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IRIN - Comoros





 



Helping people recover from floods

Sun, 09 Sep 2012 23:00:00 +0000

In April, the archipelago nation of Comoros was lashed by its heaviest rains in decades, uprooting families and destroying the crops and incomes of its poorest people. At a donor conference last week, the country, backed by the UN and the South African government, made an appeal for just over US$19 million to help the country get back on its feet.  “The amount of money needed [for the country’s nine-month recovery plan] is rather small compared to disasters elsewhere,” said Sivu Maqungo, chief director of the East Africa desk in the South African Ministry of International Relations and Cooperation, which organized the donor conference for Comoros in South Africa. It should not be a problem to raise the requested amount, he added. The five-day downpour in April was nearly equivalent to the country’s annual rainfall, flooding three islands and affecting 9 percent of the country’s population of more than 750,000 people. Douglas Casson Coutts, the UN resident coordinator for Comoros, was emphatic that Comorians “are not looking for hand-outs. They want the knowledge that will help them protect themselves from any such future shocks.” He had been prompted to work on the appeal when five elderly mayors called on him soon after the floods, saying they wanted the know-how to never be taken by surprise again. The recovery plan will help set up a disaster risk reduction (DRR) strategy for the country.   Comorians 'are not looking for hand-outs. They want the knowledge that will help them protect themselves from any such future shocks' The Comorians are no strangers to disaster; in 2005, the eruption of the Karthala volcano displaced between 180,000 to 250,000 people on the main island of Njazidja. Yet the country does not have a DRR plan in place. Moreover, the April floods destroyed the seismological surveillance equipment on Mount Karthala and damaged several meteorological stations, leaving the country even more vulnerable. South Africa is going to help Comoros with technical skills to set up a DRR strategy, said Maqungo. The island country is also seeking support from the University of South Africa to set up a long-term planning capacity in Comoros. Climate change and poverty Storms on the islands have been getting more intense and frequent over the last decade, said Col Ismael Mogne Daho, the director general of Civil Security, an agency established last year to respond to disasters. He blamed increasing weather severity on the changing global climate. Gary Eilerts, programme manager of the Famine Early Warning Systems Network (FEWS NET), run by the US Agency for International Development (USAID), said in a study published in 2011 that the Indian Ocean was rapidly warming, drawing all the moisture off the African continent and causing heavier downpours over the ocean and the islands in it - like the Comoros islands. One of the world’s poorest countries, Comoros has few natural resources to support its rapidly growing population. Almost 80 percent of Comorians depend on agriculture, which accounts for 40 percent of the country’s GDP. Most families get by with the help of remittances from 150,000 Comorians living abroad, who sent about $12 million home in 2006. Rural poor most affected Most of the people affected by the floods in April are small-scale farmers, who depend on food and income from growing banana, cassava, sweet potato, coconut and rice. Some grow cash crops like cloves, ylang-ylang, vanilla and black pepper. The affected farmers are in their lean season, and agriculture in Comoros is not geared to withstand shocks, explained Coutts. Comorian farmers are usually besieged by several factors that hold them back, such as lack of seeds and agricultural tools, poor storage facilities, poor water management and infrastructure, and lack of credit services. Even before the April rains, most people in the country did not have enough to eat. Malnutrition among mothers and children under age five as the leading underlying cause of child mortality. Eleven districts out of 17 have a malnutr[...]



Rain in Comoros brings flooding, crop damage, disease

Tue, 19 Jun 2012 23:00:00 +0000

Some 65,000 people on the Comoros islands, or 8 percent of the population, were affected by flooding, power outages and an increased incidence of disease following heavy rains during the wet season that runs from November through to May.

Ingrid Nordström-Ho, based in Geneva and deployed by the UN Office for the Coordination of Humanitarian Affairs (OCHA) to assist in the emergency response, told IRIN: “The rains were unheard of. Even the very old people told me that they have never seen anything like it in their life.”

Senior humanitarian officials on the islands said in a 15 June report that a further 80,000 people in the capital, Moroni, and surrounding areas had had water supplies interrupted, adding: “Distribution of chlorine tablets is a priority.”

Vanilla producers on the main island, Grand Comore, have also been badly hit, with an estimated 80-90 percent of crops destroyed, the report said.

Moroni power station’s output “continues to deteriorate and functions with only 3 MW, with a gap of 17 MW,” the report added.

On the island of Anjouan malaria cases had risen “particularly in the [eastern] region of Pomoni, where cases are multiplied by five compared to before the floods. There are also other cases of non-identified fevers,” the report said.

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95697 (image) 200812105.jpg News Food Health Environment and Disasters Rain in Comoros brings flooding, crop damage, disease IRIN JOHANNESBURG Comoros



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 Isr[...]



Low HIV prevalence has its own challenges

Sun, 20 May 2012 23:00:00 +0000

Madagascar has a low level of HIV prevalence, and managing its AIDS programme should present no major difficulties. But the apparent advantage of a low infection rate, combined with the ongoing political crisis, has brought its own challenges. Madagascar, and the neighbouring islands states of Comoros, Mauritius and Seychelles, are anomalies in the context of HIV/AIDS in Africa. Prevalence is very low - around 0.37 percent, or 24,000 confirmed cases - and restricted to a few sections of the population. Recent research has revealed that the groups most infected are men having sex with men (14 percent), intravenous drug users (7 percent) and prison populations. HIV prevalence among female commercial sex workers is relatively low. The UNAIDS Inter-Country Coordinator, Dr Mamoudou Diallo, says the low prevalence makes it a challenge to carry out a concerted national programme. "In the Indian Ocean islands, HIV and AIDS is a condition very few people have seen. It's not like the African mainland, where everyone knows someone who has it. As a result, many people here are not convinced of the danger of AIDS. This includes the leaders." Getting antiretroviral (ARV) drugs to the 472 patients who need them is not easy, and recent stock-outs have sometimes left patients without treatment for months, exposing them to the risk of developing drug-resistance. The Malagasy Ministry of Health and its private sector distributor, Salama, have problems placing orders because suppliers are not interested in providing small quantities, making it difficult to keep adequate supplies of ARVs in stock. "We try to use a supply station in Denmark and place the order through UNICEF [UN Children’s Fund]," Diallo told IRIN/PlusNews. The expensive drugs can't be given to patients for months in advance and must be held in stock. One possibility being explored is putting in place a central purchasing mechanism for the four Indian Ocean countries. This facility would fall under the oversight of the High Level Partnership Forum, which is expected to be set up after discussions with the Indian Ocean Commission, an inter-governmental cooperation group. The forum would include Ministers of Foreign Affairs, Ministers of Health; Networks of people living with HIV, support groups, and various financial partners.   In the Indian Ocean islands, HIV and AIDS is a condition very few people have seen ... As a result, many people are not convinced of the danger of AIDS. This includes the leaders. Donors warn that although the spread of HIV/AIDS in Madagascar has been limited until now, the potential for an epidemic still exists. The country’s growing industries, mining, and tourism are all potential sources of rising HIV infection, while its young people are among the groups most vulnerable to HIV infection. Madagascar's 2008/09 Demographic and Health Survey (DHS), notes that more than half of the young men and women 15 to 24 years of age had their first sexual encounter before the age of 18. Nearly one out of five young men had more than one sexual partner in the past year, but only 8.8 percent used a condom. In the adult population the percentage of condom use was even lower: 7.4 percent for men and 7.6 percent for women. Diallo sees a real but hidden threat of escalating HIV/AIDS infection in this behaviour. "Since men having sex with men is not accepted in Malagasy society, a third of these men are also married, potentially passing the virus on to wives and the wider society," he said. Low condom usage has already caused one of the highest rates of sexually transmitted infections (STIs) in the world: syphilis prevalence is as high as 4.4 percent among pregnant women and 12.1 percent among female sex workers, according to government figures. "We need a system of vigilance, and to carry out a prevention plan to help fight HIV at every level and with everyone involved," Diallo said. But AIDS prevention work has been complicated by the political instability of the l[...]



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 Grea[...]



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[...]



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 Côt[...]



Government wage bill ballooning

Thu, 07 Apr 2011 23:00:00 +0000

The convoluted transition of the Comoros presidency could push the government’s wage bill to more than three-quarters of its revenue, "exceeding [its] budgetary capacity", the International Monetary Fund (IMF) said in a statement after a recent mission to the Indian Ocean archipelago. Presidential elections were held in December 2010, and won by the former vice-president of Comoros, Ikililou Dhoinine, who will be sworn into office on 26 May 2011. The long transition period is a consequence of reforms to the governance system, regarded as one of the world's most complex, even though the population of Comoros is only about 800,000. In 2001 Comoros adopted a new constitution, known as the Fomboni Accords, designed to put an end to a history of more than 20 coups and secession attempts since the archipelago gained independence from France in 1975. The accords provided a semi-autonomous government and president for each of the three islands - Grande Comore, Moheli and Anjouan - with a rotating presidency for the over-arching Union government. Four separate parliaments and presidents and many other prerogatives made governing the islands very expensive - some estimates had put administration costs for one of the world's poorest countries at 80 percent of the central government's annual budget. According to the African Economic Outlook (AEO) website, there are no official estimates for unemployment in Comoros; "underemployment is likely to be the norm, however, as little formal employment is available outside the public sector". About 45 percent of the population live on US$1 day or less. An "unintended consequence" of the political accords had been the holding of elections every year, because the parliaments and presidential terms of the islands were not synchronized, and terms of office also differed, the UN Resident Coordinator in the Comoros, Opia Kumah, told IRIN. Harmonization of elections The 2010 poll harmonized elections. Without this, starting in 2011, there would have been "elections every year until 2019", Kumah said. Apart from the costs and disruption of election days, government officials engaged in campaigning for their respective parties months ahead of voting, which reduced government efficiency and raised political tension. The island president of Anjouan agreed to serve only half his five-year term, while the other two island leaders cut their terms of office by 18 months, allowing all periods of office to run concurrently in future.   Without an urgent change in wage policy, the wage bill could reach 11 percent of GDP in 2011, absorbing 76 percent of government revenue Kumah acknowledged "the courage" of the country's politicians for "sacrificing" their terms of office, allowing the country to navigate a tricky part of its political evolution. Tension rose in Moheli in early 2010 because the islanders believed they would miss out on the rotating Union presidency, which had previously been held by Grande Comore and Anjouan in turn. A compromise was reached with Moheli citizens - the presidential election would be held in 2010, and the presidency of outgoing Union of Comoros President Ahmed Abdallah Mohamed Sambi would end between 1 January and 1 June 2011. Note of caution The next parliamentary elections are scheduled for 2014, and island governor and presidential polls will be held in 2015. The system of rotating the national presidency between islands will continue. Comoros expenditure on both health and education in 2010 was about 5.9 percent of Gross Domestic Product (GDP) and in 2011 is expected to increase to 6.1 percent. The IMF estimates that remittances account for more than 25 percent of the island's GDP, however, such high levels of transfers "have helped secure much higher imports than permitted by a narrow export base, but failed to boost domestic economic activity." After the I[...]



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 Bangl[...]



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 ha[...]