Complete Wellness

Zofeen Ebrahim interviews NAFIS SADIK, special adviser to the U.N. Secretary General and special envoy for HIV and AIDS in Asia

BERLIN, Sep 10 2009 (IPS) – As secretary-general of the International Conference on Population and Development (ICPD) in September 1994, Nafis Sadik had described this groundbreaking event as a quantum leap in reinforcing commitments to addressing infant and maternal mortality, education and reproductive health and family planning.

Nafis Sadik (right) Credit: Global NGO Forum

The programme of action that came out of that historic global summit the Cairo Consensus that has today reached its 15th year had the potential to change the world , the former head of the United Nations Population Fund (UNFPA) had predicted at the time.

Sadik spoke to IPS on the sidelines of a Sep 2-4 forum here that took stock of progress in implementing the Cairo agenda, called Global Partners in Action: NGO Forum on Sexual and Reproductive Health and Development Invest in Health, Rights and the Future .

She also talked about how sexual and reproductive health and rights has been undermined by extremism and militancy in her native Pakistan, and what can be done to breath new life into efforts to counter these.

IPS: In the Pakistani context, do you think extremism has been a death blow for sexual and reproductive health and rights?

NAFIS SADIK: I think the whole Taliban movement is very detrimental to the progress of the sexual and reproductive health and rights movement. They deny women and girls the right to education, which is fundamental. They are also opposed to family planning and sexual and reproductive health and rights and want women to be in bondage, not to be seen or heard. This is totally against Islamic concepts.
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IPS: What can the government do to address this extremist assault?

NS: Governments can do so much. To my mind, one way to counteract this onslaught is for all sections of society to form an alliance. Today, there is a movement against, what is known as Talibanisation. The non-governmental organisations, civil society and the corporate sector must forge forces with the government.

The way to go about it is to work at the community level. Firstly, because of insidious poverty, the people are compelled to send the children to madrasah (religious seminaries). We have to counteract this. We must find the source from where these madrasah are financed and stop this. At the same time, we need to improve our own school systems. We must get our primary schools in order.

Secondly, we need to find champions from within the local communities, both men and women who will talk about the real and right aspects of Islam. Our society is very traditional and people believe everything told to them. Some of the theologians are distorting religion. So we must concentrate on finding an intellectual group, in sufficient mass, countering that.

IPS: Where do we get such a learned, progressive mass of people?

NS: There are many movements now to educate men and women scholars that aim at enlightening them. It s not a question of getting them; it s about changing minds. That s the change in society that we need. I understand it can t be done overnight, and cannot certainly be done by governments. But I think civil society as a whole, and I don t mean just NGOs, can start to play an active role by which I mean boldly and courageously talking, speaking, speaking out against such atrocities.

IPS: You think there is political will for this?

NS: If they are scared enough, and it seems they (government) are now, then now is a good time. I think there will be some leaders emerging from all that is going on in Pakistan today.

IPS: Would it be prudent to use Islam as a way to get back at extremism?

NS: Yes, I think we also have to invoke religion because, in my opinion, we cannot take on religion. You can never win if you take on religion. We do not choose our religion and yet we defend it to death. We have the right to choose, but the right to choose religion is denied. I myself am a born Muslim and I defend Islam. It goes against my grain to give in that there are some things in Islam that I don t actually agree with.

IPS: Can women be prayer leaders? For if they can, perhaps they can begin to have a far more influencing role in society than their male counterparts?

NS: Islam allows women to be leaders. In our society, which is really quite backward-thinking, that s like a major shift in attitude, to ask women to lead. I think we should make incremental changes. I would take that on when the time is right. I wouldn t take it up as a first thing, as you might upset the whole movement to change.

IPS: Do you find that there has been any progress in Pakistan with regard to sexual and reproductive health and rights since the Cairo conference of 1994?

NS: I think that there has been a lot of progress in the world, not just in Pakistan. Women are much more knowledgeable. Many, without being empowered, try to empower themselves. There are many brave women in Pakistan.

IPS: What are your views about the recent passage of the domestic violence bill in the lower House?

NS: Now that s the starting point. I am very happy with changes and one can build on these changes and get voices from the community. The only problem is (that) in Pakistan, we all work in silos. These voices remain scattered . If only we could have them together. In that way, the success of the ICPD was that many different disciplines came together under the same umbrella.

IPS: Do you think the Millennium Development Goals have taken away the thunder from the ICPD?

NS: I don t think so. All the issues that we worked on at the ICPD have been incorporated in the MDGs. Every goal of the MDGs has come from the ICPD. The education for all, gender equality, maternal mortality reduction, infant mortality, all were in the ICPD. Five of the eight goals have come straight from the ICPD. The MDGs have caught the attention of all the world governments. This is something powerful and we need them.

IPS: But then the ICPD is now redundant?

NS: ICPD forms the underpinnings of the MDGs. These goals haven t come out of the air. These have come out based on a series of recommendations from conferences on development, population, environment. The one that was omitted on reproductive health for all has now been put back. It was omitted by certain governments, especially the United States. It s now back as a target and a very strong one.

IPS: You were one of the lead authors of the Cairo Consensus, which people here have termed a visionary document. Now on its 15th year, how do you see it?

NS: I think we have made a lot of progress because reproductive health is accepted everywhere. Sexual health is talked about but not necessarily accepted, but that in itself is a big change. And the linkage of sexual and reproductive health and rights to women s empowerment and gender equality is a very strong element and that has been totally accepted.

The fact that you can t have demographic goals from the top down without acknowledging individual choices, especially the choice for women, is a strong part of the ICPD and that is totally accepted in all societies. Coercive policies and top-down imposition of contraception have really gone now.

IPS: So there is reason to celebrate the ICPD at 15?

NS: Part reason to celebrate. I am disappointed that maternal mortality stays the same, that access to family planning is still not universal and those that need them don t necessarily have them.

I am disappointed that while laws have changed as far as women are concerned, the societal attitude and mindset is still slow (to follow). Nevertheless, I am optimistic and we have made progress. You know, issues like rape, incest were hidden, private matters but are now out in the open. I am encouraged that there are more young leaders now, much more involved in their own future and this brings hope.

IPS: So what can we do in next five years?

NS: Maybe we can join forces again. I think NGOs can be more powerful voices if they didn t work in silos. I think the underlying need is the empowerment of women that is a common theme.

Eli Clifton

WASHINGTON, Dec 7 2009 (IPS) – Attention over the past week has focused on United States President Barack Obama s decision to surge troop levels in Afghanistan to 30,000 and begin a drawdown in 18-months, but a new report calls attention to the failure of the Afghanistan government and international donors to protect women s rights.
The report released by Human Rights Watch (HRW) on Sunday calls attention to the George W. Bush administration s citing of the defence of women s rights as one of the primary reasons for defeating the Taliban and Al-Qaeda.

Eight years after the fall of the Taliban, and the establishment of the [Hamid] Karzai government, Afghan women continue to be among the worst off in the world. Their situation is dismal in every area, including in health, education, employment, freedom from violence, equality before the law, and political participation, said the report.

HRW warns that women s rights have been largely overlooked by the Afghan government and international donors who have chosen to focus on the armed conflict against the Taliban and Al-Qaeda.

In March, the poor condition of women s rights in Afghanistan was brought into the news again by the parliament s passing of the Shia Personal Status law which Karzai went on to sign.

The law which Obama called abhorrent regulates the personal affairs of Shia Muslims and among other things: requires that wives seek their husbands permission before leaving home expect for in reasonable legal situations; gives child custody rights to fathers and grandfathers but not mothers or grandmothers; allows a husband to discontinue maintenance to his wife; requires that a woman make herself up or dress up when demanded by her husband; and not refuse sex when her husband demands it.
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The Shia law provided a timely reminder of how vulnerable Afghan women are to political deals and broken promises, said Rachel Reid, Afghanistan researcher at HRW. Karzai should begin his new presidency with a clear signal to women that his will be a government that wants to advance equality.

For many, at question is not just the Karzai government s failure to address women s rights but also the focus of resources by international donors and U.S. foreign aid to Afghanistan designed to strengthen civil society.

The interests of women are the interests of civil society. As soon as you dispense with things you think to be women s concerns you put health, sanitation and education on the back burner, Ann Jones author of Kabul in Winter and contributor to The Nation told IPS.

The thing the Americans do is end up building roads. If you talk to Afghans, roads are way down on the list of things they want. And if you talk to Afghan women you ll find roads aren t part of the things they need for their families, Jones went on to say.

HRW found that violence against women and attacks on women who participate in public life remain high.

The Apr. 12, 2009 murder of Sitara Achakzai a human rights defender and local councillor in Kandahar was an example of the danger facing women who participate in politics, human rights activism, teaching, health work or journalism.

No one has been prosecuted for her murder and HRW says that the killing of women who publicly participate in society scares off countless women from entering public life.

Police and judges see violence against women as legitimate, so they do not prosecute cases, Soraya Sobhrang of the Afghanistan Independent Human Rights Commission told HRW.

A 2008 survey of 4,700 women found that 87.2 percent had experienced at least one form of physical, sexual, or psychological violence, or forced marriage in their lifetimes and in the vast majority of cases women do not seek help because of their fear of police abuse, corruption, or retaliation by those who committed the violence.

Adding to the situation is the fact that rape is not a crime in the Afghan Penal Code and that rapists can only be charged with forced adultery, which can also result in women being prosecuted for adultery.

In addition to documenting the rampant violence against women, HRW points out that 57 percent of marriages which take place in Afghanistan are with girls under the age of 16 and 70 to 80 percent are forced marriages.

These marriages lead to girls dropping out of school and early childbearing, which results in a heightened chance of health complications during childbirth.

Curbing the dangerously high levels of violence against women and children and forced marriage has proven difficult because police receive little or no training in gender based violence or women s rights.

[T]raining has been increasingly focused on counter-insurgency and security skills rather than crime prevention, crime solving and community policing, said the report.

Little has been done to reverse cultural prejudices which lead to women facing discrimination and prejudice when dealing with the police or the courts.

Finally, despite significant efforts by international donors to improve education for girls, a disappointing 11 percent of secondary-school-age girls are enrolled in grades 7 to 9 and only four-percent are enrolled in grades 10 through 12.

The failure to educate girls warns HRW will often lead to child marriage, early childbearing, and the risk of dying during pregnancy.

HRW calls on Karzai s government and international donors to: promote the protection of women s rights as part of the reconstruction of Afghanistan; improve the Elimination of Violence Against Women law to bring it up to international standards; embark on a large-scale rape awareness campaign for law enforcement, judges, parliament, civil servants and the Afghan public; and make marriage registration more widely available and compulsory.

In addition: Karzai should order the release of, apology and compensation to all women charged with running away from home; the government and donors should strengthen training and Women and Family Response Units in the police to deal with gender based violence and increase the availability of girls secondary schools; the U.N. and government should prioritise the security of women candidates and voters for the 2010 parliamentary elections; and international donors and the U.N. with the Afghan Ministry of Women s Affairs should conduct a full gender audit of all spending in Afghanistan.

Women s rights advocates have also called attention to the inclusion of former warlords many of whom are known for violating human rights into the government.

We don t need to have so many mullahs and warlords who have attitudes towards women which are restrictive, President of The Feminist Majority Eleanor Smeal, told IPS. We would urge that [the government] appoint people from different parts of society who understand that women need to be empowered to make civil society function properly.

Lewis Mwanangombe

NDOLA, Zambia, Nov 23 2009 (IPS) – When Obed Mumba first came to the Zambian copper mining town of Ndola in search of work, it was still known reverently as Ku kalale the land of the white man. In the decades since, he has witnessed his Kabushi township outgrow the limited dreams of its planners.

Building a biodigester in Kabushi. Credit: Lewis Mwanangombe/IPS

Now 56, he is affectionately known in the Kariba section of the location as Ba Shikulu-Mumba , Grandpa Mumba. The neighbourhood was built in the 1940s specially to accommodate single men like Mumba, who came to Ndola from the northern region of Luapula to work in the Bwana Mkubwa Copper Mine.

Kariba comprised 130 housing blocks of six rooms each that were the envy of many native workers at the time. The changed fortunes of the town are felt keenly here, as the bright young men of today have quickly learned that it pays to follow revered sons of the city like Frederick Chiluba and Levy Mwanawasa (both former presidents of Zambia) to Lusaka, where fame and money are more readily found.

Hostels long outgrown

Established in the 1940s, Kariba section was built specially to accommodate people like Mumba who came to Ndola from Luapula as a single and eventually found work with Bwana Mkubwa (which means Big Boss).

This section comprised 130 swanky new housing blocks of six rooms that were the envy of many indigenous workers of the time.
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But in the years since the rules preventing miners families from living with them were cast aside, each room became living quarters for a family of five or more. Shacks, known locally as cabins , were thrown up to house teenaged sons and daughters and extended family members.

The original sanitation arrangements, eight communal ablution blocks, each designed to serve 100 people, were soon overwhelmed. By the early 1980s the communal showers and toilets were completely abandoned.

We had to dig shallow pit latrines near our houses and children who feared to fall into them began to defecate in the open. The whole place began to smell terrible with flies everywhere, Mumba, who today runs a small grocery store, recalls.

Among those who had left Ndola to make his career was Bernard Phiri. He had risen to become chief executive officer of the Kafubu Water and Sewerage Company, responsible for the town s water and sanitation, when in 2007 a non-governmental organisation from Germany established links with the Water and Sanitation Association of Zambia.

Appropriate technology

BORDA, the Bremen Overseas Research and Development Association, had been working on biogas projects in India since the late 1970s, and was interested in setting up a pilot project in Zambia.

Kabushi township was chosen for the pilot for a decentralised wastewater treatment system, intended as a waste and energy solution for a poor neighbourhood lacking sanitation. The system depends on bio-digesters to process human waste to give off methane gas.

A bio-digester is a reservoir typically round built out of burnt bricks and mortar or plain concrete with two vents fitted with valves. Through one vent, raw human waste flows in, which is hungrily fed on by bacteria, until out of the other flows an odorless, biodegraded slurry that can safely be used as manure in a vegetable garden.

Methane gas released by the bacteria collects at the top of the structure s convex roof, and is piped away to feed stoves in the nearby homes.

Five hundred forty-seven toilets were constructed by Kafubu in Kabushi. These are pour flush toilets with an integrated shower. The water supply is metered and the effluent from 156 households feeds the two biogas digesters that have already been constructed, Phiri explains.

Waste not, want not

Each household is expected to pay for the piped water used in the toilet, kitchen and shower billed at a rate of 59,200 Zambian kwacha just under $13 for 38 cubic metres of water.

Ba Shikulu-Mumba is one of the 30 grateful homeowners who has been connected to the gas network. He says it is much cheaper to cook on gas than on charcoal.

A bag of charcoal costs about 30,000 kwacha and if your wife is careless you can end up with a bill of more than 150,000 ZMK (just over $30) a month, he observed. A typical household in Kabushi gets by on roughly $100 each month.

As more digesters are built in the area, the plan is to connect all the houses as raw sewerage is expected to come in from more affluent neighbourhoods.

Sustainable development

The Kabushi project is the first integrated water treatment system in Zambia, and has already been copied by four of the country s ten other water utilities.

Bwalya Nondo, spokesperson for the ministry of environment and natural resources points out that the project s benefits extend beyond refurbished toilets and cheap fuel for residents. Harnessing renewable energy from human waste will also go a long way to protect Zambia s fast-disappearing forests.

At the moment charcoal burners destroy as much as 300,000 hectares of forest cover each year, Nondo said.

The two biodigesters, and the gas pipes and support structures built in Kariba section of Kabushi has cost Kafubu Water and Sewerage Company around $830,000. The biodigesters have put Kabushi and the city of Ndola on the road to a sustainable new order for their city.

Susan Anyangu-Amu

NAIROBI, Dec 21 2009 (IPS) – Kenya s new Anti-Counterfeit Act will be challenged on Mar 8 next year in the country s Constitutional Court on the basis that it violates the right to health. The petitioners, three people living with HIV, argue that the law confuses generic and fake medicine. This could cause a health crisis as generics constitute 90 percent of medicines used in Kenya.

James Kamau says wrong interpretations of the law by customs officials could cost many lives. Credit: Wambi Michael/IPS

The three petitioners want the Constitutional Court to declare the law, which was enacted in the middle of this year, unconstitutional on the grounds that it will deny them access to affordable life-saving generic medicines and therefore rob them off their right to life, says Peter Munyi, an intellectual property rights lawyer working with Health Action International (HAI) Africa.

HAI Africa is part of a global network working to increase access to life-saving medicines.

The issue is of life-and-death importance as generics, which are between 70 and 90 percent cheaper than their brand-name counterparts, have enabled poor people in developing countries to get the necessary treatment.

International donors that fund drug distribution, including the U.S. President s Emergency Plan for AIDS Relief (Pepfar) and the Global Fund to Fight AIDS, Tuberculosis and Malaria, also source from generics manufacturers.

James Kamau, co-ordinator of the Kenya Treatment Access Movement, an activist organisation advocating access to anti-retrovirals, has previously pointed out that the Anti-Counterfeiting Act of 2008 contains ambiguities which could lead to misinterpretation, undermining the government s efforts to ensure access to essential medicines for all Kenyans.
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Christa Cepuch, director of programmes at HAI Africa, adds that the act, which is aimed at cracking down on fake batteries, pens, drugs and cosmetics, contains a vague definition of counterfeiting which could be read to include generic drugs . She describes generic medicines as legitimate, effective and exact copies of brand-name products.

The law makes the manufacturing, importation or sale of counterfeit goods a criminal offence rather than a civil matter, which is the usual way in which disputes over intellectual property rights are resolved.

The onus to verify whether goods are fakes or not has been put on customs officials and police officers. We ll have Kenya Revenue Authority officials trying to figure out if drugs are fakes or not. This increases the risk of products being labelled fakes, Cepuch says.

The law further gives these officials excessive powers, making the process difficult and expensive. Moreover, the onus to prove the products are not fakes lies with the accused, a price many will not be willing to pay.

Activists such as Kamau argue that the existing Pharmacy and Poisons Board should be in charge of combating counterfeit medicines as it has the necessary technical expertise to deal with such issues which customs officials don t. The latter could imagine something is counterfeit and cost the lives of many.

The idea that essential medicines could be delayed for months at ports of entry is not far-fetched, based on what has happened in Europe where 22 seizures of perfectly legitimate generic drugs destined for developing countries have taken place in the recent past.

The risk is simply too high and will potentially keep away generics manufacturers and importers. This is also because the cost of the whole process, should the products be confused for counterfeits, will be too high, Munyi cautions.

The Kenyan law seems to be serving as a template for similar policies at regional level in East Africa and in neighbouring Uganda. Health advocates fear an anti-counterfeiting agenda is being pushed by actors who do not have the interests of poor people at heart.

Suspicion has also been raised by the speed at which the Kenyan bill was passed and acceded to.

Parliament was under immense pressure to pass bills that would change Kenya s political dispensation (after the election violence in 2008). However, they somehow found time to deal with this less urgent bill at the time. And no sooner had it been passed when the commencement notice was published by the minister despite earlier indications that there was no budget allocated to effect the bill, Munyi says.

He is referring to the minister for industrialisation publishing a notice in the government gazette on Jul 24, 2009 that backdated commencement of the legislation to Jul 7, 2009, a day before the suit was launched in the Constitutional Court.

We believe the government should combat counterfeiters and counterfeit goods, including medicines, some of which have been seized in the Kenyan market. However, this should not be done at the expense of the health of millions of Kenyans and their right of life, according to Cepuch.

Susan Anyangu-Amu

NAIROBI, Feb 2 2010 (IPS) – The threat by influential Christian leaders to mobilise a vote against Kenya s draft constitution if it does not explicitly prevent any expansion of abortion rights appears to have succeeded.

Thousands of young women risk their health procuring abortions each year: will a new constitution entrench restrictive laws on termination? Credit: Ann Weru/IRIN

The draft assembled by a Committee of Experts for consideration by the Parliamentary Select Committee (PSC) contained no specific reference to abortion, but the National Council of Churches (NCCK) and the Catholic Church were up in arms about a phrase stating that everyone has a right to life while failing to define where life begins and ends.

Canon Peter Karanja of the NCCK told IPS, Life is sacrosanct. The definition of life must be stipulated in the supreme law of the land, the Constitution. Life must be defined as starting at conception and ending at natural death.

The parliamentary committee has completed deliberations on the draft, and decided to define life as beginning at conception.

Phrases guaranteeing everyone the right to health care (including reproductive health care) and stating that no one may be refused emergency medical treatment have been deleted; added is a phrase ruling out abortion unless in the opinion of a registered medical practitioner the life of the mother is in danger .

The changes have raised an uproar, with professional associations of medical practitioners saying it will have negative effects on Kenya s attempt to reduce maternal deaths.
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As health care providers, we are familiar with both the human impact of unsafe abortion and the public health burden it represents. Including prohibition against abortion in the constitution and defining life as beginning at conception will fail to prevent incidences of abortion, says Dr Otieno Nyunya, chairman of the reproductive health committee of the Kenya Medical Association.

Grace Maingi-Kimani, the acting executive director of Federation of Women Lawyers Kenya (FIDA), says the move by the PSC is disheartening and will serve to limit access to choice for women and young girls who are raped and end up pregnant.

The PSC was not thinking about the hundreds of women who were raped during the post-election violence and were forced to have children sired by men who violated them and possibly killed their husbands. The PSC was not thinking of young girls who are abused by their teachers and forced to cut short their education due to unwanted pregnancies, Kimani says.

It is the poor women and teenage girls who die at the hands of quacks, says Professor Joseph Karanja, an associate professor of obstetrics and gynaecology at the University of Nairobi.

He says wealthy, well-educated women are able to find safe ways to terminate pregnancies; ignoring international commitments Kenya has made guaranteeing the right to health, he charges, the PSC, has created a platform that puts the most vulnerable at still greater risk.

On its part, the Church is happy with the prohibition of abortion and definition of life as beginning at conception, and has again warned it will reject anything less.

We should not victimise the innocent unborn children, who do not have a say in this matter. Even in the case of rape and incest, the life in the womb of the woman is innocent, says Father Paulino Wondo of the Holy Trinity Catholic Mission in the Nairobi slum of Kariobangi.

Members of the Kenya Medical Association, FIDA, Kenya Obstetrical and Gynaecological Society, Family Health Options Kenya and the National Nurses Association of Kenya, have written a protest note to the PSC, the Committee of Experts and Parliament, calling for the controversial phrases to be reviewed.

Currently, abortion is permitted in Kenya only to save the life of the mother. Despite this, every year large numbers of women seek assistance to terminate pregnancies wherever they can find it.

Dr Joachim Osur, an advisor with reproductive health rights organisation IPAS a member of the RHRA argues that opponents of expanded abortion rights in Kenya have their heads buried in the sand.

Despite termination of pregnancy being restricted in Kenya, induced abortions remain common. In Kenya it is estimated that 300,000 spontaneous and induced abortions occur annually, about 29 abortions for every 100 live births, says Osur.

Unsafe abortions contribute a significant margin to the maternal deaths in this country at 30 percent. It is estimated that 2,000 women die annually from unsafe abortions.

Dr Otieno Nyunya, chairman reproductive health committee of the Kenya Medical Association says research done by his association alongside IPAS and FIDA in 2004 found 316,560 spontaneous and induced abortions occurred that year.

Nearly 21,000 women are admitted each year to Kenya s public hospitals for treatment of complications from incomplete abortions, either spontaneous or induced.

The study further shows that 800 unsafe abortions are performed every day and 2,600 women die from unsafe abortions in Kenya each year, representing 30 to 40 percent of Kenya s total maternal deaths, according to Kenya Obstetric and Gynaecological Society and Kenya Medical Association.

Nyunya says that 60 percent of the beds in the gynaecological ward at Kenyatta National Hospital, the largest referral hospital in East and Central Africa, are occupied by patients suffering from abortion complications.

He says a conservative estimate of the cost to the state for the management of these cases is approximately four million dollars a year.

The cost to women s lives is much higher.

Joshua Kyalimpa

KAMPALA, Mar 9 2010 (IPS) – Fourteen-year-old Isaac Wadyegere of Bundesi village in Bududa district woke up to a rainy and chilly Monday morning and went to school as usual. But Mar. 1 was not a usual day in eastern Uganda.

Officials assessing the damage caused by the latest landslides in Kabale, western Uganda. Credit: Joshua Kyalimpa/IPS

When he heard the sound of rocks and soil tumbling down Mountain Elgon on a path to destroy part of his school, Wadyegere, along with other pupils, fled home.

But instead of finding the refuge he hoped for, disaster awaited Wadyegere.

His house and family were destroyed.

My father, mother, step-mother, and five siblings all died when our house was covered by the landslides, the boy says.

Orphaned Wadyegere now stays in a camp set up by the Uganda Red Cross for survivors of the landslides that buried three other villages including; Nametsi, Namakansa and Kubewo villages in the Bududa district.
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So far 92 bodies have been dug out of the rubble by the army and rescue workers and over 300 people are still missing. More than 300,000 people will be displaced by the worst disaster in the region according to Joel Aguma, the police commander for eastern Uganda. We never planned for this and here we are, with so many people to look after, the scale of this disaster is surely beyond our capacity but we are trying our best, Aguma said as the rescue continued.

Government has now declared the scene of the Bududa landslides a mass grave.

Minister of state for disaster preparedness, Musa Ecweru, says government has called off the search for survivors after dysentery broke out and rescuers contracted it. We realised it will take longer to get all the bodies out and it was increasingly risky for the rescuers, Ecweru says.

Experts warn that the worst is yet to come. A weather outlook report released recently by the Intergovernment Authority on Development s (IGAD) Climate Prediction and Adaptation Centre (ICPAC) based in Nairobi, stated that the region was expected to have higher rainfall than normal.

The statement was released during the Climate Outlook Forum for the Greater Horn of Africa held in Nairobi, Kenya in February. National, regional and international climate scientists reviewed the state of the global climate system and its implications on the seasonal rainfall over the region.

Experts said regional systems that include sea surface temperatures in the Indian Ocean, which are currently warmer than average, and Atlantic Ocean will have greater influence on the rainfall performance over Uganda

Professor Laban Ogalo, director of ICPAC advises countries in the region to plan accordingly as the changing rainfall pattern may be both a blessing and a curse.

Rain is a good thing if managed well. The region can benefit from it if it s used to spur food production for those who get it in plenty so they can supply others who will get less rain, says Ogalo. He said heavy rains in the region could be destructive to infrastructure and may lead to loss life.

Ugandan weather experts are warning of more landslides and floods in the east, central and western parts of the country as heavy rains continue in most parts of the country. River Malaba in Busia district in eastern Uganda, near the Bududa district, has already burst its banks.

Bildard Baguma, deputy secretary general of the Uganda Red Cross, says there is an increasing possibility of flooding from the river if rains continue. Baguma says people in the affected areas will be evacuated from their villages to higher ground where temporary camps are to be set up.

Uganda s government has asked residents in low-lying and flood-prone areas to move before tragedy hits. The ministry for disaster preparedness has already started registering people in high risk areas for relocation. Over 300,000 affected people in the Mountain Elgon region and the neighbouring lowlands of Butaleja, Budaka and Tororo are expected to be relocated.

Deus Bamanya, a senior meteorologist with the department of metrology, explains that extreme weather conditions in southern Europe weakened the high pressure systems in north Africa, which in turn pushed the rain belt down to Uganda. Heavy rains that could lead to flooding are expected to continue until June.

Prime Minister Apollo Nsibambi has told parliament government is appealing for donor funds to carry out the relocation exercise before further rainfall causes more destruction.

As the country still mourns the death of those in Bududa district, landslides have displaced hundreds in western Uganda. Heavy rainfall resulted in landslides on Mar. 4. Officials from the ministry for disaster preparedness have rushed to Kabale, which borders Rwanda and DR Congo, to assess the extent of the damage.

District authorities say landslides hit Rubaya and Butanda sub-counties destroying houses and blocking the only access road. Rescuer workers spent an entire day clearing the road before they could access the area.

Three people have been confirmed dead after they were swept by fast running waters off Kigarama Bridge in Kabale district. Soldiers have joined Kabale district authorities in verifying reports that some people are still trapped under the collapsed mud walls of their houses.

Mark Choono, the United Nations Children s Fund s Uganda emergency coordinator, warns that an outbreak of water borne diseases is also likely.

We are concentrating on providing safe drinking water, which is the biggest problem in areas affected by landslides and floods. We have begun providing water purifying chemicals to affected people, says Choono.

Already in Bududa 60 people have contracted cholera.

But as the devastation continues some experts say that the destruction of the natural vegetation on the mountains by settlers, who have cleared the areas for cultivation of crops, has made the soil loose, resulting in the landslides.

Dr. Festus Bagoora, an expert on weathering and land formations at the Department of Geography at Makerere University, says past human activity has contributed to the catastrophe.

A combination of factors is causing this, of course the rocks have been weakened due to weathering but people have removed all the natural vegetation on (the) mountains for faming and with the heavy rains landslides are bound to happen, says Bagoora.

He told IPS that he and other experts submitted a study for the National Environment Management Authority warning of areas where landslides are more likely to happen but no action was taken.

He says they had recommended the relocation of people in areas they considered to be more prone to floods and landslides.

Pam Bailey

GAZA, Apr 13 2010 (IPS) – It was bad enough that Ahmad Asfour was severely maimed by an Israeli drone strike outside his house on Jan. 9, 2009. But, his search for advanced treatment landed the journalism student, now 19, in Israeli prison where he remains.

Samir Asfour with a picture of his son, Ahmed, at a weekly protest in Gaza by families of Israeli prisoners. Credit: Pam Bailey/IPS

According to Mahmud Abo Rahma of the Al Mezan Centre for Human Rights, not many Palestinians are arrested as Ahmed was, but it is increasingly common for patients entering Israel to be denied treatment unless the patient or family agrees to collaborate.

Al Mezan has joined the Physicians for Human Rights and the ADALA Centre (which defends the rights of Palestinian Arabs in Israel) to charge Israel with blackmailing Palestinian patients in Gaza, exploiting their need for medical treatment to pressure them into collaborating with its intelligence agencies.

Ahmad and four teenaged cousins were hit by fragments from a missile fired by an Israeli drone, east of Khan Younis, in the southern region of the Gaza Strip, just 14 days after Israel launched its massive, 22-day assault on the densely populated strip of land wedged between Israel and Egypt. The fragments lodged in his left eye, broke his jaw, shattered his teeth, severely lacerated both hands and right thigh, destroyed his genitals, and damaged his pancreas and intestines.

His father, Samir, was in Egypt at the time with one of Ahmad s brothers, who had been injured just eight days before. Due to the siege imposed by Israel since Hamas took control in 2007, medical care in Gaza is often inadequate. Gazans have been unable to repair the 15 (out of 27) hospitals and 43 (of 110) primary healthcare facilities damaged in last year s Israeli invasion, because of the ban on importation of construction materials.

Treatment in Egypt is not advanced and, according to Abo Rahma, the risk of contracting Hepatitis C is significant. Getting permission to enter Israel is difficult for Palestinians during normal times, and it was impossible during and immediately after the invasion. Even a year later, the UN reports that almost a quarter of the 1,103 patients who had sought permits for treatment in Israel in December 2009 were denied or delayed. As a result, 27 patients died while awaiting referral last year.
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Ahmad and his cousins were rushed to the local hospital by his oldest brother, and the medical director sent them immediately to Egypt. Ahmad spent the next eight months there, but little could be done. In fact, because of the damage to his pancreas and the lack of appropriate treatment, he soon developed diabetes.

Doctors caring for Ahmad recommended he travel to Germany. But there was a catch: Ahmad needed a visa, and for that he was required to go to Tel Aviv an impossibility for Gazans.

Finally, one physician suggested a hospital in Jerusalem, St. Joseph s. As part of the approval process, Samir took his wheelchair-bound son to the Erez Crossing into Israel on Nov. 23. After waiting four hours, they were turned away, and told to return two days later. When they arrived, they were subjected to a harrowing ordeal.

Here I am with my injured son, terrified about his health, and we were forced to remove all of our clothes so we could be strip searched. Then they took my son away from me, recounted Samir through an interpreter. Ahmad needed insulin every two hours, but I couldn t give it to him The next thing I know he is in shackles! They took the medication I had brought for Ahmed and all the money I had collected from charities (about US$2,500) and he was gone.

It was 20 days, says Samir, before he finally found out what had happened to his son, after he sought help from human rights organizations.

Lawyers from the Al Mezan Center for Human Rights discovered that other young men who had gone before Ahmad to Erez and been interrogated had apparently implicated him, claiming he had been in possession of a gun and an explosive for one of the Gaza-based militias. (Samir claims the explosive was actually his son s insulin vials.)

Ahmad maintained his innocence during his four hours of interrogation at Erez, and as a result, he was transferred to an Israeli prison in Ashkelon. After five consecutive days of further interrogation, Ahmad could take no more and confessed. The charges: membership in a terrorist organization, observation of and passing information to the enemy, providing services for a terrorist organization and possession of firearms.

He was subjected to practices that we consider torture and ill treatment, mainly in the form of forced stress positions for long hours, such as sitting on a chair with hands cuffed behind, the Al Mezan legal team said in a response to an inquiry. Torture is unconscionable at any time, but it is particularly cruel when the victim is already medically vulnerable.

Samir, who receives information on his son from the attorneys and the Red Cross, said he learned later that his son had been told that his father was in jail as well, and that therefore he must cooperate with the Shin Bet, Israel s internal security agency. Meanwhile, Physicians for Human Rights learned that Ahmad was being denied all medical treatment except for his insulin, and has been advocating on his behalf. Samir says the latest news he received is that one of his son s arms may need to be amputated.

Today, Ahmed is still in prison, although he has been transferred to Beersheba. Based on his confession, he was offered a plea bargain of 33 months incarceration or a shortened list of charges with sentencing to be determined. He rejected the bargain and at a Mar. 24 session, the court set a new hearing for June, to allow the prosecution to call its witnesses the police who conducted the interrogation.

Every Palestinian has the right to health, which is enshrined in Article 25 of the Universal Declaration of Human Rights, Al Mezan stated in a March 2009 report. This right must be provided without any conditions hinged to it, a principle that Israel repeatedly violates. The Shin Bet has on numerous occasions pressured Palestinians in need of external medical treatment to become informants in exchange for permission to leave Gaza.

According to Physicians for Human Rights, agents interrogate Gazans who want to enter Israel for medical care about their relatives, neighbors and friends; those who don t cooperate often don t get travel clearance. It has received reports from 32 patients in Gaza who say they were denied permission to leave for refusing to cooperate with Israeli questioners at the Erez Crossing by answering questions about the political affiliations of relatives, friends and acquaintances.

Samir has hired an Israeli attorney to plead his son s case, but so far doesn t have the money to pay her. He will sell his house, he says, if he has to.

My son is not guilty! exclaims Samir in frustration and pain. If my son was a militant, would I have tried to take him through Erez? He is just a boy who needs treatment, who is being used as part of their game.

Mantoe Phakathi

MANZINI, Swaziland, May 13 2010 (IPS) – Africa cannot survive without us, is the message from grandmothers representing all corners of the continent.

March at the birth of the African Grandmothers Movement: We demand economic independence to support our families. Credit: Mantoe Phakathi/IPS

More than 3,000 grandmothers marched in the streets of Swaziland s commercial hub, Manzini on May 8, demanding financial independence to provide nutritious food, decent housing, access to ongoing quality education for their grandchildren and a better life.

We demand the economic independence to support our families, said 90-year-old Judith Simelane as she read the Manzini statement, marking the birth of the African Grandmothers Movement.

Freda Shabangu (70), a grandmother of 12 whose five children have all passed away, also participated in the march. From the meagre grant equivalent to about U.S. $80 that she receives from the Swazi government every three months, Shabangu has to provide for all the needs of her grandchildren.

I m happy that for the first time grandmothers are speaking for themselves about their problems, she told IPS.

With sub-Saharan Africa accounting for two-thirds of people living with HIV and AIDS globally, grandparents, especially grandmothers like Shabangu, have had to take up the responsibility of caring for ailing children and raising their grandchildren. Unfortunately, most African nations provide little or nothing in the way of social security support for this group. They also receive little recognition their contribution to national efforts to deal with HIV.
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We must have the resources to build our own capacity to raise healthy families and assist one another, said Simelane. We call for more training in critical areas such as home-based care, HIV/AIDS education, parenting orphans, healthcare, literacy and financial management.

Supported by the Stephen Lewis Foundation, the first ever African Grandmothers Gathering brought together 500 grandmothers from 14 countries in Africa and 42 of their Canadian counterparts.

The Canadian grandmothers present here are part of thousands back home who are in solidarity with their African sisters, said Elizabeth Rennie from the Grandmothers to Grandmothers Campaign.

These Canadian grandmothers, Rennie added, are raising funds back home to support programmes that are aimed at giving their African counterparts a better life .

The idea of the gathering, according to Swaziland Positive Living (SWAPOL) director Siphiwe Hlophe, was conceived back in 2006 in Toronto, Canada, in response to the emerging crisis grandmothers face in sub-Saharan Africa.

This event is the beginning of a process for Africa to recognise grandmothers who have been valiantly coping with the HIV/AIDS pandemic for over two decades, said Hlophe. Ilana Landsberg-Lewis, the executive director of the Stephen Lewis Foundation, said her organisation has a philosophy that if communities were to get the money they need to start businesses, they could turn the tide around.

That s what these grandmothers are asking for, said Landsberg-Lewis. They are demanding for better policies that would support them in their communities.

Towards this end, the foundation is funding income-generating programmes for grandmothers in some African countries. In Uganda, an NGO called St. Francis is helping grandmothers establish businesses and also save their profits. The organisation has been working with 120 grandmothers since 2007. Most of these grandmothers are living with HIV/AIDS.

We give each granny 100 dollars to start whatever business they think is suitable for them, said Angela Kirabo Ashaba, St. Francis grandmothers programme officer. St. Francis removes the burden of travelling to banks and engaging in complicated paperwork by keeping grandmothers savings safe at their offices.

Besides the fact that banks are intimidating to grandmothers, said Anne Mwangi from Kenya s WEM Integrated Health Services (WEMIHS), interest generated through the traditional revolving money fund goes back to the grandmothers. It doesn t go to the bank or micro-lending company.

The organisation also helps the grandmothers decide how to spend their savings on necessities such as school fees for their grandchildren and buying food.

Conference delegates also discussed strategies for coping with HIV/AIDS through the establishment of support groups for grandmothers, disclosure of HIV-positive grandchildren, social security and violence against grandmothers.

Speaking at the official opening, Ntombi Tfwala, the Queen Mother of Swaziland, said rape of grandmothers is now common. In other cases we hear that thugs attack and rob elderly women of the little that they have, said Tfwala. I take this opportunity to rebuke these evils that are making life uncomfortable for all of us.

A good look at the grandmothers attending the gathering was enough to dispel the stereotypical image of a grandmother. Not only your typical grey-haired women, the definition of grandmothers is contextual as observed by United Nations Population Fund country representative-Swaziland Aisha Camara-Drammeh.

In the African context, particularly in Swaziland, a grandmother can either be an elderly woman irrespective of age, married or unmarried but as long as she has a grandchild, said Camara-Drammeh.

She said a grandmother could also be someone who does not have children of her own but becomes granny because of being part of an extended family.

From the above description, Camara-Drammeh said the roles of grandmothers are different and the burden felt varies depending on the situation at hand.

Adam Robert Green

LONDON, Jun 28 2010 (IPS) – A proposed anti-counterfeit trade deal between 10 countries and the European Union (EU) could create a new set of barriers to the export of generic medicines to low income countries .

Everest Panda gets medicine for her baby from nurse Khetase Kapira in the children s ward at Kamuzu Central Hospital, Lilongwe, Malawi. Credit: Eva-Lotta Jansson/Oxfam

This warning comes from Rohit Malpani, senior advisor at Oxfam America, who spoke to IPS on the eve of the ninth round of negotiations on the Anti-Counterfeiting Trade Agreement (ACTA) taking place from Jun 28 to Jul 1 in Lucerne, Switzerland.

ACTA is aimed at tackling the trade in fake products from luxury watches and cosmetics to car parts and medicine and those persons infringing on intellectual property (IP) rights by strengthening powers of customs officials in signatory countries to seize counterfeit goods.

International trade of IP-infringing products is worth over 150 billion euro per year, according to estimates of the Organisation for Economic Cooperation and Development (OECD), representing rich countries.

Instigated by the U.S. and Japan in 2006, the ACTA negotiators now include the EU, Australia, Canada, Korea, Mexico, Morocco, New Zealand, Singapore and Switzerland.

But, critics warn, by not clearly distinguishing between fake medicines and legal generic drugs, which are often subject to patent dispute, the agreement could lead to the wrongful seizure of generic medicines en route to developing countries.
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ACTA is not just focusing on issues related to trademark law that is, medicines that are illegally and deceptively mislabelled but will also include patent law, which means that generic drugs will be covered, explains Joel Lexchin, MD, professor in the school of health policy and management at York University, Canada.

A patent involves the exclusive right, granted by a government, to use an invention for a specific period of time.

According to Lexchin, ACTA s inclusion of patents could substantially impede the flow of generic medicines. For instance, a company could claim that its IP rights have been violated in the production of a generic drug. That drug could then be seized by customs officials when it enters the country.

According to the World Trade Organisation s (WTO s) Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPs), WTO members must grant exclusive patent rights on medicines.

However, they can in some circumstances allow the production of lower-cost, generic versions of patented drugs in exchange for royalties paid to the patent holder.

But, crucially, TRIPs only allows such medicines to be sold in the domestic market of the developing country that produces it. Problems thus arise when low income countries, which cannot make their own generics, import them from larger developing countries like India, and in transit they enter a country where the patent is active.

Under ACTA, a multinational pharmaceutical company can say to customs officials in the transit country: That product infringes our patent in this territory, so even though the medicine is safe and can be legally exported from one developing country to another, we still want you to prevent it from reaching its destination , Malpani explains.

Such seizures occurred after the European Commission (EC) issued a crackdown on IP infringement which led to shipments of generic drugs being wrongfully intercepted.

Companies from India dubbed the pharmacy of the developing world for its leading generics sector had HIV, cardiovascular disease and common infections drugs, on their way to African countries, turned back by overzealous EU customs officials.

A famous case concerns the antiretroviral medicine, abacavir, shipped from India with Nigeria as destination but intercepted in the Netherlands. GlaxoSmithKline, the patent-holder, did not wish to initiate a legal action but Dutch customs authorities still referred the case to the criminal courts.

Felix Addor, deputy director general of the Swiss Federal Institute of Intellectual Property, told IPS that such outcomes mean the broad approach is unworkable.

Initially we did not see how you could discriminate between different IP rights. But having analysed the various transit cases, we now advocate that ACTA should either exclude patent-protected goods entirely or at least exclude these products from any border measures.

We expect that this decision will ultimately be supported by other delegations.

Swiss pharmaceutical companies deny civil society accusations that the industry wants to use ACTA to crack down on competing generics.

It is neither the policy nor the practice of our member companies to encourage authorities to use IP law enforcement to prevent the flow of legitimate generic products, says Bruno Henggi, head of public affairs at Interpharma, which represents major Swiss multinationals including Novartis and Roche.

We advocate that ACTA excludes patents from its scope. Our companies contribute to improving access to medicines in developing countries via large-scale donation programmes, preferential pricing and voluntary licensing, as well as through extensive participation in not-for-profit partnership activities.

If ACTA includes patent-protected generics and more developing countries sign up to the agreement, generics will be obstructed. This will cause competition to be delayed, (hence) medicine prices will increase, Malpani predicts.

Ultimately, high prices for medicines encourage counterfeiters to sell those very fake medicines that ACTA is trying to stamp out.

The justification that ACTA will tackle fake medicines, which account for almost 10 percent of world medicine, is widely rejected. Wilfully mislabelled medicines are already illegal under TRIPS, and patent infringement has nothing to do with fake or dangerous medicines , Malpani argues.

Lexchin adds that, the public health problem related to counterfeits is that substandard medicines will be used or medicines will contain contaminated or substituted ingredients.

The way to address this, though, is through better regulation of the pharmaceutical supply chain from producer to end user, particularly by strengthening regulatory authorities in developing countries .

Isaiah Esipisu

NAIROBI, Jul 20 2010 (IPS) – Because of societal pressure and the criminality associated with men who have sex with men (MSM) in Kenya, Omondi Maina* married a woman. This is despite being involved in a homosexual relationship for the last 10 years.

David Kuria of the Gays and Lesbians Coalition of Kenya says hundreds of members of the coalition are married and hide their homosexuality. Credit: Isaiah Esipisu/IPS

And Maina is not the only gay man in Kenya having sexual intercourse with both a homosexual man and heterosexual woman.

New research has found that the strain of HIV among gays in Kenya is 100 percent similar to the HIV strain found in heterosexuals in the country. It is unlike the clearly defined strains of HIV found among homosexuals and heterosexuals in most countries.

The study released by the Kenya Medical Research Institute (KEMRI) found that MSM in Kilifi, a region along Kenya s coast, have a HIV strain similar to the one found in female sex workers, as well as in the general public.

The findings are a clear indication that sex within gays in Kenya is interlinked with female sex workers and the general public, said Dr Mary Mwangome, the lead researcher of the study: Evaluation of HIV Type 1 Strains in Men Having Sex with Men and in Female Sex Workers in Mombasa, Kenya.

David Kuria, the chairman of the Gays and Lesbians Coalition of Kenya (GALCK) says that hundreds of members of the coalition are married men and women, but on the side they engage either in homosexuality, or lesbianism.
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All gays in Kenya are stigmatised. And to avoid this, most of them end up marrying women to guise as being straight . Or even worse, because they do not want permanent heterosexual relationships, they end up hiring female sex workers for their friends to think that they are straight, said Kuria, one of the most outspoken Kenyan gay activists.

And recent studies have shown that due to the sexual link between homosexual men and heterosexual women, the dangers associated with homosexuality are directly passed on to the general public.

Anal sex is ten times riskier than vaginal sex in terms of HIV transmission. This puts MSMs at the highest risk of transmission, which is automatically transmitted to the general public if at all they engage in unprotected heterosexual affairs, said Dr Preston Izulla, a health research scientist at the University of Nairobi.

It also means that homosexuality is not traded by foreigners alone. It is present among indigenous Kenyans. We expected to find gays and female sex workers HIV strains commonly found in the Western World because of the tourism activities. But instead, we discovered that the strain found in most of the subjects was local, meaning that it was not contracted from foreigners, said Mwangome.

The study involved 211 MSM, 96 percent of whom are Kenyan citizens and 148 female sex workers, 98 percent of who are Kenyans. Out of them 23 were found to be HIV-positive. Upon testing, 17 of them were found to have a pure HIV strain that is common in the general public, while the rest had a combination of strains that are well local.

The study confirms findings in the latest Kenya Aids Indicator Survey (KAIS) published in 2007. According to the survey, 65 percent of gay men who were interviewed confessed to being involved in another affair with a woman somewhere. As a result, 15 percent of new HIV infections in Kenya was found among gays.

A commercial sex worker in Nairobi told IPS that she had a husband, yet she was involved in commercial sex.

I have been married for the past six months. But my husband knows that I work in a Casino. He married me when I was a commercial sex worker, and am not planning to stop until we are financially stable, said the 23-year-old who only wanted to be identified as Anita*. She works in a commercial sex outlet in Nairobi known as Modern Green .

But Mwangome says the findings have revealed worrying trends that cannot be ignored. The fact that there is a relationship between female sex workers, gays and the general public means that a bigger population in the country is at risk of contracting HIV. This is because such minority groups which unfortunately operate in top secret have little access to intervention, yet the chances of infection are higher, said Mwangome.

Intervention in such groups should be made a policy issue in order to attract more attention, she added.

According to Izulla, only one in 20 gays living with HIV has access to prevention, care and treatment services.

*Names have been changed.