease can travel from a remote village and can be carried to major cities worldwide, according to the United States Centers for Disease Control and Prevention (CDC). If anything kills over 10 million people in the next few decades, it would mostly likely be a highly infectious virus rather than a war. The next disaster is not missiles, but microbes, said Bill Gates in his .

As Gates was giving his 2015 TED Talk, the Ebola outbreak in West Africa was coming to an end after causing the , reducing the GDPs of Guinea, Liberia Sierra Leone by $3 billion and devasting the health workforce in the three countries. Overall, the 2014 Ebola outbreak in West Africa cost global economy an estimated .

As long as there are communities globally in which people are unable to access healthcare because of their inability to pay or due to other inequities, the risks of infectious diseases remain

Outbreaks are not a thing of the past, however. In 2019, there are measles outbreaks in the  and ; Ebola outbreak in DRC and Uganda and several other infectious disease outbreaks in ,  and .

To be assigned a ReadyScore, countries should undergo a (JEE) which is a voluntary, collaborative, multisectoral process to assess country capacities to prevent, detect and rapidly respond to public health risks whether occurring naturally or due to deliberate or accidental events.

Right now, only 100 out of 195 countries (51 percent) have conducted the JEE. Until all 195 countries conduct the JEE, it would be difficult to assess global preparedness for prevention, detection and response to epidemics.

Based on records on , the following G20 countries have an unknown ReadyScore; Brazil, China, France, India, Italy, Russia and Turkey. An unknown score implies that a country has not volunteered to have a JEE. On the other hand, the ReadyScore of Argentina, Canada, Germany and Mexico is pending.

This means that they have committed to have a JEE, but data are unavailable. Some G20 countries that do have a ReadyScore include United Kingdom (84 percent), USA (87 percent), South Africa (62 percent), Indonesia (64 percent) and Japan (92 percent).

The ReadyScore provides clear and concise country-level data on epidemic preparedness. It measures a country s ability to find, stop and prevent health threats.

To , a country must have a ReadyScore of 80 percent and above, otherwise the international community cannot categorically say that all G20 countries can prevent, detect and rapidly respond to infectious disease outbreaks. So, what needs to happen next?

First, the G20 should work with the World Health Organisation and other partners to conduct JEE to make our world safer. JEE is a voluntary activity and no nation can be compelled to conduct one and very few G20 countries have their ReadyScore. The WHO on its own must strengthen advocacy to the G20 countries that have no ReadyScore. The advocacy should make these countries acknowledge that when it comes to epidemic preparedness, the world is as strong as its weakest.

Second, must both be addressed together. Billions of people do not have access to healthcare, and this poses serious risks for global health security. As long as there are communities globally in which people are unable to access healthcare because of their inability to pay or due to other inequities, the risks of infectious diseases remain.

A number of G20 countries already fund different health interventions in low- and middle-income countries. It is time for the G20 to push for integrated health programs instead of the current vertical system in recipient countries. Universal health coverage is heavily dependent on political will.

Therefore, the G20 should use its influence to advocate to countries without universal health coverage to gradually move to one. Development aid to such countries earmarked for health should be conditional – to be used to develop a publicly-funded universal health coverage health system which is accessible to all.

Third, G20 countries can invest in networks of reference and specialised laboratories as part of disaster prevention. Detection and control of infectious diseases is delayed if bio samples have to be taken to other countries located thousands of miles away in order to get definitive diagnoses.

For example, during the 2014 Ebola outbreak in West Africa, to confirm Ebola in Nigeria, blood samples had to be taken to Senegal (more than 3 hours by flight). This obviously delayed the response efforts. Although the Nigeria Centre for Disease Control (NCDC) has since increased its diagnostic capacity, national public health institutes such as NCDC still require financial and technical support to ensure global health security.

G20 countries should lead by example and get a ReadyScore by being open for joint external evaluations and meet all Osaka Leaders’ global health commitments. If other countries follow suit, then the world would move closer to being better prepared to handle epidemics.

Dr. Ifeanyi Nsofor is a medical doctor, the CEO of , Director of Policy and Advocacy for 

Africa Investment Forum 2018

ROME, Oct 18 2019 (IPS) – Headwinds are blowing amid IMF warnings of a “synchronised slowdown” in global economic growth, yet Africa’s investment drive is still gathering pace, supported by intense international competition in development finance.

Despite the global slowdown, 19 sub-Saharan countries are among nearly 40 emerging markets and developing economies forecast by the IMF to maintain GDP growth rates above 5 percent this year. Particularly encouraging for Africa is that its present growth leaders are richer in innovation than natural resources.

While Akinwumi Adesina, president of the African Development Bank, admits to sleepless nights over the “headwinds” to African growth – primarily the US-China trade war – he remains excited over the continent’s prospects as the AfDB gears up for its annual Africa Investment Forum.

The November 11-13 gathering in Johannesburg follows major milestones achieved in 2019, notably the coming into force of the African Continental Free Trade Agreement, described by Adesina as a “phenomenal development”.

In May, 54 of Africa’s 55 countries became signatories to the initiative which aims to eliminate 90 percent of tariffs on goods and significantly reduce non-tariff barriers. The free trade area means to integrate Africa into a unified market with a population of over one billion and output of $1.3 trillion.

The AfDB does not gloss over the enormous challenges ahead, however, noting that 120 million Africans remain out of work, 42 percent of the population live below the $1.25 poverty line and about one in four in sub-Saharan Africa are undernourished. Africa is also most vulnerable to the global climate crisis, although it is the world’s least contributor to carbon emissions.

Akinwumi Adesina

Under Adesina, appointed in 2015 and backed by his native Nigeria for a second term, the AfDB has responded to such challenges by scaling up investment in five priority areas dubbed the High 5s: electricity and energy; food; industrialisation; integration, and improving the quality of life.

At the UN climate crisis summit in September, Adesina announced the AfDB would double its climate financing to emerging economies to $25 billion from 2020-2025. Half would be aimed at helping governments adapt to the impacts of climate change, such as droughts and rising sea levels.

“Poor countries didn’t cause climate change, they shouldn’t be holding the short end of the stick,” the AfDB president said.

The bank will invest $20 million to help fund the Sahel’s new Desert to Power solar scheme, with Adesina seeing renewable energy as a driver of economic development and replacing all of Africa’s coal-fired power stations.

During his term the bank has increased the renewable power share of its energy portfolio to 95 percent from about 60 percent. Off-grid solar-powered energy is seen as key to connecting the 50 per cent of African households without access to electricity.
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Last year’s inaugural Africa Investment Forum generated $38.7 billion in “investment interest” in infrastructure projects, and the multilateral lender is setting a target of $60 billion this year to close what it sees as Africa’s “infrastructure gap” amounting to $108 billion. As an investment marketplace which attracts heads of state, the AfDB says it will work at the Forum in conjunction with all commercial banks across Africa, as well as development finance institutions, global sovereign wealth funds and pension funds.

China’s presence at the Forum is sure to come under close scrutiny given Beijing’s focus on Africa, with President Xi Jinping’s flagship Belt and Road Initiative pledging $60 billion in financing for projects across the continent. China’s trade with Africa has soared over the past 20 years from about $10 billion to close to $200 billion. In a reflection of shifting balances of power, an analysis by Quartz found that nearly twice as many African leaders attended the Forum on China-Africa Cooperation in Beijing in September than the UN General Assembly in New York two weeks later.

Not to be outdone, Russia has invited over 50 African leaders to its first Russia-Africa summit in Sochi in late October, the culmination of a strategic push that marks Moscow’s re-entry into the continent, with its focus on military deals and oil and gas contracts. With trade and investment replacing aid, US and European multilateral lenders are also directing more funds towards Africa.

The Africa Investment Forum may also enjoy the glow of more favourable headlines for the continent in recent weeks: Mozambique held relatively peaceful presidential elections in mid-October, which followed the signing in August of a peace deal between the ruling Frelimo party and former civil war rivals Renamo; and Ethiopian Prime Minister Abiy Ahmed was awarded the Nobel peace prize for his role in resolving the border conflict with Eritrea, as well as promoting peace and reconciliation in Ethiopia and the wider East African region.

Farhana Haque Rahman

Mozambique sees itself on the brink of substantial investments following its discovery of huge gas reserves while, as commentators noted, Abiy’s first official state visit outside Africa after coming to office last year was not to the traditional western capitals or even Beijing, but to Riyadh and Abu Dhabi, major investors in his ambitions to transform Addis Ababa.

With foreign investors and multilateral institutions gathering at the door, the AfDB’s president is addressing fears that Africa is piling up debt and mortgaging its future.

“What’s important is that African countries get into deals that are transparent with terms of engagement that are clear,” he told Bloomberg in September.

“If there were cases where some folks got away with deals in the past because others aren’t around the table to help negotiate well that’s changing. I don’t think any African nation should trade away its future for immediate gains. We want fair and transparent transactions.”

Farhana Haque Rahman is Senior Vice President of IPS Inter Press Service; a communications expert, she is a former senior official of the United Nations Food and Agriculture Organization and the International Fund for Agricultural Development.

Credit: Busani Bafana / IPS

MILAN, Italy, Dec 3 2019 (IPS) – A coffee producer will receive a cent and a half from a $2.50 cup of coffee. This one stark fact stood out as scientists, researchers, activists and grappled with solutions for change in food and nutrition practises, which would benefit the greater community.

While the solutions are many – slow food to artificial intelligence – it was clear that the delegates were united around one idea: Key to the solution is to ensure that the solutions need to be put in the hands of the broad community – not just in the hands of the powerful.

This also needs the commitment of every sector of society – from multi-national businesses to small scale local farmers.

This message was reinforced by Guido Barilla, founder of the Barilla Centre for Food and Nutrition at the 10th International Forum on Food and Nutrition. The forum had the theme of Fostering Business and Innovation while preserving Mother Earth.

He urged all stakeholders come together and educate on the importance of sustainable and virtuous food systems.

Professor Angelo Riccaboni agreed – cooperation between institutions, corporations, NGOs, philanthropic institution and academia was crucial for changing the trajectory.

Ertharin Cousin reminded delegates that biologist Paul Ehrlich once predicted large scale famines, particularly in India – but through innovation in the agricultural sector and community of actors involved in the Green Revolution, these grim visions were overcome.

Even so, she said the challenges are huge – and research suggests that by 2030 half the world’s population would suffer from some form of malnutrition, whether from a shortage of food or micronutrient deficiency.

Delegates debate at the 10th International Forum on Food and Nutrition in Milan. Credit: Busani Bafana / IPS

Jeremy Oppenheim, founder of Systemiq, who used the example of the cup of coffee pointed out how starkly pointed out how unequal the chain of production, processing, distribution, consumption and the way it is disposed of requires a radical overall.

The mixed signals were unhelpful, he said.

“We re sending all these mixed signals, every single day to people … In the next in the run up to Christmas again in the UK, food companies, and retailers will spend, 100 billion pounds advertising largely unhealthy food.”

Mattia Galletti , IFAD Technical specialist, pointed out 70 million people in the world belong to different indigenous people and in studies in the Amazon, for example, where indigenous farming is practised there was no deforestation.

Carlo Petrini, Founder and President, Slow Food International, agreed. Local communities had the solution in their “DNA” and had essential answers to the critical problems of climate change.

The biggest challenge today is climate change, and politicians are still ridiculing youth asking for climate justice,” says Petrini.

However, he warned that the economy needed to change – one that was rooted in local communities and not in the hands of a few. It was only then that sustainable development could be achieved. Any other solution was just “blah, blah, blah”, he warned.

However, Galina Peycheva-Miteva suggested that the “idea of farming” had to change.

“Farming is not considered prestigious by the young generation. We have to modernize and digitize farming. We have to make farming attractive again.”

If the return to traditional technologies and systems was a big discussion, so too was the use of modern technologies and artificial intelligence as a solution to food security and diet. The technology could be harnessed for everything from testing the soil, to encouraging people, through the use of Apps, to follow healthy diets.

What is clear, though, is that there needs to be a shared agenda for the future.

“We need everyone to work together, we must travel the same road. We need lawmakers to enact clear rules, Barilla concluded.

A Malawian nurse at a training session. A report looking into the discontinuation of U.S. global health assistance to foreign non-governmental facilities providing abortion or abortion-related services, says that the ban is affecting the population in Malawi. Credit:Claire Ngozo/IPS

UNITED NATIONS, Feb 19 2020 (IPS) – A report released last week has detailed the complex ways in which President Donald Trump’s ‘Global Gag Rule’ (GGR), that blocks U.S. global health assistance to foreign non-governmental facilities providing abortion or abortion-related services, is affecting the population in Malawi, a country already hard hit with numerous climate change disasters. 

The report, titled ‘A Powerful Force: U.S. Global Health Assistance and Sexual and Reproductive Health and Rights in Malawi’ was released on Feb. 10 by Washington, D.C.-based sexual and reproductive health rights organisation . 
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Serra Sippel, president of CHANGE, told IPS they chose to study Malawi in part because the country is a recipient of U.S. assistance in the three key fields of sexual and reproductive health: family planning, maternal and child health, and HIV and AIDS. 

“The GGR impacts health structures and when health structures are impacted, it is often the marginalised and criminalised groups who bear the brunt of the impact,” Sippel told IPS. “This includes people living in rural areas, adolescent girls and young women, and female sex workers.”

The report details the numerous ways in which GGR affects the fabric of a country where many communities are already averse to abortion, often owing to religious concerns. This means that when a young woman needs to get an abortion, they might do so in unsafe ways in order to keep them secret. 

One partner organisation is quoted in the report as saying, sometimes a girl “would drink a potion like a solution of washing powder and some will use sticks” to engineer her own abortion. 

In the Sub-Saharan country, where abortion is a taboo and can even lead to 14 years in prison in cases where there is no “life endangerment” of the pregnant person, more than 50,000 women suffer annually from unsafe abortion practices, according to the report. 

, which doesn’t have direct services in Malawi, estimates that about 78,000 women undergo unsafe abortion practices in the country, according to the report. Abebe Shibru, MSI’s country director in Zimbabwe, shared with IPS the general effect it’s having in sub-Saharan Africa.  

“The GGR continues to aggravate the situation of undermining women’s right for choice,” Shibru told IPS. “Lack of adequate services for family planning, increasing rate of teen age pregnancy and increasing maternal mortality, mostly from unsafe abortions, are some of the issues that the GGR contributes to.”   

Sippel told IPS that the local MSI affiliate Banja La Mtsogolo (BLM) was “forced to end their participation in the U.S. PEPFAR DREAMS Partnership, a highly effective HIV prevention programme, because of the GGR”.

Some of the impact is top-down from the government. In 2015, the Termination of Pregnancy Bill, introduced in Malawi to ensure safe abortion in cases of incest, rape, fetal anomaly, was “slowed down” by the Minister of Health given their fears that it would affect U.S. foreign aid in the country while President Trump is in office, according to the report. 

“We also met with the affiliate who was forced to stop their participation in the LINKAGES project which provides HIV and AIDS prevention, care, and treatment services for key populations. Because of the GGR they were forced to close four clinics,” Sippel added. 

There is also a further effect on a community that’s hard hit by climate change, and vulnerable to such as intense rainfall and droughts, among many other issues. These issues, although not directly related to GGR, further amplify the negative effects such foreign policy has on those at the center of the crisis, according to advocates.

“When women are displaced because of climate change, their risk of exposure to gender-based violence often increases,” Sippel told IPS. “They are walking longer distances to get water and firewood. Also, as women enter camps post-disaster, their access to SRHR services can often be limited.”