http://www.irinnews.org/irin-fp.aspxUpdated everydayen-gbThu, 05 Nov 2009 19:13:58 GMTJUBA Thursday, November 05, 2009 (IRIN) - Sudan has started registering voters for presidential, legislative and regional elections, but officials in the south and international observers say the process has begun on a flawed note.JUBA Thursday, November 05, 2009 (IRIN) - Sudan has started registering voters for presidential, legislative and regional elections, but officials in the south and international observers say the process has begun on a flawed note.

"This process could easily be referred to as ‘dead on arrival’," Anne Itto, secretary-general for the south of the Sudan People's Liberation Movement (SPLM), said on 3 November.

The National Election Commission (NEC) deputy head Abdalla Ahmed, however, told the Sudan Tribune on 2 November that the NEC had mobilized concerned authorities to ensure the success of the exercise.

The month-long process began on 1 November. It is a key step towards the April 2010 polls that are seen as a landmark of the 2005 peace agreement that ended two decades of civil war between north and south.

An estimated two million people died in that war, which ended with the signing of the Comprehensive Peace Agreement (CPA).

"In the context of Southern Sudan, where you don’t have [telephone] networks, where you don’t have roads, where you don’t have public transport, it is very unrealistic to expect registration to be completed by 30 November," Itto told reporters in the Southern capital, Juba.

Should the NEC fail to take immediate and drastic action, warned the SPLM, fewer than 10 percent of eligible voters in the south would be able to register and vote.

"If things go the way they are going now, I believe less than 10 percent of the total population will be registered," Itto said.

The NEC has set up some 15,000 registration centres to cater for an estimated 20 million Sudanese voters.

Concerns

Observers, however, said the centres had been slow to open even in state capitals, and reports indicated that access for rural populations was poor.

Awareness that registration had begun or even knowledge of the need to register was low, while state election committees had complained of delays in operational funding.

Those concerns were echoed by the US-based Carter Center, whose international observers are monitoring the electoral process, which said more must be done countrywide to ensure registration.

On 2 November, the centre "expressed concerns about the obstacles facing election observers, including delays in finalizing their accreditation procedures and delays in election preparations, as well as continued reports of harassment of political party and civil society activity".

Citing Darfur, it warned of the difficulty of running election activities in the troubled region: "The continuing state of emergency means that a free and open electoral process remains difficult to contemplate."

Insecurity worries

Separately, the Washington-based Enough Project warned that poor preparations would impact on future key events, including the referendum on the south’s potential full independence slated for January 2011.

"The deck is stacked against a free and fair election in five months," wrote Sudan-based researcher Maggie Fick in a 5 November report. "There are worrying signs that it could be a trigger for further insecurity."

The process, she added, could, however, provide key lessons for the actual elections. The voter registration process “could also serve as a trial run in which some of the issues that could negatively impact [on] the polling period could be resolved", she added. "Alternately, the registration process could expose a reality that... has been felt on the ground for some time: these elections could destabilize already insecure areas as the all-important 2011 referendum draws nearer."

Awareness problems

In capitals like Juba, awareness is poor, despite efforts by the authorities to advertise the process through street marches, poster campaigns and radio broadcasts.

"I registered on the first day, but I know many people who are not aware," Opio Moses Korduk, a local resident, told IRIN.

Others however, said that as southerners, their concern was the 2011 referendum and not the election.

"The north cheated us when they ran the census results," said James Deng, a student at Juba University, referring to the contested national census results released earlier this year.

"So why should we think the election will be any different? I am waiting for the referendum because independence is the only future for the south," he added.

Rising tensions

Meanwhile, talks continued between north and south following meetings with the US Special Envoy Scott Gration to tackle sticking points of the CPA.

"It is a difficult and lengthy process, but failure is not an option," Gration warned in Khartoum on 2 November.

Tensions have risen between north and south, especially following comments by Southern President Salva Kiir that voting for unity in 2011 would make southerners "second-class" citizens in Sudan.

The two sides are still divided by ideological, religious and ethnic differences over which the civil war was fought.

"It is why it is critical that we ensure that the process is fair and credible and that the will of the people, as expressed through the national elections and the referendum, is respected peacefully," added Gration.

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http://www.irinnews.org/report.aspx?ReportId=86894WAJIR EAST Thursday, November 05, 2009 (IRIN) - The sound of the evening bell at a local boarding high-school in Wajir, in the northeast of Kenya, did not always signal the end of the day's classes. Instead it marked the end of the evening bathroom break as “bucket toilets” were emptied for the day. WAJIR EAST Thursday, November 05, 2009 (IRIN) - The sound of the evening bell at a local boarding high-school in Wajir, in the northeast of Kenya, did not always signal the end of the day's classes. Instead it marked the end of the evening bathroom break as “bucket toilets” were emptied for the day.

Such stories are commonly told with a mixture of humour and concern in the semi-arid region of Wajir, where most residents have little access to improved sanitation - with serious health implications.

"Wajir is prone to diarrhoea outbreaks," Francis Njoroge, Wajir East medical health officer, told IRIN. "Diarrhoeal diseases are [the] third [most] common illness in children below five years.

"Several factors could be contributory: the town lacks a sewerage system [and] uses a bucket system... people depend on boreholes... and many of the community water wells are not protected, exposing them to contamination," Njoroge said.

Outside the town, people use water from open dams, which they share with animals. "During the rainy season, run-off water washes animal waste into the dam, contaminating it," he said.

Wajir residents rely on shallow wells, due to increasing water salinity at depth, which are exposed to contamination during flash floods and from seepage.

The larger Wajir, which borders Somalia, Ethiopia, as well as the Kenyan towns of Mandera, Moyale, Isiolo and Garissa, lies in an area with large aquifers supplied by perennial rivers and dry seasonal river basins - also sources of contamination.

Like most of northern Kenya, Wajir has experienced a prolonged drought and livestock deaths. Animal carcasses litter watering points, posing a further health risk.

Contamination

Wajir South Development Association (WASDA) programme manager, Haretha Bulle, told IRIN of the challenges.

"There are [largely] no flush toilets and no pit latrines," Bulle told IRIN. A few flush toilets can be found in some hotels and in newer settlements but are rare in households.

According to a UN World Health Organization report, latrine coverage in rural Wajir is about 5 percent and just a little higher in the town.

Because of the high water table, pit latrines are not viable, and residents mainly rely on unhygienic bucket toilets - improvised from plastic jerry cans.

"Waste is collected from the bucket latrines by a tractor, which serves the whole town," Bulle noted. The town has a population of about 220,000.

"Households are not able to dispose of waste [and] are forced to dispose it anywhere," she said. "When it rains, the whole town smells. The water gets contaminated more easily and changes colour."

Refuse pit and open pit dumping is prevalent.

El Niño threat

According to Wajir town resident, Khadijah Ibrahim, ongoing El Niño-related rains will only exacerbate the situation. Her family of eight shares one bucket toilet with three other households - about 24 people in total.

"Sometimes the municipal council comes to empty the bucket after a week or 15 days. By the time the waste collectors come, the bucket toilet is already overflowing," Ibrahim said.

Her children, the youngest of whom is three, have been trained to wear shoes before going to the toilet to protect themselves, "but they only use soap to wash their hands before they eat", Ibrahim said.

Eco-toilets

The Arid Lands Development Focus (ALDEF) NGO is piloting eco-toilets, which use heat trapped by solar panels to burn human waste, reducing it to ash.

The toilets do not use water, instead relying on a dehydration/evaporation system. Diyad Hujale, ALDEF programme manager, told IRIN the target was mainly the town centre, which requires about 5,000 toilets.

Hujale recommended that Wajir town’s by-laws should make it compulsory for any upcoming construction to have an eco-toilet facility. The challenge, he said, is "how to get rid of the bucket toilet".

However, the cost of setting up an eco-san unit, about KSh60,000 (US$800), is prohibitive for private households.

Health education

Past recommendations to improve drainage and sanitation in Wajir have not yielded much, according to Bulle of WASDA. "It is one disaster after the other. When the rains come, we think of the drainage but forget about it when the drought comes."

At present, village elders in Wajir are being taught how to chlorinate the community wells, according to health officer Njoroge. Health education on the importance of protecting the wells is also being provided.

He said the construction of more toilets is being encouraged in new settlements, where communities are provided with water treatment chemicals.

"Health education is ongoing. Of importance is that there is continued disease surveillance in the district," he said. The solution lay in "providing clean water to the community and safe disposal of human waste via a sewerage system".

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http://www.irinnews.org/report.aspx?ReportId=86896NAIROBI Wednesday, November 04, 2009 (IRIN) - Encouraging the use of traditional African herbal medicines could prevent some of the one million malarial deaths on the continent, according to specialists attending a conference www.mimalaria.org/pamc in Nairobi. Many poor communities, especially in rural settings, cannot afford modern malarial drugs and many people die due to inaccessibility of treatment.NAIROBI Wednesday, November 04, 2009 (IRIN) - Encouraging the use of traditional African herbal medicines could prevent some of the one million malarial deaths on the continent, according to specialists attending a conference www.mimalaria.org/pamc in Nairobi. Many poor communities, especially in rural settings, cannot afford modern malarial drugs and many people die due to inaccessibility of treatment.

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

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

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

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

Preserving traditional knowledge

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

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

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

Educating the youth

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

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

Effectiveness and dangers

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

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

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

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

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http://www.irinnews.org/report.aspx?ReportId=86866NAIROBI Wednesday, November 04, 2009 (IRIN) - Authorities in central Kenya have ordered hundreds of people to evacuate after a girl was killed when a mudslide destroyed her home following heavy rains.NAIROBI Wednesday, November 04, 2009 (IRIN) - Authorities in central Kenya have ordered hundreds of people to evacuate after a girl was killed when a mudslide destroyed her home  following heavy rains.

The incident took place in Gathaithi, in Murang’a East district.

“I have ordered all those living near the ill-fated home to vacate immediately and move to safer  ground. The government will provide them with essentials like tents and food,” District Commissioner George Natambeya said.
 
 In the past two weeks, heavy rains have been reported in most parts of the country and the government has ordered some families in landslide-prone areas of the larger Murang’a, Maragwa and Nyeri districts in central Kenya to vacate their homes.  Several deaths have occurred in the area as a result of mudslides because of the area’s topography.

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http://www.irinnews.org/report.aspx?ReportId=86870NANYUKI Wednesday, November 04, 2009 (IRIN) - Two years after violence forced Samuel Mwangi off his farm in the Kiambogo location of Nakuru District in Rift Valley Province, the father of seven is still struggling to rebuild his life and educate his children. Rift Valley, one of Kenya's grain baskets, was the worst-affected by the violence and food security has yet to recover.NANYUKI Wednesday, November 04, 2009 (IRIN) - Two years after violence forced Samuel Mwangi off his farm in the Kiambogo location of Nakuru District in Rift Valley Province, the father of seven is still struggling to rebuild his life and educate his children. Rift Valley, one of Kenya's grain baskets, was the worst-affected by the violence and food security has yet to recover.

Mwangi, who is now living in the central region of Laikipia as an internally displaced person (IDP), spoke to IRIN:

"Before the violence, I had a five-acre farm in Kiambogo where I used to grow maize and beans. I would say that by local standards I was a 'kabudaa' [slang for a rich man]. I also used to buy cereals from neighbouring farms, which I would then re-sell to the National Cereals Board.

"After the violence started [in early 2008], we fled Kiambogo and had to walk many kilometres to Nakuru town [Rift Valley's capital]. I left one of my injured parents behind when we fled as I could do nothing to help.

"Once in Nakuru, we got a lift to Kiganjo [in central Kenya] where we found ourselves stranded for three days. We then found our way to Naromoru [also in central] where we stayed in a makeshift tent by the sewerage area for six months relying on help from well-wishers.

"Then one day, one of the local chiefs asked me to work as a farm caretaker in the neighbouring area of Murero. This is the job I now have. I also work as a casual labourer digging people's farms and helping clean cowsheds to earn some money.

"I have enrolled my children in the local schools although paying school fees is difficult. I go to the schools and explain my situation to the headmaster so that he keeps allowing my children to stay in school even without any money.

"We are still waiting for the promised government compensation money [about US$465] to buy a cow and some goats as the money cannot buy land. In the meantime, we are also relying on relief food.

"I have heard that people have gone back to their former homes but even if I am told to return, I do not think I will. There is nothing left [there] for me; no property, no land and maybe I will be attacked again.

"We have been hearing on the radio that people are getting new land to resettle. If I get new land I will willingly go even if it is not fertile and full of stones. I will go there and develop it the best way I can as I believe in hard work. The most important thing is security.

"Even on the farm where I am a caretaker, I am planting some trees and vegetables to express my gratitude to the [farm] owner for letting my family have a place to live.

"We are facing many challenges two years after we left home but it is often not easy speaking directly to those who should be assisting us. Being an IDP is like being in jail."

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http://www.irinnews.org/report.aspx?ReportId=86871NAIROBI Tuesday, November 03, 2009 (IRIN) - Three years after being diagnosed with HIV, Alice Mworia, 28, went for a routine medical check-up during which she told the nurse she had noticed an unusual vaginal discharge; a test revealed she had pre-cancerous lesions on her cervix that could develop into cancer if untreated.NAIROBI Tuesday, November 03, 2009 (IRIN) - Three years after being diagnosed with HIV, Alice Mworia, 28, went for a routine medical check-up during which she told the nurse she had noticed an unusual vaginal discharge; a test revealed she had pre-cancerous lesions on her cervix that could develop into cancer if untreated.

"I was experiencing a bad smell from my private parts and I wondered whether it was because I was HIV-positive; I could not keep quiet any more and I shared with one of the nurses and she referred me to the doctor," Mworia told IRIN/PlusNews. "I did not even know there was anything called cervical cancer, which I was informed can kill very easily."

According to the UN World Health Organization (WHO) [http://apps.who.int/hpvcentre/statistics/dynamic/ico/country_pdf/KEN.pdf], some 2,635 Kenyan women are diagnosed with cervical cancer every year, with 2,111 dying from the disease, making it the most prevalent cancer among women in the country. About 38.8 percent of women in the general population are estimated to harbour cervical human papillomavirus (HPV) infection [http://www.cancer.gov/cancertopics/factsheet/Risk/HPV] - a leading cause of cervical cancer - at any given time.

High risk, low knowledge

For cervical HPV infection to progress to cancer, certain co-factors must be in place, including smoking, long-term hormonal contraceptive use and co-infection with HIV.

"Women who are HIV-positive have weak immune systems and this makes them very susceptible to persistent human papillomavirus that develops into cancer of cervix," said Lucy Muchiri, a senior lecturer in human pathology at the University of Nairobi's College of Health Sciences and a member of the sub-Saharan Africa Cervical Cancer Working Group.

"It takes a relatively shorter time for the HPV virus to develop into full-blown cancer of the cervix for women who have the HIV infection … It would take relatively longer in women who are not infected with HIV."

Pap smear tests - which check for changes in the cells of the cervix - are available at most district health facilities in Kenya, but according to WHO, fewer than 6 percent of women access them.

"I think many women die from the disease for a number of reasons - one is ignorance because knowledge about the disease among women and in the general population is very low and it is mistaken for other diseases," she said. "It is appalling that despite most cancer-related deaths in women happening because of cervical cancer, it is the least talked about or even known by people, including women."

According to Francis Kimani, director of medical services at the Ministry of Health, Kenya is planning a screening programme for early detection and treatment of cervical cancer as well as a widespread education campaign.

Education gap

"I think our best bet is to carry out education to let people know about the disease and that early detection of it can be very helpful," Kimani told IRIN/PlusNews. "It is true that not many people - especially in rural areas - know about the disease."

Studies [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2631263] have shown that HPV is higher among women who have multiple sexual partners and unprotected sex.

"Maybe to prevent it in the first place, the same methods used in combating HIV, like condom use, abstinence and keeping to one faithful partner, should be encouraged in this case too," Muchiri suggested.

She noted that the government also needed to invest in making the HPV vaccine - which protects against four major types of HPV, including two types that are responsible for 70 percent of cervical cancers - widely available in public hospitals.

Vaccine availability

The Kenya Pharmacy and Poisons Board approved the sale of an HPV vaccine in the country in 2007, but its availability is extremely limited and it is still prohibitively expensive for most Kenyans.

"HPV is a sexually transmitted virus and with the vaccine in place, it is important to encourage parents to take their young girls between the ages of nine and 15 to be vaccinated before they debut into sex," she said.

A recent study by the local NGO, Centre for the Study of Adolescence, found that four in 10 Kenyan girls had sex before the age of 19, many of them as early as 12.

"Once they [women] become sexually active, it is important to encourage [them] to go for Pap smear tests or visual detection of the pre-cancerous lesions but even vaccination at this stage is still feasible so long as one has not contracted the virus," Muchiri added.

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http://www.irinnews.org/report.aspx?ReportId=86853PADER/NAIROBI Monday, November 02, 2009 (IRIN) - Most Ugandans displaced by two decades of conflict in the north have returned to their villages but a significant number are still stuck in camps and should be helped to leave, observers say. PADER/NAIROBI Monday, November 02, 2009 (IRIN) - Most Ugandans displaced by two decades of conflict in the north have returned to their villages but a significant number are still stuck in camps and should be helped to leave, observers say.

"Significant numbers of those who remain in the camps are there not out of choice but because they are unable to return to their home areas," the Internal Displacement Monitoring Centre (IDMC) states in an August report.

"Some IDPs [internally displaced persons] cannot return because land disputes prevent them from accessing land, while IDPs with special needs and vulnerabilities are unable to support themselves in the return areas."

Years of conflict between the government and the rebel Lord's Resistance Army (LRA) forced two million people from their homes, but according to the government fewer than 500,000 remain in camps.

"Sustaining returns remains a challenge that must be addressed by quick impact recovery and development activities, which requires stronger action by development agencies and support of donors," Walter Kälin, Representative of the UN Secretary-General on the Human Rights of IDPs, said in a 26 October statement to the General Assembly.

"Despite the huge progress made thus far, the fate of a considerable number of particularly vulnerable individuals left behind in camps or living in transit sites as well as a general lack of synchronicity between the phasing out of humanitarian assistance and the increase of development activities in returnee areas continue to be a source of concern," he added.

Testimonials

At Geregere camp in Pader, the IDPs say age and disability have prevented them from building shelters or farming. They also cite illness and disease, and disputes over land rights and ownership.

Richard Opio, 62, said he had depended entirely on food donations since arriving at Geregere in 2003. To supplement these rations, he had tried planting some crops, supported by two of his eight children.

He was, however, unable to leave after being disabled by a long convalescence following a beating by the LRA. His knee hurt and he was waiting for some oxen to help him with the planting.

Before the war, he said, he had farmed his 15ha about 2km from the camp, rotating sorghum, maize, groundnuts and millet. He also had seven cows, 11 goats and nine sheep.

Asked what he would do if there was no help forthcoming, he said he would still return next year when the grass was long.

Josephine Ladwong, 73, came to Geregere from Lateling village, about 5km away. Initially, she spent time in Patongo camp, then was moved to Geregere in 2005 as part of a resettlement plan for overcrowded camps.

She had 12 children, 10 of whom had died - two killed by the LRA. She said she had stayed at Geregere because she was not strong enough to build a hut on her land, and was waiting for someone to help.

Theophilo Ongwec inherited the land on which Geregere IDP camp is built from his father. When the government established the camp in 2005, they did not compensate him.

Asked whether there had been any offer to assist him to restore the land as people went home, he said there had been the promise of a tractor, but this had yet to arrive.

The returns followed the signing of a Cessation of Hostilities Agreement between the government and the LRA in 2006.

"Most of the 15 percent remaining in camps are particularly vulnerable – widows, the elderly and disabled, child-headed households and those suffering from HIV/AIDS," the UN Under-Secretary General for Humanitarian Affairs and Emergency Relief Coordinator John Holmes said during a 21 October visit to the camp.

Basics lacking

According to the IDMC, returnee communities needed assistance to reintegrate these vulnerable IDPs. At the same time, much work remains to be done to ensure that returns are sustainable.

For example, basic infrastructure and services in the return areas are inadequate or non-existent. Lack of access to clean water poses a risk of epidemics, and clinics and schools struggle with insufficient facilities and qualified personnel.

While returnees have begun to grow their own food, the situation is still fragile, particularly as low rainfall since April 2009 means harvests are predicted to be more than 60 percent lower than normal.

"The old, the orphans and the terminally ill are stuck in camps and as other people have ventured out to go back home, they cannot return and their rights over many issues are compromised," Norbert Mao, Gulu district council chairman, told IRIN in July.

Calling them Uganda’s "invisible war victims", he sought urgent help to enable them to move from IDP camps to a normal existence.

Ugandan authorities began closing down the camps in the north in October.

"We must do more to help them too regain an independent life outside the camp," Holmes said after his visit, describing the IDPs still in camps as a "residual caseload".

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http://www.irinnews.org/report.aspx?ReportId=86841MOMBASA Thursday, October 29, 2009 (IRIN) - After days of heavy rain, flash floods in Kenya's coastal Magarini district have displaced at least 500 families, sweeping away houses and livestock, officials said.MOMBASA Thursday, October 29, 2009 (IRIN) - After days of heavy rain, flash floods in Kenya's coastal Magarini district have displaced at least 500 families, sweeping away houses and livestock, officials said.

Most of the affected families were from Kurawa and Kanagoni villages in Magarini. Many have already sought alternative shelter, with some heading to a camp for the displaced along the Malindi-Garissa highway.

John Manasseh, a local leader, told IRIN on 28 October: "We had assumed that since the rains were delayed at the beginning of the year, we would not experience any flooding. We even started cultivating our farms in readiness for the rain, but it seems we were all wrong."

Most of the coastal region has been dry, having not had rains since early 2009. In August, the Kenya Meteorological Department warned that the country could soon experience El Niño-related enhanced rainfall. Already, heavy rains have been reported in many parts of the country, with Coast Province being the latest to experience flooding.

The Magarini flash floods occurred a day after two people reportedly died in Kolongoni village in neighbouring Kilifi district, after a house in which they were sleeping collapsed after a downpour, crushing them.

Jillo Galgalo, one of those displaced by the floods in Magarini, said they lacked clean water for domestic use and were at risk of infection from waterborne diseases.

"Most pit latrines have been washed away because nobody expected any floods to occur this soon," Galgalo said. "We are in dire need of clean water because most water points are now filled with all sorts of waste, including human waste and cow dung."

Along with the neighbouring Tana River district - where roads connecting the towns of Mombasa, Garissa and Lamu have been cut off due to the rains - roads in Kilifi have not been spared, with most roads connecting local trading centres impassable.

Security issues

At least 100 trucks and passenger vehicles plying several routes along the north coast region have either become stuck in mud or were parked by the roadside. Most of the drivers, especially those on the Malindi-Garissa route, have expressed concern over possible bandit attacks.

"Our main concern is security, keeping in mind the number of times we've had cases of fellow drivers being attacked by armed bandits in recent times," Abdalla Musa, a truck driver, said.

However, the Tana Delta district commissioner, Ireri Ngatia, said the government would provide security for all drivers using the route.

Ngatia and his Magarini counterpart, Richard Kananu, have also appealed to residents living in low-lying areas to move to higher ground.

Meanwhile, the Kenya Red Cross Society and other humanitarian organizations are assessing the situation and preparing to start providing the necessary assistance.

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http://www.irinnews.org/report.aspx?ReportId=86793JOHANNESBURG Thursday, October 29, 2009 (IRIN) - An African international agreement has opened the door to a debate on the rights and protection of people displaced by natural disasters, with a nod to migration as a result of climate change. JOHANNESBURG Thursday, October 29, 2009 (IRIN) - An African international agreement has opened the door to a debate on the rights and protection of people displaced by natural disasters, with a nod to migration as a result of climate change.

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

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

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

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

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

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

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

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

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

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

Can of worms

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

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

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

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http://www.irinnews.org/report.aspx?ReportId=86805DAR ES SALAAM Tuesday, October 27, 2009 (IRIN) - HIV-positive Tanzanians are not taking advantage of the availability of life-prolonging anti-retroviral medication in hospitals around the country, says a senior government official.DAR ES SALAAM Tuesday, October 27, 2009 (IRIN) - HIV-positive Tanzanians are not taking advantage of the availability of life-prolonging anti-retroviral medication in hospitals around the country, says a senior government official.

"We have an adequate supply of ARVs in our hospitals and other outlets, but there are few people who are turning out for this important service," David Mwakyusa, Health and Social Welfare Minister, told IRIN/PlusNews.

An estimated 250,000 people are taking ARVs, while another 190,000 who need them are not accessing them. In 2008, the government re-affirmed its commitment to achieving universal access to ARVs by 2010.

"We are working hard to encourage people to check their HIV status and those infected to go for further medical attention and when necessary start taking ARVs, which are in good supply," the minister said.

Mwakyusa also bemoaned the fact that few pregnant women made use of prevention of mother-to-child transmission (PMTCT) services available at antenatal clinics; just 33 percent of pregnant women who require PMTCT services access them, according to UNAIDS.

Research [http://www.ncbi.nlm.nih.gov/pubmed/16987051] has found that although HIV-positive Tanzanians welcome anti-retroviral therapy, they fear that transportation and supplementary food costs, ill-treatment at hospitals and difficulties in sustaining long-term treatment all act as barriers to accessing treatment. Fear of stigma as well as HIV denial, which often led patients to seek treatment from alternative healers, and inadequate numbers of trained medical personnel, also prevented patients from accessing healthcare.

"Multi-faceted interventions are required to promote regular HIV clinic attendance, including ongoing education, counselling and support in both clinic and community settings," authors of a recent study [http://www.ncbi.nlm.nih.gov/pubmed/19444672?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_Discovery_RA&linkpos=1&log$=relatedarticles&logdbfrom=pubmed] by the Centre for Population Studies and the London School of Hygiene and Tropical Medicine recommended.

Mwakyusa noted that Tanzania was planning to cut the cost of ARVs by producing them locally. He said it was important for the country to become more self-sufficient, especially in the face of the global economic downturn.

"We are praying that despite the global financial crisis, donors will continue supporting our efforts," he said. "The financial crisis is clearly affecting the capacity of donors to fund international programmes on AIDS."

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http://www.irinnews.org/report.aspx?ReportId=86756KAMPALA Tuesday, October 27, 2009 (IRIN) - The African Union Convention for the Protection and Assistance of Internally Displaced Persons in Africa is a comprehensive document that will, if ratified, fill a void in international humanitarian law, say experts. KAMPALA Tuesday, October 27, 2009 (IRIN) - The African Union Convention for the Protection and Assistance of Internally Displaced Persons in Africa is a comprehensive document that will, if ratified, fill a void in international humanitarian law, say experts.

Whereas the rights of people who flee across national boundaries are protected under the 1951 Convention Relating to the Status of Refugees and a similar instrument introduced 18 years later by the Organization of African Unity (now the African Union), there has been no international legislation catering specifically for people displaced within their own country (IDPs).

IDPs vastly outnumber refugees in Africa. In just 10 of the 18 countries in east and central Africa, there are more than 10 million IDPs, according to the UN Office for the Coordination of Humanitarian Affairs (OCHA), with Sudan (four million), the Democratic Republic of Congo (2.12 million) and Somalia (1.55 million) heading the list.

In the same region, there are refugees in 16 countries, totalling just less than two million, according to OCHA.

This latest instrument, also known as the Kampala Convention because it was signed in the Ugandan capital, "obliges governments to recognize that IDPs have specific vulnerabilities and must be supported", said Walter Kälin, Representative of the UN Secretary-General on the Human Rights of Internally Displaced Persons.

"It covers all causes of displacement, is forceful in terms of responsibility and goes beyond addressing the roles of states to those of others like the AU and non-state actors."

Signed by 17 African states at the end of summit on 23 October, the convention defines IDPs broadly, irrespective of who is displacing them.

According to the International Committee of the Red Cross (ICRC), the convention provides a solid framework for enhancing the protection and assistance of IDPs in Africa. The ICRC is the custodian of international humanitarian law.

"The crucial challenge now is the same one facing international humanitarian law in general – ensuring that once the convention is signed and ratified by as many states as possible, it is actually implemented and respected," ICRC president Jakob Kellenberger said.

"States must now take concrete steps to implement the convention into their own national legislation and regulation systems, and develop plans of action to address issues of displacement.

"The convention goes further than international humanitarian law treaties in some aspects, for example, in the rules it contains on safe and voluntary return, and on access to compensation or other forms of reparation," Kellenberger added.

Next steps

To become a binding document, the convention has to be ratified by 15 of the AU's 53 member states.

"No international treaty is perfect, and the AU IDP Convention does have a few weaknesses. Concerns over the lack of effective enforcement mechanisms and insufficient guarantees for equality and non-discrimination have been raised," the Brookings-Bern Project on Internal Displacement noted in a statement.

"There is some question regarding the extent to which non-state actors and armed groups called upon by the convention to protect IDPs can be bound by its provisions. Nevertheless, the convention, which has benefited from the input of international experts, is considered to be generally consistent with international standards such as the Guiding Principles on Internal Displacement."

AU officials in Kampala were cautiously upbeat, urging member states to remain engaged. "It is the responsibility of member states that the convention becomes a binding instrument," Jean Ping, AU Commission President, said. "At this point, it is an achievement, but not an end in itself."

Zambian president Rupiah Banda also chose his words carefully. "We have given legal force to the task ahead and Zambia is ready to sign," he said. "Those who are displaced should not be forgotten."

An observer who requested anonymity said progress would require member states to demonstrate greater political will to implement the convention and address concerns about sovereignty and enforcement.

"It is a question of a progressive [AU] Commission versus [conservative] member states," he told IRIN in Kampala. "For example, the inclusion of armed groups in the draft was interpreted by some member states as lending legitimacy to such groups."

The convention emphasizes the sovereignty of member states but spells out the obligations and responsibilities of armed groups. Among others, it prohibits armed groups from carrying our arbitrary displacement, recruiting children and impeding humanitarian assistance.

"Overall, though, the convention has a good chance of getting the necessary signatures rather quickly," the observer added. "In April, SADC’s [Southern African Development Community] 11 members committed to speedy signature."

Political will

Civil society leaders, attending a parallel event, insisted political will and demonstrated commitment were key to progress. The fact that only five presidents came to Kampala, they said, called for an urgent strategy to bring on board more states.

Present were Banda, Ugandan President and host, Yoweri Museveni, Zimbabwe's Robert Mugabe, Somalia's Sheikh Sharif Sheikh Ahmed and Mohamed Abdelaziz of Saharawi, along with high-level UN, INGO and AU delegations.

"It is one thing to have a good convention and another to implement it," Dismas Nkunda of the New York-based International Refugee Rights Initiative told IRIN.

In 2007, the AU adopted the African Charter on democracy, elections and governance, but it has so far been ratified by only two member states.

The basic question of impunity also needed to be addressed. Until African countries learn to respect the law, participants said, the continent would "remain at rock bottom" in its attempts to address the problems of the displaced.

AU officials seemed conscious of these sentiments. "We have come a long way, but a plan of action is now envisaged," Jolly Joiner, AU commissioner for political affairs, told IRIN. "Once member states are on board, we will take this convention forward."

Antonio Guterres, head of the UN Refugee Agency (UNHCR) and representative of the UN Secretary-General at the summit, said solving the question of displacement in Africa required political solutions.

"There is no humanitarian solution to conflict," he explained. "The solution is always political."

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http://www.irinnews.org/report.aspx?ReportId=86762NAIROBI Tuesday, October 27, 2009 (IRIN) - Before 15 January 2008, Erick Kioko was a typical ghetto youth - juggling several petty jobs to survive, but mostly, he liked working as a part-time disc-jockey for local entertainment outfits operating from Mathare slums in the Kenyan capital, Nairobi.NAIROBI Tuesday, October 27, 2009 (IRIN) - Before 15 January 2008, Erick Kioko was a typical ghetto youth - juggling several petty jobs to survive, but mostly, he liked working as a part-time disc-jockey for local entertainment outfits operating from Mathare slums in the Kenyan capital, Nairobi. Other times he served as a tout on city minibus routes, earning KSh50 (US66 cents) per trip. Sometimes he was a porter at a taxi rank. He did all these jobs to support his wife and child, mother and three siblings. Then the country went to the polls in December 2007 and the ensuing violence changed Kioko's life for ever.

Kioko found himself trapped in Kisumu, in the west, where he had gone for a DJ gig. Somehow he made it to Nairobi after two days to find Mathare engulfed in chaos. Kioko, now aged 26, spoke to IRIN about how he lost his arm:

"When I realized that the violence was getting worse, all I wanted to do was check that my family was safe; I arrived in Mathare on 15 January 2008 to find that youths had formed groups to guard their homes from being burnt by rival groups. I found my mother at the gate of the [Moi] Air Force Base where many people had sought refuge.

"In the evening we heard that one of the groups had ordered everyone to remain indoors. I decided to make my way home but I found a group of men - I think they were more than 15 - raping a woman. They were armed with many weapons, including machetes. The woman's screams were so painful, I decided to pick up a few stones and start stoning the mob in the hope that they would leave her alone.

"I continued throwing stones at the group without realizing that three of them had detached themselves and surrounded me. I realized too late that they wanted to cut me up. One of them was so close to me, he aimed his machete at my head. Instinctively, I put my left hand up to shield myself. The next thing I knew my hand was on the ground, he had cut it off! I was in shock.

"I saw the others move closer to me and somehow an inner voice told me to run. I took off with all my strength, heading for the air force base; I just wanted to be near my mother. There I was quickly helped into an ambulance and rushed to Kenyatta National Hospital.

"I stayed in hospital for a month, sleeping on the floor and sometimes going without food as the place was very congested. All they did was dress the wound, I was promised surgery but I was only operated on towards the end of February. Later, Blue House [a charity operating in Mathare] helped me with two other operations in another hospital where the stump was further reduced.

"Now I have healed and I am trying to get on with life, but how can I be a DJ with only one arm? I can no longer be a tout because you need both hands; I can't be a porter either. I dropped out of school in Class Three due to lack of fees so I can't get less-tiring jobs easily. My wife and I live with my mother because I can no longer afford to rent our own place. I spend the nights with friends because I cannot sleep in the same room as my mother.

"All I have right now are questions. Why me? Why has the government forgotten those like me yet it is compensating IDPs [internally displaced persons] who lost property? What of us who lost limbs? I have not even paid the debt I owe Kenyatta National Hospital. I have written to the district commissioner … telling him about my plight but I have not had a response. I plan to go back to his office soon.

"I just need to find a way of supporting myself again. Most of all, I wish I could leave this slum; it is a constant reminder of my lost arm. Friends have even shown me where they found the hand. I wish I had a prosthetic hand so I could resume being a DJ, I wish I could start a small business and be able to rent a house but all these remain just that - wishes - for now.”

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http://www.irinnews.org/report.aspx?ReportId=86763NAIROBI Tuesday, October 27, 2009 (IRIN) - Replacing manual data with electronic health records would significantly improve the quality of care and enable African HIV treatment programmes to be scaled up more efficiently, say the authors of a new article on the subject. NAIROBI Tuesday, October 27, 2009 (IRIN) - Replacing manual data with electronic health records would significantly improve the quality of care and enable African HIV treatment programmes to be scaled up more efficiently, say the authors of a new article on the subject.

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

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

More efficient care

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

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

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

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

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

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

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

Not all smooth sailing

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

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

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

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

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http://www.irinnews.org/report.aspx?ReportId=86768MIDRAND Tuesday, October 27, 2009 (IRIN) - Disaster risk reduction as a tool for climate change adaptation is a "technical mouthful" said Rachel Shebesh, chair of the African Parliamentarian Initiative for Climate Risk Reduction. MIDRAND Tuesday, October 27, 2009 (IRIN) - Disaster risk reduction as a tool for climate change adaptation is a "technical mouthful" said Rachel Shebesh, chair of the African Parliamentarian Initiative for Climate Risk Reduction.

Members of the Pan-African Parliament thought so too. The legislative body of the African Union met in Midrand, halfway between Johannesburg and Pretoria in South Africa, for a parliamentary debate on climate change in Africa.

Shebesh, the new champion of disaster risk reduction (DRR) in Africa for the UN International Strategy for Disaster Reduction (UN-ISDR) has been given the job of making the subject accessible.

Why?

The UN Special Representative of the Secretary-General for Disaster Risk Reduction, Margareta Wahlström, said DRR was "the first line of defence" against climate risks. Many countries did not have a plan that covered what to do to adapt to the impact of climate change, but drawing up a disaster risk reduction plan was a starting point.

DRR deals with the short-term changes in climate variables, such as temperature; adaptation to climate change is about long-term changes to climate. It is now widely acknowledged that reducing vulnerability to climatic variables could improve resilience to the increased hazards associated with climate change.

What does it mean?

Wahlström acknowledged that trying to explain to countries what this meant, and how to take DRR into account, could sometimes be problematic. Essentially, it is about "disaster-proofing" any plan or programme.

"You take into account the current and future disaster risks. If you are building a bridge in an area, you study the soil, ask the people who live in the area about what they know about the conditions in the area: do they build in the area? What precautions do they take? The easiest thing to do is draw up a check list."

Wahlström said she had come across several cities and towns in developing countries who had already been doing this, and "we are now busy putting all this information together for our next report."

She also said she would not be surprised if "disaster-proofing" became a pre-requisite for sourcing money for any climate change adaptation project, "but I would rather countries took up the initiative on their own." India, she said has made it mandatory for projects costing a certain amount to be disaster-proof so as to qualify for funds.

jk/he http://www.irinnews.org/report.aspx?ReportId=86774KAMPALA Monday, October 26, 2009 (IRIN) - Seventeen countries signed the African Union convention on internally displaced persons (IDPs) after years of preparation culminated in a week of meetings in the Ugandan capital but a lot more hard work remains before it becomes effective, according to observers.KAMPALA Monday, October 26, 2009 (IRIN) - Seventeen countries signed the African Union convention on internally displaced persons (IDPs) after years of preparation culminated in a week of meetings in the Ugandan capital but a lot more hard work remains before it becomes effective, according to observers.

"The most important step now is implementation," Julia Dolly Joiner, AU commissioner for political affairs, said. "We need to move from intentions to actions."

For the Brookings-Bern Project on Internal Displacement,  it is crucial that implementation is carried out "in a timely fashion and in a manner that makes a real difference to the lives of persons affected by internal displacement in the region, including host communities.
 
"The first step forward should involve a process of national dialogue and civic education aimed at securing the Convention's ratification and implementation by the State parties," according to a statement by the project, which monitors displacement issues worldwide to promote best practice among governments and other actors.

Fifteen countries must ratify the convention before it enters into effect.

Organizers of the 19-23 October meetings  insisted that the fact that only 17 signed did not represent a lack of political will and commitment on the part of the African states.

"We debated together and we agreed but when it comes to signing, the person has to have been given the authority by his government to sign," one AU official told IRIN. "Only 17 had such authorization."

Ugandan President Yoweri Museveni, who chaired the summit, praised it as "a very important milestone [that] has gone beyond conflicts to address issues of development.

"We have at least agreed in words, we now have to put our words [into] action," he told a news conference. "The solace for the women in Darfur may not be very immediate, but the fact is that people have come together to discuss the matter."

Partnerships urged

Joiner called for international support. "Africa cannot do it alone; that is why we are calling for partnerships," she told IRIN. "We are optimistic that countries will be faithful to their commitments under the convention.”

The AU will now try to get more signatures, and lobby 15 countries to ratify the convention so it can become a binding document. Observers, however, say much more work needs to be done to generate political will, given that most presidents stayed away from the summit.

The convention addresses the root causes of displacement in Africa, where at least 11 million people are displaced by conflict and climate change-related natural disasters, among other reasons.

According to the Brookings-Bern Project, three of the world's top five countries with the largest populations of conflict-induced IDPs are in Africa.

These include Sudan, with an estimated 4.9 million IDPs, the Democratic Republic of Congo, with at least one million, and Somalia, where the UN estimates 1.5 million are displaced. Hundreds of thousands more are displaced in Cote d'Ivoire, Ethiopia, Kenya, Uganda, and Zimbabwe.

Overall, citizens in at least 20 African states are experiencing internal displacement.

The convention aims to promote regional and national measures to prevent, mitigate, prohibit and eliminate the root causes of internal displacement as well as provide durable solutions.

"People who flee persecution or conflict and cross into another country are categorized as refugees and, as such, benefit from a long-standing and well-oiled international legal protection system, including the 1951 Refugee Convention," the UN High Commissioner for Human Rights, Navi Pillay, said.

"Until now [IDPs] have been more or less excluded from the system of international legal protection, even though they are often displaced in exactly the same way, and for exactly the same reasons, as refugees. At least in Africa, that should no longer be the case."

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The IDP convention obliges states to:

- Prohibit and prevent arbitrary population displacements, respect the principles of humanity and human dignity, as well as aspects of international humanitarian law concerning the protection of IDPs;

- Ensure assistance to IDPs, incorporate obligations under the convention into domestic law and designate a body to coordinate IDP protection and assistance;

- Devise early warning systems on potential displacement and establish disaster risk reduction strategies, protect communities and respect individual rights on protection against arbitrary displacement;

- Respect the mandates of the AU and UN, and the roles of international humanitarian organizations; and

- Take necessary action to effectively organize humanitarian relief and guarantee security; respect, protect and not attack humanitarian personnel or resources, and ensure armed groups conform with their obligations.

It prohibits armed groups from:

- Carrying out arbitrary displacement, hampering the provision of protection and assistance to IDPs and restricting the movement of IDPs;

- Forcibly recruiting, kidnapping or engaging in sexual slavery and trafficking; or

- Attacking humanitarian personnel or resources.


It obliges the AU:

- To intervene in respect of grave circumstances such as war crimes and crimes against humanity;

- To respect the right of members to request such an intervention and support efforts to support IDPs; and

- Strengthen capacity and coordinate the mobilization of resources for protection and assistance to IDPs.

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http://www.irinnews.org/report.aspx?ReportId=86746DAR ES SALAAM Friday, October 23, 2009 (IRIN) - An outbreak of cholera in northern Tanzania has continued to spread, claiming 59 lives over the past two months. Health ministry officials reported 60 new cases last week.DAR ES SALAAM Friday, October 23, 2009 (IRIN) - An outbreak of cholera in northern Tanzania has continued to spread, claiming 59 lives over the past two months. Health ministry officials reported 60 new cases last week.

"We have recorded 3,454 cases of cholera in Tanga region during the last eight weeks," Nsachris Mwamaja, a spokesman for the health ministry, said.

He added that the most affected area was in Handeni District, where health officials have attributed the outbreak to ignorance of hygiene practices.

Mwamaja said the government was making efforts to check the spread of the disease to other regions such as Arusha, Kilimanjaro, Coast and the commercial capital, Dar es Salaam.

"Sufficient supplies of medicines and medical personnel have been sent to the affected areas," he said.

Seif Mpembenwe, Handeni district commissioner, said schools that had been closed because of the outbreak were expected to re-open in November.

"We will continue with sensitization campaigns until the situation improves," he said.

Mpembenwe said residents had been advised to dig and use toilets as well as boil drinking water to prevent cholera, an acute illness characterized by watery diarrhoea. The disease is caused by the bacterium Vibrio cholerae and is spread by eating food or drinking water contaminated with the bacteria.

Health officials fear that the long rains due now could lead to more cases of cholera if correct hygiene is not observed.

Meanwhile, the country continues its efforts to curb the spread of the H1N1 influenza. At least 1,000 suspected cases have been reported, mostly in the northern district of Mbulu.

Blandina Nyoni, the permanent secretary in the Ministry of Health and Social Welfare, said of the suspected cases, 339 had been confirmed from the 985 samples officially tested.

She said the disease had so far caused one death. The government had stepped up preventive measures, including screening centres at entry points and enhancing public education.

"People should not panic," Nyoni said. "Much as we don't have vaccines for swine flu in the country, there are adequate supplies of tamiflu antibiotics that are used in the treatment of swine flu."

The influenza is caused by a viral infection. Its symptoms are similar to those of influenza, such as fever, sore throat, muscle pains, severe headache, coughing, weakness and general discomfort.

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http://www.irinnews.org/report.aspx?ReportId=86709NAIROBI Friday, October 23, 2009 (IRIN) - The Inter-Agency Standing Committee (IASC), a grouping of UN and non-UN organizations that since 1992 has worked to harmonize humanitarian best practice, is conducting a review of its various policy statements, guidelines and manuals.NAIROBI Friday, October 23, 2009 (IRIN) - The Inter-Agency Standing Committee (IASC), [http://www.humanitarianinfo.org/iasc/pageloader.aspx] a grouping of UN and non-UN organizations that since 1992 has worked to harmonize humanitarian best practice, is conducting a review of its various policy statements, guidelines and manuals.

Until the end of October, anybody involved in the humanitarian world is invited to take part in brief surveys [http://tinyurl.com/iascreview] designed to gauge the overall familiarity, accessibility and utility of selected IASC products.

These include policy documents on civilian-military partnerships, assisting the elderly in humanitarian crises, and mental health and psycho-social support in emergency settings.

The surveys take 5-7 minutes to complete.

am/cbhttp://www.irinnews.org/report.aspx?ReportId=86715KAMPALA Friday, October 23, 2009 (IRIN) - With increasing natural disasters, including floods, storms and droughts, hitting the continent, more people in Africa are likely to be displaced, creating a challenge for governments, the UN warns.KAMPALA Friday, October 23, 2009 (IRIN) - With increasing natural disasters, including floods, storms and droughts, hitting the continent, more people in Africa are likely to be displaced, creating a challenge for governments, the UN warns.

Displacement caused by natural disasters, said John Holmes, the UN Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator, promised to be one of the greatest challenges African countries would face.

“As many countries… know from recent painful experiences, climate change is already increasing the frequency and intensity of extreme hazard events, particularly floods, storms and droughts,” Holmes told an African Union (AU) summit in the Ugandan capital, Kampala, on 22 October.

In 2008, Africa reported 104 natural disasters, of which 99 percent were climate-related, according to the UN Office for the Coordination of Humanitarian Affairs (OCHA).

Over the past 20 years, the population of Africans affected by natural disasters doubled from nine million in 1989 to 16.7 million in 2008. Of all the disasters on the continent, 75 percent were a result of drought.

“By 2020, rain-fed agriculture is expected to have reduced by half because of shifting rainfall patterns, scattering millions of people across the continent in search [of] new livelihoods,” Holmes said.

The meeting is discussing a draft convention for the protection and assistance of internally displaced persons and a declaration on refugees, returnees and the internally displaced.

The convention is the first such global document that aims to comprehensively address the problems of Africa’s 12 million IDPs.

Transitional justice

Before the meeting, civil society leaders called for concrete action on the convention, when adopted. Chris Dolan of the Uganda Refugee Law Project urged delegates to look beyond existing models of protection and assistance to IDP, refugee and returnee populations and draw from creative transitional justice practices around Africa.

“One step towards this would be to ensure that the plan of action that is put in place to implement the decisions adopted at the summit makes links between the African Union’s draft… and the policy on post-conflict reconstruction and development,” he added.

“Another will be to link… to ongoing transitional justice processes on the continent.”

At least 15 countries need to ratify the proposed convention for it to come into force, and diplomats at the summit are confident the signatures will be raised soon. Preparatory work, they added, had shown broad support across the continent.

“It is the responsibility of member states that the convention becomes a binding instrument,” Jean Ping, AU Commission chairman, told the meeting. “It is an achievement, but not an end in itself. It is a beginning.”

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http://www.irinnews.org/report.aspx?ReportId=86716KAMPALA Thursday, October 22, 2009 (IRIN) - Civil society and government officials are gathered in the Ugandan capital of Kampala to discuss the Convention on the Protection and Assistance of Internally Displaced Persons (IDPs) in Africa and a declaration on refugees, returnees and IDPs.KAMPALA Thursday, October 22, 2009 (IRIN) - Civil society and government officials are gathered in the Ugandan capital of Kampala to discuss the Convention on the Protection and Assistance of Internally Displaced Persons (IDPs) in Africa [http://www.irinnews.org/Report.aspx?ReportId=86585] and a declaration on refugees, returnees and IDPs.

“It is a good convention, but the next steps are even more important,” said Dismas Nkunda of the New York-based International Refugee Rights Initiative. “The key test to the continent’s commitment to it will be the implementation.”

Countries such as Cote d’Ivoire, said Traore Wodjo of the Ivorian civil society coalition, needed to quickly implement the convention because political developments there could raise tensions, leading to renewed displacement.

“Some of those who were displaced during the 2003 conflict are yet to recover,” he added. “Forced displacement again, without protection, would completely disrupt their lives.”

The leaders at the summit, including presidents Robert Mugabe of Zimbabwe, Sheikh Sharif Sheikh Ahmed of Somalia, Yoweri Museveni of Uganda and Ruppiah Banda of Zambia, realize just how important is the challenge of displacement in Africa.

“Displacement is a scourge that is blighting the African landscape – and some of us are talking from experience,” said Zainab Bangura, former activist and now Sierra Leone’s foreign minister. “One day you are a minister, the next you are on a boat running for your life – with nothing on your back.”

Uganda’s Prime Minister Apolo Nsibambi, while praising his country’s policies on refugees, said: “The inability to effectively protect, assist and find timely solutions to the problems that created these displacement situations is posing a major threat to Africa’s development."

The convention, the first such global document, aims to comprehensively address the problems of Africa’s 12 million IDPs. It contains provisions on obligations of state parties relating to internal displacement and protection and assistance.

It also contains provisions on obligations relating to armed groups, the African Union, as well as obligations on sustainable returns, local integration or relocation and compensation.

“The concern is that there are already millions of laws that should protect IDPs, but they are not always observed,” Nkunda said. “So we need to ensure that this convention is respected by setting some kind of benchmarks against which we will evaluate its implementation.”

Civil society and AU role

The civil society meeting will make recommendations to the summit, which should strengthen the convention’s implementation processes, Nkunda said, and is keen to work with the AU to ensure it succeeds.

AU officials are upbeat that the summit, whose side events include an exhibition by actors in the humanitarian field, will fully explore the root causes of forced displacement in Africa and ways to prevent it.

“We are here to reflect on the specific challenges facing IDPs and to adopt an instrument that would bridge existing policy and legal gaps,” said Julia Joiner, AU political affairs commissioner.

Delegates include the UN High Commissioner for Refugees, Antonio Guterres, and the UN Under-Secretary-General for Humanitarian Affairs, John Holmes. There is also a big NGO and government presence.

Before the summit, Holmes flew to the northern Ugandan district of Pader where most returnees are resettling in their villages. He visited IDP camps, host communities and met aid workers and local leaders.

“As emergency relief needs reduce, development efforts need to be stepped up,” he said of the Ugandan situation, where about 500,000 out of more than two million IDPs are still in camps.

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http://www.irinnews.org/report.aspx?ReportId=86700GOZ BEIDA Thursday, October 22, 2009 (IRIN) - The UN Refugee Agency is colour-coding villages red, yellow and green in eastern Chad marking how safe it is for internally displaced persons to return home: people from areas classified as green – “safe” – will no longer be considered as IDPs, but can remain in the camps. GOZ BEIDA Thursday, October 22, 2009 (IRIN) - The UN Refugee Agency is colour-coding villages red, yellow and green in eastern Chad marking how safe it is for internally displaced persons (IDPs) to return home: people from areas classified as green – “safe” – will no longer be considered as IDPs, but can remain in the camps.

“People won’t be forced to go home; they have a right to live wherever they want,” Joel Fischel, UNHCR’s head of office in the eastern Chad town of Goz Beida, told IRIN. “But as long as the reasons which forced them to flee are no longer there, there is no longer a reason to consider them as IDPs.”

Almost 170,000 people displaced by fighting in eastern Chad still live in tents – some who have been displaced for years. All together nearly half a million people have sought shelter in eastern Chad from fighting within the country and in neighbouring Sudan and Central African Republic.

UNHCR’s Fischel told IRIN that displaced people from villages deemed safe for return will no longer receive food or other supplies like mats, kettles and jerry cans. But they will still have a right to the camp school, health services and water points, he said.

The refugee agency estimates that 15,000 IDPs have already left the camps, mostly to return to areas south of Goz Beida that are ranked green in the new security grading system: Loboutigué, Kerfi and Angarana. While people have returned to villages near the border with Sudan, few have approached Adé, located directly on the border.

Khadija Yusuf Hassan, displaced since 2006 from Komo village near Adé, told IRIN she is scared to return. “I have heard that insecurity reigns over there on the border. We heard from other people who go there that there are attacks, thefts, cars being stolen.”

The UN Mission in the Central African Republic and Chad (MINURCAT) peacekeeping force – which has a mandate until March 2010 to encourage people to return home by improving security – is preparing to shift troops from camps to villages.

“This does not mean we will neglect to go to the camps,” MINURCAT commanding officer Howard Berney told IRIN. “But the general information we have is that the camps are safe now and it is possible to start refocusing our efforts.”

MINURCAT initially was to be a 5,200-strong force by December 2009, but deployment delays and insufficient equipment have led the UN to decrease the troop goal to 4,700. As of August 2,368 MINURCAT troops were in Chad and Central African Republic.

Halime Nassir told IRIN she cannot go home with her four children to Kerfi, south of Goz Beida, because of safety concerns – but she does not feel safe at the camp either.

“There is still conflict around the camps when women go out to collect extra wood and water. There is not enough for us here. Almost every day we hear that someone has been attacked; some women are raped. I do not feel safe here in the camp. I will not feel safe [either] if I…go home.”

While rebel attacks are still a threat in Chad, MINURCAT’s Berney said banditry is his main concern in many villages.

Hassan Yassim Bakar, local leader in the town of Adé, said security is improved in the area but not enough and that could discourage returns. “They [would-be returnees] will not want to stay and help us [rebuild the community] if they do not think it is safe.”

ch/pt/nphttp://www.irinnews.org/report.aspx?ReportId=86703KITGUM Wednesday, October 21, 2009 (IRIN) - Military contingents from five East African countries have begun field training in disaster and emergency response as well as anti-terrorism in the northern Ugandan district of Kitgum.KITGUM Wednesday, October 21, 2009 (IRIN) - Military contingents from five East African countries have begun field training in disaster and emergency response as well as anti-terrorism in the northern Ugandan district of Kitgum.

"The joint field training being conducted in northern Uganda is expected to develop further the capacity of the East African Community's armed forces in humanitarian assistance; disaster relief management; and, to some extent, peace support operations, counter-terrorism operations, disaster management and crisis response," Beatrice Kiraso, the deputy secretary-general of the East Africa Community (EAC) in charge of the community's political federation, told IRIN.

Supported by the US army, the 10-day training is codenamed "Natural Fire 10" because it is the 10th time such exercises have taken place since their inception in 1998. It began on 16 October with contingents from Burundi, Kenya, Rwanda, Tanzania and Uganda participating. At least 550 US marine personnel and 133 military personnel from each of the five countries are taking part.

An LRA connection?

US military officials have dismissed speculation that Natural Fire is being held in preparation for a new offensive against the Lord’s Resistance Army (LRA), whose rebellion has devastated northern Uganda, the Kitgum area in particular. In late 2008 the US was a partner with Ugandan troops in Operation Lightning Thunder, a botched attempt to capture LRA leader Joseph Kony in the Democratic Republic of Congo. Tens of thousands of civilians in the DRC, Southern Sudan and the Central African Republic have been displaced because of LRA activity.

According to long-time regional observer Peter Eichstaedt, author of First Kill Your Family - Child Soldiers in Uganda and the Lord’s Resistance Army, the joint exercises convey a clear, if tacit, message to Kony. “That message being, of course, that a multi-national force of 1,000 - an effective number for a fighting force anywhere in the world - can be assembled in this strategic location with relative ease,” Eichstaedt wrote on his blog. http://petereichstaedt.blogspot.com/

“Such a force would be a huge problem for someone like Kony, should he think about a return to northern Uganda. It shows that Uganda has allies who are willing not only to donate moral support and money in the fight against Kony and his maniacal militia, but are willing to put boots on the ground.

“This is an acknowledgement that Kony is much more than Uganda's problem, and has become a regional nightmare,” he writes.

While it makes no mention of the LRA, the US Army's Africa website says http://www.usaraf.army.mil/NEWS/NEWS_090929_STAND_TO_NATURAL_FIRE_10.html of Natural Fire: “By building capacity within partner nations and increasing our ability to work together, US Army Africa will be better prepared for future engagements. In doing so, the US Army also solidifies military rapport with allies in East Africa, key to supporting stability in the region.”

Regional threats

Kiraso said the training was taking place while the EAC was embarking on a new phase of strengthening regional integration even as the region faces "real and potential complex emergencies", which could translate into threats to socio-economic, cultural and political wellbeing of East Africans.

These threats, she said, ranged from natural to man-made disasters; poverty and disease; porous borders and the proliferation of small arms and light weapons; internal strife; and insecurity in states neighbouring the EAC.

"It is very important to develop the East African Community’s capacity to handle such emergencies and threats to peace, security and stability," Kiraso said.

Maj-Gen William B. Garrett, the commanding general, US Army-Africa and US Army-Southern European Taskforce, said the training would help build the capacity of East African armies in combating terrorism and responding to humanitarian catastrophes.

Ugandan army commander, Gen Aronda Nyakarima, said the LRA was no longer a threat to Uganda’s peace as the group was now in the Democratic Republic of Congo and in the Central African Republic. Regional cooperation, he added, was therefore required to get rid of the LRA.

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http://www.irinnews.org/report.aspx?ReportId=86678NAIROBI Monday, October 19, 2009 (IRIN) - Julia Nyaberi's* "clinic" in Majengo, a slum in Kenya's capital, Nairobi, caters to one type of client only - pregnant women seeking abortions.NAIROBI Monday, October 19, 2009 (IRIN) - Julia Nyaberi's* "clinic" in Majengo, a slum in Kenya's capital, Nairobi, caters to one type of client only - pregnant women seeking abortions.

Young women writhe in pain on the floor of the poorly lit house; the neighbours all know what happens here and have become immune to the moans and wails.

"They come to me and each pays me 50 shillings [US$0.70]," Nyaberi told IRIN/PlusNews. "Most of them are sex workers who operate here in Majengo and have conceived by mistake."

She uses a concoction of herbs to induce abortion, and admits there have been fatalities. "Even qualified drivers at times cause accidents; I do not do this job to kill anyone, but at times some are unlucky and go together with the child they came to abort," she said.

Diana Awuor*, 21, is a sex worker in Majengo, and fell pregnant after unprotected sex with a regular client.

"Not that I have sex without a condom every day but there are some regular clients you can excuse at times and I think that is how I became pregnant," she said. "We cannot do our work while pregnant because nobody will want you, so I have to abort to stay in business, and also, I don't want a baby."

Back-street clinics

Ministry of Health statistics put the number of Kenyan girls and women who have abortions every year at 300,000; abortion remains illegal so many of these take place in back-street clinics like Nyaberi's. According to the International Planned Parenthood Federation, http://www.ippf.org/NR/rdonlyres/8D4783F5-D516-47D3-8B34-61F6D510202A/0/Death_Denial_unsafe_abortion_poverty.pdf, unsafe abortions account for between 30 and 50 percent of maternal deaths in Kenya.

"One person attending to up to even five women without sterilizing whatever instruments are being used can spread HIV," said Jacky Abuor, a counsellor at the faith-based Kenyan NGO, Crisis Pregnancy Ministries, which works with young women dealing with unwanted pregnancies.

The legalization debate

A recent study by the local NGO, Centre for the Study of Adolescence (CSA), http://www.csakenya.org found that four in 10 Kenyan girls had sex before the age of 19, many with multiple partners and often in exchange for gifts such as mobile phone airtime or food. Along with the predictable public outcry, http://allafrica.com/stories/200910131192.html the report re-ignited the legalization debate.

Women's rights groups have long urged the government to legalize abortion to prevent the high number of maternal deaths from unsafe procedures. A Reproductive Health and Rights Bill proposing that "safe and accessible abortion-related care" be enshrined in the constitution as a reproductive right was tabled in Parliament in 2008 by the Federation of Women Lawyers and the Coalition On Violence Against Women; MPs have yet to vote on the issue.

The country's anti-abortion movement has powerful backers, from religious leaders to politicians, such as Vice-President Kalonzo Musyoka.

Sex education

"When you say four out of 10 girls have engaged in sex, how do we keep the remaining six from being lured into early sex? The window lies in counselling and education," said Anne Muisyo, “Abstinence and worth the wait” programme coordinator at Crisis Pregnancy Ministries.

"Sex education at the early stages of life and especially targeting young people can significantly turn the tide and prevent new cases of HIV," Paul Mitei, head of gynaecology in western Kenya's Nyanza Provincial Hospital.

Kenya's Ministry of Education has an HIV/AIDS prevention and sex education curriculum that focuses on upper-primary and secondary school, but no specific time is set aside for this during the school day, leaving teachers and school heads to fit in the subject at their discretion.

Speaking at a recent meeting in Nairobi, Kenya's director of public health, Shanaaz Sharif, admitted that opposition from parents, religious groups and some civil society bodies had led to a "censored sex education campaign" in schools.

Agnes Odawa, in charge of guidance and counselling at the education ministry, told IRIN/PlusNews the government had plans to introduce a more detailed sex education package as part of the school curriculum.

Responding to the CSA's findings, the head of the National AIDS Control Council, Alloys Orago, said the government was also looking into the promotion of condom use among teenagers.

Currently the government's HIV prevention programme for teens revolves around the promotion of abstinence, with a nationwide media campaign urging young people to "chill", or abstain, from early sex.

"Many young girls and even boys in rural areas and poor settings do not really know about contraception; those of them who use the condom only know it as a means of preventing HIV," said Mitei. "There is a need to promote condoms to young people both as an HIV preventive measure and birth control measure."

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* not her real name

http://www.irinnews.org/report.aspx?ReportId=86641NAIROBI Monday, October 19, 2009 (IRIN) - As countries across East Africa and the Horn of Africa begin to receive El Niño-related enhanced rainfall, disaster risk reduction experts from 10 countries in the region are meeting in Nairobi to develop strategies for reducing the negative impact of the evolving El Niño phenomenon.NAIROBI Monday, October 19, 2009 (IRIN) - As countries across East Africa and the Horn of Africa begin to receive El Niño-related enhanced rainfall, disaster risk reduction experts from 10 countries in the region are meeting in Nairobi to develop strategies for reducing the negative impact of the evolving El Niño phenomenon.

"Africa, and in particular the Horn of Africa, suffers more and more the impact of climate-induced hazards," Pedro Basabe, the Africa programme representative of the UN International Strategy for Disaster Reduction (UNISDR), said on 19 October at the beginning of the three-day conference, organized by the InterGovernmental Authority on Development (IGAD) and World Bank. "Drought and floods affect directly or indirectly millions of people each year, in particular the poor who are the most vulnerable."

According to the IGAD Climate Prediction and Applications Centre (ICPAC), which produces monthly and seasonal climate outlooks, the Greater Horn of Africa is prone to extreme climate events such as drought and floods, which often have severe negative effects on the region’s key socio-economic sectors.

Experts from Burundi, Djibouti, Ethiopia, Eritrea, Kenya, Rwanda, Tanzania, Uganda, Sudan and Somalia are attending the conference, of which the second and third day will be held in the western town of Kisumu, with participants making field trips to nearby flood-prone areas.

In a keynote speech, Moses Gitari, a senior deputy secretary in the Kenyan Ministry of State for Special Programmes, said memories of the negative impacts of the 1997-1998 El Niño and awareness efforts by climate experts had helped the country develop several disaster preparedness strategies.

"These include education, awareness and information sharing, risks and vulnerability analysis, people-centred early warning, adaptation to climate change, environmental protection, vulnerability reduction through development and social programmes and community coping mechanisms," Gitari said.

He added that community level intervention was pivotal to any disaster risk reduction strategy.

Gitari said the meeting was timely since some of the intervention efforts could require support beyond individual countries' borders.

Abbas Gullet, secretary-general of the Kenya Red Cross Society, said the government, UN agencies and NGOs had, in September, developed a National Contingency Plan for El Niño, "which is being [put into operation] currently".

"We have pre-positioned relief items, human and material resources countrywide in all the eight regions we work in and have conducted drills in some of the regions with a view to putting preparedness capacity on alert status," Gullet said. "It is our hope that this workshop will provide opportunities to explore the various ways and means of entrenching disaster risk reduction in communities we work with and provide a way forward for building safer and resilient communities countrywide."

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http://www.irinnews.org/report.aspx?ReportId=86642AWER Friday, October 16, 2009 (IRIN) - Ambrose Obiya, 70, and his family returned home in March after spending 13 years in a nearby camp, or protected village, because the war between the army and the rebel Lord’s Resistance Army had subsided. Although life improved with the move, it was something of a hard homecoming, explains Obiya, who lost his sight in a car accident in 1978.AWER Friday, October 16, 2009 (IRIN) - Ambrose Obiya, 70, and his family returned home in March after spending 13 years in a nearby camp, or protected village, because the war between the army and the rebel Lord’s Resistance Army had subsided. Although life improved with the move, it was something of a hard homecoming, explains Obiya, who lost his sight in a car accident in 1978.

“Life in the camp was very dangerous because the rebels used to take children and loot food and even killed people. At first there weren’t enough soldiers so the rebels came to disturb people until the government added more.

“When I came back to this place there were no huts; we built them this year. We had nothing to eat and no money. We had to rely on relief food until we planted crops like sweet potatoes and beans.

“Life in the village is better than the camp because in the camp we could not raise our children properly or teach them properly because it was so congested.

“In the camp we had only one primary school for 2,000 children with few teachers so children could not get a good education. And there was only one health centre to serve three camps.

“We don’t have enough food yet because by the time we returned in March there was no rain, dry weather came and the food people planted dried up. The rains started just in August, that is why people are planting few crops, which we will have in the future but not now.

“What we need in the villages first of all is water because we don’t have enough, and secondly infrastructure like roads, because we see now with the rainy season our road is not good when it gets wet because it gets muddy and very slippery and causes lots of accidents. Feeder roads within villages are also not there - this makes movement difficult. Rivers need bridges. If possible the government should help.

“Healthcare is not adequate. First of all, there are not enough staff in the health units; we have a few nurses and at times there is no medicine.

“As for persons with disabilities, I think this problem has been forgotten by both the government and NGOs. We have been crying to the government that they should help our children with education because we people with disabilities don’t have any means of earning money.

“I think with the current security situation we hope to remain home for ever but we don’t know what will happen in the future. People have one fear, that if the rebels return people will be forced back to the camps but we pray they should not return. We ask the world community to assist us in eliminating [LRA leader Joseph] Kony for ever. If the international community could help us with that we would be very pleased.”

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http://www.irinnews.org/report.aspx?ReportId=86601NAIROBI Friday, October 16, 2009 (IRIN) - A draft bill before the Ugandan parliament that seeks to impose stricter sanctions on homosexuality would drive men who have sex with men further underground, making it even more difficult for them to access HIV services, according to AIDS activists.NAIROBI Friday, October 16, 2009 (IRIN) - A draft bill before the Ugandan parliament that seeks to impose stricter sanctions on homosexuality would drive men who have sex with men further underground, making it even more difficult for them to access HIV services, according to AIDS activists.

According to Uganda's New Vision newspaper [http://www.newvision.co.ug/D/8/12/697859], the draft bill, tabled by ruling party MP David Bahati, proposes a seven-year jail term for anyone who "attempts to commit the offence" or who "aids, abets, counsels or procures another to engage in acts of homosexuality".

"If this bill is passed it will be a clear violation of human rights and will push men who have sex with men even further underground than they are," Beatrice Were, a Ugandan HIV/AIDS activist, told IRIN/PlusNews.

"Our national strategic plan for HIV/AIDS aims to achieve universal access to HIV prevention, treatment and care, but if people are criminalized and not allowed to exist, how can they access these services?" she added.

Homosexual acts, or "carnal knowledge against the order of nature", are already criminalized in Uganda, carrying a maximum penalty of life imprisonment.

Under the draft bill, “promotion of homosexuality”, including publishing information or providing funds, premises for activities, or other resources, is also punishable by a seven-year sentence or a fine of US$50,000.

If passed, the bill would see the death penalty handed down for the crime of “aggravated homosexuality” - a sexual assault committed against a member of the same sex who is under 18 or disabled. Anyone found guilty of the offence of homosexuality would be forced to take an HIV test.

"Bahati's proposed bill also supports stigma and discrimination against HIV-positive people, and would undermine years of efforts to tackle the epidemic," Solome Nakaweesi-Kimbugwe, a human rights activist, and Frank Mugisha, co-chair of the rights group, Sexual Minorities Uganda, said in a statement.

"Uganda has been considered a 'best practice' leader in the fight against HIV and AIDS," the statement continued. "If [the bill is] passed, this leadership status would be put in serious question."

The Uganda AIDS Commission classes men who have sex with men (MSMs) as “most at risk”, yet there are no HIV programmes targeting them and no action has been taken in response to a 2009 study [http://www.unaidsrstesa.org/files/u1/Uganda_MoT_Country_Synthesis_Report_7April09_0.pdf] by UNAIDS and the Uganda government recommending that "legal impediments to the inclusion of most-at-risk populations, including commercial sex workers, MSMs and IDUs [intravenous drug users], in the HIV/AIDS national response should be reviewed".

"Morals do not stop HIV; what stops HIV is the evidence from science - we know that using condoms can prevent infection, using PEP [post-exposure prophylaxis] after exposure can stop infection, and ARVs [life-prolonging anti-retroviral drugs] prevent mother-to-child transmission," Were said. "People must feel comfortable enough to seek these services regardless of their sexual orientation."

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