<?xml version="1.0" encoding="UTF-8"?><rss xmlns:content="http://purl.org/rss/1.0/modules/content/" version="2.0"><channel><title>IRIN - Papua New Guinea</title><link>http://www.irinnews.org/</link><description>Updated everyday</description><language>en-gb</language><lastBuildDate>Thu, 14 Mar 2013 14:00:46 GMT</lastBuildDate><item><title>PNG grapples with ageing health workforce</title><pubDate>Thu, 14 Mar 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2013/201303130229230763t.jpg" />]]>PORT MORESBY 14 March 2013 (IRIN) - Papua New Guinea (PNG) is a Pacific country rich in natural resources, yet its health staffing levels are comparable to the world’s poorest countries due to a rapidly retiring force and lack of qualified replacements.</description><body><![CDATA[PORT MORESBY 14 March 2013 (IRIN) - Papua New Guinea (PNG) is a Pacific country rich in natural resources, yet its health staffing levels are comparable to the world’s poorest countries due to a rapidly retiring force and lack of qualified replacements. 

“If we do not do anything about our ageing workforce quickly, the health system may collapse,” former health minister Jamie Maxton Graham told parliament in 2012. 

Despite repeated warnings of the shortage, first at a 2002 national health conference, again in 2008 during a government health resources forum, and most recently by a 2011 World Bank report [ http://www-wds.worldbank.org/external/default/WDSContentServer/WDSP/IB/2013/01/24/000333037_20130124103924/Rendered/PDF/NonAsciiFileName0.pdf ], the country still faces what the government calls a “drastic” health worker shortage.The World Bank report predicted a large decline in the “backbone of rural service delivery” (nurses and midwives) - by up to half. 

All this is unfolding in a mostly rural half-island of seven million residents where the closest health clinic might be hours by boat, foot, or at best, local transport, from the village, said Miriam Lovai, former head of the national midwife association. 

Rural health care is especially threatened, noted 2011 field research [ http://www.care.org.au/Document.Doc?id=666 ] led by Care Australia and the Australian National University. Twice as many infants and three times as many children under five die in rural areas than urban ones, according to the country’s latest census in 2000. 

Two years since the Bank’s “call to action” report, PNG’s health workforce (mostly nurses and midwives) is dwindling through retirement or attrition while the country continues fighting high malnutrition rates in remote highland communities, as well as high infant and child mortality (57 and 75 per 1,000 live births, respectively) [ http://www.irinnews.org/Report/94352/PAPUA-NEW-GUINEA-Tackling-maternal-health-crisis ].

Training

Health experts say the shortage of qualified nurses is due to falling government support to nursing schools, starting in 1999, which has forced the closure of all but three of the eight public nursing schools.  

The team leader of the World Bank report, Aparnaa Somanathan, told international media in 2011: “I think training capacity in PNG has weakened considerably over the last 10-15 years. There is less and less resources being put into training, so PNG’s ability to train more and more doctors and nurses has declined.” 

Fourteen community health worker (CHW) schools produce graduates who work mainly in facilities in rural areas - where 90 percent of the population lives - mostly in clinics known locally as “aid posts”. 

Churches or faith-based groups operate the posts, which are staffed with a nurse or CHW. In areas largely bereft of government services, these posts provide frontline primary care and become the de facto village doctors.  

The World Health Organization (WHO) recommends at least 23 health workers per 10,000 residents to provide basic care, including vaccinations; PNG has five nurses and doctors per 10,000 residents.  

“Many of our qualified nurses have taken up employment in the resource [oil, gas and mining sector] for better pay and conditions,” said Manga Bengi, a public relations officer with Mount Hagen Provincial Hospital, the country’s third largest hospital in Western Highlands Province.  

Mineral deposits account for nearly 70 percent of the country’s export earnings.  

Meanwhile, with poorly-funded health training opportunities, almost no midwives have registered with the state since 2000. However, since the Australian government gave US$120 million last year for midwifery training, Port Moresby reopened four midwifery schools in 2012; a new group of midwives is due to graduate this month.  

Even so, these graduates will be far outnumbered by the number of health workers expected to retire soon. Out of 570 doctors, 3,429 nurses and 4,400 community health workers, 20 percent have passed the legal retirement age of 55, while nearly 40 percent are 45-55, according to the government in 2012.  

Nurses will retire the soonest, with more than one-third of specialist nurses (including midwives) expected to retire in the short term, according to a 2011 health profile [ http://www.hrhhub.unsw.edu.au/HRHweb.nsf/resources/MNRH_PNG-Web.pdf/$file/MNRH_PNG-Web.pdf ] by the Australia-based University of New South Wales and health think tank Burnet Institute. 

What next? 

Prime Minister Peter O’Neill told local media in December 2012 foreign workers are needed as a stop-gap measure. 

Port Moresby General Hospital in the capital, which is the country’s largest referral hospital, recently recruited two nurses from the Philippines, but critics say this temporary solution diverts attention from the need to boost local health worker training and retention through improved benefits and pay.

About 10 years ago, former Prime Minister Sir Michael Somare moved to bring in nearly 100 nurses and doctors from Cuba on temporary work contracts, but the cost and heated opposition from the local medical community of being “replaced” by foreign workers stymied the effort. 

The present government’s latest bid to import health workers has met similar resistance, but plans proceed uninterrupted. 

Also, the government recently approved a health workforce plan in 2013. 

“We know exactly how many nurses we need and a training plan is now put in place to meet our manpower requirements,” chief secretary to the government, Manasupe Zurenuoc, told IRIN.

Nationwide there are 28 hospitals, 551 health centres and nearly 2,000 aid posts, which together process up to 10 million outpatients and 200,000 in-patients annually, according to the National Health Department.  

Zurenuoc added that the National Executive Council earlier this month directed the Department of Personnel Management - responsible for the recruitment and salaries of all civil servants - to finalize salary reforms for CHWs, which will then be submitted for government approval. One proposed change is for the government to do away with a longstanding parallel pay scale system in which CHWs in church-run facilities earn on average 33 percent less than those employed in the public sector. 

Of the 4,400 community health workers nationwide, church health services employ a “substantial” number of them, according to the country’s Churches Medical Council, which oversees faith-based health services.  

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]]></body><link>http://www.irinnews.org/Report/97643/PNG-grapples-with-ageing-health-workforce</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2013/201303130229230763t.jpg"/></td><td valign="top">PORT MORESBY 14 March 2013 (IRIN) - Papua New Guinea (PNG) is a Pacific country rich in natural resources, yet its health staffing levels are comparable to the world’s poorest countries due to a rapidly retiring force and lack of qualified replacements.</td></tr></table>]]></content:encoded></item><item><title>In Brief: Condoms needed in PNG prisons</title><pubDate>Thu, 14 Mar 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2010/201012021344220326t.jpg" />]]>BANGKOK 14 March 2013 (IRIN) - A Papua New Guinea (PNG) study released today calls for condoms to be made more widely available in prisons.</description><body><![CDATA[BANGKOK 14 March 2013 (IRIN) - A Papua New Guinea (PNG) study released today calls for condoms to be made more widely available in prisons.

“All prisoners must have condoms,” Angela Kelly, one of the authors of the study [ http://www.pngimr.org.pg/research%20publications/Kelly%20et%20al%202012%20%20Emerging%20HIV%20Risk%20in%20PNG.pdf ] by the PNG Institute of Medical Research, told IRIN, noting that they could help prevent the spread of HIV/AIDS.

Although condoms are one of the government’s key HIV prevention tools, there is no official policy in place regarding prisons, with many viewing their distribution as supporting male-to-male sex which is illegal in PNG.

The study found that unsafe, forced and consensual male-to-male sex was taking place in four of the country’s 19 overcrowded prisons visited; some sexual relations were long-term, some sex was for goods or as a punishment, and some involved more than one partner.

Only one of the four prisons provided condoms to inmates; most prison staff believed condoms encouraged sex, the study found. While there is no figure for HIV prevalence in PNG prisons, it is widely believed to exceed the national average of 0.8 percent.

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]]></body><link>http://www.irinnews.org/Report/97646/In-Brief-Condoms-needed-in-PNG-prisons</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2010/201012021344220326t.jpg"/></td><td valign="top">BANGKOK 14 March 2013 (IRIN) - A Papua New Guinea (PNG) study released today calls for condoms to be made more widely available in prisons.</td></tr></table>]]></content:encoded></item><item><title>Bednet indifference threatens PNG progress on malaria</title><pubDate>Fri, 15 Feb 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2013/201302151032570388t.jpg" />]]>MASUMAVE 15 February 2013 (IRIN) - Papua New Guinea (PNG) could face an upsurge in malaria cases due to overly relaxed attitudes to the use of bednets, health experts warn.</description><body><![CDATA[MASUMAVE 15 February 2013 (IRIN) - Papua New Guinea (PNG) could face an upsurge in malaria cases due to overly relaxed attitudes to the use of bednets, health experts warn. 

“Sometimes I use it, sometimes I don’t,” Susan Kake, 45, said outside her hut in Masumave, a village of 2,000 largely subsistence farmers in PNG’s remote Eastern Highlands Province. “If I’m going to get it, I’m going to get it.” 

The country has made progress in stemming the disease’s spread in the past few years, but such fatalism is worrying. 

According to PNG’s National Health Information System, 500-700 people die annually from malaria - the country’s second most common cause of hospital admissions, says the Department of Health. 

In 2004 the government intensified its malaria control efforts with support from the Global Fund to Fight AIDS, Tuberculosis and Malaria [ http://www.theglobalfund.org/en/ ], launching a five-year campaign in 2009 to provide two insecticide-treated nets (ITNs) per household nationwide free of charge. 

Alongside insecticide spraying and anti-malarial medicines,ITNs are one of the most effective interventions to control malaria in the absence of a vaccine, says the World Health Organization (WHO) [ http://www.who.int/malaria/publications/world_malaria_report_2012/wmr2012_factsheet.pdf ], as they act as physical barriers to mosquitoes, and help reduce their numbers. 

“Most areas of the country have received nets at least once,” said Tim Freeman, project manager for Rotarians Against Malaria [ http://www.ram.com.pg/ ], a local NGO which has been overseeing bednet distributions since 2010 - in an effort already paying dividends. 

A survey conducted in 17 of PNG’s 20 provinces between November 2010 and August 2011 showed that just 6.8 percent of respondents were infected with malaria parasites, compared around 18 percent in a survey two years earlier. 

Freeman said 2.7 million nets had been delivered to households over the past three years, and 450,000 to vulnerable groups (mainly pregnant women, schools and prisons). 

Gap 

But unless the nets are properly used, their distribution is meaningless, experts say.

“Bednet distribution is one thing. Ownership is another. There seems to be a gap between ownership and utilization,” Walter Kazadi Mulombo, a scientist studying malaria and other vector-borne diseases for WHO in Port Moresby, told IRIN. “Time and time again we’ve seen this globally. Any relaxation of control measures can result in a resurgence.” 

According to a 2012 nationwide survey by the PNG Institute of Medical Research (IMR) [ http://www.pngimr.org.pg/ ], which has been evaluating the campaign, over 80 percent of surveyed households had at least one insecticide treated mosquito net at home, mostly obtained through village-based distribution campaigns, yet fewer than 50 percent of those surveyed reported sleeping under an ITN the night before the survey. 

At the same time, many nets were still found in their original packaging, with fewer than 40 percent of respondents sleeping under a mosquito net the night before the survey. 

“We found multiple reasons why people did not use their nets, but it was indifference rather than lack of understanding that was a highlight,” said Justin Pulford, head of IMR’s Population Health and Demographic Unit. 

Some found the nets too difficult to hang, while others complained it made their sleeping space smaller or too hot. 

Net usage was highest among infants and children, but decreased with age, the study found. 

Global Fund support 

While indifference is one concern, another is the fact that current Global Fund support for the campaign (the National Malaria Control Programme) is due to end in late 2014. 

“Historically, what we have seen if intensive malaria control efforts are not followed up or maintained, then malaria rebounds; often with a dramatic increase,” said Pulford. 

“We’re certainly in a period when we are experiencing a reduction and we expect that to continue. But we’re all a bit nervous about what will happen at the end of 2014.” 

Most bednets last three years, meaning those who have already received a net will need to have them replaced. Treated bednets perform best for the first two years of usage (though how, and how often, they are washed, affects this, studies show). 

“The bednet, with a shelf life of 3-4 years, may need a replacement. For that we’ll need money,” WHO’s Mulombo said. 

According to WHO [ http://www.who.int/malaria/publications/world_malaria_report_2012/wmr2012_no_profiles.pdf ], an estimated US$5.1 billion is needed globally every year between 2011 and 2020 to achieve universal access to malaria interventions. At present, only $2.3 billion is available. 

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]]></body><link>http://www.irinnews.org/Report/97481/Bednet-indifference-threatens-PNG-progress-on-malaria</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2013/201302151032570388t.jpg"/></td><td valign="top">MASUMAVE 15 February 2013 (IRIN) - Papua New Guinea (PNG) could face an upsurge in malaria cases due to overly relaxed attitudes to the use of bednets, health experts warn.</td></tr></table>]]></content:encoded></item><item><title>In Brief: First major survey of cervical cancer in PNG</title><pubDate>Mon, 04 Feb 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2013/201302040934170011t.jpg" />]]>BANGKOK 04 February 2013 (IRIN) - A large-scale survey of cervical cancer will be launched later this month in Papua New Guinea (PNG), where more than 1,500 women die of the disease each year.</description><body><![CDATA[BANGKOK 04 February 2013 (IRIN) - A large-scale survey of cervical cancer will be launched later this month in Papua New Guinea (PNG), where more than 1,500 women die of the disease each year.

“Results of the study will be available later in 2013 when, for the first time, PNG will have the necessary evidence to build a solid public health policy in this area,” Andrew Vallely, deputy director of science at the PNG Institute of Medical Research [ http://www.pngimr.org.pg/ ], who will be overseeing the study, told IRIN.

Cervical cancer is caused by the human papilloma virus (HPV), with the two most common types (HPV16 and HPV18) resulting in 75 percent of all cancers. While effective vaccines are available against both, authorities do not know how much or what type of HPV they are dealing with.

According to the World Health Organization [ http://www.who.int/reproductivehealth/topics/cancers/en/index.html ], cervical cancer is the most common cancer among women aged 15-44 in PNG. There is no data on the HPV burden in PNG’s general population, but worldwide an estimated 11.4 percent of women harbour cervical HPV.

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]]></body><link>http://www.irinnews.org/Report/97404/In-Brief-First-major-survey-of-cervical-cancer-in-PNG</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2013/201302040934170011t.jpg"/></td><td valign="top">BANGKOK 04 February 2013 (IRIN) - A large-scale survey of cervical cancer will be launched later this month in Papua New Guinea (PNG), where more than 1,500 women die of the disease each year.</td></tr></table>]]></content:encoded></item><item><title>Concern over unsafe abortions in Papua New Guinea</title><pubDate>Fri, 25 Jan 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2013/201301250820190695t.jpg" />]]>BANGKOK 25 January 2013 (IRIN) - Health experts are concerned about the number of unsafe abortions taking place in Papua New Guinea (PNG).</description><body><![CDATA[BANGKOK 25 January 2013 (IRIN) - Health experts are concerned about the number of unsafe abortions taking place in Papua New Guinea (PNG).

“Nobody knows the actual numbers, but it’s clear the number of school-age girls [having unsafe abortions] is unacceptably high,” says Lisa Vallely, head of the maternal and child health section of the PNG Institute of Medical Research (IMR) and principal investigator of a new study on the issue.

“These are the figures at the hospital level only. We still don’t know what is happening outside in the community,” she told IRIN on the sidelines of the Second International Congress on Women’s Health and Unsafe Abortion in Bangkok [ http://www.womenhealth.or.th/iwac/index.php# ].

The six-month study (not online) looked at all admissions of spontaneous and induced abortions in Eastern Highlands Provincial Hospital in Goroka. Of 120 reported miscarriages admitted to the hospital over the period, 23 percent (28 women) were induced abortions, with more than half taking place 12-26 weeks into the pregnancy.

Most were young girls, attending school or higher education, and most of these induced abortions took place using prescription-only tablets purchased through healthcare workers or at a pharmacy. Others reported using traditional herbs and physical means, including strenuous exercise, inserting a stick into the vagina and tying a rope around the abdomen.

Many women resorted to abortions for fear of shaming their family; so they could continue their education; or because they were still breastfeeding another child, the study found.

A recent study [ http://onlinelibrary.wiley.com/doi/10.1111/j.1479-828X.2009.01116.x/abstract ] of the situation in Goroka highlighted sepsis due to unsafe abortion as a leading cause of maternal mortality.

According to the World Health Organization, unsafe abortions - almost all in developing countries - cause an estimated 47,000 deaths annually. Unsafe abortion is one of the main contributors (13 percent) [ http://whqlibdoc.who.int/publications/2011/9789241501118_eng.pdf ] to maternal mortality worldwide, and encompasses procedures outside hospitals, clinics and surgeries, or without qualified medical supervision.

Maternal health [ http://www.irinnews.org/Report/94352/PAPUA-NEW-GUINEA-Tackling-maternal-health-crisis ] remains a key challenge in PNG. According to an inter-agency review based [ http://apps.who.int/gho/data/ ] on 2008 data, some 250 mothers die per 100,000 live births.

Abortion is illegal in PNG unless two doctors agree a woman’s life may be at risk. However, the practice of induced abortions is widely practised, health workers say.

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]]></body><link>http://www.irinnews.org/Report/97331/Concern-over-unsafe-abortions-in-Papua-New-Guinea</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2013/201301250820190695t.jpg"/></td><td valign="top">BANGKOK 25 January 2013 (IRIN) - Health experts are concerned about the number of unsafe abortions taking place in Papua New Guinea (PNG).</td></tr></table>]]></content:encoded></item><item><title>Activists rap Australia’s offshore processing of migrants</title><pubDate>Mon, 14 Jan 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2013/201301141238210209t.jpg" />]]>PERTH 14 January 2013 (IRIN) - Human rights groups have strongly condemned conditions at Australia’s two offshore processing centres for asylum seekers on the Pacific islands of Nauru and Manus.</description><body><![CDATA[PERTH 14 January 2013 (IRIN) - Human rights groups have strongly condemned conditions at Australia’s two offshore processing centres for asylum seekers on the Pacific islands of Nauru and Manus.

“Conditions are overwhelmingly inadequate, with intolerable physical conditions that seriously add to the mental health problems of detainees,” Ian Rintoul, a spokesman for the Refugee Action Coalition (RAC) [ http://www.refugeeaction.org.au/ ], told IRIN.

His comments come amid unconfirmed reports of unrest at the centres, and at least one attempted suicide on Manus Island over the weekend.

To date, 181 people have been transferred to Manus (maximum capacity 600), while 363 people have been taken to Nauru (maximum capacity 900).

In early January, photos leaked by Manus Island detainees showed tin huts with no doors or windows and susceptible to malaria-carrying mosquitoes, as well as detainees, including children, sleeping outside to escape the heat - often without mosquito nets.

Average hot season temperatures on Manus Island, 320km north of Papua New Guinea, are around 31 degrees Celsius (90 Fahrenheit), with humidity rising to over 95 percent almost daily.

The Australian authorities, however, say there have been no reported cases of malaria, and vaccinations and prophylactic antibiotics are available on Manus Island.

“Health services are designed and delivered broadly comparable with Australian standards,” said Department of Immigration and Citizenship (DIAC) spokesman Sandi Logan.

But according to refugee activists, health services on Manus Island during the government’s previous offshore processing policy were inadequate.

In a bid to discourage the number of boat arrivals to the country, on 13 August 2012, Canberra returned to offshore processing [ http://www.irinnews.org/report/96104/MIGRATION-Reaction-to-Australian-policy-reforms ] in both locations after abandoning it in 2007, following strong criticism by human rights groups. Close to 1,500 asylum seekers were processed on Nauru under the previous government’s Pacific Solution, with another 365 on Manus.

Mistreatment allegation

“Manus Island should be closed,” said RAC’s Rintoul, following this weekend’s unrest and the transfer of another 40 single male asylum seekers from Darwin. “The idea that it is a fit place to send families and children is absurd. Not only is the Australian government refusing to process claims of asylum seekers asking for protection in Australia, it is deliberately mistreating them by sending them to Manus Island.”

Echoing this, Victoria Martin-Iverson, a spokeswoman for the Refugee Rights Action Network [ http://rran.org/ ], who is in direct contact with detainees on the island, said that in addition to concerns over malaria, housing for asylum seekers did not even have proper doors, meaning “detainees cannot sleep or change clothing in private, which is severely compromising their human dignity.”

Conditions on Nauru, just 21sqkm, and 4,000km northeast of Sydney, are not much better.

In December, the UN Refugee Agency (UNHCR) released a critical report [ http://unhcr.org.au/unhcr/images/2012-12-14%20nauru%20monitoring%20report%20final.pdf ] on conditions at the facility, noting that they fell short of international protection standards. The team found accommodation conditions harsh, a fully functioning legal framework absent, and an inadequate capacity to assess refugee claims.

Noise and dust from construction work on a more permanent facility did not help. UNHCR also found a number of transferred asylum-seekers with pre-existing trauma, some of them survivors of torture, the report said.

Meanwhile, Amnesty International researchers on a three-day inspection of the same facility recently found [ http://www.amnesty.org/en/news/australia-asylum-camp-cruel-and-inhumane-2012-11-23 ] a “toxic mix of uncertainty, unlawful detention and inhumane conditions, creating an increasingly volatile situation on Nauru, with the Australian Government spectacularly failing in its duty of care to asylum seekers.”

Graham Thom, refugee coordinator for Amnesty International, noted first-hand reports of regular toilet, shower and drain overflows, particularly when monsoon rain flooded the camp. He also expressed concern over subsequent skin infections as a result of bed and clothing being left sodden for extended periods of time.

In January, water and sanitation remained an ongoing concern, and a potential violation of Australia’s human rights obligations, said Australian NGO Humanitarian Research Partners [ http://www.humanitarianresearchpartners.org/hrp-blog.html#.UPPTQOR1_g8 ], which has called for an immediate rectification of conditions by the Australian government.

“Such conditions could amount to cruel, inhuman and degrading treatment, which is absolutely prohibited by the Convention Against Torture [ http://www2.ohchr.org/english/law/cat.htm ] as an impeachable rule of international law,” the Perth-based group said.

Hunger strike

Meanwhile, there have been unconfirmed reports of self-harm, including up to 30 suicide attempts at the two facilities since they reopened. According to RAC on 14 January, a group of five Iranian, 15 Afghan and 25 Iraqi asylum seekers were on hunger strike following their transfer to Manus Island.

“These people are being punished, despite having committed no crime, just so the government can make an example of them. The government needs to end this practice before more senseless damage is done,” said Greens Party Senator Sarah Hanson-Young.

Most asylum seeker arrivals to Australia come from Afghanistan, Iran, and Sri Lanka, with the latter being most at risk of being sent home.

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]]></body><link>http://www.irinnews.org/Report/97243/Activists-rap-Australia-s-offshore-processing-of-migrants</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2013/201301141238210209t.jpg"/></td><td valign="top">PERTH 14 January 2013 (IRIN) - Human rights groups have strongly condemned conditions at Australia’s two offshore processing centres for asylum seekers on the Pacific islands of Nauru and Manus.</td></tr></table>]]></content:encoded></item><item><title>PAPUA NEW GUINEA: West Papuan refugees hope for citizenship</title><pubDate>Mon, 17 Dec 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2012/201212161358040361t.jpg" />]]>PORT MORESBY 17 December 2012 (IRIN) - Access to citizenship could prove the best hope yet for thousands of West Papuan refugees living in Papua New Guinea (PNG).</description><body><![CDATA[PORT MORESBY 17 December 2012 (IRIN) - Access to citizenship could prove the best hope yet for thousands of West Papuan refugees living in Papua New Guinea (PNG).

“I want citizenship. I’ve been here 28 years and want to get on with my life,” said Donatus Karuri, a 57-year-old father of six, outside the shelter he shares with five other families at the Hohola refugee settlement. It is one of four settlements for West Papuan refugees in the capital Port Moresby.

Like most West Papuan refugees, he is unable to work legally and has only limited access to public services.

According to the UN Refugee Agency (UNHCR), there are more than 9,000 West Papuan refugees in PNG today, many of whom have been in the Pacific island nation for over three decades.

Others know no other home and can’t imagine living anywhere else.

“I was born here. This is the only country I know,” said Dan Hanasbey, 27, another refugee wanting citizenship.

Flight from Indonesia

Between 1984 and 1986, more than 11,000 West Papuans fled east into PNG from the western, Indonesian half of New Guinea Island to escape political turmoil and economic discontent [ http://www.irinnews.org/Report/90159/INDONESIA-Economic-marginalization-fuelling-conflict-in-Papua ]; the area’s longstanding secessionist sentiments towards Jakarta continue to simmer today.

West Province, a former Dutch colony rich in natural resources, was later divided into two separate provinces - Papua and West Papua - however, indigenous West Papuans continue to refer to the entire Indonesian area as West Papua.

At the time the refugees arrived, the PNG government was not yet a signatory to the 1951 Refugee Convention [ http://www.unhcr.org/4ec262df9.html ]. It granted the West Papuans prima facie refugee status shortly after accession to the convention in 1986 - but with seven reservations, including Article 34 on naturalization.

Of the close to 9,300 West Papuan refugees in PNG today, almost half live along the border area [ http://www.irinnews.org/report/96567/PAPUA-NEW-GUINEA-No-relief-for-flood-affected-refugees ] with Indonesia.

Another 2,435 live in urban areas, while 2,290 live in East Awin, the only officially sanctioned area for West Papuan refugees to settle. There, regular assistance is available and access to 6,000 hectares of government land is provided - about 120km away from the Indonesian border. The site was established in an effort to resettle the refugees away from the border areas to avoid possible political problems with the Indonesian government.

Those who resettle in the area for six months are provided permissive residency permits (PRPs), which allow them certain rights, including the right to work and travel internally (excluding border areas), and gives them access to health and education services.

Few refugees, however, wish to resettle in East Awin, preferring instead to stay close to the border area and their land and families on the other side. Others frown upon its remote jungle location and inaccessibility.

The government estimates only 40 percent of West Papuan refugees hold PRPs. As a result, most survive on subsistence farming - particularly in the border area. Those in urban settings live on private or government land, under constant risk of eviction, and often work illegally.

The cost of citizenship

Despite these challenges, many West Papuans - who share a similar Melanesian ancestry to Papua New Guineans - have integrated well in this nation of 7.3 million and would like to stay. 

“Local integration with the opportunity to be granted PNG citizenship is the best solution for many West Papuan refugees under the current circumstances,” Walpurga Englbrecht, UNHCR country representative for PNG, told IRIN.

“The problem, however, is the application fee is too high.”

Under PNG law, any foreigner - including refugees - wishing to apply to citizenship and who has fulfilled eight years of residency must pay a 10,000 kina (US$5,000) application fee.

“We can’t afford that. It’s impossible,” Freddy Warome, 58, a West Papuan community leader, complained.

Under Article 34 of the Refugee Convention, signatory states should facilitate the assimilation and naturalization of refugees, and make every effort to expedite naturalization and reduce the costs as far as possible.

To date, the PNG government appears mindful of this responsibility, but it remains unclear when they might act upon it.

Speaking at a 2011 ministerial meeting to mark the 60th anniversary of the Refugee Convention, Moses Manwau, PNG’s former vice minister for foreign affairs and immigration, confirmed the government’s commitment to withdrawing its earlier reservations to the Convention, and to waiving all fees or introducing nominal fees for refugees seeking naturalization.

“We are determined to give refugees the kind of life, liberty, peace and prosperity they deserve so that they can hold their own against any other citizens in Papua New Guinea,” he said.

UNHCR believes there should be a path to citizenship for those who desire it, while those West Papuans lacking PRPs who would like to remain in the country should be provided PRPs without having to relocate to East Awin, Englbrecht said.

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]]></body><link>http://www.irinnews.org/Report/97057/PAPUA-NEW-GUINEA-West-Papuan-refugees-hope-for-citizenship</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2012/201212161358040361t.jpg"/></td><td valign="top">PORT MORESBY 17 December 2012 (IRIN) - Access to citizenship could prove the best hope yet for thousands of West Papuan refugees living in Papua New Guinea (PNG).</td></tr></table>]]></content:encoded></item><item><title>Analysis: Australia&apos;s offshore asylum process</title><pubDate>Fri, 30 Nov 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2011/201110310939490345t.jpg" />]]>MELBOURNE 30 November 2012 (IRIN) - Activists in Australia have expressed concern over a recent decision by the government to reinstate the processing of asylum seekers offshore.</description><body><![CDATA[MELBOURNE 30 November 2012 (IRIN) - Activists in Australia have expressed concern over a recent decision by the government to reinstate the processing of asylum seekers offshore.

“This policy will see asylum seekers sent to Nauru [in the Pacific] or Manus Island [Papua New Guinea (PNG)] before having their refugee status assessed in a move Australia hopes will circumvent its international human rights obligations,” Benjamin Pynt, the director of Humanitarian Research Partners [ http://www.humanitarianresearchpartners.org/ ], based in Australia, told IRIN.

“It will deny asylum seekers the right to claim protection in Australia and exclude these people from the justice system.”

Currently 386 people are awaiting processing of their claims on Nauru, with another 47, including 16 children, on Manus Island, which reopened its doors on 21 November.

Most asylum seekers on Manus are Sri Lankan and Iranian, while Nauru has mainly people from Afghanistan, Sri Lanka and Pakistan, with smaller numbers from Iraq and Iran.

On 15 August, the government returned to offshore processing in both locations after abandoning it in 2007, following heavy criticism by human rights groups.

Close to 1,500 asylum seekers were processed on Nauru under the previous government’s Pacific Solution [ http://www.aph.gov.au/About_Parliament/Parliamentary_Departments/Parliamentary_Library/pubs/BN/2012-2013/PacificSolution#_Toc334509642 ], with another 365 on Manus.

Inhumane conditions

However, conditions in the two facilities are far from good.

According to a 23 November report [ http://www.amnesty.org/en/library/asset/ASA42/002/2012/en/33cb74aa-5d53-4ed2-80a4-df9d4965485e/asa420022012en.pdf ] by Amnesty International, researchers on a recent three-day inspection of the facility in Nauru found a “toxic mix of uncertainty, unlawful detention and inhumane conditions creating an increasingly volatile situation on Nauru, with the Australian Government spectacularly failing in its duty of care to asylum seekers.”

Described as “totally inappropriate and ill-equipped”, the facility reportedly had hundreds of men crammed into five rows of leaking tents and suffering from physical and mental ailments.

Current capacity in Manus and Nauru is 500 people on each island. However, upon completion, the combined capacity will exceed 2,000, the government says.

“Offshore processing on Nauru and Manus Island will only serve to break vulnerable people in these ill-conceived limbo camps, who have fled unimaginable circumstances,” said Graham Thom, the national refugee coordinator at Amnesty International Australia.

The watchdog group has called on the government to immediately cease transfers to Nauru - a move it sees as penalizing people for seeking asylum.

“These people are taken to a country, detained, and told if they don’t like it they can go home,” Thom said, recalling the story of one Iraqi man who, if returned to Iraq, would have no choice but to flee to Turkey with his family.

“There is no option for most of these people,” the Amnesty official said.

"No Advantage" principle

According to Canberra, the government’s recent policy response to an issue that has preoccupied officials and the public for years is simply an attempt to tackle the growing problem of boat arrivals.

More than 30,000 people have made their way to Australia by boat since 1976, according to Australia’s Department of Immigration and Citizenship [ http://www.immi.gov.au/ ].

Each year scores of people travelling in overcrowded, dilapidated boats lose their lives on the high seas in an effort to reach Australia, often just off the coast of Indonesia [ http://www.irinnews.org/Report/95714/INDONESIA-Asylum-seekers-take-to-boats-out-of-frustration ].

In 2011, 69 boats carrying 4,565 passengers arrived in the country, while as of 30 November, 256 boats carrying 15,910 passengers had arrived in 2012, the immigration department reported.

Since 2010, the government of Prime Minister Julia Gillard has sought to renew an offshore processing system for boat refugees and introduced the prospect of swapping refugees with other countries in the region.

In 2011 the High Court ruled against the Malaysia Solution where Australia would effectively send 800 boat arrivals to Malaysia in exchange for accepting 4,000 refugees currently in Malaysia over the next four years.

When the return to offshore processing was announced in August, Chris Bowen, Australia’s minister for immigration and citizenship, said the policy would “discourage irregular and dangerous maritime voyages,” and “promote the maintenance of a fair and orderly refugee programme”.

Under the policy, the government adopted the “no advantage” principle, which effectively means all asylum applications will be processed in the same time period as those elsewhere, including those in neighbouring Indonesia, and regardless of whether they had arrived in Australia or not.

“People arriving by boat are subject to this `no advantage’ principle, whether that means being transferred offshore to have their claims processed, remaining in detention, or being placed in the community,” Bowen said in a statement.

“Consistent with `no advantage’, people from this cohort going on to bridging visas will have no work rights and will receive only basic accommodation assistance, and limited financial support,” Bowen said.

Activists concern

But despite the government’s position, activists remain concerned.

“The Australian government must remain focused on building a regional refugee protection framework and it must meet its responsibilities as a signatory to the Refugee Convention,” Paul Power, chief executive officer of the Australian Refugee Council, told IRIN, saying the recent changes to the country’s asylum policy were “disheartening, unfair and set a poor example for refugee protection in the Asia region”.

More than 7,000 asylum seekers are in immigration detention facilities and alternative places of detention in the country, including hundreds of children, the country’s Department of Immigration reported.

“The government claimed all asylum seekers would be treated the same, but a small number are being sent to Manus Island and they are being persecuted with different detention and conditions to those asylum seekers released in Australia,” said Ian Rintoul, a spokesman for the Refugee Action Coalition in Sydney.

Meanwhile, Human Rights Watch (HRW) says the transfer of children for offshore processing of refugee status needs to be addressed immediately. Australia’s policy violates its obligations to children under the Convention of the Rights of the Child, which protects all children in Australia’s jurisdiction, including children of non-citizens, it said.

“Migrant children are often survivors of traumatic journeys to reach Australia,” said Alice Farmer, a children’s rights researcher with HRW.

“Australia is callously disregarding their best interests and failing to provide them an opportunity for refuge when it pushes them out of Australian territory.”

Refugee rights

And then there is the whole question of legality.

Legal experts say the recent decision to return to the offshore processing of refugees is a violation of the international conventions and treaties to which Australia is a signatory, including the UN Refugee Convention [ http://www.unhcr.org/pages/49da0e466.html ].

“This is a total derogation of Australia’s responsibility as a signatory to the Refugee Convention and human rights treaties,” said Susan Kneebone, an international expert on refugee law based at Monash University, describing it as Australia’s lowest point in its treatment of refugees.

Last week, the UN Refugee Agency (UNHCR) raised concerns over the government’s policy, calling for a “more compassionate and principled approach to the asylum debate in Australia…

“UNHCR is deeply troubled that as long as the focus remains primarily on deterrence, the humanitarian, ethical and legal basis of asylum, and the protection of refugees, will be seriously undermined,” said UNHCR regional representative Richard Towle on 23 November.

All asylum-seekers in Australia, including those transferred to PNG and Nauru, must be given a full, fair and expeditious assessment of their refugee claims as soon as possible, it said.

Those found to be refugees should be given basic human rights and the rights to which they are entitled under the Refugee Convention, including family reunion, work and freedom of movement. Those found not to need protection can be expected to leave the country, the statement said.

UNHCR is particularly concerned about the decision to transfer families, including children, to Manus Island, in the absence of any adequate legal framework, procedures or resources in PNG to assess their claims.

"The current movement of refugees and asylum-seekers raises many challenges for states but we encourage Australia to ensure a humanitarian approach that is fully compatible with the Refugee Convention,” Towle said.

UNHCR’s preference remains that all people arriving in Australia be assessed in Australia under fair, efficient and, as needed, robust asylum procedures.

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]]></body><link>http://www.irinnews.org/Report/96940/Analysis-Australia-apos-s-offshore-asylum-process</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2011/201110310939490345t.jpg"/></td><td valign="top">MELBOURNE 30 November 2012 (IRIN) - Activists in Australia have expressed concern over a recent decision by the government to reinstate the processing of asylum seekers offshore.</td></tr></table>]]></content:encoded></item><item><title>PAPUA NEW GUINEA: No relief for flood-affected refugees</title><pubDate>Wed, 17 Oct 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2012/201210170442590952t.jpg" />]]>BANGKOK 17 October 2012 (IRIN) - Environmental damage caused by copper mining in Papua New Guinea (PNG) has affected thousands of refugees from the neighbouring Indonesian province of West Papua who have not received any support from PNG or the mining company, according to the UN Refugee Agency (UNHCR) and NGOs.</description><body><![CDATA[BANGKOK 17 October 2012 (IRIN) - BANGKOK, 17 October 2012 (IRIN) - Environmental damage caused by copper mining in Papua New Guinea (PNG) has affected thousands of refugees from the neighbouring Indonesian province of West Papua who have not received any support from PNG or the mining company, according to the UN Refugee Agency (UNHCR) and NGOs.

“Some of the border settlements of West Papuan refugees have become severely affected by flooding associated with sediment build-up in the rivers due to the Ok Tedi mine,” [ http://www.oktedi.com/ ] said Ben Farrell, a regional UNHCR spokesperson, referring to a mine that has operated in PNG’s western provinces since 1984.

The western half of New Guinea Island, West Papua, is an Indonesian province where separatists have fought for independence for decades. The 1984 Indonesian government crackdown on the Free Papua Movement of West Papuan separatists led to thousands of West Papuans fleeing to neighbouring PNG.

At least 1,500 West Papuan refugees hosted by PNG along Fly river - the second longest river running through the half-island nation’s western provinces - have been affected by ongoing mine-induced flood damage, according to Wren Chadwick, the former advocacy and information officer for Jesuit Refugee Service (JRS) based in the capital, Port Moresby.

Flooding has destroyed food gardens and sago palms, the traditional food staple, “forcing people into the jungle to wait out the floods so they can access food sources,” said Chadwick.

In a 2009 JRS assessment, more than 3,200 refugees living along the river cited pollution from the mines as the main obstacle to growing food. 

“Die-back” sludge

The Ok Tedi mine dumps roughly 90 million tons of waste into the Ok Tedi and Fly rivers annually, according to the company’s environmental assessments. Mine sediment causes river beds to rise, forcing mine-contaminated water onto surrounding fields where it has killed up to 3,000sqkm of vegetation in a phenomenon known as “die-back” [ http://www.oktedi.com/community-and-environment/the-environment/impacts-of-mining ].

“In PNG mines have polluted rivers, damaged agricultural land and displaced communities from their homes and farmland,” said Chris Albin-Lackey, Human Rights Watch's senior researcher on extractive industries based in New York.

The Ok Tedi mine contributes to roughly 18 percent of the country's annual GDP, according to a 2012 World Bank report [ http://www-wds.worldbank.org/external/default/WDSContentServer/WDSP/IB/2012/09/21/000386194_20120921041953/Rendered/PDF/724410Revised00l70Issue209020012web.pdf ].

Compensation, but not for refugees

While Ok Tedi mine has paid out nearly US$980 million to affected communities, West Papuan refugees do not qualify because they are living outside the area designated for them under amendments made to the 1987 Migration Act which restricts them to East Awin camp, 6,000 hectares in the country’s northeast.

Relocation plans are under way for local communities, but refugees living alongside those communities are not included, according to UNHCR.

“West Papuan refugees without Permissive Residence Permits and [other] non-Melanesian asylum seekers and refugees have no access to documentation or some basic rights such as access to the labour market,” said Farrell.

Refugees continue to live along the rivers due to kinship ties, despite the lack of working papers in a place where even subsistence farming for survival requires documents.

As of 2010 there were some 9,700 West Papuan refugees in PNG, of whom nearly 2,300 were in the designated East Awin area, 5,000 in border areas and some 2,400 in cities [ http://lib.ohchr.org/HRBodies/UPR/Documents/Session11/PG/UNHCR_UNHighCommissionerforRefugees-eng.pdf ].

The 1996 Limited Integration Policy for West Papuan refugees stipulated that only refugees who have lived in East Awin for at least six months can get Permissive Residency Permits, which entitle them to freedom of movement, the right to work, and access to health services and education.

Those who decline relocation to camps in East Awin bear the impact of flooding without assistance as well as “run-down shelters, lack of adequate water and sanitation facilities, and lack of security of land tenure and the threat of forced eviction,” according to UNHCR's Farrell.

“The biggest issue is lack of a national refugee policy that realistically deals with refugees who refuse to move to East Awin,” Chadwick said.

An official with the government-funded think-tank Consultative Implementation and Monitoring Council Secretariat, which has helped draft national refugee policy, said no refugees should be refused humanitarian assistance.

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]]></body><link>http://www.irinnews.org/Report/96567/PAPUA-NEW-GUINEA-No-relief-for-flood-affected-refugees</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2012/201210170442590952t.jpg"/></td><td valign="top">BANGKOK 17 October 2012 (IRIN) - Environmental damage caused by copper mining in Papua New Guinea (PNG) has affected thousands of refugees from the neighbouring Indonesian province of West Papua who have not received any support from PNG or the mining company, according to the UN Refugee Agency (UNHCR) and NGOs.</td></tr></table>]]></content:encoded></item><item><title>HEALTH: Asia fails to take up rotavirus vaccine</title><pubDate>Fri, 07 Sep 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2012/201209070934180240t.jpg" />]]>BANGKOK 07 September 2012 (IRIN) - Most countries in Asia have yet to make the rotavirus vaccine part of their national immunization programme (NIP), despite a World Health Organization (WHO) recommendation to do so.</description><body><![CDATA[BANGKOK 07 September 2012 (IRIN) - Most countries in Asia have yet to make the rotavirus vaccine part of their national immunization programme (NIP), despite a World Health Organization (WHO) recommendation to do so.

“Timely vaccination with one of the two effective rotavirus vaccines [Rotarix and Rotateq] can prevent many cases of [rotavirus] illness and hospitalizations,” WHO’s Manila office said in an email to IRIN on 7 September. “WHO recommends the inclusion of rotavirus vaccine in the national immunization schedules of all countries.”

According to WHO, rotavirus is the most common cause of severe diarrhoeal disease in young children, with more than 500,000 children under the age of five dying worldwide each year. Highly contagious, the virus causes vomiting and severe diarrhoea that can lead to dehydration and potential death. [ http://www.irinnews.org/Report/87899/AFRICA-Rotavirus-data-must-propel-immunization-experts ]

Children aged six months to two years are particularly vulnerable to infection. Worldwide, rotavirus accounts for 37 percent of all diarrhoea deaths in children under five with 95 percent of those deaths occurring in developing countries. [ http://www.gavialliance.org/library/publications/gavi-fact-sheets ] 

While the virus is treatable by providing fluids and salts, health experts note that it has a devastating and deadly impact in areas where people cannot access medical care. There are no antibiotics or any other drug to fight the infection and since 2009 WHO has recommended the global use of the rotavirus vaccine. [ http://www.irinnews.org/Report/84764/GLOBAL-WHO-move-boosts-fight-against-fatal-diarrhoea ]

“For rotavirus vaccine the main aim is to prevent or reduce the severity of the first one or two infections in young children,” Tony Nelson, professor of paediatrics at the Chinese University of Hong Kong and member of the Rotavirus Organization of Technical Allies (ROTA council), told IRIN. “It is these first infections that are the most severe and most likely to cause life-threatening dehydration.”

The international health NGO PATH [ http://www.path.org/publications/detail.php?i=2197 ] reports that in Asia 42 percent of all hospital admissions of children under five with diarrhoea are the result of rotavirus, while 188,000 children under five die each year. 

“As many of these deaths and admissions could be prevented by vaccination, it is sad that very few countries in Asia have announced plans to include rotavirus vaccines in their NIPs,” Nelson said. 

As of September 2012, 41 countries worldwide have introduced rotavirus vaccines in their NIPs. [ http://rotacouncil.org/rotavirus-burden-vaccine-introduction-map ] Four African countries - Botswana, Ghana, Rwanda and Sudan - have fully introduced the oral vaccine in their NIPs, while South Africa and Zambia introduced rotavirus vaccination on a regional basis. [ http://rotacouncil.org/national-and-regional-rotavirus-introductions/ ]

However, only two countries in Asia - Philippines and Thailand - are vaccinating (or are about to) children against rotavirus: “Price continues to be an important barrier to introducing rotavirus vaccine,” WHO explained. 

In July, Philippines [ http://vad.createsend1.com/t/ViewEmail/r/680743A8ADBDDBE1/E38B11B8894CC5F54BD7C9066BE4161D ] started vaccinating an estimated 700,000 children each year aged 1.5-3.5 months from the poorest communities.

In the same month Thailand [ http://rotacouncil.org/news/botswana-yemen-launch-rotavirus-vaccines-nationally/ ] announced it will vaccinate regionally, but has yet to provide an actual launch date.

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]]></body><link>http://www.irinnews.org/Report/96259/HEALTH-Asia-fails-to-take-up-rotavirus-vaccine</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2012/201209070934180240t.jpg"/></td><td valign="top">BANGKOK 07 September 2012 (IRIN) - Most countries in Asia have yet to make the rotavirus vaccine part of their national immunization programme (NIP), despite a World Health Organization (WHO) recommendation to do so.</td></tr></table>]]></content:encoded></item><item><title>MIGRATION: New Australian refugee quota welcomed</title><pubDate>Fri, 24 Aug 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2011/201109190803140375t.jpg" />]]>BANGKOK 24 August 2012 (IRIN) - Refugee rights groups have welcomed a decision by the Australian Government to increase its annual refugee quota to 20,000, a key recommendation in a recent panel report on asylum seekers.</description><body><![CDATA[BANGKOK 24 August 2012 (IRIN) - Refugee rights groups have welcomed a decision by the Australian Government to increase its annual refugee quota to 20,000, a key recommendation in a recent panel report [ http://expertpanelonasylumseekers.dpmc.gov.au/sites/default/files/report/expert_panel_on_asylum_seekers_full_report.pdf ] on asylum seekers.

"The increase to Australia’s resettlement quota will provide positive options for more refugees living in very difficult and often dangerous conditions, at a time when durable solutions for refugees are greatly needed,” Paul Power, chief executive officer of the Australian Refugee Council, [ http://www.refugeecouncil.org.au/ ] told IRIN.

“We are pleased that such critical steps are being taken to implement the more positive measures outlined in the expert panel’s report. This is something Amnesty International has long called on the government to do,” said Graham Thom, the national refugee coordinator at Amnesty International Australia.

“Until today, these components have been absent from debate. Instead, the government hastily prioritized the more punitive measures of the report, such as offshore processing, which focus on penalizing refugees and asylum seekers rather than protecting them,” Thom noted, referring to a recent government decision to establish asylum-seeker processing centres on remote Nauru Island, and Papua New Guinea's Manus Island.

On 23 August, Canberra announced it would increase its yearly intake of refugees from 13,750 to 20,000, following the release of the report on 13 August [ http://www.irinnews.org/report/96104/MIGRATION-Reaction-to-Australian-policy-reforms ] by a three-member expert panel appointed to examine the issue and find ways to curb the flow of asylum seekers arriving in the country.

Increasing Australia’s annual refugee quota was one of 22 key recommendations by the panel, led by former defence chief Angus Houston, aimed at encouraging migrants to use official channels of asylum rather than making long and dangerous boat journeys.

The number of boat people arriving in Australia in recent years has been increasing, the report noted, with more than 8,000 asylum seekers arriving in 2012 alone, according to local media reports.

“This increase is targeted to those in most need - those vulnerable people offshore, not those getting on boats, ''Prime Minister Julia Gillard was reported as saying. ''People who arrive by boat will get no advantage. It's not worth the risk to life and it's not worth the money, because there is absolutely no benefit to getting on that people-smuggler's boat.''

Hundreds of asylum seekers [ http://www.irinnews.org/Report/95714/INDONESIA-Asylum-seekers-take-to-boats-out-of-frustration ] have lost their lives making the dangerous journey in overcrowded, rickety boats from Sri Lanka, Indonesia, and elsewhere in the region.

If the new policy recommendations are effective in reducing the number of boat arrivals, the report proposed that Australia raise its annual refugee intake to 27,000 within five years.

But despite the government’s announcement, many activists remain concerned, noting the “devil is in the detail”. “Even with the increase, the refugee intake is still lower as a proportion of refugees to population than it was in the early 90s, before the [John] Howard [Prime Minister 1996-2007] government cut it in half,” said Ian Rintoul, a spokesman for the Refugee Action Coalition.

“There are many details still to be announced. And the Expert Panel recommended that 3,800 of the extra places should go to refugees waiting within the region, so taking only an extra 400 refugees from Indonesia is only a small start. And they need to know now, when they will be coming to Australia… The four hundred recognized UNHCR refugees in Indonesia should be brought to Australia immediately.”

The government’s decision to re-establish an asylum processing centre on the remote island of Nauru was in line with the Houston Report. “The bitter pill of violating refugee rights on Nauru is not going to be sweetened by increasing Australia’s overall [refugee] intake,” Rintoul added.

Refugee policy has long been a divisive issue [ http://www.irinnews.org/Report/93697/Analysis-Outsourcing-Asia-s-refugees ] in Australia, even though the country receives only a small number of the world's asylum seekers annually, many on Christmas Island, a remote Australian outpost off the coast of Indonesia.

According to UNHCR, [ http://www.unhcr.org/4e9beaa19.pdf ] Australia received 11,500 asylum applications in 2011 - down nine percent from the year before - out of 441,000 lodged in the West that year.

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]]></body><link>http://www.irinnews.org/Report/96164/MIGRATION-New-Australian-refugee-quota-welcomed</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2011/201109190803140375t.jpg"/></td><td valign="top">BANGKOK 24 August 2012 (IRIN) - Refugee rights groups have welcomed a decision by the Australian Government to increase its annual refugee quota to 20,000, a key recommendation in a recent panel report on asylum seekers.</td></tr></table>]]></content:encoded></item><item><title>MIGRATION: Reaction to Australian policy reforms</title><pubDate>Tue, 14 Aug 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2012/201207121522470807t.jpg" />]]>BANGKOK 14 August 2012 (IRIN) - The Australian government’s recent decision to transfer asylum seekers to Pacific islands to process their applications will undermine efforts to find a solution to the region’s asylum seekers and refugees, human right groups and activists warn.</description><body><![CDATA[BANGKOK 14 August 2012 (IRIN) - The Australian government’s recent decision to transfer asylum seekers to Pacific islands to process their applications will undermine efforts to find a solution to the region’s asylum seekers and refugees, human right groups and activists warn. 

“Policies like offshore processing will see refugees languish on [Papua New Guinea’s] Nauru [Island] for years, and will not make refugees safer, but rather undermine prospects for a genuine regional solution for refugees,” Alex Pagliaro, refugee campaign coordinator in the Melbourne office of Amnesty International, told IRIN. 

The Refugee Council of Australia also warned that sending asylum seekers to the islands placed them at risk of human rights abuses. [ http://www.refugeecouncil.org.au/n/media/120814_ExpertPanel.pdf ]

On 28 June the Australian government invited a three-member expert panel to propose recommendations to curb the flow of asylum seekers reaching Australia by boat from Indonesia, Sri Lanka and elsewhere. [ http://www.irinnews.org/report/95714/INDONESIA-Asylum-seekers-take-to-boats-out-of-frustration ] 

The panel recently released 22 recommendations [ http://expertpanelonasylumseekers.dpmc.gov.au/sites/default/files/report/expert_panel_on_asylum_seekers_full_report.pdf ] that include reopening the processing centres on Nauru and Manus islands in Papua New Guinea - suspended in 2007 by the previous government - and urge greater government cooperation with Indonesia to combat people smugglers. [ http://www.irinnews.org/report/95250/INDONESIA-Missing-children-raise-trafficking-concerns ] 

“There are serious questions [as to] whether Nauru or Manus islands can ensure the human rights of asylum seekers and refugees,” said Ian Rantoul, a spokesman for the Sydney-based Australian Refugee Action Coalition, who pointed out that neither island has the resources or the capacity to process and care for asylum seekers, or those determined to be refugees. 

“Reintroducing offshore processing in places like Nauru is a terrible step backwards for Australia's refugee policy,” said Pagliaro of Amnesty International. “We do not believe that this approach will solve anything. Instead, we know that it will leave vulnerable refugees languishing in limbo for years.” 

Jessie Taylor, a human right activist and lawyer based in Melbourne, said, “The major problem with the proposal is that it is predicated on people arriving by boat, and then being moved on to Nauru or Malaysia after that. It does not give asylum seekers any incentive not to get on a boat - only a disincentive in the form of a punishment, if and when they do.” 

Other recommendations include an immediate increase in Australia's humanitarian intake of asylum seekers from 13,500 to 20,000 annually with the possibility of reaching 27,000 within five years, a move welcomed by refugee rights groups; restricting the ability of asylum seekers to sponsor family members; and activation of the Malaysia Solution, which is still under negotiation. 

In July 2011 the Australian government signed a controversial deal to transfer to Malaysia asylum seekers who reach Australia, in exchange for refugees with official status from the UN Refugee Agency (UNHCR) in Malaysia. [ http://www.irinnews.org/Report/93697/Analysis-Outsourcing-Asia-s-refugees ]

Under the proposed “Malaysia Solution”, which the Australian high court ruled against because Malaysia is not a signatory to the UN Refugee Convention, [ http://www.unhcr.org/pages/49da0e466.html ] Australia was to exchange the next 800 boat migrants for 4,000 refugees in Malaysia, mostly Burmese. [ http://www.irinnews.org/Report/93760/MIGRATION-Timeline-of-Australian-asylum-seeker-debate ]

The Australian government has announced its intention to seek improved safeguards for asylum seekers from the Malaysian government. 

NGOs that submitted recommendations to the expert panel say the restrictions imposed on family reunions of migrants arriving by sea are “inhumane”. Under the recommendations, soon to be enacted, reunions could occur only in terms of the family reunion programme applying to immigrants, which takes longer than the humanitarian programme. 

“Separating people from their families as a matter of deterrence or punishment is ineffective,” said Taylor, the lawyer. 

Head of the expert panel, former Australian Defence Force Chief Angus Houston, defended the recommendations' fairness, as quoted in Australian media. [ http://www.theaustralian.com.au/national-affairs/immigration/labor-caucus-backs-expert-panel-on-asylum-policy/story-fn9hm1gu-1226449423972 ] “We recommend a policy approach that is hard-headed, but not hard-hearted. This is realistic, not idealistic. [It] is driven by a sense of humanity as well as fairness.” 

A 2012 study published by the Australian parliament reported that in 2011-2012, 190 boats carrying 7,983 people had arrived in Australia by early July 2012. [ http://www.aph.gov.au/About_Parliament/Parliamentary_Departments/Parliamentary_Library/pubs/BN/2011-2012/BoatArrivals#_Toc285178607 ] According to the Department of Immigration and Citizenship, some 5,800 people were being held in detention centres pending status review on 30 June 2012. [ http://www.immi.gov.au/managing-australias-borders/detention/_pdf/immigration-detention-statistics-20120630.pdf ] 

More than half of those people had been in detention for six months or longer, and more than two-thirds had been in detention for at least one year. [ http://www.irinnews.org/Report/94232/MIGRATION-Australia-will-pay-the-price-for-mandatory-detention ] 

fm/pt/he 

]]></body><link>http://www.irinnews.org/Report/96104/MIGRATION-Reaction-to-Australian-policy-reforms</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2012/201207121522470807t.jpg"/></td><td valign="top">BANGKOK 14 August 2012 (IRIN) - The Australian government’s recent decision to transfer asylum seekers to Pacific islands to process their applications will undermine efforts to find a solution to the region’s asylum seekers and refugees, human right groups and activists warn.</td></tr></table>]]></content:encoded></item><item><title>PAPUA NEW GUINEA: Violence and belief in magic raise risk of HIV for women</title><pubDate>Wed, 18 Apr 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2010/201003251007110759t.jpg" />]]>PORT MORESBY 18 April 2012 (IRIN) - High levels of sexual violence and a cultural belief in witchcraft are putting an increasing number of women at risk of HIV in Papua New Guinea (PNG), health experts say.</description><body><![CDATA[PORT MORESBY 18 April 2012 (IRIN) - High levels of sexual violence and a cultural belief in witchcraft are putting an increasing number of women at risk of HIV in Papua New Guinea (PNG), health experts say.
 
According to the Joint United Nations Programme on HIV/AIDS (UNAIDS), PNG accounts for most of the 30,000 reported cases of people living with HIV in the Pacific region, around 59 percent of which are women.
 
“This might be due to most HIV surveillance data coming from antenatal clinics where pregnant women are tested, a [genuine] high incidence among women, or both,” Stuart Watson, UNAIDS country director told IRIN.
 
PNG’s HIV prevalence of 0.9 percent [ http://www.unaids.org/en/media/unaids/contentassets/documents/factsheet/2010/20101123_FS_oceania_em_en.pdf ] is the highest among Pacific region countries.
 
Violence contributing to HIV
 
However, gender inequality is proving a major driver in the spread of HIV. “The low status of women in the community makes them prone to violence - sexual and otherwise,” Watson said.
 
Gender-based violence [ http://www.irinnews.org/Report/95030/PAPUA-NEW-GUINEA-Gender-based-violence-left-untreated ] is widespread among the country’s 6.5 million ethnically divided inhabitants.
 
The PNG Law Reform Commission reported that 70 percent of women had been physically abused by their husbands, and in some parts of the country the number reaches 100 percent.
 
Human Rights Watch (HRW) [ http://www.hrw.org/news/2009/01/27/where-violence-against-women-rampant ] estimated that 50 percent of women in PNG have experienced forced sex in their lifetime.
 
Abused girls at higher risk of HIV
 
A UNAIDS study found strong links between gender-based violence and HIV infection, and noted that the first sexual encounter of many girls was forced. “These circumstances make it extremely difficult to negotiate condom use. The trauma of experiencing abuse usually sets off a pattern of unsafe sexual practices,” Watson said.
 
The report also found that women who had been sexually abused as children, [ http://www.unaids.org.fj/index.php?option=com_content&view=article&id=573:abused-girls-more-at-risk-of-hiv&catid=23:hiv-in-the-pacific&Itemid=68 ] or experienced sexual abuse by an intimate partner, were twice as likely to test positive for HIV than those who had not.
 
Adding to the HIV risk that women are exposed to, it is common practice for men to have multiple sexual partners and wives. “Polygamy is an accepted practice,” said Ume Wainetti, head of the Family Sexual Violence Centre (FSVC) in PNG.
 
“Older men take on a younger bride because they think she is “clean” [free of HIV infection]. “Some girls also become victims of gang rapes, known as ‘line-ups’,” Wainetti said.
 
Witchcraft and other cultural practices
 
Human rights watchdog Amnesty International reported that [ http://www2.ohchr.org/english/bodies/cedaw/docs/ngos/AmnestyInternational_PapuaNewGuinea46.pdf ] “puri-puri” or “sanguma”, a traditional belief in witchcraft and magic, is widely practised in remote communities and highland provinces, and is often “a pretext for brutal acts of violence against women who are accused of being a witch and spreading HIV.”
 
“Sorcery is still practiced,” said John [not his real name], an office employee in the capital, Port Moresby. “People buy spells to avenge transgressions, or if someone gets sick and they don’t know how to explain it, they say it is due to sorcery - it’s a much easier explanation for many. Sometimes you need someone to blame [for a death].”
 
The Amnesty report also noted that women are six times more likely to be accused of witchcraft than men. Under the 1971 Sorcery Act of PNG, it is a criminal act punishable by up to two years in prison.
 
The UN Special Rapporteur on Violence against Women, Rashida Manjoo, ended her week-long visit to the country in March by calling for the government to repeal the act.
 
“I was shocked to witness the brutality of the assaults perpetrated against suspected sorcerers, which in many cases include torture, rape, mutilations and murder. Any misfortune or death within the community can be used as an excuse to accuse such person of being a sorcerer,” Manjoo said.
 
Watson pointed out that “The belief in sorcery makes for little health-seeking behaviour, and this makes matters worse, especially for women.”
 
According to Australian Agency for International Development (AusAID), HIV is one of the biggest developmental challenges facing this mineral-rich nation.
 
If HIV continues to spread at its current rate, AusAID estimates that [ http://www.ausaid.gov.au/publications/pdf/png_hiv_strategy.pdf ] over half a million Papua New Guineans will be living with HIV by 2025.
 
as/ds/he

]]></body><link>http://www.irinnews.org/Report/95312/PAPUA-NEW-GUINEA-Violence-and-belief-in-magic-raise-risk-of-HIV-for-women</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2010/201003251007110759t.jpg"/></td><td valign="top">PORT MORESBY 18 April 2012 (IRIN) - High levels of sexual violence and a cultural belief in witchcraft are putting an increasing number of women at risk of HIV in Papua New Guinea (PNG), health experts say.</td></tr></table>]]></content:encoded></item><item><title>PAPUA NEW GUINEA: Sexual violence forcing girls out of school</title><pubDate>Fri, 06 Apr 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2012/201204051759080347t.jpg" />]]>PORT MORESBY 06 April 2012 (IRIN) - In the Pacific nation of Papua New Guinea (PNG) sexual violence against young girls, and the shame and stigma that follows, is forcing many out of school and others into early marriage.

 </description><body><![CDATA[PORT MORESBY 06 April 2012 (IRIN) - In the Pacific nation of Papua New Guinea (PNG) sexual violence against young girls, and the shame and stigma that follows, is forcing many out of school and others into early marriage.

 

A recent study [ http://www.msf.org.au/uploads/media/MSF_PNG_Hidden_and_Neglected_2011.pdf ] by Médecins Sans Frontières (MSF), one of the country’s main providers of medical and psychological assistance to survivors of family and sexual violence, showed that from 2008 to 2011, a significant proportion of patients who received treatment as a result of violence were children, some under the age of five.

 

In the rural settlement of Tari, 31 percent of those who reported violence were between five and 12 years old. In Lae, the second biggest city after the capital, Port Moresby, 26 percent were between the ages of 13 and 17.

 

Almost half of those reporting sexual violence In Lae from January 2008 to June 2010 - some 520 people - were under 18 years old. In Tari, 248 were minors, said Patrick Almeida, MSF’s medical coordinator.

 

“In both places, in over 70 percent of the cases, the perpetrators were known by the survivors,” he added.

 

“It’s really bad,” said Ume Wainetti, head of the NGO, Family Sexual Violence Action Centre (FSVAC), based in Port Moresby. [ http://www.inapng.com/cimc/FSVAC.html ]

 

Young girls are already disadvantaged when it comes to education, and the threat of rape and sexual abuse aggravates these inequalities. As it is, parents generally hesitate to send their daughters to school because they will just get married and have babies. Boys will carry on the family name and continue to work,” Wainetti said.

 

The 2010 UN Educational, Scientific and Cultural Organization (UNESCO) Education Digest [

http://unesdoc.unesco.org/images/0018/001894/189433e.pdf ] listed PNG as one of 16 countries worldwide with “severe” gender disparities. In PNG, boys are at least 10 percent more likely to start the first year of primary school than girls.

 

Gross enrolment rates in 2009 were close to 82 percent for boys, but only 74 percent for girls, according to the UN Children’s Fund (UNICEF). [ http://www.unicef.org/png/Part_1.pdf ]

 

The cost of tuition is one of the main reasons for the gap, according to UNICEF. In 2009 the government adopted a plan to gradually phase out school fees by 2015, when it expects to fully fund basic education. [ http://www.education.gov.pg/quicklinks/plans/ube-plan-2010-2019.pdf ]

 

A dangerous path

 

The remote locations of schools have even greater implication for girls, noted UNICEF. [ http://www.unicef.org/png/Part_1.pdf ] “Some kids have to walk for hours to get to school and the journey on the way to school makes them vulnerable to attack, especially for girls,” said Joseph Logha, Department of Education assistant secretary.

 

“The experience of sexual violence definitely affects a girl’s education in terms of being able to stay in school and school performance,” said Ruth Kauffman, MSF project coordinator at a Family Support Centre in Lae.

 

These donor-funded hospital-based centres [ http://www.ausaid.gov.au/publications/pdf/vaw_cs_png.pdf ] are intended to be safe houses and “one-stop shops” for survivors of violence for medical, psychosocial and legal assistance.

 

“If a girl is raped, she may be blamed and beaten by family members. If she gets pregnant, she misses one year of school and may not be able to go back. Even if she doesn’t [fall pregnant], she’s already a different person. The trauma makes it difficult for her to concentrate on school work,” Kauffman said.

 

In some cases, the girl is married off to the perpetrator for a “bride price”- similar to a dowry. “Some communities see marrying her to the offender as a way to make him accountable for his behaviour, without considering the additional emotional trauma that the child will suffer,” said Elaine Bainard, UNICEF’s chief of child protection in PNG.

 

Wainetti said one way of ending a culture of violence is to change people seeing violence against women as a given. The NGO has recruited more than 1,000 male volunteers of varying ages nationwide to receive “gender sensitivity” training.

 

“Some witnessed violence and did not like seeing how their mothers were treated,” Wainetti said. “They want to have a role in ending that cycle, and this is a start.”

 

as/pt/he]]></body><link>http://www.irinnews.org/Report/95249/PAPUA-NEW-GUINEA-Sexual-violence-forcing-girls-out-of-school</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2012/201204051759080347t.jpg"/></td><td valign="top">PORT MORESBY 06 April 2012 (IRIN) - In the Pacific nation of Papua New Guinea (PNG) sexual violence against young girls, and the shame and stigma that follows, is forcing many out of school and others into early marriage.

 </td></tr></table>]]></content:encoded></item><item><title>PAPUA NEW GUINEA: Tetanus vaccination campaign underway</title><pubDate>Mon, 02 Apr 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2012/201204020352170255t.jpg" />]]>PORT MORESBY 02 April 2012 (IRIN) - The Papua New Guinea (PNG) Health Ministry and international aid agencies have launched a mass vaccination of 1.8 million women and girls aged 15-45 against maternal and neonatal tetanus (MNT).</description><body><![CDATA[PORT MORESBY 02 April 2012 (IRIN) - The Papua New Guinea (PNG) Health Ministry and international aid agencies have launched a mass vaccination of 1.8 million women and girls aged 15-45 against maternal and neonatal tetanus (MNT).

The tetanus toxoid vaccine will be administered from 2 April to 15 May at public health facilities and schools in all 20 of the country’s provinces. 

While the Ministry of Health has carried out supplementary vaccination programmes to protect against polio and measles, this is the first large-scale MNT vaccination. 

“We have one of the highest maternal mortality ratios [http://www.irinnews.org/Report/94352/PAPUA-NEW-GUINEA-Tackling-maternal-health-crisis ] in the region, if not the world,” said Jaime Maxtone-Graham, Minister for Health and HIV/AIDS. “We need to change that trend.”

Some progress has been made since the government convened a taskforce in 2009 to tackle maternal deaths, [ http://www.unfpa.org/sowmy/resources/docs/library/R149_DOH_PNGUINEA_2009_Ministerial_Taskforce_report_final_version_3.pdf ] but out of every 100,000 live births, some 250 women are still dying, according to a 2008 inter-agency estimate.

Some 1 percent of maternal deaths are linked to MNT, according to the UN Children’s Fund (UNICEF). 

The agency lists 38 countries worldwide where MNT remains endemic, [ http://www.unicefusa.org/work/health/tetanus/endemic-countries.html ] killing an estimated 100,000 mothers and newborns around the world annually. 

Tetanus is lethal but highly preventable with early diagnosis and prevention through vaccination, say health experts, but figures for MNT-related deaths are hard to come by and the disease is often under-reported.

“Data collection has always been a problem because tetanus is mostly present in rural, marginalized communities. Often, the women and newborns die before they reach the health centres and their cases can be recorded,” said Grace Kariwiga, UNICEF’s officer in charge of health and nutrition in PNG. 

“If 1 percent of maternal deaths can be attributed to MNT, then that would be a good inference of the number of women we can save [with this vaccination programme],” the World Health Organization (WHO) representative in PNG, William Adu-Krow, told IRIN.

According to the WHO, tetanus is a disease caused by bacteria commonly found in soil containing manure and its spores are widespread in the environment. Tetanus can grow in wounds if they are not cleaned and treated, or in a newborn’s umbilical cord if it is cut with unsterilized equipment. [ http://www.who.int/topics/tetanus/en/ ]

Pregnant women and newborns are at risk for tetanus before and after delivery, especially in birthing facilities with poor sanitation. 

Nationwide, 53 percent of women gave birth with a skilled attendant present in 2006, when the government’s most recent national health survey was conducted. [ http://www.nso.gov.pg/census-a-surveys/demography-a-health-survey-2006 ] Access to healthcare in some provinces is worse than in others.

At the time of the 2000 census almost nine out of 10 people nationwide lived in rural areas but the number of health staff in rural facilities declined by 25 percent between 1987 and 2000.

as/pt/he
]]></body><link>http://www.irinnews.org/Report/95213/PAPUA-NEW-GUINEA-Tetanus-vaccination-campaign-underway</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2012/201204020352170255t.jpg"/></td><td valign="top">PORT MORESBY 02 April 2012 (IRIN) - The Papua New Guinea (PNG) Health Ministry and international aid agencies have launched a mass vaccination of 1.8 million women and girls aged 15-45 against maternal and neonatal tetanus (MNT).</td></tr></table>]]></content:encoded></item><item><title>ASIA: Parliamentarians mull how to boost health</title><pubDate>Tue, 20 Mar 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2009/200901083t.jpg" />]]>BANGKOK 20 March 2012 (IRIN) - The World Health Organization (WHO) is bringing together on 19-21 March in Bangkok lawmakers from across Southeast Asia to discuss how to bolster their health systems back home.</description><body><![CDATA[BANGKOK 20 March 2012 (IRIN) - The World Health Organization (WHO) is bringing together on 19-21 March in Bangkok lawmakers from across Southeast Asia [ http://www.searo.who.int/EN/Section2711.htm ] to discuss how to bolster their health systems back home. 
 
Many health systems in the region - defined as health services, workforce, information, financing, leadership as well as equitable access - are ill-equipped to meet growing challenges of non-communicable diseases, [ http://www.irinnews.org/Report/93756/HEALTH-Call-for-healthier-lifestyles-may-fall-on-deaf-ears ] including diabetes and cancer; [ http://www.irinnews.org/Report/94726/HEALTH-The-true-burden-of-cancer ] long-term care in a region with one of the world’s largest concentrations of ageing persons; [ http://www.irinnews.org/Report/94856/ASIA-Isolation-poverty-loom-for-an-aging-population ] and the economic incentive to prevent diseases rather than face “skyrocketing costs” of treatment, said Samlee Pilanbangchang, WHO regional director in Southeast Asia. 
 
“When you try to promote health as wellness, people have disease ingrained in their heads… Health is associated with illness. It is something negative. When we try to promote health, people don’t understand - still,” he told IRIN.
 
Most countries in the region spend less than the internationally recommended 5 percent of gross domestic product (GDP) or 34 purchasing power parity (PPP) dollars per person per year [ http://www.who.int/macrohealth/background/en/ ] needed to ensure basic health care. 
 
In the region, only Vietnam and Timor-Leste exceeded the recommended minimum of health spending as a percentage of GDP, 7 and 12 percent respectively, though Timor-Leste is also ranked as one of the worst countries worldwide for its child health care, [ http://www.savethechildren.org.uk/sites/default/files/docs/HealthWorkerIndexmain_4.pdf ] according to the UK-based NGO, Save the Children. 
 
Myanmar’s government investment in health care is among the lowest globally - 2 percent of GDP - and patients bore almost all of what was not covered by the government, which was 9.7 percent in 2009, the most recent year for which WHO compiled data.
 
Only when the out-of-pocket percentage falls to 15-20 percent does the risk of financial catastrophe become negligible, according to WHO.
 
Healthy equity and social justice are still lacking in the region, despite the “hip hip hooray” media accorded universal health coverage programming, said Samlee. 
 
“It [universal health coverage] is not working yet,” he added, citing the region’s status as having the world’s highest rate of out-of-pocket costs for patients. 
 
The governments of Laos and Cambodia have mostly relied on donors to reach the poor, while those in Bangladesh, Thailand, the Philippines, Indonesia, Vietnam and Sri Lanka are in different stages of expanding care in various ways, including payroll taxes. 
 
These efforts are only becoming more urgent said Porapan Punyaratabandhu, a senator from Thailand and secretary-general of the Asian Forum of Parliamentarians on Population and Development. “Equity is a matter of life and death.”
 
Parliamentarians meeting from 19-21 March are called on to advocate the boosting of health spending, workforces and access to health care in their home countries in addition to drafting “healthy public policies”, such as conducting health assessments before large infrastructural projects are undertaken or setting up industries. 
 
pt/cb

]]></body><link>http://www.irinnews.org/Report/95110/ASIA-Parliamentarians-mull-how-to-boost-health</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2009/200901083t.jpg"/></td><td valign="top">BANGKOK 20 March 2012 (IRIN) - The World Health Organization (WHO) is bringing together on 19-21 March in Bangkok lawmakers from across Southeast Asia to discuss how to bolster their health systems back home.</td></tr></table>]]></content:encoded></item><item><title>PAPUA NEW GUINEA: Gender-based violence left untreated</title><pubDate>Thu, 08 Mar 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2010/201003251007110759t.jpg" />]]>PORT MORESBY 08 March 2012 (IRIN) - Critical gaps in the treatment of survivors of domestic and sexual violence are placing thousands of women at serious physical and psychological risk in Papua New Guinea (PNG), health experts warn.</description><body><![CDATA[PORT MORESBY 08 March 2012 (IRIN) - Critical gaps in the treatment of survivors of domestic and sexual violence are placing thousands of women at serious physical and psychological risk in Papua New Guinea (PNG), health experts warn. 

In a recent report, [ http://www.msf.org.au/uploads/media/MSF_PNG_Hidden_and_Neglected_2011.pdf ], Médecins Sans Frontières (MSF) - the largest provider of specialized medical and psychosocial services to survivors of family and sexual violence in the country - highlights the "urgent, unmet medical and emotional needs of survivors of gender violence" in this half-island nation. 

The international health NGO said it had seen more than 11,000 survivors of family and sexual violence in PNG, including 2,000 survivors of sexual violence, between January 2008 and October 2011. 

In Lae, Morobe Province, between January 2008 and October 2011, MSF and Angau Hospital treated 6,869 survivors of intimate partner violence - the equivalent of 149 a month - and 1,599 survivors of sexual violence (35 per month). 

In Tari, Hela Province, from September 2009 to October 2011, MSF and Tari Hospital reported 1,471 survivors of intimate partner violence or 59 per month and 398 survivors of sexual violence or 16 cases per month. 

"The problems have always been there but we did not have any concrete data and information. Now that MSF has moved into the country, the situation is becoming much clearer," Ume Wainetti, head of the Family and Sexual Action Committee, a government programme set up to address gender violence, told IRIN. 

PNG, with more than six million inhabitants, is known for its high rate of gender-based violence. 

According to the PNG Law Reform Commission, 70 percent of women in PNG say they have been physically abused by their husbands. That number reaches 100 percent in some parts of the country. 

And though domestic violence is a criminal offence, it continues to be viewed as a private matter and rarely addressed in public, according to the Social Institutions and Gender Index [ http://www.oecd.org/document/39/0,3343,en_2649_33935_42274663_1_1_1_1,00.html ] of the Organization for Economic Co-operation and Development. 

Over the years, when survivors sought care at hospitals or health centres, their specific medical and psychological needs were not recognized. 

"Survivors with serious physical injuries will have their wounds tended to and will be sent back home. Their less visible health needs, with negative and potentially fatal long-term consequences, are completely neglected by Papua New Guinea's healthcare services. 

"This neglect is causing suffering and, at times, putting lives at risk," MSF said in its report. 

Guidelines 

Joan* fled her home in the capital, Port Moresby, in late 2011, leaving her four children and their abusive father, a senior government official, with a broken arm, after living a life she described as hell. 

"We survived on the little income I was earning from the ice blocks I was selling. My children and I never saw his wages. When I inquired, I was bashed up and told to shut up. He drank and gambled a lot," the 30-year-old said from her Chimbu village where she is recovering in her family home. 

MSF recommends that the National Department of Health take charge of policy-making and set up treatment protocols and guidelines for survivors, implement operational guidelines, provide support to family support centres, and waive fees for treatment of survivors of family, sexual violence and child abuse. 

And while the government is aware of the problem, it has no reliable data to work on. The most recent is about 20 years old and was gathered by the Constitutional Law Reform Commission, which works on new legislation for the government before parliament passes it. 

However, it has moved to address gender violence, albeit slowly, both at the political and administrative levels. 

"Already parliament had passed the Lukautim Pikinini Act [ http://www.unicef.org/png/FBO_Manual_Part_4.pdf ], to protect children from all forms of abuse. In 2002, it also passed amendments to the Criminal Code, to protect women from domestic and sexual violence, even marital rape, but we still have problems with enforcement. The Family Protection Bill is still awaiting parliament to pass it. Hopefully this will be done next year," Wainetti said. 

At the administrative level, all major hospitals in the country set up family support centres to provide medical and psychological services but they are operating with unskilled staff and on very small budgets. 

"We have already provided training to staff at Mendi, Mt Hagen, Vanimo, Goroka, Nonga and Kudjip hospitals. We are training staff right now at Buka, Alotau and Wabag hospitals," Patrick Almeida, medical coordinator of MSF, said. 

Meanwhile, a lack of financial support has seen the closure of a number of shelters for abused women in PNG. Of four in the capital, only one can provide services effectively. 

"The problem is bad. We pretend that it is not there," Wainetti said. 

*Not her real name 

pk/ds/mw 

]]></body><link>http://www.irinnews.org/Report/95030/PAPUA-NEW-GUINEA-Gender-based-violence-left-untreated</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2010/201003251007110759t.jpg"/></td><td valign="top">PORT MORESBY 08 March 2012 (IRIN) - Critical gaps in the treatment of survivors of domestic and sexual violence are placing thousands of women at serious physical and psychological risk in Papua New Guinea (PNG), health experts warn.</td></tr></table>]]></content:encoded></item><item><title>PAPUA NEW GUINEA: Poor eye care worsens rural suffering</title><pubDate>Mon, 05 Mar 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2009/200912310709320674t.jpg" />]]>PORT MORESBY 05 March 2012 (IRIN) - Serious eye problems are affecting tens of thousands across the half-island Pacific nation of Papua New Guinea (PNG) and exacerbating suffering in rural areas, say health workers.</description><body><![CDATA[PORT MORESBY 05 March 2012 (IRIN) - Serious eye problems are affecting tens of thousands across the half-island Pacific nation of Papua New Guinea (PNG) and exacerbating suffering in rural areas, say health workers.

"The need for treatment must be prioritized in this country as the number of people suffering from blindness or low vision is high and the problem is growing," the country's chief ophthalmologist, Simon Melenges, told IRIN.

Almost 200,000 people nationwide have poor eye-sight or no vision; many go without treatment due to inadequate eye-care facilities, specialists, surgical supplies and drugs.

The state estimates it will cost nearly US$8 million to provide eye care to those in need in 2012, with the cost expected to double by 2016 - this in a country where almost nine out of 10 people live in rural areas and are dependent on erratic farming income.

For children unable to get into one of the country's seven special education programmes for blind children, in which 6,000 are enrolled, blindness consigns them to a life of begging to survive when they are unable to support their family in the fields or find other income sources, said Arnold Koima, a local special education expert.

"People with vision problems or who are blind and living in rural areas do not get all the support they need. Many adult[s] are left to suffer in silence and wait to die."

Widowed and living alone, Kuragl Ambu, over 60 years old, was doing fine in her village in the Highlands Province of Chimbu, 450km from the capital, Port Moresby.

Until she lost her vision.

"I could make my own garden, collect my own firewood and look after my pigs but because I could not see, I stayed at home. I could not go anywhere."

The mountainous topography and population concentration in rural areas make eye care all the more critical in a country where rural healthcare and income are already precarious, noted recent research [ http://www.care.org.au/Document.Doc?id=666 ] by the NGO CARE Australia conducted in a community 50km from Ambu's.

In Obura-Wonenara District of Eastern Highlands Province, of the 262 surveyed families, more than 60 percent earned less than $100 the previous month through coffee sales, comprising most of their income and 75 percent of those surveyed reported problems obtaining enough food.

"This is exacerbated by isolation, the lack of alternative income sources, and the lack of options afforded to them through their low levels of education," wrote the authors of CARE's report.

"We have a very sad situation here. In most of the cases, it's just the need for a pair of glasses. People in this country live with blindness not only because they can't access [medical care] but because they can't afford it," said Eileen Tagum of the local NGO, PNG Eye Care.

One-third of surveyed patients over the age of 50 in a study published in 2006 [ http://onlinelibrary.wiley.com/doi/10.1111/j.1442-9071.2006.01219.x/full ] were visually impaired and 8.9 percent were completely blind.

Cost factors

A pair of prescription eyeglasses can cost from $150 to $250. There is no health insurance or sliding-scale payment plan for the country's poor. Cataract surgery costs up to $40 plus the cost of the hospital stay.

Uncorrected refractive error and cataracts are the leading causes of vision impairment, followed by corneal infections, pterygium (growth of scar tissue and blood), uveitis (eye inflammation), trauma and eye disease complications from diabetes, said Melenges.

Nationwide, there are seven functioning eye clinics partially funded by the Australian government; almost all lack sufficient stocks of drugs to treat eye infections, surgery supplies or prescription glasses, PNG Eye Care says.

The country needs 60 eye specialists to treat the 6.9 million population, but there are only 18 ophthalmologists practising, according to the government.

"The government needs to do more for eye-care services in the country," said Melenges.

Working with the National Department of Health to address poor eye care are local NGOs such as Callan Services and PNG Eye Care; Fred Hollows Foundation New Zealand [ http://www.hollows.org.nz/ ]; Australia-based International Centre for Eye Care Education [ http://www.icee.org/index.asp ]; St. John Association for the Blind [ http://www.orderofstjohn.org/papua-new-guinea ]; and Royal Australian and New Zealand College of Ophthalmologists [ http://www.ranzco.edu/ ].

"Eye-care NGOs are coordinating more to spread our services. We are increasing our presence in the community. The need is there," Tagum said.

Practitioners wrote and submitted the country's first National Eye Plan - covering 2011-2015 - to the National Department of Health in April 2011.

"It is now up to the department to take it up with government for funding," Melenges said.

pk/pt/mw

]]></body><link>http://www.irinnews.org/Report/95005/PAPUA-NEW-GUINEA-Poor-eye-care-worsens-rural-suffering</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2009/200912310709320674t.jpg"/></td><td valign="top">PORT MORESBY 05 March 2012 (IRIN) - Serious eye problems are affecting tens of thousands across the half-island Pacific nation of Papua New Guinea (PNG) and exacerbating suffering in rural areas, say health workers.</td></tr></table>]]></content:encoded></item><item><title>ASIA: Isolation, poverty loom for an aging population</title><pubDate>Tue, 14 Feb 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2011/201112300914140084t.jpg" />]]>BANGKOK 14 February 2012 (IRIN) - With 60 percent of the world’s population, Asia has one of the largest concentrations globally of aging persons, creating a host of potential challenges, experts warn.</description><body><![CDATA[BANGKOK 14 February 2012 (IRIN) - With 60 percent of the world’s population, Asia has one of the largest concentrations globally of aging persons, creating a host of potential challenges, experts warn. 

“Asian countries, besides Japan perhaps, need to plan now. These countries have grown older before they have grown rich,” said Somnath Chatterji with the World Health Organization (WHO) office in New Delhi. 

One in four people in Asia will be 60 or older by the year 2050, rising from one in 10 in 2010, according to the UN Economic and Social Commission for Asia and the Pacific. [ http://www.unescap.org/sdd/publications/datasheet-2011/Datasheet-2011-full.pdf ] 

Over 65 percent of Asia’s elderly population will be women. 

“China and India clearly will be the countries with the largest population of older adults in absolute terms. However, China is ageing more rapidly than India because of its one child policy,” Chatterji added. 

The over-60 population will rise from 165 million to 439 million in China and from 93 million to 323 million in India from 2010 to 2050, according to government projections reported to the UN. 

India’s overall population is expected to exceed China’s in the same period. 

Philip Guest, the Bangkok-based assistant director of the UN Population Fund (UNFPA) for South and Southeast Asia, told IRIN aging will “severely” affect developing countries throughout the region. 

One of the sharpest increases in the region will be in Bangladesh, where the elderly will almost quadruple from 6.6 percent of the population in 2010 to 22.5 percent in 2050, according to UNFPA. 

IRIN asked experts about the biggest challenges facing this population. 

Income 

In many developed countries pensions and social security schemes are tied to employment, which cannot be easily replicated in Asia where most people work in the informal sector. 

“Informal sector means workers are not in the social security programme. Half of Thai people will not have income when they retire,” said Amornrat Apinunmahakul, an economics professor at Thailand’s National Institute of Development Administration, a government-run graduate university. 

He proposed a universal pension scheme, noting funding problems. 

“Now the [Thai] government has a universal programme for the older population; they give 500 baht [US$16] per month. But the minimum wage in Thailand is 1,500-1,600 baht [$48-$52], so this is not enough.” 

“The general feeling within the [South Asia] region is that such schemes are not affordable,” said Dave Mather, who heads the New Dehli-based South Asia centre of NGO HelpAge. 

Health 

Chronic illness has eclipsed communicable disease due to people living longer, wrote Sarah Harper, a professor at the UK-based Oxford Institute of Ageing, in a 2010 report [ http://papers.ssrn.com/sol3/papers.cfm?abstract_id=1683691 ] on adapting health care for an ageing population. 

“[Greater] life expectancy without the bonus of increased health may be increasing to such an extent that we are on the verge of an epidemic of frailty.” 

Beyond physical frailty, the number of dementia patients in the Asia-Pacific region will rise from 14 million in 2005 to 24 million in 2020 and become as high as 65 million by 2050, estimated Alzheimer’s Disease International (ADI), an London-headquartered NGO. 

Depression is also fairly common among older adults, said Chatterji with WHO. 

Experts cite loneliness, disorientation, a sense of abandonment and lack of self-worth as causes of depression and poor mental health, as people become less active. 

A key to ensuring the elderly receive the care they need is to ensure they have a solid support network - one that is slowly shrinking.
 
"Social isolation of this population - as the family size shrinks and migration [ http://www.irinnews.org/theme.aspx?theme=MIG ] [leading] to older adults living by themselves - will be a major concern,” predicted Chatterji. 

ms/pt/cb]]></body><link>http://www.irinnews.org/Report/94856/ASIA-Isolation-poverty-loom-for-an-aging-population</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2011/201112300914140084t.jpg"/></td><td valign="top">BANGKOK 14 February 2012 (IRIN) - With 60 percent of the world’s population, Asia has one of the largest concentrations globally of aging persons, creating a host of potential challenges, experts warn.</td></tr></table>]]></content:encoded></item><item><title>PAPUA NEW GUINEA: Rescue effort for landslide survivors continues</title><pubDate>Wed, 25 Jan 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2012/201201251323180932t.jpg" />]]>PORT MORESBY 25 January 2012 (IRIN) - Rescue efforts are continuing in Papua New Guinea&apos;s (PNG) gas-rich Hela Province, a day after what officials have described as one of the Pacific nation&apos;s worst landslides ever.</description><body><![CDATA[PORT MORESBY 25 January 2012 (IRIN) - Rescue efforts are continuing in Papua New Guinea's (PNG) gas-rich Hela Province, a day after what officials have described as one of the Pacific nation's worst landslides ever. 

"At this point, relief efforts are ongoing," Martin Mose, head of PNG's National Disaster Centre (NDC), [ http://www.pngndc.gov.pg/site/ ] told IRIN in Port Moresby on 25 January, describing the situation on the ground as "fluid". 

Characterized by high terrain and precipitous slopes, the remote region in the Southern Highlands of Papua New Guinea is home to a controversial multi-billion dollar liquefied natural gas (LNG) project [ http://www.irinnews.org/report.aspx?reportid=91810 ]. 

However, no direct link has been established between the landslide and the operational activities of the ExxonMobil project. 

Dozens of people are feared dead, with local rescuers estimating many are still buried under the debris, after the landslide in Komo Maggarima District struck in the early hours of 24 January, catching many residents off guard.

The landslide affected an area of more than 2km and spread along the Highland highway, which runs between the town of Tari and Mt Hagen. The affected stretch of road was completely covered in earth and debris and access to the LNG site was cut off, local observers say. 

Workers, vehicles and machinery were buried, with debris estimated to be up to 15m high in some places. Current estimates as to how many people have been affected remain unclear as a spontaneous settlement of people claiming to be landowners seeking compensation for the use of the quarry had recently formed below it. 

Moreover, many of those in the settlement were from other parts of the highlands and not known by locals. "Heavy rain in recent weeks caused part of the mountain to collapse and come down. The slip is about 2km long and 500m wide. This is a national disaster," Libe Parindali, chairman of the Hides Gas Development Corporation (HGDC), an umbrella company of the landowners, said. 

PNG is experiencing one of the worst wet seasons, which traditionally runs from December to May, ever, local authorities say. 

Prime Minister Peter O'Neill flew with Esso Highlands managing director Peter Graham and members of the National Disaster and Emergency Service to the Tari area on 25 January. 

"It looks very bad. I have instructed Chief Secretary to Government, Manasupe Zurenuoc, to take charge of emergency relief operations," O'Neill said before he left. 

Zurenuoc told IRIN that O'Neill was impressed with the relief and rescue operation that had already commenced and commended Esso Highlands, the developer of the LNG project. 

Esso Highlands, a subsidiary of Exxon Mobil, has taken the lead in the rescue and relief operation. Other companies and organizations have offered to provide assistance to survivors and dig for bodies.

Meanwhile, relatives are already in mourning, as they await news of those still missing. "I called and called her mobile phone and it kept ringing until it went dead. I know she is dead," Wendy Waimasi said of her sister. 

According to the UN Office for the Coordination of Humanitarian Affairs (OCHA), it is difficult to access the Hides area by road, thus necessitating air access to the affected area. 

The Australian government has reportedly offered logistics assistance to transport rescuers by helicopter to the site; however, as of the evening of 25 January, there had been no confirmation as to whether that offer has been accepted or not. A team led by the NDC, with representatives from AusAID and the Australian High Commission, is on the ground for a rapid assessment. Specific humanitarian needs will be known after it is released, on 26 or 27 January.

pk/ds/mw

]]></body><link>http://www.irinnews.org/Report/94725/PAPUA-NEW-GUINEA-Rescue-effort-for-landslide-survivors-continues</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2012/201201251323180932t.jpg"/></td><td valign="top">PORT MORESBY 25 January 2012 (IRIN) - Rescue efforts are continuing in Papua New Guinea&apos;s (PNG) gas-rich Hela Province, a day after what officials have described as one of the Pacific nation&apos;s worst landslides ever.</td></tr></table>]]></content:encoded></item><item><title>HEALTH: Yaws treatment study prompts WHO review</title><pubDate>Wed, 11 Jan 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2012/201201110749170559t.jpg" />]]>BANGKOK 11 January 2012 (IRIN) - Findings that a one-time oral treatment to cure yaws, a neglected tropical disease, is as effective as the currently recommended penicillin injection have prompted the World Health Organization (WHO) to convene a meeting on how the disease may be wiped out.</description><body><![CDATA[BANGKOK 11 January 2012 (IRIN) - Findings that a one-time oral treatment to cure yaws, a neglected tropical disease, is as effective as the currently recommended penicillin injection have prompted the World Health Organization (WHO) to convene a meeting on how the disease may be wiped out. 
 
 "We may be closer now than we have been in decades," Kingsley Asiedu, a yaws expert with WHO's Department of Neglected Tropical Disease Control, told IRIN, calling the study [ http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)61624-3/abstract ] on the bacterial skin disease, which leads to chronic disfiguration and disability in 10 percent of untreated cases, the most significant in half a century. 
 
 After a UN-led worldwide control programme cut infections from 50 million to 2.5 million in 1964 in 46 countries, the disease re-emerged in the 1970s when control efforts lagged, affecting an estimated 460,000 people - mostly children - in poor, tropical rural areas mainly in Africa and Asia, according to the most recent figures reported to WHO in 1995. 
 
 In 2010, the Lihir Medical Centre in Papua New Guinea (PNG), where the disease is still endemic, gave the one-time oral dose of the antibiotic azithromycin to about half of 250 infants and children from six months to 15 years infected with yaws. 
 
 Follow-up exams in 2011 showed the treatment was as effective as penicillin injections, which - unlike oral antibiotics - require trained health staff and equipment often scarce in areas most in need of treatment, wrote the researchers. 
 
 In a recent index of health workers' outreach [ http://www.savethechildren.org.uk/sites/default/files/docs/HealthWorkerIndexmain_4.pdf ] by the NGO Save the Children, PNG ranked in the bottom 20 of 161 surveyed countries. 
 
 The meeting of yaws experts convened by WHO in Geneva from 5-7 March will "fully define how we are going to embark [on a new yaws treatment regimen] using azithromycin", said Asiedu. 
 
 WHO's yaws treatment guidelines date back to the 1960s and there have been no alternatives since, he added. 
 
 In Southeast Asia, WHO set the goal for regional eradication by 2012 in two remaining endemic countries - Indo¬nesia and Timor-Leste. PNG, the Solomon Islands and Vanuatu have also reported cases. 
 
 Sub-Saharan Africa was the most heavily affected based on earlier estimates, but the "picture is not entirely clear now", said Asiedu. Cameroon, Central African Republic, Congo, Côte d'Ivoire, Democratic Republic of Congo, Ghana, Sierra Leone and Togo have all reported cases. 
 
 More studies are needed to ensure resistance to azithromycin treatment does not develop, said David Mabey from the London School of Hygiene and Tropical Medicine. 
 
 While penicillin "has stood the test of time" - still as effective fighting the bacteria causing yaws after roughly 60 years - he noted mass azithromycin had only been used in developing countries for about a decade to treat trachoma [ http://www.irinnews.org/report.aspx?reportid=89568 ], another bacterial disease prevalent in poor rural areas. 
 
 Discussions at the upcoming WHO meeting will include a measure to monitor antibiotic resistance, said Asiedu. "Antibiotic resistance is a risk in any treatment and we always have to be vigilant." 
 
 pt/mw

]]></body><link>http://www.irinnews.org/Report/94621/HEALTH-Yaws-treatment-study-prompts-WHO-review</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2012/201201110749170559t.jpg"/></td><td valign="top">BANGKOK 11 January 2012 (IRIN) - Findings that a one-time oral treatment to cure yaws, a neglected tropical disease, is as effective as the currently recommended penicillin injection have prompted the World Health Organization (WHO) to convene a meeting on how the disease may be wiped out.</td></tr></table>]]></content:encoded></item><item><title>PAPUA NEW GUINEA: Population growth fuels conflict</title><pubDate>Wed, 21 Dec 2011 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2011/201102021231230078t.jpg" />]]>GOROKA 21 December 2011 (IRIN) - Unchecked population growth is fast proving an additional source of conflict in Papua New Guinea (PNG), a country with a history of clan violence and clashes over land, experts say.</description><body><![CDATA[GOROKA 21 December 2011 (IRIN) - Unchecked population growth is fast proving an additional source of conflict in Papua New Guinea (PNG), a country with a history of clan violence [ http://www.irinnews.org/report.aspx?ReportId=91559 ] and clashes over land, experts say. 
 
 “Without doubt, rapid population growth is adding to the risk of conflict,” Max Kep, director of the PNG’s national Office of Urbanization, told IRIN, noting that various types of conflict are fuelled by limited resources, including a shortage of land. 
 
 As PNG’s population nears seven million, comprised of nearly 700 ethnic groups speaking some 800 languages, communities are increasingly fighting over smaller plots of land, while city dwellers in swelling urban areas are clashing with nearby owners of traditional land, Kep said. 
 
 Over the past 30 years, the country’s population has more than tripled, from 2.1 million to 6.7 million, government figures reveal. 
 
 At the same time, the average total fertility rate of 4.4 births per woman remains one of the highest in the Pacific region, says the UN. 
 
 According to a recent government task force report [ http://www.unfpa.org/sowmy/resources/docs/library/R149_DOH_PNGUINEA_2009_Ministerial_Taskforce_report_final_version_3.pdf ] on maternal health, PNG’s population will probably double in the next 25 years. 
 
 Pressure on towns 
 
 Adding to this challenge is PNG’s increasing youth population, with more than half of the country’s population now under the age of 20, according to World Bank figures. [ http://web.worldbank.org/WBSITE/EXTERNAL/COUNTRIES/EASTASIAPACIFICEXT/PAPUANEWGUINEAEXTN/0,,contentMDK:20174825~pagePK:1497618~piPK:217854~theSitePK:333767,00.html<http://web.worldbank.org/WBSITE/EXTERNAL/COUNTRIES/EASTASIAPACIFICEXT/PAPUANEWGUINEAEXTN/0%2c%2ccontentMDK%3a20174825%7EpagePK%3a1497618%7EpiPK%3a217854%7EtheSitePK%3a333767%2c00.html ] 
 
 “It’s like having wild grass lying around waiting to be struck by lightning for a brushfire,” Helen Ware, a professor at the University of New England in Australia who has studied and practised peace-building in PNG, explained, noting the risk of so many idle, underemployed men. 
 
 Migrants - drawn to towns and cities for jobs and services - are fuelling population growth in urban areas, Kep said, adding that urban areas are now growing at an average of 4.5-5 percent a year. 
 
 Some 97 percent of the country’s land is under customary tenure law, meaning it is reserved for traditional land owners and the state has no jurisdiction over it. Land owners often are unwilling to release land for urban growth, so PNG’s cities have nowhere to expand, according to the UN Human Settlements Programme (UN-HABITAT). 
 
 The Eastern Highlands city of Goroka, for example, is facing critical land shortages which have caused rapid and informal urbanization, according to a UN-HABITAT report. [ http://www.unhabitat.org/pmss/listItemDetails.aspx?publicationID=2965 ] 
 
 Kep, with the Office of Urbanization, said a government initiative to encourage landowners to lease their land to municipalities is aimed at empowering them, with increased income and access to government services. 
 
 Many of those flocking to urban areas today are the young. But with few job opportunities when they arrive, the country has also witnessed an increase in urban youth gangs, known as `raskol’ gangs, who often turn to crime, according to residents. 
 
 Violent clashes have erupted between local landowners and `raskols’, Albert Sams, a 24-year-old health worker from Ifiufa, a village 20km from Goroka, explained. 
 
 Family, community feuds 
 
 Significantly, land disputes between family members and communities are also now more common under the strain of population growth, residents and international agencies say. 
 
 “Villages which once were separated are now bordering one another, and conflicts are definitely arising through competition for resources,” said Chris Turner, from Marie Stopes International, an NGO providing family planning and reproductive services in PNG. [ http://www.mariestopes.org.au/how-we-help/where-we-work/papua-new-guinea ] 
 
 In fact, in and around Goroka, fighting between families is also turning violent. 
 
 “There are a lot of land disputes between families - some verbal abuse, and sometimes they fight with knives, sticks, stones or guns,” Sams said. 
 
 Jeffery Korowa’s story is typical of large families struggling to live off the land. Hailing from a family of five siblings, the 49-year-old says all his brothers and sisters have had several children, leading to more than 15 offspring arguing over smaller and smaller pieces of property. 
 
 “I’m already fighting with my brothers over land,” said Korowa, a nurse who owns land outside Mount Hagen, the provincial capital of West Highlands Province. “I can take my brothers to court. But I’m pretty sure if it comes to push and shove, it will become violent.” 
 
 mk/es/cb 
 
]]></body><link>http://www.irinnews.org/Report/94512/PAPUA-NEW-GUINEA-Population-growth-fuels-conflict</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2011/201102021231230078t.jpg"/></td><td valign="top">GOROKA 21 December 2011 (IRIN) - Unchecked population growth is fast proving an additional source of conflict in Papua New Guinea (PNG), a country with a history of clan violence and clashes over land, experts say.</td></tr></table>]]></content:encoded></item><item><title>PAPUA NEW GUINEA: Political impasse threatens stability</title><pubDate>Fri, 16 Dec 2011 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2011/201112160815130137t.jpg" />]]>PORT MORESBY 16 December 2011 (IRIN) - An uneasy calm hangs over Papua New Guinea (PNG), as a political impasse over the premiership continues after almost a week, experts say.</description><body><![CDATA[PORT MORESBY 16 December 2011 (IRIN) - An uneasy calm hangs over Papua New Guinea (PNG), as a political impasse over the premiership continues after almost a week, experts say. 

"At the moment, there is relative peace and order on the streets of Port Moresby," Ray Anere, a senior research fellow with the National Research Institute of Papua New Guinea (NRI) [ http://www.nri.org.pg/ ], told IRIN in the capital. "There's a strong interest across the country to have the political conflict addressed within the due process of law as soon as possible." 
 
 But the potential for real conflict remains, analysts warn, in a country now saddled with two prime ministers, two police chiefs and two governor-generals. 
 
 "I'm very concerned that it could escalate, particularly because of the divisions between the police and the pressure to involve the army," Anthony Regan, a constitutional lawyer and fellow at Australia National University's College of Asia and the Pacific [ http://asiapacific.anu.edu.au/ ], explained. 
 
 Their comments come five days after the country's highest court ruled by three to two that Peter O'Neill had not been legitimately installed as prime minister in August. 
 
 Parliament voted him in after removing Sir Michael Somare, who had been receiving extended medical treatment in Singapore, and served as prime minister three times since the country gained independence from Australia in 1975. 
 
 Parliament rejected the Supreme Court's move, suspending the governor-general, who signed in the 75-year-old Somare, and reinstating O'Neill. 
 
 Confusion 
 
 "This can spill over into a crisis which neither Sir Michael nor O'Neill may later reverse but which both will regret," a local newspaper, The National, wrote in a 15 December editorial. "People are getting more confused, uncertain, frustrated and angrier by the day." 
 
 Elizabeth Waugla, who lives in Port Moresby with her seven children, is worried. 
 
 "At present, we are going around doing our normal business but there is a feeling of uncertainty, anxiety in the air... you can feel it," said Waugla, who is self-employed. 
 
 "People are finding life hard, and they are blaming Somare and his government for their problems. They were happy that the government has changed, but if Somare gets back, there will be violence," she said. 
 
 At present, armed police are guarding state institutions and blockades have been set up around Port Moresby. Police authorities have barred any protests that may lead to civil unrest, said NRI's Anere, adding that the public, police and armed forces have thus far shown "great restraint". 
 
 And while the commander of the PNG defence force has said his forces will remain neutral, divisions among the police are troubling, Regan said, and tensions could flare if the army is pressured to take sides. 
 
 Should that happen, essential services could be shut down due to insecurity. 
 
 "This is the kind of thing that could spark off civil unrest in unpredictable ways," said Regan, who lived in PNG for 17 years and has worked there on and off for 30. 
 
 As the power struggle drags on, leaders on both sides will be tempted to mobilize popular support, he said. 
 
 On 15 December, about 500 protesters rallied outside parliament in support of O'Neill, according to local news reports. The same day, more than 150,000 union workers gave the rival leaders 48 hours to negotiate, or essential public services - including water, electricity and health - could be shut down. 
 
 Local NGOs also led a march in Goroka, the administrative seat of the Eastern Highlands Province. 
 
 History of violence 
 
 UN Secretary-General Ban Ki-moon [ http://www.un.org/apps/sg/sgstats.asp?nid=5761 ] has called on all sides "to exercise maximum restraint and to avoid an escalation of the situation". 
 
 The mineral-rich [ http://www.irinnews.org/report.aspx?reportId=91810 ] half-island nation, home to some 800 ethnic groups, about 6.8 million people, is no stranger to clashes [ http://www.irinnews.org/report.aspx?reportId=91559 ], crime and other violence [ http://www.irinnews.org/report.aspx?reportId=92374 ]. 
 
 Political disputes around constitutional issues typically have been settled with limited social unrest, Regan said. But electoral violence erupted in the 2002 elections, described as the worst ever in PNG's electoral history, Anere said. More than 100 people were killed. 
 
 "At the moment, the conflict is between members of Parliament who are on opposing sides," Anere said. "The general public is watching from the sidelines but also urging both sides to resolve this as soon as possible." 
 
 PNG's next general election is expected in mid-2012. 
 
 es/ds/mw

]]></body><link>http://www.irinnews.org/Report/94486/PAPUA-NEW-GUINEA-Political-impasse-threatens-stability</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2011/201112160815130137t.jpg"/></td><td valign="top">PORT MORESBY 16 December 2011 (IRIN) - An uneasy calm hangs over Papua New Guinea (PNG), as a political impasse over the premiership continues after almost a week, experts say.</td></tr></table>]]></content:encoded></item><item><title>PAPUA NEW GUINEA: Tackling maternal health &quot;crisis&quot;</title><pubDate>Wed, 30 Nov 2011 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2011/201112010053060610t.jpg" />]]>GOROKA 30 November 2011 (IRIN) - Decades of neglect, a failing health system and remote mountainous topography have created a &quot;crisis in maternal health&quot;, according to a government taskforce in Papua New Guinea.</description><body><![CDATA[GOROKA 30 November 2011 (IRIN) - Decades of neglect, a failing health system and remote mountainous topography have created a "crisis in maternal health", according to a government taskforce in Papua New Guinea. 
 
 While progress has been made since the taskforce released its recommendations in 2009 [ http://www.soroptimistinternational.org/assets/media/Ministerial_Taskforce_report_final_version_5_A4.pdf ], some 250 women are still dying for every 100,000 live births, according to a 2008 inter-agency estimate [ http://apps.who.int/ghodata/ ]. 
 
 Maternal mortality rates in PNG doubled from 1996-2006, states the government's most recent national health survey [ http://www.nso.gov.pg/census-a-surveys/demography-a-health-survey-2006 ], which prompted the government-appointed taskforce to find ways to make pregnancy less deadly. 
 
 Inaccessible and ill-equipped health centres, early pregnancies, poor care and ineffective communication are among the reasons health and aid workers cite for the still-high level of maternal deaths. 
 
 Access 
 
 In PNG, the nearest health clinic might be hours by boat, foot, or in the luckiest of circumstances, local transport, from the village, says Miriam Lovai, former head of the national midwife association. 
 
 "On the Sepik River [the country's longest river] and other rivers they [women] are floated down on rafters consisting of tied banana trees or other logs," said Lovai. 
 
 At least four out of 10 people in parts of PNG cannot access healthcare due to distance or lack of roads, according to the taskforce. 
 
 Even when a woman can access trained medical care, there is still little understanding of when to seek care during childbirth, said Grace Kariwiga from the UN Children's Fund (UNICEF) office in the capital, Port Moresby. "The woman, the family or the husband, often delay seeking care, because they don't recognize the danger signals." 
 
 "Most give birth at home, because there is a lack of money, and [transport] infrastructure, so it is difficult for them to come in," said George Manapel from the national Department of Health in Goroka, the capital of East Highlands Province, one of 21 provinces. 
 
 Nationwide, 53 percent of women gave birth with a skilled birth attendant in 2006, but access to healthcare in some provinces is worse than others, noted the government taskforce. 
 
 To make it easier for pregnant women to seek care, it recommended transport subsidies. 
 
 It also suggested expanding local solutions such as a "red card" system in the remote Trobiand Islands of Milne Bay Province where women in labour can display a red card on the side of the road, which obliges any car to take her to the nearest health centre. 
 
 Child mortality 
 
 In a recent index of health workers' impact by the NGO Save the Children [ http://www.savethechildren.org.uk/sites/default/files/docs/HealthWorkerIndexmain_4.pdf ], PNG ranked in the bottom 20 of 161 surveyed countries. 
 
 Children in those countries, which all fall below the World Health Organization (WHO) minimum threshold of just over two health workers per 1,000 people, are five times more likely to die, noted the index. 
 
 PNG had one health worker (including doctors, midwives, nurses and community health workers) for every 1,000 residents in 2008, according to WHO. 
 
 Even when health workers are available to serve a population growing at 2.7 percent annually, according to the most recent census in 2000, local health centres lack resources, said Lovai. 
 
 In one case Lovai tried to travel by boat to a woman five hours away who was bleeding excessively following a home birth. But the clinic did not have enough fuel, and by the time Lovai purchased some, the woman had died. 
 
 Health system 
 
 Decentralization of the health system in the 1980s, which put regional governments in charge of health budgets, has worsened access for women seeking maternal healthcare, noted the taskforce. 
 
 "The vast majority of women live in rural areas, but the rural health service is not there and is not functioning for various reasons," said Caroline Ninnes from local NGO Susu Mamas, which means Breastfeeding Mums in Pidgin, one of PNG's official languages. 
 
 "There is no support and no equipment... and supporting rural health services when access is by boat, foot, road, or even inaccessible is difficult." 
 
 Almost nine out of 10 people nationwide lived in rural areas at the time of the 2000 census [ http://www.nso.gov.pg/census-a-surveys/demography-a-health-survey-2006/population-household-characteristics ], but the number of health staff in rural facilities declined by 25 percent between 1987 and 2000. 
 
 Communication 
 
 Ninnes said illiteracy made it difficult to educate women about the importance of giving birth with the assistance of a trained health worker - or waiting longer to have children. 
 
 With 800 different languages [ http://www.who.int/countryfocus/cooperation_strategy/ccsbrief_png_en.pdf ] across PNG, outreach is not easy. "Languages even vary a lot between villages," said Ninnes. 
 
 Susu Mamas is calling on provincial health departments to recruit nurses from underserved communities who speak local languages in addition to the official national languages of Pidgin, Motu and English. 
 
 Almost 7 percent of women had given birth before the age of 20 in 2006, which can elevate the risk of pregnancy-related complications, according to the UN Population Fund (UNFPA). 

After 27-year-old Lisa Micheals had given birth to her fifth child, she needed little persuasion to end her child-bearing days, which began at 16. 

"I saw so many women die in the village, giving birth. So I got them [fallopian tubes] tied," she said. 

Initiatives 

The Health Ministry and regional health offices are trying to implement the taskforce's recommendations with support from Susu Mamas, as well as UNFPA, WHO and UNICEF, said Ninnes. 
 
 For example, the Health Ministry is trying to educate Papuans that husbands and communities should ensure safe pregnancies and deliveries. 
 
 Traditionally, pregnancy and birth have been considered a woman's domain in most of Papua's tribal societies where men and women live in separate houses. This has led to many men not understanding the dangers women face giving birth, said Lahui Geita, a government maternal health adviser. 
 
 "Pregnancy is everyone's business. It is not an issue that the mother should have to deal with alone," he said. 
 
 mk/pt/mw

]]></body><link>http://www.irinnews.org/Report/94352/PAPUA-NEW-GUINEA-Tackling-maternal-health-quot-crisis-quot</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2011/201112010053060610t.jpg"/></td><td valign="top">GOROKA 30 November 2011 (IRIN) - Decades of neglect, a failing health system and remote mountainous topography have created a &quot;crisis in maternal health&quot;, according to a government taskforce in Papua New Guinea.</td></tr></table>]]></content:encoded></item><item><title>ASIA: Boosting cities&apos; food resilience</title><pubDate>Fri, 18 Nov 2011 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2011/201106081056010171t.jpg" />]]>BANGKOK 18 November 2011 (IRIN) - From rooftops to railroad tracks, Asia&apos;s largest cities will need to maximize every bit of space to feed one of the world&apos;s fastest-growing populations, said experts at a UN Food and Agriculture Organization (FAO) workshop in Bangkok on resilient food systems in Asia.</description><body><![CDATA[BANGKOK 18 November 2011 (IRIN) - From rooftops to railroad tracks, Asia's largest cities will need to maximize every bit of space to feed one of the world's fastest-growing populations, said experts at a UN Food and Agriculture Organization (FAO) workshop in Bangkok on resilient food systems in Asia. 
 
 "Food-sensitive urban planning is now a necessity," said Mariko Sato, chief of the Asia regional office of the UN Human Settlements Programme (UN-HABITAT). 
 
 Although fewer people live in cities than in Asia's rural areas - approximately 43 percent - the UN projects an 89 percent increase in the region's urban population (1.6 billion people) by 2050. 
 
 Asia had 12 megacities of more than 10 million people each, half the world's population and the second-fastest rate of urbanization worldwide as of 2010, according to the UN Economic and Social Commission for Asia and the Pacific (ESCAP). 
 
 Feeding this expanding urban population will be a "challenge" due to the widespread lack of land tenure and access to cash and markets - and the resulting lack of incentive to farm - as well as insufficient rural-to-urban food transport and storage, said Brian Roberts, an Australia-based urban management specialist from the Centre for Developing Cities at the University of Canberra. 
 
 In addition, farmers may not have market information about what urbanites prefer and produce blindly without diversifying, he added. "Growing food to meet the needs of the population will be a struggle." 
 
 Growing recognition 
 
 The FAO launched its food for the cities initiative in 2000, but it was not until 11 years later that the group published its position paper. 
 
 "Since [the] 2008 [food price riots], people have started to realize urban food security is a very big deal. Not enough attention had been paid beforehand," said Paul Munro-Faure, FAO's principal officer in the climate, energy and tenure division, who chairs the initiative. 
 
 Tools to assess poverty have traditionally focused on the countryside, said Carla Lacerda, a programme officer with the World Food Programme (WFP) regional office for Asia, who added that FAO and WFP were working to create urban assessment and intervention tools. 
 
 Less than 10 percent of WFP Asia emergency programming, including cash vouchers, is focused on cities, she said. 
 
 "It is hard to target hunger in cities because urban issues are intricate. It is easier for humanitarian agencies to get into, but harder to come out because [the issues] are mostly about development and government responsibilities." 
 
 Additional challenges include the risk of luring rural dwellers away from depressed economies and degrading farms with urban food programmes; overlapping with agencies pursuing development goals; the increased difficulty of supporting livelihoods in cities rather than rural areas; and the challenge to measure impact due to scattered living arrangements, said Lacerda. 
 
 More than half the world's population - 642 million people - go hungry (fewer than 2,100 kilocalories per day) in the region. 
 
 Official rates of urban poverty trail that of the countryside in the region's three most populous countries (China, India and Indonesia), according to ESCAP, but the situation is changing, said FAO's Munro-Faure. 
 
 "Food security is not only a rural producers' problem... The rural-urban divide is really a continuum and we must take on board urban populations." 
 
 The two-day FAO workshop concludes on 18 November. 
 
 pt/mw

]]></body><link>http://www.irinnews.org/Report/94233/ASIA-Boosting-cities-apos-food-resilience</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2011/201106081056010171t.jpg"/></td><td valign="top">BANGKOK 18 November 2011 (IRIN) - From rooftops to railroad tracks, Asia&apos;s largest cities will need to maximize every bit of space to feed one of the world&apos;s fastest-growing populations, said experts at a UN Food and Agriculture Organization (FAO) workshop in Bangkok on resilient food systems in Asia.</td></tr></table>]]></content:encoded></item></channel></rss>