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Trouble in CAR, trapped in Raqqa, and Trump at the UNGA: The Cheat Sheet

Fri, 15 Sep 2017 15:48:02 +0000

IRIN editors have scanned the humanitarian horizon to get you up to speed with this forward-looking weekly digest:   CAR risks return to civil war   Central African Republic is on the brink and without a safety net. Amnesty International says (in a report detailing terrible cruelty) that civilians are the direct targets of a wave of violence by sectarian militia, forcing those that can to flee. More than 1.1 million people have been displaced, the “highest level ever”, notes UNHCR. The violence has been particularly acute in the centre, northwest, east, and southeast. The insecurity is blocking humanitarian access to those in need, with Médecins Sans Frontières announcing this week it had been forced to pull out of the town of Zemio as a result of recent attacks. Behind the violence is the largely Muslim UPC (see earlier IRIN coverage) and rival primarily Christian anti-balaka and assorted armed “self-defence” groups. Their victims are civilians on either side of the religious divide. Amnesty is scathing (as are most people in the country) over the ineffectiveness of the UN peacekeeping force. “MINUSCA has failed to prevent these abuses,” the rights group says. “Amnesty International is calling for a review of MINUSCA’s capacity to carry out its mandate, covering factors such as training, equipment, coordination and the number of uniformed and civilian personnel.”   Do they ever learn?   MINUSCA was part of a sex abuse scandal (see IRIN’s exclusive interview with Anders Kompass) in 2014, and now there are fresh allegations over the mishandling of additional cases. The US-based Code Blue Campaign says it has received 14 internal UN reports that demonstrate how investigations were a botched and “manifestly sham process”. According to the accountability NGO, the leaked files reveal the hidden scope of sex abuse by UN peacekeepers. A new report by the NGO Redress, ahead of a high-level-meeting on Monday at UN headquarters, says the world body must do much more to enable victims of sexual exploitation and abuse by peacekeepers to “access reparation, support and assistance”. Something’s got to give.   Trump at the UNGA   Next week’s UN General Assembly is the first of President Donald Trump’s presidency. After hosting world leaders to discuss UN reform on Monday, he’ll be one of the first debate speakers on Tuesday and, given his past UN negativity and penchant for sharp cuts in US funding, diplomats are wary about what he might say. There’s also a lot to get on with. Catastrophic flooding in South Asia and record-setting Atlantic hurricanes will lend urgency to Secretary-General Antonio Guterres’ climate change roundtable on Monday and a high-level meeting later in the week. NGOs hope that attention will rub off on the sustainable development goals more broadly, with warnings that countries are falling behind.   It will also be the first UNGA for the World Food Programme’s David Beasley and new OCHA chief Mark Lowcock. With more than 20 million people in Somalia, Yemen, South Sudan, and Nigeria at risk of famine, perennial funding issues will once again be to the fore. Last year, huge migration into Europe was a hot topic; next week it’ll be the exodus from Myanmar. Guterres has said the Rohingya Muslims are experiencing “ethnic cleansing” and Aung San Suu Kyi has cancelled her inaugural trip to the forum in the midst of a growing international storm. After years of warnings about the situation, the UN is facing mounting pressure to take action.   When will aid return to Rakhine State?   While aid groups struggle with a massive influx of Rohingya refugees to Bangladesh, there’s also rising concern for vulnerable people back in Myanmar’s Rakhine State. Humanitarian agencies have been shut out of northern Rakhine for the past three weeks, after attacks on border posts triggered a military crackdown that has pushed 400,000 Rohingya into Bangladesh. The violence has forced aid groups to suspend their services in northern Rakhine, the flashpoint of the conflict, an[...]



Cost of clinical trials worries donors

Wed, 23 May 2012 23:00:00 +0000

The more medical successes there are, the more it costs to find the next one, prompting donors to demand more from researchers carrying out large-scale trials of drugs, vaccines and global health impacts. “As a funder, I hate clinical trial applications,” said Jimmy Whitworth, head of international activities at the science funding division of UK-based Wellcome Trust, which finances health research. Clinical trial costs have spiralled in recent years - one recent report estimated a 70 percent cost rise per patient between 2008 and 2011 - but without sound evidence of beneficial medicinal effect, regulatory agencies will not approve. A clinical drug trial can take up to 12 years, enrol thousands of participants across continents, and cost from as much as US$1.3 billion to nearly $12 billion for each new drug before it is approved for public use. And the costs keep climbing. “We need other ways of funding that are more flexible, quicker,” said Geoff Garnett, deputy director of the HIV Department at the US-based Bill & Melinda Gates Foundation. “I think a lot of what we should be doing is public health trials rather than clinical trials,” Garnett commented. “If we bog down our public health trials with clinical trial requirements, then we miss out on some of the important behavioural and organizational interventions that make clinical care and prevention work much better.” Why so costly? A greater number of participants must be tested in more settings, including those living where reports of a particular disease are falling, to determine whether improvements are the result of the proposed intervention or are being produced by existing ones. Bloated trials mean more researchers, institutes and funders, which in turn increases regulatory requirements. “The reality is, trials are getting steadily larger and more expensive… regulation is becoming ever more complicated,” said Chris Witty, research director at the UK Department for International Development (DFID). “We’re paying more and more for less and less.” Too ambitious As researchers compete for dwindling research and development dollars, donors criticize overly ambitious proposals. “The timetables are often extremely optimistic, so there is a real problem in that funding may run out before the research question is actually answered, said the Wellcome Trust’s Whitworth. “Frankly, very often clinical trials don’t look great value for money.” HIV research has tended to carry out trials in the most expensive way, Witty said, noting that researchers often make poor correlations between cost and the potential impact of a study. Donors and researchers are looking at partnerships and other ways to bring down costs, including “adaptive testing”, which uses real-time data to modify an ongoing trial. New funding In 2010, the Bill & Melinda Gates Foundation pledged $10 billion to research and develop vaccines for some of the world’s poorest countries and its grants database shows more than $70 million going to clinical trials since 2004. In the UK, the Wellcome Trust, the Medical Research Council (MRC) and DFID have committed $57 million to fund late-stage trials of interventions in cash-strapped countries. “Give us the evidence,” said Wendy Ewart, deputy chief executive and director of strategy at MRC. “Make the case for future funding.” oja/pt/he 95507 200709057.jpg Feature Health Cost of clinical trials worries donors IRIN LONDON Global Afghanistan Africa Armenia Angola Saudi Arabia Azerbaijan Bangladesh Burkina Faso Bahrain Burundi Benin Bhutan Botswana Belarus East Africa DRC Central African Republic Congo Côte d’Ivoire Cameroon Comoros Cape Verde Djibouti Algeria Egypt Eritrea Ethiopia Gabon Georgia Ghana Great Lakes Gambia Guinea Equatorial Guinea Guinea-Bissau HORN OF AFRICA Haiti Indonesia Israel Inde Iraq Iran[...]



Nouveau médicament contre le paludisme

Mon, 25 Apr 2011 23:00:00 +0000

l’Organisation mondiale de la santé (OMS) vient de recommander un changement dans le traitement de première ligne du paludisme qui pourrait permettre de sauver près de 200 000 vies par année. Les activistes de la santé en Afrique se préparent cependant à une longue bataille pour faire appliquer les nouvelles directives. La plupart des cas de paludisme sont peu complexes et non mortels, en particulier lorsque les patients ont été exposés au parasite et qu’ils ont développé une réponse immunitaire. Chaque année toutefois, environ 8 millions de personnes contractent un paludisme « sévère ». En 2009 seulement, 781 000 personnes en sont décédées, dont 90 pour cent en Afrique, où la maladie est la principale cause de mortalité chez les enfants. Depuis des années, la quinine est le médicament de choix pour traiter les cas graves de paludisme, mais elle est difficile à administrer et peut avoir des effets secondaires dangereux. « Il faut faire beaucoup de calculs », a dit Véronique de Clerk, coordinatrice médicale de l’organisation non gouvernementale (ONG) internationale Médecins Sans Frontières (MSF) dans le district de Kaabong, dans le nord de l’Ouganda. « Il faut la diluer pour préparer les injections et administrer celles-ci par intraveineuse pendant quatre heures [toutes les huit heures]. Et pour surveiller la procédure, il faut disposer de personnel qualifié ». En Afrique rurale, où on constate une pénurie de travailleurs de la santé, les patients reçoivent souvent trop peu ou trop de quinine, ce qui peut se révéler mortel, a ajouté Mme De Clerk. « Récemment, des études réalisées en Ouganda ont révélé qu’une administration de quinine sur quatre n’était pas faite correctement ». Si l’OMS recommande déjà depuis 2006 l’utilisation de l’artésunate pour traiter les adultes atteints de paludisme sévère, dernièrement , l’organisation a revu ses directives et décidé de recommander également le traitement par artésunate pour les enfants. Cette décision se fonde sur les résultats d’un essai clinique réalisé dans neuf pays africains en 2010 et qui conclut que sur 41 enfants traités avec de l’artésunate plutôt qu’avec de la quinine, une vie supplémentaire est sauvée. « Il est très rare qu’un médicament présente un avantage aussi évident par rapport à un autre, en particulier pour les maladies négligées comme le paludisme », a indiqué Nathan Ford, coordinateur médical pour la campagne de MSF pour l’accès aux médicaments essentiels. Au cours des dix dernières années, plusieurs essais cliniques importants ont démontré que l’artésunate était plus sûr, plus facile à utiliser et plus efficace que la quinine. L’artésunate doit être administrée pendant trois jours par perfusion intraveineuse ou par injection intramusculaire quotidienne. Il est dès lors possible de former du personnel non médical pour l’administrer et d’ainsi permettre aux communautés rurales et isolées de profiter d’un traitement efficace.  Dans son nouveau rapport intitulé « Making the Switch », MSF répertorie les avantages du traitement par artésunate et les défis que suppose ce changement dans la politique et la pratique. Le principal obstacle demeure le prix : l’artésunate coûte en effet deux à trois fois plus cher que la quinine – soit environ 3,30 dollars par enfant traité contre 1,30 dollar pour la quinine – et l’adoption du traitement suppose des frais supplémentaires pour la formation des travailleurs de la santé. « Tout changement dans le protocole entraînant une augmentation des coûts risque de représenter un défi dans les pays où les budgets de la santé sont très serrés », a dit à IRIN M. Ford. MSF estime à 31 millions de dollars par an le coût supplémentaire que suppose l’utilisation du traitement par artésunate dans le monde entier. M. Ford a dit que les bailleurs de fonds[...]



Where to watch prices

Sun, 24 Apr 2011 23:00:00 +0000

Against a global background of steadily climbing food prices, IRIN lists a selection of websites that offer some useful insights into how, why and where food is becoming more expensive. • UN Food and Agriculture Organization (FAO) food price index This monthly price list consults private sector as well as government sources for prices and export orders. It is officially accepted by countries and used by governments, policy-makers, humanitarian agencies and financial institutions. In its April edition the index showed that food prices had declined but this was a temporary dip reflecting the crises in North Africa and Japan in March, which delayed cereal purchases. The FAO food price index includes an average of the trading prices of five essential commodities - cereals, cooking oil, dairy products, meat and sugar. The average value of the export share of each of these commodities between 2000 and 2004 forms the base for making comparisons. The month-to-month changes in the prices of each of these commodities is shown in graphs based on detailed information on the prices of a broad range of commodities, including 11 kinds of oils, various varieties of rice and kinds of meat. • FAO Global Food Price Monitor If you need more details on how global cereal prices are affecting individual countries then consult the FAO Global Food Price Monitor. Information from markets and FAO offices around the world feed into this information service, which has also created a food price tool. With a few clicks you can access the price of a particular food commodity in any country. • The World Food Programme (WFP) Market Monitor If you are a policy maker or a humanitarian aid worker and need to find out how food prices are affecting the purchasing power of people in 63 vulnerable countries, then consult this quarterly bulletin.  The April edition, covering the first quarter of 2011, reported that in 44 of the 63 countries monitored, the overall basic food basket had increased more than 10 percent above the 5-year average. Read more  EASTERN AFRICA: Consumers, traders feel the burn as prices skyrocket UGANDA: As food prices bite, HIV-positive people turn to kitchen gardens VIETNAM: Struggling to cope with rising prices AFGHANISTAN: Government stockpiling wheat ahead of expected drought Biofuels make a comeback as prices rise In 16 of the countries the cost of the food basket had increased more than 10 percent since the last quarter of 2010, and by more than 20 percent in Ghana, Somalia, Afghanistan, Georgia, and El Salvador. The market monitor uses information collected by WFP field offices and in the April edition it also examined the impact of fuel prices on essential food commodities. It noted that the highest increases in fuel prices occurred in Ethiopia and Haiti, where fuel subsidies have been scaled back, and in Malawi and Uganda. • World Bank Food Price Watch The World Bank has begun producing regular food prices bulletins, using its own food price index based on information drawn from its offices across the world, the FAO food price index, and the US Department of Agriculture, which also regularly produces updates on global supplies of food commodities. The information is detailed and often contains useful analyses not found on other websites. The current update looks at the projected impact of continued food price increases on poverty. jk/he 92568 2008070416.jpg News Food Health Where to watch prices IRIN JOHANNESBURG Global Afghanistan Africa Armenia Angola Saudi Arabia Azerbaijan Bangladesh Burkina Faso Bahrain Burundi Benin Bhutan Botswana Belarus East Africa DRC Central African Republic Congo Côte d’Ivoire Cameroon Comoros Cape Verde Djibouti Algeria Egypt Eritrea Ethiopia Gabon Georgia Ghana Great Lakes Gambia Guinea [...]



Stillbirths "absent from global health agenda"

Wed, 13 Apr 2011 23:00:00 +0000

The annual number of stillbirths around the world is more than double the number of people who die from HIV-related causes, according to a new report that says this widely overlooked epidemic could be dramatically mitigated with better antenatal care. Some 2.64 million foetuses die after the 28th week of pregnancy, most of them in low- and middle-income countries, according the report published by The Lancet. While the number of stillbirths globally has fallen from an estimated three million in 1995, the decline lags behind progress in reducing deaths in children under the age of five. The series authors say the lack of recognition of the issue at a global health level means not enough is being done to prevent more babies from dying. "Parental groups must join with professional organizations to bring a unified message to UN agencies regarding the need to include stillbirths in global health policy." The authors report that grieving mothers are often disenfranchised from their communities; stillbirths can also affect future parenting and lead to divorce. In many countries, bereavement counselling is not widely available for families dealing with depression after a stillbirth. "Behind the statistics are individual stories of families devastated by the loss of their precious child," Janet Scott, research manager at Sands, a British stillbirths and neonatal death charity, said in The Lancet. "A baby who dies before he or she is born is no less loved and cherished, the grief and pain for the parents no less agonizing and enduring, and the guilt at not being able to protect that child no less intense." According to the UN World Health Organization, the five main causes of stillbirth are childbirth complications, maternal infections in pregnancy, maternal disorders such as hypertension and diabetes, foetal growth restriction and congenital abnormalities. A baby who dies before he or she is born is no less loved and cherished, the grief and pain of the parents no less agonizing and enduringHealth facilities overwhelmed At Madiany Hospital in Rarieda District in western Kenya's Nyanza Province, doctors and midwives deal with stillbirths on a daily basis; health workers are overwhelmed by expectant mothers from the entire district, even though the number of women who seek antenatal care is a mere fraction of what it should be. "We are just one hospital serving a whole district with a huge population. To reduce cases of irregular antenatal visits among pregnant mothers - one of the biggest contributing factors to stillbirths - we need to build the capacity of lower level health centres to provide antenatal care," Sylvia Warom, in charge of the hospital's maternity ward, told IRIN. "Many women come to the hospital when they realize they are pregnant and you never see them again until they are ready to deliver; it is unfortunate because many come to deliver already dead children," she added. In rural Nyanza, health centres are few and far between, and many women lose their babies on the long journey from home to the hospital, while others lose babies by choosing to deliver at home. More than half of all Kenyan women deliver their babies without the benefit of skilled medical professionals. According to The Lancet series, an estimated 1.2 million of all stillbirths happen during labour and delivery, highlighting the need to increase the number of women delivering babies with skilled birth attendants present. Better healthcare, better data "In Uganda only 42 percent of women receive skilled attended delivery," said Robina Biteyi, national coordinator of the Uganda chapter of The White Ribbon Alliance, an international maternal health NGO. "It is estimated that 15 percent of all pregnancies are likely to develop life-threatening complications and will need emergency obstetric care but in Uganda, only 24 percent have access to it." The authors of The Lancet seri[...]



Protection takes centre stage in new Sphere guidelines

Wed, 13 Apr 2011 23:00:00 +0000

Avoiding exposing vulnerable people to further harm, ensuring their access to impartial aid and assisting them to claim their rights and recover from abuse are some of the guidelines given to humanitarian actors in a new edition of the Sphere handbook, a set of common principles and universal standards for aid delivery. Incorporating a new chapter on protection principles, the third edition of the Sphere Handbook, Humanitarian Charter and Minimum Standards in Humanitarian Response (2011), stresses that protection is an intrinsic aspect of all humanitarian response. "The handbook incorporates a stronger focus on protection and safety of affected populations and considers emerging issues like climate change, disaster risk reduction, disasters in an urban setting, education, as well as early recovery of services, livelihoods and governance capacity of affected communities," Maxine Clayton, head of the Inter Agency Working Group (IAWG), said. Philip Wijmans, Kenya's country representative for the Lutheran World Federation (LWF), said: "This new edition of the Sphere handbook is a lifeline for humanitarian aid workers... it marks the beginning of a roll-out strategy." Besides the chapter on protection, the handbook incorporates a rewritten Humanitarian Charter and restructured chapters on core standards as well as minimum standards. According to the Sphere Project, at least 650 experts and more than 300 organizations in 20 countries were involved in the preparation of the 2011 edition, which is aimed at improving the quality of aid given to communities affected by natural disasters and armed conflict. "The Humanitarian Charter and Minimum Standards will not of course stop humanitarian crises from happening, nor can they prevent human suffering," the Sphere project said in a statement marking the launch. "What they offer, however, is an opportunity for the enhancement of assistance with the aim of making a difference to the lives of people affected by disaster." Launched alongside the Sphere handbook was Preventing Corruption in Humanitarian Operations by Transparency International Kenya (TI Kenya), the anti-corruption NGO. It is a practical guide to help aid organizations deal with corruption in their operations. This new edition of the Sphere handbook is a lifeline for humanitarian aid workers... it marks the beginning of a roll-out strategy "It highlights best practice tools for preventing and detecting corruption in humanitarian organizations," Rachel Mbai, TI Kenya's vice-chairwoman, said. "Transparency International defines corruption as 'abuse of entrusted power for private gain'. This includes financial corruption such as fraud, bribery, nepotism and extortion but also encompasses non-financial forms such as the diversion of humanitarian assistance to benefit non-target group." Mbai said humanitarian organizations must be accountable, not only to their development partners but also to the people they have the mandate to serve. "They have the duty to be transparent about their mandate, their scope of work, the eligibility criteria of the relief and services they are providing to communities," she said. Roslyn Hees, TI senior adviser and co-author of the handbook, said: "The handbook is a menu of good practice tools to help organizations deter, detect and deal with specific corruption risks in their operations. It can also be used by donors as a checklist when looking at the institutional policies of the aid organizations they work with." js/mw 92478 20081127.jpg News Human Rights Conflict Protection takes centre stage in new Sphere guidelines IRIN NAIROBI Global United Nations HQ Afghanistan Africa Armenia Angola Saudi Arabia Azerbaijan Bangladesh Burkina Faso Bahrain Burundi Benin Bhutan Botswana Belarus East Africa DRC Central African Republic Congo Côte d’Ivoire Cameroon [...]



Invest in adolescents' education and training, urges UNICEF

Fri, 25 Feb 2011 00:00:00 +0000

With the majority (88 percent) of the world's 1.2 billion adolescents living in developing countries, investing in their education and training could break entrenched cycles of poverty and inequality, says the UN Children's Fund (UNICEF) 2011 State of the World’s Children report. “We need to focus more attention now on reaching adolescents - especially adolescent girls - investing in education, health and other measures to engage them in the process of improving their own lives,” Anthony Lake, UNICEF executive director, said in a statement issued at the launch of the report, Adolescence: An Age of Opportunity, on 25 February. Lake said: "Adolescence is a pivot point – an opportunity to consolidate the gains we have made in early childhood or risk seeing those gains wiped out." In Nairobi, UNICEF's regional director for eastern and southern Africa, Elhadj As Sy, told IRIN: "Africa has the largest proportion of children, adolescents and young people in the world. Almost half its population is younger than 18 years and almost two-thirds are younger than 25 years. "As the gap between rich and poor, men and women, urban and rural keeps widening, and inequality generates a 'nothing to lose' generation, paying more attention to adolescents and young people is especially critical for the African nations." According to UNICEF, strong investments during the last two decades have resulted in "enormous gains" for young children up to the age of 10, with a 33 percent drop in the global under-five mortality rate. "On the other hand, there have been fewer gains in areas critically affecting adolescents. More than 70 million adolescents of lower secondary [school] age are currently out of school, and on a global level, girls still lag behind boys in secondary school participation," UNICEF said in a statement. "Without education, adolescents cannot develop the knowledge and skills they need to navigate the risks of exploitation, abuse and violence that are at their height during the second decade of life." Among the challenges facing today's adolescents, UNICEF said, are health risks such as injury, eating disorders, substance abuse and mental health issues - "it is estimated that around one in every five adolescents suffers from a mental health or behavioural problem". Today's investment will lay the foundation for a generation of active agents of change for a better future Challenges The agency said global challenges facing adolescents include the current bout of economic turmoil, climate change and environmental degradation, explosive urbanization and migration, ageing societies, the rising costs of healthcare and escalating humanitarian crises. To enable adolescents to effectively deal with these challenges, UNICEF recommends improved data collection to increase the understanding of adolescents’ situation; investing in education and training to lift adolescents out of poverty; expanding opportunities for youth to participate and voice their opinion; promoting laws, policies and programmes that protect the rights of adolescents, and stepping up the fight against poverty and inequality through child-sensitive programmes to prevent adolescents from being prematurely catapulted into adulthood. Lake said: "Millions of young people around the world are waiting for greater action by all of us. Giving all young people the tools they need to improve their own lives will foster a generation of economically independent citizens who are fully engaged in civic life and able to actively contribute to their communities." js/mw 92041 2006461.jpg News Human Rights Conflict Invest in adolescents' education and training, urges UNICEF IRIN NAIROBI Global Afghanistan Africa Armenia Angola Saudi Arabia Azerbaijan Bangladesh Burkina Faso Bahrain Burundi Benin [...]



Billions lack access to life-saving surgery

Thu, 24 Feb 2011 00:00:00 +0000

More than two billion people, mostly in low-income countries, lack adequate access to life-saving surgical procedures, which is a potential obstacle to achieving health-related Millennium Development Goals (MDGs), say specialists. "It is not news that the poor have worse access to hospital services like surgery. But the size of the population is a shock," said Atul Gawande, associate professor at Harvard School of Public Health and head of the World Health Organization (WHO) initiative, Safe Surgery Saves Lives.  "Surgery has been a neglected component of public health planning and this clearly needs to change," he added. Even though a substantial number of diseases worldwide require surgery, residents of higher-income regions undergo 75 percent of surgeries annually, versus the poorest third who account for only 4 percent, according to a 2010 Harvard University School of Public Health study. Based on profiles of 769 hospitals in 92 countries, wealthier countries had 14 operating theatres per 100,000 people versus two in lower-income regions. Shortfalls Surgery has been a neglected component of public health planning and this clearly needs to change A separate February 2010 study of 132 health facilities in eight countries (Sri Lanka, Mongolia, Tanzania, Afghanistan, Sierra Leone, Liberia, The Gambia and São Tomé and Príncipe) revealed infrastructure to be just one of the "enormous shortfalls" in emergency surgical care.  "Are there staff to assist with surgery? Next, do they have the supplies and equipment necessary to undertake the procedures? . Lastly, do the personnel have the knowledge and capability to treat?" asked Adam Kushner, the study's co-author and founder of the New York City-based NGO, Surgeons OverSeas. The study highlighted shortages in all those areas. No surveyed centres reported uninterrupted water or electricity (and therefore oxygen supply), with most reporting less than a 50 percent supply of all three. For MDG 5 (improve maternal health), 44 percent of facilities offered Caesarean sections. For MDG 6 (combating the spread of HIV/AIDS) 48 percent of the surveyed centres offered male circumcision, recommended by WHO to fight the spread of HIV. Where are the surgeons? Specialist surgeons and anaesthetists are scarce where they are most needed, for example, in sub-Saharan Africa, according to a 2010 medical survey published in Plos Medicine of eight district hospitals in Uganda, Mozambique and Tanzania. In 2008, Uganda had 10 specialist surgeons and 350 anaesthetists for a population of more than 30 million. In Mali, Mamby Keïta, a surgeon at the country's largest hospital, Gabriel Touré Hospital in the capital Bamako, told IRIN there were three paediatric surgeons nationwide in 2010 to serve an estimated 2.2 million under-five children (2008); four more are in training but not expected to graduate until 2012. "We also need paediatric anaesthetists. The absence of such technicians limits how many paediatric surgeries we can do," said Keïta. Stop-gap To help cover the shortage of local surgeons, there are international doctors serving short-term contracts; NGOs; visiting humanitarian projects such as Operation Smile or the faith-based NGO, Mercy Ships, a hospital at sea that docks for months at a time to offer medical procedures including surgery; or mid-level health workers and nurses. Non-doctors carried out half of all surgical procedures in the centres surveyed in the Plos Medicine study. Kushner said it was critical to prepare all levels of health workers to carry out emergency surgical procedures - rather than foregoing surgical care. What next? A resolution for the next WHO World Health Assembly in May 2011 to create a WHO Department of Surgical Care and Anaesthesia has been circulated to health ministries. There is [...]



Destitution among asylum seekers

Mon, 07 Feb 2011 00:00:00 +0000

Oxfam has added its voice to a growing chorus of concern about Britain’s system for deciding on asylum claims, and the suffering it causes, in a report on destitute asylum seekers, who are forbidden to work but cannot claim state benefits. These men and women, who told their stories anonymously in Coping with Destitution: Survival strategies of asylum seekers in the UK, live in the shadows, penniless and dependent on the charity of others. “They treat you with no respect, they take advantage of you, you become ‘food for work’, cleaning the house and doing laundry… Living with friends is a hard thing. They get fed-up looking after you if you have no income,” one asylum seeker told the Oxfam researcher during an interview. “You might use a bus pass, shuffling around all night on the bus. It’s very risky as you go to places you don’t know, spend time at the bus stop during nights, and might be caught... You might have a place to go, but you feel that your friend needs privacy, or you don’t feel comfortable staying there,” said another, outlining the difficulties of daily life. “I knew a man who worked for three months, and was promised £35 (US$56) every day, and after three months he asked for the wage, but the manager said he would give him just £50 ($80) for three months. ‘But I need £3,000 ($4,800)!’ he said. But the manager threatened to report him to immigration, so what could he do?” the report quoted an asylum seeker as saying. Some, whose cases have not yet been decided, have administrative problems and find themselves forbidden to work, and also to claim any kind of public support. Falling into the gap Most of those who are destitute have had their applications for asylum refused, yet would rather live penniless in the UK than return to their home countries. In 2005 the British government’s National Audit Office estimated that there were between 155,000 and 283,500 people in this position, with no legal source of income. The assistance available to people seeking asylum in Britain has been steadily reduced over the past 10 years. At one time they could claim normal welfare benefits, and apply for permission to work if they had to wait more than six months for a decision on their application. Now, the only benefits they can claim are accommodation and a reduced living allowance of £35 (about $55) a week, provided by the National Asylum Support System (NASS). Once a claim and any appeal have been refused, the support stops and a claimant is supposed to leave the country within three weeks. At this point many asylum seekers try to stay on, without any means of support. Even in cases where it is difficult or impossible for them to leave because they don’t have the necessary papers, or their home country is considered too dangerous, many choose to disappear rather than stay on in NASS accommodation, where they could easily be found and deported. Oxfam said cutting off benefits to get failed asylum seekers to return home is “demonstrably failing to achieve its aims. Destitute asylum seekers, who are considered by the authorities to be at the end of the asylum process, are simply not returning to their countries of origin, regardless of how awful things are in the UK.” Organizations working with asylum seekers say poor decision-making on asylum claims is at the root of many of the problems, since decisions that are seen as arbitrary and unfair encourage claimants to stay on and try their luck with appeals or further applications. We never need to force anyone to make a choice between destitution and persecution. So many people who have turned to us for sanctuary have not been given a fair hearing Debora Singer, of Asylum Aid, which offers legal help to asylum seekers, told IRIN that half the women s[...]



Prepare now for future migration surge, says IOM

Mon, 03 Jan 2011 00:00:00 +0000

Decisions taken by local authorities on land use, building regulations and access to health services probably affect migrants more than decisions taken nationally, “yet in most countries, migration policy is set at the national level with little attention to capacity-building at the local level, where policy is usually implemented,” says the new World Migration Report 2010.  The report, published every two years by the International Organization for Migration (IOM), highlights several such gaps, and explores the extent to which countries are prepared for a surge in migration over the coming decades. The current number of 214 million migrants globally, according to IOM, could rise to 405 million by 2050. It says new trends in migration could be affected by varying rates of population growth (slowing in the developed world and prompting an even greater demand for labour); environmental change; and shifts in the global economy. The current “lull” in international migration due to economic recession, IOM says, should be used by countries to prepare for larger flows of people: capacity-building and better managed databases could be areas to look at. The report provides a self-evaluation checklist to help countries and organizations assess their preparedness levels. jk/cb 91513 201010210751260211.jpg News Human Rights Migration Prepare now for future migration surge, says IOM IRIN JOHANNESBURG Global Afghanistan Africa Armenia Angola Saudi Arabia Azerbaijan Bangladesh Burkina Faso Bahrain Burundi Benin Bhutan Botswana Belarus East Africa DRC Central African Republic Congo Côte d’Ivoire Cameroon Comoros Cape Verde Djibouti Algeria Egypt Eritrea Ethiopia Gabon Georgia Ghana Great Lakes Gambia Guinea Equatorial Guinea Guinea-Bissau HORN OF AFRICA Haiti Indonesia Israel Inde Iraq Iran Jordan Kenya Kyrgyzstan Cambodia Kuwait Kazakhstan Laos Lebanon Sri Lanka Liberia Lesotho Libya Morocco Middle East and North Africa Madagascar Mali Myanmar Mauritania Mauritius Maldives Malawi Moldova Mozambique Namibia Niger Nigeria Nepal Oman Palestine Papua New Guinea Philippines Pakistan Qatar Russia Rwanda Southern Africa South Africa Seychelles Sudan Sierra Leone Senegal Somalia Sao Tome and Principe Syria Swaziland Turkmenistan Chad Togo Thailand Tajikistan Timor-Leste Tunisia Tanzania Ukraine Uganda Uzbekistan Vietnam West Africa Western Sahara Yemen Zambia Zimbabwe Français العربية [...]