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EDITOR’S TAKE: Yemen needs commercial imports to avoid famine (#LetTradeIn)

Wed, 22 Nov 2017 19:26:28 +0000

After increasingly dire warnings that Yemen is on the verge of (or in the midst of) famine, the Saudi Arabian-led coalition has announced it will reopen on Thursday a key port and airport for “humanitarian and relief efforts”, ending a partial blockade lasting more than two weeks.   Hodeidah port and Sana’a airport were shut down after Houthi rebels fired a missile at Riyadh earlier this month, and the coalition responded by closing all routes into Yemen, saying it was to prevent weapons smuggling.   The situation inside Yemen deteriorated quickly and was feared to get much worse, with a run on fuel, water shortages, and concerns that food stores would empty within the next few months. Humanitarians have been tweeting about the impending disaster with the hashtag #LetAidIn.   The semi-opening of Hodeidah and Sana’a is welcome news, if indeed the ships and planes full of food and vital medical supplies are really granted entry. But many Yemenis will need more than aid if they are to survive this crisis; they'll need commercial imports too.   The importance of Hodeidah   Forces loyal to internationally recognised (but deposed) Yemeni President Abd Rabu Mansour Hadi, backed by the Saudi-led coalition, have been trying to oust Houthi rebels and fighters who side with former president Ali Abdullah Saleh for more than two and a half years.   Even before the war, Yemen was the poorest country in the Arabian Peninsula, with 4.5 million Yemenis classified as "severely food insecure" in 2014. Yemenis rely on imports for 80-90 percent of their food, including two key staples – wheat and rice – the majority of which comes through Hodeidah and the nearby smaller (and also shuttered) Saleef port. Wheat is mostly shipped to Yemen unprocessed and in bulk and processed at Hodeidah, which, despite its diminished capacity thanks to airstrikes, still has working silos and grain mills. Vitally, there’s no indication yet that the Saudis plan to re-open this port to commercial imports.   Aden, under the Saudi coalition’s control, was re-opened last week for commercial trade and aid deliveries, but it only has 40 percent of the milling and storage capacity of Hodeidah. Other seaports were never really closed, but are too small to handle large-scale shipping anyway.   If traders are forced to use Aden for commerical imports, they may have to pivot to packaged flour or rice. A shift to flour would likely be costly, and that cost would be passed down to the Yemeni consumer.   But it’s not only rising prices that are a concern. A Yemeni source familiar with the matter told IRIN that Aden is also unlikely to be able to scale up quickly enough to handle the amount of imports that could soon be directed its way. Issues include the union that controls the boats and staffing, and the fact that the port’s customs department only works part-time – when the air conditioning in the hangar it uses is actually functioning.   Then there’s the problem of location. By UN estimates, 71 percent of the nearly 19 million Yemenis who need assistance are in Houthi-Saleh controlled areas. Getting food – or aid for that matter – to them from Aden, which is in the hands of various competing forces nominally loyal to Hadi – is extremely difficult. The source told IRIN there are dozens, even as many as 100 checkpoints on the route that can handle lorries between Aden and Houthi-Saleh run Sana’a. Hodeidah and Saleef, which fall in Houthi-Saleh territory, are the natural fit for bringing food to this population.   The Famine Early Warning Systems Network (FEWS NET), which is funded by the US Agency for International Development (USAID), recently reported that “even if throughput [through Aden] improves significantly, famine will remain likely, once stocks are depleted, in areas that had relied on food imports from [Hodeidah] ports, but that are less able to shift towards Aden as a source of staple food.”   It added that even for areas that are able to access imports from Aden, the famine risk remains, given the likely in[...]

IRIN TEDx Talk: Stop eating junk news

Mon, 20 Nov 2017 14:05:17 +0000

Over the last decade, we've awoken to the fact that junk food hurts us. It's time for a similar revolution in our news consumption. 

In this new TEDx Talk, IRIN Director Heba Aly takes on the role of ‘chief news nutritionist’. Fake news is one thing but Heba explains why we must stop consuming the more insidious, less obvious variety of junk news: “If classical junk news is your greasy double bacon cheeseburger, junk coverage of important news is the low fat blueberry muffin that looks healthy but is actually loaded with calories.”

A journalist covering humanitarian crises for the past 10 years, Heba highlights through personal experiences and powerful examples the dangers of simplistic narratives that can warp our views of conflicts and crises, affect realities on the ground and even impact peace negotiations.

“It has never been more important to understand our ever-complex world because we cannot prevent, respond to or resolve these crises if we do not properly understand them,” she says. 

“This isn’t just about a failure to understand the world around us. Junk news erodes our democracies because it fails to give us the information we need to be responsible, active citizens and to make informed decisions about our own lives.” 

IRIN’s mission is to put quality, independent journalism at the service of the most vulnerable people on earth. As Heba explains, “reliable journalism does exist - you just have to seek it out and consume it, and where possible support the journalists producing it.”

Food is fuel; knowledge is power. Better diets make us healthier. High quality news helps change the world for the better. Support IRIN’s journalism here.

Stop eating junk news | Heba Aly | TEDxChamonix

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Rohingya death count, war games, and a non-coup in Zimbabwe: The Cheat Sheet

Fri, 17 Nov 2017 15:27:22 +0000

Every week, IRIN’s team of specialist editors scans the humanitarian horizon to curate a reading list on important and unfolding trends and events around the globe:   Plus ça change in Zimbabwe   It all started with tanks; except the military vehicles globally reported on the outskirts of Harare on Tuesday evening weren’t tanks at all, but infantry fighting vehicles. Anyway, things like tanks on the streets, the president under house arrest, a man in uniform on state TV insisting it’s all a temporary measure, everything will return to normal shortly. Has to be a coup, right? Not so fast. It’s increasingly apparent that Zimbabwe’s army has no intention of effecting fundamental political changes. It may have determined it’s time for President Robert Mugabe, 93, in power since 1980, to leave office, but they haven’t actually yet deposed him, and still refer to him as the head of state. And, as this article published by African Arguments postulates, what’s really been happening in recent days is a “realignment” and an “internal settling of scores” within the long-ruling ZANU-PF party. “This is no revolution giving the power to the people. The army has done its duty in giving power back to the party,” it concludes. For more on life after Mugabe, read our recent analysis (Not that we’re claiming we saw this coming).   Libya’s descent   Libya is hell for migrants, with rape, extortion, and imprisonment rife. Utter chaos has allowed smugglers – allied with some of the country’s militias and competing political forces – to run rampant. Two months ago, the UN launched an action plan to get an “inclusive political process” going again and establish some sense of stability. But Ghassan Salamé, the UN’s special representative in Libya, hinted in a Thursday briefing to the Security Council that it would be a complicated and long road ahead: “Elections should not take place until we are certain that they will not add a third Parliament or fourth government.” It’s in part thanks to political instability that Libya’s economy is in a bad way. Despite a small rebound in oil outputs, inflation is rising and the country is unable to fund much in the way of food imports or defend its foreign reserves. On the ground – with many going unpaid and food prices rising steadily – some Libyans are getting desperate. Reuters reports that in Tripoli, people are selling foreign currency and jewelry to pay for medical care. Whose fault is the economic collapse? According to Libya’s Central Bank Governor Sadiq al-Kabir earlier this week: “everyone”.   Tracking deaths in Bangladesh’s swelling Rohingya camps   Health authorities in Bangladesh are investigating a measles outbreak in the crowded Rohingya camps of Cox’s Bazar, to where more than 620,000 refugees have fled since late August. In that time, there have been at least 611 cases. Aid groups have warned that disease outbreaks are likely in the makeshift camps, where authorities have struggled to keep pace with the swelling refugee numbers and even basic water and sanitation systems are severely inadequate. Ongoing tests of drinking water sources in the camps, for example, found 83 percent tested positive for faecal contamination. It’s forced health authorities and aid groups to keep a close eye for early signs of problems. Health providers have set up an early warning reporting system in Cox’s Bazar, tracking everything from severe diarrhoea and respiratory infections to a recent, worrying uptick in cases of “unexplained fever” – there were more than 49,000 reported cases as of mid-November. This surveillance system is also a thorough, if dispassionate, record of what’s killing people in the camps, which now have the population, but none of the infrastructure, of a bustling city. Until 12 November, the system recorded 199 deaths since the most recent influx began. For more, read some of IRIN’s recent reporting looking at the monumental task of setting up [...]

Peeking through the cracks into Yemen’s war

Wed, 15 Nov 2017 08:47:13 +0000

In a city positioning itself as a bastion of stability and safety in the midst of war, Yemen’s humanitarian crisis (which the UN calls the largest in the world) is still palpable. You just have to peer through the cracks to see it.   Sometime in the far-gone past, several legends go, the Queen of Sheba (Bilquis in Arabic) ruled over a wealthy kingdom from what is now the middle of Yemen.   What she did, or if she even existed, differs based on religious text and archaeological record, but her past is very much present in today’s Yemen.   Politicians, academics, and tribal leaders invoke the ruler as an example of a time when the country prospered. So perhaps it’s no coincidence the ruins of her supposed throne were one of the first places a group of Western journalists and researchers (myself included) were shown earlier this month in Marib, a city that is booming both because of and in spite of Yemen’s long war. Annie Slemrod/IRIN The six-columned Queen of Sheba's throne is believed to have been a temple   The temple is the sort of place you could get lost in, with its towering stone columns and carvings in an ancient script, were it not for the armed men surrounding the site (for our benefit) and their hurried instructions to move out.   As we did so, the jarring reality hovered in my head that today’s Yemen is not only at war but also in the throes of a humanitarian catastrophe that is the antithesis of the famed riches of Bilquis.   A Saudi Arabian-led coalition and forces allied with the internationally recognised (but deposed) President Abd Rabu Mansour Hadi have been battling Houthi rebels and fighters loyal to former president Ali Abdullah Saleh for more than two and a half years.   The war is in something of a stalemate now, but more than 5,350 civilians (likely a massive undercount) are dead (the majority by Saudi airstrikes), millions can’t afford enough food, and a cholera epidemic has swept through the country, killing thousands more.   Rare access   Foreign journalists are rarely able to access the country (with a few notable exceptions), and so when the Sana’a Center for Strategic Studies managed to secure visas and organise a trip – even to one of the less hard-hit parts of Yemen – I was in.   That meant heading to Marib, which presents itself as an island of calm in the midst of a country in collapse. Thanks to oil, a charismatic governor with ties to a modern-day royal family in Saudi Arabia, a major military headquarters, plus tribal politics, it is growing and considered relatively safe, at least for those with sympathies on one side of the war.   But it’s not yet secure enough for a gaggle of journalists to roam the streets, or so deemed Marib’s provincial governor Sultan al-Arada and his diligent security team. So when they said to move, I did (perhaps not as swiftly as they would have liked). I listened to talk of expansion and of the war’s progression, and I went where I could.   I did not see the malnourished children that are the face of a country that could be about to plunge into famine if aid does not get in soon, and perhaps they weren’t there. But I did catch glimpses of the crisis.   As the Sana’a Center’s co-founder and chairman Farea al-Muslimi put it to me after the trip: “It’s a… Yemeni habit to hide your pain and exaggerate your good… Just because you didn’t see [the full extent of the crisis], doesn’t mean it doesn’t exist.”   Water, water, everywhere and not a drop to drink   It’s said that the collapse of the Marib dam, around 575 CE, apocryphally attributed to a mouse, set off one of the world’s first refugee crises – the flood of tens of thousands of people out into the Arabian Peninsula.   Today’s dam is functioning just fine – it’s full enough for a few people to have a swim and float on black inner tubes.   The water from the dam, experts told us[...]

Yemen “starvation” warnings as Saudi Arabia shuts borders

Thu, 09 Nov 2017 14:13:10 +0000

  Aid agencies are ringing loud alarm bells after the Saudi Arabia-led coalition closed Yemen’s land borders, sea ports, and airspace, warning of the extreme dangers of cutting off access and assistance to a country already on the verge of famine.   The UN’s top relief official Mark Lowcock told reporters on Wednesday that if the new restrictions – now in place for three days – were not lifted, Yemen faces “the largest famine the world has seen for many decades”.   On the same day, 18 major NGOs said in a joint statement that “the humanitarian situation is extremely fragile and any disruption in the pipeline of critical supplies such as food, fuel, and medicines has the potential to bring millions of people closer to starvation and death”.   The Saudi Arabia-led coalition announced on Monday that it was closing all routes into Yemen, two days after a missile was fired by Houthi rebels towards the Saudi capital, Riyadh. The missile was intercepted, but the coalition said it was sealing off the country to “address vulnerabilities” in inspection procedures that had allowed Houthi rebels to obtain missiles like the one aimed at Riyadh, as well as other military equipment.   The coalition is fighting alongside forces loyal to internationally recognised (but deposed) President Abd Rabu Mansour Hadi to oust Houthi rebels and forces allied with former president Ali Abdullah Saleh.   The impact of the war has been drastic: The breakdown in Yemen’s health system and sanitation facilities contributed to a cholera epidemic that has killed 2,196 people and infected close to a million since April. The UN counts 5,353 civilian deaths related directly to the war and 8,912 injuries since March 2015 – the real numbers are believed to be much higher. Malak Shaher/MSF Yemen could see a resurgence of cholera if aid remains blocked The coalition’s statement said it would take into consideration the entry and exit of humanitarian supplies and crews, but aid agencies said flights and aid shipments had already been stopped. In some areas, the impact can already be seen on the ground, with fuel and gas prices in Sana’a reportedly soaring.   The International Committee of the Red Cross said a shipment of its chlorine tablets – necessary for fighting cholera – had been denied entry. It is also expecting 50,000 vials of insulin by next week, and ICRC Regional Director for the Near and Middle East Robert Mardini said the medical aid couldn’t wait at a shuttered border as it must be kept refrigerated.   “Without a quick solution to the closure, the humanitarian consequences will be dire,” Mardini said in a written statement.   Médecins Sans Frontières recently reduced its involvement in the cholera response following a decrease in suspected cases, but Justin Armstrong, head of MSF’s mission in Yemen, told IRIN that if the restrictions are not lifted soon there’s “a very valid concern” that the outbreak could worsen again.   Armstrong pointed out that a large proportion of Yemen’s population relies on trucked water for safe drinking, but distribution may be limited with the run on fuel and increase in prices. “If people take greater risks in terms of how they get their water, this could lead to a resurgence of cholera,” he told IRIN.   Lack of food   Getting aid and commercial imports into Yemen was a challenge before this shutdown , and throughout the war rights groups have repeatedly accused the Saudi-led coalition of delaying and diverting aid into the country. The Houthis have also been accused of confiscating aid and limiting humanitarian access, especially in the besieged city of Taiz.  The country’s main port, Hodeidah, has long been operating at low capacity due to airstrikes knocking out four of its five functioning cranes in August 2015. Most commercial ships won’t dock there given the lon[...]

Afghan healthcare under siege as escalating conflict cuts off access

Thu, 26 Oct 2017 14:30:06 +0000

The baby fell asleep clinging to his father, who perched on the edge of a hospital cot, cradling the child protectively.  Ihsanullah, 17 months, suffers from a virulent, drug-resistant strain of tuberculosis, which has alarmed his father and challenged the doctors. "There are injections and so many pills,” said his father, Bismillah. “The baby sees everyday the doctors with a white coat coming to inject him, so he is afraid." But despite the daily needles and pills, Ihsanullah is fortunate: his father left his job as a soldier in the north of Afghanistan so he could bring Ihsanullah to receive cutting-edge treatment at a specialised clinic in the southern province of Kandahar – the country's ethnic Pashtun heartland and a former Taliban stronghold. Throughout Afghanistan, however, an increasingly violent struggle for control is threatening access to vital healthcare. Pressure from a web of armed groups, including a resurgent Taliban, has seen medical workers targeted and health clinics commandeered or shut.  This has obstructed access to lifesaving care for hundreds of thousands of Afghans this year – and heightened the risk from deadly but treatable diseases like Ihsanullah’s tuberculosis. Ashley Hamer/IRIN Ihsanullah, 17 months, and his father wait while the baby receives treatment for drug-resistant tuberculosis at a clinic in Kandahar. The child has embarked on an intensive nine-month treatment regime. New treatments, limited reach For the past two months, Ihsanullah has been a patient with aid group Médecins Sans Frontières, which runs one of only two facilities in the entire country where his complex strain of drug-resistant TB can be treated. The baby's case is particularly troubling because tuberculosis is airborne and spread in close quarters, yet none of Ihsanullah's immediate family tested positive for the disease. He has nine months of heavy daily medication ahead of him. The clinic in Kandahar was launched a year ago – the first of its kind for MSF in an active conflict setting. There is limited clinic bed space and a small patient guesthouse, both designed for long-term treatment. New technology allows health workers to speed up the cumbersome diagnosis process and fast-track treatment. A state-of-the-art molecular testing machine brought in by MSF can now identify specific strains of TB on the spot. Previously, smear samples had to be sent to the capital, Kabul, or even to Europe.  Once diagnosed positive for a drug-resistant strain, the patient begins a newly-introduced treatment programme that lasts only nine months – the usual treatment for drug-resistant TB takes two years and requires close medical monitoring throughout. “It is essential that people complete the standard TB treatment regime, because if they stop halfway or take the wrong drugs – which they do – they build up resistance,” said Rod Miller, project coordinator for MSF in Kandahar.  If left untreated, the drug-resistant TB is passed onto others; sufferers face a prolonged, excruciating death. Ashley Hamer/IRIN Specialist equipment brought to Kandahar can now identify specific strains of tuberculosis on the spot. Previously, smear samples had to be sent to the capital, Kabul, or to Europe.  Afghanistan, a nation of 34 million people beset by decades of conflict, counts at least 60,000 ordinary TB cases annually. The disease kills some 12,000 people each year. Globally, the TB epidemic killed 1.4 million people in 2015. Only two new anti-TB drugs have been developed in the last 50 years, which means the same medicines have been in circulation for decades. Naturally, bacteria evolve to resist them. MSF calculates there are at least 2,000 new cases of multi drug-resistant TB across Afghanistan every year – driven b[...]

How do you build a health system from scratch in the middle of a refugee crisis?

Tue, 24 Oct 2017 03:21:11 +0000

Noor Mohammed groans in pain as doctors push a needle into his withered vein. He lies exhausted on a metal bed that has a cut-out hole in the middle of it and a plastic bucket underneath. His frail body is weakened by severe, constant diarrhoea.  Noor says he is the sole survivor of a family brutally killed by soldiers in Myanmar. When he fell ill, neighbours in Bangladesh’s swelling refugee camps carried him to a doctor. But now he’s alone. Just a week earlier, the bustling 20-bed dysentery clinic he is recovering in was an empty warehouse. But relief efforts have to move fast in the Rohingya camps, where aid agencies are scrambling to construct a healthcare system in record time for the world’s fastest-growing refugee crisis.  While new health posts are sprouting up in the camps, the needs are immense. Vast distances and still-growing refugee numbers make delivering life-saving aid a monumental challenge. Keeping pace More than 600,000 refugees have flocked into southern Bangladesh since 25 August, after a Rohingya militant group’s attacks in Myanmar’s Rakhine State triggered a brutal military crackdown. Refugees say they have survived killings and forced expulsions from their villages. Many are malnourished; most require some form of health assistance. Many have set up tents in the existing Kutupalong camp, which has hosted previous waves of Rohingya refugees since the 1990s. But new settlements are mushrooming throughout Cox’s Bazar district. Clean water and sanitation are largely unavailable in many of the new sites, making the camps breeding grounds for dangerous infectious diseases.  Stefanie Glinski/IRIN Noor Mohammed grimaces as he receives treatment at a dysentery clinic run by Medical Teams International. The magnitude of the sudden influx has made it impossible to reach all of the refugees. Aid groups in Cox’s Bazar estimate that about 300,000 people have received health services – half the number of new arrivals. The government has set aside a large swathe of land to house most of the newly arrived refugees. Authorities and aid groups have earmarked one health post for every 14,000 camp residents. But while many refugees have already moved in, most of the health facilities have not. “The Rohingya arrived quickly and before structures were put in place. The humanitarian community responded immediately to the crisis, but at this point many people had already settled,” said Frank Tyler of Medical Teams International, whose team runs the dysentery clinic where elderly Noor is being treated. The in-patient facility was the first dysentery clinic to be set up in the camp; its 20 beds are somehow supposed to serve 50,000 refugees. Preventing cholera With such large numbers living in close quarters and with little access to proper sanitation, health officials fear the risk of disease outbreaks like measles and cholera. The World Health Organisation has warned of a “very highly likely” chance that small clusters of cholera will emerge. A massive cholera vaccination campaign has been underway in the camps this month. Reaching more than 700,000 people, UNICEF is calling it the second-largest oral vaccination campaign the world has ever seen. Stefanie Glinski/IRIN Volunteers administer cholera vaccines to people in Rohingya refugee camps. Many of the volunteer teams walk hours into the camps to distribute the vaccine. The teams who distribute the vaccines have to be hardy. Equipped with 500 doses in small glass containers, they hike deep into the muddy camps, walking for kilometres in the scorching sun to reach the most remote communities. “The camp is a logistical challenge. We adjust our plans daily and remain flexible,” said Maya Vandenent, chief of health at UNICEF Bangladesh[...]

Afghan attacks, Raqqa redux, and plague in Madagascar: The Cheat Sheet

Fri, 20 Oct 2017 16:45:57 +0000

Every week, IRIN’s team of specialist editors scans the humanitarian horizon to curate a reading list on important and unfolding trends and events around the globe:   AU and EU: new BFFs?   African and European leaders are scheduled to meet in a summit in November at a time when relations have reached a turning point, the International Crisis Group says in a report released this week. The African Union has launched potentially transformative reforms that will shake up its peacekeeping operations and should increase its financial self-sufficiency. Because of Brexit, the EU is losing one of its most influential and internationally engaged members – with implications for Africa. One component critical to reshaping AU-EU relations is the Cotonou Agreement, a partnership between the EU and 79 countries from sub-Saharan Africa, the Caribbean, and the Pacific that expires in 2020 and will be renegotiated over the next two years. It’s unclear what shape the post-Cotonou settlement will take, and the future of the linked European Development Fund is equally uncertain. The AU’s reform of its peace and security architecture also has consequences for the EU – its chief funder. There are many points of friction: For the AU, the EU’s “paternalism” grates, while Brussels worries that it’s perceived as a “cash machine” – not to mention serious divergences over the migration issue. But there are deep-shared strategic interests. Both sides “must confront key areas of disagreement and frustration,” says the ICG. “In this context, the AU-EU summit comes at a particularly opportune moment.”   Biggest plague outbreak since 2008 (probably)   In Madagascar, 94 people have died in the worst outbreak of plague since 2008. Since 1 August, there have been 1,153 suspected cases, according to the WHO. This outbreak is nearly three times bigger than the typical seasonal outbreaks the island has every year, and it's reached the capital city, Antananarivo. Also bad: The pneumonic variant that can spread directly from human to human is responsible for two thirds of the cases. Speaking to reporters in Geneva, Ibrahima Soce Fall, the WHO’s emergency director for Africa, said the outbreak could be contained quickly and that all strains tested so far are treatable with standard antibiotics. The likelihood of international spread is minimal, he argued. However, the WHO's own literature admits the pneumonic form can produce "terrifying" outbreaks. The International Federation of the Red Cross and Red Crescent Societies has appealed for 5.5 million Swiss francs to support its work on the outbreak, which “involves illness, fear, stigma and discrimination”. Justifying the hefty investment, IFRC Secretary General Elhadj As Sy said: “we are adopting a ‘no regrets’ approach to this response”. In recent years, Madagascar has reported three quarters of the cases of human plague worldwide – a sign, according to a study, of the "deteriorating fabric” of the country’s health system. However, not all cases are reported to the WHO: Weak surveillance in northeastern Democratic Republic of Congo, another endemic country (it reported 1,962 cases in 2008), may hide continuing outbreaks there.    New lows in Afghanistan   It has been a deadly week in Afghanistan: Multiple attacks claimed by the Taliban have killed at least 100 people and injured hundreds more. Taliban militants targeted an Afghan Army base in Kandahar Province, killing 43 soldiers — the majority of the troops stationed there, according to media reports. Separate attacks in Paktya and Ghazni provinces killed at least 60 and injured at least another 200, according to the UN mission. These attacks are just the latest signs of Afghanistan’s deteriorating security situation. More than 8,000 civilians have been killed or injured in conflict through the first n[...]

What’s really stopping a cholera vaccination campaign in Yemen?

Tue, 17 Oct 2017 07:08:44 +0000

Politicians, aid officials, and health experts are once again mulling a cholera vaccination campaign in Yemen, but negotiations appear to be stuck on whether there’ll be enough doses available to render it effective.   Yemen is currently in the midst of a cholera outbreak that, by the World Health Organisation’s latest count, has killed 2,167 people since the end of April and is suspected to have infected 841,906.   In June, as the disease killed one person an hour and the WHO deemed its spread “unprecedented”, the International Coordinating Group – the body that manages the global stockpile of emergency cholera vaccines – decided to deploy one million doses of the vaccine to Yemen for urgent use.   The plan was soon walked back, amidst questions about the vaccine’s efficacy at such an advanced stage in the outbreak, as well as – IRIN can now report – concerns about the number of doses available.     But aid agencies, technical experts, and health ministries from the country’s two warring governments are once again in talks about how vaccines might help prevent cholera, particularly into 2018, when heavy rains are expected by March and experts fear a new wave of the disease.   “We don't have any reservations over addressing the needs of the Yemeni citizen [with vaccines],” Dr Ali al-Walidi, deputy minister of public health and population for the Aden-based government of the deposed (but internationally recognised) President Abd Rabbu Mansour Hadi, told IRIN. “The ministry does not oppose organising a cholera vaccination campaign once [more] vaccines are available,” he added. Timing and reservations   In June, the WHO facilitated a request from Yemen for 3.4 million doses of the oral cholera vaccine. The ICG approved one million – the largest single shipment since the stockpile was developed five years ago.   Al-Walidi told IRIN that “the provision of vaccines was delayed [in] July because [only] one million vaccines were at hand.”   At the Sana’a-based Ministry of Public Health, run by an increasingly fractured alliance of Houthi rebels and loyalists of former president Ali Abdullah Saleh, spokesman Dr Abdulhakim Alkuhlani told IRIN that “for 2018, the issue [of vaccines] is under discussion.” He said the decision to stop the shipment earlier in the year was “a scientific group decision… not a political decision and not a security decision.”   Among the concerns he listed was that the “low effectiveness of the OCV [Oral cholera vaccine] may affect the trust of the community about other routine vaccines for children.”   But another source in the Sana’a ministry, who requested anonymity, told IRIN that the relatively low number of doses available remained a bone of contention. Motaz Fuad/UNICEF A child with suspected cholera - acute watery diarrhoea - is treated with oral rehydration solution in Sana'a   A high-ranking aid official involved in the cholera response, who also spoke off the record, told IRIN it was important to begin immunising as soon as possible, even if a less than ideal amount of the vaccine is immediately to hand.   The original 3.5-million-dose request was “unrealistic” as there were only two million doses in stock globally at the time, the official said.   Given that 900,000 doses of the oral cholera vaccine have just been sent to Bangladesh to counter the possibility of an outbreak among Rohingya refugees sheltering in unsanitary conditions, not to mention the need in other countries, the official said a “step-by-step” approach of delivering vaccines in Yemen would make the most sense.   “I would go for something [in Yemen]… initially like vaccinating half a million as a first step, see how it goes, see how it works… and then step up.[...]

Malnutrition stalks Rohingya refugees in Bangladesh

Mon, 09 Oct 2017 10:21:04 +0000

Four-year-old Huzaifa stood nervously against a wall as a nurse recorded her measurements. Her stick-like arms hung limp by her sides and her ribcage protruded against the skin of her chest. She is one of more than a half-million people who, since 25 August, have fled ethnic violence in Myanmar’s Rakhine State for the relative security of the sprawling refugee camps of Cox’s Bazar in Bangladesh. More than half of the new arrivals are children like Huzaifa. They are completely dependent on humanitarian aid for basic needs like food, water, and sanitation. As the crisis pushes into a seventh week, refugees are facing another challenge: the risks of malnutrition. Tommy Trenchard/IRIN Four-year-old Huzaifa is measured by ACF staff at a feeding centre in Kutupalong refugee camp in southern Bangladesh. Many Rohingya refugees are going hungry as aid groups and the government struggle to reach the sprawling camps with consistent food supplies. One in five children in the camps is malnourished, according to Action Against Hunger, or ACF, which has been screening young children for malnutrition at a feeding centre in Kutupalong camp. And more than 14,000 newly arrived children are showing signs of severe acute malnutrition, which can be life-threatening, according to aid groups. Huzaifa’s story is typical of those who have fled the latest wave of violence in Myanmar. When soldiers arrived in her village in the Tangbazar area of Rakhine State, the entire population fled in panic. Huzaifa’s father, Nur Lamin, said he stayed just long enough to see the first houses at the southern end of the village set on fire by soldiers, before fleeing to the hills with his family. Aurélie Marrier d'Unienville/IRIN A Rohingya refugee carries a baby ashore after arriving on mainland Bangladesh, on the Teknaf peninsula. More than half of the recent arrivals have been children. “We were walking for nine days. We slept on the ground, in the dirt, even when it was raining” he told IRIN. “We had nothing to eat. Only a few dried snacks.” Food was hard to find even after reaching the camps. International aid agencies have struggled to keep pace with the rapid influx, which saw some 300,000 refugees surge into Bangladesh in just the first two weeks. Local volunteers drove along the main roads, throwing out bundles of food and clothes. For those not in the right place at the right time, there was often little help. Nur Lamin said he and his family were in the camps for nine days before they had their first cooked meal. Tommy Trenchard/IRIN A crowd of Rohingya refugees clamours for food during a distribution by volunteers in Kutupalong in southern Bangladesh. Tommy Trenchard/IRIN Children reach for food handouts during a distribution by a volunteer organisation in Kutupalong camp in southern Bangladesh. Food distribution has become more organised in recent weeks. The World Food Programme told IRIN nearly all new refugees have received some sort of food assistance: mainly rice or fortified biscuits. But securing enough to eat is still an ordeal. At distribution points throughout the camps, people wait patiently under the baking sun in queues that stretch for hundreds of metres. Diarrhoea, stemming from dire sanitation in the camps, is making the problem worse, said Mahabubul Hasan, an ACF programme manager who works on nutrition in the camps. “Once diarrhoea sets in, they become malnourished very quickly,” he said. “Even before the latest influx, that was a problem here.” Heavy rainfalls and the resulting floods [...]