http://www.irinnews.org/irin-fp.aspxUpdated everydayen-gbThu, 11 Mar 2010 15:53:58 GMTJOHANNESBURG Thursday, March 11, 2010 (IRIN) - Rivers throughout central and northern Mozambique are swollen above flood alert level and thousands of people have been relocated to higher ground, but national disaster management authorities and aid agencies in Mozambique say "the situation is under control". JOHANNESBURG Thursday, March 11, 2010 (IRIN) - Rivers throughout central and northern Mozambique are swollen above flood alert level and thousands of people have been relocated to higher ground, but national disaster management authorities and aid agencies in Mozambique say "the situation is under control".

After weeks of torrential rain in Mozambique and its regional southern African neighbours, Zambia and Zimbabwe, the National Institute for Disaster Management (INGC) indicated that 130,000 people were living in risk zones and could be forced to move if water levels kept rising.

A Red Alert was declared on 9 March for the basins of the Zambezi, Pungue, Buzi and Licungo rivers, but the Representative of the UN Children's Agency (UNICEF), Leila Pakkala, who is responsible for coordination in the Humanitarian Country Team, said the government and aid partners had started moving people pre-emptively.

"Thirteen thousand people have already been moved to secure areas," she told IRIN. Although the rain was expected to diminish, they were still "closely monitoring the situation in affected areas to ensure needs are identified and immediately addressed".

The cholera season in central Mozambique is at its peak; given the large populations moving through cholera-affected areas to get to places of safety, Mozambique's Provincial Health Directorate has warned of possible outbreaks in the new accommodation centres.

Pakkala said cholera prevention and response activities - like the rehabilitation of water systems, water chlorination, and informing people that they should adopt hygienic habits - were already ongoing. "Supplies have been dispatched from the pre-positioned locations by the Red Cross and UN partners," she said.

Watching regional water management

The latest National Hydrological Bulletin, released on 10 March by the National Water Directorate, said water levels in the Zambezi, Africa's fourth largest river, would remain above alert level and keep rising, "possibly aggravating localized flooding".

In neighbouring Zimbabwe, water levels in the Kariba Dam – one of the largest on the Zambezi – have been rising and the Zambezi River Authority had to open one of its flood gates on 9 March.

Downstream in Mozambique, the Cahora Bassa Dam has also increased its outflow to 4,700 cubic meters per second, and will maintain this volume until 15 March.

The UN Office for the Coordination of Humanitarian Affairs warned in its 10 March Southern Africa Floods Regional Update: "While the opening of one Kariba Dam floodgate is not a significant event in itself, any additional flow from the dam may force another increase in discharge from the Cahora Bassa [downstream], increasing the possibility of flooding in Mozambique."

tdm/hehttp://www.irinnews.org/report.aspx?ReportId=88399JOHANNESBURG Wednesday, March 10, 2010 (IRIN) - Mozambique's National Disaster Management Institute (INGC) has raised the flood alert level to "red" and some 130,000 people living along three main rivers in central Mozambique are at risk of possible floods and need to be moved. JOHANNESBURG Wednesday, March 10, 2010 (IRIN) - Mozambique's National Disaster Management Institute (INGC) has raised the flood alert level to "red" and some 130,000 people living along three main rivers in central Mozambique are at risk of possible floods and need to be moved urgently.

"Teams are already evacuating people," Casimo Sande, Acting UN Emergency Coordination Support Officer, told IRIN. Weeks of torrential rains have swollen the Zambezi, Pungue and Buzi rivers in the central provinces of Tete, Manica, Sofala and Zambezia.

Sande said government agencies, NGOs, the Mozambican Red Cross, UN agencies and the local Civil Protection Unit, UNAPROC, were assisting affected communities, and assessments of the damage were underway. The National Water Board (DNA) warned of floods in central Mozambique on 2 March.

Mozambique is flood-prone: in 2000 and 2001 over 800 people were killed and hundreds of thousands left homeless. Up to 300,000 people in river communities throughout central Mozambique were affected by flooding in early 2008, when 29 people died.

The government resettled entire communities when the recurring floods caused hundreds of deaths and the displacement of many thousands almost every year, particularly at the onset of the rainy season. This year a drought in the resettlement areas lured thousands back to the fertile flood plains and river banks.

More sluice gates on Mozambique's biggest dam, the Cahora Bassa, were opened to ease pressure on the structure, and rains in the region eased off during the past week. According to Sande, "In terms of water level trend, the situation has improved."

tdm/hehttp://www.irinnews.org/report.aspx?ReportId=88386NAIROBI Tuesday, March 09, 2010 (IRIN) - Global funding shortfalls for fighting AIDS could make it impossible for developing countries to implement new World Health Organization treatment guidelines, activists have said. NAIROBI Tuesday, March 09, 2010 (IRIN) - Global funding shortfalls for fighting AIDS could make it impossible for developing countries to implement new World Health Organization treatment guidelines, activists have said.

WHO released new guidelines on antiretroviral therapy (ART) in December 2009, raising the CD4 count - a measure of immune strength - at which HIV-positive people should start ART from 200 to 350. Research has shown that starting ART earlier reduces the rate of death and opportunistic disease.

"WHO's new recommendations are excellent in theory, but they did not give us a practical way of implementing the guidelines - already we have shortages of drugs in trying to put people with CD4s below 200 on treatment," said James Kamau, coordinator of the Kenya Treatment Access Movement.

"How will we now put so many more people on ARVs? The increased number of people on drugs means not just more drugs, but more labs, more health centres and health workers, more general care - the expense is enormous."

An estimated four million people around the world are currently on ART - a 10-fold increase since 2003, when the drugs became widely available - but this figure still represents just over one-third of the people who need the medication.

"If WHO's new recommendations are not implemented, the international community risks subsidising less expensive yet sub-standard care for developing countries," said Sharonann Lynch, MSF's HIV/AIDS policy advisor, in a press release.

"Avoiding this will depend on the willingness of donors to make new commitments. Although this is not easy in today's financial environment, donor countries cannot back away from supporting the promise of universal access to treatment made five years ago."

"The situation is now an emergency"

In Uganda, where the government plans to release new treatment guidelines reflecting WHO's recommendations, officials said the number of people needing treatment would rise from 300,000 to about 750,000. The country recently suffered drug shortages in its public health sector, partially caused by funding problems.

"The numbers will be too great for us to manage," said Dr David Kigawalama, head of prevention services at the Uganda AIDS Commission. "We need to sit with our AIDS development partners to forge a way forward."

Ahead of a high-level meeting between Group of Eight (G8) leaders and AIDS advocates in London on 10 March, AIDS activists met with British International Development Minister Gareth Thomas on 9 March and called on the world's wealthiest nations to honour their 2005 Gleneagles pledge to achieve universal access to HIV prevention, treatment and care by 2010.

"Instead of building on progress, some donor nations and governments of highly affected countries are backing away from the universal access commitment with a series of poorly funded half-measures on AIDS," the executive director of the International AIDS Society, Robin Gorna, said in a press statement.

"The situation is now an emergency: new treatment enrolments in many countries are coming to a standstill, the risk of drug resistance is increasing, and fragile gains made over the last 10 years may soon erode, with potentially serious consequences for future efforts to control this epidemic."

The activists singled out Canada - the only G8 nation firmly opposed to the Financial Transactions Tax, a tiny tax on financial transactions that could raise the billions of dollars needed to fulfil the universal access pledge.

The global economic downturn forced the Global Fund to Fight AIDS, Tuberculosis and Malaria, the world's largest funder, to cut disbursements by 10 percent in 2008, while the US President's Emergency Plan for AIDS Relief (PEPFAR) has flat-lined funding to many countries, limiting the growth of PEPFAR-funded treatment programmes.

kr/kn/he http://www.irinnews.org/report.aspx?ReportId=88368NAIROBI Friday, March 05, 2010 (IRIN) - Here are the most popular new articles on the IRIN website over the last 24 hours. Updated hourly. This feature was launched on 18 July, but will display the latest, most popular items of today.NAIROBI Friday, March 05, 2010 (IRIN) - ---http://www.irinnews.org/report.aspx?ReportId=73277NAIROBI Tuesday, March 02, 2010 (IRIN) - Medical male circumcision is now widely recognized as an important HIV prevention tool, and several African countries have included it in their national HIV strategies.NAIROBI Tuesday, March 02, 2010 (IRIN) - Medical male circumcision is now widely recognized as an important HIV prevention tool, and several African countries have included it in their national HIV strategies.

IRIN/PlusNews lists the progress of 13 nations in eastern and southern Africa identified as priority countries for male circumcision scale-up by the UN World Health Organization.

Kenya: An estimated 85 percent of men are circumcised, but just 40 percent of those in Nyanza province, which has the country's highest prevalence, have had the procedure. In 2008 the government launched a national campaign and by the end of 2009 more than 90,000 men had been circumcised, 40,000 of them during a two-month "rapid results" initiative in Nyanza.

The government aims to have all uncircumcised men - an estimated 1.1 million http://www.plusnews.org/Report.aspx?ReportId=87074 - undergo the procedure by 2013. Kenya is the only African country to have successfully rolled out male circumcision on such a large scale.

Zambia: Male circumcision prevalence is 13 percent, and Zambia aims to circumcise about 250,000 men every year. More than 16,000 men were circumcised at 11 sites in 2009, and the goal is to have 300 sites offering the services by 2014.

Swaziland: The Ministry of Health and Human Services plans to provide circumcision to 80 percent of men aged 15 to 24 by the end of 2014 http://www.plusnews.org/Report.aspx?ReportId=86444. Just eight percent of Swazi men are circumcised. The country - which has the world's highest HIV prevalence - developed a male circumcision strategy in 2008; by the end of 2009 more than 5,000 men had undergone the surgery.

Botswana: Five centres of excellence have been identified to scale-up circumcision services, and Botswana's Ministry of Health aims to reach at least 460,000 HIV negative men and boys below the age of 49 by 2012. More than 4,300 men have been circumcised since April 2009.

Zimbabwe: In April 2009 the pilot phase of service delivery began, during which 1,818 men were circumcised at four sites. A national male circumcision policy was launched in November 2009.

Rwanda: Since 2008 the government has been rolling out male circumcision in the army, where prevalence is 4.5 percent compared to a national rate of three percent. A recent study http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000211 suggested that Rwanda should also be scaling up circumcision across a broad range of age groups, especially the very young, where the procedure was found to be highly cost-effective.

South Africa: The government has been criticized for moving too slowly http://www.plusnews.org/Report.aspx?ReportId=87315 in developing a national circumcision strategy. By December 2009 the country had a draft policy but no mechanisms for training, quality assurance, or monitoring and evaluation.
South Africa has the world's largest HIV-positive population.

About 35 percent of men are circumcised. Data from the only site currently providing free circumcision - Orange Farm, near Johannesburg - reveals that 14,253 men were circumcised in 2009.

Namibia: A draft policy was submitted to parliament and training of surgical health professionals is underway. Five circumcision pilot sites have been identified, two of which are in operation. A 2009 field analysis http://www.malecircumcision.org/programs/documents/Namibia11209.pdf showed that the unit cost per procedure was very high: US$88 for adults and $72 for newborns.

Lesotho: About 4,000 men are circumcised annually at government and private clinics. A policy has been approved but is yet to be launched, and formal scale-up has not yet started. The Puisano Outreach Organization, a local NGO, is engaged in male circumcision campaigns throughout the country.

Tanzania: A 2009 situation analysis http://www.malecircumcision.org/programs/documents/TanzaniaMaleCircumcisionSituationAnalysis_September_09.pdf found male circumcision was accepted, even among traditionally non-circumcising communities, and 70 percent of Tanzanian men were circumcised. A national policy is being developed and three demonstration sites have been set up.

Mozambique: No formal policy for male circumcision has been developed, but an existing operational plan for HIV prevention includes circumcision. Five pilot sites have been selected for scale-up in 2010.

A 2008 study found that rolling out adult male circumcision in Mozambique would put undue pressure on health workers, which would limit the scale and effectiveness of the programme.

Malawi: The country is conducting data analysis to inform its male circumcision strategy. A local NGO, Banja la Mtsogolo, http://www.banja.org.mw is providing male circumcision services in its clinics, where it has 19 trained clinicians performing the procedure.

Uganda: This is one of the three countries where studies showed the link between male circumcision and HIV, but only 25 percent of men are circumcised and HIV prevalence is rising. There has been some criticism for failing to start male circumcision quickly enough - the country still has no policy, nor has it started service delivery.

A 2009 situational analysis http://www.malecircumcision.org/programs/documents/MC_situation_analysis_Uganda_full.pdf found that most practitioners would need additional training to perform male circumcision.

kr/he http://www.irinnews.org/report.aspx?ReportId=88286JOHANNESBURG Monday, March 01, 2010 (IRIN) - When a crisis strikes, access to antiretroviral (ARV) drugs can be among the first casualties, particularly in countries where many people are on treatment. JOHANNESBURG Monday, March 01, 2010 (IRIN) - When a crisis strikes, access to antiretroviral (ARV) drugs can be among the first casualties, particularly in countries where many people are on treatment.

But experience in Southern Africa has shown that although preventing treatment disruptions may be wishful thinking, preparing for them has become a pressing need.

New research by the Health Economics and HIV/AIDS Research Division (HEARD) at South Africa's University of KwaZulu-Natal compared three recent crises that caused treatment disruption - Mozambique's 2008 floods, Zimbabwe's ongoing public healthcare crisis, and South Africa's 2007 public sector strike – to identify potential strategies for keeping patients on treatment during emergencies.

The HEARD report, Unplanned ARV Treatment interruptions in southern Africa: what can we do to minimise the long-term risks?, identified poor planning as the biggest weakness in responding to gaps in treatment access, and suggested that doctors and patients receive better training on what do during disruptions.

"Despite crises – whether political, economic or environmental – being relatively common in southern Africa, there has been very little systematic planning for them within ARV programmes," said HEARD's Andy Gibbs, who co-wrote the report. The region's weak health systems were often the cause of disruptions.

"Strong health systems have strong planning capacity, an ability to monitor what's happening and [to mobilize] the skills and resources to cope with unexpected issues," Gibbs said. Research has linked disrupted treatment to increased risks of drug resistance and treatment failure.

Weathering the storm

Southern Africa has some of the highest HIV prevalence rates in the world, while droughts, floods and cyclones typically spark humanitarian emergencies in this chronically vulnerable region. The Southern African Development Community (SADC) has pushed member states to integrate ARV treatment into national disaster preparedness planning.

The UNAIDS regional humanitarian response advisor for East and Southern Africa, Mumtaz Mia, said Mozambique, Zimbabwe and Namibia had taken the lead in ensuring that people did not miss ARV doses amid disasters.

Mozambique experienced some of the worst flooding in the country's history in 2007, and more than 56,000 people were affected by floods in 2008, but Mia noted that planning by UNAIDS, the national AIDS council and the National Institute for Disaster Management had helped minimize treatment disruptions.

HEARD found that Mozambique had mapped the location of ARV patients in flood-prone areas, and had educated community outreach workers in the vicinity in ARV provision ahead of the devastating floods in 2008.

Dr Mit Philips, a health policy analyst at the international medical and humanitarian organization, Medicines Sans Frontiers (MSF), pointed out the importance of giving patients information before and during treatment interruptions. MSF has been working in Mozambique, Zimbabwe and South Africa, and also provided ARV treatment during Kenya's 2008 post-election violence.

"When the [post-election violence] happened in Kenya, we set up a free hotline, we used radio spots and peer networks so that patients knew how to find us to pick up their pills and continue treatment," she told IRIN/PlusNews.

"You don't need to go and find patients, you need to make sure patients know how to go and find you. If you can foresee it, it's important that the patients know how to deal  with possible disruptions at their usual health centres – it should be part of treatment literacy."

When the public sector isn't so public

In 2007, South Africa was rocked by a public servant strike that lasted for a month and affected up to half a million employees, including health workers. Data from South Africa's Gauteng Province showed that the number of patients initiated on treatment in areas like Johannesburg's inner city dipped to one of the lowest in four years.

Testimony gathered in the Western Cape Province by Treatment Action Campaign, an AIDS lobby group, showed that during the strike some pharmacies were so short-staffed they were only able to fill 25 percent of orders.

Patients and doctors used varying coping strategies to deal with the treatment disruptions and the South African HIV Clinicians Society released guidance on how to cope with treatment interruptions. Some patients were able to get more than one month's supply of drugs.

HEARD researchers argued that the South African authorities could have foreseen such an interruption and provided both patients and doctors with better training on what to do when ARVs cannot be obtained.

In Zimbabwe ARV treatment in the public health sector has also seen its share of hard times. The economic crisis sparked migration among doctors and nurses as well as patients, while hyperinflation and high levels of unemployment meant the tests required before starting ARVs were often unavailable or prohibitively expensive.

To help migrants continue treatment in other countries, MSF gives patients portable copies of their medical records, including which ARV regimen they are on.

SADC has received funding to implement a similar regional "health passport" system, but national health ministers would have to get draft legislation passed to implement it. Access to treatment, even for documented migrants like asylum seekers and refugees, is problematic.

Funding flows pose their own threat

MSF's Philips said interruptions in financial flows posed as big a threat to ARV programmes as any flood or bout of civil unrest, and might become a threat of increasing importance as HIV and AIDS funding constricted in the global financial crisis.

"What we have been seeing in the last six months to one year are increasing disruptions to programmes ... many of these are due to delays in funding, or delays in the supply chain," she commented. "IN a way, it's more difficult to prepare for these [than for natural disasters] because the information on the risk of treatment disruption isn't always shared with implementing partners in a transparent way ahead of time."

In 2009, South Africa's Free State Province experienced widespread treatment disruption due to a combination of funding problems and allegations of poor management.

Philips noted that several countries including Malawi, Mozambique and Uganda  had experienced problems with funding or drug procurement, and were more vulnerable to disruptions not only because of weak health systems but also because of a heavy reliance on a single funding source. According to an MSF report, Punishing Success, the bulk of Malawi's ARV funding as of 2009 came from the Global Fund to Fight AIDS, Tuberculosis and Malaria.

"What we are seeing is that quite a lot of donors seem to see the Global Fund as a main channel of international funding for HIV treatment. If there is only one channel and something happens, there's nothing you can do," she said. "Countries depend on the timely arrival of supplies; when money for drugs was delayed in Malawi, there was no buffer."

Few countries carry ARV buffer stocks - surplus drugs kept aside and used in the event of a drug shortage. Philips said this strategy was successfully employed in the Democratic Republic of Congo, which put a pool of donor-funded ARVs under World Health Organization management.

Fareed Abdullah, director of the Fund's Africa Unit, said the Global Fund had begun addressing funding delays after the issue was raised at the organization's highest level.

"Clearly, the reasons behind stock-outs are multi-factorial, and responsibility for them lies with various donors and implementing agencies, not least of all, governments," he told IRIN/PlusNews. "Having said that, there are certainly a number of steps within our financing process where the Global Fund considers the risk of drug stock-outs."

The Fund offers countries emergency disbursements to cover unexpected treatment shortages, and allows two years of gap funding to cover ARV treatment specifically, between grant disbursements, Abdullah said. The Fund has also taken on additional responsibilities in an effort to reduce treatment disruptions due to problematic procurement.

"Sometimes we finance drugs that make their way to the central store, and they don't get from the central store to the clinics – that's really for countries to address, alongside implementing partners," Abdullah commented.

"However, in some countries we have a failure of procurement and, even though we have resisted taking over those functions because we believe in country ownership, we now have a mechanism where we will procure drugs for a country."

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http://www.irinnews.org/report.aspx?ReportId=88272JOHANNESBURG Wednesday, February 24, 2010 (IRIN) - Temperatures seem set to soar to perilously high levels because of climate change. In another 40 years, would maize still be the staple food in Kenya, already hit by five failed rainy seasons? If not, what could people grow and eat? And if you could grow maize, how much water and fertilizer would it need? JOHANNESBURG Wednesday, February 24, 2010 (IRIN) - Temperatures seem set to soar to perilously high levels because of climate change. In another 40 years, would maize still be the staple food in Kenya, already hit by five failed rainy seasons? If not, what could people grow and eat? And if you could grow maize, how much water and fertilizer would it need?

If you live in the remote semi-arid Karamoja region of northeastern Uganda - beset by 14 droughts in 25 years - you might also want to know what your options are for continued food security.

For the first time, a customized regional climate model linked to crop growing and water models, run on a supercomputer at Michigan State University (MSU), will help provide crop breeders in three East African countries - Kenya, Uganda and Tanzania - with detailed answers on crop yields.

Many research institutions have been working on models to predict the impact of climate change on food production in Africa, but in a few months the MSU model will help scientists and breeders to zoom in at a regional level on the possible impact of climate change on a wide variety of crops in these countries.

The research could help produce climate-resilient varieties of food crops, said Jennifer Olson, lead researcher and associate professor at MSU's College of Communication Arts and Sciences.

"East Africa is already experiencing the impact of climate change - food crops are experiencing extreme water stress," she commented. People living in Kenya's highlands, who have traditionally grown tea and coffee, have begun experimenting with maize and beans as the climate has grown warmer.

Work on the model began 10 years ago with the recording of relevant data, such as the impact of nutrients on a certain food crop, or the impact of water stress on another, which were subsequently fed into the model. "The model is still being perfected," said Olson.

The model can experiment with the impact of climate change, such as high temperature and water stress on a certain crop variety, saving the time that would have been spent on field trials, "which will help speed up the agricultural research cycle", she noted.

The researchers intend to launch the model at a workshop in June. Concern about increasing food insecurity in East Africa has prompted two institutions to set up a research grants to encourage innovative solutions.

The New Partnership for Africa's Development (NEPAD), based in South Africa, and the International Livestock Research Institute (ILRI), in Nairobi, Kenya, announced a US$10.67 million grant from the Swedish International Development Agency (SIDA) to support the establishment of a multidisciplinary competitive funding mechanism for biosciences in Burundi, Ethiopia, Kenya, Rwanda, Tanzania and Uganda.

ILRI's Bruce Scott said they would be looking for innovative solutions using bioscience to improve crop resilience to climate change, or perhaps to improve the shelf-life of a food product.

jk/he http://www.irinnews.org/report.aspx?ReportId=88225JOHANNESBURG Friday, February 05, 2010 (IRIN) - Economic conditions in most southern African countries declined as a result of the global recession, pushing many more people towards greater food insecurity. According to a new food security update which focused on some southern African countries, food prices have risen and are still climbing in several countries.JOHANNESBURG Friday, February 05, 2010 (IRIN) - Economic conditions in most southern African countries declined as a result of the global recession, pushing many more people towards greater food insecurity. According to a new food security update which focused on some southern African countries, food prices have risen and are still climbing in several countries.

The price of most fertilizers doubled in 2008 and continued to rise through 2009, affecting the quantity of crops planted throughout the region. High input costs prompted many governments to either extend their input subsidy programme or consider implementing one.

Here is a snapshot of food security in the region, based on an update compiled by the Famine Early Warning System Network (FEWS NET), the UN Food and Agriculture Organization (FAO), the UN Children's Fund (UNICEF), the UN Office for the Coordination of Humanitarian Affairs (OCHA) and the UN World Food Programme (WFP).


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Zimbabwe

Agriculture

Area planted increased since 2008, but most parts of the country have experienced dry spells since December 2009. About 57 percent of communal farmers received input support, but input schemes face critical shortages of ammonium nitrate, which has compromised crop quality.

Food availability

Farmers' stocks have been depleted. Food aid and purchases are now major sources of cereals. Basic foodstuffs easily available in markets. Tax-free import of food items extended to 31 July 2010.

Food access/Prices

Declining supplies driving up maize prices. Around 1.6 million people will be food insecure between January and March 2010, with about 1.9 million receiving food aid.

Nutrition/Health

At least 35 percent of children are severely malnourished. Measles outbreaks reported in 16 of 62 districts. A few cholera cases reported in 10 districts by 3 January 2010.

Comments

Economic recovery sluggish. Amount of foreign currency in circulation still limited. Provision of basic services still problematic.


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Lesotho

Agriculture

Rains were on time, but area planted by end of December 2009 dropped by 25 percent compared to previous season. Government subsidized seeds and fertilizer by between 30 and 50 percent.

Food availability

The only country in southern Africa where food production fell in 2009, perhaps because farmers could not afford inputs. Government will have to import cereals from South Africa.

Food access/Prices

Between 400,000 and 450,000 of Lesotho's 2.1 million people will need food aid before the next harvest in April 2010.

Nutrition/Health

Data from a food consumption survey by WFP, UNICEF and the National University of Lesotho yet to be analyzed.

Comments

Government income from the Southern African Customs Union, a major source of revenue, fell by 35 percent in 2009/10 and is expected to shrink further in 2010/11.


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Namibia

Agriculture

Rainfall has been erratic and insufficient. Few farmers have ploughed their fields.

Food availability

Rural households have no food stocks. Namibia will need to import between 150,000mt and 156,000mt of grain according to various estimates - almost its entire requirement of 159,000mt.

Food access/Prices

Most households have depleted their stocks and depend on markets and or government food aid.

Nutrition/Health

African swine fever was reported in the Ohangwena region of northern Namibia, affecting transportation of inputs to the neighbouring fertile Kavango region.

The report on the 2008 Demographic Health Survey is still being finalized; the 2010 survey is being planned.

Comments

Chronic food insecurity in the northern communal crop-producing areas was worsened by shocks such as droughts and floods in 2009. Namibia is a net cereal importer.


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Mozambique

Agriculture

Irregular and poor distribution of rainfall and very high temperatures have affected crops, mainly in the south and central provinces.

Food availability

Food is available because of the good 2008/09 season, but food security could become critical in the southern and central provinces.

Food access/Prices

Maize prices have risen. At least 267,000 people will need food aid until the harvest in April 2010.

Nutrition/Health

Chronic malnutrition levels are high - 44 percent- according to the last survey in 2008.

Comments

The National directorate of water has forecast a high risk of flooding until March 2010 in the Zambezi River basin in the central region, and the Messalo River basin in the far north.


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Malawi

Agriculture

Long dry spells have affected crops in most districts. An attack of army worms has also affected maize, rice, millet and sorghum crops.

Food availability

The food security situation remains favourable in most parts of the country.

Food access/Prices

Most markets have recorded a slight increase in maize prices but generally it is affordable and accessible.

Nutrition/Health

The findings of a 2009 micronutrient survey have yet to be released.

Comments

Food is available in the Karonga district of northern Malawi, which experienced a series of earthquakes in December 2009


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Madagascar

Agriculture

Input prices have gone up by between five and 10 percent but subsidies have been suspended, which could adversely affect food production. The cyclone season began in December 2010 and the island will remain under threat until April 2010.

Food availability

Supplies of the staple cereal, rice, are adequate.

Food access/Prices

A good harvest in 2009 reduced the number of food insecure among poor and vulnerable households from 65 percent in 2008 to 40 percent in November 2009. Local rice prices are stable.

Nutrition/Health

The country has the highest levels of acute malnutrition (15 percent) and chronic malnutrition (53 percent) in southern Africa

Comments

More than 200,000 jobs were lost in 2009 as a result of the economic and political crisis. The USA has terminated its trade benefits because of the political situation and another 500,000 jobs could be lost. The UN Country Team has raised concerns over the approaching cyclone season, which usually affects some of the poorest regions of Madagascar.


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Zambia

Agriculture

Government increased the number of people receiving subsidized fertilizer by halving the amount given to each household.

Food availability

The country has surplus food and will not require imports.

Food access/Prices

Maize prices stable until the end of 2009, yet remain high compared to previous surplus years, probably because of high input costs. High prices are expected to affect low-income households.

Nutrition/Health

High food prices and recurrent floods have pushed up child malnutrition levels, according to the Jesuit Centre for Theological Reflection in Zambia.

Comments

Food has been pre-positioned for the current rainy season in the three most flood-prone districts.


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Swaziland

Agriculture

Government has announced a plan to subsidize inputs later in 2010.

Food availability

Annual maize harvest improved but the country still needs to import around 90,000mt to meet requirements.

Food access/prices

At least 256,000 people are facing food shortages.

Nutrition/Health

The last nutritional survey in 2008 found chronic malnutrition of around 40 percent. Maternal nutrition figures indicate a problem of over-nutrition rather than under-nutrition among women.

Comments

Trend analysis shows that increasing levels of stunting could result from both economic decline and continued high HIV prevalence rates.


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South Africa

Agriculture

Most of the country received good rainfall but some drought conditions related to El Nino experienced in central and western parts.

Food availability

The country is expected to produce a surplus.

Food access/prices

Food prices have come down slightly but remain high.

Nutrition/Health

Infant mortality is high - 49 out every 1,000 infants born every year die, largely because of HIV/AIDS.

Comments

Government is working with agriculture and health institutions to improve existing food security initiatives.

jk/he

http://www.irinnews.org/report.aspx?ReportId=88014DAKAR Wednesday, January 27, 2010 (IRIN) - Health experts hope the release of data showing the success of rotavirus vaccine will help compel policymakers to ensure all children will be immunized. DAKAR Wednesday, January 27, 2010 (IRIN) - Health experts hope the release of data showing the success of rotavirus vaccine will help compel policymakers to ensure all children will be immunized.

Rotavirus – the top cause of severe and often fatal diarrhoea and dehydration in children – kills some 527,000 children a year globally, nearly half of them in sub-Saharan Africa.

“It is our hope that these data will catalyze action so that one day we can live in a world where no child dies from diarrhoea,” Kathy Neuzil, senior clinical advisor for vaccines at the international health non-profit PATH, said in a 27 January statement.

Published on 27 January in the New England Journal of Medicine, results from first-ever clinical trials in South Africa and Malawi show that a live, oral rotavirus vaccine significantly reduces the episodes of severe rotavirus gastroenteritis in African children during the first year of life.

The data “provide policymakers with the critical information they need to make decisions about rotavirus vaccine introduction,” George Armah, professor and rotavirus expert at Ghana’s Noguchi Memorial Institute for Medical Research, said.

The trial results led the World Health Organization in June 2009 to recommend global use of the vaccine.

The Africa trials focused on the vaccine’s performance in high mortality, low-income settings, according to a 27 January communiqué by PATH and GAVI Alliance.

Health experts point out that while rotavirus infection in treatable, it has devastating and deadly impact in rural and poor areas where people cannot access medical care. “Vaccines represent the best hope for preventing the severe consequences of rotavirus infection,” Nigel Culiffe of University of Liverpool said in statement.

The trials were coordinated and co-funded through a partnership between GlaxoSmithKline Biologicals and the GAVI Alliance-funded Rotavirus Vaccine Trials Partnership – PATH, WHO and the US Centers for Disease Control and Prevention.

np/ajhttp://www.irinnews.org/report.aspx?ReportId=87899JOHANNESBURG Tuesday, January 19, 2010 (IRIN) - The best search and rescue workers have stamina, a phenomenal sense of smell, and sharp hearing - they usually also have four legs. JOHANNESBURG Tuesday, January 19, 2010 (IRIN) - The best search and rescue workers have stamina, a phenomenal sense of smell, and sharp hearing - they usually also have four legs.

Highly trained dogs and their handlers can offer the best chance of survival to people buried in the rubble of an urban search and rescue (USR) site, where there are often no outward signs of life.

The dog

Intelligence and a remarkable nose make dogs ideal for the job, according to Ann Christensen, Canine Committee Chair at the US-based National Association for Search and Rescue. Most dogs have better vision than humans, particularly in the dark, and more acute hearing. But it is their sense of smell - said to be a thousand times more sensitive than that of people - that really sets them apart.

Popular breeds are German Shepherds, Border Collies and Golden or Labrador retrievers, with trainers looking for a specific combination of talents. "There are only a few dogs can do this type of work, that have the right stuff. The average family pet can't do this, no matter what training you give them," Christensen told IRIN.

Disaster sites are usually extremely dangerous and stressful, so "a disaster dog has to be confident, courageous and agile"; it must be able to focus while sniffing through the wreckage and ignore all other scents and noises, no matter how tempting.

The training

"It takes a minimum of around 18 months to two and a half years to train a ... team [consisting of a dog and handler]. Normally, if you have a dog that has the ability, the drive, the focus to carry out the job, it actually takes longer to train the handler," said Chris Pritchard, Coordinator for USR Dog Teams at the International Search and Rescue Team of the United Kingdom Fire and Rescue Service.

Handlers are an integral part of the dog's training and by the end of it, if the chemistry is right, they are partnered for the duration of the dog's working life - about 10 years.

"When a handler certifies with a dog, they certify as a team and they work together. You develop a very strong bond with the dog because you spend a lot of time training with the dog, travelling with the dog, going on missions with the dog – you spend almost more time with your dog than you do with your family," said Christensen.

According to Wolfgang Zörner, president of the International Rescue Dog Organisation, the global umbrella body that ensures members comply with the standards set by the UN International Search and Rescue Advisory Group (INSARAG), international teams must pass a mission readiness test to qualify for deployment.

"Once you pass, the certification is valid for three years, but the test is very hard - it goes on continuously day and night for two days, and not more than 40 percent pass," he commented.

The Equipment

Canine-handler teams need to be completely self-sufficient for up to 10 days after deployment. That means they arrive on site with tents, food, medical and veterinary equipment or water. The dogs need at least one litre per day - more in hotter climates - to maintain workable levels of hydration. Appropriate kennelling is also important to keep the dogs secure on site.

Besides their leash and collar, equipment can range from lifting harnesses and cooling jackets to dog boots. "You want to protect the dog so that it can do its job - they are as important as the rescuers," said the UK's Pritchard.

The deployment

The first 24 hours after a disaster has struck is the "golden day", Pritchard commented. "The ability of the individuals that may be trapped to survive starts to decrease dramatically after that."

Zörner noted that "every disaster is different, but the main objective is to be on site as soon as possible. In every catastrophe there are always some miracles, and some people survive longer, but normally a person cannot stay alive without water for more than four days."

His last mission was the Padang earthquake in Indonesia. "When the call comes in we can be ready to deploy with the dogs within eight hours," he said. Typically, a call will come through the INSARAG Virtual On Site Operations Coordination Centre (OSOCC) – an online information exchange and coordination tool for disaster managers and international response organisations.

The canine-handler teams become part of a larger group of USR specialists. Once medical checks are passed, teams are briefed, equipment is checked and palletised for transportation, and the team heads off, either on civilian or military aircraft.

The search

On arrival the teams report to the OSOCC, usually set up by INSARAG in cooperation with the local emergency management authority. "The problem on the spot is always transportation. To get from the airport to the [OSOCC] and then to the sites," said Zörner.

Given the limited time and resources, initial reconnaissance to identify priority areas is essential. "It is important that they [OSOCC] already know where it is useful to search with dogs; that they have conducted an initial assessment," he noted.

The dogs are one part of the "technical search element", the others are highly sensitive acoustic equipment that can pick up minute sounds, and tiny cameras that can be manoeuvred through tiny cracks or holes drilled in concrete.

"It's a big game of hide and seek - that's the only reason the dogs go out and find. If the dog locates a scent source it will demonstrate that by either scratching, or through a focused bark, and will continuously bark at that point where the scent is most strong," said Pritchard.

"But that does not necessarily mean that the person is buried right under them - the scent can travel a considerable distance. We then work the dog at different angles to see if the scent is coming out somewhere else." A second dog is often brought in to verify a find.

The dogs are used in more than one phase of the rescue operation. "Once rubble is removed from an area and dogs can get closer, that may open a scent channel and allow the dogs to pick up on the scent of a person that is trapped. We recommit dogs to the building as we remove large pieces of rubble," Prichard said.

The rescue

"They recognize a human scent picture made up of many different scents - like the clothing that people wear ... the food that they ate, the polish of their shoes, sweat glands." It is generally understood that they also home in on skin rafts – scented skin cells that drop off human beings at a rate of 40,000 a minute.

Once a find is confirmed, the dogs are removed so that the victim can safely be taken out. Because searching is essentially a game, a find is always rewarded – usually with a toy – to ensure the dogs remain motivated.

Zörner said a dog worked for 20 minutes, because "If it works too long the dog loses interest and the work is no longer secure – he can give an indication even when it is not absolutely sure," and then rested for the same amount of time.

"We search only for live people - that is the priority." When the search is called off - usually 10 days after the disaster began - the dog-handler teams are sent home.

Then, as the humanitarian phase of the relief operation intensifies, another specialist sniffer dog - the cadaver dog - is brought in to search for the dead.

tdm/oa/hehttp://www.irinnews.org/report.aspx?ReportId=87790NAIROBI Tuesday, January 19, 2010 (IRIN) - More than two-thirds of African countries have laws criminalizing homosexual acts, and despite accounting for a significant percentage of new infections in many countries, men who have sex with men tend to be left out of the HIV response. NAIROBI Tuesday, January 19, 2010 (IRIN) - More than two-thirds of African countries have laws criminalizing homosexual acts, and despite accounting for a significant percentage of new infections in many countries, men who have sex with men tend to be left out of the HIV response.

"[They] are going underground; they are hiding themselves and continuing to fuel the epidemic," UNAIDS executive director Michél Sidibé told IRIN/PlusNews recently. "We need to make sure these vulnerable groups have the same rights everyone enjoys: access to information, care and prevention for them and their families."

IRIN/PlusNews has compiled a short list of human rights violations against gay Africans:

Malawi - On 28 December 2009, soon after a traditional engagement ceremony, Steven Monjeza and Tiwonge Chimbalanga were arrested and charged with "unnatural offenses", which carries a maximum prison term of 14 years, and "indecent practices between males", which carries five years.

The men deny that they have had sexual relations, but the state prosecutor has applied for them to be sent to hospital to prove they have had sex, which rights activists and their lawyers say would violate their constitutional right to dignity. The trial has been postponed until 25 January 2010.

Uganda - In October 2009, David Bahati, parliamentary representative of the ruling party, tabled the Anti-homosexuality Bill (2009), a private member's Bill. It proposes, among other things, the death sentence for the crime of "aggravated homosexuality" when an HIV-positive person engages in homosexual sex with someone disabled or below the age of 18.

Homosexuality is illegal in Uganda and punishable by a maximum sentence of life in prison.

AIDS advocates and human rights groups have strongly criticized the Bill as violating the privacy of gay people, and after pressure from several international leaders, President Yoweri Museveni has distanced himself from it, reducing the likelihood that it will be passed in its current form.

Nevertheless, a local tabloid, The Red Pepper, routinely releases lists of alleged Ugandan homosexuals.

Tanzania - In May 2009, a local newspaper, Ijumaa, featured a photograph of two men in bed together with the headline, "Caught Live!" A report by several gay rights groups http://www2.ohchr.org/english/bodies/hrc/docs/ngos/LGBT_Tanzania96.pdf noted that the accompanying article included derogatory and discriminatory language about men who have sex with men.

An Ijumaa reporter, accompanied by three policemen, had followed the men from the street into a private hotel, where they had invaded their room and taken the photographs that later appeared in the newspaper.

According to the International Gay and Lesbian Human Rights Commission http://www.iglhrc.org/cgi-bin/iowa/article/takeaction/resourcecenter/993.html, more than 40 gay and lesbian activists in Tanzania were arrested on charges of debauchery in 2009.

Burundi - In April 2009, President Pierre Nkurunziza signed into law a bill criminalizing homosexuality for the first time in Burundi's history. Anyone found guilty of engaging in homosexual activity faces imprisonment for two to three years and a fine of up to US$80.

Paradoxically, other articles in the same legislation take steps to protect human rights, including abolition of the death penalty and the outlawing of torture, genocide, war crimes and crimes against humanity.

Senegal - In December 2008, the Senegalese government arrested nine men involved in providing HIV prevention, care and treatment services to the country's lesbian, gay, bisexual and transgender community http://www.plusnews.org/Report.aspx?ReportId=82453.

The men were later sentenced to eight years in prison on charges of "membership of a criminal organization and engaging in acts against the order of nature", but in April 2009 an appeals court overturned this verdict http://www.plusnews.org/Report.aspx?ReportId=84064.

Arrests for homosexual activity are not uncommon in Senegal; in August 2008 two men were arrested at their home in Dakar and charged with "homosexual marriage" and acts against the order of nature. According to rights groups, a total of 30 men were arrested on charges of homosexuality in 2009.

Egypt - In May 2008, a court in the Egyptian capital, Cairo, convicted five HIV-positive men of "habitual practice of debauchery", a phrase that encompasses consensual sexual acts between men.

The convictions were part of a crackdown on people living with HIV/AIDS, during which 12 men suspected of being HIV-positive were arrested; while in custody, they were subjected to HIV tests and anal examinations to determine whether they had had sex with other men. Earlier in the crackdown, in January 2008, four HIV-positive men sentenced to one-year prison terms for debauchery.

Gambia - In May 2008, Gambian President Yahya Jammeh gave gay people 24 hours' notice to leave the country. He promised stricter laws on homosexuality than in Iran, and threatened to behead any gay people discovered in the country.

Jammeh's statements were thought to have been in response to a number of Senegalese gay men fleeing across the border into Gambia to escape persecution in their own country.

South Africa - In April 2008, Eudy Simelane, the openly gay star of South Africa's Banyana Banyana national female football squad, was found murdered in a park on the outskirts of Johannesburg. She had been gang-raped and brutally beaten before being stabbed to death.

Rights groups said the attack was likely to have been an incident of "corrective rape", in which men rape lesbian women on the pretext of trying to "cure" them of their sexual orientation.

Since then there has been a spate of similar attacks http://www.plusnews.org/Report.aspx?ReportId=85268 on lesbian women in the country, but few ever reach the courts. According to a 2009 report by the NGO, ActionAid, there have been 31 recorded murders of lesbian women since 1998, with just three cases reaching the courts, and only one conviction.

Cameroon - In January 2008, a Cameroonian court sentenced three men accused of homosexuality to six months' hard labour. Homosexual acts are punishable by up to five years in prison, and gay men are routinely imprisoned.

Although the penal code does not give the state the power to arraign someone unless the person was caught in flagrante delicto, rights groups say people suspected of being gay are often arrested in public restaurants and bars.

Nigeria - In August 2007, 18 men - all allegedly cross-dressers - were arrested in Bauchi State, a predominantly Muslim state in the north of the country; they were charged with sodomy, the charges were later changed to vagrancy or idleness. The men were eventually freed on bail, but in March 2009 the case was still pending.

kr/kn/he http://www.irinnews.org/report.aspx?ReportId=87793TETE Monday, January 11, 2010 (IRIN) - Stefania*, 17, who has been wheelchair-bound since being involved in a traffic accident as a child, likes to go to Celso's, a popular bar in Matundo, a suburb of Tete city in northwestern Mozambique.TETE Monday, January 11, 2010 (IRIN) - Stefania*, 17, who has been wheelchair-bound since being involved in a traffic accident as a child, likes to go to Celso's, a popular bar in Matundo, a suburb of Tete city in northwestern Mozambique.

From her vantage point at Celso's she can see the long line of trucks waiting to cross the Zambezi River on one of the few bridges in the region, making Matundo a busy hub for people and merchandise travelling between the port of Beira and Malawi.

Adult HIV prevalence in Mozambique is 16 percent, but what Stefania knows about the disease she has had to learn through her own observations.

"I come here to relax, and I see lots of girls getting into the trucks," she told IRIN/PlusNews. "Some of them have become pregnant, and two of my neighbours have fallen very ill, so having a lot of lovers can end in disgrace."

The World Health Organization (WHO) estimates that 10 percent of Mozambique's 20 million inhabitants have some form of disability, but HIV prevention campaigns have so far ignored the fact that young disabled people are also at risk of infection. The Ministry of Health has put the number of HIV-positive handicapped Mozambicans at around 324,000.

A 2007 study involving children and young people between 11 and 23 years of age with and without disabilities, by Miracles in Mozambique (MIM), a missionary organization, found that a lack of educational opportunities for disabled people meant they also lacked information about HIV/AIDS, and were especially vulnerable to infection at the beginning of their sexual lives.

Just 10 percent of the disabled respondents knew the difference between the virus (HIV) and the disease (AIDS), and only four percent knew the symptoms of AIDS.

"I know HIV/AIDS exists," said Stefania. "You can get infected by kissing or having sexual relations with someone who's very sick. Other than that, I don't know any other ways of getting infected."

The MIM study also revealed that AIDS campaigns did not take into account some of the basic needs of those living with handicaps by, for example, using sign language to reach the hearing impaired, or publishing information in oversized type or Braille for the visually impaired.

"We've registered cases of sexual abuse against disabled people," said Sérgio Reis, president of the Mozambican Association of Youths With Disabilities (AJUDEMO) in Tete.

"There is still a low level of knowledge about the disease, which is allied to the campaigns' lack of effectiveness. People with disabilities are a part of this world and are also victims of the misfortunes that befall this society."

Educating to inform

AJUDEMO has been working with various partners in Tete and the neighbouring city of Moatize to include people living with disabilities in AIDS initiatives and turn them into activists.

"The activists are trained and given the task of identifying other handicapped people in their neighbourhoods, and planning interventions based on their individual needs and capacities," said Reis.

Conversations with the intellectually handicapped are kept simple and direct, sign language interpreters design programmes for the deaf, and the blind are taught how to handle condoms. The activists also help disabled people overcome structural barriers at medical centres so that they can access HIV counselling, testing and treatment.

Handicap International, in partnership with the Forum of Mozambican Associations for the Disabled (FAMOD), has also advocated the construction of ramps to ease access to health facilities for the wheelchair-bound. Income-generation projects to reduce begging - which makes disabled people even more vulnerable - are also being set up.

The Tete Sports Association for Disabled People is using tournaments and musical shows to reach disabled people with messages about HIV and AIDS. Ilton Qualquer, an association member, said many disabled people attended and participated in the tournaments, and felt more at ease in expressing themselves at such events.

Stefania was eager for more information, commenting: "If I had knowledge and were trained as an AIDS activist, I would help a lot of girls from my neighbourhood and other disabled people to take care of themselves and lead a healthy life."

*Not her real name

ac/cb/ks/hehttp://www.irinnews.org/report.aspx?ReportId=87697MANICA Tuesday, January 05, 2010 (IRIN) - Without a four-wheel drive, Manica's potholed dirt roads would be impassable, but thanks to a steady stream of illicit diamonds from neighbouring Zimbabwe, more and more people in the impoverished town in western Mozambique can afford one. MANICA Tuesday, January 05, 2010 (IRIN) - Without four-wheel drive, Manica's potholed dirt roads are a challenge, but thanks to a steady stream of illicit diamonds from neighbouring Zimbabwe, more and more people in the impoverished town in western Mozambique can afford one.

Manica is bustling with business and the newfound wealth - manifest in the latest Hummer or a high-end Toyota, always with tinted windows - is flaunted along Eduardo Mondlane Avenue, the dusty border town’s only significant road.

It is a new frontier energized by diamonds: new restaurants and shops have opened and offer a wide assortment of practically anything – all imported from South Africa.

The region used to be better known for its high levels of poverty and malnutrition. Now diamond dealers, many of them foreign, watch the luxury vehicles parade from freshly whitewashed terraces and hurriedly revamped hotels. .

"The diamonds enter Mozambique in an obscure and clandestine way. Nobody in Manica is permitted to [buy or sell] them because we do not have this mineral," Jose Tefula, administrator of Manica district, told IRIN.

The diamonds are believed to come from the vast Chiadzwa diamond fields in the eastern province of Manicaland, about 90km southwest of Zimbabwe's eastern city of Mutare, not far from the border. Traders use “mules”, who often ingest the stones, to smuggle the diamonds into Mozambique, Tefula said.

According to Alberto Limeme, head of the border patrol at Machipanda, the main border post between Mozambique and Zimbabwe: "The diamonds cannot cross the border without proper certification but we don’t have enough personnel for adequate control."

Stones worth hundreds of thousands of dollars are allegedly being smuggled in every month. In December 2009 authorities seized more than 500g of diamonds from a single smuggler.

A recent joint operation by the Mozambican Migration Services and Border Patrol to stem the flow had not managed to contain the illegal traffic of the precious stones, Limeme admitted.

Political involvement

Limeme said the Zimbabwean authorities had long been aware of the illegal diamond pipeline but "as long as the Zimbabweans do not clamp down on the illegal trafficking, it will be very difficult for us to restrain the entrance of the diamonds".

Hundreds of thousands of artisanal miners had swarmed into the Chiadzwa region and in late 2008, Zimbabwean President Robert Mugabe sent troops to flush them out after repeated attempts by the police to establish control failed.

A June 2009 report by the international watchdog, Human Rights Watch, accused Zimbabwean security forces of killing more than 200 miners in 2008 - an allegation denied by Mugabe's government - and recommended that Zimbabwe be suspended from the Kimberley Process Certification Scheme, which polices the diamond trade.

The fields are now controlled by the military and villagers are allegedly forced by soldiers to dig for stones for the benefit of senior government officials or military commanders.

A 2009 report, Zimbabwe, Diamonds and the Wrong Side of History, by Partnership Africa Canada, one of the architects of the certification scheme, states: "Zimbabwean diamonds are produced from mines that benefit political and military gangsters, and they are smuggled out of the country by the bucket-load."

Risk and reward

One Zimbabwean diamond trader in Manica, who wished to remain anonymous, told IRIN that "people were very willing to risk their lives to carry diamonds across the border".

But there were risks involved: "In Zimbabwe it is necessary to bribe the soldiers guarding the mines and then you still have to make the journey across the mountains to get to the border. But this is creating a lot of wealth in Manica."

Diamonds were sold to foreign buyers by the gram at about 1,350 Meticais (US$46.50), far below average global prices, he said. Dealers from Mali, Nigeria, Somalia, the Great Lakes, Israel and Lebanon then take them out of the country to be processed and sold on the global market.

ac/tdm/mwhttp://www.irinnews.org/report.aspx?ReportId=87634JOHANNESBURG Tuesday, December 15, 2009 (IRIN) - The "humanitarian nature" of the mass movement of Zimbabweans to neighbouring Southern African countries has blurred the distinction between what is a "refugee" and an "economic migrant", because such people fit neither category perfectly and fall between the cracks, a new report says. JOHANNESBURG Tuesday, December 15, 2009 (IRIN) - The "humanitarian nature" of the mass movement of Zimbabweans to neighbouring Southern African countries has blurred the distinction between what is a "refugee" and an "economic migrant", because such people fit neither category perfectly and fall between the cracks, a new report says.

"Official responses to Zimbabwean migration in Botswana, Malawi, Zambia and Mozambique are still premised on this distinction, and so are failing to protect both Zimbabweans and [their own] citizens," noted Zimbabwean Migration into Southern Africa: New Trends and Responses, a report released in early December by the Forced Migration Studies Programme (FMSP) at the University of the Witwatersrand.

Neighbouring countries have been an essential lifeline for thousands of poor Zimbabweans, said Monica Kiwanuka, the main researcher for the report. Those crossing the border were not refugees - most did not even apply for refugee status – and, given the extent of economic collapse at home, could hardly be considered "voluntary" economic migrants.

"Many Zimbabweans who qualify for refugee status ... do not apply for asylum due to the need to move back and forth across borders to support families left behind. They resist the category of refugee, which connotes dependency, and they emphasize their ability to work," Kiwanuka told IRIN.

"Yet there are currently no legal instruments in the region, or in specific countries, that address the needs of this forced, mixed and livelihood-seeking migration," she commented. Only recognized refugees and asylum seekers qualify for humanitarian assistance and legal protection in a host state.

"So many Zimbabweans are not legally protected, nor do they receive humanitarian support, as they fall outside the mandates of these support structures," Kiwanuka commented.

With the exception of South Africa, protection and access to services in most countries in the region is contingent on receiving refugee status, and require asylum seekers to stay in isolated camps, unable to work or travel, and thus send money home.

South Africa is considering the introduction of a special permit for Zimbabweans but the policy is still under review.

"These [conditions] are unsuited to [their] needs," Kiwanuka said, and defeated the purpose of crossing the border, so most Zimbabweans did not apply for asylum. The alternative of having to fend for themselves allowed the flexibility to move back and forth between countries as shoppers, labourers and traders.

Despite persistent deportations, xenophobic attacks and other means of exclusion, poor Zimbabweans have been prepared to risk anything to earn an income in a host country.

A Zimbabwean interviewed in Botswana explained: "To accept to return home after being dropped [for deportation] at Plumtree [on the Zimbabwe/Botswana border] means I have agreed to let my people die ... you [would] rather die trying to get back inside [Botswana] and find money to keep them alive."

Kiwanuka said responses to Zimbabwean migrants were not harmonized among the four countries: "In Botswana, Zambia and Malawi, asylum is available to Zimbabweans; in Mozambique, the few people who have applied for asylum have been rejected due to the state's decision to consider Zimbabweans as 'economic' and not forced humanitarian migrants."

Obtaining a Zimbabwean passport was not only very difficult but also extremely expensive, which contributed to the problem. "We all want to be out of trouble, but where can we find the passports these people want from us?" another migrant in Botswana complained.

"Since undocumented migrants fall outside the mandates of the two key support structures in humanitarian assistance – government and non-government institutions," the needs of undocumented Zimbabweans remained "invisible and unmet". Migrants lived precariously, "earning meagre incomes in the host countries and barely covering their basic human needs for shelter and food," the researchers found.

Beyond semantics

"Lack of protection of migrants in the region is based on a false distinction between a forced and an economic migrant, instead of focusing on the real and urgent needs some of these migrants have," Kiwanuka said.

The report suggested that a better term would be "forced humanitarian migrants", who moved for the purpose of their and their dependents' basic survival.

Underscoring the importance of a common humanitarian position on the outflow of Zimbabweans into the region, and the challenge various agencies faced in reconciling their mandates with real needs on the ground, the Regional Office for Southern Africa of the UN Office for the Coordination of Humanitarian Affairs coined the term "migrants of humanitarian concern" in 2008.

Nde Ndifonka, spokesman for the International Organization for Migration (IOM), told IRIN: "We categorize these migrant populations from Zimbabwe broadly as 'mobile and vulnerable populations'.

"Refugees have some specific needs, rights and responsibilities, which fall under the mandate of UNHCR [the UN Refugee Agency]. They also have more general needs, rights and responsibilities within the broader category migrants, which is where IOM operates, he said.

In general, "Migrants, as everyone else within the country, are the responsibility of government. As an intergovernmental organization with expertise in migration management, IOM, just like UNHCR, works with the government to address migration and migrant (including refugee) challenges, within the available resources," Ndifonka commented.

But the bottom line, said FMSP's Kiwanuka, was that interventions would "need to acknowledge the humanitarian nature of migration from Zimbabwe", and "policy response should focus on providing some measure of humanitarian support to the most vulnerable, supporting employment and self-employment, and permitting cross-border mobility."

tdm/he

http://www.irinnews.org/report.aspx?ReportId=87434DAKAR Tuesday, December 08, 2009 (IRIN) - African health experts are calling on governments to vaccinate all children against rotavirus, to end an “unacceptable” yet preventable situation in which the virus kills some 1,400 children in developing countries daily.DAKAR Tuesday, December 08, 2009 (IRIN) - African health experts are calling on governments to vaccinate children against rotavirus, to end an “unacceptable” yet preventable situation in which the virus kills some 1,400 children in developing countries daily.

The West African Rotavirus Advisory Board on 3 December held a meeting in the Senegalese capital, Dakar, as part of efforts to advance the vaccine’s use after the World Health Organization recommended its inclusion in national immunization programmes worldwide.

George Armah, professor and rotavirus expert at Ghana’s Noguchi Memorial Institute for Medical Research, told IRIN the evidence is clear and must be used to push policymakers to act. “Rotavirus is one of the major causes of diarrhoea deaths and hospital admissions. There are vaccines that are very effective and can radically reduce mortality and morbidity from rotavirus infection.”

Rotavirus is the leading cause of severe diarrhoea and dehydration in children, with some 527,000 deaths of under-fives per year – 85 percent of them in Africa and Asia, according to WHO.

Following a recent rotavirus meeting in Kenya, a number of countries in southern and eastern Africa applied to the GAVI Alliance – the global public-private partnership to increase vaccine access – for assistance in introducing rotavirus and pneumococcal vaccine.

Call to action

The Dakar meeting – financed by GlaxoSmithKline, makers of one of two rotavirus vaccines – was in part a chance to present to West African countries a “call to action” from the Kenya meeting; the document says governments must immediately recognize the magnitude of the rotavirus problem and make vaccination against the virus a priority.

GAVI supports the introduction of vaccines in eligible countries, with a commitment that the country will gradually increase its contribution.

Armah said health officials are still learning about rotavirus. He said the key is making them understand the toll rotavirus takes and the importance of vaccination.

“It’s largely a question of ignorance. I’ve been to meetings where ministers have said, ‘We do not have a rotavirus problem in our country.’ But then we show them evidence and say, ‘Yes, there is a problem’.”

Health experts in West Africa say while rotavirus infection is treatable, for many people in rural areas who cannot easily access medical care, vaccination is the most effective way to avoid severe cases and deaths.

Caught early, rotavirus infection can generally be treated with oral rehydration solutions, according to a 3 December op-ed by Armah and Ousmane Ndiaye, paediatrics professor at the University of Dakar and head of paediatrics at Abass Ndao hospital.

“The main problem is that despite this simple treatment many children in West Africa continue to die of the illness. It is distressing for a mother to lose a child if a preventive measure like a vaccine is available.”

Armah and Ndiaye estimate that by 2025 the vaccine could prevent worldwide 100 million hospital stays and 2.5 million deaths.

np/cb

http://www.irinnews.org/report.aspx?ReportId=87363NAIROBI Thursday, November 26, 2009 (IRIN) - From the first goat sales about five years ago, creative NGO fundraisers have expanded a range of animal and farm-related "gifts" for sale online to benefit developing countries. NAIROBI Thursday, November 26, 2009 (IRIN) -  From the first goat sales about five years ago [http://news.bbc.co.uk/2/hi/uk_news/magazine/4078527.stm], creative NGO fundraisers have expanded a range of animal and farm-related "gifts" for sale online to benefit developing countries.
 
The approach has its detractors and not all NGOs have joined the trend. IRC [www.theirc.org], which is promoting its gift catalogue this week, for example, offers no living creatures, sticking to school supplies and mosquito nets.
 
Important: Inclusion in the list below does not imply endorsement by IRIN, nor should exclusion be interpreted as significant. Buyer beware and always read the fine print. The NGOs may not literally spend the funds on the purchase of an individual animal.  
 
Nonetheless, as the Christmas fund-raising season picks up, IRIN has rounded up a few options just to give a whiff of the livestock-related fundraising available. If you have found more "funusual" (or outrageous) charity gift ideas, drop us a line at feedback and we'll make a list  [LINK].
 
Manure: (Oxfam Australia, from AUS$15) - [http://www.oxfamunwrapped.com.au/Product.php?productid=103] (promotional video here: http://www.oxfamamericaunwrapped.com/beep.html)
 
Sheep: (Save the Children, $30) [https://secure.savethechildren.org/01/web_cat_d_1_sheep]
 
Goat: (ADRA, $70) [https://secure2.convio.net/ccadra/site/SPageNavigator/giftcatalog10]
 
Pig: (World Vision Spain, EUR60) [http://worldvision.es/colaborar_regalos_pedido.php?action=add&id_regalo=4]
 
Alpaca: (Practical Action, £50) [http://www.practicalpresents.org/view_product.php?product_id=9]
 
Llama: (Project Concern, $100) [https://secure2.convio.net/pci/site/Ecommerce/692413658?VIEW_PRODUCT=true&product_id=1121&store_id=1141]
 
Cow: (Send a Cow, £125) [http://www.sendacowgifts.org.uk/mumstheword]
 
Camel: (£230, Muslim Hands) [http://www.muslimhands.org/en/gb/great_charity_gifts/select_gift/?gift=G1]
 
And finally:
 
Fermented cow's urine: (Farm Africa, £20) [http://www.farmafricapresents.org.uk/buy/item/9]
 
28 Farm Animals (2 sheep, 2 cows, 2 goats, 2 pigs and 20 chickens): ($2,000, World Vision) [http://donate.worldvision.org/OA_HTML/xxwv2ibeCCtpItmDspRte.jsp?section=10375&item=92]
 
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http://www.irinnews.org/report.aspx?ReportId=87197DUSHANBE Thursday, November 12, 2009 (IRIN) - Even as world food production grows, hunger is on the rise in many poor countries, according to the Global Crop Prospects and Food Situation report for November, published by the Food and Agriculture Organization (FAO) on 12 November.DUSHANBE Thursday, November 12, 2009 (IRIN) - Even as world food production grows, hunger is on the rise in many poor countries, according to the Global Crop Prospects and Food Situation report for November [http://www.fao.org/docrep/012/ak340e/ak340e00.htm], published by the Food and Agriculture Organization (FAO) on 12 November.

The report highlights a contradiction: world cereal production is at its second-highest level ever, yet food prices remain very high. It identifies 77 countries that are both low-income and food deficit.

In East Africa, cereal prices range from 68 percent to 177 percent over the 2007 numbers. In southern Africa, prices are 58-200 percent higher than in 2007, and in most of Asia prices are up 40-70 percent. Since most low-income food deficit countries are food importers, they lose far more from high prices than they gain from steady crop production.

Hunger, in most cases, is caused by lack of money rather than a shortage of food production, according to the World Food Programme (WFP). [http://www.wfp.org/hunger/causes] In 2008 the number of undernourished people in the world increased by 40 million, despite record harvests. [http://www.fao.org/news/story/en/item/8836/icode/]

The new FAO report suggests that 2009 is likely to see a similar increase in hunger.

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http://www.irinnews.org/report.aspx?ReportId=87006JOHANNESBURG Wednesday, November 11, 2009 (IRIN) - A move by donor countries to provide aid agencies with cash, allowing them the flexibility to source cheaper or more appropriate food in the region or beneficiary country and save on transport and warehousing costs, is not addressing nutritional needs, according to a new report.JOHANNESBURG Wednesday, November 11, 2009 (IRIN) - A move by donor countries to provide aid agencies with cash, allowing them the flexibility to source cheaper or more appropriate food in the region or beneficiary country and save on transport and warehousing costs, is also not addressing nutritional needs, according to a new report.

Food aid should include foodstuffs fortified with micronutrients and animal protein. "The emphasis is more on quantity rather than quality, and rarely does the food aid target the most vulnerable groups: children under five, pregnant women and lactating mothers," said Stéphane Doyon, of the international medical charity, Médecins Sans Frontières (MSF), a co-author of the organization's report, Malnutrition: how much is being spent?

"Barely 1.7 percent of interventions reported as 'development food aid/food security' and 'emergency food aid' between 2004 and 2007 actually address nutrition needs," he said.

The MSF report was published ahead of a new UN Children's Fund (UNICEF) report, which points out that the level of child and maternal undernutrition "remains unacceptable" throughout the world; 90 percent of the developing world's chronically undernourished or stunted children live in Asia and Africa.

jk/he http://www.irinnews.org/report.aspx?ReportId=86993MAPUTO Thursday, November 05, 2009 (IRIN) - Helena Numaio was 12 years old in 1990 when she lost both her legs and a finger in a landmine explosion while collecting firewood in the Moamba district of Maputo Province, Mozambique. MAPUTO Thursday, November 05, 2009 (IRIN) - Helena Numaio was 12 years old in 1990 when she lost both her legs and a finger in a landmine explosion while collecting firewood in the Moamba district of Maputo Province, Mozambique.

The landmine put an end to her education. Nearly 20 years later Numaio has fled an abusive marriage and now is solely responsible for bringing up her three children aged five, eight and 10. She sells food and second-hand clothes on the streets of the capital, Maputo, to make a living.

Mozambique's only local NGO dedicated to assisting victims of landmines and unexploded ordnance, RAVIM, gave her a wheelchair in 2007 and she went back to school, but had to withdraw after two years. The fees were US$4 a year, but an extra levy of $2 a month to pay for the after-hours security guard at the local school meant she would have to choose between providing for her children and improving her education.

"Before getting the wheelchair I was dependent on others to take me anywhere," Numaio told IRIN. The wheelchair enabled her to set up a small business, but the city's broken roads and sidewalks were unforgiving, and the wheelchair that had given her a new lease on life now stands immobile.

Emmanuel Mounier, seconded to RAVIM from Handicap International (HI), which works with landmine victims, told IRIN the harsh environment shortened the lifespan of crutches, wheelchairs and other aids used by the disabled, but spare parts were hard to come by and there were few specialized workshops, so repairs were expensive.

No assistance for victims

Landmines are the third leading cause of amputations in Mozambique, after diabetes and road accidents, and the threat they still pose - more than 17 years after peace came to the country following four decades of independence and civil wars - is deemed big enough for HI to spend 40 percent of its annual country budget on mine clearance.

Both conflicts saw the extensive use of landmines and HI believes that the handful of recorded victims killed or maimed each year grossly underestimates the ongoing impact of these hidden weapons.

Yann Faivre, HI's programme director in Mozambique, told IRIN that "the number of mine accidents each year are given as a minimum by the authorities, but we just don't know the number of accidents."

There are no benefits for the survivors of landmine blasts, or those who died, or their next of kin, so there is no incentive to report incidents of landmine accidents to the authorities, Faivre said.

In one of the world's poorest nations, assistance for the disabled is often far down the list of priorities. There are government-run orthopaedic centres in the 10 provincial capitals, except Manica Province, where it is situated in Chimoio, but all share a common bond of "essential equipment not working or not being replaced," Faivre said.

"For example, in Inhambane [in central Mozambique, currently the most mined province] the [orthopaedic] centre is not open. In Beira [Mozambique's second city] the oven to make prosthetics is broken and has not been replaced," he said. "The situation [at orthopaedic centres in Mozambique] is not at the level of the minimum standard."

The majority of Mozambique's 20 million people live in rural areas, and the poor reputation of the orthopaedic centres means that "most people needing assistance don't bother to go [to the provincial capital] as they see it as a wasted and expensive journey," Faivre said.

The plight of landmine victims and the lack of assistance in many of the world's mine affected territories will be a major focus of the Cartagena Summit on a Mine-Free World, or the second five-year Review Conference of the Mine Ban Treaty, which begins on 29 November 2009 in the Colombian port city of Cartagena.

HI, which works with all disabilities, said it supported the Cartagena summit's aims of providing greater assistance to mine victims, as it might also lead to improved resources for all the disabled in impoverished countries. "No one is going to ask someone without a leg, who goes to an orthopaedic centre, how they lost it. Improved facilities will be made available for all the disabled," Faivre said.

Self help

Luis Silvestre Wamusse, national coordinator and a co-founder of RAVIM, which was established in 2005, told IRIN: "If you compare someone who was born disabled, they had no choice but to adjust to their situation. It is more difficult for someone who lived a first life as a normal person and then, from one day to another, suddenly sees their dreams broken. They have to first accept their new condition and then start their second life."

In 1984 Wamusse was a 22-year-old student in Tete Province in northwestern Mozambique, when he lost a leg and two fingers to a landmine while looking for firewood. His family brought him back to Maputo for rehabilitation. Manuel Amisse, co-founder and programme director of RAVIM, was a 26-year-old government soldier when he stepped on a mine on 11 August 1982 while on patrol in Tete.

After being evacuated by donkey cart, Amisse was eventually treated by a "not very skilled intern" in Songo, a town east of the Cahora Bassa dam, and underwent two more amputation procedures to produce a "proper stump".

"The main priorities for victims are psychological rehabilitation, the healing of the wound, and getting a prosthesis - but that first need is already not covered," Wamusse said.

In March 2007 an armoury exploded in the city of Maputo, spewing rockets, ammunition and other ordnance into the surrounding suburbs, killing more than 100 people and injuring hundreds more. RAVIM provided counselling to people who had lost limbs or sustained other injuries.

"People did not believe that we [Wamusse and Amisse] were also victims and had had limbs amputated, so we had to take off our prosthetics in the hospital and show them that we have adapted to live a normal life ... I told them, 'You lost your leg, you did not lose your life, so please do not lose your will to live'," Wamusse said.

Tales of a child soldier

Paulino Alfredo Sambo was a 15-year-old rebel soldier when he was caught in an ambush by government soldiers near Vilanculos in Inhambane Province in 1991, a year before the civil war ended. The impact of a rocket propelled grenade severed one leg below the knee and left his remaining foot in tatters. It was amputated by a nurse in a primary health care facility soon after.

After a stint in rehabilitation and attending a government re-skilling programme for former soldiers, where he trained as a metal worker, seven years after the ambush, HI provided him with prosthetics.

"After the incident I excluded myself from society - I was ashamed of my condition - but I have accepted that I will not have legs for the rest of my life," Sambo told IRIN.

He lives with his wife, Nilsa, and three children aged two, three and four in Matola City, about 20km from Maputo. He has a lathe in the front garden and from the proceeds of his work is gradually building a family home.

The stigma associated with landmine victims and the disabled in general nearly thwarted their marriage. "Neighbours [of his prospective wife's parents] spoke against me. They told Nilsa and her parents that I would not be able to support her. I told Nilsa, 'You have the choice - I will never change."

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http://www.irinnews.org/report.aspx?ReportId=86892NAIROBI Wednesday, November 04, 2009 (IRIN) - Encouraging the use of traditional African herbal medicines could prevent some of the one million malarial deaths on the continent, according to specialists attending a conference www.mimalaria.org/pamc in Nairobi. Many poor communities, especially in rural settings, cannot afford modern malarial drugs and many people die due to inaccessibility of treatment.NAIROBI Wednesday, November 04, 2009 (IRIN) - Encouraging the use of traditional African herbal medicines could prevent some of the one million malarial deaths on the continent, according to specialists attending a conference www.mimalaria.org/pamc in Nairobi. Many poor communities, especially in rural settings, cannot afford modern malarial drugs and many people die due to inaccessibility of treatment.

“Malaria kills many people in Africa, both children and adults, despite the availability of free treatment in certain African countries. While it is true many governments in Africa, with development partners, give free pediatric treatment for malaria, many still cannot access this facilities and resort to home treatment,” says Merlin Wilcox of the Research Initiative on Traditional Antimalarial Methods and the University of Oxford.

Some specialists at the ongoing 5th MIM Pan African Malaria Conference in Nairobi said medicines drawn from plants that abound in the continent could be utilized to save many people, especially those in poor settings, from malaria.

BN Prakash, a researcher with the Foundation for the Revitalization of Local Health Traditions, based in Bangalore, said Africa could draw on experiences in India where medicinal plants have been used with great success in the control of malaria-related deaths.

“Research in India has shown a 5-10 times reduction in malaria-related deaths among communities who use traditional medicinal plants like Guduchi [tinospore coeditdia], a local medicinal plant found in India,” said Prakash.

Preserving traditional knowledge

Another speaker, Gemma Burford of the Global Initiative for Traditional Systems of Health, said while there had been increased cases of loss of knowledge about traditional medicinal plants, student-led research could be used to preserve knowledge and create a database on these plants.

“When we carried out research involving school children in rural Tanzania about traditional Maasai medicines, we found out that 48 percent of these children already had knowledge about these plants. We used [this knowledge] to create a database for the purposes of preserving the knowledge and these plants too,” said Burford.

“It is important to note that many malarial drugs are still bought from commercial pharmaceutical shops and not many of them are that cheap. Costs also involve how easy or not it is to access these government facilities, especially in Africa where medical facilities are far-flung,” Burford said.

Educating the youth

Speakers at the conference called on African governments to introduce educational programmes that would teach the younger generations about the traditional methods of treating malaria and other diseases plaguing the continent.

“The biggest obstacle to use of traditional medicines is lack of interest from the youth and teaching them about these medicines would be the best way to let them appreciate their values. Evangelical churches and development agencies must also be persuaded to stop fighting traditional African medicine because modernity and tradition can be married to provide a formidable force against malaria,” added Burford.

Effectiveness and dangers

Doumbo Ogobara, director of the Mali Malaria Research and Training Centre, and a lecturer at the University of Bamako, said there should be more research to ensure the effectiveness of traditional medicinal plants in the treatment and management of malaria.

“More research must be directed towards finding out the effectiveness of these traditional medicinal plants and their safety and efficacy because initiatives on using them could be counter-productive if this is not done. More emphasis therefore must be laid on research for plant-based prophylactics for malaria,” said Ogobara.

Mahamadou Sissoko of the Centre called for caution in taking the traditional medicinal route, arguing that many malaria-related deaths have occurred even among communities that have relied heavily on traditional plants for treatment.

“People are dying even in places where there is still widespread use of traditional medicinal plants and unless the efficacy of a traditional plant on malarial treatment can be ascertained through vigorous research, we could have our backs against the wall. Many traditional healers will abuse this and give anything as medicine so long as it is a plant - we must urge caution,” said Sissoko.

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http://www.irinnews.org/report.aspx?ReportId=86866SONGO Tuesday, November 03, 2009 (IRIN) - The conversations of deminers are often illustrated with sketches on the reverse side of old reports or the toe of a boot drawing lines in the sand to show how a single mine can close 35km of road, make a bridge redundant or deny a community a swathe of farming land. They are a meticulous fraternity that knows the devil is very much in the detail.SONGO Tuesday, November 03, 2009 (IRIN) - The conversations of deminers are often illustrated with sketches on the reverse side of old reports or the toe of a boot drawing lines in the sand to show how a single mine can close 35km of road, make a bridge redundant or deny a community a swathe of farming land. They are a meticulous fraternity that knows the devil is very much in the detail.

In one of the world's longest running search-and-destroy operations they have hunted landmines for 17 years across all the terrains of Mozambique, destroying hundreds of thousands of mines and unexploded ordnance (UXO) left over from independence and civil wars spanning four decades.

Soil movements have brought some landmines into view, but most remain hidden a few centimetres below the surface, waiting for the 6kg or more of pressure
required to set them off; others are planted on spikes, the trip wire entangled and camouflaged by vegetation - a country's weeping wound decades after the fighting has ceased.

Thick catalogues carried by deminers detail hundreds of different types of landmines: cheap, simple weapons produced in their millions by most of the
world's industrialized countries, designed with only two purposes - to kill or to maim.

Mines that maim fall into two categories: those designed to tear off arms and legs, and the euphemistically named "toe-popper", which mangles a foot in a heavy boot to a pulp.

Every minefield has its story. In the absence of records, maps or data, distinct patterns show the extensive use of landmines during the war of independence against Portugal's colonial administration, and the subsequent civil war by Frelimo, Mozambique's first post-colonial government, against
the rebel Renamo movement.

Maputo Province in the south, where the capital, Maputo, is located; the Beira Corridor in central Mozambique, which gave land-locked Zimbabwe - a staunch Frelimo supporter - access to the port city of Beira; the approaches to the Cahora Bassa hydroelectric scheme in the northwestern province of Tete, and the northern provinces bordering Tanzania, where Frelimo launched its anti-colonial struggle, provide the broad brush strokes of where intensive landmine activity occurred.

Small villages and hamlets were not spared as remote communities acquired strategic military importance. Basic infrastructure and boreholes provided bases for government soldiers, who laid minefields as barriers against rebel attacks. When peace came in 1992, these poor and vulnerable communities sank
back into irrelevance, but the landmine legacy turned subsistence farming or a game of soccer into deadly pursuits.

Mine clearance is like a combination of gardening and archaeology; with the exception of the metal detector, the tools - such as clippers and trowels - can be bought at gardening shops, but that is where the similarities end. The rule of thumb among mine disposal experts is that for every 5,000 mines cleared, one deminer is killed and two others injured.

Helen Tirebuck, a location manager at HALO Trust, Mozambique's biggest humanitarian deminer, told IRIN in a rudimentary shelter serving as an office during a mine clearance operation, that deminers always leave a gift, because the area "becomes part of Mozambique again".

The investigators

Locating a field begins like any other investigation into finding a killer: by interviewing the witnesses.

Geraldo Pedro, a survey officer at HALO Trust, has criss-crossed most of the country's 128 districts in search of leads to identify the killing fields that made Mozambique one of the world's nine most mined countries.

The reliability of clues provided by "informants" is gauged on four levels: first prize is information by people who laid the mines, or witnesses; next by people living in the vicinity since the minefield was laid; then incidents of people or livestock killed or injured by landmines; lastly, areas merely suspected of being mined.

"You have to get into the heart of the informants," Pedro told IRIN, "and you need two informants to corroborate the information ... one informant does not know everything." Exposing a hustler hoping for a reward by inventing the existence of a minefield, or awakening the memory of a genuine witness to one, can take hours.

Occasionally there are exceptions. Pedro once met a cellphone company employee who was working in the area where he had served as a government soldier during the 16-year civil war. "He was quite confident about where the mines were laid - he pointed out where four mines were laid, and we found four mines - but if that happens, we're lucky," he told IRIN.

"I have found that in [previously] Renamo[-held] zones, people do not supply information easily and I have to make them understand that we are not dealing with political parties here, we are clearing mines for everyone," he said.

The Baseline Assessment in 2007 determined that just over 12 million square metres of the country was still mine-contaminated, a sharp drop from the
more than 500 million square metres identified by the 2001 Landmine Impact Survey. Mozambique could become the first of the world's most mined countries to be declared mine-free if donor support does not continue to wane.

In October 2009 the HALO Trust began clearing an 11km mine belt bracketing the Cahora Bassa dam, which provides hydroelectricity to a number of
southern African states, including the continent's economic power house, South Africa.

The area was heavily mined by the Portuguese; now desperately poor communities practice subsistence agriculture close to and sometimes within the minefields, their home-made hoes cutting into the soil at the optimum depth for burying anti-personnel mines.

During Pedro's survey of the Cahora Bassa mine belt, near the village of Nhamchene on the western side, he was informed of another mine belt near the town of Songo on the eastern side, where the community had hung pieces of red plastic on trees to mark the location of mines that had killed or maimed people, or livestock that had been tempted to graze in the more lush vegetation of the minefield.

The work day

The Songo site is being cleared first. The deminers live in a tented camp and their day begins at dawn. They work a seven hour day on six and half days per week, and take a break in the fourth week; then the monthly cycle starts again. Alcohol is banned.

Before the deminers arrived, Pedro provided a final survey map of the minefield, known as a polygon, with GPS coordinates of its extent, landmarks for a safe approach, type of vegetation and soil, a record of mine accidents, and where they occurred.

Tirebuck visited the site many times in preparation for demining. Permission to demine had been sought and given by national, provincial and local authorities, the Songo police were informed, and the necessary permits to transport explosives to destroy mines had been obtained. A report detailing the position of a destroyed mine or UXO, as well as the ground cleared is sent to the Mozambique national demining institute every month.

A radio check with HALO's country headquarters in Maputo is made daily and a satellite phone is on hand as back-up. If communications are not working, neither do the deminers; if an accident occurs, all HALO's demining operations throughout Mozambique stop to keep the airwaves clear.

The standard operating procedures do not vary, but each minefield has its idiosyncrasies - this site is on rocky slopes covered by light vegetation and the deminers require protection, "so their knees are not destroyed," Tirebuck told IRIN.

Her main concern is the evacuation of personnel in case of an accident, and adequate supplies of water for drinking and ablutions. The area can only be accessed by an old, very broken road and young men from the local community have been enlisted to repair the worst of it, providing a cash injection to a community largely devoid of it. "They are helping us as much as we are helping them," Tirebuck said.

Each demining section has 9 personnel, including six deminers, two of which are trained paramedics, a section commander, a supervisor - responsible for destroying the mines - and a driver, who also doubles up as radio operator.

When a mine or UXO is detected, the deminer begins excavating the mine from about 50cm back, and when a portion of it is exposed and it is identified as a mine, a supervisor will place the explosives while other deminers act as sentries to prevent anyone entering the area.

The deminer's world is the square metre that he or she kneels before, which is swept with mine-detectors about 46 times on average, only pausing between each sweep to run a piece of metal across the detector's head to ensure it is working. Tirebuck expects the terrain will allow for each deminer to clear about 40m of a corridor 1m wide each day.

"This is one of the hottest minefields I have ever been in, but it is just the way it is," said Tirebuck, whose first assignment with HALO Trust was in
Cambodia. Temperatures are above 40 degrees Celsius, but deminers have to wear blast-proof face visors and heavy protective gear. They only stop work for rain because it impairs vision through the visor.

Training

The deminers have been trucked in from Chimoio, a cooler part of the country, and Tirebuck decides whether they should start work earlier, take a
noon break and begin again once the heat fades.

Joao Madamol, a HALO Trust demining trainer, went to the church on the first Sunday he was there and recruited more potential deminers than he had vacancies. In a battered marquee tent, with large rocks for chairs, he hauls out FFE (free from explosives) mines to teach them about the types of mines
expected to be found in the area, their fuses and killing radius.

The new recruits will complete a three-week course and are expected to be better acclimatized to the scorching temperatures. Those that perform best will undergo a paramedic course, and the best of these will then receive training as a section leader.

Many of the recruits recognize the mines from their area, and talk about "finally feeling free" when the explosives are gone. A new recruit told IRIN: "I feel anger for everyone who has planted a mine anywhere."

The final act of mine clearance is the most important, and brings closure, Tirebuck said. It is the "walk-through" by the community and deminers across the former minefield that has killed, maimed and haunted generations of Mozambicans.

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http://www.irinnews.org/report.aspx?ReportId=86860NAIROBI Friday, October 30, 2009 (IRIN) - The use of mid-level health workers rather than doctors to prescribe antiretroviral treatment (ART), a strategy called task-shifting, has enabled Mozambique to triple the number of facilities providing medication within six months, according to a new study.NAIROBI Friday, October 30, 2009 (IRIN) - The use of mid-level health workers rather than doctors to prescribe antiretroviral treatment (ART), a strategy called task-shifting, has enabled Mozambique to triple the number of facilities providing medication within six months, according to a new study.

The report, published in the in the latest edition of the Journal of Acquired Immune Deficiency Syndromes, by Kenneth Sherr from the University of Washington and officials in Mozambique's Health Ministry, found that patients from rural and disadvantaged areas could also access quality ART services as a result of the task-shifting.

Shortly after independence in 1974, the majority of physicians - mostly Portuguese nationals - departed from Mozambique, leaving fewer than 80 physicians to care for a population of 10.6 million.

Since then the country has largely relied on 'técnicos de medicina' - non-physician clinicians who undergo training for 30 months - to provide the clinical and managerial tasks ordinarily carried out by doctors.

Political instability and economic structural adjustment programmes in the 1980s hit Mozambique's health system hard, forcing the closure of up to 50 percent of public health centres. HIV prevalence reached 15 percent in 2003, yet only one percent of people had access to treatment; the government again looked to técnicos to fill the gap.

Rapid expansion

"Because the numbers of existing physicians were inadequate to cover the large number of facilities in the rapid scale-up, the national plan included a renewed effort to train new técnicos as an essential element of workforce expansion for HIV care," the report noted.

By mid-2006, the first wave of newly graduated técnicos had been deployed at health facilities; about a year later 167 health centres covering 147 Mozambican districts and municipalities were providing treatment.

The scale-up also integrated ART into public healthcare, so physicians and técnicos would attend to all patients, not only those infected with HIV.

"Deployment of newly trained técnicos provides opportunities to staff rural and smaller urban clinics with clinical cadres that are more likely to continue to work in public healthcare. Furthermore, training, salaries, and benefits cost less for técnicos than for physicians," the authors said.

"Supported by the integrated care approach, the number of facilities with ART tripled over a six-month period, including predominately small, rural, and peri-urban health centres, 45 percent of which were managed by a técnico de medicina."

A continuing effort

Mozambique is also increasing its number of trained physicians; student intake at the country's main medical school has doubled, and two new medical schools have been opened. According to the study, the quality of care provided by técnicos is equivalent to or better than that provided by medical doctors.

However, an evaluation of the técnicos' training found that they were not sufficiently prepared for actual clinical responsibilities, especially where health system resources were inadequate, and the health workforce would have to be multiplied several-fold to achieve the United Nations Millennium Development Goals.

Nevertheless, the report concluded that "Using a mix of physicians and responsible task-shifting to non-physician providers, the Mozambique health system can maintain its momentum in ART scale-up while strengthening the wider public healthcare system."

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http://www.irinnews.org/report.aspx?ReportId=86813JOHANNESBURG Thursday, October 29, 2009 (IRIN) - An African international agreement has opened the door to a debate on the rights and protection of people displaced by natural disasters, with a nod to migration as a result of climate change. JOHANNESBURG Thursday, October 29, 2009 (IRIN) - An African international agreement has opened the door to a debate on the rights and protection of people displaced by natural disasters, with a nod to migration as a result of climate change.

The Kampala Convention, a ground-breaking treaty adopted by the African Union (AU), promises to protect and assist millions of Africans displaced within their own countries. Significantly, the treaty recognized natural disasters as well as conflict and generalized violence as key factors in uprooting people.

Jean Ping, chairperson of the Commission of the African Union, told IRIN that "more and more people are likely to be displaced" as Africa experiences more frequent droughts and floods brought about by climate change.

He said the inclusion of displacement by natural disasters was informed by the global debate on the need to develop a framework for the rights of "climate refugees" - people uprooted from their homes and crossing international borders - because the changing climate threatened their survival.

The treaty also calls on governments to set up laws and find solutions to prevent displacement caused by natural disasters, with compensation for those who were displaced. Migration expert Etienne Piguet said with the Kampala Convention the AU had "once again" tried to push the envelope.

In 1969 the Convention Governing the Specific Aspects of Refugee Problems in Africa, adopted by the then Organization of African Unity, had gone a step further than the 1951 UN Refugee Convention by using a definition of "refugee" that included not only people fleeing persecution but also those fleeing war or events seriously disturbing public order.

Piguet described the reference to people displaced by natural disasters as an "interesting attempt" to find "adequate answers to the new concern about migration linked to environmental degradation".

In 2008 climate-related natural disasters like droughts, hurricanes and floods forced 20 million people out of their homes, while 4.6 million people were internally displaced by conflicts, according to a recent joint study by the UN Office for the Coordination of Humanitarian Affairs (OCHA) and the Geneva-based Internal Displacement Monitoring Centre.

The Representative of the UN Secretary-General (RSG) on the Human Rights of the Internally Displaced Persons in a submission to the UN Framework Convention on Climate Change noted that people uprooted from their homes by natural disasters enjoyed protection under the existing human rights law and the guiding principles on internal displacement.

However, the Kampala Convention also calls on governments to "prevent or mitigate, prohibit and eliminate root causes" of displacement, and find "durable solutions" to them.

Moussa Idriss Ndele, President of the Pan-African Parliament, the legislative body of the AU, said the debate in Kampala on the rights of people displaced by natural disasters did not "quite evolve properly - we did not address the issue of climate change" because most people still believed conflict was the biggest trigger of displacement.

Can of worms

However, it was unclear which events could be linked to climate change. "More and more people are being displaced by floods, which are becoming more and more frequent and intense," said Rachel Shebesh, chair of the African Parliamentarian Initiative for Climate Risk Reduction.

The RSG said there was a need to clarify or even develop a legal framework to help people who moved inside or outside the country because environmental degradation and slow-onset disasters - like desertification, salination of soil and groundwater - made areas uninhabitable, and if displaced persons could not return to their homes they should be considered forcibly displaced.

The Intergovernmental Panel on Climate Change (IPCC) has projected more frequent and intense floods and droughts in Africa during the next few decades, and the debate is not only set to continue, but to intensify.

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http://www.irinnews.org/report.aspx?ReportId=86805NAIROBI Tuesday, October 27, 2009 (IRIN) - Replacing manual data with electronic health records would significantly improve the quality of care and enable African HIV treatment programmes to be scaled up more efficiently, say the authors of a new article on the subject. NAIROBI Tuesday, October 27, 2009 (IRIN) - Replacing manual data with electronic health records would significantly improve the quality of care and enable African HIV treatment programmes to be scaled up more efficiently, say the authors of a new article on the subject.

"Talkin' About a Revolution", published in the latest edition of the Journal of Acquired Immune Deficiency Syndromes, looked at the Academic Model for Providing Access to Healthcare (AMPATH), a programme that uses electronic health records in care and treatment services for around 100,000 HIV-positive patients at sites across western Kenya.

"Scaling up treatment programmes requires timely data on the type, quantity and quality of care being provided," the authors said. "Health care is an information business; managing patient care requires managing patients' data at many levels ... health care systems the size of AMPATH (or larger) cannot effectively be managed without ... [electronic] data."

More efficient care

The health data system can help programme managers avoid medical errors and stock-outs of key medicines, while enabling clinicians to monitor and care for their patients more effectively.

"Electronic records help us store data efficiently, retrieve it when we need it, and monitor and evaluate the progress of our programmes much more easily than if we were using manual systems," said Erica Kigothe, AMPATH's programme manager in charge of data management.

"When a patient comes to a clinic for a visit, instead of poring over large files, the clinician has one summary sheet that contains all the vital patient information and should he or she need more information, they can always go back to the patient's computerized file," she told IRIN/PlusNews.

A previous study comparing an AMPATH clinic before and after the adoption of electronic health records found that patient visits were 22 percent shorter, provider time per patient was reduced by 58 percent, and patients spent 38 percent less time waiting.

Kigothe noted that assessing disease trends was also easier with electronic records, as was collating data for the purposes of research and new directions in programme development.

Electronic health systems have been successfully used in the care and treatment of HIV in Lesotho, Malawi, Rwanda, South Africa and Uganda, but few African countries have adopted the systems on a large scale.

"Programme implementers in low-income countries sometimes see clinicians' recording of patient data and the management of those data as secondary to providing good care, or even a distraction," the article's authors commented.

Not all smooth sailing

The programme has not been without its difficulties. "In one of our sites in Busia [town on the Kenya-Uganda border] they have very frequent power outages, so they have had to find ways to work around it, inputting data when power is on, even if that is at night," Kigothe said.

Finding people with computer skills is not always easy in the developing world, particularly in rural areas, and "like any equipment, computers break down from time to time and require repair or replacement, which can cause some problems" and incur additional expenses, she said. "In addition, the data collectors are human, and therefore prone to the occasional error."

Electronic systems are not cheap; they require considerable investment in computers, training data collectors and hiring information technology experts. However, according to the study, AMPATH's total cost of care is under US$100 per patient per year, making the system financially feasible even in resource-poor settings.

"You're going to have to spend quite a lot of money to set up the system," Kigothe said. "But looking at the big picture, it saves so much in the long run - for example, each of our data collectors manages 2,000 patients' information, something that would be impossible using manual data collection."

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http://www.irinnews.org/report.aspx?ReportId=86768DONDO Tuesday, October 27, 2009 (IRIN) - Mozambique's effort to become the first of the world's major mine-contaminated countries to be declared mine-free is faltering on the home straight.DONDO Tuesday, October 27, 2009 (IRIN) - Mozambique's effort to become the first of the world's major mine-contaminated countries to be declared mine-free is faltering on the home straight.

There are a variety of reasons: Mozambique's donor-dependent government no longer sees demining operations as a priority; the withdrawal of humanitarian demining operations, sending the wrong signals to donors that the job was done, and that the focus of global demining activities has largely shifted to Iraq and Afghanistan.

"We can finish this. We can get rid of them [landmines] ... This is not a never-ending story," Aderito Ismael, Mozambique's Mine Action Coordinator for Handicap International (HI), a non-governmental organization, told IRIN. "I want to be out of a job by 2013, or maybe by 2012."

Handicap International, one of three humanitarian demining operations still working in the mine-infested territory, is only continuing operations through the support of the UN Development Programme (UNDP), while the HALO Trust - Mozambique's largest humanitarian deminer - is working below capacity because of funding shortfalls. APOPO is the third and smallest of the operations in the country.

When demining activities began in 1992, predictions were that clearing anti-personnel landmines and unexploded ordnance left by four decades of independence and civil wars could take about 50 years.

"Mozambique could set an example of a country significantly affected by mines ... ticked off as cleared ... we are talking about a marginal timeframe," Hanoch Barlevi, UNDP's chief technical advisor seconded to Mozambique's Institute of National De-mining, told IRIN.

If donor funding had not subsided, Mozambique may have already lost its sobriquet as one of world's most heavily mined countries, leaving such countries as Angola, Afghanistan and Cambodia as reluctant holders of the title.

Mozambique, a signatory to the 1999 Mine Ban Treaty (MBT), was granted a five-year extension of the 1 March 2009 deadline to remove all known anti-personnel mines and unexploded ordnance on its territory, saying that "Through a relatively modest investment [about US$39 million] on the part of both the Republic of Mozambique and the international community, Mozambique can indeed fulfill its obligations in a relatively short time."

The government attributed its failure to meet the deadline to the size of the job - 123 of the country's 128 districts were identified as mine contaminated - the competing needs of demining and poverty alleviation in one of the world's poorest nations, and "some donor fatigue, which in turn resulted in a slow-down of efforts to implement Article 5 [of the MBT]."

Article 5 of the treaty states that "Each State Party undertakes to destroy or ensure the destruction of all anti-personnel mines in mined areas under its jurisdiction or control as soon as possible but not later than ten years after the entry into force of this Convention [MBT] for that State Party."

A country that became a minefield

Exactly how many mines were planted during the conflicts is unknown - estimates vary from millions to about 500,000 - but whatever the numbers, there were enough to place the southern African country in the premier league of mine contaminated countries.

Mozambique began to address the daunting challenge 17 years ago. There were no records or maps of where landmines were laid, memories had dimmed, witnesses to the laying of minefields had died, and some communities still feared retribution for informing the authorities about where mines had been planted.

Landmines were widely used. The Portuguese colonial administration and Mozambique's first post-colonial government, ruled by the Frelimo party, used them for "defensive purposes" to protect infrastructure.

In the civil war that followed independence Frelimo often commandeered schools to use as army barracks and surrounded them with landmines to deter attacks by Renamo, the anti-government rebel movement.

Mine belts turned villages and towns into fortresses, as much for government soldiers to defend their positions "as to ensure control of population movement," a former Frelimo soldier told IRIN.

Renamo would sometimes create phantom minefields, planting landmines by day in view of communities and then removing them clandestinely at night, but the effect of denying land to communities was the same.

Better information

Mozambique's extraordinary progress towards becoming a mine-free state has been achieved by meticulously digging out the weapons - which have no expiry date - and more accurate assessments by deminers.

The first survey in 1992 estimated there were about two million mines, but the Landmine Impact Survey (LIS) in 2001 - the first comprehensive survey, later recognized as flawed - said that about 1.5 million Mozambicans, or 9 percent of the population, lived in 1,374 mine-affected areas covering an area of about 561,689,063 square metres.

Most information on the location of minefields was provided by local communities, but flooding in 2000 displaced thousands of people and the LIS was undertaken after the water subsided. HI's Ismael told IRIN that the "large number of suspected sites [identified by the LIS] did not represent reality", and the survey was undertaken by people who often did not have the technical skills to gauge the extent of a minefield.

In 2007 the HALO Trust, which removes war debris, produced the Baseline Assessment after eradicating duplicate sites, conducting thousands of site visits, and collating data from HI and Norwegian People's Aid (NPA), and concluded that 12,166,401 square metres of Mozambique at a total of 541 sites were known to be contaminated.

Having a mine-free state suddenly became possible, as the task of clearing more than 500 million square metres was reduced to a more manageable area of just over 12 million square metres within six years.

However, after 13 years in Mozambique, Norwegian People's Aid (NPA) closed its operations in 2006, following the exit of other international operators, such as the German deminer Menschen Gegen Minen (People against Landmines) in 2003, and the Washington DC-based humanitarian and commercial mine action and ordnance disposal organization, Ronco, in 2006, creating the perception that mines were no longer a major problem.

Per Nergaard, the NPA director of mine action, told IRIN the organization was comforted that HALO Trust and HI remained in the country when the decision was made "to take our limited resources [elsewhere]."

UNDP's Barlevi said the Baseline Assessment and NPA's decision to withdraw led to two different responses by donors between 2006 and 2007. Some donors used NPA's exit to close the chapter on their funding, while the findings of the Baseline assessment encouraged other donors to return because the task had been defined.

"The paradox is that the number of mine victims has dropped to a few a year, and if there was 50 mine accidents each year people would jump up, that is the irony. The human impact is going down, but it is not going away," Barlevi said. "There is less money around, and even less in Mozambique."

An ever present danger

According to Mozambique's 2008-2014 National Mine Action Plan, between 1993 and 2006, 269 million square metres were demined, 173,091 landmines were cleared and 133,143 items of unexploded ordnance were destroyed.

The four northern provinces of Niassa, Cabo Delgado, Nampula and Zambezia are currently undergoing a verification process following the end of demining operations; the remaining provinces of Tete, Manica, Sofala, Inhambane - seen as the worst affected province - Gaza and Maputo had yet to be cleared.

Landmines had also been found along 200km of the border with Zimbabwe, as well as in a belt around the Cahora Bassa dam, and beneath about 200 electricity pylons stretching 80km between the South African border town of Komatiepoort and into the high density suburbs of the Mozambican capital, Maputo. Further surveys were required in areas bordering South Africa, Zambia, Malawi and Swaziland.

Helen Gray, HALO Trust's Mozambique's programme officer, like others in the demining community, is optimistic that the 2014 deadline can be met with "an increase in funding ... soon". They expect to have 208 deminers in the field by November 2009, but ideally require 364 deminers, excluding support staff and management, to meet the revised deadline.

Gray said they needed about $4.2 million annually for the Mozambique operation, but were getting by with about $2.5 million. "Achieving a milestone like [demining the] Maputo [pylons] will help things," she said.

Peri-urban communities scratch a living on the vacant land along the corridor created by the pylons from Komatiepoort to Maputo, growing the staple maize and other crops, often within a few metres from the estimated 20,000 landmines planted along the pylon route.

Up to 200 mines have been found at each pylon, planted by Frelimo to protect the electrical infrastructure from saboteurs during the civil war; it takes two or three deminers about a month to clear a pylon. "We are behind the curve ... but we still might meet the ... deadline by 2014," Gray said.

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