<?xml version="1.0" encoding="UTF-8"?><rss xmlns:content="http://purl.org/rss/1.0/modules/content/" version="2.0"><channel><title>IRIN - Children</title><link>http://www.irinnews.org/irin-fp.aspx</link><description>Updated everyday</description><language>en-gb</language><lastBuildDate>Fri, 03 Feb 2012 16:30:37 GMT</lastBuildDate><item><title>HEALTH: Malaria mortality &quot;underestimated&quot; </title><pubDate>Fri, 03 Feb 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://irinnews.org/images/2010/201011010851010191t.jpg" />]]>LONDON 03 February 2012 (IRIN) - A new attempt to quantify malaria deaths over the past 30 years suggests the death toll, especially among adults, has been greatly underestimated. The figures also show the fragility of the gains made in fighting the disease. </description><body><![CDATA[LONDON 03 February 2012 (IRIN) - A new attempt to quantify malaria deaths over the past 30 years suggests the death toll, especially among adults, has been greatly underestimated. The figures also show the fragility of the gains made in fighting the disease.

  Collecting data on malaria deaths is notoriously tricky; the countries where the disease is most prevalent have the weakest statistics. And even where causes of death were recorded, the researchers found many deaths were simply attributed to “fever” – probably malaria, but possibly not. 

In addition, a malaria infection is often a contributory cause of death along with other health problems.  However, after some complicated number-crunching, researchers, based at the Institute for Health Metrics in Seattle, believe they have produced the best estimates so far of how many people in the world die of malaria.  

The figures, published in the London-based medical journal, The Lancet, http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60034-8/fulltext produced some surprises, principally because they are significantly higher than those issued last year by the World Health Organization (WHO) – more than eight times higher in the case of older children and adults in Africa, where most of the deaths occurred.

 The difference was smaller in the case of children under five, but the researchers said they believed malaria was a more important cause of death in under-fives than the 2011 World Malaria Report estimated, causing 24 percent of child deaths in Africa.  

Christopher Murray and his colleagues said they believed the fact that almost half a million extra deaths occurred in adults and older children each year had practical implications. “Traditional teaching in most medical schools argues that acquired immunity [in endemic areas] means that adults have clinical malaria, but are not likely to die from it.

 Inspection of the basic... data, however, clearly shows a substantial percentage of malaria deaths in individuals aged 15 years and over, even in endemic areas such as sub-Saharan Africa.”  In the light of this they suggest a shift of control strategies to pay more attention to all adults, not just women and children, in the distribution of insecticide-treated bed nets.  

The research also tracked malaria deaths through time, from 1980 to 2010. Global malaria deaths almost doubled between 1980 and 2004; child deaths in Africa almost tripled over the same period. The researchers suggest the HIV/AIDS epidemic and resistance to chloroquine as probable causes, along with an increase in population in malaria-endemic areas.  After that the number of deaths started to fall, although they are still not down to 1980 levels. 

The results of hard-fought campaigns, and the resources provided by the Global Fund to fight AIDS, Tuberculosis and Malaria, do show up in the figures. The authors say “the risk of malaria death in several countries that have scaled up control efforts, such as Zambia, Tanzania, Kenya and Ethiopia, has decreased between 2000 and 2010 figures”.  The reverses of the 1980s and 1990s signal the fragility of the gains in the war against malaria, and the researchers say this underscores the danger posed by the world economic crisis, and the slowdown in health funding. 

They conclude: “The announcement by the Global Fund [in November] that their next round of funding would be cancelled raises enormous doubts as to whether the gains in malaria mortality reduction can be built on or even sustained.”  Sarah Kline, executive director of Malaria No More UK, told IRIN this fragility of funding, especially from the Global Fund, was a big source of discussion and anxiety for the whole malaria community. 

“The total funding gap for malaria, from all sources, if we are going to meet our 2015 targets, is around US$3 billion a year, although we did have some positive announcements at Davos about extra funding from the Gates Foundation, and the governments of Saudi Arabia and Japan.”  The funding gap was also addressed by the Liberian President Ellen Johnson Sirleaf when she was elected to head the African Leaders' Malaria Alliance on 2 February, and urged African countries to step up their own funding for control campaigns and find innovative sources of finance to close the gap.  

eb/mw]]></body><pubDate>Fri, 03 Feb 2012 00:00:00 GMT</pubDate><link>http://www.irinnews.org/report.aspx?ReportId=94796</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://irinnews.org/images/2010/201011010851010191t.jpg"/></td><td valign="top">LONDON 03 February 2012 (IRIN) - A new attempt to quantify malaria deaths over the past 30 years suggests the death toll, especially among adults, has been greatly underestimated. The figures also show the fragility of the gains made in fighting the disease. </td></tr></table>]]></content:encoded></item><item><title>COTE D&apos;IVOIRE: Meningitis spreads as people scramble for vaccine</title><pubDate>Thu, 02 Feb 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://irinnews.org/images/2009/200904201848030218t.jpg" />]]>KORHOGO 02 February 2012 (IRIN) - Eleven people have died from meningitis out of 40 reported cases in four departments across Côte d’Ivoire as of 31 January, leaving people scrambling to access the vaccine for their families.</description><body><![CDATA[KORHOGO 02 February 2012 (IRIN) - Eleven people have died from meningitis out of 40 reported cases in four departments across Côte d’Ivoire as of 31 January, leaving people scrambling to access the vaccine for their families. 
 
The Ministry of Health has declared the outbreaks in the departments of Kouto and Tengrela in the north as epidemics, and is providing free vaccinations in both locations through mobile health teams, with the help of the World Health Organization and UNICEF. 
 
Bacterial and viral meningitis are diseases which cause inflammation in layers of the brain and spinal cord, and the former has a high fatality rate. 
 
Residents of also-affected Saminkro in the centre of the country and Kani in the centre-west must pay US$5 each for a vaccination, or $3 if they come forward as a group. Ivoirians in these departments - and in surrounding areas - are lobbying the Health Ministry to bring down prices as many cannot afford to raise enough money to vaccinate their families.
 
“It’s a question of economics,” Jeremie Ipo, director of the district health centre in the village of Poungbè in Korhogo region, told IRIN. “We can only reduce the price of the vaccine as soon as there are enough people demanding it.”
 
The government recently abandoned the provision of free health care for all because of skyrocketing costs. [ http://www.irinnews.org/report.aspx?reportid=94729 ] While birth deliveries and some immunizations for children under age six are still covered, meningitis is not included. 
 
Côte d’Ivoire is part of the meningitis belt of sub-Saharan Africa, which stretches from Senegal in the west to Ethiopia in the east. A 2009-2010 meningitis outbreak killed over 900 people and infected over 13,000 in Burkina Faso, Mali, Niger and Nigeria. 
 
oa/aj/cb

]]></body><pubDate>Thu, 02 Feb 2012 00:00:00 GMT</pubDate><link>http://www.irinnews.org/report.aspx?ReportId=94783</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://irinnews.org/images/2009/200904201848030218t.jpg"/></td><td valign="top">KORHOGO 02 February 2012 (IRIN) - Eleven people have died from meningitis out of 40 reported cases in four departments across Côte d’Ivoire as of 31 January, leaving people scrambling to access the vaccine for their families.</td></tr></table>]]></content:encoded></item><item><title>TANZANIA: Good results in programme to boost TB detection</title><pubDate>Wed, 01 Feb 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://irinnews.org/images/2011/201103231336000697t.jpg" />]]>ARUSHA 01 February 2012 (IRIN) - A pilot community programme to improve TB detection in northern Tanzania has shown good results and could be replicated nationwide as the country seeks to improve its TB treatment and prevention systems.</description><body><![CDATA[ARUSHA 01 February 2012 (IRIN) - A pilot community programme to improve TB detection in northern Tanzania has shown good results and could be replicated nationwide as the country seeks to improve its TB treatment and prevention systems. 

Tanzania has been battling TB for years, a struggle intensified by the parallel HIV epidemic; approximately 47 percent of new adult cases in the country are HIV-positive. Without proper treatment, about nine in 10 people living with HIV who become ill with active TB will die within two to three months, according to UNAIDS [ http://data.unaids.org/pub/PressRelease/2010/20100722_pr_tb_en.pdf ]. 

The programme, which ran from April to September 2011, systemized the way suspected TB cases were reported and handled. It encouraged healthcare professionals to work closely with community leaders to raise awareness of symptoms at every opportunity, such as at village meetings. It also used posters and slogans to make sure high-risk groups were aware of symptoms. This produced more patient referrals to health centres for diagnosis, treatment and follow-up care. 

Another crucial part of the TB pilot project was the creation of a "cough register" in each area, recording who was referred to a healthcare professional for further testing, by whom and the results of that referral. 

Management Science for Health collaborated with the NGO, PATH, and the National Tuberculosis and Leprosy Programme, with financial support from the US Agency for International Development, at 12 health facilities in northern Tanzania's Arusha and Meru district councils. A crucial tenet of the programme was emphasising that TB and HIV treatment must be done "hand in hand". 

Results 

"In both districts the standard operating procedure intervention has improved TB case notification in children and women," said Zahra Mkome, director, TB/HIV projects at PATH in Tanzania. "[It] improved team work, commitment, motivation of healthcare workers, awareness and involvement of communities in TB control activities." 

An evaluation comparing six months of TB case notification before and after the project showed a 54 percent increase in detection of TB in all forms in Meru, while in Arusha it increased by 117 percent. 

The standard operating procedure “rules” were used to provide clear and simple instructions to the health workers on how to improve TB case detection at different units and sections within health facilities, both outpatient and inpatient departments. Each area was provided with a plan and goals to implement their strategy, plus additional equipment to aid diagnosis such as paediatric score charts. Each area appointed a task force for TB treatment and these groups were encouraged to hold regular feedback meetings. 

Little data exists on the scale of the TB epidemic in Tanzania, and experts believe the records created by this system could prove a crucial tool in combating its spread and establishing where it is already most prevalent. 

One doctor based in a rural practice was particularly encouraged by the increased reporting of paediatric cases. He said some children suffering severe respiratory distress had been saved, "who in normal circumstances would have died". A number of the clinicians involved attributed an increase in notification of cases in the under-16 age group specifically to the wider use of paediatric diagnostic score charts. 

However, several challenges were flagged during the pilot: healthcare workers at Arusha's Selian Hospital said there was an urgent need to strengthen laboratory services to help confirm diagnoses; a lack of microscopes in labs and delays in issuing results were also highlighted. 

Challenges to scale-up 

Rolling out the rules on a national scale could also prove challenging as the majority of Tanzanians live in very rural areas and a poor road network means access to healthcare is limited. 

Mobile diagnosis and training centres that offer new methods of testing - for example, with the use of fluorescence microscopes [ http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001057 ] - could make diagnosis much faster and more accurate. 

"Patients in Tanzania often have to travel very long distances as most live in rural areas, which costs them money to travel every day and some are essentially too week to go on their own as a very large number are already suffering from the weakness that comes with HIV," said Alex Schulzer of the Novartis Foundation for Sustainable Development, which runs patient-centred TB programmes with the government. 

A shortage of medical professionals could also hinder the expansion of the programme; Schulzer recommended the use of lower cadre health workers and the community itself to fill gaps. The Novartis programme gives patients the choice to either take the daily treatment at a health facility under the supervision of a medical professional, or at home, supported by a family or community member. In the case of home-based treatment, the patient and treatment supporter are required to visit the health facility once a week during the two-month intensive phase to refill prescriptions and see a medical professional. 

Schulzer said the programme had created a system that gave patients "the freedom not to have to walk miles to the clinic every day. 

"We also needed to relieve some of the healthcare providers who cannot cope with such large patient numbers on a daily basis," he added. 

ah/kr/mw

]]></body><pubDate>Wed, 01 Feb 2012 00:00:00 GMT</pubDate><link>http://www.irinnews.org/report.aspx?ReportId=94771</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://irinnews.org/images/2011/201103231336000697t.jpg"/></td><td valign="top">ARUSHA 01 February 2012 (IRIN) - A pilot community programme to improve TB detection in northern Tanzania has shown good results and could be replicated nationwide as the country seeks to improve its TB treatment and prevention systems.</td></tr></table>]]></content:encoded></item><item><title>SOUTH AFRICA: Refugee children miss out on school</title><pubDate>Tue, 31 Jan 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://irinnews.org/images/2012/201201311400500759t.jpg" />]]>JOHANNESBURG 31 January 2012 (IRIN) - In the inner-city Johannesburg neighbourhood of Berea, where a large proportion of residents are refugees and asylum-seekers, it is not uncommon to see children playing football in the street or killing time at one of the local parks on a weekday. Judith Manjoro, an out-of-work teacher from Zimbabwe, teamed up with some other community workers two years ago to quiz the children about why they were not in school.</description><body><![CDATA[JOHANNESBURG 31 January 2012 (IRIN) - In the inner-city Johannesburg neighbourhood of Berea, where a large proportion of residents are refugees and asylum-seekers, it is not uncommon to see children playing football in the street or killing time at one of the local parks on a weekday. Judith Manjoro, an out-of-work teacher from Zimbabwe, teamed up with some other community workers two years ago to quiz the children about why they were not in school.

“They told us [the schools] asked them to produce ID documents and permits which they don’t have," she said. "We also found the parents weren't working and couldn't afford to pay school fees, even for public schools."

In early 2011, Manjoro and several other unemployed teachers from Zimbabwe and elsewhere, decided to start a project that would go some way towards meeting the need of local refugee and migrant children for affordable schooling with no bureaucratic strings attached. Word quickly spread and today iTemba Study Centre accommodates about 140 children in five cramped classrooms on the first floor of an office building in Berea. In the mornings the centre is open to pre-primary pupils and in the afternoons, seven volunteer teachers teach grades 1-8 using donated textbooks. 

"It's a good school, but we don't have enough supplies," said Duduzile Zulu, 15, from Zimbabwe, who started coming to the centre about a year ago after her mother's income as a waitress failed to cover the cost of her attending a nearby private school. To progress to Grade 9 she will need to transfer to another school, "but I don't have a birth certificate and my Mum can't get time off work to go to [the Department of] Home Affairs," she told IRIN, adding that she knew of other migrant children who did not attend school at all.

The UN Refugee Agency (UNHCR) released a report on refugee education in November 2011 [ http://www.unhcr.org/4ebd3dd39.html ] highlighting the limited access refugee children have to education, particularly at secondary levels and for those living in urban areas. 

Barriers

While the quality of education available in refugee camps varies, the difficulties of accessing education in urban settings are generally greater. In addition to legal and policy barriers and the often prohibitive costs of sending a child to a local school, the UNHCR report noted that: "refugee children often have less support than in a camp-based school in adjusting to a new curriculum, learning a new language, accessing psychosocial support, and addressing discrimination, harassment, and bullying from teachers and peers. They may also encounter a lack of familiarity by local school authorities for the processes of admitting refugee children and recognizing prior learning."

A year-long, yet-to-be published study by the Centre for Education Rights and Transformation at the University of Johannesburg into the rights of refugees, asylum-seekers and migrants to education in South Africa found that schools often demanded documents to enrol a child which are not legally required. 

"Often the students don’t have, according to the schools, the right papers," said Ivor Baatjes, one of the study researchers, adding that school principals and staff at public schools were often ignorant of South Africa's actual policy which grants every child the right to access education. "Even for children of undocumented migrants, children have the right to be in school and nothing should be a barrier," he told IRIN.

Demands that parents pay fees at government schools which have been designated as no-fee schools, create a further barrier, said Baatjes, especially for refugees who are often unaware of the law or of their rights. The study also found that those children who are admitted sometimes have to contend with xenophobic attitudes from both teachers and other pupils.

"They treat people equally here," commented Antonia Tshili, a 16-year-old from Zimbabwe, who left a government school last year after the fees became too much for her mother, and started attending iTemba. "At the other school there is this thing that Zimbabweans should go back to their country; they bullied me."  

UNHCR changes tack

Historically, UNHCR provided scholarships for refugee children to study in government or private schools in urban areas, but with nearly half of refugees now living in urban areas and only 4 percent of UNHCR's total budget in 2010 dedicated to education, this approach is no longer viable and the agency now prioritizes working with governments to advocate the integration of refugees into national school systems. 

In South Africa, UNHCR channels funding through local NGOs which educate refugees about their rights and school principals about their obligation to admit refugee children. Additional funding goes to helping refugee children with school books, uniforms and transport while a new approach, being piloted in Durban, is experimenting with donating lump sum contributions to inner-city government schools on the understanding that they will not turn away any refugee child seeking admission.  

"When you look at most of these schools, they host a number of under-privileged children, not only refugees, and the subsidy from government is not great," said Mmone Moletsane, UNHCR community services officer in South Africa. "While no child should be refused education because there’s no money, schools have to survive."

Despite such efforts by UNHCR and the NGO community, Baatjes said that centres like iTemba and a similar project based at Sacred Heart College in the nearby neighbourhood of Observatory, provided "a much needed space and service" to local migrant and refugee communities.

The donor-funded Three2Six Project at Sacred Heart College, now in its fifth year, uses classrooms vacated by the school's regular pupils during the afternoons, to teach refugee children up to Grade 6 level. The project also employs teachers who are refugees themselves and able to overcome language and cultural barriers.  

"While the parents are busy organizing their lives and trying to get papers from Home Affairs, the children come here," explained project coordinator Esther Oliver Munonoka. "The aim is not to keep the children here, but prepare them for proper school. By the time they leave, they can understand English and integrate into any school."

In reality, however, many of the students stay for as long as they can. Nzanga Kapena, 11, from the Democratic Republic of Congo (DRC), who has been coming to the Three2Six Project since 2008, said her mother could not afford "regular schools" and that she does not know what will happen next year when she finishes grade six and will have to leave. "My sisters and brother, when they left here, they just stayed at home," she said.  

Future uncertain

The future of iTemba and the Three2Six Project are also uncertain. Neither are recognized by the Department of Education or receive any public funding. The Three2Six Project receives enough donations from faith-based organizations in Europe that its 150 students can attend for free and are given uniforms, stationery and books, but is still not fully-funded for 2012 and will likely have to cut its Grade 6 class next year despite what Munonoka describes as an ever increasing need for its services.

iTemba charges those parents who can afford it R200 (US$26) a month to cover rental of the building and to pay teachers a small stipend, but according to Manjoro, "a number are failing to afford it."

"My aunt doesn't pay anything for me to come here," said Sarah Dube*, a 16-year-old from Zimbabwe, whose mother sent her and her sister to South Africa "to get a better education".

"I'd like to go to a proper school, but I don't trust myself that I can make it," she added. "I think I'm behind."

*Not her real name

ks/cb

]]></body><pubDate>Tue, 31 Jan 2012 00:00:00 GMT</pubDate><link>http://www.irinnews.org/report.aspx?ReportId=94766</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://irinnews.org/images/2012/201201311400500759t.jpg"/></td><td valign="top">JOHANNESBURG 31 January 2012 (IRIN) - In the inner-city Johannesburg neighbourhood of Berea, where a large proportion of residents are refugees and asylum-seekers, it is not uncommon to see children playing football in the street or killing time at one of the local parks on a weekday. Judith Manjoro, an out-of-work teacher from Zimbabwe, teamed up with some other community workers two years ago to quiz the children about why they were not in school.</td></tr></table>]]></content:encoded></item><item><title>CHAD: Why polio is so hard to eliminate</title><pubDate>Tue, 31 Jan 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://irinnews.org/images/2012/201201311204350177t.jpg" />]]>DAKAR 31 January 2012 (IRIN) - Poor-quality emergency immunization campaigns and low routine polio immunization coverage are helping the polio virus to spread in Chad, with 132 cases reported in 2011 - five times the number in 2010. More commitment is needed across the board, especially from local health authorities, to try to get immunizations right, say aid agencies.</description><body><![CDATA[DAKAR 31 January 2012 (IRIN) - Poor-quality emergency immunization campaigns and low routine polio immunization coverage are helping the polio virus to spread in Chad, with 132 cases reported in 2011 - five times the number in 2010. More commitment is needed across the board, especially from local health authorities, to try to get immunizations right, say aid agencies. 
 
The current outbreak in Chad has been ongoing since 2007, classifying Chad as a “re-established transmission zone” according to the World Health Organization (WHO). [ http://www.polioeradication.org/Dataandmonitoring/Poliothisweek.aspx ] Polio is endemic in Nigeria, Pakistan, India and Afghanistan - in other words, transmission of the disease in these places has never been broken. 
 
While a dysfunctional health system is linked to poor routine immunization coverage, “the primary reason [for the upsurge] is operational,” said Oliver Rosenbauer, spokesperson for the Global Polio Eradication Initiative at WHO in Geneva. “It is not to do with insecurity or lack of infrastructure… The outbreak response has not been sufficient to stop it [the outbreak]… They continue to miss too many children.”
 
Why children missed
 
Immunizers have missed children for a variety of reasons: In some cases government and agency staff or volunteers inaccurately mapped out where they lived; or may have ordered too few vaccines or too few ice packs to cover each district, said WHO. Often communities are not well-sensitized in advance so families remain reluctant to bring their children forward, some resist on religious grounds, or they simply may not know that they can immunize a child even if he or she is sick, said WHO and UNICEF’s West Africa communication for development specialist Irina Dincu.
 
Human error also plays a role, added Dincu, explaining that an ill-trained vaccinator may rest en route, breaking the cold chain, or a team may miss a few houses in a village. 
 
An outbreak of the polio virus would not spread so far if routine polio immunization coverage was better, said Rosenbauer. Polio immunizations are rigorous to administer: vaccinators must go house-to-house, and must give each child four doses over a 6-12 month period, reaching 90 percent of all children to eliminate polio, according to WHO. 
 
Coverage rates are estimated to be 60 percent at most in Chad, partly due to a poor-quality health system: Just 30 percent of health clinics are operational across the country; access to health care is poor; and routine immunization strategies are poorly planned. 
 
The godmother approach
 
To ensure fewer children are missed, immunizers need to make better use of “social data” to find out why and where a campaign is not working, says Dincu. Agencies used to take a purely medicalized approach to polio immunization but this has now changed. “Immunization campaigns are not just a medical intervention. You need to address campaigns from a medical, political and societal angle,” said Rosenbauer.
 
Social data has been used creatively in India and Nigeria to help vaccinators reach more children, according to UNICEF. In Nigeria’s Kebbi State households were assigned “godmothers” who came regularly pre-immunization day to discuss the disease and why vaccination was important. When poring over the data afterwards to find missed children, the “godmothers” could identify them by place, name and age, making them much easier to re-trace. 
 
These are the kinds of approaches that could be adopted in Chad, say practitioners, where despite its weak health system, polio should not be too challenging to control, says Rosenbauer. “We don’t face the same high-population challenges that we do in Nigeria, or insecurity as is the case of Afghanistan and Sudan. Here it is more a question of political and societal will.”
 
In his view, polio could be eliminated in six months if the government committed to doing so at all levels.
 
Government commitment
 
International efforts to combat polio are mounting: the Centers for Disease Control (CDC) [ http://www.cdc.gov/ ] has established an Africa-based emergency operations centre which will tackle public health crises, including polio.
 
Meanwhile, the Polio Eradication Initiative - made up of WHO, UNICEF, CDC, the Bill and Melinda Gates Foundation and the Rotary Foundation - has designated polio a “programmatic public health emergency” until eradication is achieved. 
 
The Chadian government appears to be taking polio seriously: President Idriss Déby has emphasized the importance of fighting it, and catalyzed the development of a six-month polio emergency action plan (which will then be renewed for a further six months). This includes targeting high-risk areas and analyzing what is and is not working. 
 
But commitment at the district and sub-district level in some parts of the country is weak, say aid agency staff. National authorities need to hold “sub-national” staff accountable for their performance, said Rosenbauer. “The virus doesn’t respect district boundaries so we need high commitment in every single one,” he told IRIN.
 
IRIN could not reach anyone in the Health Ministry for an interview.
 
Without local-level government commitment, elimination efforts will fail, says Rosenbauer. The number of cases in Nigeria rose from 21 to 57 between 2010 and 2011 partly due to local authorities focusing on presidential elections; while election-related violence also distracted from efforts to quash 36 cases that broke out in Côte d’Ivoire in 2011. 
 
And until polio is eliminated in Nigeria and in Chad, all West African countries are at high-risk, according to WHO. “There are immunization gaps in many countries - it can strike in the most unexpected places… that is why it is such a dangerous disease.”
 
aj/cb

]]></body><pubDate>Tue, 31 Jan 2012 00:00:00 GMT</pubDate><link>http://www.irinnews.org/report.aspx?ReportId=94769</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://irinnews.org/images/2012/201201311204350177t.jpg"/></td><td valign="top">DAKAR 31 January 2012 (IRIN) - Poor-quality emergency immunization campaigns and low routine polio immunization coverage are helping the polio virus to spread in Chad, with 132 cases reported in 2011 - five times the number in 2010. More commitment is needed across the board, especially from local health authorities, to try to get immunizations right, say aid agencies.</td></tr></table>]]></content:encoded></item><item><title>PAKISTAN: Disabled by the 2005 quake and still out of school</title><pubDate>Mon, 30 Jan 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://irinnews.org/images/2012/201201300958210387t.jpg" />]]>PESHAWAR 30 January 2012 (IRIN) - Jawad Khan, 15, spends most of his day at home in his village in the remote Battagram District of Khyber Pakhtoonkhwa Province (KP), sometimes glancing at a magazine, or occasionally helping his mother shell peas or cut up potatoes.</description><body><![CDATA[PESHAWAR 30 January 2012 (IRIN) - Jawad Khan, 15, spends most of his day at home in his village in the remote Battagram District of Khyber Pakhtoonkhwa Province (KP), sometimes glancing at a magazine, or occasionally helping his mother shell peas or cut up potatoes.
 
His three younger siblings spend their day in school, and Jawad, a top student in his grade till a year ago, assists them with revision and homework. He has himself refused to go to school for over a year as the new private school set up in the area lacks a ramp to accommodate his wheelchair.
 
Jawad lost both legs after he was trapped for over two hours under the rubble of his public school during the devastating quake of 2005 which killed at least 73,000 people in parts of KP (then known as the North West Frontier Province) and Pakistan-administered Kashmir.
 
That school is still to be built, and Jawad says he “feels too embarrassed” to be carried into his classroom. To add to his problems, his wheelchair, donated soon after his legs were amputated when he was nine, has also virtually fallen apart. “My family cannot afford a new one,” he told IRIN.
 
According to the UN Children’s Fund (UNICEF), the 2005 quake left 23,000 children disabled. [ http://reliefweb.int/node/269151 ] UNICEF itself is building “child friendly” [ http://www.unicef.org/pakistan/reallives_4676.htm ] schools across the quake zone, complete with facilities for the disabled, and last year opened 16 more such schools. [ http://tribune.com.pk/story/176113/improving-education-unicef-opens-16-schools-in-azad-kashmir/ ]
 
"At the Child Friendly Schools UNICEF is building, we try to mainstream disabled children. Ramps are provided when needed, but issues like access to schools for children in remote areas are huge ones,” Jan Madad, an education specialist at UNICEF, told IRIN.
 
But the 165 schools UNICEF has agreed to build cannot cater for the needs of all the quake-affected children.
 
According to the Earthquake Relief and Rehabilitation Authority, set up by the government immediately after the quake, 5,751 educational institutions damaged or destroyed by the quake needed to be reconstructed [ http://www.erra.pk/sectors/education.asp ]. Some 73 percent had been completed by the start of September 2011. Work continues on others, but this still means many children have lacked access to school. Some still do, while for the disabled it is sometimes impossible to go back to inaccessible classrooms.
 
Difficult terrain
 
Apart from school design, the terrain where the quake struck affects this. Ali Khan, now 12, lives in the Allai administrative unit of Battagram District. With his legs damaged during the quake, he can only hobble about on crutches. But the 4km walk down a steep mountain path to the school nearest his village is too arduous for him to make.
 
Ali, who once dreamt of becoming an engineer, told IRIN: “This is fate. I have to live with it, and I just help my father the best I can around our farm. This is all that is left for me know.”
 
Scattered across the quake zone, other children are in a similar situation. The 5km distance along a rickety path in her village near Bagh in Kashmir cannot be negotiated in the wheelchair used by Asma Sharif, 13, and she receives only occasional lessons at home from her uncle. “He is too busy to help any more, but at least I have kept up some of the studies I had begun before the quake,” Asma told IRIN from Bagh.
 
Zahoor Uddin, a doctor at the Islamabad-based Hashoo Foundation NGO, which has worked with quake victims since 2005, told IRIN: “The problems are exacerbated because wheelchairs wear out quickly in that terrain, and the victims have no funds to replace them.” In some cases he said tutors had been arranged for children unable to reach school.
 
Carried to school
 
The problems for many children are acute. “I have a nine-year-old pupil, Gul Muhammad, who is carried to school on his father’s back. His friends help him to the toilet, and the hard chairs are uncomfortable for him as he has a back problem. I feel sorry to see him and wish our school had better facilities,” said Alimuddin Ali, 35, a school teacher in Battagram. 
 
He told IRIN he knew of disabled children in other villages with no access to school - either because of distance or the way schools were designed. 
 
“I have read of education by radio in some areas of the world for children in remote communities. Perhaps we can use FM radio to offer them broadcasted lessons,” he suggested.
 
“The thing is these children need to go to schools. Radio can’t help them. My son is growing, I am getting older, and I worry about how long I can carry him to school,” said Gul’s father, Hakim Uddin.
 
kh/eo/cb

]]></body><pubDate>Mon, 30 Jan 2012 00:00:00 GMT</pubDate><link>http://www.irinnews.org/report.aspx?ReportId=94752</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://irinnews.org/images/2012/201201300958210387t.jpg"/></td><td valign="top">PESHAWAR 30 January 2012 (IRIN) - Jawad Khan, 15, spends most of his day at home in his village in the remote Battagram District of Khyber Pakhtoonkhwa Province (KP), sometimes glancing at a magazine, or occasionally helping his mother shell peas or cut up potatoes.</td></tr></table>]]></content:encoded></item><item><title>COTE D&apos;IVOIRE: Separated children yet to return home</title><pubDate>Mon, 30 Jan 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://irinnews.org/images/2012/201201301355140418t.jpg" />]]>MAN 30 January 2012 (IRIN) - Hundreds of children in Côte d’Ivoire were separated from their parents when people fled their villages during post-election violence in 2011, but nine months after the conflict formally ended only a quarter of those children have been reunified with their families, says the UN Children’s Fund (UNICEF).</description><body><![CDATA[MAN 30 January 2012 (IRIN) - Hundreds of children in Côte d’Ivoire were separated from their parents when people fled their villages during post-election violence in 2011, but nine months after the conflict formally ended only a quarter of those children have been reunified with their families, says the UN Children’s Fund (UNICEF).

Most are living with strangers who offered to take in the children. “I have difficulty supporting them but God is great,” said Brigitte Lahou, a subsistence farmer.
 
In March 2011, she took three separated children into her home outside Danané in western Côte d’Ivoire. One of the children - Doriane aged six - now has contact with her father and will be moving back home soon. However, the others - Davila, eight, and Junior, seven - have still not seen their parents since leaving home. 

“[Davila] lost her family along the road and can’t explain where she came from. She was crying when she arrived,” Lahou said from under a tree in front of her dilapidated wooden home.

UNICEF and its partners documented 686 children who were separated or unaccompanied in Côte d’Ivoire as a result of the 2011 conflict, in which one million people were displaced. One hundred and thirty-seven have been reunified and 60 have returned on their own, their records show.

A UN Weekly Situation Report for 9-18 January, compiled by the UN Office for the Coordination of Humanitarian Affairs, also shows that by mid-January, some 1,600 unaccompanied and separated children were still living in refugee camps in Liberia’s Nimba and Grand Gedeh [ http://www.irinnews.org/report.aspx?reportid=93419 ] counties. Some 128,000 refugees remain in Liberia [ http://www.irinnews.org/report.aspx?reportid=93417 ].

Barriers to reunification

The reunification of children requires people on the ground to do the tracing, to do the reunification, and others who can go to the most isolated rural zones. “We still have reports of families living in the forested area along the Liberian border. This is all posing a challenge for reunification,” said Christina de Bruin, deputy head of UNICEF Côte d’Ivoire.

UNICEF and partners Save the Children, International Rescue Committee and Caritas Côte d’Ivoire also had limited access to the region for months following the capture of former President Laurent Gbagbo in April 2011. 

“The continuous volatile security situation hampered access and hampered the research,” de Bruin said. 

In addition, the area where children were separated is vast and many of the villages are isolated. Finding the families of very young children poses special challenges. “There are cases where we don’t have any information about the families,” said Irene Capet, an emergency response coordinator with Caritas Côte d’Ivoire.

At Sainte Philomene Orphanage in the western city of Man, Capet stands over a group of children who are too young to explain where their villages are, their parents’ names, or even their own.

“We don’t know her real name, but we call her Juliana,” said Capet, pointing to a toddler sitting alone on a plastic mat playing with a spoon, her head bandaged from a fall at the orphanage.

In April, “Juliana” was found following a group of people fleeing killings in Bloléquin, an Ivoirian town about 40km east of the Liberian border. No one in the group knew from where she had come. When she arrived at the orphanage, she showed signs of acute trauma. Capet said the girl did not talk for three months and had lost most of her hair. Efforts to locate the child’s family members - by posting her photos in camps for the displaced and disseminating messages through other NGOs - have failed. 

“We have no idea where her parents are,” Capet said.

Best interests of the child

In some cases, organizations charged with reunification establish contact between a child and his or her parents, but contact does not result in automatic reunification. 

“A key principle for UNICEF is the best interest of the child so we will not force reunification if it is not in the best interest of the child,” de Bruin said.

Determining what is best for each child requires specialists. Red Cross volunteers, in close coordination with the International Committee of the Red Cross, [ http://www.icrc.org/fre/where-we-work/africa/cote-d-ivoire/index.jsp ] have been very involved in reunification.

"When we manage to trace the parents, we ask them if they want us to repatriate their children; then we ask the children if they agree to return to their parents," Albert Jamah, charged with restoring family links for the ICRC in Liberia, said in a January statement. "Every family must meet the best interests of the child."

With the displaced returning to their villages and continued improvements in security, it may be easier to reunify children now. “The program will be scaled up and accelerated in coming months,” says de Bruin.

lb/oss/cb

]]></body><pubDate>Mon, 30 Jan 2012 00:00:00 GMT</pubDate><link>http://www.irinnews.org/report.aspx?ReportId=94757</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://irinnews.org/images/2012/201201301355140418t.jpg"/></td><td valign="top">MAN 30 January 2012 (IRIN) - Hundreds of children in Côte d’Ivoire were separated from their parents when people fled their villages during post-election violence in 2011, but nine months after the conflict formally ended only a quarter of those children have been reunified with their families, says the UN Children’s Fund (UNICEF).</td></tr></table>]]></content:encoded></item><item><title>COTE D&apos;IVOIRE: Government scraps free health care for all</title><pubDate>Thu, 26 Jan 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://irinnews.org/images/2012/201201261102520386t.jpg" />]]>ABIDJAN 26 January 2012 (IRIN) - Côte d&apos;Ivoire is abandoning free health care for all after a brief experiment because of skyrocketing costs.</description><body><![CDATA[ABIDJAN 26 January 2012 (IRIN) - Côte d'Ivoire is abandoning free health care for all after a brief experiment [ http://www.irinnews.org/report.aspx?reportid=93290 ] because of skyrocketing costs. 
 
“In nine months the government had to pay 30 billion CFA francs [about US$60 million] under difficult circumstances," Ivoirian Health Minister Yoman N'dri said in Abidjan on 24 January.
 
As of February, the free service would only be available to mothers and their children. Specifically, this will mean free care for deliveries and free treatment for diseases affecting children under six years old. Consultation fees would drop from 1,000 CFA francs to 650 francs CFA ($2-1.5).
 
Aid organizations say the government move is understandable given the country’s recent political turmoil. "As long as women and children continue to receive care we are satisfied because they are among the most vulnerable," said Louis Vigneault-Dubois, head of communications for the UN Children’s Fund (UNICEF) in Côte d'Ivoire.
 
"Women and children are often exposed to diseases and with so many families living in poverty this is already a major problem solved for them,” said Zana Sanogo, executive director of Community Health and Development, a local NGO collaborating with the UN Office for the Coordination of Humanitarian Affairs.
 
Theft, poor management and rising costs have made the service - introduced by President Alassane Ouattara’s government at the end of civil conflict to ease a dire public health situation - unaffordable. 
 
Health Minister N’dri said implementation of the service had been poorly planned, and the Public Health Pharmacy, the state’s central body for distribution of medical supplies throughout the country, had just 30 percent of its required stock, much of which had been pilfered.
 
"From the start some nurses and doctors, under the pretext of providing free health care, had been taking drugs home which they would then sell,” said Florantin Yao, staff nurse at the government-run Port-Bouët General Hospital in the south of Abidjan.
 
The Ministry of Health says 20 doctors and nurses have been “severely punished”. One received a two-year prison term. 

Community health analyst and consultant Issouf Ouattara said free health care would have been more viable had health authorities spellt out details of the policy. "We fear that practitioners and patients continue to misunderstand the free health care policy. Medical consultation and drugs should be free,” he added.
 
aa/oss/cb

]]></body><pubDate>Thu, 26 Jan 2012 00:00:00 GMT</pubDate><link>http://www.irinnews.org/report.aspx?ReportId=94729</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://irinnews.org/images/2012/201201261102520386t.jpg"/></td><td valign="top">ABIDJAN 26 January 2012 (IRIN) - Côte d&apos;Ivoire is abandoning free health care for all after a brief experiment because of skyrocketing costs.</td></tr></table>]]></content:encoded></item><item><title>AFRICA: High cost of child trafficking</title><pubDate>Wed, 25 Jan 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://irinnews.org/images/2012/201201250915460081t.jpg" />]]>POINTE NOIRE 25 January 2012 (IRIN) - Forced child labour remains rampant in Central Africa, where poverty fuels the trafficking of children from poorer countries to oil-rich states such as Gabon, Equatorial Guinea and the Republic of Congo, according to experts.</description><body><![CDATA[POINTE NOIRE 25 January 2012 (IRIN) - Forced child labour remains rampant in Central Africa, where poverty fuels the trafficking of children from poorer countries to oil-rich states such as Gabon, Equatorial Guinea and the Republic of Congo, according to experts.

“Trafficking in children is real,” said Gabon’s social affairs director-general, Mélanie Mbadinga Matsanga. 

“Gabon, for example, is considered an Eldorado and draws a lot of West African immigrants who traffic children.” Matsanga was speaking at a conference on preventing child trafficking held in Congo’s southern city of Pointe Noire.

The meeting was attended by delegates from Cameroon, the Democratic Republic of Congo (DRC), Equatorial Guinea and Gabon. Gabon is primarily a destination and transit country for children and women, who are subjected to forced labour and sex trafficking; boys are forced to work as street hawkers or mechanics, states the US State Department’s human trafficking report for 2011. [ http://www.state.gov/documents/organization/164454.pdf ] 

Child trafficking is defined by the Protocol to Prevent, Suppress and Punish Trafficking in Persons, Especially Women and Children [ http://www.unodc.org/unodc/en/treaties/CTOC/index.html#Fulltext ] as the recruitment, transportation, transfer, harbouring or receipt of children for the purpose of exploitation. This definition is especially important in West and Central Africa where it often occurs with the consent of the parents and sometimes, of the children themselves, notes a UN Children’s Fund (UNICEF) report [ http://www.unicef-irc.org/publications/pdf/insight7.pdf ]. 

But a “near total absence of data” on the scope of the problem prevents media coverage of the issue, which is essential in influencing public opinion, noted the 2002 UNICEF report. A decade later, the problem persists. “It is hard to count the number of children [affected]. It is even difficult to talk [about them] because their attitude shows that [the children] themselves are convinced that the work they are forced to do is not normal,” Marianne Flach, UNICEF’s representative in the Congo, told IRIN.  

“The parents in the countries of origin do not even know what happens to their children in the countries of destination,” added Flach. 

Children and their families are ensnared by the empty promises of a better life, leading to the smuggling across borders every year of hundreds of thousands of children, denying them education, health, the right to grow up within a family and to protection from exploitation and abuse, say experts. 

Kidnapping on the rise 

In Cameroon, says the State Department report, trafficking operations usually target two or three children, such as when rural parents hand over their children to a middleman promising education or a better life in the city. 

But traffickers there are increasingly kidnapping their victims, as heightened public awareness means parents are giving away fewer of their children to middlemen.  

“Trafficking is nothing but abuse,” Marcelline Pambou Loubondo of the NGO Movement of Mothers for Peace, Solidarity and Development, told IRIN.  “The traffickers are looking for a better life. They want to get rich very fast, which is why they employ children.” 

The children are often forced to engage in petty trade day and night, lest they are beaten up, added Loubondo. 

The presence of local and foreign armed groups also poses a threat to children’s rights, as do burgeoning oil and mineral sectors. In the DRC, for example, armed groups continue to abduct and forcibly recruit men, women and children as combatants, labourers and sex slaves.  

A significant number of unlicensed Congolese artisanal miners – men and boys – are also exploited in situations of debt bondage by businessmen and supply dealers from whom they acquire cash advances, tools, food, and other provisions at inflated prices, and to whom they must sell the mined minerals at below-market prices, notes the State Department report.   

In Equatorial Guinea, children “…are believed to be exploited in Malabo and Bata where a burgeoning oil industry creates demand for cheap labour and commercial sexual exploitation”. 

According to delegates at the conference, source and destination countries need to form bilateral accords given the trans-border nature of trafficking. 

Weak law enforcement  

At present, those involved in human trafficking are not systematically targeted by law enforcement officials even as trafficking seems to undergo a “seemingly uncontrollable rapid expansion”, noted Congo’s Social Affairs Minister, Emilienne Raoul. 

In Gabon too, according to the US State Department report, the lack of enforcement of counter-trafficking laws has meant there have been no convictions, despite the arrest of more than 68 suspected trafficking offenders between 2003 and 2010. 

While trafficking is often associated with clandestine migration, the merging of these two issues has serious consequences, with trafficked children seen as young offenders rather than victims in need of special protection measures, notes the International Organization for Migration. 

“Human trafficking is a form of migration particularly detrimental to human rights,” added Robert Kotchani, a UN human rights official. 

But, “in the same manner that slavery ended, human trafficking can equally end”, said Viviane Tchignoumba Mouanza, a magistrate and president of the association of female jurists in the Congo. “It is a problem with the mentality, sensitization and reach of the law.”  

lmm-aw/mw

]]></body><pubDate>Wed, 25 Jan 2012 00:00:00 GMT</pubDate><link>http://www.irinnews.org/report.aspx?ReportId=94721</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://irinnews.org/images/2012/201201250915460081t.jpg"/></td><td valign="top">POINTE NOIRE 25 January 2012 (IRIN) - Forced child labour remains rampant in Central Africa, where poverty fuels the trafficking of children from poorer countries to oil-rich states such as Gabon, Equatorial Guinea and the Republic of Congo, according to experts.</td></tr></table>]]></content:encoded></item><item><title>SOUTH SUDAN: Nyaluak Deng Awuol, “This child, who will look after him now?”</title><pubDate>Mon, 23 Jan 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://irinnews.org/images/2012/201201231001550169t.jpg" />]]>JUBA 23 January 2012 (IRIN) - Nyaluak Deng Awuol is caring for her orphaned nephew, five-year-old Ajai Mawut Garang, who is recovering from a gunshot wound in Juba hospital. He was injured along with dozens more in the latest revenge attack in South Sudan’s Jonglei state, which the government said killed more than 80 people in the town of Duk Padiet, Duk County.</description><body><![CDATA[JUBA 23 January 2012 (IRIN) - Nyaluak Deng Awuol is caring for her orphaned nephew, five-year-old Ajai Mawut Garang, who is recovering from a gunshot wound in Juba hospital. He was injured along with dozens more in the latest revenge attack in South Sudan’s Jonglei state, which the government said killed more than 80 people in the town of Duk Padiet, Duk County.  

Government and UN forces have failed to quell the ethnic violence that has reached a dramatic peak in recent weeks as a militia of up to 8,000 youths from the Lou Nuer, joined by some Dinka, attacked the minority Murle, exacting revenge for a long-standing vendetta over cattle that has turned increasingly deadly [ http://www.irinnews.org/report.aspx?reportid=94673 ].  

Aid agencies and authorities in the newly independent nation, whose euphoric birth just six months ago united the nation after decades of civil war with Sudan, are increasingly concerned at the violent nature of attacks that have left mainly women, children and the elderly among the dead and injured as they could not run from attackers. Nyaluak Deng Awuol spoke to IRIN about her experience: 

“This child is my sister’s. She was killed in the attack with her other three children. 

“The Murle came and attacked the people. When they attacked, we escaped while they killed all the others. 

“They shot people with guns and killed people with knives. When they shoot someone and they are still alive, they have to finish them with a knife. 

“I have seen many people die, including my sister. “Those with children were killed. If you had three to four children, you could not run fast. Those without children could run faster, so those with several children died, and the old people. 

“I found my sister dead and this one child alive. 

“His mother had been killed with three children, and when I went looking for them, this one was still alive and sitting up, looking for someone. 

“The village has been burnt down and the people have been scattered. Even until now some people cannot be traced - it is a very big trouble. 

“They have killed people and they have stolen herds of cattle. “There is no protection - people in the village do not have guns, so they [attackers] just came in and killed people and took everything. “Those who attacked Duk Padiet are Murle army - they are the soldiers wearing the green uniform; it is revenge. 

“The ones who remain will die with anger. Some of them have even had their clothes taken. “People from my village are too weakened to [take] revenge. So many are dead. It is up to the government to think and act now. “But this child, who will look after him now?” 

hm/mw

]]></body><pubDate>Mon, 23 Jan 2012 00:00:00 GMT</pubDate><link>http://www.irinnews.org/report.aspx?ReportId=94704</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://irinnews.org/images/2012/201201231001550169t.jpg"/></td><td valign="top">JUBA 23 January 2012 (IRIN) - Nyaluak Deng Awuol is caring for her orphaned nephew, five-year-old Ajai Mawut Garang, who is recovering from a gunshot wound in Juba hospital. He was injured along with dozens more in the latest revenge attack in South Sudan’s Jonglei state, which the government said killed more than 80 people in the town of Duk Padiet, Duk County.</td></tr></table>]]></content:encoded></item><item><title>SRI LANKA: Tea rich but nutrient poor</title><pubDate>Fri, 20 Jan 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://irinnews.org/images/2012/201201191510030565t.jpg" />]]>COLOMBO 20 January 2012 (IRIN) - Tea in Sri Lanka is one of the country&apos;s biggest cash crops, but families working on tea estates are among the nation&apos;s poorest in terms of earnings as well as nutrition, say experts who back regional approaches to tackle nutrition disparity.</description><body><![CDATA[COLOMBO 20 January 2012 (IRIN) - Tea in Sri Lanka is one of the country's biggest cash crops, but families working on tea estates are among the nation's poorest in terms of earnings as well as nutrition, say experts who back regional approaches to tackle nutrition disparity. One in every five children younger than five is malnourished nationwide and one in six newborns has a low birth weight, one cause of infant deaths, according to a recent study from the Colombo-based Institute of Policy Studies (IPS). [ http://www.ips.lk/research/highlights/highlight_archive/2011/december/policy_brief_english.pdf ]

But the situation is worse for children of tea estate workers, with one in three classified as underweight and 40 percent of babies born with too-low weight, IPS noted.  

Ramasamy Ramakrishnan, 46, a tea estate worker and father of five, and his wife, who is also a tea harvester, earn US$130 monthly to support a family of seven, including five school-aged children. "It is difficult. We survive somehow. But I cannot find any other job," he told IRIN.  

His family is among the one-and-a-half million people - or some 5 percent of Sri Lanka's 21 million population - who work in the tea sector, according to government estimates. The most recent national poverty study conducted in 2009-2010 noted that 11.4 percent of these families lived below the national poverty line of 3,028 Sri Lankan rupees per month, or roughly $27. [ http://www.statistics.gov.lk/poverty/PovertyIndicators2009_10.pdf ]  

Income nutrition cycle  

Household income plays a major role in determining nutrition levels of under-fives, with those among the country's poorest 20 percent three times more likely to be malnourished as those in the richest quintile, noted IPS.  

In the government's most recent demographic and health survey (DHS) conducted in 2006-2007 [ http://www.statistics.gov.lk/social/DHS%20200607%20FinalReport.pdf ] some 17 percent of under-fives surveyed were stunted - a sign of chronic malnutrition and lack of nutrients.  

Nuwera Eliya District - 150km south of the economic capital of Colombo - and the adjoining Badulla District, which both have large tea plantations, recorded the highest stunting rates nationwide that year, 44 and 33 percent respectively.  

Angela de Silva, a lecturer at the University of Colombo's Faculty of Medicine and vice-president of the Nutrition Society of Sri Lanka [ http://www.nutritionsocietysrilanka.com/ ] said poverty and poor living conditions created an inter-generational cycle of malnutrition.  

"The disadvantaged kid grows up to be a disadvantaged mother, often with early marriage, teenage pregnancies or starting off pregnancy with both micro- and macro-nutrient malnutrition; in turn she has a low birth-weight baby and poor pregnancy outcomes."  

Regional approaches  

Sri Lanka's government has programmes that promote exclusive breastfeeding in the baby's first six months [ http://www.irinnews.org/report.aspx?reportid=85570 ] - recommended by the World Health Organization to boost a child's lifelong nutrition - and provide nutrients and supplements to vulnerable populations, including pregnant women, breastfeeding mothers and infants, in government clinics.  

There are plans to "fine-tune" this breastfeeding promotion to target regions where malnutrition is high, said De Silva.  

Education levels and mothers' knowledge about basic healthcare play a major part in determining their children's nutrition levels, said Kumari Navaratna, a senior health specialist at the World Bank's Colombo office.  

"The primary caregiver for a child is the mother and evidence again and again is showing that if the mother is knowledgeable on appropriate feeding and caring practices, she is able to provide the best care to the child."  Regional targets  

The Nutrition Society of Sri Lanka and Ministry of Health have advised taking into account regional economic and nutrition disparities as well as varying knowledge levels when tackling malnutrition. [ http://www.icmr.nic.in/ijmr/2009/november/1121.pdf ]  

Since May 2011 the government's National Nutrition Council has established a multi-sectoral pilot project in areas with high malnutrition, including Nuwera Eliya District.  

District health, agriculture and livestock departments are designing regional nutrition interventions, including growth monitoring programmes and child-friendly clinics.  

Government welfare policies dating back to independence in 1948 have largely failed to achieve long-term nutrition improvements, said Muttukrishna Sarvananthan, head of the Point Pedro Institute of Development [ http://pointpedro.org/ ] in Sri Lanka and research fellow at Monash University in Australia.  

"Government welfare policies should focus on the quality of outputs rather than the quantity of inputs, which has been the case hitherto."  To tackle malnutrition, policies have focused on handouts, such as nutritional supplements, without considering vulnerable groups' needs separately, or policy efficacy, said Sarvananthan.  

ap/pt/mw

]]></body><pubDate>Fri, 20 Jan 2012 00:00:00 GMT</pubDate><link>http://www.irinnews.org/report.aspx?ReportId=94685</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://irinnews.org/images/2012/201201191510030565t.jpg"/></td><td valign="top">COLOMBO 20 January 2012 (IRIN) - Tea in Sri Lanka is one of the country&apos;s biggest cash crops, but families working on tea estates are among the nation&apos;s poorest in terms of earnings as well as nutrition, say experts who back regional approaches to tackle nutrition disparity.</td></tr></table>]]></content:encoded></item><item><title>In Brief: 40,000 Rohingya children in Myanmar unregistered</title><pubDate>Thu, 19 Jan 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://irinnews.org/images/2008/200810267t.jpg" />]]>BANGKOK 19 January 2012 (IRIN) - An estimated 40,000 Rohingya children are believed to be unregistered in Myanmar, according to a new report.</description><body><![CDATA[BANGKOK 19 January 2012 (IRIN) - An estimated 40,000 Rohingya children are believed to be unregistered in Myanmar, according to a new report [ http://www.burmalibrary.org/docs12/AP-CRCMyanmar-12-01.pdf ].  

"Despite recent reform efforts in Myanmar, the government has reaffirmed its deeply discriminatory policies against the Rohingya, and the children bear the brunt of this," Chris Lewa, director of The Arakan Project and author of the report, told IRIN before a session of the UN Committee on the Rights of the Child in Geneva on 19 January.  

These include the requirement of government authorization for marriage and a "two-child policy". These restrictions have made children "evidence" of unregistered marriages, an act punishable with up to 10 years in prison, while third and fourth children who are unregistered are essentially "blacklisted" for life - unable to travel, attend school or marry.  

Under Myanmar's 1982 citizenship law, Rohingya children - both registered and unregistered - are stateless and hence, face limited access to food [ http://www.irinnews.org/report.aspx?reportid=83733 ] and healthcare, leaving them susceptible to preventable diseases and malnutrition. Many are prevented from attending school and used for forced labour [ http://www.irinnews.org/report.aspx?reportid=88240 ], contributing to a Rohingya illiteracy rate of 80 percent. More than 60 percent of children aged between five and 17 have never enrolled in school, the report said.  

or/ds/mw

]]></body><pubDate>Thu, 19 Jan 2012 00:00:00 GMT</pubDate><link>http://www.irinnews.org/report.aspx?ReportId=94672</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://irinnews.org/images/2008/200810267t.jpg"/></td><td valign="top">BANGKOK 19 January 2012 (IRIN) - An estimated 40,000 Rohingya children are believed to be unregistered in Myanmar, according to a new report.</td></tr></table>]]></content:encoded></item><item><title>TANZANIA: Good progress in male circumcision campaign</title><pubDate>Wed, 18 Jan 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://irinnews.org/images/2010/201011021334300722t.jpg" />]]>DAR ES SALAAM 18 January 2012 (IRIN) - The demand for medical male circumcision is growing among Tanzania&apos;s non-circumcising communities, and officials say the country is on track to surpass its goal of reaching 2.8 million men by 2015.</description><body><![CDATA[DAR ES SALAAM 18 January 2012 (IRIN) -  The demand for medical male circumcision is growing among Tanzania's non-circumcising communities, and officials say the country is on track to surpass its goal of reaching 2.8 million men by 2015.  

 "The response is good and encouraging. Government and health officials are very cooperative," said Charles Wanga, a communications officer with Jhpiego [ http://www.jhpiego.org ], an NGO affiliated with Johns Hopkins University that is working with the government to roll out the programme in Iringa, a region in the southern Tanzanian highlands.  

 An estimated 67 percent of Tanzanian men are circumcised, but prevalence varies from region to region; in some parts of western Tanzania, circumcision levels are as low as 20 percent.  The programme - launched [ http://www.irinnews.org/report.aspx?reportid=91849 ] in 2011 - aims to circumcise 2.8 million males aged between 10 and 34 within five years. It focuses on seven regions in western Tanzania where levels of male circumcision are particularly low: Iringa, Kagera, Mar, Mwanza, Rukwa, Shinyanga and Tabora.  

 Wanga told PlusNews that the project aimed to circumcise 260,000 men and boys in Iringa by 2015; the first phase, which ended in December 2011, was expected to cover 20,000.  

 "Up to September [2011], 30,000 men and boys were circumcised under the programme, which reflects success of 150 percent," he said.  

 According to Jhpiego, most of those volunteering for male circumcision in Iringa are adolescent boys and unmarried men; older, married men have been more reluctant to come forward.  Just 38 percent of Iringa men are circumcised; the region has an HIV prevalence rate of 15.7 percent - about three times the national average.  

 In the northwestern region of Kagera, more than 13,000 men and boys underwent circumcision between 2010 and 2011, according to Songoro Biki, an official with the NGO, International Centre for AIDS Prevention, which is supporting male circumcision in the area.  

 "The response to the campaign is quite promising as more people were showing up voluntarily for the 'cut'; we expect to reach over 300,000 by 2015," he said.  

 He said the service was being provided at the Bukoba Regional hospital and Rubya hospital, in Muleba district, adding that plans were under way to provide the service at Maruku and Izimbya Wards, in Bukoba Rural district.  

 The programme - supported by the Tanzanian government, the US government and the Global Fund to fight AIDS, Tuberculosis and Malaria - provides the service free of charge; male circumcision usually costs US$10-17. Tanzania has also trained nurses to perform the procedure, as the country has a shortage of doctors.  

 Three randomized controlled trials in Kenya, South Africa and Uganda provided evidence [ http://www.plusnews.org/report.aspx?reportid=62729 ] that male circumcision can reduce a man's risk of becoming infected with HIV through heterosexual intercourse by as much as 60 percent.  

 According to the UN World Health Organization [ http://whqlibdoc.who.int/publications/2011/9789241502511_eng.pdf ], Tanzania needs to circumcise some 1,373,271 men in order to achieve 80 percent prevalence, which would potentially avert 200,000 new HIV infections within five years.  

jk/kr/mw

]]></body><pubDate>Wed, 18 Jan 2012 00:00:00 GMT</pubDate><link>http://www.irinnews.org/report.aspx?ReportId=94667</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://irinnews.org/images/2010/201011021334300722t.jpg"/></td><td valign="top">DAR ES SALAAM 18 January 2012 (IRIN) - The demand for medical male circumcision is growing among Tanzania&apos;s non-circumcising communities, and officials say the country is on track to surpass its goal of reaching 2.8 million men by 2015.</td></tr></table>]]></content:encoded></item><item><title>ETHIOPIA: Drought, floods hit education</title><pubDate>Wed, 18 Jan 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://irinnews.org/images/2012/201201181247390096t.jpg" />]]>ADDIS ABABA 18 January 2012 (IRIN) - Parts of Ethiopia are still reeling from the effects of recent drought, flooding, conflict or a combination of the three, resulting in increased numbers of children dropping out of school, say officials.</description><body><![CDATA[ADDIS ABABA 18 January 2012 (IRIN) - Parts of Ethiopia are still reeling from the effects of recent drought, flooding, conflict or a combination of the three, resulting in increased numbers of children dropping out of school, say officials. 

At least 385,000 school-children need "emergency education assistance this school year", Alexandra Westerbeek, the UN Children’s Fund (UNICEF) communication manager in Ethiopia, told IRIN. 

"In addition, 70,000 children among [the] refugee population also need emergency education assistance."  

Parts of the affected regions of Afar, Amhara, Benishangul-Gumuz, Diredawa, Gambella, Harar, Oromia, Somali Region, Southern Nations, Nationalities and People's Region (SNNPR) and Tigray are under-developed and suffer chronic emergencies.    

According to Mohamed Abubeker, head of the special support and inclusive education office at the Ministry of Education, the Afar and Somali regions were the most affected. 

"Between June and July 2011, the drop-out rate had reached 50 percent in some of these areas, although it is now showing a stabilizing trend," Abubeker said. 

A number of formal and alternative basic education schools have also been damaged by wind storms.  

The alternative schools are non-formal programmes for children aged seven to 14, enabling pupils in pastoral areas to cover the equivalent of the first four grades of primary school in three years before transitioning into formal schools. 

“Food for education” 

The school-feeding programme is helping to draw pupils back to school, according to Abubeker. In an e-mail to IRIN, Melese Awoke, the UN World Food Programme (WFP) spokesperson, said WFP and partners were trying to secure additional funding to expand the “food for education” intervention. 

At present, WFP is assisting at least 625,000 children in 1,186 schools in six of the regions. But the WFP intervention is under-funded, according to Melese. 

Funding for emergency education was also a major gap in the humanitarian response from mid-2011, according to UNICEF, which noted that "the challenge for 2012 is to design more flexible programmes which are able to respond to the changing educational needs, whatever they are". 

Newer approaches are needed to tackle the problem. "The severity of the drought has caused different [types] of migration," said Arlo Kitchingman, the education cluster coordinator of the Inter-Agency Network for Education in Emergencies.  

"The longer students are out of school, research and experience suggests, the more likely they are not to return..." 

Kitchingman recommended "making the school calendar more flexible to accommodate pastoralists and nomadic movement with the intention that the school year doesn’t fall when the drought is most severe". 

If the school year followed such a pattern, he said, "It wouldn’t matter if children are migrating or moving to different areas, it won’t affect their academic calendar."

bt/aw/mw

]]></body><pubDate>Wed, 18 Jan 2012 00:00:00 GMT</pubDate><link>http://www.irinnews.org/report.aspx?ReportId=94669</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://irinnews.org/images/2012/201201181247390096t.jpg"/></td><td valign="top">ADDIS ABABA 18 January 2012 (IRIN) - Parts of Ethiopia are still reeling from the effects of recent drought, flooding, conflict or a combination of the three, resulting in increased numbers of children dropping out of school, say officials.</td></tr></table>]]></content:encoded></item><item><title>GLOBAL: Fighting for the rights of child soldiers</title><pubDate>Tue, 17 Jan 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://irinnews.org/images/2012/201201170934140626t.jpg" />]]>NAIROBI 17 January 2012 (IRIN) - At end-November 2011, Somalia and the Central African Republic became the latest countries to commit to end the use of child soldiers – a move seen as “encouraging” by the UN, albeit with the proviso that the situation in both countries remains volatile.</description><body><![CDATA[NAIROBI 17 January 2012 (IRIN) - At end-November 2011, Somalia and the Central African Republic became the latest countries to commit to end the use of child soldiers – a move seen as “encouraging” by the UN, albeit with the proviso that the situation in both countries remains volatile.

All sides to the Somali conflict have reportedly been recruiting children. An official working with an NGO that monitors the state of children in the country told IRIN [  http://www.irinnews.org/report.aspx?reportid=92249   ] that although the exact number of child soldiers was unknown, his group suspected between 2,000 and 3,000 children were in different armed groups.

Up to 300,000 children are still involved in more than 30 conflicts worldwide, according to the UN Children’s Fund (UNICEF) [ http://www.unicef.org/emerg/files/childsoldiers.pdf  ].

In April 2011, the UN listed dozens of groups that continued to recruit or use children in its annual report on children and armed conflict [ http://www.un.org/children/conflict/_documents/S2011250.pdf ] . This bid to “name and shame” countries into cooperating with the law has only a limited effect, however. While fewer children are being used as child soldiers today, it is thanks to conflicts having ended, not the practice of recruiting and using children.

“Despite some examples of progress, the bigger picture remains essentially unaltered: the recruitment and use of boys and girls by armed groups remains widespread,” according to the latest report by the Coalition to Stop the Use of Child Soldiers in 2008 [ http://www.childsoldiersglobalreport.org/ ].

Gender is no protection, as girls are recruited into armed groups or abducted for forced labour or sex. Age also proved no barrier; in Columbia, the FARC militia announced it would recruit all children over the age of eight, reported the UN Secretary-General in April 2011: “In one characteristic use of children, a child was used by FARC-EP to carry out an attack against a police station using explosives. The explosives were attached to the child and activated as he approached the police station, killing him instantly.” [ http://www.un.org/children/conflict/english/colombia.html ]

Defenceless

“Many children have few alternatives to, or defences against, joining armed groups,” states the 2008 Coalition report. It cited poverty, discrimination and social exclusion, lack of access to education, and limited job prospects as some of the factors pushing minors to join armed groups.

Not all children associated with armed forces are used as fighters. Minors have been seen manning checkpoints, acting as scouts and guides in battles, running errands, cooking and cleaning for forces during the Côte d’Ivoire election conflict, [  http://www.irinnews.org/report.aspx?reportid=93323  according to government social workers, UN agency and NGO staff, as well as direct testimonies from children. Social workers in Duékoué, in the west, told NGO Save the Children they saw children involved whom they estimated to be as young as 11  [  http://www.irinnews.org/report.aspx?reportid=94468  ]

Augustin Habyaremye was forcibly recruited into one of the Democratic Republic of Congo’s (DRC) armed groups, the Mai-Mai PARECO, at 15, and tasked with quizzing local villagers about the movements of militia forces because of his knowledge of Kinyarwanda, an official language of Rwanda. He cannot remember how many skirmishes and battles he was involved in during his six years with them, but in July 2011 he managed to slip away and was brought to the demobilization camp in the eastern DRC city of Goma, in search of “a normal life”.  [ http://www.irinnews.org/report.aspx?reportid=93737   ]

Suicide bombers

Children have also been made to carry explosives between Afghanistan and Pakistan, conduct military operations in the DRC, Philippines, Myanmar and Somalia, carry out arson attacks and collect kidnap ransoms in Haiti; they were used as suicide bombers in Iraq, according to the Secretary-General’s 2010 report, as well as Pakistan [ http://www.irinnews.org/report.aspx?ReportId=76701 ] and Afghanistan.

According to a Foreign Policy Association blog [  http://foreignpolicyblogs.com/2008/02/13/the-continued-rise-of-the-child-suicide-bomber/ ]: “The use of child suicide bombers appears to be increasing, and while many children are educated and reared into this deadly fate, many are thankfully saved or removed before their actions have deadly consequences. Many have seen the images of infants and toddlers dressed in mock suicide bomber outfits in Palestine, and while they may not commit such acts when they grow up, their fate is one undoubtedly leaning towards violence.”

Laws not applied

There are various instruments outlawing the recruitment and use of children for combat in human rights law, humanitarian law, labour law and criminal law - but a chasm exists between these standards and their application. The Coalition report cites ineffective government and a lack of enforcement mechanisms as reasons why armed groups continued to operate with relative impunity.

Although child soldiers are used all over the world, the largest numbers are in Africa, despite the 1999 African Charter on the Rights and Welfare of the Child, the only regional treaty in the world that prohibits the use of child soldiers.


Most observers agree that the practice continues because children make for cheap and obedient fighters, easily frightened or brainwashed into compliance. The accessibility of light weaponry has also fed into the problem, making it possible for very young children to bear and use arms.

“Any country that has an active armed conflict can expect that troop-hungry commanders will use children to fill their ranks,” said professor, author and psychologist Michael Wessells in a United States Department of State webchat in June 2008 [   http://www.america.gov/st/washfile-english/2008/June/20080613165714xjsnommis0.5646936.html  ]


But all agree that the most obvious reason armed forces take on children is because they can. Despite the regulations outlawing the practice, most of those who violate the conventions and international agreements are not prosecuted.

Children who have been displaced or separated from their parents, have limited access to education, or who have suffered an injustice or emotional abuse, are more vulnerable to recruitment, according to UNICEF.

Among other things, protection involves addressing these vulnerabilities, and identifying non-violent ways for them to contribute to their families and communities. Resources and capacity are particularly needed to extend education and vocational training, as well as to revive agriculture and provide other economic opportunities, according to the UN.

Demobilizing, reintegrating and rehabilitating children who have already participated in armed conflict is as difficult as protecting them. “Children who transition successfully into civilian life are less likely to continue the life of the gun, with its inherent dangers. However, instability in the post-conflict environment can put children at grave risk of re-recruitment and thwart their reintegration,” Wessells wrote in his 2006 book, Child Soldiers: from violence to protection.

The effects on children

Child soldiers are subject to ill-treatment and sexual exploitation. They are often forced to commit terrible atrocities, and beaten or killed if they try to escape. They are subjected to brutal initiation and punishment rituals, hard labour, cruel training regimes and torture. Many are given drugs and alcohol to agitate them and make it easier to break down their psychological barriers to fighting or committing atrocities.

 

Some speak of having been forced to witness or commit atrocities, including rape and murder. Others speak of seeing friends and family killed. Susan, 16, captures the brutalization children suffered at the hands of the Lord's Resistance Army (LRA) in northern Uganda in the following testimony [ http://articles.latimes.com/2006/feb/24/opinion/oe-brooks24  ] :

"One boy tried to escape but he was caught. His hands were tied and then they made us, the other new captives, kill him with a stick. I felt sick. I knew this boy from before; we were from the same village. I refused to do it and they told me they would shoot me. They pointed a gun at me, so I had to do it… I see him in my dreams and he is saying I killed him for nothing, and I am crying."

“Fighting groups have developed brutal and sophisticated techniques to separate and isolate children from their communities. Children are often terrorized into obedience, consistently made to fear for their lives and well-being,” wrote the UN’s Office of the Special Representative of the Secretary-General for Children and Armed Conflict. “Sometimes they are compelled to participate in the killing of other children or family members, because it is understood by these groups that there is ‘no way back home’ for children after they have committed such crimes.” [  http://www.un.org/children/conflict/english/childsoldiers.html  ]

Many child soldiers report psycho-social disturbances - from nightmares and aggression that is difficult to control to strongly anti-social behaviour and substance abuse - both during their involvement in war and after their return to civilian life. Others, who held high ranks and were feared and respected by other children, find it difficult to go back to classrooms or family dwellings where they are expected to be subservient.

For that reason, according to UNICEF, successful demobilization and rehabilitation programmes not only involve taking the guns out of children's hands but finding ways to reunite and resettle the children with their families and communities, and provide for their psycho-social care and recovery.

 

In Burundi, for example, the lucky ones among the country’s 3,421 former child soldiers who went through a demobilization, disarmament and reintegration (DDR) process returned to school but most languish in poverty, with little to do, officials told IRIN [  http://www.irinnews.org/report.aspx?ReportId=92371    ].

Cyprien Ndayishimiye, supervisor of former child soldiers in Bubanza province, said the situation for many former child soldiers was "dangerous" as even those who underwent vocational training during reintegration had yet to find gainful employment or set up income-generating activities.

"Many have even sold the materials they got from the DDR programme, such as sewing machines for those who learned sewing, and planes for those who hoped carpentry would help them," Ndayishimiye said.

 

Tougher for girls

Girls - especially orphans or unaccompanied girls - are especially vulnerable because they are often sexually exploited, raped or otherwise abused, subjected to human trafficking and prostitution, and forced to be “wives” by other combatants. This, in turn, can result in physical and psychological trauma, unwanted pregnancies, sexually transmitted diseases (including HIV/AIDS) and social stigmatization.

 

“Girls are mostly used by armed opposition groups, paramilitaries and militias, but they are also used by government forces,” wrote Dyan Mazurana and Khristopher Carlson in a paper for the UN. “Worldwide estimates suggest girls may account for between 10 to 30 percent of children in fighting forces.” [  www.un.org/womenwatch/daw/egm/elim-disc.../EP.12%20Mazurana.pdf  ]

 

Girls returning from war are often stigmatized and ostracized by their communities, especially if they return with children. 

 

“Girl soldiers are exploited in all the ways that boys are and carry the added burden of gender-based violence,” wrote Wessells.

Girls in particular continue to be excluded from official demobilization, disarmament, repatriation, resettlement and reintegration (DDRRR) programmes, despite their special post-conflict needs.

 

For example, some 3,000 girl soldiers in Liberia were officially demobilized while as many as 8,000 were excluded or did not register, according to the 2008 Coalition report. In the DRC, only about 15 percent of the girls believed to have been involved in the conflict were officially demobilized as the national programme drew to a close.

 

For the girls who do not go through the official programmes, there is no formal support at all.

Society pays a high price

Military recruitment is not only harmful to the children themselves but to societies as a whole. Children's lost years of schooling reduce societies' human and economic development potential. The educational system is further damaged when violent attacks are aimed at schools. The UN reported in 2010 that such attacks are becoming a “significant and a growing trend”. [ http://www.un.org/apps/news/story.asp?NewsID=38343&Cr=children&Cr1=armed+conflict ]


Tensions may also be high between children returning from combat and those who stayed behind, especially when social support and reintegration programmes are aimed at ex-combatants, seeming to reward participation in violence.

Though child soldiers have committed and continue to commit some terrible crimes in wartime, they are still entitled, as children, to special provision and protection.

Besides criminal proceedings, “other, more age- and culturally-appropriate options exist, including truth and reconciliation commissions, community-based rehabilitation and reintegration programmes and the traditional practice of cleansing rituals”, wrote Radhika Coomaraswamy, Special Representative to the UN Secretary-General for Children and Armed Conflict. [ www.un.org/children/conflict/_documents/OPACArticle.pdf  ]

There is no international consensus on the minimum legal age for criminal responsibility, said Coomaraswamy. International Criminal Court (ICC) Article 26 prevents the court from prosecuting anyone under the age of 18, but not because it believes children should be exempt from prosecution for international crimes, “but rather that the decision on whether to prosecute should be left to states”, says Coomaraswamy’s office   [   Working Paper Number 3: Children and Justice During and in the Aftermath of Armed Conflict, September 2011  ]. “[The] exclusion of children from the ICC jurisdiction avoided an argument between States on the minimum age for international crimes,” it noted. [   http://www.irinnews.org/report.aspx?reportid=93900  ]

There are substantial challenges in healing and reintegrating children  [  http://www.un.org/children/conflict/english/ddrforchildren.html ]  into their communities when they have been instruments of brutality and atrocities, and whole societies must sometimes be involved in communal healing and acceptance of the returnees.

Somehow, the differing needs for justice and the reintegration in society of former child soldiers have to be accommodated.

Progress update

The past decade has seen a steady commitment to ending the use and abuse of children in conflict, and a strengthened framework to protect minors and bring perpetrators to justice.

By 2010, 129 countries had signed up to the Optional Protocol to the Convention on the Rights of the Child on the Involvement of Children in Armed Conflict [   http://www.un.org/children/conflict/_documents/OPACArticle.pdf   ] while 143 had also ratified it.

The Protocol outlaws recruitment of children under 18 years of age, obliges states to ensure that members of their armed forces under age 18 do not take direct part in combat, raises the minimum age for voluntary enlistment into armed forces to 16 years and includes specific measures requiring proof of a wish to enlist.

In 2006, integrated disarmament, demobilization and reintegration standards were created, and the Paris Principles and Guidelines on children associated with armed forces or armed groups were created in 2007 to protect children from being recruited, and helping those who already were. A 2009 policy directive mainstreamed the protection, rights and well-being of children affected by armed conflict within peacekeeping operations.

Local approaches to justice and reconciliation are increasingly playing a role in transitional justice strategies, building upon traditional norms to strengthen the protection of children in communities.

In addition, the UN says more attention is being paid to understanding the root causes of child soldiering in an effort to provide more insight into children’s vulnerability and decision-making. There is, for example, increasing recognition of the role that notions of masculinity play in enticing or coercing children into armed groups.

The UN Security Council passed resolutions 1539 in 2004 [   http://www.un.org/Docs/sc/unsc_resolutions04.html ] ; 1612 in 2005 [  http://www.un.org/Docs/sc/unsc_resolutions05.htm  ]; and 1882 in 2009  [  http://www.un.org/Docs/sc/unsc_resolutions09.htm  ], which together created a working group and a monitoring and reporting mechanism to systematically monitor, document and report on the recruitment, abduction, killing or maiming of children, rape and sexual violence, attacks on schools and hospitals, and the denial of humanitarian access. It also led to systematic listing of parties that recruited or used child soldiers, in the Secretary-General’s annual report.

This public humiliation may be effective:  in the last two years, five armed groups have signed special Action Plans with the UN, the first step in being de-listed from the annual report.

“However, the gap between what governments say and what they do remains wide,” says the 2008 Coalition report.

The UN does not monitor and report on every country where children are being used in fighting or these grave violations occur. For example, Côte d’Ivoire is not on the official list of countries monitored by the UN Security Council task force for recruitment of children, yet, as cited earlier, social workers told Save the Children they saw children involved with armed groups who they estimated to be as young as 11 [  http://www.irinnews.org/report.aspx?reportid=94468  ].

Other parties pledge to change but do not, despite the “naming and shaming” of the annual report. “More must be done to systematize and activate the full range of options available to the international community to ensure more robust action against recalcitrant violators,” said the Office for the Special Representative for the Secretary-General on Children and Armed Conflict. “There are, for instance, 16 such persistent violators who have been explicitly named and listed by the Secretary-General for five years or more and the lack of action against them undermines accountability initiatives.”

And of course, national governments are only part of the problem. The Optional Protocol outlaws the recruitment or participation of anyone under 18 in insurgency groups and rebel forces, but “a wide array of armed groups – with diverse aims, methods and constituencies – continue to use children as soldiers and they have proved resistant to pressure or persuasion to stop the practice”, says the Coalition to Stop the Use of Child Soldiers.

“Despite progress, the overall picture is one of armed groups that have ignored international law and standards, that renege on commitments, are resistant to pressure and persuasion, or have so far proved to be beyond the reach of efforts to end the involvement of children in conflict and political violence,” said the Coalition’s 2008 report.

Higher political profile

The UN said [   http://www.un.org/children/conflict/english/workingtoendimpunity.html ]  national and international tribunals were setting important precedents in the fight to end impunity for grave child rights violations, serving as a deterrent for commanders and warlords all over the world and creating leverage for their compliance with international norms.  

Of the 12 individuals publicly indicted by the International Criminal Court at The Hague, seven have been charged with war crimes against children such as using child soldiers. They include Lord’s Resistance Army leaders Joseph Kony, Vincent Otti (since deceased) and Okot Odhiambo. Also on trial or in the pre-trial stage are cases against Thomas Lubanga Dyilo, a militia leader from the Democratic Republic of Congo, who is on trial for recruiting children under 15. The ICC also has open cases on DRC commanders Bosco Ntaganda, Germain Katanga and Matthieu Ngudjolo Chui for their crimes against children.

The Special Court for Sierra Leone is nearly finished trying a case in The Hague against Liberia’s Charles Taylor for war crimes and crimes against humanity, including conscripting or enlisting children into armed forces or groups and using them to participate actively in hostilities. The trial of a former president is a strong message to the world that even leaders of nations are not beyond the reach of international law when it comes to protecting the rights of children.

Calls for future action

Tackling impunity remains a key priority for the international community. “Concerted emphasis must be maintained on fighting the impunity of perpetrators,” said Coomaraswamy’s office. 

It is also strengthening the data collection and reporting on sexual violence, in the hope it will allow for better identification of perpetrators and better analysis of trends on sexual violence against children. The proliferation of small arms is another issue that the UN would like to see addressed in order to make sure weapons do not end up in the hands of children.

In 2010, Coomaraswamy, with the Special Representative of the Secretary-General on Violence against Children, UNICEF and the Office of the High Commissioner on Human Rights, launched the Zero Under 18 Campaign: a two-year initiative to achieve universal ratification of the Optional Protocol to the Convention on the Rights of the Child on the Involvement of Children in Armed Conflict by 2012. The push is premised on the belief that the strongest defence against impunity for child rights violators is to have an international moral consensus that no child should take part in armed conflict - and a strong enforcement mechanism to back it up.

“I think the political will is there. What is lacking is the momentum, and that is what we hope to achieve in this campaign,” said Coomaraswamy.

Ending child soldiering remains a daunting challenge. “The military imperatives of the group and the political, economic and social factors that drive conflicts and cause children to enlist – often underpinned by local cultural attitudes towards the age of majority – can outweigh legal and moral arguments,” said the 2008 Coalition report.

The report analyzed 21 conflicts where children were used or deployed and found that children will “almost inevitably” become involved when armed conflict breaks out.

And no matter how strongly the international community pushes for stronger protection and decreased impunity, national laws have to reflect the same in order for change to take place.

Governments must also remember that the problem has deeper and more human roots than the conflict du jour. Because children are more likely to be drawn to armed groups if they have experienced human rights violations or other forms of violence, “governments and societies that fail to prioritize the promotion and protection of children’s rights – economic, social and cultural, as well as civil and political – share responsibility for driving children into the ranks of armed groups”, says the Coalition report. Understanding these deep-seated drivers of child involvement in conflict will be essential in devising a plan to protect them, and punish those who do not.

jb/mw/oa
]]></body><pubDate>Tue, 17 Jan 2012 00:00:00 GMT</pubDate><link>http://www.irinnews.org/report.aspx?ReportId=94657</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://irinnews.org/images/2012/201201170934140626t.jpg"/></td><td valign="top">NAIROBI 17 January 2012 (IRIN) - At end-November 2011, Somalia and the Central African Republic became the latest countries to commit to end the use of child soldiers – a move seen as “encouraging” by the UN, albeit with the proviso that the situation in both countries remains volatile.</td></tr></table>]]></content:encoded></item><item><title>KENYA: The downside of male involvement in PMTCT</title><pubDate>Mon, 16 Jan 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://irinnews.org/images/2007/200710269t.jpg" />]]>KISUMU 16 January 2012 (IRIN) - Involving men is increasingly being promoted as a key element in the prevention of mother-to-child transmission of HIV, and while its benefits are well-documented - in one Kenyan study it reduced the risks of vertical transmission and infant mortality by more than 40 percent compared with no involvement - it can occasionally lead to domestic discord and even violence.</description><body><![CDATA[KISUMU 16 January 2012 (IRIN) -  Involving men is increasingly being promoted as a key element in the prevention of mother-to-child transmission of HIV, and while its benefits are well-documented - in one study [ http://www.ncbi.nlm.nih.gov/pubmed/21084999 ] it reduced the risks of vertical transmission and infant mortality by more than 40 percent compared with no involvement - it can occasionally lead to domestic discord and even violence.  

 Silvia*, a 33-year-old mother of six, now living at her mother's home in western Kenya, says her 14-year marriage was doomed the minute she followed her healthcare worker's advice to bring her husband for an antenatal visit after she tested HIV-positive. "I was tested and I was told I was positive; I asked if I could go ahead and just carry the pregnancy and the nurse assured me it was fine," she said. "She, however, asked me to bring my husband when coming for the next visit and I agreed."  

 She convinced her husband to accompany her on her next visit, but when he tested HIV-negative, he accused her of cheating on him. "He left me at the hospital... When I got home, he beat me up and said the child I was carrying wasn't his and he chased me away," she added. "The nurse thought she was helping us but it turned out to be a curse for me."  

 There is limited research into the area of gender-based violence following HIV-testing, but a presentation by the NGO, the Sonke Gender Justice Network, [ http://www.slideshare.net/evonleer/3-ias-men-and-pmtct-peacockvienna-2010 ] at the 2010 International AIDS Society conference in Vienna, Austria, reported that women's experiences upon disclosing their status to their male partners were often "complex and positive": some studies reported violence levels of up to 14 percent, while others stated that about half of HIV-positive women said their partners reacted supportively to the disclosure.  

 According to Beatrice Misoga, PMTCT programme officer with the AIDS Population Health Integrated Assistance (APHIA Plus), gender-based violence is more common in discordant relationships where the man is HIV-negative. "Male involvement has helped realize success with PMTCT programmes where it has been applied because prevention of mother to child transmission is a family issue, but yes, there have been challenges in certain aspects like the possibility of gender-based violence targeting women and more so in a situation where the male partner is not willing to be part of it."  

 Tensions  

 In 2009, Human Rights Watch cautioned [ http://www.plusnews.org/report.aspx?reportid=87598 ] the Kenyan government to ensure that human rights were protected during a large-scale home-based counselling and testing programme; HRW noted that HIV-positive mothers - among them girls under the age of 18 - sometimes suffered violence, mistreatment, disinheritance, and discrimination from their husbands, in-laws, or their own families.  

 Some women, too fearful of the repercussions of revealing their HIV status to their husbands, opt out of PMTCT programmes altogether. "A woman comes to the facility but the moment you mention her man, she disappears and might resurface to give birth - some go to traditional birth attendants," said Julie Miseda, a nurse at Nyanza Province's Siaya District Hospital. "Some will tell you they are not married but the day they give birth, a man appears and claims he is the father.  

 "At times, involving both of them creates tension between them and they tend to keep very crucial information, for example, a history of a sexually transmitted infection, to themselves," she added.  

 Supporting men  

 According to APHIA Plus's Misoga, to preserve the benefits of male involvement in PMTCT, health clinics had to become more aware of the counselling needs of men. "Despite the disadvantages, the benefits of male involvement are immense and what needs to be done is to make these antenatal clinics male friendly. It is also important to give constant information and messages targeting men on the need to be part of prevention of mother to child transmission programmes," she said.  

 Christopher Mukabi, a local peer educator, says male support groups have proved useful in improving the way couples deal with an HIV diagnosis. "Bringing men together in male support groups and then using these groups to convince them to get into PMTCT programmes can help deal with some of the challenges, but stigma and alcoholism are still problems in getting men involved."  

 ko/kr/mw

*Not her real name

]]></body><pubDate>Mon, 16 Jan 2012 00:00:00 GMT</pubDate><link>http://www.irinnews.org/report.aspx?ReportId=94652</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://irinnews.org/images/2007/200710269t.jpg"/></td><td valign="top">KISUMU 16 January 2012 (IRIN) - Involving men is increasingly being promoted as a key element in the prevention of mother-to-child transmission of HIV, and while its benefits are well-documented - in one Kenyan study it reduced the risks of vertical transmission and infant mortality by more than 40 percent compared with no involvement - it can occasionally lead to domestic discord and even violence.</td></tr></table>]]></content:encoded></item><item><title>DRC: Rebuilding the lives of children associated with armed groups</title><pubDate>Mon, 16 Jan 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://irinnews.org/images/2012/201201161305140867t.jpg" />]]>NAIROBI 16 January 2012 (IRIN) - A partnership of humanitarian organizations working with community volunteers in South Kivu, eastern Democratic Republic of Congo (DRC), has helped demobilize thousands of children formerly associated with armed groups in the province, says the UN Children&apos;s Fund (UNICEF).</description><body><![CDATA[NAIROBI 16 January 2012 (IRIN) - A partnership of humanitarian organizations working with community volunteers in South Kivu, eastern Democratic Republic of Congo (DRC), has helped demobilize thousands of children formerly associated with armed groups in the province, says the UN Children's Fund (UNICEF). 

"Children are the first to suffer from the burden of conflict; they are caught up in violence as victims of sexual assaults; they lose their families and homes as a consequence of constant migration and they are involved in combat as perpetrators of the conflict," Cornelia Walther, UNICEF's chief of communication in the DRC, said.   

Walther said 101 children aged between 11 and 17 years were currently in the Centre of Transit and Orientation (CTO) in Bukavu, South Kivu's provincial capital, following their demobilization from armed forces or groups.

At least 33,000 children have been demobilized across the country with UNICEF's assistance since 2004, according to Alessandra Dentice, UNICEF's chief of child protection in the DRC.

CTO is managed by the Congolese association, Bureau des Volontaires pour l'Enfance et la Sante (BVES), which has helped to demobilize more than 2,500 children since 2002. 

Who does what 

While UNICEF funds the programme and CTO oversees the demobilization process, the International Committee of the Red Cross (ICRC) undertakes family tracing and provides medical support; a network of 34 foster families hosts youth close to their homes in remote areas of the province; community volunteers regularly monitor the reintegration process; and, the UN World Food Programme (WFP) provides food for the children at CTO. 

According to the UN, an estimated five million people in the DRC have been killed by war or disease since 1998. Irregular birth registration across the vast country is one of the major challenges in demobilizing children. A 2010 UNICEF survey indicates that fewer than one in three Congolese children has a birth certificate. 

Murhabazi Namegabe, director of BVES in Bukavu, said recently: "Administratively, these children do not exist. How do you prove to a commander that his soldier is a minor, if even the child itself does not know his age?"  

Many children come from areas where the conflict continues, Namegabe said, adding that such children returning home faced the likelihood of being enrolled in armed groups again. "Every day when a child can be saved is a successful day," he said. 

"There are children who do not want to return home because they are ashamed of what they have done; and finally there are families who refuse to take their children back - because they are afraid of what they have become," Namegabe added. 

Trauma 

The situation for girls associated with armed groups is especially dire, Namegabe said, as they suffer from trauma, most of them having been raped and sometimes made pregnant. All demobilized girls are taken to Panzi Hospital in Bukavu, a medical centre which treats survivors of sexual violence. 

Julia*, 17, told the UNICEF team: "I was born in Rwanda, but I never knew my parents. When I was 16 years old a commander of the national army took me by force. When I got pregnant he threw me away. At a support centre for refugees I was raped a second time. I am grateful to be here now with my baby. If possible I would like to start a small shop of my own." 

At CTO, the children and youth have formal classes, peer-to-peer group discussions and career counselling on their options after the centre. "The situation that brought them into an armed group has not changed; it's important that they have a clear project for their life in this context," Namegabe said. "We want them to build dreams, realistically."  

Rohanne Rosine, CTO's director for the protection of girls, said: "The poverty of families is a big problem. Before they take back their daughters they request food or money, because they have too many starving mouths at home."  

js/mw

]]></body><pubDate>Mon, 16 Jan 2012 00:00:00 GMT</pubDate><link>http://www.irinnews.org/report.aspx?ReportId=94655</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://irinnews.org/images/2012/201201161305140867t.jpg"/></td><td valign="top">NAIROBI 16 January 2012 (IRIN) - A partnership of humanitarian organizations working with community volunteers in South Kivu, eastern Democratic Republic of Congo (DRC), has helped demobilize thousands of children formerly associated with armed groups in the province, says the UN Children&apos;s Fund (UNICEF).</td></tr></table>]]></content:encoded></item><item><title>IRAQ: New research highlights link between FGM/C and mental disorders</title><pubDate>Fri, 13 Jan 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://irinnews.org/images/2012/201201130942410803t.jpg" />]]>DUBAI 13 January 2012 (IRIN) - New data out of Iraq shows what many psychologists suspected though little research had confirmed: Girls who have undergone female genital mutilation/cutting (FGM/C) are more prone to mental disorders, including post-traumatic stress disorder (PTSD).</description><body><![CDATA[DUBAI 13 January 2012 (IRIN) - New data out of Iraq shows what many psychologists suspected though little research had confirmed: Girls who have undergone female genital mutilation/cutting (FGM/C) are more prone to mental disorders, including post-traumatic stress disorder (PTSD).

Results of the research [ http://scielo.isciii.es/scielo.php?script=sci_pdf&pid=S0213-61632011000200004&lng=en&nrm=iso&tlng=en ] - conducted by Jan Ilhan Kizilhan of the University of Freiburg, an expert in psychotraumatology (psychotherapy for people who have suffered extreme trauma) - were published in the April-June 2011 edition of the European Journal of Psychiatry.

Kizilhan found “alarmingly high rates” of PTSD (44 percent), depression (34 percent), anxiety (46 percent) and somatic disturbances (mental disorders whose symptoms are unexplainable physical illnesses - 37 percent) among a group of 79 circumcised girls in the Kurdistan region of northern Iraq, aged 8-14, who did not otherwise suffer any traumatic events.

These rates were up to seven times higher than among non-circumcised girls from the same region and were comparable to rates among people who suffered early childhood abuse.

Last year, shortly after receiving the results of the research, Kizilhan said, the Kurdish parliament in northern Iraq banned [ http://www.hrw.org/news/2011/07/25/iraqi-kurdistan-law-banning-fgm-positive-step ] FGM/C.

He told IRIN he hopes the results will also lead to more and better treatment of PTSD among girls who have undergone FGM/C, using special techniques which include the family in the process as much as possible.

The existence of FGM/C in the Middle East is less known than in Africa. Estimates of the prevalence of FGM/C in Iraqi Kurdistan vary wildly depending on the province, but surveys have indicated the overall figure could be around 40 percent. The region is home to five million people, but has just 13 psychologists and only one with expertise in psychotherapy, Kizilhan said.

ha/cb

]]></body><pubDate>Fri, 13 Jan 2012 00:00:00 GMT</pubDate><link>http://www.irinnews.org/report.aspx?ReportId=94638</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://irinnews.org/images/2012/201201130942410803t.jpg"/></td><td valign="top">DUBAI 13 January 2012 (IRIN) - New data out of Iraq shows what many psychologists suspected though little research had confirmed: Girls who have undergone female genital mutilation/cutting (FGM/C) are more prone to mental disorders, including post-traumatic stress disorder (PTSD).</td></tr></table>]]></content:encoded></item><item><title>HEALTH: Yaws treatment study prompts WHO review</title><pubDate>Wed, 11 Jan 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://irinnews.org/images/2012/201201110749170559t.jpg" />]]>BANGKOK 11 January 2012 (IRIN) - Findings that a one-time oral treatment to cure yaws, a neglected tropical disease, is as effective as the currently recommended penicillin injection have prompted the World Health Organization (WHO) to convene a meeting on how the disease may be wiped out.</description><body><![CDATA[BANGKOK 11 January 2012 (IRIN) - Findings that a one-time oral treatment to cure yaws, a neglected tropical disease, is as effective as the currently recommended penicillin injection have prompted the World Health Organization (WHO) to convene a meeting on how the disease may be wiped out. 
 
 "We may be closer now than we have been in decades," Kingsley Asiedu, a yaws expert with WHO's Department of Neglected Tropical Disease Control, told IRIN, calling the study [ http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)61624-3/abstract ] on the bacterial skin disease, which leads to chronic disfiguration and disability in 10 percent of untreated cases, the most significant in half a century. 
 
 After a UN-led worldwide control programme cut infections from 50 million to 2.5 million in 1964 in 46 countries, the disease re-emerged in the 1970s when control efforts lagged, affecting an estimated 460,000 people - mostly children - in poor, tropical rural areas mainly in Africa and Asia, according to the most recent figures reported to WHO in 1995. 
 
 In 2010, the Lihir Medical Centre in Papua New Guinea (PNG), where the disease is still endemic, gave the one-time oral dose of the antibiotic azithromycin to about half of 250 infants and children from six months to 15 years infected with yaws. 
 
 Follow-up exams in 2011 showed the treatment was as effective as penicillin injections, which - unlike oral antibiotics - require trained health staff and equipment often scarce in areas most in need of treatment, wrote the researchers. 
 
 In a recent index of health workers' outreach [ http://www.savethechildren.org.uk/sites/default/files/docs/HealthWorkerIndexmain_4.pdf ] by the NGO Save the Children, PNG ranked in the bottom 20 of 161 surveyed countries. 
 
 The meeting of yaws experts convened by WHO in Geneva from 5-7 March will "fully define how we are going to embark [on a new yaws treatment regimen] using azithromycin", said Asiedu. 
 
 WHO's yaws treatment guidelines date back to the 1960s and there have been no alternatives since, he added. 
 
 In Southeast Asia, WHO set the goal for regional eradication by 2012 in two remaining endemic countries - Indo¬nesia and Timor-Leste. PNG, the Solomon Islands and Vanuatu have also reported cases. 
 
 Sub-Saharan Africa was the most heavily affected based on earlier estimates, but the "picture is not entirely clear now", said Asiedu. Cameroon, Central African Republic, Congo, Côte d'Ivoire, Democratic Republic of Congo, Ghana, Sierra Leone and Togo have all reported cases. 
 
 More studies are needed to ensure resistance to azithromycin treatment does not develop, said David Mabey from the London School of Hygiene and Tropical Medicine. 
 
 While penicillin "has stood the test of time" - still as effective fighting the bacteria causing yaws after roughly 60 years - he noted mass azithromycin had only been used in developing countries for about a decade to treat trachoma [ http://www.irinnews.org/report.aspx?reportid=89568 ], another bacterial disease prevalent in poor rural areas. 
 
 Discussions at the upcoming WHO meeting will include a measure to monitor antibiotic resistance, said Asiedu. "Antibiotic resistance is a risk in any treatment and we always have to be vigilant." 
 
 pt/mw

]]></body><pubDate>Wed, 11 Jan 2012 00:00:00 GMT</pubDate><link>http://www.irinnews.org/report.aspx?ReportId=94621</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://irinnews.org/images/2012/201201110749170559t.jpg"/></td><td valign="top">BANGKOK 11 January 2012 (IRIN) - Findings that a one-time oral treatment to cure yaws, a neglected tropical disease, is as effective as the currently recommended penicillin injection have prompted the World Health Organization (WHO) to convene a meeting on how the disease may be wiped out.</td></tr></table>]]></content:encoded></item><item><title>BANGLADESH: Trying to stay polio-free</title><pubDate>Wed, 11 Jan 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://irinnews.org/images/2008/200812012t.jpg" />]]>BANGKOK 11 January 2012 (IRIN) - Mobile health teams in Bangladesh are conducting “child-to-child” searches to reach the remaining half million children not vaccinated during a nationwide polio immunization campaign launched on 7 January.</description><body><![CDATA[BANGKOK 11 January 2012 (IRIN) - Mobile health teams in Bangladesh are conducting “child-to-child” searches to reach the remaining half million children not vaccinated during a nationwide polio immunization campaign launched on 7 January. 
 
 The campaign’s goal was to vaccinate 22 million children under five. Only 560,791 children short of reaching it, mobile teams have been conducting house visits, concluding on 11 January, to vaccinate the remainder, Arun Bhadra Thapa, World Health Organization’s country representative, told IRIN. 
 
 Hard to reach areas include hilly sub-districts, [ http://www.irinnews.org/report.aspx?reportid=93224 ] coastal belts, temporary river islands known as `chars’ [ http://www.irinnews.org/report.aspx?reportid=77342 ] and swampy marshlands, he added. 
 
 To reach every child, more support and supervision are needed for hard-to-reach and high-risk areas, said UN Children’s Fund representative Pascal Villeneuve. 
 
 Neighbouring India is one of four countries worldwide where polio remains endemic, the others being Afghanistan [ http://www.irinnews.org/report.aspx?reportid=90692 ] , Pakistan [ http://www.irinnews.org/report.aspx?reportid=92285 ] and Nigeria [ http://www.irinnews.org/report.aspx?reportid=93480 ]. 
 
 Mahmuda Akhter, a medical officer with local NGO Family Planning Association of Bangladesh, [ http://www.fpab.org/ ] who participated in the most recent vaccinations, said reaching the children of migrants in areas bordering India was the main challenge now. 
 
 “Migrants there should get the attention," she said. 
 
 Despite the challenges, the programme is running properly and reaching almost all children, she said. 
 
 Since 1995 health workers have conducted annual nationwide polio immunizations with the exception of 2005. Since a polio outbreak in 2006 of an imported viral strain, the government has not reported any infections, pledging annual polio vaccinations until India is declared polio-free. 
 
 On 13 January - for the first time in history - India will pass one year without a single child being paralyzed by polio, if no cases are reported and if all pending samples return negative in the coming weeks. [ http://www.polioeradication.org/Dataandmonitoring/Poliothisweek.aspx ] 
 
 Bangladesh’s next round of polio vaccinations is scheduled for 11 February. 
 
 pt/cb 

]]></body><pubDate>Wed, 11 Jan 2012 00:00:00 GMT</pubDate><link>http://www.irinnews.org/report.aspx?ReportId=94626</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://irinnews.org/images/2008/200812012t.jpg"/></td><td valign="top">BANGKOK 11 January 2012 (IRIN) - Mobile health teams in Bangladesh are conducting “child-to-child” searches to reach the remaining half million children not vaccinated during a nationwide polio immunization campaign launched on 7 January.</td></tr></table>]]></content:encoded></item><item><title>EGYPT: Calls for minors to be kept out of political clashes</title><pubDate>Thu, 05 Jan 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://irinnews.org/images/2011/201112210656030269t.jpg" />]]>CAIRO 05 January 2012 (IRIN) - The involvement of children in violence during ongoing clashes between protesters and police in Egypt should be addressed because it is against international norms, say child rights activists.</description><body><![CDATA[CAIRO 05 January 2012 (IRIN) - The involvement of children in violence during ongoing clashes between protesters and police in Egypt should be addressed because it is against international norms, say child rights activists.
  
 “I have seen hundreds of children leading the fight against military and civilian policemen in violent clashes across the nation over the past months,” Mahmud al-Badawi, a lawyer and the chairman of local NGO Egyptian Association for the Assistance of Juveniles and Human Rights, [ http://www.euromedalex.org/fr/node/14635 ] told IRIN. “This is totally against local and international laws.”
  
 Children were caught up in deadly clashes between demonstrators and military policemen guarding the cabinet and parliament buildings in central Cairo on 17 December. Some were seen hurling stones at the police and setting public buildings on fire.
  
 Some children were injured, others were killed in the violence, which has persisted since protests began against former president Hosni Mubarak in February 2011.
  
 “Too often children are caught up in the spiralling violence,” said Philippe Duamelle, the UN Children’s Fund (UNICEF) representative in Egypt, in a statement [ http://www.unicef.org/egypt/media_6754.html ] on 22 December. “Reports and first-hand testimony by children paint a graphic picture of how the latest confrontations affect them.”
  
 Children were also caught up in deadly clashes near Cairo’s Tahrir Square on 23 November. Activists say most of those involved in violence live on the streets. That is why the problem of street children should be at the top of the National Salvation government’s agenda, they say.
 
 “The government has to pay some attention to these children who suffer a deplorable lack of the most basic services,” said Fadia Abu Shahba, an expert from the state-run National Centre for Social and Criminological Research. “These children have found no care whatsoever from society.”
  
 Cash inducements?
  
 According to Mahmud al-Badawi, children have been exploited and cajoled into participation in Egypt’s political conflicts.
  
 When clashes occurred outside the cabinet building on 17 December, he hurried to the scene along with other colleagues and found children holding money and cigarettes. 
  
 “The fact that these children were holding money shows that they might have been paid by somebody to be part of these incidents,” said al-Badawi. 
  
 Whether these children were paid to attack military policemen guarding the cabinet and the parliament buildings remains to be seen. A large number of juveniles taking part in the clashes were arrested and are being interrogated, according to local media reports.
 
 “UNICEF urges the authorities and all other parties to fully respect the rights of children and protect them in accordance with Egyptian and international humanitarian and human rights law,” said Philippe Duamelle. “They should not be victims of violence nor unnecessary witnesses to violence.”
  
 ae/eo/cb
 
 ]]></body><pubDate>Thu, 05 Jan 2012 00:00:00 GMT</pubDate><link>http://www.irinnews.org/report.aspx?ReportId=94587</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://irinnews.org/images/2011/201112210656030269t.jpg"/></td><td valign="top">CAIRO 05 January 2012 (IRIN) - The involvement of children in violence during ongoing clashes between protesters and police in Egypt should be addressed because it is against international norms, say child rights activists.</td></tr></table>]]></content:encoded></item><item><title>ETHIOPIA: New PMTCT plan needs men</title><pubDate>Wed, 04 Jan 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://irinnews.org/images/2011/201105121223560149t.jpg" />]]>ADDIS ABABA 04 January 2012 (IRIN) - Ethiopia&apos;s new plan to eliminate mother-to-child HIV transmission by 2015 cannot be attained unless men are more meaningfully involved in reproductive health, experts say.</description><body><![CDATA[ADDIS ABABA 04 January 2012 (IRIN) - Ethiopia's new plan to eliminate mother-to-child HIV transmission by 2015 cannot be attained unless men are more meaningfully involved in reproductive health, experts say. 
 
 "Among the pregnant women who come to our hospital, less than 10 percent of them come with their partners," said Etalem Gebrehiwot, head nurse at the prevention of mother-to-child transmission (PMTCT) wing of Gandhi Memorial Hospital. "Those who find out that they are living with the virus usually face a problem while taking medicines, given that most prefer to take it without the knowledge of their partners." 
 
 Studies [ http://www.search4dev.nl/document/185326 ] show that low male partner involvement is one of the challenges to the success of the country's PMTCT programme. 
 
 According to experts, men's involvement in PMTCT can have a positive impact on PMTCT by encouraging their partners to visit antenatal clinics and have skilled health workers attend the birth of their children. In a 2010 Kenyan study [ http://www.ncbi.nlm.nih.gov/pubmed/21084999 ], male partner involvement in PMTCT reduced the risks of vertical transmission and infant mortality by more than 40 percent compared to no involvement. 
 
 "The biggest challenge we are currently facing is to convince mothers to get tested in order to determine that they are eligible for PMTCT services... the major reason for their resistance is lack of consent from their husbands or partners, who are more influential in family matters including this," said Aster Shewa, who supervises Zewditu Hospital antiretroviral service centre in Addis Ababa. 
 
 "Besides, after they know their status, most HIV-positive mothers refrain from disclosing it, which usually impacts the way they use PMTCT services and their effectiveness," she added. 
 
 Many men do not see the advantages of an HIV test; one father, whose wife gave birth to a daughter in November 2011, told IRIN/PlusNews: "We are married - what is there to test about?" 
 
 "At the moment, hospitals with PMTCT services are increasing, and we have to work hard in convincing pregnant women, along with their partners, to use health facilities with the service in order to reach zero new infections," said Aster. 
 
 New national plan 
 
 The national accelerated emergency PMTCT plan - launched in December 2011 - has three objectives: reaching 90 percent of pregnant women with access to antenatal care services; ensuring universal access by pregnant women to a skilled attendant during delivery; and providing ARVs to at least 80 percent of HIV-positive pregnant women. 
 
 An estimated 1.2 million Ethiopians are living with HIV, including about 90,000 pregnant women; just 9.3 percent of pregnant women who are eligible for HIV services are currently receiving them. The number of Ethiopian women who visit antenatal clinics is growing - from 616,763 in 2008-2009 to 796,099 in 2009-2010 - and the number of mothers receiving HIV testing as part of PMTCT services has grown to over 70 percent, but just 6 percent of births are attended by a skilled health worker, according to the UN World Health Organization [ http://www.who.int/whosis/whostat/EN_WHS10_Full.pdf ]. 
 
 "The new plan will focus on increasing the quality of services that expectant mothers get in the health services and also retain those who are using it. We intend to work on both in the demand and supply side of the service," said Tadesse Ketema, a maternal health adviser at the Ministry of Health. 
 
 "Through the health extension programme, the country manages to create easy access for family planning services for many families and that has worked so far. We are now planning to copy that in the PMTCT programme to reach out [to] each pregnant woman and give the service at their convenience," he added. 
 
 Ethiopia's "health extension programme" [ http://www.irinnews.org/report.aspx?reportid=72371 ] employs more than 30,000 lower cadre health workers to provide basic health care at village level. The government also intends to use "health development armies" - community groups mobilized to further government health programmes - to create demand and convince the community, including male partners, to benefit from nearby PMTCT services. 
 
 bt/kr/cb

]]></body><pubDate>Wed, 04 Jan 2012 00:00:00 GMT</pubDate><link>http://www.irinnews.org/report.aspx?ReportId=94579</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://irinnews.org/images/2011/201105121223560149t.jpg"/></td><td valign="top">ADDIS ABABA 04 January 2012 (IRIN) - Ethiopia&apos;s new plan to eliminate mother-to-child HIV transmission by 2015 cannot be attained unless men are more meaningfully involved in reproductive health, experts say.</td></tr></table>]]></content:encoded></item><item><title>WEST AFRICA: Call for more coordinated approach to child protection</title><pubDate>Wed, 04 Jan 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://irinnews.org/images/2012/201201041152580355t.jpg" />]]>DAKAR 04 January 2012 (IRIN) - A new report on child migration in West Africa says thousands of children are being sold, exchanged or transported out of their communities each year in violation of internationally-recognized rights of the child, and calls on the Economic Community of West African States (ECOWAS) to persuade governments to better protect these children.</description><body><![CDATA[DAKAR 04 January 2012 (IRIN) - A new report on child migration in West Africa says thousands of children are being sold, exchanged or transported out of their communities each year in violation of internationally-recognized rights of the child, and calls on the Economic Community of West African States (ECOWAS) to persuade governments to better protect these children.
 
 Among the recommendations identified were: the need to align social norms, national laws and international standards of protection; the need to improve the development of children within their locale; the promotion of community mechanisms for child protection; the inclusion of children’s views in any protection regime; and joint initiatives to protect children from unlawful cross-border movement.
 
 The 79-page report [ http://www.tdh.ch/en/documents/which-protection-for-children-involved-in-mobility-in-west-africa ] drawn up by representatives of several national and international NGOs, entitled Quelle protection pour les enfants concernés par la mobilité en Afrique de l’Ouest? (What Protection for Child Migrants in West Africa?) looked at the problem in Benin, Burkina Faso, Guinea and Togo in 2008-2010.
 
 “At the governmental level measures are generally limited to passing national laws. Joint action might simply amount to police intercepting and repatriating children,” said Moussa Harouna, programme coordinator for NGO the African Movement of Child and Youth Workers, stressing that greater unity of action was required by governments and international organizations to support village development initiatives and set up child protection measures. 
 
 The report calls on states and development agencies to integrate child migration into their development and child protection strategies. It wants any future ECOWAS action on the movement of people, particularly children, to be an essential part of a “coherent and pragmatic policy” against human trafficking and child labour.
  
 In addition, it calls on individual states to boost their ability to find victims of child trafficking and to differentiate this practice from other forms of mobility. 
  
 Push factors
 
 Children may leave their communities because of conflict within the family, or the desire for education, apprenticeships or job opportunities to help their families. Some parents force their children to leave, but often departure is voluntary and motivated by the quest for a better life.
  
 Zelmet Fatimah and Zeydata Amina from Niger, two girls who beg along the Teteh Quarshie Interchange, a busy highway in the Ghanaian capital Accra, say they left home because of hunger. “There is no food there,” said Zeydata, “I come here every day with my sisters and my parents to beg for money. I beg because we don’t have money and I am hungry.”
  
 However, push factors are many and varied: “The children’s motivations are rooted in the current changing world… It is misleading to believe that a state, civil society and development partners have the capacity and sufficient legitimacy to end, simply, this many-sided practice of child mobility,” said the report. 
  
 Positive outcomes
  
 While no one knows the precise scale of child migration, the report says outflows of children are generally from Mali, Niger and Guinea-Bissau, and their destinations are Benin, Cote d’Ivoire, Ghana, Nigeria and Togo.
  
 Outflows north are less intense. The report says just 10 percent of the total number of children seeking to reach the Maghreb and Europe are from West Africa. Many are seasonal travellers, leaving for short or medium periods at the end of the farming season. 
  
 The migration of children is not always a negative phenomenon: migrant children send money home. Those from the same community might collectively fund a project. 
  
 Harouna said this had been the case in some villages in the Niger region of Makalondi, near the border with Burkina Faso, where migrant children had jointly paid to build a school for their community. The effect had been to encourage those who were too young to migrate to remain in their communities, at least for much longer, and others to return. 
  
 “The objective is no longer to stop migration at all cost,” Haround said. “It is also to improve conditions in the communities so that children do not have to leave to seek fortunes and a better life. Yet, even if they do, then organized protection must be provided within their host states or new communities in their own countries.” 
  
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 ]]></body><pubDate>Wed, 04 Jan 2012 00:00:00 GMT</pubDate><link>http://www.irinnews.org/report.aspx?ReportId=94582</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://irinnews.org/images/2012/201201041152580355t.jpg"/></td><td valign="top">DAKAR 04 January 2012 (IRIN) - A new report on child migration in West Africa says thousands of children are being sold, exchanged or transported out of their communities each year in violation of internationally-recognized rights of the child, and calls on the Economic Community of West African States (ECOWAS) to persuade governments to better protect these children.</td></tr></table>]]></content:encoded></item><item><title>PAKISTAN: &quot;An unforgiveable sin&quot;</title><pubDate>Tue, 03 Jan 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://irinnews.org/images/2012/201201030710510805t.jpg" />]]>LAHORE 03 January 2012 (IRIN) - The murder of infants, particularly girls, by poverty-stricken parents in Pakistan appears to be on the rise. Late at night two months ago in a village in Pakistan’s Punjab Province, the parents of a two-day-old infant girl smothered the child, and then buried her tiny body in a distant field, carefully patting down the soil to hide any signs of digging. The mother cries often and says she still has nightmares about the event.</description><body><![CDATA[LAHORE 03 January 2012 (IRIN) - The murder of infants, particularly girls, by poverty-stricken parents in Pakistan appears to be on the rise.
 
 Late at night two months ago in a village in Pakistan’s Punjab Province, the parents of a two-day-old infant girl smothered the child, and then buried her tiny body in a distant field, carefully patting down the soil to hide any signs of digging. The mother cries often and says she still has nightmares about the event. 
 
 “I cried myself; I had delivered the baby and she was perfectly healthy. But her parents had two daughters already, and felt they couldn’t afford another. The father, a labourer, earned only 4,000 rupees (US$46.50) a month, and I know those people ate just once a day,” Suriya Bibi, a `dai’ or traditional midwife from the village, told IRIN.
 
 According to Anwar Kazmi, a spokesperson for the charitable Edhi Foundation, more and more bodies of infants are being collected from the streets. “I would say there has been a 100 percent increase over the past decade in the number of bodies of infants we find. Nine out of 10 are girls,” he told IRIN.
 
 Girls are traditionally considered a `burden’ on families, with large sums frequently spent on their marriages. “People feel girls make no economic contribution to families,” Gulnar Tabassum, a women’s rights activist, told IRIN.
 
 Kazmi said 1,210 bodies of dead infants were found last year - compared to 999 in 2009. 
 
 “The reasons are linked to mindset and to poverty,” he said. While the Edhi Foundation places cradles outside the orphanages it runs, and urges people to leave babies in them rather than kill them, only a few choose to do so. 
 
 According to the Foundation, about 200 babies are left each year in the 400 cradles it puts out nationwide with signs urging parents to use them. 
 
 Since children born out of wedlock in this conservative society are at greater risk of infanticide, the Foundation encourages the placing of such children with responsible surrogate parents. 
 
 “These children are innocent,” said Kazmi.
 
 No accurate statistics
 
 The Foundation also collects its data mainly from larger cities. It is unknown how many other deaths may be taking place in rural areas, or regions in the tribal areas and Balochistan and Sindh provinces where official figures show poverty is highest.
 
 “The number of tiny babies we bury is increasing. In some cases the neck or wrists have been slashed open,” said Muhammad Taufiq, a gravedigger in Lahore.
 
 “I have had women who are pregnant come to me crying, because their husbands or in-laws say any baby born must be killed since they cannot raise it. I can do little to help, since abortion is illegal [ http://www.irinnews.org/report.aspx?reportid=86999 ] in the country, and for various cultural reasons the use of birth control [ http://www.irinnews.org/report.aspx?reportid=91656 ] is far too low, though many woman want to use it,” said gynaecologist Faiqa Siddiq who works at a charitable clinic for women. 
 
 “The mothers themselves wish to save the children but they also see the economic struggle of their families in a time of growing inflation,” she says.
 
 According to data from the Federal Bureau of Statistics reported in the media, [ http://www.dawn.com/2011/12/03/inflation-shoots-up-by-1019pc-in-nov.html ] non-perishable food items saw price rises of 11.83 percent in the year to November 2011. Other percentage increases during the year were: tomatoes (42.02), spices (36.37), fresh fruit (29.62), betel leaves and nuts (24.56), condiments (23.50), milk (21.11), milk products (20.47), beverages (19.79), cooking oil (19.56), and meat (19.35).
 
 “Times are becoming harder and harder. I have just given birth to my fourth child. We will do all we can to raise the children, and murder of course is an unforgivable sin, but sometimes I understand the despair of parents who do so,” said Safia Bibi, a washerwoman whose husband is an odd-job man. 
 
 The family earns a monthly income of Rs. 6,000 ($70). “The children go barefoot because just feeding them is next to impossible. We survive mainly on `roti’ [bread] and pickles,” she said.
 
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]]></body><pubDate>Tue, 03 Jan 2012 00:00:00 GMT</pubDate><link>http://www.irinnews.org/report.aspx?ReportId=94574</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://irinnews.org/images/2012/201201030710510805t.jpg"/></td><td valign="top">LAHORE 03 January 2012 (IRIN) - The murder of infants, particularly girls, by poverty-stricken parents in Pakistan appears to be on the rise. Late at night two months ago in a village in Pakistan’s Punjab Province, the parents of a two-day-old infant girl smothered the child, and then buried her tiny body in a distant field, carefully patting down the soil to hide any signs of digging. The mother cries often and says she still has nightmares about the event.</td></tr></table>]]></content:encoded></item><item><title>ZIMBABWE: Growing risk of waterborne diseases in rural areas</title><pubDate>Tue, 03 Jan 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://irinnews.org/images/2009/200902176t.jpg" />]]>MHONDORO 03 January 2012 (IRIN) - Barbra Phiri, 20, a single mother living on a farm settlement in rural Mhondoro, about 45km southwest of the Zimbabwean capital Harare, does not think twice about letting her two-year-old twins splash about in a pool of greenish water close to her hut.</description><body><![CDATA[MHONDORO 03 January 2012 (IRIN) - Barbra Phiri, 20, a single mother living on a farm settlement in rural Mhondoro, about 45km southwest of the Zimbabwean capital Harare, does not think twice about letting her two-year-old twins splash about in a pool of greenish water close to her hut. 
 
 Since the rains began several weeks ago, dirty water has been accumulating on the settlement, now home to hundreds of former farmworkers and others displaced during Operation Murambatsvina [ http://www.un.org/News/dh/infocus/zimbabwe/zimbabwe_rpt.pdf ] in 2005 which razed illegal structures and left thousands without shelter. 
 
 Phiri remembers the 2008-2009 outbreak of cholera which killed more than 4,000 people and infected nearly 100,000 others, but sees it as a thing of the past and is still ignorant of how waterborne diseases are spread. 
 
 Her twins have a skin infection and frequent bouts of diarrhoea but, like most residents, she attributes such ailments to witchcraft, consulting a traditional healer for a cure. 
 
 Phiri told IRIN her first child died two years ago from diarrhoea. “We don’t use dirty water for drinking or cooking. We get clean water from the dam or the wells, so how can our children die from waterborne diseases?” she asked. 
 
 A few metres from Phiri’s hut is an overflowing pit latrine. Many inhabitants have resorted to relieving themselves in the open since most of their pit latrines are overflowing and unusable. 
 
 The 2009 Multiple Indicator Monitoring Survey (MIMS) [ http://ochaonline.un.org/Surveys/MIMS2009/tabid/5465/language/en-US/Default.aspx ], compiled by the government and UN Children’s Fund (UNICEF), listed diarrhoea as one of the major causes of infant mortality resulting in around 4, 000 deaths in Zimbabwe annually. 
 
 The MIMS survey showed a 20 percent increase in under-five mortality since 1990. 
 
 With the advent of the rainy season and poor sanitary and hygienic facilities, people living in rural and peri-urban settlements like Phiri’s are vulnerable to waterborne diseases. 
 
 The survey said: “Recent assessments show a significant decline in rural sanitation sector performance,” adding: “The inability of vulnerable populations to access safe water and basic sanitation… has resulted in frequent diarrhoeal and cholera outbreaks.” 
 
 The Consolidated Appeals Process (CAP) for Zimbabwe, [ http://reliefweb.int/node/462237 ] launched in early December 2011, said “a third of rural Zimbabweans still drink from unprotected water sources and are thus exposed to waterborne diseases,” and noted reports of cholera cases in rural Chipinge, in the eastern province of Manicaland, and Chiredzi in the southeast of the country. 
 
 More people seek treatment 
 
 A senior nurse at a clinic in rural Seke District, about 50km south of Harare, who preferred anonymity, told IRIN the number of people seeking treatment for diarrhoea and dysentery had increased since the onset of the rains. 
 
 “Typical of this time of the year when the rains fall, we treat a high number of people suffering from waterborne diseases… We have not received any cases of cholera but there is need to be on the alert all the time, because the surrounding villages are characterized by poor hygiene and sanitation. Many villagers tend to relieve themselves in the open because they cannot rehabilitate the Blair pit toilets [ http://en.wikipedia.org/wiki/Blair_toilet ] that were built long ago,” she said. 
 
 Blair pit toilets were constructed in large numbers to improve rural sanitation in the 1980s. A fine wire mesh allowed gases produced by decomposition to escape, but prevented flies around the faecal matter from exiting the septic tank and so prevented the spread of diseases. 
 
 According a 2011 report by the UN Children’s Fund (UNICEF) and the government entitled A Situational Analysis on the Status of Women’s and Children’s Rights in Zimbabwe, 2005-2010 [ http://reliefweb.int/node/392557 ] 42 percent of people in rural communities practised open defecation, while cholera, which used to see significant outbreaks every 10 years or so in the 1980s and 1990s, has now become an annual event. 
 
 Poor household income, the senior nurse said, prevented some villagers from seeking treatment, “meaning that the number of people suffering from waterborne diseases could be higher as some of the cases go unreported [as people cannot afford to travel to clinics].” 
 
 David Shoniwa, 65, from Dema village in Seke District, said people in his community tended to relieve themselves along river beds during the dry season. 
 
 “The boreholes that were drilled in the 1980s have broken down and only a few that were sunk in recent years still function while, due to poor rains, it is difficult to sink new wells. When the rains fall, people turn to the rivers for water to drink and use for cooking, thereby exposing themselves to the diseases carried by the human waste,” Shoniwa told IRIN. 
 
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]]></body><pubDate>Tue, 03 Jan 2012 00:00:00 GMT</pubDate><link>http://www.irinnews.org/report.aspx?ReportId=94575</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://irinnews.org/images/2009/200902176t.jpg"/></td><td valign="top">MHONDORO 03 January 2012 (IRIN) - Barbra Phiri, 20, a single mother living on a farm settlement in rural Mhondoro, about 45km southwest of the Zimbabwean capital Harare, does not think twice about letting her two-year-old twins splash about in a pool of greenish water close to her hut.</td></tr></table>]]></content:encoded></item></channel></rss>
