Complete Wellness

THIRUVANANTHAPURAM, Jul 12 2011 (IPS) – When Sujatha’s husband learned that she had conceived just five months after they got married, he became agitated over what he called her ill-timed pregnancy . To worsen her husband’s anxiety, a test to determine the sex of the foetus showed she was carrying a girl.
Sujatha, a public school teacher, and her husband, a civil engineer – who asked that their full names be withheld – are from well-off and educated families in Thiruvananthapuram, the capital of the southern state of Kerala. Yet they dared violate the law, approaching doctors at the Sree Avittam Thirunal Hospital for an abortion; they were granted one within a month.

The law prohibits Indian couples from selecting the sex of their unborn children, and from discriminating against female foetuses. Abortions are legal only for certain reasons, like when the mother is ill and pregnancy would endanger her life, or when a foetus is found to be severely handicapped.

But even with these laws in place, educated urban couples like Sujatha and her husband are opting for sex-selective abortions, thus causing a decline in the female population.

Sex determination tests have spurted across the nation, despite efforts to strengthen the Pre- Conception and Pre-Natal Diagnostic Techniques (PC PNDT) Act, the law against the misuse of pre- natal tests for sex selection.

Indian health minister Ghulam Nabi Azad told reporters in New Delhi that the central supervisory board on the PC PNDT Act has been reconstituted to prevent widespread sex determination tests.
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Azad said the Medical Council of India (MCI) should urgently ensure that guidelines for accreditation of training and experience are put in place quickly. The government has asked the MCI to implement a tough accreditation system for institutes that give training on the use of ultrasound machines, while considering the increasing trend of fraudulent institutions that use bogus certificates.

The health departments of the different states have also started cracking down on illegal sonography centres and fraudulent maternity clinics.

The Indian parliament enacted the PC PNDT law in 1994 and amended it in 2003. Sources in the central health department said that between 2003 and March this year, 805 cases had been filed against doctors for violating the law, resulting in 55 convictions.

The Indian socio-cultural psyche prefers a son to a daughter. This belief is very strong in northwest India, including Haryana and Delhi, where sex selection tests are very common, Dr. V. Raman Kutty, a health activist and professor at the Achutha Menon Centre for Health Science Studies in Thiruvananthapuram, told IPS.

Advances in medical science have aided the popularity of these tests. The metros are the major centres for the tests with sophisticated laboratories. However, amniocentesis and ultrasound are available even in the clinics of small towns and cities, he pointed out.

A study led by Dr. Prabhat Jha of the University of Toronto’s Centre for Global Health Research and published in the British medical journal The Lancet estimates that up to 12 million selective abortions of girl foetuses had occurred in India in the past three decades.

Sex-selective abortion was rare in India during the first half of the 20th century, but the availability of ultrasound machines has made sex determination easier, leading to an increase in the frequency of such tests.

Experts observe that the abortion law in the country, called the Medical Termination of Pregnancy (MTP) Act, has many loopholes that save violators from penal action.

Dr. Sunny Sebastian, a health expert in Mumbai, told IPS that in the present system, the doctor and patient can do abortions for wrong reasons. A survey conducted in Mumbai revealed that both doctors and patients do not heed legal warnings and have done abortions in advanced stages of pregnancy after discovering the foetus was female.

Sex selection is taking its toll on the population. The 2011 Census data found a decline in the number of girls in the zero-to-six age group, reflecting a steady decline in the child sex ratio (CSR). In 1981, there were 971 girls for every 1,000 boys; in 2011, the number of girls dropped to 914.

The data revealed that CSR has declined in 431 districts, but improved in 149 districts of the country.

While citing the new census data, Azad said there were 7.1 million fewer girls than boys. In 2001, this gap was six million. This means around 3.1 to six million girls have been aborted in the past decade.

Activists say preventing female foeticide is a serious challenge before Indian society and that the economic factor plays a key role in the change in CSR.

Durga Lakshmi, a social activist and lecturer in Metca Institute of Teacher Education at Varkala, Kerala, told IPS that the financial wellness of a family determines whether it will decide to have a girl child or not.

Through empowerment, strengthening of rights, campaigning against vicious practices and ensuring strict implementation of law, society can wipe out sex selection and abortion of girls. Economic distress is the basis for smaller families preferring sons. Daughters are thought to be an economic burden in poor families, she said.

Denis Foynes

UNITED NATIONS, Aug 12 2011 (IPS) – A new report by the International Committee of the Red Cross (ICRC) describes a pattern of attacks on medical staff that the group says is undermining the safe delivery of medical assistance and health care across the globe.
The violence against health care faculties and medical personnel must end. It s a matter of life or death, said Yves Daccord, head of the ICRC. The human cost is staggering civilians and fighters often die from their injuries simply because they are prevented from receiving timely medical assistance.

The lists hundreds of attacks on patients, health care workers and facilities, including looting and kidnapping, as well as arrests by security forces and deliberate obstruction of access to vital medical help.

The ICRC focused on 16 war-torn countries, including Libya, Afghanistan, Somalia and Colombia. It analysed reports collected over a two-and-a-half year period, describing 655 violent incidents, using data obtained from humanitarian agencies, including the ICRC, and from open sources such as the media and websites.

In 33 percent of the cases, the violence was committed by state armed forces, and 36.9 percent by armed groups. The report says that these criminal actions could result in the unnecessary deaths of thousands if not a million people around the world.

Under a 150-year-old principle adopted in the first Geneva Convention, it is the right of those wounded in war to receive medical treatment and the right of medical workers to move freely to help people in need of vital assistance.
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Despite numerous efforts by the International Red Cross and its partner, the Red Crescent Movement over decades to put an end to these acts, the problem nonetheless continues, says the ICRC.

The most shocking finding is that people die in large numbers not because they are direct victims of a roadside bomb or a shooting, said Robin Coupland, whose research in the 16 countries formed the basis of the report.

They die because the ambulance does not get there in time, because health-care personnel are prevented from doing their job, because hospitals are themselves targets of attacks or simply because the environment is too dangerous for effective health care to be delivered.

A recent example of a hospital failing to be granted neutrality in a conflict zone can be seen in Manama, Bahrain during this year s Arab Spring revolt.

As injured protestors came into the hospital in Manama for treatment, the facility slowly evolved into a focal point for the movement. As thousands more took to the streets in the pursuit of democracy, the hospital filled with protestors and international media.

Allegations began to fly between the army and medical staff. The latter were accused of aiding the revolution, only treating rebels and supplying propaganda.

Forty-seven doctors were detained and put on trial, accused of aiding the protesters and trying to overthrow the state. They denied the charges, and said that some of their staff were tortured in the pursuit of confessions.

Asked by IPS about the root causes of the problem, Bijan Frederic Farnoudi, a Red Cross spokesperson, said that, There are several issues involved here which make an explanation quite complex. One fact is that while attacks of medical services are certainly illegal, in some places they are accepted as the norm.

Also the change in warfare must be considered. Conflict mainly takes place in urban areas now. Patients go to the hospital along with the military, hence the hospital and the staff becomes drawn into the conflict.

What is important to remember about the report is that while we have always known medical staff are hindered by these factors, the staggering extent of the damage this causes is now clearer, he said.

Asked what can be done by the international community, Farnoudi stated, There are a number of methods to tackle this problem. It is important to remember that this is cannot be solved by the Red Cross or the health community. This is because these attacks are not health issues but security issues.

There are a number of short-term or long-term solutions out there. The reason we are releasing this report and holding press conferences is to generate publicity and force the governments, armed forces and NGO s into action and protect medical services, he said.

Doctors and medical staff are now themselves becoming causalities of war. In the words of Daccord, the current situation is one of the most urgent yet overlooked humanitarian tragedies, the issue has been staring us in the face for years. It must end.

The release of the report marks the beginning of a four year campaign by the ICRC to remind armed groups of their responsibility to allow the injured to receive their treatment and to permit medical personnel to workout obstruction.

Elizabeth Whitman

UNITED NATIONS, Sep 21 2011 (IPS) – There is a well-documented and shameful history of certain players in industry who put public health at risk to protect their own profits, U.N. Secretary-General Ban Ki-moon told world leaders Monday as they met to address the issue of non-communicable diseases at the 66th U.N. General Assembly.
The high-level meeting provided countries with a chance to share stories of success and innovation to combat NCDs, the most common of which are cancer, diabetes, chronic respiratory illness, and cardiovascular disease.

Responsible for 63 percent of deaths worldwide, or 36 million deaths per year, NCDs constitute a serious threat to global social and economic development.

Yet throughout events held on Monday and Tuesday, and in the agreed upon by member states outlining the steps they would take to address NCDs, a clear, persistent and pervasive challenge emerged: ensuring that profit-driven corporations and industry groups are not able to influence policies or other efforts aiming to improve public health.

Government and civil society leaders alike agreed that, as the political declaration stated, NCD prevention and control require multisectoral approaches . But many also expressed concern that no clear boundaries exist to distinguish appropriate involvement of the private sector from the inappropriate and potentially unethical, or to ensure that profits do not trump public health.

A demonstrated conflict of interest
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The political declaration itself explicitly noted a fundamental conflict of interest between the tobacco industry and public health, but it did not do the same for the food and beverage or pharmaceutical industries. Rather, it called on the private sector to consider producing and promoting more food products consistent with a healthy diet and to contribute to efforts to improve access and affordability for medicines.

Tobacco, overconsumption of alcohol, an unhealthy diet, and lack of exercise are the four main causes of NCDs. Industry groups play a key role in the first three of these areas, though whether that role is advantageous or dangerous to public health can vary.

Bill Jeffery, national coordinator for , Canada (CSPI-Canada), told IPS private sector engagement will have no integrity without a code of conduct. Nor was the relationship between trade and health squarely addressed in this political declaration, Jeffery pointed out.

CSPI-Canada is part of the calling for the creation of such a code.

Douglas Bettcher, director of the s (WHO) Tobacco Free Initiative WHO is considered the world s primary specialised health agency told IPS that WHO had very clear and strict guidelines vis-à-vis work with commercial enterprises to make sure that our policy work is not deviated and not open to undue influence by the private sector.

He insisted that the political declaration did protect against such undue influence. It says very strictly, where and as appropriate,’ he told IPS.

Nevertheless, there are certain aspects of reducing risk factors where the cooperation of the industry can be beneficial, Bettcher said. Actually implementing policies by cutting down on sodium in foods and engaging in responsible marketing can help improve public health, for example.

But when industry groups participate in discussions or are involved in policy making decisions, their influence can run the gamut from directly opposing public health interests to emphasising control of NCDs, a more profitable aspect from the pharmaceutical perspective, for instance, over prevention.

Ensuring that the focus is less on prevention and more on how to control NCDs is one way the pharmaceutical industry can profit from the NCD crisis, Gigi Kellet, deputy campaign director for , told IPS.

Prior to the start of the NCD summit, PepsiCo co-hosted, with two U.N. agencies, a breakfast panel discussion at the U.N. on Monday for government representatives.

When asked about the potential for a conflict of interest in such an event, Bettcher told IPS that side events were separate from the U.N. and WHO.

Dr. Mehmood Khan, CEO of PepsiCo s Global Nutrition Group, spoke at a related event on Tuesday, where he emphasised the need for public- private partnerships. He stated explicitly that his job was to help the group grow to 30 billion dollars by 2020, and reminded the audience, Processing (foods) equals preservation of important food groups.

Resistance to hard targets

WHO recommended setting a goal of reducing NCD deaths by 25 percent by the year 2025, a target whose exclusion from the political declaration drew criticism from many leaders. Monitoring NCDs and setting reduction targets are the next crucial steps and challenges they said.

Without clear targets there will be neither accountability nor a real incentive to deliver, Princess Dina Mired of Jordan, director of the King Hussein Cancer Foundation in Jordan, told the General Assembly on Monday.

Joanna Ralston, CEO of the World Heart Forum, a member of the NCD Alliance, highlighted the disparity between NCD rates in developed versus developing countries, where 90 percent of NCD-related deaths occur.

Because people are increasingly urbanised, living in huge dense cities in low and middle income countries, their lifestyles and food options have changed, Ralston told IPS. They generally get less exercise and don t have as many options for healthy food.

There s a host of factors that affect this, she elaborated, ranging from urban planning to agricultural development to trade. These aspects are in some ways part of the problem, but they can also be part of the solution, she said. She also mentioned a need for stronger language surrounding specific targets.

Regulating the amount of sodium allowed in foods, for instance, has a clear impact on cardiovascular disease, Ralston said.

All over the world, evidence points to the feasibility of reducing NCD deaths. The challenge that remains for many countries is simply to take action.

After imposing advertising bans and anti-tobacco laws, Uruguay, for example, saw a 25 percent reduction in smoking over a three-year period. Meanwhile, Brazil has taken steps to increase the amount of physical activity children get at school and to better label foods while reducing sodium content and eliminating trans fats from foods.

WHO estimates that NCD-related deaths will increase by 17 percent in the next decade, but in Africa the increase will be 24 percent. According to the World Economic Forum, over the next 20 years, the global economic impact of the four major NCDs, plus mental ill- health, could total 47 trillion dollars.

UNITED NATIONS, Nov 8 2011 (IPS) – More than 5,000 Haitian cholera victims are seeking compensation, action and an apology from the U.N. and the United Nations Stabilisation Mission in Haiti (MINUSTAH) for the ongoing epidemic that has killed more than 6,600 Haitians and sickened more than 476,000 since October 2010.

A young child is seen crossing one of the canals of the Artibonite River, identified as the source of the cholera outbreak. Credit: UN Photo/Sophia Paris

Brian Concannon, who is based in Boston and is the director at the , helped organise a petition from Haitian victims and relatives of victims, before filing the claim to the U.N. simultaneously with a claim to its peacekeeping mission in Haiti, last Thursday.

The victims petition alleges that the U.N. and MINUSTAH are liable for hundreds of millions of dollars for failing to screen and treat peacekeeping soldiers arriving from Southeast Asian countries experiencing cholera epidemics, dumping untreated waste from a U.N. base directly into Haiti s longest and most important river, the Artibonite, and failing to respond adequately to the epidemic.

Concannon and his team say in the petition that reports compiled by the United States-based Centres for Disease Control and Prevention, the Harvard Cholera Group, Dr. Renaud Piarroux, a French epidemiologist who has spent his career studying cholera, the Wellcome Trust Sanger Institute in Cambridge, England and the International Vaccine Institute in Seoul, Korea found that the Vibrio cholerae bacteria was introduced to Haitian waters by MINUSTAH personnel deployed to Haiti from Nepal.

Prior to the peacekeepers arrival, Haiti had not reported a single case of cholera for more than 50 years.

Awaiting a U.N. Response
While Concannon and Kurzban are waiting for a response from the U.N., MINUSTAH has requested a meeting to discuss their petition, the date is yet to be scheduled.
“As far as we know, this hasn’t been done before, so it all depends on the U.N.’s response about how they will deal with it,” Concannon told IPS, in regards to how long they will wait until they pursue further action with a national court.
“If they come back to us and say they are willing to talk about it and follow a fair formula, then we will be happy to wait. This is the worst cholera epidemic in the world and some experts expect the death toll to reach 20,000, unless there is swift action. We want the U.N. to bring in medical treatment straight away.”
Kurzban agreed and said their goal was to work with the U.N. to resolve the issue before it goes too far.
Ever since the cholera outbreak, we have had people coming to us asking us what to do, Concannon told IPS.

We originally thought the U.N. would take on responsibility as we didn t originally see this as a legal case at first. But we could no longer dismiss the people after no action was taken.

Vibrio cholera

Cholera, a waterborne illness that causes diarrhoea and vomiting, is a result of an infection with a pathogenic strain of the Vibrio cholerae bacteria. If it is not treated immediately, cholera can kill adults and children in a matter of hours. According to the World Health Organisation, up to 80 percent of cases can be treated successfully with oral rehydration salts.

The virus, which is endemic in Nepal, reportedly had a surge of cases in the Kathmandu Valley in August and September 2010. With peacekeeping troops from Nepal deployed to Haiti every six months, a new contingent arrived at the Mirebalais camp on Oct. 9, 12 and 16, 2010. These troops had spent three months training in the Kathmandu Valley.

According to the petition, Nepalese soldiers deployed as part of the MINUSTAH mission in Haiti were not tested for cholera prior to entering Haiti.

Ira Kurzban, an attorney at Kurzban, Kurzban, Weinger, Tetzeil Pratt P.A. in Florida who is involved with the petition, said at a press conference at the U.N. Tuesday that a number of cholera carriers do not exhibit active symptoms which left room for error, as the U.N. only conducted tests on individuals who showed active symptoms.

According to the New York Times, the Cuban mission in Haiti has asked the U.S. to help finance a 30-million-dollar major hospital for specialists as part of a broader effort to remake the health system. Since the outbreak of cholera, the Cuban mission has treated more than 76,000 cases of the disease, with just 272 fatalities.

The chief of the Cuban medical mission, Dr. Lorenzo Somarriba, said they send people to the homes of the victims to educate them on the disease and provide them with tabs to clean the water purification tablets that have been critical in a country where treated water is rare.

In a statement released by the spokesman for the U.S. Embassy, Jon Piechowski, he said while recovery in Haiti was a broad international effort, particularly to advance the health sector support to Haiti, they had not entered into any agreements with the Cubans.

Compensation

Concannon spoke of a victim who was one of the first to die from cholera on Oct. 22, 2010. The petitioner had been working in a rice field and drank from the canal that irrigates the field. Afterwards, he alerted his family about a boiling water sensation in his stomach and began to vomit before spending the night at home in excruciating pain.

The next morning he went to hospital, and in the afternoon he died. He left his wife and 12 children behind.

The petitioners, who hail from Mirebalais, St. Marc, Hinche and Port- au-Prince regions of Haiti, make up more than 5,000 individuals filing a claim including victims, parents of children and relatives of victims who have died.

They are requesting three things 50,000 dollars per person or 100,000 dollars per person who died, an adequate nationwide response from the U.N. that includes better sanitation and clean water facilities to help prevent further cases, and a public apology.

Our clients are challenging the institution to act consistently with what it knows to be true and just, said Concannon.

Response

Secretary-General Ban Ki-moon appointed an independent panel of scientific experts to investigate the source of cholera in Haiti on Jan. 7, with a report released in May.

While the experts concluded that, the evidence overwhelmingly supports the conclusion that the source of the Haiti cholera outbreak was due to contamination of the Meille tributary of the Artibonite River, with a pathogen strain of current south Asian type Vibrio cholera as a result of human activity , they didn t attribute the outbreak to an individual.

At a press conference Tuesday, the secretary-general s spokesperson said the U.N. peacekeeping mission as well as humanitarian development agencies were working with Haitian authorities to do everything possible to bring the spread of cholera under control.

He confirmed that the U.N. and MINUSTAH had received the letter and it would be looked at by the relevant part of the peacekeeping department.

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The independent panel of experts concluded that the Haiti cholera outbreak was caused by the confluence of circumstances as described in the report and was not the fault of or deliberate action of a group or individual person, said the spokesperson addressing the U.N. s response to the petition.

The key focus for the U.N. has been since the outbreak and it remains the focus, to combat the outbreak and to help those who have suffered. That s what the U.N. will continue to do.

A MINUSTAH spokesperson emailed IPS and confirmed that the petition had been received and would follow the procedures to be transmitted.

She wrote, MINUSTAH keeps and will remain committed in supporting all the efforts undertaken to fight the epidemic and its impact, in support of the government.

Fabíola Ortiz

RIO DE JANEIRO, Dec 23 2011 (IPS) – The fall in world tobacco consumption, especially in industrialised nations, is a sign of the urgent need for producer countries like Brazil, China, India and the United States to offer their farmers alternatives to growing tobacco.

Graphic picture-based health warnings on cigarette packs can help prevent youngsters from starting to smoke. Credit: Kara Santos/IPS

Tobacco has been grown in Brazil for 120 years, and is important for the trade balance of this South American country.

Tobacco industry statistics for 2011 show that China is the world leader in tobacco production with 2.4 million tonnes, and Brazil is the runner-up, with 867,000 tonnes.

Some 200,000 small-scale family farms, located mainly in the south and northeast of the country, produce 95 percent of Brazil s tobacco.

President Dilma Rousseff signed a tobacco control law Dec. 15 which increases taxes on tobacco, sets minimum prices for cigarettes, bans smoking in all public spaces and enclosed workplaces, and forbids advertising at points of sale.

Brazil, with its 192 million people, may thus become the most populous country to declare itself smoke-free, said the U.S.-based Campaign for Tobacco-Free Kids.

Brazil is the largest country to have adopted an anti-tobacco law, activist Patricia Sosa, in charge of Latin American programmes for the , told IPS.

Every year, exposure to secondhand smoke causes over 600,000 premature deaths, and passive smokers who are exposed to it at home or at work have a 30 percent higher risk of developing lung cancer, she said.

The new law bans advertising on cigarette packs and only permits the display of products with health warning messages that cover at least 30 percent of the front of the packets. This regulation will come into effect Jan. 1, 2016.

Taxes on cigarettes were increased by 300 percent, which will raise the consumer price by 20 percent in 2012, and by 55 percent in three years time.

But in the view of the Brazilian civil society organisation Aliança de Controle do Tabagismo (ACT Alliance for the Control of Tobacco Use), the tobacco industry remains extremely lucrative.

Around 90 percent of the tobacco produced in Brazil is exported, and tobacco production in the country is fairly high, although the prevalence of smoking has declined over the last two decades, ACT deputy director Mônica Andreis told IPS.

The tobacco industry argues that the new measures will bring economic chaos to the country. But many family farmers who depend solely on this crop to survive are exposed to difficult labour conditions, and they get sick from having direct contact with tobacco leaf chemicals, she said.

Working on tobacco plantations creates health problems associated with intensive use of toxic agricultural chemicals, as well as green tobacco sickness (GTS), a form of nicotine poisoning caused by absorption of nicotine through the skin as a result of handling wet tobacco leaves.

Many of the tobacco farmers have already said they would prefer to diversify or switch crops, Andreis said.

The ministry of agricultural development announced that during 2011 it invested six million dollars in technical support and agricultural extension services for approximately 10,000 family farmers who wish to diversify away from growing tobacco.

The funds have been used principally for families in the seven tobacco-growing states: Alagoas, Sergipe, Bahia and Paraiba in the northeast, and Rio Grande do Sul, Santa Catarina and Paraná in the south.

In one year s time, the government plans to increase to 50,000 the number of families receiving aid from the National Programme to Support Product Diversification in Tobacco-Growing Areas, created in 2005.

According to the authorities, this programme is part of one of the country s largest inter-ministerial initiatives, created to meet the guidelines of the World Health Organisation (WHO) Framework Convention on Tobacco Control, which came into force in 2005 and was ratified by Brazil that same year.

The programme facilitates access by tobacco farmers to funding and technology with the aim of converting or diversifying from tobacco growing.

Sixty-five current projects to diversify away from tobacco cultivation on family farms include raising chickens or dairy cattle, fish farming, and fruit and vegetable production. Over the last six years, 14 million dollars have been spent on services for 80,000 tobacco-farming families.

According to a study published by the Association of Tobacco Growers of Southern Brazil, out of nearly 187,000 families who grow tobacco, 47,000 have no land of their own and work as sharecroppers. And 80 percent of the 140,000 farms are less than 20 hectares in size.

The WHO Framework Convention on Tobacco Control, the first international public health treaty, has 174 states party at present and guides the implementation of public policies for combating smoking, regarded by the WHO as a non-communicable global epidemic.

Although the number of smokers in Brazil has been dropping for the past 20 years, there are still nearly 25 million people aged over 15 who smoke, Andreis said.

The typical Brazilian smoker is male and aged between 45 and 64 this group accounts for nearly 22 percent of tobacco consumers. The majority of smokers are people living in rural areas, less educated and with the lowest family income per person, according to a survey by the Brazilian Institute of Geography and Statistics (IBGE) and the National Cancer Institute (INCA).

Among people who had received less than one year of education, or none, 41 percent started smoking before they were 15 years old; and the proportion of students who had tried cigarettes in 2009 was almost 25 percent, Andreis said.

Latin America has a for applying the Framework Convention on Tobacco Control. Ten countries have already adopted tough restrictions on advertising, publicity and sponsorship by tobacco companies. Five countries have imposed taxes of 70 percent or more on the price of cigarettes, and seven have introduced compulsory health warnings that cover at least 30 percent of the packs.

Uruguay was the first country in the region to enact tough anti-tobacco laws. In the small South American country, health warnings and graphic images cover 80 percent of cigarette packets.

While the Ethiopian government boasts that the country can soon be categorised as middle-income, economic analysts are more cautious saying that the country has made “significant progress”.

ADDIS ABABA , Feb 21 2012 (IPS) – Ethiopia says that the double-digit economic growth the country has experienced over the last seven years has started benefitting its majority by boosting their income and productivity in agriculture and small-scale businesses.

While the and the state that the country has registered 8.7 percent GDP growth, the government claims the economy has grown by 11.4 percent.

However, the country was declared the second-fastest growing economy in Africa for 2011, after Ghana, in the annual economic report by the (ECA).

In the past, Ethiopia has made headlines for recording some of the worst famine situations in Africa, and for its poor health indicators – it has posted one of the highest maternal mortality rates in the world. In 2005, 871 women died per 100,000 live births.

But this is slowly changing as the government has made progress in the provision of social services such as health, education and infrastructure.
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“In 2010, Ethiopia continued to register the fast growth, as it has for the last five years. GDP growth in 2010 remained strong at 8.8 percent. Growth is driven by the service sector (14.5 percent), followed by the industrial (10.2 percent) and agricultural (six percent) sectors,” the ECA report indicated.

In an exclusive interview with IPS, State Minister of the Office of Government Communication Affairs, Alemayehu Ejigu, said Ethiopia has registered remarkable growth by increasing major crop production from 11.9 percent in 2005 to 18.08 percent by the end of 2010. People’s lives are changing for the better in rural and urban areas because of health facilities and infrastructure development, he said.

Ejigu attributed the success to the effective implementation of the national five-year Growth and Transformation Plan (GTP). He said that the country’s GTP for 2011 to 2016 would help Ethiopia join the grouping of middle-income countries.

Ejigu also told IPS that the government planned job creation opportunities through the construction of 73,000 kilometres of rural roads. “This would create an opportunity for farmers to easily transport agricultural products to market,” Ejigu said.

Abeba Bezu, an economic affairs consultant in Addis Ababa, said that under the country’s ambitious Plan for Accelerated and Sustained Development to End Poverty government had reduced poverty from 38.7 percent in 2005 to 31 percent five years later.

“Although struggling with a large population estimated to be 82 million people, making it the second-most populous country in Sub-Saharan Africa, there has been significant progress towards improving livelihoods. There is notable development.”

However, assistant Professor Teshome Adugna at the Economics Department of the cautioned that as GDP considers the market value of goods and services, it cannot be a perfect instrument to show the country’s actual growth, given Ethiopia’s poor record handling and management systems.

“Since the GDP reporting does not provide information on who produces how much, it is difficult to know how individual citizens benefit from the reported growth,” he said.

Adugna described Ethiopia’s growth as “broad-based”, which he attributed to the growth of the agricultural, industrial and service sectors.

“Of course, we should not expect urban unemployment to end very shortly,

“I can say that many people are benefiting from the economic growth in Ethiopia, but I would not say that the life of the majority has improved. We need time to bring about social development that can change the lives of the majority.”

Ten years ago, only two thirds of Ethiopians had access to healthcare services, leaving another 68 million people across the expansive rural areas in dire need.

“Since 2004, the Ministry of Health has expanded access to healthcare through the (HEP), which targets the rural population,” said Amanuel Ayalew, a volunteer health worker in northern Ethiopia.

As a result, Ethiopia’s country report by the Department for International Development (DFID), the United Kingdom’s government department responsible for promoting development and poverty reduction, revealed that the impact of the health programme is notable since HEP reaches nine million households. DFID will spend an average of 524 million dollars per year in Ethiopia until 2015.

With more than 35 million insecticide-treated bed nets for malaria, there has been a 73 percent reduction in malaria cases. This, coupled with a massive and consistent vaccination programme for children under five against killer diseases, has seen deaths in that age group reduced by a significant 62 percent in villages with access to HEP.

There are now about 1.4 million more women on contraceptives than there were in 2005, and the gross primary school enrolment rate has risen from 91.3 to 96 percent between 2005 and 2010.

However, challenges remain.

“In spite of a constituent economic growth of double digits in the last five years with economic analysts projecting a similarly impressive growth, sustainable growth and poverty reduction remains a challenge,” Bezu said.

A majority of rural poor are still grappling with severe climate change and are still highly susceptible to drought.

It is a situation that government partially acknowledges. “When we say the country is growing it does not mean that every citizen has no problem…even in the United States there are people who are provided with food aid,” Ejigu said. He, however, added that no one would die of as there would be no food shortages in the country.

It is a view that the leader of the opposition Ethiopian Democratic Party, Mushe Semu, does not agree with.

“Ethiopia is a country where many citizens are starved. It is not a question of having food two or three times a day,” Semu told IPS.

He said it was impossible for Ethiopia to become a middle-income country. “When we think of the majority of the Ethiopian population we are talking about our farmers and rural communities that are 85 percent of the people. Here, the land management and fertility should be considered,” he said.

He said that without effectively distributing all arable land to people, and with the prevailing land degradation, it was not possible to bring about development.

The country is not conducive for private sector growth, analysts say.

The newly completed African Union building in downtown Addis Ababa. Credit: Mekonnen Teshome/IPS

“Although the government envisions a private sector led development, the environment is not conducive for the growth of the private sector. In fact, private investment as a percentage of GDP has remained on the decline since 2004,” Bezu said.

In a World Bank global survey dubbed Ease of Doing Business, in 2010 and 2011 Ethiopia ranked 103 and 104 respectively out of 183 countries.

But meanwhile, civil servant Abiy Getahun said that the double-digit economic growth repeatedly propagated by the government media has not yet brought the desired social development to his life. He cited the low wages paid in Ethiopia, which, according to him, are low compared to the rest of Africa. In the 2011 Human Development Report Ethiopia ranks 174 out of 187 countries worldwide.

He said that most people, especially urban dwellers, could not withstand the skyrocketing price of good and services.

“The total salary increment I got over the last 10 years is only 400 Ethiopian Birr (less than 25 dollars) while the price of goods and services has risen in an unbelievable manner.”

* Additional reporting by Miriam Gathigah in Nairobi.

(END/2012)

BUENOS AIRES, Mar 29 2012 (IPS) – A novel research study in Argentina explored women s knowledge and beliefs about cervical cancer, in the provinces with the highest mortality from this highly preventable form of cancer, to design more effective policies.
Although there are now effective tools to prevent cervical cancer, and vaccination against human papillomavirus (HPV) is free and mandatory for 11-year-old girls, the death rate from cervical cancer is not declining in Argentina, and the geographical distribution of the burden is extremely unequal.

This scenario was the starting point for the study titled (What Women Think: Knowledge and perceptions about cervical cancer and the Pap test , published by the Argentine Health Ministry and the Pan American Health Organisation (PAHO).

The study concluded that women have only a vague understanding of this health problem, and that most are unaware that HPV, a sexually transmitted disease, can cause cervical cancer.

Medical research has established that persistent infections with certain types of HPV cause nearly all cases of cervical cancer. Left untreated, invasive cervical cancer is almost always fatal, according to the World Health Organisation (WHO).

They do not always know what the Pap smear is for, say the authors, referring to women’s understanding of the Papanicolau screening test, which involves taking a small scraping of cells from the cervix – the narrow lower portion of the uterus where it joins with the top end of the vagina.
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Examination of the sample in a laboratory can detect pre-cancerous lesions before they develop into cancer, a potentially life-saving step if it is followed by prompt treatment.

One of the authors, Dr. Silvina Arrossi, who is the scientific coordinator of the , told IPS the goal of the study was to find out about women s perceptions and knowledge about this type of cancer, in order to incorporate their views into prevention strategies at the design stage.

In Argentina, cervical cancer is the second cause of deaths from cancer in women aged 35 to 64.

We wanted to know if there were problems with the information women have about it, in order to design user-friendly educational materials that could help to overcome those difficulties, Arrossi said.

The interviews were carried out with women in the eastern province of Buenos Aires – the most populous and in the northern provinces of Jujuy, Salta, Misiones and Chaco, which have the highest cervical cancer mortality rates.

The national average for cervical cancer mortality is 7.5 deaths per 100,000 women. But in these four northern provinces, the mortality rate rises to as many as 15 deaths per 100,000, while in the city of Buenos Aires it falls to four deaths per 100,000 women, so the study examined both statistical extremes.

The interviews with the women were revealing. A considerable number believe the cancer lives in the body in a latent state, and is awakened by events like an abortion, rough intercourse, or insertion of an intra-uterine device (IUD).

According to this view, the Pap smear, seen as an invasive procedure, could also disturb or awaken the dormant cancer, the study says. One woman said her 52-year-old mother-in-law had never had a Pap test because of this fear.

Another mistaken idea that cropped up frequently in the interviews is that older women do not need to have Pap tests if they are no longer sexually active and are feeling well. There s nothing wrong with me, so why should I go to the doctor? one woman remarked.

The women referred to other difficulties, related to their home-making role, that cause them to put off their own needs. Who ll serve your father his dinner? one woman asked her daughter, when the younger woman urged her mother to go in for a Pap test.

The study also found that women are not always well enough informed about the continuing precautions they need to take to prevent the illness.

A 38-year-old mother of nine from Chaco has never had a Pap test in spite of the many times she has attended health clinics for antenatal care and childbirth. Evidently the health system is failing here, the authors said.

The women s most common sources of information about cervical cancer are television, radio and other women. The health system, in contrast, was not frequently cited as a source of knowledge.

Several women call cervical cancer la pudrición ( rot or putrefaction), because of the fetid odour of vaginal discharge when the cancer is in an advanced state. They are fatalistic and pessimistic about the disease, and in some cases they say directly that there is no cure.

Another worrying finding is that some women have a Pap test, but do not return for the test result. According to the authors, this would seem to indicate that they do not fully understand the importance of having the test and then following it up.

In general, the respondents also showed a complete lack of knowledge that untreated HPV infection is the main cause of cervical cancer.

In October 2011, the Health Ministry added HPV vaccination to the mandatory series of routine shots for 11-year-old girls. Arrossi believes the vaccination campaign will help spread knowledge of the association between the virus and cervical cancer.

The study, by Arrossi, Nina Zamberlin and Laura Thouyaret emphasises that in spite of these highly effective and low cost preventive measures, cervical cancer continues to be one of the main causes of cancer deaths among women in developing countries.

Experience in the industrialised world shows that screening women with the Pap test is effective in reducing incidence and mortality, the researchers point out. However, in Latin America incidence of cervical cancer has not declined because of the low coverage of screening, the study says.

Mortality from cervical cancer in Argentina has not declined significantly in the last 40 years, and the distribution of the burden (of deaths) is extremely unequal, it says.

In 2009, the Health Ministry found that only 46 percent of women aged 35 to 64 in the northeast and northwest of Argentina had had a Pap test in the two years prior to the survey.

Based on the information collected by Arrossi and her colleagues, a photo-novella has been designed in which a woman tells her daughter she (the mother) does not need to have Pap smears any more because of her age. But the daughter explains to her mother that, in fact, she really does need to keep having the test.

Training will be given to health centre personnel who offer women health advice, in order to ensure that they engage women in dialogue and exchange of information, rather than just send them away with a leaflet, Arrossi said.

Many of the women interviewed for the survey admitted that they felt embarrassed when they had Pap smears taken by male doctors. The study therefore recommends that health centre teams always have a woman available to take samples for the Pap test.

RIO DE JANEIRO, May 4 2012 (IPS) – María dos Prazeres de Souza has lost count of the number of births without a single death she has attended as a midwife, an occupation that there is renewed interest in strengthening in traditional communities in Brazil where state services are not available or are not entirely acceptable for cultural reasons.

In countries like Mexico, where this indigenous baby was born, and Brazil, many mothers still give birth at home, attended by midwives. Credit: Mauricio Ramos/IPS

The 74-year-old de Souza says that prior to 2008 she attended 1,000 births in her home city of Jaboatão dos Guararapes, in the rest of the state of Pernambuco, and in neighbouring states in Brazil s impoverished Northeast.

She said she never ceases to be amazed every time a mother s expression changes from pain to joy.

A woman in labour feels pain, but when her baby is born she smiles and cries with happiness, she told IPS, recalling the tears of emotion she has shed herself at each birth she has attended.

De Souza, an indigenous woman, learned her skills as part of her cultural heritage. Her mother, grandmother and great-grandmother taught her the skills from childhood.

At first I would attend the births of cats, dogs and other animals, but later on in emergency situations, when my mother was not available, I began to attend women in their homes, she said. Subsequently she trained as an obstetric nurse and worked in hospitals for 20 years.
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Now retired, she still attends home births, sometimes in exchange for just a thank-you hug, like many of her colleagues who are midwives in the poorest parts of the country.

It is undeniable that the technologies and practices of the official health model have brought great advances, but we must try to achieve a balance between the traditional and the biomedical approaches if we want to guarantee the health of mothers and children, not just physically but also mentally and spiritually, said Paula Viana, coordinator of the in Pernambuco.

Because of their wisdom and experience, in, not excluded from, the health system, Viana said in an interview with IPS.

The Curumim programme has shown that traditional midwives contribute to earlier identification of problems in pregnancy, and that as natural leaders they help in cases of women who have been raped, in vaccination campaigns or in HIV/AIDS prevention programmes.

Midwives have contributed to the increase in prenatal checkups at public health facilities and healthy practices like breastfeeding, while they provide therapies such as massages, relaxing baths and emotional support.

The Curumim Group, on the occasion of International Day of the Midwife this Saturday May 5, is launching a campaign for recognition of the value of the role of traditional midwives among indigenous people and in quilombolas , communities of descendants of escaped slaves.

The campaign is also seeking recognition of home births attended by midwives within the Sistema Único de Saúde (SUS), the Brazilian national public health system, as well as the designation of midwives knowledge and practices as part of Brazil s intangible cultural heritage.

Traditional midwives are the bridge between the community and the health services. In many places where there are no doctors, they provide primary health care for the general population, and at other times they are the only person with the connections to get a sick person to hospitals or health clinics in nearby cities, Viana said.

De Souza has personal experience of the isolation of many rural, riverside or jungle communities. Once she attended a birth on the second floor of a half-built house that still did not have a stairway, so she had to climb up a rope rigged precariously by two police officers.

After the birth I had a lot of trouble getting down on my own, because one of the police officers was carrying the baby and the other was carrying the mother, she said.

According to Health Ministry statistics, 41,000 women a year give birth at home in this country of 192 million people, most of them attended by midwives. But the authorities admit the number may be higher.

Although health policies and projects officially take home births into consideration, the fact is that these births mostly take place in marginalised and isolated communities, without the involvement of the SUS, Viana said.

Traditional midwives can probably teach more than they can learn, but like any other health professionals they must train to improve and update their skills, and must have access to adequate materials and equipment, as well as means of transport for emergencies, she said.

De Souza said many of her colleagues in Brazil have no social benefits or labour rights, and receive no recognition for their work.

The government has to address this issue, especially as we have had a Brazilian president who was brought into the world by a traditional midwife, the expert said, referring to former president Luiz Inácio Lula da Silva (2003-2011), who is from the Northeast.

Viana emphasised that risk is inherent to childbirth, whether it takes place in a woman s home or in a hospital. But the danger of a serious health complication would increase if women in labour were deprived of the support of traditional midwives, she said.

That is why the Curumim Group s representative is calling for both healthcare models, the traditional and the biomedical, to join together, especially in remote and isolated communities.

In de Souza s view, pregnancy is a natural process, but many women have got it into their heads that they are ill, or else they don t want to suffer pain and they ask for a caesarean. SUS figures for 2008 show that half of the three million births registered that year were by .

The maternal mortality rate has declined steadily in Brazil since 1990, when there were 140 maternal deaths per 100,000 live births. By 2010 the figure was 58 per 100,000 and it is expected to drop still further. The main causes of childbirth-related death among women are hypertension, haemorrhages and postpartum infections.

The infant mortality rate has also fallen, to 15.6 per 1,000 live births in 2010, 47 percent lower than in 2000, according to the latest census.

In these circumstances, Viana said, the full range of regional obstetric care should be considered in order to achieve further improvement.

The more the scientific community endeavours to establish the biomedical model of health, the more we need to analyse the consequences of the excessively interventionist and medicalised nature of childbirth, she said, pointing out that the number of traditional midwives is in decline.

De Souza, the midwife who has brought more than 1,000 babies into the world, says: We have been blessed, and we continue to be blessed. We have thousands of years of history behind us, and that must command respect.

UNITED NATIONS, Jun 11 2012 (IPS) – The headline in a New York newspaper last March captured the essence of a future potential threat to political stability the world over: U.S. Report Sees Tensions Over Water.

The study, a collective vision of the U.S. intelligence community, warned that during the next 10 years, many countries important to the United States will almost certainly experience water problems shortages, poor water quality or floods that will contribute to the risk of instability and state failure, and increase regional tensions.

Carrying drinking water in a low-income Cairo district. Credit: Victoria Hazou/IPS

Still, there are fears that next week s U.N. Conference on Sustainable Development, also known as Rio+20, may marginalise both water and sanitation when it finalises its plan of action titled The Future We Want.

So is there a future for water in the U.N. scheme of things?

Not really, says Karin Lexen of the Stockholm International Water Institute (SIWI), a Swedish policy institution that seeks sustainable solutions to the world s escalating water crisis.

Many people are losing faith in the U.N. system and a weak Rio+20 outcome will build on to this mistrust, she told IPS.

We would of course like to see a strong outcome with concrete and forward thinking commitments, she added.

Lexen said that an agreement on Sustainable Development Goals (SDGs) would be one important outcome.

As a cross-cutting resource and the bloodstream of the green economy, water is an obvious candidate for one overarching SDG, but it also should be reflected in the other SDGs, particularly those on food and energy, she added.

The summit, to be attended by over 120 heads of state and government, will take place Jun. 20-22, and is a follow up to the 1992 Earth Summit in Rio de Janeiro.

Secretary-General Ban Ki-moon said last week he expects the summit to make progress on some of the building blocks of sustainability: energy, water, food, cities, oceans, jobs and the empowerment of women.

The U.N. Special Rapporteur Catarina de Albuquerque has already made a strong pitch urging member states to fully support the human right to safe drinking water and sanitation at Rio+20.
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In an open letter to member states negotiating the final outcome document, she expressed concern that a clear recognition of the human right to water and sanitation is at risk of being suppressed from the original text after three rounds of informal-informal negotiations held in New York in the past three months.

Some States suggested alternative language that does not explicitly refer to the human right to water and sanitation; some tried to reinterpret or even dilute the content of this human right, she said.

De Albuquerque, the first U.N. special rapporteur on the human right to safe drinking water and sanitation, said that water already has been recognised as a human right under international law, including by the General Assembly and the Human Rights Council in 2010.

When agreeing on a sustainable development target for water and sanitation, she said, governments have to integrate the human right to water and sanitation and aim at achieving access to safe and affordable drinking water and sanitation for all without discrimination.

They should also be available in sufficient quantities to protect human health and dignity, particularly for the most marginalised.

SIWI s Lexen told IPS that action to improve the wise and sustainable management of water is also critical to outcome at Rio.

By 2030, in a business as usual scenario, humanity s demand for water could outstrip supply by as much as 40 percent.

This, she warned, would place water, energy and food security at risk, increase public health costs, constrain economic development, lead to social and geopolitical tensions and cause lasting environmental damage.

Therefore, the foundation for a resource efficient green economy must be built upon water, energy and food security and these issues must be addressed in an integrated, holistic manner and be reflected in the Rio outcome and also as a cornerstone in the SDGs, she said.

Asked if water has found its rightful place on the international agenda since the first Stockholm Conference on the Human Environment back in 1972, Lexen said that given the fundamental role water has for all life, for wealth and economic development and being a source for conflict but also a tool for cooperation, water has not been given the prominent role it should have.

Water has a place in the Rio draft, but the different thematic areas are still very much compartmentalised.

Take the energy section, for example: water is not mentioned once in the remaining texts despite the fact that it is an essential resource for energy production, she said.

Other issues, like the recognition of access to drinking water and sanitation as a human right, and transboundary waters, are still under discussion now, only a few days before the Rio Summit begins.

She said The Friends of Water group has played a role in pushing water into the global environmental agenda.

But we have important work in the final week ahead, and at the summit, to ensure that a wider group priorities water and ensure concrete commitments and a strong outcome document is produced in Rio, Lexen said.

Sex workers march through a street in the Indian city Kolkata to condemn U.S. denial of visas to attend an AIDS conference. Credit: Sujoy Dhar/IPS.

KOLKATA, Jul 26 2012 (IPS) – Bare-chested and beaming in the company of many like him, London-based male sex worker Thierry Schaffauser wipes the beads of sweat trickling down his face on a humid Kolkata evening, and slams U.S. President Barack Obama.

“He is against sex workers. His policies are actually killing sex workers across the world and hindering HIV/AID prevention,” says France-born Thierry.

Thierry and thousands of sex workers from across the world who are gathered in Kolkata Jul. 21 to 27 at the ‘Sex Workers Freedom Festival’ are critical of the U.S. government for denying them visas to attend the international HIV/AIDS conference being held this week in Washington.

The International AIDS Conference is the premier gathering for those working in the field of HIV, as well as policy makers, persons living with HIV and other individuals committed to ending the pandemic.

But sex workers, who are the most HIV/AIDS prone community, were denied entry in the U.S. under laws which limit travel for sex workers.

The sex workers community chose instead to hold a parallel meeting in this eastern city. Nearly 800 sex workers and activists turned up from 41 countries to join thousands of Indian counterparts at the Kolkata meet.

Sex workers from India were also vocal against the U.S. laws. “I am here because this is like a festival for us,” says a transsexual sex worker from south Indian state of Andhra Pradesh. “But we are also protesting the U.S. visa denial. It is like denying one’s human rights.”

Anna, who represents the Canadian sex workers’ organisation Stella, says the Kolkata conference will send a strong message.

“I am a worker. A sex worker is a real worker. You should decriminalise the profession and accept us as workers. It is strange that the U.S. does not understand that,” says Anna, marching with hundreds of others holding a red umbrella, now a sex workers symbol of resistance against discrimination.

Visitors from across the world are overwhelmed by the organisational skills of the host organisation Durban Mahila Samanwaya Committee (DMSC).

With 65, 000 members, DMSC is the world’s largest association of sex workers. It operates out of Sonagachi in Kolkata, the hub of more than 10,000 brothel-based sex workers.

Akhila Sivadas, executive director of New Delhi-based Centre for Advocacy and Research, which is partnering with the Global Network of Sex Work Projects (GNSWP), the All India Network of Sex Workers (AINSW) and DMSC to organise the conference, says the Kolkata gathering is the manifestation of a bold stand taken by the community.

“This conference is an affirmative statement where sex workers from diverse cultures and economies have come together. There are differences but the overall similarities are the same. If you do not decriminalise you will lose the battle.”

According to Dr. Smarajit Jana, chair of the conference and father figure of the sex workers’ movement in Kolkata, the U.S. is continuing with an earlier restriction on visa denial to sex workers. “So when they were denied visa by the U.S., we in Kolkata came forward. The government in India does not have such restrictions on entry of sex workers.

“Despite all our failures and social taboos, India is transparent about fighting AIDS and so we could bring down the HIV population from five million to 3.5 million at the moment,” says Dr. Jana. “The policy in India is effective and progressive.”

“The roadmap ahead is to clearly strengthen partnership at every level,” says Akhila Sivadas. “The community is designing, shaping, fighting economic injustice to fight HIV/AIDS.

“We will focus more on social entitlement and economic justice,” she says. “Here DMSC is the ideological vanguard because they started at a time when tolerance was not there. But while they are at the vanguard, those taking inspiration from them have to also innovate in their environment in each area, in different milieus.”